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MFHCC Meeting March 7, 2017 Jefferson County Public Health Lakewood, CO Welcome and Introductions Agenda • Arrive, sign in, grab lunch • Welcome & Introductions – Lisa • Previous Action Items - Lisa • Agency Updates - All – Janelle • Updates/Changes to HCCs and Healthcare Preparedness Program (HPP) – Lisa and • • • • • • • • Janelle Upcoming Training and Events – Lisa and Janelle Member Agency Spotlight – N/A Infectious Disease Update: Mumps & Measles – Carol McDonald Health Alert Network (HAN) Overview – Lisa and Christine Healthy Jeffco Data Portal – Christine Inpatient Bed Tracking Discussion – Janelle and Lisa Review New Action Items – Janelle Networking REVIEW PREVIOUS ACTION ITEMS Lisa Review Previous Action Items Contact Christine/Cali if interested in becoming a JCPH or Denver Closed POD. All On-going Email Janelle or Lisa to sign up for workgroups of interest, including the PHED EX workgroup. All On-going Member Spotlight - email Janelle and Lisa if you would like to be featured on the website. ALL ON-GOING Cali will e-mail the Inventory Management System Excel form to all Denver Closed POD partners for confirmation and for POD site records. Consider writing a letter of support for EMS Bus grant Cali Zimmerman TBD James Robinson Christine Billings, Alexis Garcia Lisa and Janelle On-going Christine Billings DONE Contact Ginny Schwartzer if interested in participating in a Disaster Book Club Ginny Schwartzer On-going Contact Karri Knight if interested in participating in exercise at DIA on July 26, 2017. Karri Knight TBD Contact DIA if interested in serving as evaluator or controller for the exercise at DIA on July 26, 2017 Ashlee Herring On-going Inform North Central Region public health committee about the need for HazMat/Decon training Lisa and Janelle DONE Provide job postings to Janelle and Lisa Share updates about HPP/HCC changes Include sample language regarding review of Emergency Operations Plan (EOP) in the Minutes 3/10/17 DONE AGENCY UPDATES Janelle Agency Updates • Please mention brief updates you would like to share with the entire group • Include your name and agency name • High level reports applicable to various agencies • Updates requiring in depth discussions may transition into workgroups Agency Updates • Epidemiology Update • Hospitals • Public/Environmental Health • EMS Provider • Emergency Management • Long Term Care • Mental/ Behavioral Health • Outpatient Medical Services (Example: community health center, clinic, dialysis, etc.) • Other HCC Partner (Example: education, private, federal entity, coroner, etc.). HOSPITAL PREPAREDNESS PROGRAM (HPP) AND HCC CHANGES FY 2017 – 2022 Lisa Next Steps • Current plan to be shared at Colorado Healthcare Coalition Council meeting Friday, March 10th • Janelle and Lisa will be attending and share info with the MFHCC as needed UPCOMING TRAININGS AND EVENTS Lisa and Janelle Networking Event • Thank you to all who attended Full Moon Snowshoe Hike/Dinner on February 11th! • Lisa Filipczak • Sarah Janci • Donna Kline • Karri and Adam Knight (and puppy Annie!) • Will Moorhead • Ginny Schwartzer • Charles Smedly • Janelle Worthington and Treye McKinney Upcoming Events & Trainings Idaho Springs dinner and Mt. Evans/Echo Lake snowshoe hike MFHCC Website - 2017 Training and Exercise Opportunities in our Community • March 8 – Develop an Emergency Action Plan for an Active Shooter • • • • • • • • Event March 23 – Emergency Preparedness for Aging Populations March 29 – Closed Point of Dispensing (POD) Workshop by CDPHE April 12 – Detecting Workplace Violence Throughout the year - Mental Health First Aid Trainings May 8 - Trauma Informed Care Workshops, Jefferson Center for Mental Health July 25-26 - Public Information in an All-Hazards Incident Sept. 19-20 - Pediatric Disaster Response and Emergency Preparedness Relayed request for PPE/Decontamination/HazMat trainings to North Central Region PHED EX • Public Health Emergency Dispensing Exercise (PHED EX) – June 2017 • Workgroup divided into two groups: 1. Denver PHED EX Workgroup 2. Jefferson/Clear Creek/Gilpin PHED EX Workgroup • Working on scheduling IMS drill for April or May • Agency participation – please update or add your agency info to this spreadsheet • March 29 – Closed Point of Dispensing (POD) Workshop by CDPHE • Communications workgroup • Will meet to review draft plan and eventually test it Hazard Vulnerability Assessment (HVA) Tool Trainings • CDPHE Office of Emergency Preparedness and Response (OEPR) developed new HVA Tool for partners and stakeholders • In-person: HVA Tool Training following April 4th MFHCC Meeting, 1:30-3pm, led by Michael Delgado • All MFHCC partners encouraged to attend • Please register on CO.train (see email and minutes for details) • Webinar Options through June 1st: 9:30-11:00AM and 1:30- 3:00PM each Tuesday and Thursday. *Let Lisa & Janelle know if you participate in a webinar MEMBER AGENCY SPOTLIGHT Lisa REMEMBER THESE DISEASES - THEY ARE BACK MUMPS and MEASLES Carol McDonald, MSN, RN Denver Public Health HISTORY-MEASLES 9th Century-First accounts published by a Persian physician 1757-Scottish physician demonstrated that the disease was caused by an infectious agent in the blood 1912-became a nationally notifiable disease in the U.S. 1912-1922-Average of 6,000 measles-related deaths reported annually 1950’s-nearly all children got the disease by the time they were 15 years old 1950’s-early 1960’s-Estimated annually that 400-500 people died, 48,000 were hospitalized, and 4,000 suffered encephalitis 1963-John Enders and colleagues