State of Florida
Department of Health, Bureau of Epidemiology
EPI UPDATE In this issueJanuary 8, 1999
Richard S. Hopkins, M.D., M.S.P.H., Bureau
Chief, State Epidemiologist
Don Ward, Surveillance Section Administrator, Epi Update Managing Editor
Natalie E. Tackett, Epi Update Editor
Bureau of Epidemiology Frequent Contributors:
Steven Wiersma, M.D., M.P.H., Deputy State Epidemiologist |
William J. Bigler, Ph.D., M.S. Senior Epidemiologist |
Jodi Baldy, M.P.H., Biological Scientist IV |
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Ursula E. Bauer, Ph.D., M.P.H., M.A., Chronic Disease Epidemiologist |
John Werth, M.A. Bureau Education Coordinator |
Lisa Conti, D.V.M., M.P.H., State Public Health Veterinarian |
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Regional Epidemiologists |
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Dolly Katz, Ph.D., M.P.H., SE Florida |
Roger Sanderson, R.N., M.A., SW Florida |
Carina Blackmore, M.S. Vet. Med., Ph.D., NE Florida |
Zuber Mulla, M.S.P.H., Central Florida |
Gérard Krause, M.D., D.T.M.H., NW Florida |
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Please print out this material and share with epidemiology staff, county health department directors, administrators, medical directors, nursing directors, environmental health directors and others with an interest in information of this type. Thank you.
The Bureau of Epidemiology is available 24 hours a day, 7 days a week for consultation at our main number (suncom 278-2905 or 850/488-2905) PLEASE NOTE: Consultation after 5 p.m. & on weekends is intended for emergencies.
New 24-hour toll free Disease Control Help Line 1-888-880-5782
Epi Update has a home on the World Wide Web at --- http://www.doh.state.fl.us
1. Press Release: Meningitis
2. Good-Bye, Davis...
3. 1999 Florida Youth Tobacco Survey Underway
4. Anti-Influenza Drug Developments
5. Tampa Lab Ready for Norwalk Testing
6. Shipping Requirements for Rabies Testing
7. Influenza Summary
8. Florida's Past: 60th Anniversary
9. Educational Opportunities
10 Future Events
11. Weekly Disease Table
FOR IMMEDIATE RELEASE
January 6, 1999
Contact: Pam Potter-Ricco
850-487-3220
HEALTH OFFICIALS IDENTIFY MORE LINKS IN PALATKA
MENINGITIS CASES AND CONFIRM EIGHTH CASE
- -CLAY COUNTY CASE IS RULED OUT- -
Tallahassee - - State health officials announced they have been able to establish more links between the cases of Neisseria meningitidis in the Palatka area through an eighth case that was identified today in a 25-year-old Palatka male. The young man is in stable condition and is recovering at a local hospital.
"Although this new case was just outside the target age range for our vaccination campaign, he is a Palatka resident and is suspected of having contact with other cases and their contacts," said Dr. Steven Wiersma, Deputy State Epidemiologist. "This most recent case has made it easier to conclude that cases are occurring only among close contacts and that those outside the target group are not at increased risk."
In response to questions regarding a case of meningitis outside of Palatka, health officials confirm that one case did have an address outside the target area but is a relative of other cases and spent a significant amount of time with relatives in the Palatka-East Palatka area during the time period when disease transmission was likely to have occurred. This case was considered a household contact of the Palatka-East Palatka residents because of the daily contact occurring during the pertinent time frame.
"We are confident that residents of Palatka and East Palatka are most at-risk for this disease, especially if they have been in close contact with confirmed cases," said Wiersma.
Other state officials are also in support of the department’s strategy. "I have been working closely with both local and state health officials," said State Representative Kelley Smith. "Putnam County Health Department Administrator Cheryll Lesneski and the Putnam County Health Department staff have done an incredible job in a difficult situation and they deserve our support."
The Department of Health has confirmed a total of eight cases of bacterial meningitis in the Palatka-East Palatka area of Putnam County. One of the eight cases resulted in the death of an 18-year-old Palatka man on December 30. Last week, health officials identified residents of Palatka and East Palatka aged two through 22 as being most at-risk for contracting bacterial meningitis and conducted a three-day vaccination campaign to prevent additional cases. Over 13,500 people participated in the vaccination campaign.
Health officials report that their primary strategy to control the outbreak of bacterial meningitis in the Palatka-East Palatka area has been to identify close contacts of the confirmed cases and provide medication to those people to prevent the development of disease. Providing medication to close contacts prevents illness from developing as a result of initial contact. A person can be re-exposed to the disease if they continue close contact with infected individuals.
The transmission of bacterial meningitis requires close, personal contact with an infected individual. Health officials report that examples of very close personal contact include kissing on the mouth, sharing cigarettes, cups or bottles, eating utensils, or items such as bongs or pipes used to smoke marijuana or other drugs.
Fieldwork by the Department of Health staff has revealed that many of the people who have contracted this disease and who are at-risk of contracting the disease may be reluctant or unable to identify their close contacts.
"Our priority is to identify contacts and provide them with medication to stop the disease while educating them about re-infection if exposure to infected individuals continues," said Wiersma. "We also want to urge people who may be contacts of confirmed cases to come forward to the health department for treatment. We want to assure them that their identity or their relationship to confirmed cases will not be revealed. Our only goal is to keep people healthy and prevent further illness."
People who may be close contacts of confirmed cases of bacterial meningitis in the Palatka area should call the Putnam County Health Department at 904-329-0420.
Health officials also confirmed today that the 13-year-old Clay County resident who was taken to a Jacksonville hospital Sunday night with symptoms of meningitis does not have meningitis due to Neisseria meningitidis, despite earlier reports from sources outside the Department of Health. This case is in no way linked to the situation in Palatka.
Residents with questions about bacterial meningitis can contact the Florida Department of Health’s toll-free hotline at 1-888-880-5782.
Sadly, we must bid goodbye to Davis Janowski, the creative force behind the Epi-Update for the past 2 1/2 years. His writing and editing skills, personal interest and enthusiasm contributed greatly to the evolution of this publication. We have come to expect the Epi-Update to "show up" every week, and sometimes take for granted Davis’ fervor (and often fever) in getting it to us. It is difficult to see it happening without him. That being said, we are anxious to begin work with the new editor of the Epi-Update, Natalie E. Tackett. Natalie comes to the Bureau of Epidemiology with two primary assignments: to assist Dr. Ursula Bauer with communication and publication related to the Florida Youth Tobacco Survey and to serve as editor of the Epi-Update. Her credentials will serve her well in both endeavors; Natalie has an impressive history in health communications. For the past two years, she has been a member of the executive staff of the Florida Medical Association with the title of FMA Alliance Associate Director. Her duties in that position included serving as the managing editor of two Alliance publications, the "Alliance Advocate" and the "STAT" newsletter. Much of her editorial work included original writing, layout and design. During the two previous years, Natalie worked as communications assistant with the Florida Medical Association, producing the initial design and layout for the FMA‘s online computer information system and assisting in the editing of the FMA Journal. Those publications witness her high level of creativity and technical expertise. We welcome Natalie and hope that you will share your comments, suggestions and criticisms with her as you have with Davis.
3. 1999 Florida Youth Tobacco Survey Underway
Ursula Bauer, PhD, Chronic Disease Epidemiologist
The 1999 Florida Youth Tobacco Survey is underway! Beginning in January the Bureau of Epidemiology will be conducting the second FYTS, with extraordinary assistance from the Coordinated School Health Program, the local school districts, and the county health departments.
In the year since we conducted the first youth tobacco survey among Florida public middle and high school students, the state has implemented an aggressive and multifaceted tobacco use prevention program. Four areas of activity have constituted the base of the program: a media campaign, a youth and community partnership program, an education and training component, and an enforcement arm. The 1998 FYTS was designed to establish baseline parameters for many of these activities.
Seven reports have been published based on the 1998 FYTS data. These all are available
on the worldwide web at WWW.STATE.FL.US/TOBACCO or by calling the
Bureau at 850-488-2907. An eighth report is due out this week. The following topics have
been covered:
The 1999 Florida Youth Tobacco Survey will be a much-enhanced enterprise. The
questionnaire has been revised and improved and private middle and high schools have been
added to the sample. In addition, a 15-item survey will be conducted among students
enrolled in 4th or 5th grades. This year 400 Florida public
elementary, middle and high schools and 30 non-public middle and high schools will be
surveyed. This is an increase from 255 schools surveyed in 1998. Results from the 1999 survey will be used to evaluate, inform, and improve the Florida
Pilot Program on Tobacco Control. Florida Youth Tobacco Facts
Jodi Baldy, MPH, Biological Scientist
The first major field trial of the live-attenuated vaccine being developed was published in the New England Journal of Medicine earlier this year, and documented a high level of efficacy in children. The trial was conducted during the 1997-98 season, and documented 86% efficacy against the A/Sydney strain. This is all the more remarkable because the strain in the vaccine was the same as that in the inactivated vaccine, which was estimated to have little or no efficacy against the A/Sydney strain. A parallel trial carried out in adults and reported on at the November 1998 Infectious Diseases Society of America annual meeting, did not show comparable results, however.
The second important development in 1998 are results of studies with neuraminidase inhibitors – a class of anti-influenza drugs that threatens to put amantadine and rimantadine on the back shelf. These inhibitors are active against both influenza A and B, but not against other respiratory viruses. Two drugs, which will likely compete with one another, are being developed: one is given by an inhaler and the other is given by mouth. The therapeutic efficacy of both is comparable to that of amantadine or rimantadine, shortening by one to two days an illness of five to seven days. Adverse effects of both drugs have been described as minimal. A great deal of work needs to be done, however, but the neuraminidase inhibitors appear to offer a great deal of promise so far.
5. Tampa Lab Ready for Norwalk Testing
Don Ward, Surveillance Section Administrator
In the past, we have reported in the Epi-Update that the Bureau of Epidemiology and the Tampa Laboratory have been working together to enhance the laboratory’s ability to more accurately diagnose Norwalk disease. The focus of the collaboration is the eventual testing of both clinical and environmental specimens for Norwalk. Thus far, using grant funds provided by the CDC to the Bureau of Epi, the Tampa lab has hired and trained a staff member to be dedicated to the Norwalk project and is now ready to set up a method for clinical (stool) specimens. Dr. Lillian Stark, Director of the Tampa laboratory says that the laboratory is now ready to receive stool specimens for Norwalk testing. County Health Departments that collect stool from patients suspected of having Norwalk disease should send those stool samples (un-preserved and refrigerated not frozen) to the Tampa lab. If the health department wishes to send specimens to CDC for Norwalk analysis, the specimen should be split, and one sent to the Tampa lab. Counties should also remember to report all potential Norwalk outbreaks to the appropriate environmental epidemiologist for investigation.
6. Shipping Requirements for Rabies Testing
Lisa Conti, DVM, MPH, State Public Health Veterinarian
Recently a memo was sent to the CHD Environmental Health Directors regarding Rabies specimen submission. This generated a number of telephone calls to the DOH laboratories and warrants further clarification.
Rules for shipping and transporting biological specimens are issued by the Dept of Transportation (DOT) and the International Air Transport Association (IATA):
Individual shipping companies can require stricter criteria if they so choose (e.g., UPS requires everything shipped through them to be packaged and labeled as an infectious substance even if that has not been determined yet).
The DOT and IATA rules allow for differentiation between diagnostic specimens and infectious substances. An animal head being shipped for initial rabies testing is a diagnostic specimen. Diagnostic specimens must be packaged in a leak-proof inner container and placed in a rigid outer container -- so an animal head needs to be placed in 1 or preferably 2 plastic bags and the bags put in a Styrofoam shipping container. This is the procedure the counties are currently using. These instructions are also on the back of the rabies test form.
A "Clinical Specimens/Biological Products" label should be placed on the outside of the box. The DOH Central Laboratory in Jacksonville has these labels and will supply them to the counties. Counties can fax a request to Paul in the shipping department of the DOH Central Laboratory at SC 866-1627 stating that they need the labels for their rabies shipping containers.
Carina Blackmore, M.S. Vet. Med., Ph.D., NE Florida
National: Influenza activity continues to gradually increase in the United States. Since September 1998, laboratory confirmed-influenza has been reported from 30 states. Influenza A (H3N2) has been reported from 15 states including Alaska, California, Texas, Wisconsin and Massachusetts. Three states (Michigan, Minnesota and Florida) have reported Influenza A (H1N1) and 19 states have reported Influenza B. Sixteen (27%) of the 43 influenza B isolates reported by WHO collaborating laboratories came from Florida.
During Week 50, 5 states (Georgia, Maryland, New York, Tennessee and Virginia) reported regional influenza activity as assessed by State and Territorial epidemiologists. Twenty-two states reported sporadic activity and the remaining reported either no activity or did not report.
Of the total patient visits to sentinel physicians, 1% were due to ILI (influenza-like-illness) in the US overall; percentages ranged from 0%-2% - within the expected range (0%-3%) for this time of year. The percentage of pneumonia and influenza deaths reported from the 122 cities during Week 50 was 6.2%; this is within the range expected for this time of year and below the epidemic threshold of 7.0%.
Florida During week 52 (27 December-2 January) there were 3 laboratory-confirmed isolate of influenza reported: The influenza A isolate was reported from Hillsborough county. Since September 23 and to date, there have been 62 isolates reported; 35 (56%) of these were type B, 11 (18%) were type A(H3N2), 1 (2%) was type A(H1N1) Isolates have been reported from: Broward (6), Dade (4), Duval (8), Hillsborough (26), Indian River (1), Leon (6), Orange (2) Pinellas (3), Polk (2) and Sarasota (4) counties. .
Of the total patient visits in Florida to sentinel physicians for Week 52, 1% were due to ILI. This is within the expected range of 0-3%. Since October 4 the percentage has ranged between 1 and 2%. Influenza-like illness has been reported from health care providers in 16 of the 20 Florida counties represented in the sentinel physician surveillance network.
8. Florida's Past: 60th Anniversary
William J. Bigler, Ph.D.
In the February 1949 issue of Florida Health Notes (Volume 14, Number 2) the State Board of Health Celebrated its 60th Anniversary, 1889-1949 with "A Glimpse into the Past. " It opens with a special dedication to the people of the state and closes with an article on how and why mortality attributable to the infectious diseases had declined over time.
Dedication
"The Florida State Board of Health owes its very existence to the loyal support of the people it strives to protect. Without this support, the public health program begun sixty years ago this month would not have succeeded.
So it is with justifiable pride and appreciation that the State Board of Health dedicates this issue of HEALTH NOTES – to the people, who by their encouragement, confidence and constructive criticism – have caused Florida to gain both in health and wealth."
Compared to Then
It would be of great interest to be able to compare death rates and the occurrence of various diseases in 1889 with present rates. Unfortunately, this is impossible. Dr. Porter recognized the importance of statistical information almost at once—vigorously and continuously advocating the establishment of a Bureau of Vital Statistics until this was finally brought about in 1916. There is every reason to believe that progress made prior to that time was remarkable, but there is little statistical evidence to support this belief. However, we can note the progress made since 1917.
There has been a steady decline in the crude death rate during the thirty-one year period 1917-1947. If we had the same death rate now that we had in 1917—6,063 more people would have died during 1947. The rate for 1947 is slightly higher than that for 1945 and 1946. It would not be surprising if the crude death rate rises still further in the coming years when we consider the increasing percentage of our population that is made up of older people. The remarkable decline, however, in mortality from malaria, diphtheria, tuberculosis, the enteric diseases and the drop in maternal and infant death rates is gratifying.
It would be presumptuous (sic) for the State Board of Health to claim the credit for all these accomplishments. In making these public health gains it shares the honor with the people who backed its programs—the physicians, the legislators, the teachers, the press and radio, and the many organizations representing people from every walk of life. Not the least to receive credit are the loyal employees of the State Board of Health, from the first "assistant" 60 years ago to the 1184th employee today. Appreciation and sincere gratitude is also felt for the distinguished gentlemen who have served on the Board at various intervals.
Public health has come a long way since the day when people expected a "good" health officer to fall into rapture over a newly whitewashed outhouse. Public health now is concerning itself more and more with the problems of older people, the effects of sodium fluoride, with hospital construction, nursing education, accident prevention, and the new antibiotics. As the public health program expands or retracts, the State Board of Health still follows the dictates of the people in providing the health services necessary to preserve Florida’s most precious resource—the public’s health.
EDUCATIONAL OPPORTUNITIES GRANT FUNDED – NO COST TO CHD’s
For Information/Application Forms: John F. Werth, Bureau of Epidemiology
E-mail: John_Werth@doh.state.fl.us -Phone: (904) 414-1684/ SC 994-1684
A.Epidemiology In Action: A Course For Public Health Professionals, 4/26 -5/7/99
Rollins School of Public Health and The Centers for Disease Control and Prevention
All applications must be received at the Bureau of Epidemiology by the deadline of 1/29/99.
Applications received after this date will only be considered if other applicants decline.
Please share this information with other interested parties and those without Epi Update access.
The Bureau of Epidemiology has funds available to support 6 participants from county health departments to travel to Atlanta and attend the Course: "Epidemiology in Action". This two-week introductory course will be offered April 26 through May 7, 1999, at Rollins School of Public Health of Emory University, 1518 Clifton Road, Atlanta Georgia. The course is intended for public health professionals performing epidemiological functions whose duties include: collection and analysis of epidemiological data; decision making involving issues arising from surveillance, investigations and special studies, and responsibilities for on-going epidemiologic programs. Prerequisites for competitive funding through the bureau are completion of the CDC SS3030G, "Principles of Epidemiology" self-study course, skill and experience in the use of personal computers, and performance of epidemiology functions/duties in the county health department.
The Bureau of Epidemiology funding will include: $700 for tuition, $300 for airfare, $1,400 for lodging, $294 for meals, and $30 for shuttle costs. Any additional expenses will be the responsibility of the participant or county health department. If you are interested in taking advantage of this opportunity, please e-mail or call John Werth.
B. Principles Of Epidemiology, SS3030 / CDC – Distance Learning Course
Sponsorship: Bureau of Epidemiology, Florida Department of Health
The Bureau of Epidemiology is receiving applications from county health department staff members who are interested in enrolling in the CDC homestudy course, "Principles In Epidemiology." The course, three months in length, will be offered through the bureau quarterly, and involves extensive reading, active participation in a weekly conference call, and a final exam. Bureau staff will provide guidance and support through the workbook, including individual assistance.
Session I, Jan-April, 1999 is full.
Session II, April-June, 1999 is half-full so register early.
Principles of Epidemiology SS3030
This self-study course presents concepts, principles, and general methods used in the surveillance and investigation of health-related events. The course describes key features and applications of descriptive and analytic epidemiology; provides methods to calculate and interpret ratios, proportions, incidence rates, mortality rates, prevalence, and years of potential life lost. The course also provides calculations and interpretations of mean, median, mode, range, variance, standard deviation, and confidence interval and development of tables, graphs, and charts from such statistics. The processes, uses, and evaluation of public health surveillance are described, followed by the steps of an outbreak investigation.
Continued Professional Education:
Registration Selection Criteria:
10. Future Events
(from the CDC website: http://www.cdc.gov/events.htm)
Jan. 14-15
Workshop on the Potential for Transfusion-Transmission of Tickborne Agents
Holiday Inn Select
Decatur, GA
Contact: Tanya Mercer (404) 639-1075
Jan. 28-29
Preventing Neural Tube Birth Defects with Folic Acid: Working Together for Healthier
Babies
The Doubletree Hotel - Pentagon City
Arlington, VA
Contact: Linda Mitchell, (770) 488-7170
Jan. 31-Feb. 2
Addressing Tobacco in Managed Care:
Building the Future Piece by Piece Wyndham Emerald
Plaza Hotel San Diego, CA
Contact:Registration -(202)778-3269
General Conf. Info-AAHP (770)801-7144 or www.aahp.org
Feb. 1-5
Occupational & Environmental medicine
Radisson Miyako Hotel
San Francisco, CA
Contact: CME Registration Office, (415) 476-5808 cme.ucsf.edu www.ucsf-icom.org
Feb. 2-5
3rd Annual Disease Management Congress (Outcomes Measurement & Quality Improvement)
National Managed Health Care Congress (NMHCC)
The Pasadena Center
Pasadena, CA
Contact: Registration, (888) 882-2500
Feb. 4-5
The Eighth Annual Managed Health Care Conference
Holiday Inn Beachfront
Longboat Key, FL
Contact: Registration, (941) 923-1697
Feb. 9-11
A Public Health Response to Asthma
Sheraton Colony Square Hotel
Atlanta, GA
Contact: Leslie Boss, (770) 488-7329
Feb. 16-17
National Symposium on Medical and Public Health Response to BioTerrorism
Crystal Gateway Marriott
Arlington, VA
Contact: Registration, (800) 481-7901 or (702) 798-6380
Feb. 17-18
Measuring Performance within Government Agencies
Wyndham Bristol Hotel
Washington, DC
Contact: Registration, (888) 670-8200
http://www.iir-ny.com
Feb. 18
Midwest Social Marketing Conference
A Vital Link to the Future of Public Health Programming
Location (to be announced)
Contact: Stephani Wilmer, (614) 895-6784
Feb. 19
24 Hour Telephone Triage & Health Information Standards Workshop
URAC
Washington, DC
Contact: Registration
Webpage Only: http://www.urac.org
Feb. 27 - Mar 3
7th Biennial Symposium on Minorities, the Medically Underserved & Cancer
Grand Hyatt - Washington Center
Washington, DC
Contact: Carlotta Handcock, (713) 798-5383
Mar. 15-17
The Association of Maternal & Child Health Programs
1999 Annual Meeting: Back to the Future, Re-Examing Our Title V Roots
Omni-Shoreham Hotel
Washington, DC
Contact: Meeting Management Services (703) 271-0409
Mar. 18-21
Scientific, Political & Social Priorities for the 21st Century
Marriott Crystal Gateway
Washington, DC
Contact: ACPM & ATPM, (202) 466-2569; FAX: (202) 466-2662;
Email: prevention @acpm.org
Mar. 18-21
Prevention "99"
American College of Preventive Medicine
Washington, DC
Contact: Registration (202) 466-2044
Mar. 29 - Apr. 1
The National Managed Health Care Congress (NMHCC)
Georgia World Congress Center
Atlanta, GA
Contact: Registration
(888) 882-2500 FAX: (941) 365-0157
Internet: www.nmhcc.org
Apr. 12-13
Building Bridges V
The Health Care Puzzle: Using Research to Bridge the Gap Between Perception and Reality
The Drake Hotel
Chicago, IL
Contact: AAHP/Registrar (202) 778-3269
Apr. 14-18
Second UICC Cancer Management Meeting
't Elzenveld Congress Centre,
Antwerp, Belgium
Contact: Registration +32 3 202 78 72
Email: Louis.denis@skynet.be
Apr. 19-23
Annual EIS Conference
Centers for Disease Control and Prevention
Atlanta, GA
Contact: Chris Zahniser, (404) 639-4000
Apr. 26-29
1999 CDC - Diabetes Translation Conference
Albuquerque Marriott Hotel
Albuquerque, NM
Contact: Margaret Hurd (770) 488-5505
Apr. 26-29
Conference on Mathematical Modeling of STDs
Eldorado Hotel
Santa Fe, NM
Contact: Luetta Schneider (404) 639-8356; Email: lks5@cdc.gov
11. Reportable Disease Table, Week 52
County-Confirmed Cases, Sorted Alphabetically by Disease
NR represents years that the disease lacked status as a reportable condition
DISEASE |
1995 TO DATE |
1996 TO DATE |
1997 TO DATE |
3 YEAR AVER-AGE TO DATE |
1997 TOTAL CASES |
1998 TO DATE |
| Amebiasis | 73 | 72 | 35 | 60 | 35 | 70 |
| Anthrax | 0 | 0 | 0 | 0 | 0 | 0 |
| Botulism | 1 | 0 | 1 | 0.7 | 1 | 1 |
| Brucellosis | 1 | 5 | 0 | 2 | 0 | 3 |
| Campylobacteriosis | 1299 | 1128 | 608 | 1011.7 | 608 | 856 |
| Ciguatera | 1 | 17 | 4 | 7.3 | 4 | 7 |
| Cryptosporidiosis | 231 | 350 | 80 | 220.3 | 80 | 163 |
| Cyclosporiasis | 44 | 188 | 52 | 94.7 | 52 | 7 |
| Dengue | 2 | 0 | 2 | 1.3 | 2 | 8 |
| Diphtheria | 0 | 0 | 0 | 0 | 0 | 0 |
| E. coli O157:H7 | 39 | 37 | 33 | 36.3 | 33 | 54 |
| E. coli, other (known serotype) | 9 | 9 | 4 | 7.3 | 4 | 12 |
| Ehrlichiosis, Human | NR | 5 | 1 | 3 | 1 | 1 |
| Encephalitis, Eastern Equine | 1 | 1 | 2 | 1.3 | 2 | 0 |
| Encephalitis, St. Louis | 1 | 0 | 3 | 1.3 | 3 | 2 |
| Encephalitis, other (known organism) | 12 | 8 | 6 | 8.7 | 6 | 7 |
| Encephalitis, post-infectious* | 32 | 19 | 10 | 20.3 | 10 | 17 |
| Giardiasis (acute) | 1957 | 2060 | 934 | 1650.3 | 934 | 1473 |
| Haemophilus influenzae*, invasive | 30 | 23 | 12 | 21.7 | 12 | 37 |
| Hansen’s Disease (Leprosy) | 0 | 2 | 0 | 0.7 | 0 | 4 |
| Hantavirus Infection | NR | 0 | 0 | 0 | 0 | 0 |
| Hemolytic Uremic Syndrome | 3 | 2 | 2 | 2.3 | 2 | 11 |
| Hemorrhagic Fever | 0 | 0 | 0 | 0 | 0 | 0 |
| Hepatitis A | 503 | 554 | 335 | 464 | 335 | 504 |
| Hepatitis B | 456 | 526 | 230 | 404 | 230 | 444 |
| Hepatitis Non-A, Non-B | 65 | 91 | 66 | 74 | 66 | 49 |
| Hepatitis, unspecified | 7 | 5 | 6 | 6 | 6 | 22 |
| Histoplasmosis | 7 | 14 | 4 | 8.3 | 4 | 15 |
| Kawasaki | 40 | 28 | 19 | 29 | 19 | 49 |
| Lead Poisoning | 1800 | 2090 | 855 | 1581.7 | 855 | 1041 |
| Legionellosis | 28 | 40 | 12 | 26.7 | 12 | 44 |
| Leptospirosis | 1 | 1 | 0 | 0.7 | 0 | 2 |
| Lyme Disease | 13 | 31 | 20 | 21.3 | 20 | 62 |
| Malaria | 67 | 78 | 45 | 63.3 | 45 | 82 |
| Measles | 14 | 1 | 6 | 7 | 6 | 2 |
| Meningococcal Disease (N. meningitidis) | 155 | 177 | 96 | 142.7 | 96 | 129 |
| Meningitis, Group B Streptococci | 23 | 26 | 8 | 19 | 8 | 21 |
| Meningitis, Haemophilus influenzae | 19 | 8 | 6 | 11 | 6 | 10 |
| Meningitis, Streptococcus pneumoniae | 105 | 100 | 47 | 84 | 47 | 82 |
| Meningitis, Listeria monocytogenes | 4 | 7 | 1 | 4 | 1 | 6 |
| Meningitis, other bacterial (including unspecified) | 92 | 94 | 39 | 75 | 39 | 67 |
| Mercury Poisoning | 1 | 7 | 2 | 3.3 | 2 | 1 |
| Mumps | 14 | 12 | 7 | 11 | 7 | 11 |
| Paralytic Shellfish Poisoning | 0 | 3 | 0 | 1 | 0 | 0 |
| Pertussis | 81 | 90 | 37 | 69.3 | 37 | 39 |
| Pesticide Poisoning | 1 | 1 | 0 | 0.7 | 0 | 1 |
| Plague | 0 | 0 | 0 | 0 | 0 | 0 |
| Poliomyelitis | 0 | 0 | 0 | 0 | 0 | 0 |
| Psittacosis | 1 | 0 | 0 | 0.3 | 0 | 2 |
| Rabies, Animal | 246 | 258 | 217 | 240.3 | 217 | 215 |
| Reye Syndrome | 0 | 0 | 0 | 0 | 0 | 1 |
| Rocky Mountain Spotted Fever | 6 | 4 | 3 | 4.3 | 3 | 2 |
| Rubella, including congenital | 12 | 10 | 2 | 8 | 2 | 4 |
| Salmonellosis | 3108 | 2598 | 1341 | 2349 | 1341 | 2760 |
| Shigellosis | 1540 | 1683 | 936 | 1386.3 | 936 | 2156 |
| Streptococcal Disease, invasive Group A | NR | 12 | 20 | 16 | 20 | 44 |
| Streptococcus pneumoniae, Drug Resistant | NR | 47 | 101 | 74 | 101 | 446 |
| Tetanus | 3 | 3 | 1 | 2.3 | 1 | 3 |
| Toxic Shock Syndrome | 0 | 0 | 2 | 0.7 | 2 | 4 |
| Toxoplasmosis | 19 | 13 | 3 | 11.7 | 3 | 13 |
| Typhoid Fever | 17 | 24 | 7 | 16 | 7 | 13 |
| Typhus (Louse & Murine) | 0 | 0 | 1 | 0.3 | 1 | 1 |
| Vibrio cholerae (serogrp O1) | 5 | 2 | 0 | 2.3 | 0 | 0 |
| Vibrio cholerae (serogrp Non-O1) | 0 | 4 | 8 | 4 | 8 | 11 |
| Vibrio vulnificus | 17 | 21 | 10 | 16 | 10 | 32 |
| Vibrio other (including unspecified) | 23 | 26 | 17 | 22 | 17 | 70 |
| Yellow Fever | 0 | 0 | 0 | 0 | 0 | 0 |
*Haemophilus influenzae can be the agent responsible for disease under three of the reportable conditions listed--"Haemophilus influenzae, invasive" and under "Encephalitis, post infectious." Cases of Haemophilus influenzae meningitis are reported under "Meningitis, H. influenzae."
Reminder: Reporters periodically call the Bureau of Epi for statewide numbers. It is important that cases be reported to the Bureau as soon as possible so that the correlation between actual case numbers and reported case numbers is high.
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