Course: Outbreak Investigation

Outbreak Investigation

Outbreak Investigation
Outbreak Investigation Home Page
This course on Outbreak Investigation provides an introduction to the basic principles and steps involved in investigating and managing infectious disease outbreaks. All components of this training are free, including registration, learning, testing, and a certificate of completion. This course is intended for undergraduate and graduate-level students of medicine, environmental sciences or public health.
The Outbreak Investigation course is co-sponsored by the University of the Incarnate Word and sponsored in part by the Annenberg Physician Training Program. Like all NextGenU courses, it is competency-based, using competencies from the ASPHER’s European List of Core Competencies for the Public Health Professional and the Public Health Emergency Preparedness Core Competencies for EU Member States. This course uses learning resources from world-class academic and governmental organizations such as National Center for Biotechnology Information, the U.S. Centers for Disease Control and Prevention, the European Centre for Disease Prevention and Control, and Cambridge University Press. The course developers are Professor Dick Heller, MB BS MD FRCP FFPH FRACP FAFPHM; Hugo Andres Rojas Aldieri MD, MSc; and Valeria Reynolds, MD.

A special thanks to the Skills Online Programme of the Public Health Agency of Canada where this course first appeared, and was then used by Peoples-Uni. In 2020, the course was donated to NextGenU.org and underwent revision and restructuring with new modules, learning resources, and assessments.
For a publication on this course’s efficacy, see “A Novel Integration of Online and Flipped Classroom Instructional Models in Public Health Higher Education,” (2014), BMC Medical Education, https://doi.org/10.1186/1472-6920-14-181; see also “Building Public Health Capacity through Online Global Learning,” (2018), Open Praxis, to see more research related to NextGenU.org’s educational model, have a look at NextGenU.org’s publication page.
There are 4 modules to complete, which provide:
A basic introduction to the goal, objectives and steps of an outbreak investigation;

An overview on descriptive and analytical epidemiology;

Skills to conduct an Outbreak Investigation.
The completion time for this course is estimated at 16 hours: 4 hours of didactics and curated resources and 12 hours of work studying the resources and participating in activities to assist the student in synthesizing the materials.

You’ll need to connect with a mentor with professional health care training who has both a Master of Public Health (MPH), and epidemiological experience (or their equivalent) to guide your addressing mentor-requiring competencies if you decide to engage with this course’s mentored activity. The mentored activity is required for those aiming to fulfill the Public Health Emergency Preparedness Core Competencies for EU Member States oriented for public health epidemiologists, public health microbiologists, and NFP for preparedness. We hope this is a wonderful learning experience for you, and the feedback you provide after completing the course will help us improve the course for future students.

The course requires completion of all case studies and peer activities. At the end of each lesson, there is a practice quiz. At the end of the course, after you’ve completed each lesson, quiz, and activity, you’ll have access to a final exam, and a chance to evaluate this course. Once you’ve passed that last test, you will be able to download a certificate of completion from NextGenU.org and our course’s co-sponsoring organizations (listed above). We keep all of your personal information confidential, never sell any of your information, and only use anonymized data for research purposes, and we are also happy to report your testing information and share your work with anyone (your school, employer, etc.) at your request.

Engaging with this Course:

You may browse this course for free to learn for your personal enrichment; there are no requirements. To register in this course, it is required that learners have obtained a college-level/bachelor's degree.

To obtain a certificate a learner must successfully complete
- all the reading requirements,
- all quizzes and pass with a 70% with unlimited attempts,
- all case studies,
- the peer activity,
- the final exam with a minimum of 70% and a maximum of 3 attempts, and
- the self and course evaluation forms.
To obtain credit
- complete all requirements listed above for the certificate, and
- your learning institution or workplace should approve the partner-university-sponsored NextGenU.org course for educational credit, as they would for their learner taking a course anywhere.
NextGenU.org is happy to provide your institution with
- a link to and description of the course training, so they can see all its components, including the cosponsoring universities and other professional organization cosponsors;
- your grade on the final exam;
- your work products (e.g. case study activities), and any other required or optional shared materials that you produce and authorize to share with them;
- your evaluations -- course, and self assessments;
- a copy of your certificate of completion, with the co-sponsoring universities and other organizations listed.
To obtain a degree, NextGenU.org co-sponsors degree programs with institutional partners. To obtain a full degree co-sponsored with NextGenU.org, registrants must be enrolled in a degree program as a student of a NextGenU.org institutional partner. If you think that your institution might be interested in offering a degree with NextGenU.org contact us.

