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.

After a (85%) successful implementation of the first round of the Merlin system, we have completed planning for the adjustments, enhancements and additions for 2001. Our decisions are based on considerable input from the county health departments, deliberations of our own staff members and some systems requirements. (Oh and yes, the availability of financial resources.) Our colleagues and ourselves think that the potential for Merlin’s usefulness is so great that we will be able to accomplish ( this year) only about 25% of what we would like. However, in the coming year, you can look forward to seeing:

A series of "canned reports:" Several counties have given us examples of reports

that they produce regularly. We are already developing report templates.

Case definition screens: Merlin currently has a case definition/diagnosis feature for hepatitis. We will be soon adding others.

Extended data screens: Again, this is a feature only available for hepatitis. We will soon be adding extended data (CRF) data for other diseases. We are nearly finished with extended data screens for chronic hepatitis.

Merlin export: Members of the team are currently working on: (1) loading all old 2016 data into the Merlin database, and (2) developing an export function that will enable users to easily download Merlin data into other software (Excel, Epi-Info) for analysis.

Laboratory connection: We are in the planning phase of developing a link to a Bureau of Laboratory’s database to enable the daily downloading of positive laboratory results directly into Merlin.

In addition to our scheduled new development, we are working to resolve issues outstanding from last year; we have about 30 key change control issues to consider and need to improve the query/line list function. This promises to be an exciting and rewarding year for Merlin.

The Date Reported is the date the case was reported to you at the local CHD. Along with the Date Reported you have two fields: Reporter Type and Reporter. These two fields are for your use to track how you came to know about the case, laboratory, physician, or individual. In the text field for Reporter you can put the person’s name or contact at the laboratory or hospital that reported the case to you.

I know I reported cases this week but I can’t find them when I use the weekly report.

Remember that cases you are reporting in 2001 that have event dates in 2000 will get put into reporting week 52 of 2000. Run another weekly report for week 52 of 2000 for your county.

Lab results that were previously faxed to your CHD are now being put into Merlin for you and will appear on your Lab Result Task List. These labs may not need follow-up and can be closed by clicking on the hyperlinked OPEN in the status column. Lab results that end up as cases of morbidity can be attached to the completed case data after selecting the case and clicking Case Related Lab. Paper copies are kept here in the Bureau of Epidemiology and you can always request a fax copy if necessary or print out the lab record directly from Merlin.

The Department of Health, Bureau of Immunization, in conjunction with the Office of Performance Improvement, is making available the Epidemiology and Prevention of Vaccine-Preventable Diseases (VPD) teleconference through the Department of Health Telnet Videoconference Sites. This live, interactive satellite broadcast will provide the most current information available in the constantly changing field of immunization. The four-session course will be aired from 12:00 noon to 3:30 p.m. (EST) on March 15, March 22, March 29 and April 5, 2001.

The Centers for Disease Control and Prevention (CDC) will offer continuing education credits for a variety of professions (excluding pharmacy credits) based on 14 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.

For the name and telephone number of the site coordinator in your area, please call Linda Zeigler of the Bureau of Immunization at (850) 245-4342 or SunCom 205-4342.

(Week ending January 20, 2001-Week 3)

Florida: Florida is one of 19 states still reporting low levels of influenza activity. Overall, two percent of 13,676 patients seeking care by reporting physicians in the influenza sentinel surveillance met the case definition for ILI during week 3. Influenza-like illness activity was detected statewide from Escambia to Miami Dade. Higher flu activity than expected for this time of year (>3%) was reported by physicians in Duval and Seminole counties. More than 10 percent of patients seen by sentinels in Orange and Leon counties were diagnosed with ILI. Ten isolates of influenza were recovered in the state this week: influenza A (H1N1) was isolated from patients in Hillsborough (1), Indian River (1), Nassau (1) and Polk (1) counties and flu B from patients in Charlotte (1), Duval (3), Hillsborough (1) and Seminole (1) counties. An adenovirus isolation was also reported this week from a patient in Hillsborough County. Since October 1, 85 influenza isolations have been reported to the state health office: 34 influenza A (H1N1) isolates from Broward, Charlotte, Dade, Duval, Escambia, Indian River, Lake, Leon, Nassau, Orange and Polk counties, one influenza A (H3N2) from Duval county, 10 untyped influenza A isolates from Alachua, Clay, Columbia, Hillsborough, Orange, Palm Beach and Pinellas counties) and 40 influenza B isolates from Brevard, Broward, Charlotte, Clay, Duval, Hillsborough, Indian River, Leon, Levy, Orange, Palm Beach, Polk, Santa Rosa, Seminole and Volusia counties.

National report: Influenza activity is increasing nationwide. Twelve state and territorial health departments reported widespread and 18 states reported regional activity during week 3. Influenza isolates were recovered from twenty-two percent of the 1772 specimens tested by WHO and NREVSS laboratories. Seventy six percent of the isolates were flu A predominating (65-88% of all isolates) during the last three weeks in the East North Central, Mountain, New England, South Atlantic, West North Central and West South Central regions. Influenza B has predominated in the Mid-Atlantic (New York, Pennsylvania and New Jersey) and Pacific regions and approximately equal numbers of influenza A and influenza B has been reported from the East South Central (Alabama, Kentucky, Mississippi and Tennessee) region.

Of the 153 virus strains that have been antigenically characterized at CDC, all but eight have been antigenically similar to the vaccine strains. Eight A (H1N1) (7%) 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 3, the percentage of all deaths due to P&I as reported by the vital statistics offices of 122 U.S. cities was 7.9%, which is below the epidemic threshold of 8.6%

Three 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 Mountain, Pacific and West South Central regions.