Epi Update - Weekly Publication of the Bureau of Epidemiology

Friday, February 27, 2004

 

         This Week in the News

"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.
International Journal of Epidemiology
1976; 5:29-37

  2004 Statewide Epidemiology Seminar Plans Laid
This ninth annual event will be held again in Lake Mary. The theme, "Emerging Issues in Epidemiology," will bring topical and challenging questions into focus and serve as a catalyst for useful discussions. 
Bi-Weekly CHD Conference Call Report on Varicella Zoster in Duval County
Among other items discussed, a report on an outbreak of Varicella zoster in Duval County was presented during the call among county health department participants and Bureau of Epidemiology staff.
Getting Acquainted - Meet the Bureau's Cancer Epidemiologist
In a continuation of this new series about Bureau of Epidemiology staff members, learn now about Tara Hylton, MPH, one of two new members of the Chronic Disease Surveillance Section.
    Preparing Your Hospital For SARS
A one-day training even for hospital administrators, physicians, nurses and infection control professionals, co-sponsored by the Department of Health and the Florida Hospital Association will be held on March 5th in Orlando
Epi Update Managing Staff:   The Life Cycle of a Virus - A New Approach to HIV Treatment?
A brand-new discovery provides clues about innate protection against viral infection in monkeys that could lead the way to immunity for humans.
John Agwunobi, MD, MBA, Secretary,  Department of  Health   Coming Your Way - The First-ever Epi Readers Survey 
No, we won't bother you during dinner hour. But we will be providing a link to a 10-question survey in an upcoming issue, and we're hoping you'll take a few moments to respond with your thoughts and ideas.
Landis Crockett, MD, MPH, Director, Division of Disease Control    This Week on EpiCom
 An unusual case of susumber poisoning, pufferfish poisoning, and other food borne illnesses affect various counties throughout the state.  
 Don Ward, 
Acting Bureau Chief, Epi Update
Managing Editor 
  Florida Influenza Surveillance For the Week Ending February 14, 2004
Reports from the state, the nation and around the world for Week 6.
Jaime Forth, Copy Editor/ Writer   Mosquito-Borne Disease Update
A report outlining activities for February 15-21, 2004 for confirmed cases.
   
   

A R T I C L E S

Melanie Black, MSW, Professional Training Coordinator, Bureau of Epidemiology   2004 Statewide Epidemiology Seminar Plans Laid

The Bureau of Epidemiology is excited to announce the dates for the Ninth Statewide Epidemiology Seminar, May 18-19, 2004 in Lake Mary, Florida at the Orlando Marriott Hotel. Last year’s meeting brought together over 200 epidemiologists and other public health professionals representing the state department of health, county health departments, and other partners to discuss current issues in communicable and chronic disease prevention and control. The Department of Health disease prevention staff and other medical providers will share ideas and methods presented by disease prevention experts from Florida, other states and the Centers for Disease Control and Prevention.

The theme for this year’s program is “Emerging Issues in Epidemiology.” We are in the process of developing an interesting, informative and challenging agenda, a list of exciting speakers and an excellent poster session, not to mention time and occasion for colleagues to interact. Be sure to take advantage of this once-a-year opportunity!

Further details about this program and accommodations will be made available in the Epi Update and on the Bureau of Epidemiology Internet website. Melanie Black, MSW, will be managing this activity and can be reached at (850) 245-4444 ext. 2448 or SunCom 205-4444 ext. 2448.

Jaime Forth, Copy Editor/Writer, Bureau of Epidemiology   Bi-Weekly CHD Conference Call Report on Varicella Zoster in Duval County

The bi-weekly conference call among county health department personnel and Bureau of Epidemiology staff which occurred on February 13th is briefly related here for those who weren't able to participate.

Announcements. Don Ward announced that the Chief of Surveillance and Investigator positions will be readvertised. Highly desirable candidates would have experience in an epidemiology program at the state, city or county level. Persons with questions about the positions should telephone him.

Merlin Extended Data and Case Forms. Karen Wheeler outlined goals and objectives for the year, which include more thorough reporting when filling out case forms. Report all clusters and outbreaks to the bureau, in addition to any other entities to whom the reporting is conducted; this is particularly important for effective epidemiologic analysis. We're also looking at ways to provide a more rapid analysis of data for state outbreaks. Items such as the sex of the patient, the case outcome (whether the person lived or died), and supplying the state in which the disease was acquired will give our staff necessary data to analyze. This type of information will also assist counties later in determining the extent of outbreaks in their communities. All the information can be reported to us through EpiCom.

Animal Rabies Lab Request. Travis McLane announced that beginning March 1st, animal rabies testing results will be submitted electronically through Merlin, in advance of the printed copy.

