MINNESOTA DEPARTMENT ISEASE ONTROL EWSLETTER OF HEALTH D C N Volume 38, Number 1 (pages 1-32) January/July 2010 Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health, 2009 Introduction Government Data Practices Act Incidence rates in this report were Assessment of the population’s (Section 13.38). Provisions of the calculated using disease-specifi c health is a core public health function. Health Insurance Portability and numerator data collected by MDH and Surveillance for communicable Accountability Act (HIPAA) allow for a standardized set of denominator diseases is one type of assessment. routine disease reporting without data derived from U.S. Census data. Epidemiologic surveillance is the patient authorization. Disease incidence is categorized as systematic collection, analysis, and occurring within the seven-county Twin dissemination of health data for Since April 1995, MDH has participated Cities metropolitan area (metropolitan the planning, implementation, and as an Emerging Infections Program area) or outside of it in Greater evaluation of health programs. The (EIP) site funded by the Centers Minnesota. Minnesota Department of Health for Disease Control and Prevention (MDH) collects information on (CDC) and, through this program, Anaplasmosis certain infectious diseases for the has implemented active hospital- and Human anaplasmosis (formerly purposes of determining disease laboratory-based surveillance for known as human granulocytic impact, assessing trends in disease several conditions, including selected ehrlichiosis) is caused by Anaplasma occurrence, characterizing affected invasive bacterial diseases and food- phagocytophilum, a rickettsial organism populations, prioritizing control efforts, borne diseases. transmitted to humans by bites from and evaluating prevention strategies. Ixodes scapularis (the blacklegged Prompt reporting allows outbreaks to Isolates for pathogens associated tick). The same tick also transmits be recognized in a timely fashion when with certain diseases are required to the etiologic agents of Lyme disease control measures are most likely to be be submitted to MDH (Table 1). The and babesiosis. A. phagocytophilum effective in preventing additional cases. MDH Public Health Laboratory (PHL) can also be transmitted by blood performs microbiologic evaluation transfusion. In Minnesota, communicable disease of isolates, such as pulsed-fi eld reporting is centralized, whereby gel electrophoresis (PFGE), to In 2009, 317 anaplasmosis cases (6.1 reporting sources submit standardized determine whether isolates (e.g., cases per 100,000 population) were report forms to MDH. Cases of disease enteric pathogens such as Salmonella continued on page 4 are reported pursuant to Minnesota and Escherichia coli O157:H7, and Rules Governing Communicable invasive pathogens such as Neisseria Diseases (Minnesota Rules 4605.7000 meningitidis) are related, and Inside: - 4605.7800). The diseases listed in potentially associated with a common Table 1 (page 2) must be reported to source. Testing of submitted isolates Use of Reduced (4-Dose) Vaccine MDH. As stated in the rules, physicians, also allows detection and monitoring for Postexposure Prophylaxis to health care facilities, laboratories, of antimicrobial resistance, which Prevent Human Rabies ...............25 veterinarians and others are required continues to be an important problem. to report these diseases. Reporting Antimicrobial Susceptibilities of sources may designate an individual Table 2 summarizes cases of selected Selected Pathogens, 2009 ..........28 within an institution to perform routine communicable diseases reported reporting duties (e.g., an infection during 2009 by district of the patient’s 16th Annual Emerging Infections in control preventionist for a hospital). residence. Pertinent observations for Clinical Practice and Public Health Data maintained by MDH are private some of these diseases are presented Conference, November 19, 2010, and protected under the Minnesota below. Registration and Program ..........30 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 (animal and human cases and suspected cases) Brucellosis (Brucella spp.) a Rubella and congenital rubella syndrome a Cholera (Vibrio cholerae) a Severe Acute Respiratory Syndrome (SARS) Diphtheria (Corynebacterium diphtheriae) a (1. Suspect and probable cases of SARS. 2. Cases of health Hemolytic uremic syndrome a care workers hospitalized for pneumonia or acute respiratory Measles (rubeola) a distress syndrome.) a Meningococcal disease (Neisseria meningitidis) Smallpox (variola) a (all invasive disease) a, b Tularemia (Francisella tularensis) a Orthopox virus a Unusual or increased case incidence of any suspect Plague (Yersinia pestis) a infectious illness a Poliomyelitis a Report Within One Working Day Amebiasis (Entamoeba histolytica/dispar) Malaria (Plasmodium spp.) Anaplasmosis (Anaplasma phagocytophilum) Meningitis (caused by viral agents) Arboviral disease (including but not limited to, Mumps LaCrosse encephalitis, eastern equine encephalitis, western Neonatal sepsis, less than 7 days after birth (bacteria isolated from equine encephalitis, St. Louis encephalitis, and a sterile site, excluding coagulase-negative West Nile virus) Staphylococcus) a, b Babesiosis (Babesia spp.) Pertussis (Bordetella pertussis) a Blastomycosis (Blastomyces dermatitidis) Psittacosis (Chlamydophila psittaci) Campylobacteriosis (Campylobacter spp.) a Retrovirus infection Cat scratch disease (infection caused by Bartonella spp.) Reye syndrome Chancroid (Haemophilus ducreyi) c Rheumatic fever (cases meeting the Jones Criteria only) Chlamydia trachomatis infection c Rocky Mountain spotted fever (Rickettsia rickettsii, R. canada) Coccidioidomycosis Salmonellosis, including typhoid (Salmonella spp.) a Cryptosporidiosis (Cryptosporidium spp.) a Shigellosis (Shigella spp.) a Cyclosporiasis (Cyclospora spp.) a Staphylococcus aureus (vancomycin-intermediate S. aureus [VISA], Dengue virus infection vancomycin-resistant S. aureus [VRSA], and death or critical Diphyllobothrium latum infection illness due to community-associated S. aureus in a previously Ehrlichiosis (Ehrlichia spp.) healthy individual) a Encephalitis (caused by viral agents) Streptococcal disease (all invasive disease caused by Groups A Enteric E. coli infection (E. coli O157:H7, other enterohemorrhagic and B streptococci and S. pneumoniae) a, b [Shiga toxin-producing] E. coli, enteropathogenic E. coli, Syphilis (Treponema pallidum) c enteroinvasive E. coli, 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 Guillain-Barre syndrome e Trichinosis (Trichinella spiralis) Haemophilus infl uenzae disease (all invasive disease) a,b Tuberculosis (Mycobacterium tuberculosis complex) (Pulmonary or Hantavirus infection extrapulmonary sites of disease, including laboratory Hepatitis (all primary viral types including A, B, C, D, and E) confi rmed or clinically diagnosed disease, are reportable. Histoplasmosis (Histoplasma capsulatum) Latent tuberculosis infection is not reportable.) a Human immunodefi ciency virus (HIV) infection, including Typhus (Rickettsia spp.) Acquired Immunodefi ciency Syndrome (AIDS) a, d Unexplained deaths and unexplained critical illness Infl uenza (unusual case incidence, critical illness, or laboratory (possibly due to infectious cause) a confi rmed cases) a Varicella-zoster disease Kawasaki disease (1. Primary [chickenpox]: unusual case incidence, critical Kingella spp. (invasive only) a, b illness, or laboratory-confi rmed cases. 2. Recurrent [shingles]: Legionellosis (Legionella spp.) a unusual case incidence, or critical illness.) a Leprosy (Hansen’s disease) (Mycobacterium leprae) Vibrio spp. a Leptospirosis (Leptospira interrogans) Yellow fever Listeriosis (Listeria monocytogenes) a Yersiniosis, enteric (Yersinia spp.) a Lyme disease (Borrelia burgdorferi) Sentinel Surveillance (at sites designated by the Commissioner of Health) Methicillin-resistant Staphylococcus aureus Clostridium diffi cile a Submission of clinical materials required. If a rapid, non- b Isolates are considered to be from invasive disease if they are culture assay is used for diagnosis, we request that positives isolated from a normally sterile site, e.g., blood, CSF, joint fl uid, be cultured, and isolates submitted. If this is not possible, send etc. specimens, nucleic acid, enrichment broth, or other appropriate c Report on separate Sexually Transmitted Disease Report Card. material. Call the MDH Public Health Laboratory at 651-201- d Report on separate HIV Report Card. 4953 for instructions. e Reportable as of October 1, 2009-September 30, 2011 2 DCN 38;1 January/July 2010 Table 2. Cases of Selected Communicable Diseases Reported to the Minnesota Department of Health by District of Residence, 2009 District (population per U.S. Census 2009 estimates) 2,810,414) 320,342) Disease Metropolitan ( Northwestern (153,218) Northeastern ( Central (715,467) Central West (229,186) South Central (286,956) Southeastern (486,517) Southwestern (218,293) Unknown Residence Total (5,220,393) Anaplasmosis 84 40 43 123 5 5 13 4 0 317 Arboviral disease LaCrosse 0 0 0 0 0 0 0