Johnson County Health Department - EPI Update Newsletter

Summer heat is especially dangerous for the elderly. People 65 years of age and older are more prone to heat stress than younger people for several reasons:

Elderly people do not adjust as well as young people to sudden changes in temperature.
They are more likely to have a chronic medical condition that upsets normal body responses to heat.
They are more likely to take prescription medicines that impair the body’s ability to regulate temperature or that inhibit perspiration.

There are two very dangerous types of heat illness – heat stroke and heat exhaustion. Heat stroke is the most serious heat-related illness, and occurs when the body becomes unable to control its temperature. The body’s temperature rises rapidly, and loses its ability to sweat. Warning signs of heat stroke include:

An extremely high body temperature (above 103 degrees)
Red, hot, and dry skin without sweating
Rapid, strong pulse
Throbbing headache
Dizziness
Nausea

Heat exhaustion is a milder form of heat illness. It can occur after multiple days of exposure to high temperatures without the correct level of replacement of fluids. Symptoms include:

Heavy sweating
Paleness
Muscle cramps
Tiredness
Weakness
Dizziness
Headache
Nausea or vomiting
Fainting
Cool and moist skin
Fast and weak pulse rate
Fast and shallow breathing

Protecting yourself from heat stroke is simple with a few easy steps.

Drink cool, nonalcoholic beverages
Rest
Take a cool shower, bath, or sponge bath
Seek and air-conditioned environment
Wear lightweight clothing
Remain indoors during the heat of the day
Do not engage in strenuous activities

During periods of extreme heat, it is important to check on elderly relatives and neighbors. Visit older adults at least twice a day and watch them for signs of heat exhaustion or heat stroke. Take them to air-conditioned locations if they have transportation problems, and make sure they have access to an electric fan whenever possible.
If you believe someone is experiencing symptoms of heat stress, call for medical assistance immediately. In the meantime, also take steps to begin cooling the person, including:

Get the person to a shady area
Cool the person rapidly. Some suggestions:

Immerse the person in a tub full of cool water;
Place the person in a cool shower;
Spray the person with cool water from a garden hose;
Sponge the person with cool water;
Or if humidity is low, wrap the person in a cool, wet sheet and fan him or her vigorously.

Monitor body temperature and continue cooling efforts until the body temperature drops to 101 to 102 degrees.
If emergency medical personnel are delayed, call the hospital emergency room for further instructions.
Do not give the person alcohol to drink.
Get medical assistance as soon as possible.

Source: http://emergency.cdc.gov/disasters/extremeheat/elderlyheat.asp

Going to the Olympics? Make Sure You Are Prepared

Are you or someone you know traveling to China this summer for the Olympic Games? Read below for health travel information.

Make an appointment with a clinic familiar with travel health at least four to six weeks before departing. Have an itinerary and your medical history ready to make sure you receive the correct vaccinations, medicines, and information on travel safety.
Get your travel shots. At least make sure you and your travel companions are up-to-date on routine vaccinations. The Centers for Disease Control and Prevention (CDC) also recommends Hepatitis A, Hepatitis B, Typhoid, pre-exposure rabies (for those travelers spending a lot of time outdoors in rural areas – currently in shortage – if available), and Japanese encephalitis (if visiting rural or farming areas.) Some areas of China also require taking anti-malarial drugs – speak with your physician to see if your travel plans warrant a prescription. See the CDC’s “Health Information for Travelers to China” page at http://wwwn.cdc.gov/travel/destinationChina.aspx
Tell others you are going. Register with the State Department’s travel registration Web site so the U.S. Embassy or Consulate in China can contact you in an emergency. Make extra copies of your passport and travel documents to leave with a family member or friend, as well as details of your travel plans and how to contact you while abroad. Also, make arrangements to check in with your employer, a trusted colleague, or family and friends at regular intervals.
Plan ahead for health and safety. Familiarize yourself with basic first aid so you can self-treat minor injuries. Have a listing of doctors and hospitals in advance, and check your health insurance plan to make sure you are covered in case you become sick or injured during your trip. Keep important medications at hand during your travels by preparing a travel health kit. Things to include:

