April 29, 2005

Epi Update Managing Staff:

John A. Agwunobi, MD, MBA, MPH, Secretary, Florida Department of Health
Landis Crockett, MD, MPH, Director, Division of Disease Control
Dian K. Sharma, MS, PhD, Bureau Chief, Bureau of Epidemiology, Editor-in-Chief
Jaime Forth, Managing Editor, Bureau of Epidemiology

"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




Registration Still Open for Statewide
Epidemiology Seminar
by Melanie Black, MSW

It’s not too late to register for the 10th Annual Epidemiology Statewide Seminar, "Emerging Issues in Epidemiology," being held at the Orlando Marriott Hotel in Lake Mary, Florida, 15 miles NE of downtown Orlando on May 17-18, 2005. Syndromic surveillance, antibiotic resistance, lab development of diseases associated with bioterrorism, hurricane related BRFSS data, asset typing, Avian flu, competencies and applied epidemiology, obesity contributions to maternal morbidity, and carbon monoxide poisoning are among just some of the issues that will be presented for discussion. 

The evening of May 16^th there will be a cook-out and the opportunity to pre-register for the first day. A poster session and reception will be held the evening of May 17^th.  The judged poster event will feature awards for the best communicable disease poster, the best presentation by a Florida EIS fellow, the best chronic disease poster and the best county health department display. Three additional categories have been added, one for environmental health, one for the best poster by a student in public health and the last for spatial analysis/visualization. The winners will be announced at the following day’s luncheon.

Golden Partnership Awards will be featured this year as well. These will be presented during the first day’s luncheon to partners who have made significant contributions in support of disease surveillance and epidemiology.

Currently the hotel is at full occupancy; however, the newly constructed Hampton Inn across the street from the Orlando Marriott is accepting reservations at $99.00 for a standard room. They can be reached by dialing 407.995.9000. 

Further information can be found on the Bureau of Epidemiology Internet website at http://www.doh.state.fl.us/disease_ctrl/epi/conf/training.html, or contact Melanie Black at the Bureau of Epidemiology in Tallahassee at 850.245.4444, ext. 2448

Melanie Black, MSW, is the professional training coordinator for the Bureau of Epidemiology in Tallahassee and can be reached via email at melanie_black@doh.state.fl.us.

Investigation of Increase in Cyclospora Cases in Florida
by Roberta Hammond, PhD

Florida epidemiologists and environmental health specialists are investigating an increased number of cases of cyclospora. To date, 40 cases have been confirmed in multiple counties across the state. Cyclospora is a single-cell parasite with an incubation period of about 1 week that causes frequent episodes of watery diarrhea that can follow a remitting-relapsing course of illness. Other symptoms include loss of appetite, substantial loss of weight, bloating, increased flatus, stomach cramps, nausea, vomiting, muscle aches, low-grade fever and persistent fatigue.  If untreated, cyclosporiasis can last for a few days to a month. Some infections are asymptomatic.

Cyclosporiasis is a reportable disease in the State of Florida. If you see a patient who has had watery diarrhea for a week or more, please consider requesting an ova and parasite (O & P) test for cyclospora. Confirmed cases must be reported to your local county health department. For preferred methods of treatment, please consult the attached fact sheet from the CDC Division of Parasitic Diseases at http://www.cdc.gov/ncidod/dpd/parasites/cyclospora/2004_Cyclosporiasis_HCP.pdf. See also the CDC Cyclospora Fact Sheet at http://www.cdc.gov/ncidod/dpd/parasites/cyclospora/2004_Cyclospora_FS.pdf.

Dr. Hammond is statewide coordinator of food and waterborne disease at the Bureau of Community Enivronmental Health in Tallahassee. She can be reached at 850.245.4116 or via email at roberta_hammond@doh.state.fl.us. 

May Grand Rounds Presentation to be
on Methicillin-resistant Staphylococcus Aureus
by Janet Hamilton, MPH
 

Title: Analysis of Methicillin-Resistant Staphylococcus aureus cases from a Single Hospital 

Presenter: Janet Hamilton, MPH, Florida Epidemic Intelligence Service Fellow, Escambia County Health Department, Bureau of Epidemiology, Florida Department of Health 

Date: Tuesday, May 31, 2005 at 11:00 a.m.

Abstract:
The emergence of resistance to antimicrobial agents is a global public health problem. Antimicrobial resistance results in increased illness, deaths, and health-care costs. The distribution of antimicrobial-resistant pathogens changes with time and varies between hospitals and different loci in the same hospital. First reported in the 1960s, MRSA has become increasingly prevalent since the 1980s. Knowledge of the scope of antimicrobial resistance is useful to hospital administrators, physicians, insurers, and public health personnel involved in implementing measures to effectively treat active infection and prevent the spread of MRSA. 

