Overview of Outbreak Investigations
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Transcript Overview of Outbreak Investigations
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…
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.