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commit;

--
-- Dumping data for table `searchindex`
--

set autocommit=0;
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specific organization structure roles and responsibilities meeting and voting schedules workgroup rules and more '),(1935,'slug',0,1,''),(1935,'title',0,1,''),(1979,'field',43,1,' corha bylaws '),(1979,'slug',0,1,''),(1980,'field',1,1,''),(1980,'field',11,1,''),(1980,'field',15,1,''),(1980,'field',63,1,''),(1980,'slug',0,1,''),(1981,'field',3,1,' revised and approved by council voting representatives on november 17 2023 i history and purpose in 2015 the centers for disease control and preventions division of healthcare quality promotion cdc dhqp funded the association of state and territorial health officials astho and the council of state and territorial epidemiologists cste to create and co chair the council for outbreak response healthcare associated infections hai and antimicrobial resistant ar pathogens corha and serve as founding members hais including ar pathogens cause hundreds of thousands of illnesses and deaths among u s patients each year consistent and coordinated approaches are needed to speed up detection of new threats develop tools to support outbreak investigation stop outbreaks from spreading and better inform prevention activities the council will work to build capacity for public health and healthcare to improve outbreak detection response and prevention ii mission to improve practices and policies at the local state and national levels for detection investigation control and prevention of hai ar outbreaks across the healthcare continuum including emerging infections and other risks with potential for healthcare transmission iii vision public health and healthcare collaborating effectively to protect patients and prevent harms from hai ar outbreaks iv membership in corha member organizations include the following categories founding member organizations are cdc dhqp astho cste and the national association of county and city health officials naccho founding member organizations form the corha governance committee see section v 2 and do not have membership term limits stakeholder member organizations serve four year terms on corha and the governance committee votes to renew the four year term of each member organization federal partner liaison member organizations include federal agencies invited to participate on corha in a non voting member capacity federal partner liaison member organizations serve four year terms on corha and the governance committee votes to renew the four year term of their membership individual members of corha include the following categories voting members refers to the formal voting representatives identified by founding member organizations and stakeholder member organizations non voting federal liaisons refers to the primary and alternate representatives from federal partner liaison member organizations e g cms fda non voting workgroup members refers to all workgroup members workgroup members should have an association with founding member organizations stakeholder member organizations or federal partner liaison member organizations v corhas organizational structure corhas organizational structure includes organizations professional associations and other agencies that have an active interest in delivering safe healthcare and promoting patient safety full council corha the council refers to the assembly of founding member organizations stakeholder member organizations and federal partner liaison member organizations as defined in section iv each member organization designates one individual to serve as their representative on corha the number and specific mix of member organizations are approved for addition or subtraction from corha through action by the governance committee the governance committee the governance committee is comprised of representatives from corhas founding member organizations cdc dhqp astho cste and naccho each of which appoints an individual representative as described in section vi below workgroups and committees see section viii below for more information vi corha voting representatives and responsibilities each corha member organization as defined in section iv designates one individual to serve as a voting representative on corha the following exceptions apply corha co chair organizations astho and cste will each have three voting representatives on the council one of whom will be designated to serve as co chair on the governance committee founding member organizations that are not co chairs naccho and cdc dhqp will each have two voting representatives on the council one of whom will be designated to serve on the governance committee federal partner liaison member organizations will each have a formally designated representative and an alternate representative but they will participate in a non voting capacity corha voting representatives will have a strong scientific background knowledge of hai outbreak and response extensive knowledge of the organization they represent understanding of hai policy issues and be dedicated to the mission and vision of corha corha voting representative responsibilities include supporting and implementing the decisions of the governance committee approving modifications to the corha bylaws approving the addition of organizations to add to covered membership approving changes to corhas vision mission or strategic map participating in and or providing support and guidance to corha workgroups participating in in person meetings and quarterly member conference calls providing feedback on corha initiatives reviewing approving and voting on corha developed products disseminating and promoting final and approved corha products a casting votes and quorum regarding corha covered business action a quorum must be established with a simple majority of the total number of voting representatives for a vote to occur each voting representative may cast one vote for an action to be considered approved the total number of affirmative votes must be equal to the simple majority of the total number of voting representatives if a voting representative knows in advance that he she will not be present for a vote that member may designate a proxy from the same member organization to vote on his or her behalf corha developed products requiring approval and a vote will follow the processes and guidelines outlined in the corha workgroup to publication process corha voting representatives will be responsible for obtaining the appropriate level of input from their respective organizations during open review periods b meeting attendance and participation the council will strive to meet quarterly including two in person meetings per year e g once in the spring summer and once in the fall winter with intervening meetings occurring via video or teleconference in person meetings are subject to availability of council funds if a voting representative is unable to represent their organization at quarterly meeting they or their member organizations should propose an alternate notification of all proposed alternates must be sent to the council co chairs and the meeting planning staff as soon as possible prior to the meeting or call alternates should have a strong scientific background knowledge of hai outbreak and response extensive knowledge of their member organization they represent and understanding of hai outbreak policy issues and corha vii corha governance committee responsibilities the corha governance committee is responsible for providing overall guidance for corha one representative from each of the four founding member organizations astho cdc dhqp cste naccho serves on the governance committee governance committee members are appointed by the organizations they represent and have relevant leadership and management experience if a governance committee member is no longer able to serve on the governance committee the sponsoring organization will present another candidate for consideration the governance committee strives to make decisions by consensus but when consensus is not clear a vote will be conducted each governance committee member will have one vote and a decision must be approved by at least three fourths of governance committee members corha governance committee responsibilities include approving changes to corhas vision mission and strategic map providing strategic direction for corha introducing prioritizing and maintaining a list of proposed corha projects for consideration providing guidance on policy legal and financial matters of corha approving new corha processes and all internal and external facing documents bearing the corha logo suggesting vetting and approving member organizations to be voted upon by corha approving four year term renewals for additional member organizations approving federal liaison member organizations approving corha voting representatives and workgroup members approving the creation scope and goals of workgroups providing guidance to corha workgroups committees and other initiatives inviting voting representatives their alternates selected non voting representatives or subject matter experts to corha meetings promoting and representing corha at public events responding to media requests for corha granting permission to persons and organizations who wish to make presentations announcements to or on behalf of corha attending corha meetings and conference calls providing resolution if conflicts arise with member organizations advocating for corha corha workgroups and committees corha workgroups and committees will be formed to address specific short or long term projects as approved by the corha governance committee corha workgroups will be led by a chair and a co chair one of whom should be a current corha voting representative if corha voting representatives do not volunteer to serve in these roles the governance committee will consider an alternate designee individual workgroup members may be identified and recommended by corha voting representatives and the governance committee 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'),(3924,'slug',0,1,''),(3924,'slug',0,2,''),(3924,'title',0,1,' cste large logo scaled e1632844105244 1 4 '),(3924,'title',0,2,' cste large logo scaled e1632844105244 1 4 '),(3925,'field',1,1,''),(3925,'field',11,1,''),(3925,'field',63,1,''),(3925,'slug',0,1,''),(3926,'field',3,1,' corha is led by a governance committee with members from the association of state and territorial health officials astho the council of state and territorial epidemiologists cste the centers for disease control and prevention cdc and the national association of county and city health officials naccho this committee provides strategic direction and oversight to ensure that corhas initiatives align with national public health priorities and effectively address the challenges of healthcare associated infections and antibiotic resistance additional corha member organizations include the association for professionals in infection control and epidemiology apic which brings frontline expertise in infection prevention and control the society for healthcare epidemiology of america shea which contributes advanced knowledge in healthcare epidemiology the centers for medicare and medicaid services cms which oversees healthcare quality and regulatory standards the u s food and drug administration fda which ensures the safety and efficacy of medical products and the association of public health laboratories aphl which provides critical laboratory expertise and capabilities for outbreak detection and response we extend our heartfelt thanks to our member organizations for their invaluable contributions and unwavering commitment to advancing public health and improving practices and policies to improve outbreak response efforts '),(3926,'slug',0,1,' temp luzbntaqpmuffoqvwgswdnxyyofczrqykdox 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'),(4078,'title',0,1,''),(4120,'field',98,1,' strategies for crusted scabies outbreaks in institutional settings health departments public health strategies specific to outbreaks of crusted scabies '),(4120,'slug',0,1,''),(4121,'field',99,1,' health departments '),(4121,'field',100,1,''),(4121,'field',101,1,' public health strategies specific to outbreaks of crusted scabies '),(4121,'field',104,1,' strategies for crusted scabies outbreaks in institutional settings '),(4121,'slug',0,1,' temp chdeihwanfclanyvojlhgvgrghapfvatzoas '),(4121,'title',0,1,''),(4677,'slug',0,1,' overview '),(4677,'title',0,1,' 1 overview '),(4678,'field',46,1,' overview '),(4678,'field',47,1,' learn about key terms including hai ar outbreak and response and get a high level view of corhas principles practices '),(4678,'slug',0,1,' temp gucwfboqwxyayoootzkdyygjckxtmkqixsiw '),(4678,'title',0,1,''),(4692,'slug',0,1,' temp vfaviaohqeywxrohkvmhyhqdmyjylsmcunrx '),(4692,'title',0,1,''),(4693,'slug',0,1,' temp anpmslktaamiyuasjvkwpibcdgffwzbhlwdi '),(4693,'title',0,1,''),(4975,'field',1,1,''),(4975,'field',11,1,''),(4975,'field',63,1,''),(4975,'slug',0,1,''),(4976,'field',3,1,' chapter summary this chapter introduces healthcare outbreak response and provides an outline of corhas principles practices in its entirety while the primary audience for the corha principles practices consists of public health agency personnel the information presented here can also be useful to healthcare professionals and other partners involved in healthcare outbreak response the field of healthcare epidemiology has expanded tremendously during the last few decades an extensive network of healthcare and public health professionals has begun working collaboratively to decrease healthcare associated infections hais and antimicrobial resistance ar one part of this partnership is rapid and efficient outbreak responses to prevent and halt the transmission of pathogens or spread of disease the term hai ar outbreak includes outbreaks involving infections that meet the definition of an hai as well as infections or colonizations with organisms typically associated with the receipt of healthcare including pathogens demonstrating resistance to antimicrobial treatment ar pathogens the term outbreak response or simply response refers to efforts made to assist with assessment and investigation of specific acute hai ar risks the types of hazards addressed by healthcare outbreak response include overt outbreaks clusters of infections sentinel cases e g an uncommon hai or emerging ar threat or serious breaches in infection control practice please consult chapter 1 for additional information including an expanded table of contents with detailed outlines of the topics covered in each chapter and section '),(4976,'slug',0,1,' temp ujxycslsgbcaghabuwdjdgythvbvfhcbbgbf '),(4976,'title',0,1,''),(4977,'field',1,1,''),(4977,'field',11,1,''),(4977,'field',63,1,' what individual roles should the outbreak response team consist of and what are their responsibilities since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what equipment supplies documents toolkits and other resources should a response team have since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(4977,'slug',0,1,''),(4978,'field',3,1,' introduction '),(4978,'slug',0,1,''),(4978,'title',0,1,''),(4979,'field',64,1,' what are the general roles and responsibilities of various agencies during an outbreak '),(4979,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(4979,'slug',0,1,' temp cgwjitblvvhtzzcyuiyiulvsqetcueaspqoh '),(4979,'title',0,1,''),(4980,'field',64,1,' what individual roles should the outbreak response team consist of and what are their responsibilities '),(4980,'field',65,1,' since states organize their governmental public health systems in 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responsibility may rest primarily with the local health department '),(4986,'slug',0,1,' temp riinprsoxjxnleyrqzluunjzsgjyqrojoxnq '),(4986,'title',0,1,''),(4987,'field',64,1,' what is an incident command center '),(4987,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(4987,'slug',0,1,' temp hwncnaajahvszwzgfobvawkpxceqlbjfbmwd '),(4987,'title',0,1,''),(5588,'field',1,1,''),(5588,'field',11,1,''),(5588,'field',63,1,''),(5588,'slug',0,1,''),(5589,'field',3,1,' additional topics '),(5589,'slug',0,1,' temp npqmykzveegxqvjcdswlxgscmdfcuguxdbhq '),(5589,'title',0,1,''),(5590,'field',64,1,' what other legal ethical or privacy concerns should be considered '),(5590,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(5590,'slug',0,1,' temp ahmkdnpibqsvrenqkizczplppsiojybijuam '),(5590,'title',0,1,''),(5591,'field',64,1,' how can an outbreak response team plan for recovery and follow up '),(5591,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(5591,'slug',0,1,' temp vzeocmsdgdzkbridnfnqzijshjoihuhnnizv '),(5591,'title',0,1,''),(5592,'field',1,1,''),(5592,'field',11,1,''),(5592,'field',63,1,''),(5592,'slug',0,1,''),(5593,'field',3,1,' as advances occur in outbreak protocols this guidance document will be updated previous changes can be tracked below 2nd edition published june 2024 1st edition published october 2022 urls in the document are valid as of may 31 2024 '),(5593,'slug',0,1,' temp zyvdrlbtqetfxhlqcukncmrshnzkzvmzocda '),(5593,'title',0,1,''),(5594,'field',1,1,''),(5594,'field',11,1,''),(5594,'field',63,1,''),(5594,'slug',0,1,''),(5595,'slug',0,1,''),(5596,'field',1,1,''),(5596,'field',11,1,''),(5596,'field',63,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem 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in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor september 05 2022 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor february 19 2022 '),(5596,'slug',0,1,''),(5597,'field',3,1,' previous changes '),(5597,'slug',0,1,''),(5597,'title',0,1,''),(5598,'field',64,1,' december 10 2023 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outbreak detection and response as healthcare associated infection and antimicrobial resistance hai ar surveillance improves and outbreaks are recognized earlier the public health and healthcare communities are better positioned to reduce patient harm from hais ar pathogens and healthcare outbreaks the ultimate goal of healthcare outbreak response is to rapidly detect and respond to potential outbreaks ensuring that any unsafe practices are discovered and corrected before further harm can occur the chapter contains information on healthcare settings investigators may encounter as part of an hai ar outbreak response changes to healthcare delivery regulations funding and public health capacity over time that have impacted hai ar surveillance practices and outbreak response activities trends in surveillance including descriptions of systems used to identify potential outbreaks as well as types of outbreaks and other events to which public health routinely responds '),(9063,'slug',0,1,' 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decentralized home rule states this responsibility may rest primarily with the local health department what individual roles should the outbreak response team consist of and what are their responsibilities since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what equipment supplies documents toolkits and other resources should a response team have '),(9064,'slug',0,1,''),(9065,'field',3,1,' introduction '),(9065,'slug',0,1,''),(9065,'title',0,1,''),(9066,'field',64,1,' what are the general roles and responsibilities of various agencies during an outbreak '),(9066,'field',65,1,' since states organize their 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states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what is an incident command center since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9069,'slug',0,1,''),(9070,'field',3,1,' protocol responsibilities '),(9070,'slug',0,1,''),(9070,'title',0,1,''),(9071,'field',64,1,' what communication needs should an outbreak response team be prepared for '),(9071,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9071,'slug',0,1,' temp wwuzwabkhvorcsjufvnkxszoatptxljtxtxt '),(9071,'title',0,1,''),(9072,'field',64,1,' how should an outbreak response team manage their records '),(9072,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9072,'slug',0,1,' temp rxkghzlplhxxolygneaqhcszcspjtdosahqw '),(9072,'title',0,1,''),(9073,'field',64,1,' when should an outbreak response team ask for help and who can provide it '),(9073,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9073,'slug',0,1,''),(9073,'title',0,1,''),(9074,'field',64,1,' what is an incident command center '),(9074,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9074,'slug',0,1,''),(9074,'title',0,1,''),(9075,'field',1,1,''),(9075,'field',11,1,''),(9075,'field',63,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what other legal ethical or privacy concerns should be considered since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department how can an outbreak response team plan for recovery and follow up '),(9075,'slug',0,1,''),(9076,'field',3,1,' additional topics '),(9076,'slug',0,1,''),(9076,'title',0,1,''),(9077,'field',64,1,' what other legal ethical or privacy concerns should be considered '),(9077,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9077,'slug',0,1,''),(9077,'title',0,1,''),(9078,'field',64,1,' how can an outbreak response team plan for recovery and follow up '),(9078,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9078,'slug',0,1,''),(9078,'title',0,1,''),(9079,'field',1,1,''),(9079,'field',11,1,''),(9079,'field',63,1,''),(9079,'slug',0,1,''),(9080,'field',3,1,' as advances occur in outbreak protocols this guidance document will be updated previous changes can be tracked below 2nd edition published june 2024 1st edition published october 2022 urls in this document are valid as of april 29 2024 '),(9080,'slug',0,1,' temp xolszmsyzjbyrhayzgedgrzvaflbdemscyru '),(9080,'title',0,1,''),(9081,'field',1,1,''),(9081,'field',11,1,''),(9081,'field',63,1,''),(9081,'slug',0,1,''),(9082,'field',3,1,' january 5 2024 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9082,'slug',0,1,''),(9082,'title',0,1,''),(9083,'field',1,1,''),(9083,'field',11,1,''),(9083,'field',63,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor december 10 2023 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor april 23 2023 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor september 05 2022 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor february 19 2022 '),(9083,'slug',0,1,''),(9084,'field',3,1,' previous changes '),(9084,'slug',0,1,''),(9084,'title',0,1,''),(9085,'field',64,1,' december 10 2023 '),(9085,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9085,'slug',0,1,''),(9085,'title',0,1,''),(9086,'field',64,1,' april 23 2023 '),(9086,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9086,'slug',0,1,''),(9086,'title',0,1,''),(9087,'field',64,1,' september 05 2022 '),(9087,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9087,'slug',0,1,''),(9087,'title',0,1,''),(9088,'field',64,1,' february 19 2022 '),(9088,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9088,'slug',0,1,''),(9088,'title',0,1,''),(9089,'field',1,1,''),(9089,'field',11,1,''),(9089,'field',63,1,''),(9089,'slug',0,1,''),(9090,'field',3,1,' centers for disease control and prevention cdc hai data https www cdc gov hai data index html siegel jd rinehart e jackson m chiarello l healthcare infection control practices advisory committee 2007 guideline for isolation precautions preventing transmission of infectious agents in healthcare settings 2007 last update july 2019 https www cdc gov infectioncontrol guidelines isolation index html christensen be fagan rp healthcare settings in rasmussen sa goodman ra eds the cdc field epidemiology manual us department of health and human services centers for disease control and prevention cdc 2018 chap 18 https www cdc gov eis field epimanual chapters healthcare settings html centers for disease control and prevention cdc antibiotic antimicrobial resistance ar amr about antimicrobial resistance https www cdc gov drugresistance about html currie k melone l stewart s et al understanding the patient experience of health care associated infection a qualitative systematic review am j infect control 2018 46 8 936 942 doi 10 1016 j ajic 2017 11 023 national quality forum nqf glossary of terms www qualityforum org measuring performance submitting standards nqf glossary aspx centers for medicare and medicaid services cms quality safety oversight certification compliance https www cms gov medicare provider enrollment andcertification certificationandcomplianc centers for medicare and medicaid services cms glossary https www medicare gov glossary mcdermott kw elixhauser a sun r trends in hospital inpatient stays in the united states 2005 2014 agency for healthcare research and quality cost and utilization project hcup statistical brief 225 https www hcup us ahrq gov reports statbriefs sb225 inpatient usstaystrends jsp utm source=ahrqutm medium=en1utm term=utm content=1utm campaign=ahrq en7 18 2017 kc a schaefer mk stone nd perz j characterizing healthcare delivery in the united states using census bureaus county business patterns 2000 2016 infect control hosp epidemiol 2020 41 6 723 728 doi 10 1017 ice 2020 78 dentler j outpatient migration 6 trends and developments beckers hospital review 2018 may 21 https www beckershospitalreview com hospital management administration outpatientmigration 6 trends and developments html centers for disease control and prevention cdc yellow book 2020 health information for international travel chapter 9 travel for work other reasons https wwwnc cdc gov travel yellowbook 2020 travel for work other reasons medicaltourism bartles r dickson a babade o a systematic approach to quantifying infection prevention staffing and coverage needs am j infect control 2018 46 5 487 491 doi 10 1016 j ajic 2017 11 006 pogorzelska maziarz m gilmartin h reese s infection prevention staffing and resources in u s acute care hospitals results from the apic megasurvey am j infect control 2018 48 8 852 857 doi 10 1016 j ajic 2018 04 202 centers for medicare and medicaid services cms memo specialized infection prevention and control training for nursing home staff in the long term care setting is now available march 11 2019 https www cms gov medicare provider enrollment andcertification surveycertificationgeninfo policy and memos to states and regionsitems qso19 10 nh langmuir a the surveillance of communicable diseases of national importance n engl j med 1963 268 182 192 doi 10 1056 nejm196301242680405 world health organization who regional office for the eastern mediterranean public health surveillance https www emro who int health topics public health surveillance index html franklin sm crist mb perkins km perz jf outbreak response capacity assessments and improvements among public health department health care associated infection programs united states 2015 2017 j public health manag pract 2022 28 2 116 125 doi 10 1097 phh 0000000000001148 centers for disease control and prevention cdc national healthcare safety network nhsn cms requirements https www cdc gov nhsn cms index html centers for disease control and prevention cdc national notifiable diseases surveillance system nndss surveillance case definitions for current and historical conditions https ndc services cdc gov centers for disease control and prevention cdc national antimicrobial resistance monitoring system for enteric bacteria narms https www cdc gov narms index html centers for disease control and prevention cdc lab capacity in action to fight antibiotic resistance https www cdc gov drugresistance solutions initiative ar lab network html emori tg culver dh horan tc et al national nosocomial infections surveillance system nnis description of surveillance methods am j infect control 1991 19 1 19 35 doi 10 1016 0196 6553 91 90157 8 edwards jr peterson kd mu y et al national healthcare safety network nhsn report data summary for 2006 through 2008 issued december 2009 am j infect control 2009 37 10 783 805 doi 10 1016 j ajic 2009 10 001 centers for disease control and prevention cdc state based hai prevention activities states with hai reporting mandates https www cdc gov hai state based required to report hainhsn html centers for disease control and prevention cdc current hai progress report 2020 national and state healthcare associated infections progress report https www cdc gov hai data portal progressreport html cdc aa refval=https%3a%2f%2fwww cdc gov%2fhai%2fsurveillance%2fprogres s report%2findex html centers for disease control and prevention cdc national healthcare safety network nhsn about nhsn https www cdc gov nhsn about nhsn index html centers for disease control and prevention cdc antibiotic resistance patient safety portal https www cdc gov hai data portal ar patient safety portal html world health organization who regional office for europe guidance for sentinel influenza surveillance in humans https www euro who int data assets pdf file 0020 90443 e92738 pdf jernigan db kargacin l poole a kobayashi j sentinel surveillance as an alternative approach for monitoring antibiotic resistant invasive pneumococcal disease in washington state am j public health 2001 91 1 142 145 doi 10 2105 ajph 91 1 142 smith ge elliot aj lake i et al syndromic surveillance two decades experience of sustainable systems its people not just data epidemiol infect 2019 147 e101 doi 10 1017 s0950268819000074 centers for medicare medicaid services cms infection control breaches which warrant referral to public health authorities may 30 2014 revised october 28 2016 https www cms gov medicare provider enrollment andcertification surveycertificationgeninfo downloads survey and cert letter 14 36 pdf bagchi s watkins j pollock da edwards jr allen bridson k state health department validations of central line associated bloodstream infection events reported via the national healthcare safety network am j infect control 2018 46 11 1290 1295 doi 10 1016 j ajic 2018 04 233 backman la nobert g melchreit r fekieta r dembry lm validation of the surveillance and reporting of central line associated bloodstream infection denominator data am j infect control 2014 42 1 28 33 doi 10 1016 j ajic 2013 06 014 vannice k benoliel e kauber k notes from the field clinical klebsiella pneumoniae isolate with three carbapenem resistance genes associated with urology procedures ─ king county washington 2018 mmwr morb mortal wkly rep 2019 68 30 667 668 doi 10 15585 mmwr mm6830a4 ross km mehr js carothers bl et al bacterial septic arthritis infections associated with intraarticular injection practices for osteoarthritis knee pain new jersey 2017 infect control hosp epidemiol 2019 40 9 1013 1018 doi 10 1017 ice 2019 168 njuguna hn stinson d montgomery p et al hepatitis c virus potentially transmitted by opioid drug diversion from a nurse washington august 2017 march 2018 mmwr morb mortal wkly rep 2019 68 16 374 376 doi 10 15585 mmwr mm6816a3 perkins km reddy sc fagan r arduino mj perz jf investigation of healthcare infection risks from water related organisms summary of cdc consultations 2014 2017 infect control hosp epidemiol 2019 40 6 621 626 doi 10 1017 ice 2019 60 nanduri sa metcalf bj arwady ma et al prolonged and large outbreak of invasive group a streptococcus disease within a nursing home repeated intrafacility transmission of a single strain clin microbiol infect 2019 25 2 248 e1 248 e7 doi 10 1016 j cmi 2018 04 034 pena sa davis ss lu x et al severe respiratory illness associated with human metapneumovirus in nursing home new mexico usa emerg infect dis 2019 25 2 383 384 doi 10 3201 eid2502 181298 epson ee pisney lm wendt jm et al carbapenem resistant klebsiella pneumoniae producing new delhi metallo v lactamase at an acute care hospital colorado 2012 infect control hosp epidemiol 2014 35 4 390 397 doi 10 1086 675607 david s reuter s harris sr et al epidemic of carbapenem resistant klebsiella pneumoniae in europe is driven by nosocomial spread nature microbiol 2019 4 11 1919 1929 doi 10 1038 s41564 019 0492 8 vallabhaneni s kallen a tsay s et al investigation of the first seven reported cases of candida auris a globally emerging invasive multidrug resistant fungus ─ united states may 2013 august 2016 am j transplant 2017 17 1 296 299 doi 10 1111 ajt 14121 novosad sa lake j nguyen d et al multicenter outbreak of gram negative bloodstream infections in hemodialysis patients am j kidney dis 2019 74 5 610 619 doi 10 1053 j ajkd 2019 05 012 kutty pk forster ts wood koob c et al multistate outbreak of toxic anterior segment syndrome 2005 j cataract refract surg 2008 34 4 585 90 doi 10 1016 j jcrs 2007 11 037 centers for disease control and prevention cdc toxic anterior segment syndrome after cataract surgery ─ maine 2006 mmwr morb mortal wkly rep 2007 56 25 629 630 martone wj williams ww mortensen ml et al illness with fatalities in premature infants association with an intravenous vitamin e preparation e ferol pediatrics 1986 78 4 591 600 burwen dr olsen sm bland la arduino mj reid mh jarvis wr epidemic aluminum intoxication in hemodialysis patients traced to use of an aluminum pump kidney int 1995 48 2 469 74 doi 10 1038 ki 1995 315 pearson ml levine wc finton rj et al anesthesia associated carbon monoxide exposures among surgical patients infect control hosp epidemiol 2001 22 6 352 326 doi 10 1086 501912 oyong k coelho l bancroft e terashita d health care associated infection outbreak investigations in outpatient settings los angeles county california usa 2000 2012 emerg infect dis 2015 21 8 1317 1321 doi 10 3201 eid2108 141251 cheng vcc chen jhk wong scy et al hospital outbreak of pulmonary and cutaneous zygomycosis due to contaminated linen items from substandard laundry clin infect dis 2016 62 6 714 721 doi 10 1093 cid civ1006 alroy preis s daly er adamski c et al large outbreak of hepatitis c virus associated with drug diversion by a healthcare technician clin infect dis 2018 67 6 845 853 doi 10 1093 cid ciy193 kainer ma reagan dr nguyen db et al fungal infections associated with contaminated methylprednisolone in tennessee n engl j med 2012 367 23 2194 2203 doi 10 1056 nejmoa1212972 mikosz ca smith rm kim m et al fungal endophthalmitis associated with compounded products emerg infect dis 2014 20 2 248 256 doi 10 3201 eid2002 131257 lyman mm grigg c kinsey cb et al invasive nontuberculous mycobacterial infections among cardiothoracic surgical patients exposed to heater cooler devices emerg infect dis 2017 23 5 796 805 doi 10 3201 eid2305 161899 van ingen j kohl ta kranzer k et al global outbreak of severe mycobacterium chimaera disease after cardiac surgery a molecular epidemiological study lancet infect dis 2017 17 10 1033 1041 doi 10 1016 s1473 3099 17 30324 9 kracalik i ham c smith ar et al notes from the field verona integron encoded metallo betalactamase producing carbapenem resistant pseudomonas aeruginosa infections in u s residents associated with invasive medical procedures in mexico 2015 2018 mmwr morb mortal wkly rep 2019 68 20 