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Division of Acute Disease Prevention and Emergency Response

Division of Environmental Health


Division of Behavioral Health

IOWA DEPARTMENT OF PUBLIC HEALTH

Iowa Surveillance of
Notifiable and Other
Diseases

Annual Report 2010

Mariannette Miller-Meeks,
B.S.N., M.Ed., MD
Director
Mary J. Jones, BSEMS, MA
Deputy Director, ADPER Director

Patricia Quinlisk, MD, MPH


State Medical Director/State
Epidemiologist

Iowa Department of Public Health

PrimaryAuthors
ThefollowingCenterforAcuteDiseaseEpidemiologystaffaretheprimaryauthorsofthisreport:
YumeiSun,PhD
DianaVonStein,MPH
ArielPleva,MPH
AnnGarvey,DVM,MPH

ContributingAuthorsandEditors

IowaDepartmentofPublicHealth
DivisionofEnvironmentalHealth
MedicalDirector/StateEpidemiologist
DivisionDirector
PatriciaQuinlisk,MD,MPH
KenSharp,MPA

DivisionofAcuteDiseasePreventionand
BureauofEnvironmentalHealthServices
EmergencyResponse
CarmilyStone,MPH,CPFS(BureauChief)
DeputyDirector/DivisionDirector
*TimWickam,MPH
MaryJ.Jones,BSEMS,MA

BureauofLeadPoisoningPrevention
BureauofImmunizationandTB
*RitaGergely,M.Ag.(BureauChief)
*AllanLynch
*KathyLeinenkugel,MPA,REHS,MT
DonCallaghan(BureauChief)

DivisionofBehavioralHealth
CenterforAcuteDiseaseEpidemiology
DivisionDirector
PamDeichmann,RN,MPH(BureauChief)
KathyStone,MBA
CarrieStief

JohnSatre
BureauofHIV,STD,andHepatitis
JudyGoddard,RN,BS
*JerryHarms,MPH,CART
MaryRexroat,RN,BS
*AnnaBode
ChrisGaleazzi,MPH
*AlagieJatta,MS
MattHobson,MA
*RandyMayer,MS,MPH(BureauChief)
ElizabethMiller,PhD
RobRamaekers,MPH,CPH

DenyseGipple,MPH,CIC,CPH
StateHygienicLaboratory
BarbaraLivingston,RN,BSN,MPH,CIC
attheUniversityofIowa
LucyDesJardin,PhD
ShawniceCameron
SandyJirsa
ChrisTate,MPH

KemiOni,MPH

*Denotesdirectprogramspecificdataandtextcontribution,andeditorialreview

Divisions of Acute Disease Prevention and Emergency Response, Environmental Health, and Behavioral Health

Contents

ExecutiveSummary

Introduction.........................................................................................................................................8
Methods.............................................................................................................................................9

SummaryofRespiratoryandVaccinePreventableDiseases...............................................................11
HaemophilusinfluenzaetypeB(Hib),invasivedisease.............................................................................11
HepatitisB(acuteandchronic)..................................................................................................................11
Influenza......................................................................................................................................................11
Measles.......................................................................................................................................................12
Meningococcalinvasivedisease.................................................................................................................12
Mumps........................................................................................................................................................13
Pertussis.....................................................................................................................................................13
RespiratorySyncytialVirus(RSV)................................................................14
Tuberculosis...............................................................................................................................................14

SummaryofSexuallyTransmittedDiseases,
HepatitisC,HIVandAIDS...........................................................................................................................15
HIV/AIDS.....................................................................................................................................................15
HepatitisC..................................................................................................................................................17
Sexuallytransmitteddiseases....................................................................................................................17
Chlamydia.....................................................................................................................................17
Gonorrhea.............................................................................................................18
Syphilis..................................................................................................................18

SummaryofEntericDiseases.............................................................................................................19
Campylobacteriosis.....................................................................................................................................19
Cryptosporidiosis........................................................................................................................................19
E.coliO157:H7andothershigatoxinproducingstrains...................................................20
Giardiasis.....................................................................................................................................................20
HepatitisA...................................................................................................................................................21
Listeriosis.....................................................................................................................................................21
Salmonellosis..............................................................................................................................................21
Shigellosis....................................................................................................................................................22

SummaryofZoonoticDiseases...........................................................................................................23
Denguefever......................................................................................................23
Ehrlichiosis/Anaplasmosis......................................................................23
Hantavirus..............................................................................23
Lymedisease.......................................................................23
Malaria..............................................................................23
Rabies,animal..................................................................23
Rabies,human.............................................................24
RockyMountainspottedfever....................................24
WestNilevirus.......................................................25

Iowa Department of Public Health

SummaryofRareandUnusualDiseases............................................................................................26
Hansensdisease.........................................................................................................................................26
Legionellosis...............................................................................................................................................26
ToxicShockSyndrome...............................................................................................................................26
Tetanus........................................................................................................................26

SummaryofEnvironmentalHealthConditions..................................................................................27
CarbonMonoxidePoisoning.....................................................................................................................27
Methemoglobinemia..........................................................................................................28
HeavyMetalPoisoning(NonLead)............................................................................................28
ChildhoodLeadPoisoning..........................................................................................................................28
AdultLeadPoisoning..................................................................................................................................29
TraumaticWorkRelatedFatalitiesSurveillance....30

OutbreakSummary...........................................................................................................................31
Foodborneoutbreaksummary..................................................................................................................31
Nonfoodborneoutbreaksummary...........................................................................................................32

References........................................................................................................................................48
Figures
FIGURE1.LABORATORYCONFIRMEDCASESOFINFLUENZAREPORTEDTOTHEIOWADEPARTMENTOFPUBLIC
HEALTH,20102011...12
FIGURE2.INFLUENZAASSOCIATEDHOSPITALIZATIONBYAGEGROUP,20102011..................................................12
FIGURE3.NUMBEROFPERTUSSISCASESREPORTEDTOIDPH,IOWA,20032010....................................................13
FIGURE4.PERCENTOFRAPIDRSVTESTSPOSITIVEANDNUMBEROFTESTSPERFORMED,20102011....................14
FIGURE5.NUMBEROFLATENTTBINFECTIONSBYYEARINIOWA,20002010.........................................................14
FIGURE6.NUMBEROFNEWLYDIAGNOSEDCASESOFHIVBYYEAR,20002010.......................................................15
FIGURE7.PERCENTDISTRIBUTIONOFNEWLYDIAGNOSEDCASESBYRACEANDETHNICITY...................................16
FIGURE8.ESTIMATEDNUMBEROFPERSONSWITHHIVORAIDSINIOWA,1986201017
FIGURE9.NUMBEROFCASESOFCHLAMYDIAANDGONORRHEABYYEAR,20002010...........................................18
FIGURE10.NUMBEROFCASESOFSYPHILISBYYEAR,20002010............................................................................18
FIGURE11.CAMPYLOBACTERIOSISCASESVERSUSMAXIMUMEXPECTEDCASESORTHRESHOLDBYMONTH,2010
...........................................................................................................................................................................19
FIGURE12.CRYPTOSPORIDIOSISCASESVERSUSMAXIMUMEXPECTEDCASESORTHRESHOLDBYMONTH,2010...19
FIGURE13.E.COLIO157:H7ANDOTHERSTXPRODUCINGSTRAINSVERSUSMAXIMUMEXPECTEDCASESOR
THRESHOLDBYMONTH,2010...........................................................................................................................20
FIGURE14.GIARDIASISCASESVERSUSMAXIMUMEXPECTEDCASESORTHRESHOLDBYMONTH,2010.................20
FIGURE15.HEPATITISACASESVERSUSMAXIMUMEXPECTEDCASESORTHRESHOLDBYMONTH,2010.............21
FIGURE16.SALMONELLOSISCASESVERSUSMAXIMUMEXPECTEDCASESORTHRESHOLDBYMONTH,2010.........21
FIGURE17.SHIGELLOSISCASESVERSUSMAXIMUMEXPECTEDCASESORTHRESHOLDBYMONTH,2010...............22
FIGURE18.CONFIRMEDANDPROBABLECASESOFLYMEDISEASEREPORTEDTOIDPH,20002010........................23
FIGURE19.SEVERITYOFHEALTHIMPACTAMONGCASEPATIENTSWITHCARBONMONOXIDEPOISONING,2010.27
FIGURE20.SOURCESOFEXPOSUREAMONGCASEPATIENTSWITHCARBONMONOXIDEPOISONING,2010..........27
FIGURE21.REPORTEDCASESOFARSENIC,CADMIUM,ANDMERCURYPOISONINGINIOWA,2010.28

