Viral Hepatitis

Viral hepatitis is the inflammation of the liver caused by a virus. The most common types are Hepatitis A, Hepatitis B, and Hepatitis C. These three viruses are spread in different ways but cause similar illness. Hepatitis A is an acute illness. Hepatitis B and Hepatitis C can be either acute (short-term) or chronic (long-term) illnesses. The number of acute Hepatitis A and Hepatitis B cases have been declining in the United States, mostly due to the availability of Hepatitis A and Hepatitis B vaccines. Currently, there is no vaccine for Hepatitis C. According to the Centers for Disease Control and Prevention, in the United States, an estimated 1.2 million Americans are living with chronic Hepatitis B and 3.2 million are living with chronic Hepatitis C. These chronic diseases are more common than HIV/AIDS in the United States.

Epidemiology investigates cases of viral hepatitis to determine the source of infection, risk factors and to refer contacts for prophylaxis.

The link below presents surveillance data on Hepatitis A, Hepatitis B and Hepatitis C infections in Fulton County from 2010 – 2015. Please click here for general hepatitis information

• Viral Hepatitis in Fulton County, 2010-2015

The West Nile virus—identified in Uganda in 1937—appeared in the United States for the first time in the New York City area in August 1999. It is transmitted to humans by the bite of an infected mosquito. Mosquitoes become infected by biting birds that harbor the virus. The virus  is spread from birds to humans when mosquitoes that have fed on infected birds then bite humans. The virus has now been found in 111 bird species and about a dozen mammals. Most cases of West Nile occur during the warm weather months. Nonetheless, the mild climate in southern states is expected to sustain the mosquitoes beyond those months.

The Fulton County Board of Health and its team of epidemiologists work in collaboration with the Georgia Department of Public Health to perform surveillance, education, and assessment of human cases, and also monitor environmental and weather threats that might lead to mosquito-borne outbreaks. As it does each year, the Environmental Health Division oversees mosquito spraying, larviciding and what’s called “adulticiding” through the services of licensed pest control companies that specialize in this area. Citizens have become familiar with these services as part of our annual anti-West Nile Virus program. Samples near basins and standing water are collected periodically and tested to determine if there’s a West Nile Virus positive mosquito pool, and immediate action is taken should infected mosquitoes be present. The EHS staff also performs outreach education at health fairs, community meetings, and neighborhood meetings. To schedule a speaker or get more information, contact the central Environmental Office at 404-613-1303.

What Can I Do to Prevent WNV?

You can reduce your risks of contracting WNV or any other mosquito-borne disease by preventing mosquito bites.

Personal protection measures such as those listed below are effective in reducing the likelihood of being bitten by infected mosquitoes:

• When you are outdoors, use insect repellent containing an EPA-registered active ingredient. Follow the directions on the package.  Research suggests that repellents containing DEET (N,N-diethyl-m-toluamide) or picaridin (KBR 3023) typically provide longer-lasting protection than the other products, and oil of lemon eucalyptus (p-menthane-3,8-diol) provides longer lasting protection than other plant-based repellents. Please visit the Centers For Disease Control and Prevention’s West Nile Virus page for more information.
• Many mosquitoes are most active at dusk and dawn. Be sure to use insect repellent and wear long sleeves and pants at these times or consider staying indoors during these hours.
• Make sure you have good screens on your windows and doors to keep out mosquitoes.
• Get rid of mosquito breeding sites by emptying standing water from flower pots, buckets, and barrels.
• Change the water in pet dishes and replace the water in birdbaths weekly. Drill holes in tire swings so water drains out. Keep children's wading pools empty and on their sides when they aren't being used.

• Be aware of outside working conditions, i.e., the presence of equipment or areas where water may accumulate.
• Inspect work areas and, where possible, get rid of sources of stagnant or standing water to remove a potential breeding ground for mosquitoes.
• Workers should avoid touching dead birds. Instead, have them report dead birds and forward the report to local authorities.
• Avoid use of perfumes and colognes when working outdoors during peak times when mosquitoes may be active; mosquitoes may be more attracted to individuals wearing perfumes and colognes.
• Do NOT spray insect repellent on skin that is under clothing, skin that is already irritated, or to cuts/lacerations, or pump products in enclosed areas. Also, Do NOT spray a pump or aerosol product directly on your face. First, spray on hands and carefully rub on face (do not allow insect repellent to contact your eyes and mouth).
• After returning indoors, use soap and water to wash skin that has been treated with insect repellent.

