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Division of Public Health

STATE HEALTH OFFICER. Division of Public Health. Bi-Monthly Webcast September 23, 2011. Overview. Welcome and Introduction – Dr. Henry Anderson Announcements Chemical Vulnerability in Wisconsin – James Drew National Immunization Survey, Measles Update – Dan Hopfensperger   

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Division of Public Health

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  1. STATE HEALTH OFFICER Division of Public Health Bi-Monthly Webcast September 23, 2011

  2. Overview • Welcome and Introduction – Dr. Henry Anderson • Announcements • Chemical Vulnerability in Wisconsin – James Drew • National Immunization Survey, Measles Update – Dan Hopfensperger    • State – Local Coordination of Communicable Disease Outbreaks – Rick Heffernan Protecting and promoting the health and safety of the people of Wisconsin

  3. Announcements Protecting and promoting the health and safety of the people of Wisconsin

  4. ANNOUNCEMENTS Retirements: Becky Johnson, Health Officer Menominee County • Talks to merge the City of Oshkosh and the City of Neenah Health Department and Winnebago County Health Department into one county health department continues. • If approved by the various governments, a merger of the three health departments should occur in 2012. Protecting and promoting the health and safety of the people of Wisconsin

  5. Survey Results Thank you for taking the survey 72 responses Most thought the Webcasts are useful! Protecting and promoting the health and safety of the people of Wisconsin

  6. Webcast Scheduling • Format is OK • Time of Day is OK • Length of Broadcast is OK • Bi-monthly Schedule is OK Protecting and promoting the health and safety of the people of Wisconsin

  7. Favored Topics for Future Broadcasts • Federal budget and grant opportunities • Syndromic surveillance • Ending health disparities • Tracking healthiest WI 2020 • Nutrition and physical activity • Workplace Wellness • Seasonal issues Protecting and promoting the health and safety of the people of Wisconsin

  8. Received 35 Recommendations for Future Broadcasts Recurring themes included - • Filling the state health officer position • Reform and legislation • What’s new and important to the statewide public health community Protecting and promoting the health and safety of the people of Wisconsin

  9. Thanks for your input Protecting and promoting the health and safety of the people of Wisconsin

  10. BUILDING AWARENESS FOR RECOGNITION OF CHEMICAL VULNERABILITY IN WISCONSIN James Drew Coordinator WI National Toxic Substance Incidents Program Bureau of Environmental and Occupational Health Protecting and promoting the health and safety of the people of Wisconsin

  11. PROGRAM BACKGROUND Hazmat Surveillance Coordinator (HSEES) HSEES “Spills” Data Highlights (1993-2009) HSEES Events: N = 6,755 HSEES Victims: N = 1,899 HSEES Evacuees: N = 72,174 Most Frequent Substance Released: Ammonia Protecting and promoting the health and safety of the people of Wisconsin

  12. PROGRAM BACKGROUND(continued) HSEES Web Link http://www.dhs.wisconsin.gov/eh/hsees/ Contact James Drew (608) 266-2663 James.drew@wi.gov Protecting and promoting the health and safety of the people of Wisconsin

  13. OFFER OF SUPPORT DPH-GIS Technical Support ArcView Licensing & /ESRI-BA Support HR: Direct DPH Outreach Support Preparedness Program Interactions Protecting and promoting the health and safety of the people of Wisconsin

  14. ELEMENTS OF CHEMICAL VULNERABILITY Jim’s Overview – WI Examples Transportation Corridors Previous Spills (not necessarily predictive) Chemical Storage Quantities – SensitiveInformation Population Density Vulnerable Protecting and promoting the health and safety of the people of Wisconsin

  15. Protecting and promoting the health and safety of the people of Wisconsin

  16. Protecting and promoting the health and safety of the people of Wisconsin

  17. Protecting and promoting the health and safety of the people of Wisconsin

  18. Protecting and promoting the health and safety of the people of Wisconsin

  19. Protecting and promoting the health and safety of the people of Wisconsin

  20. Protecting and promoting the health and safety of the people of Wisconsin

  21. QUESTIONS?? Protecting and promoting the health and safety of the people of Wisconsin

  22. National Immunization SurveyMeasles Update Dan Hopfensperger, Director Wisconsin Immunization Program Bureau of Communicable Disease and Emergency Response Protecting and promoting the health and safety of the people of Wisconsin

  23. National Immunization Survey(NIS)January – December 2010 Daniel Hopfensperger, Wisconsin Immunization Program Ph 608-266-1339 E-mail: Dan.Hopfensperger@wisconsin.gov

  24. NIS TeenAdolescents aged 13–17 years >1 Td or Tdap>1 Tdap>1MenACWY (95% CI) (95% CI) (%% CI) US 81.2 (80.2-82.2) 68.7 (67.5-69.8) 62.7 (61.5-63.9) WI 91.6 (87.4-94.5) 81.3 (75.2-86.1) 69.4 (62.7-75.3) Protecting and promoting the health and safety of the people of Wisconsin

