The Anthrax Epidemiologic Tool Kit: An Instrument for Public Health Preparedness

Dori B. Reissman, Ellen B. Steinberg, Julie M. Magri, Daniel B. Jernigan


Biosecur Bioterror. 2003;1(2) 

In This Article


To identify and obtain items for the tool kit, we developed a list of desired materials, interviewed CDC field teams and EOC staff, reviewed field team reports and EOC documents, searched state and local health department web sites, requested materials directly from on-scene teams via email and telephone, and attended daily epidemiologic and operational meetings at CDC. We sought many types of items, such as questionnaires, fact sheets, training and orientation materials, shipping and laboratory protocols, descriptions of surveillance systems used to detect persons with possible anthrax infections (i.e., case-finding), and press releases. In addition, we participated in debriefings of returning field team members, covering issues such as management, communication, and team dynamics. We also sought informal feedback from team members on the usefulness of the various items they had created in the field and submitted for the tool kit.

We created the tool kit in both paper and electronic forms. If an electronic version of a document was unavailable, a paper version was included in the tool kit with the plan to later scan the paper version or obtain the electronic file. We developed a file-naming strategy to clarify the source and type of information included. Paper and electronic versions of each document used the same document identifiers and were stored in a manner to facilitate ease of use. We categorized each submitted document according to the purpose of the document and by the field investigation site in which it was used. In addition, we created an inventory of surveillance systems used by each field team and cross-referenced the inventory to relevant documents in the tool kit. We developed and regularly updated a table of contents for the tool kit to facilitate use.

We maintained the electronic version of the tool kit on a shared network server that allowed for access by multiple authorized users. To prevent inadvertent loss of information, we also kept copies of the tool kit on a second server and on portable storage media. During the process of creating the tool kit, members of the various investigating teams shared their experiences, including lessons learned and advice for future teams. We compiled and organized subjective feedback from debriefing sessions and interviews, along with our own observations.


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