Epidemiology Partners and Resources

Session 2, Part 2

Learning ObjectivesSession 2, Part 2

• Identify allied health and community partners in the practice of epidemiology

• List ways in which epidemiologists work with the media

• Describe how the Centers for Disease Control and Prevention (CDC) serves as a resource for training, technical support, and surveillance and reporting of epidemiological data

OverviewSession 2, Part 2

• Partners in the practice of epidemiology

• Media

• Centers for Disease Control and Prevention (CDC)

• Example investigation

Partners in the Practice of Epidemiology

Colleagues and Collaborators

• Public health response teams

• Disease investigation specialists

• First responders

• Environmental health specialists

• Public health laboratory staff

First Responders

Traditional• Fire Department• Law Enforcement• Emergency

Management• HazMat• Emergency Medical

Services • Department of

Transportation • Environmental

Protection Agency

Non-traditional• Hospitals

• Public Health Laboratories

• Public Works

Outbreak Investigation Teams

Outbreak Investigation TeamsRole of an Epidemiologist /Communicable

Disease Nurse

• Determines existence of an outbreak • Determines a case definition, • Conducts interviews with cases, family members,

contacts and controls• Generates a hypothesis• Designs an appropriate study (if necessary)• Reviews, analyzes, and interprets interview, analytic

study, and laboratory data

Outbreak Investigation Teams

Role of a public health laboratory staffer

• Cultures blood and / or stool samples

• Identifies a pathogen and strain of pathogen via DNA fingerprinting (called Pulse Field Gel Electrophoresis)

Outbreak Investigation Teams

Role of an environmental health specialist

• Collects and tests food, water, or other environmental elements of interest

• Inspects food service establishments for sanitation violations or deficiencies

The Media as a Tool

3 Key Applications of Media

1. Risk and crisis communication

2. Reaching people potentially exposed in an outbreak

3. Press releases– Public information officers (PIO)

Media Applications

Example: Working with the Media

• Toronto health department during the SARS outbreak

• Media disseminated timely, accurate information to the public and physicians

“SARS: When a Global Outbreak Hits Home” (October 2003)

http://publichealthgrandrounds.unc.edu/archive.htm

Centers for Disease Controland Prevention

About CDC

• Has 20 specialized centers, institutes and officesMission to protect health through health promotion, prevention of disease, injury and disability, and preparedness for new health threats

• Works with international, state and local partners

http://www.cdc.gov

3 Tools from CDC

1. Training

2. Technical support

3. Surveillance and reporting

CDC: Training

• Scientific Education and Professional Development Program Office – Epidemic Intelligence Service– Public Health Informatics Fellowship– http://www.cdc.gov/osels/scientific_edu/index.html

• Satellite broadcasts, continuing education training, printed education materials on a broad range of topics– http://www.cdc.gov/learning/

CDC: Technical Support

• Technical information on CDC main webpage, division, program, office, and branch sub-pages

• Epidemic Intelligence Service (EIS)

• Partnerships with agencies and organizations

• Financial support for training, programs, and services

CDC: Surveillance and Reporting

• Office of Surveillance, Epidemiology, and Laboratory Services– Gulf States Population Survey (GSPS)– National Electronic Disease Surveillance System

(NEDSS)– National Electronic Telecommunications System for

Surveillance (NETSS)– Behavioral Risk Factor Surveillance System (BRFSS)

• MMWR– Publication public health information and

recommendations

Example

Foodborne Disease Outbreak

Foodborne Outbreak (FBO) Background

• Mentally handicapped population

• 200 bed residential facility

• 30 GI illness complaints of unknown cause

Partners and Resources

• Relationships and diplomacy

–Facility staff

–Laboratory

–Media

–Medical examiner

–Environmental health program

Additional Partners and Tools

• Dedicated and knowledgeable Epidemiology Response Team

• Interviewing skills• Outbreak investigation techniques• Analytic skills• Reliable references• Diplomacy and advocacy

Results

• Cause of illness– Clostridium perfringens – Contaminated chopped pork

• 30 ill residents, 1 associated death• Actions taken

– Improved food preparation and monitoring– Legislative measures for more funding

Summary

• Partnerships in the community and among other public health professionals are vital to surveillance and outbreak investigation

• The media is used for communicating with professionals and the affected population

• The CDC is used as a resource for training, support, and surveillance

References and Resources• Communicable Disease Epidemiology Program. Summary of Reported

Hepatitis A Cases in Colorado, 2000-2009. Denver, Colo: Communicable Disease Epidemiology Program; March 2011. Available at: http://www.cdphe.state.co.us/dc/Hepatitis/hepa/HepAsummary.pdf. Accessed March 1, 2012.

• Jenkins P. Anatomy of a Foodborne Outbreak [online training]. UNC Center for Public Health Preparedness, University of North Carolina at Chapel Hill School of Public Health; 2004. UNC CPHP Training Web Site. Available at: http://cphp.sph.unc.edu/training/HEP_ANAT/certificate.php. Accessed March 1, 2012.

• Pfau SE, Brunette K. Recognizing an Outbreak [online training]. UNC Center for Public Health Preparedness, University of North Carolina at Chapel Hill School of Public Health; 2004. UNC CPHP Training Web Site. Available at: http://cphp.sph.unc.edu/training/HEP_IIS1/certificate.php. Accessed March 1, 2012.

References and Resources

• Rybka, T. Risk Communication [online training]. UNC Center for Public Health Preparedness, University of North Carolina at Chapel Hill School of Public Health; 2004. UNC CPHP Training Web Site. Available at: http://cphp.sph.unc.edu/training/HEP_RISKC/certificate.php. Accessed March 1, 2012.

• ICS in Action: Using the Incident Command System in Public Health Outbreak Investigations. North Carolina Center for Public Health Preparedness, University of North Carolina at Chapel Hill School of Public Health / North Carolina Public Health Regional Surveillance Team 6; 2009. Available at: http://cphp.sph.unc.edu/trainingpackages/ics_in_action/index.html. Accessed March 1, 2012.

• Stehr-Green P, Stehr-Green J. Environmental Health Investigations: Conducting Traceback Investigations. FOCUS on Field Epidemiology [serial online]. 2005:3(3). North Carolina Center for Public Health Preparedness, University of North Carolina at Chapel Hill School of Public Health. Available at: http://cphp.sph.unc.edu/focus/vol3/issue3/3-3Traceback_issue.pdf. Accessed March 1, 2012.

References and Resources• Trust for America’s Health. Public Health Laboratories: Unprepared and

Overwhelmed. Issue Report. Washington, DC: Trust for America’s Health; June 2003. Available at: http://healthyamericans.org/reports/files/LabReport.pdf . Accessed March 1, 2012.

• Roper WL, Gerberding JL, Barry MA, Tilson HH. SARS: When a Global Outbreak Hits Home. Public Health Grand Rounds Broadcast. University of North Carolina at Chapel Hill School of Public Health / Centers for Disease Control and Prevention; October 23, 2003. Available at: http://www.publichealthgrandrounds.unc.edu/sars/index.htm. Accessed March 1, 2012.

• Roper WL, Martin R, Turner L, Tilson HH. Disease, Disaster, and Detection: Partnering with Public Health Laboratories. Public Health Grand Rounds Broadcast. University of North Carolina at Chapel Hill School of Public Health / Centers for Disease Control and Prevention; September 26, 2003. Available at: http://www.publichealthgrandrounds.unc.edu/labsafety/index.htm. Accessed March 1, 2012.