Friday, March 12, 2004

         This Week in the News

Foege, WH., et al., 
International Journal of Epidemiology
1976; 5:29-37

A R T I C L E S

The Bureau of Epidemiology has conducted the Florida Youth Tobacco Survey (FYTS) annually since 1998. An up-to-date report developed by the bureau and based on the 2003 FYTS reveals a continuous decrease in tobacco use among Florida youth. Compared to 2002, almost all main indicators in 2003 were either improved or at least maintained at 2002 levels. 

The major findings from this survey among Florida public schools during 1998 to 2003 are:

·        Number of students who ever tried cigarettes decreased by 40% among middle school students and by 26% among high school students.

·        Number of students who have committed to never smoking increased by 55% among middle school students and by 81% among high school students. 

·        Number of current cigarette smokers decreased by 57% among middle school students and by 36% among high school students.

·        Number of current any-tobacco users decreased by 52% among middle school students and by 33% among high school students.

·        Number of students exposed to second-hand smoke decreased by 7% among middle school students and by 8% among high school students.

Improving public health practice through respiratory syncytial virus (RSV) surveillance
Karen Wheeler, MPH
Florida Department of Health, Bureau of Epidemiology, Tallahassee, FL
 

Introduction

RSV is the leading cause of lower respiratory tract illness, hospitalization and viral death in infants and children less than two years of age. Prophylaxis is administered to at-risk infants as a preventative method; however, prophylaxis is not effective in the treatment of RSV. Although RSV is present year-round in Florida, peak activity is detected in the winter months. RSV is considered to be widespread when at least 10% of all specimens tested for RSV during a surveillance week are positive. In Florida, the Department of Health’s RSV Surveillance System monitors RSV activity at the state, regional and local levels.  RSV surveillance began in October 1999 for the North, Central, Southeast, and Southwest regions of the state and in January 2001 for the Northwest region. The RSV Surveillance System is an essential component to the statewide effort of preventing and controlling RSV year round. 

Methods
Data are collected on a weekly basis from 14 sentinel hospitals throughout the five regions.  Each site reports the total number of RSV tests performed and the total number positive to the Bureau of Epidemiology via email or fax. All data are stored in an Access database and reports and graphs displaying the total number of specimens tested for RSV, the total number of specimens testing positive for RSV and the percent positive for RSV are generated based on the data obtained. Regional and statewide data are available to public health professionals, health care providers and the public via web or email requests. Site-specific data is kept confidential and is only available to the providers at that site.  

Results
Since RSV surveillance began in October 1999, there have been only five months (February 2000, June 2000, May 2001, June 2001, and May 2003) in which the statewide proportion of RSV specimens testing positive was below 10% (Graph1). The peak month for statewide RSV activity is December. The timing and severity of regional activity varies across regions and from year to year as indicated in Table 1. Figure 1 depicts the average number of specimens tested annually for each region, as well as the location of the sentinel sites.  Based solely on site-participation and average number of specimens tested a year, the Southeast region is the best represented region with four participating sites and an average of 6,804 specimens tested annually.   

Conclusions
Data obtained through the RSV Surveillance System indicates seasonal and geographical RSV trends and determines the timing of seasonal peaks of RSV activity. The determination of seasonal trends of RSV activity serves as a guide to community providers for initiating prophylaxis to children at high-risk for RSV infection. Timeliness of prophylaxis decreases hospitalization rates and other respiratory tract infections associated with RSV. Additionally, recognizing peak months of RSV activity allows for prompt institution of control measures to prevent large outbreaks of nosocomial RSV infections from occurring in hospital nursery settings. Data from the surveillance system also helps practitioners, hospitals and health management organizations measure the cost effectiveness of prophylaxis programs. The current number of participating sentinel sites is a limiting factor in this surveillance system, contributing to an underrepresented sample of the population. Therefore, recruitment of additional sentinel sites is essential to accurately represent the at-risk population and adequately monitor RSV activity.
 

The editors have established a deadline of March 19th for submissions.

This survey contains 10 multiple choice questions and takes as little as five minutes to complete. For aspiring writers who would like to submit suggestions, there's even space provided for comments. Time's a' wasting!  Click on the link to begin. 

