Lessons Learned From an Intensive Writing Training Course for Applied Epidemiologists.

Although writing is a valued public health competency, authors face a multitude of barriers (eg, lack of time, lack of mentorship, lack of appropriate instruction) to publication. Few writing courses for applied public health professionals have been documented. In 2017 and 2018, the Council of State and Territorial Epidemiologists and the Centers for Disease Control and Prevention partnered to implement a Intensive Writing Training course to improve the quality of submissions from applied epidemiologists working at health departments.

An Innovative Method of Measuring Changes in Access to Healthful Foods in School Lunch Programs: Findings from a Pilot Evaluation.

Introduction: A large local health department in Colorado partnered with 15 school districts to develop an approach to evaluate changes in access to healthy foods in reimbursable school lunches and a la carte offerings.

Materials And Methods: School district nutrition managers were engaged at the start of this project. Health department dietitians developed criteria to classify food items as "Lower Fat and less added Sugar" (LFS) and "Higher Fat and more added Sugar" (HFS) based on the percentage of calories from fat and grams of added sugar.

Risk of very low birth weight based on perinatal periods of risk.

Objective: To determine the risk factors associated with having a very low birth weight (VLBW) infant as a follow-up to the first phase of a Perinatal Periods of Risk approach.

Design And Sample: Retrospective cohort analysis of birth certificates. Population-based sample of 53,427 birth certificates for the city under study during the years 1999-2006.

Comparison of 3 school-based influenza surveillance indicators: lessons learned from 2009 pandemic influenza A (H1N1)--Denver Metropolitan Region, Colorado.

Context: Early in the 2009 pandemic influenza A (H1N1) experience, children aged 5 to 17 years were determined to be disproportionately affected compared with recent influenza seasons.

Objective: To characterize the pandemic among school-aged children, to enable timely influenza outbreak identification, and to determine which school-based influenza surveillance indicator correlated most closely with a laboratory-based standard influenza indicator (standard) and, therefore, might be most useful for future school-based influenza surveillance.

Design: : During the 2009-2010 school year, we monitored students using 3 different surveillance indicators: (1) all-cause absenteeism, (2) influenza-like illness (ILI)-related absenteeism, (3) and ILI-related school health office visits.

Derby district redevelopment in Colorado: case study on the health impact assessment process.

Health Impact Assessment (HIA) is a tool that is increasingly utilized in the U.S. to shape policies that may impact the public's health.

Needlestick injury surveillance during mass vaccination clinics: lessons learned and why more is needed--Tri-County (Denver Metropolitan) region, Colorado, 2009.

Tri-County Health Department studied needlestick injury (NSI) risks in pandemic influenza A (H1N1) mass vaccination clinics through incident reports and an Internet-based vaccinator survey. The mass vaccination clinic NSI rate was 4.9 times the mean rate observed during Tri-County Health Department's 2003 to 2009 routine vaccination clinics.

Outbreak of shiga toxin-producing Escherichia coli serotype O26: H11 infection at a child care center in Colorado.

Background: Shiga toxin-producing Escherichia coli (STEC) O26:H11 is an emerging cause of disease with serious potential consequences in children. The epidemiology and clinical spectrum of O26:H11 are incompletely understood. We investigated an outbreak of O26:H11 infection among children younger than 48 months of age and employees at a child care center.

Primary care physicians perceptions and practices regarding fall prevention in adult's 65 years and over.

Background: Falls are the leading cause of injury deaths and the most common cause of disability, premature nursing home admissions, medical costs, and hospitalizations among people 65 years and over. Interventions targeting multiple fall risk factors can reduce fall rates by 30-40%. Yet, national studies show that screening conducted by physicians for older adult falls is short of acceptable standards.

Use of hospital discharge data to evaluate notifiable disease reporting to Colorado's Electronic Disease Reporting System.

Objective: Notifiable disease surveillance systems are critical for communicable disease control, and accurate and timely reporting of hospitalized patients who represent the most severe cases is important. A local health department in metropolitan Denver used inpatient hospital discharge (IHD) data to evaluate the sensitivity, timeliness, and data quality of reporting eight notifiable diseases to the Colorado Electronic Disease Reporting System (CEDRS).

Methods: Using IHD data, we detected hospitalized patients admitted from 2003 through 2005 with a discharge diagnosis associated with one of eight notifiable diseases.

Assessment of shellfish practices in licensed retail food establishments in response to increased Vibrio illnesses in a landlocked area.

Cases of non-cholera Vibrio illness are typically associated with exposure to shellfish from marine coastal areas (U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, 2009), not landlocked states such as Colorado.

Cluster of presumed organic dust toxic syndrome cases among urban landscape workers-Colorado, 2007.

Background: Organic dust toxic syndrome (ODTS) is an influenza-like illness typically affecting agricultural workers exposed to organic dusts. In July 2007, Tri-County Health Department investigated a cluster of acute respiratory illnesses among urban landscape workers with known mulch exposure.

Methods: An epidemiologic study of landscape workers was conducted.

Health care-associated outbreak of Salmonella Tennessee in a neonatal intensive care unit.

