Epi-Update Weekly Publication of Bureau of Epidemiology

Friday, May 30, 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."

Forge 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 


Don Ward, 
Deputy Bureau Chief 
Epi Update Managing Editor 


Jaime Forth, 
Editorial Assistant 




               SPECIAL EDITION

 Pre-Conference Information  
Final details for next week's 8th Annual Statewide Epidemiology Seminar, exclusively on these pages.  



 Poster Session and Reception 
This year for the first time, a panel of judges will be on hand to select the best posters in four different categories. Plus, you won't want to miss the chance to greet long-lost colleagues at the concurrent reception.  


Speakers  
A thoughtfully prepared roster of experts in their fields will be on hand to share their knowledge. 

Surveys 
In an effort to bring you a bigger, better seminar next year, we're asking everyone who attends this year's conference to fill out the survey included in their welcome bag. 


Activities  
Interested in checking out the local sites while you're in the Orlando area? Need we say there is a LOT to do in the evening after an exhilarating day of learning and networking? 

                   
And, in every issue... 

Weekly Influenza Report 
Confirmed cases for Week 20, ending May 17, 2003.  


Arboviral Disease Report
Statistics for the week ending May 26, 2003.


► 
Weekly Disease Table
Florida Department of Health, Bureau of Epidemiology, Weekly Morbidity Report. Week 21, ending May 24, 2003. Selected diseases and conditions (confirmed cases).

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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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pre-conference Information 

The telephone number for the Marriott Hotel Lake Mary is 407.995.1100. The Web site is located at www.marriott.com/MCOML. Lake Mary is situated 15 miles NE of Orlando. Be sure to check in at our conference registration desk in the first floor Grand Foyer upon arrival, to pick up your conference materials plus your name badge. This is essential if you're registering for CEUs. The friendly personnel there can direct you to our other conference sites within the hotel.

Remember that breakfast and lunch are included in the cost of registration.  Dinner, however, will be on your own both Monday and Tuesday evening. We've planned it this way to allow our guests more time to interact socially with friends and colleagues.

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Poster Session and Reception 

Nearly 30 entries have been received for this year's poster session. Topics range from the history of GIS application systems to recent tobacco survey findings.  Our judges will be watching for the Best Presentation by an EIS Officer, Best Presentation by a County Health Department, Best Presentation for Chronic Disease, and Best Infectious Disease display. Winners will be announced at the Wednesday luncheon.  

The reception, which starts at 6:00 p.m., will take place in Salons E-H on the first floor of the hotel. Attire is business casual, and there will be a cash bar.  

Please be sure to arrive early if you're presenting a poster, so you'll have plenty of time to set up. You'll also need to disassemble your exhibit before you leave for dinner. Neither conference staff nor hotel staff will be responsible for this task.   

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Speakers 

We've lined up a noteworthy array of speakers guaranteed to inform and inspire.  Check the start times on your conference agenda, and don't forget to arrive punctually. Seating in some rooms is limited.

Tuesday's speakers speakers are -

Jennifer Bencie, Seminole County Health Department
Bonnie Sorensen, Florida Department of Health
Lynette Brammer, CDC
Fermin Arguello, Florida Department of Health (CDC EIS)
David Atrubin, Florida Department of Health
Don Ward, Florida Department of Health
Joann Schulte, U.S. Public Health Service
Mary Jo Trepka, Miami-Dade Health Department
Kathryn Teates, Florida Department of Health
Jill MacKinnon, University of Miami

Michael Lo, Florida Department of Health
Robert Hammond, Florida Department of Health
Richard Meyer, CDC
Bobby Bickley, Department of Agriculture and Consumer Services

Wednesday's speakers are -

Alan Rowan, Florida Department of Health
Tracee Treadwell, CDC
Carmella Mancini, Florida Department of Health
Stacy Hall, Louisiana Office of Public Health
Youjie Huang, Florida Department of Health
Marie Bailey, Florida State University
Ziya Gizlice, North Carolina Center for Health Statistics
Lina Balluz, CDC
Pete Garner, Florida Department of Health
Perry Brown, Florida A&M University
Segaran Pillai, Florida Department of Health
Loretta Fauerbach, Shands Hospital at the University of Florida
Robert Bull, Naval Medical Research Center

Some of these may change, so check your agenda and our conference desk for last-minute revisions.

