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is the study of the distribution and determinants of disease in a population. Public health epidemiologists monitor the health and illness of a population, investigate the factors that affect the community's health, and recommend interventions to reduce the risk of disease. Epidemiology is practiced in health departments daily and involves principles of surveillance, investigation, laboratory testing, data management and communication.

Blue Bell Creameries Voluntarily Expands Recall

A multi-state outbreak of Listeria infection linked to Blue Bell Creameries products continues to be investigated. To date, there have been 10 cases identified. No cases have been identified in Virginia. The most up-to-date information can be found on the CDC Multistate Outbreak of Listeriosis Linked to Blue Bell Creameries Products webpage.

Current Situation
Several strains of Listeria monocytogenes are involved in this outbreak. Information indicates that various Blue Bell brand products produced in facilities in Texas and Oklahoma are the source of this outbreak.

As of April 21, 2015, a total of ten people with listeriosis related to this outbreak have been confirmed from 4 states: Arizona (1), Kansas (5), Oklahoma (1), and Texas (3). Three deaths were reported from Kansas. No cases have been identified in Virginia.

What is Listeriosis?
Listeriosis is a disease caused by eating food contaminated with the Listeria monocytogenes bacteria (germ). The bacteria are found in soil, food for horses and cattle, water, mud and silage. It is spread by ingesting raw or contaminated milk, soft cheeses, unwashed raw vegetables, undercooked poultry, and ready-to-eat meats (like cold-cuts). It can also be spread from a pregnant woman to her baby in the womb or during birth.

Who is most at risk and what are possible symptoms?

  • People with weakened immune systems and people over 65 years old: Symptoms can include fever, muscle aches, headache, stiff neck, confusion, loss of balance, and convulsions.
  •  Pregnant women: Pregnant women typically experience only a mild, flu-like illness. However, infection during pregnancy can lead to miscarriage, stillbirth, premature delivery, or life-threatening infection of the newborn.
  • Other people: Most healthy people can consume contaminated foods without getting ill. Occasionally, healthy people aged less than 65 years old may develop invasive (meaning the bacteria spread to the bloodstream or other sites) listeriosis. In addition, people exposed to a very large dose of Listeria bacteria can develop a non-invasive illness, and may develop diarrhea and fever.

Which Blue Bell products are being recalled:
As of April 20th, Blue Bell has voluntarily recalled all of its products made at all of its facilities in order to ensure Listeria contamination can be eliminated. Products include all Blue Bell brand ice cream, frozen yogurt, sherbet, and frozen snacks.

If recalled product(s) are or were in your home:

  • Return any recalled products to the place of purchase for a full refund or throw them away.
  •  If throwing away recalled products, dispose of recalled products in a closed plastic bag placed in a sealed trash can. This will prevent people and animals from eating them.
  •  For more information, consumers with questions may call 1-866-608-3940 Monday – Friday 8 a.m. – 8 p.m., Saturday 10 a.m. – 2 p.m. CST or go to

What to do if you have eaten food contaminated with Listeria:
It can take between a few days to one month for someone infected with Listeria to show symptoms. It may take up to 70 days for pregnant women.  A person who ate a product recalled because of possible Listeria contamination and develops symptoms of listeriosis after eating the recalled product should consult their health care provider.

If you have eaten a recalled product and do not have any symptoms, most experts believe that tests or treatment are not needed.

Institutions and retailers:

  • Inspect freezers and inventory for Blue Bell products
  • Do not serve or sell any Blue Bell products for the duration of the recall

Contact Information

Communicable Disease Fax Line
(804) 862-6294

Emergency After-Hours Call Number

District Epidemiologist
Louise Lockett, MPH
(804) 862-8986
Tuberculosis Nurse
Angelia Brennan, RN
(804) 862-8901
Communicable Disease Nurse
Catherine Bailey, RN
(804) 862-7617
STI Intervention Specialist
Tia Sanchez
(804) 862-8923
CD/TB Outreach
Charmin Davis
(804) 862-8902
STI Intervention Specialist
Sterling Stewart
(804) 862-8927

Resources for Health Care Professionals

Communicable Disease Quarterly Report

Request for Epi-1 Forms

Request for Data

Online Resources

Office of Epidemiology
Home page for VDH’s Office of Epidemiology.  It will connect you with the Divisions of Surveillance and Investigation, Disease Prevention, Environmental Epidemiology, Immunization and Radiological Health.

