Board of Health Meeting - Tuesday, December 3, 2024 ...

[Mission]
To assure access to quality services and to improve community health and wellness.
Board of Health Meeting
Tuesday, December 3, 2024
Agenda
Surmeet Bedi, M.D. Dr. Mary Burkhardt Jennifer Forrester, M.D.
Edward B. Herzig, M.D. Christopher Lewis, M.D. Raynal Moore
Ken Patel Kiana Trabue Ashlee Young
6:00 pm – 6:05 pm Call to Order and Roll Call
6:05 pm – 6:10 pm Review and Approval of Minutes
o Vote: Motion to Approve the Minutes from October 22, 2024, Board of Health Meeting.
Old Business
6:10 pm – 6:15 pm Introduction of New Board Member—Dr. Mary Burkhardt
6:15 pm – 6:25 pm COVID-19 Update – Ms. Kim Wright
6:25 pm – 6:35 pm Cincinnati Country Club Pool Gate Variance Resolution No. 2024-006—Mr. Antonio Young
o Vote: Motion to Suspend the statutory rule requiring three readings of Resolution No.
2024-006.
o Vote: Motion to Approve Resolution No. 2024-006 APPROVING the Cincinnati Country
Club Pool Gate Variance request for a limited variance from the requirements of Ohio
Administrative Code 3701-31-04(B)(6)(s), subject to the approval of the Ohio
Department of Health.
6:35 pm – 6:45 pm Air Quality Sampling Presentation – Ms. Meriel Vigran
6:45 pm – 6:55 pm Finance Committee – Ms. Ashlee Young
o Vote: Motion to Approve Hamilton County Solid Waste District– Contract 55x10731
o Vote: Motion to Approve UC Health, LLC Parking Lease—Contract 35x10531, 1st
Amendment
o Vote: Motion to Approve Hamilton County Public Health –Contract 55x10741
6:55 pm – 7:05 pm Finance Update – Mr. Mark Menkhaus Jr.
7:05 pm – 7:10 pm Personnel Actions—Dr. Grant Mussman
o Vote: Motion to Approve Personnel Actions dated December 3, 2024
New Business
7:10 pm – 7:15 pm Additional New Business and Public Comments

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[Mission]
To assure access to quality services and to improve community health and wellness.
7:15 pm Adjourn
Next Meeting January 28, 2025

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CINCINNATI BOARD OF HEALTH
BOARD OF HEALTH MEETING
October 22, 2024
Ms. Ashlee Young, Chair of the Board of Health, called the October 22, 2024, meeting of the Cincinnati
Board of Health to order at 6:00 p.m.
I. ROLL CALL:
Board Members Attending: Dr. Surmeet Bedi, Dr. Jennifer Forrester, Dr. Edward Herzig, Dr. Christopher
Lewis, Dr. Monica Mitchell, Ms. Raynal Moore, Mr. Ken Patel, Ms. Kiana Trabue, Ms. Ashlee Young
Absent: none
Others Present: Mr. Timothy Collier, Ms. Sa-Leemah Cunningham, Dr. Michelle Daniels, Mr. Ian Doig, Mr.
John Dunham, Dr. Yury Gonzales, Dr. Camille Jones, Mr. Mark Menkhaus Jr, Dr. Grant Mussman, Ms.
Ashanti Salter, Ms. Joyce Tate, Ms. Kim Wright, Mr. Antonio Young
AGENDA
October BOH
Agenda Packet-10.22.24.pdf
ITEM TOPIC RESPONSIBLE
PARTY
ACTION/MOTION
Minutes Motion that the Board of Health approves the minutes
from September 24, 2024, Board of Health Meeting.
(Dr. Lewis joined after this vote)
Ms. Sa-Leemah
Cunningham
Vote: Approval of
Minutes
Motion: Ms. Kiana
Trabue
2nd: Mr. Ken Patel
Action: 8-0 Passed
Old Business
Emergency
Preparedness
Presentation	BOH 10_22_24.ppt
Discussion Items: Presentation included in the
agenda.
Mr. John Dunham gave a presentation regarding
Potential HazMat Events and Response to the Board.
Highlights:
• Mr. Dunham was asked to speak by Dr
Mussman in response to recent incidents in
Cleves and Whitewater township.
• Mr. Dunham discussed CHD Emergency
Preparedness Core Functions: Public Health
Mr. John
Dunham
n/a

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Emergency Preparedness Grant, Cities
Readiness Initiative, and Biowatch.
• Mr. Dunham showed a picture of a biohazard
release that happened at CHD in 2005 (as an
example of what it looks like) and stated this
could happen again.
• Mr. Dunham informed of CHD response
actions in these incidents:
o Coordinate with Cincinnati Fire
Department Emergency Management
Office and CFD’s HazMat Team
o Provide reach back for decision support
on Shelter in Place, Evacuations
o Provide information on population
protection measures determined by the
threat.
▪ Access and Functional Needs
Populations
▪ Schools, Nursing Homes,
Hospitals
o Provide air monitoring to establish safe
zones
o Work with American Red Cross and
partners to establish shelters if needed
o Coordinate with Ohio EPA, Hamilton
County EMA, USEPA
o Utilize Federal assets to determine plume
migration
• Mr. Dunham went over a commodities study
and strategies performed by Hamilton County
Emergency Management Agency. The study
found that there is a large amount of toxic
materials that move through the region
daily—on the roads, river and rail.
• Mr. Dunham presented a sample of rail
commodities, an example which included the
top 10 materials found on railways.
1. Alcohol
2. Propane
3. Elevated Temperature liquid
4. Sulfur, molten
5. FAK-Freight of All Kinds
6. Butane
7. Hydrochloric acid
8. Sodium hydroxide solution
9. Propane
10. Liquified petroleum gas
• Mr. Dunham ended by stating the region will
always face threats from transportation accidents.
All jurisdictions prepare for the worst and plan to
mitigate and minimize the threat to populations,
property and the environment

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• Ms. Young asked if there are any proactive
preventions that can be carried out on
railways to prevent incidents.
o Mr. Dunham answered that the
railways have a lot of power in their
own regulations, which gives local
input very minimal.
• Dr. Herzig praised Mr. Dunham for his amazing
work during the COVID response.
• Ms. Trabue asked if there were any plans to
do another mass casualty exercise anytime
soon.
o Mr. Dunham answered that the local
emergency planning committee plans
those large exercises. This usually
happens one every 4 years.
•
Commissioner’s
Report
Discussion Items: Memo included in the agenda
packet.
Health Commissioner
Executive Summary 10-17-2024.docx
Dr. Grant Mussman presented his commissioner’s
report to the Board.
CHD capital planning:
• Dr. Mussman updated the board that the CHD
Capital planning process is progressing, with
the CHD capital planning committee scheduled
to meet on 10/21/24.
• He elaborated that Invitees include CHD
leadership, representatives from CHD and
CCPC boards, as well as representatives from
the city manager’s office, budget, purchasing,
planning and engagement, and real estate law.
Opioid mitigation through the OneOhio settlements
• Dr. Mussman announced that CHD is taking
the lead in developing an RFP to distribute
Cincinnati’s share of the OneOhio settlement
funds as grant awards
• Dr. Mussman explained that the OneOhio plan
allows local jurisdictions to combine in opioid
litigation and receive funds, with 55% going to
the OneOhio Recovery Foundation (regional
funds), 30% to local governments, and the
remainder to the state.
• He stated goals are to create a simple and
efficient process that avoids duplication of
Dr. Grant
Mussman
n/a

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awards between the county and city and the
Target date for the RFP will be January 1st.
Biowatch functional exercise
• Dr. Mussman told the board that the
Cincinnati Biowatch (Dr. Mussman, chair)
conducted a functional exercise this month
based on a fictional WMD scenario
• He explained that the Biowatch is a federal
sentinel system for known weaponized
bioterror agents
• John Dunham, CHD’s emergency response
coordinator, presented at this board meeting.
Lead program completes ODH site visit
• Dr. Mussman announced that CHD’s Lead
Poisoning Prevention team recently
completed a site visit from the Ohio
Department of Health. The Lead Poisoning
Prevention program follows up on lead levels
in Cincinnati children that exceed the 3.5
mcg/dL threshold
• Dr. Mussman updated that the ODH team
found our program in full compliance, and
called out our team’s excellent successful
closure rate in their report
COVID-19 Update Discussion Items: Memo included in the agenda
packet.
COVID-19 update
BOH 10.15.2024.docx
Ms. Wright updated the Board on the COVID-19 Data
for September 2024.
Highlights
• As of October 11, 2024, 94,136 cases of COVID
were reported.
• Hospitalizations and wastewater indicators were
trending down.
• No big updates on seasonal respiratory viruses.
Minimal RSV and Flu activity. One flu
hospitalization was reported locally.
• CHD had been working with one of the local
universities who had been experiencing a Pertussis
(Whooping cough) outbreak. These were
vaccinated students residing on campus (8 cases).
Total cases in Cincinnati were 14 cases. Working
with the university to get it under control.
• CHD received a text illness monitoring tool
which was piloted in early 2024 and is free.
Gives CHD the allowance to monitor
Dr. Kim Wright n/a

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symptoms and give people the allowance for
CHD give them assistance. All CDU staff will be
trained in this as well as epidemiologists.
Food License &
Facility Review
Fees for License
Year 2025-2026
Presentation—
Reading #3
Attachment 4.docx	Attachment 3
RESOLUTION_Amending Reg 00079 to update fees and add mobile food service operations (00407128-3xC2130).docx
Attachment 2.docx
Attachment 1.docx	2025 - 2026 BOH
Memo.docx
Discussion Items: Document and Presentation
included in the agenda.
Mr. Antonio Young Discussed the third and final
reading of the Food License & Facility Review Fees for
License Year 2025-2026 and BOH resolution 2024-003.
• Final reading for this resolution. Mr. Young
requested a motion to approve, fully
recommended by CHD.
• Mr. Young did a small overview of the resolution.
Motion to Approve Resolution 2024-003, amending
Board of Health Regulation No. 00079, “Fees Retail Food
Establishments; Food Service Operations,” to establish
the fees for inspection of food establishments and food
service operations.
Mr. Antonio
Young
Motion: Dr. Edward
Herzig
2nd: Dr. Jennifer
Forrester
Action: 9-0 Passed
2025 Solid Waste
Transfer Station
Licensure for
Republic Services
(CSI)
Discussion Items: Document and Presentation
included in the agenda.
2025 Resolution
Granting Republic License.docx
2025 CSI Transfer
Station_ License for BOH (1).doc
Mr. Antonio Young Discussed Resolution 2024-005
granting Republic Services of Ohio Hauling, LLC a
license for the year 2025 to operate a solid waste
transfer station at 5701 Este Avenue, Cincinnati, OH.
• A transfer station is a holding point for trash
or solid waste prior to being transported off to
a landfill for disposal.
• CHD does regular year-round inspections of
this site.
• The environmental team inspects those
facilities to make sure that they have proper
sanitation, waste is being distributed properly,
among other things.
• All inspections done thus far this year have
been successful.
Mr. Antonio
Young
Vote: Waive 3x Reading
Motion: Dr. Christopher
Lewis
2nd: Dr. Jennifer
Forrester
Action: 9-0 Passed
Vote: Resolution 2024-
005
Motion: Dr. Jennifer
Forrester
2nd: Dr. Edward Herzig
Action: 9-0 Passed

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• Mr. Young and his team approve their
licensure for 2025.
Motion to Suspend the statutory rule requiring three
readings of Resolution No. 2024-005.
Vote: Motion to Approve Resolution 2024-005 granting
Republic Services of Ohio Hauling, LLC a license for the
year 2025 to operate a solid waste transfer station at
5701 Este Avenue, Cincinnati, OH.
Finance Update Discussion Items: Memo and materials were included
in the agenda.
Finance Update BOH
as of August 2024 10.11.2024.docx
August Financial
Report BOH 10.14.24.docx
Mr. Menkhaus gave an update on CHD Financials for
August 2024 and Year over Year.
Highlights
• Revenue total was $8,593,569.30, a decrease of
5.95%.
o Private Pay Insurance decreased by 7.40%.
o Medicare increased by 5.87%.
o Medicaid decreased by 69.58%.
o Medicaid managed care increased by
26.54%.
o Self-Pay patients increased by 26.08%.
o Board of Ed Svcs (School Nurse’s Salary)
decreased by 97.24%.
o Grants/Federal increased by 68.01%.
• Expenses were $8,938,176.59, an increase of
2.97%.
o Property expenses decreased by 5.09%.
o Personnel expenses increased by 6.47%.
o Contractual costs decreased by 6.37%.
o Material costs increased by 18.22%.
o Fixed costs decreased by 25.41%.
o Fringes increased by 3.64%.
The total available is $1,842,092.71, increased by
303.34%
Mr. Mark
Menkhaus Jr.
N/A
Personnel Actions Motion to Approve the personnel actions dated
October 22, 2024
Dr. Grant
Mussman
Motion: Dr. Edward
Herzig
2nd: Dr. Monica Mitchell
Action: 7-0 passed
New Business
Additional New
Business and
Public Comments
Dr. Herzig, Ms. Young, Dr. Lewis, Dr. Mussman,
additional Board members, and CHD honored and
praised Dr. Mitchell for her contributions and years on
the board, as this was her last board meeting.
Public Comments
• There were no public comments.
Ms. Ashlee
Young
n/a

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6:57 p.m. adjourned.
Next meeting: Tuesday, December 3, 2024, at 6pm via Zoom.
Meeting can be viewed at: Internet Archive: Digital Library of Free & Borrowable Texts, Movies, Music
& Wayback Machine
Minutes Approved by:
_________________________ ____________________________
Sa-Leemah Cunningham Ashlee Young
Cincinnati Board of Health Clerk Chairperson, Board of Health

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Board Members Roll Call
9.24.24 BOH
Meeting
Minutes
Approve Food
Fees
Resolution
2024-003
Waive 3x
reading for
resolution 2024-
005
Approve
Resolution 2024-
005 2025 Solid
Waste Transfer
Station Licensure
for Republic
Services (CSI)
Personnel
Actions Dated
10.22.24
Dr. Surmeet Bedi x x Present
Dr. Jennifer Forrester x 2nd 2nd M 2nd Yay
Dr. Edward Herzig x M 2nd Nay
Dr. Christopher Lewis x M M Absent
Dr. Monica Mitchell-Chair x Didn't vote but present
Ms. Raynal Moore x M Move
Mr. Ken Patel x 2nd 2nd Second
Ms. Kiana Trabue x M
Ms. Ashlee Young x
Motion Result: Quorum Passed Passed Passed Passed Passed
STAFF
Sa-Leemah Cunningham-Clerk x
Dr. Grant Mussman-Commissioner x
Antonio Young x
Ian Doig x
Mark Menkhaus Jr. x
Kim Wright x
Timothy Collier x
Joyce Tate x
Dr. Michelle Daniels x
Dr. Camille Jones x
Ashanti Salter x
Dr. Yury Gonzales x
John Dunham x
October 24, 2024 Meeting Attendance/vote sheet

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1
DATE: December 1, 2024
TO: Cincinnati Health Department Board of Health
FROM: Kim Wright, Supervising Epidemiologist Communicable Disease Prevention and
Control - CHES
SUBJECT: December COVID-19 and CDU Update
New Reports in 2025
• Beginning in January, our Monthly Infectious Disease Surveillance Report will also
include Tuberculosis, Sexually Transmitted Disease, and Human Immunodeficiency
Virus numbers for Cincinnati residents, to provide a more complete communicable
disease snapshot for the Board of Health.
• This Board of Health report which has been focused primarily on pandemic COVID-
19 response over the last four years, will begin providing the Board of Health with a
“What’s Bugging Us” update, meant to provide communicable disease trends and
topics that are affecting Cincinnati residents presently or may affect Cincinnati
residents in the near future. This change will also begin in January.
Cincinnati COVID-19 Data Highlights:
• As of November 22, 2024 CHD reported a cumulative total of 94,136 COVID-19
confirmed and probable cases (94,136 were reported last meeting), 3590 (3578)
COVID-19 hospitalizations, and 816 (812) COVID-19 deaths.
• The Cincinnati community transmission continued to decline to 10.5 (15.1) new cases
per 100,000 cumulative over a 7-day period, which is Moderate (10-49.99) at the time
of this report
• The regional SALT Respiratory Virus Situational Awareness updated on November
22, 2024, reports the 80+ age group continues to have the highest weekly incidence
rate, but also much lower, at 34.8 (82.5), followed by the 60–69-year-old age group at
17.4. The 0–19-year-old age group rate rose slightly to 12.0 (10.7), and the 20–29-
year-old group had the lowest rate at 8.6.
• Deaths remain low in the region, but it is noted that there were 4 COVID-19 deaths
reported since the last meeting in Cincinnati (3 were reported last month).
• Ohio Department of Health has advised the requested change to make only COVID-
19 Hospitalizations reportable in Ohio is still in process of being approved.
COVID-19 Vaccination Updates Kimber
• On June 27, 2024, the CDC Director adopted the ACIP’s recommendations for use of
2024–2025 COVID-19 vaccines in people ages 6 months and older as approved or
authorized by FDA. Additionally, persons 65 and older are recommended to receive 2
doses of any 2024–2025 COVID-19 vaccine 6 months* apart (*while it is
the recommended to get 2024-2025 COVID-19 vaccine doses 6 months apart,
the minimum time is 2 months apart, which allows flexibility to get the second dose prior

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2
to typical COVID-19 surges, travel, life events, and healthcare visits, according to the
CDC). For the full list of recommendations, please visit Staying Up to Date with COVID-
19 Vaccines | COVID-19 | CDC.
• The 2024-2025 Moderna vaccine is now available for CCPC patients.
COVID-19 Test to Treat
• https://aspr.hhs.gov/TestToTreat/Pages/default.aspx provides information about the
available resources in the community.
• CHD has plenty of free home test kits for the community and continues to support
congregate settings while supplies last.
COVID-19 Wastewater Analysis
• N2 COVID levels are steady in all 4 sewersheds over the time period from October
29, 2024 – November 17, 2024. Sporadic Influenza Type A is also being detected at
each site. For more information visit ODH WW Dashboard.
ODH COVID Reports November 21, 2024
• Key State Indicators trends at right show cases, hospitalizations, ICU admissions
and deaths declining as of the last update.

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3
CDC COVID Reports as of November 22, 2024
CDC COVID Variant Report
Nationally, CDC Nowcast projects KP.3.1.1 continuing to be the dominant Omicron
variation circulating at 44% (57.2%), XEC is next at 33% (10.7%), and MC.1 at 6% is
now in the top 3 of all the variants detected in clinical specimens in the US as of
November 23, 2024. For more variant analysis please visit
https://covid.cdc.gov/covid-data-tracker/#variant-proportions.

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4
CDC Respiratory Guidance Links
• As of March 1, 2024 CDC aligned COVID-19 guidance with other Respiratory
Guidance that recommends people stay home until they have been fever free for 24
hours without having taken fever reducing medication, and then continue to take
precautions to prevent spread of disease, as illustrated in the CDC graphic below.
This change did not include health care workers who have COVID-19. However,
CDC notes: In general, asymptomatic healthcare personnel (HCP) who have had a
higher-risk exposure do not require work restriction, regardless of vaccination status,
if they do not develop symptoms or test positive for SARS-CoV-2.
CDC Respiratory Guidance
• According to the CDC respiratory activity locator respiratory activity is LOW
nationally. Ohio emergency department trends are pictured below.

