0 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
US VIRGIN ISLANDS 
DEPARTMENT OF 
HEALTH 
 
Epidemiology Division 
 
2025 Annual Report 
 
 
 
 
 
 
 
  
 
 
 
   “I AM PROUD OF OUR WORK   
I 
 
 
 
 
 
Territorial  
 
 
 
   “I AM PROUD OF OUR WORK   
AND  
 
 
 
 
 
 
 
 
 
 
 
Justa Encarnacion 
Health Commissioner 
Virgin Islands Department of Health 
 
 
 
Dr. Esther Ellis 
Territorial Epidemiologist, 
Director, 
Epidemiology Division 
Virgin Islands Department of Health 
Message from the Commissioner 
 
As Commissioner of Health, I am honored to present—together with Dr. 
Esther Ellis—the 2025 Epidemiology Annual Report of the Virgin Islands 
Department of Health. This report reflects our unwavering commitment to 
safeguarding the health of all Virgin Islanders through evidence-based 
practice, strategic action, and strong community partnerships. Over the past 
year, the VIDOH has advanced several key public health priorities:  
• 
Infection Control: A territory-wide response to early-year Hand, Foot, 
and Mouth Disease cases led to a significant reduction in infections 
through timely community education and prevention messages.  
• 
Community Wellness: Our teams expanded healthcare access during the 
2025 Health & Wellness Fair, Mental Health Awareness Month 
activities, and the Breast and Prostate Cancer Awareness Walks—
providing essential services, screenings, and education.  
• 
Youth Health: The successful implementation of the 2025 Youth Risk 
Behavior Survey will help guide targeted prevention and wellness 
initiatives for our young people.  
• 
Preparedness: Public health messaging emphasized heat safety, 
hydration, and hurricane season preparedness to reduce preventable 
illness, injury, and hospitalization.  
While we celebrate this progress, we also recognize the ongoing challenges 
we must address — particularly in chronic disease prevention, equitable 
access to care, and the expansion of mental health support. I extend my 
deepest appreciation to our dedicated public health professionals, our 
partners, and our community members for their resilience and commitment.  
Justa “Tita” Encarnacion, RN, BSN, MBA/HCM  
 
Message from the Director 
 
As the Territorial Epidemiologist, I am proud to present the Epidemiology 
Division 2025 Annual Report, which provides a comprehensive overview of 
reportable disease trends across the U.S. Virgin Islands, along with 
highlights of the Division’s major accomplishments during the past year. 
This report reflects both the challenges we confronted, and the collective 
progress made in protecting the health of our community. Disease 
surveillance remains the cornerstone of effective public health practice. 
Through systematic data collection, analysis, and interpretation, we can 
detect emerging threats, monitor disease activity, and guide evidence-based 
interventions. In 2025, the Division responded to several key public health 
challenges. A territory-wide outbreak of Hand, Foot, and Mouth Disease 
(HFMD) was effectively contained through rapid detection, education, and 
outreach. The Division also investigated cases of Legionellosis and lead 
exposure, working closely with healthcare and environmental partners to 
ensure timely intervention. Throughout the year, we were vigilant against 
endemic diseases such as dengue, influenza, and COVID-19, sustaining 
strong surveillance and response systems. A major milestone was the launch 
of the Virgin Islands’ modernized disease surveillance system, transitioning 
to a secure, cloud-based platform that enhances timeliness, data quality, and 
interoperability—making the territory a national leader in public health 
modernization. These accomplishments reflect the dedication of our 
epidemiology team, healthcare providers, and community partners whose 
collaboration ensures the strength of our public health infrastructure. As we 
look ahead, we remain committed to advancing surveillance capacity, 
building workforce expertise, and engaging communities to promote a 
healthier, more resilient Virgin Islands.  
Esther M. Ellis, PhD 
2 
2 
 
 
 
 
 
 
 
 
 
 
 
 
Table of Contents
1
Previous Years’ Annual Reports are available on 
the VIDOH-EPI Data Dashboard. 
Ms. Milly Cruz, Ms. Andra Prosper, and Mr. 
Aubrey Drummond, Vector Control Technician 
(left to right), provided public education on 
mosquito-borne illness prevention at Cost-U-Less 
on St. Croix, USVI, February 2025. 
The Epidemiology Division (VIDOH-EPI) 
The Virgin Islands Department of Health, Epidemiology Division 
(VIDOH-EPI) conducts surveillance of nationally notifiable 
diseases (NNDs) needed for disease monitoring, analysis, and 
timely reporting of findings to guide public health policy and 
decision-making. The VIDOH-EPI and the Public Health 
Laboratory (PHL) are funded through the Epidemiology and 
Laboratory Capacity for Prevention and Control of Emerging 
Infectious Diseases Cooperative Agreement from the U.S. Centers 
for Disease Control and Prevention (CDC). 
Ms. Terri Pietka presented her discussion on the 
VIDOH Epidemiology Data Dashboard, its 
functionality, technology, and public health 
utilization at the Council of State and Territorial 
Epidemiologists (CSTE) 2025 Annual Conference 
in Grand Rapids, MI, June 2025.  
01 
Messages from the Commissioner and the Director 
02 
The Epidemiology Division, Forms and Resources 
03 
Sociodemographic Characteristics of the USVI 
04 
Snapshots 2025 VIDOH-EPI 
05 
Disease Reporting in the USVI 
06 
Notification of Infectious Disease Form (EPI-1) 
07 
Disease Surveillance in the USVI 
08 
Table 1: 2025 Reportable Disease Case Counts 
09 
Vector-borne and Arboviral Diseases, Hepatitis, HAIs 
10 
Lead, Vaccine Preventable Diseases 
11 
Respiratory Diseases, Foodborne and Waterborne 
Diseases 
12 
Legionellosis 
13 
Other Notifiable Conditions 
14 
Special Public Health Surveillance – Wastewater 
15 
USVI Fellowships and Field Officers 
16 
VIDOH Data Dashboard 
17 
Workforce Highlights 
18 
Scientific Publications, Presentations, and Accolades 
19 
Contact Information 
Forms and Resources 
VIDOH-EPI website
Data Dashboard
Food & Waterborne Illness complaint form
General surveillance forms
Vaccine Preventable Disease (VPD) surveillance forms
Specimen collection job aids for clinicians
 
 
 
  
 
Sociodemographic Characteristics of the U.S. Virgin Islands (USVI) 
  
The U.S. Virgin Islands is a U.S. territory located between the Atlantic Ocean and the Caribbean Sea, consisting 
of four major islands: Saint Croix (STX), Saint Thomas (STT), Saint John (STJ), and Water Island (WI). The 
USVI covers approximately 133 square miles of combined land area (approximately twice the area of the District 
of Columbia). USVI is located 40-50 miles east of Puerto Rico and extends from west to east ~60 miles at the top 
of the arc of the other Caribbean Islands. Compared to the U.S. Census Bureau 2010 Decennial Census of Island 
Areas (DECIA) for USVI*, the 2020 DECIA indicated that the population of the USVI decreased by 19,259 (-
18.1%) residents for a remaining total of 87,146 residents. This decrease differed by island. STX reported a 
decrease of 9,957 (-19%) residents, STT reported a decrease of 9,373 residents (-18.2%), and STJ reported a 
decrease of 289 (-6.9%) residents. 
  
