Miranda Hawker, MPH Administrator

Patricia Lewis, MD Executive Medical Director

Rose Parker, RN Director of Nursing

Maureen Feaster, RN Senior Community Health Nursing Supervisor, Epidemiology

Cheryl Dunn, RS Environmental Health Manager

Joan Rivera Public Health Preparedness Coordinator

Barb Progul ske, DVM, MPH Environmental Health Consultant Editor

Main Location 1900 27th Street Vero Beach, FL 32960 772-794-7400

Gifford Health Center 4675 28th Court Vero Beach, FL 32967 772-770-5151

http://www.myirch d.org

Inside this Issue:

Diseases & Cond i- 1 tions Reportable to Public Health - Who is Responsible?

Reportable Diseases 2 & Cond it ions in Florida - Practitioner List

2013 Reportable 3 Disease Summary

Diseases & Conditions Reportable to Public Health - Who is Responsible? Who is required to report? Healthcare providers, veterinarian, licensed medical facilities and laboratories are all required by law (F.S. 381.0031, F.A.C. 64D-3) to report certain diseases, conditions and diagnoses and suspected outbreaks to the Health Department. Even animal control and wildlife officers, and animal laboratories are required to report. The list of reportable diseases and conditions in Florida is on page 2, and can also be found on the Florida Department of Health website at http://www.floridahealth.gov!diseases-and-co nd itions! d isea se- reporti n g-a nd -ma na gem ent! d isease-reporti n g-a nd-su rve ilia nce!

documents!reportable-diseases-fl.pdf. Reporting requirements for laboratories differ, and can be found at http:((www.floridahealth.gov!diseases-and-conditions!disease­repo rti n g-a nd -m a na gem ent! docum ents!la boratorypa cket. pdf

Is reporting to the Health Department a violation of HIPAA? No, protected health information (PHI) can be disclosed to public health authorities and their authorized agents for public health purposes including but not limited to public health surveillance, investigations and interventions.

Health Insurance Portability and Accountability Act of 1996 ("HIPAA") §1178(b): "Public Health - Nothing in this part shall be construed to invalidate or limit the authority, power, or procedures established under any law providing for the reporting of disease or injury, child abuse, birth, or death, public health surveillance, or public health investigation or intervention".

How do I report a disease or condition to the Health Department? Reports of diseases or conditions can be made via telephone or fax weekdays from 8:00 am to 5:00 pm. After hours, on weekends and holidays, reports can be made via tele­phone to the public health professional on call:

Phone: 772-794-7472 (24/7) Fax: 772-794-7482

What does the Health Department do with this information? Our goal is to prevent disease spread and outbreaks. The primary task of public health surveillance systems is to quickly detect diseases of public health significance so inter­ventions can be undertaken to reduce morbidity and mortality. Cases must be identified and contacted early so disease control measures can be implemented quickly. Cases are interviewed to identify risk factors for disease, allowing for effective targeting of appropriate public health interventions.

Department of Health in Indian River County is part of the national reportable disease surveillance system, where epidemiologic trends are monitored state wide by Department of Health and nationwide by the Centers for Disease Control and Prevention (CDC). These data guide public health policy development and research. Locally, we use these data to implement disease control measures (e.g., administering post exposure prophylaxis; exclusion of ill workers from sensitive workplace situations; and providing education on disease prevention), and to detect and respond to outbreaks.

Thanks to all of you who serve as our eyes and ears in the community. Without you our public health surveillance system wouldn't work. Thanks again for your partnership!

/ '\

Reportable Diseases/Conditions in Florida Practitioner* List 11/24/08

! - "oport immediately 2417 by phone upon 1nl~.1 OtJsp;ciOl1 or laboratory t .. torder

'B' - Report immediately 24/7 by phone Did you know that you are required by Florida statute** to report

certain diseases to your local county health department? *Reporting requirements for laboratories differ. For specific information on disease reporting, consult Rule 640-3, FlDrida Administrative Code (FAC).

! Any disease outbreak ! Any ca .. , cluster of cases, or outbreak of a

disease or condition found In the general community or any defined setting such as a hosplUl, school Or other Instkution, not I~ted below that is 01 urgent public health significance. This Inclodes those indicative 01 person to person spread, zoonotic spread, the presence 01 an environmental, food or waterborne source of expcsure and those that reso~ hom a deliberate act of terrorism. Acquired Immune Deficiency Syndrome (AIDS) + Amebic encephalitis'

Anaplasmosis'

! Anthrax

!

!

!

!

