Friday, August 6 2004

         This Week in the News
 

Foege, WH, et al., 
International Journal of Epidemiology
1976; 5:29-37

►Bureau of Epi Publishes First Data from 2004 FYTS Survey
The self-administered survey of public high school students in Florida provided some satisfying comparisons between the state and rest of the country.

►Introductory Course Offered for Counselors and Outreach Workers
Only two courses are left this year. If you'd like to take advantage of this introductory training, don't delay!

A R T I C L E S

7,364 public middle school students and 7,023 public high school students completed the 2004 FYTS questionnaire in March and April. The survey data show that in 2004:

·        One in thirteen (7.8 percent) of middle school students and one in six (17.3 percent) of high school students are current cigarette smokers.

·        More than one quarter (26.7 percent) of middle school students and almost half (46.7 percent) of high school students had ever tried cigarettes (lifetime cigarette smokers).

·        One in fifty (2.0 percent) of middle school students and one in fourteen (7.4 percent) of high school students are frequent cigarette smokers.

·        There are no significant gender differences in prevalence of current smoker, lifetime smoker, or frequent cigarette use.

·        Non-Hispanic White students have higher prevalence of current smoker, lifetime smoker, or frequent cigarette use than non-Hispanic Black students.

·        Non-Hispanic White students also have higher prevalence of current smoker or frequent cigarette use than Hispanic students.

When compared with FYTS data in the past, the latest survey data show that:

·        The prevalence of current smoker, lifetime smoker, and frequent cigarette use among students remained at the same level as that in 2003.

·        Across all years since 1998 when the first FYTS was conducted, the prevalence of cigarette use among Florida middle and high school students decreased faster between 1998-2001 than during 2001-2004.

Readers can review detailed information from this report online at the bureau?s Website at http://www.doh.state.fl.us/disease_ctrl/epi/topics/pubs.htm

The Bureau of Epidemiology will be hosting a satellite broadcast on Wednesday, August 25, 2004 from 10:00 ? 11:00 a.m., EST on EpiCom and ER Census. Pete Garner, surveillance systems administrator, Bureau of Epidemiology, Florida Department of Health will moderate the program. EpiCom is an outbreak communications and emergency notification system developed and managed by the Florida Department of Health, Bureau of Epidemiology. The EpiCom system allows users to post messages related to suspected and confirmed disease outbreaks, then notifies selected users once a threat to public health has been identified.  EpiCom also contains a feature that tracks hospital emergency room admissions data and produces charts and graphs that can identify aberrant census levels. The ER census feature is designed to help hospitals and county health departments gather meaningful data so they can recognize and respond to unusual trends or clusters. 

Information regarding the program can be found on the Bureau of Epidemiology Internet website http://www.doh.state.fl.us/disease_ctrl/epi/conf/sat/index.htm.

One hour of CEUs will be provided to nurses, environmental health professionals and laboratorians for this program. For technical questions regarding the broadcast, please contact either Shawna Goodwin or Jennifer Bruce in the Office of Performance Improvement, Distance Learning Network 850.245.4008 or SunCom 205.4008. 
 

On Wednesday, August 11 and September 8, 2004, from 2:00 - 3:00 p.m., the Florida Hepatitis and Liver Failure Prevention and Control Program offers a one-hour introductory training course titled "Hepatitis 101: for Counselors and Outreach Workers.?   

The course is presented in a telephone conference call format, with a slide set available on the Web, and provides an introduction to hepatitis A, hepatitis B, and hepatitis C. Prior to each course date, the ?Meet Me? phone number, along with the slide set Web address, will be emailed to all registrants. Continuing Education Credit is available for laboratorians and nurses. To register for this course, please complete the form found on the following link: Hepatitis 101 Registration

Announcements. Don Ward announced a live satellite educational broadcast on EpiCom and ER census surveillance will air on August 25 featuring Pete Garner, Christie Luce and Karen Wheeler.

August Grand Rounds on the 31st will feature EIS Fellow Robyn Kay. She'll present on a quinolone-resistant salmonella outbreak which occurred in Duval County.

The CDC grants advisory board approved approximately $9 million in bioterrorism funding for Focus Area B (surveillance and epidemiology) this year.

Bureau staff are developing several materials for distribution to long term care facilities, hospitals, detention facilities and community health centers in anticipation of the influenza season. These brochures will address specific issues related to surveillance and prevention. 