463 464 doi 10 15585 mmwr mm6820a4 '),(9090,'slug',0,1,' temp savwcesdclygunxiwansxqcmypmtjyfemarz '),(9090,'title',0,1,''),(9146,'slug',0,1,' planning preparation '),(9146,'title',0,1,' 3 planning preparation '),(9147,'field',46,1,' planning preparation '),(9147,'field',47,1,' learn about agency roles team structures and tips for organizing managing and optimizing response activities '),(9147,'slug',0,1,' temp rgjfcjgivkkfbvvdjojwocgwobjbrpshscrg '),(9147,'title',0,1,''),(9148,'field',58,1,' also useful for epidemiologists '),(9148,'field',59,1,' for infection prevention specialists '),(9148,'slug',0,1,' temp hiqyilxtiufxlzedeiuqqwpmxtkjvrjpvcmr '),(9148,'title',0,1,''),(9149,'field',58,1,' also useful for associated specialists '),(9149,'field',59,1,' for health departments healthcare facilities '),(9149,'slug',0,1,' temp hgsmjiaajpbjjjexbbzorpnoemhuwvxfbcfy '),(9149,'title',0,1,''),(9150,'slug',0,1,' temp jpsylhdduysopiyoewwdhrjloulnnqktmyaa '),(9150,'title',0,1,''),(9151,'slug',0,1,' temp aaiguvstvispuzkxhsmzpkqyapyozrtgjkou '),(9151,'title',0,1,''),(9152,'slug',0,1,' temp brinvavemdsrsdynftjogjrporrneuuavemh '),(9152,'title',0,1,''),(9154,'field',1,1,''),(9154,'field',11,1,''),(9154,'field',63,1,''),(9154,'slug',0,1,''),(9155,'field',3,1,' chapter summary preparations made ahead of a healthcare associated infection hai or antimicrobial resistant ar pathogen outbreak lay the groundwork for actions taken during the outbreak response in chapter 3 planning preparation we lay out the roles resources processes and relationships that should be in place prior to initiating an outbreak response example activities include developing the capacity to rapidly collect and analyze large amounts of information taking rapid action to stop transmission and communicating effectively with stakeholders background information on agencies and partners that may be involved in an outbreak response is provided and their respective roles and responsibilities are described including considerations for a coordinating agency and the composition of outbreak response teams other topics include planning and preparation for resource identification and record management communication considerations understanding legal authorities and preparation for escalation recovery and follow up including potential implementation of an incident command system '),(9155,'slug',0,1,' temp avwhucxnbobrkmplolixiifvkvacrxgcsmza '),(9155,'title',0,1,''),(9156,'field',1,1,''),(9156,'field',11,1,''),(9156,'field',63,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what are the general roles and responsibilities of various agencies during an outbreak since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what individual roles should the outbreak response team consist of and what are their responsibilities since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what equipment supplies documents toolkits and other resources should a response team have '),(9156,'slug',0,1,''),(9157,'field',3,1,' introduction '),(9157,'slug',0,1,''),(9157,'title',0,1,''),(9158,'field',64,1,' what are the general roles and responsibilities of various agencies during an outbreak '),(9158,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9158,'slug',0,1,''),(9158,'title',0,1,''),(9159,'field',64,1,' what individual roles should the outbreak response team consist of and what are their responsibilities '),(9159,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9159,'slug',0,1,''),(9159,'title',0,1,''),(9160,'field',64,1,' what equipment supplies documents toolkits and other resources should a response team have '),(9160,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9160,'slug',0,1,''),(9160,'title',0,1,''),(9161,'field',1,1,''),(9161,'field',11,1,''),(9161,'field',63,1,''),(9161,'slug',0,1,''),(9162,'field',3,1,' protocol responsibilities '),(9162,'slug',0,1,' temp lahbtxkdvkpsdicthtgjkbxmwnksksituivu '),(9162,'title',0,1,''),(9163,'field',64,1,' what communication needs should an outbreak response team be prepared for '),(9163,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9163,'slug',0,1,' temp qylxmohulsquqoydhxiokmfggqijscjamoez '),(9163,'title',0,1,''),(9164,'field',64,1,' how should an outbreak response team manage their records '),(9164,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9164,'slug',0,1,' temp kurrklwaaarzvypjarbbnvwesygekzifyohd '),(9164,'title',0,1,''),(9165,'field',64,1,' when should an outbreak response team ask for help and who can provide it '),(9165,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9165,'slug',0,1,' temp czbyfykgrogzrmzdhwfobjiljkyxrislgqye '),(9165,'title',0,1,''),(9166,'field',64,1,' what is an incident command center '),(9166,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9166,'slug',0,1,' temp jjfacvrtxosxnasnxfwesdpqofkxsbobkbgq '),(9166,'title',0,1,''),(9167,'field',1,1,''),(9167,'field',11,1,''),(9167,'field',63,1,''),(9167,'slug',0,1,''),(9168,'field',3,1,' additional topics '),(9168,'slug',0,1,''),(9168,'title',0,1,''),(9169,'field',64,1,' what other legal ethical or privacy concerns should be considered '),(9169,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9169,'slug',0,1,' temp nqyitjcpsferiahxlperjgejzwfhqrgqnrrl '),(9169,'title',0,1,''),(9170,'field',64,1,' how can an outbreak response team plan for recovery and follow up '),(9170,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9170,'slug',0,1,' temp kzhvbgnevcdsatvsqkauqjaymkaytupemqcr '),(9170,'title',0,1,''),(9171,'field',1,1,''),(9171,'field',11,1,''),(9171,'field',63,1,''),(9171,'slug',0,1,''),(9172,'field',3,1,' as advances occur in outbreak protocols this guidance document will be updated previous changes can be tracked below 2nd edition published june 2024 1st edition published october 2022 urls in this document are valid as of april 29 2024 '),(9172,'slug',0,1,' temp hunguguacjbklrykexrwkypehaxvdvostgil '),(9172,'title',0,1,''),(9173,'field',1,1,''),(9173,'field',11,1,''),(9173,'field',63,1,''),(9173,'slug',0,1,''),(9174,'field',3,1,' january 5 2024 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9174,'slug',0,1,''),(9174,'title',0,1,''),(9175,'field',1,1,''),(9175,'field',11,1,''),(9175,'field',63,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor december 10 2023 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor april 23 2023 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor september 05 2022 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor february 19 2022 '),(9175,'slug',0,1,''),(9176,'field',3,1,' previous changes '),(9176,'slug',0,1,''),(9176,'title',0,1,''),(9177,'field',64,1,' december 10 2023 '),(9177,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9177,'slug',0,1,''),(9177,'title',0,1,''),(9178,'field',64,1,' april 23 2023 '),(9178,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9178,'slug',0,1,''),(9178,'title',0,1,''),(9179,'field',64,1,' september 05 2022 '),(9179,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9179,'slug',0,1,''),(9179,'title',0,1,''),(9180,'field',64,1,' february 19 2022 '),(9180,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9180,'slug',0,1,''),(9180,'title',0,1,''),(9181,'field',1,1,''),(9181,'field',11,1,''),(9181,'field',63,1,''),(9181,'slug',0,1,''),(9182,'field',3,1,' centers for disease control and prevention cdc public health professionals gateway healthdepartment governance https www cdc gov publichealthgateway sitesgovernance index html centers for disease control and prevention cdc state based hai prevention activities https www cdc gov hai state based index html franklin sm crist mb perkins km perz jf outbreak response capacity assessments and improvements among public health department health care associated infection programs united states 2015 2017 j public health manag pract 2020 2022 28 2 116 125 doi 10 1097 phh 0000000000001148 centers for disease control and prevention cdc epidemic intelligence service urgent assistance epi aids https www cdc gov eis request services epiaids html u s food drug administration information sharing https www fda gov federal state localtribal and territorial officials communications outreach information sharing holt jd ghosh sn black jr legal considerations in rasmussen sa goodman ra eds the cdc field epidemiology manual us department of health and human services centers for disease control and prevention cdc 2018 chap 13 https www cdc gov eis field epimanual chapters legal html california hospital association emergency preparedness drills and exercises https www calhospitalprepare org exercises centers for disease control and prevention cdc healthcare associated infections hais infection control assessment tools https www cdc gov hai prevent infection controlassessment tools html centers for disease control and prevention cdc quick observation tools quots for infection prevention https www cdc gov infectioncontrol tools quots html heymann dl ed control of communicable diseases manual 20th ed apha press 2015 centers for medicare and medicaid services cms emergency preparedness rule https www cms gov medicare provider enrollment andcertification surveycertemergprep emergency prep rule html christensen be fagan rp healthcare settings in rasmussen sa goodman ra eds the cdc field epidemiology manual us department of health and human services centers for disease control and prevention cdc 2018 chap 18 https www cdc gov eis field epimanual chapters healthcare settings html centers for disease control and prevention cdc outpatient settings policy options for improving infection prevention october 2015 https www cdc gov hai pdfs prevent outpatient settings policy options pdf us department of health human services hhs public health 45 cfr 164 512 b https www hhs gov hipaa for professionals special topics public health index html us department of health human services hhs summary of the hipaa privacy rule https www hhs gov hipaa for professionals privacy laws regulations index html '),(9182,'slug',0,1,' temp eekhhbrqlppsbwneworqfzepgvclxcxmmcjw '),(9182,'title',0,1,''),(9266,'slug',0,1,' outbreak detection reporting '),(9266,'title',0,1,' 4 detection reporting '),(9267,'field',46,1,' outbreak detection reporting '),(9267,'field',47,1,' learn how potential outbreaks are identified and get practical advice for improving detection and reporting '),(9267,'slug',0,1,' temp sbffsqdgxhoiqpfnkwlvaejfemjerfdbucfy '),(9267,'title',0,1,''),(9268,'field',58,1,' also useful for epidemiologists '),(9268,'field',59,1,' for infection prevention specialists '),(9268,'slug',0,1,' temp veigxaeeaunmjzmmdszwqbvriyscwqybsosi '),(9268,'title',0,1,''),(9269,'field',58,1,' also useful for associated specialists '),(9269,'field',59,1,' for health departments healthcare facilities '),(9269,'slug',0,1,' temp mneazqsuizqbjlgxkrvlwgqpsgjyoacovuyp '),(9269,'title',0,1,''),(9270,'slug',0,1,' temp outrsyditlzibngravyvcffxfjaizofflofv '),(9270,'title',0,1,''),(9271,'slug',0,1,' temp pkbeddfzuapjyzuwppbxcbdstatuvfkxcxzo '),(9271,'title',0,1,''),(9272,'slug',0,1,' temp caexalvkglrdbsiwjwopyklapwykzzqnxpko '),(9272,'title',0,1,''),(9274,'field',1,1,''),(9274,'field',11,1,''),(9274,'field',63,1,''),(9274,'slug',0,1,''),(9275,'field',3,1,' chapter summary detection and reporting provide the foundation for a healthcare outbreak response triggering activities aimed at assessing the situation implementing control measures and halting disease transmission in chapter 4 outbreak detection reporting we examine the two primary pathways for recognizing potential outbreaks detection via reports and through use of surveillance data definitions of sentinel cases clusters and outbreaks are described the section on direct reporting of outbreaks includes information on reporting within a healthcare facility and reporting to public health entities that can report to public health and types of events that may be reported this is followed by an overview of the use of routine surveillance systems for cluster and outbreak detection strengths and limitations key determinants of successful detection and model practices are described for both types of detection methods health departments can improve outbreak detection by regularly communicating reporting mechanisms and expectations to hospitals long term care facilities and other provider types consider establishing thresholds for reporting that are specific to commonly encountered conditions the chapter concludes with some considerations for detecting and reporting multifacility and multijurisdictional outbreaks a topic that is unpacked further in supplement b infection control breach investigations '),(9275,'slug',0,1,' temp ejlhymvsiwfdbdpybzmlypzagwmjdzrlyawl '),(9275,'title',0,1,''),(9276,'field',1,1,''),(9276,'field',11,1,''),(9276,'field',63,1,''),(9276,'slug',0,1,''),(9277,'field',3,1,' introduction '),(9277,'slug',0,1,' temp rwcpulmtqkanqtwfdadluhnrlzsdvyhufatw '),(9277,'title',0,1,''),(9278,'field',64,1,' what are the general roles and responsibilities of various agencies during an outbreak '),(9278,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9278,'slug',0,1,' temp rteyjnnetsftylvrbumbomiofjghvyqoojyl '),(9278,'title',0,1,''),(9279,'field',64,1,' what individual roles should the outbreak response team consist of and what are their responsibilities '),(9279,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9279,'slug',0,1,' temp ahlaaeovjpiylovqvnscapcugodgjgmpjpsq '),(9279,'title',0,1,''),(9280,'field',64,1,' what equipment supplies documents toolkits and other resources should a response team have '),(9280,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9280,'slug',0,1,' temp neroecvbllofmkxhtkvpiiegqplqwqsqexpu '),(9280,'title',0,1,''),(9281,'field',1,1,''),(9281,'field',11,1,''),(9281,'field',63,1,''),(9281,'slug',0,1,''),(9282,'field',3,1,' protocol responsibilities '),(9282,'slug',0,1,' temp fwfurikgnszpuueikrwdxsxwjyizmostbzan '),(9282,'title',0,1,''),(9283,'field',64,1,' what communication needs should an outbreak response team be prepared for '),(9283,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9283,'slug',0,1,' temp yjhcldiyrhanheohvffzpjdoviwmayzjsxlx '),(9283,'title',0,1,''),(9284,'field',64,1,' how should an outbreak response team manage their records '),(9284,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9284,'slug',0,1,' temp owuufucsyboncyvjplacgewtlsztwmiysjte '),(9284,'title',0,1,''),(9285,'field',64,1,' when should an outbreak response team ask for help and who can provide it '),(9285,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9285,'slug',0,1,' temp rhzilzzxdufqexlegfjlrkhloodbdzahktdx '),(9285,'title',0,1,''),(9286,'field',64,1,' what is an incident command center '),(9286,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9286,'slug',0,1,' temp ylbruchfcdinsavzzmfsjqmpimhiclgkvolt '),(9286,'title',0,1,''),(9287,'field',1,1,''),(9287,'field',11,1,''),(9287,'field',63,1,''),(9287,'slug',0,1,''),(9288,'field',3,1,' additional topics '),(9288,'slug',0,1,' temp glaveuofdqpdplbvvvsppzdynoxsfscjuqrj '),(9288,'title',0,1,''),(9289,'field',64,1,' what other legal ethical or privacy concerns should be considered '),(9289,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9289,'slug',0,1,' temp vnttrbrcjtovykcnqwjplvxnyggwczihzbeu '),(9289,'title',0,1,''),(9290,'field',64,1,' how can an outbreak response team plan for recovery and follow up '),(9290,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9290,'slug',0,1,' temp htszhidwgsvlntjgpzaluizkqqilhytjmzfy '),(9290,'title',0,1,''),(9291,'field',1,1,''),(9291,'field',11,1,''),(9291,'field',63,1,''),(9291,'slug',0,1,''),(9292,'field',3,1,' as advances occur in outbreak protocols this guidance document will be updated previous changes can be tracked below 2nd edition published june 2024 1st edition published october 2022 urls in this document are valid as of april 30 2024 '),(9292,'slug',0,1,' temp pudrwknbpsrwauqnsebmaqrzcllkjxranhqo '),(9292,'title',0,1,''),(9293,'field',1,1,''),(9293,'field',11,1,''),(9293,'field',63,1,''),(9293,'slug',0,1,''),(9294,'field',3,1,' january 5 2024 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9294,'slug',0,1,''),(9294,'title',0,1,''),(9295,'field',1,1,''),(9295,'field',11,1,''),(9295,'field',63,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor december 10 2023 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor april 23 2023 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor september 05 2022 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor february 19 2022 '),(9295,'slug',0,1,''),(9296,'field',3,1,' previous changes '),(9296,'slug',0,1,''),(9296,'title',0,1,''),(9297,'field',64,1,' december 10 2023 '),(9297,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9297,'slug',0,1,''),(9297,'title',0,1,''),(9298,'field',64,1,' april 23 2023 '),(9298,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9298,'slug',0,1,''),(9298,'title',0,1,''),(9299,'field',64,1,' september 05 2022 '),(9299,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9299,'slug',0,1,''),(9299,'title',0,1,''),(9300,'field',64,1,' february 19 2022 '),(9300,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9300,'slug',0,1,''),(9300,'title',0,1,''),(9301,'field',1,1,''),(9301,'field',11,1,''),(9301,'field',63,1,''),(9301,'slug',0,1,''),(9302,'field',3,1,' centers for medicare and medicaid services cms center for clinical standards and quality survey certification group infection control breaches which warrant referral to public health authorities may 30 2014 revised october 28 2016 https www cms gov medicare provider enrollment andcertification surveycertificationgeninfo downloads