Fourth 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! 
Significant increase in congenital syphilis cases

Pregnant woman with doctor
There have been 6 cases of congenital syphilis reported to the Kansas Department of Health and Environment (KDHE) in 2018 (as of Oct. 12), compared to only a single case in the previous five years. This reflects the alarming national trends observed by the Centers for Disease Control and Prevention (CDC), who recently reported that rates of congenital syphilis have more than doubled over the past 5 years, with 2017 having the highest number of reported cases in 20 years.

All pregnant women should be tested for syphilis at the first prenatal visit . For women who are at high risk for syphilis, live in areas of high syphilis morbidity, are previously untested, or had a positive screening test in the first trimester, the syphilis screening test should be repeated during the third trimester (28 to 32 weeks gestation) and again at delivery. Any woman who delivers a stillborn infant after 20 week's gestation should also be tested for syphilis.

Providers should report all positive tests, diagnoses, or treatment of syphilis to KDHE. The current CDC treatment guidelines for congenital syphilis can be found here.
Johnson County nurses present at statewide TB program 

TB Nurse Conference Logo
Building a good rapport with a tuberculosis (TB) patient at the beginning of a contact investigation in order to obtain as much information as possible is just one of the tips TB nurses from the Johnson County Department of Health and Environment presented to attendees at a statewide TB educational program last month.  

Contact investigators, correctional health providers, nurses and others who provide care and treatment for TB patients also learned when to initiate a contact investigation and how to overcome challenges in a TB contact investigation during one of the two classes taught by JCDHE's nurses.  A second class emphasized the importance of taking a patient-centered approach to case management in order to promote adherence to treatment and to improve quality of life for patients. 

According to World Health Organization, there were 1.7 million deaths related to tuberculosis including four million TB deaths among people with HIV. TB is the leading cause of death from Infectious diseases worldwide. More information about TB testing and treatment at JCDHE's walk-in clinics in Olathe and Mission can be found here.   
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.  
Johnson County publishes article in CDC's MMWR 

Rubella Diagnosis
The events surrounding a 2017 case of an unvaccinated pregnant woman in Johnson County who was diagnosed with rubella were published last month in the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report

This article highlights several important points. Health care institutions should ensure that all persons working in health care facilities have documentation of adequate vaccination against measles, mumps, and rubella or evidence of immunity. Health care providers should routinely assess women of childbearing age for evidence of rubella immunity (IgG antibodies) and recommend vaccination when appropriate. Pregnant women testing negative for rubella immunity should be vaccinated immediately after delivery. When a pregnant woman develops a rash illness, providers should ask about international travel for both the patient and her contacts. 

More information about pregnancy and rubella can be found here
Shingrix vaccine temporarily unavailable at health 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).  We are also 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.
Meet the Disease Investigation Team: Serina Taylor 

Serina Taylor DHE
Serina Taylor, MPH, began her career with the Johnson County Department of Health and Environment on Aug. 6. She graduated from Kansas State University's Masters in Public Health program in May with an emphasis in Infectious Disease and Zoonoses. Before that she was an undergraduate student at K-State where she earned a bachelors degree in Biology with an emphasis in Pre-Veterinary Medicine. 

Serina is currently training and navigating through entry-level investigations and helping to plan the 2019 Kansas Infectious Disease Symposium.
 
She enjoys relaxing in the sun next to any body of water (the ocean is preferred), shopping with friends and family, reading a good mystery book and cheering on the Wildcats and Chiefs during football season. You can reach her at 913-826-1214 or Serina.Taylor@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

Holiday Closures

Holiday Ornaments
The Johnson County Department of Health and Environment's offices and clinics will be closed on the following holidays:

Thursday, Nov. 22-Friday, Nov. 23, 2018 (Thanksgiving)

Monday, Dec. 24-Tuesday, Dec. 25, 2018 (Christmas)

Tuesday, Jan. 1, 2019 (New Year's Day)

Monday, Jan. 21, 2019 (Martin Luther King, Jr. Day)
News from the CDC

New CDC analysis shows steep and sustained increases in STDs in recent years

Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the ACIP

Flu vaccine reduces risk of flu hospitalization among pregnant women


More US adolescents up to date on HPV vaccination

Vaccination Coverage Among Children Aged 19-35 months

Vaccination Coverage for Selected Vaccines and Exemption Rates Among Children in Kindergarten 
Johnson County Department of Health and Environment |  jcdhe@jocogov.org
REPORT A DISEASE:  (913) 826-1303; Fax: (913) 826-1300
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