Monthly Epidemiology Reports: 1996
Erie County Health Department (ECHD)
(Provided with the permission of the ECHD)
SUMMARY FOR OCTOBER/NOVEMBER 1996
232 pertussis cases in county through November: big spike. Adults are probably the reservoir. Anybody who is symptomatic should be treated, with their contacts, before laboratory confirmation.
Influenza activity has started. Pneumovax should be up to date.
Warn patients about chitterlings -- watch for Yersinia enterocolitis.
According to the recommendations of the Centers for Disease Control and prevention, all the programs offering Influenza Vaccine were to have started by October 1st. This was two weeks earlier than last year. If the pattern remains the same, locally we should expect to see increased flu-like activity at the end of December. Concerns have been voiced by the NYSDOH over the decline in use of pneumococcal vaccine for the persons of high risk. It is recommended that health care providers review their patients to see that they have received their pneumococcal vaccine, if indicated. Indications attached.
The number of reported cases of pertussis is still increasing. As of 10/25/96, there were 17 reported cases bringing the yearly total to 62. This trend is the same in other counties of NYS as well as nationally. Adults are believed to be the reservoir for pertussis and when found to be symptomatic should be referred for testing.
There were eight reports of food related illness during October. Three were referred to the Environmental Food Outbreak Teams for field investigations and further action. One of the reports resulted in a large scale food outbreak investigation that involved 140 persons. 29 of these persons reportedly became ill following the suspect meal.
Pneumococcal vaccine recommended for: all adults aged 65 years and older and adults of all ages with long-term illnesses that are associated with a high risk, including heart or lung disease, diabetes, alcoholism, cirrhosis, or CSF leaks. Also adults with immunocompromise, including splenectomy, hodgkin's, lymphoma, myeloma, kidney failure, nephrotic syndrome and organ transplant.
The number of reported cases of pertussis as of 11/30 is 232. 170 of those cases were reported during November. All of the cases since September have been confirmed by a PCR test at Children's Hospital. All except 9 of these cases have been interviewed and have met the outbreak case definition of pertussis according to CDC guidelines. It appears that the number of reported cases are starting to taper off at the end of November. The NYSDOH is recommending that physicians seeing a patient with pertussis-like symptoms treat the patient and close contacts immediately without waiting for the results of the laboratory work. Further analysis by age group and immunization status appears in the next monthly report.
For the past two years Erie County has experienced clusters of yersiniosis cases from November through January associated with home preparation of "chitterlings". On Nov. 21, 1996, the NYSDOH, NYS Agriculture and Markets and the ECHD met with vendors who retail "chitterlings" in the area. They have been requested to distribute handling and preparation materials with the product in an attempt to stop the recurrence of illness this season. In addition, the media was contacted to air warnings against mishandling the product. Local physicians should be watching for cases of diarrheal illness that may be due to Yersiniosis. The NYS laboratories will offer confirmative testing and serotyping for all Yersinia isolates.
On Dec. 5, the ECHD was notified by the ECMC virology laboratory that they have confirmed their first case of influenza A in a 14 year old male from Buffalo. On 12/6, the Children's Hospital virology laboratory isolated their first case of Influenza A in a 3 week old from Buffalo. Influenza activity has already been confirmed across New York State and other counties.
There were eight reports of food related illness during November. Two of these were referred to NYS Agriculture and Markets for further investigation.
The Pertussis Outbreak that occurred with Erie County is starting to taper off with the report of 64 additional cases during December. The total for the year is now 296. There are currently nine additional positive laboratory reports of Pertussis pending an investigation. Further analysis of this cluster of cases is ongoing.
Influenza activity has been documented throughout New York State. As was stated in last month's report, Influenza Type A was first isolated within Erie County on 12/5/96. The sub typing was not completed until later in the month. It was identified as A/Wuhan/359/95-like(H3N2). The Influenza 96-7 vaccine contained A/Nanchang/933/95(H3N2), therefore there will be cross protection for those exposed to the Wuhan strain. High risk individuals who have not yet been vaccinated are encouraged to consult with their health care providers for vaccination. Those high risk individuals who have contracted influenza should contact their physician for the possible use of Amantadine or Rimantadine.
Confirmed cases of rabies in animals in Erie County has decreased. There were only 8 confirmed cases in 1996, compared to 1994 (N-89) and 1995 (N-44). However, the total number of Post Exposure Rabies Treatments (N-126) for 1996 is quite significant.
During December there were 17 reports of food related illness. Twelve were referred to ECHD Environmental Health for field investigations. One additional report was referred to the New York State Department of Agriculture and Markets for further investigation.