PUBLIC HEALTH PREPAREDNESS: MOBILIZING STATE BY STATE
Section 2: Snapshots of Public Health Preparedness in States and Directly Funded Localities: Montana
Related Website: Montana Department of Public Health
Montana Responds to a Case of Multi-Drug Resistant Tuberculosis
Clear isolation and quarantine statutes contribute to a more timely and authoritative response.
When Montana state and local
health departments learned of a
multi-drug resistant tuberculosis
(MDR TB) case in 2006, urban
and rural counties worked seamlessly with the state
health department TB program to prevent the spread of
the disease. First, the local health department issued an
isolation order restricting the infected patient’s travel.
Because the infected patient had planned to travel
internationally from an airport located in an adjacent,
urban county, that county’s public health department
also issued an order restricting flight from that airport.
To restrict air travel from any other city, the regional
CDC quarantine office and airline were notified. The
infected patient was permitted to travel, within specified
parameters, to a hospital for treatment. When no longer
contagious, the patient was allowed to return home.
After-hours communication and relationships among state
and local laboratories facilitated the exchange of clinical
testing results. In addition, a communicable disease nurse
was dedicated to manage the complex public health and
medical issues related to this case.
Cooperative agreement funds contributed to the successful response. Local health authorities could rapidly issue a county isolation order because Montana had reviewed and updated its public health statutes, including isolation and quarantine authorities, and local public health departments adopted and updated their protocols. Montana also updated its high-level biosafety laboratory with the infrastructure needed to protect staff from highly infectious samples, such as MDR TB.
Snapshot of Public Health Preparedness
Below are activities conducted by Montana in the area of public health preparedness. They support CDC preparedness goals in the areas of detection and reporting, control, and improvement; crosscutting activities help prepare for all stages of an event. These data are not comprehensive and do not cover all preparedness activities.
Disease Detection and Investigation
The sooner public health professionals can detect diseases or other health threats and investigate their causes and effects in the community, the more quickly they can minimize population exposure.
| Category of Activities | Specific Activity | Response |
|---|---|---|
| Detect & Report | Could receive and investigate urgent disease reports 24/7/3651 | Yes |
|
Telephone | |
| Linked state and local health personnel to share information about disease outbreaks across state lines (through the CDC Epi-X system)3 | Yes | |
| Conducted year-round surveillance for seasonal influenza4 | Yes | |
* Telephone, fax, and electronic reporting are all viable options for urgent disease reporting, as long as the public health department has someone assigned to receive the reports 24/7/365. 1 CDC, DSLR; 2005 2 CDC, DSLR; 2006 3 CDC, Epi-X; 2007 4 HHS, OIG; 2007 |
||
Public Health Laboratories
Public health laboratories test and confirm agents that can threaten health. For example, advanced DNA “fingerprinting” techniques and subsequent reporting to the CDC database (PulseNet) are critical to recognize nationwide outbreaks from bacteria that can cause severe illness, such as E. coli O157:H7 and Listeria monocytogenes.
| Category of Activities | Specific Activity | Response |
|---|---|---|
| Detect & Report | Number of Montana laboratories in the Laboratory Response Network1 | 1 |
| Rapidly identified E. coli O157:H7 using advanced DNA “fingerprinting” techniques (PFGE):2 | ||
|
5 | |
|
100% | |
| Rapidly identified Listeria monocytogenes using advanced DNA “fingerprinting” techniques (PFGE):2 | ||
|
None |
|
|
N/A | |
| Had a laboratory information management system that could create, send, and receive messages3 (8/05 – 8/06) | yes | |
|
Yes | |
| Had a rapid method to send urgent messages to frontline laboratories that perform initial screening of clinical specimens3 (8/05 – 8/06) | Yes | |
| Crosscutting | Conducted bioterrorism exercise that met CDC criteria4 (8/05 – 8/06) | Yes |
| Conducted exercise to test chemical readiness that met CDC criteria4 (8/05 – 8/06) | N/A | |
1 CDC, DBPR; 2007 2 CDC, DSLR; 2007 3 APHL, Public Health Laboratory Issues in Brief: Bioterrorism Capacity; May 2007 4 CDC, DSLR; 2006 |
||
Response
Planning provides a framework for how a public health department will respond during an emergency. The plans can be tested through external reviews, exercises, and real events. After-action reports assess what worked well during an exercise or real event and how the department can improve.
| Category of Activities | Specific Activity | Response |
|---|---|---|
| Control | Developed a public health response plan, including pandemic influenza response, crisis and emergency risk communication, and Strategic National Stockpile (SNS)1, 2 | Yes |
| Montana SNS plan reviewed by CDC2 | Yes | |
|
80 | |
| Number of Montana cities in the Cities Readiness Initiative3 | 1 | |
| Crosscutting | Developed roles and responsibilities for a multi-jurisdictional response (ICS) with:1 (8/05 – 8/06) | |
|
Yes | |
|
Yes | |
|
No | |
| Public health department staff participated in training to support cooperative agreement activities4 | Yes | |
| Public health laboratories conducted training for first responders5 (8/05 – 8/06) | Yes | |
| Activated public health emergency operations center as part of a drill, exercise, or real event*†6 (partial year, 9/06 – 2/07) | No | |
| Conducted a drill or exercise for key response partners to test communications when power and land lines were unavailable†6 (partial year, 9/06 – 2/07) | No | |
| Improve | Finalized at least one after-action report with an improvement plan following an exercise or real event†6 (partial year, 9/06 – 2/07) | Yes |
* Activation means rapidly staffing all eight core ICS functional roles in the public health emergency operations center with one person per position. This capability is critical to maintain in case of large-scale or complex incidents, even though not every incident requires full staffing of the ICS. † States were expected to perform these activities from 9/1/2006 to 8/30/2007. These data represent results from the first half of this period only. 1 CDC, DSLR; 2006 2 CDC, DSNS; 2007 3 CDC, DSNS CRI; 2007 4 CDC, DSLR; 1999-2005 5 APHL, Chemical Terrorism Preparedness; May 2007 6 CDC, DSLR; 2007 |
||
Get email updates
To receive email updates about this page, enter your email address:
Contact Us:
- Centers for Disease Control and Prevention
1600 Clifton Rd
Atlanta, GA 30333 - 800-CDC-INFO
(800-232-4636)
TTY: (888) 232-6348
24 Hours/Every Day - cdcinfo@cdc.gov
