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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; [email protected]
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; [email protected]
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; [email protected]
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
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; [email protected];
Christopher Cox, MS; DVRD, CDC; 404-639-0045; [email protected]
Peter J. Costa, MPH CHES; Alliance for Rabies Control; 919-830-2199; [email protected]
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
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
WorldRabiesDay.Org
Howard Pue, DVM, MSVPM; State Public Health Veterinarian, Missouri; 573-751-6117; [email protected]
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; [email protected]
Selected Zoonotic Diseases Conference Call
August 5, 2009
Update: West Nile
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Selected Zoonotic Diseases Conference Call
August 5, 2009
