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Operation Sally 2008

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Title: Operation Sally 2008


1
Operation Sally 2008
  • Salmonella Contamination
  • Municipal Water Supply
  • Alamosa, Colorado

2
Alamosa, Colorado
  • Resident Population
  • 11,000 people /-
  • Daytime Population
  • 30,000 people /-
  • Adams State College
  • Trinidad State Junior College
  • San Luis Valley Medical Center
  • Located in South Central Colorado
  • Elevation is 7,544 feet above sea level
  • Rio Grande bisects the community

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Alamosa, Colorado Demographics
  • Home Rule Municipality
  • County Seat
  • 3,215 housing units
  • Median family household income
  • 33,017
  • 46 Hispanic population
  • Largest alpine mountain valley in the world. (San
    Luis Valley)

7
Alamosa, Colorado Water Source
  • Deep Earth Aquifer
  • 6 wells, with individual well heads
  • 600 to 2,000 feet deep Artesian wells
  • Range from 72 to 94 degrees in temperature
  • 22 psi Artesian, pumped up to 65 psi for
    distribution
  • No treatment of entire water system.
  • Great public confidence in the integrity of the
    public water system.

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Initial Confusion of Illnesses
  • Reported Sickness for 5-7 days
  • Severe Abdominal Cramps
  • Severe Headaches
  • Vomiting and Nausea
  • Bloody Diarrhea
  • Public Health attempted to tie cases together
  • Initial reports and research by SLV RMC and
    Alamosa County Public Health Dept.
  • Initial lab confirmations of Coliform bacteria

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Initial Origin Quest
  • First confirmed case of Salmonella was from a
    McDonalds worker.
  • Alamosa County Public Health Dept. responded to
    check their food processing protocols.
  • This lead to many accusations/rumors and much
    speculation.

12
EpiCurve On Set Map
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Initial EOC panic
  • Agreement/Pact with all leaders
  • We slowed everything down.
  • 12 hour shifts for PD
  • The first order of business was to assure all
    citizens that everything was going to be fine and
    that we would provide enough water for everyones
    needs.

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3 Types of Salmonella Enterica
  • Typhi (Most severe of the 3 types)
  • Causative agent of typhoid fever
  • Often fatal
  • Can only infect humans
  • From swallowing infected water
  • Typhimurium
  • Food poisoning, mainly with mice
  • Not normally fatal
  • Enteritidis (Smiliar to Typhimurium)
  • Single most common cause of food poisoning
  • Adept at spreading through chickens

16
From Birds called Coliiforms
  • Coliform bacteria are the commonly-used bacterial
    indicators of sanitary quality of foods and
    water.
  • Coliforms are abundant in the feces of
    warm-blooded animals, but can also be found in
    the aquatic environment.

17
This one scared me!
  • Salmonella infection can rapidly spread
    throughout the whole food chain. A chicken from
    a single farm may be distributed over many
    cities, and even states, and hence Salmonella can
    be rapidly dispersed through millions of people
  • www.salmonella.org

18
This one too!
  • Unfortunately, in immunocompromized people, that
    is the elderly, young, or people with depressed
    immune systems, Salmonella infections are often
    fatal if they are not treated with antibiotics
  • www.salmonella.org

19
Case Study/Research
  • 5 reported cases of waterborne salmonella since
    1985.
  • 2 involved cracked pipes in distribution system
  • 2 involved insufficient water treatment
  • 1 involved untreated groundwater
  • 1993 case of Salmonella Typhimurium in water
  • Gideon, Missouri
  • 1,100 population of the City
  • 650 people became ill
  • 7 people died

20
Gideon, Missouri Facts
  • 31 of the cities population drank unboiled
    water, after the boil order was issued.
  • Reasons given for non-compliance
  • Did not remember 44
  • Disbelieved the order 25

21
Timeline
  • Thursday, March 6 2008
  • First case of illness onset reported
  • Monday, March 17 2008
  • E.O.C. established by Alamosa County Health Dept.
  • Tuesday, March 18 2008
  • 52 total cases of Salmonella confirmed

