epidemiology and surveillance
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Epidemiology and Surveillance. Southwest Florida Disaster Healthcare Coalition June 13, 2014 Jennifer Roth, MSPH Director of Epidemiology Florida Department of Health – Lee County. Objectives. Review the disease and outbreak reporting and investigation process - PowerPoint PPT PresentationTRANSCRIPT
EPIDEMIOLOGY AND SURVEILLANCESouthwest Florida Disaster Healthcare Coalition
June 13, 2014
Jennifer Roth, MSPH
Director of Epidemiology
Florida Department of Health – Lee County
2
Objectives
• Review the disease and outbreak reporting and investigation process
• Identify ways DOH contacts pertinent partners during an outbreak
• Discuss different types of surveillance methods
5
Who reports diseases in Florida?• Required:
• Licensed medical practioners• Osteopathic medicine• Chiropractors• Naturopathy
• Veterinarians• Hospitals• Laboratories
6
Who reports diseases in Florida?
• School nurses• Nursing home and assisted living facilities• Self or family reports• Media• Other regulatory agencies
7
How are diseases reported?
• Electronic labs• Faxes• Direct call from providers, school nurses etc.
• Concerned public• Complaints to other agencies
8
Reporting Process
Diseases can happen ANYWHERE at ANYTIME
• Any single case of a reportable disease• Any suspected outbreak or cluster (2 or more) in a location• Hospital• Nursing home• Neighborhood• School
9
Reporting ProcessPhysician, lab,
hospital contacts health department
by phone or fax
Health department may call back
requesting more information
Need: Patient contact information, lab results, pertinent
notes
Health department may request more
testing or prophylaxis
Physician or laboratory sends
specimens to state lab
10
Outbreak Investigation Steps
1. Prepare for field work
2. Establish the existence of an outbreak
3. Verify the diagnosis
4. Define and identify cases
5. Describe and orient the data in terms of time, place, and person
11
Case Definitions
• Describe the evidence needed to classify a case
• Laboratory• Clinical
• Cases can be defined in many ways• Confirmed• Probable• Suspect
14
Outbreak Investigation Steps
6. Develop hypotheses
7. Evaluate hypotheses
8. Refine hypotheses and carry out additional studies
9. Implement control and prevention measures
10. Communicate findings
15
Response to Outbreaks
• Nursing homes• Alert EMS shift commander• Alert hospital Infection Control Practioners
• Schools• Alert Director of Nursing at Department of Education
• Alert parents
• Correctional facilities• Alert Warden
16
Response to Outbreaks
May need to contact:
• Local providers• Blast fax/Everbridge/EpiCom
• Local EOC• Work with Preparedness Coordinator and Regional Emergency
Response Advisor
• Mosquito Control• State epidemiology office
• Coordination with state lab and CDC
• Media• Coordinate with PIO and possibly JIC
18
Surveillance• Sentinel providers for influenza• Local hospital and ERs submit weekly numbers for influenza
• Local hospitals submit Carbapenem-resistant enterobacteriaceae cases when found
• Weekly and monthly review of reportable disease cases• ESSENCE
• ER and urgent care • Poison control• Death records
19
Surveillance10
/5/2
013
10/1
0/20
1310
/15/
2013
10/2
0/20
1310
/25/
2013
10/3
0/20
1311
/4/2
013
11/9
/201
311
/14/
2013
11/1
9/20
1311
/24/
2013
11/2
9/20
1312
/4/2
013
12/9
/201
312
/14/
2013
12/1
9/20
1312
/24/
2013
12/2
9/20
131/
3/20
141/
8/20
141/
13/2
014
1/18
/201
41/
23/2
014
1/28
/201
42/
2/20
142/
7/20
142/
12/2
014
2/17
/201
42/
22/2
014
2/27
/201
43/
4/20
143/
9/20
143/
14/2
014
3/19
/201
43/
24/2
014
3/29
/201
44/
3/20
144/
8/20
144/
13/2
014
4/18
/201
44/
23/2
014
4/28
/201
45/
3/20
145/
8/20
14
0
20
40
60
80
100
120
140
Total Number of Flu Labs Reported in Lee County from October 2013 to May 2014
Influenza Report Week
Nu
mb
er o
f P
osi
tive
Flu
Lab
s R
epo
rted
25
Contact Information
Jennifer RothFlorida Department of Health in Lee County
3920 Michigan AvenueFt Myers, FL 33916
Phone: (239) 332-9657Fax: (239) 332-9553
Email: [email protected]