MINNESOTA DEPARTMENT OF HEALTH D ISEASE C ONTROL N EWSLETTER Volume 33, Number 4 (pages 37-56) July/August 2005 Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health, 2004 Introduction private and protected under the Incidence rates in this report were Assessment is a core public health Minnesota Government Data Practices calculated using disease-specific function. Surveillance for communi­ Act (Section 13.38). Provisions of the numerator data collected by MDH and a cable diseases is one type of assess­ Health Insurance Portability and standardized set of denominator data ment. Epidemiologic surveillance is the Accountability Act (HIPAA) allow for derived from U.S. Census data. systematic collection, analysis, and routine communicable disease report­ Disease incidence may be categorized dissemination of health data for the ing without patient authorization. as occurring within the seven-county planning, implementation, and evalua­ Twin Cities metropolitan area or outside tion of health programs. The Minnesota Since April 1995, MDH has participated of it (Greater Minnesota). Department of Health (MDH) collects as an Emerging Infections Program information on certain communicable (EIP) site funded by the Centers for Anaplasmosis diseases for the purposes of determin­ Disease Control and Prevention (CDC) Human anaplasmosis (HA) is the new ing disease impact, assessing trends in and, through this program, has imple­ nomenclature for the disease formerly disease occurrence, characterizing mented active hospital- and laboratory- known as human granulocytic affected populations, prioritizing control based surveillance for several condi­ ehrlichiosis. HA (caused by the efforts, and evaluating prevention tions, including selected invasive rickettsia Anaplasma phagocytophilum) strategies. Prompt reporting allows bacterial diseases and food-borne is transmitted to humans by Ixodes outbreaks to be recognized in a timely diseases. scapularis (deer tick or black-legged fashion when control measures are tick), the same tick that transmits Lyme most likely to be effective in preventing Isolates for pathogens associated with disease. additional cases. certain diseases are required to be submitted to MDH (Table 1). The MDH Similar to Lyme disease, HA case In Minnesota, communicable disease Public Health Laboratory performs numbers also increased during 2004, reporting is centralized, whereby extensive microbiologic evaluation of from 78 cases in 2003 (1.6 per reporting sources submit standardized isolates, such as pulsed-field gel 100,000 population) to 139 cases (2.8 report forms to MDH. Cases of disease electrophoresis (PFGE), to determine per 100,000). The record high oc­ are reported pursuant to Minnesota whether isolates (e.g., enteric patho­ curred in 2002, with 149 cases (3.0 per Rules Governing Communicable gens such as Salmonella and Escheri 100,000 population). Eighty-one (58%) Diseases (MN Rules 4605.7000 - 4605. chia coli O157:H7 and invasive case-patients reported in 2004 were 7800) which were recently updated pathogens such as Neisseria male. The median age of case-patients (See “Revisions to the Communicable meningitidis) are related, and poten­ was 59 years (range, 1 to 89 years). Disease Reporting Rule” in the May/ tially associated with a common source. The peak in onsets of illness occurred June 2005 issue [vol 33. no. 3] of the Testing of submitted isolates also in June and July (77 cases [56%] of Disease Control Newsletter). The allows detection and monitoring of 137 cases with known onset). Co- diseases listed in Table 1 (page 38) antimicrobial resistance, which contin­ infections with Lyme disease and HA must be reported to MDH. As stated in ues to be an important problem. continued... these rules, physicians, health care facilities, laboratories, and veterinarians Table 2 summarizes cases of selected Inside: are required to report these diseases. communicable diseases reported Mark the Date: 11th Annual Reporting sources may designate an during 2004 by district of the patient’s Emerging Infections in Clinical individual within an institution to residence. Pertinent observations for Practice and Emerging Health perform routine reporting duties (e.g., some of these diseases are discussed Threats Conference, an infection control practitioner for a below. Minneapolis, November 10- hospital). Data maintained by MDH are 11(half-day), 2005........................56 Table 1. Diseases Reportable to the Minnesota Department of Health Report Immediately by Telephone Anthrax (Bacillus anthracis) a Q fever (Coxiella burnetii) a Botulism (Clostridium botulinum) Rabies Brucellosis (Brucella spp.) a (animal and human cases and suspected cases) Cholera (Vibrio cholerae) a Rubella and congenital rubella syndrome a Diphtheria (Corynebacterium diphtheriae) a Severe Acute Respiratory Syndrome (SARS) a Hemolytic uremic syndrome a Smallpox (variola) a Measles (rubeola) a Tularemia (Francisella tularensis) a Meningococcal disease (Neisseria meningitidis) Unusual or increased case incidence of any (all invasive disease) a, b suspect infectious illness a Orthopox virus a Plague (Yersinia pestis) a Poliomyelitis a Report Within One Working Day Amebiasis (Entamoeba histolytica/dispar) Listeriosis (Listeria monocytogenes) a Anaplasmosis (Anaplasma phagocytophilum) Lyme disease (Borrelia burgdorferi) Arboviral disease (including but not limited to, Malaria (Plasmodium spp.) LaCrosse encephalitis, eastern equine encephalitis, Meningitis (caused by viral agents) western equine encephalitis, St. Louis encephalitis, Mumps and West Nile virus) Neonatal sepsis, less than 7 days after birth (bacteria isolated from a Babesiosis (Babesia spp.) sterile site, excluding coagulase-negative Staphylococcus) a, b Blastomycosis (Blastomyces dermatitidis) Pertussis (Bordetella pertussis) a Campylobacteriosis (Campylobacter spp.) a Psittacosis (Chlamydophila psittaci) Cat scratch disease (infection caused by Bartonella spp.) Retrovirus infection Chancroid (Haemophilus ducreyi) c Reye syndrome Chlamydia trachomatis infection c Rheumatic fever (cases meeting the Jones Criteria only) Coccidioidomycosis Rocky Mountain spotted fever (Rickettsia rickettsii, R. canada) Cryptosporidiosis (Cryptosporidium spp.) a Salmonellosis, including typhoid (Salmonella spp.) a Cyclosporiasis (Cyclospora spp.) a Shigellosis (Shigella spp.) a Dengue virus infection Staphylococcus aureus (vancomycin-intermediate S. aureus [VISA], Diphyllobothrium latum infection vancomycin-resistant S. aureus [VRSA], and death or critical illness Ehrlichiosis (Ehrlichia spp.) due to community-associated S. aureus in a previously healthy Encephalitis (caused by viral agents) individual) a Enteric E. coli infection Streptococcal disease (all invasive disease caused by Groups A and B (E. coli O157:H7, other enterohemorrhagic [Shiga toxin-producing] streptococci and S. pneumoniae) a, b E. coli, enteropathogenic E. coli, enteroinvasive E. coli, Syphilis (Treponema pallidum) c enterotoxigenic E. coli) a Tetanus (Clostridium tetani) Enterobacter sakazakii (infants under 1 year of age) a Toxic shock syndrome a Giardiasis (Giardia lamblia) Toxoplasmosis (Toxoplasma gondii) Gonorrhea (Neisseria gonorrhoeae) c Transmissible spongiform encephalopathy Haemophilus influenzae disease Trichinosis (Trichinella spiralis) (all invasive disease) a Tuberculosis (Mycobacterium tuberculosis complex) Hantavirus infection (Pulmonary or extrapulmonary sites of disease, including laboratory Hepatitis (all primary viral types including A, B, C, D, and E) confirmed or clinically diagnosed disease, are reportable. Latent Histoplasmosis (Histoplasma capsulatum) tuberculosis infection is not reportable.) a Human immunodeficiency virus (HIV) infection, including Typhus (Rickettsia spp.) Acquired Immunodeficiency Syndrome (AIDS) a, d Unexplained deaths and unexplained critical illness Influenza (possibly due to infectious cause) a (unusual case incidence, critical illness, or laboratory Varicella-zoster disease (1. Primary [chickenpox]: unusual case confirmed cases) a, e incidence, critical illness, or laboratory-confirmed cases. 2. Recurrent Kawasaki disease [shingles]: unusual case incidence, or critical illness.) a Kingella spp. (invasive only) a Vibrio spp. a Legionellosis (Legionella spp.) a Yellow fever Leprosy (Hansen’s disease) (Mycobacterium leprae) Yersiniosis, enteric (Yersinia spp.) a Leptospirosis (Leptospira interrogans) Sentinel Surveillance (at sites designated by the Commissioner of Health) Methicillin-resistant Staphylococcus aureus a Submission of clinical materials required. If a rapid, non-culture c Report on separate Sexually Transmitted Disease Report Card. assay is used for diagnosis, we request that positives be cultured, and isolates submitted. If this is not possible, send specimens, d Report on separate HIV Report Card. enrichment broth, or other appropriate material. Call the MDH Public Health Laboratory at 612-676-5396 for instructions. e For criteria for reporting laboratory confirmed cases of influenza, see www.health.state.mn.us/divs/idepc/dtopics/reportable/index.html. b Isolates are considered to be from invasive disease if they are isolated from a normally sterile site, e.g. blood, CSF, joint fluid, etc. continued... 38 DCN 33;4 July/August 2005 Table 2. Cases of Selected Communicable Diseases Reported to the Minnesota Department of Health, by District of Residence, 2004 District* (population per U.S. Census 2000) 2,642,056) 322,073) Disease Metropolitan ( Northwestern