Race and Ethnicity: In 2020, the racial distribution of USVI included 67,769 (77.8%) residents identifying as 
Black or African American, 11,584 (13.3%) residents as White, 910 (1.0%) residents as Asian, 371 (0.4%) 
residents as American Indian and Alaskan Native, 51 (0.1%) residents as Native Hawaiian or Other Pacific 
Islander, 5,478 (6.3%) residents as some other race, and 6,569 (7.5%) residents as two or more races. A total of 
16,075 (18.4%) residents identified as having Hispanic ethnicity. Approximately 1/3 of the population is foreign-
born with familial and cultural ties elsewhere, primarily in the Caribbean.  
  
Current Sex: In the 2020 DECIA, approximately 49% of the USVI population were reported as male sex and 
51% were reported as female sex.  
  
Insurance: Of the 84,630 persons reported by households in the 2020 DECIA, the number of individuals without 
insurance was 20,825 (24.6%). Of the 63,805 (75.4%) insured individuals, 46.6% had private health insurance 
and 37.2% had medical assistance. The proportion of uninsured persons in the USVI in 2020 (24.6%) was almost 
three times the national estimate for uninsured persons (8.6%) in 2020.  
  
Educational Attainment 
In 2020, 38.8% of residents ≥ 25 years had at least a high school diploma, while only 22.3% had a bachelor’s 
degree or higher.  
  
Language: According to the 2020 DECIA, 69.8% of USVI residents ≥ 5 years spoke only English at home. Of 
the 30.2% who reported speaking another language at home, 56.9% spoke Spanish, 29.3% spoke French Creole, 
and 13.8% spoke a language other than Spanish or French Creole.  
  
Household Income: In 2019, the median household income in the USVI was $40,408 (in 2019 inflation-adjusted 
dollars), which is considerably lower than the U.S. median household income of $67,521, and lower than the 
USVI household median income in 2009 of $44,499. A greater proportion of USVI households have a household 
income of < $25,000 per year compared with the overall U.S. (32.9% vs 18.1%). In 2020, the unemployment rate 
for USVI was 9.7%. 
  
Country of Birth: In 2020, 47% (39,916) of the USVI population were born in USVI, 18.1% (15,396) of 
residents were born in the U.S. or other U.S. island area or Puerto Rico, and 34.8% (29,579) of residents were 
born elsewhere (predominantly in Latin American or the Caribbean). 
 
Children: In 2020, there were 17,086 children in the U.S. Virgin Islands, comprising approximately 20% of the 
total population. For more information specific to children in the U.S. Virgin Islands, please access the St. Croix 
Foundation’s KIDS COUNT USVI 2025 Data Book ⴕ: https://www.flipsnack.com/5A76ADFF8D6/2025-kids-
count-usvi-data-book_st-croix-foundation 
 
 
 
* Reference: U.S. Census Bureau (2022). 2020 Island Areas Censuses: U.S. Virgin Islands.  
ⴕ  Reference: St. Croix Foundation for Community Development (2025). KIDS COUNT 2025 Data Book, When Data Speaks: The Voices of Our Children.  
4 
 
 
 
 
 
 
 
