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May and June pub

VIEWS: 18 PAGES: 7

									 Volume 10, Issue 3                        Publication Number 40064529                                                                                                                                                Capital Health
 May and June 2006


                  Communicable Disease Corner
                                     MUMPS INFECTION
 The increasing incidence of mumps (infectious paroti-      pancreatitis. However, an estimated 20% to 30%
 tis) infections in some developed countries has re-        of mumps cases are asymptomatic. Although
 cently been highlighted in the media. This includes        complications are relatively frequent, permanent
 the current outbreak (nearly 3,000 cases) in the           sequelae are rare.
 United States, which is the largest mumps epidemic
                                                            Nationally, mumps infection rates in Canada have
 reported there in more than 20 years. Similarly, there
                                                            decreased from 3.5 per 100,000 population in
 was a huge outbreak (56,390 cases) in the United
                                                            1989 to 0.1 per 100,000 population in 2004 (fig 1).
 Kingdom in 2005. In Canada, smaller outbreaks
                                                            In 1938, there was an outbreak of mumps in Ed-
 among university students in Nova Scotia occurred in
                                                            monton, Alberta with a rate of 6,440.8 cases per
 May 2005 and January 2006 (32 cases in the 2 out-
                                                            100,000 persons, i.e., about 65,000 thousand
 breaks), and some cases in 2006 were genetically
                                                            cases based on the current population in Capital
 linked to the 2005 outbreak in the United Kingdom.
                                                            Health. Between 1998 and 2004, the infection rate
 The last outbreak in Alberta (nearly 200 cases) oc-
                                                            in Capital Health ranged between 0.0 and 0.3 per
 curred in 2001-2002, mostly among unimmunized
                                                            100,000 population but increased to 0.6 per 100,
 persons.
                                                            000 population in 2005 when six mumps cases
                                                            were reported (Figure 1).
 Peak incidence in most of these outbreaks has
 shifted to adolescents and young adults where trans-
 mission is often associated with social contact and
 exposure in settings such as schools or universities.
 Sustaining high immunization rates is critical in pre-
 venting mumps outbreaks, and it is also necessary to
 maintain vigilance to identify populations at risk and
 control potential outbreaks.

 Mumps (infectious parotitis) is a viral infection of the                                                                                Canada
 salivary glands spread through coughing, sneezing
 and sharing saliva. Maximum infectivity occurs be-
 tween 2 days before to 4 days after the onset of
 illness. The incubation period is usually between 16
 to 18 days. Symptoms include fever, swelling, and
 tenderness of the parotid or other salivary glands;
 headache and myalgia. Orchitis occurs in 20 to 30%
 of post pubertal males. Mumps also can result in
 sensory neural hearing loss, aseptic meningitis and                                                                                     Alberta

                                                                                               3.50

                                                                                               3.00
Inside This Issue:
                                                                 Rate per 100,000 population




                                                                                               2.50

                                                                                               2.00



Mumps Infections                                      1,2                                      1.50

                                                                                               1.00

                                                                                               0.50


Monthly Data                                          3,4                                      0.00
                                                                                                      1989

                                                                                                             1990



                                                                                                                           1992

                                                                                                                                  1993



                                                                                                                                                1995




                                                                                                                                                                     1998



                                                                                                                                                                                   2000

                                                                                                                                                                                          2001



                                                                                                                                                                                                        2003

                                                                                                                                                                                                               2004
                                                                                                                    1991




                                                                                                                                         1994



                                                                                                                                                       1996

                                                                                                                                                              1997



                                                                                                                                                                            1999




                                                                                                                                                                                                 2002




                                                                                                                                                        Year




Monthly Notifiable disease summary                    5,6                                                              Capital Health

Public Health Staff Division Directory                 7
                                                            Figure 1. Mumps per 100,000 population in
                                                            Canada, Alberta and Capital Health 1989 - 2004
                                                                                                                                                 PAGE 2



