National guidelines for outbreak investigation: an evaluation study

Abstract

This paper reports an independent epidemiological study to evaluate the validity of the results of an official investigation into an outbreak of gastroenteritis at a university campus in Yasuj, central-south Islamic Republic of Iran. The official report of the outbreak by the Department for Disease Control at the provincial health centre found only 65 cases over a 5-day period, all females, living in the student halls of residence. This contrasts with a questionnaire survey of 963 students at the same university, which found 395 students (192 males and 203 females), living in residences and at home, who reported at least 1 gastrointestinal symptom over a 12-week period. Within this period at least 2 outbreaks occurred. Such a large discrepancy between the official report and the current study suggests that the health services and the public may have been misled about the proper response to the outbreak.

The epidemiology of cholera in the Islamic Republic of Iran, 1965-2014

“…Moreover, epidemiologic feature and control of cholera disease based on related factors was investigated for the last three epidemics in this study. While under-ascertainment of cholera cases due to mild or no symptom of infections (90-95%) is common, under-reporting and variations for case definitions and methods of case finding in communicable disease surveillance system in the country during 50 years should be indicated as main limitation of our study (27,28). However, in case of cholera, under-ascertainment and under-reporting issues were improved following intensified sensitivity of the communicable diseases surveillance system, so that it has become an urgent notifiable disease for at least three decades (29,30).…”