ISEASE ONTROL EWSLETTER DVolume 46, Number 1 (pages 1-30) C N 2019 Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health, 2018 Introduction Anaplasmosis Assessment of the population’s health is a core public health function. Anaplasmosis, caused by Anaplasma Surveillance for communicable diseases is one type of assessment. Epidemiologic phagocytophilum, is transmitted surveillance is the systematic collection, analysis, and dissemination of health by bites from Ixodes scapularis, data for the planning, implementation, and evaluation of health programs. the blacklegged tick. Although the The Minnesota Department of Health (MDH) collects information on infectious organism that causes anaplasmosis diseases for the purposes of determining disease impact, assessing trends in was previously known by other disease occurrence, characterizing affected populations, prioritizing control names and thought to be a part of efforts, and evaluating prevention strategies. Prompt reporting allows outbreaks the genus Ehrlichia, anaplasmosis and to be recognized in a timely fashion when control measures are most likely to be ehrlichiosis (due to E. chaffeensis) are effective in preventing additional cases. distinct diseases caused by different rickettsial species. The same tick vector In Minnesota, communicable disease reporting is centralized, whereby reporting also transmits the etiologic agents of sources submit standardized reports to MDH. Cases of disease are reported Lyme disease, babesiosis, ehrlichiosis pursuant to Minnesota Rules Governing Communicable Diseases (Minnesota (due to E. muris), and Powassan Rules 4605.7000 -4605.7800). The diseases listed in Table 1 must be reported virus. In rare circumstances, A. to MDH. As stated in the rules, physicians, health care facilities, laboratories, phagocytophilum may be transmitted veterinarians, and others are required to report these diseases. Reporting by blood transfusion. sources may designate an individual within an institution to perform routine reporting duties (e.g., an infection preventionist for a hospital). Data maintained In 2018, 496 confirmed or probable by MDH are private and protected under the Minnesota Government Data cases (8.9 cases per 100,000 Practices Act (Section 13.3805). population) were reported, down from the 638 cases reported in 2017 (Figure Since April 1995, MDH has participated as an Emerging Infections Program 1). Despite some annual fluctuations in (EIP) site funded by the U.S. Centers for Disease Control and Prevention (CDC) reported cases, the overall trend is an and, through this program, has implemented active hospital- and laboratory- increase in yearly case totals over time, based surveillance for several conditions, including selected bacterial diseases, with a median of 627 cases reported foodborne diseases, tickborne diseases, and hospitalized influenza cases. per year since 2010. Sixty-two percent (307) of cases reported were male. Isolates of pathogens from certain diseases are required to be submitted to The median age of cases was 61 years MDH (Table 1: Minnesota Rules Governing Communicable Diseases (Minnesota (range, 2 to 92), 17 years older than Rules 4605.7000-4605.7800). The MDH Public Health Laboratory (PHL) performs the median age of confirmed Lyme microbiologic and molecular evaluation of isolates, such as pulsed-field gel disease cases. As is typical, most cases electrophoresis (PFGE) and whole genome sequencing (WGS), to determine had illness onsets during the summer whether isolates (e.g., enteric pathogens such as Salmonella and Escherichia coli months, with 72% of cases reporting O157:H7, and invasive pathogens such as Group A streptococcus) are related and illness onsets in June and July. In 2018, potentially associated with a common source. Testing of submitted isolates also 132 (27%) cases were hospitalized for allows detection and monitoring of antimicrobial resistance. their infection, with a median duration of 4 days (range, 2 to 33 days). Table 2 summarizes cases of selected communicable diseases reported during 2018 by district of the patient’s residence. Pertinent observations for some continued on page 4 of these diseases are presented below. Incidence rates in this report were calculated using disease-specific numerator data collected by MDH and a standardized set of denominator data derived from U.S. Census data. Disease INSIDE: incidence is categorized as occurring within the seven-county Twin Cities metropolitan area (metropolitan area) or outside of it in Greater Minnesota Emerging Infections in Clinical Practice and (unless otherwise indicated). Public Health Announcement and Registration ...............................................28 Table 1. Diseases Reportable to the Minnesota