There is an outbreak of unknown disease on an isolated island lost in the ocean.

There is an outbreak of unknown disease on an isolated island lost in the ocean. People are getting very sick. Looks like this island was “forgotten” by the rest of the world due to its very remote location. For this reason, local people had never been vaccinated against any contagious diseases.

It was noticed that the outbreak started after the island was visited by some unidentified military ship that delivered “humanitarian help” to the island and immediately left.

The disease is contagious, it spreads from one person to another.

The incubation period for the disease (the length of time the pathogen in a person’s body before they look or feel sick) can last up to 14 days.

The first symptoms of disease include a high fever, fatigue, a headache, and a backache. After 2 to 3 days of illness, a flat, red rash appears. It usually starts on the face and upper arms, and then it spreads all over your body. Over the next 2 to 3 weeks, the flat, red spots become firm and dome-shaped and fill with pus. Then they scab over. Scabs fall off 3 to 4 weeks after the rash first appears, and they leave pitted scars.

At least 30% of the sick die. Some are left blind.

It appears that this disease affects only humans. It resembles a disease that is believed to be completely eradicated by 1980.

A group of HCC microbiology students is going to the island to discover the cause of the outbreak, to provide help to the sick and possibly stop the outbreak.

Due to a very remote location and constant severe storms, the group can bring only limited supplies. They will need to eat local food (plants/animals), drink local water. They need to do it safely using universal precautions as the disease may have different routes of transmission. Another contagious disease can be present on the island as well.

What will you bring? What precautions (preventive measures) should be done by students to be protected from a contagious disease before going on the trip?

The condition seems to be transmitted through physical contact with infected humans, which means that they have to wear PPEs as precautions and for protective measures. Since the outbreak was first identified after unidentified military ship landed into the island, it would be recommended that the students carry their own food as it was the main supplies donated by the military ship. Another precaution that they need is to prepare isolation facilities where the infected persons will be placed as they investigate the unidentified illness.

What vaccines if any?

Based on the description of the physical symptoms of the disease, it is most likely that the victims are suffering from small pox, which as well is contagious, transmitted from one person to another. Therefore, it would be recommended that the students get a smallpox vaccination just in case the unidentified disease is small pox.

What is your strategy?

The strategy is to pick up samples from the patients and take them to the laboratory for testing.

How would you start?

I would start by isolating the affected population from the general population. Then, take samples from the infected persons and some samples from the seemingly healthy populations. After taking the samples, I would take them to the laboratory for testing to help identify the strains present as the cause of the infectious disease.

If you need to set up the lab, what BSL it would be?

Setting up a laboratory is a must to help test the collected samples from the patients. Since the specimen to be used in the laboratory can result to infections of healthy individuals, I would set up a Biosafety Level 2 (BSL-2) laboratory which would include access to equipment that can decontaminate laboratory wastes including an incinerator, an autoclave, as well as other methods of decontamination. Access to the laboratory will be highly restricted when work is conducted to keep the risk of infection at minimal.

What pathogen, you suspect, is causing this outbreak?

A pathogen is an organism that causes disease. Based on the symptoms of the diseases such as rushes in the skin and fever; it can be concluded that the pathogen is variola virus. The virus is contagious and can be spread from one person to another. Individuals with such pathogens experience symptoms of fever and a distinctive, progressive skin rash.

What is the treatment?

Smallpox is a virus and thus there is no cure, but management of the disease. Vaccines are used to control the spread of smallpox and therefore, administering smallpox vaccines to the entire population in the island can help control the spread of the virus. Also, the administration of antiviral drugs can also be used to treat the spread of smallpox in the region.

What should be done with the team upon return to prevent spreading this disease? Their belongings? To the ship that picked them up after the mission was over? To everybody who was on the ship?

Minimizing the spread of the disease is the utmost importance to both the residents of the island as well as back home. For this reason, the team that had gone to the island to control the spread of the infectious disease should be vaccinated and isolated from the general population for a period of at least a period of two weeks. Isolating these individuals will minimize contact and thus, if they had been infected, they will not infect other people and this will help control the spread of the virus. In regard to their belongings, they should be decontaminated to help contain the virus. However, it would be recommended that most of the belongings be incinerated to ensure the complete elimination of the virus. To the ship that was used to pick them after the mission, it should be decontaminated and withdrawn from the active fleets to ensure that no more people get infected with the virus. Everyone who was in the ship might as well be required to isolate or be quarantined for a period of at least two weeks to minimize chances of spread in the event that they had been infected without knowledge. They should as well be vaccinated as the infection might be in the mild stage, implying that they can be potential spreaders of the disease.

Please refer to the rubric.

The form of submission is informal. It can be a journal, a movie, a Power Point presentation, etc. Be creative!

Some suggested (but not limited to) resources:

https://blu-med.com/airborne-diseases-an-overview/(Isolation of sick)

Microbial Control (course lecture material)

Immunity and Vaccines (course lecture material)

Biosafety Levels https://www.cdc.gov/training/quicklearns/biosafety/

Smallpox https://www.cdc.gov/smallpox/index.htmlDonning PPE https://www.youtube.com/watch?v=5cvn8G-1NUADoffing of PPE https://www.youtube.com/watch?v=Acfzjrd4BBsHow Scientist Enter and Exit BSL4 Lab https://www.youtube.com/watch?v=9gqRBB8QgJUBSL4 Waste Management https://www.youtube.com/watch?v=DdptQ7BLPNASmallpox https://www.cdc.gov/smallpox/index.htmlhttps://www.empr.com/home/news/fda-approves-tembexa-for-smallpox-treatment/