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Epidemiology and Emerging Infections Reportable Infectious Diseases Reference ManualSeptember 16, 20192019Epidemiology and Emerging InfectionsReportable Infectious DiseasesReference ManualROUTINE REPORTABLE INFECTIOUS DISEASE FOLLOW-UPFOR CT STATE AND LOCAL HEALTH DEPARTMENT STAFFCONNECTICUT DEPARTMENT OF PUBLIC HEALTH – INFECTIOUS DISEASES SECTION410 Capitol Ave., MS# 11FDS, Hartford, CT 06134Phone: 860-509-7995FAX: 860-509-7910
Epidemiology and Emerging Infections Reportable Infectious Diseases Reference ManualTHIS PAGE INTENTIONALLY LEFT BLANKConnecticut Department of Public HealthSeptember 16, 2019
Epidemiology and Emerging Infections Reportable Infectious Diseases Reference ManualSeptember 16, 2019Table of ContentsImportant Documentation. 1The purpose of this reference manual: . 2Additional Resources for Control Related Follow-up . 3Reportable Disease Follow-up in Connecticut. 4Reportable Diseases Listing . 4Mandated Reporting. 4Authority to Conduct Case Follow-up . 5Reportable Disease Follow-up Responsibilities by the State and Local Health Departments . 6LHD Primarily Responsible for: . 6Joint Responsibility. Diphtheria – 860-509-7929 . 7Haemophilus influenza disease/Meningococcal disease – DPH EEIP – 860-509-7994 . 7Hepatitis A – DPH EEIP – 860-509-7994 . 7Tuberculosis – 860-509-7801 . 7DPH Primarily Responsible for: . 7Surveillance Systems . 8What is CTEDSS/Maven? . 8What is FoodNet? . 8What is FoodCORE?. 8Confidentiality . 9Health Insurance Portability and Accountability Act of 1996 (HIPAA) . 10Background . 10Connecticut General Statutes . 10BIOTERRORISM. 12BOTULISM . 14THE DISEASE AND ITS EPIDEMIOLOGY. 14ACTIONS REQUIRED AND CONTROL MEASURES . 16Connecticut Department of Public HealthPage i
Epidemiology and Emerging Infections Reportable Infectious Diseases Reference ManualSeptember 16, 2019CAMPYLOBACTERIOSIS. 18THE DISEASE AND ITS EPIDEMIOLOGY. 18ACTIONS REQUIRED AND CONTROL MEASURES . 19CHOLERA . 21THE DISEASE AND ITS EPIDEMIOLOGY. 21ACTIONS REQUIRED AND CONTROL MEASURES . 22CRYPTOSPORIDIOSIS . 24THE DISEASE AND ITS EPIDEMIOLOGY. 24ACTIONS REQUIRED AND CONTROL MEASURES . 25CYCLOSPORIASIS . 27THE DISEASE AND ITS EPIDEMIOLOGY . 27ACTIONS REQUIRED AND CONTROL MEASURES . 28GIARDIASIS . 30THE DISEASE AND ITS EPIDEMIOLOGY. 30ACTIONS REQUIRED AND CONTROL MEASURES . 31HEMOLYTIC UREMIC SYNDROME . 33THE DISEASE AND ITS EPIDEMIOLOGY. 33ACTIONS REQUIRED AND CONTROL MEASURES . 34HEPATITIS A INFECTION . 36THE DISEASE AND ITS EPIDEMIOLOGY. 36ACTIONS REQUIRED AND CONTROL MEASURES . 37LISTERIOSIS . 40THE DISEASE AND ITS EPIDEMIOLOGY. 40ACTIONS REQUIRED AND CONTROL MEASURES . 41SALMONELLOSIS . 42THE DISEASE AND ITS EPIDEMIOLGY . 42ACTIONS REQUIRED AND CONTROL MEASURES . 43SHIGA TOXIN-PRODUCING ESCHERICHIA COLI . 45THE DISEASE AND ITS EPIDEMIOLOGY. 45ACTIONS REQUIRED AND CONTROL MEASURES . 46SHIGELLOSIS . 48THE DISEASE AND ITS EPIDEMIOLOGY. 48ACTIONS REQUIRED AND CONTROL MEASURES . 49Connecticut Department of Public HealthPage ii
Epidemiology and Emerging Infections Reportable Infectious Diseases Reference ManualSeptember 16, 2019TRICHINELLOSIS . 51THE DISEASE AND ITS EPDEMIOLOGY . 51ACTIONS REQUIRED AND CONTROL MEASURES . 52TYPHOID/PARATYPHOID FEVER. 53THE DISEASE AND ITS EPIDEMIOLOGY. 53ACTIONS REQUIRED AND CONTROL MEASURES . 54VIBRIO INFECTION, non-cholera . 56THE DISEASE AND ITS EPIDEMIOLOGY. 56ACTIONS REQUIRED AND CONTROL MEASURES . 57YERSINIOSIS . 58THE DISEASE AND ITS EPIDEMIOLOGY. 58ACTIONS REQUIRED AND CONTROL MEASURES . 59SEXUALLY TRANSMITTED DISEASES . 62VACCINE PREVENTABLE DISEASES . 64VECTOR-BORNE DISEASES. 66ATTACHMENT A. 67Physician Reportable Diseases List . 67ATTACHMENT B . 69Reportable Disease Confidential Case Report Form – PD23 . 69ATTACHMENT C. 71Laboratory Reportable Significant Findings List. 71ATTACHMENT D. 73Reportable Laboratory Findings Form – OL-15C . 73ATTACHMENT E . 75Example of a Confidentiality Pledge . 75ATTACHMENT F . 77Food Protection Program - FDA Food Code Information . 77ATTACHMENT G . 79GEDIF for Salmonella and Campylobacter . 79ATTACHMENT H . 81GEDIF for Shigella . 81ATTACHMENT I . 83GEDIF for Yersinia. 83Connecticut Department of Public HealthPage iii
