Cover
Introduction
1. Content
2. Special Features
3. Case Studies in the Classroom
4. Features of Outbreak, Second Edition
5. Recommendations for Using the Case Studies
6. Acknowledgments
About the Author
SECTION I: Outbreaks of Diseases of the Respiratory Tract
1. OUTBREAK I‐1 A Legionellosis Outbreak—Barceloneta
2. OUTBREAK I‐2 An Outbreak of Respiratory Syncytial Virus Infection—Arviat, Canada
3. OUTBREAK I‐3 A Tuberculosis Outbreak in a Prison Housing Inmates Infected with HIV—South Carolina
4. OUTBREAK I‐4 An Otitis Media Outbreak in a Child Care Center—Georgia
5. OUTBREAK I‐5 An Outbreak of a Rash—Venezuela and Colombia
6. OUTBREAK I‐6 Hantavirus Pulmonary Syndrome Outbreak—Vermont
7. OUTBREAK I‐7 A Diphtheria Outbreak—Newly Independent States of the Former Soviet Union
8. OUTBREAK I‐8 An Outbreak of Mycoplasmal Pneumonia—Ohio
9. OUTBREAK I‐9 A Pneumonia Outbreak in a Nursing Home—New Jersey
10. OUTBREAK I‐10 Past and Future Pandemics of Influenza A—Worldwide, 1918 to Present
11. OUTBREAK I‐11 A Pharyngitis Outbreak in the Marine Corps—San Diego
12. OUTBREAK I‐12 A Measles Outbreak in Kosovar Refugee Children—Albania
13. OUTBREAK I‐13 A Swimming Pool‐Related Outbreak of Pharyngitis and Conjunctivitis—Spain
14. OUTBREAK I‐14 A Cruise Ship‐Associated Legionnaires’ Disease Outbreak
15. OUTBREAK I‐15 A Pertussis Epidemic—Washington State
16. OUTBREAK I‐16 COLLEGE PERSPECTIVE
17. OUTBREAK I‐17 GLOBAL PERSPECTIVE
18. REFERENCE MATERIAL
SECTION II: Outbreaks of Disease of the Gastrointestinal Tract
1. OUTBREAK II‐1 A Salmonella enterica serovar Enteritidis Outbreak from Eating Eggs—Multistate
2. OUTBREAK II‐2 A Diarrhea Outbreak Associated with Swimming Pool Use—Ohio
3. OUTBREAK II‐3 Diarrhea among Attendees of the Washington County Fair—New York
4. OUTBREAK II‐4 An Amoebiasis Outbreak—Georgia
5. OUTBREAK II‐5 A Typhoid Fever Outbreak Linked with a Frozen Fruit Drink—Florida
6. OUTBREAK II‐6 A Diarrhea Outbreak in a Day Care Nursery—Juneau, Alaska
7. OUTBREAK II‐7 A Foodborne Outbreak of Bloody Diarrhea—Multistate
8. OUTBREAK II‐8 A Multistate Outbreak of Listeriosis—Northeastern United States
9. OUTBREAK II‐9 An Outbreak of Rotaviral Gastroenteritis among Children—Jamaica
10. OUTBREAK II‐10 Bloody Diarrhea Associated with Eating Ground Beef—United States
11. OUTBREAK II‐11 A Hepatitis Outbreak Associated with Restaurant Onions—Pennsylvania
12. OUTBREAK II‐12 A Rotavirus Outbreak among College Students—District of Columbia
13. OUTBREAK II‐13 A Cholera Outbreak in a Refugee Camp—Democratic Republic of the Congo
14. OUTBREAK II‐14 A Diarrhea Outbreak Associated with Raw Milk and Cheese Consumption—Pennsylvania
15. OUTBREAK II‐15 A Listeriosis Outbreak Associated with Pasteurized Milk—Massachusetts
16. OUTBREAK II‐16 An Outbreak Associated with Seasonal Consumption of Raw Ground Beef—Wisconsin
17. OUTBREAK II‐17 COLLEGE PERSPECTIVE A Diarrhea Outbreak Associated with an Adventure Race—Nevada
18. OUTBREAK II‐18 GLOBAL PERSPECTIVEA Case‐Control Study of an Outbreak of Clostridioides difficile at a Tertiary Care Medical Center—Amsterdam, The Netherlands
SECTION III: Pathogens and Diseases That Are Transmitted Sexually
1. OUTBREAK III‐1 An STD Outbreak among Teenagers—Georgia
2. OUTBREAK III‐2 An STD Outbreak among Hispanic Men—California
3. OUTBREAK III‐3 An Outbreak of HIV Disease in the Adult‐Film Industry—California
4. OUTBREAK III‐4 An Outbreak of Azithromycin‐Resistant Gonorrhea—Kansas City
5. OUTBREAK III‐5 Invasive Cervical Cancer among Women—United States
6. OUTBREAK III‐6 A Proctitis Outbreak among Men Who Have Sex with Men—Netherlands
7. OUTBREAK III‐7 A Syphilis Outbreak Connected to a Cybersex Chat Room—San Francisco
8. OUTBREAK III‐8 STDs in Operation Iraqi Freedom/Operation Enduring Freedom—Iraq
9. OUTBREAK III‐9 Herpes Simplex Virus Type 2 Infection among U.S. Military Service Members
10. OUTBREAK III‐10 COLLEGE PERSPECTIVE STD Risk Increased by Using the Internet To Find Casual Sexual Partners
11. OUTBREAK III‐11 GLOBAL PERSPECTIVE
12. REFERENCE MATERIAL
