10/17/13 — Salmonella tops communicable disease list in Wayne

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Salmonella tops communicable disease list in Wayne

By Phyllis Moore
Published in News on October 17, 2013 1:46 PM

Keeping track of communicable diseases is an intense job, the director of the program told the Wayne County Board of Health.

"Communicable disease is a core public health function and public health provides education, prevention surveillance and outbreak investigation," Josa Raynor-Vaughn said. She is the communicable disease program manager at the county Health Department.

Her office handles a laundry list of reportable incidents -- from sexually transmitted diseases and tuberculosis to West Nile Virus and salmonella, she said.

According to the state's statutes, any licensed physician who sees or is consulted about someone with a communicable disease or condition on the reportable list of incidents is required to notify the local health director, county or district where it occurs. Conditions are also reported by health care providers, laboratories, infection control practitioners, school nurses, medical examiners and organ donation centers.

She shared with the board an overview of the program's statistics for 2012-13.

On the general communicable disease report, in addition to five cases of strep, two cases of Rocky Mountain Spotted Fever, and one each of West Nile infection, malaria and Hepatitis A, the most prevalent category was salmonella, with 21 cases, she said.

"In E Coli, we had one and we had one adult death last year for influenza," she said, along with seven cases of Hepatitis B -- chronic and one case of Hepatitis B -- acute.

Not everything makes the list, however.

"We get a lot of things that are reported to the Health Department," she told the board. "People going to the doctor are symptomatic but then it comes back tested and negative. We do get a lot of reports, I don't call them false but they're not confirmed in the laboratory."

Sexually transmitted disease still remains a community concern, with chlamydia still the No. 1 STD in Wayne County, followed by gonorrhea, she said.

Between Jan. 1, 2012 and last week, she said there have been 1,428 cases of chlamydia and 369 cases of gonorrhea.

An estimated 5,139 clients were scheduled to be seen in the Health Department's STD clinic, but the no-show rate was calculated at 40 percent. Ultimately, she said, 3,589 clients were seen between July 1, 2012 through June 30, 2013. There included 957 males and 2,632 females.

Board member Joe Daughtery asked how the department responds to no-shows, and Ms. Raynor-Vaughn replied that staff makes attempts to follow-up by making contact and rescheduling those patients.

Another problem, though, is in the collection of statistic data.

"The state is a little behind. They're like a year behind (in reporting numbers) from HIV and syphilis," she said.

She could provide local numbers, however. For the current fiscal year, Wayne County had a total of seven diagnosed cases of HIV. As of Dec. 31, 2011, an estimated 276 people in this county are living with HIV and AIDS, she said.

"Wayne County ranks 22 in the number of people with HIV and AIDS, as of 2011," she said.

According to the state 2011 HIV/STD Surveillance Report, the highest number of cases are the larger populated areas. Mecklenburg County had the most, with 4,715. Cases in surrounding counties were 342 in Wilson, 255 in Lenoir, and 167 in Duplin.

Tuberculosis also remains a concern, with nine cases reported in Wayne County from Jan. 1, 2012 to date.

"Three were female and six were male and six of them were African-American and three of them were what we call white Hispanics," Ms. Raynor-Vaughn said.

"Does that include incarcerated?" Health Director Davin Madden asked.

"No, that does not include incarcerated," Ms. Raynor-Vaughn replied. "We have one client. He's at Cherry Hospital but he came from another county. They have a TB unit at Cherry Hospital. He's there for what we call public health law violation.

"We also have quite a few people with what we call latent TB infection. They don't have TB but they have a skin test and chest x-ray is positive. We have about 17 of those that we're currently treating."