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Indiana Field Epidemiologist. Fungal Meningitis Outbreak Response. APIC IN April 12, 2012. District 2 EPI, Mona Wenger (317) 439-9648 mwenger@isdh.in.gov. District 3 EPI , Erika Pitcher (317) 412-2137 epitcher@isdh.in.gov. District 1 EPI , Donna Allen (317) 430-3844
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Indiana Field Epidemiologist Fungal Meningitis Outbreak Response APIC IN April 12, 2012
District 2 EPI,Mona Wenger (317) 439-9648 mwenger@isdh.in.gov District 3 EPI, Erika Pitcher (317) 412-2137 epitcher@isdh.in.gov District 1 EPI, Donna Allen (317) 430-3844 dallen@isdh.in.gov District 4 EPI, Susan Pickerill (317) 508-1675 spickerill@isdh.in.gov District 6 EPI, Stephanie English (317) 697-8683 senglish@isdh.in.gov District 5 EPI, Sandy Gorsuch (317) 430-3848 sgorsuch@isdh.in.gov District 7 EPI, Robert Allen (317) 430-3851 rtallen@isdh.in.gov District 10 EPI, Karen Gordon (317) 430-3852 kgordon@isdh.in.gov District 9 EPI, Jim Ignaut (317) 412-2138 jignaut@isdh.in.gov District 8 EPI, Jill Stauffer (317) 605-6829 jstauffer@isdh.in.gov
Field Epidemiologist (FEPI) Job Duties • Outbreak Investigations • Vaccine Preventable Disease Investigations • ISDH Liaison • Data collection/statistical analysis • EpiNewsletter/SOPs/Education/Trainings
District 2 Outbreak Response (2006-Present) • TB – (2004 – 2006)* • Human Rabies (2006)* • Ecoli 0157-H7 – spinach (2006)** • Norovirus – Multi-county/multi-state/International (2006, 2008,2012)* • MRSA – (2007) • Botulism – canned chili (2007) • Salmonella – peanut butter (2007) • Salmonella – pot pies (2008) • Salmonella – deli meat (2009) • AH1N1pdm09 (2009) Neisseria meningitis pediatric death (2009)* • Measles (2011, 2012) • Rotovirus (2011)* • Salmonella typhi (2011)* • Varicella – School outbreaks (2011, 2012)* • H3N2v (2012) • Salmonella – cantaloupe (2012) • ESBL – ecoli/urine (2012) • Shigella (2012)* • Botulism (2012)* • Fungus meningitis (2012) • Endophthalmitis Cluster (2012)*
Fungal Meningitis Outbreak Response Timeline • 10/04/2012 – District 2 Field EPI actively engaged - IHAN and ISDH Press Release - ECHD and SJCHD notified • 10/05/2012 – First case identified from District - Hospital spreadsheet distributed to EGH, MSB, SJRMC/Mishawaka . - Hospitals conduct active/passive surveillance • 10/11/2012 - IN reported first death (Out of State Resident) • 10/13/2012 – Hospital Spreadsheet distributed to CHB, IU Health Goshen, SJRMC/Plymouth – Hospitals conduct active/passive surveillance • 10/16/2012 – CDC EPI-AID Team District 201/04/2013 – ISDH/ECHD/Clinic conference call on MRI + reports • 01/15/2013 – ISDH/SJCHD/Clinic conference call on MRI + reports
Outbreak Response (continued) • Daily • IPs reported case updates daily to FEPI by 9:30 am • FEPI reported to ISDH meningitis EPI by 10:00 am • Meningitis EPI reported to CDC by 11:00 am • CDC updated Fungal meningitis website daily at 2:00 pm • “The Huddle” Beacon Health Care System daily conference calls • f/u with clinics on all suspect cases reported
Fungal Meningitis Outbreak Spreadsheet Data • Fungus Meningitis Outbreak Spreadsheet disseminated to hospitals (11 variables) • Data on clinic patients • Name • DOB • Clinic • Injection Date • Number of Injections • Site of injection • Clinical: chief complaint; CSF: WBC, protein, glucose; or MRI + • Clinic patient spreadsheet disseminated to hospital IP/ED/LHD (7 variables) • All the above but clinical • Address (street, city, state) • Phone number • ISDH spreadsheet developed and data entered (54 variables)
Fungal Meningitis Case Count • US (03/28/2013) • Case Count: 730 • Deaths: 51 • States: 20 • IN (03/28/2013) • Case Count: 84 (4 out of state) • Deaths: 11 • D2 (03/28/2013) • Case Count: 66 (3 out of state) • Deaths: 7 (3 out of state)