Epi Update for Friday, March 7, 2014
Center for Acute Disease Epidemiology (CADE)
Iowa Department of Public Health (IDPH)
Items for this week's EPI Update include:
- Measles in a border state
- CDC Vital Signs: Antibiotic Rx in Hospitals: Proceed with Caution
- Epidemic of epidemics
- Salmonella and Easter Chicks and Ducklings
- Meeting announcements and training opportunities
Measles in a border state
Two cases of measles have recently been confirmed in McDonough County Illinois, near the Iowa border. Measles is a highly contagious viral illness that is easily spread through the air. Signs and symptoms include high fever, malaise, cough, runny nose, conjunctivitis and rash, and typically appear between seven to 14 days after exposure. Those who are showing symptoms should stay away from others and contact their doctor immediately. Also, any health care professionals who suspect measles in their patients should call public health immediately. Measles is a public health emergency.
Salmonella and Easter Chicks and Ducklings
Outbreaks of Salmonella infections have been linked to exposure to baby chicks and ducklings. Many of these outbreaks have occurred during spring, particularly around Easter. Children are most susceptible to infection because they are more likely than others to put their fingers into their mouths and because their immune systems are still developing. Others at increased risk include persons with HIV/AIDS, pregnant women, the elderly and other immunocompromised persons. Whether your patients raise chicks or ducklings as a source of food or keep them as pets, recommend the following measures to protect them and their families from illness:
- Do not let children under age 5 or others at high risk handle poultry or items contaminated by poultry.
- Wash hands thoroughly after handling poultry or their droppings.
- Do not eat or drink around poultry or their living areas.
- Do not let poultry live inside your home.
- Do not wash the birds' food and water dishes in the kitchen sink.
For more information visit, www.cdc.gov/healthypets/easter_chicks.htm.
CDC Vital Signs: Antibiotic Rx in Hospitals: Proceed with Caution
This week CDC released a "Vital Signs" article describing the risk of poor antibiotic prescribing practices for hospitalized patients. CDC is providing resources for hospitals to use in establishing antibiotic stewardship programs. For more information visit:
Epidemic of epidemics
On February 28th Medscape published Dr. John Bartlett's brief review of the epidemics witnessed in recent years.
Infection with West Nile virus was first reported in New York City in 1999. It is now endemic in all 48 contiguous states. In 2012, 5674 cases were reported, the highest number since 2003. The incidence of Lyme disease in the United States has been reported to be about 30,000 cases, and has increased.
An outbreak of meningitis caused by Exserohilum rostratum was attributed to contaminated products at a compounding pharmacy. Endemic Blastomycosis and Coccidioidomycocsis is recognized in the respective regions but need to be considered outside these known areas.
The largest number of imported malaria cases ever reported was in 2011. An ongoing epidemic of Chikungunya is occurring, including US travelers to the Caribbean.
Pertussis, measles and meningococcal meningitis continue to cause outbreaks and can be a challenge due to refusal of vaccination and the waning of pertussis immunity. The sudden outbreaks of polio internationally are a serious setback to global eradication.
Viral respiratory infections
Middle East Respiratory Syndrome coronavirus (MERS-CoV) and influenza viruses H7N9 and H5N1 are zoonoses and can travel by airplane on patients. They can also be transmitted person-to-person but sustained human-to-human transmission has not occurred.
Outbreaks of Listeria and Cyclospora infections can spread over wide geographic areas due to the massive shipments by trains and trucks. Norovirus in the US accounts for 21 million cases, 71,000 hospitalizations and 1.1 million emergency department visits annually.