Johnson County Health Department - EPI Update Newsletter

State laws and regulations require that cases of Tuberculosis within Johnson County be reported to the Johnson County Health Department or to the Kansas Department of Health & Environment (KDHE). This applies for all stages of the disease, including latent TB infection. With active TB infection, a telephone report is required by law within four hours of suspect or confirmed cases. Physicians can call (913) 826-1303 with reportable cases or questions.

The Johnson County Health Department has a form to complete for individuals with a positive TB test. This form should be filled out and faxed to (913) 826-1210.

Tuberculosis (TB) is a serious disease caused by a type of bacteria that can be spread from person to person through the air. A person with TB disease spreads the bacteria to others by coughing, laughing, sneezing, or even by speaking. TB is most commonly spread to others in confined, poorly ventilated spaces. Although anyone can be exposed to this disease, certain individuals are at higher risk for exposure, including health care professionals, the homeless, and people who were born in countries with high TB rates. Elderly people and individuals with HIV or AIDS are also more likely to get TB because their bodies are less able to fight off infections.

The State of Kansas has 57 reportable diseases, all which can be found on the Johnson County Health Department website at:
http://health.jocogov.org/docs/KANSAS_NOTIFIABLE_DISEASE_FORM%202006.pdf

Sources:
www.kdheks.gov
http://health.jocogov.org

Salmonella Outbreak

The Centers for Disease Control and Prevention (CDC) is currently working with local and state public health officials to investigate a Salmonella Typhimurium outbreak.

As of January 21, 2009, 486 people from 43 states and Canada have been infected with the Salmonella Typhimurium strain. Two have been sickened in Kansas.

The investigation continues and more products may be implicated, but Salmonella has been found in peanut butter and sandwich crackers containing peanut butter. Preliminary analysis by CDC and other public health officials indicated that peanut butter is a likely source of the bacteria causing infections. Many companies are voluntarily recalling products made with or containing peanut butter. A full listing of these recalls can be found here. To date, no association has been found with major national brand name jars of peanut butter sold in grocery stores.

The CDC and other health department personnel are conducting detailed interviews with ill persons as well as non-ill to compare foods they recently ate as well as other exposures. Once a potential contaminate is identified, testing is completed. This process may take several weeks, and is not always successful. Once a contaminated product is found, public health officials advise the public to avoid it and conduct recalls when appropriate.

Salmonella symptoms include diarrhea, fever, and abdominal cramps 12 to 72 hours after initial infection, and the illness lasts four to seven days. Infection is usually diagnosed by culture of a stool sample. While most will recover without treatment, severe infections have been known to occur. Those at higher risk for a more severe infection include infants, the elderly, and those who are immunocompromised. When severe infection occurs, Salmonella may spread from the intestines to the bloodstream and then to other body sites and can cause death unless the person is treated promptly with antibiotics.

http://www.cdc.gov/salmonella/typhimurium/
http://www.fda.gov/oc/opacom/hottopics/salmonellatyph.html#products

Beginning Wednesday, January 21, 2009, the Johnson County Health Department will be posting flu and syndromic surveillance information on WEBEOC Wednesday afternoons. The influenza numbers reported are from rapid tests and cultures done at area healthcare facilities. Three Johnson County hospitals are providing syndromic surveillance data to the Health Department and that information will be posted on a weekly basis.

The attachment provides background information and recent illness trends in our county. If you have questions, please contact me or one of the epidemiologist at 913-826-1303.

Public health surveillance is the continuous, organized gathering, investigation, analysis and distribution of data about a health-related event. The knowledge gained is used to determine proper public health interventions to decrease morbidity and mortality rates and improve the overall health of a community.

Flu Surveillance
Currently the state of Kansas does not require influenza cases to be reported unless a death in a child under the age of eighteen occurs.

In order to enhance Johnson County Health Department’s Disease Containment Division surveillance capabilities, we have requested volunteer participation from the local medical community. The influenza numbers reported are from rapid tests and cultures done at healthcare facilities.

Comparison of Influenza Cases

Syndromic Surveillance
This is related to all symptoms, whether influenza, foodborne illness, and communicable diseases. Surveillance data allows public health to support case detection and interventions, estimate the impact of a health condition, describe the natural history of a disease, determine the communicability and distribution of an illness, generate hypotheses and stimulate research, evaluate prevention and control measures, and facilitate planning in case of an outbreak. Outbreak detection identifies increases in frequency of disease above the natural occurrence of the disease, and is a significant function of surveillance.

Three hospitals within Johnson County are providing syndromic surveillance data to the Johnson County Health Department Disease Containment Division so that information regarding current illness being observed can be posted on a weekly basis (unless an increased frequency is needed) for individuals with access to WEBEOC.