22
Timeline
  • Wednesday, March 19 2008
  • Bottled water order issued by Colorado Department
    of Health and Environment
  • Full E.O.C. opened with County and City
  • COHELP Line activated
  • Denver Water Quality arrives
  • Held First Public Meeting with City Council

23
First Public Council Meeting
  • People who declared we were wrong
  • False accusations
  • Rabbit Trails
  • McDonalds and Cantaloupe
  • Legal issues/threats
  • From flyers to liars
  • Rumors and Innuendo
  • From Chicken Little to the Arm Chair Scientist

24
Timeline
  • Thursday, March 20 2008
  • American Red Cross arrives with 18 volunteers
  • Three public water distribution sites established
    and opened
  • K-Mart
  • Boyd Park
  • San Luis Valley Regional Medical Center

25
Recognition
  • More than we could sustain/handle as a City for
    the initial time periods of being without water.
  • 3 weeks with NO use of the public water system.

26
Water Distribution
  • Avoid Citizen Panic
  • Water availability had to be immediate
  • Delivery to home bound patients, and
    infra-structure locations, first
  • This would hopefully engender community trust
  • Infrastructure Maintenance
  • SLV Regional Medical Center, Adams State College,
    Alamosa County Jail
  • We delivered water the next day to our citizens!
  • Delivery Schedules
  • Altered nature
  • 3 sites, 1 for the walking population
  • Resource Management
  • Staging area(s)
  • Security
  • Cleanliness of tanks and sites

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Water Distribution Site
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Water Distribution In Gallons
43
Water Distribution by Site
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Water Distribution by Time
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Timeline
  • Friday, March 21 2008
  • Governor Ritter issues an emergency order
  • Colorado National Guard Advance Team arrives, (3
    members)

47
Emergency Declaration by Colorado Governor Bill
Ritter
  • National Guard
  • Allocation of 300,000
  • National Incident Management Team
  • 3 Separate Colorado Teams
  • The transition challenge/shuffle

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National Guard
  • 3 Advanced Team Members
  • 15 soldiers
  • 1 water tanker
  • 3,000 gallons of potable water
  • 2 vans
  • Soldier transport

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One of the best things the Colorado National
Guard helped us with.
  • Creating a consistent media message plan that was
    structured in a manner that was easily understood
    by everyone.
  • They stressed consistency in both message and
    delivery, and it paid off.

54
National Guard and NIMS Team Associated Costs
  • Approximately 34,000 per day
  • Approximate total cost through 4/11/08
  • 600,000

55
Water Distribution Site Security
  • The integrity of the water supply points was
    critical.
  • We never left unattended water supplies
  • The cleanliness of the bulk water supply points
    was critical.
  • Procedures for dispensing

56
Timeline
  • Saturday, March 22 2008
  • Governor Bill Ritter arrives
  • U.S. Senator Ken Salazar arrives
  • U.S. Congressman John Salazar arrives
  • They did a press release, met with community
    members and handed out water.

57
Timeline
  • Sunday, March 23 2008
  • Delegation of authority to first National
    Incident Management Team from Colorado
  • More than 170 volunteers distribute Stage 1/Red
    Flyers
  • Main focus of flyer was to announce impending
    restrictions and notify of the Flush

58
National Incident Management Team
  • 1 Incident Commander
  • 1 Logistics Chief
  • 1 Planning Chief
  • 1 Operations Chief
  • 1 Finance Officer
  • 1 Safety Officer
  • 2-3 Media Officers
  • Key!

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Flyer Distribution
  • 900 Volunteers
  • More than 4,000 hours
  • Water Distribution Sites
  • House to House flyer distribution
  • Stage1/Red and Stage 2/Yellow
  • Stage 3/Green was delivered in stores and via our
    local newspaper.

