Infectious Disease Emergency Preparedness Plan
INFECTIOUS DISEASE EMERGENCY
PREPAREDNESS PLAN
2015
Updated:
August 2018
January 2020
Table of Contents
| III. | Agencies and Acronyms |
| Agencies and Acronyms |
| IV. | Appendix |
| IDAC Members and Contact Information |
I. INFECTIOUS DISEASE EMERGENCY PREPAREDNESS |
Introduction back to top
Kansas State University (K-State) Infectious Disease Emergency Preparedness Plan (IDEPP) has been developed by the Infectious Disease Advisory Committee (IDAC) to provide guidance to the university’s administration in following proactive guidelines that can minimize the impact of a pandemic flu as well as other major infectious diseases on the campus community and its business operations.
Included in this plan are annexes pertaining to Pandemic Flu, Ebola, SARS, Mumps, Meningitis, MERS, Measles and Varicella. These annexes provide detailed information to assist with the appropriate infectious situation. These individual annexes may be expanded or revised during an infectious event as more is known about the causative agent and/or situation.
Included in this document is the organization of the Infectious Disease Advisory Committee (IDAC) that will be responsible for annually reviewing the IDEPP by Aug. 1 each year. The IDAC will also recommend that special meetings be called to review urgent issues. The IDAC will determine the need for training exercises or drills and for testing of the plan on an annual basis in consultation with the Incident Commander (IC).
Authority back to top
This plan has been approved by the K-State President’s Cabinet. The Incident Commander, in consultation with the IDAC is responsible for directing, coordinating and implementing an emergency public health response to any infectious disease situation at K-State. The direction of local, state or federal public health authorities may alter the strategies that are outlined in this plan.
Purpose back to top
The purpose of the IDEPP is to provide guidelines and response activities to reduce morbidity, mortality, social and economic disruption caused by an outbreak of infectious diseases within the campus community.
Scope back to top
The IDEPP provides the basic structure and guidance to plan and coordinate, monitor and assess, prevent and control health systems response, develop communication, and provide public education in response to an infectious disease outbreak. Furthermore, the IDEPP is part of the Continuity Plan at K-State and will be implemented in preparation and response to an infectious disease outbreak.
Infectious Disease Incident Management Team (IMT) back to top
This section identifies the position of members of the IMT. Appendix A will list member names and contact information. In addition, two alternates will be listed for possible contact consistent with emergency preparedness.
Incident Commander – Director, Lafene Health Center (LHC Director/IC)
- Responsible for setting the incident objectives, strategies and priorities.
- Overall responsibility for the infectious event
- Initiates Infectious Disease Advisory Committee.
Health Response Officers – Medical Director, Lafene Health Center
- Identify essential LHC personnel and inform them of their responsibilities.
- Assess Personal Protective Equipment (PPE) needs of essential personnel; obtain PPE stock.
- Continue surveillance of patients with relevant infectious disease symptoms that present to LHC.
- Determine instructions for students who are seeking care at LHC.
- Promote appropriate health education and prevention programs.
- Provide in-service training on infectious diseases for LHC.
- Determine appropriate levels of staffing and actions to take for managing phones, triage and patient care.
- Develop means of patient assessment and health counseling services other than face to face.
- Plan for expansion of telephone counseling, phone triage system.
- Plan for temporary clinic modification to isolate potential cases that can spread infection.
- Develop a system for: triage and prioritizing treatment interventions; surveillance documentation; ordering of relevant medications/vaccines; and ensure adequate medical supplies and consent to treatment/vaccination forms.
- Keep abreast of status of new and emergent infectious diseases as indicated by the CDC, WHO and federal, state and local health authorities.
Safety Officer – Director, Environmental Health and Safety (EHS)
- Identify essential personnel and inform them of their responsibilities.
- Assess and stock PPE for needs of essential personnel.
- Evaluate use of contracted custodial supplies to ensure efficacy for destroying viral and/or bacterial organisms.
- Develop management plan for control and disposal of increased volumes of infectious waste.
- Monitors safety conditions and develops measures for assuring safety of all personnel
Public Information Officer – VP for Communications and Marketing
- Serves as the conduit for information to internal and external stakeholders, including the media or other organizations seeking information directly related to the infectious event.
- Identify essential personnel and inform them of their responsibilities.
- Coordinate with local community (website, newspaper, radio, television, RCHD, for reporting mechanism) for the reporting of disease information.
- Develop educational materials (Web and online PDF) in coordination with LHC and EHS on disease and hand hygiene.
- Assess and stock PPE for essential personnel.
Finance Officer – Chief Financial Officer
- Monitors the costs related to the infectious event.
- Establish system to maintain payroll, accounts payable and purchasing.
- Communicate with campus vendors.
Operations Officer – Emergency Management Coordinator
- Responsible for tactical operations to carry out the plan.
- Responsible for developing the tactical objectives.
- Directs all tactical resources.
Logistics Officer – VP for Human Capital
- Responsible for support, resources and all other services needed to meet the operational objectives.
- Identify essential personnel and inform them of their responsibilities.
- Plan for temporary changes in leave policies.
- Plan for potential disruption of wages and benefits.
- Assess and stock PPE for essential personnel in coordination with EHS.
Crisis Management Officer – VP for Student Life
- Identify essential personnel and inform them of their responsibilities.
- Ask fraternities, sororities and other student organizations to heighten awareness of infectious event.
- Enact planning for quarantine of students.
- Assess and stock for PPE needs of essential personnel in coordination with EHS.
- Essential personnel receive specialized training (specific to infectious disease).
- Identify essential departmental personnel.
- Activate Emergency Phone Bank, includes weekly updates.
- Off-campus Liaison.
- Formulate plan to address needs for all students (undergraduates, graduates, and commuter).
Residence Life Officer – Housing and Dining
- Residence Life Director will identify essential departmental personnel.
- Identify floors/buildings to be used for quarantined students.
- Enact planning for quarantine of students.
