Outbreak investigations
In order to fully address a disease that has affected a county, it is important to be able to determine whether a disease is an outbreak or a cluster. A disease outbreak pertains to the incidence of a particular disease with a higher than normal frequency in the area of interest. It is important, though that there is some form of baseline medical information about the geographical area, so that comparisons could be made in order to determine whether a disease is indeed an outbreak. Disease outbreaks may develop in a specific locality, or may spread through a number of countries that are involved with frequent travel and business exchange.
In addition, a disease outbreak may present itself with different lengths of duration, such as days, months or even years. One of the most straightforward methods of determining a disease outbreak is the characteristic of reporting one infectious case that has not been observed in that geographic area. The infectious disease may be caused by the inoculation of a bacteria or a virus, resulting in the corresponding medical symptoms that would indicate a particular infection. This approach also includes the identification of a previously undocumented disease.
It is thus important that medical professional immediately attend to such cases and report to the incident to the proper public health authorities. In the situation that the number of cases increases within a short period of time in the same locality, then a comprehensive investigation should be performed in order to establish its occurrence as an outbreak. A disease cluster, on the other hand, pertains to the incidence of disease in a particular population (Neutra, 1990). Examples of such populations include the school, church or neighborhood.
In this type of population, a disease is observed to affect only members of this structural unit and the outcome of the disease may be predicted. In addition, the actual causative factor associated with the disease is easily identified and is generally independent, wherein its occurrence is simply random. A cluster is thus regarded as an unusual incidence of a disease that affects only a certain population. However, it is still important that its occurrence be reported to the proper health officials for documentation and further evaluation.
An example of a cluster is that of the health effects of workers at a factory who have been exposed to vinyl chloride (Waxweiler et al. , 1976). A significant number of these workers developed angiosarcoma and the direct influence of vinyl chloride was easily established after the appropriate testing and diagnosis. Another example of a cluster is the cases involving Pneumocystis carinii-caused pneumonia in seven homosexual males in the county of Los Anges (CDC, 1981).
The occurrence of disease clusters allows health professionals and biomedical researchers to further investigate the causative effect and epidemiology of this particular disease. These efforts often result in establishing the actual pathology of the disease in that specific population. More importantly, the investigations may also generate information on how to prevent future occurrences and further spreading of the disease to other individuals. It is thus important to understand the differences between an outbreak and a cluster.
The occurrence of a disease in a specific population may be different, depending on the actual causative factor and the type of population that is affected. Health officials should be vigilant in determining if any new diseases are reported by each county or hospital, as this will determine whether additional examinations of the disease incidence should be conducted. Once a disease is determined to be an outbreak or a cluster, the proper health practices and preventive and promotion programs should be performed in order to control the further spread of the disease to the rest of the population.
References Centers for Disease Control. (1981). Pneumocystic pneumonia-Los Angeles. MMWR, 30, 250-252. Neutra, R. R. (1990). Counterpoint from a cluster buster. American Journal of Epidemiology, 132, 1-8. Waxweiler, R. J. , Stringer, W. , Wagoner, J. K. , Jones, J. , Falk, H. and Carter, C. (1976). Neoplastic risk among workers exposed to vinyl chloride. Annals of the New York Academy of Sciences, 271, 40-48.
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