In this podcast, we talk to CDC career epidemiology field officer Rebecca Sunenshine about her response efforts to a suspected tuberculosis case aboard a US Airways flight and the development of an airport emergency response plan. Created: 4/9/2014 by Office of Public Health Preparedness and Response (PHPR).
Date Released: 4/9/2014. Series Name: CDC Emergency Preparedness and You.
[Announcer] This program is presented by the Centers for Disease Control and Prevention.
[Ted Pestorius] CDC's Office of Public Health Preparedness and Response leads the agency's preparedness and response activities. We work with local, state, tribal, national, territorial, and international public health partners by providing direction, support, and coordination. I’m your host, Ted Pestorius, and I’d like to welcome you to “Boots on the Ground,” where we talk with CDC public health professionals in the field to see how their work affects local health preparedness and response.
Today, I’m interviewing Rebecca Sunenshine, a CDC career epidemiology field officer serving as the Medical Director and Administrator of the Disease Control Division for the Maricopa County Department of Public Health in Arizona. She’ll tell us about her experiences responding to public health threats, including a suspect tuberculosis case and how it led to the development of an airport emergency response plan. Thanks for joining us today, Rebecca.
[Rebecca Sunenshine] Thank you for having me.
[Ted Pestorius] Now, as a career epidemiology field officer, what does the phrase “Boots on the Ground” mean to you?
[Rebecca Sunenshine] “Boots on the Ground” means being a public health first responder. We get to be the first ones to hear about a problem and work through next steps to a solution.
[Ted Pestorius] And why is your job important to public health security and emergency preparedness and response?
[Rebecca Sunenshine] As the Disease Control Division Director in Maricopa County, Arizona, everything we do every day helps us plan for and respond to emergencies. We’re constantly detecting outbreaks and investigating diseases, which prepares us to respond to any public health threat or any public health emergency that we see on a regular basis.
[Ted Pestorius] Thanks, Rebecca. What kind of work do you do at the Maricopa County Department of Public Health?
[Rebecca Sunenshine] As a CDC career epidemiology field officer stationed in Maricopa County, Arizona, I serve as the Medical Director and Administrator for the Disease Control Division. Our health department serves about four million people with 20 percent of the average per capita budget of other large local health jurisdictions. My job is to figure out how to stretch our resources so we can maximize our impact and control as much of the disease out there as we can.
[Ted Pestorius] Tell us about your experience responding to the suspect tuberculosis case aboard a flight to Phoenix, Arizona.
[Rebecca Sunenshine] One of the things I do is serve as the physician-on-call for Maricopa County, which has about four million residents. During one week on call, I received a phone call from the airport emergency response through our disease reporting line that there was a suspected TB case aboard a US Airways flight. Unfortunately, we were only learning of this about 20 minutes before the flight landed. The fire and law enforcement folks at the airport were on-scene, but they really had no idea what to do with a suspected TB case. I was able to contact all the appropriate people back at the Division of Global Migration and Quarantine, get our tuberculosis program folks and our TB doc on-site with a respirator at the airport. We were able to drive onto the runway with law enforcement, examine and interview the patient, get him to the hospital, get all of the tests done, and we were able to learn that he did not ultimately have TB. There was a lot of information-sharing, a lot of cross-border communications, and work both with CDC and other federal, state, and local partners that had to be done, and we avoided a potentially very severe threat to the individuals on the airplane.
[Ted Pestorius] And how did you get organizations like the FBI, TSA, local fire and law enforcement, US Airways, and the airport administration involved in the airport emergency response plan?
[Rebecca Sunenshine] We already had worked together to develop a communicable disease emergency response plan, and this potentially suspected TB case on the plane gave us an opportunity to exercise that plan. And what we learned was that that plan didn’t really apply to tuberculosis and that that was going to be the most likely thing that we were all going to run across. So, instead of going exactly with that plan, we had to work together on the spot to come up with a way to respond to tuberculosis which is not a time to quarantine an entire plane-load of people. We were able to handle the situation and now we’re working with FBI, TSA, local fire and law enforcement, and the airlines and airport emergency response to revise the plan to appropriately address tuberculosis and then other more severe diseases. The other important thing about this exercise is that all of those partners are now much more aware of the role that public health plays in an emergency response at the airport.
[Ted Pestorius] How can people be prepared for emergencies while they are travelling?
[Rebecca Sunenshine] I think the most important thing is that people are constantly aware of what they would do if there was an emergency. Let individuals at home know where you’re going, your itinerary, and that if you don’t call them or notify them, to perhaps try to find out where you are. The other important thing is to bring your phone numbers written down somewhere. A lot of people rely on their cell phones to have important phone numbers to call in an emergency, and if their phone dies, they’re out of luck. Lastly, it’s just to be aware of your surroundings.
[Ted Pestorius] And, finally, what does being prepared mean to you?
[Rebecca Sunenshine] Being prepared is having a plan. Having a go-bag, knowing who is going to take care of your kids and your pets. When I get called into an emergency, or if I’m not with my child and my pets, how I’m going to meet them if I’m not already with them. Lastly, it’s making sure that everybody in my family knows the plan in an emergency so that we don’t have to get a hold of each other to try to figure that out on the spot.
[Ted Pestorius] Thank you for telling us your story, Rebecca.
[Ted Pestorius] For more information on CDC’s preparedness and response activities, follow @CDCready on Twitter or visit www.cdc.gov/phpr.
Thanks for joining us for “Boots on the Ground.” Stay tuned for more interviews in this podcast series. Until next time, I’m Ted Pestorius.
[Announcer For the most accurate health information, visit www.cdc.gov or call 1-800-CDC-INFO.