- Review emergency response menu planning for various degrees of need.
- Review food delivery process and make appropriate adjustments.
- Identify food service personnel and ensure their presence during infectious disease event.
- Review plans for alternate dining services for students and staff.
- Review plan for feeding students in isolation and/or quarantine on campus.
- Consider possible stockpiling of food.
- With EHS assistance, provide safe food-handling procedures for food service management and staff.
Depending upon the infectious disease and level of threat, additional university departments will need to review, update and potentially implement aspects of their Continuity of Operations Plan.
University Level of Action back to top
To prepare the K-State community for the possibility of an infectious disease outbreak, a number of actions should be undertaken during each of the action levels. The applicable level will be determined by the Incident Commander (IC) in accordance with guidance from CDC, WHO, KDHE and coordination with IDAC. In this document, references to the K-State community include all students, employees, staff and administration.
University Level of Action | |
Level 0 |
|
Level 1 |
|
Level 2 |
|
Level 3 |
|
Level 4 |
|
PROCEDURES FOR INFECTIOUS DISEASE OUTBREAK back to top
| back to top Infectious Disease Incident Management Team: | |||||
| Level 0 | Level 1 | Level 2 | Level 3 | Level 4 |
K-State Response Level | Pre-event assessment and planning by IDAC. | Intense university planning and preparation by IMT. President’s Cabinet considering additional strategies. | University preparing to suspend classes. | Upon review of outbreak and impact to the university, classes may be suspended for seven to 10 days. | No class activity; only essential personnel. |
| back to top Incident Response Level Criteria | ||||
| Level 1 | Level 2 | Level 3 | Level 4 |
K-State Incident Response Level Criteria | Minimal immediate risk to K-State community; requires minimal outside agency assistance. | Increased risk to K-State community and required coordination with outside agencies (e.g. KDHE, RCHD, and CDC). | Additional increased risk to K-State community and requires substantial coordination with outside agencies. | Significant risk to K-State community and requires substantial coordination/compliance with outside agencies. |
| back to top IC Emergency Management Responsibilities | ||||
| Level 1 | Level 2 | Level 3 | Level 4 |
Incident Commander (IC) | Convene first IDAC meeting. Assess threat in consultation with IDAC. Provide update to President and Provost. Begin tracking expenses. | Evaluate infectious disease impact and re-evaluate response plan and priorities. Provide update to President and Provost. Continue tracking expenses. | Evaluate infectious disease impact and re-evaluate response plan and priorities in collaboration with President’s Cabinet. Plan for post-recovery and resumption of normal university operations. Plan for revised instruction calendar and completion of the session. Continue tracking expenses. | Evaluate infectious disease impact and re-evaluate response plan and priorities in collaboration with President’s Cabinet. Plan for post-recovery and resumption of normal university operations. Continue tracking expenses. President issues closure notice. |
| back to top IDAC Emergency Management Responsibilities | |||||
| Level 0 | Level 1 | Level 2 | Level 3 | Level 4 |
Infectious Disease Advisory Council (IDAC) | At a minimum, meet annually to review the IDEPP. | Assess threat and recommend appropriate Level 1 activity in consultation with President’s Cabinet. Bring in Housing and Dining Services (HDS) for quarantine planning. Implement hand sanitation procedures. LHC develops a point of distribution (POD) for vaccines/prophylaxis. Work with DCM to communicate to all campus entities. | Assess threat and implement appropriate Level 2 activities. IDAC inactivated; activation of IMT. Plan for recovery. | Assist during alterations in university operations. | Plan for post-recovery and resumption of normal university operations. Establish time to debrief and complete Quality Improvement strategies. |
| back to top IMT Emergency Management Responsibilities | |||||
| Level 0 | Level 1 | Level 2 | Level 3 | Level 4 |
Incident Management Team (IMT) | IMT not activated. | IMT not activated. | Develop post-incident communications (medical clearance, recovery). Actively collaborate with President’s Cabinet regarding possible suspension of classes. Access and coordinate each Team Leader Plan. Communicate with KDHE, RCHD, CDC and other agencies as needed. Track CDC reports. Work with DCM to communicate to all campus entities. | Prepare for suspension of events and classes. Communicate with KDHE, RCHD, CDC and other agencies as needed. Work with DCM to communicate to all campus entities. Track CDC reports. Access and coordinate each Team Leader Plan. Communicate with President’s Council on a daily basis. Work with President regarding possible closure notice. | Ensure that each group’s function is covered. Communicate with KDHE, RCHD, CDC and other agencies as needed. Work with DCM to communicate to all campus entities. Track CDC reports. Debrief after event. |
| back to top Responsibilities of Team Leaders and Respective Units | ||||
| Level 1 | Level 2 | Level 3 | Level 4 |
Office of the Provost/Academic Affairs and Information Technology Services (AA and ITS) | Essential personnel receive specialized training (specific to outbreak type). Train and educate essential personnel in appropriate PPE through EHS. ITS Online Learning will continue training all faculty and staff in order to meet the challenges of converting classroom courses to online courses and uploading lecture recordings to their course shells in Canvas. Work with ITS and DCM to assess how information should be disseminated to students, faculty and staff. | Provost determines, in consultation with the IC, Health Response Officer and LHC Risk Manager, when illness levels call for excusing students from classes with no academic punishment/failure. If available, essential personnel to receive vaccinations with LHC assistance. ITS Online Learning will continue to implement Canvas campuswide and finalize the design and transition of face-to-face courses to online delivery. The office will also integrate online course content and lecture recordings, online faculty services and online student services via Canvas. Coordinate with DCM to have a systematic way of informing the K-State community. | Provost determines, in consultation with the IC, Health Response Officer and LHC Risk Manager, when illness levels call for excusing students from classes with no academic punishment/failure. Essential personnel to receive vaccinations with LHC assistance. ITS resources such as Canvas, class video capture and Web conferencing are now on standby. Continue to monitor day-to-day online course activities and update, if needed, the courses offered during that specific semester and make lists available to the ITS Online Learning Team. | Report to work if essential personnel. ITS resources such as Canvas, class video capture and Web conferencing are now on stand-by. Bulletins are posted on Canvas in coordination with DCM to have a systematic way of informing students, faculty and staff. If staff access to K-State is shutdown, essential personnel will provide online support from remote locations. |
