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The 14th Annual Michigan Communicable Disease Conference

May 19, 2014

Preventive medicine residents from the University of Michigan Program travelled north on Thursday to Bay City, Michigan to join the largest meeting of the state’s infectious disease epidemiologists and public health staff. While the trip up there was gloomy, cold, and rainy, when we absorbed the first presentation on the impact of medical history on public health and its upstream path, it seemed only symbolic of where we started. The progress we made in sanitation, sewerage and infection control, with the infamous Great Stink from the Thames that forced London MPs to meet outside of London, to the situation we are in now, was immense. However, as the meeting went on, we realized there were many challenges that we continue to face as a nation and in Michigan, specifically.

The presenters noted that:

  1. Carbapenem-Resistant Enterobacteriaceae (CRE) infections are increasing. That there is a potential threat from community spread and that the treatments available are extremely limited, with pan-resistant strains identified.
  • The importance of hand hygiene and contact precautions were highlighted. There was some good news with 51 cases in Michigan that were prevented.
  1. There is a Methicillin-Resistant Staphylococcus Aureaus (MRSA) and Clostridium Difficile Prevention Initiative, a collaborative between the Michigan Department of Community Health, Michigan Society for Infection Prevention & Control, and others to integrate evidence-based practice to reduce MRSA/CI in Michigan.
  • Monthly data collection from acute care centers and skilled nursing facilities and conference calls to communicate updates between collaborators has been ongoing since 2011.
  1. There has been a Hepatitis A outbreak in several counties in Michigan, of unknown source.
  2. Patterns of hospitalizations in Michigan for influenza has been found to be similar to national patterns.
  3. High rates of undervaccination in Michigan likely related to a high number of waivers. Michigan has the 4th highest number of waivers in the nation.
  4. There was a measles outbreak in Midland County in an unvaccinated family.
  5. Hepatitis C (HCV) diagnosis and treatments are underfunded from Medicaid, not matching increasing incidence and mortality rates and future expectations from HCV infection. The number of confirmed cases in Michigan have risen more than 50% since 2004. The number of young adults (18-25 years) is rising, so it is not just a cohort effect from those who were infected in the 1960s.
  • It is essential to incorporate measures of deduplication in HCV surveillance to ensure not counting cases more than once.

All in all, this was a great opportunity to learn of our state’s public health with regards to communicable disease. Though we were left concerned with several issues, for example the withdrawal of Medicaid funding for newer HCV treatments, our outlook and awareness improved markedly on our way back, as with the weather!

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