Third Quarter 2018
 
The EPI Update is a quarterly e-newsletter provided by the disease containment staff of the Johnson County Department of Health and Environment (JCDHE). This newsletter will arm health care providers and public health professionals with information about infectious disease trends in Johnson County, Kan. and JCDHE's services. If you have a story idea for a future issue, send an email to jcdhe@jocogov.org. We encourage you to share this newsletter with your colleagues! 
Travel history and vaccine status can identify potential disease outbreaks

The measles outbreak in the metro area earlier this year is a good example of how diseases not usually seen in the United States, like measles and rubella, are only a plane ride away. As our society continues to be more mobile, healthcare providers should routinely ask patients for travel histories and vaccination status. If patients have not traveled, ask if their contacts have recently been abroad. 

Health officials in Kansas were first notified of a case of measles in a Johnson County child care facility on March 8 after an infant who was too young to be vaccinated was infected with the disease while traveling internationally. T he Johnson County Department of Health and Environment and the Kansas Department of Health and Environment identified 22 cases of measles that were epidemiologically linked to this case. In early April 2018, cases of measles began to appear in Kansas City, Mo. after an unvaccinated adult was exposed to measles while traveling abroad.

Measles is still common in other parts of the world, including many countries in Europe, Asia, the Pacific and Africa. Every year, unvaccinated people get measles while they are abroad and bring the disease into the United States and spread it to others. Anyone 6 months or older who is planning to travel outside the U.S. should get the MMR vaccine 4-6 weeks before departure. 

JCDHE offers travel vaccines on a walk-in basis at its Olathe (11875 S. Sunset Dr.) and Mission (6000 Lamar Ave.) immunization clinics. Travelers can also get immunizations from Children's Mercy Hospital or one of the private pay travel clinics in Johnson County. 
KHEL laboratories offer West Nile Virus and Arboviral testing 

West Nile virus (WNV) serology testing is now available at the Kansas Health and Environmental Laboratories (KHEL) for patients who present with neuroinvasive disease including encephalitis or meningitis.  

WNV testing at KHEL can be performed on serum specimens only. Collection and shipping information can be found here

The Kansas Department of Health and Environment recently confirmed two cases of neuroinvasive WNV disease  in Johnson County residents on July 31.

The Centers for Disease Control and Prevention's Arborviral Diseases Branch will now offer routine diagnostic testing for Heartland and Bourbon viruses. Testing for these viruses should be considered for patients with an acute febrile illness with the past three months AND at least one epidemiologic criterion AND at least one clinical criterion. 

Contact the KDHE Epidemiology Hotline at 877-427-7317 for specimen approval and questions. 
Free criminal-epidemiology course offered on Oct. 4

An intentional release of a pathogen may result in separate law enforcement and public health investigations. By working together, public health and law enforcement can achieve their separate, but often overlapping, objectives of determining if the outbreak is intentional or natural, and protecting public health and safety. 

The Johnson County Department of Health and Environment, the Federal Bureau of Investigation's Kansas City Field Office (FBI) and the Kansas Department of Health and Environment want to bring together these disciplines for a FREE one-day course on Oct. 4 in Wichita, Kan. to share knowledge and increase interoperability.

Pre-registration is required on Kansas TRAIN (Course #1079086). Questions about the course or registration can be sent to Tiffany.Wallin@jocogov.org
Get notified about disease outbreaks in Johnson County 


The Johnson County Department of Health and Environment uses NotifyJoCo to alert local healthcare providers about disease outbreaks in Johnson County, Kan. and other related information. This service is in addition to the Kansas Health Alert Network (KS-HAN) messages you may already be receiving from the Kansas Department of Health and Environment.  

Healthcare providers can sign up to receive these alerts by clicking here. Choose My Subscriptions --> Johnson County Subscriptions --> Dept of Health & Environment.  Next, choose "Department of Health Community Partner" as the type of contact. There is no need to select a building or duty assignment.  Your contact information will only be used to send out alerts from JCDHE via NotifyJoCo. 

