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Case study

Outbreak investigation of an unknown gastrointestinal illness in District Victoria, Country Mala, 2016

Outbreak investigation of an unknown gastrointestinal illness in District Victoria, Country Mala, 2016

Muhammad Asif Syed1, Nigus Abebe Shumuye2,3, Maria Anyorikeya4, Nurbolot Usenbaev5, Eva Mertens6,7,&, Hedia Bellali8,9, Elizeus Rutebemberwa10,11,12


1Field Epidemiology and Laboratory Training Program (FELTP), Islamabad, Pakistan, 2Mekelle University, College of Veterinary Sciences, P.O. Box: 2084, Tigray, Ethiopia, 3Graduate School of Chinese Academic of Agricultural Sciences, Lanzhou Veterinary Research Institute, Gansu Province, China, 4Navrongo Health Research Centre, Navrongo, Ghana, 5Republican Center of Quarantine and Extremely dangerous diseases of Ministry of Health, Bishkek, Kyrgyzstan, 6Bernhard Nocht Institute for Tropical Medicine, Department of Infectious Disease Epidemiology, Bernhard-Nocht-Strasse 74, 20359 Hamburg, Germany, 7Global Partnership Initiated Biosecurity Academia for Controlling Health Threats (GIBACHT), Hamburg, Germany, 8Habib Thameur Hospital, Department of Clinical Epidemiology, Tunis, Tunisia, 9Medical Faculty of Tunis, Tunis El Manar University, Tunis, Tunisia, 10Programs, African Field Epidemiology Training Network, Kampala, Uganda, 11Makerere University College of Health Sciences, Kampala, Uganda, 12Global Partnership Initiated Biosecurity Academia for Controlling Health Threats (GIBACHT), Kampala, Uganda



&Corresponding author
Eva Mertens, Bernhard Nocht Institute for Tropical Medicine, Department of Infectious Disease Epidemiology, Bernhard-Nocht-Strasse 74, 20359 Hamburg, Germany




This case study is based on an outbreak investigation conducted by multisectoral team from animal and public health offices in Kaktong (a remote village in Zhemgang District Bhutan) during July-September 2010. This outbreak caused by ingestion of infected cow meat which had died after a brief illness (bleeding of unclotted blood from nostrils). The owner of the affected cow had opened the carcass and dressed the meat, which he shared or sold within the village for human consumption. It simulates an epidemiological investigation including active and passive case finding, descriptive and analytical epidemiology, laboratory confirmation, risk communication with implementation of control measures. This case study is designed for the training of front-line public health professional, basic, intermediate and advanced level field epidemiology trainees. The case study will build the capacity of the trainees regarding investigating illnesses caused by animal-human interface.



How to use this case study    Down

General instructions: this case study is an added resource for students of epidemiology and public health with specialised knowledge who need further information on the outbreak investigation with management and risk communication. The case study is ideally conducted in groups of about 10-20 participants under supervision of facilitator. Each student will participate in the case study by reading the paragraph on his/her turns. The facilitator will be responsible for engaging students in discussion, clarifying any confusing concepts or data analysis, and encouraging participants to think about the answers of the given questions. Notes for facilitator are coupled with each question in the facilitator version of case study with objective to aid facilitation.

Target audience: this case study was designed for public health professional (medical doctors, nurses, environmental health officers or laboratory scientists etc.) and trainees of field epidemiology (frontline, intermediate and advance level)

Prerequisites: before using this case study, participants should have background knowledge on Anthrax (natural history of disease), public health surveillance and outbreak investigation.

Time required: Approximately 3.5 hours

Language: English



Case study material Up    Down

  • Download the case study student guide
  • Request the case study facilitator guide



Competing interest Up    Down

The authors declare no competing in interests.



Acknowledgement Up    Down

We wish to acknowledge the Global Partnership Initiated Academia for Controlling Health Threats (GIBACHT) and their funding body, the German Federal Foreign Office, for their support in developing this case study.



References Up    Down

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