Varicella Zoster Outbreak in Duval County. Ruth Voss and Robyn Kay presented a report on an outbreak which occurred in January. They received a call on January 23rd from a homeless shelter concerning three adult men appearing to have no prior connection, but who presented with identical rash. The shelter staff requested assistance and documentation. Voss and Kay briefed shelter staff on prevention methods and agreed to consult with members of the shelter clinic. Examination and lab samples proved positive for Varicella Zoster. Voss and Kay toured the facilities and advised other shelter residents on the need for good personal hygiene. No other cases have been reported.

Training Announcements. Melanie Black reminded listeners that the topic of the February 24th Grand Rounds will be "Norovirus at a Private Elementary School in Duval County" and that CEUs will be provided. The Polk County Regional Training set for February 25th-26th has only a couple of slots remaining. In addition, the Bureau of Epidemiology annual statewide seminar will be held May 18-19 at Lake Mary. This year's theme, "Emerging Issues in Epidemiology," will feature two main issues: Chronic infections and nosocomial diseases in Florida.

Anyone wishing to participate in future conference calls should be aware they are scheduled on alternate Fridays from 10:00-11:00 a.m. EST. The call-in number is 1.800.351.6803        and the code for the calls is 69698. To be placed on the agenda, contact Melanie Black, MSW, at 850.245.4444, ext. 2448 or Don Ward at 850.245.4444, ext. 4405.
 

Jaime Forth, Copy Editor/Writer, Bureau of Epidemiology   Getting Acquainted - Meet the Bureau's Cancer Epidemiologist
Tara Hylton was a University of Miami graduate with a major in Biology and a minor in Chemistry and Sociology when a chance conversation with another student alerted her to the potential of a career in public health. For Tara, public health combined the social aspects of health awareness and health planning with the scientific approaches for prevention, treatment, and cure of health illnesses. Tara completed her Masters of Public Health, with a concentration in chronic disease epidemiology, from the Rollins School of Public Health, Emory University.

While attending Emory University, she worked with Go Girls!, a community-based intervention program funded by the NIH. Go Girls! is a program tailored to provide young girls and their mothers in urban Atlanta best nutritional habits and exercise regimens to reduce associated risks of weight gain (i.e. chronic diseases and/or conditions). Additionally, Tara worked with the Emory Center for Outcomes Research participating in statistical analyses of chronic diseases, focusing on race and family history of kidney disease on end-stage renal disease.

At the Bureau of Epidemiology, Tara is the primary contact for cancer registry questions and will soon embark on analyzing trends in cancer registry data.  Also, she is developing a protocol for cancer cluster inquires from the public. In 1978, the State of Florida created the statewide cancer registry, which collects cancer incidence and mortality statistics. Reported by hospitals, laboratories and other medical facilities, this information is available to researchers and the general public.  .

 

Melanie Black, MSW, Professional Training Coordinator, Bureau of Epidemiology   Preparing Your Hospital For SARS

On March 5, 2004 the Florida Hospital Association and the Florida Department of Health will co-sponsor a one-day seminar entitled, “Preparing Your Hospital for SARS” to be held at the Hyatt Regency Orlando International Airport. Every hospital in Florida should be prepared to identify, triage and manage SARS patients. This program will focus on surveillance and rapid identification of suspected, isolation of all potential SARS patients, identifying adequate resources for an effective response, implementation of infection control practices and contact tracing to interrupt SARS-CoV transmission, laboratory capacity, treatment, surge capacity, quarantine and rapid communication between healthcare facilities and health departments.  

The target audience for this seminar includes hospital administrators, physicians, nurses, infection control, plant facilities/engineering and county health department staff. For further information regarding hotel accommodations, agenda, registration and registration fees please visit the Florid Hospital Association website http://www.fha.org/acrobat/2004SARSmeeting.pdf.
 

Jaime Forth, Copy Editor/Writer, Bureau of Epidemiology   The Life Cycle of a Virus  - A New Approach to HIV Treatment?

A professor of pathology at Harvard's Dana-Farber Cancer Institute and his team of researchers announced in a February 26, 2004 article in the journal, "Nature," that they have discovered a clue that could lead to the development of new antiviral therapies to combat infections such as AIDS.

They began their study by searching for a way to infect Old World primate cells with the human virus, HIV. They were successful only when using viruses that contained both HIV and SIV (primates are able to resist the human virus but are susceptible to the simian type). Viruses generally spread throughout the body by entering cells and then using their mechanisms to replicate themselves. Focusing on searching out the differences between the HIV and SIV containing cells, they began to look more closely at the virus' protective coating ("capsid").

The scientists discovered that if they surrounded HIV genetic material with an SIV capsid, a monkey would be infected with HIV and develop AIDS. But when they made a mixed human and monkey capsid, monkey cells could no longer be infected. They identified a protein called TRIM-5 alpha, which floats inside the monkey cells and provides natural immunity to HIV. Such proteins are found only in vertebrates and are not essential to life. Humans make a protein that is similar but only fifty percent as effective in blocking HIV. The monkey TRIM5-alpha protein is only fifty percent effective in blocking SIV.