Additions to USVI Notifiable Conditions 
During 2025, Dr. Ellis, Dr. Ekpo, and other public health leaders came together to review 
and update the official USVI Notifiable Conditions list. Considering the important 
impact of certain conditions and diseases in the territory, additions were made to specify 
reporting requirements. Additions under Category A (immediately notifiable) include  
Candida aruis infection, elevated lead in blood, RSV-associated mortality, and typhus 
infection. Additions under Category C (reported within 4 working days) include 
COVID-19 (distinct from any novel coronaviruses which are under Category A) and any 
maternal death as defined by the CDC as the death of a person while pregnant or within 
42 days of termination of pregnancy.  
CDC Foundation Site Visit 
The CDC Foundation (CDCF) is an important  
collaborator for the VIDOH-EPI program and has  
played a critical role in driving USVI data  
modernization and impact through the  
Workforce Acceleration Initiative (WAI).  
During October 2025, CDCF team members  
attended a site visit to USVI where they were  
able to have in-person meetings with local  
partners and gain a better understanding of the  
environment and public  
CSTE DSTT 2025–2026: Cross-Division Team 
The CSTE’s Data Science Team Training (DSTT) program is a  
team-based, on-the-job training program to promote data science 
upskilling and support the data modernization at local public health 
agencies. Learners in the 12-month program work collaboratively on 
the project while concurrently participating in trainings, peer-to-peer 
learning, professional development, and coaching. VIDOH-EPI was  
accepted into the 2025–2026 DSTT Program and will focus on a 
joint project with the VIDOH Chronic Disease Division.  
Food and Water Safety Complaint Portal  
The VIDOH launched the online food and water safety  
complaint portal in December 2025, making it easier for  
residents to report suspected foodborne or waterborne  
illnesses, as well as concerns related to sanitation, hygiene,  
and food safety practices at food service establishments. All 
submissions are reviewed and investigated by the VIDOH-EPI  
in collaboration with the Environmental Health Division. The  
portal helps to modernize USVI’s public health infrastructure by 
minimizing reporting barriers and strengthening disease 
surveillance.  
5 
5 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
The reporting of nationally notifiable diseases to VIDOH by 
healthcare providers is required by law in the U.S. Virgin 
Islands. 
Disease Reporting in the USVI 
Overview 
The reporting of Nationally Notifiable Diseases (NNDs) to 
VIDOH by healthcare providers is required by law in the 
USVI. The current list of USVI Notifiable Conditions can be 
accessed here 
  (left panel). 
Diseases are reported using two primary forms, the 
Notification of Infectious Diseases Form (EPI-1) 
 and the 
Dengue, Chikungunya, Zika, and Febrile Illness Reporting 
Form (EPI-2)  
 The EPI-1 form is included on the next 
page for immediate referral. Additionally, VIDOH-EPI uses 
disease-specific surveillance and investigation forms for 
case-based investigation requirements of all NNDs.  
What  
In addition to NNDs, any outbreaks, exotic diseases, and 
unusual group expression of disease must be reported. All 
diseases require the reporting of patient information, 
including name, age, sex, race/ethnicity, date of birth, 
address and estate, telephone number, disease, date of onset, 
and symptomology. Other required information includes the 
method of diagnosis, laboratory result (if applicable), date of 
diagnosis, as well as the name, address, and telephone 
number of the reporting health care provider.  
When  
Cases or suspected cases of illness considered to be public 
health emergencies, outbreaks, exotic diseases, and unusual 
group expression of disease must be reported to the VIDOH 
immediately (Category A). Other diseases for which there 
must be a quick public health response must be reported 
within two working days (Category B). All other conditions 
must be reported within four working days (Category C).  
How 
Reporting forms can be downloaded from the VIDOH-EPI 
Data Dashboard website; complete forms can be faxed to 
Territorial Epidemiology Fax at 1-888-400-8620 or securely 
emailed to epi@doh.vi.gov. In case of emergency 
(Category A, select Category B conditions or major 
outbreak/incident), reports can be made by telephone to 
the Territorial Epidemiologist at (340) 626-1654. 
Summary 
• Disease reporting of notifiable diseases to VIDOH is
required by law in the USVI.
• Unusual diseases or outbreaks of any kind should be
reported immediately.
• Report diseases by following the instructions in the EPI-1
or EPI-2 forms. These and all investigation forms can be
downloaded here 
.
Category A 
Acute Flaccid Myelitis 
Anthrax 
Botulism 
Brucellosis 
Candida auris* 
Chikungunya 
Cholera 
Coronavirus (novel) 
CRE/CP-CRE 
Dengue 
Diphtheria 
E.coli (O 157)
Encephalitis
Enterovirus D-68
Foodborne Outbreak
Haemophilus influenzae
Influenza (mortality,
novel) 
Lead in blood* 
Legionellosis 
Leptospirosis 
Measles 
Melioidosis 
Meningococcal disease 
Mpox 
Pertussis 
Plague 
Poliovirus 
Q Fever 
Rabies 
RSV-associated 
mortality* 
Rubella 
Smallpox 
Tuberculosis 
Tularemia 
Typhoid (S. typhi) 
Typhus* 
Viral Hemorrhagic 
Fever (Ebola, 
etc.) 
Waterborne Outbreak 
West Nile 
Yellow Fever 
Zika  
Category C 
Babesiosis 
Campylobacteriosis 
Chickenpox (Varicella) 
Coccidioidomycosis 
COVID-19* 
Cryptosporidiosis 
Cyclosporiasis 
Giardiasis 
Influenza (seasonal) 
Listeriosis 
Lyme Disease 
Maternal Death* 
Mumps 
Salmonellosis 
STEC 
Shigellosis 
Spotted Fever 
Tetanus 
Toxic-shock Syndrome 
Vibriosis 
USVI Notifiable Conditions 
Category B 
Anaplasmosis 
Chancroid 
Chlamydia 
Ciguatera 
Ehrlichiosis 
Gonorrhea 
Hansen’s Disease 
(Leprosy) 
Hantavirus Infection 
Hepatitis A 
Hepatitis B 
Hepatitis C 
HIV/AIDS 
HUS 
Invasive pneumococcal 
disease 
Malaria 
Psittacosis (ornithosis) 
S. aureus (drug resistant)
S. pneumoniae (drug
resistant) 
Syphilis 
Trichinellosis 
VISA/VRSA 
VRE 
*New condition added
during 2025
Date of Report:
              
THE REPORTING OF NOTIFIABLE DISEASES TO THE DEPARTMENT OF HEALTH IS REQUIRED BY LAW IN THE US VIRGIN ISLANDS. Information collected 
is confidential pursuant to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and reports will be maintained by the US Virgin Islands 
Department of Health.
(PI-1
This form may be used to report suspected and confirmed cases of notifiable conditions in the US Virgin Islands (USVI) based on their reporting time frames on the 
current USVI Notifiable Conditions List. In addition, any oXtEreaN e[otic Gisease or XnXsXaO groXp e[pression of Gisease that may be of public health concern 
should be reported by the most expeditious means available.  A Health Department epidemiologist will contact you if further investigation is required.
         
Island:
mmddyyyy
Name of Physician or Person Reporting
Physician/Reporter Address
Physician/Reporter Phone
( 
) 
-
extension 
Admitted to Hospital"
Patient Name /ast
)irst
0I
Telephone: (
) 
 
Address
(indicate ESTATE)
City 
State 
Zip Code 
Country
Date of Birth 
(mm/dd/yyyy)
Age 
*ender:
  F 
(thnicity:
 Hispanic 
 Not Hispanic 
5ace:  Black  White
 Unknown   Other:
Additional information such as pregnancy status ('', occupation food handler, school namegrade, daycare facility, traYel history 
Revised November 2025
Source of Information:  Private Physician  Private Laboratory
 Hospital 
 School
 Clinic
 St. Croix
 St. Thomas
 St. John
 Water Island
 Asian
 1o  <es
'ate Admitted:
Parent*uardian: 
          (if applicable)
&ateJory A  5eport I00(DIAT(/< to the 8S9I Department of Health
SE5IOUS PUBLIC HEALTH 5IS.. 0ake an additional I00E'IATE telephone report to the US9I 'epartment of Health.
 Rabies
 RSV-
associated Death
 Tularemia
 Rubella
 Tuberculosis
&ateJory %  5eport :ITHIN  H285S to the 8S9I Department of Health
SI*1I)ICA1T PUBLIC HEALTH 5IS.. An additional telephone report is only reTuired for those diseases indicated by the 
. 
 Anaplasmosis
 Chancroid
 Chlamydia
 Ciguatera
 Ehrlichiosis
 Gonorrhea
Treatment Provided?
&OinicaO ,nforPation
 1o  <es
Specify Treatment:
mmddyyyy
Symptom Onset Date: 
________________________
Clinical Symptoms:
/aEoratory ResXOts:
Date 1 (mm/dd/yyyy)
Date 2 (mm/dd/yyyy)
Date 3 (mm/dd/yyyy)
Test Name 1
Test Name 2
Test Name 3
Result 1
Result 2
Result 3
 Hansen's Disease*
 HantaYiUus Pulmonary Syndrome*
 Hemolytic Uremic Syndrome
 Hepatitis A*
 Hepatitis B
 Hepatitis C
 HIV/AIDS
 Malaria
 Psittacosis
 Staph. aureus (drug resistant)
 Streptococcus pneumoniae 
 Syphilis*
 Trichinosis
Vancomycin Resistant:
 (nterococcus
 Staph
 Coccidioidomycosis
 COVID-19
 Cryptosporidiosis
 Lyme Disease
 Maternal Death
 Mumps
 CRE / CP-CRE
 Dengue
 Diphtheria
 Babesiosis
 Campylobacter
 Chickenpox (varicella)
 Suspect Case 
 Symptoms  Laboratory
Diagnosis 6tatXs

