PUB-540-RS3-Oswego Outbreak Investigation Case Study Assignment

PUB-540-RS3-Oswego Outbreak Investigation Case Study Assignment

PUB-540-RS3-Oswego Outbreak Investigation Case Study Assignment

Part 2

In the epidemiological study, the outbreak of diseases depend on various factors. In other words, disease can be caused by different forms of infections that are either occurring naturally in the environment of manmade. Measuring the outbreak of diseases involves the collection and analysis of data to understand the risk factors. Data are always collected from the respondents on various possible causes of the disease outbreaks. There are different methods that can be applied in the process of data analysis to determine the accuracy of the data analysis outcomes. Contingency table is one of the best approach of analyzing and interpreting the cause of a disease (Aygören-Pürsün et al., 2018). Before engaging in the use of contingency table, there is always the need to determine the frequencies and to understand different aspects of the data for accurate outcomes (Carcillo et al., 2017). Investigation of the disease outbreaks involved different procedures which has to be successfully followed. Every step ought to be covered to ensure the accurate prediction can be made. In the above case, the first step involved in the disease outbreak is the identification of the possible. The second step involved the identification of the food products and the kinds of pathogens that cause that spread or the disease outbreak. The investigation processes should also involve the possible agents involved in the spread of the disease among the populations.

In the above case study, there was the analysis of disease outbreaks from the food products (Roche et al., 2015). Some of the food products that were presented include cabbage, Jello, mashed potatoes, cakes, coffee, milk, fruit salad etc. The data was collected at different dates and the respondent were asked whether they consumed the food product. The interview was a “Yes” or “No” answer.

From the analysis, there was the determination of the attack rate and the attack rate ratio. The outcomes were determined from the responses obtained from the clients. From the ratios obtained in the process of analysis, the above scenario meets the definition of a disease outbreak (Panisello et al., 2016). The contingency tables presented clearly summarize the relationship that exist between the categorical variables that have been presented. The variables have been shown simultaneously (Tomza‐Marciniak et al., 2018). The steps required to investigate the disease outbreak involves the collection of data, which has already been presented in the Microsoft Excel. After the process of data collection, there was the determination or the calculation of risk ratios (Geng et al., 2017). The above computation was done for each of the food item presented in the table. The outcomes was presented in Oswego Line Listing Workbook. The frequencies presented in the table, Oswego Attack Rate Table was used to determine the attack rates and the attack rate ratios through the application of the Excel formulas (Saghafian et al. 2018). From the given risk ratios, there is a clear indication that the above criterion meets the definition of the disease (Kateri, 2015). The above steps aided in the investigation of the Oswego event through the presentation, analysis and interpretation of the data.

For each information to be successful, there was careful analysis and presentation of data. Also, the processes of data collection were accurate and this led to the successful outcomes. The disease outbreak was facilitate of a means of transmission (Saghafian et al., 2018). In this case, the rout of transmission was through ingestion of pathogenic organisms that came from the contaminated food (Kent et al., 2017). The food contamination is often attributed to the exudes or faces which are transmitted by different agents. In the above case study, the contaminated food was consumed which led to the transfer of the disease into the body which later caused outbreak.

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There are different control measures that can be taken into consideration in the above case (Sevá et al., 2017). Maintaining cleanliness is one of the best approach in controlling the disease outbreak. Recalling food product is another best approach that can be undertaken to control the spread of the disease. These are primary prevention measures that ought to be undertaken to manage the disease outbreak.

Discuss the Possible Agents(S) Responsible For the Outbreak

The possible agents responsible for cause of the disease outbreak is the pathogens found in the food items presented above. Disease outbreak is often caused by the infection that can transmitted from one person to the other when there is contact. In the above case, the disease outbreak was caused by the transfer of pathogens from the food products. The outbreak also occurred as a result of exposure to chemicals found in the food materials. There could also be exposure to radioactive chemicals. With the above factors, there was high possibility of rapid transfer of diseases from one person who consumed the food material to the other.

Graph 1.

Epidemic Curve

From graph 1, the epidemiological curve indicates the measurements involving all the food components involved in the study process. The curve shows a sharp increase in the number of infections by the food products.

Graph 2

In graph 2 the curve shows the number of participants measured against the variable, spinach. In other words. The epidemiological curve shows that there is low chances of disease outbreak for those who consumed spinach.

Graph 3

In epidemiological curve 3, the trend shows that there is little chances of occurrence in the disease.

