EpiNotes Florida Department of Health - Hillsborough ...hillsborough.floridahealth.gov/programs-and... · 3/1/2017  · Cyclospora 4 1 1 2.00 0 0 Escherichia coli, Shiga toxin-producing

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Florida Department of Health - Hillsborough County Disease Surveillance Newsletter

February 2017

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Mission: To protect, promote & improve the health of all people in Florida through integrated state & community efforts. Vision: To be the Healthiest State in the Nation

Rick Scott Governor

Celeste Philip, MD, MPH State Surgeon General

EpiNotes

Director Douglas Holt, MD 813.307.8008

Medical Director (HIV/STD/EPI) Charurut Somboonwit, MD 813.307.8008

Medical Director (TB/Refugee) Beata Casanas, MD 813.307.8008

Medical Director (Vaccine Outreach) Jamie P. Morano, MD, MPH 813.307.8008

Community Health Director Leslene Gordon, PhD, RD, LD/N 813.307.8015 x7107

Disease Control Director Carlos Mercado, MBA 813.307.8015 x6321

Environmental Administrator Brian Miller, RS 813.307.8015 x5901

Epidemiology Warren R. McDougle Jr., MPH 813.307.8010 Fax 813.276.2981

TO REPORT A DISEASE: Epidemiology 813.307.8010

After Hours Emergency 813.307.8000

Food and Waterborne Illness Patrick Rodriguez 813.307.8015 x5944 Fax 813.272.7242

HIV/AIDS Surveillance Erica Botting 813.307.8011

Lead Poisoning Cynthia O. Keeton 813.307.8015 x7108 Fax 813.272.6915

Sexually Transmitted Disease Sophia Hector 813.307.8045 Fax 813.307.8027

Tuberculosis Irma B. Polster 813.307.8015 x4758 Fax 813.975.2014

Articles and Attachments Included This Month

Zika Fever Update 1 Florida Food Recalls 2 Health Advisories and Alerts 2 Epi in the News 2 Influenza Activity 3 Guidelines for Control of Outbreaks of Enteric Disease in Child Care

Settings 4 Reportable Disease Surveillance Data 5 Reportable Diseases/Conditions in Florida, Practitioner List 8 FDOH, Practitioner Disease Report Form 9

Zika Fever Update (March 1, 2017)

Infection Type Infection Count 2016

Infection Count 2017

Travel-Related Infections of Zika 1,076 13

Locally Acquired Infections of Zika 274 0

Undetermined 32 0

Pregnant Women with Lab-Evidence of Zika 262 4

Note, these categories are not mutually exclusive and cannot be added together. Please visit our website to see the full list of travel-related cases by county.

The total number of Zika Cases reported in Hillsborough County Infection Type Hillsborough County

2016 Hillsborough County

2017

Travel-Related Infections of Zika

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Florida no longer has any identified areas with active Zika transmission, but we will continue to see isolated cases of local transmission so it is important for residents and visitors in Miami-Dade County to remain vigilant about mosquito bite protection. Zika in the news: Sofosbuvir: an antiviral drug with potential efficacy against Zika infection

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Florida Department of Health - Hillsborough County Disease Surveillance Newsletter

February 2017

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Mission: To protect, promote & improve the health of all people in Florida through integrated state & community efforts. Vision: To be the Healthiest State in the Nation

Rick Scott Governor

Celeste Philip, MD, MPH State Surgeon General

EpiNotes

Brand Names Food Date of

Recall Health Risk

Link to

Recall

Ready Pac Foods Inc. Chicken salad product w/ cheese 02/22/2017 Listeria Details

MDS Foods, Inc. Various cheese products - Expanded Recall 02/20/2017 Listeria Details

