M - Franklin County

Transcription

M - Franklin County

Protecting the Community in
Public Health Emergencies
The Health of our Community is our Future.
DEFINITIONS:
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Definitions
In order to make the operating procedures easier to read, a few specialized terms and abbreviations have been defined.
CERT
Community Emergency Response Teams
CERT
(Missouri Department of Health and Senior Services)
Center for Emergency Response and Terrorism
CCC
Citizen Corps Council – Organization dedicated to
education, training, and volunteer service
CDC
Centers for Disease Control and Prevention
CRI
Cities Readiness Initiative
Distribution
The process of releasing the SNS from a staging warehouse to LPHAs,
treatment centers, and other locations.
FEMA
Federal Emergency Management Agency
LPHA
Local Public Health Agency
MDHSS
ICS
Missouri Department of Health and Senior Services.
Incident Command System
MRC
Medical Reserve Core (MRC) Program educates people about disaster
preparedness for hazards that may impact their area and trains them in
basic disaster response skills and medical needs.
MSA
Metropolitan Statistical Area
Open POD
Closed POD
POD
A dispensing site operated by Public Health and volunteers - Open to
everyone in the community.
A dispensing site operated for internal employees – not open to the public.
Points of Dispensing - Community locations where the public receives
prophylactic medicines.
Prophylactic drugs
Drugs that protect against biological threats, such as Anthrax, Tularemia
or Plague.
SNS
The Strategic National Stockpile SNS of drugs and other medical materiel
that CDC will deliver to Missouri.
Triage
ODP
Evaluation of patient information to determine type of treatment or
assistance needed.
Office of Domestic Preparedness
Local Public Health Departments in Illinois
Bond County Health Department
503 South Prairie, Greenville, IL 62246
Phone: 618-664-1442 • Fax: 618-664-1744
www.bchd.us
Calhoun County Health Department
P.O. Box 158, Hardin, IL 62047
Phone: 618-576-2428 • Fax: 618-576-9808
www.calhouncountyhealth.com
Clinton County Health Department
930-A Fairfax Street, Carlyle, IL 62231
Phone: 618-594-2723 • Fax: 618-594-5474
www.clintoncohealthdepartment.com
East Side Health District
650 N. 20th Street, E. St. Louis, IL 62205
Phone: 618-271-8722 • Fax: 618-875-5038
www.eshd.org
Jersey County Health Department
1307 State Hwy. 109, Jerseyville, IL 62052Phone: 618-498-9565
Fax: 618-498-3165
www.jerseycountyhealth.org
Macoupin County Health Department
805 North Broad Street Carlinville, IL 62626
Phone: 217-854-3223 • Fax: 217-854-3225
www.mcphd.net
Madison County Health Department
101 E. Edwardsville Rd, Wood River, IL 62095
Phone: 618-692-8954 ext 8 • Fax: 618-692-8905
www.madisonchd.org
Monroe-Randolph Bi-County Health Department
2515 State Street, Chester, IL 62233
Phone: 618-826-5007 • Fax: 618-826-5223
www.egyptian.net/~mrch
St. Clair County Health Department
19 Public Square, Suite 150
Belleville, IL 62220
Phone: 618-233-7769 • Fax: 618-236-0676
www.scchd.org
Local Public Health Departments in the St. Louis Metropolitan Area
Franklin County Department of Health
15 South Oak
Union, MO 63084
Phone: 636-583-7300 • Fax: 636-593-7305
www.franklinmo.org
Jefferson County Health Department
1818 Lonedell
Arnold, MO 63010
Phone: 636-282-1010 • Fax: 636-282-2525
www.jeffcohealth.org
Jefferson County Main offices
405 Main Street
P.O. Box 437
Hillsboro, MO 63050
Phone: 636-789-3372 • Fax: 636-797-4631
Lincoln County Health Department
5 Health Department Drive
Troy MO 63379
www.lchdmo.org/hserv/
Phone: 636-528-6117 • Fax: 636-528-8629
St. Charles County Department of Community
Health and the Environment
1650 Boonslick Road
St. Charles, Missouri 63301
Phone: 636-949-7400 (toll-free 800-822-4012)
Fax: 636-949-1802 • www.scchealth.org
Crawford County Health Department
202 W Main St.
P. O. Box 367 Steelville, MO 65565
Phone 573-775-2555 • Fax: 573-775-3826
St. Louis City Department of
Health and Hospitals
634 North Grand
St. Louis, MO 63103
or P.O. Box 14702 • St. Louis, MO 63178
Phone: 314-612-5100 • Fax: 314-612-6490
www.stlouis.missouri.org/citygov/health
St. Louis County Department of Health
111 S. Meramec Avenue
Clayton, Missouri 63105
Phone: 314-615-1600 • Fax: 314-615-6435
www.stlouisco.com/doh
Warren County Health Department
104 W. Booneslick - Suite H
Warrenton, MO 63383
www.warrencountyhealth.com
Phone is 636-456-7474 • Fax is 636-456-4966
Washington County Health Department
520 Purcell Drive • Potosi, MO 63640
Phone: 573-438-2164 • Fax: 573-438-4759
www.washingtoncountyhealthdepartment.org
Your Community’s Health
Y
ou protect your community by partnering with your
Local Public Health Agency and preparing emergency
plans for your facility. In today’s world, it is more
important than ever to have emergency plans in place.
