December 2013 Inside this issue:
Contents
December 2013 Inside this issue:
Active 2012-2013 Flu Season ..................................................1
Healthcare Coalitions Respond to 2012-2013 Influenza
Season..................................................................................1
Director’s Chair .......................................................................1
Happy New Year .....................................................................2
Local Public Health Preparedness............................................2
What to do with friends and relatives – put them on ICE..2
The Household 5 .................................................................2
Minnesota measles case, July 2013: Successful use of
quarantine & exposure precautions ...................................2
The Agony and Ecstasy of Reporting……………………..3
procedures if needed. Both coalitions held weekly strategy
meetings and coordinated requests between healthcare
facilities to share equipment and supplies. There were a
number of instances where healthcare facilities were able to
leverage mechanical ventilators, flu vaccine, and lab testing
kits to alleviate spot shortages. One region opened a “flu
wing” within a hospital to accommodate the patient surge, and
all the hospitals established joint information coordination
between healthcare facilities and public health to provide
consistent messaging. One such message was how hospitals
were jointly restricting patient visitation to reduce exposure
and risk to both healthcare workers and patients. Both
responses demonstrate the continued value of multi-agency
planning through our health coalitions.
http://www.health.state.mn.us/divs/idepc/diseases/flu/basics/fi
ghtflu/index.html#bkmk
Upcoming Events .....................................................................3
Editorial Board .........................................................................4
Active 2012-2013 Flu Season
Healthcare Coalitions Respond to 2012-2013
Influenza Season
All healthcare organizations understand the influenza virus
may spread among patients, healthcare personnel, and visitors
even when core prevention strategies are implemented. MDH
provides information on seasonal influenza for health
professionals at:
http://www.health.state.mn.us/divs/idepc/diseases/flu/index
.html
During the 2012-13 flu season, Minnesota experienced larger
than normal flu related hospital admissions, with the Metro
and South Central Regions seeing higher flu related hospital
admissions than other parts of the state. This prompted
hospitals in both regions to request activation of their health
coalition response plans. Acting primarily at the regional
level, with some resource information sharing throughout the
state, both coalitions actively coordinated information and
resource sharing between healthcare facilities, including
coordination with the jurisdictional health departments.
The two health coalitions identified a number of successes: All
hospitals participated in daily bed reporting and implemented
strategies for increasing bed availability through earlier
discharge where appropriate and canceling of elective
Director’s Chair
Jane Braun, Director of Emergency Preparedness
There are a number of positive developments and
accomplishments moving along in the field of health
readiness; here are just a few:
All indicators from the federal government are that they have
stabilized on what they are asking for with capabilities and
reporting requirements.
We are making excellent progress on our priority setting
process, part of our effort to focus on a smaller number of
critical tasks in sequence rather than trying to take on all the
capabilities.
Pam Darnell, the CRI Coordinator, has been on board for
several weeks, and Laura Andersen, the Metro Public Health
Preparedness Consultant, will start on January 6. This will be
the first time our local consultant positions will all have been
filled in well over a year.
The health coalitions are really starting to gel with their new
focus, formal relationships, and work plans, which will benefit
December 2013
all communities through increased situational awareness and
coordination.
Minnesota fared well on three recent national evaluations of
our emergency preparedness and response—the National
Health Security Preparedness Index, the Trust for America’s
Health Outbreaks: Protecting Americans from Infectious
Diseases, and another that is currently embargoed but will go
public in January.
Thanks to all our wonderful partners for all your efforts to
keep Minnesota safe!
As more people carry smartphones and more phones are
locked to prevent unauthorized use, does the ICE program still
have merit? App developers have created tools to make ICE
information available even when the rest of your phone
remains locked. Typical ICE apps allow you to list
information such as your name, date of birth, allergies and
relevant medical information, as well as the names and
telephone numbers of people you would want to be contacted.
The Minnesota Department of Health does not recommend a
specific app, but these programs are available for iPhones and
Android smartphones. Many are available without charge.
Read the user reviews and carefully check the privacy settings
of a specific app before you download one onto your phone.
Happy New Year
“Whether we want them or not, the New Year will bring new
challenges; whether we seize them or
not, the New Year will bring new
opportunities.”
Michael Josephson
Local Public Health Preparedness
The Household 5
There are 5 easy things to do to help prepare your household
for an emergency.
 Pick an Emergency Contact. Choose someone
elsewhere in the country. Local lines tie up quickly; long
distance ones don’t as easily. Memorize the number.
 Compile a disaster kit. Check it at least once a year.
 Inventory possessions. Photograph and log items of
monetary or sentimental value inside and outside.
 Identify your region’s top risks. Ours are winter
storms, summer storms, power outages, and infectious
disease outbreaks.
 Plan for family. Think through “what ifs”; plan, talk and
practice for all members, including animals.
What to do with friends and relatives – put them
on ICE
ICE (in case of
emergency) is an
acronym that can tell
emergency responders
whom they should
contact on your behalf if
you are unable to
communicate. ICE was
originated and promoted
by British paramedic
Bob Brotchie, beginning
in 2005. Based on his own experience of using patients’ cell
phones to find contact information, Bob selected ICE as a
consistent way for people to label – and responders to search
for - primary points of contact in a medical emergency.
