Graduation Date

Spring 5-6-2017

Document Type

Thesis

Degree Name

Master of Science (MS)

Programs

Emergency Preparedness

First Advisor

Sharon Medcalf, Ph.D.

Abstract

In November 2016, a 15-19 year old high school student was diagnosed with active pulmonary Tuberculosis (TB) and reported to the Douglas County Health Department (DCHD) in Omaha, Nebraska. A contact investigation led the health department to a local urban high school with a diverse and mobile population. A modified point of dispensing (POD) clinic was determined to be the efficient method to test the 196 faculty and students that were exposed to the index case. Emergency response coordinators (ERC’s) at DCHD adapted the POD dispensing plan with an embedded Incident Command System (ICS) to fit a smaller incident as well as for the unique needs of a public health emergency. The first clinic was held on December 6th - 9th. A total of 173 faculty and students were tested resulting in the identification of seven latent positives. An epidemiological investigation showed all latent are not related to the index case and had other risk factors for their latent TB. The second clinic was held February 21st – 22nd and 163 of the 189 identified contacts were tested. There was one student who tested positive after initially testing negative the first time. Therefore, it is possible this was due to the exposure to the index case, also known as a conversion. In conclusion, adaption of the POD dispensing plan worked very well for the DCHD in the contact investigation of the TB case at this urban high school. This investigation allowed the DCHD to implement and modify POD plans, improve coordination between multiple divisions within the department and successfully limit the spread of TB to the community.

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