|
August 5, 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
Email
addresses are no longer provided as a method of contact for contributing
authors.
We regret this inconvenience. This is a security
measure designed to prevent Internet
hackers access to Department of
Health email accounts.
Border Health and Quarantine at Ports of
Entry to be Topic of August Grand Rounds
by Kiren
Mitruka, MD
Title: Epidemiology Grand Rounds: Border Health and CDC Miami
Quarantine Station
Presenter: Kiren Mitruka, MD, Medical Officer, CDC Miami Quarantine
Station Division of Global Migration and Quarantine
Date: August 30, 2005
Abstract
Miami is one of the United States’ busiest ports of entry, with an active
cruise and airline industry. The Miami International Airport serves over
110 national and international airlines from 65 countries. It is the third
busiest US airport for international passenger traffic, with 14.2 million
international travelers in 2003, and more than half of all arrivals to the
United States from South and Central America entering through Miami. As
evidenced by the global transmission of SARS in 2003, air travel can
effectively introduce a communicable disease into a community and cause a
world-wide outbreak. In the face of emerging infectious diseases, threats
of bioterrorism, and strong anticipation of the next influenza pandemic,
public health preparedness at our ports of entry is critical. The Centers
for Disease Control and Prevention Miami Quarantine Station, under the
auspices of the CDC’s Division of Global Migration and Quarantine, is
committed to working together with local, state and federal partners, such
as local health departments, the U.S. Coast Guard, U.S. Customs and Border
Protection, in developing a well-coordinated public health response, to
build a strong defense against the importation of communicable diseases
into our community.
The
CDC Miami Quarantine Station (QS) is responsible for the prevention and
control of communicable diseases at all the ports of entry in Florida. The
Miami QS is physically located at the Miami International Airport (MIA),
and is one of 16 national field quarantine stations. The mission of DOGMA
is “to make and enforce regulations necessary to prevent the introduction,
transmission, or spread of communicable diseases from foreign countries
into the United States.” To enforce the legal and regulatory authority of
DOGMA in support of its mission, the Miami QS works closely with other
federal agencies (e.g., U.S. Customs and Border Protection, U.S. Department
of Agriculture, U.S. Fish and Wildlife, and Federal Bureau of
Investigations) and local partners (state and county health departments,
county aviation, police, and fire rescue) in tasks such as monitoring the
health status of immigrants, refugees and travelers; performing
inspections of maritime vessels and cargo for infectious disease agents;
distributing immunobiologics and investigational drugs when indicated;
providing travelers with essential health information; and ensuring
appropriate disposition as well as public health action for illnesses on
planes and vessels.
In
the past, the Miami QS has responded to special public health challenges
posed by mass migration from Cuba and Haiti, and global outbreaks such as
SARS. To better prepare for future public health emergencies, the Miami QS
has developed strong partnerships with local health authorities and first
responders, and together they have carried out field and tabletop
exercises. The Miami QS will continue to promote and strengthen
collaborative work with its community partners, for the development of a
well-coordinated response to bioterrorism threats and communicable
diseases of public health significance.
Additional Information
The grand rounds presentation will begin promptly at 11:00 a.m. ET on
Tuesday, August 30, 2005. The PowerPoint slides and dial-in number will be
posted on the Bureau of Epidemiology intranet website on Friday, August
26, 2005. CEUs will be provided for nursing and environmental health
professionals. If additional information is needed, contact Melanie Black,
MSW, professional training coordinator, at 850.245.4444 ext. 2448.
Dr. Mitruka is a medical officer at the
CDC's Miami Quarantine Station,
Division of Global Migration and Quarantine.
Cholesterol and Blood Pressure Among
Adults with Diabetes in Florida, 2002
by Regan Glover, MS
Background
Diabetes is associated with high blood pressure and high cholesterol,
which are linked with heart disease and stroke. In fact, people who have
diabetes are 2-4 times as likely to develop heart disease than people who
don’t have diabetes1,
and 2 out of 3 people with diabetes die from heart disease and stroke.
Most of the cardiovascular complications related to diabetes have to do
with the way the heart pumps blood through the body. Diabetes can change
the chemical makeup of blood components and this can cause blood vessels
to narrow or clog up. There are many things people with diabetes can do to
lower their risk of developing heart disease or a stroke. Lowering blood
pressure and cholesterol levels if they are too high are important first
steps.
