A Shot in the Rear, Not a Shot in the Dark

The Centers for Disease Control’s (CDC) guidelines for providing emergency smallpox vaccinations proved useful and practical during a hepatitis A outbreak.

In August and September 2003, tainted green onions from an eastern Tennessee restaurant led to 65 cases of hepatitis A. After tests confirmed hepatitis A in employees and patrons, two regional health departments established a single mass-site clinic. The health departments estimated that roughly 6,000 patrons had eaten at the restaurant during the spread of the outbreak. The mass clinic provided immune serum globulin (ISG), a hepatitis preventive.

This article describes the mass clinic built in response to the Tennessee hepatitis outbreak; the authors present statistics from the four days that the clinic operated; in addition, the article discusses how the Tennessee mass clinic applied CDC guidelines.

Key Findings:

• Mass clinic staff provided 1.45 ISG doses per person-hour.
• Over the clinic’s four days, the mean time from triage to injection was 9 to 6 minutes per person.

Two regional health departments in east Tennessee successfully adapted CDC guidelines for providing smallpox vaccines in emergency mass clinics. The Tennessee hepatitis A mass clinics can serve as a guide for responding to future outbreaks.