The given case is an outbreak because it reports the occurrence of more cases of disease as expected in a localized area (Centers for Disease Control and Prevention, 2012). To manage this, the Centers for Disease Control and Prevention (2012) have recommended steps for outbreak investigation as follows: preparation, ensuring that the occurrence is an outbreak, verifying the diagnosis, setting the definition of a working case, finding cases systematically, recording data, perform descriptive epidemiology, developing hypotheses, evaluating hypotheses epidemiologically, modifying hypotheses, if needed, comparing and reconciling with laboratory and/or environmental studies, implementing control and prevention measures, monitoring, and publishing or presenting findings
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