Coordinating with the Community for Outbreak Response

1. Coordinating with the Community for Outbreak Response Lilian Peake, M.D., M.P.H. District Health Director Thomas Jefferson Health District Virginia Department of Health

2. Health Department’s Role in an Outbreak Epidemiological investigation & on-going surveillance for cases Is this an outbreak of a communicable disease ? What is the potential impact? Could this be bioterrorism? Inform, educate & coordinate with healthcare community, first responders, officials & public Isolate ill persons What controls can be placed to prevent spread of disease? Provide preventive treatment Quarantine & monitor exposed Environmental health monitoring& controls Assistance with sheltering;mortuary support; mass care

3. Before the Outbreak

4. Identify community partners • Establish communication systems • Routine coordination and collaboration

5. Communication Systems • Letters • E-mail • Blast Fax • Website • Facebook • Conference Calls • Post signs • Call centers • Web-based systems • Others?

6. Routine Coordination • Disease Reporting • Epi-1 • Infection Control Committee • Emergency Planning Committee • LEPC • Communications

7. Vital Signs is a community health promotion column sponsored by Martha Jefferson Hospital, Region Ten, Thomas Jefferson Health District and the University of Virginia Health System. A public health message from www.vdh.virginia/LHD/ThomasJefferson Un mensaje de salud publica de Dear Dr. Hoke: www.vdh.virginia/LHD/ThomasJefferson

8. Public Health Response Public Information & Education Committee Health Department Hospitals Local governments University & colleges Schools

9. www.communityemergency.org

10. Outbreak Response

11. Identify partners • Establish communication systems • Develop shared guidelines, communications • Share data

12. Critical First Step • In-person meeting(s) with partners • Agree on system for regular communication throughout outbreak

13. Who are the partners? • Private provider reports suspected case of measles in an elementary school student • Places where contact may have occurred • Media • VDH Office of Epidemiology • DCLS – state public health laboratory • Neighboring local health departments • CDC • Community physicians • Urgent Care • Hospitals • Hospital Epidemiology & Infection Control • Lab • Emergency Department • School • Students & Families • Staff • Administration • School Board

14. Communication Systems HEALTH ALERT To: Providers in Thomas Jefferson Health District     From: Lilian Peake, M.D., M.P.H, District Health Director Date: May 25, 2011 Re: Additional Measles Cases Two cases of measles…

15. Conference Calls • PVCC TB Investigation • Communications Conference Call 9/29/10 PVCC Anita Showers Mary Jane King UVA Peter Jump Costi Sifri, MD Kyle Enfield, MD Beth Mehring • TJHD • Lilian Peake, MD • Peggy Brown Paviour • VDH • Suzi Silverstein • Cheryle Rodriguez • Maribeth Brewster • Decisions:

16. Attention Valued Customers IMPORTANT MEASLES HEALTH ALERT NOTICE If you were outside of the Paramount Theater MAY 20, 2011 BETWEEN 4:30 PM AND 8:30 PM Please call Virginia Department of Health Hotline at 2-1-1

17. On-line Appointment System You may receive free testing at the Charlottesville-Albemarle Health Department during a special clinic just for PVCC students. To make an appointment, please go on-line at www.vdh.virginia.gov/AppointmentCenter.

18. Shared Guidelines Instructions for Collecting Suspected Measles Specimens – Updated 6/3/11 *Use airborne and droplet precautions while collecting specimens* Adult Serum Testing: Exclusion Assessment Tool for Health Care Workers Exposed to Measles The purpose of this assessment tool is to assist public health, infection control practitioners, and doctor’s office/ clinic staff in evaluating the exposure of workers in a healthcare setting. These are general rules and may be updated as additional information becomes available.

19. Isolation for Suspected or Confirmed Measles Immediately place a mask on the patient. Do not allow the patient to remain in the waiting room… Immediately call Infection Prevention and Control at PIC 1243 from 8:00 AM – 5:00 PM and PIC 9204 at other hours. IP&C will communicate with the health department and coordinate transfers if needed. For any questions or concerns, please call Infection Prevention & Control Phone 924-0260 PIC 1243 (8 AM – 5 PM) Costi Sifri, MD Hospital Epidemiologist

20. Shared Communications Thomas Jefferson Measles Investigation – Talking Points May 16, 2011 The Virginia Department of Health is currently investigating a suspected case of measles in a resident of the Thomas Jefferson Health District… Thomas Jefferson Health District H1N1 Update - 7/27/09 Novel Influenza A (H1N1) continues to circulate in our community and throughout Virginia…

21. Public Information Designated spokespersons Joint interviews Joint PSAs

22. Message Map Scenario: Measles Update Stakeholder: General Public Concern: Misinformation

23. VDH Hotline VDH Measles Frequently Asked Questions and Answers Updated 5/26/2011 FOR CALL CENTER USE ONLY – NOT FOR PUBLIC DISTRIBUTION • What is measles? Measles is a very contagious, vaccine-preventable viral disease with an incubation period of approximately 10 days (range 7– 21 days) from exposure to rash onset.

24. Shared Information to Contacts October 4, 2010 (First Name, Last Name) (Address 1, Address 2) (City, State Zip) Dear (First name): As a student at Piedmont Virginia Community College your health and safety is a primary concern to us. We have identified you as someone who may have been exposed to tuberculosis (TB)…

26. After the Outbreak

27. THOMAS JEFFERSON HEALTH DISTRICT MEASLES OUTBREAK INVESTIGATION AFTER ACTION REPORT/IMPROVEMENT PLAN JUNE 15, 2011

28. Questions?