Table 3.

Selected International Epidemic-Assistance Investigations and Response Efforts Conducted by the Centers for Disease Control and Prevention’s Epidemic Intelligence Service Officers, 1976–1985

Year	Location (Reference No.)	Category	Etiology	No. of Cases, Deaths, Case-Fatality and Attack Rates, if Available	Risk Factors	Public Health Actions	Collaborators
1977	Haiti (25)	Disaster	Drought	400 families selected for study to examine the impact of drought on water restriction	Diarrhea rate higher for children from homes with less than one 5-gallon (18.9-L) can of water/person per day	Concluded that the field epidemiologist can provide much needed information to planners concerned with providing adequate water supplies	Haiti Ministry of Health, Agency for International Development
1977	DRC (26)	Zoonotic	Ebola	318 cases; 280 deaths; 38 serologically confirmed survivors	Injections received at hospital, contact with infected patient	Recommendations included active national surveillance and disseminating information to medical personnel regarding surveillance	Institut de Medecine Tropicale (Belgium), Commissariat de la Sante Publique (Zaire/DRC), Institut Pasteur (France), Fonds Medical Tropical (Zaire/DRC), South African Institute of Medical Research
1979	South Sudan (27)	Zoonotic	Ebola	34 cases; 22 deaths (65% case-fatality rate)	5 families primarily affected; 21 females, 13 males; nosocomial acquired infection	Contact tracing for patients; laboratory testing to identify Ebola	WHO, Belgian Assistance Program Sleeping Sickness Project
1981	Venezuela (28)	Other infectious	Delta-agent superinfection with hepatitis B	149 Yucpa Indians; 34 died; 22 experienced chronic hepatitis	Ages 1–14 years	NA	Venezuela Ministry of Health, Pan American Health Organization
1982	Canada (29)	Injury	Pediatric deaths	Case-fatality rate elevated; 43.1 deaths/10,000 patient-days; 25/33 infant deaths occurred during 12:00–6:00 AM	Children with severe congenital heart disease; for 4 patients, investigation indicated possible intravenous overdose of digoxin	Recommendations that hospital strengthen control for dispensing medicines and implement a system for monitoring deaths by time and place within the hospital	Ontario Ministry of Health, Ontario Ministry of Labour, Laboratory Centre for Disease Control, Health and Welfare Canada
1983	Mexico (30)	Foodborne/enteric	Non-O1 cholera	Case-control study conducted; exact numbers unavailable	Compared with controls, more cases had eaten home-prepared gelatin during the 5 days before illness onset	NA	Mexican Ministry of Health, Pan American Health Organization
1983	Kenya (31)	Zoonotic	Rabies	Female American Peace Corps volunteer died 20 days after illness onset	Bitten by her puppy who had rabies	Recommendation for persons in developing countries to test their rabies antibody for seroconversion	US Peace Corps, Kenya Medical Research Institute, US Department of State, US Army Medical Research Unit
1985	Canada (32)	Foodborne/enteric	Botulism	1 confirmed and 20 suspected cases of botulism	Cases associated with eating at a Vancouver restaurant, August 27–September 11, 1985	Physicians told to be aware of the outbreak and to report suspect cases to local and state public health authorities	Department of National Health and Welfare, Ottawa, Canada, US Food and Drug Administration
1985	Sao Paulo, Brazil (33)	Other infectious	Brazilian purpuric fever	10 cases among children, 100% case-fatality rate	Antecedent purulent conjunctivitis more present among ill children than controls (2 case-control studies conducted); children aged 1–4 years at higher risk	Disease investigated; working case definition used for surveillance and to identify other cases	Pan American Health Organization, Sao Paulo Ministry of Health
1985	France (34)	Nosocomial	Aspergillus	7 cases	Epidemiologic study did not reveal the risk factors; study affected by laboratory contamination of other samples being tested for Aspergillus	Transplant unit closed to new admissions; testing undertaken; substantial numbers of additional cases above the norm led investigators to discover that laboratory testing was false	Service de Microbiologie Medicale, Institut Gustave Roussy, Direction de l’Action Sociale de l’Hygiene et de la Sante de la ville de Paris
1985	Haiti (35)	Foodborne/enteric	Shigellosis	339 cases of diarrheal illness among tourists and hotel employees	Case-control study; illness associated with being of North American origin and eating raw or rare hamburger	Ill kitchen staff no longer allowed to work in the kitchen	Pan American Health Organization, Government of Haiti

Abbreviations: CDC, Centers for Disease Control and Prevention; DRC, Democratic Republic of Congo; NA, information unavailable; WHO, World Health Organization.