We hope that you will find this a rewarding learning experience, and we count on your assessment and feedback to help us improve this training for future students.

Here are the next steps to take the course for credit.
- Complete the registration form.
- Take the pre-test.
- Begin the course with Module 1: Introduction to Outbreak Investigation. In each lesson, read the description, complete all required readings and any required activity, and take the corresponding quizzes.
^{This course was first developed by Skills Online from the PHAC, then adapted by Peoples-uni, then revised by NextGenU.}
Module 1: Introduction to Outbreak Investigation
Competencies covered in this module
- The public health professional shall know and understand basic demographic and epidemiological aspects.
- Understand international disease reporting requirements.
- The public health professional shall know and understand the contested nature of definitions, models and concepts of health and disease.
- Be familiar with the steps of an outbreak investigation.
Click here for a brief module introduction
- This module will focus on key terms and fundamental knowledge needed to understand outbreak investigations.
  Acquiring an infection or a disease - as well as the occurrence of an outbreak - results from a complex interaction between the host, the agent and the environment. Understanding this chain of infection is one of the goals of this lesson. It is also crucial to understand how initiating an investigation early in an outbreak, prior to the disease becoming widespread, can help guide control measures that will reduce the effect of the disease on vulnerable people. The purpose of an outbreak investigation is to determine the necessary measures to control (in the short term) and prevent (in the long term) a health problem that is generally acute. This lesson also covers operational objectives of an outbreak investigation. Finally, there are enormous financial and legal considerations of outbreaks of disease, not only for those affected by the disease, but also as a result of the investigation process itself.
  Please note that the steps for Outbreak Investigation may vary slightly between resources. For the purpose of this training, the steps used are from Principles of Epidemiology in Public Health Practice, Third Edition. An Introduction to Applied Epidemiology and Biostatistics by the U.S. Centers for Disease Control and Prevention.
Module 1: Lesson 1: Introduction
Learning objectives:
- Remember basic demographic and epidemiological aspects.
- Explain the International Disease Reporting requirements.
- Discuss the contested nature of models and concepts of health and disease
- Discuss the steps of an outbreak investigation.
Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour and 53 minutes

Click here to start this lesson
13 URLs, 1 Page, 1 Forum, 1 Quiz
- Required Learning Resources and Activities
- Basic Epidemiological Definitions URL
  This book on Principles of Epidemiology in Public Health Practice from the CDC will provide you with basic epidemiological definitions to understand the principles of Outbreak Investigation.
  Read Section 1 pages 2-3, and Section 1 pages 72-73
- Cluster Investigations of Non-Infectious Health Events URL
  This article provides an overview of the definition of Cluster and how to perform Cluster investigation.
  Read pages 1, 2 and 3 until section Step 1: Initial ascertainment of cluster
- International Health Regulations (IHR) URL
  Read the IHR coordinated by the World Health Organization (WHO) that aims to keep the world informed about public health risks and events.
- Deciding whether to investigate a possible outbreak URL
  Read the section on Deciding whether to investigate a possible outbreak
- Natural History and Spectrum of Disease URL
  This book on Principles of Epidemiology in Public Health Practice from the CDC will help you understand the natural history of disease.
  Read Section 1 pages 52-68
- Steps in an outbreak investigation Page
- Forum: Reflect on the Outbreak response plan from your city/country
  Reflect on your country/region outbreak response plan. Please describe in less than 150 words the following:
  Whether your jurisdiction's plan is specific to one pathogen or is general for any outbreak.
  
  Is the identification of roles and responsibilities clear?.
  
  Does your jurisdiction's plan comply with International Health Regulations?
  To post your response click on the button at the bottom of the screen labeled 'Add a new discussion topic.'
  You will also need to comment on at least one other post made by your peers in a respectful and professional manner. If a peer comments on your posting, please reply back. Tp post a reply, click on the particular discussion, then click on 'reply'.
  
