|
Carina
Blackmore, M.S. Vet. Med., Ph.D.
Carina
Blackmore, M.S. Vet. Med., Ph.D.
Caroline
Collins,
Arbovirus Surveillance Coordinator
Lisa Conti, DVM, MPH
State Public Health Veterinarian
and D’Juan Harris,
GIS Coordinator
Disclaimer:
Please note that
numbers are subject
to change with
confirmatory information.
To
report dead birds use:
http://wildflorida.org/bird/
http://wld.fwc.state.fl.us/bird/
or call toll free 1-800-871-9703
The
Disease Outbreak Information Hotline offers updates on medical alert status
and surveillance at 888-880-5782.
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►
Norovirus
Outbreaks Reported Statewide
Recent
reports to the Bureau of Epidemiology indicate widespread activity of
Noroviruses (previously called Norwalk-like viruses and winter-vomiting
disease) in Florida. Noroviruses usually cause a self-limiting illness
with acute-onset vomiting, watery non-bloody diarrhea with abdominal
cramps and nausea.
The viruses are transmitted primarily through the fecal-oral route,
either by consumption of fecally contaminated food or water or by direct
person-to-person spread. Aerosol transmission of virus particles in
vomitus is also possible.
Noroviruses are extremely contagious.
Food-borne outbreaks are common, and the viruses can spread very
quickly in institutional settings.
The Bureau of Epidemiology reports suggest that we currently have
multiple outbreaks with high attack rates in nursing homes and schools
across the state including outbreaks in Brevard, Charlotte, Columbia,
Duval, Flagler, Hillsborough, Jackson, Lee, Nassau, Okaloosa, Osceola,
Pinellas, Polk, Sarasota and Volusia counties.
Diagnosis
Testing for Noroviruses is available at Bureau of Laboratories, Tampa.
Please see attached word document for sampling instructions. Make sure to
notify Dr Stark’s lab (813-974-8000 or sc 574-8000) before shipping.
Norovirus testing is done by PCR so turnaround time is usually very quick
(2-3 d).
Outbreak management
Outbreaks in nursing homes and other health care facilities should be
taken seriously. Although the disease normally is mild, dehydration, a
common complication in elderly, may require hospitalization and can even
be fatal. Outbreak control measures in nursing homes and other health care
facilities need to be aggressive and must be implemented quickly to be
successful.
The most important prevention method is good hand washing. Further
guidelines on infection control measures can be found in MMWR
Recommendations and Reports on Norwalk-Like Viruses (MMWR 2001; 50: RR9, http://www.cdc.gov/ncidod/dvrd/revb/gastro/rr5009.pdf).
You also want to consider notifying other health care facilities
about confirmed norovirus outbreaks in your community.
Reporting
Please report suspect Norovirus outbreaks in your community to the
Bureau of Epidemiology.
We are also more than happy to assist you in any way with your
outbreak investigation and outbreak control efforts.
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►
Influenza Virus Surveillance Summary Update
Week
ending January 25, 2003-Week 4
Florida: During week 4 (January
19-25, 2003) 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% which is slightly higher than the national baseline of 1.9%. An
influenza outbreak was reported from Indian River County this week.
Cultures are underway. Higher flu activity than expected for this time of
year (>2%) was also reported by physicians in Broward, Leon, Monroe,
Okaloosa, Orange and Polk counties. Positive rapid tests were reported
from Miami-Dade and Pinellas counties. During the last 4 weeks influenza A
(H1N1) viruses were also detected in Collier, Indian River, Lake, Leon,
Palm Beach, Polk, Seminole and Volusia counties and influenza B in
Hillsborough, Indian River, Okaloosa, Santa Rosa, Sarasota and St.
John’s counties. Since December 15 reports of influenza A of unknown
subtype have come from Alachua, Brevard, Duval, Lee and Orange counties
and positive rapid tests from Alachua, Duval, Indian River, Miami-Dade,
Pasco and Pinellas counties.
