Georgia epidemiology report, Vol. 18, no. 7 (July 2002)

July 2002

volume 18 number 07

Division of Public Health http://health.state.ga.us
Kathleen E. Toomey, M.D., M.P.H. Director
State Health Officer
Epidemiology Branch http://health.state.ga.us/epi
Paul A. Blake, M.D., M.P.H. Director
State Epidemiologist
Mel Ralston Public Health Advisor
Georgia Epidemiology Report Editorial Board
Carol A. Hoban, M.S., M.P.H. - Editor Kathryn E. Arnold, M.D. Paul A. Blake, M.D., M.P.H.
Susan Lance-Parker, D.V.M., Ph.D. Kathleen E. Toomey, M.D., M.P.H.
Angela Alexander - Mailing List Jimmy Clanton, Jr. - Graphic Designer
Georgia Department of Human Resources
Division of Public Health Epidemiology Branch Two Peachtree St., N.W. Atlanta, GA 30303-3186 Phone: (404) 657-2588 Fax: (404) 657-7517
Please send comments to: Gaepinfo@dhr.state.ga.us
The Georgia Epidemiology Report is a publication of the Epidemiology Branch,
Division of Public Health, Georgia Department of Human Resources

Notifiable Disease Reporting
Introduction
The Georgia Department of Human Resources, under the legal authority of OCGA 31-12-2 and with the approval of the Board of Human Resources, has designated certain diseases and conditions notifiable. The purpose of the reportable disease surveillance is to:
1. Identify in a timely way any diseases or conditions that may require immediate public health intervention and follow up (e.g., outbreak of E. coli 0157 infections);
2. Detect changing trends or patterns in disease occurrence (e.g., recent increase in shigellosis); 3. Identify areas or communities that require special public health response as a result of
changes in disease patterns (e.g., "hot spots" for hepatitis A); and 4. Assess and evaluate control and prevention interventions (e.g., decrease in a disease after
a vaccine is introduced).
In Georgia, more than 60 diseases and conditions are under public health surveillance. The data are collected by local and state health agencies who are responsible for analyzing, interpreting and disseminating the information to "those who need to know" for administrative, program planning, and decision making purposes.
All Georgia physicians, laboratories and other health care providers are required by law to report patients with the conditions listed on page 3 to their County Health Department or District Health Office. Cases may also be reported to the Notifiable Disease Section of the Epidemiology Branch of the State Division of Public Health. Both lab-confirmed and clinical diagnoses are reportable within the time interval specified. Reporting enables appropriate public health follow-up for your patients, helps identify outbreaks, and provides a better understanding of disease trends in Georgia.
How to Report
Cases may be reported electronically through the State Electronic Notifiable Disease Surveillance System (SENDSS) at http://sendss.state.ga.us, by completing a Notifiable Disease Report Form and mailing in an envelope marked CONFIDENTIAL, or by calling your County Health Department or District Health Office. If your District Health Office cannot be reached, call the Georgia Division of Public Health at 404-657-2588, or after business hours at 770-578-4104. A statewide toll free reporting hotline is being established and will be available in the near future. To obtain Notifiable Disease Reporting cards or a copy of the latest laminated Disease Reporting poster, please contact the Notifiable Disease Section at 404-657-2588, or via email at Gaepinfo@dhr.state.ga.us.
What to Report
The disease or condition, patient's name (except for HIV), address, phone, and date of birth; physician's name and phone; name, institution and phone of person reporting; and pregnancy status. Please report unsual or unexplained cases and any cluster of cases immediately. This is our most important way of detecting diseases that require immediate public health action (e.g., bioterrorism agents).
Influenza Surveillance Expands in Georgia
Although influenza activity typically peaks during the winter months, influenza viruses circulate year-round and remain a threat to persons who are very young or old or who have chronic medical conditions. The emergence of a novel influenza strain capable of causing a pandemic is also a possibility, and surveillance improves public health's ability to rapidly identify new strains of influenza for possible inclusion in the influenza vaccine. For these reasons, Georgia is one of several states participating in a pilot program to conduct influenza surveillance throughout the year, rather than just during the winter months. Summer influenza surveillance is possible thanks to the continued efforts of several volunteer sentinel health-care providers throughout the state. You may learn more about flu surveillance at http://health.state.ga.us/epi/ flu, or call 404-657-2588 if you are a clinician interested in volunteering to assist in Georgia's influenza sentinel surveillance network.

