Abstract:

Agents involved in biological incidents and outbreaks of infection can spread easily, so response teams are required to quickly implement a recovery plan to decontaminate and restore the environment impacted by these incidents to minimise public risks. A group of academics at De Montfort University (DMU, UK), with support from first responders during the 2014-16 Ebola outbreak, are developing appropriate training to provide basic skills so human health science students can respond to biological incidents. Following the competences identified by the European Commission, we have created key competences for these students based on the core skills that any medical first responder to biological emergencies should have. To provide students with the key competences related to environmental planning, we have created specific training that consisted of a 2 hours practical plus theory related to emerging diseases and the international response provided to tackle the Ebola pandemic. The practical component was a research-led workshop to develop a complete protection and recovery plan to respond to an outbreak of infection by Cyclospora cayetanensis in an urban area. Students used the novel methodology developed by Public Health England [“UK Recovery Handbook for Biological Incidents” (Pottage et al., 2015)] to select appropriate options or techniques to protect and recover the affected environment, according to the physiological characteristics of the biological agent/microorganism involved and the environment impacted. Critical thinking and discussion is also needed to select recovery options (R.O.), e.g. use of chlorine-based decontamination liquids as part of the R.O. “reactive liquids” will have limited efficacy as oocysts of Cyclospora are resistant to these. After successful testing of the training with postgraduate students, we introduced it in a level 6 module in the DMU degree programme BMedSci in Medical Science in 2016/17 (n=24). A small proportion of these BMedSci students reported that they did not enjoy (13.4%) or were satisfied (20%) with the training provided, which could be attributed to the fact that the topic of the training (environmental sciences) was not of direct interest for these students who are studying a degree more related to medicine. However, despite the short duration of the training, students were able to tailor an appropriate response with the resources and information provided (physiological characteristics and a literature review on decontamination/inactivation techniques for Cyclospora was provided to overcome time constraints). Specifically, 73.3% indicated that they gained some public health prevention/preparedness knowledge against a biological incident; 80% highlighted that they learnt how to establish some public health interventions; and 60% learnt how to tailor a recovery plan. A few students (20%) had difficulties with the recovery concepts and the interpretation of the physiological characteristics, which may be attributed to limited background knowledge of microbiology and parasitology (as the BMedSci programme does not have a complete module dedicated to the study of these topics). In conclusion, the increased prevalence of biological contamination incidents necessitates development of appropriate training to include environmental decontamination strategies to protect human health. The short teaching intervention described in this paper could be used to easily address this necessity.

Keywords:

Biological incidents, Cyclospora, undergraduate training, environmental decontamination, recovery.