EPI UPDATE

The Department of Health has a home on the World Wide Web at http://www.doh.state.fl.us

For information on diseases and conditions of public health importance go to MyFlorida.com, click on Health and Human Services, then Consumers--Diseases and Conditions.

Carina Blackmore, M.S. Vet. Med., Ph.D.

National report: During week 3 (January 13-19, 2002), 167 (13.9%) of 1200 specimens tested by the World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories across the United States were positive for influenza. During the past three weeks (weeks 1-3) the highest proportion of positive influenza cultures were reported from the West South Central and Mountain regions of the United States (spanning from Texas, New Mexico and Arizona in the south to Idaho and Wyoming in the north). Since September 30, a total of 25,779 specimens for influenza viruses have been tested and 1,299 (5.0%) specimens from 45 states were positive. Of the 1,299 isolates identified, 1,278 (98%) were influenza A viruses and 21 (2%) were influenza B viruses. Four hundred and seventy-seven viruses were subtyped, 469 (98%) were influenza A (H3N2) and 8 were influenza A (H1N1) viruses. So far this season, CDC has characterized 10 influenza isolates antigenically. All viruses were similar to one of the three strains in the 2001-2002 vaccine. The proportion of patient visits to sentinel physicians for influenza-like illness (ILI) overall was 2.2%, which is above the national baseline of 1.9%. The proportion of deaths attributed to pneumonia and influenza as reported by the vital statistics offices of 122 U.S. cities was 7.7% during week 3. This percentage is below the epidemic threshold of 8.1% for this time. Influenza activity was reported as widespread in Colorado, New York, Utah and Virginia, regional in Alaska, Connecticut, Kansas, Maryland, New Mexico, Oregon, Pennsylvania, South Dakota, Tennessee, Texas and Washington this week. Sporadic activity was reported from 31 states, including Florida.

Florida: Influenza activity, calculated based on the proportion of patients with influenza-like illness (ILI) seeking care by physicians participating in the Florida Sentinel Physicians Surveillance Network was 2.4% this week (3), the highest reported level of activity so far this season. Influenza-like illness activity was detected in 18 of 24 participating counties from Escambia to Monroe. Higher flu activity than expected for this time of year (>2%) was reported by physicians in Alachua, Brevard, Broward, Duval, Escambia, Leon, Monroe, Palm Beach, Polk and Seminole Counties. Two outbreaks were reported, a community outbreak among children residing in the Tampa Bay area and an outbreak in a Sarasota County long-term care facility. Fourteen cases of influenza A were laboratory confirmed this week. Influenza A (H3N2) was confirmed from Broward (2), Duval (2), Escambia (1), Indian River (2), Levy (1), Pinellas (1), Polk (1), Santa Rosa (1), and Sarasota (1) Counties and influenza A (H1N1) was recovered from a patient in Palm Beach County. Influenza A of unknown subtype was detected from patients in Hillsborough, Martin and Pinellas Counties. Between September 4 and January 31, influenza A (H3N2) was isolated from 45 patients residing in Broward, Collier, Duval, Escambia, Hillsborough, Indian River, Leon, Levy, Marion, Monroe, Palm Beach, Pinellas, Polk, Santa Rosa, Sarasota and St. John’s Counties. Influenza A (H1N1) from 2 patients in Duval and Palm Beach Counties and influenza A of unknown subtype, was diagnosed in patients in Gadsden, Martin, Pinellas, Palm Beach and Hillsborough County. Influenza B has been recovered from patients in Hillsborough (2) and Palm Beach (1) Counties. In addition, positive rapid antigen tests were reported from Duval County (1), Hillsborough (11), Palm Beach (1), Marion (8), Miami-Dade (13), Okaloosa (2) and Volusia (6) Counties.

2. HHS Announces $1.1 Billion in Funding to States for Bioterrorism Preparedness

HHS Press Office
January 31, 2002

HHS Secretary Tommy G. Thompson today sent letters to governors detailing how much each state will receive of the $1.1 billion to help them strengthen their capacity to respond to bioterrorism and other public health emergencies resulting from terrorism. The money will allow states to begin planning and building the public health systems necessary to respond.

