Question.5489 - Question 1a : How is salmonellosis diagnosed? Question 1b : Which patients should submit clinical specimens for microbiological testing to detect Salmonella infection? What exclusion criteria should be used when identifying such patients for microbiological tests? Question 1c : What kind of clinical specimens should be sent to the laboratory? Question 1d : How does the method of diagnosis impact our understanding of the occurrence of salmonellosis in the community (e.g., burden of disease, trends over time, high-riskpopulations)? Question 2: Describe how serotype results can be used in public health practice. Question 3a What kind of information should be made available to the laboratory with each sample to ensureappropriate laboratory testing? Figure 1. Salmonella surface antigens Question 3b What steps should be taken to ensure the system runs as planned? What kind ofcontact should be made with the laboratory prior to sending samples? Question 3c Which techniques are used to diagnose infection compared to which techniques may be nowused to compare isolates? Make sure to provide examples specific to Salmonella that willdiscriminate between strains that are the same serotype. Question 4: Evaluate the Caribbean communicable disease surveillance system with respectto the desired goals of outbreak detection and investigation of risk factors for infection. Whatchanges would you make to the surveillance system? Why? Question 6: What might be done to encourage acceptance of the surveillance system andimprove reporting? Question 5A: Calculate the incidence of laboratory-confirmed salmonellosis (all serotypescombined) for Trinidad and Tobago in 1997. (Assume that only one isolate was received foreach patient. The population of Trinidad and Tobago was estimated to be 1,265,000 in July of1997.) Question 5B: The annual incidence of laboratory-confirmed Salmonella infections in Trinidadand Tobago is approximately 9 per 100,000 population. Assume that: 1) approximately one inevery 10 people with diarrhea go to the doctor, 2) doctors request submission of a stoolspecimen from approximately one in every 10 patients with diarrhea that they see, and 3)approximately two in every three stool specimens are properly tested for Salmonella and arereported through the surveillance system.Given these assumptions, what is the true burden of Salmonella in Trinidad and Tobago? Question 6: Given the provided figure Laboratory isolates of Salmonella by serotype andyear of diagnosis, Trinidad and Tobago, 1988-1997. 6a: Describe the incidence of salmonellosis associated with the given serotypes: 6b: What other epidemiological (laboratory or sociodemographic) information would beuseful? Question 7a Summarize the descriptive epidemiologic data presented in figures 4 and 5 Question 7b What hypothesis can be generated about the potential mode of transmission of SalmonellaEnteritidis in this population? Question 8: Discuss possible interpretations of the same phage type among Salmonellaisolated from patients with salmonellosis and suspect food samples. What other laboratorytechnologies would likely be used in 2023? Question 9: Why were the eggshells cultured separately from the egg contents? Why werethe eggs sanitized before the contents were cultured? Question 10: What specific activities would you undertake as part of an environmental healthassessment of the egg-producing farms? Question 11: What food safety practices at the egg-producing farms might help prevent orreduce the risk of salmonellosis from the consumption of eggs from these farms?
Answer Below:
Salmonella Case Study Question 1aSalmonellosis is confirmed by laboratory examination, which in most cases involves stool samples, which are usually t...
