Monthly Epidemiology Reports: 2004
2004
Erie County Health Department (ECHD)
(Provided with the permission of the ECHD)
January 2004
Update on Influenza 2003-4 Activity:
During the first two weeks of January 2004, there was a background level of Influenza throughout the county. During mid-January there was decreased activity. However, this was well within the suspected level of influenza activity for this time period. Influenza A (H3N2) activity slowly decreased across New York State during January.
The NYSDOH and the HAN Notification System alerted health care facilities to enhance their surveillance activities for influenza with a special emphasis on watching for the avian flu (H5N1) where a patient has given travel history to Cambodia, mainland China, Indonesia, Japan, Laos, South Korea, Thailand, or Viet Nam.
Update on SARS Activity
We do not know whether Severe Acute Respiratory Syndrome (SARS) will emerge in New York State this year. However, the NYSDOH and ECHD are deep in preparation for handling of such an event. SARS guidance materials have been distributed to health care providers. Legal protocols are being developed to address Isolation and Quarantine Issues. A close watch is being done on the progression of cases and suspect cases of SARS in Asia.
CDC Immunization News Release
On February 12, 2004, the Advisory Committee for Immunization Practices (ACIP) issued a recommendation that health care providers temporarily suspend routine use of the fourth dose of the Pneumococcal Conjugate Vaccine (PCV7) to help conserve vaccine and reduce the risk of shortages caused by production and supply problems at Wyeth Vaccines.
During January 2004, there were 8 reports of food illness. Five were referred to ECHD Environmental Health for field investigations. Two others were referred to NYS Agriculture and Markets for further investigation.
February 2004
Update on Influenza 2003-4 Activity
During February 2004, influenza activity continued at a low level. The concern over the H5N1 affecting the United States is diminishing in that the patterns of transmission in the afflicted counties appears to be bird to human, not human to human. There was also the appearance of the H7N1 in the chicken flocks in Delaware and Texas. However, this variety seems to have a low human pathogenesis.
The NYSDOH has given Erie County a large supply of Influenza 2003-4 Vaccine at the end of February for distribution to private physicians at no charge. If you are interested in receiving some of this vaccine, call Kelly Asher at 858-6025 (Monday thru Friday 8:30 -4:30).
CDC Immunization News Release
On March 2, 2004, the Centers for Disease Control and Prevention issued Advisory 00187, "Suspension of Routine 3rd and 4th Doses of Prevnar". All health care providers should temporarily suspend routine use of both the third and fourth doses of pneumococcal conjugate vaccine (PCV7). CDC had previously recommended the suspension of only the 4th dose. However, the delay in production and distribution is much greater than expected.
During February 2004, there were 9 reports of food illness. Two were referred to ECHD Environmental Health for field investigations. One other was referred to NYS Agriculture and Markets for further investigation.
March 2004
Update on Influenza 2003-4 Activity
Influenza activity on a nationwide basis continues at a low level. In Western New York influenza cases are only sporadic. Typically the Influenza season should end around mid -May. The Centers for Disease Control and Prevention has released the antigen make-up for the Influenza Vaccine 2004-5, that is (A-Fujian, A- New Caledonia, and B- Shanghai).
The NYSDOH has given Erie County a large supply of Influenza 2003-4 Vaccine at the end of February for distribution to private physicians at no charge. If you are interested in receiving some of this vaccine, call Kelly Asher at 858-6025 (Monday thru Friday 8:30 -4:30).
Manufacturer's Recall of Human Rabies Vaccine
The Centers for Disease Control and Prevention issued a notice to readers on April 2, 2004 regarding a voluntary recall by Aventis Pasteur of IMOVAX Lot numbers X0667-2, X0667-3, W1419-2, and W1419-3, distributed in the United States from September 23, 2003 through April 2, 2004. If any of those lot numbers were administered to patients, contact ECHD, Disease Control at 858-7697 for the appropriate corrective action
During March 2004, there were 13 reports of food illness. Four were referred to ECHD Environmental Health for field inspections. Four others were referred to NYS Agriculture and Markets for further investigation.
April 2004
Update on Influenza 2003-4 Activity
The Flu Season is rapidly coming to an end. Influenza A cases have dropped off dramatically during the past few weeks. Some clusters of Influenza B have occurred across NYS, but nothing in Western New York. Some concern is being raised about the timely distribution of Influenza Vaccine 2004-5. The private health care providers are reminded to verify that their orders for the Influenza Vaccine 2004-5 have been processed. This upcoming year is predicted to be the same as previous years, in that, partial orders will be shipped during October, with the remainder being shipped during November or December.
