EBOLA CONTACT TRACING FOR LOCAL HEALTH DEPARTMENTSAn Overview of North Carolina’s Procedure for Ebola Contact Tracing :Guidance, Tools, and Exercises for Public Health

Operation: Ready, Set, Go

Presented by the N.C. Communicable Disease Branch October 2014

Objectives

Use this next week to Get Ready:

Acknowledge the critical role that contact tracing plays in interrupting disease transmission

Assess your capacity to conduct a scalable Ebola contact tracing event

Describe the process and locate the data collection data management tools

Prepare for onsite state and federal assistance Exercise multiple tabletop exercises for Ebola

contact tracing

Contact tracers are the people who will stop the outbreak of Ebola:

Get Ready, Get Set…..

R – Review the GuidanceE – Engage your Epi TeamA – Assess your CapacityD – Designate your Tracers

Y – Yes to Tabletop Exercises

State Support for Local Public Health Contact Tracing

Deploy state team immediately for assistance with data management Epidemiologist

Deploy state team for field investigations Nurse Consultant Disease Intervention Specialist

Access to Risk Assessment Advisor Personal Readiness KitsThermometers

Safety

Prepare, Practice and PracticeKnow the ProceduresKnow the ToolsTalk, Reassure, SupportTravel in PairsDo not touch

EZ Document ID Ebola Document Name

-- N.C. Contact Tracing Webinar PresentationsA N.C. Contact Tracing Procedure

B1 N.C. Contact Listing Questionnaire- Part 1 B2 N.C. Contact Listing Questionnaire- Part 2B3 N.C. Contact Listing SpreadsheetC N.C. Contact Investigation Questionnaire

D1 N.C. Monitoring Instructions for the LHDD2 N.C. Monitoring Instructions for the Contact

D2-F N.C. Monitoring Instructions for the Contact (French)

D2-S N.C. Monitoring Instructions for the Contact (Spanish)

D3 N.C. Guidance for the Contact Who Becomes Ill

D3-F N.C. Guidance for the Contact Who Becomes Ill (French)

D3-S N.C. Guidance for the Contact Who Becomes Ill (Spanish)

D4 N.C. Ebola Symptom Monitoring LogD4-F N.C. Ebola Symptom Monitoring Log (French)D4-S N.C. Ebola Symptom Monitoring Log (Spanish)

E N.C. Case Investigation Form

Documents Table of Contents

A few things to keep in mind:

Ebola Contact Tracing: Procedures

Ebola Contact Tracing: Phases

a. Identify contacts by interviewing patient or other informants

b. Interview all identified contacts to evaluate need for PH follow-up

Monitor contacts with high- or low-risk exposures for 21 days following last exposure

Release on 22nd day following last exposure

1. Identification and interviewing

2. Active monitoring

3. Discharge

Symptomatic Contacts

At ANY point in this process you may encounter contacts with symptoms of

Ebola.

You must know and be able to carry out your LHD procedure to safely respond to

this situation.

Identification and Interviewing Tools

a. Identify contacts by interviewing patient or other informants

1. Identification and interviewing

b. Interview all identified contacts to evaluate need for PH follow-up

Identification and Interviewing Tools

a. Identify contacts by interviewing patient or other informants

1. Identification and interviewing

b. Interview all identified contacts to evaluate need for PH follow-up

Identification and Interviewing Tools

a. Identify contacts by interviewing patient or other informants

1. Identification and interviewing

b. Interview all identified contacts to evaluate need for PH follow-up

Identification and Interviewing Tools

a. Identify contacts by interviewing patient or other informants

1. Identification and interviewing

b. Interview all identified contacts to evaluate need for PH follow-up

Monitoring Tools

Monitor contacts with high- or low-risk exposures for 21 days following last exposure

2. Active monitoring

Monitoring Tools

Monitor contacts with high- or low-risk exposures for 21 days following last exposure

2. Active monitoring

Monitoring Tools

Monitor contacts with high- or low-risk exposures for 21 days following last exposure

2. Active monitoring

Monitoring Tools

Monitor contacts with high- or low-risk exposures for 21 days following last exposure

2. Active monitoring

3. Discharge

Discharge

Release on 22nd day following last exposure

Ebola Contact Tracing: Phases

a. Identify contacts by interviewing patient or other informants

b. Interview all identified contacts to evaluate need for PH follow-up

Monitor contacts with high- or low-risk exposures for 21 days following last exposure

Release on 22nd day following last exposure

1. Identification and interviewing

2. Active monitoring

3. Discharge

Data Management

EID EXXX

1. Every case and potential contact receives a unique ID

Contact ID Number nNNNN-XXX

Contact ID Number 1 NNNN-XXX

3. If any contact becomes a case they also receive an NC EDSS Event Number:

2. For each case a person may have been exposed to, a contact ID Number is created:

Every potential contact will receive a minimum of two ID numbers: an EID and at least one contact ID number (a person may have multiple contact ID numbers if exposed to multiple cases). They will also have an NC EDSS event number if they become symptomatic.

Identification of persons in Ebola Contact Tracing

Example of ID numbers

Name EID NC EDSS Event Number

Contact ID Number

John Snow E001 100905678

Edward Jenner E002 5678-001

Louis Pasteur E003 5678-002

Name EID NC EDSS Event Number

Contact ID Number

Florence Nightingale

E004 --- 4567-001

Louis Pasteur E003 --- 4567-002

Contact tracing for our second case

Contact tracing for our first case

100904567

ID numbers continued

EZ Document ID Ebola Document Name

-- N.C. Contact Tracing Webinar PresentationsA N.C. Contact Tracing Procedure

B1 N.C. Contact Listing Questionnaire- Part 1 B2 N.C. Contact Listing Questionnaire- Part 2B3 N.C. Contact Listing SpreadsheetC N.C. Contact Investigation Questionnaire

D1 N.C. Monitoring Instructions for the LHDD2 N.C. Monitoring Instructions for the Contact

D2-F N.C. Monitoring Instructions for the Contact (French)

D2-S N.C. Monitoring Instructions for the Contact (Spanish)

D3 N.C. Guidance for the Contact Who Becomes Ill

D3-F N.C. Guidance for the Contact Who Becomes Ill (French)

D3-S N.C. Guidance for the Contact Who Becomes Ill (Spanish)

D4 N.C. Ebola Symptom Monitoring LogD4-F N.C. Ebola Symptom Monitoring Log (French)D4-S N.C. Ebola Symptom Monitoring Log (Spanish)

E N.C. Case Investigation Form

Documents Table of Contents

Documents Table of Contents

Documents are available online

The CDB webpage: http://epi.publichealth.nc.gov/cd/diseases/hemorrhagic.html

OR

CD Manual:http://

epi.publichealth.nc.gov/cd/lhds/manuals/cd/reportable_diseases.html

Tabletop Exercises

And More…• Survey Monkey

Evaluation• Onsite

Instruction for Tracers

Questions, Comments, Concerns

Thank you

Kathy Dail, RN MEd Heather Dubendris,

MSPH Kristin Sullivan,

MPH Rob Pace, BGS Reed Underhill, BA

North Carolina Division of Public HealthCommunicable Disease Branch

Bhavini Patel Murthy, MD, MPHPreventive Medicine ResidentUniversity of North Carolina at Chapel Hill

Neil Chandra Murthy, MD, MPHEmergency Medicine ResidentDuke University Medical Center