1. T T H H I I Tennessee Health Indicators STATE EPIDEMIOLOGIST: TIMOTHY F. JONES, MD DEPUTY STATE EPIDEMIOLOGIST: JOHN R. DUNN, DVM, PHD Communicable and Environmental Diseases & Emergency Preparedness April - 2012 TENNESSEE DEPARTMENT OF HEALTH Communicable and Environmental Diseases & Emergency Preparedness 1

2. T T H H I I Tennessee Health Indicators CEDEP Mission Division Mission – Discover and eliminate the threat of communicable diseases – Educate people how to protect themselves from illnesses – Conduct surveillance activities in order to monitor new emerging infections or identify clusters of cases that could be related – Conduct investigations to pinpoint the source of disease to prevent dangerous outbreaks April - 20122 TENNESSEE DEPARTMENT OF HEALTH Communicable and Environmental Diseases & Emergency Preparedness

3. T T H H I I Tennessee Health Indicators CEDEP Programs Programs within CEDEP – Administration – Emergency Preparedness – Emerging Infections Active Bacterial Core Surveillance (ABCs) FoodNet * Clostridium difficile Infection (CDI) Surveillance – Davidson County – Environmental Epidemiology * – General Environmental Health Environmental Health Specialist Network (EHS-Net) – Healthcare Associated Infections * – HIV/STD * – Immunizations * – Surveillance Systems and Informatics – Tuberculosis Elimination * – Vectorborne and Zoonotic Diseases April - 20123 *Included in THI project TENNESSEE DEPARTMENT OF HEALTH Communicable and Environmental Diseases & Emergency Preparedness

4. T T H H I I Tennessee Health Indicators FoodNet Program Mission – FoodNet is a collaborative effort among: Centers for Disease Control and Prevention (CDC) 10 state health departments Academic institutions U.S. Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS) Food and Drug Administration (FDA) – The program’s primary mission is to conduct population-based active surveillance of select laboratory confirmed pathogens commonly transmitted though food. Healthy People (HP) 2020 Objective – Reduce infections caused by key pathogens transmitted commonly through food (Incidence=# of cases/100,000 persons) April - 20124 TENNESSEE DEPARTMENT OF HEALTH Communicable and Environmental Diseases & Emergency Preparedness

5. T T H H I I Tennessee Health Indicators FoodNet Indicators April - 20125 Number of culture-confirmed cases (per 100,000 persons), by pathogen, Tennessee, 2010 TENNESSEE DEPARTMENT OF HEALTH Communicable and Environmental Diseases & Emergency Preparedness

6. T T H H I I Tennessee Health Indicators FoodNet Indicators April - 20126 Number of Campylobacter cases (per 100,000 persons), by region, Tennessee, 2010 TENNESSEE DEPARTMENT OF HEALTH Communicable and Environmental Diseases & Emergency Preparedness

7. T T H H I I Tennessee Health Indicators Environmental Epi April - 20127 TENNESSEE DEPARTMENT OF HEALTH Communicable and Environmental Diseases & Emergency Preparedness Program Mission – The Environmental Epidemiology Program (EEP) is responsible for environmental public health activities that relate to chemical exposures and pollution in Tennessee

8. T T H H I I Tennessee Health Indicators EEP Indicators Environmental Health HP 2020 Objectives – Outdoor Air Quality – Water Quality – Toxics and Waste* – Healthy Homes and Healthy Communities – Infrastructure and Surveillance* – Global Environmental Health April - 20128 TENNESSEE DEPARTMENT OF HEALTH Communicable and Environmental Diseases & Emergency Preparedness *EEP data support

9. T T H H I I Tennessee Health Indicators EEP Indicators Toxics and Waste: – Minimize the risks to human health and the environment posed by hazardous sites Agency for Toxic Substances and Disease Registry (ATSDR) Appletree Cooperative Agreement Public Health Assessments Infrastructure and Surveillance: – Increase the number of States, Territories, Tribes, and the District of Columbia that monitor diseases or conditions that can be caused by exposure to environmental hazards National Toxic Substances Incidents Program (NTSIP) April - 20129 TENNESSEE DEPARTMENT OF HEALTH Communicable and Environmental Diseases & Emergency Preparedness

10. T T H H I I Tennessee Health Indicators HAI Program Program Mission – Zero preventable harm from healthcare- associated infections across the continuum of care – Top priorities are to reduce: Central line-associated bloodstream infections (CLABSI) Surgical site infections (SSI) MRSA bloodstream infections Clostridium difficile infections April - 201210 TENNESSEE DEPARTMENT OF HEALTH Communicable and Environmental Diseases & Emergency Preparedness

11. T T H H I I Tennessee Health Indicators HAI Indicators Standardized Infection Ratio (SIR) – Risk-adjusted measure analogous to a standardized mortality ratio Adjusts for patient- and/or hospital-specific variables, depending on the type of HAI being monitored – SIR = Observed / “Predicted” number of infections Predicted (statistically “expected”) number is calculated using national baseline data from CDC’s National Healthcare Safety Network (NHSN) for 2006-2008 Reference SIR = 1 (observed = predicted) April - 201211 TENNESSEE DEPARTMENT OF HEALTH Communicable and Environmental Diseases & Emergency Preparedness

