1?12? Georgia Department of Public Health Board of Public Health Meeting Tuesday, June 13, 2017 We Protect Lives. Call to Order Phillip Williams, Chair We Protect Lives. Roll Call Judy Greenlea Taylor, DDS Secretary We Protect Lives. Approval/Adoption of Minutes Judy Greenlea Taylor, DDS Secretary We Protect Lives. Commissioner's Update Brenda Fitzgerald, MD Commissioner, DPH We Protect Lives. Board Elections Phillip Williams, Chair We Protect Lives. Braves Stadium Tobacco-Free Policy Kenneth Ray, MPH Office of Tobacco, Policy, System and Environmental Change Deputy Director, DPH GTUPP Mission To reduce disease, disability, and death related to tobacco use by— 1. Preventing initiation of tobacco use among young people; 2. Promoting quitting among adults and young people; 3. Eliminating non-smoker’s exposure to second-hand smoke; and, 4. Identifying and eliminating tobacco-related disparities. Prevent Tobacco Use Initiation Among Youth and Young Adults Tobacco-free youth-serving places— • 121/181 school districts • 14/115 charter schools • 28/43 park and recreation associations • 46/128 colleges and universities Promoting Quitting Among Adults and Young People through Systems Change Healthcare providers using an Ask, Advise, Refer model, including a fax or EMR referral to the Georgia Tobacco Quitline— • Health Districts: 9 • Hospitals/Health Systems: 6 • • • Mental Health Facilities: 5 Pharmacy: 1 Primary Care Clinics: 5 English: 1-877-270-STOP Spanish:1-855 DEJELO-YA Hearing Impaired:1-877-777-6534 Eliminating Exposure to Second-Hand Smoke Tobacco and Smoke-Free Places— • Many partners statewide • 17/189 public housing authorities has adopted smokefree policies • 5 out of 443 cities and 1 out of 159 counties has a model smoke-free ordinance protecting all workers and citizens • Now, SunTrust Park is tobaccofree, too! ?New? dow?o? {that e) eme?? gtowlp of? ithowgh?ttw?g oomm?ititeo] @?it?zetmo @em ehotmgje {the wot?ol Emdeedg ?it ?g {the om?y ith?tmgg {that ewe? hog!? Margaret Mead, Anthropologist We Protect Lives. Contributors to the Tobacco-Free Braves Stadium Policy Initiative Braves and SunTrust Park Rex Hamre, VP Sustainability Director, Jones Lang LaSalle Incorporated or JLL Jim Allen, VP Corporate Partnerships, The Atlanta Braves Drew King, Corporate Partnerships Manager, The Atlanta Braves Mike Plant, President of Development, The Atlanta Braves Cobb-Douglas Public Health Jack Kennedy, District Health Director Lisa Crossman, Deputy Director Jazmyn McCloud, Tobacco & Asthma Policy Specialist Department of Public Health Chronic Disease Prevention Jean O’Connor, Chronic Disease Prevention Director Andrea Wimbush, Chronic Disease Deputy for Administration Kenneth Ray, Tobacco Program Manager Colleen Commons, Quitline Coordinator Yomi Fabayo, Tobacco-Free Places Coordinator Alina Chung, Tobacco Epidemiologist Anne-Marie Coleman, Youth Tobacco Use Prevention Coordinator Alesia Gales, Administrative Assistant Emma Bicego, Tobacco Program Evaluator Department of Public Health Executive Leadership and Communications Brenda Fitzgerald, Commissioner Nancy Nydam, Communications Director J. Patrick O’Neal, Health Protection Division Director Connie Smith-Lindsey, Communications Manager Tobacco?Free SunTrust Park/Braves Stadium Recognition mi in?. am. an! (an! I'm an VIE We Protect Lives. Zika Update Cherie Drenzek, DVM, MS State Epidemiologist, DPH We Protect Lives. Overview Zika is still an unprecedented public health threat, in both geographic scope and clinical impact. The top priority for the Zika public health response is still to protect pregnant women and their fetuses. • Science Update • Global Epidemiology • National Epidemiology • Georgia Epidemiology • Other DPH Zika Activities Zika Science Update • Zika infection during pregnancy can lead to severe fetal and infant brain abnormalities and microcephaly. • The largest study (so far) of pregnancy outcomes among women infected with Zika during their pregnancy was published in the CDC MMWR on June 9, 2017 (https://www.cdc.gov/mmwr/volumes/66/wr/mm6623e1.htm) • The study followed 2,549 pregnant women with laboratory evidence of Zika infection during January 1, 2016–April 25, 2017 in the U.S. territories of American Samoa, Puerto Rico, U.S. Virgin Islands, Federated States of Micronesia, and Marshall Islands. • Overall, 5% (122) of fetuses or infants resulting from these pregnancies had Zika-related birth defects; 108 had microcephaly. • Zika infection during the first trimester had a slightly higher risk of birth defects (8%) than if infected during the second (5%), and third trimesters (4%). • Identification and follow-up of infants born to women with lab evidence of Zika infection during pregnancy is critical for timely referral to clinical intervention services. Zika Virus: Global Epidemiology • Zika is considered a risk for close to 100 countries worldwide, including countries in South America, Central America, the Caribbean, India, Asia, and Africa. • CDC and WHO recommend