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January 15, 2019 Shawnee County Health Department Volume 4, Issue 1 EPI-SURVeillance ‘Tis the Season for !

INSIDE THIS ISSUE

Norovirus in Shawnee County…… 1 December Disease Summary ……. 2 2018 Annual Disease Summary ... 3

Shawnee County Health Department

WIC and Administrative Offices Over the last ten years, there have been at least nine outbreaks of norovirus in Shawnee 2600 SW East Circle Drive County. Norovirus can cause illness throughout the year; however, norovirus outbreaks are Topeka, Kansas 66606 most commonly seen between November and April. In this column, we want to remind 785.251.5600 Shawnee County providers to think about norovirus for patients with compatible symptoms, especially this time of the year. Immunization/Communicable Disease Norovirus is the leading cause of vomiting and diarrhea from acute among all Clinic age groups. It is also the leading cause of foodborne illnesses nationwide. A norovirus case is 2115 SW 10th Street Topeka, Kansas 66604 defined as having abrupt diarrhea, vomiting, and/ or lab detection of norovirus. An outbreak 785.251.5700 of norovirus is defined as an occurrence of two or more similar illnesses resulting from a common exposure that is either suspected or laboratory-confirmed to be caused by no- Environmental Health rovirus. Norovirus outbreaks tend to occur in semi-closed populations such as health and 1515 NW Saline, Suite 221 long-term care facilities (LTCF), restaurants, schools, daycare centers, and cruise ships. Topeka, Kansas 66618 Last month, the Shawnee County Health Department conducted three different norovirus 785.251.5608 outbreak investigations, one at a local school and two others at different LTCFs, all located within Shawnee County. At LTCF A, 17 people (staff and residents) reported gastrointestinal illness and all 17 individuals met the case definition for norovirus. At LTCF B, 27 people (staff NEED TO REPORT A and residents), reported gastrointestinal illness, all but one individual met the case definition COMMUNICABLE DISEASE? for norovirus. Two people were hospitalized, and no deaths were reported. At both LTCF, the Health Department ruled out food prepared at the facility as a source of exposure. The norovirus may have been transmitted by contact of contaminated environmental surfaces or Call the Health Department 24/7 from person-to-person transmission from an ill staff or resident. At the local school, 9 staff members reported gastrointestinal illness. Only 5 individuals met 785. 806. 6297 the case definition for norovirus. No hospitalization or death was reported. The Health De- Call the Kansas Department of partment did not receive enough information to determine the source of the outbreak. Health and Environment Norovirus is a highly contagious pathogen with a low infectious dose. It is transmitted primari- Epidemiology Hotline 24/7 ly through a fecal-oral route, and norovirus particles can spread through direct contact or 877. 427. 7317 consumption of fecally- contaminated food or water. Proper hand washing and using chlorine Disease Reporting Information: bleach disinfectants to clean surfaces is essen- List of Reportable Diseases tial in the prevention and controlling the spread of the disease. Disease Reporting Information To report suspect cases or outbreaks of no- Kansas Reportable Disease Form rovirus, please contact the Health Department Disease Investigation Guidelines at 785.251.5700.

DECEMBER COMMUNICABLE DISEASE SUMMARY

Last month, there were 34 new reports of notifiable diseases and conditions in Shawnee County. Of the 34 new reports, 27 have been classified as Confirmed or Probable Cases by the Shawnee County Health Department and/or the Kansas Department of Health and Environment based on standardized case definitions. The chart below shows the number of disease reports which met the criteria of Confirmed or Probable. These are preliminary numbers and may change as case status changes with new information or further investigation. Below is a summary of select reports investigated in the month of December of 2018.

