The City of Philadelphia is the fifth most populated city in the United States (1.58 million people, 6 million in the greater metropolitan statistical area), the biggest economic center in Pennsylvania, and second largest in the eastern United States. The city’s population is very diverse both ethnically and socially with extensive global and domestic travel through interstate highways, major railway systems and an international airport that houses a CDC Quarantine Station. Poverty and access to health services is a great challenge to many Philadelphia residents and immigrants who may not seek care. There are large populations of people living homeless in Philadelphia, those who are incarcerated and a large population actively using drugs and experiencing addiction. The city has a large and active LGBTQ community and is the epicenter for the region regarding social interactions, disease transmission and access to specialty health services. Philadelphia is a popular tourist destination and frequently hosts high-profile special events, which draw many visitors to the City, such as the Papal Visit in 2015 and political national conventions (RNC 2000, DNC 2016). All major professional sports leagues have teams based in Philadelphia that draw large crowds from the region to attend games and victory celebrations (Phillies, Eagles, Flyers, 76rs, Villanova Wildcats).
In the past year, the Philadelphia Department of Public Health (PDPH) Division of Disease Control (DDC)has executed several large and varying responses with notably larger numbers of cases and/or exposed persons compared with responses in recent years (e.g., mumps outbreak at a university, increases in Hepatitis A among men who have sex with men and other adults, legionella cluster in an area dense with cooling towers, influenza in a low resource homeless shelter, infection control breaches at dental practices). The opioid epidemic has presented further challenges with documented increases in HIV, syphilis, and invasive Group A Streptococcal (GAS) infections among persons who inject drugs in Philadelphia and the potential threat of a large Hepatitis A outbreaks among persons among this population. PDPH also continues to monitor for importations of emerging and previously eliminated infections (e.g., MERS-CoV, Ebola, measles, malaria, travel-associated arboviruses) and continues to immediately respond to patients under investigation for high consequence pathogens (e.g., MERS-Cov, Ebola, human rabies. Transmission of infectious diseases in healthcare settings and drug resistant organisms occur with great frequency locally where DDC's Healthcare Associated Infections Program has established itself with a critical role to investigate, respond and inspect facilities to control spread. Epidemiology Laboratory Capacity (ELC)funding has greatly improved the local public health laboratory (PHL) testing and advancing the laboratory in the direction of more cutting-edge and efficient testing methods. PHL has been able to sustain RT-PCR testing for influenza and norovirus. While local resources are still limited, PDPH DDC has incorporated specimen collection and coordination of molecular testing and advanced molecular detection testing at CDC, the PADOH Bureau of Laboratories, and regional reference laboratories into routine surveillance activities for vaccine-preventable
and enteric diseases.
The 2019 ELC cooperative funding opportunity gives PDPH the means to continue and to improve essential public health services by enhancing disease control programs, improving electronic laboratory reporting, expanding diagnostic testing capacity, activating response activities, and establishing better collaboration and efficiency through a new leadership and management approach. This funding is critical to protect the public as we continue to see increases among vaccine preventable diseases and rare importation of high consequence pathogens locally.