Diagnostic &riteria: 
 2ther Gisease pOease specify:
  Other
  M
Confirmed Case 
 Salmonellosis
 Shigellosis
 Spotted Fever
 Vibriosis
Disease )ataO"  1o  Yes 
 Smallpox
 Acute Flaccid Myelitis
 Anthrax
 Botulism
 Brucellosis
 Chikungunya
 Cholera
 Coronavirus, novel 
or emerging
'ate Discharged:
'ate of Death:
Other:
&ateJory &  5eport P520PT/< :ITHIN  H285S to the 8S9I Department of Health
1otification of ,nfectioXs Disease )orP
Territorial (SiGePioloJ\ )a[: 1-888-400-8620 , Emergency Phone: (340) 626-1654
***Fax HIV/STD reports to the Communicable Diseases Division Fax: 1-612-712-7878***
 Meningococcal disease
 Mpox Virus Infection
 Pertussis
 Plague
   Poliomyelitis
 4 )eYeU
 Enterovirus D-6
 E. coli (O157)
 Encephalitis
 +aePophilXs inIlXen]ae
Influen]a, novel 
 Lead in Blood
 Legionellosis
 Leptospirosis
 Measles
 Foodborne Outbreak
 Cyclosporiasis
 Giardia
    
 Listeriosis
 Typhoid
 Typhus
 Viral Hemorrhagic 
Fever, including Ebola
 Waterborne Outbreak   
  West Nile
 Yellow Fever
 Toxic Shock Syndrome
 Tetanus
 Meningitis
 Influen]a, seasonal
 =ika
7 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Disease Surveillance in the USVI 
NEDSS Modernization to Transform Public Health 
VIDOH utilizes National Electronic Disease Surveillance 
System (NEDSS) Base System (NBS), a CDC-developed 
information system, to manage NND data and share disease-
related health information with partners such as the CDC. NBS 
integrates data from multiple sources on all territorially 
reportable conditions to help VIDOH officials identify and track 
cases of disease over time. NBS supports public health 
investigation workflows, allows for data extraction, processing, 
and analysis, and facilitates the adoption of national consensus 
standards across public health and healthcare including HL7, 
LOINC, and SNOMED. 
During January 2024, the VIDOH-EPI identified a critical need 
to maintain the cloud-hosted NBS instance. After consulting 
with federal partners and subject matter experts, VIDOH 
leadership identified a solution to preserve the USVI system 
that would also support the local data modernization initiative. 
VIDOH chose to migrate the integrated disease surveillance 
system to a new platform hosted on Amazon Web Services 
(AWS) and update the NBS instance to the most advanced 
version, NBS 7.  
The USVI NBS 7 instance went live on May 6, 2025, with 
USVI becoming the second US jurisdiction utilizing NBS 7 in 
production and the first to implement NBS 7 on AWS. Benefits 
of this change included cost savings, additional bandwidth, real-
time data ingestion and updates, the ability to have greater 
autonomy over the data and its endpoints, and an opportunity to 
build local informatics capacity. By the end of 2025, VIDOH 
successfully re-onboarded 93.6% (103/110) of all previously 
connected electronic reporting facilities and onboarded one new 
reporting laboratory previously unable to connect due to 
interoperability barriers.  
Updating the USVI database to NBS 7 in a locally owned, 
cloud-hosted, AWS environment has improved disease 
surveillance by providing the most up-to-date CDC-supported 
data system, improving timeliness of reporting by offering local 
providers more flexibility in electronic reporting options, and 
giving USVI direct control over workflow decision 
functionality. Furthermore, improved interoperability and 
maintaining a cloud-based platform were additional benefits of 
the database migration.  
Supporting a USVI disease surveillance system that is modern, 
functional, and cost-efficient is important to be able to monitor 
and respond to disease threats quickly and inform appropriate 
public health action. This important investment in public health 
infrastructure will allow USVI public health providers, 
clinicians, policymakers, and other stakeholders to work 
together towards the common goal of protecting population 
health. 
Ms. Milly Cruz (left) and Ms. Taylor Warren (right) 
provided event services during the 2025 USVI 
Health and Wellness Fair on St. Croix, USVI, June 
2025. 
Ms. Terri Pietka, Ms. Rachel Azanleko-Akouete 
(Project Manager for Workforce Acceleration 
Initiatives), Ms. Leah de Wilde, Ms. Michelle 
Panneton (Director of Programs for Workforce 
Acceleration 
Initiatives), 
Commissioner 
Justa 
Encarnacion, Dr. Esther Ellis, and Dr. Lisa LaPlace 
Ekpo (left to right) collaborated during the CDC 
Foundation Workforce Acceleration Initiative site 
visit on St. Thomas, USVI, October 2025.  
8 
 
 
 
 
 
 
Disease Surveillance and Trends in the USVI 
VIDOH-EPI Report Overview 
This report provides a summary of all nationally notifiable 
diseases/conditions reported to VIDOH-EPI in 2025 by program 
area. A list of all reported case counts identified as confirmed or 
probable can be found in Table 1. This report excludes cases 
under the jurisdiction of the Communicable Diseases Division: 
sexually transmitted infections, human immunodeficiency virus, 
and tuberculosis/latent tuberculosis infection. 
Table 1: 
2025 Reported Case Counts 
for Nationally Notifiable Diseases 
CONDITION 
CASE COUNT 
Campylobacteriosis 
3 confirmed 
Dengue 
47 confirmed 
Giardiasis 
3 confirmed 
Hepatitis B virus, acute 
2 probable 
Hepatitis B virus, chronic 
9 confirmed or probable 
Hepatitis C virus, acute 
2 confirmed 
Hepatitis C virus, chronic or 
resolved 
8 confirmed 
Influenza 
378 confirmed 
Lead in blood 
9 confirmed, 
3 probable, 
3 suspect 
Legionellosis 
4 confirmed, 
1 probable 
Lyme Disease 
1 confirmed (off-island 
exposure) 
COVID-19 
140 confirmed 
Salmonellosis  
(excluding S. typhi/paratyphi) 
7 confirmed 
Shigellosis 
1 confirmed 
Varicella (Chickenpox) 
3 probable 
Vibriosis 
1 confirmed 
Ms. Annellie Gumbs (back), plus Mr. Aubrey 
Drummond (left) and Mr. Donald Bough (right), 
Public Health Technicians, performed field 
investigation 
in 
response 
to 
a 
case 
of 
Legionellosis on St. Thomas, USVI, June 2025. 
Mr. David Delgado (left), Chronic Disease 
Diabetes Program Manager, and Dr. Esther Ellis 
(right) participated in the Battle of the Agencies at 
Cramer’s Park on St. Croix, USVI, September 
2025. 
9 
 
