August 15, 2017 | Volume 6, Issue 16

The Hospital and Healthsystem Association of Pennsylvania, Keystone Health Preparedness Digest, Improving Health Preparedness and Response

Emergency Preparedness Hot Topics

New Health Alerts and Advisories

PAHAN #387 - 08/11/17 - ADV - Detection and Control of Emerging Drug-Resistant Candida auris. The Pennsylvania Department of Health (PADOH) is asking all health care providers to review the U.S. Centers for Disease Control and Prevention's (CDC) guidelines for the identification, treatment, and infection control of C. auris and report any suspect cases of C. auris to their local public health jurisdiction.

PAHAN #386 - 08/09/17 - ADV - Increase in Reported Cases of Cyclospora cayetanensis Infection, United States, Summer 2017. PADOH is forwarding the following advisory to health care providers from the CDC. If you have questions or concerns, please call PADOH at 1-877-PA-HEALTH (1-877-724-3258) or your local health department. 

CDCHAN-00405: August 7, 2017: The CDC, State and Local Health Departments, and the Food and Drug Administration (FDA) are investigating an increase in reported cases of cyclosporiasis. The purpose of this HAN Advisory is to notify public health departments and health care facilities and to provide guidance to health care providers of the increase in reported cases. Please disseminate this information to health care providers in hospitals and emergency rooms, to primary care providers, and to microbiology laboratories.
Health care providers should consider a diagnosis of cyclosporiasis in patients with prolonged or remitting-relapsing diarrheal illness. Testing for Cyclospora is not routinely done in most U.S. laboratories, even when stool is tested for parasites. Health care providers must specifically order testing for Cyclospora, whether testing is requested by ova and parasite (O&P) examination, by molecular methods, or by a gastrointestinal pathogen panel test. Cyclosporiasis is a nationally notifiable disease; health care providers should report suspect and confirmed cases of infection to public health authorities.

Health professionals: Sign up for the Pennsylvania Health Alert Network (PA-HAN).

PA Statewide Knowledge Center (HIMS) Training Available

Pennsylvania health care facilities are requested to contact their HAP Regional Manager to schedule training.

National Preparedness News and Updates

Big Easy on Edge as City Scrambles to Fix Pumping System (AP News) Flood-weary residents remained on edge as Louisiana's governor declared a state of emergency in New Orleans, but this time the threat wasn't churning in the Gulf of Mexico. The city's malfunctioning water-pumping system and the threat of more rain have left some neighborhoods at a greater risk of flooding. Article

Hurricane Season, Already Busy, May Get Even Busier (New York Times) Government forecasters said that the Atlantic hurricane season, already a busy one, may be the busiest since 2010 and is likely to produce two to five major hurricanes. Article

The Latest: 7 Earthquakes Hit Oklahoma City Area in 3 Days (AP News) At least seven earthquakes have struck the Oklahoma City area recently, including one that knocked out electrical service to nearby residents. The Oklahoma Corporation Commission says the quakes rattled the area from Tuesday, August 1, to Thursday morning, August 3. Each had a magnitude of 3.0 or stronger. Article

INFECTIOUS DISEASES
ZIKA

Common Mosquito Can Carry Zika Virus: Brazilian Scientists (Can-India.com) The common Culex mosquito is able to transmit the harmful Zika virus, Brazilian scientists have discovered. Scientists at the Oswaldo Cruz Foundation (Fiocruz) in the Pernambuco state revealed that the virus can reach the insect's salivary gland, "which is believed to indicate that Culex mosquitoes may be one of the vectors of the Zika virus," reports Xinhua news agency. Article

Florida Adds Dozen More Zika Cases (News 4 JAX) Florida health officials added another 12 reported cases of the Zika virus during the past week, including the first sexually transmitted case in 2017, according to information posted on the state Department of Health website. Article

Thermo Fisher Zika Test Gets FDA Emergency Use Authorization (Genome Web. Free registration required.) The U.S. Food and Drug Administration granted emergency use authorization to Thermo Fisher Scientific's TaqPath Zika Virus Kit. The kit is authorized to be conducted by CLIA-certified labs in the U.S. only for the qualitative detection of RNA from Zika virus and diagnosis of Zika virus infection in human serum and urine collected alongside a patient-matched serum specimen. Individuals receiving the test must meet U.S. CDC Zika virus clinical and/or epidemiological criteria. Article

