Epidemiology, Incidence, and Prevalence

As a nursing practitioner, I have just been informed that there is a severe influenza outbreak in my community. The ten steps I would take to help in managing the outbreak are as follows:

Step 1: Conduct field work

I would organize with a team of public health officers and other relevant health practitioners to collect the necessary materials and other needed safety equipment and go to the ground to conduct investigations (Kane and Morley, 2017). The surveys would center on whether or not the said infectious disease is present. This preparation would involve getting experts to assess the area and the people in the community.

Step 2: Establish the existence of the outbreak

This step would involve finding out the nature of the infectious disease, the number of people who have already been infected, and the symptoms that they exhibit. Here I will also concentrate on the severity of the infection, the possibility of further spread, and the availability of any measures of control to prevent this (Kane and Morley, 2017). The step would also involve getting to the root cause of the disease. Also, this step would entail getting to know if the infectious disease is an outbreak or just a matter of a few cases.

Step 3: Verify the diagnosis

In this step, I would take measures to ensure that the infectious disease has been identified as being a severe case of influenza. It is an essential step because if any control measures are to be taken, we have to ensure that they are disease specific. This step is also crucial to enable us to rule out any errors in the lab tests as the foundation for the increased number of reported cases (Ungchusak and Iamsirithaworn, 2014). I would also have direct conversations with some of the infected people to develop a better understanding of the clinical symptoms of the affected patients. This move is critical because it will help me generate a hypothesis about the etiology of the disease and its spread.

Step 4: Construct a working case definition

In this step, I will decide whether the individuals should be categorized as having influenza. I will do this by classifying the patients according to their symptoms such as high fever, cough, running nose, watery eyes, blocked nose or headache. I will then restrict the patients by the person, time, and place (Ghebrehewet and Stewart, 2016). The criteria will be classified as ‘confirmed,’ ‘probable’ or ‘suspect.’ The confirmed cases will be the ones that have been established to have the infection through laboratory tests.

Step 5: Find cases systematically and record information

In this step, I will try to identify the data of the patients already affected such as the name, address, and contact information. I will also find demographic information such as age, occupation, and sex because this information is essential to characterize the population at risk. I will also find out about the clinical information such as the signs and symptoms, the onset date, duration of illness, and whether any form of medication, hospitalization, or death has occurred to characterize the illness’ spectrum. More important I will investigate the risk factor report such as what may make the people susceptible to the infection (Ghebrehewet and Stewart, 2016). I will consider past the past event that may have led to the disease.

Step 6:    Generate Hypothesis

This step is crucial because causes of the illness may already be suspected, but a formal hypothesis will be able to determine the most likely cause of the disease. This action will be made possible by obtaining microbiological results of the environmental samples and veterinary reports if necessary.

Step 7:    Analytical Epidemiology

In this step, I will investigate if the controls were appropriately selected to reduce bias of the results obtained. This step is also crucial in testing the hypothesis to determine its validity (Reingold, 2014). In the cohort study, I will include every person who has been potentially exposed and the relative risk and rate of attack.
Step 8:    Evaluate Control Measures

In this step, once the measures of control have been enforced, I will monitor incidences of the cases, and lab results which may be useful for continuous identification of the agent of infection in the cases. I will also watch the response to control measures or treatment if applicable.

Step 9:    Surveillance

This step will involve documenting how effective the control measures were and also enhance surveillance through healthcare providers and laboratories to monitor the progress of the treatment and patient responses.

Step 10: Implement Control Measures

Although there may have been immediate control measures implemented at the start of the outbreak, I will ensure that long term control measures are put in place to protect the people who have not been infected and to prevent future outbreaks from occurring. These control measures will be guided by environmental investigations as well as epidemiological results from the laboratories.


After the ten steps have all been implemented, I will communicate the findings with the relevant sources. For example, I will communicate with the local media stations or outlets about the progress that has been made to ensure that the people are feeling safe. I will also conduct an oral briefing with the local authorities informing them of the findings, the progress, and future recommendations (Reingold, 2014). I will also prepare a written report that abides by the legal, scientific format. This information will provide a blueprint for the measures taken and will also serve as a performance record and legal document for possible legal issues.

The training in avoiding epidemiological traps comes in handy in such an incident because it teaches on how to avoid mistakes during an outbreak investigation. One example of an epidemiological trap is bias in the process. In the case above, this trap was prevented by ensuring that all the controls were appropriately selected as this would reduce bias and ensure accurate results.



Ghebrehewet, S., & Stewart, A. G. (2016). Incidents and outbreak management. Health protection: Principles and practice, 204-215.

Kane, A. J., & Morley, P. S. (2017). How to investigate a disease outbreak. In Proceedings of the Annual Convention of the AAEP (Vol. 45, pp. 137-141).

Reingold, A. L. (2014). Outbreak investigations–a perspective. Emerging infectious diseases, 4(1), 21.

Ungchusak, K., & Iamsirithaworn, S. (2014). 6.4 Principles of outbreak investigation.