                                                        MUMPS INFECTIONS Cont’d.
                                                                                              References:
Although the number of cases in Capital Health in
2005 seems small compared to the number of cases                                              Alberta Health and Wellness. Public Health Notifiable
reported in 1938, this is the highest number of cases                                         Disease Management Guideline. Edmonton: Alberta
in Capital Health in the past decade (Fig. 2). No                                             Health and Wellness, 2005.
documentation of immunization was available for any                                           American Academy of Pediatrics. Mumps. In: Pickering
of the 2005 cases, although one self-reported a                                               LK, ed. Red Book: 2003 Report of the Committee on
history of mumps immunization. Two of them were                                               Infectious Diseases. 26th ed. Elk Grove Village, IL: Ameri-
born before 1970 and reportedly had locally acquired                                          can Academy of Pediatrics; 2003: 439-43.
                                                                                              Canadian Network for Public Health Intelligence, Canadian
infection. The other cases ranged in age from 19
                                                                                              Outbreak Surveillance Centre. Public Health Alerts RA-
years to 23 years old and were either infected while                                          000886. https://www.cnphi-rcrsp.ca. Accessed June 2006.
traveling abroad (two persons), or had secondary                                              Capital Health. Communicable Disease Control Manual.
infection subsequent to exposure to travel-related                                            Edmonton: Public Health Division, 2004.
cases (two individuals).                                                                      Centers for Disease Control and Prevention. Update:
                                                                                              multistate outbreak of mumps – United States, January 1-
                                                                                              May 2, 2006. Morbidity and Mortality Weekly Report
                                                                                              (MMWR) 2006; 55(20):559-63.
                     9                                               1.2                      Centers for Disease Control and Prevention. Mumps
                     8                                                                        epidemic – United Kingdom, 2004 – 2005. Morbidity and
                                                                     1.0
   Number of cases




                     7                                                                        Mortality Weekly Report (MMWR) 2006; 55(07): 173-5.
                                                                           Rate per 100,000




                     6                                               0.8                      Edmonton Board of Health. Report of the Local Board of
                                                                              population




                     5                                                                        Health. Edmonton, 1938.
                                                                     0.6
                     4                                                                        National Advisory Committee on Immunization. Mumps
                     3                                               0.4                      vaccine. In: Canadian Immunization Guide, 6th edition
                     2                                                                        (Health Canada, Catalogue H49-8/2002E). Ottawa: Minis-
                                                                     0.2                      ter of Public Works and Government Services Canada,
                     1
                                                                                              2002.
                     0                                               0.0
                                                                                              Public Health Agency of Canada. Notifiable Diseases On-
                                                                                              Line. http://dsol-smed.phac-aspc.gc.ca/dsol-smed/ndis/
                      96
                           97
                           98
                                     99
                                     00
                                               01
                                                     02

                                                          20 3
                                                             04
                                                             05
                                                             0
                     19
                          19
                               19
                                    19
                                         20
                                              20
                                                   20
                                                        20


                                                          20




                                                                                              c_time_e.html. Accessed June 2006.
                                                                                              Heymann D, ed. Control of Communicable Diseases
                                              Year           Cases    Rate                    Manual. 18th ed. Washington, DC: American Public Health
                                                                                              Association, 2004.
Figure 2. Mumps Cases and Rates
Capital Health 1996 - 2005

At the present time in Capital Health, residents born
prior to 1970 are not eligible for provincial MMR
                                                                                                   DID YOU KNOW?
vaccine as they are considered to have been ex-
posed to natural disease. Those born in 1970 or later                                              Duggan Public Health Centre is no
who have no history of mumps infection and have not                                                longer offering child health clinic and
received at least one dose of MMR vaccine should                                                   immunization services.
be encouraged to obtain MMR vaccine through their
local public health centre.                                                                        Since August 2003, child health clinic
                                                                                                   and immunization services have been
There is no increased mumps activity in Alberta at                                                 moved to:
this time. However, in Capital Health all suspect
cases of mumps should be reported to the Medical                                                   Twin Brooks Public Health Center
Officer of Health as soon as possible. Physicians                                                  Suite 201,
who suspect mumps infection in patients are asked                                                  1110 - 113 Street
to order mumps serology (IgM and IgG). Further                                                     (in the George P Nicholson school, up-
laboratory specimens for viral culture, a urine sample                                             stairs above the YMCA daycare).
and a nasopharyngeal swab, may be collected by
public health staff if required.                                                                   Please call 413 - 5630 for more informa-
                                                                                                   tion or to book an appointment.
Beverley Baptiste, Surveillance Coordinator
Communicable Disease Control
                                                                                                                                 PAGE 3