Influenza

Philippines Reports First Avian Flu Outbreak, to Cull 200,000 Birds (Reuters) The Philippines will cull 200,000 chickens, quails, and ducks after confirming the country's first outbreak of bird flu, according to Agriculture Secretary Emmanuel Pinol. Article

Emerg. Microbes & Inf: Role of Ducks in Emergence of New H5N1 Genotype—Bangladesh (Avian Flu Diary) The Asian HPAI H5N1 virus (clade 0)—which first appeared in Guangdong Province in the mid 1990s—has since evolved into dozens of clades and scores of genotypes—most of which have disappeared, supplanted by the generation of more 'fit' viruses. Article

MERS

MERS Infects 7 More in Saudi Arabia, Some Part of Hospital Cluster (CIDRAP) The Saudi Arabian Ministry of Health reported seven new cases of MERS-CoV, including five connected to a cluster in Dumah Al Jandal, apparently linked to a hospital setting. Article

Other Emerging Disease

Pa. Health Department Announces First Human Case of West Nile in 2017 (TribLive) A Montgomery County resident tested positive for probable West Nile virus, marking the first human case in Pennsylvania this year. Article

Ohio Doughnut Shop Linked to Norovirus Outbreak; 200-plus Ill (Food Safety News) A doughnut shop in suburban Toledo, OH, remained closed as county health inspectors continued an investigation into a norovirus outbreak that has sickened more than 200 people. Mama C's Donuts & Coffee on Conant Street in the Toledo suburb of Maumee, OH, voluntarily closed after public health officials informed the owners of illnesses among customers, according to multiple media outlets in the area. Article

Rapid Malaria Tests Work, but with Unexpected Drawbacks (New York Times) Rapid diagnostic tests have greatly improved malaria treatment in the last decade, but they also had some unexpected bad consequences, a large new study has found. Article

CYBER

Ransomware 2.0: It's coming, and health care needs to get prepared (Healthcare IT News)
Some cybersecurity experts say health care has only dealt with “Ransomware 1.0” to date, which begs the question: How much worse will “Ransomware 2.0” be for a sector already under siege? Article

BCI: Ransomware attacks caused a fifth of infected SMEs to cease business operations immediately (Disaster Recovery Journal) More than one-third of businesses have experienced a ransomware attack in the last year, and more than one in five (22%) of these impacted businesses had to cease operations immediately, according to a study by Malwarebytes. Article

OPIODS

Trump Declares Opioid Crisis a "National Emergency" (CBS News) President Donald Trump is officially declaring the opioid crisis a "national emergency." "The opioid crisis is an emergency and I'm saying officially right now it is an emergency," Mr. Trump said. "It's a national emergency. We're going to spend a lot of time, a lot of effort and a lot of money on the opioid crisis." Article

Interagency Board issues opioid response related safety guidance: Recommendations on Selection and Use of Personal Protective Equipment and Decontamination Products for First Responders Against Exposure Hazards to Synthetic Opioids, Including Fentanyl and Fentanyl Analogue. Guidance

More Than a Third of U.S. Adults Prescribed Opioids (Scientific American) The U.S. needs to curb excessive opioid prescribing and improve access to pain management techniques, suggests a new government study. Researchers found that more than one-third of U.S. adults were prescribed the medications in 2015 and many also misused the drugs. Article

18 Pittsburgh police officers sent to hospital after possible fentanyl exposure during ICE raids (TribLive) Eighteen Pittsburgh SWAT officers were sickened by suspected fentanyl while assisting federal officials on a series of raids in the West End of the city. Article

HEALTH SYSTEM PREPAREDNESS

Handheld Spectral Analyzer Turns Smartphone into Diagnostic Tool (Phys.org) Researchers at the University of Illinois at Urbana-Champaign have developed technology that enables a smartphone to perform lab-grade medical diagnostic tests that typically require large, expensive instruments. Costing only $550, the spectral transmission-reflectance-intensity (TRI)-Analyzer from Bioengineering and Electrical & Computer Engineering Professor Brian Cunningham's lab attaches to a smartphone and analyzes patient blood, urine, or saliva samples as reliably as clinic-based instruments that cost thousands of dollars. Article