| back to top Responsibilities of Team Leaders and Respective Units | ||||
| Level 1 | Level 2 | Level 3 | Level 4 |
K-State Police Department (K-State PD) | Essential personnel, officers, dispatchers and security receive specialized training specific to outbreak type. Train and educate essential personnel in the use of PPE through EHS. | Distribute PPE to essential personnel. Provide security for general campus. Alert LHC of students showing visible symptoms of potential illness. If available, essential personnel to receive vaccinations with LHC assistance. | Provide security for general campus. Alert LHC of students showing visible symptoms of potential illness. | Essential personnel report to work. Provide security for essential personnel and general campus. Secure all buildings and deny entry/exit as directed by the Incident Commander. |
| back to top Responsibilities of Team Leaders and Respective Units | ||||
| Level 1 | Level 2 | Level 3 | Level 4 |
K-State Center for Child Development (CC) (licensed by KDHE) | Essential personnel, childcare specialists and center staff receive specialized training specific to outbreak type. Encourage appropriate vaccination of center staff. Increase of daily health checkups upon arrival/departure of child. | Determination of possible closure of facility made by President’s Cabinet. | Continue same actions/services as previous level. | Plan for post-recovery and resumption of normal university operations. |
| back to top Responsibilities of Team Leaders and Respective Units | ||||
| Level 1 | Level 2 | Level 3 | Level 4 |
Environmental Health and Safety (EHS) | Essential personnel receive specialized training (specific to outbreak type). Train and educate essential personnel from all divisions in appropriate PPE. Conduct training, in conjunction with LHC, for appropriate infection control methods. Conduct hazard analysis of custodial functions to ensure appropriate infection control methods are in place.
| Distribute PPE to essential personnel. Provide a training program in infection control to Custodial Services. If available, essential personnel to receive vaccinations with LHC assistance. | Essential personnel to receive vaccinations with LHC assistance. Arrange for additional infectious waste pickups. | Report to work if essential personnel. Assist IMT and (LHC Director/IC) as necessary. |
| back to top Responsibilities of Team Leaders and Respective Units | ||||
| Level 1 | Level 2 | Level 3 | Level 4 |
Human Capital (HC) | Essential personnel receive specialized training (specific to outbreak type). Train and educate essential personnel in appropriate PPE through EHS. Prepare for an increase in phone calls regarding benefits and leave procedures. | Distribute PPE to essential personnel. Disseminate information to university employees on leave policies during an emergency. Direct employees to EAP counseling services. If available, essential personnel to receive vaccinations with LHC assistance. Request from all departments a weekly list of absences due to personal or household members with infectious disease. | Request from all departments a daily list of absences due to personal or household members with infectious illness. Execute critical processes for employee benefits and payroll, having ensured exigent systems are in place. Direct employees to counseling services as appropriate. | Report to work if essential personnel. Available to provide instructions for absentee personnel. Assist with benefits information and any other HC related issues. |
| back to top Responsibilities of Team Leaders and Respective Units | ||||
| Level 1 | Level 2 | Level 3 | Level 4 |
Division of Communications and Marketing (DCM) | Essential personnel receive specialized training (specific outbreak type). Train and educate essential personnel in appropriate PPE through EHS. Work with IDAC and IC (LHC Director) to draft internal and external bulletins and announcements. Prepare the Crisis Response Center. | Distribute PPEs to essential personnel. Appoint liaison to interface with IMT. Work with IMT and IC (LHC Director) to draft internal and external bulletins and announcements. Serve as university spokespersons. Activate the Crisis Response Center. If available, essential personnel to receive vaccinations with LHC assistance. | Essential personnel to receive vaccinations with LHC assistance. Work with IMT and IC (LHC Director) to draft internal and external bulletins and announcements. Prepare the Media Relations Center. Write and record bulletins and updates on the K-State emergency website, K-State Alerts, etc. | Report to work if essential personnel. Establish Media Relations Center; coordinate press releases, and manage news teams and interviews, etc. |
| back to top Responsibilities of Team Leaders and Respective Units | ||||
| Level 1 | Level 2 | Level 3 | Level 4 |
Division of Facilities (DF) | Essential personnel receive specialized training (specific to outbreak type). Train and educate essential personnel in appropriate PPE through EHS. Map and identify building ventilation systems. Monitor and maintain sanitation dispensers at locations throughout campus. Communicate with Custodial Services. | Distribute PPE to essential personnel. Prepare plan to shut down ventilation systems on buildings on an individual or campuswide basis if appropriate. Monitor and assess routine cleaning activities provided by Custodial Services. Monitor and maintain sanitation dispensers at locations throughout campus. If available, essential personnel to receive vaccinations with LHC assistance. Communicate with Custodial Services. | Essential personnel to receive vaccinations with LHC assistance. Stand by to shut down utilities as directed by IC (LHC Director), if necessary. Communicate with Custodial Services. | Report to work if essential personnel. Shut down ventilation systems and utilities to buildings as instructed by IC (LHC Director), if appropriate. |
| back to top Responsibilities of Team Leaders and Respective Units | ||||
| Level 1 | Level 2 | Level 3 | Level 4 |
Education Abroad (EA), International Student and Scholar Services (ISSS) and Office of International Programs (OIP) | EA: Monitor international travel alerts and warnings regarding health, natural disasters and political issues. EA: Provide education regarding the need for students to consult travel clinic of their primary care providers to discuss future travel plans. EA: Continue to implement pre-departure orientation that incorporates health planning. ISSS: Provides information to LHC regarding contact information for students from infected areas. | Travel warning issued to K-State community as determined by the IC, OIP and VP DCM. Approval by President and Provost. EA: Maintains communication with students, parents and schools abroad regarding infectious disease event and resulting university plans. If available, essential personnel to receive vaccinations with LHC assistance. | OIP: Places pertinent information regarding infectious disease event on website, along with travel insurance information to communicate with employees regarding travel warnings. OIP: Associate Provost makes final decision regarding whether to bring students home or to cancel a trip. | Continue same actions/services as previous level. |
| back to top Responsibilities of Team Leaders and Respective Units | ||||
