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Epidemiology Surveillance Report

February 2023
A Communicable Diseases Update for providers in
Alleghany, Botetourt, Covington, Craig, Roanoke City and County, and Salem
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To optimally protect the community’s health, Virginia’s healthcare professionals and laboratories are required to report over 70 conditions. The full list of reportable conditions is available on the Virginia Department of Health (VDH) website.

This newsletter is intended to provide timely updates about reportable conditions in the Roanoke City and Alleghany Health Districts (RCAHD) for our local partners in public health. This issue reflects disease activity reported January 1-31, 2023.
In this issue:
  • Welcome to new team members
  • Summary of reportable diseases in January 2023
  • RCAHD Spotlight on Group A Streptococcus
Welcome to new RCAHD epidemiologists

We are pleased to welcome to Sara Cilino and Anthony Diaz as new epidemiologists serving with our RCAHD team. 

Sara will support our disease investigations in the Alleghany Health District (Alleghany County, Botetourt County, Covington, Craig County, Roanoke County, and Salem). Anthony will support our disease investigations in the Roanoke City Health District.
Summary of Reportable Diseases
  • There were no notable communicable disease concerns in January, with the following exceptions:
  1. Continued identification of individuals with hepatitis C (15 new cases reported in January 2023)
  2. An increase in community acquired invasive Group A Streptococcus (see below)

  • COVID-19 activity surged after the holiday season, peaking the second week of January, however the surge was far less pronounced compared to the previous two years. Currently, omicron variant XBB.1.5 is the most predominantly circulating strain.

  • Reportable Sexually Transmitted Infections 
Sexually Transmitted Infections reported to RCAHD:
(fields with 1-4 cases suppressed)

  • Rabies investigations: Of the 42 investigations for potential exposure to rabies, 40 investigations involved domestic animals. Post-exposure prophylaxis was recommended in 7 cases.
Spotlight: Group A Streptococcus
Group A Streptococcus (group A strep or GAS) bacteria can cause a wide range of both non-invasive and invasive infections. These can include:
  • minor illnesses (strep throat and impetigo)
  • moderate illnesses (abscesses and cellulitis)
  • very serious disease (necrotizing fasciitis and streptococcal toxic shock syndrome) 

Only invasive disease (iGAS) is reportable to the health department. Compared to 2021, RCAHD has noted an increase in the number of community-acquired cases reported in 2022 (26 cases). Unfortunately, six cases have already been reported in January 2023.
The two most common risk factors for RCAHD iGAS cases in 2022 included:

  • A history of minor injury with compromise to skin integrity (e.g., scrapes and burns) leading to invasive disease (10 cases/26)

  • Substance use disorder (10 cases/26)
The most important strategy to prevent group A strep infections is to practice good hygiene, including hand washing and appropriate wound care in the event of an injury to the skin. Early recognition of GAS and appropriate antibiotic use remain the most important strategies to prevent invasive group A strep.
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