John Snow proved that contaminated drinking water causes cholera. Firstly, the epidemiological study showed that only the persons who used the drinking water from the contaminated well got infected with Cholera. This was seen even among persons residing in the areas away from the contaminated well who ended up drinking its water. Secondly, persons within the geographical area covered by the contaminated well who did not drink its water did not get infected (HarvardX, 2017). Strategies utilized in the outbreak investigation.This went on to show that only persons who drank the contaminated well water got infected, thereby establishing a cause-effect relationship. Besides that, the causal effect was shown not to be due to confounding elements, bias (systematic error) or chance (random error). The confounding elements were controlled by collected data from areas covered by other water wells. Bias was controlled by collecting all the data as presented. Chance was controlled by checking for infection outside the covered area and linking the infection to the contaminated well water. As such, John Snow proved that contaminated drinking water causes cholera (Sergeant & Perkins, 2015).Strategies utilized in the outbreak investigation.
Management and operational issues
A good field investigator must be a good manager and collaborator as well as a good epidemiologist, because most investigations are conducted by a team rather than just one individual. The team members must be selected before departure and know their expected roles and responsibilities in the field. Does the team need a laboratorian, veterinarian, translator/interpreter, computer specialist, entomologist, or other specialist? What is the role of each? Who is in charge? If you have been invited to participate but do not work for the local health agency, are you expected to lead the investigation, provide consultation to the local staff who will conduct the investigation, or simply lend a hand to the local staff? And who are your local contacts?Strategies utilized in the outbreak investigation.
Depending on the type of outbreak, the number of involved agencies may be quite large. The investigation of an outbreak from an animal source may include state and federal departments of agriculture and/or the Food and Drug Administration (FDA). If criminal or bioterrorist intent is suspected, law enforcement agencies and the Federal Bureau of Investigation (FBI) may be in charge, or at least involved. In a natural disaster (hurricane or flood), the Federal Emergency Management Agency (FEMA) may be the lead. Staff from different agencies have different perspectives, approaches, and priorities that must be reconciled. For example, whereas the public health investigation may focus on identifying a pathogen, source, and mode of transmission, a criminal investigation is likely to focus on finding the perpetrator. Sorting out roles and responsibilities in such multi-agency investigations is critical to accomplishing the disparate objectives of the different agencies.Strategies utilized in the outbreak investigation.
A communications plan must be established. The need for communicating with the public health and clinical community has long been acknowledged, but the need for communicating quickly and effectively with elected officials and the public became obvious during the epidemics of West Nile Virus encephalitis, SARS, and anthrax.Strategies utilized in the outbreak investigation. The plan should include how often and when to have conference calls with involved agencies, who will be the designated spokesperson, who will prepare health alerts and press releases, and the like. When a federal agency is involved in the survey of 10 or more individuals, the data collection instrument must first be cleared by the White House Office of Management and Budget (OMB).Strategies utilized in the outbreak investigation.
In addition, operational and logistical details are important.
Arrange to bring a laptop computer, cell phone or phone card, camera, and other supplies. If you are arriving from outside the area, you should arrange in advance when and where you are to meet with local officials and contacts when you arrive in the field. You must arrange travel, lodging, and local transportation. Strategies utilized in the outbreak investigation.Many agencies and organizations have strict approval processes and budgetary limits that you must follow. If you are traveling to another country, you will need a passport and often a visa. You should also take care of personal matters before you leave, especially if the investigation is likely to be lengthy