| Level 1 | Level 2 | Level 3 | Level 4 |
Housing and Dining Services (HDS) | Ensure food delivery process will not be affected. Identify/purchase foods to stockpile for local delivery to quarantined students in residence halls. Create necessary purchasing documents for vendors. Assist with communication to international students and their families. Implement consultation with food science specialist(s) on campus. | Continue same actions/services as previous level. If available, essential personnel to receive vaccinations with LHC assistance. | Identify roles of essential staff: leadership, communications, food production, food delivery, maintenance and housekeeping. Auxiliary Services – Essential personnel to receive available vaccinations with LHC assistance. On campus food services closed to general public. All food preparers monitored as appropriate, with EHS assistance. | Auxiliary Services – Implement internal feeding plan. |
| back to top Responsibilities of Team Leaders and Respective Units | ||||
| Level 1 | Level 2 | Level 3 | Level 4 |
Student Life (SL) | Identify essential personnel and inform them of their responsibilities. Ask fraternities, sororities and other student organizations to heighten awareness of infectious event response. Essential personnel receive specialized training, specific to infectious disease. Prepare the Crisis Response Center. Activate off-campus liaison – includes weekly updates. Formulates plan to address needs for all students (undergraduates, graduates and commuter students. | Prepare to activate Business Continuity Plans. Access and stock for PPE needs of essential personnel. Enact planning for quarantine students. Activate the Crisis Response Center. If available, essential personnel to receive vaccinations with LHC assistance. | Communicate situation and needs to owners and landlords of rented properties. Identify roles of essential staff: leadership, communications, food production, food delivery, maintenance and housekeeping. Crisis Response Center responds to closure questions. Communication about transfer options as students travel home. | Continue same actions/services as previous level. |
| back to top Responsibilities of Team Leaders and Respective Units | ||||
| Level 1 | Level 2 | Level 3 | Level 4 |
Lafene Health Center (LHC) | Ongoing surveillance of incidence and prevalence of infectious diseases. Promote and Implement seasonal influenza vaccines and other specific vaccines as appropriate. Create appropriate algorithm to address specific infectious disease. Education provided regarding risk reduction campuswide. Begin work with EHS and public health authorities regarding preparation. | Implement specific infectious disease algorithm as appropriate. Evaluate phone/in-person triage staffing and systems and review procedures in light of potential increased demand. Prepare to alter appointment schedule. Maintain open communication with public health authorities. If available, essential personnel to receive vaccinations with LHC assistance. | Implement specific infectious disease algorithm as appropriate. Assist with investigation of suspected cases and contact tracing as directed by public health authorities. Cancel routing appointments. Increase LHC staff on phones and in clinic as needed to meet patient demand. Provide psychosocial support, if needed. | Implement specific infectious disease algorithm as appropriate. Assist with investigation of suspected cases and contact tracing as directed by public health authorities. Encourage isolation and self-care for suspected cases. Refer patients with serious symptoms to emergency department. Increase LHC staff on phones and in clinic as needed to meet patient demand. Continue to refer for psychosocial support. |
| back to top Responsibilities of Team Leaders and Respective Units | ||||
| Level 1 | Level 2 | Level 3 | Level 4 |
Chief Financial Officer (CFO) | Essential personnel receive specialized training (depending on outbreak). Train and educate essential personnel in appropriate PPE through EHS. Communicate with campus vendors. Begin tracking expenses. | Distribute PPE to essential personnel. If available, essential personnel to receive vaccinations with LHC assistance. Identify funds for business continuity and recovery. Communicate with campus vendors. Continue tracking expenses. If available, essential personnel to receive vaccinations with LHC assistance. | Report to work if essential personnel. Consider allowing off-campus access to financial planning, budgets and payroll information systems to allow staff to work from home. Communicate with campus vendors. Continue tracking expenses. | Report to work if essential personnel. Ensure business continuity through financial means. Communicate with campus vendors. Continue tracking expenses. |
| back to top Responsibilities of Team Leaders and Respective Units | ||||
| Level 1 | Level 2 | Level 3 | Level 4 |
College of Veterinary Medicine (CVM) and Veterinary Health Center (VHC) | Determine the potential of zoonotic involvement. If so, then implement CVM and VHC EOP and university’s ESF-11. | Continue actions/services based on potential of zoonotic involvement. If available, essential personnel to receive vaccinations with LHC assistance. | Continue actions/services based on potential of zoonotic involvement. | Continue actions/services based on potential of zoonotic involvement. |
| back to top Responsibilities of Other Officials, Units, and Departments | ||||
| Level 1 | Level 2 | Level 3 | Level 4 |
All departments and units | Coordinate training for Essential personnel with EHS. Review communications from DCM in reference to preventive measures. Identify departmental service priorities. | Prepare to activate Business Continuity Plans. Plan distancing measures/ dispersion for essential personnel. Make sure essential personnel receive PPE. Report absent employees to HC on a weekly basis. Confirm highest priority services. | Activate Business Continuity Plans. Report absent employees to HC on a daily basis. Provide highest priority services with personnel available. | Report to work if essential personnel. Review K-State website for updates. |
II. ANNEXES |
Annex A. Pandemic Influenza back to top
History
Pandemics are a part of human history. Three pandemics took place in the last century: 1918, 1957 and 1968. The most deadly of the three was the pandemic of 1918, which was caused by Influenza A (H1N1) and killed approximately 50 million people worldwide. Currently, there is heightened concern about H5N1, a highly pathogenic avian viral strain that first appeared in Hong Kong in 1997. There are striking similarities between the H1N1, the virus responsible for the 1918 pandemic, and H5N1. Despite the fact that millions of birds, domestic and wild, have been culled, the infection has been persistent in the bird population and is spreading along the flight paths of migratory birds. In addition to the persistence of infection in the bird population, the virus has crossed species and infected humans, tigers, leopards, cats and pigs. Although it has crossed species, it has done so in a very limited number of cases given the millions of birds that are infected with the virus. There have been a few cases in which human-to-human transmission is believed to have occurred. However, it has not spread beyond one contact.
