Monthly Epidemiology Reports: 2000
Erie County Health Department (ECHD)
(Provided with the permission of the ECHD)
Throughout the month of January there was increased Flu-like activity in Erie County. There were 13 additional Health Related Facilities that had confirmed cases of Influenza A (H3N2) Sydney-like. One school was closed for one day during January due to Flu-like illness in the teachers. On the state level there were 81 confirmed outbreaks of influenza in health related facilities during the latter part of December and the beginning of January.
The New York State Department of Health has set up a Public Web Site for health care providers to monitor Flu-like activity:
The Erie County Health Department has compiled data from a survey of students who will be entering the Seventh Grade in September 2000. The NYS School Immunization Law will require that these students be immunized against Hepatitis B prior to admission in September 2000. Approximately 66% of the these students will need immunizations. To meet the needs of Erie County residents the ECHD will be extending hours at the Free Well Child Clinics until 6:00 PM in the Depew, Hamburg and Tonawanda sites. Appointments only.
CALL 858-6450 TO MAKE APPOINTMENTS
During January 2000 there were 13 reports of food related illness. Two were referred to NYS Agriculture and Markets for further investigation. One additional report was referred to ECHD Environmental Health for a field investigation.
Flu-like activity continued throughout the month of February in Erie County. Centers for Disease Control and Prevention acknowledged that flu-like activity is nationwide. The monitoring of mortality due to pneumonia and influenza in 122 cities indicates an increase by approximately 3% over the previous four years. A region-wide planning committee has been formed including the public and private sectors to address the needs of the community for the Influenza 2000-1 Season.
The New York State School Immunization Law 2164 has been changed to require that students entering the Seventh Grade in September 2000, be immunized against Hepatitis B. To meet the needs of Erie County residents the ECHD will be extending hours at the Free Well Child Clinics until 6:00 PM in the Depew, Hamburg and Tonawanda sites. Appointments only.
CALL 858-6450 TO MAKE APPOINTMENTS
During February 2000 there were 14 reports of food related illness. Seven were referred to ECHD Environmental Health for a field investigation.
Note: There has been a change in the monthly totals of some of the reportable diseases during the months of January and February.
There was a significant increase in the number of reported cases of Salmonella (N-12) during March 2000, when compared to January (N-7) and February (N-3). The twelve cases were all coded as sporadic, in that, none could be linked to another. The sero groupings were B (N-3), C1 (N-5), and D (N-4).
The New York State Department of Health has alerted the counties across the state to be on the watch for a reoccurrence of West Nile Virus this year. Erie County has been listed as Category I. ( No Evidence of WNV ). Health care providers in the area should be on the watch for encephalitis cases and contact the ECHD, Bureau of Disease Control at 858-7698 or after hours at 898-4225. The ECHD, Environmental Health Office has been directed to investigate any reports of dead or dying crows in the area, since that species has a high fatality rate when infected with WNV.
The NYSDOH has set a tentative date of June 1, 2000, for implementation of HIV/AIDS Reportability Law. In an effort to educate health care providers as to their responsibility for reporting, statewide teleconferences are being set for 5/3/00 and 5/12/00. The exact times and locations will be forthcoming.
During March 2000 there were 17 reports of food related illness. Six were referred to ECHD Environmental Health for a field investigation.
Since January 2000, there have been 12 reports of animals found to be positive for rabies within Erie County. These were:
RACCOONS (N-10> Number Location 4 Grand Island 2 Amherst 2 Clarence 1 Lancaster 1 Sardinia FOX (N-2) Number Location 1 (Grey) Aurora 1 (Red) Holland
During that same time period 24 sets of Post Exposure Rabies Series were administered to persons within Erie County.
ECHD is actively engaged in monitoring for West Nile Virus (WNV). To date, three dead crow specimens have been submitted to Ward Stone in Albany for testing. In the near future, the NYSDOH should have a Geographic Information System in place to monitor the positive specimens for WNV. Since Erie County is not an endemic county, no surveillance of mosquitoes is recommended. However, The Town of Amherst is carrying on its own mosquito surveillance program and control measures.
During April 2000 there were 9 reports of food related illness. Four were referred to ECHD Environmental Health for field investigation.
During June 2000 there was an increase in the number of reported cases of Giardiasis ( N-13). Nine of the thirteen were refugees or aliens. The rise appearsto be correlated to the increase parasitic screening for refugees and aliens by the medical providers. The recommendation from Centers for Disease Control and Prevention is that refugees and aliens receive a screening physical within a month of arrival.
Mosquito activity in Western New York State seems to be on an all time high. To date there has been no confirmation of West Nile Virus in patients or other avian specimens submitted to New York State Wadsworth Laboratories. Health care providers were asked to be watching for encephalitis cases with unknown etiology. Persons aware of sick or fresh dead crows are asked to report to the Erie County Health Department.
During June 2000 there were 5 reports of food related illness. Two were referred to the Erie County Health Department Environmental Health for field investigation. One was a sizeable outbreak with approximately 50 persons exposed, resulting in 57% of the persons becoming ill following the meal.
Again in July , the number of reported cases of Giardiasis continues to rise (N-17). Nine of the seventeen were reported in refugees or aliens. The total for the year is now 84.
