More Cases Get Reported

By the end of September, five more Giardiasis cases are reported to the Dunnit LBOH.

You have been the public health nurse in Dunnit for many years, and when you review your records, you see that in the previous calendar year, a total of six Giardiasis cases were reported to the LBOH in Dunnit.

 

Excerpt from Section 4 of the Guide - Reported Incidence Is Higher Than Usual/Outbreak Suspected

If the number of reported cases of Giardiasis in your city/town is higher than usual, or if you suspect an outbreak, investigate to determine the source of infection and the mode of transmission. A common vehicle (e.g., water, food, or association with a daycare center) should be sought, and applicable preventive or control measures should be instituted (e.g., removing an implicated food item from the environment).

Control of person-to-person transmission requires special emphasis on personal cleanliness and sanitary disposal of feces. Consult with the epidemiologist on-call at the MDPH Division of Epidemiology and Immunization at (617) 983-6800. MDPH epidemiologists can help determine a course of action to prevent further cases and can perform surveillance for cases across town lines, which would otherwise be difficult to identify at the local level.

As you interview the confirmed cases, you should try to identify a common vehicle.

Questions to ask yourself include:

  • Are the cases the same age, gender, race?
  • Do the cases live near each other or go to the same school or daycare?
  • Do the cases visit the same parks, clubs, or restaurants?
  • Do the cases have friends or parties in common?
  • Where do the cases get their drinking water from?

Controlling Further Spread

At the same time you're conducting your case investigations, you must also work to control further spread of the disease. This will take a coordinated effort from not only the Dunnit LBOH, but also from other town agencies, community partners, and MDPH.

Depending on the number and location of the reported cases, LBOH from other towns may have to get involved. In cases of large outbreaks, MDPH can also ask for assistance from the CDC.