Friday, August 15,
"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.
International Journal of Epidemiology
Epi Update Managing Staff:
John Agwunobi, MD, MBA, Secretary, Department of Health
Landis Crockett, MD, MPH, Director, Division of Disease Control
Acting Bureau Chief,
Epi Update Managing Editor
Jaime Forth, Copy Editor/ Writer
| This Week in the News|
►Collier County Vehicular Mortality Rates Examined in Grand Rounds
According to a study performed by a member of the Florida Epidemic Intelligence Service, Collier County rates highest in the state for age-adjusted death rates in fatal motor vehicle crashes. Hear this report firsthand on August 26 at 11:00 a.m. EST.
►Chronic Disease Working Group Preparing 2004 Questionnaire
Statewide chronic disease experts are convening to determine questions for a CDC-sponsored telephone survey to be finalized in mid-September.
►Conference-Goers Struck by C. Jejuni in Europe
Approximately 50 conference attendees became ill, and EpiCom subscribers were there to record the outset of the disease.
►Influenza, Meningitis, SARS discussed at Bi-weekly Conference Call
Information sharing between county health departments and the Bureau of Epidemiology included briefings by a Department of Corrections representative and the head of the Alachua County Health Department.
►Medical Examiners Expand Public Health Role
At their scheduled meeting earlier this month, the Florida Medical Examiners reviewed a proposal by the Bureau of Epidemiology to participate in unexplained death surveillance.
Bureau Announces Latest Information
A R T I C L E S
Michael Lo, MSPH, Florida Epidemic Intelligence Service, Bureau of Epidemiology
Marie A. Bailey, MA, MSW, BRFSS Coordinator, Bureau of Epidemiology
Pete Garner, Surveillance Systems Manager, Bureau of Epidemiology
Jaime Forth, Copy Editor/ Writer, Bureau of Epidemiology
Melanie Black, MSW, Professional Training Coordinator, Bureau of Epidemiology
Jaime Forth, Copy Editor/Writer, Bureau of Epidemiology
Pete Garner, Surveillance Systems Manager, Bureau of Epidemiology
Motor Vehicle Traffic Accident Mortality in Collier County, 1997-2001
Death certificate data from the Florida Department of Health’s Office of Vital Statistics and crash data from the Florida Department of Highway Safety and Motor Vehicles (DHSMV) were obtained for analysis to better inform the preventive efforts of the task force. Frequencies on a variety of demographic and crash variables related to fatal traffic accidents were tabulated and cross-tabulated, and traffic accident death rates and adjusted odds ratios of death determined from logistic regression modeling were calculated for the various demographic strata. It was found that males, residents ages 15–24, Hispanics, Immokalee residents, and combinations thereof were more likely to have died from motor vehicle traffic accidents between 1997–2001. Lack of safety belt use, alcohol abuse, and dangerous intersections were found to have been factors in fatal motor vehicle crashes in Collier County during the same time period. On the basis of these findings, the demographic groups identified will be targeted for a traffic safety education campaign in partnership with other agencies and community-based organizations in Collier County.
On July 23, 2003, the Florida BRFSS Working Group convened at the state Department of Health building in Tallahassee to discuss development of the 2004 FL BRFSS questionnaire. The Florida Behavioral Risk Factor Surveillance System (BRFSS) Working Group is a diverse group of chronic disease experts representing chronic disease prevention and intervention programs, policies, and research. In attendance were representatives from county health departments, the American Cancer Society, American Lung Association and American Heart Association, Florida A&M University and other research universities and various bureaus and divisions in the central office.
The BRFSS is a state-based telephone survey of the civilian, non-institutionalized adult population. It was developed by the CDC and is designed to monitor risk behaviors, chronic conditions, access to medical care and other emerging public health issues among adults in Florida. With support from the CDC, the Florida Department of Health has conducted the Florida BRFSS annually since 1986. Funding from members of the Florida BRFSS Working Group or other entities supports additional questions to the BRFSS. The cost for additional questions is $2,500 each or $1,750 each asked for a subgroup (e.g., women only, those aged 50 and older).
Florida BRFSS Working Group members as well as other interested parties are encouraged to submit proposals for the 2004 BRFSS to DOH by COB August 22, 2003. The questionnaire will be finalized by September 14, 2003 and sent to the CDC. Please see our website for more information about the Florida BRFSS at http://www9.myflorida.com/disease_ctrl/epi/brfss/index.htm, or contact:
A. Bailey, MA, MSW
many as three hundred attendees were possibly exposed to the bacteria while
attending a conference recently at a hotel in Belvedere, Italy, with 45-50
attendees becoming ill. Upon returning to the United States, at least one
Collier County resident was confirmed to have contracted the disease with an
onset date consistent with attendance at the conference. Information gathered
in Collier County contributed to the CDC’s efforts to trace many other
attendees and monitor their condition.
The Bureau of Epidemiology has commended Dean Bodager (regional environmental epidemiologist) for his efforts to coordinate the information provided by Mark Crowley (Collier CHD) and Robin Terzagian (regional environmental epidemiologist), and encourages those interested to logon to https://www.epicomfl.net and register with EpiCom, Florida’s Epidemiological Information Exchange and Emergency Notification Surveillance system.
