Influenza Outbreak: Reduce Disease Transmission in a Community
Information Obtained during a Project/Incident:
Bloom County, population 120,000, is a metropolitan county in Minnesota. The residents became the client of this case study when they experienced the first confirmed influenza case during the winter holiday season. Unfortunately, the person was employed as a clerk at a store located in a large regional shopping mall, continued to work while feeling ill during the busy holiday season, and exposed many people. The clerk died five days after becoming ill.
Residents began to panic. Although the health department quickly exhausted their supply of vaccine, the U.S. Centers for Disease Control and Prevention sent enough doses for all county residents the following week. The Bloom County Health Department then offered 24-hour/day immunization clinics. Many of the clinics were inundated with worried residents and security became a concern. In addition, there were numerous people including friends, family members, and co-workers of confirmed cases who experienced mild symptoms of fever and cough. It was not possible to know if they were experiencing the early stages of influenza and needed to be quarantined to protect others, or a milder illness.
The health department's health educators, public health nurses, and other staff conducted an aggressive media campaign with the help of the state health department and local pharmacists, physicians, health care facilities, stores, churches, and other community groups. In addition to providing information about disease prevention and treatment and how to obtain vaccine, the campaign included warnings about the limitations of the vaccine and the need to reduce contact with others. Many residents were unwilling to follow a voluntary quarantine especially because it was the holiday season; few events were cancelled or postponed and event attendance decreased minimally. Despite a public plea to schedule appointments with health care providers for specific symptoms, many residents continued to visit local emergency departments.
Health department staff conducted contact investigations for documented influenza cases and attempted to quarantine exposed family members. Staff members worked with the state health department to disseminate accurate and timely public information and quell the rising panic of the public. By the time the influenza outbreak ended, the county experienced more than 200 cases and 31 deaths.
Application of the Omaha System:
Problem: Communicable/infectious condition (high priority)