12. T T H H I I Tennessee Health Indicators HAI Indicators Central Line-Associated Bloodstream Infection SIR and 95% Confidence Interval, Adult and Pediatric ICUs, Tennessee, 2010 April - 201212 TENNESSEE DEPARTMENT OF HEALTH Communicable and Environmental Diseases & Emergency Preparedness

13. T T H H I I Tennessee Health Indicators HIV/STD Program Program Mission: – To prevent, control, and treat the spread of sexually transmitted diseases in Tennessee. The Tennessee HIV/STD Program is responsible for all control activities in Tennessee. The priorities for HIV/STD control include: 1.Case Identification/Treatment 2.Partner Services Activities (Contact Tracing) 3.Targeted Testing /Behavioral Interventions 4.Ryan White Services 5.Surveillance and Epidemiology Services April - 201213 TENNESSEE DEPARTMENT OF HEALTH Communicable and Environmental Diseases & Emergency Preparedness

14. T T H H I I Tennessee Health Indicators HIV/STD Indicators April - 201214 TENNESSEE DEPARTMENT OF HEALTH Communicable and Environmental Diseases & Emergency Preparedness Number of cases of Gonorrhea (per 100,000 persons), by year, Tennessee, 2006-2010

15. T T H H I I Tennessee Health Indicators HIV/STD Indicators April - 201215 TENNESSEE DEPARTMENT OF HEALTH Communicable and Environmental Diseases & Emergency Preparedness Number of cases of HIV disease (per 100,000 persons), by year, Tennessee, 2008-2010

16. T T H H I I Tennessee Health Indicators TN Immunization Program Program Mission – Minimize the burden of vaccine-preventable diseases by optimizing the timely use of recommended vaccines for all ages – Goal: at least 90% of people in Tennessee receive each vaccine recommended to protect them Maintaining Tennessee Immunization Registry (TWIS) Tracking compliance with childhood vaccine recommendations and school requirements Conducting educational outreach Case management of infants of hepatitis B-infected women April - 201216 TENNESSEE DEPARTMENT OF HEALTH Communicable and Environmental Diseases & Emergency Preparedness

17. T T H H I I Tennessee Health Indicators TIP Indicators April - 201217 * 2010 NIS^ 2011 TIP 24 month old survey, 2010 NIS~ 2010 NIS-Teen TENNESSEE DEPARTMENT OF HEALTH Communicable and Environmental Diseases & Emergency Preparedness

18. T T H H I I Tennessee Health Indicators TB Elimination Program Mission: – The mission of the Tennessee TB Elimination Program (TTBEP) is to control, prevent and eliminate tuberculosis as a public health threat in Tennessee. TTBEP is responsible for TB control activities in Tennessee. The three priorities for TB control are: – Cases – Contacts – Targeted Testing April - 201218 TENNESSEE DEPARTMENT OF HEALTH Communicable and Environmental Diseases & Emergency Preparedness

19. T T H H I I Tennessee Health Indicators TTBEP Indicators April - 201219 TENNESSEE DEPARTMENT OF HEALTH Communicable and Environmental Diseases & Emergency Preparedness Number of newly diagnosed tuberculosis cases (per 100,000 persons), by year, Tennessee, 1986-2011

20. T T H H I I Tennessee Health Indicators TTBEP Indicators Completion of Treatment Indicator: For patients with newly-diagnosed TB for whom 12 months or less of treatment is indicated, increase the proportion of patients who complete treatment within 12 months to 93.0% by 2015 Cohort includes patients who are indicated for ≤ 12 months of therapy and alive at diagnosis; patients who died during therapy are excluded 2010 progress: 88.8% April - 201220 TENNESSEE DEPARTMENT OF HEALTH Communicable and Environmental Diseases & Emergency Preparedness

21. T T H H I I Tennessee Health Indicators Program Contacts Program AreaProgram Director Data Director or Secondary Contact AdministrationBrenda EggertAnn Brewer Emergency PreparednessCraig ShepherdPaul Petersen Emerging InfectionsJohn DunnAmanda Ingram Environmental Epidemiology Bonnie BashorDavid Borowski General Environmental Health Hugh AtkinsLori LeMaster April - 201221 TENNESSEE DEPARTMENT OF HEALTH Communicable and Environmental Diseases & Emergency Preparedness

22. T T H H I I Tennessee Health Indicators Program Contacts Program AreaProgram Director Data Director or Secondary Contact Healthcare Associated Infections Marion KainerBrynn Berger HIV/STDCarolyn WesterThom Shavor ImmunizationsKelly MooreRobb Garman Surveillance Systems and Informatics Erin HoltTonya McKennley Tuberculosis EliminationJon WarkentinJason Cummins Vectorborne and Zoonotic Diseases John DunnCaleb Wiedeman April - 201222 TENNESSEE DEPARTMENT OF HEALTH Communicable and Environmental Diseases & Emergency Preparedness

23. T T H H I I Tennessee Health Indicators For More Information To reach anyone within CEDEP: – Main Phone: (800) 404-3006 or (615) 741-7247 – Main Fax: (615) 741-3857 Website: – http://health.state.tn.us/CEDS/ Obtain Reportable Diseases and Events list (updated annually) Access more specific program area content Run Disease Data Interactive Reports Access newsletters, annual reports, etc. April - 201223 TENNESSEE DEPARTMENT OF HEALTH Communicable and Environmental Diseases & Emergency Preparedness