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Andrew J. Edmonds, BS, Natalie Fuller, BS, Alisa Diggs-Gooding, PA-C, MPH, and Vjollca Berisha, MD, MPH. Division of Epidemiology and Bio-Defense Preparedness and Response, Maricopa County Department of Public Health, 1010 E. McDowell Rd. Ste. 300, Phoenix, AZ 85006, (602) 372-2619, andrewedmonds@mail.maricopa.gov
Early in the 2003-2004 influenza season, the widely publicized influenza-related child deaths across the country signaled the potential for an epidemic. To address this concern, Maricopa County Department of Public Health supplemented routine influenza surveillance by developing an enhanced reporting system with the Maricopa County Medical Examiner (ME).
The collaboration resulted in the development of a protocol outlining the immediate report of all non-traumatic pediatric deaths submitted for autopsy. Information reported included decedent’s age, circumstances of death, and illness history. Epidemiologists investigated these unexplained deaths by contacting hospital infection control practitioners, obtaining medical records, querying the state death database and retrospectively cross-matching records to past laboratory confirmed cases. Post-mortem specimens collected by the ME were forwarded to the state laboratory for viral screening. Though none of the four pediatric influenza-related deaths reported in Maricopa County were identified via the ME, several ME cases did yield such viruses as parainfluenza, cytomegalovirus, and enterovirus.
The significance of increased inter-agency collaboration has been demonstrated by the discovery of the etiologies of several deaths that could have gone unexplained. Although the incorporation of ME data into the surveillance system did not identify excess influenza-related mortality this season, sustained ME involvement will undoubtedly afford greater perspective to future influenza epidemics. Continuing to develop this model’s applicability in disease surveillance as a whole is promising – in conjunction with existing resources, timely and cost effective ME data can play a key role in the early detection and identification of public health threats that might otherwise go unnoticed.
Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to
Keywords: Death, Data/Surveillance
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.