January PCHD Surveillance Report

The Pima County Health Department has released its January Surveillance Report which covers the influenza season, rubella, parotitis and reporting procedures for carabapenem resistant enterobacteriaceae.

Always remember providers are our eyes and ears in the community. Please report immediately unusual numbers of patients presenting with similar symptoms, unusual symptoms, or unexplained infectious diseases in healthy individuals. Do not wait until laboratory results become available.

You are welcome to call or fax in reports to:
Phone (520) 724-7797
Fax (520) 838-7538
For urgent reporting after hours or on holidays, please call (520) 743-7987.

2017-2018 Influenza Season

Arizona is experiencing widespread flu activity for week 2 (Dec 31, 2017 to Jan 6, 2018). Flu seasons are unpredictable. Flu vaccination is still recommended because the vaccine can protect against 4 types (quadrivalent vaccine) of influenza and decreases the hospitalization rate of those who do catch the flu.

For week 1 Pima County reported:

• 1,711 cases of influenza the majority were type A H3N2
• Overall for Arizona the 65 and older age group had 31% of the cases followed by the 19-49 age group with 24% and 5-18 age group with 18%
• Three pediatric deaths have been reported in Maricopa County
• 156 cases of RSV were reported with the majority occurring in the 1-4 year age group

The cases included in this report represent a small proportion of the true number of cases of influenza. Many people do not visit the doctor when ill and doctors should not be expected to run tests on all patients exhibiting influenza-like symptoms.

Rubella

Arizona Department of Health Services is investigating a possible rubella exposure to a pregnant woman. She was unvaccinated and was exposed to a family member that had traveled to a foreign country. Japan documented an increase in CRS in 2012 due to low vaccination rates. It is important for clinicians to recognize that many of their child bearing age patients have not received an MMR vaccination. Many foreign countries still have outbreaks of rubella and unvaccinated travelers may bring the disease back and expose others. Encourage your adult patients to update their vaccinations to prevent the devastating consequences of Congenital Rubella Syndrome (CRS).

Parotitis

During the 2014-2015 influenza season several hundred confirmed flu cases with parotitis were reported to the CDC. The majority of these cases were male school aged children. The majority were infected with the H3N2 type A virus. Although there has been no documented increase in flu associated parotitis this flu season, consider influenza in the differential diagnosis in children with parotitis and no history of travel or exposure to a laboratory confirmed mumps case. Other respiratory illnesses to consider in the differential diagnosis are Epstein-Barr (EBV), Human Herpes 6B (HHV-6B), and Human parainfluenza-2 and 3 (HPIV-2 and HPIV-3).

Please contact the Pima County Health Department (PCHD) if you suspect a patient has mumps so proper testing can be performed. Also report any confirmed flu cases with parotitis to PCHD.

Carbapenem Resistant Enterobacteriaceae

Go here to find the algorithm for reporting Carbapenem Resistant Enterobacteriaceae (CRE). CRE should be reported within 5 working days of obtaining a positive result using the ELR or lab reporting form, Fax: 602-364-3199.

Labs should use the updated CLSI MIC cutoffs to determine reporting and submitting isolates to public health, independent of the susceptibility interpretation- See attachment

Submit the isolate and drug susceptibility testing results to the Arizona State Public health lab at 250 N 17th Ave. Phoenix, AZ 85007. Phone: 602-542-1188. Fax: 602-364-0758

For urgent reporting after hours or on holidays, please call (520) 743-7987

Please complete a Communicable Disease Report available here.

You may also reach the Arizona Department of Health Services (ADHS), Disease Surveillance Hotline at 1-800-314-9243.