Alert, response, and capacity building under the International Health Regulations (IHR)

Case studies

Case study 1: Collaboration between laboratory specialists and epidemiologists

Learning objectives

At the end of the exercise, the participants will be able to:

  • map out the kind of problems and misunderstanding that may arise between laboratory specialists and epidemiologists;
  • identify the determinants of these problems and misunderstandings;
  • propose solutions to improve the collaboration between the two groups.
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Case study 2: An Outbreak of Cholera, West Bengal, India

Learning objectives

At the end of the case study, the student will be able to:

  • understand the role of the laboratory in surveillance and outbreak detection;
  • identify the number of samples to take, and the transport media to use, during an outbreak of suspected cholera;
  • provide the minimum information needed to ensure appropriate laboratory testing;
  • take appropriate measures to prevent contamination and/or infection when collecting specimens to send to a laboratory;
  • identify the appropriate laboratory tests to request during an outbreak of diarrhoea;
  • understand the key elements of quality assurance for laboratories;
  • interpret Vibrio cholerae biotypes and serotypes;
  • understand the relevance of antibiotic susceptibility testing during the investigation of an outbreak of cholera;
  • decide whether environmental samples are needed during an outbreak of diarrhoea;
  • integrate epidemiological and laboratory data to formulate conclusions during cholera outbreak investigations.
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Case study 3: Salmonella in the Caribbean

Learning objectives

At the end of the case study, the participant will be able to:

  • understand the role of the laboratory in public health surveillance;
  • identify which samples to take and the transport media to use for the diagnosis of diarrheal diseases;
  • provide the minimum epidemiologic information needed to ensure appropriate testing by the laboratory;
  • identify the appropriate laboratory tests to request for the diagnosis of diarrheal diseases;
  • understand and implement personal protective measures when collecting and preparing specimens for transportation to a laboratory;
  • understand the key elements of quality assurance for laboratories;
  • understand typing techniques used to study the epidemiology of salmonellosis;
  • interpret Salmonella serotypes and phage types;
  • identify the role of non-human samples in an investigation of salmonellosis;
  • integrate epidemiological and laboratory data to formulate conclusions during an investigation.
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Case study 4: An outbreak with respiratory symptoms - SARS

Learning objectives
  • understand the importance of laboratory data for surveillance of respiratory pathogens and outbreak detection;
  • understand the limitations of laboratory data in surveillance and outbreak detection;
  • devise an optimal sampling strategy for the type and the number of samples to take during an outbreak of respiratory illness;
  • follow ethical guidelines and consider requirements for informed consent in patient sampling;
  • use personal protective measures to prevent infections when taking samples and preparing them for transport;
  • transport samples according to national and/or international regulations, as applicable;
  • identify the laboratory techniques that may be used to test specimens collected during a respiratory outbreak;
  • understand limitations of results of PCR and serology testing;
  • interpret phylogenetic trees to understand the spread of disease; origin and relatedness of the pathogen;
  • interpret laboratory data in context of epidemiological data in order to make recommendations for public health action.
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