Figure It Out!

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Welcome to Figure It Out Your job, as a surveillance officer, is to rapidly investigate reports of disease. The cause of illness is sometimes a mystery and requires efficient use of tools, skills, and knowledge. This is because the job, while rewarding, also has challenges. There are often constraints in money and time. Can you use evidence and figure out the cause of an outbreak? Click ahead for the [[Scenario]].  (set: $myCash to 100) (set: $myTime to 100) (set: $myConfidence to 100) (set: $deathsAvoided to 0) (set: $playedSearch1 to false) (set: $game1Code to "") (set: $IntGuests to false) (set: $TestEnv to false) (set: $TestPeople to false) (set: $lastAct to "")  (set: $playedSearch2 to false) (set: $game2Code to "") (set: $symptoms to (a:)) (set: $illnessFacts to (a:)) (set: $paperResults to (a:)) (set: $recomendationOne to true) (set: $recomendationTwo to true) (set: $recomendationThree to true) (set: $recomendationFour to true) (set: $failedToAdviseCorrectly to false) (set: $numResults to 0) (set: $actionSelectedPrior to false)

{(set: $name to (prompt: "Your name, please:", "Name Here")) You receive a notification: } { Surveillance Officer $name, there was a wedding in the southeast of Liberia. In the days immediately following the wedding, four guests died and some of the other guests began to feel sick. } { You have $100 and 100 hours to figure out what killed the wedding guests and how to prevent others from dying. Remember to use your resources wisely and practice skills carefully! } [[More details]]

Here are more details: About 200 people attended a wedding outside of Greenville. Many families were there, including those with children. It was a hot day and the food was sitting out for several hours in the sun. The wedding took place near a river, which some of the children played in. Two days after the wedding, 25 of the guests were sick with symptoms: (text-colour: "red")[headaches], (text-colour: "red")[weakness], (text-colour: "red")[mental confusion] and (text-colour: "red")[vomiting]. By the 4th day, ten of those affected with symptoms had died - this (10 out of 25) is a (text-colour: "#F5A700")[high fatality rate]. In order to prevent the spread of the illness and to save as many lives as possible, you must find out what caused the illness. You have to decide: [[Act]] immediately or Do some background (link: "Reading")[(set: $myTime -= 0.5)(goto:"Reading")] (0.5hr) (set: $symptoms to $symptoms + (a: "Headaches", "Weakness", "Mental Confusion", "Vomiting")) (set: $illnessFacts to $illnessFacts + (a: "High fatality rate"))  (hidden:)[[Reading]]

$name, what will you do now? The county health team and reference laboratory have limited resources, so you should act as efficiently as possible. You will be able to choose which actions to take and in what order. {<ul> <li>(link:"Interview Guests")[ (set:$myTime -= 10) (set:$myConfidence to (prompt: "How confident do you feel about the decision you just made (0-100)?", "")) (goto:"Interview Guests")] (10hr needed)</li> <li>(link:"Test Environment")[ (set:$myConfidence to (prompt: "How confident do you feel about the decision you just made (0-100)?", "")) (set:$myTime -= 20) (set:$myCash -=80) (goto:"Test Environment")] (20hr and $80 needed)</li> <li>(link:"Test Guests")[ (set:$myConfidence to (prompt: "How confident do you feel about the decision you just made (0-100)?", "")) (set:$myTime -= 12) (set:$myCash -=80) (goto:"Test Guests")] (12hr and $80 needed)</li> {(if: $playedSearch1 is false) [<li> (link:"Literature Search")[(set:$myTime -= 0.5)(goto:"Search")] (0.5hr)</li>]} </ul>} {  (hidden:)[[Interview Guests]] (hidden:)[[Test Environment]] (hidden:)[[Test Guests]] (hidden:)[[Search]] }

Good idea $name! Once you reach the site of the wedding, you'll want to quickly review the possibilities for causative agent types and exposure routes. The cause may be on Liberia's list of priority diseases or may be something new to the area. Click ahead for a list of [[Reading Terms]].

