Section 3 Narratives for Selected Reportable Diseases/Conditions Of

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83 Section 3: Narratives for Selected Reportable Diseases/Conditions of Infrequent Occurrence

84 Section 3: Narratives for Selected Reportable Diseases/Conditions of Infrequent Occurrence

Summary

Age Age (in Years)

Gender

Race

Ethnicity Table 1. Characteristics of Anaplasmosis Cases Reported in 2016, Florida in 2016, Reported Cases Anaplasmosis of Characteristics 1. Table was exposedcase howeverCounty.one inJohns St. Five 2016. ofwereinthe six acquired cases northeastern U.S.states where vector isthe common, Allsix of cases reported in2016 were 60 years or older. Onsetdates ranged Mayfrom to ofAugust Seepreventioneducation. Table1 additionalonforinformation anaplasmosiscasesreported in2016. ofillness, understand burden epidemiology species,the of each areas andofhigh target incidence for uncommon.isit Surveillanceanaplasmosis is for intended to incidencemonitor overtime, estimate innortheastern acquired the and midwesternU.S. vectorsis possible. tick,and is Anaplasmosis transmittedhumans bitesto by primarily tick from aches. Anaplasma granulocyticanaplasmosis(HGA)when thewasbacterium genus changed from humanpreviously as known granulocyticehrlichiosis (HGE), butwas humanlaterrenamed ais tickAnaplasmosis Anaplasmosis

Number of cases in 2016 5-year trend (2012 to 2016)

Mean Median Min-max

Female Male Unknown gender

White Black Other Unknown race

Non-Hispanic Hispanic Unknown ethnicity Narratives for Selected Reportable Diseases/ConditionsNarratives Reportable ofInfrequent forSelected Occurrence

Moresevere infections can seenbe in theelderly and those who immunosuppressed.are I. pacificusI. . Typical . symptomsof anaplasmosis include fever,headache, chills,malaise,and muscle

Unlike ehrlichiosis, mostHGA cases reported in Florida aredue infectionsto , , the western black - borne bacterialborne disease caused by

Number

60 60 - 75

67 66

2 4 0

4 0 0 2

4 0 2

(Percent) (33.3) (66.7) (0.0) (Percent) (66.7) (0.0) (0.0) (33.3) (Percent) (66.7) (0.0) (33.3) - legged tick.

Case Classification Case

Outcome

Outbreak Status

Location Where Exposed

County of Residence

Confirmed Probable

Interviewed Hospitalized Died Died

Sporadic Sporadic Outbreak-associated Outbreak status unknown

Maine Florida Massachusetts New York

Miami-Dade Miami-Dade Alachua Duval St. Johns Sumter Anaplasma Co

- infectionwith other pathogens foundin these Anaplasmaphagocytophilum

infectionscan acquired be in Florida but

Number

Number Ixodes scapularis

3 3

4 1 0

6 0 0

3 1 1 1

2 1 1 1 1

(Percent) (50.0) (50.0) (Percent) (67.0) (16.7) (0.0) (Percent) (100.0) (0.0) (0.0) (Percent) (50.0) (16.7) (16.7) (16.7) (Percent) (33.3) (16.7) (16.7) (16.7) (16.7)

Ehrlichia

, black, the .wasIt to - legged

85 Section 3: Narratives for Selected Reportable Diseases/Conditions of Infrequent Occurrence

86 Section 3: Narratives for Selected Reportable Diseases/Conditions of Infrequent Occurrence

Table 2. Characteristics of Brucellosis Cases Reported in 2016, Florida 2016, in Reported Cases Brucellosis of Characteristics 2. Table eatingunpasteurized softcheeses. Floridathat(note non risks.exposureaddition, aIn residentwas beconfirmedTexas infected to with Brucella 12 overa hadpre a case This casewasconfirmed causedby wasconfirmed There one one and probable caseofbrucellosisin Florida in2016.residents The in2016. reported toa responding bioterrorist incident. See Table2 additionalforinformation brucellosiscaseson productsincluding contaminated transfusion,andfood, organtransplant products;and detectingand preventprophylaxis laboratoryto exposure earlierawareness diagnosisand offor infected treatment persons; intervening early providing and identifying populationsat risk toallow targeted for prevention outreach; increasing healthcare provider actionsthat health be can takentohelpincidence infection.reduce ofthis actionsinclude These Brucellosisinfections.is toreportablepublic health authorities because aretherea of publicnumber and cattleinfected sheep, with withassociatedcommonly them.U.S.,Outside the unpasteurized productsmilk frominfected goats, anddolphinsdogs Although infectedbe may with own their swine to feral infectedwith oranimal human cultures. Humaninfections in Floridaare most commonly with exposureassociated thewithbacteria. Laboratorians be can atrisk to exposurefor exposedwhenbe into theycan contact withcome infectedanimals orproductsanimal contaminated pain, andjoint fatigue. bacteriaare primarilyThese among reservoirs,animaltransmitted but people Brucellosis weakness. cancause alsolong symptoms inof humans that includemay fever,sweats,back headaches, loss, weightand pain, systemicBrucellosisa is byillnessof several species caused Brucellosis

Summary

Age Age (in Years)

Gender

Race

Ethnicity

Number of cases in 2016 5-year trend (2012 to 2016)

Mean Median Min-max

Female Male Unknown gender

White Black Other Unknown race

Non-Hispanic Hispanic Unknown ethnicity Narratives for Selected Reportable Diseases/ConditionsNarratives Reportable ofInfrequent forSelected Occurrence culturesresulted fromthis case. The probable case wasa homeless man who recalledno - monthperiod. Thirty

- existinghealth condition (diabetes mellitus)and was culture - Florida residentsare notincluded in Table 2). The Texas resident reported

Number

50 50 - 54 B.suis

52 52

0 2 0

1 1 0 0

2 0 0 -

(Percent) (0.0) (100.0) (0.0) (Percent) (50.0) (50.0) (0.0) (0.0) (Percent) (100.0) (0.0) (0.0) one potentiallaboratory exposures involving laboratoriansworking with B. melitensis B. suis .Dogs and domestic livestock may also infected be with

. Risk . includedfactors working in aslaughterhouse andhunting.

Case Classification Case

Outcome

Outbreak Status

Location Where Exposed

County of Residence

- -

Confirmed Probable

Interviewed Hospitalized Died Died

Sporadic Sporadic Outbreak-associated Outbreak status unknown

Florida

Gadsden Hillsborough relatedinfections developing;from detecting potentially lasting orchronic symptoms thatinclude recurrent fevers,

and B. abortusB.

