How to Focus Your Efforts When Investigating Infectious Disease Outbreaks

Arjun Srinivasan, MD, Associate Director, Healthcare-Associated Infection Prevention Programs, Centers for Disease Control and Prevention, shares how to focus your efforts for infectious disease outbreak investigations.

Interview Transcript (slightly modified for readability)

“The approach to antibiotic-resistant outbreaks is very similar to the approach that we take for any type of outbreak. These common factors of coming up with a definition for the cases, looking for associated factors, and then looking for the behavioral practices that might be leading to the transmission. Those are common [strategies that we do] for almost all of the types of pathogens.

That’s one of the advantages of learning to do an outbreak investigation because once you learn, you can apply those skills to really any type of pathogen. What you do have to know though, is the specifics of what the pathogen is doing; how is it transmitted? For example, [organisms] like Burkholderia or Ralstonia, those tend to be organisms that live in water-borne areas, and wet things. So, you’re going to focus your efforts on the factors that are most likely to lead to transmission of things that like it to be wet. Something like [Vancomycin-resistant Enterococcus] VRE likes to live on surfaces, so you’ll focus your efforts on surfaces that might be shared between different patients.

The approach that you take is similar, whether the organism is resistant or susceptible, but the things that you look for would be different depending on the specific type of organism that you’re dealing with, and that’s why it’s so helpful to engage your microbiologists in the investigation because they are the experts who can really help guide you to where you might be most likely to find the problem.”