Johnson County Health Department - EPI Update Newsletter

CDC recommends a yearly flu vaccination as the first and most important step in protecting against this serious disease.

Influenza (the flu) is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness, and possibly death. Every year in the United States, an average of 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 individuals, such as older people, young children, and those with certain health conditions, are at high risk for serious flu complications. Symptoms of flu include:

fever (usually high)
headache
extreme tiredness
dry cough
sore throat
runny or stuffy nose
muscle aches
Stomach symptoms, such as nausea, vomiting, and diarrhea, also can occur but are more common in children than adults

Complications of flu can include bacterial pneumonia, ear infections, sinus infections, dehydration, and worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes.
Flu viruses are spread from person to person by coughing or sneezing. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose. Most healthy adults may be able to infect others beginning one day before symptoms develop and up to five days after becoming sick. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick.

Yearly flu vaccination should begin in September or as soon as vaccine is available and continue throughout the influenza season, into December, January, and beyond. This is because the timing and duration of influenza seasons vary. While influenza outbreaks can happen as early as October, most of the time influenza activity peaks in January or later. It usually takes two weeks after vaccination to develop antibodies for protection against influenza virus.

There are two types of vaccines:

The "flu shot" – an inactivated vaccine (containing killed virus) that is administered with a needle. The flu shot is approved for use in people six months of age and older, including healthy people and people with chronic medical conditions.

The nasal-spray flu vaccine – a vaccine made with live, weakened flu viruses that do not cause the flu (sometimes called LAIV for “Live Attenuated Influenza Vaccine”). LAIV is approved for use in healthy* people two to 49 years of age who are not pregnant and who live with or care for those in a high risk group.
In general, anyone who wants to reduce their chances of getting the flu can get vaccinated. However, certain people are at higher risk of having serious flu-related complications or because they live with or care for high risk persons. During flu seasons when vaccine supplies are limited or delayed, the Advisory Committee on Immunization Practices (ACIP) makes recommendations regarding priority groups for vaccination.

People at higher risk are:

Children aged six months up to their 19th birthday
Pregnant women
People 50 years of age and older
People of any age with certain chronic medical conditions
People who live in nursing homes and other long-term care facilities
People who live with or care for those at high risk for complications from flu, including:
a. Health care workers
b. Household contacts of persons at high risk for complications from the flu
c. Household contacts and out of home caregivers of children less than six months of age (these children are too young to be vaccinated)

People who should not get vaccinated without first consulting a physician are:

People who have a severe allergy to chicken eggs
People who have had a severe reaction to an influenza vaccination in the past
People who developed Guillain-Barre Syndrome (GBS) within six weeks of getting an influenza vaccine previously
Children less than six months of age (influenza vaccine is not approved for use in this age group)
People who have a moderate or severe illness with a fever should wait to get vaccinated until their symptoms lessen

If you have questions about whether you should get a flu vaccine, consult your healthcare provider.
http://www.cdc.gov
http://www.cdc.gov/flu/about/season/index.htm
http://www.cdc.gov/flu/weekly/fluactivity.htm
http://www.cdc.gov/flu/professionals/vaccination/index.htm

Influenza Season Surveillance Letter

Flu Surveillance Sheet

Get Your Chickenpox Vaccine Today!

Getting a chickenpox vaccination is the best way to protect from getting the disease. Being vaccinated not only protects yourself, but also those around you that cannot get the shot because of illness or other conditions. While no vaccine is totally effective, eight to nine of every 10 people who are receive it are completely protected against chickenpox. If a vaccinated person does get the disease, it is usually a very mild case lasting only a few days and will less skin lesions.
The State of Kansas requires students from Kindergarten through fifth grade to receive one dose of varicella vaccination unless they have had the disease. The recommended vaccination schedule for varicella is:

First dose – 12 to 15 months
Second dose – four to six years

All children and adults without evidence of immunity to varicella need the vaccine. Evidence of immunity includes any of the following:

Documentation of two doses of varicella vaccine
Blood tests to show you are immune to varicella or laboratory confirmation of prior disease
Born in the United States before 1980, excluding healthcare workers, pregnant women, and immunocompromised persons. These individuals need to meet one of the other criteria for evidence of immunity
Receipt from a healthcare provider of a) diagnosis of chickenpox or b) verification of a history of chickenpox
Receipt from a healthcare provider of a) diagnosis of herpes zoster (shingles), or b) verification of a history of herpes zoster (shingles).

