Team D Overview
MDH epidemiologists oversee a team of 8 to 10 interviewers (“Team Diarrhea”) who are part-time MDH employees hired from a pool of MPH students at the University of Minnesota, School of Public Health. Each student works approximately 20 hours per week. Team Diarrhea’s hours of operation are Monday through Thursday, 9 a.m. to 8:30 p. m.; Friday, 9 a.m. to 5 p.m.; and Sunday 4 p.m. to 8 p.m. Scheduling night and weekend hours for interviewers increases the likelihood that cases will be able to be reached for interview.
The Team Diarrhea students are intensively trained and supervised by MDH epidemiologists. They conduct phone interviews of reportable enteric pathogen cases identified through surveillance with a detailed questionnaire about illness and exposures, including brand and variety names of foods eaten and where foods were purchased. When a potential outbreak is identified, the data from these questionnaires is reviewed by an epidemiologist as the first step in the outbreak investigation. As the investigation progresses, the Team Diarrhea students will conduct additional interviews as needed, assist with data entry and analysis, and assist the epidemiologist with other duties. When a suspect food vehicle is identified, the lead epidemiologist works with the appropriate state and federal regulatory agencies to address the suspect food. This approach allows MDH to rapidly detect, investigate, and solve foodborne disease outbreaks.
Team Diarrhea Activities
Team Diarrhea is responsible for the collection of case data from health care providers:
- Reportable diseases rule requires reporting by health care provider AND submission of isolate/clinical materials to the Public Health Laboratory (PHL).
- Team Diarrhea students will look for report cards based on positive results at the PHL. If any (or all) data are missing, they will call the health care provider and/or clinical laboratory to get the information.
- Team Diarrhea students interview cases about their illness and exposures.
Cluster and outbreak investigations
Team Diarrhea’s role includes:
- Interview cases and controls
- If a PFGE cluster: students may have to call cases back to ask additional questions (determined by lead epidemiologist investigator). Students are encouraged to review questionnaires of previously interviewed cluster cases before calling new cases
- Data entry
- Data analysis (encouraged)
- Specimen collection kit drop-off/pick-up (we have a state car available at all times)
- Look up phone numbers for names on reservations or credit cards
- Participate in outbreak conference calls
- Participate in unit meetings
Students are briefed on what epidemiologists know/think. New students are trained on the form (i.e., why we need an onset time, or why we need each answere circled)
Data entry, data management, data analysis, and/or miscellaneous projects
Team Diarrhea students are responsible for data collection and data entry for surveillance and outbreaks, and are able to work on special projects. Examples of activities include:
- Enter surveillance data into MEDSS
- Enter data from exposure interviews
- Enter PFGE updates
- Enter data for special projects
- Participate in different aspects of special projects
FoodNet research studies
Team Diarrhea students play an important role in studies conducted in collaboration with FoodNet. Their responsibilities include:
- Interviewing cases, and recruiting and interviewing controls, for case-control studies of sporadic infection
- Perform other study-related duties as assigned (e.g., updating tracking spreadsheets)
- Data entry
- Participate in conference calls
Assist with other disease investigations
Students work on major public health emergencies investigated in the Acute Disease Investigation and Control Section as needed. They may help make phone calls or take calls from the public, they may staff hotlines, or they may pick up samples. 2012 examples: H1N1 and fungal meningitis.
On the job training is provided to all the Team D students:
- MDH new employee training done on the first couple of days (sick, vacation, holidays, policies, evacuation plan, time cards, harassment policy, etc.)
- Data practices (state laws regarding private vs public data) and how it relates to HIPAA training done upon hiring (HIPAA rules training is done at the University)
- Minnesota Electronic Disease Surveillance system (MEDSS) training upon hiring
- Calling clinics training done by pairing with current student
- Interviewing training done by epidemiologist (go over every question), followed by listening to a more experience student. Students start out with the easiest interviews, and asked to do more difficult ones once they gain experience. Completed interviews are reviewed by epidemiologists and feedback is provided.
- Disease-specific training is done by: 1 – having students read reference materials; 2 – providing a summary “cheat sheet”; and, 3 – on-going feedback (i.e., epidemiologists discuss what we know about each pathogens on a regular basis).
Field Experience and Master’s Projects
- Students can use their Team d experience to fulfill their field experience requirement (90 hours) for their MPH degree.
- Many students will use MDH data for their MPH thesis projects. Typically they will work with an epidemiologist as their project advisor; several MDH epidemiologists have adjunct appointments at the University and thus can serve on student thesis committees.
Team Diarrhea was first formed in 1995. From 1999 through 2013, 129 students have worked as part of Team Diarrhea. Of those, 20 were unpaid interns. One hundred and sixteen of the 129 were students enrolled in the University of Minnesota School of Public Health. Fifty-six (48%) completed their MPH thesis project using MDH data, and 41 (35%) received field experience credits for their work in Team Diarrhea.
If you have questions regarding Team D or are interested in more information please contact Dr. Carlota Medus. Dr. Medus has a MPH and PhD in epidemiology and environmental health from the University of Minnesota School of Public Health. She has been an epidemiologist at MDH and has supervised Team D since 1999.
|Carlota Medus, MPH, PhD
Minnesota Department of Health
625 N. Robert Street
St. Paul, MN 55155