Searching is a good strategy. By taking time to obtain more information, you can be strategic about how you use your resources on the ground. Play this <a href="http://ardeaarts.org/IDM/MiniOne_v4/" target="_blank">game</a> that helps you refine your search skills so you will be able to find articles that help you solve the mystery. After you have played, you will be given a code to type in the box to continue [[Solving the Outbreak]]

{(set: $playedSearch1 to true) (set: $LastAct to "PlayedSearch1") (set: $game1Code to (prompt: "the code, please:", "")) }(if: $actionSelectedPrior is true) [Good job choosing to go back and search. It's always smart to take time to learn more skills. Now, let's go check on the [[Results]] of your choice.] (if: $game1Code is "12345" and $actionSelectedPrior is false) [Good job $name! Now it is time to [[Act]] ] (else-if: $game1Code is "12345" and $actionSelectedPrior is true) [] (else:)[ That isn't the right code. You could [[Search]] again or go to [[Reading]] ]

{ (set: $IntGuests to true) (set: $LastAct to "IntGuest") (set: $actionSelectedPrior to true) } (if: $myTime < 0 or $myCash <0 ) [You ran out of time or money, sorry! Want to [[try again->TitlePage]]?] (else: ) [{You chose to interview guests. There were over 200 people at the wedding. You interviewed the 25 people who got sick, 50 people who did not get sick (as controls), and the families of the 10 deceased. You asked what they ate, what they touched, whom they embraced, and who they ate with. You typed the answers in a spreadsheet so you could keep track of people who got sick and those who ate a particular food or who were near a particular person. You also asked those infected about their symptoms.} (link:"Results")[(goto:"Results")] { (hidden:)[[Results]] }]

{(set: $TestEnv to true) (set: $LastAct to "TestEnv") (set: $actionSelectedPrior to true) } { (if: $myTime < 0 or $myCash <0 ) [You ran out of time or money, sorry! Want to [[try again->TitlePage]]?] }(else: )[ You chose to test the environment. It has been almost a week since the wedding occurred, but there are tea and food samples leftover. You also swab surfaces where the food had been prepared and take water samples from the pond where children were playing and the well which was the source of the water for cooking and washing. Since you don't know what agent you are going to test for, it will take some time and be rather expensive to test for any potential pathogens. 30 tests for any available pathogen = $80 {(if: $playedSearch1 is false)[It would be good for you to do a [[literature Search->Search]] before proceeding.] } Go to (link:"Results")[(set: $myTime -= 12)(goto:"Results")]. (hidden:)[[Results]] ]

{(set: $TestPeople to true) (set: $LastAct to "TestPeople") } { (if: $myTime < 0 or $myCash <0 ) [You ran out of time or money, sorry! Want to [[try again->TitlePage]]?] }(else: )[ You chose to test the guests. Those who became ill are in the hospital and the diagnostic officer is working to obtain their samples. You will need to coordinate with specimen transport drivers. Since you don't know what pathogen you are looking for, it will take some time and be expensive to test widely. Some of the samples will be sent to an international reference laboratory. Testing blood, stool, and urine from 25 sick guests = $80 (if: $playedSearch1 is false)[It would be good for you to do a [[literature Search->Search]] before proceeding.] (link:"Results")[(set: $myTime -= 12)(goto:"Results")] (hidden:)[[Results]]]

{(if: $myTime < 0 or $myCash <0 ) [You ran out of time or money, sorry! Want to [[try again->TitlePage]]?] }(else: ) [ { (if:$LastAct is "TestPeople" or $LastAct is "TestEnv")[ (set:$myTime -=12) { Officer $name, 12 hours have passed and your results have arrived. The results of your first choice are:} ] (if: $LastAct is "IntGuest") [Good work! You learned that: everyone who got sick drank the same tea, but so did people who did not become sick. You also found that there is an association between feeling sick and having interacted with certain people. Some of the symptoms reported by those who got sick included: (text-colour: "red")[mental confusion], (text-colour: "red")[vomiting], and (text-colour: "red")[generalized weakness]. (set: $symptoms to $symptoms + (a: "Generalized Weakness")) You could: (display:"ActOptions") ] (elseif: $LastAct is "TestPeople") [You tested the blood, stool, and urine of 20 people for the agents that cause the priority diseases and got negative results for several different agents, including Lassa and Ebola viruses. So you know what the pathogen isn't but not what it is. You could: (display:"ActOptions") ] (elseif: $LastAct is "TestEnv") [You tested 12 different surfaces, the water in the pond, and food samples. No coliforms or other disease-causing agents were identified, but additional samples were sent to an international reference laboratory. You could: (display:"ActOptions") ] (if: $playedSearch1 is true)[ Since you took the time to practice and refine your searching skills earlier, you can now use the information you've gathered to get more detailed information about the potential disease by doing a web search. Let's try to uncover more information by playing the (link:"Search II")[(set:$myTime -= 0.5)(goto:"Search II")] game. (0.5 hr)] (if: $playedSearch1 is false ) [It is unfortunate that you didn't practice doing a literature search. Using data to inform your actions is not only more efficient, but also safer! Would you like to learn how to (link:"Search")[(set:$myTime -= 0.5)(goto:"Search")]? (0.5 hr)] } ] {  (hidden:)[[Test Guests]] (hidden:)[[Interview Guests]] (hidden:)[[Test Environment]] (hidden:)[[Advise Authorities]] (hidden:)[[Search II]] (hidden:)[[Search]] }

