Title: Florida Emergency Workers Teach Bioprep To Young Students
Date: June 4, 2012
Source: BioPrepWatch

Abstract: First responders from Hernando County, Florida, recently taught students about bioterrorism, emergency response and weapons of mass destruction during a two day event held at a local elementary school.

Teachers at the Challenger K-8 School of Science and Mathematics received special training from Hernando Fire Rescue and the Hernando hazardous response team that focused on what their jobs entail, according to TampaBay.com.

The emergency crews watched PowerPoint presentations and videos with the students, and some students were even selected to enter a decontamination chamber.

“We learned about how you can get hazardous materials off your body,” student Brooke Fielder said, TampaBay.com reports. “You can either dilute it, absorb it, (use a) power wash and (go into) isolation.”

In a lesson on cross-contamination, students innocently passed around a helmet that had been covered in a substance that glowed in the dark, but was invisible under normal light. When a black light was turned on, the students were able to see how a seemingly innocuous object could potentially harm everyone that came into contact with it.

The lessons fit into the students’ curriculum by covering benchmarks for science, including the study of toxins, infectious diseases and other pathogens. The students were also assigned to read “Code Orange,” a book about a smallpox outbreak (BioPrepWatch, 2012).

 Florida Closes Only Tuberculosis Hospital Amid Worst US Outbreak In 20 Years
Date: July 9, 2012
Source: Guardian

Abstract: Health officials in Florida hastened their closure of the nation's only dedicated tuberculosis hospital on cost-cutting grounds as one of the worst outbreaks of the deadly disease in 20 years was taking a grip on the state, it has been revealed.

At least 3,000 people in Jacksonville may have been exposed to the highly contagious respiratory illness that claimed 13 lives in the city and left another 100 sick in the last two years, a report from the Atlanta-based Centers for Disease Control and Prevention (CDC) concluded.

But news of the severity of the outbreak never reached Florida's politicians, who voted in March to bring forward the closure of the 100-bed AG Holley state hospital in Lantana by six months to July 2.

As a result, patients once deemed too sick for contact with the public were released into the community and others newly diagnosed with the disease, mostly from the homeless population, are being put up in local motels in an effort to keep them on their medications.

"The high number of deaths in this outbreak emphasises the need for vigilant active case finding, improved education about TB, and ongoing screening at all sites with outbreak cases," states the report written by Robert Luo, a senior doctor with the CDC's epidemic intelligence service, and obtained by the Palm Beach Post following a public records request.

The CDC confirmed it was one of the worst outbreaks of TB anywhere in the United States for at least two decades.

Meanwhile, the Florida department of health expects to save up to $10m a year by closing AG Holley, which had treated patients with the most severe cases of the disease since 1950. The hospital discharged its last patients a week ago.

In a statement, the department defended the closure, insisting that patients in need of hospitalisation would receive adequate care at public hospitals in Miami and Jacksonville, which also agreed to take some of the most severe AG Holley cases.

"We move into the future with confidence that these patients will receive continued high quality care in settings closer to their communities," said Dr John Armstrong, Florida's surgeon general.

Yet before the closure was announced the department always claimed that patients admitted to AG Holley "cannot be treated and cured in the community".

In its 2013 health plan, it stated: "All of AG Holley's patients have failed treatment in their communities or have been diagnosed as medically complex requiring specialised care and treatment."

Of the patients discharged last week, 18 were released into the care of their own doctors, supervised by their county health departments. The state health board said that declining cases of TB statewide, 753 in 2011, a 10% decrease on the previous year, justified the hospital's closure.

Opponents have demanded an investigation by Florida governor Rick Scott, saying that the hospital's closure was rushed and that the need for a purpose-built facility with rooms with individual air and water systems to combat virulent airborne diseases was greater than ever.

Maria Lorts Sachs, a state senator who represents Lantana and a vocal long-term supporter of the hospital, told the Guardian: "Who knows how the vote would have been impacted by knowledge of this outbreak?

"It's a serious thing when a major fact is withheld from us. There needs to be an inquiry into whoever kept this secret and there needs to be an inquiry into why there was such a rush to close the hospital. The governor should stop everything, stop the closure and have a review. This is a dangerous thing and we need to make sure our people are safe."

The CDC's investigation into the Jacksonville outbreak revealed that only 253 people from about 3,000 exposed to the infection in Duval County's homeless shelters, prisons and mental health clinics had been traced and tested.

Effective treatment often requires regular, long-term uses of drugs, which officials acknowledge is often difficult to administer. If medications are not taken regularly, strains of the disease can become drug-resistant.

Charles Griggs, spokesman for the Duval County health department, said: "Since the identified outbreak cluster is primarily concentrated within at-risk individuals in Jacksonville's homeless community, we are concentrating our efforts in the most impacted areas of need.

"We are also trying to guard against the further negative stigmatisation of an already challenged population. There is no evidence to suggest that the identified cluster outbreak has had a significant impact on the local general population.

"The closure of AG Holley has very little impact on our local outbreak. Over the past two years, DCHD has been engaged in active TB outreach screenings at various locations that service our local homeless community.

