Bureau of Epidemiology
Bureau of Epidemiology October 1998 Utah Department of Health
A Call To Action  
Influenza Updates are Posted Weekly on the Utah Infectious Diseases Listserver!  
Biological Terrorism
Is the Food That You Prepare in Your Home Safe? 
Monthly Morbidity Summary


A Call To Action: Young People can "Be a Force for Change"
World AIDS Day ‘98
-Submitted by Sara Jordan, Community Health Specialist, Utah Department of Health

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Last year, an estimated 5.8 million people worldwide were newly infected with HIV. Nearly half of all new infections occurred in young people between the ages of 15-24. In fact, according to United Nations AIDS office, five people, between the ages of 10-24, are infected with HIV each minute. This results in 7,000 new youth infections every day and 2.6 million infections each year. In the U.S., AIDS related illnesses are the sixth leading cause of death for young people. By 1997, 13,000 young adults were reported with HIV, most through sexual contact. Yet, in our society, many adults are still reluctant to talk openly with young people about sex. Thus far, in 1998, 28 Utahns between the ages of 13-29 have been reported with HIV disease. Many, many more young people are impacted by the disease through their relationships with the nearly 2,400 Utahns living with the disease.

Clearly not every young person is at risk for HIV/AIDS, but many are. Youth who may be include:

Young men who have sex with men (MSM)
Roughly three out of four HIV infections nationwide occur in young MSM. In addition to often having to deal with homophobia, young MSM of color sometimes have the burden of ethnic/cultural traditions which inhibit family/community support.

Young women
AIDS-related illnesses are the third leading cause of death for women between the ages of 25-44. Women who developed AIDS by the age of 30 were probably infected with HIV during their teenage years or in their early twenties. African-American and Latino women over the age of 13 comprised 80% of reported AIDS cases among women last year.

Homeless/disenfranchised/substance using youth
Young people who live on the street often exchange sex for shelter, security or food, and are thus at increased risk for HIV infection. Some young people who are addicted to drugs suffer from an increased risk of becoming infected with HIV by exchanging sex for drugs. Alcohol and drug use as part of sexual activity is not uncommon among young people seeking validation and intimacy.

Although there have been increasing numbers of HIV prevention programs targeted to youth, many programs fail to address the issues which put youth most at risk including injection and other drug use and unsafe sex practices. It is vital that young people learn how to protect themselves from all sexually transmitted diseases (STDs). Infection with one STD increases the risk of a second infection and STD rates within some populations are alarmingly high. Among African-American teenagers in the U.S., for example, gonorrhea rates are four times higher than the average rate. In Utah, 70% of reportable STDs are among youth. Factors that contribute to infection of all types of STDs include unstable relationships/serial monogamy/multiple partners; anatomical susceptibility (especially of young women); the sense of invulnerability many young people have; inadequate access to health care/use of services with particular concerns about parental involvement or lack of money.

In addition, community norms which discourage discussion of sex in general can inhibit frank discussions of safer sex practices and related issues. Studies from around the country indicate that many young people do not understand the risks of anal sex and many who are engaging it, are not protecting themselves against infection. For some youth, this information can make the difference between life and death.

Prevention programs and communities must also address the social context of HIV risk. This requires addressing issues related to family systems, violence and abuse, self-esteem and personal/social responsibility, communication, etc. While dealing with these issues may not be easy, we must if we want to create a world where the HIV risks to our young people are decreased. To do so requires the commitment of all of us, regardless of gender, age, HIV status, profession, sexual orientation, religion, etc.

On December 1, 1998, Utah, along with the rest of the world, will observe the eleventh annual World AIDS Day. The theme this year is "Be A Force for Change." This organized effort is designed to encourage public support for programs that prevent the spread of HIV infection and to provide education and awareness of issues surrounding HIV/AIDS.

World AIDS Day ‘98 kicks off a year long campaign to raise awareness about youth and HIV/AIDS. This Fall, organizations throughout the state have been working with youth to design and implement HIV prevention activities. The theme, "Be a Force for Change," challenges young people around the world to recognize the crucial role they play in the ever-changing course of the AIDS pandemic. The theme is intended to be a call to action for young people and adults.

