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Communicable and infectious diseases are no strangers to campus health. Multiple factors in the campus environment contribute to increased risk for students, faculty, and staff. Awareness of current and future risks, and identifying responsibilities and resources result from partnerships with campus and local community capacity. Legal, policy, and organizational responsibilities may differ from campus to campus. Thus, each campus health program should identify its role within the context of its practice. Tracking of immunization compliance, isolation, and quarantine of impacted students along with academic program coordination are unique functions to consider for the management of an infectious disease outbreak on a college campus. Ongoing prevention programs, planning, and training for communicable and infectious diseases allow campus health services to identify and successfully control outbreaks.

We compared syndromic categorization of chief complaint and discharge diagnosis for 3,919 emergency department visits to two hospitals in the U.S. National Capitol Region. Agreement between chief complaint and discharge diagnosis was good overall (kappa=0.639), but neurologic and sepsis syndromes had markedly lower agreement than other syndromes (kappa statistics 0.085 and 0.105, respectively).

Introduction:In recent years, government and hospital disaster planners have recognized the increasing importance of pharmaceutical preparedness for chemical, biological, radiological, nuclear, and explosive (CBRNE) events, as well as other public health emergencies. The development of pharmaceutical surge capacity for immediate use before support from the (US) Strategic National Stockpile (SNS) becomes available is integral to strengthening the preparedness of local healthcare networks.Methods:The Pharmaceutical Response Project served as an independent, multidisciplinary collaboration to assess statewide hospital pharmaceutical response capabilities. Surveys of hospital pharmacy directors were conducted to determine pharmaceutical response preparedness to CBRNE threats.Results:All 45 acute care hospitals in Maryland were surveyed, and responses were collected from 80% (36/45). Ninety-two percent (33/36) of hospitals had assessed pharmaceutical inventory with respect to biological agents, 92% (33/36) for chemical agents, and 67% (24/36) for radiological agents. However, only 64% (23/36) of hospitals reported an additional dedicated reserve supply for biological events, 67% (24/36) for chemical events, and 50% (18/36) for radiological events. More than 60% of the hospitals expected to receive assistance from the SNS within ≤48 hours.Conclusions:From a pharmaceutical perspective, hospitals generally remain under-prepared for CBRNE threats and many expect SNS support before it realistically would be available. Collectively, limited antibiotics and other supplies are available to offer prophylaxis or treatment, suggesting that hospitals may have insufficient pharmaceutical surge supplies for a large-scale event. Although most state hospitals are improving pharmaceutical surge capabilities, further efforts are needed.

In the event of a major chemical, biological, radiological, nuclear, or explosive (CBRNE) attack or a natural disaster, large quantities of pharmaceuticals and medical supplies may be required with little or no warning. Pharmaceutical surge capacity for immediate response, before Strategic National Stockpile (SNS) supplies become available, remains a significant gap in emergency preparedness. To date, limited attempts have been made to assess collective regional hospital pharmaceutical response capabilities. In this project, we characterized the level of hospital pharmaceutical response preparedness in a major metropolitan region.The Johns Hopkins Office of Critical Event Preparedness and Response (CEPAR) convened a collaborative partnership to assess hospital pharmaceutical response capabilities. A survey was developed to characterize pharmaceutical response preparedness to CBRNE threats.All 22 acute care hospitals in the Maryland region were sent pharmaceutical response surveys, and responses were received from 86% (19/22). Within the past year, 84% (16/19) of hospitals had implemented an exercise with pharmacy participation. More than half of the hospitals expect to receive assistance from the SNS in 48 hours or less. Seventy-four percent (14/19) of the hospitals reported an additional dedicated reserve supply for biological events, 74% (14/19) for chemical events, and 58% (11/19) for radiological events.Many hospitals in this metropolitan region have taken important steps toward enhancing pharmaceutical preparedness. However, hospitals generally remain underprepared for CBRNE threats and collectively have limited supplies of antibiotics to provide prophylaxis or treatment for hospital staff, their families, and patients in the event of a significant biological incident.

To determine the short-term functional and medical outcomes and predictors of outcome following discharge from an acute hospital emergency department, 100 elderly (greater than or equal to 65 yr) and 100 nonelderly (less than 65 yr) patients were studied prospectively. Patients were interviewed at three days and again at three weeks following emergency department discharge. The number of new prescriptions given to both groups in the emergency department was similar (elderly 41%; nonelderly, 31%). The elderly were as likely as the nonelderly to know the correct name (elderly, 88%; nonelderly, 87%), dosage schedule (elderly, 90%; nonelderly, 90%) and purpose (elderly, 85%; nonelderly, 94%) of their new medications. There was no difference in patients' understanding of the diagnosis (elderly, 72%; nonelderly, 72%) or in medication compliance (elderly, 81%; nonelderly, 74%). Elderly patients were more likely to keep scheduled follow-up appointments (87% vs 65%; P less than .05). Despite these similarities the elderly had worse medical outcomes at three weeks; 67% of the elderly were better and 20% were worse, including seven patients who required interim hospitalization, four of whom died. In contrast, 82% of the nonelderly were better and only 4% were worse (P less than .01). None of the nonelderly required hospitalization or had died. Functional impairments were more common in the elderly both at baseline (elderly, 26%; nonelderly, 6%; P less than .01) and at three weeks (elderly, 27%; nonelderly, 5%; P less than .001). Independent predictors of poor medical outcome included age greater than or equal to 65 (P less than .009) and functional impairment at baseline (P less than .022).(ABSTRACT TRUNCATED AT 250 WORDS)