"No patient who requires the level of treatment and care associated with hospitalisation are housed at local motels. Only low-risk clients who may require directly observed therapy as treatment are potentially housed in motels" (Guardian, 2012).

Title: Florida Parish Conducts Anthrax Exercise
Date: July 27, 2012
Source: BioPrepWatch

Abstract: More than 100 first responders and volunteers recently participated in an anthrax release response drill held in Amite, Florida.

The Tangipahoa Parish Office of Homeland Security organized the exercise, which was funded by a grant acquired through the federal government. Representatives from the U.S. Centers for Disease Control and Prevention were on hand to evaluate the results, according to HammondStar.com.

Tangipahoa President Gordon Burgess said that he wants everyone in the parish to be prepared for a possible pandemic and was pleased with how the exercise played out.

“In the event that we do have such an outbreak, whether it is anthrax or whatever, we want to be prepared as best we can,” Burgess said, HammondStar.com reports. “This small drill is something that we’re hoping never happens in reality. It was just something we needed to do. Hopefully we’ll never need it, but we want to be prepared for it.”

Kevin Davis, the director of the Governor’s Office of Homeland Security and Emergency Preparedness, said that the exercise was well organized and worthwhile.

“It’s a great opportunity to be able to actually deploy and get the folks responsible involved,” Davis said, HammondStar.com reports. “A lot of people ask why we’re doing this, but you always have to be prepared. It’s very important that everybody knows what their roles are” (BioPrepWatch, 2012)

Title: Hillsborough County Health Officials Issue Vibrio Vulnificus Warning
Date: August 16, 2012
Global Dispatch

Abstract: The death of two Hillsborough County, Florida residents has prompted health officials to issue a warning about a potentially deadly bacterial infection contracted from eating raw or undercooked oysters or swimming in local waters with open wounds.

According to a BayNews9 report Tuesday, in addition to the two fatalities, the Hillsborough County Health Department (HCHD) said an additional five other cases of Vibrio vulnificus have been reported in the county.

Throughout the Tampa Bay area and the state of Florida, raw oyster bars are everywhere and the places are packed with patrons. However for a certain group of people, the bacterium that lurks in the oyster can cause a rapid and extremely serious illness.

As the summer comes and the waters start getting warmer, the waters where oysters, clams, crabs and finfish are harvested appear to become more concentrated with Vibrio vulnificus.

Vibrio vulnificus is a bacterium that is found in all coastal waters of the United States. It has also been found in brackish waters of some interior states. It may be normal flora in salt water and acquiring this organism from shellfish or water exposure does not imply that the water is contaminated by sewage. Most infections that happen are attributed to consuming raw oysters harvested in the Gulf of Mexico during the summer. Because the oysters are shipped all over the country, infections are not limited to the Gulf States.

Oysters are sedentary bivalve mollusks that feed by filtering plankton (small plants and animals) from estuarine water. Because Vibrio vulnificus occurs naturally in the same waters that oysters feed, the bacteria is ingested and becomes assimilated and concentrated in the animal’s tissues.

Healthy, non at-risk individuals are not at risk for serious infection. Non at-risk patients with gastroenteritis have a relatively mild illness consisting of vomiting, diarrhea and abdominal cramps and rarely require hospitalization.

However there are certain medical conditions that can put you at risk for very rapid, serious and possibly deadly disease. Individuals with diabetes, liver disease like cirrhosis, leukemia, AIDS or those who take immunosuppressive drugs or steroids are particularly susceptible to primary septicemia, a serious “blood poisoning”. In these individuals the bacteria gets into the bloodstream resulting in septic shock and death in more than 50% of those infected.

Wound infections are another problem with Vibrio vulnificus. These infections result either from contaminating an open wound with sea water harboring the organism, or by lacerating part of the body on coral, fish, etc., followed by contamination with the organism.

This infection can be diagnosed by isolating the organism in stool, wound or blood cultures. It can be treated with a antibiotic regimen and supportive care.

What can you do to prevent this infection? Patients with chronic liver disease or immunocompromising conditions are particularly vulnerable to infection and are advised to avoid raw or undercooked seafood. Persons with open wounds should avoid contact with warm seawater.

Here is a list of preventive measures recommended in the journal American Family Physician:

• Avoid contact with raw seafood juices; use separate cutting boards and knives for seafood and nonseafood
• Avoid eating raw oysters or seafood, especially if an immunocompromising condition or chronic liver disease is present; the risk is highest with seafood harvested in the summer
• Cook shellfish thoroughly:
• In the shell: boil until the shells open, then boil for another five minutes; or steam until the shells open, then steam for another nine minutes (do not eat shellfish that do not open during cooking)
• Shucked oysters: boil for at least three minutes, or fry for at least 10 minutes at 375°F (191°C)
• Promptly refrigerate leftover seafood
• Wear gloves when handling raw oysters or shellfish
Persons with open wounds:
• Avoid contact between open wounds and seawater, especially if water temperature is more than 68°F (20°C), or raw seafood
• Wash any wound that is exposed to seawater with soap and clean water
• Immediately seek medical care for any wound that appears infected
(Global Dispatch, 2012).