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How are Outbreaks Recognized?
•Review of routinely collected surveillance data
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•Astute observation of a sentinel event or cluster of events by a health care provider
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•Members of the community observe unusual trend in illness
Speaking Points

An outbreak, or the occurrence of more cases of disease than expected, can be detected in a number of ways:

•By review of routinely collected surveillance data – as we discussed previously, this in one of the main reasons we conduct surveillance

•Astute observation of something out of the ordinary by a health care provider, such as an unusual sentinel event or cluster of events. In September 2001, the first anthrax case was detected in Florida by an astute physician; West Nile virus was originally detected in New York City by a neurologist who saw a cluster of patients with an unusual encephalopathy

•Members of the community observe unusual trend in illness – recent NYT article about woman who noticed from reading local obituaries that many of the people who were reported to have died from variant Creutzfeldt-Jakob disease in New Jersey had connections to a local race track. As a result of this woman’s observation, two U.S. Senators have asked the CDC to investigate this possible cluster

References
•Max DT. The Case of the Cherry Hill Cluster. New York Times. 2004 March 28; Sect. 6:50 (col. 1).