Emergencies are considered local events that are handled on
a local level before anyone else can help.
This guide introduces the concept of operating an OPEN or
CLOSED Point of Dispensing (POD) in the event there is a
federally declared disaster. The goal of the Local Public
Health Departments is to Protect, Promote and Prevent disease. During a public health emergency,
health agencies are responsible for dispensing medications to the entire population in the Region within
a 48-hour time frame using dispensing sites (PODs).
This program is a part of the Cities Readiness Initiative (CRI) in cooperation with the Department of
Health and Senior Services (DHSS) and Homeland Security. The Cities Readiness Initiative is a
federally funded effort to prepare for emergencies in major US Metropolitan Statistical Areas (MSA).
In an event, the plan is to dispense antibiotics to the entire population within 48 hours. The St Louis
Metropolitan Statistical Area (MSA) was selected based upon population and geographical location for
potential vulnerability. The CRI is a collaborative, multi-jurisdictional effort between local, state, county,
and federal authorities that transcends jurisdictional
boundaries.
Funding for CRI is provided through the Centers for
Disease Control and Prevention (CDC) and the Public
Health Emergency Preparedness (PHEP) Cooperative
Agreement. The funding is provided to enhance the
mass dispensing capabilities of the CRI cities by utilizing
the Strategic National Stockpile (SNS).
The Strategic National Stockpile (SNS) serves as a
national supply of medications and medical supplies for
emergency situations. The SNS program is a 12-hour
―
Push Pack‖ that contains inventory vital for medical resources. The ―
Push Pack:‖ is referred to as
12-hours because it would be delivered within that time frame. Large quantities of medical supplies will
arrive in our area to be utilized for a national disaster and distributed to all of Franklin County and in
other counties of Region C. (More information about SNS can be found on line at the following
address - http://www.bt.cdc.gov/stockpile/#resources).
T
his training guide will help you to plan for
mass dispensing of medication and to
familiarize you with common terms such as
the Strategic National Stockpile (SNS) and
Points of Dispensing (POD)s. Our government
officials and Emergency Management Agency are
involved with the local public health in this planning
effort. Your participation is also needed.
Imagine This Scenario
A biological agent has been released at a
baseball game in St. Louis Busch Stadium, where
thousands of people from Franklin County and
other surrounding counties attended. People that
have been infected are unaware. Some commute
home to Franklin County. Within 24-hours people
have already become ill and overwhelm the only
area hospital .In response to the emergency that
is now reported in other counties the governor has
declared a National Emergency. Within two days,
the affected population needs immediate
medication.
The purpose of this Emergency Guide is to plan for
a possible event, such as disease outbreak i.e.,
Anthrax, Tularemia or Plaque. This plan may also
be used in the event of a Pandemic.
Protecting the community requires delivering
medication within 48-hours to the entire population.
The sheer magnitude of this could be
overwhelming, if it were not for a community effort
and others responding. The Cities Readiness
Initiative (CRI) is a federally funded program setup
to enhance preparedness. The Local Public Health
agencies have been identified as a leading agency
to response.
The CRI is defined by the largest population where
more than 50% of the population resides. There is
at least one city in every state identified as a CRI city.
More information can be found online at
http://www.bt.cdc.gov/cri/
Methods of Dispensing and Planning Efforts
T
he goal of mass prophylaxis is to protect and prevent as many people as possible from
becoming ill. This process can only be accomplished by using both a “PULL” and “PUSH”
method. The "PULL" method pulls people into an OPEN facility or POD. These facilities are
open to the general population. The OPEN facilities have been selected because they have
adequate parking or large auditoriums that can be setup quickly for dispensing medications. Area schools
and local retail pharmacies work well for this purpose because they have staff that could help to distribute.
Most schools already have emergency plans in place for fires, earthquakes or floods and other natural
disasters. But these plans may not include areas identified to be used as PODs.
The "PUSH" method is used for CLOSED PODs.
This is accomplished by pushing medications out to
predefined agencies. A CLOSED POD might be a
local area business or medical facility that could
distribute to their staff and family members.
Facilities that participate in either Open or Closed
dispensing enter into agreements with the
Department of Public Health by signing an
Memorandum of Understanding (MOU). A signed
(MOU) with Franklin County Health Department
insures they would receive their medication and
that medications will be used according to the
guidelines. They also we be reimbursed for
expenses.
The public health plan also includes First Responder agencies and would be considered CLOSED PODs. They would receive medications first, for
themselves and family members so that they can accomplish the tasks needed. First responders are
defined as fire, ambulance, police and local area medical providers. They are required to have medical
protocols setup in advance and also a signed MOU.
The purpose of this guide is to encourage you and family members to get involved and be a prepared
and partner with the Franklin County Public Health Department. Having a Memorandums of
Understanding (MOUs) in place or volunteering for Public Health will assist us. (See Page 10)
Local government officials, local area physicians, nurses, staff, students and the entire community
would be affected in an emergency. The local Health Department in Franklin County is working hard to
collaborate with area businesses, first responders, pharmacists and other local resources in the
community. In an emergency, more than one method of dispensing may take place simultaneously.
A drive-thru clinic or other consideration such as the US Postal Service may be used.. Volunteers are
needed for Public Health for staffing dispensing sites.
Volunteers who work during the dispensing would also be considered first responders. Volunteers
would be asked to fill out a Health Assessment Form and receive credentialing and training to assist in
working at the Point of Dispensing location. A sample Health Assessment form is included at the back
of this guideline. Identifying and training volunteers to work at our Dispensing sites in advance is
crucial to our success. This form may be filled out and kept on file with personnel records at the facility.
Closed PODs would help significantly to reduce the number of people coming to the Open PODs and
give us an opportunity to evaluate additional needs in advance. A Memorandum of Understanding
(MOUs) is required with the Public Health Department. (See page 11)
Below is a list of items a facility may need.
An incident command flow
Emergency contact personnel 24/7
Prior credentialing and identification
Training and yearly exercises
Job activity sheets for volunteers
A facility assessment and floor plans
A communication plan for the facility
Be Ready
Planning for health emergencies:
I
n the event of a bio-terrorism attack or an outbreak of
contagious disease, the Franklin County Department of
Health is the coordinating agency for distributing medications.
Depending on the situation, an Open or Closed POD would be
used, as well as other methods. Arrangements have been made
to use local schools as "PODs" to treat a large number of
people. Since large numbers of volunteers will be needed to
operate PODs, our local resource volunteer groups may be
called to help. Franklin County Department of Health is in the
process of recruiting volunteers to assist us with a Medical Response. The Red Cross may also respond
in an Emergency. This Point of Dispensing (POD) Guide provides community agencies with the basic
information they need if called upon to help with POD operations.
Bio-terrorism and other disease threats:
The Center for Disease Control (CDC) has identified
several diseases which may cause a health
emergency. These diseases may include anthrax,
plague, and tularemia. (See page 9) These
diseases can also be weaponized and they have a
high death rate if not treated. Whether a health
emergency is a result of bio-terrorism or of a natural
outbreak, prompt action can limit the spread of
these diseases, save lives, and prevent local
hospitals from being overwhelmed with seriously ill
people.
Emergency Contact Information:
I
n the event of a health emergency, the emergency contact you provide on the Incident Command
Chart will be notified (See page 12), by phone to give you specific instruction. Please keep your
contact information up to date by notifying the Franklin County Local Health Department of any
changes in addresses, phone numbers, or e-mails. (Contact: Jeanette Hale – Regional Planner at
636-583-7310 * halej1@lpha.mopublic.org.
Point of Dispensing (POD) Operations
S
ome disease threats require operating mass dispensing sites to immunize or give preventive
medications to the general public before they become ill. In a federally declared disaster, the
Health Department plans to utilize some area schools. Examples of Points of Dispensing (PODs)
are listed below:
Facility Use - High school auditoriums make a
practical setting for these PODs, because they can
be organized into work stations quickly and have
ample parking and staff. The staff is already
familiar with their facility and would be perfect as
volunteers.
Legislation in our area has been
passed to enable the Franklin County Health
Department to utilize our school facilities during a
federal disaster.
Volunteer Roles - Volunteers will work side-byside with the school agency and Public Health.
Following a Work Flow preventive treatment will be
given to a large number of people quickly by
assessing the patient information form (see page
19). Some volunteer assignments must be done by
doctors, nurses, or other health professionals
because of Medical Protocols. Other assignments
can be done by volunteers with no medical training
such as Triage, Information, and Exit review.
A one way flow diagram of work stations shown would be set up for mass dispensing in which patients
would move through the stations.
1. Triage: Volunteers will greet and screen people by asking specific questions to verify those entering
the PODs are free of symptoms. If needed, those who are ill will be directed to a separate area where
they can be treated without exposing other people.