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Timeline
  • Monday, March 24 2008
  • Colorado Department of Public Health and
    Environment announces laboratory confirmation of
    Salmonella in the City of Alamosa public water
    supply.
  • CDC confirmed 5 positive tests on 5 tested
    samples
  • 18 Additional Colorado National Guard arrive
  • Governor Ritter asked for 9 federal
    specialists/experts to come to Alamosa, CO

64
Timeline
  • Monday, March 25 2008 - Continuation
  • Alamosa Public Schools cancelled classes
  • Adams State College cancelled classes
  • Loaded with water - Readiness
  • Parents and kids then stayed home
  • Water had been staged into schools and work
    places as secondary supply points

65
Timeline
  • Tuesday, March 25 2008
  • 0900 hours system flushing begins
  • 5,500 newspaper inserts
  • Arrival of Health and Human Services staff
  • The first day was less dramatic than we thought

66
The Flush
  • 25 ppm of Chlorine for 24-48 hours
  • Maintain 10 ppm of Chlorine for 3 days
  • 6-7 ppm Chlorine is the chlorination of an
    average swimming pool
  • Minimum of 2 ppm of Chlorine for drinking
  • Less than 1 ppm of Chlorine forward

67
Stage 1, Red Phase
  • Stated Flyer Instructions
  • Do not drink city water
  • Do not use city water for food preparation
  • including all baby formula
  • Do not use city water to bathe or shower
  • Do not use city water to brush your teeth
  • Do not use city water for any pets
  • Do not use your dishwasher
  • Do not use your clothes washing machine

68
Stage 1, Red Phase
  • We could flush our toilets, and that was it!
  • It is amazing how the little things in life can
    make you so happy.

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Kill Time - Chlorine to Salmonella
  • At 1 ppm Chlorine, Salmonella is killed in 34
    minutes
  • At 10 ppm Chlorine, Salmonella is killed in 3.5
    minutes
  • At 25 ppm Chlorine, Salmonella is virtually
    instantly killed

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Timeline
  • Wednesday, March 26 2008
  • Full system flush continued
  • City Council updated at meeting
  • Personnel from Centers for Disease Control arrive
  • Start of daily recorded messages from Mayor

73
Timeline
  • Thursday, March 27 2008
  • Comfort Inn opens for free public showers
  • This was 7 days after the bottled water order.
  • Everyone was getting stinky and irritable!

74
Timeline
  • Friday, March 28 2008
  • My first shower at Comfort Inn
  • 106 of 119 regulated food industries had been
    inspected and re-opened for business by the
    Consumer Protection Division of the Colorado
    Department of Public Health.
  • All areas in the City had received the super
    chlorination

75
Timeline
  • Saturday, March 29 2008
  • My wifes first shower at Comfort Inn
  • Water tests continued throughout the system
  • Stage 2/Yellow flyers were distributed through
    the City as tests confirmations allowed
  • National Guard personnel reduced by 11 with 9
    remaining for water distribution

76
Stage 2, Yellow Phase
  • Stated Flyer Instructions
  • All of the same restrictions of Stage 1/Red
    Phase except for
  • We could take Sponge bathes or brief showers
    only in luke-warm (not hot) water.

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Hold on a minute!
  • We were supposed go to Stage 3/Green on
    Wednesday, 4/09/08.
  • The Colorado State Health Dept. advised us
  • Giradia and Cryptosporidium were also present
    in some earlier tests.

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Timeline
  • Sunday, March 30 2008
  • 99 of the City went into Stage 2/Yellow phase
  • Only the 20 homes on the golf course were not in
    Stage 2.
  • Schools were to re-open on the next Monday

80
Timeline
  • Monday, March 31 2008
  • The entire City was in Stage 2/Yellow of the
    flush process.
  • Approval to use water to wash clothes was
    announced.

