Epi Update Weekly Publication of the Bureau of Epidemiology

September 09, 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


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Regional Epidemiology Seminar
to be Held in Ocala 

by Melanie Black, MSW
 

The Regional Epidemiology Seminar, co-sponsored by the Bureau of Epidemiology and the Marion County Health Department will be held at the Marion County Health Department, Ocala, Florida on Thursday, September 29th and Friday, September 30th, 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; 12.25 hours for nursing, 13 hours for environmental health professionals and 4.25 hours for laboratorians. 

Additional information will be provided in future Epi Updates and on the Bureau of Epidemiology website. We intend to offer additional training programs in other regions of the state. If you're interested in hosting one of the training sessions or have questions related to this program, please feel free to contact Professional Training Coordinator Melanie Black, 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 the professional training coordinator for the Bureau of Epidemiology in Tallahassee and can be contacted at 850.245.4444, ext. 2448.

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Epidemiological Study of IBD
Making Progress

by Regan Glover, MS

 


Several advances have been made in the epidemiological study of Inflammatory Bowel Disease. House Bill 869, formerly cited as “Inflammatory Bowel Disease Research Act,” is now referred to as “Crohn’s and Colitis Disease Research Act.”   

The Bureau of Epidemiology has finalized an advisory committee with the recent appointment of Florida House Representative Eleanor Sobel and Senator Gwen Margolis. Several members of the Crohn’s and Colitis Foundation of America (CCFA) participated in a recent advisory meeting, including Suzanne Rosenthal, a co-founder of the CCFA. Data are currently being collected from Blue Cross Blue Shield of Florida for their members.  Medicaid data will be analyzed for both in- and out-patients, as well as state wide hospital discharge records. Preliminary results are expected by the end of September. 

Three questions have been added to the Florida Behavioral Risk Factor Surveillance System (BRFSS) survey to address Crohn’s and ulcerative colitis in the general population. The BRFSS will be utilized for a period of 4 months, from September 1, 2005, until December 31, 2005. An expected 1,000 households are to be interviewed during this time. In addition, a short survey is being administered to all active GI physicians in the state of Florida. Finally, an abstract has been submitted and is currently under review for presentation at the Fourth Annual Advances in the Inflammatory Bowel Diseases national conference to be held this December.

Regan Glover is the Crohn's and Colitis research coordinator for the Bureau of Epidemiology. She works in the Chronic Disease Section and can be reached at 850.245.4444, ext. 2424.

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Survey Shows Concerns About Natural
Disasters Ahead of Fear of AttackMan in biosuit

 


Nearly half of emergency response leaders in the U.S. said their organizations have made little or no progress in preparing for an emergency four years after the Sept. 11 terrorist attacks, a survey by Ross & Baruzzini showed. The telephone survey was conducted by a St. Louis–based engineering and technology design firm, which questioned employees of municipalities, airports, seaports and state homeland security departments. Among the other data:

  • 48% of emergency response leaders said they were more concerned about a natural disaster, such as a tornado or hurricane
  • 12% said they were more concerned about a terrorist attack
  • 19% said they were most concerned about a catastrophic accident such as a chemical spill
  • Nearly half said that bureaucracy was the largest barrier to securing federal funds to improve preparedness
  • 23% said lack of expertise in applying for the grants was the largest barrier.

This data was printed in the September 9, 2005 issue of The Weekly Homeland Security Newsletter, published by the Homeland Security Institute.
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   September CHD Conference Call Features
  CO  Poisoning, Sentinel Physician Program

           by Jaime Forth


For those unable to participate in the Friday, September 9 conference call between Bureau of Epidemiology staff in Tallahassee and CHD personnel around the state, a brief overview of the call is presented below.