Three conditions must be met for a pandemic to occur: a new influenza virus subtype emerges; the virus infects humans; and the virus gains efficient and sustainable transmission from human to human. Two of the three conditions have been met in regard to H5N1. The third condition can be met either through mutation or a reassortment event, in which the bird virus exchanges genetic material with a human virus during co-infection of a human or pig, thereby gaining the ability to be passed efficiently from human to human. It is now known that the 1918 virus was not a reassortment event. For the first time in history, we have an opportunity to track the activity of a virus that has the potential to cause a pandemic and to prepare for such an event.
While many strategies are underway, including the development of antivirals and vaccines, most experts agree that we are inadequately prepared to respond to a pandemic. If a virus would gain sustainable, efficient transmissibility, the public health strategy would focus on slowing the spread because it would be virtually impossible to stop it. Slowing the spread of disease would allow for better allocation and a more even use of limited resources by flattening the surge of cases.
Recent Pandemic Information
On June 11, 2009, the World Health Organization (WHO) signaled that a global pandemic of novel influenza A (H1N1) was underway by raising the worldwide pandemic alert level to Phase 6. This action was a reflection of the spread of the new H1N1 virus, not the severity of illness caused by the virus. At the time, more than 70 countries had reported cases of novel influenza A (H1N1) infection and there were ongoing community level outbreaks of novel H1N1 in multiple parts of the world.
Since the WHO declaration of a pandemic, the new H1N1 virus continued to spread, with the number of countries reporting cases of novel H1N1 nearly doubling. The Southern Hemisphere’s regular influenza season has begun and countries there have reported that the new H1N1 virus continues to spread, causing illness along with regular seasonal influenza viruses. In the U.S., significant novel H1N1 illness continued into summer 2009, with localized, and in some cases, intense outbreaks occurring. The U.S. reported some of the largest number of novel H1N1 cases of any country worldwide; however, most people who became ill recovered without requiring medical treatment.
The CDC anticipates that there will be more cases, more hospitalizations and more deaths associated with this pandemic in the U.S. during the fall and winter months. The novel H1N1 virus, in conjunction with regular seasonal influenza viruses, poses the potential to cause significant illness with associated hospitalizations and deaths during the U.S. influenza season.
Table 1
| |
Seasonal Flu | Pandemic Flu |
Outbreaks follow predictable season patterns; they occur annually, usually in winter, and in temperate climates. | Occurs rarely. |
Usually some immunity built up from previous exposure. | No previous exposure; little or no pre-existing immunity |
Healthy adults usually not at risk for serious complications; the very young, the elderly and those with certain underlying health conditions are at increased risk for serious complications. | Health systems may be overwhelmed. |
Vaccine developed based on known flu strains and available for annual flu season. | Vaccine probably would not be available in the early stages of a pandemic. |
Adequate supplies of antivirals are usually available. | Effective antivirals may be in limited supply. |
Average U.S. deaths approximately 36,000/year. | Number of deaths could be quite high. |
Symptoms: fever, cough, runny nose, muscle pain. Deaths often caused by complications, such as pneumonia. | Symptoms may be more severe and complications more frequent. |
Generally causes modest impact on society (e.g., some school closing, encouragement of people who are sick to stay home). | May cause major impact on society |
Manageable impact on domestic and world economy. | Potential for severe impact on domestic and world economy. |
Pandemic Periods
The World Health Organization (WHO) has defined periods and phases of pandemic activity to assist those responsible for public health and medical and emergency preparedness to respond to threats and occurrences of pandemic influenza.
Table 2
| ||
Inter-pandemic Period | Phase 1 | No new influenza virus subtypes have been detected in humans. An influenza virus subtype that has caused human infection may be present in animals. If present in animals, the risk of human infection or disease is considered to be low. |
Phase 2 | No new influenza virus subtypes have been detected in humans. However, a circulating animal influenza virus subtype poses a substantial risk of human disease. | |
Pandemic Alert Period | Phase 3
| Human infection(s) with a new subtype, but no human-to-human spread, or at most rare instances of spread to a close contact. |
Small cluster(s) with limited human-to-human transmission but spread is highly localized, suggesting that the virus is not well adapted to humans. | ||
Larger cluster(s) but human-to human spread still localized, suggesting that the viruses is becoming increasingly better adapted to humans, but may not yet be fully transmissible (Substantial pandemic risk). | ||
Pandemic Period | Phase 6 | Pandemic phase: increased and sustained transmission in general population. |
Subsided Period | The Subsided Period is the term used for the period that may occur between waves of the pandemic. | |
Post-pandemic Period |
| Return to Inter-pandemic Period. |
* The distinction between Phase 1 and Phase 2 is based on the risk of infection or disease from circulating strains in animals.
** The distinction between Phase 3, Phase 4 and Phase 5 is based on the risk of a pandemic.
Annex B. Ebola Virus Disease (EVD) back to top
History
Ebola, previously known as Ebola hemorrhagic fever, is a rare and deadly disease caused by infection with one of the Ebola virus strains. Ebola can cause disease in humans and nonhuman primates (monkeys, gorillas, and chimpanzees). Ebola is caused by infection with a virus of the family Filoviridae, genus Ebolavirus. There are five identified Ebola virus species, four of which are known to cause disease in humans: Ebola virus (Zaire ebolavirus); Sudan virus (Sudan ebolavirus); Taï Forest virus (Taï Forest ebolavirus, formerly Côte d’Ivoire ebolavirus); and Bundibugyo virus (Bundibugyo ebolavirus). The fifth, Reston virus (Reston ebolavirus), has caused disease in nonhuman primates, but not in humans.