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5
The regional SALT Respiratory Virus Situational Awareness is also offering viral
respiratory trends as percent of all emergency department visits in the United
States as of October 5, 2024:
Ohio Department of Health (ODH) began updating the state influenza dashboard again
in October. Ten influenza-associated hospitalizations were reported week ending 10/5/2024
with other activity indicators increasing. Cincinnati is reporting 3 hospitalizations in the
month of October, and none yet to date in November.

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6
COVID Command Center Highlights
• CHD is currently fielding approximately 50 calls per week to our 513-357-7462 line
from residents seeking COVID-19 vaccination or testing opportunities in Cincinnati,
having questions about isolation or in need of a replacement vaccination card.
• On-site 3 contractual staff are currently making approximately 50 calls per week.
This includes investigations, and returning calls made after regular business hours.
• Staff are also working with CDU epidemiologists on a four-year summary of how
people in Cincinnati were affected by COVID-19 for the years 2020-2023.
• Free COVID-19 Test Kits are offered to congregate settings, households of positive
cases, community groups, daycares and other settings where the residents of
Cincinnati can have access to free testing resources, while supplies last.
• CHD continues to also assist residents with proof of COVID-19 vaccination or
testing results as needed for work, school, and/or travel.
• Weekly updates are provided to the team to keep them prepared for calls that may
come in, ongoing outbreaks and other communicable disease-related concerns.
Communicable Disease Prevention and Control Unit Updates
• Mpox updates:
o CDU reports a total of 26 cases of mpox (25 total cases were reported last
month).
o Clade I was detected in the United States and a new health advisory was
issued on November 18, 2024. CDC continues to report that the risk to the
overall US population is low. However, CHD was recently informed that
based upon the latest forecasting model (added to packet), Hamilton County
may be vulnerable to an outbreak scenario, if Clade I were to infect the at-
risk community, identified by the modelers using the Ending the HIV

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7
Epidemic in the US (EHE) | EHE Initiative | CDC data, due to having only
estimated 8% immunity, a calculation based upon vaccination rate and
previous infections. Acknowledging some limitations of the data analysis, the
CDC modeling shows very little impact of the arrival of Clade I to counties in
the United States where there is an estimated 50% immunity in the at-risk
population. The JYNNEOS vaccine is approximately 75% effective at
preventing infection in patients who have only received 1 dose, and 86%
effective in patients having completed the 2-dose recommendation. CHD
CDU met with Hamilton County Public Health, CDC and ODH to hear more
about the upcoming report that is expected to be published on the website in
the near future. Our challenge is reaching and vaccinating the people at
greatest risk. CDC believes an estimated 10,000 people are at risk in
Hamilton County and City of Cincinnati. For the latest information, visit
About Mpox | Mpox | CDC.
o CDU plans to continue free JYNNEOS vaccination sessions since the
expiration date was extended until August 2026! JYNNEOS vaccine is also
available commercially now. The vaccine is FDA approved for and expected to
protect against both clades and all subclades of mpox according to the CDC.
o CHD’s TPOXX for the treatment of Mpox does not expire until 2025 and
continues to be available for providers who diagnose Mpox in patients at high
risk for severe disease. ODH also continues to have capsules and limited IV
TPOXX if needed by diagnosing providers in Ohio.
Pertussis Outbreak
• CDU continues to work closely with University of Cincinnati officials to contain an
outbreak of Pertussis in students. The majority of cases were current with Tdap
vaccination at the time of diagnosis and the majority are residing in dormitories or
other congregate university settings. CHD has supported UC with supplementary
masks and COVID-19 home test kits. At the time of this report 15 students were
laboratory confirmed and a total of 53 students had been tested. UC Student Health
provides isolation guidance and treatment to all who are suspected of having
pertussis at the university and prophylaxis to all contacts of the cases as they are
identified. In efforts to prevent the spread into the secondary settings during the
holiday, UC sent additional communications to the parents of UC students, for their
continued awareness.
• CHD also responded to media requests for more information about Pertussis at UC
and in the community. As of November 22, 2024, CHD was reporting a total of 25
cases of Pertussis to date in 2024. The state of Ohio was reporting 1280 cases as of
week ending November 16, 2024. According to the CDC vaccination is the best
way to prevent pertussis. However, as typical infection patterns return to the
United States, CDC expects pertussis cases to increase both in unvaccinated and
vaccinated populations. Pertussis occurs in vaccinated people since protection from
vaccination fades over time.
Influenza A(H5N1) Bird Flu November 22, 2024 Situational Update
• CHD continues to report no detection of H5N1 in people who reside in Cincinnati.
• CDC continues to monitor people who have been exposed to animals with H5N1 and
conduct surveillance for human cases through the many seasonal influenza
monitoring systems already in place since October.
• Last week Canadian health officials reported a teenager in critical condition with
H5N1 whose exposure was unknown at the time of the report.

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8
• CDC is reporting the first child to be infected with H5N1 in the United States in a
November 22, 2024 release: CDC confirms H5N1 Bird Flu Infection in a Child in
California | CDC Newsroom.
Healthcare Associated Infections/Antimicrobial Resistance (HAI/AR)
• CDU nurses are sharing education and best practices for the prevention and control
of Candida auris and other multidrug-resistant organisms (MDROs) with acute and
long-term care providers as cases are diagnosed and clusters are detected in
healthcare facilities in Cincinnati.
• CHD was recently awarded a new grant from NACCHO to support HAI/AR outbreak
control and prevention.
Marburg Virus Disease Monitoring
• To date ODH has reported one traveler returning from Rwanda for Marburg
symptom monitoring to CHD. The traveler’s risk assessment was low risk. On
November 25, 2024 CDC modified the Interim Recommendations for Post-Arrival
Public Health Management of Travelers from Rwanda | Marburg | CDC. The current
situation in Africa can be viewed here: Marburg Outbreak in Rwanda Situation
Summary | Marburg | CDC.
CHD CDU Reports and Dashboards
• Please find the October Communicable Disease Report included in the packet or
visit the Communicable Disease Dashboard, available on the CHD website.
• The state ODH dashboard can be found here: Summary of Infectious Diseases in
Ohio | DataOhio.

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THE CINCINNATI COUNTRY CLUB, GRANDIN ROAD, CINCINNATI, OHIO 45208
September 1, 2024
Cincinnati Health Department
3101 Burnet Ave
Cincinnati, Ohio 45229
Cincinnati Country Club, 2348 Grandin Rd, Cincinnati, OH 45208: Variance for Ohio
Administrative Code (OAC) 3701-31-04 (8)(6)(s)" all perimeter barriers shall be with gates or
doors that are self-closing and lockable unless otherwise permitted by law."
Cincinnati Country Club and SwimSafe Pool Management are requesting a variance from
OAC 3701-31-04 (B)(6)(s)_Self-Closing and Lockable Gate for Cincinnati Country Club. The
entrances to the pool will be through two gates in the perimeter fence which are self-closing,
self-latching and lockable. The entrances to the pool will be through two monitored check-in
areas. The standard operating procedure is for each check-in desk to always be attended by
a staff person when the pool is open.
When the pool is open, there are lifeguards always on duty. When the pool is closed the
gates will be closed and locked, and the pool will not be accessible. During non-operating
hours we will post proper, "Danger Pool Closed" signage. The facility was designed for this
operating procedure. It is our belief that this will not pose any danger to the public because
the Cincinnati Country Club will ensure there is always an attendant monitoring the entrance,
checking people into the pool, checking age and monitoring occupancy count. All other
gates and access points have been fitted with
self-closing, self-latching and lockable gates for egress only.
Cincinnati Country Club and SwimSafe are requesting this variance for a period of ten years
from date of approval.
Shane Wiggins
SwimSafe Pool Management, Inc.
President
107 Commerce Blvd Loveland, OH 45140
Robert Snider
Cincinnati Country Club
Assistant General Manager
2348 Grandin Rd, Cincinnati, OH 45208

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{00410189-1}
Cincinnati Board of Health
Resolution No. 2024 -
RESOLUTION
BOARD OF HEALTH OF THE CITY OF CINCINNATI
A RESOLUTION of the Board of Health of the City of Cincinnati approving The Cincinnati
Country Club’s (“Licensee’s”) request for a limited variance from the requirements of Ohio
Administrative Code 3701-31-04(B)(6)(s), subject to the approval of the Ohio Department of
Health, where the variance is not contrary to the public interest, and where Licensee has shown
both that there is good cause for the issuance of a variance and that the variance will not result
in any adverse effect on the public health and safety.
WHEREAS, The Cincinnati Country Club (“Licensee”) is licensed by the Board of
Health of the City of Cincinnati (the “Board”) under Ohio Administrative Code (“OAC”) 3701-
31-03 to operate three public swimming pools (including a lap pool, a family pool, and a
baby/wading pool) located at 2348 Grandin Rd., Cincinnati, OH 45208 (the “Facility”); and
WHEREAS, pursuant to OAC 3701-31-04(B)(6)(s), Licensee is required to maintain a
perimeter barrier around the Facility with gates or doors that are self-closing and lockable unless
otherwise permitted by law and Licensee has requested a limited variance from the requirements
of OAC 3701-31-04(B)(6)(s); and
WHEREAS, Licensee’s standard operating procedure during the Facility’s operating
hours is to keep the Facility’s two entrance gates open while employees staff check-in areas at
the entrances to the Facility, constantly monitoring membership, user ages, pool occupancy, and
access to the Facility; and
WHEREAS, pursuant to OAC 3701-31-04(E)(4), Licensee provides lifeguards on duty
during the Facility’s operating hours; and
WHEREAS, all Facility gates and access points are closed and locked during the
Facility’ non-operating hours, with appropriate signage stating “Danger – Pool Closed;” and
WHEREAS, all Facility gates and access points other than the entrance gates will be
fitted with self-closing and latching hardware, or remain locked to prevent unauthorized access;
and
WHEREAS, the Board is permitted to grant this limited variance pursuant to OAC 3701-
31-03(H), subject to the approval of the Ohio Department of Health;
BE IT RESOLVED by the Board of Health of the City of Cincinnati, State of Ohio:
Section 1. That pursuant to Ohio Administrative Code 3701-31-03(H), and subject to the

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{00410189-1}
approval of the Ohio Department of Health, the Board or Health of the City of Cincinnati (the
“Board”) approves the grant of a limited variance to The Cincinnati Country Club (“Licensee”)
from the requirements of Ohio Administrative Code 3701-31-04(B)(6)(s).
Section 2. That the Board finds that this variance is not contrary to the public interest,
that good cause exists for the issuance of this variance, and that this variance will not result in
any adverse effect on the public health and safety.
Section 3. That Licensee shall constantly monitor the Facility’s entrance gates during
they Facility’s operating hours to ensure against unauthorized entry.
Section 4. 	That Licensee shall fit all Facility gates and access points other than the
entrance gates with self-closing and latching hardware, or keep those gates locked at all times.
Section 5. That Licensee shall close and lock all Facility entrances and access points and
post appropriate signage stating “Danger – Pool Closed” during the Facility’s non-operating
hours.
Section 6. That this variance will expire ten years from the date of approval unless further
action is deemed necessary by the Board.
ADOPTED: 	, 2024
____________________________
Ashlee Young, MPH, CHES
Chairperson, Board of Health
____________________________
Grant Mussman, MD, MHSA
Health Commissioner

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1
City of Cincinnati Board of Health Finance Committee
Ashlee Young, Chair of the Board of Health Finance Committee, called the
Tuesday, November 19, 2024 Finance Committee meeting to order at 5:03p.m.
Roll Call
Members present: Tim Collier and Camille Jones (5:14), Dr. Edward Herzig, Mark Menkhaus Jr., Commissioner Dr. Grant
Mussman, Joyce Tate, Kiana Trabue, and Ashlee Young.
Topic Discussion Action/Motion
Approval of
Minutes
The Chair asked Committee members if everyone had the opportunity to review
the minutes from September 17, 2024.
Motion: That the Board of Health (BOH) Finance Committee approves the minutes
from September 17, 2024.
Motion: Herzig
Second: Trabue
Action: Pass
Review of
Contracts for
BOH
Approval:
Nov. 19,
2024
The Chair began reviewing contracts going to BOH for approval.
Hamilton County Solid Waste Management District-55x10731
Mr. Menkhaus Jr. explained that this is a one-year contract (January 1, 2025, to
December 31, 2025) between the Cincinnati Health Department (CHD) and the
Hamilton County Solid Waste District.
This contract, which CHD has held for many years, is for the inspection of solid
waste landfills.
Dr. Herzig asked why the Hamilton County Solid Waste Management District
doesn't offer a multi-year contract. Mr. Menkhaus explained that Hamilton County
Solid Waste District only commits one year at a time because this contract is
funded through their operating budget.
Motion: That the BOH Finance Committee recommends approval.
UC Health, LLC Parking Lease-35x10531 1st Amendment
Mr. Menkhaus Jr. explained that this is an existing contract with UC Health for 20
parking spaces in the lot adjacent to the ADAS Building at 3009 Burnet Avenue,
Cincinnati, Ohio 45219. These spaces provide overflow parking for staff and
visitors.
The amendment includes a 2% annual increase in the rental fee, effective on the
anniversary of the contract's start date.
Motion: That the BOH Finance Committee recommends approval.
Motion: Young
Second: Trabue
Action: Pass
Motion: Young
Second: Herzig
Action: Pass
Review of
Contracts for
BOH
Information:
Nov. 19,
2024
The Chair began reviewing the following contract, going to BOH for information.
The Community Builders, Inc.-55x10728
Ms. Tate explained that this agreement with Community Builders allows us to
lease space in the Avondale Town Center Shopping Center for vendors at the
annual fall festival held at Ambrose Health Center.

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2
Financial
Update
Mr. Menkhaus provided an overview of the financial statement for the period
ending in September 2024
Total Revenue: As of the end of September was $12,501,829.70. Which is a 8.39%
increase from September 2023.
o Total net gain after the capital revenue transfer was $529,610.04.
o Expenses as of September 2024 totaled $14,159,219.66 which is a 1.3%
increase from September 2023.
o As of September, we had $48,283.66 in overtime compared to September
of 2023’s total of $44,806.76. Neither year had any disaster overtime in
the month of September.
o Capital revenue transfer for FY25 in the amount of $2,187,000. In FY24 we
received partial revenue transfer in December and the balance in February
for a total of $1,227,000.00.
o Medicaid revenue is down 76.46% from the year prior. This is because the
FY24 figure was inflated because CHD received several months of
backlogged payments from Medicaid resulting from ODM’s transition from
MITS system to the Provider Network Management System (PNM).
Meanwhile, the FY25 figure is down because of interruptions with OBS
claims going to Medicaid wrap. The issue with Medicaid wrap payments
was resolved as of October 2024
Total Expenses: $29 million in FY ’24.
o 71—Personnel- An increase of 5.5%. This increase is due to COLAs for
non-represented and AFSCME staff.
o 7500-Fringes saw a corresponding increase of 3.35%.
o 7200-Contractual-A decrease of 5.94% (6.37% decrease in prior month).
o 7300- Materials & Supplies- A decrease by 12.41% (18.22% increase in
prior month). The increases are due to the timing of invoices paid. In FY25
we have paid Drame $140,975.87 as of September, yet in FY24 we paid
Drame $166,408.45 as of September.
o 7400-Fixed Cost: A decrease of 5.06% (25.41% increase in prior month).
The decrease is the timing of invoices paid. In FY25 we paid Ochin
$291,924.11 as of September, yet in FY24 we paid Ochin $337,918.80 as of
September.
o 7600-Property: An increase of 3.35% (5.09% increase in the previous
month).
Total Available: $529,610.04
New
Business
Dr. Jones asked about the City Council's request to use CHD funds for counseling
services for transgender youth. Mr. Menkhaus Jr. explained that City Council will
vote tomorrow on a motion to allocate $250,000 from CHD's budget to support
the mental and physical health of transgender and non-binary youth.
Dr. Herzig asked who would provide these counseling services. Dr. Mussman
responded that although CHD has behavioral counselors, none specialize in
pediatric counseling or suicide risk, particularly for this population.
Dr. Jones then asked if CHD would lead the process of finding a service provider.
Dr. Mussman said that he didn't foresee any issues with this and welcomed input
on who should be involved in that process.
Ms. Young announced that Ms. Trabue will be the new chair of the board of
finance. Ms. Trabue expressed her gratitude.

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3
Public
Comment
Ms. Salter stated that as of 5 p.m. today, no questions or comments from the
public were received.
Meeting Adjourned: 5:30 p.m.
Next Meeting: Tuesday, December 17, 2024, 5 p.m.
Minutes prepared by Ashanti Salter
The meeting can be viewed and is incorporated in the minutes: https://fb.watch/pD-N3kOzkN/

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4
Board of Health Finance Committee Roll Calls for November 19, 2024
Roll Call Minutes Hamilton County Solid
Waste Management
District-55x10731
UC Health, LLC Parking
Lease-35x105311 1st
Amendment
Tim Collier 5:14 pm - - -
Dr. Edward Herzig Y MY Y 2Y
Dr. Camille Jones 5:14 pm - - -
Mark Menkhaus Jr. Y Y Y Y
Dr. Grant Mussman Y Y Y Y
Joyce Tate Y Y Y Y
Kiana Trabue Y 2Y 2Y Y
Ashlee Young Y Y MY MY
Y=Yes | N=No | A=Abstain | P=Present | R=Recuse | M=Moved | 2=Second
Others present: Ashanti Salter (Clerk).

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Preparation Date 55x10731
CINCINNATI HEALTH DEPARTMENT CONTRACT AND GRANT INFORMATION SHEET
This information must be supplied to the Contract Liaison no less than one week prior to the Board of
Health meeting.
Vendor Hamilton County Solid Waste Management District
Contract # 55x10731
Person and Division responsible for administering contract/grant/lease:
Initiator Person & Phone # Robin Anderson 513-564-1782
Division Head & Phone # Antonio Young , 513-357-7202
Division Environmental Services
Type of Contract/Agreement Accounts Payable X Accounts Receivable
Service Contract (no $) Lease
Funding Source General Fund Grant Fund X Other Funding
Action Required: X Board Approval Board Information
CONTRACT DOLLAR AMOUNT
Original Amount $72,000
TERM
Original Term Start Date 01/01/2025 End Date 12/31/2025
EXECUTIVE SUMMARY
This is a long-standing contract between the Cincinnati Health Department and the Hamilton
County Solid Waste District.
The Environmental Waste Unit of the CHD will inspect the Solid Waste Transfer Station, the
Class II Composting Facility, the Closed Municipal Solid Waste Landfill, all Registered Scrap
Tire Transporters, and Open Dump Complaints; at the frequency stated in the contract. In return
for performing these inspections, the HCSWD will pay the CHD $72,000 total. Billing and
payment will be quarterly.
The term will be from January 1, 2025 to December 31, 2025.