Dutch Valley Food Distributors,

Schlabach Branch Assorted Cheese Items 02/17/2017 Listeria Details

Century Packing Corp. Chicken Sausage Products Due To

Misbranding FL School Distribution 02/15/2017 MSG Allergen Details

Canadian Marketplace PC Organics Various Baby Food Pouches 02/15/2017 Clostridium

botulinum Details

Sargento Select Cheese Products 02/14/2017 Listeria Details

Country Fresh Various Cooking & Snacking Products 02/13/2017 Listeria Details

MDS Foods, Inc. Various cheese products 02/13/2017 Listeria Details

Barberi International Inc. Sunmba Frozen Ajiaco (vegetable mix) 02/01/2017 Listeria Details

Dutch Valley Food Distributors, Inc. Cappuccino Snack Mix 01/12/2017 Salmonella Details

Tupperware U.S., Inc. Southwest Chipotle Seasoning 01/11/2017 Salmonella Details

Palmer Candy Company Certain chocolate products 01/10/2017 Salmonella Details

Hostess Brands, LLC Limited-Edition Holiday White Peppermint

Hostess® Twinkies® 01/09/2017 Salmonella Details

Florida Food Recalls in January & February

Epi in the News

CDC Travel Health Alert- Level 2- Brazil: The Brazilian Ministry of Health has reported an ongoing outbreak of yellow fever starting in December 2016. In response to this outbreak, health authorities have recently expanded the list of areas in which yellow fever vaccination is recommended for travelers.

Health Advisories and Alerts

Leptospirosis Cluster in Concourse neighborhood of the Bronx in New York City

An outbreak of the mumps virus is occurring in Arkansas, Missouri, and Oklahoma.

The Pan American Health Organization and World Health Organization report on an increasing number of cases of malaria reported in Central and South America, as well as recent locally acquired cases in Costa Rica and Cuba.

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Florida Department of Health - Hillsborough County Disease Surveillance Newsletter

February 2017

3

Mission: To protect, promote & improve the health of all people in Florida through integrated state & community efforts. Vision: To be the Healthiest State in the Nation

Rick Scott Governor

Celeste Philip, MD, MPH State Surgeon General

EpiNotes

Figure 2.

Influenza Activity

Week 7 Florida Flu Review

Influenza season is here. Florida reported widespread activity to the Centers of Disease Control and Prevention (CDC) for the sixth week in a row.

In week 7, influenza activity in Florida continued to steadily increase. Elevated influenza activity is expected for several weeks, with peak activity still ahead.

Since the start of the 2016-17 influenza season, the most common influenza subtype detected at the Bureau of Public Health Laboratories (BPHL) statewide has been influenza A (H3).

For the full version of the weekly Florida Flu Review, visit here: http://www.floridahealth.gov/diseases-and-conditions/influenza/florida-influenza-surveillance-reports/index.html

Hillsborough Flu Activity

Figure 1 shows the percent of weekly visits due to influenza-like illness (fever and cough or sore throat) to our local EDs and some urgent care centers, based on chief complaint data.

In the 2016-2017 influenza season, Hillsborough County has reported six outbreaks of influenza or influenza-like illness.

The majority of lab results electronically reported to DOH for Hillsborough residents in recent weeks have been for influenza A, as seen in Figure 2.

Influenza Vaccine

The CDC’s interim estimates of 2016–17 seasonal influenza vaccine effectiveness demonstrate an overall vaccine efficacy of 48% (vaccination reduced the risk for influenza-associated medical visits by approximately half).

Figure 1.

EpiNotes January 2017

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Guidelines for Control of Outbreaks of Enteric Disease in Child Care Settings – January, 2017

