A Publication by the Bureau of Epidemiology
May 31, 2002
"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.
Steven T. Wiersma, MD, MPH—Bureau Chief and State Epidemiologist
Don Ward, Deputy Bureau Chief (Management), Epi Update Managing Editor
Catie Richards, Editorial Assistant
Bureau of Epidemiology Frequent Contributors:
Kathryn S. Teates, MPH
Surveillance Section Administrator
Jodi Baldy, MPH,
Biological Scientist IV
Lisa Conti, DVM, MPH,
State Public Health Veterinarian
Dolly Katz, PhD, MPH, SE Florida
Roger Sanderson, RN, MA, SW Florida
Carina Blackmore, MS Vet. Med., PhD, NE Florida
Zuber Mulla, PhD MSPH,
Central Florida Carina Blackmore, MS Vet. Med., PhD,
Please print out this material and share with epidemiology staff, county health department directors, administrators, medical directors, nursing directors, environmental health directors and others with an interest in information of this type. Thank you.
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 Department of Health has a home on the World Wide Web athttp://www.doh.state.fl.us
For information on diseases and conditions of public health importance go toMyFlorida.com, click on Health and Human Services, then Consumers--Diseases and Conditions.
In this issue:
Official CDC Health Update
*No weekly disease table is included because of technical difficulties
1. Official CDC Health Update
Distributed via Health Alert Network
May 30, 2002, 14:27 EDT (02:27 PM EDT)
The Centers for Disease Control and Prevention (CDC) is hosting four public forums to provide health professionals and the general public with information about smallpox and smallpox vaccine, and to solicit comments on the use of smallpox vaccine before and after a potential smallpox outbreak or bioterrorist attack.
Who: Centers for Disease Control and Prevention
What: Public Forums on the use of smallpox vaccine
Thursday, June 6, 2002
New York, New York
Mt. Sinai Hospital
One Gustave L. Levy Place
8:00 AM - 5 PM Eastern Time
San Francisco, California
San Francisco Marriott Downtown
55 Fourth Street
8:00 AM - 5 PM Pacific Time
Saturday, June 8, 2002
St. Louis, Missouri
Renaissance Airport Hotel
9801 Natural Bridge Road
8:00 AM - 5 PM Central Time
Tuesday, June 11, 2002
San Antonio, Texas
Henry B. Gonzalez Convention Center
200 East Market Street
8:00 AM - 5 PM Central Time
Why: CDC and the Department of Health and Human Services (DHHS) have asked the Advisory Committee on Immunization Practices (ACIP) and the National Vaccine Advisory Committee (NVAC) to review the current U.S. smallpox vaccine recommendations. These two groups advise the CDC and DHHS on vaccine use and policies. The ACIP-NVAC Smallpox Working Group met on May 8-9, 2002 in Atlanta to discuss this issue, and plans to provide an updated set of smallpox vaccine recommendations to the CDC and DHHS by June 20. After these forums, the National Academy of Science will hold a scientific forum on June 15 in Washington, DC to obtain input from scientists, clinicians, and others about the options for smallpox vaccine use. The ACIP will then meet in Atlanta on June 19-20 to formulate recommendations to be presented to the Secretary, Health and Human Services. The ACIP meeting will also allow for approximately 4 hours of public comment.
Background: The last natural case of smallpox occurred in 1977. The ACIP currently recommends that only scientists and laboratory personnel who work with viruses related to smallpox be vaccinated with smallpox vaccine. The ACIP does not currently recommend that any other people, including members of the general public, be vaccinated prior to a confirmed case of smallpox. By the end of this year or early 2003, DHHS expects to have a stockpile of 286 million doses of smallpox vaccine-enough to protect every United States citizen, if needed.
The ACIP-NVAC Smallpox Working Group review primarily involves three questions:
1. With no known cases of smallpox worldwide, should there be any change in the current recommendation for not vaccinating members of the general public before there is a confirmed smallpox case or a confirmed bioterrorism attack using smallpox?
2. In addition to laboratory workers who work with viruses related to smallpox, are there other individuals in specific occupational groups who should be vaccinated to enhance smallpox preparedness? If so, what guidelines should be used to determine which individuals should be vaccinated before there is a confirmed smallpox case or a confirmed bioterrorism attack using smallpox?