 
 
                                                                              
Ms. Leah de Wilde presented her analysis of high-
risk substances in USVI wastewater at the 
Council of State and Territorial Epidemiologists 
(CSTE) 2025 Annual Conference in Grand 
Rapids, MI, June 2025. Photo credit: Brandon 
Cruz Photography, courtesy of CSTE. 
Vector-borne and Arboviral Diseases 
Arboviral Diseases Overview 
Arboviral diseases are caused by viruses transmitted through the 
bites of mosquitoes, ticks, or other arthropods. Examples include 
Zika, chikungunya, dengue, and yellow fever viruses. During 
2016–2025, VIDOH-EPI utilized ArboNET, a specialized 
database for arboviral surveillance, in addition to VI-NEDSS 
surveillance, enabling us to enhance reporting in the territory. 
There were no reports of active cases of Zika, chikungunya, or 
yellow fever within the territory in 2025.  
Dengue 
Dengue virus is an arbovirus with four serotypes (DENV1–4) and 
spread by Aedes mosquitoes. Infection is often asymptomatic, but 
~25% of patients experience febrile illness, 5% experience severe 
disease, and <1% die.  
Following the 2024 outbreak of dengue virus in the USVI, the 
VIDOH continued to perform surveillance, investigate potential 
cases, and implement vector control strategies to prevent disease 
transmission. After the 2024 USVI dengue outbreak, local trends 
steadily declined. In 2025, USVI documented 47 confirmed cases 
of dengue. 
Hepatitis 
Reported 2025 events reflect zero confirmed or probable cases of 
acute hepatitis A virus infection. For hepatitis B virus (HBV) 
infection, there were two probable cases of acute HBV and nine 
confirmed or probable cases of chronic HBV. For hepatitis C virus 
(HCV) infection, there were two confirmed or probable cases of 
acute HCV and eight confirmed cases of chronic HCV.  
Healthcare-Associated Infections (HAI) 
VIDOH uses CDC’s National Healthcare Safety Network (NHSN) 
as a critical tool for tracking and monitoring HAIs and other key 
healthcare-related patient safety and quality indicators. These data 
are reported by healthcare facilities, including acute care hospitals 
and dialysis centers. These consistent reports enable timely 
identification of infection trends, help to support targeted 
prevention efforts, and inform quality improvement initiatives.  
In 2025, NHSN reports include 21 dialysis events, four ventilator-
associated events (VAE), three catheter-associated urinary tract 
infections (CAUTI), and one blood stream infection (BSI). The 
pathogens contributing to infection were Escherichia coli (n=2), 
Enterobacter cloacae (n=1), Enterococcus faecalis (n=1), and 
Klebsiella pneumoniae (n=1). 
Ms. Terri Pietka, Ms. Leah de Wilde, Dr. Esther 
Ellis, and Dr. Hannah Cranford (left to right) 
attended the Council of State and Territorial 
Epidemiologists 
(CSTE) 
2025 
Annual 
Conference in Grand Rapids, MI, June 2025. 
10 
 
 
 
 
 
 
 
 
 
 
 
 
Lead 
Following the 2024 VIDOH Safe Haven–Lead-Free Families 
initiative, enhanced lead exposure surveillance activities continued. 
During 2025, VIDOH-EPI officially added “Lead in Blood” as a 
Category A Notifiable Condition, requiring the immediate report of 
elevated blood lead levels. 
Lead is a naturally occurring metal that can cause negative health 
effects. Children younger than six years are more likely to be 
exposed due to their hand-to-mouth behavior. No safe blood lead 
level (BLL) in children has been identified. Even low levels of lead 
in blood are associated with developmental delays, difficulty 
learning, and behavioral issues. 
A blood lead test is the best way to determine if a child has been 
exposed to lead. Testing for blood lead requires: 1) a positive 
capillary screening test and 2) a confirmatory venous blood draw 
test (≥3.3μg/dL). After a blood lead case has been confirmed, a 
home assessment is conducted to identify possible lead exposure 
sources. 
During 2025, VIDOH-EPI documented nine confirmed, three 
probable, and three suspect cases of elevated lead in blood. Of the 
nine confirmed cases, six were on St. Croix and three were on St. 
Thomas. Four were adults and five were children (aged 1–4 years 
old). Home assessments identified potential sources of lead 
exposure to be walls with chipping paint, ceramic/porcelain tiles, 
cooking pots, and ceramic kitchenware (e.g., plates). Certain 
businesses were identified to be higher risk of exposure to lead, 
including indoor shooting ranges. 
VIDOH-EPI continues to perform surveillance of potential lead 
exposures across the Territory, offer home assessments to identify 
lead in homes, and provide guidance and support to families 
impacted by lead exposure. 
Vaccine Preventable Diseases (VPDs) 
During 2025, VIDOH-EPI documented three probable cases of 
varicella. Furthermore, VIDOH-EPI investigated three reports of 
suspected measles and one report of meningococcal disease that 
were investigated and determined to not be epidemiologically 
confirmed cases. For a complete list of VPDs click here. To report 
a suspected case of varicella, download and complete the VPD-22 
form, linked below, and submit to VIDOH-EPI.  
Mr. Aubrey Drummond, Vector Technician, Ms. 
Annellie Gumbs, and Ms. Jayla Norman (left to 
right) performed lead detection procedures during 
a home assessment on St. Croix, USVI, October 
2025. 
Ms. Jayla Norman, Ms. Joy Adkins, and Ms. 
Milly Cruz (left to right) perform lead detection 
procedures during a home assessment on St. 
Croix, USVI, November 2025. 
Download the varicella 
investigation form  
(VPD-22) here. 
11 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Respiratory Diseases 
 
Influenza Surveillance 
VIDOH-EPI engages providers across the territory and maintains 
ongoing partnerships to ensure consistent participation and timely 
weekly reporting to the U.S. Outpatient Influenza-like Illness 
Surveillance Network (ILINet). ILINet data contribute to the 
Centers for Disease Control and Prevention (CDC) national 
influenza surveillance report, FluView, and serve as a key 
component of the national Influenza Surveillance System. For 
surveillance purposes, influenza-like illness (ILI) is defined as a 
fever (temperature ≥100°F [37.8°C]) accompanied by a cough 
and/or sore throat in the absence of a known cause other than 
influenza. ILI surveillance for 2025 identified 766 visits for ILI 
among 47,869 total outpatient visits, representing 1.6% of all visits. 
These data were submitted by five consistently participating 
providers conducting surveillance with the support of VIDOH-EPI.  
 
In 2025, VIDOH-EPI investigated 378 laboratory-confirmed 
influenza cases. Of these, 68 (18.0%) were reported in St. Croix, 
296 (78.3%) in St. Thomas, and 14 (3.7%) in St. John. This 
represents the highest case count recorded in the past five years. 
 
