October 2019 Florida Department of Health - Hillsborough County

Disease Surveillance Newsletter

1

EpiNotes

Ron Desantis

Governor Mission: To protect, promote & improve the health of all

people in Florida through integrated state & community

efforts.

Vision: To be the Healthiest State in the Nation

Director

Douglas Holt, MD

813.307.8008

Medical Director (HIV/STD/EPI)

Charurut Somboonwit, MD

813.307.8008

Medical Director (TB/Refugee)

Beata Casanas, MD

813.307.8008

Medical Director (Vaccine Outreach)

Jamie P. Morano, MD, MPH

813.307.8008

Community Health Director

Leslene Gordon, PhD, RD, LD/N

813.307.8015 x7107

Disease Control Director

Carlos Mercado, MBA

813.307.8015 x6321

Environmental Administrator

Brian Miller, RS

813.307.8015 x5901

Epidemiology

Michael Wiese, MPH, CPH

813.307.8010 Fax 813.276.2981

TO REPORT A DISEASE:

Epidemiology

813.307.8010

After Hours Emergency

813.307.8000

HIV/AIDS Surveillance

Erica Botting

813.307.8011

Lead Poisoning

Cynthia O. Keeton

813.307.8015 x7108 Fax 813.272.6915

Sexually Transmitted Disease

Sophia Romeus

813.307.8045 Fax 813.307.8027

Tuberculosis

Irma B. Polster

813.307.8015 x4758 Fax 813.975.2014

Articles and Attachments Included This Month

Health Advisories and Alerts 1

January 2019 Reportable Disease Summary 2

Florida Food Recalls 5

About Vaping-Associated Pulmonary Illness (VAPI) 6

Weekly Influenza Report 7

Flu Season means Flu Shots are in Style 8

Dengue Information for Clinicians 9

Drain and Cover 10

Reportable Diseases/Conditions in Florida, Practitioner List 12

FDOH, Practitioner Disease Report Form 13

• Health Officials In Hillsborough County Issue Mosquito-Borne Illness Advisory - A human case of locally-acquired dengue fever has been confirmed.

• CDC Travel Notices:

• Hurricane Dorian in the Bahamas - Parts of the Bahamas,

including the Abacos and Grand Bahama Island, have been

severely affected by Hurricane Dorian. US residents should

avoid nonessential travel to affected parts of the Bahamas.

• Polio in the Philippines

• Yellow Fever in Nigeria (Updated)

• Dengue in the Mediterranean, Asia and the Pacific Islands,

Africa and the Middle East, and the Americas

• Extensively drug-resistant typhoid fever in Pakistan

Health Advisories, News, and Alerts

2 October 2019

231.7

49.7 22.7 58.3

221.3

72.7

12.7

274

50 4260

224

2812

Campylobacteriosis Cryptosporidiosis Escherichia coli,Shiga toxin-

producing (STEC)

Giardiasis Salmonellosis Shigellosis Vibriosis

January-September Reportable Disease Summary - Enteric Infections

September YTD 2016-2018 Average

September YTD 2019

2.0

48.0

40.3

1.7 4.0 1.3

17.36

5248

2

8

0

18

Mumps Pertussis Varicella Listeriosis Meningitis (Bacterial,Cryptococcal,

Mycotic)

MeningococcalDisease

Legionellosis

September YTD 2016-2018Average

2.0

48.0

40.3

1.74.0

1.3

17.3

6

52

48

28

0

18

Mumps Pertussis Varicella Listeriosis Meningitis (Bacterial,Cryptococcal,

Mycotic)

MeningococcalDisease

Legionellosis

January-September Reportable Disease Summary - Other Common Reportable Infections

September YTD 2016-2018 Average

September YTD 2019

These vaccine reportable diseases are summarized monthly in the state Vaccine

Preventable Disease Report, which is available online at:

http://www.floridahealth.gov/diseases-and-conditions/vaccine-preventable-

disease/vaccine-preventable-disease-report-archive.html

3 October 2019

10.0

35.321.7

250.3

1,139.7

145

4064

267

936

Hepatitis A Hepatitis B (Acute) Hepatitis C (Acute) Hepatitis B (Chronic) Hepatitis C (Chronic)

