1. Journal Club Slides

2. Objectives
Describe the core public health functions and essential services.
Explain what is meant by active surveillance.
Describe the role of the physician in the public health system.
Explain what is meant by a case series.

3. What is Public Health?
Organized effort to promote and protect the health and well-being of patients and communities.
Public health system consists of all private, public and voluntary individuals or groups that contribute to the health of a community.
Medical providers are a very important part of the public health system.

4. Core Public Health Functions
Three Core Functions:
Assessment
Policy Development
Assurance
Ten Essential Services
Activities that communities should undertake to improve the well-being of their constituents

6. Importance for Patient Management
Public health core functions and essential services help you manage your patients
Zika example

7. MONITOR HEALTH
Surveillance: Systematic, continuous, organized way to collect and analyze data
Need information on Zika, number of cases, risk factors, outcomes, etc.
IRB NOT REQUIRED – NOT RESEARCH!
Active surveillance: Providers and labs are required to report cases and public health agencies are proactive and contact providers and labs to get more complete information about cases

8. MONITOR HEALTH
Zika is on the list of 2016 Nationally Notifiable Conditions
Zika virus disease, congenital
Zika virus disease, no-congenital
Zika virus infection, congenital
Zika virus infection, non-congenital
Providers, labs required to report
Case definition identifies clinical criteria

13. Zika Pregnancy Registry
Need an information system for surveillance
US Zika Pregnancy Registry

14. What can Ob/Gyns Do?

15. US Data on Zika - 2016 As of October 20, 2016
953 pregnant women with lab evidence of possible Zika infection
23 live births with birth defects
5 pregnancy losses (miscarriages, stillbirths, terminations with evidence of birth defects)
Source:

16. NYSDOH Zika Report – YTD*
Source: * As of October 26,

17. What if patient wants to be tested?
Criteria for testing
Pregnant and travelled to place where Zika is being transmitted
Ill with Zika symptoms within 4 weeks of travel
Need approval from local health department
Physician can write a script for testing
NYSDOH fact sheet

18. Case Series
Several clinical cases with something in common (often the exposure)
Recommend at least five cases to be called a series, but studies with fewer cases have been called case series
Descriptive study
Describe the exposure (Zika virus) and outcomes (birth defects, pregnancy losses, normal births)
Step beyond a case report