NC's epidemiology and laboratory capacity for prevention and control of emerging infectious diseases - north carolina is the 9TH most populous U.S. State, with an estimated population of nearly 11…

NC's epidemiology and laboratory capacity for prevention and control of emerging infectious diseases - north carolina is the 9TH most populous U.S. State, with an estimated population of nearly 11 million persons. The population has grown more than 12% since the 2010 census, and demographers suggest that our state will become the 7TH most populous state by the early 2030S. While the majority of the population (57%) is concentrated in metropolitan statistical areas, most of our counties (71 of 100) remain rural. According to CDC, rural americans face numerous health disparities compared with their urban counterparts due to a variety of factors including higher rates of poverty, less access to healthcare and public health services, and lower rates of health insurance coverage. During the covid-19 pandemic, these factors contributed to higher mortality rates among persons in rural counties. Furthermore, recent studies have shown a widening GAP in childhood vaccination rates between urban and rural residents, increasing the risk of infectious diseases in rural communities. During 2023, the communicable disease branch received and reviewed slightly more than 157,000 reportable events. Following case investigation, more than 120,000 of these case reports were determined to meet criteria for reporting and national notification and submitted to CDC as part of the national notifiable disease surveillance system. Additionally, as of march 27, 2024, in BP5 our epidemiologist on call had processed reports from local health departments of 1,515 possible outbreaks, and answered 2,235 calls from local health departments, medical providers, and the general public. The overall communicable disease burden in north carolina in comparison to other US states is difficult to quantify, but several infectious diseases have increased significantly in recent years. These include e. Coli, carbapenemase-producing organisms, invasive meningococcal disease, legionellosis, and syphilis. In addition, we continue to experience high rates of covid-19 associated mortality and continue to receive new reports of mpox infections. North carolina is a national leader in livestock farming, with chicken, turkey, and PIG production among the top 3 states. The scope and scale of these industries in the state as compared to other states presents an increased risk for infections with zoonotic potential, as demonstrated by recent outbreaks of highly pathogenic avian influenza in north carolina poultry farms and in one dairy herd. This threat requires close collaboration between public health and agriculture to ensure adequate capacity exists for surveillance, investigation, and response. Since antibiotics are commonly used in the livestock industry, robust epidemiology and laboratory capacity is also needed to detect and respond to antimicrobial disease threats at the human-animal interface. Tracking respiratory diseases is a top priority in north carolina. We have a very robust surveillance infrastructure consisting of our case-based reporting system, north carolina electronic disease surveillance system (NC edss); our syndromic surveillance system, north carolina disease event tracking and epidemiologic collection tool (NC detect); the north carolina wastewater monitoring network; and the laboratory information management system (lims). Significant investments in surveillance and public data sharing for influenza, RSV, and covid-19 have translated to more informed individual risk-based decision making and have helped raise awareness of racial and ethnic disparities.