Tables
TABLE1.SUMMARYOFCOMMON,NOTIFIABLEDISEASES,20072010ANDPERCENTCHANGEINNUMBEROF
CASESREPORTEDCOMPAREDTO3YEARAVERAGE...........................................................................................7
TABLE2.CASESOFMENINGOCOCCALDISEASEBYSEROGROUPS,2010....................................................................12
TABLE3.NUMBEROFANIMALSPOSITIVEFORRABIESVIRUSBYSPECIES,2010........................................................23
4

Divisions of Acute Disease Prevention and Emergency Response, Environmental Health, and Behavioral Health

TABLE4.NUMBEROFANIMALSPOSITIVEFORRABIESVIRUSBYSPECIESANDYEAR,20012010.24
TABLE5.IOWAWESTNILEVIRUSACTIVITYBYSPECIESANDOUTCOMES,2002201025
TABLE6.GENDEROFCASESWITHCARBONMONOXIDEPOISONINGMEETINGCASEDEFINITION,2010..................28
TABLE7.IOWAADULTBLOODLEADTESTSRESULT,20092010ANDCHANGESFROM2009TO2010......................29
TABLE8.FOODBORNEOUTBREAKS,2010...................................................................................................................31
TABLE9.NONFOODBORNEORUNKNOWNCAUSEOUTBREAKS,2010.....................................................................32
TABLE10.CASESANDRATESPER100,000POPULATIONFOR2010BYAGEGROUP..................................................35
TABLE11.CASESANDRATESPER100,000POPULATIONFOR2010BYSEX,IOWA....................................................36
TABLE12.NOTIFIABLEDISEASESBYYEAR,19912010................................................................................................37
TABLE13.SALMONELLASEROTYPESREPORTED2010................................................................................................39
TABLE14.SHIGELLASEROGROUPS19912010...........................................................................................................40
TABLE15.IOWACHILDRENBORNIN2004ANDTESTEDFORBLOODLEADLEVELSBEFORETHEAGEOF6YEARS...41
TABLE16.ADULTLEAD2010SUMMARYDATA43
TABLE17.COMMONNOTIFIABLEDISEASESBYCOUNTY,2010..................................................................................44

Iowa Department of Public Health

ExecutiveSummary
PromotingandprotectingthehealthofIowansisthemissionoftheIowaDepartmentofPublicHealth
(IDPH).Surveillanceofnotifiablehealthconditionsisessentialinestablishingwhat,how,andwhen
eventsimpactthepublicshealth.Multipledivisionsandbureausarededicatedtoaccomplishingthe
goalsofsurveillance.In2010,thereweremorethan60,000laboratoryresultsofinfectiousdiseaseand
conditionssubmittedtoIDPHdiseasesurveillanceprograms.IDPHalsoinvestigatesconditionsrelatedto
lead,occupational,andenvironmentalhazardslikecarbonmonoxide.Approximately100,000bloodlead
testresultswerereportedtoIDPHin2010.

CrucialpartnerscontributingtothesurveillanceandreductionofdiseaseincludetheStateHygienic
Laboratory(SHL)attheUniversityofIowa,localpublichealthagenciesbothcityandcounty,andhealth
professionals.

In2010,thenumberofthevaccinepreventablediseasesdecreasedwhencomparedtothethreeyear
average(20072009),however,thenumberofpertussiscasesandmumpscasesincreased.Pertussis
caseshada229percentincreasewhencomparedtothethreeyearaveragewhilemumpshada73
percentincrease.