Syndromic Surveillance December 2008

Johnson County Emergency Preparedness Information

Johnson County Emergency Management & Homeland Security staff has recently introduced a new preparedness website and blog to keep citizens aware of department projects and updates. The site, www.jocoprepared.org, offers preparedness tips, information on current and past preparedness projects in the Johnson County area and personal profiles of individuals working in the emergency community.

The blog, http://www.jocoprepared.blogspot.com, which is updated almost daily, offers community members a chance to see the day-to-day operations of the department as well as provide feedback to staff through blog comments. The blog can be followed from the website or subscribed to via e-mail or RSS feeder.

We encourage you to take a look at both of these sites. Thank you for helping Johnson County be a Community Prepared.

Johnson County Disease Report

Disease Name	Jan 08	Feb 08	March 08	April 08	May 08	June 08	July 08	Aug 08	Sept 08	Oct 08	Nov 08	Dec 08	Total YTD
Calicivirus/Norwalk-like virus (norovirus)	3	1	14	1	1	0	0	0	0	0	0	0	20
Campylobacter Infection (Campylobacter spp.)	8	1	5	10	0	9	25	20	4	7	1	3	93
Cryptosporidiosis (Cryptosporidium parvum)	1	0	0	1	1	1	2	6	0	1	0	0	13
Dengue	0	0	0	0	0	0	1	2	0	0	0	0	3
Dengue Hemorrhagic Fever	0	0	0	0	0	0	1	0	0	0	2	0	3
Enterohemorrhagic Escherichia coli shiga toxin positive (not serogrouped)	0	1	0	1	1	2	0	3	0	4	0	1	13
Enterohemorrhagic Escherichia coli toxin positive (serogroup non-O157)	2	0	0	0	0	0	1	0	1	0	0	0	4
Enterohemorrhagic Escherichia coli 0157:H7	0	0	0	0	0	0	1	0	0	1	1	0	3
Giardiasis (Giardia lamblia)	9	2	4	4	3	2	6	11	3	1	3	2	50
Salmonellosis (Salmonella spp.)	6	0	4	6	5	8	9	5	10	7	3	3	66
Shigellosis (Shigella spp.)	1	0	0	0	1	0	3	1	1	2	0	1	10
Amebiasis (Entamoeba histolytica)	0	0	0	0	0	1	0	0	0	0	0	0	1
Ehrlichiosis, human monocytic (HME)	0	0	3	1	2	2	2	1	0	3	0	0	14
Ehrlichiosis, human monocytic (HGE)	0	0	0	0	1	1	2	0	1	1	0	0	6
Hepatitis A	2	3	1	3	1	4	3	5	0	3	1	2	28
Hepatitis B, acute	1	0	2	1	1	2	0	2	1	1	0	2	13
Hepatitis B, chronic	16	16	19	10	10	6	8	2	6	3	5	4	105
Hepatitis C virus infection (past or present)	14	20	51	26	17	12	4	9	11	10	17	22	213
Legionellosis	0	1	2	0	0	1	0	0	1	1	2	0	8
Listeriosis (Listeria monocytogenes)	0	0	0	0	0	1	0	0	0	0	1	0	2
Lyme Disease (Borrelia burgdorferi)	0	1	2	3	4	0	1	2	5	2	4	0	24
Malaria	0	0	0	0	0	0	0	1	0	0	0	0	1
Meningitis, other bacterial	0	0	1	0	1	0	0	0	0	1	0	2	5
Rocky Mountain Spotted Fever (Rickettsia rickettsii) (RMSF)	0	1	2	1	1	3	2	0	7	3	5	3	28
Streptococcal Disease, Invasive, Group A (Streptococcus pyogenes)	1	1	2	4	1	3	3	0	0	0	1	0	16
Streptococcal pneumoniae, invasive, drug-resistant	2	2	1	2	1	0	1	0	0	0	1	1	11
Transmissable Spongioform Encephalitis (TSE./CJD	0	0	0	0	0	0	0	0	2	0	0	0	2
West Nile, non-neurological (includes WN Fever)	0	0	0	0	0	2	1	1	0	0	0	0	4
Haemophilus influenzae, invasive	0	0	0	0	1	2	0	0	1	1	0	0	5
Measles (Rubeola)	0	0	0	0	0	0	0	0	0	1	0	1	2
Mumps	0	0	0	0	0	0	1	0	0	2	0	2	5
Pertussis (Bordetella pertussis) (Whooping cough)	4	6	4	2	2	4	3	1	5	10	11	0	52
Varicella (Chickenpox)	24	57	38	25	26	3	7	14	23	13	12	19	261
Early Syphilis	0	1	4	2	3	1	0	3	2	1	0	0	17
Gonorrhea	N/A	28*	11	5	12	9	13	11	10	13	13	13	138
Chlamydia	N/A	182*	90	81	122	102	120	99	106	95	95	94	1186

*totals are for January and February

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.