Office of Epidemiology

The Office of Epidemiology seeks to prevent and control the transmission of communicable diseases and exposure to toxic substances and radiation. Through an integrated approach to respond to these public health challenges, the office protects the health of all Virginians.

Statewide Immunization Registry Pilot Program Underway
The Division of Immunization, in partnership with private physician groups, health insurers and other agencies, successfully supported a bill in the 2005 General Assembly that authorized the establishment of a statewide immunization registry. A one-year registry pilot program is now underway with full statewide implementation projected to begin in the fall of 2006. Implementation of a statewide registry will ensure that patients served by public and private health care providers receive appropriate and timely immunizations. The registry will also ensure the availability of a definitive immunization record on each patient and reduce the cost to VDH, parents, health care providers and health care insurers of duplicate doses of vaccine. Implementation of the registry addresses the agency goals of improving the collection, maintenance and dissemination of understandable public health information, and preventing the transmission of communicable disease.

Toxic Substances Information Staff Keep Public Informed
Toxic Substances Information staff responded to more than 500 inquiries for information and health hazard evaluations of chemical, biological and radiological agents in the past year. The number of citizen inquiries regarding health effects of mold increased significantly after remnants of tropical storm Gaston caused flooding in 2004. The staff also issued fish consumption advisories on several water bodies in the state where fish were found to contain elevated levels of contaminants.

Establishing a Measured Protocol for Isolation and Quarantine
The Division of Surveillance and Investigation made considerable progress this year in preparing for how to respond to communicable diseases which pose a threat to public health. These are diseases that can be spread from person-to-person, cause severe illness and have the potential to cause great societal and economic disruption. Division staff wrote guidelines for health department staff to follow if isolation and/or quarantine need to be implemented, developed forms to use to order and monitor isolation and quarantine and set up and delivered training on the topic.

HIV Incidence and Resistance Testing
Virginia is one of 34 jurisdictions funded by the Centers for Disease Control and Prevention (CDC) to implement HIV incidence and resistance testing. HIV incidence testing (which indicates how many people were infected within the last year) will provide a window into the epidemic at an earlier stage. This will allow public health officials, led by the Division of HIV, STD and Pharmacy Services, to better monitor the disease, allocate resources and plan prevention programs. Resistance testing measures the prevalence and transmission of drug-resistant virus and other atypical viruses. This testing provides useful information to both the client’s physician for making treatment decisions as well as researchers and public health authorities making treatment recommendations or developing new treatments. Virginia was one of the first states in the country to successfully launch both programs. With strong support from health district directors and staff, these programs were initially implemented in three local health departments and expanded to 52 additional health departments in 2005.

Preparing for Radiation Emergencies
The Radiological Health Program acquired a new mobile radiation laboratory to be used in responding to incidents at the two nuclear power plants in Virginia, acts of terrorism and accidents involving radioactive materials and other sources of radiation. Funding for the acquisition of the mobile laboratory came from the CDC through a grant for preparedness for bioterrorism and other public health emergencies.

VDH Assures Most TB Patients Successfully Complete Treatment
Tuberculosis (TB) case report and case management records have been reviewed for 2003 and 2004. Virginia met or exceeded CDC TB program objectives for successful completion of treatment for 2003 cases. Ninety percent of patients with drug-susceptible organisms completed treatment within one year of beginning treatment. Cases from 2004 cannot yet be evaluated as a full year has not passed since July-December cases were diagnosed, but a preliminary review suggests that national objectives will be met for 2004 cases. The successful completion of treatment for the majority of patients is a direct result of the efforts of Virginia’s public health nurses and TB outreach workers.

Partnership Helps Control Human Risk From Animals
In recent years, concerns have increased about infectious diseases that are newly emerging or re-emerging and those that might be used in a bioterrorism attack. Most of these diseases are zoonoses, or diseases transmitted from animals to humans. For example, West Nile virus, which emerged in the United States in 1999, is spread by mosquitoes that become infected from birds. Anthrax, which infected humans via intentional contamination of mail, is primarily a disease of livestock. To monitor and respond to threats from zoonoses, VDH hired a veterinarian (shared with the Virginia Department of Agriculture and Consumer Services) with public health experience to work with state agencies and other organizations involved in animal health to improve coordination, communication and collaboration on diseases of mutual interest. As a result, ad hoc and regular communication among state and federal partners has increased, as has the understanding of each other’s roles and the willingness to share resources. A recent meeting will lead to written memos of understanding on collaboration and will help reduce Virginian’s risk from animal diseases.