Johnson County Health Department - EPI Update Newsletter

The Centers for Disease Control and Prevention (CDC) announced on March 31, 2005 that during the 2004-05 flu season, the majority of the nation’s influenza vaccine went to the people at greatest risk for serious complications from flu, including 6 to 23 months old children, people 65 years of age and older, and people with chronic health conditions. Importantly, despite an unexpected and substantial vaccine shortfall, influenza vaccination coverage levels among adults in priority groups through January nearly reached levels similar to previous years, while coverage levels among adults not in priority groups were approximately half of historic levels.

“We know this was a challenging year for many patients and clinicians who patiently waited for influenza vaccine,” said Dr. Julie Gerberding, CDC director, “but overall our extensive efforts paid off. Thanks to outstanding cooperation between the manufacturers, federal, state and local health departments and round the clock engagement of the CDC teams, we had influenza coverage rates for priority groups similar to previous years, and we did with much less vaccine than last year.”

To see the full text of this article, please click here.

The Centers for Disease Control and Prevention (CDC) has learned of additional cases of Serratia marcescens bloodstream infection (BSI) following infusion of intravenous (IV) magnesium sulfate that was not manufactured or compounded by Pharmedium. This may be related to pharmaceutical components common to various products. CDC would like to request that hospital infection control personnel (ICP) review their microbiology records from January 2004 to the present to look for clusters or unusual numbers of S. marcescens BSI. If S. marcescens clusters are identified, the ICP should contact their local or state health department. CDC is interested in cases of S. marcescens BSI occurring within approximately 72 hours of an IV infusion of magnesium sulfate, regardless of the manufacturer. Additionally, any available S. marcescens isolates from suspected cases should be saved for molecular typing to determine relatedness.

For more information, go to www.phppo.cdc.gov/HAN/ArchiveSys/ViewMsgV.asp?AlertNum=00224.

On March 23, 2005, the World Health Organization (WHO) confirmed Marburg virus (family Filoviridae, which includes Ebola virus) as the causative agent of an outbreak of viral hemorrhagic fever (VHF) in Uige Province in northern Angola. Testing conducted by CDC's Special Pathogens Branch detected the presence of virus in nine of 12 clinical specimens from patients who died during the outbreak.

During October 1, 2004-March 29, 2005, a total of 124 cases were identified; of these, 117 were fatal. Approximately 75% of the reported cases occurred in children aged <5 years; cases also have occurred in adults, including health-care workers. Predominant symptoms have included fever, hemorrhage, vomiting, cough, diarrhea, and jaundice.

WHO and international partners in the Global Outbreak Alert and Response Network (GOARN) are working with the Ministry of Health in Angola in conducting an investigation and public health response to the outbreak. Outbreak-control efforts are directed at providing technical support for case management, strengthening infection control in hospitals, improving surveillance and contact tracing, and educating local residents about the disease and its modes of transmission.

Source: CDC.
To see the full text of this report, please go to: www.cdc.gov/mmwr/preview/mmwrhtml/mm54d330a1.htm.
For more information about Marburg Hemorrhagic Fever, go to www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/marburg.htm.

Multiple venues encourage or permit the public to come in contact with animals, resulting in millions of human-animal contacts each year. These settings include county or state fairs, petting zoos, animal swap meets, pet stores, zoologic institutions, circuses, carnivals, farm tours, livestock-birthing exhibits, educational exhibits at schools, and wildlife photo opportunities. Although multiple benefits of human-animal contact exist, infectious diseases, rabies exposures, injuries, and other human health problems associated with these settings are of concern. Rabid or potentially rabid animals in public settings can result in extensive public health investigation and action. Infectious disease outbreaks reported during the previous decade have been attributed to multiple organisms, including Escherichia coli O157:H7, Salmonella, Coxiella burnetti, Mycobacterium tuberculosis, and ringworm. Such incidents have substantial medical, public health, legal, and economic effects.

The Compendium of Measures to Prevent Disease Associated with Animals in Public Settings, 2005 provides standardized recommendations for public health officials, veterinarians, animal venue operators, animal exhibitors, visitors to animal venues and exhibits, and others concerned with disease-control and with minimizing risks associated with animals in public settings. The recommendation to wash hands is the single most important prevention step for reducing the risk for disease transmission. Other critical recommendations are that venues include transition areas between animal areas and nonanimal areas (where food is sold) and that animals are properly cared for and managed in public settings. In addition, the compendium recommends educating venue operators, staff, exhibitors, and visitors regarding the risk for disease transmission where animal contact is possible.

To read the Compendium of Measures to Prevent Disease Associated with Animals in Public Settings, 2005, please click here.

Source: CDC.

Aventis Pasteur has alerted the Johnson County Health Department that our regular order for the Typhoid Vaccine is being reduced. This is because all available doses are being sent for tsunami victims. Until these restrictions are lifted, we are operating under a shortage of Typhoid Vaccine. Typhoid Live Oral (Vivotif Berna) may be taken by mouth but does not provide 100% protection. Four doses of the oral must be completed at least one week before travel to areas of exposure. The decision to take the oral Typhoid should be made in conjunction with a medical doctor.

To see more information about typhoid fever and the vaccine, please visit www.cdc.gov/ncidod/diseases/submenus/sub_typhoid.htm.

To see upcoming workshops, satellite broadcasts, and more at the Johnson County Health Department, check out the What’s New? page of our website to see our calendar of events.

March Communicable Disease Report:

Disease Category	Mar 2005	Mar 5yr Avg	YTD 2005	2004 Total	2003 Total	2002 Total
Enteric Diseases:
Salmonella	6	2.4	13	85	50	38
Central Nervous System:
Meningitis, Aseptic (including viral and fungal meningitis)	0	0.2	1	29	14	26
West Nile Encephalitis/Meningitis	0	0	0	2+	5	2
West Nile Fever	0	0	0	1+	0	0
Sexually Transmitted Infections:
Infection Numbers (excluding HIV/AIDS - see below)	72	59.4	218	981	849	876
Vaccine Preventable Diseases:
Influenza, A&B	0	0.4	4	1	7	1
Measles	0	0	0	0	0	0
Pertussis	0	0	1	19	5	4
Varicella	7*+	*	68*+	51*+	*	*
M. tuberculosis:
Confirmed Cases	2!	0.4	6	7	14	12
Rare Diseases (other than listed):
Brucellosis	0	0	0	2	0	0
HIV and AIDS	Jan - Mar 2005	Jan - Mar 5yr avg	YTD 2005	2004 Total	2003 Total	2002 Total
HIV	4	3.8	4	18	16	18
AIDS	4	3.6	4	23	19	8

* Became reportable in June 2004
+ Includes probable as well as confirmed cases
! 14 cases under investigation

Disease Reporting Notes:

The new meningitis vaccine, Menactra (conjugated meningococcal vaccine) for people ages 11-55 is now available at the JCHD. Meningitis vaccination is recommended for children aged 11-12, students entering high school or college freshmen living in dormitories.

New vaccination requirements: Hepatitis B and varicella vaccines are now required for students entering Kindergarten and First Grade for the 2005-2006 school year.

National Infant Immunization Week is April 24th - 30th. This is an annual observance to promote the benefits of immunizations and to focus on the importance of immunizing infants against 12 vaccine-preventable diseases by age two. For materials, contact the CDC's Community Outreach and Planning Branch, or go to www.cdc.gov/nip/events/niiw/

The Immunization Program from the JCHD is sponsoring a Kids Stay Healthy and Safe Fair to increase community awareness and to educate on immunizations and health and safety issues related to children. The fair will be held at the Price Chopper at Santa Fe and Murlen in Olathe on April 30th from 12 - 3 PM. Look for more information to follow.

If you have any questions about the monthly communicable disease report, 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 us a call if you have any questions or concerns (913-826-1303). On behalf of the Disease Containment Staff, 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.