SECTION IV: Outbreaks of Diseases of the Skin, Soft Tissues, and Eyes
1. OUTBREAK IV‐1 An Outbreak of Pseudomonas Dermatitis from Hotel Pool and Hot Tubs—Colorado
2. OUTBREAK IV‐2 An Outbreak of Skin Lesions in a Wrestling Team—Alaska
3. OUTBREAK IV‐3 An Outbreak of Conjunctivitis at an Elementary School—Maine
4. OUTBREAK IV‐4 A Measles Outbreak among Internationally Adopted Children—United States
5. OUTBREAK IV‐5 An Outbreak of “Flesh‐Eating Bacterium” Disease—Saint John, Brunswick, Canada
6. OUTBREAK IV‐6 An Outbreak of Invasive Group A Streptococcus at a Child Care Center—Boston
7. OUTBREAK IV‐7 An Outbreak of a Rash at a Camp for HIV‐Infected Children—Connecticut
8. OUTBREAK IV‐8 A Rubella Outbreak—Arkansas
9. OUTBREAK IV‐9 An Outbreak of Invasive Disease Associated with Varicella in a Child Care Center—Boston
10. OUTBREAK IV‐10 An Outbreak of Boils Associated with Footbaths at a Nail Salon—California
11. OUTBREAK IV‐11 An Outbreak of Boils Associated with Steam Bathing, Alaska
12. OUTBREAK IV‐12 A Skin Infection Outbreak at a Local School—Houston, Texas
13. OUTBREAK IV‐13 An Outbreak of MRSA at Surgical Sites—Paris
14. OUTBREAK IV‐14 An Outbreak of Necrotizing Fasciitis and Cellulitis Associated with Vein Sclerotherapy—Australia
15. OUTBREAK IV‐15 COLLEGE PERSPECTIVE Skin Infections among Tattoo Recipients—Ohio
16. OUTBREAK IV‐16 GLOBAL PERSPECTIVE A Gas Gangrene Outbreak after a Tsunami—Papua New Guinea
17. REFERENCE MATERIAL
SECTION V: Outbreaks of Diseases of the Cardiovascular and Lymphatic Systems
1. OUTBREAK V‐1 An Outbreak of Typhus—Burundi
2. OUTBREAK V‐2 An Outbreak of Cyclic Fevers—India
3. OUTBREAK V‐3 An Outbreak of Mononucleosis—Puerto Rico
4. OUTBREAK V‐4 Fever in a Traveler Returning from Venezuela—California
5. OUTBREAK V‐5 Cases of Rash and Fever, One Fatal, in a Family Cluster—Kentucky
6. OUTBREAK V‐6 An Outbreak of Ebola Hemorrhagic Fever—Uganda
7. OUTBREAK V‐7 An Outbreak of Leptospirosis during Eco‐Challenge—Malaysia
8. OUTBREAK V‐8 A Dengue Fever Outbreak—Puerto Rico
9. OUTBREAK V‐9 A Disease Outbreak Associated with International Travel—Chicago
10. OUTBREAK V‐10 Pseudomonas Bloodstream Infections Associated with a Heparin‐Saline Flush—Missouri
11. OUTBREAK V‐11 A Brucellosis Outbreak Due to Unpasteurized Raw Goat Cheese—Andalusia, Spain
12. OUTBREAK V‐12 An Acute Respiratory Illness Associated with Dried Animal Hides—New York City
13. OUTBREAK V‐13 A Plague Outbreak—India
14. OUTBREAK V‐14 A Hepatitis Outbreak from a Pain Clinic—Oklahoma
15. OUTBREAK V‐15 An Outbreak of Staphylococcus aureus with Increased Vancomycin Resistance—Illinois
16. OUTBREAK V‐16 COLLEGE PERSPECTIVE An Outbreak of Lyme Disease—United States
17. OUTBREAK V‐17 GLOBAL PERSPECTIVEThe Zika Virus Spreads from Uganda to the United States
18. REFERENCE MATERIAL
SECTION VI: Outbreaks of Diseases of the Nervous System
1. OUTBREAK VI‐1 An Outbreak of Acute Flaccid Paralysis—Cape Verde
2. OUTBREAK VI‐2 An Outbreak of Paralysis from Eating Fermented Beaver Tails—Alaska
3. OUTBREAK VI‐3 Rabies Infections from Organ Donor Tissues—Multistate
4. OUTBREAK VI‐4 A Tetanus Outbreak—Puerto Rico
5. OUTBREAK VI‐5 An Outbreak of Aseptic Meningitis among Recreational Vehicle Campers—Connecticut
6. OUTBREAK VI‐6 A Mad Cow Disease Outbreak in Humans and Cattle—United States, Canada, Europe, and Japan
7. OUTBREAK VI‐7 Foodborne Paralysis from Eating Home‐Pickled Eggs—Illinois
8. OUTBREAK VI‐8 An Outbreak of Encephalitis—New York
9. OUTBREAK VI‐9 An Outbreak of Haemophilus influenzae Type b Meningitis—Alaska
10. OUTBREAK VI‐10 An Outbreak of Foodborne Botulism from Home‐Prepared Fermented Tofu—California
11. OUTBREAK VI‐11 Meningitis among Travelers Returning from Saudi Arabia—United States
12. OUTBREAK VI‐12 COLLEGE PERSPECTIVE Meningitis Outbreaks Traced to Raves and Clubs—Michigan and Argentina
13. OUTBREAK VI‐13 GLOBAL PERSPECTIVE An Outbreak of Pneumococcal Meningitis—Central African Republic
14. REFERENCE MATERIAL
APPENDIX: Selected Sources
Index
End User License Agreement