January-September Reportable Disease Summary - Viral Hepatitis

September YTD 2016-2018 Average

September YTD 2019

52%33%

15%

Cases who Report Drug Use as a Risk Factor

Yes No Unknown

January 2018 to September 2019 Case Summary

Total Number of cases 229

Number of cases acquired in Florida or Unknown

226

Age of Cases

Mean 39.3

Median 38

Min-max 7 - 71

Cases by Age Category Number (%)

0-19 4 (1.7%)

20-29 41 (18.1%)

30-39 80 (35.4%)

40-49 62 (27.4%)

50-59 32 (14.2%)

60+ 7 (3.1%)

Gender Number (%)

Female 69 (30.5%)

Male 157 (69.5%)

Race Number (%)

White 183 (81.0%)

Black 14 (6.2%)

Other 26 (11.5%)

Asian 2 (0.9%)

Unknown race 1 (0.4%)

Ethnicity Number (%)

Non-Hispanic 191 (84.5%)

Hispanic 34 (15.0%)

Unknown ethnicity 1 (0.4%)

Hillsborough County is currently

experiencing a large increase in

infections of hepatitis A, which is

a viral infection transmitted

through the fecal-oral route.

There is a vaccine available to

prevent hepatitis A.

4 October 2019

0.7 2.0

6.7

4.3

15.3

0

18

4 43

Chikungunya Dengue Lyme Disease Malaria Zika Fever

September YTD 2016-2019Average

September YTD 2019

January-September Reportable Disease Summary – Arboviral Infections

Cases of any infection are reported based on the county where the person’s home

address is. Hillsborough County has reported infections of imported mosquito-borne

diseases every year, which means the individual was infected while traveling outside

of the county. In October 2019 Hillsborough County reported one case of locally

acquired dengue fever.

The Florida Department of Health releases a weekly arboviral surveillance report that

is available here: http://www.floridahealth.gov/%5C/diseases-and-

conditions/mosquito-borne-diseases/surveillance.html

The data in these charts represent the most common reportable diseases investigated by

the Epidemiology Program. All of the state’s reportable disease data is available for the

public to search on FL CHARTS here:

http://www.flhealthcharts.com/charts/CommunicableDiseases/default.aspx To build your

own search, click on the link for “Reportable Diseases Frequency Report”.

The case numbers for 2018 and 2019 are provisional and subject to change until the

yearly database is closed, usually around April of the following year. Once the numbers

are finalized, the state puts together a comprehensive Florida Annual Morbidity Statistics

Report that details case trends and notable outbreak investigations. The report for 2017

and previous years are available at: http://www.floridahealth.gov/diseases-and-

conditions/disease-reporting-and-management/disease-reporting-and-surveillance/data-

and-publications/fl-amsr1.html

Florida is seeing an increase in dengue infections

in people traveling from other countries. The

majority of cases in Florida have reported travel

to Cuba. When there is an increase in infections

in returning travelers, this is an increased risk for

local introduction. In 2019 Miami-Dade has

reported 11 cases of locally acquired dengue

fever and Hillsborough has reported one.

5 October 2019

Florida Food Recalls (September 15, 2019 – October 16, 2019)

