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Are You Prepared? January 11, 2003

Are You Prepared? January 11, 2003. By Michele Ginsberg, MD Community Epidemiology Division San Diego County Health & Human Services Agency. What Can San Diego Medical Providers Do?. PERSONALLY Develop an emergency plan for you and your family.

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Are You Prepared? January 11, 2003

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  1. Are You Prepared?January 11, 2003 By Michele Ginsberg, MD Community Epidemiology Division San Diego County Health & Human Services Agency

  2. What Can San Diego Medical Providers Do? PERSONALLY • Develop an emergency plan for you and your family. • Be able to rapidly contact your family and ensure their safety. PROFESSIONALLY • Develop, review and practice your facility’s emergency plan. • Compile emergency contact information and upgrade regularly. • Ensure primary and redundant communication systems in place. • Ensure staff have contact information for local public health.

  3. What Can San Diego Medical Providers Do ? • Educate staff to recognize signs & symptoms of diseases believed most likely in a bioterrorist attack (examples): Bacterial Agents: Anthrax, Plague, Tularemia Viral Agents: Smallpox, Viral Hemorrhagic Fever Toxins: Botulism, Ricin, Staph Enterotoxin B • Post Recognition and Reporting Information

  4. Visit Informational Websites: • Centers for Disease Control & Prevention: www.bt.cdc.gov • California Dept Health Service: www.dhs.ca.gov/ps/dcdc/bt • San Diego County EMAN (Emergency Medical Alert Network): www.emansandiego.com

  5. What Can San Diego Medical Providers Do ? • Promptly report diseases reportable by law (80+ diseases). • Report unusual disease occurrence as soon as observed. • Post contact information for Epidemiology Division: (619) 515-6620Mon – Fri 8-5 (858) 565-5255Evenings, weekends, holidays • Ensure key medical contacts at your facility participate in the Emergency Medical Alert Network (EMAN): (619) 515-6620

  6. Communicating with the Public • Be calm - callers consider you authoritative - they’re calling for information and reassurance from you • Know your resources: • Internet websites: • Centers for Disease Control CDC): www.bt.cdc.gov • Office of Disaster Preparedness (ODP): www.co.san-diego.ca.us • Anthrax & Smallpox Vaccination Recording (Local) • 1-800-600-9594 • Seek consultation or refer if you’re not sure

  7. Possible Smallpox CaseSan Diego – December 15, 2002 • 40 y/o male presented to local physician December 13, 2002 with: • 3 day history of fever and chills • Skin lesion on chin DIAGNOSIS – Viral Syndrome • December 14, 2002 - Symptoms progress: • Lesions on face • Anterior trunk • Patient contact on call physician • Patient was referred to Emergency Department

  8. Hospital Evaluation • Patient seen in Emergency Department • Patient admitted Possible Smallpox • Infectious Disease Specialist contacted • Patient admitted to negative pressure isolation room • ID consultant called • Public Health notified

  9. Hospital Evaluation,Continued • ID consultant evaluation – 40 y/o male born in Trinidad moved to U.S. in 1973 • Prior history of smallpox vaccination • No history of chickenpox or varicella vaccination • Lesions on face, shoulders, anterior trunk • No lesions on palms and soles • Lesions at different stages some appeared umbilicated. • Clinical diagnosis – Varicella

  10. Hospital Evaluation, Continued • ID Specialist and Community Epidemiology confer • Specimen obtained for diagnosis • Public Health Laboratory – PCR confirmed Varicella within 3 hours

  11. Public Health Laboratory

  12. What to do if you suspect a Case at your facility: • Notify Epidemiology at 619-515-6620 • Do NOT send patient away! • Place patient in a separate room • NEGATIVE PRESSURE IF AVAILABLE – CLOSE DOOR • Initiate airborne and contact precautions • Obtain contact information on ALL people who may have had contact with patient • Detain them for interview if possible

  13. Public Health Actions • Promptly investigate original case • Confirm laboratory results at PH Laboratory/State DHS • Identify and interview case contacts as needed • Initiate active surveillance for additional cases • Take immediate public health prevention action as needed

  14. Continued • Collaborate/notify FBI, State DHS and CDC as indicated • Alert local medical community/public as indicated • Determine need for Rx of contacts/health professionals • Mobilize needed assets at regional, state, federal level • Maintain contact with case family and reporting doctor

  15. How to Report? IMMEDIATELY NOTIFY: Community Epidemiology Division (619)515-6620 Mon-Fri 8 – 5 pm (858)565-5255/5200 After-hours

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