Disease Surveillance

Emerging Infections Program

A collaboration of the Tennessee Department of Health, the Vanderbilt University School of Medicine, Department of Health Policy and the Centers for Disease Control and Prevention

The Emerging Infections Program (EIP) is a population-based network including the Centers for Disease Control and Prevention and state health departments, working with collaborators (academic centers, local health departments, infection control practitioners, and other federal agencies) to assess the public health impact of emerging infections and to evaluate methods for their prevention and control.

Currently, the EIP Network consists of 10 sites: California, Colorado, Connecticut, Georgia, Maryland, Minnesota, New Mexico, New York, Oregon and Tennessee.

The Tennessee Emerging Infections Program (EIP) is a collaborative effort of the Communicable and Environmental Diseases and Emergency Preparedness section of the Tennessee Department of Health, the Vanderbilt University School of Medicine, the Department of Health Policy, and the Centers for Disease Control and Prevention. The following twenty counties in Tennessee are involved in the EIP:  Anderson, Blount, Cheatham, Davidson, Dickson, Grainer, Hamilton, Jefferson, Knox, Loudon, Madison, Roane, Robertson, Rutherford, Sevier, Shelby, Sumner, Union, Williamson and Wilson.  Some programs of the EIP encompass the entire state of Tennessee as of January 2003.

The core activity of the EIP is active surveillance of laboratory-confirmed cases of reportable pathogens. Laboratory directors and staff, physicians, nurses, infection control practitioners and medical records personnel are key participants in EIP. Components of the EIP in Tennessee investigate foodborne infections (FoodNet), invasive bacterial infections (ABCs), influenza activities, and healthcare associated infections. 

Contact Information

Influenza Activities

A National Surveillance Resource

The Emerging Infections Programs (EIP) were established in 1995 in response to the Centers for Disease Control and Prevention's (CDC) 1994 strategy, Addressing Emerging Infectious Disease Threats: A Prevention Strategy for the United States  [PDF - 23 pages]. An updated plan released by CDC in 1998, Preventing Emerging Infectious Diseases: A Strategy for the 21st Century  [PDF - 19 pages], described the important role assumed by the EIPs in addressing emerging infections.

The EIP is a network of state health departments and their collaborators in local health departments, academic institutions, other federal agencies, public health and clinical laboratories, infection preventionists, and healthcare providers. The EIP population is roughly representative of the U.S. population on the basis of demographic characteristics such as age, gender, race, and urban residence, as well as health indicators such as population density and percent at or below the poverty level.

The EIP network is a national resource for surveillance, prevention, and control of emerging infectious diseases. EIP activities go beyond routine functions of health departments by:

• Addressing the most important issues in infectious diseases and selecting projects that the EIP network is particularly suited to investigate
• Maintaining sufficient flexibility for emergency response and addressing new problems as they arise
• Developing and evaluating public health interventions and ultimately transferring what is learned to public health agencies
• Incorporating training as a key function of EIP activities
• Giving high priority to projects that lead directly to the prevention of disease

EIP Network Activities 

• Active Bacterial Core surveillance (ABCs): Active population-based laboratory surveillance for invasive bacterial disease. Pathogens included: groups A and B streptococcus, Haemophilus influenzae, Neisseria meningitidis, Streptococcus pneumoniae, and methicillin-resistant Staphylococcus aureus.
• FoodNet: Active population-based laboratory surveillance to monitor the incidence of foodborne diseases. Surveillance is conducted for seven bacterial and two parasitic pathogens: E. coli O157:H7, Campylobacter, Listeria, Salmonella, Shigella, Yersinia, Vibrio, Cryptosporidium, and Cyclospora.
• Influenza activities: Active population-based surveillance for laboratory confirmed influenza-related hospitalizations. EIP sites also conduct influenza vaccine effectiveness evaluations among groups for which ACIP recommends annual vaccination.
• Healthcare Associated Infections-Community Interface (HAIC) projects: Active population-based surveillance for Clostridium difficile infection and other healthcare associated infections caused by pathogens such as MRSA, Candida, and multi-drug resistant gram-negative bacteria. Sites also utilize the National Healthcare Safety Network (NHSN) to perform time-limited evaluations of HAIC data among NHSN facilities participating in the EIP NHSN network.
• The HPV Vaccine Impact Monitoring Project (HPV-IMPACT):  Active population-based surveillance to monitor trends in high-grade cervical lesions, identify changes in HPV subtypes causing disease, and assess the impact of the HPV vaccine. This surveillance effort is ongoing in Davidson County.
  

