Kansas Successfully Starts Centralized Interviewing in a Decentralized State
In 2016, a higher than average number of Salmonella, Shiga toxin-producing Escherichia coli (STEC), and Listeria cases were reported in Kansas. However, competing demands from other investigations make it challenging for some local health departments (LHDs) to interview enteric illness cases quickly and completely. To improve enteric disease surveillance and outbreak response, the Kansas Department of Health and Environment (KDHE) started offering state-level support for centralized interviewing for cases of Salmonella, STEC, and Listeria infection.
KDHE emailed letters to every LHD offering the opportunity to participate in a centralized interviewing program. They encouraged participation by promoting the benefits, such as after-hours interviewing, reducing the burden of interviewing on LHD staff, and the availability of timely and complete interview data for cases.
“One of the benefits of the centralized interviewing program is the evening hours for the dedicated investigators, which are also more convenient for our residents and eases this particular strain on our program.”
—Program Participant
To implement centralized interviewing, KDHE used existing staff and created two new part-time positions, called public health consultants. Consultants were recruited from two area universities that offer Master’s degrees in public health: Kansas State University and the University of Kansas. The consultants conducted Salmonella and STEC interviews using a standard questionnaire. For Listeria cases, a KDHE epidemiologist conducted in-person interviews. LHDs were able to view the information for their cases in the statewide disease reporting system so they could monitor KDHE’s attempts to interview cases, review interview details, and conduct additional case follow-up or investigation activities.
In the first year, 96 of Kansas’ 100 LHDs decided to participate in centralized interviewing. KDHE investigated over 400 Salmonella, STEC, and Listeria cases. Over 80% of interviews for Salmonella and STEC, and all Listeria interviews, were completed. Ninety percent of patients were contacted within three days from receiving a case report for an interview for Salmonella and STEC and the majority of those interviews were completed within five days. All interviews for Listeria were conducted within four days.
LHDs play a crucial role in investigating enteric diseases but are also responsible for many other public health services. By working closely with their LHDs, KDHE successfully started centralized interviewing to improve their enteric disease surveillance and outbreak response. Centralized interviewing supports the work of LHDs and also helps identify and respond to outbreaks faster, which can keep help limit the spread of enteric disease.