Letter of Invitation - Concurrence_Multiple States

Concurrence Statements from Collaborating Jurisdictions
Background
In fall 2018, the US experienced an increase in the number of cases of acute flaccid myelitis (AFM). To date,
there have been 232 confirmed AFM cases in 41 states with onset during 2018 compared with 35 AFM cases in
16 states during 2017. The majority of cases have occurred in children. No common exposures have been
identified among the cases and the risk factors for developing this disease are not well understood. In an effort
to better understand common exposures among AFM patients, state and local health jurisdictions with AFM
cases are collaborating with CDC to investigate these 2018 cases more broadly. In addition, they are
investigating anecdotal information suggesting that diagnosis might have been delayed in some cases, perhaps
due to a lack of awareness about AFM by healthcare providers.
The Minnesota Department of Health has requested technical assistance from the Centers for Disease Control
and Prevention (CDC) to create a comprehensive hypothesis-generating questionnaire instrument for this
investigation. Other state and local jurisdictions have indicated to CDC that they wish to collaborate with CDC on
this activity which involves administering the hypothesis-generating questionnaire to all 2018 confirmed AFM
patients reported to their jurisdiction. The objectives of the activity are to identify common exposures and
characterize the medical care received prior to an AFM diagnosis. The response is urgent in nature since timely
data are needed to inform rapid public health action to prevent and reduce disease in children. In addition, the
results from this investigation will be used to help identify gaps in clinician awareness that can be targeted
through public health messaging. This activity will remain under the direction and supervision of each respective
state and local health jurisdiction. Each jurisdiction will retain ownership of data collected from their respective
AFM cases.
Below is the concurrence from the states that will collaborate in this investigation.

Alabama
From: [email protected]
Sent: Thursday, April 25, 2019 9:25 AM
To: AFM Info (CDC)
Cc: Stevens, Kelly (CDC adph.state.al.us) ;
[email protected]
Subject: RE: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET
I concur.
Sherri
*********************************************
Sherri L. Davidson, Ph.D., M.P.H.
Interim State Epidemiologist
Epidemiology, Surveillance, & Informatics
Infectious Diseases & Outbreaks Division
Alabama Department of Public Health
Phone 334-206-2050 or 334-206-5971

Arizona
From: Shane Brady
Sent: Tuesday, April 23, 2019 11:41 AM
To: AFM Info (CDC)
Cc: Vaccine Preventable Diseases
Subject: Re: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET
Hello,
I am indicating our jurisdiction's concurrence with these activities and response.
Thanks,
Shane
Shane Brady, MPH
Deputy State Epidemiologist
Arizona Department of Health Services

150 North 18th Avenue, Suite 140, Phoenix, AZ 85007

Direct 602-364-3147
Mobile 602-540-6749
Email
[email protected]
Health and Wellness for all Arizonans

Arkansas
From: Dirk Haselow
Sent: Wednesday, April 17, 2019 9:37 AM
To: AFM Info (CDC)
Cc: Cat Waters
Subject: FW: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET

I am supportive of AR participating in the below AFM project.
Dirk
Dirk Haselow, MD, PhD
State Epidemiologist and Medical Director for Outbreak Response
Arkansas Department of Health
4815 W. Markham St., Slot 48
Little Rock, AR 72211

California
From: Chu, Victoria@CDPH
Sent: Tuesday, April 16, 2019 5:33 PM
To: AFM Info (CDC)
Cc: Harriman, Kathleen@CDPH
Subject: RE: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET

Hi Adriana,
I am indicating our jurisdiction's concurrence to have CDC assist with this response. Thank you
for consideration of this request. We very much appreciate the support and assistance of the
CDC to help protect the public health of our citizens.
Victoria Chu (California), Vaccine Preventable Diseases Coordinator

Colorado
From: Herlihy - CDPHE, Rachel
Sent: Monday, May 6, 2019 1:02 PM
To: AFM Info (CDC)
Cc: Spence Davizon - CDPHE, Emily ; Amanda Metz
; McKay, Susannah (CDC/DDID/NCIRD/DVD) ; Marin, Mona
(CDC/DDID/NCIRD/DVD) ; Lopez, Adriana (CDC/DDID/NCIRD/DVD)
Subject: Re: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET
Apologies for my delay, Adriana. Colorado requests CDC's assistance with this response. We would also
like to request the assistance of an EIS officer(s) for this investigation.
Please let me know if you need a more detailed request.
Regards,
Rachel

