April - June 2009
As the threat of the novel H1N1 swine-origin influenza virus spread across the world, we at the North Carolina Center for Public Health Preparedness (NCCPHP) were keen to contribute to the public health response. Preparing for pandemic influenza has been a strong area of focus for the past 3 years and we plan to continue our efforts as the public health community gets ready for the potential impact of H1N1 on the upcoming influenza season.
In the initial days of the outbreak, we provided consultation to the UNC Gillings School of Global Public Health on appropriate response measures in our role as participants in the All-Hazards Preparedness Committee. We created a just-in-time training on swine influenza, and made available another 15 online trainings on influenza which were disseminated to 25,000 people. Our student volunteer group Team Epi-Aid was activated and assisted in the Public Health Command Center set up by the North Carolina Division of Public Health. We educated our co-workers, ourselves, and our families about H1N1 and how to protect ourselves against this virus.
While the novelty of H1N1 has subsided for now in the United States, the threat of a related influenza pandemic with potentially severe consequences has not lessened. We will continue our involvement with The School’s All-Hazards Committee, maintain our partnerships with the North Carolina Division of Public Health to provide technical support to the local health departments, strive to provide training opportunities to public health practitioners, keep our Team Epi-Aid students engaged, and continue our related curriculum development projects for organizations such as the US Centers for Disease Control and Prevention (CDC) and the Council of State and Territorial Epidemiologists.
---Pia MacDonald, NCCPHP Director
Surveillance & Epidemiology
Team Epi-Aid (SPH student volunteers to assist urgent public health response)
Team Epi-Aid student volunteers spent a week in the Public Health Command Center at the North Carolina Division of Public Health in Raleigh assisting with the initial response to the H1N1 swine-origin influenza virus outbreak. Six students made phone calls responding to questions from local health departments and clinicians in North Carolina.
Technical Assistance to North Carolina
North Carolina Electronic Disease Surveillance System (NC EDSS)
This quarter, 7 trainings were held for 54 attendees from local health departments across the state on the North Carolina Electronic Disease Surveillance System (NC EDSS). NCCPHP staff also continued to provide support through topic-specific webinars. Eight webinars were offered for approximately 250 participants from more than 59 local health departments. NCCPHP staff also continue to develop modules for an online training course about NC EDSS. The first module, focusing on use of the system for tuberculosis, will be pilot-tested in July.
Epi Info™
We have also held several Epi Info™ trainings around the state this quarter. Seven participants attended a training in Randolph County in April, 6 participants attended a training in Forsyth County in May, and 3 participants attended a training in Cumberland County in June.
Emergency Planning for At-Risk Groups: A Toolkit for Local Health Departments
The toolkit of resources on planning for at-risk populations for local health departments in North Carolina is nearing completion. The toolkit follows the structure of a planning guide produced by the Association of State and Territorial Health Officials, and includes practical tips, topic spotlights, resources, and interviews with key figures from successful projects in the state. This quarter, work centered on editing the toolkit and developing the Web site. In addition, the toolkit and the at-risk planning activities of one North Carolina county were presented at the World Conference on Disaster Management in Toronto in June.
Research
North Carolina Preparedness and Emergency Response Research Center (NCPERRC)
The North Carolina Preparedness and Emergency Response Research Center (NCPERRC) hosted a Synergy & Translation Committee meeting in Chapel Hill in May. State partners facilitated group discussions and each of the 4 project research teams presented recent progress on their work.
NCPERRC has also announced the winners of 4 pilot project mini-grants and a new investigator award to researchers from UNC Chapel Hill and other institutions. More information on the specific projects and investigators is available on the NCPERRC Web Site.
Training & Education
Training Web Site
Nine new trainings, primarily on influenza, were added to the NCCPHP Training Web Site this quarter, bringing the number of trainings to 173. There were 2,068 new users in this quarter, bringing the total number of users to 33,809. And finally, there were 5,922 new course completions, with 67,643 total course completions from 149 countries.
FOCUS on Field Epidemiology
One issue of FOCUS on Field Epidemiology is newly available in Spanish: Volume 4, Issue 6: Rastreo por Contacto (Contact Tracing).
All issues are available on the FOCUS Web site.
Field Epidemiology Training Program for Central America
NCCPHP is in the third year of a 4-year cooperative agreement with the Universidad del Valle de Guatemala, CDC’s Regional Office for Central America and Panama, and the Division of Epidemiology and Surveillance Capacity Development in the CDC Coordinating Office for Global Health to develop a master’s level curriculum in field epidemiology for national and regional public health professionals in Guatemala and Central America as part of the Central America Field Epidemiology Training Program. Principal goals include building institutional capacity within each country for epidemiologic assessment, investigation, and surveillance, as well as fostering a scientific, data-based approach for implementing effective public health programs and policies.
This masters-level curriculum serves as the top tier for a 3-tiered pyramidal training approach. There is also an intermediate level with a district/regional focus and a basic level curriculum, both of which are under development. NCCPHP has assisted with curriculum design and development for all levels of the curriculum. Curriculum materials include modular learning materials consisting of face-to-face lectures (slides and scripts), in-class activities and homework assignments, small group exercises and discussion groups, quiz and test questions, distance-based learning exercises to be completed in the field, and a detailed trainer’s guide and schedule.
In April, NCCPHP staff traveled to Guatemala to observe Module 1 of the Intermediate level training. Back at home, development continues on additional modules for the Basic and Intermediate levels, as well as the accompanying distance-based Tutor’s curriculum.
CDC Sustainable Management Development Project
This quarter, NCCPHP and partners at the CDC completed work on a “Distance Based Readiness Assessment” for alumni of the CDC’s Management for International Public Health Program. The survey was sent to approximately 230 alumni, and 83 persons completed the survey. Early results indicate that most participants have the technological capability to participate in distance-based learning opportunities and are interested in doing so.
Avian Influenza Online Training Course
The emergence of the novel swine-origin H1N1 influenza virus slightly disrupted work on the Seasonal, Avian, and Pandemic Influenza Training Course with our CDC partners. Nonetheless, NCCPHP staff have now completed all work on the 11-module interactive training course in conjunction with CDC partners. Once the final remaining modules complete the CDC clearance process, the final product will be piloted again internationally. The details of that pilot are still being determined. This course will be used by CDC international staff who might be called upon to assist in a pandemic.
Assessment of Reproductive Health Needs After Disasters
This quarter, we worked with students at UNC-Chapel Hill to adapt the reproductive health needs assessment survey created by NCCPHP and partners at the CDC for use in a new setting. The adapted survey was then deployed in Nicaragua through a summer program with the Universidad Nacional Autónoma de Nicaragua.
Incident Command System Training Video
In partnership with Public Health Regional Surveillance Team (PHRST) 6, NCCPHP is developing an Incident Command System (ICS) training video to assist local health departments with implementing ICS for routine activities such as outbreak investigation. This activity is being carried out as a CPHP state partner activity. In May and June, NCCPHP staff traveled to western North Carolina to conduct videotaped interviews with the health directors for Swain and Jackson counties, the director of the Health and Medical Division of the Eastern Band of Cherokee Indians and the team leader for PHRST 6. Interviews focused on the use of ICS to manage an outbreak of Shigella in the region in 2007. The video footage will be used to accompany didactic materials. The ICS training video will be available this fall.
Workforce Development
We also continue to provide assistance on the use of the Public Health Workforce Development System, utilized to assess North Carolina local and state public health professionals’ training needs. This quarter, we provided support to users in Moore, Cleveland, Rockingham, Johnston, Davidson, Jackson, Chatham, and Wayne counties.