Johnson County Health Department - EPI Update Newsletter

Lyme disease is endemic in Johnson County for surveillance purposes. The Centers for Disease Control and Prevention (CDC) has released a 2008 surveillance case definition that follows the 1995 definition, stating a county in which Lyme disease is endemic is one in which at least two confirmed cases have been acquired in the county or which established populations of a known tick vector are infected with B. burgdorferi. Johnson County had three cases diagnosed in 2006 and two in 2007.

Exposure to Lyme disease is defined as having been (less than or equal to 30 days before onset of erythema migrans) in wooded, brushy, or grassy areas (i.e. potential tick habitats) in a county in which Lyme disease is endemic. A history of tick bite is not required.

Lyme disease is caused by the spirochete Borrelia burgdorferi and is transmitted to humans by the bite of infected blacklegged ticks. Early manifestations of infection include fever, headache, fatigue, and a characteristic skin rash called erythema migrans. Left untreated, late manifestations involving the joints, heart, and nervous system can occur.

Persons living in Lyme disease endemic areas can take steps to reduce their risk for infection, including daily self-examination for ticks, selective use of acaricides and tick repellents, use of landscaping practices that reduce tick populations in yards and play areas, and avoidance of tick-infected areas.

Source: www.cdc.gov

Influenza usually starts suddenly and may include the following symptoms:

Fever (usually high)
Headache
Tiredness (can be extreme)
Cough
Sore throat
Runny or stuffy nose
Body aches
Diarrhea and vomiting (more common among children than adults)

Having these symptoms does not always mean that you have the flu. Many different illnesses, including the common cold, can have similar symptoms.

Diagnosing the Flu
It is very difficult to distinguish the flu from other infections on the basis of symptoms alone. A doctor's exam may be needed to tell whether you have developed the flu or a complication of the flu. There are tests that can determine if you have the flu as long you are tested within the first two or three days of illness.

If you develop flu-like symptoms and are concerned about your illness, especially if are at high risk for complications of the flu, you should consult your health-care provider. Those at high risk for complications include people 65 years or older, people with chronic medical conditions (such as asthma, diabetes, or heart disease), pregnant women, and young children.

Know the Risks from the Flu
In some people, the flu can cause serious complications, including bacterial pneumonia, dehydration, and worsening of chronic medical conditions, such as congestive heart failure, asthma or diabetes. Children and adults may develop sinus problems and ear infections.

People May Have Different Reactions to the Flu
The flu can cause mild to severe illness and at times can lead to death. Although most healthy people recover from the flu without complications, some people, such as older people, young children, and people with certain health conditions (such as asthma, diabetes, or heart disease), are at high risk for serious complications from the flu.

Know How the Flu Spreads
The flu usually spreads from person to person in respiratory droplets when people who are infected cough or sneeze. People may become infected by touching something with influenza virus on it and then touching their mouth, nose or eyes. Healthy adults may be able to infect others one day before getting symptoms and up to five days after getting sick. Therefore, it is possible to give someone the flu before you know you are sick as well as while you are sick.

What has the flu season been like in the United States so far?
So far during the 2007-2008 flu season, low levels of influenza activity have been reported in the United States. This is similar to the low levels of activity seen at this point in time during most years. CDC’s Influenza Division collects, compiles and analyzes information on influenza activity in the United States each week from October through May.

flu map

Source: www.cdc.gov

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What is Tuberculosis (TB)?
Tuberculosis (TB) is a disease caused by a germ called Mycobacterium tuberculosis that is spread from person to person through the air. The disease usually affects the lungs, but it can also affect the brain, kidneys, and spine. When a person with infectious TB coughs or sneezes, droplets containing M. Tuberculosis are expelled into the air. TB is NOT spread by shaking hands, sharing food or drink, touching bed linens and toilet seats, sharing toothbrushes, kissing, or smoking or sharing cigarettes.
Not everyone infected with TB becomes sick. There are two different kinds of TB-related conditions: latent TB infection and active TB disease.

What is the difference between latent and active TB?

Individuals with latent TB infection:
• Usually have a skin test or blood test indicating TB infection
• Have a normal chest x-ray and a negative sputum test
• Have TB bacteria in his/her body that are alive, but inactive
• Does not feel sick
• Cannot spread TB bacteria to others
• Needs treatment for latent TB infection to prevent TB disease
Latent TB is a reportable disease.

Individuals with active TB infection:
• Usually has a skin or blood test result indicating TB infection
• May have an abnormal chest x-ray, or positive sputum smear or culture
• Have active TB bacteria in his/her body
• Usually feels sick, and may have symptoms such as coughing, fever, and weight loss
• May spread TB bacteria to others
• Needs treatment to treat active TB disease

General symptoms of active TB disease include: unexplained weight loss, loss of appetite, night sweats, fever, fatigue, chills, coughing for three weeks or longer, coughing up blood, and chest pain.

