EPI
UPDATE
A weekly publication by the Bureau of Epidemiology
For September 13, 1999
"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 et al. Int. J of Epidemiology 1976; 5:29-37.
Richard S. Hopkins, MD, MSPH, Bureau Chief, State Epidemiologist
Don Ward, Surveillance Section Administrator, Epi Update Managing Editor
Jill H. Parker, MSP, Epi Update Editor
Bureau of Epidemiology Frequent Contributors:
Steven
Wiersma, MD, MPH,
Deputy State Epidemiologist |
William
J. Bigler, PhD, MS,
Senior Epidemiologist |
Jodi
Baldy, MPH,
Biological Scientist IV |
Ursula
E. Bauer, PhD,
Chronic Disease Epidemiologist |
John
Werth, MA,
Bureau Education Coordinator |
Lisa
Conti, DVM, MPH,
State Public Health Veterinarian |
Regional Epidemiologists:
| Dolly Katz, PhD, MPH, Southeast
Florida |
Roger Sanderson, RN, MA, Southwest
Florida |
Carina Blackmore, MS Vet. Med.,
PhD, Northeast Florida Carina Blackmore, MS Vet. Med., PhD, |
Zuber Mulla, MSPH, Central
Florida Carina Blackmore, MS Vet. Med., PhD, |
Gérard Krause, MD, DTMH, Northwest
Florida |
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.
In this issue:
1. Dont Forget to Register for the Annual Statewide
Epidemiology Seminar (ASES)!
2. Vibrio vulnificus and
Oysters
3. Eastern Equine Encephalitis (EEE)
Update
4. Employment Opportunities
5. Internet Resources for the Public
Health Professional
6. Florida Past - Medicine,
Folklore and Superstition
7. Weekly Disease Table - Week 35
1. Don't Forget to Register for the Annual Statewide Epidemiology
Seminar (ASES)!
The time is rapidly approaching for the Annual Statewide Epidemiology Seminar (
September 30-October 1). We believe we have developed an interesting, informative and
challenging agenda, a list of exciting speakers and an excellent poster session, not to
mention time and occasion for colleagues to interact. Be sure to take advantage of this
once-a-year opportunity! Reserve your hotel room and register for the meeting early.
For those interested in laboratory issues related to epidemiology, a pre-seminar
meeting will be held on the evening of Wednesday, September 29th, for
participants to learn more about these issues. There is no registration fee for
this meeting.
Additional details regarding the Annual Seminar or the
pre-seminar laboratory meeting are available on the Department of Health internet and
intranet web sites, or by contacting John Werth, Bureau Education Coordinator. ¨
2. Vibrio vulnificus and Oysters
Richard S. Hopkins, MD, MSPH, Bureau Chief, State Epidemiologist
Cases of Vibrio vulnificus infections continue to occur in people who recently
ate uncooked oysters; another death was reported this week. People at greatest risk of
severe disease and death include those with chronic liver disease or immune dysfunction.
Many people with heavy alcohol intake have liver damage but do not know it or do not
acknowledge it. Restaurants and stores serving or selling raw oysters are required by
Florida administrative rules to post warning signs. ¨
3. Eastern Equine Encephalitis (EEE) Update
Lisa Conti, DVM, MPH, State Public Health Veterinarian
A case of EEE in a child from Walton County was confirmed earlier this week. This is
the first case for 1999. The average annual number of cases in Florida is one. An updated
map entitled " EEE in Horses by Owner's County of Residence and Month of Report,
January through August 31, 1999" is attached. The map will also be posted to the DOH
internet web page at www.doh.state.fl.us
. Should you have trouble accessing the map via e-mail or the internet, please
contact Jill Parker. ¨
EEE in Horses by
Owner's County of Residence and Month of Report
4. Employment Opportunities
Bureau of Epidemiology, Chronic Disease Section (submitted by Dan Thompson)
The Bureau of Epidemiology has an opening in the Chronic Disease Section. The position
is a Medical/Health Care Program Analyst, which is a pay grade 24 with a minimum salary of
$34,831. The closing date is 9/29/99. Due to fiscal constraints, we plan to hire at or
very close to the minimum salary. This position was held until recently by Annette
Schwabe.
