Johnson County Health Department - EPI Update Newsletter

The Johnson County Health Department is seeing an increase in reported cases of varicella (chickenpox). This is an increase of 30 percent from this time last year. Chickenpox is a disease caused by the varicella zoster virus, which causes fever and an itchy rash.

The best way to protect against chickenpox is to be vaccinated. A new requirement for varicella vaccine in the state of Kansas starting school year 2008-09 is for students through fifth grade to have one dose of varicella vaccine. Two doses are recommended for children, adolescents, and adults. The first dose should be administered between 12 to 15 months of age, and the second dose from four to six years of age.

Symptoms of chickenpox include a skin rash of blister-like lesions, covering the body but usually more concentrated on the face, scalp, and trunk. Most, but not all, infected individuals have fever, which develops just before or when the rash appears. It is highly contagious and is spread by coughing and sneezing, by direct contact, or by aerosolization of the virus from skin lesions.

Source: www.cdc.gov/vaccines/vpd-vac/cvaricella/in-short-adult.htm

Flu Update

flu map

CDC says "Take 3" this flu season:

1. Take time to get a flu vaccine.
2. Take everyday preventative actions (like washing your hands often and covering your cough.)
3. Take antiviral drugs if your doctor says to.

Vaccine-preventable disease levels are at or near record lows. Even though most infants and toddlers have received all recommended vaccines by age two, many under-immunized children remain, leaving the potential for outbreaks of disease. Many adolescents and adults are under-immunized as well, missing opportunities to protect themselves against diseases such as Hepatitis B, influenza, and pneumococcal disease.
Please remember the following diseases are reportable to the health department. Please notify us if you have diagnosed a client with any of the following:

Disease	Overview
Anthrax	Naturally occurring in animals, but can occur in humans when they are exposed to infected animals or tissues. Anthrax spores can be used as a bioterrorist weapon. http://emergency.cdc.gov/agent/anthrax/\
Diphtheria	A respiratory disease caused by bacteria. Symptoms include gradual onset of a sore throat and low-grade fever. http://www.cdc.gov/vaccines/vpd-vac/diphtheria/default.htm
Haemophilus Influenzae B (Hib)	A severe bacterial infection, occurring primarily in infants and children under five years of age. http://www.cdc.gov/vaccines/vpd-vac/hib/in-short-adult.htm
Hepatitis A	A disease of the liver caused by the Hepatitis A virus. Symptoms include yellow skin or eyes, tiredness, stomachache, loss of appetite, or nausea. http://www.cdc.gov/vaccines/vpd-vac/hepa/in-short-adult.htm
Hepatitis B	A serious disease caused by a virus that attacks the liver. It can cause lifelong infection, cirrhosis of the liver, liver cancer, liver failure, and death. http://www.cdc.gov/ncidod/diseases/hepatitis/b/
Measles	A respiratory disease caused by a virus. Symptoms can include a rash, high fever, cough, runny nose, and red, watery eyes. http://www.cdc.gov/vaccines/vpd-vac/measles/in-short-adult.htm
Meningococcal Disease	Meningitis is an infection of the fluid of a person’s spinal cord and the fluid that surrounds the brain. It is usually carried by a viral or bacterial infection. http://www.cdc.gov/ncidod/dbmd/diseaseinfo/meningococcal_g.htm
Mumps	An acute viral illness caused by the mumps virus. Symptoms include fever, headache, muscle aches, tiredness, loss of appetite, and swelling of the salivary glands. http://www.cdc.gov/vaccines/vpd-vac/mumps/in-short-adult.htm
Pertussis	A respiratory disease caused by bacteria. After one to two weeks, it may progress to a stage characterized by bursts of numerous rapid coughs. http://www.cdc.gov/vaccines/vpd-vac/pertussis/in-short-both.htm
Poliomyelitis (Polio)	A highly infectious disease caused by a virus that invades the nervous system. Symptoms include fever, fatigue, nausea, headache, flu-like symptoms, stiffness in the neck and back, and pain in the limbs. http://www.cdc.gov/vaccines/vpd-vac/polio/in-short-both.htm
Rabies	A viral disease most often transmitted through the bite of a rabid animal. Rabies virus infects the central nervous system, causing encephalopathy and death. http://www.cdc.gov/rabies/about.html
Rubella	An acute viral disease spread by coughing and sneezing that causes fever and rash for two to three days. It can cause birth defects if acquired by a pregnant woman. http://www.cdc.gov/vaccines/vpd-vac/rubella/in-short-adult.htm
Smallpox	A serious, contagious, and sometimes fatal infectious disease. Marked by fever and a distinctive progressive skin rash, vaccine was used to successfully eradicate smallpox from the human population. http://www.cdc.gov/vaccines/vpd-vac/smallpox/default.htm#disease
Tetanus	A disease of the nervous system caused by bacteria that enters the body through a break in the skin. Early symptoms include lockjaw, stiffness in the neck or abdomen, and difficulty swallowing. http://www.cdc.gov/vaccines/vpd-vac/tetanus/in-short-both.htm
Varicella	A skin rash of blister-like lesions, covering the body but usually more concentrated on the face, scalp, and trunk. http://www.cdc.gov/vaccines/vpd-vac/varicella/in-short-adult.htm
Yellow Fever	A viral disease that is transmitted through the bite of infected mosquitoes. Illness ranges in severity from an influenza-like syndrome to severe hepatitis and hemorrhagic fever. http://wwwn.cdc.gov/travel/yellowBookCh4-YellowFever.aspx

