Development of an Ebola response plan for Flathead City-County Health Department in Kalispell, Montana

Theresa Majeski, MPHPublic Health Advisor/PHAP Associate

Public Health Associate ProgramOffice for State, Tribal, Local and Territorial Support

Centers for Disease Control and Prevention

2015 PHAP/PHPS Summer SeminarJune 3, 2015

Centers for Disease Control and Prevention

Office for State, Tribal, Local and Territorial Support

Background

First Ebola case in United States – September 2014 Lack of Ebola-specific preparedness by health departments

Flathead City-County Health Department (FCCHD) did not have an Ebola response plan Third most populous county in Montana, with a large medical center

Methods

Community partner meetings were held Fall 2014 FCCHD, 2 local hospitals, emergency services, law enforcement

FCCHD response plan developed to guide responders through all of the steps necessary to manage an Ebola patient or contact Quarantine and Isolation Order power transferred Checklists were developed Flowchart algorithm was created

Methods

Excerpt from FCCHD Ebola Response Plan Flowchart Algorithm

Methods

Developed Ebola contact/traveler monitoring protocol Protocol included:

• Staff instructions• Checklists• Introduction packet for contact/traveler

Direct Active Monitoring and Active Monitoring Orders created Trained four public health nurses to be Contact Investigators

(monitoring personnel) Held internal exercises

Methods

Excerpts from FCCHD Ebola Monitoring Introduction Packet

Methods

Community-wide drills tested the response plan First drill – December 2014

• Tested response plan involving monitoring protocol and Contact Investigator duties

• Patient was “dry” and developed symptoms at home in presence of Contact Investigator

Second drill – January 2015• Tested response plan without involving the monitoring protocol or Contact

Investigator• Patient was “wet” and presented at a local emergency department

Photo credit: Brenda Ahearn/Daily Inter Lake

Results

Community-wide drills Highlighted communication deficiencies among partners and internally Emphasized the need for partners to understand each other’s internal

protocols to enhance coordination efforts

Monitoring protocol Successes

• Video chatting• Data collection forms

Identified unclear outside partner communication roles and responsibilities

Challenges Overcome

Rapidly changing CDC guidelines Contact Investigators training

Unexpected challenges arose from an out of state healthcare worker staying in Flathead County for 21-day monitoring

Future Implications

Response plan is translatable to other health departments and other communicable diseases

Response plan can be scaled up as needed

Working with community partners on the Ebola response has led to discussions about preparing for the next known or unknown communicable disease outbreak

For more information, please contact CDC’s Office for State, Tribal, Local and Territorial Support

4770 Buford Highway NE, Mailstop E-70, Atlanta, GA 30341Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: OSTLTSfeedback@cdc.gov Web: http://www.cdc.gov/stltpublichealth

The findings and conclusions in this presentation are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Questions?Theresa Majeski, MPH

Public Health Advisor/PHAP AssociateCDC/OSTLTS/OD1035 1st Ave West

Kalispell, MT 59901406-260-4906

ypn6@cdc.gov

Centers for Disease Control and Prevention

Office for State, Tribal, Local and Territorial Support