The ECHD was notified on 8/4/00, that a dead crow submitted for testing was found positive for West Nile Virus (WNV). According to the NYSDOH WNV Plan this means that ECHD moves from a Tier I to a Tier III. Active and Passive Surveillance Activities would be enhanced. A mass education campaign has been started both for the health care providers and the general public. In addition, the ECHD has started larval and adult mosquito monitoring to determine the presence of the Culex and Aedes species. The dead bird sighting activity is being continued. Only fresh dead crows are being submitted to the laboratory for testing. Health care providers are asked to be on watch for cases of encephalitis or aseptic meningitis that may be due to WNV. CSF and or Sera will be tested for arborviral agents at NYSDOH Wadsworth Laboratories at no cost. If there are any questions on this matter, contact the ECHD, Bureau of Disease Control at 858-7698, or After hours at 898-4225 (MERS).
During July 2000 there were 9 reports of food related illness. Four were referred to ECHD Environmental Health for field investigations. Two additional ones were referred to NYS Agriculture and Markets for product testing.
The focus of the Erie County Health Department for August was on West Nile Virus (WNV) and the implementation of control measures. On 8/4/00, ECHD received notice from NYSDOH Wadsworth Laboratories that there was a crow submitted that had proven positive for WNV. Upon receiving this notification steps were taken to do a mass education campaign for the general public. In addition, special information was disseminated to health care providers and an Active Surveillance Program for WNV was started.
Simultaneously, Environmental Health embarked on surveillance in the locality of the positive bird. Larvae sampling and adult mosquito sampling was started. Larviciding was started in areas of standing water. As of 9/15/00, there have been 11 birds confirmed as having WNV.
As of 8/31/00, the NYSDOH has changed the list of Reportable Communicable Diseases.
Chlamydia trachomatis infection
Group B streptococcal infections (invasive disease)
Streptococcus pneumoniae infections (invasive disease, both sensitive and resistant strains)
Single nosocomial cases of newborn diarrhea and newborn staphylococcal infection
During August 2000 there were 9 reports of food related illness. Four were referred to ECHD Environmental Health for field investigations.
During the latter part of September, the Erie County Health Department had started to downsize the activities for West Nile Virus Surveillance due to an early frost. The dead bird surveillance, especially dead crows, will continue until late Fall. WNV will likely return in early Spring of 2001. At that time, the focus will be on timely human case identification and surveillance of ponding water to determine if the infected mosquitoes have over wintered.
The ECHD has started its annual Pre-Exposure Rabies Clinic for animal handlers, dog control officers and wildlife rehabbers. Over 450 serologies were drawn for rabies titers and an additional 65 persons were started on the three dose Pre-Exposure Rabies Series.
There is a delay in the shipments of the 2000-1 Influenza vaccine orders. The ECHD had still not received its limited supply. If a health care provider is having difficulty obtaining a supply of Influenza Vaccine, he may contact ECHD, Disease Control at 858-7698 for a list of alternate suppliers. The CDC has revised the Vaccine Information Form (VIF) for 2000-1 Influenza Vaccine and Pneumococcal Vaccine. Copies may be obtained from ECHD Disease Control.
During September 2000 there were 8 reports of food related illness. Six were referred to ECHD, Environmental Health for field investigations and one was referred to Niagara County.
The problem with the delay in shipments of the Influenza 2000-1 Vaccine has still not been resolved. The latest version is that shipments are to be expected by the end of November, or according to some vendors not at all. The immediate focus of influenza vaccine use should be for high risk individuals and persons working directly with these high risk persons. The ECHD has been informed that General Injectables & Vaccine (GIV) (1-800-521-7468) has ample supply of Influenza Vaccine. However, their price is somewhat higher. To date there have been no confirmed cases of influenza in New York State.
During October, there was a significant number of reported cases of Viral/Aseptic Meningitis (N-16). A large number of these were found to be due to Enterovirus. These numbers are within the expected norms that occur with this seasonal illness (July thru October).
During October 2000 there were 13 reports of food related illness. Seven were referred to ECHD, Environmental Health for field investigations. One additional complaint was referred to Wyoming County.
Update on Influenza Vaccine 2000-1: According to the vaccine suppliers, the back orders will be filled during the first half of December for health care providers who previously ordered vaccine. The vaccination programs have been restarted by Kaleida Health at the Tops and Wegman Stores. ECHD has started its influenza vaccine program for the medically indigent at the homeless shelters and soup kitchens. To date there have not been any reported isolates of Influenza in Western New York. If a health care provider is interested in culturing for Influenza, arrangements may be made by contacting ECHD, Disease Control at 858-7698 for Viral Culture Kits. The ECMC Virology Laboratory has the antigens for testing all three strains of influenza contained in this year's vaccine.
The number of reported cases of Viral/Aseptic Meningitis have dropped off during the month of November (N-3). This is consistent with the expected level of disease for the month.
During November 2000 there were 7 reports of food related illness. One was referred to ECHD, Environmental Health for a field investigation. One additional complaint was referred to NYS Agriculture and Markets.
Update on Influenza 2000-1 Activity: The most recent directive from the Centers for Disease Control state that due to the late arrival of Influenza Vaccine, the immunization programs should continue "through the month of January and beyond." As of 12/28/00, Influenza Type A has been confirmed in the Bronx; and Influenza Type B in Nassau and Suffolk Counties. To date there have been no isolates of influenza in Erie County. The ECHD Active Surveillance is showing a slight increase in Flu-like activity throughout the county.
Update on the NYSDOH West Nile Plan 2001: The planning meetings and draft of the WNV Plan are currently being reviewed on a statewide level. Input from the affected counties is being received via Bi-weekly teleconferences with NYSDOH. Surveillance activities will be started in May 2001. Focus will be on identification of mosquito pools and testing to determine if WNV has over wintered. Enhanced human surveillance will be focused on identification and reporting of all Aseptic/Viral Meningitis and Encephalitis Cases.
During December 2000, there were 11 reports of food related illness. Four of these were referred to Environmental Health Offices for further investigation.