Hi all, some suggested additions following the lecture at the introductory course 2015

10 steps - control measures are placed at the side, to express the idea that they could and should be considered and implemented at any stage

Understanding the 10 steps

The modified 10 steps lose the step to define the population at risk. It can be easier to define a case in terms of a population at risk plus clinical / laboratory findings. This ensures inclusion of time , place , person in the definition.

In reality the case definition and population at risk are developed in an iterative loop, as once cases have been found and described, this may lead to a hypothesis about the cause and the population at risk. So an early case definition may be broad in both disease syndrome and population , a later one has a more clearly demarcated population at risk.

The outbreak team

The outbreak team is a group of people with appropriate skills and responsibilities joined by the aim of investigating and controlling the outbreak. It is usually multidisciplinary , including ( non-exhaustive list) epidemiologists, microbiologists, public health authorities, clinicians and healthcare managers, environmental and food inspectors, veterinarians, communications specialists.

An OCT should act as as single body and behave as a effective team. There should be a lead to chair the meeting and ensure decisions are taken , documented and acted upon. The OCT has collective responsibility for the outbreak - if it goes wrong, responsibility is shared. The outputs, especially public health advice and external communications , should be consistent from each member and agency, although there may be disagreements during meetings.

Other models can be useful. In at least one country, a team similar to an OCT meets every week to manage incidents and outbreaks, making more routine the often hasty convening of s meeting of senior professionals.