Johnson County Health Department - EPI Update Newsletter

The Kansas Department of Health and Environment (KDHE) is urging Kansans to begin take personal precautions now against West Nile Virus (WNV) in anticipation of the return of the virus to the state. 2005 will mark the fourth year for the virus in Kansas and the sixth year for its presence in the U.S.

“We are certain that West Nile Virus will be back in Kansas in 2005,”said KDHE Director of Health, Howard Rodenberg, M.D., M.P.H. “Human cases typically appear in late June, then increase through the late summer months and early fall months, but Kansans should begin taking precautions now to protect themselves and their families.”

To see the full text of this article, including WNV surveillance and reporting info for 2005, prevention recommendations and case totals for 2004, please click here.

On April 12, Kansas Governor Kathleen Sebelius signed House Bill (HB) 2264 into law. This new legislation clarifies requirements for an order for isolation or quarantine, processes for appealing a quarantine or isolation order, and enforcement issues.

To see the full text of this article and more info about House Bill 2264, click here.
For complete text of the bill, see www.kslegislature.org/bills/2006/2264.pdf.

There is an outbreak of acute hepatitis B in Kansas. From 2000 to 2004, fewer than 20 cases of acute hepatitis B were reported to BEDP in the first quarter of each year. However, in the first quarter of 2005, almost 30 cases have been reported. This is 2 times more than expected. Of the cases reported in the first quarter of 2005, 86% ≥35 years of age and 62% are ≥ 45 years of age.

To see the full text of this article, please click here.

Update of Serratia marcescens Bacteremia Associated with Contaminated Magnesium Sulfate
In follow-up to the previous notification of S. marcescens bacteremia associated with contaminated magnesium sulfate from PharMEDium (March 18, 2005), the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration have obtained new information in their ongoing investigation. Because evidence exists to implicate at least three contaminated PharMEDium lots of magnesium sulfate, CDC recommends that magnesium sulfate solution from PharMEDium not be administered to patients until the scope of contamination can be determined. PharMEDium is voluntarily recalling all 50 mL magnesium sulfate admixtures. These 50 mL preparations will not be available until further notice. www.phppo.cdc.gov/HAN/ArchiveSys/ViewMsgV.asp?AlertNum=00226

Update on Possible Anthrax Exposure in Department of Defense Mail Facility
On March 10th, routine samples from an air sampling device at the Pentagon Remote Delivery Facility were collected and preliminary tests, reported to the Department of Defense (DoD) on March 14, indicated the possibility of the presence of Bacillus anthracis. Also, on March 14th, an alarm at a separate Defense office in the Skyline complex indicated the possibility of the presence of a biohazard. As a result, employees in close proximity to the mail handling at these two facilities and the United States Postal Service (USPS) V-Street feeder facility were placed on a 3-day course of prophylactic antibiotics. www.bt.cdc.gov/agent/anthrax/han031505.asp

See other resources and helpful preparedness links for different audiences by visiting our Public Health Emergency Preparedness & Response Program page.

By Renee Semarge, JCHD Epidemiologist

The Department of Defense has announced that Pentagon scientists will collaborate with military biologists from Canada , Great Britain , and Northern Ireland to develop a vaccine against plague. A Pentagon announcement released April 15 th said that the three nations will work together towards a vaccine that will ultimately be licensed for human use.

For more than five years, the United States and United Kingdom have operated separate plague vaccine development programs. In 2000, both countries and Canada signed a memorandum of understanding to share vaccine development information.

Two plague vaccines are in development – one being researched by the US Army Medical Research Institute of Infectious Diseases (USAMRIID), and another researched by British scientists. Researchers began testing the USAMRIID vaccine early this year at the University of Kentucky . The British vaccine candidate is scheduled to begin testing in the US later this year, under guidelines set out by the Food and Drug Administration. Officials will use results from these tests to determine which vaccine to continue developing.

Plague is classified by the Centers for Disease Control and Prevention as a Level A bioterrorism agent. High priority agents in this group pose a risk to national security because they can be easily disseminated or transmitted from person-to-person and result in high mortality rates. Level A agents can cause public panic and social disruption. Other Level A agents include anthrax, botulism, smallpox, tularemia, and the viral hemorrhagic fevers.

Resource:
Pentagon to participate in international plague vaccine effort. www.govexec.com/dailyfed/0405/041805d1.htm.

In times of uncertainty, the thought that our pets that provide comfort and companionship could also protect us from bioterrorist activities, is a pleasant one. Researchers at Purdue University ’s School of Veterinary Medicine seem to think that our pets may hold the key to producing a surveillance system that could help detect the presence of a bioterrorism event in its earliest stages. Presently, epidemiology and environmental medicine scientists at the university are working in conjunction with the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Center for Veterinary Medicine (CVM), and Software and Services (SAS) statistical analytical technologies.

