Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Virginia's 'hybrid' surveillance strategy aided response to contaminated steroid outbreak

31.05.2013
Innovative approach relied on coordination between public health and clinical partners, says report in Journal of Public Health Management and Practice

An innovative "hybrid" surveillance strategy—highlighted by close cooperation between public health officials and clinical partners—helped Virginia mount an efficient and effective response to the ongoing outbreak of fungal meningitis and other infections, according to a report in the July/August issue of Journal of Public Health Management and Practice . The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

The Virginia Department of Health (VDH) "worked closely with clinical partners, combining assessment, referral to care and public health surveillance methodologies in a hybrid surveillance model," according to the article by Dr. Laurie Forlano and colleagues. They believe their strategy—involving "intensive collaboration" between public health officials and hospitals and doctors serving the affected communities—is a promising model for responding to future public health threats.

'Hybrid' Surveillance Response to Contaminated Steroid Crisis

The VDH implemented the hybrid strategy in response to the 2012 outbreak of meningitis and other fungal infections, which was traced to contaminated steroid products supplied by a Massachusetts compounding pharmacy. Virginia was one of the hardest-hit states, with 53 affected patients—including two deaths—over a six-month period. Two Virginia healthcare facilities—both free standing pain/interventional radiology clinics in the southwest region of the state—received the contaminated products.

Because of the subtle symptoms, potentially long incubation period, and the risk of serious illness and death, Virginia public health officials decided that intensive, active surveillance was needed to contact and track nearly 700 exposed residents. The VDH rapidly developed a "hybrid" active surveillance strategy, reflecting a combination of traditional active surveillance performed by public health personnel, and additional surveillance and clinical follow-up performed by health care providers and hospitals.

In the hybrid surveillance model, public health personnel took the lead in contacting potentially exposed patients who may have received spinal injections with the contaminated steroids. Telephone follow-up included weekly calls to assess for new signs and symptoms of possible infection, and to refer patients to clinical care if indicated.

'Excellent Partnership' between Public Health and Clinical Partners

Once patients had received testing and care from clinical partners, responsibility for further tracking and follow-up was passed on to the treating physicians. If the patient was diagnosed with a fungal infection, the doctor reported the suspected case back to the VDH. The VDH maintained close contact with partner hospitals to keep up with evolving clinical information.

"It was a division of labor of sorts, as the volume of patients requiring close follow up was just so large," Dr. Forlano explains. "In most cases, if a patient with symptoms sought medical attention—whether from an emergency room, primary care doctor, infectious disease specialist, or elsewhere—that exposed person became the responsibility of the clinical team.

"Both the clinical teams and the public health team provided weekly follow up on the people for whom they were responsible," Dr. Forlano adds. "It was an excellent partnership—the clinicians were willing to do follow up even on patients who didn't meet the VDH definition of 'cases' so we could focus on the exposed persons who hadn't yet developed symptoms."

From the start of October through the end of November, 2012, the VDH documented nearly 3,100 patient contacts. The initial surveillance program was stopped after eight weeks, based on evidence suggesting that any infections caused by the contaminated steroids would have developed within that time.

One-on-one contact was essential to the success of the hybrid surveillance approach, according to Dr. Forlano and her colleagues at the VDH. They believe their experience highlights the need to address key areas of communication with exposed patients and between public health and clinical personnel.

Dr. Forlano and coauthors also believe their hybrid model could be usefully applied to future large-scale health threats, whether natural or man-made. They conclude, "It should be used as a basis for planning the response to events requiring time-sensitive, active follow-up of a large number of exposed individuals that could be required after an intentional or unintentional community wide exposure to a biologic, radiologic or chemical agent."

About Journal of Public Health Management and Practice

Journal of Public Health Management and Practice publishes articles which focus on evidence based public health practice and research. The journal is a bi-monthly peer-reviewed publication guided by a multidisciplinary editorial board of administrators, practitioners and scientists. Journal of Public Health Management and Practice publishes in a wide range of population health topics including research to practice; emergency preparedness; bioterrorism; infectious disease surveillance; environmental health; community health assessment, chronic disease prevention and health promotion, and academic-practice linkages.

