Preparing For and Responding to a Meningitis Outbreak

1. Preparing For and Responding to a Meningitis Outbreak Joey Pons Environmental Health and Safety Director Safetyman@louisiana.edu

2. We Are The Rajun Cajuns

7. Fast Facts About UL Lafayette • 16,300 Students, Doctoral II Research Institution • 1700 employees • 100% Accredited (SACS) • 261 buildings, 4.2 mil. Sq. ft, 1400 acres of land • Campus in 3 Parishes • Primate Center – 6000 monkeys, 500 chimps • Commuter school, but 1750 campus residents

8. Communicable DiseaseContagiousness v/s Severity Influenza (including H1N1) – very contagious, not so severe Meningitis, SARS – very severe, not easily spread

9. Meningococcal Disease May cause Meningitis, affecting the lining of the brain Viral Meningitis, treated symptomatically, usually no involvement Bacterial, treated with antibiotics Spread through sharing saliva Lab work takes time to determine V or B, and specifics 5 serotypes – vaccination effectiveness

10. We Planned For This • Following 1999 ACIP Recommendation • DHH/CDC relationships established • Awareness campaign • Immunizations offered at SHS • Meningitis plan established with ERT • Yearly training/review of the plan

11. UL Lafayette Meningitis OutbreakFebruary 2006 What Caused This? Fraternity Super bowl Party

12. UL Lafayette Meningitis OutbreakFebruary 2006 Fast Facts 6 confirmed cases in Lafayette Parish 5 related to university 1 community college student with ties 2 university student deaths CDC Defined Outbreak 2 or more deaths/ 100,000 population

13. Timeline – This Happens Fast January 27 – 1st student death, isolated February 5 – Superbowl Party February 7, 5:55 am – 2nd victim identified February 7, 11:00 am – 4th victim identified, 2nd death February 8, 8:00 am – 5th victim identified February 10, Circle of Contagiousness Identified February 13 – Mass Vaccination Initiated February 16 – Mass Vaccination Completed

14. Who Was At The Table Administration Public Relations/News Services Student Health Services University Police EH@S DHH – Office of Public Health Housing Dean of Student Personnel Dean of Students Counseling and Testing VP, Academic Affairs College of Nursing

15. During the Event - Basic RolesStudent Health Services • Primary contact with OPH, DHH, and CDC • Evaluation/treatment for suspect contacts • Mass Vaccination Administration

16. During the Event - Basic RolesDean of Students • Close the circle of contagious (who’s been with who?) • Interviewing – forward to SHS if suspect • Distribution of prepared materials to students and groups

17. During the Event - Basic RolesPublic Relations • Serves as the PIO for the event • Media • Legal issues (HIPPA)

18. During the Event - Basic RolesHousing • One confirmed case was a resident • Training • Bloodborne Pathogens refresher • OSHA guidelines for general cleanliness’ • Prepared a quarantine facility (never used)

19. During the Event - Basic RolesSupport Operations • University Police – increased security • Counseling/Testing – mental issues, emotional stress • Nursing Faculty/Students – volunteer for mass vaccination

20. What About The Safety Director? • Center of Communication • Ensures message is consistent • Work the plan – read and adjust • Liaison to academics • Webpage –updates, information, training, FAQ • Fielding questions – facilitate simple answers

21. Mass Vaccination • Supply/Demand problem, new vaccine • Original request to CDC, 6500 doses, received 5000 • Decided on a tiered approach

22. Mass Vaccination • 1st Tier – Fraternities, Sororities, Residents of affected Housing • 2nd Tier – students under 21 • Later – 2nd Tier modified to include all students

23. Mass Vaccination - Results Vaccinations Administered: • 1st Tier – 360 • 2nd Tier – 3700 • Total Including OPH - 6005 • Private providers: thousands more

24. Managing The Mass Vaccination Student Health Services/Office of Public Health • Defined areas • Developed volunteer pool • Acadian Ambulance • medical clearance • support for possible emergencies • Procured equipment and supplies

25. Managing The Mass Vaccination Student Health Services/Office of Public Health (cont) • Assigned positions/stations; signage • Check in area • Interview Areas (Nurse I and II) • Medical clearance area (doctors) • Emergency area: Acadian Ambulance

26. Managing The Mass Vaccination Student Health Services/Office of Public Health (cont) • Nurse I (university volunteers) • Answers disease or vaccination questions; reviews contraindications/questionnaire: Volunteers • Nurse II (Public Health staff) • Confirms allergies; administers vaccination; collects consent to be entered into LINKS: OPH Nurses Only • Waiting area to ensure no reaction

27. Managing The Mass Vaccination Dean of Students: • Site preparation • Coordinates security with University Police • Parking for volunteers • Check-in area

28. Managing The Mass Vaccination News Services • Media release • AG, confidentiality laws • For Tier I, no media • For Tier II, media allowed in before shots start • this is an issue, be prepared for this

29. Pictures of the Mass Vaccination (Tier 2)

30. Check In/Interview Area

31. Nurse I Stations

32. Nurse I Stations

33. Nurse II Stations

34. Lessons Learned • Go with your best information available • Media compromise was effective • Annual review of your plan, plan for turnover • Pre-plan your volunteer effort • Pre-form your written resources • Legislation, incoming freshmen to be vaccinated

35. In Summary • The OPH Partnership was critical • The plan worked • Human element cannot be ignored

36. Resources You Can Use(Available on the Webpage) Parts of the Plan

37. Flowchart – Excellent Training Tool

38. Working List for Possible Contacts (Dean of Students)

39. General Information For Students/Employees

40. Policy and Procedure For Dean Of Students

41. Other Resources You Can Use • Similar Policy/Procedure • Student Health Service • Housing • International Student Office • Public Relations • University Police • Powerpoint Presentation

42. Thank You!! Questions?