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EIS
CASE STUDIES
Student
guides are provided for each case study. You must have
Adobe Reader installed on your computer to read these files. Please
download the freeware from
www.adobe.com. Instructor guides for each case study
are available for teachers/trainers upon request.
Please submit all questions and comments about the case studies to Julie
Magri, MD, MPH at
zvd0@cdc.gov.
An Epidemic
of Thyrotoxicosis
#873-703,
updated 2003: Outbreak with
unknown etiology and mode of transmission, crossing state lines, 1985; a
nice wrap-up study.
Learning
Objectives
After completing this case study, the student should be able to:
-
List
the key tasks involved in investigating epidemics of unknown cause;
-
Describe
the roles, responsibilities, and relationships of federal versus
state public health agencies in a field investigation;
-
Assign
appropriate priority to key tasks during an investigation; and
-
Describe
jurisdictions of health agencies at various levels of government.
Student873-703.pdf
Cigarette
Smoking and Lung Cancer
#731-703,
updated 2003: Based on the
classic studies of Doll and Hill, 1950's; addresses study design,
interpretation of measures of association and impact of association.
Learning
objectives:
After
completing this case study, the student should be able to:
-
Discuss the elements of study design, and
the advantages and disadvantages of case-control versus prospective
cohort studies;
-
Discuss some of the biases which might have
affected these studies;
-
Calculate
a rate ratio, rate difference, odds ratio, and attributable risk
percent;
-
Interpret each measure and describe each
measure’s use; and
-
Review the criteria for causation.
Student731-703.pdf
Oral
Contraceptive Use and Ovarian Cancer
#811-703,
updated 2003: Multicenter
case-control study, 1980-1982; addresses bias, analysis of case-control
studies.
Learning
objectives:
After
completing this case study, the student should be able to:
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Outline the sequence of an epidemiologic
analysis;
-
Discuss the biases of particular concern in
case-control studies and ways to minimize their influence;
-
Describe
why and when to use crude and adjusted odds ratios and 95%
confidence intervals, and how to interpret them; and
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Define and recognize effect modification and confounding.
Student811-703.pdf
Oswego:
An Outbreak of Gastrointestinal Illness Following a Church Supper
#401-303,
updated 2003: S.
aureus outbreak among church picnic attendees, 1940; the classic,
straightforward outbreak investigation in a defined population.
Learning
objectives:
After
completing this case study, the student should be able to:
-
Define the terms “cluster”,
“outbreak” and “epidemic”;
-
List the steps in the investigation of an
outbreak;
-
Draw, interpret and describe the value of
the epidemic curve;
-
Calculate and compare food-specific attack
rates to identify possible vehicles;
-
List reasons for investigating an outbreak
that has apparently ended.
Compendium401-303.pdf
Student401-303.student.pdf
Paralytic
Illness in Ababo
Learning objectives: After completing this case study, the student should be able to:
-
Define
incidence, prevalence, and case-fatality rate;
-
Define
surveillance and identify the key features of a surveillance system;
-
List
the types of information that should be collected on a surveillance
case report form;
-
List
the factors that can account for a change in the reported incidence
of a disease;
-
Define
sensitivity of a surveillance system, and the effect of different
case definitions on sensitivity.
Student891-903.pdf
Screening
for Antibody to the Human Immunodeficiency Virus
#871-703,
updated 2003: Hypothetical
health department anticipating the release of the first HIV antibody
test, 1985; focused on
screening issues.
Learning
objectives:
After
completing this case study, the student should be able to:
-
Define and perform calculations of
sensitivity, specificity, predictive-value positive and predictive-value
negative;
-
Describe the relationship between prevalence
and predictive value;
-
Discuss the trade-offs between sensitivity
and specificity; and
-
List the principles of a good screening
program.
Student871-703.pdf
Suspected
Legionnaires’ Disease in Bogalusa
#912-303,
updated 2003: Community outbreak of Legionnaires' disease in Bogalusa,
Louisiana in 1989, ultimately traced to grocery store mist machine;
addresses all the steps of a field investigation, plus statistical power
of a case-control study.
Learning objectives:
After completing this case study, the student should be able to:
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Discuss the relationship between and roles
of state-based and Atlanta-based EIS officers in a field investigation.
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Develop an epidemiologic case definition;
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Calculate power for a case-control study;
and
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Describe different sources of controls for a community-based
outbreak.
Student912-303.pdf
Surveillance
for E. coli 0157:H7 - Information for Action
Learning objectives:
After completing this case study, the student should be able to:
-
Discuss
the process and criteria for placing a disease or condition on a
state or national notifiable disease list;
-
List
the categories of information that should be included in a
surveillance instrument;
-
Summarize
and interpret surveillance data;
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Recognize
difficulties in balancing public health concerns with consumer and
industry considerations in emerging issues.
Student903.pdf
Texarkana
- Epidemic Measles in a Divided City
Learning objectives: After completing this case study, the student should be able to:
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Discuss
the advantages and disadvantages of using a sensitive and/or
specific case definition in an epidemic investigation;
-
Calculate
vaccine efficacy and discuss its interpretation; and
-
Discuss
the advantages and limitations of selecting a specific age as the
recommended target date for administering vaccinations.
Student711-903.pdf
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