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Gonorrhea Surveillance & Control New York State

Gonorrhea Surveillance & Control New York State. NYSDOH Bureau of STD Control CDC Gonorrhea Control Meeting New York, NY November 9, 2009. Trends in Reported Gonorrhea Cases by Sex, NYS, 1992-2008*. # Gc Cases. * Excludes NYC. NYSDOH/BSTDC.

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Gonorrhea Surveillance & Control New York State

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  1. Gonorrhea Surveillance & Control New York State NYSDOH Bureau of STD Control CDC Gonorrhea Control Meeting New York, NY November 9, 2009

  2. Trends in Reported Gonorrhea Cases by Sex,NYS, 1992-2008* # GcCases * Excludes NYC NYSDOH/BSTDC

  3. Trends in Reported Gonorrhea Cases by Race/Ethnicity, NYS, 1992-2008* # Gc Cases * Excludes NYC NYSDOH/BSTDC

  4. Rate of Gonorrhea by Age and Sex, NYS*, 2008 Rate( per 100,000 population) *Excludes NYC NYSDOH/BSTDC

  5. Clinton Franklin St. Lawrence Essex Jefferson Lewis Hamilton Warren Herkimer Oswego Washington Orleans Oneida Niagara Saratoga Wayne Monroe Fulton Genesee Onondaga Montgomery Cayuga Ontario Madison Erie Schenectady Seneca Seneca Seneca Seneca Livingston Rensselaer Otsego Wyoming Chenango Schoharie Yates Albany Cortland Tompkins Greene Schuyler Allegany Cattaraugus Columbia Delaware Steuben Chautauqua Tioga Broome Chemung CENTRAL NEW YORK REGION CAPITAL DISTRICT REGION WESTERN REGION Ulster Dutchess Sullivan METROPOLITAN REGION Putnam Orange Orange Orange Orange Westchester Rockland Bronx Bronx Suffolk New York Richmond Nassau Queens Kings NYSDOH/BSTDC

  6. Rate of Gonorrhea by Region, NYS*, 1992-2008 NYSDOH/BSTDC *Excludes NYC

  7. Gonorrhea Case Reports by Race/Ethnicity and Provider Type, NYS*, 2008 Hispanic White Black Other NYSDOH/BSTDC *Excludes NYC

  8. 2008 Gonorrhea Cases Treatment Verification and Time to Treat Median time to treat =6.0 days NYSDOH/BSTDC *Excludes NYC

  9. Challenges • Budget Cuts • County contracts cut by 8% in 2008, 10% in 2009 = reduction in local STD services • Restrictions on Travel • Loss of Staff • State budget restrictions impact federally-funded initiatives • Laboratory Capacity • State laboratory serves primarily as reference lab • Limited number of NYS-licensed labs with culture capacity, even fewer perform susceptibility testing • Resource Allocation • Fewer DIS to cover large geographic area or duties not limited to STD • Federal IPP dollars prescribed

  10. Optimizing Partner Management Strategies For Gonorrhea With Limited Resources Dennis Murphy Bureau of STD Control New York State Department of Heath dpm04@health.state.ny.us

  11. Gonorrhea-Reported Rates: NYS Exclusive of NYC and United States, 1992-2008 *2008 data not available

  12. Gonorrhea-Rates by Race/Ethnicity: United States, 2003-2007

  13. Gonorrhea-Rates by Race/Ethnicity: NYS Exclusive of NYC, 2003-2007* * These data should be interpreted with caution; 30% of NYS Race/Ethnicity data are missing ** 2006 American Indian Rate not included

  14. Key Terms • Core - Census tract with 50% of morbidity • Adjacent - Census tract with 30% of morbidity • Peripheral - Remaining Census tracts with 20% of morbidity

  15. Key Terms (cont.) • Self Selection - core infected patients are most likely to have selected their partners from the core area. Adjacent cases are most likely to become infected due to exposure with a core resident • Force of Infectivity - the time period between infection and treatment

  16. Characteristics of a Core Area • Small population compared to adjacent and peripheral areas • High population density • Low socioeconomic status of residents • Frequently, but not necessarily minority residents • High number of repeat infection

  17. Gonorrhea Core Epidemiologic Tracts, Monroe County, NYS, 2007

  18. New York State’s Approach to Gonorrhea Partner Services • For transmission purposes all gonorrhea cases are not equal, therefore: • Intensely interview core residents • Only interview adjacent or peripheral cases if resources allow • Target gonorrhea screening to facilities and providers that serve the core population

  19. New York State’s Approach to Gonorrhea Partner Services (cont.) • Interview as many core gonorrhea positive cases as possible, but at a minimum 65% of the total • Target STD clinic services to meet the needs of the core population • Don’t be afraid to “tweek” the typical gonorrhea interview • Look for social network

  20. Evaluation • Reason for Examination • Voluntary / Symptomatic • Screening • Epi Investigation

  21. Reported Gonorrhea Cases and Core Epi Interventions, Monroe County: 2002-2007 Data Source: New York State Department of Health, Bureau of STD Control

  22. Gonorrhea-Reported Rates: NYS Exclusive of NYC and Monroe County, 1992-2007

  23. DATA SOURCES • New York State Department of Health, Bureau of STD Control • Division of STD Prevention. STD Surveillance, U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention

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