The Florida Department of Health has released an updated version of the document “Guidelines for Control of Outbreaks of Enteric Disease in Child Care Settings.” This document describes control procedures for outbreaks of enteric disease in child care settings caused by Cryptosporidium, Shiga-toxin producing Escherichia coli (STEC), hepatitis A, Giardia, Shigella, nontyphoidal Salmonella, and other enteric pathogens, as well as those of unknown etiology. These procedures are referenced by Rule 64D-3.013(5), F.A.C.; compliance may be required by the county health department as part of compliance with the rule. The County Health Officer has the authority under Chapter 64D-3, F.A.C., to issue isolation or quarantine orders, close facilities, and limit the movements of people if the officer or designee determines that these measures are necessary for disease control. Laboratory testing is performed to assist in public health decision making and for epidemiologic investigations. Symptomatic staff and children may be requested to submit stool specimens to establish the cause of the outbreak. Once the etiologic agent for the outbreak has been identified, additional testing of new symptomatic staff or children is usually not required for public health purposes and these persons may be referred to their health care providers for laboratory testing. When cultures are specified in the readmission criteria below, they can be conducted at the Bureau of Public Health Laboratories. If determined necessary for disease control purposes, asymptomatic children and staff may be required to submit stool specimens in order to implement additional control measures. These guidelines apply anytime an outbreak of gastrointestinal illness is detected in any child care setting. An outbreak is defined as two or more cases of gastrointestinal illness with similar symptoms occurring within 72 hours among children or staff who share an exposure or are in close contact and who do not live in the same household. If the etiologic agent is known, an outbreak is defined as two or more cases occurring within the maximum incubation period of the disease among children or staff who share an exposure or are in close contact and who do not live in the same household. For hepatitis A, an outbreak in a child care setting is defined as one or more cases in children or staff members, or cases in two or more households of center attendees within the maximum incubation period. A key provision in this document is notifications. Immediately upon suspicion of the outbreak the child care center will notify the local health department. And, within 24 hours of detecting a gastrointestinal illness outbreak, child care facilities will notify parents and staff in writing of the outbreak. The following information should be included in the written notification: the suspected or confirmed cause, prevention measures to be taken, exclusion requirements, instructions to contact the facility and their health care provider if their child becomes ill, and a contact number for the county health department. Facilities are to work with the county health department to develop the written notification. Additionally, if the DCF child care licensing office has not been notified by the facility within 24 hours of detecting an outbreak, the county health department will notify the local DCF child care licensing office. County health departments should routinely coordinate with the DCF licensing office during disease outbreaks in child care settings to ensure appropriate notification. Any child care center reporting a GI outbreak will be required to perform active surveillance. As directed by the county health department, child care staff will determine if symptoms of GI illness are present in children or staff daily. These illnesses will be logged on a form provided or approved by the county health department. All new illnesses detected should be reported to the county health department the same business day. If you have any questions about the “Guidelines for Control of Outbreaks of Enteric Disease in Child Care Settings” requirements, please call the Florida Department of Health in Hillsborough County Epidemiology Program at 813-307-8010.

The full document is available here.

EpiNotes January 2017

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Disease Category Annual Totals**