Simply label your primary emergency contacts with the ICE
acronym; “ICE – Mom” or “ICE-Terry.” Emergency
responders can then quickly search your phone contact lists for
these numbers. Bob’s website, incaseofemergency.org,
strongly recommends that you have a conversation with each
person you have labeled as an ICE contact, so they are aware
they could be contacted during a medical emergency.
Ready to Respond Newsletter
Minnesota measles case, July 2013: Successful
use of quarantine & exposure precautions
On July 16th, 2013 the Minnesota Department of Health
(MDH) confirmed a case of measles in a 2 year-old,
unvaccinated male adoptee from China. During late June
2013, the case was traveling with his adoptive father in China
along with several other families with new adoptees. Two
other adoptees were symptomatic at the time with what was
later confirmed as measles.
Upon return to Minnesota, the case’s family took the
asymptomatic child into the clinic for a routine medical
evaluation where they informed the provider of the recent
measles exposure. The child was believed to be unvaccinated
due to a medical condition, though his parents and five
siblings were all up-to-date with MMR (measles, mumps and
rubella) vaccination. The provider then called MDH for
guidance.
The case was placed in voluntary quarantine by MDH given
the fact that it was too far out from the initial exposure to offer
immune globulin for post-exposure prophylaxis, and the
case’s mother refused an IgG blood draw to assess immune
status. During the quarantine period, MDH monitored
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compliance and symptom development with daily calls. The
family was compliant in providing information and on July
10th the case started developing symptoms consistent with
measles, with rash onset beginning July 13th. MDH
recommended medical evaluation despite knowing that
exposures might occur in the process of getting the child into
the clinic.
MDH provided guidance on how to minimize transmission of
measles in a healthcare setting to the primary care provider
and family prior to their clinic visit. As instructed, the case
was taken into the building through the back entrance, was
masked, and did not walk past any other patients or visitors in
the waiting room. The child was immediately placed in an
exam room, which was not used by anyone else for the
remainder of the day. The immune status of the nurse and
provider who evaluated the case was verified prior to the
appointment.
As a result of quarantine and precautions taken to minimize
clinic exposures, there were no additional exposures requiring
follow-up for this case. In contrast, the 1 measles case
confirmed at MDH in February, 2013 generated 250
exposures, each requiring assessment and notification, and 20
of which received post-exposure prophylaxis (MMR or IG).
Reports also help us look at preparedness activities, barriers,
and progress from a population perspective instead of the
individual city or county level. The population perspective is
the cornerstone of public health practice. It helps us examine
issues across the state (or nation) to see if they are unique or
are common. Common issues often can be addressed together.
While few of us will ever enjoy sitting down to write these
required reports, perhaps if we keep in mind the important
reasons for reporting, we will deliver better reports that tell the
story of the incredible work we are doing for the people of
Minnesota.
Upcoming Events
Save the Date: MRC Together Conference
If you are a Medical Reserve Corps director, coordinator, or
leader, or are interested in establishing an MRC unit, please
save April 1-2, 2014 for the MRC Together: Learn, Train,
Network conference. This conference will be held in St.
Cloud, MN and the fee is $30.00. Registration will be done
via MN.TRAIN, with more information to come.
Key message: Quarantine, symptom watch and exposure
precautions benefit public health and save time and money for
health departments!
The Agony and Ecstasy of Reporting
It feels like all we do lately is fill out yet another report.
We’ve got better things to do than writing reports, right?
Wrong! It is time to change our perspective on reporting from
agony to ecstasy. Okay – completing reports is never going to
be fun, but we can change our attitude by looking at the
benefits of reports. Yes, really – the benefits.
Reports are a key communication vehicle, enabling us to
speak to our stakeholders, elected officials (local, state,
federal), partners (local, regional, state), and the public. The
taxpayers can see that their tax dollars are being spent
responsibly. Stories of misspent funds decrease the public’s
trust and respect for government at all levels, which in turn
often results in decreased funding for the critical work we are
trying to accomplish.
Reports help us stop and reflect on progress. Too often we
focus on what still needs to be done rather than celebrating
how far we have come. And reflecting back to the taxpayers
again, reports help them see that their communities will be
better able to respond to and recover from an incident, which
may help build resiliency. Seeing that their community
organizations such as public health are working on disaster
response tells individuals and families that this is important
and can spur them to get ready, too.
Ready to Respond Newsletter
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Editorial Board
Editorial Board members include representatives from MDH
divisions that receive preparedness funds.
Jane Braun, Director of Emergency Preparedness
Kris Ehresmann, Infectious Disease Epidemiology, Prevention
& Control
Gloria Riggs, Office of Emergency Preparedness
Nancy Torner, Communications Office
Maureen Sullivan, Public Health Laboratory
Steven Dwine, Office of Emergency Preparedness
Tina Firkus, Editor, Office of Emergency Preparedness
Contributors to this issue
Jane Braun, MDH Office of Emergency Preparedness
Mickey Scullard, MDH Office of Emergency Preparedness
Deb Radi, MDH Office of Emergency Preparedness
Steven Dwine, MDH Office of Emergency Preparedness
Emily Banerjee, MDH, Infectious Disease Epidemiology,
Prevention & Control
Barbara Lundgren, MDH Office of Emergency Preparedness
Gloria Riggs, MDH Office of Emergency Preparedness
Ready to Respond Newsletter
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