Content Information
A. Purpose of Surveillance and Reporting
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To determine cases and clusters of cases that could be associated with a bioterrorism event
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To focus prevention and control efforts
- To determine whether a source of infection may be a public health concern
B. Laboratory and Healthcare Provider Reporting Requirements
Tularemia requires immediate reporting if the provider reasonably believes or suspects that that Francisella tularensis infection may be the result of a deliberate act of terrorism. Tularemia is also reportable if it is a cause or suspected cause of an outbreak, which would be an uncommon situation given its usual modes of spread.
Laboratory Testing Services Available
The University of Iowa State Hygienic Laboratory (SHL) provides services for testing clinical specimens for Francisella tularensis and for confirmation of isolates from sentinel laboratories. Sentinel laboratories can send specimens (blood, tissue biopsies, discharge fluid, vesicle fluid, etc.) to SHL. Isolates submitted from other laboratories will be confirmed and/or identified. Additionally, all laboratories are asked to submit all isolates cultured for further identification to aid in the public health surveillance and necessary to prevent the spread of this disease. SHL must be contacted before samples are submitted for safety purposes. For more information on submitting samples, contact SHL at 319-335-4500, or visit: www.shl.uiowa.edu/
Iowa Administrative Code 641-1.3(139) stipulates that the laboratory and the healthcare provider must report. The preferred method of reporting a case that is NOT SUSPECTED of being related to bioterrorism is by utilizing the Iowa Disease Surveillance System (IDSS). However, if IDSS is not available, the reporting number for IDPH Center for Acute Disease Epidemiology (CADE) is (800) 362-2736; fax number (515) 281-5698.
C. Local Public Health Agency Follow-up Responsibilities
Case Investigation: Investigation of cases is directed by the Iowa Department of Public Health Center for Acute Disease Epidemiology (CADE). The cooperation of local public health agencies, laboratories, and medical providers is requested.