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Marathon County Board of Health Tuesday, April 5, 2016 at 7:30 AM Meeting Location: 1000 Lake View Drive, Suite 100 Wausau, WI 54403

Committee Members: John Robinson, Chair; Craig McEwen, Vice-Chair; Sue Gantner, RN, Secretary; John Bandow; Susan Coleman; Dean Danner; Julie Fox, DDS; Laura Scudiere; Lori Shepherd, MD Marathon County Mission Statement: Marathon County Government serves people by leading, coordinating, and providing county, regional, and statewide initiatives. It directly or in cooperation with other public and private partners provides services and creates opportunities that make Marathon County and the surrounding area a preferred place to live, work, visit, and do business. (Last updated: 12-20-05) Marathon County Health Department Mission Statement: To advance a healthy Marathon County community by preventing disease, promoting health, and protecting the public from environmental hazards. (Last updated: 5-7-13) Call Meeting to Order Public Comment (15 minute limit) Policy Interpretation

1. Consent Agenda a. Minutes of March 1, 2016

Policy Issues for Discussion and Possible Action

2. Finalize the Selection of the 2017-2020 Community Health Priorities and Overview of Next Steps in Developing Community Health Improvement Plan

3. Highlights of the 2016 County Health Rankings 4. Overview of Marathon County Government Priority Based Budgeting Process 5. Report from the Health & Human Services Committee Meeting held on March 10, 2016

Related to Policy Issues Impacting Public Health

Education, Reports and/or Policy Issues for Discussion Only 6. Update on the Medical College of Wisconsin – Healthier Wisconsin Partnership Program

Behavioral Health Grant 7. Share Healthy Marathon County Educational Letter AB 864 8. Update on Staff Changes and Student Internship Opportunities

Future Agenda Items

9. Next Meeting – May 2, 2016

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Adjourn

FAXED TO: Daily Herald, City Pages, Signed______________________________ Marshfield News, Mid-West Radio Group THIS NOTICE POSTED AT THE COURTHOUSE Date _______ Time______________ By ______________________________ Date_________ Time________________ Any person planning to attend this meeting who needs some type of special accommodation in order to participate should call the County Clerk’s Office at 715-261-1500 or e-mail infomarathon@mail.co.marathon.wi.us one business day before the meeting.

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MARATHON COUNTY BOARD OF HEALTH

March 1, 2016 Present: Craig McEwen, Vice-Chair; Sue Gantner, Secretary; John Bandow, Dean Danner,

Julie Fox, Laura Scudiere Guests: Brad Jourdan, Karen Katz, Corrie Norrbom, Jen Smith MCHD Staff: Judy Burrows, Eileen Eckardt, Dale Grosskurth, Vicki Kowalski, Amanda

Ostrowski, Aaron Ruff, Joan Theurer, Chris Weisgram Call to Order The meeting was called to order by Craig McEwen at 7:31 a.m., followed by introductions. Public Comments No members of the public were present. Policy Interpretation 1. Consent Agenda

A. Minutes – February 2, 2016 Motion to approve the consent agenda made by Sue Gantner. Second made Julie Fox. The consent agenda was approved. Policy Issues for Discussion and Possible Action 2. Selection of the 2017-2020 Community Health Priorities

Joan introduced the task of selecting preliminary priorities for 2017-2020 by the Board of Health and representatives of Healthy Marathon County Board of Directors, with discussion led by Amanda Ostrowski. Amanda explained to the members that have already begun reviewing their top indicators, and asked them to note on easel pads around the room which indicators they individually selected. Gallery Walk – Members reviewed what was selected by the others, and took note of what stands out, and why it has meaning. Members discussed what stood out to them.

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Amanda asked for an explanation of the difference between mental health and behavioral health. Members thought about mental health as a part of behavioral health. Sue shared that she looked up the definitions of both, and found that behavioral health is causative, and affected by environment. Several of the issues could be combined because of similarities, and some go hand-in-hand with each other. Amanda asked for questions about what issues there are questions about. - Karen asked about childhood immunizations – Joan shared that childhood

immunization rates have been going down over the last several years. - Members asked for more information about the issues including childhood trauma,

Early Childhood, etc. All of the childhood specific issues are inter-related, and have a significant impact on development.

