Unit of competency details

Unit Descriptor 

This unit covers the competency required to investigate and control outbreak of disease within the Australian Defence Force (ADF).

Application of the Unit 

The application of this unit in the workplace includes initiating an investigation within an organisation including gathering data through interview, and inspecting, sampling and analysing that information to draw conclusions to classify the disease. It also includes identifying and implementing immediate and long-term control measures to prevent the re-occurrence of disease outbreak.

This function may be performed in collaboration with other health service personnel and may be initiated and led by a medical officer.

This unit of competency is applicable to preventive medicine technical officers. This function is limited to the performance of tasks in accordance with organisational policies and procedures.

Employability Skills 

This unit contains employability skills.

Pre-requisite Unit /s 

Nil

Elements describe the essential outcomes of a Unit of Competency.

Performance Criteria describe the required performance needed to demonstrate achievement of the element. Where bold italicised text is used, further information is detailed in the Required Skills and Knowledge and/or the Range Statement. Assessment of performance is to be consistent with the Evidence Guide.

ELEMENT 

PERFORMANCE CRITERIA 

1. Gather data in support of the investigation 

1.1 Relevant personnel  within affected organisation are liaised with to gain consent for investigation and to inform them of the process to be undertaken

1.2 Factors affecting the complexity of the investigation  are determined and addressed to facilitate commencement of investigation activities

1.3 Persons assisting with the investigation are tasked and provided with appropriate guidance to enable them to assist independently

1.4 Verification of outbreak is confirmed by comparison of reported cases with the usual incidence of cases experienced

1.5 If possible, presumptive diagnosis is obtained from medical officer to focus investigation effort

1.6 Initial control measures  are instigated to limit the spread of disease and to provide early treatment to those displaying symptoms of the disease

1.7 Interviews are conducted with both affected and non-affected personnel to identify the common factors in the outbreak of disease  including the potential source/s of disease

1.8 Information gathered is treated as in -confidence  and is only disclosed to persons needing to know who are assisting in the investigation

1.9 Questionnaires are administered to both affected and non-affected personnel to elicit further information of the common factors in the outbreak of disease

1.10 On site inspections are conducted of places found to be common to those affected by the disease to gather site information  to assist with the identification of the disease source/s

1.11 Equipment  is used during on site inspection in accordance with organisational policies and procedures

2. Analyse data to classify the path of disease 

2.1 Data from all sources is collated to enable comparison and analysis

2.2 Data assessed as being not related to the disease outbreak is removed to enable accurate analysis

2.3 Characteristics of the disease  are assessed to determine the route of disease and likely targets

2.4 Disease attack rate is determined to establish the cumulative incidence rate of disease over the period of the outbreak

2.5 Data is used to develop an endemic curve diagram to show the spread of infection over time and to identify the likely incidents of exposure to the disease

2.6 Attack rate data and likely incidence of exposure are used as a basis for identifying risk factors  present in disease outbreak to focus the scope of further investigation

2.7 Further data is gathered, based on the identified risk factors, and is integrated into analysis

2.8 Information gathered during on site inspection, such as sample testing results, is compared with analysis findings to classify the disease source, route and target

2.9 Finding from the analysis are documented and communicated to relevant personnel to enable appropriate notification to occur and to inform the development of control measures

3. Determine and implement disease control measures 

3.1 Compliance factors  are reviewed to identify the systemic issues which may have contributed to the disease outbreak and which require corrective action

3.2 Clean up procedures  are determined to allow facilities and/or the environment connected with the source of disease to return to normal activity as soon as possible

3.3 Monitoring procedures  are determined to confirm compliance with initial clean up and adherence with organisational policies and procedures aimed at preventing the spread of disease

3.4 Disease control measures  are determined to provide both immediate and long term control of disease including prevention and early detection

3.5 Investigation findings and disease control measures are compiled into a disease outbreak report and issued to relevant personnel for review and implementation

3.6 Those directly and indirectly involved in the disease outbreak are debriefed to clarify the investigation outcomes and to provide an opportunity for learning on the prevention of disease

3.7 Disease control measures are integrated with the wider environmental health support plan to apply lessons learned in the disease outbreak to other operating areas and groups

REQUIRED SKILLS AND KNOWLEDGE 

This describes the essential skills and knowledge and their level, required for this unit.

Required Skills 

• communicate clearly and concisely, orally and in writing
• communicate professionally with members of the organisation and health services
• conduct full range of investigational activities
• document investigation findings and produce detailed written reports
• establish and maintain administrative systems
• establish and maintain cooperative working relationships with those contacted in the course of work
• interpret the significance of medical, health and other data obtained from a variety of sources
• interview cases to determine demographic, medically relevant information and risk factor data
• lead, plan, assign and review the work of personnel assisting with the investigation
• maintain confidentiality
• prioritise tasking
• respond to organisational inquiries and provide information within area of own expertise
• work independently in the absence of supervision

