Building Multi-Agency Response Capacity to Emergent or Bioterrorism Related Zoonotic Disease Outbreak Threats: Collaboration Results and Next Steps in Georgia

Key Objectives:
1. Discuss multi-agency zoonotic disease response plan development, including operational considerations 2. Discuss stakeholder engagement, including agency roles and responsibilities 3. Discuss Georgia's notification and communication drill results as well as tabletop exercise outcomes    

Brief Summary:
Background: The Georgia Department of Public Health (DPH) is responsible for protecting the lives of Georgians, and routinely conducts surveillance for notifiable zoonotic diseases, including those that are emergent or agents of bioterrorism.   DPH and the Georgia Department of Agriculture (GDA) collaborate whenever cases of notifiable zoonotic diseases are identified in humans or animals to ensure appropriate case management and disease containment. While responses to these cases have been efficiently managed, DPH and GDA identified a need to develop a response strategy for a more widespread zoonotic disease outbreak whether naturally occurring or human caused.     Methods: DPH collaborated with GDA, the Georgia Emergency Management Agency (GEMA), the Georgia Veterinary Medical Association (GVMA) and others through the Atlanta Health Security/ BioWatch Advisory Committee (HS/BAC) to determine agency response actions to mitigate the health impacts in primarily companion animals, following an identification of zoonotic disease outbreak. Protocols for inter- agency notification, and communication as well as external communication protocols were developed.  A series of drills and a tabletop exercise were conducted to test the notification and communication protocols and to discuss results and next steps. Results: Notification protocols were tested through notification drills involving the HS/ BAC and GVMA.  Subsequently, GVMA facilitated a communications drill targeting its statewide membership directing participants to contact the DPH SUrge for Public Health Emergency Response (SUPHER) phone system to receive information and response instructions following an *exercise* zoonotic disease outbreak.  More than 800 veterinarians throughout Georgia participated in this drill. A tabletop exercise for HS/ BAC members and animal health stakeholders was held two weeks later to discuss drill results and identify additional Multi-Agency response issues that must be addressed following a zoonotic disease outbreak.    Summary: Georgia’s multi-agency collaboration to address zoonotic disease outbreaks has resulted in formalized notification and communication protocols, as well as the identification of state and federal animal laboratory testing facilities that may be called upon during a response.   Remaining significant issues include developing agent specific human and animal surveillance strategies during a zoonotic disease outbreak, data collection, sharing and analysis strategies, as well as formalized laboratory sampling and submission protocols to support public health sentinel surveillance.