This presentation provides an overview of data analysis regarding methicillin-resistant Staphylococcus aureus in a single hospital. Data were supplied to the Escambia County Health Department from a local hospital. This facility has experienced an increase in the number of MRSA wound related issues treated in the emergency department over the past several years as reported by physicians. Data were abstracted electronically from the hospital medical record system for a two year period, November 1, 2002 – November 1, 2004. Data analysis examines the epidemiologic characteristics and antimicrobial resistance patterns of MRSA patients presenting for care.

Additional Information:
The grand rounds presentation will begin promptly at 11:00 a.m. EST on Tuesday, May 31, 2005. The PowerPoint slides and dial-in number will be posted on the Bureau of Epidemiology intranet website on Friday, May 27. CEUs will be provided for nursing, laboratorians and environmental health professionals. If additional information is needed, contact Professional Training Coordinator Melanie Black, MSW, at 850.245.4444 ext. 2448, or email at Melanie_Black@doh.state.fl.us.
                     
Janet Hamilton is a Florida Epidemic Intelligence Service Fellow currently assigned to the Escambia County Health Department. She can be reached at 850.595.6267.

         
Office of Preparedness, Education and Training
 Presents Spring Distance Learning Schedule

A sampling of the excellent learning opportunities available during the month of May includes topics as diverse as children and the consequences of crime, a manual for building a 21st Century health department, women and arthritis, and the role of dental teams in disaster preparedness. Check below for a subject that interests you and logon to the distance learning network program page for more information at http://esetappsdoh.doh.state.fl.us/irm00dln/pagesProgram/ProgramList.aspx. Most programs are free and many offer CEUs. This is just a partial list:

Exercising: Weapons of Mass Destruction and Bioterrorism
May 5,  2:00 - 3:00 p.m.
Deadline for registration is May 5
Targeted audience is all interested staff
No fee and no CEUs

Description: Collaborative exercises among many agencies with special expertise and equipment is essential to effectiveness. The program features four BT and WMD events where resources are beyond immediate fire and law enforcement response capabilities.

Wildland Urban Interface Fires - An Overview for Responders
May 18, 2 - 3:00 p.m.
Deadline for registration is May 12
Targeted audience is all interested staff
No fee and no CEUs

Description: The program looks at how firefights are trained to look at and think about fire. The program also covers the differences between structural and wildland fires and what do first, what can be saved, what is beyond hope, and how to live to tell the tale.

Disaster Preparedness: The Dental Team's Role
May 18, 7:30 - 9:30 p.m.
Deadline for registration is May 2
Targeted audience is dental hygienists, dentists and others who are interested
No fees - CEUs provided to dentists and dental hygienists

Description: The film explores state and local public health and preparedness efforts and the role of dentists and dental hygienists in that partnership.

Excessive Sleepiness: Assessing its Impact on Patient Wellness
May 18, 12 - 1:00 p.m.
Deadline for registration is May 12
Targeted audience is certified case managers, nurses, pharmacists, physicians and psychologists
No fee - CEUs provided to physicians, nurses, psychologists and social workers

Description: In a pool conducted by the National Sleep Foundation conducted in 2005, 75% of adults reported having sleep problems such as snoring or waking during the night. Twenty-five percent say their sleep problems impact their quality of life. The program covers the topic of rest and restoration experienced by individuals and how the experiences are measured.

Integrated Pest Management: The Big Picture!
May 19, 9 - 10:00 a.m.
Deadline for registration is May 12
Targeted audience is nurses
No fee and no CEUs offered

Description: Dr. Stephen Frantz, an international consultant, provides information on population dynamics and the complexities of vector remediation. The principles of integrated pest management are also covered.

For more information on the satellite broadcast program, contact Jennifer Bruce, distance learning coordinator, at 850.245.4444, ext. 2184.

Preparation Guidelines Offered for
Bureau of Epi Poster Competition
by Melissa Murray, MS
 

The poster session and reception will occur the evening of May 17. Participants will be expected to set up the posters on May 16 so that judges will have sufficient time to view all entries. Posters can be displayed in a three-fold form board format or a flat poster board. Please note that electricity and/or Internet connections will not be provided. Be sure to have a primary and secondary point of contact for presenting your poster. Technical assistance will be available through Bureau of Epidemiology staff.  

Tips for Poster Preparation

• Posters should stimulate discussion, not require a long presentation by the author. Therefore, keep text to a minimum, emphasize graphics, and make sure every item in your poster is necessary.

• When choosing a background, remember that neutral colors will be easier on the eyes than a bright color. Color photos look best when mounted on gray.

• Draw a rough sketch of your poster first. You may find it helpful to use graph paper and small pieces of paper (e.g., Post-it Notes cut to size) to better visualize where the components of your poster will go.

• Materials must be easily read at a distance of 4 feet. Carelessly prepared handwritten copy is unacceptable. As a rule of thumb, use a font size of at least 14 point and double space the text.

• Place related materials (e.g., photo with accompanying text) close together, and then highlight by framing with blank space.

• Space your information proportionally: Divide your poster either horizontally or vertically into three or four sections, and place your materials within those spaces.

• Supplement your poster with handouts.

