Alisa Diggs-Gooding, PA-C, MPH¹, Vjollca Berisha, MD, MPH¹, Andrew J. Edmonds, BS¹, Allison L. Wood, MPH¹, John Sollenberger, MS¹, Charles Holloway, MPH¹, and Ron Klein, RN, BSN². (1) 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) 372-2612, alisadiggs@mail.maricopa.gov, (2) Community Health Nursing, Maricopa County Department of Public Health, 926 E. McDowell Rd., Phoenix, AZ 85006

In March 2003, Maricopa County Department of Public Health noted a significant increase in aseptic meningitis case reports from local health care institutions. The outbreak peaked in August with a ten-fold increase in aseptic meningitis reports compared to the previous year.

Due to the magnitude of the epidemic an outbreak response was initiated which included enhanced surveillance, increased communication with local healthcare providers, collaboration with state and federal public health agencies, and dissemination of information to the community. In addition, a laboratory survey was coordinated among five local hospitals.

Of the 132 cases with known etiologies (11% of 1246 total), 94% were reported as enterovirus and 42% were reported as echovirus 30 (an enterovirus subtype). Twenty-six echovirus 30 isolates were sent to CDC for genotyping.

Four to fifteen year olds comprised the largest group affected, accounting for over one-third of all cases identified. A questionnaire was designed to better characterize the outbreak and identify risk factors for developing aseptic meningitis. The results revealed swimming to be a predominant behavior among the affected (68% swam two weeks prior to symptoms) and hand washing to be sub-optimal (case results only, no controls).

The purpose of this presentation is to review the demographic trends, behavioral patterns, and laboratory findings of this investigation and to discuss the potential implications of genotyping studies still underway. Our recent experience and successful collaborations with the community and multiple agencies will no doubt broaden the understanding of seasonal infectious disease outbreaks and improve local response in the future.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Discuss demographic trends and behavioral patterns relevant to enteroviral outbreaks.
• Understand the value of laboratory studies in determining the etiologies of aseptic meningitis outbreaks.
• Describe how inter-agency collaboration are a useful tool for response to public health threats.

Keywords: Data/Surveillance, Outbreaks

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.