Influenza outbreaks in correctional facilities. Sara Straub, infection control coordinator at the Department of Corrections outlined recent efforts to understand the nature of ‘flu outbreaks at Glades and Okeechobee Correctional Institutions occurring since July. Glades has experienced over 100 cases. Okeechobee reported 35-50 cases. Neither staff nor transferred inmates appear to be the cause. Standard vaccines are offered to inmates every fall, with approximately ¼ of the population participating in the vaccine program. No flu patients have been hospitalized, with all positive tests showing influenza A H3M2. Quarantine was established early, which helped to control the spread of the disease. The situation is still ongoing.
Meningitis outbreak update. Tom Belcoure, Alachua County Health Department administrator, briefed listeners on the latest developments with regard to the Spring 2003 cases of viral meningitis in Gainesville. The first patient case was a 16-year old high school student, discovered on May 23rd. Since then, 67 cases have been identified, primarily on the east side of the city in an age group under nine years and moving into older patients as the disease has spread. No significant neurological trauma has occurred in any patient, although 85% have been hospitalized. Department of Health staff rapidly moved into the affected areas to educate the population on hand hygiene, visiting childcare centers, private homes, schools and other public places. After the first several cases, no secondary familial cases were reported.
SARS Update. Dr. Fermin Arguello, epidemic surveillance officer at the Bureau of Epidemiology gave an overview of the latest actions by CDC regarding SARS. In mid-July, the CDC changed the definition of the disease, which consequently changed the number of cases reported by the state of Florida. Rather than 22 suspected cases, there are now officially four suspected and two probable cases in the state, due to a zero number of positive tests for the coronovirus.
SARS planning. Don Ward reported that although no SARS cases have been reported in Florida for some time, the Department of Health is planning for the potential for new SARS outbreaks. Current planning activities include:
Additional details will be provided as available.
Wrap-up. Beginning with the next county health department/epidemiology conference call, the Bureau of Epidemiology will present a monthly surveillance and morbidity analysis of Florida data for a specific disease. The first presentation will be made by Dr. Joann Schulte and will address morbidity trends and other issues for Group B Streptococcus. We encourage participation by county health department staff and others. As future presentations are being developed, Bureau of Epidemiology staff may contact CHD staff members to solicit participation.
The Florida Medical Examiners
Commission met last week in Ponte Vedre Beach to discuss legislative issues, the
NIH childhood drowning study and additional matters. The commission is comprised
of representatives from law enforcement agencies, the funeral industry, the state
attorney's office, attorney general's office and others.
The Centers for Disease Control and Prevention (CDC) has released the publication "Pneumococcal Vaccination for Cochlear Implant Candidates and Recipients: Updated Recommendations of the Advisory Committee on Immunization Practices" as an "MMWR Early Release" (July, 31, 2003/52:1-2). The current recommendations update those last made by CDC in October 2002.
Because the rate for pneumococcal meningitis is higher in children with cochlear implants, the Advisory Committee on Immunization Practices recommends that all those who have had, or are scheduled to receive a cochlear implant should have the pneumococcal vaccination in accordance with the recommendation.
The electronic version of the recommendations can be accessed at http://www.cdc.gov/mmwr/preview/mmwrhtml/m2e731a1.htm. For further information, contact Phyllis Yambor, Bureau of Immunization at (850) 245-4342 or SunCom 205-4342.
CDC Announces Number of Children Receiving Vaccines is at All-Time High
According to the CDC, the number of children in the nation receiving immunizations remains at an all time high, with significant increases in the coverage rates for varicella (chickenpox) and pneumococcal conjugate vaccine, two of the most recent additions to the childhood immunization schedule.
Vaccines are among the most successful and cost-effective public health tools for preventing disease and death. Because of nationwide immunization efforts, the number of most vaccine-preventable diseases has been reduced by more than 99 percent since the implementation of immunization programs.
"Vaccines are one of the most important tools we have to protect the health of our nation's most vulnerable citizens, our children," said HHS Secretary Tommy G. Thompson. "These results demonstrate our nation's ability to reach high immunization coverage rates. The President and HHS remain committed to ensuring that our children continue to get the vaccines they need for a healthy start in life."
For more information on childhood vaccinations, contact Phyllis Yambor of the Bureau of Immunization at (850) 245-4342 or SunCom 205-4342. To access the press release from the CDC website, go to http://www.cdc.gov/od/oc/media/pressrel/r030731.htm.
IOM Report Recommends New Strategy for Purchasing and Delivering Vaccines
A new report released August 4th from the Institute of Medicine (IOM) calls for a new approach to financing and distributing vaccines to achieve more widespread immunization throughout the U.S. and to sustain development and production of vaccines in the future.
“Financing Vaccines in the 21st Century: Assuring Access and Availability” recommends the implementation of a new insurance mandate – combined with a government subsidy and voucher plan to administer all recommended vaccines. This would effectively change the government's role from buying vaccines to assuring immunization.
A panel convened by the IOM
suggests that all medical insurance carriers should be mandated by the
government to cover vaccinations for their customers. The group also recommends
that people without insurance receive vaccine vouchers from the government
►This Week on EpiCom
WN virus activity in animals: Nine WN virus infected horses from Bay, Dade, Escambia, Hendry, Holmes, Marion (2), Santa Rosa and Volusia counties was reported this week, for a YTD total of 11 statewide. Twenty-eight seroconversions to WN virus were confirmed in sentinel chickens, for a YTD total of 132 WN seroconversions in 26 counties. Twenty-seven dead birds were reported positive for WN virus, for a YTD total of 99. Forty-three counties have reported WN virus activity this year, with sporadic distribution around the state, compared to 30 last year by this time.
The complete report can be viewed at: http://www.doh.state.fl.us/Environment/hsee/arbo/weekly_summary2003.htm