{(set: $failedToAdviseCorrectly to true)} { (if: $myTime < 0 or $myCash <0 ) [You ran out of time or money, sorry! Want to [[try again->TitlePage]]?] }(else: )[ You are unsure about the causative agent and the route of exposure, although you have identified some clinical and epidemiological information. What would you advise authorities to do? [[Treat the sick or exposed->Final Game Results]] [[Vaccinate->Final Game Results]] [[Promote more hand-washing and personal protection->Final Game Results]] [[Encourage people to stay away from the environment of the wedding->Final Game Results]] ]

{ (if: $myTime < 0 or $myCash <0 ) [You ran out of time or money, sorry! Want to [[try again->TitlePage]]?] (else: )[ Now that you've gotten more experience, let's see if you can use what you've learned to craft a more detailed search. The goal of this search will be to return articles that can help you understand what the causitive agent is and what your next steps should be. To test your knowledge, play this <a href="http://ardeaarts.org/IDM/MiniTwo_v4/" target="_blank">game</a>. If you succeed, you'll be given the titles to some papers that will guide you. After you've beaten the game, you will be given a code to type in the box. Type the code in to continue the [[Solving the Outbreak2]]. ]}

{(set: $playedSearch2 to true) (set: $game2Code to (prompt: "the code, please:", "")) } { (if: $myTime < 0 or $myCash <0 ) [You ran out of time or money, sorry! Want to [[try again->TitlePage]]?] }(else: )[ (if: $game2Code is "6789") [Good job. Using the data you've gathered during your investigation, along with your new search skills, you now have a good sense of possible causative agents. You decide to take samples from 10 of the sick individuals and test for specific pathogens that appeared in your results. These include meningococci, bacteria responsible for meningococcal disease. This will take time and money, but significantly less than before the Search since you have specific targets for testing. [[Get the diagnostic results]] ] (else:) [ That isn't the right code. You could (link:"Search II")[(set:$myTime -= 0.5)(goto:"Search II")] (0.5 hr) again or go to [[Results]] ] ]  (hidden:)[[Search II]]

{(if: (passage:)'s name is "TitlePage")[] (if: (passage:)'s name is "Intro")[] (if: (passage:)'s name is "Review key terms")[] (if: (passage:)'s name is "Report")[] (else-if: (passage:)'s tags contains "donotshowkeyterms")[]} (else:)[[Review important information]]

(if: $symptoms's length > 0)[The keys terms you've run into so far include: (text-colour: "red")(print: $symptoms)] (else:)[You haven't encountered any key terms so far.] (if: $illnessFacts's length > 0)[So far, you've uncovered that the illness has: (text-colour: "#F5A700")(print: $illnessFacts)] (else:)[You don't know any facts about the illness yet.] (if: $paperResults's length > 0)[After gathering data and performing detailed searches online, you've learned that: (print: $paperResults)] (else:)[ ] (link-undo:"Return")