Brucella areimportant sourcesof human Brucella Brucella

Number

species,human illness is not bacteriathatcan cause a range

1 1

2 2 0

2 0 0

1 1 species whileworkingwith

(Percent) (50.0) (50.0) (Percent) (100.0) (100.0) (0.0) (Percent) (100.0) (0.0) (0.0) (Percent) (100.0) (Percent) (50.0) (50.0) B. melitensis - positive threetimes

B. suisB. while in .

Summary

Age Age (in Years)

Gender

Race

Ethnicity Table 3. Characteristics of Chikungunya Fever Cases Reported in 2016, Florida in 2016, Reported Cases Fever Chikungunya of Characteristics 3. Table had symptom onsetsymptom had ofnear2015theend butwere notreported until2016. criteria toassembletheas onsetdate). data (such casesinincludedas 2016 cases this Two report incounts Case reportarethis based year on report and differmay other from usereports that different additionaloninformation chikungunyacasesreported in 2016. fever transmission,ongoing overincidencemonitor andtime, estimate theburdenof illness. identify important to implementindividualand control cases measures toprevent introductionand resultedinimmunityin2014 people in manyfor Surveillance thoseareas. chikungunya for isfever reasonprimary thisfor decrease. Extensive inspreadCentralSouth and and the America Caribbean Infection withchikungunya virus isbelieved lead to tolifetime immunity, whichisconsidered to be the OverallinincidenceFloridadramaticallydecreased cases) andcases).(121 2016 in2015 (10 with chikungunya fever, casesreported.No 12 locallycaseswere identifiedin2015 or2016.acquired identifiedinFloridaand Florida was residents theonlyU.S. state continental localto casesofreport identifiedbeen inhas countries Americas.throughoutand theCaribbean the 2014, 442 caseswereIn was reportedAmericas on theisland of St.Martin 2013.SinceinDecember local then, transmission or organtransfusion transplants. autochthonous firsttransmission The ofchikungunya virus inthe that mosquitoes andtransmit Zikaviruses).dengue virusRarely the be can transmitted bloodthrough oftenvirus most isspreadtopeople by infectedwhenbecomeMosquitoes theyon feed personalreadya infected withvirus. the Chikungunya oryears. months muscle pain, headache, jointswelling, orrash. ofchikungunyasymptoms virus infection areand jointpain. Otherfever symptoms includemay aisChikungunya fever mosquito ChikungunyaFever

Number of cases in 2016 5-year trend (2012 to 2016)

Mean Median Min-max

Female Male Unknown gender

White Black Other Unknown race

Non-Hispanic Hispanic Unknown ethnicity Narratives for Selected Reportable Diseases/ConditionsNarratives Reportable ofInfrequent forSelected Occurrence Chikungunya virus is transmitted topeople through thebites ofinfected mosquitoes.

Number

19 19 - 68

40 40

7 3 0

6 1 2 1

3 6 1

(Percent) (70.0) (30.0) (0.0) (Percent) (60.0) (10.0) (20.0) (10.0) (Percent) (30.0) (60.0) (10.0) - borneillness caused by the chikungunya virus. Themost common Aedes aegypti

Case Classification Case

Outcome

Outbreak Status

Location Where Exposed

County of Residence

Confirmed Probable

Interviewed Hospitalized Died Died

Sporadic Sporadic Outbreak-associated Outbreak status unknown

South America Asia Caribbean Central America Mexico or Caribbean

Palm Beach Broward Duval Hillsborough Manatee Pinellas Relapse of jointpain canoccur and may persist for

and Aedesalbopictus

Number

2 8

8 2 0

0 0

4 2 2 1 1

4 2 1 1 1 1

(Percent) (20.0) (80.0) (Percent) (80.0) (20.0) (0.0) (Percent) (100.0) (0.0) (0.0) (Percent) (40.0) (20.0) (20.0) (10.0) (10.0) (Percent) (40.0) (20.0) (10.0) (10.0) (10.0) (10.0)

mosquitoes (thesame See Table 3 for

87 Section 3: Narratives for Selected Reportable Diseases/Conditions of Infrequent Occurrence

88 Section 3: Narratives for Selected Reportable Diseases/Conditions of Infrequent Occurrence

Summary

Age Age (in Years)

Gender

Race

Ethnicity in Florida health careproviders.inFlorida health 2005 cases reported from Average time fromonsettodiagnosisyearswas 1.1 in2016,which improved has 1.75 years from for enhancedregional to andtraining outreach efforts, population orother demographics, factors. was primarilyresidence countiesin thecentral in ofpartthe state. unclearisIt if distribution this is due National to the Program,DiseasewhichHansen’s tendtohaveyounger aage.Case median county of wereold.yearsone exceptolder age≥53 This distribution differs fromoverall casesreportednational people, contact wasthose years 50 earlier. ofmedianinfectedpeople age The all wasand years 67 wereas Floridareported difficultoftenis identify. to However,seven infectedpeoplespent or most livesall their inFloridaand Due to thelong incubationperiod forHansen’s disease and a mobile population, location ofexposure oninformation Hansen’s casesreported disease in 2016. minimizenerve permanent and prevent damage further transmission.4See additional Table for Surveillanceimportantisto earlyappropriatefacilitate diagnosisand treatmentexpert by an to possiblyarmadillosand soilas contaminated a ofsourceexposure beingis investigated further. bethought was endemicto innot Florida. More recently nationally,inFloridaand of theinfectedrole respiratorydroplets closeextendedfollowing contact with infectedperson.an Historically, disease the Once spread. recognized, istreatment effective. are Bacteria tospreadthoughtperson andhighly devastatingcontagious disease.stillis clearlyTransmission defined,not butit hardis to resultincrippling can ofparalysis, and feet, hands andLeprosy blindness. aswas a once feared andearlytreatment, disease diagnosis can the beHowever, cured. leftif theuntreated,nervedamage leprae Mycobacterium (alsodisease Hansen’s infectionknownan leprosy)isby as slowcaused the Disease(Leprosy) Hansen’s Table 4. Characteristics of Hansen’s Disease (Leprosy) Cases Reported in 2016, Florida 2016, in Reported Cases (Leprosy) Disease Hansen’s of Characteristics 4. Table

Number of cases in 2016 5-year trend (2012 to 2016)

Mean Median Min-max

Female Male Unknown gender

White Black Other Unknown race

Non-Hispanic Hispanic Unknown ethnicity Narratives for Selected Reportable Diseases/ConditionsNarratives Reportable ofInfrequent forSelected Occurrence . affect. canIt the nerves, skin, eyes,and lining of the nose (nasal mucosa). With

Number

37 37 - 81 - acquired. Only three people reporteddirect armadillo and contact forone of through 2014.Earlier diagnosis mayin be part due to increased awareness

65 67

2 0 0

0 0

(Percent) (38.9) (61.1) (0.0) (Percent) (88.9) (11.1) (0.0) (0.0) (Percent) (100.0) (0.0) (0.0)

Case Classification Case

Outcome

Outbreak Status

Location Where Exposed

County of Residence

Confirmed Probable

Interviewed Hospitalized Died Died

Sporadic Sporadic Outbreak-associated Outbreak status unknown

Unknown Florida

Brevard Martin Alachua Hillsborough Orange Polk Seminole

Number

1 0

0 1

2 1 1 1 1 1

(Percent) (100.0) (0.0) (Percent) (100.0) (5.6) (0.0) (Percent) (94.4) (0.0) (5.6) (Percent) (61.1) (38.9) (Percent) (61.1) (11.1) (5.6) (5.6) (5.6) (5.6) (5.6)

