Local Public Health Department. Communicable diseases Environmental health Chronic diseases Emergency preparedness Special programs

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1 Susan I. Gerber, MD

2 Local Public Health Department Communicable diseases Environmental health Chronic diseases Emergency preparedness Special programs

3 Public Health Reporting Ground Zero Local government City, county, municipality Regional Management State Managing local health department interactions National Coordination and Policy Federal Centers for Disease Control and Prevention

4 Control of Communicable Diseases Considered to be infectious, communicable, and dangerous to the health of the public Need to be reported to the local health department The state of Illinois publishes Rules & Regulations for communicable diseases

5 Ground Zero: Disease Control Local public health receives disease reports from mandated reporters: Physicians Nurses Hospitals Laboratories Long term care facilities Schools or any entity with knowledge of a communicable disease

6 Classes of Diseases Class 1 Report to the local health department as soon as possible, but within 24 hours Class 2 Report to the local health department as soon as possible, but within 7 days

7 Class I Diseases Any unusual case or cluster of cases that may present a public health hazard Anthrax Cholera Diptheria Foodborne or waterborne illness Hepatitis A Measles Pertussis Meningitis and other invasive disease (N.meningitidis, H. influenzae) Plague Rabies, human Smallpox Typhoid

8 Class II Diseases Blastomycosis Cryptosporidiosis Giardiasis Hepatitis B Hepatitis C Legionella Leptospirosis Listeria Salmonella Shigella Tickborne disease Non-cholera vibrio Yersinia

9 Communicable Disease Investigations Cases are reported by infection control personnel and microbiology laboratories Cases are assigned to communicable disease investigators Information pertaining to individual cases and sometimes contacts is obtained depending on the particular disease

10 Enteric Investigations Includes diseases such as Salmonella, Shigella, E. coli These organisms can be spread person to person or can infect food Can cause diarrhea, vomiting, fever, and abdominal pain Most effective way to prevent these diseases is handwashing

11 Enteric Investigations Investigate factors pertaining to spread of disease Restrict food handlers or personnel in sensitive occupations when necessary Surveillance activities Identification of foodborne disease outbreaks

12 Facts about Foodborne Illness Symptoms generally last for at least several hours to several days Bacterial toxins, bacteria, and viruses have incubation periods that can range from approximately 1 hour to several days. Public health determines whether a group of illnesses can be considered a foodborne disease outbreak

13 Determining Whether or Not Illnesses are Part of a Foodborne Disease Outbreak The diagnosis of foodborne disease should be considered when 2 or more persons who have a shared meal develop an acute illness characterized by nausea, vomiting, diarrhea, and occasionally other symptoms.

14 Diagnosing a Foodborne Disease Outbreak Must determine what causative agent makes sense using: information about clinical syndrome incubation period Commonly associated foods with specific organisms

15 How are Foodborne Diseases Diagnosed? Most often, the key to identifying what organism is causing the illness is through: STOOL SPECIMENS

16 Causes of Persistent Vomiting in a School- Age Child Enteric viruses which are passed from child to child Viruses and bacteria from food Trauma to the abdomen Urinary infections Food intolerance Migraine headaches and neurologic diseases Psychogenic Medications and drugs Toxins (eg. Lead) Metabolic diseases Peptic ulcer disease Appendicitis Pregnancy

17 What is Meningitis? Infection of the fluid around the spinal cord and the fluid that surrounds the brain Could be caused by a virus or a bacteria Symptoms: High fever Headache Stiff neck Unable to look at bright lights

18 Viral Meningitis Less severe People get better quickly Can be caused by lots of viruses: Summer viruses are common (enteroviruses) West Nile Virus Sometimes viruses that only cause colds can cause mild meningitis

19 Enteroviruses: The Viruses of Summer Summer viral meningitis Commonly occurs in late summer and early fall Lots of different kinds Commonly seen in children Illness improves within a few days Doctor might call this viral meningitis

20 Bacterial Meningitis Usually more severe Less common than viral meningitis New vaccines have decreased the number of children who get bacterial meningitis Examples of bacteria that cause meningitis: Pneumococcus (Streptococcus pneumoniae) Meningococcus (Neisseria meningitidis) Haemophilus influenzae

21 A Source of Confusion Meningitis Meningococcus Meningitis just refers to some type of infection of the spinal fluid Meningococcus is a type of bacteria that can cause both meningitis AND bloodstream infections

22 Meningococcus The bacteria is called Neisseria meningitidis Severe type of meningitis, but also causes an infection in the blood 5-10% of people carry this bacteria in their noses without ever getting ill Can be spread in a household or by secretions (sneezing and coughing directly onto someone else)

23 Meningococcus Can be treated with antibiotics Rarely causes outbreaks Two different types of vaccines are available to prevent some types of this disease Close contacts to cases are recommended to receive antibiotics as a precaution

24 All Meningitis: Viral and Bacterial Can be diagnosed by a healthcare provider If symptoms of high fever, headache, and stiff neckshould see a doctor IMMEDIATELY Diagnosis is made by lumbar puncture and examination of spinal fluid Only by looking at spinal fluid can a person conclusively tell if there is meningitis

25 Reducing Spread of Any Type of Meningitis Just like reducing the chance of any bacterial or viral disease: Good handwashing with soap and water! Using alcohol based sanitizers also works! People covering their mouth and nose when sneezing and coughing

26 Questions? Cook County Department of Public Health:

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