(set: $recomendationOne to false) This was a smart choice! As you learned from researching, people that live in the same house as someone with meningiococcal are at a high risk of contracting the disease. Treating only the people who attended the wedding and not those they live with does not do enough to defeat the disease and stop it's spread. { (set: $options to (a: $recomendationOne, $recomendationTwo, $recomendationThree, $recomendationFour)) (if: (count:$options,false) > 2) [Let's check the [[Final Game Results]] to see how you did.] (else-if: (count:$options,false) > 1) [ While you've done a good job at narrowing down the possible choices, there is still a lot you don't know. In order to make the best decision possible, you should do more [[Research->VaccineAlert2]] into the disease. ] (else:)[ While you've done a good job at narrowing down the possible choices, there is still a lot you don't know. In order to make the best decision possible, you should do more (display: "ResearchController") into the disease.] }

(set: $myTime -= 1.5) (set: $deathsAvoided += 2) (set: $recomendationThree to false) You chose to remove the option of ordering a vaccine for families of those infected. Vaccines are a strong choice when it comes to preventing diseases from spreading, but work best when used proactively. In the future, vaccines may be a good choice for preventing diseases before they happen, but in this case, they may not be the best choice. { (set: $options to (a: $recomendationOne, $recomendationTwo, $recomendationThree, $recomendationFour)) (if: (count:$options,false) > 2) [Let's check the [[Final Game Results]] to see how you did.] (else-if: (count:$options, false) is 1) [ Let’s read more in the second research paper: ‘Emergency vaccination against epidemic meningitis in Ghana: implications for the control of meningococcal disease in West Africa’” While you've done a good job at narrowing down the possible choices, there is still a lot you don't know. In order to make the best decision possible, you should do more (display: "ResearchController") into the disease.  ] (else:) [ While you've done a good job at narrowing down the possible choices, there is still a lot you don't know. In order to make the best decision possible, you should do more [[research->VaccineAlert]] into the disease. ] }

(if: $myTime < 0 or $myCash <0 ) [{You ran out of time or money, sorry! Want to [[try again->TitlePage]]? }](else-if: $recomendationTwo is false and $recomendationThree is false and $recomendationFour is false)[{Your chosen option was only treating people who went to the wedding for meningicoccal disease. Let's check the [[Final Game Results]] to see how you did. }](else-if: $recomendationOne is false and $recomendationThree is false and $recomendationFour is false)[{Your chosen option was treating everyone who people who went to the wedding for meningicoccal disease. Let's check the [[Final Game Results]] to see how you did. }](else-if: $recomendationOne is false and $recomendationTwo is false and $recomendationThree is false)[{Your chosen option was ordering a vaccine for those exposed. However, there are no vaccines in country, so it took extra time for them to arrive and be administered. Let's check the [[Final Game Results]] to see how you did. }](else-if:$recomendationOne is false and $recomendationTwo is false and $recomendationThree is false)[{Your chosen option was ordering everyone exposed to the disease to recieve an antibiotic as treatment. Let's check the [[Final Game Results]] to see how you did. }](else:) [Using the information you have available, which of these options seems to be the (text-colour: "red")[//least effective//]? Don't forget to review the important information you've uncovered so far, as it can help you make better decisions. It's important to find the best solution as soon as possible. Remember, lives depend on it! (set: $options to (a: $recomendationOne, $recomendationTwo, $recomendationThree, $recomendationFour)) {  Please select the option you wish to (text-colour: "red")[//remove//]. } {<ul> (if: $recomendationOne is true)[ <li>(link:"Treat only sick people who went to the wedding")[(set:$myTime -= 1.5) (set:$myConfidence to (prompt: "How confident do you feel about the decision you just made (0-100)?", "")) (set:$deathsAvoided += 10)(goto:"Treat only sick people who went to the wedding")] (1.5 hr) </li> ] (else:)[ <li class="strikeThru">Treat only sick people who went to the wedding (1.5 hr)</li> ] (if: $recomendationTwo is true)[ <li> (link:"Order an antibiotic prophylactically for the households of everyone who went to the wedding")[(set:$myTime -= 1.5) (set:$myConfidence to (prompt: "How confident do you feel about the decision you just made (0-100)?", "")) (set:$deathsAvoided -= 5)(goto:"Order an antibiotic prophylactically for the households of everyone who went to the wedding")] (1.5 hr) </li>] (else:)[ <li class="strikeThru">Order an antibiotic prophylactically for the households of everyone who went to the wedding (1.5 hr)</li> ] (if: $recomendationThree is true)[ <li> (link:"Order a vaccine for the families of sick individuals")[(set:$myTime -= 1.5) (set:$myConfidence to (prompt: "How confident do you feel about the decision you just made (0-100)?", "")) (set:$deathsAvoided += 2)(goto:"Order a vaccine for the families of sick individuals")] (1.5 hr) </li> ] (else:)[ <li class="strikeThru">Order a vaccine for the families of sick individuals (1.5 hr)</li> ] (if: $recomendationFour is true)[ <li> (link:"Test all people who went to the wedding to determine if they have the bacteria")[(set:$myTime -= 1.5) (set:$myConfidence to (prompt: "How confident do you feel about the decision you just made (0-100)?", "")) (goto:"Test all people who went to the wedding to determine if they have the bacteria")] (1.5 hr) </li> ] (else:)[ <li class="strikeThru">Test all people who went to the wedding to determine if they have the bacteria (1.5 hr)</li> ] </ul>} ]{  (hidden:)[[Treat only sick people who went to the wedding]] (hidden:)[[Order an antibiotic prophylactically for the households of everyone who went to the wedding]] (hidden:)[[Order a vaccine for the families of sick individuals]] (hidden:)[[Test all people who went to the wedding to determine if they have the bacteria]] }

