Friday, August 13 2004
This Week in the News
|"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.,
►Florida Breast Cancer Treatment Modalities, 2000
|►Satellite Broadcast on Immunization Scheduled|
To learn about the most recent developments in immunization and earn CEUs, tune in on August 19th.
►Epi Bureau, Staff Garner Awards
|Epi Update Managing Staff:||►Number of Viscerotropic, Cutaneous Leishmaniasis Seen in Military Gulf War Veterans
When soldiers travel overseas, they sometimes bring home unseen injuries that don't appear until months afterward.
MD, MBA, MPH,
Secretary, Department of Health
►New EpiCom Brochure Unveiled
A recent widespread mailout to hospitals around the state drew interest from infection control practitioners and others who were not aware of EpiCom's capabilities.
|Landis Crockett, MD,
Division of Disease
|►August Grand Rounds Topic Will be Quinolone-resistant Salmonella
This month's presenter is Robyn Kay, MPH, an EIS Fellow currently working with the Duval County Health Department in Jacksonville.
Acting Bureau Chief,
|►This Week on EpiCom
Log on regularly to access information that could be vital to your organization if you're in the middle of an investigation. Someone else could be experiencing an outbreak that may be similar to yours.
Copy Editor / Writer
|►Mosquito-Borne Disease Update
A report outlining activities for the week August 1 - 7, 2004 for confirmed cases.
A R T I C L E S
|Tara Hylton, MPH, Cancer Epidemiologist, Chronic Disease Surveillance Section, Youjie Huang, MD, MPH, Dr. PH, Section Administrator|
Florida Breast Cancer Treatment Modalities, 2000
For women, breast cancer is the site with the highest incidence of cancer. Of cancer deaths, only lung cancer exceeds breast cancer deaths for women in Florida. All women are at risk for breast cancer but as women age, the risk increases. Effective methods of treatment are needed to reduce the number of lives lost to this disease.
|Charles Alexander, Chief, Bureau of Immunization, Florida Department of Health
|Satellite Broadcast on Immunization Scheduled
August is National Immunization Awareness Month
For further information, go to the NPI, NIAM Web site at http://www.partnersforimmunization.org/niam.html, or contact Tom Bendle of the Bureau of Immunization at 850.245.4444, extension 2391 or SunCom 205.4444, extension 2391.
Immunization Update 2004
Anticipated topics include new recommendations for influenza vaccine, including routine vaccination of children and expanded use of live attenuated influenza vaccine; pneumococcal conjugate vaccine shortage; varicella vaccine; and vaccine safety issues. Continuing education (CEU) credits will be offered for a variety of professions, based on 2.5 hours of instruction.
|Jaime Forth, Copy Editor / Writer, Bureau of Epidemiology
|Epi Bureau, Staff Garner Awards
Carmela Mancini, MPH, administrator of the Bureau of Epidemiology Surveillance and Reporting Section has been elected chair of the Epidemiology Lab Section of the Florida Public Health Association for the upcoming year. Her responsibilities will entail representing her section as a voting member of the board of directors, holding business meetings and planning educational programs, attendance at standing committee meetings, and contributing articles to the association newsletter.
Melissa Murray, MS, appeared in The Florida State University Everything FSU newsletter for her presentation, Associations between alcohol and Drug use and injury among Florida's high school students at the annual conference of the Council of State and Territorial Epidemiologists in Boise, Idaho in June.
Longtime staff member Cadedra Parmer graduated August 7th from Florida State University with a BS degree in chemical science and a minor in biology. Cadedra works as a data entry operator in the Surveillance and Reporting Section at the Bureau of Epidemiology, and plans to attend the University of Central Florida to earn a master's degree in forensic science.
The bureau itself was the recipient of a Department of Health Certificate of Acknowledgement for 100% compliance in submittal of purchasing card reconciliations for the months April through June 2004. This was mainly due to the diligence of Theresa Vivas, who specializes in purchasing and requisitioning for the bureau.
The Bureau of Epidemiology is proud of the achievements of these team members and we wish them continued success in all their endeavors.
|Jaime Forth, Copy Editor / Writer, Bureau of Epidemiology
|Number of Viscerotropic, Cutaneous Leishmaniasis Seen in Gulf War Military Veterans|
During the Gulf War in 1990-1991, U.S. soldiers serving in Southwest and Central Asia complained of problems with high fever, chills and malaise. Seven were treated by physicians at Walter Reed Army Medical Center for tropical Leishmaniasis after Leishmania parasites were cultured from bone marrow aspirates in all seven patients. A year or so later, 22 soldiers with ulcerated lesions on their bodies were treated for cutaneous Leishmaniasis after tissue cultures tested positive for Leishmania major.
Persons who live in or travel to the tropics, subtropics and southern European countries where Leishmaniasis is endemic are at risk for bites by the phlebotomine sandfly, the cause of the disease. Kabul, Afghanistan accounts for about a third of all cutaneous Leishmaniasis cases in the world. This week, the World Health Organization declared it would set up emergency operations there in an effort to halt the longstanding problem.
