ANNUAL SUMMARY OF COMMUNICABLE DISEASES 2015 Carroll County General Health District Carroll County, Ohio

Transcription

1 ANNUAL SUMMARY OF COMMUNICALE DISEASES 2015 Carroll County General Health District Carroll County, Ohio 1

2 ANNUAL SUMMARY OF COMMUNICALE DISEASE 2015 Carroll County, Ohio Published 2016 Compiled and Prepared y: Natasha Yonley, MPH Epidemiologist Carroll County General Health District 2

3 Table of Contents Introduction... 4 Demographic Profile of Carroll County... 5 Counts and Rate of Communicable Disease... 7 Enteric... 7 Hepatitis... 8 Sexually-Transmitted... 8 Vaccine-Preventable... 9 Vectorborne and Zoonotic Other Disease by Township Deaths Associated with Reportable Diseases Infectious Disease Outbreaks in Carroll County Disease Spotlight: Chlamydia Disease Spotlight: Gonorrhea Disease Spotlight: Listeria Featured Outbreak Investigations Timeliness of Disease Reporting Notes References ACKNOWLEDGEMENTS We would like to thank the following: Carroll County General Health District staff Scott A. rewer, MPH, RS Franklin County Public Health randi ennett Epidemiologist, Outbreak Response and T Investigation Team (ORIT) Katie Cibulskas Epidemiologist, Outbreak Response and T Investigation Team (ORIT) 3

4 Introduction This report summarizes notifiable communicable disease reported to Carroll County General Health District in Communicable diseases (also called infectious diseases ) are illnesses caused by bacteria, viruses, and parasites (also called microorganisms ), and are transmitted from an infected person or animal to another. The route of transmission varies by disease; however, it may include: contact with contaminated objects, direct contact with contaminated body fluids (e.g., blood) or respiratory secretions, the bite of an animal or vector (e.g., insect) carrying the microorganism, inhalation of contaminated airborne particles, or ingestion of contaminated food or water. The Annual Summary of Communicable Diseases 2015 includes cases of reportable diseases that were diagnosed among residents of Carroll County, reported to public health, and found to meet the public health surveillance definition of a confirmed, probable, or suspected case. These data do not represent all cases of reportable infectious disease that occurred in the community, as individuals may not seek medical care for mild or asymptomatic infections. Data in this summary are considered provisional. Ohio Administrative Code reads, cases and suspected cases of selected infectious diseases are required to be reported to Ohio and local public health agencies. Carroll County General Health District (CCGHD) has been reporting, tracking, and investigating infectious disease cases through Ohio Disease Reporting System (ODRS). Many of these diseases must also be reported by state health departments to the Centers for Disease Control and Prevention (CDC) as part of national public health surveillance of infectious diseases. The Know your ACs: A Quick Guide to Reportable Infectious Disease in Ohio can be found on page six (6) of this document. This breaks down each disease by class, rather than type of disease.please note that data in tables 3-8 are grouped by type of disease. Table 9 is the distribution of disease by each township in Carroll County in There are two columns for each year; one column states and the second column states. The column includes cases that were suspected, probable, or confirmed. This summary is intended to be a resource for individuals and public health partners concerned about infectious diseases in Carroll County. Further information on communicable diseases may be obtained by contacting Carroll County General Health District. KEY FINDINGS: In 2015, 113 cases of infectious disease* were reported among Carroll County residents, compared to 122 cases in Rates of Chlamydia and Gonorrhea decreased from 2014 to 2015 in Carroll County residents. Rates of Campylobacteriosis, Giardiasis, Legionnaires disease and Listeria all increased from 2014 to 2015 in Carroll County residents. Rates of Salmonellosis and Shigellosis decreased from 2014 to 2015 in Carroll County residents. *Excludes Hepatitis 4

