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Tennessee Emerging Infections Program


Tennessee Department of Health
Vanderbilt University School of Medicine, Department of Preventive Medicine
Centers for Disease Control and Prevention


Welcome to the Tennessee Emerging Infections Program site! It will introduce you to the people and projects of the Tennessee EIP.

The Emerging Infections Program (EIP) is a population-based network including the Centers for Disease Control and Prevention and state health departments, working with collaborators (academic centers, local health departments, infection control practitioners, and other federal agencies) to assess the public health impact of emerging infections and to evaluate methods for their prevention and control.

Currently, the EIP Network consists of 10 sites: California, Colorado, Connecticut, Georgia, Maryland, Minnesota, New Mexico, New York, Oregon and Tennessee.

The Tennessee Emerging Infections Program (EIP) is a collaborative effort of the Communicable and Environmental Disease Services section of the Tennessee Department of Health, the Vanderbilt University School of Medicine Department of Preventive Medicine, and the Centers for Disease Control and Prevention. From December 1999 until December 2002, the following eleven counties in Tennessee were involved in the EIP: Cheatham, Davidson, Dickson, Hamilton, Knox, Robertson, Rutherford, Shelby, Sumner, Williamson and Wilson. In January 2003, the entire state became part of one major program of the EIP, the Foodborne Diseases Active Surveillance Network (FoodNet).

The core activity of the EIP is active surveillance of laboratory-confirmed cases of reportable pathogens. Laboratory directors and staff, physicians, nurses, infection control practitioners and medical records personnel are key participants in EIP. Components of the EIP in Tennessee investigate foodborne infections (FoodNet), invasive bacterial infections (ABCs) and human papillomavirus (HPV Impact Project).


Active Bacterial Core Surveillance (ABCs)

At 10 Emerging Infections Program sites (EIPs), laboratory-based surveillance is conducted for invasive bacterial diseases due to pathogens of public health importance. For each case of invasive disease in the study population, a case report with basic demographic information is filed and, in most cases, bacterial isolates from a normally sterile site from patients are sent to CDC for laboratory study.  


  • To determine the incidence and epidemiologic characteristics of invasive disease due to Group A Streptococcus, Group B Streptococcus, Haemophilus influenzae, Neisseria meningitidis, Streptococcus pneumoniae and methicillin-resistant Staphylococcus aureus in several large populations.
  • To determine molecular epidemiologic patterns and microbiologic characteristics of public health relevance for isolates causing invasive infections from select pathogens.
  • To provide an infrastructure for further research, such as special studies aimed at identifying risk factors for disease, post-licensure evaluation of vaccine effectiveness, and monitoring effectiveness of prevention policies.

Pathogens under Surveillance:

  • Group A Streptococcus (GAS)
  • Group B Streptococcus (GBS)
  • Haemophilus influenzae
  • Neisseria meningitidis
  • Streptococcus pneumoniae
  • Methicillin-Resistant Staphylococcus aureus (MRSA)

Surveillance Catchment Area:
The total population nationwide under surveillance is approximately 39 million. Residents of Cheatham, Davidson, Dickson, Hamilton, Knox, Robertson, Rutherford, Shelby, Sumner, Williamson and Wilson coounties are included in our surveillance catchment area for all but one of the invasive pathogens listed above. For MRSA, however, Tennessee restricts the population just to Davidson county to ensure complete reporting and good audit data.

Current Projects:

  • Evaluation of Tetravalent Meningococcal Conjugate Vaccine Effectiveness
    Among Persons Aged 11-19 years
  • Evaluation of Adherence to the 2002 Revised Guidelines for
    the Perinatal GBS Disease
  • Respiratory Disease Activity
    • Pediatric Influenza Hospitalization Surveillance Project
    • Adult Influenza Hospitalization Surveillance Project
    • Protocol for Assessing the Effectiveness of Trivalent Inactivated Vaccine among Children Aged 6-23 months in Preventing Hospitalization with Influenza during the 2005-2006 Influenza Season

For more information, contact the ABCs Coordinator or RDA (Respiratory Disease Activity Coordinator) at (615) 322-6838.

