august 2009 cdc selected zoonotic diseases conference call

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Selected Zoonotic Diseases Conference Call

August 5, 2009

Pierre Rollin, MD; Division of Viral and Rickettsial Diseases, CDC; 404-639-1124; prollin@cdc.gov

Selected Zoonotic Diseases Conference Call

August 5, 2009

Update: Ebola-Reston in the Philippines

Kendra E. Stauffer, DVM; Division of Foodborne, Bacterial, and Mycotic Diseases, CDC; 404-639-3435; kstauffer@cdc.gov

Selected Zoonotic Diseases Conference Call

August 5, 2009

The Changing Face of Brucellosis in the United States

Kelly K. Stimpert, MPH, PhD candidate; Division of Parasitic Diseases; 770-488-4968; kkstimpert@cdc.gov

Selected Zoonotic Diseases Conference Call

August 5, 2009

Update on Chagas disease in the United States

Update on Chagas Disease in the United States

Kelly Stimpert, MPH

kkstimpert@cdc.gov

AREF Health Communication Specialist

Centers for Disease Control and Prevention

Division of Parasitic Diseases

Chagas disease

• Protozoan parasite Trypanosoma cruzi only found in the Americas

• Vector-borne zoonosis, many animal reservoirs

• Transmission– Triatomine bugs – most common – Congenital– Contaminated blood components, organ or tissue– Laboratory accidents– Foodborne

• Estimated 8 – 11 million people have Chagas disease in Latin America

Trypanosoma cruzi lifecycle

Clinical diagnosis of Chagas disease

• Acute phase– Detection of circulating parasite– PCR– Problems with sensitivity

• Chronic phase– Persistent circulating antibody– Problems with specificity and sensitivity

• No gold standard test for Chagas disease

Clinical Chagas disease

• Acute phase ~4 – 8 weeks, usually asymptomatic

• Chronic phase lifelong– Asymptomatic indeterminate form– 10 – 30% develop symptomatic disease

• Cardiac – sudden death, stroke• Gastrointestinal

• Treatment drugs difficult to tolerate and most effective during early infection

Who is at risk in the U.S.

• People who acquired the infection in endemic countries of Latin America– Travelers to endemic areas

• People who acquire the infection in the United States– Exposed to infected vectors/ reservoirs – Children of infected mothers– Transplant recipients– Transfusion recipients– Laboratory staff working with vectors, reservoir

species, or parasite

Source: Schmunis Mem Inst Osw Cruz 2007

18 million people in the U.S. born in Mexico, Central and South America

Chagas disease in the United States

• Based on immigrant population data in the U.S., there are an estimated*– 300,167 people chronically infected – 30,000–45,000 cardiomyopathy cases– 63–315 congenital infections annually

• Not nationally notifiable disease– Reportable only in AZ and MA

* Bern and Montgomery, CID 2009

FDA approves first blood donation screening assay December 2006

• Screening for antibody to T. cruzi • Most blood centers started screening

early 2007• ~75 – 90 % of the blood supply

currently screened• March 2009 FDA issues draft guidance

– Deferral of donors based on screening test– Universal screening, likely will revise to less

frequent screening– Lookback of previous donations by positive

donors– Can use radioimmune precipitation assay (RIPA)

to confirm

Confirmed positive blood donors2007 – 2009*, n = 940

*Source: AABB Biovigilance program, as of July 31, 2009

Donors mapped by ZIP code of residence

Are healthcare providers aware of Chagas disease?

• Most are not– ACOG Knowledge/ Attitude/ Practices

(KAP) surveys– Medscape KAP surveys of subspecialties

• Updated recommendations for treatment BUT many still refer to older practices

• Many donors seeking care from primary healthcare providers, clinics for the uninsured

Treatment drug availability in United States

• Nifurtimox and benznidazole only antiparasitic medicines used to treat Chagas disease (in United States)

• Not FDA approved • Available only from CDC under

investigational protocols• Of 940 identified positive blood donors,

only approx. 11% have contacted CDC for treatment

Chagas disease online resources

• CDC’s Chagas disease main page http://www.cdc.gov/chagas

• Publications http://www.cdc.gov/chagas/publications.html

• Fact sheet for healthcare providers http://www.cdc.gov/chagas/hcp/factsheet.pdf

• Fact sheet for the public http://www.cdc.gov/chagas/factsheets/onepage.pdf

• English language Podcast http://www2a.cdc.gov/podcasts/player.asp?f=8683

• Spanish language Podcast http://www2a.cdc.gov/podcasts/player.asp?f=8785

Thanks to

• Caryn Bern, CDC• Susan Montgomery, CDC• Susan Stramer, ARC• Jennifer Verani, CDC

The findings and conclusions in this presentation have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.

Dr. Carlos Chagas

Jesse Blanton, MPH; Division of Viral and Rickettsial Diseases (DVRD), CDC; 404-639-2289; jblanton@cdc.gov;

Christopher Cox, MS; DVRD, CDC; 404-639-0045; cmcox1@cdc.gov

Peter J. Costa, MPH CHES; Alliance for Rabies Control; 919-830-2199; peter.costa@worldrabiesday.org

Selected Zoonotic Diseases Conference Call

August 5, 2009

World Rabies Day – George Baer Memorial Rabies Symposium

•www.worldrabiesday.org •www.cdc.gov/rabies/events/WRD09.html

World Rabies Day

Health Department Toolkit

Planning Tools

Public Relations/Promo Materials

eMedia and Social Media

World Rabies Day

Toolkit Objectives

1: Promote World Rabies Day Events

2: Promote Rabies Awareness in Conjunction with WRD

World Rabies Day

Toolkit Contents 1: Planning

Step 1: Lay the Foundation Step 2: Plan Activities Step 3: Evaluate Activities Community Partnership Example Previous WRD Events

World Rabies Day Toolkit Contents 2: PR/Promotion

Working with the Media Modifiable Press Release Modifiable Media Advisory Modifiable Radio PSA Matte Articles Key Messages/Talking Points Opinion Editorial Print PSAs/Flyers

World Rabies Day

Toolkit Contents 3: eMedia

Social Media

Health eCards

Buttons/Badges

World Rabies Day

Toolkit Contents 3: eMedia (cont.)

Social Media Twitter Facebook MySpace

Guidance for Usage Pre-written Content

World Rabies Day

Questions or Comments:

Christopher Cox

Health Communications Specialist

404-639-0045

exo5@cdc.gov

World Rabies Day:World Rabies Day:Why is it so important?Why is it so important?

• Estimated 55 million educated

• Over 300 events in 100 countries

• >1.5 million animal vaccinations

• 140K web visitors, 200 countries– 52% (72,682) from U.S.; 83% new

U.S. Web Visitors by StateGoogle Analytics

Measuring Impact2007 & 2008

Organizational Partners

• Be a Resource – (Toolkit)– Website, redirect to WRD – State media/PR office– Communicate to animal

control, vet clinics, shelters• Work with Local Orgs

– Support efforts at vet schools, health depts., etc

– Point source for event info • Host a RABIES Webinar

– Internet video conference• Spread the Message

– Add WRD logo to web site, signature block, written correspondence

– Listserv, Twitter, etc

Get Involved – WRD 2009

Peter CostaGlobal Communications Coordinator

Alliance for Rabies Control

World Rabies Day Campaign

919-830-2199

peter.costa@worldrabiesday.org

WorldRabiesDay.Org

Howard Pue, DVM, MSVPM; State Public Health Veterinarian, Missouri; 573-751-6117; howard.pue@dhss.mo.gov

Selected Zoonotic Diseases Conference Call

August 5, 2009

Missouri Rabies/Tetanus Symposium

Emily Zielinski-Gutierrez, MPH, DRPH; Division of Vector-borne Infectious Diseases, CDC; 970-221-6477; EZielinskiGutierrez@cdc.gov

Selected Zoonotic Diseases Conference Call

August 5, 2009

Update: West Nile

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Selected Zoonotic Diseases Conference Call

August 5, 2009