Bureau of Epidemiology
Bureau of Epidemiology September 2001 Utah Department of Health
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Best Strategies for Utah’s 2001/2002 Flu Season

Epidemics of influenza generally occur during the winter months on an annual or near annual basis and are responsible for approximately 20,000 deaths in the United States each year. Influenza virus infections cause disease in all age groups. Rates of infection are highest among infants, children, and adolescents, but rates of serious morbidity and mortality are highest among people 50 years of age or older and people of any age who have medical conditions that place them at high risk for complications from influenza.

Annual vaccination of people at high risk for complications before the influenza season is the most effective measure for reducing the impact of influenza. In Utah, due to the 2002 Winter Olympic Games coinciding with the influenza season, vaccination for influenza is particularly important. Persons at greatest risk from influenza include those 65 years of age, those in institutionalized care, children and adults with certain chronic diseases, particularly of the lungs and heart, health care workers, close contacts of high-risk individuals, women in the second or third trimester of pregnancy, and all travelers. Individuals between 50 and 65 are also at increased risk and are recommended to receive an annual influenza vaccination. A comprehensive list of recommendations for the 2001/2002 flu season may be found on the web at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5027a3.htm

Pneumococcal vaccination is another first-line defense against serious complications from the flu. Target groups for influenza and pneumococcal vaccination overlap considerably. Both vaccines can be administered at the same time at different sites without increasing side effects. However, influenza vaccine is administered each year, while pneumococcal vaccine is not. Infants and children at high risk for influenza-related complications can receive influenza vaccine at the same time they receive other routine vaccinations.

High-risk children comprise an often overlooked group that should receive influenza and pneumococcal vaccinations. The vaccination rate among high-risk children recommended for annual influenza vaccination is very low. High-risk children who are eligible for vaccines under the Vaccines for Children (VFC) Program can receive the vaccine at no cost and providers may bill Medicaid for administration fees or charge these fees to the parents of VFC-eligible children not enrolled in Medicaid. Providers interested in enrolling in the VFC Program should contact the Utah Department of Health/ Immunization Program at (801) 538-9450.

Manufacturers have reported that even though current projections of the total vaccine supply expected for this year exceed that of prior years, there will be delays in the delivery and the completion of delivery could be as late as December. Approximately 25% or less of the total vaccine supply will be available in October and should be used to vaccinate only high-risk individuals. The Utah Department of Health/ Immunization Program therefore encourages all providers to use the following CDC general guidelines for the 2001/2002 influenza season:

  • Target use of vaccine available early in the season to persons at greatest risk of complications from influenza.

  • Defer vaccination of low risk persons until November when vaccine supplies should increase.

  • Extend the recommended optimal time for vaccination from October through the end of November and encourage continued vaccination through December and later, as long as vaccine is available.

If you have questions about this year’s influenza season, or would like information about influenza clinic sites and schedules, call the Immunization Hotline at 1-800-275-0659.

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Campylobacter

Elevated campylobacteriosis rates have prompted the Bureau of Epidemiology to issue an advisory to those that may be at increased risk of contracting the disease. Campylobacteriosis is an acute enteric disease characterized by diarrhea, malaise, abdominal pain, fever, nause and vomiting. The disease, caused by Campylobacter bacteria, has an onset within two to five days after exposure to the organism and commonly lasts another two to five days. People can spread the disease for several days to several weeks after they are infected. However, the period of communicability can be shortened to a few days by providing effective treatment, which may include rehydration and electrolyte replacement. Campylobacter jejuni and Campylobacter coli, the primary etiologic agents of campylobacteriosis, are susceptible to several antimicrobial agents, including erythromycin, tetracyclines and quinolones, but these agents are of value only early in the illness and when the identity of the infecting organism is known.

Utah typically has more than 220 confirmed cases of campylobacteriosis reported each year (see Figure 1). To date, more than 189 confirmed cases have been reported in 2001.

People can become infected with Campylobacter by handling raw chicken, eating undercooked poultry or drinking unpasteurized milk and inadvertently ingesting animal feces after handling infected animals, such as puppies, kittens, and other pets. Mountain streams and wells contaminated with animal feces may also pose a hazard. This type of exposure is what caused an outbreak in 2000 and accounts for the elevated number of cases in August and September of that year.

When handling animals, people need to avoid hand-to-mouth activities (i.e. eating, smoking, or merely touching the mouth) until they wash their hands. Persons with diarrhea should wash their hands thoroughly and frequently with soap and warm water, for at least 20 seconds, to reduce the risk of spreading the infection to others.

All persons who become ill with a diarrheal illness should see their health care provider to have a stool sample tested. Individuals who have experienced an illness following exposure to animals are encouraged to report it to the Utah Department of Health, Office of Epidemiology at (801) 538-6191 or to their respective local health department. For more information on campylobacteriosis, visit UDOH’s webpage at http://www.health.state.ut.us/els/epidemiology/epifacts/campy.html.

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Quarterly Report of Diseases of Low Frequency Year to Date, January—September 2001 (including a comparison for same time period 1997-2000)

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Exceptional Effort in Public Health

The Utah Health Alert Network (HAN) was developed to provide local health departments with information, technology, and ongoing training needed to address the health threats within the communities they serve. Some of the components of the HAN are:

  • Conduct an assessment of public health information/communication systems, workforce skills and competencies, organizational capacities, and other activities related to bioterrorism preparedness;
  • Establish and support Internet connection links and other information/communication systems needed in each local public health jurisdiction;
  • Establish and support technical infrastructure at the local and state health department to allow rapid receipt and broadcast of health alerts and other urgent information to alert recipients;
  • Develop a plan to respond to bioterrorism within each local health jurisdiction;
  • Enhance and develop the public health training capacity with emphasis on distance based learning;
  • Strengthen the organizational capacity of local and state public health agencies to respond to bioterrorism.

In an effort to provide these services to all the local health departments throughout Utah, the HAN organized a statewide “Seminar in Communications and Response” that was held the last week of August 2001, in Park City, Utah. Representatives from public safety, hospitals, emergency response, and public health were in attendance. The work that went into this meeting deserves recognition as an EXCEPTIONAL EFFORT IN PUBLIC HEALTH. We would like to thank Kathy Froerer, Lee Ann Wessol, Susan Lester, and Dean Penovich for all their work and efforts to plan, develop, and successfully carry out this meeting.

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Important Information

When Reporting a Communicable Disease: 
Call: (801) 538-6191
Or:
Fax: (801) 538-9923

Or in an emergency: 
24 hour Pager: (801) 241-1172

The September 2001 Epidemiology Newsletter is the most current Newsletter online.
For Information on Fact Sheets for Diseases or Annual Report Information, as well as The
Epidemiology Newsletter, you can browse our website:

http://health.utah.gov/epi/

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Utah Department of Health, Bureau of Epidemiology
Monthly Morbidity Summary - September 2001
Provisional Data

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The Epidemiology Newsletter is published monthly by the Utah Department of Health, Division of Epidemiology and Laboratory Services, Office of Epidemiology, to disseminate epidemiologic information to the health care professional and the general public.

Send comments to:  The Office of Epidemiology, Box 142104, Salt Lake City, UT 84114-2104, or call (801) 538-6191

Approval 8000008:  Appropriation 3705

Rod Betit, Executive Director, Utah Department of Health
Charles Brokopp, Dr.P.H., Division of Epidemiology and Laboratory Services
Gerrie Dowdle, MSPH, Managing Editor
Connie Dean, Production Assistant

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