Background: In December 2006, we investigated an outbreak of Salmonella serotype Tennessee in a neonatal intensive care unit (NICU) that coincided with a nationwide Salmonella Tennessee outbreak associated with contaminated peanut butter.

Methods: Salmonellosis was defined as isolation of Salmonella Tennessee from any clinical specimen or more than 1 episode of bloody stool within a 24-hour period. We conducted a cohort study among 13 NICU infants, reviewed medical records, cultured stool from infants and staff, collected environmental samples, and examined infection control practices.

Internet- versus telephone-based local outbreak investigations.

We compared 5 locally conducted, Internet-based outbreak investigations with 5 telephone-based investigations. Internet-based surveys required less completion time, and response rates were similar for both investigation methods. Participant satisfaction with Internet-based surveys was high.

Environmental predictors of human West Nile virus infections, Colorado.

To determine whether environmental surveillance of West Nile Virus-positive dead birds, mosquito pools, equines, and sentinel chickens helped predict human cases in metropolitan Denver, Colorado, during 2003, we analyzed human surveillance data and environmental data. Birds successfully predicted the highest proportion of human cases, followed by mosquito pools, and equines.

Active influenza surveillance at the local level: a model for local health agencies.

Laboratory-supported, community-based local surveillance systems for influenza can act as early warning systems in identifying the initial entry points of different influenza strains into the community. Unfortunately, local health departments often have limited resources to implement this type of surveillance. We developed and evaluated an active, local influenza surveillance system in 3 metropolitan Denver, Colo, counties that enabled timely case ascertainment and strain identification at little cost.

Assessment of missing immunizations and immunization-related barriers among WIC populations at the local level.

Objective: Low childhood immunization rates have been a challenge in Colorado, an issue that was exacerbated by a diphtheria-tetanus-acellular pertussis (DTaP) vaccine shortage that began in 2001. To combat this shortage, the locally based Tri-County Health Department conducted a study to assess immunization-related barriers among children in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a population at risk for undervaccination.

Methods: This study assessed characteristics and perceptions of WIC mothers in conjunction with their children's immunization status in four clinics.

Rapid needs assessment among Hurricane Katrina evacuees in metro-Denver.

During September 2005, 3,600 Gulf Coast evacuees arrived in metropolitan Denver, in the aftermath of Hurricane Katrina. To better meet the medical and non-medical needs of this displaced population, a rapid needs assessment was conducted among 106 evacuee households. The assessment identified a large need for prescription medications, with 60.

Evaluation of the timeliness and completeness of a Web-based notifiable disease reporting system by a local health department.

Objective: To evaluate the completeness and timeliness of the Colorado statewide Web-based system for reporting notifiable diseases, called the Colorado Electronic Disease Reporting System. This project demonstrates how a local health department can conduct a surveillance evaluation to identify areas of improvement.

Methods: Reports received by Colorado for 2004 were categorized as Tri-County Health Department (TCHD) reports and reports received for the rest of Colorado.

Hepatitis A in a food worker and subsequent prophylaxis of restaurant patrons.

A laboratory-confirmed case of hepatitis A was reported to Tri-County Health Department (TCHD) in Colorado, and the infected person was subsequently determined to have been a food worker at a local restaurant during the period of infectiousness. After conducting a public health risk assessment, TCHD decided to offer immune globulin (IG) to potentially exposed restaurant patrons. A two-day clinic in Adams County, Colorado, administered IG to 693 individuals.

Cluster of invasive salmonellosis cases in a federal prison in Colorado.

We report a cluster of 3 cases of invasive salmonellosis without gastroenteritis among prisoners, in the absence of a gastroenteritis outbreak. Raw foods illicitly taken from the prison kitchen and improperly stored and prepared were possible sources of infection. We describe the investigation of this cluster and discuss the unique implications of invasive, nongastroenteritis salmonellosis in the prison setting, both for clinicians and for public health agencies that seek to control infections in prisons.

Follow-up of 2003 human West Nile virus infections, Denver, Colorado.

Tri-County Health Department and Boulder County Public Health conducted a follow-up study of all nonfatal West Nile virus (WNV) cases reported during 2003 in 4 metropolitan Denver, Colorado, counties. Self-reported patient information was obtained approximately 6 months after onset. A total of 656 (81.

Escherichia coli O157:H7 outbreak associated with consumption of ground beef, June-July 2002.

Objective: A case-control and environmental study tested the hypothesis that purchasing and eating ground beef from a specific source was the cause of a cluster of cases of hemolytic uremic syndrome (HUS) and Escherichia coli (E. coli) O157:H7 gastroenteritis.

Methods: A case-control study comparing risk factors was conducted over the telephone on nine case-patients with 23 selected controls.

A Foodborne Outbreak Traced to Niacin Overenrichment.

In September 1983, the Vermont Department of Health identified seven employees who developed facial and skin flushing and erythema within minutes of eating lunch in a hospital cafeteria. None had vomiting or diarrhea. Because of the unusual nature of the symptoms, a case-control study was undertaken.