Brand Name Food Date of Recall

Health Risk

Arla Apetina Marinated Feta

& Olives in Oil, Pitted 10/10/2019 Clostridium botulinum Details

Premo and Fresh Grab Ham and Cheese Wedge

Sandwiches 10/7/2019 Listeria monocytogenes Details

Cornerstone Frozen Blackberries 10/4/2019 Norovirus Details

Robin Hood Flour All-Purpose Flour 10/3/2019 E. coli O26 Details

Mrs. Stratton’s, Star, Ballard’s

Farm, Laura Lynn, more

Chicken and tuna salad

products 10/2/2019 Listeria monocytogenes Details

Deli Express, Market Sandwich,

Market Artisan, more Sandwiches 10/2/2019 Listeria monocytogenes Details

Lipari Old Tyme, Premo, Fresh

Grab, Premo Signature

Chicken Salad and

Chicken Salad

Sandwiches

10/2/2019 Listeria monocytogenes Details

Captain K Salmon Slightly Salted

Pieces 10/2/2019 Listeria monocytogenes Details

Mical Seafood Yellowfin Tuna 10/1/2019 Elevated Levels of Histamine

or Scombroid Fish Poisoning Details

Tip Top Poultry, Inc. Ready-To-Eat Poultry

Products 9/28/2019 Listeria monocytogenes Details

TDBBS, LLC Pig Ears 9/20/2019 Salmonella Details

Roland Foods, LLC Red Lumpfish Caviar and

Black Lumpfish Caviar 9/20/2019 Clostridium botulinum Details

Captain K Salmon Slightly Salted

Pieces 9/20/2019 Listeria monocytogenes Details

Gold Medal Unbleached All Purpose

Flour 9/16/2019 E. coli O26 Details

6 October 2019

About Vaping-Associated Pulmonary Illness (VAPI)

Vaping-Associated Pulmonary Illness (VAPI) cases are lung injury cases with pulmonary infiltrates or

opacities on CT scan which lack infectious or other alternative medical diagnoses among people who use

vaping devices. The condition may present similarly to pneumonia of infectious origin with elevated white

blood cells and fever, but lacks an infectious or other internal disease process. Vaping devices include e-

cigarettes, vape pens, and others. 11 confirmed and probable cases have been reported in Hillsborough

County as of October 10th, 2019.

In Hillsborough County, approximately 91% of the individuals are white and non-Hispanic. Of the cases,

82% were male, 73% were under 35 years of age (average 28.5 years). The most frequently reported

symptoms were cough (64%), fever (64%), vomiting (64%), shortness of breath (55%), and diarrhea

(55%). While much of the vaping product history is unknown at this time, the majority of individuals (82%)

with confirmed or possible VAPI have reported use of marijuana and/or THC (tetrahydrocannabinol) oils

in their vaping device. The illegality of THC oils in the State of Florida may lead to incomplete reporting of

THC vape oil usage among cases.

While the direct cause of these lung injury cases is unknown, it is suggested for individuals who currently

vape to stop use vaping devices and cartridges, especially those containing THC. If an individual who is

currently using a vaping device to quit smoking, it is not recommended to return to smoking cigarettes.

The VAPI situation is developing and new guidelines may be provided in the future.

For more healthcare provider information, including guidelines for patient evaluation, diagnosis and

management, visit https://www.cdc.gov/mmwr/volumes/68/wr/mm6841e3.htm?s_cid=mm6841e3_w

For information from the Florida Department of Health on Lung Injury Associated with E-Cigarette Use,

Vaping please visit http://www.floridahealth.gov/newsroom/2019/09/092019-outbreak-of-lung-injury-

associated-with-ecigarette-use-vaping.pr.html

For a full summary of United States vaping associated illness status from the Centers for Disease Control

and Prevention, please visit https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-

disease.html

For case definition, please visit https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-

disease/health-departments/index.html

7 October 2019

Hillsborough County Weekly Influenza Report (Week 41, 2019)

Flu Trend:

Increasing

Flu Level:

Mild Flu Activity This Week (October 6 – October 12)

• Influenza like illness (ILI) activity continues to remain at low levels, although

there is an increase in flu activity. (Figure 1).

• Positive influenza labs increased and are mostly influenza type B.

• One ILI outbreak was reported in a child care facility in week 41.

• No pediatric mortalities were reported in the previous week.

Flu Activity This Season (September 29 – October 12)

• Total Outbreaks: One ILI outbreak has been reported during the 2019-2020 flu

season.

• Total Deaths: Hillsborough County has reported no pediatric mortalities in the

current flu season.

Figure 1: In week 41, the percent of emergency department and urgent care center visits for ILI* in

Hillsborough County increased and is slightly above levels seen in previous seasons.

*Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE-FL) measures trends in ILI

visits from emergency departments (ED) and urgent care clinics (UCC). Participating EDs and UCCs in Hillsborough County

(n=21) electronically transmit visit data into ESSENCE-FL daily or hourly. The ESSENCE-FL ILI syndrome captures visits with

chief complaints that include the words “influenza” or “flu,” or chief complaints that include the words “fever” and “cough,” or “fever”

and “sore throat.”

For statewide data

see the Florida Flu

Review.

8 October 2019

Flu Season means Flu Shots are in Style

Flu season begins each year in week 40, which means that the season is currently underway. If you have

not already received your flu shot, you should get yours as soon as possible. Typically, it takes about two

weeks following receipt of the flu shot for immunity to be established, so a head start on preventing the flu

is critical. Flu activity is currently increasing in the state of Florida. Doctor’s offices and many retail stores

in Florida offer flu shots either for free or at a reduced cost to help provide protection against the flu.

Early pre-season vaccine availability provides plenty of time for people to get vaccinated before the start

of the season, but it’s not too late to receive the vaccine after the season starts! Flu vaccination coverage

among the American population is typically low, with estimates under 50% of the population receiving a

flu vaccine in 2017-2018 and 2018-2019. To protect as many people from the flu as possible, everyone

should get their flu vaccine every year. Flu sickens millions of Americans every year, hospitalizes

hundreds of thousands, and kills thousands every single year.

Here are some frequently asked questions about flu shots:

Q: Won’t the flu shot give me the flu?

A: No - the flu shot only contains completely killed viruses. It is impossible for killed viruses to cause

disease. There are many different types of flu shots available this year, with different recommendations

for each based on age. There is only one flu vaccine which is live, the live attenuated influenza vaccine

(LAIV). The LAIV can only multiply in the nose and will not survive in the warmer temperature in your

lungs. Sometimes, people do develop mild symptoms that may look like flu symptoms (e.g. aches,

malaise), but they are from the immune system’s response to the vaccine, not an actual case of illness. It

is possible to catch the flu after receiving a flu shot if you are infected before immunity develops, or if the

strain of flu that they catch is different from one of the covered strains in the vaccine.

Q: Why do I have to get a new flu shot every year?

A: Flu viruses change every year – the viruses mutate. Because the viruses change, you may not have

immunity against new viruses from one year to the next.

Q: If other people get the flu shot, why should I get it?

A: Flu vaccine coverage isn’t typically high among the US population, which means that every person

who gets the vaccine helps to increase the coverage. While most people are able to receive the flu shot,

children under 6 months of age can’t get a flu vaccine which makes it very important for people around

them to get their shots. Infections with the flu among children under 2 years of age can be fatal.

Resources:

For Florida flu activity visit http://www.floridahealth.gov/diseases-and-conditions/influenza/index.html

For 2017-2018 Flu Season information from CDC, visit https://www.cdc.gov/flu/about/burden/2017-

2018.htm

For 2018-2019 Flu Season information, visit https://www.cdc.gov/flu/fluvaxview/coverage-

1819estimates.htm

For facts about flu vaccines, please visit https://www.cdc.gov/flu/prevent/keyfacts.htm

Dengue Fever – Information for Clinicians Version 2.1 5/10/2019

Please contact your county health department (CHD) immediately during business hours if you suspect a patient has dengue to ensure prompt mosquito control efforts. Dengue infection is caused by any of four distinct but closely related dengue virus (DENV) serotypes (called DENV-1, -2, -3, and -4). Dengue is currently the most frequent cause of acute febrile illness among returning U.S. travelers from the Caribbean, Central and South America, and Asia. Transmission occurs through the bite of an infected mosquito. Dengue may also be transmitted from mother to fetus in utero or to neonate at parturition. An infected person should avoid mosquito bites while ill to prevent infection of local mosquitoes. Incubation period is 3 to 14 days. Clinical Presentation: Dengue fever can range from a mild non-specific febrile syndrome to classic dengue fever or “break-bone fever,” or in the most severe forms of the disease (2–4% of cases), dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). More than 20% of cases may be asymptomatic. Dengue should be considered when locally acquired infection is suspected or in persons who live in or have traveled to a dengue endemic area in the two weeks prior to symptom onset and have fever. Dengue fever signs and symptoms may include:

• Headache or retro-orbital pain

• Myalgia, bone pain, or arthralgia

• Anorexia and nausea

• Rash

• Thrombocytopenia

• Leukopenia

Hemorrhagic fever or shock symptoms may appear after the febrile phase and include abdominal pain or tenderness, persistent vomiting, mucosal bleeding, liver enlargement, clinical fluid accumulation, or laboratory results indicating an increase in hematocrit concurrent with a rapid decrease in platelets. Patients at risk for severe disease:

• Previously infected with another dengue virus

• Elderly

• Infants

• Sickle cell anemia

• Diabetes mellitus

• Chronic renal failure

Patients with suspected dengue fever also should be evaluated, tested and managed for possible Zika or chikungunya virus infection if travel was to areas where these viruses are present, as co-infection is possible. Laboratory Testing: Polymerase chain reaction (PCR) can be used to detect viral RNA in serum samples collected during the first seven days post-symptom onset. Testing for DENV-specific IgM antibodies should be requested for serum specimens taken six or more days after onset. Approximately 20% of dengue patients who have been previously exposed to another dengue serotype may show elevated IgG titers and have transient or no elevated dengue IgM titers, making identification of such cases difficult without PCR testing on the acute sample. PCR testing is available commercially and is the only way to definitively diagnose acute cases. In 2018 alone, over 75 individuals tested PCR-positive for dengue virus after travel to affected areas. More than one third of these would not have been identified without complete dengue testing, including PCR. Your CHD can provide guidance on how and when to submit samples to the Florida Department of Health (FDOH) Bureau of Public Health Laboratories. Resources: Hillsborough County Health Department: 813-307-8010 FDOH: www.floridahealth.gov/diseases-and-conditions/dengue/index.html CDC: www.cdc.gov/dengue/clinicallab/clinical.html

Mosquito BiteProtection in FloridaFloridaHealth.gov • Florida Department of Health

Not all mosquitoes are the same. Different mosquitoes spread different diseases and bite at different times of the day. Somemosquito species bite during the day, such as those mosquitoes that can spread chikungunya, dengue and Zika viruses. Otherspecies of mosquitoes bite most often at dawn and dusk, including those that can transmit West Nile virus.

* The use of commercial names is to provide information about products; it does not represent an endorsement of these products by the Centers for Disease Control and Preventionor the U.S. Department of Health and Human Services.

Use Environmental ProtectionAgency (EPA)-registered insectrepellentsWear repellent when you are outdoors. Useproducts with active ingredients that are safeand effective.nAlways follow the product label instructions.

nDo not spray repellent on skin under clothing.

nIf you use sunscreen, put sunscreen on first and insect repellentsecond.

nIt is safe for pregnant or nursing women to use EPA-approvedrepellants if applied according to package label instructions.

nLearn more: www2.epa.gov/insect-repellents.

Cover up with clothingnWear long-sleeved shirts and long pants.

nMosquitoes can bite through thin clothing.Treat clothes with permethrin or anotherEPA-registered insecticide for extra protection.

Use permethrin-treated clothing and gear.nPermethrin is an insecticide that kills mosquitoes andother insects.

nBuy permethrin-treated clothing and gear (boots, pants, socks,tents), or use permethrin to treat clothing and gear—followproduct instructions closely.

nRead product information to find out how long the permethrinwill last.

nDo not use permethrin products directly on skin.

05/2018

Mosquitoes can live indoors and will bite at any time, day or night.

USE INSECT REPELLENTWITH ONE OF THESE

ACTIVE INGREDIENTS

BRAND EXAMPLES*Overseas brand names

may vary.

DEET➜➜ Off!, Cutter, Sawyer,Ultrathon

Picaridin (KBR 3023),Bayrepel and icaridin➜➜

Skin So Soft BugGuard Plus

Oil of lemon eucalyptus(OLE) or para-menthane-

diol (PMD)➜➜

Repel

IR3535➜➜ Skin So Soft Bug GuardPlus Expedition, Skin Smart

Higher percentages of active ingredient=longer protection

➜

If you have a baby or child:nAlways follow product instructionswhen applying insect repellent tochildren.

nSpray insect repellent onto your handsand then apply to a child’s face.

nDo not apply insect repellent to achild’s hands, mouth, cut or irritated skin.

nDo not use insect repellent on babies younger than 2 months.

nDress babies or small children in clothing that covers arms andlegs.

nCover cribs, strollers or baby carriers with mosquito netting.