Ebola viruses are found in several African countries. Ebola was first discovered in 1976 near the Ebola River in what is now the Democratic Republic of the Congo. Since then, outbreaks have appeared sporadically in Africa. The natural reservoir host of Ebola virus remains unknown. However, on the basis of evidence and the nature of similar viruses, researchers believe that the virus is animal-borne and that bats are the most likely reservoir. Four of the five virus strains occur in an animal host native to Africa.
The 2014 Ebola epidemic is the largest in history, affecting multiple countries in West Africa. There were a small number of cases reported in Nigeria and a single case reported in Senegal; however, these cases are considered to be contained, with no further spread in these countries.
Two imported cases, including one death, and two locally acquired cases in health care workers have been reported in the United States. CDC and partners are taking precautions to prevent the further spread of Ebola within the United States. CDC is working with other U.S. government agencies and the World Health Organization (WHO) to help coordinate technical assistance and control activities with partners. CDC has also deployed teams of public health experts to West Africa and will continue to send experts to the affected countries.
The possible consequences of further international spread are particularly serious considering the following factors:
- The virulence (ability to cause serious disease or death) of the virus,
- The widespread transmission in communities and health care facilities in the currently affected countries, and
- The strained health systems in the currently affected and most at-risk countries.
Signs and Symptoms
Symptoms may appear anywhere from two to 21 days after exposure to Ebola, but the average is eight to 10 days.
- Fever
- Severe headache
- Muscle pain
- Weakness
- Fatigue
- Diarrhea
- Vomiting
- Abdominal (stomach) pain
- Unexplained hemorrhage (bleeding or bruising)
Recovery from Ebola depends on good supportive clinical care and the patient’s immune response. People who recover from Ebola infection develop antibodies that last for at least 10 years.
Response
The university will follow CDC guidelines regarding early recognition and reporting of suspected Ebola exposure. Any member of the K-State community who is from or has traveled through identified risk countries must have a screening completed by an LHC nurse or provider using the Ebola Virus Disease (EVD) Risk Questionnaire. Because of the contagious nature of Ebola, if one case occurs on campus, Level 2 response would be implemented and IMT activated.
Annex C. Severe Acute Respiratory Syndrome (SARS) back to top
Signs & Symptoms
SARS is a respiratory illness. The disease can be life threatening, and anyone who suspects they may be developing symptoms should seek medical care immediately. SARS begins with a fever of 100.4°F (38°C) or higher, and is shortly followed by one or more of these symptoms: cough, shortness of breath, difficulty breathing and diarrhea. The only people who are considered to be at risk for SARS are those who have had close contact with someone known or suspected to have SARS or people who have traveled within the last 10 days to or through SARS affected areas.
CDC guidelines recommend that individuals traveling from or through SARS affected areas self-monitor their health 10 days following their initial arrival in the United States for any of the following symptoms:
- Fever greater than 100.4°F (38°C) and
- Cough
- Difficulty breathing
Response
The university will follow CDC guidelines regarding SARS. The university will ask all persons arriving from or through SARS affected areas to self-monitor for 21 days for fever greater than 100.4°F (38°C), and cough, or difficulty breathing. Student Life will encourage students coming from the SARS-affected areas to arrive early for check-in/registration.
Lafene Health Center will distribute SARS self-monitoring kits to students who have traveled from or through SARS-affected areas. The steps for reducing SARS risk after a confirmed case would be similar to steps we take with other infectious diseases (e.g., tuberculosis). LHC has a very close working relationship with the Riley County Health Department.
Annex D. Mumps back to top
Definition
Mumps is a viral infection of the salivary glands that is spread through coughing, sneezing and saliva. It can spread by sharing drinking glasses, kissing, sneezing and coughing. Symptoms include swelling of the glands close to the jaw, fever, headache and muscle aches. Mumps is a mild to moderate disease; however, mumps can cause serious complications, including meningitis, miscarriage if infected during pregnancy, breast swelling, hearing loss and sterility in men.
Students born after 1956 and never had the mumps or haven’t received two mumps shots, are considered at greater risk for being infected with mumps. Since 1989, two doses of the measles/mumps/rubella shot (MMR) have been recommended to prevent infection of the mumps virus. These typically are done initially around 15 months of age, and again when starting kindergarten or high school.
Exposure to Mumps
Not everyone who is exposed to someone with mumps will get sick. Exposed people who have been vaccinated with two doses of mumps vaccine are very unlikely to get mumps. However, a person who hasn’t been vaccinated nor had mumps disease may become sick if exposed to the mumps virus. Symptoms may appear two to three weeks after exposure. A person is contagious (able to spread the virus to others) from around three days before they develop symptoms to nine days after the symptoms begin.
Response
Because of the contagious nature of the mumps virus, students should NOT come to campus if they are experiencing mumps symptoms. Students should contact LHC or their primary care provider immediately. Laboratory testing to confirm infection with the mumps virus will be conducted. If a student is diagnosed with mumps, RCHD and KDHD will be notified and facilitate follow-up in coordination with LHC. Students will not be allowed to return to work or class until a release from is signed by LHC or their primary care provider.