Summary of Trends in Number of Cases of Selected Diseases Reported, by Year, 1995-2001, and Five Year Mean/Median for 1997-2001

Disease AIDS - Diagnosed Aseptic Meningitis Campylobacteriosis Chlamydia genital infection Cryptosporidiosis Cyclosporiasis E. coli O157:H7 Giardiasis Gonorrhea Haemophilus influenzae (invasive) Hepatitis A (acute) Hepatitis B (acute) Legionellosis Listeriosis (invasive) Lyme Disease Malaria Meningococcal Disease (invasive) Mumps Pertussis Rabies - Animal S. pneumoniae Invasive DRSP Salmonellosis Shigellosis Streptococcal Disease - Group A (invasive) Streptococcal Disease - Group B (invasive) Syphilis - Total* Tuberculosis Yersiniosis

1995 2193
100 1050
110
29 577
37
84 103
19 14 14 42 113
12 30 294
1674 1426
51
188
721

1996 2052
47 795
93
39
50
414 61 3 10 1 37
146
9 20 303 236
1462 1126
113
155
2479 779

1997 1581
55 769
74
46
41
765 224
6 26
9 57 107
11 18 323 255
1377 1206
80
165
2562 681

1998 1500
428 769 25243 152
85 1215 20700
69
879 213
8 32
5 43 102
2 38 310 324
1839 1137
91
259
2118 623

1999 1365
180 729 30788 165
10 42 1357 21476 80
482 232
5 30
32 72
4 52 247 556
1977 284 113
354
1900 662 52

2000 1259
205 607 29220 190
11 45 1201 19253 86
376 353
10 20
48 53
2 52 357 581
1688 339 150
363
1678 683 48

Five Year

(1997-2001)

2001

Mean

1145 1370.0

272

228.0

640

702.8

32687

162

148.6

29

45

52.6

961

18349

109

77.0

930

686.4

435

291.4

12

8.2

16

24.8

7.0

49

45.8

57

78.2

9

5.6

23

36.6

402

327.8

435

430.2

1721 752 188

1720.4 743.6 124.4

408

309.8

1905 562 49

2032.6 642.2

Five Year (1997-2001)
Median 1365 205 729
162
45
80
765 232
8 26
7 48 72
4 38 323 435
1721 752 113
354
1905 662

* Total includes Primary, Secondary, Early Latent, Other, Congenital The article was written by Carol A. Hoban, M.S., M.P.H. and Elizabeth Poole.

Birth Defects Will Soon Be Reportable Conditions Statewide

Birth defects are the leading causes of infant mortality and morbidity in the United States. In Georgia, few statewide data exist, making improvements in public health programs difficult. In response to this, birth defects were made reportable under State Laws Official Georgia Code Annotated (OGCA)31-12-2 and 31-3-3.2 which mandate the reporting of notifiable diseases, conditions and injuries, and newborn hearing screening, and Chapters 290-5-3-.02 and 290-5-24 of the Rules of Department of Human Resources, which regulate the reporting of notifiable diseases and metabolic disorders. To date, the authority granted by these laws and regulations with regard to birth defects has only been activated within the 5-county metropolitan Atlanta area. Mandatory reporting will be activated throughout the state in 2002. The following conditions will be reportable: congenital anomalies, Fetal Alcohol Syndrome, genetic and metabolic conditions and Cerebral Palsy.
The Georgia Birth Defects Reporting and Information System (GBDRIS) is a passive surveillance system designed to provide information on incidence, prevalence, trends and epidemiology of birth defects. The GBDRIS collects information on children from birth to six years of age. The mission is to develop and maintain a birth defects reporting and information system for Georgia that supports

