When cases of an infectious disease are diagnosed in a specific area, an Outbreak Response is triggered to stop the spread of an infectious disease swiftly, keeping as few people as possible from being infected. The Task Force works with ministries of health and organizations to help ensure that countries and the world are ready to stop the next outbreak by training disease detectives, mobilizing skilled response teams, and supporting disease detection efforts.
In this closely connected world where an infectious disease could spread far and wide within a matter of days, the need to respond quickly has never been greater, yet many of the health systems protecting populations’ health around the world are not strong enough or prepared to react and respond quickly and effectively to a disease outbreak. As deadly outbreaks like the Ebola crisis in Western Africa have proven, diseases know no borders so all health systems must have the ability to respond if the outbreak is going to be stopped with as few casualties as possible. This requires having outbreak response plans in place at national, provincial, and community-levels, including a skilled network of disease detectives who can mobilize quickly to identify where the infection originated and how far it has spread. Until all health systems are backed up with strong emergency and disease outbreak response plans, all people are vulnerable to any infectious disease outbreak.
The Task Force supports outbreak response through our polio activities, our Public Health Informatics Institute and our Training Programs in Epidemiology and Public Health Interventions Network (TEPHINET).
Developing a Cadre of Field Epidemiologists
TEPHINET’s mission is to empower and mobilize a competent field epidemiology workforce or disease detectives for all people through standardized training, experiential learning, training program quality improvement, mentoring, and knowledge exchanges in order to connect epidemiologists better and faster across the globe. Through our support of Field Epidemiology Training Programs (FETPs) around the world, TEPHINET helps build a cadre of field epidemiologists who are pivotal to the frontline of defense during a disease outbreak. In order to ensure program quality across regions and help countries produce highly qualified epidemiologists, TEPHINET has developed an FETP accreditation process.
Connecting the Epidemiology Alumni Network
Due to how unprepared the world was during the Ebola outbreak in 2014 and the Zika outbreak in 2016, a key issue that was identified during those outbreaks was how the global community was unable to quickly mobilize qualified epidemiologists and disease specialists who could help coordinate a response to address the outbreak. As a solution, TEPHINET launched TEPHIConnect, a global online networking platform built exclusively for field epidemiology training program (FETP) alumni, in 2017. TEPHIConnect has more than 1,600 active users — more than ten percent of the global FETP alumni community — from 96 countries. Working as a social networking tool, it is a forum for FETP alumni to share their work, collaborate with other experts, and maintain situational awareness. The platform helps leverage rapid response teams from around the world to a specific infectious disease outbreak when it occurs. For example, 112 FETP alumni have responded to a call to support the Democratic Republic of the Congo (DRC) during the 2018 to present Ebola outbreak. Once TEPHIConnect members are identified for a specific outbreak, they are deployed through the World Health Organization (WHO) Global Alert and Response Network (GOARN). The platform can also be used as a FETP trainee tracking and outreach tool for FETPs. regional FETPs, and the global FETP network. TEPHIConnect was developed in partnership with the WHO and other global organizations.
Supporting Diseases Detection
Besides our efforts to strengthen disease surveillance in-country, TEPHINET manages projects in developing countries that help strengthen their health system. The key areas that they focus on that support outbreak response are:
- Infectious diseases detection, prevention and elimination which supports projects like Influenza Surveillance and Training in Central Asia,
- Outbreak response and preparedness mobilization which includes Improving Public Health Emergency Management Capacity and Coordination, and
- Strengthening public health infrastructure which includes projects like Regional Lab Strategy for Zika in Central American and the Caribbean.
These various projects help countries address specific regional and country-based needs that ultimately lead to stronger protection of their populations in disease emergencies.
Supporting the “Last Mile” of Polio Eradication
With polio zeroing in on eradication, responding to every outbreak quickly is essential in order to contain the virus. Containment of eradicated polioviruses is a key objective of the Global Polio Eradication Initiative (GPEI) Polio Endgame Strategy 2019-2023 and will be critical for maintaining the global polio-free status. Our Poliovirus Containment work includes biosafety and biosecurity requirements for laboratories, vaccine production sites, or any other facility that handles or stores eradicated polioviruses, to minimize the risk of these viruses being released into the community.
Our Polio Eradication Surge Capacity Support is a team of polio experts in partnership with GPEI who have the nimble ability to respond quickly to new polio cases. The time element is critical since an investigation must be initiated within 24 hours after a case has been detected, with a rapid response team deployed within 72 hours and a vaccination campaign to follow within 14 days. The Surge team will play a critical role in the “last mile” of polio eradication.
Even in a highly developed country like the United States, the process for reporting an outbreak is not sophisticated or even electronic and the majority of the time, health departments were not immediately made aware of the diagnosis of an infectious disease case. Thus, our Public Health Informatics Institute (PHII) catalyzed a pilot project called Digital Bridge with the support of various funders and partners to create a digital process that was immediately initiated when a health care provider diagnosed an infectious disease. Previously these cases were reported by paper and sent to the relevant health departments, resulting in a slow and highly problematic response. However, with the use of Digital Bridge, health care providers could electronically document an infectious diseases incident and notify the necessary health departments while the patient was still in the doctor’s office. The goal is for this system to be implemented throughout all health facilities across the country.
Using Cell Phones for Contact Tracing: Partnering with Google, Apple and CDC Foundation, Q&A with Task Force Public Health Informatics Expert
Vivian Singletary, JM, MBA, serves as Director of The Task Force for
This story was originally published in TEPHINET’s Field Notes from FETPs Fighting
Help Respond to Disease Outbreaks
Angela Hilmers, MD, MPH
Where We Work
Header photo caption: A field-epidemiologist smokes a house in Laos where mosquitoes with zika were found.