licensed the first measles vaccine in the U. S. 1968-An improved vaccine was developed by Maurice Hilleman and colleagues; it was called the Edmonston-Enders strain, a more attentuated vaccine 1971-Combined vaccines debut, MMR 1989-1991-Outbreaks in the U.S. sickened thousands 2000-Measles disease was declared eliminated from U.S. 2008-CDC updated recommendations for administration of MMRV References: References: http://www.immunize.org/timeline/ and http://www.historyofvaccines.org/timeline?timeline_categories[]=51 ABOUT THE DISEASE Also known as rubeola virus Highly contagious respiratory infection-90% secondary attack rate among susceptible persons Incubation period-usually 8-14 days (range of 7-21 days) Symptoms Usually begins with a high fever, cough, runny nose, red/watery eyes 2-3 days after the above symptoms, Koplik spots may appear inside the mouth 3-5 days after symptoms begin, a flat/red rash appears usually on the face at the hairline and spreads downward to the neck/trunk/arms/legs/feet. Small raised bumps may appear on top of the flat red spots. Coalescing of the rash may occur as it spreads from the head and down the body. For disease control purposes, consider cases infectious 4 days before rash onset through 5 days of rash (count rash onset as day 0) COMPLICATIONS Estimated that 30% of reported cases have one or more complications Complications are more common among children <5 years of age and adults >20 years of age Young children-diarrhea, otitis media, croup, and pneumonia Acute encephalitis can occur in 1 out of every 1000 cases Death can occur predominately due to respiratory and neurological complications, 1-3 out of every 1000 cases DIAGNOSIS LABSome false-positive results occur even with modern lab tests Restrict testing to those most likely to have the disease (fever AND generalized maculopapular rash) Blood , urine, nasopharyngeal aspirates or throat swabs Investigate ALL measles reports IMMEDIATELY Establish a diagnosis Get vaccination history Obtain detail of case(s) activity Notification of risk to exposure Exclusion until 4 days after rash onset (day of onset counted as day 0) CONTACTS-MEASLES Main purpose of identification is to determine susceptibility to disease and provide information about PEP MMR vaccine or Immune Globulin PEP has to occur within 72 hours of exposure Non-immune contacts that can’t receive PEP within 72 hours may be quarantined at home from the 7th through the 21st day following exposure If exposure occurs or involves a school(s), all susceptible students and staff that don’t receive PEP or lack proof of immunity will be excluded (until 21 days after the onset of rash in the last reported case) No specific antiviral treatment is available. HISTORY-MUMPS 5th Century-Hippocrates wrote about the symptoms 1790-First detailed scientific description by Robert Hamilton 1913-Two French physicians tried to transmit mumps from humans to monkeys but this failed 1921-Another scientist transmitted saliva from mumps patients into cats 1934-Discovered by Ernest W. Goodpasture and Claude D. Johnson 1948-First effective vaccine created by John Enders and was used from 1950-1978 1967-Vaccine became available 1971-MMR vaccine became available ABOUT MUMPS Viral disease also know as epidemic parotitis Caused by the Rubulavirus Characterized by swelling and tenderness of one or more of the salivary glands, usually the parotid gland(s) Not all cases of parotitis are due to mumps infection SYMPTOMS Symptoms of body aches, loss of appetite, fatigue, headache, and low-grad fever may occur several days prior to salivary gland swelling Adults have a higher risk for complications Aseptic meningitis-headache and stiff neck Severe complications are rare but can include: arthritis, encephalitis, inflammation of the thyroid, mastitis, inflammation of the kidneys, myocarditis, oophoritis, pancreatitis, sterility, and hearing impairment Exposure to infection during 1st trimester of pregnancy is associated with an increased risk of spontaneous abortion OTHER INFORMATION Transmitted by direct contact with respiratory droplets or saliva. Can be spread by freshly contaminated fomites. Average incubation period is 16-18 days with a range of 1225 days For disease investigation purposes, consider cases infectious 2 days prior to salivary gland swelling through 6 days of swelling Outbreaks-factor contributing is being in a crowded environment Disease occurring in fully vaccinated individuals DIAGNOSTICS Clinical diagnosis may not be reliable Blood specimen and buccal swab collection CONTACTS Identify household and other close contacts Case’s activities Evidence of immunity Vaccination history Lab evidence Birth before 1957 Documentation of physician –diagnosed mumps There is no specific treatment or PEP for mumps infection Public Health intervention-EDUCATION CASE COUNTS-MUMPS Questions? Contact: Carol McDonald, MSN, RN Denver Public Health [email protected] 303-602-3626 • To report an illness or suspected outbreak in Denver: Call: (303) 602-3614 Email: [email protected] HEALTH ALERT NETWORK (HAN) OVERVIEW Christine Billings and Lisa Filipczak Health Alert Network (HAN) HEALTHY JEFFCO DATA PORTAL Christine Billings Healthy Jeffco Data Portal http://www.healthyjeffco.com/dataportal INPATIENT BED TRACKING DISCUSSION Lisa and Janelle Inpatient Bed Discussion • How do you currently report and share information on bed availability? • Would inpatient bed capacity information be helpful to share and know? Why and when? • How would we collect and share that information? Review New Action Items Lisa Thank you! Networking