Investigation of a cluster of cases of vomiting and diarrhea among children who had attended a birthday party at an indoor swim club in Vermont in 2004.  

Learning Objectives:

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

1. List categories and examples of questions that should be asked of key informants who report a suspected infectious disease outbreak;
2. Discuss considerations in working with businesses that might be identified as a possible source of an outbreak;
3. Outline components of swimming pool design and operation that help prevent the transmission of pathogenic agents;
4. Discuss the action of chlorine to disinfect water and factors that influence its effectiveness;
5. Interpret test results for chlorine and pH with respect to swimming pool water quality;
6. Identify activities that increase a person’s risk for exposure to pathogens in recreational water;
7. Interpret results from a cohort study, including attack rates, relative risks, and P values; and      
8. Describe the steps for management of fecal incidents in treated recreational water venues.