3 Year Average

Year-To-Date**

2014 2015 2016 Jan

2016 Jan

2017

Vaccine Preventable Diseases

Diphtheria 0 0 0 0.00 0 0

Measles 0 0 0 0.00 0 0

Mumps 1 1 2 1.33 0 0

Pertussis 65 41 73 59.67 9 5

Poliomyelitis 0 0 0 0.00 0 0

Rubella 0 0 1 0.33 1 0

Smallpox 0 0 0 0.00 0 0

Tetanus 0 0 0 0.00 0 0

Varicella 59 74 70 67.67 7 2

CNS Diseases & Bacteremias

Creutzfeldt-Jakob Disease 1 3 3 2.33 1 0

H. influenzae (Invasive Disease in children <5) 3 2 4 3.00 1 1

Listeriosis 2 2 0 1.33 0 0

Meningitis (Bacterial, Cryptococcal, Mycotic) 12 16 9 12.33 0 1

Meningococcal Disease 2 2 2 2.00 0 0

Staphylococcus aureus (VISA, VRSA) 0 0 0 0.00 0 0

S. pneumoniae (Invasive Disease in children <6) 5 2 3 3.33 0 0

Enteric Infections

Campylobacteriosis 155 152 197 168.00 13 4

Cholera 0 0 0 0.00 0 0

Cryptosporidiosis 351 101 62 171.33 10 2

Cyclospora 4 1 1 2.00 0 0

Escherichia coli, Shiga toxin-producing (STEC) 6 16 24 15.33 1 3

Giardiasis 64 55 105 74.67 4 5

Hemolytic Uremic Syndrome 1 2 1 1.33 1 0

Salmonellosis 343 287 308 312.67 31 9

Shigellosis 66 216 76 119.33 3 9

Typhoid Fever 0 0 1 0.33 0 1

Viral Hepatitis

Hepatitis A 5 5 5 5.00 0 0

Hepatitis B (Acute) 59 62 53 58.00 4 4

Hepatitis C (Acute) 29 48 31 36.00 2 4

Hepatitis +HBsAg in Pregnant Women 35 27 23 28.33 7 0

Hepatitis D, E, G 0 1 0 0.33 0 0

Reportable Disease Surveillance Data

EpiNotes January 2017

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Disease Category Annual Totals**

3 Year Average

Year-To-Date

2014 2015 2016 Jan

2016 Jan

2017

Vectorborne, Zoonoses

Chikungunya 33 10 1 14.67 0 1

Dengue 6 7 2 5.00 0 0

Eastern Equine Encephalitis 0 0 0 0.00 0 0

Ehrlichiosis/Anaplasmosis 2 0 0 0.67 0 0

Leptospirosis 0 1 0 0.33 0 0

Lyme Disease 11 12 6 9.67 0 1

Malaria 11 2 6 6.33 0 0

Plague 0 0 0 0.00 0 0

Psittacosis 0 0 0 0.00 0 0

Q Fever (Acute and Chronic) 0 0 0 0.00 0 0

Rabies (Animal) 4 3 3 3.33 0 0

Rabies (Human) 0 0 0 0.00 0 0

Rocky Mountain Spotted Fever 0 0 0 0.00 0 0

St. Louis Encephalitis 0 0 0 0.00 0 0

Trichinellosis 0 0 0 0.00 0 0

Tularemia 0 0 0 0.00 0 0

Typhus Fever (Epidemic) 0 0 0 0.00 0 0

Venezuelan Equine Encephalitis 0 0 0 0.00 0 0

West Nile Virus 0 2 1 1.00 0 0

Western Equine Encephalitis 0 0 0 0.00 0 0

Yellow Fever 0 0 0 0.00 0 0

Others

Anthrax 0 0 0 0.00 0 0

Botulism, Foodborne 0 0 0 0.00 0 0

Botulism, Infant 0 0 0 0.00 0 0

Brucellosis 0 0 1 0.33 0 0

Glanders 0 0 0 0.00 0 0

Hansen's Disease (Leprosy) 0 0 0 0.00 0 0

Hantavirus Infection 0 0 0 0.00 0 0

Legionellosis 7 20 25 17.33 1 2

Melioidosis 0 0 0 0.00 0 0

Vibriosis 7 11 11 9.67 0 0

Reportable Disease Surveillance Data

EpiNotes January 2017

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Disease Category Annual Totals**