The focus of this
report is cholesterol2 and
blood pressure3 among
adults with diagnosed diabetes4 in
Florida. Data from the 2002 Florida County Behavioral Risk Factor
Surveillance System (BRFSS) survey were used for this analysis and are
based on a sample size of 34,551 respondents, of whom 3,582 reported being
told by their doctors that they have diabetes.
Cholesterol
The
prevalence of having blood cholesterol checked among adults with diagnosed
diabetes (94.9 percent) is significantly higher than among adults without
diabetes (82.0 percent). Among those adults with diabetes, 98.1 percent
had their cholesterol checked in the past 2 years. Among all adults,
those diagnosed with diabetes were significantly more likely to be told
they had high cholesterol (57.6 percent) than were adults without diabetes
(32.8 percent).
Cholesterol among
adults with diagnosed diabetes
The only significant differences in the prevalence of high cholesterol
among adults with diagnosed diabetes were observed for educational
attainment, such that adults with a high school education or less were
more likely to have high cholesterol (64.9 percent) than those with some
college (51.5 percent; see Figure 1.) No significant differences were
observed by sex, race/ethnicity, age, marital status or income (see Table
1.)
Blood pressure
The prevalence of being told by a health professional that one has high
blood pressure is significantly higher among adults with diagnosed
diabetes (62.5 percent) than for adults without diabetes (24.5 percent).
High blood pressure
among adults with diagnosed diabetes
Among adults with diagnosed
diabetes, significant differences were observed by age, educational
attainment and income. Adults with diabetes ages 18-44 years were
significantly less likely to have been told that they have high blood
pressure (44.1 percent) than were adults age 65 and older (71.3 percent).
Those with less than a high school education were more likely to have high
blood pressure (75.1 percent) than those with some college (56.5 percent).
Adults with diabetes and incomes exceeding $50,000 are less likely to have
been told they have high blood pressure (51.6 percent) than are adults
with incomes less than $25,000 (69.9 percent). (see Figure 2.) No
significant differences in the prevalence of high blood pressure among
adults with diabetes are observed by sex, race/ethnicity, or marital
status (see Table 2.)
Conclusion
High cholesterol mostly relates to diet and biological factors,
while high blood pressure relates to biological and social factors. The
prevalence of having blood cholesterol checked is significantly higher
among adults with diabetes than among adults without diabetes. Adults
with diabetes were more likely to have high cholesterol than those without
diabetes. Among adults with diabetes, those with a high school diploma
were more likely to have high cholesterol than those with some college.
The prevalence of high blood pressure is significantly higher among adults
with diabetes than adults without diabetes. Among adults with diabetes,
those age 18-44, with some college, or incomes exceeding $50,000 are less
likely to have high blood pressure than adults age 65 and older, less than
a high school education, or incomes less than $25,000.
The Behavioral Risk
Factor Surveillance System (BRFSS)
The BRFSS survey is a telephone survey of civilian,
non-institutionalized adults (age 18 and older) with telephones, and is designed
to monitor trends in risk behaviors related to preventable chronic
diseases and conditions. Respondents are asked about health status,
including diabetes and blood pressure; health behaviors, such as
nutrition, physical activity, tobacco, and alcohol use; use of screening
services, such as mammography; and access to health insurance and health
care.
The BRFSS data are
weighted. Because the BRFSS is a random survey, the results from the
county survey are slightly different than results from the state survey.
For more information about the Florida BRFSS, please visit our web site at
http://www.doh.state.fl.us/disease_ctrl/epi/brfss/index.htm . For more
information about the strengths and limitations of the BRFSS, please visit
The Centers for Disease Control and Prevention web site at
www.cdc.gov/brfss/.
