Navigation Links
Virginia's 'hybrid' surveillance strategy aided response to contaminated steroid outbreak

Philadelphia, Pa. (May 30, 2013) An innovative "hybrid" surveillance strategyhighlighted by close cooperation between public health officials and clinical partnershelped Virginia mount an efficient and effective response to the ongoing outbreak of fungal meningitis and other infections, according to a report in the July/August issue of Journal of Public Health Management and Practice . The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

The Virginia Department of Health (VDH) "worked closely with clinical partners, combining assessment, referral to care and public health surveillance methodologies in a hybrid surveillance model," according to the article by Dr. Laurie Forlano and colleagues. They believe their strategyinvolving "intensive collaboration" between public health officials and hospitals and doctors serving the affected communitiesis a promising model for responding to future public health threats.

'Hybrid' Surveillance Response to Contaminated Steroid Crisis

The VDH implemented the hybrid strategy in response to the 2012 outbreak of meningitis and other fungal infections, which was traced to contaminated steroid products supplied by a Massachusetts compounding pharmacy. Virginia was one of the hardest-hit states, with 53 affected patientsincluding two deathsover a six-month period. Two Virginia healthcare facilitiesboth free standing pain/interventional radiology clinics in the southwest region of the statereceived the contaminated products.

Because of the subtle symptoms, potentially long incubation period, and the risk of serious illness and death, Virginia public health officials decided that intensive, active surveillance was needed to contact and track nearly 700 exposed residents. The VDH rapidly developed a "hybrid" active surveillance strategy, reflecting a combination of traditional active surveillance performed by public health personnel, and additional surveillance and clinical follow-up performed by health care providers and hospitals.

In the hybrid surveillance model, public health personnel took the lead in contacting potentially exposed patients who may have received spinal injections with the contaminated steroids. Telephone follow-up included weekly calls to assess for new signs and symptoms of possible infection, and to refer patients to clinical care if indicated.

'Excellent Partnership' between Public Health and Clinical Partners

Once patients had received testing and care from clinical partners, responsibility for further tracking and follow-up was passed on to the treating physicians. If the patient was diagnosed with a fungal infection, the doctor reported the suspected case back to the VDH. The VDH maintained close contact with partner hospitals to keep up with evolving clinical information.

"It was a division of labor of sorts, as the volume of patients requiring close follow up was just so large," Dr. Forlano explains. "In most cases, if a patient with symptoms sought medical attentionwhether from an emergency room, primary care doctor, infectious disease specialist, or elsewherethat exposed person became the responsibility of the clinical team.

"Both the clinical teams and the public health team provided weekly follow up on the people for whom they were responsible," Dr. Forlano adds. "It was an excellent partnershipthe clinicians were willing to do follow up even on patients who didn't meet the VDH definition of 'cases' so we could focus on the exposed persons who hadn't yet developed symptoms."

From the start of October through the end of November, 2012, the VDH documented nearly 3,100 patient contacts. The initial surveillance program was stopped after eight weeks, based on evidence suggesting that any infections caused by the contaminated steroids would have developed within that time.

One-on-one contact was essential to the success of the hybrid surveillance approach, according to Dr. Forlano and her colleagues at the VDH. They believe their experience highlights the need to address key areas of communication with exposed patients and between public health and clinical personnel.

Dr. Forlano and coauthors also believe their hybrid model could be usefully applied to future large-scale health threats, whether natural or man-made. They conclude, "It should be used as a basis for planning the response to events requiring time-sensitive, active follow-up of a large number of exposed individuals that could be required after an intentional or unintentional community wide exposure to a biologic, radiologic or chemical agent."


Contact: Connie Hughes
Wolters Kluwer Health

Related medicine news :

1. Barefoot Yoga Announces New Hybrid Nature Yoga Mats
2. Ultimate Aquatics, announces the acquisition of SUP Products, the industry leader in U.S. Made Private Label Hybrid Molded Composite (HMC) Stand Up Paddle Boards (SUP) & Accessories.
3. Virtual Edge Institute to Showcase Digitell's New Hybrid Event Syndication Service
4. Results released for first multicenter study of hybrid revascularization
5. Hybrid vaccine demonstrates potential to prevent breast cancer recurrence
6. Your immune system: On surveillance in the war against cancer
7. Research from the 2013 Genitourinary Cancers Symposium highlights new insights on high-risk prostate cancer prevalence and treatment, compares benefit of surveillance and surgery for management of small kidney tumors
8. Hospital infection surveillance system flawed, say experts
9. Active surveillance can reduce suffering among men with prostate cancer
10. Report focuses on sustainability of infectious disease surveillance
11. Researchers develop secure protocol for linking data registries for HPV surveillance
Post Your Comments:
(Date:11/24/2015)... ... November 24, 2015 , ... ... it comes to several aspects of orthopedic care. They have received recognition for ... and general orthopedic care. , Becker's Hospital Review selected hospitals for inclusion ...
(Date:11/24/2015)... ... November 24, 2015 , ... It takes only three to ... it is critical that the first impression be positive and reflects business values. If ... to buy anything or want to return. They will also share their thoughts about ...
(Date:11/24/2015)... (PRWEB) , ... November 24, 2015 , ... ... LENR HHT Bolier Reactor System. Brillouin is the developer of renewable energy technologies ... low energy nuclear reactions (“LENR”), announced today that its WET™ and HHT™ Boiler ...
(Date:11/24/2015)... (PRWEB) , ... November 24, 2015 , ... ... advisory organization, is pleased to welcome Winter-Dent & Company as its newest Partner ... day one to become a client's most trusted advisor regardless of whether that ...
(Date:11/24/2015)... ... November 24, 2015 , ... ... States to support their local poison centers through donations on Tuesday, Dec. 1, ... calls it “a day that inspires people to collaborate in improving their local ...
Breaking Medicine News(10 mins):
(Date:11/24/2015)... , Nov. 24, 2015  Family Rentals, a ... announced the launch of their newly designed, mobile-responsive ... --> Logo ... --> --> Now, renting essential ... and vacation, just got a whole lot easier ...
(Date:11/24/2015)... --> --> Opportunities ... and PPAR Agonists cholesterol-lowering drugs market ? ... rates? This visiongain report shows you potential ... there. ,  ,Our 199-page report provides 153 tables, charts, ... industry and the future market prospects. Our new study ...
(Date:11/24/2015)... , Nov. 24, 2015  Boston Scientific Corporation (NYSE: ... Oppenheimer 26th Annual Healthcare Conference on December 8, in ... Susie Lisa , vice president, Investor Relations, will participate ... beginning at approximately 8:35 a.m. ET. --> ... in a 30-minute question-and-answer session with the host analyst ...
Breaking Medicine Technology: