Model Tuberculosis Outbreak Response Plan Template for Low-Incidence Areas

The Model Tuberculosis (TB) Outbreak Response Plan (ORP) is a customizable template to help ensure comprehensive and timely response to a TB outbreak.

The ORP includes the following sections: purpose, indications for initiating the response plan, legal authority, composition of the response team, notification procedures, local and state public health responsibilities, data management, communication, training and education, community partnerships, evaluation, de-activation, and glossary. Guidelines for contact investigations are provided in the TB Manual, another project of Task Order #6.

The following describes an assessment of the ORP conducted in Boise, Idaho (2006).

Assessment of a Model Tuberculosis Outbreak Response Plan for Low-Incidence Areas

Laura Freimanis, Karen Steingart, Christine Hahn, Kathy Cohen, Lisa Pascopella, Charles Nolan

BACKGROUND: Timely identification and response to tuberculosis outbreaks has become increasingly challenging as TB declines in the United States. An assessment (2003) in Idaho, Montana, Utah, and Wyoming* determined that written plans for responding to TB outbreaks were limited. A customizable outbreak response plan (ORP) was created with input from the four states and Centers for Disease Control and Prevention. A TB outbreak (Boise) presented an opportunity to assess the utility of the ORP.

METHODS: Key informants (KIs) were interviewed (April 2006) using semi-structured questionnaires after pilot testing. Interview themes were used to assess validity of the ORP and identify areas for improvement and training. Selected KIs provided structured feedback on ORP sections (eg, outbreak definition, initiating the response plan, legal authority, local and state responsibilities, education and training, and internal and external communication).

RESULTS: We interviewed 17 KIs (state [4]; district [6]; community [6]; CDC [1]) who knew of or were involved in the outbreak. State and local TB programs had implemented most recommended activities (eg, case management, contact investigation) without a written ORP. However, all respondents felt the ORP would improve coordination among participants in outbreak response. Respondents considered ORP sections on outbreak definition and communication as most helpful; evaluation, as needing improvement; and genotyping and legal issues, as training opportunities. We revised the ORP based on these recommendations.

CONCLUSION: In low-incidence areas, an ORP that addresses essential activities can be a useful management tool for coordinating response to TB outbreaks, planning for additional resources, and prioritizing training.

* Task Order #6 "Regional Capacity-Building in Low-Incidence Areas," Tuberculosis Epidemiological Studies Consortium, CDC

For information, please contact:
Karen R. Steingart, MD, MPH

Date of Release: August 2006