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CLINTON ADMINISTRATION WORKS TO HELP PROTECT THE PUBLIC HEALTH FROM RECENT INFECTIOUS DISEASE OUTBREAKS

Release Date: 09/16/99
Contact Information:

Department of Health and Human Services

Thursday, September 16, 1999

Contact: CDC Press Office: 404-639-3286
EPA Communications: 202-260-9828


CLINTON ADMINISTRATION WORKS TO HELP PROTECT
THE PUBLIC HEALTH FROM RECENT INFECTIOUS DISEASE OUTBREAKS


Overview: The Clinton Administration has made helping states deal with the serious public health concerns of infectious disease outbreaks a priority. The Administration is providing necessary assistance to New York City as it deals with a St. Louis encephalitis outbreak and to Illinois and New York as they deal with two separate E. coli outbreaks. Additionally, the Centers for Disease Control and Prevention (CDC), Environmental Protection Agency (EPA) and other federal health agencies will build upon existing outreach efforts, enhancing existing public education initiatives. EPA also will release guidance to states on accessing available funding for water monitoring.

St. Louis encephalitis: This disease is passed on to humans through mosquitoes, which are particularly prevalent in wet areas. Since 1964, 4,478 human cases of St. Louis encephalitis have been reported in the United States, with an average of 128 cases reported annually. Infection occurs within 5 to 15 days, with mild infections sometimes showing no other symptoms besides fever with headache.

More severe infection is marked by headache, high fever, neck stiffness, stupor, disorientation, coma, tremors, occasional convulsions (especially in infants) and spastic (but rarely flaccid) paralysis. No specific treatment exists for St. Louis encephalitis. Young children, the elderly and others with compromised immune systems should be especially careful.

The disease does not spread easily. It cannot be passed from person to person, only from infected birds to Culex mosquitoes and from mosquitoes to humans. Even if a person is bitten by an infected mosquito, only a small proportion of persons infected develop severe disease.

Since the first instances of disease were reported, public health officials in New York City have identified 11 cases of St. Louis encephalitis and three deaths due to the disease.

E. coli: Thousands of people are infected by E. coli 0157:H7 in the United States each year. Infection often leads to bloody diarrhea and occasionally to kidney failure. Most illness has been associated with eating undercooked, contaminated ground beef. Person-to-person contact in families and child care centers is also a common mode of transmission. Infection also can occur after drinking raw milk and after swimming in or drinking water contaminated with sewage or animal waste.

E. coli 0157:H7 is one of hundreds of strains of the bacterium Escherichia coli. Although most strains are harmless and live in the intestines of healthy humans and animals, this strain produces a powerful toxin and can cause severe illness. The combination of letters and numbers in the name of the bacterium refers to the specific markers found on its surface and distinguishes itself from other types of E. coli.

Recent outbreaks of E. coli in Illinois and New York have potentially infected hundreds of people and have been linked to the deaths of two people in New York. Currently, public health officials suspect that the outbreak in New York is due to water-borne E. coli infection. Illinois is conducting a study to determine the mode of transmission.

FEDERAL ACTION TO CONTROL THE SPREAD
OF ST. LOUIS ENCEPHALITIS IN NEW YORK CITY

Providing technical assistance to local public health officials. CDC is providing laboratory support and working with the city and state to independently confirm the presence of the disease and accurately track the extent of the outbreak. On Sept. 2, CDC received blood samples from the New York City Department of Health from the first possible cases of encephalitis. On Sept. 3, the CDC analysis of the sample confirmed the diagnosis of St. Louis encephalitis and immediately provided consultation with appropriate intervention.

Sending a team of scientists to provide on-the-ground support. Once the outbreak was confirmed, CDC immediately sent a team of scientists, including epidemiologists, entomologists and wildlife biologists to provide on-site staff support to local public health officials. CDC, together with experts from the New York City and state Department of Health, have recently isolated a potential breeding site for the carrier mosquitoes and have already begun appropriate interventions.

Assisting New York City to implement a safe, effective mosquito control program. EPA will work with local public health officials to provide technical assistance as they implement a mosquito control campaign, including providing information on the appropriate application of insecticides in New York City.
Educating the public about how to prevent infection and the public health necessity of launching a mosquito control campaign. CDC is working with local public health officials as they educate the public about preventing infection. EPA also is fielding hundreds of questions from the public about the mosquito control sprays being used in New York City. The agency will assist local public health officials by providing guidance about how to conduct an intensive education and safety campaign to notify the public about all aspects of the spraying. In addition, EPA has expanded its toll-free pesticide hotline number (1-800-858-7378) hours and has the line operational seven days a week to answer questions about the spraying.

FEDERAL ACTION TO ENHANCE
E. COLI RESPONSE TO OUTBREAKS IN ILLINOIS AND NEW YORK

Providing on-the-ground support to local public health officials. Two federal Epidemic Intelligence Service Officers from CDC are on-site in New York and are providing technical assistance in Illinois.

Supporting local public health officials with scientific expertise and technical assistance. CDC is providing laboratory support and working with the city and state to independently confirm the presence of the diseases and accurately track the extent of the outbreak.

In addition, federal health agencies are building upon existing federal and state efforts to address the spread of waterborne E. coli infection by:

· Enhancing public education efforts on preventing E. coli infection. EPA has expanded its efforts to ensure that the public is provided with the information it needs to protect against deadly strains of E. coli. EPA’s drinking water hotline (1-800-426-4791) specifically responds to the public’s questions and concerns about possible water contamination in local communities. In addition, the agency will update its website and link to other sites to provide information on waterborne E. coli,including, the early warning sings of infection and information on state-certified laboratories where homeowners can have their private wells tested.
· Enhancing public education efforts on waterborne E. coli. Federal health agencies will increase efforts to develop and distribute information for health care providers and clinical laboratories on the early diagnosis and treatment of infection with life-threatening strains of waterborne E. coli.
· Providing new guidance to states on accessing federal funds for water monitoring. EPA will issue guidance to states on how to access existing federal funds to improve their current water monitoring systems.

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