Johnson County Health Department - EPI Update Newsletter

What is the difference between a cold and the flu?
The flu and the common cold are both respiratory illnesses but they are caused by different viruses. Because these two types of illnesses have similar flu-like symptoms, it can be difficult to tell the difference between them based on symptoms alone. In general, the flu is worse than the common cold, and symptoms such as fever, body aches, extreme tiredness, and dry cough are more common and intense. Colds are usually milder than the flu. People with colds are more likely to have a runny or stuffy nose. Colds generally do not result in serious health problems, such as pneumonia, bacterial infections, or hospitalizations.

How can you tell the difference between a cold and the flu?
Because colds and flu share many symptoms, it can be difficult (or even impossible) to tell the difference between them based on symptoms alone. Special tests that usually must be done within the first few days of illness can be carried out, when needed to tell if a person has the flu.

What are the symptoms of the flu versus the symptoms of a cold?
In general, the flu is worse than the common cold, and symptoms such as fever, body aches, extreme tiredness, and dry cough are more common and intense. Colds are usually milder than the flu. People with colds are more likely to have a runny or stuffy nose. Colds generally do not result in serious health problems, such as pneumonia, bacterial infections, or hospitalizations.

Source: www.cdc.gov

Updated Mumps Recommendations

In 2006, during a mumps resurgence in the United States, the latest national recommendations from CDC and the American Academy of Pediatrics (AAP) stipulated that persons with mumps be maintained in isolation with standard and droplet precautions for 9 days after onset of parotitis. However, the existence of conflicting guidance (i.e., that the infectious period of mumps extended through the fourth day after parotitis onset†) led to confusion regarding the appropriate length of isolation. In addition, during the 2006 resurgence, compliance with recommendations for isolation in university settings was substantially lower for 9 days (65%) compared with 4--5 days (86%) . In 2007, after a review of the evidence supporting the 9-day isolation guidance by AAP and CDC, AAP changed its isolation guidance for health-care workers in ambulatory settings from 9 days to 5 days. In February 2008, after review of data on mumps in health-care settings, mumps viral load, and mumps virus isolation, the Healthcare Infection Control Practices Advisory Committee (HICPAC) approved changes in its recommendations related to mumps in in-patient settings. As a result, CDC, AAP, and HICPAC all now recommend a 5-day period after onset of parotitis, both for isolation of persons with mumps in either community or health-care settings and for use of standard precautions and droplet precautions. This report summarizes the scientific basis for these changes in mumps isolation guidance.

Based on this review, CDC, AAP, and HICPAC now recommend a 5-day period after onset of parotitis for 1) isolation of persons with mumps in either community or health-care settings and 2) use of standard and droplet precautions. Post-exposure recommendations remain unchanged. HCP with no evidence of mumps immunity who are exposed to patients with mumps should be excluded from duty from the 12th day after first exposure through the 26th day after last exposure.

Mumps, a vaccine-preventable illness transmitted by respiratory droplets and saliva, has an incubation period most commonly of 16 to 18 days. The classic clinical presentation of mumps is parotitis (inflammation of the salivary gland), which can be preceded by several days of nonspecific early symptoms; however, mumps also can be asymptomatic, especially in young children. Mumps transmission can occur from persons with subclinical or clinical infections and during the prodromal or symptomatic phases of illness.

The best strategy for preventing mumps in the community and among HCP is promoting high levels of immunity by vaccination. A 2-dose regimen is currently recommended for all children, with the first MMR vaccine dose administered at 12--15 months and the second at 4--6 years. Unless they have other evidence of mumps immunity,§ all school-aged children, students in post high school institutions (e.g., colleges), international travelers, and HCP also should receive 2 doses of MMR vaccine. Other adults should receive at least 1 dose of MMR vaccine. Other methods for decreasing transmission in the community and health-care settings include 1) isolation of cases, 2) postexposure exclusion from duty of HCP without evidence of immunity, and 3) use of standard precautions (including respiratory hygiene and cough etiquette) and transmission-based droplet precautions while caring for patients with mumps.

Source: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5740a3.htm

On October 8, Johnson County Government exercised its emergency response plans in its largest exercise to-date. The Johnson County Emergency Operations Center, Johnson County Health Department Departmental Operations Center, the Med-Act Departmental Operations Center as well as city Emergency Operations centers were activated. The exercise simulated an anthrax attack with a large number of the population of Johnson County being affected and needing medication to prevent illness.

All staff members from the Health Department were on hand to work the medication dispensing site located at Blue Valley West High School and the separate volunteer center. Members from Olathe’s CERT team, the Medical Reserve Corps of Kansas City, and other organizations were on hand to assist wherever necessary, including staffing the dispensing sites as registration clerks, foot traffic control workers, and assisting individuals in filling out health history forms. In addition, the Health Department exercised the use of radio and internet communications between sites, as well as WebEOC, a virtual emergency operations center that spans several separate locations. Students from physical education classes at the high school were sent through the site as individuals needing medication. Time studies were conducted to see how quickly the students moved through the site and how the Health Department can increase flow through the sites in the future. That will help the Health Department give medication to everyone necessary within 48 hours after an event occurs.

“This was a great example of how advances in technology can help us respond better in an emergency situation,” Liz Ticer, Johnson County Health Department Emergency Preparedness Coordinator, said. “It was also a great exercise in collaboration with other county partners – on a scale which we’ve never done before. It was a great learning experience for everyone.”

