Influenza Surveillance for the 1998-1999 Season

To identify the virus type(s) associated with influenza morbidity and define the beginning and end of the influenza season, the Bureau of Epidemiology conducts surveillance each influenza season. “Influenza” is the category used in Utah’s morbidity reporting system to record cases of laboratory confirmed influenza. “Influenza-like illness” is the category used to report similar upper respiratory illnesses based on a physician’s clinical impression. Viral respiratory diseases dominate this category, with illness due to influenza, parainfluenza, respiratory syncytial virus and adenoviruses comprising the majority of morbidity. Symptoms associated with influenza and “influenza-like illnesses” include fever of 101 degrees or greater, malaise, chills, sore throat, myalgia, cough and coryza. Severity of illness varies, depending on a patient’s age and previous immunity. Surveillance for the 1998-99 influenza season began the week of October 18, 1998, and continued weekly through April 3, 1999 . Surveillance participants included physicians’ offices, clinics, and university health centers. Various schools throughout the state also reported the number of students absent per week during the surveillance period. We wish to thank all who participated in the influenza surveillance program.

The most effective measure for reducing the impact of influenza is vaccination of persons at high risk each year before the influenza season. Influenza vaccine is strongly recommended for any person > six months of age who, because of age or an underlying medical condition is at increased risk for complications of influenza. Health-care workers and others in close contact with persons in high-risk groups should also be vaccinated. In addition, influenza vaccine may be administered to any person who wishes to reduce the chance of becoming infected with influenza. However, those with a known anaphylactic hypersensitivity to eggs or to other components of the vaccine should not receive the influenza vaccine.

Each year’s influenza vaccine contains virus strains representing the influenza viruses that are likely to circulate in the upcoming winter. U.S. manufacturers will use the antigenically equivalent strains of influenza vaccines because of their growth properties. Although the current influenza vaccine can contain one or more of the antigens administered in the previous year, annual vaccination with the current vaccine is necessary because immunity declines in the year following vaccination and because the current vaccine differs slightly from that of the previous year. As a result, supplies of 1998-99 vaccine should not be administered to provide protection for the 1999-00 influenza.

If you are not currently part of our surveillance program and would like to participate, please call the Communicable Disease Control Program, Bureau of Epidemiology, at 538-6191.

Return

Campylobacter

The Utah Department of Health state laboratory has begun using a different medium to test for a broader spectrum of Campylobacter agents. The Bureau of Epidemiology has, therefore, expected to see a moderate increase in Campylobacter disease reported. A variety of serotypes occur and their identification may be beneficial for epidemiologic purposes. Campylobacter jejuni and, less commonly, C. coli cause gastroenteritis, while other organisms, such as C. fetus and C. laridis, have also been associated with diarrhea in humans.

The disease generally incubates for two to five days, with a range of 1-10 days, depending on dose ingested. The illness may remain communicable throughout the entire course of infection which may last from several days to several weeks. However, those not treated with antibiotics may shed the organism for up to seven weeks. When given early in the course of infection, erythromycin shortens the duration of illness and prevents relapse. Treatment with the antibiotic usually eradicates the organism from stool within two to three days. Ciprofloxacin is an alternative agent that is effective, but is not approved by the Food and Drug Administration for persons younger than 18 years.

Campylobacter contamination can be prevented by thoroughly cooking all animal-derived foodstuffs, especially those from poultry. Cross-contamination can be avoided by handwashing after handling animals or raw poultry and thoroughly washing cutting boards and utensils with soap after contact with the food. Pasteurization of milk and chlorination of water supplies are also important in hampering infection. Infected food handlers and hospital employees who are asymptomatic pose no known hazard for disease transmission and need not be excluded from work if proper personal hygiene measures are maintained. Outbreaks are uncommon in child care centers, however, infants and children in diapers with symptomatic C. jejuni infection should be excluded from child care or cared for in a separate protected area until diarrhea has subsided.