2007 - Alabama Department of Public Health

ureau of communicable disease
The Immunization Division annually conducts a School
Entry Survey in conjunction with the Alabama Department
of Education and a Day Care/Head Start Survey in
cooperation with the Alabama Department of Human
Resources. These surveys evaluate the immunization status
of all children to ensure they have a current Certificate
of Immunization or a valid exemption on file. During the
2006-07 school year, all public and private schools in the
state responded to the School Entry Self-Survey, while 37
percent of day care and Head Start centers in the state
responded to the self-survey. To validate the surveys, each
year Immunization staff audit at least 25 percent of the
schools and day care/Head Start centers in Alabama. In
2007, 527 schools and 765 child care centers were visited.
Of the records reviewed, 93.6 percent of school students
and 93.7 percent of the child center children were found to
have a valid certificate on file.
As part of the Immunization Division’s surveillance and
outreach to monitor and prevent the spread of vaccinepreventable
diseases, Immunization staff investigates
vaccine-preventable diseases reported by physicians and
laboratories. The number of pertussis (whooping cough)
cases reported in all of 2007 increased slightly; as of early
November 2007, 97 new cases had been investigated.
Seventeen possible cases of mumps were investigated
resulting in 11 probable and three confirmed cases in the
state. Chickenpox, a reportable disease since 2004, had
over 500 cases reported in 2007. The division’s Perinatal
Hepatitis B program provided case management for 105
infants born to mothers who were reported as positive
for hepatitis B, 93 of those were identified prospectively.
Immunization staff are in constant contact with hospitals
and physicians to emphasize the importance of identifying
possible cases to hasten intervention and prevention of
further cases.
division of TUBERCULOSIS (TB) CONTROL
The ultimate goal of the Division of TB Control is to
eliminate tuberculosis in Alabama. Until that goal is
reached, the division strives to reduce the annual burden
of disease, limit transmission, and prevent future cases
through the provision of diagnostic, treatment, and case
management activities. The Division of TB Control
provides these services to all persons in Alabama,
regardless of the ability to pay. This commitment to the
citizens of Alabama has contributed to the historic decline
in morbidity noted below.
In 2007 the Division of TB Control verified and reported
175 cases of active TB disease. This figure represents a
decrease of 21 cases (10.7 percent) from 2006, and is the
second consecutive year that ADPH reported fewer than
200 cases.
Prevention of future cases relies upon the ability
of ADPH staff to (a) promptly identify and evaluate
contacts with latent TB infection, and (b) assure the
initiation of preventive therapy. Contact evaluation
and treatment data (reported a year in arrears) are now
available for 2006, when ADPH staff evaluated 3,093
contacts to tuberculosis – an evaluation rate of 91 percent.
These investigations resulted in the identification of
11 additional persons with active TB disease, and 727
persons with latent TB infection.
While annual declines in tuberculosis morbidity offer
tangible evidence of a successful public health effort, the
division will continue to seek linkages with providers who
serve populations at increased risk for TB. Fewer cases
in the community may contribute to a lowered “index of
suspicion” for TB, resulting in diagnostic delays. The
medical community is encouraged to “Think TB” when
patients present with persistent cough, or chest pain
accompanied by weight loss. Chest radiography, as
well as collection of sputum to “rule out” TB, should be
considered for patients with these symptoms. Hospitals
and private providers should refer patients with such
symptoms to TB control staff through their local health
department.
historical trend of tuberculosis
cases in alabama
2000
1500
1000
500
0
1515
704
541
405
175
1967 1977 1987 1997 2007
10