AI Can Now Detect Anthrax Which Could Help the Fight Against Bioterrorism (The Verge) In an effort to combat bioterrorism, scientists in South Korea have trained artificial intelligence to speedily spot anthrax. The new technique is not 100 percent accurate yet, but it could revolutionize how we screen mysterious white powders for the deadly bioweapon. Article

ECDC Tool for the Prioritization of Infectious Disease Threats (ECDC) This qualitative tool, implemented as an Excel workbook, is based on multi-criteria decision analysis. It ranks infectious disease threats in a transparent, comparable and methodologically reproducible manner. The tool enables the relative ranking of different infectious disease threats. It is intended as a supplement to other methods that also support decision-making in preparedness planning. Article

In High Demand: How Health Centers Can Build Surge Capacity, Support People with Access and Functional Needs, and Advance National Health Security (ASPR Blog) Our nation's network of nearly 1,400 community health centers play a vital role in providing health care services to almost 25 million patients, including 8.4 million patients in rural health centers. When a disaster strikes, they have a key role in supporting national health security by continuing to provide services to the people they care for every day. Article

Regional News

HAP regional manager contact information and the latest regional news and reminders are available at the Emergency Preparedness page of the HAP website.


Coalition News

2017-2022 ASPR HPP Health Care Coalition Capabilites Document

New! ASPR 2016 HCC Performance Measures released!

CMS Emergency Preparedness Rule

CMS Emergency Preparedness Rule Home Page Source for all official information regarding the rule and implementation.

Training and Educational Opportunities
Knowledge Center (KC) Training Summit

September 13 to 15, 2017, at Texas A&M Engineering Extension Service (TEEX) EOC Training Center in College Station, Texas. At this experiential training summit, attendees will get hands-on time using the KC Healthcare Incident Management System to manage simulated emergencies based on “real world” situations. This state-of-the-art, internationally recognized training center shares a campus with Brayton Fire Training Field, making this an ideal location for realistic simulations and in-depth exercises. Register online. Registration deadline: August 30, 2017.

G290 Public Information Officer Training

G290 Public Information Officer Training, September 19 and 20, 2017, at the Joint Operations Center, 4300 Broadway, Allentown, PA. This training will equip participants with the basic skills needed to be full- or part-time PIOs such as oral and written communications, understanding and working with the media, and basic tools and techniques needed to perform effectively. You must register at TRAIN PA. Please search under course ID 1066853.

Pennsylvania EMS 40th Annual Conference

September 20 to 22, 2017, DoubleTree Resort, Lancaster, PA. More information.

Cyber Security Incident Management

Cyber Security Incident Management, AWR-136 & MGT-384, September 25 and 26, 2017, sponsored by the Department of Homeland Security through TEEX. Hosted by LVHN OEM at Lehigh Valley Health Network OEM, 2024 Lehigh St. Allentown, PA 18103. These courses are focused on basic cyber security principles and strategic-level community management of cyber-attack events. Please note: attendance at the first course (AWR-136) is required for the second course (MGT-384). More information is available online or contact Kyle Horton.  Registration is required through PEMA’s LMS. Once at TRAIN PA, you can register for an account and search for course registration by the course numbers. You will also need a FEMA SID to apply. This can be completed quickly at FEMA's website.

Advanced Incident Command Training—Multiple dates

Advanced Incident Command Training—Multiple dates at Montgomery County Fire Academy, 1175 Conshohocken Road, Conshohocken, PA 19428

ICS 300—September 6 and 7, 2017, from 6:30 pm to 10:30 pm; September 9 and 10, 2017, from 8 am to 5 pm

ICS 400— October 21 and 22, 2017, from 8 am to 5 pm

Register online through TRAIN PA.
Course ID: 1067423 (300) and 1062436 (400)
This training is funded though MCDPS by a grant from the U.S. Department of Homeland Security. For information please contact Heather Morgan, MEP, Training and Exercise Coordinator, at (610) 631-6517

Governor's Emergency Preparedness Summit 2017

Pre-conference September 30 to October 1. Main conference October 2 to 4. Hershey Lodge, 325 University Drive, Hershey, PA. More information is availlable online, Registration Is NOW OPEN, or contact Claudia M. Madrigal, DOH Bureau of Public Health Preparedness at (717) 346-0640 with questions.