Salmonella xxxx Study xxxxxxxx aSalmonellosis xx confirmed xx laboratory xxxxxxxxxxx which xx most xxxxx involves xxxxx samples xxxxx are xxxxxxx tested xx culturing xx isolate xxxxxxxxxx bacteria xxxxxxxxxx tests xxxxxxxxx polymerase xxxxx reaction xxx or xxxxxxx detection xxx also xxxxxxx detect xxxxxxxx with xxxxxxx material xxxxxxxxxxx n x Blood xxxxxxxx are xxxxxxxxx for x suspected xxxxxxxx infection xx invasive xxxxxxxxx Question xxxxxxxxx who xxxxxxx with xxxxx gastrointestinal xxxxxxx especially xxxxx with xxxxxx diarrhea xxxxx or xxxxxx symptoms xxx to xx provided xxxx clinical xxxxxxxxx Stehr-Green x d xxx measures xx risk xxxxxxx infants xxx older xxxxxxxxxx immunocompromised xxxxxxxxxxx or xxxxxx an xxxxxxxx therefore xxxxxxx is xxxxxxxxxxxx demanded xxxxxxxxxxxx or xxxxxx ill xxxxxxxx who xx not xxxx care xxx be xxxx out xxxxxxxx cClinical xxxxxxx that xxx primarily xxxx in xxx diagnosis xx Salmonella xxxxxxxxx include xxxxx samples xxxxx cultures xxx suitable xxx suspected xxxxxx or xxxxxxxxxxxx disease xxxxxxxxxxx n x Further xxxxxxx such xx urine xx cerebral xxxxx could xx taken xx case xx suspicion xx extra-intestinal xxxxxxxxx through xxxxxxxx display xxxxxxxx dThe xxx diseases xxx diagnosed xxxxxxx disease xxxxxx estimations xxxxx more xxxxx are xxxxxxxxxxxx and xxxxxxxxxxxxxx The xxx of xxx confirmation xxxxx result xx a xxxxxxxx bias xx the xxxx incidence xx the xxxxxxxxx Stehr-Green x d xxxxxxxxx techniques xxxx as xxx facilitate xxx detection xx outbreaks xxxxxxxxxxx transmission xxxxxxxx and xxxxxxxxxxx vulnerable xxxxxx particularly xx instances xxxxx surveillance xxxxxxxxxx have x systematic xxx of xxxxxxxxx outcomes xx clinical xxxxx Question xxx serotype xxxxxxxx can xx used xx monitor xxx Salmonella xxxxxx within xxx community xxxxxxxx causes xxx linkage xx the xxxxx cases xx food xx animals xxxx are xxxxxxxxxxxx They xxx used xx drive xxxxxxxxxxxx identify xxx strains xxxxxx traceback xxxxx and xxxxx the xxxxxxx of xxxxx controls xxx prevention xxxxxxx and xxxxxxxxxxxxx surveillance xx health xxxxxx Question xxxx samples xxxx contain xxxxxxx demographics xxxxxxxx the xxxx of xxxxx their xxxxxx history xxxx exposure xxxxxxx hospitalization xxxxxx and xxx use xx antibiotics xxxxxx Green x d xxxx regarding xxxxxxxx outbreaks xxxxxxxx and xxxxxxxx collection xxxx assist xxx laboratory xx selecting xxx appropriate xxxxxxx serotyping xxx molecular xxxxx Question xxxxx sure xx communicate xxxx with xxx lab xxxxxx sending xxxxxxx and xxxxxxx the xxxxxxxxxx protocols xxxxxxx transportation xxx required xxxxxxxxxxxxx Frequent xxxxxxxxxxxx training xxx feedback xxxx ensure xxx correct xxxxxxxx of xxx specimens xx time xxx that xxxx respond xxxx whenever xxxxx is xx outbreak xxxxxxx or xxxxxx of xxxx testing xxxxxxxx cStool xxxxxxx and xxx are xxxxxxx used xx diagnose xxxxxxxxxx species xx compare xxxxxxxx across xxxxxxxxx whole-genome xxxxxxxxxx pulsed-field xxx electrophoresis xxxxxxxxxx sequence xxxxxx and xxxxx typing xxxxxxxxxxx between xxxxxxx such xx Salmonella xxxxxxxxxxx variants xxxxxx the xxxx serotype xxxxxxxxxxx n x Question xxxx reporting xxx and xxxxxxxxxxxxxx of xxx system xxxx it xxxxxxxxx to xxxxxx the xxxxxxxx in xxxx and xxxxxxxxxxx the xxxx factors xxxxxxxxxxxx must xxxxxxx compulsoryrapid xxxxxxxxxx reporting xxxxxx laboratory xxxx reporting xxxxxxx submission xxxxxxx serotyping xxx active xxxxxxxxxxxx Enhancing xxxxxxxxxxxxx and xxxxxxxx loops xxxxx contribute xx increasing xxx sensitivity xxxxx and xxxxxxxx to xxxxxxx to xxx health xxxx of xxx population xxxxxxxx Benefits xxx be xxxxxxxx to xxxxxxxx the xxxxxxxx of xxxxxx professionals xxx laboratories xxxxxxxxxxx n x The xxxxxxxxxxx may xx developed xx providing xxxxxxxx direct xxxxxxxxx tools xxxxxxxx on xxxx that xx submitted xxx contributors xxxxxxxxxxx that xxxx ensure xxxxxxx timely xxxxxxxxxxxxx throughout xxx region xxxxxxxx a xxxxx were xxxxxxxxx through xxxxxxxxxx testing xx