What do Epidemiologists do? They count things.

Transcription

1 What do Epidemiologists do? They count things.

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3 Official definition: Epidemiology: deals with the study of the causes, distribution, and control of diseases in populations.

4 WHO is NORM? (a very brief sketch) Just so you don t think I m only a boring epidemiologist - Amateur Radio Operator (love Morse Code) - Motorcycle rider (and instructor) - Music lover (especially Doo-wop and Rock-a-billy) - Like to repair & tinker with things - Live in the country by St. Louis, like nature a lot - Two sons - Remarried five years ago (gained two TEENAGE daughters!) - Enjoy helping people - Still don t know what I want to be when I grow up

5 Public Health Surveillance and Outbreak Investigation Norm Keon Epidemiologist

6 Definition: Public Health Surveillance The ongoing systematic collection, analysis, interpretation, and dissemination of health data.

7 Data sources for disease surveillance Reportable diseases Laboratory specimens Medical records Surveys and The Public

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10 Surveillance components and resulting public health action Surveillance Collection Analysis Interpretation Dissemination/ communication Public Health Action Priority setting Planning, implementing, and evaluating disease investigation control prevention

11 Ongoing Surveillance Line List 2016 Salmonella MMDHD FIRST SEROTYPE COUNTY ONSETDATE AGE SEX Tracey enteritidis Clinton 14-Jan 45 F x Keith newport Montcalm 25-Jan 52 M x Wife saintpaul Montcalm 21-Feb 62 F x?relative in Kent Co. also salm. - ana Husband heidelberg Montcalm 21-Feb 86 M blood also x Thomas albert Clinton 7-Mar 67 M never in MI! x Tony enteritidis Clinton 14-Mar 4 M x Lorraine enteritidis Clinton 22-Mar 62 F x Destini enteritidis Montcalm 1-May 2 F x Stephen infantis Clinton 27-Jun 24 M maybe carrier x Christian enteritidis Gratiot 28-Jun 5 M lizard x Ruthann typhimurium Gratiot 15-Jul 48 F blood also x Kendall thompson Montcalm 14-Jul 9 F campy also? x Laura I 4,12:b:- Gratiot 20-Jul 56 F x Teresa paratyphi B (java) Montcalm 21-Jul 45 F rpt via StarLims x Carson Hosp John infantis Gratiot 1-Aug 64 M exposed N. Carolina? x Noah typhimurium Montcalm 5-Aug 7 M rpt via StarLims x Carson Hosp Jennifer typhimurium Gratiot 6-Aug 44 F rpt via StarLims x Carson Hosp Nancy braenderup Gratiot 20-Aug 65 F rpt via StarLims x Carson Hosp Tegan adelaide Clinton 5-Sep 2mo M also Aseptic x Stephanie enteritidis Clinton 14-Sep 30 F x Rachel enteritidis Montcalm 15-Sep 27 F x Patricia (Spectrum - no cult) Montcalm 27-Sep 87 F - Beverly paratyphi B (java) Clinton 29-Sep 67 F x George muenster Clinton unk 48 M urine x John javiana Clinton 9-Dec 44 M blood x Sarah enteritidis Montcalm 9-Dec 31 F works NH x Tracy (MMMC-Gratiot) Gratiot 25-Dec 49 F