National report: One hundred
forty eight isolates (83 influenza A and 65 influenza B viruses)
were made from 1,475 specimens tested by the World Health Organization
(WHO) and National Respiratory and Enteric Virus Surveillance System
(NREVSS) collaborating laboratories this week. Since September
29, 3.5% (n=1,195) of the 33,901 specimens tested nationwide have been
positive. One hundred and thirty-six (36%) of the 375 influenza A viruses
have been sub typed; 116 were influenza A H1 viruses and 20 were influenza
A (H3N2). Influenza A and influenza B viruses have been identified in 29
states. The majority of influenza B isolates (70%; n=820) were identified
in Texas and Missouri. Ten states (Connecticut, Hawaii, Idaho, Michigan,
New Jersey, Ohio, Oregon, Tennessee, Utah and Wyoming) have reported only
influenza A viruses, and 5 states (Alaska, Arkansas, Kansas, Kentucky and
Nevada) have reported only influenza B viruses. CDC has characterized 11
influenza A (H1N1), 1 influenza A (H1N2), 18 influenza A (H3N2) and 47
influenza B isolates antigenically. All strains were similar to
corresponding vaccine strains. The proportion of patient visits to
sentinel physicians for influenza-like illness (ILI) was 2.6% nationwide.
The State and Territorial Epidemiologists in Missouri, Texas and Virginia
reported widespread influenza activity. Flu outbreaks were reported in 14
additional states (Alabama, Arkansas, Colorado, Delaware, Georgia, Kansas,
Mississippi, Nebraska, New York, Oklahoma, South Dakota, Tennessee,
Virginia and Utah). Sporadic influenza activity was reported from 32
states. The proportion of deaths attributed to pneumonia and influenza as
reported by the vital statistics offices of 122 U.S. cities was 7.3%
during week 4. This percentage is below the epidemic threshold of 8.2% for
this time.
For additional information on influenza and influenza surveillance
results, please visit our website at: http://www.doh.state.fl.us/disease_ctrl/epi/htopics/flu/index.htm
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►
Arboviral Activity Summary Week Ending
February
3, 2003
During the period of January 28, 2003 through February 3,
2003, 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 cases of arboviral
meningo-encephalitis were reported this week.
Sentinel Chickens:
Four WN seroconversions were
confirmed in Charlotte (1), Lee (2) and Pinellas (1)
counties. One
of the positive Lee specimens was collected in 2003, the remainder
represent 2002 activity.
This week, 391 samples were tested from 10 counties.
Equine*: No new cases of
equine arboviral infection were reported this week.
Bird Mortality: No
dead birds tested positive for arbovirus this week.
In 2002, 3,370 birds were tested and an additional 400+ were
too decomposed to be tested. Last
year, 9,993 bird reports were logged representing 11,680 dead birds; 1,230
(11%) were crows; 1,353 (12%) were blue jays and 320 (3%) were raptors.
Thus far in 2003, 279 reports have been logged representing 471
dead birds; of these, 168 were tested and results were negative.
Mosquito Pools:
No new mosquito pools
were reported WN or EEE positive this week.
Over 4,200 mosquito pools collected during 2002 were submitted for
testing at the DOH Tampa Laboratory.
At least 982 additional pools were tested by mosquito control
agencies and 298 pools were tested by Department of Defense installations
in the state. Thus far in
2003, 386 mosquito pools have been tested and none were positive.
Florida is currently at
“Level 1” in the Arbovirus Response Plan (see http://www9.myflorida.com/disease_ctrl/epi/htopics/arbo/index.htm).
DOH Press releases can be seen at http://apps3.doh.state.fl.us/IRM/PressReleaseSearch/search.cfm
.
2003 Cumulative Arbovirus Activity by County
1.
Human Surveillance
No new activity for 2003 has been reported for WN, SLE, EEE or Dengue.
2. Animal Surveillance
West Nile Virus
Positive samples from 3
sentinel chickens in 2 counties
were received. Date of
first positive bleed is shown in parentheses.
