Communicable Diseases

Transcription

1 Communicable Diseases Tarrant County 29 Pertussis Foodborne Illnesses Aseptic Meningitis Chickenpox 29 H1N1 Influenza Sexually Transmitted Diseases Tarrant County Public Health Safeguarding our community s health

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3 Communicable Diseases Tarrant County, 29 Tarrant County Public Health Lou K. Brewer, RN, MPH Health Director Division of Epidemiology and Health Information Tarrant County Public Health 111 S. Main Street Fort Worth, Texas 7614 Communicable Disease Reporting : (817) /7 Disease Reporting: (817)

4 Authors Diana Cervantes, MS, MPH Epidemiologist Tarrant County Public Health Anita K. Kurian, MBBS, DrPH Division Manager & Chief Epidemiologist Tarrant County Public Health Acknowledgements Special thanks to Michelle Markham from Tarrant County Public Health and all of those who assisted with this project. Suggested Citation Communicable Diseases, Tarrant County, 29. Tarrant County Public Health, 21.

5 Table of Contents Reportable Diseases in Tarrant County... 1 Background Information for Statistical Summaries... 1 Tarrant County Population Distributions by Gender, Race/Ethnicity, and Age Group... 3 Ten Leading Communicable Diseases in Tarrant County... 4 Selected Communicable Diseases by City... 8 Selected Communicable Diseases by ZIP Code Chlamydia Chronic Hepatitis C... 2 Gonorrhea Chronic Hepatitis B Salmonellosis Varicella Early Syphilis HIV Aseptic Meningitis Pertussis H1N1 Influenza: Pandemic of the 21 st Century References Tarrant County Communicable Disease Report, 29 i

6 List of Tables Table 1: Notifiable Conditions, Table 2: Population Estimates by Gender, Tarrant County, Table 3: Population Estimates by Race/Ethnicity, Tarrant County, Table 4: Population Estimates by Age Group (in Years), Tarrant County, Table 5: Ten Leading Communicable Diseases by Gender, Tarrant County, Table 6: Ten Leading Communicable Diseases by Race/Ethnicity, Tarrant County, Table 7a: Ten Leading Communicable Diseases by Age Group (in Years), Tarrant County, Table 7b: Ten Leading Communicable Diseases by Age Group (in Years), Tarrant County, Table 8a: Selected Communicable Diseases by City, Tarrant County, Table 8b: Selected Communicable Diseases by City, Tarrant County, Table 8c: Selected Communicable Diseases by City, Tarrant County, Table 9a: Selected Communicable Diseases by ZIP Code, Tarrant County, Table 9b: Selected Communicable Diseases by ZIP Code, Tarrant County, Table 9c: Selected Communicable Diseases by ZIP Code, Tarrant County, Table 9d: Selected Communicable Diseases by ZIP Code, Tarrant County, Table 9e: Selected Communicable Diseases by ZIP Code, Tarrant County, Table 9f: Selected Communicable Diseases by ZIP Code, Tarrant County, Tarrant County Communicable Disease Report, 29 ii

7 List of Figures Figure 1: Chlamydia by Gender, Tarrant County, Figure 2: Chlamydia by Race/Ethnicity, Tarrant County, Figure 3: Chlamydia by Age Group (in Years), Tarrant County, Figure 4: Geographic Distribution of Chlamydia by ZIP Code, Tarrant County, Figure 5: Chronic Hepatitis C by Gender, Tarrant County, Figure 6: Chronic Hepatitis C by Age Group (in Years), Tarrant County, Figure 7: Geographic Distribution of Chronic Hepatitis C by ZIP Code, Tarrant County, Figure 8: Gonorrhea by Gender, Tarrant County, Figure 9: Gonorrhea by Race/Ethnicity, Tarrant County, Figure 1: Gonorrhea by Age Group (in Years), Tarrant County, Figure 11: Geographic Distribution of Gonorrhea by ZIP Code, Tarrant County, Figure 12: Chronic Hepatitis B by Gender, Tarrant County, Figure 13: Chronic Hepatitis B by Age Group (in Years), Tarrant County, Figure 14: Geographic Distribution of Chronic Hepatitis B by ZIP Code, Tarrant County, Figure 15: Salmonellosis by Gender, Tarrant County, Figure 16: Salmonellosis by Race/Ethnicity, Tarrant County, Figure 17: Salmonellosis by Age Group (in Years), Tarrant County, Figure 18: Geographic Distribution of Salmonellosis by ZIP Code, Tarrant County, Figure 19: Varicella by Gender, Tarrant County, Figure 2: Varicella by Race/Ethnicity, Tarrant County, Figure 21: Varicella by Age Group (in Years), Tarrant County, Figure 22: Geographic Distribution of Varicella by ZIP Code, Tarrant County, Tarrant County Communicable Disease Report, 29 iii

8 Figure 23: Early Syphilis by Gender, Tarrant County, Figure 24: Early Syphilis by Race/Ethnicity, Tarrant County, Figure 25: Early Syphilis by Age Group (in Years), Tarrant County, Figure 26: Geographic Distribution of Early Syphilis by ZIP Code, Tarrant County, Figure 27: HIV by Gender, Tarrant County, Figure 28: HIV by Race/Ethnicity, Tarrant County, Figure 29: HIV by Age Group (in Years), Tarrant County, Figure 3: Geographic Distribution of HIV by ZIP Code, Tarrant County, Figure 31: Aseptic Meningitis by Gender, Tarrant County, Figure 32: Aseptic Meningitis by Race/Ethnicity, Tarrant County, Figure 33: Aseptic Meningitis by Age Group (in Years), Tarrant County, Figure 34: Geographic Distribution of Aseptic Meningitis by ZIP Code, Tarrant County, Figure 35: Pertussis by Gender, Tarrant County, Figure 36: Pertussis by Race/Ethnicity, Tarrant County, Figure 37: Pertussis by Age Group (in Years), Tarrant County, Figure 38: Geographic Distribution of Pertussis by ZIP Code, Tarrant County, Figure 39: 29 H1N1 Influenza Hospitalizations by Gender, Tarrant County, Figure 4: 29 H1N1 Influenza Hospitalizations by Age Group (in Years), Tarrant County, Tarrant County Communicable Disease Report, 29 iv

9 Reportable Diseases in Tarrant County Several Texas laws (Health & Safety Code, chapter 81, 84, and 87) require specific information regarding notifiable conditions to be provided to the local health department. Tarrant County Public Health is the designated health department for reporting notifiable conditions in the county. Health care providers, hospitals, laboratories, schools, and others are required to report patients who are suspected of having a notifiable condition (chapter 97, Title 25, Texas Administrative Code). All notifiable conditions in Tarrant County as well as Texas for 29 are listed in Table 1. In addition to these, any outbreak, exotic diseases, and unusual group expressions of disease must be reported. All diseases must be reported by name, age, gender, race/ethnicity, date of birth, address, telephone number, disease, date of onset, method of diagnosis, and name, address, and telephone number of physician. Background Information for Statistical Summaries The frequency and incidence rate of communicable diseases are presented overall, by gender, by race/ethnicity, by age group, by city, and by ZIP code. Incidence rates are calculated as follows: Numerator 29 incidence of disease in Tarrant County Denominator 29 Tarrant County population at risk (2 population for rates by ZIP code) per 1, population Incidence rate is an essential and valuable public health measure; however, the interpretation of the rate should be made with caution. s based on numbers less than 2 are not recommended for reliable comparison because such rates can fluctuate widely each year. The tables in this report include rates for diseases with five or more cases. Conditions with less than five cases are not presented to protect confidentiality. The 29 Tarrant County population estimates used to calculate incidence rates overall, by gender, by race/ethnicity, and by age group are listed in Table 2 Table 4. Population estimates were obtained from the Texas Department of State Health Services. The 29 population estimates by city were obtained from the North Central Texas Council of Governments. Population estimates by ZIP code were obtained from the US Census Bureau, 2 Census. Tarrant County Communicable Disease Report, 29 1

10 Conditions Immediately Reportable Notifiable Conditions in Tarrant County Table 1. Notifiable Conditions, 29 Conditions Reportable Within One Week Anthrax Acquired Immune Deficiency Botulism, foodborne Syndrome (AIDS) 25 Diphtheria Amebiasis < 5 Haemophilus influenzae Arbovirus infection < 5 type b infections, invasive Botulism, infant, wound, and other Measles (rubeola) Campylobacteriosis 97 Meningococcal infections, invasive 6 Chancroid Plague Chickenpox (varicella) 298 Poliomyelitis, acute paralytic Chlamydia trachomatis infection 7,795 Rabies, human Creutzfeldt-Jakob disease < 5 Severe Acute Respiratory Cryptosporidiosis 55 Syndrome (SARS) Cyclosporiasis < 5 Smallpox Cysticercosis Staphylococcus aureus, Dengue Vancomycin-resistant (VISA & VRSA) Ehrlichiosis Tularemia Encephalitis Viral hemorrhagic fever Escherichia coli, enterohemorrhagic 2 Yellow fever Gonorrhea 2,435 Hansen's disease (leprosy) Conditions Reportable Within One Working Day Hantavirus infection Hemolytic Uremic Syndrome (HUS) < 5 Brucellosis < 5 Hepatitis B, C, D, E and unspecified (acute) 6 Hepatitis A (acute) Influenza-associated pediatric mortality* 21 < 5 Hepatitis B, acute or chronic Human Immunodeficiency Virus Hepatitis B, perinatal 29 H1N1 Influenza, Hospitalizations 173 identified prenatally or at delivery (HIV) infection H1N1 Influenza, Intensive Care Unit 33 Legionellosis H1N1 Influenza, non-pediatric mortality 9 Leishmaniasis Pertussis 22 Listeriosis < 5 Q fever Lyme disease 6 Rubella (including congenital) Malaria 5 Tuberculosis Meningitis (Aseptic and non-neisseria Bacterial) (including all M. tuberculosis complex) Mumps < 5 Vibrio infection, including cholera < 5 Relapsing fever Salmonellosis, including typhoid fever 36 Shigellosis 6 Spotted fever group rickettsioses Streptococcal disease 243 (group A, B, S. pneumo), invasive Syphilis (early stages) 28 Taenia solium and undifferentiated Taenia infection Tetanus Trichinosis Typhus West Nile Fever < 5 Yersiniosis < 5 Note: This table represents communicable conditions that were reportable in 29. Additions/changes made for 21 are not presented in Table 1. Conditions with less than five cases not presented to protect confidentiality. * All influenza-associated pediatric mortalites were attributed to the 29 H1N1 subtype Tarrant County Communicable Disease Report, 29 2

11 Tarrant County Population Distributions by Gender, Race/Ethnicity, and Age Group Table 2. Population Estimates by Gender, Tarrant County, 29 Total Percent Male 895, Female 885, Total 1,78, Data source: Texas Department of State Health Services Table 3. Population Estimates by Race/Ethnicity, Tarrant County, 29 Total Percent White 899, Black 239, Hispanic 52, Other 121, Total 1,78, Data source: Texas Department of State Health Services Table 4. Population Estimates by Age Group (in Years), Tarrant County, 29 Total Percent -4 Yrs 142, Yrs 13, Yrs 123, Yrs 129, Yrs 126, Yrs 29, Yrs 281, Yrs 245, Yrs 168, Yrs 141, Total 1,78, Data source: Texas Department of State Health Services Tarrant County Communicable Disease Report, 29 3

12 Ten Leading Communicable Diseases in Tarrant County Table 5. Ten Leading Communicable Diseases by Gender, Tarrant County, 29 Overall Male Female n () n () n () Chlamydia 7,795 (437.7) Hep. C, chronic 2,738 (153.7) Gonorrhea 2,435 (136.7) Hep. B, chronic 719 (4. 4) Salmonellosis 34 (17. 1) Varicella 298 (16. 7) Early Syphilis Chlamydia 1,847 (26.3) Hep. C, chronic 1,64 (179.2) Gonorrhea 1,115 (124.6) Hep B, chronic 365 (4.8) HIV 183 (2.4) Early Syphilis 179 (2.) Varicella Chlamydia 5,948 (671.5) Gonorrhea 1,319 (148.9) Hep. C, chronic 1,127 (127.2) Hep. B, chronic 354 (4.) Salmonellosis 163 (18.4) Varicella 154 (17.4) Aseptic Meningitis 28 (15. 7) 144 (16.1) 14 (11.7) HIV Salmonellosis Early Syphilis 233 (13. 1) 141 (15.8) 11 (11.4) Aseptic Meningitis Aseptic Meningitis Pertussis 228 (12. 8) 124 (13.9) 1 (11.3) Pertussis Pertussis Strep. pneumoniae 22 (11. 3) 12 (11.4) 79 (8.9) n = number of cases; per 1, population HIV/AIDS data are preliminary. The number of cases may change. 29 population estimates obtained from Texas Department of State Health Services Tarrant County Communicable Disease Report, 29 4

13 Table 6. Ten Leading Communicable Diseases by Race/Ethnicity, Tarrant County, 29 White n () Black Hispanic Other n () n () n () 1 Chlamydia Chlamydia Chlamydia Hep. B, chronic 1,965 (218.5) 3,349 (1,399.3) 2,272 (436.3) 191 (157.2) Hep. C, chronic 746 (82.9) Gonorrhea 378 (42.) Salmonellosis 135 (15.) Varicella 13 (14.5) Aseptic Meningitis 129 (14.3) Pertussis/ Strep. pneumoniae 84 (9.3) Gonorrhea Gonorrhea Chlamydia 1,711 (714.9) 311 (59.7) 145 (119.4) Hep. C, chronic Hep. C, chronic Hep. C, chronic 35 (127.4) 2 (38.4) 38 (31.3) Early Syphilis Varicella Tuberculosis 17 (71.) 88 (16.9) 3 (24.7) HIV Pertussis Gonorrhea 126 (52.6) 82 (15.7) 19 (15.6) Hep. B, chronic Salmonellosis Varicella 95 (39.7) 59 (11.3) 1 (8.2) Strep. pneumoniae Early Syphilis Aseptic Meningitis 44 (18.4) 52 (1.) 9 (7.4) TB Aseptic Meningitis HIV 33 (13.8) 46 (8.8) 7 (5.8) 9 Hep. B, chronic 59 (6.6) Aseptic Meningitis/ Varicella HIV Salmonellosis 39 (7.5) 5 (4.1) 1 HIV 58 (6.4) 31 (13.) Hep. B, chronic 3 (5.8) AIDS/ Campylobacteriosis/ Group B Strep./ Hep. < 5* n = number of cases; per 1, population s based on less than 2 cases are considered unstable and should be interpreted with caution. * Less than five cases not reported; numerator too small for rate calculation Rankings for race/ethnicity should be interpreted with caution due to missing data. Race/ethnicity data are missing for 53% of chronic Hepatitis C cases, 48% of chronic Hepatitis B cases, and 27% of salmonellosis cases. HIV/AIDS data are preliminary. The number of cases may change. 29 population estimates obtained from Texas Department of State Health Services Tarrant County Communicable Disease Report, 29 5

14 Table 7a. Ten Leading Communicable Diseases by Age Group (in Years), Tarrant County, 29-4 Yrs 5-9 Yrs n () n () 1-14 Yrs Yrs 2-24 Yrs n () n () n () Salmonellosis Varicella 18 (75.8) 136 (13.9) Pertussis Salmonellosis 97 (68.) 45 (34.4) Varicella Pertussis 65 (45.6) 4 (3.6) Chlamydia Chlamydia Chlamydia 119 (96.6) 2,826 (2,188.8) 2,776 (2,188.4) Varicella Gonorrhea Gonorrhea 83 (67.4) 837 (648.3) 819 (645.6) Pertussis Early Syphilis Hep. C, chronic 4 (32.5) 3 (23.2) 72 (56.8) 4 Aseptic Meningitis Aseptic Meningitis Gonorrhea Hep. C, chronic Early Syphilis 51 (35.8) 22 (16.8) 36 (29.2) 21 (16.3) 71 (56.) 5 Shigellosis Shigellosis 22 (15.4) 16 (12.2) Salmonellosis Aseptic Meningitis/ HIV 17 (13.8) Hep. B, chronic 49 (38.6) 6 7 Campylobacteriosis Campylobacteriosis Aseptic Meningitis Hep. B, chronic 17 (13.2) 21 (14.7) 11 (8.4) 15 (12.2) 43 (33.9) Strep. pneumoniae Strep. pneumoniae Campylobacteriosis HIV Aseptic Meningitis 2 (14.) 8 (6.1) 9 (7.3) 14 (1.8) 19 (15.) 8 9 Hep. C, chronic 9 (6.3) EHEC (E. coli)/ Group B Strep Cryptosporidiosis/ Hep. B, chronic/ Hep. C, chronic Hep. B, chronic Salmonellosis Salmonellosis 6 (4.9) 9 (7.) 1 (7.9) EHEC (E. coli)/ Hep. C, chronic Pertussis 7 (5.4) Campylobacteriosis/ Tuberculosis 1 6 (4.2) < 5* < 5* Varicella 5 (3.9) 6 (4.7) n = number of cases; per 1, population * Less than five cases not reported; numerator too small for rate calculation s based on less than 2 cases are considered unstable and should be interpreted with caution. HIV/AIDS data are preliminary. The number of cases may change. 29 population estimates obtained from Texas Department of State Health Services Tarrant County Communicable Disease Report, 29 6

15 Table 7b. Ten Leading Communicable Diseases by Age Group (in Years), Tarrant County, Yrs Yrs n () n () Yrs Yrs 65 + Yrs n () n () n () Chlamydia Hep. C, chronic 1,615 (556.5) 487 (172.8) Gonorrhea Chlamydia 539 (185.7) 346 (122.8) Hep. C, chronic Hep. B, chronic 254 (87.5) 178 (63.2) Hep. B, chronic Gonorrhea 14 (48.2) 144 (51.1) Hep. C, chronic Hep. C, chronic Hep. C, chronic 1,1 (448.5) 61 (355.6) 185 (13.4) Hep. B, chronic Hep. B, chronic Hep. B,chronic 147 (59.9) 127 (75.1) 58 (4.9) Chlamydia Strep. Pneumoniae Salmonellosis 86 (35.1) 36 (21.3) 34 (24.) Gonorrhea Chlamydia Strep. pneumoniae 44 (17.9) 22 (13.) 33 (23.3) 5 Early Syphilis HIV 8 (27.6) 59 (2.9) Early Syphilis Salmonellosis 35 (14.3) 2 (11.8) Group B strep./ Tuberculosis 6 HIV Early Syphilis 68 (23.4) 46 (16.3) HIV/ Strep. Pneumoniae Tuberculosis 16 (9.5) 19 (13.4) 7 Aseptic Meningitis Aseptic Meningitis 38 (13.1) 27 (9.6) 33 (13.5) Early Syphilis 15 (8.9) Cryptosporidiosis/ Group A Strep. 8 Salmonellosis Tuberculosis 21 (7.2) 2 (7.1) Salmonellosis Aseptic Meningitis 27 (11.) 14 (8.3) 12 (8.5) 9 Tuberculosis Strep. pneumoniae Tuberculosis Campylobacteriosis/ Aseptic Meningitis 16 (5.5) 15 (5.3) 24 (9.8) Gonorrhea 9 (6.3) 1 Crypto/ Strep. Pneumo Salmonellosis 12 (4.1) 13 (4.6) Hep. B, acute 13 (7.7) Hep. B, acute 19 (7.7) 7 (4.9) n = number of cases; per 1, population s based on less than 2 cases are considered unstable and should be interpreted with caution. HIV/AIDS data are preliminary. The number of cases may change. 29 population estimates obtained from Texas Department of State Health Service Tarrant County Communicable Disease Report, 29 7

16 Selected Communicable Diseases by City Table 8a. Selected Communicable Diseases by City, Tarrant County, 29 Aseptic Meningitis Chlamydia Gonorrhea 29 H1N1 Hospitalizations Population Arlington 37, , Azle 1,95 < < < Bedford 49, Benbrook 23,9 < < Blue Mound 2,4 < < < Burleson 7, Colleyville 22, < Crowley 12,2 < < Euless 54, Everman 5, Forest Hill 11, < Fort Worth 72, , , Grand Prairie 168, < Grapevine 47, < Haltom City 39, < Haslet 1, ,724.1 < Hurst 38,75 < < Keller 39, Kennedale 6,45 < < < Lake Worth 4,85 < < Lakeside 1,3 < < Mansfield 55, North Richland Hills 66, < Pantego 2,75. < Richland Hills 8,35 < River Oaks 7, < < Saginaw 19, < < Sansom Park 4, Southlake 26,65 < < < Watauga 24, < Westworth Village 3,1. < < White Settlement 16, per 1, population Less than five cases not reported to protect = rate not calculated for less than five cases s based on less than 2 cases are considered unstable and should be interpreted with caution. HIV/AIDS data are preliminary. The number of cases may change. 29 city population estimates were obtained from the North Central Texas Council of Governments Tarrant County Communicable Disease Report, 29 8

17 Table 8b. Selected Communicable Diseases by City, Tarrant County, 29 Hep. B, chronic Hep. C, chronic HIV Pertussis Population Arlington 37, Azle 1,95 < < Bedford 49, < Benbrook 23, < Blue Mound 2,4 < < Burleson 7, < Colleyville 22, < < Crowley 12, < < Euless 54, Everman 5,8 < < Forest Hill 11,95 < < Fort Worth 72, , Grand Prairie 168, Grapevine 47, < < Haltom City 39, < Haslet 1,45 < < Hurst 38, < < Keller 39, < Kennedale 6,45 < < Lake Worth 4,85 < Lakeside 1,3.... Mansfield 55, < < North Richland Hills 66, < Pantego 2,75. < < Richland Hills 8,35 < < < River Oaks 7,35. < < Saginaw 19, Sansom Park 4, Southlake 26, Watauga 24, < Westworth Village 3,1. < White Settlement 16,15. < per 1, population Less than five cases not reported to protect = rate not calculated for less than five cases s based on less than 2 cases are considered unstable and should be interpreted with caution. HIV/AIDS data are preliminary. The number of cases may change. 29 city population estimates were obtained from the North Central Texas Council of Governments Tarrant County Communicable Disease Report, 29 9

18 Table 8c. Selected Communicable Diseases by City, Tarrant County, 29 Salmonellosis Early Syphilis Tuberculosis Varicella Population Arlington 37, Azle 1, Bedford 49, < Benbrook 23,9 < < < Blue Mound 2,4. < < < Burleson 7,713 < < Colleyville 22,55 < < Crowley 12,2 < < Euless 54, < Everman 5,8.... Forest Hill 11,95 < < < Fort Worth 72, Grand Prairie 168,5 < Grapevine 47, < < Haltom City 39, < < Haslet 1,45 < Hurst 38, < Keller 39, < < Kennedale 6,45 < Lake Worth 4,85... < Lakeside 1,3.... Mansfield 55, < < < North Richland Hills 66, < < Pantego 2, Richland Hills 8,35 < < River Oaks 7,35 < Saginaw 19,35 < < < < Sansom Park 4, Southlake 26, < Watauga 24,35 < < Westworth Village 3,1... < White Settlement 16, per 1, population Less than five cases not reported to protect = rate not calculated for less than five cases s based on less than 2 cases are considered unstable and should be interpreted with caution. 29 city population estimates were obtained from the North Central Texas Council of Governments Tarrant County Communicable Disease Report, 29 1

19 Selected Communicable Diseases by ZIP Code Table 9a. Selected Communicable Diseases by ZIP Code, Tarrant County, 29 Aseptic Meningitis Chlamydia Gonorrhea 29 H1N1 Hosptialization ZIP Code Population ,86 < , < ,252 < < 7553 NA < NA - < 5 - < , , , , , , , ,566 < ,355 < 16 1, < 763 NA < NA - < 5 - < NA - < ,678 < NA < , , ,898 < < , < ,134 < < , ,63 < < , < , < , < 7619 NA < ,33 < < < ,643 < < ,38 < < , , , < ,731 < < ,66 < < , < , , , < , < ,253 < < , ,141 < < < , , , , , ,68 < < < 7694 NA NA - < NA - < NA NA per 1, population Less than five cases not reported to protect = rate not calculated for less than five cases s based on less than 2 cases are considered unstable and should be interpreted with caution. HIV/AIDS data are preliminary. The number of cases may change. ZIP code population estimates from 2 Census NA = ZIP code population not available Tarrant County Communicable Disease Report, 29 11

20 Table 9b. Selected Communicable Diseases by ZIP Code, Tarrant County, 29 Aseptic Meningitis Chlamydia Gonorrhea 29 H1N1 Hosptialization ZIP Code Population ,432 < 9 1, ,32 < < , , ,47 < 276 1, , ,665 < < , < ,7 < ,742 < < ,53 < < ,436 < NA < 5 - < ,438 < < ,9 < , < , < ,62 < < ,484 < 432 1, ,928 < 11 1, < NA - < NA - < 5 - < ,636 < 16 1, < NA ,454 < < < < NA < NA - < , , ,542 < ,73 < < ,575 < < , < NA , < ,632 < 2 1, < NA , < 7615 NA - < , < NA - < NA - < < NA - - < NA < < , , , < NA < < NA NA NA < < 5 - < ,53... < ,924 < ,475 < < per 1, population Less than five cases not reported to protect = rate not calculated for less than five cases s based on less than 2 cases are considered unstable and should be interpreted with caution. HIV/AIDS data are preliminary. The number of cases may change. ZIP code population estimates from 2 Census NA = ZIP code population not available Tarrant County Communicable Disease Report, 29 12

21 Table 9c. Selected Communicable Diseases by ZIP Code, Tarrant County, 29 Hep. B, chronic Hep. C, chronic HIV Pertussis ZIP Code Population ,86 < < < < ,299 < , < < 7553 NA < NA < 5 - < ,184 < , , , , , , , < < 762 7, < < 763 NA - < NA - < < NA - < , NA - < ,26. < , , < , < , < , , , < , < , < < 7619 NA ,33 < < , < , < < , < , , < < , < < , < , < ,318. < 765 5, , < < ,912 < < , < < ,686 < < 766 5,141 < < , < < ,966. < , , , , NA NA NA - < NA - < NA - < per 1, population Less than five cases not reported to protect = rate not calculated for less than five cases s based on less than 2 cases are considered unstable and should be interpreted with caution. HIV/AIDS data are preliminary. The number of cases may change. ZIP code population estimates from 2 Census NA = ZIP code population not available Tarrant County Communicable Disease Report, 29 13

22 Table 9d. Selected Communicable Diseases by ZIP Code, Tarrant County, 29 Hep. B, chronic Hep. C, chronic HIV Pertussis ZIP Code Population , ,739.6 < , < , < , ,7 < < < , < , < , < ,742 < < ,53 < < < , < NA - < 5 - < , < , < < , , < , < , , < < NA NA , < NA - < ,454 < < < < < NA NA , < , < , < , ,989 < < < NA - < , < < , < < NA - < , < < 7615 NA , < < NA - < NA NA - < NA < < , < , < NA < < NA NA NA 6 - < < , , , < < , per 1, population Less than five cases not reported to protect = rate not calculated for less than five cases s based on less than 2 cases are considered unstable and should be interpreted with caution. HIV/AIDS data are preliminary. The number of cases may change. ZIP code population estimates from 2 Census NA = ZIP code population not available Tarrant County Communicable Disease Report, 29 14

23 Table 9e. Selected Communicable Diseases by ZIP Code, Tarrant County, 29 Salmonellosis Early Syphilis TB Varicella ZIP Code Population ,86. < < < ,299.. < ,252 < < < < 7553 NA NA - < , , , , , , , , < < 762 7,355 < < < NA NA NA < ,678 < < 767 NA , , ,898 < < ,488 < < < < , < < ,127 < < < ,63 < < , < < ,6 < < < ,918 < < < < 7619 NA , ,643. < < < ,38 < < ,776 < < < , ,643 < < ,731 < < ,66 < < < < , < , , , < < ,912 < ,253 < < , < < 766 5,141 < , < < , , , , , < 7694 NA NA < NA NA NA per 1, population Less than five cases not reported to protect = rate not calculated for less than five cases s based on less than 2 cases are considered unstable and should be interpreted with caution. ZIP code population estimates from 2 Census NA = ZIP code population not available Tarrant County Communicable Disease Report, 29 15

24 Table 9f. Selected Communicable Diseases by ZIP Code, Tarrant County, 29 Salmonellosis Early Syphilis TB Varicella ZIP Code Population , < ,32 < < < ,511 < < < ,47 < < , < , < < < , < , < < , < < < ,53 < , < NA < , < < ,9 < < < , < < , < < < ,62 < < < ,484 < ,928 < < NA NA - < ,636 < < < NA ,454 < < < < NA NA , < < , < < ,73 < ,575 < < , < NA , < < ,632 < < NA ,7 < < < 7615 NA - < , NA NA NA NA < 5 - < < , < < , < < NA < NA NA NA < < 5 - < , , < < ,475 < per 1, population Less than five cases not reported to protect = rate not calculated for less than five cases s based on less than 2 cases are considered unstable and should be interpreted with caution. ZIP code population estimates from 2 Census NA = ZIP code population not available Tarrant County Communicable Disease Report, 29 16

25 1. Chlamydia Chlamydia is a bacterial infection caused by Chlamydia trachomatis. Chlamydia is not only the most reported sexually transmitted disease (STD) in Tarrant County, but also the most commonly reported STD in the United States with 1,21,523 cases (a rate of 41.3 cases per 1, population) reported nationally in 28. Chlamydia infections are usually asymptomatic and can cause serious conditions in women such as pelvic inflammatory disease (PID), ectopic pregnancy, and chronic pelvic pain. Chlamydia can also be passed by pregnant women during delivery, potentially causing neonatal ophthalmia and pneumonia. 1 A total of 7,795 cases (a rate of cases per 1, population) of Chlamydia were reported in Tarrant County in 29. The incidence among females in 29 (5,948 cases, per 1, population) was more than three times that among males (1,847 cases, 26.3 per 1, population) (Figure 1). Figure 1. Chlamydia by Gender, Tarrant County, 29 7, 7 6, 6 5, 5 4, 3, 4 3 2, 2 1, 1 Male Female per 1, population Among racial/ethnic groups, the highest incidence rate of Chlamydia was observed among Blacks (3,349 cases, 1,399.3 per 1, population). The rate among Blacks was more than three times that of Hispanics (2,272 cases, per 1, population), more than six times that of Whites (1,965 cases, per 1, population), and almost twelve times that of Others (145 cases, per 1, population) (Figure 2). Tarrant County Communicable Disease Report, 29 17

26 Figure 2. Chlamydia by Race/Ethnicity, Tarrant County, 29 4, 1,6 3, 1,2 2, 8 1, 4 White Black Hispanic Other per 1, population The highest incidence rates of Chlamydia were observed in the year age group (2,826 cases, 2,188.8 per 1, population) and 2-24 year age group (2,776 cases, 2,188.4 per 1, population). New cases of Chlamydia observed in other age groups are ranked as follows: year age group (1,615 cases, per 1, population), year age group (346 cases, per 1, population), 1-14 year age group (119 cases, 96.6 per 1, population), year age group (86 cases, 35.1 per 1, population), and year age group (22 cases, 13. per 1, population). There were less than five cases in age group -4 years as well as those 5-9 years of age; no cases were reported in the 65+ age group (Figure 3). Figure 3. Chlamydia by Age Group (in Years), Tarrant County, 29 3, 2,5 2, 1,5 1, ,4 2, 1,6 1,2 8 4 per 1, population The numerator was too small for rate calculation for the 65+ year age group. Data Source: Tarrant County Public Health Since infection with Chlamydia is usually asymptomatic, screening is important. Data has shown that Chlamydia screenings can reduce the incidence of PID (a principal cause of infertility) by as much as 6 percent. The Centers for Disease Control and Prevention (CDC) recommends annual Chlamydia screening among sexually active women younger than 26 years of age. 1 Tarrant County Communicable Disease Report, 29 18

27 7551 Figure 4. Geographic Distribution of Chlamydia by ZIP Code, Tarrant County, These data were prepared by Tarrant County Public Health for its use, and may be revised any time, without notification. Tarrant County Public Health does not guarantee the correctness or accuracy of any features on this map. Tarrant County assumes no responsibility in connection therewith. Said data should not be edited by anyone other than designated personnel, or through written approval by GIS Manager. These data are for informational purposes only and should not create liability on the part of Tarrant County Government, any officer and/or employees thereof. per 1, No or Excluded Data County Boundary Tarrant County Communicable Disease Report, 29 19

28 2. Chronic Hepatitis C Hepatitis C is a liver disease caused by the Hepatitis C virus (HCV). Chronic Hepatitis C infection occurs in percent of infected persons. Symptoms of Hepatitis C infection include jaundice, fatigue, dark urine, abdominal pain, loss of appetite, and nausea; although, 7-8 percent of infected persons are asymptomatic. Potential long-term effects include chronic liver disease, liver transplant, and death. Hepatitis C is most often spread through illegal injection drug use, but can be spread through sexual contact, accidental needle sticks, and transmission from mother to child. 2 Overall, there were 2,738 cases (153.7 per 1, population) of chronic Hepatitis C reported in Tarrant County for 29, with more cases observed among males (1,64 cases, per 1, population) than females (1,127 cases, per 1, population) (Figure 5). Figure 5. Chronic Hepatitis C by Gender, Tarrant County, 29 2, 1,6 1, Male Female per 1, population Race/ethnicity data for chronic Hepatitis C are not included due to missing data. Data are missing for approximately 53 percent of chronic hepatitis C cases. of chronic Hepatitis C were reported among all age groups, with the highest incidence rates observed in the older age groups. The highest rate occurred on the year age group with 1,1 cases (448.5 per 1, population) reported. The incidence rate then decreased as follows: year age group (61 cases, per 1, population), year age group (487 cases, per 1, population), 65 years and older age group (185 cases, 13.4 per 1, population), year age group (254 cases, 87.5 per 1, population), 2-24 year age group (72 cases, 56.8 per 1, population), year age group (21 cases, 16.3 per 1, population), and -4 year age group (9 cases, 6.3 per 1, population). Finally, there were less than five cases of chronic Hepatitis C among the 5-9 year age group as well as the 1-14 year age group (Figure 6). Tarrant County Communicable Disease Report, 29 2

29 Figure 6. Chronic Hepatitis C by Age Group (in Years), Tarrant County, 29 1, per 1, population No vaccines are available to prevent Hepatitis C infection. Some preventive measures include not injecting illegal drugs, not sharing needles, and always practicing safe sex. Since a large number of persons with Hepatitis C may not show symptoms, the number of true cases is unknown. It is estimated that 3.2 million Americans have chronic Hepatitis C. 2 Appropriate testing and medical management are offered at Tarrant County Public Health. Tarrant County Communicable Disease Report, 29 21

30 7551 Figure 7. Geographic Distribution of Chronic Hepatitis C by ZIP Code, Tarrant County, These data were prepared by Tarrant County Public Health for its use, and may be revised any time, without notification. Tarrant County Public Health does not guarantee the correctness or accuracy of any features on this map. Tarrant County assumes no responsibility in connection therewith. Said data should not be edited by anyone other than designated personnel, or through written approval by GIS Manager. These data are for informational purposes only and should not create liability on the part of Tarrant County Government, any officer and/or employees thereof. per 1, No or Excluded Data County Boundary Tarrant County Communicable Disease Report, 29 22

31 3. Gonorrhea Gonorrhea is a sexually transmitted disease (STD) caused by the bacterium Neisseria gonorrhoeae. Gonorrhea is the third most commonly reported disease in Tarrant County and the second most common in the United States with 336,742 cases (a rate of cases per 1, population) reported nationally in 28. Persons infected with gonorrhea may be asymptomatic; however, gonorrhea infections in women can cause serious conditions such as pelvic inflammatory disease (PID), ectopic pregnancy, and chronic pelvic pain. In men, gonorrhea infections can lead to epididymitis a painful condition of the testicles that can lead to infertility. In 26, an increase in resistance among Neisseria gonorrhoeae bacteria to quinolones resulted in restrictions in national treatment guidelines to include only the cephalosporin class of drugs. Historically, the national rate of gonorrhea infection was higher among males, but the rate of new infections has been similar among both genders for the past eight years. Nationally, the incidence rate of gonorrhea was highest among 2-24 year olds in Screening and treatment services for gonorrhea are available at Tarrant County Public Health. Overall, there were 2,435 cases (136.7 per 1, population) of gonorrhea reported in Tarrant County for 29. Incidence was slightly higher among females (1,319 cases, per 1, population) compared to males (1,115 cases, per 1, population) (Figure 8). Figure 8. Gonorrhea by Gender, Tarrant County, 29 1,6 2 1, Male Female per 1, population Among racial/ethnic groups, the highest incidence of gonorrhea was observed among Blacks. The rate among Blacks (1,711 cases, per 1, population) was approximately 46 times higher than Others (19 cases, 15.6 per 1, population), 17 times higher than Whites (378 cases, 42. per 1, population), and 12 times higher than Hispanics (311 cases, 59.7 per 1, population) (Figure 9). Tarrant County Communicable Disease Report, 29 23

32 Figure 9. Gonorrhea by Race/Ethnicity, Tarrant County, 29 2, 1,2 1,5 96 1, White Black Hispanic Other per 1, population The highest incidence rate of gonorrhea was observed in the year age group (837 cases, per 1, population) followed by the 2-24 year age group (819 cases, per 1, population), year age group (539 cases, per 1, population), year age group (144 cases, 51.1 per 1, population), 1-14 year age group (36 cases, 29.2 per 1, population), year age group (44 cases, 17.9 per 1, population), and year age group (13 cases, 7.7 per 1, population). Less than five cases were reported for those 5-9 years of age and those 65+ years of age and older (9 cases, 6.6 per 1, population). No cases were reported in the -4 year group (Figure 1). Figure 1. Gonorrhea by Age Group (in Years), Tarrant County, 29 1, per 1, population Tarrant County Communicable Disease Report, 29 24

33 7551 Figure 11. Geographic Distribution of Gonorrhea by ZIP Code, Tarrant County, These data were prepared by Tarrant County Public Health for its use, and may be revised any time, without notification. Tarrant County Public Health does not guarantee the correctness or accuracy of any features on this map. Tarrant County assumes no responsibility in connection therewith. Said data should not be edited by anyone other than designated personnel, or through written approval by GIS Manager. These data are for informational purposes only and should not create liability on the part of Tarrant County Government, any officer and/or employees thereof. per 1, No or Excluded Data County Boundary Tarrant County Communicable Disease Report, 29 25

34 4. Chronic Hepatitis B Hepatitis B is a liver disease caused by the Hepatitis B virus (HBV). The younger a person is when they first become infected with HBV, the greater the risk of becoming chronically infected. Ninety percent of infants who are infected with HBV at birth will become chronically infected, as will 25-5 percent of children infected between the ages of one to five years, and 6-1 percent of persons over five years of age. Symptoms of Hepatitis B infection include jaundice, fatigue, abdominal pain, loss of appetite, nausea, vomiting, and joint pain. An estimated 3-5 percent of infected persons are asymptomatic with symptoms less common in children than in adults. Potential long-term effects include chronic liver disease, liver transplant, and death. Hepatitis B is spread through sexual contact with an infected person, direct contact with blood or sores from an infected person, sharing needles, accidental needle sticks, and transmission from mother to child. 4 Overall, there were 719 cases (a rate of 4.4 cases per 1, population) of chronic Hepatitis B reported in Tarrant County in 29. The incidence rate was roughly the same among males (365 cases, 4.8 per 1, population) and females (354 cases, 4. per 1, population) (Figure 12). Figure 12. Chronic Hepatitis B by Gender, Tarrant County, Male Female per 1, population Race/ethnicity data for chronic Hepatitis B are not included due to missing data. Data are missing for approximately 47 percent of chronic Hepatitis B cases. The incidence of chronic Hepatitis B was highest among the year (127 cases, 75.1 per 1, population), year (178 cases, 63.2 per 1, population), year (147 cases, 59.9 per 1, population) and the year age groups (14 cases, 48.2 per 1, population). The incidence then declined as follows: 58 cases (4.9 per 1, population) in the 65+ year age group, 43 cases (33.9 per 1, population) in the 2-24 age group, 17 cases (13.2 per 1, population) in the year age group, and 6 cases (4.9 per 1, population) in the 1-14 age group. Less than five cases were reported in the -4 year and 5-9 year age groups (Figure 13). Tarrant County Communicable Disease Report, 29 26

35 Figure 13. Chronic Hepatitis B by Age Group (in Years), Tarrant County, per 1, population The numerator was too small for rate calculation of the -4 year and 5-9 year age groups. Vaccination for Hepatitis B has been available since Routine vaccination is recommended for persons -18 years of age and persons over 18 years of age who are at high risk. Some prevention measures include always practicing safe sex, not injecting illegal drugs, not sharing needles, and getting vaccinated. Since a large number of persons with Hepatitis B are asymptomatic, the number of true cases is unknown. It is estimated that 8, million Americans have chronic Hepatitis B. 4 Appropriate testing and medical management are offered through Tarrant County Public Health. Tarrant County Communicable Disease Report, 29 27

36 7551 Figure 14. Geographic Distribution of Chronic Hepatitis B by ZIP Code, Tarrant County, These data were prepared by Tarrant County Public Health for its use, and may be revised any time, without notification. Tarrant County Public Health does not guarantee the correctness or accuracy of any features on this map. Tarrant County assumes no responsibility in connection therewith. Said data should not be edited by anyone other than designated personnel, or through written approval by GIS Manager. These data are for informational purposes only and should not create liability on the part of Tarrant County Government, any officer and/or employees thereof. per 1, No or Excluded Data County Boundary Tarrant County Communicable Disease Report, 29 28

37 5. Salmonellosis Salmonellosis is a bacterial disease caused by the bacterium Salmonella. Symptoms start 12 to 72 hours after infection and typically include diarrhea, fever, and stomach pain. Symptoms usually last four to seven days, and treatment is not necessary for most people. In some cases, however, severe complications may occur. For instance, the diarrhea may be severe enough for hospitalization. The infection may spread into the blood stream which could result in death if not medically treated. Salmonellosis may be contracted through eating foods contaminated with animal feces such as undercooked beef and poultry, milk, and raw eggs. Thorough cooking kills Salmonella. Infection may also be spread by handling baby chicks and reptiles such as turtles, lizards, and snakes. Children, the elderly, and immune-compromised persons are at a higher risk of infection. 5 There were 34 cases (a rate of 17.1 cases per 1, population) of salmonellosis reported in Tarrant County in 29. The incidence was lower among males (141 cases, 15.8 per 1, population) than females (163 cases, 18.4 per 1, population) (Figure 15). Figure 15. Salmonellosis by Gender, Tarrant County, Male Female per 1, population Data for the racial/ethnic distribution of reported salmonellosis cases should be interpreted with caution due to the high percentage (26%) of missing data for race/ethnicity. Of collected data, the highest rate of salmonellosis cases were observed among Whites (135 cases, 15. per 1, population), followed by Hispanics (59 cases, 11.3 per 1, population), Blacks (25 cases, 1.4 per 1, population), and then Others (5 cases, 4.1 per 1, population) (Figure 16). Tarrant County Communicable Disease Report, 29 29

38 Figure 16. Salmonellosis by Race/Ethnicity, Tarrant County, White Black Hispanic Other per 1, population Rankings for race/ethnicity should be interpreted with caution due to missing data. Race/ethnicity data are missing for 26% of salmonellosis cases. Data Source: Tarrant County Public Health The highest incidence rate of reported salmonellosis cases was observed in the -4 year age group (18 cases, 75.8 per 1, population) followed by the 5-9 year age group (45 cases, 34.4 per 1, population). Incidence in the other age groups (by decreasing incidence rate) were: 24. per 1, population (34 cases) in the 65 years and older age group, 13.8 per 1, population (17 cases) in the 1-14 year age group, 11.8 per 1, population (2 cases) in the year age group, 11. per 1, population (27 cases) in the year age group, 7.9 per 1, population (1 cases) in the 2-24 year age group, 7.2 per 1, population (21 cases) in the year age group, 7. per 1, population (9 cases) in the year age group, and 4.6 per 1, population (13 cases) in the year age group (Figure 17). Figure 17. Salmonellosis by Age Group (in Years), Tarrant County, per 1, population Tarrant County Communicable Disease Report, 29 3

39 7551 Figure 18. Geographic Distribution of Salmonella by ZIP Code, Tarrant County, These data were prepared by Tarrant County Public Health for its use, and may be revised any time, without notification. Tarrant County Public Health does not guarantee the correctness or accuracy of any features on this map. Tarrant County assumes no responsibility in connection therewith. Said data should not be edited by anyone other than designated personnel, or through written approval by GIS Manager. These data are for informational purposes only and should not create liability on the part of Tarrant County Government, any officer and/or employees thereof. per 1, No or Excluded Data County Boundary Tarrant County Communicable Disease Report, 29 31

40 6. Varicella Varicella, more commonly known as chickenpox, is caused by the varicella-zoster virus. Varicella infection causes a skin rash of blister-like lesions that may occur anywhere on the body but are usually concentrated on the face, scalp, or trunk of the body. It is highly contagious and spreads from person to person through direct contact, coughing, and sneezing. Mild effects of infection include an itchy rash, tiredness, dehydration, headache, and fever. Serious complications of infection can include bacterial skin infection, swelling of the brain, pneumonia, and even death. A person is contagious from one to two days before the appearance of the rash until all of the blisters have formed scabs. Symptoms generally appear 1-21 days after contact with someone who is infected. 5 There were 298 cases (16.7 per 1, population) of varicella reported in Tarrant County during 29. The incidence was slightly higher among females (154 cases, 17.4 per 1, population) than males (144 cases, 16.1 per 1, population) (Figure 19). Figure 19. Varicella by Gender, Tarrant County, Male Female per 1, population The incidence rate of varicella cases was highest among Hispanics (88 cases, 16.9 per 1, population) followed by Whites (13 cases, 14.5 per 1, population). The rate was lowest among Others (1 cases, 8.2 per 1, population) followed by Blacks (31 cases, 13. per 1, population) (Figure 2). Tarrant County Communicable Disease Report, 29 32

41 Figure 2. Varicella by Race / Ethnicity, Tarrant County, White Black Hispanic Other per 1, population Higher incidence rates of varicella were observed among the younger age groups. The highest rate occurred in the 5-9 year age group (136 cases, 13.9 per 1, population) followed by the 1-14 year age group (83 cases, 67.4 per 1, population), -4 year age group (65 cases, 45.6 per 1, population), and year age group (5 cases, 3.9 per 1, population). Less than five cases were reported for the year age group, the year age group, and the 65 and older age group. No cases were observed among those years of age as well as those years of age (Figure 21). Figure 21. Varicella by Age Group (in Years), Tarrant County, per 1, population The numerator was too small for rate calculation of the year, year and 65 years and older age groups. Varicella is preventable through vaccination. The vaccine is recommended for children and adults who have not previously had varicella. It is possible to be infected twice, but it is rare. 5 Vaccination is available at Tarrant County Public Health. Tarrant County Communicable Disease Report, 29 33

42 7551 Figure 22. Geographic Distribution of Varicella by ZIP Code, Tarrant County, These data were prepared by Tarrant County Public Health for its use, and may be revised any time, without notification. Tarrant County Public Health does not guarantee the correctness or accuracy of any features on this map. Tarrant County assumes no responsibility in connection therewith. Said data should not be edited by anyone other than designated personnel, or through written approval by GIS Manager. These data are for informational purposes only and should not create liability on the part of Tarrant County Government, any officer and/or employees thereof. per 1, No or Excluded Data County Boundary Tarrant County Communicable Disease Report, 29 34

43 7. Early Syphilis Syphilis is a sexually transmitted disease (STD) caused by the bacterium Treponema pallidum whose symptoms are often difficult to distinguish from those of other diseases or conditions. Since 21, syphilis incidence in the United States has been gradually increasing with 13,5 primary and secondary cases (4.5 cases per 1, population) reported nationally during 28, an 18.4 percent increase since Persons infected with syphilis may be asymptomatic; however, if untreated, syphilis infections can facilitate the transmission of disease and among pregnant women, result in perinatal death or transmission of the bacteria to the fetus. Recent increases in the national rate of syphilis have occurred primarily among men. Nationally and in Tarrant County, the incidence rate of primary and secondary syphilis was highest among 2-24 year olds in There were 28 cases (a rate of 15.7 cases per 1, population) of early syphilis (includes primary, secondary, and early latent syphilis infections) reported in Tarrant County in 29. The incidence was higher among males (179 cases, 2. per 1, population) than females (11 cases, 11.4 per 1, population) (Figure 23). Figure 23. Early Syphilis by Gender, Tarrant County, Male Female per 1, population Among racial/ethnic groups, the highest incidence rate of early syphilis was observed among Blacks (17 cases, 71. per 1, population). The rate among Blacks was more than seven times that of Hispanics (52 cases, 1. per 1, population) and almost twelve times that of Whites (55 cases, 6.1 per 1, population) (Figure 24). Tarrant County Communicable Disease Report, 29 35

44 Figure 24. Early Syphilis by Race/Ethnicity, Tarrant County, White Black Hispanic Other -5 per 1, population The numerator was too small for rate calculation for Other race/ethnicity group. The incidence rate of early syphilis was highest among individuals aged 2-24 years (71 cases, 56. per 1, population). The remaining age groups incident rates ranked from highest to lowest as follows: year age group (8 cases, 27.6 per 1, population), year age group (3 cases, 23.2 per 1, population), year age group (46 cases, 16.3 per 1, population), year age group (35 cases, 14.3 per 1, population), and year age group (15 cases, 8.9 per 1, population). Less than five cases were reported among the 65 years and older age group, and no cases were reported for the -4 year, 5-9 year and 1-14 age groups (Figure 25). Figure 25. Early Syphilis by Age Group (in Years), Tarrant County, per 1, population The numerator was too small for rate calculation for the -4 year, 5-9 year and 1-14 year age groups. Tarrant County Communicable Disease Report, 29 36

45 7551 Figure 26. Geographic Distribution of Early Syphilis by ZIP Code, Tarrant County, These data were prepared by Tarrant County Public Health for its use, and may be revised any time, without notification. Tarrant County Public Health does not guarantee the correctness or accuracy of any features on this map. Tarrant County assumes no responsibility in connection therewith. Said data should not be edited by anyone other than designated personnel, or through written approval by GIS Manager. These data are for informational purposes only and should not create liability on the part of Tarrant County Government, any officer and/or employees thereof. per 1, No or Excluded Data County Boundary Tarrant County Communicable Disease Report, 29 37

46 8. HIV HIV (human immunodeficiency virus) is the virus that causes AIDS. HIV attacks a person s immune system and reduces a person s ability to fight off infections. Approximately 21 percent of persons infected with HIV do not know they are infected with the virus. HIV is transmitted through having sex with someone who is infected, sharing needles with someone who is infected, or being exposed during birth or breastfeeding. It is not transmitted by casual touching, mosquitoes, or drinking after someone. No vaccine is available for HIV at this time. Some preventive measures include abstaining from sexual contact or always practicing safe sex, not injecting illegal drugs, and not sharing needles. In 28, the CDC approximated that around 56,3 individuals were newly infected with HIV during 26. (Since a large number of persons with HIV are asymptomatic, the number of true cases can only be estimated.) 8 A total of 233 new cases (13.1 per 1, population) of HIV were reported in Tarrant County in 29. The incidence rate among males (183 cases, 2.4 per 1, population) was almost four times the rate among females (5 cases, 5.6 per 1, population) (Figure 27). Figure 27. HIV by Gender, Tarrant County, Male Female -3 per 1, population HIV/AIDS data are preliminary. The number of cases may change. The incidence rate of reported HIV cases among Blacks (126 cases, 52.6 per 1, population) was more than eight times higher than among Whites (58 cases, 6.4 per 1, population), seven times higher than among Hispanics (39 cases, 7.5 per 1, population) and roughly nine times higher that the incidence of HIV reported among Others in Tarrant County during 29 (Figure 28). Tarrant County Communicable Disease Report, 29 38

47 Figure 28. HIV by Race/Ethnicity, Tarrant County, White Black Hispanic Other per 1, population The numerator was too small for rate calculation for Other race/ethnicity group. HIV/AIDS data are preliminary. The number of cases may change. Across age groups, the highest rate of newly reported HIV cases was observed among young adults age 2-24 years (49 cases, 38.6 per 1, population). This was followed by the year age group (68 cases, 23.4 per 1, population), the year age group (59 cases, 2.9 per 1, population), the year age group (33 cases, 13.5 per 1, population), the year age group (14 cases, 1.8 per 1, population), and the year age group (1 cases, 5.9 per 1,). No cases were reported in the -4 year, 5-9 year, 1-14 year age and 65 years and older age groups (Figure 29). Appropriate HIV testing and medical management are offered at Tarrant County Public Health. Figure 29. HIV by Age Group (in Years), Tarrant County, per 1, population The numerator was too small for rate calculation for the -4 year and 65+ year age groups. HIV/AIDS data are preliminary. The number of cases may change. Tarrant County Communicable Disease Report, 29 39

48 7551 Figure 3. Geographic Distribution of HIV by ZIP Code, Tarrant County, These data were prepared by Tarrant County Public Health for its use, and may be revised any time, without notification. Tarrant County Public Health does not guarantee the correctness or accuracy of any features on this map. Tarrant County assumes no responsibility in connection therewith. Said data should not be edited by anyone other than designated personnel, or through written approval by GIS Manager. These data are for informational purposes only and should not create liability on the part of Tarrant County Government, any officer and/or employees thereof. per 1, No or Excluded Data County Boundary Tarrant County Communicable Disease Report, 29 4

49 9. Aseptic Meningitis Meningitis is an infection of the fluid around the brain and spinal cord which results in the inflammation of the tissues that cover these organs. Meningitis can be caused by a virus, bacteria, or fungi. Aseptic meningitis, or viral meningitis, is the most common form of meningitis; 9 percent of cases are caused by enteroviruses which spread through the respiratory secretions of infected persons. Symptoms of aseptic meningitis may include fever, severe headache, stiff neck, drowsiness or confusion, nausea, and vomiting. Additional symptoms to watch for with infants include fretfulness or irritability, difficulty in awakening, and refusal to eat. Although aseptic meningitis is not as serious as bacterial meningitis, it can be serious in persons with weak immune systems. Most people, however, recover in 7 to 1 days with no long-term effects. Hand washing and disinfecting surfaces are the best ways to prevent infection. 9 Overall, 228 cases (a rate of 12.8 cases per 1, population) of aseptic meningitis were reported in Tarrant County in 29. The incidence was slightly higher among males (124 cases, 13.9 per 1, population) than females (14 cases, 11.7 per 1, population) (Figure 31). Figure 31. Aseptic Meningitis by Gender, Tarrant County, Male Female per 1, population The incidence rate was highest among Whites (129 cases, 14.3 per 1, population), followed by Blacks (31 cases, 13. per 1, population), Hispanics (46 cases, 8.8 per 1, population), and lastly, among Others (9 cases, 7.4 per 1, population) (Figure 32). Tarrant County Communicable Disease Report, 29 41

50 Figure 32. Aseptic Meningitis by Race/Ethnicity, Tarrant County, White Blac k Hispanic Other per 1, population The numerator was too small for rate calculation for Other race/ethnicity group. The incidence rate of aseptic meningitis for the -4 year age group (51 cases, 35.8 per 1, population) was more than five times higher than the incidence rate in the year (16 cases, 6.5 per 1, population), and the 65 years and over (9 cases, 6.3 per 1, population) age groups. The incidence rate of aseptic meningitis was two to three times higher than the incidence rate for the -4 year age group in the 5-9 year (22 cases, 16.8 per 1, population), 1-14 year (15 cases, 12.2 per 1, population), year (17 cases, 13.2 per 1, population), 2-24 year (19 cases, 15. per 1, population), and the year (38 cases, 13.1 per 1, population) age groups. The other age groups in decreasing order of incidence rate are the year age group (27 cases, 9.6 per 1, population), and year age group (14 cases, 8.3 per 1, population) (Figure 33). Figure 33. Aseptic Meningitis by Age Group (in Years), Tarrant County, per 1, population Tarrant County Communicable Disease Report, 29 42

51 7551 Figure 34. Geographic Distribution of Aseptic Meningitis by ZIP Code, Tarrant County, These data were prepared by Tarrant County Public Health for its use, and may be revised any time, without notification. Tarrant County Public Health does not guarantee the correctness or accuracy of any features on this map. Tarrant County assumes no responsibility in connection therewith. Said data should not be edited by anyone other than designated personnel, or through written approval by GIS Manager. These data are for informational purposes only and should not create liability on the part of Tarrant County Government, any officer and/or employees thereof. per 1, No or Excluded Data County Boundary Tarrant County Communicable Disease Report, 29 43

52 1. Pertussis Pertussis (also known as whooping cough ) is a highly contagious respiratory disease caused by a type of bacteria called Bordetella pertussis. Pertussis is the most commonly occurring vaccine-preventable disease in the United States. There has been an increase in the number of pertussis cases nationally since the 198 s with the greatest increase occurring among children and teens (1-19 years old) and infants less than six months of age. 1 Early pertussis symptoms are often mistaken for the common cold: runny nose or congestion, sneezing, fever, and perhaps a mild cough. After a week or so however, sever and painful coughing begins. The coughing episodes become so violent and occur so rapidly that all the air is forced out of the lungs, resulting in the need to inhale forcibly creating a loud whooping sound characteristic of the disease. 1 The key to pertussis prevention is vaccination. Children are protected with a series of five DTaP shots occurring between the ages of two months and approximately five years. DTaP protects against three different diseases: diphtheria, tetanus, and pertussis. Protection has been shown to wane over time and a booster shot (called Tdap) is recommended for pre-teens (ages years). Tdap is also recommended for adults who have never received a pertussis booster, especially among pregnant women and families with infants. 1 Overall, 22 cases (11.3 per 1, population) of pertussis were reported in Tarrant County in 29. The incidence among males (12 cases, 11.4 per 1, population) and females (1 cases, 11.3 per 1, population) was similar (Figure 35). Figure 35. Pertussis by Gender, Tarrant County, Male Female per 1, population The incidence rate of pertussis cases was highest among Hispanics (82 cases, 15.7 per 1, population) followed by Blacks (29 cases, 12.1 per 1, population) and Whites (84 cases, 9.3 per 1, population). There were less than five cases among Others (Figure 36). Tarrant County Communicable Disease Report, 29 44

53 Figure 36. Pertussis by Race/Ethnicity, Tarrant County, White Black Hispanic Other per 1, population The numerator was too small for rate calculation for Other race/ethnicity group. The incidence rate of pertussis was highest among children. The highest rate was observed in the -4 year age group (97 cases, 68. per 1, population) followed by the 1-14 year age group (4 cases, 32.5 per 1, population) and the 5-9 year age group (4 cases, 3.6 per 1, population). s then dropped considerably among the year age group (7 cases, 5.4 per 1, population) and the year age group (7 cases, 2.4 per 1, population). Fewer than five cases were reported among each of the following age groups: 2-24 years, years, years, and 65 years and older. No cases were reported for the year age group (Figure 37). Figure 37. Pertussis by Age Group (in Years), Tarrant County, per 1, population The numerator was too small for rate calculation for the following age groups: years, 2-24 years, years, years, and 65+ years. Tarrant County Communicable Disease Report, 29 45

54 7551 Figure 38. Geographic Distribution of Pertussis by ZIP Code, Tarrant County, These data were prepared by Tarrant County Public Health for its use, and may be revised any time, without notification. Tarrant County Public Health does not guarantee the correctness or accuracy of any features on this map. Tarrant County assumes no responsibility in connection therewith. Said data should not be edited by anyone other than designated personnel, or through written approval by GIS Manager. These data are for informational purposes only and should not create liability on the part of Tarrant County Government, any officer and/or employees thereof. per 1, No or Excluded Data County Boundary Tarrant County Communicable Disease Report, 29 46

55 29 H1N1 Influenza: Pandemic of the 21 st Century In mid-march 29, surveillance systems in Mexico detected increases of influenza-like illness (ILI) and pneumonia, an atypical pattern for that time of the year. 11 Soon afterwards in late March, specimens collected in California from two children and tested under routine influenza surveillance were diagnosed with an influenza A virus which could not be further characterized into seasonal influenza subtypes by local public health laboratories. On April 15, 29 the first case of a novel influenza A virus, later known as the 29 H1N1 influenza virus, was detected in the United States and reported to the World Health Organization (WHO). 12 Worldwide spread and identification of the 29 H1N1 influenza virus prompted WHO to declare the start of an influenza pandemic on June 11, Prompted by the detection of this novel influenza virus in the United States, enhanced surveillance of patients presenting with febrile respiratory illness was instituted during the week of April 19 th. On April 23 rd, the first two cases of 29 H1N1 influenza (two 16 year old males) were detected in Texas near San Antonio and on April 25 th, the first case of influenza 29 H1N1 influenza in Tarrant County was detected in a 12 year old female. Subsequently, national reporting of 29 H1N1 influenza-associated hospitalizations and deaths was instituted by the Council of State and Territorial Epidemiologists. The 29 H1N1 influenza virus appeared to have similar transmission patterns as observed with traditional seasonal influenza. 11 Those infected with the novel virus may transmit the virus from one day prior and until seven days after onset of symptoms. 11 The majority of those infected with the 29 H1N1 influenza virus exhibited symptoms similar to those seen with infection due to seasonal influenza including fever, cough, sore throat, malaise and headache. 11 But compared to previous influenza seasons predominated by the influenza A H3N2 virus, the 29 H1N1 influenza season was associated with higher pediatric mortality (children 18 years of age and younger) and higher rates of hospitalizations in children and young adults. 12 In the United States, from April 29 until June 12, 21, 344 laboratory confirmed 29 H1N1 influenza-associated pediatric deaths were reported. 12 In Tarrant County during the same time period, thirteen total laboratory confirmed 29 H1N1 influenza-associated deaths were reported, including less than five pediatric deaths. In Tarrant County, 173 hospitalizations due to laboratory confirmed 29 H1N1 influenza were reported. Hospitalizations were roughly similar among males (82 cases) and females (91 cases) (Figure 39). Of those hospitalized, 33 (19%) required care in the intensive care unit. Total counts of laboratory confirmed 29 H1N1 hospitalizations were highest in the -4 year age group followed by the year age group (Figure 4). Note that as the numbers of total 29 H1N1 influenza infections in Tarrant County are not available, rates could not be calculated. Total counts are therefore provided and should be interpreted with caution. On August 1, 21 WHO declared the end of the pandemic phase and entrance into the post-pandemic phase, with disease levels returning to those normally seen during a typical influenza season. 12 Tarrant County Communicable Disease Report, 29 47

56 Figure H1N1 Influenza Hospitalizations by Gender, Tarrant County, 29 Hospitalizations Male Female Figure H1N1 Influenza Hospitalizations by Age Group (in Years), Tarrant County, 29 Hospitalizations Tarrant County Communicable Disease Report, 29 48

57 References 1. Centers for Disease Control and Prevention, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. STD Surveillance 29. National Profile: Chlamydia. Available at: 2. Centers for Disease Control and Prevention, Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Hepatitis C FAQs for the Public. Available at: 3. Centers for Disease Control and Prevention, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. STD Surveillance 29. National Profile: Gonorrhea. Available at: 4. Centers for Disease Control and Prevention, Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Hepatitis B FAQs for the Public. Available at: 5. Centers for Disease Control and Prevention, National Center for Immunizations and Respiratory Diseases. Varicella (Chickenpox) Vaccination at a glance. Available at: 6. Centers for Disease Control and Prevention, Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases. Cryptosporidiosis: General Information. Available at: 7. Centers for Disease Control and Prevention, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases. Salmonellosis: FAQ Available at: 8. Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases, Meningitis and Vaccine Preventable Diseases Branch. Pertussis: What you need to know. Available at: 9. Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases. Viral Meningitis Questions. Available at: 1. Centers for Disease Control and Prevention, Divisions of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Basic Statistics. Available: Novel H1N1 influenza (Swine flu) update. Center for Infectious Disease Research and Policy (CIDRAP). Available at: iew.html. Tarrant County Communicable Disease Report, 29 49

58 12. Update: Influenza Activity- United States, 29-1 Season. Morbidity and Mortality Weekly Report, The Centers for Disease Control and Prevention. July 3, (29); Tarrant County Communicable Disease Report, 29 5

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60 Tarrant County Public Health 111 S. Main Street Fort Worth, TX