Question

On saturday May 19th, Buckeye County Health Department Staff are continuing to perform phone interviews with affected individuals. The hospital reports 3 new cases today: 2 students and 1 staff member from Northside Elementary School. The superintendent of Buckeye County School District contacts Buckeye County Health Department to discuss whether or not the school should be closed until a cause can be determined. On sunday May 20th, Preliminary analysis of the data from the initial phone interviews reveals that all cases, including those at the hospital, are limited to the individuals at the school, nursing home and surrounding neighborhood. The hospital reports 1 new case and the nursing home reports 2 new cases today. No cause has yet been identified. The PIO prepares a press release describing what is happening and what steps are being taken to investigate and control the outbreak. On monday May 21st at 9:00 AM , Buckeye School District elects to close Northside Elementary School pending further investigation. The hospital and nursing home report all cases are negative for the most common causes of atypical pneumonia (see note above). Buckeye County Health Department (BCHD) conducts a conference call with the State Health Department (SHD) and Ms. Dolor, the IP from Smallsville Hospital to determine what additional samples should be submitted for further testing and where they should be sent. After reviewing the histories and the consensus of the expert opinions, they decide to perform additional tests for Francisella tularensis, Hantavirus and Coxiella burnetti. Ms. Dolor agrees to collect the samples that the experts recommend and ship them overnight to the corresponding lab. On wednesday May 23rd at 11:00 AM, The hospital reports two new cases today; no new cases have been identified at the nursing home or elementary school. You also received a call from the SHD reporting the results of the additional tests for the first 6 patients: All six were positive for Q-Fever (Coxiella burnetii) on PCR. Q-Fever is a nationally notifiable disease in the US, so the BCHD and the SHD contact the Centers for Disease Control and Prevention (CDC) to report these cases and to request assistance in continuing the epidemiologic investigation. The PIO prepares another press release.

Question: AS THE INVESTIGATION REALLY BEGINS, WHAT KIND OF INFORMATION DO YOU WANT TO PROVIDE TO THE PUBLIC ABOUT THE SITUATION AT THIS POINT AND THEIR CHANCE OF GETTING SICK? AND WHAT ADVICE SHOULD YOU GIVE SCHOOL OFFICIALS AND THE STAFF OF THE NURSING HOME REGARDING RISK OF TRANSMISSION WITHIN THE SCHOOL AND NURSING HOME?

Answer 1

Q-fever is a zoonotic disease caused by Coxiella burnetii. The primary reservoirs for C. burnetti are sheep, goats and cattleand diease is global in distribution. In U.S. it is considered as class B bioterrorism agent.

Best advice that can be provided to the public and officials is to let them know about the disease, symptoms and causes so that they can get prepared. For example: Answers to questions such as what Q-fever is, what are symptoms, who are at risk, how it is spread and at last information about steps to reduce exposure like avoid contact with infected animals during birthing when possible. If you assist in animal deliveries or have contact with birth products, protect yourself by wearing Gloves, Eye protection, Protective clothing (e.g., coveralls and boots), Masks (an N95 or higher respirator is the most effective type of mask for protecting against Q fever bacteria), shower and change your clothes and shoes after working with animals and eat and drink only pasteurized milk and milk products (cheese, cream, butter).