5 Demographic Profile of Carroll County CARROLL COUNTY POPULATION, The population of Carroll County decreased 2.3%, from 28,836 in 2010 to 28,187 in In 2014, 49.8% of Carroll County residents were female, and 50.2% were male. In 2014, 97.6% of Carroll County residents were White; 0.6% were African American; and 0.3% were American Indian or Alaska Native. TALE 1: CARROLL COUNTY POPULATION Y GENDER, 2014 Gender 2014 Population Percent (%) Female 14, Male 14, Total 28, TALE 2: CARROLL COUNTY POPULATION Y RACE, 2014 Race 2014 Population Percent (%) White 27, African American American Indian or Alaska Native Asian Two or more Races Total 28, TALE 3: CARROLL COUNTY POPULATION Y AGE GROUP, 2014 Age (Years) 2014 Population Percent (%) Persons under 5 1, Persons under 18 6, Persons between 18 and 64 15, Persons 65 and over 5, Total 28,

6 6

7 Counts and Rate of Communicable Disease Table 3: Counts and Rate of Enteric Reportable Diseases among Carroll County Residents, ENTERIC DISEASES Year: Population: 28,836 28,836 28,836 28,187 # of Case # of Case # of Case # of Case # of Case # of Case # of Case # of Case Class Disease Name Rate Rate Rate Rate Rate Rate Rate Rate Amebiasis Campylobacteriosis A Cholera Cryptosporidiosis Cyclosporiasis E. coli O157:H7 E. coli, unspecified E. coli, not O157 Giardiasis Hemolyric uremic syndrome (HUS) Listeriosis Salmonellosis Shigellosis Trichinellosis Typhoid fever Vibrio parahaemolyticus infection Vibriosis, other (not cholera) Yersiniosis = Rate per 100,000 population 7

8 Table 4: Counts and Rate of Reportable Hepatitis* among Carroll County Residents, Hepatitis Year: Population: 28,836 28,836 28,836 28,187 Class Disease Name # of Case Rate # of Case # of Case # of Case # of Case # of Case # of Case # of Case Rate Rate Rate Rate Rate Rate Rate Hepatits A Hepatitis, perinatal Hepatitis E = Rate per 100,000 population, * = Data on acute and chronic Hepatitis and Hepatitis C are not included in this report Table 5: Counts and Rate of Reportable Sexually-Transmitted Diseases among Carroll County Residents, Sexually-Transmitted Disease^ Year: Population: 28,836 28,836 28,836 28,187 # of Case # of Case # of Case # of Case # of Case # of Case # of Case # of Case Class Disease Name Rate Rate Rate Rate Rate Rate Rate Rate ^ HIV/AIDS N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Chancroid Chlamydia trachomatis infections Gonorrhea (Neisseria gonorrhoeae) Syphilis = Rate per 100,000 population, ^ = reported per OAC , N/A = data not recorded in Carroll County these results are sent to Stark County 8

9 Table 6: Counts and Rate of Reportable Vaccine-Preventable Diseases among Carroll County Residents, Vaccine-Preventable Diseases Year: Population: 28,836 28,836 28,836 28,187 Class Disease Name # of Case # of Case # of Case # of Case # of Case # of Case # of Case # of Case Rate Rate Rate Rate Rate Rate Rate Rate A Diphtheria Haemophilus influenza, invasive Influenzaassociated hospitalization Influenzaassociated pediatric mortality A Influenza A novel virus A Measles A Meningococcal disease (N. meningitides) Mumps Pertussis Poliomyelitis Rubella A Rubella, congenital Tetanus Varicella = Rate per 100,000 population 9

10 Table 7: Counts and Rate of Reportable Vectorborne and Zoonotic Diseases among Carroll County Residents, Vectorborne and Zoonotic Diseases Year: Population: 28,836 28,836 28,836 28,187 # of Case # of Case # of Case # of Case # of Case # of Case # of Case # of Case Class Disease Name Rate Rate Rate Rate Rate Rate Rate Rate abesiosis N/A N/A N/A N/A N/A N/A N/A N/A rucellosis Dengue Eastern equine encephalitis virus disease Ehrlichiosis/Anaplasmosis Hantavirus La Crosse virus disease Leptospirosis Lyme disease Malaria Other arthropod-borne disease A Plague Powassan virus disease Psittacosis Q fever A Rabies, human Spotted fever rickettsiosis, including Rocky Mountain spotted fever (RMSF) St. Louis encephalitis virus disease A Tularemia Typhus fever A Viral hemorrhagic fever (VHF) West Nile virus infection Western equine encephalitis virus diseases A Yellow fever = Rate per 100,000 population, N/A = not a reportable condition 10

