Bureau of Epidemiology
Bureau of Epidemiology January 1997 Utah Department of Health
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1996:  The Year in Review
Hello and Goodbye!
Monthly Morbidity Summary  

 

1996: The Year in Review

Enteric Diseases

Based on preliminary data, 1996 saw a further increase in almost all of the enteric diseases reported to the health department. The only exception was shigellosis where the number of cases decreased from 764 cases in 1995 to 312 in 1996. Reported cases of campylobacteriosis increased 13% from 214 cases in 1995 to 243 cases in 1996. Only one additional case of E. coli 0157:H7 was reported in 1996 (30) compared to 1995 (29). The number of giardiasis cases increased to 333, an increase of 35% from 247 cases in 1995.

The number of cases of salmonellosis (280 cases in 1995 and 529 cases in 1996) increased 88% in 1996 as compared to 1995 (Figure 1). The increase seen in the latter part of 1995 of Salmonella enteritidis carried over into 1996 with 297 cases reported, an increase of 147 % over 1995 (see Epidemiology Newsletter, May 1996). In addition, an outbreak of salmonellosis was associated with a northern Utah restaurant resulting in nearly 200 people becoming ill. Sixty-two cases were confirmed as Salmonella enteritidis (see Epidemiology Newsletter, October 1996).

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Viral Hepatitis

In 1996, 1078 cases of hepatitis A were reported and the incidence rates for hepatitis A reached all time highs (Figure 2). The estimated 1996 rate per 100,000 was 54.1, or approximately four and a half times the 1995 national rate of 12.1 per 100,000. The estimated rate for men (62.2) was over a third higher than the estimated rate for females (45.7).

Salt Lake County accounted for over 70% of the cases in Utah (92.3 per 100,000). It was also a big year for hepatitis A in Wasatch and Weber Counties with the estimated rates of 90.1 and 72.3 per 100,000 respectively.

Of the total number of hepatitis A cases identified during 1996, 75 (7.0%) were found to be foodhandlers. An even greater number, 129 (11.9%) were associated with day care centers.

Reports of hepatitis B cases increased from 75 in 1995, to 128 in 1996. Approximately 70% of the reported cases were male and 75% were 20-39 years old.

During 1996, 50 perinatal hepatitis B carriers were identified statewide. A total of 81 household and sexual contacts were identified and evaluated.

Reports of hepatitis non-A, non-B increased in 1996. Hepatitis non-A, non-B went from 13 cases in 1995 to 20 cases in 1996. The number of cases of hepatitis unspecified decreased from 10 cases in 1995 to three cases in 1996. Once again we strongly urge health care providers to test individuals presenting with signs and symptoms of hepatitis rather than relying on a clinical diagnosis.

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HIV/AIDS

According to the Bureau of HIV/AIDS/TB Control/ Refugee Health, 188 AIDS cases and 113 new HIV positive individuals were reported during 1996. The 188 reported AIDS cases represent a 19% increase over the 158 reported in 1995.

Meningitis

Meningococcal disease remained constant at 18 cases in 1996. Cases were evenly distributed throughout the year with no outbreaks identified. Isolates identified in cases from 1996, were Neisseria meningitidis serogroup B (6), serogroup C (6), serogroup Y (5) and unknown (1). The ages of the 1996 cases ranged from 1 month to 65 years. The mean age of cases was 19.1 years. The mean age of males infected with N. meningitidis was markedly lower at 10.3 years compared to 26.1 years for females. These infections resulted in four deaths (3 males, 1 female). Other causes of bacterial meningitis included Streptococcus pneumoniae (11), E. coli (3), other Streptococcus (3), and other bacterial species (2).

Viral meningitis increased slightly from 30 cases during 1995 to 32 cases during 1996. For most cases, the etiology was not established. An enterovirus was isolated from only two of the cases.

Sexually Transmitted Diseases

A total of 277 gonorrhea cases were reported for 1996, a 10.4% decrease compared to the 306 cases reported in 1995. Of the 277 cases, there were ten cases of Penicillinase-Producing Neisseria gonorrhea (PPNG) reported, compared to three cases reported during 1995. Nine of the ten reported PPNG cases were from Salt Lake County. There were four cases of gonococcal related Pelvic Inflammatory Disease (PID) reported in 1996. Reported cases among the 15-24 year olds (112 out of 263) represented 42.6% of Utah's gonorrhea morbidity in 1996. Uncomplicated cases of chlamydia decreased in 1996 with 1583 compared to 1670 in 1995. Chlamydia associated PID increased this year with 15 cases identified as compared to five cases reported in 1995. Seventy-seven percent of chlamydia cases reported were among females. Seventy-four percent of the chlamydia cases reported occurred among 15-24 year olds. There were eleven cases of early syphilis reported in 1996 (eight early latent and three primary), as was also reported in 1995 (three primary, one secondary, and seven early latent).

