Vaccine Preventable Disease Alameda County

Transcription

1 Vaccine Preventable Disease Alameda County Erica Pan, MD, MPH, FAAP Deputy Health Officer Director, Division of Communicable Disease Control and Prevention Alameda County Public Health Department Clinical Professor Pediatric Infectious Diseases

2 Disease Reporting Clinicians Make the Difference

3 How/Where to Report Report to local health jurisdiction where case resides

4 Vaccine Preventable Disease Highlights Hepatitis A Influenza Pertussis Human Papillomavirus Perinatal Hepatitis B

5 Vaccine Preventable Diseases in Alameda County (annual counts) Alameda County data for vaccine preventable diseases - yearly counts Disease * 2017* Cumulative Diphtheria Polio Rubella Tetanus Measles Haemophilus influenzae type b (aged <15 years only) Mumps Varicella (hospitalizations and deaths only) Influenza ( : pediatric deaths only; : deaths <65 yo only) Meningococcal disease Hepatitis A (acute) Hepatitis B (acute) Pertussis Pertussis rates (per 100,000 )and 95%CI 3.9 ( ) 4.2 ( ) 2.3 ( ) 29.4 ( ) 15.0 ( ) 4.4 ( ) 8.9 ( ) 24.4 ( ) 12.6 ( ) 5.1 ( ) 7.3 ( ) * provisional

6 Vaccine Preventable Disease Cases Mumps Meningococcal disease * 2017* Measles * 2017* Acute Hepatitis * 2017* * 2017* Hepatitis A (acute) Hepatitis B (acute)

7 Hepatitis A Largest person-person outbreak in CA history Began in San Diego, spread to other counties Governor declared an emergency Majority of cases among homeless or illicit drug users We wanted to prevent an outbreak in Alameda County

8 Partnering with Community from December 2017-April 2018 Developed handouts and Hep A info Trained 22 PH staff and ~50 outreach workers Created a Field Operations Guide and followed Incident Command System (ICS) Principles

9 Hepatitis A Efforts Visited 11 shelters, 6 encampments, 7 needle exchanges, 4 churches, 1 community event and 1 boys and girls club Put on 30 events With partners we vaccinated 687 people! Participating Organizations Shelter 37% Encampment 20% Needle Exchange 23% Churches 13% Other (Events, Clubs) 7% 1,032 total vaccines given and distributed 1729 Total Encounters Average 45% participation rate

10 Hepatitis A vaccinations with Street Medicine

11 Hepatitis A vaccinations at night with HEPPAC 3/22/2018

12 Influenza -- What to Report Fatal Influenza Reporting < 65 years Lab-confirmed influenza in fatal cases <=65 years old Outbreaks or unusual occurrence In institution with >=1 case of lab confirmed flu in the setting of a cluster (>=2) of ILI within 72h In institution or congregated living setting associated with hospitalization or fatalities Other public health importance eg travel to area with novel flu, close swine/avian contact

13 Influenza Particularly bad year surge was put to the test Nov 26 Dec 2, 2017 Dec 23, March 17, 2018 March 25 April 7, 2018 April 15 April 28, 2018

14

15 Influenza Masking order within Alameda County and Bay Area was extended through April 30 (November 1 - April 30)

16 Influenza Vaccine Distribution and Programs Flu vaccine distribution program For low-income, un- or under-insured adults Visit to participate Shoo the Flu School Located Influenza Clinic campaign Oakland and Piedmont schools Since 2014, has vaccinated 37,465 students and staff contact our IZ program at for more information

17 Pertussis Cycles We re Due for another Epidemic Alameda County Pertussis Cases by Epidemic Year Yr 2010 Yr cases 355 cases

18

19 Tdap in last trimester of EVERY Pregnancy Best strategy to avoid infant deaths weeks during EVERY pregnancy We re following up on infants <4 mos old We want to make sure that ob/gyns find out about any missed opportunities What is your follow-up strategy if you do not have the vaccine?

20 What is HPV-Impact? Population-based surveillance of cervical precancer to evaluate the impact of the HPV vaccines, by 1. Monitoring cervical pre-cancer 2. Monitoring HPV types Alameda County 3. Tracking HPV vaccine history and cervical cancer screening

21 Cervical Pre-Cancer is a Reportable Condition in Alameda County WHY? Every year in California, HPV causes an estimated 5,200 cancers in men and women. There were almost 1,400 cervical cancer cases in California and over 470 deaths from cervical cancer in WHAT CAN PROVIDERS DO TO HELP? Ask and document vaccination history Complete HPV-Impact Case Report Forms Sign up for the California Immunization Registry (CAIR)

22 Incidence (per 100,000 population) Incidence of cervical pre-cancer decreasing in women aged N= 7, Year year olds year olds year olds 87% t Note: 2016 data is preliminary.

23 ACPHD Perinatal Hep B Prevention Program Prevent transmission of Hep B virus: Provide education to pregnant women w/chronic Hep B Identify household contacts & refer to screen & evaluate Maintain contact with mothers & MDs to ensure: Hep B vaccine series is given Post-vaccine serology is completed to assess immune status Thank you for communicating with us about these patients!!

24 Thank You Disease Reporting: (after hours) Immunization Questions: