Johnson County Health Department - EPI Update Newsletter

Pertussis is a bacterial respiratory illness characterized by severe spasms of coughing that can last for several weeks or even for months. Pertussis is usually spread from person-to-person through close contact with respiratory droplets released when a person coughs or sneezes. Before the introduction of vaccination in the 1940s, pertussis was a major cause of serious illness and death among infants and young children in the United States.

An average of more than 160,000 cases and more than 5,000 deaths were reported every year in the 1920s-30s. At its peak during this period, the annual number of case-reports was more than 250,000 with up to 9,000 deaths. In the 1940s, whole-cell pertussis vaccine combined with diphtheria and tetanus toxoids (DTP) was introduced, and case-reports of pertussis decreased more than 99% by 1976, when the number of reported cases reached a record-low of 1,010 cases.

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Five Amish children in a central Minnesota community have been diagnosed with the polio virus. Three of the children are in a single family, and the two other children are each in unrelated families in the same community.

The index case, identified on September 29 by the Minnesota Department of Health, was in an immunocompromised 7-month-old girl. The patient has no paralysis, and the source of her infection is unknown. Following a hospitalization at a community hospital in July for pneumonia, the index patient was hospitalized continuously at three additional hospitals since August 22 with failure to thrive, diarrhea, and recurrent infections. A stool specimen from this patient obtained on August 27 tested positive for type 1 poliovirus. Further testing showed that the virus was a strain derived from one of the three Sabin poliovirus strains in the oral polio vaccine. Investigators are reviewing staff and patient records at hospitals to determine whether the infant was exposed at a hospital or through another immunocompromised person.

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An influenza pandemic is a global outbreak of disease that occurs when a new influenza A virus appears or “emerges” in the human population, causes serious illness, and then spreads easily from person to person worldwide. Pandemics are different from seasonal outbreaks or “epidemics” of influenza. Seasonal outbreaks are caused by subtypes of influenza viruses that already circulate among people, whereas pandemic outbreaks are caused by new subtypes, by subtypes that have never circulated among people, or by subtypes that have not circulated among people for a long time. Past influenza pandemics have led to high levels of illness, death, social disruption, and economic loss.

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What is avian influenza (bird flu)?
Bird flu is an infection caused by avian (bird) influenza (flu) viruses. These flu viruses occur naturally among birds. Wild birds worldwide carry the viruses in their intestines, but usually do not get sick from them. However, bird flu is very contagious among birds and can make some domesticated birds, including chickens, ducks, and turkeys, very sick and kill them.

Do bird flu viruses infect humans?
Bird flu viruses do not usually infect humans, but several cases of human infection with bird flu viruses have occurred since 1997.

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What is meningitis?
Meningitis is an infection of the fluid of a person's spinal cord and the fluid that surrounds the brain. People sometimes refer to it as spinal meningitis. Meningitis is usually caused by a viral or bacterial infection. Knowing whether meningitis is caused by a virus or bacterium is important because the severity of illness and the treatment differ. Viral meningitis is generally less severe and resolves without specific treatment, while bacterial meningitis can be quite severe and may result in brain damage, hearing loss, or learning disability. For bacterial meningitis, it is also important to know which type of bacteria is causing the meningitis because antibiotics can prevent some types from spreading and infecting other people. Before the 1990s, Haemophilus influenzae type b (Hib) was the leading cause of bacterial meningitis, but new vaccines being given to all children as part of their routine immunizations have reduced the occurrence of invasive disease due to H. influenzae. Today, Streptococcus pneumoniae and Neisseria meningitidis are the leading causes of bacterial meningitis.

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Hepatitis A is a liver disease caused by the hepatitis A virus. Hepatitis A can affect anyone. In the United States, hepatitis A can occur in situations ranging from isolated cases of disease to widespread epidemics.

Good personal hygiene and proper sanitation can help prevent hepatitis A. Vaccines are also available for long-term prevention of hepatitis A virus infection in persons 12 months of age and older. Immune globulin is available for short-term prevention of hepatitis A virus infection in individuals of all ages.

More information about Hepatitis A can be found at the following link:
http://www.cdc.gov/ncidod/diseases/hepatitis/a/index.htm

Some of the topics covered include:

CDC en Español! - Hepatitis
Correctional Settings
Educational Materials (brochures, slide sets)
Fact Sheet
Foodborne Hepatitis A
Frequently Asked Questions
Links
Surveillance
U.S. Maps: Hepatitis A Rates
Vaccine
Vaccine Schedules

As Thanksgiving approaches, cooking the traditional turkey dinner gives rise to anxieties and questions. What kind of turkey should I buy? Should I buy a frozen turkey or a fresh one? How do I store my turkey?

A few simple steps will not only ease your holiday fears, but will ensure a delicious and a safe meal for you, your family, and your friends. The following information may help you prepare your special Thanksgiving meal and help you countdown to the holiday.

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It’s that time of year again. Temperatures and wind chills that can take your breath away. Snow and ice that make stepping outside a dangerous proposition. You know all too well how winter affects you. It is important to take a moment to think about how it affects your car as well. After all, you don’t want to be stranded in those sub-zero temperatures.

If you live where it snows, you know the damage that snow, ice, loose gravel and salt can do to your car. Minor scratches and nicks turn to rust, your heater gets a workout it may not be prepared for, and your windshield must deal with the temperature stress of a warm interior and a freezing exterior.

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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.

October Communicable Disease Report:

Disease Category	Oct 2005	Oct 5yr Avg	YTD 2005	2004 Total	2003 Total	2002 Total
Enteric Diseases:
Salmonella	3	3.6	76	85	50	38
Shigella	6	1.2	38	11	6	30
Central Nervous System:
Meningitis, Aseptic (including viral and fungal meningitis)	2	4.2	11	29	14	26
West Nile Encephalitis/Meningitis	0	0.8	1	2+	5	2
West Nile Fever	0	0.4	0	1+	0	0
Sexually Transmitted Infections:
Infection Numbers (excluding HIV/AIDS - see below)	64	68.2	862	981	849	876
Vaccine Preventable Diseases:
Influenza, A&B	0	0	4	1	7	1
Measles	0	0	0	0	0	0
Pertussis	6	0.4	21	19	5	4
Varicella	38*+	n/a	194*+	51*+	*	*
M. tuberculosis:
Confirmed Cases	1!	1	8	7	14	12
Rare Diseases (other than listed):
Brucellosis	0	0	0	2	0	0
Listeria	1	0	1	0	1	0
HIV and AIDS	July-Sep 2005	July-Sep 5yr avg	YTD 2005	2004 Total	2003 Total	2002 Total
HIV	5	4.4	14	17	18	19
AIDS	4	4	14	26	15	8

* Became reportable in June 2004
+ Includes probable as well as confirmed cases
! 9 cases under investigation
n/a not applicable

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.