Anthrax in the cattle-keeping corridor of Uganda: a One Health case study

Photo credit: Centers for Disease Control and Prevention (CDC)

Background

This classroom-based case study is based on investigations undertaken in 2018 by the Ugandan Public Health Fellowship Program. However, the case study is not a fully factual account of these investigations: aspects have been altered to assist in meeting the desired learning objectives.

The original case study was developed by Ausvet and the Australian National University in 2019, and edited by Dr. Richard Dicker, Lead of the Curriculum Development Unit in the Workforce and Institute Development Branch at the U.S. Centers for Disease Control and Prevention (CDC). Version 1.0 includes a participant and instructor guide.

A second version was created in 2021 by Dr. Dicker to align more with the completed e-learning case study version of this outbreak investigation. Version 2.0 pulls from both the original classroom version and the e-learning version. Version 2.0 includes a participant guide, and an instructor packet, including instructor guide, implementation guide, supplemental reading, and data file.

The authors would like to acknowledge the original outbreak investigation team, especially Kisaakye Esther and Bainomugisha Kenneth, the lead investigators and Kween District Rapid Response Team.

Level of Case Study

Intermediate

Time Required

Approximately 3.5 hours, excluding break(s)

Languages

English, Spanish, French, Portuguese, and Arabic

Target Audience

Learners from intermediate-level Field Epidemiology Training Programs (FETPs) are the primary target audience for this case study, but it is flexible enough for use by learners from FETP-Frontline, FETP-Advanced, FETP-V (veterinarian) and FELTP (lab) as well as public health students, public health workers who may participate in rapid needs assessments, and others who are interested in this topic.

Prerequisites

For this case study, participants should have received instruction or conducted readings on outbreak investigation and epidemiological study design. This includes defining an outbreak, constructing a case definition, developing a case investigation form and calculating relative risks.

Version 1.0 Learning Objectives

After completing this case study, the learner should be able to:

  • Describe the usual sequence of steps of the outbreak investigation, and how they might differ when investigating a zoonotic disease outbreak.
  • Define the One Health approach and its relevance to preventing and responding to zoonotic disease outbreaks.
  • List the multi-disciplinary team members required to effectively investigate and respond to a zoonotic disease outbreak, and describe the roles of each.
  • Calculate attack rates and risk ratios to identify associations between exposures and disease.
  • Identify strategies for joint control of disease in animals and people in the context of a zoonotic disease outbreak.
  • Describe challenges that can limit effective multisectoral coordination for outbreak investigation and control of zoonotic diseases.
Version 2.0 Learning Objectives

After completing this case study, the learner should be able to:

  • Describe each of the steps of an outbreak investigation, particularly when investigating a zoonotic disease outbreak
  • Describe the One Health approach to an outbreak investigation, including its challenges
  • Develop and evaluate hypotheses about the source of an outbreak
  • Interpret epidemiologic data, both descriptive and analytic
  • Identify strategies for control and prevention of zoonotic disease in animals and people
Access

Both participant and instructor versions of this case study are available in the TEPHINET Library. All five languages are accessible from the same Library page. 

Access all case study documents here

Note: You must have instructor status on the website to download the instructor files. Please email learning [at] tephinet [dot] org to request instructor status.

Disclaimer

This case study was supported by TEPHINET, a program of the Task Force for Global Health, Inc., through Cooperative Agreement number NU2GGH001873, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention, the Department of Health and Human Services, The Task Force for Global Health, Inc. or TEPHINET.