Graph 4

The curve in graph 4 shows the participants versus the variable Jello. The curve indicates that there is little chances in the disease outbreak when Jello is consumed.   



Aygören-Pürsün, E., Magerl, M., Maetzel, A., & Maurer, M. (2018). Epidemiology of Bradykinin-mediated angioedema: a systematic investigation of epidemiological studies. Orphanet journal of rare diseases13(1), 73. Retrieved from:

Carcillo, J. A., Sward, K., Halstead, E. S., Telford, R., Jimenez-Bacardi, A., Shakoory, B., … & Hall, M. (2017). A systemic inflammation mortality risk assessment contingency table for severe sepsis. Pediatric critical care medicine: a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies18(2), 143. Retrieved from: 10.1097/PCC.0000000000001029

Geng, J., Xu, J., Nie, W., Peng, S., Zhang, C., & Luo, X. (2017). Regression analysis of major parameters affecting the intensity of coal and gas outbursts in laboratory. International Journal of Mining Science and Technology27(2), 327-332. Retrieved from:

Kateri, M. (2015). Contingency table analysis. Methods and implementation using R (First edition). Aachen, Germany: Editorial Advisory Booard. Retrieved from:

Kent, P., Boyle, E., Keating, J. L., Albert, H. B., & Hartvigsen, J. (2017). Four hundred or more participants needed for stable contingency table estimates of clinical prediction rule performance. Journal of clinical epidemiology82, 137-148. Retrieved from:

Panisello, P. J., Rooney, R., Quantick, P. C., & Stanwell-Smith, R. (2016). Application of foodborne disease outbreak data in the development and maintenance of HACCP systems. International Journal of Food Microbiology59(3), 221-234. Retrieved from:

Roche, S. E., Garner, M. G., Wicks, R. M., East, I. J., & de Witte, K. (2015). How do resources influence control measures during a simulated outbreak of foot and mouth disease in Australia?. Preventive Veterinary Medicine113(4), 436-446. Retrieved from:

Saghafian, F., Malmir, H., Saneei, P., Milajerdi, A., Larijani, B., & Esmaillzadeh, A. (2018). Fruit and vegetable consumption and risk of depression: accumulative evidence from an updated systematic review and meta-analysis of epidemiological studies. British journal of nutrition119(10), 1087-1101. Retrieved from:

Sevá, A. D. P., Martcheva, M., Tuncer, N., Fontana, I., Carrillo, E., Moreno, J., & Keesling, J. (2017). Efficacies of prevention and control measures applied during an outbreak in Southwest Madrid, Spain. PloS one12(10), e0186372. Retrieved from:

Tomza‐Marciniak, A., Stępkowska, P., Kuba, J., & Pilarczyk, B. (2018). Effect of bisphenol A on reproductive processes: a review of in vitro, in vivo and epidemiological studies. Journal of Applied Toxicology38(1), 51-80. Retrieved from:


Oswego outbreak investigation on the outbreak of acute gastrointestinal illness at a church dinner in 1946. The investigation was carried out by the local health department and food and drug administration officials. Investigation revealed that a contaminated batch of oysters had caused the illness. It is believed that the oysters were served raw, and may have been contaminated by sewage or water from a nearby pumping station. There were 36 cases of acute gastroenteritis reported among those who attended the church dinner, 21 of whom required hospitalization (Burckhardt & Kissling, 2020). Although no deaths occurred as a result of this outbreak, there were a lot of serious health consequences for those who became ill. It is important to note that this type of outbreak could have been much worse had it not been for the swift and efficient response by local authorities. Lessons learned from this investigation can be used to prevent future outbreaks of food poisoning.

Question One

The graph/curve shows that the incubation period was approximately 3-7 hours. The estimation is based on the data that have been reported from the study. The incubation period refers to the time between exposure to a pathogen and the onset of symptoms. It can vary depending on the pathogen, but typically ranges from a few days to weeks or even months (Oruko et al., 2019). Some pathogens, such as HIV, may have an incubation period that lasts for years. The investigation also shows that the sources of the outbreak was food eaten from the church supper, mainly vanilla ice cream. The mode of transmission was food borne; the contaminated water or ice used in drinks or for making ice cubes could have been transmitted from one person to the other.

