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Intro to the Office of Infectious Disease Epidemiology and
Outbreak Response
Alvina Chu, MHS (JHSPH ’98)
DHMH Location DHMH Location
201 West Preston Street Baltimore, MD 21201
GOVERNOR Martin O’Malley
Regulatory Programs
Secretary John M. Colmers
Health Care Financing Operations
Governmental Affairs
Financial Management
Office of Human Resources
Information Resources Management Admin.
Vital Statistics Administration
Capital Planning, Budgeting and
Engineering Services
Office of Procurement and Support Services
Health Professional Boards and
Commissions Maryland
Board of Nursing
Maryland Board of Physicians
Maryland Health Care Commission
Health Services Cost Review commission
Maryland Community Health Resources
Commission Office of
Health Services
Office of Eligibility
Office of Operations and Pharmacy
Public Health Services
Infectious Disease and Environmental Health
Administration
Family Health Administration
Laboratories Administration
Office of the Chief Medical Examiner
Office of Preparedness and Response
Anatomy Board
Office of the Inspector General Office of Health Care Quality
Office of the Attorney General Chief Administrative Officer
Behavioral Health and Disabilities
Forensic Services Resident Grievance System
Co-occurring Disorders Alcohol and Drug Abuse
Administration
Developmental Disabilities Administration
Mental Health Administration
Office of Minority Health and Health Disparities Office of Diversity and Inclusion
Office of Planning
Volunteer Services
Health Workforce
Maryland Department of Health and Mental Hygiene
Local Public Health
Infectious Disease Epidemiology and Outbreak Response (IDEOR)
• Responsible for all communicable diseases – except HIV/AIDS, TB, STIs
– Approximately 60-70 employees
– ~ 50% are epis (Masters-level and higher)
• Program Director: David Blythe, MD, MPH
Selected IDEOR Activities
• Lead and coordinate outbreak investigations – Outbreaks are reportable in MD – Average ~350 outbreaks/year
• Coordinate ID surveillance – >30,000 reports/year – NEDSS (current statewide system)
Selected IDEOR Activities
• Develop ID-related – Plans – Guidelines – Fact sheets – Other public educational materials
• Coordinate immunizations
• Conduct applied public health research
Reportable Infectious Diseases in MD
• By Maryland law, certain diseases and conditions must be reported
• Two principal sources of reports: – Health care providers (Health-General §18-201) – Laboratories (Health General §18-205)
• Reports go to the health officer (or a “duly designated representative”) then is transmitted to the Secretary
Reportable Infectious Diseases and Conditions of Public Health Importance
• Amebiasis • Anaplasmosis • Animal bites • Anthrax • Arboviral infections Babesiosis • Bacteremia in newborns • Botulism • Brucellosis • Campylobacteriosis • Chancroid • Chlamydia trachomatis, genital infections • Cholera • Coccidioidomycosis • Creutzfeldt-Jakob disease • Cryptosporidiosis • Cyclosporiasis • Diphtheria • Ehrlichiosis • Encephalitis, infectious • Epsilon toxin of Clostridium perfringens • Escherichia coli O157:H7 infection • Giardiasis • Glanders • Gonococcal infection • Haemophilus influenzae, invasive disease • Hantavirus infection • Harmful algal bloom related illness • Hemolytic uremic syndrome, post-diarrheal
• Hepatitis A infection • Hepatitis, viral (B, C, D, E, G, all other types
and undetermined) • Human immunodeficiency virus (HIV) • Influenza-associated pediatric mortality • Influenza: novel influenza A virus infection • Isosporiasis • Kawasaki syndrome • Legionellosis • Leprosy • Leptospirosis • Listeriosis • Lyme disease • Malaria • Measles (rubeola) • Melioidosis • Meningitis, infectious • Meningococcal, invasive disease • Microsporidiosis • Mumps (infectious parotitis) • Mycobacteriosis, other than tuberculosis and
leprosy • Pertussis • Pertussis vaccine adverse reactions • Pesticide related illness • Plague • Pneumonia in a health care worker resulting
in hospitalization • Poliomyelitis
• Psittacosis • Q fever • Rabies (human) • Ricin toxin poisoning • Rocky Mountain spotted fever • Rubella (German measles) and congenital
rubella syndrome • Salmonellosis (nontyphoidal) • Severe acute respiratory syndrome (SARS) • Shiga-like toxin producing enteric bacterial
