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Ebola, first appeared on the map in 1976 in the Democratic Republic of Congo (DRC). Identified as a deadly zoonotic disease. Ebola spreads to humans through contact with bodily fluids and tissues of infected animals after which transmission can occur human-to-human via the same mode of transmission (direct contact with bodily fluids). What started with two cases in the Bikoro region in May of 2018 turned into the 9th Ebola outbreak since 1976 which lasted from May 2018 to July 2018 and resulted in 54 cases and 33 deaths. 

Continue reading “Ebola Outbreak in the Democratic Republic of Congo: A Case Study by Alyson Marcinkowski”

The Christchurch Mosque shooting of March 15, 2019 catalyzed New Zealand’s gun law reform and increased scrutiny surrounding the use of social media as a primary source of information following this tragic event. As Alnsour describes in a recount of the events, White supremacist Brenton Harrison Tarrant began his attack on Al Noor Mosque, shooting at about 190 worshippers before driving to the Linwood Mosque to continue his rampage on another 100 worshippers. Tarrant killed 51 people with the use of 5 different guns, all of which he had legally purchased before he was arrested by the police.

Continue reading “New Zealand Christchurch Mosque Shootings: A Case Study by Sabaa Alnsour”

On April 20, 2010, an explosion at the Deepwater Horizon oil rig off the coast of Louisiana killed 11 workers, injured 17, and leaked 210 million gallons of oil into the Gulf of Mexico. It took four days to understand the scale of the explosion and to identify the leak, and it took about a month for the leak to be sealed following many unsuccessful attempts by BP. While the well was declared “effectively dead” at the time, reports conducted in 2012 found the well active and still leaking two years later. This event led to over 100 civil and criminal lawsuits against BP and other defendants responsible for the incident, which ended in more than $65 billion in costs for cleanup, charges, and penalties. 

Rebecca Payne goes into great detail discussing this case from a public health standpoint. In this case study, Payne explains the epidemiological aspects of the case with a specific focus on the human health implications. Following the spill, the oil rig workers reported physical symptoms ranging from throat irritation to rectal bleeding to miscarriages as well as mental health symptoms including depression and Post Traumatic Stress Disorder (PTSD). Payne also discusses the management surrounding the clean-up of the Deepwater Horizon Oil Spill (DHOS) which proved to not only be expensive but also controversial. The use of dispersants to contain the spread failed while simultaneously resulting in major destruction to the marine wildlife and underwater ecosystem. These efforts appear to also have been mishandled by BP who failed to provide proper Personal Protective Equipment (PPE) and safety training for the clean-up crew, despite orders from Occupational Safety and Health Administration (OSHA). 

Overall, as Payne explains, communication was poor and inefficient as both BP and the federal government under President Obama’s leadership failed to act in a timely manner, confirming that there are many lessons to be learned from this case. Payne explains that so long as the world continues to rely on petroleum, there will continue to be oil spills. However, the DHOS can serve as a cautionary tale and pave the way for improvement in public health policy, response time, clean-up efforts, and PPE while mitigating the effects on the surrounding biological environment. 

Download the case study here.

On the night of November 7, 2018, 28-year-old Marine Corps veteran Ian David Long opened fire on the 259 patrons and employees of the Borderline Bar and Grill in Thousand Oaks, California with the sole purpose of targeting as many college students as possible. Over the course of 20 minutes, Long issued multiple attacks on the establishment using a .45-caliber handgun illegally fitted with a high capacity magazine, ending in the fatal shooting of 12 people before Long committed suicide. 

In this case study, author Maryam Razzaq discusses the epidemiological aspects and management of this fatal event as well as the communication involved between local law enforcement, the media, and the public. While an extensive epidemiological study has not been conducted, Razzaq discusses the details of a 2021 report released by the Ventura County Sheriff’s Office which describes Long’s potential motive, risk factors including his mental health, and eye-witness testimony. During the event, on-site command posts and off-site information centers were effective in coordinating operations and managing the influx of media and concerned family members safely. However, the first choice of placement of the command post was not appropriate and may have hindered early assessment of the scene and rapid deployment of resources. 

Razzaq also explains the utilization of social media before, during, and after the shooting as a conduit of real-time information while also describing the criticism faced by the Ventura County Sheriff’s office on their lack of transparency with the public during such a confusing and stressful situation. Overall, Razzaq stresses the importance of gun legislation reform as well the need to strengthen the public’s education and accessibility of the law as a preventative measure. 

Download the case study here. 

In 1984, the community of The Dalles, Oregon experienced a large-scale outbreak of Salmonella Typhimurium. This foodborne disease outbreak, which infected a total of 751 people, was eventually traced back to the salad bar of a local restaurant. However, as investigators continued to pursue this case to further understand the primary food source and gather more information on the pathogen, the investigation continued to turn up with inconsistent information due to the sporadic nature of the outbreak. Following an inconclusive environmental study, a criminal investigation was conducted to find that the Salmonella outbreak was an intentional act of terrorism conducted by the members of the Rajneeshpuram religious association to affect the voter turnout of an upcoming election.

In her case study, Khadija Akther discusses the epidemiological events that made up this case along with the management of the outbreak and communication of information between health officials and the public. The 751 patients were identified through passive surveillance and examination of stool samples for the sample pathogen, which helped investigators categorize the cases into three cohorts: case employees, case customers, and secondary cases. As Akther explains, many different agencies were involved in this case due to the inconsistencies in the identification of the outbreak source. Healthcare workers first reached out to the CDC to aid in the investigation but the case was eventually passed over to law enforcement.

While the Rajneeshpuram organization was identified as the culprit, the overall handling of the case faced many limitations and inefficiencies due to lack of proper management. Akther reports lack of communication and cooperative collaboration amongst the agencies involved leading to disorganization and delays in closing the case.

You can read more about the investigation and it’s implications on the future of foodborne outbreak surveillance in Akther’s case study found here.