Mid-atlantic Emergency Preparedness & Hazmat Response Conference

October 17 to 19, 2017, Stations Square, Pittsburgh, PA. Half-day to two-day training programs, mass casualty/venue tabletop exercise, outdoor equipment display, numerous breakout sessions, motivational speaker and artist Sam Glenn, exhibit hall with the latest in products and services, and networking with peers from across the country! More details and registration information available online.

2017 Association of Healthcare Emergency Preparedness Professionals (AHEPP) Annual Conference

November 7 to 9, 2017, Dallas, Texas. More information is available online.

National Healthcare Coalition Preparedness Conference

November 28 to 30, 2017, the Sheraton Hotel and Marina in San Diego, CA. The conference is independent and exists for coalitions, by coalitions. The conference also supports coalition efforts to meet requirements for emergency preparedness grant programs offered by the U.S. Department of Health and Human Services. Register online or call (202) 759-5794.

Ongoing Training Opportunities

The CDC is offering a new online course for health professionals concerning reproductive health and emergency preparedness.

Center for Domestic Preparedness Resident Training

The Disaster Resistant Communities Group has more than 100 online just-in-time "training videos" to enhance emergency preparedness. Many are related to health care.

Federal and CDC COCA Partner conference and training information for the next six months.

FEMA Emergency Management Institute Training Opportunities Independent Study Courses

Psychological First Aid for Leaders (PFA-L) Training—This interactive, online training has broad utility for response and health care partners as well as those in existing leadership roles. The training takes about 90 minutes to complete.

Public Health Nursing Disaster Surge Course is based upon the 25 Public Health Nursing (PHN) Competencies for disaster surge, and is intended to provide participants with a comprehensive view of PHN surge from preparedness to response to recovery. There is no cost for this course.

Suspicious Activity Reporting (SAR) Training for Health Care Workers

The Nationwide SAR Initiative (NSI) recently released the new online training module, Public Health and Health Care Partners, developed to teach workers to recognize suspicious behavior associated with pre-incident terrorist activities. The training also discusses civil rights, privacy, and how and when to report suspicious activity. NSI also offers a two-page PDF resource Suspicious Activity Reporting (SAR) for Public Health and Healthcare Partners. This training module could easily be added to any in-house training for new employees or yearly refresher training for established personnel.

TRAIN PA

DOH and the Pennsylvania Emergency Management Agency have established Train PA, the Pennsylvania affiliate for the Public Health Foundation’s learning management system and network. TRAIN PA is a free, collaborative resource provided by the Commonwealth of Pennsylvania to public health organizations and academic institutions across the state to assist in their educational and workforce development efforts. Signing up for a TRAIN PA user account is simple, and it offers you access to thousands of trainings provided by public health agencies at all levels of government, schools of public health and other academic institutions, and other related organizations. If you already have a TRAIN account through TRAIN National, MRC TRAIN, or CDC TRAIN, you can log in to TRAIN PA using the username and password you use at these other sites. If you have any questions or would like to explore how you could use TRAIN PA as a training provider or administrator, please feel free to contact the TRAIN PA administrator team.

Training Trigger: Tourniquet Use Under Medical Protocols

This one-page document from the Interagency Board for Equipment Standardization and Interoperability provides information about the use of tourniquets in emergency medical services. Lessons learned in recent mass casualty incidents and combat casualty care have shown that a properly applied tourniquet can save the patient's life in cases where severe (critical) blood loss endangers the survival of the patient.

Reference Resources
Our pledge to a healthy Pennsylvania

The Hospital and Healthsystem Association of Pennsylvania
30 North Third Street, Suite 600
Harrisburg PA, 17101