Chickenpox, also known as varicella, is spread by coughing and sneezing, direct contact, and by aerosolization of virus from skin lesions. Symptoms include a skin rash of blister-like lesions, mostly concentrated on the face, scalp, and trunk. Most people will experience fever just before or when the rash appears. Chickenpox has been known for years as a common childhood disease; however, it can become dangerous and cause bacterial infection of the skin, swelling of the brain, and pneumonia. Adolescents and adults are at higher risk for severe cases of the disease.

http://www.cdc.gov/vaccines/vpd-vac/varicella/in-short-adult.htm

http://www.cdc.gov/vaccines/vpd-vac/varicella/default.htm#disease

Issues surrounding food safety have taken a front seat with the recent outbreak of E. coli 0111 in northeastern Oklahoma. The investigation into the outbreak centers on a restaurant, which has been closed while investigators continue to gather pertinent information. Currently, there are no other food service establishments being linked to the outbreak. The outbreak has revealed that at least 206 individuals have become sick, including 149 adults, 53 children, and four others whose age has not yet been confirmed. Those sickened range in age from two months old to 88 years old. Officials from the Oklahoma State Department of Health believe the number of persons hospitalized at the peak of the outbreak exceeded 50 persons. There has also been one death associated with the outbreak. At this time, officials are uncertain if or what food item or items made these people sick, as not everyone who ate at the restaurant became ill.
E. coli (Escherichia coli) are a large and diverse group of bacteria. Most strains are harmless, but some can make you sick with diarrhea (which is sometimes bloody), abdominal cramps, urinary tract infections, respiratory illnesses including pneumonia, and other illnesses. Five to 10 percent of those who are diagnosed with an E. coli infection develop hemolytic uremic syndrome (HUS), a potentially life-threatening complication. Someone with HUS will experience a decrease of urination, fatigue, and losing color in cheeks and inside the lower eyelids. Persons with HUS are usually hospitalized due to problems with their kidneys or other serious problems. Most patients with HUS recover within a few weeks, some will suffer permanent damage and some may even die
How can E. coli infections be prevented?

Wash your hands thoroughly after using the bathroom, changing diapers ,and before preparing or eating food.
Wash your hands after any contact with animals or their environments (farms, petting zoos, fairs, even your own home and backyard).
Cook meats thoroughly. Ground beef and meat that has been needle-tenderized should be cooked to a temperature of at least 160 degrees Fahrenheit.
Avoid raw milk and unpasteurized dairy products and juices (like fresh apple cider).
Avoid swallowing water when swimming or playing in lakes, ponds, streams, swimming pools, and backyard “kiddie” pools.
Prevent cross-contamination in food preparation areas by thoroughly washing hands, counters, cutting boards, and utensils after they touch raw meat.

Sources: http://www.ok.gov/health/Organization/Office_of_Communications/News_Releases/2008_News_Releases
/Northeastern_Oklahoma_GI_Outbreak_Updates.html
http://www.cdc.gov/nczved/dfbmd/disease_listing/stec_gi.html

Pasteurization is the only effective method for eliminating the harmful bacteria in raw milk, raw milk products, and fruit and vegetable juices.
Most of the milk and juices sold in the United States are pasteurized, but recently there has been a growing trend to consume more non-pasteurized foods because they are thought to be healthier. Unfortunately, this is not always the case. Every year many individuals become ill from drinking or eating foods made from raw milk and drinking fresh squeezed fruit or vegetable juices Many foodborne illnesses are actually caused by consuming non-pasteurized food items.
Raw milk and products made from raw milk may harbor a host of disease-causing organisms (pathogens), such as the bacteria Campylobacter, Escherichia coli, Listeria monocytogenes, Salmonella, Yersinia, and Brucella.
Some grocery stores, health food stores, cider mills, and farm markets sell freshly squeezed fruit and vegetable juices that are made on site and have not been pasteurized. Some of these products may also harbor many of the same harmful bacteria.
Common symptoms of foodborne illness from the types of bacteria mentioned include diarrhea, stomach cramps, fever, headache, vomiting, and exhaustion.
Most healthy people recover from foodborne illness within a short period of time, but others may have symptoms that are chronic, severe, or even life-threatening.
Individuals who should avoid unpasteurized foods include:

Pregnant women or women considering pregnancy
Children under five years of age
The elderly
Persons infected with HIV
Persons with cancer
Anyone who is immunocompromised (such as persons with organ transplants)

Some of the non-pasteurized food items by law have to have a warning label on them like the one below.

