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EPI UPDATE
A weekly publication by the Bureau of Epidemiology
For October 4, 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 |
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, |
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. Florida Hepatitis C Hotline Launched on October 3, 2000
2. Flu Vaccine Supply Update
3. Retirement Party for Bill Bigler to be Held October 9,2000
4. Communicable Disease Epidemiology Regional Training to be Held October 26th - 27th in West Palm Beach
5. Weekly Disease Table: Week 39
1. Florida Hepatitis C Hotline Launched on October 3, 2000
Himal Dhotre, Bonnie Kwan, Sandra Roush
Bureau of Epidemiology
The toll-free Florida Hepatitis C Hotline, 1-866-FLA-HEPC, was successfully launched on October 3, 2000. The hotline, which operates under contract to the Florida Department of Health (FDOH), provides hepatitis C education and testing information. Florida residents for whom hepatitis C testing is routinely recommended following criteria established by the CDC, will learn about testing options, and may be eligible to obtain a free Hepatitis C Check home test kit through the hotline. For additional information, you and your clients may visit our web site at www.doh.state.fl.us, click on "Epidemiology" under Florida’s Health, then "Health topics", and finally, "Hepatitis."
We encourage each county health department to join the educational campaign to raise hepatitis C awareness for members of their community. Some suggestions include:
using hepatitis C educational brochures & posters. Examples can be found in the FDOH Approved List of HIV/AIDS Educational Materials brochure catalog (April 2000), or you may download CDC brochures from the FDOH or CDC websites, and
marketing the Hepatitis C Hotline to the public. The hotline number, 1-866-FLA-HEPC, was successfully launched October 3, 2000.
If you are interested in participating in this campaign, or would like additional information, you may contact the FDOH, Bureau of Epidemiology, Hepatitis and Liver Failure Prevention and Control Program.
2. Flu Vaccine Supply Update
(The following press release was issued by the CDC on September 28,2000)
Update: Flu Vaccine Supply
Sept. 28, 2000 Contact: CDC
Media Relations (404) 639-3286
Important actions taken to reach high risk persons with flu vaccine despite delays this season:
Today public health officials announced that flu vaccine supplies should be approximately what was distributed last year; however, they also noted a substantial amount of vaccine will reach providers later than usual. In June, influenza vaccine manufacturers told federal public health officials to expect delays in flu vaccine shipments this flu season and possible shortages.
Flu vaccine is the best tool to prevent severe illness and death related to influenza among the elderly and chronically ill in the United States. CDC's overriding public health concern has been to prevent hospitalizations and deaths, especially among high-risk persons, that could result from an insufficient supply of flu vaccine. Therefore, since June, the CDC has been developing contingency plans and if needed, CDC has guaranteed
the production of up to 9 million doses of additional influenza vaccine to make up for possible shortfalls experienced by some of the vaccine manufacturers.
The Food and Drug Administration estimates that 66 million doses will be available from manufacturers through normal production plus 9 million doses to be guaranteed by the CDC for a total of 75 million doses. The 75 million doses this flu season should meet the expected usual annual demand. During last year's flu season in the United States, an estimated 74 million doses were distributed to providers from the 80 to 85 million doses produced. Although a severe flu vaccine shortfall is no longer expected, the vaccine delays will continue to challenge influenza vaccination efforts this flu season in the United States.
The Advisory Committee on Immunization Practices (ACIP) met Sept. 28, by teleconference, to review recommendations about the timing and priority of flu vaccination in the United States for this upcoming flu season. The first public health priority is to help ensure high-risk persons who choose to be vaccinated can obtain vaccine to help prevent the flu and complications related to influenza illness. The ACIP recommended the following:
* As vaccine first becomes available, vaccination efforts should be focused on persons at high risk of complications associated with influenza disease and on health care workers (Health care workers should be vaccinated to stop the potential spread to vulnerable persons). These efforts should continue into December and later, as long as influenza vaccine is available.
* Mass vaccination campaigns should be scheduled later in the season as availability of vaccine is assured.
* Special efforts should be undertaken in December and later to vaccinate persons 50-64 years of age who are not at high risk and are not household contacts of high risk persons.
* Immunization efforts for all groups (e.g., high risk persons, health care workers, household contacts of high risk persons, other persons 50-64 years of age, and other people who wish to decrease their risk of influenza) should continue into December and later, as long as influenza vaccine is available.
* Assuring pneumoccocal vaccination of high risk persons early in the influenza season, in accordance with ACIP recommendations, will confer substantial protection from a major complication of influenza, secondary bacterial pneumonia, but is not a substitute for influenza vaccine.
The degree of delay for individual providers will vary, depending on the vaccine manufacturer, distributor, and when vaccine was ordered. Officials urge high-risk persons to remain patient but persistent as they work with their health care provider to obtain their annual flu vaccination. At the same time, the CDC will be working with states, industry and health systems to help providers obtain vaccine for high-risk persons. For example, this fall a new CDC Internet website will help providers and distributors make contact about where to obtain additional influenza vaccine supplies.