Chicago
From: Marielle Fricchione
Sent: Thursday, April 25, 2019 9:50 AM
To: AFM Info (CDC)
Subject: Re: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET
I am indicating Chicago jurisdiction's concurrence to have CDC assist with this AFM response.
Thank you,
Marielle Fricchione, MD

Medical Director, Immunization Program
Chicago Department of Public Health
2160 W. Ogden Ave
Chicago, IL 60612
Office: 312.746.5382
Fax: 312.746.6388
[email protected]

Georgia
From: Adam, Carolyn
Sent: Thursday, April 25, 2019 3:34 PM
To: AFM Info (CDC) ; Lopez, Adriana (CDC/DDID/NCIRD/DVD)
Cc: Drenzek, Cherie (CDC dph.ga.gov) ; Thomas, Ebony

Subject: RE: Feedback needed: AFM hypothesis generating concurrence
Hi Adriana,
Our state epidemiologist, Cherie Drenzek (cc’d), has approved the AFM hypothesis generating activity
detailed below. Please let me know if you need any additional information from us.
Thanks!
Carolyn

Carolyn M. Adam, MPH
Vaccine Preventable Disease Surveillance Coordinator
Georgia Department of Public Health
2 Peachtree St. NW
Suite 14-264

Atlanta, GA 30303

Phone: 404-657-2438

Fax: 404-657-2608

[email protected]

Houston
From: Zafar, Amara - HHD
Sent: Monday, April 22, 2019 12:07 PM
To: AFM Info (CDC)

Cc: Zhang, Yufang - HHD ; Short, Kirstin - HHD

Subject: RE: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET
Good Morning,

I am indicating our jurisdiction's concurrence to participate/assist with this activity by administering the
hypothesis-generating questionnaire to all 2018 confirmed AFM patients reported to our jurisdiction
(Houston).
Sincerely,
Amara Zafar, M.P.H.
Epidemiologist Specialist, VPD Coordinator
Bureau of Epidemiology
Houston Health Department
8000 N Stadium Drive
Houston TX, 77054
Phone: 832-393-4566
Fax: 832-393-5232
Email: [email protected]

Illinois
From: Layden, Jennifer E.
Sent: Thursday, April 25, 2019 9:20 AM
To: AFM Info (CDC)
Cc: Reid, Heather
Subject: Fw: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET
Importance: High
Good morningI am indicating our jurisdiction's concurrence to have CDC assist with this response. Thank you for
consideration of this request. We very much appreciate the support and assistance of the CDC to help
protect the public health of our citizens.
For Illinois, if the case is in Chicago (resident or at a Chicago facility), Chicago DPH will conduct the
investigation. All others will go to the CDC EISO.

thanksjen
Jennifer E Layden, MD, PhD
Chief Medical Officer and State Epidemiologist
IDPH
312-835-0249

Indiana
From: Pontones, Pamela
Sent: Wednesday, April 17, 2019 9:57 AM
To: AFM Info (CDC)
Cc: Hawkins, Eric (CDC isdh.in.gov) ; Richards, Shawn (CDC isdh.in.gov)
; Milroy, Lauren M
Subject: Indiana concurrence with AFM HGQ
Good morning,
I am indicating Indiana’s concurrence to have CDC assist with the investigation of common exposures
among 2018 AFM cases, including the administration of a hypothesis-generating questionnaire to all
2018 confirmed AFM patients reported in Indiana.
Please let me know if you have any questions.
Respectfully,
Pam Pontones
PAM PONTONES, MA
Deputy State Health Commissioner
State Epidemiologist
Indiana State Department of Health
317.233.7861 office
317.430.3842 mobile
317.234.2812 fax
[email protected]
www.StateHealth.in.gov

Iowa
From: Pedati, Caitlin
Sent: Thursday, April 25, 2019 1:55 PM
To: Lopez, Adriana (CDC/DDID/NCIRD/DVD)
Cc: Rob Ramaekers
Subject: Fwd: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET
Hi Adrianna,
Our jurisdiction concurs.

