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Public Health Communication

State: TX Type: Model Practice Year: 2011

In El Paso County, Colorado rabies has made a comeback and it is at unprecedented levels among wild animals, including skunks, foxes and bats. The spread of rabies from skunks to foxes raises the possibility that rabies may spread to unvaccinated domestic animals, such as dogs and cats, and ultimately, endanger people. Our Department launched a rabies prevention campaign April 2010. We organized a low cost rabies vaccination clinic using volunteer veterinarians and other community partners as a way of kicking off the campaign to get as much free publicity as possible to raise awareness about the problem and educate people about prevention measures.
The use of social media, specifically YouTube, has proven to be an innovative and effective communication tool in assisting infectious disease staff with their routine role of investigations and interventions aimed at protecting and saving lives in El Paso County, Colorado. Our county is home to more than 600,000 residents and has been recognized as one the largest populated counties in Colorado, second to Denver. Late summer August 2010, we learned about a potentially dire situation involving two young people in their early 20’s who submitted a rabid bat at 2:30 a.m. to the Humane Society of the Pikes Peak Region (HSPPR). They left the bat in an overnight drop box, with no contact information only a note reading, “bat hurt, please help.” We had the bat tested and it tested positive for rabies, which was unknown to the people dropping it off. Rabies is almost always fatal once symptoms begin. So the clock was ticking to meet the goal of finding these young people to conduct a thorough evaluation, as with any disease investigation, to determine their level of exposure and an appropriate course of action to protect public health. Our objectives focused on mass communication, using traditional methods such as local news media and direct channels including partner agencies, the crisis communication network and popular social media (Facebook, Twitter and YouTube). Our hope was to quickly identify the people who dropped off the rabid bat. We were able to obtain digital photos and surveillance video provided by the HSPPR and implement outreach efforts like crime stoppers, law enforcement and shows like America’s Most Wanted do on a routine basis. We chose to use social media tools to try and reach people in their early 20’s, our target demographic. We stressed in our messaging that these people did nothing wrong and that “they are not in trouble,” we just need to make contact with them to conduct a thorough investigation that could potentially save their lives. Within nine working days (actual days our health department was open) we were able to identify the individuals. Our efforts of combining a disease investigation with mass communication, specifically social media, resulted in identifying the two individuals who dropped off the rabid bat. They were very surprised and thankful that they were found and educated about rabies and that their level of exposure was thoroughly assessed and appropriate recommendations were able to be made. An unintended positive consequence occurred due to our education outreach. A dad and his son were on a boating trip in Wyoming, but who are from the Denver, Colorado area. The son used his hat to rescue a bat from the water. The bat, once rescued, bit the boy and flew away. The dad heard a National Public Radio (NPR) interview provided by one of our experts about rabies prevention and efforts to find these two individuals. The dad called the Colorado State Health Department with his concerns. It was determined that the boy was exposed to rabies and needed treatment. The dad was so relieved that he heard the information on NPR and was able to seek quick help and have his concerns addressed for the sake of his son’s life.
Agency Community RolesIn our community, we have the sole responsibility of conducting communicable disease investigations using the reportable conditions established in Colorado, and rabies is included in that list, for the purposes of limiting and/or stopping the spread of disease while always keeping in mind the ultimate goal of protecting public health in our community. We have built and maintained a strong working relationship with the medical community, academia, various non-profit/for-profit businesses, and local news media over many years. These relationships don’t happen over night or within a few months; over the years our Health Department has built a reputation for being accurate, credible and relevant, being very cautious, keeping public health topics and concerns in perspective, being transparent and keeping to the facts to not to cause unnecessary panic and/or worry. Addressing rabies concerns and launching a rabies prevention campaign is our responsibility, and when there are heightened concerns it’s our responsibility to address those concerns using science-based information to properly assess and then respond appropriately. When we learned about the two people being potentially exposed to rabies through the rabid bat, we asked many of our partner agencies in the community for help. We were upfront, sharing all the details and why we had concerns about the health of these people and we led outreach efforts on a daily basis. Our relationships and credibility paid off, which was demonstrated by the hundreds of thousands of people being reached with our messaging to find these two young people and ultimately finding these individuals among a population of over 600,000. ImplementationIn August 2010, El Paso County Public Health learned about a potentially dire situation involving two people in their early 20’s who submitted a rabid bat at 2:30 a.m. to the Humane Society of the Pikes Peak Region. The unidentified couple left the bat in an overnight drop box, with no contact information only a note reading, “bat hurt, please help.” The bat tested positive for rabies, which was unknown to the couple. Rabies is almost always fatal once symptoms begin. The clock was ticking to find these young people to conduct a thorough evaluation, as with any disease investigation, to determine their level of exposure and an appropriate course of action to protect public health. In order to reach the anonymous couple and conduct an evaluation, our agency had to develop and disseminate its message quickly. To accomplish that goal, we used social media, specifically YouTube, as an innovative and effective communication tool in assisting infectious disease staff with this investigation. Specific tasks: 1. Determine public health threat and target demographic. 2. Evaluate potential mass communication outlets for targeted outreach to the intended demographic (i.e., local news media, direct channels with partner agencies, crisis communication networks, and popular social media such as Facebook, Twitter and YouTube). 3. Detail messaging to reach target demographic, define urgency of situation and action steps that the public needs to take. 4. Leverage local partnerships to expand reach of message. Public health threats happen quickly and our response to each threat must be targeted and timely. In this instance, the public health communication was initially issued via traditional media, including two local newspaper websites and local television news on August 18. It was determined within a few days that traditional media was not reaching the early 20-year old demographic, and that we would need to strategically leverage our connections partner agencies and use YouTube to reach this audience. A constant push of interviews and news stories and social media occurred between August 18 and September 1, when the couple was located. The total timeframe for this project was two weeks. Once the couple was located, the remainder of the investigation was kept private to preserve the couple’s anonymity. Once it was determined that the two were not exposed to rabies and the public health threat has subsided; a final news release thanking the public, partner agencies and the news media was issued.