COVID-19 Surveillance 
During 2025, VIDOH-EPI continued surveillance for SARS-CoV-2 
in the local community. A total of 140 COVID-19 cases were 
reported to the VIDOH. Zero COVID-19-related fatalities were 
reported for 2025. 
 
Foodborne and Waterborne Diseases  
During 2025, VIDOH-EPI investigations identified three confirmed 
cases of campylobacteriosis, three confirmed cases of giardiasis, 
seven confirmed cases of salmonellosis, one confirmed case of 
shigellosis, and one confirmed case of vibriosis.  
 
Foodborne & Waterborne Illness Complaint 
Apart from confirmed cases of reportable food and water related 
illness, VIDOH-EPI also collects information from the public about 
food or water related complaints or concerns, such as “food 
poisoning,” contamination concerns, unsanitary conditions in food 
establishments, or unsafe food handling practices. This information 
can be collected via phone by calling the USVI Food Safety Hotline 
at (340) 725-5389 or (340)774-7477 ext. 5647 (Monday-Friday, 
8:30 AM-5 PM) or via the online USVI Food & Waterborne Illness 
Complaint Form 
.  
 
VIDOH-EPI successfully launched the public-facing USVI Food & 
Waterborne Illness Complaint Form webpage in December 2025.  
This form serves as a place where community members can report 
incidents of food and waterborne illness or file complaints related to 
food establishments in USVI to the VIDOH. VIDOH-EPI 
collaborates with the VIDOH Environmental Health Division to 
investigate specific consumer complaints potentially linked to an 
illness outbreak. They work together to conduct epidemiological 
investigations, conduct health inspections, and environmental 
assessments.  
 
Dr. Esther Ellis presented on workforce 
development strategies at the CSTE Annual 
Conference in Grand Rapids, Michigan, June 
2025. 
Ms. Andra Prosper (left) and Ms. Leah de Wilde  
(right) provided public education on mosquito-
illness prevention at AgriFest on St. Croix, USVI, 
February 2025. 
12 
Legionellosis 
During 2025, VIDOH-EPI investigated ten suspected cases of 
legionellosis: four were identified as confirmed and one as a 
probable case. Legionellosis is a bacterial infection caused by 
inhaling water droplets or mist containing Legionella pneumophila 
bacteria. Symptoms include cough, fever, headache, muscle aches, 
and shortness of breath. One type of legionellosis is Legionnaires’ 
Disease, a type of severe pneumonia. People at increased risk of 
legionellosis include people 50 years or older, current or former 
smokers, and people with weakened immune systems. 
Legionella bacteria occur naturally in freshwater environments but 
can become a health risk when the bacteria enter building water 
systems. Legionella most commonly spreads to people through 
devices that use water such as hot tubs or air conditioning systems. 
Common sources of Legionella in USVI include household cisterns, 
plumbing systems that are inadequately disinfected, hot water 
heaters that are not functioning properly, and sink faucets and 
showerheads. Factors that can lead to growth of Legionella in water 
systems include the maintenance of certain temperatures (77-113 
degrees Fahrenheit), insufficient disinfectant or filtration, stagnant 
water, and biofilm, a slime of bacterial growth.  
In 2025, Legionella investigation and response took place across a 
variety of sites including diverse businesses, facilities, and private 
homes. Steps in the VIDOH-EPI legionellosis investigation process 
include reportable disease notification, active case finding, 
environmental water sampling, laboratory culture, and public 
notification and education during outbreaks. VIDOH-EPI identified 
Legionella growth in cisterns, underground wells, hot water heaters, 
sink faucets, and showerheads.  
When Legionella is detected, VIDOH-EPI provides remediation 
guidance often including information regarding the replacement of 
broken hot water heaters, the replacement of sinks or faucets, 
cistern disinfection, water filtration installation, and the 
hyperchlorination of the water system, when possible. After 
remediation has been implemented, the VIDOH-EPI then provides 
sample re-testing, if requested by the facility. 
The key to preventing legionellosis is to control Legionella bacteria 
growth and spread. Buildings and devices at increased risk 
for Legionella should have a water management program based on 
industry standards. Cisterns that collect and store rainwater can be 
ripe for Legionella growth if not properly maintained. Owners of 
certain devices, like cisterns and hot tubs, should take steps to 
reduce the risk of Legionella growth by ensuring they are properly 
cleaned and disinfected. 
For more information on cistern maintenance, please see Your 
Health and Cisterns – A USVI Comprehensive Guide .  
Ms. Milly Cruz (left) and Mr. Aubrey Drummond 
(right) traveling for a legionellosis field 
investigation on St. Croix, USVI, April 2025. 
Mr. Aubrey Drummond perform Legionella 
sampling on a showerhead on St. Croix, USVI, 
April 2025.  
13 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Dr. Lisa LaPlace Ekpo presented at a Legislative 
Hearing session on the Hand, Foot, and Mouth 
Disease outbreak and Measles preparedness on St. 
Thomas, USVI, April 2025. 
Ms. Rachel Azanleko-Akouete (center) presented 
Ms. Leah de Wilde (left) and Ms. Terri Pietka 
(right) with "Rising Public Health Tech Star" 
awards for publicly presenting their work at the 
CDC Foundation Summit on Chicago, IL, June 
2025. 
Other Notifiable Conditions 
VIDOH also monitors other communicable diseases that may 
impact the USVI community including illnesses such as norovirus 
and hand, foot, and mouth disease. In addition to routine 
surveillance activities, the VIDOH-EPI conducted full 
investigations for two reported cases of human herpesvirus 6, 
ensuring appropriate public health follow-up and response.  
 
Hand, Foot, and Mouth Disease (HFMD) 
During February–April 2025, the VIDOH-EPI identified and 
responded to an outbreak of HFMD across the Territory. A total 
of 247 cases—243 on St. Thomas and four on St. Croix—were 
reported at USVI day cares and schools.  
 
HFMD a common illness in children under five years old that can 
spread quickly at schools and day care centers. Symptoms are 
often mild, lasting for 7–10 days, and can include fever, sore 
throat, mouth sores, and rash commonly found on the hands and 
feet. HFMD is often self-limiting; supportive care can include 
over-the-counter pain relievers, soothing mouth rinses or sprays, 
hydration, and adequate rest.  
 
HFMD is spread through direct contact with an infected person’s 
saliva, mucus, or blisters, respiratory droplets from an infected 
person’s cough or sneeze, contaminated surfaces, or contact with 
infected feces, such as changing diapers. To reduce the risk of 
infection, frequent hand washing and cleaning and disinfecting 
commonly touched surfaces and shared items (e.g., toys) are 
critical.  
 
