A team of Epidemic Intelligence Service officers from the CDC arrives in Rhode Island, homework help

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Hello!  I have the follow questions that need answered.  Do you think you can help?  

A team of Epidemic
Intelligence Service officers from the CDC arrives in Rhode Island to assist
the state health department with investigation and control of an outbreak of
measles.  The team is asked to include
the entire state in the investigation; thus, the case definition for measles in
this outbreak is any resident of Rhode Island meeting the clinical case
definition (you can find it at the CDC web site if you want to see it) who
either has a positive laboratory test for measles IgM antibody or is a contact
of someone with a positive test. 
Individuals meeting the clinical case definition who did not have
laboratory confirmation and were not contacts were classified as “possible
cases”. 

The team members
arrive in Rhode Island on March 1st
They discover 13 individuals who met the clinical/laboratory case
definition with dates of rash onset in February.  Ten of these 13 are Rhode Island residents,
the other three are residents of neighboring states who were seen and treated
at Brown University Medical Center in Providence, RI.  Nine of these 10 were still ill as of March
1.  The tenth, the probable index case
for the outbreak, was a teenager who had traveled to Europe and returned three
days prior to her rash onset.  She had
recovered from her illness by the time the investigative team arrived.

During March, 31
additional Rhode Island residents were discovered who met the clinical case
definition for measles, with rash onsets after March 1st.  Twenty-three of these had laboratory
confirmation and 6 others were contacts of those who had.  An extensive statewide record-checking and
vaccination program was undertaken throughout March, focusing on those schools,
communities, and other settings where cases had occurred.  Only two of the cases had rash onset in the
last week of March.

For
the purposes of this exercise, use one million for the Rhode Island state
resident population.

 Note:  remember to express all rates (incidence is a rate) per unit of population and per unit of
time.  Prevalence (a ratio) needs only to
be expressed per unit of population.

1) 
What
was the prevalence of measles in Rhode Island as of March 1st?

2) 
What
was the incidence of measles in Rhode Island for March? 

3) 
What
would the incidence be if possible cases were included?

4) 
If all
but two of the February cases, and seven of the March (confirmed) cases had
recovered by March 24, what would the prevalence have been as of that date?

5) 
Fill in the blanks
on the following table using the formula for determining prevalence, incidence
and duration (1 point each).  Complete
all answers in blue.

Prevalence and Incidence of Selected Diseases

Disease

Prevalence per 100,000

Incidence per 100,000 per year

Years Duration

Epilepsy

30.8

12.2

Multiple
Sclerosis

  56

  5.0

Parkinson’s
Disease

157

7.85

Motor Neuron Disease

  7

  1.7

Central Nervous
System

17.3

3.99

Neoplasms

10

2

6) 
Observing the data in
the table above, what interpretation can you give?  What applications do you find there for the clinical
practitioner?  For the
epidemiologist?  (5 points)?

In a city of
100,000 people, there were last year 1000 deaths and 1500 live births (none
were multiple births), of which 1200 infants survived to see their first
birthday.  Three mothers died in
childbirth.

Calculate: 

7) 
infant mortality
ratio (you will often hear this called an “infant mortality rate”, but it is
really not) (2 points): 

8) 
crude death rate (2
points): 

14) crude
birth rate (2 points): 

15) 
What possible
conclusions could you draw from these rates, about the overall health status of
people in this city (5 points)?

Thank you,

Mindy

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