Utah communicable disease report, 2019

Introduction

The Utah communicable disease report 2019 is a web-based report. You can navigate through the different chapters by using the tabs and dropdown menus at the top of the screen.

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Acknowledgements

The The Department of Health and Human Servies (DHHS) recognizes the efforts of local health department (LHD) personnel throughout the state who play a critical role in data collection and case investigation; their work allows for accurate and timely reporting of communicable disease data.

DHHS also recognizes the efforts of other reporting partners, including laboratories, healthcare facilities, healthcare providers, and the public, in the provision of communicable disease data that have contributed to this report.

Reportable communicable disease data for Utah are published by the Utah Department of Health and Human Services, Office of Communicable Diseases.

Please direct questions or comments to:

DHHS Office of Communicable Diseases
PO Box 142104
Salt Lake City, Utah 84114
Phone: (801) 538-6191
Email:
Website: www.health.utah.gov/epi

Preface

The Communicable disease annual report for Utah, 2019 contains data related to Utah’s reportable diseases and conditions reported in Utah for 2019. The data reported are collected from Utah’s local health departments (LHDs), laboratories, healthcare providers, hospitals, and other healthcare facilities. The Utah Department of Health and Human Services (DHHS) tracks more than 75 communicable diseases in Utah annually. Each case of disease is investigated in collaboration with the LHDs.

The Highlights section presents noteworthy epidemiologic information from 2019 for selected diseases and additional information to aid in the interpretation of surveillance data. Incidence data (new cases of reportable conditions in 2019), historical 5-year averages, and the incidence rates are presented in [State Disease Activity] table. In addition, a summary of cases of reportable disease by LHD is presented in the Jurisdiction disease activity section, and historical case counts and rates are presented in Yearly disease comparison section. Cases are counted by the year the disease occurred as determined by the Morbidity and Mortality Weekly Report (MMWR) week assigned by the Centers for Disease Control and Prevention (CDC).

Important note about influenza

Throughout this report, influenza data are presented in the year the influenza season ended, and represent data for the CDC defined influenza season. Influenza season typically begins in October and surveillance extends through May of the following year. For example, data presented for the year 2019 is indicative of data collected from the 2018–2019 influenza season. This type of data presentation provides accurate measures for annual influenza activity. Sporadic cases of influenza that occur outside of the traditional influenza season are assigned to the previous season (i.e., an influenza case reported in August of 2018 would be assigned to the 2016–2017 influenza season). This report reflects activity for the 2018–2019 influenza season. More information on influenza activity in Utah can be found here.

Background

Utah established a multidisciplinary approach to communicable disease control and includes prompt reporting, data analysis, data interpretation, case investigation, identification of common risk factors, treatment, and implementation of disease prevention interventions. The successes of medicine and public health have dramatically reduced the risk of illnesses, hospitalizations, and deaths due to infectious agents during the 20th century. However, emergence of new diseases and the rapid spread of diseases globally, made possible by advances in transportation, trade, food production, and other factors, highlight the continual threat to health from infectious diseases. Attention to these threats and cooperation among all healthcare providers, government agencies, and other entities who are partners in protecting the public’s health are crucial to maintain and improv the health of Utah’s citizens. 1

CDC expresses the important role surveillance plays in protection of the public’s health as follows:

“Case-reporting of reportable diseases at the local level protects the public’s health by ensuring the proper identification and follow-up of cases. Public health workers ensure that persons who are already ill receive appropriate treatment; trace contacts who need vaccines, treatment, quarantine, or education; investigate and halt outbreaks; eliminate environmental hazards; and close premises where spread may occur. Surveillance of notifiable conditions helps public health authorities monitor the effect of notifiable conditions, measure disease trends, assess the effectiveness of control and prevention measures, identify populations or geographic areas at high risk, allocate resources appropriately, formulate prevention strategies, and develop public health policies. Monitoring surveillance data enables public health authorities to detect sudden changes in disease occurrence and distribution, identify changes in agents and host factors, and detect changes in health-care practices.”2

Reportable communicable diseases in Utah, 2019

Reportable communicable diseases in Utah, 2019 3

Acinetobacter species with resistance to carbapenems

Acute flaccid myelitis

Acquired immunodeficiency syndrome (AIDS)

Adverse event resulting from smallpox vaccination

Anaplasmosis

Anthrax

Arbovirus infection, including Saint Louis encephalitis and West Nile virus

Babesiosis

Botulism

Botulism, infant

Brucellosis

Campylobacteriosis

Chancroid

Chickenpox

Chlamydia trachomatis infection

Cholera

Coccidioidomycosis

Colorado tick fever

Creutzfeldt-Jacob disease and other transmissible human spongiform encephalopathies

