Hi,
We are experiencing an outbreak of gastrointestinal illness in one of the largest prisons in our city. What methods would you suggest in investigating this outbreak and controlling it quickly?
thanks in advance
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The investigation of an outbreak in a closed facility like a prison, school or hospital, generally follows the same methodological framework as the outbreak investigation in a more open setting. What changes is the context in which you work and what logistical, security and feasibility constraints this might lay on the team.
The important point to remember is that as soon as you hear about a suspected outbreak, it is good to try and already start implementing some control measures (based on the limited information that you have) to reduce the number of new cases. In this case, a gastrointestinal disease could be linked to the consumption of contaminated food or water (as the most likely sources of infection). Your first point of action should therefore be to ensure that the water quality, food safety and environmental conditions of where food and water are distributed are adequate. As you get new information during your investigation, you can adjust these measures when and where relevant.
A lot has been written about the 10 steps of an outbreak investigation. Two useful sources of information and guidance are available here: Outbreak investigations 10 steps, 10 pitfalls and here: Principles of Epidemiology: Lesson 6, Section 2|Self-Study Course SS1978|CDC
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