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Preparation Date 11/6/2024
CINCINNATI HEALTH DEPARTMENT CONTRACT AND GRANT INFORMATION SHEET
This information must be supplied to the Contract Liaison no less than one week prior to the Board of
Health meeting.
Vendor UC Health, LLC Parking Lease
Contract # 35x10531 – 1st Amendment
Person and Division responsible for administering contract/grant/lease:
Initiator Person & Phone # Mark Menkhaus, Jr., 513-357-7469
Division Head & Phone # Mark Menkhaus, Jr., 513-357-7469
Division Fiscal
Type of Contract/Agreement X Accounts Payable Accounts Receivable
Service Contract (no $) Lease
Funding Source General Fund Grant Fund Other Funding
Action Required: X Board Approval Board Information
CONTRACT DOLLAR AMOUNT
Original Amount $21,534.34 (after 2% increases in 2023 and 2024)
Amendment Amount $10,886.81
Total Amount $31, 009.45 (after 2% increases in 2025 and 2026)
TERM
Original Term Start Date 11/1/2022 End Date 10/31/2024
Amendment Term Start Date 11/1/2024 End Date 10/31/2026
EXECUTIVE SUMMARY
CHD wants to develop a parking contract with UC Health, LLC for a total of 20 parking spaces in the parking lot
adjacent to the ADAS Building located at 3009 Burnet Avenue, Cincinnati, Ohio 45219 for a cost of $62.31 per
space per month, for a total (for 20 spaces) of $1,246.20/month. Rent shall increase by 2% each year, effective on
the anniversary date of the Commencement Date. The term will begin on 11/1/22 and end on 10/31/2024.
The first amendment will extend the contract through 10/31/2026 with a 2% increase in rent 2025 and 2026.

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Preparation Date November 26, 2024
CINCINNATI HEALTH DEPARTMENT CONTRACT AND GRANT INFORMATION SHEET
This information must be supplied to the Contract Liaison no less than one week prior to the Board of
Health meeting.
Vendor Hamilton County Public Health
Contract # 55x10741
Person and Division responsible for administering contract/grant/lease:
Initiator Person & Phone # Grant Mussman, 513-357-7215
Division Head & Phone # Grant Mussman, 513-357-7215
Division Health
Type of Contract/Agreement X Accounts Payable Accounts Receivable
Service Contract (no $) Lease
Funding Source General Fund Grant Fund X Other Funding
Action Required: X Board Approval Board Information
CONTRACT DOLLAR AMOUNT
Original Amount $304,000 annually
TERM
Original Term Start Date Upon effective
date
End Date
1 year after affective
date w/2 add’l annual
renewals
EXECUTIVE SUMMARY
HCPH currently has a professional services contract with the Cincinnati Health Department
(“CHD”) for opioid harm reduction services, which expires on December 31, 2024. This new
contract between HCPH and the CMO would supply separate funding for HCPH to staff a brick-
and-mortar site in one of the neighborhoods most affected by opioid deaths, which would allow
HCPH to provide additional opioid harm reduction services in that area.
Because CMO is interested in increasing harm reduction activities throughout the City, including
syringe exchange services, Narcan distribution, and related activities, and because CHD does not
currently have a framework to provide such programming, CMO believes it is in the best interest
of the City to waive competition for these services and enter into an agreement with HCPH to
enhance HCPH’s well-established program for harm reduction activities.
HCPH’s harm reduction services may include, but not be limited to:
• Client intake and needle exchange
• New client surveys and data collection
• Distribution of safe injection supplies and materials
• Coordination of provision of rapid tests for HIV, hepatitis C, syphilis, and pregnancy
• Distribution of and education on use of naloxone when available

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• Distribution of personal care items when available; including condoms
• Packaging of supplies for distribution
• Volunteer recruitment, training, scheduling, and other general coordination needs
• Acting as peer navigators to facilitate referrals to treatment and linkage to care for healthcare
and social service providers
• Arranging substance use treatment entry and accompany clients to intake visits as needed
• Social service referrals (e.g. housing, clothes, food, financial assistance, medical insurance, etc.)
Materials and resources provided to clients by HCPH may include, but not be limited to:
• Educational materials about substance use treatment, treatment for hepatitis C & HIV
• Safer sex and safer injection education
• Overdose prevention (recognize signs of overdose and how to respond appropriately)
• Updated list of resources for substance use, mental/behavioral health, and infectious diseases
treatment
• Donated personal care items, food, water, and clothing when available

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DATE: December 3, 2024
TO: City of Cincinnati Board of Health
FROM: Mark Menkhaus, Jr., CFO
SUBJECT: Fiscal Presentation 2025
FINANCIAL STATEMENTS REVIEW FOR THE FISCAL YEAR 2025 – September
2024 September Highlights:
o Revenue as of the end of September was $12,501,829.70. Which is a 8.39% decrease
from September of 2023. Expenses as of September 2024 totaled $14,159,219.66 which
is a 1.3% increase from September 2023. Total net gain after the capital revenue
transfer was $529,610.04.
Year over Year:
o As of September, we had $48,283.66 in overtime compared to September of 2023’s total
of $44,806.76. Neither year had any disaster overtime in the month of September.
o Medicaid revenue is down 76.46% from the year prior. This is because the FY24 figure
was inflated because CHD received several months of backlogged payments from
Medicaid resulting from ODM’s transition from MITS system to the Provider Network
Management System (PNM). Meanwhile, the FY25 figure is down because of
interruptions with OBS claims going to Medicaid wrap. The issue with Medicaid wrap
payments was resolved as of October 2024. Next month’s report will show this line
leveling out.
o We received capital revenue transfer for FY25 in the amount of $2,187,000. In FY24
we received partial revenue transfer in December and the balance in February for a
total of $1,227,000.00.
o 7100-Personnel increased by 5.5%. This increase is due to COLAs for non-represented
and AFSCME staff. 7500-Fringes saw a corresponding increase of 3.35%.
o 7200- Contractual Services saw a decrease of 5.94% (6.37% decrease in prior month),
and 7300- Materials & Supplies decreased by 12.41% (18.22% increase in prior month).
The increases are due to the timing of invoices paid. In FY25 we have paid Drame
$140,975.87 as of September, yet in FY24 we paid Drame $166,408.45 as of September.
o 7400-Fixed Costs decreased by 5.06% (25.41% increase in prior month). The decrease
is the timing of invoices paid. In FY25 we have paid Ochin $291,924.11 as of
September, yet in FY24 we paid Ochin $337,918.80 as of September.
o 7600-Property increased by 3.35% (5.09% increase in prior month).

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Cincinnati Board of Health Financial Statement for the period of September
FY25 Actual FY24 Actual Variance
Revenue
8236-Pools/Spa $856.50 $1,997.23 -57.12%
8237-Household Sewage System $1,205.00 $1,140.00 5.70%
8239-Tatto/ Body, Environmental Waste License Fee $450.00 $37,025.00 -98.78%
8241-Food Service (Mobile-Temporary) $40,070.44 $58,112.00 -31.05%
8242-Vending Machine Licenses $13.44 $37.86 -64.50%
8244-Food Establishments $32,461.00 $1,465.00 2115.77%
8249-Food, NOC $18,204.50 $21,346.00 -14.72%
8432-Vending Machine Proceeds $0.00 $0.00 0.00%
8536-Grants\State $175,725.59 $140,362.33 25.19%
8556-Grants\Federal $2,417,229.15 $2,060,600.97 17.31%
8563-Bd of Ed Svc (School Nurses Sal.) $439,542.39 $968,004.74 -54.59%
8564-Ham Co Service $89,885.27 $99,100.01 -9.30%
8571-Specific Purpose\Private Org. $170,502.85 $519,250.70 -67.16%
8618-Overhead Charges Indirect Costs $61,340.00 $0.00 0.00%
8731-Birth & Death Certificates $138,052.84 $138,157.10 -0.08%
8732-Vital Stats - Other $769.52 $773.29 -0.49%
8733-Self-Pay Patient $236,283.56 $241,678.98 -2.23%
8734-Medicare $1,343,986.80 $1,299,336.32 3.44%
8736-Medicaid $490,148.35 $2,081,929.07 -76.46%
8737-Private Pay Insurance $260,480.88 $265,128.77 -1.75%
8738-Medicaid Managed Care $1,462,964.86 $1,279,123.96 14.37%
8739-Misc. (Medical rec.\smoke free inv.) $649,059.08 $339,870.19 90.97%
8784-Private Lot Litter & Weed $0.00 $0.00 0.00%
8811-Unclaimed Remains $0.00 $0.00 0.00%
8914-Bond/Note Proceeds $0.00 $0.00 0.00%
8917-Deferred Sewer Assessment Collections $226.60 $342.49 -33.84%
8932-Prior Year Reimbursement $125,847.40 $3,024.70 4060.66%
% That is attributable from 416 $4,346,523.68 $4,088,727.68 6.31%
Total Revenue $12,501,829.70 $13,646,534.39 -8.39%
Expenses
71-Personnel $6,960,111.50 $6,596,969.88 5.50%
72-Contractual $2,189,307.73 $2,327,476.20 -5.94%
73-Material $982,807.59 $1,121,999.59 -12.41%
74-Fixed Cost $624,181.26 $657,436.16 -5.06%
75-Fringes $3,341,337.32 $3,233,185.58 3.35%
76-Property $61,474.26 $41,068.87 49.69%
Total Expenses $14,159,219.66 $13,978,136.28 1.30%
Net Gain (Losses) ($1,657,389.96) ($331,601.89) 399.81%
8936-Transfer $2,187,000.00 $0.00
Total Available $529,610.04 ($331,601.89) 259.71%

-- 31 of 82 --

Interdepartmental
Correspondence Sheet
To: 	MEMBERS of the BOARD of HEALTH
From: 	Grant Mussman, MD MHSA, Health Commissioner
Copies: 	Leadership Team, HR File
Subject: 	PERSONNEL ACTIONS for December 3, 2024 BOARD of HEALTH MEETING
NON-COMPETITIVE APPOINTMENT –pending EHS and/or background check
ALEXANDRIA ASHRAF 	EPIDEMIOLOGIST 	CHES
(Promotional vacancy)
Salary Bi-Weekly Range: 	$2,577.67 to $3,464.17 	Revenue Fund
Alexandria Ashraf received her bachelor’s degree in biology from West Virginia University in 2013 and her
master’s degree in public health Genetics from University of Pittsburgh in 2016. She is currently finishing
her master’s in Epidemiology at Oregon Health and Science University. She has several years of experience
in applied epidemiology at large universities and has training in collecting and analyzing data, reporting
findings to stakeholders, and providing programmatic support. She has also worked with medical records,
including emergency room data, and previously served as a patient family liaison. Her experiences make her
an excellent candidate for the epidemiologist position working with our clinical data.
ASHLEY BACHER 	OPTOMETRIC TECHNICIAN 	CCPC
(Resignation vacancy)
Salary Bi-Weekly Range: 	$1,802.50 to $2,462.69 	Revenue Fund
Ashley Bacher is an optometric technician with over 12 years of experience in the optometric field. She is
currently working in a optical office, serving patients of all ages, including pediatrics. The office primarily
serves patients with Medicaid giving Ms. Bacher strong experience with the various Medicaid vision plans.
She has strong pediatric experience. Ms. Bacher has a passion for working with underserved populations
and will provide valuable services to Cincinnati Health Department dental patients.
Date: 	12/3/2024

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PERSONNEL ACTIONS for December 3, 2024 , BOARD of HEALTH MEETING
Page 2 of 4
NON-COMPETITIVE APPOINTMENT –pending EHS and/or background check
TONYA BEST 	PUBLIC HEALTH NURSE 2 	CCPC
(Promotional vacancy)
Salary Bi-Weekly Range: 	$2,374.81 to $3,206.05 	Grant Fund
The Cincinnati Health Department - City of Cincinnati Primary Care (CCPC) wishes to hire Tonya Best, RN
- at Bobbie Sterne Health Center. Ms. Best attended Mount Saint Joseph where she received a bachelor’s
degree in nursing in 1997. Ms. Best has 27 years of nursing experience with various age groups, from
pediatrics to adulthood. Ms. Best is currently employed by Necco serving children in the community that
have behavioral/mental health challenges. Her clinical nursing skills include assessing patient's conditions,
gathering information on their medical history, and providing necessary health care. Ms. Best is well-
rounded, having clinical experience working in a hospital, clinic, and school setting. Ms. Best has
experience with Epic, Microsoft Word, Excel, and accessing ImpactSIIS.
During her interview Ms. Best expressed a desire to serve a broader population and her advocacy for the
underserved.
We are requesting our Board of Health, to approve Ms. Best for the Public Health Nurse 2 position here at
Bobbie Sterne Health Center.
YASMINE BERNARD 	MEDICAL ASSISTANT 	CCPC
(Resignation vacancy)
Salary Bi-Weekly Range: 	$2,052.24 to $2,167.95 	Revenue Fund
Yasmine Bernard graduated with a medical assistant certification, from Good Samaritan College of Nursing
in 2019.
Ms. Bernard has been working as a medical assistant since she graduated at multiple locations across the city
of Cincinnati. She has experience in family practice at TriHealth Family Medical Group and Kenwood
Family Medicine. She has worked in pediatrics as a medical assistant at Cincinnati Children’s Hospital and
as a scheduler at Hyde Park Pediatrics. Ms. Bernard also has experience in customer service as an
administrative representative at CXR since 2015.
The skills and experience Ms. Bernard has will bring a wealth of knowledge to the medical assistant position
in the School Based Health Center Program. Ms. Bernard has a desire to serve students and the community.
Her skills and knowledge will be an added benefit for both the Cincinnati Health Department and the School
Based Health Centers.

-- 33 of 82 --

PERSONNEL ACTIONS for December 3, 2024 , BOARD of HEALTH MEETING
Page 3 of 4
SHAKIYLA CUNNINGHAM 	MEDICAL ASSISTANT 	CCPC
(Transfer vacancy)
Salary Bi-Weekly Range: 	$2,052.24 to $2,167.95 	Revenue Fund
Ms. Cunningham has a varied background working in customer service and the medical field. Her customer
service background includes working as a shuttle driver at Cincinnati Children’s Hospital and Talbert
House, and customer service representatives at varied places of business. Her medical field experience
began in 2022 as a patient care assistant at UC Health’s Daniel Drake Center and The Little Clinic. She has
been working at St. Elizabeth Physicians Women’s Health. Ms. Cunningham has experience in all aspects of
caring for a patient, both in the inpatient and outpatient setting.
Ms. Cunningham will bring enthusiasm to learn and grow to her role as a medical assistant in the School
Based Health Center Program. Ms. Cunningham has a desire to work more closely with students and the
community. Her skills and knowledge will be an added benefit for both the Cincinnati Health Department
and the School Based Health Centers.
TANARA ELLIS 	PHARMACIST 	CCPC
(New Position)
Salary Bi-Weekly Range: 	$5,607.18 to $6,500.26 	Revenue Fund
Dr. Tanara Ellis is a registered Clinical Pharmacist. She received her Doctor of Pharmacy from Oklahoma
University in 2023 and completed her PGY1 Residency from the University of Cincinnati (UC)in 2024.
Tamra was the Health Departments resident for 2023 and 2024. She was instrumental in helping develop the
startup of our Clinical Pharmacy Program and is passionate about patient counseling, has excellent
attendance, and strong organizational skills. She also has a good understanding of FQHC finances as she
completed a residency project with HRSA back in 2022. She comes to us highly recommended from the UC
Pharmacy program. She will be an asset to the city’s Clinical Pharmacy program and impact the quality
improvement for patients.
During her interview Ms. Best expressed a desire to serve a broader population and her advocacy for the
underserved.
We are requesting our Board of Health, to approve Ms. Best for the Public Health Nurse 2 position here at
Bobbie Sterne Health Center.
KANY SOW 	PHARMACY TECHNICIAN 	CCPC
(New Position)
Salary Bi-Weekly Range: 	$2,024.09 to $2,125.13 	Revenue
Kany is a Registered Certified Pharmacy Technician with 8 years of pharmacy experience and a BS degree.
Kany comes to us from Good Sam Hospital where she served as a Certified Tech since 2019 in various
capacities. Her references indicate that she has great experience in customer service, excellent attendance,
strong organizational skills, and clinical services. She is also fluent in French. She will be an asset to the
city’s Pharmacy program.

-- 34 of 82 --

PERSONNEL ACTIONS for December 3, 2024 , BOARD of HEALTH MEETING
Page 4 of 4
ANTUAN WALKER 	CUSTOMER RELATIONS REPRESENTATIVE 	CCPC
(Promotion)
Salary Bi-Weekly Range: 	$2,051.94 to $2,167.63 	Revenue
The City of Cincinnati Primary Care Central Scheduling Unit would like to hire Antuan Walker as Customer
Relations Representative. Mr. Walker has 15 years of customer service experience, 7 years’ experience in a
customer facing setting, and 2 years in a call center setting. He has experience dealing with diverse
populations, account management, and customer service. His experience will be an asset to the team.
LINDA WALKER 	MEDICAL ASSISTANT 	CCPC
(Resignation)
Salary Bi-Weekly Range: 	$2,052.24 to $2,167.95 	Revenue
Ms. Walker completed her training to become a medical assistant from Kaplan College in 2010. Since 2011,
Ms. Walker has worked at multiple hospitals across the city including TriHealth, UC Health, and The Christ
Hospital. Ms. Walker also has experience as a phlebotomist with The Christ Hospital. She has worked in
the emergency room, inpatient, and outpatient settings throughout her career.
Ms. Walker wants to continue to grow as a medical assistant in the School Based Health Center Program.
Ms. Walker is a graduate of Cincinnati Public Schools and wants to work with CPS students and the
community. Her varied skills and knowledge will benefit the school health program.
BRIANNA WASHINGTON 	MEDICAL ASSISTANT 	CCPC
(Promotion)
Salary Bi-Weekly Range: 	$2,052.24 to $2.167.95 	Revenue
The Cincinnati Health Department- City of Cincinnati Primary Care (CCPC) wishes to hire Brianna
Washington as a Medical Assistant. Ms. Washington attended Fortis Certified Medical Assistant Program and
has been a certified medical assistant for 4 years. Crossroads Health Center currently employs Ms.
Washington. She is skilled in rooming and exiting patients, phlebotomy, and vaccine administration. She is
skilled in providing health care services for patients of various ages (infants to adults). Ms. Washington has
well-rounded clinical experience working in a health center setting. Ms. Washington is skilled in Athena,
Microsoft, Outlook, and Excel. During her interview Ms. Washington expressed her strength was
communication and caring for her patients and the desire to grow and continue learning.
We are requesting, our Board of Health, to approve Ms. Washington for the Medical Assistant position.

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Health Commissioner’s Report |1
October 2024
.
Date: December 3, 2024
To: Board of Health
From: Grand Mussman, MD, Health Commissioner
Subject: Health Commissioner’s Report, Reflects October 2024
WIC Updates October 2024
1. The WIC caseload in October increased to 16,000. Women: 3702, Infants: 4050, Children: 8248
2. October breastfeeding initiation rate for WIC infants was 63%. Breastfeeding at 6 months was 35%.
Breastfeeding rates have been stable. WIC continues to offer on-line and in-person breastfeeding classes
along with walk-in hours for breastfeeding assistance.
3. WIC continues to inform all women of the Urgent Maternal Warning Signs during the prenatal and
postpartum periods. WIC reviews warning signs and provides a handout to all pregnant and postpartum
women during their visits. In October WIC provided this education to 430 women participants.

