Public health incident management: Logistical and operational aspects of the 2009 initial outbreak of H1N1 influenza in Mexico

Miguel A. Cruz, PhD; Nicole M. Hawk, MPA; Christopher Poulet, MS; Jose Rovira, MS; Edward N. Rouse, MPA

doi:10.5055/jem.2015.0219

Authors

Miguel A. Cruz, PhD
Nicole M. Hawk, MPA
Christopher Poulet, MS
Jose Rovira, MS
Edward N. Rouse, MPA

DOI:

https://doi.org/10.5055/jem.2015.0219

Keywords:

emergency management, outbreaks, incident command system, international agencies, public health

Abstract

Hosting an international outbreak response team can pose a challenge to jurisdictions not familiar with incident management frameworks. Basic principles of team forming, organizing, and executing mission critical activities require simple and flexible communication that can be easily understood by the host country's public health leadership and international support agencies. Familiarity with incident command system principles before a public health emergency could save time and effort during the initial phases of the response and aid in operationalizing and sustaining complex field activities throughout the response. The 2009 initial outbreak of H1N1 in Mexico highlighted the importance of adequately organizing and managing limited resources and expertise using incident management principles. This case study describes logistical and operational aspects of the response and highlights challenges faced during this response that may be relevant to the organization of public health responses and incidents requiring international assistance and cooperation.

Author Biographies

Miguel A. Cruz, PhD

Office of Environmental Health Emergencies, US Centers for Disease Control and Prevention, Atlanta, Georgia.

Nicole M. Hawk, MPA

Office of Public Health Preparedness and Response, US Centers for Disease Control and Prevention, Atlanta, Georgia.

Christopher Poulet, MS

Division of Regional Operations, Agency for Toxic Substances and Disease Registry, Denver, Colorado.

Jose Rovira, MS

Emergency and Humanitarian Assistance, World Health Organization, Geneva, New York

Edward N. Rouse, MPA

Office of Public Health Preparedness and Response, US Centers for Disease Control and Prevention, Atlanta, Georgia.

References

Cruz-Vega F, Sun C, Brink B, et al: 5th Asia-Pacific Conference on Disaster Medicine. Theme 6: multidisciplinary team interaction: Summary and action plan. Prehosp Disaster Med. 2001; 16(1): 39-41.

World Health Organization: Guiding principles for international outbreak alert and response. Available at http://www.who.int/csr/outbreaknetwork/guidingprinciples/en/. Accessed July 20, 2010.

Pesik N, Keim M: Logistical considerations for emergency response resources. Pacific Health Dialog. 2002; 9: 97-103.

Department of Homeland Security: National Incident Management System. December 2008. Available at http://www.fema.gov/pdf/emergency/nims/NIMS_core.pdf. Accessed February 15, 2014.

Zane R, Prestipino AL: Implementing the hospital emergency incident system: An integrated delivery system's experience. Prehosp Disaster Med. 2004; 19(4): 311-317.

Kim-Ferley RJ, Celentano JT, Gunter C, et al: Standardized emergency management system and response to a smallpox emergency. Prehosp Disaster Med. 2003; 18(4): 313-320.

King RV, North CS, Larkin GL, et al: Attributes of effective disaster responders: Focus group discussions with key emergency response leaders. Disaster Med Public Health Prep. 2010; 4: 332-338.

Cruz MA, Keim ME, Schier JG, et al: Organizational and command aspects for coordinating the public health response to an outbreak of acute renal failure, Republic of Panama, 2006. Prehosp Disaster Med. 2011; 26: 219-225.

Papagiotas SS, Frank M, Bruce S, et al: From SARS to 2009 H1N1 influenza: The evolution of a public health incident management system at CDC. Public Health Rep. 2012; 127: 267-274.

Mignone AT, Davidson R: Public health response actions and the use of emergency operations centers. Prehosp Disaster Med. 2003; 18: 217-218.

