Epi Update Weekly Publication of the Bureau of Epidemiology

July 1, 2005

Epi Update Managing Staff:

John A. Agwunobi, MD, MBA, MPH, Secretary, Florida Department of Health
Landis Crockett, MD, MPH, Director, Division of Disease Control
Dian K. Sharma, MS, PhD, Bureau Chief, Bureau of Epidemiology, Editor-in-Chief
Jaime Forth, Managing Editor, Bureau of Epidemiology

"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


Divider
Email addresses are no longer provided as a method of contact for contributing authors.
We regret this inconvenience. This is a new security measure designed to prevent Internet
hackers access to Department of Health email accounts.

Divider


Florida PRAMS 2000 Through 2003 Surveillance
Data Books Released

by Curt Miller
 

The Florida Department of Health, Bureau of Epidemiology is pleased to announce the latest four reports from the Florida Pregnancy Risk Assessment Monitoring System (PRAMS). The titles of these reports are “Florida PRAMS 2003 Surveillance Data Book,” “Florida PRAMS 2002 Surveillance Data Book,” “Florida PRAMS 2001 Surveillance Data Book” and “Florida PRAMS 2000 Surveillance Data Book.” 

These data books contain detailed statistics for all maternal and child health variables available in the Florida PRAMS datasets. These publications are presented in three sections: Maternal Health and Behaviors, Prenatal and Postpartum Care, and Infant Health. To make navigation through the material as user-friendly as possible, the layout of the bookmarks follows that of the table of contents. The release of these four data books marks the completed publication of the four most current years of Florida PRAMS data. Access these and other Florida PRAMS publications online at the following Florida Department of Health website http://www.doh.state.fl.us/disease_ctrl/epi/prams/prams.htm 

These reports have been of particular interest to Secretary of Health Dr. John O. Agwunobi who forwarded copies of the 2003 report to the executive heads of other state departments including the Agency for Health Care Administration, the Office of Children and Families, and the Executive Office of the Governor. Copies of all these reports will also be made available on CD-ROM.  

A similar analysis has also been completed for each Florida PRAMS data set from 1993 through 1999. Each report will be posted online upon completion. This series of historic information is being produced retrospectively beginning with 2003, Florida’s most current PRAMS data. 

Anyone with questions about these special reports can contact either Helen Marshall, PRAMS coordinator, at 850.245.4444, extension 2415, or Curt Miller, data analyst at 850.245.4444, extension 2407.

Curt Miller is a data analyst in the Chronic Disease Section at the Bureau of Epidemiology in Tallahassee.  Contact him by calling 850.245.4444, ext. 2407.

Divider
 

Cancer Incidence in a Population
Adjacent to a Landfill Incinerator

by Prakash S. Patel, MBBS, MPH; Josefa Schlottmann, PhD; David R. Johnson, MD, MS;
Randy Merchant, MS; Laurel Harduar-Morano, MPH


Introduction
The Florida Department of Health performed a cancer incidence data analysis for the community adjacent to the Wingate road municipal incinerator and landfill which was operated by the city of Ft. Lauderdale from 1954 to 1978.

Combustion of municipal solid waste generates fly ash of various compositions. Fly ash is the fine-grained ash that is carried to the smoke stack or emission control facility. Fly ash consists of 70 to 95% inorganic matter, primarily silicon, iron, aluminum, calcium, magnesium, and sodium. The remaining 5 to 30% of fly ash contains dioxins, furans, polynuclear aromatic hydrocarbons and metals, such as arsenic, cadmium, chromium, nickel and lead.

Considering fly ash released by the incinerator as a possible route of inhalation exposure, arsenic and dioxin were selected as chemicals of concern. According to the ATSDR’s toxicological profiles, cancers of lung, liver, bladder, kidneys and skin may be associated with long-term exposure to arsenic, whereas soft tissue sarcoma, non-Hodgkin’s lymphoma and cancers of the respiratory system may be associated with long-term exposure to dioxins.

Methods
Using the Florida Cancer Data System, the incidence data on selected cancer types were analyzed for 1986 to 2000 with the fifteen years combined for the study area defined according to the Department of Environmental Protection’s fly ash dispersion model. Additionally, to identify possible trends among selected cancer types, cancer cases in the study area residents were analyzed in three different time periods (1986 to 1990, 1991 to 1995, and 1996 to 2000).

Population information for Broward County and the state of Florida were collected from the Office of the Governor. For the census tracts that form the study area, the populations for inter-census years were estimated from the values for the 1980, 1990 and 2000 census using linear interpolation.

The incidence of cancers associated with dioxin and arsenic were considered for analysis individually. As dioxin is identified as a promoter for all types of cancers, the incidence of all cancers combined was analyzed as a category by itself.

For the period 1986 to 2000, Standardized Incidence Ratios (SIR) were calculated by dividing observed number of cases by the expected number of cases for a particular cancer type and race group for the area of concern. To assess the statistical significance, 95% confidence intervals (CI) were calculated for each SIR of each cancer type selected, and for the SIR of all cancers combined category.

For the trend analysis, SIRs with the CIs were calculated for each of the three five-year period aggregates. The three periods were compared for each race and type of cancer. 

Results
Reviewing all different types of cancers of concern for the area during the interval 1986 to 2000; among non-whites, none of the cancer types considered had elevated SIRs. Among the white population, kidney, non-Hodgkin’s lymphoma and soft tissue sarcomas had increased SIRs which were not statistically significant.

Review for the trend analysis, SIRs calculated for each of the three five-year period aggregates for each race and type of cancer showed no statistically significant increases in the SIRs of cancers.

Review of all cancers combined among whites, the SIR was increased only during the 1996 to 2000 period, but was not statistically significant. Among non-whites, the SIRs did not increase during any of the three five-year periods. 

Conclusion
For all of the cancer types individually evaluated from 1986 to 2000 in the study area, there was no statistically significant difference between the study area and the state. All cancer types combined were reviewed for the same time interval for the area, and no increase was observed compared to the state. Similarly all categories were reviewed for three separate five-year intervals (1986-1990, 1991-1995 and 1996-2000) to identify the trends, if any existed. No statistically significant elevations in cancer rates during those three five-year intervals, in comparison with the rest of the state, were found.

   

Prakash S. Patel is an environmental epidemiologist at the Bureau of Community Environmental Health and can be reached at 850.245.4576.  Dr. Josefa Schlottmann, Randy Merchant and Laurel Harduar-Morano are also epidemiologists at the Bureau of Community Environmental Health in Tallahassee.  Dr. David Johnson is currently the acting state epidemiologist.

This was one of many abstracts submitted for the poster session at the Bureau of Epidemiology 2005 annual seminar this spring. Look for more abstracts from the seminar in upcoming issues of Epi Update.
 

Divider


University of Florida to Offer Course
on Bacterial Pathogens
by Jaime Forth

The University of Florida at Gainesville is offering two days of specialized training this August on keeping unhealthy levels of E. coli and Salmonella out of your ecology. The Soil and Water Science Department is teaching the course.

The program will include lectures and laboratory demonstrations to illuminate microbiological testing techniques for quality, basic biology and survival strategies of E. coli and Salmonella, management programs for control and elimination of E. coli and Salmonella outbreaks, and research presentations.  Lessons learned from recent outbreaks in petting zoos, E. coli drinking water contaminations, multi-state gastro-intestinal illnesses, bioterrorism attacks, and programs to control water-borne bacterial pathogens will also be discussed.

Disease control professionals and environmental epidemiologists, journalists, first responders and veterinarians, environmental engineers and scientists, government officials and others will learn from this program. The course is scheduled for August 17 and 18th in Gainesville, with a short web course available at http://conference.ifas.ufl.edu/soils/pathogens/index.htmlLink will open in a new window 

Fee for the course is $300 prior to July 15 and includes a printed course manual, instruction, training materials and daily refreshments. To register, contact call Dr. Max Teplitski at 352.392.1951, ext. 254 or Beth Miller Tipton at 352.392. 5930.

Jaime Forth is managing editor of Epi Update and can be reached at 850.245.4444, ext. 2440.

Divider
Mosquito-borne Disease Update   June 19 - 25, 2005
Rebecca Shultz, MPH, Caroline Collins, Tasharra Kenion, Calvin DeSouza, Carina Blackmore, Ph.D.



Weekly Update
: During the period June 12 -18, 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: None this week. To date, eight counties have reported confirmed WN activity compared to 21 at this time last year.

Eastern Equine Encephalomyelitis (EEE) virus activity: Thirteen seroconversions to EEE virus were confirmed in sentinel chickens from Alachua (3), Bay, Flagler, Nassau, Orange (2), Osceola, St. Johns (2), and Volusia (2) counties. Fifteen horses from Alachua, Duval, Escambia, (2), Gilchrist, Highlands, Lake (2), Levy (2), Osceola and Polk (4) counties were confirmed with EEE virus infection this week. Three out of four live wild birds captured in Okaloosa, six out of 14 captured in Santa Rosa, one out of eight captured in N. Walton, and three out of 15 captured in Washington County (altogether 13 of 41 birds) tested positive for EEE virus this week. One mosquito pool (Cx. nigripalpus) from Volusia County tested positive for EEE this week. One dead bird from Alachua County tested positive for EEE virus this week. To date, 31 counties have reported confirmed EEE activity, compared to 19 at this time last year.

Highlands J (HJ) Virus activity: Seven seroconversions to HJ virus were confirmed in sentinel chickens from Alachua, Bay (2), Duval and Putnam (3) counties.

Other arbovirus activity: One mosquito pool (An. crucians) from Sarasota County tested positive for California Group Virus this week. There has been no St. Louise Encephalitis (SLE) virus activity yet this year.

Humans:

None

 

 

 

 

 

 

 

 

 

 

 

 

Sentinel Chicken:  (County)

Collection Date

SLE

WN

EEE

HJ

Seroconversion rate

Alachua

6/07, 6/14

 

 

3

11.11%  EEE

Bay

6/07, 6/14

 

 

1

2

5.55%  EEE

Duval

6/06

 

 

 

 1

3.13%

Flagler 6/13     1   5.56%
Nassau 6/13     1   2.50%
Orange 6/13     2   2.99%
Osceola 6/14     1   2.13%
Putnam 6/02, 6/03       3 13.64%
St. Johns 6/13     2   3.85%
Volusia 6/13     2   4.54%
             

Dead Birds:  

Collection Date

 

 

 

 

Species 

 Alachua

6/07

 

 

1

 

rock dove

             

Horses: (onset date) 

Onset Date

 

 

 

 

 

Alachua

6/23

 

 

1

 

 

Duval 6/24     1    
Escambia 6/23, 6/24     2    
Gilchrist 6/24     1    
Highlands 6/23     1    
Lake 6/20, 6/23     2    
Levy 6/23, 6/24     2    
Osceola 6/20     1    
Polk 6/20, 6/23     4    
             

Wild/Live/Captive Birds: (collection date, species)

Collection Date

 

 

 

 

Species 

Okaloosa 6/8, 6/9     3   2 blue jays, 1 cardinal
Santa Rosa 6/8     6   4 blue jays, 2 cardinals
N. Walton 6/8     1   1 cardinal
Washington 6/1     3   2 cardinals, 1 grackle
             

Mosquito Pools:

Collection Date

 

 

 

CA. Group 

Species 

Sarasota 4/6       1 An. crucians
Volusia 5/26     1   Cx. nigripalpus

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/birdLink will open in new window. 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.

Divider

 Temp

     

           This Week on EpiCom
                                  
    by Christie Luce

The Bureau of Epidemiology encourages Epi Update readers to not only register on the EpiCom system at https://www.epicomfl.netLink will open in new window but to sign up for features such as automatic notification of certain events (EpiCom_Administrator@doh.state.fl.us) and contribute appropriate public health observations related to
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.
  • Suspected botulism case in a child in Miami-Dade County
  • Cryptosporidium cluster associated with T-ball tournament teams in Duval County

Christie Luce is an EpiCom consultant in the Surveillance Systems Section of the Bureau of Epidemiology. She can be reached at 850.245.4444, ext. 2450.Divider
 

                         Weekly Disease Table
                                                          by D'Juan Harris, MSP

Click hereLink will open in new window 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 Epidemiology.
He can be reached at 850.245.4444, ext. 2435.

Divider



      Bureau of Epidemiology                       Epi Update Archives                                      CDCLink will open in new window

      FL Department of Health                              My Florida                                         Contact Us

Divider
Epi Update is a journal of the Florida Department of Health Bureau of Epidemiology and is
published weekly on the Internet. To receive a special email reminder simply send an email to HSD_EpiUpdate@doh.state.fl.us.