Epidemiology and Emerging Infections Reportable Infectious Diseases Reference ManualSeptember 16, 2019ATTACHMENT J . 85GEDIF for Cryptosporidium . 85ATTACHMENT K . 87Cholera and Other Vibrio Illness Surveillance Report Form . 87ATTACHMENT L . 89Hepatitis A Case Report Form and Contact Management Form . 89ATTACHMENT M . 91Typhoid and Paratyphoid Fever Surveillance Report Form . 91ATTACHMENT N. 93Annual FoodNet/FoodCORE Letter . 93Connecticut Department of Public HealthPage iv
Epidemiology and Emerging Infections Reportable Infectious Diseases Reference ManualSeptember 16, 2019Important DocumentationFor the most up to date reportable disease informationand forms, please visit the DPH websitehttps://portal.ct.gov/DPH.Documents for the information below, with the exceptionof the FDA Food Code, are attached for your convenienceand are current as of August 2019.AttachmentsA - Physician Reportable Diseases ListB - Reportable Disease Confidential Case Report Form(PD-23)C - Laboratory Reportable Significant Findings ListD - Reportable Laboratory Findings Form (OL-15C)E - Example of a Confidentiality PledgeF - Food Protection Program For the following FDA guidance please gram/Main-PageFDA Food Code FAQFDA Food Code 2017G - GEDIF for Salmonella and CampylobacterH - GEDIF for ShigellaI - GEDIF for YersiniaJ - GEDIF for CryptosporidiumK - Cholera and Other Vibrio Illness Surveillance ReportThe information on this page includesa list of documents that you will needwhen conducting some diseasefollow-up or investigations.Please keep in mind that theReportable Diseases List and the list ofReportable Laboratory Findings arereviewed annually, and may beupdated, as are the ConfidentialDisease Reporting Form - PD23 andthe Reportable Laboratory FindingsForm OL-15C.To assure you have the most up-todate information concerningreportable diseases, please visit theReporting of Diseases, EmergencyIllnesses, Health Conditions, andLaboratory Findings webpage esses-HealthConditions-and-Laboratory-Findings.For the most current reportabledisease forms, please ms/Forms and select theform for your specific needs.L - Hepatitis A Case Report Form Hepatitis A Case Contact Management Form is thelast page of the Case Report FormM - Typhoid and Paratyphoid Fever Surveillance ReportConnecticut Department of Public HealthPage 1
Epidemiology and Emerging Infections Reportable Infectious Diseases Reference ManualSeptember 16, 2019The purpose of this reference manual:The Connecticut Epidemiology and Emerging Infections (EEIP), Reportable Infectious DiseasesReference Manual (the manual) describes infectious disease investigation and follow-uprecommendations of the Connecticut Department of Public Health (DPH) EEIP, and outlines theresponsibilities of the DPH and local health department (LHD). Primary users include Connecticut localhealth directors, public health nurses, sanitarians, and other LHD personnel, and DPH employees.The focus of the manual is on routine follow-up of the reportable infectious diseases that are not coveredby the STD/HIV/Hepatitis Programs, Immunizations Program or the Tuberculosis Program, which havetheir own disease-specific recommendations. The manual does not specifically address possible agentsof bioterrorism, except by providing URLs to the Connecticut Public Health Emergency Response cy-Response-Plan), and to the resources available on the Centers for Disease Control andPrevention (CDC) website (https://emergency.cdc.gov/bioterrorism/).For follow-up instructions on other reportable infectious diseases, contact the responsible programdirectly:Healthcare Associated Infections