Protecting Public Health through Infectious Disease Surveillance

Belinda E. Ostrowsky, M.D.

This blog post is part of a weekly series focusing on different aspects of public health leading up to Public Health Thank You Day on Monday, November 21, 2016. Join the conversation on social media with the hashtag #PHTYD and visit www.publichealththankyouday.org for more information. 

I remember walking into my first patient consultation as a medical student on Infectious Diseases (ID) rotation.

“Are you the detective who is going to figure out what is wrong with me?” The patient asked.

As one of the few specialties that covers the entire body, ID physicians evaluate patients in great detail and with an open mind.

Because infections and the effects of antibiotics reach far beyond individual patients, we must think globally. This flexibility and diverse skill set allow ID clinicians to tackle evolving public health challenges.                      

ID physicians contribute to public health in a variety of ways:

  • Working at health departments to lead outbreak responses and immunization and screening efforts;
  • Conducting surveillance of antimicrobial resistance and other threats;
  • Evaluating the effectiveness of public health interventions;
  • Developing new vaccines and other prevention tools;
  • Leading public health efforts at hospitals.

I lead the infection prevention and control program and the antimicrobial stewardship program at my hospital, and regularly interface with state and local public health officials.

Infections can complicate many other areas of medicine, including surgeries, chemotherapy, and care of fragile patients. Infection prevention and control programs are required by Medicare and necessary for successful patient care. As the leader of my hospital’s program, I design and implement protocols to prevent and rapidly identify infections and reduce transmission. I also coordinate with state and local public health entities to track threats, patterns, and the impact of our efforts. My specialized ID training has given me expert knowledge on how best to interrupt the transmission of infections and gives my colleagues in other areas of medicine confidence in my advice.

I also lead my hospital’s antimicrobial stewardship program, which promotes appropriate antibiotic use. This effort is significant because antibiotic misuse and overuse is a key driver in the development of antibiotic resistance and C. difficile.

I educate other prescribers about antibiotic use, provide tools and assessment to help clinicians make optimal choices regarding diagnosis and antibiotic use, and assess our institution’s trends regarding antibiotic use and resistance patterns. My ID training has endowed me with deep knowledge in the use of antimicrobial drugs, the use and interpretation of diagnostic tests, the management of patients with serious infections, and the broader impact of antibiotic use on public health. I am fortunate that leadership at my healthcare system realized more than 8 years ago that these activities are integral to patient safety and community success (such as improved antibiotic use in outpatient settings). 

As our nation grapples with healthcare-associated infections and antimicrobial resistance, w​e need a robust workforce, including ID physicians, to lead, communicate, and educate different stakeholders about these important efforts. Luckily, we are well trained, experienced, nimble, and up for whatever challenges may come!

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