2. Health Forms and Distribution: Volunteers will give Medical Health Assessment forms to patients.
This information will be used by medical workers to decide on the best course of treatment. Volunteers
will give patient information about the disease and the preventive treatment which will be given, in a
handout form (See page 15-18). Some patients may require help filling out their Health Assessment
forms, particularly those with special needs. Mental Health experts and social workers or volunteers
would be particularly helpful in the event the special needs population is overwhelming.
3. Medical Review: A volunteer may review the medical history forms for conditions which may need
special attention. Patients will either be referred to Medical Advice (physician) or to treatment.
+ Medical advice: Patients will talk to a licensed health professional one-on-one about any medical
conditions which may require special consideration before they are treated.
4. Dispensing: At the dispensing station patients will receive medication. Patients will be immunized by
a health care professional. At this station, patients will be given a supply of antibiotics which will prevent
the disease. At this time the drug of choice is either Ciprofloxacin or Doxycycline.
5. Exit Review: As patients leave, volunteers will give them
information about follow up care. People who have been given
antibiotics will receive an information sheet on the medication they
received and make sure they know where to call for information.
Our Commitment to Volunteers: Volunteers for Public Health
may come from many sources, however, we are also trying to
identify those specific to our needs.
Notification: If a major health emergency occurs, you will be
contacted by Franklin County Department of Health or the Emergency Management Agency and given
specific instructions. Volunteers will be asked to report to a "staging area" where they will sign in and
receive credentials, preventive treatment, and ―
Just in Time‖ training, before starting to work at a POD.
You will then report to the POD Manager of the station assigned.
Preventive Treatment: For the safety and peace of mind of volunteers, the Health Department will
provide preventive First Meds and treatment to all volunteers before they begin working in dispensing
clinics. Families of volunteers will also be given priority treatment. Identifying volunteers ahead of time
allows health assessment forms to be filled out in advance and credentialing in advance. We recommend
that volunteers have their basic medical information on hand for themselves and all family members to
expedite treatment in an emergency situation.
What you need to know.
What medications are you taking? Are you allergic to any antibiotics or other drugs?
Do you or any family members have kidney or liver disease?
Are any family members pregnant?
If children are under age of 9, a pediatric dose may be required. Please consider the child's weight.
Is there a family member that has a medical condition which might need special consideration?
(Eczema immune system problems or currently taking chemotherapy).
Be prepared to show your medical records.
Have you had your regular flu vaccinations?
As a volunteer, you will receive training on disease agents, how to protect yourself and your family,
and mass clinic operations.
Below is a listing of diseases the Center for Disease Control CDC considers most serious and the actions
which would be taken by the Health Department if these diseases occurred in our area.
Disease
Description/Risks
Public Health Actions
Smallpox
Viral infection which causes skin lesions similar to
chicken pox. Contagious. High death rate among
unvaccinated people.
PODs
Security
Storage for Vaccine
Anthrax
(Inhaled)
Not contagious; spread by spores, which can be used
as weapons. High death rate if not treated early.
PODs
Antibiotic Dispensing
Security
Plague
Bubonic: spread by bites from infected fleas. Lymph
nodes become swollen or Inflamed. Pneumonic:
Severe respiratory infection. High death rate if not
treated early.
PODs
Security
Tularemia
Occurs naturally in animals, but not spread human-tohuman. In natural form, can cause sores. In bioweapons, these can cause severe respiratory infection.
PODs
Security
Botulism
Not contagious. Bacteria which occurs naturally,
produces a toxin which causes paralysis.
Remove source of bacteria
Viral
Hemorrhagic
Fevers
Not native to US; occurs in Africa and South America.
Carried by "vector" animals, but may be transmitted
human-to-human.
Isolation/quarantins
Security
SARS
Severe respiratory infection spread by a corona virus.
Very contagious.
Isolation and/or quarantin
(No vaccine available. Does
not respond to antibiotics)
Influenza
Outbreak
A contagious respiratory illness caused by viruses.
PODs
Vaccination
Antiviral medication
Pandemic
Influenza
i.e., H1N1 or
H5N1
A highly contagious viral infection.
PODs
Vaccination
Isolation/quarantins, Antiviral
medication
Volunteer Preparedness and Response Request
O
ur mission at the Health Department is to protect the general health of all residents and visitors in
Franklin County. In response to a Presidential Directive, the Franklin County Department of
Health is recruiting volunteers to assist at Points of Dispensing or other Public Health Disaster.
Disaster refers to: Any occurrence or potential of a major Category III damage, ecological
disruption, and loss of human life, deterioration of health or services, sufficient to warrant an
extraordinary response from the community.
Franklin County Department of Health is responsible for planning for health related emergencies that
would require an extraordinary response. If the community required medication to keep people from
becoming ill because of a disaster, we would need many volunteers to help. Our Health Department
is hoping to identify volunteers to register with us in advance.