Tuberculosis

Reported cases of tuberculosis increased from 48 cases in 1995 to 58 cases in 1996, an increase of 21%. The majority of cases were male (69%) although somewhat less than in 1995 (77%). No single age group or race/ethnic group were responsible for the majority of cases.

Vaccine-Preventable Diseases

The largest outbreak of measles (rubeola) in the U.S. during 1996 occurred in southwest Utah. A total of 119 cases were confirmed and reported. Nearly all of the cases occurred in persons younger than 30 years of age. No cases of rubella were reported in 1996. Cases of pertussis decreased from 37 in 1995 to 12 in 1996. There were eight reported cases of Haemophilus influenzae disease in 1996, down from 12 in 1995. A polio case was reported in 1996 that occurred in 1994. This was a case of vaccine induced disease, oral polio vaccine was given to an undiagnosed immunocompromised infant.

Zoonotic and Vectorborne Diseases

The number of cases of bat rabies in 1996 decreased by 64% with a total of five bats testing positive. There were no other animals found to be positive for rabies. Two cases of Hantavirus Pulmonary Syndrome (HPS) were diagnosed in 1996. The first case was diagnosed in June of 1996 in a 25-year-old female whose illness occurred in April of 1991. The second case was diagnosed in October of 1996 in a 39-year-old male who died of HPS. This brings the total number of HPS cases diagnosed in Utah residents to 10. Cases of Colorado Tick Fever decreased from 11 cases in 1995 to four cases in 1996. One case of Lyme disease, two cases of relapsing fever and three cases of tularemia were reported in 1996. A total of five cases of imported malaria were reported in 1996.

Other reportable diseases

No cases of Toxic Shock Syndrome (TSS) were reported in 1996. Although active surveillance for TSS was discontinued in 1995, the condition is still reportable. Reports of Kawasaki disease decreased slightly from 13 cases in 1995 to 10 cases in 1996. Once again in 1996, there were two reports of infant botulism. The number of cases of legionellosis decreased to eight in 1996, a reduction of 50%.

Once again we wish to express our gratitude to the people in the laboratories, physicians' offices, local health departments, schools, hospitals, clinics and nursing homes throughout Utah, whose reports are the basis for this summary. Please keep up the good work.

 

Hello and Goodbye!

We would like to welcome Nicole Stone, Sally Higginson and Erick Henry to the Bureau of Epidemiology. Nicole graduated from the University of Utah in Community Health Education in 1992. She has worked at Salt Lake City County Health Department since then and has experience in environmental health and communicable diseases.

Sally graduated from Utah State University in 1995 and is currently completing a Masters in Community Health Education. Both Nicole and Sally are Community Health Specialists in the Communicable Disease Control Program.

Erick graduated from Brigham Young University in 1994 with a B.S. in Environmental and Occupational Health and Safety. He worked as a Community Health Educator with the Violence and Injury Prevention Program. He now works as the Coordinator for the Childhood Blood Lead Surveillance Project.

Our best wishes go to Edma Diller as she leaves the Bureau of Epidemiology. Edma has accepted a position at the University of Utah, School of Medicine, Department of Pediatric Critical Care, as an Applied Biostatistician. She came to the Bureau in 1991 as a Community Health Specialist working with infection control issues. While here, she assisted with the development of the Communicable Disease Policy and Exposure Plan for OSHA Bloodborne Pathogen/TB Safety and occupational health issues and chaired the OSHA Compliance Committee for the Utah Department of Health.

 

Utah Department of Health, Bureau of Epidemiology

Monthly Morbidity Summary - January 1997 - Provisional Data

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

Send comments to:  The Bureau of Epidemiology Box 142870 Salt Lake City, UT 84114-2870 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
Craig R Nichols, MPA, Editor, State Epidemiologist, Director, Bureau of Epidemiology
Cristie Chesler, BA Managing Editor