Narang Jigna

On 3/29/2017, the Maricopa County Department of Public Health (MCDPH) received three reports of confirmed HAV infection from an onsite clinic at Campus A that assists individuals experiencing homelessness, a population at risk for HAV transmission. To identify the scope of the problem, the department initiated rapid HAV infection case detection using NSSP ESSENCE.

Objective:

To demonstrate the utility of the National Syndromic Surveillance Program’s (NSSP) version of the Electronic Surveillance System for Early Notification of Community-based Epidemics (ESSENCE) for case detection during a 2017 outbreak of hepatitis A virus (HAV) infection among persons experiencing homelessness in Maricopa County, Arizona.

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.