Arsenic poisoning· Botulism (loodOO<oe, wound, onspecllled, other) Botulism (infant)·

Brocellosis California serogroup virus (neuroinvasive and non-neuroinvasive disease)·

Campylobacteriosis' Cancer (except non-melanoma skin cancer, and including benign and borderline intracranial and CNS tumors)+ Carbon monoxide poisoning·

Chancroid' Chlamydia'

Cholera Ciguatera fish poisoning (Ciguatera)' Congenital anomalies'

Conjunctivitis (in neonates ~ 14 days old)' Creutzfeldt-Jakob disease (CJD)'

Cryptosporidiosis' Cyclosporiasis' Dengue·

Diphtheria Eastern equine encephalitis virus disease (neuroinvasive and non-neuroinvasive)·

Ehrlichiosis' Encephalitis, other (non-arboviral)' Enteric disease due to:

Escherichia coli, 0157:H7 Escherichia coli, other pathogenic E. coli including entero- toxigenic, invasive, pathogenic, hemorrhagic, aggregative strains and shiga toxin positive strains

Giardiasis·

! Glanders Gonorrhea·

Granuloma inguinale' ! Haemopllillls illlilleflzae (meningitis and

Invasive disease) Hansen's disease (Leprosy)'

• Hantavirus infection 'B' Hemolytic uremic syndrome

'B' Hepatitis A Hepatitis B, C, D, E, and G' Hepatitis B surface antigen (HBsAg) (positive in a pregnant woman or a child up to 24 months old)' Herpes simplex virus (HSV) (in infants up to 60 days old with disseminated infection with involvement of liver, encephalitis and infections limited to skin, eyes and mouth; anogenital in children ~ 12 yrs)' Human Immunodeficiency Virus (HIV) infection (all, and including neonates born to an infected woman, exposed newborn)+

Human papillomavirus (HPV) (associated laryngeal papillomas or recurrent respiratory papillomatosis in children ~ 6 years of age; anogenital in children ~ 12 yrs)'

! Influenza duo to novel or pandemic strains 'B' Influenza-associated pediatric mortality (in

persons aged < 18 yrs)

! I

,

Lead poisoning (blood lead level ~ 1 0pg/dL); additional reporting requirements eXISt for hand held and/or on-site blood lead testing technology, see 64D-3 FAC' Legionellosis'

Leptospirosis' Listeriosis Lyme disease'

Lymphogranuloma venereum (LGV)'

Malaria' Measles [Rubeola] Melioidosis

Meningitis (bacterial, cryptococcal, mycotic)' Meningococcal disease (Inclode. meningitis and meningococcemia)

Mercury poisoning'

Mumps' 'B' Neurotoxic shellfish poisoning • Pertussis

Pesticide-related illness and injury'

! Plague ! Pollomvelltls, paralytic and oon-paral'{tlc

Psittacosis (Ornithosis)' Q Fever·

'B' Rabies (human, animal)

• = Report next business day

+ = Other reporting timeframe

'\.. ./

! Rabies [pcsslble expcsure]

!

!

!

!

Ridn toxicity Rocky Mountain spotted fever' Rubella (including congenital)

St. Louis encephalitis (SLE) virus disease (neuroinvasive and non-neuroinvasive)· Salmonellosis'

Saxitoxin poisoning including paralytic shellfish poisoning (PSP)' Severe Acute Re.piratorJ Svndrome­associated Coronavlrus (SAR5-CoV) disease Shigellosis'

Smallpcx Staphylococcus aureus, community associated mortality·

'B' Staphylococcus aureus (infection with intermediate or full resistance to vancomycin, VISA,VRSA)

'B' Staphylococcal enterotoxin B (disease due to)

Streptococcal disease (invasive, Group A)' Streptococcus pneumoniae (invasive disease)' Syphilis'

'B' Syphilis (in pregnant women and neonates) Tetanus·

!

!

Toxoplasmosis (acute)'

Trichinellosis (Trichinosis)' Tuberculosis (TB)'

Tularemia Typhoid fever TVphus fever (disease due to Rickettsia prownzekli iolect lon)

Typhus fever (disease due to Rickettsia typhi, R. lelis infection)'

! Vaccinia dlseas.

!

!

!

Varicella (Chickenpox)' Varicella mortality· Venezuelan equine encephalitis virus dlseas. (neurolnyasiv. and non-neuroinv8swe)

Vibriosis (Vibrio infections)' Viral hemorrhagic levers (Ebola, Marburg, Lassa, Machupc)

West Nile virus disease (neuroinvasive and non-neuroinvasive) •

Western equine encephalitis virus disease (neuroinvasive and non-neuroinvasive)· Yellow tever

