This cooperative agreement will improve surveillance infrastructure through enhancement of the epidemiology and laboratory capacity of the existing EIP network by providing additional support for: 1. Personnel, especially those who have responsibilities across multiple EIP activities; 2. Education and training related to infectious diseases; 3. Improvements in information technology consistent with applicable federal standards and the capacity to exchange information pertinent to multiple EIP activities among public health partners; 4. Enhancement of EIP site capacity to a) support the evaluation and validation of proposed reporting metrics for healthcare associated bloodstream infections among dialysis patients in outpatient dialysis centers and b) monitor and assess the burden of influenza following the 2009-2010 Influenza A (N1N1) pandemic. Proposed Activities 1, 2, and 3 - Personnel, Training, IT For activities 1, 2, and 3, we are requesting funding for 1 FTE Microbiologist who works at the DPH Laboratory. This person will be responsible for testing of specimens for organisms related to FoodNet activities (Salmonella, Shigella, E. coli, Vibrio) as well as the active bacterial core surveillance project (Streptococcus pneumoniae, N. meningitidis, Listeria monocytogenes, Haemophilus influenzae). We are requesting funding for a .5 FTE Epidemiologist who will work in the Infectious Diseases Section and assist with food and water-borne outbreaks, and surveillance for influenza associated hospitalizations and deaths. Funds in this proposal will also support training of EIP staff epidemiologists to acquire and improve technical skills needed for successfully conducting EIP activities. The trainings are held at Emory University in Atlanta, GA. They include control of foodborne and waterborne diseases, epidemiology and analytical methods. The CT EIP is a collaborative effort between the DPH and Yale University School of Public Health. The EIP projects conducted at Yale have relied on computer support from Yale IT staff who are assigned to provide service to the entire School of Public Health community or from IT technical support by telephone in emergency situations. However, with the increasing amounts and complexity of data needed for these projects, to best use epidemiologist staff resources, and to share information with the DPH and CDC, additional IT support is needed. Funds are being requested to support a .5 FTE Programmer/Analyst to provide needed computer and database expertise to the staff of the Yale EIP. At a minimum, this person will be certified in 'desktop support' and have a background in computer network security. Proposed Activity 4a. Influenza The DPH is requesting funding to support a .5 FTE Epidemiologist 1 who will work on influenza associated hospitalizations and deaths. Currently, 1.5 FTE epidemiologists are supported by the EIP for these labor intensive and time sensitive activities. We are also requesting funds for .5 FTE Research Associate at the Yale EIP to carry out the activities of the Influenza Burden Projection Project. This person will work directly with CDC and other EIP sites in the development of the standard protocol to be used at all sites. Additional funds are also requested for a .3 FTE Programmer/Analyst, who will provide the needed computer and database support. This project aims to develop a model for estimating the number of cases, hospitalizations and deaths due to influenza. Development of the model will provide needed information to policy makers when evaluating prevention and control measures. Activity 4.b. Healthcare Associated Infections - (Non-ACA funds) The DPH is requesting funds to support the EIP cooperative agreement Healthcare Associated Infections Program End Stage Renal Dialysis Blood Stream Surveillance special pilot project. The project is part of an initiative for the prevention of blood stream infections among dialysis patients initiated by the Center for Medicare and Medicaid Services and CDC. The Network of New England will be the Group Administrator for the project, enroll dialysis providers, conduct administrative functions such as training and user support with CDC, assure the correct submission of accurate data into the national data system, and report on the lessons learned from the project to CMS and CDC. The funds will include support for a Project Coordinator who will communicate with providers and encourage enrollment in retention in the project and also an administrative assistant who will assist the project coordinator with communication and assist in all aspects of the project.