  Note: If you cannot locate a plan for your own setting, see if you can use a different setting.
- Quiz: Module 1:Lesson 1
  To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.
- Additional Resources for Optional Learning
- Pandemics: Risks, Impacts, and Mitigation URL
  This book on Disease Control Priorities: Improving Health and Reducing Poverty will help you understand the main reasons to investigate an outbreak.
  Read pages 315-325
- WHO Disease Outbreak News and Weekly Epidemiological Report URL
  Reports of current verified outbreaks are included in the weekly WHO Disease Outbreak News. The Weekly Epidemiological report (WER) provides epidemiological information on cases and outbreaks of disease of public health importance.
- ProMed URL
  The global reporting system for outbreaks of emerging infectious diseases & toxins, open to all sources. ProMed- mail the Program Monitoring Emerging Diseases, is a program of the International Society for Infectious Diseases.
- U.S. FoodNet Population Survey data URL
  Useful resource from the U.S. Centers for Disease Control and Prevention for identifying food consumption patterns.
- Public Health Agency of Canada Surveillance URL
  Canadian government surveillance sistem of infectious and non infectious diseases.
- FluWatch URL
  FluWatch is Canada's national surveillance system that monitors the spread of flu and flu-like illnesses. FluWatch reports with information on flu activity in Canada are posted every Friday.
- Canada Communicable Disease Report (CCDR) Weekly URL
  The Canada Communicable Disease Report (CCDR) Weekly provides reports of national and international communicable disease issues and incidents.
- West Nile Surveillance Information URL
  Learn about the different types of surveillance for West Nile virus and the reported number of cases in humans.
Module 2: First Stages (Steps 1 to 4)
Competencies covered in this module
- Be familiar with the steps of an outbreak investigation
Module 2: Lesson 1: Prepare for Field Work - Step 1
Learning objectives:
- Identify the local officials, healthcare providers and other personnel who would assist in an outbreak investigation.
- Describe the roles of the various local officials, healthcare providers and other personnel who would assist in an outbreak investigation.
- Communicate the connection between roles of various local officials, healthcare providers, the investigators and other personnel contribute to the outbreak investigation.
- Discuss the limitations that legal and policy frameworks may create during an outbreak response.
- Identify the need for PPE and other safety procedures/equipment during an outbreak response.
- Communicate how an outbreak response relates to mobility restriction politics.
Approximate time required for the readings for this lesson (at 144 words/minute): 56 minutes

Click here to start this lesson
2 URLs, 1 Page, 1 Forum, 1 Interactive Component, 1 Quiz
- Required Learning Resources and Activities
- The outbreak management team URL
  
  The Field Epidemiology Manual Wiki from the European Centre for Disease Prevention and Control (ECDC).
  
  Read the entire section on The outbreak management team.
- Step 1 - Prepare for field work Page
  This brief resource explains the scientific and operational preparations that must be carried out to start an Outbreak Investigation.
- Regulations and Laws That May Apply During a Pandemic URL
  Read the entire resource to understand how regulations an laws relate to outbreak responses.
- Forum: Discuss Mobility Restriction Politics
  During COVID-19 outbreak, several mobility restriction politics have been applied all around the globe, discuss how epidemiological reports were related to mobility restriction politics in your region/country.
  Step 1: Analyze how mobility restriction politics in your region/country relate to epidemiological reports during COVID-19 outbreak, if your country/region did not apply mobility restrictions, you may use this resource and choose the mobility restriction politics from other country.
  Step 2: Write a 150 words paragraph with your discussion.
  Step 3: To post your response click on the button at the bottom of the screen labeled 'Add a new discussion topic.'
  Step 4: You will also need to comment on at least one other post made by your peers in a respectful and professional manner. If a peer comments on your posting, please reply back. Tp post a reply, click on the particular discussion, then click on 'reply'.
- Case study step 1 Interactive Component
  This interactive case study is divided into 12 sections that allow you to apply your knowledge of outbreak investigation. As you go through the course, you have the opportunity to complete the entire case study. To benign, click on the button, start the course and then click con proceed. Then, some text will appear on your screen, read the text carefully, and when you are ready, click proceed to solve a question that you need to answer correctly to continue. This process will repeat until you reach the final window of the activity. Once you have completed the activity then you can engage with the rest of the course.
- Quiz: Module 2:Lesson 1
  To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.
Module 2: Lesson 2: Establish the Existence of an Outbreak - Step 2
Learning objectives:
- Describe the importance of epidemiological characteristics in the identification of an outbreak.
- Summarize sources of exposure.
Approximate time required for the readings for this lesson (at 144 words/minute): 43 minutes

Click here to start this lesson
1 Page, 1 URL, 1 Interactive Component, 1 Quiz
- Required Learning Resources and Activities
- Step 2 - Establish the existence of an Outbreak Page
  This brief resource explains how outbreaks are recognized, and the role of surveillance in outbreak detection.
- Outbreaks in Health Care Settings URL
  
  This article refers to when clusters require investigation and how are pseudo-outbreaks recognized.
  
