Approved Minutes of August 27, 2025

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MINUTES ORANGE COUNTY BOARD OF HEALTH August 27, 2025 S:\Managers Working Files\BOH\Agendas & Abstracts\2025 Agenda and Abstracts/ August Page 4 • Dr. Pettigrew reminded the Board that the CD branch of the Health Department is charged with investigating incidents and reducing morbidity and mortality related to communicable diseases. • There were no notable trends in foodborne illnesses, though there have been some outbreaks which help keep the team busy. In response to Dr. Pickett’s question, Dr. Pettigrew explained that, as of this meeting, the reporting requirements for North Carolina have not been changed and foodborne illnesses will continue to be monitored in Orange County despite upheaval at the Center for Disease Control (CDC). • Dr. Royce asked if campylobacter was seeing an upward trend since 2020, to which Dr. Pettigrew clarified that none of the analyses were completed to the degree of determining statistical significance, but a general impression of trends in communicable diseases in Orange County over the past seven years. She said that she compared the data to national trends and didn’t see anything concerning and added that it’s likely more important to compare data from pre- and post-COVID, as 2020 and 2021 were unusual years and may not accurately reflect trends. • Regarding vaccine-preventable diseases, pertussis and measles are seeing definite upward trends nationwide. While pertussis numbers in Orange County trended significantly higher in 2024, this report does not include the recent outbreak of pertussis in the schools, as it will be captured in the 2025 report. Dr. Pettigrew reiterated that measles is a huge threat, per her presentation to the Board in April. • Most cases of vectorborne illnesses in Orange County are travel related, though Rocky Mountain Spotted Fever and Ehrlichiosis are tickborne and transmitted locally. While these infections are typically more concentrated in western NC, they will likely become more pervasive as climate change increases the spread. Commissioner Fowler clarified that the reported cases included both lab-confirmed and diagnosed/suspected cases, which Dr. Pettigrew confirmed, saying that often patients receive initial testing but fail to return for follow-up testing. Dr. Jonnal noted that, as an emergency room doctor, she has anecdotally seen more patients showing concern about tickborne illnesses and requesting testing than in the past, which may also be driving the increase in case numbers. In response to Dr. Jonnal’s question about communicable disease reporting requirements, Dr. Pettigrew explained that both the lab and the clinician who made the diagnosis are legally required to report cases to the county in which the diagnosis was made – county staff will then work to determine the location where the case originated. • The case numbers for waterborne illnesses are so low that it’s difficult to identify trends. • For sexually transmitted infections (STIs), case numbers for chlamydia and gonorrhea have stabilized, possibly related to improved modalities for treatment and prevention. Syphilis cases, particularly congenital syphilis, are on the rise, and are usually related to vertical transmission when a birthing parent receives late or no prenatal care • Dr. Pettigrew shared that the FDA recently changed approval for the COVID vaccine, restricting it to those who are 65+ years old or who have certain underlying conditions. She said that this presents a lot of concerns about insurance coverage and provider liability if the vaccine is administered to someone for whom it is not recommended; in response to Dr. Jonnal’s question about how this compares to other vaccines that are primarily recommended for older populations, such as Numavax or Shingrix, Dr. Pettigrew clarified that these new FDA recommendations do not align with the scientific data, i.e., the benefits and risks of the COVID vaccine are not notably different for different age groups, leading to conflicting recommendations from various health organizations. Dr. Pettigrew added that, though COVID is no longer a reportable condition, we are still seeing spikes.