epinotes florida department of health - hillsborough
TRANSCRIPT
November 2019 Florida Department of Health - Hillsborough County
Disease Surveillance Newsletter
1
EpiNotes
Ron DeSantis
Governor Mission: To protect, promote & improve the health of all
people in Florida through integrated state & community
efforts.
Vision: To be the Healthiest State in the Nation
Director
Douglas Holt, MD
813.307.8008
Medical Director (HIV/STD/EPI)
Charurut Somboonwit, MD
813.307.8008
Medical Director (TB/Refugee)
Beata Casanas, MD
813.307.8008
Medical Director (Vaccine Outreach)
Jamie P. Morano, MD, MPH
813.307.8008
Community Health Director
Leslene Gordon, PhD, RD, LD/N
813.307.8015 x7107
Disease Control Director
Carlos Mercado, MBA
813.307.8015 x6321
Environmental Administrator
Brian Miller, RS
813.307.8015 x5901
Epidemiology
Michael Wiese, MPH, CPH
813.307.8010 Fax 813.276.2981
TO REPORT A DISEASE:
Epidemiology
813.307.8010
After Hours Emergency
813.307.8000
HIV/AIDS Surveillance
Erica Botting
813.307.8011
Lead Poisoning
Cynthia O. Keeton
813.307.8015 x7108 Fax 813.272.6915
Sexually Transmitted Disease
Sophia Romeus
813.307.8045 Fax 813.307.8027
Tuberculosis
Irma B. Polster
813.307.8015 x4758 Fax 813.975.2014
Articles and Attachments Included This Month
Health Advisories and Alerts 1
October 2019 Reportable Disease Summary 2
Florida Food Recalls 5
Thanksgiving Food Safety 5
County Influenza Report 6
Reportable Diseases/Conditions in Florida, Practitioner List 15
FDOH, Practitioner Disease Report Form 16
• CDC Health Advisory #422: Hot Tub Displays and Legionella Risk—Guidance for Environmental and Public Health Practitioners
• Update: Interim Guidance for Health Care Providers for Managing Patients with Suspected E-cigarette, or Vaping, Product Use–Associated Lung Injury — United States, November 2019
• CDC, public health and regulatory officials in several states, and the US Food and Drug Administration (FDA) are investigating a multistate outbreak of E. coli O157:H7 infections. The investigation is ongoing to determine the source of the outbreak.
• Outbreak of Salmonella Infections Linked to Ground Beef
• CDC Travel Notices:
• Polio in the Philippines
• Dengue in Asia and the Pacific Islands
• Ebola in Democratic Republic of the Congo (Updated)
Health Advisories, News, and Alerts
2 November 2019
2.3
50.7
45.0
1.7 5.7 1.3
20.3
6
5559
2 8 0
18
Mumps Pertussis Varicella Listeriosis Meningitis (Bacterial,Cryptococcal,
Mycotic)
MeningococcalDisease
Legionellosis
January-October Reportable Disease Summary - Other Common Reportable Infections
October YTD 2016-2018 Average
October YTD 2019
252.3
53.324.0
66.7
254.0
76.3
13.3
293
5747
67
251
31 13
Campylobacteriosis Cryptosporidiosis Escherichia coli,Shiga toxin-producing
(STEC)
Giardiasis Salmonellosis Shigellosis Vibriosis
January-October Reportable Disease Summary - Enteric Infections
October YTD 2016-2018 Average
October YTD 2019
These vaccine reportable diseases are summarized monthly in the state Vaccine
Preventable Disease Report, which is available online at:
http://www.floridahealth.gov/diseases-and-conditions/vaccine-preventable-
disease/vaccine-preventable-disease-report-archive.html
Beginning in 2018, the CDC and USDA
investigated a multistate outbreak of drug resistant
Salmonella related to raw turkey products. CDC is
continuing to monitor for reports of ill people
because this Salmonella strain is present in the
turkey industry. See page 5 for Thanksgiving
food safety tips, or read about the outbreak here:
https://www.cdc.gov/salmonella/reading-07-
18/index.html
3 November 2019
13.3
40.324.0
282.0
1,266.7
153
4868
288
1069
Hepatitis A Hepatitis B (Acute) Hepatitis C (Acute) Hepatitis B (Chronic) Hepatitis C (Chronic)
January-October Reportable Disease Summary - Viral Hepatitis
October YTD 2016-2018 Average
October YTD 2019
53%33%
14%
Cases who Report Drug Use as a Risk Factor
Yes No Unknown
January 2018 to October 2019 Case Summary
Total Number of cases 236
Number of cases acquired in Florida or Unknown 233
Age
Mean 39.1
Median 38
Min-max 7-71
Cases by Age Category Number (%)
0-18 3 (1)
19-29 44 (19)
30-39 84 (36)
40-49 63 (27)
50-59 29 (12)
60+ 10 (4)
Gender Number (%)
Female 72 (31)
Male 161 (69)
Race Number (%)
White 188 (81)
Black 15 (6)
Other 25 (11)
Asian 3 (1)
Unknown race 2 (1)
Ethnicity Number (%)
Non-Hispanic 195 (84)
Hispanic 35 (15)
Unknown ethnicity 3 (1)
Hillsborough County is currently
experiencing a large increase in
infections of hepatitis A, which is
a viral infection transmitted
through the fecal-oral route.