Spontaneous volunteers are wonderful, but those trained for a specific disaster response know exactly
what is expected of them. It's important to credential and train local area volunteers for public health. If
you would like to serve as a volunteer, please register on the form provided below. You may mail this
form to Franklin County Department of Health 15 South Oak, Union, MO 63084. You are the vital link in
the recovery success of our community in an emergency. We appreciate and recognize any help you can
assist with. Please review and consider the following areas you may provide assistance.
Can you provide assistance to help in one of the following areas?
Coordinator or manager
Clinic flow and triage
Health and medical
Office support or clerical
Training
Packaging, dispensing and inventory control
Counseling - mental health, or spiritual
Security or traffic control
Communication interpreter services, (i.e., sign language) or other languages
Name: _____________________________________Title:________________________________
Address: __________________________________City: _______________State: _____Zip:_____
Home phone: ____________________________Work: _________________ Cell: _____________
Email Address: ___________________________Drivers License no. or SS #_________________
Special skill or interest: _____________________________________________________________
Only those over the age of 18 and willing to be credentialed and character check.
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A Memorandum of Understanding (MOU)
T
A Public Health Emergency Agreement between
he Franklin County Department of Health in collaboration with other First Responders and
Agencies. The purpose of this agreement is to prepare in advance for a large unexpected public
health emergency. This agreement is entered into partnership with the Franklin County Presiding
Commissioner, the Franklin County Department of Health, and the Emergency Management Agency. The
facility’s building grounds, supplies and equipment may be used for community services.
A Federal Disaster
Any occurrence or potential of a major category III damage, ecological disruption, and loss of human life,
deterioration of health or services, sufficient to warrant an extraordinary response from the community.
Franklin County Health Department agrees to exercise care and responsibility in the use of the facility, in
the event the facility listed below is used. This agreement is in compliance with State and Federal
regulations and the Franklin County Emergency Operations plan. In the event of a natural disaster,
biological, or bioterrorism event the following may occur. All participants agree the facility will be used for
an undefined amount of time. The facility may be used in conjunction with other groups that have already
been established.
This facility may also be used for the following conditions:
Setting up a Point of Dispensing (POD), packaging, and distribution of medicine during the Strategic
National Stockpile (SNS) in a federally declared disaster.
Meetings, training and storing of medical equipment/supplies, such as respirators or medicine.
Those signing this agreement give Franklin County Department of Health and/or the Emergency
Management Agency governing powers, responsibility over the facilities designated area defined for a
Point of Dispensing (POD) in a federally declared disaster. This agreement is binding from the date
signed, unless notified 30 days in advance in writing.
Facility: _______________________________________ Address: _________________________________
Signature: ___________________________________________ Date: ______________________________
Title: _________________________________________ Phone Number: ___________________________
Cell/Fax number: _________________________ Email __________________________________________
Franklin County Commissioner: _________________________ Date: ______________________________
Emergency Management Agency: _____________________________ Date: ________________________
Franklin County Department of Health Director: ________________________ Date: ___________________
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Emergency Call Down List
Franklin County Sheriff’s Department
County Emergency Management Agency
911 Emergency Call Up
(Emergency)
636-583-2560 (non-emergency) 24/7
636-583-1679 (EMA)
Local level
The Missouri Department of Health and Senior Services (DHSS)
For emergencies or disease reporting
24/7 days a week to report a:
1- 800-392-0272
National Response Center Biological Hotline
1-800-424-8802
1st Responders in Franklin County Department of Health
Franklin County Department of Health - Conn Roden, (Director/Administrator) 24/7
Office: 636-583-7304 Fax: 636-583-7305 Cell: 636-795-3077
Jeanette Hale, Regional (Planner Bio terrorism) 24/7
Office: 636-583-7310
Work Cell: 636-584-3590
Dawn Sharp, (Environmental Supr) 24/7
Office: 636-583-7308
Lana Langhorst, RN (Nursing Supervisor)
Office: 636-583-7303
Tony Buel, (Environmental Specialist) 24/7
Office: 636-583-7309
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Biological Threats and Frequently asked Questions
A
nthrax is an acute infectious disease caused by the spore-forming bacterium Bacillus Anthracis. Anthrax
most commonly occurs in hoofed mammals and can also infect humans. In persons exposed to anthrax,
infection can be prevented with antibiotic treatment. Early antibiotic treatment of anthrax is essential. Delay
lessens chances for survival. Anthrax usually is susceptible to penicillin, doxycycline, and fluoroquinolones.
An anthrax vaccine also can prevent infection. Vaccination against anthrax is not recommended for the general
public to prevent disease and is not available.
What are the symptoms of Anthrax?