Sentinel Influenza Physician Program. Melanie Black announced that packets to aid in recruitment of physicians for this year's program were mailed several days ago. Local county health departments should feel free to be proactive in maintaining contact with physicians they recruit; although Janet Hamilton, administrator of the Surveillance and Reporting Section, is the primary point of contact. Reports, questions and other matters should be referred to her at 850.245.4444, ext. 2403. The framework of the program will be reviewed over the next weeks to ensure there is an appropriate amount of flexibility, and that someone is always available to respond to issues as they arise.

Carbon Monoxide Prevention Efforts. Lisa VanderWert-Hourigan outlined the general purpose of a new working group designing a public prevention campaign for CO.  A flyer will be sent to CHDs to assist in educating their staff and the public about safety issues. Dan Chertow revealed that in a telephone survey conducted in 2004, the results showed half the households where poisoning occurred had situated generators inside the building, and the other half had placed the generators outside but within 10 feet of the exterior. Manufacturers don't make recommendations on safe distances so Tim Wallace is working with the Product Safety Commission to partner on safety PSAs.

Burkholderia Cepacia in Hillsborough / Sarasota Counties. Roger Sanderson reported on a case of healthcare-associated Burkholderia Cepacia, initially reported to the CDC on August 22.  The patient was hospitalized in a Hillsborough County hospital, and believed to have been exposed to the bacteria through a non-alcoholic mouthwash distributed to hospital in-patients. The bacteria is not a normal cause of infection in healthy individuals.  Contaminated lots and cultures are being sent to the CDC.  The FDA issued a recall on August 26, and we relayed the information to CHDs on August 31.

David Atrubin followed-up with a report of two elderly patients who were infected. The reports were posted on Epi-X, mentioning four concurrent cases in Texas. One of the Florida patients died shortly after the report was made. Scott Prichard noted that the Sarasota CHD reported 3 cases, followed by another 6 cases.  All nine were immune compromised. The disease became reportable when it was realized that an outbreak had occurred.

MRSA in Volusia County. Andre Ourso provided information concerning a cluster of 6 cases of MRSA in a neo-natal unit at a local hospital. The first report was on August 29. Infection control was initiated immediately and since then, no additional cases have been reported.

Special Interest Surveillance Group. Paul Lindeman announced that an enterprise disease surveillance program is to be developed soon. The HMS special interest group is the model vehicle for this new initiative. The new group will meet monthly and a follow-up email with further information will be sent within the next couple of days.

Epi Hurricane Response to Mississippi. Richard Hopkins commented for Alan Rowan. Two teams of epidemiologists were deployed to Mississippi at the request of the Mississippi governor. A forward team was dispatched first to perform a needs assessment. The two teams are establishing outbreak surveillance, and training personnel from the host state in epi investigation methods. We don't yet know whether other teams will be necessary but there is a third team poised to react if needed.

The next regularly-scheduled conference call will be on Friday, September 23 at 11:00 a.m. An agenda will be posted in the training section of the Bureau of Epidemiology website a day or so prior to the call. Contact Mary Hilton, MNO, planning manager, at 850.245.4444, ext. 2732 if you'd like to appear on the agenda.

Jaime Forth is managing editor of Epi Update and can be reached at 850.245.4444, ext. 2440.

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                       Dengue Fever to be Topic
                      of September Grand RoundsWoman with flu-like symptoms
                               by Maria Donnelly, MSPH

 

Date: Tuesday, September 27, 2005
Time:
11:00 a.m. – 12:00 p.m.
Title:
Investigation of Imported Dengue Fever, Pinellas County Florida, 2005
 

Presenter: Maria N. Donnelly, MSPH, Florida EIS Fellow, Pinellas County Health Department, Bureau of Epidemiology, Florida Department of Health

Abstract:
In the summer of 2005, four imported cases of dengue fever were reported to the Pinellas County Health Department. All cases reported recent travel from Costa Rica or Puerto Rico. This presentation will discuss the clinical and epidemiologic aspects of dengue in general and detail this investigation of imported dengue. Dengue is an arboviral disease transmitted by mosquitoes that populate Florida, thus surveillance and response to imported cases is of utmost importance to prevent future local transmission. 