81
Stage 3, Green Phase
  • Stated Flyer Instructions
  • Friday, 4/11/08, at 1630 hours
  • Run all taps for at least 2 minutes
  • Sanitize any water filtration systems
  • Clean and sanitize kitchen sink
  • Run dishwasher empty 3 times
  • Run ice-makers 3 times, and discard all ice
  • Drain refrigerator water dispensers for 5 minutes
  • Brew 4 pots of hot water in coffee makers

82
Media Exposure
  • Print
  • Daily articles in the Valley Courier
  • Everything written/spoken in English and Spanish
  • This is very exciting Denver Post
  • Video
  • KENY TV (Channel 10)
  • Daily taped video messages from the Mayor
  • Radio
  • National
  • Good Morning America
  • CNN

83
Daily Police Business Continues
  • We received messages on impending looting in
    Alamosa from our State Intelligence/Analysis
    Center.
  • Calls for Service were relatively low, but
    steady.
  • There were many public inquires and questions.
  • We were completing the building of our new Police
    Department, with a timeline.

84
Colorado Citizen Help Line Calls
  • CO Help Line
  • 2,855 Total Calls
  • 1,420 talked to a live person
  • 1,435 listened to the voicemail
  • Setting up this resource was probably one of the
    better things that we did.

85
Potential Bacteria Origin/Causes
  • Cross Connections
  • 140 potential individual cross connections
  • No backflow prevention device at that onnection
  • Loss of system pressure causing a backflow into
    the water distribution system.
  • Storage tank contamination from small discovered
    cracks.
  • Intentional?

86
Potential Scams
  • Door to door collection of money to Help the
    City of Alamosa pay the State of Colorado for all
    the bottled water.
  • EPA personnel in town asking to enter homes and
    inspect water systems, then make
    recommendations on purchasing a water filtration
    system.

87
Overall Case Statistics
  • Reported Illnesses, as of 4.21.08
  • 411 Cases Reported
  • 112 Confirmed Cases of Salmonella
  • 18 Hospitalizations
  • 1 Death
  • Ages
  • 3 Weeks to 87 years
  • Median age of 11 years
  • Now being transmitted person to person
  • Over 270 water tests were conducted
  • Volunteers
  • 900 Volunteers, plus
  • 4,000 Hours, plus

88
Overall Water Statistics
  • Bottled Water Distributed
  • 53,528 Gallons
  • Bulk Water Distributed
  • 133,932 Gallons
  • Total Water Distributed
  • 187,460 Gallons

89
Contributing Agencies/Companies Intellect/Informat
ion
  • 36 Different Agencies
  • Municipalities, Counties, States
  • From Across the United States
  • Denver Water
  • Federal Agencies
  • DHS, FDA, Preparedness and Response, CDC
  • Red Cross

90
Contributing Donors Product
  • Safeway Grocery, King Sooper Grocery, Coors,
    Anheuser-Busch, Wal-Mart, Walgreen's, Nestles,
    McDonalds, Albertsons Grocery, Burger King,
    Costco, LDS Church
  • Comfort Inn

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Current Situation
  • Stage 3/Green at 1630 hours on Friday 4/11/08
  • 2 ppm of Chlorine for a period of time
  • Will go down to .7 to 1 ppm Chlorine
  • Epidemiology continues
  • We are still seeking the origin of bacteria
    influx
  • We probably have the cleanest water in all of
    Colorado
  • City Manager Nathan Cherpeski

94
A Bad Headline Day
  • Death Linked to Salmonella
  • Friday, March 18 2008

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NIMS importance
  • Go to, and Pay Attention to the Training
  • Develop and Institute a EOC plan
  • Inter and Intra Dept. Cooperation
  • Agreements and/or MOUs
  • Speak the same language
  • Cooperate with each other

97
Lessons Learned
  • Leaders must make critical decisions in the face
    of great scrutiny.
  • Remain calm with the public.
  • Make a plan, follow your plan, but be flexible.
  • Resources management is huge!
  • Staging Areas and Accountability
  • Press release information must be accurate and
    systematically done.

98
Questions
  • Alamosa Colorado Police Department
  • Chief John A. Jackson
  • 2431 Main Street
  • Alamosa, Colorado 81101
  • 719-589-2548
  • jjackson_at_cc.alamosa.co.us
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