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EPI UPDATE
A weekly publication by the Bureau of Epidemiology
For July 5, 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
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 Department of Health has a home on the World Wide Web at http://www.doh.state.fl.us
1. Florida Past – Offensive Warfare Against Disease
William J. Bigler, PhD
Ever since its creation the Florida State Board of Health used the latest vaccines to control or prevent outbreaks in at risk populations. However, when the agency launched a mandatory smallpox vaccination program in the early 1900’s it ran into some severe resistance from the population at large. In the early 1920’s the public was strongly encouraged through a variety of media to take advantage of the vaccinations available for diphtheria, typhoid and smallpox. Then in 1925, an all out campaign to provide free vaccine to every person in the state was launched. Announcement of the Board’s plans were announced in a news article entitled IMMUNIZATION PROGRAM MAY BE INAUGURATED IN STATE that was published in the Florida Times Union on March 15, 1925. Excerpts follow:
An extensive program of Schick testing, toxin-antitoxin and smallpox vaccination will probably be inaugurated in the near future, according to Dr. F. A. Brink, Director of the Bureau of Communicable Diseases, State Board of Health, whose plans have been heartily endorsed by Col. Raymond C. Turk, State Health Officer.
The program, as outlined by Dr. Brink will reach every person, both children and adults. In reaching the schools, Dr. Brink stated yesterday in making public his plans, "consent" or "request" blanks will be sent to the parents of each child and returned to the teacher. As a preliminary educational move, letters will be sent by the county superintendent of public instruction to all public school teachers, who will tell the children what the Schick test is and will instruct them concerning the advisability of toxin-antitoxin, typhoid immunization and smallpox vaccination.
Upon receipt of the returned "request" blanks properly filled out by the parents of the children, the district health officer, assisted by others, will visit the various schools and give the Schick tests, toxin-antitoxin immunization or smallpox vaccination. In addition they would have an opportunity to make health talks before the children of each school…
"For some time the state health board has been furnishing material for vaccination against typhoid, diphtheria and smallpox free to all who have applied," said Dr. Brink last night. "A large number of treatments have been given by state health officials and by practicing physicians who have offered wholehearted cooperation with the department in the work."
"The proposed program as I have set forth, is merely an offensive warfare against disease. If plans for the conduct of this program materialize, every person in the state will be given the opportunity to obtain immunization from typhoid, diphtheria and smallpox."
Editorial Note: By Henry T. Janowski, Chief, DOH Bureau of Immunization
It is truly amazing how much things change and yet remain the same even over a period of almost one hundred years. Dr. Brink’s approach to an "offensive warfare against disease" utilizing the vaccines of the day is not unlike our approach to preventative immunization services today. The utilization of the media to educate the population and involving the parents and school system with "request" blanks was the obvious precursor to our important information statements and informed consent procedures of today. If I understand some of the historical perspective correctly, the ever present adversarial element that always appears to be near by voicing negative opinions about immunizations were present even during the early 1900’s. Still, today the public health system, along with our community partners, has managed to increase immunization levels to greater than 96 percent in Florida’s school population and decrease the incidence of vaccine preventable disease’s better than 99 percent. Congratulations to all those, both past and present, for their contributions to this incredibly successful effort.
