Transcript Overview of Outbreak Investigations

Anatomy and Physiology of an
Outbreak Team
Goals
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The goals of this presentation are to
discuss:
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Management strategies during an outbreak
investigation
Team member roles
Necessary equipment
Lines of communication
In the Beginning…
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Successful investigations require a
multidisciplinary approach, effective
communication and collaboration
Steps:
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Assemble team members
Present available information
Outline plan for investigation and team
communication
Assign roles and responsibilities
Questions to Consider
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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
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Who will interact with the media?
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How will data be shared and analyzed?
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Who will write the final report and
present the information?
How will the team communicate with
each other?
Team Member Roles
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Team Leader
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Experience in outbreak investigation and
epidemiology
Selection can be result of outbreak setting or
etiologic agent
Role can be filled by:
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County health director,
Public health nurse,
Epidemiologist, or
Environmental health specialist
Role may change depending on stage of
investigation
Team Member Roles
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Epidemiologist
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Develop study design and survey
questionnaires
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Create database and conduct data analysis
Team Member Roles
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Microbiologist
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Verify the diagnosis
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Subtype pathogens to help refine case
definition
Team Member Roles
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Environmental health specialists (EHS)
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Collect food and environmental samples
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Provide guidance on food safety
regulations and engineering
Team Member Roles
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Interviewers
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Collect data in person or by telephone
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Role can be filled by health department
personnel, state or federal personnel, or
health science students
Team Member Roles
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Clinicians
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Administer vaccines or prophylaxis
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Collect clinical specimens
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Role can be filled by health department or
local medical community
May include veterinarians,
depending on type of outbreak
Team Member Roles
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Regulators
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Facilitate identification of the source of
outbreak and develop prevention strategies
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Role can be filled by state or federal
agency employees
Team Member Roles
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Media Spokesperson
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Deliver clear and consistent messages to
community
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Role can be filled by one outbreak team
member or representatives from each
agency
Team Equipment
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Computer with access to internet
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Email communication
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Literature searches (PUBMED)
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Data entry and analysis (Epi-Info 2002
http://www.cdc.gov/epiinfo/epiinfo.htm)
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Written reports
Team Equipment
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Specimen collection tools
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Rectal swabs or specimen cups
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Phlebotomy equipment
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Cooler to transport specimens
Communication
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Information flows in both directions
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Leader should update the team during
meetings, conference calls, or email
Members provide regular updates to team
leader
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Acts as tool for measuring progress
Enables leader to provide feedback and
direction to team members
Communication
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Keep lines of communication open
through regular meetings or phone
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Include local, state, and federal public
health agencies
Document progress
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Allows all members to remain up-to-date
Assists in drafting final report
Conclusion
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Working as a team requires:
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A wide range of expertise
Clear communication
A rapid but careful and systematic
approach in dealing with outbreaks
References
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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.