Cigarette Use Among Florida Youth. Melissa Murray, MPH provided an overview of the most  recent survey of Florida public high school students conducted by the Chronic Disease Surveillance Section of the Bureau of Epidemiology. According to the National Center for Tobacco-Free Kids, 35,900 teens begin smoking each year in the U.S.

Our survey of 7,000 high school and 7,000 middle school students revealed that between 1998 and 2004 there was a decrease in the prevalence of smoking among teenagers in Florida, which is below the national level. It also showed no significant differences according to gender. The self-reporting survey also showed that the rate of smoking tends to increase with grade level.

The questionnaire will be added to the bureau Web site. Special analyses of data are possible.

Influenza Update. Angela Fix confirmed there are 70 sentinel providers committed to the program for this year. Updated recruitment materials will be mailed to county health departments very soon. Health departments should be sure that Angela has their central point of contact and correct address so the materials arrive promptly.

Pertussis Outbreak/Santa Rose County. Sam Williamson announced there is a third confirmed patient case of pertussis in his county. Investigation has turned up no known connection between the first two cases and the latest case. The first was a 32 year old military man who was treated in June. Case two was a 17 year old female who was treated in May. She was a babysitter for two toddlers, one of whom was current on immunizations but nevertheless tested positive for pertussis. Twenty-three contacts have so far been prophylaxed.

Sam emphasized that three cases are highly unusual for Santa Rosa County. All local physicians have been contacted through blast fax to request that they test any suspicious cases for pertussis. 

In the United States, WN virus causes morbidity and mortality in many bird species. In some species, especially crows and blue jays (corvids), there has been substantial mortality due to WN infection. Detection of local bird mortality may indicate the presence of the virus
in a geographic area. In Florida, bird mortality sightings are to be reported to the Florida Fish and Wildlife Conservation Commission (FWCC)'s website www.wildflorida.org/bird/. The data are mapped weekly and used to detect focal areas with intense WN virus activity.  

To determine if the cause of an increase in corvid or overall bird mortality is related to WNV,  a representative sample may be submitted to the Tampa laboratory for WN testing. Submission instructions can be found at http://www.myfloridaeh.com/hsee/arbo/index.htm.Clusters of mortality of single species or non-corvid families of birds such as doves, ducks or pelicans are usually not caused by WN virus; however, the findings need to be reported. The FWCC tracks all clusters of wild bird mortality in the state.    

It costs nothing to report dead bird sightings, yet the information is valuable not only for WN surveillance but the investigation of other potential causes of bird mortality as well. Since testing is costly, the decision to collect carcasses and submit for testing should be made judiciously. 

Dead bird reporting must be tracked closely on a local level to be most relevant. It is expected that although the virus is present throughout the year in Florida, the intensity and location will vary over time and space. Both human and bird reporting were highest in north Florida counties last year. So far this year, the primary WN virus transmission focus is in Miami-Dade County. Reporting of dead birds was significantly increased over baseline for the month of July (Figure 1), which correlates closely with the clustering of human cases. Six human cases have been reported to date in Miami-Dade. Sixteen of the 23 birds (70%) submitted for testing were WN positive.

Dead bird surveillance is one of the tools we use to promote actions that reduce the risk of mosquito-borne diseases in people. Remember to focus your data collection on data you will use. Without subsequent appropriate action, surveillance is pointless. 
 

Abstract:
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. 

Additional Information:
The grand rounds presentation will begin promptly at 11:00 a.m., ET on Tuesday, August 31, 2004. The PowerPoint slides will be available on the Bureau of Epidemiology intranet website on Friday, August 27, 2004. CEUs will be provided for nursing, environmental health professionals and laboratorians. Please remember you must complete the entire registration form including the evaluation and test questions. Registration for CEUs will be accepted August 31 - September 2. Registrations received prior to the beginning of the program will not be accepted.
 

This Week on EpiCom

• Highland County is monitoring an outbreak of hepatitis A
• Hillsborough County reports 16 residents and 9 staff at long-term care facility stricken with gastroenteritis

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.

Eastern Equine Encephalomyelitis (EEE) virus activity: One horse each from Madison, Marion, Pasco and Wakulla counties was confirmed with EEE virus infection this week. There were three seroconversions to EEE virus in sentinel chickens from Marion, Orange and St. Johns 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: None this week. Eight 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/.

See the Web page for more information at www.MyFloridaEH.com. 

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