Department of Health Reportable Diseases, MN Rules 4605.7000 to 4605.7900 Diseases Reportable to the Minnesota Department of Health 651-201-5414 or 1-877-676-5414 24 hours a day, 7 days a week REPORT IMMEDIATELY BY TELEPHONE Anthrax (Bacillus anthracis) M Hemolytic uremic syndrome M Rabies (animal and human cases and suspected Botulism (Clostridium botulinum) Measles (rubeola) M cases) Brucellosis (Brucella spp.) M Melioidosis (Burkholderia pseudomallei) M * Rubella and congenital rubella syndrome M Cholera (Vibrio cholerae) M Meningococcal disease (Neisseria meningitidis) Severe Acute Respiratory Syndrome (SARS) M R Diphtheria (Corynebacterium diphtheriae) M (invasive) M S Smallpox (variola) M Free-living amebic infection M Middle East Respiratory Syndrome (MERS) M Tularemia (Francisella tularensis) M (including at least: Acanthamoeba spp., Orthopox virus M Unusual or increased case incidence of any Naegleria fowleri, Balamuthia spp., Sappinia Plague (Yersinia pestis) M suspect infectious illness M spp.) Poliomyelitis M Viral hemorrhagic fever M Glanders (Burkholderia mallei) M * Coxiella burnetii (including but not limited to Ebola virus disease Q fever ( ) M and Lassa fever) REPORT WITHIN ONE WORKING DAY Amebiasis (Entamoeba histolytica/dispar) Haemophilus influenzae disease (all invasive Staphylococcus aureus M Anaplasmosis (Anaplasma phagocytophilum) disease) M S (only vancomycin-intermediate Staphylococcus Hantavirus infection aureus [VISA], vancomycin-resistant Arboviral disease Staphylococcus aureus [VRSA], and death or (including, but not limited to, La Crosse Hepatitis (all primary viral types including A, B, critical illness due to community-associated encephalitis, eastern equine encephalitis, C, D, and E) B Staphylococcus aureus in a previously healthy western equine encephalitis, St. Louis Histoplasmosis (Histoplasma capsulatum) encephalitis, West Nile virus disease, Powassan individual) virus disease, and Jamestown Canyon virus Human immunodeficiency virus (HIV) infection, Streptococcal disease - invasive disease caused disease) including Acquired Immunodeficiency by Groups A and B streptococci and Syndrome (AIDS) B S. pneumoniae M S Babesiosis (Babesia spp.) Influenza M Blastomyces dermatitidis Streptococcal disease - non-invasive Blastomycosis ( ) (unusual case incidence, critical illness, or S. pneumoniae Candida auris M ** laboratory-confirmed cases) (urine antigen laboratory-confirmed Campylobacteriosis (Campylobacter spp.) M Kawasaki disease pneumonia) Carbapenem-resistant Enterobacteriaceae (CRE) M Kingella spp. (invasive only) M S Syphilis (Treponema pallidum) B Cat scratch disease (infection caused by Legionellosis (Legionella spp.) M Tetanus (Clostridium tetani) Bartonella species) Leprosy (Hansen’s disease) (Mycobacterium Toxic shock syndrome M Chancroid (Haemophilus ducreyi) leprae) Toxoplasmosis (Toxoplasma gondii) Chikungunya virus disease Leptospirosis (Leptospira interrogans) Transmissible spongiform encephalopathy Chlamydia trachomatis infections Listeriosis (Listeria monocytogenes) M Trichinosis (Trichinella spiralis) Coccidioidomycosis Lyme disease (Borrelia burgdorferi, and other Tuberculosis (Mycobacterium tuberculosis Cronobacter sakazakii in infants under one year Borrelia spp.) complex) M of age M Malaria (Plasmodium spp.) (pulmonary or extrapulmonary sites of disease, Cryptosporidiosis (Cryptosporidium spp.) M Meningitis (caused by viral agents) including clinically diagnosed disease). Latent Cyclosporiasis (Cyclospora spp.) M Mumps M tuberculosis infection is not reportable. Dengue virus infection Neonatal sepsis M S Typhus (Rickettsia spp.) Diphyllobothrium latum infection (bacteria isolated from a sterile site, Unexplained deaths and unexplained critical Ehrlichia excluding coagulase-negative Staphylococcus) illness Ehrlichiosis ( spp.) less than seven days after birth (possibly due to infectious cause) M Encephalitis (caused by viral agents) Pertussis (Bordetella pertussis) M Varicella (chickenpox) M Enteric Escherichia coli infection M Vibrio spp. M (E. coli O157:H7, other Shiga toxin-producing Psittacosis (Chlamydophila psittaci) E. coli, enterohemorrhagic Retrovirus infections Yellow fever E. coli, enteropathogenic E. coli, enteroinvasive Salmonellosis, including typhoid (Salmonella Yersiniosis (enteric Yersinia spp. regardless of E. coli, enteroaggregative spp.) M specimen source) M E. coli, enterotoxigenic E. coli, or other Shigellosis (Shigella spp.) M Zika virus disease B pathogenic E. coli) Spotted fever rickettsiosis Zoster (shingles) M Giardiasis (Giardia intestinalis) (Rickettsia spp. infections, including Rocky (all cases <18 years old; unusual case incidence/ Gonorrhea (Neisseria gonorrhoeae infections) Mountain spotted fever) complications