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Disaster
Preparedness and Public Health Response
What does disaster preparedness mean to you? People
often associate preparedness with catastrophic events, such
as a major earthquake or an airplane crash. They may also feel
that any steps they could take to prepare would not be effective
because these events would be so horrendous. The truth is that
while most of us may never experience a major disaster, the
majority of us will experience disasters on a smaller scale.
Fires, floods, harsh winter conditions, chemical spills, serious
industrial accidents, terrorist activities, and even a tornado
have all occurred in Utah. Disaster preparedness is a way of
thinking ahead about how to prepare for and respond to the unexpected.
It is something we all should do.
Traditional disaster preparedness has been the
responsibility of public safety, law enforcement, and emergency
response agencies. However, in recent years, the need for public
health services before, during and after an emergency is increasing.
People trained in public health can support traditional response
activities by providing accurate information about how to recognize
disease threats that may arise in a disaster situation and how
to prevent illnesses from occurring. Public health workers and
the entire medical community now have an additional role in
disaster preparedness. If a biologic agent were used as a weapon,
the initial exposure may go unrecognized. It would instead be
incumbent upon medical and public health personnel to recognize
a sudden influx of sick people as an unusual event, and to respond
quickly and appropriately.
Any disaster will impair the ability of public
health to respond to that disaster, and it will likely increase
the demand for public health services. What adjustments can
be made to the public health infrastructure that will improve
its ability to respond? When most of us think about what to
do in the event of a disaster, we first think of our families,
our home and ourselves. Emergency responders, including public
health personnel, have the additional concerns of taking care
of the public. It is imperative that public health employees
involved with disaster response ensure that they have prepared
adequate personal resources. Their families should be properly
trained to deal with the emergencies so that the employee can
devote full attention to the public. When the disaster strikes,
there isnt much time to act.
There are four phases to a disaster that should
be addressed by the following: the family, the community, the
state and the nation (Table 1). How does one get ready? Here
are five steps to consider:
STEP 1: Find out what could happen.
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What kinds of disasters are most likely
to happen and what will their impact be?
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How will warnings be given about those disasters?
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Think about the needs of children, disabled
and elderly persons, and family pets.
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Find out what the plans are if the disaster
strikes while family members are at school, work, or other
places frequently visited.
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Phase of Disaster
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When Phase Occurs
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Activities Conducted
During the Phase
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Preparedness
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Before
a disaster
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Analyze
the potential for a disaster to occur. Plan and practice
disaster responses.
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Response
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During
a disaster
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Quickly
tailor and implement the plan.
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Recovery
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After
a disaster
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Clean-up,
repair, possibly seek financial aid.
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Mitigation
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Before,
during and after a disaster
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Reduce
the chance of the disaster occurring and reduce the
damaging effect of the disaster.
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STEP 2: Create
a disaster plan.
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Discuss with family members what could happen,
and how they will be warned.
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Pick two places to meet: 1) just outside
of the home, and 2) outside of the neighborhood.
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Get an out-of-state friend to be your family
contact. After a disaster it may be easier to make a long
distance phone call.
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Develop and practice an evacuation plan.
Have an evacuation kit ready to go into the car.
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Remember to plan for children, disabled
and elderly persons, and family pets.
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STEP 3: Prepare your home.
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Post emergency numbers by the phone.
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Check for adequate insurance coverage.
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Maintain a working fire extinguisher.
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Install smoke and carbon monoxide detectors.
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Conduct a home hazard hunt. Anything that
can move, fall, break or cause a fire is a home hazard.
For example, a hot water heater or a book shelf can fall.
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Prepare any equipment for escaping from
your home such as ladders for upper level windows.
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Stock emergency supplies and a Disaster
Supplies Kit (a 72 hour survival kit). Pack this kit so
that you can move it quickly to your car or assembly area
if needed.
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Family Disaster Supply Kit
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Water - at least one gallon per person per
day
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Food - 72 hours of ready to eat high energy
foods (remember there may not be any power so use foods
that do not need to be refrigerated or cooked)
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Food preparation supplies
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First aid kit and non-prescription medications
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Sanitary supplies
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Shelter (a tent, camper or trailer)
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Bedding
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Extra clothing
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Tools
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Special items for babies, disabled and elderly
persons and family pets
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Copies of important family documents
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Money (you may not be able to access your
bank accounts)
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STEP 4: Train your family.
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Know how to contact local emergency medical
services.
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Know how to turn off water, gas and electricity.
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Know how to use the fire extinguisher.
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Know how to do first aid and CPR.
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Know how to escape and where to assemble.
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STEP 5: Practice and maintain your plan.
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Quiz family members every six months.
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Conduct fire and emergency evacuation drills.
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Replace outdated supplies.
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Maintain equipment.
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Replace batteries.
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For more detailed information visit the Federal
Emergency Management Agency (FEMA) web site on line at http://www.fema.gov.
Check lists for developing a family disaster plan and developing
a family disaster supply kit are available in the FEMA on line
library at http://www.fema.gov/library/.
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Communicable
Disease Rule Update
The Bureau of Epidemiology is pleased to announce
that the Communicable Disease Rule R386-702 has been updated.