  Read the sections Approach to an Outbreak and Pseudo-outbreaks
- Step 2 of an Outbreak Investigation Interactive Component
  This interactive case study is divided into 12 sections that allow you to apply your knowledge of outbreak investigation. As you go through the course, you have the opportunity to complete the entire case study. To benign, click on the button, start the course and then click con proceed. Then, some text will appear on your screen, read the text carefully, and when you are ready, click proceed to solve a question that you need to answer correctly to continue. This process will repeat until you reach the final window of the activity. Once you have completed the activity then you can engage with the rest of the course.
- Quiz: Module 2:Lesson 2
  To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.
Module 2: Lesson 3: Verify the Diagnosis - Step 3
Learning objectives:
- Discuss main epidemiological characteristics of existing microorganisms with pandemic potential.
- Show learner how to use evidence-based measures to identify likely pathogens and transmission pathways.
Approximate time required for the readings for this lesson (at 144 words/minute): 13 minutes

Click here to start this lesson
1 Page, 1 Interactive Component, 1 Quiz
- Required Learning Resources and Activities
- Step 3 - Verify the Diagnosis Page
  This brief resource explains how to use clinical and laboratory features to confirm the diagnosis.
- Step 3: Case study Part 3 - outcomes Interactive Component
  This interactive case study is divided into 12 sections that allow you to apply your knowledge of outbreak investigation. As you go through the course, you have the opportunity to complete the entire case study. To benign, click on the button, start the course and then click con proceed. Then, some text will appear on your screen, read the text carefully, and when you are ready, click proceed to solve a question that you need to answer correctly to continue. This process will repeat until you reach the final window of the activity. Once you have completed the activity then you can engage with the rest of the course.
- Quiz: Module 2:Lesson 3
  To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.
Module 2: Lesson 4: Construct a Working Case Definition - Step 4
Learning objectives:
- Demonstrate how an outbreak is described in terms of person, place and time.
- Describe how the people affected in an outbreak and the time and place of an outbreak relate to the causes of and risk factors for an outbreak.
Approximate time required for the readings for this lesson (at 144 words/minute): 15 minutes

Click here to start this lesson
1 Page, 1 Interactive Component, 1 Quiz
- Required Learning Resources and Activities
- Step 4 - Construct a working case definition Page
  This brief resource explains the criteria to create an adequate case definition that includes clinical criteria, time, person and place.
- Step 4: Case study Part 4 - outcomes Interactive Component
  This interactive case study is divided into 12 sections that allow you to apply your knowledge of outbreak investigation. As you go through the course, you have the opportunity to complete the entire case study. To benign, click on the button, start the course and then click con proceed. Then, some text will appear on your screen, read the text carefully, and when you are ready, click proceed to solve a question that you need to answer correctly to continue. This process will repeat until you reach the final window of the activity. Once you have completed the activity then you can engage with the rest of the course.
- Quiz: Module 2:Lesson 4
  To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.
Module 3: Descriptive and Analytic Epidemiology (Steps 5 to 9)
Competencies covered in this module

Be familiar with the steps of an outbreak investigation.
Describe an outbreak in terms of person, place and time in order to generate hypothesis about its cause or risk factors.
Conduct case - control studies and other epidemiologic studies to test hypotheses regarding sources of exposure.
Conduct outbreak investigations to identify pathogens and other agents, characterise affected population groups, and sources of exposure.
Perform descriptive analysis of public health surveillance data
Generate hypothesis about the cause and/or risk factors of the outbreak.
Module 3: Lesson 1: Find Cases Systematically and Record Information - Step 5
Learning objectives:
- Discuss how affected persons are categorized into population groups based on predetermined characteristics.
- Explain public health surveillance data and its relation to descriptive analysis.
Approximate time required for the readings for this lesson (at 144 words/minute): 14 minutes