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Community Health and Environmental Services (CHES) Updates for CHD BOH
Meeting 12.3.2024
Community Health and Environmental Services (CHES) updates:
• Cincinnati Health Department is partnering with the City Manager’s Office to launch a medical debt relief project
in response to Mayor Pureval’s Financial Freedom Blueprint
• Cincinnati Health Department continues to meet with the Cincy CHIP action teams on the five priorities set for
the next three years. 1) Access to Care, 2) Mental and Behavioral Health, 3) Nutrition and Food Access, 4) Infant
Vitality, 5) Housing. More information in the Accreditation section.
• Alternative Response to Crisis (ARC) pilot diverting low acuity 911 calls to a behavioral health and EMT team is
continuing in the Cincinnati community, more information can be found with the link below:
Alternative Response to Crisis (cincinnati-oh.gov)
Epidemiology
Epidemiology Data Briefs and Educational Guides:
Data Briefs and Educational Guides can be found using the website below.
https://www.cincinnati-oh.gov/health/community-health-data/epidemiology-data-briefs/
The Emergency of Antimicrobial Resistance in Cincinnati (2017-2022)
C:\Users\KIMBER~1.WRI\AppData\Local\Temp\msoA228.tmp (cincinnati-oh.gov)
2022 Annual Lead Report:
2022-LEAD-ANNUAL-REPORT-FINAL.pdf (cincinnati-oh.gov)

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Epidemiologic Infant data:
These numbers are provisional for 2021-2024:
** May 2024’s report is delayed due to ODH data warehouse update
Deaths for 2020:
City 2020 = 44
County (minus the city) 2020 = 33
Total Hamilton County 2020 = 77
The finalized number of births for 2020 (births extracted from Ohio Resident live births database (by residence
city/county) as of 9.20.22):
City of Cincinnati = 4,220
Hamilton County births outside of the City limits = 6,110
Hamilton County inclusive of the City = 10,330
The finalized infant mortality rate for 2020 based on our current numbers:
City of Cincinnati IMR = 10.4 per 1,000 live births
Hamilton County outside the City limits = 5.4 per 1,000 live births
Hamilton County IMR = 7.5 per 1,000 live births (inclusive of the city numbers)
Provisional deaths for 2021:
City 2021 = 41
County (minus the city) 2021 = 24
Total Hamilton County 2021 = 65
The provisional number of births for 2021 (births extracted from Ohio Resident live births database (by residence
city/county) as of 2.9.23):
City of Cincinnati = 4,111
Hamilton County births outside of the City limits = 6,154
Hamilton County inclusive of the City = 10,265
The provisional infant mortality rate for 2021 based on our current numbers:
City of Cincinnati IMR = 10.0 per 1,000 live births
Hamilton County outside the City limits = 3.9 per 1,000 live births
Hamilton County IMR = 6.3 per 1,000 live births (inclusive of the city numbers)
Provisional deaths for 2022:
City 2022 = 47
County (minus the city) 2022 = 42
Total Hamilton County 2022 = 89*
*three deaths OOJ excluded
The provisional number of births for 2022 (births extracted from Ohio Resident live births database (by residence
city/county) as of 2.28.24):
City of Cincinnati = 4,155
Hamilton County births outside of the City limits = 6,034
Hamilton County inclusive of the City = 10,189
The provisional infant mortality rate for 2022 based on our current numbers:
City of Cincinnati IMR = 11.3 per 1,000 live births

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Hamilton County outside the City limits = 7.0 per 1,000 live births
Hamilton County IMR = 8.7 per 1,000 live births (inclusive of the city numbers)
Provisional deaths for 2023:
City 2023 = 29
County (minus the city) 2023 = 29
Total Hamilton County 2023 = 58
The provisional number of births for 2023 (births extracted from Ohio Resident live births database (by residence
city/county) as of 10.28.24):
City of Cincinnati = 4,122
Hamilton County births outside of the City limits = 5,912
Hamilton County inclusive of the City = 10,034
The provisional infant mortality rate for 2023 based on our current numbers:
City of Cincinnati IMR = 7.0 per 1,000 live births
Hamilton County outside the City limits = 4.9 per 1,000 live births
Hamilton County IMR = 5.8 per 1,000 live births (inclusive of the city numbers)
Provisional deaths for 2024:
City 2024 = 22
County (minus the city) 2024 = 29
Total Hamilton County 2024 = 51
The provisional number of births for 2024 (births extracted from state database (by residence city/county) as of
10.28.24):
City of Cincinnati = 3,322
Hamilton County births outside of the City limits = 4,758
Hamilton County inclusive of the City = 8,080
The provisional infant mortality rate for 2023 based on our current numbers:
City of Cincinnati IMR = 6.6 per 1,000 live births
Hamilton County outside the City limits = 6.1 per 1,000 live births
Hamilton County IMR = 6.3 per 1,000 live births (inclusive of the city numbers)
Communicable Disease
COVID-19 Summary
Cincinnati Health Department continues to participate in weekly conference calls with the Ohio Department
of Health in which routine COVID-19 updates are provided. Our Command Center and Communicable
Disease Unit staff continue conducting positive case investigations and working with ODH for active
monitoring of positive cases as well as follow up regarding outbreak investigations. CHD closed the
vaccination operations at our main building March 31, 2023, and Hamilton County Public Health closed the
vaccination operations as of June 2, 2023. Community members can seek vaccination with local pharmacies

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as well as our City of Cincinnati Primary Care Health Centers. We extend great appreciation to the entire
CHD team for all their tremendous efforts. Our CCPC sites will be providing COVID-19 vaccinations for the
Pfizer 6 months to 4 years of age. The new COVID-19 vaccine is available this Fall at our CCPC sites in
limited quantity, our COVID-19 Command Center is prepared to assist callers with locations of how to get
the vaccine at local pharmacies.

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CCPC UPDATE
Figure 1. Number of Completed Patient Visits to All CCPC Community Health Center Sites
Table 1. Number of Completed Patient Visits by Location for September 2024 and FYTD
0
200
400
600
800
1000
1200
1400
4-Sep
18-Sep
2-Oct
16-Oct
30-Oct
8-Jan
22-Jan
5-Feb
19-Feb
4-Mar
18-Mar
1-Apr
15-Apr
29-Apr
13-May
27-May
10-Jun
24-Jun
8-Jul
22-Jul
5-Aug
19-Aug
2-Sep
16-Sep
Sep Oct Jan Feb Mar Apr May Jun Jul Aug Sep
2023 2024
Count
Week Beginning On
CCPC Visit Counts by Week - All Locations
September 1, 2023 - Present
PRACTITIONER VISITS NURSE VISISTS TOTAL VISITS
CCPC Community Health Centers 	9/2 	9/9 	9/16 	9/23 Sep 2025
Total
Sep 2024
Total
2025 FYTD
Total
2024 FYTD
Total
VISITS 	770 	1068 	993 	1019 	3850 	3435 	12180 	11710
AMBROSE CLEMENT 	98 	147 	119 	122 	486 	179 	1556 	552
AMBROSE CLEMENT BH 	18 	30 	27 	32 	107 	80 	385 	298
BRAXTON CANN 	52 	120 	108 	104 	384 	367 	1180 	1282
BRAXTON CANN BH 	0 	0 	0 	0 	0 	0 	0 	0
ELM ST. BH 	11 	18 	1 	18 	48 	7 	146 	43
ELM ST. 	107 	158 	146 	205 	616 	708 	1936 	2276
MILLVALE 	112 	151 	127 	110 	500 	484 	1382 	1729
MILLVALE BH 	11 	12 	6 	5 	34 	52 	112 	170
NORTHSIDE 	142 	162 	151 	155 	610 	497 	1944 	1781
NORTHSIDE BH 	1 	3 	3 	3 	10 	47 	27 	185
PRICE HILL 	193 	244 	279 	241 	957 	872 	3146 	2923
PRICE HILL BH 	25 	23 	26 	24 	98 	142 	366 	471
NEW PATIENTS 	66 	74 	66 	68 	274 	182 	798 	658
AMBROSE CLEMENT 	16 	16 	16 	19 	67 	11 	166 	33
AMBROSE CLEMENT BH 	0 	0 	0 	0 	0 	1 	6 	8
BRAXTON CANN 	7 	10 	8 	8 	33 	31 	83 	95
BRAXTON CANN BH 	0 	0 	0 	0 	0 	0 	0 	0
ELM ST. BH 	0 	1 	0 	1 	2 	0 	3 	0
ELM ST. 	9 	10 	7 	7 	33 	28 	102 	105
MILLVALE 	12 	9 	7 	6 	34 	45 	88 	164
MILLVALE BH 	0 	0 	0 	0 	0 	0 	0 	0
NORTHSIDE 	11 	14 	8 	13 	46 	26 	139 	113
NORTHSIDE BH 	0 	0 	0 	0 	0 	1 	0 	5
PRICE HILL 	11 	14 	20 	14 	59 	39 	209 	130
PRICE HILL BH 	0 	0 	0 	0 	0 	0 	2 	5

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Table 2. Number of Pharmacy Fills for August 2024 and FYTD
Figure 2. Number of Completed CCPC Dental Visits for July 2024 by Location
*August and September dental data will be updated next month
CCPC PHARMACY LOCATION 	9/2 	9/9 9/16 9/23 Sep 2025
Total
Sep 2024
Total
2025 FYTD
Total
2024 FYTD
Total
NUMBER OF FILLS 	1946 2274 2415 2070 8705 	8302 27140 28241
AMBROSE CLEMENT 	324 	393 	394 	329 	1440 	1082 	4405 	3521
BRAXTON CANN 	169 	375 	277 	317 	1138 	1280 	3654 	4247
ELM ST. 	335 	350 	457 	401 	1543 	1894 	5065 	6621
MILLVALE 	367 	346 	348 	298 	1359 	1186 	3954 	4337
NORTHSIDE 	272 	337 	304 	260 	1173 	975 	3635 	3420
PRICE HILL 	479 	473 	635 	465 	2052 	1885 	6427 	6095

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Reproductive Health and Wellness Program (RHWP) Data Report
Figure 1a. City of Cincinnati Primary Care Health Center Reproductive Health Visits by Gender and Month, Fiscal
Year 2024 – 2025
Figure 1b. City of Cincinnati Primary Care Health Center Reproductive Health Visits by Gender and Month,
Fiscal Year 2023 – 2024
FY23/24 Visits with Men: 221 patients
FY23/24 Visits with Women: 6496
patients
FY23/24 Visits Combined (men/women): 6717
patients
FY23/24 Control (Expected) Visits: 7000 patients
FY23/24 Visits as % of Control Total: 96.0%
FY24/25 Visits with Men: 278 patients
FY24/25 Visits with Women: 4496
patients
FY24/25 Visits Combined (men/women): 4774
patients
FY24/25 Control (Expected) Visits: 4081 patients
FY24/25 Visits as % of Control Total: 117.0%
Page 7 of 17

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Figure 2a. Long-acting Reversible Contraception (LARC) (Intrauterine Devices) provision by Month and Insurance Type for patients
seen at our City of Cincinnati Primary Care Health Centers, Fiscal Year 2024 – 2025
Figure 2b. Long-acting Reversible Contraception (LARC) (Intrauterine Devices) provision by Month and Insurance Type for
patients seen at our City of Cincinnati Primary Care Health Centers, Fiscal Year 2023 – 2024
Figure 3a. Long-acting Reversible Contraception (LARC) (Implants) provision by Month and Insurance Type for patients
seen at our City of Cincinnati Primary Care Health Centers, Fiscal Year 2024 – 2025

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Figure 3b. Long-acting Reversible Contraception (LARC) (Implants) provision by Month and Insurance Type for
patients seen at our City of Cincinnati Primary Care Health Centers, Fiscal Year 2023 - 2024
Table 1. Selected Demographic Characteristics of Unduplicated RHWP Patients, October 2024
Female % in col. Male % in col. Total % in col.
Race
AI/AN 7 0.92% 0.00% 7 0.86%
Asian 18 2.37% 2 3.70% 20 2.46%
Black 388 51.05% 40 74.07% 428 52.58%
PI/HN 13 1.71% 0.00% 13 1.60%
Unknown 86 11.32% 3 5.56% 89 10.93%
White 248 32.63% 9 16.67% 257 31.57%
Ethnicity
Hispanic 267 35.13% 3 5.56% 270 33.17%
Non-Hispanic 493 64.87% 51 94.44% 544 66.83%
Income
<=100% FPL 642 84.47% 35 64.81% 677 83.17%
101-249% FPL 105 13.82% 7 12.96% 112 13.76%
>=250% FPL 13 1.71% 12 22.22% 25 3.07%
Insurance
Private 81 10.66% 15 27.78% 96 11.79%
Public 324 42.63% 12 22.22% 336 41.28%
Uninsured 355 46.71% 27 50.00% 382 46.93%
Age (years)
<15 5 0.66% 0.00% 5 0.61%
15-49 685 90.13% 49 90.74% 734 90.17%
>50 70 9.21% 5 9.26% 75 9.21%
Limited English
No 470 61.84% 50 92.59% 520 63.88%
Yes 290 38.16% 4 7.41% 294 36.12%

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Table 2. Unduplicated RHWP Patients by CCPC Health Center, October 2024
Female % in col. Male % in col. Total % in col.
Health Center
Ambrose Clement 101 13.29% 49 90.74% 150 18.43%
Braxton Cann 40 5.26% 0.00% 40 4.91%
Bobbie Sterne 157 20.66% 0.00% 157 19.29%
Millvale 71 9.34% 0.00% 71 8.72%
Northside 158 20.79% 5 9.26% 163 20.02%
Price Hill 233 30.66% 0.00% 233 28.62%
* Reproductive health data is based on services as part of the Title X grant provided by our City of Cincinnati Primary
Care (CCPC) Health Centers.
Accreditation
PHAB Action Plan Update:
The PHAB annual report was submitted for 2024, it focused on the foundational capabilities of the health department
surrounding quality improvement efforts. The 2025 annual report will include an application for PHAB to conduct a
reaccreditation readiness assessment as our annual report submission in preparation for reaccreditation in 2026.

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CHD CHA Update:
Cincinnati Health Department has completed the CHD Community Health Assessment (CHA). The CHA was posted on
the CHD website, and the public comment period has closed. CHD will continue to seek feedback from the community
through our partnerships by attending several community events throughout the year.
Cincy CHIP Update:
The Cincy CHIP Steering Committee met on November 15, 2024, to provide feedback on the strategies developed by
the action teams. The amount of energy and level of detail that each action team has put into developing their
interventions promises to have great impact on addressing their priority areas.
The Cincy CHIP focus areas for the upcoming Cincy CHIP cycle are as follows:
• Access to Care
• Behavior and Mental Health
• Infant Vitality
• Nutrition and Food Access
• Housing
Regional CHNA and CHIP Update:
The Regional CHNA lead by The Health Collaborative (THC) was released January 2022. CHD is participating in the
Regional Behavioral Health Continuity of Care group, 2024 Regional CHNA Advisory committee, and 2024 CHNA
Public Health Task Force.
Quality Improvement/ Quality Assurance
Clinical QI committee has resumed meeting. Public Health QI is working with CCHMC to build the systems dashboard
for public health programs. QI training sessions have completed their training for the Healthy Homes and Lead
Programs and are in monitoring stages. Through our continued partnership with Children’s Hospital, several CHD staff
members have completed session one of their ImpactU improvement science course. Our CHD QI Steering Committee
continues to meet monthly to review progress on highlighted projects and provide feedback to colleagues.
GET VACCINATED GRANT- MONTHLY DATA TABLE 2024-2025
MONTH RM
0-18
Years
RC
0-18
Years
IQIP
Initial
Site
visit
With
office
IQIP
2 M
Follow
up
IQIP
6 M
Follow
up
IQIP
12 M
Follow
up
MOBI TIES PERI
HEPB
NEW
CASES
PERI
HEPB
CLOSED
CASES
July 570 642 0 0 0 0 0 0 0 2
August 906 1124 0 0 6 2 10 10 0 0
September 786 1176 1 0 5 5 17 15 2 3
October 822 1214 6 1 0 4 5 6 1 0

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November
December
January
February
March
April
May
June
TOTAL
RM=reminders to families for immunizations now due
RC=recalls to families behind on immunizations
IQIP= Immunization Quality Improvement Process (CDC tool including audit) (2M/6M/12M=follow ups with practices
involved in QI process)
MOBI=Maximizing Office Based Immunization education presentation for providers
TIES=Teenage Immunization Education Session -immunization education for providers regarding adolescents
Peri HEPB=Peri-natal Hepatitis
*JULY- MOBI, TIES, (7/18) and IQIP (7/30) required ODH training completed. ..training required PRIOR to initiating
MOBI,TIES,IQIP outreach
October -Immunization Coverage Disparities report submitted

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Healthy Communities Program – Tiffany White
Live Work Play Cincinnati Coalition
A multi-sector coalition that works to improve health outcomes by addressing health-related social needs and social
determinants of health at the community level.
Date of Meeting Location & Presentations Next Steps
11/13/2024 Location
2533 Kemper Ln.,
Cincinnati, OH 45206
Presentations
UC Cancer Center
Zoe Wagner
Program Coordinator
&
Luwana P. Oglsbey
Community Liaison
Next meeting is December 11, 2024, at
2533 Kemper Ln.,
Cincinnati, OH 45206
Meeting frequency: 2nd Wednesday of each
month.
Infant Vitality – Malina Harris
ODH- Cribs for Kids Subgrantee
The Ohio Department of Health (ODH), Bureau of Maternal, Child and Family Health is partnering with Cribs for
Kids® and local organizations throughout Ohio to provide Cribettes® and safe sleep education to eligible families.
# of families
served since last
report
Project Partners and Status Next Steps
101 families Partners:
All In Cincinnati, Bethany House Services,
Cherished Hearts CPR Family,
Community Action Agency, Cradle
Cincinnati Connections (CCC), Crossroad
Health Center, First Step Home, Greater
Cincinnati Behavioral Health Services,
Healthcare Access Now (HCAN),Healthy
Homes: Block by Block (Community
Matters),Healthy Moms & Babes, Helping
Young Mothers Mentor, Inc., Home
Health/CHD, Interfaith Hospitality Network
of Greater Cincinnati (IHNGC),Mercy
Health – Perinatal Outreach Program,
Nurse Family Partnership/ECS-Pathways
to Home, Rosemary’s Babies Co., Santa
Maria Community Service, Sigma Gamma
Rho Sorority, Inc. Su Casa Hispanic
Center, The Children’s Hospital/ECS, The
Children’s Home of
Cincinnati/ECS/Costars, The Christ
Hospital, The Community Builders
(TCB),TriHealth, The Salvation Army,
University of Cincinnati Medical Center
(UCMC)/Hoxworth/Women’s Center, WIC,
Plan: Cribs for Kids and DCY contracts have
been approved. Awaiting paperwork to be
received to sign.
Meeting frequency: ODH TA Meetings are
Quarterly.
Last meeting
10/7/24
Meetings are Quarterly
Next Meeting 12/3/24