FloridaHealth.gov/zika

Around all buildings:

At least once a week, empty, turn over or cover anything that

could hold water:tires

bucketstoys

pools & pool coversbirdbaths

trash, trash containers and recycling binsboat or car covers

roof gutterscoolers

pet dishes

Stop mosquitoes from breedingMosquitoes breed by laying eggs in and near standing water.

LARVA

PUPA

As little as one teaspoon or bottle cap of water standing for more than one week is enough for mosquitoes to breed and multiply.

At your house or business:Put away items that are outside and not being used because they could hold standing water.

In your garden:Keep flower pots and saucers free of standing water. Some plants, such as bromeliads, hold water in their leaves—flush out water-holding plants with your hose once a week.

EGGS

Repair holes in screens.

Keep mosquitoes outside

Use air conditioning.

Keep screens on all windows.

Keep doorsand windows shut.

www.cdc.gov/features/StopMosquitoes

www.FloridaHealth.gov/DiseaseReporting

www.FloridaHealth.gov/CHDEpiContact

! Outbreaks of any disease, any case, cluster of cases, or exposure to an infectious or non-infectious disease, condition, or agent found in the general community or any defined setting (e.g., hospital, school, other institution) not listed that is of urgent public health significance

+ Acquired immune deficiency syndrome (AIDS)

Amebic encephalitis

! Anthrax

Arsenic poisoning

! Arboviral diseases not otherwise listed

Babesiosis

! Botulism, foodborne, wound, and unspecified

Botulism, infant

! Brucellosis

California serogroup virus disease Campylobacteriosis

+ Cancer, excluding non-melanoma skin cancer and including benign and borderline intracranial and CNS tumors

Carbon monoxide poisoning

Chancroid

Chikungunya fever

Chikungunya fever, locally acquired

Chlamydia

! Cholera (Vibrio cholerae type O1)

Ciguatera fish poisoning

+ Congenital anomalies

Conjunctivitis in neonates <14 days old

Creutzfeldt-Jakob disease (CJD)

Cryptosporidiosis

Cyclosporiasis

! Dengue fever

! Diphtheria

Eastern equine encephalitis

Ehrlichiosis/anaplasmosis

Escherichia coli infection, Shiga toxin-producing

Giardiasis, acute

! Glanders

Gonorrhea

Granuloma inguinale

! Haemophilus influenzae invasive disease in children <5 years old

Hansen’s disease (leprosy)

Hantavirus infection

Hemolytic uremic syndrome (HUS)

Hepatitis A

Hepatitis B, C, D, E, and G

Hepatitis B surface antigen in pregnant women and children <2 years old

Herpes B virus, possible exposure

Herpes simplex virus (HSV) in infants <60 days old with disseminated infection and liver involvement; encephalitis; and infections limited to skin, eyes, and mouth; anogenital HSV in children <12 years old

+ Human immunodeficiency virus (HIV) infection

HIV-exposed infants <18 months old born to an HIV-infected woman

Human papillomavirus (HPV)-associated laryngeal papillomas or recurrent respiratory papillomatosis in children <6 years old; anogenital papillomas in children ≤12 years old

! Influenza A, novel or pandemic strains

Influenza-associated pediatric mortality in children <18 years old

Lead poisoning (blood lead level ≥5 µg/dL)

Legionellosis

Leptospirosis

Listeriosis

Lyme disease

Lymphogranuloma venereum (LGV)

Malaria

! Measles (rubeola)

! Melioidosis

Meningitis, bacterial or mycotic

! Meningococcal disease

Mercury poisoning

Mumps

+ Neonatal abstinence syndrome (NAS)

Neurotoxic shellfish poisoning

Paratyphoid fever (Salmonella serotypes Paratyphi A, Paratyphi B, and Paratyphi C)

