Michigan Communicable Disease Outbreak Surveillance and InvestigationRegional Epidemiology Unit (REU), Michigan Department of Health and Human Services

Wenwen Jiang; Tiffany Henderson

Created in 2001, the REU’s core

functions and services including:

• Disease surveillance

• Support to local public health

• Regional bioterrorism planning

• Data analysis, material

distribution

• Local epidemiology activities

Regional Epidemiology Unit

To develop a manual to systematically summarize roles of MDHHS in

response to communicable disease (CD) outbreaks. The manual

should cover each process of an epidemiological investigation.

A CD is an illness due to a specific infectious agent or its toxic

products that arises through transmission of that agent or its

products from an infected person, animal or inanimate reservoir to a

susceptible host.

Internship Objective

The manual clarified roles and responsibilities of the MDHHS in

initiatives to multilevel communicable disease outbreaks.

Specific response to health threats with emerging / re-emerging

diseases and bioterrorism components were also specified.

• Weekly Lab-Epi teleconferences

• Epi and Surveillance Workgroups

• CDC Morbidity and Mortality Weekly Report (MMWR) Review

• 16th Annual Michigan Communicable Disease Conference

• Shadowing the Ingham County Health Department

• District 1 Regional Medical Response Coalition Meeting

Internship Highlights

• Verify the diagnosis to the initial notification of an outbreak.• Develop a surveillance case definition specific to the outbreak.• Make a working hypothesis on risk factors for the infection.• Find additional cases by enhancing surveillance and follow-up

commonly exposed cohorts.• Interrupt the transmission or reduce exposure.

Outbreak Confirmation

Diagnosis Verification

Environmental Assessment

Epidemiological Investigation

Prevention and Control

Communication and report

• The members of MDHHS Regional Epidemiology

Unit and the Surveillance and Infectious Disease

(SIDE) Section

• The Certificate in Healthcare Infection Control

(CHIP) program at the University of Michigan

School of Public Health

Acknowledgement

https://www26.state.nj.us/doh-shad/indicator/CatInfec.html

• Michigan Disease Surveillance System (MDSS)Use national data standards. Alerts can be set to notify epidemiologists when specific single case or cluster notification are submitted.

• Michigan Syndromic Surveillance System (MSSS)Emergency and urgent care submit pre-diagnostic data of nonspecific health indicators. MSSS sends syndromic alerts to the MDHHS.

• Laboratory-based Surveillance

• Compliant-based SurveillanceSelf-reported illness calls from citizens will be re-directly referred to the local health department where the individual resides

Disease Surveillance

www.michigan.gov/cdinfo www.michigan.gov/mdss

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MDSS System Use Statistics

Referrals

Individual Case Reports

Transactions

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2006 2007 2008 2009 2010 2011 2012

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MDSS Electronic Messaging

Quest Diagnostic – Auburn Hills

Sparrow Labs

LabCorp

Mayo Labs

Hurley Hospital Lab

Garcia Labs

ARUP Labs

DMC Labs

MDCH Labs

2009-2013 Michigan Tuberculosis Epidemiologic Trends Report, MDHHS

Annual Michigan HIV Surveillance Report New Diagnoses and Prevalence (2015), MDHHS

https://www.mailman.columbia.edu/become-student/departments/epidemiology

Outbreak Response