The United States Department of Health and Human Services publishes the National Health Observances calendar. Health observances are days, weeks, or months devoted to promoting particular health concerns. The calendar lists selected health observances in three ways: the calendar shows days and weeks, and both the text listings and the “Year at a Glance” sheet show monthly health observances as well.
Health professionals, teachers, community groups and others can use these special times to sponsor health promotion events, stimulate awareness of health risks, or focus on disease prevention. Materials available from sponsoring organizations range from a single flyer to packets of promotional materials.

Website: http://www.healthfinder.gov/library/nho/nho.asp

Tamiflu-Resistant Influenza Strains Found in Europe

The European Centre for Disease Prevention and Control (ECDC) recently reported that some of the Influenza A (H1N1) viruses circulating this regular influenza season are resistant to oseltamivir, (marketed as Tamiflu). Of 437 samples from a survey of antiviral drug susceptibility, 59 from nine countries showed evidence of resistance to the first-line treatment. Norway had the majority of the drug-resistant samples, with 26 of the 37 samples sent testing positive for resistance to oseltamivir.
It is noted that it is not known what the level of oseltamivir-resistant influenza is across Europe, but that those with the resistant strains do not appear any more ill that those with the “normal” influenza. Flu experts from ECDC, the European Commission and the World Health Organization are working to develop a joint assessment based on the data available.
Oseltamivir is a neuraminidase inhibitor that fights against influenza A and B viruses. It is approved to treat and prevent flu one year of age and older. It has been in use since 1999.

Sources:
http://ecdc.europa.eu/Health_topics/influenza/antivirals.html
http://www.cdc.gov/flu/about/qa/antiviral.htm

Johnson County Disease Report

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

This does not list diseases for which no case has been reported.

Disease Category	Disease Name	January 2008	Total YTD
Enteric	Calicivirus (Norwalk-like virus (norovirus)	3	3
	Campylobacter Infection( Campylobacter spp.)	8	8
	Enterohemorrhagic Escherichia coli shiga toxin positive (serogroup non O157)	2	2
	Giardiasis (Giardia lamblia)	9	9
	Salmonellosis (Salmonella spp.)	6	6
	Shigellosis (Shigella spp.)	1	1
General	Hepatitis A	2	2
	Hepatitis B, acute	1	1
	Hepatitis B, chronic	16	16
	Hepatitis C virus infection (past or present)	14	14
	Streptococcal Disease, invasive, drug-resistant	1	1
Vaccine-Preventable Diseases	Pertussis (Bordetella pertussis) (Whooping cough)	3	3
	Varicella (chickenpox)	24	24

Communicable Disease Reporting

Communicable diseases may be reported by:

Calling (913) 826-1303 (Monday through Friday, 8:00 a.m. to 5:00 p.m.)
Calling (877) 427-7317 (KDHE after hours and on weekends)
Faxing form to (913) 826-1210

Reporting forms are available on the "Disease Containment Program" section of the Johnson County Health Department website (http://health.jocogov.org/Disease%20Programs/progDCP.htm). The forms include:

-Kansas Notifiable Disease Form
-Kansas Varicella reporting Form
-Positive TB Reactor Epidemiological Report
-Animal Bite Investigation Report Form

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) 477-8362 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.