CDC: Swine influenza A (H1N1) infection in two children—Southern California, April 2009. MMWR Morb Mortal Wkly Rep. 2009; 58: 400-402.

Global Alert and Response (GAR)—Influenza-like illness in the United States and Mexico. World Health Organization. Available at http://www.who.int/csr/don/2009_04_24/en/. Accessed May 25, 2009.

CDC: Outbreak of swine-origin influenza A (H1N1) virus infection—Mexico, March-April 2009. MMWR Morb Mortal Wkly Rep. 2009; 58: 467-470.

Cordova JA, Sarti E, Arzoz-Padres J, et al: The Influenza A (H1N1) epidemic in Mexico. Lessons learned. Health Res Policy Syst. 2009; 7: 1-7.

Stern AM, Markel H: What Mexico taught the world about pandemic influenza preparedness and community mitigation strategies. JAMA. 2009; 302: 1221-1222.

Aburto NJ, Pevzner E, Lopez-Ridaura R, et al: Knowledge and adoption of community mitigation efforts in Mexico during the 2009 H1N1 pandemic. Am J Prev Med. 2010; 39: 395-402.

Donahue AK, Tuohy RV: Lessons we don't learn: A study of the lessons of disasters, why we repeat them, and how we can learn them. Homeland Secur Aff. 2006; 2: 1-28.

Secretaria de Gobernación: Sistema Nacional de Protección Civil. Available at http://www.proteccioncivil.gob.mx/. Accessed September 26, 2013.

Burkle FM, Hsu EB, Loehr M, et al: Definition and functions of health unified command and emergency operations centers for large-scale bioevent disasters within the existing ICS. Disaster Med Public Health Prep. 2007; 1: 135-141.

Akselrod H, Mercon M, Kirkeby R, et al: Creating a process for incorporating epidemiological modeling into outbreak management decisions. J Bus Contin Emer Plan. 2012; 6: 68-83.

Powers R: Organization of a hospital-based victim decontamination plan using the incident command structure. Disaster Manag Response. 2007; 5: 119-123.

Elledge BL, Boatright DT, Woodson P, et al: Learning from Katrina: Environmental health observations from the SWCPHP response team in Houston. J Environ Health. 2007; 70: 22-26.

Freedman AM, Mindlin M, Morley C, et al: Addressing the gap between public health emergency planning and incident response. Disaster Health. 2013; 1: 13-20.

Guh A, Heyman ML, Barden D, et al: Lessons learned from the investigation of a cluster of cutaneous anthrax cases in Connecticut. J Public Health Manag Pract. 2010; 16: 201-210.

Adams EH, Scanlon E, Callahan JJ, et al: Utilization of an incident command system for a public health threat: West Nile virus in Nassau County, New York, 2008. J Public Health Manag Pract. 2010; 16: 309-315.

Enanoria WT, Crawley AW, Tseng W, et al: The epidemiology and surveillance response to pandemic influenza A (H1N1) among local health departments in the San Francisco Bay area. BMC Public Health. 2013; 13: 276.

Chamberlain AT, Seib K, Wells K, et al: Perspectives of immunization program managers on 2009-10 H1N1 vaccination in the United States: a national survey. Biosecur Bioterror. 2012; 10: 142-150.

Porter D, Hall M, Hartl B, et al: Local health department 2009 H1N1 influenza vaccination clinics-CDC staffing model comparison and other best practices. J Public Health Manag Pract. 2011; 17: 530-533.

Fishbane M, Kist A, Schieber RA: Use of the emergency incident command system for school-located mass influenza vaccination clinics. Pediatrics. 2012; 129(S): 101-106.

Ringel JS, Chandra A, Leuschner KJ, et al.: Lessons learned from the state and local response to hurricane Katrina. Working Paper. Rand. Gulf States Policy Institute and RAND Health, February 2007. Available at http://www.rand.org/content/dam/rand/pubs/working_papers/2007/RAND_WR473.pdf. Accessed December 20, 2013.