the early and accurate identification of children with birth defects to facilitate prevention, planning and evaluation programs and to facilitate improved access to health care services.
The system relies on existing data as well as hospital, laboratory and provider reporting through a web based system. Until system development has been completed, data from the following Department of Human Resources sources will be linked to provide information to the system: electronic birth certificates, fetal death certificates, death certificates, hospital discharge database, Medicaid data, Newborn Metabolic and Sickle Cell Screening Program, Newborn Hearing Screening Program and WIC data. Security procedures have been established to protect the privacy of all families, infants, physicians, and hospitals. All data within the GBDRIS are maintained in a secure environment. All identifying information is kept strictly confidential, and is published or presented only in a manner that ensures that no individual or institution can be identified. Counts of fewer than five cases a year will not be published. However, these cases will still be included in summary data. The system is maintained by the Maternal and Child Health Epidemiology Section of the Epidemiology Branch, Division of Public Health, Department of Human Resources (DHR).
This article was written by Debra Helfrick, M.P.H

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The Georgia Epidemiology Report Epidemiology Branch Two Peachtree St., NW Atlanta, GA 30303-3186

PRESORTED STANDARD U.S. POSTAGE
PAID ATLANTA, GA PERMIT NO. 4528

July 2002

Volume 18 Number 07

Reported Cases of Selected Notifiable Diseases in Georgia Profile* for February 2002

Selected Notifiable Diseases
Campylobacteriosis Chlamydia trachomatis Cryptosporidiosis E. coli O157:H7 Giardiasis Gonorrhea Haemophilus influenzae (invasive) Hepatitis A (acute) Hepatitis B (acute) Legionellosis Lyme Disease Meningococcal Disease (invasive) Mumps Pertussis Rubella Salmonellosis Shigellosis Syphilis - Primary Syphilis - Secondary Syphilis - Early Latent Syphilis - Other** Syphilis - Congenital Tuberculosis

Total Reported for Apr 2002
2002 35
2356 6 3 70
1319 5 43 14 2 0 5 2 0 0 79 79 3 16 17 8 0 20

Previous 3 Months Total

Ending in April

2000

2001 2002

129

141

113

6883

7562

7926

42

27

22

3

4

7

272

211

168

4055

3999

4019

23

31

23

69

197

146

62

87

84

3

2

3

0

0

1

16

20

10

1

5

2

12

7

4

0

0

0

222

183

212

84

68

231

40

21

16

76

77

47

160

167

94

177

242

100

9

5

0

144

131

100

Previous 12 Months Total

Ending in April

2000

2001 2002

646

631

612

28698

30616

33028

147

173

154

44

44

51

1369

1142

889

19912

19261

18400

87

94

100

376

545

866

255

401

416

9

10

12

0

0

1

70

55

42

6

7

4

61

38

20

0

1

0

1920

1672

1723

287

326

995

147

111

87

288

281

257

586

554

583

721

801

670

19

21

14

667

680

518

* The cumulative numbers in the above table reflect the date the disease was first diagnosed rather than the date the report was received at the state office, and therefore are subject to change over time due to late reporting. The 3 month delay in the disease profile for a given month is designed to minimize any changes that may occur. This method of summarizing data is expected to provide a better overall measure of disease trends and patterns in Georgia.

** Other syphilis includes latent (unknown duration), late latent, late with symptomatic manifestations, and neurosyphilis.

AIDS Profile Update

Report Period
Latest 12 Months: 06/01-05/02 Five Years Ago: 06/97-05/98 Cumulative: 07/81-05/02

Total Cases Reported* <13yrs >=13yrs Total

1

1839

1840

4

1435

1439

210

24856 25066

Percent Female
24.5
19.5
17.4

MSM
38.6 42.7 47.8

IDU
7.5 19.0 17.5

Risk Group Distribution (%) MSM&IDU HS Blood

2.5

13.6

2.1

5.1

18.0

1.2

5.5

13.4

1.9

Unknown
35.7 13.9 13.9

Race Distribution (%) White Black Other

19.4 75.9

4.7

22.9 74.5

2.6

34.3 63.3

2.4

MSM - Men having sex with men

IDU - Injection drug users

HS - Heterosexual

* Case totals are accumulated by date of report to the Epidemiology Section

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