Johnson County Health Department - EPI Update Newsletter

Chlamydia is the most frequently reported bacterial sexually transmitted infection in Johnson County and the United States. Under-reporting is substantial because most people with chlamydia are not aware of their infections and do not seek testing.

Chlamydia can be transmitted during vaginal, anal, or oral sex. Chlamydia can also be passed from an infected mother to her baby during vaginal childbirth. Women are frequently re-infected if their sex partners are not treated.

Chlamydia is known as a “silent” disease because about three quarters of infected women and about half of infected men have no symptoms. If symptoms do occur, they usually appear within 1 to 3 weeks after exposure.

In women, the bacteria initially infect the cervix and the urethra (urine canal). Women who have symptoms might have an abnormal vaginal discharge or a burning sensation when urinating. When the infection spreads from the cervix to the fallopian tubes (tubes that carry fertilized eggs from the ovaries to the uterus), some women still have no signs or symptoms; others have lower abdominal pain, low back pain, nausea, fever, pain during intercourse, or bleeding between menstrual periods. Chlamydial infection of the cervix can spread to the rectum.

Men with signs or symptoms might have a discharge from their penis or a burning sensation when urinating. Men might also have burning and itching around the opening of the penis. Pain and swelling in the testicles are uncommon.

State of Kansas Reported Cases of Chlamydia January - December 2008
http://www.kdheks.gov/std/download/std_reports/2008_STAT_Pack.pdf

Division of STD Prevention (DSTDP) Centers for Disease Control and Prevention
http://www.cdc.gov/std/

Johnson County Health Department Chlamydia facts
http://health.jocogov.org/docs/chlamydia_facts.pdf

Salmonella Outbreak Update

The Centers for Disease Control and Prevention (CDC) is continuing to work with local and state public health officials to investigate a Salmonella Typhimurium outbreak.
As of February 5, 2009, 575 people from 43 states have been infected with the Salmonella Typhimurium strain. Two cases have been identified in Kansas.

Major national brands of jarred peanut butter found in grocery stores are NOT affected by the Peanut Corporation of America (PCA) recall.

Consumers may use FDA’s online database to see if foods are on the recall list. A listing of foods that have not been recalled can be found at: http://www.peanutsusa.com/USA/index.cfm?fuseaction=home.page&pid=262.

As of January 31, low levels of influenza are being reported throughout Kansas, with elevated activity seen in the northeast region of the state. The state laboratory has confirmed five A(H1) flu viruses that are covered by this year's flu vaccine. The antiviral drug oseltamivir (Tamiflu), may not be as effective against this strain. Therefore, CDC is issuing interim recommendations for antiviral treatment and chemoprophylaxis of influenza during the 2008-09 influenza season. When influenza A (H1N1) virus infection or exposure is suspected, zanamivir or a combination of oseltamivir and rimantadine are more appropriate options than oseltamivir alone. For the CDC’s interim guidance on antiviral use, please visit http://www.cdc.gov/flu/professionals/antivirals/index.htm

flu-map

2009-2010 School Vaccination Requirements

Below are the following requirements for any individual who attends school, preschool, or a childcare program of any type.

Diphtheria, Tetanus, Pertussis (DTaP): five doses required. Four doses acceptable if dose 4 given on or after the 4th birthday. Booster dose of Tdap required at age 11.
Poliomyelitis (IPV/OPV): four doses required. Three doses acceptable if dose 3 given on or after the 4th birthday.
Measles, Mumps, Rubella: two doses required.
Hepatitis B: three doses required through grade 9.*
Varicella (chickenpox): two doses required for Kindergarten; one dose required grades 1-9* unless history of varicella disease documented by a licensed physician. Two doses are currently recommended by the ACIP for all ages.
Haemophilus influenzae type b (Hib): three doses required for children less than 5 yrs of age in preschool or childcare operated by a school.
Pneumococcal conjugate (PCV7): four doses required for children less than 5 yrs of age in preschool or childcare operated by a school.
Hepatitis A: two doses required for children less than 5 yrs of age in preschool or childcare operated by a school.

