Anoka County Tabletop Exercise on Gastrointestinal Outbreak

Anoka County Tabletop Exercise on Gastrointestinal Outbreak in a School

Susan Carolan

Rosebelle Azcuna

Marcia Engvall

Janet Jonassen

Ben Miller

Jane Nyquist

Key Aspects of the Exercise

carried out by the Anoka County Community Health and Environmental Services Department

focuses on the event of a gastrointestinal outbreak in a school

based on an actual gastrointestinal outbreak in an elementary school in Minnesota

Exercise Format

Series of scripts, each script running from 10-30 minutes

Script details:– Fictitious date and time of the setting– Timeline for discussion– List of events that occurred

– Pertinent data injects – List of issues that need to be tackled

during the discussion

Exercise Goal

To clarify roles and responsibilities of schools in notification and communication with local public health in response to a potential infectious disease event.

Exercise Objectives

1. To determine if standard procedures exist in the school district for surveillance of potential infectious disease events.

2. To identify notification, coordination, and communication strategies needed within the school district in a potential infectious disease event.

Exercise Objectives

2. To identify notification, coordination, and communication strategies between the school district and local public health in a potential infectious disease event.

3. To identify areas or issues where further clarification or planning is needed to assure an effective overall response to a potential infectious disease event.

Participants

Players (10)

Facilitator

Evaluators (2)

Recorder

Players

School health para-professional or school secretary

School nurse

School district nurse consultant

School district nurse consultant’s supervisor

School district safety manager

School principal

Players

High level school administrator

Local hospital infection control practitioner

Local public health director

Local public health disease prevention and control representative

Summary of Scripts

Script 1

10 minsInject A: Nurse’s report summarizing ill students (9 students)

Disease surveillance in school

Internal notification (principal or other administration) of increased illness

Students reporting to nurse’s office with gastro-intestinal illness

TimeData InjectsKey IssuesScript

Script 2

20 minsInject B: Updated attendance records by grade/classrm

Inject C: Attendance officer summary of symptoms reported by parents.

Further notifications regarding the event

Identifying what key pieces of information are needed as soon as possible

Thirty-two percent of students in grades K-4 are absent

TimeData InjectsKey IssuesScript

Script 3

30 minsInject D: Summary of symptoms of students

Inject E: School lunch menu from previous week.

Role of LPH & MDH in foodborne outbreak investigation

Roles & responsibilities of school officials in assisting in outbreak investigation

Notification of LPH and MDH

TimeData InjectsKey IssuesScript

Script 4

20 minsInject F:

News story

Coordination of public information/risk communication messages

Key risk communication

Parent of student informs the media

TimeData InjectsKey IssuesScript

Script 5

20 minsInject H: Exclusion policy

Risk communication to parents

Hand-washing education

Monitoring of excluded students

Return of students that are still symptomatic

TimeData InjectsKey IssuesScript

Script 6

20 minsInject I: Outbreak summary report

Impact of event on the school

Recovery issues – lessons learned

Summary of outbreak and response

TimeData InjectsKey IssuesScript

Actual Scripts

Script 1

Topic– Students reporting to nurse’s office

with gastrointestinal illness

Date and Time– 11:00 am – 3:00 pm – Thursday, September 16th

Time Allotted– 10 minutes

Script 1

Events– By 11:00 am 4 students have reported to

the school’s nurses office with gastrointestinal-like illness. The school nurse sends two of the students home.

– By the end of the day 5 additional students have presented to the nurses office with similar symptoms. Two students that visited the office in the morning return in the afternoon complaining of worsening symptoms.

Script 1

Data Inject– Data Inject A:

Nurse’s report summarizing ill students (9 students)

Issues for Discussion– Disease surveillance in school

– Internal notification (principal or other administration) of increased illness

Script 2

Topic– Thirty-two percent of students in grades

K-4 are absent

Date and Time– 9:00 am Friday– September 17th

Time Allotted– 20 minutes

Script 2

Events– The attendance officer is receiving

numerous calls from parents indicating that many children in grades K-4 are ill with gastrointestinal illness. The parents are reporting that the children are experiencing vomiting, diarrhea, and fever.

Script 2

Events– At 9:00 am the attendance report

is given to the school nurse. Twenty-five of 78 students in grades K-4 are absent.

Script 2

Data Inject

– Data Inject B:

Updated attendance records by grade or classroom

– Data Inject C:

Attendance officer summary of symptoms reported by parents

Script 2

Issues for Discussion

– Further notifications regarding the event– Identifying what key pieces of

information are needed as soon as possible

Recommendations

Further development of scriptsExercise developmentReview existing SOPDraft procedures / revise existing policies

Evaluation

OBSERVERS

F

E E

SE

Seating Arrangement