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EPI UPDATE
A weekly publication by the Bureau of Epidemiology
For June 21, 2000
"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:
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Steven Wiersma, MD, MPH,
Deputy State Epidemiologist |
William J. Bigler, PhD, MS,
Senior Epidemiologist |
Jodi Baldy, MPH,
Biological Scientist IV |
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Ursula E. Bauer, PhD,
Chronic Disease Epidemiologist |
John Werth, MA,
Bureau Education Coordinator |
Lisa Conti, DVM, MPH,
State Public Health Veterinarian |
Regional Epidemiologists:
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Dolly Katz, PhD, MPH,
SE Florida |
Roger Sanderson, RN, MA,
SW Florida |
Carina Blackmore, MS Vet. Med., PhD,
NE Florida Carina Blackmore, MS Vet. Med., PhD, |
Zuber Mulla, MSPH,
Central Florida Carina Blackmore, MS Vet. Med., PhD, |
Gérard Krause, MD, DTMH,
NW 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.
The Bureau of Epidemiology is available 24 hours a day, 7 days
a week for consultation at our main number (850/245-4401) PLEASE NOTE:
Consultation after 5 p.m. & on weekends is intended for emergencies.
In this issue:
1. Grand Rounds for June 27, 2000: "Racial Disparities in Health
Status - Florida: What the Epidemiological Data Tell Us"
2. Reminder: Communicable Disease Epidemiology Training to be held July 13th- 14th in Orlando
3. Florida Past - Florida Health Notes
4. Weekly Disease Table: Week 24
1. Grand Rounds for June 27, 2000
"Racial Disparities in Health
Status - Florida: What the Epidemiological Data Tell Us"
Ursula Bauer, PhD, Chronic Disease Epidemiologist, Bureau of Epidemiology
11:00 AM -12:00 PM EST
Abstract:
This presentation reviews the epidemiological data that describe racial disparities in health status in Florida and highlights the complexity and multi-directionality of the disparities, as well as the role that education, income, community and social structure may play in the disparities. The role of the epidemiologist in informing the discussion on disparities and taking action to reduce them will be briefly discussed.
Additional Information:
Further details regarding the audio-conference call and PowerPoint files will be posted on the Bureau of Epidemiology Intranet web site. Information about upcoming topics and presenters will also be posted in future Epi Updates..
Important!
We have instituted a new procedure for Grand Rounds. The conference call will be locked ten (10) minutes after Grand Rounds has begun. While we realize you may not always be able to call in at 11:00 AM, it can be distracting to the speakers and others in the audience when participants dial-in throughout the hour. You will still be able to view the PowerPoint presentation, however you will not be able to hear the speaker or join in on the question and answer segment at the end. Also, please try to remember to put your phones on mute when you call in so as not to disturb others. Thank you for your cooperation.
2. Reminder: Communicable Disease Epidemiology Training to be held July 13th- 14th in Orlando
Melanie Black, LCSW, Bureau of Epidemiology
The Bureau of Epidemiology and the Orange County Health Department are sponsoring a regional training program in the fundamentals of epidemiology for county health department staff members and partner agencies involved in epidemiology. The training program, which will take place in Orlando on July 13th-14th, will provide an overview of epidemiologic principles such as disease reporting, disease surveillance and communicable disease outbreak investigation.
The deadline for registration is Friday July 7th. On-line registration is now available on the Bureau of Epidemiology Intranet and Internet
(www.doh.state.fl.us, choose epidemiology as subject) web pages. Space is limited so please register as soon as possible. Nursing CEU's will be provided.
3. Florida Past - Florida Health Notes
William J. Bigler, PhD
From the outset, when he took office as the State Board of Health’s (SBH) first State Health Officer in 1889, Dr. J. Y. Porter strongly advocated the education of the public in health matters. He introduced a public health magazine entitled Florida Health Notes in 1892 to "stimulate an interest in sanitary matters, not only for the masses, but to arouse those who are charged with the protection of the public health in the counties to active measures." The publication summarized monthly statistical information collected from the counties, together with short articles on popular health subjects, with abstracts of interest and value from standard journals as well as with advice on improving personal hygiene, household disease prevention and sanitation practices. In the November 1937 issue of "Health Notes," George Gross, Director of the SBH Bureau of Health Education, summarized the history of the publication up until that time in an article entitled "Chronicle of Florida Health Notes." Some excerpts follow:
When the June 1937 issue of the Florida Health Notes came off the press, forty-seven years had elapsed since this official publication of the Florida State Board of Health began its humble start in June 1890 as a monthly bulletin containing tabulated tables of vital statistics. In 1892 this bulletin…was enlarged to include "original" articles on sanitation, office correspondence, and "valuable extracts" from sanitary periodicals. Flattering communications had been received by the State Board of Health assuring them that the bulletin was appreciated…
By the year 1893 the monthly printing of news items had so increased in favor and in circulation that the Notes, as titled by Dr. Porter, were "uniquely and appropriately styled "The State Board of Health in Print." The infant venture…had developed into a "yearling of good growth and promising vigorous constitution." Thirty dollars a month was appropriated to defray printing costs and postage and 1000 copies were printed. The subscription price, which was to cover merely the cost of printing and mailing, was listed at 50 cents per annum, and it was not until January 1915 that the Florida Health Notes was sent free of charge to the people of Florida. An additional amount of $7.50 per month was appropriated in February 1894, and the circulation of the Florida Health Notes was increased to two thousand copies – "continuing to grow in favor with the people of Florida."
