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Communicable and Environmental Disease Services 5962 CEDS_03_AR_Covr 11/2/04 8:07 AM Page 1 Tennessee Department of Health Communicable and Environmental Disease Services Tennessee Department of Health. Authorization No. 343341, 700 copies. This public document was 2003 Annual Report promulgated at a cost of $5.25 per copy. 10/04 Tennessee Department of Health Communicable and Environmental Disease Services 2003 Annual Report Communicable and Environmental Disease Services Section Tennessee Department of Health 4th Floor Cordell Hull Building 425 5th Avenue North Nashville, TN 37247-4911 615-741-7247 (24/7) 1-800-404-3006 FAX 615-741-3857 Communicable and Environmental Disease Services Annual Report 2003 Tennessee Department of Health Communicable and Environmental Disease Services Kenneth S. Robinson, MD, Commissioner of Health Wendy J. Long, MD, MPH, Deputy State Health Officer Bureau of Health Services Allen S. Craig, MD, State Epidemiologist; Director, Communicable and Environmental Disease Services Available electronically at the Tennessee Department of Health website. Click on Programs, and then click on Communicable and Environmental Disease Services. http://tennessee.gov/health This report reflects the contributions of the many committed professionals who are part of the Communicable and Environmental Disease Services Section, Tennessee Department of Health. i Communicable and Environmental Disease Services Annual Report 2003 TABLE OF CONTENTS Section I. Introduction...........................................................................................................................1 A. Purpose of Report.................................................................................................................3 B. Notifiable Diseases in Tennessee ...........................................................................................3 C. Reporting Notifiable Diseases ...............................................................................................4 D. Isolate Characterization at the State Laboratory .....................................................................5 E. Emerging Infections and the Emerging Infections Program.......................................................5 F. Communicable and Environmental Disease Services Website ..................................................5 G. Useful Telephone Numbers, Addresses, and Contact Persons...................................................6 H. List of Notifiable Diseases in 2002 ........................................................................................7 I. Referral of Cultures to the Department of Health.....................................................................8 J. Tennessee Population Estimates 2002 ....................................................................................9 K. Tennessee Department of Health Regions .............................................................................10 L. Notes on Sources Used in Preparing the Annual Report........................................................10 M. Tennessee’s Nonmetropolitan Regions..................................................................................11 Section II. Tennessee Reported Cases by Year of Diagnosis, 1995-2003 .................................15 Numbers and Rates per 100,000 Population, Selected Notifiable Diseases, by Age Group, Tennessee, 2003 ....................................................................................16 Section III. Disease Summaries ...........................................................................................................17 A. Foodborne Disease ............................................................................................................19 The Tennessee FoodNet Program.........................................................................................21 Campylobacteriosis ............................................................................................................24 E. coli O157:H7 and Hemolytic Uremic Syndrome..............................................................25 Listeriosis...........................................................................................................................26 Norovirus ..........................................................................................................................27 Salmonellosis.....................................................................................................................29 Shigellosis .........................................................................................................................30 Food and Waterborne Parasitic Diseases.............................................................................32 Cryptosporidiosis ...............................................................................................................32 Cyclosporiasis....................................................................................................................33 Giardiasis .........................................................................................................................33 Foodborne Outbreaks ........................................................................................................34 B. Hepatitis............................................................................................................................37 Hepatitis A ........................................................................................................................39 Hepatitis B.........................................................................................................................40 Perinatal Hepatitis B ...........................................................................................................41 Hepatitis C ........................................................................................................................41 iii Communicable and Environmental Disease Services Annual Report 2003 C. Meningitis/Encephalitis and Septicemia...............................................................................43 Active Bacterial Core Surveillance: the ABCs Program ..........................................................45 Encephalitis and the Tennessee Unexplained Encephalitis Study (TUES) ..................................46 Group A Streptococcal Disease...........................................................................................48 Group B Streptococcal Disease ...........................................................................................49 Meningococcal Disease ......................................................................................................51 Rabies...............................................................................................................................52 Streptococcus pneumoniae Invasive Disease.........................................................................54 D. Sexually Transmitted Diseases .............................................................................................55 HIV (Human Immunodeficiency Virus)..................................................................................57 AIDS (Acquired Immunodeficiency Syndrome)......................................................................57 Pediatric HIV/AIDS Due to Perinatal Risk.............................................................................58 Chlamydia.........................................................................................................................58 Gonorrhea ........................................................................................................................59 Syphilis .............................................................................................................................60 E. Vaccine-preventable Diseases .............................................................................................63 Pertussis ............................................................................................................................67 Tetanus..............................................................................................................................68 Recommended Childhood Immunization Schedule ................................................................69 F. Vector-borne Diseases ........................................................................................................71 Arboviral Diseases .............................................................................................................73 La Crosse Encephalitis ...................................................................................................73 West Nile Fever/Encephalitis .........................................................................................75 Tick-borne Disease .............................................................................................................76 Ehrlichiosis....................................................................................................................76 Lyme Disease ................................................................................................................78 Rocky Mountain Spotted Fever .......................................................................................79 G. Tuberculosis .......................................................................................................................83 Section IV. Environmental Health........................................................................................................87
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