Johnson County Health Department - EPI Update Newsletter

Johnson County has 11 confirmed cases of H1N1 influenza, four cases in adults and seven in children. The first county case was listed as probable on May 1, with others quickly following.

The Kansas Department of Health and Environment (KDHE) decided in mid-May that samples from Johnson and Wyandotte counties in Kansas would no longer be accepted in the state lab (with an exception for hospitalized cases) as it’s been verified that the disease is indeed present in our community. The state lab is shifting focus to verifying the disease in other areas of the state.

At this time, the Johnson County Health Department (JCHD) and KDHE are encouraging individuals use standard flu precautions of covering your cough, washing your hands, and staying home when you are sick. The travel advisory for Mexico has now been downgraded to a travel health precaution.

Symptoms
Symptoms of H1N1 are similar to seasonal influenza symptoms, and include fever greater than 100 degrees, cough, sore throat, body aches, and respiratory congestion. Some people have reported diarrhea and vomiting associated with this strain of influenza. Like seasonal flu often does, H1N1 can cause a worsening of underlying chronic medical conditions.

Treatment recommendations
The Centers for Disease Control and Prevention (CDC) recommend the use of oseltamivir (Tamiflu) or zanamivir for the treatment/of patients and contacts at higher risk for influenza-related complications.

Exclusions
Students, faculty or staff with influenza-like illness should stay home and not attend school or go into the community except to seek medical care for seven days after symptom onset or 24 hours after symptoms resolve, whichever is longer.

Students, faculty and staff who are still sick seven days after they become ill should continue to stay home from school until at least 24 hours after symptoms have resolved.

Those individuals who appear to have an influenza-like illness at arrival or become ill during the school day should be isolated promptly in a room separate from other students and sent home.
Likewise, adults with these symptoms should stay home from work if they are sick.

Safety Net Clinics

The safety net clinics in Johnson County are a way to reach the low-income, uninsured residents of the area. The target population for these clinics are those who do not qualify for Medicare or Medicaid, are not offered insurance through employment, are not offered dependent coverage or it is not affordable, and with incomes at or below 200% of the federal poverty level. Clinic staff can help determine if you qualify for services.

These clinics are available to see individuals for various types of care. With the recent cases of H1N1 influenza in our county, the medically uninsured are encouraged to seek out care at one of these sites if they have flu symptoms, including fever greater than 100 degrees, cough, sore throat, body aches, and headaches. Safety net clinics do have the ability to diagnose and treat influenza viruses. Please refer clients and others that you think might benefit from these services to the following clinics in our area:

Health Partnership Clinic of Johnson County - (913) 648-2266
Mercy and Truth Medical Missions – (913) 248-9965

Gardening, camping, hiking, or just playing outdoors…. these are all great spring and summertime activities, but remember the ticks that may be sharing the same environment. Fortunately, there are several tactics you can use to prevent tick bites and reduce your risk of tick-borne disease.

Ticks live in or near wooded or grassy areas. This is why it’s especially important to check children for ticks after playing outdoors, even in your own yard. Conduct a body check from potentially tick-infested areas by searching your entire body for ticks. Use a hand-held or full-length mirror to view all parts of your body and remove any tick you find. Check these parts of the body for ticks:

Under the arms
In and around the ears
Inside the belly button
Back of the knees
Under the arms
In and around the hair
Between the legs
Around the waist

Check your children for ticks, especially in the hair, when returning from potentially tick-infested areas. It is also a good idea to check your clothing and pets for ticks. Placing clothes into a dryer on high heat effectively kills ticks.

For information on tick removal, please visit the CDC website.

If your family is going to be spending a lot of time outdoors this summer, make sure to protect them from tick bites with the following steps:

Know where to expect ticks. Ticks live in or near wooded or grassy areas, or in leaf litter or on shrubs. Always walk in the center of trails to avoid ticks.
Use a repellent with DEET (on skin and clothing) or permethrin (on clothing) and wear long sleeves, long pants, and socks. Always follow the product instructions.
Wear light-colored clothing, which allows you to see ticks crawling on your clothing.
Tuck your pant legs into your socks so that ticks cannot crawl up the inside of your pant legs.

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Johnson County Disease Report

Disease Name	Jan 09	Feb 09	Mar 09	April 09	Total YTD
Calicivirus/Norwalk-like virus (norovirus)	0	0	0	0	0
Campylobacter Infection (Campylobacter spp.)	2	3	8	4	17
Cryptosporidiosis (Cryptosporidium parvum)	0	0	1	2	3
Dengue	0	0	0	0	0
Dengue Hemorrhagic Fever	0	0	0	0	0
Enterohemorrhagic Escherichia coli shiga toxin positive (not serogrouped)	0	1	1	0	2
Enterohemorrhagic Escherichia coli toxin positive (serogroup non-O157)	0	0	0	0	0
Enterohemorrhagic Escherichia coli 0157:H7	0	0	0	1	1
Giardiasis (Giardia lamblia)	1	3	2	2	8
Salmonellosis (Salmonella spp.)	2	2	3	2	9
Shigellosis (Shigella spp.)	1	2	1	1	5
Amebiasis (Entamoeba histolytica)	0	0	0	2	2
Brucellosis	0	0	1	0	1
Ehrlichiosis, Ehrlichia chaffeensis	0	1	1	0	2
Ehrlichiosis, ehrlichia ewingii	0	0	0	0	0
Ehrlichiosis, human other	0	0	0	0	0
Hepatitis A	1	4	3	1	9
Hepatitis B, acute	1	0	0	1	2
Hepatitis B, chronic	7	10	10	5	32
Hepatitis C virus infection (past or present)	21	14	12	18	65
Legionellosis	1	0	0	1	2
Listeriosis (Listeria monocytogenes)	0	0	0	0	0
Lyme Disease (Borrelia burgdorferi)	1	1	1	2	5
Malaria (Plasmodium spp.)	1	0	0	0	1
Meningitis, Niesseria meningitidis	0	0	1	0	1
Meningitis, other bacterial	0	0	0	1	1
Q Fever (Coxiella burnetii)	0	1	1	1	3
Rocky Mountain Spotted Fever (Rickettsia rickettsii) (RMSF)	3	2	1	3	9
Streptococcal Disease, Invasive, Group A (Streptococcus pyogenes)	0	5	1	3	9
Streptococcus pneumoniae, invasive, drug-resistant	2	2	2	2	8
Toxic Shock Syndrome, streptococcal and staphylococcal	0	1	1	0	2
Transmissable Spongioform Encephalitis (TSE./CJD	0	0	0	0	0
West Nile, non-neurological (includes WN Fever)	0	0	0	0	0
Haemophilus influenzae, invasive	0	0	1	1	2
Measles (Rubeola)	0	0	0	0	0
Mumps	1	0	2	2	5
Pertussis (Bordetella pertussis) (Whooping cough)	6	9	7	7	29
Varicella (Chickenpox)	13	23	22	27	85
Early Syphilis	2	4	1	1	8
Gonorrhea	5	25	18	9	57
Chlamydia	61	176	80	118	435
Latent Tuberculosis infection	20	29	34	23	106
Active Tuberculosis infection	2	5	7	0	14

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

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) 826-1222 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.