Program860-509-7995HIV Prevention Program860-509-7807Immunization Program860-509-7929Sexually Transmitted Diseases (STD) Program860-509-7920Tuberculosis Program860-509-7801We recommend that all users of the manual have their own copies of the following resources as they willbe needed to begin investigations by reviewing the appropriate sections: Control of Communicable Diseases Manual, 20th Edition (American Public Health Association,David L. Heymann, MD, Editor), or most recent edition;Red Book: 2018 Report of the Committee on Infectious Diseases, 31st Edition (AmericanAcademy of Pediatrics, David W. Kimerlin, MD, FAAP, Editor), or most recent edition.Much of the disease-specific information in the manual is derived from these two resources, and frommaterials available on the CDC website (https://www.cdc.gov/). The manual is intended to providesupplemental information that will help public health practitioners in Connecticut implement nationallyrecognized disease prevention and control measures for reportable infectious diseases.DPH staff conducts follow-up on all reportable vector-borne diseases.The diseases are listed alphabetically with each topic including information for routine follow-up andURL addresses to websites that include additional information as well as fact sheets. Attachmentsinclude forms and questionnaires that are necessary for proper follow-up.Connecticut Department of Public HealthPage 2
Epidemiology and Emerging Infections Reportable Infectious Diseases Reference ManualSeptember 16, 2019Additional Resources for Control Related Follow-upControl Measures Nationally Notifiable Infectious Diseases case definition ational Resources Centers for Disease Control and Prevention online: https://www/cdc/govConnecticut Department of Public Health online: https://www.ct.gov/dphU.S. Department of Health and Human Services. U.S. Food & Drug Administration. “Bad BugBook – Foodborne Pathogenic Microorganisms and Natural Toxins cut Department of Public HealthPage 3
Epidemiology and Emerging Infections Reportable Infectious Diseases Reference ManualSeptember 16, 2019Reportable Disease Follow-up in ConnecticutReportable Diseases ListingConnecticut General Statutes (CGS) §19a-2A(9), and §19a-36-A2 le 19a/036pdf.pdf?la en) of the Connecticut Public Health Code (CPHC)mandate the Commissioner of the DPH to annually issue a list of reportable diseases, emergencyillnesses and health conditions and a list of reportable laboratory findings. The Commissioner shall alsoprepare printed forms that include instructions to report and return. An advisory committee of publichealth officials, clinicians, and laboratorians contribute to the process.Mandated ReportingCGS §19a-215b, and §19a-36-A3 of the CPHC require that health care providers, includingadministrators of health care facilities, report the diseases listed in the List of Reportable Diseases,Emergency Illnesses, and Health Conditions cies/DPH/dph/infectious diseases/pdf forms /ReportableDiseases.pdf?la en). These reports areconfidential (pursuant to CGS §19a-25 and §19a-215d,e). As indicated in §19a-36-A4 of the CPHC,diseases fall into two categories: Category 1: These diseases must be reported immediately by telephone on the day ofrecognition or strong suspicion, due to the need for timely public health action. On weekdays,contact the DPH Epidemiology and Emerging Infections Program (EEIP) at 860-509-7994, andthe LHD of the patient’s town of residence. [A list of local health departments can be found A/Local-Health-Administration---Site-Map.]On evenings, weekends, and holidays, contact the DPH’s afterhours and emergency number at860-509-8000. A Reportable Disease Confidential Case Report Form (PD-23) or a diseasespecific report form must be completed and mailed to both the DPH and LHD within 12 hours.Forms are found on the DPH website Forms.Category 2: These diseases must be reportable by mail