Johnny had a fever for a few days and then coughed for over 2 weeks. While he was still coughing, his new baby sister became ill with a fever and then developed a severe cough with a whoop. The doctor was suspicious, prescribed an antibiotic and sent in a lab test for the baby. It was confirmed that the baby had whooping cough, also known as pertussis.
When Sam told the doctor his joints had been aching for several weeks and were preventing him from his spring gardening, he was asked if he had ever been bitten by a tick. He had removed a very small tick last fall but had not been concerned because the bite had healed very quickly. The doctor ordered a blood test to see if it was Lyme disease.
Jill went to the doctor with abdominal cramps and diarrhea. A stool specimen was sent to the lab for testing. The doctor wanted to see if it was salmonella, giardia, or some other gastorintestinal illness. Sarah had routine blood work during her pregnancy and was informed that she was positive for hepatitis B. During a pre-employment physical, Tony's blood test revealed that he'd had a past exposure to hepatitis C.
All of these people have had positive lab tests for diseases included on the State of New Jersey's list of over 50 diseases that are reportable to the local health department by the doctor, laboratory, or hospital. Negative results are not reportable. Certain diseases, such as HIV or STDs are reportable directly to the State Health Department.
These individuals have become cases in New Jersey's Communicable Disease Reporting & Surveillance System (CDRSS). Communicable diseases, including food borne illness, hepatitis, and vaccine preventable illnesses are monitored by public health through mandatory reorting to CDRSS. Information gathered helps us learn more about the epidemiology of a disease. Who gets it? What does it look like? How do they get it? Why do they get it?
Public health aims to control disease and disease outbreak. While a doctor concentrates on the individual patient, public health focuses on the population in the community. Public health surveillance looks for changes in the number of cases of regularly occurring diseases in the general population, providing us with updates and other alerts. Public health professionals can evaluate if prevention and containment efforts are working or if the strategy needs to be changed.
Recent events involving measles, SARs, salmonella, H1N1 and E.coli crossed local, state, national, and international boundaries, and required the combined efforts of public health doctors, nurses, health educators, health inspectors, epidemiologists, and others at many different levels. Notification of positive lab results triggers further investigation by the Public Health Nurse (PHN) at the local health department. Most patients are unaware of this process. It may often be completed by the PHN gathering information on the patient and illness from the doctor alone.
The PHN works to confirm the case, ensure adequate treatment, identify the source if possible, protect others who might have been exposed, and to prevent further spread of communicable disease. This is confidential, confirms that the patient is aware of the diagnosis, and can reduce the risk of further spread of the disease. In some cases, the patient is provided with fact sheets that explain symptoms, treatment, and how to prevent the spread of a disease. Good hand washing practice is often emphasized as it is one of the simplest and most effective safeguards in preventing disease transmission.
In 2011 alone, there were over 72 case investigations completed in the City of Englewood. This number refers only to the residents that were tested for certain illnesses or whose doctor reported a possible case based on symptoms. People get ill but may not go to the doctor because it is "just a stomach virus" or "just a nagging cough". Some recover after a few days, but others may still spread germs. As a result, others are unintentinoally exposed to communicable diseases. Accurate information generated by CDRSS allows health departments to encourage awareness, protection, prevention, testing, treatment, and report to reduce the spread of communicable disease in our communities.