Anatomy and physiology of an outbreak team
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Anatomy and Physiology of an Outbreak Team. Goals . The goals of this presentation are to discuss: Management strategies during an outbreak investigation Team member roles Necessary equipment Lines of communication. In the Beginning….

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Presentation Transcript

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Goals

  • The goals of this presentation are to discuss:

    • Management strategies during an outbreak investigation

    • Team member roles

    • Necessary equipment

    • Lines of communication


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In the Beginning…

  • Successful investigations require a multidisciplinary approach, effective communication and collaboration

  • Steps:

    • Assemble team members

    • Present available information

    • Outline plan for investigation and team communication

    • Assign roles and responsibilities


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Questions to Consider

  • What resources, including personnel, are available?

  • What resources could be provided by outside collaborators?

  • Who will direct the day-to-day investigation?


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More Questions to Consider

  • Who will interact with the media?

  • How will data be shared and analyzed?

  • Who will write the final report and present the information?

  • How will the team communicate with each other?


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Team Member Roles

  • Team Leader

    • Experience in outbreak investigation and epidemiology

    • Selection can be result of outbreak setting or etiologic agent

    • Role can be filled by:

      • County health director,

      • Public health nurse,

      • Epidemiologist, or

      • Environmental health specialist

    • Role may change depending on stage of investigation


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Team Member Roles

  • Epidemiologist

    • Develop study design and survey questionnaires

    • Create database and conduct data analysis


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Team Member Roles

  • Microbiologist

    • Verify the diagnosis

    • Subtype pathogens to help refine case definition


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Team Member Roles

  • Environmental health specialists (EHS)

    • Collect food and environmental samples

    • Provide guidance on food safety regulations and engineering


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Team Member Roles

  • Interviewers

    • Collect data in person or by telephone

    • Role can be filled by health department personnel, state or federal personnel, or health science students


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Team Member Roles

  • Clinicians

    • Administer vaccines or prophylaxis

    • Collect clinical specimens

    • Role can be filled by health department or local medical community

    • May include veterinarians, depending on type of outbreak


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Team Member Roles

  • Regulators

    • Facilitate identification of the source of outbreak and develop prevention strategies

    • Role can be filled by state or federal agency employees


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Team Member Roles

  • Media Spokesperson

    • Deliver clear and consistent messages to community

    • Role can be filled by one outbreak team member or representatives from each agency


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Team Equipment

  • Computer with access to internet

    • Email communication

    • Literature searches (PUBMED)

    • Data entry and analysis (Epi-Info 2002 http://www.cdc.gov/epiinfo/epiinfo.htm)

    • Written reports


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Team Equipment

  • Specimen collection tools

    • Rectal swabs or specimen cups

    • Phlebotomy equipment

    • Cooler to transport specimens


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Communication

  • Information flows in both directions

    • Leader should update the team during meetings, conference calls, or email

    • Members provide regular updates to team leader

      • Acts as tool for measuring progress

      • Enables leader to provide feedback and direction to team members


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Communication

  • Keep lines of communication open through regular meetings or phone

    • Include local, state, and federal public health agencies

  • Document progress

    • Allows all members to remain up-to-date

    • Assists in drafting final report


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Conclusion

  • Working as a team requires:

    • A wide range of expertise

    • Clear communication

    • A rapid but careful and systematic approach in dealing with outbreaks


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References

  • Butler JC, Cohen ML, Friedman CR, Scripp RM, Watz CG. Collaboration between public health and law enforcement: new paradigms and partnerships for bioterrorism planning and response. Emerg Infect Dis 2002;8(10):1152-6.

  • Frace RM, Jahre JA. Policy for managing a community infectious disease outbreak. Infect Control Hosp Epidemiol 1991;12(6):346-7.

  • Sobel J, Griffin PM, Slutsker l, Swerdlow DL, Tauxe RV. Investigation of multistate foodborne disease outbreaks. Public Health Rep 2002;117(1):8-19.


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