|
Table 2: Prevalence of having high blood pressure among adults without
and with diabetes, Florida, 2002 |
|
|
|
|
|
|
|
|
|
|
|
Adults Without Diabetes |
|
Adults With Diabetes |
|
|
% |
95% CI* |
|
% |
95% CI* |
|
All |
24.5 |
23.5 |
25.6 |
|
62.5 |
58.6 |
66.3 |
|
Sex |
|
|
|
|
|
|
|
|
Male |
25.5 |
23.9 |
27.1 |
|
63.1 |
57.7 |
68.5 |
|
Female |
23.8 |
22.3 |
25.2 |
|
61.9 |
56.4 |
67.3 |
|
Age Group |
|
|
|
|
|
|
|
|
18-44 |
10.9 |
9.6 |
12.1 |
|
44.1 |
32.6 |
55.6 |
|
45-64 |
30.0 |
27.9 |
32.0 |
|
61.0 |
54.3 |
67.6 |
|
65+ |
49.5 |
47.0 |
52.0 |
|
71.3 |
66.7 |
75.8 |
|
Race/Ethnicity |
|
|
|
|
|
|
|
|
White, non-Hispanic |
25.7 |
24.5 |
26.8 |
|
63.1 |
59.4 |
66.9 |
|
Black, non-Hispanic |
28.1 |
23.8 |
32.3 |
|
66.6 |
55.1 |
78.2 |
|
Hispanic |
16.7 |
12.4 |
21.0 |
|
60.3 |
37.3 |
83.3 |
|
Marital Status |
|
|
|
|
|
|
|
|
Never married |
12.7 |
10.3 |
15.2 |
|
63.8 |
50.1 |
77.5 |
|
Married/cohabitating |
24.5 |
23.2 |
25.9 |
|
61.1 |
55.8 |
66.3 |
|
Divorced/ widowed/ separated |
34.0 |
31.8 |
36.2 |
|
63.7 |
57.9 |
69.4 |
|
Education |
|
|
|
|
|
|
|
|
Less than high school |
33.2 |
28.6 |
37.9 |
|
75.1 |
66.3 |
83.9 |
|
High school, GED |
26.7 |
24.8 |
28.6 |
|
65.3 |
58.7 |
71.9 |
|
More than high school |
22.1 |
20.7 |
23.4 |
|
56.5 |
51.1 |
61.9 |
|
Annual Household Income |
|
|
|
|
|
|
|
|
Less than $25,000 |
29.4 |
26.7 |
32.1 |
|
69.9 |
64.7 |
75.2 |
|
$25,000—$50,000 |
23.2 |
21.3 |
25.1 |
|
62.2 |
54.7 |
69.6 |
|
More than $50,000 |
19.9 |
18.3 |
21.6 |
|
51.6 |
42.5 |
60.8 |
1 For more
information about diabetes and heart disease, please visit the American
Diabetes Association web site at
http://www.diabetes.org.
2 Among those who responded “yes” to having blood cholesterol
checked, those with high cholesterol were identified by their response to
the following question, “Have you ever been told that your blood
cholesterol is high?”
3 Blood pressure is assessed by the following question, “Have you
ever been told by a doctor, nurse or other health professional that you
have high blood pressure?”
4 Diabetes is assessed by the following question, “Have you ever
been told by a doctor that you have diabetes?”
*Confidence intervals
for Tables 1 and 2 are constructed utilizing the Statistical Analysis
Software (SAS) 9.1 version.
Regan Glover is the
IBD coordinator in the Chronic Disease Surveillance Section of the Bureau
of Epidemiology in Tallahassee. She can be reached at 850.245.4444, ext.
2424.
|
Neurotoxis Shellfish Poisoning,
Charlotte County, 2005
by
Robin Terzagian
On late Friday afternoon July 22, 2005,
the Charlotte County Health Department (CHCHD) was
informed by the Pinellas County Health Department that three Charlotte County
residents were diagnosed with acute paralytic shellfish poisoning after
ingestion of oysters presumed to be contaminated with red tide. Initial
reports indicated two of the cases, (brothers aged 6 and 9) were shipped
to All Children's Hospital in St. Petersburg, Florida. The 6
year-old was intubated in the ICU having seizures and then stabilized to
the floor and discharged on July 21, 2005. The 3rd case,
(mother, age 31), was admitted to Fawcett Memorial Hospital in Port
Charlotte, Florida on July 14, 2005 and was discharged on July 15, 2005.
The Charlotte County Health Department contacted the infection control nurse at Fawcett
Memorial Hospital on Friday, July 22, who reported she was not aware of
this incident and would look into it on Monday. On July 25, Fawcett
Memorial Hospital faxed the state’s reportable disease list and the
patients' histories to CHCHD.
