Susan I. Gerber, MD - Cook County Department of Public Health

Susan I. Gerber, MD

Local Public Health Department
• Communicable diseases
• Environmental health
• Chronic diseases
• Emergency preparedness
• Special programs

Public Health Reporting
Ground Zero
• Local government
• City, county, municipality
Regional
Management
• State
• Managing local health department interactions
National
Coordination and
Policy
• Federal
• Centers for Disease Control and Prevention

Control of Communicable Diseases
• Considered to be infectious, communicable, and
dangerous to the health of the public
• Need to be reported to the local health department
• The state of Illinois publishes Rules & Regulations for
communicable diseases

Ground Zero: Disease Control
• Local public health receives disease reports from
mandated reporters:
• Physicians
• Nurses
• Hospitals
• Laboratories
• Long term care facilities
• Schools or any entity with knowledge of a
communicable disease

Classes of Diseases
•Class 1
•Report to the local health
department as soon as possible, but
within 24 hours
•Class 2
•Report to the local health
department as soon as possible , but
within 7 days

Class I Diseases
Any unusual case or cluster of cases that
may present a public health hazard
• Anthrax
• Cholera
• Diptheria
• Foodborne or
waterborne illness
• Hepatitis A
• Measles
• Pertussis
• Meningitis and other
invasive disease
(N.meningitidis, H.
influenzae)
• Plague
• Rabies, human
• Smallpox
• Typhoid

Class II Diseases
• Blastomycosis
• Cryptosporidiosis
• Giardiasis
• Hepatitis B
• Hepatitis C
• Legionella
• Leptospirosis
• Listeria
• Salmonella
• Shigella
• Tickborne disease
• Non-cholera vibrio
• Yersinia

Communicable Disease
Investigations
• Cases are reported by infection control personnel and
microbiology laboratories
• Cases are assigned to communicable disease
investigators
• Information pertaining to individual cases and
sometimes contacts is obtained depending on the
particular disease

Enteric Investigations
• Includes diseases such as Salmonella, Shigella, E. coli
• These organisms can be spread person to person or
can infect food
• Can cause diarrhea, vomiting, fever, and abdominal
pain
• Most effective way to prevent these diseases is
handwashing

Enteric Investigations
•Investigate factors pertaining to spread
of disease
•Restrict food handlers or personnel in
sensitive occupations when necessary
•Surveillance activities
•Identification of foodborne disease
outbreaks

Facts about Foodborne Illness
• Symptoms generally last for at least several hours to
several days
• Bacterial toxins, bacteria, and viruses have incubation
periods that can range from approximately 1 hour to
several days.
• Public health determines whether a group of illnesses
can be considered a foodborne disease outbreak

Determining Whether or Not
Illnesses are Part of a Foodborne
Disease Outbreak
• The diagnosis of foodborne disease should be
considered when 2 or more persons who have a
shared meal develop an acute illness characterized
by nausea, vomiting, diarrhea, and occasionally
other symptoms.

Diagnosing a Foodborne Disease
Outbreak
• Must determine what causative agent makes sense
using:
• information about clinical syndrome
• incubation period
• Commonly associated foods with specific organisms

How are Foodborne Diseases
Diagnosed
• Most often, the key to identifying what organism is
causing the illness is through:
STOOL SPECIMENS

Causes of Persistent Vomiting in a
School- Age Child
• Enteric viruses which are passed from child to child
• Viruses and bacteria from food
• Trauma to the abdomen
• Urinary infections
• Food intolerance
• Migraine headaches and neurologic diseases
• Psychogenic
• Medications and drugs
• Toxins (eg. Lead)
• Metabolic diseases
• Peptic ulcer disease
• Appendicitis
• Pregnancy

What is Meningitis
• Infection of the fluid around the spinal cord and the
fluid that surrounds the brain
• Could be caused by a virus or a bacteria
• Symptoms:
• High fever
• Headache
• Stiff neck
• Unable to look at bright lights

Viral Meningitis
• Less severe
• People get better quickly
• Can be caused by lots of viruses:
• Summer viruses are common (enteroviruses)
• West Nile Virus
• Sometimes viruses that only cause colds can cause mild
meningitis

Enteroviruses:
The Viruses of Summer
• Summer viral meningitis
• Commonly occurs in late summer and early fall
• Lots of different kinds
• Commonly seen in children
• Illness improves within a few days
• Doctor might call this viral meningitis

Bacterial Meningitis
• Usually more severe
• Less common than viral meningitis
• New vaccines have decreased the number of children
who get bacterial meningitis
• Examples of bacteria that cause meningitis:
• Pneumococcus (Streptococcus pneumoniae)
• Meningococcus (Neisseria meningitidis)
• Haemophilus influenzae

A Source of Confusion
•Meningitis ≠
Meningococcus
•Meningitis just refers to some type
of infection of the spinal fluid
•Meningococcus is a type of bacteria
that can cause both meningitis AND
bloodstream infections

Meningococcus
• The bacteria is called Neisseria meningitidis
• Severe type of meningitis, but also causes an infection
in the blood
• 5-10% of people carry this bacteria in their noses
without ever getting ill
• Can be spread in a household or by secretions
(sneezing and coughing directly onto someone else)

Meningococcus
• Can be treated with antibiotics
• Rarely causes outbreaks
• Two different types of vaccines are available to prevent
some types of this disease
• Close contacts to cases are recommended to receive
antibiotics as a precaution

All Meningitis:
Viral and Bacterial
• Can be diagnosed by a healthcare provider
• If symptoms of high fever, headache, and stiff neckshould
see a doctor IMMEDIATELY
• Diagnosis is made by lumbar puncture and
examination of spinal fluid
• Only by looking at spinal fluid can a person
conclusively tell if there is meningitis

Reducing Spread of Any Type of Meningitis
• Just like reducing the chance of any bacterial or viral
disease:
• Good handwashing with soap and water!
• Using alcohol based sanitizers also works!
• People covering their mouth and nose when sneezing
and coughing

Questions
• Cook County Department of Public Health:
• 708-633-8030
• www.cookcountypublichealth.org