Cutaneous Leishmaniasis (CL) is the most common and produces large numbers of lesions on exposed parts of the body. Typical lesions do not hurt and emerge slowly, evolving from papules to nodules to ulcerations. This type of infection can be asymptomatic or yield only mild, nonspecific symptoms which are felt only weeks or even months after the bites.
Visceral (VL) (which, through aggressive testing will show differently from the Viscerotropic Leishmaniasis mentioned earlier) is the most serious, and is characterized by irregular fever, excessive weight loss, and abdominal pain caused by swelling of the liver and spleen. Left untreated, the fatality rate in underdeveloped countries can reach 100%.
Mucocutaneous lesions (MCL) form around the mucous membranes of the nose, mouth and throat cavities in this third form, and destroy the surrounding tissues. No U.S. or allied soldiers are reported to have been diagnosed with this form of the disease.
Leishmanias is endemic on five continents and 88 countries around the world. An emerging concern to the WHO is the frequency with which HIV co-infections are being reported. Physicians for the organization note that VL hastens the onset of AIDS, especially since Leishmania parasites and HIV destroy the same cells. When co-infection reporting began in 1998, the number of cases represented by southwestern Europe was two-thirds of the total number. Approximately 71% of those co-infected patients are IV drug users; Leishmaniasis can be transmitted from person to person through needles.
In Afghanistan and Iraq, American soldiers are provided traditional wartime equipment but they're also given prophylaxis, permethrin-treated bed netting and insect repellent containing DEET. They know that in addition to a visible enemy they've been trained to deal with, there's another menace for whom they need to be vigilant - a tiny female sandfly.
|Christie Luce, EpiCom Marketing Consultant, Surveillance Systems Section
|New EpiCom Brochure Unveiled|
On July 19, 2004 the Bureau of Epidemiology proudly unveiled its new EpiCom brochure. This tri-fold pamphlet is intended to provide community partners a thorough understanding of the EpiCom communication system and how it can assist them in networking with other medical caregivers, and receive vital, real time information in the event of an emergency.
The initial distribution was made to infection control practitioners at all Florida hospitals and netted a very satisfactory number of responses from non-Department of Health users.
|Robyn S. Kay, MPH, Florida EIS Fellow, Florida Department of Health, Bureau of Epidemiology||August Grand Rounds Topic Will be Quinolone-resistant Salmonella|
Date: Tuesday, August 31, 2004 11:00 a.m. ? 12:00 p.m. EST
Title: Salmonella senftenberg: A Nosocomial Infection
Presenter: Robyn S. Kay, MPH, Florida EIS Fellow, Bureau of Epidemiology, Florida Department of Health
In the fall of 1999, Northeast Florida experienced an increase in quinolone resistant salmonella in a local hospital. The Florida Bureau of Laboratories in Jacksonville identified the strain to be multi-drug resistant Salmonella senftenberg. Nosocomial transmission of Salmonella senftenberg has been documented in neonatal wards, burn units, and adult intensive care units in India. This rare bacteria causes diarrhea, pneumonia, or may be asymptomatic. Salmonella senftenberg may also cause urinary tract, blood, and wound infections.
This descriptive epidemiological analysis will encapsulate the current information known about Salmonella senftenberg infected patients including antibiotic resistance, control/prevention, surveillance, and education. In addition, patient transfers have led to the transmission of the organism to additional healthcare facilities. Salmonella senftenberg is an emerging infectious organism with significant public health implications for the state of Florida.
|Pete Garner, Surveillance Systems Manager, Bureau of Epidemiology||
The Bureau of Epidemiology encourages Epi Update readers to not only register on the EpiCom system at https://www.epicomfl.net but to browse EpiCom frequently and contribute public health observations related to any suspicious or unusual occurrences or circumstances, as appropriate. EpiCom is the primary method of communication between the Bureau of Epidemiology and other state medical agencies during emergency situations.
|Arbovirus Surveillance Team: Samantha Rivers, MS, Caroline Collins, Kristen Payne, Calvin DeSouza, and Carina Blackmore, MS Vet. Med., PhD., State Public Health Veterinarian||Mosquito-Borne Disease Update|
West Nile (WN) virus activity: Two residents of Miami-Dade County were confirmed with WN illness this week, bringing the county?s total to seven and the state-wide total to nine. There were five seroconversions to WN virus in sentinel chickens from Brevard, Hillsborough, and Palm Beach counties and two positive dead birds from Miami-Dade County. So far this year, 22 counties have reported WN activity. Miami-Dade County is under medical alert for mosquito-borne disease.
Eastern Equine Encephalomyelitis (EEE) virus activity: There were eight seroconversions to EEE virus in sentinel chickens from Alachua, Hillsborough and Orange counties. So far this year, 25 counties have reported EEE activity.
St. Louis Encephalitis (SLE) virus activity: None this week. Two counties reported SLE this year.
Highlands J (HJ) Virus activity: There were five seroconversions to HJ virus in sentinel chickens from Hillsborough, Marion, Nassau, Putnam and Walton counties. Nine counties reported HJ this year.
Mosquito populations are present in many areas of the state. All are urged to take precautions against mosquito bites. Dead birds should be reported to www.wildflorida.org/bird/.