survey and cert letter 14 36 pdf christenson be fagan rp healthcare settings in rasmussen sa goodman ra eds the cdc field epidemiology manual us department of health and human services centers for disease control and prevention cdc 2018 chap 18 https www cdc gov eis field epimanual chapters healthcare settings html centers for disease control and prevention cdc principles of epidemiology in public health practice an introduction to applied epidemiology and biostatistics 3rd edition october 2006 https www cdc gov csels dsepd ss1978 index html lyman mm grigg c kinsey cb et al invasive nontuberculous mycobacterial infections among cardiothoracic surgical patients exposed to heater cooler devices emerg infect dis 2017 23 5 796 805 doi 10 3201 eid2305 161899 navon l clegg wj morgan j et al notes from the field investigation of elizabethkingia anophelis cluster illinois 2014 2016 mmwr morb mortal wkly rep 2016 65 48 1380 1381 doi 10 15585 mmwr mm6548a6 kainer ma reagan dr nguyen db et al fungal infections associated with contaminated methylprednisolone in tennessee n engl j med 2012 367 23 2194 2203 doi 10 1056 nejmoa1212972 franklin sm crist mb perkins km perz jf outbreak response capacity assessments and improvements among public health department health care associated infection programs united states 2015 2017 j public health manag pract 2022 28 2 116 125 doi 10 1097 phh 0000000000001148 lee tb montgomery og marx j olmsted rn scheckler we recommended practices for surveillance association for professionals in infection control and epidemiology apic inc am j infect control 2007 35 7 427 440 doi 10 1016 j ajic 2007 07 002 greene lr cain ta khoury r krystofiak sp patrick m streed s apic position paper the importance of surveillance technologies in the prevention of healthcare associated infections hais association for professionals in infection control and epidemiology apic may 29 2009 http www apic org resource tinymcefilemanager advocacypdfs surveillance technologies position paper 2009 5 29 09 pdf natale a stelling j meledandri m messenger la ancona f use of whonet satscan system for simulated real time detection of antimicrobial resistance clusters in a hospital in italy 2012 to 2014 euro surveill 2017 22 11 30484 doi 10 2807 1560 7917 es 2017 22 11 30484 bamberg w kainer m bryan n anderson m assessment of hai ar outbreak detection data tools and barriers poster board 183 presentation at international conference on emerging infectious diseases aug 2018 atlanta georgia https www cdc gov iceid docs iceid 2018 program book p pdf leclere b buckeridge dl boelle p y astagneau p lepelletier d automated detection of hospital outbreaks a systematic review of methods plos one 2017 12 4 e0176438 doi 10 1371 journal pone 0176438 centers for disease control and prevention cdc u s global antimicrobial resistance laboratory networks how to participate lab testing https www cdc gov drugresistance laboratories ar lab network testing details html mikosz ca smith rm kim m tyson c lee eh adams e et al fungal endophthalmitis associated with compounded products emerg infect dis 2014 20 2 248 256 doi 10 3201 eid2002 131257 dolan sa littlehorn c glode mp et al association of bacillus cereus infection with contaminated alcohol prep pads infect control hosp epidemiol 2012 33 7 666 671 doi 10 1086 666334 '),(9302,'slug',0,1,' temp xgecqbyusmbfxftdmrqlywwmlfteykhruvpa '),(9302,'title',0,1,''),(9356,'slug',0,1,' investigation control '),(9356,'title',0,1,' 5 investigation control '),(9357,'field',46,1,' investigation control '),(9357,'field',47,1,' learn about the key steps involved in responding to and stopping hai ar outbreaks '),(9357,'slug',0,1,' temp mehmpepcjrsjyyglqprknrzwwvbsbfmkqopo '),(9357,'title',0,1,''),(9358,'field',58,1,' also useful for epidemiologists '),(9358,'field',59,1,' for infection prevention specialists '),(9358,'slug',0,1,' temp mzcxsdcurlsubaijutjocdsitrgfjndvrfql '),(9358,'title',0,1,''),(9359,'field',58,1,' also useful for associated specialists '),(9359,'field',59,1,' for health departments healthcare facilities '),(9359,'slug',0,1,' temp zrogmjthtetkdijtnjpnutgxghkggvohapus '),(9359,'title',0,1,''),(9360,'slug',0,1,' temp urvafbransuxsslvqnpynqvlbeddwmkqwmlf '),(9360,'title',0,1,''),(9361,'slug',0,1,' temp ulzlttcdjydjzaitdvlvudjehjnekwpeobwu '),(9361,'title',0,1,''),(9362,'slug',0,1,' temp qmhpjtjbiqfmycithzulkzgwcpwrozofywjo '),(9362,'title',0,1,''),(9364,'field',1,1,''),(9364,'field',11,1,''),(9364,'field',63,1,''),(9364,'slug',0,1,''),(9365,'field',3,1,' chapter summary collaboration between public health and healthcare is essential for an effective outbreak response while healthcare settings are responsible for disease prevention and infection control practices on their premises public health officials are generally responsible for ensuring the health and safety of the entire population within their jurisdiction including patients visitors and employees in healthcare settings in chapter 5 investigation control we review the key elements and steps involved in the investigation and control of outbreaks involving hais and ar pathogens during an outbreak investigation a systematic approach is necessary to determine the nature and scope of the problem identify the etiologic agent establish the existence of an outbreak define the population at risk determine risk factors and routes of transmission implement appropriate control measures and develop strategies to prevent future occurrences the chapter is arranged to follow steps typically followed in an outbreak investigation recognizing that such steps may indeed not occur in linear order and will depend on the precise nature and needs of the response the chapter also reviews the goals of a healthcare outbreak investigation and includes collections of resources to support and improve hai ar outbreak response '),(9365,'slug',0,1,' temp iogutgvjxnoaalzsksyfkmqzoaglbzflvpmp '),(9365,'title',0,1,''),(9366,'field',1,1,''),(9366,'field',11,1,''),(9366,'field',63,1,''),(9366,'slug',0,1,''),(9367,'field',3,1,' introduction '),(9367,'slug',0,1,''),(9367,'title',0,1,''),(9368,'field',64,1,' what are the general roles and responsibilities of various agencies during an outbreak '),(9368,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9368,'slug',0,1,' temp pjixmuechuhbbcmjbepanfjnxqxisblqabuq '),(9368,'title',0,1,''),(9369,'field',64,1,' what individual roles should the outbreak response team consist of and what are their responsibilities '),(9369,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9369,'slug',0,1,' temp izyanqymtkdllbpmmrsuqxyafteyhxrtakzr '),(9369,'title',0,1,''),(9370,'field',64,1,' what equipment supplies documents toolkits and other resources should a response team have '),(9370,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9370,'slug',0,1,' temp cwaonrzoglopezwcznavfyndbqkbpupmszwp '),(9370,'title',0,1,''),(9371,'field',1,1,''),(9371,'field',11,1,''),(9371,'field',63,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what communication needs should an outbreak response team be prepared for since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department how should an outbreak response team manage their records since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department when should an outbreak response team ask for help and who can provide it since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what is an incident command center '),(9371,'slug',0,1,''),(9372,'field',3,1,' protocol responsibilities '),(9372,'slug',0,1,''),(9372,'title',0,1,''),(9373,'field',64,1,' what communication needs should an outbreak response team be prepared for '),(9373,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9373,'slug',0,1,''),(9373,'title',0,1,''),(9374,'field',64,1,' how should an outbreak response team manage their records '),(9374,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9374,'slug',0,1,''),(9374,'title',0,1,''),(9375,'field',64,1,' when should an outbreak response team ask for help and who can provide it '),(9375,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9375,'slug',0,1,''),(9375,'title',0,1,''),(9376,'field',64,1,' what is an incident command center '),(9376,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9376,'slug',0,1,''),(9376,'title',0,1,''),(9377,'field',1,1,''),(9377,'field',11,1,''),(9377,'field',63,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what other legal ethical or privacy concerns should be considered since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department how can an outbreak response team plan for recovery and follow up '),(9377,'slug',0,1,''),(9378,'field',3,1,' additional topics '),(9378,'slug',0,1,''),(9378,'title',0,1,''),(9379,'field',64,1,' what other legal ethical or privacy concerns should be considered '),(9379,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9379,'slug',0,1,''),(9379,'title',0,1,''),(9380,'field',64,1,' how can an outbreak response team plan for recovery and follow up '),(9380,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9380,'slug',0,1,''),(9380,'title',0,1,''),(9381,'field',1,1,''),(9381,'field',11,1,''),(9381,'field',63,1,''),(9381,'slug',0,1,''),(9382,'field',3,1,' as advances occur in outbreak protocols this guidance document will be updated previous changes can be tracked below 2nd edition published june 2024 1st edition published october 2022 urls in this document are valid as of may 1 2024 '),(9382,'slug',0,1,' temp pyjhyceldewdqtxzzffxacohpikncvnnocos '),(9382,'title',0,1,''),(9383,'field',1,1,''),(9383,'field',11,1,''),(9383,'field',63,1,''),(9383,'slug',0,1,''),(9384,'field',3,1,' january 5 2024 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9384,'slug',0,1,''),(9384,'title',0,1,''),(9385,'field',1,1,''),(9385,'field',11,1,''),(9385,'field',63,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor december 10 2023 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor april 23 2023 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor september 05 2022 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor february 19 2022 '),(9385,'slug',0,1,''),(9386,'field',3,1,' previous changes '),(9386,'slug',0,1,''),(9386,'title',0,1,''),(9387,'field',64,1,' december 10 2023 '),(9387,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9387,'slug',0,1,''),(9387,'title',0,1,''),(9388,'field',64,1,' april 23 2023 '),(9388,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9388,'slug',0,1,''),(9388,'title',0,1,''),(9389,'field',64,1,' september 05 2022 '),(9389,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9389,'slug',0,1,''),(9389,'title',0,1,''),(9390,'field',64,1,' february 19 2022 '),(9390,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9390,'slug',0,1,''),(9390,'title',0,1,''),(9391,'field',1,1,''),(9391,'field',11,1,''),(9391,'field',63,1,''),(9391,'slug',0,1,''),(9392,'field',3,1,' franklin sm crist mb perkins km perz jf outbreak response capacity assessments and improvements among public health department health care associated infection programs united states 2015 2017 j public health manag pract 2022 28 2 116 125 doi 10 1097 phh 0000000000001148 christensen be fagan rp healthcare settings in rasmussen sa goodman ra eds the cdc field epidemiology manual us department of health and human services centers for disease control and prevention cdc 2018 chap 18 https www cdc gov eis field epimanual chapters healthcare settings html lyman mm grigg c bicking kinsey c et al invasive nontuberculous mycobacterial infections among cardiothoracic surgical patients exposed to heater cooler devices emerg infect dis 2017 23 5 796 805 doi 10 3201 eid2305 161899 centers for disease control and prevention cdc healthcare associated infections hais contaminated heater cooler devices http www cdc gov hai outbreaks heater cooler html banach db johnston bl al zubeidi d et al outbreak response and incident management shea guidance and resources for healthcare epidemiologists in united states acute care hospitals infect control hosp epidemiol 2017 38 12 1393 1419 doi 10 1017 ice 2017 212 centers for disease control and prevention cdc epidemic intelligence service urgent assistance epi aids available at http www cdc gov eis request services epiaids html ostrowsky be weil lm olaisen rh et al real time virtual infection prevention and control assessments in skilled nursing homes new york march 2020 a pilot project infect control hosp epidemiol 2022 43 3 351 357 doi 10 1017 ice 2021 100 centers for disease control and prevention cdc tap water quality and infrastructure discussion guide for investigation of potential water associated infections in healthcare facilities https www cdc gov hai pdfs water quality discussion guide p pdf centers for disease control and prevention cdc targeted environmental investigation checklist for outbreaks of invasive infections caused by environmental fungi i e aspergillus mucormycetes https www cdc gov fungal pdf targeted environmental investigationchecklist 508 pdf '),(9392,'slug',0,1,' temp cgllxxdqhrltfzebkyffaruqvaxocakfshjr '),(9392,'title',0,1,''),(9434,'slug',0,1,' laboratory best practices '),(9434,'title',0,1,' 6 laboratory best practices '),(9435,'field',46,1,' laboratory best practices '),(9435,'field',47,1,' learn how laboratory partners contribute to healthcare outbreak response providing key information to help initiate and guide investigations '),(9435,'slug',0,1,' temp ggyfxiqvqoprkyfmzlvrexqibphlwhgsiqwg '),(9435,'title',0,1,''),(9436,'field',58,1,' also useful for epidemiologists '),(9436,'field',59,1,' for infection prevention specialists '),(9436,'slug',0,1,' temp cyxxkhgwehnkndsenhqeeoiebnscxvfsxezi '),(9436,'title',0,1,''),(9437,'field',58,1,' also useful for associated specialists '),(9437,'field',59,1,' for health departments healthcare facilities '),(9437,'slug',0,1,' temp lisqvxrsyksdhinmuhbfjohtrsjfkpfafvfn '),(9437,'title',0,1,''),(9438,'slug',0,1,' temp pzphsoafjjfmbcikydrqpvyfjmpvlrihzicn '),(9438,'title',0,1,''),(9439,'slug',0,1,' temp cbkkjecasdaeumsleftbhuqabkfqmrwbuhvt '),(9439,'title',0,1,''),(9440,'slug',0,1,' temp ujedsbprmqhskqewryguhjmigoncyejwhexj '),(9440,'title',0,1,''),(9442,'field',1,1,''),(9442,'field',11,1,''),(9442,'field',63,1,''),(9442,'slug',0,1,''),(9443,'field',3,1,' chapter summary technological advances and increased interconnectivity among laboratory partners are helping generate data to detect and respond to outbreaks more quickly and more effectively in chapter 6 laboratory best practices we expand on the basic concepts presented in previous chapters to highlight the roles and contributions of laboratory partners this chapter further develops concepts explanations and processes while adding examples and emphasizing best practices this chapter begins with an overview of the various types of laboratories and their roles public health laboratories are well positioned for the early recognition of sentinel cases those involving unusual pathogens or resistance patterns or clusters of related illness many aspects of healthcare outbreak response benefit from active collaboration and coordination between public health laboratories and other types of laboratories public health agencies and healthcare partners the chapter continues with descriptions of laboratory functions that support outbreak response and the importance of reliable and clearly communicated data specific to laboratorians we also address safety practices to be followed when working with ar pathogens and the validation of ar and hai test methods '),(9443,'slug',0,1,' temp iecllgqrnjtviqqybjiztlubvccwtgbcgyno '),(9443,'title',0,1,''),(9444,'field',1,1,''),(9444,'field',11,1,''),(9444,'field',63,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what are the general roles and responsibilities of various agencies during an outbreak since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what individual roles should the outbreak response team consist of and what are their responsibilities since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what equipment supplies documents toolkits and other resources should a response team have '),(9444,'slug',0,1,''),(9445,'field',3,1,' introduction '),(9445,'slug',0,1,''),(9445,'title',0,1,''),(9446,'field',64,1,' what are the general roles and responsibilities of various agencies during an outbreak '),(9446,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9446,'slug',0,1,''),(9446,'title',0,1,''),(9447,'field',64,1,' what individual roles should the outbreak response team consist of and what are their responsibilities '),(9447,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9447,'slug',0,1,''),(9447,'title',0,1,''),(9448,'field',64,1,' what equipment supplies documents toolkits and other resources should a response team have '),(9448,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9448,'slug',0,1,''),(9448,'title',0,1,''),(9449,'field',1,1,''),(9449,'field',11,1,''),(9449,'field',63,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what communication needs should an outbreak response team be prepared for since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department how should an outbreak response team manage their records since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department when should an outbreak response team ask for help and who can provide it since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what is an incident command center '),(9449,'slug',0,1,''),(9450,'field',3,1,' protocol responsibilities '),(9450,'slug',0,1,''),(9450,'title',0,1,''),(9451,'field',64,1,' what communication needs should