To contain the outbreak and prevent further illness, the VIDOH-
EPI provided phone consultations and in-person visits for direct 
observation and infection control training at affected schools and 
daycares. Improved hand hygiene protocols and environmental 
cleaning efforts were recommended for all school and childcare 
settings.  
 
14 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Special Public Health Surveillance   
 
Wastewater Surveillance  
Wastewater surveillance monitors pathogens and chemicals in 
aggregate human waste to describe trends in infectious diseases and 
substance use across communities. It has been used in the U.S. since 
the 1940s as an early warning system for public health response. 
Because of its flexible nature, established methodology, and 
potential for near real-time reporting, wastewater surveillance can 
be used to monitor trends of ongoing and emerging public health 
threats such as respiratory infections or drug use. VI-DOH partners 
with the Virgin Islands Waste Management Authority to collect 
weekly wastewater samples for respiratory disease and substance 
surveillance from five sampling sites across St. Croix, St. Thomas, 
and St. John. 
 
VI-DOH analyzed substance wastewater surveillance data from 
October 2023 through December 2024 to better 
understand community-level substance use patterns in the Territory, 
addressing limited drug use prevalence and outcome data. A total of 
204 wastewater samples were tested for select parent drugs and 
metabolites (indicated in parentheses), including cocaine 
(benzoylecgonine), fentanyl (norfentanyl), methamphetamine and 
amphetamine, xylazine (4-hydroxy xylazine), and a nicotine 
metabolite (trans-3′-hydroxycotinine). Cocaine, benzoylecgonine, 
and trans-3′-hydroxycotinine were detected in almost every sample, 
while fentanyl and norfentanyl were detected less frequently. 
Xylazine biomarkers were not detected during the study period. 
Community consumption estimates (mg/day/1,000 people) were 
calculated using measured drug concentrations, wastewater flow, 
and population estimates that included both resident and estimated 
tourist populations. 
 
Separately, VI-DOH analyzed respiratory disease wastewater 
surveillance data from 2022 to evaluate the relationship between 
wastewater SARS-CoV-2 RNA concentrations and epidemiological 
COVID-19 case data. Samples were analyzed via PCR, and viral 
concentrations were evaluated as both raw measurements and 
normalized effective concentrations using a fecal indicator. 
Epidemiological COVID-19 case data were analyzed using daily 
counts and rolling averages, and associations between wastewater 
and case data were assessed using Spearman correlation and lead-
time analyses. 
 
At the territory level, wastewater SARS-CoV-2 RNA 
concentrations were moderately correlated with reported COVID-19 
cases (ρ = 0.50–0.57, p<0.05). When analyzed by island, 
statistically significant moderate to strong correlations were 
observed for St. Croix and St. Thomas, while associations for St. 
John were not significant. Lead-time analyses indicated that 
increases in wastewater SARS-CoV-2 RNA appeared before 
reported case surges by 1–8 days across all islands, with the 
strongest lead times observed for St. Croix and St. Thomas. 
 
Integrating wastewater monitoring into routine public health 
practice can strengthen outbreak preparedness, response, and 
substance use prevention efforts in the USVI. 
Ms. Sheri Hirter, Fiscal Coordinator, attended the 
Public Health Management Corporation Event on 
St. Croix, June 2025. 
Mr. Cosme Harrison (center) and Ms. Annellie 
Gumbs (right) provided education on public 
health opportunities at the Careers in Healthcare 
Fair held on St. Thomas, October 2025. 
15 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Career Epidemiology Field Officer (CEFO): 
CEFOs are epidemiologists deployed by the Centers 
for Disease Control and Prevention (CDC) with 
experience in surveillance, epidemiology, 
preparedness, research, training, and policy 
development. Their mission is to strengthen state, 
tribal, local, and territorial epidemiology capacity for 
public health preparedness and response. 
Epidemic Intelligence Service (EIS):  
The EIS is a prestigious two-year fellowship program 
employed by the CDC designed to train doctoral-level 
professionals in the practice of consequential 
epidemiology, which is the collection, analysis, and 
interpretation of data for evidence-based public health 
action. The EIS Officers are assigned to either the 
CDC headquarters in Atlanta or to local, territorial, or 
state health departments to gain experience in the 
rapid and effective response to emerging infectious 
and non-infectious disease threats. The EIS program 
plays a critical role in strengthening the United States 
public health workforce. 
Applied Epidemiology Fellowship: 
The Applied Epidemiology Fellowship is a two-year 
training program implemented by the Council of State 
and Territorial Epidemiologists (CSTE). The program 
is designed for recent and current graduate students of 
public health who want to gain professional skills in a 
state, territorial, local, or tribal health department 
including data analytics, communication, community 
partnership, management and finance, leadership, 
systems thinking, and policy and program 
development.  
Mr. Aubrey Drummond performed lead detection 
procedures during an assessment on St. Croix, 
USVI, December 2025. 
Ms. Jayla Norman performed lead detection 
procedures on a cooking pan during a home 
assessment on St. Thomas, USVI, October 2025. 
USVI Fellowships and Field Officers 
16 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
2025 Interactive Enhancements  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The dashboard is designed to translate complex health data into an accessible, interactive format, 
allowing a broad audience to engage with critical information through visual storytelling and 
dynamic features. Data is organized by program area and allows users to explore time-series 
trends, summary statistics, and demographic information specific to various health conditions.  
 
With real-time data updates, the dashboard ensures that individuals and organizations have access 
to the most current and relevant information, strengthening their ability to respond proactively to 
emerging issues.  
 
 
VIDOH-EPI 
Data Dashboard  
QR Code 
U.S. Virgin Islands Epidemiology 
Data Dashboard 
Accurate, timely communication of health data empowers communities. 
In the USVI, public health data has not been consistently available to 
the public. To address this gap, in 2024, the VIDOH-EPI launched the 
first user-friendly public health data dashboard. This tool provides data 
on disease trends, emerging outbreaks, and other health concerns 
impacting the territory. By integrating data from laboratory reports and 
surveillance systems, the dashboard ensures that USVI residents, 
policymakers, and healthcare professionals have access to reliable, up-
to-date public health information.  
NEW KEY FEATURES:  
 
• Customizable Filters – Users can view data by island, 
time period, or health condition.  
 
• Recent 12-Month Trends – Epicurves provide a 
visual representation of public health trends across the 
territory and individual islands, helping users track the 
most recent changes and developments.  
 
• Time-Series Charts – Displays historical trends over 
the past decade, offering a clear view of how health 
data has evolved over time.  
 
• Geospatial Case Data – Estate or community level 
maps by island detailing critical emerging disease 
outbreaks for enhanced situational awareness.  
 
