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Public Health Investigation and Response

Public Health Investigation and Response. to a Varicella Outbreak in Uinta County, Wyoming. 37th National Immunization Conference March 17-20, 2003 Chicago, Illinois. Presented by: Christy Remick Surveillance Coordinator Wyoming Department of Health Cheyenne, Wyoming. Introduction.

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Public Health Investigation and Response

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  1. Public Health Investigation and Response to a Varicella Outbreak in Uinta County, Wyoming 37th National Immunization Conference March 17-20, 2003 Chicago, Illinois Presented by: Christy Remick Surveillance Coordinator Wyoming Department of Health Cheyenne, Wyoming

  2. Introduction

  3. Wyoming Department of Health • Reportable Diseases and Conditions list • May 2001: Chickenpox • January 2003: Varicella (chickenpox or shingles) • Unusual illnesses or clusters of illnesses

  4. Uinta County Public Health Nursing (PHN) Services • Physician report to Uinta County PHN manager • UC PHN local follow-up • PHN report to WDH

  5. PHN and WDH collaborations • Reasons for investigation • High-risk populations • Pregnant women involved • Minority group (location) • Adults involved • Bioterrorism Grant • PHN volunteers to take the lead • Conducts interviews • Provides educational information

  6. Second Wave • Uinta County Community Event • Fishing Derby • 235 children in attendance • adult volunteers and parents • Immediate Public Health Action • Public Awareness regarding varicella • Confirmation of varicella

  7. Materials and Methods

  8. Investigation • Questionnaire • Contact information • Table to list: participants, age, previous varicella, vaccination history / date, referral for vaccine • Section to list non-registered participants • Line Listing • Disease verification • Specimen collection method • Laboratories • The Centers for Disease Control and Prevention • North Dakota Public Health Laboratory

  9. Analysis • Graph by month of illness • Graph by onset of illness date • Epi Plot by onset of illness

  10. Vaccination • Determining susceptibility • PHN questionnaire • Vaccine supply (WDH) • 160 doses of vaccine ordered • adults offered vaccine free-of-charge • Vaccine administration (PHN) • vaccination clinic • answering service

  11. Education • Press release • Epi X posting • Presentation • Wyoming Public Health Association Conference • 37th National Immunization Conference

  12. Results

  13. Questionnaire

  14. Laboratory

  15. Graph

  16. Epi Plot

  17. Vaccination • 111 children had disease history • All 3 pregnant women had disease history • OB-GYN referral was made • In addition, 4 infants attended • All 4 mothers reported disease history

  18. Discussion

  19. WDH Lessons Learned • Importance of timely reporting • Verification of outbreak • Obtaining control • Prevention measures • Effects of in-depth surveillance and prevention • Public awareness effect on possible large exposure • PHN vaccination clinic and local coordination • prevention of further disease

  20. WDH Lessons Learned • Importance of proper education for physicians • Serology timing, best test for varicella • Serum: range between 7 – 14 days • Swab: during the vesicular stage • Why outbreaks should be investigated • Verification of disease • Collaboration skills • Outbreak investigation practice

  21. Thank You!

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