John Thought About Explained for Students (Easy Guide)

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Original Question

John thought about this afternoon’s picnic. Everyone had a great time. For a while it had seemed almost too warm, but plenty of cold drinks were available, and by late afternoon it had become quite pleasant. The games were fun, too . . . Frisbee, soccer, softball, and volleyball. Then, there was the picnic itself—turkey, potato salad, bread and butter, milk, and dessert—served about noon. It was now 8 p.m. the next night, and instead of studying as he had planned, John was lying on his bed with a bad stomachache. He was experiencing severe diarrhea and had made several hurried trips to the bathroom in the last half-hour. John received a message from his roommate Michael. He had gone to his girlfriend’s house after the picnic to work on a class project with her. He and Caroline were both sick with stomach cramps and diarrhea, and Michael was wondering if John was sick, too. John began to think about what a coincidence it was that all three of them were sick with the same symptoms at about the same time. Could they have become ill from food they ate at the picnic? There were about 50 people at the picnic; how many others might also be sick? Was it the heat? Was it the food? Was this an epidemic? A half-hour later, John messaged Michael to tell him that he had decided to go to the campus health center. Elsewhere . . . This had turned out to be an interesting volunteer experience. As a requirement for her community health class, Kim had agreed to volunteer at the local health department. The spring semester was almost over now, and she was writing a final report of her activities. During the term, she had spent her Friday afternoons accompanying a sanitarian on his inspections of restaurants and retail food stores. She also had helped him complete his reports on substandard housing and malfunctioning septic tanks. Dr. Turner, the health officer, had given Kim permission to use one of the department’s computers for preparing her final report. Because it was late Sunday evening, she was alone in the health department office when the telephone rang. She briefly considered not answering it but finally picked up the receiver. It was Dr. Lee from the University Health Center. He said he was calling in the hope that someone might be there because he needed to reach Dr. Turner immediately. He said that he had admitted six students to the infirmary with severe stomach cramps, vomiting, and diarrhea. The students had been at a picnic the previous day, and he thought they could have a foodborne illness. He called to ask Dr. Turner to investigate this outbreak and asked Kim to try to reach him as soon as possible. Assume that you were Kim and you were able to reach Dr. Turner, the local health officer. He then asked whether you would like to help in the investigation of the foodborne outbreak mentioned in the scenario. You agreed to help. So far, you have learned that on Sunday, May 28, 49 people were at a picnic where they had eaten, beginning about noon. People began to report their illnesses later that night. Dr. Turner developed a foodborne outbreak investigation worksheet, which you helped to complete by making numerous phone calls and house visits with the public health nurse. The histories of people attending the picnic appear in Table 3.12. Using Table 3.13, the Epidemic Curve Tally Sheet, you tally the cases by hour of onset of illness. Using the results of the tally, you establish the incubation period—the range of hours (after the meal) over which symptoms started. Next, you prepare a graph to illustrate the epidemic curve of the outbreak. Try to answer the following questions: Questions: 1. What is the incubation period? 2. Does the curve you prepared suggest a single- or multiple-exposure epidemic? 3. Based solely on the incubation period, can you make a guess as to the cause of the outbreak? Unfortunately, by the time the investigation began, all the picnic food had been discarded, and no samples were available for laboratory testing. To determine which food at the picnic might have caused the outbreak, you need to calculate attack rates for people eating each food as well as for people not eating each food. Using Table 3.14, the Attack Rate Worksheet, calculate the attack rates for those who ate and did not eat each food served. TABLE 3.14 Attack Rate Worksheet Questions: 4. Which food would you most suspect of causing the illness? 5. Based on this information, what might the causative agent have been? 6. How could the internet be of assistance to health department officials in this situation?

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