A Publication by the Bureau of Epidemiology
June 28, 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 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:
*No Weekly Disease Table due to technical difficulties
1. PRESS RELEASE FOR IMMEDIATE DISTRIBUTION: Health Oficials Report Meningitis in Gainesville,FL Resident
Alachua County Health officials, working with Shands at Alachua General Hospital, have confirmed a case of meningitis caused by the bacteria Streptococcus pneumoniae. The Gainesville, FL resident was admitted through Shands at AGH Emergency Department with mental status changes and confusion, and passed away on 6-19-02.
The general public is not at an increased risk of contracting S. pneumoniae meningitis. The germ is spread by direct contact with secretions from the nose and throat, or by kissing, coughing, sneezing and sharing of cigarettes, drinks and food. S. pneumoniae can present with the following symptoms: high fever, stiff neck, headache, and may develop in several hours or 1-2 days. Health officials stress S. pneumoniae meningitis should not be confused with Neisseria meningitis or Haemophilus influenzae meningitis, both of which have greater epidemic potential. All the contacts at risk have been notified. In the past year Alachua County has had no confirmed cases of S. pneumoniae meningitis while the State of Florida has had 32 cases. For people who contract S. pneumoniae meningitis the death rate is about 20%.
Please contact Tom Belcuore or Jean Munden, Health Department, at 334-7901 for further information.
2. Broward County Health Department Investigating One Case of Hepatitis A
For Immediate Release
June 25, 2002
Media Inquiries Contact:
Broward County Health Department
James Cresanta, M.D.
Broward County Health Department Investigating One Case of Hepatitis A
Ft. Lauderdale --The Broward County Health Department announced today a food service worker employed at Hard Rock Cafe Restaurant, located at Sawgrass Mills Mall in Sunrise, has been diagnosed with Hepatitis A.
Although the risk to restaurant patrons is low, as a precautionary measure, the Broward County Health Department is recommending immune globulin for Hard Rock patrons who dined at the restaurant between Friday, June 14 and Wednesday, June 19, 2002. Immune globulin provides temporary protection against Hepatitis A infection when given within 14 days of exposure. Therefore, the shot must be taken within 14 days of dining.
Health department staff will be available Monday through Friday, 8:00 a.m. to 5:00 p.m., to answer questions and determine if you should receive a shot of immune globulin (IG). Please call the following numbers for information: 954-467-5991; 954-468-2724; 954-759-5456; or 954-467-4756. Special clinic hours have been set up at the Broward County Health Department's Fort Lauderdale Health Center (2421 SW 6 Avenue) and Sunrise Health Center (900 NW 31 Avenue) from Thursday, June 27 through Tuesday, July 2, 8:00 a.m. – 4:00 p.m. In addition, the Ft. Lauderdale Health Center will be open on Saturday, June 29, 2002, 9:00 a.m. – 2:00 p.m.
Hepatitis A is a disease of the liver that can affect anyone. The disease is often a mild illness lasting one to two weeks, but in rare cases can be a severely disabling disease lasting several months. Symptoms include abdominal pain, loss of appetite, fatigue, nausea, diarrhea, fever and jaundice (yellowing of eyes or skin). It is extremely important that individuals consult with their physician if they experience symptoms of Hepatitis A.
Most Hepatitis A infections result from contact with a household member or sex partner who has Hepatitis A. Casual contact, as in the usual office, factory, or school setting, does not spread the virus. People most at risk for Hepatitis A include travelers, men who have sex with men, users of injecting and non-injecting drugs, persons who have clotting-factor disorders, persons working with nonhuman primates, and persons with chronic liver disease. Health officials stress that people at increased risk get vaccinated, and that the public practice good hand washing with soap and water after using the bathroom, changing a diaper, and before preparing or eating food.
Additional information on Hepatitis A is available on the Broward County Health Department website www.browardchd.org (look under Hot Topics).
Hepatitis A Fact Sheet
3. Arboviral Activity Summary through the Week Ending June 21, 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 June 15 through June 21, 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 human cases were reported to the Bureau of Epidemiology this week.
Sentinel Chickens: Two EEE and three WN seroconversions were confirmed in Volusia County. Two WN seroconversins were confirmed in Pinellas County. 612 samples tested; 20 counties submitting sentinel specimens.
Equine*: Two horses in Holmes County and one donkey in Hillsborough County were reported with EEE.
Bird Mortality: No new birds were reported with WN this week. 53 dead birds were reported, of which 10 (18.86%) were crows and 2 (3.77%) were jays. Cumulatively, 2,654 reports have been made for 3,861 dead birds, 750 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, 544 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, Highlands, Marion, Osceola, Pinellas, Polk, St. Johns and Volusia counties.
2002 Cumulative Arbovirus Activity by CountyAnimal Surveillance
West Nile Virus state totals: 5 dead birds, 11 sentinel birds and 7 horses*. Date of disease onset (horses, people), death (birds) or first bleed (sentinels) shown in parentheses.
Eastern Equine Encephalomyelitis virus state totals: 42 sentinel chickens, 12 horses.* Date of disease onset (horses, people), death (birds) or first bleed (sentinels) shown in parentheses.
- Alachua: 1 dead bird (1 hawk 1/29)
- Duval: 1 horse (4/11)
- Liberty: 1 dead bird (1 wild turkey 1/10)
- Marion: 4 horses (1/5, 1/15, 1/21, 2/7)
- Miami Dade: 1 horse (3/23)
- Palm Beach: 1 sentinel chicken (3/4), 1 dead bird (1 peacock 3/20)
- Pinellas: 3 sentinel chicken (6/3, 6/10, 6/10)
- Polk: 1 horse (2/7)
- Putnam: 2 dead birds (crow 4/8, 4/24)
- Volusia: 5 sentinel chickens (1/28, 5/27, 5/27, 5/27, 5/27)
- Walton: 2 sentinel chickens (1/7, 3/25)
- Charlotte: 1 horse (5/14)
- Flagler: 3 sentinel chickens (5/1, 5/8, 5/15)
- Hillsborough: 5 sentinel chickens (3/18, 3/25, 4/8, 5/20), 1 horse (6/10)
- Holmes: 2 horses (6/3, 6/10)
- Lake: 1 horse (3/25)
- Lee: 1 horse (4/7)
- Marion: 1 horse (5/13)
- Orange: 15 sentinel chickens (1/2, 1/2, 1/10, 2/28, 3/4, 3/7, 3/8, 3/8, 3/21, 3/26, 3/28, 3/28, 4/16, 4/23, 5/28)
- Osceola: 1 horse (4/23)
- Pinellas: 1 sentinel chicken (3/4)
- Polk: 2 horses (2/20, 3/25)
- Seminole: 3 sentinel chickens (1/4, 1/4, 1/4)
- St. Johns: 1 horse (4/14)
- Volusia: 9 sentinel chickens (1/7, 1/7, 1/7, 1/7, 2/26, 4/2, 4/2, 6/10, 6/10); 1 horse (4/25)
- Walton: 6 sentinel chickens (1/7, 1/14, 3/4, 3/4, 4/6, 4/22)
Eastern Equine Encephalomyelitis
One confirmed case with diease onset of 6/3 (Highlands) has been reported to the State Health Office.
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.
Disclaimer: Please note that numbers are subject to change with confirmatory information