List of Tables

Chapter 1
1. Table I‐1 Selected outbreak‐causing respiratory pathogens
Chapter 2
1. Table II‐1 Selected outbreak‐causing pathogens of the GI tract
2. Table II‐3 Comparison of activities at the fair of cases and controls
3. Table II‐15 Characteristics of patients with listeriosis associated with past...
4. Table II‐17 Comparison of case patients with control subjects among participa...
5. Table II‐18 Crude ORs of potential risk factors for the development of CDI ri...
Chapter 3
1. Table III‐1 Selected STD‐causing pathogens
2. Table III‐8a Final diagnosis in female military personnel seeking gynecologic...
3. Table III‐8b Chief complaints in female military personnel seeking gynecologi...
4. Table III‐9 HSV‐2 seropositivity among case patients and controls^a
Chapter 4
1. Table IV‐1 Selected outbreak‐causing pathogens of skin and soft tissue
2. Table IV‐13 Demographic and clinical data of patients^a
3. Table IV‐15 Characteristics of tattoo‐associated MRSA skin infection clusters
Chapter 5
1. Table V‐9 Clinical and laboratory findings on hospital admission and treatmen...
2. Table V‐11 Case‐control study results^a
Chapter 6
1. Table VI‐9 Summary of four cases of Hib meningitis^a