Young people can get involved in reducing their risk and the spread of HIV/AIDS by educating their peers and by developing responsible, healthy habits. Adults can support youth in their efforts to do so. Adults can also support youth by developing policies which protect the rights of young people to be informed and educated about the risk of HIV/AIDS, by establishing programs which provide access to needed medical and social services and by ensuring that young people are protected from discrimination or exploitation resulting from their lifestyle choices. Every adult in the state has an opportunity this next year to show their commitment to keeping Utah kids safe and healthy, physically and emotionally, by becoming educated about HIV disease and by working to ameliorate the social conditions which contribute to the risk of infection.

The kick-off event will be the annual candlelight vigil. It will be held on Tuesday, December 1st at 5:30, at Rowland-Hall St. Marks High School in Salt Lake City. The purpose of the vigil is to remember those who have died from complications related to HIV/AIDS, to come together in support of those living with the disease, which includes increasing numbers of Utah youth and to recognize the millions of young adults worldwide who are affected - directly and indirectly - by HIV/AIDS. The entire candlelight vigil program will be youth focused. Youth, their teachers, families and friends are strongly encouraged to attend. COME SHOW YOUR SUPPORT FOR UTAH YOUTH!


Influenza Updates are Posted Weekly on the Utah Infectious Diseases Listserver!

We will post weekly updates of Utah’s influenza activity on the listserver during influenza season. We will also post information about influenza subtypes as soon as this becomes available. If you would like to receive this timely information, you are invited to subscribe by sending a message to lyris@list.state.ut.us with ‘Subscribe microbiology’ in the subject line. (To unsubscribe, send a message to the same address with ‘Unsubscribe microbiology’ in the subject line.) Once you are a member, you can post messages by sending a post to microbiology@list.state.ut.us. (and please include a relevant subject line).


Biological Terrorism

Personnel from the Utah Department of Health as well as members of several local health departments were invited to join with army reservists to attend an interactive satellite broadcast titled "The Medical Response to Biological Warfare and Terrorism." The broadcast was a three day training seminar developed and presented by the US Army Medical Research Institute of Infectious Diseases (USAMRIID). Topics covered by the broadcast included the epidemiology, detection, diagnosis, and treatment of a variety of microbial agents and toxins that might be used by terrorists to conduct biological terrorism. In addition, participants learned about military and civilian resources available to assist in developing effective intervention programs.

In 1969 President Nixon stopped all offensive biological weapon research in the United States. Since 1969, USAMRIID has been conducting defensive biological warfare research. The US along with other countries signed a treaty prohibiting the development, production and stockpiling of biological weapons in 1972. However, there are some countries and terrorist organizations that continue to support or actively participate in the development and production of biological weapons agents. Biological terrorism has occurred in the United States. In 1984, a religious group put salmonella into salad bars of restaurants in The Dalles, Oregon area to influence a local election. More than 750 persons became ill in that incident. More recently, several hoax incidents involving anthrax and other agents have occurred.

Today, the most significant agents that might be used by terrorists include anthrax, brucellosis, pneumonic plague, tularemia, smallpox, viral encephalidities, viral hemorrhagic fevers, and toxins such as the botulinum toxins, ricin, and staphylococcal enterotoxin B. The most likely method of deploying these agents is through aerial dispersion, although direct contamination of food or water may also be used.

Except for pneumonic plague and smallpox, infections with organisms are not transmissible by casual person-to- person contact. Only those persons who were directly exposed to the contaminated air, water or food would become infected. The lethality of these agents range from almost no mortality to very high numbers. Diagnosis can be difficult because of the non-differentiating signs and symptoms or due to the fact that few clinicians have seen cases of these agents. Disease resulting from biological terrorism may be difficult to distinguish from a naturally occurring infectious disease outbreak. Good epidemiology is important in identifying these events. Maintaining effective disease surveillance is an essential first step in preparedness and is important in effective law enforcement activities.

During recent years, the federal government has established policies that promote increased awareness and preparedness of public health agencies in the defense against biological terrorism. These policies include the enhancement of public health capabilities, more regulation in culture collection procedures, and extension of educational and training opportunities such as the broadcast by USAMRIID.


Is the Food That You Prepare in Your Home Safe?

wpe2.gif (3208 bytes)      Holiday 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 165F.

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.

 wpe3.gif (2353 bytes)      General Safe Food Handling Tips

Keep food out of the "danger zone" (between 45F and 149F). This minimizes bacterial growth that could cause foodborne illness.

Thaw frozen food 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 140F 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 use 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 area.


Utah Department of Health, Bureau of Epidemiology
Monthly Morbidity Summary - October 1998 - 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 142104
Salt Lake City, UT 84114-2104
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