• Characteristics of reported symptoms among confirmed and suspect cases of Zika virus in Georgia, 2016

      Thompson, Ashton; Georgia Department of Public Health (Georgia Public Health Association, 2017)
      Background: In May 2015, Zika virus was detected in Brazil. The virus has since spread through several countries in the Americas. Knowledge of the major symptoms of Zika virus infection was based on historic data from two previous outbreaks in the Pacific Islands. Currently-known Zika-specific symptoms include rash, conjunctivitis, arthralgia, and fever. Epidemiologists at the Georgia Department of Public Health (GDPH) began surveillance for travel-related Zika virus infections in January 2016. Surveillance data from GDPH contributes to better characterization of the current Zika clinical picture and more efficient triage of suspect cases for laboratory testing and prevention measures. Methods: For each patient approved for Zika testing, GDPH epidemiologists created an entry in the Zika Active Monitoring System (ZAMS) within the State Electronic Notifiable Disease Surveillance System (SendSS). Patients are categorized as “asymptomatic” or “symptomatic” and reported symptoms are noted. For symptomatic patients, clinical data are compared to determine differences in the distribution of symptoms in Zika negative and positive patients. Results: GDPH has approved testing for 383 symptomatic suspect Zika patients as of October 19, 2016; 88 (23%) were confirmed Zika infections. Among symptomatic positive patients, the most common Zika-specific symptom was maculopapular rash (95%); other common symptoms were headache and myalgia (27%). Among symptomatic Zika-negative patients, the most common Zika specific symptom was fever (62%), and the most common non-Zika specific symptom was headache (19%). Conclusions: Maculopapular rash is the most suggestive symptom of a true Zika virus infection, with 95% of symptomatic Zika positive patients in Georgia exhibiting the symptom. These data can be taken into consideration when updating the testing criteria for Zika virus. GDPH currently does not approve a patient for testing based on fever or non-Zika specific symptoms alone, and that guideline is reaffirmed by these results.
    • Financing public health in Georgia

      Denson, Dionne; Georgia Department of Public Health (Georgia Public Health Association, 2017)
      Background: The public health system in Georgia is carried out through a hybrid governance structure. The Department of Public Health and the county boards of health have responsibility for serving the public health needs for the Georgia citizens. Funding for the Georgia public health system is derived from a number of funding sources which include federal, state, local, and private funds. Methods: Georgia's public health system relies on multiple funding streams to provide services. These public health services have the potential to provide a return on investment and positive impact on the local economy. In the hybrid governance structure, local board of health members have an important role in financing of the Georgia public health system. Results: The funding relationship between state and local boards of health is essential to support the public health system in Georgia. To maintain the public health system, funding should be integrated where possible and used to enhance or expand services. The relationship with community leaders, key stakeholders, and other organizations are important to maintaining the public health system. Conclusions: Board of Health Members understanding the Georgia public health funding structure, and the importance of the role of the local county boards of health is key to sustainability.
    • Shelter surveillance and local public health

      Erickson, Amber; Georgia Department of Public Health (Georgia Public Health Association, 2017)
      Background: 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.
    • Tailoring a hybrid program for reducing health and education disparities in Georgia communities: Outcomes of listening sessions

      Ejikeme, Chinwe; Georgia Department of Public Health (Georgia Public Health Association, 2017)
      Background: Minorities in Georgia experience increased rates of chronic disease and poor health and education outcomes. In the general population in 2013, about 35% of adolescents were either overweight or obese and approximately 13% of children 2-4 years old were obese, with minorities accounting for higher rates. In 2010, 23% of students from low-income families, comprising a higher proportion of minorities, scored at or above proficient level for reading at the end of third grade. Targeting children 0-5 years, Georgia Department of Public Health developed an integrated curriculum to train Early Childcare Educators (ECEs) to increase their knowledge and skills to model food, activity and language nutrition in their classrooms and to coach families. We conducted listening sessions to understand attitudes and knowledge around nutrition in 3 communities with significant racial and ethnic populations. Methods: Listening sessions with ECEs and families were conducted separately in each community. Participants engaged in guided one-hour discussions around food, activity and language nutrition and completed a post-listening session survey to assess their nutrition practices with the children in their care or homes. Results: 70 ECEs and families participated in the sessions and post session surveys. With an over 80% satisfaction rate with sessions, results showed that although baseline understanding of and challenges to modelling nutrition differed in different communities, many strategies used to support nutrition were common across communities. Participants also demonstrated a need for support in increasing access to resources to improve nutrition. Conclusions: This study suggested that multiple issues hinder optimal engagement of children 0-5 years in improved nutrition. Addressing the factors specific to targeted communities is essential to reducing disparities. Thus, integrating these findings in the development of the curriculum and training strategy has the potential to produce more knowledgeable and skilled ECEs as coaches for improving nutrition.