{ (if: $myTime < 0 or $myCash <0 ) [You ran out of time or money, sorry! Want to [[try again->TitlePage]]?] (else: )[ Meningococcal disease is caused by a bacterial agent. People may be carriers of bacteria without showing symptoms. This is called carriage. A study found that people in households that had a case of meningococcal disease became carriers of meningococci at rates 4-5 times that of people in households that did not have a case. People remain carriers for 3.4 months, on average. Using this new information, it's time to narrow down your possible choices and [[review your options]] before advising authorities. (set: $paperResults to $paperResults + (a: "it is important to treat everyone in the household (not just those at the wedding)")) ]}

{(set: $failedToAdviseCorrectly to true)} { (if: $myTime < 0 or $myCash <0 ) [You ran out of time or money, sorry! Want to [[try again->TitlePage]]?] (else-if: $recomendationTwo is false and $recomendationThree is false and $recomendationFour is false)[Your chosen option was only treating people who went to the wedding for meningicoccal disease. This choice was a mistake and does not align with the research and data that you've collected. By making this choice, everyone who lives with the person infected will become exposed and is at a higher risk of transmitting the disease and dying. As a result of this decision, multiple people who lived with the exposed contracted the disease, leading to needless deaths. Want to [[try again->TitlePage]]?] (else-if: $recomendationOne is false and $recomendationThree is false and $recomendationFour is false)[Your chosen option was treating everyone who people who went to the wedding for meningicoccal disease. This was a smart choice! By treating all of the exposed, you helped to mitigate the spread and helped to save those infected. This decision was smart and helped to save lives! However, there is always more to learn. Want to [[try again->TitlePage]]?] (else-if: $recomendationOne is false and $recomendationTwo is false and $recomendationThree is false)[Your chosen option was ordering a vaccine for those exposed. However, there are no vaccines in country, so it took extra time for them to arrive and be administered. This decision is one that works best for being proactive, not reactive. By choosing this route, you had to wait for vaccines to be flown in, taking time and costing lives. This decision was not the best option, and hurt people needlessly. Want to [[try again->TitlePage]]?] (else-if:$recomendationOne is false and $recomendationTwo is false and $recomendationThree is false)[Your chosen option was ordering everyone exposed to the disease to recieve an antibiotic as treatment. This was a smart choice! By ordering the antibiotic to treat the disease, everyone exposed to meningicoccal was able to be treated. This decision saved lives and helped to prevent any needless death. However, there is always mroe to learn. Want to [[try again->TitlePage]]?] (else: )[(if: $failedToAdviseCorrectly is true)[Without taking the time to properly research the disease or gather more data, you rushed to make a reccomendation. It will not be possible to get the correct treatment or vaccine without knowing the causative agent. This has cost many people to unnecessarily lose their lives and cost the response lots of time and money. Would you like to [[try again->TitlePage]]?]]}

