1. is for Epi Epidemiology basics for non-epidemiologists

2. Session II Part II An Epidemiologist’s Toolkit

3. Data and Technology “Tools”

4. Data Key Sources Surveillance “The ongoing systematic collection, analysis, and interpretation of health data, essential to the planning, implementation, and evaluation of public health practice, closely integrated with the timely dissemination to those who need to know.” Questionnaires and Interviews

5. -Physicians -Laboratories -STD clinics -Community health clinics County and state health departments and CDC who analyze data using statistical methods -Public health officials -Health directors -Health policy officials Change in public health practice (vaccination, reduction of risk factors, medical intervention, etc.) Standardized data collection Dissemination to those who need to know Public health planning and intervention Public health evaluation

6. Surveillance as a Tool Determine baseline for detection of epidemics Early detection of epidemics –Estimate magnitude of the problem –Determine geographical distribution

7. Surveillance as a Tool

8. North Carolina Salmonella Rates by County: 2002 Rate numerators: NC Communicable Disease Data for 2000 Rate denominators: U.S. Census population data, by county, for 2000

9. Questionnaires and Interviews Outbreak Investigations Rapid Needs Assessments

10. Questionnaires and Interviews: 2 other applications 1. Contact tracing case High Risk Contact Contact’s Contact 2. Case follow up

11. Data Management and Analysis Computer software packages –Epi Info –SAS –SPSS –Stata

12. Epi Info Software http://www.cdc.gov/epiinfo/downloads.htm http://www.cdc.gov/epiinfo/downloads.htm Features: –Relational database structure –On screen data entry form –Data analysis –Data graphing –Data mapping

13. Epi Info Software Training http://www.sph.unc.edu/nccphp/training http://www.sph.unc.edu/nccphp/training "Introduction to Screen Components And Analysis Commands" "Importing and Exporting Data Tables" "Relating and Merging Data Tables" "Manipulating Data Prior to Analysis Part A" "Manipulating Data Prior to Analysis Part B“ “Generating and Interpreting Analysis Output Part A” “Generating and Interpreting Analysis Output Part B”

14. Data Management and Analysis Rely on software to: Store databases –Surveillance systems –Outbreak investigations –Medical records Generate Descriptive Statistics –Frequencies, proportions, rates –Graphs: bar, line, histogram (Epi Curves) –Maps: census tracts; counties; districts Generate Test Statistics –Odds ratios, risk ratios, and corresponding measures of association

15. Data Management and Analysis Rely on Epidemiologists to: Generate Hypotheses –Make judgments about linkages between exposure and outcome Interpret Data –Identify or correct mistakes –Interpret laboratory tests Make Decisions –Evidence-based –Determine if an epidemic is in progress

16. The Media as a “Tool”

17. Media Applications Risk and crisis communication Reaching people potentially exposed in an outbreak Press releases –Regional Public Information Officers http://www.vdh.state.va.us/news/PRcontacts.asp

18. Media Applications

19. Working with the Media Crisis communication strategy employed by the Toronto health department during the SARS outbreak Harnessed the power of the media to disseminate timely, accurate information to the public and physicians “ SARS: When a Global Outbreak Hits Home” (October 2003). GrandRounds@sph.unc.eduGrandRounds@sph.unc.edu

20. Centers for Disease Control and Prevention http://www.cdc.gov http://www.cdc.gov

21. CDC as a Tool Training Technical Support Surveillance and Reporting

22. CDC: Training Division of Applied Public Health Training –Epidemic Intelligence Service program Division of Public Health Surveillance and Informatics –Public Health Informatics Fellowship Program Numerous satellite broadcasts, continuing education training, printed education materials on a broad range of topics

23. CDC: Technical Support Epidemic Intelligence Service Officers National Center for Infectious Diseases

24. CDC: Technical Support

25. CDC: Surveillance and Reporting Division of Public Health Surveillance and Informatics –NETSS –Morbidity and Mortality Weekly Reports FoodNet PulseNet Sentinel Surveillance - Influenza

26. Universal Epidemiological Methods Descriptive epidemiology Analytic epidemiology

28. References and Resources Association of Public Health Laboratories http://www.aphl.org http://www.aphl.org Centers for Disease Control and Prevention web site (January 2005). http://www.cdc.govhttp://www.cdc.gov Centers for Disease Control and Prevention (2003). Smallpox Response Plan Guide. http://www.bt.cdc.gov/agent/smallpox/response-plan. http://www.bt.cdc.gov/agent/smallpox/response-plan Division of Laboratory Systems, Centers for Disease Control and Prevention (2004). The National Laboratory System: Public and Private Benefits. http://www.phppo.cdc.gov/mlp/nls.aspx http://www.phppo.cdc.gov/mlp/nls.aspx

29. References and Resources Jenkins, P. ( 2004). Anatomy of a Food borne Outbreak Investigation. North Carolina Center for Public Health Preparedness Training web site: http://www.sph.unc.edu/nccphp/traininghttp://www.sph.unc.edu/nccphp/training North Carolina Center for Public Health Preparedness (2004). Recognizing an Outbreak. Public Health Training and Information Network program. http://www.sph.unc.edu/nccphp/traininghttp://www.sph.unc.edu/nccphp/training North Carolina Center for Public Health Preparedness (2004). Risk Communication. Public Health Training and Information Network program. http://www.sph.unc.edu/nccphp/traininghttp://www.sph.unc.edu/nccphp/training Salyers, M. (2004). Incident Command Systems for Public Health. North Carolina Center for Public Health Preparedness Training web site: http://www.sph.unc.edu/training.http://www.sph.unc.edu/training

30. References and Resources Stehr-Green P., Stehr-Green J. (2005). Environmental Health Studies: Conducting Traceback Investigations. North Carolina Center for Public Health Preparedness, UNC Chapel Hill. Trust for America’s Health (June 2003). Public Health Laboratories: Unprepared and Overwhelmed. http://healthyamericans.org/reports/files/LabReport.pdf http://healthyamericans.org/reports/files/LabReport.pdf University of North Carolina at Chapel Hill School of Public Health and the Centers for Disease Control and Prevention (October 2003). SARS: When a Global Outbreak Hits Home. Public Health Grand Rounds Broadcast. www.PublicHealthGrandRounds.unc.edu.www.PublicHealthGrandRounds.unc.edu University of North Carolina at Chapel Hill School of Public Health and the Centers for Disease Control and Prevention (September 2003). Disease, Disaster, and Detection: Partnering with Public Health Laboratories. Public Health Grand Rounds Broadcast. www.PublicHealthGrandRounds.unc.edu. www.PublicHealthGrandRounds.unc.edu