Symptoms Begin

In mid-to-late August, as the summer is coming to an end, some Dunnit residents begin experiencing a variety of gastrointestinal (GI) illnesses. Their symptoms include watery diarrhea, foul smelling stool, abdominal pain and distension, and anorexia.

Some of these residents visit their healthcare provider and get treated for their symptoms. While these symptoms can be attributed to a variety of ailments, let's consider four diseases.

  1. Campylobacteriosis
  2. Cryptosporidiosis
  3. Giardiasis
  4. Salmonella (non-typhoid)

Read the Guide then answer these questions.

 

First Confirmed Case

The first confirmed case of Giardiasis (a young child named Benson Peppers) is reported to the Dunnit LBOH on September 16. (Remember, residents of Dunnit began experiencing GI illnesses in mid-to-late August.)

Is this delay between symptom initiation and reporting unusual?

No. Many healthcare providers treat the GI symptoms and may not routinely order stool sample analysis. If an analysis is done, the Guide states: Report laboratory-confirmed cases, defined as the detection of Giardia organisms, antigen, or DNA in stool, intestinal fluid, tissue samples, biopsy specimens, or other biological samples.

The laboratory test results submitted to the LBOH in Dunnit detected Giardia organisms.

 

Open the Giardiasis chapter in the Guide, and use Section 3 (Reporting Responsibilities and Case Investigation) to answer the following question.

 

 

Case Investigation

 

What is MAVEN?

MAVEN (Massachusetts Virtual Epidemiologic Network) is a secure web-based surveillance and case management system for infectious diseases that enables rapid, efficient communication between local and state health departments and laboratories.

 

After receiving the first confirmed case, a young child, you log in to MAVEN to start your required reporting to MDPH.

You use the MAVEN packages to guide your investigation (demographics, clinical, and risk exposure/control & prevention). You also schedule an interview with the mother of Benson Peppers (the young child who was confirmed to have Giardiasis).

 

Case Interview

Watch the case interview concerning Benson Peppers.

 

Additional Notes from the Interview

  • Benson lives with his mother, father, and two siblings (ages 5 and 7), none of which experienced GI illness symptoms.
  • The Peppers' home in Dunnit is supplied with municipal water, which is their primary source of drinking water.
  • Benson often goes to Dunnit Square Park or Dunnit East Side Park after he gets out of daycare.
  • The Peppers family took a vacation to Martha's Vineyard the last week in July. They swam in the ocean and ate at three restaurants: Best of Atlantic, Vineyard Sandwich Cafe, and Wicked Ice Cream.
  • Benson attended two birthday parties over the summer - one on July 17 for James Oliver at the Oliver home that included a BBQ and swimming (Benson did not swim, but he did eat the BBQ); and another on August 12 for Taylor Smith that included eating cake and ice cream, and splashing in the sprinkler.