There is a vaccine available to
prevent hepatitis A.
4 November 2019
January-October Reportable Disease Summary – Arboviral Infections
Cases of any infection are reported based on the county where the person’s home
address is. Hillsborough County has reported infections of imported mosquito-borne
diseases every year, which means the individual was infected while traveling outside
of the county. Hillsborough County has not had any infections of chikungunya,
dengue, zika, or malaria acquired through mosquitos in our county in 2018 or 2019.
The Florida Department of Health releases a weekly arboviral surveillance report that
is available here: http://www.floridahealth.gov/%5C/diseases-and-
conditions/mosquito-borne-diseases/surveillance.html
The data in these charts represent the most common reportable diseases investigated by
the Epidemiology Program. All of the state’s reportable disease data is available for the
public to search on FL CHARTS here:
http://www.flhealthcharts.com/charts/CommunicableDiseases/default.aspx To build your
own search, click on the link for “Reportable Diseases Frequency Report”.
The case numbers for 2018 and 2019 are provisional and subject to change until the
yearly database is closed, usually around April of the following year. Once the numbers
are finalized, the state puts together a comprehensive Florida Annual Morbidity Statistics
Report that details case trends and notable outbreak investigations. The report for 2017
and previous years are available at: http://www.floridahealth.gov/diseases-and-
conditions/disease-reporting-and-management/disease-reporting-and-surveillance/data-
and-publications/fl-amsr1.html
0.7 1.3
6.74.7
17.3
0
22
54 3
Chikungunya Dengue Lyme Disease Malaria Zika Fever
October YTD 2016-2019 Average
October YTD 2019
5 November 2019
Thanksgiving Food Safety
Thanksgiving is a holiday when many people get together to eat with friends and family. It is also a day where there
is the potential for food safety issues which could lead to transmission of foodborne illnesses. When preparing and
serving food for your family and friends, it is important to remember to practice proper food safety. Here are some
quick facts to help keep you and your dinner guests healthy:
• Thaw turkeys safely in the refrigerator. Don’t thaw your turkey in the sink, outside, or on the counter. Juices
from the meat may carry common bacteria such as campylobacter, which can contaminate kitchen surfaces
if a turkey is left out. Bacteria can also grow more easily at room temperature than they can in the
refrigerator, which raises the risk for causing foodborne illness.
• Keep hot food hot, and cold food cold! This will help keep bacteria that can make you sick from growing. If
you must leave food out, be sure to do so for less than two hours indoors, and 1 hour outdoors if it’s hot
outside. Quickly cool leftovers to prevent bacterial growth.
• Leftovers are great but be sure to finish all your leftovers within 3-4 days following the holiday. Leftovers
can grow bacteria, even in the refrigerator. Also be sure to store any leftovers in containers that aren’t too
deep or big, as this can cause them to take too long to cool down and encourage bacterial growth.
• Don’t use a cutting board or knife that you’ve used on raw meat for dishes that are not cooked before they
are served, such as salads. Cross-contamination can make people sick from bacteria from raw meat.
• Wash your hands frequently when cooking, especially after handling raw meat or eggs before preparing
other dishes. This also helps prevent cross-contamination with harmful bacteria.
Please see the following link from the CDC if you’re interested in learning more:
https://www.cdc.gov/foodsafety/communication/rules-of-game.html
Florida Food Recalls (October 15, 2019 – November 20, 2019)
Brand Name Food Date of Recall Health Risk
Mill Stream Corp. Cold Smoked Salmon 11/6/2019 Clostridium botulinum Details
Whole Foods Market Vegetable Products 11/6/2019 Listeria
monocytogenes Details
Cay Thi Queentrees
Food USA Poultry Products 11/4/2019
Without Benefit of
Inspection Details
Mann, various private
brands
Various Vegetable
Products 11/3/2019
Listeria
monocytogenes Details
King Arthur Flour Unbleached All-Purpose
Flour 11/1/2019 E. coli O26 Details
Season's Choice,
Raley's
Frozen Raspberries,
Frozen Berry Mixes 10/30/2019 Hepatitis A Details
H&T Seafood Inc. Siluriformes products 10/29/2019 Without Benefit of
Inspection Details
Great Lakes, more Fresh Apple varieties 10/25/2019 Listeria
monocytogenes Details
George's Prepared
Foods
Ready-to-eat pork and
turkey products 10/18/2019 Salmonella Details
Pride of Florida Beef Products 10/18/2019 E. coli O157:H7 Details
6 November 2019
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
Influenza Labs Reported Electronically to DOH-Hillsborough by Report Week, 2019 - 2020
Percent Positive
Percent Flu A
Percent Flu B
Hillsborough County Weekly Influenza Report (Week 46, 2019)
Flu Trend:
Increasing
Flu Level:
Moderate Flu Activity This Week (November 10 – November 16)
• Influenza like illness (ILI) activity continues to increase in Hillsborough
County.
• Positive influenza labs increased and are mostly influenza type B (Figure 1).
• Two ILI outbreaks were reported in schools in week 46.
• No pediatric mortalities were reported in the previous week.
Flu Activity This Season (September 29 – November 16)
• Total Outbreaks: Twelve outbreaks of influenza or ILI have been reported
during the 2019-2020 flu season.
• Total Deaths: Hillsborough County has reported no pediatric mortalities in the
current flu season.
Figure 1: In week 46, 29% of 1736 reported electronic labs were positive for influenza, and 91% of the
positive results were reported as influenza B.
For statewide data
see the Florida Flu
Review.
www.FloridaHealth.gov/DiseaseReporting
www.FloridaHealth.gov/CHDEpiContact
! Outbreaks of any disease, any case, cluster of cases, or exposure to an infectious or non-infectious disease, condition, or agent found in the general community or any defined setting (e.g., hospital, school, other institution) not listed that is of urgent public health significance
+ Acquired immune deficiency syndrome (AIDS)
Amebic encephalitis
! Anthrax
Arsenic poisoning
! Arboviral diseases not otherwise listed
Babesiosis
! Botulism, foodborne, wound, and unspecified
Botulism, infant
! Brucellosis
California serogroup virus disease Campylobacteriosis
+ Cancer, excluding non-melanoma skin cancer and including benign and borderline intracranial and CNS tumors
Carbon monoxide poisoning
Chancroid
Chikungunya fever
Chikungunya fever, locally acquired
Chlamydia
! Cholera (Vibrio cholerae type O1)
Ciguatera fish poisoning
+ Congenital anomalies
Conjunctivitis in neonates <14 days old
Creutzfeldt-Jakob disease (CJD)
Cryptosporidiosis
Cyclosporiasis
! Dengue fever
! Diphtheria
Eastern equine encephalitis
Ehrlichiosis/anaplasmosis
Escherichia coli infection, Shiga toxin-producing
Giardiasis, acute
! Glanders
Gonorrhea
Granuloma inguinale
! Haemophilus influenzae invasive disease in children <5 years old
Hansen’s disease (leprosy)
Hantavirus infection
Hemolytic uremic syndrome (HUS)
Hepatitis A
Hepatitis B, C, D, E, and G
Hepatitis B surface antigen in pregnant women and children <2 years old
Herpes B virus, possible exposure
Herpes simplex virus (HSV) in infants <60 days old with disseminated infection and liver involvement; encephalitis; and infections limited to skin, eyes, and mouth; anogenital HSV in children <12 years old
+ Human immunodeficiency virus (HIV) infection
HIV-exposed infants <18 months old born to an HIV-infected woman
Human papillomavirus (HPV)-associated laryngeal papillomas or recurrent respiratory papillomatosis in children <6 years old; anogenital papillomas in children ≤12 years old
! Influenza A, novel or pandemic strains
Influenza-associated pediatric mortality in children <18 years old
Lead poisoning (blood lead level ≥5 µg/dL)
Legionellosis
Leptospirosis
Listeriosis