Foodborne Disease Active Surveillance Network (FoodNet)

The Foodborne Diseases Active Surveillance Network (FoodNet) is the principal foodborne disease component of CDC's Emerging Infections Program (EIP). FoodNet is a collaborative project of the CDC, ten EIP sites (California, Colorado, Connecticut, Georgia, Maryland, Minnesota, New York, New Mexico, Oregon, and Tennessee ), the U.S. Department of Agriculture (USDA), and the Food and Drug Administration (FDA).
The project consists of active surveillance for foodborne diseases and related epidemiologic studies designed to help public health officials better understand the epidemiology of foodborne diseases in the United States.


  • Determine the burden of foodborne illness in the United States
  • Monitor trends in the burden of specific foodborne illness over time
  • Attribute the burden of foodborne illness to specific foods and settings
  • Disseminate information that can lead to improvements in public health practice and the development of interventions to reduce the burden of foodborne illness

Pathogens under Surveillance:

  • Bacterial Pathogens
    • Salmonella
    • Shigella
    • Campylobacter
    • Shiga-toxin producing Escherichia coli, including E. coli O157 and E. coli non-O157s
    • Listeria
    • Yersinia
    • Vibrio
  • Parasitic Pathogens:
    • Cryptosporidium
    • Cyclospora

Other Condtions under Surveillance:

  • Hemolytic Uremic Syndrome (HUS)

Surveillance Catchment Area:
In 1995, FoodNet surveillance began in five locations: California, Connecticut, Georgia, Minnesota and Oregon. Each year the surveillance area, or catchment, has expanded, with the inclusion of additional counties or additional sites (New York and Maryland in 1998, eleven counties in Tennessee in 2000 with statewide coverage in 2003, Colorado in 2001,and New Mexico in 2002 ). The total population of the current catchment is 44.1 million persons, or 15% of the United States population.

Current Projects:

  • E. coli 0157:H7 Antibiotic Exposure and the Risk of Hemolytic Uremic Syndrome (HUS)
  • Genetic Predictors of Developing Hemolytic Uremic Syndrome (HUS) following Infection with Shiga-toxin producing Escherichia coli (STEC)
  • Clinical Outcomes in Multi-Drug Resistant non-Typhi  Salmonella Serotypes
  • FoodNet Case-Control Study of Selected Salmonella Serotypes
  • Clostridium difficile Infection Surveillance Through the Emerging Infections Program
  • Application of Spatial Analysis, at Three Geographic Scales, to Detect Clustering of Humans with Campylobacteriosis Reported to the Tennessee Department of Health (conducted at the University of Tennessee, Knoxville)
  • FoodNet Population Survey (conducted every other year by a CDC contractor)

For more information, contact the FoodNet Coordinator at (615) 741-7247.

HPV Impact Project: HPV Vaccine Impact Monitoring
Through Surveillance of CIN 2/3, AIS, and Associated Types

In 2006, a vaccine against human papillomavirus, (HPV), was approved for use in girls and women ages 11-26. Though it will take decades to measure the impact of the vaccine on cervical cancer incidence, the HPV Impact Project was launched to monitor short term changes that can be assessed through surveillance of CIN 2/3 and AIS, which occurs with greater frequency and is detectable much earlier than cancer. These conditions were made reportable conditions through the Tennessee Cancer Registry (TCR) in 2008.

Cases will be identified by reporting from hospital and commercial pathology laboratories directly to the cancer registry. For some cases, histologic specimens will be sent to the CDC for HPV subtyping.

This multi-faceted effort will also involve monitoring vaccine coverage and cervical screening patterns in the population. Providers will be asked for information about patients reported to the TCR with high-grade cervical dysplasia. All communications and data collection methods are designed with careful attention to protecting patient confidentiality.

The HPV Impact Project (HPVIMP) is being conducted at five EIP sites; California, Connecticut, New York, Oregon, and Tennessee. In Tennessee the HPVIMP is a collaborative effort of the Department of Health’s Communicable & Environmental Disease Services, (CEDS), and the Tennessee Cancer Registry, (TCR).

