Health

Infectious Disease Epidemiology, Prevention and Control

Statewide Outcome(s):

The Infectious Disease Epidemiology, Prevention and Control Division supports the following statewide outcome(s).

Minnesotans are healthy.

People in Minnesota are safe.

Context:

The Infectious Disease Epidemiology, Prevention and Control Division (IDEPC) assures the health and safety of Minnesotans by maintaining strong public health systems and capabilities to protect the public from infectious diseases and to save lives during infectious disease outbreaks and other unusual public health events.

Today’s infectious disease challenges are broader and more complex than ever. The diversity of organisms and their ability to evolve and adapt to changing populations, environments, practices, and technologies creates ongoing threats to health as well as challenges to disease prevention and control activities.

·         Food safety, respiratory infections, vaccine-preventable diseases, zoonotic and vector borne diseases, HIV/AIDS, sexually transmitted disease, chronic viral hepatitis, healthcare associated infections and antimicrobial resistance continue to be infectious disease issues of special concern.

·         Infectious diseases such as SARS and H1N1 underscore the importance of developing a “One Health” approach which advocates for a better understanding of the linkages between human, animal, and environmental factors on infectious disease.

·         Changes in the way we live, eat, travel, etc. all contribute to infectious disease illness and death.

o    The aging population is more susceptible to infectious disease, and youth, females, African-Americans and Hispanics are disproportionately impacted by Chlamydia, which is reaching epidemic levels in Minnesota.

o     International travel has created the potential for rapid transmission of infectious diseases like pandemic influenza;

o    Immigration of world populations increases the potential for introduction of diseases such as measles or tuberculosis;

o    Changes in climate can cause infectious diseases to emerge in new areas; and human encroachment on wilderness areas increases the contact with zoonotic and vectorborne diseases such as Lyme disease and West Nile virus.

o    Also, international political and social unrest has created the urgent need to be prepared to detect and respond to potentially devastating biological terrorism.

All Minnesota residents are served by the work of IDEPC. Specific populations who are served include infants and children, adolescents, high-risk adults, older adults, those with chronic disease, refugees, immigrants and other foreign-born individuals, patients in hospitals and long-term care facilities, and health care workers.

Minnesota's infectious disease control system is funded almost entirely by federal grants, with only 15 percent of funding coming from state taxes and fees.

Strategies:

IDEPC protects the health and safety of Minnesotans and addresses the many challenges of disease control and prevention through a broad array of strategies:

·         Assures early and rapid detection, investigation, and mitigation of infectious disease health threats by maintaining a 24/7 response capability to identify and respond to infectious disease threats;

·         Conducts real-time statewide monitoring for infectious disease health threats;

·         Detects and investigates infectious disease outbreaks, identifies newly emerging health threats, such as Powassan virus, as well as rare and highly dangerous health threats, such as Naegleria fowleri, the organism that causes primary amebic meningocencephalitis (PAM);

·         Continuously looks for emerging infectious disease trends and recommends evidence-based policy for infectious disease prevention measures;

·         Recommends evidence-based and cost-effective policies to reduce infectious diseases, and collaborates with public and private partners to improve prevention, detection, and control of infectious diseases;

·         Promotes vaccine to prevent disease, and provides vaccines for children whose families can’t afford them; and

Collaborates with a variety of federal, state, and local partners to prevent and control infectious disease.

Significant IDEPC activities that serve to carry out these strategies include:

·         Maintain the 24/7 Epidemiology On-call Disease Reporting Line to assure early detection and response to disease outbreaks and public health threats;

·         Maintain the Foodborne Illness Hotline (1-877-FOOD-ILL) to receive reports of foodborne illness;

·         Analyze disease reports to detect outbreaks, identify the source, and implement control measures;

·         Alert health care providers, local public health, and the public about outbreaks and preventive measures;

·         Continuously monitor for unusual patterns of infectious disease;

·         Prevent the spread of infectious disease by providing HIV prevention grants to community groups for screening and testing, by promoting and distributing vaccines for children and adults, by providing medications for tuberculosis (TB) patients, and by coordinating refugee health screenings to identify and treat health problems;

·         Notify federal and state officials, hospitals and clinics, and the general public about products that present a public health threat and should be removed from the market;

·         Help medical professionals managing persons ill with, or exposed to, infectious disease; and

·         Locate epidemiologists in eight regions in outstate Minnesota to provide technical assistance to local public health and health care providers on infectious disease issues.

Key Partners

IDEPC collaborates with a variety of partners including: local, state, and federal public health officials including local public health agencies and the Centers for Disease Prevention & Control; local, state public safety officials including emergency preparedness personnel, Homeland Security Emergency Management, and the Federal Bureau of Investigation; local veterinarians and the Board of Animal Health; and other state agencies including Agriculture, Human Services, and the Minnesota Pollution Control Agency; community organizations; and infection control specialists, public and private health care facilities, and laboratories.

Results:

Although tuberculosis (TB) cases reported in Minnesota declined from 238 in 2007 to 137 in 2011, TB remains a significant health problem in MN. The total number of cases can fluctuate from year to year, depending on a number of factors outside the control of MDH. Making sure patients complete their therapy prevents the spread of TB and reduces the development of resistant strains of the disease. State funding provides access to medication and reduces barriers to the completion of therapy.

Minnesota is well-known nationally for its ability to identify and trace the source of foodborne disease outbreaks. In 2008 it correctly identified jalapeno peppers as the source for an outbreak that sickened more than a thousand people in 43 states. In 2009, it identified a certain brand of peanut butter as the source for a major national outbreak of salmonella. Identifying and tracking the source of foodborne disease outbreaks helps to identify steps needed to prevent the spread of disease, including food recalls, or changes to food handling practices.

Screening of newly arrived refugees is an effective public health tool used to identify and treat health problems and prevent the spread of infectious disease.

The Minnesota Immunization Practices Advisory Committee has identified adolescent vaccination as a priority. Rates of vaccination are impacted by a variety of partners and factors.

Performance Measures Notes:

1.     MDH TB Program Data. Data is from 2008 and 2010

2.     MDH Foodborne Outbreak Data. Data is from 2005 and 2011

3.     MDH Refugee Health Program Data. Data is from 2010 and 2011

4.     National Immunization Survey-Teen, 2010. Data is from 2008 and 2010