In a 400-600 word answer, properly cited with an APA-formatted reference list and in-text citations, please answer the following questions. In addition to the researched facts you present as your answer, you may provide opinions and real-world experiences where appropriate.
- Read the study and supporting information published by Simon Cauchemez, et al. provided in the resources section below. What criteria did the authors set as the clinical definition of a case? What were the specific symptoms included in that definition? The study was affected by a limitation in relation to the method of defining a case. What was the limitation and how might it affect the data or usefulness of the study results?
- The structure of the school into grade levels, including more than one class per grade level, had an impact on child-to-child transmission rates. According to the data provided, contrast the probabilities of between-class (same grade, different classroom) transmission and within-class (same grade, same classroom) transmission. How does the transmission rate among students in the same grade level compare to that among students in different grade levels? Please provide specific transmission rates and an explanation of these results.
- During the outbreak, a pattern in the onset of infection in boys versus girls emerged. Figure 1C of the full report reveals a group of boys became infected a few days before a group of girls. What characteristic of the social network is thought to account for this pattern? Please provide specific data from the report to support your answer.
- What appears to account for the increase in cases after May 7 as shown in Figure 1? Which activities that the 4th graders attended on May 6 or May 7 may have contributed to an increase in transmission (superspread)?
- Based on the results provided in the example, what measures could have been put in place to disrupt the transmission of the virus, if any?
Resources to get you started:
Role of social networks in shaping disease transmission during a community outbreak of 2009 H1N1 pandemic influenza
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3041067/pdf/pnas.201008895.pdf
Role of social networks in shaping disease transmission during a community outbreak of 2009 H1N1 pandemic influenza, Supporting Information
http://www.pnas.org/content/suppl/2011/01/29/1008895108.DCSupplemental/pnas.201008895SI.pdf#nameddest=STXT4
1. Cauchemez et al. (2010) used "detailed data on populations such as demographics in households, schools, and workplaces; mobility and land-use data; contact surveys; of time-use data", and "made assumptions about how transmission rates change with the type of interaction" (Cauchemez et al., 2010, p.1). This is the criteria the authors set as the clinical definition of the case. The particular symptoms included in the definition are "acute respiratory illness (ARI), which is defined as at least two symptoms among fever, cough, sore throat, and runny nose" (Cauchemez et al., 2010, p.1). Also, the lack of detailed data on out-of-home transmission and an appropriate statistical approach limits case definition. Moreover, because survey data is self-reported, it may contain medically inaccurate information (Cauchemez et al., 2010). Those inaccurate data on the number of infected cases may affect the usefulness of the study results.
2. Cauchemez et al. (2010) estimated child-to-child transmission probabilities as 3.5% within a class. And they found that transmission probabilities between students of the same grade but in a different class and also between students from different grades were about five times smaller than between classmates (Cauchemez et al., 2010). I can conclude that having students in the same classroom increased transmission rates, facilitating the introduction of influenza within the home.
3. Figure 1C shows the number of ARI cases by date of symptom onset and sex among fourth graders. From April 27 to May 7, eight boys developed symptoms, but girl, only five girls developed symptoms (Cauchemez et al., 2010). And also according to the epidemic curve of fourth graders, boys' average onset time was May 6, 8 PM but girls' average onset time was May 9, 12 AM (Cauchemez et al., 2010). So we can conclude a group of boys became infected about 2.5 days before a group of girls. This means that boys are more likely to be in contact with other boys than girls. The social network and the structure of the school into classes and grades surely strongly affected the transmission rate and spread.
4. Grade 4 students recorded the highest crisis rate (54%) on May 7, and the number of cases increased significantly after the day. Therefore, it is reasonable to think that the infection has spread further through fourth-year students. The seating charts, social networks, division of the population into households, infection patterns related to sex, etc., are all elements that fourth graders experienced that may have contributed to the increase in infections (Cauchemez et al., 2010).
5. Cauchemez et al. (2010) said, "to estimate the proportion of student-to-student transmission taking place inside the school, one would, for example, need to have a good proxy for the proportion of effective contacts occurring between students in and out of the school" (p.5). We can prevent the spread of infection in the same classroom by using masks or washing hands and gargling, and at the same time, reduce contact infections with students in other grades, which will reduce the overall number of infections.
Thank you, professor. Have a nice day:) (500 words)
Reference
Cauchemez, S., Bhattarai, A., Marchbanks, L.T., Fagan, R. P., Ostroff, S., Furguson, N. M., Swerdlow, d., & the Pennsylvania H1N1 working group (2010). Role of social networks in shaping disease transmission during a community outbreak of 2009 H1N1 pandemic influenza. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3041067/pdf/pnas.201008895.pdf
댓글