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Ga Arboviral Surveillance

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Ga Arboviral Surveillance

  1. 1. GEORGIA UPDATE 2009 Rosmarie Kelly Public Health Entomologist Georgia Division of Public Health
  2. 2. 2009 <ul><li>drought </li></ul><ul><li>SNOW </li></ul><ul><li>warm </li></ul><ul><li>flood </li></ul><ul><li>COLD warm </li></ul><ul><li>more weird weather </li></ul><ul><li>SWINE FLU </li></ul><ul><li>flood </li></ul><ul><li>BRRRRR!!! </li></ul>veterinary cases mosquito surveillance (25 counties) virus # cases EEE 46 WNV 3 County # cases VIRUS Cherokee 1 LAC White 1 LAC HUMAN CASES  Bibb 1 WNV Clinch PVBD WNV Muscogee 2 WNV Tift 1 WNV Ware PVBD WNV County # pools submitted # WNV+ pools % WNV+ DeKalb 536 5 0.93% Fulton 326 8 2.45% Lowndes 1235 8 0.65% Muscogee 36 3 8.33%
  3. 3. Human Arboviral Disease Surveillance in Georgia Meghan Weems
  4. 4. Most Common Arboviral Diseases in Georgia <ul><li>West Nile Virus </li></ul><ul><li>Lacrosse Encephalitis </li></ul><ul><li>Eastern Equine Encephalitis </li></ul><ul><li>Internationally acquired Dengue </li></ul>
  5. 5. Reporting Sources <ul><li>Georgia Public Health Laboratory </li></ul><ul><li>Commercial Labs </li></ul><ul><li>Local hospitals </li></ul><ul><li>Blood organizations such as American Red Cross </li></ul>
  6. 6. How to report <ul><li>Via reportable disease card sent in mail </li></ul><ul><li>Via SENDSS, Georgia’s internet based reportable disease surveillance system </li></ul><ul><li>Via fax </li></ul><ul><li>Via phone call with district or state epidemiologists </li></ul>
  7. 7. Where cases are reported <ul><li>Cases are reported in SENDSS </li></ul><ul><li>Cases are then entered into our Arboviral database, which is used to populate maps on Oasis. </li></ul><ul><li>Cases are also entered into CDC’s Arbonet, which populates USGS’s national case maps </li></ul>
  8. 8. What information is collected? <ul><li>Basic case demographics </li></ul><ul><li>Hospitalization status </li></ul><ul><li>Admitting diagnosis </li></ul><ul><li>Testing history and results </li></ul><ul><li>Blood donation/organ donation history </li></ul><ul><li>Underlying medical conditions and medication use history </li></ul>Data are used to educate physicians about arboviral diseases. clinical # cases % uncomplicated fever   0% encephalitis/meningitis 4 67% other   0% asymptomatic 2 33%   Gender # cases % male 4 67% female 2 33% unknown   0%
  9. 9. Presumptive Viremic Blood Donor <ul><li>Receive presumptive viremic blood donor reports from blood banks </li></ul><ul><li>Data are collected from donor screening tests performed by nucleic acid amplification testing (NAT) </li></ul><ul><li>A PVD is a person associated with a blood donation that meets at least one of the following criteria: </li></ul><ul><ul><li>One reactive NAT with a signal-to-cutoff ≥17 </li></ul></ul><ul><ul><li>Two reactive NATs </li></ul></ul>
  10. 10. Veterinary Cases Georgia Department of Agriculture Dr Rhonda Veit
  11. 11. Georgia Dept of Agriculture <ul><li>The Animal Health office governs the prevention, control and eradication of certain infectious and communicable diseases of livestock and  other domestic animals. </li></ul><ul><li>Reportable Arboviral Diseases </li></ul><ul><ul><li>EEE </li></ul></ul><ul><ul><li>WNV </li></ul></ul>
  12. 12. Who Reports <ul><li>Veterinarians, veterinary technicians, lab technicians, wildlife biologists, and animal owners are required to report. </li></ul><ul><li>Depending upon the disease or syndrome, reporting is required whether a clinical diagnosis, laboratory diagnosis, or just a reasonable suspicion of a disease is present. </li></ul>
  13. 13.
