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  • Wehave unusually a high number of cases that are admitted with a myriad of similar symptoms.
  • Charlote Maxeke Johannesburg Academic Hospital SA
  • Charlote Maxeke Academic Hospital Boardroom
  • We have also at the labarotory noticed an increase in the lab diagnosis of…..
  • Charlote Maxeke Johannesburg Academic HospitalSA
  • Alright Lets alert our district health manager, maybe this is the case in other hospitals inthe region.
  • Charlote Maxeke Academic Hospital Boardroom
  • ......
  • It’s been 64 days since the discovery of the index case, was this localized to Charlot Maxeke or is it Distributed across the region
  • Office of the Ditrict Health manager (DHM)
  • Our health information systems show that Over a period of 60 days, 5890 cases of infected individuals were reported .
  • I will alert the relevant political headsabout the situation and advise them to assembly a team of public health expertsto get to the bottom of this.
  • Doctors and other allied medical staff are having their morning meetings i
  • Office of the Ditrict Health manager (DHM)
  • ....... .
  • Telephonicconversation between Minister of health, DHM and the Mayor
  • Doctors and other allied medical staff are having their morning meetings i
  • So we have a possible disease outbreak with over 5890 cases in our district
  • we have the patient records, with laboratory analysis and medical history at our disposal ....We can use the data at disposal to look similar exposures that the diseased have
  • the task team headquarters where the team ofpublic health experts is debriefing and strategizing
  • The DHM(Left) is having a meeting with the head of the health management systems Unit(Right) in the district
  • AHA! Maybe we can do a case control study because of time, and besides its less expensive, requires a smaller sample size and is useful for rare diseases
  • The minister called... we need to know what is causing the chaos?
  • The DHM(Left) is having a meeting with the head of the health management systems Unit(Right) in the district
  • Three way phone call between DHM(Upper slide ) , Mayor (Middle slide ) and minister of health(lower slide )
  • By the powers vested in me by the constitution and the National Health Act 61 of 2003I will appoint a task team comprising of public health experts that will investigate this.
  • We need to do something fast
  • Discussion between public health experts on how to investigate outbreak
  • Remember that case control studies cannot determine causality and are not too useful when it comes to rare exposures which might be the case here.
  • I fully agree … let’s do a cohort study so that we can determine incidence and can determine causality of exposure because we have quite an adequate sample size here.
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