Virginia Department of Health. Office of Epidemiology Carl W. Armstrong, M.D., Director [email protected] Office of Epidemiology Carl W. Armstrong, M.D., Director. Division of Disease Surveillance and Investigation Diane Woolard, PhD Director.
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Carl W. Armstrong, M.D.,
Disease Surveillance and Investigation
Diane Woolard, PhD
Division of Health Hazards Control
Khizar Wasti, Ph.D.
Zoonotic and Environmental Epidemiology
Susan Fischer Davis, MD
Division of HIV/STD
Division of Immunization
Division of Tuberculosis Control
Margaret Tipple, M.D.
Virginia Department of Health
Office of Epidemiology
79% ($46M) Federal / 21% ($12M) State.
Richmond City HD is investigating two cases of acute hepatitis B (IgM+) diagnosed in two residents of a residential adult care center. Both patients are diabetic, using the same glucometer. There are a total of 20 diabetics in the home and we don't know the total number of residents. There are a total of 4 shared glucometers. Lack of adherence to standard precautions and failure to implement long-standing recommendations against sharing fingerstick devices are well described in the public health literature as placing LTC residents at risk for acquiring infections from bloodborne pathogens such as HBV. For situations like this, we have typically offered testing for hepatitis B for all the diabetic residents.
This service area receives state general fund dollars for general epidemiologic services and for terrorism preparedness. In addition, federal funds are awarded from the Centers for Disease Control and Prevention’s Epidemiology and Laboratory Capacity Program and Expanding Existing Surveillance to include Pfiesteria, Other Harmful Algal Blooms, and Marine Toxins. The Environmental Protection Agency also supplies federal funds from the Beach Monitoring and Notification program.
The Suffolk Health Department is working with the Virginia Department of Health’s (VDH) Virginia Epidemiology Response Team (VERT) to address the rise in syphilis infections in Suffolk. VDH deployed VERT, an outbreak response team, to assist the Suffolk Health Department in conducting community syphilis screenings and partner notification. The team also is responsible for heightening awareness and education in the local community about the risk factors for syphilis. “VERT is a tremendous resource,” said Casey W. Riley, director of VDH’s Division of HIV, STD, and Pharmacy Services. “The team is trained to monitor infections, counsel clients on testing and treatment services, and strengthen community involvement and partnerships.”
VDH has been closely following the syphilis infection rates in Suffolk. Syphilis is being seen in both men and women. Additionally, the disease can be passed on by pregnant women to their unborn children, who are placed at risk of developing congenital syphilis. Congenital syphilis can result in blindness or death of a baby.
VERT provides temporary staff to Richmond and Henrico
Syphilis outbreak response (1 yr) in Danville. VERT borrows DIS from LHDs
VERT provides temporary staff to Lynchburg, Crater, Fredericksburg, Norfolk, and Peninsula
VERT assists with Anthrax surveillance
VERT begins syphilis response (1 yr) in Norfolk
VERT assists with TB and food borne outbreaks
Syphilis outbreak response in Suffolk
VERT assists Richmond (2 yrs) with gonorrhea and chlamydia problem
VERT assists with TB outbreak in Chesapeake
Outbreak Response Unit created
The chief source of funding for Sexually Transmitted Disease Prevention and Control is federal funds from the Centers for Disease Control and Prevention. Federal funds are intended to supplement (not replace or supplant) state and local resources but matching of these funds is not required. The service area also receives some general funds. Within the general fund, 75% of the funds are used for central office personnel and the remaining 25% supports STD testing and travel.
HIV prevention services, including HIV counseling and testing, are supported through state and federal funds. The U.S. Centers for Disease Control and Prevention provides the majority of these funds with approximately $5,000,000 annually.
HIV treatment services receive both federal and state funding. The largest portion of funding for these services, approximately $22.7 million annually, is provided by Title II of the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, which is administered federally by the Health Resources and Services Administration.
The Surveillance program receives approximately $1.24 million federal dollars annually from the U.S. Centers for Disease Control and Prevention to support multi-faceted programs essential to measuring the effectiveness of HIV prevention activities.
A 70 yo female day care worker with a history of pneumonia, +PPD for 40 years, has one positive AFB smear and a positive MTB probe. The day care serves members of the news media. LHD is working with the daycare to obtain list of all staff and children from daycare who are currently in daycare or who have left since 9/14/04 when case first went to volunteer. The day care will assemble most of the parents and staff so LHD can provide risk communication with recommendations based on CDC guidelines. LHD is offering PPD testing in cooperation with the daycare and giving written materials to families and staff.
Tuberculosis Prevention and Control is supported by both general funds and federal funds. The Federal funds
come through a categorical cooperative agreement from the Centers for Disease Control and Prevention and are
intended to supplement (not replace or supplant) state and local resources.
In May 2005 there was an outbreak of lymphocytic choriomeningitis (LCM) among organ recipients (not in Virginia) that was associated with a donor who had purchased a hamster from a pet store. A trace back led to a hamster distributor in Ohio where about 3% of sampled animals were positive. DZEE was called this morning by CDC to inform us that some of the rodents from the implicated distributor appear to have ended up in Virginia--at small, independent pet shops. CDC is planning to publish a public advisory. They will not be recalling the animals, just asking for stores to stop selling them and giving advice to pet owners. Because this organism can be found in wild rodents, it is difficult to require a recall and depopulation.
As media attention to a possible influenza pandemic continues, citizens are asking their physicians to prescribe oseltamivir (Tamiflu) for personal stockpiles for possible later use during an influenza pandemic. VDH is not encouraging the practice of writing such prescriptions or the establishment of personal stockpiles. However, since physicians may wish to consider the special circumstances of individual patients before making a decision about whether to honor these requests, VDH has developed guidance regarding the advantages and disadvantages of such prescribing.
15% of Division funding
The total budget for the service area has two funding streams consisting of general and non-general funds. Nongeneral funds are received in a federal, categorical, cooperative agreement from the Centers for Disease Control and Prevention.