Bureau of Epidemiology

Provides epidemiological services including technical assistance and expert consultation to county health departments and others to investigate outbreaks of infectious and other diseases that have epidemic potential. Develops statewide policies for disease prevention and intervention strategies for disease containment or control. Conducts special studies to assess health risk associated with newly emerging infectious agents and other public health hazards. Provides surveillance and infectious disease education and training on surveillance activities, investigation of outbreaks and general epidemiologic principles and practices. Provides technical assistance regarding disease reporting, data management, investigation and disease intervention and control. Provides chronic disease epidemiological services including cancer case reporting, manages the state cancer registry, the Behavioral Risk Factor Surveillance system and the Pregnancy Risk Assessment Monitoring System. Other responsibilities include the analysis of information collected during epidemiologic investigation of chronic diseases including cancer, heart disease, stroke, diabetes, hypertension and similar conditions.

The Bureau of Epidemiology is charged with the responsibility to provide current information and technical support to public and private health care providers regarding the control of communicable diseases in accordance with Florida Statutes, Chapter 381, and Florida Administrative Code, Chapter 10D-3. Activities include statewide investigation, intervention, monitoring and coordinated reporting of communicable diseases; epidemiological education and consultation to infectious disease control staff including county health departments, laboratories, local hospitals, managed care organizations and private physicians. Weekly reporting and coordination of services with the Centers for Disease Control and Prevention (CDC) is also required including data and information used to prepare the Morbidity and Mortality Weekly Report (MMWR) published by the U.S. Public Health Service, Centers for Disease Control and Prevention. County health department staff forward reports of communicable diseases to state program staff and investigate cases to determine source of the agent, the mode of transmission, the time of transmission and whether other people have been exposed. Outbreaks are investigated to determine source. Control measures are taken around individual cases and outbreaks. Surveillance of reportable diseases by county health department staff permit the Department to take prompt preventive measures around individual cases of preventable diseases. For example:

• Provide emergency antibiotic treatment to children and staff in day care centers exposed to a case of bacterial meningitis;
• Take prompt preventive measures when a cluster of preventable diseases occur-for example, to deal with a hot tub or ventilation system in a building that is leading to cases of Legionnaire's disease;
• Take prompt preventive measures when a foodborne outbreak is identified by closing a restaurant temporarily or excluding specific food-handlers from working;
• Identify high-risk groups for certain infections and concentrate preventive measures-for example, by identifying neighborhoods in which measles immunization levels are low in preschool children and set up special immunization clinics;
• Identify high-risk groups for certain infections in which screening programs are needed-for example, groups of children who might need tuberculosis screening and preventive treatment.

The Bureau operates Florida's state cancer registry through a contract with the University of Miami and under NPCR have supplemental CDC funding. Cancer incidence and mortality data are available at the Florida Cancer Data System. Annual summaries of cancer incidences and mortality are published. Analysis of cancer data support planning, evaluation of cancer prevention and control programs. State Cancer Registry data are also used to evaluate possible cancer clusters.

The Behavioral Risk Factor surveillance System is a rolling telephone survey of Florida adults that provides needed information on the prevalence of smoking, obesity, seat belt use, mammography usage, and similar measures of risk of serious illness. The Pregnancy Risk Assessment Monitoring System (PRAMS) is a continuing random survey of mothers of Florida newborns, designed to provide information about risk factors for pregnancy adverse outcomes and ill health in newborns. Finally, the Florida Youth Tobacco Survey is a school-based survey of tobacco beliefs, attitudes and behaviors.