Symptoms of disease vary depending on how the disease was contracted, but usually occur within
seven days after exposure. The serious forms of human anthrax are inhalation anthrax, cutaneous
anthrax, and intestinal anthrax. Initial symptoms of inhalation anthrax infection may resemble a
common cold. After several days, the symptoms may progress to severe breathing problems and
shock. Inhalation anthrax is often fatal.
The intestinal disease form of anthrax may follow the consumption of contaminated food and is
characterized by an acute inflammation of the intestinal tract. Initial signs of nausea, loss of appetite,
vomiting, and fever are followed by abdominal pain, vomiting of blood, and severe diarrhea.
Direct person-to-person spread of anthrax is extremely unlikely, if it occurs at all. Therefore, there is
no need to immunize or treat contacts of person(s) ill with anthrax, such as household contacts,
friends, or coworkers, unless they also were also exposed to the same source of infection.
What is the treatment for exposure to Anthrax?
In persons exposed to anthrax, infection can be prevented with antibiotic treatment. Early antibiotic treatment of
anthrax is essential–delay lessens chances for survival. Anthrax usually is susceptible to penicillin, doxycycline,
and fluoroquinolones.
How should I handle a suspicious package?
Do not shake or empty the contents of any suspicious package or envelope.
Do not carry the package or envelope, show it to others or allow others to examine it.
Put the package or envelope down on a stable surface; do not sniff, touch, taste, or look closely at it or at any
contents which may have spilled.
Alert others in the area about the suspicious package or envelope. Leave the area, close any doors, and take
actions to prevent others from entering the area. If possible, shut off the ventilation system.
WASH hands with soap and water to prevent spreading potentially infectious material to face or skin
If at work, notify a supervisor, a security officer, or a law enforcement official. If at home, contact the local law
enforcement agency.
If possible, create a list of persons who were in the room or area when this suspicious letter or package was
recognized and a list of persons who also may have handled this package or letter.
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T
ularemia is an infectious disease caused by a hardy bacterium, Francisella tularensis, found in animals,
especially rodents, rabbits, and hares). Typically, persons become infected through the bites of arthropods
(most commonly, ticks and deerflies) that have fed on an infected animal, by handling infected animal
carcasses, by eating or drinking contaminated food or water, or by inhaling infected aerosols.
What are the Symptoms?
Symptoms of tularemia could include sudden fever, chills, headaches, muscle aches, joint pain, dry
cough, progressive weakness, and pneumonia. Persons with pneumonia can develop chest pain and
bloody spit and can have trouble breathing or can sometimes stop breathing. Other symptoms of
tularemia depend on how a person was exposed to the tularemia bacteria. These symptoms can
include ulcers on the skin or mouth, swollen and painful lymph glands, swollen and painful eyes, and
a sore throat. Symptoms usually appear 3 to 5 days after exposure to the bacteria, but can take as
long as 14 days.
Tularemia is not known to be spread from person to person, so people who have tularemia do not
need to be isolated. A vaccine for tularemia is under review by the Food and Drug Administration and
is not currently available in the United States.
Does tularemia occur naturally in the United States?
Yes. It is a widespread disease of animals. Approximately 200 cases of tularemia in humans are reported annually
in the United States, mostly in persons living in the south-central and western states. Nearly all cases occur in rural
areas and are associated with the bites of infective ticks and biting flies or with the handling of infected rodents,
rabbits, or hares. Occasional cases result from inhaling infectious aerosols and from laboratory accidents.
Can someone become infected with the tularemia bacteria from another person?
No. People have not been known to transmit the infection to others, so infected persons do not need to be isolated.
Can tularemia be effectively treated with antibiotics?
Yes. After potential exposure or diagnosis, early treatment is recommended with an antibiotic from the tetracycline
(such as doxycycline) or fluoroquinolone (such as ciprofloxacin) class, which are taken orally, or the antibiotics
streptomycin or gentamicin, which are given intramuscularly or intravenously. Sensitivity testing of the tularemia
bacterium can be done in the early stages of a response to determine which antibiotics would be most effective.
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P
neumonic Plague is an infectious disease that affects animals and humans. It is caused by the bacterium
Yersinia pestis. This bacterium is found in rodents and their fleas and occurs in many areas of the world,
including the United States. Y. pestis is easily destroyed by sunlight and drying. Even so, when released into
air, the bacterium will survive for up to one hour, although this could vary depending on conditions.
Pneumonic plague is one of several forms of plague. Depending on circumstances, these forms may occur
separately or in combination:
Pneumonic plague occurs when Y. pestis infects the lungs. This type of plague can spread from person to
person through the air. Transmission can take place if someone breathes in aerosolized bacteria, which
could happen in a bioterrorist attack. Pneumonic plague is also spread by breathing in Y. pestis suspended
in respiratory droplets from a person (or animal) with pneumonic plague. Becoming infected in this way
usually requires direct and close contact with the ill person or animal. Pneumonic plague may also occur if a
person with bubonic or septicemic plague is untreated and the bacteria spread to the lungs.