Monthly Data - March
                                                         Immunization
The following table is a summary of preschool immunization within the Capital Health Region. It
shows completed immunization rates for the month of March 2006. The immunization targets are
set by Alberta Health and Wellness.

                               4 Months
                  DTaP-IPV-Hib          Meningo-C         Pneumo-C
Imm/Eligible          913/964            911/964             913/964
(% Imm)                 95%                95%                95%
Target                  95%                95%                95%

                                               15 Months
                 DTaP-IPV-Hib         Meningo-C        Pneumo-C             MMR             Varicella*
Imm/Eligible        927/983            927/983          924/983            872/983              857/983
(% Imm)               94%               94%               94%                89%                  87%
Target                95%               95%               95%                95%                  95%

                                                 24 Months
                 DTaP-IPV-Hib         Meningo-C        Pneumo-C              MMR                Varicella*

Imm/Eligible        813/922            878/922           824/922           877/922              859/922
(% Imm)               88%               95%                  89%             95%                  93%
Target                97%               97%                  97%             98%                  98%

 *Number immunized includes children who had disease.

Legend:
DTaP-IPV-Hib – Diphtheria, Tetanus, acellular Pertussis, Polio, Haemophilus influenzae type b
Meningo-C – Meningococcal Conjugate
Pneumo-C – Pneumococcal Conjugate
MMR – Measles, Mumps, Rubella
Varicella – Chickenpox




 C OMMUNITY I NFECTION C ONTROL


  Incidence of MRSA, VRE and ESBL within the CH Region

   Type of Organism             Mar        YTD/        YTD/
                                06          06          05
                                                                   Legend:
          MRSA                  78          210        165         MRSA - Methicillin - Resistant Staphylococcus aureus
                                                                   VRE - Vancomycin - Resistant Enterococcus
                                                                   ESBL - Extended Spectrum Beta-lactamase Producing Organisms
           VRE                  26           34         11

          ESBL                  26           60         37
                                                                                                                                   PAGE 4



Monthly Data - April
                                                         Immunization
The following table is a summary of preschool immunization within the Capital Health Region. It
shows completed immunization rates for the month of April 2006. The immunization targets are set
by Alberta Health and Wellness.

                               4 Months
                  DTaP-IPV-Hib         Meningo-C          Pneumo-C
Imm/Eligible         968/1014           963/1014          963/1014
(% Imm)                 95%               95%                95%
Target                  95%               95%                95%

                                                15 Months
                  DTaP-IPV-Hib         Meningo-C        Pneumo-C              MMR               Varicella*
Imm/Eligible         870/932           878/932           863/932            840/932             821/952
(% Imm)                93%                94%               93%               90%                 86%
Target                 95%                95%               95%               95%                 95%

                                                24 Months
                  DTaP-IPV-Hib         Meningo-C         Pneumo-C             MMR               Varicella*
Imm/Eligible         813/909            867/909           814/909           872/909             847/909
(% Imm)                89%                95%               90%                96%                93%
Target                 97%                97%               97%                98%                98%
*Number immunized includes children who had disease.

