Outbreak Response TISWG, 2010 Rachel Wiseman, MPH DSHS Infectious Disease Control Unit

Mumps Outbreak, 2010 July 16: –2 mumps cases identified in county jail Since then: –10 additional cases in the county jail –1 possible community case identified –4 cases identified in a TDCJ facility –Several other community and correctional based suspects have been ruled out

Public Health Response Interview Lab confirmation Identify who was exposed –Locate exposed contacts –Quarantine exposed contacts (inmates) –Vaccinate contacts of exposed contacts –Education of cases and contacts Continue to look for mumps in correctional facilities

Parties Involved Central Office –Immunizations Branch –Laboratory Services –Infectious Disease Control Unit Five Health Service Regions Two Local Health Departments TDCJ (and UTMB) Two County Jails Four Hospitals CDC

Resources Used Staff, staff, staff! Over 1,600 MMR doses –Multiple vaccine clinics Blast fax to local physicians and ERs Media CDC Consultation Laboratory services –Private, state and federal

Pertussis California pertussis –1,964 cases reported to CDC (8/7/10) –Spread throughout the state –Seven infant deaths reported Texas pertussis –1,519 cases reported to CDC (8/7/10) –Regionally focused distribution –No deaths reported

Distribution of Texas Pertussis Primarily in Central Texas in 2009 and 2010 Multiple outbreaks identified in 2009 in two counties in Central Texas Surveillance and laboratory practices specific to Central Texas led to over-identification of potential cases –Pertussis case definition not specific enough to rule out all symptomatic people Case numbers continue to be elevated, possibly artificially Surveillance/lab practices have been addressed to be uniform across the state and for all diseases

Pertussis Campaigns 2002 Controlling Pertussis in Texas--Provider Workshop –The Immunization Branch held a pertussis symposium for providers 2002/2003 Pertussis Campaign –A parent and general audience awareness and education campaign 2006 Pertussis Public Awareness Campaign –The incidence of pertussis continued, and in 2005 there were 9 deaths, a new campaign was launched to address the issue

Pertussis Campaigns, cont’d 2007 Pertussis Campaign –DSHS Immunization Branch conducted a campaign to raise public awareness of pertussis th DTaP Healthcare Provider Campaign –Campaign for healthcare providers on the importance of not missing opportunities to provide the fourth dose of DTaP 2008 DTaP Study –Survey of children in ImmTrac who did not have the fourth DTaP to identify barriers to on-time DTaP

Pertussis Campaigns, cont’d 2010 Cocooning Initiative –The Immunization Branch has contracted with the Texas Medical Association (TMA), Texas Pediatric Society (TPS), Texas Academy of Family Physicians (TAFP), and Texas Association of Obstetricians & Gynecologists (TAOG) to promote the Cocooning strategy in all health care settings TVFC Educational Message, Ongoing –Educational message on the importance of the fourth DTaP for Texas Vaccine for Children (TVFC) participating doctors’ offices