Bubonic plague is the most common form of plague. This occurs when an infected flea bites a person or
when materials contaminated with Y. pestis enter through a break in a person's skin. Patients develop
swollen, tender lymph glands (called buboes) and fever, headache, chills, and weakness. Bubonic plague
does not spread from person to person.
Septicemic plague occurs when plague bacteria multiply in the blood. It can be a complication of pneumonic
or bubonic plague or it can occur by itself. When it occurs alone, it is caused in the same ways as bubonic
plague; however, buboes do not develop. Patients have fever, chills, prostration, abdominal pain, shock,
and bleeding into skin and other organs. Septicemic plague does not spread from person to person.
What are the Symptoms?
With pneumonic plague, the first signs of illness are fever, headache, weakness, and rapidly
developing pneumonia with shortness of breath, chest pain, cough, and sometimes bloody or watery
sputum. The pneumonia progresses for 2 to 4 days and may cause respiratory failure and shock.
Without early treatment, patients may die. Early treatment of pneumonic plague is essential. To reduce
the chance of death, antibiotics must be given within 24 hours of first symptoms. Streptomycin,
gentamicin, the tetracyclines, and chloramphenicol are all effective against pneumonic plague. A
plague vaccine is not currently available for use in the United States.
Why are we concerned about pneumonic plague as a bioweapon?
Yersinia pestis used in an aerosol attack could cause cases of the pneumonic form of plague. One to six days
after becoming infected with the bacteria, people would develop pneumonic plague. Once people have the
disease, the bacteria can spread to others who have close contact with them. Because of the delay between
being exposed to the bacteria and becoming sick, people could travel over a large area before becoming
contagious and possibly infecting others. Controlling the disease would then be more difficult. A bioweapon
carrying Y. pestis is possible because the bacterium occurs in nature and could be isolated and grown in quantity
in a laboratory. Even so, manufacturing an effective weapon using Y. pestis would require advanced knowledge
and technology.
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Is pneumonic plague different from bubonic plague?
Yes. Both are caused by Yersinia pestis, but they are transmitted differently and their symptoms differ. Pneumonic
plague can be transmitted from person to person; bubonic plague cannot. Pneumonic plague affects the lungs and
is transmitted when a person breathes in Y. pestis particles in the air. Bubonic plague is transmitted through the
bite of an infected flea or exposure to infected material through a break in the skin. Symptoms include swollen,
tender lymph glands called buboes. Buboes are not present in pneumonic plague. If bubonic plague is not treated,
however, the bacteria can spread through the bloodstream and infect the lungs, causing a secondary case of
pneumonic plague.
Can a person exposed to pneumonic plague avoid becoming sick?
Yes. People who have had close contact with an infected person can greatly reduce the chance of becoming sick if
they begin treatment within seven days of their exposure. Treatment consists of taking antibiotics for at least seven
days.
How quickly would someone get sick if exposed to plague bacteria through the air?
Someone exposed to Yersinia pestis through the air—either from an intentional aerosol release or from close and
direct exposure to someone with plague pneumonia—would become ill within one to six days.
Can pneumonic plague be treated?
Yes. To prevent a high risk of death, antibiotics should be given within 24 hours of the first symptoms. Several
types of antibiotics are effective for curing the disease and for preventing it. Available oral medications are a
tetracycline (such as doxycycline) or a fluoroquinolone (such as ciprofloxacin). For injection or intravenous use,
streptomycin or gentamicin antibiotics are used. Early in the response to a bioterrorism attack, these drugs would
be tested to determine which is most effective against the particular weapon that was used.
Would enough medication be available in the event of a bioterrorism attack involving pneumonic plague?
National and state public health officials have large supplies of drugs needed in the event of a bioterrorism attack.
These supplies can be sent anywhere in the United States within 12 hours.
How is plague diagnosed?
The first step is evaluation by a health worker. If the health worker suspects pneumonic plague, samples of the
patient’s blood, sputum, or lymph node aspirate are sent to a laboratory for testing. Once the laboratory receives
the sample, preliminary results can be ready in less than two hours. Confirmation will take longer, usually 24 to 48
hours.
Is a vaccine available to prevent pneumonic plague?
Currently, no plague vaccine is available in the United States. Research is in progress, but we are not likely to have
vaccines for several years or more.
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Questions
Is it possible that our facility will operate as a POD after hours, during
weekends, or on a holiday?
Emergencies can happen at any time. It is essential that our Emergency Plans include after hour numbers and a
plan of how to contact those that work at the facility so that we can set up a Point of Dispensing (POD) for the
community quicker. A national emergency requires an immediate response to be effective.