- The Board held discussion on aging and end of life care, and the difference between the two.

- Joan asked how we recognize that health is affected by socioeconomic factors, whether it becomes an overarching concept, or other. Sue Gantner commented that it sometimes gets pushed to the side, with the thought that other agencies such as United Way are working on the issue.

- Discussion on where to focus effort, given the issues are intertwined - where is the best place to intervene?

Amanda explained that the next step of the exercise included the opportunity for participants to move their names to different issues, and indicate their top five. The various groupings of issues discussed will be taken into consideration. Members discussed the difficulty in narrowing choices to five issues, and how when the priorities are selected, other issues receive no focus. There are only so many areas that can be impacted, given the limited resources. Joan shared that the State of Wisconsin is in the process of reviewing their ten year plan, with the goal of identifying a few top priorities to leverage resources for the next 4-5 years. Identified issues were prioritized to six areas. Discussion on what areas of Oral Health caused the issue to be selected, including impacts on overall health, and broad general health – need to transition to more preventative care. Discussion on access to health care access and how this affects oral health. Members discussed combining related issues into obesity and childhood trauma. Obesity is the basis for many health issues. Joan shared that the implementation plan would outline who is responsible for each issue, and that current initiatives and available resources would be taken into consideration. Amanda shared that some other organizations are working on certain issues with specific strategies, but there may be gaps in how the issues are addressed. The members discussed partnerships currently in place, such as between the health department and schools for providing fresh foods to students. Joan shared the community health plan is to address county-wide issues and directs resources and identifies opportunities with public health system partners.

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Preliminary selection of community health priorities included: Priority Final Votes Adverse Childhood Experiences Includes votes from Early Childhood (8), Childhood Trauma (2), ACEs (1), Child Abuse and Neglect (2), Early Prenatal Care (1), Social/Emotional Development (1), and Intimate Partner Violence and Sexual Assault (1)

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Alcohol and Other Drug Misuse and Abuse 15 Behavioral Health (Access to Mental Health) 13 Oral Health 9 Social and Economic Factors that Influence Health Includes Health Equity (1) and Access to Healthcare (3)

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Health Needs of Aging 5 Healthy Weight Includes votes from Health Eating (2)

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Joan reviewed next steps: revisit preliminary selection of priorities in relationship to the criteria, share State of WI preliminary selection, and further narrow focus within priorities selected. Further discussion will take place at the next meeting.

3. Determine Interest in Attending the WPHA/WALHDAB Annual Public Health

Conference May 24-26, 2016 at the Radisson Paper Valley Hotel, Appleton

Craig asked if there was interest from the Board members in attending the conference. Laura Scudiere and Sue Gantner indicated interest in attending. Joan will bring names forward to the Health & Human Services committee. Others can e-mail Joan if they decide they would like to attend.

4. Report from the Health & Human Services Committee Meetings held on February 25,

2016 Related to Policy Issues Impacting Public Health

Updates will be provided at next month’s meeting. The Committee is looking to start meeting twice a month, given the issues being addressed.

5. Review Updated “Board of Health Policy Opportunities & Strategies for 2016”

Document and Develop a Communication Plan with Area Legislators and Policy Makers on Public Health

Joan reviewed the update provided in the packet on conversation held at the last meeting. Board members had expressed interest to connect with policy makers to increase awareness of public health funding and issues impacting the health of our community.

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Previous discussion of holding sessions with policy makers in March or April would have impacts on planning time from health department staff. Joan recommended this be revisited after April’s identification of priorities so there is more time to plan in light of staff and Board resources that would be needed. Joan indicated that the Healthy Marathon County is looking at bringing funding partners to the table in the fall to share opportunities. There could be similar meetings for policy makers.