Legend:
DTaP-IPV-Hib – Diphtheria, Tetanus, acellular Pertussis, Polio, Haemophilus influenzae type b
Meningo-C – Meningococcal Conjugate
Pneumo-C – Pneumococcal Conjugate
MMR – Measles, Mumps, Rubella
Varicella – Chickenpox




   C OMMUNITY I NFECTION C ONTROL



  Incidence of MRSA, VRE and ESBL within the CH Region

  Type of Organism               Apr         YTD/         YTD/
                                 06           06           05        Legend:
                                                                     MRSA - Methicillin - Resistant Staphylococcus aureus
          MRSA                    41          251         223        VRE - Vancomycin - Resistant Enterococcus
                                                                     ESBL - Extended Spectrum Beta-lactamase Producing Organisms
          VRE                     11            45          20

          ESBL                    16            76          42
                                                                                                                         PAGE 5



                              March Notifiable Disease Summary (preliminary†)
                                              Number         3 Month Period         Historical Average      Number of
                                              Reported       (Jan 06 – Mar 06)      (Jan 01 – Mar 05)        Cases in
                                                                                                              2006
Disease                                        Mar 06        Number       Rate*      Number        Rate*
Ameobiasis                                        2             7         0.69          4.8         0.54        7
Campylobacter                                     13            38        3.74         39.8         4.34       38
Chickenpox                                        28            79        7.78         181.4        20.13      79
Cryptosporidiosis                                 1             2         0.20          2.8         0.29        2
E Coli O157:H7                                    1             2         0.20          6.2         0.67        2
Giardiasis                                        5             28        2.76         24.0         2.61       28
Group A Streptococcal, Inv.                       6             22        2.17         15.8         1.71       22
Hepatitis A                                       0             4         0.39          4.4         0.48        4
Hepatitis B Carrier                               8             42        4.13         41.4         4.51       42
Hepatitis B Case                                  0             1         0.10          4.2         0.46        1
Hepatitis B Prenatal                              3             4         0.39          7.4         0.81        4
Hepatitis C                                       38           127       12.50         166.4        18.31      127
HIV Infection                                     11            24        2.36         20.8         2.28       24
Leprosy                                           0             1         0.10          0.2         0.02        1
Meningitis - Bacterial, Other                     2             5         0.49          1.8         0.20        5
Meningococcal – Invasive                          0             3         0.30          4.2         0.49        3
Pertussis                                         2             11        1.08         17.2         1.81       11
Pneumococcal, Invasive                            19            45        4.43         36.6         3.98       45
Salmonella (non-typhoidal)                        10            45        4.43         62.6         6.99       45
Salmonella Paratyphi (paratyphoid)                3             4         0.39          1.0         0.11        4
Salmonella Typhi (typhoid)                        0             1         0.10          0.4         0.04        1
Sexually Transmitted Diseases
-         Chlamydia                              267           778       76.60         645.4        68.95      778
-         Gonorrhea                               81           212       20.87         122.4        13.08      212
-         Mucopurulent Cervicitis**1              11            25        4.90         18.5         3.69       25
-         Non-Gonococcal Urethritis**             58           149       29.50         157.2        33.75      149
-         Syphilis – Infectious2                  6             16        1.58          6.4         0.68       16
•         Syphilis – Other2
                                                  1             2         0.20          4.6          0.5        2
Shigella                                          4             9         0.89          7.0         0.75        9
Tuberculosis                                      5             13        1.28          8.2         0.88       13
Varicella Zoster, Shingles                        7             14        1.38          1.8         0.18       14
Vibrio Parahaemolyticus                           0             1         0.10          0.2         0.02        1
Yersiniosis                                       1             1         0.10          3.6         0.38        1
    †
     Excludes notifiable diseases with no cases in current year.
    *Rates are reported as per 100,000 people and calculated on population estimates:
    2001 839845                                                  2004 990826
    2002 856020                                                  2005 1015730
    2003 978049                                                  2006 1015730

    **Rate calculated using gender specific population figures

    Numbers and rates calculated using population statistics of new boundaries April 1, 2003. Historical rates include
    current boundaries and boundaries as they existed between January 2000 and March 31, 2003.
    1
        Due to changes in definition of MPC reporting historical data 2004 – 2005 only
    2
        Syphilis is separated into infectious and other; other includes late latent and congenital cases
                                                                                                                         PAGE 6



