Report of Immediately Reportable Outbreak, Incident or Situation
Received by LHD (or after hours, weekends and Holidays by NJDOH)
LHD reports to NJDOH:
 LHD assigns a Principal Investigator
 NJDOH CDS assigns a Principal Investigator and an E number;
 LHD and NJDOH CDS identify the investigative team, including, as needed:
o Disease primary
o Environmental specialist
o Infection Preventionist
o Licensing agency
o Clinical laboratory / PHEL
o CDC consultant
 LHD performs all single case investigations and leads the initial investigation of all outbreaks,* and continues** when all
cases/sources are within this same jurisdiction;
 NJDOH provides consultation and guidance;***
 NJDOH coordinates ALL multi-jurisdictional investigations.
 NOTE: If LHD does not have capacity and/or expertise to investigate (e.g., Health Officer and communicable disease staff
have never investigated this disease, or there isn’t enough staff . . .) , the Health Officer may make a formal request of the
State Epidemiologist for additional aid. If NJDOH cannot identify the necessary aid internally, NJDOH will call for an epiaid within the state, and if none available, from CDC.
* FIRST steps in an outbreak investigation:
 Confirm outbreak
 Validate diagnosis/causative agent
 Notify public health partners, as appropriate
** OUTBREAK INVESTIGATION continues:
 Preliminary investigation to identify case group and commonalities
(develop linelist, case definition, epi curve, attack rates . . . )
 Institute preliminary control measures (barrier precautions, cohort,
handwashing . . )
 Continue detailed investigation
—> Evaluate lab reports and control measure recommendations
—> Revise case definition and control measures
recommendations, as needed
—> Perform data analysis
 Update public health partners, as needed
 Write report
—> Include findings, conclusions and control measures
recommended
—> Recommend modifications in practice and policy to
prevent similar events in the future
—> Report findings to public health partners, as needed
 Publish
 Perform presentations
 Develop guidelines
*** NJDHSS guidance includes:
 Disease expertise;
 Epidemiology expertise, including recommendations regarding multidisciplinary team membership;
 Health education expertise;
 Laboratory expertise;
 Manpower, as needed/possible;