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Surveillance Update TISWG May, 2011 Rachel Wiseman, MPH Epidemiologist Emerging and Acute Infectious Diseases May 18, 2011
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VPDs in Texas, 2005-2010 200520062007200820092010 Hep A461330264259184139 Hep B742833741562420394 Peri Hep B813812 HIB8111411712 Measles307010 Meningo- coccal 614555705359 Mumps2558212040121 Pertussis2,2249541,0512,0463,3582,848 Pneumo- coccal 7359011,4171,8841,9521,912 Tetanus010310 Varicella8,33611,76810,0617,8394,4452,760
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2010 Deaths Pertussis: NONE!! Meningococcal: 3 (lower than expected) Pneumococcal: 123 (expected) Varicella: 2 All other VPDs: NONE!! Unfortunately we did recently have a 2011 pertussis death Too young for vaccination No contacts with pertussis
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Correctional Mumps Outbreaks, 2010-11 July-September 2010 Primarily Central, NE Texas 30 cases October 2010 Valley 9 cases December 2010-March 2011 Most of the state except N Texas, W Texas 35 cases
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Measles 2011 89 cases reported to CDC in 2011 Annual average ~50 Outbreaks in Europe Endemic areas Outbreaks in multiple US states Texas has 6 cases in 2011 Most characterized by delays in diagnosis and/or reporting
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2011 Measles Cases—Texas Case 1. Unvaccinated 23 mo from Houston area Travel to Philippines Parents “too busy” to vaccinate Case 2. Unvaccinated 7 mo from Houston area Travel to India, probably exposed on flight home Children as young as SIX months can receive MMR if they are going to be traveling abroad
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2011 Measles Cases—Texas (2) Exposed at Trade Show in Orlando Florida Case 3. Adult with 1 MMR Case 4. Unvaccinated spouse of above Case 5. Unvaccinated adult Case 6. Unvaccinated 11 month old child No secondary transmission except from 4 to 5. Two cases identified in other states, not Florida.
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Peak: week 7
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Texas Flu Summary, 2010-2011 Predominant influenza type: A Subtype: H3N2 Seasonal peaks ILINet peak: mid February Laboratory peaks: mid to late January mid February
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CDC Grant Objectives (1) 90% of VPD investigations are sent to CDC within 30 days of receiving report Texas reality: <80% within 30 days Why timeliness is important Many interventions have time restrictions Detect state-wide or national trends/outbreaks Improvement Plan Provide semi-annual feedback to locals/regions on timeliness Improve turn around time at Central Office
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CDC Grant Objectives (2) Known vaccination status for at least 90% of cases Texas reality 100% HIB <5 years 36% meningococcal 75% in <18 age group 70% mumps 93% in <18 age group 79% pertussis 92% in <18 age group
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CDC Grant Objectives (2) Capturing vaccination status is important to assess control measures, vaccine efficacy/schedule, vaccination policies, etc Giving feedback to local and regional health departments on semi-annual basis Include reminders about all possible ways to capture vaccine information Exploring ways to streamline data capture (can Immtrac talk to our database?)
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Questions?
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