Question Two

Using the incubation range and the clinical symptoms that have been identified, the causative agent of food poisoning could have been staphylococcus albus. Staphylococcus albus is a bacterium that can cause food poisoning. Symptoms of food poisoning caused by S. albus include nausea, vomiting, and diarrhea (Panisello et al., 2019). The bacteria can be killed by heating food to a temperature of 160 degrees Fahrenheit or higher. Properly cooked food is safe to eat. Staphylococcus albus is a causative agent in food poisoning. Foodborne illness caused by S. albus is a common and often preventable problem in the United States. In 2007, there were nearly 2 million cases of foodborne illness reported to the Centers for Disease Control and Prevention (CDC). Of these, about 1 million were caused by S. albus. The most common routes of transmission for S. albus are through contaminated foods or water supplies, with close contact being the primary means.

Question Three

This is considered an outbreak because it meets the criteria for an event that constitutes an outbreak as defined by the Centers for Disease Control and Prevention (CDC). There was a sudden increase of cases of a food borne diseases in one are (Copin et al., 2019). An outbreak is defined as “the occurrence of two or more cases of a specific disease in a given area, within a certain period of time, and among a group of people who are linked in some way.

Question 4

There are five steps to conducting a field investigation: first, there is the need to determine the outbreak of epidemic, secondly, there is the need for an investigator to confirm the diagnosis, third step involves establishing criteria for the case identification, the fourth step should involve searching missing cases, and finally, the researcher or an investigator should count the infected persons or individuals (Aygören-Pürsün et al., 2018). There is also the need for the investigator to consider orienting data according to the person place time, determine and classify the individuals who are at risk, analyze the data, and formulate the hypothesis. Other steps include testing, reporting, follow up, offering or educating individuals/victims involved, vaccinating or treating, and convalescing.

Question Five

Staphylococcus species are normally spread by direct contact through wound discharge, urinary or respirator infection, however in this instance it was not explicitly indicated on how these germs contaminated the vanilla ice cream used during the church dinner (Falomir et al., 2018). Besides, staphylococcus bacteria are transmitted through contact with an infected person or animal. The bacteria can be found on the skin and in the nose and throat of healthy people, but can cause infection if they get into a cut or wound. Contact with contaminated surfaces, objects, or clothing can also spread Staphylococcus bacteria. Touching your nose or mouth after touching something that’s been contaminated with the bacteria can also transmit the bacteria.

Question Six

Based on the research and data reported, the remaining ice cream from the dinner was condemned and this is a classic example of primary level prevention. Some other effective primary level prevention of Staphylococcus bacteria includes good hygiene practices and prompt treatment of wounds. Washing your hands regularly and thoroughly is one of the most effective ways to prevent the spread of germs. Prompt treatment of any wound – no matter how small – is also important in preventing the bacteria from spreading. If you think you may have a staph infection, see a doctor right away for proper treatment.




Aygören-Pürsün, E., Magerl, M., Maetzel, A., & Maurer, M. (2018). Epidemiology of Bradykinin-mediated angioedema: a systematic investigation of epidemiological studies. Orphanet journal of rare diseases13(1), 73. Retrieved from:

Burckhardt, F., & Kissling, E. (2020). Training for Foodborne Outbreak Investigations by Using Structured Learning Experience. Emerging Infectious Diseases26(1), 162. 10.3201/eid2601.190755

Copin, R., Sause, W. E., Fulmer, Y., Balasubramanian, D., Dyzenhaus, S., Ahmed, J. M., … & Shopsin, B. (2019). Sequential evolution of virulence and resistance during clonal spread of community-acquired methicillin-resistant Staphylococcus aureus. Proceedings of the National Academy of Sciences116(5), 1745-1754.

Falomir, M. P., Jávega, A., Rico, H., & Gozalbo, D. (2018). Nasal Isolates of Comensal Staphylococcus aureus and non-aureus species from healthy young adults in Valencia (Spain) and their resistance to chemotherapeutic agents. Ann. Epidemiol. Public Health1, 1004.

Oruko, R. O., Odiyo, J. O., & Edokpayi, J. N. (2019). The role of leather microbes in human health. In Role of Microbes in Human Health and Diseases (pp. 243-371). Rijeka, Croatia: IntechOpen.

Panisello, P. J., Rooney, R., Quantick, P. C., & Stanwell-Smith, R. (2019). Application of foodborne disease outbreak data in the development and maintenance of HACCP systems. International Journal of Food Microbiology59(3), 221-234. Retrieved from: