NACCHO has recently announced that Dr. Dawn Terashita, MD, MPH, FACPM, Associate Director for the Acute Communicable Disease Control Program within the Los Angeles County Department of Public Health (LACDPH) has been selected as a NACCHO Infection Prevention and Control (IPC) Champion. NACCHO’s new IPC Champion recognition highlights the IPC achievements of local health departments and honors the staff leading this work.

Dr. Terashita, the founder and Chief of LACDPH’s Healthcare Outreach Unit, is a leader in healthcare outbreak response and a champion for the critical role of local public health in preventing healthcare-associated infections (HAIs).

Dr. Terashita’s dedication to excellence in infection prevention and control strategies with Los Angeles County through the surveillance and targeting of HAIs, antimicrobial resistance, and related events in healthcare settings warrant special recognition as NACCHO’s inaugural IPC Champion.

Impact at the Local Level: Los Angeles County Department of Public Health

The LACDPH Healthcare Outreach Unit, founded in 2003 in response to the Severe Acute Respiratory Syndrome (SARS) epidemic has since expanded to include 18 staff members who work with approximately 100 hospitals, 350 skilled nursing facilities and countless outpatient facilities in LAC. The unit is responsible for acting as a liaison between public health and all healthcare facilities, as well as investigating healthcare outbreaks, coordinating the National Healthcare Safety Network LA County group, and serving as a consultant for HAIs in the county. In 2018 alone, under Dr. Terashita’s leadership, the Healthcare Outreach Unit created a long-term acute care facility collaborative, launched a healthcare personnel influenza vaccination project with 11 hospitals, conducted targeted infection prevention assessments in 10 hospitals, provided antimicrobial stewardship evaluations and consultations, and hosted educational events, all in addition to ongoing surveillance and outbreak investigations as needed. Reflecting on the achievements of her department, Dr. Terashita noted, “The Healthcare Outreach Unit is in the enviable position of receiving HAI and antimicrobial resistance data from 100% of acute care hospitals and using these data to monitor trends and identify and investigate outbreaks and emerging infectious pathogens.”

In this role, Dr. Terashita has enhanced communication between clinicians, hospitals, and public health offices and advanced innovative programs to prevent and control HAIs through collaboration and persistence, and with a forward-thinking perspective that puts the work of her team at the forefront of local health departments doing this work. It is important that our healthcare partners understand that the primary role of HOU is collaborative. Dr. Terashita shared that, “The team is trained in infection control and conducts friendly on-site visits to each hospital at least once a year. We evaluate and adapt frequently to ensure we are meeting needs of our partners; for example, during the pandemic we focused on COVID.”

Service beyond LA County

Since being appointed to NACCHO’s Infectious Disease and Prevention Control (IDPC) Workgroup in 2016, Dr. Terashita has served as a subject matter expert informing IDPC content for NACCHO programs and policy statements and has served as chair since 2018. In addition to her service on the IDPC workgroup, Dr. Terashita supports opportunities to share best practices with other local health departments. In January 2021, Dr. Terashita facilitated the infection prevention and control Q&A session that was part of NACCHO’s Project Firstline webinar last month.

Also, Dr. Terashita has served as the NACCHO representative on the governance committee of the Council for Outbreak Response: Healthcare-Associated Infections and Antimicrobial Resistance Pathogens (CORHA) since its inception. She has contributed to CORHA’s mission of improving practices and policies for the prevention of HAI and antimicrobial-resistant (AR) outbreaks at the local, state and national levels. For example, she is also an active member of CORHA’s investigation and Control and Policy workgroups, where she supports the identification of consistent approaches to investigation and control of infectious disease outbreaks within healthcare facilities and considers the legal and policy considerations related to outbreaks of healthcare-associated infections (HAIs). As Dr. Terashita described to NACCHO, “Moving forward, the biggest challenge in HAI/AR is the current system of long-term healthcare. The combination of increasing numbers of high risk individuals living in lower resourced congregate facilities will inevitably lead to HAI and antimicrobial resistance. This is evident in increasing outbreaks of carbapenem resistant enterobacteriaceae, Candida auris, and COVID.”

Dr. Terashita consistently goes beyond her LACDPH role to improve patient safety and healthcare outbreak response on a national scale by sharing her expertise on multiple HAI and AR-related state and national level committees and working groups, developing guidance and tools that can be leveraged nationwide. She serves on the Council for State and Territorial Epidemiologists (CSTE) Antimicrobial Resistance Surveillance Task Force and the CSTE HAI Standards Committee. Additionally, from 2018 to 2019, she chaired the California Department of Public Health Healthcare-Associated Infections Advisory Committee.

Due to her extensive IPC experience and expertise, Dr. Terashita has been a key contributor to multiple guidelines and recommendations to strengthen and clarify basic infection control, healthcare outbreak reporting and investigation, or patient notification and public disclosure practices. This includes authoring the CSTE’s 1) standardized definition for Carbapenem-resistant Enterobacteriaceae (CRE), 2) recommendation for sub-classification and stratified reporting and 3) 2019 revision to the Case Definition for National Legionellosis Surveillance (healthcare-associated legionellosis definition).

Dr. Terashita’s work in LA County, experience, and advisory capacities regarding the practice of infection control and strategies for surveillance, prevention, and control of HAIs, antimicrobial resistance, and related events in settings where healthcare is provided warrant special recognition as NACCHO’s inaugural IPC Champion.

Read Dr. Terashita’s IPC-Related Publications

Please find a few of Dr. Terashita’s publications related to IPC below:

1. Sakamoto S, Terashita D, Balter S. Liaison Public Health Nurse Project: Innovative Public Health Approach to Combat Infectious Disease in Hospitals. J Public Health Manag Pract. 2020;26(6):557-561.
2. Jarashow MC, Terashita D, Balter S, Schwartz B. Mycobacteria chimaera infections associated with heater-cooler unit use during cardiopulmonary bypass surgery—Los Angeles County, 2012-2016. Morb Mortal Wkly Rep 2019;67(51 and 52):1428-1429.
3. Humphries RM, Hindler JA, Epson E, Horwich-Scholefield S, Miller LG, Mendez J, Martinez JB, Sinkowitz J, Sinkowtiz D, Hershey C Marquez P, Bhaurla S, Moran M, Pandes L, Terashita D, McKinnell JA. Carbapenem-Resistant Enterobacteriaceae Detection Practices in California: What Are We Missing? Clinical Infectious Diseases. 2018 Mar 19;66(7):1061-1067.
4. OYong K, Coelho L, Bancroft E, Terashita D. Health care-associated infection outbreak investigations in outpatient settings, Los Angeles County, California, USA, 2000-2012. Emerging Infectious Diseases. 2015;21(8):1317-1321.
5. Marquez P, Terashita D. Long-term acute care hospitals and carbapenem-resistant Enterobacteriaceae: A reservoir for transmission. (2013) Clinical Infectious Diseases. 2013;57(9):1253-5.