WARNING: This product has not been pasteurized and therefore may contain harmful bacteria that can cause serious illness in children, the elderly, and persons with weakened immune systems.

It can also prevent such contagious diseases as tuberculosis, diphtheria, polio, Q fever, strep throat, scarlet fever, and typhoid fever that can be spread by bacteria in milk.

Source: www.cdc.gov

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	Total YTD
Enteric	Calicivirus/Norwalk-like virus (norovirus)	3	1	14	1	1	0	0	0	20
	Campylobacter Infection (Campylobacter spp.)	8	1	5	10	0	9	25	20	78
	Cryptosporidiosis (Cryptosporidium parvum)	1	0	0	1	1	1	2	6	12
	Dengue	0	0	0	0	0	0	1	2	3
	Dengue Hemorrhagic Fever	0	0	0	0	0	0	1	0	1
	Enterohemorrhagic Escherichia coli shiga toxin positive (not serogrouped)	0	1	0	1	1	2	0	3	85
	Enterohemorrhagic Escherichia coli toxin positive (serogroup non-O157)	2	0	0	0	0	0	1	0	3
	Enterohemorrhagic Escherichia coli 0157:H7	0	0	0	0	0	0	1	0	1
	Giardiasis (Giardia lamblia)	9	2	4	4	3	2	6	11	41
	Salmonellosis (Salmonella spp.)	6	0	4	6	5	8	9	5	43
	Shigellosis (Shigella spp.)	1	0	0	0	1	0	3	1	6
General	Amebiasis (Entamoeba histolytica)	0	0	0	0	0	1	0	0	1
	Ehrlichiosis, human monocytic (HME)	0	0	3	1	2	2	2	1	11
	Ehrlichiosis, human monocytic (HGE)	0	0	0	0	1	1	2	0	4
	Hepatitis A	2	3	1	3	1	4	3	5	22
	Hepatitis B, acute	1	0	2	1	1	2	0	2	9
	Hepatitis B, chronic	16	16	19	10	10	6	8	2	87
	Hepatitis C virus infection (past or present)	14	20	51	26	17	12	4	9	153
	Legionellosis	0	1	2	0	0	1	0	0	4
	Listeriosis (Listeria monocytogenes)	0	0	0	0	0	1	0	0	1
	Lyme Disease (Borrelia burgdorferi)	0	1	2	3	4	0	1	2	13
	Malaria	0	0	0	0	0	0	0	1	1
	Meningitis, other bacterial	0	0	1	0	1	0	0	0	2
	Rocky Mountain Spotted Fever (Rickettsia rickettsii) (RMSF)	0	1	2	1	1	3	2	0	10
	Streptococcal Disease, Invasive, Group A (Streptococcus pyogenes)	1	1	2	4	1	3	3	0	15
	Streptococcal pneumoniae, invasive, drug-resistant	2	2	1	2	1	0	1	0	9
	West Nile, non-neurological (includes WN Fever)	0	0	0	0	0	2	1	1	4
Vaccine-Preventable Diseases	Haemophilus influenzae, invasive	0	0	0	0	1	2	0	0	3
	Pertussis (Bordetella pertussis) (Whooping cough)	4	6	4	2	2	4	3	1	26
	Mumps	0	0	0	0	0	0	1	0	1
	Pertussis (Bordetella pertussis) (Whooping cough)	4	6	4	2	2	4	3	1	26
	Varicella (Chickenpox)	24	57	38	25	26	3	7	14	194
Sexually Transmitted Diseases	Early Syphilis	0	1	4	2	3	1	0		11
	Gonorrhea	N/A	28*	11	5	12	9	13	11	89
	Chlamydia	N/A	182*	90	81	122	102	120	99	796

*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.