May 13, 2005
Epi Update Managing Staff:
"The reason for collecting, analyzing and disseminating information on a disease is to control that disease. Collection and analysis should not be allowed to consume resources if action does not follow."
Foege WH., International
Journal of Epidemiology 1976; 5:29-37
The FL-EIS program was created on October 11, 2001 and signed by Governor Jeb Bush as part of the state’s response to terrorism. The program offers two-year, postgraduate applied epidemiology training for health professionals under the direction of the Bureau of Epidemiology and various county health departments. The intent of the program is to recruit and train epidemiologists to assist county health departments in identifying and resolving disease outbreaks and to become leaders in the field of public health. The long-term goal of this program is to increase the capacity of the Department of Health to respond to new challenges in disease control and prevention.
The Bureau of Epidemiology provides salary and didactic training, and candidates are matched with qualifying county health departments to spend their time working with trained epidemiologists and public health professionals. There were five openings this year for graduates of MPH programs and others who demonstrated similar skills and backgrounds. The program provides a practical field epidemiology training program for successfully matched candidates.
Five county health departments were selected to come to Tallahassee to interview the five best graduate level epidemiologists that applied for the program. The epidemiologists were selected from over 140 applicants. Dr. Agwunobi, Nancy Humbert, Dr. Sharma, and Dr. Rowan welcomed the county mentors and epidemiologists to Match Day and described their vision for the future of public health in Florida and how the FL-EIS fit into that vision.
After a description of the program and the counties, the fellows interviewed and were interviewed by the county mentors. After four exhausting hours of interviews the results were in; Ms. Nicole Basta will be working at Collier County; Ms. Sharlene Emmanuel will be working at Polk County; Mr. Aaron Kite-Powell will be working at Broward County; Dr. Patti Ragan will be working in the NW consortium of Florida; and Ms. Sharleen Traynor will be working in Duval County. The 2005 class of FL-EIS fellows will begin this month and next. Congratulations to all!
Dr. Rowan is administrator of the Florida EIS program and can be reached at 850.245.4404.
It’s not too late to register for the 10th Annual Epidemiology Statewide Seminar, "Emerging Issues in Epidemiology," being held at the Orlando Marriott Hotel in Lake Mary, Florida, 15 miles NE of downtown Orlando on May 17-18, 2005. You can register and pay at the door. Syndromic surveillance, antibiotic resistance, lab development of diseases associated with bioterrorism, hurricane related BRFSS data, asset typing, Avian flu, competencies and applied epidemiology, obesity contributions to maternal morbidity, and carbon monoxide poisoning are among just some of the issues that will be presented for discussion.
The evening of May 16th there will be a cook-out and the opportunity to pre-register for the first day. A poster session and reception will be held the evening of May 17th. The judged poster event will feature awards for the best communicable disease poster, the best presentation by a Florida EIS fellow, the best chronic disease poster and the best county health department display. Three additional categories have been added, one for environmental health, one for the best poster by a student in public health and the last for spatial analysis/visualization. The winners will be announced at the following day’s luncheon.
Golden Partnership Awards will be featured this year as well. These will be presented during the first day’s luncheon to partners who have made significant contributions in support of disease surveillance and epidemiology.
Currently the hotel is at full occupancy; however, the newly constructed Hampton Inn across the street from the Orlando Marriott is accepting reservations at $99.00 for a standard room. It can be reached by dialing 407.995.9000.
Further information can be found on the Bureau of Epidemiology Internet
or contact Melanie Black at the Bureau of Epidemiology in Tallahassee at
850.245.4444, ext. 2448.
Third Consecutive Award
In 1997, NAACCR instituted a program that annually reviewed member registries for their ability to produce complete, accurate, and timely data.The certification program then recognizes registries meeting the highest standards of data quality with gold or silver recognition certificates for each data year. The standards for a gold certificate include very detailed measures in five categories. These categories are percent of completeness of case ascertainment, percent of missing/unknown variables, percent of cases identified by death certificate only, percent of duplicate primary cases, and percent of records passing editing checks. The Florida Cancer Data System has again achieved all these highest standards. Moreover, NAACCR indicates that the measures for three categories of Florida data exceeded the U.S. average considerably.
FCDS was developed by the Department of Health as mandated by Florida Statute 385.202 in 1981. It is operated by the University of Miami Medical School through a contract that is administered by the Bureau of Epidemiology’s Chronic Disease Surveillance Section. The Florida CDS is one of the largest central cancer registries in the country and receives approximately 160,000 cancer case reports from more than 800 hospitals, freestanding facilities, pathology laboratories and other providers each year. FCDS also examines millions of hospital discharges and death certificate records to identity new cancer cases.
Dr. Huang is administrator of the Chronic Disease Surveillance Section at the Bureau of Epidemiology in Tallahassee. Contact him at 850.245.4407 or email him at Yougie_Huang@doh.state.fl.us.
The Federal Food and Drug Administration on May 3, 2005 approved a combination booster vaccine designed to protect youths aged 10-18 against pertussis, diphtheria and tetanus. There are presently booster immunizations available which contain tetanus and diphtheria, but none until now have been developed to include a pertussis inoculation. The new vaccine is made by GlaxoSmithKline and will be sold as Boostrix which, according to the FDA, is a "Tetanus Toxoid (T), Reduced Diphtheria Toxoid (d) and Acellular Pertussis Vaccine (ap) Adsorbed."
Researchers are unsure how long an immunity the booster will provide. The drug was tested for efficacy by measuring susceptibility to the vaccine antibody strength. Immunity from the single vaccination received in childhood normally starts to wear off around 5-10 years after receiving the shot.
Pertussis, or whooping cough, is a highly contagious bacterial respiratory infection that can cause severe coughing spasms. Initial symptoms include mild fever, cough and runny nose and can progress to a more severe cough, often producing the whooping sound and even vomiting. The number of pertussis cases in the US among unimmunized persons in all age groups has risen in the past several years; in fact, experts believe the disease is currently underreported.
For more information, logon to the FDA website at http://www.fda.gov/cber/products/tdapgla050305.htm.
Jaime Forth is managing editor of Epi Update and can be reached at 850.245.4444, ext. 2440.
Cyclospora Outbreak. Roberta Hammond provided an update on the number of lab confirmed cases, announcing that clusters had become apparent in Sarasota, Manatee, Flagler and Palm Beach counties. She reminded case workers to report suspected and confirmed cases on Merlin, and informed listeners that due to other commitments she was transferring the team lead role to Carina Blackmore.
Richard Hopkins added that the case definition is a case that tests positive for O&P, and a probable case is a compatible illness linked to a positive case, with symptoms that are long lasting.
Influenza A H2N2 Testing Kits. Phil Amuso stated that all Florida testing kits have been located and destroyed. ProMed mail contains information on the status of kits in other countries.
Lyme Disease. Carina Blackmore cautioned listeners that an article appearing in a recent issue of MMWR concerning Lyme disease contained faulty information which the CDC had tried, but could not validate. She advised anyone hesitant about a diagnosis to look closely at the case definition and to use the two-tiered approach when making their decision. Dr. Crockett added that Lyme disease is not a large problem in the state of Florida, that many of our reported cases of Lyme were acquired in other states.
Epi in Action. Loyce Hill reported on an Epi in Action course she recently attended in Atlanta, sponsored by the CDC. She recommend the class highly because it applied epidemiologic field investigations techniques in a hands-on class setting, taught by excellent teachers with practical experience in other countries. Melanie Black added that she is currently working to bring the course to Florida later this year or early next.
Salmonella in Lee County. Robert South reported that Lee County experienced 173 cases of Salmonella last year and 23 year so far this year. Recently, after two staff members reviewed a case involving bread pudding and realized they had purchased food at the same deli, they concluded there was a link. In this case, a deli worker was wearing wrist-length gloves, but was plunging his entire arms into a bowl of bread pudding to mix the concoction. Dr. South's "food for thought" was to ensure good communication between staff members and other agencies. Although the Salmonella rate in Lee County is high, CHD personnel have found that 95% of the cases are isolated, with most linkage through family members.
Influenza B in Pinellas County. Julia Gill provided details of an investigation involving a 19-year old female private lab technician who had been splashed by chicken blood in the face and eyes, and then visited a local hospital to complain of flu-like symptoms. Hospital physicians, the health department and the hospital lab worked together to quickly obtain lab results and ascertain the absence of Influenza B. The lab employee remembered afterward that she had experienced the flu prior to the event.
Training Announcements. Melanie Black reminded attendees that the next Grand Rounds will be held on May 31 - the Tuesday following Memorial Day. Janet Hamilton will give an overview of data analysis on methicillin-resistant Staph A cases from a single hospital in Escambia County. She also announced that registration is still open for the statewide epidemiology seminar, scheduled for May 17-18 in Lake Mary. Details are available on the bureau website.
Due to the annual epidemiology seminar at Lake Mary, the next scheduled conference call will be on June 3, 2005. Anyone who would like to contribute agenda items to these conference calls should contact Melanie Black, MSW, via firstname.lastname@example.org.
Jaime Forth is managing editor of Epi Update and can be reached via email at email@example.com.
Disease Update May 1-7, 2005
Weekly Update: During the period May 1-7, 2005, the following arboviral activity (St. Louis encephalitis [SLE] virus, eastern equine encephalomyelitis [EEE] virus, Highlands J [HJ] virus, West Nile [WN] virus and dengue virus) was recorded for Florida:
West Nile (WN) virus activity: Seven seroconversions to WN were confirmed in sentinel chickens from Flagler, Hillsborough, Jackson and Sarasota Counties
Eastern Equine Encephalomyelitis (EEE) virus activity: Five seroconversions to EEE virus were confirmed in sentinel chickens from Putnam, St. Johns and Volusia counties.
St. Louis Encephalitis (SLE) virus activity: None yet this year.
Highlands J (HJ) Virus activity: None this week.
There are no counties currently under medical alert for mosquito-borne disease. Where mosquitoes are present, people are urged to take precautions against getting bitten.
Dead birds should be reported to www.wildflorida.org/bird/. See the web page for more information at www.MyFloridaEH.com. The Disease Outbreak Information Hotline offers recorded updates on medical alerts status and surveillance at 888-880-5782.
The Bureau of Epidemiology encourages
Epi Update readers to not only register on the EpiCom system at
https://www.epicomfl.net but to sign up for features such as automatic
notification of certain events
contribute appropriate public health observations related
any suspicious or unusual occurrences or circumstances. EpiCom is the primary method of communication
between the Bureau of Epidemiology and other state medical agencies during emergency situations.
Pete Garner is
administrator of the Bureau of Epidemiology Surveillance Systems
Click here to review the most recent disease figures provided by the Florida Department of Health Bureau of Epidemiology.
D'Juan Harris is a GIS
specialist in the Surveillance Systems Section of the Bureau of