                           April Notifiable Disease Summary (preliminary†)
                                          Number         3 Month Period         Historical Average       Number of
                                          Reported       (Feb 06 – Apr 06)       (Feb 01 – Apr 05)        Cases in
                                                                                                           2006
Disease                                     Apr 06       Number       Rate*      Number        Rate*
Ameobiasis                                     1             5        0.49          3.8         0.42          8
Brucellosis                                    1             1        0.10          0.0         0.00          1
Campylobacter                                  8            30        2.95         37.6         4.04          46
Chickenpox                                    22            72        7.09         154.8       16.70         103
Cryptosporidiosis                              1             2        0.20          3.2         0.35          3
E Coli O157:H7                                 3             5        0.49          6.8         0.74          5
Giardiasis                                     5            20        1.97         24.6         2.64          34
Group A Streptococcal, Inv.                    3            18        1.77         13.4         1.42          26
Hemolytic Uremic Syndrome                      0             1        0.10          0.6         0.06          1
Hepatitis A                                    0             2        0.20          3.0         0.31          4
Hepatitis B Carrier                           11            40        3.94         41.0         4.38          58
Hepatitis B Case                               1             1        0.10          3.4         0.37          2
Hepatitis B Prenatal                           3             6        0.59          6.2         0.67          7
Hepatitis C                                   39           123       12.11         171.8       18.70         174
HIV Infection                                  5            22        2.17         20.4         2.21          29
Leprosy                                        0             0        0.00          0.2         0.02          1
Malaria                                        1             1        0.10          3.2         0.34          1
Meningitis - Bacterial, Other                  0             4        0.39          2.0         0.22          5
Meningococcal – Invasive                       0             1        0.10          3.2         0.37          3
Pertussis                                      6            11        1.08         18.2         1.89          17
Pneumococcal, Invasive                        19            56        5.51         38.6         4.15          65
Salmonella (non-typhoidal)                    13            40        3.94         60.4         6.70          58
Salmonella Paratyphi (paratyphoid)             0             4        0.39          0.8         0.09          4
Salmonella Typhi (typhoid)                     0             1        0.10          0.4         0.04          1
Sexually Transmitted Diseases
-       Chlamydia                             230          728       71.67         624.8       66.75         1008
-       Gonorrhea                             61           203       19.99         115.6       12.35         273
-       Mucopurulent Cervicitis**1             7            23        4.50         16.5         3.29          32
-       Non-Gonococcal Urethritis**           30           127       25.14         148.8       31.94         179
-       Syphilis – Infectious2                 6            18        1.77          6.8         0.73          22
•       Syphilis – Other2
                                               0             2        0.20          6.2         0.7           2
Shigella                                       1             6        0.59          8.0         0.85          10
Tuberculosis                                   2            14        1.38         10.8         1.15          15
Varicella Zoster, Shingles                     3            16        1.58          2.2         0.22          18
Vibrio Parahaemolyticus                        0             0        0.00          0.0         0.00          1
Yersiniosis                                    0             1        0.10          2.8         0.29          1
    †
      Excludes notifiable diseases with no cases in current year.
    *Rates are reported as per 100,000 people and calculated on population estimates:
    2001 839845                                                        2004 990826
    2002 856020                                                        2005 1015730
    2003 978049                                                        2006 1015730
    **Rate calculated using gender specific population figures
    Numbers and rates calculated using population statistics of new boundaries April 1, 2003. Historical rates include
    current boundaries and boundaries as they existed between January 2000 and March 31, 2003.
    1
      Due to changes in definition of MPC reporting historical data 2004 – 2005 only
    2
      Syphilis is separated into infectious and other; other includes late latent and congenital cases
                                                                                                                                             PAGE 7