Required Knowledge 

• administrative systems
• aetiology of infectious diseases, including microbiology
• best use of available resources
• biological, ecologic and social factors that promote the spread of a disease
• causes of manpower wastage
• chronic and communicable diseases, including bioterrorism agents, their transmission, prevention and control methods
• control measures for disease transmission
• current disease surveillance methods
• documentation processes relevant to own workplace
• epidemiologic investigative principles, practices and procedures
• epidemiology of disease
• water quality assurance measures
• food storage and distribution standards including the Hazard Analysis and Critical Control Point (HACCP) approach to food control
• legal rights and responsibilities
• organisational policies and procedures
• planning and control systems
• risk management principles
• role and capabilities of other health care providers including environmental health team
• team leadership management principles
• time management strategies to set priorities

EVIDENCE GUIDE 

Critical aspects for assessment and evidence required to demonstrate competency in this unit 

Assessment must confirm the ability to:

• gather data using a minimum of three data collection methods outlined in the performance criteria
• classify the path of disease using calculated attack rates, endemic curve diagrams and assessed risk factors as the basis for analysis
• determine control measures applicable to the disease and the circumstances of the outbreak.

Consistency in performance 

Competency should be demonstrated over a minimum of two investigation scenarios.

Context of and specific resources for assessment 

Context of assessment 

Competency should be assessed in a simulated situation or scenario.

Specific resources for assessment 

Access is required to:

• simulated situation or scenario of outbreak of disease with all supporting information
• equipment required to perform measurement, testing and on site inspection.

RANGE STATEMENT 

The Range Statement relates to the Unit of Competency as a whole. It allows for different work environments and situations that may affect performance. Bold italicised  wording in the Performance Criteria is detailed below.

Data may include 

Circumstances which allegedly implicate a particular source

Copies of menus (for at least three days prior to the onset of symptoms for the first case)

Distribution of the disease by:

• time (onset time and epidemic curve)
• place (potential places where the implicated meal was served such as cafeterias, restaurants and picnics)
• person (distribution of the disease by age, gender and food items eaten)

Illness in any person prior to the event or whether anyone vomited in a public place

Information regarding events leading up to, during or after a disease outbreak, including:

• action on first reported case
• environmental protection activities
• epidemiology of presenting disease
• food sources
• group activities
• hygiene procedures
• operating environment
• referral action
• response to treatment by health personnel
• secondary infections
• subsequent environmental protection activities
• water sources

Measurement results

Names and phone numbers of any contact person or organisers or contact details for all exposed persons

Sample test results (microbiological)

Symptoms and severity i.e. if any cases have been hospitalised, duration

Whether any personnel were ill prior to the outbreak or worked while symptomatic

Relevant personnel may include 

Activity commander

Environmental health officer

Health planning personnel

Medical personnel

Pathology specialist

Factors affecting the complexity of the investigation may include 

Availability of personnel

Availability of resources

Continued prevalence of disease

Operational constraints

Time lapse since first reported case

Wellness of personnel affected by the disease

Initial control measures may include 

Diverting to the use of alternative sources of food and water

Early referral for treatment

Exclusion of suspected personnel from duties (e.g. food handlers)

Quarantine of water, food, personnel

Restriction of personnel to designated areas

Screening of personnel for illness

Shutting down food, water production facilities

Common factors in the outbreak of disease may include 

Activity

Attendance at facilities

Food history (72 hours)

General health history

Hygiene practices

Movement

Onset of symptoms

Report to medical facility

Routine

In-confidence may include 

Adherence to Privacy Act

Information disclosed to an appropriate person consistent with the responsibility of this position

Interview area with privacy

Legal and ethical requirements

Secure location for written records

Site information may include 

Compliance records

Environmental swabs

Measurements

Qualitative and quantitative data gathered through interview

Policies and procedures

Quality records

Samples

Site layout diagram

Site occupant status (such as numbers, activity, health, attendance, qualifications)

Equipment may include 

Adhesive tape

Cotton swabs (sterile)

Dial thermometers

Forceps (sterile)

Ice, wet or dry

Microbiological lab test request form samples

Pencils

Phosphate buffered solution

Questionnaires for use in collecting information from patients

Rubber bands

Sample bottles (sterile)

Sample spoons (sterile)

Sharp knife

Characteristics of the disease may include 

Expected duration

Incubation period

Route of infection

Signs and symptoms

Time to onset

Risk factors may include 

Occupation:

• child care worker
• food handler
• health care worker

Possible source:

• contact with other cases
• environmental
• food
• institutional
• occupational
• water

Travel:

• interstate
• intrastate
• overseas

Compliance factors may include 

Compliance with:

• HACCP
• hygiene procedures
• organisational policies and procedures
• preventive maintenance
• quality control measures
• routine testing program

Clean up procedures may include 

Discarding contaminated water

Discarding foodstuff

Safely removing suspect or contaminated items

Sanitising an area

Monitoring procedures may include 

External auditing

Internal auditing

Periodic/random inspections

Quality control checks

Disease control measures may include 

Controlling or modifying the host response to exposure:

• immunising susceptible hosts
• modifying behaviour or using a barrier (such as education)
• using prophylactic chemotherapy

Controlling the source of the pathogen:

• inactivating or neutralising the pathogen
• removing persons from exposure
• removing source of contamination

Interrupting the transmission of disease:

• controlling mosquito or vector transmission using skin repellents
• improving personal sanitation (such as washing hands before eating)
• sterilising or disinfecting environmental sources of transmission

Co-requisite Unit /s 

Nil