Programs and Services
The Epidemiology and Laboratory Capacity (ELC) Program conducts communicable disease surveillance, investigates disease outbreaks, and disease control activities. The ELC Program records and analyzes reportable disease information, conducts interviews with infected individuals and their contacts, refers individuals for medical treatment, analyzes data from disease investigations, identifies risk factors, provides education and recommendations on disease prevention, and works in conjunction with appropriate agencies to enforce communicable disease laws.
Communicable Disease Health Headlines
Acute Flaccid Myelitis
Acute flaccid myelitis (AFM) is a condition that affects the nervous system, specifically the spinal cord, which can result from a variety of causes including viral infections. AFM is characterized by a sudden weakness in one or more arms or legs, along with loss of muscle tone and decreased or absent reflexes. Numbness or other physical symptoms are rare, although some patients may have pain in their arms or legs. In some cases, dysfunction of the nerves controlling the head and neck, resulting in such features as facial weakness, difficulty swallowing, or drooping of the eyes, may accompany the limb weakness.
More information can be found on the Provider tab on the right hand column of this page or at the link to the CDC below.
CaliciNet is a national norovirus outbreak surveillance network of federal, state, and local public health laboratories in the United States. CDC launched CaliciNet in 2009 to collect information on norovirus strains associated with gastroenteritis outbreaks in the United States. Public health laboratories electronically submit laboratory data, including genetic sequences of norovirus strains, and epidemiology data from norovirus outbreaks to the CaliciNet database. The norovirus strains can be compared with other strains in the database, helping CDC link outbreaks to a common source, monitor norovirus strains that are circulating, and identify newly emerging norovirus strains.
Epidemiology is the study of the distribution and determinants of health problems in specified populations and the application of this study to control health problems. Epidemiology is the scientific method used by "disease detectives"-epidemiologists-to get to the root of a public health problem or emerging public health event affecting a specific population.
HAI Prevention Infrastructure
Healthcare Associated Infections (HAIs) are infections that patients acquire during the course of receiving treatment for other conditions within a healthcare setting. HAIs are one of the top ten leading causes of death in the United States, accounting for an estimated 1.7 million infections and 99,000 associated deaths in 2002.
Health Information Systems Capacity
The purpose of the Health Information Systems Capacity program is to develop and improve health information systems infrastructure in public health agencies that advances standards-based electronic data exchange, increases information systems interoperability, and sustains and enhances National Electronic Disease Surveillance System (NEDSS) compatible integrated surveillance information systems. Enhancing electronic exchange of information between public health agencies and clinical care entities will make a critical contribution to health reform in Nevada.
Influenza Surveillance and Diagnostic Testing
Influenza is an acute respiratory disease caused by infection with influenza viruses. Influenza types A and B viruses are responsible for epidemics of respiratory illness that occur almost every winter in temperate climates and are often associated with increased rates of hospitalization and death. Although the highest rates of illness occur among school-aged children, the highest rates of hospitalizations from influenza-related causes occur among infants and pre-school children, persons of any age with certain chronic medical conditions and among those aged 65 or older. The estimated rates of influenza-associated hospitalizations and influenza-related deaths vary substantially from one influenza season to the next, depending, in part, on the characteristics of the circulating influenza virus strains. Seasonal influenza surveillance currently consists of 8 system components which provide data on influenza viruses, outpatient influenza-like illness, laboratory-confirmed influenza-associated hospitalizations, influenza-associated deaths, and the geographic spread of influenza viruses and will form the foundation of pandemic influenza surveillance. The Influenza Surveillance and Diagnostic Testing program will work to develop a comprehensive plan for detecting, measuring, and reducing the impact of influenza. It will build a foundation to build capacity for the detection, investigation, and reporting of influenza to enable future prevention initiatives.
The purpose of the Laboratory Capacity program is to provide support to maintain and strengthen public health laboratories so that the state public health agencies can effectively respond, prevent and control known and emerging (or re-emerging) infectious diseases. Laboratory capacity is intended to help achieve modern and well-equipped public health laboratories with well-trained staff, high quality laboratory processes, and systems that foster communication and appropriate integration between laboratory and epidemiology functions.
Antimicrobial resistance is one of our most serious health threats. Infections from resistant bacteria are now too common, and some pathogens have even become resistant to multiple types of classes of antibiotics (antimicrobials used to treat bacterial infections). The loss of effective antibiotics will undermine our ability to fight infectious diseases and manage the infectious complications common in vulnerable patients. National Antimicrobial Resistance Monitoring System (NARMS) activities are designed to improve laboratory-based surveillance for emerging enteric bacterial pathogens, with a focus on antimicrobial resistant enteric pathogens and support submission and transport of bacterial pathogens isolated from ill persons to the CDC.