Click here to start this lesson
1 Page, 1 Interactive Component, 1 Quiz
- Required Learning Resources and Activities
- Step 5 - Find cases systematically and record information Page
  This brief resource explains how to create a line list to identify and track cases.
- Step 5: Case study Part 5 - outcomes Interactive Component
  This interactive case study is divided into 12 sections that allow you to apply your knowledge of outbreak investigation. As you go through the course, you have the opportunity to complete the entire case study. To benign, click on the button, start the course and then click con proceed. Then, some text will appear on your screen, read the text carefully, and when you are ready, click proceed to solve a question that you need to answer correctly to continue. This process will repeat until you reach the final window of the activity. Once you have completed the activity then you can engage with the rest of the course.
- Quiz: Module 3:Lesson 1
  To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.
Module 3: Lesson 2: Perform Descriptive Epidemiology - Step 6
Learning objectives:
- Describe how the people affected in an outbreak and the time and place of an outbreak relate to the causes of and risk factors for an outbreak.
- Provide examples of descriptive analysis of public health surveillance data.
Approximate time required for the readings for this lesson (at 144 words/minute): 28 minutes

Click here to start this lesson
1 URL, 1 Interactive Component, 1 Forum, 1 Quiz
- Required Learning Resources and Activities
- Step 6 - Perform descriptive epidemiology URL
  Read the entire section on Step 6: Perform descriptive epidemiology from the US Center for disease control and prevention.
- Step 6: Case study Part 6 - outcomes Interactive Component
  This interactive case study is divided into 12 sections that allow you to apply your knowledge of outbreak investigation. As you go through the course, you have the opportunity to complete the entire case study. To benign, click on the button, start the course and then click con proceed. Then, some text will appear on your screen, read the text carefully, and when you are ready, click proceed to solve a question that you need to answer correctly to continue. This process will repeat until you reach the final window of the activity. Once you have completed the activity then you can engage with the rest of the course.
- Discussion Forum: Variation by Personal Characteristics
  In this activity, you will assess the importance of considering personal characteristics while performing an outbreak investigation. You will also reflect on the potential implications of collecting personal information along with ways to avoid stigma and marginalization.
  Step 1: Reflect on the following: Sex and age are the most common host characteristics studied in an outbreak investigation. Given the example of a hepatitis B outbreak, which other personal characteristics would you study?
  Step 2: Read this article about substance use disorders and stigma. Which measures would you take to prevent stigmatization while collecting and evaluating information?
  Step 3: Prepare a 200 - 400 word piece of writing to summarize your reflections on steps 1 and 2.
  Step 4: To share your work, click on the “Reply” button under this post and paste your work in the “message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B. references are excluded from word counts).
  Step 5: To complete the activity, you will need to reply to at least two posts made by your peers in a respectful and professional manner. Be sure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “post to forum.”
- Quiz: Module 3:Lesson 2
  To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.
Module 3: Lesson 3: Develop Hypotheses - Step 7
Learning objectives:
- Demonstrate hypothesis development.
Approximate time required for the readings for this lesson (at 144 words/minute): 9 minutes
1 Page, 1 Interactive Component, 1 Quiz
- Required Learning Resources and Activities
- Step 7 - Develop hypotheses Page
  This brief resource explains how to develop a hypothesis.
- Step 7: Case study Part 7- outcomes Interactive Component
  This interactive case study is divided into 12 sections that allow you to apply your knowledge of outbreak investigation. As you go through the course, you have the opportunity to complete the entire case study. To benign, click on the button, start the course and then click con proceed. Then, some text will appear on your screen, read the text carefully, and when you are ready, click proceed to solve a question that you need to answer correctly to continue. This process will repeat until you reach the final window of the activity. Once you have completed the activity then you can engage with the rest of the course.
- Quiz: Module 3:Lesson 3
  To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.
- Additional Resources for Optional Learning
Module 3: Lesson 4: Evaluate Hypotheses Epidemiologically - Step 8
Learning objectives:
- Develop epidemiological studies to test hypotheses regarding sources of exposure.
Approximate time required for the readings for this lesson (at 144 words/minute): 31 minutes
Click here to start this lesson
1 URL, 1 Interactive Component, 1 Quiz
- Required Learning Resources and Activities
- Step 8 - Evaluate hypotheses epidemiologically URL
  Read the entire section on Step 8: Evaluate hypotheses epidemiologically from the US Center for disease control and prevention.
- Step 8: Case study Part 8- outcomes Interactive Component
  This interactive case study is divided into 12 sections that allow you to apply your knowledge of outbreak investigation. As you go through the course, you have the opportunity to complete the entire case study. To benign, click on the button, start the course and then click con proceed. Then, some text will appear on your screen, read the text carefully, and when you are ready, click proceed to solve a question that you need to answer correctly to continue. This process will repeat until you reach the final window of the activity. Once you have completed the activity then you can engage with the rest of the course.
- Quiz: Module 3:Lesson 4
  To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.
Module 3: Lesson 5: As Necessary, Reconsider, Refine, and Re-evaluate Hypotheses - Step 9
Learning objectives:
- Discuss the steps of an outbreak investigation.
Approximate time required for the readings for this lesson (at 144 words/minute): 12 minutes
Click here to start this lesson
1 URL, 1 Interactive Component, 1 Quiz
- Required Learning Resources and Activities
- Step 9: Reconsider, refine, and re-evaluate hypotheses URL
  Read the entire section on Step 9: Reconsider, refine, and re-evaluate hypotheses from the US Center for disease control and prevention.
- Step 9: Case study Part 9 Interactive Component
  This interactive case study is divided into 12 sections that allow you to apply your knowledge of outbreak investigation. As you go through the course, you have the opportunity to complete the entire case study. To benign, click on the button, start the course and then click con proceed. Then, some text will appear on your screen, read the text carefully, and when you are ready, click proceed to solve a question that you need to answer correctly to continue. This process will repeat until you reach the final window of the activity. Once you have completed the activity then you can engage with the rest of the course.
- Quiz: Module 3:Lesson 5
  To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.
Module 4: Control, Surveillance and Communication (Steps 10-13)
Module 4: Lesson 1: Compare and Reconcile with Laboratory and Environmental Studies - Step 10
Learning objectives:
- Discuss the steps of an outbreak investigation.
Approximate time required for the readings for this lesson (at 144 words/minute): 6 minutes
Click here to start this lesson
1 URL, 1 Interactive Component, 1 Quiz
- Required Learning Resources and Activities
- Step 10: Compare and reconcile with laboratory and environmental studies URL
  Read the entire section on Step 10: Compare and reconcile with laboratory and environmental studies from the US Center for disease control and prevention.
- Step 10: Case study Part 10 Interactive Component
  This interactive case study is divided into 12 sections that allow you to apply your knowledge of outbreak investigation. As you go through the course, you have the opportunity to complete the entire case study. To benign, click on the button, start the course and then click con proceed. Then, some text will appear on your screen, read the text carefully, and when you are ready, click proceed to solve a question that you need to answer correctly to continue. This process will repeat until you reach the final window of the activity. Once you have completed the activity then you can engage with the rest of the course.
- Quiz: Module 4:Lesson 1
  To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.
Module 4: Lesson 2: Implement Control and Prevention Measures - Step 11
Learning objectives:
- Summarize the evidence that influences policy during an outbreak.
- Connect how evidence influences policy development and change.
- Present the methods used to identify preventative measures to control an outbreak.
- Explain how evidence based methods influence outbreak control and preventative measures.
Approximate time required for the readings for this lesson (at 144 words/minute): 12 minutes