- growingbacteria - to - person via

Summary

Age Age (in Years)

Gender

Race

Ethnicity Table 5. Characteristics of Hepatitis E Cases Reported in 2016, Florida 2016, in Reported Cases E Hepatitis of Characteristics 5. Table cases. was lost case to follow with exposuresassociated inother countriesin2016. infectionOnlyone in wasFlorida. acquired One whentoCompared2015 of six reportedfour infections were acquired inFlorida, infections weremost See trends. 5 additionalfor Table oninformation E hepatitis casesreported in2016. liver loss, andfailure, Surveillance fetal death. U.S.conductedis inthe to andincidencemonitor withhepatitis E, particularlyin those secondthe or third trimester,are at an millionthree acutecasesofhepatitis overE,hepatitis and E 57,000 becauseit important ais causesignificantof morbidity withestimatedan 20 million HEV infections, Mostlocallyinfections acquired no report specific risk Surveillance factors. hepatitis Efor worldwide is pigs; to exposure ofundercookedconsumption pork, wild orshellfish; andgame, blood transfusions. Althoughwater. rareindeveloped outbreaksindividualand countries, linked cases have been to stoolsof infectedthe persons. Globally,HEVtransmitted is mainlycontaminatedthrough drinking causeHEValsochronicinfection,primarily may inimmunocompromised virus is persons. The shed in liver acute particularly failure, womanpregnantand with persons among preexisting liver disease. stool,and colored jointpain. Hepatitis usuallyE is self includeloss fatigue, offever, appetite, vomiting,nausea, pain,abdominaldarkurine, jaundice, clay symptomsoccur, do When theyaresimilar tothoseof other oftypesacute viral and can hepatitis developingworld,epidemicslarge causing ofacute hepatitis.Many areasymptomatic. infections E isliverHepatitis a hepatitis causedby disease the E virus (HEV).HEV iswidespread inthe E Hepatitis

Number of cases in 2016 5-year trend (2012 to 2016)

Mean Median Min-max

Female Male Unknown gender

White Black Other Unknown race

Non-Hispanic Hispanic Unknown ethnicity Narratives for Selected Reportable Diseases/ConditionsNarratives Reportable ofInfrequent forSelected Occurrence

- up andup exposures were unknown. No commonalities wereidentified among

Number

20 20 - 58

46 50

1 4 0

3 0 1 1

3 1 1

(Percent) (20.0) (80.0) (0.0) (Percent) (60.0) (0.0) (20.0) (20.0) (Percent) (60.0) (20.0) (20.0)

Case Classification Case

Outcome

Outbreak Status

Location Where Exposed

County of Residence

Confirmed Probable

Interviewed Hospitalized Died Died

Sporadic Sporadic Outbreak-associated Outbreak status unknown

Florida Bangladesh Mauritius Saudi Arabia Saudi Arabia Unknown

Manatee Miami-Dade Miami-Dade Okaloosa Orange Palm Beach - limiting,butsome cases developmay into

Number

Number - relateddeaths. Pregnant women

4 1

4 1 0

4 0 1

1 1 1 1 1

(Percent) (80.0) (20.0) (Percent) (80.0) (20.0) (0.0) (Percent) (80.0) (0.0) (20.0) (Percent) (20.0) (20.0) (20.0) (20.0) (20.0) (Percent) (20.0) (20.0) (20.0) (20.0) (20.0) increasedrisk ofacute

89 Section 3: Narratives for Selected Reportable Diseases/Conditions of Infrequent Occurrence

90 Section 3: Narratives for Selected Reportable Diseases/Conditions of Infrequent Occurrence

Summary

Age Age (in Years)

Gender

Race

Ethnicity 1 mortalitiesreportedin theyear.2016 report influenza Seethan season. 6 additional for Table oninformation thesix influenza influenzawere17 10 season, deaths Datareported. summarized are onhere report based year rather startsin season October yearand each continuesMaythrough year.the During2016of following the seeseason,influenza Section 6: Influenzaand Influenza syndromic Forand additionalsurveillance. information aboutinfluenza 2016surveillance the and activityusingvariety a conducted isof surveillance includingsystems, laboratory pediatricdeaths are reportablein Florida. Additional surveillance influenza of and influenza Individualwomen.of novel (acases influenzanew influenza) andof subtype influenza prevention,influenza particularly inhigh outbreaks;and detect determine theonset, peak, waneinfluenza and of seasonto assistwith Surveillancepandemics. identifyconductedalso is to unusually ofinfluenza;presentations severe virus,which theyearvaccineanddetermine helps compositioneach prepare andepidemics for vaccinated to isget each year. Influenzasurveillanceconductedis changes into influenzadetect the bestwaynose. The preventpreventand severeinfluenza to complicationsoroutcomes infection from orobject surface a with contaminated influenza virus own then touching their oreyes,possibly mouth, orsneeze,Less people cough, often, atalk. person mightinfectedbecome with byinfluenza touching 2010. millionillnesses,140,000to710,000hospitalizations, and 12,000to56,000 annuallydeaths since and Control PreventionDisease estimate influenza thatresulted inbetween has 9.2 million 60.8and orInfluenza, is flu, a respiratoryinfection caused byvarietya influenzaCenters of viruses. The for Influenza Table 6. Characteristics Influenza of Characteristics 6. Table

Number of cases in 2016 5-year trend (2012 to 2016)

Mean Median Min-max

Female Male Unknown gender

White Black Other Unknown race

Non-Hispanic Hispanic Unknown ethnicity

UnitedStates. Available at Influenza Illnesses,Medical Visits,Hospitalizations, and Deaths Averted by Vaccination in the RolfesMA, Foppa IM, GargS, Flannery B, Brammer L, Singleton JA, et al. 2016. Estimated Narratives for Selected Reportable Diseases/ConditionsNarratives Reportable ofInfrequent forSelected Occurrence 1

Mostexperts believe influenza that virusesspread mainlyby made whendroplets infected - AssociatedPediatric Mortality

Number

5 5 - 16

11 11

4 2 0

4 0 2 0

4 2 0 -

(Percent) (66.7) (33.3) (0.0) (Percent) (66.7) (0.0) (33.3) (0.0) (Percent) (66.7) (33.3) (0.0) Associated Pediatric Mortality Pediatric Associated 2016, Reported Cases in Florida www.cdc.gov/flu/about/disease/2015 - risk populationsrisk likethe very young, elderly, the and pregnant

Case Classification Case

Outcome

Outbreak Status

Location Where Exposed

County of Residence

Confirmed Probable

Interviewed Hospitalized Died Died

Sporadic Sporadic Outbreak-associated Outbreak status unknown

Florida New Hampshire

Broward Collier Monroe Orange Palm Beach Sarasota

- Like Like IllnessSurveillance. Note thatinfluenza

Number

Number - 16.htm

6 0

3 4 6

6 0 0

5 1

1 1 1 1 1 1

(Percent) (100.0) (0.0) (Percent) (50.0) (66.7) (100.0) (Percent) (100.0) (0.0) (0.0) (Percent) (83.3) (16.7) (Percent) (16.7) (16.7) (16.7) (16.7) (16.7) (16.7) .