Education, Reports and/or Policy Issues for Discussion Only 6. Overview of Zika Virus and Public Health Surveillance and Prevention Activities

Occurring in Wisconsin Eileen provided an update in the packet, and shared that most requests for information have been from health care providers. Testing is being conducted in the state, but only for pregnant women at this time. Sue Gantner asked if the technical college and UWMC are aware of how to share information with students who may be travelling for spring break. The health department is conducting surveillance throughout the year on a variety of current and potential diseases in the community.

7. Opportunity to Partner with Ministry Health Care Community Benefit & Community Health Improvement to Share UW Population Health Fellow 2016-2018 Joan shared that Julie Hladky, who works in community benefits for Ministry Health Care, applied for having the fellowship as a partnership between Ministry and the Health department. A phone interview for the candidate is scheduled for next week.

Future Agenda Items 8. Next Meeting – April 5, 2016 Motion to adjourn made by Laura Scudiere. Second made by Dean Danner. The meeting adjourned at 8:54 a.m. Respectfully submitted, Sue Gantner, Secretary Chris Weisgram, Recorder

March 25, 2016 Page 1

Health Officer Notes April 2016

Policy Issues for Discussion and Possible Action 2. Finalize the Selection of the 2017-2020 Community Health Priorities and Overview of Next

Steps in Developing Community Health Improvement Plan – Representatives from the Healthy Marathon County Board of Directors will be joining a facilitated process to review and finalize the selection of the 2017-2020 Community Health Priorities. Amanda Ostrowski, Public Health Educator, will facilitate the process that is expected to take one hour. I will provide an overview of next steps in developing the 2017-2020 Community Health Improvement Plan to guide partners and our department’s actions in support of priorities selected. A summary of the March 1, 2016 discussion and preliminary discussion is enclosed, along with a worksheet to be completed prior to the April 5, 2016 meeting.

3. Highlights of the 2016 County Health Rankings – I will briefly highlight gains made, and challenges, based upon the measures of health from the County Health Rankings released on March 16, 2016. Enclosed, find the Community Health Rankings Q & A document along with one-page indicators.

4. Overview of Marathon County Government Priority Based Budgeting Process – I will briefly explain the process and benefits of Marathon County working with the Center for Priority Based Budgeting for the 2017 budget and beyond.

5. Report from the Health & Human Services Committee Meeting held on March 10, 2016 Related to Policy Issues Impacting Public Health – John Robinson will provide an update on policy issues discussed at the March 10, 2016 Health & Human Services Committee meeting.

Education, Reports and/or Policy Issues for Discussion Only

6. Update on the Medical College of Wisconsin – Healthier Wisconsin Partnership Program

Behavioral Health Grant – Judy will share an update on the grant process. Twenty-three proposals were submitted. Marathon County Health Department was selected to move on to the second phase of the grant process and will provide a “pitch” presentation on April 7th. Thirteen grants were selected to provide a “pitch” presentation, having up to ten proposals selected. Communities selected will be funded for up to eight years.

7. Share Healthy Marathon County Educational Letter AB 864 – Enclosed, find a copy of an educational letter to Senators Petrowski, Moulton, and Tiffany on behalf of Healthy Marathon County. The Senate did pass this bill.

8. Update on Staff Changes and Student Internship Opportunities – Heather Busig, Public Health Nurse, resigned on March 17, 2016. The Health Department is in the process of filling the positon. The Health Department will be sharing a UW Population Health Fellow with Ministry Health Care, starting in July 2016, for a two-year placement.

Review the definitions of the seven selected health priorities. Consider what type of action can be taken within the next four years. If you feel there is capacity to address a health priority with a specific action, place a checkmark in that box. For example, if I believe our community can address healthy weight by modifying the environment, I would place checkmark in the corresponding box. If it helps you, jot down a few notes to share with the group what type of intervention you were thinking of.

Access: Addressing access barriers to services which can include availability, affordability, transportation, language and cultural barriers.

Awareness/Attitude: Increasing individual's/family's, organization's and community's awareness of the nature of the problem/issue and understanding of the impact and what can be done.

Knowledge/Skill: Educating individuals/families, organizations and communities on choices they have, benefits of those choices and empowering them to act by giving them needed skills.

