Question
CASE STUDY IN EPIDEMIOLOGY On April 12, 2012 at around 5:00 PM, just after the graduation ceremony of BTS Elementary School in the municipality of
CASE STUDY IN EPIDEMIOLOGY
On April 12, 2012 at around 5:00 PM, just after the graduation ceremony of BTS Elementary School in the municipality of D.A., the P.T.A. members served merienda cenna to 342 people composed of visitors, teachers and graduates composed of soft drink, sandwich and fruit salad.
At 7 PM, 21 persons of varying ages who participated in that occasion were brought to the municipal hospital of the town complaining of diarrheas, vomiting, abdominal cramps and body weakness.
At 10 PM, another 26 persons of varying ages and complaints of symptoms as in the above were again brought to the same hospital. They all attended the same occasion.
At 12 midnight, 23 persons from the same occasion again were brought to the same hospital complaining of varying symptoms as above. However the twelve patients with severe symptoms died after several minutes in the hospital.
At 2 AM, another batch of 37 persons from the same group were again brought to same hospital but because they are already full, the hospital Physician referred them to the hospital in the adjoining town. Seven of them, with severe dehydration, low blood pressure and severe body weakness, who unfortunately, died before reaching the hospital in the other town.
The following morning, the Municipal Health Officer upon learning of the incidence that happened in that graduation ceremony conducted investigation. Review of records show the following data:
