Case Studies (Home Page)

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Past QMRA Case Studies

Title Organism Exposure Location
Human Health Risks posed by High Tech Fomites Influenza A Fomites/Surfaces MSU QMRA Summer Institute August 2011
Disease Outbreak in Natural Disaster Zones V. cholerae Fomites/Surfaces MSU QMRA Summer Institute August 2011
Norovirus in Drinking Water Norovirus Drinking Water MSU QMRA Summer Institute July 2011
Boil Water Advisory Campylobacter and Cryptosporidium Drinking Water MSU QMRA Summer Institute June 2010
Q-Fever in Air Coxiella Burnetii Outside Air (Aerosalized pathogens) MSU QMRA Summer Institute 2014
Drainage of Urban Water Cryptosporidium Recreational Water Brazil QMRA II Institute July 2013
Tularemia in Water Francisella tularensis Drinking Water MSU QMRA Summer Institute
Risk management of Giardia exposure in South American communities Giardia Interaction of POU devices and secondary transmission Brazil QMRA II Institute July 2013
Biosolids Ascaris, Enterovirus, Salmonella Biosolids India July 2014
Toxoplasma gondii in Brazil Toxoplasma gondii Child risk of infection with Toxoplasma gondii via drinking water in Brazil Brazil QMRA II Institute July 2013
QMRA of Recreational Water Enterococci Recreational water - marine water Brazil QMRA II Institute July 2013
Irrigation of Lettuce With Reclaimed Water: Health Risk Comparison Among United States, Mexico and Brazil Norovirus and E.coli Lettuce Brazil QMRA II Institute July 2013
Yamuna River Salmonella anatum , Salmonella meleagridis , Salmonella Typhi , Shigella flexneri , Vibrio cholerae IHERA-Drexel December 2013
Cholera V. cholerae Marine and fresh water IHERA-Drexel December 2013
Indoor Air Pollution E. coli , Bacillus, Staphylococcus IHERA-Drexel December 2013
Schuylkill River Cryptosporidium IHERA-Drexel December 2013
Solid Waste Case Study Proteus sp., Bacillus sp., Klebsiella, Salmonella sp., E. coli, Staphlococcus aureus, Pseudomonas aeruginosa IHERA-Drexel December 2013
Legionella Case Study Legionella IHERA- Delhi July 2014
SOIV case study Influenza virus, H1N1 IHERA- Delhi July 2014
Solid waste case study Pathogenic E. coli, Salmonella, Rhinovirus, RVS IHERA- Delhi July 2014
Yamuna case study Vibrio spp., Shigella spp. IHERA- Delhi July 2014
Biosolids case study Adenovirus IHERA- Delhi July 2014
Bioterrorism: Risk Characterization and Emergency Response to Anthrax Attack in Love Park, Philadelphia Bacillus anthracis Outside Air (Aerosalized pathogens) IHERAII - Drexel June 2015
Guanabara Bay E. coli, Coliforms, Cryptosporidium, Enterococci, Giardia Recreational Water IHERAII - Drexel June 2015
Health Risk Assessment for Rag Pickers Staphylococcus aureus Solid Waste IHERAII - Drexel June 2015
Microbial Risk from the Philadelphia Water Supply Cryptosporidium Drinking Water IHERAII - Drexel June 2015

Getting Started

Case Study Template:

Case Study

Get started with QMRA case studies:

Getting Started

Case Study Criteria

  1. 1. Name the microbe(s) Genus and species and strain if known.
  2. 2. What is the source of the microbe? (eg. feces, tap water)
    • a. What is known about attack rates?
    • b. From what sources
    • c. Add reference
  3. 3. What types of disease results from infection?
  4. 4. What are the incubation times?
    • a. Context (e.g. the context of the reference study used, such as a specific outbreak, age group, etc.)
    • b. range
    • c. median
    • d. (REF)
  5. 5. What are the morbidity rates?
    • a. Context (e.g. the context of the reference study used, such as a specific outbreak, age group, etc.)
    • b. Range
    • c. Median
    • d. Ref
  6. 6. What are the mortality rates?
    • a. Context (e.g. the context of the reference study used, such as a specific outbreak, age group, etc.)
    • b. Range
    • c. Median
    • d. Ref.
  7. 7. What are the hospitalization rates?
    • a. Source (e.g. the context of the reference study used, such as a specific outbreak, location, age group, etc.)
    • b. Range
    • c. Median
    • d. Ref.
  8. 8. Does this effect sensitive populations? Y/N
    • a. How?
  9. 9. What are excretion rates?
    • a. Concentrations per unit of bodily fluid
  10. 10. What are the secondary transmission rates?
    • a. Source (e.g. context of data used, such as transmission to family members,children in daycare centers)
    • b. Range
    • c. Median
    • d. Ref.
  11. 11. Other information

