Online Program

Pertussis outbreak in a rural county: Issues, interventions and outcomes

Wednesday, November 6, 2013 : 9:30 a.m. - 9:50 a.m.

Laura L. McDermott, Ph.D, FNP, RN, Tioga County Health Department, Owego, NY
In 2012, upstate New York (NY) experienced a pertussis epidemic of over 2000 reported cases. The increase of pertussis cases strained local health departments (LHDs), especially rural counties, which have minimal staffing resources to thoroughly investigate and stop the spread of the disease. As a result, one rural county implemented changes to: increase knowledge and awareness to the general public; increase early identification, detection, and treatment/prophylaxis; and decrease the incidence and extent of the disease. Problems identified by one LHD included: knowledge deficit by medical providers in pertussis outbreak control guidelines and non-reporting of suspect cases to LHD, decreased public access to care due to limited or no health insurance coverage, public resistance to care because of personal belief systems, and decreased communication between contiguous counties and neighboring state. Multiple interventions implemented consisted of: development of an epidemic plan with community leaders and medical providers, education of the larger community, and the use of midlevel providers to conduct assessments. Lessons learned comprise: effective collaboration among employees and community partners who promoted early access to care and pertussis case load reduction; public awareness campaigns, which built community support; and the use of midlevel providers such as Nurse Practitioners to conduct assessments, provide prophylaxis of high risk people. Future recommendations consist of: education and public awareness campaigns, vaccination clinics, in-services with local medical providers and community partners, collaboration with contiguous governmental units, and supplementation of midlevel providers at primary care offices.

Learning Areas:

Administer health education strategies, interventions and programs
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Protection of the public in relation to communicable diseases including prevention or control
Public health or related nursing

Learning Objectives:
Describe two interventions that can assist in early identification, detection, treatment/prophylaxis and investigation of pertussis cases. Discuss two ways to improve communication with community partners and the public in a rural community. Identify one method used to maximize limited available resources for increased effectiveness during pertussis investigations.

Keyword(s): Communicable Disease, Interventions

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have my Doctorate in Community Health Nursing, am a full time educator, and a part-time Nurse Practitioner at Tioga County Health Department. Furthermore, I was the primary investigator of all pertussis cases in Tioga County for the 2012 outbreak.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.