The plan is to utilize the Banfield, The Pet Hospital’s database. Banfield, The Pet Hospital is a privately owned practice that includes more than 400 hospitals in 44 states and services the greatest percentage of the 160 million cats and dogs throughout the United States . Banfield, The Pet Hospital maintains pet health records for over 10 million office visits in a unique database. Researchers are able to access that database and extract seven demographic variables in a tabular format. In doing so they are hoping to develop a pet surveillance system: the Veterinary Medical Data-Surveillance of Syndromes (VMD-SOS). The specific information that is being utilized is the pets’ demographic information, physical examination findings, lab tests ordered, treatments administered, data involving the office visit, the diagnosis recorded by the veterinarian about the visit and free-text medical notes.

In addition to being able to monitor for potential bioterrorist activities, scientists are also hoping to use the surveillance system to follow chronic diseases and other epidemics.

References:
Pets as Early Predictors . www.sas.com/success/purduevet.html.
National Pet Health Surveillance System in the Works. www.avma.org/onlnews/javma/may03/0305151.asp.
Veterinary Role in Bioterrorism Surveillance.www.aasv.org/news/story.php?id=480.
Homeland Security Experts.www.mail-archive.com/nahl@purdue.edu/msg00006.html.
Other Ways to Find the Bugs.www.ndu.edu/ctnsp/biosensing_03.htm.

April 12 marked the 50 th anniversary of the licensure of the first poliovirus vaccine. After more than 17 years of research driven by Jonas Salk and his team at the University of Pittsburgh and funded by the National Foundation for Infantile Paralysis (now the March of Dimes), the vaccine was released in 1955.

The fight against polio was a national collaboration and, at that time, the largest cooperative effort in history. Children in communities across the United States participated in field trials as “Polio Pioneers,” while thousands of health care personnel and lay people volunteered their time to assist with those trials. Millions of Americans helped to raise funds in their communities to support the research efforts.

Polio was eliminated in the Americas in 1994. However, the disease still circulates in Africa and Asia , and polio vaccination remains important for the health of American children.

For more information, click here: www.cdc.gov/nip/events/polio-vacc-50th/.

To see upcoming workshops, satellite broadcasts, and more at the Johnson County Health Department, check out the What’s New? page of our website to see our calendar of events.

April Communicable Disease Report:

Disease Category	Apr 2005	Apr 5yr Avg	YTD 2005	2004 Total	2003 Total	2002 Total
Enteric Diseases:
Campylobacter	5	3.2	14	53	48	35
Salmonella	8	3.6	21	85	50	38
Central Nervous System:
Meningitis, Aseptic (including viral and fungal meningitis)	0	0.2	1	29	14	26
West Nile Encephalitis/Meningitis	0	0	0	2+	5	2
West Nile Fever	0	0	0	1+	0	0
Sexually Transmitted Infections:
Infection Numbers (excluding HIV/AIDS - see below)	66	63.4	284	981	849	876
Vaccine Preventable Diseases:
Influenza, A&B	0	0	4	1	7	1
Measles	0	0	0	0	0	0
Pertussis	1	0	2	19	5	4
Varicella	7*+	*	80*+	51*+	*	*
M. tuberculosis:
Confirmed Cases	0!	1.2	6	7	14	12
Rare Diseases (other than listed):
Brucellosis	0	0	0	2	0	0
HIV and AIDS	Jan - Mar 2005	Jan - Mar 5yr avg	YTD 2005	2004 Total	2003 Total	2002 Total
HIV	4	3.8	4	18	16	18
AIDS	4	3.6	4	23	19	8

* Became reportable in June 2004
+ Includes probable as well as confirmed cases
! 21 cases under investigation

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Click here for the Kansas Certificate of Immunization (KCI) and Kansas Immunization Requirements: www.kdhe.state.ks.us/immunize/imm_manual_pdf/kci_form.pdf.

The new meningitis vaccine, Menactra (conjugated meningococcal vaccine) for people ages 11-55 is now available at the JCHD. Meningitis vaccination is recommended for children aged 11-12, students entering high school or college freshmen living in dormitories.

New vaccination requirements: Hepatitis B and varicella vaccines are now required for students entering Kindergarten and First Grade for the 2005-2006 school year.

If you have any questions about the monthly communicable disease report, or any other disease surveillance or containment questions, please contact Nancy Tausz, RN, BSN, Director of the Disease Containment Division, at 913-826-1222 or by email at: Nancy.Tausz@jocogov.org.

Communicable disease reporting is the cornerstone of public health surveillance and disease control. Please remember to maintain an index of suspicion for bioterrorism and reportable disease, and give us a call if you have any questions or concerns (913-826-1303). On behalf of the Disease Containment Staff, thank you for your continued support.

Johnson County government does not discriminate on the basis of race, color, national origin, gender, religion, age and handicapped status in employment or the provision of programs and services.