  1. 1. What is the microbe(s) used, Genus, species, strain if known.
  2. 2. What model was used?
  3. 3. Why?
  4. 4. If from the wiki add experiment # if not add reference
  5. 5. Best-fit parameters
  6. 6. Infection, morbidity and/or mortality
  7. 7. List rates used for morbidity and or mortality if applicable
    • a. References
  8. 8. Was this used in a Monte Carlo?
    • What distribution and ranges?
    • If a two parameter model is used, what is the covariance between the parameters?
    • Were confidence limits used?
    • What were the simplified assumptions used?
  9. 9. Was a new DR model calculated for this Case study?
    • a. Add data used for the model (table form from DR)

  1. 1. What is (are) the exposure scenario(s)?
  2. 2. What are the sources, pathways and routes of exposure?
    • Note that source refers to the origin; route of exposure refers to the route of transmission
    • What is the exposure media?
  3. 3. What are the exposed populations and subpopulations?
  4. 4. Identify the concentrations, durations and frequencies of the exposure?
    • Is this data taken from modeling or measurement?
  5. 5. What exposure model framework was used? What exposure modeling approach is required?
    • - What environmental factors should be taken into consideration?
    • - Are you modeling fate and transport?
    • - Are you considering inactivation and/or growth?
    • What rates are you intake; and exposure pathway refers to route of transmission using?
    • What are the references for this information?
  6. 6. What are the sources of variability in the exposure assessment?
    • What distribution and confidence range surround these estimates?
    • What are the references for this information?
  7. 7. What are the sources of uncertainty in the exposure assessment?
  8. 8. What other information will be used?
  9. 9. What is the end result of the exposure model? i.e. distribution of estimates, point values, etc.

  1. What is the best estimate of the risk (or risks)?
    • What is the range of plausible risk estimates?

  2. Provide a table of input values (from dose-response and exposure assessments).
    • What are the sources and assumptions for each value?
    • Upload the spreadsheet used for the model.

  3. What inputs contribute the most to the uncertainty in the risk estimate?
    • Provide results of sensitivity analyses

  4. What might be done to reduce uncertainties in these inputs?

  5. What subgroups may suffer disproportionately?
    • What are risks for these subgroups?

  6. How does risk differ under alternate scenarios or model assumptions?
    • - Which assumptions have the most influence on results? (i.e. provide report generated by Crystal Ball or trial and error results from changing input values)
    • - How might the validity of these assumptions be assessed?

  1. 1. Does an established acceptable level of risk exist? What is it? Where did it come from?
  2. 2. What actions can be taken to reduce the risk? What are the options or alternatives for controlling the risk?
    • How much reduction is achieved by each alternative or the chosen alternative?
    • What were the sources used for these quantities?
  3. 3. Did you consider tradeoffs between risks, benefits and costs?
  4. 4. What are the other (i.e. the social, cultural, political, and economic) considerations associated with the possible risk management decisions?
  5. 5. What are the likely impacts of the risk management decisions?
  6. 6. What is the best strategy for risk communication?
    • -Who is the audience? What are their perceptions of the risk?
    • What information needs to be communicated? Who should the communication come from?
    • What method of communication should be used (i.e. brochure, radio, television, etc.)?
  7. 7. We might ask what stakeholder engagement efforts are proposed and might even ask them to respond to these three evaluation questions:
    1. 1. Is communication two-way?
    2. 2. Are substantive issues up for negotiation?
    3. 3. Is the process evaluated?


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