Thank you.
Best,
Caitlin S. Pedati MD, MPH, FAAP
Medical Director & State Epidemiologist| Iowa Department of Public Health | 321 E. 12th Street | Lucas
State Office Bldg. | Des Moines, IA 50319 | Office: 515-281-3826 | [email protected]

P rotecting and I m proving the Health of I ow ans

Kansas
From: Farah Ahmed [KDHE]
Sent: Tuesday, April 23, 2019 12:21 PM
To: AFM Info (CDC)
Cc: Sheri Tubach [KDHE] ; Chelsea Raybern [KDHE] ;
Allison Zaldivar [KDHE]
Subject: AFM hypothesis generating activity concurrence (Kansas)
I am indicating our jurisdiction's concurrence to have CDC assist with this response. Thank you for
consideration of this request. We very much appreciate the support and assistance of the CDC to help
protect the public health of our citizens.
Farah S. Ahmed, MPH, PhD
Environmental Health Officer and State Epidemiologist
Bureau of Epidemiology and Public Health Informatics
Curtis State Office Building
1000 SW Jackson St., Suite 330 Topeka, KS 66612-1365
Phone: (785) 296-6426 Fax: 1-877-427-7318
Email: [email protected] (Please note new email)
EpiHotline: 1-877-427-7317

Kentucky
From: Thoroughman, Douglas (CHS-PH)
Sent: Thursday, April 18, 2019 7:55 PM
To: AFM Info (CDC)
Cc: Royalty, Kristy (CHS-PH) ; Robeson, Sara (CDC ky.gov)

Subject: Fw: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET
I am indicating Kentucky's interest in assisting CDC with this response. I approve Jody Schweitzer from
the Kentucky Department for Public Health's Immunization Program to participate in the AFM
hypothesis-generating questionnaire activity and for you to communicate with her regarding data
collection and questionnaire review/revision activities.
Thanks, so much, for the opportunity to participate in this activity.
Doug

Doug Thoroughman, PhD, MS
State Epidemiologist (Acting)
CDC Career Epidemiology Field Officer
Kentucky Department for Public Health
275 E. Main St., HS 2GW-C
Frankfort, KY 40621
Phone: 502-564-3418 x4315
Fax: 502-564-9626

Maryland
From: David Blythe -MDH-
Sent: Friday, May 3, 2019 12:05 PM
To: AFM Info (CDC)
Cc: Seeto, Kurt (CDC maryland.gov) ; Ruth Thompson

Subject: Fwd: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET

Adriana and all - As State Epidemiologist for Maryland, I write to confirm our concurrence to
have CDC assist with this response.
Thanks and let me know if you need anything more. - David

Massachusetts
From: Brown, Catherine (DPH)
Sent: Tuesday, April 23, 2019 4:35 PM
To: AFM Info (CDC)
Cc: Burns, Meagan (DPH)
Subject: FW: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET

Good AfternoonPlease find my concurrence to have Massachusetts assist CDC with this effort with the adjusted
language as defined below. Deletions are indicated as strike-through and additions are
underlined.
In fall 2018, the US experienced an increase in the number of cases of acute flaccid myelitis
(AFM). To date, there have been 228 confirmed AFM cases in 41 states with onset during 2018
compared with 35 AFM cases in 16 states during 2017. The majority of cases have occurred in
children. No common exposures have been identified among the cases and the risk factors for
developing this disease are not well understood. In an effort to better understand common
exposures among AFM patients, state and local health jurisdictions with AFM cases are
collaborating with CDC to investigate these 2018 cases more broadly. In addition, they are

investigating anecdotal information suggesting that diagnosis might have been delayed in some
cases, perhaps due to a lack of awareness about AFM by healthcare providers.
The Minnesota Department of Health has requested technical assistance from the Centers for
Disease Control and Prevention (CDC) to create a comprehensive hypothesis-generating
questionnaire instrument for this investigation. Other state and local jurisdictions have
indicated to CDC that they wish to collaborate with CDC on this activity which involves
administering the hypothesis-generating questionnaire to all 2018 confirmed AFM patients
reported to their jurisdiction. The objectives of the activity are to identify common exposures
and characterize the medical care received healthcare seeking behavior of patients and their
families prior to an AFM diagnosis. The response is urgent in nature since timely data are
needed to inform rapid public health action to prevent and reduce disease in children. In
addition, the results from this investigation will be used to help identify gaps in clinician
awareness that can be targeted through public health messaging. Results from this
investigation could be used to help raise awareness about this newly emerging syndrome which
lacks a specific diagnostic tool and does not have, as of yet, any standard of care established.
This activity will remain under the direction and supervision of each respective state and local
health jurisdiction. Each jurisdiction will retain ownership of data collected from their
respective AFM cases. The plan is for CDC to summarize the findings from all jurisdictions and
disseminate a summary of results in aggregate form to participating jurisdictions. Decisions
about additional analyses and particularly any public release of information would be done
using a collaborative, shared decision-making approach between CDC and all contributing
jurisdictions.
I am indicating our jurisdiction's concurrence to have CDC assist with this response. Thank you
for consideration of this request. We very much appreciate the support and assistance of the
CDC to help protect the public health of our citizens.