The reportable
disease list showed another case, a 35 year-old woman who is the friend of
the 3rd case in the initially reported cases. On July 14, 2005,
the group of four had visited a local beach in Boca Grande and dug up some
clams from a low tidal area of Boca Grand Pass in Lee County
(recreationally harvested). The clams were then boiled and eaten by the
two children and two adults around 5:00 pm. Shortly thereafter, their
symptoms began (see following table).
|
Symptoms |
Frequency |
Percentage |
|
Dizziness |
1 |
25% |
|
Vomiting |
2 |
50% |
|
Headache |
2 |
50% |
|
Abdominal cramps |
3 |
75% |
|
Tingling (extremities/face/mouth) |
3 |
75% |
|
Muscle spasm/cramps |
4 |
100% |
According to the Florida Department of Agriculture and Consumer Services, Division of
Aquaculture, the Boca Grande Pass area has been closed for shellfish
harvesting since June 30, 2005 due to the presence of red tide (caused by
Gymnodium breve renamed Karenia brevis dinoflagellates). Cell counts in
the water exceeded 5000 cells per liter.
http://www.floridaaquaculture.com/pdfmaps/58.pdf
http://www.floridaaquaculture.com/pdfmaps/62.PDF
The waters are monitored for red tide organisms during these closures. The past couple of sampling excursions
indicated that there were no red tide cells in the waters of these areas.
When red tide cells are no longer found in the waters, the shellfish tissue sampling can begin to determine if the
toxin has cleared out of the shellfish (Florida Fish and Wildlife Research
Institute conducts the mouse bioassays to determine if toxin remains in
the shellfish and if the shellfish are safe to consume or not). Generally,
shellfish take about 2 to 3 weeks to cleanse themselves of red tide
toxins. Since red tides initiate offshore and do not bloom in estuaries,
the highest cell counts and highest levels of toxins in shellfish tissues
are found near the passes/inlets.
Shellfish tissues were collected on
Thursday, July 21 in the Gasparilla Sound Shellfish Harvesting
Area and resulted in negative mouse bioassay results, and the area was
reopened to harvest on sunrise, July 23, 2005. Shellfish tissues will be
collected from the Pine Island Sound Shellfish Harvesting Area this week
for mouse bioassays.
Recreational and commercial harvest areas
must be closed when there are >5,000 cells per liter in the waters, and
the area remains closed until both 1) the cell counts drop below 5,000
cells per liter in the water and, 2) the shellfish test negative for
toxin.
Red tide is a harmful algal bloom resulting from the multiplication of
single-celled algae called Karenia brevis. Red tide is a natural phenomenon not caused by man-made pollution.
The term refers to a bloom of toxic or harmful marine microorganisms that
may color the water or be invisible; toxins may also be released.
Shellfish accumulate large amounts of brevetoxin and can then cause NSP
after consumption. Commercial shellfish harvesting areas are closed by the
Department of Agriculture and Consumer Services Molluscan Shellfish
Program when red tide occurs. Red tide assessments are based on the
following concentrations of cells:
Key for Results
|
Description |
Karenia brevis
cells/liter |
Possible Effects (K. brevis only) |
|
PRESENT |
normal levels of
1000 cells or less |
None |
|
VERY LOWa |
>1000 to <5000 |
Possible respiratory irritation |
|
VERY LOWb |
5,000 to <10,000 |
Possible respiratory irritation and
shellfish harvesting closures |
|
LOWa |
10,000 to <50,000 |
Respiratory irritation, but
chlorophyll levels too low to be detected by satellites |
|
LOWb |
50,000 to <100,000 |
Respiratory irritation, maybe fish
kills, and bloom chlorophyll probably detected by satellites |
|
MEDIUM |
100,000 to
<1,000,000 |
Respiratory irritation and probable
fish kills |
|
HIGH |
>1,000,000 |
As above plus discoloration |
Neurotoxic Shellfish Poisoning (NSP) is a notifiable disease in Florida (s. 64D-3.002 (1) qq, Florida Administrative
Code). NSP is an illness caused by eating shellfish that have accumulated
brevetoxin and its derivatives. The main symptoms include tingling and/or
numbness of the lips, tongue, throat, hands and feet. Symptoms tend to be
mild and resolve quickly and completely. Onset of this disease occurs
within a few minutes to a few hours; duration is fairly short, from a few
hours to several days. Recovery is complete with few sequellae; no
fatalities have been reported. Other shellfish poisonings include
Paralytic Shellfish Poisoning (PSP), Diarrheic Shellfish Poisoning (DSP)
and Amnesic Shellfish Poisoning (ASP). See table summary of the different
shellfish poisonings.
