Pandemic Influenza Plan - Questar III

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Section 8: Travel-Related Disease Control and Community Prevention Case isolation will be valuable during all phases of pandemic influenza. Isolation of cases when the novel virus first emerges can slow the initial spread of the pandemic. During later pandemic phases, isolation will reduce the risk of exposing uninfected persons. Quarantine of contacts can be justified for a limited range of situations. Quarantine is appropriate: • In the area where the novel virus first emerges; • When the novel virus first arrives in a new area; • When the number of cases is limited and when all local cases are either imported or have clear epidemiologic links to other cases; • Intervention is likely to either significantly slow the spread of infection or to decrease the overall magnitude of an outbreak in the community. Detailed guidance for the identification and management of contacts, including quarantine, appears in Appendix 8-B, along with a contact record form (Appendix 8-C) and daily log of temperature and symptoms (Appendix 8-D). A tracking form for following up with contacts is provided in Appendix 8-E. Quarantine should be coupled with monitoring of exposed persons for symptoms and provision of medical care and infection control precautions as soon as symptoms are detected (see Sections 6 and 7). Enforcement of isolation and quarantine orders may require assistance from law enforcement and the courts. B. Community Prevention Containment strategies aimed at controlling and slowing the spread of a novel virus include measures that affect: • Individuals or groups of exposed persons (e.g., isolation of patients and quarantining of their contacts), and • Entire communities (e.g., cancellation of public gatherings; implementation of community-wide snow days). Guided by epidemiologic data, state and local authorities will implement the most appropriate measures to maximize impact on disease transmission and minimize impact on individual freedom of movement. 1. Isolation and quarantine of infected/ill persons or groups of exposed persons These measures include: • Case isolation at home or in a special isolation facility; • Quarantine of groups of exposed persons, including: o Persons exposed to an influenza case via family members, at a public gathering, on an airplane or cruise ship or other closed conveyance, at their school or workplace, or o Healthcare providers who work at a facility where influenza cases receive care. February 7, 2006 8-4
Section 8: Travel-Related Disease Control and Community Prevention The purpose of isolation and quarantine is to reduce influenza transmission by separating infected persons from uninfected persons, exposed persons from non-exposed persons, and monitoring exposed persons for symptoms and providing medical care and infection control precautions as soon as symptoms are detected. Case isolation and quarantine and monitoring of exposed persons may be accomplished by various arrangements (e.g., home isolation or quarantine, isolation or quarantine in a designated facility, etc.). Case isolation will be valuable during all phases of pandemic influenza. Guidance for the care of an ill person who does not require hospitalization and is isolated at home, including infection control, can be found in Section 4: Infection Control, and Section 5: Clinical Guidelines. Isolation conducted in healthcare settings is discussed in these same sections. Home-based and alternate facility-based isolation and quarantine is discussed below. The home is generally the preferred setting for isolation and quarantine, but alternative sites for isolation and quarantine may be necessary in certain situations. For example, persons who do not have a home suitable for this purpose or those who require isolation or quarantine away from home (e.g., during travel or homeless) will need to be housed in an alternative location. Special isolation facilities and staffing should be identified in advance and be available to operate beginning in the late pandemic alert period and throughout the pandemic phase. Quarantine facilities and staffing should be identified in advance and will be needed during the late pandemic alert period and early in the pandemic phase. A home/facility checklist to assess the suitability of a home or facility for isolation and quarantine is in Appendix 8-A. Necessary support services for the home and for isolation and quarantine facilities are described below in Part C – Community Support. Monitoring of cases isolated at home or in a special facility and monitoring of contacts quarantined at home or in a special facility will be needed during the late pandemic alert period and early in the pandemic phase. When the pandemic becomes widespread, public health monitoring of cases and quarantined persons will no longer be justified. NYSDOH, in consultation with federal health authorities, will advise LHDs regarding when individual case management of persons in isolation and quarantine is warranted. Detailed guidance for the identification and management of contacts, including quarantine, appears in Appendix 8-B, along with a contact record form (Appendix 8-C) and daily log of temperature and symptoms (Appendix 8-D). A tracking form for following up with contacts is provided in Appendix 8-E. Quarantine should be coupled with monitoring of exposed persons for symptoms and provision of medical care and infection control precautions as soon as symptoms are detected. <strong>Plan</strong>s should be developed for instances requiring the enforcement of isolation and quarantine measures. Contacts of influenza patients can be managed by various interventions designed to facilitate early recognition of illness in persons at greatest risk of becoming infected and thereby prevent transmission to others. Measures applied to individuals may not be feasible or effective during the <strong>Pandemic</strong> Period, when tracing and quarantining of close February 7, 2006 8-5
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February206 Pandemic Plan NewYorkSt
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Introduction Pandemic influenza occ
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example, at this time, it is realis
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Acronyms (cont.) IND IHANS IRB ISHS
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Section 1: Command and Control I. O
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Section 1: Command and Control pers
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February 7, 2006 Appendix 1-A
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Appendix 1-B The Public Health Law
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Appendix 1-B communicable diseases
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Appendix 1-C Management Office or t
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Appendix 1-E Suspension of Public M