Then in…1901, on the 3rd of March, the calamitous fire which nearly obliterated the city of Jacksonville…,destroyed the building in which was located the office of the State Board of Health…The publication of Florida Health Notes had to be suspended after this great fire, and it was not until July 1906 that it was revived. At this time the publication was begun as a second issue, and the first issue became Vol. 1, No. 1, a sixteen-page bulletin containing information on sanitary matters…
Again in February 1919 the publication of the Florida Health Notes was discontinued – this time because it was believed that they were not being generally read and that being limited in number, they were not reaching a sufficient number of the people of Florida…according to the State Health Officer at that time. (He said "practically every citizen of the State…has opportunity of reading the newspapers and consequently the advice and information sent out by the State Board of Health.")
But the people of Florida did not agree with his thought, and consequently, after repeated communications had been received, the publication…was resumed in March 1922. During the first months the mailing list increased from three thousand to four thousand five hundred copies…Dr. (Stewart G.) Thompson was named editor and he was untiring in his efforts to make this publication a success.
With this issue…the Florida Health Notes will have served the people of Florida forty years.
Editorial Note: "Florida Health Notes" changed considerably over the years but somehow managed to survive until 1976. When the Division of Health was reorganized by the legislature to become the Health Program Office under the Department of Health and Rehabilitative Services, "Florida Health Notes" became a subsection within a departmental newsletter called "Access." That arrangement was not permanent and within a year public health articles were published randomly throughout the "Access" magazine and the section entitled "Florida Health Notes" quietly disappeared.
4. Weekly Disease Table: Week 24
County-Confirmed Cases, Sorted Alphabetically by Disease
(NR represents years that the disease lacked status as a reportable condition)
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DISEASE |
1997 TO DATE |
1998 TO DATE |
1999 TO DATE |
3 YEAR AVERAGE
TO DATE |
1999 TOTAL CASES |
2000 TO DATE |
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Amebiasis |
22 |
25 |
17 |
21.3 |
66 |
11 |
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Anthrax |
0 |
0 |
0 |
0 |
0 |
0 |
|
Botulism |
0 |
0 |
0 |
0 |
4 |
0 |
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Brucellosis |
0 |
1 |
0 |
0.3 |
3 |
1 |
|
Campylobacteriosis |
375 |
287 |
373 |
345 |
988 |
363 |
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Ciguatera |
2 |
6 |
1 |
3 |
2 |
0 |
|
Cryptosporidiosis |
35 |
47 |
47 |
43 |
180 |
19 |
|
Cyclosporiasis |
46 |
4 |
1 |
17 |
5 |
1 |
|
Dengue |
0 |
1 |
2 |
1 |
3 |
1 |
|
Diphtheria |
0 |
0 |
0 |
0 |
0 |
0 |
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E. coli O157:H7 |
21 |
9 |
13 |
14.3 |
54 |
17 |
|
E. coli , other (known serotype) |
2 |
2 |
9 |
4.3 |
16 |
5 |
|
Ehrlichiosis, Human |
2 |
0 |
0 |
0.7 |
2 |
1 |
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Encephalitis, Eastern Equine |