Update on SARS Activity
CDC and WHO are closely following the cases of SARS in China. As of 4/23/04, China confirmed two cases of SARS, one of which expired becoming the first SARS death since July 2003. About 1,000 persons in Beijing and Anhui remain in quarantine following their exposure to SARS cases.
Update on WNV Activity
We are again in the West Nile Virus season. Effective May 1st, reports of dead or dying crows, blue jays, or raptors will be taken at the respective ECHD Environmental Health Offices:
- City of Buffalo Buffalo D.O. 961-6800
- South towns Hamburg D.O. 649-4225
- North towns Tonawanda D.O. 874-1070
- East towns Lancaster D.O. 683-6487
All other dead bird reports go directly to Dead Bird Hotline 1-866-537-2473.
During April 2004, there were 12 reports of food illness. Eight were referred to ECHD Environmental Health for field inspections. Three others were referred to NYS Agriculture and Markets for further investigation.
May 2004
Update on WNV Activity
West Nile Virus has made it way back into the avian population in the Western Region of New York State. Niagara County reported its first confirmed case in a crow. The Niagara Region of Ontario, Canada also has reported a crow to be positive for WNV. To date there have been no confirmed avian cases of WNV in Erie County. Reports of dead or dying crows, blue jays, or raptors will be taken at the respective ECHD Environmental Health Offices:
- City of Buffalo Buffalo D.O. 961-6800
- Southtowns Hamburg D.O. 649-4225
- Northtowns Tonawanda D.O. 874-1070
- Easttowns Lancaster D.O. 683-6487
All other dead bird reports go directly to the Dead Bird Hotline 1-866-537-2473.
Immunization Schedule Update
The Recommended Childhood and Adolescent Immunization Schedule-United States, July - December 2004 has been released. It is available on website:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5316-Immunizationa1.htm
During May 2004, there were 12 reports of food illness. Eight were referred to ECHD Environmental Health for field inspections. One other was referred to Wyoming County Health Department.
June 2004
Update on WNV Activity
On June 17, 2004, Erie County had its first confirmed case of West Nile Virus in a crow found at Brookfield Lane, Clarence on 6/7/04. This was confirmed by Wadsworth Laboratories in Albany. To date there have been no human WNV cases in New York State. As of June 22, 2004, human WNV has been confirmed in 7 states (Arizona, California, Florida, Nebraska, New Mexico, South Dakota and Wyoming.)
Wadsworth Laboratories is no longer accepting dead birds for WNV testing. Reports of dead or dying crows, blue jays, or raptors will be taken at the respective ECHD, Environmental Health Offices. However, reports of dead birds are to be called into the: Dead Bird Hotline 1-866-537-2473.
During June 2004, there were 5 reports of food illness (2 were referred to ECHD, Environmental Health for field inspections; 1 was referred to Cattaraugus County Health Department; 1 was referred to New York State Agriculture and Markets).
July 2004
During July there was a substantial increase in the number of reported cases of Giardiasis (N-19) when compared to the previous reporting periods. However, fifteen of the nineteen cases were found in refugees recently arriving in this area. Campylobacter (N-11) for the month of July has shown a slight increase from the previous months. This is probably due to the seasonal increase in outdoor activity and outdoor cooking. As a preventive measure, ECHD is recommending that all poultry and poultry products be cooked to a minimum of 165 degrees F (internal temperature).
During July 2004, there were 13 reports of food illness. Seven were referred to ECHD, Environmental Health for field inspections, and one was referred to New York State Agriculture and Markets.
August 2004
During August there was another substantial increase in the number of reported cases of Giardiasis (N-32) when compared to the previous reporting periods. Again , twenty-two of thirty-two cases were found in refugees recently arriving in this area.
On August 16, 2004 , ECHD issued Health Advisory #95 regarding Syphilis cases.
Through July 31 st of this year, ECHD has a total of 8 reported Syphilis cases.
There has been a slight increase in the number of cases in the MSM population. A like pattern has also appeared in Monroe County .
During August 2004, there were 18 reports of food illness. Nine were referred to ECHD, Environmental Health for field inspections.
