Disease Control and Surveillance

Mission:
To appropriately survey and investigate reported infectious and non-infectious diseases, and enforce the Ohio state regulations regarding reportable diseases in the Akron area.

Duties and Services

	Maintain the surveillance of reportable communicable diseases as mandated by Ohio state law
	Investigate reportable communicable diseases
	Help maintain the Summit County Centralized Communicable Disease Registry
	Provide educational programs on communicable diseases to health care professionals and the public
	Provide written educational materials about communicable diseases to health care professionals and the public
	Conduct the Summit County Influenza Surveillance system from October through April
	Coordinate the Summit County Hepatitis Support Group

Telephone Numbers:

Disease Surveillance and Control
330-375-2145
330-375-2013

Centralized Communicable Disease Registry
(for disease reporting only)
330-375-2662
330-375-2447 FAX

Disease Surveillance and Control

Communicable disease surveillance in the United States is over 100 years old. The Disease Surveillance and Control section of the Office of Epidemiology collects reports of and investigates reportable diseases in City of Akron residents. The State of Ohio mandates the reporting of approximately 80 different communicable diseases (Ohio’s Reportable Diseases). Some of these infections are significant public health concerns because of their contagiousness, some because of their rareness in Ohio, some because of increasing antibiotic resistance, and some because they may indicate a common source (food for example) of infection. Understanding the nature and extent of communicable diseases in a community is key to preventing their spread to others, and to identifying new threats to health.

Investigation of communicable diseases is done confidentially. Information collected is shared with the Ohio Department of Health. That agency removes personal identity data and sends the numbers of reported cases of the different diseases to the Centers for Disease Control and Prevention in Atlanta where a registry of communicable disease information for the United States is kept.

Not all diseases reported require an investigation by disease control personnel. Individual case investigation typically occurs only when intervention may limit the spread of the infection to others.

When a disease investigator interacts with a patient five things are emphasized:

	Ensuring the patient understands the disease he or she has;
	Ensuring that the patient has medical follow-up if necessary;
	Identifying possible contacts (and imposing work restrictions if the disease is one of the few that require them);
	Attempting to determine where or how the person may have contracted the disease by asking a series of detailed questions;
	Giving the person information on how to avoid contracting the same or similar diseases in the future.

Sometimes it is not always possible to say exactly where an individual picked up the disease. However, the information is important in looking for trends or possible common sources. Only by learning what diseases are present and why they are occurring can anything be done to control them.

Reporting a Communicable Disease

Ohio law requires that laboratories report any positive laboratory test for any of the reportable diseases. Physicians or anyone having knowledge of a reportable disease are also required by law to report it. There are different time limits for reporting for different diseases (see Ohio’s Reportable Disease List). Disease reports can be made by telephone, mail, or fax (except HIV or AIDS reports that should only be mailed). The form on which to fax or mail communicable disease reports can be downloaded here (Disease Report Form)

The diseases are to be reported to the health department in whose jurisdiction the patient with the infection lives. This can sometimes be confusing in counties with more than one health department. In Summit County the Summit County Centralized Communicable Disease Registry solves the dilemma of where to report a disease by establishing a single telephone number to use for reporting, no matter where in the county the infected person lives.

In addition to reporting the communicable diseases required by law, health care providers and the public are encouraged to report to the health department any strange or unusual occurrence of disease. A heightened level of vigilance and reporting helps to minimize the likelihood that important risks to health will be overlooked.

Summit County Centralized Communicable Disease Registry

Begun in November of 1998, the Summit County Centralized Communicable Disease Registry (CCDR) is a joint project of the Akron Health Department, the Barberton Health District and the Summit County Health District. Instead of health care professionals and laboratories having to decide to which health department a communicable disease report should be sent, now all reports are sent to a single location. This simplifies the reporting process resulting in an increased number of reports, improved surveillance of individual infections and trends, more prompt and thorough identification of actual and potential outbreaks in the county, and more prompt distribution of information about disease occurrence in Summit County.

Reports can be made to the Summit County CCDR by
Telephone:	330-375-2662
FAX:	330-375-2447
Mail:	Summit County CCDR Akron Health Department 177 S. Broadway Akron, OH 44308

The fax and mail reports can be made on the reportable disease report form (Disease Report Form).

