In Texarkana, the investigators defined a case as an “illness which is clinically compatible with measles.” Critique this case definition.

Introduction:

This case study is based on an investigation by Philip Landrigan, EIS ’70. The investigation is described in: Landrigan PJ. Epidemic measles in a divided city. JAMA 1972; 221: 567-570.

This case study was original developed by Philip Landrigan, Lyle Conrad and John Witte in 1971. The current version was updated by Richard Dicker in 2001 and 2003.

Part II

The investigators obtained names of cases from the health departments, physicians, school and nursery records. They conducted a door-to-door survey. They also asked families of cases for names of other cases. They used the same methods of case-finding and epidemiologic investigation on both the Arkansas and Texas sides of town.

Clinical Picture

The illness was clinically compatible with measles. Typically, the patients had a 4- to 5-day prodrome with high fever,
coryza (runny nose), cough, and conjunctivitis (red, irritated eyes) followed by the appearance of a bright maculopapular (red spots and areas) rash. The temperature usually returned to normal 2 to 3 days after appearance of the rash, while the rash persisted for 5 to 7 days.

Directions:

Measles is the theme of this Case Study. Answer the questions listed for part 2 (below) using APA citation and
formatting in a 4-page paper after reading the material and using the resources provided. Use references as appropriate to answer the questions fully. Remember to cite all sources.

Use professional references (not common websites), cite the reference where used in the narrative, and use correct reference formatting.

Answer the following questions with responses:

• Question 3: How might you define a case for purposes of this investigation?

• Question 4: Describe the difference between a sensitive case definition and a specific case definition. What are
the advantages and disadvantages of each? Provide an example of a situation where each would be helpful.

• Question 5: In Texarkana, the investigators defined a case as an “illness which is clinically compatible with
measles.” Critique this case definition.

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