12 2007 Salmonella as of 11/08/2007 CMDHD LASTNAME FIRST SEROTYPE COUNTY ONSETDATE AGE SEX Michele enteritidis Gladwin 9-Jan 27 F Karen enteritidis Isabella 28-Jan 42 F Geraldine tennessee Gladwin 9-Mar 77 F Peanut butter Beverly newport Gladwin 4-Apr 75 F Doris thompson Clare 8-May 66 F blood, terminal CA Devin thompson Osceola 26-May 7 F Robert enteritidis Isabella 15-Aug 19 M rcvd 8/20 MDCH Sue Ellen enteritidis Clare 13-Jul 39 F Roger typhimurium Arenac 24-Aug 54 M Kacie derby Isabella 23-Sep 23 F Wedding Stanton Sat aftnoon 22nd Darin 4:5:12:i:- Gladwin 6-Oct 40 M Dorie 4:5:12:i:- Osceola 20-Oct 50 F Pot Pie sub-type 0 MMDHD LASTNAME FIRST SEROTYPE COUNTY ONSETDATE AGE SEX Hannah tennessee Montcalm 1-Feb 24 F Peanut butter Rachel typhimurium Clinton 28-Mar 7 F Chad (Biotech lab) Clinton 6-Apr 14 M never sent to MDCH Susan Grp B[4,5,12:nonmotile Montcalm 21-Apr 60 F Alan typhimurium Gratiot 18-May 11 M Siblings Collected 5/20, to Sparrow, MDCH rpt 6/ Emma typhimurium Gratiot 18-May 12 F Siblings Collected 5/21, to Sparrow, MDCH rpt 6/ Alexandra typhimurium Montcalm 16-Jul 7 F Allen typhimurium Clinton 20-Jul 40 M part of nationwide ground beef outbreak Ryan typhimurium O-5 neg Montcalm 28-Jul 23 M Justus typhimurium Clinton 13-Aug 5 M rcvd 8/21 at MDCH Mary enteritidis Montcalm 13-Aug 69 F Wayne hartford Clinton 19-Aug 79 M Nancy Group B Gratiot 18-Aug 63 F contact Jan on 17th if no serogroup Ricardo 4:5:12:b:- Montcalm 26-Aug 17 M Rpt Grp B 8/30 Katherine Group D Montcalm 23-Aug 52 F contact Jan on 17th if no serogroup Grp D 8/31 Bernard typhimurium O-5 neg Gratiot 26-Aug 35 M bacti not done, parisitology Harry 4:5:12:b:- Clinton 29-Aug 75 M Karen typhimurium Montcalm 10-Oct 50 F GCH sent to MDCH! Pamela agona Montcalm 29-Oct 50 F Caden rcvd MDCH 11/6 Clinton 1-Nov 4 M Judith MMRMC Midland Gratiot 30-Oct 67 F Urine

13 Positive Animal Rabies by Year by County Mid-MI District Health Dept. (all Bats) Clinton Gratiot 1 3 Montcalm

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15 OUTBREAK INVESTIGATION

16 Needed for an Outbreak (Epi Triad) Agent (bacteria, virus, toxin) Host (human, animal) Environment/Vector (allows transmission)

17 Descriptive Epi Person Age/Sex/Race/Occupation/Habits Place Event/Building/Geo. Area/Restaurant Time Week/Day/Hour

18 Greenville Patient Care Center Norovirus (NV) Outbreak December 1-2, 2016 Greenville, Montcalm County Onset of Illness by Date/Time by Person by Laboratory Result (including secondary spread case "2 ") Number of Cases NV+ Employee Employee 2 case Wed 30 Thu 1 AM Thu 1 PM Fri 2 AM Fri 2 PM Sat December

19 Ithaca Family Care Center Norovirus (NV) Illness Investigation Gratiot Co. -- March 2007 Onset of Illness by Date by Person by Lab Result Number of Cases Patients at clinic March (+)NV Patients Patients (+)NV Staff Clinic Staff

20 Various Other Investigations & Activities Meningococcal meningitis Botulism Pertussis Tuberculosis Psittacosis (including retrieving a dead parakeet for examination) Case consultation with nurses Interfacing with MDHHS epis and lab PBB Studies with Emory University

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22 A CHRONOLOGY OF NORM S INVOLVEMENT WITH EMORY April 8, 2013 I wrote to Michele Marcus to introduce myself May 7, 2013 I met with Melanie Pierson in person at MMDHD GBO May 14-15, 2013 We held a clinic at GBO to draw 23 bloods for their grant application Dec 14-15, 2013 Emory held weekend clinic at St. Louis city offices. Overflowed. Mar 7-17, 2014 Emory held large 10-day clinic at GBO offices. Larger than expected. Mar 15, 2014 I met with the Emory PBB Citizens Advisory Committee at Alma College and presented our case for obtaining the PBB Registry. Unanimous support. Dec 2, 2014 Doc Dec 4, 2014 Dec 9, 2014 Jan 6, 2015 Never sent. Jan 14, 2015 I sent my proposal to obtain the PBB Registry to Marcus, Bonnie and Marcus signed my letter requesting the registry to Jeff Taylor at MPHI Jeff Taylor called Marcus. Corrine Miller at MDCH is objecting I sent a draft reply letter to be sent to Jeff Taylor to Marcus for review. Marcus and I recorded program/interview on PBB at WMLM Aug 8, 2015 Marcus told me that MPHI would have another meeting with us (phone?) concerning registry. Never happened. Dec 16, 2015 I met with Andrea to present my case for our department gathering basic family exposure data when we see clients and enter it into Insight Jan 26, 2016 PBB registry Discussed with Marcus MPHI s status. Claims lack money to work on April 29, 2016 Participated in Emory s PBB Citizens Advisory Board meeting at Alma College (day after the Transgenerational Chemical Exposure meeting there) Aug to? Participated in monthly conference calls as a part of Emory s PBB Leadership committee

23 Good surveillance does not necessarily ensure the making of right decisions, but it reduces the chances of wrong ones. -Alexander D. Langmuir