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Epidemiology and Surveillance. Southwest Florida Disaster Healthcare Coalition June 13, 2014 Jennifer Roth, MSPH Director of Epidemiology Florida Department of Health – Lee County. Objectives. Review the disease and outbreak reporting and investigation process
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Epidemiology and Surveillance Southwest Florida Disaster Healthcare Coalition June 13, 2014 Jennifer Roth, MSPH Director of Epidemiology Florida Department of Health – Lee County
Objectives • Review the disease and outbreak reporting and investigation process • Identify ways DOH contacts pertinent partners during an outbreak • Discuss different types of surveillance methods
Who reports diseases in Florida? • Required: • Licensed medical practioners • Osteopathic medicine • Chiropractors • Naturopathy • Veterinarians • Hospitals • Laboratories
Who reports diseases in Florida? • School nurses • Nursing home and assisted living facilities • Self or family reports • Media • Other regulatory agencies
How are diseases reported? • Electronic labs • Faxes • Direct call from providers, school nurses etc. • Concerned public • Complaints to other agencies
Reporting Process Diseases can happen ANYWHERE at ANYTIME • Any single case of a reportable disease • Any suspected outbreak or cluster (2 or more) in a location • Hospital • Nursing home • Neighborhood • School
Outbreak Investigation Steps 1. Prepare for field work 2. Establish the existence of an outbreak 3. Verify the diagnosis 4. Define and identify cases 5. Describe and orient the data in terms of time, place, and person
Case Definitions • Describe the evidence needed to classify a case • Laboratory • Clinical • Cases can be defined in many ways • Confirmed • Probable • Suspect
Outbreak Investigation Steps 6. Develop hypotheses 7. Evaluate hypotheses 8. Refine hypotheses and carry out additional studies 9. Implement control and prevention measures 10. Communicate findings
Response to Outbreaks • Nursing homes • Alert EMS shift commander • Alert hospital Infection Control Practioners • Schools • Alert Director of Nursing at Department of Education • Alert parents • Correctional facilities • Alert Warden
Response to Outbreaks May need to contact: • Local providers • Blast fax/Everbridge/EpiCom • Local EOC • Work with Preparedness Coordinator and Regional Emergency Response Advisor • Mosquito Control • State epidemiology office • Coordination with state lab and CDC • Media • Coordinate with PIO and possibly JIC
Surveillance • Sentinel providers for influenza • Local hospital and ERs submit weekly numbers for influenza • Local hospitals submit Carbapenem-resistantenterobacteriaceaecases when found • Weekly and monthly review of reportable disease cases • ESSENCE • ER and urgent care • Poison control • Death records
Surveillance Number of ILI patients seen in local ERs in Lee County from October 2013 to May 2014
Rates of rash illness by zip code in Lee County from March to June 2014
Contact Information Jennifer Roth Florida Department of Health in Lee County 3920 Michigan Avenue Ft Myers, FL 33916 Phone: (239) 332-9657 Fax: (239) 332-9553 Email: Jennifer.Roth@flhealth.gov