Disease Regulation Information
Contains the complete regulations for disease reporting and control for Virginia.  You will also find the reportable disease list, conditions reportable by laboratories, outbreak reporting requirements and the reporting form (Epi-1). 

Disease Fact Sheets
Contains all of VDH's disease fact sheets. From head lice to whooping cough to West Nile Virus, this is the first stop for quick, reliable disease information. Fact sheets are also available here in Spanish.

Communicable Disease Chart for Schools
Direct link to the PDF.  Make sure to review the footnotes at the bottom of this document.  Last revised November 1st, 2011.  More information can be found in the VDOE School Health Guidelines (located at the bottom of the page).

Nursing Facility Regulations
Contains a line list of guidelines from VDH’s Office of Licensure and Certification.  The Rules and Regulations for the Licensure of Nursing Facilities in Virginia can be found here.

VDSS Assisted Living Facility Regulations
Contains information on regulations, Code of Virginia, application process, guidelines, forms, training and more.

Successful Strategies for Infection Prevention & ControlThis toolkit contains infection prevention presentations, resources, and tools that have been adapted for the assisted living facility (ALF) and nursing home (NH) setting whenever possible. Much of the tools like infection prevention guidance, fact sheets and surveillance logs, however, are generally applicable to other settings.

EPA Registered Disinfectants
Contains listings of EPA registered antimicrobial products that are effective against HIV, Hepatitis B and C, Norovirus, MRSA and more.

FDA Bad Bug Book
Provides basic facts regarding foodborne pathogens and natural toxins

CDC Health Alert Network
Provides recent and archived health alerts, advisories, updates and informational messages regarding vital health information.

Ebola Outbreak in West Africa

Current Situation
The countries of Guinea, Sierra Leone, and Liberia continue to experience an outbreak of Ebola. For the most up-to-date information, including case counts, visit the CDC Ebola Outbreak webpage.

Public health efforts to control disease transmission include:

  • Airport exit screening of travelers leaving countries experiencing widespread Ebola transmission. Travelers determined to have symptoms are detained for further evaluation.
  • Airport entrance screening of travelers from Ebola-affected countries entering the United States. Travelers are evaluated for symptoms and risk of Ebola exposure.
  • Post-arrival 21 day monitoring of all travelers from Ebola-affected countries entering the United States. Travelers from Guinea, Sierra Leone, Liberia, and Mali are monitored for 21 days by public health authorities.

What is Ebola?
Ebola hemorrhagic fever is one of several Viral Hemorrhagic Fevers. It a rare and deadly disease caused by one of the Ebola virus strains. People who become infected typically develop fever, headache, weakness, joint and muscle aches, diarrhea, vomiting, stomach pain, and loss of appetite. Some people may also begin to hemorrhage (bleed) inside and outside of the body. It is spread by direct contact (through broken skin or mucous membranes) with an infected person’s blood or body fluids, such as urine, saliva, feces, vomit, and semen. It is also spread through contact with objects (like needles) that have been contaminated with infected secretions. For more information, see the CDC Ebola fact sheet.

Risk in the U.S.
Transmission of the virus requires direct contact with an infected person’s blood or body fluids or contact with objects contaminated with infected secretions. Therefore, there is no significant risk for widespread transmission in the U.S.

Healthcare providers in the U.S.
CDC encourages all U.S. healthcare providers to

  • Take good travel histories of their patients to determine if they have traveled to Guinea, Sierra Leone, Liberia or Mali within the last 3 weeks.
  • Know the symptoms of Ebola—fever, headache, joint and muscle aches, weakness, diarrhea, vomiting, stomach pain and lack of appetite, and in some cases bleeding.
  • For symptomatic patients with recent travel to Guinea, Sierra Leone, Liberia or Mali or contact with a known case, isolate the patient properly, then follow infection control precautions to prevent spread.
  • Contact your local health department to discuss any suspected case and testing.

For complete Ebola Information for Healthcare Providers and Facilities, click here.

Information Resources
For more information about Ebola and what the Virginia Department of Health is doing, visit the VDH Ebola website or call 211.


Last Updated: 04-23-2015

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