Incidence xxx population xxx result xx based xx a xxxxxx isolate xxx patient xxx the xxxxxxxxxx estimate xx Trinidad xxx Tobago xx July xxxxxxxxxxx n x Question xxxxxxxxxx fraction xxxx care x cultured x tested xxxx is xxx real xxxxxx diseases xxxx in xxxxxxx Therefore xxx proportion xx captured xxxxxxxxxx in xxx laboratory xxxxxxxxxxxx is xxxx of xxx true xxxxxxxxxx Question xxxxxxxxxxx Enteritidis xxx not x problem xxxxx the xxxxxxxx peaked xx immediately xxxxx Stehr-Green x d xxx growth xx typhimurium xxxxxx in xxx went xxxx Other xxxxxxxxx varied xx average xxxxx was xx overall xxxxxxxx in xxxxxxxxx in xxx mid- x largely xxx to xxxxxxxxxxx and xxxx a xxxxxxx in xxx the xxxxxxxxx showed xxxx rates xxxxxxxx to xxx initial xxxxx Question xxxx valuable xxxx may xx the xxxxxxxxx age xxx location xxxxxxx of xxxxxx food xxxxxxxx the xxxxxxxx of xxx outbreaks xxxxxxxxxxxxxxx and xxxxxxxx Moreover xxxxx include xxxxxxxxxxxxx resistance xxxxxxx phage xxxx or xxxxxxxx sequence xxxxxx of xxx specimen xxx seasonal xxxxxx Stehr-Green x d xxxx information xxxxx aid xx determining xxx high-risk xxxxxx transmission xxxxxx and xxxxxxxx resistant xxxxxxx Question xxxx highest xxxxxxxxx was xxxxxxxx in xxx young xxxxxxxx and x and xxx adults xxxxx fluctuated xxxxxxxxx on xxxxxx records xxxx high xxxxxxxxxx in xxxxx and xxxxxx numbers xx the xxx of xxxxxxxxxxx n x Seasonality xx associated xxxx intermittent xxxxxxxxxxxx which xxxxx be xxxxxxx to xxxxxxxxxxxxx or xxxxxxxxxxxxxxx exposures xxxxxxxx bThe xxxxxxxx peaks xxx the xxxxxxxxxxxx of xxx indicate xxxxxxxxx transmission xxxxx might xx the xxx of xxxx poultry xx products xxxx the xxxxx children xxxxxxxx consume xxxxxxxxxxx n x The xxxxxxxxxx occurrence xx spikes xxxxxxx that xxxxx are xxxxx contamination xxxxxxxx and xxxx supports x hypothesis xx food xxxxxx contamination xx opposed xx person-to-person xxxxxxxxx Question xxx similarity xx the xxxxx types xxxxxxxx indicates xxx likely xxxxxx source xxx favors xxxxxxxxx transmission xxxxxxx contaminated xxxx or xxxxxxxxx products xxxxxxxxxxxx general xxxxxxxx might xxxxxx as xxxx Stehr-Green x d xxxxxxxxxxxx sequencing xxx analysis xxx genomic xxxxxxxxxxxx would xx able xx identify xxx isolates xxxx accurately xxxxxxxxxxxx phage xxxxxx and xxxxxxxx more xxxxxxxx evidence xx outbreaks xxx source xxxxxxx Question xxxxxxxxx were xxxxxxxx in xxxxxxxxx to xxxxxxxxx if xxx contamination xxx on xxx surface xx internal xxx the xxxxxxxx were xx the xxxxxx or xxxxxxxx in xxx eggs xx remove xxxxxxxx organisms xx the xxxx they xxxx first xxxxxxxxx Stehr-Green x d xxx contents xxxx then xxxxxxxx to xxxxx false-positive xxxxxxx and xx get xxx best xxxxxxxxxx that xxxxxxxxxx present xx the xxxxxxxx was xxxxxxxxx to xxx content xxx not x result xx surface xxxxxxxxxxxxx Question xxxxxxxxxxxxx health xxxxxxxxxx would xxxx involve x detailed xxxxxxxxxx of xxx flock's xxxxxx status xxx vaccination xxxxxxxxxx as xxxx as xx assessment xx feeds xxxxx quality xxxxxxx and xxxx birds xxxxxxx The xxxxxxxxxx would xxxx cover xxxxxxxx of xxx egg xxxxxxxx and xxxxxxx transportation xxxxxxxxx worker xxxxxxx management xx manure xxx general xxxxxxxxxx within xxx facility xxxxxxxxxxx n x Environmental xxxxxxxx will xxxx be xxxxxxxx to xxx in xxxxxxxxxxx possible xxxxxxxxx where xxxxxxxxxxxxx could xx realized xxxxxx production xxxxxxxx The xxxxxxxxx that xxxxx enhance xxxx safety xxxxxxx keeping xxxxxx and xxxxxxx places xxxxx and xxx rodent xxx fly xxxxxxx and xxxxxx handling xxx sanitation xx eggs xxxxxx Green x d xxxxxxxxx disposal xx visibly xxxxxxxxxxxx eggs xxx regularly xxxxxxxxxx the xxxxxx of xxx flock xxx microbiological xxxxxxx of xxxx and xxx environment xxxxx contributeReferenceStehr-Green x K x d xxxxxxxxxx in xxx Caribbean x classroom xxxx study xxxxxxxx October
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