an outbreak response team be prepared for '),(9451,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9451,'slug',0,1,''),(9451,'title',0,1,''),(9452,'field',64,1,' how should an outbreak response team manage their records '),(9452,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9452,'slug',0,1,''),(9452,'title',0,1,''),(9453,'field',64,1,' when should an outbreak response team ask for help and who can provide it '),(9453,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9453,'slug',0,1,''),(9453,'title',0,1,''),(9454,'field',64,1,' what is an incident command center '),(9454,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9454,'slug',0,1,''),(9454,'title',0,1,''),(9455,'field',1,1,''),(9455,'field',11,1,''),(9455,'field',63,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what other legal ethical or privacy concerns should be considered since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department how can an outbreak response team plan for recovery and follow up '),(9455,'slug',0,1,''),(9456,'field',3,1,' additional topics '),(9456,'slug',0,1,''),(9456,'title',0,1,''),(9457,'field',64,1,' what other legal ethical or privacy concerns should be considered '),(9457,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9457,'slug',0,1,''),(9457,'title',0,1,''),(9458,'field',64,1,' how can an outbreak response team plan for recovery and follow up '),(9458,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9458,'slug',0,1,''),(9458,'title',0,1,''),(9459,'field',1,1,''),(9459,'field',11,1,''),(9459,'field',63,1,''),(9459,'slug',0,1,''),(9460,'field',3,1,' as advances occur in outbreak protocols this guidance document will be updated previous changes can be tracked below 2nd edition published june 2024 1st edition published june 2023 urls in this document are valid as of may 31 2024 '),(9460,'slug',0,1,' temp yekokqivoxgrmnshcnbqrgbgyvduqdhtvdvp '),(9460,'title',0,1,''),(9461,'field',1,1,''),(9461,'field',11,1,''),(9461,'field',63,1,''),(9461,'slug',0,1,''),(9462,'field',3,1,' january 5 2024 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9462,'slug',0,1,''),(9462,'title',0,1,''),(9463,'field',1,1,''),(9463,'field',11,1,''),(9463,'field',63,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor december 10 2023 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor april 23 2023 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor september 05 2022 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor february 19 2022 '),(9463,'slug',0,1,''),(9464,'field',3,1,' previous changes '),(9464,'slug',0,1,''),(9464,'title',0,1,''),(9465,'field',64,1,' december 10 2023 '),(9465,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9465,'slug',0,1,''),(9465,'title',0,1,''),(9466,'field',64,1,' april 23 2023 '),(9466,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9466,'slug',0,1,''),(9466,'title',0,1,''),(9467,'field',64,1,' september 05 2022 '),(9467,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9467,'slug',0,1,''),(9467,'title',0,1,''),(9468,'field',64,1,' february 19 2022 '),(9468,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9468,'slug',0,1,''),(9468,'title',0,1,''),(9469,'field',1,1,''),(9469,'field',11,1,''),(9469,'field',63,1,''),(9469,'slug',0,1,''),(9470,'field',3,1,' centers for disease control and prevention u s about the ar lab network centers for disease control and prevention 2023 feb available from https www cdc gov drugresistance ar lab networks domestic html centers for disease control and prevention u s national healthcare safety network centers for disease control and prevention 2023 march available from https www cdc gov nhsn index html tindall bj sutton g garrity gm enterobacter aerogenes hormaeche and edwards 1960 approved lists 1980 and klebsiella mobilis bascomb et al 1971 approved lists 1980 share the same nomenclatural type atcc 13048 on the approved lists and are homotypic synonyms with consequences for the name klebsiella mobilis bascomb et al 1971 approved lists 1980 int j syst evol microbiol 2017 67 2 502 4 american society for microbiology kirby bauer disk diffusion susceptibility test protocol 2009 december available from https asm org getattachment 2594ce26 bd44 47f6 8287 0657aa9185ad kirby bauer disk diffusion susceptibility test protocol pdf pdf clinical laboratory standards institute ast news update june 2022 updating breakpoints new developments from cap available from https clsi org about blog ast news updatejune 2022 updating breakpoints new developments from cap prussing c canulla t singh n mcauley p gosciminski m king e et al characterization of the first carbapenem resistant pseudomonas aeruginosa clinical isolate harboring blasim 1 from the united states antimicrob agents chemother 2021 sep 17 65 10 e0106621 reller lb weinstein m jorgensen jh ferraro mj antimicrobial susceptibility testing a review of general principles and contemporary practices clin infect dis 2009 dec 1 49 11 1749 55 centers for disease control and prevention u s antibiotic resistance threats in the united states 2019 2019 november available from https stacks cdc gov view cdc 82532 clinical laboratory standards institute performance standards for antimicrobial susceptibility testing 32nd ed clsi supplement m100 2022 association of public health laboratories best practice guidance specimen and specimenproduct storage and retention 2016 february accessed at https www aphl org aboutaphl publications documents id specimen storage 0216 pdf sehulster l rose l noble wang j chapter 72 microbiologic sampling of the environment in healthcare facilities hospital epidemiology and infection control edited by c mayhall 4th edition wolters kluwer health 2012 pp 1059 75 '),(9470,'slug',0,1,' temp yvaywfytvitunanhfktnvwljjeqjmmmshesn '),(9470,'title',0,1,''),(9513,'slug',0,1,' notification communication '),(9513,'title',0,1,' 8 notification communication '),(9514,'field',46,1,' notification communication '),(9514,'field',47,1,' learn about the who what how why and when for notifying patients and other stakeholders as part of a healthcare outbreak response '),(9514,'slug',0,1,' temp hddreopxyegknwckmuiufiuockuubfihbjaz '),(9514,'title',0,1,''),(9515,'field',58,1,' also useful for epidemiologists '),(9515,'field',59,1,' for infection prevention specialists '),(9515,'slug',0,1,' temp pzkwyjyithwwfifygnazpznovpkmszzlsqvf '),(9515,'title',0,1,''),(9516,'field',58,1,' also useful for associated specialists '),(9516,'field',59,1,' for health departments healthcare facilities '),(9516,'slug',0,1,' temp gpskqhkszpexuubrwzajwidkkdjvkffjxoxc '),(9516,'title',0,1,''),(9517,'slug',0,1,' temp ssoimydzsxvihdysvutkgufhdwaljgatwnck '),(9517,'title',0,1,''),(9518,'slug',0,1,' temp uenkvharwanorjvowvyvoiucpwnlxnminhnw '),(9518,'title',0,1,''),(9519,'slug',0,1,' temp kurtupcteapwhoerjtfdtrjtyzlznmybfkko '),(9519,'title',0,1,''),(9521,'field',1,1,''),(9521,'field',11,1,''),(9521,'field',63,1,''),(9521,'slug',0,1,''),(9522,'field',3,1,' chapter summary when patients are placed at risk as a result of an infection or disease outbreak in a healthcare setting a serious infection control breach or another situation that jeopardizes their health they have a right to know what happened the extent of their risk and what they need to do in chapter 8 notification communication we describe who what how why and when for the notification of patients and other stakeholders along with a detailed review of applicable risk communication principles and strategies this chapter contains information on patient stories and ethical considerations for notification notification of affected and exposed patients stakeholders such as providers and healthcare facilities and the general public both during and after an outbreak advice on managing effective communications as part of patient notification including managing differences of opinion between public health agencies and healthcare facilities pointers for engaging the media either proactively or reactively examples detailing notification procedures in outbreak situations involving a legionella in a hospital setting and b antibiotic resistant infections in a long term care facility '),(9522,'slug',0,1,' temp oxogdvnknqrmzywnnzodtbvrdpircggmcsbf '),(9522,'title',0,1,''),(9523,'field',1,1,''),(9523,'field',11,1,''),(9523,'field',63,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what are the general roles and responsibilities of various agencies during an outbreak since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what individual roles should the outbreak response team consist of and what are their responsibilities since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what equipment supplies documents toolkits and other resources should a response team have '),(9523,'slug',0,1,''),(9524,'field',3,1,' introduction '),(9524,'slug',0,1,''),(9524,'title',0,1,''),(9525,'field',64,1,' what are the general roles and responsibilities of various agencies during an outbreak '),(9525,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9525,'slug',0,1,''),(9525,'title',0,1,''),(9526,'field',64,1,' what individual roles should the outbreak response team consist of and what are their responsibilities '),(9526,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9526,'slug',0,1,''),(9526,'title',0,1,''),(9527,'field',64,1,' what equipment supplies documents toolkits and other resources should a response team have '),(9527,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9527,'slug',0,1,''),(9527,'title',0,1,''),(9528,'field',1,1,''),(9528,'field',11,1,''),(9528,'field',63,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what communication needs should an outbreak response team be prepared for since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department how should an outbreak response team manage their records since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department when should an outbreak response team ask for help and who can provide it since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what is an incident command center '),(9528,'slug',0,1,''),(9529,'field',3,1,' protocol responsibilities '),(9529,'slug',0,1,''),(9529,'title',0,1,''),(9530,'field',64,1,' what communication needs should an outbreak response team be prepared for '),(9530,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9530,'slug',0,1,''),(9530,'title',0,1,''),(9531,'field',64,1,' how should an outbreak response team manage their records '),(9531,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9531,'slug',0,1,''),(9531,'title',0,1,''),(9532,'field',64,1,' when should an outbreak response team ask for help and who can provide it '),(9532,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9532,'slug',0,1,''),(9532,'title',0,1,''),(9533,'field',64,1,' what is an incident command center '),(9533,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9533,'slug',0,1,''),(9533,'title',0,1,''),(9534,'field',1,1,''),(9534,'field',11,1,''),(9534,'field',63,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what other legal ethical or privacy concerns should be considered since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department how can an outbreak response team plan for recovery and follow up '),(9534,'slug',0,1,''),(9535,'field',3,1,' additional topics '),(9535,'slug',0,1,''),(9535,'title',0,1,''),(9536,'field',64,1,' what other legal ethical or privacy concerns should be considered '),(9536,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9536,'slug',0,1,''),(9536,'title',0,1,''),(9537,'field',64,1,' how can an outbreak response team plan for recovery and follow up '),(9537,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9537,'slug',0,1,''),(9537,'title',0,1,''),(9538,'field',1,1,''),(9538,'field',11,1,''),(9538,'field',63,1,''),(9538,'slug',0,1,''),(9539,'field',3,1,' as advances occur in outbreak protocols this guidance document will be updated previous changes can be tracked below 2nd edition published june 2024 1st edition published june 2023 urls in this document are valid as of may 31 2024 '),(9539,'slug',0,1,' temp vgwwdendhhfmakaiylbzhiiuilsvgbigabre '),(9539,'title',0,1,''),(9540,'field',1,1,''),(9540,'field',11,1,''),(9540,'field',63,1,''),(9540,'slug',0,1,''),(9541,'field',3,1,' january 5 2024 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9541,'slug',0,1,''),(9541,'title',0,1,''),(9542,'field',1,1,''),(9542,'field',11,1,''),(9542,'field',63,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor december 10 2023 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor april 23 2023 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor september 05 2022 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor february 19 2022 '),(9542,'slug',0,1,''),(9543,'field',3,1,' previous changes '),(9543,'slug',0,1,''),(9543,'title',0,1,''),(9544,'field',64,1,' december 10 2023 '),(9544,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9544,'slug',0,1,''),(9544,'title',0,1,''),(9545,'field',64,1,' april 23 2023 '),(9545,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9545,'slug',0,1,''),(9545,'title',0,1,''),(9546,'field',64,1,' september 05 2022 '),(9546,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9546,'slug',0,1,''),(9546,'title',0,1,''),(9547,'field',64,1,' february 19 2022 '),(9547,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9547,'slug',0,1,''),(9547,'title',0,1,''),(9548,'field',1,1,''),(9548,'field',11,1,''),(9548,'field',63,1,''),(9548,'slug',0,1,''),(9549,'field',3,1,' author not reported the surprising way to stay safe in the hospital consumer reports 2014 dec available at https www consumerreports org cro magazine 2015 02 the surprisingway to stay safe in the hospital index html day k sticky john mcclearys mrsa nightmare mccleary mrsa prevention webpage 2009 feb 9 available at http mcclearymrsaprevention com p=12 petersen m uci doctors plan to stop superbugs is widely used at her own hospital it didnt work los angeles times 2017 may available at https www latimes com business la fi uciinfant outbreak 20170515 story html dudzinski dm hebert pc foglia mb gallagher th the disclosure dilemma ─ large scale adverse events n engl j med 2010 sep 2 363 10 978 86 sandman pm introduction to risk communication and orientation to this website the peter sandman risk communication website available at https www psandman com indexintro htm schaefer mk perkins km link gelles r kallen aj patel pr perz jf outbreaks and infection control breaches in health care settings considerations for patient notification am j infect control 2020 jun 48 6 718 724 centers for disease control and prevention cdc crisis and emergency risk communication cerc manual available at https emergency cdc gov cerc manual index asp centers for disease control and prevention cdc injection safety patient notification toolkit available at https www cdc gov injectionsafety pntoolkit index html prouty cd foglia mb gallagher th patients experiences with disclosure of a large scale adverse event j clin ethics 2013 winter no 4 353 363 sakamoto s terashita d balter s liaison public health nurse project innovative public health approach to combat infectious disease in hospitals j public health manag pract 2020 nov dec 26 6 557 561 urbina i fink s a deadly fungus and questions at a hospital new york times 2014 apr available at https www nytimes com 2014 04 29 us a deadly fungus and questions at ahospital html duffy j harris j gade l sehulster l newhouse e oconnell h noble wang j rao c balajee sa chiller t mucormycosis outbreak associated with hospital linens pediatric infect dis j 2014 may 33 5 472 6 available at https pubmed ncbi nlm nih gov 24667485 '),(9549,'slug',0,1,' temp asnpuzbaqtmpbeqqmmphnhexnpdndedpcunk '),(9549,'title',0,1,''),(9592,'slug',0,1,' infection control breach investigations '),(9592,'title',0,1,' b breach investigations '),(9593,'field',46,1,' infection control breach investigations '),(9593,'field',47,1,' learn about resources to help investigate reports of substandard care such as unsafe injections practices or drug diversion '),(9593,'slug',0,1,' temp nqkwshuylhdhqqmoivvvlrjkfpirmztefkis '),(9593,'title',0,1,''),(9594,'field',58,1,' also useful for epidemiologists '),(9594,'field',59,1,' for infection prevention specialists '),(9594,'slug',0,1,' temp uxhddmhwkizogroqbksalvbtxabhgdfoxefk '),(9594,'title',0,1,''),(9595,'field',58,1,' also useful for associated specialists '),(9595,'field',59,1,' for health departments healthcare facilities '),(9595,'slug',0,1,' temp vbrohdlkmzpiwvjleuprviieiytnbxezpztu '),(9595,'title',0,1,''),(9596,'slug',0,1,' temp hgkhyozhsarlohdrcacgfttwamiyggarbcat '),(9596,'title',0,1,''),(9597,'slug',0,1,' temp zndcllrqbbkmdhgtcxffcefnczzzgfpbqfuf '),(9597,'title',0,1,''),(9598,'slug',0,1,' temp cmmrtzhoflhxoilyvskzvdhzzkmuognnshub '),(9598,'title',0,1,''),(9600,'field',1,1,''),(9600,'field',11,1,''),(9600,'field',63,1,''),(9600,'slug',0,1,''),(9601,'field',3,1,' chapter summary outbreak investigation has long been a core public health function and deficits in infection control practices are frequently identified during healthcare outbreak investigations in contrast the investigation of isolated reports of serious infection control breaches in the absence of known patient infections represents relatively new territory in supplement b infection control breach investigations we describe resources available to assist investigators responding to reports of substandard care practices such as reuse of single use devices or the failure to follow requirements for reprocessing reusable medical equipment the aims of this type of response