Communicable Disease Prevention Skagit County Public Health Communicable Disease Prevention Team Funded by: Island Hospital Skagit County Public Health Department Skagit-Island Counties Medical Society Skagit Valley Hospital United General Hospital January 2007 Table of Contents Preface: Bacteria, Vectors and Viruses on the Move ...................................................................... 1 Demographics of Communicable Disease ......................................................................................... 2 Preventing Communicable Disease .................................................................................................3 Reportable Communicable Diseases ................................................................................................5 Vaccine Preventable Diseases ......................................................................................................... 6 Tuberculosis in Washington State and Skagit County ................................................................... 7 Our Immune System........................................................................................................................................ 8 Sexually Transmitted Diseases ...................................................................................................... 10 Food and Water. .............................................................................................................................. 11 Bloodborne Diseases ....................................................................................................................... 12 HIV/ AIDS ....................................................................................................................................... 13 New and Emerging Infectious Diseases ......................................................................................... 14 Conclusions ..................................................................................................................................... 16 From left to right TB staff: STD/ family planning Admin Staff Communicable Immunization Team Sharon Kirkman clinicians Luanne Geerdes Disease Nurse Amie Tidrington, RN Magdalena Smith, LPN Alba Gutierrez, PA Maria Vivanco Maryl Skjei, RN Marjorie Reece, RN Debbie Chavarria, RN Cathy Smith, ARNP Graciela Ibarra Report prepared by: Sandi Paciotti, RN, BSN Communicable Disease Nursing Supervisor e-mail: [email protected] Alex von Cube, MPH, Ph.D. Population and Health Information Manager e-mail: [email protected] Peter Browning, Director Sandi Paciotti, Nursing Supervisor A special thank-you to Jennifer Walton for editorial Howard Leibrand, Health Officer fine-tuning. Thanks to all Hospital Infection Control Staff and our laboratories for timely reporting of communicable diseases. Consistent with the policy objective of prevention, the Skagit County Public Health Department publishes periodic reports on demographic and health issues relevant to Skagit County residents. Skagit County Public Health Department Skagit County Board of Health 700 South Second Street Commissioner Don Munks, District 1 Mount Vernon, WA 98273 Commissioner Kenneth A. Dahlstedt, District 2 Peter Browning, Director Commissioner Sharon Dillon, District 3 Howard L. Leibrand, MD, Health Officer PREFACE BACTERIA, VECTORS AND VIRUSES ON THE MOVE Our report is intended to share information which controlled. Yet, we know better. will help you protect yourself from contracting a communicable disease--a major source of illness. In fact, we increasingly find infectious disease pro- I cesses can exacerbate chronic disease. For ex- Everybody is aflutter about the dreaded bird flu. ample, hepatitis B and C can lead to chronic liver It has us making emergency plans for a disease disease. ere which we are unsure if it will come, when it will come or how virulent it will be. It has a lot of people Some diseases are veritable champion communi- scared; it has a lot of us preparing and we hope cators. Contamination can occur in various ways: some of this preparation will pay off for other dis- from human to human, environment to human, ease threats. animal to human, and from bird to human. Unfortunately the threat from communicable disease What is Public Health’s role in communicable is not limited to bird flu. Visualize the world of disease? communicable disease as a crowded restaurant. Since 2000 alone the world population has grown 1. To trace the source and extent of a disease and by 410 million. We have moved a little closer to to track over 60 reportable diseases in coopera- each other, and are a little more prone to catch tion with the State Department of Health (pg 5). diseases due to globalism, increased trade activ- ity and shortened travel times. 