2. Epidemiology Partners and Resources Session 2, Part 2

3. Learning Objectives Session 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

4. Overview Session 2, Part 2 Partners in the practice of epidemiology Media Centers for Disease Control and Prevention (CDC) Example investigation

5. Partners in the Practice of Epidemiology

6. Colleagues and Collaborators Public health response teams Disease investigation specialists First responders Environmental health specialists Public health laboratory staff

7. 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

8. Outbreak Investigation Teams

9. Role 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

10. 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)

11. 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

12. The Media as a Tool

13. 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)

14. Media Applications

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

16. Centers for Disease Control and Prevention

17. About CDC Has 20 specialized centers, institutes and offices Mission 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

18. 3 Tools from CDC 1.Training 2.Technical support 3.Surveillance and reporting

19. CDC: Training Scientific Education and Professional Development Program Office –Epidemic Intelligence Service –Public Health Informatics Fellowship –http://www.cdc.gov/osels/scientific_edu/index.htmlhttp://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/http://www.cdc.gov/learning/

20. 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

21. 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

22. Example Foodborne Disease Outbreak

23. Foodborne Outbreak (FBO) Background Mentally handicapped population 200 bed residential facility 30 GI illness complaints of unknown cause

24. Partners and Resources Relationships and diplomacy –Facility staff –Laboratory –Media –Medical examiner –Environmental health program

25. Additional Partners and Tools Dedicated and knowledgeable Epidemiology Response Team Interviewing skills Outbreak investigation techniques Analytic skills Reliable references Diplomacy and advocacy

26. 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

27. 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

28. 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. http://www.cdphe.state.co.us/dc/Hepatitis/hepa/HepAsummary.pdf 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. http://cphp.sph.unc.edu/training/HEP_ANAT/certificate.php 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.http://cphp.sph.unc.edu/training/HEP_IIS1/certificate.php

29. 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. http://cphp.sph.unc.edu/training/HEP_RISKC/certificate.php 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. http://cphp.sph.unc.edu/trainingpackages/ics_in_action/index.html 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.http://cphp.sph.unc.edu/focus/vol3/issue3/3-3Traceback_issue.pdf

30. 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. http://healthyamericans.org/reports/files/LabReport.pdf 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. http://www.publichealthgrandrounds.unc.edu/sars/index.htm 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. http://www.publichealthgrandrounds.unc.edu/labsafety/index.htm