Cases of NSP in Florida are often misdiagnosed as Paralytic Shellfish Poisoning (PSP), which can cause a much
more serious illness that can result in death. According to the Fish and
Wildlife Research Institute, no algal species that cause PSP have been
verified in the Gulf of Mexico. PSP cases have been reported from Alaska, California, Maine, Massachusetts, Oregon,
Tennessee (seafood from elsewhere), and Washington. Also, in 2002, 2003
and 2004, several cases of saxitoxin poisoning from the consumption of the
Southern pufferfish harvested in the Indian River Lagoon (Florida’s
Atlantic coast) were reported. Saxitoxin is the same toxin that causes
PSP, but to date has not been found in the waters off the Gulf Coast of
Florida.
Information on the status of red tides in
Florida can be obtained from the Fish and Wildlife Research Institute
website at
http://www.floridamarine.org/features/category_sub.asp?id=4434.
Information on the harvesting status of commercial shellfish beds in
Florida can be obtained at
http://www.floridaaquaculture.com/.
Click on Shellfish Harvesting, then click on the drop down menu arrow and
choose Shellfish Harvesting Daily Area Status.
Summary of Shellfish
Poisoning Types
|
Type of illness |
Area of 0ccurrence |
Incubation period |
Symptoms |
Toxin |
|
Neurotoxic
shellfish poisoning |
In USA: mostly in
Florida, Texas, and North Carolina. Also in Mexico |
Few minutes-several
hours |
Tingling and
numbness of lips, mouth, fingers, toes; diarrhea, sensory cold-hot
reversal, dizziness, pupil dilation. |
Brevetoxins |
|
Paralytic shellfish
poisoning |
In USA: mostly in
California, Oregon, Washington, Alaska, Maine, Massachusetts |
30 minutes |
Numbness in lips,
mouth and face, tingling in fingers and toes; headache, dizziness,
muscle weakness, nausea, vomiting, motor in coordination, paralysis,
death |
Saxitoxins,
gonyautoxins, others. |
|
Diarrheic shellfish
poisoning |
Mostly Europe,
Japan, South America. Okadaic acid has also been found in Gulf of
Mexico shellfish and causative species occur Gulf-wide |
30 minutes – few
hours |
Vomiting, diarrhea,
nausea, abdominal pain. |
Okadaic acid,
dinophysistoxins, other. |
|
Amnesic shellfish
poisoning |
In USA: California,
Oregon, Washington. Also, Canada. Domoic acid has been found in Gulf
of Mexico shellfish and the causative species occur Gulf-wide. |
A few hours to 24
hours. |
Vomiting, muscle
cramps, disorientation, short-term memory loss. |
Domoic acid. |
References:
1.
Control
of Communicable Diseases Manual, 17th Edition, 2000, James
Chin, M.D., Editor, APHA.
2.
FDA
Badbug Book:
http://www.cfsan.fda.gov/~mow/chap37.html
3. Florida
Department of Health Epi Updates, September 11, 1996 and December 7, 2001
Acknowledgement: Thanks to David Heil,
PhD., MPH, Florida Department of Agriculture, Bureau of Aquaculture
Environmental Services for his assistance.
Robin Terzagian is a regional
environmental epidemiologist in Ft. Myers, Florida and can be reached at
239.338.2744.
Bureau of
Epidemiology Studies
Featured in CDC Publication
by
Jaime Forth
The Friday, July 22, 2005 edition of the Centers for Disease
Control and Prevention's MMWR featured two
articles by several Florida Department of Health authors. Both pieces were
written about findings connected to the four hurricanes that swept through
our state in 2004.
The first article, entitled "Epidemiologic
Assessment of the Impact of Four Hurricanes - Florida, 2004" is a summary
of the BRFSS survey to assess the impact of the hurricanes on state
residents. The second article, "Carbon Monoxide Poisoning from
Hurricane-Associated Use of Portable Generators - Florida, 2004" was
based on an investigation into deaths attributed to fatal and nonfatal
poisonings caused by misplacement of portable, gasoline-powered generators
used during power outages after the storms.
