Regional collaboration on a Shigellosis issue

Introduction: In December 2007, Harris County Public Health and Environmental Service (HCPHES) approached other local health departments in the area to discuss an increase in the number of Shigellosis cases and determine if this increase was being observed by other epidemiologists.

Methods: Texas Department of State Health Services (DSHS) Health Services Region (HSR) 6/5S coordinated a teleconference among local health departments in Harris and contiguous counties. In this teleconference Shigellosis data for each jurisdiction was discussed. It was decided the level of disease activity warranted further evaluation. Houston Department of Health and Human Services (HDHHS) utilized geographic information system (GIS) software to create time-series maps showing counts of cases by zip code for each month (September 1 through December 17, 2007). They were distributed to regional partners prior to a second teleconference to discuss the spatial case distribution.

A third discussion was planned for the January 25, 2008 Regional Bioterrorism and Epidemiology Meeting. Map animations depicting the weekly progression of cases across the region from September 2007 through January 17, 2008 were presented to regional partners, who discussed their interpretation.

Results: A regional increase in Shigellosis cases for all local health department jurisdictions in HSR 6/5S for 2007 was recognized. GIS map products identified areas across the region with the highest incidence of cases.

Conclusion: Communicable disease knows no boundaries. Communication among local health departments in a region and sharing of resources enhanced understanding of the scope of the Shigellosis situation in HSR 6/5S.