Based on our process evaluation and that we reached our goal of finding the two individuals who were potentially exposed to a rabid bat we feel our efforts were tremendously successful. We leveraged many long-standing relationships in the community that were quick to respond to our requests of assisting us in a disease investigation. Our local broadcast news media provided 32 free “earned” T.V. news stories during their regular newscasts (The total value of T.V. alone is estimated at $14,520). Some of the headlines from print news media publications: September 2, 2010—“The Colorado Springs Independent,” Rescuers of rabid bat found. September 1, 2010—“The Gazette" Bat-bearing couple found. August 27, 2010—“The Woodmen Edition” and “The Cheyenne Edition,” Rabies: A Current Matter of Concern (two people leave rabid bat at Humane Society.) August 26, 2010—“The Colorado Springs Independent,” Bat rescuers still sought. August 21, 2010—“The Gazette,” Who dropped off the rabid bat? August 19, 2010—“The Gazette,” Officials seek help finding at-risk pair. August 18, 2010—“The Denver Post,” Rabid bat left at El Paso County humane society. Headlines from some of the news media websites: August 31, 2010—“The Gazette” website, Couple found who dropped off rabies-infected bat. (10:17 a.m.) August 31, 2010—The Colorado Springs Independent,” Bat rescuers found. August 20, 2010—“The Gazette” website, Still no sign of couple who dropped off rabid bat. August 19, 2010—“The Colorado Springs Independent,” Breaking News: Health Department seeking people regarding rabid bat. August 18, 2010—“The Gazette” website, Health officials issue urgent appeal for couple who handled rabid bat. Combining an estimated value for this nine day outreach effort would be much greater than the $14, 520 that is estimated for T.V. news stories alone, however a price tag can’t be placed on the achievement of saving lives (including the dad and son on the boating trip who heard our outreach of rabies prevention as we branched out with on NPR).
In our community, we have the sole responsibility of conducting communicable disease investigations using the reportable conditions established in Colorado. We have built and maintained a strong working relationship with the medical community, academia, various non profits, for profit businesses, and local news media over many years. These relationships don’t happen over night or within a few months; over the years our Health Department has built a reputation for being accurate, credible and relevant, being very cautious, keeping public health topics and concerns in perspective, being transparent and keeping to the facts to not to cause unnecessary panic and/or worry. Addressing rabies concerns and launching a rabies prevention campaign is our responsibility, and when there are heightened concerns it’s our responsibility to address those concerns using science-based information to properly assess and then respond appropriately. When we learned about the two people being potentially exposed to rabies through the rabid bat, we asked many of our partner agencies in the community for help. We were upfront, sharing all the details and why we had concerns about the health of these people and we led outreach efforts on a daily basis. Our relationships and credibility paid off, which was demonstrated by the hundreds of thousands of people being reached with our messaging to find these two young people and ultimately finding these individuals among a population of over 620,000. We anticipate that we would be able to repeat this project again for any communicable disease investigation that would require this kind of outreach. Our Health Department does not work in silos in the community; we are very inclusive and depend upon many of our partners to be cooperative, knowing we achieve the best results through a “public health system” rather than “just” our Department efforts. Our job is to use science-based public health information, focusing primarily on the health and safety of residents and visitors in El Paso County and leading efforts with our many stakeholders for positive outcomes in public health. We foster much collaboration within the community by working with agencies that share mutual goals and always a willingness to be helpful and having a public service attitude and mentality. Maintaining great working relationships in the community comes in extremely handy when we needed to ask for timely dedicated help, which is demonstrated by our response to leveraging partner agency networks, targeting the early 20s demographic to identify and make contact with the two young people potentially exposed to rabies.