Download WEST MIDLANDS HEALTH PROTECTION TEAM

WEST MIDLANDS HEALTH
PROTECTION TEAM
Basics in Public Health
Michele Lawrence
Objectives
•
Overview of Health protection in the West Midlands
•
What is health protection
•
Purpose of outbreak management
•
Outbreak management communications
•
Outbreak management control measures
•
Outbreak control team
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INTRODUCTION
We have one Health Protection Team across the West Midlands based in
three locations in Birmingham, Stafford and Kidderminster serving a combined
population of 5.7 million.
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What is Health Protection?
The primary role of the health protection team is to provide specialist health
protection advice, epidemiological and microbiological support.
To ensure there are effective arrangements in place locally for preparing,
planning and responding to health protection concerns and emergencies,
including the future impact of climate change.
We have a legal requirement to respond to incidents/emergencies and
outbreaks as a Category 1 responder. (i.e. emergency services, local
authorities, NHS).
The Regulations of the Public Health Act include legal powers, available to
enforce actions to protect public health: Part 2A Orders.
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Key Partners in the West Midlands
• 22 x CCGs
• 14 x Local Authorities
• 23 x Hospitals
• 12 x Universities
• 2,200 Other educational settings including primary schools,
secondary schools and further education establishments.
• 2 x Airports
• 12 x Prisons
• 1,800 x Care Homes (with and without nursing)
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Acute Desk
We have an acute response service that covers the West Midlands operating
from three locations.
• The Acute Desk is staffed from 9am – 5pm from the office (also an out of
hours service operates between the hours of 5pm and 9am 365 days a year
and is covered by the clinical team.
• We respond to incoming enquiries, cases, outbreaks and incidents
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•
Giving advice (clinical team)
•
Following up with other partners on current incidents/situations
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Sending information and advice (letters, e-mails, faxes)
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Collecting information for statutory reporting obligations
•
Collecting information relevant to cases and incidents (immunisation status,
lab test results)
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HPZone
• National web-based case management system
• Rolled out nationally in 2009
• Records all enquiries, cases and incidents
• Geographical “contexts” allows cases to be linked nationally
• Provides each HPT with a local ‘dashboard’ summarising all current activity
• Helps improve continuity in incident management
• Enables users to view, query and extract timely and comprehensive
information on incidents and outbreaks
• HP Zone Dashboard allows users to query data nationally
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What is an Outbreak?
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What is an Outbreak?
•Two or more linked cases of an illness
•A single case of an unusual or rare infection.
•A greater than expected rate of infection compared with the usual background
rate that is expected in that population for that place or time.
•A suspected, anticipated or actual event involving microbial contamination of
food or water
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Purpose of Outbreak Management
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Outbreak Management Framework
Case definition
•Confirm diagnosis in known cases
•Determine background incidence of disease
•Case-finding
•Data collection
•Descriptive epidemiology
•Microbiological investigation
•Environmental investigation
•Hypothesis generation
•Analytic epidemiology
•Communications
•Control measures
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Outbreak Management: Communications
Robust communication systems are required for:
•Investigation – active case finding (e.g. from GPs, microbiologists)
•Control – disseminating advice to the public, health professionals and other
agencies
•Liaison – with public, media, and health & non-health agencies
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Outbreak Management: Control Measures
Basic principles:
•Removing source of infection
Isolate cases
Product recall
•Interrupting transmission
Personal hygiene e.g. hand washing
•Protecting persons at risk
Prophylaxis
Vaccination
•Preventing recurrence
Guidelines
Recommendations
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Outbreak Management: Control Measures
TASK
What control measures could be put into place for the following:
•Food poisoning outbreak
•Pandemic flu
Basic Principles
•
Remove source of infection
•
Interrupting transmission
•
Protecting persons at risk
•
Preventing recurrence
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Outbreak Control Team: Membership
Chair (usually a CCDC)
•Environmental Health
•Public Health Laboratory representative
•Consultant Microbiologist
•Administrative and secretarial support
•Director of Public Health (or nominated deputy)
•Consultant Epidemiologist
•Communications Officer
•Health Protection Nurse/Practitioner
•Community Infection Prevention & Control
•Hospital Infection Prevention & Control
•
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Outbreak Control Team: Membership
Clinical Virologist
•Toxicologist
•CCG Representative
•NHS England Area Team Representative
•Representatives from affected NHS Trust
•Health & Safety Executive representative
•Food Standards Agency representative
•Environment Agency representative
•Department for Environment, Food & Rural Affairs representative
•State Veterinary Service representative
•Water Company representative
•Legal Officer
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Challenges for Health Protection in the
West Midlands
Varied population health challenges including:
• High rate and complex nature of acute reactive work
• Tuberculosis
• Hepatitis
• Emergency Planning
• Health Care Acquired Infections
• High number of prisons in WM area
• Environmental Issues
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major incidents
Buncefield Explosion 2005
Poisoning of Alexander Litvinenko 2006
Pandemic flu 2009
Zika 2016
Ebola 2014
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Any Questions………………….
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