Monthly Epidemiology Reports: 2002
2002
Erie County Health Department (ECHD)
(Provided with the permission of the ECHD)
January 2002
Update on Influenza Activity 2001-2
The first case of Influenza A in Western New York was identified by Rapid Antigen Testing on 12/24/01, by Children's Hospital Virology Laboratory, was further identified as Influenza A Panama-Like (H3N2). This particular strain is cross-covered by the Influenza A Moscow-like antigen in the 2001-2 Influenza Vaccine. During January 2002, five Long Term Care Facilities in Erie County have been reported as experiencing clusters of Influenza-like illness. Four of the five have been identified as Influenza A, either by Rapid Antigen Test, or viral culture.
Erie County still has a limited supply of Influenza 2001-2 Vaccine that is available for private physicians. This may be requested by calling Disease Control at 858-7698.
During January 2002, there were 13 reports of illness involving food establishments. One complaint was referred to NYS Agriculture and Markets for further investigation. Six other reports were referred to ECHD Environmental Health Units for field investigations.
February 2002
Update on Influenza Activity 2001-2
Influenza activity substantially increased throughout Erie County during the month of February. Six additional Long Term Care Facilities were reported as having flu-like illness in their residents. Four of these were confirmed as due to Influenza A. Seven schools reported absenteeism exceeding 10 % due to flu-like illness. Two of the seven closed for one or more days due to teacher illness.
The first isolate of Influenza B in Erie County was from a 10 year old male in a specimen collected on 2/26/02. As was the case in previous years, Influenza B disease is usually milder than Influenza A disease.
Update on West Nile Virus Activities:
The ECHD Vector Laboratory and the Environmental District Offices are gearing up for the upcoming mosquito season. They are requesting that dead birds, especially crows and blue jays, be reported to the Health Department. At this time there are no plans to pick up and ship dead birds for testing for West Nile Virus. Dead bird sightings may be reported to the following locations:
- City of Buffalo - Buffalo District Office 881 - 4052
- Erie County - Central Lancaster District Office 683 - 6487
- Erie County - North Tonawanda District Office 874 - 1070
- Erie County - South Hamburg District Office 649 - 4225
During February 2002, there were 15 reports of illness involving food establishments. Five reports were referred to ECHD Environmental Health Units for field investigations.
March 2002
Update on Influenza Activity 2001-2
By the end of March 2002 influenza activity has rapidly decreased in Erie County. Six Long Term Care Facilities had confirmed outbreaks of Influenza A in their residents. Six schools reported students and/or staff absences exceeding 10%. However, only one school closed for two days due to faculty illness. Statewide and national trends parallels those observed locally.
National Shortage of Td Adult Immunization
The national shortage of Td Adult Immunization has still not been resolved. CDC now states that the shortage may persist until January 2003. In order to assist private medical providers in properly treating their patients, the ECHD Commissioner of Health has offered to provide Td Adult Immunizations for patients meeting one of the following criteria at no charge:
- persons traveling to a country where the risk for diphtheria is high
- persons requiring tetanus vaccination for prophylaxis in wound management
- persons who have received < 3 doses of any vaccine containing tetanus and diphtheria toxoids
- pregnant women who have not been vaccinated with Td during the preceding 10 years.
Procedure: The attending physician should issue the patient a prescription stating which of the above criteria is met. The patient in turn calls the ECHD at 858-6450 for an appointment.
During March 2002, there were 8 reports of illness involving food establishments. One report was referred to NYS Agriculture and Markets for further investigation. Three other reports were referred to ECHD Environmental Health Units for field investigations.
April 2002
Update on Influenza Activity 2002-3
The new ACIP on Prevention and Control of Influenza 2002-3 was released by CDC in the MMWR, Vol. 51/ RR-3 dated April 12, 2002. All indications predict that there should be an adequate supply of Influenza Vaccine. However, distribution in a timely manner to health care providers may be a problem. Orders for influenza vaccine should be placed as soon as possible.
National Shortage of Td Adult Immunizations:
The national shortage of Td Adult Immunization has still not been resolved. CDC now states that the shortage may persist until January 2003. In order to assist the private medical providers in properly treating their patients, the ECHD Commissioner of Health has offered to provide Td Adult Immunizations for patients meeting one of the following criteria at no charge:
- persons traveling to a country where the risk for diphtheria is high
- persons requiring tetanus vaccination for prophylaxis in wound management
- persons who have received < 3 doses of any vaccine containing tetanus and diphtheria toxoids
- pregnant women who have not been vaccinated with Td during the preceding 10 years.
Procedure: The attending physician should issue the patient a prescription stating the patient's name and which of the above criteria is met. The patient in turn calls the ECHD at 858-6450 for an appointment.
