The use of an immunization information system to establish baseline childhood immunization rates and measure contract objectives.

Measuring progress toward national immunization objectives at the local level, although difficult, is becoming more feasible owing to statewide immunization information systems. This article describes how a state immunization program expanded the scope of immunization service contracts with local health departments (LHDs) to address the immunization rates among children living within their jurisdictions using the Wisconsin Immunization Registry (WIR) to measure achievement of population-based objectives. By contract year (CY) 2008, 99 percent of Wisconsin LHDs selected population-based contract objectives. In late 2008, the Wisconsin Immunization Program assessed all children at 24 months of age for completeness of the 4:3:1:3:3:1 (diphtheria, tetanus, pertussis/poliovirus/measles-containing vaccine/Haemophilus influenzae type b/hepatitis B/varicella) series by county for each of four CYs, using the WIR. From CY 2005 to CY 2008, LHDs in 61 (86%) of the 71 counties demonstrated increased series completeness rates for the series, and the overall statewide series completeness increased from 58 percent to 64 percent. However, the increases we observed cannot be attributed solely to LHDs' acceptance of population-based objectives because controlling for other factors known to influence immunization coverage levels was outside the scope of this case study. We found the WIR to be a powerful tool that can measure immunization coverage among local populations independent of the immunization provider, assess improvement toward contract objectives, and target resources toward pockets of need.

Epidemiologic trends in infection, mortality, and transplants related to hepatitis C in Wisconsin.

Hepatitis C virus (HCV) infection is the most common chronic bloodborne infection in the United States. An estimated 3.9 million persons nationally and 85,000 persons in Wisconsin are currently infected. The disease is responsible for approximately 8000 to 10,000 deaths nationally each year. This article summarizes epidemiologic trends in infection, mortality and transplants related to HCV in Wisconsin. It presents surveillance data collected during 1997-2004; HCV-related deaths during 1995-2002, with HCV as an underlying or contributing cause of death; and data for liver transplants related to HCV between 1993 and 2004. During the time periods reviewed, there were 16,668 cases of HCV infection reported, 1186 HCV-related deaths, and 356 HCV-related liver transplants involving HCV in Wisconsin. Infection rates and related adverse health outcomes related to HCV are highest in males, persons ages 35-64, Milwaukee residents, and inmates in the state correctional system. African Americans have high rates of morbidity (24% of cases) and mortality (16% of decedents), but are under-represented among recipients of HCV-related transplants (6% of recipients).

Hepatitis C virus infection: an overview of Wisconsin's public health resources.

Hepatitis C virus (HCV) infection is the most common chronic bloodborne infection in the United States, with an estimated 3.9 million infected persons nationally and 85,000 persons infected in Wisconsin. HCV infection results in significant morbidity and mortality and contributes to high health care costs associated with specialized medical care, medications, and hospitalization. This report is an overview of HCV-related resources for consumers and clinicians caring for persons with HCV infection in Wisconsin.