Extensions The teacher can have the students create an intervention or prevention plan for the town. The plan could include a campaign with brochures or posters about ways to prevent neural tube defects. Other Modifications The amount of material in the file folders could be reduced or expanded to increase or decrease the difficulty. The file folders could be eliminated entirely to make the research less guided and more challenging. However, in this case the names of the county (Cameron) and town (Brownsville) in Texas should be changed to fictitious names so that the students don’t find the real story and the real outcome during the research phase. Education Standards • Population growth • Natural resources • Environmental quality • Natural and human-induced hazards • Science and technology in local, national, and global challenges Pretest Causes of Birth Defects: An Epidemiological Mystery Trish Strohfeldt, CDC’s 2005 Science Ambassador Program Think about what you already know about birth defects. 1. What do you know about the causes of birth defects, or what contributes to them? 2. List the names of any birth defects that you know. If you don't know their names then describe the characteristics of the defect. 3. What are some of the ways that birth defects can be prevented? 4. What processes or steps do you think are taken to determine the cause of a cluster of birth defects (when more than a normal rate of birth defects in a certain population is seen)? References Pretest Answer Key Causes of Birth Defects: An Epidemiological Mystery Trish Strohfeldt, CDC’s 2005 Science Ambassador Program Think about what you already know about birth defects. 1. What do you know about the causes of birth defects, or what contributes to them? Some examples are included in the following list (1,2) a. Behavioral (smoking, drinking, etc.) b. Maternal age, weight c. Maternal diabetes d. Genetics or "runs in families" e. Unknown cause 2. List the names of any birth defects that you know. If you don't know the name then describe the characteristics of the defect. Some examples might include spina bifida, cleft lip/palate, heart defects, or other birth defects that they have seen on TV or affect family members. (2,3) 3. What are some of the ways that birth defects can be prevented? Some examples include not smoking or drinking during pregnancy, taking prenatal vitamins with folic acid before and during pregnancy, and achieving good gylcemic control before and during pregnancy for women with diabetes. (2,4) 4. What processes or steps do you think are taken to determine the cause or contributors of a cluster of birth defects (when more than a normal rate of birth defects in a certain population is seen)? First, you might identify the group of birth defects as a cluster, and then identify possible connections between cases. During this investigation, you might look to doctors, parents, epidemiologists, lab technicians, and others to help determine why this cluster occurred. (5) 1. Kucik, J. Surveillance and Epidemiology [presentation]. CDC’s Science Ambassador Workshop, 2005. 2. March of Dimes. Birth Defects [online]. 2005. [cited 2005 July 29]. Available from URL: 206.asp. 3. National Institutes of Health..htm. 5. Honein, P. Reefhuis, J. Risk Factors for Birth Defects [presentation]. CDC’s Science Ambassador Workshop, 2005. Causes of Birth Defects: An Epidemiological Mystery Trish Strohfeldt, CDC’s 2005 Science Ambassador Date: May 24, 2005 Re: Recent Cluster of Birth Defects in Cameron County Texas In the past three days there have been three cases of neural tube defects (NTDs) in Brownsville, Texas.. NTDs are serious birth defects of the brain and spine that include anencephaly and spina bifida. Epidemiologists from the Centers for Disease Control Prevention have been called in to investigate this cluster of birth defects. The epidemiologists are working with the doctors and the Texas Department of State Health Services to try to determine the cause of the cluster of NTDs. There are many possible causes for this cluster of NTDs. It is possible that factors including maternal diet, race, or age, or health conditions like diabetes, or behaviors like smoking by the mother may be associated with the cluster. Many people in the area suspect an environmental cause, like water pollution. Cameron County Texas is located on the Mexican Border and has a population of 270,524. The population is over 80% Hispanic and over 40% of the population is classified as having a low income. Your Role: Each of you will be assigned a role in this investigation. As you assume your role you will research the cases in Cameron County and try to determine the cause of the birth defects in that area. Once you have pinpointed a cause you will need to make a recommendation to the town as how best to correct the problem and create an intervention or prevention system. Good Luck! Note: This investigation is actually based on an outbreak of NTDs that occurred in Cameron County in 1991. Please visit the following Web site for more information: Texas Department of State Health Services. Neural Tube Defects and the Texas-Mexico Border [online]. 2005. [cited 2005 July 29]. Available from URL: http://www.dshs.state.tx.us/birthdefects/ntd%5Fborder.shtm Conclusions What I think is causing the NTDs