The Fort Wayne-Allen County Department of Health (DOH) and the Fort Wayne Community School system (FWCS) were informed on the evening of Friday, December 11, 2015 of a case of meningococcal disease in someone who was present at St. Joseph Central Elementary School. This disease is caused by the bacterium Neisseria meningitidis and generally affects people in two ways:
· Meningitis (an inflammation of the tissues covering the brain and or spinal cord)
· Bloodstream infection (that usually leads to bleeding under the skin)
With support of the Indiana State Department of Health (ISDH) and the Centers for Disease Control and Prevention (CDC), the DOH conducted a contact investigation for a suspect case of Neisseria Meningitis in an Allen County resident. All family and healthcare contacts were provided preventative antibiotics. 100 percent of all close contacts were identified and treated.
Because of the circumstances associated with the person’s activities and potential for closeness to a large number of people at St. Joseph Central Elementary school, a collaborative decision with the DOH, ISDH and the CDC was made to offer preventative antibiotics to all students and faculty of the school present during the period of infectiousness for this disease (as well as to contacts identified of periphery activities in which the person was involved).
To ensure timely administration of the preventive antibiotic, a mass prophylaxis dispensary clinic was held on Tuesday, December 15, 2015, for students, faculty, and staff of the school. 449 people were provided with medication. The DOH partnered with Parkview Pharmacy for the event and they coordinated the on-site medication dispensary as well as the needed pharmacy consultation with patients. Prescriptions to local pharmacies were coordinated by the DOH for all other close household and periphery contacts identified in need of medication. The involved hospital coordinated prescriptions for all involved healthcare and emergency response personnel. FWCS provided a site for the mass dispensary and notified all parents and faculty of the potential exposure and set the hours for and location of the mass dispensing site. School nurses and volunteers systematically weighed all children and reviewed registration forms. In all, 496 people were provided preventative antibiotics.
Communication experts from the DOH, FWCS system, Parkview Regional Medical Center and ISDH developed and implemented a media strategy to inform the public in a timely manner of the both the infection and the planned interventions to minimize transmission to future cases. Two media events where held. In addition, a hotline was established to answer questions directly from the public. The hotline received 56 calls in two days.
Specimens were sent to the CDC for confirmation testing. On December 21, 2015, the ISDH notified the DOH that the specimen was indeed positive for Neisseria Meningitis. The patient has since been released from medical care and is now recovering.
DATA & COSTS
| CONTACT NOTIFICATION | |
| # of Students on School Roster/Notified (letter/other) | 411 |
| # of Faculty/Misc Staff Notified | 112 |
| # of Close Contacts, Healthcare Workers and Periphery Event Contacts Notified | 58 |
| TOTAL | 581 |
| PROPHYLAXIS PROVISION to close contacts, healthcare workers & periphery event contacts: | |
| Physician/Medical Staff/EMS/Fire | 12 |
| Household/Family/Friend Close Contacts | 8 |
| Other Periphery Event Contacts | 27 |
| TOTAL | 47 |
| % of those close contacts notified who opted to receive prophylaxis | (81%) |
| MASS DISPENSARY CLINIC ATTENDANCE (for others potentially exposed): | |
| # of Students provided prophylaxis at mass clinic | 335 |
| # of misc (students, volunteers, interns, etc.) treated at mass clinic | 11 |
| # of Faculty/Misc provided prophylaxis at mass clinic | 103 |
| # of declinations | 4 |
| TOTAL | 449 |
| TOTAL PROVIDED PROPHYLAXIS | 496 |
| % of those notified overall who opted to receive prophylaxis | 85% |
| HOME DELIVERIES (included in #’s above): | |
| # of home deliveries conducted by DOH on 12/16/15 | 13 |
| STAFF AND SUPPLY COSTS: | |
| DOH Staffing and costs | |
| # of DOH staff involved with event overall | 19 |
| DOH hours worked total for this event | 153 |
| DOH Hours (OT worked but unpaid to the employees as they are mgmt. or executive-4 people) | 81.75 |
| DOH staffing costs for this event | $11,745.83 |
| DOH Medication and Supply costs for this event | $2,957.49 |
| FWCS Nursing Staffing and costs | |
| # of FWCS staff involved with event overall | 12 |
| FWCS hours worked total for this event (**) (^) | 91 |
| FWCS staffing costs for this event (**) | $2,856.00 |
| Parkview Pharmacy Staffing and costs | |
| # of Parkview Pharmacy staff involved with event overall | 9 |
| Parkview Pharm Staff costs for this event (***) | $770.00 |
| Parkview Pharm supply costs for this event | $145.56 |
| TOTAL COSTS FOR THIS EVENT (not including mgmt wages for overtime) | $18,474.88 |
| MEDICATIONS DISPENSED/PRESCRIBED (at Dispensary) | |
| Ciprofloxacin | 441 |
| Rifampin | 8 |
| Ceftriaxone | 1 |
** does not include PIO costs for Parkview or FWCS
^ time is just of nurses time
*** does not include amount for mgmt staff of Parkview Pharmacy as they are unable to be paid overtime