Additional Information:
The grand rounds presentation will begin promptly at 11:00 a.m. on Tuesday, September 27, 2005. The PowerPoint slides and dial-in number will be posted on the Bureau of Epidemiology intranet website on Friday, September 23, 2005. CEUs will be provided for nursing, laboratorians and environmental health professionals. If additional information is needed, contact Melanie Black, MSW, professional training coordinator, at 850.245.4444 ext. 2448.

Maria Donnelly is an EIS fellow assigned to the Pinellas CHD.  She can be reached at 727.824.6900.

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Mosquito-borne Disease Update August 28 - September 3, 2005
Rebecca Shultz, MPH, Caroline Collins, Tasharra Kenion, Calvin DeSouza, Carina Blackmore, Ph.D.


During the period August 28 - September 3, 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, August   2      

Sentinel Chickens: (County)

           
Alachua 8/15,8/16     6   35.29
Bay 8/23     1   5.88
Citrus 8/15     1   3.45
Hillsborough 8/23   5     9.26
Indian River 8/18   1     2.08
Leon 8/05, 8/19     2   12.12
Manatee 8/22   1     1.43
Nassau 8/15, 8/22   1 1   2.56 WN, 2.63 EEE
Orange 8/15       1 1.39
Pinellas 8/22   4     7.69
St. Johns 8/22   1     1.75
N. Walton 8/17   1     2.70

Dead Birds:  (County) 

           
Pinellas 8/1   1     Blue Jay

Horses: (County)

           
Escambia 7/29     1   Dead
Jackson 8/23     1   Dead
Santa Rosa 7/29     1   Euthanized
Walton 7/29     1   Dead

Wild Live Captive Birds: (County)

           
Okaloosa 8/25     2   2 Blue Jays
N. Walton 8/18, 8/24     4   3 Cardinals, 1 Blue Jay
Washington 8/18, 8/24   1* 5   3 Cardinals, 2 Blue Jays, 1 Grackle

Mosquito Pools: (County)

           
None            

*Bird tests positive for antibodies to flavivirus

Gadsden, Leon, Pasco, Polk, Pinellas and Suwannee Counties are currently under medical alert for mosquito-borne disease. Hillsborough County is currently under a medical advisory for mosquito-borne disease.   

Dead birds should be reported to www.wildflorida.org/bird/.Page will open in a new window See the web page for more information at www.MyFloridaEH.comPage will open in a new window. The Disease Outbreak Information Hotline offers recorded updates on medical alerts status and surveillance at 888.880.5782.

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 Woman with thermometer

     

           This Week on EpiCom
                                  
    by Christie Luce

The Bureau of Epidemiology encourages Epi Update readers to not only register on the EpiCom system at https://www.epicomfl.netPage will open in a new window but to sign up for features such as automatic notification of certain events (EpiCom_Administrator@doh.state.fl.us) and contribute appropriate public health observations related to
any suspicious or unusual occurrences or circumstances. EpiCom is the primary method of communication
between the Bureau of Epidemiology and other state medical agencies during emergency situations.
  • 2 GI outbreaks (not hurricane associated) in Escambia County likely due to Norovirus
  • Vibrio vulnificus infection - hurricane related
  • Bacterial Meningitis in a child in Collier County

Christie Luce is an EpiCom consultant in the Surveillance Systems Section of the Bureau of Epidemiology. She can be reached at 850.245.4444, ext. 2450.Divider
 

                         Weekly Disease Table
                                                          by D'Juan Harris, MSP

Click herePage will open in a new window to review the most recent disease figures provided by the Florida Department of Health Bureau of Epidemiology.

D'Juan Harris is a GIS specialist in the Surveillance Systems Section of the Bureau of Epidemiology.
He can be reached at 850.245.4444, ext. 2435.

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