Unformatted Attachment Preview
You have been designated the chair of an outbreak investigation and
prevention committee by the CEO of South Suburban Hospital. Your
committee’s charge is to investigate a concern presented by the State
Health Department, which maintains registries for most infectious diseases.
Review of these registries revealed that over the past five years, sixteen
cases of acute HBV infection had a commonality: all sixteen patients had
visited the same hospital-based medical practice, housed in South
Suburban Hospital, before the onset of the infection. The State Health
Department conducted an investigation, consisting of the collection of blood
samples from health care personnel coupled with a series of
comprehensive interviews. Results of the investigation indicated the
following: none of the health care personnel had a history of acute hepatitis
or HBV immunization, and two physician dermatologists had negative HBV
surface antigen tests but positive HBV surface antibody tests, which
indicated that the physicians were exposed to HBV. Further investigation
revealed that these two physicians had seen 15,000 patients over the fiveyear study period (that is, 15,000 patient visits).
The majority of these patients were White, female, and over the age of 50.
The State Health Department has issued the following questions to be
investigated by your outbreak investigation and prevention committee:
(1) What is the source of the hepatitis B virus outbreak?
(2) How did the outbreak begin?
(3) Who is the index case,
(4) Has the outbreak ended? And
(5) What is the hospital’s plan to ensure that future outbreaks will not
The State Health Department has notified local news media about its
concern and investigation. A local newspaper suggests that medical
practices at South Suburban Hospital will be closed within thirty days due
to substandard treatment practices. The story erroneously details that the
CDC has dispatched an epidemic investigation team, and may possibly
close the entire hospital due to patients acquiring infections while
hospitalized. Before investigating the outbreak and searching for answers
to the questions posed by the State Health Department,
what preliminary question must be answered by your committee?
What methods would you use to answer this preliminary question?
What is an appropriate personnel configuration for the outbreak
investigation and prevention committee? Why?
Which patient records should your committee review? What medical care
protocols, if any, should be reviewed?
What question must be first answered by the committee?
a. What methods would you use to answer these questions?
What personnel should be on your committee?
What patient records should your committee review?
What medical care protocols (if any) should be reviewed?
What additional testing (if any) should be done?