238106 Maximizing health department resources to identify and prevent outbreaks of healthcare associated transmission of viral hepatitis

Wednesday, November 2, 2011: 10:50 AM

Patricia High, MHS, CHES , Communicable Disease Division, Ocean County Health Department, Toms River, NJ
Kimberly Cervantes, MA, MPH, CIC , Community Health Planning Division, Cape May County Department of Health, Cape May Court House, NJ
BACKGROUND: Transmission of viral hepatitis from healthcare associated exposures is of increasing concern in light of recently recognized outbreaks of hepatitis B and C. Prompt identification and investigation of suspected healthcare associated cases is needed to ascertain the source of illness and to implement appropriate control measures. However, local health department resources are limited and the burden of hepatitis makes prioritization and investigation of cases difficult.

METHODS: A cross-sectional survey was conducted to assess hepatitis investigation practices in New Jersey. Respondents were asked about the investigation of routine hepatitis B and C reports as well as cases with healthcare associated exposures.

RESULTS: The survey results showed that current investigation guidelines were not effective in identifying acute cases or those with healthcare associated exposures. Additionally, staffing resources were not optimized and considerable time was spent on tasks having minimal public health impact. By targeting investigations to identify cases that have the potential for an effective public health response, local resources can be maximized and disease burden reduced.

In response to the survey results, training needs were identified, local investigation guidelines were developed, and triggers for investigation of suspect acute or healthcare associated cases were delineated.

Three training needs identified: 1. Laboratory test interpretation and case classification 2. Infection control for ambulatory care and other healthcare settings 3. Standardized hepatitis investigation guidelines and forms

CONCLUSION: These training needs were incorporated into the local investigation guidelines. By prioritizing viral hepatitis investigation, local investigation resources are optimized to provide maximum public health impact.

Learning Areas:
Basic medical science applied in public health
Conduct evaluation related to programs, research, and other areas of practice
Program planning
Protection of the public in relation to communicable diseases including prevention or control
Public health or related nursing

Learning Objectives:
Describe an investigation protocol for viral hepatitis that maximizes both local health department resources and public health impact. Name investigation triggers for viral hepatitis that prioritize acute cases and those with healthcare associated exposures.

Keywords: Communicable Disease, Epidemiology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I oversee epidemiological investigations and assess disease prevention and investigation activities.
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.