within 12 hours of recognition or strongsuspicion to both the DPH and LHD.Section 19a-36-A3 of the CPHC requires that directors of clinical laboratories must report to the DPHand LHD any laboratory evidence suggestive of diseases on the Reportable Laboratory Finding /DiseaseReporting/Laboratory-Reporting). A completedReportable Laboratory Findings Form rms/Forms) must be mailed to both the DPH and LHD ofthe patient’s town of residence. Laboratories participating in Electronic Laboratory Reporting atoryReporting) do not need to submit OL-15C forms.Connecticut Department of Public HealthPage 4
Epidemiology and Emerging Infections Reportable Infectious Diseases Reference ManualSeptember 16, 2019Authority to Conduct Case Follow-upCGS §19a-215d grants authority to the DPH and the LHD director or his/her authorized personnel tocontact the reporting physician and the person with a reportable condition for the purposes of diseasecontrol. All information collected, as part of this follow-up investigation, is considered confidential,pursuant to §19a-25.Connecticut Department of Public HealthPage 5
Epidemiology and Emerging Infections Reportable Infectious Diseases Reference ManualSeptember 16, 2019Reportable Disease Follow-up Responsibilities by the State and LocalHealth DepartmentsThe following reflects the recommendations of the DPH Infectious Diseases Section regardingresponsibility for the routine follow-up of reportable infectious diseases to obtain additional surveillancedata and implement control measures.LHD Primarily Responsible for:The LHD is responsible for completing state and/or CDC case report forms if indicated, and for assuringthat appropriate control measures are being taken independently of any assistance from the DPH. TheLHD has primary responsibility for obtaining surveillance data on diseases in the following list:Foodborne – 860-509-7994**See annual FoodNet/FoodCORE letter (Attachment N) for yearly updates on respective follow-upresponsibilities. Campylobacteriosis (NOT reported by Quest Diagnostics)o ᴧSpecial Note on Campylobacter: Beginning in 2018, Campylobacter cases reported byQuest Diagnostics will be interviewed by DPH. LHDs must check CTEDSS in order toknow which cases will be interviewed by DPH. A message indicating “CASE TO BEINTERVIEWED BY DPH” will be entered into the “Notes” field in CTEDSS forselected Campylobacter cases targeted for DPH interview. LHDs should interview allother Campylobacter cases. See annual FoodNet/FoodCORE letter for almonella (unless LHD defers to FoodCORE)Typhoid feverYersiniosisHepatitis – 860-509-7900 Hepatitis BHepatitis CSexually Transmitted Diseases – 860-509-7920 ChancroidChlamydiaGonorrheaJoint ResponsibilityFor some diseases, follow-up for both investigation and control is a joint responsibility between theLHD and DPH. In general:Connecticut Department of Public HealthPage 6
Epidemiology and Emerging Infections Reportable Infectious Diseases Reference Manual September 16, 2019The role of the LHD is to take the necessary action. The DPH may take necessary actions if theLHD does not have the resources.The primary role of the DPH is to assure that appropriate investigation and control actions aretaken for each lla/Diphtheria – 860-509-7929The DPH Immunization Program staff assures that appropriate diagnostic work has been done andworks with LHD staff to assure that contacts to each case have been identified, and that appropriaterecommendations for vaccination, exclusion, etc., have been made.Haemophilus influenza disease/Meningococcal disease – DPH EEIP – 860-509-7994The DPH EEIP staff assures that the appropriate diagnostic work has been done, and works withLHD staff to assure that close contacts have been identified and referred to their primary careprovider for prophylactic treatment.Hepatitis A – DPH EEIP – 860-509-7994The DPH EEIP staff conduct case investigations and work with LHD staff