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Case study

Investigation of an outbreak caused by an unknown infectious pathogen in rural Zola

Investigation of an outbreak caused by an unknown infectious pathogen in rural Zola

Fortress Yayra Aku1, Dinara Beisembekova2, Nurudeen Ayobami Adebisi3, Eva Mertens4,5,&, Lea Wende7,8, Sayed Mahdi Marashi6, Janine Dywicki7,8


1Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Hohoe Campus, Ghana, 2Nazarbayev University, University Healthcare Department, Nur Sultan, Kazakhstan, 3Department of Chemical Pathology, University College Hospital, Ibadan, Oyo State, Nigeria, 4Bernhard Nocht Institute for Tropical Medicine, Department of Infectious Disease Epidemiology, Bernhard-Nocht-Strasse 74, 20359 Hamburg, Germany, 5Global Partnership Initiated Biosecurity Academia for Controlling Health Threats (GIBACHT), Hamburg, Germany, 6Tehran University of Medical Sciences, School of Public Health, Department of Virology, Tehran, Iran, 7Robert Koch Institute, Centre for International Health Protection, Preparedness and Operations Support, Nordufer 20, 13353 Berlin, Germany, 8Global Partnership Initiated Biosecurity Academia for Controlling Health Threats (GIBACHT), Berlin, Germany



&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 was written as part of a fellowship in biosafety and biosecurity organised by the German Biosecurity Programme, namely the Global Partnership Initiated Biosecurity Academia for Controlling Health Threats (GIBACHT). Among other objectives, the fellowship focuses on equipping participants with the skills of developing their own country-specific case studies with focus on biosafety- and biosecurity-related scenarios. Upon completion of the underlying case study, participants should be able to identify some existing gaps with regards to early detection and investigation of outbreaks, describe the key steps in outbreak investigation, explain the role of communication and coordination among the various stakeholders in outbreak investigations and analyse epidemiological data obtained during outbreak investigations. They should also be able to suggest appropriate control and prevention measures for specific disease outbreaks with focus on foodborne outbreaks and to distinguish between biosafety and biosecurity concepts.



How to use this case study    Down

General instruction: this case study should be used as an add-on training and capacity-building resource for public health and epidemiology trainees meant to complement the theoretical aspects learned through lectures and/or other formats in a practical way. Also, it can serve as a supplementary material in the context of in-service training activities for frontline public health professionals to refresh their knowledge and skills regarding the principles and concept of outbreak investigation and related biosafety as well as biosecurity matters. Ideally, the case study should be led by 2 facilitators per group of around 5 participants each. To enhance interactivity, participants should read the subsequent paragraphs of the case study in turns. Discussions within the group during the conduction of the case study constitute a key element of the process and should be oriented towards the collective identification of an outbreak investigation strategy as a team. Respectively, facilitators should lead the discussion through guiding questions and further hints making use of materials such as flip charts. The integration of role plays as a facilitation method can also enhance the overall interactivity of the case study at hand.

Audience: the underlying case study targets a broad range of public health professionals working in outbreak prevention and control, especially disease control and surveillance officers, students of epidemiology training programs and other public health practitioners.

Prerequisites: prior to the use of this case study, participants should have basic background knowledge of the principles of outbreak investigation as well as biosafety and biosecurity issues related to the handling of samples in the context of outbreak investigations.

Materials required: computer with MS Excel or other spreadsheet software, pen, notebooks, calculator, flip charts and markers.

Level of training and associated public health activity: intermediate level in outbreak investigation

Time required: this case study is expected to take between 2.5 to 3 hours.

Language: English



Case study material Up    Down

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



Competing interests Up    Down

The authors declare no competing interests.



Acknowledgement Up    Down

The authors 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

  1. Ministry of Health Ghana. Technical guidelines Integrated disease Surveillance and Response Ghana. 2nd edition. 2011.

  2. Centre for Disease Control Prevention. Principles of Epidemiology in Public Health Practice. May 2012. Accessed on 02 August 2021.

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  9. Reintjes R, Zanuzdana A. Modern Infectious Disease Epidemiology: Concepts, Methods, Mathematical Models, and Public Health. Outbreak Investigations. 2009;159-176. Google Scholar

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