The CCDR is for the reporting and surveillance of diseases only. Each health department receives a list of diseases reported in its jurisdiction and is responsible for the investigation of the diseases in its jurisdiction. For communicable disease information or questions, please contact the Akron Health Department Disease Surveillance and Control office (330-375-2145) or the communicable disease offices at the Barberton Health District (330-745-6067) or the Summit County Health Department (330-923-4891).

Ohio’s Reportable Diseases
This list contains the diseases that are required by law to be reported to the health department.

Know your ABCs: a quick guide to Reportable Infectious Diseases in Ohio (15k pdf)

*AIDS, ARC, HIV

AIDS, ARC and positive HIV tests are reportable per section 3701-3-12 of the Ohio Administrative Code. All cases of Acquired Immunodeficiency Syndrome (AIDS), AIDS-related complex (ARC), and all confirmed positive tests for infection with the human deficiency virus (HIV) must be reported to the local health department designated to receive such reports for each individual county.

Reporting will be to the designated health department where the physician's or dentist's office, hospital, or laboratory is physically located. Information regarding AIDS, ARC, and HIV reporting in your county may be obtained by calling any health department in the county.

Note: criteria for confirmed positive HIV tests are defined in Section 3701-3-10 of the Ohio Administrative Code. Copies of this section can be obtained by writing to: HIV/AIDS Surveillance, Infectious Disease Surveillance, Ohio Department of Health, P.O. Box 118, Columbus, OH 43266-0018

Monthly Communicable Disease Report for Summit County

Each month the number of reportable diseases for the three health departments will be posted here. The chart shows the diseases reported for each health department jurisdiction as well as the total for the county. If there are any questions, please contact Dr. Marguerite Erme, Akron, Health Department, 330-375-2145.

Summit County Reported Diseases March 2004
Disease	Akron Health Dept.	Barberton Health District	Summit County Health District	Summit County (total for month)	Summit County (total year to date)
Aids	0	0	0	0	1
Campylobacter	0	1	2	3	8
Chlamydial infections	129	3	17	149	353
Cryptosporidiosis	0	0	1	1	2
E. Coli	0	0	0	0	0
Encephalitis	1	0	0	1	1
Giardiasis	1	0	2	3	8
Gonococcal Infections	54	4	2	60	170
Hepatitis A	0	0	0	0	1
Hepatitis B (acute)	4	0	1	5	11
Hepatitis B (chronic)	3	1	3	7	22
Hepatitis C (acute)	0	0	0	0	0
Hepatitis C (chronic)	21	5	13	39	118
Kawasaki’s disease	0	0	0	0	1
Legionaire’s disease	0	0	0	0	1
Listeriosis	0	0	0	0	0
Lyme disease	0	0	0	0	0
Meningitis, aseptic	0	0	0	0	3
Meningitis, other bacterial	1	0	1	2	6
Meningoccal disease	0	0	0	0	0
Pertussis	0	0	1	1	2
Pneumococcal disease, invasive	6	1	1	8	28
Salmonellosis	3	2	1	6	16
Shigellosis	2	0	0	2	4
Group A strep, invasive	1	0	0	1	4
Syphilis	0	0	0	2	5
TB	0	0	0	2	3
Yersiniosis	0	0	0	0	1

Summit County Influenza Surveillance
(weekly October through April)

The Akron Health Department conducts weekly influenza surveillance for Summit County from October through April each year. This surveillance system gathers data from approximately 25 different sites throughout Summit County. The data include influenza diagnoses at hospital emergency departments, primary care sites, nursing homes, and infirmaries; positive influenza cultures from laboratories; school absentee numbers; business absentee numbers; and calls to ask-a-nurse lines. The purpose of the surveillance is to give the health department, the health care community, and the public a better idea of when influenza is striking (and leaving) our area. Weekly charts describing surveillance results will be placed on this website during the surveillance season.