- - based surveillance based associated pediatric associated

- associated - like illness - 17

- Summary

Age Age (in Years)

Gender

Race

Ethnicity from the international from the Floridacaseand the ofclustercases. on specimenscollected during theinvestigation and identified identical genotype D8measlesvirus twoinfected members. family CentersThe Diseasefor ControlPrevention and sequencingconducted internationallycase. acquired measles adult That infectedan childunvaccinatedinFlorida, who inturn same from the household. cluster resulted aThe vaccinatedadultfrom exposedinIllinois toan oftheOut confirmedfive casesinwere2016, four epidemiologically and of threethosewerelinked Table7 additional for information on measlescasesreported in 2016. ofsymptoms measles earlyto facilitate reducethe risk diagnosis and of furthertransmission. contacts. susceptible isIt importantalso educate to potentially andthe people about signs exposed transmittingthevirus to byothers isolatingthe infectedperson identifyingand vaccinatingand any Surveillancetalks. measlesfor importantis identify to infectedpeople and them prevent from from the mouth,nose,orthroatinfected ofan usually person, personwhencoughs, orthe sneezes, Measles appears. inisonlyhumans,is and found byspreadof aerosolized droplets saliva mucus or susceptible people canamong spreadand others to from daysfourbefore to daysfourafter the rash orred reddish cough, runnynose,redeyes, soreand throat,possibly insidespots tinyfollowed by white the mouth, a www.measlesrubellainitiative.org control measles isefforts availableMeasles & Rubella Initiativethe on atwebsite infected incases others theircommunities,causing outbreaks.Additional information on global while infected abroad, traveling symptomaticbecame afterreturning tothe andU.S.,United insome casesimportedMost U.S.measles into the havefrom come U.S.whounvaccinatedresidents became France, Kingdom, Germany,Philippines,India,and the whereoutbreaks large have been reported. importedhasbeen into measles theU.S. from frequentlyvisitedUnited including countries, the arerateslow, countriessome including inAfrica, Europe,andAsia, thePacific. years,In recent disease has the illnesschildren,ininfants, adults.and young Most people havenow vaccinatedin U.S. been the and virus.Beforea routinevaccination programwas introducedintheU.S., measleswas common a isalsoMeasles, as vaccineknown rubeola, a (Rubeola)Measles Table 7. Characteristics of Measles (Rubeola) Cases Reported in 2016, Florida in 2016, Reported Cases (Rubeola) Measles of Characteristics 7. Table

Number of cases in 2016 5-year trend (2012 to 2016)

Mean Median Min-max

Female Male Unknown gender

White Black Other Unknown race

Non-Hispanic Hispanic Unknown ethnicity Narratives for Selected Reportable Diseases/ConditionsNarratives Reportable ofInfrequent forSelected Occurrence - brown generalizedmaculopapular rash, and high fever.Measles is highlycontagious become Measlesrare. isstillcommon in manypartsof theworld where vaccination

Number

3 3 - 48

24 30

2 3 0

5 0 0 0

2 3 0

(Percent) (40.0) (60.0) (0.0) (Percent) (100.0) (0.0) (0.0) (0.0) (Percent) (40.0) (60.0) (0.0) . Atypical case of measles beginswith mild tomoderate fever,

Case Classification Case

Outcome

Outbreak Status

Location Where Exposed

County of Residence

Confirmed Probable

Interviewed Hospitalized Died Died

Sporadic Sporadic Outbreak-associated Outbreak status unknown

Florida Illinois

Miami-Dade Miami-Dade Collier - preventable respiratorydisease causedby the measles

Number

5 0

5 2 0

1 4 0

4 1

(Percent) (100.0) (0.0) (Percent) (100.0) (40.0) (0.0) (Percent) (20.0) (80.0) (0.0) (Percent) (80.0) (20.0) (Percent) (80.0) (20.0)

See

91 Section 3: Narratives for Selected Reportable Diseases/Conditions of Infrequent Occurrence

92 Section 3: Narratives for Selected Reportable Diseases/Conditions of Infrequent Occurrence

Summary

Age Age (in Years)

Gender

Race

Ethnicity

Serogroup Table 8. Characteristics of Meningococcal Disease Cases Reported in 2016, Florida in 2016, Reported Cases Disease Meningococcal of Characteristics 8. Table 1 vaccines. transmission.Surveillanceconductedalsois toeffectivenessmonitor ofimmunization programsand arein actions totaken responseevery suspected disease meningococcal to prevent case secondary diminished. a multicaused also majorityofinvasivecases disease meningococcal insouthFloridaover thepasteighthas and years meningitidis themostB is identifiedserogroup.frequently Beginning inlate 2008,a dominant ofclone infectioncausing serogroup inFlorida, which significantlydiffers national from wheretrends serogroup againstprotectionthese serogroups. meningitidis inhalation ofor respiratorynose droplets from the ofor a throat colonizedinfectedperson. or Five oftendeadly.illnessescan Bacteriabe are and severe spreadpersonto personby directfrom contact brain of and the spinalcord bloodstream(meningitis)and infections (bacteremiaor septicemia). bacteriaSometimes the causebodycertainillnesses,invadeand infections the ofincluding thelining in bacteria thebackand of their throatnose with or symptomssigns no of (i.e.,disease colonized). disease causedMeningococcal isby Disease Meningococcal

Number of cases in 2016 5-year trend (2012 to 2016)

Mean Median Min-max

Female Male Unknown gender

White Black Other Unknown race

Non-Hispanic Hispanic Unknown ethnicity

Group W Group B Group C Group Y Unknown

16(1):113 Serogroup Meningococci, W135 Southeastern Florida,2008 DoyleMejia TJ, Narratives for Selected Reportable Diseases/ConditionsNarratives Reportable ofInfrequent forSelected Occurrence See Table 8 foradditional information on 1

serogroup emergedW in south Florida.This serogroups cause almostall invasive disease B, (A, C, Y and VaccinesW). provide Surveillance for meningococcaldisease is importantbecause i - 115. Available115. at - - EcheverryFiorellaA, P,Leguen LivengoodF, J,Kay etR, al. 2010. Cluster of yearincrease ininvasive meningococcaldisease in the region,which now has

Number

0 0 - 96

40 34

8 0

1 2 0

2 0

6 5 3 1 3

(Percent) (55.6) (44.4) (0.0) (Percent) (83.3) (5.6) (11.1) (0.0) (Percent) (88.9) (11.1) (0.0) (Percent) (33.3) (27.8) (16.7) (5.6) (16.7) https://wwwnc.cdc.gov/eid/article/16/1/09 Serogroup continued W to be the most frequentlyidentified Neisseriameningitidis

Case Classification Case

Outcome

Outbreak Status

Location Where Exposed

County of Residence

Confirmed Probable

Interviewed Hospitalized Died Died

Sporadic Sporadic Outbreak-associated Outbreak status unknown

Florida Chile North Carolina Saint Martin

Broward Hillsborough Palm Beach Bay Collier Duval Lee Leon Marion Miami-Dade Miami-Dade Okaloosa Pasco Pasco Polk St. Johns meningococcaldisease N. meningitidis

bacteria.About 1 inpeople 10 have these –

Number

Number 2009.