Pertussis

Pesticide-related illness and injury, acute

! Plague

! Poliomyelitis

Psittacosis (ornithosis)

Q Fever

Rabies, animal or human

! Rabies, possible exposure

! Ricin toxin poisoning

Rocky Mountain spotted fever and other spotted fever rickettsioses

! Rubella

St. Louis encephalitis

Salmonellosis

Saxitoxin poisoning (paralytic shellfish poisoning)

! Severe acute respiratory disease syndrome associated with coronavirus infection

Shigellosis

! Smallpox

Staphylococcal enterotoxin B poisoning

Staphylococcus aureus infection, intermediate or full resistance to vancomycin (VISA, VRSA)

Streptococcus pneumoniae invasive disease in children <6 years old

Syphilis

Syphilis in pregnant women and neonates

Tetanus

Trichinellosis (trichinosis)

Tuberculosis (TB)

! Tularemia

Typhoid fever (Salmonella serotype Typhi)

! Typhus fever, epidemic

! Vaccinia disease

Varicella (chickenpox)

! Venezuelan equine encephalitis

Vibriosis (infections of Vibrio species and closely related organisms, excluding Vibrio cholerae type O1)

! Viral hemorrhagic fevers

West Nile virus disease

! Yellow fever

! Zika fever

! Report immediately 24/7 by phone

upon initial suspicion or laboratory test order Report immediately 24/7 by phone

Report next business day + Other reporting timeframe

Reportable Diseases/Conditions in Florida Practitioner List (Laboratory Requirements Differ)

Per Rule 64D-3.029, Florida Administrative Code, promulgated October 20, 2016 Florida Department of Health

*Subsection 381.0031(2), Florida Statutes, provides that “Any practitioner licensed in this state to practice medicine, osteopathic medicine, chiropractic medicine, naturopathy, or veterinary medicine; any hospital licensed under part I of chapter 395; or any laboratory licensed under chapter 483 that diagnoses or suspects the existence of a disease of public health significance shall immediately report the fact to the Department of Health.” Florida’s county health departments serve as the Department’s representative in this reporting requirement. Furthermore, subsection 381.0031(4), Florida Statutes, provides that “The Department shall periodically issue a list of infectious or noninfectious diseases determined by it to be a threat to public health and therefore of significance to public health and shall furnish a copy of the list to the practitioners…”

9

Patient Information Medical Information

SSN: MRN:

Last name: Date onset: Date diagnosis:

First name: Died: Yes No Unknown

Middle: Hospitalized: Yes No Unknown

Parent name: Hospital name:

Gender:

Male Female Unknown

If female, pregnant:

Yes No Unknown

Date admitted: Date discharged:

Insurance:

Birth date: Death date: Treated: Yes No Unknown

Race:

American Indian/Alaska native Asian/Pacific islander Black

White Other Unknown

Specify treatment:

Ethnicity:

Hispanic Non-Hispanic Unknown

Laboratory testing:

Yes No Unknown Attach laboratory result(s) if available

Address: Provider Information

ZIP: County: Physician:

City: State: Address:

Home phone: City: State: ZIP:

Other phone: Phone:

Emergency phone: Fax:

Email: Email:

To obtain local county health department contact information, see www.FloridaHealth.gov/CHDEpiContact. See www.FloridaHealth.gov/DiseaseReporting for other reporting questions. HIV/AIDS and HIV-exposed newborn notification should be made using the Adult HIV/AIDS Confidential Case Report Form, CDC 50.42A (revised March 2013) for cases in people ≥13 years old or the Pediatric HIV/AIDS Confidential Case Report, CDC 50.42B (revised March 2003) for cases in people <13 years old. Please contact your county health department for these forms (visit www.FloridaHealth.gov/CHDEpiContact to obtain contact information). Congenital anomalies and neonatal abstinence syndrome notification occurs when these conditions are reported to the Agency for Health Care Administration in its inpatient discharge data report pursuant to Chapter 59E-7 FAC. Cancer notification should be directly to the Florida Cancer Data System (http://fcds.med.miami.edu). All other notifications should be to the CHD where the patient resides.