Annex E. Meningitis back to top
History
Community-acquired meningococcal disease is typically caused by a variety of serogroups of Neisseria meningitidis; serogroups B and C cause 46% and 45% of the endemic cases, respectively. Serogroups A, Y and #W-135 account for nearly all of the remaining endemic cases. In contrast, epidemic meningococcal disease has, since the early 1990s, been caused increasingly by serogroup C. Nosocomial transmission of N meningitidis is uncommon. In rare instances, when proper precautions were not used, N meningitidis has been transmitted from patient to personnel, through contact with the respiratory secretions of patients with meningococcemia or meningococcal meningitis, or through handling laboratory specimens. Lower respiratory tract infections caused by N meningitidis may present a greater risk of transmission than either meningococcemia or meningitis, especially if the patient has an active, productive cough. The risk of personnel acquisition of meningococcal disease from casual contact (e.g., cleaning rooms or delivering food trays) appears to be negligible. N meningitidis infection is probably transmitted by large droplets; the incubation period is from two to 10 days, and patients infected with N meningitidis are rendered noninfectious by 24 hours of effective therapy.
Transmission
Transmission of meningococcal disease occurs through close contact (e.g. mouth-to-mouth resuscitation, endotracheal intubation, and endotracheal management) or other direct / close contact with respiratory droplets from the nose and throat of an infected person. Exposure occurs by direct mucous membrane contact of an uninfected individual to the respiratory secretions of an infected individual. Close contact may include kissing, sharing cigarettes, and using the same eating and drinking utensils, glasses and plates. Close contact may also include an individual who administered care or treatment that required close prolonged face-to-face contact such as oral care, feeding or similar tasks.
Response
Students who are identified as a contact may be treated at LHC after notification reference their contact status or will be referred to their private physician, emergency room or urgent care center to receive the appropriate post-exposure prophylaxis treatment. Said students must bring a health clearance note from their physician/provider to LHC before returning to classes if they have been treated at a site other than LHC.
Should a patient present to the LHC with symptoms-like meningitis, the clinical practitioners will contact Emergency Medical Services. Once a possible case is suspected, the Riley County Health Department and the Kansas Department of Health and Environment will be notified. LHC will collaborate with RCHD and KDHE in further identifying students who might have been exposed.
Annex F. Middle East Respiratory Syndrome (MERS) back to top
History
In September 2012, a case of novel coronavirus infection was reported involving a man in Saudi Arabia who was admitted to a hospital with pneumonia and acute kidney injury in June 2012. Only a few days later, a separate report appeared of an almost identical virus detected in a second patient with acute respiratory syndrome and acute kidney injury. The second patient initially developed symptoms in Qatar, but had traveled to Saudi Arabia before he became ill and then sought care in the United Kingdom. Many subsequent cases and clusters of infections have been reported. This novel coronavirus was named Middle East Respiratory Syndrome coronavirus (MERS or MERS-CoV).
Since April 2012, more than 900 cases of MERS-CoV infection have been reported with the actual number of cases likely to be higher. The median age is 47 years (range 9 months to 94 years) and 64% of cases have been male. The number of cases in the Middle East increased dramatically in March and April 2014, then declined sharply in mid-May 2014. An increase also occurred during March and April in 2012 and 2013.
Transmission
MERS-CoV is thought to be of animal origin and appears to be related to several bat coronaviruses. It is likely that some infections occur via intermittent zoonotic transmission or possibly via an environmental source. Camels likely serve as intermediate hosts and the presence of case clusters strongly suggests that human-to-human transmission occurs.
Response
The following discussion has been adapted from recommendations issued by the CDC for the investigation of possible cases in the United States. Health care providers should evaluate individuals for MERS-CoV infection if they have fever and pneumonia or acute respiratory distress syndrome (based on clinical or radiographic evidence) and one of the following:
- A history of travel from countries in or near the Arabian Peninsula, South Korea, or any country of current risk of MERS within 14 days before symptom onset or
- Close contact with a symptomatic traveler who developed fever and acute respiratory illness (not necessarily pneumonia) within 14 days after traveling from countries in or near the Arabian Peninsula or
- Is a member of a cluster of patients with severe acute respiratory illness (e.g., fever and pneumonia requiring hospitalization) of unknown etiology and where MERS-CoV is being evaluated or
- Is a close contact with a confirmed or probable case of MERS-CoV while the affected person was ill
Currently, no treatment is recommended for coronavirus infections except for supportive care as needed. An increased level of infection control precautions is recommended when caring for patients with probable or confirmed MERS-CoV infection compared with that used for patients with community-acquired coronaviruses or other community-acquired respiratory viruses. The CDC recommends the use of standard, contact and airborne precautions for the management of hospitalized patients with known or suspected MERS-CoV infection. Additional information can be found at the CDC website.
Annex G. Measles back to top
History
Measles is a highly contagious respiratory disease caused by a virus and occurs worldwide. In temperate zones, peak incidence occurs in late winter and early spring. A single dose of MMR vaccine induces measles immunity in about 95% of vaccines; however, due to measles extreme infectiousness, two doses are recommended. In developing countries, case fatality rates average 3-5% but can be as high as 10-30%. Since 1995, the incidence of measles in the United States has been very low with only a few hundred cases reported each year. An increasing proportion of these cases are imported.
Agent:Measles virus causes measles.
Clinical Description:
Two to four day prodrome (before rash): fever, malaise, nonproductive cough and coryza (runny nose). Conjunctivitis and bronchitis often present. Low fever initially will be followed by higher temperatures peaking, with the rash onset. Swollen glands occur in younger children. Older children may have sensitivity to light and, occasionally, muscle aches.
Within two to four days after prodromal symptoms, a rash made up of large, blotchy red areas initial appears behind ears and on the face (typically the hairline). The rash gradually proceeds over the next three days downward and outward, reaching the hands and feet. Typically the rash lasts three to seven days and then fades in the same pattern it appeared.
Complications include diarrhea, otitis media, pneumonia and encephalitis. The case fatality rate ranges between 1 and 3 per 1,000 cases. Increased risk for pneumonias, encephalitis and death occur with immunocompromised persons.
Reservoirs: Humans.
Mode(s) of Transmission:
Airborne droplet or direct contact with infectious nasopharyngeal secretions.
