First Quarter 2020
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, Kansas. If you have a story idea for a future issue, send an email to Share this newsletter with your colleagues! 
Novel Coronavirus 2019
Plans in place to protect the community from coronavirus

As confirmed cases and deaths from the novel coronavirus (COVID-19) continue to rise in China, U.S. health officials have put quarantine and monitoring orders in place to slow the impact of the virus in the United States.

The CDC issued a Level 3 travel warning  that recommends travelers avoid all nonessential travel to China. All travelers returning to the United States from China will be assessed for exposure to the virus and the presence of fever and lower respiratory symptoms. Travelers may either be quarantined or allowed to complete their trip and self-isolate at home for 14 days while local public health monitors them for symptoms.

Even though the risk of this new virus to Johnson County, Kansas residents is low at this time,
Johnson County Department of Health and Environment Preparedness Program Manager Steve Maheux says the health department is working closely with its partners across the healthcare system to evaluate the coronavirus outbreak and putting protective measures in place wherever possible. T he measures include: staying up-to-date on the latest state and federal guidance from the Kansas Department of Health and Environment and the Centers for Disease Control and Prevention; securing enough personal protective equipment (PPE) if an outbreak occurs in the community; using existing tools to receive alerts if/when high risk patients present at hospitals; and educating the public on risk and prevention.

Globally, reported illnesses in people with COVID-19 have ranged from mild (no or few signs and symptoms), to severe, including death. These findings are consistent with other coronaviruses, including Severe Acute Respiratory Syndrome (SARS) and  Middle East Respiratory Syndrome (MERS). No vaccine or specific treatment for COVID-19 infection is available. At present, medical care for patients with COVID-19 is supportive.

Healthcare providers should obtain a detailed travel history for patients being evaluated with fever and acute respiratory illness. The CDC clinical criteria for a COVID-19 patient under investigation (PUI) have been developed based on what is known about MERS-CoV and SARS-CoV and are subject to change as additional information becomes available.

Report all suspect case of COVID-19 to  the  Kansas Department of Health and Environment (KDHE) at 1-877-427-7317. KDHE is coordinating all testing for COVID-19.
Influenza B causing more illness this flu season

Girl with flu
Influenza B took an early grip on the nation and Johnson County, Kansas this flu season. This is a shift in the predominant strain causing the majority of illnesses.  Influenza B viruses have not predominated in the United States for 27 years. 

Hardest hit this season have been children, according to the Johnson County Department of Health and Environment's (JCDHE) weekly flu report . Since flu reporting is not mandated in Kansas, JCDHE compiles flu data from Johnson County physicians, urgent care centers, schools and hospitals to identify unusual flu activity, determine which viruses are more predominate, and how those viruses may affect the community.

Influenza B virus infection is more common among children and can cause complications, resulting in hospitalization or death. That's why the  Centers for Disease Control and Prevention issued a health alert on Jan. 10 asking clinicians t o vaccinate patients as long as influenza viruses are circulating, and to promptly start antiviral treatment of all hospitalized, severely ill, and high-risk patients with suspected influenza without waiting for laboratory confirmation.    

Flu Exclusion 
JCDHE recommends that anyone with influenza-like illness who has received a positive laboratory test for influenza or is being treated with antiviral medication for influenza, remain in home isolation for five days following onset of illness. If fever persists for more than 5 days, continue exclusion until 24 hours fever-free.

For each person hospitalized with a case of influenza, droplet precautions shall be followed for five days following onset of illness. If fever persists for more than 5 days, continue droplet precautions until 24 hours fever-free.
Johnson County health data now available on website

The Johnson County Department of Health and Environment recently released its Community Health Assessment data at . The site tells the story (with pictures) about how residents live, learn, work and play in Johnson County, Kansas.
The narrative of Kansas' healthiest county begins with one, life-altering data point: There is a 12-year difference in life expectancy between Johnson County communities located just five miles apart. How can Johnson County be ranked number one in the County Health Rankings  and still have such disparity?
The site punctuates the narrative with interactive data graphics users can download and use in their own work. Get the latest data on suicide, chronic diseases, access to medical care, and maternal and child health. The site  also explores the issues residents reported, including financial fragility, high housing costs, mental health problems like depression and anxiety, and their need to better connect to friends, families and neighbors.
Visit and learn how community members and organizations can work together to build a healthier, more equitable Johnson County.
Vaping devices lab
Vaping-related lung injury cases

The Centers for Disease Control and Prevention (CDC) reports that the number of cases of E-cigarette, or Vaping, Product Use-Associated Lung Injury (EVALI) appears to be declining, but states are still reporting new hospitalized EVALI cases.  Therefore, CDC recommends that clinicians remain vigilant with EVALI case finding and reporting. 

