Section 2: Snapshots of Public Health Preparedness in States and Directly Funded Localities: Chicago

Related Website: Chicago Department of Public Health

Chicago Responds to Salmonella Outbreak at a Citywide Food FestivalChicago Robust public health capabilities are needed to respond to multiple emergencies.

Chicago Flag The 20th annual “Taste of Chicago”Chicago festival was held in 2007 and drewChicago an estimated 3.5 million people.Chicago Many hailed from the tri-state area,Chicago while others traveled from across the United States asChicago well as overseas. However, for the first time in the event’sChicago history, the festival was marred by a salmonella outbreakChicago that affected almost 800 people. Compared to theChicago typical salmonella case count of only 300 per year in theChicago Chicago area, this outbreak was unprecedented in bothChicago number and scope and tested the city’s ability to respondChicago effectively to contain the outbreak and inform the public.

According to the Chicago DepartmentChicago of Health, the cooperative agreement isChicago valuable because previously, it would haveChicago been difficult to have the surge capacity toChicago respond to large-scale or multiple eventsChicago as the public health infrastructure andChicago resources became depleted. Chicago has beenChicago able to hire staff with relevant expertise inChicago preparedness. Additional resources have alsoChicago enabled the city to increase competencies andChicago response capabilities of its staff.

The Chicago Department of Public Health called uponChicago many resources in order to contact patients and conductChicago interviews as part of the epidemiological investigation.Chicago Staff were able to investigate and trace the source ofChicago salmonella back to a single dish from a single vendor.Chicago During the outbreak investigation, the department’sChicago resources were stretched thin by other concurrent healthrelatedChicago incidents. Some of these incidents included theChicago discovery of imported counterfeit toothpaste,

Snapshot of Public Health Preparedness

Below are activities conducted by Chicago in the area of public health preparedness. They support CDC preparednessChicago goals in the areas of detection and reporting, control, and improvement; crosscutting activities help prepare for all stagesChicago 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 inChicago the community, the more quickly they can minimize population exposure.

Table. Disease Detection and Investigation Activities in Chicago
Category of Activities	Specific Activity	Response
Detect & Report	Could receive and investigate urgent disease reports 24/7/365¹	Yes
	Primary method for receiving urgent disease reports^*2	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	^____
* 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.

Table. Public Health Laboratory Activities in Chicago
Category of Activities	Specific Activity	Response
Detect & Report	Number of Chicago laboratories in the Laboratory Response Network¹	1
	Rapidly identified E. coli O157:H7 using advanced DNA “fingerprinting” techniques (PFGE):²


	Rapidly identified Listeria monocytogenes using advanced DNA “fingerprinting” techniques (PFGE):²


	Had a laboratory information management system that could create, send, and receive messages3 (8/05 – 8/06)	^__
	System complied with CDC information technology standards (PHIN)3 (8/05 – 8/06)	^__
	Had a rapid method to send urgent messages to frontline laboratories that perform initial screening of clinical specimens3 (8/05 – 8/06)	^__
Crosscutting	Conducted bioterrorism exercise that met CDC criteria4 (8/05 – 8/06)	Yes
Crosscutting	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.

Table. Response Activities in Chicago
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
	Chicago SNS plan reviewed by CDC²	Yes
	Score on CDC technical assistance review (1-100)	88
	Participated in the Cities Readiness Initiative²	Yes
Crosscutting	Developed roles and responsibilities for a multi-jurisdictional response (ICS) with:¹(8/05 – 8/06)
	Hospitals	Yes
	Local/regional emergency management agencies	Yes
	Federal emergency management agencies	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)	^__
	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