About Lippincott Williams & Wilkins

Lippincott Williams & Wilkins (LWW) is a leading international publisher of trusted content delivered in innovative ways to practitioners, professionals and students to learn new skills, stay current on their practice, and make important decisions to improve patient care and clinical outcomes.

LWW is part of Wolters Kluwer Health, a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company with 2012 annual revenues of €3.6 billion ($4.6 billion).

Connie Hughes | EurekAlert!
Further information:
http://www.wolterskluwer.com

More articles from Health and Medicine:

nachricht Why might reading make myopic?
18.07.2018 | Universitätsklinikum Tübingen

nachricht Unique brain 'fingerprint' can predict drug effectiveness
11.07.2018 | McGill University

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: First evidence on the source of extragalactic particles

For the first time ever, scientists have determined the cosmic origin of highest-energy neutrinos. A research group led by IceCube scientist Elisa Resconi, spokesperson of the Collaborative Research Center SFB1258 at the Technical University of Munich (TUM), provides an important piece of evidence that the particles detected by the IceCube neutrino telescope at the South Pole originate from a galaxy four billion light-years away from Earth.

To rule out other origins with certainty, the team led by neutrino physicist Elisa Resconi from the Technical University of Munich and multi-wavelength...

Im Focus: Magnetic vortices: Two independent magnetic skyrmion phases discovered in a single material

For the first time a team of researchers have discovered two different phases of magnetic skyrmions in a single material. Physicists of the Technical Universities of Munich and Dresden and the University of Cologne can now better study and understand the properties of these magnetic structures, which are important for both basic research and applications.

Whirlpools are an everyday experience in a bath tub: When the water is drained a circular vortex is formed. Typically, such whirls are rather stable. Similar...

Im Focus: Breaking the bond: To take part or not?

Physicists working with Roland Wester at the University of Innsbruck have investigated if and how chemical reactions can be influenced by targeted vibrational excitation of the reactants. They were able to demonstrate that excitation with a laser beam does not affect the efficiency of a chemical exchange reaction and that the excited molecular group acts only as a spectator in the reaction.

A frequently used reaction in organic chemistry is nucleophilic substitution. It plays, for example, an important role in in the synthesis of new chemical...

Im Focus: New 2D Spectroscopy Methods

Optical spectroscopy allows investigating the energy structure and dynamic properties of complex quantum systems. Researchers from the University of Würzburg present two new approaches of coherent two-dimensional spectroscopy.

"Put an excitation into the system and observe how it evolves." According to physicist Professor Tobias Brixner, this is the credo of optical spectroscopy....

Im Focus: Chemical reactions in the light of ultrashort X-ray pulses from free-electron lasers

Ultra-short, high-intensity X-ray flashes open the door to the foundations of chemical reactions. Free-electron lasers generate these kinds of pulses, but there is a catch: the pulses vary in duration and energy. An international research team has now presented a solution: Using a ring of 16 detectors and a circularly polarized laser beam, they can determine both factors with attosecond accuracy.

Free-electron lasers (FELs) generate extremely short and intense X-ray flashes. Researchers can use these flashes to resolve structures with diameters on the...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Leading experts in Diabetes, Metabolism and Biomedical Engineering discuss Precision Medicine

13.07.2018 | Event News

Conference on Laser Polishing – LaP: Fine Tuning for Surfaces

12.07.2018 | Event News

11th European Wood-based Panel Symposium 2018: Meeting point for the wood-based materials industry

03.07.2018 | Event News

 
Latest News

Global study of world's beaches shows threat to protected areas

19.07.2018 | Earth Sciences

New creepy, crawly search and rescue robot developed at Ben-Gurion U

19.07.2018 | Power and Electrical Engineering

Metal too 'gummy' to cut? Draw on it with a Sharpie or glue stick, science says

19.07.2018 | Materials Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>