If you have questions about the sign up process, call 913-826-5555.  
Flublok® vaccine now available at health clinics 

The Johnson County Department of Health and Environment expects to receive its supply of season flu vaccine for the 2018-19 influenza season in early September. 

JCDHE will offer the seasonal flu shot for anyone 6 months of age and older and the Flublok® Quadrivalent vaccine for adults. Flublok® contains three times more antigen than all other quadrivalent influenza vaccines and does not contain any preservatives, egg proteins, gelatin or latex. Adults over age 65 will be offered the Fluzone® high-dose flu shot. 

The Centers for Disease Control and Prevention have listed the composition of the upcoming flu vaccine in the June 8  Morbidity and Mortality Weekly Report (MMWR). This same report also gives an update on the  Advisory Committee on Immunization Practices' (ACIP)  recommendation for the use of Quadrivalent Live Attenuated Influenza Vaccine this season. 

JCDHE offers flu shots on a walk-in basis at it's health clinics in Olathe (11875 S. Sunset Dr.) and Mission (6000 Lamar Ave). 
Meet the Disease Investigation Team: Tiffany Wallin 

Tiffany Wallin, RN , has been with the Johnson County Department of Health and Environment for 8 years. Prior to joining JCDHE, she worked at Truman Medical Center as an ER nurse and was also in the Air Force Reserves where she was the non-commissioned officer in charge of the Immunization Clinic and Readiness.

A typical day for Tiffany includes tracking disease trends in Johnson County, investigating disease outbreaks and providing community education through speaking engagements. 

Tiffany is also in charge of putting on the annual Kansas Infectious Disease Symposium. She is currently planning speakers and recruiting exhibitors (see story below)  for the third annual event taking place May 1-2, 2019 in Johnson County, Kan.
 
Her interests include working out, listening to live music, yoga in the vineyard, Sunday brunch, and anything outside when it's warm! You can reach her at 913-826-1252 or tiffany.wallin@jocogov.org
Volunteers Needed for Community Health Assessment

Community Health Assessment
Every three years the Johnson County Department of Health and Environment joins with nonprofit hospitals and other community partners to conduct a Community Health Assessment (CHA).

The purpose is to identify factors that affect the health of our residents. We need volunteers on Saturday, Sept. 8, 2018 to go to preselected neighborhoods to survey citizens about their health and the health of the community.

Volunteers will start the day at 8 a.m. with training on the survey and then go in pairs to neighborhoods to conduct the surveys until 5 p.m. Each survey takes about 10 minutes.  This is a great way to help the community, enjoy a nice walk, get a t-shirt and meet new people! Volunteers will be eligible to win a gift card for their participation. 

You must be 18 years or older to volunteer. Sign up here Questions? Call 913-477-8364 or  barbara.mitchell@jocogov.org.
Rabid bat found in Johnson County

A bat found in a Johnson County, Kan. home in early July was confirmed to have rabies. During the summer months, the bat population in Johnson County increases as young bats begin to leave their nests and seek shelter in trees and homes. 

Wearing protective gloves when touching a bat (living or dead) and keeping pets vaccinated for rabies are two important ways to prevent rabies. An unvaccinated pet exposed to rabies could spend up to six months in quarantine. 

The Department of Health and Environment created a short video about what is considered a rabies exposure and when a bat needs to be tested for rabies. JCDHE also participated in a Twitter chat last week called #ThingsThatBiteKC which provided tips on rabies and vector-borne disease prevention. 

Patients needing follow up rabies vaccines following the IG and their first two doses from the hospital can get them at a local travel immunization clinic. For more information about rabies and how it's transmitted, visit the CDC's website
New guide about communicating radon risk

Doctor talking to patient
The Conference of Radiation Control Program Directors (CRCPD) recently published a guide for health care providers to use when communicating with their patients about radon and radon risk.  

This guide will help health care providers communicate the lung cancer risk posed by radon and the importance of conducting a radon test in the home. This is important as 40% of the homes in Johnson County have elevated radon levels.
Exhibitors, sponsors needed for third annual Kansas Infectious Disease Symposium 

Plans are underway for the third annual Kansas Infectious Disease Symposium to be held May 1-2, 2019 in Johnson County, Kan.