List of Illustrations

Chapter 1
1. Figure I‐1a Micrograph of direct fluorescent‐antibody assay of L. pneumophil...
2. Figure I‐1b L. pneumophila growing on charcoal‐yeast extract agar.
3. Figure I‐2 Direct fluorescent‐antibody assay for respiratory syncytial virus...
4. Figure I‐3a Acid‐fast stain of the pathogen.
5. Figure I‐3b Chest X ray of a patient with tuberculosis.
6. Figure I‐4a Growth of the pathogen on blood agar.
7. Figure I‐4b Gram stain of the pathogen.
8. Figure I‐5a Maculopapular rash.
9. Figure I‐5b Koplik spots on the buccal mucosa.
10. Figure I‐6a Chest radiograph of a patient with hantavirus pulmonary syndrome...
11. Figure I‐6b Transmission electron micrograph of Sin Nombre virus.
12. Figure I‐6c A deer mouse.
13. Figure I‐7 Gram stain of the pathogen.
14. Figure I‐8 Transmission electron micrograph of Mycoplasma.
15. Figure I‐9a Chest X ray of a patient with pneumonia.
16. Figure I‐9b Growth of the pathogen on blood agar.
17. Figure I‐11a Gram stain of the pathogen.
18. Figure I‐11b Growth of the pathogen on blood agar.
19. Figure I‐12a Maculopapular rash.
20. Figure I‐12b Koplik spots on the buccal mucosa.
21. Figure I‐13 Cases of pharyngoconjunctival fever by date of disease onset (ac...
22. Figure I‐16 Number of mumps cases by week of illness onset.
23. Figure I‐17 DPT vaccination coverage in Cali for children <1 year old.
Chapter 2
1. Figure II‐1a Growth of the pathogen on MacConkey agar.
2. Figure II‐1b Growth of the pathogen on Hektoen enteric agar.
3. Figure II‐2 Light micrograph of an acid‐fast stain of a fecal smear.
4. Figure II‐3a Gram stain of the bloody‐diarrhea‐causing pathogen.
5. Figure II‐3b Growth of the pathogen on sorbitol MacConkey agar.
6. Figure II‐4 Light micrograph of a fecal smear.
7. Figure II‐5a Rose‐colored macular rash.
8. Figure II‐5b Growth of the pathogen on Hektoen enteric agar.
9. Figure II‐6 Light micrograph of a fecal smear.
10. Figure II‐7a Growth of the pathogen on MacConkey agar.
11. Figure II‐7b Light micrograph of a fecal sample.
12. Figure II‐8 Gram stain of the pathogen.
13. Figure II‐9 Transmission electron micrograph of rotavirus.
14. Figure II‐10a Gram stain of the pathogen.
15. Figure II‐10b Growth on MacConkey agar.
16. Figure II‐11 Transmission electron micrograph of the pathogen.
17. Figure II‐12a Transmission electron micrograph of the pathogen.
18. Figure II‐12b Rapid test for rotavirus.
19. Figure II‐13a Stool sample.
20. Figure II‐13b Dehydration caused by cholera.
21. Figure II‐13c Flagellar stain of the pathogen.
22. Figure II‐14 Number of cases of diarrheal illness caused by infection with S...
23. Figure II‐16a Gram stain of the pathogen.
24. Figure II‐16b Growth of the pathogen on sorbitol MacConkey agar.
25. Figure II‐17 Number of cases of illness among participants in a long‐distanc...
Chapter 3
1. Figure III‐1 Dark‐field microscopy of the pathogen.
2. Figure III‐2a Ulcer resulting from the pathogen.
3. Figure III‐2b Gram stain of an ulcer scraping.
4. Figure III‐3 Transmission electron micrograph of HIV.
5. Figure III‐4a Gram stain of pus discharge.
6. Figure III‐4b Pus discharge from urethra.
7. Figure III‐5a Genital warts.
8. Figure III‐5b Cervical cancer.
9. Figure III‐5c Incidence of localized invasive cervical cancer among Hispanic...
10. Figure III‐5d Incidence of advanced invasive cervical cancer among Hispanic ...
11. Figure III‐6 Positive DFA assay for C. trachomatis.
12. Figure III‐7a Ulcer on the penis.
13. Figure III‐7b Silver‐stained micrograph of tissue infected by the pathogen....
14. Figure III‐10a Syphilis chancre.
15. Figure III‐10b Pus discharge associated with gonorrhea.
16. Figure III‐11a A baby abandoned by his parents in a home for young HIV‐infec...
17. Figure III‐11b A student at a primary school in Africa where about one‐third...
Chapter 4
1. Figure IV‐1a Folliculitis.
2. Figure IV‐1b Gram stain of the pathogen.
3. Figure IV‐2a Skin lesion.
