"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 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 

A r t i c l e s:

Melanie Black, MSW, Professional Training Coordinator, Bureau of Epidemiology

Alan Rowan, Ph.D., EIS Supervisor, Bureau of Epidemiology

Jaime Forth, Editorial Assistant, Bureau of Epidemiology

Jaime Forth, Editorial Assistant, Bureau of Epidemiology

Caroline Collins, Arbovirus Surveillance Coordinator and Carina Blackmore, M.S., Vet Med, Ph.D., Deputy State Public Health Veterinarian

Please note that numbers are subject to change with confirmatory information

► Epidemiology Seminar Smashing Success

On behalf of the Bureau of Epidemiology, I would like to thank everyone who participated in making the Statewide Epidemiology Seminar such a great success.  Since the meeting ended, we have been overwhelmed with positive comments from attendees. Virtually everyone enjoyed the accommodations and food and felt that the presentations rivaled those of national level meetings.  Some miscellany about the attendees:

• 218 participants attended
• 52 county health departments were represented
• A breakdown by profession included—63 epidemiologists, 83 registered nurses, 13 MDs, 11 environmental health professionals and others
• There were more than 35 entries in the poster and demonstration session
• The Bureau of Epidemiology was pleased to be able to support the attendance of 114 staff members from county health departments, many of whom would not otherwise have been able to attend.

This Statewide Epidemiology Seminar marked the first time awards were given for the poster session—the competition was intense. At the opening night event, an esteemed panel of public health experts served as judges, ranking the posters for prizes in four categories. At lunch the following day, Dr. Landis Crockett, Director of the Division of Disease Control recognized the winners, who were:

• D’Juan Harris, Utilizing Geographic Information Systems for Epidemiological Applications (Best Infectious Diseases)
• Dr. Youjie Huang, Disparities in Cancer Screening, Incidence and Outcomes (Best Chronic Diseases)
• Carmela Mancini, Bad Luck at Pot Luck (Best EIS Officer)
• Miami-Dade County Health Department, Current Knowledge, Practices and Attitudes of Miami-Dade Residents about West Nile Virus and Its Prevention (Best Health Department).

We are already reviewing suggestions to make next year’s seminar even better.

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► Prairie Dogs Found to Carry Monkeypox Disease

The Florida Department of Health and various county health departments are currently investigating reports of illness associated with exposure to prairie dogs. The concern of the department is that these reports of illness may be related to the cases of monkeypox reported in the other states.  According to the CDC Office of Communications, Illinois is currently investigating 19 cases of suspected monkeypox, Indiana has reported 26, Ohio 2, and Wisconsin 34.  

Monkeypox is a rare disease found primarily in central and west Africa. The disease has not previously been reported in the US.  In humans, the illness produces vesicular and pustular rash similar to smallpox, a related virus. It is possible to transmit this disease person-to-person. The incubation period is about 10-12 days. The case-fatality rate ranges from 1% to 10%¹. Monkeypox signs and symptoms generally consist of fever, headaches, dry cough, swollen lymph nodes, chills, and drenching sweat. One to ten days later, patients develop rashes consisting of blister-like pimples which are full of pus, break open, and produce scabs. The rash appears on the head, trunk, arms, and legs².  Any persons who have been exposed to prairie dogs and have experienced these symptoms should be evaluated by a physician immediately. 

The current public health concerns arise from a shipment of rodents, including Gambian rats, from Africa to a Texas dealer. Some of the prairie dogs exposed to the Gambian rats became infected with monkeypox. The prairie dogs were subsequently shipped to various parts of the country. Authorities have been concerned that the wide range of monkeypox is due to the existence of pet swap meets which are unregulated. On June 11, the FDA and the CDC announced a ban on the import of all rodents from Africa into the United States. This includes the sale, distribution, transport or release of prairie dogs and six named African rodent species. The embargo includes any sale or distribution that occurs within a state.  

The investigations in Florida are ongoing but so far have not resulted in any positive cases of monkeypox. CDC has announced that smallpox vaccine will be made available to people who have been, or may be exposed, to prairie dogs and other animals who have been exposed to monkeypox. Any questions or concerns about monkeypox can be addressed to Dr. Rowan at 850-245-4404 or Dr. Blackmore at 850-245-4444 ext. 2159.
1.   Control of Communicable Diseases Manual, 2000
2.  http://www.cdc.gov/ncidod/monkeypox/index.htm

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► Grand Rounds Scheduled At A.G. Holley

A.G. Holley State Hospital has scheduled a Grand Rounds entitled, "False Results From The TB Laboratory," on Wednesday, July 9th at 10:00 a.m. The program will last until noon. 

Continuing credits will be offered to on-site attendees only, although a conference call line has been established for those who would like to listen to the lecture but cannot attend. That number is 850.921.6623. If you do call in, be sure to place your phone on mute, so as not to disturb the speaker. Dr. Max Salfinger, professor at the New York Department of Health will be the presenter. 

If you'd like to attend or have questions, call Melody McIntosh at 561.540.3364 or e-mail her at Affette_McIntosh@doh.state.fl.us. You must register prior to July 3rd. Lunch will be provided, and a Q&A session will be included in the program.  

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► Africa Malaria Report Released 

In a report released April 12th by the World Health Organization and UNICEF, the success in curbing malaria in Africa by 2012 (the Abuja Targets) was revealed.  

