org355: Vampire facials

From The New York Times.

Over time officials identified four former clients and a sexual partner who had received H.I.V. diagnoses between 2018 and 2023, despite reporting few risks associated with infection, such as injection drug use, blood transfusion or sexual contact with a new partner.

1. As above, there was an infection outbreak and the transmission route was unclear. What steps should an epidemiologic take?

2. What study design is most suitable here? Why?

3. Assuming you could administer a questionnaire to the people who had been infected, how would you figure out what 'exposures' to ask about?

Re: Vampire facials

by | Damalie Namponye - Thursday, 2 May 2024, 2:23 PM

I recently learnt about the list experiment as a way to ask people about socially sensitive experiments. I would set up a survey that utilizes the list experiment. A case-control is most suitable here because we already have the outcomes. I would ask about any kind of needle exposure, including for medical or dental work, but I would also use the list experiment to improve validity of the answers given.

It is sad that one would get exposed to a blood-borne disease through facials.

Re: Vampire facials

by | MADHUTANDRA SARKAR - Thursday, 2 May 2024, 5:38 PM

Hi Sujit,

The following are my answers:

1. The steps need to be taken are:
• First the epidemiologist should develop a case definition and define the population at risk. Then the incidence risk in the study population should be compared with that in the general population as reported in the previous years (past reports/media coverage) to confirm the presence of an outbreak.
• Then the epidemiologist should interview the infected people regarding the possible exposures (e.g. receipt of any injection, any history of injection drug use, history of blood transfusion, history of surgery, sexual contact, etc. for HIV infection). Then the incidence risk in the study population should be compared with the incidence risk in the population who did not have any exposure.
• The epidemiologist should also investigate whether any specific exposure is associated with this outbreak if there are history several modes of exposures (e.g. sexual exposure, blood contact, etc. in HIV infection).

2. I would prefer a matched case-control study. Because the outcome has already happened, and it will be easier to recruit controls from the neighbourhood, age and sex-matched. It will improve the efficiency of the study.

3. After confirming the presence of an outbreak, I would ask the infected people about the key exposures related to the infection to identify the primary mode of transmission in this outbreak. I would review the literature, and also my current knowledge of this infection would help to figure out the key exposures.

Looking forward to your feedback.

Thanks in advance!

Madhutandra