Bureau of Epidemiology
Bureau of Epidemiology October 1997 Utah Department of Health
Little Talk on Sexual Diseases
Epidemilogy and Laboratory Capacity for Infectious Diseases
Work-Related Burns Surveillance Project
Prepare Meals Safely at Home for the Holidays
Thanksgiving Fable
Morbidity Summary

Little Talk on Sexual Diseases by Tamar Lewen
Adapted from The New York Times Company, Copyright 1997, and the Henry J. Kaiser Family Foundation, New Release, Monday, September 15, 1997.

Although more than 12 million new cases of sexually transmitted diseases are diagnosed each year, three million of them among teenagers alone, a recent survey of women from 18 to 44 years old found that most did not discuss such diseases in their first visits with a new gynecologist or obstetrician.

According to the survey, conducted for the Kaiser Family Foundation and Glamour Magazine, only 15 percent of the 482 women polled had discussed sexually transmitted diseases other than AIDS in their reproductive health visits.

The women raised the topic 3 percent of the time, and the doctor or other health professional raised it in 12 percent of the visits.

AIDS and HIV, the virus that causes the disease, were discussed somewhat more frequently, being raised in 21 percent of the visits, by the patient in 2 percent and by the doctor in 19 percent.

By comparison, breast self-examinations and Pap smears were discussed in three-quarters of the visits, birth control in more than half and alcohol use in a quarter (Table 1). "I think you can summarize the whole reason people don't talk about sexually transmitted diseases with the word shyness," said Dr. Felicia H. Stewart, the director of reproductive health programs at Kaiser.

"Patients are shy about raising the issue and clinicians are shy about asking the questions, so you get a vicious circle of 'don't ask, don't tell.' The end result is a dangerous ‘don’t know’."

A telephone survey was conducted by Market Facts Inc. in May and June, with a national sample of women who had been to a new gynecologist or obstetrician for the first time within the previous year.

The margin of sampling error was plus or minus five percentage points. According to the survey, only 3 percent of the women believed themselves to be at risk for sexually transmitted diseases. However at the current rates of infection, from 25 percent to 50 percent of all Americans will contract a sexually transmitted disease at some point in their lives.

Most of the women surveyed said it should be up to the health professional to initiate the topic of sexually transmitted diseases.

The two most common sexually transmitted diseases are chlamydia, which infects approximately four million people a year, and trichomoniasis, which infects an estimated three million. Both, left untreated, can cause serious reproductive difficulties. Both are now more prevalent in the United States than in any other industrialized nation.

Unfortunately, according to a previous Kaiser survey, few women are aware of either of the diseases, or their consequences. Less than a quarter of the women, when asked what sexually transmitted diseases they were aware of, could name chlamydia, and only 2 percent could name trichomoniasis. The majority of the women were unaware that such infections increased susceptibility to HIV infection.

Kaiser's surveys have also found that many women believe erroneously that they are automatically tested for a wide range of sexually transmitted diseases as part of their regular gynecological examinations.

The American College of Obstetricians and Gynecologists’ 1996 Guidelines for Women’s Health Care recommends evaluation and counseling on sexually transmitted diseases as part of the routine assessment of all women under 65.

According to Peggy Northrop, Senior Health Editor, Glamour Magazine, "Women need to take more responsibility for their sexual health, but health care providers must get over any reluctance to address these issues. If they don’t, too many women will remain in the dark about their risks and end up going untreated for an STD, which could compromise their fertility."

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Epidemiology and Laboratory Capacity for Infectious Diseases

The Bureau of Epidemiology, Communicable Disease Control Program has received $203,537 from CDC to support the "Epidemiology and Laboratory Capacity for Infectious Diseases" cooperative agreement. Funding from CDC will allow the Division of Epidemiology and Laboratory Services to expand testing for enteric diseases and emerging pathogens by implementing pulsed-field gel electrophoresis (PFGE) and rapid screening for foodborne pathogens. In addition, the Bureau of Epidemiology will develop an electronic reporting system for laboratories, establish a surveillance system for infections caused by antibiotic resistant organisms and improve electronic communication systems for surveillance, outbreak control and disease reporting.

Equipment is being purchased and new staff are expected to be hired by November 1997. If program objectives are met, the grant can be extended over a five year period.

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Work Related Burns Surveillance Project

Work-related burns are a leading cause of occupational injury in the United States. Approximately 1.4 million persons in the United States sustain burns each year, of which approximately 54,000-108,000 are hospitalized. Of all serious burns, 20-25% are work-related. In Utah, from 1992 to 1995, there were a total of 10,352 work-related burns (thermal and chemical) reported to the Industrial Commission of Utah, of which a total of 167 required hospitalization. Work-related burns accounted for 20% of all serious burns requiring hospitalization in Utah between 1992 and 1995. Of the 167 hospitalized cases reported in Utah, 6% occurred among adolescent workers aged 15-19 years old, and 88% occurred among workers 20-54 years old.