Temporary Shortage of Other Childhood Vaccines:
The NYSDOH, New York State Immunization Update Winter 2002 Issue states that DTaP Vaccine shortages may be more so among some health care providers. The national shortage is expected to continue through December 2002.
The Pneumococcal Conjugate Vaccine (PCV-7) has shown spot shortages in both the public and private sectors. Approximately 50 to 60 % of the national need is being supplied at this time. By mid 2002 the shortage should be eliminated.
During April 2002, there were 22 reports of illness involving food establishments. Eighteen of these were referred to ECHD Environmental District Offices for field inspections.
May 2002
Update on Influenza Activity 2002-3:
The Texas Department of Health reported that several hundred children in Austin, Galveston, Houston and El Paso, Texas have been infected with the Hong Kong type B Influenza Virus with the last case being confirmed as recently as May 28, 2002. The antigen for this type of influenza will be included in the 2002-3 vaccine.
West Nile Virus Activity in New York State:
To date, there have been no confirmed human cases of WNV in New York State for this mosquito season. There have been 11 confirmed avian cases of WVN in NYS, (5-Albany County, 4-Rockland County, and 2-Nassau County). Erie County is currently accepting dead bird reports, and shipping dead crows, blue jays and raptor species. Twenty specimens have been sent from Erie County this year and 17 of those have been reported back as negative. During May 2002, there were 15 reports of illness involving food establishments. Six were referred to ECHD Environmental District Offices for field inspections. One additional report was referred to NYS Agriculture and Markets for further investigation.
June 2002
Update on Influenza Activity 2002-3
According to the MSN website, the Potential Killer Flu Virus may be incubating in Asia. Radical shifting of the Hong Kong Flu Virus (known as the H5N1) has been reported. So far, the recent shifts have occurred resulting in strains not primarily affecting humans. These changes may be underway.
West Nile Virus Activity in New York State
To date, there have been no confirmed human cases of WNV in New York State for this mosquito season. On 6/24/02, Niagara County reported it first case of WNV in a crow submitted for testing. On 6/27/02, Erie County reported two confirmed cases of WNV in crows submitted to Wadsworth Laboratories.
Bioterrorism Update
The New York State Department of Health distributed the Bioterrorism Rapid Response Card to all licensed physicians within New York State. The purpose of the response card is to educate private sector physicians on the recognition, treatment and control of potential bioterrorism agents. The Erie County Department of Health has obtained additional cards and will distribute them to other health care professionals on request.
During June 2002, there were 8 reports of illness involving food establishments. Two were referred to ECHD Environmental District Offices for field inspections.
July 2002
Update on Influenza Activity 2002-3
Centers for Disease Control and Prevention stated that there should be ample supply of Influenza 2002-3 Vaccine. However, the distribution by vendor may
directly determine when the individual physician's supply will arrive. Again, the same as last year, CDC is recommending prioritizing patient immunization by risk factor.
West Nile Virus Activity in New York State
To date, there are no confirmed human cases of WNV in Western New York State. As of August 12, 2002, nationwide there have been 145 confirmed cases of WNV, including 8 fatalities.
The States affected are:
- Alabama 2
- District of Columbia 1
- Illinois 2
- Indiana 1
- Louisiana 85
- Mississippi 41
- Texas 13
In Erie County we have confirmed WNV in crows and a blue jay. In addition, we have one confirmed mosquito pool on Grand Island. Literature for preventing WNV is available from ECHD Health Education Office (858-2737). If a physician has a patient with suspect WNV, he/she should contact ECHD Disease Control (858-7698) for diagnosis criteria and testing guidelines. Viral testing is provided by NYSDOH Wadsworth Laboratories at no charge.
During July 2002, there were 16 reports of illness involving food establishments. Seven were referred to ECHD Environmental District Offices for field inspections. Two additional complaints were forwarded to New York State Agriculture and Markets for further follow up.
August 2002
Update on Influenza Activity 2002-3
According to the Centers for Disease Control and Prevention and the ACIP, it is recommended that physicians and health care providers make an effort to target patients of high risk for complications following influenza illness. Administration of Influenza Vaccine for this group should begin in October. All other patients should be immunized starting in November.
West Nile Virus Activity in New York State
ECHD was notified of its first confirmed human case of WNV on September 10, 2002. Following that, one additional case and one suspect case have been reported. Health care providers are asked to review the protocol sent to them by the NYS Department of Health regarding the evaluation of patients for WNV and the appropriate specimen collection.
During August 2002, there were 12 reports of illness involving food establishments. Nine were referred to Environmental Health for further investigation.
September 2002
Update on Influenza Activity 2002-3
There appears to be an adequate supply of Influenza 2002-3 Vaccine for Western New York. The private sector including Kaleida, Independent Nursing Care, Tops, Wegmans, Rite Aid, Vix, and Eckert are starting their clinics in Mid-October. Health Care Providers that are not offering flu vaccine for their patients this year may refer them to ECHD Health Information at 858-7690 for a listing of clinic sites, date and times.
