Division of Disease Control and Health Protection

May 27, 1999

Jeret Madei, the Bureau of Epidemiology webmaster, was recently selected by the Department of Health Internet and Intranet webmasters to receive the "Charlotte Award" for web authoring excellence. As a result of Jeret’s efforts, the Bureau’s web sites were recognized as "having made the most significant contribution to the DOH web in May 1999." We, in the Bureau of Epidemiology, are fully aware of the time, interest, dedication and expertise that exemplifies Jeret's work, on the websites and other projects. We are gratified to see that recognition by others. Thanks, Jeret.

"I want to thank you for your participation this year in expanded surveillance for meningococcal disease among college students. I'm pleased to report that all 50 states participated in this project by determining if a 17-30 year old patient with meningococcal disease was a college student and filling out a supplemental case report form for all these cases. Since information on college attendance is not routinely reported, this has been our first opportunity to gather national information on meningococcal disease in college students.

"Between September 1998 and May 21, 1999, we identified 83 cases of meningococcal disease among college students. Cases were reported from 32 states. The median age of cases was 19 years (range 18-37) and ½ the cases were male. 46% of cases were among freshmen and 46% lived in dormitories. 6 patients died. 53% of patients had meningitis and 8% had pneumonia. Among the 60 students for which we have serogroup information, 47% were serogroup C, 27% serogroup B and 19% serogroup Y. Most importantly, we found that the rate of meningococcal disease among college students between 9/98 and 5/21/99 was 0.6/100,000 and among undergraduates was 0.7/100,000. These rates are actually less than the overall rate of 1.0/100,000 between 18-23 year olds. However, rates were elevated among subgroups of college students. Freshmen had a rate of 1.4 and freshmen living in dormitories had a rate of 3.8/100,000.

"These findings suggest that while overall college students are not at higher risk for meningococcal disease, subgroups of college students may be at higher risk. As you may know, we are also collaborating with the American College Health Association in a case-control study with controls matched to cases by school, sex, and age, and we expect to complete enrollment by the end of the month. The purpose of the case-control study is to confirm these findings, as the most likely prevention strategy will target freshmen, especially those living in dormitories.

"We plan to report the preliminary results from enhanced surveillance at the American College Health Association Meeting in Philadelphia on June 1. We would appreciate if you could share the results of this surveillance with others in your department of health in advance of that meeting.

"Again, I'd like to thank you for your participation this year in this important project. We plan to continue enhance surveillance for a 2nd year and hope that you will continue to participate.

The 2^nd Annual Foodborne Pathogen Analysis Conference sponsored by the Florida Department of Agriculture and Consumer Services (DACS) will be held July 14-16, 1999 at the Tradewinds on St. Petersburg Beach, Florida. Topics will include a keynote address by Dr. Michael Brodsky titled "Food Safety – An Elusive Goal?" Dr. Robert Buchanan with FDA and Dr. Larry Beuchat with the University of Georgia will discuss fresh produce issues and a panel of FDA, DACS, and DOH staff will present the recent foodborne typhoid outbreak in Florida. Dr. Tim Barrett from CDC will present current information on PulseNet and FoodNet and Dr. Gerald Crawford of USDA will discuss new more rapid testing for E.coli 01577.

The Department of Agriculture and Consumer Services is also sponsoring the 36^th Annual Pesticide Residue Workshop on July 11-14, 1999 immediately prior to the Foodborne Pathogen Analysis Conference. This workshop brings together government, private and academic scientists from all over the world, in order to exchange information related to pesticide residue analyses and pesticide regulatory issues.

Both influenza A (H3N2) and B viruses circulated in the United States during the 1998-99 season. Type A predominated (77% of all typed isolates at WHO laboratories). Influenza activity peaked in the United States overall and in most areas of the country between early February and mid-March. The maximum number of isolates reported nationally during any one week occurred the week ending February 20, 1999, when 1,707 of 6,491 specimens tested at the WHO laboratories were positive for influenza.

During week 19, less than 1% of patient visits to U.S. sentinel physicians were due to influenza-like illness (ILI). Percentages of ILI were 0%-1%, within baseline values of 0%-3% in all nine regions of the country. Influenza morbidity peaked during the first three weeks of February when 5% of the total patient visits were due to ILI.

State and Territorial Epidemiologists in thirteen states reported sporadic influenza activity during week 19. No influenza activity was reported from 24 states and 14 states did not report. In early February, when the peak activity occurred, 42 states reported either regional or widespread activity.

The percentage of deaths attributed to pneumonia and influenza reported by the 122 U.S. cities was at the epidemic threshold (6.8%) this week. The epidemic threshold was exceeded during 19 of 32 weeks during the 1998-1999 season. Pneumonia and influenza mortality peaked at 8.8% during the week ending March 13, 1999.

Florida: No influenza isolates were reported during week 19 (9-15 May 1999). Since September 23 and to date, there have been 272 isolates reported; 67 (25 %) of these were type B, 205 (75%) type A. Of the influenza A isolates, 74 were typed; 68 (30 %) were type A (H3N2) and 6 (3 %) were type A (H1N1). Isolates have been reported from: Alachua (1), Brevard (5), Broward (27), Dade (5), Desoto (1), Duval (14), Hillsborough (54), Indian River (5), Jackson (2), Leon (20), Martin (2) Okaloosa (2), Orange (22), Osceola (1), Palm Beach (17), Pinellas (12), Polk (7), Sarasota (68), Seminole (2), St. John’s (2) and Volusia (3) counties.

Of the total patient visits to sentinel physicians during Week 19, 1 % were due to ILI. This is within the baseline levels of 0-3 %.

Influenza activity peaked in Florida during late January and February (weeks 3-8). Sentinel physicians in the state reported the highest incidence of disease during week 5 when 4% of their visits were due to ILI. The greatest number of laboratory-confirmed isolates were reported during week 7 (27 isolates) followed by week 5 (20 isolates).

This is the last report for the 1998-1999 influenza season. Weekly influenza morbidity updates will resume in October 1999. We greatly appreciate the efforts of everyone (in medical practices, county health departments and laboratories) who have contributed data to the influenza surveillance program in Florida this year.

In Table 2, the Number for Asia/South Pacific is 6 (not 5) and for Percent for Asia/South Pacific it should read 10.9 (not 9.1). The Total Number now adds up to 55 (instead of 54). We apologize for this error.