{ (if: $myTime < 0 or $myCash <0 ) [You ran out of time or money, sorry! Want to [[try again->TitlePage]]?] (else: )[ During an outbreak in Ghana, vaccination was undertaken reactively soon after the outbreak started. Without vaccination, the final size of the outbreak would have had 23% more cases and 18% more deaths than were actually observed. A study used a model to determine that, if vaccination had started routinely during childhood and before the outbreak (that is, proactively), there would have been 61% fewer cases. (set: $paperResults to $paperResults + (a: "vaccines are useful in lowering the mortality rate (but work better when used proactively)")) Now that you've learnt more about the disease and how to treat it, would you like to make [[review your options]] to authorites or gather more [[research->Research3]]? ]}

{ (if: $myTime < 0 or $myCash <0 ) [You ran out of time or money, sorry! Want to [[try again->TitlePage]]?] (else: )[Nice choice! Even though it can take more resources to research something, it's always important to make sure you are making decisions with as much data as possible. While doing more research into meningococcal, you came across the review article in your search results: "Antibiotics for preventing meningococcal infections." You learned that there is an antibiotic that can be used to help treat infections. The antibiotic, Ciprofloxacin, is administered to those who have been infected with or exposed to meningococcal. The risk of failure to eradicate the disease was 28 times higher in settings where people did not receive the antibiotic compared to in settings where people did receive the antibiotic. Now that you've gathered all the facts you can about meningococcal, it is time to [[review your options]] one last time before making your reccomendation to authorities! (set: $paperResults to $paperResults + (a: "antibiotics are useful in treating this disease")) ]} (if: $recomendationOne is false and $recomendationTwo is false ) [Out of your remaining options, which recommendation would you like to make?]

Wow! Looks like you made a good choice. As you were continuing your research, you learned that there are no vaccines available in country. Having them imported would take time and money that is not available. By choosing to remove the option of vaccination, you no longer have to worry about ordering and administering vaccines, saving time and lives. Now that you have this information, it is time to get back to your [[research->Research3]]. Remember, people are counting on you! (set: $myTime -= 1)

Some disease-causing agents with examples are: {<ul> <li>virus (causes Ebola and Lassa Fever)</li> <li>parasite (causes intestinal worms and malaria)</li> <li>fungus (causes skin irritation)</li> <li>bacterium (causes typhoid)</li> <li>toxic chemical (causes neurological sympmtoms)</li> </ul>} Deciding on a causative agent requires appropriate laboratory diagnosis. Rather than testing for all agents (which costs money and takes time), it is important to consider how people were exposed. Continue [[Reading more Terms]]

That was a great review, $name. It's time to decide: You could [[Act]] on your current knowledge or [[Search]] to gain knowledge

Here are some scientific papers from the results of your search. Let's Figure Out how to act using evidence from the study findings. Click to get [[Fast Fact 1]] from the first research article: 'Household transmission of Neisseria meningitidis in the African meningitis belt: a longitudinal cohort study'. </style><img src="https://schoolsweek.co.uk/wp-content/uploads/2020/04/Science-scientists-SM.jpg" width="500" height="300" alt="Placeholder image"></div>

Some possible exposure routes may be: {<ul> <li>environmental (in the area where people congregated)</li> <li>aerosol (small droplets in the air)</li> <li>direct contact (touching)</li> <li>fomite (objects that can hold and move disease agents)</li> <li>oral (through the mouth)</li> <li>vector (insects or rodents through which germs can travel)</li> <li>foodborne (contracted through eating)</li> </ul>} Knowing which exposure routes could have led to the sickness at the wedding requires epidemiological investigation. Move next to make a [[Decision based on Reading]]

{(unless: (passage:)'s tags contains "no-header")[ { <div class="resources"> <div data-raw="">⌛ <tw-expression type="variable" name="myTime">$myTime</tw-expression></div> <div data-raw="">💰 <tw-expression type="variable" name="myCash">$myCash</tw-expression></div> <div>life saved: $deathsAvoided</div> <div> Confidence: <input type="range" min="1" max="100" class="slider" id="confRange" data-varname="myConfidence"> <span id="confRangeText">$myConfidence</span> </div> <script>onLoad();</script> </div> }]}

(set: $myTime -= 1.5) (set: $deathsAvoided -= 8) (set: $recomendationFour to false) You chose to remove the option of testing more people. This is a good choice since it prevents spending additional time and money while the bacterial infection is spreading, particularly to household members. (set: $options to (a: $recomendationOne, $recomendationTwo, $recomendationThree, $recomendationFour)) (if: (count:$options,false) > 2) [Let's check the [[Final Game Results]] to see how you did.]  (else:)[ While you've done a good job at narrowing down the possible choices, there is still a lot you don't know. In order to make the best decision possible, you should do more (display: "ResearchController") into the disease.]