2. To conduct an epidemiological investigation, identifying and promptly treating individuals who Although the threat of bird flu cannot and should have come into contact with the bacteria, viruses not be dismissed, existing reality is that there were or other infectious agents. 3.1 million AIDS deaths in 2005 worldwide with close to 5 million persons newly infected with the 3. To prevent the further spread of a disease. In virus. Two million persons die annually of TB with special cases, this might require isolating individu- more than twice that number of new TB cases als to protect the community from being infected emerging yearly. SARS, Mad Cow and Marburg with a serious illness and/ or to educate the indi- Disease--all relatively new emerging diseases-- vidual how to prevent the spread of their disease. have given us no comfort about the prospects for communicable disease in the US. 4. Finally, the steady, quiet daily prevention ac- tivities of immunizations and education to assure Prior to the twentieth century, communicable dis- disease does not spread out of control from the eases such as diphtheria killed huge numbers of many ‘ready-made incubators’ such as child care, people in this country and throughout the world. schools, churches, hospitals and other places where The history of preventing infectious diseases with children and adults congregate, eat and otherwise vaccines goes back about one hundred years. Vac- are in close contact. Our nurses answer an end- cinations reduce fatalities by about two thirds. less stream of questions from the public, health Vaccinations of millions of sheep and cattle against care providers, child care providers--anyone con- anthrax and the inoculation of a child bitten by a cerned with preventing and treating communi- rabid dog are testimony to major improvements. cable disease. As we continue to be vaccinated against many in- fectious diseases and our life expectancy increases in the US, the emergence of chronic diseases de- mands our attention. We begin to think infectious diseases are gradually being eliminated or well- 1 Untitled-1 1 2/20/2007, 1:56 PM DEMOGRAPHICS OF COMMUNICABLE DISEASE Our “bread and butter” work in UNEQUAL RISK Skagit Population 2005 communicable disease touches by Five Year Age daily lives and responds to daily We are not equally at risk Groups by Sex needs. It is the basis for effective for communicable disease. and early response to potential Age Male Female Our immune systems are weak emergencies. as we first come into this world, I strengthen in our teens and 0-4 3,574 3,401 PREVENTION weaken again as we grow old. 5-9 3,748 3,615 10-14 4,128 3,959 ere In response to this life cycle, we 15-19 4,391 4,025 Public Health provides health immunize our babies and edu- 20-24 3,485 3,282 education through press and cate the population not to take 25-29 3,031 3,019 other media, immunization unnecessary risks. We immu- 30-34 3,191 3,137 education, limited testing and nize again as we age and become 35-39 3,533 3,460 screening (e.g. for water and sep- more prone to catch diseases 40-44 3,915 4,089 tic, hepatitis, TB, HIV), and edu- when our immune response 45-49 4,321 4,318 cation/monitoring about appro- weakens. 50-54 4,048 4,149 priate food preparation. We en- 55-59 3,480 3,595 courage healthy behaviors like Beyond this general propensity 60-64 2,794 2,832 handwashing, testing for STD, for diseases, there are many risk 65-69 2,063 2,224 and not sharing needles. groups with vectors and viruses 70-74 1,849 1,972 ever ready to attack. 75-79 1,471 1,684 We try to get the word out 80-84 1,058 1,551 to Skagit County residents We protect our children from 85+ 884 1,619 about communicable dis- disease through a series of im- ease risks and preventive measures. This is done by munizations. Based on esti- Total: 54,967 55,933 mates from the National Immu- various technological and per- nization Survey in 2003, sonal means: children’s immunization per- PUBLIC HEALTH’S ROLE ♦ Satellite broadcasts hosted centages ranged from about 70 IN COMMUNICABLE DISEASE to 95 percent. by CDC What do we do for you? ♦ Adolescent health confer- From time to time we may have From watching TV and listen- ence for all Skagit providers ♦ to revaccinate due to outbreaks. ing to the radio, one could get Vaccines for Children (VFC) Recent examples are the out- the impression that all we do is program conference for pro- breaks of mumps in Iowa or wait for the dreaded bird flu to viders ♦ whooping cough in Washington arrive, so we can ‘show our stuff’ The media ♦ State. in a disease disaster. Site visits as needed to provide education and/or Other communicable diseases We do have an active role in assistance with vaccine stor increase and ebb according to emergency