The South Dakota Department of Health has formulated the following plan in the event of an outbreak of tuberculosis.
1. Summary of the TB outreach response plan
The TB outbreak response plan is intended to provide for the evaluation and management of potential TB transmission in various settings (i.e. schools, employment settings, community site). The plan will ensure an adequate and timely statewide response for a TB outbreak or case cluster.
2. Definition of a TB outbreak
For the purpose of this plan, a TB outbreak is defined as the following: 1) when the current reported TB cases represent more than 25% above the expected baseline 5-year median OR 2) when a cluster of 2 or more TB cases can be epidemiologically linked (i.e. same school, family, employment site).
3. Reporting of a TB outbreak
The Office of Disease Prevention, Surveillance Manager will notify the TB Control Program Coordinator if the reported TB cases represent more than 25% above the expected baseline 5-year median. Disease Intervention Specialists staff (DIS) are responsible for immediately reporting a TB case cluster or outbreak to the TB Control Program Coordinator the same day it is known. The TB Control Program Coordinator is then responsible for notifying the TB Outbreak Response Team and will convene a meeting within 2 working days to discuss this event.
4. TB outbreak response team members
The members of the TB outbreak response team will include the TB Control Program Coordinator, the Office of Disease Prevention Field Services Coordinator, the Office of Disease Prevention Director, the Office of Disease Prevention Surveillance Manager and the State Epidemiologist.
5. TB outbreak response team responsibilities
Once reported, the TB outbreak response team will be responsible for convening a meeting to discuss the report of the TB outbreak and develop a plan of action based on the individual characteristics of the report. At a minimum, the team will develop a written recommendation to the Department of Health administration on the appropriate course of action and recommended intervention activities. In addition, the team will assess whether additional staff time is needed to handle the reported case cluster and if so, will include a recommendation that additional DIS staff be assigned to work the event. If necessary, CHN staff may also be asked to assist with intervention activities.
6. Follow-up and monitoring of reported TB outbreaks
The TB Control Program Coordinator will work with the DIS field staff that have been assigned case management activities for the TB cases involved in the outbreak and will ensure that appropriate intervention activities are ongoing. The TB Control Program Coordinator will provide a weekly E-mail update to the members of the TB outbreak response team (and other Department of Health administration as needed) to update the team of the ongoing activities surrounding the outbreak. If necessary, the TB Control Program Coordinator will schedule additional meetings for the TB outbreak response team to review the current response activities to determine if additional interventions are necessary.
7. Notifying CDC of a TB case cluster
The TB outbreak response team will determine, based on the characteristics of the report, if it is necessary to report the event to CDC for outside assistance. This decision will be made on a case by case basis.