KDHE Home - Division of Health - OSE - Table of Contents 1996
Kansas Department of Health and Environment
INTRODUCTION
Purpose and format of this report
This is the fifth annual summary of reportable diseases by the Kansas Department
of Health and Environment. The purpose of the report is to provide useful information
on notifiable diseases in Kansas for health care providers, public health workers
and policy makers.
The report is divided into two sections. Section I presents summaries of 38 diseases or conditions of public health importance. Data are presented mainly by graphs and statistics. Rates have been calculated to adjust for population size allowing for more meaningful interpretation of the data. Rates by demographic characteristics and proportional changes from last year are reported when there were more than 50 cases of a disease reported in the state. If the total number of cases in the state was <4, then no demographic information is presented (to ensure confidentiality of the patients). Whenever possible, information on disease trends for the United States has been included for comparison with Kansas trends.
Disease incidence for urban and rural areas has also been included for most diseases. Urban counties were defined as counties with a population density of 150 or more persons per square mile, and represent the four largest metropolitan areas in the state [Kansas City (Johnson and Wyandotte Counties), Wichita (Sedgwick County), Topeka (Shawnee County), and Lawrence (Douglas County)], which account for 48% of the population. The remaining 100 counties in the state are classified as rural for the purposes of this report.
Section II provides the list of reportable diseases during 1996, a summary of cases of reportable diseases by year for 1983-1996, and a summary of cases by county for 1996. Also included are a list of county abbreviations for use with Table 2, a map of Kansas with county names, and a list of publications on disease control from KDHE in 1996.
Disease reporting in Kansas
Selected diseases are reportable by law in Kansas by health care providers,
laboratories and hospitals (Section II, Table 1). Reports are usually first
sent to the local health department, which is responsible for providing basic
public health interventions such as providing immune globulin to a household
contact of a person with hepatitis A or treating sexual contacts of a person
with gonorrhea.
Reports are then sent to the Office of Epidemiologic Services or the Bureau of Disease Prevention and Health Promotion in the Kansas Department of Health and Environment for review. After reports have been entered into the National Electronic Telecommunications System for Surveillance (NETSS), weekly summaries are forwarded to the Centers for Disease Control and Prevention (CDC) for inclusion in the Morbidity and Mortality Weekly Report. The final step in the surveillance system occurs when CDC sends selected data to the World Health Organization.
Local, state, national and international health agencies that collect surveillance data are responsible for analyzing and interpreting the data. The information is used for planning, implementing and evaluating public health programs. Surveillance data can be used to determine the need for public health action and to assess the effectiveness of programs.
Important disease trends in 1996
The number of vaccine-preventable diseases remained low with no cases of polio,
rubella or diphtheria reported. Measles, mumps, and Haemophilus influenzae meningitis
remained at low levels. Even with the decline in pertussis and hepatitis B,
these diseases are still problematic.
Cases, and rates for the three major sexually transmitted diseases (chlamydia, gonorrhea and syphilis) continued to decline in 1996. Chlamydia continues to be the most commonly reported STD in the state, with 91 of 105 counties reporting at least one case during the year. Despite an increased number of screening sites and persons screened, chlamydia cases declined by 16% and gonorrhea by 27% compared to 1995. Both infections are the leading causes of preventable infertility, pelvic inflammatory disease and ectopic pregnancy. The number of primary and secondary cases of syphilis declined by 40% compared to last year, marking the fourth consecutive yearly decrease. Of notice is a change in the age distribution of syphilis cases: most cases occurred in patients 15-24, who in 1995 represented only the third most common age group diagnosed with syphilis. No cases of congenital syphilis were reported for the year.
The number of reported Kansas AIDS cases in 1996 (135) showed a decrease over those reported in 1995 (286). This decrease may have been due to delayed progression from HIV to AIDS as a result of improved drug therapy, an increased delay of reporting, and/or a decrease in the number of HIV cases. The decrease mirrors similar trends at the national level.
The number of reported tuberculosis (TB) cases in 1996 (73) showed an 18% decrease from 1995 (89). The case rate for TB decreased from 3.5 per 100,000 to 2.8 per 100,000, well below the national average. Forty percent of cases occurred among foreign-born individuals. This was the first decrease in Kansas TB case rates since 1992. While the dropping case rate for TB in Kansas is encouraging, increases in drug resistant TB remain a cause for concern. Resistance to at least one drug rose from 10% of all cases in 1995 to 18% in 1996. In addition, 2 cases of multi-drug resistance (i.e., resistance to INH & rifmpin combined) were reported in 1996, while no cases were reported in 1995.
The number of Hepatitis A cases increased by 143% compared to 1995. Different outbreaks in several parts of the State (mostly in the East) accounted for most of the increase.
Enteric infections (salmonellosis, shigellosis and giardiasis) continued to be reported in large numbers. Reports of E. coli O157:H7, which became reportable in January 1996, continued to increase. Two outbreaks of foodborne illness were reported and formally investigated by Office of Epidemiologic Services during the year. One outbreak was attributed to Norwalk-like virus. In the other outbreak, no causative agent was identified.
Interpreting the data
When interpreting the data in this report it is important to remember that disease
reporting is incomplete and often varies by disease. For example, reporting
of AIDS cases is very good whereas reporting of chickenpox is poor. Absolute
numbers are less meaningful than trends when interpreting the data. However,
trends can be influenced by changes in case definitions or in reporting patterns.
It is also important to note that since 59% (62/105) of counties in Kansas have
populations less than 10,000, it is possible to have high rates of disease in
these counties even if only one case is reported.
Acknowledgments
We would like to thank all the physicians, nurses, hospitals, laboratorians,
county health department staff and others who participated in reportable disease
surveillance during 1996. We would also like to acknowledge the Bureau of Disease
Prevention and Health Promotion staff for their support.