3 Year Average

Year-To-Date

2014 2015 2016 Jan

2016 Jan

2017

Chemicals/Poisoning

Arsenic 0 0 0 0.00 0 0

Carbon Monoxide 18 20 20 19.33 11 0

Lead 208 246 154 202.67 6 8

Mercury 0 13 0 4.33 0 0

Pesticide 2 1 2 1.67 0 0

Influenza

Influenza, Pediatric Associated Mortality 1 0 0 0.33 0 1

Influenza, Novel or Pandemic Strain 0 0 0 0.00 0 0

HIV/AIDS*

AIDS 167 177 160 172.00 15 15

HIV Infection 332 361 369 354.00 24 47

STDs

Chlamydia 7304 7423 8097 7608.00 NA NA

Gonorrhea 1848 1991 2345 2061.33 NA NA

Syphilis, Congenital 4 4 2 3.33 NA NA

Syphilis, Latent 166 199 210 191.67 NA NA

Syphilis, Early 141 147 198 162.00 NA NA

Syphilis, Infectious 208 222 223 217.67 NA NA

Tuberculosis

TB 49 41 43 44.33 2 0

Food and Waterborne Illness Outbreaks

Food and Waterborne Cases 58 27 1 28.67 0 7

Food and Waterborne Outbreaks 3 2 1 2.00 0 1

Reportable Disease Surveillance Data

* Current HIV Infection data by year of report reflects any case meeting the CDC definition of ‘HIV infection’ which includes all newly reported HIV cases and newly reported AIDS cases with no previous report of HIV in Florida. If a case is later identified as being previously diagnosed and reported from another state, the case will no longer be reflected as a Florida case and the data will be adjusted accordingly. Data from the most recent calendar year (2016) are considered provisional and therefore should not be used to confirm or rule out an increase in newly reported cases in Florida. The final year-end numbers are generated in July of the following year, after duplicate cases are removed from the dataset, as is customary of HIV surveillance in the US. ** Includes confirmed and probable cases reported in Florida residents (regardless of where infection was acquired) by date reported to the Bureau of Epidemiology in Merlin. Data for 2016 are provisional and subject to change. Counts are current as of the date above, but may change. Please note that counts presented in this table may differ from counts presented in other tables or reports, depending on the criteria used. Changes in case definitions can result in dramatic changes in case counts. Please see Florida Surveillance Case Definitions on the Bureau of Epidemiology for information on case definition changes (http://www.floridahealth.gov/diseases-and-conditions/disease-reporting-and-management/disease-reporting-and-surveillance/case-def-archive.html).

Birth Defects

+ Congenital anomalies

+ Neonatal abstinence syndrome (NAS)

Cancer

+ Cancer, excluding non-melanoma skin cancer and including benign and borderline intracranial and CNS tumors

HIV/AIDS

+ Acquired immune deficiency syndrome (AIDS)

+ Human immunodeficiency virus (HIV) infection

HIV, exposed infants <18 months old born to an HIV-infected woman

STDs

Chancroid

Chlamydia

Conjunctivitis in neonates <14 days old

Gonorrhea

Granuloma inguinale

Herpes simplex virus (HSV) in infants <60 days old with disseminated infection and liver involvement; encephalitis; and infections limited to skin, eyes, and mouth; anogenital HSV in children <12 years old

Human papillomavirus (HPV), associated laryngeal papillomas or recurrent respiratory papillomatosis in children <6 years old; anogenital papillomas in children <12 years old

Lymphogranuloma venereum (LGV)

Syphilis

Syphilis in pregnant women and neonates

Tuberculosis Tuberculosis (TB)

All Others

! Outbreaks of any disease, any case, cluster of cases, or exposure to an infectious or non-infectious disease, condition, or agent found in the general community or any defined setting (e.g., hospital, school, other institution) not listed that is of urgent public health significance

Amebic encephalitis

! Anthrax

Arsenic poisoning

Arboviral diseases not otherwise listed

! Botulism, foodborne, wound, and unspecified

Botulism, infant

! Brucellosis

California serogroup virus disease Campylobacteriosis

Carbon monoxide poisoning

Chikungunya fever

Chikungunya fever, locally acquired

! Cholera (Vibrio cholerae type O1)

Ciguatera fish poisoning

Creutzfeldt-Jakob disease (CJD)

Cryptosporidiosis

Cyclosporiasis

Dengue fever

Dengue fever, locally acquired

! Diphtheria

Eastern equine encephalitis

Ehrlichiosis/anaplasmosis

Escherichia coli infection, Shiga toxin-producing

Giardiasis, acute

! Glanders

! Haemophilus influenzae invasive disease in children <5 years old

Hansen’s disease (leprosy)

Hantavirus infection

Hemolytic uremic syndrome (HUS)