Reportable Diseases and Conditions in Florida Notify upon suspicion 24/7 by phone Notify upon diagnosis 24/7 by phone

Amebic encephalitis

Anthrax

Arsenic poisoning

Arboviral diseases not otherwise listed

Babesiosis

Botulism, foodborne, wound, and unspecified

Botulism, infant

Brucellosis

California serogroup virus disease

Campylobacteriosis

Carbon monoxide poisoning

Chancroid

Chikungunya fever

Chikungunya fever, locally acquired

Chlamydia

Cholera (Vibrio cholerae type O1)

Ciguatera fish poisoning

Conjunctivitis in neonates <14 days old

Creutzfeldt-Jakob disease (CJD)

Cryptosporidiosis

Cyclosporiasis

Dengue fever

Diphtheria

Eastern equine encephalitis

Ehrlichiosis/anaplasmosis

Escherichia coli infection, Shiga toxin-producing

Giardiasis, acute

Glanders

Gonorrhea

Granuloma inguinale

Haemophilus influenzae invasive disease in children <5 years old

Hansen’s disease (leprosy)

Hantavirus infection

Hemolytic uremic syndrome (HUS)

Hepatitis A

Hepatitis B, C, D, E, and G

Hepatitis B surface antigen in pregnant women and children <2 years old

Herpes B virus, possible exposure

Herpes simplex virus (HSV) in infants <60 days old with disseminated infection and liver involvement; encephalitis; and infections limited to skin, eyes, and mouth; anogenital HSV in children <12 years old

Human papillomavirus (HPV)-associated laryngeal papillomas or recurrent respiratory papillomatosis in children <6 years old; anogenital papillomas in children ≤12 years old

Influenza A, novel or pandemic strains

Influenza-associated pediatric mortality in children <18 years old

Lead poisoning (blood lead level ≥5 ug/dL)

Legionellosis

Leptospirosis

Listeriosis

Lyme disease

Lymphogranuloma venereum (LGV)

Malaria

Measles (rubeola)

Melioidosis

Meningitis, bacterial or mycotic

Meningococcal disease

Mercury poisoning

Mumps

Neurotoxic shellfish poisoning

Paratyphoid fever (Salmonella serotypes Paratyphi A, Paratyphi B, and Paratyphi C)

Pertussis

Pesticide-related illness and injury, acute

Plague

Poliomyelitis

Psittacosis (ornithosis)

Q Fever

Rabies, animal or human

Rabies, possible exposure

Ricin toxin poisoning

Rocky Mountain spotted fever and other spotted fever rickettsioses

Rubella

St. Louis encephalitis

Salmonellosis

Saxitoxin poisoning (paralytic shellfish poisoning)

Severe acute respiratory disease syndrome associated with coronavirus infection

Shigellosis

Smallpox

Staphylococcal enterotoxin B poisoning

Staphylococcus aureus infection, intermediate or full resistance to vancomycin (VISA, VRSA)

Streptococcus pneumoniae invasive disease in children <6 years old

Syphilis

Syphilis in pregnant women and neonates

Tetanus

Trichinellosis (trichinosis)

Tuberculosis (TB)

Tularemia

Typhoid fever (Salmonella serotype

Typhi)

Typhus fever, epidemic

Vaccinia disease

Varicella (chickenpox)

Venezuelan equine encephalitis

Vibriosis (infections of Vibrio species and closely related organisms, excluding Vibrio cholerae type O1)

Viral hemorrhagic fevers

West Nile virus disease

Yellow fever

Zika fever

Outbreaks of any disease, any case, cluster of cases, or exposure to an infectious or non-infectious disease, condition, or agent found in the general community or any defined setting (e.g., hospital, school, other institution) not listed above that is of urgent public health significance. Specify in comments below.

Practitioner Disease Report Form Complete the following information to notify the Florida Department of Health of a reportable disease or condition. This can be filled in electronically.

Per Rule 64D-3.029, Florida Administrative Code, promulgated October 20, 2016 (laboratory reporting requirements differ).

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