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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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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… • 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
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?
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?
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
Team Member Roles • Epidemiologist • Develop study design and survey questionnaires • Create database and conduct data analysis
Team Member Roles • Microbiologist • Verify the diagnosis • Subtype pathogens to help refine case definition
Team Member Roles • Environmental health specialists (EHS) • Collect food and environmental samples • Provide guidance on food safety regulations and engineering
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
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
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
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
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
Team Equipment • Specimen collection tools • Rectal swabs or specimen cups • Phlebotomy equipment • Cooler to transport specimens
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
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
Conclusion • Working as a team requires: • A wide range of expertise • Clear communication • A rapid but careful and systematic approach in dealing with outbreaks
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.