that pregnant women not travel to any area where there is a risk of Zika virus, including areas with active local transmission and areas with previous or interrupted transmission (endemic). https://wwwnc.cdc.gov/travel/page/worldmap-areas-with-zika Zika Virus: National Epidemiology • On June 5, Puerto Rico declared the peak of its Zika epidemic to be over; only 10 locally-acquired cases have been reported each month since April (down from 8,000 per month last year). • CDC has not lifted its travel warning, though, noting that pregnant women should still not travel to Puerto Rico. • No ongoing local transmission in the continental U.S. • On June 2, CDC lifted the Zika “cautionary” (yellow) designation for Miami-Dade County since no new cases of local transmission for more than 45 days. • Cumulatively, over 5,000 travel-associated Zika cases have been reported in the continental U.S. since January 2016 (124 total in 2017), including 46 via sexual transmission. U.S. Zika Pregnancy Registry • Cumulatively, since January 2016, 1,883 pregnant women in the continental U.S. have lab evidence of Zika infection and are being followed in the CDC U.S. Zika Pregnancy Registry, which tracks any adverse pregnancy outcomes and the infants up to 12 months after delivery. • So far in continental U.S.,CDC has documented 72 live-born infants with Zika-related birth defects and 8 pregnancy losses. Zika Epidemiology/Response in Georgia • In Georgia, since last January, DPH Epidemiology has triaged about 2,800 Zika clinical inquiries. • Facilitated Zika testing at our Georgia Public Health Laboratory for about 2,015 persons (~75% among pregnant women). • No local Zika transmission in Georgia. • Cumulatively, since January 2016, we have documented 118 travel-related Zika infections. In 2017, we have had only 4 travel-associated Zika cases in Georgia (most recent one was May 4, 2017). • Cumulatively, we have documented ten pregnant women with Zika, two congenital infections, and two instances of sexual transmission. Closing Comments Don’t forget about Zika! • Zika remains a significant public health threat, particularly to pregnant women and their fetuses. • Be aware of travel warnings and areas with previous Zika transmission (such as South Florida), and take appropriate precautions. • Practice strict mosquito-bite prevention while traveling and when you return back to Georgia (for 3 weeks after travel) AND prevent sexual transmission of Zika. • WHO (and DPH) recommends that both women and men who are returning from Zika-affected areas abstain or practice safe sex for 6 months. Acknowledgments Zika Epidemiology Team • Amanda Feldpausch • Ashton Thompson • Skyler Brennan • Jersuha Barton • Shawna Feinman • Teri Graham • Dr. Julie Gabel District Epidemiologists Georgia Public Health Laboratory Other DPH Zika Activity Updates FIND OUT WHAT IT TAKES TO STOP ZIKA Travelmg? PREVENT 7% THE SPREAD OF Virus lm?ectiom Opioid Outbreak Pat O?Neal, MD Health Protection Director Hw Pi i a; Surveillance Observations for the Overdose No.Clayton Cobb- 4 Jonosboro) Dough m8 3-2 . Fulton (W000) ?i mamThese data are limited to patient visits observed from participating hospitals within the North Central Health District who presented with a chief complaint consistent with overdose. The time series below represent dailvr visit counts from Jan 1, 201? through June 3th, 201?. The most signi?cant Idavr at present is June 5th, with 19 visits meeting the narrow overdose definition. We Protect Lives. Overdose for MACON (5-2) 06/05/2017l11? Red bars indicate present, Click to see Raw Del 19 Visits 20 2. 24% of totalas?" w? it Q. Q- 3 WARNING: These data are based on patient chief complaint records from participating emergency departments. These are pre?diagnostic records that rely on language processing techniques that are irnprecise so the actual case counts may be higher or lower. These data are only intended to help identify changes in patient cornplaint patterns and help public health focus etiorts for actual case ?nding. Please do not reproduce or re?distribute. We Protect Lives. Surveillance Observations for the Overdose Overdose for MACON (5-2) 4? 0 Red bars indicate C1.C2.C 3 flags present. Click to see Raw Data gL? 06/05/201 7 (111' '5 19 Vlsits 2. 24% of totalWARNING: These data are based on patient chief complaint records from participating emergency departments. These are pre?diagnostic records that rely on language processing techniques that are imprecise so the actual case counts may be higher or lower. These data are only intended to help identify changes in patient complaint patterns and help public health focus efforts for actual case finding. Please do not reproduce or re?distribute. We Protect Lives. Closing Comments Phillip Williams, Chair We Protect Lives. The next Board of Public Health meeting is currently scheduled on Tuesday, August 8, 2017 @ 1:00 PM. To get added to the notification list for upcoming meetings, send an e-mail to huriyyah.lewis@dph.ga.gov