Objectives

The Maryland Active Bacterial Core surveillance (MD ABCs) is a component of the Maryland Emerging Infections Program (EIP) sponsored by the Emerging Infections Program of the Centers for Disease Control and Prevention (CDC) and is a partnership between the Maryland Department of Health and Mental Hygiene (DHMH) and the Johns Hopkins Bloomberg School of Public Health. The MD ABCs, based at the Johns Hopkins Bloomberg School of Public Health, conducts active population based surveillance for emerging infectious disease throughout the state of Maryland.

The goals of ABCs surveillance are:

• To determine the incidence and epidemiologic characteristics of invasive disease due to Neisseria meningitidis, Haemophilus influenzae, Group A Streptococcus (Streptococcus pyogenes), Group B Streptococcus (Streptococcus agalactiae), Streptococcus pneumoniae, and methicillin-resistant Staphylococcus aureus (MRSA) in the state of Maryland. 
• To determine molecular epidemiologic patterns and microbiologic characteristics of public health relevance for isolates causing the above invasive infections.
• To provide an infrastructure for and to conduct additional special studies including those aimed at identifying risk factors for disease, evaluating prevention policies, and estimating the rate of subsequent disease among household members.

ABCs Core activities and Catchment Areas

The MD ABCs core surveillance activities include:

• Surveillance for Streptococcus pneumoniae and Group A Streptococcus (GAS) in the Baltimore Metropolitan Area (BMA). The BMA includes Baltimore City and its five surrounding counties (Anne Arundel, Baltimore, Carroll, Harford and Howard).
• Surveillance for Haemophilus influenzae, Neisseria meningitidis, and Group B Streptococcus (GBS) statewide.
• Surveillance for invasive methicillin-resistant Staphylococcus aureus (MRSA) in Baltimore City and Baltimore County.

ABCs Case Ascertainment

The MD ABCs identifies cases through:

• Reporting: Infection Control and Laboratory professionals at hospitals and laboratories serving residents in the catchment areas report cases identified at their facility. Cases are reported by faxing a completed “ABCs Notification Form” to 410-502-1951 or by calling 410-502-1945. 
• Laboratory audits: To ensure the completeness of surveillance, the MD ABCs conducts monthly audits at the majority of reporting laboratories to identify cases not previously reported. 

Additional MD ABCs surveillance in Maryland

In addition to core surveillance activities the MD ABCs conducts surveillance for:

• Influenza:  The MD ABCs conducts surveillance of adult and pediatric hospitalized cases of influenza types A & B in the BMA. Additionally, surveillance has begun for adult and pediatric hospitalized cases of the 2009 H1N1 influenza strain in the BMA.
• Candidemia: The MD ABCs conducts active population-based surveillance for cases of candidemia and antifungal drug resistance in Baltimore City and County.

For more information about ABCs activities, including current Case Definitions and Surveillance Methodology, please visit the CDC ABCs website.

Maryland Emerging Infections Program/ABCs
Johns Hopkins University Bloomberg School of Public Health
Candler Building
111 Market Place, Suite 850, Room 8546
Baltimore, MD 21202
Phone: 410-223-1810
Fax:  410-223-1815
 mdabcs@jhsph.edu