Joint tabletop exercise looks at measles response

Joint tabletop exercise looks at measles response

A recent joint exercise among the North Dakota University System, its 11 public colleges and universities and the North Dakota Department of Health, took a look at how public agencies would respond in the event of measles cases at the campuses.

The highly-infectious disease has seen its numbers rise in recent years, with nearly 1,300 cases across 31 states in 2019 alone. According to the Department of Health, 75 percent of those cases were linked to outbreaks elsewhere. In North Dakota, the last confirmed case was in 2011.

During the holiday break, health care specialists and campus representatives took time to connect via teleconference to walk through a simulated tabletop exercise that allowed participants to walk through action plans for different scenarios.

Over the course of the roughly two-hour call, the bulk of the time was spent by participants moving through scenarios and what-ifs. NDUS Director of Student Affairs Katie Fitzsimmons noted that the tabletop gave everyone involved a starting point to tailor their own plans if these types of scenario were to play out in real life.

“College campuses are considered a high-risk area for disease outbreaks because of several factors: people live in close quarters and those individuals share community spaces for recreation, class, and meals; there exists a high rate of international travel amongst faculty, staff, and students; and we have seen an increase in the unvaccinated populations on our campuses,” she said. “Measles has been making a comeback after nearly being eradicated. More often than not, it brings about non-life threatening symptoms, but it can cause severe complications and death.

“Additionally, measles is incredibly contagious and it travels through communities at an alarming rate,” Fitzsimmons continued. “It is an airborne virus that can live in the air for up to two hours. Meaning, if an infected individual attended a class in a lecture hall from 9-9:50 a.m., you could reasonably expect that 90 percent of all unvaccinated persons in the 10 AM and 11 a.m. sections of that class that use that same space would also contract the disease. And that’s without any direct contact with the individual. As you can see, if we have many at-risk individuals on a campus and a case arises, it can truly spread like wildfire and take months to contain.”

In order to better understand the impacts of such an outbreak, scenarios were brought up that dealt with what would need to occur if measles cases were ever confirmed at any of the public campuses, and if the public health authority of the health department could be used to aid university system in those situations. Feedback was noted as being largely positive.

Fitzsimmons said in the past few years, campuses had run similar exercises simulating an Ebola outbreak and the mass administration of a serogroup B meningococcal vaccine, so the concept of outbreak containment was not new to them.

“Walking through the exercise allowed campuses to identify areas that they need to address and spots where they have a good handle on the issue,” she added. “As with anything, room for improvement can always exist, but campuses must also remain flexible, as all of the nuances of a real situation are impossible to predict or plan for. However, the good partnerships with local public health units and the Department of Health provide great resources and connections for the campuses.”

The main scenario illustrated a student who was not vaccinated, contracted measles abroad during a semester break and returned to campus. The student was contagious but was not aware she was infected, so she moved back into the residence hall, shopped around town, attended sporting events, went to all her classes, ate in the dining hall, and exercised at the gym, and only went to the clinic after presenting symptoms. By the end of the simulation, more than 20 people had contracted the disease throughout the community and campus with the outbreak lasting from January until May.

“Seeing the possible impact of such a disease and learning how it is so very contagious before an individual evens knows they are sick was truly mind blowing,” Fitzsimmons said. “The system office is thrilled to work as a bridge between the Department of Health and the campuses in order to make valuable exercises like this happen, but it must be noted that this was prompted by Melissa Fettig and her staff at Minot State University. Melissa started this conversation and convened the campuses in June 2019 to address outbreak procedures, namely for measles. Without the diligent attention of our healthcare staffs, this wouldn’t have come to fruition. They truly care about their students and campus communities and want to be prepared for anything and everything; an attitude I cannot commend enough.”

At this time, no further outbreak exercises planned, but the campuses look forward to further collaborations with the health department and public health units.