The position is Career Service and is funded by the National Program of Cancer
Registries Grant from CDC. Most of the work of this position is in the areas of cancer
epidemiology and cancer registry issues. One of the major duties for this position is the
production of the Florida Annual Cancer Report. An example of this report is the 1995
report available on the Epidemiology web page within the DOH internet site
(www.doh.state.fl.us).
Good candidates for this position are persons with experience working with large data
sets and programming in SPSS, SAS or similar software, and experience in cancer
epidemiology and statistics. Last but certainly not least, is the inclination and ability
to write up the results of the work.
Persons interested in this job can find out how to apply and learn more about the
required education and experience by looking up the Job Announcement on the internet at
http://www.state.fl.us/oraweb/owa/jobvac.detail?pvac_key=9638. The position
number is 068590.
Bureau of Sexually Transmitted Disease (STD)
After many years of dedicated public health service, Jack Wroten is retiring from his
position as Chief of STD Prevention and Control. Those persons interested in applying for
the vacancy can find the job description and additional information on the internet at
http://www.state.fl.us/oraweb/owa/jobvac.detail?pvac_key=9631. The position number is
048119 and the closing date is September 17, 1999. ¨
5. Internet Resources for the Public Health Professional
(The following
information was excerpted from The C· a·
use: Careful Antibiotic Use to Prevent Resistance, Summer Issue, Volume 2, July 1999.)
The CDC's Division of Bacterial and Mycotic Diseases has a website focusing on the
prevention of antibiotic resistance. Updated information and educational materials about
antibiotic resistance are available. The website is:
http://www.cdc.gov/ncidod/dbmd/antibioticresistance/. ¨
6. Florida Past - Medicine, Folklore and Superstition
William
J. Bigler, PhD
For many years the State Board of Health kept scrapbooks of clippings from newspapers
throughout the state. The material saved generally focused on local, state and national
public health issues, but occasionally an odd item was included. Th following article
entitled "SURE CURES FOR ALL" appeared in the Key West Citizen on June 22, 1934.
"A complete list of superstitious ideas concerning the prevention or cure of
diseases, prevalent among ignorant people even to this day, would be almost endless. In a
recent address Dr. Joseph L. Miller, long a practicing physician among the hill folk of
West Virginia, enumerated a few of them, including the following:"
"Soot or cobwebs stop bleeding; a bag of asafetida hung around the neck prevents
measles, diphtheria and whooping cough; amber necklaces prevent goiter; rubbing a greasy
dishrag over a babys face stops convulsions; piercing the ears aids weak eyes;
nutmegs worn around the neck prevent indigestion and colic; blood from a black cat cures
erysipelas; carrying horse chestnuts in the pocket prevents rheumatism; a coin held under
the upper lip and a cold key dropped down the back will stop a nosebleed."
"The annoyance of hiccoughs may be readily abated by taking nine sips of water,
counting to nine backwards and turning around nine times; putting on a babys clothes
feet first insures normal growth; wearing the knee cap of a sheep prevents cramps; placing
a pan of water under the bed stops night sweats; wearing a rattlesnake skin prevents
lumbago; rubbing snake oil, skunk fat or fishing worm oil into the joints cures
inflammation; wrapping a warm red woolen sock around the neck cures sore throat."
"The ritual of curing asthma is more elaborate. Back the patient up against a
tree, peg a lock of hair into a hole bored in its trunk and snip it off. When the bark
grows over the hair the asthma will be gone."
"All the foregoing are utterly foolish procedures of course, but superstitious
persons believe in some or all of them. And if such beliefs give them any comfort, who
should worry." ¨
7. Weekly Disease Table: Week 35
County-Confirmed Cases, Sorted Alphabetically by Disease
(NR represents years that the disease lacked status as a reportable condition)
DISEASE |
1996 TO DATE |
1997 TO DATE |
1998 TO DATE |
3 YEAR AVERAGE
TO DATE |
1998 TOTAL CASES |
1999 TO DATE |
| Amebiasis |
52 |
39 |
45 |
45.3 |
91 |
33 |
| Anthrax |
0 |
0 |
0 |
0 |
0 |
0 |
| Botulism |
0 |
0 |
0 |
0 |
0 |
0 |
| Brucellosis |
5 |
0 |
2 |
2.3 |
3 |
1 |
| Campylobacteriosis |
775 |
667 |
497 |
646.3 |
975 |
612 |
| Ciguatera |
8 |
6 |
7 |
7 |
7 |
2 |
| Cryptosporidiosis |
114 |
79 |
90 |
94.3 |
203 |
84 |
| Cyclosporiasis |
176 |
63 |
6 |
81.7 |
6 |
5 |
| Dengue |
0 |
3 |
2 |
1.7 |
5 |
2 |
| Diphtheria |
0 |
0 |
0 |
0 |
0 |
0 |
| E. coli O157:H7 |
19 |
38 |
26 |
27.7 |
57 |
38 |
| E. coli, other (known serotype) |
3 |
5 |
3 |
3.7 |
12 |
12 |
| Ehrlichiosis, Human |
4 |
2 |
0 |
2 |
1 |
2 |
| Encephalitis, Eastern Equine |
0 |
2 |
0 |
0.7 |
0 |
0 |
| Encephalitis, St. Louis |
0 |
0 |
0 |
0 |
2 |
0 |
| Encephalitis, other (known organism) |
4 |
8 |
3 |
5 |
7 |
3 |
| Encephalitis, post-infectious1 |
12 |
6 |
8 |
8.7 |
21 |
5 |
| Giardiasis (acute) |
1155 |
984 |
862 |
1000.3 |
1636 |
697 |
| Haemophilus influenzae, invasive1 |
15 |
17 |
29 |
20.3 |
45 |
33 |
| Hansens Disease (Leprosy) |
1 |
0 |
3 |
1.3 |
4 |
2 |
| Hantavirus Infection |
0 |
0 |
0 |
0 |
0 |
0 |
| Hemolytic Uremic Syndrome |
0 |
3 |
7 |
3.3 |
12 |
6 |
| Hemorrhagic Fever |
0 |
0 |
0 |
0 |
0 |
0 |
| Hepatitis A |
298 |
320 |
330 |
316 |
539 |
438 |
| Hepatitis B |
341 |
255 |
263 |
286.3 |
466 |
280 |
| Hepatitis C2 |
NR |
NR |
NR |
NR |
NR |
40 |
| Hepatitis Non-A, Non-B |
57 |
59 |
59 |
58.3 |
95 |
4 |
| Hepatitis, perinatal B2 |
NR |
NR |
NR |
NR |
NR |
2 |
| Hepatitis, unspecified |
3 |
5 |
10 |
6 |
26 |
11 |
| Hepatitis, +HBsAg, pregnant woman2 |
NR |
NR |
NR |
NR |
NR |
12 |
| Lead Poisoning |
1293 |
916 |
1163 |
1124 |
1805 |
444 |
| Legionellosis |
24 |
18 |
24 |
22 |
48 |
18 |
| Leptospirosis |
0 |
0 |
1 |
0.3 |
2 |
0 |
| Listeriosis2 |
NR |
NR |
NR |
NR |
NR |
21 |
| Lyme Disease |
11 |
21 |
27 |
19.7 |
71 |
24 |
| Malaria |
57 |
54 |
40 |
50.3 |
96 |
56 |
| Measles |
1 |
3 |
2 |
2 |
2 |
2 |
| Meningococcal Disease (N. meningitidis) |
135 |
108 |
92 |
111.7 |
133 |
78 |
| Meningitis, Group B Streptococci |
17 |
11 |
11 |
13 |
22 |
11 |
| Meningitis, Haemophilus influenzae1 |
5 |
6 |
11 |
7.3 |
12 |
11 |
| Meningitis, Streptococcus pneumoniae |
75 |
51 |
58 |
61.3 |
96 |
75 |
| Meningitis, Listeria monocytogenes |
4 |
2 |
4 |
3.3 |
13 |
6 |
| Meningitis, other bacterial (including
unspecified) |
72 |
40 |
39 |
50.3 |
75 |
50 |
| Mercury Poisoning |
5 |
2 |
0 |
2.3 |
4 |
2 |
| Mumps |
6 |
8 |
9 |
7.7 |
11 |
3 |
| Neurotoxic Shellfish Poisoning2 |
3 |
0 |
0 |
1 |
0 |
0 |
| Pertussis |
68 |
50 |
32 |
50 |
39 |
60 |
| Pesticide Poisoning |
1 |
0 |
1 |
0.7 |
1 |
1 |
| Plague |
0 |
0 |
0 |
0 |
0 |
0 |
| Poliomyelitis |
0 |
0 |
0 |
0 |
0 |
0 |
| Psittacosis |
0 |
0 |
1 |
0.3 |
2 |
0 |
| Rabies, Animal |
159 |
197 |
140 |
165.3 |
215 |
131 |
| Rocky Mountain Spotted Fever |
1 |
2 |
1 |
1.3 |
2 |
2 |
| Rubella, including congenital |
10 |
1 |
3 |
4.7 |
4 |
0 |
| Salmonellosis |
1412 |
1218 |
1434 |
1354.7 |
3038 |
1507 |
| Shigellosis |
952 |
835 |
1391 |
1059.3 |
2343 |
916 |
| Smallpox2 |
NR |
NR |
NR |
NR |
NR |
0 |
| Staphlococcus aureus, (GISA/VISA)2 |
NR |
NR |
NR |
NR |
NR |
0 |
| Staphlococcus aureus, (GRSA/VRSA)2 |
NR |
NR |
NR |
NR |
NR |
0 |
| Streptococcal Disease, invasive Group A |
2 |
25 |
32 |
19.7 |
57 |
67 |
| Streptococcus pneumoniae, invasive
disease |
4 |
135 |
300 |
146.3 |
493 |
433 |
| Tetanus |
1 |
1 |
2 |
1.3 |
3 |
2 |
| Toxic Shock Syndrome |
0 |
1 |
4 |
1.7 |
4 |
4 |
| Toxoplasmosis |
6 |
4 |
7 |
5.7 |
15 |
10 |
| Typhoid Fever |
17 |
7 |
11 |
11.7 |
16 |
22 |
| Vibrio cholerae (serogrp O1) |
0 |
0 |
0 |
0 |
0 |
1 |
| Vibrio cholerae (serogrp Non-O1) |
2 |
6 |
6 |
4.7 |
11 |
8 |
| Vibrio vulnificus |
7 |
10 |
17 |
11.3 |
35 |
12 |
| Vibrio other (including unspecified) |
16 |
21 |
53 |
30 |
73 |
30 |
| Yellow Fever |
0 |
0 |
0 |
0 |
0 |
0 |
1 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."
2 The reportable disease rule was revised in July, 1999. Kawasaki Disease,
Histoplasmosis, Reye Syndrome, and Typhus were deleted from the weekly disease table since
cases are no longer reportable as of July 4, 1999. Hepatitis C; perinatal hepatitis B;
hepatitis B +HbsAg, pregnant woman; listeriosis; smallpox, S. aureus (GISA/VISA) and S.
aureus (GRSA/VRSA) were added to the reporting requirements as of July 4, 1999. Paralytic
shellfish poisoining is now referred to as neurotoxic shellfish poisoning.
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