17 18

1 0

1 1 1

3 2 2 1 1 1 1 1 1 1 1 1 1 1

(Percent) (100.0) (0.0) (Percent) (94.0) (100.0) (5.6) (Percent) (94.4) (5.6) (0.0) (Percent) (83.3) (5.6) (5.6) (5.6) (Percent) (16.7) (11.1) (11.1) (5.6) (5.6) (5.6) (5.6) (5.6) (5.6) (5.6) (5.6) (5.6) (5.6) (5.6) EmergingInfectious Diseases - clonecaused has the 1026_article mmediatepublic health casesreported in 2016. .

These N.

, Summary

Age Age (in Years)

Gender

Race

Ethnicity Table 9. Characteristics of Mercury Poisoning Cases Reported in 2016, Florida 2016, in Reported Cases Mercury Poisoning of Characteristics 9. Table with with fish mercury.be notplanning pregnantto andnotWomen menshouldeat thantwomore mealsweek a of permonth meal of with fish childrenand young should not eat more thanone mealper weekof withfish consumption fish areavailable at notpeople didreport the of amount consumed. fish 36 six people ate Oneofpoisoning.the affectedpeople ateounces≤17of perweek; sixfish 18 people ate All reported mercurypeople with poisoningin 2016 reported consumption fish as the ofsource oninformation mercurypoisoningcases in reported 2016. informand possible, to thepublicabouthow to reducethe risk ofexposure.9 See additional Table for amalgams),prevent furtherorcontinued exposure through remediationor elimination whenof sources ofsource a mercuryofexposurepublic health concern (e.g.,broken fish, thermometer,dental and weakness.walking; muscle Surveillance mercuryfor poisoningimportantis determine ifto isthere and aroundfeet, hands, thelackmouth); ofcoordinatedimpaired hearing,speech,movements; and peripheralimpaired disturbedvision; sensations(e.g., and “pinsneedles usually feelings” inthe adversehealth effects in the generalpopulation and cause can impaired neurologicaldevelopment; orcookedaway, outof cleaned, fish. sensitivemore tothe effectsof whichmercury, canimpactbrain development.Mercury becannot cut of much increasecertainexposure can fish to mercury. Eatingmammals. isfish can healthyreduce theand risk attack ofheart and but strokes,eating too itsinto organic which form, build upcan in environment andinthe accumulate and fishmarine Methylmercury salts). is whencreated microorganismsin environment the inorganicconvert mercury ethylmercuryconsumption), insome(found medical preservatives),inorganicand mercury (mercuric insomevapor(found thermometersanddental amalgam), methylmercurywith(associated fish Forms vapors. ofmercury likely most encountered by publicinclude the general elemental mercury threats. health Mercury areexposurestypically toofingestion mercuryorinhalationdue of mercury mercurycompounds,inorganicwith each compounds),characteristics unique potentialand man Mercurynaturallya isoccurringelement distributed intheenvironment asof a result bothnaturaland MercuryPoisoning

Number of cases in 2016 5-year trend (2012 to 2016)

Mean Median Min-max

Female Male Unknown gender

White Black Other Unknown race

Non-Hispanic Hispanic Unknown ethnicity Narratives for Selected Reportable Diseases/ConditionsNarratives Reportable ofInfrequent forSelected Occurrence - moderate made processes. Thereare three formsof mercury(elemental or metallicmercury, organic verylow mercury. - mercury,one meal per week of fishwith 65 ounces,65 two people ate66

Number

24 24 - 83

57 60

18 low

1 0 0

1 0

(Percent) (31.6) (68.4) (0.0) (Percent) (94.7) (5.3) (0.0) (0.0) (Percent) (94.7) (5.3) (0.0) mercury,and they should avoid eatingany fishwith www.doh.state.fl.us/FloridaFishAdvice Methylmercuryisthe mostlikely source of mercuryleading to

Case Classification Case

Outcome

Outbreak Status

Location Where Exposed

County of Residence

Confirmed Probable

Interviewed Hospitalized Died Died

Sporadic Sporadic Outbreak-associated Outbreak status unknown

Florida Unknown

Lee Palm Beach Broward Bay Indian River Pasco Pasco Polk Sarasota St. Lucie - 95 ounces,95 and two people ate≥126 ounces. Two TheFlorida DepartmentofHealth guidelines for Developing fetusesand young children are

low mercury, ormercury, oneper meal month of fish

Number

0 0

5 5 3 1 1 1 1 1 1

(Percent) (100.0) (0.0) (Percent) (95.0) (0.0) (0.0) (Percent) (100.0) (0.0) (0.0) (Percent) (94.7) (5.3) (Percent) (26.3) (26.3) (15.8) (5.3) (5.3) (5.3) (5.3) (5.3) (5.3) .

Women of childbearing Women age verylow moderate mercuryoneor - 35 ounces,35

93 Section 3: Narratives for Selected Reportable Diseases/Conditions of Infrequent Occurrence

94 Section 3: Narratives for Selected Reportable Diseases/Conditions of Infrequent Occurrence

Summary

Age Age (in Years)

Gender

Race

Ethnicity Table 10. Characteristics of Mumps Cases Reported in 2016, Florida in 2016, Reported Mumps Cases of Characteristics 10. Table oftheclose 2016 morbidity dataset. OnecaseinitiallyEngland. assporadic was laterreported be outbreakfound to aftersymptoms theclose ofthe 2016 morbiditydataset. caseswereThese inColombiaand acquired unknownan werelocation laterdetermined tohave traveledthe country outside beforeonset the of campus outbreak.college with symptomssomeone who wasrecentlytraveled. identifiedcase One asof partan out the16 Of sixreported cases, casesacquired mumps frominternational travel close had contact toor cases reported in2016. preventionprogramsand vaccine effectiveness. andreduce diagnosis therisk of further transmission.Surveillance areusedalso evaluatedata to potentially educate people aboutsignssymptoms and ofexposed the mumps to facilitateearly infected isolating identifyingthe personand and vaccinating anysusceptible contacts. importantisIt to identify important to infectedpeople and prevent them from transmitting theinfection bytoothers an infectedperson,of usually sneezesorpersoncoughs,when the talks. Surveillancemumps is for onlyinishumans, found spreadbyis droplets and ofsaliva or frommucus themouth, nose orthroat like contact, immunitycollege campuses. thoughtis toplayin role Waning a theseoutbreaks.Mumps inU.S. beencases the increasinghas mainlytoadultsoutbreaksdue in settingsinyoung with close illness common ininfants, children youngadults.Despiteand vaccination, routine number ofthe salivaryBeforea glands. routine vaccination programwas introducedintheU.S., was mumps a fewheadache,aches, days of fever, muscle tiredness lossand ofappetite, followed swellingof by vaccineMumpsa is Mumps

