The Scenario
A cluster of severe, atypical respiratory infections has been reported at Atrium Health Wake Forest Baptist hospital.
- Initial PCR panels rule out common seasonal pathogens.
- Several of the patient reports having visited a local farmer’s market where they purchased a live chicken and other livestock were present.
The Response Team
An incident command center has been activated to coordinate the response.
The response team is responsible for the following:
Pathogen Identification and Diagnostics
This group will be responsible for taking the specimens that were collected from the field team and identifying the pathogen that is causing the outbreak.
Objective Identify the pathogen within the time and budget allotted.
You only have 48 hours to identify the agents and a limited budget.
Questions
- Did you identify the pathogen?
- What kind of constraints did you operate with?
- Did all of the specimens test positive? Why or why not?
- Were specimens testing positive for multiple things?
Diagnostics Available
You only have the specimens that were collected from the initial field team.
| Diagnostic | Description | Cost | Time |
|---|---|---|---|
| Culture |  |
$500 | 2 hours |
| PCR |  |
$2,000 | 4 hours |
| EM |  |
$5,000 | 8 hours |
| WGS |  |
$15,000 | 24 hours |
Testing Response Team
This group is responsible for designing our testing plan.
Objective: Maximize testing coverage within the budget, minimize false negatives and false positives, and limit the response time to 21 days.
Questions
- What was the optimum configuration given your budget? How long would it take to deploy?
- How did the assay choice impact your testing coverage, cost, and time line?
- What do you think the conseqences of false negative/positives would be in a response?
- If money were no object, how much would it cost to use all of each type of test?
