Epi-Update Weekly Publication of Bureau of Epidemiology
 Friday, August 1, 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."

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, Copy Editor/ Writer 

          
       This Week in the News

Joint Conference Calls Gaining Momentum
Last week's forum on issues concerning county health departments was the biggest ever. Don't miss the next one! 


 EpiCom U
If you work in a hopsital or county health department and don't use this essential communications tool, you won't want to delay any longer. 


 FDA Clears West Nile Virus Test
PanBio has been cleared by the FDA to manufacture the first test for the West Nile virus antibody in the U.S.  


 Grand Rounds 2003
Start clearing your calendar - Here are some Grand Rounds you won't want to miss. 


 Be Prepared
The old Boy Scout motto has never more relevant. We'll acquaint you with the latest materials to help organize and train for exercises to keep you prepared.  


Arboviral Disease Report
Statistics through the week ending July 28, 2003 for confirmed cases only.


Weekly Disease Table
Florida Department of Health, Bureau of Epidemiology Weekly Morbidity Report for the current week only includes selected diseases and conditions for confirmed cases.


Submissions to Epi Update should be emailed to Jaime Forth at jaime_forth@doh.state.fl.us. Articles must be submitted as a Word document attachment in plain 10-point Arial font with no boxes, centering or other elements added to the text. Please clearly identify the author. Only final documents (not drafts) are accepted. If you have questions, call 245.4444, ext. 2440. We look  forward to hearing from you!

 

 

A R T I C L E S

Jaime Forth, Copy Editor/ Writer, Bureau of Epidemiology

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 








Pete Garner, Surveillance Systems Section Administrator, Bureau of Epidemiology

 

 












Jaime Forth, Copy Editor/ Writer, Bureau of Epidemiology

 

 

 

 

 

 

 

 

 

 

 



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



 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


Caroline Collins, Arbovirus Surveillance Coordinator and Carina Blackmore, DMV, Ph.D., Acting State Public Health Veterinarian, Bureau of Community Environmental Health


 

 

 

 

 


Please note that numbers are subject to change with confirmatory information

 

Joint Conference Calls Gaining Momentum          

The number keeps going up! Last week’s conference call drew a record 161 participants, and we’re pleased that the level of interest in this bi-weekly information exchange continues to grow. For county health department personnel who missed the July 25th call, here’s a brief synopsis.

New Regional Training. Don Ward announced that quarterly training, which had been postponed due to SARS, our annual conference and other events, will resume within the next couple of months. Look for communications from Melanie Black via the Epi Update and other channels shortly. Classes will be scheduled on EpiCom useage and case investigations; plus, shipments of resource materials to each county health department will start soon.

Bioterrorism Grant Update. August 30th marks the end of the 2002/03 bioterrorism grant year. Unspent funds will not be allowed to roll over. If you have questions or concerns regarding this issue, email Debbie Ford at debbie_ford@doh.state.fl.us. For the new grant year, continued support will be provided for established positions.

Case Definitions and Reportable Diseases. Kathryn Teates noted that new definitions have been posted on the web. For accuracy, please ensure your administrators use the most recent version. The latest lab findings will be posted on the web site next week. Future changes to case definitions will be published in batches. Questions should be referred to Travis McLane at travis_mcLane@doh.state.fl.us.

ER Surveillance Update. Karen Wheeler discussed the present state of the bioterrorism emergency room census surveillance system and outlined goals for the future of the program. EpiCom will likely be the vehicle for a simple notification and analysis system, placed on the web for easy access. She will market the ER surveillance system to recruit participation among hospitals in areas with heavier tourist populations, and work with county health departments to designate a point of contact so communication will be easier to facilitate. Any health department or hospital that is not currently using EpiCom should contact Pete Garner.

Merlin Frequency Reports. Pete Garner announced that a sanitized version of our Merlin reporting data is now available on the web, allowing users to create their own queries. Since only case counts are identified, breaching confidentiality is not an issue. A crystal viewer component is required. The web site address is http://hpe00ws/charts/chart.aspx. 

BFRSS Working Group. Dr. Youjie Huang reported that the working group is preparing questions for the 2004 survey, and the meeting was well attended. Oversampling of racial or non-English speaking groups is under consideration this year. If county health departments have questions they’d like included in the survey, he’d be happy to work with them. Please contact Dr. Huang via email at youjie_huang@doh.state.fl.us.

The next conference call is scheduled for Friday, August 8 from 10:00 – 11:00 a.m. EST. If you have an item for the agenda or ideas for discussion, please email Don Ward at donald_ward@state.fl.us or Melanie Black at melanie_black@doh.state.fl.us. The conference call agenda will be emailed on Thursday, August 7, 2003.

Back to top

EpiCom U


EpiCom users have a distinct advantage over non-EpiCom users because the former have an immediate link to other Florida public health professionals for the latest information on disease outbreaks and other key issues. This will be an essential form of communication in the event of an emergency, and has already been helpful in tracking disease outbreaks around the state.

