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.