Entericdiseases,likesalmonellosisandcampylobacteriosis,weregenerallyhigherthaninprevious
years.

DiseasesspreadviainsectsandothervectorscontinuetoimpactIowans.NinecasesofWestNilevirus
weredetectedin2010.Sevenoftheninecaseswerehospitalizedandtwopatientsdied.

Whilethenumberofgonorrheaandsyphilisdiagnosesremainsrelativelystable,diagnosesofchlamydial
infectionscontinuetoincrease.ThenumberofnewlydiagnosedHumanImmunodeficiencyVirus(HIV)
casesdecreasedwhencomparedtotheaveragenumberofdiagnosesforthepreviousthreeyears.
However,alongtermviewindicatesaslow,steadyincreaseindiagnoses.TheincreaseinHIVdiagnoses
isprimarilyamongmalesfrom13to24yearsofageandmalesolderthan44yearsofage.Thedataalso
continuetoshowadisproportionatenumberofdiagnosesamongnonHispanicAfricanAmericans,a
groupthatmadeup2.9percentofIowasgeneralpopulationin2010,butaccountedfor26percentof
thenewHIVdiagnoses.

Greatstridesweremadeinimprovingsurveillanceforcarbonmonoxidepoisoningandleadexposurein
youngchildren.Thesedatahavealreadybeguntohelpshapenewpoliciesincludingalegislative
requirementforchildrentohavecompletedleadscreeningpriortokindergartenentry.

MorehealthworkersreporteddiseasesthroughtheIowaDiseaseSurveillanceSystem;asystemthatis
nowcapableofreceivingelectroniclaboratoryresultsonadailybasis.Iowassurveillancesystemsare
becomingincreasinglystreamlined,electronicallyandwebbased,andinterconnected.

Asprogressinassessingdiseaseimproveseveryyear,theIowaDepartmentofPublicHealthandits
partnerswillkeepmovingforwardinpromotingandprotectingthehealthofIowans.

Divisions of Acute Disease Prevention and Emergency Response, Environmental Health, and Behavioral Health

Table1.Summaryofcommon,notifiablediseases,20072010andpercentchangeinnumberofcases
reportedcomparedto3yearaverage

2007

2008

2009

3yraverage
20072009

2010

Percent
change

751
10542
397
173
284
1804
11
15
112
16
3
87
10
38
705
530
57
68

35.2%
15.3%
5.8%
4.9%
7.2%
2.4%
83.1%
50.0%
4.0%
15.8%
30.8%
23.5%
40.0%
72.7%
229.4%
21.4%
54.5%
0.0%

Numberofcases

Campylobacteriosis
Chlamydia
Cryptosporidiosis
E.coliandothershigatoxinproducing
Giardiasis
Gonorrhea
HepatitisA
HepatitisB,acute
HIV(newdiagnoses)
Legionellosis
Listeriosis
Lymedisease
Meningococcalinvasivedisease
Mumps
Pertussis(whoopingcough)
Salmonellosis
Shigellosis
Syphilis

524
8643
610
175
301
1928
48
27
125
12
8
124
15
27
150
477
109
64

591
9372
284
208
326
1700
109
25
101
21
1
109
19
24
257
425
214
75

552
9406
232
163
291
1658
38
38
124
24
4
108
16
15
235
408
53
65

556
9140
375
182
306
1762
65
30
117
19
4
114
17
22
214
437
125
68

Thepercentchangeiscalculatedbysubtractingthe3yearaveragefromthetotalcasesfor2010anddividingbytheabsolute
valueofthe3yearaverage.
Tableincludesallconfirmedandprobablecases.

Iowa Department of Public Health

Introduction
Thepurposeofthisreportistoprovidean
overallsnapshotofthetypesandtrendsof
notifiableandotherdiseasesthatoccurinIowa.
Whenpossible,detailsspecifictothedisease
areprovided,includinginformationonwhich
serotypesorgroupswereprevalentandwhich
strainscausedoutbreaks.Comparisonsto
nationalratesareprovidedwheneverpossible.
Aggregatedcountyleveldataareprovidedina
tableattheendofthereport.Thereportis
intendedforpublic,media,publichealth,and
healthcareuseatalllevels.

