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Background: The outbreak of fungal meningitis and other infections, beginning in 2012, is considered one of the largest healthcare-associated outbreaks in U.S. history. CDC, working closely with state and U.S. Federal Drug Administration counterparts, was able to establish a model platform for crisis communications. Daily monitoring and analysis of news coverage and social media conversations demonstrated that the public considered CDC a trusted source of critical information.
Program background: CDC activated its Emergency Operations Center (EOC) and Joint Information Center (JIC) for the first 35 days of the response to coordinate the dissemination of communications to healthcare providers, patients, policymakers, and the media. The focus and strategy centered on getting ahead of requests for information and alleviating fears of patients who had just been given the terrifying news that they were potentially exposed to fungus-contaminated medication.
Evaluation Methods and Results: CDC’s media monitoring and analysis strategy has been built over a decade of responding to various types of major public health emergencies. During the 35 days of the EOC activation, JIC staff members conducted qualitative analysis of news stories (print, television, and Internet) and social media posts (Twitter, Facebook, blogs) to identify key public health themes, health protection information gaps, rumors and misinformation, emerging communication issues, and depictions of federal agencies’ response. We also collected quantitative information on the number of news stories and social media posts, reporter requests for information, visits to the CDC outbreak website, and public and clinician inquiries. Interest was strongest during the first half of October when the outbreak was first identified with observable peaks as new information emerged. Results from the qualitative analyses were used to forecast potential problems (e.g., confusion about the time from injection to symptom onset), understand the scope of rumors (e.g., that seasonal influenza vaccines might be among recalled products), and develop a proactive messaging and communication strategy. For social media in particular, CDC made a deliberate decision to use agency Twitter and Facebook accounts to drive people to the CDC website for the latest information and to respond to direct inquiries from potential patients. However, we did not use social media to promote general awareness of the outbreak since the infections were not communicable and we wanted to avoid artificially escalating the alarm among people who were not affected by the outbreak. The CDC outbreak website was updated daily, including latest information on case counts, clinical guidance, and information for patients and the public. Initial web user survey was positive – 94 percent satisfaction rating. CDC also assisted states in their communication efforts, providing daily talking points to the state health departments and the National Public Health Information Coalition.
Conclusions: CDC’s response to the multistate outbreak of fungal meningitis and other infections can serve as a model for other large-scale patient notification efforts.
Implications for research and/or practice: Given the growing move toward healthcare transparency, patient notifications are likely to increase in coming years. Recent successes in large-scale patient notifications can serve as a model for best practices in future notification events.