What is MDR TB?
MDR TB, or multi drug-resistant TB, is a strain of TB that is resistant to at least two of the best anti-TB drugs, isoniazid and rifampicin. Resistance to anti-TB drugs can occur when these drugs are misused or mismanaged, for example, when patients do not complete their full course of treatment; when health-care providers prescribe the wrong treatment, the wrong dose, or length of time for taking the drugs; when the supply of drugs is not always available, or when drugs are of poor quality.

What is XDR TB?
XDR-TB, or extensively drug-resistant TB, is a rare type of MDR-TB. It is resistant to almost all drugs used to treat TB, including the two best first-line drugs, as well as the best second-line medications. Because XDR-TB is resistant to the most powerful first and second-line drugs, patients have less treatment options that are much less effective and often have worse treatment outcomes.

Sources:
www.cdc.gov
http://www.cdc.gov/tb/surv/surv2006/pdf/FullReport.pdf

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Winter Safety Tips

Serious health problems can result from prolonged exposure to the cold. The most common cold-related problems are hypothermia and frostbite. Listed below are three common winter safety health issues:

Hypothermia
When exposed to cold temperatures, your body begins to lose heat faster than it can be produced. Prolonged exposure to cold will eventually use up your body’s stored energy. The result is hypothermia, or abnormally low body temperature. Body temperature that is too low affects the brain, making the victim unable to think clearly or move well. This makes hypothermia particularly dangerous because a person may not know it is happening and won’t be able to do anything about it.

Warning signs of hypothermia in adults include: shivering, exhaustion, confusion, fumbling hands, memory loss, slurred speech, and drowsiness. Infants might exhibit bright red, cold skin and very low energy levels.

If you notice any of these signs, take the person’s temperature. If it is below 95 degrees, get medical attention immediately.

Frostbite
Frostbite is an injury to the body that is caused by freezing. Frostbite causes a loss of feeling and color in affected areas. It most often affects the nose, ears, cheeks, chin, fingers, or toes. Frostbite can permanently damage the body, and severe cases can lead to amputation. The risk of frostbite is increased in people with reduced blood circulation and among people who are not dressed properly for extremely cold temperatures.

Symptoms of frostbite include: a white or grayish-yellow skin area, skin that feels unusually firm or waxy, and numbness. A victim is often unaware of frostbite until someone points it out because the frozen tissues are numb.

If you detect symptoms of frostbite, seek medical care. Because frostbite and hypothermia both result from exposure, also check for signs of hypothermia at the same time.

Carbon Monoxide
Carbon monoxide, or CO, is an odorless, colorless gas that can cause sudden illness and death. CO is found in combustion fumes, such as those produced by cars and trucks, small gasoline engines, stoves, lanterns, burning charcoal and wood, and gas ranges and heating systems. CO from these sources can build up in enclosed or semi-enclosed spaces. People and animals in these spaces can be poisoned by breathing it.

The most common symptoms of CO poisoning are headache, dizziness, weakness, nausea, vomiting, chest pain, and confusion. High levels of CO inhalation can cause loss of consciousness and death. People who are sleeping or intoxicated can die from CO poisoning before even experiencing symptoms.

To help prevent CO buildup in the home:

Have your heating system, water heater and any other gas, oil, or coal burning appliances serviced by a qualified technician every year.
Do not use portable flameless chemical heaters indoors. Even though they don’t have a flame, they burn gas and can cause CO buildup inside your home, cabin, or camper.
If you smell an odor from your gas refrigerator’s cooling unit, have an expert service it.
When purchasing gas equipment, buy only equipment carrying the seal of a national testing agency, such as the American Gas Association or Underwriters’ Laboratories.
Install a battery-operated CO detector in your home and check or replace the battery when you change the time on your clocks each spring and fall.

Sources:
http://emergency.cdc.gov/disasters/winter/staysafe/
http://www.cdc.gov/co/faqs.htm

Food Recalls & Safety Alerts: Inform Yourself

Food recalls and safety alerts help let consumers know about products that may be mislabeled due to undeclared ingredients or about products that may be contaminated with a disease-causing organism. According to the U.S. Food and Drug Administration (FDA), “recalls are actions taken by a firm to remove a product from the market. Recalls may be conducted on a firm's own initiative, by FDA request, or by FDA order under statutory authority.”

For more information on recalls, market withdrawals, and safety alerts or to sign up to receive alerts, visit the following website: http://www.fda.gov/opacom/7alerts.html.

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.