May 9, 2003
"The reason for collecting,
Foege WH et al.
|This Week in the
► Alcohol-Based Hand Sanitizers in Food Service Settings
A report on the latest findings by The Centers for Disease Control and Prevention.
► Statewide Epidemiology Seminar June 3-4
This annual seminar will be held at the Orlando Marriott in beautiful Lake Mary, Florida. Registration, plus accommodations information, is now available online.
► Merlin Reporting System Classes Underway
Dates for regional classes will soon be determined. In the meantime, here's what you need to know about Merlin.
► Call for Conference Posters
A reception and poster session will be part of the Statewide Epidemiology Seminar next month. Find out how to participate.
► Infection Control Seminar Slated for Pensacola
The Northwest Florida Infection Control Practitioners Association annual seminar, entitled "Breaking the Chain," will be held on Friday, May 16th at the Pensacola Civic Center.
► Helpful Hints for Merlin
Having a little difficulty responding to those pesky "Requests for More Information"? Help is on the way!
► Weekly Influenza Report - Week 17
Confirmed cases only for the period April 20-26, 2003.
► Arboviral Activity Summary
Statistics provided for the week ending May 5, 2003.
► Weekly Disease Table
Florida Department of Health, Bureau of Epidemiology, Weekly Morbidity Report, Week 18, ending May 3, 2003.
Selected Diseases and Conditions (confirmed cases only)
A r t i c l e s:
Melanie Black, MSW, Professional Training Coordinator, Bureau of Epidemiology
Travis McLane, Surveillance Program Specialist, Bureau of Epidemiology
Ronee' Wilson, MPH, Surveillance Section Epidemiologist, Bureau of Epidemiology
Vivian Logsdon, President, Northwest Florida Infection Control Practitioners Association
Ronee' Wilson, MPH, Surveillance Section Epidemiologist, Bureau of Epidemiology
Kathryn S. Teates, MPH, Communicable Disease Surveillance & Reporting Manager
Caroline Collins, Arbovirus
Surveillance Coordinator and Carina Blackmore, M.S. Vet. Med., Ph.D.,
Deputy State Public Health Veterinarian
Please Note! Some numbers
may change with confirmatory information
Sanitizers in Food Service Settings
FDA's Food Code contains federal recommendations for preventing food borne illness in restaurants, grocery stores, institutions and vending machines. To maintain consistency with national food regulatory policy, local, state and federal regulators use the FDA Food Code as the model for development or revision of their own food safety rules. The Food Code contains specific hand hygiene guidance for retail and food service workers. Hand sanitizers, meeting specific criteria described in section 2-301.16 of the Food Code, may be used after proper hand washing in retail and food service.
CAN ALCOHOL-BASED HAND GELS SERVE AS A SUITABLE ALTERNATIVE TO HAND WASHING FOR RETAIL AND FOOD SERVICE WORKERS?
CDC recently issued "CDC Guideline for Hand Hygiene in Health-Care Settings" (Morbidity and Mortality Weekly Reports, October 25, 2002). The guidance document recommends alcohol-based hand gels as suitable alternatives to hand washing for health-care personnel in health-care settings. These guidelines were not intended for food establishments. This exclusion is based on the differences in controlling common nosocomial pathogens in health-care settings and common food borne pathogens in retail and food service settings. Some significant differences between health-care settings and retail/ food service settings include:
CONCLUSION: Proper hand washing, as described in the Food Code, continues to be a vital practice in retail and food service settings. Alcohol gels in place of hand washing do not adequately reduce important food borne pathogens on food workers' hands. Concern about using alcohol-based hand gels in place of hand washing with soap and water can be summarized as such:
FDA and CDC continue to monitor new data to ensure the best public health measures are in place for retail and food service establishments.
To take advantage of our special group rate, be sure to make your hotel reservations early. Call the Marriott directly at 407.995.1100, or through their reservations line at 800.228.9290. Refer the booking agent to the FDOH-Epidemiology Statewide Seminar, code FDOFDOH. You can also reserve accommodations through the hotel website at www. marriott.com/MCOML. Click on the red button labeled Reserve a Room, enter the dates, and then scroll down to the box labeled "Group Code." Enter FDOFDOH and follow instructions to complete the arrangement.
For further information,
contact Melanie Black at the Bureau of Epidemiology in Tallahassee at 850.245.4444, ext. 2448.
Merlin is a new reporting software package developed and used exclusively by Florida health professionals. The system serves as a central repository for real-time data reporting and as an information-gathering tool. Results are then forwarded by state officials to The Centers for Disease Control and Prevention in Atlanta.
A schedule for the remainder of the year is noted below. Exact dates have not been determined, but an e-mail announcement with solid dates and enrollment details will be released soon. Plan on attending at least one Merlin Basic Training this year to keep abreast of all the latest features and technology. Each presentation should provide you enough information to enable you to return to your computer thoroughly energized, and fully equipped to apply your newfound knowledge!
This list does not include Merlin Basic Training sessions that will be offered the day preceding Regional Epidemiology Training. For further information, contact Travis McLane in Tallahassee at 850.245.4444, extension 2413.
Poster presentations give conference attendees a great opportunity to share research with colleagues and friends. Examples of poster topics include results of an outbreak investigation, new prevention programs at the local level or new laboratory methods in disease control. The session also presents an opportunity to demonstrate new computer and Web-based systems related to public health.
Format for posters will follow the basic scientific paper outline, where applicable:
Background - the
problem under investigation or a hypothesis
The poster session and reception will occur the first evening of the seminar. Posters can be displayed in a three-fold foam board format or any other appropriate conference style. Whichever method you choose, be sure to have a primary and secondary plan for presenting your poster. Each presenter will be responsible for ensuring his or her display is set up prior to the beginning of the session, and removed promptly afterward. Technical assistance will be available through Bureau of Epidemiology staff.
If you would like to participate, please contact Ronee' Wilson at 850.245.4444, ext. 2445 by May 23rd.
details or to order a brochure, call or email Vivian Logsdon at Vivian_Logsdon@doh.state.fl.us,
Lab results are received by key county health department staff in three ways. One way is electronically, from state laboratories. These labs show up on your Unprocessed Electronic Labs task list in Merlin. Some lab results are entered by data entry staff at the state health office and are displayed on your Unattached Labs task list. After the electronic labs are processed, they are displayed on the Unattached Labs task list. Other lab results are received by mail.
Electronic Lab Results: Lab results that appear on the Unprocessed Electronic Labs task list are submitted from the state laboratories. While processing the lab, you’ll have an opportunity to attach the electronic lab to a case, if one has been entered for that patient or profile. Click on the radio button next to the appropriate case at the bottom of the screen. Save it. If you process an electronic lab and do not attach it to a case, the lab result will be moved to your Unattached Labs task list (see Unattached Lab Results).
Unattached Lab Results: Lab results that appear on the Unattached Labs task list were entered manually by a state health employee or CHD staff. If you create a case based on a lab result that is on your Unattached Lab task list, you’ll need to attach the lab to the case before you report it. This can be performed from the Summary screen.
Typically, users will receive an error message if they try to report a case in Merlin that does not include an attached lab result. However, there are exceptions to every rule! Hepatitis A is one condition that can be reported in Merlin without a positive lab result. A case of hepatitis A can be considered confirmed if it is epidemiologically linked to another case with a positive lab result.
Although it is technically possible to report hepatitis A cases in Merlin without an attached lab, a positive lab is required if the case is not epi-linked. If you do not have a positive lab result, make sure you document (in the case notes) the ways in which this case is epidemiologically linked.
Entering Symptoms/Onset Dates:
Documentation of symptoms and their onset dates is often necessary to confirm certain diseases and conditions by surveillance case definition. For example, the case definition screen for hepatitis A displays check boxes by statements concerning clinical criteria. If you check the box stating the patient had "Discrete onset of symptoms", "Jaundice", and was "Anti-HAV positive" make sure you document the symptoms and the onset dates in the Symptoms section either on the Basic Case screen or the Extended Data screen, and be sure to enter the case related lab results.
We hope these Merlin Helpful Hints are useful. Your hard work and
dedication are appreciated! Please feel free to contact the Merlin
with any questions or concerns, and, of course, continue to check
issues of the EPI Update for upcoming Merlin training courses.
The Netherlands reported in April the first fatal human case of influenza A (H7N7).
An outbreak of highly pathogenic avian influenza A (H7N7 HPAI) in chickens began during February 2003 in The Netherlands and, despite control measures (restricting transport and culling), has spread to Belgium and Germany, to swine herds in The Netherlands, and humans. Of the 83 confirmed cases of human H7N7 in The Netherlands, 79 exhibited conjunctivitis and 13 had mild ILI. Possible human-to-human transmission was suggested when three family members of two poultry workers fell ill with a minor respiratory disease. The WHO Influenza Collaborating Centers are to begin production of a reagent kit to identify H7N7 viruses. More information about this outbreak of H7N7 HPAI can be found at: http://www.who.int/csr/don/2003_04_24/en/
Asia. An avian flu virus strain, influenza A (H5N1), was recovered from two influenza cases in Hong Kong earlier this year. CDC has issued recommendations on increased influenza surveillance in the United States. Of particular importance is to consider influenza cultures on patients, with recent travel histories to Asia, who are hospitalized with unexplained pneumonia, acute respiratory distress syndrome or severe respiratory illness.
* Reporting is incomplete for this week. Numbers may change as more reports are received.
For additional information on influenza and influenza surveillance results in Florida, please visit our website at http://www.doh.state.fl.us/disease_ctrl/epi/htopics/flu/2002/index.htm
Links to current diseases of concern: Severe Acute Respiratory Syndrome (SARS): http://www.doh.state.fl.us/PHNursing/SARS/SARSindex.html
Human: No cases of arboviral meningo-encephalitis were reported this week. Gilchrist County is under Medical Alert for EEE virus.
One seroconversion to WN virus in Lee County and seven seroconversions to EEE virus were confirmed in Alachua (2), Hillsborough, Orange (3) and Pasco counties. This week, 877 samples were tested from 21 counties.
Bird Mortality: No dead birds were reported positive for arbovirus this week.
Equine*: Seven EEE virus infections in horses were reported from Bradford, Duval, Levy, Osceola, Suwannee, Union/Columbia and Volusia counties.
Wild and Captive Birds: See Arbovirus Ecology to view database.
Mosquito Pools: No mosquito pools were reported positive for WN or EEE virus this week.
The Disease Outbreak Information Hotline offers updates on medical
alert status and surveillance at 888.880.5782. Florida is currently at
Level I in the Arbovirus Response Plan. DOH press releases can be viewed
► Weekly Disease Table
Florida Department of Health, Bureau of Epidemiology, Weekly Morbidity Report, Week 18, ending April 26, 2003.
Selected Diseases and Conditions (confirmed cases only). Access the very latest information at:
|Bureau of Epidemiology|