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Annual Summary of Communicable Disease Reported to MDH, 2003

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MINNESOTA DEPARTMENT OF HEALTH DISEASE CONTROL N EWSLETTER Volume 32, Number 4 (pages 33-52) July/August 2004 Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health, 2003 Introduction Minnesota Government Data Practices do not appear in Table 2 because the Assessment is a core public health Act (Section 13.38). Provisions of the influenza surveillance system is based function. Surveillance for communi- Health Insurance Portability and on reported outbreaks rather than on cable diseases is one type of ongoing Accountability Act (HIPAA) allow for individual cases. assessment activity. Epidemiologic routine communicable disease report- surveillance is the systematic collec- ing without patient authorization. Incidence rates in this report were tion, analysis, and dissemination of calculated using disease-specific health data for the planning, implemen- Since April 1995, MDH has participated numerator data collected by MDH and a tation, and evaluation of public health as one of the Emerging Infections standardized set of denominator data programs. The Minnesota Department Program (EIP) sites funded by the derived from U.S. Census data. of Health (MDH) collects disease Centers for Disease Control and Disease incidence may be categorized surveillance information on certain Prevention (CDC) and, through this as occurring within the seven-county communicable diseases for the program, has implemented active Twin Cities metropolitan area (Twin purposes of determining disease hospital- and laboratory-based surveil- Cities metropolitan area) or outside of it impact, assessing trends in disease lance for several conditions, including (Greater Minnesota). occurrence, characterizing affected selected invasive bacterial diseases populations, prioritizing disease control and food-borne diseases. Anaplasmosis efforts, and evaluating disease preven- Human anaplasmosis (HA) is the new tion strategies. Prompt reporting allows Isolates for pathogens associated with nomenclature for the disease formerly outbreaks to be recognized in a timely certain diseases are required to be known as human granulocytic fashion, when control measures are submitted to MDH (Table 1). The MDH ehrlichiosis. HA (caused by the most likely to be effective in preventing Public Health Laboratory performs rickettsia Anaplasma phagocytophilum) additional cases. extensive microbiologic evaluation of is transmitted to humans by Ixodes isolates, such as pulsed-field gel scapularis (deer tick or black-legged In Minnesota, communicable disease electrophoresis (PFGE), to determine tick), the same tick that transmits Lyme reporting is centralized whereby whether isolates (e.g., enteric patho- disease. reporting sources submit standardized gens such as Salmonella and Escheri- report forms to MDH. Cases of disease chia coli O157:H7 and invasive Similar to Lyme disease, HA case are reported pursuant to Minnesota pathogens such as Neisseria numbers also dropped during 2003, Rules Governing Communicable meningitidis) are related, and poten- from a record high of 149 cases in Diseases (MN Rules 4605.7000 - tially associated with a common source. 2002 (3.0 per 100,000 population) to 4605.7800). The diseases listed in Testing of submitted isolates also 78 cases (1.6 per 100,000). Fifty-five Table 1 (page 34) must be reported to allows detection and monitoring of (71%) case-patients reported in 2003 MDH. As stated in these rules, physi- antimicrobial resistance, which contin- were male. The median age of case- cians, health care facilities, medical ues to be an important problem. patients was 61 years (range, 3 to 91 laboratories, veterinarians, and continued... veterinary medical laboratories are Table 2 summarizes the numbers of required to report these diseases. cases of selected communicable Reporting sources may designate an diseases reported during 2003 by Inside: individual within an institution to district of the patient’s residence. Mark the Date: 10th Annual perform routine reporting duties (e.g., Pertinent observations for some of Emerging Infections in Clinical an infection control practitioner for a these diseases are discussed below. A Practice and Emerging Health hospital). Data maintained by MDH are summary of influenza surveillance data Threats Conference private and protected under the also is included. However, these data November 12, 2004.....................52 Table 1. Diseases Reportable to the Minnesota Department of Health (All reportable diseases must be reported within 1 working day, unless otherwise specified.) Foodborne, Vectorborne and Zoonotic Diseases Vaccine Preventable Diseases Amebiasis (Entamoeba histolytica/dispar) Diphtheria (Corynebacterium diphtheriae) b,g Anaplasmosis (Anaplasma phagocytophilum) h Hepatitis (all primary viral types including A, B, C, D, and E) Anthrax (Bacillus anthracis) a,d Influenza (unusual case incidence, critical illness, or laboratory-confirmed Arboviral Disease h cases) d Babesiosis (Babesia spp.) Measles (Rubeola) a,d Botulism (Clostridium botulinum) a Mumps Brucellosis (Brucella spp.) d,g Pertussis (Bordetella pertussis) b Campylobacteriosis (Campylobacter spp.) b Poliomyelitis a,d Cat scratch disease (infection caused by Bartonella spp.) Rubella and congenital rubella syndrome g Cholera (Vibrio cholerae) a,b Smallpox d,g,h Cryptosporidiosis (Cryptosporidium parvum) d Tetanus (Clostridium tetani) Cyclosporiasis (Cyclospora cayetanensis) d,h Varicella-zoster (Primary [chickenpox] - unusual case incidence, critical Dengue virus infection illness or laboratory-confirmed cases; or recurrent [shingles] - unusual Diphyllobothrium latum infection case incidence or critical illness) d,h Ehrlichiosis (Ehrlichia spp.) Encephalitis (caused by viral agents) Sexually Transmitted Diseases and Retroviral Infections Enteric E. coli infection (E. coli O157:H7, other Chancroid (Haemophilus ducreyi) e enterohemorrhagic [Shiga toxin-producing] E. coli, Chlamydia trachomatis infection e enteropathogenic E. coli, enteroinvasive E. coli, Gonorrhea (Neisseria gonorrhoeae) e enterotoxigenic E. coli) b Human immunodeficiency virus (HIV) infection, Enterobacter sakazakii d,h,i including Acquired Immunodeficiency Syndrome (AIDS) f Giardiasis (Giardia lamblia) Retrovirus infection (other than HIV) Hantavirus infection Syphilis (Treponema pallidum) e Hemolytic uremic syndrome d,g Other Conditions Kingella spp. d,h Blastomycosis (Blastomyces dermatitidis) Leptospirosis (Leptospira interrogans) Coccidioidomycosis h Listeriosis (Listeria monocytogenes) b Histoplasmosis (Histoplasma capsulatum) Lyme disease (Borrelia burgdorferi) Kawasaki disease Malaria (Plasmodium spp.) Legionellosis (Legionella spp.) d Plague (Yersinia pestis) d,g Leprosy (Mycobacterium leprae) Psittacosis (Chlamydophila psittaci) Meningitis (viral agents) Q fever (Coxiella burnetii) d,g Orthopox virus d,g,h Rabies (animal and human cases and suspects) a Reye syndrome Rocky Mountain spotted fever (Rickettsia spp., R. canada) Rheumatic fever (cases meeting the Jones Criteria only) Salmonellosis, including typhoid (Salmonella spp.) b Severe Acute Respiratory Syndrome (1. Suspect and probable Shigellosis (Shigella spp.) b cases of SARS and 2. Cases of health care workers hospitalized Toxoplasmosis for pneumonia or acute respiratory distress syndrome) a,b Trichinosis (Trichinella spiralis) Staphylococcus aureus (including only vancomycin-intermediate Tularemia (Francisella tularensis) d,g Staphylococcus aureus [VISA], vancomycin-resistant Staphylococcus Typhus (Rickettsia spp.) aureus [VRSA], and deaths or critical illness due to community-acquired Vibrio spp. d,h Staphylococcus aureus in a previously well individual) d,h Yellow fever Transmissible spongiform encephalopathy h Yersiniosis, enteric (Yersinia spp.) b Tuberculosis (Mycobacterium tuberculosis and M. bovis) b Invasive Bacterial Diseases Unexplained deaths b and unexplained critical illness Haemophilus influenzae disease (all invasive disease) b,c (possibly due to infectious cause) d,h Meningococcal disease (Neisseria meningitidis) b,c,g Unusual or increased case incidence of any illness a,d Neonatal sepsis (infants <7 days of age; excluding coagulase-negative Staphylococcus) c,d,h Streptococcal disease (all invasive disease caused by Groups A and B streptococci and S. pneumoniae) b,c Toxic shock syndrome b a Report immediately by telephone: 612-676-5414 or 1-877-676-5414. d Submission of isolates or clinical materials requested; reporting rule b Submission of isolates required. If a rapid, non-culture assay is used for change expected in 2004. diagnosis, we request that positives be cultured, and isolates submitted. e Report on separate Sexually Transmitted Disease Report Card. If this is not possible, send specimens, enrichment broth, or other f Report on separate HIV Report Card. appropriate material. Call the MDH Public Health Laboratory at g Requested to report immediately by telephone; reporting rule change 612-676-5396 for instructions. expected in 2004. c Isolates are considered to be from invasive disease if they are isolated h Addition to reporting rule change expected in 2004. from a normally sterile site, e.g. blood, CSF, joint fluid, etc. i Infants only; reporting rule change expected in 2004. years). The peak in onsets of illness HA is highest in the same east-central For additional information on HA, see occurred in June and July (43 cases Minnesota counties where the risk of “Lyme Disease and Human Anaplas- [55%]). Co-infections with Lyme Lyme disease is greatest, including mosis
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