Catherine M. Brown, DVM, MSc, MPH
State Epidemiologist and State Public Health Veterinarian
Bureau of Infectious Disease and Laboratory Sciences
Massachusetts Department of Public Health
305 South Street
Jamaica Plain, MA 02130
(617) 983-6800
FAX: (617) 983-6840
E-mail: [email protected]

Michigan
From: LyonCallo, Sarah (DHHS)
Sent: Tuesday, April 16, 2019 8:53 PM
To: Johnson, Shannon (DHHS) ; AFM Info (CDC)
Cc: Bidol, Sally (DHHS) ; Collins, Jim (CDC michigan.gov)

Subject: Re: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET
Michigan agrees to pilot CDC’s hypothesis generating AFM questionnaire.
Sarah Lyon-Callo, PhD

Mississippi
From: Byers, Paul
Sent: Thursday, April 25, 2019 9:50 AM
To: AFM Info (CDC)
Cc: Dobbs, Thomas E ; Kittle, Theresa (CDC msdh.ms.gov)
; Anderson, Jannifer ; Winston,
Melody
Subject: RE: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET

I, as State Epidemiologist for the Mississippi State of Health, am indicating our jurisdiction's
concurrence to have CDC assist with this response. Thank you for consideration of this
request. We very much appreciate the support and assistance of the CDC to help protect the
public health of our citizens.
Regards,
Paul Byers, MD
State Epidemiologist
Mississippi State Department of Health
Office: 601.576.7725
Fax: 601.576.7497
Email: [email protected]

Missouri
From: Bos, John
Sent: Sunday, April 28, 2019 10:52 AM
To: AFM Info (CDC)
Cc: Hahn, Rachael RH (CDC health.mo.gov) ; Hernandez Arroyo, Joseline
; Turabelidze, George
Subject: RE: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET
Hello Adriana,
Dr. George Turabelidze, State Epidemiologist for Missouri has requested that I respond as his designee.
Missouri concurs with the stated AFM hypothesis generating activity.
Thanks!

John Bos, MPH
Assistant Bureau Chief
Bureau of Communicable Disease Control and Prevention
Missouri Department of Health and Senior Services
Southwestern District Office
149 Park Central Square Suite 116
Springfield, MO 65801-0777
Phone: (417) 895-6945
Fax: (417) 895-6959

Montana
From: Pride, Kerry
Sent: Thursday, April 18, 2019 2:51 PM
To: AFM Info (CDC)
Subject: Re: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET
Hello,
I am the acting state epidemiologist for Montana and we will participate in the investigation of common
exposures among 2018 AFM cases. Please let me know if you need any additional information from me
at this time.
Thank you!
Kerry
Kerry R. Pride, DVM, MPH, DACVPM
MT DPHHS/PHSD
1400 Broadway Rm 201B
Helena, MT 59620
406-600-1594
406-444-5980

Nebraska
From: Safranek, Tom
Sent: Wednesday, May 1, 2019 2:36 PM
To: AFM Info (CDC)
Cc: Hendrickson, Blake
Subject: RE: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET
Adriana:

We are totally on board. I have heard from several patients/families and I think they would be thrilled
to see further interest and investigation. We will do those surveys ourselves per your guidance.
Thanks so much.
Tom
Tom Safranek, M.D.
State Epidemiologist
Division of Public Health
Nebraska Department of Health and Human Services
301 Centennial Mall, Lincoln, NE 68509
MAIN LINE: 402-471-2937 DIRECT: 402-471-0550 CELL: 402-440-5729
DHHS.ne.gov | Facebook | Twitter | LinkedIn

Nevada
From: Melissa Peek-Bullock
Sent: Tuesday, April 16, 2019 5:18 PM
To: AFM Info (CDC)
Cc: Devin Raman ; Larson, Sandra (CDC health.nv.gov)
Subject: RE: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET
Thank you for reaching out. Nevada concurs and agrees with participation.

