"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.

The Bureau of Epidemiology is available 24 hours a day, 7 days a week for consultation at our main number (SunCom 205-4401 or 850/245-4401) PLEASE NOTE: Consultation after 5 p.m. & on weekends is intended for emergencies.

In this issue:

2. Merlin Helpful Hints

The presentation is intended to familiarize participants with genetic screening and diagnostic tests by describing examples of preconception, prenatal, pediatric and adult onset genetic testing. The role of the health care provider and genetic counseling in these contexts will also be explored.

Identify the principles of genetics, genetic factors associated with health and disease, and new advances in genetic-health related technology.

Plan options for incorporating genetic health care services and information into your practice. Identify genetic health care services for patients.

Target audience: Physicians, nurses and other healthcare providers who are interested in learning more about genetics.

Sponsors: The Florida Chapters of the March of Dimes, The Florida Department of Health, and Florida Birth Defects Registry. The speakers presenting this information are Dan Riconda, MS, CGC, Genetic Counselor, Arnold Palmer Hospital in Orlando and Shane Palmer, MS, CGC, Territory Manager, Genzyme Genetics in Miami.

Contact Person: If you have questions or need additional information, please contact Jane Correia at (850) 245-4444 ext. 2198.

Kathryn Snavely, MPH, Surveillance Section

The year 2001 is off to a great start with the Merlin Reporting System and Hepatitis Registry. A couple of months have passed since the first of the Merlin training sessions, so we have included some helpful hints using Merlin below:

When searching for a patient profile in the database, do your search on the first 3-4 letters of the last name. This will insure that your patient will be returned in the search results even if the last name may be misspelled.

Before entering data into the "resources" area for a hospital or medical center, decide how many physicians you want to include from the provider. Remember, only physicians and laboratories that report communicable disease diagnoses need to be part of Merlin. It is not necessary to enter every physician into the system.

Make your county Task List the first destination after logging into the Merlin Reporting System. The Task List will show you what cases have been entered into Merlin but not reported to the Bureau of Epidemiology. Additionally, the laboratory results Task List will display the potential stand-alone laboratory results entered at the Bureau of Epidemiology that require follow-up.

When reporting cases from your Task List use the Refresh button on the Internet Explorer tool bar to update the list and remove cases from the Task List..

For navigating around Merlin you can use the Back button on the Internet Explorer tool bar at the top of your screen. The small, black down arrow to the right of the Back button will give you a drop down menu of all the previous pages. The down arrow can be used to navigate two or three pages back from your current location, instead of hitting the Back button multiple times.

If you have any other questions, please contact Kathryn Snavely, S/C 205-4444, x2447 or email the Merlin Helpdesk

Carina Blackmore, MS Vet. Med., PhD, NE Florida

(Week ending December 23, 2000-Week 51)

Florida: Data from Florida still suggests low levels of influenza activity. Overall, two percent of 10911 patients seeking care by reporting physicians in the influenza sentinel surveillance network met the case definition for ILI during week 51. Influenza-like illness activity was detected in 14 of the 20 counties represented in this week’s data set. Higher flu activity than expected for this time of year (>3%) was reported by physicians in Duval, Escambia and Palm Beach counties. More than 10% of patients seen by sentinel physicians in Leon county were diagnosed with ILI. Influenza A (H1N1) was isolated from patients in Broward and Polk counties. Since October 1, 42 influenza isolations

have been reported to the state health office: 21 influenza A (H1N1) isolates from Broward, Charlotte, Duval, Escambia, Lake, Leon, Orange and Polk counties, one influenza A (H3N2) from Duval county, 9 untyped influenza A isolates from Alachua, Columbia, Hillsborough, Orange, Palm Beach and Pinellas counties) and 12 influenza B isolates from Brevard, Broward, Hillsborough, Leon and Volusia counties.

Respiratory syncytial virus (RSV) activity remains high in northeastern, central and the southwestern part of the state where 38.6-52.4% of tested specimens were positive for RSV. Nineteen percent of RSV specimens tested in the southeast were positive. Twelve hospital laboratories in the state participate in this program.

National report: During week 51 (December 17-23, 2000), 65 of the 830 specimens tested by the WHO and National Respiratory and Enteric Virus Surveillance System (NREVSS) laboratories were positive for influenza type A virus and 16 were positive for type B virus. Twelve (18%) of the influenza A isolates were typed. All of them were influenza A (H1N1). Since October 460 (3%) influenza isolates (174 influenza A (H1N1), 8 influenza A (H3N2) and 90 influenza B of 15,364 specimens tested in US laboratories have yielded virus. Three hundred and eighty-one (83%) of the 460 U.S. isolates have been reported from the West South Central [248 (65%)], Pacific [79 (21%)], and South Atlantic regions. Influenza A(H1N1) viruses have predominated in the West South Central and South Atlantic regions. In the West South Central region, the majority [223 (90%)] of isolates reported were from Texas. In the Pacific region, influenza type B viruses accounted for 65 (82%) of the 79 isolates reported. Fifty-three (67%) of the 79 influenza B viruses reported in the Pacific region were from Alaska.

CDC has antigenically characterized 33 U.S. virus isolates (6 influenza A (H3N2); 19 influenza A (H1N1) and 8 influenza B). They are all similar to respective vaccine strains.

The percentage of all deaths due to Pneumonia and Influenza (P&I) as reported by the vital statistics offices of 122 U.S. cities was 7.2% during week 51. This percentage is below the epidemic threshold of 8.3% for this time of year.

Influenza activity was assessed as regional by the state and territorial health departments in Colorado, Kentucky, New York, Oregon, Tennessee, Texas and Virginia). Thirty-four states reported sporadic influenza activity and no activity was reported from 7 states (Connecticut, Maine, Maryland, New Jersey, North Dakota Pennsylvania and Vermont).

* Last week’s disease table (52) should have been (51), officially making this current week (52). Sorry for any inconvenience.