Behavior/Environment: Supporting individual's/family's, organization's and community's health choices and behaviors. This includes modifying the environment to support the desired behavior.

Policy: Developing policies within organizations, communities, county, state and federal level to support desired outcome.

Oral Health: Promoting healthy teeth and the entire mouth such as gums, chewing muscles, palate, tongue, with the goal of being free of tooth decay, gum disease, oral cancer and free of chronic oral pain. Behavioral Health: Promoting well-being by preventing or intervening in mental illness such as depression or anxiety, along with preventing or intervening in substance abuse or other addictions. Alcohol and Other Drug Use and Misuse: Creating a culture in communities where alcohol is used responsibly and other drugs (prescription and elicit) are not misused.

Health Needs of Aging: Developing and maintaining optimal mental, social, and physical well-being and function into older adulthood. Includes addressing basic needs, optimizing health and well-being, promoting social/civic engagement, and supporting independence.

Adverse Childhood Experiences: Preventing or reducing the impact of potentially traumatic events that can have negative, lasting effects on health and well-being. These experiences range from physical, emotional, or sexual abuse to parental divorce or the incarceration of a parent or guardian.

Social and Economic Factors that Influence Health: Addressing conditions in which "people are born, grow, live and work and age" and the broader forces that shape the health of our communities including "economics, social policies, and politics". Includes employment, community safety, income, educational attainment, family and social support, as well as racism and other forms of discrimination. In addition, includes concept of "health equity" as defined as "fairness in the distribution of power and resources and the freedom to achieve healthy outcomes between groups of differing levels of social disadvantage." Healthy Weight: A weight that lowers your risk for health problems. Achievement or maintenance of a healthy weight includes healthy food choices and physical activity.

Community Health Improvement Plan Process March 1, 2016

Decisionmakers: Board of Health Member, Healthy Marathon County Members

After a facilitated in process in which various health priorities were reviewed, selected, discussed, then ranked by group members, the following health priorities rose to the top:

Priority Final Votes Adverse Childhood Experiences Includes votes from Early Childhood (8), Childhood Trauma (2), ACEs (1), Child Abuse and Neglect (2), Early Prenatal Care (1), Social/Emotional Development (1), and Intimate Partner Violence and Sexual Assault (1)

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Alcohol and Other Drug Misuse and Abuse 15 Behavioral Health 13 Oral Health 9 Social and Economic Factors that Influence Health Includes Health Equity (1) and Access to Healthcare (3)

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Health Needs of Aging 5 Healthy Weight Includes votes from Health Eating (2)

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• Heavy votes are priorities that are "behaviors" • Mental health is part of behavioral health, with the caution that it can be seen that the

behavior is the responsibility of person, not considering their environment • Health equity is woven through

• Core public health functions (did they pick them because they felt this is what MCHD/Public Health is *supposed* to do?) Joan shared that the CHIPP is greater than the workplan of public health.

• Great Start for kids is the ultimate preventer; 2-generational approach • Health Needs of Aging and Mental Health have an intersect: Dimentia • Where in the cycle of poverty do you start? Suggestion was multi-sector approach--everyone

takes a piece of the web • How do we focus on priorities yet still consider other issues? • Access: can a person get to a provider?

Detailed discussion regarding Oral Health was had. A few considerations that were shared by group

members included:

• Impacts on overall health and broad general health • Aesthetic (i.e. impact on ability to get hired, thus leading to impact on income and

unemployment)

• Currently, people are taking care of their oral health as a reaction to pain, not primary prevention

• Oral healthcare comes last in priorities • Inter-professional education (i.e. with OBs)