Surveillance efforts of these core EIP activities generate reliable estimates of the incidence of certain infections and provide the foundation for a variety of epidemiologic studies to explore risk factors, spectrum of disease, and prevention strategies.

Impact

The EIP network’s unique strength and contribution lies in its ability to quickly translate surveillance and research activities into informed policy and public health practice. For example, EIP work has been instrumental in the nation’s post-licensure evaluation of the 7-valent pneumococcal conjugate vaccine, evaluating and honing strategies for preventing severe disease in newborns caused by Group B Streptococcus, developing methodology to estimate ranges of 2009 H1N1 influenza cases and related hospitalization and deaths, and defining the rapidly changing epidemiology and growing burden of MRSA. The network has generated more than 510 publications since 1995 with data obtained from core EIP activities, Active Bacterial Core surveillance (ABCs), FoodNet, Influenza projects, and Healthcare Associated Infections - Community Interface projects, as well as other special studies.

EIP 20th Anniversary

The September 2015 issue of the Emerging Infectious Diseases journal commemorates the 20th anniversary of CDC’s signature Emerging Infections Program (EIP) in 2015. A partnership between CDC, state and local health departments, academic institutions, practitioners, and others, EIP advances CDC’s core mission to prevent the spread of infectious diseases and save lives through pioneer programs like Active Bacterial Core surveillance and FoodNet. The journal features articles on various EIP activities, highlighting how this vital network has strengthened the science base and informed public health policy.

CDC MMWR Publications

www.cdc.gov/mmwr

Interactive Disease Data

Overview of Available Data

The interactive disease data dashboard above displays data on diseases and events reported to the Tennessee Department of Health
(TDH), Division of Communicable and Environmental Diseases and Emergency Preparedness (CEDEP). The dashboard may be used to view data at the state or county/regional level over multiple years.

Data are made available for selected diseases reported since 1995. Additional data or data elements may be requested by emailing tn.health@tn.gov or calling CEDEP at 1-800-404-3006. For information on the current list of all reportable diseases and events in Tennessee, please visit https://www.tn.gov/health/cedep/reportable-diseases.html.

Rates of disease (the number of diseases reported per 100,000 population) were calculated using population projections provided

the TDH Division of Policy, Planning, and Assessment. For more information on health statistics, please visit https://www.tn.gov/health/health-program-areas/statistics.html.

Eighty-nine county health departments operated by the TDH are grouped into 7 administrative regions. Six metropolitan areas and the county they are located within provide service under contract from the TDH. For a map of metropolitan counties and regional health jurisdictions, please visit https://www.tn.gov/health/health-program-areas/localdepartments.html.

Definitions and Data Limitations

Only selected reportable disease and events are available on the dashboard. 

Some records are missing County or Region of residence.

Some diseases and events were not reportable during all years present in the data.

Case definitions and surveillance methods often change, which can produce artificial fluctuations in the number of diseases reported. Case definitions for nationally notifiable conditions are available to view at https://wwwn.cdc.gov/nndss/conditions/search/. 

Case counts for La Crosse Neuroinvasive disease within these data were aggregated with other California serogroup viruses up through 2014. 

Preliminary Data for Animal Rabies

Preliminary Data for Reportable Diseases & Events

Preliminary data is subject to change because of ongoing revision of information and delayed reporting. Careful consideration should be given to any use or presentation of preliminary data. Diseases and events are reported based on Event Date, except for tuberculosis. Event Date based on the following in hierarchical order: date of onset, date of diagnosis, date first reported to county, date first reported to state, and the date the investigation was created in the State surveillance system. Direct questions, comments, or additional recommendations to CEDEP.Surveillance@TN.gov 

 More Information on Assigning MMWR Week in Tennessee

Preliminary STD Reports

Preliminary STD reports are now included in the preliminary Communicable and Environmental Diseases and Emergency Preparedness (CEDEP) weekly reports.