activity include assessing the degree of departure from recommended practices evaluating the risk of communicable disease transmission associated with the breach and identifying potentially exposed individuals who have not yet developed or been diagnosed with infection or colonization this supplement takes the form of an annotated bibliography and includes key resources providing materials and advice to assist in the investigation of and response to infection control breaches including patient notification with examples of publications in which breach investigators describe their specific findings and experiences general resources outlining infection control guidelines plus some detailed resources relevant to specific types of higher risk infection control breaches resources offering guidance and useful background for the investigation of healthcare drug diversion events such as when tampering or substitution may have introduced infection risks '),(9601,'slug',0,1,' temp nypbbzixewyfgltmbqucndljmmxjzshxzlja '),(9601,'title',0,1,''),(9602,'field',1,1,''),(9602,'field',11,1,''),(9602,'field',63,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what are the general roles and responsibilities of various agencies during an outbreak since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what individual roles should the outbreak response team consist of and what are their responsibilities since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what equipment supplies documents toolkits and other resources should a response team have '),(9602,'slug',0,1,''),(9603,'field',3,1,' introduction '),(9603,'slug',0,1,''),(9603,'title',0,1,''),(9604,'field',64,1,' what are the general roles and responsibilities of various agencies during an outbreak '),(9604,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9604,'slug',0,1,''),(9604,'title',0,1,''),(9605,'field',64,1,' what individual roles should the outbreak response team consist of and what are their responsibilities '),(9605,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9605,'slug',0,1,''),(9605,'title',0,1,''),(9606,'field',64,1,' what equipment supplies documents toolkits and other resources should a response team have '),(9606,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9606,'slug',0,1,''),(9606,'title',0,1,''),(9607,'field',1,1,''),(9607,'field',11,1,''),(9607,'field',63,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what communication needs should an outbreak response team be prepared for since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department how should an outbreak response team manage their records since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department when should an outbreak response team ask for help and who can provide it since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what is an incident command center '),(9607,'slug',0,1,''),(9608,'field',3,1,' protocol responsibilities '),(9608,'slug',0,1,''),(9608,'title',0,1,''),(9609,'field',64,1,' what communication needs should an outbreak response team be prepared for '),(9609,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9609,'slug',0,1,''),(9609,'title',0,1,''),(9610,'field',64,1,' how should an outbreak response team manage their records '),(9610,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9610,'slug',0,1,''),(9610,'title',0,1,''),(9611,'field',64,1,' when should an outbreak response team ask for help and who can provide it '),(9611,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9611,'slug',0,1,''),(9611,'title',0,1,''),(9612,'field',64,1,' what is an incident command center '),(9612,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9612,'slug',0,1,''),(9612,'title',0,1,''),(9613,'field',1,1,''),(9613,'field',11,1,''),(9613,'field',63,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what other legal ethical or privacy concerns should be considered since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department how can an outbreak response team plan for recovery and follow up '),(9613,'slug',0,1,''),(9614,'field',3,1,' additional topics '),(9614,'slug',0,1,''),(9614,'title',0,1,''),(9615,'field',64,1,' what other legal ethical or privacy concerns should be considered '),(9615,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9615,'slug',0,1,''),(9615,'title',0,1,''),(9616,'field',64,1,' how can an outbreak response team plan for recovery and follow up '),(9616,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9616,'slug',0,1,''),(9616,'title',0,1,''),(9617,'field',1,1,''),(9617,'field',11,1,''),(9617,'field',63,1,''),(9617,'slug',0,1,''),(9618,'field',3,1,' as advances occur in outbreak protocols this guidance document will be updated previous changes can be tracked below 2nd edition published june 2024 interim version published october 2022 urls in this document are valid as of may 31 2024 '),(9618,'slug',0,1,' temp ljvoyezwfawuifwshsjqwjidotzjrysmomoq '),(9618,'title',0,1,''),(9619,'field',1,1,''),(9619,'field',11,1,''),(9619,'field',63,1,''),(9619,'slug',0,1,''),(9620,'field',3,1,' january 5 2024 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9620,'slug',0,1,''),(9620,'title',0,1,''),(9621,'field',1,1,''),(9621,'field',11,1,''),(9621,'field',63,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor december 10 2023 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor april 23 2023 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor september 05 2022 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor february 19 2022 '),(9621,'slug',0,1,''),(9622,'field',3,1,' previous changes '),(9622,'slug',0,1,''),(9622,'title',0,1,''),(9623,'field',64,1,' december 10 2023 '),(9623,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9623,'slug',0,1,''),(9623,'title',0,1,''),(9624,'field',64,1,' april 23 2023 '),(9624,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9624,'slug',0,1,''),(9624,'title',0,1,''),(9625,'field',64,1,' september 05 2022 '),(9625,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9625,'slug',0,1,''),(9625,'title',0,1,''),(9626,'field',64,1,' february 19 2022 '),(9626,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9626,'slug',0,1,''),(9626,'title',0,1,''),(9627,'field',1,1,''),(9627,'field',11,1,''),(9627,'field',63,1,''),(9627,'slug',0,1,''),(9628,'field',3,1,' investigation of infection control breaches this section lists some key resources that provide useful background materials and advice to assist with the investigation and response to infection control breaches as well as some examples of publications in which infection control breach investigators described their specific findings and experiences 1 schaefer mk perkins km link gelles r kallen aj patel pr perz jf outbreaks and infection control breaches in health care settings considerations for patient notification am j infect control 2020 jun 48 6 718 724 available at https www ncbi nlm nih gov pmc articles pmc7894041 this paper provides a useful framework for patient notification considerations including a description of triggers for performing a notification when investigating an infection control breach as well as examples of commonly encountered scenarios 2 patel pr srinivasan a perz jf developing a broader approach to management of infection control breaches in healthcare settings am j infect control 2008 36 685 90 available at https www ajicjournal org article s0196 6553 08 00683 4 fulltext this paper introduced a number of useful concepts and suggested approaches for investigating infection control breaches many of which were revisited and expanded upon by schaefer et al reference 1 from this section 3 centers for medicare and medicaid services cms infection control breaches which warrant referral to public health authorities available at https www cms gov medicare providerenrollment and certification surveycertificationgeninfo downloads survey and cert letter14 36 pdf beginning in 2014 cms required the reporting of infection control breaches discovered during accrediting or certification survey visits to public health agencies 4 braun bi chitavi so perkins km perz jf et al referrals of infection control breaches to public health authorities ambulatory care settings experience 2017 available at https www ncbi nlm nih gov pmc articles pmc7876613 the authors characterized and summarized the ipc breaches that were identified by joint commission surveyors during the ambulatory health care and office based surgery accreditation process and reported to state health departments in 2017 5 cdc injection safety patient notification toolkit available at https www cdc gov injectionsafety pntoolkit index html this toolkit provides step wise guidance to assist public health agencies and healthcare facilities with conducting a patient notification following identification of an infection control breach the toolkit is intended to be used after the decision has been made to notify patients and offers resources and template materials such as sample notification letters as well as some essential tips and strategies 6 schoonover h haydon k incident command structure using a daily management system and the centers for disease control and preventions patient notification toolkit drives effective response to an infection control breach j healthc risk manag 2018 oct 38 2 19 26 available at https onlinelibrary wiley com doi abs 10 1002 jhrm 21323 the authors describe how an incident command structure information management system and cdc patient notification toolkit were used to drive an effective response to an infection control breach resulting in 92% of affected patients completing the recommended testing 7 arnold s melville sk morehead b vaughan g moorman a crist mb notes from the field hepatitis c transmission from inappropriate reuse of saline flush syringes for multiple patients in an acute care general hospital texas 2015 mmwr morb mortal wkly rep 2017 66 258 260 available at https www cdc gov mmwr volumes 66 wr mm6609a4 htm this report provides an example of an infection control breach investigation which uncovered hepatitis c virus transmission 8 rasmussen sa goodman ra editors 2018 the cdc field epidemiology manual available at https www cdc gov eis field epi manual index html this reference does not address infection control breaches specifically but provides a comprehensive resource for responding to outbreaks with many principles that can also be applied to infection control breach investigations particularly relevant chapters to healthcare infection control breach investigations include chapters 3 conducting a field investigation 12 communicating during an outbreak or public health investigation and 18 healthcare settings selected infection control resources and references this section provides general resources for understanding the basic principles of infection control as well as some detailed resources that are relevant to some of the more commonly reported infection control breaches 1 centers for disease control and prevention cdc infection control available at https www cdc gov infectioncontrol index html this webpage is the base directory for cdc infection control resources including links to resources for standard and transmission based precautions infection control guidelines reference 2 in this section training and education resources and tools for specific healthcare setting types 2 centers for disease control and prevention cdc infection control guidelines guidance library available at https www cdc gov infectioncontrol guidelines index html this webpage contains links to a variety of cdc infection control guidelines and documents including those developed under the auspices of the healthcare infection control practices advisory committee hicpac 3 association for professionals in infection control and epidemiology apic the apic text available at https apic org resources apic text a comprehensive infection control resource organized by chapter subscription required 4 centers for disease control and prevention cdc essential elements of a reprocessing program for flexible endoscopes ─ recommendaoons of the hicpac available at https www cdc gov hicpac recommendations flexible endoscope reprocessing html because many breaches involve medical device reprocessing techniques this resource can assist public health agencies in related investigations and can be a useful document to share with and help educate facilities 5 centers for disease control and prevention cdc infection prevention during blood glucose monitoring and insulin administration available at https www cdc gov injectionsafety bloodglucose monitoring html this cdc resource provides essential background when investigating infection control breaches associated with blood glucose monitoring or other forms of point of care testing involving capillary blood samples or insulin pens and other medication cartridges 6 centers for disease control and prevention cdc injection safety available at https www cdc gov injectionsafety index html a website landing page for information about safe injection practices safe injection practices are part of standard precautions and are aimed at maintaining basic levels of patient safety and healthcare provider protections 7 dolan sa arias km felizardo g barnes s kraska s et al apic position paper safe injection infusion and medication vial practices in health care am j infect control 2016 jul 1 44 7 750 7 available at https apic org resource tinymcefilemanager position statements 2016apicsippositionpap er pdf position paper from the association for professionals in infection control and epidemiology describing risks and outbreaks associated with unsafe injection practices and associated recommendations investigation of a drug diversion event broadly speaking when prescription medicines are obtained or used illegally it is called drug diversion healthcare providers who steal prescription medicines such as opioids for their own use put patients at risk for harms this can include exposure to infectious diseases for example when a provider commits diversion by tampering with or otherwise misusing injection supplies medications or other equipment these items might become contaminated with hepatitis b or c virus hiv or bacteria drug diversion investigations involve assessments and actions that are akin to infection control breach investigations but with many special considerations the resources below provide guidance and useful background for investigation of healthcare drug diversion events 1 schaefer mk perz jf outbreaks of infections associated with drug diversion by us health care personnel mayo clin proc 2014 89 7 878 87 available at https www ncbi nlm nih gov pmc articles pmc4669560 this review article summarizes a variety of drug diversion related outbreak investigations and includes a table describing key investigation steps 2 centers for disease control and prevention cdc injection safety drug diversion available at https www cdc gov injectionsafety drugdiversion index html this website provides information on drug diversion including outbreaks associated with drug diversion resources for clinicians and additional resources 3 council of state and territorial epidemiologists 2019 healthcare associated infections hai drug diversion planning and response toolkit for state and local health departments available at https www cste org page drug diversion toolkit this toolkit provides information on best practices when responding to a drug diversion and provides resources informed by past drug diversion investigations 4 brummond pw chen df churchill ww clark js dillon kr et al ashp guidelines on preventing diversion of controlled substances am j health syst pharm 2017 mar 1 74 5 325 348 available at https www ashp org media assets policyguidelines docs guidelines preventing diversion of controlled substances ashx this guidance document is a framework from the american society of health system pharmacists describing controlled substance diversion prevention programs and provides useful context for public health partners and others charged with investigating a drug diversion report '),(9628,'slug',0,1,' temp jdqwbmkzygirizxsyvzskgnambxjdbofxthn '),(9628,'title',0,1,''),(9670,'slug',0,1,' special considerations for multi facility multi jurisdiction outbreaks '),(9670,'title',0,1,' 7 multifacility jurisdiction '),(9671,'field',46,1,' multifacility multijurisdictional outbreaks '),(9671,'field',47,1,' learn about the complexities and challenges when a healthcare outbreak involves more than one facility or local state federal jurisdiction '),(9671,'slug',0,1,' temp ausejupduxtxezbexaaizuccutjwolcsmqvy '),(9671,'title',0,1,''),(9672,'field',58,1,' also useful for epidemiologists '),(9672,'field',59,1,' for infection prevention specialists '),(9672,'slug',0,1,' temp mtjndlamwxqfzxalrlovxzbatescuphmoosm '),(9672,'title',0,1,''),(9673,'field',58,1,' also useful for associated specialists '),(9673,'field',59,1,' for health departments healthcare facilities '),(9673,'slug',0,1,' temp bweoyjhjwgxgbjzslmcqegumcwrqtyuydjky '),(9673,'title',0,1,''),(9674,'slug',0,1,' temp zsjjizcpzydrswarnpnwxsgclzfhugszvega '),(9674,'title',0,1,''),(9675,'slug',0,1,' temp xiynhoggqqbqadktrcrtbwphojhinxrnvsyh '),(9675,'title',0,1,''),(9676,'slug',0,1,' temp enwjwatphuhiplymgubssgdqybvpcbiwjffa '),(9676,'title',0,1,''),(9678,'field',1,1,''),(9678,'field',11,1,''),(9678,'field',63,1,''),(9678,'slug',0,1,''),(9679,'field',3,1,' chapter summary compared with outbreaks affecting a single healthcare facility with responsibility for investigation falling squarely within the