Information Epidemiology Essential Services

Epidemiology Essential Services During Pandemic Influenza

Criteria for determining essential services: infectiousness (human to human), virulence/severity of disease, vaccine preventable, and services available through public health.

Investigations of the following diseases will continue with the top priority diseases listed first. As staffing and resources are reduced, the diseases at the bottom of the list will not be investigated immediately. Prioritization may be District specific; however, all diseases listed below will be included.

Pandemic influenza surveillance: Enhanced surveillance activities will continue until the disease is established in the District and then surveillance will be reduced to maintaining the number and demographics of cases. Also, laboratory testing of suspect cases will stop when the lab stops accepting specimens.

Clusters or outbreaks: the definition of cluster or outbreak might be modified. Example: Instead of investigating any cluster or outbreak of illness in 2 or more individuals, the investigation threshold might be raised to "3 or more" or "4 or more" individuals.

Any bioterrorism agent: Any case involving a suspected bioterrorism agent will continue to be investigated.

Human rabies exposure: Since rabies is fatal, cases of humans exposed to possible rabid animals will be investigated and referred.

Measles: Although rare, and often imported, any case of measles will be investigated.

E. coli O157H7/Shiga toxin +/HUS: Immediate investigations of any infants and daycare attendees.

Hepatitis A: Since health departments are the only source of Immune globulin, this disease will continue to be followed.

Bacterial meningitis: Although not highly infectious, a case could be perceived as a threat by the public during a time of increased public tensions.

Pertussis: Highly contagious disease. Disease can be severe in infants.

Typhoid: Although rare, and often imported, any case will be investigated.

Action steps before a pandemic:
Start an education campaign during the regular flu season. All individuals should be screened and encouraged to receive any recommended immunizations to remain current on their immunization status. Screening and recommendations should be made for all vaccine preventable diseases to include the new pertussis vaccine for adults, MMR, Pneumococcal and hepatitis A & B. This will reduce the burden of these diseases during a pandemic influenza outbreak.

Work with the STD/TB units and discuss cross training and utilizing staff during a pandemic influenza outbreak. Possible use of Environmental Health staff as well.

For more information, contact:

The Office of Infectious Disease

Program Director- Heidi Davidson 404-508-7851
Public Health Nurse- Wanda Jallow 404-294-2854