2. Brief Introduction to Outbreak Investigations

3. Outbreaks Outbreaks are considered a “public health emergency” Outbreak investigations are conducted in order to identify and control a health problem

4. 1.Verify the diagnosis and confirm the outbreak 2.Define a case and conduct case finding 3.Tabulate and orient data: time, place, person 4.Take immediate control measures 5.Formulate and test hypothesis 6.Plan and execute additional studies 7.Implement and evaluate control measures 8.Communicate findings Basic Steps to an Outbreak Investigation

5. Legal authority for mandatory disease reporting is derived from state law States may have different organizational structures and approaches depending on state laws All 50 states require that certain diseases be reported to state or local health department –List of reportable diseases varies by state –Each local public health department also has specific guidelines and legal regulations Legal Authority

6. Massachusetts General Laws (MGL) – Chapter 111: Public Health – Chapter 111D: Clinical Laboratories Code of Massachusetts Regulations (CMR) – 105 CMR 300.100: Diseases reportable to LBOH – 105 CMR 300.120: Confidentiality – 105 CMR 300.134: Illness Believed to be Part of a Suspected or Confirmed Cluster or Outbreak – 105 CMR 300.190 Surveillance and Control of Diseases Dangerous to the Public Health – 105 CMR 300.191: Access to Medical Records and Other Information State Legal Authority

7. What is Epidemiology? Epidemiology is the study of distribution and determinants of disease frequency in a population. Who is getting the disease in a population? (person) When is the disease occurring? (time) Where is the disease occurring? (place)

8. Modules Included Module I: Managing Case Information: Creating a Line Listing Module II: Graphic Depiction of an Outbreak: Creating an Epidemic Curve Module III: Interviewing Techniques

9. References 1.http://www.nwcphp.org/training/courses- exercises/courses/what-is-epihttp://www.nwcphp.org/training/courses- exercises/courses/what-is-epi 2.Last, JM. A Dictionary of Epidemiology. Oxford Univ Press, 2001. 3.“I is for Investigation, Session I: Recognizing an Outbreak.” UNC Chapel Hill School of Public Health North Carolina Center for Public Health Preparedness.