Responding. Whooping Cough Epidemic. to the. Janna Bardi Office of Immunization and Child Profile Washington State Department of Health
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1 Responding to the Whooping Cough Epidemic Janna Bardi Office of Immunization and Child Profile Washington State Department of Health
2 Objectives Describe the incidence and distribution of whooping cough in Washington state Explain the decision-making process for declaring an epidemic List methods for working collaboratively with partner agencies when declaring and responding to a whooping cough epidemic Describe strategies for working with the media during an epidemic Overview
3
4 Pertussis Incidence by County,2011
5 Pertussis Incidence by County, 2012 (January - March)
6 Pertussis Incidence by County, 2012 (April - June)
7 Pertussis Incidence by County, 2012 (July - September)
8 Whooping Cough Epidemic: Key Dates October 2011 Several counties send notices to health care providers, state issues news release encouraging adult vaccination March 15, 2012 Created whooping cough response team April 2, 2012 Health officer letter sent to all health care providers April 3, 2012 Epidemic declared (640 cases at that time), state launches public awareness May 3, 2012 Gov. Chris Gregoire provides emergency funds September 10, 2012 Epidemic surpasses 4,000 reported cases (more than double 2011 case numbers) Overview
9 Why Declare an Epidemic? Growing number of cases, babies at risk Adults don t know they need vaccine Get provider attention Get public and media attention Get people moving Overview
10 DOH Incident Command Mary Selecky/ Policy Group Communications Liaison Tim Church Managing Executive Allene Mares Health Officer Maxine Hayes Local Health Jurisdiction Liaison Marie Flake Finance Liaison Harvey Perez Planning Section Sabine Meuse Incident Commander Janna Bardi/ Deputy IC Wayne Turnberg Assignment Coordinator and CDC Liaison Lin Watson Media/Communications Vaccine Surveillance Provider Engagement Team Team Team Team Michele Roberts Backup Michelle Harper Jan Hicks- Thomson Backup Mike Bin Chas Debolt Backup Marisa D Angeli Diana McMaster Backup Shana Johnny Revised June 12, 2012
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12 Department of Health Response Promoted national program that provides free vaccine Bought 42,000 Tdap doses for uninsured and under-insured adults Worked with local/tribal health, schools, and child cares Requested CDC Epi-Aid Provided technical assistance and staffing help to local health Overview
13 Result More than twice as many getting Tdap vaccine
14 Informing the Public Vaccination messages by mail reaching 470,000 families Radio/TV ads, English/Spanish YouTube, other social media Regular website updates News releases and news conferences Billboard and bus ads Overview
15 Pertussis cases and rates by age, WA State, 2012 Source: CDC MMWR, July 20, 2012
16 Pertussis cases by age, US, 2012 Source: CDC MMWR, July 20, 2012
17 Reported Cases of Pertussis by Notification Week Washington State, 2011 vs YTD (week 44)
18 Epi Threshold image
19 Resources Frequently asked questions Weekly updates on reported cases Guidance on surveillance, testing, treatment and vaccination Posters, facts sheets and more that you can order for FREE MMWR article Pertussis Epidemic Washington, 2012 July 20, 2012 issue
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21 Local Response to Pertussis Snohomish County
22 Investigations Pre Epidemic Investigate all reports (school nurses) Follow up at 14 days to assess if still coughing Issue classroom alerts only Post Epidemic Discontinue investigations of school nurse reports Recruit & cross-train health district nurses Focus on high risk contacts (infants & pregnant women), then follow up for prophylaxis Do full investigations of household contacts only if cough 14 days (to complete PHIMS entries) Response to Epidemic
23 Prophylaxis Pre Epidemic Prophylax all close contacts (household, school, work) Post Epidemic Refer to provider Facilitate only if high risk in household or for any other high risk contacts Advise symptom watch if no provider Response to Epidemic
24 Testing Guidance Pre Epidemic Urge testing whenever pertussis suspected Post Epidemic Urge testing of symptomatic patients regardless of vaccination history, especially if high risk Once cultures confirmed pertussis, urge polymerase chain reaction (PCR) testing instead Response to Epidemic
25 School Communications Pre Epidemic Classroom letters for each case Emphasize symptom watch & referral to provider Post Epidemic School letter for second case school letter for first case Emphasize vaccination Response to Epidemic
26 Provider Communications Pre Epidemic Provide limited provider alerts & education Post Epidemic Communicate frequently Repeatedly emphasize testing, correct prophylaxis of contacts (not just Tdap!), exclusions, vaccination for all Urge masking health care workers & coughing patients Response to Epidemic
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