I was assigned as an intern in a local health department, most especially, in the office of Shoua

Shinde, the staff epidemiologist. With newly reported outbreak of diarrhea in hospitals, Shinde assigned
me to process the data given by the public health nurse, Terry Tower. The use of mapping technique
may broadly identify the geographical source of the disease based from the similarities of the cases’
destinations, trips, and even their own location. Many situations in the game utilizes this technique
leading to the consideration of Thompson Park an area of interest. Although the maps are helpful in
identifying the broader picture of the origin of the outbreak, specific areas within the site must also be
determined for possible vehicles in disease transmission. To which, it could be a contamination of the
water supply or by a biological vector. Subsequent reports indicated that the fruit punch from the
concession stand might be the cause of the spread. However, using these maps alone provides no
explanation of the causative agent. The use of laboratory techniques helps bridge this gap along with
the samples I collected from the site and the supplemental information the employee in the stand
provided me with. With results yielded from the investigation, Ted Hawthorn was able to communicate
to the public the cause and the intervention the city would do in order to resolve the problem. With this,
it gives the public the assurance and information to the recent problem in Watersedge.

As an intern, advices given by the public health professionals were helpful on my mission to
identify the source of the outbreak and the cause of its spread. The utilization of the cases’ travel
history within the span of two days were helpful in constructing the maps. All patients reported to have
visited the Thompson Park on the Saturday in May 25 which became an area of interest in the
investigation. Upon closer inspection, five areas in the park were considered by Shinde significant
which are the water fountains near the beach and baseball diamond, the beach, and the drain. I took
water samples and submitted it to the laboratory for processing. The laboratory results reported that the
fountain near the beach is positive for Cryptosporidium. Along with new reported cases, new set of data
were also gathered. In order to process this information, I constructed another mapping technique
based from the specific areas within the park. Through which, the fruit punch from the concession stand
was of particular interest in the investigation because most cases attributed to have consumed it.
However, there seems to be no connection between fruit punch and to the laboratory result that the
water fountain near the beach containing Cryptosporidium. Moreover, some of the patients did not even
drink water from the particular fountain, but only fruit punch from the concession stand. Actually, upon
interviewing the employee of the stand, it was discovered that on Saturday in May 25 the employee had
to source his water from the fountain near the beach due to the growing demand from the clean-up
event. To determine the cause of the contamination, Shinde relayed that only the water fountain near
the beach is supplied from a local well and its respective filter is broken, thus considered to be the
source of the outbreak. Leslie Hernandez also informed me of recent problem within Watersedge
concerning of a runoff due to heavy rains. In summary, due to the well’s close proximity near the cattle
farm, a potential runoff caused by heavy rains carrying Cryptosporidium from infected cattle
contaminated the water source. A malfunctioning water filter exacerbated the problem, potentially
delivering contaminated water to park-goers on Saturday in May 25.

Before starting the investigation in Watersedge, I had the chance to read and watch the
materials provided in the department’s kiosk area. I was particularly interested in Dr. Asha George’s
talk about commitment and crisis which was strongly influenced from her experiences in the army. She
argues that the difference between the living and the dead is the courage to act upon a decision. In a
battlefield, the urgency of the situation forces soldiers to make a decision and enact on it that would
ensure their survival. Whereas, failure to do so, endangers his life and his fellow countrymen. So, to
speak, the dead met its fate because of his failure to make a decision. Similar to public health crisis,
health officials must initiate control measures in parallel to their ongoing investigation to contain and
mitigate the problem. Along formulating preventative measures, to ensure a similar problem would not
arise again. The interplay of urgency and necessity are vital to the decision-making in public health in
which it sorts through what aspects should be prioritized first. Thus, one can say in the realm of public
health, one must be committed to enact their duty. Aside from my exploration in the kiosk, I was
expecting that the data gathered from the patients was in a form of statistics and somehow, we need to
analyze it. However, in the game, clues and hints are given and we are only required to construct the
map based on where the patients have travelled or have eaten in the last two days prior to
hospitalization. Initially, I thought food-borne disease was the cause of the outbreak because all initial
five cases seemed to have consumed a lettuce or green salad alongside the frequency of the patients
going to the park on May 25. This presumption totally undermines the unexpectedness of the
investigation and possibly the real-life practice. Moreover, gathering information from the patients
regarding their recent activities and trips are significant in identifying the possible source of the
outbreak. Alongside, collecting information and samples from the site through note-taking and picture-
taking. Surprisingly, part of the job is by being well-informed in the community’s current events that may
have affected the outbreak, particularly, the newspaper headline Lisa Fernandez had informed me.
Overall, the experience in conducting an investigation as an intern under the health department’s
epidemiologist, Shoua Shinde, was insightful to which we were able to build rapport with the community
through information gathering and, in return, information dissemination.