Any medicines you take every day in their original containers. (Bring more than you think you will need)
Copies of your prescriptions
Malaria prevention medicine, if needed
Medicine for traveler’s diarrhea (check with your physician to see if a prescription is necessary)
Over-the-counter medicines like pain relievers and diarrhea medicine
Alcohol-based hand gel (60% alcohol)
Sunscreen (at least SPF 15)
Insect repellent containing DEET
Oral rehydration solution packets
First aid items, such as bandages, gauze, and antiseptic ointment
Thermometer
Battery-powered smoke alarm

Sources:
http://wwwn.cdc.gov/travel/destinationChina.aspx
http://cdc.gov/Features/OlympicTravel/
http://wwwn.cdc.gov/travel/contentOlympics2008.aspx
http://wwwn.cdc.gov/travel/contentOlympicsPreparingForTrip.aspx

Beginning the 2008-2009 school year, the State of Kansas will REQUIRE:

Kindergarten through 5th grade to have completed the Hepatitis B series

The recommended vaccine schedule for Hepatitis B is:
First dose—at birth
Second dose –1 to 2 months of age
Third dose—6 months of age

One dose of varicella (chickenpox) vaccine unless they have had the disease.

The recommended vaccination schedule for varicella is:
First dose –12 to 15 months of age
Second dose—4 to 6 years of age
Most individuals who get varicella vaccine will not get chickenpox. However, if someone who has been vaccinated does get chickenpox, the illness is usually very mild. The patient will typically have fewer blisters, is less likely to have a fever, and will recover faster.

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	Jan 2008	Feb 2008	March 2008	April 2008	May 2008	June 2008	Total YTD
Enteric	Calicivirus/Norwalk-like virus (norovirus)	3	1	14	1	1	0	20
	Campylobacter Infection (Campylobacter spp.)	8	1	5	10	0	9	33
	Cryptosporidiosis (Cryptosporidium parvum)	1	0	0	1	1	1	4
	Enterohemorrhagic Escherichia coli shiga toxin positive (not serogrouped)	0	1	0	1	1	2	5
	Enterohemorrhagic Escherichia coli toxin positive (serogroup non-O157)	2	0	0	0	0	0	2
	Giardiasis (Giardia lamblia)	9	2	4	4	3	2	24
	Salmonellosis (Salmonella spp.)	6	0	4	6	5	8	29
	Shigellosis (Shigella spp.)	1	0	0	0	1	0	2
General	Amebiasis (Entamoeba histolytica)	0	0	0	0	0	1	1
	Ehrlichiosis, human monocytic (HME)	0	0	3	1	2	2	8
	Ehrlichiosis, human monocytic (HGE)	0	0	0	0	1	1	2
	Hepatitis A	2	3	1	3	1	4	14
	Hepatitis B, acute	1	0	2	1	1	2	7
	Hepatitis B, chronic	16	16	19	10	10	6	77
	Hepatitis C virus infection (past or present)	14	20	51	26	17	12	140
	Legionellosis	0	1	2	0	0	1	4
	Listeriosis (Listeria monocytogenes)	0	0	0	0	0	1	1
	Lyme Disease (Borrelia burgdorferi)	0	1	2	3	4	0	10
	Rocky Mountain Spotted Fever (Rickettsia rickettsii) (RMSF)	0	1	2	1	1	3	8
	Streptococcal Disease, Invasive, Group A (Streptococcus pyogenes)	1	1	2	4	1	3	12
	Streptococcal pneumoniae, invasive, drug-resistant	2	2	1	2	1	0	8
	West Nile, non-neurological (includes WN Fever)	0	0	0	0	0	2	2
Vaccine-Preventable Diseases	Haemophilus influenzae, invasive	0	0	0	0	1	2	3
	Pertussis (Bordetella pertussis) (Whooping cough)	4	6	4	2	2	4	22
	Varicella (Chickenpox)	24	57	38	25	26	3	173
Sexually Transmitted Diseases	Early Syphilis	0	1	4	2	3	1	11
	Gonorrhea	N/A	28*	11	5	12	9	65
	Chlamydia	N/A	182*	90	81	122	102	577

*Totals are for January and February

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.