Number of cases in 2016 5-year trend (2012 to 2016)

Mean Median Min-max

Female Male Unknown gender

White Black Other Unknown race

Non-Hispanic Hispanic Unknown ethnicity Narratives for Selected Reportable Diseases/ConditionsNarratives Reportable ofInfrequent forSelected Occurrence

- preventable disease caused bymumps the virus. Mumps typicallywithstarts a

Number

14 14 - 62

Two cases thatwere initially as reported acquired Florida in andacquired in

38 42

7 9 0

7 3 2 4

9 2 5

(Percent) (43.8) (56.3) (0.0) (Percent) (43.8) (18.8) (12.5) (25.0) (Percent) (56.3) (12.5) (31.3)

Case Classification Case

Outcome

Outbreak Status

Location Where Exposed

County of Residence

Confirmed Probable

Interviewed Hospitalized Died Died

Sporadic Sporadic Outbreak-associated Outbreak status unknown

Florida Unknown Bangladesh Iowa Indiana India Europe

Miami-Dade Miami-Dade Broward Hillsborough Alachua Citrus Gadsden Okaloosa Orange Palm Beach See Table10 foradditional information on mumps

Number

4 0

3 1

9 2 1 1 1 1 1

5 3 2 1 1 1 1 1 1

(Percent) (37.5) (62.5) (Percent) (94.0) (25.0) (0.0) (Percent) (75.0) (18.8) (6.3) (Percent) (56.3) (12.5) (6.3) (6.3) (6.3) (6.3) (6.3) (Percent) (31.3) (18.8) (12.5) (6.3) (6.3) (6.3) (6.3) (6.3) (6.3) - associatedafter the - of - state

Summary

Age Age (in Years)

Gender

Race

Ethnicity Cases Reported in 2016, in 2016, Reported FloridaCases Rickettsiosis Fever Spotted Fever and Spotted Mountain Rocky of Characteristics 11. Table notcouldbe species determined. positive for each other.to confirmedAll cases three wereinternational exposedduring traveltoSouth Africawere and unrelated oninformation SFRcasesreported in 2016. areasoccurrence,and ofhigh incidence target prevention Seeeducation.for 11 additional for Table overincidencemonitor estimatetime, burdenofillness, monitor temporal geographical and species. provide can laboratories reference at performed otherdifferentiate SFRs fromRMSF limited,currently though is withreact testsserologicRMSF the for organism spotted feverrickettsial species assuch RMSF includeboth Florida and SFRs. other adoptedchange inJunethis Humanantibodies 2014. to Coast the Gulf tick ( months. year Africa. southern in countries to traveling people in particularly regularly, occur inFlorida reported areacquired innorthern andthe centralregions ofthe state. I oftenescharat thean sitedevelops of the tick bite with infection following SFRs. other including symptoms, fever,and headache,are rash, often severebut less thanRMSF. RMSF,Unlike be can if and notfatal treated early thewithcorrectantibiotic. OtherSFRs haveandsimilarsigns SFR is U.S. Rocky Mountain spotted (RMSF)by fever caused Rickettsia Spotted rickettsiosesfever (SFRs)area of tick group RockySpottedFever and Mountain Rickettsiosis

Number of cases in 2016 5-year trend (2012 to 2016)

Mean Median Min-max

Female Male Unknown gender

White Black Other Unknown race

Non-Hispanic Hispanic Unknown ethnicity Narratives for Selected Reportable Diseases/ConditionsNarratives Reportable ofInfrequent forSelected Occurrence - round withoutround distinct seasonality, though peak transmissiontypically occursduring summer the include Theprincipal vectorstick in Florida are theAmerican dog tick ( bacteria.The mostserious and commonlyreported spotted fevergroup rickettsiosisin the R.conorii

R. parkeriR. Escharswabs twofrom ofthe confirmed cases tested PCR positive SFR; for one was Amblyomma maculatum

and one for ,

Number

14 14 - 83 R. africaeR.

53 53

4 8 0

9 1 0 2

7 2 3

(Percent) (33.3) (66.7) (0.0) (Percent) (75.0) (8.3) (0.0) (16.7) (Percent) (58.3) (16.7) (25.0) ,and R.africae R.conorii R.parkeri

Case Classification Case

Outcome

Outbreak Status

Location Where Exposed

County of Residence

Confirmed Probable

Interviewed Hospitalized Died Died

Sporadic Sporadic Outbreak-associated Outbreak status unknown

Florida South Africa Pennsylvania South Carolina

Duval Miami-Dade Miami-Dade Okaloosa Broward Clay Manatee Marion Palm Beach Suwannee . . The casethird was confirmedusing serologic assays so

). In 2010,In national the reporting criteria wereexpanded to . R. rickettsiiR. RMSF symptomsinclude headache,fever, and rash , R.amblyommii - borne diseases causedbyborne diseases closely related R. rickettsii Surveillance SFRs for isimportant to . Commercial . antibody testing to PCR testing of eschar swabs swabs eschar of PCRtesting

Number

Number , R.africae

. Examples . ofother causes of

3 9

8 0

0 0

7 3 1 1

2 2 2 1 1 1 1 1 1 Dermacentorvariabilis

(Percent) (25.0) (75.0) (Percent) (83.0) (66.7) (0.0) (Percent) (100.0) (0.0) (0.0) (Percent) (58.3) (25.0) (8.3) (8.3) (Percent) (16.7) (16.7) (16.7) (8.3) (8.3) (8.3) (8.3) (8.3) (8.3) , and , Casesare reported mported cases also also cases mported

R.conorii Mostinfections cross ) and )

95 Section 3: Narratives for Selected Reportable Diseases/Conditions of Infrequent Occurrence

96 Section 3: Narratives for Selected Reportable Diseases/Conditions of Infrequent Occurrence

Summary

Age Age (in Years)

