L4 Homework Scenario Loosely based on a true story- applied epi

L4 Homework Scenario

Loosely based on a true story

You are an epidemiologist in a local health department. On July 21st, you received a call from a rather distraught woman calling from out-of-state. She stated that yesterday, when staying at a local hotel in your town, she woke to discover a light fog in her room, and that she’d suffered respiratory syptoms (tightness in chest, coughing), nausea, and a headache. She did not seek medical care, but was concerned that she had been exposed to something toxic that could potentially cause long-term effects; the hotel was not giving her satisfactory answers. She stated she had alerted the front desk staff of the fog, and they assured her it was probably condensation from the air conditioning, but they would send someone up to check the room. It took two hours for someone to get to her room, and by then the fog was gone. She stated that when she complained to the front-desk manager, he offered to take 20% off the room charge for the inconvenience of waiting, but that there was no evidence that she had been exposed to anything in the hotel, and perhaps she was just experiencing allergies. The woman stated to you that she does not have a history of allergies or respiratory conditions.

After hanging up and organizing your notes, you phoned the hotel and spoke to the general manager, who denied knowing anthing about the incident. You called the next morning and spoke to one of the front desk staff, who stated she remembered the woman, and, per company policy, had logged the woman’s complaint in to an incident log, just as she had for the other similar-type complaints she’d received during the few months that she had worked there. She also stated that she alerted her supervisor (the front-desk manager) to the situation, who had stated these were people trying to get their room charge dismissed or discounted, so she should ignore them. She was also told that only “true injuries” needed to be reported in the incident log. You asked her to fax you a copy of the incident log, which she did. (She was later fired for doing so).

The incident log showed several recent reports of respiratory symptoms. You decided to create a line listing based on what was recorded in the incident log. Here’s what you found:

ID	DATE	SEX	AGE	ROOM	FOG	CHEST	COUGH	H.ACHE	NAUS	OTHER
1	7/20	F	48	474	Yes	Yes	Yes	Yes	Yes
2	7/13	F	66	667	No	Yes	yes	yes	no
3	7/13	M	69	667	No	no	yes	yes	no	Spouse of case 2
4	6/29	M	27	565	No	yes	yes	no	no	Odor
5	6/29	M	57	374	Yes	yes	yes	yes	yes	Odor
6	6/22	F	31	571	No	yes	no	yes	yes	Window open
7	6/15	F	55	374	yes	yes	yes	yes	yes
8	6/15	F	51	374	Yes	yes	yes	yes	yes	Roommate of case 7
9	6/15	M	37	466	no	no	yes	yes	yes
10	6/1	F	64	467	yes	yes	yes	yes	no
11	6/1	F	36	467	yes	no	yes	yes	no	Daughter of case 10
12	6/1	M	7	467	?	no	yes	yes	no	Grandson of case 10
13	6/1	M	58	366	no	yes	yes	yes	no
14	5/25	F	37	368	no	no	yes	yes	no

You also obtained a floor plan of the hotel (see attached) .

Your Tasks:

1. Describe the situation in terms of person, place, and time. Please be specific and thorough. Use graphics/charts/tables as warranted. An epi curve and spot map must be included, as well as a table/graphic related to person factors. (Note: you do not have to do a per-floor spot map)

2. Based on your findings, state at least one hypothesis for what is causing the respiratory symptoms.

3. What would you do next, and why?

Parking Structure

Main Entrance

Street

Courtyard

Courtyard

The first two floors house the lobby, gift shop, restaurant, bar, fitness facility, and meeting rooms. The diagonal wing has a basement level where the kitchen and laundry facilities are located, as well as the incinerator and main HVAC units.

This is the layout for floors 3 – 12. Each floor has the same numbering system, with the first digit(s) reflecting the floor number.

Pool