infections • Shigellosis • Smallpox and other orthopoxvirus infections • Staphylococcal enterotoxin B poisoning • Streptococcal invasive disease, Group A • Streptococcal invasive disease, Group B • Streptococcus pneumoniae, invasive disease • Syphilis • Tetanus • Trichinosis • Tuberculosis and suspected tuberculosis • Tularemia • Typhoid fever (case, carrier, or both, of
Salmonella Typhi) • Varicella (chickenpox), fatal cases only • Vibriosis, non-cholera • Viral hemorrhagic fevers (all types) • Yersiniosis
Local Health Departments
Daily Activities
• Keeping up to date with latest research and guidance
• Creating guidance for case and outbreak investigations
• Writing public information (e.g. fact sheets, FAQs, website)
Daily Activities
• Consulting with CDC • Coordinating
investigations within MD and with other state health departments
• Responding to media and public requests for information
Daily Activities
• Analyzing data for research studies, investigations
• Assuring data quality
• Entering data to databases and reporting systems
Daily Activities
• Training LHDs • Presenting and
lecturing for groups
Daily Activities
• Evaluating quality of investigations at LHDs (i.e. site visits)
• Consulting on-site or working in the field during investigations
“Rooftop survey of downtown”
Daily Activities
• Participate in field investigations: interview cases
“Interviewing FSWs during outbreak investigation”
Daily Activities
• Participate in field investigations: collect specimens
“Demonstrating use of PPE”
How I got here …
• 4th grade: ES science fair • College major: Natural sciences • Masters at JHSPH: MMI • 1st PH job: GIS mapping of infectious
diseases (Lyme, STIs) • 1st DHMH job: Syndromic surveillance for
bioterrorism events post-2001 anthrax event • 2nd DHMH job: Outbreak investigations
Who’s hiring epis?
Industries with the highest levels of employment in this occupation:
Industry Employment % of industry employment
Hourly mean wage
Annual mean wage
State Government 1,430 0.06 $28.96 $60,230
Local Government 1,160 0.02 $29.36 $61,060
General Medical and Surgical Hospitals 580 0.01 $37.91 $78,850
Colleges, Universities, and Professional Schools 360 0.01 $31.54 $65,610
Scientific Research and Development Services 330 0.05 $35.75 $74,370
U.S. Dept. of Labor, Bureau of Labor Statistics: Occupational Employment and Wages, May 2010
What’s the pay like? Top paying industries for this occupation:
Industry Employment Percent of industry
employment
Hourly mean wage
Annual mean wage
Pharmaceutical and Medicine Manufacturing 230 0.08 $50.23 $104,470
Outpatient Care Centers 70 0.01 $39.51 $82,180
General Medical and Surgical Hospitals 580 0.01 $37.91 $78,850
Management, Scientific, and Technical Consulting Services 230 0.02 $36.63 $76,190
Specialty (except Psychiatric and Substance Abuse) Hospitals 50 0.02 $36.30 $75,500
U.S. Dept. of Labor, Bureau of Labor Statistics: Occupational Employment and Wages, May 2009
Pay Scale for Epis at DHMH
• Epi I (base pay ~ $40 - 60,000) – Master's in PH field
• Epi II (base pay ~ $43 - 67,000)
– Master’s in PH field + 2 years experience
• Epi III (base pay ~ $46 - 73,000) – Master’s in PH field + 3 years experience – OR Doctorate in PH field
A Day (July 11, 2010) in the Life of…
• Outbreak of giardiasis associated with a community swimming pool
• Outbreak of pneumonia/rule-out legionellosis at a long term care facility
• International outbreak of measles in refugees, exposures at camp and on plane.
• Case investigation of typhoid fever carrier ex UK
A Day (July 2, 2010) in the Life of…
• Case investigation and restrictions for S. Paratyhpi A positive foodservice worker
• Follow up on reassorted swine-origin H3N2/2009 H1N1
• Outbreak of S. Berta associated with a pig roast
• Follow up on post-exposure assessment for MD residents to rabid Zebra in Kenya
How to apply to DHMH
1. Complete MS-100 “Job Application”
How to apply to DHMH
2. OHR will tell you if you are “Best Qualified”, “Better Qualified”, “Qualified”, or not qualified
3. Will be placed on “Eligible List” (for 1 year) to receive notifications about active recruitments
4. Then some variable amount of time passes…
How to apply to DHMH
5. May receive a notice that there is an active recruitment going on
6. If you are interested, send in your resume to the address on the notice
7. If you are not interested, return the form saying you are not interested
8. If you do not return the form, you will be removed from the Eligible List
