Johnson County Health Department - EPI Update Newsletter

Meningitis has been in the news lately due to a recent death in Johnson County, as well as others in Wichita and Fort Leonard Wood, Missouri. Meningitis most often occurs in late winter and early spring. It is an infection of the fluid of a person's spinal cord and the fluid that surrounds the brain, usually caused by a viral or bacterial infection. Because the severity of illness and the treatment differ, knowing whether meningitis is caused by a virus or bacterium is important.

Bacterial meningitis can be quite severe and may result in brain damage, hearing loss, learning disability, or death if not treated promptly. Also is important to know is which type of bacteria is causing the meningitis as antibiotics can prevent some types from spreading and infecting other people. Today, Streptococcus pneumoniae and Neisseria meningitidis are the leading causes of bacterial meningitis.

High fever, headache, and stiff neck are common symptoms of meningitis in anyone over the age of two years. These symptoms can develop over several hoursto one or two days. Other symptoms may include nausea, vomiting, discomfort looking into bright lights, confusion, and sleepiness. In newborns and small infants, the classic symptoms of fever, headache, and neck stiffness may be absent or difficult to detect, and the infant may only appear slow or inactive, or be irritable, have vomiting, or be feeding poorly. As the disease progresses, patients of any age may have seizures.

Bacterial meningitis can be treated with a number of effective antibiotics. It is important however, that treatment be started early in the course of the disease. Appropriate antibiotic treatment of most common types of bacterial meningitis should reduce the risk of dying from meningitis to below 15 percent, although the risk is higher among the elderly.

Some forms of bacterial meningitis are contagious. The bacteria are spread through the exchange of respiratory and throat secretions (i.e., coughing, kissing). Fortunately, none of the bacteria that cause meningitis are as contagious as things like the common cold or the flu, and they are not spread by casual contact or by simply breathing the air where a person with meningitis has been.

All information courtesy of http://www.cdc.gov/meningitis/index.htm

Varicella Documentation

NOTE: Health departments are able to document varicella disease history for school requirements for 2009-2010.

With more people outside enjoying the warm weather, there is an increased risk for dog bites. Last year there were 168 dog bites reported in Johnson County.

Nationwide, almost five million Americans are bitten by dogs each year, and one in five dog bites results in injuries that require medical attention. There are ways to make dog bites less likely and to help prevent children from being bitten.

Children are most at risk for dog-bite related injuries. Kids between five and nine years of age are more likely than adults to receive medical attention for dog bites. Adult males are also at higher risk than adult females, and people with dogs in their homes have an increased risk of being bitten. To help prevent from being bitten by dogs, the following basic safety tips are recommended:

Do not approach an unfamiliar dog.
Do not run from a dog or scream. Remain motionless when approached by an unfamiliar dog.
If knocked over by a dog, roll into a ball and lie still.
Children should not play with a dog unless supervised by an adult.
Immediately report stray dogs or dogs displaying unusual behavior.
Avoid direct eye contact with a dog.
Do not disturb a dog that is sleeping, eating, or caring for puppies.
Do not pet a dog without allowing it to see and sniff you first.

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Vector-Borne Diseases

A disease that is transmitted to humans or other animals by an insect or other arthropod is called a vector-borne disease. These diseases include West Nile Disease, Lyme disease and malaria. Most vector-borne diseases in Kansas are transmitted through an infected tick or mosquito.

Although great advances have been made in vaccines or chemoprophylactic drugs against vector-borne diseases such as yellow fever and malaria, individuals should still use repellents and other measures against mosquitoes and ticks. Exposure to these creatures can be minimized by modifying patterns of activity or behavior, including:

Staying inside during dawn and dusk when mosquitoes are most active;
Wearing long-sleeved shirts, long pants, and hats to minimize areas of exposed skin;
Applying mosquito and tick repellents to clothing, shoes, tents, etc. to enhance protection. Repellents containing DEET are the most effective.
Check yourself and any pets often for ticks if you have spent time in brushy or wooded areas.

Disease	Overview
Lyme Disease	Transmitted to human by the bite of an infected deer or western blacklegged tick. Symptoms include fever, headache, fatigue, and a characteristic skin rash called erythema migrans. http://www.cdc.gov/ncidod/dvbid/Lyme/index.htm
Rocky Mountain Spotted Fever	RMSF is the most severe and most frequently reported rickettsial illness in the U.S. The disease is cause by Rickettsia rickettsii, a species of bacteria that is spread to humans by hard ticks. Initial symptoms include sudden onset of fever, headache, muscle pain, followed by development of rash. http://www.cdc.gov/ticks/diseases/rocky_mountain_spotted_fever/
Plague	Usually transmitted from being bitten by a rodent flea that is carrying the plague bacterium. Symptoms vary by type: bubonic, septicemic, or pneumonic plague. http://www.cdc.gov/ncidod/dvbid/plague/facts.htm
Tularemia	Caused by bacteria found in rodents, rabbits and hares. Symptoms include fever, chills, headaches, diarrhea, muscle aches, joint pain, dry cough, and progressive weakness. Tularemia can be used as a biological weapon. http://www.cdc.gov/ncidod/dvbid/tularemia.htm
West Nile Encephalitis	Spread through infected mosquitoes. About one in 150 people affected with WNV will develop serious illness. Severe symptoms can include high fever, headache, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, vision loss, numbness, and paralysis. http://www.cdc.gov/ncidod/dvbid/westnile/wnv_factsheet.htm

