BUREAU OF EPIDEMIOLOGY
Bureau of Epidemiology September 1997 Utah Department of Health
Changes to Influenza Surveillance for 1997-98
Influenza Prevention 1997-98
TB Medication Program
Quarterly Report
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Changes to Influenza Surveillance for 1997-98

The Centers for Disease Control and Prevention (CDC) has requested help from state health departments to improve the national influenza surveillance system by upgrading the sentinel physician surveillance system and improving the electronic transmission of data between the states and CDC. In the past, CDC has had one sentinel physician in Utah who would report the number of influenza-like illnesses seen in the previous week directly to CDC. This year, the Bureau of Epidemiology, with the assistance of the local health departments, has increased the sentinel physicians to nineteen located throughout the state. These physicians will electronically transmit influenza data directly to CDC on a weekly basis.

The school-based absenteeism portion of the active influenza surveillance will remain the same as last year. This has been a good indication of when influenza-like illnesses are present in the school population. The local health department or staff from the Bureau of Epidemiology will contact selected schools or district offices for the number of students absent the previous week. Using the number of students enrolled in the fall, a rate of absenteeism can be determined for the school or district. These numbers are reported by the Bureau of Epidemiology to CDC on a weekly basis. A report will be received the following week from CDC with the state and national influenza summary updates using the sentinel physician and other local and school based data.

For health care providers interested in submitting specimens for influenza testing, a standard throat swab or throat washing is acceptable. Specimens should be collected within three days of clinical onset, kept cold during transport, and received by the State Public Health Laboratory within 24 hours. If you have any questions, contact the Virology lab at (801) 584-8400.

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Influenza Prevention 1997-98

It’s time to get in line for your annual "flu" shot. This year’s vaccine from U.S. manufacturers will contain the following strains: A/Johannesburg/82/96 (H1N1), A Nanchang/933/95 (H3N2), and B/Harbin/07/94.

Those individuals that should be first in line include:

Persons aged 65 or older
Residents of long term care facilities
Adults or children with chronic pulmonary or cardiovascular disorders
Individuals with chronic met-abolic diseases, renal dys-function, hemoglobinopathies, or immunosuppression
Children and teenagers on long-term aspirin therapy
Women who will be in the second or third trimester of pregnancy during the influenza season.

Individuals that work or live with persons at high risk should also be vaccinated. Although receiving the vaccine is recommended for individuals with human immunodeficiency virus (HIV) infection, they should check with their physicians before being immunized.

Only those with a known anaphylactic hypersensitivity to eggs or to other components of the vaccine should not receive the influenza vaccine. For those individuals, a physician should be consulted for other means to prevent influenza this season. (MMWR, Vol. 46, No. RR-9)

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TB Medication Program

Medications for the treatment of Tuberculosis (TB) infection and disease are now available through the local health departments/districts (LHD) and contracted local pharmacies. Previously, medications were only available through the TB Control Program at the Utah Department of Health and required a wait of up to three weeks before a client with a TB infection could start on medication. The change to local provision of medication streamlines this process dramatically. Medications are available through local pharmacies that have developed relationships with the LHD. The State TB Control Program provides an inventory of anti-tuberculosis medications to each contracted pharmacy, enabling rapid dispensing of TB medications.

The state-wide program was modeled after a project conducted by the Weber-Morgan Health District in 1996. The shift to local pharmacy providers has dramatically improved completion of therapy rates for TB infection and disease. Previous to implementing this program, Weber-Morgan had a 30% non-adherence rate for individuals on preventive therapy. Since the initiation of the local dispensing program, non-adherence has been reduced to 8%. This program has offered more autonomy for clients, who can pick up medications at convenient locations and times, and improved accountability for the public health nurses, who can quickly place clients on preventive therapy or disease treatment without delay.

Each LHD has a voucher process that allows clients to obtain medications for the treatment of TB infection or disease at no charge. Please contact the LHD in your area for further information regarding the TB Medication Program. As always, any questions regarding tuberculosis can also be directed to the TB Control Program at (801) 538-6096.

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