What is Emergency Preparedness and Response?

Jefferson County Public Health’s (JCPH) Emergency Preparedness and Response Program works year-round to help prepare the county for any public health threats, from a biological Anthrax attack, to a foodborne outbreak of E. Coli, to a global pandemic. JCPH’s epidemiologists, emergency response planners and health communications team work together to ensure we are prepared and ready to respond.

Disease Detectives

Commonly known as disease detectives, infectious disease epidemiologists investigate infectious disease outbreaks in the community. By investigating outbreaks, epidemiologists can contain the spread of the disease in the population and help prevent a similar outbreak from happening in the future. JCPH’s epidemiologists investigate approximately 25 to 30 outbreaks from Norovirus to E. Coli., and respond to over 150 disease complaints each year.

Every disease outbreak is unique, however most investigations follow the same process. JCPH works in coordination with health and medical systems across the county and throughout Colorado. Working together they use robust surveillance systems to quickly identify potential outbreaks. Diseases that are particularly concerning are classified as reportable conditions. This means that anytime someone is diagnosed with one of these diseases, it must be reported to the local health department. This helps health departments quickly identify potential outbreaks so they can be rapidly contained.

If there is an outbreak, the epidemiologist will start an investigation. The epidemiologist will interview the index case to determine what he or she has been doing, or where they have been and who they’ve come into contact with. This helps to determine how the person may have become infected, and who else they may have infected while they were contagious. This is called contact tracing. The epidemiologist will use the information they gather during contact tracing to develop a scientific hypothesis or explanation about the source of the outbreak. They will research their hypothesis and use their findings to help the health department determine how they will control the outbreak.

Public Health Emergency Response Planners

Public health emergency response planners plan for the worst public health disaster that they can possibly imagine. From a biological anthrax attack to a fictional zombie apocalypse, public health planners work to ensure that the community is prepared for any type of public health disaster. Planners start their work by analyzing the threats to the community so that they know what the most likely potential threats are. They work alongside Emergency Management, Fire Departments, EMS, Law Enforcement Agencies, and Healthcare Agencies to find effective and efficient ways to prepare the community.

Public health planners focus on public health threats and provide expertise about the public health impact of any disaster, such as smoke inhalation during a wildfire. They write plans, train professionals and the public, and conduct drills and exercises to test their plans and their trainings. At the end of the day, emergency response planners create a more prepared community.

We are Not Our of the Woods Yet . . . Novel Influenza A (H1N1)

We are Not Out of the Woods Yet . . . Novel Influenza A (H1N1)

The novel influenza A (H1N1) virus took center stage in April of this year and within weeks had infected people in the United States and across the globe. Public Health officials around the world sounded the alarm, our media, government, and community partners responded accordingly and the general public had the opportunity to watch from their living rooms and computer screens a new and potentially deadly influenza virus emerge onto the world stage.

Fortunately, the severity of illness caused by H1N1 has been fairly mild and most are able to recover at home without complications, yet for some the illness has proved deadly and no one really knows how severe this virus really is. As community spread has occurred, the Centers for Disease Control and Prevention and its State counterparts are focused on tracking more severe illness and case counts reflect only those hospitalized with confirmed illness in their Novel H1N1 Flu Situation Updates. Thus official case counts greatly underestimate actual spread through the community and the exact number of infected persons will never be known. What is known is that the virus is here, and public health professionals nationwide expect that illnesses and deaths may continue for some time. Since you, or people around you, may become ill with influenza it is important to know how to recognize the symptoms and take appropriate actions.
The symptoms of H1N1 flu virus are similar to the symptoms of seasonal flu and include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some of those infected have also reported diarrhea and vomiting. If you get sick, stay home and take measures to prevent spreading illness to others. Be sure to contact a physician if symptoms do not resolve or if you have other chronic health conditions or if you are pregnant.
Jefferson County Public Health continues to be actively involved in responding to H1N1 influenza A. At this time, our response goals are to reduce the spread and severity of illness, and to provide information to help health care providers, government officials and the public address the challenges posed by this new public health threat. We are working with schools, community partners, hospitals, municipalities, volunteers and others to be sure Jefferson County is ready for the influenza season this fall and the potential for a reemergence of this novel virus. During the past weeks these activities have included frequent outreach with health care providers and dissemination of information to higher risk settings for spread, including nursing homes, hospitals, correctional facilities, child care centers and schools. Because the majority of mild illness is not detected by our current disease surveillance systems, we are working with our school district to track absenteeism-- related to fever and respiratory symptoms--at every school. This system will greatly help us to track the probable return of this and related flu strains in the fall.

It is important that we not let our guard down and pay close attention to messages about preventing the spread of disease in our communities,” says Dr. Gayle Miller, Jefferson County Public Health Senior Epidemiologist. Officials monitoring the H1N1 influenza are looking closely south of the equator where flu season is just beginning. How H1N1 spreads there, whether it exchanges genetic material with another virus could give us a good idea of what might happen next fall here in the United States. “We know from past pandemics that there is a possibility that this strain of H1N1, which happened to have emerged in the Spring at the tail end of seasonal influenza season, could come back with a vengeance in the Fall. We need to be prepared for that.” (Learn more information on the history of flu pandemics.)
Public health and its disease detectives are keeping a close eye on the novel H1N1 influenza A virus and will inform the public of necessary updates as they unfold. The public also has an important role in disease control, we urge you to do you part and pay close attention to preventing the spread of disease in our communities.
Protect Yourself, Your Family, and Community

• Stay informed. Health officials will provide additional information as it becomes available. Visit the CDC H1N1 Flu website. Colorado HelpLine at 1-877-462-2911
• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
• Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
• Avoid touching your eyes, nose or mouth. Germs spread this way.
• Try to avoid close contact with sick people.
• If you are sick with a flu-like illness, stay home for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer. Keep away from other household members as much as possible. This is to keep you from infecting others and spreading the virus further.
• Learn more about how to take care of someone who is ill in "Taking Care of a Sick Person in Your Home"
• Follow public health advice regarding school closures, avoiding crowds, and other social distancing measures.
• If you don’t have one yet, consider developing a family emergency plan as a precaution. This should include storing a supply of extra food, medicines, and other essential supplies. Further information can be found in the "Flu Planning Checklist "

For more information on Novel Influenza A (H1N1) and its warning signs, visit our website at www.jeffco.us/health.

Getting to Know a Public Health Nurse

By this time, I’m sure most of you have heard about the Salmonella outbreak related to products containing certain types of peanut butter. It still amazes me that epidemiologists are able to narrow down a source for a national outbreak affecting hundreds of people. One of the exciting parts of my job is that, often, I get to be involved in these investigations. With this outbreak, I had the chance to interview someone who had become sick with this particular type of Salmonella.
Certain illnesses are required to be reported to the state health department, and every day our team is notified of Jefferson County residents who have tested positive for a reportable condition. Salmonella is a “reportable” illnesses, and after receiving the original report, I started our standard investigation for Salmonella infection. After the first interview, I heard from the state health department that this individual “matched” an outbreak being tracked nationally. From there, we did more and more focused interviews. Initially, this individual thought the illness came from eating some undercooked chicken or cleaning out the cage of a pet snake. (Both legitimate ways of getting a Salmonella infection.) After further interviews, we discovered that peanut butter sandwich crackers were eaten 6 to 7 times each week, prior to the illness.
Though we regularly deal with diagnosed illnesses, at times we receive reports of illnesses in the community that have not yet been identified. School nurses may call to report a rash illness in their schools, or a nursing home may call for guidance with an outbreak of a diarrhea in their residents. This can start with a call to one of the communicable disease control nurses, and depending on the situation, different people within the county health department may become involved. For example, a person who calls with a complaint of getting sick after eating at a restaurant may need to speak with an Environmental Health Specialist. Other situations require intervention by our epidemiologists. Each person plays different roles at different times, but the overall goal is the same- to protect Jefferson County citizens from infectious diseases.