Epi Update Weekly Publication of the Bureau of Epidemiology
 Friday, September 5, 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.
International Journal 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, 
Acting Bureau  Chief, 
Epi Update  Managing Editor 


Jaime Forth, Copy Editor/ Writer 
         This Week in the News

Public Health Laboratories to be Focus of September Grand Rounds
Aired live via satellite and webcast, this program, sponsored by the Association of Public Health Laboratories, will describe how leadership and communication fostered the improved quality of laboratories in one northern community.


Outbreak of Norwalk-like Virus Lands Cruise Ship
A cruise ship outbreak affecting over 300 passengers was investigated by CDC officials soon after docking in New York harbor.


Influenza Surveillance Orientation Set for County Health Department Personnel
The Sentinel Physician Network is recruiting new providers. Year-round reporting and enhanced surveillance techniques are on the agenda for a meeting scheduled for September 8th at 10:00 a.m.


Merlin Assessment Underway
The Merlin Development Team is assessing various areas of the system for change. If you have comments or would like to participate in the discussions, two conference calls will give you opportunity to talk with Bureau of Epidemiology staff about the issues.


Arboviral Disease Report
Statistics through the week ending September 1, 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.
 

To submit articles to Epi Update, sent them in Word format as an email attachment to jaime_forth@doh.state.fl.us by noon on Wednesday. If you have questions, call Jaime Forth at 850.245.4444, ext. 2400. We look forward to hearing from you!

 

 

A R T I C L E S

 

Jaime Forth, Copy Editor/Writer, Bureau of Epidemiology
 

 

 

 

 

 

 

 

 

 

 

Jaime Forth, Copy Editor/Writer, Bureau of Epidemiology

 

 

 

 

 

 

 

 

 

 

 

 

 

Kathryn S. Teates, MPH, Communicable Disease Surveillance and Reporting Manager

 

 

 

 

 

 

Kathryn S. Teates, MPH, Communicable Disease Surveillance and Reporting Manager

 

 

 

 

 

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

 

 

 

 

 

 

 

Please note that numbers are subject to change with confirmatory information

 

 

 
                                               
Public Health Laboratories to be Focus of September Grand Rounds
 
The Association of Public Health Laboratories will sponsor a program on the role of public health laboratories on Friday, September, 26th from 2:00 to 3:00 p.m. EST, aired live via satellite and webcast. To earn CEUs for the course, entitled Disease, Disaster and Detection: Partnering with Public Health Laboratories, you must register as a participant. 

The focus of the hour-long program will be a case study of the Minneapolis/Saint Paul laboratory network, which developed a system for strengthening the relationship between its public health and clinical laboratories. The program will describe how leadership and communication fostered the quality of improvement among the laboratories. 

A panel discussion, led by Dr. Robert Marin, director of CDC’s Division of Laboratory Systems and including Dr. Hugh Tilson, clinical professor of epidemiology and health policy at the University of North Carolina School of Public Health, Dr. Lou Turner, director of North Carolina’s State Laboratory of Public Health, and Dean Bill Roper of the UNC School of Public Health will follow the case study. Leaders of public health laboratories, clinics, boards of health, and professionals from state and local government health organizations should find the program interesting, informative and helpful as they seek ways to improve their own communities here in Florida.  

For more information, call Public Health Grand Rounds at 919.842.9261, email them at Grand.Rounds@sph.unc.edu or log on to their web site at www.PublicHealthGrandRounds.unc.edu.

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Outbreak of Norwalk-like Virus Lands Cruise Ship

A cruise ship en route from Copenhagen to New York cut short its voyage last week due to an outbreak of a Norwalk-like norovirus among 300-some passengers, and docked instead in New York harbor. The ship, stopping in Britain, Ireland and Iceland before arriving in New York City, underwent a routine investigation by members of CDC’s Vessel Sanitation Program (VSP) shortly after it docked.

Because cruise ships are required to track gastrointestinal illnesses for each trip on which they embark and to radio that information to the nearest quarantine station or port where the ship will arrive, the CDC was able to immediately begin evaluating the data to detect patterns and work with the ship’s crew to determine how the outbreak may have occurred.

