The Year in Review
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
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.
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.
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).
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.
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.
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
Morbidity Summary - January 1997 - Provisional Data
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