jurisdiction of a single local state federal agency outbreaks involving multiple healthcare facilities or multiple jurisdictions are more complex and often more difficult to detect coordinate and investigate in chapter 7 multifacility and multijurisdictional outbreaks we examine the unique aspects of these types of investigations compared with single facility outbreaks those that involve multiple facilities or multiple jurisdictions are more complex and are often more difficult to detect coordinate and investigate as the numbers of involved facilities agencies and levels of organizations across jurisdictions increase the need for special efforts to maintain effective communication and coordination increases as well this chapter contains information on example scenarios investigators may encounter coordination and information sharing needs beginning with initial detection of a potential multifacility multijurisdictional outbreak designation of a coordinating agency assembly and management of a multidisciplinary outbreak response team and regular assessment of the scope of the outbreak and the resources needed considerations for ramping down and concluding an interagency response '),(9679,'slug',0,1,' temp ncxbbqimijnmsgrepwrakpxezzgpsemxuqcj '),(9679,'title',0,1,''),(9680,'field',1,1,''),(9680,'field',11,1,''),(9680,'field',63,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what are the general roles and responsibilities of various agencies during an outbreak since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what individual roles should the outbreak response team consist of and what are their responsibilities since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what equipment supplies documents toolkits and other resources should a response team have '),(9680,'slug',0,1,''),(9681,'field',3,1,' introduction '),(9681,'slug',0,1,''),(9681,'title',0,1,''),(9682,'field',64,1,' what are the general roles and responsibilities of various agencies during an outbreak '),(9682,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9682,'slug',0,1,''),(9682,'title',0,1,''),(9683,'field',64,1,' what individual roles should the outbreak response team consist of and what are their responsibilities '),(9683,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9683,'slug',0,1,''),(9683,'title',0,1,''),(9684,'field',64,1,' what equipment supplies documents toolkits and other resources should a response team have '),(9684,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9684,'slug',0,1,''),(9684,'title',0,1,''),(9685,'field',1,1,''),(9685,'field',11,1,''),(9685,'field',63,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what communication needs should an outbreak response team be prepared for since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department how should an outbreak response team manage their records since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department when should an outbreak response team ask for help and who can provide it since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what is an incident command center '),(9685,'slug',0,1,''),(9686,'field',3,1,' protocol responsibilities '),(9686,'slug',0,1,''),(9686,'title',0,1,''),(9687,'field',64,1,' what communication needs should an outbreak response team be prepared for '),(9687,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9687,'slug',0,1,''),(9687,'title',0,1,''),(9688,'field',64,1,' how should an outbreak response team manage their records '),(9688,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9688,'slug',0,1,''),(9688,'title',0,1,''),(9689,'field',64,1,' when should an outbreak response team ask for help and who can provide it '),(9689,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9689,'slug',0,1,''),(9689,'title',0,1,''),(9690,'field',64,1,' what is an incident command center '),(9690,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9690,'slug',0,1,''),(9690,'title',0,1,''),(9691,'field',1,1,''),(9691,'field',11,1,''),(9691,'field',63,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what other legal ethical or privacy concerns should be considered since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department how can an outbreak response team plan for recovery and follow up '),(9691,'slug',0,1,''),(9692,'field',3,1,' additional topics '),(9692,'slug',0,1,''),(9692,'title',0,1,''),(9693,'field',64,1,' what other legal ethical or privacy concerns should be considered '),(9693,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9693,'slug',0,1,''),(9693,'title',0,1,''),(9694,'field',64,1,' how can an outbreak response team plan for recovery and follow up '),(9694,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9694,'slug',0,1,''),(9694,'title',0,1,''),(9695,'field',1,1,''),(9695,'field',11,1,''),(9695,'field',63,1,''),(9695,'slug',0,1,''),(9696,'field',3,1,' as advances occur in outbreak protocols this guidance document will be updated previous changes can be tracked below 2nd edition published june 2024 urls in this document are valid as of may 31 2024 '),(9696,'slug',0,1,' temp ayygttpdyeztxdmlamcapplduajwpkixahxq '),(9696,'title',0,1,''),(9697,'field',1,1,''),(9697,'field',11,1,''),(9697,'field',63,1,''),(9697,'slug',0,1,''),(9698,'field',3,1,' january 5 2024 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9698,'slug',0,1,''),(9698,'title',0,1,''),(9699,'field',1,1,''),(9699,'field',11,1,''),(9699,'field',63,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor december 10 2023 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor april 23 2023 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor september 05 2022 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor february 19 2022 '),(9699,'slug',0,1,''),(9700,'field',3,1,' previous changes '),(9700,'slug',0,1,''),(9700,'title',0,1,''),(9701,'field',64,1,' december 10 2023 '),(9701,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9701,'slug',0,1,''),(9701,'title',0,1,''),(9702,'field',64,1,' april 23 2023 '),(9702,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate 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8639 jpg '),(9779,'kind',0,1,' image '),(9779,'kind',0,2,' image '),(9779,'slug',0,1,''),(9779,'slug',0,2,''),(9779,'title',0,1,' supplement b '),(9779,'title',0,2,' supplement b '),(9794,'slug',0,1,' medical product investigations '),(9794,'title',0,1,' a medical product investigations '),(9795,'field',46,1,' medical product investigations '),(9795,'field',47,1,' learn how contaminated drugs devices and other medical products can cause outbreaks and the actions needed to prevent further harm '),(9795,'slug',0,1,' temp mmumqcfxinobcukqqopefyharqkhkkjptzpk '),(9795,'title',0,1,''),(9796,'field',58,1,' also useful for epidemiologists '),(9796,'field',59,1,' for infection prevention specialists '),(9796,'slug',0,1,' temp lmznhsrbkwjitqzzlcwdgzkdtjjwqqjthfce '),(9796,'title',0,1,''),(9797,'field',58,1,' also useful for associated specialists '),(9797,'field',59,1,' for health departments healthcare facilities '),(9797,'slug',0,1,' temp bvizcvynzvriobglsubbzowufvzxnmilbqvn '),(9797,'title',0,1,''),(9798,'slug',0,1,' temp crvbbblrqmoslxzwmayofwcuvvznezkegnfs '),(9798,'title',0,1,''),(9799,'slug',0,1,' temp afcejsjkicrdfkrrksbkwxvvdxidykcxexwq '),(9799,'title',0,1,''),(9800,'slug',0,1,' temp elfdpznmnralswdqvniohmvsslqnxzksiorx '),(9800,'title',0,1,''),(9802,'field',1,1,''),(9802,'field',11,1,''),(9802,'field',63,1,''),(9802,'slug',0,1,''),(9803,'field',3,1,' chapter summary healthcare associated infections hais and outbreaks can be caused by use of contaminated medical products these medical products include devices also known as instruments or equipment and drugs also known as medications as well as biological products nutrition products and patient care items the general principles outlined in the corha principles and practices can be employed when responding to events related to medical product contamination these investigations often involve infection control assessments and require the active coordination of investigation partners across multiple jurisdictions in supplement a medical product investigations we address some unique challenges associated with identifying and responding to outbreaks related to contamination events this supplement contains information on intrinsic contamination which occurs before a medical product arrives at its point of use in a healthcare facility extrinsic contamination which results from errors made during a medical products storage preparation and use in a healthcare facility advice on recognizing and evaluating possible causes of product related transmission relative to clinical illness and other factors investigation procedures for outbreaks that potentially involve drugs and devices with an emphasis on intrinsic product contamination additional keys to success related to medical product investigations '),(9803,'slug',0,1,' temp gvhphhqianiqsivckmoruibnkugqqfbmphqd '),(9803,'title',0,1,''),(9804,'field',1,1,''),(9804,'field',11,1,''),(9804,'field',63,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what are the general roles and responsibilities of various agencies during an outbreak since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what individual roles should the outbreak response team consist of and what are their responsibilities since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what equipment supplies documents toolkits and other resources should a response team have '),(9804,'slug',0,1,''),(9805,'field',3,1,' introduction '),(9805,'slug',0,1,''),(9805,'title',0,1,''),(9806,'field',64,1,' what are the general roles and responsibilities of various agencies during an outbreak '),(9806,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9806,'slug',0,1,''),(9806,'title',0,1,''),(9807,'field',64,1,' what individual roles should the outbreak response team consist of and what are their responsibilities '),(9807,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9807,'slug',0,1,''),(9807,'title',0,1,''),(9808,'field',64,1,' what equipment supplies documents toolkits and other resources should a response team have '),(9808,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9808,'slug',0,1,''),(9808,'title',0,1,''),(9809,'field',1,1,''),(9809,'field',11,1,''),(9809,'field',63,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what communication needs should an outbreak response team be prepared for since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department how should an outbreak response team manage their records since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department when should an outbreak response team ask for help and who can provide it since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what is an incident command center '),(9809,'slug',0,1,''),(9810,'field',3,1,' protocol responsibilities '),(9810,'slug',0,1,''),(9810,'title',0,1,''),(9811,'field',64,1,' what communication needs should an outbreak response team be prepared for '),(9811,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments 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for help and who can provide it '),(9813,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9813,'slug',0,1,''),(9813,'title',0,1,''),(9814,'field',64,1,' what is an incident command center '),(9814,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9814,'slug',0,1,''),(9814,'title',0,1,''),(9815,'field',1,1,''),(9815,'field',11,1,''),(9815,'field',63,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department what other legal ethical or privacy concerns should be considered since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department how can an outbreak response team plan for recovery and follow up '),(9815,'slug',0,1,''),(9816,'field',3,1,' additional topics '),(9816,'slug',0,1,''),(9816,'title',0,1,''),(9817,'field',64,1,' what other legal ethical or privacy concerns should be considered '),(9817,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9817,'slug',0,1,''),(9817,'title',0,1,''),(9818,'field',64,1,' how can an outbreak response team plan for recovery and follow up '),(9818,'field',65,1,' since states organize their governmental public health systems in diverse ways the relative roles of local and state health departments will vary in states where governance is centralized responsibility for conducting outbreak investigations rests primarily with state health departments conversely in jurisdictions where governance is decentralized home rule states this responsibility may rest primarily with the local health department '),(9818,'slug',0,1,''),(9818,'title',0,1,''),(9819,'field',1,1,''),(9819,'field',11,1,''),(9819,'field',63,1,''),(9819,'slug',0,1,''),(9820,'field',3,1,' as advances occur in outbreak protocols this guidance document will be updated previous changes can be tracked below 2nd edition published june 2024 1st edition published march 2024 urls in this document are valid as of may 31 2024 '),(9820,'slug',0,1,' temp cybgvddijrrftkbuutprhbrugnblolclejoh '),(9820,'title',0,1,''),(9821,'field',1,1,''),(9821,'field',11,1,''),(9821,'field',63,1,''),(9821,'slug',0,1,''),(9822,'field',3,1,' january 5 2024 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9822,'slug',0,1,''),(9822,'title',0,1,''),(9823,'field',1,1,''),(9823,'field',11,1,''),(9823,'field',63,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor december 10 2023 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor april 23 2023 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor september 05 2022 added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt vestibulum removed nulla semper est sem updated in nec sollicitudin nisi eget viverra lectus phasellus at leo varius eros suscipit varius sit amet ut nisi cras sit amet ullamcorper erat vestibulum pretium luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor february 19 2022 '),(9823,'slug',0,1,''),(9824,'field',3,1,' previous changes '),(9824,'slug',0,1,''),(9824,'title',0,1,''),(9825,'field',64,1,' december 10 2023 '),(9825,'field',65,1,' added lorem ipsum dolor sit amet consectetur adipiscing elit added etiam vulputate tincidunt 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luctus justo at volutpat odio finibus nec removed praesent volutpat diam et vestibulum malesuada aenean cursus nibh a odio vehicula sodales sed pellentesque convallis neque ac tempor '),(9828,'slug',0,1,''),(9828,'title',0,1,''),(9829,'field',1,1,''),(9829,'field',11,1,''),(9829,'field',63,1,''),(9829,'slug',0,1,''),(9830,'field',3,1,' medical product investigations key resources 1 dolan sa arias km felizardo g et al apic position paper safe injection infusion and medication vial practices in health care am j infect control 2016 jul 1 44 7 750 7 2 fda medwatch accessed at https www accessdata fda gov scripts medwatch index cfm 3 fda sharing non public information available at https www fda gov downloads drugs guidancecomplianceregulatoryinformation pharmacy compounding ucm446165 pdf contaminated medical products selected examples endoscopes 1 botana rial m leiro fernandez v nunez delgado m alvarez fernandez m otero fernandez s et al a pseudo outbreak of pseudomonas putida and stenotrophomonas maltophilia in a bronchoscopy unit 2016 92 4 274 278 2 fda infections associated with reprocessed duodenoscopes available at https www fda gov medical devices reprocessing reusable medical devices infectionsassociated reprocessed duodenoscopes 3 guy m vanhems p dananche c perraud m regard a et al outbreak of pulmonary pseudomonas aeruginosa and stenotrophomonas maltophilia infections related to contaminated bronchoscope suction valves lyon france 2014 euro surveill 2016 jul 14 21 28 4 humphries rm yang s kim s muthusamy vr russell d et al duodenoscope related outbreak of a carbapenem resistant klebsiella pneumoniae identified using advanced molecular diagnostics clin infect dis 2017 oct 1 65 7 1159 1166 5 kumarage j khonyongwa k khan a desai n hoffman p taori sk transmission of multi drug resistant pseudomonas aeruginosa between two flexible ureteroscopes and an outbreak of urinary tract infection the fragility of endoscope decontamination j hosp infect 2019 may 102 1 89 94 6 rahman mr perisetti a coman r bansal p chhabra r goyal h duodenoscope associated infections update on an emerging problem dig dis sci 2019 jun 64 6 1409 1418 heater cooler devices 1 cdc contaminated heater cooler devices health alert available at https www cdc gov hai outbreaks heater cooler html 2 lyman mm grigg c kinsey cb et al invasive nontuberculous mycobacterial infections among cardiothoracic surgical patients exposed to heater cooler devices emerg infect dis 2017 may 23 5 796 805 3 perkins km lawsin a hasan na et al notes from the field mycobacterium chimaera contamination of heater cooler devices used in cardiac surgery united states mmwr morb mortal wkly rep 2016 65 1117 1118 4 van ingen j kohl ta kranzer k hasse b keller pm et al global outbreak of severe mycobacterium chimaera disease after cardiac surgery a molecular epidemiological study lancet infect dis 2017 oct 17 10 1033 1041 medication product 1 dolan sa littlehorn c glode mp dowell e xavier k et al association of bacillus cereus infection with contaminated alcohol prep pads infect control hosp epidemiol 2012 jul 33 7 666 71 2 kainer ma reagan dr nguyen db et al fungal infections associated with contaminated methylprednisolone in tennessee n engl j med 2012 dec 6 367 23 2194 2203 3 west k janelle s schutz k hamilton s mayo k et al outbreak of serratia marcescens bacteremia in pediatric patients