Cryptosporidiosis

Cyclosporiasis

Dengue fever

Diphtheria

Ehrlichiosis, human granulocytic, human monocytic, or unspecified

Encephalitis

Enterobacter species with resistance or intermediate resistance to carbapenems

Escherichia coli with resistance or intermediate resistance to carbapenems

Giardiasis

Gonorrhea

Haemophilus influenzae, invasive disease

Hansen’s disease (Leprosy)

Hantavirus pulmonary syndrome

Hemolytic uremic syndrome, post-diarrheal

Hepatitis A

Hepatitis B, cases and carriers

Hepatitis C, acute and chronic

Hepatitis, other viral

Human immunodeficiency virus (HIV) infection

Influenza-associated hospitalization

Influenza-associated pediatric death

Klebsiella species with resistance or intermediate resistance to carbapenems

Legionellosis

Listeriosis

Lyme disease

Malaria

Measles

Meningitis (aseptic, bacterial, fungal, parasitic, protozoan, and viral)

Meningococcal disease

Mumps

Mycobacteria other than tuberculosis

Norovirus

Pertussis (whooping cough)

Plague

Poliomyelitis, paralytic

Poliovirus infection, nonparalytic

Pregnancy associated with hepatitis B, hepatitis C, HIV, Listeria, rubella, syphilis, or Zika virus infection]

Psittacosis

Q fever

Rabies, human and animal

Relapsing fever, tick-borne and louse-borne

Rubella

Rubella, congenital syndrome

Salmonellosis

Severe acute respiratory syndrome (SARS)

Shiga toxin-producing Escherichia coli (STEC) infection

Shigellosis

Smallpox

Spotted fever rickettsioses, including Rocky Mountain spotted fever

Staphylococcus aureus with resistance (VRSA)

Streptococcal disease, invasive, including:
Streptococcus pneumoniae and groups A, B, C, and G
streptococci isolated from a normally sterile site

Syphilis, all stages and congenital

Tetanus

Toxic-shock syndrome, staphylococcal or streptococcal

Trichinellosis

Tuberculosis

Tularemia

Typhoid, cases and carriers

Vibriosis

Viral hemorrhagic fevers, including Ebola, Lassa, Marburg, and Nipah virus-related illnesses

Yellow fever

Zika virus

Highlights

The following are summaries for selected communicable diseases which are intended to highlight conditions that had notable incidence, outbreaks, or other factors.

Select Disease Highlight

Influenza-associated hospitalization

Seasonal influenza outbreaks are a major cause of morbidity (disease) and mortality (death) each winter influenza season. Influenza-associated hospitalization is a reportable condition in Utah and includes people who have been hospitalized (for any length of time) and have a positive influenza diagnostic test. This report contains information for the 2018–2019 influenza season that ran from October 6, 2018 to May 18, 2019. During the 2018–2019 season, influenza activity peaked during early February, 2019. The total number of influenza-associated hospitalizations, 1,791, was second-highest out of the previous 5 years, behind the 2017–2018 season. Adults older than 65 had the highest percentage of influenza-associated hospitalizations (40.4%). Rates of Influenza-associated hospitalizations per 100k population were highest among adults age 65 and older (216), followed by 50–64 (83) and 0–4 (83). The 2018–2019 was also above average in reported outpatient influenza-like illness, which also peaked in early February 2019 and was the second highest in the previous 5 years. The predominant influenza virus early was influenza A H1N1 from October 6 to February 10. After February 10, influenza A H3N2 was the predominant virus, making this an unusually long influenza season.

Botulism, foodborne

In January 2019, the Utah Department of Health and Human Services(DHHS) was notified of a case of foodborne botulism. Upon further investigation, it was determined that the patient also had a family member who likely had botulism in November 2018 but was misdiagnosed and did not receive antitoxin. Both patients had eaten home canned green beans that later tested positive for botulism toxin. These were the first cases of foodborne botulism in Utah since 2015.

Tyfoid fever

Typhoid fever is a rare but serious condition most often acquired outside of the United States. Utah typically sees 1 to 2 cases of typhoid fever per year. In 2019, DHHS identified 7 cases of typhoid fever. Investigators determined that 6 of the 6 cases were most likely due to travel in Central or South America. No source of infection was identified for the last case.

Overall state disease activity

Top diseases of 2019

The top 5 highest disease counts in the state of Utah were:

  1. Chlamydia with 11,071 cases.
  2. Gonorrhea with 2,872 cases.
  3. Influenza-associated hospitalization with 1,804 cases.
  4. Hepatitis C, chronic with 1,427 cases.
  5. Campylobacteriosis with 582 cases.

