Epidemiology

What is the role of epidemiology in public health?

Epidemiology identifies the distribution of diseases, factors underlying their source and cause, and methods for their control; this requires an understanding of how political, social and scientific factors intersect to exacerbate disease risk, which makes epidemiology a unique science.

The Bullitt County Health Department (BCHD) investigates cases of communicable diseases such as respiratory viruses, food-borne illnesses, hepatitis, tuberculosis, and sexually transmitted infections (STIs), per 902 KAR 2:020. The epidemiologist is in charge of investigating all of these except for tuberculosis and STIs.

BCHD communicates this information to the Kentucky Department for Public Health who later sends information to the Centers for Disease Control and Prevention (CDC). We also disseminate information to surveillance sites, and community partners, facilitating collaborative efforts to monitor the health status of Bullitt County. This data also aids public and private health officials in educating patients and clients, planning staff training on timely disease topics, and preparing for and responding to disease outbreaks.

Health professionals that are reporting diseases to the Bullitt County Health Department as required by state law can find the appropriate and required forms listed in the link below. Upon completion, please fax the forms to (502) 543-2998. If you have any questions, concerns, or need assistance in reporting please contact our office at (502) 955-7837.

Infectious Disease Branch

Respiratory Viruses

Kentucky Respiratory Disease Dashboard

Table of Reportable Diseases in Kentucky

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Physicians, hospitals, and laboratories are required by 902 KAR 2:020 to report certain communicable diseases to the Health Department’s Epidemiology Unit.

Qualified Health Department staff investigate reported cases and submit required information to the Kentucky Department for Public Health, which then reports appropriate data to the Centers for Disease Control and Prevention (CDC).

Download the appropiate form below and submit via fax (502-543-2998) or phone (502-955-7837).

For Providers Only

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Hand, foot, and mouth disease (HFMD) is a viral infection that spreads through infected droplets. Droplets are sent into the air when a person sneezes or coughs. These can also spread if a person sneezes or coughs into their hand and then touches a surface. This surface can then become contaminated with those droplets. HFMD also can cause blisters to appear on the skin, most commonly on the hands, feet, and the mouth. The fluids from these blisters can spread the virus.

HFMD causes fever, runny nose, and blisters around the hands, feet, and mouth that can be painful and/or itchy. It most commonly affects younger children and is oftentimes spread around schools because of the close contact. To protect your child, be sure to encourage them to have good hand washing habits, and to avoid touching their face. Disinfect your household’s doorknobs and surfaces that they touch if they are sick.

Since these infections are typically minor and resolve on their own, the health department does not usually investigate them. However, if there are more than 3 cases within 72 hours at a daycare, contact the health department. Most often, it is recommended to treat your child by encouraging them to drink water and providing fever-reducing medications like Tylenol or Ibuprofen. It’s important to speak with your family’s pediatrician for more specific recommendations. The Seattle Children’s Hospital has some great recommendations for when you should contact your doctor:

Seattle Children's Hospital

You should keep your child home from school until they have been fever-free without the use of fever-reducing medications for at least 24 hours. Additionally, the blisters on their skin should be dried up and not releasing any excess fluids. Some children may drool because of the mouth sores. If your child is drooling, they should stay home. Their saliva can make people sick.

As an adult, you can get sick, too, but it’s less common. If you do get sick, your symptoms will be very similar to those of your child. Stay home from work as soon as you have a fever, and follow the same guidelines as above (stay home until you have no fever, no blister fluids, and no drooling).

Here are some further resources about hand, foot, and mouth disease from trusted sources:

CDC

Cleveland Clinic

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We have tick removal tweezers and tick wipes available for free (while supplies last)! Data has shown recently that ticks are looking to be especially bad this year, so be sure to stay on guard.

The data (provided by the CDC at https://www.cdc.gov/ticks/data-research/facts-stats/tick-bite-data-tracker.html) is currently showing that in the Southeast Region of the United States, emergency room visits for tick bites are at a recent high, with April having more ER visits for tick bites than any year since 2019, and March having nearly double the number of visits than any year in the past decade. Visits to the ER for tick bites are typically at their highest in May and June, and begin to decline in July, bottoming out around October. Data shows that more males than females have visited the ER for tick bites this year. Children aged 0 to 9 years old have the most ER visits for tick bites than any other age group.

The CDC explains that it is important to remember that these numbers just represent people who had tick bites mentioned in their medical visit notes or chart. They may have visited the ER for some other reason and simply mentioned their tick bite just in case. In any case, these numbers show us two things: (1) ticks may be biting more people this year, and/or (2) there are more ticks this year.

Remember to always check your body for ticks after being outside, especially after being in woody or brushy areas. Tasks that stir up the grass like mowing can make ticks more likely to come out. If you are bit by a tick and start feeling anything abnormal such as joint pains, confusion, stiff neck, or have a rash, it’s a good idea to visit your doctor to rule out any tickborne illnesses.

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Alpha-Gal Syndrome (AGS), also known as the red meat allergy, is a condition associated with tick bites. When a tick bites a human—specifically the Lonestar tick, a species that is found throughout Kentucky—their saliva can contain a sugar molecule called galactose-α-1,3-galactose, or “alpha-gal”. This sugar molecule is found in most mammal products, such as their meat and milk. This is why, after developing AGS, some people will break out in allergic reactions after eating foods like red meat, pork, and sausage, or drinking milk. However, people who have developed AGS can still eat meats like chicken and turkey, since these products do not come from mammals, and are therefore not red meat products. Fish are another great option for those with AGS.

After eating a product that causes a reaction, about 2-10 hours later, one might break out in hives (seen in the image on the right) and experience extreme itchiness; swollen lips, eyelids, or tongue; wheezing, shortness of breath; and drops in blood pressure. Additionally, there can be extreme stomach discomfort and diarrhea. Not everyone will experience every symptom. Some may experience symptoms so severe that they must be rushed to the hospital.

A close-up image of the underside of a human wrist with a red spotted rash on it.

A realistic rendering of a bacterium being destroyed by the immune system with spherical antibodies entering it.

If you suspect you may have AGS, your doctor can test you in a couple of ways. The main way they can test you is by drawing your blood and examining it for the presence of the alpha-gal antibody. Remember, simply eating mammal or red meat does not introduce alpha-gal sugars into the body even though they are present in the meat.

However, the body does become exposed to the alpha-gal sugar from some tick bites, since it wasn’t eaten, but instead sent into the body’s tissues from the tick’s saliva, where it avoids your body’s digestion in the stomach. This leads to your body creating antibodies, known as IgE (immunoglobulin E) antibodies, against alpha-gal sugars.

After the development of these IgE antibodies, once you eat red meats, these IgE antibodies recognize the alpha-gal sugar, triggering an immune response against the alpha-gal. This immune response is what leads to the symptoms that you may experience, like stomach pains, diarrhea, and hives. If your doctor finds these alpha-gal IgE antibodies in your blood, then you may have AGS.

The current guidance to reduce your risk is to protect yourself against tick bites. If you think you may have alpha-gal, speak to your physician to discuss getting tested. AGS is not always permanent, and some cases resolve over time, especially when future tick bites are avoided.

Reference: Yale Medicine. (2023, October 5). Alpha-GAL syndrome (AGS). Yale Medicine. https://www.yalemedicine.org/conditions/alpha-gal-syndrome-ags