  25. NIS Teen Adolescents aged 13–17 years Females HPV 3 dose >1 HPV>3 doses HPVseries comp. (95% CI) (95% CI) (95% CI) US 48.7 (46.9-50.5) 32.0 (30.3-33.6) 69.6 (66.8-72.2) WI 54.4 (44.5-63.9) 44.1 (34.7-54.0) 85.8 (73.5-93.0) Protecting and promoting the health and safety of the people of Wisconsin

  26. NISChildren aged 19-35 months MMR (>1 dose) PCV (>4 doses) Hep B (birth) (95% CI) (95% CI) (95% CI) US 91.5 (+ 0.7) 83.3 (+ 1.0) 64.1 (+ 1.3) WI 93.2 (+ 3.3) 88.4 (+ 4.9) 61.4 (+ 6.9) Protecting and promoting the health and safety of the people of Wisconsin

  27. NISChildren aged 19-35 months Vaccine series HepA (>2 doses)Rotavirus(modified) * (95% CI) (95% CI) (95% CI) US 49.7 (+ 1.4) 59.2 (+ 1.4) 72.7 (+ 1.2) WI 52.1 (+ 7.0) 64.7 (+ 6.9) 82.7 (+ 5.2) * Includes: 4 DTP/DT/DTaP, > 3 polio, > measles cont. vac, > 3 HepB, > 1 var, > 4 PCV, Hib vaccine excluded Protecting and promoting the health and safety of the people of Wisconsin

  28. State-Local Coordinating of Communicable Disease Outbreaks Rick Heffernan Section Chief Communicable Disease Epidemiology Bureau of Communicable Diseases and Emergency Response Protecting and promoting the health and safety of the people of Wisconsin

  29. Current state-local communicable disease Investigations • E. coli O157:H7 – multiple clusters • Salmonellosis – multiple clusters • Listeriosis – national outbreak • Legionellosis – local increase • Measles, tuberculosis • Others… Protecting and promoting the health and safety of the people of Wisconsin

  30. Essential to all these investigations … • Prompt specimen collection & testing; prompt forwarding of isolates to WSLH for typing • Complete and timely patient interviews as soon as possible after case is reported. Interview delays = poor recall Protecting and promoting the health and safety of the people of Wisconsin

  31. State-local coordination is facilitated by … • WEDSS • Electronic Laboratory Reporting (ELR) & web reporting • Surveillance and Outbreak Support (SOS) Team Protecting and promoting the health and safety of the people of Wisconsin

  32. WEDSS • Single, web-based system • We now work with the same information! • Faster reporting • Electronic Laboratory Reporting (ELR) & web reports • Easier to monitor the progress of case investigations and to track local and state actions • Secure transfer of confidential information • Distributed WEDSS “workforce” = surge capacity Protecting and promoting the health and safety of the people of Wisconsin

  33. SOS Team • SOS = Surveillance and Outbreak Support • Modeled after Minnesota’s “Team Diarrhea”; adapted to Wisconsin’s Home Rule structure • Staffed by full-time epidemiologist and part-time graduate students (evenings) • Goals • Complete & timely case interviews & data entry • Monitor case reports, identify lags, offer assistance • Closely coordinated with local investigators • Surge capacity during outbreaks Protecting and promoting the health and safety of the people of Wisconsin

  34. Example • Feb 4, 2011 - WSLH identifies 3 E. coli O157:H7 cases with matching PFGE • All 3 cases had complete & timely interviews conducted by LHDs and entered in WEDSS. • Nuts one of several early hypotheses • Cases re-interviewed by SOS Team • Tracebacks converged on CA wholesaler • Mar 4 – Recall of in-the-shell hazelnuts; first reported link with E. coli O157:H7 Protecting and promoting the health and safety of the people of Wisconsin

  35. Weekly E. coli O157:H7 and other STEC cases, Wisconsin, 2000 – 9/17/2011 Protecting and promoting the health and safety of the people of Wisconsin

  36. Weekly E. coli O157:H7 and other STEC cases, Wisconsin, 2010 – 9/17/2011 Protecting and promoting the health and safety of the people of Wisconsin

  37. Given current increase in E. coli O157:H7 infections…. • Local health agencies • Conduct complete interviews when cases are first reported; enter data into WEDSS • Assess patients for high risk occupations and exclude as appropriate • Request SOS Team support for hard-to-reach patients, including evening calling • State • Monitor WEDSS to identify lags in reporting and investigations • Coordinate closely with local investigators • Provide technical support Protecting and promoting the health and safety of the people of Wisconsin

  38. THANK YOU FOR JOINING US Protecting and promoting the health and safety of the people of Wisconsin

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