1. New Jersey Experience and Protocol Development Teresa Hamby Infectious & Zoonotic Disease Program New Jersey Department of Health & Senior Services

2. 2 Outline Introduction Overview of NJ Surveillance Protocol Development Conclusions

3. 3 NJ Surveillance - Overview NJ Public Health Partners o NJDHSS o Local Information Network Communications System (LINCS) NJ’s HAN 22 jurisdictions statewide Regional epidemiologists in each LINCS agency o Local Health Departments Total 114 o Hospitals Approximately 80 acute care facilities

4. 4 NJ Surveillance - Components Emergency Department (ED) Surveillance o Daily analysis of ED visits and admissions o Enhanced during periods of heightened threat status Hospital Divert Status o Housed in NJDHSS o Website review o Relate to ED volume

5. 5 NJ Surveillance - Components Communicable Disease Reporting and Surveillance System (CDRSS) o Weekly reporting Over-The-Counter Drug Sales o Daily RODS website review o FTP download and analysis BioSense o Daily review

6. 6 BioSense Experiences “Initiation by Smallpox” o FIRST SIA follow up investigation by state or local PH o Approximately three weeks after SIAs implemented o Diagnosis related to vaccination reaction in military personnel

7. 7 Experiences Additional alerts o Miscodes Plague Crimean hemorrhagic fever o Vaccination-related Yellow fever Because of experiences = need for guidance in response at both state and local levels

8. 8 Protocol Development Need for… o Role-specific guidance NJDHSS surveillance staff NJDHSS epidemiology staff Regional epidemiologists / investigators o Level of response? o Clear instructions for investigation and follow up

9. 9 Protocol Development Existing models to draw from… o Republican Convention, NYC 2004 o Presidential Election 2004 o Smallpox Vaccination Program

10. 10 Protocol Elements Description of BioSense system and SIAs Instructions by staff role o Assessment of true “threat”? o Investigation and follow up requirements Closure of event

11. 11 Update Current status o Review and comment by Medical and Program Directors o LINCS epidemiologists developing similar protocol for local use Next steps o Feedback from epidemiology staff at NJDHSS o Input from LINCS epidemiologists o Final approval by all partners

12. 12 Conclusions BioSense is one component of NJ’s surveillance activities Specific SIA experiences revealed need for protocol development at state and local levels Protocol development is an ongoing activity o Additional experiences help in fine-tuning response expectations

13. 13 Thank you! Contacts: Teresa Hamby Teresa.Hamby@doh.state.nj.us Stella Tsai Stella.Tsai@doh.state.nj.us Infectious & Zoonotic Disease Program (609) 588-7500