Gender

Race

Ethnicity Vancomycin Cases Reported in 2016, Florida in 2016, Reported Cases Vancomycin of Characteristics 12. Table historiespast medical increasethat the risk person’sinfections.for One riskwere unknown.factors Ofthe four reported casesin2016, threewere admitted from community,the witheach significant additionaloninformation VISA casesin reported 2016. theemergencetrack ofa relatively rareclinically and neworganism. 12See important Table for patient transmittinginfection others, to prevent and such to Additionally, transmission. importantisit to identifyintendedis infectedpeople,to evaluate theirrisk infection,assessfactors for ofathe risk hastransmission.everNo VRSAbeen infection detected inFlorida. Surveillance andVISA VRSA for theoreticallytosusceptible transferable orstrains sois thereorganisms, potential person for Recentexposurevancomycin organism. notto is necessary. typeofThis gene of strain mechanismresistance nottransferrable is tosusceptible strains. Incontrast, whenVRSA emerges a repeated exposedto vancomycinand the use vancomycin.emergesVISA when patientwitha preexisting vancomycin vancomycinwell,as treatment options are limited. Vancomycin with bacteriainfected arethat resistant to antibiotics.many thebacteriabecome resistant to When relyphysiciansConsequently, heavilyprimary vancomycinthe on as antibiotic treatingpatientsfor aureusS. with contaminated body containingfluids health careworkersof the themselves;ordevices, items, orother environmental surfaces contaminatedbecome by withinfectedpatients; contact or colonized colonizedinfectedbody sites or direct contact.Commonly amonghealth careworkers,found orwho procedures haveindwelling devices.medical infections, especiallyassociated chronically among who haveillpatients recently invasivehad orpneumoniawound can occur. infections, Mostpeople. aureus Staphylococcus Staphylococcus

Number of cases in 2016 5-year trend (2012 to 2016)

Mean Median Min-max

Female Male Unknown gender

White Black Other Unknown race

Non-Hispanic Hispanic Unknown ethnicity Narratives for Selected Reportable Diseases/ConditionsNarratives Reportable ofInfrequent forSelected Occurrence S.aureus withresistance tomany antibiotics hasbecome morecommon in thelast decade. - resistant S.aureus aureus acquires the S. aureus Staphylococcus aureus

Number

infectionsare minor, but sometimes serious or fatalbloodstream infections,

40 40 - 74 isa bacterium commonly onfound the skin andin noses the of healthy Infection,Vancomycin

56 56

1 3 0

3 1 0 0

4 0 0

(Percent) (25.0) (75.0) (0.0) (Percent) (75.0) (25.0) (0.0) (0.0) (Percent) (100.0) (0.0) (0.0) vanA (VRSA)have acquiredintermediate or complete resistance to

gene afrom vancomycin S. aureus

Case Classification Case

Outcome

Outbreak Status

Location Where Exposed

County of Residence

Confirmed

Interviewed Hospitalized Died Died

Sporadic Sporadic Outbreak-associated Outbreak status unknown

Florida

Lake Lake Pasco Pasco Pinellas Suwannee Infection, Intermediate Resistance to S.aureus S. aureus - IntermediateVancomycin and .

S.aureus is also analsois important of health care cause

straindevelops a thicker cell wall. This S.aureus S.aureus - - resistant istransmitted person intermediate

Number

1 4 0

4 0 0

1 1 1 1 infection orcolonization is

is spread byhands that

(Percent) (100.0) (Percent) (25.0) (100.0) (0.0) (Percent) (100.0) (0.0) (0.0) (Percent) (100.0) (Percent) (25.0) (25.0) (25.0) (25.0) Enterococcus

S.aureus - mediatedresistance is - Resistant - to (VRE) - (VISA)and person byperson -

to - - person

Summary

Age Age (in Years)

Gender

Race

Ethnicity toxoid vaccine withintoxoidyear.vaccine the past toxoid vaccinationtetanus within past10andperson years, one athe had ofprevioustetanus dose wasOnewomanof died; deathlimited. the cause was unknown. nailOnewhile no acuteinjuriesoutdoors. womanhad known and information injuryaboutone man’s outdoors,while hismanwhopainting a hand cut whileand car, aa towing onwoman who stepped a theOf casesreportedfive in2016,theexposures illness leading includedto whoa cuthisman finger in2016. itsfacilitate prevention and control. vaccinesand to collect information onthe temporal, geographic,and demographic occurrence to purposeoftetanusThe surveillance monitor theto effectivenessisof immunization and programs breaks bodyinthrough theskin or(usuallypuncture woundscuts caused objects).by contaminated andexcrementanimal peopleinfectedbecome can when soil, contaminated ordust, entermanure the spread not from persontoperson. up stay of arecases among tetanus people who havenever receivedtetanus a vaccinewho or adults do not different formulations.Booster tetanus vaccines areatrecommendedleast everyNearly years. all10 vaccination ratesbecause arehigh. vaccinesTetanus areavailable andchildren adults inseveralfor and seizures,sweating, highblood fever pressure,andheart rate. fast isTetanus rareintheU.S. symptoms Other muscleincludemayheadache, spasms,painful musclestiffness all overthebody, causesaoften it person's neckand jaw muscles tolock, making hard it or themouth to open swallow. is entirelyTetanus immunization.preventablethrough Another name is tetanus for "lockjaw" because is lifea Tetanus Tetanus Table 13. Characteristics of Tetanus Cases Reported in 2016, Florida in 2016, Reported Tetanus Cases of Characteristics 13. Table

Number of cases in 2016 5-year trend (2012 to 2016)

Mean Median Min-max

Female Male Unknown gender

White Black Other Unknown race

Non-Hispanic Hispanic Unknown ethnicity Narratives for Selected Reportable Diseases/ConditionsNarratives Reportable ofInfrequent forSelected Occurrence - to

- date ondate their 10 - threateningdisease caused by the toxin producedby

Number

36 36 - 77 - yearbooster Unlike shots. other vaccine

52 43

2 3 0

4 1 0 0

4 1 0

(Percent) (40.0) (60.0) (0.0) (Percent) (80.0) (20.0) (0.0) (0.0) (Percent) (80.0) (20.0) (0.0) C. tetani

See Table 13 foradditional information on tetanuscases reported

Case Classification Case

Outcome

Outbreak Status

Location Where Exposed

County of Residence

Probable

Interviewed Hospitalized Died Died

Sporadic Sporadic Outbreak-associated Outbreak status unknown

Florida

Pinellas Broward Miami-Dade Miami-Dade Okaloosa bacteria are infound high concentrationsin soiland

Number

Number Fourpeople did not recallreceiving a - preventable diseases, tetanusis

3 4 1

5 0 0

2 1 1 1 Clostridium tetani

(Percent) (100.0) (Percent) (60.0) (80.0) (20.0) (Percent) (100.0) (0.0) (0.0) (Percent) (100.0) (Percent) (40.0) (20.0) (20.0) (20.0) .

bacteria.

