Pasadena Public Health Department

Disease Surveillanceand Investigation

Presented by

Dr. Ying-Ying Goh, MD, MSHSHealth Officer for the City of Pasadena

November 17, 2014

Pasadena Public Health Department

Disease Surveillance and Investigation

Communicable diseases occur regularly in our community…

Influenza virus

B. pertussis (whooping cough)

M. tuberculosisScabies mite

Photos from: U.S. Centers for Disease Control and Prevention2

Pasadena Public Health Department

Disease Surveillance and Investigation

Some diseases are not present, but we would want to know immediately if they did occur…

Ebola virus (filovirus)

Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

Photos from: U.S. Centers for Disease Control and Prevention3

Pasadena Public Health Department

Essential Public Health Functions

How do we know which diseases are present in our community?

The Public Health Department conducts disease surveillance through mandated reporting

How do we prevent spread of these diseases?

Case investigation Treatment and prophylaxis Epidemiologic investigation and follow-up

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Pasadena Public Health Department

Disease Surveillance

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Pasadena Public Health Department

Disease Reporting is Mandated

Pursuant to Title 17, California Code of Regulations §2500, §2593, §2641.5-2643.20 and §2800-2812:

> ‘It is the duty of every health care provider….to report to the health officer… an individual having or suspected to be suffering from one of the conditions listed’

> ‘[an] administrator…may know of a case… and be responsible for administrative procedures to report’

> ‘health care provider means physician and surgeon, veterinarian, podiatrist, nurse practitioner, physicians assistant, registered nurse, midwife, infection control practitioner, coroner, dentist’

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Pasadena Public Health Department

Over 90 Diseases/Conditions Are Reportable

Health care providers must report all suspected and confirmed cases listed on the “Reportable Diseases and Conditions List” available at: http://cityofpasadena.net/PublicHealth/For_Providers/

List includes:> Sexually Transmitted Infections> Foodborne illness (e.g., Salmonella, E.coli)> Vector borne diseases (e.g., West Nile, rabies)> Outbreaks of any type…and many more

Reporting timeline varies by disease/condition> Immediately by telephone> Within one working day> Within seven calendar days

Pasadena Public Health Department

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Pasadena Public Health Department

Methods of Reporting

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Health care providers can report cases to the Health Department by:> Calling a 24/7 disease reporting line for

conditions that require immediate reporting Reporting phone number: (626) 744-6043

> Filling out a Confidential Morbidity Report (CMR) and faxing or mailing Note: Confidential Case Report (CCR) for

HIV/AIDS

> Entering data directly online, at the provider portal of the disease reporting database (CalREDIE)

Pasadena Public Health Department

Disease Investigation

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Pasadena Public Health Department

Investigation Procedures

Confirm the case, based on CDPH/CDC case definitions> Interpret laboratory values> Utilize clinical history

Investigate further, based on accepted disease-specific guidelines > Utilize LA County Acute Communicable Disease Manual and CA

Tuberculosis Controllers Association > Contact case(s) by phone, mail, in person> Contact doctors, employers, family members, as needed> Contact other jurisdictions and health departments, as needed

Once the immediate public health risk is removed and appropriate actions have been taken (including reporting to state), case is closed

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Pasadena Public Health Department

Epidemiologic Databases

Automated Vital Statistics System – births

Electronic Death Record System (EDRS) – death certificate data

CalREDIE - communicable diseases (except HIV/AIDS)

HIV/AIDS Case Reporting System

vCMR - LAC DPH’s reporting system12

Pasadena Public Health Department

Epidemiologic Databases

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Pasadena Public Health Department

Disease Prevention is the Key

Vaccines

Good hygiene>Cover your cough>Wash your hands often with soap and water

for 20 seconds or more>Stay home when you are sick>Avoid contact with people who are acutely sick

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Pasadena Public Health Department

Monitoring of Travelers (Ebola)

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Pasadena Public Health Department

Monitoring of Travelers (Ebola)

Travelers from Ebola-affected countries* are screened at U.S. airports>Those who pass screening return home>CDPH notifies the local health department (LHD)

LHD contacts traveler, conducts assessment, and determines risk level

Based on risk level, a monitoring plan is implemented>Active/self monitoring, frequency, duration, location of

individual, movement restrictions>Quarantine order if necessary>Inform appropriate City/County and medical partners* As of 11/16/14: Guinea, Liberia, and Sierra Leone

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Pasadena Public Health Department

Questions?