Lyme disease
Lymphogranuloma venereum (LGV)
Malaria
! Measles (rubeola)
! Melioidosis
Meningitis, bacterial or mycotic
! Meningococcal disease
Mercury poisoning
Mumps
+ Neonatal abstinence syndrome (NAS)
Neurotoxic shellfish poisoning
Paratyphoid fever (Salmonella serotypes Paratyphi A, Paratyphi B, and Paratyphi C)
Pertussis
Pesticide-related illness and injury, acute
! Plague
! Poliomyelitis
Psittacosis (ornithosis)
Q Fever
Rabies, animal or human
! Rabies, possible exposure
! Ricin toxin poisoning
Rocky Mountain spotted fever and other spotted fever rickettsioses
! Rubella
St. Louis encephalitis
Salmonellosis
Saxitoxin poisoning (paralytic shellfish poisoning)
! Severe acute respiratory disease syndrome associated with coronavirus infection
Shigellosis
! Smallpox
Staphylococcal enterotoxin B poisoning
Staphylococcus aureus infection, intermediate or full resistance to vancomycin (VISA, VRSA)
Streptococcus pneumoniae invasive disease in children <6 years old
Syphilis
Syphilis in pregnant women and neonates
Tetanus
Trichinellosis (trichinosis)
Tuberculosis (TB)
! Tularemia
Typhoid fever (Salmonella serotype Typhi)
! Typhus fever, epidemic
! Vaccinia disease
Varicella (chickenpox)
! Venezuelan equine encephalitis
Vibriosis (infections of Vibrio species and closely related organisms, excluding Vibrio cholerae type O1)
! Viral hemorrhagic fevers
West Nile virus disease
! Yellow fever
! Zika fever
! Report immediately 24/7 by phone
upon initial suspicion or laboratory test order Report immediately 24/7 by phone
Report next business day + Other reporting timeframe
Reportable Diseases/Conditions in Florida Practitioner List (Laboratory Requirements Differ)
Per Rule 64D-3.029, Florida Administrative Code, promulgated October 20, 2016 Florida Department of Health
*Subsection 381.0031(2), Florida Statutes, provides that “Any practitioner licensed in this state to practice medicine, osteopathic medicine, chiropractic medicine, naturopathy, or veterinary medicine; any hospital licensed under part I of chapter 395; or any laboratory licensed under chapter 483 that diagnoses or suspects the existence of a disease of public health significance shall immediately report the fact to the Department of Health.” Florida’s county health departments serve as the Department’s representative in this reporting requirement. Furthermore, subsection 381.0031(4), Florida Statutes, provides that “The Department shall periodically issue a list of infectious or noninfectious diseases determined by it to be a threat to public health and therefore of significance to public health and shall furnish a copy of the list to the practitioners…”
9
Patient Information Medical Information
SSN: MRN:
Last name: Date onset: Date diagnosis:
First name: Died: Yes No Unknown
Middle: Hospitalized: Yes No Unknown
Parent name: Hospital name:
Gender:
Male Female Unknown
If female, pregnant:
Yes No Unknown
Date admitted: Date discharged:
Insurance:
Birth date: Death date: Treated: Yes No Unknown
Race:
American Indian/Alaska native Asian/Pacific islander Black
White Other Unknown
Specify treatment:
Ethnicity:
Hispanic Non-Hispanic Unknown
Laboratory testing:
Yes No Unknown Attach laboratory result(s) if available
Address: Provider Information
ZIP: County: Physician:
City: State: Address:
Home phone: City: State: ZIP:
Other phone: Phone:
Emergency phone: Fax:
Email: Email:
To obtain local county health department contact information, see www.FloridaHealth.gov/CHDEpiContact. See www.FloridaHealth.gov/DiseaseReporting for other reporting questions. HIV/AIDS and HIV-exposed newborn notification should be made using the Adult HIV/AIDS Confidential Case Report Form, CDC 50.42A (revised March 2013) for cases in people ≥13 years old or the Pediatric HIV/AIDS Confidential Case Report, CDC 50.42B (revised March 2003) for cases in people <13 years old. Please contact your county health department for these forms (visit www.FloridaHealth.gov/CHDEpiContact to obtain contact information). Congenital anomalies and neonatal abstinence syndrome notification occurs when these conditions are reported to the Agency for Health Care Administration in its inpatient discharge data report pursuant to Chapter 59E-7 FAC. Cancer notification should be directly to the Florida Cancer Data System (http://fcds.med.miami.edu). All other notifications should be to the CHD where the patient resides.