• Embedded Resources – Direct access to important 
VIDOH-EPI forms (Notifiable Conditions List, EPI-1, 
etc.), public health guidance, and surveillance insights 
integrated directly into the dashboard.  
17 
 
 
 
 
 
VIDOH Pi Eating Contest Winner! Mr. Cosme Harrison  
On March 14, 2025, Pi Day, the VIDOH hosted its high-stakes Pie Eating  
Contest! Representing the powerhouse team from VIDOH-EPI, we had the  
dynamic duo: Mr. Cosme Harrison and Ms. Annellie Gumbs, fork to fork,  
locked in a battle. The competition was fierce, but in a stunning display  
of speed and stomach stamina, Mr. Harrison claimed the victory as  
King of Pi Day!   
Public Health Week 2025: Ms. Annellie Gumbs  
National Public Health Week 2025 took place from April 7–13, 2025, and was 
observed by the VIDOH with community events and opportunities to recognize 
and give thanks to public health employees. During the festivities, Ms. Annellie 
Gumbs was recognized for her determination, inspiration, and cheerful spirit for 
public health. She was crowned VIDOH’s Miss Epidemiology!    
CSTE LEAD: Dr. Hannah Cranford 
Dr. Cranford was accepted to the Council of State and Territorial 
Epidemiologists (CSTE) 12-month leadership program called LEAD: 
Leading Epidemiologists, Advancing Data. This prestigious program 
provides participants with professional training, networking, 
mentorship, and skill-building exercises to develop leaders in public 
health.  
Public Health Trainings and Education  
During 2025, the VIDOH-EPI collaborated with multiple partners to improve public  
health capacity. Some of the training projects that occurred 
included: 
• R analytics and programming  
training in collaboration with the CDC Foundation 
• Environmental Health and Food Safety training  
in collaboration with the National Environmental  
Health Association 
VIDOH Battle of the Agencies 
     The St. Croix Battle of the Agencies was a  
       Government of the Virgin Islands wellness and  
          team-building event held on September 6, 2025,  
            at Cramer’s Park. The VIDOH-EPI team  
              members participated in various physical  
   challenges including an obstacle course,  
   a kayak relay race, and a water balloon  
   contest.  
 
18 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
2025 Epidemiology Division  
Scientific Publications, Presentations, and Accolades 
1. Gallalee S, Cranford H, Prosper A, Gumbs A, Mac V, Drummond A, et al. Dengue 
Outbreak — United States Virgin Islands, January 1–November 30, 2024. Oral 
Presentation presented at: Centers for Disease Control and Prevention, EIS 
Conference 2025; 2025 Apr 23; Atlanta, GA, USA. 
 
2. Gallalee S, Drummond A, Cranford H, Ekpo LL, Ellis BR, Roth J, et al. 
Legionnaires’ Disease Linked to Two Resorts — United States Virgin Islands, 
October–December 2024. Oral Presentation presented at: Centers for Disease 
Control and Prevention, Epidemic Intelligence Service Conference 2025; 2025 Apr 
25; Atlanta, GA, USA. 
 
3. Pietka TA, De Wilde L, Orr J, Ekpo LLP, Ellis EM. Enhancing Public Health 
Awareness in the U.S. Virgin Islands through Interactive Dashboards. Oral 
Presentation presented at: 2025 Council of State and Territorial Epidemiologists 
(CSTE) Annual Conference; 2025 Jun 8; Grand Rapids, MI. 
 
4. De Wilde L, Cranford H, Gallalee S, Ekpo LL, Ellis EM. Wastewater Surveillance 
for 10 Biomarkers for Parent Drug and Metabolites of Cocaine, Fentanyl, 
Methamphetamine, Nicotine, and Xylazine High-Risk Substances — U.S. Virgin 
Islands, October 2023–September 2024. Oral Presentation presented at: 2025 
Council of State and Territorial Epidemiologists (CSTE) Annual Conference; 2025 
Jun 9; Grand Rapids, MI. 
 
5. Cranford H, Pietka TA, De Wilde L, Ekpo LL, Ellis EM. U.S. Virgin Islands 
launches modernized disease surveillance system to transform public health 
[Internet]. Council of State and Territorial Epidemiologists, Data Modernization 
Stories from the Field. 2025. Available from: https://stories.cste.org/?page_id=458.   
 
19 
 
 
VIDOH-EPI Fellows for 2021 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
St. Croix District Office 
(340) 718-1311 ext. 3840 
 
 
Clorecia Adams 
Administrative Executive 
clorecia.adams@doh.vi.gov 
 
Andrea Jean-Baptiste 
Program Manager-EPI/PHL 
andrea.baptiste@doh.vi.gov 
 
Sheri Hirter  
Fiscal Coordinator 
sheri.hirter@doh.vi.gov 
 
CONTACT INFORMATION 
 
ALL EMERGENCY REPORTING: (340) 626-1654 
Epidemiology Secure Fax: 1-888-400-8620 
 
Epidemiology Division Leadership 
 
 
 
VIDOH-EPI Officers and Fellows for 2025 
 
  
John Orr, BS 
Bioinformatics Lead 
john.orr@doh.vi.gov  
 
Data Scientists 
 
Leah de Wilde, MPH 
leah.dewilde.ctr@doh.vi.gov 
 
Terri Pietka, MS 
terri.pietka.ctr@doh.vi.gov 
 
 
 
Surveillance Officers 
 
Monifa Carrillo 
monifa.carrillo@doh.vi.gov 
 
Yamilix Cruz 
yamilix.cruz@doh.vi.gov 
 
Joy Joseph, CPT 
joy.joseph@doh.vi.gov 
 
Andra Prosper, CPT 
andra.prosper@doh.vi.gov 
 
 
St. Thomas/St. John District Office 
(340) 774-7477 ext. 5647 
 
 
Epidemiologists 
 
Dr. Hannah Cranford, PhD 
hannah.cranford@doh.vi.gov 
 
Cosme Harrison, MPH, CPH 
cosme.harrison@doh.vi.gov 
 
Surveillance Officers 
 
Annellie Gumbs, BSN 
annellie.gumbs@doh.vi.gov  
 
 
 
 
Dr. Esther Ellis, PhD 
Territorial Epidemiologist 
Epidemiology Division Director  
esther.ellis@doh.vi.gov 
Dr. Jay Roth, DrPH 
Career Epidemiology Field Officer 
jay.roth@doh.vi.gov 
Dr. Lisa LaPlace Ekpo, DrPH 
Deputy Territorial Epidemiologist 
lisa.ekpo@doh.vi.gov 
Taylor Warren  
University of South Florida 
Practicum Fellow 
Jayla Norman, MPH 
CSTE Applied Epidemiology Fellow 
jayla.norman.ctr@doh.vi.gov 
Dr. Sarah Gallalee, PhD  
Epidemic Intelligence Service Officer  
sarah.gallalee@doh.vi.gov