In previous flu seasons, although the number has been increasing, only about half of the 70 to 76 million persons CDC estimates are at high risk for complications from flu have received vaccine. The high risk populations include approximately 35 million persons aged 65 years or older, 33 to 39 million persons less that 65 years of age with high-risk medical conditions, and 2 million pregnant women.
Although the vaccine supply this year should be sufficient to meet the usual demand, the situation remains fluid and some questions about supply and demand will remain unanswered until much later into the flu season. All influenza vaccine for use in the United States is produced in the private sector and virtually all flu vaccine is distributed in the United States through private-sector distributors for use by health care providers.
The public and private communities will continue to work closely together to ensure the availability of influenza vaccine for the season and to minimize the adverse impact of delays. For more information about influenza disease and influenza vaccine visit CDC at
www.cdc.gov.
Note: Additional information about the ACIP recommendations and HHS activities for this flu season will be reported in the CDC's Oct. 6 MMWR.
3. Retirement Party for Bill Bigler to be Held October 9,2000
Bill Bigler, PhD, Senior Epidemiologist with the Bureau of Epidemiology, has retired after 35 years of distinguished service with the Florida Department of Health. Bill has served the State of Florida and its citizens in several positions including Research Director, Deputy State Epidemiologist, and Chief of the Tuberculosis Control Program. He is currently the supervisor of the Field Epidemiology section.
A retirement party will be held in his honor on October 9, 2000, from 2 to 4
PM in Room 310A of the Prather Building, Capital Circle Office Complex in
Tallahassee. We are looking for pictures (originals will be returned), stories
(written or oral), and cards/other greetings. Join us for a reunion and farewell
and relive memories of how Bill has survived snakebites, overturned vehicles,
attempted robbery, and reorganizations, all in the line of duty. For additional
information, please contact Melanie Black.
4. Communicable Disease Epidemiology Regional Training to be Held October 26th - 27th in West Palm Beach
Melanie Black, LCSW, Bureau of Epidemiology
The Bureau of Epidemiology is pleased to announce the next Principles of Epidemiology training program for county health department staff members, which will be held in West Palm Beach, Florida on October 26-27, 2000. The target audiences for the regional training programs are county health department staff members and partner agencies who are involved in epidemiology. County health directors and administrators are welcome to attend.
This program will provide an overview of epidemiological principles such as disease surveillance and reporting and communicable disease outbreak investigation. On-line registration will be available Monday October 2, 2000 through October 20, 2000 on the Bureau of Epidemiology web page.
Space is limited to 45, so please register as soon as possible.
Information will be provided in the Epi Update and on the Bureau of Epidemiology web page. We intend to offer one other training session this year in southwest Florida. If you are interested in hosting a training session or have questions related to this program, please feel free to contact Melanie Black, LCSW,
Professional Training Coordinator for the Bureau of Epidemiology.
5. Weekly Disease Table: Week 39
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 |
|
Anthrax |
0 |
0 |
0 |
0 |
0 |
0 |
|
Botulism |
0 |
0 |
3 |
1 |
4 |
0 |
|
Brucellosis |
0 |
3 |
1 |
1.3 |
3 |
2 |
|
Campylobacteriosis |
737 |
576 |
682 |
665 |
988 |
711 |
|