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Surveys 

We really do want to know what you have to say about your conference experience. Our staff believe they owe it to you, our colleagues, to bring you the best, most informative program of events possible; so if you have comments, suggestions or opinions this is a perfect opportunity to share them.   

It'll only take a few moments of your time, but the input you provide will be invaluable to us.  

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Activities

Now that the day's activities are over, you may be wondering what's available in the form of entertainment. The easiest way to do a little investigating beforehand is to visit the Orlando Convention Visitor's Bureau (CVB) Website. 

While in Orlando you you can watch a performance of the world-famous Cirque du Soleil at Downtown Disney, see a murder mystery at the Murderwatch Dinner Theatre, discover ancestors of the Incas at the Orlando Museum of Art, or take in the Tiffany lamp exhibit at the Morse Museum of Art.  These events are all happening while our seminar is in town.  To find out more, log on to the CVB website at http://www.orlandoinfo.com/cvb/ and click on the Vacation Information button located around the middle of the screen.  

Our host hotel concierge can offer suggestions, maps and driving directions. We can also personally recommend the following:  

Angel's Diner - Two locations in town, both staffed with friendly waiters and waitresses and a huge menu of American comfort foods served in a 50's style diner.  Clean and bright and fun, with an old-fashioned Wurlitzer at every booth.  Prices are affordable. 

Gaylord Palms Hotel and Convention Center - A wonderland of fauna and flora, all situated beneath an enormous glass dome. If you want to experience the feel of Key West you can head to the reef, a shipwreck with tall drinks, fresh seafood and live music. For the most stylish buffet in town, there's a restaurant right by the waterfall where you can people-watch to your heart's content. The magnificent hotel lobby and arboretum alone are worth the drive to this spot, and the stroll around the arboretum is a pleasant alternative to all that sitting you did earlier in the day.

Citiwalk at Universal Studios -  Emeril's Restaurant is here, plus Jimmy Buffet's Margaritaville, NBA City Restaurant, and the Motown Cafe. All are fun, provide menus ranging from pasta to steak to pizza and BBQ, and feature a variety of price options.  After dinner, walk off that meal as you take in the sights and sounds of CitiWalk. You'll return to your hotel room
having been entertained and energized by the best in the business! 

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Weekly Influenza Report 
 

Florida:
During week 20 (May 11-17, 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 0.73%. This is lower than the national baseline of 1.9%. Higher flu activity than expected for this time of year (>2%) was reported by surveillants in Indian River and Polk counties. Light to moderate influenza activity was seen in five other counties.

National report: During week 20, four isolates (3 influenza A and 1 influenza B viruses) were made from 511 specimens tested by the World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories this week.  The proportion of deaths attributed to pneumonia and influenza as reported by the vital statistics offices of 122 U.S. cities was 6.3% during Week 20. This percentage is below the epidemic threshold of 7.5% for this time. The proportion of patient visits to sentinel physicians for influenza-like illness (ILI) was 0.9% nationwide. The State and Territorial Epidemiologists in Massachusetts reported regional influenza activity. Twenty-one states, New York City and Washington D.C. reported sporadic activity, and 24 states reported no influenza activity.

Since September 29, 11.6% (n=11,027) of the 94,966 specimens tested nationwide have been positive. Three thousand three hundred and eighty-one (53%) of the 6,324 influenza A viruses have been subtyped; 2,534 (75%) were influenza A (H1N1 and H1N2) viruses and 847 (25%) were influenza A (H3N2) viruses. Influenza A viruses were reported more frequently than influenza B viruses (range 58% - 86%) in the New England, East North Central, Pacific, Mountain, and Mid-Atlantic regions, and influenza B viruses were reported more frequently than influenza A viruses (range 53% - 78%) in the West North Central, West South Central, South Atlantic, and East South Central regions.

CDC has characterized 173 influenza A (H1N1), 55 influenza A (H1N2), 105 influenza A (H3N2) and 254 influenza B isolates antigenically. The neuraminidase typing for one H1 viruses is pending. All influenza A strains were similar to corresponding vaccine strains. One influenza B strain was more similar to B/Shizuoka/15/01 than to the vaccine strain (B/Hong Kong/ 330/01).

International report:

The Netherlands: No further updates have been found for the outbreak of highly pathogenic avian influenza A (H7N7 HPAI) in chickens which began during February 2003 in The Netherlands. Between February and April of 2003, this outbreak had spread to Belgium and Germany, to swine herds in The Netherlands, and to humans. The 83 confirmed cases of human H7N7 in the Netherlands included one death, 79 with conjunctivitis and 13 with mild ILI. 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

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  Arboviral Disease Report

Please Note:  Numbers are subject to change with confirmatory information

Weekly Update: During the period May 20 through May 26, 2003, the following arboviral activity (St. Louis encephalitis [SLE] virus, eastern equine encephalomyelitis [EEE] virus, West Nile [WN] virus and dengue virus) was recorded for Florida:

Human: No cases of arboviral meningo-encephalitis were reported this week. Gilchrist County is under Medical Alert for EEE virus.

Sentinel Chickens: Two seroconversions to WN virus were confirmed in Indian River and Lee counties. Six seroconversions to EEE virus were confirmed in Alachua (2) and Orange (4) counties. This week, 853 samples were tested from 23 counties.

Bird Mortality: One dead bird from Madison County was reported positive for EEE virus this week.

Equine*: Five EEE virus infections in horses were reported from Marion (2), Osceola, Seminole and Suwannee counties.

Wild and Captive Birds: See http://www.pherec.org/DECS Arbovirus Ecology to view database.

Mosquito Pools: No mosquito pools were reported positive for WN or EEE virus this week.

Current Bird Mortality Reporting Guidelines:

1. Report dead birds to www.wildflorida.org/bird/. From that site, you can link to online bird identification sites. There is value in the information submitted even if the bird is not tested, especially for those counties which don't have sentinel chickens or who have sites situated sparsely in the county.

2. The DOH Lab in Tampa will test anything that's shipped in good condition. Instructions for submission of dead birds are found at: http://www9.myflorida.com/Environment/hsee/arbo/index.htm Select "How Do I Report?" then choose "Protocol for Collecting and Shipping Bird Carcasses" under "Dead Birds" subtopic.

3. If local agency must cut back on bird submissions, consider only sending crows and jays.

4. If personnel are not able to offer pick-up service, have a drop off station and provide the caller with clear handling instructions. A county may modify their testing approach depending on the availability of other surveillance systems in the county.

The Disease Outbreak Information Hotline offers updates on medical alert status and surveillance at 888-880-5782. Florida is currently at "Level 1" in the Arbovirus Response Plan (see http://www9.myflorida.com/Environment/hsee/arbo/index.htm). DOH Press releases can be seen at http://apps3.doh.state.fl.us/IRM/PressReleaseSearch/search.cfm.

* Equine cases are determined by the Department of Agriculture and Consumer Services.

For more information please see the DOH web site at:
http://www.doh.state.fl.us/Environment/hsee/arbo/index.htm.

Acknowledgements/data sources: county health departments, Department of Health Laboratories, Department of Agriculture and Consumer Services, mosquito control agencies, Florida Fish and Wildlife Conservation Commission, medical providers and veterinarians.

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Weekly Disease Table 

Information on confirmed cases cited by Bureau of Epidemiology Morbidity Report for Week 21, ending May 24, 2003 can be accessed at:

http://www9.myflorida.com/disease_ctrl/epi/DiseaseTable/2003_weekly/diseasetable.htm

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