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Epidemics:

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1. Briefly define the disease and its natural history. Be sure to include the following: presenting symptoms and outbreak characteristics. Anthrax is an infectious disease caused by a gram positive, rod-shaped bacteria called Bacillus anthracis. It can be found naturally in soil. There are 4 types of anthrax, cutaneous, inhalation, gastrointestinal, and injection. Cutaneous anthrax develops when a person handles infected animals or animal products and is the most common form on anthrax. Inhalation anthrax develops when a person breathes in the anthrax spores. It is considered the most deadly and infection usually develops within a week after exposure. Gastrointestinal anthrax occurs when a person eats raw or undercooked meat from an infected animal. It affects the upper GI and has rarely been reported. Injection anthrax has recently been identified in heroin-injecting drug users in northern Europe but hasn’t been reported in the U.S yet.
How do we get infected you ask?  The Bacillus anthracis produce spores that are dormant and live in the soil. The spores get into the body of an animal (breath in or in-gest spores from contaminated soil, plants or water) or person (breath in, eat or drink the animals that are contaminated with it or drink water) and can get activated. Once acti-vated they become anthrax and spread throughout the body and cause serious illness or death.
Symptoms for each of the types are as follows: Cutaneous anthrax-group of small itchy blisters or bumps followed by a painless ulcer with a black center. It usually occurs around the face, neck, arms, or hands. Inhalation anthrax- fever, chills, SOB, chest dis-comfort, dizzy, cough, N/V, headache, sweats, extreme tired and body aches. GI an-thrax-fever, chills, sore throat, painful swallowing, hoarseness, N/V/D, headache, flush-ing, fainting, swelling of abdomen. Injection anthrax-fever and chills, small blis-ters/bumps, swelling around sore, abscesses deep under the skin or in muscle where drug was injected.

2. Identify an occurrence of the disease by searching the Internet for recent reports of this disease. Compare this episode or occurrence with information from the CDC website. How closely did that outbreak resemble the case definition?
The occurrence of 2001 was after the 9/11 attacks. Several letters were sent out to sev-eral people including public officials that contained spore powders. Ultimately 5 Ameri-cans were killed and 17 became very ill. The CDC explained it as a as a dangerous at-tack in the form of mailed letters in 2001. It also provided the FBI website on the at-tack. http://www.fbi.gov/about-us/history/famous-cases/anthrax-amerithrax/amerithrax-investigation 3. Using the "How To Conduct an Investigation" box on page 278 of your Stanhope & Lancaster textbook, for each bulleted point, list one example of how you would complete this step if you were the assigned Community Health Nurse for your as-signed infectious disease. http://www.cdc.gov/excite/classroom/outbreak/steps.htm I used the CDC website to help me with this investigation.
Confirm the existence of an outbreak. I would use health department surveillance records, hospital discharge/death records.
Verify the diagnosis and/or define a case.
I would verify the diagnosis by reviewing clinical findings and lab results. I might also visit some of the individuals that became ill.
Estimate the number of cases.
I would estimate the number of cases by what is called “line listing”. This consist of columns with important variables such as name, age, classifications. You can add to the list as more cases are found.
Orient the data collected to person, place, and time.
Using the data from the line listing will assist with this task. It also uses what is called descriptive epidemiology and describes what has occurred in the population that is being studied. You can then develop the epidemic curve.
Develop and evaluate a hypothesis.
You then develop a hypothesis by using all the information from above. They hypothe-sis will address the following: source of the agent, the mode (vehicle or vector) of transmission, and the exposures that caused the disease. It can be evaluated by either comparing the hypothesis with established facts or an analytic epidemiology.
Institute control measures and communicate findings.
Control measures would have carried out as soon as you know the source of the out-break. It should be aimed at links in the infection chain, the agent, and destroying the source. (i.e. food, contaminated water etc.) http://www.cdc.gov/anthrax/ http://www.fbi.gov/about-us/history/famous-cases/anthrax-amerithrax/amerithrax-investigation

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