MIDLAND COUNTY DEPARTMENT OF PUBLIC HEALTH 2015 ANNUAL COMMUNICABLE DISEASE REPORT

3 YEAR HISTORY OF REPORTED DISEASES IN MIDLAND COUNTY Case Status: Confirmed, Probable

Disease Group Disease 2013 2014 2015 Foodborne See Notes and Trends List 34 31 32 Influenza Flu-Like Disease* 887 1566 1504 Meningitis Meningitis - Aseptic 3 1 3 Meningitis Meningitis - Bacterial Other 2 3 1 Meningitis Streptococcus pneumoniae, Inv 3 2 0 Other Gastrointestinal Illness* 81 51 254 Other Head Lice* 44 98 146 Other Legionellosis 0 2 4 Other Strep Throat* 173 322 279 Other Streptococcal Dis, Inv, Grp A 2 1 3 Rabies Rabies Animal 0 1 0 STD Chlamydia (Genital) 161 177 153 STD Gonorrhea 10 11 11 STD Lymphogranuloma venereum 0 0 0 Tuberculosis Tuberculosis 0 0 0 VPD Chickenpox (Varicella) 9 5 8 VPD H. influenzae Disease - Inv. 2 0 2 VPD Measles 3 0 0 VPD Pertussis 5 25 2 Vectorborne Lyme Disease 3 1 0 Viral Hepatitis Hepatitis B, Chronic 3 3 2 Viral Hepatitis Hepatitis C, Acute and Chronic 43 66 57

Notes and Observed Trends FoodBorne Disease Group Includes Campylobacter, Cryptosporidiosis, Giardiasis, Salmonellosis, Shiga toxin-producing Escherichia coli (STEC) and Shigellosis. Chlamydia Cases of Chlamydia decreased from 177 cases in 2014 to 153 cases in 2015, a 14% decrease. The age range of cases was from 16 to 57 years old. 93% of cases were less than 30 years old. Chickenpox (Varicella) Case ages ranged from 8 months to 53 years old. 4 cases were vaccinated at recommended levels. Of the 4 unvaccinated cases 2 were less than 1 year old and 1 reported history of prior disease. 3 cases were confirmed with appropriate lab testing. Case numbers continue to decline in the state of Michigan, from 724 cases in 2014 to 547 cases in 2015, a 25% decrease. Pertussis Pertussis cases reported in Midland County decreased by 92% from 25 cases in 2014 to 2 cases in 2015. Suspected, untested cases of pertussis are not always reported and so the true incidence of pertussis in Midland County may be higher. The state of Michigan experienced a 64% decrease in cases from 1409 in 2014 to 505 in 2015. Lymphogranuloma venereum (LGV) Although Midland County had no cases of LGV, the state of Michigan had 12 cases in 2015. LGV is a rare, poorly characterized STD, that until 2015 hadn't occurred in Michigan since 2008. LGV is typically seen in Africa, Southeast Asia, Central and South America and Caribbean countries, with a more recent increase in Europe. Michigan's outbreak began in 2015 in the southeast part of Michigan, with nearly all cases in African American men who have sex with men (MSM), who also have HIV. LGV is caused by infection with L1, L2 or L3 genotypes of chlamydia trachomatis. Symptoms may include proctocolitis, inguinal/ femoral lymphadenopathy, or genital or rectal ulcers. Hepatitis C, Acute and Chronic 57 new cases of acute and chronic were reported in 2015. 28 of these cases (49%) reported risk factor data. Of these 28, 18 (64%) reported ever injecting unprescribed drugs, and 13 cases (46%) reported a history of incarceration. *Flu-like Disease, Gastrointestinal Illness, Head Lice and Strep Throat Aggregate numbers of cases are reported weekly by schools and other congregate settings. This report underestimates the true prevalence in Midland County.