Ottawa County Gastrointestinal Event—Summer, 2004



Ottawa County Gastrointestinal Event—Summer, 2004

Case Questionnaire

Hello. My name is _________ and I am working with the Ottawa County and Ohio Departments of Health. May I please speak with _________________(or parent)? We are investigating an outbreak of diarrhea among people who traveled to South Bass Island, OH during July or August, 2004. We understand that you were ill and have previously spoken with someone from the health department, and we appreciate your assistance. At this time, we are collecting additional information from both ill and well people in order to better understand what caused this outbreak. We would like to ask you some very specific questions about your visit to the island on ____/____/____ to ____/____/__________(dates) which were not asked previously.

The interview will take about 8-10 minutes. Your participation is voluntary, and all of the information you provide will be kept confidential. You may skip any questions you choose not to answer, and you may stop the interview at any time.

Would you like to continue? Y N

If not, May I call you back some other time? Y (date/time_______________) N

Thank you.

→ If matched control on the line list is a household member:

We would also like to interview your travel companion(s), ________________, who did not become ill immediately after the visit. It is important to compare the activities of both ill and well people in order to understand the cause of the outbreak. Will this be possible? Y or Don’t Know N

If yes or don’t know, please thank the case and arrange to do the control interview(s) after completing the case interview. If no, please thank case and terminate interview.

→ If contact information is not available for the matched control(s) on the line list:

It is important to compare the activities of both ill and well people in order to understand the cause of the outbreak. Would you be willing to provide phone numbers for ___________? Y N Will call us with # later

If yes or will call later, please thank the case and record name/# on the line list.

If no, complete the case interview anyway.

If the case cannot immediately provide # but is willing to find it for us, they may call the Ottawa County Health Dept at 419-734-6800 when the number is available, and you may proceed with the interview.

ILLNESS INFORMATION

1. What is your age? ________years Sex?__________

2. On what dates did you visit South Bass Island? ____/____/____ to ____/____/____

3. Can I confirm that you got sick after traveling to South Bass Island?

|( Yes got sick |

|When did you first symptom start? Date: Onset ____________ Time:______________ |

|When did you feel “back to normal”? Date: Onset ____________ Time:______________ |

|( No did not get sick |

If no, apologize and say goodbye.

If yes, I’m going to read you a list of symptoms. If you had the symptoms during your illness please answer “yes”, and if you did not have the symptom, please answer “no”. If you can’t remember whether or not you had the symptom, it is OK to say that you “don’t know”.

Notes to interviewer: Read each symptom, record “Y” for yes, has symptoms, “N” for doesn’t have symptoms or “DK” for don’t know.

|SYMPTOMS |YES |NO |DK |

|Abdominal cramps | | | |

|Diarrhea – | | | |

|(diarrhea is defined as three or more loose stools in a 24 hour period) If yes, #days| | | |

|with diarrhea_______ | | | |

|If yes to diarrhea, was there any blood visible? | | | |

|Nausea | | | |

|Vomiting | | | |

|If yes, # days with any vomiting______ | | | |

|# vomiting episodes on worst day_______ | | | |

|Headache | | | |

|Body Aches | | | |

|Chills | | | |

|Fever | | | |

|If yes, highest temperature in °F______ | | | |

|Any Other Symptoms If yes, describe: | | | |

4. In the two days before your illness were you in contact with anyone else who had similar symptoms or illness like yours?

( Yes Name __________________contact info_________________________

( No

EXPOSURE INFORMATION

Now we would like to ask you some questions about the food and water you consumed on the island.

5. Did you fill up and drink any water bottles with tap water while on South Bass Island?

Y N DK

6. Did you drink any commercially bottled water while on South Bass Island?

Y N DK

7. How much tap water did you drink before you became ill on South Bass Island? I will read you a list of choices: (interviewer please tick)

a. None (

b. ................
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