*All students will be required to have 3 doses of Hepatitis B and 2 doses of varicella for the 2010-2011 school year.

In addition to the immunizations required for school entry listed above, the 2009 ACIP recommendations also include the following for school children:

Meningococcal (MCV4): one dose recommended for > 11 years of age; not required for school entry.
Human Papillomavirus (HPV): three doses recommended for females >11 years of age; not required for school entry.
Influenza: yearly vaccination recommended for all ages > 6 months of age; not required for school entry.

Sources: http://www.kdheks.gov/immunize/download/School_Imm_Req_Memo_UPDATE_02-06-2009.pdf

http://www.kdheks.gov/epi/download/prop_regs/2008/28-1-20_draft_regs.pdf

JCHD Has Federal Preparedness Assessment

The Johnson County Health Department Public Health Emergency Program (PHEP) had their annual preparedness plan assessment on Tuesday, February 3, 2009.

The review was conducted by the Centers for Disease Control and Prevention (CDC) and assessed the health department’s ability to dispense large amounts of medication to the entire county population in the event of a public health emergency. Focus areas included: dispensing plans, state and federal materials requesting, managing materials, public information and communication, dispensing security, inventory control and material distribution.

There are two Metropolitan Statistical Areas (MSAs) in the state of Kansas – the Kansas City and Wichita areas. The Kansas City MSA includes Kansas City, Missouri and surrounding counties, and in Kansas, covers Franklin, Johnson, Leavenworth, Linn, Miami, and Wyandotte counties. However, each state is reviewed separately by different representatives from the CDC. Combined scores for Kansas counties and the state of Kansas directly affect federal grant funding levels for the state. The State, Wichita and Kansas side metro MSAs must achieve the average combined score of 79 points to ensure public health preparedness funding levels.

For more information on assessment criteria and funding sources, go to http://emergency.cdc.gov/cri/.
Information on state of Kansas CRI score: http://www.kdheks.gov/cphp/download/KsPT_Fall07.pdf

Johnson County Disease Report

Disease Name	Jan 09	Total YTD
Calicivirus/Norwalk-like virus (norovirus)	0	0
Campylobacter Infection (Campylobacter spp.)	2	2
Cryptosporidiosis (Cryptosporidium parvum)	0	0
Dengue	0	0
Dengue Hemorrhagic Fever	0	0
Enterohemorrhagic Escherichia coli shiga toxin positive (not serogrouped)	0	0
Enterohemorrhagic Escherichia coli toxin positive (serogroup non-O157)	0	0
Enterohemorrhagic Escherichia coli 0157:H7	0	0
Giardiasis (Giardia lamblia)	1	1
Salmonellosis (Salmonella spp.)	2	2
Shigellosis (Shigella spp.)	1	1
Amebiasis (Entamoeba histolytica)	0	0
Ehrlichiosis, human monocytic (HME)	0	0
Ehrlichiosis, human monocytic (HGE)	0	0
Hepatitis A	1	1
Hepatitis B, acute	1	1
Hepatitis B, chronic	7	7
Hepatitis C virus infection (past or present)	21	21
Legionellosis	1	1
Listeriosis (Listeria monocytogenes)	0	0
Lyme Disease (Borrelia burgdorferi)	1	1
Malaria (Plasmodium spp.)	1	1
Meningitis, other bacterial	0	0
Rocky Mountain Spotted Fever (Rickettsia rickettsii) (RMSF)	3	3
Streptococcal Disease, Invasive, Group A (Streptococcus pyogenes)	0	0
Streptococcal pneumoniae, invasive, drug-resistant	2	2
Transmissable Spongioform Encephalitis (TSE./CJD	0	0
West Nile, non-neurological (includes WN Fever)	0	0
Haemophilus influenzae, invasive	0	0
Measles (Rubeola)	0	0
Mumps	1	1
Pertussis (Bordetella pertussis) (Whooping cough)	6	6
Varicella (Chickenpox)	13	13
Early Syphilis	2	2
Gonorrhea	5	5
Chlamydia	61	61

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 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.