1. Communicable Diseases: the Reporting Law & Incidence in Southeastern Kentucky Nurse Practitioner Meeting Jenny Wiley State Park August 6, 2005 Lyle B. Snider, Ph.D. Big Sandy Regional Public Health Epidemiologist

2. Learning Objectives 1. Describe the Kentucky Department of Public Health’s (KDPH) Reportable Disease Desk Reference and Internet Communicable Disease Resources 2. Outline the KY Regulations That Mandate Reporting of Communicable Diseases by Primary Care & Other Health Care Providers 3. Compare the Incidence of Communicable Diseases in KY with specific KY counties and regions 4. Describe the Distribution of Reportable Disease Diagnoses in KY 5. Describe the Frequency of Reporting by Type of Health Care Agency Submitting the Report 6. Outline the Major Components of the KDPH’s Electronic Public Health Record System 7. Discuss Mechanisms for Improving Communicable Disease Reporting in Southeastern KY

3. The Reportable Disease Desk Reference List of Reportable Diseases on the Back Cover – When & Where to Report KY Dept. of Public Health Contacts, pp. 4-5 Local Health Dept. Contacts, pp. 6-20 Regional Epidemiologists, pp. 21-22 Epid 200 Form, p. 43 Basic Report Form for All Reportable Diseases Some Diseases Have Supplemental Forms

4. Desk Reference Continued Disease-specific Information, pp. 53-276 Identification: Clinical Description, Reporting Criteria & Case Definition Actions Required/Prevention Measures Health Care Providers Reporting Requirements – The Law List of Report Forms to be Completed Prevention Measures Public Health Interventions Contacts for Consultation Related References

5. The Law That Mandates Reporting of Communicable Diseases, pp. 277-86 Health Care Providers Notify the Public Health Department Serving Jurisdiction Where Patient Resides or the KY Dept. of Public Health Specifies Actions of State and Local Health Departments Lab Reporting of Influenza Isolate Results No Sanctions of Health Care Providers That Fail to Report

6. Internet Communicable Disease Resources KY Dept. of Public Health Find It Fast Index http://chfs.ky.gov/dph/topics/ & CDC A-Z Index http://www.cdc.gov/az.do http://chfs.ky.gov/dph/topics/http://www.cdc.gov/az.do STD’s http://chfs.ky.gov/dph/diseases/std.htm http://www.cdc.gov/node.do/id/0900f3ec8000 9a98http://chfs.ky.gov/dph/diseases/std.htm http://www.cdc.gov/node.do/id/0900f3ec8000 9a98 TB http://chfs.ky.gov/dph/epi/tb.htmhttp://chfs.ky.gov/dph/epi/tb.htm

7. Analysis Focuses on “Your” Counties - Hopefully 51 Appalachian Counties 31 Counties in the following 5 Area Development Districts: Big Sandy Cumberland Valley FIVCO Gateway KY River

8. Fivco Gateway Big Sandy Cumberland Valley KY River

9. Appalachian KY Is Cancer an Infectious Disease? http://www.kcr.uky.edu/

10. The 2004 Incidence of Communicable Diseases in KY Incidence refers to newly diagnosed or acute disease, not chronic disease (such as hepatitis C that was diagnosed in a previous year) 1,320 confirmed cases reported for all diagnoses Does NOT include animal rabies, TB, influenza isolates, STDs or Unconfirmed Reports Jefferson Co had the most – 203 cases, followed by Kenton Co – 91, Fayette Co – 77 Five counties had no cases (including Carter, Elliott, & Johnson in our region), and half of the 120 counties had five or fewer cases

11. 2004 Communicable Disease Case Report Frequencies & Rates – All Diagnoses Higher Than KY Average Frequencies Too Small for Reliable Rates

12. 2004 Communicable Disease Case Report Frequencies & Rates – All Diagnoses, By Region Frequencies Big Enough for More Reliable Rates

13. The 2004 KY 10 Most Common Reported Communicable Disease Diagnoses Total of 34 Diagnoses

14. Is Salmonella Concentrated in Certain Counties? Rates are Not Reliable if County Frequencies Less Than ~20

15. What About Pertussis? Pertussis is Concentrated in Jefferson & Oldham Counties