Case Synopsis

A suspected cluster of variant Creutzfeldt-Jakob Disease (CJD) cases (a fatal neurodegenerative disease) has been identified in Toronto. Renée Dubois, a public health nurse, must utilize epidemiological data to recognize the outbreak, and mobilize resources to support patients and health care providers. The assembled epidemiological information gathered by the CJD surveillance system must be used to further support data analysis, public health decision-making, and public messaging. This case may be used to supplement lectures covering relevant public health events or epidemic analysis.

Case Objectives

  1. Understand the importance of case reporting and laboratory data for surveillance of infectious diseases and outbreak detection.
  2. Identify limitations of diagnostic tests and laboratory data, as well as the importance of ethical guidelines and informed consent in patient sampling.
  3. Devise an emergency preparedness management strategy in the event of a communicable disease outbreak.
  4. Interpret epidemiological data to understand the spread, origin, and effects of communicable disease.
  5. Interpret laboratory data in context of epidemiological data in order to make recommendations for timely public health action.

Case Study Questions

  1. What is an outbreak? a. What are some modern examples of outbreaks?
  2. How can you recognize an outbreak?
  3. What sources of information would you consult to confirm that it is an outbreak?
    a. How would you access this information?
    b. What are the limitations of diagnostic tests and laboratory data?
  4. What information is most relevant for public health decision-making?
  5. What is the role of media in outbreak investigation and communication?
    a. How do you ensure confidentiality in a high profile outbreak?
    b. What is the public message you would communicate, and what would that look like?
    - Relate this to current public health events.


epidemiology, Creutzfeldt-Jakob Disease (CJD), outbreak management, surveillance data, PHAC

Additional Author Information

Elizabeth Fan, BSc, MPH

Michel Deilgat, BA, MD, Medical Advisor

Mark Speechley, PhD, Professor



Recommended Citation

Fan, E., Deilgat, M., Speechley, M. (2017). Investigating Suspected Outbreaks of Rare Infectious Disease Using Surveillance Data: The CJDSS Perspective. in: John-Baptiste, A. & McKinley, G. [eds] Western Public Health Casebook 2017. London, ON: Public Health Casebook Publishing.