Melissa Peek-Bullock

State Epidemiologist
Nevada Department of Health and Human Services
Division of Public and Behavioral Health | Office of Public Informatics and Epidemiology
500 Damonte Ranch Pkwy, Ste 657 |Reno, NV 89521
T: (775) 684-5285|E: [email protected]
www.dhhs.nv.gov | http://dpbh.nv.gov
Out of Office Alert: 3/22/19 – 4/05/19
5/06/19 – 5/10/19
It is the mission of the Division of Public and Behavioral Health to protect, promote and improve
the physical and behavioral health of the people of Nevada

New Hampshire
From: Chan, Benjamin
Sent: Tuesday, April 23, 2019 2:27 PM
To: AFM Info (CDC)
Cc: Hansen, Katrina ; Mathewson, Abigail
; Dreisig, John ; Daly, Elizabeth
; Elizabeth Talbot
Subject: Re: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET

New Hampshire concurs and supports administration of the AFM hypothesis generating activity and
questionnaire.
Thanks,
Ben
Benjamin P. Chan, MD, MPH
State Epidemiologist
Division of Public Health Services
NH Department of Health & Human Services
29 Hazen Drive
Concord, NH 03301
Phone: (603) 271-4612
Fax: (603) 271-4827
E-mail: [email protected]

New Jersey
From: Hannagan, Susan E
Sent: Wednesday, April 17, 2019 11:49 AM
To: AFM Info (CDC)
Cc: Zaremski, Elizabeth F ; Montana, Barbara
; Tan, Christina CT (CDC doh.nj.gov)
Subject: RE: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET
Hi Adriana and team,
As the designee for New Jersey, I am indicating our concurrence with this activity. Our state
epidemiologist, Christina Tan, is in agreement and is copied here as well.
Thanks,
Susan E. Hannagan, MS, MPH
Surveillance Specialist
New Jersey Department of Health
Vaccine Preventable Disease Program
Office (609) 826-5964
Fax (609) 292-5821
[email protected]

New York City
From: Marcelle Layton
Sent: Friday, April 19, 2019 4:52 PM
To: AFM Info (CDC)
Cc: Danielle Bloch ; Weiss, Don (CDC health.nyc.gov)
; Layton, Marci (CDC health.nyc.gov)

Subject: FW: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET

I am indicating our jurisdiction's concurrence to have CDC assist with this response. Thank you
for consideration of this request. We very much appreciate the support and assistance of the
CDC to help protect the public health of our citizens.
Marci Layton MD
Assistant Commissioner
Bureau of Communicable Disease
NYC Department of Health and Mental Hygiene

New York State
From: Blog, Debra S (HEALTH)
Sent: Wednesday, April 24, 2019 8:43 AM
To: AFM Info (CDC)
Subject: RE: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET
Sorry this is late. Blame it on measles.

I am indicating our jurisdiction's concurrence to have CDC assist with this response. Thank you
for consideration of this request. We very much appreciate the support and assistance of the
CDC to help protect the public health of our citizens.
Debra Blog, MD, MPH
Director Division of Epidemiology
Corning Tower Room 503
Empire State Plaza
Albany, NY 12237
518-474-4394

North Carolina
From: Moore, Zack
Sent: Wednesday, April 17, 2019 7:33 AM
To: AFM Info (CDC)
Cc: Albertson, Justin ; Valiani, Anita ;
Maillard, Jean-Marie (CDC dhhs.nc.gov) ; Sullivan, Susan
; Fleischauer, Aaron (CDC dhhs.nc.gov)
Subject: Re: [External] AFM hypothesis generating activity concurrence -- please respond by Tuesday,
April 23 at 5pm ET
North Carolina concurs and plans to participate in this activity.
Zack Moore, MD, MPH

State Epidemiologist and Epidemiology Section Chief
Division of Public Health
North Carolina Department of Health and Human Services
919 546-1725 office
919 733 0490 fax (secure)
[email protected]
225 N. McDowell St.
Raleigh, NC 27603
1902 Mail Service Center
Raleigh, NC 27699-1902

North Dakota
From: Dethloff, Michelle A.
Sent: Thursday, May 16, 2019 1:08 PM
To: Lopez, Adriana (CDC/DDID/NCIRD/DVD)
Cc: Miller, Tracy (CDC nd.gov) ; Galbraith, Jennifer
Subject: RE: AFM hypothesis generating activity concurrence -- please respond ASAP

Hi Adriana,
North Dakota can participate in the HGQ project for 2018 conformed AFM cases. We had one in ND in 2018 and
can administer this questionnaire to our case.