Hepatitis A

Hepatitis B, C, D, E, and G

Hepatitis B surface antigen in pregnant women or children <2 years old

Herpes B virus, possible exposure

! Influenza A, novel or pandemic strains

Influenza-associated pediatric mortality in children <18 years old

Lead poisoning

Legionellosis

Leptospirosis

Listeriosis

Lyme disease

Malaria

! Measles (rubeola)

! Melioidosis

Meningitis, bacterial or mycotic

! Meningococcal disease

Mercury poisoning

Mumps

Neurotoxic shellfish poisoning

Pertussis

Pesticide-related illness and injury, acute

! Plague

! Poliomyelitis

Psittacosis (ornithosis)

Q Fever

Rabies, animal or human

! Rabies, possible exposure

! Ricin toxin poisoning

Rocky Mountain spotted fever and other spotted fever rickettsioses

! Rubella

St. Louis encephalitis

Salmonellosis

Saxitoxin poisoning (paralytic shellfish poisoning)

! Severe acute respiratory disease syndrome associated with coronavirus infection

Shigellosis

! Smallpox

Staphylococcal enterotoxin B poisoning

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

Streptococcus pneumoniae invasive disease in children <6 years old

Tetanus

Trichinellosis (trichinosis)

! Tularemia

Typhoid fever (Salmonella serotype Typhi)

! Typhus fever, epidemic

! Vaccinia disease

Varicella (chickenpox)

! Venezuelan equine encephalitis

Vibriosis (infections of Vibrio species and closely related organisms, excluding Vibrio cholerae type O1)

! Viral hemorrhagic fevers

West Nile virus disease

! Yellow fever

! Report immediately 24/7 by phone upon

initial suspicion or laboratory test order Report immediately 24/7 by phone

Report next business day + Other reporting timeframe

*Section 381.0031 (2), Florida Statutes (F.S.), provides that “Any practitioner licensed in this state to practice medicine, osteopathic medicine, chiropractic medicine, naturopathy, or veterinary medicine; any hospital licensed under part I of chapter 395; or any laboratory licensed under chapter 483 that diagnoses or suspects the existence of a disease of public health significance shall immediately report the fact to the Department of Health.” Florida’s county health departments serve as the Department’s representative in this reporting requirement. Furthermore, Section 381.0031 (4), F.S. provides that “The department shall periodically issue a list of infectious or noninfectious diseases determined by it to be a threat to public health and therefore of significance to public health and shall furnish a copy of the list to the practitioners…”

Reportable Diseases/Conditions in Florida Practitioner List (Laboratory Requirements Differ) Effective June 4, 2014

Florida Department of Health, Practitioner Disease Report Form Complete the following information to notify the Florida Department of Health of a reportable disease or condition, as required by Chapter 64D-3, Florida Administrative Code (FAC). This can be filled in electronically.

Patient Information

SSN:

Last name:

First name:

Middle:

Parent name:

Gender: MaleFemaleUnk

Birth date: Death date:

Race: American Indian/Alaska NativeAsian/Pacific IslanderBlack

WhiteOtherUnk

Ethnicity: HispanicNon-HispanicUnk

Address:

ZIP: County:

City: State:

Home phone:

Other phone:

Emer. phone:

Pregnant: YesNoUnk

Died: Yes No Unk

Hospitalized:

Date admitted: Date discharged:

Date onset: Date diagnosis:

Physician:

Address:

City: State: ZIP:

Phone: Fax:

Email:

Medical Information

Yes No Unk

Provider Information

Hospital name:

Insurance:

Treated: Yes No Unk

Specify treatment:

Laboratory

testing:

Yes No Unk Attach laboratory result(s) if available.

