Epidemelolgy and Risk Management
The information given tells us that hospital-east and hospital-west celebrated their 50th year anniversary of incorporation. A special dinner was served to 1000 staff members. Proceeding the dinner, 35 people died and 115 called in sick complaining of diarrhea. Information given tells us that water was served with dinner and that no other drink was consumed. The townships share one landfall. Hospital-east receives their water supply from Metropolis while Hospital-west receives their water supply from the Concentrates filtrated water system.
The town’s mall aquifer which supplies water to the town by way of water wells is located beneath the town’s landfill. It is known that the landfill is contaminated with polycarbonate phenyl (Pubs) and lead that exceeds the allowed amount approved by the Environmental Protection Agency (EPA). This landfill is toxic and is possibly the cause of many illnesses and deaths among the attendees. Investigators can search for similar occurrences to determine what steps to take in order to gain control over the outbreak. On August 31, 1854, Dry. Snow investigated a series of deaths which occurred by ingestion.
He determined that the distribution of contaminated water was the cause. One hundred twenty-seven deaths occurred during the time of investigation and less
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Today epidemiologist mimic after Dry. Snows method of research and investigation to determine source and ways to treat and prevent the spread of diseases. Another historical event that took place occurred in Wobble, Massachusetts from the period of 1969 thru 1979. This epidemic affected children in the worst way. A case study was conducted on children that suffered from childhood leukemia. During this period, many cases arose which alarmed investigators. The Massachusetts Department of Public Health (MATH) began an investigation concerning reports of childhood leukemia, liver cancer, renal caner, and bladder cancer.
Emphasis was placed on water sources in that area. Investigators found that water from the water well G and H could have been the source of the outbreak. “Residents of Wobble and neighboring towns have complained about their water and unpleasant atmospheric odors for at least 100 years” (Parker, Rosen 1981). Recent complaints were heard from residents who only source of water came from water wells in that region. The arguments were based on the conclusion that chemical factories in that region contaminated the town’s water well for more than ten years. Parents believed “industrial solvents” in Wobble killed their children.
The case was tried in a court of law by 69 families and at the end of the proceedings; the court did not render a verdict which caused the families to settle out of court. Several studies went underway leading to inconclusive results. According to the author of this publication, “a case study of childhood leukemia in Wobble, Massachusetts: the relationship between leukemia incidence and exposure to public water, finally established that the relative risk of developing childhood leukemia was greater for those children whose mothers were likely to have consumed water from wells G and
H (which had been contaminated by industrial solvents) during pregnancy than for those who did not. ” (Ropier, 2013). The cholera epidemic of 1854 and the cancer cluster epidemic of 1969 both show a population of people who were affected by water contamination. The main water source for both towns relied heavily upon water from the pump in London and water wells G and H in Wobble. Taylor Township and Simon Township were both exposed to the water from the well in their town.
An epidemiologist would more than likely study both cases to gather information of similarities and to also look for clues that could aide in preventive assures. He/she would study the geographic location, possible factories that may be responsible for releasing toxins into the water, landfills, and other possible causes. Researching both incidents could help the investigator look at other factors associated with the outbreak if any. The epidemiologist would review maps of surrounding areas to locate the source and to find out where it began and where it ended.
The epidemiologist would review air and water quality and if air pollution has any bearing on the epidemic in question. He/she might also review these cases to find out if the outbreak was an isolated event. The investigator might look at the population size in general to narrow down the possibility of the outbreak continuing after taking necessary precautions to prevent future occurrences. Diarrhea can occur due to many things and is not limited to food and water intake. Bacteria causes diarrhea and is a part of our life whether we like it or not.
Diarrhea can stem from diarrhea as well. Among the attendees, for some, medication could have been the culprit behind the diarrhea outbreaks. Stress is not a possibility and can be ruled out. It is also possible for some individuals suffering from a viral infection to show animal symptoms and maybe the food and water triggered the body to expel the food in liquid form. Looking at what occurred, when it occurred, and why it occurred, can help in determining how it occurred. During my research on the topic, conducting an outbreak investigation is very important.
An outbreak investigation can identify risk factors that are associated with the infection. The outbreak investigation can not only identify risk but prevent risks associated with the infection. An outbreak investigation also includes a preliminary phase, an analytic phase, and a control and follow-up phase. All of which is important in controlling the outbreak as well as preventing recurrences. An epidemiologist first step would be to control the outbreak to prevent further exposure and interrupt transmission of the disease.
There are 10 steps used in an outbreak investigation and they are according to EXCITE: 1 . Prepare for field work 2. Establish the existence of an outbreak 3. Verify the diagnosis 4. Define and identify cases 5. Describe and orient the data in terms of time, place, and person 6. Develop hypotheses 7. Evaluate hypotheses 8. Refine hypotheses and carry out additional studies 9. Implement control and prevention measures 10. Communicate findings Although control is at the bottom of the list, investigators are encouraged to implement control and prevention measures early on.
In Taylor Township Hospital- East celebrated their 50th anniversary of being incorporated. The guest list included 500 employees. In Simon Township Hospital-West celebrated their 50th anniversary of being incorporated. The guest list also included 500 staff members. Both hospitals served a meal along with water for their chosen drink. Taylor Township and Simon Township sits on the east and west side of town. Taylor Township main water source is from the water well that lies underneath a land fill. A small percentage of Simon Township residents use the same well water.