Congratulations on successfully concluding the Sparta outbreak. This module was based on a real outbreak of hepatitis A, although details were changed to focus on specific learning objectives.

One of the important aspects of this case is that it illustrates that solving public health problems requires skills from multiple disciplines.

An ongoing system of surveillance, with cooperation among practitioners, and the local and state departments of health, is essential to monitoring the health of the population and identifying problems. The need to collect potentially sensitive personal information and to inspect restaurants and enforce health regulations raises legal and ethic problems regarding privacy and the power of the state.

At the outset of the case, an understanding of the biology of the disease was essential to figuring out the cause of the outbreak and to effective intervention to prevent additional cases.

Epidemiology played an important role in identifying the source of the outbreak. This included descriptive epidemiology, which was important for generating hypotheses about the source, and analytic epidemiology, when the case-control study was conducted to test the hypotheses.

Biostatistics obviously played an important role in assessing the role of chance when trying to establish the source.

In summary, dealing with this problem required skills and concepts from multiple disciplines.

                                                             Case Reporting Is Important!!!

Laboratory personnel and health care providers should report new cases of acute or active hepatitis A (IgM+) to the local board of health immediately. (If they are unable to contact the local board, new cases should be reported immediately to the Massachusetts Department of Public Health, Division of Epidemiology and Immunization by calling (617) 983-6800 during business hours or (617) 983-6200 during nights and weekends.)

Local boards of health should report new cases to the Massachusetts Department of Health immediately by calling (617) 983-6800 during business hours or (617) 983-6200 during nights and weekends. An official MDPH Hepatitis A Report Form should also be submitted.