September 2004
Enteric Illness Update
During the month of September there was a substantial increase in the number of reported cases of Salmonella (N-25). Twenty-three of these were linked to a common source referred to as a "point source outbreak".
There was another increase in the reported case of Giardiasis (N-25) during September. As in previous months, 16 of the 25 were in recently arrived refugees.
Update on Influenza Vaccine 2004-5
This year United States is in short supply of Influenza Vaccine 2004-5. There were only two manufacturers of the vaccine, Aventis-Pasteur and Chiron. The latter of the two ran into contamination of the product that resulted in no supply for this year. Nationwide, there were 54 or 55 million doses produced by Aventis-Pasteur. Thirty million doses have been distributed so far. This is a shortfall of the projected 87 million vaccine usage of the previous year. There is also a nasal administered vaccine that was produced this year (approximately 1.1 million doses). The Centers for Disease Control has currently secured the remaining vaccine from Aventis-Pasteur and will be working with state health departments in the distribution for use in "high risk patients".
During September 2004, there were 11 reports of food illness. Five were referred to ECHD, Environmental Health for field inspections. One was referred to NYS Agriculture and Markets; one to Ontario Ministry of Health; and one more to Erie County Health Department in Pennsylvania .
October 2004
Enteric Illness Update
An excessively high number of Giardiasis cases were reported again in October (N-23). The majority of these reports are linked to recently arrived refugees and aliens.
Update on Influenza Vaccine 2004-5
The CDC, the State Health Department and the Local Health Departments are working together in the redistribution of Influenza Vaccine 2004-5. The plan is to ensure that the persons of highest risk receive their vaccination first. There was a Commissioner's Order issued directing that health care providers use the inactivated flu vaccine for patients and health care workers meeting the criteria issued by CDC on 10/5/04. If there are medical providers still in need of influenza vaccine, they should contact ECHD "Flu Hot Line" at 858-2929, to have their name placed on the list.
During October 2004, there were 8 reports of food illness. Five were referred to ECHD, Environmental Health for field inspections. One was referred to Genesee County Health Department.
November 2004
Enteric Illness Update
Again during November the number of Giardiasis cases was higher than expected (N-19). The ECHD Disease Control was able to establish a connection on four of these cases. Eleven others were determined to be recently arrived refugees.
Update on Influenza Vaccine 2004-5
The ECHD has been receiving allocations of Influenza Vaccine 2004-5 for distribution to hospitals, skilled nursing facilities, diagnostic and treatment centers, residential care facilities, and private physicians for use on their health care workers with direct patient contact and patients at high risk of complications from influenza illness. These groups have been notified and directed to contact ECHD Disease Control at 858-7697 to place an order.
Update on Influenza Disease
According to CDC and NYSDOH these is widespread influenza activity throughout the country as well as New York State . Reports are sporadic cases only with an absence of large outbreaks. On 12/14/04 , ECHD was notified about a positive Influenza A Rapid Antigen Test collected from a 14 Y.O., resident of Buffalo . A culture is being grown at WCHOB Virology Laboratory and will be forwarded to ECMC Virology Laboratory for sub-typing.
During November 2004, there were 12 reports of food illness. Five were referred to ECHD, Environmental Health for field inspections. One was referred to New York State Agriculture and markets.
December 2004
Update on Influenza Vaccine 2004-5
Throughout December, ECHD has been receiving an ample supply of Influenza Vaccine 2004-5 for distribution to facilities and health care providers in need. The CDC restricted use guidelines for the influenza vaccine were kept in place until 1/3/05 , when usage was expanded to include:
Adults aged 50 years and older.
Household contacts and out of home caregivers of persons aged 65 and older, persons with chronic conditions such as diabetes, heart or lung disease, or weakened immune systems because of illness or medication, and children less than 2 years of age.
There is still an ample supply of Influenza Vaccine Inactivated and Flu-Mist at ECHD, Disease Control free of charge. Contact ECHD Disease Control at 858-7697 to place an order.
Update on Influenza Disease
According to CDC and NYSDOH these is widespread influenza activity throughout the country as well as New York State . Clusters of cases are been confirmed in long term care facilities and skilled nursing facilities. Within Erie County all the culture positive Influenza A isolates are (H3N2). This Type is covered in the Influenza Vaccine 2004-5.
During December 2004, there were 20 reports of food illness. Thirteen were referred to ECHD, Environmental Health for field inspections.
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