TUBERCULOSIS DISASTER

1
TUBERCULOSIS DISASTER
OR
BE PREPARED WE WERE NOT!
2
LOUISIANA
Katrina
Rita
3
Pre-Katrina

• August 25th 26th all 140 TB cases and suspects
  were given DOT as usual
• At 430 PM on the 26th, employees were ordered to
  evacuate
• Backup disk of Region I TB Register taken by DIS
  Manager to Monroe
• No meds or records removed from the offices

4
Evacuation

• On 27th and 28th, evacuees fled to motels,
  relatives, friends or shelters
• No known addresses
• Few clothes, no medications, and no records
• Evacuation closed at 400PM on the 28th
• Well only be gone for 2 or 3 days

5
Katrina August 29th

• Everyone watched as the Greater New Orleans and
  Northshore areas were torn apart
• Relief that the storm had not flooded New Orleans
• Astonishment at the breech of the levees on 30th
• Watched the Superdome flood knowing the State
  Office Building would be underwater

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Lost

• Communications still good on 30th (Email Server
  still running)
• Lost on 30th
• Central Pharmacy
• Central Laboratory
• Email Server approximately 1000 PM
• Cellular Phone contact through NO
• All Region l operations

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Essentials for Response

• Communication
• Dedicated personnel
• National network
• CDC support
• State support

8
Reasoning

• Locate evacuated Disease Intervention staff
• Begin checking resources for recovery
• Provide essentials for remainder of the state
• Determine Cases and Suspects evacuated

9
Recovery

• Two Supervisors from Region I located (Houston
  and Monroe)
• Confirmed losses and contacted Texas, VersaPharm,
  NTCA and CDC
• Communicated with TB Managers in all regions to
  determine needs
• BY LUCK found the list of cases and suspects
  evacuated

10
Help is on the way!

• Texas State Lab began performing all Louisiana TB
  bacteriologies
• VersaPharm donated three months of medications
• NTCA and CDC established a Katrina Hotline for
  locating evacuees
• TB Public Health Advisors assigned (Lafayette and
  Baton Rouge)
• Mobile Clinic established in Region I

11
New Problems

• Governors Executive Order (Boards)
• Maintaining TB Programs in other Regions
• Patients return before food, water, power and TB
  services are available
• Find experienced DIS for New Orleans
• No address
• No one to ask
• Find housing for Staff in devastated areas

12
Katrina Outcome

• All 10 Northshore patients located in 8 days
• All 130 Region I patients located by
• 10-10-05 (six weeks)
• TB medication supplies never interrupted
• Treatment of LTBIs never interrupted
• Lab services continuous
• Mobile Clinic established in Region I

13
Lessons for the Future

• Cases and suspects
• Issued four week supply of meds
• Phone numbers for follow-up
• Collected contact numbers from patients
• Made copies of records
• Evacuated with Meds, PPD etc. in hand
• Staff to report to nearest HD after evacuation
• Finish Web LATB (all records able online)