This new understanding about the role of capsids in fighting viruses "could lead to drugs to treat AIDS infection or a vaccine to prevent it." said Carl Dieffenback, director of basic science research for AIDS at the National Institutes of Health, U.S. Department of Health and Human Services in Bethesda, Maryland.
 

Jaime Forth, Copy Editor/Writer, Bureau of Epidemiology   Coming Your Way - The First-ever Epi Readers Survey

After a full 18 months on the Web including changes in staffing and tweaks to the editorial content and layout, Epi Update is ready to ask its readers, "C' mon, what do you reeaally think?"

In next week's issue, a link will be provided that will direct readers to a brief, 10-question survey covering various aspects of this publication. We hope you'll take a few moments to share your thoughts and ideas. These will play an important role as we take a look back and then begin to formulate strategies for an improved publication that will reach even more Florida public health professionals in the future. 

Pete Garner, Surveillance Systems Manager, Bureau of Epidemiology   This Week on EpiCom

Consumption of wild susumber caused a small number of dinner guests to report to the  hospital emergency room in Broward County.

Consumption of pufferfish caused hospitalization for at least one person on Florida's east coast. Other foodborne illnesses are listed in other counties.

The Bureau of Epidemiology encourages Epi Update readers not only to register with the EpiCom system at https://www.epicomfl.net but to brose EpiCom frequently and to contribute public health observations related to any suspicious or unusual situations or circumstances as appropriate.
 

Angela Fix, MPH, Respiratory Disease Surveillance Epidemiologist, Melissa Covey, Influenza Surveillance Coordinator   Florida Influenza Surveillance For the Week Ending February 7, 2004

Florida influenza-like illness (ILI) activity continues to decrease across the state for the week ending February 14, 2004.  Eight counties reported as having a high ILI% activity for the week.  However, not all sentinels have reported at the time that this summary was written (76% reporting as of February 16, 2004).  Compared to the previous week, nine counties reported an increase in ILI activity, eight counties reported a decrease and twelve counties remained at a level activity.  Four counties did not have at least 50% of the active sentinels reporting or did not report the previous week and therefore the change in ILI activity could not be determined.  Ten counties across the state have reported no influenza-like illness activity for the week ending February 14, 2004. The Florida Sentinel Physician Influenza Surveillance Network (FSPISN) providers reported seeing 17,349 total patients during week 06, of which, 189 were seen with influenza-like illness symptoms.  The overall state ILI activity for the week was 1.09%. 

Across the nation, two states reported regional ILI activity, eleven states, including Florida, reported local activity, thirty-three states reported sporadic activity, and four states reported no ILI activity for the week ending February 14, 2004. The percentage of deaths due to influenza and pneumonia remained level compared to the previous week (8.6% and 8.7%, respectively).  This percentage is above the epidemic threshold of 8.3% for Week 06. 

As of February 23, thirty-two laboratory confirmed cases of avian influenza A (H5N1) infections in humans were reported in Asian countries. Twenty-three cases are from Vietnam, of which, fifteen have been fatal.  Nine cases have been reported from Thailand, of which, five have been fatal. The Bureau of Epidemiology continues to work with local health departments, physicians and health care professionals in an effort to monitor for potential avian influenza infections in Florida as well as update the public with the most recent conditions in Asia. A fact sheet about the significance of avian influenza for human health can be found at the World Health Organization’s website: http://www.who.int.

To view the complete report, [click here.]
 

Arbovirus Surveillance Team: Caroline Collins, Kristen Payne and Calvin DeSouza, and Program Manager Carina Blackmore, DVM, Ph.D., Acting State Public Health Veterinarian, Bureau of Community Environmental Health   Mosquito-Borne Disease Update

No Florida counties are under medical alert. In areas with mosquitoes present, people are still encouraged to take precautions against mosquito bites.   

WN Virus activity: There were 3 seroconversions reported this week in sentinel chickens from Walton County.  So far this year, there have been 35 seroconversions to WN virus in sentinel chickens, two dead birds from Marion and Miami-Dade counties have tested positive for WN Virus and one horse from Polk County tested positive for WN virus. 

SLE Virus activity:  None to report this week. So far this year, five sentinel chickens from Charlotte and Lee County have tested positive for SLE. 

EEE Virus activity: There was one seroconversion to EEE virus in a sentinel chicken from Orange County this week. So far this year, five sentinel chickens and two horses have tested positive for EEE virus.

See the web page for maps and summary information on 2003 activity: http://www.doh.state.fl.us/Environment/hsee/arbo/index.htm


Disclaimer: Please note that data is subject to change with confirmatory information. 

For more surveillance information, please see the DOH web site at: http://www.doh.state.fl.us/Environment/hsee/arbo/index.htm or call the Disease Outbreak Information Hotline which offers updates on medical alert status and surveillance at 888-880-5782.    

     
   

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