Office of Epidemiology

From interpreting scientific data to determine whether fishermen can eat their catch to identifying people exposed to tuberculosis, the Office of Epidemiology’s primary goal is always the protection of human health. The office takes an integrated approach to respond to public health challenges, regularly coordinating with internal and external agency counterparts to bolster communication, surveillance and investigation efforts.

Division of Immunization Responds Effectively To Unexpected Shortage of Flu Vaccine
On October 5, public health officials across the country learned that, due to significant problems in its manufacturing process, one of the two licensed manufacturers of injectable flu vaccine would not be shipping any vaccine to the U.S. As a result, VDH stood to lose about half of the vaccine that it had ordered for the 2004-05 flu season.

Along with all other state health departments, VDH worked closely with the U.S. Centers for Disease Control and Prevention (CDC) to develop contingency plans. CDC obtained a commitment from the remaining licensed injectable flu vaccine manufacturer, Aventis-Pasteur, to redirect a portion of its vaccine that had not yet been distributed in order to ensure maximum immunization coverage for population groups at highest risk of developing severe and potentially fatal complications from the flu.

VDH collaborated with the 35 local health districts to develop local flu vaccine distribution plans. Each local health district tried to determine the best way to meet the needs of the high-risk people in their community. By the end of December, 371,000 doses of flu vaccine had been distributed to Virginia’s local health districts and other health care providers.

Division of Surveillance and Investigation Identifies Sources of Several Multi-State Outbreaks
In 2004, the Division of Surveillance and Investigation (DSI) conducted investigations that originated from epidemiologists identifying patterns of unusual illness in Virginia, alerts from the Division of Consolidated Laboratory Services (DCLS), or notification from the CDC of clusters detected in other states. DCLS’s foodborne disease genetic analysis system alerted DSI to several illness clusters, and led to DSI conducting one intrastate study and participating with the CDC and other state health departments in three multi-state studies to identify the source of foodborne outbreaks. After interviewing people, analyzing data and collecting specimens, the results of these studies pointed the way for the U.S. Food and Drug Administration (FDA) to conduct traceback investigations of suspected produce items. Once the source of infection is identified, ways to prevent future outbreaks can be implemented.

Radiological Health Program Participates In State Emergency Operation Plan
Every two years, the Federal Emergency Management Agency (FEMA) requires a demonstration of the State Emergency Operation Plan. In August 2004, VDH’s Radiological Health Program participated in the State Emergency Operation exercise with various state and local agencies, including the Virginia Department of Emergency Management, and the owner and operator of the North Anna Nuclear Power Station. Staff from FEMA observed and evaluated emergency preparedness and response elements of each participating organization. It was determined, that based on simulated accident conditions, the participating agencies are capable of providing necessary measures to ensure the health and safety of the public in a radiological emergency.

Beach Monitoring Program Uses New Source Tracking to Keep Virginia Beaches Clean
In 2004, a new component to VDH’s beach monitoring program included collaboration with a Virginia Tech researcher to conduct source tracking at beaches that exceeded the standard for bacteria. One tracking method provided information on whether a human waste stream was present at the beaches; a second method provided greater detail into the source of contamination as identification of the bacteria were linked to more specific sources, such as pets, wildlife, human, or waterfowl sources. The source tracking techniques have proved valuable to both Hampton and Newport News in providing information to assist them in identifying where to target mitigation efforts in an attempt to control wastewater contamination of beaches in their localities.

Get Smart Virginia Campaigns for Consumer Education on Appropriate Antibiotic Use
VDH’s Get Smart Virginia program, in cooperation with the Medical Society of Virginia, kicked-off Antibiotic Awareness Month with a media campaign in October 2004. The month-long media campaign focused on educating consumers about when to use antibiotics and the problem of bacterial resistance. Activities included television, radio, print and bus advertising, employer-sponsored health activities and the distribution of educational materials at flu clinics, schools, libraries and public health agencies statewide. Articles about the campaign were published by the Virginia Pharmacists Association and in local and regional medical society newsletters.

Division of HIV, STD, and Pharmacy Services Use of Rapid HIV Test Gets Good Results
In 2004, the Division of HIV, STD, and Pharmacy Services began using OraQuick (rapid) HIV test technology with three Community-Based Organizations (CBOs) and four health districts. These CBOs had been conducting OraSure testing, an oral test that can produce results in a week. Because preliminary results are available within an hour, the use of OraQuick is expected to increase the percentage of individuals who receive their test results. Data from health districts show that 99.1 percent of clients receiving OraQuick testing were post-test counseled as compared to a statewide average of 37.7 percent with other antibody testing. The percentage of clients receiving post-test counseling with OraQuick testing by the CBOs is 99.7 percent, compared to 68.3 percent with the OraSure testing.

VDH Investigates Tuberculosis Exposure in Chesapeake
In response to the death of a hospital nurse from tuberculosis last June, Chesapeake Health District led a tuberculosis exposure investigation identifying thousands of people exposed to the disease. The District immediately activated their emergency response plan and established a command center and hotline. With the support of the Division of Tuberculosis Control, Community Emergency Response Teams, Medical Reserve Corps, the local hospital, school system, police, health department volunteers, public relations staff and others, the District was able to efficiently locate and screen people who were thought to have been exposed to tuberculosis infection. The District screened 2,742 people, including those screened at a Chesapeake high school, local health departments and private medical clinics. Of these, 1,561 individuals were evaluated as exposed and tested for tuberculosis infection. A total of 110 people tested positive for exposure to tuberculosis and were referred for treatment. The investigation found that only two active cases of tuberculosis were associated with this exposure.