COMMUNICABLE DISEASE OUTBREAK MANUAL New Jersey s Public Health Respnse Outbreak Investigatin Team Rles and Respnsibilities BUILDING THE INVESTIGATION TEAM Befre an utbreak, identify key individuals wh will fulfill the varius tasks f the Investigatin Team. Chsing team members wh are familiar with the day-t-day activities f the lcal health department will facilitate a rapid, efficient respnse. Depending n the disease, sme r all f these individuals will be crucial in executing the lcal health department s respnse. All investigatin team members shuld be infrmed f the epidemilgy f the causative agent r suspected agents, and shuld be instructed n hw t cmplete investigatin frms and cllect and submit specimens fr labratry testing. COMPOSITION OF THE INVESTIGATION TEAM Suggested investigatin team members include persns wh can prvide clinical and diagnstic advice, epidemilgical supprt, nursing services, public infrmatin, envirnmental health cnsultatin and inspectins, administratr, infrmatin technlgy supprt, and case investigatins. One f the team members shuld be designated as the TEAM LEADER, wh will crdinate all the respnse activities f the team, and wh will be the primary pint-f-cntact fr the New Jersey Department f Health and Reginal Epidemilgist. Page 1 f 6
ROLES AND RESPONSIBILITIES OF THE INVESTIGATION TEAM MEMBERS Listed belw are sme the respnsibilities f the team members. Additinal rles fr the designated TEAM LEADER are utlined last. This list is intended t serve as a guide, and may be adjusted t meet the needs and available resurces f the health department. Clinician Prvide educatin t lcal prviders abut the disease under investigatin. Assist the attending physician in specimen cllectin, diagnsis, and treatment. Train lcal health department staff n prper prtcls fr treatment and prphylaxis. Attend daily meetings with utbreak team and prvide updates. Assist in the creatin f a case definitin. Epidemilgist Frmulate a case definitin; classify cases int suspect, prbable, cnfirmed r ruled-ut. Maintain a current line listing f cases, an epidemic curve and number f suspect cases pending investigatin. Prvide daily status reprts f the number f suspect, prbable and cnfirmed cases reprted, investigatins cmpleted and pending and number f fllw-ups fr cntacts. Maintain a timeline f events. Include dates and names n initial reprt, initial and subsequent cntact with different agencies, meeting/cnference calls, and decisins pertaining t the utbreak. Instruct thers if cnducting case finding r active/enhanced surveillance, prspectively and/r retrspectively fr missed cases. Train case investigatrs n hw t cmplete an interview and cmpile the infrmatin daily. Review case reprt/investigatin frms t ensure cmpleteness f data cllectin. Prvide daily updates, including case cunt and epi-curves, t the investigatin team. Clean and edit the database f redundant files and errrs daily. Submit cmpleted investigatin frms and Cmmunicable Disease Reprts t the ADHS utbreak epidemilgist weekly. Ensure a final written reprt f the utbreak is submitted t ADHS within 30 days f the end f the utbreak. Page 2 f 6
Health Officer/Administratr Ensure that sufficient resurces (within r frm an utside surce) are available t respnd t the utbreak and cntrl its spread. If a hme visit is needed, ensure availability f transprtatin fr case investigatr. Ensure all individuals requiring cmputers, phnes, cpiers, etc. have access t equipment. Ensure vertime, after hurs building access, travel reimbursement, cellular phne access, etc. are handled. Assess resurces available. Begin steps t pull case investigatrs and ther resurces. Stagger hurs if needed. Arrange staff assignments fr the fllwing 24-48 hurs (r mre). Public Infrmatin Officer Prepare/Review press releases. Respnd t individual media inquiries. Infrmatin Technlgy Specialist Assist in the creatin f an utbreak database r mdifying existing database. Prvide supprt fr any prblems that may arise frm the database. Request data entry persnnel and train persnnel n hw t enter data crrectly int the database. Public Health Nurse Set up vaccinatin clinics as necessary. Order additinal vaccine/antibitics/isg (Immunglbulin G) as needed. Institute accelerated vaccinatin schedule when recmmended. Train vaccinatin nurses n prcedures and prvide updates when necessary. Attend daily meetings with utbreak team and prvide updates. Fllw up with patients t ensure treatment r with cntacts fr prphylaxis r surveillance Cnduct hme visits as needed Cmplete investigatin and reprting frms. If trained, cllect specimens and ensure availability f specimen cllectin supplies. Arrange fr delivery f specimens t the State Labratry. Arrange medical hme visits and/r treatment. Page 3 f 6
Arrange fr prphylaxis, and implement prcedures fr handling persns withut medical insurance. Identify expsed cntacts and surce cases. Educate cases and cntacts regarding cmpliance and preventin. Cntact and/r visit prviders t reinfrce reprting and utbreak cntrl recmmendatins. Registered Envirnmental Health Specialist Perfrm inspectins f facilities t determine pssible surce(s) f expsure. Cllect fd r water samples fr testing. Cntact NJDOH Outbreak Epidemilgist t crdinate testing f samples. Fill ut submissin frms fr fd r water testing. Implement cntrl measures affecting the facility. Wrk with the NJDOH t perfrm trace backs f implicated fd items r ingredients Prvide daily updates t team members n inspectin findings and status f cntrl measures. Case Investigatrs The assrtment f tasks t be accmplished by case investigatrs varies with the type f disease utbreak. The cmprehensive list belw includes mst activities fr varius types f utbreaks; nt all tasks will be cmpleted fr every utbreak. Carryut case investigatin activities as delegated by the Team Leader. Prvide daily status reprt f utstanding and cmpleted investigatins t the Team Leader. Prvide feedback frm r abut patients and prviders. Cmplete investigatin and reprt frms daily and give t the epidemilgist. If trained, cllect specimens and ensure availability f specimen cllectin supplies. Arrange fr delivery f specimens t the State Labratry. Identify expsed cntacts and surce cases. Educate cases and cntacts regarding cmpliance and preventin. If necessary, fllw-up n cmpletin f prphylaxis. Page 4 f 6
Team Leader Serves as pint-f-cntact t the NJDOH and Reginal Epidemilgist. Initial Ntificatin Upn cntacting NJDOH, the team leader will be given the name and cntact infrmatin f the NJDOH utbreak epidemilgist. The NJDOH utbreak epidemilgist will serve as the cmmunicatin liaisn between the lcal and state health departments, the state epidemilgist, and the state labratry. He/she will als serve as cnsultant t the lcal utbreak team leader. Depending upn the disease and situatin, review with NJDOH utbreak epidemilgist the methds and specimens needed t identify and type agent(s) suspected; specimen cllectin and transprt issues such as time, temperature, transprt media, quantity, etc. Request fr NJDOH assistance as needed. Cntinued Cmmunicatin The utbreak team leader and the NJDOH utbreak epidemilgist shuld maintain cmmunicatin after the initial ntificatin. Apprise the NJDOH Outbreak epidemilgist n the status f the utbreak and interventin daily t weekly, depending upn the disease and circumstances. Ntify NJDOH utbreak epidemilgist f the need fr additinal labratry specimen testing, test media, specimen kits, etc. Request fr NJDOH assistance as needed. Review the epidemilgy f the disease, measures fr cmpleting investigatin frms, specimen cllectin prcedures, pririty f investigatins, and state and cunty regulatins pertinent t the disease and situatin with all investigatin team members. Priritize and delegate the fllwing activities t investigatin team members: Crdinatin f specimen cllectin and testing f suspected cases (r btaining labratry reprts frm medical facilities r labs). Inspectin f facilities such as day cares, restaurants, etc. Interviewing cases. Implementatin f cntrl and preventin measures. Check surveillance database t determine the number f cases during the previus weeks, mnths, and similar time perids. Lead daily meetings with investigatin team members. Discuss findings f inspectins, case investigatins, and labratry results. Discuss hyptheses fr pssible increases in the disease. Update cre grup n day s activities and priritize next day s activities. Page 5 f 6
Discuss the need fr imprved cntrl measures. Facilitate cmmunicatin with schls, childcare centers, and ther invlved institutins: Ntificatin f the utbreak and cntrl recmmendatins (e.g., schl exclusins). Facilitate review f immunizatin recrds and indicated fllw up. Educatin f schl, childcare r institutin staff. Arrange fr interventin clinics (immunizatin, prphylaxis, etc.) Facilitate cmmunicatin with health care prviders, hspitals, ERs. Ntificatin f the utbreak thrugh NJLINCS. Develp prvider alerts, infrmatin r fact sheets and reprting reminders. Ensure prper disseminatin f public infrmatin. Assign and train staff t handle public calls and respnd t questins. Develp/prvide educatinal materials fr the public and media. Once an utbreak has been cnfirmed, an fficial declaratin f an utbreak can be made. Adapted frm: Arizna Department f Health Services. Guide t Cnducting Outbreak Investigatins fr Arizna. 2013. www.azdhs.gv/phs/ids/pdf/guide.dc June 2013 Dwnlad the full Cmmunicable Disease Outbreak: New Jersey s Public Health Respnse at www.njlmn2.rutgers.edu/exchange/njacch-utbreak-investigatin-manual Page 6 f 6