Thereportisdividedintothefollowingsections:
respiratoryandvaccinepreventablediseases,
sexuallytransmitteddiseases,HIV/AIDS,
hepatitisC,entericdiseases,zoonoticdiseases,
rareandunusualdiseases,andenvironmental
healthconditions.

TheIowaDepartmentofPublicHealthhas
sevendivisionsandofthose,threecontributed
diseasedatatothisreport,includingthe
DivisionofBehavioralHealth(BH),Acute
DiseasePreventionandEmergencyResponse
(ADPER),andEnvironmentalHealth(EH).Two
bureauswithinADPERareresponsiblefor
infectiousdiseaseinvestigationtheCenterfor
AcuteDiseaseEpidemiology(CADE)andthe
BureauofImmunizationandTuberculosis(BIT).
CADEconductssurveillanceforcommonand
emerginginfectiousdiseases,agentsof
bioterrorism,diseaseoutbreaks,and
occurrenceofrareandunusualacutediseases.
BITconductssurveillanceoftuberculosisand
perinatalhepatitisB,aswellascoordinatesthe
immunizationprogramforthestate.Specific
diseaseconditionsarereportabletothe
departmentperIowaAdministrativeCode641,
Chapter1.Theurgencytiedtoreportingvaries
bydisease 1.
TheDivisionofEnvironmentalHealthhasthree
Bureaus:theBureauofRadiologicalHealth,
BureauofLeadPoisoningPrevention(BLPP),
andtheBureauofEnvironmentalHealth
Services(BEHS).Eachbureauhasdistinctgoals
andobjectivesandiscomprisedofverydiverse
8

programs.Certainhealthconditionsof
environmentaloriginarerequiredtobe
reportedtoIDPHperIowaAdministrativeCode
641,Chapter1.Thecontentinthisreport
includesdatafromBEHS,whichincludes
disease/outbreaksurveillancewiththeEHSNet
programandsurveillanceoncarbonmonoxide
poisoningandmethemoglobinemia,anditalso
includesdatafromtheBLPP,whichincludesall
reportsofchildhoodandadultbloodlead
levels,reportsofotherheavymetalpoisonings,
pesticidepoisonings,andreportsoffatalwork
relatedinjuries.
TheDivisionofBehavioralHealthincludesthe
BureauofHIV,SexuallyTransmittedDisease
(STD),andHepatitis.Thisbureauprevents,
identifies,monitors,andsupportspersonswith
HIV/AIDS,STDs,orviralhepatitis.Disease
reportingandtrackingarealargecomponentof
theworkaccomplishedbythisbureau,asis
locating,counseling,andtestingpartnersof
personswithsexuallytransmitteddiseases.
Publichealthemergencyresponseplanning
playsamajorroleinpreparingIDPHtorespond
toeventsofpublichealthsignificance.The
departmenthasusedanincidentmanagement
systeminseveraleventssuchasthesevere
weatherin2008andthe2009H1N1pandemic.
Preparednessplanningatboththestateand
locallevelshasgreatlyimprovedthewaypublic
healthrespondstolargescaledisease
outbreaks.

Thisreportprovidesanoverviewofdisease
investigationsandrepresentsonlyafractionof
workaccomplishedbyIDPHstaffeachyear.The
timeinvestedineachdiseasereportvaries
greatlybydiseaseandnatureofthereport.
Somereportsrequireaquickdatabasequery
andupdateofanelectronicfile.Othersrequire
hoursofstafftimeincontacttracing,mentoring
otherhealthinvestigators,andcommunication,
education,andinterventionimplementation.

Supportfortheinitiativesofbothdivisionsstem
fromfederalandstateallocationsandgrants.
TheTB,STD,andHIV/AIDSsurveillance
programsarefundedunderseparate

Divisions of Acute Disease Prevention and Emergency Response, Environmental Health, and Behavioral Health

cooperativeagreementswiththeCentersfor
DiseaseControlandPrevention(CDC),National
CenterforHIV/AIDS,ViralHepatitis,STDandTB
Prevention.

