In your role as Minnesota’s state epidemiologist, how do you work with others to slow or prevent the spread of infectious disease?
Protecting the public’s health is a holistic endeavor which needs participation and collaboration from the public, clinical practitioners and public health staff at the local, state and federal levels. Certain disease are reportable to the Minnesota Department of Health (MDH) through clinicians, infection preventionists and laboratorians. Staff at MDH will conduct surveillance for these diseases, including abstracting medical records for demographic, clinical and outcome information. An isolate from the laboratory (depending on the disease) will undergo confirmation and characterization at the MDH public health laboratory (PHL). Sometimes case-control studies will be done to determine risk factors for disease. This information is then used to develop infection prevention and control measures that can be put into place, such as intrapartum antibiotic prophylaxis to prevent neonatal group B streptococcal (GBS) disease or conjugate vaccine to prevent pneumococcal disease in young children. Studies can then be done to assess the impact of these measures, and inform improved measures. For example, moving to a screening-only approach to prevent neonatal GBS (initial guidelines were risk-based or screening-based), or moving from a 7-valent pneumococcal conjugate vaccine to a 13-valent pneumococcal conjugate vaccine. It is also useful to partner with media to inform the public about infectious diseases and measures that individuals can take to minimize their risk of exposure.
Infectious diseases can emerge or re-emerge and it is essential to have a close partnership with clinicians who may recognize that something different is occurring. A number of years ago, a pediatrician reported a case of encephalitis that was investigated by MDH and found to be due to Powassan virus, an arbovirus transmitted by ticks and previously not recognized to occur in Minnesota. Subsequently, the PHL developed the diagnostic ability to test specimens and we have detected cases most years, and have developed and disseminated messages regarding the transmission of this virus by ticks and the importance of tick prevention measures.