More than 1,000 foodborne disease outbreaks occur each year in the United States. foodborne disease outbreak investigations are an essential public health function. Investigations require close collaboration between state, local, and federal agencies. Prompt and effective outbreak investigations and reporting of outbreak data are necessary to identify and remove contaminated food from the market, prevent further illness, and focus prevention strategies on critical contamination points in the path from farm to table. The Outbreak Response and Surveillance activities through OutbreakNet and NORS is to enhance capacity for detection, investigation, control, and reporting of enteric disease outbreaks.
It has been estimated that there are approximately 48 million foodborne illnesses resulting in 128,000 hospitalizations and 3,000 deaths in the U.S. annually. Efforts to address this significant public health problem will require improvements in a variety of areas including, laboratory-based surveillance for early detection of foodborne illnesses. Since 1996, PulseNet has connected foodborne illness cases together, using DNA "fingerprinting" of the bacteria making people sick, in order to detect and define outbreaks. PulseNet has detected thousands of local and multi-state outbreaks since its inception, leading to prevention opportunities and continuous improvements in our food safety systems. However, many local and multi-locality outbreaks are not detected early enough or detected at all to lead to the successful implementation of control or preventive measures. Foodborne disease surveillance and outbreak investigation faces many challenges brought by changes in food processing and distribution practices such as the increase in the number of large centralized food processing and production facilities, the globalization of the food supply, changes in the dietary habits of the population and creases in the percentage of the population at higher risk (children, elderly and immunocompromised, etc.). All these factors contribute to the "new outbreak scenario" that is often characterized by foodborne illnesses dispersed across a large region or even multiple states, in contrast to the previously dominant scenario where illnesses were focused in a smaller area. Because of these challenges, we must strive to improve our capacity to rapidly detect and control clusters of foodborne illness and identify the source of the infections. PulseNet's main objective is to provide real-time laboratory-based surveillance to assist in the rapid detection and control of outbreaks caused by the most important bacterial foodborne pathogens in the U.S. PulseNet achieves this by relying on molecular surveillance activities that are carried out "locally" in state and local public health laboratories across the country. PulseNet works with real-time communication systems (phone, web, and email) to provide training and assistance to subtyping according to established protocols and procedures.
Rabies Laboratory Capacity
Approximately 100,000 to 120,000 animals are tested for rabies each year. Most of these animals are submitted following a potential human or domestic animal exposure. As such, each animal rabies diagnosis has a direct implication on the clinical management of an exposed human or the quarantine status of domestic pets or livestock. Well trained laboratory diagnostic staff at public health, veterinary, and agricultural laboratories are necessary to ensure that samples are processed and tested appropriately. Inappropriate testing may result in unnecessary treatment (i.e., from false positives) or in a worst case scenario not receiving life-saving treatment (i.e. from false negatives). The Rabies Laboratory Capacity for National Rabies Surveillance will support public health partners in appropriate training of laboratory personnel to ensure competency in rabies diagnosis. Such support is the foundation for a sensitive and specific diagnosis system for determining management of persons potentially exposed to rabies and ensuring an accurate national surveillance system.
West Nile Virus and other Arboviral
Arboviruses are transmitted to humans primarily through the bites of infected mosquitoes and ticks. West Nile virus is the leading cause of domestically-acquired arboviral disease in the United States. Several other domestic arboviruses also cause seasonal outbreaks and sporadic disease, often in limited geographic areas or unique ecosystems (e.g., Colorado tick fever, Eastern equine encephalitis, La Crosse, and Powassan viruses). Other exotic arboviruses are also threats for introduction into the United States (e.g., Chikungunya, Japanese encephalitis, and Yellow fever viruses). Different vectors, animal hosts, and tissue tropisms contribute to variations in geographic distribution, disease incidence, clinical manifestations, and outcomes. Understanding the epidemiology and burden of arboviral disease is essential to maintaining and improving public health prevention and control efforts. The purpose of this program is to support state and local health departments to implement and maintain effective surveillance and prevention efforts, to include case detection and reporting, laboratory diagnosis, environmental monitoring, risk prediction, and implementation of interventions to reduce human infections due to West Nile virus and other arboviruses of public health importance.