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Women’s Center of Ohio, TriHealth
---------------------
Status: Active
DCY
# distributed since
last report
Project Partners and Status Next Steps
200 diapers have
been distributed
since the last BOH
report.
Partners:
Sweet Cheeks Diaper Bank
HCAN, Mercy Health, Health Vine, UC
Women’s Center, Hamilton County OEI,
Cincinnati Health Department Home
Health, WIC
---------------------
Status: Active
Plan:
Families have been referred to other
agencies to receive diapers
Planning Diaper drive at one of the CHD
Health Centers during a health fair.
Facility has moved to Walnut Hills.
Meeting frequency: Annually
Next Meeting scheduled for:
TBD
CAT- The Cincinnati-Hamilton County Community Action Team
The mission of the Cincinnati-Hamilton County Community Action Team is to optimize equitable health outcomes
for women, infants, children, and families in Cincinnati-Hamilton County through collaboration, education, and
action. This group meets monthly.
# of meetings
since last report
Project Partners and Status Next Steps
1-Last Meeting:
10/24/24
Partners:
Hamilton County
---------------------
Status: Active
Plan: Discuss the results of the Maternal &
Child Health Survey. The work Group is being
reconfigured and will meet on a quarterly basis.
Meeting frequency: Quarterly
TBD
OIPP/CIAG- Ohio Injury Prevention Partnership: Child Injury Action Group
The function of the Child Injury Action Group (CIAG) is to identify priorities and strategies to reduce child injury in
Ohio. The CIAG has identified focus areas to address in their five-year strategic plan including teen driving,
traumatic brain injury, safe sleep, youth suicide and child passenger safety.
# of meeting since
last report
Project Partners and Status Next Steps
0 Partners:
Ohio Department of Health
---------------------
Status: Active
Plan:
Strategic Plan Update
Shared progress on the standardized data
presentation the subcommittee members will be
able to brand as their own and share within their
respected communities. The presentation
includes quantitative and qualitative data from
multiple reporting sources (OPAS, CFR, etc.),
representing all of Ohio.
Presented on current work being done in the
Infant Vitality Program.
Meeting frequency: Quarterly
Next Meeting 11/7/24
Program supported projects/ meetings:
10/11/24- St. Theresa Walkathon

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10/15/24- Caresource Quarterly Seminar
10/16/24- Cribs for Kids Development Training
10/16/24- NACCHO Workgroup Meeting
10/23/24- CHD Steering Committee
10/24/24- CAT Meeting
11/5/24- Goodsam Hospital Site Visit Tour
Food Equity (Healthy Eating)- Jasmine Robinson
Heart of Hamilton County
The Heart of Hamilton County Health Fair and Food Distribution is an event that includes food demos and
giveaways and is a larger benefit for those who will attend by having health education, health screenings
and more.
# of Meetings Since Last
Report
Project Partners and Status Next Steps
1 Hamilton County ReSource Wasted
Food Stops with Us initiative, the
Cincinnati Health Department’s Food
Equity Program, Love in Action,
Freestore Foodbank, Last Mile Food
Rescue, and La Soupe.
---------------------
Status: Inactive (current location
logistics transferred to local food
rescue partner; expansion plan
possible)
Serve as project lead and manage health
partners; find new health partners to
participate in events
Meeting frequency: as needed
Produce Perks- Community Supported Agriculture Distribution (Fruit and Vegetable Program)
Produce Perks and CHD partnered to increase access to healthy fresh fruits and vegetables in the Winton Hills
neighborhood. The partnership has distributed over $50,000 in healthy foods purchased directly from Mustard Seed
Farms (a local, Cincinnati small-scale farm) strengthen healthy dietary habits and increasing nutritional/cooking
knowledge in hundreds of Winton Hills community members.
# of Meetings Since Last
BOH Report
Project Partners and Status Next Steps
1 Produce Perks, CMHA, and Mustard
Seed Farm
---------------------
Status: Active (event began 5/9/24;
last distribution completed on
10/31/24- 24 total signups)
Plan for 2024 distribution and events. Find
community champion
Meeting frequency: as needed for planning
CHD Healthy Communities Freezer
The Cincinnati Health Department (CHD) Healthy Communities Program will partner with Cincinnati Recreation
Commission (CRC) Hirsch and Millvale locations to implement a pilot community freezer program.
# of Meetings Since Last
BOH Report
Project Partners and Status Next Steps

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5 COC Office of Environment and
Sustainability, CRC, La Soupe, and
Hamilton County ReSource
---------------------
Status: Active (award received)
Find a non-profit organization to own
freezers; then, complete partner meeting to
discuss kickoff and opening events
Meetings frequency: as needed based on
contract needs and project updates.
Systems to Achieve Food Equity (SAFE) Network
a sub-network of All Children Thrive made up of individuals and organizations committed to improving food security
in Cincinnati to ensure that all children have the food that they need to grow, develop, learn, and thrive.
# of Meetings Since Last
BOH Report
Project Partners and Status Next Steps
2 CCHMC, Freestore Foodbank,
Hamilton County ReSource, La
Soupe, and more.
---------------------
Status: Active (Emcee at 2024 SAFE
Summit and participating in SAFE’s
communication, stewardship, and
food access teams as well.)
Network planning for food distribution in the
City of Cincinnati; current project funding
covers works in Avondale, East and Lower
Price Hill
Meeting frequency: 3rd Thursday of every
month
---------------------
Stakeholder meeting to report on
organizational updates, events, and needs
working towards food equity in Cincinnati.
Meeting frequency: 1st Thursday of every
month
Food Equity Program Newsletter
Each month, the Food Equity Coordinator sends a newsletter that includes local food related events such as
food/produce distribution sites, pop ups, cooking improv learning sessions and more.
# of Meetings Since Last
BOH Report
Project Partners and Status Next Steps
1 Newsletter sent to community
members and partners by the 2nd
Tuesday of each month.
---------------------
Status: Active (last newsletter sent
on 11/1/24 to over 180 recipients)
Continue to update newsletter content and
layout to meet the reader’s needs
Meeting frequency: included in monthly
program meeting with HCP program manager
and health counselor supervisor as well as
needed meetings scheduled with SAFE’s
SSF Communications team for discussion/
review
Program supported projects/ meetings:
10/15/24: CareSource Community Agency Forum
10/16/24: Cribs for Kids Development Activity Q1
10/17/24: Cincinnati Food Access Network Monthly Call
10/18/24: AMEN Presentation
10/22/24: OMJ Workshop Health Education Series: "Balancing Work and Health"
10/28/24: Hartwell Pantry Planning Group Meeting #1
10/31/24: Hartwell Pantry Planning Group Meeting #2
11/1/24: Avondale Respite Center Discussion

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11/4/24: Mt. Airy Weekly Afterschool Presentation Series
11/8/24: Department Engagement Champion Orientation
11/13/24: Voices for Food Training
11/13/24: 80 Acres Farms collaboration meeting
11/15/24: Winton Hills Intentional Food Access Meeting
Tobacco Free Living (TFL) – Courthney Calvin
Project/ Meeting Title: Youth Vape Presentation
Educate Cincinnati youth on the dangers of e-cig use.
Date and # of Students Project Partners and
Status
Next Steps
10/14/24: 40
10/15/24: 18
10/16/24: 26
10/17/24: 35
10/18/24: 21
10/24/24:168
10/28/24: 7
11/4/24: 4
11/6/24: 33
11/7/24: 22
11/13/24: 14
11/14/24: 38
Total Amount of Students
Educated:
426
Partners:
Roberts Academy
Walnut Hills High School
Mt. Airy School
Health Care Access Now
Riverview East Academy
Teen Talk Thursday-College
Hill Rec Center
---------------------
Status: Active
Plan:
To present preventative tobacco education
for youth.
Meeting frequency:
Throughout the school year
Program supported projects/ meetings:
10/14/24: Vape Education at Roberts Academy School
10/15/24: Vape Education at Roberts Academy School
10/16/24: Vape Education at Roberts Academy School
10/17/24: Vape Education at Roberts Academy School
10/18/24: Vape Education at Roberts Academy School
10/15/24: Vaping Unplugged Teen Voices and Risks Webinar
10/19/24: Cancer Justice Center Health Fair-Cessation Services
10/21/24: Tobacco Free Ohio Alliance (TFOA) Steering Committee Meeting
10/22/24: INDEPTH Facilitator Recertification and Refresher Training
10/24/24: Vape Education at Walnut Hills High School
10/2824: Vape Education-Mt. Airy School
10/28/24: TFOA Health Equity Workgroup Meeting
10/31/24: Meeting with Annabel with Exclusive Services About Vape Education in Schools
11/4/24: End of Education Program Meeting at Mt. Airy School
11/5/24: TFOA Youth workgroup meeting
11/6/24: Vape Education -Healthcare Access Now
11/7/24: Vape Education Roberts Academy
11/7/24: Cessation meeting with CHD Pharmacy
11/12/24: Fatherhood Collaborative of Hamilton County Meeting
11/13/24: Live Work Play Monthly Meeting
11/13/24: Vape Education at Riverview East Academy School
11/14/24: Teen talk Thursday (Vape Education) at College Hill Rec Center
11/14/24: School Community Partner Meeting with Digital Academy

-- 53 of 82 --

11/15/24: Cincy CHIP Steering Committee Meeting
Tobacco 21/Tobacco Retail License (TRL) - Pending
Tobacco Retail Licensing/T21
License any retailer in the City of Cincinnati selling tobacco products. Conduct underage buy attempts and issue
citations to enforce tobacco 21 laws.
Status Next Steps
103 – 2025 TRL renewals made.
2 – 2025 Annual applications
completed.
296 - Identified retailers registered.
246 # of inspections (85% total
retailers inspected).
Plan:
• Underage Buyer starts 11/25/2024
Worksite Wellness & Active Living – Scott Dean
Healthy Eating Active Living (HEAL) Capacity Building Grant for Carthage
Increased capacity for Carthage residents to engage in Healthy Eating and Active Living (HEAL) projects by
conducting the PSE assessment and identifying 1 priority health strategy.
# of Meeting since last
report
Project Partners and Status Next Steps
3 Partners: Identified 36 partner
agencies
---------------------
Status: Active
Completed 1st of a planned series in
walk audits to assess pedestrian safety
in the community surrounding the
Carthage Commons area. Work will
begin to transition from this HEAL grant
to the ODH Creating Healthy
Communities Grant
• Walk audit with smaller groups.
• Continue pushing usage of the CAGIS
Pedestrian Hazard map we created
for the community to track issues
Meeting frequency: Monthly with
additional meetings as needed
Y.E.S on Bike & Pedestrian Safety
The aim of this education series is to increase youth knowledge around the responsibilities of pedestrians, cyclists,
and drivers to create a culture of safe transportation in neighborhoods.
# of Meeting since last
report
Project Partners and Status Next Steps
1 Partners: Cincinnati Public School
(CPS), Tri-State Trails, Green
Umbrella: Green Schoolyards Team
---------------------
Status: Active
Finalized pilot curriculum and began
presentations.
Continuing to find partners to present
to
• Working with CPS contact to identify
which schools to target for this
education.
• Continue work on developing a
comprehensive curriculum.
Meeting frequency: Monthly
Program supported projects/ meetings:

-- 54 of 82 --

10/14/24 – Ohio Means Jobs Curriculum Building
10/15/24 – Live Work Play Planning Meeting
10/16/24 – Traffic Garden Discussion with Green Umbrella
10/18/24 – Completed Ohio Means Jobs Presentation
10/21/24 – Heart Of Hamilton County Toolkit Discussion
10/24/24 – Steering Committee Meeting for Winton Hills Neighborhood Plan
10/25/24 – Eviction Prevention Meeting
10/25/24 – CHIP Housing Meeting
10/28/24 – Hartwell Pantry Planning Meeting
10/29/24 – Carthage Walk Audit
10/30/24 – Roll Hill Elementary Traffic Garden Site Visit
10/31/24 – Hartwell Pantry Planning Meeting
11/1/24 – College Hill Meeting to discuss future development of playground space
11/5/24 – Meeting with Keep Cincinnati Beautiful
11/6/24 – Roll Hill LSDMC Presentation on Traffic Garden Proposal
11/8/24 – Eviction Prevention Meeting
Men’s Health – Eric Washington
Project/ Meeting Title: Buckeye Health Plan and Men’s Health
# of Meetings Since
Last BOH Meeting
Project Partners and Status Next Steps
1
Meetings
Partners:
Buckeye Health Plan – “What’s
your numbers.”
Status: Ongoing
Plan:
• Presented Community Champion Certificate
• Barbershop Series for fall ‘24
• Start Planning in Jan 25
• Planning to add churches, Salons,Etc..
Meeting frequency: Monthly x2
Project/ Meeting Title: Brother You’re on My Mind
Details/ description
# of Events Since
Last BOH Meeting
Project Partners and Status Next Steps
1 Meeting Partners:
Omega Psi Phi – Barbershop
Talk (Mental, Physical and
Spiritual Health
Status: (Ongoing Monthly)
Plan:
• Adding CRP and Men’s Health -Chronic
Disease
• Conversation dealing w/ Mental Health and
Youth Mentorship
Meeting frequency: Monthly x1
Project/ Meeting Title: Men’s Health Partnership/Resource (Maple Towers)
Details/ description
# of Events Since
Last BOH Meeting
Project Partners and Status Next Steps
1 Meeting Partners: Maple Towers
Awareness, Education and
Prevention
Status: Ongoing
Plan:
• Programming on Chair Yoga. Meditation,
Exercise –
• T.Davis will follow up with me regarding other
organization will teach
• Add a Nutrition/Healthy
• Music Component

-- 55 of 82 --

Meeting frequency: Monthly x1
Project/ Meeting Title: One Ohio
Partnering with Hamilton County Public Health to release grant funds for One Ohio.
# of Meetings Since
Last Meeting
1
Project Partners and Status
Application development.
Next Steps
Ongoing
Other Focus Areas:
Creating Health Communities Grant 24-25 - Healthy Eating and Physical Active/Active Living
Fatherhood Training
The training is evidence-based, and has a pre-training survey on the attitudes, practices and beliefs of staff around serving
fathers. The survey is designed for child welfare staff, so we’ll see how applicable it is with your group. It’s an engaging,
interactive 2.5-hour training with individual and group activities, and fatherhood case scenarios for groups to work on near
the end. The topics covered are:
• The Importance of Fathers
• Services, Systems & Fathers
• Engaging Fathers
• Fathers Mental Health
• Fatherhood Scenarios
Fatherhood Committee/Group
• Job and Family Services – Fatherhood Collaborative
• Talbert House – Fatherhood Project
• Community Action Agency - Fatherhood Male Involvement
Program supported projects/ meetings:
Recovery Ohio Drug Trends Monthly Meeting
10/15/24 – Harm Reduction Committee Meeting
10/15/24 - CareSource Community Meeting
10/15/24 – Recovery \Ohio Drug Trends Monthly Meeting
10/16/24 – Defensive Driving Training
10/16/24 – 1:1 C. Calvin
10/16/24 – Traffic Garden
10/17/24 – CHIP Behavioral Health Workgroup Summary
10/18/24 - Ohio Means Job Presentation Preparation
10/21/24 - CHC Group Meeting
10/21/24 – Mt Airy After School Program
10/21/24 – One Stop Meeting Check In
10/22/24 – Cincinnati Zoo- CHD Epi Department Presentation
10/29/24 - One Ohio Next Steps Meeting
10/30/24 – Shiloh Seventh Day Adventist Church Men’s Ministry Meeting (Mr. Hicks)
10/31/2024 – CHIP Behavioral Health Workgroup
10/31/24 – Hartwell Planning Group
10/31/24 – ROC T. Davis (Maple Towers)
11/4/24 – CHC Group Weekly Meeting
11/4/24 – Mt. Airy Weekly After School Presentation Series
11/5/24 – Healthy Communities and Keep Cincinnati Beautiful Meeting

-- 56 of 82 --

11/6/24 - 1:1 Food Equity J. Robinson
11/6/24 - Roll Hill Meeting
11/7/24 – Hartwell Pantry Survey
11/7/24 – Eval Wrap Up Meeting J. Robinson
11/12/24 – CHC Group Meeting
11/12/24 - 1:1 Meeting w/ A. Griffith
11/12/24 – Monthly Update Meeting
11/12/24 – Collaborative of Hamilton County Meeting
11/13/24 – LWPC Coalition Meeting
11/14/24 – SAFE Network Meeting
11/14/24 – Hartwell CRC Site Visit/Pantry Discussion
11/18/24 – 1:1 Infant Vitality M. Harris
11/18/24 – PSE Assessment Training
Community Outreach – Justin Berry
Project/ Meeting Title – Community Outreach
Details/ description
# of … Project Partners and Status Next Steps
4 Meeting and
Community
Members reached)
87
Partners:
GCB, City Gospel, Heroin Coalition
Team, CCRC, Step Stone and DeCoach,
First Step Home, Treatment Team, CRC
Rec Center, Our daily Bread) *New*
TruHealing
Status: (Ongoing)
Nacarn- 10 kits passed out in community
Plan:
Meeting frequency:
(Monthly and Bi-Monthly)
October was a bit of a struggling month due to
treatment places starting to fill up due to the
weather changes and a lot of placements are
starting to have to be outside of the area of
Cincinnati which can be difficult for clients that
don’t want to up and leave family. My goal for
November-December is to establish relationship
with more treatment facilities, for AOD clients
and homeless.

-- 57 of 82 --

MONTH: (2024) JAN FEB MAR APR MAY JUN JUL AUG
SEP OCT NOV DE
C
Open cases: 97 92 97 86 83 84 84 87 87 85
3.5-9 μg/dL case mgt & follow-
up: * 22/22 22/24 20/20
16/2
0 8/10 16/7
27/1
5
41/1
2
29/
14 19/
14
10+ μg/dL case mgt & follow-up: 4/15 2&18 3/15 4/12 2/20 3/11 6/12 3/10
3/1
3
5/1
5
Risk assessments: 4 1 2 2 3 1 5 3 3 5
Orders issued: 0 2 0 4 2 0 5 2 2 2
Clearances EBL: 1 1 1 3 4 1 1 1 1 1
Clearances HUD: 0 0 1 2 0 0 6 2 6 6
Owner meetings EBL: 1 3 0 0 3 0 0 0 1 1
Owner meetings HUD: 1 1 0 0 4 1 1 1 1 0
Compliance checks EBL: 23 25 19 22 21 62 26 20 24 27
Compliance checks HUD: 0 0 3 0 1 0 1 1 3 2
Contractor mtgs EBL: 0 0 1 0 0 0 2 0 0 0
Contractor Meetings HUD: 3 5 4 3 1 9 5 7 4 1
Filed for prosecution: 0 0 0 0 0 0 0 0 0 0
LIRAs: 8 4 8 4 6 5 5 4 2
6
Grant apps uploaded (ODH
/ODD/HUD) 7/2 11 1/2 5/1 4/0 2/0 13/0
3/4/
1
3/1/
0
1/0
/0
Case Update w/ Lead Clinic: 10 12 13 10 11 9 7 11 8 9

-- 58 of 82 --

Risk Assessment: If a child has a lead level of 10 ug/dL and above, a risk assessment of the property is conducted to
determine the source of lead poisoning.
Orders issued: If lead hazards are present on the property, orders are issued to the property owner to ensure compliance.
Clearances: These include soil and dust sample analysis for lead on EBL & HUD grant properties.
Owner Meetings: Meet with owners to discuss compliance with orders; meet with owners to discuss the HUD grant
program.
Compliance checks: These are conducted to inspect the licensed lead abatement contractors and workers on the project
sites for the EBL as well as the grant program.
Contractor meetings: Meet with the licensed lead abatement contractor at the job site/property to discuss the orders/work
specifications for the EBL/HUD grant program.
Filed for prosecution: When non-compliance is achieved, the property owner is referred to the Law Department for
enforcement action.
PIRA’s: Paint Inspection/Risk Assessment of the house to evaluate lead hazards for lead remediation by the HUD grant.
Case update with Lead Clinic: Collaboration with CCHMC Lead Clinic every Thursday.
Affidavit of Fact (AF): When all resources for compliance are exhausted, the AF is sent to the Auditor’s Office to flag
properties with lead hazards so new owners are aware of the BOH Lead orders on the property.