According to the report, a low percentage of young children sleep under mosquito netting and an even smaller percentage of children sleep under netting treated with insecticide. Because netting helps reduce low birth weight and serious illness in infants, pilot projects were developed that increased the number of infants sleeping under treated netting. In communities where pilot projects were positioned, the number of children dying from mosquito-related diseases has decreased by 25%.  

In some parts of Africa, resistance to insecticides has grown; in other cases, insecticides are still not available to the local population. The report emphasizes the importance of maintaining pressure on political and other entities until this problem has been fully addressed.  

Data from the report were collected in the 1990s and continue to be difficult to track. However, worldwide monetary commitment to the control of malaria rose in the late 1990s, and this year  the U.S. Agency for International Development announced a new partnership with private businesses for the purpose of providing affordable treated bed nets to citizens in Malawi and four other nations in Africa.  For information on how to become involved in the USAID project, log on to the web site at  www.usaid.gov.com. For further information about the report, log on to http://infection.thelancet.com/journal/vol3/iss6/full/laid.3.6.the_leadering_edge...

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► Bureau of Epidemiology Adds Staff

The Bureau of Epidemiology in Tallahassee announces the addition of three new staff members, which should enhance our capability to provide comprehensive service to the health care community in Florida.  

Karen Wheeler will be performing census surveillance on emergency room reports, looking for trends in data that point to bioterrorism. With a master's degree in public health from North Carolina State University, Karen specializes in bioterrorism-related issues.

Anne Frost is a senior contract manager and will be working primarily on large procurements related to competitive and contractual purchases. Her expertise is in contract management. She's a veteran of state government, having worked within the Department of Health for the past 13 years.  

Susan Pearson has been hired to manage the administrative processes of our bioterrorism and  epidemiology and laboratory capacity grants. Her background is in finance and purchasing, so her eye for detail and administration should come in handy as we seek to continue funding for our various programs.  

If you need to contact any of these personnel, you can reach them at:

Karen Wheeler  850.245.4444, ext. 2401 or karen_wheeler@doh.state.fl.us
Anne Frost  850.245.4444, ext. 2423 or ann_frost@doh.state.fl.us
Susan Pearson  850.245.4444, ext. 2411 or susan_pearson@doh.state.fl.us

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► Researchers Announce Decoding of Anthrax Genome

Last month, a team of researchers at The Institute of Genomic Research in Rockville, Maryland released the results of their studies leading to the identification of the genetic blueprint of Bacillus anthracis, or Anthrax. 

In a press release issued April 30, 2003, National Institute of Allergy and Infectious Diseases (NIAID) Director Anthony Fauci, M.D. said, "As ever more precise details emerge about the genetic make up of these organisms, our ability to design effective drugs and vaccines against the diseases they cause is greatly improved." When comparing an isolate of the Ames strain of B. anthracis with two Bacillus bacteria, he adds, "There is remarkably little difference among these genomes. In the 5,000 or more genes we analyzed, we found only 150 or so significant differences." 

The investigators used comparative genomics to draw the blueprint, and found suggestions that microbes which infect insects may be recent ancestors of the gene Yercinia pestis, the cause of plague in mammals and insects, and B. anthracis, the gene which infects mammals alone and has the ability to live on decaying animal bodies. In addition, it has the ability to scavenge iron.  

The complete sequence of the anthrax genome is published in the May 1, 2003 edition of Nature Magazine. The research project was supported by NIAID and several other federal agencies, and led by scientists Claire M. Fraser, Ph.D. and Timothy Read, Ph.D.  For information about other bioterrorism agents, log onto the web site at http://www.niaid.nih.gov/dmid/genomes.

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► Arboviral Disease Report

Weekly Update:  During the period June 3 through June 9, 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.  As yet, not one human case has been reported for 2003. Gilchrist County has been under Medical Alert for EEE virus since mid-April.   

Sentinel Chickens:  Thirteen seroconversions to EEE virus were confirmed in Duval, Hillsborough, Nassau (2), Orange (5), Putnam, Volusia and Walton (2) counties, bringing the YTD (year-to-date) total of EEE sentinel seroconversions to 52 in 13 counties. Two seroconversions to WN virus were confirmed in Collier and Putnam counties, bringing the YTD total of WN sentinel seroconversions to 36 in 13 counties. This week, 1,119 samples were tested from 27 counties.   

Bird Mortality:  Two dead crows from Alachua and Jackson counties were reported positive for WN virus this week, bringing the YTD total for dead birds testing positive for WN virus to three in as many counties. The YTD total of dead birds testing positive for EEE virus is nine in six counties. 

Equine*:  Five EEE virus infections in horses were reported from Alachua, Clay, Hendry, Hillsborough and Taylor counties, bringing the YTD total for horses infected with EEE virus to 75 in 27 counties. One horse has been reported with WN virus infection this year. 

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.   

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

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

DOH Press releases can be seen at http://apps3.doh.state.fl.us/IRM/PressReleaseSearch/search.cfm.  

Florida is currently at “Level 1” in the Arbovirus Response Plan (see http://www9.myflorida.com/Environment/hsee/arbo/index.htm).  

The Disease Outbreak Information Hotline offers updates on medical alert status and surveillance at  888-880-5782.  

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 

Click on the link below to access the latest data regarding this week's disease figures provided by the Florida Department of Health, Bureau of Epidemiology.

Current week's disease table

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