SUMMARY OF NEWLY CONFIRMED CASES OF REPORTABLE DISEASES Bloodborne: The Health Department inves- SHAWNEE COUNTY, DECEMBER tigated one B, Chronic report. The , Chronic report was a confirmed Case Report Counts* case. All 14 reports received were confirmed cases. 2015-2017 3 2018 2017 Diseases Year December Dec Dec Respiratory: The Health Department inves- Average tigated five Streptococcus pneumoniae re- Bloodborne ports, and all five were confirmed cases. The two Varicella pediatric reports investigated Hepatitis C, Chronic 14 19 13 were deemed not cases. The Health Depart- Foodborne and Waterborne ment investigated a report and was Campylobacteriosis 3 5 3.67 deemed not a case. The Coccidioidomycosis Norovirus 1 0 0 report was a confirmed case with a recent his- Vectorborne tory of domestic and international travels. Lyme Disease, Borrelia burgdorferi 1 0 0.33 Food or Waterborne: All three Campylo- Respiratory bacteriosis reports received were confirmed Coccidioidomycosis 1 0 0 cases. The one laboratory confirmed no- rovirus was associated with the larger out- Streptococcus pneumoniae, 5 1 4.33 invasive disease breaks in Shawnee County.

Vaccine Preventable Vector borne: The Health Department in- vestigated two Lyme disease reports. Of the Hepatitis B, Chronic 1 1 1.33 two reports, only one was a confirmed case. Sexually Transmitted The Health Department also investigated a 97 89 86.3 West Nile report and Rocky Mountain 76 54 35 Spotted Fever report. Neither reports were 1 1 1.3 deemed cases. Other Other: The Health Department received one Blood lead poisoning (All ages) 1 20 10.7 pediatric elevated blood lead level report. The Grand Total 201 190 156.3 elevated blood lead report was a confirmed case.

* Case report counts are provisional numbers. Case statuses may change with new information or further investigation.

Leading the way to a healthier Shawnee County 2 2018 ANNUAL DISEASE SUMMARY

Case Report Counts* Diseases 2018 2017 2015-2017 3 Year Average Bloodborne Hepatitis C, Chronic 186 162 144 Hepatitis C, acute 2 2 2 Hepatitis C, Perinatal 1 0 0 Foodborne and Waterborne Campylobacteriosis 69 66 62 Cryptosporidiosis 4 8 10 Cyclosporiasis 1 2 1 Giardiasis 8 7 8 Norovirus 1 2 6 Salmonellosis 32 44 35 Shiga toxin-producing Escherichia coli (STEC) 25 8 8 Shigellosis 52 124 44 Vibriosis (non-cholera Vibrio species infections) 6 0 0 Vectorborne Ehrlichiosis, Ehrlichia chaffeensis 5 4 4 Lyme Disease, Borrelia burgdorferi 3 0 1 Malaria (Plasmodium spp.) 1 1 0 Spotted Fever Rickettsiosis (RMSF) 9 11 9 Tularemia (Francisella tularensis) 1 4 4 West Nile virus neuroinvasive disease 1 2 1 Respiratory Coccidioidomycosis 2 0 0 Haemophilus influenzae,invasive disease (Including Hib) 8 12 8 Histoplasmosis 1 0 0 Legionellosis 2 0 1 Meningitis, Bacterial Other 1 0 1 Streptococcal disease, invasive, Group A 7 8 4 Streptococcus pneumoniae, invasive disease 39 37 29 Tuberculosis, Active 4 3 2 Tuberculosis, Latent (LTBI) 35 21 19 Preventable 1 0 0 Hepatitis B Pregnancy Event 2 5 2 Hepatitis B virus infection, chronic 14 16 11 Pertussis 1 5 7 Varicella (Chickenpox) 9 10 13 Sexually Transmitted Infections Chlamydia 1294 1166 1006 Gonorrhea 831 595 455 Syphilis 25 28 23 Other Blood lead poisoning (All ages) 26 40 20 Toxic-shock syndrome (streptococcal) 2 0 0 Transmissible Spongioform Encephalophathies (TSE / CJD) 1 0 0 Grand Total 2712 2393 1940

* Case report counts are provisional numbers. Case statuses may change with new information or further investigation. 3 Leading the way to a healthier Shawnee County