MRN:

Email:

Revised June 4, 2014

Reportable Diseases and Conditions in Florida Notify upon suspicion 24/7 by phone Notify upon diagnosis 24/7 by phone

HIV/AIDS and HIV-exposed newborn notification should be made using the Adult HIV/AIDS Confidential Case Report Form, CDC 50.42A (revised March 2013) for cases in people 13 years old or the Pediatric HIV/AIDS Confidential Case Report, CDC 50.42B (revised March 2003) for cases in people <13 years old. Please contact your local county health department for these forms (visit http://floridahealth.gov/chdepicontact to obtain CHD contact information). Congenital anomalies and neonatal abstinence syndrome notification occurs when these conditions are reported to the Agency for Health Care Administration in its inpatient discharge data report pursuant to Chapter 59E-7 FAC. Cancer notification should be directly to the Florida Cancer Data System (see http://fcds.med.miami.edu). All other notifications should be to the CHD where the patient resides. To obtain CHD contact information, see http://floridahealth.gov/chdepicontact. See http://floridahealth.gov/diseasereporting for other reporting questions.

Amebic encephalitisAnthraxArsenic poisoning

Botulism, foodborne

Botulism, infant

Botulism, wound or unspecifiedBrucellosisCalifornia serogroup virus diseaseCampylobacteriosisCarbon monoxide poisoningChancroid

ChlamydiaCholera (Vibrio cholerae type O1)Ciguatera fish poisoningConjunctivitis in neonate <14 days oldCreutzfeldt-Jakob disease (CJD)CryptosporidiosisCyclosporiasisDengue fever

DiphtheriaEastern equine encephalitisEhrlichiosis/anaplasmosis

Giardiasis, acute

GlandersGonorrheaGranuloma inguinale

Arboviral disease not listed here

Chikungunya fever

Escherichia coli infection, Shiga toxin- producing

Hansen's disease (leprosy)Hantavirus infectionHemolytic uremic syndrome (HUS)Hepatitis AHepatitis B, C, D, E, and G

Herpes B virus, possible exposure

HSV, anogenital in child <12 years old

Influenza A, novel or pandemic strains

Lead poisoningLegionellosisLeptospirosisListeriosisLyme diseaseLymphogranuloma venereum (LGV)MalariaMeasles (rubeola)

MelioidosisMeningitis, bacterial or mycotic

Haemophilus influenzae invasive disease in child <5 years old

Influenza-associated pediatric mortality in child <18 years old

Hepatitis B surface antigen in pregnant woman or child <2 years old

Herpes simplex virus (HSV) in infant <60 days old

Human papillomavirus (HPV), laryngeal papillomas or recurrent respiratory papillomatosis in child <6 years oldHPV, anogenital papillomas in child <12 years old

Meningococcal diseaseMercury poisoningMumpsNeurotoxic shellfish poisoning

Pertussis

Pesticide-related illness and injury, acute

PlaguePoliomyelitis

Psittacosis (ornithosis)

Q Fever

Rabies, animal

Rabies, human

Rabies, possible exposure

Ricin toxin poisoning

Rubella

St. Louis encephalitis

Salmonellosis

Shigellosis

Smallpox

Severe acute respiratory disease syndrome associated with coronavirus infection

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

Saxitoxin poisoning (paralytic shellfish poisoning)

Rocky Mountain spotted fever or other spotted fever rickettsiosis

Staphylococcal enterotoxin B poisoning

Syphilis

Syphilis in pregnant woman or neonate

Tetanus

Trichinellosis (trichinosis)

Tuberculosis (TB)

Tularemia

Typhoid fever (Salmonella serotype Typhi)

Typhus fever, epidemic

Vaccinia disease

Varicella (chickenpox)

Venezuelan equine encephalitis

Viral hemorrhagic fevers

West Nile virus disease

Yellow feverOutbreaks of any disease, any case, cluster of cases, or exposure to an infectious or non-infectious disease, condition, or agent found in the general community or any defined setting (e.g., hospital, school, other institution) not listed above that is of urgent public health significance. Please specify:

Streptococcus pneumoniae invasive disease in child <6 years old

Vibriosis (infections of Vibrio species and closely related organisms, excluding Vibrio cholerae type O1)

Comments

Chikungunya fever, locally acquired

Dengue fever, locally acquired

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