Michelle Dethloff
ELC Program Manager

701.328.3177

•

[email protected]

•

ndhealth.gov\disease

•

Provide Feedback

Oklahoma
From: Laurence J Burnsed
Sent: Friday, April 19, 2019 6:03 PM
To: Lopez, Adriana (CDC/DDID/NCIRD/DVD)
Cc: Lee, Anthony K (CDC health.ok.gov) ; Casey Van Woerkom
; Christie K McDonald-Hamm
Subject: RE: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET
Hi Adriana,
The Oklahoma State Department of Health has agreed to participate in the AFM hypothesis generating
activity. We concur with the methods and look forward to collaborating with other state health
departments and federal partners in completing this projects. If you need any additional information for
our state health department, please feel free to contact me.
Thanks,

Laurence Burnsed, MPH
Interim State Epidemiologist
Oklahoma State Department of Health
1000 Northeast Tenth Street
Oklahoma City, OK 73117
Phone: (405) 271-7637
Fax: (405) 271-2542
E-mail: [email protected]

Rhode Island
From: Bandy, Utpala (RIDOH)
Sent: Wednesday, April 17, 2019 9:29 AM
To: AFM Info (CDC)
Cc: Gosciminski, Michael (RI) (CDC health.ri.gov) ; Quilliam, Daniela
(RIDOH)
Subject: AFM
Adriana:
RI concurs with the plan to have CDC assist with AFM investigations.
Regards,
Dr. Bandy
Utpala Bandy MD MPH
RI State Epidemiologist

Medical & Division Director
Division of Preparedness, Response, Infectious Diseases
and Emergency Medical Services (PRIDEMS)
Rhode Island Department of Health
Room 106, 3 Capitol Hill
Providence, RI 02906

Pennsylvania
From: Watkins, Sharon
Sent: Wednesday, April 17, 2019 10:54 AM
To: AFM Info (CDC)
Cc: Fleming, Wayne S ; Lurie, Perrianne ; Nambiar, Atmaram

Subject: AFM hypothesis generating
Hello, Pennsylvania DOH will conduct the AFM hypothesis generating questionnaire. We have reached
out to our large jurisdictions as well who have agreed to also have their staff conduct the hypothesis
generating questionnaire. I understand that CDC’s approval process requires that the state
epidemiologist or designee respond to this email indicating that PADOH agrees to conduct hypothesis
generating interviews with parents/ guardians of AFM case-patients. As State Epidemiologist, I have
agreed. Sharon

Sharon M. Watkins, PhD
Director, Bureau of Epidemiology
State Epidemiologist
Pennsylvania Department of Health
Room 933, Health and Welfare Building
625 Forster Street
Harrisburg PA 17120-0701
Phone 717-787-3350 Fax 717 772 6975
[email protected]
www.health.state.pa.us

South Carolina
From: Bell MD, Linda J.
Sent: Thursday, April 25, 2019 9:48 AM
To: Traxler, Brannon ; AFM Info (CDC)
Cc: DADE_Consultants
Subject: Re: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET

Good Morning,

As South Carolina State Epidemiologist I submit my concurence that South Carolina will participate in the
AFM hypothesis generating activities. Dr. Brannon Traxler is our designated Point of Contact for all
activities associated with the investigation. She is copied here, please include her on all related
communications.
Thank you.

Linda J. Bell, M.D.
State Epidemiologist
Director, Bureau of Communicable Disease Prevention and Control
Public Health
S.C. Dept. of Health & Environmental Control
Office: (803) 898-0801
Mobile: (803) 608-6013
Connect: www.scdhec.gov Facebook Twitter

South Dakota
From: Clayton, Joshua
Sent: Thursday, April 25, 2019 10:26 AM
To: AFM Info (CDC)
Subject: RE: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET
Adriana,

I am writing to confirm South Dakota’s concurrence to have CDC assist with this response and to create
a comprehensive hypothesis-generating questionnaire instrument for this investigation.

