CASE EXERCISE OVERVIEW                                                                                 CBTI (Original) Format

Title: A Community Outbreak of Influenza-Like Illness
Author: Carman A. Ciervo, D.O., FACOFP
Author Contact Info : Dept. of Family Medicine, UMDNJ School of Osteopathic Medicine, 42 E. Laurel Rd, Stratford NJ 08084; (856) 566-6789;
Date: October 2006
Target Audience: Physician, Nurse, Social Worker
Time Required: 3 hours
Format: Tabletop
Copyrighted Original Case: YES
Link To Copyright Statement:
Publisher/Source: UMDNJ-NJ Medical School, Case-Based Training Institute
Attribution: Lloyd F. Novick, MD, MPH & Cynthia B. Morrow, MD, MPH: A Case Exercise in Bioterrorism Preparedness - A Community Outbreak of Influenza-Like Illness


  • Bio attack: tularemia (sub for pneumonic plague)


  • Commit to reporting possible CBRNE exposure on the basis of clinical suspicion without awaiting laboratory confirmation.
  • Describe one's professional roles, functions and responsibilities in CBRNE and other public health situations (i.e. one's personal role in this system/NIMS/NRP).
  • Define the Incident Command System (ICS) and National Incident Management System (NIMS), National Response Plan (NRP) and describe their general structure and components. (ICS 100 or equivalent)
  • Describe the concept of an all-hazards approach to preparedness.
  • Identify suspect and confirmed disease, conditions and events that are legally reportable, how to report and one's role.
  • Describe the four stages of emergency management: Preparedness, Response, Recovery and Mitigation.
  • Describe one's role in the local, community and statewide public health emergency response system.
  • Describe the disease surveillance and reporting systems for one's local area/region.
  • Appropriately implement components of the preparedness plan in a timely fashion.
  • Critique and evaluate components of the response plan, including one's individual role.
  • Describe the signs and symptoms of individual cases and the characteristics of epidemics that can help one distinguish between a potential bioterrorism attack and natural disease phenomena (i.e. signs/symptoms, number of case, temporality, etc).
  • Identify and describe available emergency response resources at the federal, state and local levels and their roles/responsibilities.
  • Identify a strategy (or strategies) to respond to media inquiries during a public health emergency.
  • Activate appropriate mitigation activities to lessen the impact of a potential/actual emergency.

  • NIMS: Accountability
  • NIMS: Flexibility/Adaptability
  • NIMS: Standardization
  • NIMS: Unification
  • ICS: Command & Management
  • ICS: Common Terminology
  • ICS: Facility Management
  • ICS: Incident Action Planning
  • ICS: Information & Communications Management
  • ICS: Integrated Communications
  • ICS: Manageable Span of Control
  • ICS: Measurable Objectives
  • ICS: Modular Organization
  • ICS: Resource Management
  • NRP: All-Hazards Preparedness
  • NRP: Incident Management at Lowest Possible Level
  • NRP: Preparation
  • NRP: Response

  • CBRNE Detection
  • Epidemiological Surveillance and Investigation
  • Onsite Incident Management
  • Planning
  • Responder Safety and Health