First 21 patients admitted at 7:00 PM the previous night
Name
Age
Sex
MS
Complaints
Ate
Diarrhea
Vomiting
Abd. Pain
Weakness
Salad
1. A.A.
12
M
Ch
X
X
X
x
X
2. A.B.
12
F
Ch
X
X
X
x
X
3. A.C.
12
M
Ch
X
X
x
X
4. A.D.
12
M
Ch
X
x
X
5. B.C.
13
F
Ch
X
X
X
X
6. B.D.
13
M
Ch
X
X
x
X
7. C.C.
13
F
Ch
x
X
x
X
8. C.D.
13
F
Ch
X
X
x
X
9. D.E.
35
M
M
X
X
X
x
X
10. D.F.
46
F
M
X
X
x
X
11. E.F.
15
F
S
X
X
x
X
12. E.G.
16
F
S
X
X
X
x
X
13. E.H.
17
F
S
X
X
x
X
14. F.I.
38
F
M
X
X
X
x
X
15. E.J.
29
F
M
X
X
X
x
X
16. E.K.
56
F
M
X
X
x
X
17. J.A
7
M
Ch
X
X
X
18. N.P
32
M
S
X
X
x
X
19. G.L
49
F
M
X
X
X
X
20. D.M
12
M
Ch
X
X
X
21. C.A
29
F
M
X
X
x
x
x
2nd group of 26 patients from same barangay admitted at 10PM
1. F.G.
25
M
S
X
X
X
x
X
2. F.H.
28
F
M
x
X
X
x
X
3. F.I.
46
M
M
x
X
X
x
X
4. F.J.
57
F
M
x
X
X
x
X
5. F.H.
66
M
M
x
X
X
x
X
6. G.I.
47
F
M
x
X
X
x
X
7. G.J.
59
M
M
x
X
X
x
X
8. G. K
65
F
M
x
X
X
x
X
9. G.L.
34
F
M
x
X
X
x
X
10. G.M.
71
M
M
X
X
x
X
11. G.I.
23
F
M
X
X
X
x
X
12. J.K.
22
M
S
X
X
X
X
13. J.M.
40
M
M
X
X
X
X
X
14. J.N.
30
F
M
X
X
X
X
15. M.L.
20
M
S
X
x
X
X
16. M.M.
29
F
M
X
X
X
17. M.N.
27
F
M
x
X
X
18. M.O.
26
M
S
X
x
x
X
19. M.P.
22
M
M
X
X
x
x
X
20. M.R.
22
M
M
X
x
X
21. B.C
21
F
S
X
X
X
X
22. V.A
24
F
S
X
X
X
X
23. A.C
38
M
M
X
X
X
24. O.P
31
F
M
X
X
X
X
25. C.V
22
M
S
X
X
X
X
X
26. M.P
49
M
M
X
X
X
X
3rd batch of 23 patients from said occasion were admitted at 12 midnight
1. N.A.
10
F
Ch
x
x
X
x
X
2. N.B.
12
F
Ch
x
x
X
x
X
3. N.C.
14
M
Ch
x
x
X
x
X
4. N.D.
11
F
Ch
x
x
X
x
X
5. N.E.
13
F
Ch
x
x
X
x
X
6. N.F.
12
F
Ch
x
x
X
x
X
7. N.G.
14
F
Ch
x
x
X
x
X
8. N.H.
10
M
Ch
x
x
X
x
X
9. F.G.
25
M
M
x
x
X
x
X
10. F.H.
28
F
M
x
x
X
x
X
11. F.I.
46
M
M
x
x
X
x
X
12. F.J.
57
F
M
x
x
X
x
X
13. F.H.
66
M
M
x
x
X
x
X
14. G.I.
47
F
M
x
x
X
x
X
15. J..
59
M
M
x
x
X
x
X
16. K
65
F
M
x
x
X
x
X
17. G.L.
34
F
M
x
x
X
x
X
18. G.M.
71
M
M
x
x
x
x
X
19. G.I.
23
F
M
x
x
x
x
X
20. J.K.
22
M
M
x
x
x
x
X
21. J.M.
40
M
M
x
x
x
x
X
22. J.N.
30
F
M
x
x
x
x
X
23. M.L.
20
M
M
x
x
x
x
X
4th Batch of 37 Patients Admitted at 2 AM
1. A.A.
12
M
Ch
x
x
x
x
X
2. A.B.
12
F
Ch
x
x
x
X
3. A.C.
12
M
Ch
x
x
x
X
4. A.D.
12
F
Ch
x
x
X
5. B.C.
13
F
Ch
x
x
X
6. B.D.
13
M
Ch
X
x
x
X
7. C.C.
13
F
Ch
X
x
x
X
8. C.D.
13
F
Ch
X
X
X
X
9. D.E.
35
M
M
x
X
X
X
10. D.F.
46
F
M
X
x
X
11.E.F.
15
F
S
X
x
X
X
X
12. E.G.
16
F
S
X
x
X
X
X
13. E.H.
17
F
S
X
x
X
X
X
14. F.I.
38
F
M
x
X
X
X
15. E.J.
29
F
M
x
X
X
16. E.K.
56
F
M
X
x
X
X
X
17. F.G.
25
M
M
X
x
X
X
X
18. F.H.
28
F
M
X
x
X
X
X
19. F.I.
46
M
M
X
X
X
20. F.J.
57
F
M
X
X
X
X
21.F.H.
66
M
M
x
X
X
X
22. G.I.
47
F
M
X
x
X
X
23. G.J.
59
M
M
X
x
X
X
24. G.K.
65
F
M
X
x
X
X
25. G.L.
34
F
M
X
x
X
X
X
26. G.M.
71
M
M
x
X
x
X
27. G.I.
23
F
M
X
x
X
x
X
28. J.K.
22
M
M
X
x
X
X
29. J.M.
40
M
M
x
X
x
X
30. J.N.
30
F
M
X
x
x
X
31. J.G
8
F
Ch
X
X
X
x
32. J. U
31
F
M
X
X
X
X
X
33. W.A
14
M
Ch
X
X
X
X
X
34. L. A
10
F
Ch
X
X
X
X
35. K.A
27
M
S
X
X
X
X
36. B.I
33
F
S
x
x
X
37. B.E
51
M
M
X
x
X
X
A report from the nearby hospital received by the admitting physician that 12 patients from the referred cases died few hours after admission; and 7 patients died on arrival at their hospital with a total of 19 fatalities.
The MHO not contented with the data he went to the site to investigate what really happened. He learned that the salad made already two days prior to the occasion because of the bulk and they just rely on the refrigerator. However, because of frequent brownouts, the refrigerator was not able to maintain the wholesomeness of the salad but inspite of it there are 224 people who ate the salad out of 342 who attended the occasion.
QUESTIONS:
1.Perform descriptive studies of the case as to person.
a.Present findings as to age and sex by frequency distribution.
b.Present findings as to marital status also by frequency distribution.
c.Present findings as to symptoms presented by patient also in frequency distribution.
d.If there were 224 persons who were exposed to the risk factor (eating salad), how many got sick and how many did not have the disease.
e.If there were 342 persons who attended and 224 were exposed to the risk (eating salad) how many persons were not exposed. And based on your analysis, of those who were not exposed, how many got sick and how many did not have the disease.
2.Perform descriptive study as to time. Make a histogram showing the number of cases corresponding to the time of onset of the disease. Specify the type of the outbreak based on the histogram. Is it a point source outbreak or a propagated source?
3.Solve for:
a.Attack Rate
b.Case Fatality Rate.
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Euclidean Geometry And Transformations
Authors: Clayton W Dodge
1st Edition
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