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.

In this issue:

1. National Diabetes Alert Month
2. Florida Public Health Association Regional Meeting
3. Colorectal Cancer Awareness Month
4. Influenza Surveillance Report
5. Weekly Disease Table

April Crowley, Office of Communications
Press Release
March 4, 2002

TALLAHASSEE—The Florida Department of Health’s (DOH) Diabetes Control Program is observing "National Diabetes Alert Month," an awareness program sponsored by the American Diabetes Association (ADA). The purpose is to alert citizens about the risks associated with diabetes, in addition to the warning signs and symptoms. Diabetes is a chronic metabolic disease in which the body does not produce or properly use insulin, a hormone that is needed to convert sugar, starches and other foods into energy.

In the United States, an estimated 15.7 million persons have diabetes. Nearly 1,000,000 Floridians have been diagnosed with diabetes and another 300,000 not yet diagnosed. It is estimated that almost four million people in Florida are at risk for diabetes because of age, weight and lack of physical activity.

In Florida, diabetes is the seventh leading cause of death with approximately 9,000 Floridians dying each year as a result of complications with this disease. Diabetes can cause serious health complications, including heart disease, blindness, kidney failure and lower-extremity amputations. In Florida, about 1,000 new cases of blindness, over 1,000 new cases of end-stage renal disease and 4,000 lower extremity amputations occur each year among persons with diabetes.

The goal of the Diabetes Control Program is to reduce the burden of diabetes and the health-related complications among all Floridians. The efforts will include community education; improving the access to, and quality of, diabetes care; and self-management for those who have already been diagnosed. Managing diabetes means eating the right foods, getting regular physical activity, monitoring blood sugar and taking prescribed medications. Family members are often involved in these lifestyle changes and can provide effective emotional and practical support for their loved ones with diabetes.

For more information about diabetes, visit the Department of Health’s website at http://www.doh.state.fl.us and choose Diabetes Control Program under the subject area. To take a risk assessment test, go to the ADA website at www.diabetes.org.

Second Annual Meeting, March 22, 2002, St. Augustine, Florida

"Preparing Northeast Florida Communities for the Latest Challenges in Healthcare"

The goal of this meeting is to provide an opportunity for health professionals and community leaders to:

1. Increase participants’ understanding of access to care issues and possible solutions to improve the communities’ ability to provide healthcare to all citizens.
2. Learn about the effects of bioterrorism and how the state and local communities are preparing for a possible bioterrorist threat.

At the end of the program, the participant will be able to:

1. Describe the socio-cultural, economic, political, and environmental factors that impact access to timely and appropriate healthcare.
2. Discuss how to empower citizens in organizing delivery of healthcare services in their communities, which helps eliminate access to healthcare problems.
3. Identify national, state and local "best practice" initiatives that have been effective in increasing access to healthcare.
4. Recognize the early signs of a bioterrorist attack and how to respond appropriately to such an event.
5. Describe the role of public health, law enforcement and healthcare providers in early detection and treatment of a biological agent released in the community.

Program Agenda

April Crowley, Office of Communications
Press Release
March 6, 2002

TALLAHASSEE— March is National Colorectal Cancer Awareness Month. The Florida Department of Health (DOH) is committed to promoting awareness of this potentially deadly disease, and encourages all men and women ages 50 and over to have annual screenings for colorectal cancer.

"When discovered early, the disease is curable in up to 90 percent of cases," said DOH Secretary Dr. John O. Agwunobi. He added: "It is estimated that approximately 30,000 lives a year could be saved through colorectal cancer screening in men and women."

Colorectal cancer, cancer of the colon or rectum, is the second leading cause of cancer-related deaths in the United States for men and women combined. The disease surpasses both breast and prostate cancer in mortality, and is second only to lung cancer in number of cancer deaths. Through screening and early treatment, colorectal cancer can be detected early and treated while it is still curable. An unwillingness to discuss it, or act on screening options, causes unnecessary deaths. Approximately 135,400 new cases of colorectal cancer will be diagnosed this year, and 56,700 people will die from it in the United States.

Although generally perceived as a "male disease," colorectal cancer is almost equally prevalent in men and women. Generally, anyone over the age of 50 is considered at average risk. High-risk groups include those with either a personal or a family history of colorectal neoplasia (cancer or polyps), and those with an inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease.

DOH recommends that all men and women talk with their health care provider about colorectal cancer and colorectal cancer screening tests. It is also important to know your family medical history, as colorectal cancer can be hereditary.

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

National report: During week 8 (February 17-February 23, 2002), 752 (25.9%) of 2,902 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 6-8) the highest proportion of positive influenza cultures (30-36%) were reported from the New England, East North Central, South Atlantic and West South Central region of the United States. Since September 30, a total of 55,876 specimens for influenza viruses have been tested and 7,499 (13.4%) specimens from 50 states were positive. Of the 7,499 isolates identified, 7,402 (99%) were influenza A viruses and 97 (1%) were influenza B viruses. Two thousand one hundred and eighty-eight (30%) of the influenza A viruses were subtyped, 2,162 (99%) were H3 viruses and 26 were H1 viruses. So far this season, CDC has characterized 258 influenza A viruses antigenically. All viruses were similar to the flu A strains in the 2001-2002 vaccine. Influenza B viruses can currently be divided into 2 antigenically distinct lineages, B/Yamagata/16/88 and B/Victoria/2/87. The B component of the current influenza vaccine belongs to the B/Yamagata lineage and is expected to provide lower levels of protection against viruses of the B/Victoria lineage. At this time, 4 of the 28 influenza B viruses CDC has characterized were the B/Victoria strain. In the United States B/ Victoria has been identified in Hawaii, Maryland, New Jersey and New York, but the strain has also been detected in Asia, Canada and Europe. A final decision has not yet been made in the United States regarding the influenza B component of the 2002-03 vaccine. The proportion of patient visits to sentinel physicians for influenza-like illness (ILI) overall was 3.5%, 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 8.1% during week 8. This percentage is below the epidemic threshold of 8.3% for this time. Influenza activity was reported as widespread in 14 states (Arizona, Colorado, Minnesota, Missouri, Nebraska, New Hampshire, New York, Pennsylvania, South Dakota, Tennessee, Texas, Utah, Virginia and Washington), regional in 24 states (Arkansas, California, Connecticut, Delaware, Georgia, Idaho, Indiana, Iowa, Kansas, Louisiana, Maryland, Massachusetts, Michigan, Mississippi, Montana, Nevada, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, Vermont and Wyoming) this week. Sporadic activity was reported from 11 states.

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 1.4% this week. The activity appears to be declining reaching a peak (2.7%) in mid-January (week 4). Influenza-like illness activity was detected in 17 of 23 participating counties from Escambia to Monroe. Higher flu activity than expected for this time of year (>2%) was reported by physicians in Duval, Lee, Leon, Monroe, Polk, Santa Rosa and Seminole Counties. Sixteen cases of influenza were laboratory confirmed this week. Influenza A (H3N2) was confirmed from Leon (1) County. Influenza A of unknown subtype was detected from patients in Hillsborough, Miami-Dade and Orange Counties. Positive rapid antigen tests were reported from Hillsborough County. Between September 4 and Mar 8, influenza A (H3N2) was isolated from 118 patients residing in Broward, Collier, Duval, Escambia, Hillsborough, Indian River, Lake, Leon, Levy, Marion, Monroe, Osceola, 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 Broward, Gadsden, Lee, Martin, Orange, Pinellas, Palm Beach and Hillsborough County. Influenza B has been recovered from patients in Broward (1), Hillsborough (2) and Palm Beach (2) Counties. In addition, positive rapid antigen tests were reported from Duval County, Escambia, Hillsborough, Palm Beach, Lee, Marion, Miami-Dade, Okaloosa, Pinellas and Volusia Counties.

* 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 (##).