First Quarter 2019
 
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 disease trends and public health services in Johnson County, Kan. If you have a story idea for a future issue, send an email to jcdhe@jocogov.org. Share this newsletter with your colleagues! 
Johnson County Flu Season Update

Woman ill with flu
Influenza A is hitting Johnson County citizens hard this flu season. As of Feb. 12, 1,613 cases of influenza have been voluntarily reported to JCDHE with 84 percent caused by Flu A. This is a sharp decrease in influenza cases (67 percent) from this same time last year when 4,858 cases were voluntarily reported. There has only been one death in Johnson County directly linked to influenza.  

JCDHE's immunization clinics are out of  Flublok vaccine (influenza) and the high-dose flu shot for the remainder of flu season. Clinics have plenty of seasonal (quadrivalent) flu shots for anyone 6 months and older. 

The Advisory Committee on Immunization Practices recommends routine annual influenza vaccination for all persons age 6 months and older who do not have contraindications. Vaccination providers may choose to administer any licensed, age-appropriate influenza vaccine (IIV, RIV4, or LAIV4). LAIV4 is an option for those for whom it is appropriate. More information about the 2018-19 flu season is available here. Guidance for schools and childcare providers is available here.

Providers can help JCDHE get a more accurate picture of flu activity in Johnson County by submitting a Weekly Influenza Surveillance Reporting Form. Complete the form each week and fax to 913-826-1300.
KDHE logo
Influenza exclusion included in isolation and quarantine regulations

Last spring the Kansas Department of Health and Environment updated their isolation quarantine regulations, including one for influenza which states that physician diagnosed cases shall be excluded from child care or school for 7 days following onset of illness or duration of illness if the case is immune-compromisedDisease-specific isolation and quarantine requirements can be found in this document

KDHE provided two training presentations to update healthcare providers on these changes: Changes to KDHE Infectious or Contagious Diseases and Conditions Regulations and Rabies Control Requirements
Life-threatening coagulopathy associated with synthetic cannabinoids 

The Centers for Disease Control and Prevention issued an alert on Dec. 10 about suspected vitamin K-dependent antagonist coagulopathy associated with synthetic cannabinoids. Since last spring, at least 324 people in 11 states have presented to health care facilities with serious bleeding following possible exposure. There have been at least eight fatalities. No reports have been made to the Kansas Department of Health and Environment as of Feb. 11.

Clinicians are urged to watch for symptoms of this potentially life-threatening condition in patients who are on oral vitamin K1 therapy and using synthetic cannabinoid products containing brodifacoum. If you suspect a patient is experiencing this condition, contact the Kansas Poison Control Center (1-800-222-1222) for questions on diagnostic testing and management of these patients and promptly report the case to the KDHE Epidemiology Hotline (877-427-7317). 
Shorter tuberculosis regimens show higher completion rates 

TB Regimen
Did you know that one fourth of the world's population is infected with Tuberculosis (TB)? In 2017, 10 million people around the world fell ill with TB, and 1.3 million died from this disease. TB occurs in every part of the world, including Johnson County, Kansas. 

Although TB is preventable and curable, many people still suffer from this disease  and without treatment, are at risk for developing active TB disease in the future. 

Every World TB Day (March 24th), the Centers for Disease Control and Prevention and its international partners renew their commitment to end this deadly disease, but they need our help. Clinicians are urged to "think TB" and watch for signs and symptoms of TB  so treatment can be initiated and completed to prevent progression to active disease. 

While all regimens are equally effective, CDC recommends prescribing the most convenient and shortest regimen whenever possible due to higher completion rates. A 12-week regimen is now used for latent TB (combination antibiotic therapy taken once a week for 12 weeks) and shows a higher completion rate than the more traditional Isoniazid (INH) therapy which is taken daily for 9 months. 

JCDHE offers both skin and blood tests for TB, as well as treatment for latent TB infection and active TB disease, at our walk-in clinics in Olathe and Mission.
National Public Health Week is April 1-7th 

National Public Health Week
Everyone deserves to live a long and healthy life in a safe environment. Where we live, work, worship and play impacts each of us and can determine our health and how long we live. 

Join us in observing National Public Health Week 2019 and become part of a growing movement to create the healthiest nation in one generation. During the week, we will celebrate the power of prevention, advocate for healthy and fair policies, share strategies for successful partnerships and champion the role of a strong public health system.  Working together, we can build healthier communities and, eventually, the healthiest nation. 
Save the date! 2019 Kansas Infectious Disease Symposium 

KIDS Conference Logo
Mark your calendars now to attend the third Kansas Infectious Disease Symposium on May 1, 2019 at the Johnson County Arts & Heritage Center in Overland Park, Kansas.

P ublic health leaders, first responders, law enforcement and health care providers from around the region are expected to attend this one-day event and learn how infectious diseases are contained and managed in the state of Kansas and the Midwest. 

Registration will be available in the spring. Continuing education credits will be available for purchase. Check this page often for conference updates and registration information.  
Shingrix and Yellow Fever vaccines temporarily unavailable at clinics 

Due to high demand, the Johnson County Department of Health and Environment's walk-in immunization clinics are temporarily out of the Shingrix vaccine (shingles) and the  Yellow Fever vaccine.

Because of a total depletion of their supply of YF-Vax, the manufacturer (Sanofi Pasteur) has made an alternative yellow fever vaccine, Stamaril, available at select locations until YF-Vax supply returns, which is expected by mid-2019.

Those seeking a Shingrix vaccine can search here for clinics and pharmacies that still have the vaccine.
Meet the Epidemiology Team: Jackson Ward 

Jackson Ward, MPH, joined the Johnson County Department of Health and Environment in September 2018 after completing his Masters in Public Health in Epidemiological and Biostatistical Methods for Public Health and Clinical Research from Johns Hopkins University in Baltimore, Maryland.  Prior to earning his MPH, Jackson worked for the Centers for Disease Control and Prevention as a Public Health Associate. 

Jackson primarily serves as JCDHE's environmental epidemiologist. His work involves identifying environmental exposures and how they impact our community's health by predisposing to or protecting against disease, illness, injury, developmental abnormalities or death.

Away from the cubicle, Jackson enjoys golfing, getting his heart ripped out by Wisconsin sports, and everything Guy Fieri. You can reach him by phone at 913-826-1273 or email him your favorite memes at Jackson.Ward@jocogov.org.
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
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. Create an account (if you don't have one). 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.  
News from the CDC

Johnson County Department of Health and Environment |  jcdhe@jocogov.org
REPORT A DISEASE:  (913) 826-1303; Fax: (913) 826-1300
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