-- 59 of 82 --

October 2024 BOH Report
Emergency Preparedness/Safety
Meetings, Grants, and Employee Safety
Attended the Southwest Ohio Public Health Region (SWOPHR) Emergency Response Coordinator workgroup
meeting October 4.
Attended DHS Countering Weapons of Mass Destruction BioWatch Program Office appropriations update
October 7.
Attended the Local Emergency Planning Committee (LEPC) meeting October 9.
Attended the City-wide Construction and Electrical Safety Subcommittee Meeting October 9.
Conducted the quarterly BioWatch Advisory Committee Meeting October 16.
Attended monthly Safety Meeting with City Employee Safety staff October 17.
Attended the CHD Quality Steering Committee Meeting October 23.
Attended the TriState Disaster Preparedness Coalition Meeting October 25.
Training, Exercises and Improvement Plans
Staff conducted a virtual Workplace Violence Tabletop Exercise with Millvale Health Center October 2.
Attended the SWOPHR Chemical Tabletop Exercise Initial Planning Meeting October 4.
Participated in the DHS Countering Weapons of Mass Destruction (CWMD) virtual BioWatch Functional
Exercise with other CHD leadership staff October 15.
Attended the SWOPHR Chemical Incident Tabletop Exercise Situation Manual development meeting October
21.
Staff conducted an Emergency Response Plan Review with staff at Braxton Can Health Center October 25.
Response/Preparedness Activities
No activities to report.
Cincinnati Vital Records and Statistics Program
Monthly Dashboard for October 2024
Vital Records received payment for 20 affidavits, staff assisted customers with birth certificate
corrections using the affidavit process.
Vital Records staff assisted 12 families with a paternity affidavit process to add the father to a birth
certificate.
Vital Records received 165 payments for permits (burial, cremation, transport, or entombment).
Birth and Death Certificates requested from the kiosk, web system, and mail are shown in the chart
that follows.
October 2024 Kiosk Web Mail VitalChek.com
Birth Certificates 1324 1205 18 225
Death Certificates 126 1509 12 59
Total Payments $32,530 $30,560 $1,655 $6,543

-- 60 of 82 --



-- 61 of 82 --

Monthly Infectious Disease
Surveillance Summary,
October 2024
Reportable Condition is by Category (For a description of listed conditions,
see https://odh.ohio.gov/wps/portal/gov/odh/know-our-
programs/infectious-disease-control-manual/section3/idcm-section-3.)
2024
October 2024 YTD 2023
October 2023 YTD 2023 Rate
Cincinnati 5 Year
Average Rate
(2019-2023)
Ohio 5 Year
Average Rate
(2015-2019)
Food- or Waterborne 10 114 13 125 46.22 47.32 12.32
Amebiasis 1 0.33 0.19 0.10
Brucellosis 0.06 < 0.001
Botulism 0.06 0.10
Campylobacteriosis 4 23 2 27 10.0 10.65 18
Cryptosporidiosis 15 2 20 7.43 3.25 7.50
Cyclosporiasis 2 0.66 0.84 0.50
E. coli, Shiga Toxin-Producing O157:H7 6 10 4.52 3.76 0.70
Giardiasis 7 3 12 4.20 4.22 3.70
Hepatitis A (also vaccine-preventable) 2 0.66 2.86 6.10
Legionellosis - Legionnaires' Disease 2 7 3 11 3.88 3.96 5.90
Listeriosis 0.52 0.30
Salmonellosis 1 29 1 18 6.78 9.42 12.70
Salmonella Typhi (travel associated) 1 1
Shigellosis 3 17 1 14 5.17 6.30 5.80
Vibriosis (not cholera) 2 0.33 0.32 0.30
Yersiniosis 7 1 7 2.26 0.91 0.60
Vectorborne 1 13 1 9 3.24 2.92 0.60
Chikungunya Virus Disease* 0.13 <0.001
Dengue 2 0.13 0.10
Lyme disease 3 2 0.66 1.30 2.30
Malaria* 1 7 1 7 2.58 1.17 0.50
Spotted Fever Rickettsiosis 0.13 0.30
Ehrlichiosis-Ehrlichia chaffeensis 0.06 0.10
Anaplasmosis-Anaplasma phagocytophilum 1 0 -
Vaccine-Preventable 10 320 6 67 43.62 86.37 91.00
Hemophilus influenzae, invasive disease 1 7 10 3.23 3.05 2.10
Influenza-associated hospitalization 1 254 2 17 23.9 67.34 77.30
Mumps 1 1 1 0.26 0.40
Pertussis 6 15 2 1.62 3.12 7.20
Meningococcal disease – Neisseria meningitidis 1 1 0.33 0.13 -

-- 62 of 82 --

S. pneumoniae, invasive (abx susceptible/unknown) 2 22 1 25 11.63 9.68 -
S. pneumoniae, invasive (abx resistant) 10 5 0.97 2.79 -
Varicella (chickenpox) 11 1 6 1.94 2.39 3.90
Reportable Condition2 by Category (For a description of listed conditions, see
https://odh.ohio.gov/wps/portal/gov/odh/know-our-programs/infectious-
disease-control-manual/section3/idcm-section-3.)
2024
October
2024
YTD
2023
October
2023
YTD 2023 Rate
Cincinnati 5 Year
Average Rate (2019-
2023)
Ohio 5 Year
Average Rate
(2015-2019)
Viral Hepatitis 48 380 40 370 144.76 178.58 193.12
Hepatitis B, acute (also vaccine-preventable) 5 0.33 1.56 2.80
Hepatitis B, chronic, newly identified (also vaccine-
preventable) 10 100 13 67 24.23 25.91 20.62
Hepatitis B, perinatal 0.13 -
Hepatitis C, acute 1 2 0.33 2.47 2.68
Hepatitis C, perinatal 3 1 0.33 0.52 <0.001
Hepatitis C, chronic, newly identified 38 271 27 300 119.54 147.99 167.02
Other Conditions# 222 5118 723 5623 2511.39 - 2.34
Carbapenemase-Producing Organisms (CPO) 3 19 3 36 14.86 5.58 Not Yet Reportable
Candida Auris 6 77 11 104 38.45 18.44 <0.001
COVID-19 209 4965 704 5417 2432.21 5,793.38 (4-year rate) Not yet Reportable
Coccidioidomycosis 1 1 0.33 0.65 0.20
Creutzfeldt-Jakob Disease 0.06 0.10
Hemolytic uremic syndrome (HUS) 0.06 <0.001
Meningitis, aseptic 1 15 1 14 4.85 5.06 5.40
Meningitis, bacterial (not N. meningitidis) 1 9 6 2.26 2.60 1.10
MPOX 3 2 0.97 1.50 (2-year rate) Not Yet Reportable
Multisystem Inflammatory Syndrome in Children (MIS-C)
associated with COVID-19 1.17 (4-year rate) Not Yet Reportable
Staphylococcal aureus - intermediate resistance to vancomycin
(VISA) 0.06 0.10
Streptococcal, Group A, invasive 2 26 3 37 15.51 9.29 4.80
Streptococcal, Group B, newborn 3 1 4 1.29 0.84 -
Toxic Shock Syndrome (TSS) 2 0.66 0.39 <0.001
Typhus Fever 0.06 -
TOTAL CONFIRMED AND PROBABLE CASES 291 5945 783 6194 2749.23 - 299.38
Dermatologic 3 10 3.86 0.93
Gastrointestinal 4 5 1.62 1.46
Respiratory 2 38 10 69 27.46 25.61
Other 1 9 1 1 0.66 0.65
Outbreaks (Investigation started) 3 54 11 85 33.60
1) Confirmed and probable cases reported by health care providers and laboratories among residents of the City of Cincinnati by date of event (most frequently, the date of event is the date of illness onset).
2) List includes only reportable conditions for which at least one case was reported in either year; the full list of reportable conditions in Ohio can be found at https://odh.ohio.gov/wps/portal/gov/odh/know-our-programs/infectious-disease-control-manual.
3) All data was provided through the Ohio Disease Reporting System – All data is provisional and subject to change.

-- 63 of 82 --

*Acquired through international travel
^CP-CRE (Carbapenemase-Producing Carbapenem-Resistant Enterobacteriaceae) is a multi-drug resistant condition newly reportable as of March 2018.
#Note that sexually-transmitted infections, Human Immunodeficiency Virus (HIV) infections (including AIDS) and Tuberculosis are investigated and reported by Hamilton County Public Health and are not included here.
- Case rates use the 2019 5-year U.S Census estimates and are per 100,000 residents
Any dash (-) indicates there was no available data at the time this report was published due to either lack of cases in the last 10 years, or age restrictions when calculating rates with population.

-- 64 of 82 --

Power BI Desktop
TOTAL CASES
94409
Active Cases
113
Total Hospitalized
3590
TOTAL DEATHS
816
Recovered Cases
93471
73858
Confirmed
20551
Probable
118
Probable
698
Confirmed
Females
53571
Males
39958
Age Range
0 - 107
Median Age
34 Onset of Symptoms
1/5/2020 -
11/18/2024
Total New Cases
32 13
New Confirmed
19
New Probable
New Cases by Sex
25 (78%)
7 (22%)
Sex
Female
Male
New Cases by Race
50% (50%)
28% (28.13%)
(9.38%)
3% (3.13%)
9%
Race
White
Black
Unknown
Other
Asian
RefusedToAnswer
Sex 	1-9 10-19 20-29 30-39 50-59 60-69 70-79 90-99
Female 1 	2 	1 	11 	4 	5 	1
Male 	1 	3 	1 	2
Total 	2 	5 	1 	12 	4 	5 	2 	1
New Cases by Age & Sex
0
10
Age Group
1-9 	10-19 	20-29 	30-39 	50-59 	60-69 	70-79 	90-99
Sex Female Male
Epidemiological Curve - Weekly Reported Cases
0
100
200
300
Number of Cases Reported Weekly
Jan 2023 	Jul 2023 	Jan 2024 	Jul 2024
Confirmed Probable
Epidemiological Curve (Weekly Case Rate per 100,000)
0
50
100
Date
Rate Per 100,000
Jan 2023 	Jul 2023 	Jan 2024 	Jul 2024
Confirmed Rate Probable Rate
94409
Total Cases
Total Cases by Sex
53571 (57%)
39958 (42%)
880 (1%)
Sex
Female
Male
Unknown
Total Cases by Race
(39.93%)
38% (38.5%)
(11.55%)
8% (7.85%) 40%
12%
Race
White
Black
Unknown
Other
Asian
HawaiinNative…
RefusedToAns…
AmericanIndia…
Total Cases by Age & Sex
0K
10K
Age Group
0-1 	1-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90-99 100-120
Sex Female Male Unknown
Sex 	0-1 1-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90-99 100-120
Female 	658 2729 5199 13024 10257 6807 5764 4927 2479 1221 477 	28
Male 	793 2790 4270 8843 7200 4561 4449 3861 2119 819 242 	7
Unknown 	43 80 	82 180 136 	93 104 	91 	41 	22 	7
Total 	1494 5599 9551 22047 17593 11461 10317 8879 4639 2062 726 	35
3590
Total Hospitalized
Total Hospitalized Cases by Age & Sex
0
500
Age Group
0-1 	1-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90-99 100-120
Sex Female Male Unknown
Sex 	0-1 1-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90-99 100-120
Female 	22 17 	38 177 190 159 311 403 301 235 105 	3
Male 	19 17 	23 	64 135 165 240 387 312 185 	72 	2
Unknown 	1 	1 	1 	1 	1 	1 	2
Total 	41 35 	62 242 325 325 552 791 615 420 177 	5
Total Hospitalized Cases by Sex
(55%)
(45%)
8 (0%)
1961
1621
Sex
Female
Male
Unknown
Total Hospitalized Cases by Race
2066 (58%)
(35%)
162 (5%)(0%)
1269
10 	Race
Black
White
Other
Unknown
Asian
HawaiinNative…
AmericanIndia…
RefusedToAns…
816
Total Deaths
Total Deaths by Sex
(50%)	(50%)
2 (0%)
408	406
Sex
Male
Female
Unknown
Total Deaths by Race
(50%)
(47%)
12 (1%)
407
382
Race
White
Black
Other
Unknown
Asian
AmericanIndia…
HawaiinNative…
Total Deaths by Age & Sex
0
50
100
Age Group
0-1 	10-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90-99 100-120
Sex Female Male Unknown
Sex 	0-1 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90-99 100-120
Female 	2 	4 	2 	8 	18 	50 	66 	92 	83 	73 	8
Male 	1 	2 	7 	28 	47 	84 	96 	96 	46 	1
Unknown 	1 	1
Total 	2 	5 	4 	15 	46 	97 150 189 180 119 	9
93471
Total Recovered
Total Recovered Cases by Sex
53083 (57%)
(42%)
878 (1%)
39510
Sex
Female
Male
Unknown
Total Recovered Cases by Race
37233 (40%)
35918 (38%)
(12%)
7397 (8%)
10882
Race
White
Black
Unknown
Other
Asian
HawaiinNative…
RefusedToAns…
AmericanIndia…
Total Recovered Cases by Age & Sex
0K
10K
Age Group
0-1 	1-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90-99 100-120
Sex Female Male Unknown
Sex 	0-1 1-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90-99 100-120
Female 	655 2725 5192 13006 10230 6783 5706 4851 2378 1134 402 	20
Male 	788 2782 4264 8837 7187 4532 4401 3774 2018 722 195 	6
Unknown 	43 80 	82 180 136 	93 104 	91 	40 	21 	7
Total 	1486 5587 9538 22023 17553 11408 10211 8716 4436 1877 604 	26
Hospitalizations by Week
0
50
100
Date
2021 	2022 	2023 	2024
Number of Cases (By Week)
0
200
Sep 2024 	Oct 2024 	Nov 2024
350
32	49 	44	51	43	50
154
231
64 	37
238
115
Interviewed Cases Symptomatic vs. Asymptomatic
28248 (91%)
2792 (9%)
Symptoms
Symptomatic
Asymptomatic
%Hospitalized
3.8%of Total Cases
0.9%Case Fatality Rate
Deaths by Week
0
20
Date
2021 	2022 	2023 	2024
Average Age by Month
0
20
40
Date Month
2022 Novem…	
2022 December
2023 January	
2023 February
2023 March	
2023 April	
2023 May	
2023 June	
2023 July
2023 August
2023 September
2023 October
2023 November	
2023 December
2024 January	
2024 February
2024 March	
2024 April	
2024 May	
2024 June	
2024 July
2024 August
2024 September
2024 October
2024 November
45.6 45.1 41.2 43.5 44.2
48.5 45.9 48.4 45.8
41.2 41.4 41.0 42.7 42.5 41.8 41.1
46.0 44.3 45.4 46.1 42.9 40.7
45.8 44.3
37.2
7 Day Cumulative New
Cases (Per 100,000)
10.5
CDC Transmission Rate Per 100,000
0
100
Sep 2024 	Oct 2024 	Nov 2024
115
11	16 	14	17	14	16
51
76
21 	12
78
38
CITY OF CINCINNATI COVID-19 REPORT
Updated 11/22/2024
DATA SHOWN FOR TODAY REFLECTS PAST 24 HOURS
*DATA IS PROVISIONAL CONTINGENT UPON COMPLETION OF CONTACT TRACING AND CONFIRMATION OF JURISDICTIONAL RESIDENCE
**IN ACCORDANCE WITH THE NEW CDC GUIDELINES, THE CDC EXPANDED (PROBABLE) CASE DEFINITION IS INCLUDED IN THIS REPORT. SEE:
https://www.cdc.gov/coronavirus/2019-ncov/covid-data/faq-surveillance.html
**Presumed recovered cases is defined as cases with a symptom onset date/test date >21 days prior who are not deceased. Active cases are defined as cases
with a symptom onset/test date <21 days.
***Jurisdictional transfers added based on the date they were originally reported to the local health department. These are not classified as new cases.
****For more information including detailed maps of City of Cincinnati data, please visit
https://insights.cincinnati-oh.gov/stories/s/x9if-5i85
*****Transmission indicator based on CDC defined criteria
STATE DATA SOURCE: OHIO DISEASE REPORTING SYSTEM (ODRS)
KEY METRICS
WEEKLY NEW CASE INFORMATION
DEMOGRAPHIC REPORT
ADDITIONAL COVID-19 INFORMATION
Regional COVID-19 Variant Report
The graphic below represents genomic surveillance by the CDC for the United States
Variant proportions can be found at https://covid.cdc.gov/covid-data-tracker/#variant-proportions
*Updated 11/15/2024
For more up to date information regarding hospitalizations, please refer to the Center for Clinical &
Translational Science & Training (CCTST) website at: https://www.cctst.org/covid19
*Note this is a regional report and includes data outside of the City of Cincinnati jurisdictional limits
*Transmission rate graph represents the last 3 months

-- 65 of 82 --

*Note: CCP = Critical Control Point Inspections.
*Note: FSO = Food Service Operations; RFE = Retail Food Establishment.
Environmental Health
The Environmental Health Division strives to provide quality community-based services to Cincinnati citizens through the enforcement of public health laws. Through five offices (including Licensing Administration), the Division
issues licenses, investigates complaints, abates public health nuisances, and conducts inspections of Cincinnati’s restaurants, food trucks, grocery stores, festivals, composting facilities, tattoo and body piercing parlors, infectious
waste facilities, junk vehicles, solid waste open dumps, swimming pools and spray grounds, mosquitoes, rabies exposures, household sewage treatment systems, smoking in public places, mold, no water, no heat, rat and mouse,
surfacing sewage, roaches, defective plumbing, schools, unsanitary living conditions, hotels, and institutions, along with other programs. The Environmental Health Specialists focus on prevention, consultation, and educating our
thriving community on health risks and maintaining a safe environment.
*Averages for each category are based on the last five years average for the same month.
CITY OF CINCINNATI ENVONMENTAL HEALTH REPORT
FOOD INSPECTION PROGRAM
The Food Safety Program continues to complete Tobacco 21 inspections, which are due to be completed by December 1, 2024. We aslo issued 40 Temp licenses for 4 special events ... Serenity Jam (10/5/24), Disney on Ice (10/10/24), BLINK
(10/17/24 to 10/19/24), and UC Homecoming (10/19/24).
2694
2510 2655
2471
2666 2652
3007
1989
1337
968
328 310
514
759 617
277
1172 1250
1050 1026
1285
1092
1280
917
0
500
1000
1500
2000
2500
3000
3500
2017 2018 2019 2020 2021 2022 2023 2024
Food Service Operations (FSO) by Year Inspections
Reinspections
CCP Inspections
67 	35
Reinspections
Total
	Last Month	
OCT Average
291 	323
Inspections
OCT Average	
Total
	Last Month
129 	160
CCP Inspections
OCT Average 	Total
	Last Month
 695
604 609 575 585 562
658
446	456
229
84 100
164 154
102
58	56 55 55 44 60 57 37 43	
4 2 4 6
64
7 9 4
0
100
200
300
400
500
600
700
800
2017 2018 2019 2020 2021 2022 2023 2024
RFE Program by Year RFE Inspections
RFE Reinspections
RFE Process Review
Variance Verification
62 	82
RFE Inspections
OCT Average 	Total
	Last Month
16 	13
RFE Reinspections
OCT Average 	Total
	Last Month
6 	5
RFE Process Reviews
OCT Average 	Total
	Last Month
1 	0
Variance Verifications
OCT Average 	Total
	Last Month
310 338
381
253 226
288
491
296
100
45	
78 73
34 35 33 19
0
100
200
300
400
500
600
2017 2018 2019 2020 2021 2022 2023 2024
FSO & RFE Complaints by Year
Complaints - Inspection
Complaints - Reinspection
30 	15
Complaints - Inspection
OCT Average 	Total
	Last Month
4 	0
Complaints - Reinspection
OCT Average 	Total
	Last Month
402
261 271
38
154
291 287
312
10 5	
26 14 10 5 12 27	
46
15	
38 43 52 61 54	
76
50 63 63
133
67
43
142
88
35
65
90
121
31
58 46 48
0
50
100
150
200
250
300
350
400
450
2017 2018 2019 2020 2021 2022 2023 2024
Temp Mobile Vending Licenses by Year Temporaries License
Temporary Day Inspections
Mobile Licenses, New
Mobile Inspections
Vending Inspections
17 	40
Temporaries Licenses
OCT Average 	Total
Last Month
1 	0
Temporary Day Inspections
OCT Average 	Total
	Last Month
3 	1
Mobile Licenses, New
OCT Average 	Total
	Last Month
5 	1
Mobile Inspections
OCT Average 	Total
	Last Month
1 	0
Vending Inspections
OCT Average 	Total
	Last Month
226
191
245 240 250
214	
230
199
149
125 138 128
176
133
163
129
55 56
110 100 114
96
118
58
0
50
100
150
200
250
300
2017 2018 2019 2020 2021 2022 2023 2024
Plan Review Applications by Year FSO/RFE Plans Received
FSO/Plans Approved
FSO/RFE Plans Rejected
16 	16
FSO/RFE Plans Received
OCT Average 	Total
	Last Month
12 	13
FSO/RFE Plans Approved
OCT Average 	Total
	Last Month
7 	6
FSO/RFE Plans Rejected
OCT Average 	Total
	Last Month
 14
8
9
8 8
6 6
5
14
7
9 9 9
7
4
7
0
2
4
6
8
10
12
14
16
2017 2018 2019 2020 2021 2022 2023 2024
Food Safety Traning Classes by Year
ServSafe Training Classes
PIC Training Classes
1 	0
ServSafe Training Classes
OCT Average 	Total
	Last Month
1 	0
PIC Training Classes
OCT Average 	Total
	Last Month