You are an invaluable part of Florida's disease surveillance system. rII!E For more mformatlon, please call the epidemiology Unit at your local county health department or the Bureau of Epidemiology, i1 i'~ ~!1 FlOrida Department of Health (FDOH): 850-245-4401 or VISit http://www.doh.state.fl.us/dlsease_ctrl/epl/toplcs/surv.htmil ... ~l •• **Sectlon 381 0031 (1 2) Flonda Statutes p-o~ des that ArIY p-actltloner licensed In Flonda to p-actice mediCine osteopathic mediCine chlrolxactic I (medicme'Mlo diagno";;" cr e ~xistence of a disease of PJijlC healtl Significance shailimmedlatery rep:xt tho fact to the Department of Health The FOOH coonty health departments ', ? '-"'~" ~ I ~ I-' ",,:, e ,in thi:~~E:i~"~ I "y~1 thiS SeCtlOO p-0vldes that Pfflo::Jically the Department shall Issue a list of diseases determined by It to be of PUijlC health Significance and shall Turnlsn a copy OT salo Iisttothe pmctt''''CIc ....

Selected Reportable Diseases/Conditions, Jan 1,2013 - December 31, 2013

with 3-year Comparison, Indian River County Cases (rate per 100,000 population) Florida Indian River County Enteric Diseases CY 2013 Campylobacteriosis Cryptosporidiosis Escherichia coli, Shiga toxin producing Giardiasis Salmonellosis Shigellosis Vibrio alginolyticus Vibrio parohoemolyticus Vibrio vulnificus Vector Borne Zoonoses Dengue Fever Lyme Disease Malaria Rabies, Animal Rabies, Possible Human Exposure NS & Invasive Diseases

Haemophilus infJuenzae (invasive disease)_ Meningitis (Bacterial, Cryptococcal, Mycotic)_ Staphylococcus Enterotoxin B Poisoning Streptococcus pneumoniae, invasive disease, drug resistant Streptococcus pneumoniae, invasive disease, susceptible Streptococcal disease, invasive, Group A Vaccine Preventable Mumps

titis Hepatitis A Hepatitis B (+HBsAg in pregnant women)_ Hepatitis B, Acute Hepatitis B, Chronic Hepatitis C, Acute Hepatitis C, Chronic Hepatitis D HIV AIDS" HIV AIDS

STOs" Chlamydia Gonorrhea Infectious Syphilis Others Carbon Monoxide poisoning Lead poisoning Legionellosis Mercury Poisoning Pesticide-related illness or injury

2,630 (13. 7) 414 (2.2) 544 (2.8)

1,126 (5.9) 6,350 (33.1)

1,108 (5.8) 49 (0.3) 55 (0.3) 41 (0.2)

173(0.9) 185 (1.0)

54 (0.3)_ 105 (0.6)

2,738 (14.3)

272 (1.4) 156 (0.8) ~(0.01)

521 (2.7) 583 (3.0) 302 1.6)

8 (0.04)_ 739 (3.9) 661 (3.4)

135 (0.7) 487 (2.5) 377 (2.0)

4,455 (23.2) 219 (1.1)

25,046 (130.3) 1 0.01)

5,938(30.9) 3,282 17.1)

o

o

12 (8.5) 7 4.9)

79,617 (414.3)~04 (356.2) 20,665 (107.5) 67 (47.4

1,473 (7.7) 3 (2.1)

179(0.9) 761 (4.0) 265 (1.4)

5 (0.03) 70 (0.4) 3 (0.02)

CY 2012 CY 2011 36 (25.7) 23 (16.6)

4 (2.9)t-11 (7.9) 1 (0.7) 3 (2.2)

14 (10.0): 11 (7.9) 75 (53.6) 44 (31.7) 88 (62.9)t- 4 (2.9)

1 (0.7)1--- 0 1 (0.7\-- 1 (0.7)

o 1 (0.7)

o 2 (1.4)

o o

10 (7.2),

o o

1 (0.7) 2 (1.4)

21 (15.1)

o 3 (2.2)

1 (0.7)f-- 0 o 0

1 (0.7)j---l (0.7) 2 (1.4)1--- 3 (2.2) 2 (1.4) 2 (1.4)

o

o 2 (1.4) 2 (1.4)j---2 (1.4) 1 (0.7) 0

19 (13.6): 23 (16.6) 2 (1.4) 0

166 (118.7)1155 (111.6) o 0

17 (13.9)~(1O.1) 11 (9.0), 8 (5.8)

476 (340.3)1 418(300.9) 119 (85.1)~(99.3)

3 (2.1 4 (2.9)

1 (0.7)1--- 0 4 (2.9)j---2 (1.4) 3 (2.1)1 2 (1.4) 1 (0.7)j--- 0 2 (1.4)}-3 (2.2)

o 0 Saxitoxin Poisoning (Paralytic Shellfish Poisoning)_ Tuberculosis* 6520 '_.....;41 .. 1(~2.9iO; 20

*2013 data are provisional and subject to change; ¥TD as of 12/31/2013