February 13, 2003


"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



Epi Update Managing Staff
John Agwunobi, MD, MBA,
Secretary, Department of Health 

Landis Crockett, MD, MPH, 
Director, 
Division of Disease Control 

Steven T. Wiersma, MD, MPH,
Bureau Chief, 
State Epidemiologist 

Don Ward, 
Deputy Bureau Chief 
Epi Update Managing Editor 

Catherine Richards, 
Editorial Assistant 

Elizabeth Woodsmall,
Web Page Designer

A r t i c l e s:

Carina Blackmore, M.S. Vet. Med., Ph.D., Bureau of Epidemiology















































Don Ward, Deputy Chief, Bureau of Epidemiology

Florida: During week 5 (January 25-February 1, 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 2.5% which is slightly higher than the national baseline of 1.9%. Higher flu activity than expected for this time of year (>2%) was also reported by physicians in Duval, Indian River, Lake, Leon, Monroe, Okaloosa, Orange, Polk and Sarasota counties. Influenza A (H1N1) viruses were reported from Duval, Lake and St John’s counties, influenza H3N2 from Leon County and influenza B viruses were reported from Duval, Indian River, Orange and St John’s counties this week. Positive rapid tests were reported from Orange and Pinellas counties. During the last 4 weeks influenza A (H1N1) has also been reported from Broward, Leon, Okaloosa, Orange, Palm Beach and Volusia counties, influenza A of unknown subtype from Alachua and Pinellas counties and influenza B from Hillsborough, Okaloosa, Pinellas, Santa Rosa and Sarasota counties. 

National report: One hundred sixty-six isolates (49 influenza A and 117 influenza B viruses) were made from 1,157 specimens tested by the World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories this week. Since September 29, 4.7% (n=1,714) of the 36,753 specimens tested nationwide have been positive. Two hundred and thirty-seven (44%) of the 543 influenza A viruses have been subtyped; 192 were influenza A H1 viruses and 45 were influenza A (H3N2). Laboratory confirmed influenza has been reported from 47 states. The majority of influenza B isolates (70%; n=820) were identified in Texas and Missouri. Influenza A viruses were reported more frequently than influenza B viruses (range 63%-85%) in the Mountain, New England, East North Central, Pacific, and Mid-Atlantic regions. CDC has characterized 34 influenza A (H1N1), 15 influenza A (H1N2), 23 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 2.5% nationwide. The State and Territorial Epidemiologists in six states (Alabama, Colorado, Missouri, Tennessee, Texas and Virginia) reported widespread influenza activity. Flu outbreaks were reported in 18 additional states (Arkansas, Delaware, Florida, Georgia, Iowa, Kansas, Louisiana, Minnesota, Mississippi, Nebraska, New Mexico, New York, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Washington and Utah). Sporadic influenza activity was reported from 24 states. The proportion of deaths attributed to pneumonia and influenza as reported by the vital statistics offices of 122 U.S. cities was 7.2% during week 5. 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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►From the Lexicon of Smallpox Adverse Reactions  

Many of us tend to us the terms “adverse event” and “adverse reaction” interchangeably when, in fact, they have different meanings.  According to the CDC, as presented in the “Smallpox Adverse Event Workshop for State Health Departments, they are defined as follows:

Adverse Reaction:  untoward effect extraneous to the vaccine’s primary purpose of producing immunity

• Shown to be caused by the immunization
• Also known as vaccine side effect or complications

Adverse reactions to smallpox vaccine include:

• Nonspecific dermatological conditions
• Inadvertent inoculation
• Ocular vaccinia
• Generalized vaccinia
• Eczema vaccinatum
• Progressive vaccinia (Vaccinia necrosum)
• Post-vaccinial encephalitis
• Fetal vaccinia
• Other  
• Not yet characterized

Adverse Event:  untoward effects observed or reported following immunization, but a causal relationship between the two have yet to be established
 
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► Weekly Disease Table : Week 6
Florida Department of Health, Bureau of Epidemiology
Weekly Morbidity Report, Week 6, ending  February 8, 2003
Selected Diseases and Conditions (Confirmed Cases Only)

www.doh.state.fl.us/disease_ctrl/epi/Disease%20Table/2003_weekly/diseasetable.htm


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