Respiratory Trends

Reports

CEDEP Annual Report

The Annual Report from TDH's Communicable and Environmental Disease and Emergency Preparedness Division provides health care organizations and providers, government and regulatory agencies, and other concerned individuals and groups with important statistical information about potentially preventable diseases. The report can serve as one source of data for them and can help assure that involved individuals and organizations have access to reliable information. The annual report also provides an assessment of the efforts undertaken by CEDEP over a period of years.

Select an Annual Report Year from the drop down menu below:

Immunization Status Survey Of 24-Month-Old Children in Tennessee
An annual survey of the immunization status of 24 month old children is conducted by the CEDEP Immunization Program. The survey tracks progress toward achieving at least 90% on-time immunization with 10 routinely recommended vaccines.

To read annual survey results, select a year below:

Kindergarten Immunization Compliance Assessment
The annual Kindergarten Immunization Compliance Assessment evaluates immunization coverage and exemption levels of state-required vaccines among children entering kindergarten.  The Tennessee Vaccine-Preventable Diseases and Immunization Program (VPDIP) collaborates with the Tennessee Department of Education (TDOE) to conduct this assessment of compliance with immunization requirements designed to ensure a healthy learning environment. 

To read an assessment, select an issue below:

Immunization Status of Tennessee Counties
These infographics provide information about the immunization status of kindergarten students in each of Tennessee’s 95 counties.  High immunization coverage rates are critical if vaccine-preventable disease outbreaks are to be avoided.   

To view an infographic, select a county below:

Tennessee Reports on Healthcare Associated Infections
Healthcare associated infections (HAI) are acquired by patients during the course of receiving treatment for other conditions within a healthcare setting. In Tennessee, hospitals and long-term acute care facilities are required to reporting certain HAIs to the Tennessee Department of Health through the Centers for Disease Control and Prevention’s National Healthcare Safety Network.

To read Reports on Healthcare Associated Infections, select an issue below:

EPI-News
EPI-News is a newsletter which is published by CEDEP to inform the public health community, the private medical community, and the general public on issues related to occurrence of diseases and notifiable conditions within the state.

To be placed on the mailing list for this publication, call 800-404-3006 or e-mail. To read the newsletter online, select an issue below:

Acute Chemical Releases
Tennessee’s National Toxic Substance Incidents Program (NTSIP) performs acute hazardous chemical exposure surveillance. Acute toxic incidents may range from illicit methamphetamine lab explosions in homes to chemical poisoning in automobiles and from industrial chemical releases to transportation incidents. These events frequently require actions to protect public health such as evacuation, in-place sheltering, or decontamination.

To read an Annual NTSIP Report, select a year below:

Surveillance Systems

Coronavirus Disease (COVID-19) Reporting

For more information on case reporting guidance, please visit the following link:

https://www.tn.gov/health/cedep/ncov.html

NEDSS Base System (NBS)

The National Electronic Disease Surveillance System (NEDSS) is a secure online framework that allows these healthcare professionals and government agencies to communicate about infectious and reportable diseases. Contact TDH Communicable Disease Surveillance System and Informatics Program at CEDS.Informatics@tn.gov.

Electronic Case Reporting (ECR) 

Eligible hospitals interested in ECR pilot opportunities should contact TDH Communicable Disease Surveillance Systems and Informatics Program at CEDS.Informatics@tn.gov.

Electronic Lab Reporting (ELR) - For Eligible Hospitals

Contact TDH Communicable Disease Surveillance Systems and Informatics Program at CEDS.Informatics@tn.gov.

1. TDH CEDEP Laboratory Reporting Webpage
2. ELR Submission Fact Sheet (PDF)
3. ELR On-Boarding Handbook
4. ELR FAQs