                                                                       STAFF DIRECTORY
                          Medical Officer of Health ...................Dr. Gerry Predy .................. 413-7600......Plaza 124
                          Deputy Medical Officer of Health .......Dr. Marcia Johnson ............ 413-7601......Plaza 124
                          Assoc. Medical Officer of Health........Dr. James Talbot ................ 413-7603......Plaza 124
                          Director, CDC ....................................Anita Hanrahan................... 413-7944......Plaza 124
  Contact Numbers for     Director, Environmental Health..........Bill Hohn ............................. 413-7930......Plaza 124
  Communicable Disease
                          Executive Coordinator, MOH .............Lavera Sebulsky ................. 413-7946......Plaza 124
  Control and Environ-
  mental Public Health
  Services Staff          COMMUNICABLE DISEASE CONTROL (CDC)
                          Associate Director .............................Joy Loewen ........................ 413-7941......Plaza 124
                          Senior Regional Manager STD & TB ........ Barbara Anderson .............. 413-5186......STD Centre
                          Senior Regional Manager STD & TB .......Barbara Anderson .............. 413-5186......TB Clinic
                          Manager, THS & IBU.........................Pat Crick ............................. 413-5640......Travellers Health
                          Epidemiologist, CDC .........................Joy Jaipaul.......................... 413-7940......Plaza 124
 Public Health Division
 #300, 10216-124 Street   Manager, Reg. Infection Control........Karin Fluet .......................... 413-7618......Plaza 124
 Edmonton, Alberta
                          Manager, Boyle McCauley PHO........Diane Doering..................... 422-7333......Boyle McCauley
 T5N 4A3

 Phone: (780) 413–7900    AIDS/HIV/Sexually Transmitted Disease Info ................................ 800-772-2437
 Fax: (780) 413–7950      STD Centre........................................ ........................................... 413-5156
                          TB Clinic ............................................ ........................................... 413-5755
                          Travellers Health Services/IBU.......... ........................................... 735-0100

                          NURSE SPECIALISTS
  We are on the web at
  www.capitalhealth.ca    Nurse Specialist.................................Bev Lucki ............................ 413-5670......Bonnie Doon
                          Nurse Specialist.................................Irene Hedley ....................... 413-5787......Castle Downs
                          Nurse Specialist.................................D.Cayer/A.McNamara ........ 413-5645......Eastwood
                          Nurse Specialist.................................Heather Turner ................... 980-4654......Leduc
Editorial Team:
Anita Hanrahan            Nurse Specialist.................................Carol Kuzyk ........................ 413-5685......Mill Woods
413-7944
ahanraha@cha.ab.ca        Nurse Specialist.................................Bev Clement ....................... 413-5600......North Central
                          Nurse Specialist.................................Susan Nolt .......................... 472-5020......Northeast CHC
Joy Jaipaul
413-7940                  Nurse Specialist.................................Irene Hedley ....................... 459-6671......St. Albert
jjaipaul@cha.ab.ca
                          Nurse Specialist.................................Linda Johnson .................... 467-5571......Strathcona
Joy Loewen                Nurse Specialist ………………….…..Linda Lovatt………… .......... 413-5630......Twin Brooks
413-7941
jloewen@cha.ab.ca         Nurse Specialist.................................Marcella Bobocel ................ 413-5700......W. Jasper Place
Nelson Fok                Nurse Specialist.................................Vicki Pilling ......................... 413-5720......Woodcroft
413-7936
                          Nurse Specialist.................................Tiffany Herrick .................... 939-3388......Rural North
nfok@cha.ab.ca
                          Nurse Specialist.................................Gert Jensen ........................ 968-3600......Rural West
Lance Honish
413-7923                  ENVIRONMENTAL PUBLIC HEALTH SERVICES
lhonish@cha.ab.ca         Associate Director .............................Nelson Fok ......................... 413-7936......Plaza 124
Managing Editor:          Env. Health Epidemiologist................Lance Honish...................... 413-7923......Plaza 124
Lavera Sebulsky
                          Enteric Disease Specialist .................Ingrid Zazulak ..................... 973-9136......Plaza 124
413-7946
lsebulsk@cha.ab.ca        Manager, Safe Food..........................Rick Dimock........................ 413-5767......Old Jasper Place
                          Manager, Safe Built Environ ..............Nick Skippings .................... 413-5650......Eastwood
                          Manager, Healthy Rural Environ........Bob Mowat.......................... 968-3796......Stony Plain

								
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