186393 Regional collaboration on a Shigellosis issue

Sunday, October 26, 2008

Brenda J. Thorne, MS, DTM , Bureau of Epidemiology, Houston Department of Health and Human Services, Houston, TX
Monica Slentz, PG, BS , Community Health Statistics, Houston Department of Health and Human Services, Houston, TX
Diana Martinez, MPH , Disease Control and Medical Epidemiology, Harris County Public Health and Environmental Service, Houston, TX
Cindy Kilborn, MPH, M(ASCP) , Disease Control and Medical Epidemiology, Harris County Public Health & Environmental Services, Houston, TX
Huai Lin, MD, PHD , Epidemiology Program, Texas Department of State Health Services Health Service Region 6/5S, Houston, TX
Kirstin Short, MPH , Bureau of Epidemiology, Houston Department of Health and Human Services, Houston, TX
Adebowale Awosika-Olumo, MD, MS, MPH , Bureau of Epidemiology, City of Houston, Department of Health and Human Services, Houston, TX
Christa Partridge , Brazoria County Health Department, Angleton, TX
Dana Beckham, DVM , Epidemiology Services, Galveston County Health District, LaMarque, TX
Sandra Cuellar, BA , Epidemiology Services, Galveston County Health District, LaMarque, TX
Randy Valcin , Epidemiology Services, Texas Department of State Health Services Health Service Region 6/5S, Houston, TX
Jan Prejean, RN , Bioterrorism Response Team, Brazoria County Health Department, Angleton, TX
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.

Learning Objectives:
1. Recognize the importance of cooperation and communication across contiguous jurisdictions to address an issue of public health concern. 2. Enhance sharing of GIS resources to resolve a public health concern.

Keywords: Collaboration, Geographic Information Systems

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been an infectious disease epidemiologist for 16 years and have collaborated with epidemiologists of contiguous health departments for the same length of time. In this particular issue, I suggested the use of GIS to see the distribution of cases visually.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.