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Prevention, Investigation and Control of Communicable Disease <br /> Provision of Core Public Health Services <br /> Mandated Service: <br /> Communicable Disease investigation and control is a mandated service of local Health Departments per <br /> North Carolina General Statute 130A, Article 6 and North Carolina Administrative Code <br /> Communicable Disease Statistics: • <br /> In 2007-08, Communicable Disease (CD) activities increased significantly: <br /> • 11 cases of active TB disease received 6 months of Directly Observed Treatment <br /> • 492 TB contacts of the 11 active cases needed follow-up and evaluation <br /> • 90 latent TB cases received 9 months of preventive therapy <br /> • 4,341 childhood and adult immunizations were provided (other than flu) <br /> • 227 refugees received communicable disease screenings <br /> • 3 foodborne illness outbreaks were investigated and controlled <br /> • 139 reported CD cases/conditions(other than TB) were investigated and/or monitored with <br /> follow-up to 421 contacts provided <br /> • 370 rabies exposure consultations were provided <br /> Challenges: <br /> • 30% increase in workload related to new North Carolina Electronic Disease Surveillance System <br /> (NCEDSS) <br /> • Growing foreign-born immigrant and refugee population. <br /> • 35% increase in demand for childhood immunizations. <br /> • Limited opportunities to practice mass vaccination clinics. <br /> • Explosion in the number of refugees resettling in Orange County. <br /> • Lead testing rates have remained at a very low level with limited ability to focus on gaining <br /> compliance from private providers for testing. <br /> Response: <br /> • Re-directed existing nurse with part time refugee duties to full time refugee health <br /> • Re-directed the duties of an adult health nurse to provide part-time communicable disease <br /> services and lead-based prevention program initiatives. <br /> • Severely limited the chronic disease care coordination program for elderly. <br /> • Discontinued the community-based rapid results HIV testing program. <br /> • Discontinued the lay health advisor program for community HIV education. <br /> • Eliminated community-based flu clinics other than for high-risk populations. <br /> Need: Additional communicable disease nurse to: <br /> - Assure timely investigation and follow-up of communicable diseases <br /> - Provide nursing follow-up and data management of NCEDSS cases <br /> - Provide rapid HIV counseling and testing program in high-risk communities <br /> - Provide additional childhood and adult vaccinations <br /> - Work with private medical providers to increase the number of children receiving blood lead <br /> tests <br />