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Anne has spent nearly 20 years in state service, primarily in operations and management positions entailing procurement, analysis, and contract administration. Her desire for order and clarity have remained consistent fixtures through the years as she manages a scope of work involving careful attention to detail. These served her particularly well during a year-long sabbatical in the mountains of Colorado several years ago, where a life-long interest in art led her to a year of design work in stained glass and the sale of her pieces by local art galleries.

Anne's technical training and skills range from certification in International Contract Negotiations to training as a legislative bill analyst. During the past ten years she has conducted contract management training workshops and also headed proposal evaluation teams.

Her extensive knowledge of the state procurement system plays a valuable role in the operations of the Bureau of Epidemiology.
 

►Mass Vaccination Clinics:  A Reality Check

The California Department of Health Services and the Centers for Disease Control will be conducting a satellite broadcast titled “Mass Vaccination Clinics: A Reality Check” on Thursday, March 18, 2004 12:00 –1:30 p.m. EST and 11:00 a.m.-12: 30 p.m. CST. The intended audience for this broadcast is state and local health department staff responsible for implementing vaccination clinics and staff who would respond to BT threats and/or influenza pandemics. The program will provide information on why practical exercises can improve a Bioterrorism/pandemic mass vaccination clinic plan; differences between smallpox and pandemic flu clinic operations; components necessary for a mass vaccination clinic and potential challenges faced by mass vaccination clinic planners. 

Continuing education credits will be offered for various professions based on 1.5 hours of instruction.
 

Presenter: 
Cancer Epidemiologist Tara Hylton, MPH, Bureau of Epidemiology, Florida Department of Health 

Florida’s statewide cancer registry, Florida Cancer Data Systems (FCDS), was established in 1978. Florida statutes mandate cancer reporting to FCDS. Presently, incidence data on cancer cases seen in Florida are reported from hospitals, ambulatory diagnostic and treatment centers, clinical laboratories, and physician offices. There are approximately 95,000 newly diagnosed cancer cases per year. The FCDS database contains approximately 2,000,000 case records. FCDS receives cancer case reports daily and performs quality checks to avoid duplication and compile a complete incidence record.  Cancer registry data are available for researchers to conduct cancer studies in cancer etiology, control, and treatment. 

Additional Information:
The grand rounds presentation will begin promptly at 11:00 a.m., EST on Tuesday, March 30, 2004. PowerPoint slides and the dial-in number will be available on the Bureau of Epidemiology intranet website on Monday, March 29. CEUs will be provided for nursing. Please remember you must complete the entire registration form including the evaluation and test questions. Registration for CEUs will be accepted March 30-April 1. Registrations received prior to the beginning of the program will not be accepted.
 

Across the nation, five states, including Florida, reported local activity; thirty-two states reported sporadic activity; and twelve states reported no ILI activity for the week ending February 28. One state did not report. Mortality due to pneumonia and influenza (P&I) remained below the epidemic threshold for the week ending February 28. The percentage of patient visits seen with influenza-like illness to sentinel providers across the nation was 1.1% for week 08. 

On March 9, 2004, the World Health Organization announced the 11^th confirmed human case of avian influenza H5N1 in Thailand. The patient is a 29-year-old man who developed symptoms on February 13 and was admitted to the hospital on February 20. The patient recovered and was discharged from the hospital on March 7. The man had a history of contact with diseased and dead chickens. This brings the total number of human cases to 22 in Vietnam, of which 15 have passed away and 11 in Thailand, of which 7 have passed away. 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.

WN Virus activity: There were seven seroconversions to WN virus reported this week in sentinel chickens from Collier (2/9), Pinellas (2/23x2) and Walton (2/9, 2/19x3) counties. A live blue jay captured (2/17) in Okaloosa County tested positive for WN. So far this year, there have been 45 seroconversions to WN virus in sentinel chickens from nine counties, two WN-confirmed dead birds from Marion and Miami-Dade counties, two WN-positive live birds from two counties and one WN-confirmed horse from Polk County. In all, fourteen counties have reported confirmed WN virus activity this year. 

SLE Virus activity: None this week. So far this year, six 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 (2/23). So far this year, seven sentinel chickens and two horses have tested positive for EEE virus, for a total of six counties reporting EEE virus activity in 2004.

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. 

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