Second Quarter 2018
 
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 infectious disease trends in Johnson County, Kan. and JCDHE's services. If you have a story idea for a future issue, send an email to [email protected]. We encourage you to share this newsletter with your colleagues! 
Measles investigation ongoing in Johnson County 

Health officials in Kansas were first notified of a case of measles in a Johnson County child care facility on March 8 after an infant who was too young to be vaccinated was infected with the disease while traveling internationally.  Since then, the Johnson County Department of Health and Environment and the Kansas Department of Health and Environment have identified 22 cases of measles that are epidemiologically linked. In early April 2018, cases of measles began to appear in Kansas City, Mo. after an unvaccinated adult was exposed to measles while traveling abroad. Health officials have determined that the measles cases in Kansas are NOT linked to those in Missouri.

Measles can be prevented with measles-containing vaccine, which is primarily administered as the combination measles-mumps-rubella (MMR) vaccine.  
  • Children or adults born after 1957 should have two doses of the MMR. The first dose of the MMR vaccine is usually given to children at age 12-15 months; the second dose at age 4-6 years or at least 28 days after the first dose.
  • Individuals who work in a healthcare setting or medical facility, should have two doses of a measles-containing vaccine (typically the MMR) regardless of birth year.
Measles is still common in other parts of the world, including many countries in Europe, Asia, the Pacific and Africa. Every year, unvaccinated people get measles while they are abroad and bring the disease into the United States and spread it to others. Anyone 6 months or older who is planning to travel outside the U.S. should get the MMR vaccine 4-6 weeks before departure. 

Any healthcare provider who suspects a patient may have measles should isolate the patient using airborne precautions and report the disease immediately (within 4 hours) to JCDHE at 913-826-1303 (during regular business hours) or the Kansas Department of Health and Environment at 877-427-7317 (after business hours and weekends) PRIOR to testing.

JCDHE offers travel vaccines on a walk-in basis at its Olathe (11875 S. Sunset Dr.) and Mission (6000 Lamar Ave.) immunization clinics. Travelers can also get immunizations from Children's Mercy Hospital or one of the private pay travel clinics in Johnson County. 
Healthy swimming protocols prevent illness 

Pools around Johnson County will be opening later this month and preventing recreational water illnesses (RWIs) will ensure a safe and healthy swimming experience for everyone.

Studies show that the swimming public believes that chlorine instantly kills all pathogens. This data also shows that swimmers don't think about swimming as a shared water experience. Unfortunately, these misconceptions lead to risky behaviors, such as swimming during diarrheal illness and swallowing recreational water, which lead to transmission of pathogens that cause RWIs. It is important for medical professionals to educate their patients and dispel misconceptions that lead to illness.
  • Don't swim while ill with diarrhea.
  • For patients with cryptosporidiosis, don't swim for an additional 2 weeks after diarrhea has resolved.
  • Don't swallow the water.
  • Keep ears as dry as possible and dry ears thoroughly after swimming.
  • Don't swim when you have open wounds.
If you suspect a RWI is related to a Johnson County pool, call our disease investigators at 913-826-1303 and test for enteric pathogens along with waterborne parasites including cryptosporidium and giardia. 
STD Chart
Sexually transmitted infections increasing in Johnson County 

Johnson County was named the healthiest county in the state of Kansas in March. However, the number of sexually transmitted diseases (STDs) cases in the county has room for improvement.

According to the Kansas Department of Health & Environment's Kansas STI Report January-December 2017, Johnson County had the second highest number of reported chlamydia cases, the third highest number of reported early syphilis cases and the fourth highest number of reported gonorrhea cases in the state. Although chlamydia is the most frequently reported STD in Johnson County, the number of gonorrhea infections has outpaced chlamydia and syphilis for the past three years.

Department of Health and Environment Director Lougene Marsh says this trend is concerning as gonorrhea has progressively developed resistance to the antibiotic drugs prescribed to treat it. Marsh also suspects adolescents and young adults may delay care because of concerns about confidentiality.

Marsh says healthcare providers can do their part to improve these numbers by assessing their patients' STD risk, providing risk-reduction counseling and screening patients who are at risk of contracting STDs.