11 Table 8: Counts and Rate of Other Reportable Diseases among Carroll County Residents, Other Reportable Diseases Class Year: Population: 28,836 28,836 28,836 28,187 Disease Name # of Case Rate # of Case Rate # of Case Rate A Anthrax A otulism, foodborne otulism, infant otulism, wound Coccidioidomycosis Creutzfeldt-Jakob disease Legionnaires disease Leprosy (Hansen s disease) Meningitis, aseptic (viral) Meningitis, bacterial Mycobacterial disease other than tuberculosis (MOTT) A Severe acute respiratory syndrome (SARS) A Smallpox Staphylococcus aureus, with resistance or intermediate resistance to vancomycin (VRSA,VISA) Streptococcal disease, group A, invasive (IGAS) Streptococcal disease, group, in newborn Streptococcal toxic shock syndrome (STSS) Streptococcus pneumoniae, invasive disease (ISP) Toxic shock syndrome Tuberculosis (T), including multi-drug resistant T (MDR-T) = Rate per 100,000 population # of Case Rate # of Case Rate # of Case Rate # of Case Rate # of Case Rate 11

12 Table 9: Reportable Communicable Disease by Township, Carroll County, Ohio, 2015 Reportable Condition Augusta rown Campylobacteriosis Chlamydia trachomatis infections E. coli, unspecified Giardiasis 1 1 Gonorrhea (Neisseria gonorrhoeae) Hepatits A Influenza-associated hospitalization Legionnaires disease Listeriosis Lyme disease Meningitis, bacterial 1 1 Mycobacterial disease other than tuberculosis (MOTT) 1 1 Pertussis Salmonellosis Shigellosis 1 1 Streptococcal disease, group A, invasive (IGAS) 1 1 Streptococcal toxic shock syndrome (STSS) 1 1 Streptococcus pneumoniae, invasive disease (ISP) *Only diseases that had reported cases were put into this chart. Center East Fox Harrison Lee Loudon Monroe Orange Perry Rose Union Washington Total 12

13 Deaths Associated with Reportable Diseases In 2015, one (1) death occurred among confirmed and probable cases of reportable diseases in Carroll County. Listeria (Listeriosis) was associated with the only death in Carroll County among reportable diseases. Death data were obtained from the Ohio Disease Reporting System (ODRS) and are subject to limitations. Deaths that are identified during case or outbreak investigation are entered into ODRS, but cases are not followed to determine if death occurred after the investigation ended. Therefore, the number of deaths reported in Table 10 may underestimate the actual number of deaths that occurred among reportable disease cases. Investigators do not determine whether a reportable disease contributed to an individual s death; it is not possible to determine the actual cause(s) of death without additional information from the death or medical records. Age Distribution of Deaths Among Confirmed and of Reportable Disease, 2015 (N= 1) <1 Year 1 to 10 Years 11 to 20 Years 21 to 30 Years 31 to 40 Years 41 to 50 Years 51 to 60 Years 61 to 70 Years 71 to 80 Years 81 to 90 Years > 90 Years Age Group 13

14 Infectious Disease Outbreaks in Carroll County Table 10: Number of Confirmed and Outbreaks Reported by Year, Carroll County, Outbreak Type Year: Confirmed Confirmed Confirmed Confirmed Community 1 Foodborne Healthcare- Associated Institutional 2 Unspecified (Class A) Unusual Incidence Waterborne Zoonotic Total OUTREAK DEFINITIONS 2 Outbreaks are Class C reportable conditions unless otherwise specified. Community: Two or more cases of similar illness with a common exposure in the community and not considered a foodborne, waterborne, zoonotic, healthcare-associated, or institutional disease outbreak. Foodborne: The occurrence of 2 or more cases of a similar illness resulting from the ingestion of a common food. Healthcare-Associated: The occurrence of cases of a disease (illness) above the expected or baseline level, usually over a given period of time, as a result of being in a healthcare facility or receiving healthcare-associated products or procedures. The number of cases indicating the presence of an outbreak will vary according to the disease agent, size and type of population exposed, previous exposure to the agent, and the time and place of occurrence. Institutional: Two or more cases of similar illness with a common exposure at an institution (e.g., correctional facility, day care center, group home, school, assisted-living facility) and not considered a foodborne or waterborne disease outbreak. Unspecified (Class A reporting): Any unexpected pattern of cases, suspected cases, deaths, or increased incidence of any other disease of major public health concern which, because of the severity of disease or potential for epidemic spread, may indicate a newly recognized infectious agent, outbreak, epidemic, related public health hazard, or act of bioterrorism. Unusual Incidence: Two or more cases of infectious disease that can be connected by person, place, and time, and do not meet the criteria for another type of outbreak. Waterborne: Waterborne disease outbreaks are divided into two categories, depending on the type of water implicated in the outbreak. Outbreaks associated with drinking water, water not intended for drinking (excluding recreational water), or water of unknown intent must meet two criteria: first, two or more persons must be epidemiologically linked by location of exposure to water, and by time, and characteristics of illness, and Second, the epidemiologic evidence must implicate water as the probable source of illness. Outbreaks associated with recreational water must also meet two criteria: First, two or more persons must be epidemiologically linked by the location of the exposure to recreational water, time, and illness. Recreational water settings include swimming pools, wading pools, spas, waterslides, interactive fountains, wet decks, and fresh and marine bodies of water. Second, the epidemiologic evidence must implicate water or volatilization of water-associated compounds into the air surrounding an aquatic facility as the probable source of the illness. Zoonotic: Occurs when two or more cases of similar illness after exposure to the same animal or the same or similar species of animals and epidemiologic evidence implicating animals as the probable source of illness. 14

15 Rate per 100,000 Disease Spotlight: Chlamydia Chlamydia 2015 Number of 59 Carroll County Rate (per 100,000 pop.) Ages of (in yrs.) Mean 22.4 Median 22 Range Female Rate (per 100,000 pop.) Male Rate (per 100,000 pop.) 63.9 and rates include all statuses (confirmed, probable, and suspected) EPIDEMIOLOGY: 3,4 Infectious agents: Chlamydia trachomatis bacterium FACTS: Case Definition: Illness compatible with chlamydia infection and laboratory confirmation through isolation of C. trachomatis by culture or through demonstration of C. trachomatis in a clinical specimen by detection of antigen or nucleic acid. Mode of Transmission: Sexually transmitted, except in cases of ocular trachoma (rare in the US) and neonatal infection Incubation Period: 7-21 days for adult genital infection; 5-17 days after delivery for conjunctivitis in infants; 3-16 weeks of age for infant pneumonitis. Symptoms: In men, infection may be asymptomatic or include dysuria, urinary frequency, and mucoid to purulent discharge. Clinical syndromes associated with chlamydia in men include epididymitis, proctitis, conjunctivitis, and Reiter s syndrome. In women, infection may be asymptomatic or include mucopurulent discharge. Clinical syndromes associated with chlamydia in women include acute urethral syndrome, bartholinitis, cervicitis, cervical dysplasia, pelvic inflammatory disease, conjunctivitis, perihepatitis, and arthritis. Infants with neonatal infection may demonstrate purulent conjunctivitis or pneumonitis. Treatment: Chlamydia can easily be treated and cured with antibiotics. Prevention: The surest way to avoid transmission is to abstain from sexual contact or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected. Appropriate use of latex male condoms can reduce the risk of transmission. The number of chlamydia infections decreased by ten since In 2014 and 2015, females had double the rate of chlamydia infections than males. CHLAMYDIA CASES AND RATES, CARROLL COUNTY, CHLAMYDIA CASES Y MONTH REPORTED, CARROLL COUNTY, Rate Year 0 15

16 Rate per 100,000 Disease Spotlight: Gonorrhea Gonorrhea 2015 Number of 7 Carroll County Rate (per 100,000 pop.) 24.8 Ages of (in yrs.) Mean 26.7 Median 23 Range Female Rate (per 100,000 pop.) 7.1 Male Rate (per 100,000 pop.) 17.7 and rates include all statuses (confirmed, probable, and suspected) EPIDEMIOLOGY: 5,6 Infectious agents: Neisseria gonorrhoeae bacterium Case Definition: A person with laboratory isolation of typical gram-negative, oxidase-positive diplococcic by culture (presumptive Neisseria gonorrhoeae) from a clinical specimen, or demonstration of N. gonorrhoeae in a clinical specimen by detection of antigen or detection of nucleic acid via nucleic acid amplification or hybridization with a nucleic acid probe. Mode of Transmission: Sexually transmitted, except in cases of neonatal infection Incubation Period: 3-8 days, with a range of 1-14 days in men and within 10 days for women. Symptoms: Some men with gonorrhea may have no symptoms at all. However, symptoms may include: A burning sensation when urinating; A white, yellow, or green discharge from the penis; Painful or swollen testicles (although this is less common). Most women with gonorrhea do not have any symptoms. Even when a woman has symptoms, they are often mild and can be mistaken for a bladder or vaginal infection. Symptoms in women can include: Painful or burning sensation when urinating; Increased vaginal discharge; Vaginal bleeding between periods. Treatment: Gonorrhea can be treated and cured with antibiotics. FACTS: Prevention: The surest way to avoid transmission is to abstain from sexual contact or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected. Appropriate use of latex male condoms can reduce the risk of transmission. The number of gonorrhea infections decreased by four since From 2014 to 2015 female gonorrhea rates were cut in onethird; male rates stayed the exact same in the same time span. Gonorrhea and Rates Carroll County, GONORRHEA CASES Y MONTH REPORTED, CARROLL COUNTY, Year Rate

17 Disease Spotlight: Listeria Listeria 2015 Number of 2 Carroll County Rate (per 100,000 pop.) 7.1 Female Rate (per 100,000 pop.) 3.6 Male Rate (per 100,000 pop.) 3.6 FACTS: Of the two cases in Carroll County during 2015, one was a child under 5 years old, and one person was over 30 years old. EPIDEMIOLOGY: 7,8 Infectious agents: Listeria monocytogenes Case Definition: In adults, invasive disease caused by Listeria monocytogenes manifests most commonly as meningitis or bacteremia; infection during pregnancy may result in fetal loss through miscarriage or stillbirth, or neonatal meningitis or bacteremia. Other manifestations can also be observed. Isolation of L. monocytogenes from a normally sterile site. In the setting of miscarriage or stillbirth, isolation of L. monocytogenes from placental or fetal tissue Mode of Transmission: Most infections are acquired by ingestion of contaminated meat, vegetables, or unpasteurized dairy products. Incubation Period: 3-70 days with an estimated median of 3 weeks (21 days). Symptoms: Fever, Muscle aches, Sometimes nausea or diarrhea, Headache, stiff neck, Confusion, loss of balance or seizures may occur. Infection during pregnancy can lead to premature delivery, infection of the newborn or even stillbirth. Treatment: When infection occurs during pregnancy, antibiotics given promptly to pregnant women can often prevent infection of the fetus or newborn. abies with listeriosis receive the same antibiotics as adults. Even with treatment, some infections result in death. This is more likely in the elderly and in people with other serious medical problems. Prevention: Thoroughly cook raw meat, and keep uncooked meats separate from vegetables, cooked foods and ready-to-eat foods. Even a drop of raw meat juice can contaminate a surface, plate, or other food. Wash raw vegetables thoroughly before eating. Wash utensils and surfaces that touch raw foods. Avoid raw (unpasteurized) milk or milk products made from raw milk LISTERIA CASES, CARROLL COUNTY,

