Norovirus outbreak investigation at a Vermont swim club

Epidemiological Case #2: Norovirus in Vermont

Applying Epidemiology study epidemics. More specifically, study occurrence distribution health problems. Using epidemiological techniques outlined chapters week's reading, address questions case studies outlined .

Epidemiological Case #2: Norovirus in Vermont

The questions to ask the mother include what the problem is i.e. illness description, tests performed, treatments provided, and if patient hospitalized or dead. Who is ill including names, sex, gender, occupation, and how they are related. When the person became ill, date and time the illness began. Where the infected person is located, their address and telephone numbers. Finally, what caused them to become ill?

The symptoms of the three children are mostly due to an infection. The incubation period of around 24 hours and short illness duration are consistent with a virus. Based on the information that the stool was negative for the usual bacteria, then a virus would be the likely cause of the illness (Tomov et al., 2013). On the list of possible etiologic agents, norovirus should be foremost.

Question 3

The initial step would be to contact the local health department. The local health department is better placed to report and identify similar cases. The local public health officials should be contacted to alert them of the problem. This would facilitate coordination of all public communications regarding the problem. Other party attendees should be contacted to establish if they fell ill. Stoll specimen of all infected persons for laboratory testing. The swim club manager should be contacted to establish if there are others with similar problems.

Question 4

Though the health department has the right to inspect the pool without the manager's compliance, it would not result in a quick response. Therefore, seeking the manager's full cooperation is vital. The investigators should let the manager know whom they are, why they are calling and assure him that they are only trying to establish the cause of the problem. The benefits the club would gain from the investigation should also be communicated to the manager. Any questions the manager might have should be answered with an open mind.

Question 5

The signs and symptoms presented by the patients are consistent with norovirus infection (Krickeberg, Pham, & Pham, 2012). There were nine male patients representing 43%. Seven years was the median age. The average age of the people who visited the swim club is unknown, but it is clear that children and babies were predominant. This would mean the likely source of the exposure was the club. The exposure period is between January 31 and February 1. The first case was reported on January 31 in an infant who visited the pool the same day. The number of reported cases increased, and they peaked on February 2.

Question 6

The following assessments of the swim club should be done environmental health, surrounding facilities, and operating policies and procedures. An epidemiologic study should be carried out to test the hypothesis of the outbreak source. The risks factors of the outbreak should also be identified. There should be effort to identify any vomiting and fecal incidents at the pool.

Part II

Offices to respond

The offices that need to respond are the State Health Department of Vermont, which is responsible for all outbreak investigations. The local health department should also respond since they will have direct access to the patients. There should be communication cooperation between all the departments involved to ensure that everyone is aware of what is happening. Streamlining communication will ensure that both departments approve all public communications.

Public health response

The case does need an immediate public health response because the parents of the children should understand what was ailing their children. The birthday party was blamed for serving ice cream with raw eggs, but it was later established that was not correct. The response will offer information of the virus and how it could have been transmitted. This information will also be used to prevent similar cases from occurring.

Considerations for working with businesses

Businesses identified as possible sources of an outbreak should be approached politely. This will allow the management to understand the reasons for the outbreak and be given guidance on how they can avoid such incidents. Encouraging the management to offer their full cooperation and demonstrating to them the benefits of their actions is vital. The business manager should be made aware of the outbreak and informed that the agency wants to eliminate or confirm suspicions. This would prompt the management to offer their support. The managers should be informed at all times on the investigation progress.

Activities that increase a person's risk for exposure to pathogens

Getting into the swimming pool.

Swallowing water or getting water in the mouth.

Diving into the water.

Time spent in the pool

Putting one's head under the water.