4. Figure IV‐2b Light micrograph of the pathogen (magnification, ×1,125).
5. Figure IV‐3a Conjunctivitis.
6. Figure IV‐3b Colony morphology on blood agar.
7. Figure IV‐3c Gram stain of the pathogen.
8. Figure IV‐4a Koplik spots on the buccal mucosa.
9. Figure IV‐4b Maculopapular rash.
10. Figure IV‐5a Growth of the pathogen on blood agar.
11. Figure IV‐5b Gram stain of the pathogen.
12. Figure IV‐6a Growth of the pathogen on blood agar.
13. Figure IV‐6b Gram stain of the pathogen.
14. Figure IV‐7 Vesicular rash. CDC, PHIL, 4493, 1975.
15. Figure IV‐8a Skin rash characteristic of rubella.
16. Figure IV‐8b Transmission electron micrograph of the pathogen.
17. Figure IV‐9 Cases of varicella and group A Streptococcus infection at a chil...
18. Figure IV‐10 Light micrograph of M. fortuitum (magnification, ×400). CDC/ Dr...
19. Figure IV‐11 Number of boils during the outbreak year.
20. Figure IV‐12a Growth of the pathogen on mannitol salt agar.
21. Figure IV‐12b Gram stain of the pathogen.
22. Figure IV‐14 Growth of the pathogen on blood agar.
23. Figure IV‐15 Pustules resulting from a MRSA skin infection in a tattoo recip...
24. Figure IV‐16 Gram stain of the pathogen.
Chapter 5
1. Figure V‐1a Rash caused by the pathogen.
2. Figure V‐1b Body louse.
3. Figure V‐1c Transmission electron micrograph of the intracellular pathogen....
4. Figure V‐2 Light micrograph of parasitized erythrocytes.
5. Figure V‐3a Blood smear showing atypical lymphocytes.
6. Figure V‐3b Blood smear showing atypical lymphocytes. μ, micrometers.
7. Figure V‐4a Aedes mosquito vector.
8. Figure V‐4b Transmission electron micrograph of the viral pathogen.
9. Figure V‐5a Rash caused by the pathogen.
10. Figure V‐5b Dog ticks.
11. Figure V‐6 Transmission electron micrograph of Ebola virus.
12. Figure V‐7 The pathogen in silver‐stained liver tissue.
13. Figure V‐8 A. aegypti mosquito vector.
14. Figure V‐9 Light micrograph of the pathogen parasitizing erythrocytes.
15. Figure V‐10 Gram stain of P. fluorescens.
16. Figure V‐11 Cases per family as a function of the number of weeks from the b...
17. Figure V‐12 Light micrograph of B. anthracis.
18. Figure V‐13a Gram stain of Y. pestis in a blood smear.
19. Figure V‐13b Oriental rat flea.
20. Figure V‐13c A bubo.
21. Figure V‐14a Transmission electron micrograph of hepatitis B virus. CDC/Dr. ...
22. Figure V‐14b Transmission electron micrograph of hepatitis C virus. Gleiberg...
23. Figure V‐15 Gram stain of the pathogen.
24. Figure V‐16a Engorged Ixodes tick. CDC/ Dr. Gary Alpert / Urban Pests / Inte...
25. Figure V‐16b Skin rash seen in Lyme disease. CDC/ James Gathany, PHIL, 9872,...
26. Figure V‐16c Dark‐field light micrograph of the pathogen.
27. Figure V‐17a A digitally colorized transmission electron micrograph of Zika ...
28. Figure V‐17b Rash caused by Zika virus.
29. Figure V‐17c A female A. aegypti mosquito acquiring a blood meal.
Chapter 6
1. Figure VI‐1a Children affected with paralysis from the pathogen.
2. Figure VI‐1b Transmission electron micrograph of poliovirus.
3. Figure VI‐2 An endospore stain of the pathogen.
4. Figure VI‐3 Photomicrograph of a hematoxylin‐eosin‐stained brain tissue samp...
5. Figure VI‐4 Photomicrograph of a Gram‐stained specimen of the pathogen. CDC/...
6. Figure VI‐5 Attack rate for campsites with different numbers of campers.
7. Figure VI‐6a Light micrograph of spongiform brain tissues.
8. Figure VI‐6b Lack of muscle control in a cow with bovine spongiform encephal...
9. Figure VI‐7a Gram stain of the pathogen.
10. Figure VI‐7b Endospore stain of the pathogen. CDC/
11. Figure VI‐8 Computer‐colorized transmission electron micrograph of WNV. CDC/...
12. Figure VI‐10a Light micrograph of an endospore stain of C. botulinum.
13. Figure VI‐11a Rash associated with meningitis.
14. Figure VI‐11b Light micrograph of a Gram stain of N. meningitidis.
15. Figure VI‐12 Direct fluorescent‐antibody assay for N. meningitidis.
16. Figure VI‐13 Suspected and confirmed cases of meningitis.