What is Zika?  A Decades-old Illness Makes a 21st Century Resurgence

The Zika virus is not new. It’s been recognized since the late 1940s. People can contract the Zika virus when bitten by infected mosquitoes—the Aedes aegypti —the same breed that spreads the dengue and chikungunya viruses. The mosquitoes that carry the Zika virus are NOT native to Georgia. However, Georgia does have at least 20 other types of Aedes mosquitoes. Like their Zika virus carrying cousins, they are aggressive and bite mostly during the day. These species also breed in containers and live near people’s homes. That’s why removing standing water near your home is essential in preventing mosquito-borne viral diseases.

As of December 2017, the Georgia Department of Public Health (DPH) has 120 confirmed travel-related cases of Zika cases in Georgia. The cases who weren’t pregnant have recovered. DPH cautions travelers, especially women who are pregnant, to postpone travel to areas where Zika virus transmission is ongoing.

This link will take you to a list of Zika infected countries

We have compiled a list relevant facts and frequently asked questions to assist you and your families in understanding this emerging health threat. As you will read, the Zika virus is not life-threatening to most of the population. The gravest concern presently is the transmission of the virus from pregnant mothers to their developing babies. Zika is believed to be the cause of an increase in the number of infants born with microcephaly (abnormally small brains) in Brazil in 2015. Further studies are underway to confirm the association of microcephaly with Zika virus infection during pregnancy and to understand any other adverse pregnancy outcomes associated with Zika virus infection.

History of the Virus

The virus is named after the Zika forest in Uganda where it was first discovered in 1947. The first human cases of Zika were detected in 1952. Before 2007, at least 14 cases of Zika had been documented in tropical Africa, Southeast Asia and the Pacific Islands. Other cases were likely to have occurred but were not reported because the symptoms of Zika are similar to those of many other diseases. The most common symptoms of Zika are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting for several days to a week after being bitten by an infected mosquito. People usually don’t get sick enough to go to the hospital, and they very rarely die of Zika.

FREQUENTLY ASKED QUESTIONS

How do you get the Zika Virus

Zika is a viral disease that is transmitted to people by the Aedes aegypti mosquitoes.  Zika virus can also be transmitted from mother to fetus and by sexual contact with infected men or women. In theory, the virus could be spread through a blood transfusion or organ donation, although there are no known reports of this to date.  In the past year, Zika virus infection did spread in multiple countries, mainly in the Southern hemisphere of the world where the Aedes mosquito breeds easily in those tropical and subtropical climates.  In May 2015, the Pan American Health Organization (PAHO) issued an alert regarding the first confirmed Zika virus infection in Brazil.   On February 1, 2016, the World Health Organization (WHO) declared Zika virus a Public Health Emergency of International Concern, a PHEIC.  Local transmission has been reported in many other countries and territories around the world. 

Has the Zika Virus been reported in the continental United States?

According to the Centers for Disease Control and Prevention, Provisional Data* as of January 24, 2018, 418 symptomatic Zika virus disease cases reported* (409 cases in travelers returning from affected areas, 4 cases acquired through presumed local mosquito-borne transmission in Florida (N=2) and Texas (N=2), 5 cases acquired through sexual transmission) have been reported in the Continental United States.  637 Zika virus disease cases reported* (1 case in a traveler returning from affected areas, and 636 cases acquired through presumed local mosquito-borne transmission) have been reported in the US Territories.  

Is Zika contagious?

Infected mosquitoes bite people transmitting the virus to them, but Zika does NOT spread like a cold or the flu. Zika is NOT contagious like measles or chicken pox. However, the Zika virus CAN be transmitted from mother to child as reported by the CDC:

Mother to Child

• A mother already infected with Zika virus near the time of delivery can pass on the virus to her newborn around the time of birth, but this is rare.
• A mother can pass Zika virus to her fetus during pregnancy. CDC is studying how Zika affects pregnancies.
• To date, there are no reports of infants getting Zika virus through breastfeeding. Because of the benefits of breastfeeding, mothers are encouraged to breastfeed even in areas where Zika virus is found.

The Zika virus can also be transmitted through sexual contact as reported by the CDC:

• Zika virus can be spread by a man to his sex partners.
  • In known cases of likely sexual transmission, the men had Zika symptoms.
  • In one case, the virus was spread a few days before symptoms developed.
  • The virus is present in semen longer than in blood.
• Zika Transmission through Blood Transfusion
  • To date, there have not been any confirmed blood transfusion transmission cases in the United States.
  • There have been multiple reports of blood transfusion transmission cases in Brazil. These reports are currently being investigated.
  • During the French Polynesian outbreak, 2.8% of blood donors tested positive for Zika and in previous outbreaks, the virus has been found in blood donors.
• Through laboratory and healthcare setting exposure
  • Prior to the current outbreak, there were four reports of laboratory acquired Zika virus infections, although the route of transmission was not clearly established in all cases.
  • As of June 15, 2016, there has been one reported case of laboratory-acquired Zika virus disease in the United States.
  • To date, no cases of confirmed Zika virus transmission in healthcare settings have been reported in the United States.