Ciguatera |
6 |
7 |
2 |
5 |
2 |
11 |
|
Cryptosporidiosis |
100 |
118 |
108 |
108.7 |
180 |
108 |
|
Cyclosporiasis |
66 |
6 |
3 |
25 |
5 |
6 |
|
Dengue |
3 |
3 |
3 |
3 |
3 |
2 |
|
Diphtheria |
0 |
0 |
0 |
0 |
0 |
0 |
|
E. coli O157:H7 |
39 |
32 |
44 |
38.3 |
55 |
71 |
|
E. coli , other (known serotype) |
5 |
4 |
13 |
7.3 |
15 |
11 |
|
Ehrlichiosis, Human |
2 |
0 |
2 |
1.3 |
2 |
5 |
|
Encephalitis, Eastern Equine |
2 |
0 |
2 |
1.3 |
3 |
0 |
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Encephalitis, St. Louis |
1 |
0 |
0 |
0.3 |
4 |
0 |
|
Encephalitis, post-infectious1 |
9 |
4 |
3 |
5.3 |
5 |
5 |
|
Encephalitis, other (known organism) |
8 |
10 |
6 |
8 |
14 |
6 |
|
Giardiasis (acute) |
1155 |
1036 |
836 |
1009 |
1322 |
966 |
|
Haemophilus influenzae , invasive1 |
19 |
32 |
37 |
29.3 |
53 |
45 |
|
Hansen’s Disease (Leprosy) |
0 |
4 |
3 |
2.3 |
3 |
3 |
|
Hantavirus Infection |
0 |
0 |
0 |
0 |
0 |
0 |
|
Hemolytic Uremic Syndrome |
3 |
9 |
7 |
6.3 |
7 |
9 |
|
Hemorrhagic Fever |
0 |
0 |
0 |
0 |
0 |
0 |
|
Hepatitis A |
386 |
372 |
500 |
419.3 |
796 |
361 |
|
Hepatitis B |
281 |
296 |
297 |
291.3 |
528 |
349 |
|
Hepatitis C |
NR |
NR |
37 |
NR |
55 |
32 |
|
Hepatitis Non-A, Non-B |
68 |
64 |
4 |
45.3 |
10 |
6 |
|
Hepatitis, perinatal B |
NR |
NR |
1 |
NR |
|
3 |
|
Hepatitis, unspecified |
6 |
13 |
10 |
1 |
17 |
8 |
|
Hepatitis, +HBsAg, pregnant woman |
NR |
NR |
213 |
NR |
448 |
311 |
|
Lead Poisoning |
1050 |
1348 |
1272 |
1223.3 |
1810 |
702 |
|
Legionellosis |
18 |
24 |
17 |
19.7 |
27 |
36 |
|
Leptospirosis |
0 |
1 |
0 |
0.3 |
1 |
1 |
|
Listeriosis |
NR |
NR |
24 |
NR |
37 |
23 |
|
Lyme Disease |
24 |
33 |
26 |
27.7 |
51 |
37 |
|
Malaria |
59 |
45 |
62 |
55.3 |
97 |
61 |
|
Measles |
3 |
2 |
2 |
2.3 |
2 |
1 |
|
Meningococcal Disease (N. meningitidis) |
115 |
98 |
85 |
99.3 |
122 |
88 |
|
Meningitis, Group B Streptococci |
12 |
14 |
11 |
12.3 |
14 |
15 |
|
Meningitis, Haemophilus influenzae1 |
8 |
11 |
12 |
10.3 |
13 |
6 |
|
Meningitis, Streptococcus pneumoniae |
60 |
63 |
75 |
66 |
97 |
69 |
|
Meningitis, Listeria monocytogenes |
2 |
4 |
7 |
4.3 |
14 |
4 |
|
Meningitis, other bacterial (including unspecified) |
45 |
43 |
44 |
44 |
62 |
73 |
|
Mercury Poisoning |
2 |
0 |
2 |
1.3 |
7 |
7 |
|
Mumps |
8 |
10 |
3 |
7 |
6 |
2 |
|
Neurotoxic Shellfish Poisoning |
0 |
0 |
0 |
0 |
0 |
0 |
|
Pertussis |
54 |
34 |
65 |
51 |
85 |
41 |
|
Plague |
0 |
0 |
0 |
0 |
0 |
0 |
|
Poliomyelitis |
0 |
0 |
0 |
0 |
0 |
0 |
|
Psittacosis |
0 |
1 |
0 |
0.3 |
0 |
0 |
|
Q Fever2 |
NR |
NR |
NR |
NR |
0 |
0 |
|
Rabies, Animal |
216 |
156 |
146 |
172.7 |
186 |
127 |
|
Rocky Mountain Spotted Fever |
2 |
1 |
2 |
1.7 |
2 |
1 |
|
Rubella, including congenital |
3 |
3 |
0 |
2 |
1 |
3 |
|
Salmonellosis |
1501 |
1799 |
1823 |
1707.7 |
3071 |
1831 |
|
Shigellosis |
991 |
1605 |
1028 |
1208 |
1491 |
937 |
|
Smallpox |
NR |
NR |
0 |
NR |
0 |
0 |
|
Staphylococcus aureus, (GISA/VISA) |
NR |
NR |
0 |
NR |
0 |
0 |
|
Staphylococcus aureus, (GRSA/VRSA) |
NR |
NR |
0 |
NR |
0 |
0 |
|
Streptococcal Disease, invasive Group A |
28 |
35 |
48 |
37 |
94 |
105 |
|
Streptococcus pneumoniae , invasive disease, drug resistant |
150 |
316 |
411 |
292.3 |
701 |
752 |
|
Tetanus |
1 |
2 |
2 |
1.7 |
3 |
1 |
|
Toxoplasmosis |
4 |
9 |
13 |
8.7 |
17 |
7 |
|
Typhoid Fever |
8 |
12 |
23 |
14.3 |
23 |
8 |
|
Vibrio cholerae (serogrp O1) |
0 |
0 |
0 |
0 |
0 |
0 |
|
Vibrio cholerae (serogrp Non-O1) |
7 |
6 |
9 |
7.3 |
10 |
4 |
|
Vibrio vulnificus |
13 |
23 |
16 |
17.3 |
23 |
6 |
|
Vibrio other (including unspecified) |
22 |
55 |
31 |
36 |
48 |
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 June 2000. Amebiasis and Toxic Shock Syndrome (Staphylococcal and Streptococcal) were deleted from the list of reportable diseases. Q Fever was added to the list of reportable diseases.
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