As of Feb. 4, a total of 2,758 hospitalized EVALI cases have been reported to CDC from all 50 states, the District of Columbia, and two U.S. territories (Puerto Rico and U.S. Virgin Islands).  Sixty-four deaths have been confirmed in 28 states and the District of Columbia. Two  of these deaths were reported in Kansas and the number of confirmed or probable cases in Kansas is 27.

THC-containing products continue to be the most commonly reported e-cigarette, or vaping, products used by EVALI patients, and it appears that vitamin E acetate is associated with EVALI. However, many substances and product sources are being investigated, and there might be more than one cause. Therefore, while the investigation continues, persons should consider refraining from the use of all e-cigarette, or vaping, products.

The CDC has provided updated guidance for managing patients with suspect EVALI Confidentiality is essential when assessing sensitive information, including all forms of substance use, especially among adolescents and young adults. If confirmed, the types of substances used (e.g., [tetrahydrocannabinol] THC and nicotine) should be ascertained.

Report cases or suspect cases of EVALI to JCDHE at 913-826-1303 or the Kansas Department of Health and Environment at 877-427-7317 or contact

The U.S. Food and Drug Administration encourages the public to submit detailed reports of any unexpected tobacco- or e-cigarette-related health or product issues via the online  Safety Reporting Portal.
Vape-Free Schools toolkit available 

The Kansas Vape-Free Schools Toolkit is a free guide to help schools and school districts become tobacco-free and e-cigarette-free.  The toolkit contains information and resources to help schools effectively implement, clearly communicate, regularly enforce and support a truly tobacco-free and e-cigarette-free campus. 

This resource is brought to you by Resist, a youth-led, state-wide tobacco prevention program, the Kansas Department of Health and Environment and the Tobacco Free Kansas Coalition. Resist's initiative is to help all Kansas schools implement 100 percent comprehensive tobacco-free and vape-free policies. This type of policy is critical to creating tobacco-free and vape-free learning environments for students. Download more materials here.
Free disaster preparedness training for hospitals/healthcare

Disaster Plan button
Individuals from the healthcare community are invited to attend a free two-day course on March 26-27 to acquire the knowledge and skills necessary to ensure the sustainability of their resources, facilities, and organizations during all types of disasters. 

This course introduces the fundamentals of preparedness frameworks for healthcare organizations and the community. Participants will identify strategies for business continuity, preparedness initiatives, and resource management strategies and tools available for response planning.

There is no cost to attend. Registration is open to individuals within the nine-county Kansas City metropolitan area. The class will be held from 8 a.m. to 5 p.m. each day at The University of Kansas Health System, 3901 Rainbow Blvd., Kansas City, Kansas. Lunch is on your own. 

Online registration is available. Contact  Lisa Elsas at  or 816-701-8392 with registration questions. 
Meet the Epidemiology Team: Elizabeth Lawlor Holzschuh 

Elizabeth Holzschuh
Elizabeth Lawlor Holzschuh (pronounced Whole-shoeis the population health epidemiologist at the Johnson County Department of Health and Environment, where she has worked since 2015. Her primary role is to provide data for both internal and external stakeholders to inform program and policy development and support department activities, including the community health assessment. 

Elizabeth is an adjunct professor at the University of Kansas Medical Center where she teaches Infectious Disease Epidemiology. She also facilitates workshops throughout the country for the FBI and CDC teaching local law enforcement and public health how to conduct joint investigations in the event of bioterrorism and other suspicious outbreaks.  

Prior to her current role, she served as an infectious disease epidemiologist at the Kansas Department of Health and Environment. She obtained her Master's degree with a concentration in public health, microbiology, and emerging infectious disease from the George Washington University.  

Outside of work, Elizabeth spends most of her time running after her 3 year old son, Beckett and honing her culinary skills in the kitchen. You can reach Elizabeth at 913-477-8368 or
National Public Health Week is April 6-12th

2020 NPHW logo
This year the American Public Health Association is celebrating 25 years of National Public Health Week. Each day during NPHW ( April 6-12, 2020) we will focus on a particular public health topic and how we all can make a difference. 

Follow us on Facebook, Instagram and Twitter to find out what we're doing in Johnson County to build healthier communities.

Monday: Mental Health
Tuesday: Maternal/Child Health
Wednesday: Violence Prevention
Thursday: Environmental Health
Friday: Education
Saturday: Healthy Housing
Sunday: Economics 
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

6.2 Million middle and high school students used tobacco products in 2019

1 in 5 adolescents and 1 in 4 young adults now living with prediabetes

HIV testing, treatment, prevention not reaching enough Americans

STD Awareness Week is April 12-18, 2020  
Johnson County Department of Health and Environment |
REPORT A DISEASE:  (913) 826-1303; Fax: (913) 826-1300
View our videos on YouTube