For general information about Zika virus and surveillance for mosquito-borne diseases in Georgia, call the Georgia Department of Public Health at 404‐657‐2588 or visit their website at https://dph.georgia.gov/EnvironmentalHealth

For national Zika virus data, visit the website of the Centers for Disease Control and Prevention at http://www.cdc.gov/zika/index.html
 

Is Zika Life-Threatening?

Typically, Zika is not life-threatening. Its symptoms are similar to those of many common illnesses. They generally appear 12 days after a person is bitten by an infected mosquito and last a few days to one week. Fever, rash, joint pain, and conjunctivitis (red eyes) are the most common symptoms. An estimated 80 percent of persons infected with the Zika virus are asymptomatic. The CDC says only about 1 in 5 people infected with Zika virus will develop symptoms.

How is the Zika Virus treated?

There is no vaccine available to protect humans from the Zika virus infection. However, treating the symptoms you may exhibit is similar to treating yourself when you have a bad cold or the flu. The CDC recommends that patients affected by Zika should:

• Get plenty of rest.
• Drink fluids to prevent dehydration.
• Take medicine like acetaminophen (Tylenol) to reduce fever and pain.
• Do NOT take aspirin or other non-steroidal anti-inflammatory drugs.
• Talk to your healthcare provider if you are taking medicine for another medical condition.

What’s the best way to keep from contracting the Zika Virus?

The Centers for Disease Control and Prevention recommends taking these precautions to guard against being bitten by mosquitoes:

• Wear long-sleeved shirts and long pants.
• Stay in places with air conditioning or that use window and door screens.
• Use EPA-registered insect repellents on your skin. When used as directed, these insect repellents are proven safe and effective, even for pregnant and breast-feeding women.
• Tip 'N Toss all standing water.  Remove outside water containers or dump out any standing water every three days.
• Use larvicides such as mosquito dunks or mosquito torpedoes in water that cannot be dumped out.

Plan for travel.

What is the Fulton County Board of Health doing to protect us during this upcoming mosquito season?

The Fulton County Board of Health and its team of epidemiologists are working in collaboration with with the Georgia Department of Public Health to perform surveillance, education, and assessment of human cases and monitor environmental and weather threats that might lead to mosquito outbreaks.

As it does each year, the Environmental Health Division oversees mosquito spraying, larviciding and what’s called “adulticiding” through the services of a licensed pest control company that specializes in this area. Citizens will recognize these services as part of our anti-West Nile Virus program. Samples near basins and standing water are collected periodically and tested to determine if there’s a problem, and to take immediate action should infected mosquitoes be present.

The EHS staff also performs outreach education at health fairs, community meetings and neighborhood meetings. To schedule a speaker or get more information, contact our central Environmental Health Office at 404-613-1303.

Centers for Disease Control and Prevention (CDC) Data

The Centers for Disease Control and Prevention (CDC) recently created an online platform to view state and national statistics on prevalence rates of cholesterol, diabetes, heart attack, high blood pressure, obesity, stroke, tobacco use and other data on chronic disease and behavioral risk factors. Access it here.

The 500 Cities project is a collaboration between CDC, the Robert Wood Johnson Foundation, and the CDC Foundation that provides city- and census tract-level small area estimates for chronic disease risk factors, health outcomes, and clinical preventive service use for the largest 500 cities in the United States. Get more information about the 500 Cities project and view the interactive data map here.

The CDC’s Heart Disease and Stroke Map shows state- and county-level maps of heart disease and stroke mortality rates for the United States. Access the maps here.

CDC’s Division of Nutrition, Physical Activity, and Obesity (DNPAO) has made important updates to the Data, Trends and Maps database. View information about the data here.

Georgia Department of Public Health Data

In 2016, the Georgia Department of Public Health (DPH) released the Georgia Adult Disparities in Tobacco Use Report. Although cigarette smoking has declined significantly since 1964, very large disparities in tobacco use remain across groups defined by race, ethnicity, educational level, and socioeconomic status and across regions of the country. View the report here.

The Georgia Department of Health reports on the most recent smoking rates for the United States, Georgia and Fulton County, based on the 2015 Behavior Risk Factor Surveillance System.  View the slide here.