After the first cluster of cases was identified, TCHD staff members met with Marshallese community leaders from church A to disseminate information about mumps illness and explore the possibility of hosting MMR vaccination clinics to prevent further transmission.
Early and close communication between TCHD staff members and church leaders helped to inform the affected population about the risks for mumps.
During the 45-hour period after initiating the contact investigation, TCHD held two clinics to dispense PEP.
To alert the public about the potential that lower risk exposures might have occurred in community settings, TCHD issued a press release on July 18 that advised anyone who had been in the facilities visited by the index patient during the period of infectivity to request MMR vaccination if they were not already immune to measles and to watch for symptoms.
All outbreaks in which TCHD conducted an epidemiologic investigation with a standardized questionnaire, from January through September 2006, were included in our study as either an Internet-based or telephone-based investigation.
Dr Ghosh is a medical epidemiologist at TCHD. She is also a former Epidemic Intelligence Service Officer with the Centers for Disease Control and Prevention.
TCHD initiated an investigation, consisting of interviews with patient A's family, evaluation of potential exposures to the patient, and an environmental assessment to determine the risk for further disease transmission.
TCHD evaluated potential exposures from each patient and conducted an environmental assessment to determine the risk for further disease transmission.
All laboratory results were reported to CDPHE and forwarded to TCHD.
TCHD's environmental surveillance system identified 109 (50.0%) of 218 birds that tested positive for WNV, 62 (54.9%) of 113 equines that tested positive, 58 (21.7%) of 267 mosquito pools that tested positive, and 45 (12.7%) of 354 sentinel chickens that tested positive.
As evacuees arrived at the Lowry site during the week of September 4, 2005, TCHD established syndromic surveillance at the Lowry medical clinic, an outpatient facility.
These visits were not counted by TCHD. No outbreaks of infectious disease were identified.