Confirmation! You know that the infective agent is meningicoccal disease. Meningicoccal is a highly infectious disease, so it is important to make a recommendation to authorities quickly. However, making a wrong decision could potentially lead to more deaths. You need to do more [[Research]] before you can make an informed recommendation (set: $paperResults to $paperResults + (a: "The infective agent is meningicoccal disease"))

{(set: $deathsAvoided -= 2) (set: $myTime -= 1.5) (set: $recomendationTwo to false) (set: $options to (a: $recomendationOne, $recomendationTwo, $recomendationThree, $recomendationFour)) } (if: (count:$options,false) > 2) [Let's check the [[Final Game Results]] to see how you did.] (else-if: (count:$options,false) is 1) [ This was not a great choice. The research results you just saw suggested that household members of an infected person (even if that person is carrying the bacteria without showing symptoms) are at high risk of infection. Saving as many lives as possible would mean that household members should be protected. You have lost time and money and 2 more people have died. There is still time to act though. You’ll have to work with the remaining options. Let’s learn more before deciding. (display: "ResearchController") ] (else-if: (count:$options,false) is 2) [ This was not a great choice. As you learned, this disease spreads in the home even when no symptoms are visible, so treating everyone in the home is critical in slowing it's spread and helping those infected. However, you can still do your best to save lives, as there is more to learn. In order to make the best decision possible, you should do more (display: "ResearchController") into the disease.] { }

As you were continuing your research, you learned that there are no meningococcal vaccines available in country. Having them imported would take time and money that is not available, especially if you want to prevent additional deaths. Also, as you learned from the research findings, vaccination against meningococcal disease is less effective at reducing cases and deaths when administered during an outbreak (versus proactively).Now that you have this information, it is time to get back to your [[research->Research3]]. Remember, people are counting on you! Out of your remaining options, which recommendation would you like to make

{ (set: $options to (a: $recomendationOne, $recomendationTwo, $recomendationThree, $recomendationFour)) (set: $optionSelected to 0) (for: each _item, ...$options) [(if: _item is false) [(set: $optionSelected to it+1)] ] (if: $optionSelected is 1) [ [[research->Research2]] ] (else:) [ [[research->Research3]] ] }

Double-click this passage to edit it.

{ <ul> (if: $IntGuests is false)[ <li>(link:"Interview Guests")[ (set:$myConfidence to (prompt: "How confident do you feel about the decision you just made (0-100)?", "")) (set:$myTime -= 10)(goto:"Interview Guests")](10hr needed) </li> ] (if: $TestEnv is false)[ <li>(link:"Test Environment")[ (set:$myConfidence to (prompt: "How confident do you feel about the decision you just made (0-100)?", "")) (set:$myTime -= 20)(set:$myCash -= 80)(goto:"Test Environment")] (20hr and $80 needed)</li> ] (if: $TestPeople is false) [ <li>(link:"Test Guests")[ (set:$myConfidence to (prompt: "How confident do you feel about the decision you just made (0-100)?", "")) (set:$myTime -= 12)(set:$myCash -= 80)(goto:"Test Guests")] (12hr and $80 needed) </li> ] <li>(link:"Advise Authorities")[ (set:$myConfidence to (prompt: "How confident do you feel about the decision you just made (0-100)?", "")) (set:$myTime -= 5)(goto:"Advise Authorities")] </li> </ul> }

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Welcome to Figure It Out
Your job, as a surveillance officer, is to rapidly investigate reports of disease. The cause of illness is sometimes a mystery and requires efficient use of tools, skills, and knowledge. This is because the job, while rewarding, also has challenges. There are often constraints in money and time.
Can you use evidence and figure out the cause of an outbreak?
Click ahead for the

Scenario

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