Incubation Period:
About 10 days, but may be seven to 18 days from exposure to onset of fever, usually 14 days until rash appears; rarely, as long as 19 to 21 days.
Period of Communicability:
From one day before the beginning of the prodromal period (usually about four days before rash onset) to four days after rash appearance. The vaccine virus has not been shown to be communicable. Immunocompromised patients are considered infectious for the duration of their illness.
Susceptibility and Resistance:
Immunity is life-long after infection. Adults born before 1957 are likely to have been infected naturally and are considered immune.
Response
The university will follow CDC guidelines regarding early recognition and reporting of suspected measles exposure. Because of the contagious nature of measles, if one case occurs on campus, Level 2 response would be implemented and IMT activated. Students should NOT come to campus or have contact with the public if they are experiencing measles symptoms. Students should contact LHC or their primary care provider immediately. If a student is diagnosed with measles, RCHD and KDHD will be notified and facilitate follow-up in coordination with LHC. Students will not be allowed to return to work or class until a release form is signed by LHC or their primary care provider.
Annex H. Varicella (Chickenpox) back to top
History
Varicella is an acute infectious disease. It is caused by varicella-zoster virus (VZV), which is a DNA virus that is a member of the herpesvirus group. After the primary infection, VZV stays in the body (in the sensory nerve ganglia) as a latent infection. Primary infection with VZV causes varicella. Reactivation of latent infection causes herpes zoster (shingles).
The best way to prevent chickenpox is to get the chickenpox vaccine. Before the vaccine, about 4 million people would get chickenpox each year in the United States. Also, about 10,600 people were hospitalized and 100 to 150 died each year as a result of chickenpox. The classic symptom of chickenpox is a rash that turns into itchy, fluid-filled blisters that eventually turn into scabs.
Incubation Period and Prodrome
The incubation period for varicella is 14 to 16 days after exposure to a varicella or a herpes zoster rash, with a range of 10 to 21 days. A mild prodrome of fever and malaise may occur one to two days before rash onset, particularly in adults.
Transmission
Varicella is highly contagious. The virus spreads in the air when an infected person coughs or sneezes. It can also be spread by touching or breathing in aerosolized virus from varicella lesions. A person with varicella is contagious from one to two days before rash onset until the lesions have crusted. It takes 10 to 21 days after exposure to the virus for someone to develop varicella. Based on studies of transmission among household members, about 90 percent of susceptible close contacts will get varicella after exposure to persons with the disease.
Varicella Clinical Features
The rash is generalized and pruritic (itchy). It progresses rapidly from macules to papules to vesicular lesions before crusting. The rash usually appears first on the head, chest, and back then spreads to the rest of the body. The lesions are usually most concentrated on the chest and back. Adults are at risk for more severe disease and have a higher incidence of complications. Recovery from primary varicella infection usually provides immunity for life. In otherwise healthy people, a second occurrence of varicella is uncommon and usually occurs in people who are immunocompromised.
Complications
The most common complications from varicella are bacterial infections of the skin and soft tissues in children and pneumonia in adults. Severe complications include septicemia, toxic shock syndrome, necrotizing fasciitis, osteomyelitis, bacterial pneumonia, and septic arthritis. Other complications caused by varicella include cerebellar ataxia, encephalitis, viral pneumonia, and hemorrhagic conditions.
Response
The university will follow CDC guidelines regarding early recognition and reporting of suspected Varicella exposure. Students should NOT come to campus or have contact with the public if they are experiencing varicella symptoms. Students should contact LHC or their primary care provider immediately. If a student is diagnosed with varicella, RCHD and KDHD will be notified and facilitate follow-up in coordination with LHC. Students will not be allowed to return to work or class until a release form is signed by LHC or their primary care provider.
III. AGENCIES AND ACRONYMS |
| AA | Academic Affairs |
| CC | K-State Child Development Center |
| CDC | Centers for Disease Control and Prevention |
| CFO | Chief Financial Officer |
| CVM | College of Veterinary Medicine |
| DCM | Division of Communication and Marketing |
| DF | Division of Facilities |
| EA | Education Abroad |
| EHS | Environmental Health and Safety |
| FS | Faculty Senate |
| HC | Human Capital |
| HDS | Housing and Dining Services |
| IC | Incident Commander |
| IDAC | Infectious Disease Advisory Committee |
| IDEPP | Infectious Disease Emergency Preparedness Plan |
| IMT | Incident Management Team |
| ISSS | International Student & Scholar Services |
| ITS | Information Technology Services |
| KDHE | Kansas Department of Health and Environment |
| K-State | Kansas State University |
| K-State PD | Kansas State University Police Department |
| LHC | Lafene Health Center |
| OIP | Office of International Programs |
| PPE | Personal Protective Equipment |
| POD | Point of Distribution |
| REC | Recreation Services |
| SAO | Study Abroad Office changed to Education Abroad |
| SL | Student Life |
| VHC | Veterinary Health Center |
| WHO | World Health Organization |
IV. APPENDIX |
IDAC Members back to top
K-State Department | IDAC Members | Department Phone Number |
AA | Brian Niehoff | 532-4797 |
CFO | Ethan Erickson | 532-5416 |
DCM | Cindy Hollingsworth | 532-2535 |
EHS | Christina Aguilera | 532-5856 |
DPS |
| 532-5856 |
FS | Katie Heinrich | 532-7771 kmhphd@ksu.edu |
HC |
| 532-6277 |
HDS | Derek Jackson | 532-6453 |
ISSS | Sara Thurston | 532-6448 |
K-State PD | Ronnie Grice | 532-1131 |
LHC | Jim Parker | 532-6544 |
OIP | Grant M. Chapman | 532-5498 |
REC | Steve Martini | 532-6980 |
SL | Heather Reed | 532-6432 |
TC | Danny Fronce | 532-4563 |
VHC | Christine Duvendack | 532-5708 |
VPUO/COO | Cindy Bontrager | 532-6226 |
VPSL | Thomas Lane | 532-6237 |