List of participating agencies:

Johnson County Health Department
Johnson County ITS Department
Johnson County Emergency Management
Johnson County Sheriff’s Office
Johnson County Mental Health
Johnson County Facilities
Johnson County Transit
Johnson County Wastewater
Johnson County Emergency Communications
Johnson County Med-Act
Johnson County Human Resources
Johnson County Manager’s Office
Olathe Police Department
Olathe Emergency Management
Olathe CERT
Overland Park Police Department
Blue Valley School District
Mid-America Medical Reserve Corps
Overland Park Regional Medical Center
St. Luke’s South Hospital
Wyandotte County Health Department
Clay County Health Department
Kansas City Missouri Health Department
Leavenworth County Health Department
Franklin County Health Department
Lawrence-Douglas County Health Department
Linn County Health Department
Miami County Health Department

The Johnson County Health Department held a free walk-in flu clinic Thursday, October 23 at the Old Shawnee Town Hall in Shawnee, Kansas. More than 525 people were vaccinated in the clinic that was held from 9:00 a.m. – 1:00 p.m. The Johnson County clinic was just one of many held throughout the region on October 23rd to test the response capabilities and collaboration of all major metropolitan health departments.

Influenza is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness, and at times can lead to death. The best way to prevent the flu is by getting a flu vaccination each year. Every year, five to 20 percent of the population gets the flu more than 200,000 people are hospitalized from flu complications, and about 36,000 people die from flu. Some people, such as the elderly, young children, and people with certain health conditions are at high risk for serious flu complications.
Common flu symptoms include fever, headache, fatigue, cough, sore throat, runny or stuffy nose, body aches, and diarrhea and vomiting. Having these symptoms does not always mean you have the flu – many different illnesses, including the common cold, can have similar symptoms.

If you do get sick, it’s important to remember to stay at home and get lots of rest, drink plenty of liquids, and avoid using alcohol and tobacco. There are some over-the-counter medications that can help relieve some symptoms of the flu (be sure to never give aspirin to children or teenagers who have flu-like symptoms, particularly fever.) Also, be sure to consult your doctor early on for the best treatment.

Source: www.cdc.gov/flu

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	July 2008	Aug 2008	Sept 08	Total YTD
Enteric	Calicivirus/Norwalk-like virus (norovirus)	3	1	14	1	1	0	0	0	0	20
	Campylobacter Infection (Campylobacter spp.)	8	1	5	10	0	9	25	20	4	82
	Cryptosporidiosis (Cryptosporidium parvum)	1	0	0	1	1	1	2	6	0	12
	Dengue	0	0	0	0	0	0	1	2	0	3
	Dengue Hemorrhagic Fever	0	0	0	0	0	0	1	0	0	1
	Enterohemorrhagic Escherichia coli shiga toxin positive (not serogrouped)	0	1	0	1	1	2	0	3	0	8
	Enterohemorrhagic Escherichia coli toxin positive (serogroup non-O157)	2	0	0	0	0	0	1	0	1	4
	Enterohemorrhagic Escherichia coli 0157:H7	0	0	0	0	0	0	1	0	0	1
	Giardiasis (Giardia lamblia)	9	2	4	4	3	2	6	11	3	44
	Salmonellosis (Salmonella spp.)	6	0	4	6	5	8	9	5	10	53
	Shigellosis (Shigella spp.)	1	0	0	0	1	0	3	1	1	7
General	Amebiasis (Entamoeba histolytica)	0	0	0	0	0	1	0	0	0	1
	Ehrlichiosis, human monocytic (HME)	0	0	3	1	2	2	2	1	0	11
	Ehrlichiosis, human monocytic (HGE)	0	0	0	0	1	1	2	0	1	5
	Hepatitis A	2	3	1	3	1	4	3	5	0	22
	Hepatitis B, acute	1	0	2	1	1	2	0	2	1	10
	Hepatitis B, chronic	16	16	19	10	10	6	8	2	6	93
	Hepatitis C virus infection (past or present)	14	20	51	26	17	12	4	9	11	164
	Legionellosis	0	1	2	0	0	1	0	0	1	5
	Listeriosis (Listeria monocytogenes)	0	0	0	0	0	1	0	0	0	1
	Lyme Disease (Borrelia burgdorferi)	0	1	2	3	4	0	1	2	5	18
	Malaria	0	0	0	0	0	0	0	1	0	1
	Meningitis, other bacterial	0	0	1	0	1	0	0	0	0	2
	Rocky Mountain Spotted Fever (Rickettsia rickettsii) (RMSF)	0	1	2	1	1	3	2	0	7	17
	Streptococcal Disease, Invasive, Group A (Streptococcus pyogenes)	1	1	2	4	1	3	3	0	0	15
	Streptococcal pneumoniae, invasive, drug-resistant	2	2	1	2	1	0	1	0	0	9
	Transmissable Spongioform Encephalitis (TSE./CJD	0	0	0	0	0	0	0	0	2	2
	West Nile, non-neurological (includes WN Fever)	0	0	0	0	0	2	1	1	0	4
Vaccine-Preventable Diseases	Haemophilus influenzae, invasive	0	0	0	0	1	2	0	0	1	4
	Mumps	0	0	0	0	0	0	1	0	0	1
	Pertussis (Bordetella pertussis) (Whooping cough)	4	6	4	2	2	4	3	1	5	31
	Varicella (Chickenpox)	24	57	38	25	26	3	7	14	23	217
Sexually Transmitted Diseases	Early Syphilis	0	1	4	2	3	1	0	3	2	16
	Gonorrhea	N/A	28*	11	5	12	9	13	11	10	99
	Chlamydia	N/A	182*	90	81	122	102	120	99	106	902

*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.