The funds will be used to develop comprehensive bioterrorism preparedness plans, upgrade infectious disease surveillance and investigation, enhance the readiness of hospital systems to deal with large numbers of casualties, expand public health laboratory and communications capacities, and improve connectivity between hospitals, and city, local and state health departments to enhance disease reporting. The funds come from the $2.9 billion bioterrorism appropriations bill that President Bush signed into law Jan. 10.

"We're putting money in the hands of states and local communities so they can start building strong public health systems for responding to a bioterrorism attack," Secretary Thompson said. "These funds are just the start of our efforts to help states and communities build up their core public health capabilities. We must do everything we can to ensure that America's ability to deal with bioterrorism is as strong as possible."

The funding to states and communities is divided into three parts. The first portion will be provided by the Centers for Disease Control and Prevention (CDC) and is targeted to supporting bioterrorism, infectious diseases, and public health emergency preparedness activities statewide. Each state's allocation will consist of a $5 million base award, supplemented by an additional amount based on its share of the total U.S. population.

The Health Resources and Services Administration will provide the second portion of funding, which will be used by states to create regional hospital plans to respond in the event of a bioterrorism attack. Hospitals play a critical role in both identifying and responding to any potential bioterrorism attack or disease outbreak. These funds will be allocated using a formula similar to that used by the CDC.

The third portion of the funds will be provided by the HHS Office of Emergency Preparedness and will support the Metropolitan Medical Response System (MMRS). The MMRS funding will add an additional 25 new cities to those which have already received funding in past years and will mean that 80 percent of the U.S. population will be covered by an MMRS plan. MMRS contracts are especially aimed at improving local jurisdictions' ability to respond to the possible release of a chemical or biological disease agent, but also serve to improve local response to any event involving mass casualties.

States will be permitted to begin immediately spending up to 20 percent of their allotments, so as to avoid delay in starting preparedness measures. The remaining 80 percent of the $1.1 billion in state funds will be released once complete plans have been received and approved.

State plans are due to HHS by March 15, 2002, and no later than April 15, 2002. HHS will complete its review of each plan within 30 days of receipt. Each statewide plan is to lay out how it will respond to a bioterrorism event and other outbreaks of infectious disease, but also how it will strengthen core public health capacities in all relevant areas. Each statewide plan is to be reviewed and endorsed by the governor prior to submission.

"Twenty-one days after the bill was signed HHS put together a comprehensive plan to distribute over $1 billion in funding. I commend the people who accomplished this task for their hard work, dedication and more importantly for their understanding of the importance of getting the funds in the hands of governors and state and local health officials so they can begin this important work," Secretary Thompson concluded.

A table showing state-by-state funding levels is available at www.hhs.gov/news/press/2002pres/states.html

A table showing MMRS funding levels is available at www.hhs.gov/news/press/2002pres/mmrs.html

The criteria for states to consider in developing their plans

Submitted by Affette McIntosh

A one week, hospital-based course to familiarize the clinician with all aspect of TB infection, disease and patient care using an interdisciplinary approach will be given at AG Holley, March 4-8. Upon successful completion of the course, participants will:

1. Understand current guidelines for the diagnosis, treatment and prevention of tuberculosis, including specialties of MDR-TB, pediatric TB, surgical intervention of TB and TB-HIV co-infection.

2. Become familiar with resources available on the local, state and national level to assist with patient management and TB prevention efforts.

3. Identify populations at high risk for TB infection and disease, and strategies to target these populations.

Full document and Registration form.

Submitted by Janet Baggett

The Women and Heart Disease Website can be used by both health care professionals and private individuals. The site provides a complete overview of the 2000 Florida Legislation SB 352 regarding the requirements of the Women and Heart Disease Task Force; an Interim and Final Report to the Governor on the findings of the task force, a list of the members who serve on the task force, educational materials, national guidelines regarding heart disease, research and grant information, links to other heart disease related sites and a risk assessment instrument that may be printed and used to help women and their physicians establish their risk for heart disease.

Attached are the direct web site addresses for the Women and Heart Disease Website.

http://www.doh.state.fl.us/family/taskforce/index.html

http://www9.myflorida.com/family/taskforce/index.html

* The column of data representing the "3-year average to week ##" is the average of years 1999, 2000 and 2001 cases to the current listed week (##).