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.

1. Merlin Web-based Reporting System Training

2. Grand Rounds for October 31, 2000: "Epidemiology of Motorcycle Injuries during Bike Week 2000, Daytona Beach, Florida"

3. Human Rabies - USA

4. Surveillance of Vaccine Preventable Diseases Satellite Teleconference

6. Weekly Arbovirus Activity Summary

7. Weekly Disease Table: Week 41

Don Ward, Surveillance Section Administrator

The Merlin web-based reporting system has "gone live." The four counties that served as the laboratory for the development of the system (Collier, Hillsborough, Pinellas and Sarasota) are now reporting basic case data (2016) for communicable diseases and extended data for hepatitis using the Merlin system. Predictably, there was some breath-holding as we went through the early hours, but with very few bumps, the system functions as it was designed. We are now ready to begin Merlin training for the other 63 counties. This training must be completed soon as we intend for all cases reported after January 1^st to be entered by the county health departments into the Merlin system. Several county health departments have offered their computer training facilities to assist us in Merlin training. Additionally we will conduct frequent classes using the DOH computer training facilities in Tallahassee and are working with other health department training hosts to ensure that all counties will be given several options to participate. Updated schedules will be published in upcoming Epi Updates. To register or for additional information please contact John Werth.

The confirmed training schedule (valid as of 10/20/00) is as follows:

Date Location Building/Room

November 9 (Thurs.) Tallahassee 4052/215L

November 17 (Fri.) Tallahassee 2585/110A

November 20 (Mon.) Tallahassee 4052/215L

November 28 (Tues.) Indian River CHD

November 29 (Wed.) Collier CHD

December 1 (Fri.) Tallahassee 2585/110A

December 4 (Mon.) Alachua CHD

December 8 (Fri.) Tallahassee 2585/110A

December 11 (Mon.) Tallahassee 4052/215L

December 12 (Tues.) Hillsborough CHD

December 15 (Fri.) Tallahassee 2585/110A

December 19 (Tues.) Tallahassee 4052/215L

"Epidemiology of Motorcycle Injuries during Bike Week 2000, Daytona Beach, Florida"

Dafna Kanny, PhD, Division of Unintentional Injury Prevention, National Center for Injury Prevention & Control, Centers for Disease Control & Prevention

11:00 AM - 12:00 PM EST

In March 2000, an annual motorcycle event in Daytona Beach, Florida resulted in a temporary local population increase from 64,000 residents to an estimated 600,000 people. Concomitantly, an unusually high number of motorcycle-related deaths were reported by the local and national press, making it the deadliest such event since its inception in 1937. The Volusia County Health Department and Florida Deparment of Health requested that the Centers for Disease Control and Prevention assist them in (a) determining the frequency, rate, and severity of unintentional injuries related to motorcycle crashes and other circumstances associated with the motorcycle event; and (b) identifying risk factors associated with these injury occurrences.

A CDC team was dispatched to Daytona Beach and abstracted data from the Volusia County Medical Examiner's Office, medical records from all Volusia County hospitals, EMS reports, and police crash reports from the period between March 2-13, 2000.

Further details regarding the audio-conference call and PowerPoint files will be posted on the Bureau of Epidemiology Intranet web site. Be sure and register on-line for nursing CEU's and contact hours for environmental health professionals (when applicable). Information about upcoming topics and presenters will also be posted in future Epi Updates. If either of these access points is unavailable to you, please e-mail Melanie Black to request presentation materials.

While we realize you might 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. Please try to call in on time and remember to put your phones on mute so as not to disturb others. Thank you for your cooperation.

1. November 27, 2000

2000 Dietary Guidelines for Americans

Nancy Spyker, Bureau of WIC and Nutritional Services

2. January 23, 2001

Varicella Surveillance

Savita Kumar, Epidemiologist, Palm Beach County Health Department


3. February 27, 2001

Dr. Lisa Conti, State Public Health Veterinarian

A third human rabies fatality was recently reported for year 2000 in the United States, a 26-year-old man from Georgia who was believed to have been infected by bats living in the boarding house where he was staying. The last case of someone dying from rabies in Georgia was in 1991. The two other rabies fatalities were from California (another bat rabies case) and New York (a person bitten by a rabid dog in Ghana).

The last rabies fatalities in Florida were "imported" cases. Two men were bitten by rabid dogs in Haiti and Mexico, during 1994 and 1996, respectively, and did not seek rabies post-exposure prophylaxis. The last indigenous case in the state was during 1948. This was in a man who refused treatment after being bitten by a rabid dog.

No tests are currently available to diagnose human rabies before the onset of symptoms and, if no exposure history or hydrophobia exists, there is little to initially differentiate rabies from other viral encephalitides. In a person with no previous or concurrent rabies vaccine administration, serum neutralizing antibodies can be detected at the earliest on the fifth day of clinical illness. Cerebrospinal fluid (CSF) antibody tests have been negative as long as seven days after serum antibodies were detected. Rabies virus has been isolated from saliva, CSF and nervous system tissues from clinical patients. Physicians wishing to have specimens tested for antemortem rabies evaluation must work through the county and state Department of Health for assistance. Usually CSF and a skin biopsy from the nape of the neck are needed.

Henry T. Janowski, MPH, Chief, Bureau of Immunization

The Department of Health, Bureau of Immunization, in conjunction with the Office of Performance Improvement, is making available the Surveillance of Vaccine-Preventable Diseases (VPD) interactive satellite teleconference through the Department of Health Telnet Videoconference Sites on December 8, 2000, from 12:00 noon to 3:30 p.m. (EST). This live, interactive satellite broadcast will provide guidelines for VPD surveillance, case investigation and outbreak control. The content of this teleconference is most appropriate for physicians, infection control practitioners, nurses, epidemiologists, laboratorians, sanitarians, disease reporters, and others who are involved in surveillance and reporting of VPDs.

The Centers for Disease Control and Prevention will offer continuing education credits for a variety of professions based on 3.5 hours of instruction. County health departments that have a Florida Board of Nursing Continuing Education Provider number may opt to grant contact hours following Florida Board of Nursing protocol.

Course materials for this teleconference include the Manual for the Surveillance of Vaccine Preventable Diseases (1999 edition). The manual can be purchased from the Public Health Foundation. There is a $20.00 charge, plus $5.50 for shipping and handling, for each manual. While not required for the course, the manual is highly recommended, as there are many diseases and aspects of surveillance which will not be covered during the course, but are covered in extensive detail in the book.

To participate, please register with your local site coordinator no later than November 17, 2000. No registration will be accepted after that date. For the name and telephone number of the site coordinator in your area, please contact Linda Zeigler of the Bureau of Immunization.

(The following information was excerpted from IAC Express #201 (October 16, 2000), published by the Immunization Action Coalition)

Ms. Robin Oliveri, Arbovirus Surveillance Coordinator and Dr. Lisa Conti, State Public Health Veterinarian

There are currently no Arbovirus Medical Alerts issued for the state. During the period October 7, through October 13, 2000, the following arbovirus* activity was recorded for Florida:

(*Mosquito-borne virus including St. Louis encephalitis virus, Eastern Equine encephalitis virus, West Nile encephalitis virus and dengue virus)

Sentinel chickens: Eleven sentinel chicken seroconversions to SLE were identified (647 chickens tested). (Source: DOH Tampa Laboratory from mosquito control agencies and county health departments).