Public Health Class:
Essentials of Epidemiology
The CDC BioSense program is a ‘biosurveillance program designed to increase the
nation’s preparedness through the use of a national network for disease detection and
health situational awareness.’ On Friday, October 6, 2011, the CDC BioSense reported
on a tuberculosis outbreak in the Dallas Fort Worth area.
As the epidemiologist in charge of the investigation, you must prepare a report to
present to the stakeholders (i.e., parents, public, authorities, media, etc.). In your report,
you must use the words in the table below that are related to chapters 1 through 4 of
your textbook. There are 32 words listed. You must use 22 words. Information must be
relevant and credible. Remember, you are presenting this to the stakeholders. Underline
all words you use (just like in 5th grade).
Population, Outcome, Natural History of TB, Robert Koch, Percentage, Incidence or
Incidence rate, Availability of data, Reportable disease statistics, Hypothesis, Sex,
Secular trends, Distribution, Mortality, Primary prevention, Epidemiologic transition,
Rate, Population at risk, Source of data, Life expectancy, Age, International,
Clustering, Determinate, Morbidity, Secondary prevention, Risk factor, Prevalence,
Case fatality rate, REgistries, Cross-sectional study, Race and Point epidemic.
Start your investigation by reviewing the article obtained from CDC BioSense:
Expand to Denton High School.
Expand your investigation by searching online for information related to the outbreak.
You may check the Texas Department of State Health Services to determine if
tuberculosis is a reportable disease.
Do a Google search for Tuberculosis Surveillance. What comes up? Look at the
information provided by CDC NPIN. http://www.cdcnpin.org/scripts/tb/surv.asp . Do
you find any relevant information on tuberculosis that you can put in your report?
There are no specific instructions. Use your newly found epidemiologic skills. Be
creative, but be factual.
CDC BioSense Program on Tuberculosis
Despite the Tuberculosis disease been declared not a threat to the United States population,
the menace is back again after an outbreak of the disease was reported both in Ennis and
Denton. Natural History of TB in the US indicates that for almost three decades the disease
has been effectively controlled irrespective of a few incidence or incidence rate of the
disease. However, according to Texas Department of State Health Services (2013), the
morbidity and mortality rate as a result of TB prevalence has been significantly reduced
CDC BioSense Program 2
according to reportable disease statistics. While TB outbreak is no longer the scourge of
centuries past, according to CDC (2013) about 11,000 cases of TB were reported in 2011 in
the United States where Florida, New York, California and Texas together accounted for half
of these cases. CDC has made availability of data on epidemiologic transition of TB easy by
acting as an essential source of data on secular trends, primary prevention and secondary
prevention about TB.
However, a keen consideration of the Denton TB outbreak case, the hypothesis for its origin
can be through latent TB infection which developed to full-blown TB disease since the
student had transferred from Ennis where TB incidences had been previously reported
(WFAA, 2011). Moreover, according to TB registries at CDC, there has been significant
reduction of case fatality rate which coincides with a trend of TB infections decline trend.
According to cross-sectional study of the TB disease, it is undoubtedly evident that the risk
factor for the disease is still considerably high. This is mainly because it is spread by the
respiratory-droplet route, meaning that breathing, singing, coughing, talking, even sitting next
to an infected person can put another person at risk (Gardner, 2011). The disease is air-borne
but it has to be in a certain percentage range within which is must be contained, but it can be
very easily contracted (Gardner, 2011).
The outcome of various epidemiological studies show differential race and point epidemic
since population at risk of TB infection is varied. However, the disease does not seem to
infect people differentially on basis of their age and sex, but it still remains a threat to health
with potential to significantly reduce life expectancy if not properly managed (Gardner,
2011). For instance, considering the Denton outbreak as well as the CDC statistics and trends
of the disease, it is evident that the populations at the highest risk of TB infection are the
racial/ethnic minorities and foreign-born individuals.
CDC BioSense Program 3
The reason why management of the disease is challenging is due to the fact that it typically
affects the lungs, and according to the CDC if it’s not properly treated, TB disease can be
fatal (CDC, 2011). The populations at the highest risk for transmission are those who live in
the same household, college classrooms or dorms, barracks and other close quarters. This
explains the reason for the Denton High School outbreak (WFAA, 2011).
Furthermore, it is important to note that despite the magnitude of the Denton TB outbreak, it
was effectively managed through massive testing and treatment with proper drugs (CDC,
2011). This outbreak is an eye opener to the fact that even though a disease may seem
effectively managed or totally eradicated, appropriate management and surveillance
interventions such as the CDC BioSense Program need to in place throughout in order to
address any incidence of an outbreak (WFAA, 2011). Moreover, effective collaboration
between all stakeholders both in the healthcare and education sector was a successful strategy
to address the outbreak.
CDC BioSense Program 4
CDC. BioSense Program.