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Library of Congress Cataloging-in-Publication Data

Names: Anderson, Rodney P., author. | American Society for Microbiology, issuing body.
Title: Outbreak : cases in real-world microbiology / Rodney P. Anderson.
Description: Second edition. | Washington, DC : ASM Press ; Hoboken, NJ : Wiley, [2020] | Includes bibliographical references and index.
Identifiers: LCCN 2019056743 (print) | LCCN 2019056744 (ebook) | ISBN 9781683670414 (paperback) | ISBN 9781683670421 (adobe pdf) | ISBN 9781683673552 (epub)
Subjects: MESH: Disease Outbreaks | Communicable Diseases | Disease Reservoirs | Disease Transmission, Infectious | Environmental Microbiology | Case Reports
Classification: LCC RA643 (print) | LCC RA643 (ebook) | NLM WA 105 | DDC 616.9â€“dc23
LC record available at https://lccn.loc.gov/2019056743
LC ebook record available at https://lccn.loc.gov/2019056744

Cover and interior design: Susan Brown Schmidler
Cover image credit: Shutterstock, spainter_vfx, https://www.shutterstock.com/image-illustration/connection-lines-around-earth-globe-theme-1075260245

Introduction

The science of microbiology is fascinating to those of us who have taken up the challenge of researching and teaching in this largely undiscovered and rapidly expanding field. One of the significant challenges faced by microbiology educators is to balance the need for providing a content foundation to students against the time required to demonstrate how microbiology affects their lives. The goal of Outbreak: Cases in Real‐World Microbiology is to help students make the important connections between the content of the course, their everyday lives, and the ways in which microbiology impacts society as a whole. These real‐world cases provide an opportunity for students to apply practical knowledge and to integrate their solutions to specific problems in cultures where customs, religion, public resources, and infrastructure influence the analysis.

Content

The outbreaks featured in each section are preceded by one or two tables listing the significant pathogens that can cause the infectious disease outbreaks. The cases presented in that section include only diseases caused by pathogens listed in the table(s). The diseases and pathogens chosen are those that are often covered in an introductory microbiology course. Limiting the pool of possibilities helps the students learn the basics thoroughly without having to consider the myriad possible causes normally associated with a differential diagnosis, thus making the activity more appropriate for undergraduate students. Each chapter ends with a set of descriptions of the diseases covered in the case studies. The descriptions are meant to be used by students for reference, if necessary, to gather the information needed to develop appropriate answers to the questions at the end of each outbreak. Each disease description presents information on (i) the causative agent of the disease, (ii) the pathogen’s mode of transmission from its reservoir to a new host, (iii) pathogenesis, (iv) the clinical features of the disease, (v) clinical and laboratory diagnosis, (vi) treatment of the disease, and (vii) general principles of prevention of the disease. Throughout each section, there is a balance between outbreaks that allow students to integrate and apply their knowledge and those that also require students to diagnose the pathogenic agent on the basis of lab test data and the clinical features of the disease.