Would our employees be distributed medication and their family
members?
Yes, your employees would be considered first responders and be given medication first, as well as their family
members that live in the same household. Enough medication would be distributed for a ten day regime.
Could some parts of the Region be affected more than others?
Emergencies can vary greatly and may affect the entire Region, all of the States. Disease does not know
boundaries, and the mode of transmission differs. The Franklin County Public Health Department works closely with
others in the Region as well as with CDC and the State to determine what area has been affected. When an
emergency occurs it is a local responsibility, when the local area is overwhelmed they may turn to other counties.
When a whole region is overwhelmed they may turn to the state or federal to help with the situation or event.
What about the liability for our facility?
Franklin County has passed legislation to use area schools in the event of an emergency. It’s important for our
schools to understand the National Incident Command System (ICS) and new laws recently passed that will help to
protect volunteers and others that work in the facility from liability issues. Operating under Incident Command when
emergencies take place will help our County to recover from a disaster. Free online training can be found at
www.training.fema.gov/EMIWeb/IS
ICS-100 Introduction to the Incident Command System
ICS-200 Single resource and Initial Action Incidents
ICS-700 National Incident Management System (NIMs) an Introduction
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Public Health Facility Assessment
Facility Name
Person filling Out
form: :
City (as shown in the mailing address – required)
Zip Code (required)
Supervisorial District
Disaster Management Area
Main Phone (required)
Service Planning Area
Franklin County EMA
Jurisdiction (To the right, enter EITHER the City’s name for a site that is
located in an incorporated area OR the Community’s name for a site that
is located in an Unincorporated area of the County - one of the two is
required)
Incorporated City Name
Unincorporated Community Name
Law Enforcement Agency’s Jurisdiction (required)
Thomas Guide - Map Page #
Major Cross Streets (required)
Closest Freeway/Highway (required)
Guide - Locator Grid #
FACILITY USE AUTHORIZATION CONTACT INFORMATION – (all fields, except address, are required)
Name for Contact
Daytime Phone (
Title
)
After Hours Phone (
Owner
)
Jurisdiction of Owner (e.g., County, City, Private, Etc.)
Owner’s Mailing Address, City, Zip Code and Phone (if different from above facility address)
SITE ACCESSIBILITY – (all fields are required)
Access to more than one major road or highway from site (2+ lanes)?
Access via public transit agency (MTA, Santa Monica Bus Lines, etc.)?
Distance to nearest public bus or train stop?
On-site parking?
Number of on-site parking spaces?
EXTERIOR FACILITY – (all fields are required)
Elevators?
Level landings?
Accessible doorways (min 35‖ wide)?
20 | P a g e – J u n e , 2 0 1 0
Automatic doors or appropriate door handles?
Enclosed structure (i.e. 4 walls, floor, and ceiling)?
External electrical outlets?
Building constructed before 1933?
If YES, has building been retrofitted for earthquake safety?
Single story?
If NO, list # of stories
INTERIOR FACILITY – (all fields are required)
Large, open and unobstructed space of at least 5,000 square feet (basketball court sized)?
Separate offices/rooms near large open area (excluding restrooms, kitchen)?
Number of separate offices/rooms?
Estimated total square footage of large, open and unobstructed space?
Are any tables, chairs or stanchions/security barriers stored onsite?
# Tables (approx.):
# Chairs (approx.):
# Stanchions/Barriers (approx.):
# Electrical outlets (an estimate of the total number is acceptable)?
Lighting?
Gas?
Heating system?
Electricity?
Air conditioning?
Refrigerator or cold storage?
Kitchen facility?
Refrigeration?
Hot and cold running water?
Laundry Facility:
Restrooms (also indicate the sub-totals below)?
# Women’s fixtures:
# Men’s fixtures:
# Unisex fixtures:
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COMMUNICATIONS – (all fields are required)
Internet access?
Telephone?
Total number of telephones:
# which are ―
Special Needs‖ accessible (maximum 48‖ high, earpiece - volume adjustable):
# with TDD capability:
SAFETY – (all fields are required)
Perimeter fencing?
Fencing is at least 4 feet in height?
Exterior lighting?
Public address system?
Fire extinguishers?
Fire alarm?
Fire sprinklers?
Back-up generator?
Maximum rated occupancy for largest room in structure? (Enter “0” if occupancy limit is unknown.)
Maximum rated occupancy for entire structure? (Enter “0” if no occupancy limits are posted.)?
COMMENTS
Please describe any limitations of the facility, e.g., ―f
loor space has numerous fixed obstructions,‖ ―
restrooms
outside primary structure,‖ etc. (Use back of page if necessary.)
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M - Franklin County

Transcription

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