PUBLIC HEALTH PREPAREDNESS: MOBILIZING STATE BY STATE
Section 2: Snapshots of Public Health Preparedness in States and Directly Funded Localities:Rhode Island
Related Website: Rhode Island Department of Public Health
Rhode Island Responds to a Mycoplasma Outbreak
Community involvement and outreach are critical for successful public health emergency response.
In December 2006, an elementary
school student died from
encephalitis, an inflammation of
the brain. When two additional
cases in school-aged children followed, a cooperative
epidemiologic investigation between CDC and the Rhode
Island Department of Health (RIDOH) determined that
all three cases were linked to the bacteria Mycoplasma
pneumoniae. School districts were reporting higher
than normal rates of absenteeism because of respiratory
illness and pneumonia, the most common result of
M. pneumoniae infection. The state emergency operations
center was activated at the request of RIDOH. In
addition, RIDOH activated a unified command structure,
which included RIDOH, the Rhode Island Department
of Education (RIDE), and the Rhode Island Emergency
Management Agency.
RIDOH communicated the risk of infection to healthcare providers, elected officials, and the public. RIDOH also distributed hand sanitizers and educational materials related to hand hygiene and cough etiquette to all schools in the state. A 3-day antibiotic distribution clinic with voluntary laboratory testing was established at one elementary school, and school nurses helped to institute a short-term active surveillance system for possible cases of pneumonia. RIDOH also worked with RIDE to draft and implement school policies and recommend school closures where appropriate. As a result, in the elementary school community in which two cases of neurological illness occurred, 100% of the community members were offered protective antibiotics and 97% accepted them. This was accomplished over the New Year’s holiday weekend. A significant portion of the affected families participated in testing for M. pneumoniae in collaboration with CDC epidemiologists, who helped track infections. A prospective surveillance system also was instituted to monitor for possible clusters of M. pneumoniae and its serious complications.
Snapshot of Public Health Preparedness
Below are activities conducted byRhode Island 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 ofRhode Island laboratories in the Laboratory Response Network1 | 1 |
| Rapidly identified E. coli O157:H7 using advanced DNA “fingerprinting” techniques (PFGE):2 | ||
|
5 | |
|
80% | |
| 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 | |
|
No | |
| 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) | No |
| Conducted exercise to test chemical readiness that met CDC criteria4 (8/05 – 8/06) | Yes | |
1 CDC, DBPR; 2007 2 CDC, DSLR; 2007 3 APHL, Public Health Laboratory Issues in Brief: Bioterrorism Capacity; May 2007 4 CDC, DSLR; 2006 |
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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 |
| Nebraska SNS plan reviewed by CDC2 | Yes | |
|
83 | |
| Number ofRhode Island 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 | |
|
Yes | |
| 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) | No | |
| Activated public health emergency operations center as part of a drill, exercise, or real event*†6 (partial year, 9/06 – 2/07) | Yes | |
| 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 |
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