-- 66 of 82 --

*Note: Plan Reviews are only completed when there is a new facility or renovation
*Note: Class is based on food preparation risk and facilities size.
*Note: This data reflects the number of complaints received for the entire city
HEALTHY HOMES PROGRAM
The Healthy Home team particpated in the OTR clean up organized by 3CDC, where the team spent a couple hours picking up trash in the neighborhood. This was a great event, and staff hope to participate again in the spring. The team were
involved in the ecexution of an administravtive search warrant along with fire, B&I, law and ARC.GE
14 9 18 11 4 3 7 0
25 19 18 15 22 19 16 18
43 33 35 32 39 44 41 46
152 140
158
60
163
135
171
211
146 140
84
15	
0
128
171
195
0 0 0 0 0 0 0 0	
0
50
100
150
200
250
2017 2018 2019 2020 2021 2022 2023 2024
School Food Inspections/Healthy Homes RFE/FSO - Class 1
RFE/FSO - Class 2
RFE/FSO - Class 3
RFE/FSO - Class 4
RFE/FSO - CCP
RFE/FSO - Mobile
1 	0
RFE/FSO-Class 1
OCT Average 	Total
	Last Month
2 	0
RFE/FSO-Class 2
OCT Average 	Total
	Last Month
8 	8
RFE/FSO-Class 3
OCT Average 	Total
	Last Month
22 	45
RFE/FSO-Class 4
OCT Average 	Total
	Last Month
18 	45
RFE/FSO-CCP
OCT Average 	Total
	Last Month
0 	0
RFE/FSO-Mobile
OCT Average 	Total
	Last Month
0
4 4
2
1 1 1 1
0
4 4
2
0
1 1 1
0 0 0 0 0 0 0 0	
0
1
2
3
4
5
2017 2018 2019 2020 2021 2022 2023 2024
School Food Plan Review Applications by Year
FSO/RFE Plans Received
FSO/RFE Plans Approved
FSO/RFE Plans Rejected
0 	0
FSO/RFE Plans Received
OCT Average 	Total
	Last Month
0 	0
FSO/RFE Plans Approved
OCT Average 	Total
	Last Month
0 	0
FSO/RFE Plans Rejected
OCT Average 	Total
	Last Month
3129 3084
2750
2367
2885
3933 3751
2837	2903 2974
2434 2287
2680 2737 2945
2479
0
500
1000
1500
2000
2500
3000
3500
4000
4500
2017 2018 2019 2020 2021 2022 2023 2024
General Nuisance by Year Total Complaints
Received
Total Complaints
Finished
302 	246
Complaints Received
OCT Average 	Total
	Last Month
274 	263
Complaints Finished
OCT Average 	Total
	Last Month
0
200
400
600
800
1000
1200 General Nuisance Complaints 2018
2019
2020
2021
2022
2023
2024
25
31
22
17
14
11
25
14
31 30
37
14 15
11
23
12
0
5
10
15
20
25
30
35
40
2017 2018 2019 2020 2021 2022 2023 2024
Smoking Complaints by Year
Complaints Received
Complaints Finished
3 	3
Complaints Received
OCT Average 	Total
	Last Month
2 	1
Complaints Finished
OCT Average 	Total
	Last Month

-- 67 of 82 --

ENVIRONMENTAL WASTE PROGRAM
The Waste Unit licensed a temporary two day body piercing event. Worked with OPDA to streamline the junk vehicle Tow referral process.
3 	3
Complaints Received
OCT Average 	Total
	Last Month
2 	1
Complaints Finished
OCT Average 	Total
	Last Month
1072
871
971 942 902 918 960
1045	1076
979 969 909 916 887
974 912
757
578
687 652 658
787 793 827
320 262 274 260 270	
200 223 201
0
200
400
600
800
1000
1200
2017 2018 2019 2020 2021 2022 2023 2024
Junk Vehicles by Year Junk Vehicle Complaints,
New
Junk Vehicle Re-
Investigations
Junk Vehicle Complaints
Closed
Junk Motor Complaints
Refer to Tow
76 	73
Junk Vehicle Complaints, New
OCT Average 	Total
	Last Month
84 	87
Junk Vehicle Re-investigations
OCT Average 	Total
	Last Month
61 	74
Junk Vehicle Complaints Closed
OCT Average 	Total
	Last Month
22 	17
Junk Motor Complaints Refer to Tow
OCT Average 	Total
	Last Month
71
28 24 29 27 32 30 19
223
105 95
128	
140
123
177
66	63
25 30 36 34 36 41
18
0
50
100
150
200
250
2017 2018 2019 2020 2021 2022 2023 2024
Open Dumping by Year Open Dumping Complaints, New
Open Dumping Re-Investigations
Open Dumping Complaints Closed
3 	3
Open-Dumping Complaints
OCT Average 	Total
	Last Month
12 	14
Open-Dumping Re-Investigations
OCT Average 	Total
	Last Month
4 	4
Open-Dumping Complaints Closed
OCT Average 	Total
	Last Month
30 29 34
15 21 24 24
15
133
102
123
0
75
93 92
111
7 3 0 0 1 0 0 0	1 0 0 0 0 0 0 0	
0
20
40
60
80
100
120
140
2017 2018 2019 2020 2021 2022 2023 2024
Infectious Disease by Year Treatment Facility Inspections
IW Large Quantity Generator
Inspect
IW LQG Re-Inspections
1 	1
Treatment Facility Inspections
OCT Average 	Total
	Last Month
17 	40
IW Large Quantity Generator Inspections
OCT Average 	Total
	Last Month
0 	0
IW LQG Re-Inspections
OCT Average 	Total
	Last Month
0 	0
IW Complaints
OCT Average 	Total
	Last Month
4 4 4 4
5
4
5 5
6
4
5
4 4 4
5
6
5
4
5
4
6
7
6
4
0
1
2
3
4
5
6
7
8
9
10
2017 2018 2019 2020 2021 2022 2023 2024
Landfill Inspections by Year Closed Landfill
Inspections
Transfer Station
Inspection
Compost Facility
Inspections
1 	1
Closed Landfill Inspections
OCT Average 	Total
	Last Month
1 	1
Transfer Station Inspection
OCT Average 	Total
	Last Month
1 	1
Compost Facility Inspections
OCT Average 	Total
	Last Month
73
54 61 61
74
60
158
51
91
53 46 42
59
48
116
40
0
20
40
60
80
100
120
140
160
180
2017 2018 2019 2020 2021 2022 2023 2024
Tire Storage Facility Inspections by Year Tire Storage Facility
Inspections
Tire Storage Facility Re-
Inspections
13 	1
Tire Storage Facility Inspections
OCT Average 	Total
	Last Month
10 	1
Tire Storage Facility Re-Inspections
OCT Average 	Total
	Last Month
82
21 16 11 33 0 3
100
17 10 10 10 0 2
196
4 5 5 6
99
1
87
1 14 14 12 2 9
246
7 11 11 8
136
4
431
4 22
309
14
295
7
548
0 17 13 10
401
9
587
7
464 464
9
442
1	
0
100
200
300
400
500
600
700
Body Art
Inspections
Body Art Re-
Inspections
Body Art Plans
Received
Body Art Plans
Approved
Body Art Licenses
Issued (New)
Body Art Temp
License Issued
Body Art
Complaints
Body Art 2017
2018
2019
2020
2021
2022
2023
2024

-- 68 of 82 --

Technical welcomed a new employee Lucas Young. Mr. Young is an EHS who previously worked with Butler County Health. Mosquito surveillance has concluded for the season, with a total of 24 pools of mosquitoes that tested positive for WNV.
We had no human cases in Cincinnati.
TECHNICAL ENVIRONMENTAL SERVICES (TES)
13 	1
Tire Storage Facility Inspections
OCT Average 	Total
	Last Month
10 	1
Tire Storage Facility Re-Inspections
OCT Average 	Total
	Last Month
583
528 515
433
537
677
793
586
465
544
707 726
856 829
530
475
0
100
200
300
400
500
600
700
800
900
2017 2018 2019 2020 2021 2022 2023 2024
Rabies Investigations by Year Investigation
Re-investigation
48 	59
Investigations
OCT Average 	Total
	Last Month
64 	60
Re-Investigations
OCT Average 	Total
	Last Month
601 599
775	
834 840
902
1075
863
456 417 438
308
395 356 304 263
1015 1033 1013
652
1011
884
733
862
13 33 75 111 91 117 86 69	58 98 91 57 100 51 37 46
0
200
400
600
800
1000
1200
2017 2018 2019 2020 2021 2022 2023 2024
Swimming Pools by Year Inspections
Complaint Investigation
Sampling
Re-inspection
Complaint Re-
investigation
20 	16
Inspections
OCT Average 	Total
	Last Month
2 	0
Complaint Investigations
OCT Average 	Total
	Last Month
3 	11
Sampling
OCT Average 	Total
	Last Month
1 	0
Re-Inspections
OCT Average 	Total
	Last Month
3 	0
Complaint Re-Investigations
OCT Average 	Total
	Last Month
613
537 503
623
570
699
782
559
130 112 102 122 151 132
236
92	
66
129 120 132 168	
124 130 135
8
81 93 66 82 101 78 78	63
373 407
291 312
424 431
351
0
100
200
300
400
500
600
700
800
900
2017 2018 2019 2020 2021 2022 2023 2024
Sewage (HSTS) by Year Inspections
Investigation
Completed
Re-inspection
Sampling/Recorder
101 	128
Inspections
OCT Average 	Total
	Last Month
5 	4
Investigations
OCT Average 	Total
	Last Month
3 	2
Completed
OCT Average 	Total
	Last Month
6 	4
Re-Inspection
OCT Average 	Total
	Last Month
50 	46
Sampling/Recorder
OCT Average 	Total
	Last Month
740
1189
1448
985
1748
987
824
548
58
811 853
715
849
461
598
416
19
282	
387 433
736
361
485
216
0
495 550
307 277
476	
371
572
0
200
400
600
800
1000
1200
1400
1600
1800
2000
2017 2018 2019 2020 2021 2022 2023 2024
Sewer Baiting by Year Rodent Baiting
Complaint Investigation
Complaint Re-
investigation	
Recorder
116 	41
Rodent Baiting
OCT Average 	Total
	Last Month
57 	41
Complaint Investigations
OCT Average 	Total
	Last Month
65 	3
Complaint Re-Investigations
OCT Average 	Total
	Last Month
43 	8
Recorder
OCT Average 	Total
	Last Month
25
28
22
20
15 15 15
19
10
25
29
32
28
2 3
8
0
5
10
15
20
25
30
35
2017 2018 2019 2020 2021 2022 2023 2024
Vectorborne Disease by Year Complaint Investigation
Complaint Re-
investigation
1 	2
Complaint Investigations
OCT Average 	Total
	Last Month
1 	0
Complaint Re-Investigations
OCT Average 	Total
	Last Month
61 61 56 32 23 24 25 41
534 565
399
469
408 433
578 565
31	
73 64
15 21 18 17 22
67 80 76 55 40 21 24 44
0
100
200
300
400
500
600
700
2017 2018 2019 2020 2021 2022 2023 2024
Mosquito by Year Complaint Investigation
Monitoring/Sampling
Sampling/Recorder
Complaint Re-investigation
1 	0
Complaint Investigations
OCT Average 	Total
	Last Month
2 	0
Monitoring/Sampling
OCT Average 	Total
	Last Month
3 	4
Sampling/Recorder
OCT Average 	Total
	Last Month
5 	1
Complaint Re-Investigations
OCT Average 	Total
	Last Month

-- 69 of 82 --

Risk of clade I mpox outbreaks among gay, bisexual, and other men who
have sex with men in the United States
Web title: Risk of Clade I Mpox Outbreaks Among U.S. MSM – Updated
About: To assess the impact among MSM of potential clade I mpox introduction into the U.S., CDC
modeled varying levels of transmissibility and county-specific immunity. Modeling indicated that
counties with higher population-level immunity had lower chances of a prolonged or large outbreak.
November 22, 2024
This report is one of two modeling studies exploring the potential spread of clade I mpox in the United
States. This study explores the impacts of population-level immunity and transmissibility on sexual
transmission of mpox among gay, bisexual, and other men who have sex with men (MSM) and is an
update of the original technical report, which evaluated 13 of the 50 counties analyzed here. A separate
study explores the impact of household and other non-sexual spread on number of cases and number of
households infected in an outbreak.
At a Glance
Clade I mpox is causing an ongoing outbreak in the Democratic Republic of the Congo (DRC) and
neighboring countries in Central and Eastern Africa. In some places, this outbreak has spread
predominantly through intimate or sexual contact between adults. During the ongoing clade II mpox
outbreak that began in 2022, the main transmission route was associated with sexual activity among
certain gay, bisexual, and other men who have sex with men (MSM). CDC modeled potential clade I
mpox transmission among MSM to explore potential impacts of introduction to these sexual networks in
the United States. The model accounted for varying levels of transmissibility and county-specific
population-level immunity from previous infection, estimated undiagnosed infections, and receipt of
one or two doses of the JYNNEOS vaccine. Our modeling results indicate that:
• In 23 out of the 50 U.S. counties included in the analysis, simulated clade I outbreaks among
MSM were smaller than ongoing clade II outbreaks across three transmissibility scenarios. The
clade I outbreaks were likely smaller because of prior immunity from vaccination and previous
infection, as well as the population’s related behavior change.
• The size and duration of potential mpox outbreaks varied across individual counties due to
differences in population-level immunity, defined as a combination of estimated undiagnosed
infections, vaccination coverage and previous clade II mpox case rates.
• Counties with higher population-level immunity had lower chances of a prolonged or large
outbreak. Therefore, CDC recommends all eligible people get vaccinated.
Background
In previous outbreaks in endemic African countries, clade I virus has caused a higher proportion of
severe disease and been more transmissible than clade II within close-contact settings. As of November
16, 2024, one case of clade I mpox has been detected in the United States.
The current DRC outbreak of clade I mpox has likely resulted from transmission through several modes
in different settings, including household, zoonotic, and sexual exposures. A 2024 outbreak in the

-- 70 of 82 --

Kamituga mining region in DRC has been associated with transactional sex, as 88% of hospitalized cases
reported recent transactional sex. Additionally, health authorities reported six cases among MSM in a
rural town in DRC in 2023. In a risk assessment updated as of November 18, 2024, CDC assessed the risk
posed by the clade I mpox outbreak in the DRC to the U.S. MSM population as low to moderate; higher
than the risk posed to the general population.
Here, we use a dynamic, agent-based transmission model to explore the chance of prolonged sexual
transmission and potential outbreaks sizes among MSM in 50 counties in the United States if clade I
monkeypox virus were introduced to this population. The 50 counties selected for this analysis are those
included in the Ending the HIV Epidemic (EHE) Initiative and represent a range of population size and
immunity profiles (see Methods for additional information). Given uncertainty around the
transmissibility of clade I mpox, we explored three levels of clade I transmissibility: equally transmissible
as clade II (74.5% per-contact transmissibility), 10% increased transmissibility over clade II, and 20%
increased transmissibility over clade II.
Key Findings
The county-level modeling results indicated the size and duration of potential mpox outbreaks varied
across individual counties due to differences in population-level immunity. Results indicated that
outbreaks averaging more than 50 cases did not occur when population-level immunity from vaccination
or previous infection was greater than 50% among MSM (Figure 1). Additionally, our simulation results
showed that counties with higher population-level immunity had smaller outbreaks—defined as
cumulative infections one year after introduction—and lower chance of prolonged transmission—
defined as continued incident infections one year after introduction (Figure 2). In the baseline scenario
assuming clade I is as equally transmissible as clade II, no county with population-level immunity above
21% had outbreaks larger than their clade II outbreaks (Appendix Table 1).
Our results suggest that high population-level immunity in a county, coupled with related behavior
change, would lead to a much smaller mpox clade I outbreak among MSM compared to the ongoing
mpox clade IIb outbreak. When comparing modeling results to the number of confirmed diagnoses in
the 2022 outbreak, only nine of the 50 counties had higher median numbers of mpox model-diagnosed
cases across all transmissibility scenarios modeled. However, 27 of 50 counties had higher median mpox
diagnoses in at least the 20% more transmissible scenario. All of these counties had estimated levels of
population-level immunity below 35%.

-- 71 of 82 --

Figure 1. Cumulative number of diagnosed infections expected within a year among MSM in 50 U.S. EHE
counties across three transmission scenarios, following introduction of five individuals with mpox and
with high levels of sexual activity. Transmission scenarios represent clade I (0% more transmissible than
clade II, which has 74.5% per-contact transmissibility), clade I (with 10% relative increased transmission
over clade II), and clade I (with 20% relative increased transmission over clade II).

