February 21, 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:

Alan Rowan, PhD, Bureau of Epidemiology



















































































Melanie Black, MSW, Professional Training Coordinator


Tuesday, 
February 25, 2003
11:00 AM – 12:00 PM EST


Dial-In by 11:100 AM at 
(850) 487-8587 or 
SunCom 277-8587



























Don Ward, Deputy Chief, Bureau of Epidemiology

















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

Participants will serve on the front line working side by side with local, state and federal investigators to: 

      · Conduct epidemiological investigations, research, and public health 
        surveillance

· Present epidemiological papers at scientific and medical conferences;

· Publish their work in the scientific literature; 

· Disseminate vital public health information to the media and the public; Florida EIS assignees have unique opportunities to apply training and skills to actual public health problems and issues; 

· Establish mentorships with recognized experts from around the world; 

· Attend training courses in computers, biostatistics and epidemiology. 

Professionals with a strong interest in applied epidemiology who meet one of the following qualifications are eligible to apply to the Florida EIS: 

· Physicians with at least one year of clinical training; 

· PhD, DrPH, doctoral or masters-degree holders in Epidemiology, biostatistics, the social or behavioral sciences, or the nutrition sciences; 

· Dentists, physician assistants, and nurses with a Master of Public Health (MPH) or equivalent degree; 

·  Veterinarians with an MPH or equivalent degree or relevant public health experience; 

·  Other persons with extensive public health experience.

All county health departments with Epidemiology programs and strong supervision may participate.  One of the strongest features of good field assignments is the breadth of opportunity they provide.  We encourage supervisors to promote this breadth by collaborating with fellow epidemiologists in the training of a Florida EIS assignee and by enabling the assignee to pursue investigations in a wide range of subject areas.

If you are interested in recruiting this year, please send your assignment description to the Bureau of Epidemiology electronically by no later than close of business, March 28, 2003.  You may request that the Bureau of Epidemiology review and give you comments about the content of your position description; you will also have a chance to review position descriptions submitted by other counties.  The positions are currently being advertised on www.myflorida.com.

The position match will be held in Tallahassee on April 23, 2003.  CHDs approved to participate will be invited along with successful candidates.  All candidates will begin duties in their respective counties on May 19, 2003.

 Please contact Ms. Angelena Little or Dr. Alan Rowan with any questions at SC 205-4401 or (850) 245-4401.

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►Grand Rounds:  “Florida Cancer Data Systems”

Presentors:
Jill MacKinnon, Ph.D., Administrative Director, Florida Cancer Data System, and Lora Fleming, M.D., Ph.D., M.P.H., Associate Professor, Department of Epidemiology & Public Health, University of Miami School of Medicine

Abstract:
The Florida Cancer Data System (FCDS) is Florida’s legislatively mandated, statewide, population-based cancer incidence registry.  FCDS has been a joint project of the Florida Department of Health and the Sylvester Comprehensive Cancer Center at the University of Miami School of Medicine since it’s inception in 1981.  The FCDS is the second largest cancer surveillance system in the United States collecting/processing over 160,000 cancer abstract, 150,000 mortality records, 500,000 pathology laboratory reports and over 1 million inpatient and outpatient discharge records annually.

Florida has the highest crude rate of cancer in the United States.  FCDS is a wonderful research resource for Florida’s health professionals with data dating back to 1981.  The presentation will give the audience an overview of the FCDS and it’s data query and mapping capabilities.

Additional Information:
Further details regarding the audio-conference call and the PowerPoint files will be posted on the Bureau of Epidemiology Intranet web site. Be sure and register on line at the end of the program to obtain nursing CEU’s. Information about upcoming topics and presenters will also be posted in the Epi Update. If either of these access points is unavailable to you, please email Melanie Black [Melanie_Black@doh.state.fl.us] or telephone (850) 245-4444 ext. 2448 (SunCom 205-4444 ext. 2448) to request presentation materials.

Important
While we realize you might not always be able to call in by 11:10 AM, it can be distracting to the speaker and others in the audience when participants dial-in throughout the hour. Please try to call in on time and remember to put your phones on mute so as not to disturb others. Thank you for your cooperation.

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►Bureau of Epidemiology to Host CHD Conference Calls

Beginning on Friday, March 21, and on alternating Fridays thereafter, the Bureau of Epidemiology will host a scheduled conference call with county health department staff.  The purpose of the call is to update CHD staff on  Bureau activities and to discuss issues of mutual interest.  Each week’s agenda will be determined by input from the CHDs and Bureau staff. While the majority of agenda topics will probably be directed to surveillance and investigations, any other CHD/Epi topics are appropriate.  Any CHD staff are welcome to participate and staff conducting disease control activities are encouraged to attend.  The calls will use the technology employed in the Bureau’s Grand Rounds, that is, any presentation material will be posted on the intranet the day before the call. The bi-weekly “epi-calls” will begin at 10AM and last no longer than an hour.  The number for the call is  (850) 487-8587 or Suncom 277-8587.   Please e-mail suggestions for agenda items to Don Ward at donald_ward@doh.state.fl.us.  

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► Influenza Virus Surveillance Summary Update

Week ending February 8, 2003-Week 6

Florida: During week 6 (February 2-8, 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%. Higher flu activity than expected for this time of year (>2%) was also reported by physicians in Indian River, Lake, Okaloosa, Palm Beach, Polk, Sarasota and Volusia counties. The influenza activity is wide spread. During the last two weeks over 50 laboratory confirmed influenza cases were reported from 15 counties across the state. Influenza A (H1N1) viruses were reported from Broward, Duval, Indian River, Leon, Lake, Madison, Monroe, Orange, Polk and St John’s counties, influenza H3N2 from Leon County, influenza A of unknown subtype from Alachua and Pinellas counties and influenza B viruses were reported from Alachua, Duval, Indian River, Leon, Pinellas and Sarasota counties. In addition, positive rapid tests were reported from Hillsborough, Orange and Pinellas counties. 

National report: Four hundred fifty nine isolates (214 influenza A and 245 influenza B viruses) were made from 2,205 specimens tested by the World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories this week. Since September 29, 6.0% (n=2,564) of the 42,652 specimens tested nationwide have been positive. Three hundred and thirty (35%) of the 937 influenza A viruses have been subtyped; 270 were influenza A H1 viruses and 60 were influenza A (H3N2). Laboratory confirmed influenza has been reported from 49 states. The majority of influenza B isolates (51%; n=825) were identified in Texas and Missouri. Influenza A viruses were reported more frequently than influenza B viruses (range 56%-86%) in the Mountain, New England, East North Central, Pacific, and Mid-Atlantic regions. CDC has characterized 34 influenza A (H1N1), 15 influenza A (H1N2), 28 influenza A (H3N2) and 86 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 3.0% nationwide. The State and Territorial Epidemiologists in thirteen states (Alabama, Colorado, Indiana, Iowa, Kansas, Michigan, Missouri, New Hampshire, Pennsylvania, Rhode Island, Tennessee, Tennessee, Texas and Virginia) reported widespread influenza activity. Flu outbreaks were reported in 21 additional states. Twenty four states reported sporadic influenza activity. The proportion of deaths attributed to pneumonia and influenza as reported by the vital statistics offices of 122 U.S. cities was 7.6% during week 6. This percentage is below the epidemic threshold of 8.3% 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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► Weekly Disease Table : Week 7
Florida Department of Health, Bureau of Epidemiology
Weekly Morbidity Report, Week 7, ending  February 15, 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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