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.

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.

• 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.