1. Exposure Rostering: Population Tracking Following a Disaster Melissa E. Powell, MPH Michelle F. Barber, MS Preparedness, Surveillance & Epidemiology PUBLIC HEALTH DIVISION Office of Disease Prevention & Epidemiology

2. The Public Health Approach to Disaster Response Population-based information is critical to public health action –Rapidly assess the needs of affected populations –Conduct studies and surveys (e.g., injury rates) –Conduct surveillance and investigate outbreaks –Implement, monitor and evaluate public health programs and disease/injury control efforts Data collection/analysis are linked to decision-making processes Evaluation can improve future planning efforts

3. PUBLIC HEALTH DIVISION Office of Disease Prevention & Epidemiology Post-Disaster Surveillance When, how, and why to surveil? Who should be included? Recruitment? Which data are important? Who will gather the data? Who will maintain data? When to switch to a registry? Who will do long-term follow-up? 3

4. PUBLIC HEALTH DIVISION Office of Disease Prevention & Epidemiology Public Health Emergency Preparedness in Oregon Public Health Emergency Preparedness Program (PHEP) –Improved state and local capacity to respond to health emergencies –Anticipate, detect, assess, and understand health risks –Develop and test plans –Train and collaborate between communities 4 Preparedness, Surveillance and Epidemiology Team (PSET) –Collaborate with PHEP, Communicable Disease and Environmental Health –Practice routine epidemiology –Maintain systems to provide timely and accurate information to decision makers –Train, consult and provide tools

5. PUBLIC HEALTH DIVISION Office of Disease Prevention & Epidemiology Chemical Stockpile Emergency Preparedness Program (CSEPP) Annual exercise for accidental release of chemical warfare agents –2008: Post-Disaster Surveillance Registry tools (modified ATSDR Rapid Registry, Post- Disaster Registry System) –2010: The Exposure Rostering and Laboratory Sampling Plan

6. PUBLIC HEALTH DIVISION Office of Disease Prevention & Epidemiology Background Assumptions A hazardous material event may occur HazMat teams are in place to provide support Responders are trained to decontaminate Local hospitals/providers have limited resources Local Public Health Departments (LPHD) maintains a vulnerable populations self-registry of persons within 15 mile radius 6

7. PUBLIC HEALTH DIVISION Office of Disease Prevention & Epidemiology Exposure Roster Plan 7

8. PUBLIC HEALTH DIVISION Office of Disease Prevention & Epidemiology Roster vs. Registry Quickly gather info about many individuals Early assessment tool Identify health problems Can populate future registries 8 Limited utility in the immediate aftermath Long-term follow-up of affected populations Study health problems

9. PUBLIC HEALTH DIVISION Office of Disease Prevention & Epidemiology Roles and Responsibilities – Planning LPHD/Tribes –Identify personnel for Exposure Roster Task Force –Create job-action sheets and maintain “go-kits” –Exercise/train staff State –Consult on plan development –Draft and exercise tools (i.e., forms, database) Feds (CDC/ATSDR/NIOSH) –Consult on plan development Partners (Red Cross, Private Sector) –Consult on plan development 9

10. PUBLIC HEALTH DIVISION Office of Disease Prevention & Epidemiology Roles and Responsibilities – Response LPHD/Tribes –Activate mutual aid agreement with state to implement plan –Organize Exposure Roster Task Force –Activate data and specimen collection sites State –Provide guidance on collecting exposure data and specimens –Provide tools for data collection; assist when appropriate –Conduct outreach to self-evacuees –Provide guidance on data management Feds –Provide guidance on specimen collection Partners –Cooperate/Facilitate rostering at shelter sites 10

11. PUBLIC HEALTH DIVISION Office of Disease Prevention & Epidemiology Exposure Roster Task Force 11

12. PUBLIC HEALTH DIVISION Office of Disease Prevention & Epidemiology Who is Rostered? First responders Decontaminated persons Evacuees at Assistance Centers Symptomatic hospitalized locally Those who sought treatment from their health care provider Those exposed at the site (or through secondary exposure) and do not seek medical care 12

13. PUBLIC HEALTH DIVISION Office of Disease Prevention & Epidemiology Roles and Responsibilities – Recovery LPHD/Tribes –Assist state/federal partners with tracking rostered persons if determined that registry is warranted State/Feds –Determine need for registry –Collaborate to compile a registry that links exposure roster and long- term data with clinical lab results 13

14. PUBLIC HEALTH DIVISION Office of Disease Prevention & Epidemiology Conclusions The Exposure Roster and Laboatory Sampling Plan has been included in State All Hazard Response Plan Next Steps –CSEPP National Annual Conference in PDX in June –Exercise the Exposure Rostering Plan at frequent intervals –Pilot Exposure Rostering Form –Identify effective means to notify local jurisdictions about rostering –Develop means to track affected individuals in transit –Refine public information messages 14

15. Questions? Melissa.E.Powell@state.or.us 971-673-1111