Methods
DiseasereportsaresubmittedtoIDPHvia
phone,fax,email,oranelectronicreporting
system.Reportersincludehealthcare
providers,hospitals,localpublichealth
agencies,andlaboratories.

ReportsreceivedbyCADEaretrackedinthe
webbasedIowaDiseaseSurveillanceSystem
(IDSS).Dataareelectronicallyexchanged
betweenIDSSandCDC.Electroniclaboratory
reportsaresentfromtheStateHygienic
Laboratory(SHL)attheUniversityofIowa
directlytoIDSSdaily.

Casesofacute,infectiousdiseasearetypically
referredtolocalpublichealthagenciesfor
patientinvestigationandinterview.Agencies
primarilyuseIDSStoreportinformationbackto
IDPH.

Localpublichealthagenciesarecriticalin
conductingoutbreakinvestigations.These
agenciesworktoidentify,investigate,and
containoutbreaksatthecityandcountylevel.

Afewdiseasesrequireasecondaryreporting
systemusedbyIDPHintransmittingdatato
programspecificstaffatCDC.Thesediseases
includeinfluenzaandWestNilevirus.The
NationalOutbreakReportingSystemisaCDC
sponsoredsystemusedbyIDPHtoreport
outbreaksofentericillness.

Rateswerecalculatedusingthe2009estimated
censuspopulationfortheStateofIowaorthe
appropriateestimatedcensusyear.Threshold
valuesusedinthegraphsinthesummaryof
entericdiseasewerecalculatingbyaddingtwo
standarddeviationstothethreeyearmoving
average.

CalculationswereperformedwithSPSS16,
SAS,andMicrosoftExcel.Mapswere
generatedusingARCGIS.

CADEusesthemostrecentCouncilofStateand
TerritorialEpidemiologists(CSTE)andCDCcase
definitionsfoundat
http://www.cdc.gov/epo/dphsi/casedef/case_d
efinitions.htm.CSTE/CDCdefinitionsareusedto
classifythecaseasconfirmed,probable,
suspect,notacase,awaitingmoreinformation,
orchronichepatitisBreportedinapastyear.
Onlyconfirmedandprobablecasesmeetingthe
CSTE/CDCdefinitionsareincludedinthisreport.

DiseasecasecountsandIowaspecificcase
demographicswereretrievedfromIDSS,which
ismaintainedwithinCADE.Thespecificfileused
forthisreportwascreatedinMay2011.Case
reportsoradditionalinformationthatmayhave
alteredthediseasecountsreceivedafterthis
datewasnotincludedinthisreport.Inaddition,
thedatafilewasgeneratedusingMMWR
(MorbidityMortalityWeeklyReport)year2010,
therefore,casecountsinthisreportmayvary
slightlyfromcountsgeneratedusingthe
calendaryearof2010.

Influenzasurveillancedatawerecollectedfrom
multiplesources,includingoutpatienthealth
careproviders,hospitals,publichealth,clinical
laboratories,andschools.Influenzalaboratory
confirmedcaseswerelargelybasedonreal
timepolymerasechainreaction(RTPCR)test
resultssentfromSHL.Influenzaassociated
hospitalizationswerereportedfrom21
hospitalsenrolledinInfluenzaSurveillance
Network(IISN).Schoolpercentabsenceis
calculatedbytakingthetotalabsentdueto
illnessoverthetotalenrolledtimesthenumber
ofdaysschoolwasinsession.

Respiratorysyncytialvirus(RSV)rapidantigen
testdataareusedtodeterminetheweekly
positivepredictivevalueoftherapidantigen
testsinIowa.Laboratoriesreportthetotaltests
performedandtotalpositiveeachweek.

Iowa Department of Public Health

ThesurveillancecasedefinitionsforHIV,AIDS,
STDs,andTBarethosedevelopedbyCDC.
Surveillanceisconductedaccordingtodetailed
guidelinesdevelopedbythatagency.Several
programsenterdataintoCDCdeveloped
softwareprograms.Programstransferdatavia
asecuredatanetworkonaweeklyormonthly
basis.HIV/AIDSdataarecollectedinasoftware
programcalledtheHIV/AIDSReportingSystem
oreHARS.

