1. Surveillance Update TISWG May, 2011 Rachel Wiseman, MPH Epidemiologist Emerging and Acute Infectious Diseases May 18, 2011

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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.

8. Peak: week 7

9. 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

10. 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

11. 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

12. 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?)

13. Questions?