Johnson County Health Department - EPI Update Newsletter

E coli O157:H7 has been reported in Johnson County. Though most strains are harmless, this strain can cause severe illness, including severe bloody diarrhea and abdominal cramps. In some persons, particularly the elderly and children less than five years of age, the infection can cause hemolytic uremic syndrome (HUS), where the red blood cells are destroyed, causing the kidneys to fail.
E.coli can be found on most cattle farms, and is commonly found in petting zoos. It can also be found live in the intestines of healthy cattle, deer, goats, and sheep. During slaughter of these animals, the meat can become contaminated, and organisms can be mixed into the meat when it is ground. Bacteria from a cow’s udder can also get into raw milk. E.coli has been known to contaminate the ground, railings, feed bins and fur of animals.
The bacteria can also be transmitted through poor hygiene and hand washing practices. Children who are not yet toilet trained are at a higher risk of contracting E. coli.
Infection with E. coli O157:H7 is diagnosed by detecting the bacterium in the stool. One-third of laboratories that culture stool routinely do not test for E. coli O157:H7, so it needs to be specifically requested that the stool specimen be tested on sorbitol-MacConkey (SMAC) agar for this organism. All persons with sudden onset of bloody diarrhea should get their stool tested for E. coli O157:H7.

What can you do to prevent E. coli O157:H7?
• Cook all ground beef and hamburger thoroughly. Use a digital meat thermometer to make sure it is at least 160 degrees.
• If your burger is not fully cooked, be sure to send it back for further cooking.
• Avoid spreading harmful bacteria in your kitchen. Keep meats separate from ready-to-eat foods. Wash hands, counters, and utensils.
• Drink only pasteurized milk, juice, or cider.
• Wash fruits and vegetables under running water, especially that will not be cooked.
• Drink municipal water that has been treated with chlorine or another effective disinfectant.
• Make sure persons with diarrhea wash their hands carefully with soap and water after using the bathroom.
• Wash hands after playing with all pets and animals.

There are new regulations regarding the use of isolation and quarantine procedures regarding varicella.
The regulations, updated in July 2007, state that each susceptible contact of a varicella case in a school, child care facility, or family day care home be vaccinated within 24 hours of notification to KDHE or be excluded from the school, the child care facility or the family day care home until 21 days after the onset of the last reported illness in such settings.
This regulation applies ONLY to children in grades Kindergarten through third grade, who should be covered by the vaccination requirement that was put in place a few years ago. That requirement is the same: students entering Kindergarten or first grade in a Kansas school need proof of varicella vaccination.

To see the statute in its entirety, go to http://www.kdheks.gov/epi/download/28_1_6.pdf

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Pertussis (whooping cough) is a bacterial respiratory illness that can last for several weeks or months. It is spread from person-to-person through close contact with respiratory droplets released when an infected person coughs or sneezes.
Infants under the age of 12 months run the risk of developing more serious illness from pertussis and are more likely to have complications and be hospitalized. The best way to protect infants from pertussis is to give DTaP (diphtheria, tetanus and pertussis) vaccine at two, four, six and 12 months of age. These are needed to have the maximum benefit from the vaccination. A booster will be needed at four to six years.
Over the past years, there has been an increase in cases in the adolescent and adult populations. There are vaccines available for those 10 to 64 years of age.

Consider the diagnosis of pertussis if:
• Cough last two weeks or the suspect case reports close contact with a case of pertussis, or
• Symptoms first appear as a cold with a runny nose, sneezing, cough and low-grade fever. This is the most contagious stage.
• Cough becomes more severe with repeated attacks of violent coughing with no inhalation between coughs.
• Vomiting occurs after coughing.
• Crowing or an inhalation whoop follows a series of cough.

Five days of antibiotics must be completed for suspect clinical cases and symptomatic contacts before returning to day care, school, work, etc. This also includes having company in the home.
A person is contagious from seven days following exposure to three weeks after the onset of coughing episodes. Treatment of cases or contacts for five days with certain antibiotics, such as Erythromycin, Zithromax (Z-pack), Bactrim/Septra or Biaxin, can shorten the contagious period. Five days of treatment must be completed by the suspect clinical cases and symptomatic contacts before returning to day care, school, work, etc.

Pertussis is a reportable disease in the state of Kansas. To report suspect, clinical, or confirmed cases of pertussis, call (913) 826-1201.

Source: http://www.cdc.gov/vaccines/vpd-vac/pertussis/in-short-both.htm

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.