In2010,theSTDprogrambeganusingIDSSfor
surveillanceofsyphilis,Chlamydia,and
gonorrhea.Priorto2010,theSTDprogram
entereddatainaCDCdatabasecalledSTD*MIS
ortheSTDManagementInformationSystem.

Foraccuracyofanalysis,andbecause
jurisdictionforHIVandAIDScasesis
determinedbythepersonsresidenceatthe
timeofdiagnosis,greatcareistakenboth
withinandbetweenstatestomaintain
unduplicateddatabasesforHIVandAIDS.

WithregardtoHIV/AIDSsurveillance,reports
aregeneratedsemiannually,andasneeded.
Anepidemiologicalprofileisproducedevery
threeyears,withannualinterimupdates 2.

HIV/AIDSdataanalysisforthisreportutilizeda
combinationofCDCseHARSsoftware,
MicrosoftExcel,SASandSASEnterprise
Guide.

Theresultsofbloodleadtestingdoneonall
Iowacitizensarerequiredtobereportedtothe
BureauofLeadPoisoningPrevention.Dataare
enteredintotheCDCdatabaseSTELLAR.BLPP
exportsdatafromSTELLARtoCDCona
quarterlybasisperprogrammingdevelopedby
CDC.IDPHalsoanalyzesSTELLARdataona
quarterlybasis.Theanalysesandreportsare
producedinMicrosoftAccessandMicrosoft
Excel.

Mostdiseasespecificdataaretransmittedto
CDCelectronicallyonaroutinebasis.Some
diseaseinformationiscommunicatedatthe
requestofCDC.Thestatisticsreportedby

10

ADPERprogramstoCDCareusedtodevelopa
compositepictureofdiseaseburdenintheU.S.

Divisions of Acute Disease Prevention and Emergency Response, Environmental Health, and Behavioral Health

SummaryofRespiratoryand
VaccinePreventableDiseases
Haemophilus influenzae B

CasesofHaemophilusinfluenzaetypeB(Hib),
invasivediseasearerareinIowaandtheU.S.In
1991,Hibvaccinewasrecommendedforall
infantsafteragetwomonths.Sincethen,the
incidenceofHibinchildrenlessthanfiveyears
ofagehasdeclinedgreaterthan99percent.In
2010,onecaseofHaemophilusinfluenzaetype
BwasreportedtoIDPH.Thecaseoccurredina
22yearoldmale.HehadreceivednoHib
vaccinations.
Hepatitis A

SeeSummaryEntericDiseaseSection.

Hepatitis B (acute and chronic)

HepatitisBisacontagiousliverdiseasethat
resultsfrominfectionwiththehepatitisBvirus.
Itcanbeeitheracuteorchronic.Acutehepatitis
Bvirusinfectionisashorttermillnessthat
occurswithinthefirstsixmonthsaftersomeone
isexposedtothevirus.ChronichepatitisBvirus
infectionisalongtermillnessthatoccurswhen
thevirusremainsinapersonsbody.Chronic
hepatitisBisaseriousdiseasethatcanresultin
longtermhealthproblems,andevendeath.

Atotalof15casesor0.5casesofacute
hepatitisBforevery100,000personswere
reportedtoCADEin2010.Sixtypercentofthe
casesweremales.Nationally,acutehepatitisB
infectionsoccur1.8timesmoreofteninmen
thanwomen.

TheCentersforDiseaseControlandPrevention
(CDC)estimatestherewere43,000new
hepatitisBinfectionsintheU.S.in2007.CDC

11

estimatesthatthereare800,000and1.4people
livingwithchronichepatitisBdiseaseintheU.S.