2016 County Health Rankings for Marathon County Q & A Document

March 16, 2016

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What are the County Health Rankings? The County Health Rankings rank the overall health of counties in all 50 states – using a standard way to measure how healthy people are and how long they live. The Rankings are the result of a partnership between University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation. The County Health Rankings looks at how long people live and how healthy people feel while they are alive. What do the Rankings tell us about our community? The Rankings remind community leaders and the public there is a lot more to health than access to health care – that where we live, learn, work, and play matters to our health. It’s hard to have a healthy life if you don’t live in a healthy community. What counties are the Healthiest for 2016? Wisconsin’s healthiest county is Ozaukee – followed by Calumet, St. Croix, Pierce, and Pepin. The counties in the poorest health are Menominee, Milwaukee, Washburn, Forest, and Sawyer. How does Marathon County rank for 2016? Better or Worse? Marathon County continues to be among the healthiest in Wisconsin. Marathon County ranked in the top quarter for health outcomes (16 out of 72 counties) and health factors (15). The good news is Marathon County has and continues to be in the top third of the 72 counties - 22 in 2015, 24 in 2014, 18 in 2013. How is the health of Marathon County residents measured? The overall Health Outcomes summary score is a weighted composite of Length of life (50%) and Quality of life (50%). The Rankings utilizes national data sources, analyzing data from a single year or multiple years. For 2016, several measures that were multiple years are now single year. For example, data for adult smoking and excessive drinking is from 2014. Each measure is weighted, have measures vary – for example adult smoking is weighted 10% while excessive alcohol use is weighted 2.5%. Categories of health measured include: Health Outcomes (ranked 16), made up of the following factors;

• Length of Life (ranked 26): Premature death, as defined as years of potential life lost before age 75 per 100,000 population (age-adjusted)

• Quality of Life (ranked 14): Poor or fair health, poor physical health days, poor mental health days, low birthweight

2016 County Health Rankings for Marathon County Q & A Document

March 16, 2016

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Health Factors (ranked 15), made up of the following factors; • Health Behaviors (ranked 22): adult smoking, adult obesity, food environment index,

physical inactivity, access to exercise opportunities, excessive drinking, alcohol-impaired driving deaths, sexually transmitted infections, teenage births

• Clinical Care (ranked 19): percent of uninsured under the age of 65, primary care physicians, dentists, mental health providers, preventable hospital stays, diabetic monitoring, mammography screening

• Social and Economic (17): high school graduation, some college, unemployment, children in poverty, income inequality, children in single-parent households, social associations, violent crime, and injury deaths

• Physical Environment (34): air pollution, drinking water violations, severe housing problems, driving alone to work, long commute-driving alone

For more information on the Rankings, visit www.countyhealthrankings.org Nationally, what do this year’s Rankings tell us? Nationally, this year’s Rankings show that rural counties have higher rates of premature death, higher rates of smoking, obesity, child poverty, teen births, and higher number of uninsured adults than urban counties. Large urban counties have lower smoking and obesity rates, fewer injury deaths and more residents who attend some college. Large suburban counties have the lowest rates of childhood poverty and teen births. What are leaders doing to have Marathon County be the healthiest county is Wisconsin? The Rankings inform us that health is everyone’s business. People from all different sectors in our community need to work together to create programs and policies to help people make healthy lifestyle choices and to address the social and economic drives of health. The Rankings illustrate how the health of our communities is intrinsically linked to the social and economic wellbeing of a community. The Rankings reinforce where we need to focus our resources to be among the healthiest counties in Wisconsin. The findings support the 2015-2017 LIFE Report Calls to Action, the 2012-2016 Marathon County Health Priorities and the United Way of Marathon County Community Impact Goals. Marathon County is fortunate to have rich partnerships across diverse community sectors who are involved in creating a culture where individuals and families are physically active, alcohol is used safely, and where everyone, regardless of income, is able to access healthy foods. In addition, the Rankings reinforce community initiatives underway to address the social and economic drives of health such as kindergarten readiness and family supporting jobs. To read more about what is being done in Marathon County to address key priorities visit: www.healthymarathoncounty.org and www.unitedwaymc.org.

