Kretschmer Melissa

Final Four-associated events culminated in four days of intense activity from 3/31/17-4/3/17, which attracted an estimated 400,000 visitors to Maricopa County (population 4.2 million). Field teams of staff and volunteers were deployed to three days of Music Fest, four days of Fan Fest, and three Final Four games (Games) as part of an enhanced epidemiologic surveillance system.

Objective:

To describe and present results of field-based near-real time syndromic surveillance conducted at first aid stations during the 2017 National Collegiate Athletic Association Division I Men’s College Basketball Championship (Final Four) events, and the use of field team data to improve situational awareness for Mass Gathering events.

Timely identification of arboviral disease is key to prevent transmission in the community, but traditional surveillance may take up to 14 days between specimen collection and health department notification. Arizona state and county health agencies began monitoring National Syndromic Surveillance Program BioSense 2.0 data for patients infected with West Nile virus (WNV), St. Louis encephalitis virus (SLEV), chikungunya, or dengue virus in August 2015. Zika virus was added in April 2016. Our novel methods were presented at the International Society for Disease Surveillance 2015 Annual Conference. Twice per week, we queried patient records from 15 Maricopa County BioSense-enrolled emergency department and inpatient hospitals for chief complaint keywords and discharge diagnosis codes. Our Case Investigation Decision Tree helped us determine whether records had a high or low degree of evidence for arboviral disease and necessitated further investigation. This study evaluated how Arizona’s protocol for conducting syndromic surveillance compared to traditional arboviral surveillance in terms of accuracy and timeliness in Maricopa County from August 2015 through December 2016.

Objective:

To evaluate Arizona’s arboviral syndromic surveillance protocol in Maricopa County.

The One Health paradigm emphasizes cooperation and interdisciplinary collaboration to promote health and well-being among people, animals and the environment. Though the concept of One Health has been around since the 1800’s, the phrase “One Health” was more recently coined, and projects are being developed globally under its sponsorship. Maricopa County Department of Public Health (MCDPH) has been working at a local level to enhance its One Health surveillance efforts and partnerships. This One Health partnership, comprised of representatives from the Arizona Department of Agriculture (ADA), Arizona Department of Health Services (ADHS), Arizona Game and Fish Department (AzGFD), Arizona Veterinary Medicine Association (AzVMA), Centers for Disease Control & Prevention (CDC), MCDPH, Midwestern University (MWU) Veterinary School, and local veterinarians, was employed during a response to the recent emergence of leptospirosis in Maricopa County, Arizona. Leptospirosis is a zoonotic bacterial disease typically prevalent in tropical regions, especially island countries or low-lying areas that flood. In the United States, CDC reports 100-200 human cases annually. Within the last five years, there have been two confirmed travel-associated human cases reported in Maricopa County. However, no locally acquired human or canine leptospirosis cases were reported. Two separate clusters of canine leptospirosis were reported in Maricopa County in 2016; the first was detected in February among canines within a household. To increase awareness in the veterinary community, the AzVMA published an article summarizing the cluster. This article might have aided in the identification of a second larger cluster in November that involved multiple veterinary and boarding facilities throughout Maricopa County. Following both clusters, capacity increased for canine and human surveillance, laboratory testing, and environmental remediation, and discussions were initiated regarding wildlife testing through the efforts of the One Health team.

Objective:

Demonstrate the utility of a One Health collaboration during a leptospirosis outbreak to expand outreach in human, environmental and animal health arenas.