  • Monitor HPV vaccine impact on cervical cancer precursors, cervical intraepithelial neoplasia (CIN) grade 2 and 3 and adenocarcinoma in situ (AIS).
  • Monitor HPV vaccine impact on HPV types associated with CIN 2/3 and AIS lesions.
  • Improve public health practice through local population-based surveillance of HPV-related cervical cancer precursors.
Source populations
  • Women ages 18 years and older residing in defined catchment areas. In Tennessee, the catchment area is Davidson County.

For more information please contact:
HPV Impact Project Coordinator
Tennessee Emerging Infections Program
Phone: (615) 322-1853





EPI-News is a newsletter which is published quarterly by Communicable and Environmental Disease Services to inform the public health community, the private medical community, and the general public on issues related to occurrence of diseases and notifiable conditions within the state.

To be placed on the mailing list for this publication, call 800-404-3006 or e-mail. To read the newsletter online, select an issue below:

FoodNet News

CDC FoodNet News

Case Report Forms

2005 FoodNet Bacterial CRF (.pdf)
2005 FoodNet Parasitic CRF (.pdf)
2007 ABCs CRF (.pdf)
CDC Vibrio Form (.pdf)
CDC Typhoid and Paratyphoid Form (.pdf)
Neonatal Group B Streptococcal Disease Prevention Tracking Form

Tennessee EIP Principal Investigator
Selected Publications

Karen Bloch, MD (.pdf)
Allen S. Craig, MD (.pdf)
Timothy F. Jones, MD (.pdf)
David Kirschke, MD (.pdf)
Ban Mishu-Allos, MD (.pdf)
William Schaffner, MD (.pdf)

ABCs Publications (by pathogen)

ABCs Publications (by pathogen) (.pdf)

Morbidity and Mortality Weekly Report

 2007  Preliminary FoodNet Data


News and Events

The Tennessee Food Safety Task Force is sponsoring a one-day session (February 19, 2009) on Food Recalls in Nashville. Representatives from state and federal public health agencies, the beef industry, food manufacturing and retail will provide their perspective on the steps leading to initiation of food recalls, as well as the implementation and impacts of food recalls. Speakers will participate in a panel discussion focusing on ways to improve communication, data sharing and decision making. In addition, panel members will discuss their perspective on interaction with the media and release of public information. For more details, please visit

The Annual Tennessee EIP Scientific Sessions are held yearly in Nashville. Featured speakers will present FoodNet and ABCs data gathered via active surveillance. Laboratorians, infection control practitioners, health information specialists, physicians, nurses, pharmacists, and other interested health care professionals are invited. There is no registration fee, but registration is required. Call Terry McMinn at 615-322-5874 to register. Watch this website for details about speakers and topics.

Related Sites

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FoodNet Coordinator
Tennessee Department of Health
Tennessee Emerging Infections Program
Communicable and Environmental Disease Services Section
1st Floor, Cordell Hull Building
425 5th Avenue North
Nashville Tennessee 37243
Phone: 615-741-7247
Fax: 615-741-3857

FoodNet Logo


Active Bacterial Core Surveillance (ABCs)

ABCs Coordinator
Tennessee Emerging Infections Program
Vanderbilt University Medical Center
Preventive Medicine
Village at Vanderbilt
1500 21st Avenue South, Suite 2600
Nashville, Tennessee 37212
Phone: 615-322-6838
Fax: 615-343-8722

ABCs Logo


HPV Impact Project

HPV Impact Project Coordinator
Tennessee Emerging Infections Program
Vanderbilt University Medical Center
Division of Infectious Diseases
A-2200 MCN
Nashville, Tennessee 37232-2582
Phone: 615-322-1853
Fax: 615-343-8722

Respiratory Disease Activity (RDA)

RDA Coordinator
Tennessee Emerging Infections Program
Vanderbilt University Medical Center
Preventive Medicine
Village at Vanderbilt
1500 21st Avenue South, Suite 2600
Nashville, Tennessee 37212
Phone: 615-322-6838
Fax: 615-343-8722