Click here to start this lesson
3 URLs, 1 Interactive Component, 1 Quiz, 1 SCORM package
- Required Learning Resources and Activities
- Step 11 - Implement control and prevention measures URL
  This Guidelines for the Investigation and Control of Disease Outbreaks from the Institute of Environmental Science and Research will teach you how to approach control measures during an outbreak
  Read Section: Outbreak control measures from pages 86-88
- Medical Consequences of Drug Abuse and Co-occurring Infections URL
  Read the content under the headings "Abstract" "Medical Consequences: Brief Review and Research at NIDA" "Psychiatric Conditions Complicating Hepatitis C", and "Drug Interactions"
- Outbreak investigation of needle sharing-induced malaria, Ahvaz, Iran URL
  Read the entire article
- Step 11: Case study Part 11-outcomes Interactive Component
  This interactive case study is divided into 12 sections that allow you to apply your knowledge of outbreak investigation. As you go through the course, you have the opportunity to complete the entire case study. To benign, click on the button, start the course and then click con proceed. Then, some text will appear on your screen, read the text carefully, and when you are ready, click proceed to solve a question that you need to answer correctly to continue. This process will repeat until you reach the final window of the activity. Once you have completed the activity then you can engage with the rest of the course.
- Quiz: Module 4: Lesson 2
  To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.
- Quiz 2 Module 4: Lesson 2 SCORM package
  To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.
Module 4: Lesson 3: Initiate or Maintain Surveillance - Step 12
Learning objectives:
- Explain the components of a surveillance system and how they are utilized to detect public health threats.
Approximate time required for the readings for this lesson (at 144 words/minute): 29 minutes