3. Should there be any change(s) in the recommendation that surveillance and containment ("ring vaccination") be the primary control and containment strategy in the event of a confirmed smallpox case or a confirmed bioterrorism attack using smallpox?
For more information about smallpox visit http://www.cdc.gov/
For public inquiries about smallpox call:
* English - 888 246 2675
* Espanol - 888 246 2857
* TTY - 866 874 2646
You can submit comments about smallpox vaccine recommendations online at <http://www.cdc.gov> or submit your comments in writing to ACIP-NVAC Smallpox Working Group, Centers for Disease Control and Prevention, MS E-05, 1600 Clifton Road, NE Atlanta, GA 30333
Categories of Health Alert messages:
Health Alert: conveys the highest level of importance; warrants immediate action or attention.
Health Advisory: provides important information for a specific incident or situation; may not require immediate action.
Health Update: provides updated information regarding an incident or situation; no immediate action necessary.
2. Bioterrorism Authorization Legislation As Passed by the House and Sent to the Senate
Submitted by Tom Liberti, Chief, Bureau of HIV/AIDS
(from information provided by NASTAD)
Attached is a .pdf file containing the full text (271 pages) of the "Public Health Security and Bioterrorism Preparedness and Response Act of 2002" as passed by the House of Representatives yesterday (May22-ed.) by a vote of 425-1.
This is the long awaited evolution of the Frist/Kennedy Bioterrorism authorization bill - that now includes a number of other major provisions including food and drug safety, antimicrobial resistance programs, the national stockpile, an authorization for new buildings and facilities at CDC, and the creation of a new position of Assistant Secretary for Public Health Emergency Preparedness at HHS, among others. The bill will be considered, and likely passed, by the Senate
immediately after the Memorial Day recess. The full text of the Statement of Managers on the Conference Report (the section by section explanation of what is contained in the final bill) can be found at http://energycommerce.house.gov/107/pubs/conference3448.htm
3. Arboviral Activity Summary through the Week Ending May 24, 2002
Lisa Conti, DVM, MPH, State Public Health Veterinarian and Robin Oliveri, Arbovirus Surveillance Coordinator
There are currently no Arbovirus Medical Alerts issued for the state. During the period May 18 through May 24, 2002, the following arbovirus activity (St. Louis encephalitis [SLE] virus, eastern equine encephalomyelitis [EEE] virus, West Nile [WN] virus and dengue virus) was recorded for Florida:
Human: No new arbovirus cases were reported to the State Health Office.
Sentinel Chickens: One EEE seroconversion was confirmed in Flagler County. 577 samples tested; 18 counties submitting sentinel specimens.
Equine*: One horse was reported with EEE in Osceola County and one in Marion County.
Bird Mortality: No new birds were reported with WN this week. 66 dead birds were reported, of which 6 (9.09%) were crows and 17 (25.75%) were jays. Cumulatively, 2,421 reports have been made for 3,534 dead birds, 613 were tested.
To report dead birds use http://wld.fwc.state.fl.us/bird or call toll free 1-800-871-9703.
NOTE: Online bird identification: http://www.mbr-pwrc.usgs.gov/id/framlst/framlst.html or http://data.acnatsci.org/ornithology/vireo.php
Mosquito Pools: No positive mosquito pools were identified. Cumulatively, 530 mosquito pools have been submitted for testing.
Florida is currently at "Level 1" in the Arbovirus Response Plan (see http://www9.myflorida.com/disease_ctrl/epi/htopics/arbo/index.htm). To assure data dissemination in this second year of West Nile virus actvity, weekly Friday afternoon Arbovirus Conference Calls were begun on May 17, 2002. Media releases were issued to date on local arboviral actvity in Dade, Duval, Osceola, Polk and St. Johns counties.
2002 Cumulative Arbovirus Activity by County
(Note: 1 sentinel was removed from Walton because its first serologic evidence of WN was during late 2001. )
One confirmed case (Miami-Dade) and 4 probable cases have been reported (Miami-Dade, Hillsborough, Osceola, Palm Beach). All cases were acquired outside of the United States.
No positive pools
For more information please see the DOH website at http://www.doh.state.fl.us/disease_ctrl/epi/htopics/arbo/index.htm
Acknowledgements/data sources: county health departments, Department of Health Laboratories, Department of Agriculture and Consumer Services, mosquito control agencies, Florida Fish and Wildlife Conservation Commission, medical providers and veterinarians.