97 Section 3: Narratives for Selected Reportable Diseases/Conditions of Infrequent Occurrence

98 Section 3: Narratives for Selected Reportable Diseases/Conditions of Infrequent Occurrence

Summary

Age Age (in Years)

Gender

Race

Ethnicity Table 14. Characteristics of Typhoid Fever Cases Reported in 2016, Florida in 2016, Reported Cases Fever Typhoid of Characteristics 14. Table Haitiancitizens,one citizen). Indian citizens,caseswerethree incitizens ofcountrieswhoother were currently living inFlorida(two invarious acquired countries while visiting family or ofninefriends. thecaseswere inWhile U.S. wasinHaiti acquired case orMexico whilebusiness, and traveling the for caseswere 10 other inother infection acquired countries. One wasinHaiti beforeacquired immigrating totheoneU.S., Typically,about80%ofinfections areacquired incountries;other however, in2016,all caseswere additionalinformation ontyphoid cases fever reportedin 2016. preventand suchothers identifytransmission,unrecognizedand Seeother cases. 14 Table for transmissionstop from source,sucha assess the risk ofinfectedpeople transmittinginfection to (e.g.,anconcern or infectedhandler contaminatedfood commercially product)and distributed food to Surveillancetyphoid determine intendedis for feverif to aisthere sourceinfection ofpublicof health case follow as theCanada,U.S.,such Europe, Australia,and sanitation GoodJapan. and aggressiveWestern washing Typhoid food. commonisfeverinmost parts ofthe world inindustrializedexcept regions contaminated withwhen sewage havethatbeverages beenbyperson whohandled a sheddingis Salmonella pains, headache,stomach weakness, ofappetite,loss orrash. be severe. can feverTyphoid Peoplewithbacteria. typhoidtypically sustainedhighfever a andexperiencehavefever alsomay ais Typhoid systemic illnessfever causedby TyphoidFever

Number of cases in 2016 5-year trend (2012 to 2016)

Mean Median Min-max

Female Male Unknown gender

White Black Other Unknown race

Non-Hispanic Hispanic Unknown ethnicity Narratives for Selected Reportable Diseases/ConditionsNarratives Reportable ofInfrequent forSelected Occurrence - Typhilives onlyin humans.People get typhoid feverafter eating food or drinking up helpup prevent typhoid fever becomingfrom endemicin industrializedregions.

Number

4 4 - 38

21 16

4 8 0

0 6 6 0

1 0

(Percent) (33.3) (66.7) (0.0) (Percent) (0.0) (50.0) (50.0) (0.0) (Percent) (91.7) (8.3) (0.0) Salmonella

Case Classification Case

Outcome

Outbreak Status

Location Where Exposed

County of Residence

Confirmed Probable

Interviewed Hospitalized Died Died

Sporadic Sporadic Outbreak-associated Outbreak status unknown

Haiti India Pakistan Bangladesh El Salvador Haiti or Mexico

Broward Miami-Dade Miami-Dade Palm Beach Collier Duval Hillsborough Orange St. Johns Typhibacteria intogets the waterused fordrinking or Salmonella enterica

Salmonella

Number

Number serotype Typhi(

12 11

0 0

5 2 2 1 1 1

3 2 2 1 1 1 1 1

(Percent) (100.0) (0.0) (Percent) (100.0) (91.7) (0.0) (Percent) (100.0) (0.0) (0.0) (Percent) (41.7) (16.7) (16.7) (8.3) (8.3) (8.3) (Percent) (25.0) (16.7) (16.7) (8.3) (8.3) (8.3) (8.3) (8.3) Typhistoolin their or

Salmonella

Typhi)

Summary

Age Age (in Years)

Gender

Race

Ethnicity onlyinfection identifiedfatal inFloridain2016. spent ofperson part theirperiodincubation instate their ofresidence and inFlorida. part wasThis the wasperson unavailable interview. for Information provided byfamily membersindicated that the inresidentscasecounts). unknownisIt whetherornot infection wasthe acquiredin Floridaas the non identifiedina if unknown infectionthe wasinFlorida. acquired WNV Aneuroinvasive infection was fatal also WNV Gulf Pinellas(October)and (July)counties. PinellasThe was lost donor bloodto follow 2016,definition. In twoinfectionsasymptomaticin donorswereblood identifiedinFlorida ofresidents asymptomatic While occur, infectionsdo WNV they Floridanot meet do the surveillance case othera had the illnessfebrile priordonation blood to laterdevelopedand neuroinvasive symptoms. identifiedbydonor bloodscreeningpersontests.developed after symptomsblood One donation and eight Sixcasesthe reportedhadof inneuroinvasive2016 symptoms. Twoinfectedpeople were first oninformation disease casesreported in2016. WNV incidencemonitorpublic, overtime, estimate and burden of illness. the 15 See additional for Table important identify to areas where is being WNV transmitted to targetprevention education for the other or of prevention at forms higher are risk ofbecominginfected. Surveillance infections isfor WNV of outsideamounts time occupation, (due to hobbies, orhomelessness) orinsectnotusing repellant transfusion.Symptoms typically 2days afterappear from to14 exposure. the largePeoplespending transplantation.Since2003,all donationsbloodare screened thepresencefor of prior to WNV transmittedhumans to viacontaminated transfusionsbloodand less frequently organthrough can ordeath. coma, involveandmay encephalitisand irreversible can meningitis neurological cause damage,paralysis, pain, (headache, lessfever, and than1%fatigue), suffer from theneuroinvasive ofillness, whichform Approximatelyofthoseinfectedshow clinical 80% no 20%have symptoms, mildsymptoms inallFloridacounties. 67 Peopleinfectedwith experience a can wide rangeof symptoms.WNV and detectedinfirst1999 inFloridain 2001. Since initialits detection, activitybeen reported WNV has NileWest virus (WNV)is a mosquito WestNile Virus Disease Table 15. Characteristics of West Nile Virus Disease Cases Reported in 2016, Florida 2016, in Reported Cases Disease Virus Nile of Characteristics West 15. Table

Number of cases in 2016 5-year trend (2012 to 2016)

Mean Median Min-max

Female Male Unknown gender

White Black Other Unknown race

Non-Hispanic Hispanic Unknown ethnicity Narratives for Selected Reportable Diseases/ConditionsNarratives Reportable ofInfrequent forSelected Occurrence become infectedwhen they are bitten by a mosquitoinfected with WNV. alsocan WNV be Culex - Florida residentwho was visitingFlorida (note that this reportonly includes Florida species (mosquitoes)and wild birdsare thenatural hosts.Humans and horses

Number

16 16 - 72

44 41

2 6 0

8 0 0 0

7 1 0

(Percent) (25.0) (75.0) (0.0) (Percent) (100.0) (0.0) (0.0) (0.0) (Percent) (87.5) (12.5) (0.0) - borne flavivirus thatwas introduced first to the northeastern U.S.

Case Classification Case

Outcome

Outbreak Status

Location Where Exposed

County of Residence

Confirmed Probable

Interviewed Hospitalized Died Died

Sporadic Sporadic Outbreak-associated Outbreak status unknown

Florida

Bay Escambia Escambia Duval Okaloosa Santa Rosa

Number

4 4

8 6 0

8 0 0

3 2 1 1 1

(Percent) (50.0) (50.0) (Percent) (100.0) (75.0) (0.0) (Percent) (100.0) (0.0) (0.0) (Percent) (100.0) (Percent) (37.5) (25.0) (12.5) (12.5) (12.5) - up andup isit

99 Section 3: Narratives for Selected Reportable Diseases/Conditions of Infrequent Occurrence