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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.