epidemiologically linked to pre filled heparin flushes infect control hosp epidemiol 2019 jul 25 1 2 4 hudson mj park sc mathers a parikh h glowicz j dar d nabili m lipuma jj bumford a pettengill ma sterner jr mr outbreak of burkholderia stabilis infections associated with contaminated nonsterile multiuse ultrasound gel 10 states may september 2021 morbidity and mortality weekly report 2022 dec 12 71 48 1517 5 cdc outbreak of extensively drug resistant psuedomonas aeruginosa associated with artificial tears available at https www cdc gov hai outbreaks crpa artificial tears html 6 schwartz ng hernandez romieu ac annambhotla p filardo td althomsons sp free rj li r wilson ww deutsch feldman m drees m hanlin e nationwide tuberculosis outbreak in the usa linked to a bone graft product an outbreak report the lancet infectious diseases 2022 nov 1 22 11 1617 25 7 hartnett kp powell km rankin d gable p kim jj spoto s breaker e hunter r dotson n mcallister g stevens v investigation of bacterial infections among patients treated with umbilical cord blood derived products marketed as stem cell therapies jama network open 2021 oct 1 4 10 e2128615 '),(9830,'slug',0,1,' temp etntecsaneliwxhfpdnbcwvxzehmjrzboxgv '),(9830,'title',0,1,''),(9874,'slug',0,1,' 1 '),(9874,'title',0,1,' planning preparation '),(9875,'slug',0,1,' 1 '),(9875,'title',0,1,' detection reporting '),(9876,'slug',0,1,' 1 '),(9876,'title',0,1,' investigation control '),(9877,'slug',0,1,' 1 '),(9877,'title',0,1,' laboratory best practices '),(9878,'slug',0,1,' 1 '),(9878,'title',0,1,' notification communication 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'),(11450,'title',0,1,''),(11451,'field',98,1,' c diff guidelines and prevention resources '),(11451,'slug',0,1,''),(11452,'field',99,1,''),(11452,'field',100,1,''),(11452,'field',101,1,''),(11452,'field',104,1,' c diff guidelines and prevention resources '),(11452,'slug',0,1,' temp utrooqtuzbuyefnwscmkzdmuguvigazymsrn '),(11452,'title',0,1,''),(11453,'field',98,1,' compendium of strategies to prevent clostridium difficile infections in acute care hospitals '),(11453,'slug',0,1,''),(11454,'field',99,1,''),(11454,'field',100,1,''),(11454,'field',101,1,''),(11454,'field',104,1,' compendium of strategies to prevent clostridium difficile infections in acute care hospitals '),(11454,'slug',0,1,' temp uhpdorqbwhkekskycfhecoifvsjobfmrdwkd '),(11454,'title',0,1,''),(11985,'field',1,1,''),(11985,'field',11,1,''),(11985,'field',63,1,''),(11985,'slug',0,1,''),(12047,'slug',0,1,' chicago department of public health '),(12047,'slug',0,2,' chicago department of public health '),(12047,'title',0,1,' chicago department of public health '),(12047,'title',0,2,' chicago department of public health '),(12124,'slug',0,1,' cdc chicago department of public health '),(12124,'slug',0,2,' cdc chicago department of public health '),(12124,'title',0,1,' cdc chicago department of public health '),(12124,'title',0,2,' cdc chicago department of public health '),(12469,'field',98,1,' recommended actions in fungal disease outbreak investigations this page provides specific recommended actions for both public health and healthcare personnel responding to fungal disease outbreaks '),(12469,'slug',0,1,''),(12470,'field',99,1,''),(12470,'field',100,1,''),(12470,'field',101,1,' this page provides specific recommended actions for both public health and healthcare personnel responding to fungal disease outbreaks '),(12470,'field',104,1,' recommended actions in fungal disease outbreak investigations '),(12470,'slug',0,1,' temp skhlvkcmjvxiqsezdccjtzcfvqxhnswwalhz '),(12470,'title',0,1,''),(12471,'field',98,1,' healthcare associated mold outbreak information this page includes general information and frequently asked questions pertaining to mold outbreaks in healthcare settings it also includes contact information for requesting direct consultation and support from cdc '),(12471,'slug',0,1,''),(12472,'field',99,1,''),(12472,'field',100,1,''),(12472,'field',101,1,' this page includes general information and frequently asked questions pertaining to mold outbreaks in healthcare settings it also includes contact information for requesting direct consultation and support from cdc '),(12472,'field',104,1,' healthcare associated mold outbreak information '),(12472,'slug',0,1,' temp bfvgcsfocondpghwdprtquqthyxnbcajoktr '),(12472,'title',0,1,''),(12473,'field',98,1,' a guide to investigating suspected outbreaks of mucormycosis in healthcare this publication provides an overview of key challenges and response measures related to investigating mucormycosis in healthcare settings the included information may be applicable to other environmental fungi such as aspergillus '),(12473,'slug',0,1,''),(12474,'field',99,1,''),(12474,'field',100,1,''),(12474,'field',101,1,' this publication provides an overview of key challenges and response measures related to investigating mucormycosis in healthcare settings the included information may be applicable to other environmental fungi such as aspergillus '),(12474,'field',104,1,' a guide to investigating suspected outbreaks of mucormycosis in healthcare '),(12474,'slug',0,1,' temp whdpgwlyywqsuixvitiotuuuzikkcbprobfn '),(12474,'title',0,1,''),(12475,'field',98,1,' targeted environmental investigation checklist for outbreaks of invasive infections caused by environmental fungi this tool is intended to aid in performing an environmental assessment when investigating healthcare associated disease outbreaks caused by environmental fungi e g aspergillus spp and mucormycetes not all of sections of this checklist will pertain to every investigation '),(12475,'slug',0,1,''),(12476,'field',99,1,''),(12476,'field',100,1,''),(12476,'field',101,1,' this tool is intended to aid in performing an environmental assessment when investigating healthcare associated disease outbreaks caused by environmental fungi e g aspergillus spp and mucormycetes not all of sections of this checklist will pertain to every investigation '),(12476,'field',104,1,' targeted environmental investigation checklist for outbreaks of invasive infections caused by environmental fungi '),(12476,'slug',0,1,' temp mqnavntnumgwliikwgkpmttieemiyejdymge '),(12476,'title',0,1,''),(12617,'field',1,1,''),(12617,'field',11,1,''),(12617,'field',63,1,''),(12617,'slug',0,1,''),(12618,'field',3,1,' environmentally ubiquitous fungi e g aspergillus mucormycetes are a cause of invasive infections especially among immunocompromised persons that can be associated with substantial morbidity and mortality outbreaks of fungal infections among at risk patients in healthcare settings have been linked to construction water leaks insufficient air filtration non sterile medical supplies deficient device reprocessing dental procedures contaminated linens contaminated food and supplements and other sources of mold spores in the air or on surfaces '),(12618,'slug',0,1,''),(12618,'title',0,1,''),(12619,'field',1,1,''),(12619,'field',11,1,''),(12619,'field',63,1,' read more key points there is no national level public health disease surveillance for invasive infections with environmental fungi such as aspergillus or mucormycetes to aid in determining whether disease incidence in a healthcare facility is greater than expected approaches to healthcare facility surveillance include reviewing microbiology records for positive fungal culture results and if possible reviewing histopathology specimens with evidence of tissue invasion by fungal hyphae at risk patients often have complicated medical histories with many different potential sources of exposure and the incubation period for non cutaneous infection is not well established thus it can be challenging to distinguish colonization from clinical infection and to determine whether exposure occurred within or outside the healthcare facility investigation is warranted even when it is unclear whether an increase in the number of infections represents a true outbreak particularly if cases have onset 1 week after admission appear to cluster in time or place or occur among patients who share common healthcare exposures investigation should include an observational environmental assessment i e evaluation of potential environmental sources such as the heating ventilation and air conditioning system using a standardized tool example in resources below performed in coordination among public health infection prevention facilities management and engineering and environmental services staff environmental sampling can be difficult to interpret and should only be performed in the context of an epidemiologic investigation and with a predefined sampling strategy '),(12619,'slug',0,1,''),(12620,'field',64,1,' read more '),(12620,'field',65,1,' key points there is no national level public health disease surveillance for invasive infections with environmental fungi such as aspergillus or mucormycetes to aid in determining whether disease incidence in a healthcare facility is greater than expected approaches to healthcare facility surveillance include reviewing microbiology records for positive fungal culture results and if possible reviewing histopathology specimens with evidence of tissue invasion by fungal hyphae at risk patients often have complicated medical histories with many different potential sources of exposure and the incubation period for non cutaneous infection is not well established thus it can be challenging to distinguish colonization from clinical infection and to determine whether exposure occurred within or outside the healthcare facility investigation is warranted even when it is unclear whether an increase in the number of infections represents a true outbreak particularly if cases have onset 1 week after admission appear to cluster in time or place or occur among patients who share common healthcare exposures investigation should include an observational environmental assessment i e evaluation of potential environmental sources such as the heating ventilation and air conditioning system using a standardized tool example in resources below performed in coordination among public health infection prevention facilities management and engineering and environmental services staff environmental sampling can be difficult to interpret and should only be performed in the context of an epidemiologic investigation and with a predefined sampling strategy '),(12620,'slug',0,1,' temp mkkgvldnmfnmbqhhomxoyyeihbugmdckqydf '),(12620,'title',0,1,''),(12681,'slug',0,1,' cdc arkansas department of health '),(12681,'slug',0,2,' cdc arkansas department of health '),(12681,'title',0,1,' cdc arkansas department of health '),(12681,'title',0,2,' cdc arkansas department of health '),(12798,'field',98,1,' sample line list this sample line list can be used in the investigation of healthcare associated mold outbreaks this will show up in your downloads folder '),(12798,'slug',0,1,''),(12799,'field',99,1,''),(12799,'field',100,1,''),(12799,'field',101,1,' this sample line list can be used in the investigation of healthcare associated mold outbreaks this will show up in your downloads folder '),(12799,'field',104,1,' sample line list '),(12799,'slug',0,1,' temp vllypelwfmfaxfldxknoedbtsnnhwfgkqgyb '),(12799,'title',0,1,''),(12800,'field',98,1,' patient notification about suspected hospital associated outbreaks of invasive mold infections considerations for public health and hospital personnel this article addresses the intricacies and challenges of making patient notifications in the context of hospital associated clusters of invasive mold infections with recommended practices '),(12800,'slug',0,1,''),(12801,'field',99,1,''),(12801,'field',100,1,''),(12801,'field',101,1,' this article addresses the intricacies and challenges of making patient notifications in the context of hospital associated clusters of invasive mold infections with recommended practices '),(12801,'field',104,1,' patient notification about suspected hospital associated outbreaks of invasive mold infections considerations for public health and hospital personnel '),(12801,'slug',0,1,' temp jcisbucfobtbrsxklslksuunzubpgusvdqya '),(12801,'title',0,1,''),(12802,'field',98,1,' investigation of a prolonged and large outbreak of healthcare associated mucormycosis cases in an acute care hospital arkansas june 2019 may 2021 this article describes a large outbreak of healthcare associated mucormycosis that was potentially linked to linens '),(12802,'slug',0,1,''),(12803,'field',99,1,''),(12803,'field',100,1,''),(12803,'field',101,1,' this article describes a large outbreak of healthcare associated mucormycosis that was potentially linked to linens '),(12803,'field',104,1,' investigation of a prolonged and large outbreak of healthcare associated mucormycosis cases in an acute care hospital arkansas june 2019 may 2021 '),(12803,'slug',0,1,' temp krspgaevhxcbtrwskmjnfkiepjjzhbausbzf '),(12803,'title',0,1,''),(12804,'field',98,1,' keeping health care linens clean underrecognized hazards and critical control points to avoid contamination of laundered health care textiles this article includes checklists for assessing facility linen management practices '),(12804,'slug',0,1,''),(12805,'field',99,1,''),(12805,'field',100,1,''),(12805,'field',101,1,' this article includes checklists for assessing facility linen management practices '),(12805,'field',104,1,' keeping health care linens clean underrecognized hazards and critical control points to avoid contamination of laundered health care textiles '),(12805,'slug',0,1,' temp 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prevention and control recommendations for healthcare personnel during the coronavirus disease 2019 covid 19 pandemic the recommendations in this guidance continue to apply after the expiration of the federal covid 19 public health emergency this guidance provides a framework for facilities to implement select infection prevention and control practices based on their individual circumstances '),(14382,'slug',0,1,''),(14383,'field',99,1,''),(14383,'field',100,1,''),(14383,'field',101,1,' the recommendations in this guidance continue to apply after the expiration of the federal covid 19 public health emergency this guidance provides a framework for facilities to implement select infection prevention and control practices based on their individual circumstances '),(14383,'field',104,1,' interim infection prevention and control recommendations for healthcare personnel during the coronavirus disease 2019 covid 19 pandemic '),(14383,'slug',0,1,' temp lmmacgglecopwpdkamthpsqhkxqyjzzdxvtv 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rare but severe viral hemorrhagic fever vhf caused by the ebola virus any suspected case s of evd should be promptly reported to public health the virus can spread person to person through direct contact with blood or bodily fluids of a person who is sick with or has died from evd healthcare personnel can be exposed to ebola virus by touching a patients body fluids contaminated medical supplies and equipment or contaminated environmental surfaces preventing transmission of evd in healthcare settings requires careful application of infection control measures including but not limited to the effective use of personal protective equipment ppe '),(14503,'slug',0,1,' temp paobkymdvtnqfkostrrfvdsqiaqgxcbtsdbm '),(14503,'title',0,1,''),(14504,'field',1,1,''),(14504,'field',11,1,''),(14504,'field',63,1,' read more patients sick with evd may develop symptoms anywhere from 2 to 21 days after contact with the virus with an average of 8 to 10 days the course of the illness typically progresses from dry symptoms initially such as fever aches and pains and fatigue and then progresses to wet symptoms such as diarrhea and vomiting as the person becomes sicker '),(14504,'slug',0,1,''),(14505,'field',64,1,' read more '),(14505,'field',65,1,' patients sick with evd may develop symptoms anywhere from 2 to 21 days after contact with the virus with an average of 8 to 10 days the course of the illness typically progresses from dry symptoms initially such as fever aches and pains and fatigue and then progresses to wet symptoms such as diarrhea and vomiting as the person becomes sicker '),(14505,'slug',0,1,' temp wtezjdcsyqcefbupgcuxbvvcfesbrrhpdivl '),(14505,'title',0,1,''),(14506,'field',98,1,' infection prevention and control recommendations for u s hospital patients with suspected or confirmed viral hemorrhagic fevers '),(14506,'slug',0,1,''),(14507,'field',99,1,''),(14507,'field',100,1,''),(14507,'field',101,1,''),(14507,'field',104,1,' infection prevention and control recommendations for u s hospital patients with suspected or confirmed viral hemorrhagic fevers '),(14507,'slug',0,1,' temp agmmcmualdwzdchazbvimtzwwcperxjqcmdf '),(14507,'title',0,1,''),(14508,'field',98,1,' whos health topics page on ebola virus disease '),(14508,'slug',0,1,''),(14509,'field',99,1,''),(14509,'field',100,1,''),(14509,'field',101,1,''),(14509,'field',104,1,' whos health topics page on ebola virus disease '),(14509,'slug',0,1,' temp hrjaehpqqkzrynczbigvvnzswebaojgpmkvf '),(14509,'title',0,1,''),(14510,'field',98,1,' cdcs top 10 ebola response planning tips ebola readiness self assessment for state and local public health officials '),(14510,'slug',0,1,''),(14511,'field',99,1,''),(14511,'field',100,1,''),(14511,'field',101,1,''),(14511,'field',104,1,' cdcs top 10 ebola response planning tips ebola readiness self assessment for state and local public health officials '),(14511,'slug',0,1,' temp xtdhqvklvmmavzhfgvzymdbknssyyynzdcdu 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