2. Weekly Disease Table: Week 26
County-Confirmed Cases, Sorted Alphabetically by Disease
(NR represents years that the disease lacked status as a reportable condition)
|
DISEASE |
1997 TO DATE |
1998 TO DATE |
1999 TO DATE |
3 YEAR AVERAGE
TO DATE |
1999 TOTAL CASES |
2000 TO DATE |
|
Amebiasis |
25 |
29 |
24 |
26 |
66 |
12 |
|
Anthrax |
0 |
0 |
0 |
0 |
0 |
0 |
|
Botulism |
0 |
0 |
0 |
0 |
4 |
0 |
|
Brucellosis |
0 |
1 |
0 |
0.3 |
3 |
1 |
|
Campylobacteriosis |
425 |
325 |
410 |
386.7 |
988 |
406 |
|
Ciguatera |
2 |
6 |
2 |
3.3 |
2 |
0 |
|
Cryptosporidiosis |
40 |
49 |
49 |
46 |
180 |
25 |
|
Cyclosporiasis |
53 |
4 |
2 |
19.7 |
5 |
3 |
|
Dengue |
1 |
1 |
2 |
1.3 |
3 |
1 |
|
Diphtheria |
0 |
0 |
0 |
0 |
0 |
0 |
|
E. coli O157:H7 |
25 |
12 |
14 |
17 |
54 |
19 |
|
E. coli , other (known serotype) |
3 |
2 |
10 |
5 |
16 |
6 |
|
Ehrlichiosis, Human |
2 |
0 |
1 |
1 |
2 |
1 |
|
Encephalitis, Eastern Equine |
0 |
0 |
0 |
0 |
3 |
0 |
|
Encephalitis, St. Louis |
0 |
0 |
0 |
0 |
4 |
0 |
|
Encephalitis, other (known organism) |
6 |
3 |
2 |
3.7 |
5 |
4 |
|
Encephalitis, post-infectious1 |
5 |
4 |
3 |
4 |
14 |
4 |
|
Giardiasis (acute) |
637 |
551 |
452 |
546.7 |
1322 |
488 |
|
Haemophilus influenzae , invasive1 |
11 |
20 |
24 |
18.3 |
53 |
25 |
|
Hansen’s Disease (Leprosy) |
0 |
3 |
2 |
1.7 |
3 |
0 |
|
Hantavirus Infection |
0 |
0 |
0 |
0 |
0 |
0 |
|
Hemolytic Uremic Syndrome |
2 |
3 |
2 |
2.3 |
7 |
4 |
|
Hemorrhagic Fever |
0 |
0 |
0 |
0 |
0 |
0 |
|
Hepatitis A |
197 |
258 |
307 |
254 |
796 |
238 |
|
Hepatitis B |
173 |
173 |
187 |
177.7 |
528 |
213 |
|
Hepatitis C2 |
NR |
NR |
23 |
NR |
56 |
21 |
|
Hepatitis Non-A, Non-B |
42 |
43 |
2 |
29 |
12 |
8 |
|
Hepatitis, perinatal B2 |
NR |
NR |
1 |
NR |
|
2 |
|
Hepatitis, unspecified |
3 |
5 |
9 |
1 |
17 |
4 |
|
Hepatitis, +HBsAg, pregnant woman2 |
NR |
NR |
2 |
NR |
245 |
182 |
|
Lead Poisoning |
619 |
788 |
779 |
728.7 |
1822 |
376 |
|
Legionellosis |
13 |
20 |
10 |
14.3 |
27 |
24 |
|
Leptospirosis |
0 |
0 |
0 |
0 |
1 |
1 |
|
Listeriosis2 |
NR |
NR |
10 |
NR |
38 |
11 |
|
Lyme Disease |
9 |
15 |
6 |
10 |
50 |
13 |
|
Malaria |
30 |
25 |
38 |
31 |
97 |
43 |
|
Measles |
3 |
2 |
1 |
2 |
2 |
1 |
|
Meningococcal Disease (N. meningitidis) |
85 |
68 |
58 |
70.3 |
122 |
58 |
|
Meningitis, Group B Streptococci |
6 |
9 |
6 |
7 |
14 |
7 |
|
Meningitis, Haemophilus influenzae1 |
6 |
7 |
10 |
7.7 |
13 |
1 |
|
Meningitis, Streptococcus pneumoniae |
47 |
52 |
62 |
53.7 |
98 |
50 |
|
Meningitis, Listeria monocytogenes |
2 |
4 |
5 |
3.7 |
14 |
2 |
|
Meningitis, other bacterial (including unspecified) |
27 |
27 |
23 |
25.7 |
61 |
48 |
|
Mercury Poisoning |
0 |
0 |
2 |
0.7 |
7 |
4 |
|
Mumps |
8 |
9 |
2 |
6.3 |
6 |
2 |
|
Neurotoxic Shellfish Poisoning2 |
0 |
0 |
0 |
0 |
0 |
0 |
|
Pertussis |
36 |
19 |
24 |
26.3 |
86 |
27 |
|
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 |
156 |
102 |
81 |
113 |
186 |
63 |
|
Rocky Mountain Spotted Fever |
2 |
1 |
1 |
1.3 |
2 |
0 |
|
Rubella, including congenital |
0 |
3 |
0 |
1 |
1 |
2 |
|
Salmonellosis |
764 |
773 |
910 |
815.7 |
3071 |
782 |
|
Shigellosis |
523 |
850 |
658 |
677 |
1491 |
576 |
|
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 |
21 |
25 |
31 |
25.7 |
94 |
74 |
|
Streptococcus pneumoniae , invasive disease |
117 |
264 |
283 |
221.3 |
701 |
559 |
|
Tetanus |
0 |
2 |
1 |
1 |
3 |
0 |
|
Toxic Shock Syndrome |
1 |
3 |
2 |
2 |
5 |
0 |
|
Toxoplasmosis |
3 |
6 |
5 |
4.7 |
17 |
6 |
|
Typhoid Fever |
4 |
9 |
20 |
11 |
23 |
5 |
|
Vibrio cholerae (serogrp O1) |
0 |
0 |
0 |
0 |
0 |
0 |
|
Vibrio cholerae (serogrp Non-O1) |
5 |
4 |
4 |
4.3 |
10 |
3 |
|
Vibrio vulnificus |
5 |
8 |
5 |
6 |
23 |
2 |
|
Vibrio other (including unspecified) |
16 |
29 |
19 |
21.3 |
48 |
12 |
|
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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