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Flow Chart of Outbreak Investigation

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Ben Paz

on 12 December 2012

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Transcript of Flow Chart of Outbreak Investigation

James Smith Judy Smith Mike Smith Sue Smith 18
At college
soccer player
'all-nighters' Married 41
Live in small city with Judy
Expecting another child 42
Lives in small city with James
dental hygienist
mother of 3
slightly overweight
walks everyday
No more children planned
Expecting another child Daughter Son 16 Day 1
Symptoms: Slight fever, headache
visits infirmary
other girls in dorm also sick

Monday: Feeling tired, sick
Two intense soccer games
High fever Medical History:
Broken ankle at 11
Mild Asthma controlled w/ inhaler
Drinks a lot of energy drinks and coffee
Was not vaccinated against bacterial meningitis Roommates and
Teammates on
Soccer Team Jill Symptoms:
Body feeling tight overnight
Slight fever, 99.7 F Wanda Day 1 Symptoms:
Fever over past few days
Glands in neck swollen
Woke with sore throat
Boyfriend Ray, same symptoms Maggie Day 1 Symptoms:
Scratchy throat past few days
Woke, throat 'on fire'
Head feels heavy
Can't regulate temperature Maria Symptoms:
Feeling rundown
Barely able to get out of bed
Fever, almost 103 Day 1Interventions:
Gargling saltwater
Drinking tea Anthony Arnie Symptoms:
Dry Cough
Muscle Soreness
Fever, 100 F, few days
Sinus Pressure Interventions:
OTC Cold Medicine Day 1 Symptoms:
Runny Nose
Fever, 100.5 F Intervention:
Increased Vitamin Intake All live on same floor
and same chem. class History:
Smokes occasionally Same floor, constant visitor to Sue/Jill Sorority Sisters Friends Friends and Same floor Marco Symptoms:
Extreme Fatigue
Killer Headache Lab Partners Ray Symptoms:
Swollen neck glands
sore throat Intervention:
Tylenol BF/GF Elena Shared food+drinks BF/GF Alvin Symptoms:
Sore Throat Neighbor at Dorm Day 2 Symptoms:
Neck feels tight Diagnosis: Bacterial Meningitis Day 3 Symptoms:
Glands now extremely
Extremely Tired Day 3 Symptoms:
Cannot swallow food
High fever Day 3 Interventions:
Drinking juice
Taking vitamin supplements Day 3 Symptoms:
Chills easily
Onset of fatigue Note: Alvin
possibly shared
coffee with
Wanda Sue's infection was quickly
diagnosed and treated.

Antibiotics eliminated the
infection and Sue did a full
recovery. Two Months Later:
Physician recommends she have
her hearing checked. Sean Smith Meg Smith Gina Smith Aaron Smith Married Married Tyler Smith Five month old baby
Diagnosed with cystic fibrosis 28
Thinking of starting a family 26
Thinking of starting a family Son Brother Brother Brother Brother Medical History:
Not carrier for cystic fibrosis Medical History:
Not carrier for cystic fibrosis Carter Smith New born baby Son Symptoms: last few months, pain in
upper arm. cancer? pain in right proximal humerus
in middle of growth spurt Pain is worsening, keeps him awake at night
Difficult to lift arm
Area below shoulder has gotten tender, swollen and red Diagnostic tests:
blood tests, checks for ALP and LDH levels
ALP and LDH higher than normal
x-rays show tumor close to epiphyseal plate
[sent to orthopedic oncologist]
ordered a CT scan, MRI, and bone scan
results show that Mike most likely has
localized osteosarcoma
bone biopsy of tumor Grandpa Joe Smoker for past 30 years
last year, came down with cold which
developed into pneumonia
family convinced him to join study to investigate 6 genes possibly involved with lung cancer Medical History: joined a research study investigating three genes though to be associated with osteosarcoma Carrier for cystic fibrosis Carrier for cystic fibrosis Laura diagnosed with breast cancer in her 40's
BRCA2 mutation Bill diagnosed with breast cancer in 40's Married Father Jennifer diagnosed with breast cancer at 35
tests positive for BRCA2 mutation Brother Sister Sister Sister Jack Maria Daughter Was diagnosed with precancerous cells of her cervix.
The precancerous cells were detected in the glandular tissue of her cervix during a Pap test.
Caused by a Human papillomavirus (HPV) infection.
Had the precancerous cells removed with cryosurgery.
Maria is fine now and cancer-free, but has to go in more often for routine pap tests over the next few years. oncologists try to shrink tumor with chemotherapy
if it shrinks, they will perform surgery to remove it The chemotherapy is working but the cancer has spread to surrounding nerves and blood vessels.
they decide to amputate his arm. he now requires a prosthetic Mike’s amputation surgery was a success.
The surgeon was able to remove the entire tumor, including all affected tissues and blood vessels.
Mike’s prognosis is very good and he will soon begin his last round of chemotherapy treatment to ensure that the osteosarcoma does not come back.
Mike’s pain associated with the amputation site is under control, and he is almost done receiving intravenous antibiotics to prevent infection.
Mike is up and about walking around the halls and he is regaining a lot of his strength.
Because Mike’s recovery is going smoothly, he is now ready to begin his physical rehabilitation.
Mike Smith has recovered from his surgery, has completed the last round of his post-operative chemotherapy treatment, and is learning how to use his new prosthetic arm.
Mike is visiting his oncologist today to see where he stands and if further treatment is necessary. Diana Jones History/Background:
44 years old
Type 1 Diabetes Mellitus for 20 years at 24
First 10 years - overweight and never exercised, didn't change her lifestyle
Diagnosed with high blood pressure, made her change her lifestyle
Changed eating habits, exercises regularly lost 25 pounds
normal blood pressure now Mother of three Jordan Jones Emily Jones Sarah Jones 14 years old
high school freshman 20 years old
junior at local community college 17 years old
junior at high school
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