Question

The onset of illness in all cases was acute, characterized chiefly by nausea, vomiting, diarrhea, and abdominal pain. None of the ill persons reported having an elevated temperature; all recovered within 24 to 30 hours. Approximately 20% of the ill persons visited physicians. No fecal specimens were obtained for bacteriologic examination.The investigators suspected that this was a vehicle-borne outbreak, with food as the vehicle.

- List the broad categories of diseases that must be considered in the differential diagnosis of an outbreak of gastrointestinal illness.

- What are other modes of transmission?

-If you were to administer a questionnaire to the church supper participants, what information would you collect? Group the information into categories

-What is a line listing? What is the value of a line listing?

Answer 1

ANSWER

BROAD CATEGORIES

• Gastro enteritis can occur bacterial, viral, paraciyic, fungal causes. In this case people developed symptoms of gastro enteritis one day after intake of food items, without any history of fever.
• Most propably it is a case of viral gastro enteritis.

Common virus causing infections are :

1. Noro virus

2. Roto virus ( mainly in childrens )

3. Hepatitis A

Other differential diagnosis include bacterial gastro enteritis like :

salmonella, ( found in meat, eggs )

   shijella, ( found in water )

escherichia coli, ( found in salads, ground beef )

campylobacter jejuni,( meat and poultry)

staphyloocccus ( found in disry products, meat, and eggs)

Yersinia ( found in pork )

•    fungus ( mushroom posoning)
•   parasitic causes ( amoebiasis, giardiasis, croptosporidasis)

MODE OF TRANSMISSIONS

This infections can spread through :

1. contaminated food and water items

2. feco oral routs ( uncleaned hands after the usage of toilets )

3. Person to person transmission

4. through contaminated objects

5. transmission through house flies

SURVEY QUESTIONS :

Can be use to get the sourse of infection, type of infection

QUESTIONNAIRE

Category 1 ( sourse of infection )

• Did you took food from party ?
• what food item did you took ? ( veg, non-veg, mixed )
• Did you took ice-cream or salad ?
• Did you noticed any taste different ?
• Did you wash your hands before taking foods ?
• Did you take extra food or water from outside apart from the party ?

Category 2 ( to find out the type infection )

• How many hours after taking food you develoap symptoms ?
• Any history of fever with chills and rigor ?
• Any history of blood or mucus in stool ?
• Which symptom occured first ?

​​​​​​​What is line listing ?

Line listing is a table in which important information is recorded on each person who is ill with gastro enteritis in an out break.

Purpose - Line listing allows information about time, person and place to be organized and reviewed quickly.

it is also a good way to keep track of different categories of cases

    eg ; possible, propable, confirmed cases ( laboratory confirmed, clinical confirmed or both).