The Department of Health and Environment provides confidential, affordable testing and treatment to anyone with an STD and their partner(s) regardless of income or parental consent at its walk-in clinics in Olathe (11875 S. Sunset Dr.) and Mission (6000 Lamar Ave). Both clinics are open late on Wednesdays from 10 a.m. to 6:30 p.m. and no appointment is needed. 
Meet the Disease Investigation Team: Caitlin (Walls) Kintner 

Caitlin (Walls) Kintner, MPH, Epidemiologist , has been with the Johnson County Department of of Health and Environment for three years. Prior to joining JCDHE, she worked at a local health department in Missouri for five years. 

Caitlin keeps track of disease trends in Johnson County through disease investigations. A large part of these investigations includes educating and interviewing patients to help identify outbreaks and protect others from becoming infected. 
 
Her interests include traveling with family, movies, reading and anything Disney. You can reach her at 913-826-1257 or  [email protected] .
Kansas Infectious Disease Symposium attendees learn how to prepare for biological and environmental threats

KIDS 2018
The second annual Kansas Infectious Disease Symposium was held May 10-11 at the Embassy Suites by Hilton Kansas City Olathe. 

Around 200 public health leaders, first responders, law enforcement and health care providers from around the region attended and learned how infectious diseases are contained and managed in the state of Kansas and the Midwest. P re-conference training on the National Sydromic Surveillance tool took place on May 9

If you're interested  in exhibiting or being a sponsor at the 2019 conference, contact  Tiffany Wallin at 913-826-1252 or send an email to [email protected]  
Flu cases in Johnson County were highest in 8 years 

This year's flu season was one for the record books.  As of May 11, 6,941 cases of flu have been reported to JCDHE. That's the highest total the department has recorded in 8 years. 

Influenza cases began to spike the last week of December 2017, peaked around Feb. 10 and dramatically dropped off by the first week of March. The total number of flu cases in the previous season was 2,812. Flu-related deaths in Johnson County totaled 20. No pediatric deaths have been reported in Kansas as of May 15.

Influenza is not a reportable disease in Kansas. Therefore, the Johnson County Department of Health and Environment relies on local healthcare providers to provide weekly influenza reports to our disease investigation team. 

Each week, JCDHE's disease investigators compile this information into a weekly influenza surveillance report to track trends in influenza-like illness across Johnson County. The Kansas Department of Health and Environment tracks influenza across the state too. 

Download and complete this  form  each week and fax it to 913-826-1300 to help JCDHE and others in the community get the most accurate picture of influenza activity in Johnson County.
Phase II exercise lessons learned 

Thirteen jurisdictions in the Kansas City metro area participated in a regional full-scale medical countermeasures exercise on March 5 and the week of March 12-16. The exercise focused on mass dispensing operations following an Anthrax attack, and while this is not a new scenario, it was the first time testing the administration of both pills and vaccine. It also tested the full integration of epidemiology into a public health response.

"This exercise was a great opportunity to not only test our mass dispensing capabilities, but also to extend those capabilities beyond preparedness into other areas of public health, including epidemiology, public information and clinical operations," said Steve Maheux, public health emergency preparedness/CRI program manager. 

Besides public health, law enforcement, facilities and emergency management, a number of local, regional, and state partners participated in the exercise.  "Exercises such as this one are critical in ensuring effective and efficient responses to public health emergencies," said Maheux.
Yellow Fever Vaccine Update 

The Johnson County Department of Health and Environment is temporarily out of stock of the Yellow Fever vaccine and does not expect to receive a new supply from the manufacturer until the end of 2018.  

Travelers and health care providers can find locations with remaining doses of the Yellow Fever vaccine and its alternative, Stamaril, by visiting the  yellow fever vaccination clinic search page

For information about which countries require yellow fever vaccination for entry and which countries the CDC recommends yellow fever vaccination, visit the CDC Travelers' Health website.
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

Information and reports about the mosquito surveillance conducted by Johnson County in 2017 and 2016 are also posted on our website. 
Summer Holiday Closures 

The Johnson County Department of Health and Environment's offices and clinics will be closed on the following holidays:
  • Monday, May 28 (Memorial Day)
  • Wednesday, July 4 (Independence Day)
  • Monday, September 3 (Labor Day)
News from the CDC



U.S. drug overdose deaths continue to rise; increase fueled by synthetic opioids

Healthy and Safe Swimming Week is May 21-27, 2018


Johnson County Department of Health and Environment |  [email protected]
REPORT A DISEASE:  (913) 826-1303; Fax: (913) 826-1300
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