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The decision to investigate is influenced by… • morbidity / mortality • unusual presentation – rare disease, change in pattern, new disease Control - prevent additional cases; prevention – prevent future outbreaks Research opportunities – identify new risk factors; define natural history and spectrum of the disease; measure impact of control measures or clinical interventions; etc. Program considerations – an outbreak may represent a failure or gap in public health program. Need to investigate to determine why. Public / political / legal concern – health department needs to be “responsibly responsive” Training – important that inexperienced epidemiologist accompanies senior epidemiologist to gain experience and feel more comfortable conducting an investigation the next time. |