Marathon (MR)

MarathonCounty

ErrorMargin

Top U.S.Performers^ Wisconsin Rank

(of 72)

Health Outcomes 16Length of Life 26

Premature death 5,500 5,000-5,900 5,200 6,000

Quality of Life 14

Poor or fair health** 12% 11-12% 12% 15%

Poor physical health days** 3.1 3.0-3.3 2.9 3.7

Poor mental health days** 3.3 3.1-3.4 2.8 3.7

Low birthweight 6% 6-6% 6% 7%

Health Factors 15Health Behaviors 22Adult smoking** 16% 15-17% 14% 17%Adult obesity 30% 25-34% 25% 29%

Food environment index 8.1 8.3 7.9

Physical inactivity 25% 21-29% 20% 22%

Access to exercise opportunities 74% 91% 81%

Excessive drinking** 24% 23-25% 12% 23%

Alcohol-impaired driving deaths 27% 21-33% 14% 38%

Sexually transmitted infections 247.2 134.1 411.6

Teen births 23 21-24 19 26

Clinical Care 19

Uninsured 10% 9-11% 11% 11%

Primary care physicians 1,140:1 1,040:1 1,220:1

Dentists 1,370:1 1,340:1 1,590:1

Mental health providers 700:1 370:1 590:1

Preventable hospital stays 50 46-54 38 48

Diabetic monitoring 92% 86-98% 90% 90%

Mammography screening 71% 65-76% 71% 71%

Social & Economic Factors 17

High school graduation 93% 93% 88%

Some college 63% 60-66% 72% 67%

Unemployment 5.1% 3.5% 5.5%

Children in poverty 15% 12-18% 13% 18%

Income inequality 4.1 3.9-4.2 3.7 4.3

Children in single-parent households 26% 23-29% 21% 31%

Social associations 13.9 22.1 11.8

Violent crime 133 59 255

Injury deaths 53 47-58 51 65

Physical Environment 34

Air pollution - particulate matter 11.3 9.5 11.5

Drinking water violations Yes No

Severe housing problems 12% 11-13% 9% 15%

Driving alone to work 82% 81-83% 71% 80%

Long commute - driving alone 16% 15-17% 15% 26%

^ 10th/90th percentile, i.e., only 10% are better.* Data supplied on behalf of stateNote: Blank values reflect unreliable or missing data** Data should not be compared with prior years due to changes in definition/methods

2016

Page 1 of 1Marathon County, Wisconsin | County Health Rankings & Roadmaps

3/28/2016http://www.countyhealthrankings.org/app/wisconsin/2016/county/snapshots/073/exclude-additional

1000 Lake View Drive, Suite 100 | Wausau, WI 54403 | www.healthymarathoncounty.org

March 9, 2016

Senator Jerry Petrowski P. O. Box 7882 Madison, WI 53707-7882

Subject: Assembly Bill 864: Youth Access to Alcohol

Dear Senator Petrowski:

Healthy Marathon County is writing to share our perspectives as to the potential negative impacts on public health, especially to underage youth, in regard to AB 864, Youth Access to Alcohol.

Like many communities across the state, alcohol misuse has been identified as a community health priority in Marathon County. Changing our culture around alcohol requires a multi-generational approach, which includes strategies to limit youth access. Current research shows that effective and regular compliance checks help to decrease alcohol sales to minors, reduce underage drinking, reduce traffic accidents, violence, and other health problems associated with alcohol, and build healthier and safer communities. According to What Works for Health, “…compliance checks are most effective when checks are frequent, well-publicized, well-designed, solicit community support, and involve penalties to the licensed establishment, instead of just the server. Applying penalties to the licensee encourages managerial changes that support a culture and environment that is more compliant with alcohol sales laws.”

Healthy Marathon County supports evidence based practices such as compliance checks. Current law permits licensees and/or servers to receive compliance check citations in the event that there is a sale to a minor working with law enforcement. This exercise in local control is extremely important in the event that repeated citations are written, which is evidence that the licensee is not providing sufficient training or guidance on how to check ID and screen customers. We are concerned that AB 864 will make it less likely that licensees are held responsible for alcohol sales to youth at their establishments, even with repeated violations, as AB 864 requires that citations from alcohol age compliance check violations go to the individual who sold the alcohol and not to the licensee.