This year's event drew nearly 200 public health leaders, first responders, law enforcement and health care providers from around the region to learn how infectious diseases are contained and managed in the state of Kansas and the Midwest. More than 10 exhibitors and sponsors attended. 

The 2019 symposium promises to offer more on this topic with a focus on criminal epidemiology. If you're interested  in exhibiting or being a sponsor at the 2019 conference, contact  Tiffany Wallin at 913-826-1252 or send an email to Tiffany.Wallin@jocogov.org

 Registration for this event will begin in early 2019.
Adolescent vaccines provide protection from whooping cough, meningitis and HPV cancers 

School immunizations don't end when a child starts kindergarten. The State of Kansas requires children in grades 7th-12th to receive a single dose of Tdap, the vaccine that prevents tetanus, diphtheria and pertussis (whooping cough). Whooping cough is highly contagious and can last for many weeks, which can make preteens and teens miss school and other activities. The disease can be deadly for babies who are too young to be immunized and get whooping cough from an older sibling. There were 36 confirmed/probable cases of whooping cough in Johnson County in 2017.

In addition to Tdap, providers should also give the Meningococcal, Human papillomavirus (HPV) and influenza vaccines to adolescents and teens. These vaccines protect students from serious diseases like meningitis, flu and several HPV cancers. Although not required for school entry in Kansas, these vaccines are highly recommended by the Department of Health and Environment, the American Academy of Pediatrics, the American Academy of Family Physicians and the Centers for Disease Control and Prevention.

The Department of Health and Environment's two immunization clinics in Olathe (11875 S. Sunset Dr.) and Mission (6000 Lamar Ave.) offer all of these childhood vaccines on a walk-in basis. Most insurance plans cover these immunizations in full. The Vaccines for Children (VFC) program provides vaccines for children under age 18 who are uninsured. Clinics are open late on Wednesdays from 10 a.m. to 6:30 p.m. 
Updated Guidance for Timing of Pregnancy after Zika exposure

Pregnant woman on beach
The Centers for Disease Control and Prevention (CDC) now recommends that men with possible Zika virus exposure who are planning to conceive with their partner wait at least 3 months after symptoms or possible exposure (travel to or residence in an area with risk of Zika). This shortened time frame also applies for men who are not planning to conceive with their partners but who want to prevent passing Zika virus through sex. These updated recommendations, published in MMWR, are based on emerging data, which suggest that risk of infectious Zika virus in semen appears to decline substantially during the 3 months after onset of symptoms.

All other Zika guidance remains unchanged. Men with possible Zika virus exposure whose partner is pregnant should use condoms or the couple should not have sex for the entire pregnancy to reduce the risk of transmission. 

Health care providers who have a patient that meets the criteria for Zika testing, should contact the Kansas Department of Health and Environment's epidemiology hotline at 877-427-7317 PRIOR to testing for Zika virus infection
Johnson County Disease and Surveillance Reports
 
The Johnson County Department of Health and Environment produces a monthly disease report listing cases (confirmed, suspect, probable and not a case) that are investigated by our staff. Starting in the fall through late spring, we post weekly influenza surveillance reports. We also compile end of the year reports about diseases and influenza on this page

News from the CDC

New Rapid Rabies Test Could Revolutionize Testing and Treatment

Rising Numbers of Deaths Involving Fentanyl and Fentanyl Analogs, Including Carfentanil, and Increased Usage and Mixing with Non-opioids

Recommendations for Managing and Reporting Shigella Infections with Possible Reduced Susceptibility to Ciprofloxacin

Outbreak of Hepatitis A Virus Infections among Persons Who Use Drugs and Persons Experiencing Homelessness

CDC Reported Flu Deaths in Children Exceeds Seasonal High

Study Shows Flu Vaccine Reduces Risk of Severe Illness
Johnson County Department of Health and Environment |  jcdhe@jocogov.org
REPORT A DISEASE:  (913) 826-1303; Fax: (913) 826-1300
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