Utilizing bioterrorism preparedness for traditional public health response: A hepatitis A cluster among foodhandlers

5173.0: Wednesday, October 24, 2001 - Table 3

Abstract #23155

Utilizing bioterrorism preparedness for traditional public health response: A hepatitis A cluster among foodhandlers

Kimberly A Poggemeyer, MPH, Division of Community Epidemiology, County of San Diego, Health and Human Services Agency, 1700 Pacific Highway, Room 107, San Diego, CA 92101, (619) 531-4958, kpoggehe@co.san-diego.ca.us, Steven C Wood, BS, Emergency Medical Services, County of San Diego, Health and Human Services Agency, 6255 Mission Gorge Rd, San Diego, CA 92120, and Louise S Gresham, PhD, MPH, Division of Community Epidemiology, County of San Diego, Health and Human Services Agency, and San Diego State University Graduate School of Public Health, 1700 Pacific Highway, Room 107, San Diego, CA 92101.

In May 2000, four employees of a popular juice bar tested positive for hepatitis A. Protocols developed for rapid response in San Diego bioterrorism planning were used to quickly mitigate this substantial public health threat. Given the time-sensitive nature of the situation and the need to contain the potential transmission of hepatitis A, the County Health and Human Services Agency established a community-based immune globulin (IG) clinic within 24 hours. The original estimate of persons needing prophylaxis did not include numerous worried well patients and their families who subsequently sought prophylaxis because they frequented the establishment or consumed the juice bar products distributed at a local high school and church. During the two days of the county-sponsored clinic, 993 people were prophylaxed. In addition, Naval Medical Center, San Diego administered 25 doses of IG to military dependents. A collaborative effort with the establishment’s insurance company resulted in two insurance-sponsored clinics within three days of the initial response, providing 1,411 doses of IG. A total of 2,429 people received IG. No secondary cases were linked to the juice bar. Bioterrorism protocols were used in planning for the field clinic, utilizing media capabilities, procuring pharmaceuticals, sustaining operations and overcoming obstacles. These centralized command and control processes were essential in adapting to the greater-than-anticipated response from the community. The utilization of law enforcement air support to deliver medications to the field clinic is an example of how the relationships built into the bioterrorism processes helped mitigate the impact of disease in the community.

Learning Objectives:

Participants of this session will be able to identify the bioterrorism preparedness processes utilized in a public health response to a naturally occurring infectious disease.
Participants will be able to identify non-traditional partners that may be utilized in a public health response.
At the conclusion of the session, the participant will be able to:

identify key components utilized in the command and control of a public health response.
discuss the barriers to rapidly establishing a clinic for providing prophylaxis to potentially exposed individuals.
articulate the benefits of including bioterrorism preparedness protocols in the traditional practice of public health investigation and response.

Keywords: Bioterrorism, Hepatitis A

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA