COMMUNICABLE DISEASE OUTBREAK PREVENTION AND RESPONSE *

Effective Date: 
Thu, 03/01/2012
Reviewed: 
Fri, 05/04/2018
Revised: 
Mon, 02/02/2015
Policy: 

Outbreaks of communicable diseases occur on college campuses with some frequency.  This policy outlines the roles and responsibilities of the Student Health Center in managing such outbreaks.   The Student Health Center works under the direction and in collaboration with the local and state Health Department on management of communicable diseases.   Management includes both early identification of outbreaks and the tasks required to control, contain and prevent further spread of disease.   Activities include management of sick students, identification of at-risk contacts, and post-exposure prophylaxis.  Frequently it is necessary to involve other campus entities in managing an appropriate response, for example, dining, housing, and Environmental Health and Safety (EH&S).  Campus administration must be kept informed of such situations.  Parents and the public may need information.  This policy addresses the Student Health Center’s response to communicable disease outbreaks.

Procedure: 

Identification of an Outbreak

An outbreak or suspected outbreak may be identified by clinicians, by the lab, or even by another campus entity such as housing or dining.  Suspicion of an an outbreak should be reported to the Medical Director and, if required, to the Health Department.   In the case of a suspected outbreak, diagnostic reports can be run to identify any increase in baseline levels of such conditions as gastroenteritis or influenza-like-illnesses.  Lab staff immediately notify the ordering provider and/or the Medical Director of positive lab results indicating a communicable disease. 

Some situations require collection of information to identify and track an outbreak.  Two Health Department forms are attached for collecting information.  One is a form to use in identifying impacted people and recording their symptoms.  The second form is for use in taking a Food History.   The County Health Department determines who needs to be interviewed and what information needs to be gathered.  The Health Department,  Student Health Center, Campus Life and EH&S work together to clarify who is responsible for collecting this information.

Reporting

The clinician who makes the diagnosis of a communicable disease is responsible for completing and submitting a CMR for the Health Department for all communicable diseases.  The CMR is located in Web References in PNC.  Included on the CMR are the guidelines for reporting:  some conditions require a phone report, others can be faxed in.  Some require immediate action, others do not.  The provider is responsible for reading and responding to the instructions for reporting as given on the CMR.    A copy of a CMR is scanned in to the electronic medical record. 

Responding

The Health Department determines what actions are necessary to prevent and control transmission of a communicable disease.  This includes determining the definition of who is an at-risk contact and what type of post-exposure prophylaxis is appropriate.  When the disease has potential community-wide impact,  the Health Department will generate an Exposure Notice.  This notice is for distribution to the impacted community.  It explains the situation, the recommendations for response and basic information about the disease.  The Health Department, Student Health Services, Campus Life and EH&S determine who should receive the Exposure Notice.   Typically, the Student Health Center will provide additional handouts, letters or weblinks with more information about the disease to go out with the official Exposure Notice.    

The Student Health Center identifies a specific person to act as the Communicable Disease Coordinator for any given outbreak.  This representative (Medical Director, Patient Care Coordinator or designee) works with the Health Department and on-campus collaborators to define who is responsible for notification of at-risk contacts and for provision of post-exposure prophylaxis. 

The job of the SHS coordinator for a communicable disease outbreak includes:

  1. Developing fact sheets to educate and inform students, staff and faculty about the situation in clear language.
  2. Identifying and contacting students who are at risk and require post-exposure prophylaxis.
  3. Arranging post-exposure prophylaxis including obtaining necessary materials and adjusting clinical schedules to accommodate providing prophylaxis.
  4. Documenting the event, the response and the learnings.
  5. Communicating with other campus entities as necessary to coordinate prevention activities and to keep campus officials informed.

The SHS coordinator contacts the Environmental Health and Safety officer to set up a conference call within 24 hours.  As indicated, this call may include representatives from Dining, Housing, Environmental Health and Safety, the Student Health Center, and other relevant campus offices.  Recommendations from the Health Department are reviewed and any necessary campus-level actions are determined and coordinated by this team.  Such activities might include changes to standard practices in the dining halls or cancellation of high-risk community events.  This team can also facilitate generation of the necessary lists of people at risk who require prophylaxis

The SHS coordinator works with pharmacy, lab and nursing to gather an adequate supply of any vaccinations, lab testing materials, or medications necessary for post exposure prophylaxis.

The SHS coordinator creates a written plan for the specific situation which includes the definition of an at-risk person, the recommended post-exposure prophylaxis, and any instructions around quarantine or isolation of students.   This plan should also include information to be used to answer questions about the situation from students, staff, faculty and parents.  All SHS staff should be made aware of the situation and be given adequate information to give informed answers to community questions.

All questions or requests to speak to media should be forwarded to the Medical Director or the Executive Director.

The SHS coordinator prepares a brief announcement to be placed on the SHS website providing basic information and contact information for people wishing to speak to someone about the situation.

The Executive Director is responsible for notifying the Dean of Students about communicable disease outbreaks and the SHS response.

The Executive Director works in conjunction with the Dean of Students to determine the ways in which this event is communicated to the media or the campus at large.  (See Communications Policy and Responding to Media Inquiries Policy)