Summit County Influenza Surveillance, 2003-2004
Week 25 (April 11 – April 17, 2004)
CDC Week 15

This is the final Summit County Influenza Surveillance report for the 2003-2004 season. Surveillance will resume in October 2004

Influenza activity continued to be low for this week. There were 20 clinical diagnoses in all the sentinel sites. There were no positive laboratory reports for the seventh consecutive week. Schools have been on spring break; absentee numbers have been updated. There were no pharmacy prescriptions for influenza for this week. There were seven pneumonia and influenza deaths reported to the Centers for Disease Control and Prevention (CDC) for this week.

As of Sunday, April 25, 2004, 6:30 AM, the CDC had not published a report for week 15.

The avian influenza (H5N1) infections in Southeast Asia stand at a total of 34 human cases with 23 deaths. There has been no documented human-to-human transmission of this influenza virus. Two poultry workers in Canada have been diagnosed with avian influenza A(H7); symptoms were conjunctivitis. There has been no human-to-human transmission of this influenza virus either.

As of April 23, 2004, China reported four additional cases of SARS, the first ones since January 2004. CDC is recommending that U.S. physicians maintain a greater index of suspicion for SARS in patients who 1) require hospitalization for radiographically confirmed pneumonia or acute respiratory distress syndrome (ARDS) AND 2) who have a history of travel to mainland China (or close contact with an ill person with a history of recent travel to mainland China) in the 10 days before onset of symptoms. When such patients are identified, they should be considered at high risk for SARS-CoV infection and the following actions should be taken:

Patients should immediately be placed in appropriate isolation precautions for SARS (i.e., contact and airborne precautions along with eye protection).
Patients should promptly be reported to the state or local health department. Health departments should immediately report any SARS-CoV positive test result to CDC.
Patients should promptly be tested for evidence of SARS-CoV infection as part of the diagnostic evaluation (see Appendix 2, "Guidelines for Collecting Specimens from Potential SARS Patients," in the CDC document, "In the Absence of SARS-CoV Transmission Worldwide: Guidance for Surveillance, Clinical and Laboratory Evaluation, and Reporting" at www.cdc.gov/ncidod/sars/absenceofsars.htm )

2003-2004 Participant Categories

1 residential institutions	4 Summit County emergency departments
2 pharmacy chain (20 stores)	University of Akron infirmary
4 family practice centers	1 high school
4 nursing homes	2 middle schools
6 laboratories	AHD Health Data Management
2 elementary schools	1 business

Number of influenza or influenza-like diagnoses by FP Centers, EDs, University of Akron infirmary, nursing homes, institutions, and business

Total number of absentees (diagnosis not specified) for selected elementary, middle and high schools

Number of positive influenza cultures and antigen tests from area labs

Total number of four influenza antivirals sold in a pharmacy chain

Number of pneumonia/influenza deaths reported to CDC by the Akron Health Department for the city of Akron

Dr. M. Erme, Akron Health Department, 330-375-2145
Office of Disease Control and Surveillance web site = http://www.ci.akron.oh.us/Health/Epidemiology/control.htm 11/12/01

Summit County Hepatitis Support Group

The Communicable Disease Office coordinates the Summit County Hepatitis Support Group. This group began in March 1998 to provide a support system for persons who have chronic hepatitis (hepatitis B, hepatitis C, autoimmune hepatitis, etc.) and their families. There are four educational meetings with speakers and eight member support meetings annually. To be on the mailing list for meeting notices, contact Dr. Marguerite A. Erme, 330-375-2145. The 2003 meeting dates, times and places are listed below.

Summit County Hepatitis Support Group 2004 Meeting Dates, Times and Locations
Member Support Meetings Held 7:00-9:00 PM at the Professional Center South Office Building, 55 S. Arch Street, Akron, OH 44309 (across from City Hospital); Meetings are in the Basement, (turn left when you get off the elevator); the specific room (Pod) is listed next to each date. Meetings are held in January, February, April, May, July, August, October, and November	Educational Meetings Held 7:30-8:30 PM at the Professional Center South Office Building, 55 S. Arch Street, Akron, OH 44309 (across from City Hospital); Meetings are in the Basement Auditorium (turn right when you get off the elevator) Meetings are held in March, June, September, and December; speakers to be announced.
Wednesday, January 21, 2004 Pod C	Wednesday, March 17, 2004
Wednesday, February 18, 2004 Pod F	Wednesday, June 16, 2004
Wednesday, April 21, 2004 Pod C	Wednesday, September 15, 2004
Wednesday, May 19, 2004 Pod F	Wednesday, December 15, 2004
Wednesday, July 21, 2004 Pod F
Wednesday, August 18, 2004 Pod F
Wednesday, October 20, 2004 Pod F
Wednesday, November 17, 2004 Pod F
Many thanks to Summa Health System for providing the rooms.

The Summit County Hepatitis Support Group is entering its seventh year. The member support meetings are not moderated (if anyone would like to do it, please let me know). I set up that time and location so that people would have a scheduled place and time to meet and talk and share in an informal setting. I do set up the educational meetings. If anyone has a particular topic they would like addressed, know a speaker they would like to hear, or would like to speak at an educational setting, please let me know. For more information, contact Dr. M. Erme, Akron Health Department.

Thank you.

Marguerite A. Erme, DO, MPH
Akron Health Department
330-375-2145
ErmeMa@ci.akron.oh.us

Disease Alerts and Food Recalls

Periodically the health department receives information about food recalls or disease alerts that may affect people in Ohio and/or Summit County. Food recalls and alerts will be posted on this page for four weeks after they are received. The Office of Disease Surveillance and Control keeps a record of all recalls and will provide information about older recalls removed from this web page to interested persons.

FOOD RECALL April 19, 2004 Zander's Creamery, Inc., of Cross Plains, WI, is recalling butter and butterine (60% butter and 40% margarine) products because they have the potential to be contaminated with the bacteria Listeria monocytogenes which can cause serious and sometimes fatal infections in young children, frail or elderly people and others with weakened immune systems. The only known butter and butterine sold in retail stores is at GFS Marketplace Stores located in Illinois, Indiana, Ohio, and Michigan under the GFS label, in 1 pound prints, butter cups, continentals, patties and 5 pound whipped tubs. The other butter and butterine products were distributed nationwide to restaurants and food manufacturers primarily under the Zander's and GFS labels. The recalled butter and butterine products have codes beginning with 043 to 100 as the first three digits. No illnesses have been confirmed in connection with these products to date. The recall was the result of routine sampling by the Wisconsin Department of Agriculture, Trade and Consumer Protection, the Food and Drug Administration and the company. Consumers who have purchased affected butter products are urged to return them to the place of purchase. Consumers with questions may contact the company at 1-608-798-3261.

Notices

Fact Sheet - "Mad Cow Disease"
SARS (Severe Acute Respiratory Syndrome)
Facts About Monkeypox
West Nile Virus (12k pdf)
RECALL Major Pharmaceuticals said today that it is conducting a voluntary Class I recall of certain lots of Twice-A-Day Nasal Spray 15 ml and 30 ml bottles. The product is a nasal decongestant containing the active ingredient oxymetazoline hydrochloride 0.05%. The product is contaminated with a type of bacteria called Burkholderia cepacia. Some of the recalled lots have been found to be contaminated and could cause serious or potentially life-threatening infections in patients with compromised immune systems, particularly individuals with cystic fibrosis.

The product being recalled is an over-the-counter drug product labeled "Major Soothing Twice-A-Day 12 Hour Nasal Spray Decongestant Regular Oxymetazoline Hydrochloride 0.05%. Distributed by Major Pharmaceuticals, Livonia, MI". The lot number can be found on the bottom of the carton and on the back of the bottle label. The lot numbers being recalled are E4410, F4433, H4464, K4496, L4529, L4535, M4536, A4558, A4588, and B4597.

Consumers should return the product immediately to the stores where it was purchased. Wholesalers and retailers who purchased the product from Major directly should return it to the appropriate distribution center. Anyone needing more information from Major may call customer service at 734-743-6181.

Related Sites

Barberton City Health District ( www.barbertonhealth.org )
Ohio Department of Health ( www.odh.state.oh.us )
SafetyAlerts.com ( http://www.safetyalerts.com )
Centers for Disease Control and Prevention ( www.cdc.gov)
Summit County Health District ( www.schd.org )