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City of Milwaukee Health Department
Division of Disease Control and Environmental Health

The Division of Disease Control and Environmental Health encompasses many of the foundational public health services required under statute. The division is divided into seven program areas which include:

  1. Communicable Disease Prevention and Control
  2. Environmental Health
  3. Lead Poisoning Prevention
  4. Immunizations
  5. Occupational Health, Safety, and Public Health Preparedness
  6. Sexual and Reproductive Health
  7. Tuberculosis Prevention and Care

Communicable Disease Prevention and Control
The Communicable Disease Program (CD) helps to assure the health of City of Milwaukee through surveillance, investigation, prevention, and reporting of conditions of public health concern.  More than 80 conditions are reportable to public health in Wisconsin resulting in over 15,000 cases reports annually.  Program staff investigate a subset of these cases to verify diagnosis, confirm treatment, determine the source of the illness, reinforce medical advice, provide contact notification as necessary, and provide education to prevent further spread of infection.  Hundreds of case investigations are performed annually.  In addition, disease trends are monitored in order to identify and respond to clusters or outbreaks.  The CD program also serves as a resource for the general public, schools and day cares as well as community and medical entities regarding infectious diseases, infection control and prevention.

Environmental Health
Environmental health utilizes a combination of surveillance, health promotion, enforcement, and assessment to prevent disease and injury, eliminate the disparate impact of environmental health risks and threats on population subgroups, and create health-supportive environments where everyone in Milwaukee has an equal chance to thrive.  Projects/areas of investigation include:

Lead Poisoning Prevention
The Lead Poisoning Prevention Program investigates children screened and identified with elevated blood lead levels.  Children with high levels of lead are provided nurse case management and the source of the child’s exposure is identified in the child’s environment through the completion of lead inspection and risk assessment.  If lead hazards are identified written orders are issued, the department monitors the hazard abatement by a state certified lead abatement contractor and assures the hazard is mitigated through clearance testing.  The department administers grants to assist property owners with the expense of lead hazard abatement.  In addition the Lead Poisoning Prevention program works with community partners to distribute water filters to individuals whose homes are served by lead laterals.  The program conducts water sampling in school and child care facilities to check for lead.  The program works to educate the community and medical providers around the risks of lead and the need to screen children for lead poisoning.

Immunizations
The Immunization Program seeks to reduce the incidence of vaccine preventable disease by increasing access to immunizations, increasing demand for immunizations, and reducing missed opportunities to vaccinate.  To increase access to immunizations, the Immunization Program with assistance from staff across the department offers free vaccinations to children and adolescents ages 18 years or younger at our three health centers.  Clinics are held for three hours Monday through Wednesday and Friday.  The department also provides offsite clinics in school and childcare facilities.  To increase demand for immunizations, the Immunization Program sends reminder notices out to parents to let them know when their child is due or overdue for vaccines.  The program also works with schools and childcare facilities to enforce immunization requirements.  In order to reduce missed opportunities to immunize, the program provides education to medical providers to assure that they capitalize on each and every opportunity to vaccinate.

Occupational Health, Safety, and Public Health Preparedness
The Occupational Health, Safety and Preparedness Program strives to ensure the safety of workers in both the department and community.  Program staff works to improve workplace health and safety through the development and maintenance of occupational health and safety plans, investigation of workplace hazard complaints, issuance of proper personal protective equipment and comprehensive employee training.  The program works to enhance community resiliency in the face of disasters through the development and maintenance of emergency response planning;  establishment of public health expertise and capacity to investigate contain and mitigate public health threats; and by enhancement of the department’s ability to provide public health information and warnings.

Sexual and Reproductive Health
The Sexual and Reproductive Health Program provides confidential testing and follow-up that is free of charge to residents of Milwaukee and the surrounding communities. Services are provided at the Keenan Sexual Health Clinic to anyone who is at least 12 years of age. Work is being done to expand sexual health clinic services to the Southside Health Center. Testing is available at the Northwest Health Center in partnership with Diverse and Resilient. In addition to clinical services, Disease Intervention Specialists (DIS) perform partner services, which is the notification of sexual partner(s) of individuals diagnosed with a sexually transmitted infection (STI) including HIV. The partner(s) are told that they may have been exposed to a STI and should be tested and/or treated. This is a core public health duty and is done anonymously or confidentially; sexual partner(s) are not told who referred them. The DIS follow-up clients known or suspected of having syphilis, HIV, gonorrhea (GC) and chlamydia (CT) in the city, and also conduct follow-up for HIV cases in Milwaukee County and syphilis cases across six-county area of southeastern Wisconsin.

Tuberculosis Prevention and Care
The Tuberculosis (TB) Prevention and Care Program provides TB screening for residents that are at increased risk for tuberculosis. Testing, treatment, and follow-up services are provided at no cost, to residents suspected or confirmed of having latent tuberculosis infection (LTBI) or active TB disease. Additionally, the program works with community agencies, providers, and hospitals to identify persons who have latent tuberculosis infection (LTBI) and active TB disease. An active case of TB typically requires six to nine months of case management while a drug resistant case results in extensive case management for two or more years. Directly observed therapy (DOT) is a standard of care and provided to all persons with active TB disease, most children with LTBI under 5 years old, and some high-risk individuals. People who have close contact with patients with infectious TB, or TB “contacts” are investigated systematically and actively for TB infection and disease. Contact investigations contribute to early identification of active TB, thus decreasing its severity and reducing transmission of TB to others, and identification of latent TB infection (LTBI), to allow preventive measures.