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Initial investigation by ED physicians and the New York Department of Health yielded the following additional information:

Introduction to Epidemiology

Individual Project: Outbreak Investigation in Poughkeepsie, NY

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Initial investigation by ED physicians and the New York Department of Health yielded the following additional information:
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Due Date: April 22, 2021 by 5:00pm

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Section A: An Outbreak of Illness (25% of final grade, 50 points max)

The New York Department of Health is notified by a physician attending at the Golden Age Retirement home in Poughkeepsie, NY that on the morning of November 14, 2019, nineteen nursing home residents reported an unusual occurrence of illness. Common symptoms, in decreasing order of frequency, included headache, diarrhea, eye and throat irritation, blurred vision, rapid or irregular heartbeat, and confusion. On physical examination most of the residents demonstrated normal blood pressure, hyperactive bowel sounds, and mild redness of the conjunctivae. The median duration of symptoms was 18 hours with an incubation period of 1 to 36 hours. The only symptom that lasted longer than 12 hours was headache. No other physical signs or symptoms were identified.

Questions

1. Is this a common source outbreak (with disease transmission from a single source)? What information has been presented to support or refute this? (3pts)

2. What are some of the possible causes of the illness (in terms of agent and transmission)? (3pts)

3. What other information do you need to determine the extent of the problem? (2pts)

Initial investigation by ED physicians and the New York Department of Health yielded the following additional information:

• The nursing home had a total of 76 residents and 30 employees. In addition to the 19 residents who were evaluated in the ED, 6 staff members were absent and 8 additional residents reported ill on November 14. A survey of nursing home residents and employees was conducted by the county epidemiologist and revealed the majority of these groups had symptoms compatible with upper respiratory infections, including fever, cough, malaise and runny nose. Six of the 8 ill residents and three of the six ill staff members reported symptoms similar to those who presented to the ED. None of the other residents or staff reported similar symptoms.

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