who oversee andimplement control measures when appropriate.Tuberculosis – 860-509-7801The DPH TB Control Program staff work with LHD staff to ensure that a treatment plan isdeveloped, a contact investigation is done on each case, those infected are offered preventivetherapy, and progress with completing therapy is monitored.DPH Primarily Responsible for:The DPH is responsible for obtaining additional case data for all other diseases on the list of ReportableDiseases, Emergency Illness, and Health Conditions. All diseases on the list are nationally reportable tothe CDC, and some receive federal funding to enable follow-up specifically for surveillance purposes.The assistance of the LHD is usually not required, unless initiation of control measures is neededconcurrently, as could be the case in a foodborne outbreak.Connecticut Department of Public HealthPage 7
Epidemiology and Emerging Infections Reportable Infectious Diseases Reference ManualSeptember 16, 2019Surveillance SystemsWhat is CTEDSS/Maven?Maven is Connecticut’s web-based electronic disease surveillance system (CTEDSS). Direct entry ofinterview data into CTEDSS for foodborne disease follow-up allows LHDs to complete follow-up formsonline without the need to submit paper reports to the DPH. CTEDSS allows the sharing of informationbetween LHDs and the DPH, and gives LHD staff the ability to generate reports of case data for theirjurisdiction.The DPH continues to expand disease reporting in CTEDSS. One significant benefit of the system isthat it is able to received electronic disease reports. The implementation of CTEDSS allows LHDs toacces
Epidemiology and Emerging Infections Reportable Infectious Diseases Reference Manual September 16, 2019 CONNECTICUT DEPARTMENT OF PUBLIC HEALTH – INFECTIOUS DISEASES SECTION 410 Capitol Ave., MS# 11FDS, Hartford, CT 06134 Phone: 860-509-7995 FAX: 860-509-7910 2019 ROUTINE REPORTABLE INFECTIOUS DISEASE FOLLOW-UP
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Introduction to Epidemiology Epidemiology yIs the process to study the distribution and determinants of disease frequency yIs a discipline which approaches problems systematically and quantitatively yIs the basic science of public health The Public Health Cycle Measure/Evaluate Epidemiology Analyze Epidemiology Communicate Intervene Epidemiology
Introduction to Epidemiology and Genetic Epidemiology. Major goals in Epidemiology To obtain an unbiased & precise estimate of the true effect of an exposure or intervention on outcome in the population at risk To use this knowledge to prevent and treat disease.
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Introduction to Genetic Epidemiology Different faces of genetic epidemiology K Van Steen 2 DIFFERENT FACES OF GENETIC EPIDEMIOLOGY 1 Basic epidemiology . Clayton D. Introduction to genetics (course slides Bristol 2003) Bon
form the core of traditional psychosocial epidemiology derive from those of infections disease epidemiology. That field seeks to describe the relationships among and between a population, its environment, and some disease agent, such as influenza virus. Often successful work in infectious disease epidemiology
SUSPECTED PEDIATRIC BONE AND JOINT INFECTIONS UNIVERSITY OF MICHIGAN CLINICAL PRACTICE GUIDELINE I. OVERVIEW: Bone and joint infections are relatively common invasive bacterial infections in children and adolescents. These infections can develop via hematogenous spread, via direct spread from adjacent soft tissue infection, or as a result
Accounting Standard (IAS) terminology and requiring pre sentation in International Standard format. Approach – These qualifications were designed using Pearson’s Efficacy Framework. They were developed in line with World-Class Design principles giving students who successfully complete the qualifications the opportunity to acquire a good knowledge and understanding of the principles .