18 NUMER ILL THAT WEEK Featured Outbreak Investigations Unknown Gastrointestinal Illness at Camp Carroll County General Health District (CCGHD) was notified the weekend of July 18 th and 19 th 2015 by Seven Ranges Program Director of five (5) cases that was consistent with a GI illness. Public health staff interviewed scouts and troop leaders about recent illness, foods consumed, and activities they participated. The estimated number of exposed among the attendees of the camp was approximately 170 (100 were unable to be reached), with the number of primary ill being approximately seventy (70). There were approximately six (6) secondary cases of gastrointestinal (GI) illness reported by family members and troop leaders. These numbers do not portray an accurate count as some troop leaders may not have provided a numerical count; some stated few or several. The attendees for this reservation were from all over Ohio and seven (7) other states. The other states included North Carolina, Wisconsin, New York, Pennsylvania, Arkansas, West Virginia, and Massachusetts. The etiology at the output of the investigation was not known; however, with the number of people ill with GI symptoms from a common time and location, Norovirus was highly suspected. The range of the incubation was twelve (12) to forty-eight (48) hours with a median of twenty-four (24) hours; with the highest concentration between hours. Carroll County General Health District was notified by Ohio Environmental Protection Agency (EPA) that nine (9) of the twelve (12) water tests came back positive for total coliform; however, none were determined to be positive for E. coli. On July 31 st, 2015 CCGHD Epidemiologist was notified by Ohio Department of Health (ODH) that the samples submitted to ODH Lab tested negative for Salmonella, Shigella, Shiga toxin - producing E.coli (STEC), Campylobacter, and norovirus. On December 14 th, 2015 CCGHD Epidemiologist was notified by ODH that the results that were sent to Minnesota for further testing all tested negative for adenovirus, sapovirus, rotavirus, and norovirus GI/GII. Since all results came back negative the outbreak was closed as a GI outbreak of unknown etiology. Onset of Illness Week Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 WEEK ILL 18

19 Timeliness of Disease Reporting A key part of good public health practice is timeliness of disease reporting. 9 Requirements for each reportable disease vary based on the communicability and severity of the disease as to when they should be reported (see Know Your ACs on page 6 or class definitions on page 20). Using Ohio Disease Reporting Systems (ODRS) it is possible to query the date when a healthcare provider diagnosed an illness, onset date, and the date when the local health department received notification. Table 11 lists selected diseases and the corresponding median and mean numbers of days between healthcare provider diagnosis and reporting to the local health department. The reporting lag time is the difference between the date a case was reported to the local health department (LHD) and the case s diagnosis date. If the diagnosis date is blank, ODRS is defaulted to the date fields in the following order: lap specimen collection date, lab result date, onset date, date reported to ODH, or created date. For class A diseases (immediately reported), mean and median lag time values should be less than one (1). For class diseases, the lag time values should be less than two (2). Table 11: Reporting Lag Time for Selected Reportable Diseases, Carroll County, Reportable Condition Reporting Requirement # of Mean (Days) Median (Days) % of Missing Diagnosis Date E.coli O157:H7 y end of next business day 0 N/A N/A N/A Hepatitis A y end of next business day % Listeriosis y end of next business day % Measles Immediately 0 N/A N/A N/A Pertussis y end of next business day % Rubella Immediately 0 N/A N/A N/A Salmonellosis y end of next business day % In 2015 the median and mean lag times for E.coli O157:H7, Measles, and Rubella could not be calculated because there were no cases reported in Carroll County, since there were no cases of Measles or Rubella there were no class A cases. The class diseases listed above, Hepatitis A was the only one that did not meet the goal for mean (4.7 days) and median (4 days). The mean lag time goal for Listeria (1.5 days), Pertussis (0.5 days), and Salmonellosis (2 days) were either 2 or below; this meant that the reporting lag time met the goal. 19

20 Notes Ohio Administrative Code , , and require that communicable diseases be reported to local health departments. Case and Outbreak Classifications Case and outbreak definitions can be found in the Infectious Disease Control Manual, for reporting purposes in the state of Ohio. Reportable Disease Class Definitions 2 Reportable diseases in Ohio are grouped into three classes: Class A, Class, and Class C. Class A: Diseases are to be reported immediately upon recognition that a case, suspected case or a positive laboratory result exists. These are of major public health concern because of their ease of transmission and ability for epidemic spread. Class : Diseases are to be reported by the end of the next business day after the existence of a case, suspected case, or a positive laboratory result is known. These diseases also have public health concern needing timely response because of their potential for epidemic spread. Class C: Diseases are to be reported by the end of the next business day. Reportable Disease Changes in Ohio in 2015 Changes to Ohio Administrative Code ( ) went into effect on May 1, 2015: Ohio Department of Health has updated the document "Know Your ACs: A Quick Guide to Reportable Infectious Diseases". Additions: Middle East Respiratory Syndrome (MERS) as a Class A disease; Chikungunya virus infection under Arboviral Diseases (Class ) Enumerating the four Viral Hemorrhagic Fevers in Class A (Ebola virus disease, Lassa fever, Marburg hemorrhagic fever and Crimean-Congo hemorrhagic fever). Case Definition Changes in 2015 for Nationally Notifiable Diseases 10 Changes in 2015: arboviral diseases, neuroinvasive and non-neuroinvasive; campylobacteriosis; congential syphilis; dengue and dengue-like illness; haemophilus influenzae; hantavirus infection, nonhantavirus pulmonary syndrome; hantavirus pulmonary syndrome; meningococcal disease. Notes about Reporting Systems 11 The Ohio Disease Reporting System (ODRS) was developed to make disease reporting more timely and efficient for disease reporters (i.e. laboratories, physicians, hospitals), and to improve communication about infectious diseases between disease reporters, local departments of health (LHD), and the Ohio Department of Health (ODH). Currently, ODH, LHD, and infection preventionists have the ability to enter and update case and laboratory reports in ODRS. The system uses patient address to determine correct jurisdiction in which to send the report for follow-up and investigation. HIV/AIDS Data Carroll County HIV/AIDS data is sent to Stark County. Looking at the Ohio Department of Health HIV Infections Annual Surveillance statistics Carroll County has less than ten (10) cases total in the following three categories 12 : HIV infection (not AIDS), HIV infection and a later AIDS diagnosis, and HIV infection and AIDS. Since the numbers are so small and the results are sent to another county it is difficult to know the exact number of HIV/AIDS cases in Carroll County. 20

21 References 1. United States Census ureau, Population Division. Annual Estimates of the Resident Population for Counties: State and County QuickFacts. Data derived from Population Estimates, Last revised: 14 Oct Last Accessed: January 25, Ohio Department of Health. Infectious Disease Control Manual. Last Updated: 1 Jan Last Accessed: January 25, Centers for Disease Control and Prevention. Chlamydia CDC Fact Sheet (Detailed). Last Updated: November 17, Last Accessed: January 25, National notifiable Diseases Surveillance System (NNDSS). Centers for Disease Control and Prevention. Chlamydia trachomatis infection. Last Updated: Last Accessed: January 25, Centers for Disease Control and Prevention. Gonorrhea CDC Fact Sheet (Detailed). Last Updated: November 17, Last Accessed: January 25, National notifiable Diseases Surveillance System (NNDSS). Centers for Disease Control and Prevention. Gonorrhea (Neisseria gonorrhoeae). Last Updated: Accessed: January 25, National notifiable Diseases Surveillance System (NNDSS). Centers for Disease Control and Prevention. Listeriosis (Listeria monocytogenes). Last Updated: Last Accessed: January 25, Centers for Disease Control and Prevention. Listeria (Listeriosis). Last Updated: November 20, Last Accessed: January 25, Jajosky, RA, and Groseclose, SL. Evaluation of reporting timeliness of public health surveillance systems for infectious diseases. MC Public Health. 26 Jul Centers for Disease Control and Prevention. National Notifiable Diseases Surveillance System (NNDSS) Search Results for Conditions. Last Updated: December 17, Last Accessed: January 25, Ohio Department of Health. Ohio Disease Reporting System. Last Updated: January 1, Last Accessed: January 25, Ohio Department of Health. State of Ohio HIV Infections Annual Surveillance Statistics. Last Updated: October 19, Last Accessed: January 25,