The Public Health Service Act, Section 264(a) provides the CDC authority to take measures necessary to prevent the introduction, transmission or spread of communicable disease in the United States from a foreign country. Each cruise vessel that calls on a U.S. port and also has a foreign itinerary is subject to two un-announced inspections per year by VSP staff. Ships are scored based on a 100-point scale, with an 86 or above considered a passing grade. Failing inspection means a re-inspection, usually within 30 to 45 days. These inspections are published on the web at www2.cdc.gov/nceh/vsp/vspmain.asp. In addition, cruise lines often publicize them on their own web sites.

The VSP, which was begun in the 1970s as a voluntary surveillance system for diarrhea illness on cruise ships with 13 or more passengers, was the result of a desire by the cruise industry and the CDC to reduce the number of diarrhea cases aboard cruise ships. Investigations are conducted using three disciplines; epidemiology, laboratory and environmental research and analysis.  At the conclusion, preliminary findings are presented to the ship’s master with temporary recommendations until a more thorough report can be documented. The program has been considered successful, with 12 to 15 outbreaks each year during the 1970s and 1980s, but only three diarrhea outbreaks reported on cruise ships in 1999.

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Influenza Surveillance Orientation Set for County Health Department Personnel

The influenza season is rapidly approaching and with it the recruitment of new community providers for the Florida Influenza Sentinel Physician Network. This influenza season brings new challenges to the Influenza Surveillance Program including the incorporation of year-round reporting and enhanced surveillance for influenza A viruses H7N7 and H5N1. Promotional recruitment materials were mailed to all county health departments last week and the Bureau of Epidemiology will be hosting a conference call on Monday, September 8th from 10:00 –11:00 a.m. EST for county health department influenza coordinators.  

Topics for the conference call include background on the Influenza Surveillance Program, a summary of last year’s program, recruitment strategies and instructions. Call details will be announced by email to all county health department epidemiology contacts, influenza coordinators and select laboratory personnel. 

Questions regarding the Influenza Surveillance Program should be directed to Kathryn Teates in the Bureau of Epidemiology at 850-245-4401.

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Merlin Assessment Underway

The Merlin Development Team is currently conducting a series of meetings to discuss changes to the system by assessing different areas of the application. All Merlin users are encouraged to give feedback by email, survey or by participating in the upcoming conference call. Existing change controls will automatically be included in the assessment. Comments for the lead poisoning prevention module, perinatal hepatitis B prevention module, rabies module, extended data and any other section are needed as well.   

The last of the two conference calls for county health department input will be on Wednesday, September 10th at 10 a.m. EST. This call will cover Task Lists and Electronic Laboratory Reporting. Those not able to attend the conference call should email comments to the Merlin Helpdesk indicating the assessment in the subject line of the email. 

The completed assessment and recommended changes will be published in summary form in an upcoming issue of the Epi Update.

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Arboviral Disease Report

Eastern Equine Encephalitis (EEE) activity appears to be on the decline as West Nile (WN) activity continues to rise throughout much of the state.

Two WN virus infection cases were reported this week in residents of Duval (onset 7/31) and St. Johns (onset 8/7) counties, bringing the number of cases this year to 17.  Duval and Nassau were added to the list of counties under medical alert, bringing the total to 15: Bay, Brevard, Broward, Collier, Duval, Escambia, Gilchrist, Lee, Miami-Dade, Nassau, Okaloosa, Orange, Palm Beach, Santa Rosa and St. Johns. Reported human EEE infections remain at two. Last year by this time, there was one human EEE infection in a Highlands County resident and two WN infections, a Sumter County resident with a travel history to Louisiana and a Miami-Dade transplant recipient.

EEE virus activity in animals: Two new EEE virus infections were reported in horses this week. In sentinel chickens, 3 seroconversions to EEE virus were reported. To date, 52 of Florida’s 67 counties have reported EEE virus activity, compared to 23 counties reporting EEE last year at this time.

WN virus activity in animals: Eight WN virus infected horses were reported. In addition, 61 seroconversions to WN virus were confirmed in sentinel chickens from 24 of the 33 counties that collected samples. Twenty-nine dead birds from 7 counties (14 from Bay) were reported positive for WN virus. Fifty-one counties have reported WN virus activity, compared to 44 at this time last year.  

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

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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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