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Randolph Daley, DVM, MPHCaptain, USPHS
Chief, Field Services BranchDivision of State and Local Readiness
PIHOA Board MeetingAugust 12, 2014
Career Epidemiology Field Officer
Supporting Epidemiology Preparedness in the Pacific Islands
Office of Public Health Preparedness and Response
Division of State and Local Readiness
Public Health Concernsin the Pacific
DiseasesInfectious — Measles, Chikungunya,
Malaria, Dengue, Leptospirosis, Hansen’s Disease, Tuberculosis, Influenza
Chronic — Cardiovascular disease, Diabetes
Environmental HealthNatural disasters — typhoons, tsunamisFood and water systems
Surveillance System DevelopmentPopulation Movements
Career Epidemiology Field Officer (CEFO) Program
Created in 2002 in response to attacks of 9/11
Mission — strengthen nationwide epidemiologic capability for public health preparedness and response
Assigns CDC epidemiologist to health departments
Funded through CDC’s Public Health Emergency Preparedness (PHEP) cooperative agreement
How Can a CEFO Benefit the Health Department?
Applied epidemiology Surveillance Outbreak investigation Analysis Communication
Additional expertise Clinical Scientific
How Can a CEFO Benefit the Health Department?
Connection to CDC Field Services Branch support CDC subject matter experts Liaison for information exchange
CEFO Activities
Strengthen state and local surveillance systems
Conduct outbreak investigations and response
Lead community assessment activities Provide expertise on the design,
implementation, and analysis of epidemiologic studies
Develop response plans for public health emergencies
Build partnerships for emergency preparedness
Serve on emergency response teams Lead portions of state’s planning and
response activities Lead or participate in emergency response
exercises
Surveillance
DevelopmentPostdisaster systems — outpatient,
shelter settingsRoutine — reportable conditions
MaintenanceEvaluationCoordination with CDC — BioSense
Cases of Cholera — Sofala Province, Mozambique
1 2 3 4 5 6 7 8 9 100
50100150200250300350400450
1999
2000
Week of the Year
Wee
kly
Cli
nic
al C
hol
era
Cas
es
1950
52
54
56
58
1960
62
64
66
68
1970
72
74
76
78
1980
82
84
86
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1990
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2000
0100200300400500600700800900
Year
Ca
se
s (
tho
us
an
ds
)Measles — United States, 1950–2006
2 Doses
EndemicElimination Declared
Vaccine Licensed 1963
Outbreak Investigations
Local/RegionalNationalPandemic preparednessRecent examples
Healthcare-associated infections — Hepatitis C, Clostridium difficile
Cyclosporiasis Middle East Respiratory Syndrome (MERS)
1
2
3
6
7
4
5
12 13 14 28Exposure Date
Index Case
2nd Generation Case
3rd Generation Case
PA
PA
MI
MI
TX TX
TX
Measles Outbreak — United States,August 2007
CASPER
Community Assessment for Public HealthEmergency Response
Methodology for postdisaster rapid needs assessment
Community assessmentPreparednessDisease burdenRisk factors
CASPER
CASPER
CASPER
Workforce Development
Training activitiesLecturesWorkshopsStudent Programs
MentorshipJunior health department staffEpidemic Intelligence Service (EIS)
OfficersCouncil of State and Territorial
Epidemiologist (CSTE)Applied Epidemiology Fellows
Public Health Associate Program (PHAP) Fellows
Preparedness Field Assignees (PFAs)
CEFOs in Action
Field Services Branch
Mission — strengthen nationwide public health preparedness and response capability through service at state, tribal, local, and territorial health departments
Programs Career Epidemiology Field Officer Preparedness Field Assignee
Staff CDC Headquarters — 11 CEFOs — 33 PFAs — 17
Career Epidemiology Field OfficersAssignment Locations, September 2014
Jackson Schmitz
Fleischauer MacFarquha
r
Goode
Patel Campagnolo Miller
Dentinger Harper Quinn
Thoroughma
n Groenewold
Pickard
O’Leary
Buss
Holzbauer
SunenshineAdams
Carter Tarkhashvili
M
orr
iso
n
Nett
Margaret Riggs
Kurkjian
McFadden
Pre
ace
ly
Navon
Wilken
Thomas
Roth Murphree
Edison
David Callahan
Mary DottAs of September, 2014, 33 CEFOs are assigned to 27 jurisdictions
Venuto
CEFO for the Pacific IslandsConceptPacific Island Health Officers
Association (PIHOA) Regional approach Concentration of CDC staff
Direct CDC funding Pilot of alternative funding model National health security
Collaborative direction
CEFO for the Pacific Islands
ChallengesMultiple Jurisdictions Assessment of risk and needs Collaborative prioritization from PIHOA
Board Regional projects Planned activities in all jurisdictions Enhancement of jurisdictional staff
Travel Dedicated funding Collaboration with other CDC programs In-kind support
CEFO for the Pacific Islands
ChallengesRight Candidate Diverse epidemiology skills Experience with Pacific jurisdictions Experience with CDC Collaborative and diplomatic Independent Clinical skills
CEFO for the Pacific Islands
OpportunitiesExperienced epidemiologist dedicatedto the Pacific Islands
Crosscutting approach across multiple disease areas
Strengthen regional collaborationAttract additional resources
Collaboration with regional partners Enhanced communication with CDC CDC fellowship programs
CEFO for the Pacific Islands
TimelinePlanning meetingsFeasibility assessment — June 6–13,
2014Development of support mechanisms
Contract, cooperative agreement Supervisory collaboration
Application processProgress report — August 12, 2014
CEFO for the Pacific Islands
TimelineCEFO candidate selection — Oct 2014Contract in place with PIHOA — Nov
2014CEFO assignment — Dec 2014Jurisdictional risk and needs
assessmentCooperative agreement with PIHOA —
Apr 2014
Conclusions
CEFOs provide variety of skills and expertise
CEFO placement and support must be a collaborative effort
CEFO Program will benefit Pacific Island jurisdictions
Randolph Daleywdaley@cdc.gov
CEFO Program(770) 488-8881cefo@cdc.gov
www.cdc.gov/phpr/science/cefo.htm
Questions?
Office of Public Health Preparedness and Response
Division of State and Local Readiness
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Preparedness Field Assignee (PFA) Program
Two-year practicum placing graduates of Public Health Associate Program (PHAP) with PHEP awardees
Funded directly by CDC
Mission — Develop skill in emergency preparedness and response through field experience
PFAs make a significant contribution to the awardee
PFA Activities Emergency response plans Technical assistance Exercise development and evaulation Outbreak investigations Partnership development for community
resilience GIS mapping of at-risk populations Situational awareness reports Capability-based gaps analysis
Preparedness Field AssigneesAssignment Locations, August 2014
As of August 1, 2014, 17 PFAs are assigned to 16 state , territorial, or local health departments.
McCullough
Joseph
Lira
Awardees with PFAs
Kirley
Vento
Bowman
Jean,Kurian (NYC)
Li (Los Angeles)
Cutts (Chicago)
BlackShultz
Peart
Driesse
Haugen
Burgess