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Fungal Meningitis Outbreak Response: Indiana Field Epidemiologist Role

District EPIs in Indiana respond to the fungal meningitis outbreak, conducting investigations and coordinating with state agencies and hospitals. Timely data collection and analysis aid in managing the crisis effectively.

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Fungal Meningitis Outbreak Response: Indiana Field Epidemiologist Role

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  1. Indiana Field Epidemiologist Fungal Meningitis Outbreak Response APIC IN April 12, 2012

  2. 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

  3. Field Epidemiologist (FEPI) Job Duties • Outbreak Investigations • Vaccine Preventable Disease Investigations • ISDH Liaison • Data collection/statistical analysis • EpiNewsletter/SOPs/Education/Trainings

  4. 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)*

  5. 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

  6. 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

  7. 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)

  8. 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)

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