Barcelona is a city with 1.

7 million situation,

located in the Mediteranean sea

during the last week of January 2006, some doctors call a public health official to write

reports an increasing number of people to the emergency room. Of the four large urban

hospitals who seek medical treatment for acute severe asthma. Specifically on Tuesday,

January 21, 2006, more than 130 people sought medical treatment for breathing

difficulties. Most considered to suffer from asthma. The attack took place suddenly and

cause severe problems 10% of patients requiring ventilatory support and 21% died.

1. What's thatasthma:

asthma is allergic conditions that arise in a person, the condition affects the

airways causing respiratory muscles contract and constrict, become inflamed and

mucus due antiglobulin reaction E in the body. Characterized by a distinctive

sound whezing.

2. Is this the epidemic, as more information about what you need?

Not Case Epidemic

Further information is needed:

a. When Time of the

b. agent or factor Who transmitting

c. How Factors allergens or environmental factors that trigger the onset of

d. asthma attacks Where population.

3. Review of hospital records showed that all four hospitals treated 288 people with

asthma during the month of January 2006. Now can determine if this is the

epidemic?

The case has not been able to determine the case of an epidemic or not

4. Develop a preliminary case definition.

Make a plan / preliminary in the case of descriptive epidimiolagi starting with:

a. By time

Describe the trend or tendency of diseases according to the period of the

incubation period. In the above cases, the incubation occurs daily in the period

ie on January 21, 2006

b. According to thePoints of

Keythe risk factors in place that describes the environment variable is the use

of clean water, air pollution, poor environmental sanitation. In the case of air

pollution are not a factor in singkarkan for all patients who come to show

symptoms of shortness of breath.

c. According to the

epidemiological characteristics according to insiders associated with the

spread of diseases grouped five parts: demographic characteristics,

characteristics of the biological, social and economic characteristics, behavior

characteristics, characteristics of the offspring. In the case of the above

 characteristics may be the biological characteristics associated with the system

antibody / endurance and antigen.

Table 1.
Number of persons over 14 years of age who had come to the city's four hospital
emergency rooms in the previous year (2005) with acute asthma.

Months Number of Months Number of Months Total

January 199 May 165 September 181
February 146 June 128 October 166
March 180 July 138 November 182
April 155 August 124 December 147

5. Do you now have enough information to know what an epidemic of asthma?

We have not found enough information to determine an epidemic of asthma or

not.

Table 2.
Number of persons over 14 years of age who had come to the city's four
hospital emergency rooms in the month of January 2006 with acute asthma.
Patient
Date asthma
1 5
2 8
3 8
4 5
5 5
6 4
7 4
8 9
9 7
10 9
11 9
12 5
13 8
14 6
 15 7
16 6
17 7
18 4
19 9
20 11
21 96
22 9
23 4
24

0 25 8
26 8 27
8 28

6. using the attached graph, draw a bar chart above tabulated data (table 2) any

additional information provided by the bar chart

additional information according to the table above that there has been a point

epidemic characterized by rapid increase in asthma cases within a few hours.

7. What other information useful to characterize this epidemic?

a. Environment (Allergy and pollution)

b. Agent

c. Time of the

d. locus of the

e. Population

Table 3

Data regarding age, sex, time and place of the onset of illness, for each of the

persons who Came to the emergency room with acute asthma on 21 January

2006. The

age of the type hours of point of

Gender onset onset of

41 F 10:55 4

28 M 12:50 2

27 M 13:40 2

40 F 12:00 3

30 F 13:25 2

19 F 02:20 3

17 F 11:05 2

40 M 17 : 15 1

28 M 13:50 2

49 M 17:10 1
47 M 14:30 1

40 M 10:00 3

41 M 10:08 10

28 F 13:30 2

48 F 16:30 1

29 M 13:10 2

30 M 13:15 2

27 F 14:05 2

57 M 14:40 2

28 M 14:50 2

30 F 11:25 2

29 F 14:20 2

41 M 14:10 2

28 M 14:15 2

27 F 14:25 2

40 M 12:55 4

30 M 15:25 2

19 F 15:05 2

17 M 15:40 2

40 M 15:50 2

28 F 11:50 4
49 F 15:30 2

47 M 15 : 10 2

40 M 12:40 2

37 F 09:25 8

41 M 11:40 2

40 F 12:30 2

37 M 12:15 2

38 M 16:50 2

38 F 12:25 2

39 F 13:20 2

39 M 12:17 1

40 M 12:35 1

15 M 12:25 1

40 F 15:25 2

27 F 13:05 2

47 M 16:50 2

89 M 12:10 2

49 F 15:20 2

29 F 12:20 2

19 F 17:20 1

67 F 12:30 1
40 F 17:25 1

29 F 11:20 2

78 F 11:30 2

40 M 12:05 1

37 F 11:30 1

41 M 12:08 10

40 M 19:15 6

37 M 10:17 1

38 M 10:35 1

38 F 10:45 1

39 F 10:25 1

39 M 10:25 1

40 M 10:05 1

15 F 23:25 6

68 M 12:45 1

19 M 12:25 1

38 M 18:50 1

48 F 18:30 10

37 M 11:17 1

49 M 19 : 10 3

38 F 11:45 1
 40 F 19:25 7

59 M 11:25 1

60 M 11:00 3

19 M 05:10 3

18 M 00:50 3

70 M 15:15 2

18 F 00:30 7

50 M 11:15 2

20 M 06:15 8

47 M 15:30 1

67 M 16:40 2

28 M 11:50 2

8. at City Map attached, using titik2 show the geographical distribution of disease

onset (Table 3) for the 96 people who came into the room ER with asthma acute

on January 21 what is suggested by the distribution

 of advice: in the area - the area with the onset of the disease most often committed

screening risk factor for asthma to determine the cause

9. using graph paper attached, make charts case per hour events (Table 3). What is

suggested hypothesis

testing hypothesis or suggested risk factor epidemiology is to use models include:

a. Agent
 Development of new hypotheses on aspects of the agent, which indicated their

manifestations increase in cases, in the above case related to immune factors

or allergens.

b. Host

In the above case no host factors that contribute

c. Environment

outbreaks occurred could be due to air pollution or gas poisoning.

In your discussions with the emergency personnel, do you find that this is not the

first time the hospital is full of patients suffering from acute asthma attack. You are

notified that the asthma epidemic has occurred 12 x during the last 2 years.

Noting triage with asthma dlm conditions and at certain times, you ask pollution

data in the city in the last 2 years. For Tuesday Jan. 21, air pollution levels below

normal, the level of sulfur diogsida rata2 24 hours is 54uglm and black smoke 98

micrograms / m3. , Rata2 highest huory for nitrogen dioxide adl 10ppb. 24 hours of

pollen and spores are also under rata2 number throughout the year. Meteorogi Data

show that high atmospheric pressure and stagnant air with very low wind speeds.

10. What conclusion can you get this information?

Air Pollution occurred on January 21, 2016