  14. 14. What is Done with the Data <ul><li>Veterinarians at GDA follow-up with owner of the animal to provide vaccine information </li></ul><ul><li>Data are shared with GDPH </li></ul><ul><li>Info is reported out to the Health District </li></ul><ul><li>Local Environmental Health Specialists provide education on risk reduction and mosquito control </li></ul><ul><li>Cases are then entered into our Arboviral database, which is used to populate maps on Oasis. </li></ul><ul><li>Cases are also entered into CDC’s Arbonet, which populates USGS’s national case maps </li></ul>
  15. 15. Detection of veterinary cases indicates that the risk of human disease is increasing.
  16. 16. Dead Bird Surveillance GDPH and UGA/SCWDS
  17. 17. Collecting the Data <ul><li>Dead bird surveillance has been a sensitive indicator of local epizootic transmission of WNV in Georgia and in other states and can play a role in predicting human risk of infection. </li></ul><ul><li>This surveillance involves (a) collecting and mapping reports of dead bird sightings from the public and (b) testing some dead birds for arboviruses, especially early in the season, late in the season, and where there are clusters of dead birds. </li></ul><ul><li>Environmental Health Specialists collect dead birds from members of the public. </li></ul><ul><li>Testing of dead birds for arboviruses is still offered free-of-charge at the Southeastern Cooperative Wildlife Disease Study (SCWDS) at the University of Georgia. </li></ul>
  18. 18. Where Are The Birds?
  19. 19. Mosquito Surveillance GDPH and UGA/SCWDS
  20. 20. Collecting the Data <ul><li>Mosquito surveillance is done by: </li></ul><ul><ul><ul><li>local mosquito control </li></ul></ul></ul><ul><ul><ul><li>local environmental health </li></ul></ul></ul><ul><ul><ul><li>University program </li></ul></ul></ul><ul><ul><ul><li>Public Works </li></ul></ul></ul><ul><ul><ul><li>State entomologist </li></ul></ul></ul>
  21. 21. <ul><li>Mosquito surveillance is an important part of mosquito control </li></ul><ul><li>Arboviral encephalitis can be prevented in two major ways: </li></ul><ul><ul><li>1. Personal protective measures to reduce contact with mosquitoes </li></ul></ul><ul><ul><li>2. Public health measures to reduce the population of infected mosquitoes in the environment </li></ul></ul>Mosquito Surveillance
  22. 22. USING THE DATA <ul><li>Education </li></ul><ul><li>Mosquito Control </li></ul><ul><li>Data sharing </li></ul><ul><ul><li>other agencies </li></ul></ul><ul><ul><li>stakeholders </li></ul></ul><ul><li>Media </li></ul><ul><li>Training Programs </li></ul><ul><li>Evaluation </li></ul>
  23. 23. Goal <ul><li>reducing the risk of arboviral disease transmission </li></ul><ul><li>monitor for new and emerging arboviral diseases </li></ul>
  24. 24. The Cost of WNV <ul><li>In 2005, an outbreak of West Nile virus (WNV) disease occurred in Sacramento County, California; 163 human cases were reported. </li></ul><ul><li>In response to WNV surveillance indicating increased WNV activity, the Sacramento-Yolo Mosquito and Vector Control District conducted an emergency aerial spray. </li></ul><ul><li>WNV disease in Sacramento County cost ≈$2.28 million for medical treatment and patients’ productivity loss for both West Nile fever and West Nile neuroinvasive disease. </li></ul><ul><li>Vector control cost ≈$701,790, including spray procedures and overtime hours. </li></ul><ul><li>The total economic impact of WNV was $2.98 million. </li></ul>
  25. 25. A cost-benefit analysis indicated that only 15 cases of West Nile neuroinvasive disease would need to be prevented to make the emergency spray cost-effective.
  26. 26. Emergency Mosquito Control
  27. 27. Surveillance trailer
  28. 28. Protocols <ul><li>Emergency Surveillance </li></ul><ul><ul><li>To determine the scope of the public health-related mosquito problem, both vector species and nuisance problem </li></ul></ul><ul><ul><li>Need to collect mosquito population data to send to GEMA, FEMA, CDC, budget office, GDPH, etc… </li></ul></ul><ul><li>Training </li></ul><ul><ul><li>Must be public health related </li></ul></ul><ul><ul><li>Requesting Agency to provide a prime mover and a driver </li></ul></ul><ul><ul><li>Request comes to GDPH entomologist, not GEMA </li></ul></ul>
  29. 29. RESPONSE: Surveillance and Control
  30. 30. ANY QUESTIONS ? Thanks to everyone involved in arboviral surveillance in Georgia.