The Appendix directs students to specific reference materials that provide information relevant to the study questions and encourages the students to apply the reference content to the cases they are studying.

Special Features

The last two outbreaks in each section are designated College Perspective and Global Perspective. The College Perspective presents outbreaks that directly impact the lives of students. The pathogens are typically spread easily in the college‐age population, or the outbreaks focus on issues important to students. The Global Perspective presents outbreaks that occur in non‐Western cultures. As a result, solutions developed by students for treatment and prevention require them to consider cultures in which differences in customs, religion, public resources, and infrastructure impact the analysis.

Case Studies in the Classroom

There are many ways in which case studies such as the outbreaks presented in this book can be integrated into a typical microbiology class. For example, they can be used as supplemental class readings and assignments to review application of content presented in class and to help students prepare for exams. They can be used to promote discussion to enhance lecture material. Students can become active participants in their learning by solving case studies that either review material already presented or introduce new material. Case studies can serve as the foundation for innovative approaches using cooperative learning groups. Cooperative learning groups can be used instead of lectures to allow students to investigate microbiological topics in depth. Case studies help students develop application, integration, and analysis skills. They can also be used as assessment tools to evaluate a course’s ability to develop integration and application skills. Therefore, they can be helpful in preparing for professional admission exams such as the MCAT, NCLEX, and GRE.

As with much of life, the most challenging parts are also the most rewarding. With much of science, learning the content base, although often challenging, is just the beginning. The real objective is to integrate and apply scientific concepts and principles to make a difference in the real world. The best education provides students with opportunities for both.

Features of Outbreak, Second Edition

The content of the second edition of Outbreak has changed significantly. Twenty‐five of the 75 cases in this addition are newly developed. The remaining cases have been re‐edited based on classroom feedback. In addition, all cases have an expanded section of questions to allow the students to go into more depth in the analysis of each case or to allow faculty members to choose the questions that will most apply to either the level at which they present their material or where they are in the presenting course material. All reference material has been updated, so content on the epidemiology, diagnostic methods, pathogenesis, treatment, and prevention is current.

As in the first edition, all the case studies are real. When students in the biological sciences are asked to invest their time in analyzing a case study, it is important that the information that is given be real and factual. In no time in their careers as future professionals will current students be required to solve a fictional scenario that imitates real life but is designed to be solved with simple, straightforward answers. Real problems in the world of microbiology do not always agree with our initial expectations, nor do they often lend themselves to simple solutions. As a consequence, to best prepare students for their future careers, it is important to give them opportunities to solve real‐world problems where answers require not only knowledge about microbiology but also the realities of social, economic, and health care‐related issues.

Recommendations for Using the Case Studies

Like all activities involved in the delivery of excellent health care in today’s world, the process requires a team approach. Consequently, when I integrate the case studies into my course, I have students work in collaborative learning groups when completing the case study assignments. The ability to work with others of diverse backgrounds and levels of ability is an important skill to develop for anyone choosing a career in health care. The collaborative learning groups also provide an opportunity for interprofessional education where the groups are composed of students whose goals are to pursue careers in various medical professions such as nursing, pharmacy, physicians, and physician assistants. In order to facilitate the teamwork process, it is important to introduce students to how to work successfully with others in their group by presenting some basic teamwork guidelines and rules. Teams that follow these straightforward guidelines are able to tap into others’ knowledge and expertise and present a case study analysis that is more concise and complete.

Acknowledgments

Thank you to Ohio Northern University for providing the sabbatical time that made this work possible. I also thank the staff of and the contributors to the Centers for Disease Control and Prevention’s journals and image library. The journals and images are a rich resource of information for educators and the public to use. All images credited to CDC PHIL can be located at https://phil.cdc.gov/default.aspx by using the PHIL numbers provided.