Infectious Diseases

Infectious diseases — most of which are preventable — disrupt the lives of millions of Americans each year.

New threats can arise quickly, and lapse in preparedness can leave communities unnecessarily vulnerable. Below are resources to help hospitals, health care coalitions, and other organizations prepare for and respond to the diseases that are currently a threat to our world.

Flu

MHA Conducting Weekly Flu Monitoring

Missouri health care partners continue to enhance preparedness and mitigation strategies regarding increased demands on the health care system during prevalent flu seasons. Last year, MHA partnered with hospital staff, and state and local public health leadership to implement strategies for collecting and analyzing hospital information that could serve as an early indicator of potential resource constraints from increased flu activity. Through the 2018-2019 flu season, weekly flu queries were initiated in EMResource to gather information from hospitals on flu-related status indicators. Query data then were compiled and summarized to provide critical, real-time data that can be utilized to plan for and mitigate possible impacts on hospital resources, bed availability and staffing levels. This planned approach provided timely and accurate projections of impacts to hospitals, while reducing ad-hoc queries to front-line staff during spikes in flu activity.

During the 2019-2020 flu season, MHA will initiate queries in EMResource at 10 a.m. to 2 p.m. every Thursday. Hospitals should plan for their response to these queries accordingly. A Flu Monitoring Guidance Document and memo outlines the data elements of these routine queries in EMResource and describes the triggers identified to enhance monitoring. Please note that the collection of these data elements is not intended to replace any syndromic surveillance reporting requirements by hospitals to local public health officials.

Managing Seasonal Patient Surge

Regarding managing seasonal patient surge at health care facilities, ASPR TRACIE worked with the Centers for Medicare & Medicaid Services to provide the information included in HPP’s message about 1135 waivers and temporary surge sites. Additionally, ASPR TRACIE, along with multiple subject matter experts, developed Considerations for the Use of Temporary Care Locations for Managing Seasonal Patient Surge, which describes the major issues health care facility emergency planners must consider when determining patient surge management solutions for longer-duration events, such as weeks to months of managing seasonal illness surge.

For more information:

• DHSS Influenza Website
• CDC Influenza Website

Ebola

Based on current guidance for evaluating persons with Ebola, if an individual is found to be at risk, then the specified infection control measures must immediately be instituted, and hospital leadership, along with state and local public health officials, must immediately be notified. It is very important that these steps be consistently followed in all emergency departments. To report a suspected Ebola patient call the Missouri Department of Health and Senior Services at 573-751-6113 or 800-392-0272 (24 hours a day/seven days a week), and call your local public health agency.

CDC Resources

The Centers for Disease Control and Prevention has several resources available on Ebola Virus Disease, including the following.

• guidance summarizing the current domestic personal protective equipment supply status and providing recommendations to ensure an adequate estimate and supply of PPE for Ebola planning and response
• a framework for a tiered response to care for Ebola patients
• guidance on PPE to be used by health care workers during the management of patients with confirmed Ebola or persons under investigation

Education & Publications

• DHSS: Missouri’s Response Plan for Suspected and Confirmed Patients Webinar
• MHA: Ebola Tabletop Exercise (.ppt)
• NETEC: Online Learning Portal
• ASPR TRACIE: Highly Pathogenic Infectious Disease Exercise Planning: Recording
• University of Nebraska Medical Center: ISOPOD Training Video
• Transport and Management of Patients with Confirmed or Suspected Ebola Virus Disease

Donning and Doffing of PPE

• Informational videos from the CDC demonstrate the procedures for donning and doffing PPE for all health care providers.
• UNMC’s biocontainment unit developed handouts, videos, and other materials for donning and doffing education and training. Free Ebola online courses also are available.
• DuPont released a technical bulletin that provides general guidance for the use of PPE for Ebola response.
• The CDC and Medscape produced a video on the types of PPE to be used, and processes for putting on and removing PPE.
• The North Carolina Division of Public Health and its state partners released a video demonstrating donning and doffing of PPE in hospital isolation units.