Case Study 6

1. Case Study 6 Disease Outbreak

2. Scenario • Makebelievia’s National Health Administration is concerned about an outbreak of Fairytale Pox and has enlisted your help to combat the disease

3. Characteristics of Fairytale Pox • The natural disease reservoir is unknown, but previous outbreaks have coincided with heavy spring flooding • Once in the population, the disease spreads by direct contact (e.g., like a common cold) • The incubation period of the disease is ~ 3 weeks (i.e., infected & contagious, but with no symptoms) • Mortality rates • 70% without treatment • 15% if treated upon initial detection of symptoms • 2% if treated before symptoms develop

4. Part 1: Information gathering (5 minutes) • What geographic data would you want to collect about past outbreaks to help you better understand the disease • List at least 3 data types

5. Discussion Part 1 • What were some things you came up with?

6. New Information • The disease outbreaks seem to originate from the Boondocks, a frontier region characterized by illegal settlement, poverty, lawlessness, poor healthcare, and low education • The disease seems to be most prevalent in low, swampy areas & more prevalent in areas that were recently deforested • The major water source responsible for the seasonal flooding is winter snowfall in the Overyonder Mountains • The disease typically reaches Makebelievia’s more populated areas several weeks after outbreaks are first reported in the Bookdocks • Springtime is also when the greatest flux of people occurs due to transport of mustard turnips (the Boondocks’ chief cash crop) to market • Treatment costs $19 per patient and the population of Makebelievia is 61,000,000 • Outbreaks have occurred, on average, every 3-4 years for the past several decades

7. Part 2: Prediction (10 minutes) • List 5-10 variables that might be useful for predicting an outbreak • Also include where you would search for the data and/or how you would collect it

8. Discussion Part 2 • What were some things you came up with?

9. New Information • The president of Makebelievia has proposed an ambitious levee construction project to control seasonal flooding estimated to cost $14 billion dollars and take 6 years to complete

10. Part 3 (5 minutes) • Without knowing any additional information, would you support the president’s plan? FYI: $19 * 61,000,000 = $1.159 billion

11. Discussion Part 4 • Who supports the president’s plan?

12. New Information • Fairytale pox is slowly developing drug resistance to the common treatment. Other treatments exist, but cost several times more and are less effective • The president’s administration has been accused of massive corruption and the secretary of the interior (who suggested the levee project) is the president’s brother… who also happens to own the largest construction contracting firm in the country and stands to make a lot of money • The last major governmental construction project in the country was plagued by delays and cost overruns ultimately resulting in a doubling of construction time and cost • In other countries similar levee projects have failed during very wet years, leading to major losses of lives & property from the resulting floods (e.g., new construction often occurs in unsafe areas due to a false sense of security from the levees) • Although mustard turnips are the officially recognized cash crop, the illegal narcotics trade in the opium beet (the predecessor to “Boondock Blow”) is highly lucrative

13. Part 4 • What the heck do you recommend?