Bakota Eric

Syndromic data is shifting the way surveillance has been done traditionally. Most recently, surveillance has gone beyond city limits and county boundary lines. In southeast Texas, a regional consortium of public health agencies and stakeholders in the 13-County area governs the local ESSENCE system. The Houston Health Department, (HHD) is responsible for deploying ESSENCE to the entire region. To effectively monitor the health of the region's population, a need arose to establish clear guidelines for disease investigation and data sharing triggered by syndromic surveillance across the area. Since Houston's instance of ESSENCE serves all 13 counties, the consortium instituted a cross- jurisdictional etiquette group. The purpose of the group is to determine the standard protocol for responding to ESSENCE alerts and best practices for data sharing and use among consortium members.

Objective: To demonstrate the importance of a cross-jurisdictional etiquette workgroup in the Texas Southeast region that leverages on the Syndromic Surveillance Consortium. To promote data sharing and communicate the findings of disease to assist rapid investigation and data sharing.

West Nile virus (WNV) is the leading cause of autochthonous arboviral disease in the United States. The virus is primarily spread to people through the bite of infected Culex species of mosquitos. WNV was first identified in Harris County, Texas, in 20022. Since then, the mosquito-borne virus has become endemic in the region, with surges in 2012 and 2014. Although majority of individuals infected are asymptomatic, WNV induced neuroinvasive infections often result in hospitalizations and adverse outcomes3-7, thus may pose a significant concern in public health and healthcare. The Harris County Public Health (HCPH) Surveillance and Epidemiology Unit (SEU) conducts surveillance of WNV in humans, in collaboration with Mosquito and Vector Control Division (MVCD) that monitors the virus in mosquito populations and birds. Mosquito abatement activities are implemented in areas where positive mosquitoes and human cases are identified. In this integrated model, clusters of WNV positive mosquito pools in relation with human cases provide comprehensive surveillance data to guide targeted efforts of mosquito control, disease prevention, and community education.

Objective: This abstract aims to: 1) describe human WNV infections in Harris County excluding the City of Houston, Texas, 2003 to 2018; 2) explore geographical distributions of WNV positive mosquito pools in relation to human cases; 3) provide a brief overview of the county's rigorous multidisciplinary WNV surveillance and control in mosquitoes and humans.

Drug overdose mortality is a growing problem in the United States. In 2017 alone over 72,000 deaths were attributed to drug overdose, most of which were caused by fentanyl and fentanyl analogs (synthetic opioids). While nearly every community has seen an increase in drug overdose, there is considerable variation in the degree of increase in specific communities. The Harris County community, which includes the City of Houston, has not seen the massive spikes observed in some communities, such as West Virginia, Kentucky, and Ohio. However, the situation in Harris County is complicated in mortality and drug use. From 2010 - 2016 Harris County has seen a fairly stable overdose-related mortality count, ranging from 450 - 618 deaths per year. Of concern, the last two years, 2015-2016, suggest a sharp increase has occurred. Another complexity is that Harris County drug related deaths seem to be largely from polysubstance abuse. Deaths attributed to cocaine, methamphetamine, and benzodiazipine all have risen in the past few years. Deaths associated with methamphetamine have risen from approximately 20 per year in 2010 - 2012 to 119 in 2016. This 6-fold increase is alarming and suggests a large-scale public health response is needed.

Objective: In this session, we will explore the results of a descriptive analysis of all drug overdose mortality data collected by the Harris County Medical Examiner's Office and how that data can be used to inform public health action.

In this panel, the presenters will discuss their perspective in responding to Hurricanes Harvey and Irma. Hurricane Harvey made landfall on August 25th and over the course of 4 days dropped approximately 27 trillion gallons of water on Texas and Louisiana. The flooding that ensued was unprecedented and forced over 13,000 people into shelters. These individuals needed to have their basic needs -food, shelter, clothing, sanitation- met as well as their physical and mental health needs. The George R Brown Conference Center (GRB) and NRG Stadium Center were set up as mega-shelters to house shelterees. Hurricane Irma made landfall on September 10th in the Florida Keys as a Category 4 Hurricane. The Hurricane caused 72 deaths and forced thousands of people into shelters. These weather events created novel challenges for local response efforts. Decision makers needed timely and actionable data, including surveillance data.

Objective:

In this panel, attendees will learn about how disaster surveillance was conducted in response to Hurricanes Irma and Harvey, as well as the role of CDC at the federal level in supporting local response efforts. By hearing and discussing the challenges faced and solutions identified, attendees will be better able to respond in the event of a low-frequency/high-consequence disaster occurring within their jurisdiction.