To access these articles on the Internet,
click on
http://www.cdc.gov/mmwr/PDF/wk/mm5428.pdf
and enjoy.
Jaime Forth is managing editor of Epi
Update and can be reached at 850.245.4444, ext. 2440.
Regional
Epidemiology Seminar Scheduled
for Leon County in August
by Melanie Black, MSW
The Regional
Epidemiology Seminar, co-sponsored by the Bureau of Epidemiology and the
Leon County Health Department will be held at the Homewood Suites,
Tallahassee, Florida on Thursday, August 11th and Friday, August 12th,
2005. The target audiences for the regional training programs are county
health department staff members who conduct epidemiologic investigations
and infection control practitioners.
This program will
specifically address public health surveillance and communicable disease
outbreak investigations. Topics such as principles of public health
surveillance, improving provider reporting, principles of field
epidemiology, using Merlin in investigations, measuring epidemiological
effectiveness and an outbreak scenario will be covered in this training.
On-line registration is now available and can be accessed through the
Bureau of Epidemiology Internet web site:
http://www.doh.state.fl.us/disease_ctrl/epi/conf/training/agenda.htm.
The class will be
limited to 45 participants. CEUs will be offered for this program; 8.5
hours for nursing, 11 hours for environmental health professionals and 4.5
hours for laboratorians.
Additional information will be provided in Epi Update and on the
Bureau of Epidemiology web page. We intend to offer training programs in
other regions of the state. If you are interested in hosting one of the
training sessions or have questions related to this program, please feel
free to contact Melanie Black, professional training coordinator, Bureau
of Epidemiology at 850.245.4444, ext. 2448 or SunCom 205.4444, ext. 2448.
We are truly excited
about the potential this program offers for improving disease prevention
in Florida.
Melanie Black is also planning a one-day
summit on pandemic influenza, scheduled for September in Tampa. If
interested in attending, log on to the summit website at
http://www.doh.state.fl.us/disease_ctrl/epi/conf/training/PanFlu_Summit.htm
Training in Foodborne
Disease
Investigations to be Offered
by Roberta M. Hammond, PhD
There’s
still room!
The agenda for the 2005 FEHA AEM
pre-conference training in Selected Issues in Foodborne Disease
Investigations for 5.5 EH CEUs to be conducted on Tuesday, August 9, 2005
is shown below. The cost of the training is $40.00 for FEHA members and
$50.00 for FEHA non-members. Also provided are links to the FEHA AEM
agenda and conference registration (including other pre-conference training opportunities on a variety of environmental health
issues: food plan review; safe body piercing; hurricane response; onsite
sewage; water well construction).
If interested in this or other
trainings, please register by completing the registration form and fax or
mail to the address at the bottom of the form. Address questions to FEHA,
the organization handling the registration.
Registration form for the FEHA AEM and
pre-conference training:
http://www.feha.org/aem2005/FEHA%20REGISTRATION%20FORM%202005.pdf
FEHA AEM agenda:
http://www.feha.org/aem2005/aem2005_agenda.pdf
Selected Issues in Foodborne Illness
Investigations
FEHA AEM Pre-conference Training
Presented by the DOH Food and Waterborne Disease Program
Bureau of Community Environmental Health
(5 1/2 hours CEUs)
|
Registration
|
|
8:30 am – 9:00 am |
|
Hypothesis Generation in Foodborne
Outbreak Investigations
|
Roberta Hammond, PhD |
9:00 am – 10:00 am |
|
BREAK
|
|
10:00 am – 10:15 am |
|
An Overview of Pathogenic E. coli and
Case Studies in Food and Waterborne Outbreaks
|
Robin Terzagian |
10:15 am – 11:15 am |
|
Recognition of Chemically Associated
Gastrointestinal Foodborne Illness
|
Helen Rodgers, PhD and Joshua Schier,
MD, CDC (video) |
11:15 am – 12:15 pm |
|
LUNCH
|
|
12:15 pm – 1:45 pm (1 ½ hours)
|
|
Outbreak Exercise
|
Food and Waterborne Disease Program
staff |
1:45 pm – 2:45 pm |
|
BREAK
|
|
2:45 pm – 3:00 pm |
|
Outbreak Exercise (cont.)
|
Food and Waterborne Disease Program
staff |
3:00 pm – 4:30 pm |
|
Evaluation
|
Roberta Hammond, PhD |
4:30 pm – 4:45 pm |
Dr. Hammond is the food and waterborne
disease coordinator at the Bureau of Community Environmental Health.