2019 State disease table

The State Disease Table includes the 2019 Count4, previous 5-Year count average5, Utah 2019 rate6, and the disease trend7.

Yearly disease comparison

Yearly disease counts (Table)

Yearly disease counts8

Yearly disease rates per 100,000 people (Table)

Yearly disease rates9, 10

Disease by type

Enteric (intestinal) diseases

Enteric diseases are commonly caused by micro-organisms that enter the body through the mouth through contaminated food or water, contact with animals or their environments, or contact with the feces of another infected human. For more information about enteric diseases, see the CDC website.

The top 5 enteric diseases of 2019

Diseases highlighted in green indicate those diseases that were also in the top five confirmed cases across all reportable communicable diseases in Utah.

Vaccine-preventable diseases & viral hepatitis

Vaccine-preventable diseases (VPD) are infectious diseases that can be prevented by vaccines. For more information on VPDs, see the CDC webpage.
Hepatitis is inflammation of the liver and is often caused by a virus. For more information, see the CDC webpage for viral hepatitis.

The top 5 VPDs/hepatitis infections, 2019

Diseases highlighted in green indicate those diseases that were also in the top five confirmed cases across all reportable communicable diseases in Utah.

Zoonotic diseases

Zoonotic diseases are caused by infectious organisms (bacteria, viruses, parasites) spread to humans from animals, often through vectors such as ticks and mosquitoes. More information can be found on the CDC zoonotic webpage.

The top 5 zoonotic diseases, 2019

Diseases highlighted in green indicate those diseases that were also in the top five confirmed cases across all reportable communicable diseases in Utah.

Invasive diseases and general reportable diseases

Invasive diseases are those in which the infectious agents (e.g., bacteria) infect parts of the body normally free from germs, such as the bloodstream or cerebrospinal fluid. For more information, see the CDC webpage

The top 5 invasive and other diseases, 2019

Diseases highlighted in green indicate those diseases that were also in the top 5 confirmed cases across all reportable communicable diseases in Utah.

Healthcare-associated infections

Healthcare-associated infections (HAIs) include illnesses such as central line-associated bloodstream infections, catheter-associated urinary tract infections, and ventilator-associated pneumonia. Infections may also occur at surgical sites. The DHHS works with healthcare facilities to monitor and prevent these infections and improve patient safety.

The top 5 healthcare-associated infections, 2019

Diseases highlighted in green indicate those diseases that were also in the top 5 confirmed cases across all reportable communicable diseases in Utah.

Sexually transmitted diseases

Sexually transmitted diseases (STDs) are very common and are passed from 1 person to another through sexual activity including vaginal, oral, and anal sex.

The top 5 sexually transmitted diseases of 2019

Diseases highlighted in green indicate those diseases that were also in the top 5 reported cases across all reportable communicable diseases in Utah.


  1. Utah Division of Administrative Rules. Utah Administrative Code Rule R386-702, Communicable Disease Rule. Available at: https://rules.utah.gov/publicat/code/r386/r386-702.htm ↩︎

  2. Centers for Disease Control and Prevention (2014). Summary of Notifiable Diseases–United States, 2012. Morbidity and Mortality Weekly Report (MMWR), 61(53). Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6153a1.htm↩︎

  3. Disease reporting is mandated by state legislation and administrative code. This list reflects the diseases, illnesses, and conditions to be of concern to the public health and reportable as specified in the Utah Administrative Code Rule R386-702, and required or authorized by Section 26-6-6 and Title 26, Chapter 23b of the Utah Health Code for the year 2019. The list of reportable diseases and conditions in Utah is revised periodically. A disease may be added to the list as a new public health threat emerges, or a disease may be removed as its incidence declines.↩︎

  4. Count is the total disease count in 2019. For influenza, count is the total disease count in the 2017–2018 influenza season↩︎

  5. The average disease counts for the 5 years prior to 2019↩︎

  6. The rate indicates infections per 100,000 population. Caution should be used when interpreting rates in italics; the estimate has a relative standard error greater than 30% and does not meet DHHS standards for reliability.↩︎

  7. Changes in trend are based on statistical significance (using a p-value of 0.10), i.e., higher or lower than the 5-year average.↩︎

  8. Note about hepatitis B and hepatitis C: From 2014–2016, only confirmed cases were reported; in 2017–2019 confirmed and probable cases were reported.↩︎

  9. Rates are defined as infections per 100,000 population. Caution should be used when interpreting rates listed in italics. The estimate has a relative standard error greater than 30% and does not meet the DHHS standards for reliability.↩︎

  10. Note about hepatitis B and hepatitis C: From 2014–2016, only confirmed cases were reported; in 2017–2018 confirmed and probable cases were reported.↩︎