April is National Autism Awareness Month

Autism is one of a group of disorders known as autism spectrum disorders (ASDs). ASDs are developmental disabilities that cause substantial impairments in social interaction and communication and the presence of unusual behaviors and interests. Many people with ASDs also have unusual ways of learning, paying attention, and reacting to different sensations. The thinking and learning abilities of people with ASDs can vary from gifted to severely challenged. An ASD begins before the age of three and lasts throughout a person's life.

Autism occurs in all racial, ethnic, and socioeconomic groups and are four times more likely to occur in boys than in girls. CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network released data in 2007 that found about one in 150 eight-year-old children in multiple areas of the United States had an ASD.For more information on autism and research the CDC is conducting, go to http://www.cdc.gov/ncbddd/autism/

April Flu Surveillance Update

Flu cases continue to decrease throughout the United States, however, it’s not too late to get your flu shot! The Johnson County Health Department has vaccine available. Go to http://health.jocogov.org/hours.shtml for Immunization clinic hours.

flu map

Information provided by the Centers for Disease Control and Prevention.
For more information please visit www.cdc.gov

Johnson County Disease Report

Disease Name	Jan 09	Feb 09	Mar 09	Total YTD
Calicivirus/Norwalk-like virus (norovirus)	0	0	0	0
Campylobacter Infection (Campylobacter spp.)	2	3	8	13
Cryptosporidiosis (Cryptosporidium parvum)	0	0	1	1
Dengue	0	0	0	0
Dengue Hemorrhagic Fever	0	0	0	0
Enterohemorrhagic Escherichia coli shiga toxin positive (not serogrouped)	0	1	1	2
Enterohemorrhagic Escherichia coli toxin positive (serogroup non-O157)	0	0	0	0
Enterohemorrhagic Escherichia coli 0157:H7	0	0	0	0
Giardiasis (Giardia lamblia)	1	3	2	6
Salmonellosis (Salmonella spp.)	2	2	3	7
Shigellosis (Shigella spp.)	1	2	1	4
Amebiasis (Entamoeba histolytica)	0	0	0	0
Brucellosis	0	0	1	1
Ehrlichiosis, Ehrlichia chaffeensis	0	1	1	2
Ehrlichiosis, ehrlichia ewingii	0	0	0	0
Ehrlichiosis, human other	0	0	0	0
Hepatitis A	1	4	3	8
Hepatitis B, acute	1	0	0	1
Hepatitis B, chronic	7	10	10	27
Hepatitis C virus infection (past or present)	21	14	12	47
Legionellosis	1	0	0	1
Listeriosis (Listeria monocytogenes)	0	0	0	0
Lyme Disease (Borrelia burgdorferi)	1	1	1	3
Malaria (Plasmodium spp.)	1	0	0	1
Meningitis, Niesseria meningitidis	0	0	1	1
Meningitis, other bacterial	0	0	0	0
Q Fever (Coxiella burnetii)	0	1	1	2
Rocky Mountain Spotted Fever (Rickettsia rickettsii) (RMSF)	3	2	1	6
Streptococcal Disease, Invasive, Group A (Streptococcus pyogenes)	0	5	1	6
Streptococcus pneumoniae, invasive, drug-resistant	2	2	2	6
Toxic Shock Syndrome, streptococcal and staphylococcal	0	1	1	2
Transmissable Spongioform Encephalitis (TSE./CJD	0	0	0	0
West Nile, non-neurological (includes WN Fever)	0	0	0	0
Haemophilus influenzae, invasive	0	0	1	1
Measles (Rubeola)	0	0	0	0
Mumps	1	0	2	3
Pertussis (Bordetella pertussis) (Whooping cough)	6	9	7	22
Varicella (Chickenpox)	13	23	22	58
Early Syphilis	2	4	1	7
Gonorrhea	5	25	18	48
Chlamydia	61	176	80	317
Latent Tuberculosis infection	20	29	34	83
Active Tuberculosis infection	2	5	7	14

This includes the number of reported cases investigated by JCHD (case classifications include: confirmed, probable, suspect, not a case.)

Disease Reporting Notes:

If you have any questions about the monthly Epi Update, 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 the Disease Containment staff a call if you have any questions or concerns at (913) 826-1303. On behalf of the Johnson County Health Department, 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.