Bay: 2
sentinel chickens (1/7, 1/7)
Lee: 1
sentinel chicken (1/7)
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►
Weekly Disease Table
: Week 5
Florida Department of
Health, Bureau of Epidemiology
Weekly Morbidity Report, Week 5, ending
February 1, 2003
Selected Diseases and Conditions (Confirmed Cases Only)
|
Disease
|
2003
Week
5 |
2002
Total |
2001
To
Week
5 |
2002
To
Week
5 |
2003
To
Week
5 |
Average
For
2001
Through
2003
To
Week
5 |
2003
Percent
Change
From
Average |
|
ANIMAL BITE, PEP RECOMMENDED
|
13
|
1082
|
36
|
89
|
80
|
68.33
|
17
|
|
ANIMAL RABIES
|
0
|
37
|
9
|
0
|
0
|
3.00
|
-100
|
|
ANTHRAX
|
0
|
0
|
0
|
0
|
0
|
0.00
|
0
|
|
BOTULISM
|
0
|
0
|
0
|
0
|
0
|
0.00
|
0
|
|
BRUCELLOSIS
|
0
|
6
|
0
|
0
|
0
|
0.00
|
0
|
|
CAMPYLOBACTERIOSIS
|
15
|
980
|
31
|
135
|
80
|
82.00
|
-2
|
|
CIGUATERA
|
0
|
7
|
0
|
0
|
0
|
0.00
|
0
|
|
CRYPTOSPORIDIOSIS
|
1
|
101
|
4
|
6
|
6
|
5.33
|
12
|
|
CYCLOSPORIASIS
|
0
|
32
|
5
|
1
|
0
|
2.00
|
-100
|
|
DENGUE FEVER
|
0
|
12
|
0
|
1
|
0
|
0.33
|
-100
|
|
DIPHTHERIA
|
0
|
0
|
0
|
0
|
0
|
0.00
|
0
|
|
EHRLICHIOSIS, HUMAN
|
1
|
2
|
0
|
0
|
1
|
0.33
|
200
|
|
EHRLICHIOSIS, HUMAN GRANULOCYTIC
|
0
|
1
|
0
|
0
|
0
|
0.00
|
0
|
|
ENCEPHALITIS, EASTERN EQUINE
|
0
|
1
|
0
|
0
|
0
|
0.00
|
0
|
|
ENCEPHALITIS, POST-INFECTIOUS
|
0
|
17
|
0
|
2
|
2
|
1.33
|
50
|
|
ENCEPHALITIS, ST. LOUIS
|
0
|
1
|
0
|
0
|
0
|
0.00
|
0
|
|
ENCEPHALITIS, VENEZUELAN
|
0
|
0
|
0
|
0
|
0
|
0.00
|
0
|
|
ENCEPHALITIS, WEST NILE VIRUS
|
0
|
27
|
0
|
0
|
0
|
0.00
|
0
|
|
ENCEPHALITIS, WESTERN EQUINE
|
0
|
0
|
0
|
0
|
0
|
0.00
|
0
|
|
ESCHERICHIA COLI, O157:H7
|
1
|
62
|
1
|
2
|
5
|
2.67
|
87
|
|
ESCHERICHIA COLI, OTHER
|
0
|
22
|
0
|
1
|
3
|
1.33
|
125
|
|
GIARDIASIS
|
19
|
1279
|
12
|
157
|
80
|
83.00
|
-4
|
|
H. INFLUENZAE INVASIVE DISEASE
|
0
|
94
|
9
|
14
|
12
|
11.67
|
3
|
|
HANTAVIRUS INFECTION
|
0
|
0
|
0
|
0
|
0
|
0.00
|
0
|
|
HEMOLYTIC UREMIC SYNDROME
|
0
|
4
|
0
|
0
|
0
|
0.00
|
0
|
|
HEMORRHAGIC FEVER
|
0
|
0
|
0
|
0
|
0
|
0.00
|
0
|
|
HEPATITIS A
|
4
|
1010
|
21
|
106
|
49
|
58.67
|
-16
|
|
HEPATITIS B {+HBsAg IN PREGNANT WOMEN}
|
13
|
632
|
7
|
76
|
38
|
40.33
|
-6
|
|
HEPATITIS B PERINATAL, ACUTE
|
0
|
7
|
0
|
0
|
0
|
0.00
|
0
|
|
HEPATITIS B, ACUTE
|
10
|
538
|
10
|
49
|
40
|
33.00
|
21
|
|
HEPATITIS B, CHRONIC
|
39
|
539
|
3
|
45
|
89
|
45.67
|
95
|
|
HEPATITIS C, ACUTE
|
2
|
60
|
1
|
1
|
8
|
3.33
|
140
|
|
HEPATITIS C, CHRONIC
|
322
|
3645
|
5
|
97
|
964
|
355.33
