January 22, 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 

Steven T. Wiersma, MD, MPH,
Bureau Chief, 
State Epidemiologist 

Don Ward, 
Deputy Bureau Chief 
Epi Update Managing Editor 

Catherine Richards, 
Editorial Assistant 

Elizabeth Woodsmall,
Web Page Designer

A r t i c l e s:

Travis McLane, Surveillance Section Program Specialist, Bureau of Epidemiology

Carina Blackmore, M.S. Vet. Med., Ph.D.,
Bureau of Epidemiology









































Caroline Collins, Arbovirus Surveillance Coordinator,

Lisa Conti, DVM, MPH, State Public Health Veterinarian

 D’Juan Harris, GIS Coordinator

► Merlin Basic Training 2003 Tentative Schedule

There are many changes planned this coming year for the Merlin System.  To ensure Merlin users around the state are kept informed, the Bureau of Epidemiology has developed a tentative Merlin Basic Training schedule for the upcoming year.  These dates do not include Basic Training Courses that will be offered the day preceding Regional Epidemiology Training Courses.  Below is the schedule for Merlin Basic Training for 2003.  The exact dates have not been set, but an email will be sent providing plenty of time to sign up.  The training covers all the basics and is a full day.  Plan on attending at least one Merlin Basic Training this year to keep up with all the new features. 

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► Influenza Virus Surveillance Summary Update

Week ending January 11, 2003-Week 2

Florida: During week 2 (January 5-11, 2003) influenza activity, calculated based on the proportion of patients with influenza-like illness (ILI) seeking care by physicians participating in the Florida Sentinel Physicians Surveillance Network was 1.6% which is lower than the activity reported in the state last week (2.3%) and lower than the national baseline of 1.9%. Higher flu activity than expected for this time of year (>2%) was reported by physicians in Alachua, Broward, Collier, Indian River, Monroe, Orange, Polk, and Seminole counties. Influenza A (H1N1) was reported from Duval, Palm Beach and Volusia counties this week.  Influenza B was reported from Hillsborough, Sarasota and St John’s counties. During the last 4 weeks influenza A (H1N1) viruses were also detected in Collier, Indian River, Lake, Leon, Polk, and Seminole counties and influenza B in Okaloosa County. Since December 15 reports of influenza A of unknown subtype have come from Brevard and Orange counties and positive rapid tests from Alachua, Duval, Indian River, Miami-Dade and Pinellas counties.

National report: Sixty-seven isolates (25 influenza A and 42 influenza B viruses) were made from 1,213 specimens tested by the World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories this week. Since September 29, 2.2% (n=614) of the 27,861 specimens tested nationwide have been positive. Fifty-three (32%) of the 164 influenza A viruses have been subtyped; 42 were influenza A H1 viruses and 11 were influenza A (H3N2). Influenza A and influenza B viruses have been identified in 14 states (Arizona, California, Colorado, Florida, Indiana, Louisiana, Missouri, Nebraska, New York, North Carolina, Oklahoma, South Carolina, Texas, Virginia and Wisconsin). Fifteen states (Alabama, Connecticut, Delaware, Hawaii, Illinois, Massachusetts, Michigan, Minnesota, New Jersey, Oregon, South Dakota, Tennessee, Utah, Vermont and Washington have reported only influenza A viruses, and 8 states (Alaska, Arkansas, Kansas, Kentucky, Montana, Nevada, New Hampshire and West Virginia) have reported only influenza B viruses. CDC has characterized 11 influenza A (H1N1), 1 influenza A (H1N2), 4 influenza A (H3N2) and 32 influenza B isolates antigenically. All strains were similar to corresponding vaccine strains. The proportion of patient visits to sentinel physicians for influenza-like illness (ILI) was 1.6% nationwide. The State and Territorial Epidemiologists reported flu outbreaks in 9 states (Arkansas, Kansas, Missouri, Nebraska, New York, Oklahoma, Tennessee, Texas and Virginia). Sporadic influenza activity was reported from 33 states. The proportion of deaths attributed to pneumonia and influenza as reported by the vital statistics offices of 122 U.S. cities was 7.3% during week 2. This percentage is below the epidemic threshold of 8.1% for this time. 

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► Arboviral Activity Summary through the Week Ending January 20, 2003

Disclaimer:  Please note that numbers are subject to change with confirmatory information.

During the period of January 14, 2003 through January 20, 2003, the following arbovirus activity (St. Louis encephalitis [SLE] virus, eastern equine encephalomyelitis [EEE] virus, West Nile [WN] virus and dengue virus) was recorded for Florida:

Human:  No new cases of  arboviral meningo-encephalitis were reported this week.  

Sentinel Chickens:  Nineteen WN seroconversions were confirmed in Bay (2), Collier (4), Duval (1), Indian River (6), Lee (1),  Orange (2), Seminole (2) and Volusia (1) counties.   This week,  448 samples were tested from 10 counties.   The two Bay chickens represent the first reported arboviral activity for 2003.

Equine*:  No new cases of equine arboviral infection were reported this week.

Bird Mortality:  No dead birds were reported positive for arbovirus this week.   In 2002, 3,370 birds were tested and an additional 400+ were too decomposed to be tested.  Last year, 9,993 bird reports were logged representing 11,680 dead birds; 1,230 (11%) were crows; 1,353 (12%) were blue jays and 320 (3%) were raptors.  Thus far in 2003, 245 birds have been logged representing 307 dead birds; of these, 64 were tested and results were negative.

To report dead birds use http://wildflorida.org/bird/.  Online bird identification sites include: http://www.mbr-pwrc.usgs.gov/id/framlst/framlst.html or http://data.acnatsci.org/ornithology/vireo.php.  

Mosquito Pools:  No new mosquito pools were reported WN or EEE positive this week.  Over 4,200 mosquito pools collected during 2002 were submitted for testing at the DOH Tampa Laboratory.  At least 982 additional pools were tested by mosquito control agencies and 298 pools were tested by Department of Defense installations in the state.

Florida is currently at “Level 1” in the Arbovirus Response Plan (see http://www9.myflorida.com/disease_ctrl/epi/htopics/arbo/index.htm).  DOH Press releases can be seen at http://apps3.doh.state.fl.us/IRM/PressReleaseSearch/search.cfm .  

2003 Cumulative Arbovirus Activity by County  

1. Human Surveillance   

No new activity for 2003 has been reported for WN, SLE, EEE or Dengue.

2. Animal Surveillance

West Nile Virus 
Positive samples from 2 sentinel chickens in 1 county were received.  Date of  first positive bleed is shown in parentheses. 

Bay:  2 sentinel chickens (1/7, 1/7)  

► Weekly Disease Table : Week 2

Florida Department of Health, Bureau of Epidemiology
Weekly Morbidity Report, Week 2, ending January 11, 2003
Selected Diseases and Conditions (Confirmed Cases Only)

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