-- 72 of 82 --

Figure 2. Probability of prolonged mpox transmission after one year among MSM in 50 U.S. EHE counties
across three transmission scenarios, following introduction of five individuals with mpox with high levels
of sexual activity. Transmission scenarios represent clade I (0% more transmissible than clade II), clade I
(with 10% relative increased transmission over clade II), and clade I (with 20% relative increased
transmission over clade II).
Among counties with population-level immunity under 50%, higher levels of immunity were correlated
with lower probabilities of prolonged transmission among MSM for all three levels of transmissibility we
analyzed (Figure 2). These results suggest that for counties with higher levels of population-level
immunity, the probability of prolonged transmission is lower. In particular, counties with >50%
population-level immunity had a <12% probability of prolonged transmission.
Public Health Considerations
Increasing population-level immunity through vaccination in counties can reduce both the number of
infections as well as the chance of prolonged transmission of mpox. Vaccination is an important – yet
underutilized -- tool in preventing the spread of mpox. The Advisory Committee on Immunization
Practices recommends people with potential risk of exposure to mpox receive two doses of the
JYNNEOS vaccine. Despite this, only 25% of the approximately two million people recommended to
receive the vaccine in the United States based on risk of exposure to clade II mpox have received both
doses, and an additional 15% of those eligible have received one of the two recommended doses.
JYNNEOS is also expected to protect against clade I mpox. CDC will continue to evaluate available data
and assess the risk posed to MSM in the United States by the clade I mpox outbreak in DRC.

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If you are a public health partner interested in learning more about your county-specific population-
level immunity, please contact us.
Methods
We developed an agent-based model to simulate mpox sexual transmission among MSM. We adapted a
previous model that assessed clade II transmission in MSM networks, adding new data on U.S. sexual
network structures and exploring transmission parameters to represent clade I mpox.
We produced simulations for all 50 counties in the Ending the HIV Epidemic (EHE) Initiative. The 50 EHE
jurisdictions account for more than half of all new HIV diagnoses, and many represent urban areas
across the United States with large MSM populations. For each of the 50 counties, we established
baseline population-level immunity based on quarterly mpox vaccination data as of August 2024,
estimates of undiagnosed infections, and mpox clade II case reporting as of October 1, 2024, from
DCIPHER, a cloud-based CDC data platform. We assumed that prior infection with clade II mpox provides
full protection against both mpox clades, and that vaccination with the JYNNEOS vaccine provides partial
but strong immunity (75.2% and 85.9% for one dose and two doses, respectively).
We then generated sexual networks with sizes equivalent to the estimated MSM population for each
county as a set of three interconnected dynamic networks representing main (long-term), casual
(shorter-term), and one-time sexual partnerships among MSM. The sexual behavior within the networks
was estimated from an online survey of cisgender MSM from across the United States. We assumed that
the distribution of type and frequency of sexual behavior (e.g., the proportion of people who form long-
term, short-term, and/or one-time partnerships) is the same across all counties as data does not exist to
estimate these parameters at a local level. While these patterns of sexual behavior remain constant
between counties, each modeled county is unique in terms of population size and initial immunity
conditions. Finally, we also included short-term behavioral adaptations in our modeling as a reduction in
the frequency of spontaneous or one-time sexual encounters. We assumed a level of behavioral
adaptation in our analyses that was similar to what occurred in the District of Columbia in 2022, which
was based on previous modeling work and which was documented across the United States.
The cumulative number of infections and proportion of simulation runs with infections remaining one
year after introduction of the virus were compared across three transmission scenarios. Transmission
scenarios included the following: 1) baseline, clade I equally transmissible as clade II (74.5%); 2) clade I
10% more transmissible than clade II (81.9%); and 3) clade I 20% more transmissible than clade II
(89.4%). For each simulation, we assumed that five MSM with the highest levels of sexual activity—
defined as having one or more spontaneous/one-time sexual partners per week in addition to any main
or casual partners—were exposed to mpox and ran the simulation for one year. We summarized results
across 1,000 simulation runs for each county and scenario combination, both as a median and
interquartile range (IQR) of cumulative diagnosed mpox infections after one year following introduction
(Appendix Table 2) and as the probability of prolonged mpox transmission (Appendix Table 3).
How did this model differ from previous modeling during the clade II outbreak?
The updated model was fit to sexual network data that was collected more recently (2017-2019),
representing MSM across the United States rather than a single geographic region. Furthermore, we
added data on oral sex partnerships in addition to anal sex partnerships and recalibrated sexual activity
group strata to better characterize the range of sexual activity reported in the data. We also calibrated

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the clade II transmissibility parameter using clade II mpox case data from early in the 2022 outbreak.
This parameter has a calibrated distribution of β (4.24, 1.45), with mean equal to 74.5% probability of
transmission per contact.
We also added additional transmission parameters to explore possible clade I scenarios. While there are
no studies that estimate the exact difference in per-contact transmissibility between the globally
circulating clade II virus and clade I in humans, there is evidence that rash intensity and detectable viral
loads are greater for clade I relative to clade II in traditional zoonotic and household transmission
settings, and a small-mammal model demonstrated that virulence of clade I is greater than clade II. We
generalized these lines of evidence, assuming a 10% increase relative to clade II (81.9% per-contact
transmissibility) and a 20% increase (89.4% per-contact transmissibility).
Lastly, previous work modeled a range of immunity to mpox using a single population size, where in this
work we modeled county-specific MSM population size and composition of population-level immunity.
This generates more variance in our results, but both approaches come to similar conclusions about the
overall level of population-level immunity that is protective against prolonged transmission of mpox.
What data did you use to estimate county-level immunity coverage?
Population-level immunity was calculated as the proportion of each county’s population with increased
risk of mpox exposure that had some form of protective immunity, defined as either a previous
monkeypox virus infection (diagnosed or undiagnosed), one dose of vaccine, or two doses, and weighted
by the amount of protection each type of immunity provides the individual against future infection, as
assumed in the model. We used JYNNEOS vaccine administration data through August 2024, diagnosed
mpox cases through October 1, 2024, and an estimate of the number of undiagnosed mpox infections
based on previous modeling work. We estimated the size of the MSM population with increased risk of
mpox exposure in each county using county-level estimates from survey data reduced by 40% to reflect
the smaller proportion of MSM considered to have higher sexual activity based on national survey data.
There are 11 EHE counties not included in the above set of county-level estimates. For these counties,
we instead estimated the size of the population with increased risk of mpox exposure following previous
work, as the summation of the total number of MSM living with HIV and the number of PrEP-eligible
MSM, plus 10%.
Limitations
Our analysis is subject to several limitations, including some that could lead to underestimation of
outbreak size and probability of prolonged transmission. We assumed that prior infection with clade II
mpox provides full immunity against both mpox clades (no development of mpox following exposure),
that vaccination with the JYNNEOS vaccine provides partial immunity (significantly reduced probability
of mpox development following exposure), but did not account for waning immunity from either
previous infection or vaccination in this model. We also assumed that the JYNNEOS vaccine and prior
infection with clade II will provide similar levels of immunity against clade I as for clade II, all of which
could reduce our estimates of outbreak size. In addition, variations in vaccination reporting
requirements between counties—including some that have stopped reporting to CDC since immunity
estimates were previously published and/or have individual opt-in reporting—may mean that true
population immunity could be higher than is estimated here and outbreak sizes could be smaller than

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modeled. Lastly, the number of infections reported in these counties and included in our analysis may
be lower than the actual number of infections, given under-detection and reporting of cases.
We also made several assumptions that could have led to overestimates of outbreak size and probability
of prolonged transmission. We seeded simulations with a high number of infections in highly connected
individuals. In addition, we assumed substantial behavioral adaptation in the face of an outbreak. Our
sensitivity analysis for clade II indicated that substantially larger outbreaks could occur if this assumption
is violated, though outbreak sizes did not exceed 100 cases on average for counties with >50% immunity
among MSM with increased risk of mpox exposure (defined in our model as MSM who are likely to form
spontaneous or one-time partnerships in addition to having main and/or casual partners). We also
assumed that no vaccination occurred during the simulated year. In counties where analysis indicates
that large outbreak sizes are possible, we expect—but did not model—that additional health
interventions would be implemented that could potentially reduce outbreak sizes. This analysis only
explicitly modeled 50 counties; therefore, it is not representative of the entire U.S.
Finally, we acknowledge substantial uncertainty in the size of the MSM population with increased risk of
mpox exposure (which affects coverage estimates) and note that sexual networks may not be accurately
reflected for all counties, as the survey data could not be disaggregated to the county level. While
unaccounted-for geographic variation in sexual behavior could influence the absolute outbreak size in a
given county, because previous modeling work used networks with lower levels of sexual activity and
had similar outcomes, we expect that the general conclusions presented here would hold.

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Appendix
Table 1. Key immunity thresholds by transmission scenario
Transmission Scenario Threshold Definition Minimum Population-
Level Immunity Required
All three scenarios Expected diagnoses do not exceed 50
cases 50%
Clade I: 20% increased
transmission over clade II
Expected diagnoses do not exceed
previous clade II burden 35%
Clade I: 10% increased
transmission over clade II
Expected diagnoses do not exceed
previous clade II burden 30%
Clade I: 0% increased
transmission over clade II
Expected diagnoses do not exceed
previous clade II burden 22%
Note: Cumulative number of diagnosed infections expected within a year, following introduction of five individuals
with mpox and with high levels of sexual activity.

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Table 2: Median (IQR) Cumulative Mpox Diagnoses in First 365 Days, all 50 EHE Counties
2024
Estimated
Population
-Level
Immunity EHE County, State
Model Diagnosed Cases Diagnosed
Cases
from
2022-2024
Clade II
Outbreak
Clade I
Introduction
(0% increased
transmission)
Clade I
Introduction
(10% increased
transmission)
Clade I
Introduction
(20% increased
transmission)

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6% Duval County, FL Δ 802.5 (77-1985) 1595.5 (331.75-
2381.5)
2321 (1514.75-
2752) 77
8% Hamilton County, OH Δ 511 (59.75-1467) 1010 (207.75-
1716.25)
1562.5 (856-
1971) 36
10% Bexar County, TX * 374.5 (47.75-
1594) 784 (86.75-2171) 1811 (629.5-
2847.25) 204
10% Dallas County, TX * 164 (31-818.25) 366 (61.75-1494) 1182 (174.75-
2721.25) 984
11% Shelby County, TN 226.5 (34-838.75) 357 (56-1005.5) 889 (249.5-
1401.5) 137
11% Tarrant County, TX * 237 (41-1069.5) 567.5 (82.5-
1645.75)
1289 (325.75-
2315.5) 260
11% Wayne County, MI * 182.5 (39-1197) 741.5 (91.75-
1791)
1485.5 (385.5-
2412.25) 187
13% Palm Beach County, FL 166 (32-746.5) 432 (69-1182.25) 869 (204.75-
1536.25) 121
15% Harris County, TX * 78 (27-349.25) 198 (42-746.25) 374 (73.75-1139) 993
16% Hillsborough County, FL 183.5 (32-878.25) 356 (62-1192.5) 946 (214-
1727.25) 244
17% Cuyahoga County, OH 194 (37-887.25) 474 (72-1356.25) 1011 (226.75-
1669.25) 162
17% East Baton Rouge Parish, LA
Δ 168 (39-425.25) 293 (73.75-513.5) 422 (187-604.5) 31
18% Pinellas County, FL 100 (27-422) 193.5 (45.75-
699.75)
522 (126-
1157.25) 171
18% Travis County, TX * 97 (27-486.25) 216.5 (50-911.25) 538.5 (81.75-
1249) 313
19% Maricopa County, AZ 70.5 (22.75-
318.25) 132 (34.75-632.5) 305.5 (55.75-
1035) 536
19% San Bernardino County, CA 174 (36-777.25) 326 (48-1109) 912 (215.75-
1552.75) 125
20% Orange County, CA 80 (22-315) 149.5 (35.75-
543.25) 386 (83.75-992) 315
21% Gwinnett County, GA *, Δ 143 (32.75-
476.25) 342.5 (76-660.25) 530.5 (187.25-
784.25) 116
22% Baltimore City, MD Δ 104.5 (29-408) 194.5 (45-636.5) 441.5 (87.75-
851.5) 239
22% Clark County, NV 83.5 (26-321) 148 (36-585) 319 (53-873.5) 309
22% Hudson County, NJ * 99.5 (28-445.25) 264 (45-705.5) 497.5 (95-945) 206
23% Franklin County, OH 91 (25-362.25) 156.5 (36.75-
574.5)
391.5 (69.75-
948.25) 98
24% Sacramento County, CA 70.5 (23-310) 142.5 (33-491.5) 301 (59-788.5) 160
25% Prince George's County, MD
Δ 94 (26-340) 134 (35.75-458) 373.5 (75.75-
684.25) 240
26% Marion County, IN 76 (24-295) 130.5 (39-454) 283.5 (59-624.75) 179

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27% Cobb County, GA *, Δ 92 (25-350.25) 223 (43.75-
524.25) 383 (90-636) 164
28% Essex County, NJ *, Δ 68 (22-227.25) 106 (30-339) 211.5 (51.75-482) 145
29% Orange County, FL 58 (18-184.5) 98.5 (34-333) 189.5 (46.75-
549.75) 337
29% Riverside County, CA 50 (19-138.25) 80.5 (25-219.25) 112 (33-317) 334
29% San Juan Municipio, PR *, Δ 73 (25-208.25) 105.5 (35.75-278) 206.5 (64-347.5) 75
30% Mecklenburg County, NC * 62.5 (22-212.5) 102 (32-335) 197.5 (52-495.25) 279
30% San Diego County, CA 45 (17-120) 67 (26-203) 98.5 (38-312.25) 566
31% DeKalb County, GA * 56 (20-187.25) 95 (28-304.25) 176 (46-456.75) 428
34% Montgomery County, MD Δ 58 (19-160) 78 (29-226.25) 137.5 (41.75-346) 93
36% Alameda County, CA 42 (18-120) 59.5 (23-164) 84.5 (31-258) 295
36% Philadelphia County, PA 43.5 (18-118.25) 58 (23-159) 99.5 (33-270) 557
38% Cook County, IL 28 (13-60.25) 38 (17-82) 49 (23-116) 1451
39% Fulton County, GA * 35 (15-93.25) 49 (20-117) 64 (26-154.25) 867
39% King County, WA 33 (15-78) 50 (20-109) 65.5 (26-168) 525
39% Miami-Dade County, FL 35 (15.75-81) 49 (20-124.25) 64 (26-158) 972
40% Suffolk County, MA * 36 (16-85) 48 (19-125) 76 (29-189.25) 214
43% Los Angeles County, CA 21 (11-40) 27 (14-54) 32 (16-62.75) 2686
45% Orleans Parish, LA Δ 43 (18-99.5) 51 (20-136) 83 (30-206.25) 132
46% Bronx County, NY 34 (16-81.25) 45 (19-108.25) 64.5 (25-147) 789
46% Queens County, NY 30.5 (14-69) 35 (17-87) 61.5 (25-140) 673
50% Broward County, FL 25 (12-54) 30 (14-61) 43 (19-88) 735
62% Kings County, NY 19 (11-38) 24 (12.75-45) 30 (15-59) 1071
68% San Francisco County, CA 16.5 (8-31) 21 (11-38) 24 (13-47) 954
75% New York County, NY 14 (7-25) 17 (9-29) 21 (11-36) 1674
76% District of Columbia, DC 14 (7-27) 17 (9-31) 21 (11-37) 567
(*) Indicates county does not have updated vaccination information via Immunization Information Services (IIS)
(Δ) indicates a county’s MSM population size was not included in the Grey et al. county-level estimates.
The 50 counties selected for this analysis are those included in the Ending the HIV Epidemic (EHE) Initiative.
Cumulative number of model-diagnosed infections expected within a year, following introduction of five
individuals with mpox and with high levels of sexual activity. Transmission scenarios represent increased levels of
transmission over clade II.

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Table 3: Probability of Prolonged Mpox Transmission within all 50 EHE Counties (After one year,
following introduction of 5 infectious individuals with high levels of sexual activity)
2024
Estimated
Population
-Level
Immunity EHE County, State
Model Probability of Prolonged Transmission
Clade I
Introduction
(0% increased
transmission)
Clade I
Introduction
(10% increased
transmission)
Clade I
Introduction
(20% increased
transmission)
6% Duval County, FL 67.3% 79.7% 91.7%
8% Hamilton County, OH 61.8% 75.6% 86.8%
10% Bexar County, TX 60.5% 67.5% 83.9%
10% Dallas County, TX 48.5% 61.0% 74.4%
11% Shelby County, TN 52.4% 59.8% 76.8%
11% Tarrant County, TX 53.6% 64.8% 78.7%
11% Wayne County, MI 51.9% 70.3% 79.3%
13% Palm Beach County, FL 48.2% 62.2% 76.0%
15% Harris County, TX 38.5% 50.2% 62.3%
16% Hillsborough County, FL 51.7% 58.8% 75.7%
17% Cuyahoga County, OH 51.1% 62.9% 76.8%
17% East Baton Rouge Parish, LA 37.8% 46.8% 57.1%
18% Pinellas County, FL 40.2% 50.5% 68.9%
18% Travis County, TX 41.2% 54.1% 66.4%
19% Maricopa County, AZ 35.6% 46.4% 58.3%
19% San Bernardino County, CA 49.0% 59.2% 76.2%
20% Orange County, CA 37.4% 47.6% 62.3%
21% Gwinnett County, GA 42.1% 54.9% 68.6%
22% Baltimore City, MD 40.1% 50.5% 63.7%
22% Clark County, NV 35.3% 47.9% 59.6%
22% Hudson County, NJ 40.6% 54.5% 67.1%
23% Franklin County, OH 39.2% 48.6% 61.4%
24% Sacramento County, CA 33.8% 44.1% 58.2%
25% Prince George's County, MD 35.7% 42.0% 59.8%
26% Marion County, IN 33.6% 43.9% 55.2%
27% Cobb County, GA 33.0% 47.7% 59.2%
28% Essex County, NJ 27.3% 38.0% 49.2%
29% Orange County, FL 26.9% 37.5% 49.1%
29% Riverside County, CA 22.8% 32.1% 37.4%
29% San Juan Municipio, PR 23.0% 29.5% 39.2%

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30% Mecklenburg County, NC 28.5% 37.4% 50.6%
30% San Diego County, CA 20.0% 30.0% 38.4%
31% DeKalb County, GA 26.8% 35.6% 47.6%
34% Montgomery County, MD 21.4% 27.3% 41.4%
36% Alameda County, CA 20.4% 24.9% 34.1%
36% Philadelphia County, PA 19.8% 24.4% 35.2%
38% Cook County, IL 8.7% 12.8% 19.3%
39% Fulton County, GA 13.7% 15.8% 22.6%
39% King County, WA 12.5% 17.0% 25.6%
39% Miami-Dade County, FL 12.8% 20.3% 26.0%
40% Suffolk County, MA 14.8% 18.9% 28.2%
43% Los Angeles County, CA 3.7% 5.8% 8.2%
45% Orleans Parish, LA 15.0% 18.2% 26.7%
46% Bronx County, NY 11.5% 15.5% 19.7%
46% Queens County, NY 9.0% 11.5% 20.1%
50% Broward County, FL 7.3% 8.4% 12.4%
62% Kings County, NY 3.4% 5.9% 5.6%
68% San Francisco County, CA 2.7% 2.7% 4.0%
75% New York County, NY 1.7% 2.1% 2.5%
76% District of Columbia, DC 2.3% 2.2% 2.8%
The 50 counties selected for this analysis are those included in the Ending the HIV Epidemic (EHE) Initiative.
Probability of prolonged transmission after one year, following introduction of five individuals with mpox and with
high levels of sexual activity. Transmission scenarios represent increased levels of transmission over clade II.

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