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Appendix 1-G A Guide to New York St
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Appendix 1-G health commissioner. P
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Appendix 1-G 8. State Institutions
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Appendix 1-G b. Governor May Invoke
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Appendix 1-G may direct, pursuant t
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Appendix 1-G c. Commissioner of Gen
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Appendix 1-G Designation of emergen
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Appendix 1-G physician’s assistan
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Appendix 1-H Summary of Public Offi
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Section 2: Surveillance and Laborat
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Appendix 2-A • Surveillance Crite
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Appendix 2-A • In New York City,
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NYSDOH Novel Influenza Case Report
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Appendix 2-C to health care provide
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Virus Detection History NYS Lab Num
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Section 3: Healthcare Planning and
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Section 4: Infection Control I. Ove
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Section 4: Infection Control I. Ove
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Section 4: Infection Control A. Bas
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Section 4: Infection Control Drople
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Section 4: Infection Control • Pe
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Section 4: Infection Control o Noti
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Section 4: Infection Control E. Coh
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Section 4: Infection Control If wid
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Section 4: Infection Control • En
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Section 4: Infection Control should
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Section 4: Infection Control Policy
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Section 4: Infection Control o Staf
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Section 4: Infection Control • De
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Section 4: Infection Control • Pr
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Section 4: Infection Control The ma
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Section 4: Infection Control • Up
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Section 4: Infection Control Health
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Appendix 4-A Soiled linen and laund
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Appendix 4-B Respiratory Hygiene/Co
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Section 5: Clinical Guidelines I. O
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Section 5: Clinical Guidelines incu
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Section 5: Clinical Guidelines 1) N
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Section 5: Clinical Guidelines infe
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Section 5: Clinical Guidelines Alth
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Section 5: Clinical Guidelines Infe
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Section 5: Clinical Guidelines •
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Appendix 5-B Clinical Evaluation of
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Appendix 5-C Special Situations and
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Appendix 5-D handling soiled laundr
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DRAFT Appendix 5-E Footnotes to App
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Appendix 5-F February 7, 2006 1
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Appendix 5-F 7. Guidance on the eva
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Appendix 5-H Source: U.S. Departmen
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February 7, 2006 2 Appendix 5-I
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Appendix 5-J Clinical Presentation
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Appendix 5-J diabetes mellitus), re
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Appendix 5-J resistant S. aureus (M
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Appendix 5-K eight patients—all o
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Appendix 5-L Guidelines for Managem
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Appendix 5-L testing should be perf
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Appendix 5-L February 7, 2006 5
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Appendix 9-A Public Health Risk Com
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Appendix 9-C New York State Departm
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Appendix 9-C PRE-EVENT MESSAGE MAP:
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Appendix 9-C PROTECTIVE MESSAGE MAP
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Appendix 9-C TREATMENT MESSAGE MAP:
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Appendix 9-C BUSINESS CONTINUITY PR
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Section 10: Training and Education
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Appendix 10-A NYSDOH STAFF PRIVATE
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FACILITY- BASED RNs FACILITY- BASED
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Section 11: Workforce Support I. Ov
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Section 11: Workforce Support Pande
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Section 12: Highly Pathogenic H5N1
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Section 12: H5N1 in Non-Human Anima
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Section 13: Public Health Preparedn
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Appendix 13-A NYSDOH Roles Notified
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Appendix 13-B Notifications sent by
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Appendix 13-B HAN posting is used a
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Appendix 13-B notification system t
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Appendix 13-C Overview of the Healt
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Appendix 13-C • Ongoing surveilla
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Table 1. Summary of HERDS Use To da
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Appendix 13-D Commerce Access and A
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Appendix 13-D Table 3. Organization
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