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‘æ1ƒZƒbƒVƒ‡ƒ“FNo. 4

Risk Management of Communicable Diseases: Field lnvestigations
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Michael H. Kramer, MD, MPH
CDC Consultant to FETP Japan


@The primary goal of an outbreak investigation is to control the outbreak and to establish prevention measures. For an ongoing outbreak, the investigation should start as soon as possible and may include site and procedural investigations, laboratory analyses (patient and environment), and epidemiologic studies. Before the initiation of the investigation, it is essential that the outbreak team establish good working relationships with all parties involved (e.g., public health officials, clinicians, affected populations, representatives from the institutions were the outbreak occurred). After identification of the mode of transmission and the mode of contamination of the implicated vehicle, as well as persons at risk for infection, the findings need to be disseminated in a timely and appropriate fashion to allow for a targeted intervention (e.g., elimination of the source of the outbreak, protection of persons at risk in the outbreak or in other populations). The effectiveness of the established control and prevention measures needs to be assessed by surveillance. In some cases, it also should be evaluated whether the existing laws, regulations, or standard procedures were adequately applied at the implicated sites (e.g., hospital, restaurant) or the supervising agency (e.g., health department), and whether a newly identified problem necessitates modifications of these regulations or standard practices.

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