Alcohol misuse affects every man, woman and child living in this state, contributing to child abuse and neglect, domestic violence, job loss, and criminal behavior. The cost of excessive alcohol use in Marathon County alone is $152.4 million annually, costing $1,137.05 per resident (March 2013, The Burden of Excessive Alcohol Use in Wisconsin, UW-Population Health). To create a culture where alcohol is used safely, we need to create public policy that will reduce youth access.

On behalf of Healthy Marathon County, I would like to thank you for your consideration.

Respectfully, Jennifer A. Smith, President Healthy Marathon County Board of Directors

Week Ending 1/2 1/9 1/16 1/23 1/30 2/6 2/13 2/20 2/27 3/5Chlamydia 0 9 7 6 5 2 9 9 2 6Gonorrhea 0 0 0 0 1 1 0 0 0 1Syphilis 0 0 0 0 0 0 0 0 0 0TOTAL 0 9 7 6 6 3 9 9 2 7

Week Ending 1/2 1/9 1/16 1/23 1/30 2/6 2/13 2/20 2/27 3/5Campylobacter 0 0 1 0 1 0 0 1 2 1Cryptosporidium 0 2 0 0 0 0 0 0 0 0Shiga Toxin Producing E coli 1 0 0 0 0 1 0 0 0 0Giardia 0 1 0 0 0 0 0 0 0 0Salmonella 0 0 0 0 0 0 1 0 0 0Shigella 0 0 0 0 0 0 0 0 0 0TOTAL 1 3 1 0 1 1 1 1 2 1

Category IWeek Ending 1/2 1/9 1/16 1/23 1/30 2/6 2/13 2/20 2/27 3/5Hepatitis A 0 0 0 0 0 0 0 0 0 0Pertussis 0 0 0 0 0 1 1 1 1 0TB 0 0 0 0 1 0 0 0 1 0TOTAL 0 0 0 0 1 1 1 1 2 0

OthersWeek Ending 1/2 1/9 1/16 1/23 1/30 2/6 2/13 2/20 2/27 3/5Babesiosis 0 0 0 0 0 0 0 0 0 0Blastomycosis 0 1 0 0 0 0 0 1 0 0Anaplasmosis/Ehrlichiosis 0 0 0 0 0 0 0 0 0 0Hepatitis B 0 0 0 0 0 0 0 0 0 0Hepatitis C 0 1 0 0 0 0 0 0 0 0Influenza Hospitalization 0 0 1 0 0 1 0 0 2 1Lyme 0 0 0 0 0 0 0 0 0 0Mumps 0 0 0 0 0 0 0 0 0 0Strep, invasive 1 0 0 0 0 1 2 1 0 0Varicella 0 0 0 0 0 0 0 0 1 0West Nile Virus 0 0 0 0 0 0 0 0 0 0TOTAL 1 2 1 0 0 2 2 2 3 1

TOTAL, ALL CATEGORIES 2 14 9 6 8 7 13 13 9 9

Sexually Transmitted Diseases

Food & Waterborne Disease

WEEKLY SURVEILLANCE OF REPORTABLE DISEASES 2016

Week EndingChlamydiaGonorrheaSyphilisTOTAL

Week EndingCampylobacterCryptosporidiumShiga Toxin Producing E coliGiardiaSalmonellaShigellaTOTAL

Category IWeek EndingHepatitis APertussisTBTOTAL

OthersWeek EndingBabesiosisBlastomycosisAnaplasmosis/EhrlichiosisHepatitis BHepatitis CInfluenza HospitalizationLymeMumpsStrep, invasiveVaricellaWest Nile VirusTOTAL

TOTAL, ALL CATEGORIES

Sexually Transmitted Disease

Food & Waterborne Disease

WEEKLY SURVE

3/12 3/19 YTD5 6 660 0 30 0 05 6 69

3/12 3/19 YTD0 2 80 0 20 0 20 0 10 0 10 0 00 2 14

3/12 3/19 YTD0 0 02 1 70 0 22 1 9

3/12 3/19 YTD0 0 00 0 20 0 00 0 00 0 16 4 150 0 00 0 02 0 70 0 10 0 08 4 26

15 13 118