The Epidemiology team is responsible for investigating reportable diseases in Tulsa County in a timely manner in order to prevent and/or minimize the transmission of illness. THD epidemiologists also conduct surveillance of emergency department data in order to track trends and identify potential bioterrorism events or communicable disease outbreaks. Additionally, the Epidemiology team is responsible for data analysis of internal and external data.

The Epidemiology team provides education and outreach in order to limit the spread of disease in Tulsa County. This is done through one-on-one disease investigations that are reported to THD, as well as, through community outreach events and presentations. Presentations on public health concerns were provided to local businesses, professional organizations, and residential facilities. The THD Epidemiology team also supports the mission of THD by providing data internally and externally to ensure that programs and interventions are appropriately targeting those populations most at risk of specific diseases or conditions. Throughout the COVID-19 pandemic, the epidemiology team has been the lead contact tracers making countless calls to Tulsa County to provide accurate and up-to-date recommendations for their situations. The team has also been an asset to area schools as they navigate in-person education for their students.

From Abhishek Shakya: It has been a tough journey for the epi team this past year while working on numerous cases of COVID-19 and other reportable diseases. This past year has been an emotional rollercoaster for so many individuals, families, and communities including the THD family. It was especially difficult while trying to educate and support all the individuals and families affected by COVID-19. One encounter comes to mind when I think of the last year. I came in contact with this family who had suffered loss from COVID-19. This family did not believe in COVID-19 before their loved one passed away. Then, there was a second member of the family who was infected with COVID-19. I was able to build good rapport and educate the family about the disease and help them take necessary precautions to prevent further spreading of COVID-19. This family was really receptive of the information and willing to do anything to protect others. This made me feel very positive about the job we do in the field of epidemiology to protect the public. I believe our experience with such a tragic global pandemic has made all of us stronger as we all came together to collect data, educate the public and make mass vaccinations possible. These impactful moments and many other interactions by my co-workers with clients have provided this team the resilience to cope with stress as we are constantly trying to impact the community by providing resourceful information and guidance in these trying times.

From Madison Thomas: It is sometimes challenging to think about the work we have been doing for the past year and a half during the COVID-19 pandemic and find any upside. However, something that I often think of when reflecting on the experiences of the pandemic is the new relationships that were formed and the ones that were strengthened. A great example of this involves the family of the first reported case of COVID-19 reported in Oklahoma. I was the epidemiologist assigned to this case and while I have worked hundreds of COVID-19 cases since March of 2020, this case will always stick out to me. Being the first reported case in the state came with so many unforeseen challenges for this family and as this was the first time investigating a case in these circumstances, it was truly a learning process for all involved. Despite the extremely stressful situation, this family did a wonderful job cooperating with the health department and following the COVID-19 public health guidelines that were recommended to them to protect their family, friends, and community. For many weeks this family faced new challenges and would often reach out to talk through these situations. A bond was formed with this family, and we remain in contact. This was the first of many connections made with Tulsa County residents as well as community partners and is a true testament to how important the work we do is. The pandemic has been an opportunity to build trust within the community one person at a time.

From Raven Helmick: Schools, both higher education and PreK-12, were quite heavily impacted during the COVID-19 pandemic and became responsible for providing education in a safe and protected environment. That proved difficult in the past year. Our team helped many schools and daycares navigate the rough waters. On a personal level, I got to know quite a few school nurses who were put in tough situations and needed guidance, especially when facing opposition to their goals of providing a safe environment for their students and staff. COVID-19 updates and protocols changed so much over the past year that it could make anyone’s head spin, and for every change the THD epi team was there to answer calls, provide specific situational guidance and lend a listening ear to school nurses from a variety of educational settings. Nurses and schools began to see that they could rely on our team to always be available and answer their questions with up-to-date guidance to provide next steps when a specific COVID situation would arise.

From Ciara Patuto: There was a point a few months back (May or June) where I spoke to a lady who was hesitant about becoming vaccinated against COVID-19. She seemed embarrassed to ask me some of the questions she had, so I stopped and reassured her that I was not here to judge her – I was here to help her make her decision and give her as much knowledge as I could. We ended up being on the phone for 45 minutes or so, and it was a great conversation! She ended up saying she felt much more comfortable getting her vaccine. These are the conversations that are important and make me happy to be in this field. The world is so divided right now, and it is draining for everyone to be a part of at some points. Being able to discuss hard topics openly and honestly with people is important, and I’m honored I could be that person for this lady.

Although COVID-19 was a focus for the team, the team continued to respond to other reportable diseases throughout the pandemic.

From Liz Martin: A situation that comes to mind that demonstrates the impact our program can make is with our hepatitis-C clients. Sometimes they can be difficult to reach if they are experiencing homelessness or do not have a phone. Reaching the client might involve sending notification letters to homeless shelters to request a call back, searching multiple databases and calling a hospital or doctor’s office to review contact information. It is always worthwhile once the client is reached, and they are often grateful someone took the time to speak with them about their diagnosis. Providing education and connecting a person to care in this circumstance requires additional effort on our part, but going the extra mile is essential to deliver the same caliber of service to each client.

Technology upates

The Tulsa Health Department has been conducting syndromic surveillance of local emergency department data for almost 20 years. Developed for THD in 2002, the Tulsa Area Syndromic Surveillance System (TASSS) was the first syndromic surveillance system for Oklahoma and one of the first systems set up in the country. The TASSS program was created locally to be used by THD for the early detection of diseases and bioterrorist events. In May of 2021, the THD Epidemiology team transitioned to a new syndromic surveillance system called the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE). The process of transitioning to the new system was a very involved process that required creativity, innovation and problem solving by the team as well as collaboration with internal and external partners to produce a new and improved system for conducting syndromic surveillance.

ESSENCE is used by many state and local health departments across 48 other states and the District of Columbia. ESSENCE is utilized in Oklahoma by the Oklahoma City-County Health Department (OCCHD), as well as, the Oklahoma State Department of Health (OSDH) and thus this transition allowed THD to align our syndromic surveillance efforts with OCCHD and OSDH. ESSENCE has numerous features and configuration options that the previous system did not have allowing for improvement in our processes and increased THD’s capacity to conduct syndromic surveillance.

By the Numbers

• Conducted 150 outbreak investigations related to daycares, schools, long term cares, churches, and behavioral health.
• Provided mosquito and tick-borne illness information/items to 24 individuals

Diseases

The below case count only reflects the number of confirmed and probable cases.

• Cryptosporidiosis: 12 cases
• Campylobacter: 127 cases
• Coronavirus: 71,742 cases
• E. coli: 29 cases
• H. flu: 9 cases
• HAV: 4 cases
• HBV: 318 cases
• HCV: 980 cases
• Meningitis: 0 cases
• Measles: 0 cases
• Mumps: 01cases
• Pertussis: 1 cases
• Salmonellosis: 73 cases
• Shigellosis: 2 cases
• Tickborne: 0 cases
• West Nile Virus: 0 cases