Correspondence between

Dr. M: Notes attached per our discussion. makr xxxEND_PAGE:dhhs02_b0457_1834_1834_1

Good Afternoon, Attached is the summary of the 12:30 pm call from 10/27/15. Thank you, Cheryl xxxEND_PAGE:dhhs02_b0347_1294_1294_1

Ok- so who does the follow up with family--is that us(MDHHS) or the health dept?

MDHHS has been notified this afternoon of a family from the Flint area whose dog was diagnosed with lead toxicity. | received a voice message from Dr. Michele Schalow with MDARD about this case, and Eden Wells was contacted by Linda Dykema, who was also informed of this case. At this time, | don’t have any information about the dog or why it was tested, but information is that the testing was performed at MSU’s Diagnostic Center for Population and Animal Health. Eden is getting ready to board a plane, so asked me to notify everyone. The family of the dog includes children and a pregnant woman. Her thought is that the family needs to be tested asap. Kim Kimberly Signs, DVM Emerging and Zoonotic Infectious Disease Section Bureau of Disease Control, Prevention, and Epidemiology Michigan Department of Health and Human Services 201 Townsend St., Capitol View Building, 5m Floor, Lansing, MI, 48913 @8 (517) 335-8165 = (517) 335-8263 © signsk@rmichican.aoy “) wew.michican qowmilch This message, including any attachments, is attended solely for the use of the named recipient and may contain confidential and/or privileged information. Any unauthorized review, disclosure, or distribution of any confidential and/or privileged information contained therein is expressly prohibited. If you are not the intended recipient, please contact the sender immediately and destroy any and all copies of the original message. xxxEND_PAGE:dhhs03_b0505_1792_1794_2 001794 xxxEND_PAGE:dhhs03_b0505_1792_1794_3

Sent from my iPhone Begin forwarded message:

Ht should be Linda Dykema. Both EPA and DEQ would want her involvernent.

Hi there, xxxEND_PAGE:deq20_b10_223_431_017 | just got off the phone with Dan Wyant, as he needed UMSPH contact for the Mayor's TA panel. He was wondering who will be the contacts with DEQ and EPA as water testing proceeds (such as t schools, etc) at either MDHHS and LHD. | am assuming that Linda Dykema would be the one for us (and she was on their organizing call)- Corinne agree? Mark, are you planning on talking to Mark Valacek tomorrow---I heard you were out, so wondered if you wanted myself or Sue to do so. Actually, i think there will be a number of issues to coordinate with him tomorrow, so forgive me if | am getting in the middle, just wanted to relay the questions Dan had. Eden xxxEND_PAGE:deq20_b10_223_431_018

That sounds about right. May bash, is ii CLPP’s usual process to collect the lead data on an ongoing basis.if so, at what level is the data usually analyzed (by Epi?} iS it daily nmonthly? Quarterly? Annually? How would we normally detect/know if there is an issue in a particular iocality---do you look at it at county ievel ar smaller when you peruse your data? This question may arise. E

Hi all-- E talked to Sob to confirm the information | had shared about the Hurley lab results. itis a little more nuanced than | had explained, forwarding Bol‘s explanation, FY.

OK, thanks

Mark - can respond to sorne of this tomorrow but dort have the data charts in front of rne te give the years we included: I don’t wane to a previge the wrong information. The trend data runs have just been completed but we will nat sting for a couple of

Will you check the below and help me make accurate statements? This is from that ultimatum from the press release issued by the County this morning (9-29). | suspect somebody on 7 will be asking for a response at some point on Wednesday. The County Health Officer has requested that the MDHHS provide to the County specific data to support its claim that state data is more comprehensive and does not show a significant increase. The state data was from a larger data set for ages xxxxxxxxxxxx, and for time periods xxxxxxxxxxxx. It showed no significant EBL levels in the cohorts tested. (Do we have specific data to support this?) To date, MDHHS has failed to confirm the geographic area included in their findings. The sample included all addresses identifying FLINT as the mailing address. While we realize this might include samples from areas outside Flint City (Flint Township and Mundy Township) we do not expect that to impact our findings (based on what?) We are however, conducting another determination, which will further stratify the data to represent Flint City and High Risk areas only. We will provide that analysis when it is completed, probably by Oct. 5""? We want to assure the state data is specific to the boundaries of the City of Flint, and not Flint addresses which would include addresses in areas outside of the City of Flint. See above. xxxEND_PAGE:dhhs02_b0993_3554_3555_1 003555 Maik Milter Director, Leeal Health Services Michigan Department of Health & HuPfainh Servees 201 Townsend, 6" Floor Lansing MIl 48983 65117) 33528032 millerm | Ghrichivan sve xxxEND_PAGE:dhhs02_b0993_3554_3555_2

ALL: Rashmi and | had a conference call this morning with Mark Valacak, the health officer at the Genesee County Health Department. He should be invited to the proposed press conference (below) and consulted with in advance. He’s at 810 257-3588 or mvalacak@gchel.us.