You can reach her at 850.245.4116.
Mosquito-borne
Disease Update July 24-30, 2005
Rebecca Shultz, MPH, Caroline Collins, Tasharra Kenion, Calvin DeSouza, Carina
Blackmore, Ph.D.
Weekly Update: During the period
July 24-30, 2005, the following arboviral activities (St. Louis encephalitis
[SLE] virus, eastern equine encephalomyelitis [EEE] virus, Highlands J
[HJ] virus, West Nile [WN] virus and dengue virus) were recorded in
Florida:
|
Humans: (County) |
Onset Month |
SLE |
WN |
EEE |
HJ |
|
|
Pinellas |
July x3 |
|
3 |
|
|
|
|
|
|
|
|
|
|
|
|
Sentinel Chickens: (County) |
Collection Date |
SLE |
WN |
EEE |
HJ |
Seroconversion Rate |
|
Alachua |
7/11 |
|
|
1* |
|
16.67 alpha
|
|
Brevard |
7/14, 7/15 |
|
1 |
3 |
|
5.26 EEE, 1.75 WN |
|
Duval |
7/18 |
|
|
1 |
|
3.45 |
|
Hendry |
7/18 |
|
|
1 |
|
4.00 |
|
Hillsborough |
7/19 |
|
4 |
|
|
7.55
|
|
Leon |
7/8 |
|
|
2* |
2 |
5.88 HJ |
|
Nassau |
7/10, 7/17 |
|
|
4 |
1 |
7.32 EEE, 3.03 HJ |
|
Orange |
7/8, 7/11 |
|
|
|
2 |
1.82
|
|
Putnam |
7/7, 7/8, 7/14 |
|
|
2 |
2 |
15.00 EEE, 4.65 HJ |
|
North Walton
|
7/6 |
|
1 |
3 |
|
6.67 EEE, 2.13 WN |
|
|
|
|
|
|
|
|
|
Dead Birds: (County) |
Collection Date |
SLE |
WN |
EEE |
HJ |
Species |
|
Pinellas |
7/21 |
|
1 |
|
|
Duck |
|
|
|
|
|
|
|
|
|
Horses: (County) |
Onset Date |
SLE |
WN |
EEE |
HJ |
Status |
|
Duval |
7/19, 7/21 |
|
|
2 |
|
Dead |
|
Hardee |
7/15 |
|
|
1 |
|
Dead |
|
Highlands
|
7/20 |
|
|
1 |
|
Dead |
|
Holmes |
7/14 |
|
|
1 |
|
Unknown |
|
Manatee |
7/19 |
|
|
1 |
|
Unknown |
|
Okeechobee |
7/19 |
|
|
1 |
|
Dead |
|
Osceola |
7/15 |
|
|
1 |
|
Dead |
|
Polk |
7/13, 7/16, 7/19 |
|
|
3 |
|
Dead, Dead, Unk |
|
|
|
|
|
|
|
|
|
Wild Live Captive Birds: (County) |
Collection Date |
SLE |
WN |
EEE |
HJ |
Species |
|
Hillsborough |
7/27 |
|
|
1 |
|
Vulture |
|
Okaloosa |
7/4, 7/5, 7/7, 7/12
x3, 7/14, 7/15, 7/20, 7/21 x2 |
|
|
11 |
|
7 Blue Jays, 3
cardinals, 1 Brown Thrasher |
|
North Walton |
7/14 |
|
|
1 |
|
Sparrow |
|
Washington |
7/14 x6 |
|
|
6 |
|
3 Blue Jays, 3
Cardinals |
|
|
|
|
|
|
|
|
|
Mosquito Pools: (County) |
Collection Date |
SLE |
WN |
EEE |
CA Group |
Species |
|
Escambia |
7/18 |
|
|
1 |
|
Cs. melanura |
*EEE sentinel seroconversion list includes
seroconversions to undetermined alphavirus.
Pasco and Pinellas Counties are
currently under medical alert for mosquito-borne disease. Where biting
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.
This
Week
on EpiCom
by Christie Luce
|