Click here to start this lesson
1 URL, 1 Page, 1 Interactive Component, 1 Quiz
- Required Learning Resources and Activities
- Step 12: Initiate or Maintain Surveillance URL
  This Guidelines for the Investigation and Control of Disease Outbreaks from the Institute of Environmental Science and Research will provide you a brief summary on how surveillance systems are used during outbreaks
  Read Section: Surveillance to detect outbreaks from pages 19-22
- Data collection Page
  To perform active surveillance, you will need to be familiar with data collection techniques, this resource will provide you with templates and an example on data collection.
- Step 12: Case study Part 12-outcomes Interactive Component
  This interactive case study is divided into 12 sections that allow you to apply your knowledge of outbreak investigation. As you go through the course, you have the opportunity to complete the entire case study. To benign, click on the button, start the course and then click con proceed. Then, some text will appear on your screen, read the text carefully, and when you are ready, click proceed to solve a question that you need to answer correctly to continue. This process will repeat until you reach the final window of the activity. Once you have completed the activity then you can engage with the rest of the course.
- Quiz: Module 4:Lesson 3
  To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.
Module 4: Lesson 4: Communicate Findings - Step 13
Learning objectives:
- Explain how the components of outbreak investigation are communicated in a report.
- Evaluate the applicability of the outbreak investigation process in your settings.
Approximate time required for the readings for this lesson (at 144 words/minute): 8 hour and 51 minutes

Click here to start this lesson
1 Page, 2 Forums, 1 Quiz
- Required Learning Resources and Activities
- 13. Communicate findings Page
  This short resource will provide you with information regarding the contents of a final report.
- Forum: Reflection on the case study
  In this activity, you will reflect on the case study you followed along the course.
  Step 1: Read and address the following questions plus any other you may have:
  In your opinion, is your work unit able to assemble an outbreak investigation team on short notice?
  Was the outbreak in the case study appropriately managed? Explain your answer
  How important is it to have an interdisciplinary team managing an outbreak investigation?
  Step 2: Answer the questions provided in step 1 in 200 to 500 words.
  Step 3: Submit your assignment for peer review by clicking “add a new discussion topic” below and completing the fields.
  Step 4: Review the work of one of your peers by asking yourself the questions listed below and comment on their post stating that their post meets these requirements.
  Did my peer detail the ability of their work unit to assemble an outbreak investigation team?
  Did my peer provide an overview of the management of the case study provided along the course?
  Did my peer explain the importance of having an interdisciplinary team to manage an outbreak?
  Did my peer address the questions on 200 to 500 words?
- Peer Activity: Write an Outbreak Investigation report (Step 13) Forum
  
  In this activity, you will apply your knowledge acquired along the course by performing the 13th step of an Outbreak Investigation, writing a report.
  Step 1: Read the following recap of the case:
  
  On September 19, 2015, the director of a nursing home with 169 residents in Nowhereville called the regional public health office because a number of its staff and residents were experiencing bloody diarrhea. The first case was noted on September 9th, 2015, and was followed within the next few days by approximately 50 ill residents. By September 18th, the causative organism had been identified as E. coli O157: H7. In the previous month, no cases of E. coli O157: H7 had been identified in the nursing home. However, 6 residents had complained of loose stools. In the previous 12 months, 3 cases of E. coli O157: H7 had been reported from among the residents of this institution.
  
  The hypothesis has been designed and reevaluated from: One of the meals served at the nursing home in early September that may have been contaminated, causing the outbreak. However, it is not clear which meal(s) or which food item(s) may have been implicated. To: The outbreak has been linked to eating ham sandwiches from the cafeteria and then later to person to person transmission.
  
  Team members met with the nursing home's administrator and learned about possible sources or unusual happenings before or at the time of the outbreak. They learned that on September 2, a special party was held for nursing home residents and their families. Also, the institution's kitchen had been under construction for some weeks prior to the outbreak and the residents had been fed from a temporary kitchen. On September 5th cooking activities were transferred back to the usual location. This produced considerable disruption, including several episodes when the water was disconnected. In addition, one of the kitchen staff had reported having diarrhea in early September. Immediate and long term control measures have been implemented.
  
  Step 2: Read this webpage from the ECDC and identify the information you need to write your report, then go back to the course case study activities to collect all the needed information.
  
  Step 3: Write a short Outbreak Investigation Report. Your assignment must have between 800 to 1000 words and contain the following steps:
  
  Summary
  
  Introduction and Background
  
  Methods
  
  Results
  
  Discussion
  
  Recommendations
  
  Step 4: Include your report in a document and submit your assignment for peer review by clicking “add a new discussion topic” below and completing the fields. Make sure to upload the document that contains your work, do NOT paste your work in the Description box.
  