The Bureau of Epidemiology, Environmental Epidemiology Program, was recently awarded a 5 year grant from the National Institute for Occupational Safety and Health to conduct state-wide surveillance of work-related burns. This grant, which began September 30, will be used to develop an ongoing occupational disease and injury surveillance program for work-related burns and allow the Environmental Epidemiology Program to strengthen the infrastructure of current surveillance projects.

The goal of this project is to develop a complete registry of work-related burn cases in Utah, and to use the information from cases to develop and implement intervention activities. Interventions will include education and consultation to employers where burn hazards are present, education for cases and workers, as well as broader industry-wide studies and research. Cases will be identified from a variety of sources including hospital reporting of work-related burns, hospital discharge data, workers compensation data, Utah Occupational Safety and Health Division (UOSHD) and direct reporting from physicians. Medical, demographic and sociologic information will be collected from cases to identify appropriate interventions.

The surveillance system for work-related burns will help assure that affected workers are identified and receive the appropriate medical and environmental follow-up, and appropriate prevention activities are directed toward targeted industries. Data collection and analysis on a statewide basis will be used to identify high risk areas and activities associated with elevated injuries in Utah workers and ensure that direct intervention efforts reduce injuries associated with work-related burns.

The information obtained through these surveillance activities will be disseminated to the National Institute for Occupational Safety and Health, other government agencies, researchers, medical providers and other interested persons. These efforts will help to direct efforts by federal, state, and local public health officials seeking to reduce work-related injuries as the result of burns.

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Prepare Meals Safely at Home for the Holidays!

Timely Turkey Tips

When thawing a frozen turkey, keep it refrigerated on a tray, under cold running water, or in the microwave if it is cooked immediately afterwards. Never thaw by letting it sit out on the kitchen counter.
Stuffing should be placed in the turkey just before cooking. Pack it loosely. Remove the stuffing as soon as the turkey is cooked.
Turkeys should reach an internal temperature of 185F. Take the temperature in the thickest part of the meat on the thigh away from the bone. Stuffing should reach 165 F.
Refrigerate or freeze all leftovers within 2 hours of removal from the oven. This prevents bacterial growth which may cause illness. Foods should be stored in small or shallow containers to allow them to cool quickly. Cover containers when cooled.
Stuffing and gravy will keep in the refrigerator for 1 or 2 days. Gravy should be brought to a rolling boil before serving. Turkey should be used in 3 or 4 days, unless frozen.
For more information about preparing your holiday meals safely, call the USDA’s Meat and Poultry Hotline, at 1-800-535-4555.

Safe Food Handling Tips

Keep foods out of the danger zone” (between 45F and 140F). This minimizes bacterial growth that could cause foodborne illness.
Thaw frozen foods in a manner that inhibits bacterial growth: 1) in the refrigerator on a tray to catch drainage 2) under cold running and continuously draining water 3) in the microwave, only if the food is cooked immediately after, or 4) as part of the continuous cooking process.
Cook all meats and reheat leftovers to the following temperatures: poultry (165F), ground beef (155F), rare roast beef (130F), pork (150F), others (165F).
Rapidly cool all potentially hazardous foods (including cooked rice and baked potatoes) from 140 to 45F in less than 4 hours in the refrigerator. Cool large quantities of food in shallow 4” pans in the refrigerator.
Wash platters, utensils, cutting boards and other food preparation equipment in between uses for cooked and raw foods or different types of foods.
Wash hands with soap and warm water before preparing, serving or eating food.
Do not prepare foods if there are cuts or open sores on your hands.
Never mix household cleaners without following the manufacturer’s instructions. Do not mix household bleach and dishwashing detergent. It creates harmful fumes and vapors. Keep cleaners and medications away from food storage areas. Do not spray cleaners or pesticides in food areas.

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Thanksgiving Fable

The Thanksgiving Menu is planned far ahead,
There’s Staph Aureus to be fattened and E.Coli to be fed,
Pseudomonas to be roasted, Nocardia to be stuffed,
Spirochetes to be grated and Streptococcus to be buffed,
There’s pinworms to be diced and tapeworms to be shredded,
K. Pneumoniae to be glazed, and Proteus to be netted.
No one in this world has seen such a table,
Cause thank goodness, my dears, this is only a fable.

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