Thank you,

Josh

Joshua L. Clayton, PhD, MPH
State Epidemiologist
South Dakota Department of Health
615 East 4th Street, Pierre, SD 57501
(P) 605.773.2795
(F) 605.773.5509
[email protected]

Tennessee
From: Tim F. Jones
Sent: Tuesday, April 23, 2019 1:39 PM
To: AFM Info (CDC)
Cc: Michelle Fiscus ; Cassandra Jones
Subject: RE: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET
Tennessee concurs with this activity, and will participate. Please let me know if you have additional
questions.
Sincerely,

Timothy Jones, MD
State Epidemiologist
Communicable and Environmental Diseases and Emergency Preparedness
4th Fl., Andrew Johnson Tower
710 James Robertson Pkwy.
Nashville, TN 37243
Phone: (615) 741-7247
[email protected]

Texas
From: Gaul,Linda (DSHS)
Sent: Friday, April 26, 2019 12:54 PM
To: AFM Info (CDC)
Cc: Leos,Greg (DSHS)
Subject: CDC HypGen for AFM
To whom it may concern at CDC:
I approve the Texas use of the CDC HypGen for investigation of potential cases of Acute Flaccid Myelitis. Thank
you!
Linda
Linda K. Gaul, PhD, MPH
State Epidemiologist
Texas Department of State Health Services
1100 W. 49th St., Austin, TX 78756

512-776-7198 Office
512-776-7477 Fax
512-247-1691 Cell
*Please note* My email address has changed to reflect @dshs.texas.gov domain. Please be sure to update your
contact information with the new address.

Utah
From: Angela Dunn
Sent: Wednesday, April 17, 2019 6:36 PM
To: AFM Info (CDC)
Cc: Cindy Lewis Burnett ; Akanksha Acharya ; Jeffrey Eason

Subject: Re: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET

I am indicating our jurisdiction's concurrence to have CDC assist with this response. Thank you for
consideration of this request. We very much appreciate the support and assistance of the CDC to help
protect the public health of our citizens.
-Angela C. Dunn, MD MPH
State Epidemiologist | Utah Department of Health
Office: 801-538-6226
Cell: 907-947-7235

Virginia
From: Peake, Lilian
Sent: Wednesday, May 29, 2019 4:13 PM
To: Lopez, Adriana (CDC/DDID/NCIRD/DVD)
Cc: Gray, Christine ; Marshall Vogt
Subject: Re: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET
Adriana,
We would like to collaborate with CDC on this activity which involves administering the
hypothesis-generating questionnaire to all 2018 confirmed AFM patients reported to Virginia.
Thank you,
Lilian Peake, MD, MPH
State Epidemiologist
Director, Office of Epidemiology
Virginia Department of Health
109 Governor Street
Richmond, VA 23219
804-864-8141

Washington
From: DeBolt, Chas (DOH)
Sent: Thursday, April 25, 2019 8:56 PM
To: AFM Info (CDC)
Cc: Lindquist, Scott SL (CDC doh.wa.gov) ; Turnberg, Wayne (DOH)
; Poel, Amy J (DOH)
Subject: AFM hypothesis generating activity concurrence

I am indicating our jurisdiction's concurrence to have CDC assist with this response. Thank you
for consideration of this request. We very much appreciate the support and assistance of the
CDC to help protect the public health of our citizens.
Chas DeBolt RN, MPH (designee)

Sr. Epidemiologist for Vaccine-Preventable Diseases
Washington State Department of H ealth
1610 NE 150th Street
Shoreline, WA 98155
Phone: (206) 418-5431
FAX: 206) 418-5515
E-mail: Chas.DeBolt@DOH .WA.gov

Wisconsin
From: Smiley, Stephanie L - DHS (DPH)
Sent: Sunday, April 28, 2019 9:03 PM
To: AFM Info (CDC)
Subject: FW: AFM hypothesis generating activity concurrence -- please respond by Tuesday, April 23 at
5pm ET
Good evening,
Wisconsin concurs. We will use this tool.
Thank you,
Stephanie
Stephanie Smiley
Director, Bureau of Communicable Diseases, Division of Public Health
Wisconsin Department of Health Services
D: 608-267-9363 | C: 608-250-5616
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