|
171
|
|
HEPATITIS NANB, ACUTE
|
0
|
8
|
0
|
0
|
0
|
0.00
|
0
|
|
HEPATITIS UNSPECIFIED, ACUTE
|
0
|
1
|
0
|
0
|
1
|
0.33
|
200
|
|
HUMAN RABIES
|
0
|
0
|
0
|
0
|
0
|
0.00
|
0
|
|
LEAD POISONING
|
25
|
1030
|
18
|
87
|
100
|
68.33
|
46
|
|
LEGIONELLOSIS
|
7
|
85
|
0
|
8
|
18
|
8.67
|
108
|
|
LEPROSY {HANSENS DISEASE}
|
0
|
4
|
0
|
0
|
1
|
0.33
|
200
|
|
LEPTOSPIROSIS
|
0
|
0
|
0
|
0
|
0
|
0.00
|
0
|
|
LISTERIOSIS
|
0
|
28
|
0
|
3
|
4
|
2.33
|
71
|
|
LYME DISEASE
|
0
|
77
|
1
|
5
|
5
|
3.67
|
36
|
|
MALARIA
|
0
|
75
|
1
|
7
|
7
|
5.00
|
40
|
|
MEASLES
|
0
|
2
|
0
|
1
|
0
|
0.33
|
-100
|
|
MENINGITIS, OTHER BACTERIAL
|
6
|
210
|
7
|
34
|
23
|
21.33
|
8
|
|
MENINGOCCOCAL DISEASE
|
4
|
109
|
13
|
17
|
15
|
15.00
|
0
|
|
MERCURY POISONING
|
0
|
8
|
0
|
0
|
0
|
0.00
|
0
|
|
MONKEY BITE
|
0
|
1
|
0
|
0
|
0
|
0.00
|
0
|
|
MUMPS
|
1
|
6
|
0
|
0
|
1
|
0.33
|
200
|
|
NEUROTOXIC SHELLFISH POISONING
|
0
|
0
|
0
|
0
|
0
|
0.00
|
0
|
|
OTHER VIBRIO INFECTIONS
|
0
|
43
|
0
|
1
|
0
|
0.33
|
-100
|
|
PERTUSSIS
|
2
|
39
|
0
|
1
|
4
|
1.67
|
140
|
|
PLAGUE
|
0
|
0
|
0
|
0
|
0
|
0.00
|
0
|
|
POLIOMYELITIS
|
0
|
0
|
0
|
0
|
0
|
0.00
|
0
|
|
PSITTACOSIS
|
0
|
2
|
0
|
0
|
0
|
0.00
|
0
|
|
Q FEVER
|
0
|
1
|
0
|
0
|
0
|
0.00
|
0
|
|
ROCKY MOUNTAIN SPOTTED FEVER
|
0
|
9
|
0
|
0
|
0
|
0.00
|
0
|
|
RUBELLA
|
0
|
5
|
0
|
0
|
0
|
0.00
|
0
|
|
RUBELLA, CONGENITAL
|
0
|
0
|
0
|
0
|
0
|
0.00
|
0
|
|
SALMONELLOSIS
|
32
|
4475
|
82
|
320
|
254
|
218.67
|
16
|
|
SHIGELLOSIS
|
34
|
2220
|
30
|
94
|
296
|
140.00
|
111
|
|
SMALLPOX
|
0
|
0
|
0
|
0
|
0
|
0.00
|
0
|
|
STAPHYLOCOCCUS AUREUS {GISA/VISA}
|
0
|
0
|
0
|
0
|
0
|
0.00
|
0
|
|
STAPHYLOCOCCUS AUREUS {GRSA/VRSA}
|
0
|
0
|
0
|
0
|
0
|
0.00
|
0
|
|
STREPTOCOCCAL DISEASE INVASIVE GROUP A
|
5
|
218
|
6
|
31
|
26
|
21.00
|
24
|
|
STREPTOCOCCUS PNEUMONIAE, INVASIVE DISEASE
|
18
|
648
|
60
|
99
|
76
|
78.33
|
-3
|
|
TETANUS
|
0
|
3
|
0
|
0
|
0
|
0.00
|
0
|
|
TOXOPLASMOSIS
|
0
|
28
|
0
|
5
|
0
|
1.67
|
-100
|
|
TRICHINOSIS
|
0
|
0
|
0
|
0
|
0
|
0.00
|
0
|
|
TULAREMIA
|
0
|
0
|
0
|
0
|
0
|
0.00
|
0
|
|
TYPHOID FEVER
|
0
|
19
|
0
|
5
|
0
|
1.67
|
-100
|
|
VIBRIO CHOLERAE TYPE O1
|
0
|
0
|
0
|
0
|
0
|
0.00
|
0
|
|
VIBRIO PARAHAEMOLYTICUS
|
1
|
23
|
0
|
0
|
4
|
1.33
|
200
|
|
VIBRIO VULNIFICUS
|
0
|
20
|
0
|
0
|
0
|
0.00
|
0
|
|
WEST NILE FEVER
|
0
|
8
|
0
|
0
|
0
|
0.00
|
0
|
|
YELLOW FEVER
|
0
|
0
|
0
|
0
|
0
|
0.00
|
0
|
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