Utahs list of reportable diseases is as follows:
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Acquired Immunodeficiency Syndrome
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Amebiasis
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Anthrax
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Botulism
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Brucellosis
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Campylobacteriosis
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Chancroid
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Chickenpox
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Chlamydia trachomatis
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Cholera
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Coccidioidomycosis
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Colorado tick fever
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Creutzfeldt-Jakob Disease
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Cryptosporidiosis
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Cyclospora infection
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Diphtheria
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Echinococcosis
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Ehrlichiosis, human granulocytic and human
monocytic
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Encephalitis: primary, post-infectious,
arthropod-borne and unspecified
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Enterococcal infection, vancomycin-resistant
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Escherichia coli O157:H7
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Giardiasis
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Gonorrhea: sexually transmitted and ophthalmia
neonatorum
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Haemophilus influenzae, invasive disease
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Hansen Disease (Leprosy)
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Hantavirus Infections and Pulmonary Syndrome
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Hemolytic Uremic Syndrome, postdiarrheal
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Hepatitis A
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Hepatitis B, cases and carriers
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Hepatitis, other viral: type C, and non-A
non-B
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Human Immunodeficiency Virus Infection.
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Influenza, laboratory confirmed
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Kawasaki Syndrome
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Legionellosis
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Listeriosis
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Lyme disease
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Malaria
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Measles
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Meningitis, aseptic and bacterial (specify
etiology)
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Meningococcal Disease, invasive
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Mumps
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Pelvic Inflammatory Disease
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Pertussis
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Plague
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Poliomyelitis, paralytic
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Psittacosis
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Q Fever
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Rabies, human and animal
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Relapsing fever, tick-borne and louse-borne
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Reye Syndrome
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Rheumatic fever
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Rocky Mountain spotted fever
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Rubella
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Rubella congenital syndrome
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Salmonellosis
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Shigellosis
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Staphylococcal Diseases (all outbreaks and
staphylococcus aureus with resistance or intermediate
resistance to vancomycin or resistance to methicillin
isolated from any site)
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Streptococcal Disease (invasive, group A
isolated from a normally sterile site)
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Streptococcal Toxic Shock Syndrome
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Streptococcus Pneumoniae (drug-resistant
invasive disease, isolated from a normally sterile site)
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Syphilis, all stages and congenital
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Tetanus
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Toxic-Shock Syndrome
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Trichinosis
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Tuberculosis
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Tularemia
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Typhoid, cases and carriers
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Yellow fever
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Any sudden or extraordinary occurrence of
infectious or communicable disease is also reportable.
Any disease occurrence, pattern of cases, suspect cases,
or increased incidence of any illness which may indicate
an outbreak, epidemic or related public health hazard,
including but not limited to suspected or confirmed outbreaks
of food borne or waterborne disease, newly recognized
or re-emergent diseases or disease producing agents, shall
be reported immediately by telephone to the Bureau of
Epidemiology, Utah Department of Health, 801-538-6191.
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Another addition to the rule is not only the reporting
of selected drug-resistant diseases (see above), but the mandatory
submission of specified organisms to the State public health
laboratory. These organisms include:
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Bacillus anthracis;
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Bordetella pertussis;
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Campylobacter species;
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Clostridium botulinum;
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Corny bacterium diphtheriae;
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Enterococcus, vancomycin-resistant;
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Escherichia coli, enterohemorrhagic;
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Francisella tularensis;
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Haemophilus influenzae, from normally
sterile sites;
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Influenza, types A and B;
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Legionella species;
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Listeria monocytogenes;
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Mycobacterium tuberculosis complex;
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Neisseria gonorrhoeae;
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Neisseria meningitidis, from normally
sterile sites;
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Salmonella species;
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Shigella species;
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Staphylococcus aureus with resistance
or intermediate resistance to vancomycin isolated from
any site;
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Vibrio cholera;
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Yersinia species.
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The language in the rule has also been updated
and simplified to conform with new disease control recommendations,
especially the sections dealing with rabies and typhoid fever.
If you have any questions regarding these changes,
please call the Bureau of Epidemiology at (801)538-6191.
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ANNOUNCING
WORLD TB DAY CONFERENCE
TB IN OUR WORLD TODAY
Old impacts and new public threats.
Place: State Capitol Building Main
Auditorium
Date: March 24, 2000
Time: 8:30 A.M. to 4:00 P.M. (Registration
8:008:30)
NURSING CEUS
$35.00 Advance Registration
$40.00 Day of Registration
$20.00 Student Advance Registration
$24.00 Student Day of Registration
For More Information Call
American Lung Association of Utah
1930 South 1100 East
Salt Lake City, Utah 84106
484-4456 or 1-800-LUNG-USA
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Utah Department
of Health, Bureau of Epidemiology
Monthly Morbidity Summary
- November 1999 - Provisional Data

The Epidemiology Newsletter
is published monthly by the Utah Department of Health, Division
of Epidemiology and Laboratory Services, Bureau of Epidemiology,
to disseminate epidemiologic information to the health care
professional and the general public.
Send comments to: The Bureau of Epidemiology, Box 142104,
Salt Lake City, UT 84114-2104, or call (801) 538-6191
Approval 8000008: Appropriation 3705
Rod Betit, Executive Director, Utah Department of Health
Charles Brokopp, Dr.P.H., Division of Epidemiology and Laboratory
Services
Craig R Nichols, MPA, Editor, State Epidemiologist, Director
Bureau of Epidemiology
Gerrie Dowdle, MSPH, Managing Editor
Connie Dean, Production Assistant
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