Posters will be judged using the following criteria:

1. Appropriate Methods
2. Logical Results
3. Clear Objectives
4. Appropriate Conclusion based on presented results
5. Originality
6. Organization (easy to follow)
7. Public health importance/significance
8. Overall success in conveying topic
9. Visual appeal

If you have any questions about the poster session, please contact Melissa Murray at 850.245.4444 ext. 2445 or via e-mail at melissa_murray@doh.state.fl.us

Melissa Murray, MS, is coordinator of research services within the Chronic Disease Surveillance Section at the Bureau of Epidemiology. She is the primary point of contact for the Florida youth tobacco surveys coordinated by the bureau.

Updated Information from the Centers
For Disease Control and Prevention

Laboratory Network for Biological Terrorism
Provides information about the responsibilities of the laboratory network,
including national, reference, and sentinel laboratories. 
http://www.bt.cdc.gov/lrn/biological.asp

Frequently Asked Questions About the Laboratory Response
Network (LRN) – updated
http://www.bt.cdc.gov/lrn/faq.asp

Laboratory Response Network (LRN) Partners and Other
Related Sites – updated
http://www.bt.cdc.gov/lrn/partners.asp

Mosquito-borne Disease Update   April 17 - 23, 2005
Caroline Collins, Tasharra Kenion, Calvin DeSouza, Carina Blackmore, Ph.D., State Public Health Veterinarian

Weekly Update: During the period April 17-23, 2005, the following arboviral activity (St. Louis encephalitis [SLE] virus, eastern equine encephalomyelitis [EEE] virus, Highlands J [HJ] virus, West Nile [WN] virus and dengue virus) was recorded for Florida: 

West Nile (WN) virus activity: None this week.

Eastern Equine Encephalomyelitis (EEE) virus activity: Three horses from Baker, Lake and Volusia Counties were confirmed with EEE virus infection. One dead bird, an emu, from Volusia County was confirmed with EEE virus. One seroconversion to EEE virus was confirmed in a sentinel chicken from Orange County.

St. Louis Encephalitis (SLE) virus activity: None yet this year. 

Highlands J (HJ) Virus activity: Two seroconversions to HJ virus were confirmed in sentinel chickens from St. John's and South Walton Counties.    

There are no counties currently under medical alert for mosquito-borne disease. Where mosquitoes are present, people are urged to take precautions against getting bitten.   

Dead birds should be reported to www.wildflorida.org/bird/. See the web page for more information at www.MyFloridaEH.com. The Disease Outbreak Information Hotline offers recorded updates on medical alerts status and surveillance at 888-880-5782.

The arbovirus surveillance team, Bureau of Community Environmental Health can be reached at 850.245.4444, ext. 2457.

     
           This Week on EpiCom
                                      by Pete Garner
 

• Hepatitis cluster investigation by State of Tennessee that may affect Florida residents
• Infant in Baker County exposed to pertussis
• Clay County pertussis case pending
• Influenza B in lab worker under investigation in Pinellas County
• E Coli in child being investigated in Wakulla County
• Lee County reports cluster of Salmonella
• For info on investigation into increased number of Cyclospore cases, see EpiCom for links to CDC cyclospora fact sheets

Pete Garner is administrator of the Bureau of Epidemiology Surveillance Systems Section in
Tallahassee.  He can be reached at 850.245.4444, ext. 2481.

                         Weekly Disease Table
                                                          by D'Juan Harris, MSP

Click here to review the most recent disease figures provided by the Florida Department of Health Bureau of Epidemiology.

D'Juan Harris is a GIS specialist in the Surveillance Systems Section of the Bureau of Epidemiology.
He can be reached at 850.245.4444, ext. 2435.

The managing editor is pleased to accept copy for publication in
Epi Update on an ongoing basis. If you'd like to submit an article,
be sure to observe the following guidelines:

1. Pieces must be between 250 and 2,000 words in length.
2. Use MS Word format for all articles.
3. Font should be 11-point Arial with no centering, boxes or other elements added to the text.
4. Charts, graphs, tables and other data should be emailed as a separate attachment to the main document.
5.  All graphics must be attached as a separate jpg or gif file. For instructions on how to accomplish this, email D'Juan Harris at D'Juan_Harris@doh.state.fl.us or 850.245.4444, ext. 2435.
6. State the author's name, title and professional designations for the byline, and include the bureau or business name and telephone/email for contact purposes.
7. Only final documents (not drafts) will be accepted. Please ensure the article has been proofread for accuracy prior to submission.
8. All articles will be subject to editing.
9. The deadline for submissions is Tuesday by 5:00 p.m. Email all submissions to jaime_forth@doh.state.fl.us. If you have questions, call 850.245.4444, ext. 2440.

      Bureau of Epidemiology                       Epi Update Archives                                      CDC

      FL Department of Health                              My Florida                                         Contact Us

Epi Update is a journal of the Florida Department of Health Bureau of Epidemiology and is
published weekly on the Internet. To receive a special email reminder simply send an email to
jaime_forth@doh.state.fl.us.