The first isolate of Influenza A was reported by Children's Hospital Virology Laboratory on 10/17/02, from a 6 M.O. living in Jamestown (Chautauqua County) who was subsequently hospitalized at Children's Hospital, Buffalo.
West Nile Virus Activity in New York State
As of October 7th, 2002 there have been seven reports of WNV in humans residing in Erie County, including two living in the City of Buffalo. One has expired and all the others have improved or recovered. An additional sixty-three human specimens have been submitted to Wadsworth laboratories for WNV Testing. Health Care Providers who have patients presenting with Viral Meningitis or Encephalitis are encouraged to submit blood or CSF specimens to NYSDOH Wadsworth Laboratories for WNV and other arborviral testing.
During September 2002, there were 12 reports of illness involving food establishments. Eight were referred to Environmental Health for further investigation. One of the food outbreaks resulted in 25 confirmed cases of Salmonella Group C2, including 10 that were foodhandlers
October 2002
Update on Influenza Activity 2002-3
There appears to be an adequate supply of Influenza 2002-3 Vaccine for Western New York. If a health care provider requires an additional supply of Influenza Vaccine, they may call 858-7698 for a listing of vendors supplying the vaccine. A review of the National Influenza Activity indicates only sporadic cases throughout the United States.
West Nile Virus Activity in New York State
Erie County now has eight reports of WNV in humans occurring during the 2002 mosquito season. The reporting of dead birds has now stopped for this season, and will resume in early Spring 2003. The New York State Department of Health predicts that the resurgence of WNV in Spring 2003 will be more extensive than previous years.
Botulism Type E in Lakes Erie and Ontario
The first reports or high number of "Long Tail Ducks" (formerly called Old Squaw) fatalities along Lake Erie shoreline were reported during Mid October. According to DEC Buffalo Office, this is only the beginning. The Loon and Red Breasted Merganzer migration is still to come. The latter two species were greatly affected during 2001. A warning has been issued to persons using the shoreline, "Not to touch or handle the dead waterfowl during clean up". Also, to restrict pet contact with these carcasses.
During October 2002, there were 10 reports of illness involving food establishments. Five were referred to Environmental Health for further investigation. Two were referred to New York State Agriculture and Markets.
November 2002
Update on Influenza Activity 2002-3
There appears to be an adequate supply of Influenza 2002-3 Vaccine for Western New York. If a health care provider requires an additional supply of Influenza Vaccine, they may call 858-7698 for a listing of vendors supplying the vaccine.
The ECHD has a listing of locations, date and times when Influenza immunizations will be offered by the private sector. To date there have been no laboratory confirmed cases of Influenza A or B in Erie County.
The Wyeth Ayerst drug company released a directive that they will no longer be producing Injectable Influenza Vaccine for 2003-4. In addition, they will no longer produce Pnu-Immune (pneumococcal vaccine). This action will reduce the number of vaccine producers to two in the United States.
Meningococcal Vaccine Shortage
The voluntary recall of single dose Menomune Vaccine by the producers is resulting in a reduction in the number of college bound boarding students receiving meningococcal vaccine. The multi-dose (10 dose vial) is still in adequate supply.
During November 2002, there were 13 reports of illness involving food establishments. Four were referred to Environmental Health for further investigation.
December 2002
Update on Influenza Activity 2002-3
The influenza activity across New York State continues to be very light. As of 12/31/02, there were three Influenza A culture positive cases in NYS (1-Albany, 1 - New York City, and 1- Erie County). The one in Erie County was culture positive and further identified as New Caldonia-like (H1N1). In addition to the culture positive there were reports of five other reports of Influenza A Rapid Antigen positives in patients ages 2 months to 13 Y.O.
Gastro-Intestinal Illness in Long Term Care Facilities
A NYSDOH Problem Alert has been issued regarding numerous long term facilities across NYS having patients and staff presenting with nausea, vomiting, abdominal cramps and diarrhea. Duration of illness appears to be limited to 24 to 48 hours. Illness is most likely due to Norwalk-like Virus.
ECHD Pre-Exposure Rabies Prevention Program
During October and November 2002, the ECHD Disease Control ran pre-exposure rabies prevention clinics. Sixty-eight initial Pre-exposure series were initiated. Two additional persons received boosters. Titers were drawn on 416 previous recipients of the pre-exposure series and submitted to the NYSDOH Rabies Laboratory. ECHD is still awaiting final results on the titer
During December 2002, there were 22 reports of illness involving food establishments. Eight were referred to Environmental Health for further investigation. Four were referred to New York State Agriculture and Markets. One was referred to NYSDOH Health Systems management.
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