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Shelter surveillance and local public healthBackground: One of the core responsibilities of the Epidemiology Program at the Georgia Department of Public Health is to detect and respond to population health events through traditional and novel surveillance. One type of event that we have planned for over the years has been conducting disease surveillance during a mass sheltering event. Methods: Mid-day on October 5, 2016, the North Central Health District (NCHD) Emergency Preparedness Program notified the District Health Emergency Alert and Response Team that we would be receiving evacuees from the coast of Georgia and Florida due to Hurricane Matthew and that our District Operations Center (DOC) would be staffed 24/7 for the remainder of the event. The District Epidemiology Program’s responsibility during this event was shelter surveillance and although planning had been done for this type of surveillance it was unclear as to what exactly that would look like during a real event. Results: The NCHD had 6 American Red Cross (ARC), and a few Good Samaritan shelters open during the Hurricane Matthew evacuation and shelter event. The ARC shelters housed >550 evacuees and all hotels were occupied. The district had ~130 district and county staff (~40% of total district/county staff) work the event and had assistance from the state and other districts. The DOC was staffed 24 hours per day continuously from October 5-11.However, pre- and post-planning occurred before and after those dates. Conclusions: This presentation will provide an overview of the importance of shelter surveillance during a mass sheltering event, review the NCHD DOC Shelter Surveillance Protocols developed by the NCHD District Epidemiologist, and examine the lessons learned from this event from a local epidemiology perspective.
Triple-negative breast cancer in Georgia: Burden, disparities, and connections to Georgia’s Breast Cancer Genomics ProjectBackground: Triple negative breast cancer (TNBC) is typically aggressive and unresponsive to traditional cancer treatment, and disproportionately affects young and Black women. Approximately 60%-80% of breast cancers in women with the breast cancer gene (BRCA) mutation are TNBC, and children of a parent with a BRCA mutation have a 50% chance of inheriting it. Current guidelines recommend women diagnosed with TNBC receive genetic testing and counseling. Georgia’s Breast and Cervical Cancer Program (BCCP) routinely screens clients for increased risk of genetic mutation via an online screening tool. Methods: Using data from the Georgia Comprehensive Cancer Registry (GCCR) for 2010-2013, we calculated TNBC percentages/rates, diagnosis stage, and case fatality rate based on vital status. By using TNBC data as a proxy for BRCA gene mutation prevalence, we assessed the burden of TNBC and racial/age disparities to inform Georgia’s genomics efforts. Results: The percentage of invasive breast cancers, versus in-situ, was the same for Georgia Black and White women; however, Black women had almost double the percentage of TNBC as compared to White women. Black women under 40 had a 20% higher breast cancer incidence rate than similarly aged White women, but had almost double the TNBC rate. Georgia TNBC cases were about twice as likely as non-TNBC cases to be deceased, and Black TNBC cases had higher fatality rates than White cases (almost twice as high in women under 40). Conclusions: Georgia’s genomics program began screening in 2012, and participating counties offer screening to all women’s health clients. Awareness of hormone receptor status (and furthermore, possible presence of genetic mutation) for women diagnosed with breast cancer can guide the proper course of treatment. Additionally, family members of women diagnosed with TNBC in Georgia may take advantage of the screening for risk of genetic mutation through the genomics program prior to a cancer diagnosis, and receive counseling where appropriate.