Reportable Diseases and Conditions in Florida Notify upon suspicion 24/7 by phone Notify upon diagnosis 24/7 by phone
Amebic encephalitis
Anthrax
Arsenic poisoning
Arboviral diseases not otherwise listed
Babesiosis
Botulism, foodborne, wound, and unspecified
Botulism, infant
Brucellosis
California serogroup virus disease
Campylobacteriosis
Carbon monoxide poisoning
Chancroid
Chikungunya fever
Chikungunya fever, locally acquired
Chlamydia
Cholera (Vibrio cholerae type O1)
Ciguatera fish poisoning
Conjunctivitis in neonates <14 days old
Creutzfeldt-Jakob disease (CJD)
Cryptosporidiosis
Cyclosporiasis
Dengue fever
Diphtheria
Eastern equine encephalitis
Ehrlichiosis/anaplasmosis
Escherichia coli infection, Shiga toxin-producing
Giardiasis, acute
Glanders
Gonorrhea
Granuloma inguinale
Haemophilus influenzae invasive disease in children <5 years old
Hansen’s disease (leprosy)
Hantavirus infection
Hemolytic uremic syndrome (HUS)
Hepatitis A
Hepatitis B, C, D, E, and G
Hepatitis B surface antigen in pregnant women and children <2 years old
Herpes B virus, possible exposure
Herpes simplex virus (HSV) in infants <60 days old with disseminated infection and liver involvement; encephalitis; and infections limited to skin, eyes, and mouth; anogenital HSV in children <12 years old
Human papillomavirus (HPV)-associated laryngeal papillomas or recurrent respiratory papillomatosis in children <6 years old; anogenital papillomas in children ≤12 years old
Influenza A, novel or pandemic strains
Influenza-associated pediatric mortality in children <18 years old
Lead poisoning (blood lead level ≥5 ug/dL)
Legionellosis
Leptospirosis
Listeriosis
Lyme disease
Lymphogranuloma venereum (LGV)
Malaria
Measles (rubeola)
Melioidosis
Meningitis, bacterial or mycotic
Meningococcal disease
Mercury poisoning
Mumps
Neurotoxic shellfish poisoning
Paratyphoid fever (Salmonella serotypes Paratyphi A, Paratyphi B, and Paratyphi C)
Pertussis
Pesticide-related illness and injury, acute
Plague
Poliomyelitis
Psittacosis (ornithosis)
Q Fever
Rabies, animal or human
Rabies, possible exposure
Ricin toxin poisoning
Rocky Mountain spotted fever and other spotted fever rickettsioses
Rubella
St. Louis encephalitis
Salmonellosis
Saxitoxin poisoning (paralytic shellfish poisoning)
Severe acute respiratory disease syndrome associated with coronavirus infection
Shigellosis
Smallpox
Staphylococcal enterotoxin B poisoning
Staphylococcus aureus infection, intermediate or full resistance to vancomycin (VISA, VRSA)
Streptococcus pneumoniae invasive disease in children <6 years old
Syphilis
Syphilis in pregnant women and neonates
Tetanus
Trichinellosis (trichinosis)
Tuberculosis (TB)
Tularemia
Typhoid fever (Salmonella serotype
Typhi)
Typhus fever, epidemic
Vaccinia disease
Varicella (chickenpox)
Venezuelan equine encephalitis
Vibriosis (infections of Vibrio species and closely related organisms, excluding Vibrio cholerae type O1)
Viral hemorrhagic fevers
West Nile virus disease
Yellow fever
Zika fever
Outbreaks of any disease, any case, cluster of cases, or exposure to an infectious or non-infectious disease, condition, or agent found in the general community or any defined setting (e.g., hospital, school, other institution) not listed above that is of urgent public health significance. Specify in comments below.
Practitioner Disease Report Form Complete the following information to notify the Florida Department of Health of a reportable disease or condition. This can be filled in electronically.
Per Rule 64D-3.029, Florida Administrative Code, promulgated October 20, 2016 (laboratory reporting requirements differ).
Comments: