The Junior Disease Detectives: Operation Outbreak

Created by the Centers for Disease Control and Prevention (CDC), this graphic novel and associated educational materials are intended to raise youth awareness of variant flu, which is caused by a kind of flu virus that spreads from pigs to people, as well as to educate children and teens about careers in public health and outbreak investigations (including risk communication). Grounded in an entertainment-education approach, the graphic novel and its associated educational activities are part of a broader CDC initiative with the United States (US) Department of Agriculture and 4-H to raise awareness, knowledge, and understanding of the "One Health" approach to zoonotic disease prevention and response. This approach recognises that the health of people is connected to the health of animals and the environment. It is a collaborative, multisectoral, and trans-disciplinary approach - working at the local, regional, national, and global levels - with the goal of achieving optimal health outcomes recognising the interconnection between people, animals, plants, and their shared environment.

Most variant flu infections occur in children exposed to infected pigs or their environments in agricultural fair settings. During 2017, 67 variant virus infections were reported in the US, 6 of which resulted in hospitalisation. Variant virus infections also have the potential to cause flu pandemics, should these viruses gain the ability to spread easily between people. The novel and educational activities serve as a platform to reach youth audiences, who might otherwise not receive CDC's guidance and recommendations on preventing such infections.

The graphic novel, intended for use in middle and high school science, technology, engineering. and mathematics (STEM) classrooms, follows a group of teenage 4-H members who participate in a state agricultural fair and later attend CDC's Disease Detective Camp in Atlanta, Georgia, US. When one of the boys becomes sick following the fair, the rest of the group use their newly acquired disease detective knowledge to help a team of public and animal health experts solve the mystery of how their friend became ill. One of his friends says, "However, I know that I'll be safe because I have been vaccinated. Vaccines work by causing your immune system to recognize and fight against the attacking virus." The graphic novel is available for free downloading on CDC's website in 3 different versions: web version, home print version, or professional print version.

CDC partnered with teachers participating in its Science Ambassador Fellowship to develop educational activities that highlight themes in the graphic novel to teach youth about public health science, epidemiology, biology, outbreak investigations, and associated career skills. The activities are available for free download and use, and additional classroom activities will be developed and posted to the CDC website throughout the 2018–2019 school year. Access the educational materials currently available on CDC's website:

• Educational Overview [PDF]: This downloadable document describes the learning objectives associated with the graphic novel and also topics related to influenza (flu) epidemiology, flu biology, zoonotic diseases, variant flu, novel flu, and pandemic flu. Step-by-step instructions guide teachers through a problem-based activity aligned with national standards.
• Activity 1 - The Operation Outbreak Team [PDF]: In this activity, students learn the various roles and responsibilities of the professionals involved in an outbreak response. Throughout the investigation, health communications specialists formulate a strategy based on well -established risk communications principles. They help to create communication products based on data and guidance from other public health officials to educate the public, media, and other audiences about what is known and not known about the outbreak, and what actions people should take to protect themselves and their families. Health communications specialists help coordinate communications efforts and messages between local, state, and federal partners, and then communicate necessary information to external audiences. As part of the activity, students are asked to write up a 1- to 2-page story about how the outbreak was investigated based on the steps of the influenza outbreak investigation and the communication pathways.