0 |
0 |
0 |
0 |
3 |
0 |
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Encephalitis, St. Louis |
0 |
0 |
0 |
0 |
4 |
0 |
|
Encephalitis, other (known organism) |
6 |
3 |
2 |
3.7 |
5 |
4 |
|
Encephalitis, post-infectious1 |
5 |
2 |
3 |
3.3 |
14 |
4 |
|
Giardiasis (acute) |
584 |
483 |
397 |
488 |
1322 |
426 |
|
Haemophilus influenzae , invasive1 |
8 |
20 |
23 |
17 |
53 |
22 |
|
Hansen’s Disease (Leprosy) |
0 |
3 |
2 |
1.7 |
3 |
0 |
|
Hantavirus Infection |
0 |
0 |
0 |
0 |
0 |
0 |
|
Hemolytic Uremic Syndrome |
2 |
1 |
2 |
1.7 |
7 |
3 |
|
Hemorrhagic Fever |
0 |
0 |
0 |
0 |
0 |
0 |
|
Hepatitis A |
181 |
239 |
279 |
233 |
796 |
217 |
|
Hepatitis B |
157 |
163 |
176 |
165.3 |
528 |
179 |
|
Hepatitis C2 |
NR |
NR |
22 |
NR |
56 |
16 |
|
Hepatitis Non-A, Non-B |
36 |
38 |
1 |
25 |
12 |
8 |
|
Hepatitis, perinatal B2 |
NR |
NR |
1 |
NR |
|
1 |
|
Hepatitis, unspecified |
3 |
4 |
9 |
1 |
17 |
4 |
|
Hepatitis, +HBsAg, pregnant woman2 |
NR |
NR |
1 |
NR |
245 |
163 |
|
Lead Poisoning |
577 |
707 |
688 |
657.3 |
1822 |
345 |
|
Legionellosis |
12 |
19 |
9 |
13.3 |
27 |
22 |
|
Leptospirosis |
0 |
0 |
0 |
0 |
1 |
0 |
|
Listeriosis2 |
NR |
NR |
6 |
NR |
38 |
10 |
|
Lyme Disease |
8 |
14 |
6 |
9.3 |
50 |
12 |
|
Malaria |
29 |
23 |
37 |
29.7 |
97 |
39 |
|
Measles |
1 |
2 |
1 |
1.3 |
2 |
0 |
|
Meningococcal Disease (N. meningitidis) |
81 |
64 |
55 |
66.7 |
122 |
53 |
|
Meningitis, Group B Streptococci |
5 |
8 |
6 |
6.3 |
14 |
7 |
|
Meningitis, Haemophilus influenzae1 |
4 |
7 |
10 |
7 |
13 |
1 |
|
Meningitis, Streptococcus pneumoniae |
45 |
49 |
58 |
50.7 |
98 |
46 |
|
Meningitis, Listeria monocytogenes |
2 |
4 |
4 |
3.3 |
14 |
2 |
|
Meningitis, other bacterial (including unspecified) |
23 |
26 |
21 |
23.3 |
61 |
43 |
|
Mercury Poisoning |
0 |
0 |
2 |
0.7 |
7 |
4 |
|
Mumps |
7 |
9 |
2 |
6 |
6 |
2 |
|
Neurotoxic Shellfish Poisoning2 |
0 |
0 |
0 |
0 |
0 |
0 |
|
Pertussis |
32 |
17 |
21 |
23.3 |
86 |
21 |
|
Pesticide Poisoning |
0 |
1 |
1 |
0.7 |
32 |
3 |
|
Plague |
0 |
0 |
0 |
0 |
0 |
0 |
|
Poliomyelitis |
0 |
0 |
0 |
0 |
0 |
0 |
|
Psittacosis |
0 |
1 |
0 |
0.3 |
0 |
0 |
|
Rabies, Animal |
146 |
93 |
77 |
105.3 |
186 |
63 |
|
Rocky Mountain Spotted Fever |
2 |
1 |
1 |
1.3 |
2 |
0 |
|
Rubella, including congenital |
0 |
3 |
0 |
1 |
1 |
2 |
|
Salmonellosis |
683 |
658 |
778 |
706.3 |
3071 |
665 |
|
Shigellosis |
482 |
706 |
615 |
601 |
1491 |
516 |
|
Smallpox2 |
NR |
NR |
0 |
NR |
0 |
0 |
|
Staphylococcus aureus, (GISA/VISA)2 |
NR |
NR |
0 |
NR |
0 |
0 |
|
Staphylococcus aureus, (GRSA/VRSA)2 |
NR |
NR |
0 |
NR |
0 |
0 |
|
Streptococcal Disease, invasive Group A |
20 |
25 |
27 |
24 |
94 |
73 |
|
Streptococcus pneumoniae , invasive disease |
110 |
254 |
269 |
211 |
701 |
511 |
|
Tetanus |
0 |
2 |
1 |
1 |
3 |
0 |
|
Toxic Shock Syndrome |
0 |
3 |
2 |
1.7 |
5 |
0 |
|
Toxoplasmosis |
3 |
6 |
4 |
4.3 |
17 |
7 |
|
Typhoid Fever |
3 |
8 |
20 |
10.3 |
23 |
4 |
|
Vibrio cholerae (serogrp O1) |
0 |
0 |
0 |
0 |
0 |
0 |
|
Vibrio cholerae (serogrp Non-O1) |
5 |
3 |
3 |
3.7 |
10 |
3 |
|
Vibrio vulnificus |
5 |
6 |
3 |
4.7 |
23 |
1 |
|
Vibrio other (including unspecified) |
13 |
19 |
16 |
16 |
48 |
10 |
|
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 poisoning is now referred to as neurotoxic shellfish poisoning.
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