Title : Universal Epidemic Outbreak Questionnaire
Abstract:
Epidemic outbreaks are a part of population and public health. The epidemiological triad of host, agent and environment are changing in their interaction with each other in recent years. Urbanization and deforestation cause closer contact with animal host, insect vectors and higher contaminations possibility. More localized epidemics are being observed around the world caused by a wide variety of organisms and chemicals. Some known viruses are being established in new geographical areas and new viruses are being discovered. Newer biological and chemical agents are continually being added to our environment with potential for acute or subacute epidemics. Acute chemical effects are found early, though most are subacute presentation and hence establishing causality takes time. As health care professionals lack training and time to assess risk factors of epidemic, important information about epidemic source identification (ESI) is missed. ESI is important to decrease disease burden. Irrespective of the logistics in epidemic detection, there is an immense contribution by reporting delays on population health. The reporting delay could be medical, administrative or socioeconomic. A good surveillance system is timely, sensitive, specific with readily interpretable output. These factors should motivate us to draft and implement an accessible universal epidemic outbreak questionnaire (UEOQ) with a good online database for ESI. We have tried to formulate UEOQ that may be used by providers if they suspect unusual occurrence of cluster of cases. Some of the questions have been adapted from the previous ‘Food- and waterborne disease outbreak investigation questionnaire tool repository with European Centre for Disease Prevention and Control’ with approval and attribution. This tool helps us to locate the source for food and water borne diseases. We have tried to improvise this tool to identify epidemics caused by air and dermal exposures. An optimal UEOQ should include detailed food, water, air, dermal exposure evaluation with chemical and work exposure. These factors are especially important if the disease-causing agent is unknown. Additionally, a short consent may be added for sample banking. Limitation for UEOQ is the time spent in form completion. An ideal form should be worded at fifth grade reading level with minimal necessary medical language to facilitate form completion by a patient solely or with some assistance from health care personnel. Validation of these questions is crucial. A pre-drafted Google forms database has been created for UEOQ to automatically translate to systematic data for effortless and timely data analysis. Patient identifier section is removed for possible data sharing. UEOQ could be retained as a part of patient’s medical records and the database entry is optional. The Google form database version could be obtained by writing to the corresponding author. Thus, health professionals and insurance companies could improve in-built surveillance system to alert epidemic outbreaks with immediate access to data, knowledge sharing and expert advice in epidemiology in a Health Insurance Portability and Accountability Act (HIPAA) compliant way to prevent epidemic related disease burden. In summary, UEOQ may act as an adjunct tool for early ESI for mitigating its effect on public health.
What will audience learn from your presentation?
- The audience would learn about epidemics with its types, causes, barriers to identification
- The audience if suspect cluster of cases, unusual cases could use the universal epidemic questionnaire (available at no cost through PubMed) to get detailed exposure history. This cold be retained with patient records. And could be analyzed further if needed with an online google form-based database.
- This would lead to possibly earlier epidemic source identification with decrease disease burden.