  Step 5: Review a peer’s report and evaluate it based on the reflection questions listed below.
  
  Did my peer follow the proper structure of an Outbreak Investigation report?
  
  Did my peer include the 6 steps of an Outbreak Investigation report?
  
  Is the report grammatically correct, clear, concise, and professionally written?
  
  Did my peer assignment have a minimum of 800 words?
- Quiz: Module 4:Lesson 4
  To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.
Mentored Activity: Case Study
Competencies covered in this module:
- Conduct outbreak investigations to identify pathogens and other agents, characterise affected population groups, and sources of exposure.
This mentored activity is required for those aiming to fulfill the Public Health Emergency Preparedness Core Competencies for EU Member States oriented for public health epidemiologists, public health microbiologists, and NFP for preparedness. To complete this activity, you will need to identify a mentor with professional health care training who has both a bachelor’s/college degree, a Master of Public Health(MPH), and epidemiological experience or equivalent to assist you.

Click here to start this activity
1 Assignment
- Mentored Activity: Outbreak Investigation Assignment
  In this activity, you will apply your knowledge acquired through the course to carry out an outbreak investigation.
  You will find detailed instructions to complete this activity in the link below. Once you have finished, upload your work and ask your mentor to grade your work.
  https://docs.google.com/document/d/18HzPo9ns5vcvnXB5Ls8-BB7Oho_jj7vHnuB2_yPm9vY/edit
Final Exam

Click here to start the Final Examination
- Final Exam Quiz
  Restricted Not available unless any of:
  All of:
  You belong to Miami Med
  The activity Registration Form is marked complete
  The activity Pre-Test is marked complete
  All of:
  All of:
  The activity Pre-Test is marked complete
  The activity Registration Form is marked complete
  The activity Quiz: Module 1:Lesson 1 is marked complete
  The activity Quiz: Module 2:Lesson 1 is marked complete
  The activity Quiz: Module 2:Lesson 2 is marked complete
  The activity Quiz: Module 2:Lesson 3 is marked complete
  The activity Quiz: Module 2:Lesson 4 is marked complete
  The activity Quiz: Module 3:Lesson 1 is marked complete
  The activity Quiz: Module 3:Lesson 2 is marked complete
  The activity Quiz: Module 3:Lesson 3 is marked complete
  The activity Quiz: Module 3:Lesson 4 is marked complete
  The activity Quiz: Module 3:Lesson 5 is marked complete
  The activity Quiz: Module 4:Lesson 1 is marked complete
  The activity Quiz: Module 4: Lesson 2 is marked complete
  The activity Quiz 2 Module 4: Lesson 2 is marked complete
  The activity Quiz: Module 4:Lesson 3 is marked complete
  The activity Quiz: Module 4:Lesson 4 is marked complete
  All of:
  The activity Forum: Reflect on the Outbreak response plan from your city/country is marked complete
  The activity Forum: Discuss Mobility Restriction Politics is marked complete
  The activity Discussion Forum: Variation by Personal Characteristics is marked complete
  The activity Peer Activity: Write an Outbreak Investigation report (Step 13) is marked complete
  The activity Mentored Activity: Outbreak Investigation is marked complete
  
  To take the final exam, you must complete all quizzes and complete all the required activities. The final exam consists of 28 questions, and you will have 28 minutes to complete it. When the time is over, you will have two minutes to submit your attempt before it expires, and your progress is discarded. You will not be able to answer additional questions in the grace period.
  To access the exam, click on the name of the exam provided above. On the following screen, click the attempt quiz button to respond to the questions.
Course and Self Evaluation & Certificate

In this section, you can provide feedback about this course to help us make NextGenU.org better. Once evaluations are completed, you will be able to download your certificate of completion.

Click here give your feedback
- Course Evaluation Questionnaire
  Restricted Not available unless: The activity Final Exam is complete and passed
  Please help us make NextGenU.org courses even better by submitting this evaluation. Your evaluation is confidential and used only for improving our trainings.
- Self Evaluation Questionnaire
  Restricted Not available unless: The activity Final Exam is complete and passed
  Please take the time to reflect on how you would evaluate yourself as a learner.

Learning objectives:

Required Learning Resources and Activities

Additional Resources for Optional Learning

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Competencies covered in this module: