Division of Disease Control and Health Protection

"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.

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.

An Invitation for Proposals for the Florida Hepatitis and Liver Failure Prevention and Control Program was sent to each county health department director/administrator at the beginning of November. A copy of the document is attached.

The first deadline listed within the Invitation for Proposals is Monday, November 15^th, at which time all questions regarding the Invitation for Proposals should have been submitted in writing (no phone calls will be accepted) to:

Ms. Deborah Castleberry
Investigations Section
Bureau of Epidemiology
Florida Department of Health
2020 Capital Circle SE, Bin # A-12
Tallahassee, FL 32399-1715

Answers to questions will be provided to all persons that attend the Hepatitis Prevention & Control Program proposal conference on November 23, 1999. The conference will be held from 9:00 a.m. to 4:00 p.m. or until there are no further questions, whichever is earlier. Audioconference access will be available.

Carina Blackmore, MS Vet Med. PhD

National:

During September through November 5, laboratory confirmed influenza A virus infection was reported from 26 states across the nation including Florida. Influenza B was reported from Indian River County, Florida. This is the first influenza B isolate reported in the United States since June 1999. Alaska, California, South Dakota and Puerto Rico reported regional influenza activity as assessed by state and territorial epidemiologists, and twenty-nine other states reported sporadic influenza activity.

Of the total patient visits to sentinel physicians, 1% were due to ILI (influenza-like-illness) in the US overall. The percentages were within baseline levels (0%-3%) in all 9 regions. The percentage of pneumonia and influenza deaths reported from the 122 cities was 6.7 % for week 43, which is above the epidemic threshold of 6.4%. This is the sixth consecutive week the percentage of pneumonia and influenza deaths have exceeded the baseline limits for this time of year. It is unclear whether this increase in the percentage of deaths due to pneumonia and influenza is due to early influenza activity, respiratory illness due to some other pathogen, or reporting changes underway in the 122 Cities Mortality Reporting System.

During week 43 (24-30 October 1999) 2 laboratory confirmed isolates of influenza A

H3N2/Sydney-like were reported from Broward County and one isolate from Miami-Dade County. Influenza A H3N2 has also been isolated from Alachua, Brevard, Collier, Duval, Hillsborough, Indian River, Monroe, Orange, Palm Beach, Pinellas and Sumter Counties since July 1999. Influenza B/Yamanashi-like has been isolated from Indian River County. Antigens from both influenza A/Sydney and influenza B/Yamanashi are included in the 1999-2000 influenza vaccine. Of the total patient visits to sentinel physicians for Week 43, 2% were due to ILI. This is the same level of influenza activity as reported during the first three weeks of this year's Influenza Sentinel Physicians Surveillance Network and it is within the expected range of 0-3%. So far this year, influenza-like illness has been reported from 41 health care providers in 19 of the 29 Florida counties represented in this program.

(The following Department of Health press release was issued on November 9, 1999)

John F. Werth, M.A.

11:00 AM – 12:00 PM EST

Session 9 will be presented by Dr. Gérard Krause, MD, DrMed, DTMH, CDC Epidemic Intelligence Service Officer, Bureau of Epidemiology, Florida Department of Health.

This presentation will provide an introduction to the four strategies of the global eradication of polio conducted by the World Health Organization (WHO). The focus will be the surveillance of acute flaccid paralysis, which is one of the four strategies for polio eradication. Based upon his experience as a WHO consultant in Niger, West Africa, Dr. Krause will demonstrate how a surveillance system for acute flaccid paralysis was implemented in one of the poorest countries in Africa.

Jodi Baldy, Staff Epidemiologist and Dolly Katz, PhD., Regional Epidemiologist

The Bureau of Epidemiology is assembling a set of model letters for counties to use in responding to cases and outbreaks of infectious diseases in schools. The letters, intended for distribution to parents and/or school staff, will cover diseases like meningococcal meningitis, hepatitis A, and other pathogens that cause concern among parents when cases arise in schools. The letters will provide some background on the ways the diseases are transmitted, describe the risk to other children (usually very low), and outline any measures parents can take to protect their children.

The model letters will be available 24 hours a day on the Bureau of Epidemiology’s intranet web site for counties to download and adapt. Jodi Baldy and Dolly Katz are preparing the letters and would appreciate receiving any model letters that counties already are using in response to cases of infectious diseases in schools. These can be mailed or faxed to the Bureau of Epidemiology.

William J. Bigler, PhD

Editorial Note: After the fire, the State Board had lost everything and essentially started over by taking up temporary headquarters in the Dyal-Upchurch Building in Jacksonville. As the city was rebuilding much of the charred debris was taken to a marshy dumpsite between Pearl and Julia Streets along Hogan’s Creek on the southern edge of the Springfield district. Ironically, a decade later that site was donated by the city to the State Board of Health for construction of its own building. The Department of Health is currently in the process of restoring that first State Board of Health building to its original condition.