"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.

The following information was provided to State Epidemiologist, Dr. Richard Hopkins by the Centers for Disease Control and Prevention.

Attached is the third edition of a state-specific report of viral

hepatitis surveillance data reported to CDC. This edition summarizes cases

reported during the second quarter of 2000 and covers the period of April 1,

2000 through June 30, 2000.

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

Florida: Data from Florida still suggest low levels of influenza activity (classified as sporadic). Overall, two percent of 11011 patients seeking care by reporting physicians in the influenza sentinel surveillance network met the case definition for ILI during week 1. Influenza-like illness activity was detected in 16 of the 19 counties represented in this week’s data set. Higher flu activity than expected for this time of year (>3%) was reported by physicians in Leon, Pasco, Polk, and Seminole counties. Seventeen isolates of influenza were recovered in the state this week: influenza A (H1N1) was isolated from patients in Duval (3), Leon (2) and Orange (1) counties and flu B from patients in Duval(1), Leon(5), Orange(1), Indian River(2), Palm Beach(1) and Seminole(1) counties. Since October 1, 64 influenza isolations have been reported to the state health office: 28 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 26 influenza B isolates from Brevard, Broward, Duval, Hillsborough, Indian River, Leon, Orange, Palm Beach 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: Influenza A still appear to predominating influenza strain circulating in the United States. Most (96%) of the 336 (38% of all) influenza A isolates that have been typed as flu A H1N1. Fourteen isolates of A (H3N2) have also been identified nationwide. Influenza B viruses make up 26% of all influenza isolations this far and have predominated in the Mid-Atlantic (New York, Pennsylvania and New Jersey), East South Central (Alabama, Kentucky, Mississippi and Tennessee) and Pacific regions.

Of the 78 virus strains that have been antigenically characterized at CDC, all but three have been antigenically similar to the vaccine strains. Three A (H1N1) were similar to A/Bayern/07/95. Although this is a distinct virus, the vaccine induces production of high titers of cross-reactive antibodies to A/ Bayern-like viruses.

During week 1, the percentage of all deaths due to P&I as reported by the vital statistics offices of 122 U.S. cities was 7.5%, which is below the epidemic threshold of 8.5%

Two percent of patient visits to U.S. sentinel physicians were due to influenza-like illness (ILI). The percentage of patient visits for ILI was above baseline levels (3%) in the Pacific and West South Central regions.

Savita Kumar, MD. MSPH Epidemiologist, Division of Epidemiology & Disease Control, Mario Jacomino, MD., MPH Preventive Medicine Resident, Palm Beach County Health Department

11:00 AM – 12:00 PM EST

Dial-in by 11:10 AM at (850) 487-8587 or SunCom 277-8587

Abstract:

This study was designed to put into practice the recommendations from ACIP; to reduce the incidence of chicken pox in Palm Beach County by educating parents and health care providers; and to establish surveillance for varicella disease cases.

Varicella is not a nationally notifiable disease and surveillance data are limited. A live attenuated varicella virus vaccine was licensed in the United States in 1995. ACIP issued its recommendation for vaccine usage and disease interventions in 1996. The recommendations from ACIP have not been uniformly adopted in Palm Beach County. Each year many cases of Varicella occur in children in Palm Beach County. Currently there is no varicella vaccine requirement for entry to school and day care in Florida.

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 at [Melanie_Black@doh.state.fl.us] or telephone (850) 245-4444 ext. 2448 (SunCom 205-4444 ext. 2448) 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.

Future Grand Rounds Topics:

1. February 27, 2001
Recreational Water-Related Outbreaks
Roberta Hammond, PhD. Biological Administrator II, Bureau of Environmental Epidemiology

2. March 27, 2001
Arboviral Diseases
Lisa Conti, DVM, MPH, State Public Health Veterinarian