If you haven’t logged on to EpiCom this week, you missed learning firsthand about

  • two reported cases of Malaria

  •  9 prophylaxes for pertussis exposure in Polk Country and a pertussis outbreak in South Carolina

  • reports of influenza cases at two correctional institutions  

Registering is simple and the data is dependable. To enter an initial report or provide follow-up data, simply log in and fill in the details. For further information concerning this program, send an email to EpiCom_Administrator@doh.state.fl.us. To view EpiCom, log on to https://www.epicomfl.net/.

Back to top

FDA Clears West Nile Virus Test

An Australian firm has won FDA approval for the first diagnostic blood test for West Nile virus. IgM Capture ELISA was developed by PanBio for patients presenting clinical symptoms of viral encephalitis or meningitis. 

The PanBio test reduces inter-laboratory variation through use of a standard cut-off serum. Unlike HAI, acetone extracted sera is not required, and sera need not be obtained following discharge from hospital. Differentiation between primary and secondary infection can be made through a single dilution of serum rather than a series of dilutions required in HAI assays, offering an improvement over the HAI assay for serological diagnosis of dengue infections.

Serum IgM antibodies can be detected in dengue patients as early as three to five days after onset of the fever. Tested at four different clinical sites, the assay correctly identified the West Nile Virus antibody in 90 to 99% of cases, although follow-up testing should be pursued due to similarities in viruses within the same family.

In 2002, there were 4,156 confirmed cases of West Nile infection in the United States, and 284 patients died. According to the CDC, only about one infected person in 100 develops symptoms. The pathogen was first detected in New York in 1999 and has spread steadily to the west coast, although California experienced only one case last year.

In a comment following the announcement by the FDA, Secretary of Health and Human Services Tommy Thompson said “Emerging infectious diseases such as West Nile virus present a challenge to the public health community. When industry and government collaborate closely to meet a public health need, the resulting new technology will strengthen our joint efforts to confront diseases earlier and should lower rates of infection.”

Back to top

Grand Rounds 2003

The Bureau of Epidemiology holds Grand Rounds the last Tuesday of each month, with the exception of holidays, from 11:00 a.m. until 12:00 p.m. EST. Each session seeks to introduce listeners to new concepts and increase their fluency in epidemiological issues.

As guest speakers present the latest information on their specializations, it is our hope that you will gain more knowledge and then share it with colleagues who were unable to listen with you.

Details regarding Grand Rounds and other training opportunities are posted in the training section of the bureau website at http://www9.myflorida.com/disease_ctrl/epi/index.html

For the remainder of the year 2003, the following speakers are scheduled, with topics to be announced as the dates draw nearer:

            

Back to top

Be Prepared

Access the latest documents, training manuals, periodicals and texts online from the following sources, which contain a variety of first-rate observations and practical solutions for disaster training and planning:  

State of Rhode Island Office of Emergency Preparedness -  http://www.healthri.org/biot/web_sites.doc.

International Journal of Mass Emergencies and Disasters, Los Angeles: University of Southern California – www.usc.edu/schools/sppd/ijmed/.

The Natural Hazards Center at the University of Colorado – www.colorado.edu/hazards.

Agency for Toxic Substances and Disease Registry – www.atsdr.cdc.gov.

Disaster Response: Principles of Preparation and Coordination, Auf der Heide E. – www.coe-dmha.org/dr/flash.htm.

U.S. Department of Health and Human Services Office of Emergency Preparedness and National Disaster Medical System Web Site – www.ndms.dhhs.gov/

Back to top

Arboviral Disease Report  

Three human cases of West Nile (WN) virus encephalitis were confirmed this week in residents of Collier (onset 7/9), Lee (onset 7/15), and Okaloosa (onset 7/9) counties. In addition, a case of WN fever was confirmed in a resident of Brevard County (onset 7/12). These four counties were placed under medical alert, for a total of seven counties currently under medical alert, including Bay, Gilchrist and Orange counties. 

EEE virus activity in animals: Six horses were confirmed with EEE virus infections, bringing the YTD total for horses infected with EEE virus to 174 in 47 counties (first EEE activity for Dade and Sarasota). This year so far, there are nearly seven times the number of horses than were reported with EEE in all of last year. Forty seroconversions to EEE virus were confirmed in sentinel chickens, the highest numbers being in Nassau and Orange counties. One dead bird was reported positive with EEE virus (Duval). Two juvenile live wild birds and a recent recapture were found EEE-positive in Walton County, suggesting recent infection.  Of Florida’s 67 counties, 50 have reported EEE activity, compared to 20 last year by this time. EEE activity appears to be spreading out from the central region.

WN virus activity: Seventeen seroconversions to WN virus were confirmed in sentinel chickens, for a YTD total of 84 WN seroconversions in 21 counties (first WN activity for Palm Beach). Six dead birds were reported positive for WN virus. A juvenile (suggestive of recent infection) cardinal collected in Okaloosa, previously reported positive for both SLE and EEE, has been found positive for WN virus. Thirty-seven counties have reported WN virus activity this year, with sporadic distribution around the state, compared to 24 last year by this time.

The complete report can be viewed at: http://www.doh.state.fl.us/Environment/hsee/arbo/weekly_summary2003.htm

Back to top

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

Back to top

   

                  Bureau of Epidemiology                 EpiUpdate Archives                         Florida Department of Health                   My Florida                                Contact Us