Therewere183confirmedorprobablechronic
hepatitisBcasesreportedin2010inIowa

ThenumberofacuteandchronichepatitisB
infectionsin2010decreasedfrom2009.
Influenza

TheIowaInfluenzaSurveillanceNetwork(IISN)
tracksinfluenzaactivity,agegroupsimpacted,
outbreaks,virustypeandstrain,andseverityof
seasonalinfluenza.Duringthe2010
2011season,approximately200surveillance
sitesreportedtoIISNincludingmedicalclinics,
hospitals,laboratories,schools,localpublic
healthdepartments.

Influenzaviruscirculationinthe20102011
seasonreturnedtoamoretypicalseason
distribution(asseenpriortothe2009
pandemic)withthreetypesandsubtypesof
influenzaviruses(influenzaA(H3N2),2009
influenzaA(H1N1)andinfluenzaB)identifiedin
Iowa.TheseasonoccurredfromOctober
throughMay,peakinginlateJanuaryandearly
February.

Amongthespecimenstestingpositivefor
influenzaduringtheseason(Figure1),influenza
Baccountedfor32percent,influenzaA(H3N2)
31percent,andinfluenzaA(H1N1)28percent.
Theinfluenzavaccineprotectsagainstboth
influenzaAandBstrains.

InfluenzaA(H1N1)diseasewashighestinthe
1824yearagegroupandinfluenzaBwas
highestinchildrenaged517years.While
influenzaA(H3N2)occurredmostinpeople65
andolder,highnumbersofcaseswerealso
seeninchildrenyoungerthan18yearsofage.

Iowa Department of Public Health

Figure1.LaboratoryconfirmedcasesofinfluenzareportedtotheIowaDepartmentofPublicHealth,
20102011

Figure2.Influenzaassociatedhospitalizationbyagegroup,20102011
Influenzaassociatedhospitalizationswere
reportedfromtwentyonesentinelhospitals

duringtheseason(Figure2).Fortytwo
percentofthesehospitalizationsoccurred
inpeopleyoungerthan25yearsofageand
twentysevenpercentinpeopleolderthan
64yearsofage.

Therewereapproximately165schooloutbreaks
duetoillnessreportedtoIDPHandthepercent
ofstudentsabsentduetoillnessreportedfrom
sentinelschoolswithinfluenzavirusactivityin
Iowa.
Measles

TherewasnocaseofmeaslesreportedtoIDPH
in2010.
Meningococcal invasive disease

12

In2010,therewere10confirmedandprobable
casesor0.3casesforevery100,000personsin
Iowa.Theageofcasepatientsrangedfromtwo
to69yearsoldwiththemeanageof37years.
Nationally,thereare0.36casesforevery
100,000persons.

Ofthesecases,fourweregroupY,twowere
groupB,twogroupC,onewasgroupA,and
onewasundetermined(Table3).
Table2.CasesofMeningococcaldiseaseby
serogroups,2010
A
B*
C
W135
Y
Unk
1
2
2
0
4
1
*Serogroup B is not covered by the meningococcal vaccine

CDCdefinesacommunitybasedoutbreakof
meningitisastheoccurrenceofthreeormore
confirmedorprobablecasesduringaperiodof
lessthanorequaltothreemonthsamong

Divisions of Acute Disease Prevention and Emergency Response, Environmental Health, and Behavioral Health

personsresidinginthesameareawhoarenot
closecontactsofeachotherandwhodonot
shareacommonaffiliation,withaprimary
attackrateofatleast10casesper100,000
population 3.TherewerenooutbreaksinIowa
in2010.

Meningococcalinvasivediseaseisfatalin1014
percentofcases.OneIowacase(10%)wasfatal
in2010.Therearetwotypesofmeningococcal
vaccinescurrentlylicensedforuseintheU.S.;
1)apolysaccharidevaccineand2)aconjugated
vaccine.

Mumps

In2010,therewere38casesofmumpsor1.3
casesper100,000persons,a73percent
increaseoverthepreviousthreeyearaverage
of22.Caseagesin2010rangedfromzeroto52
yearswithamedianof19yearsold.Overhalf
(21)ofthe38caseswereassociatedwithan
outbreakinNorthwestIowa(primarilyinSioux
County);almostallofthecaseshadoccurredin
youngadults,primarilycollegestudents.

In2006,Iowawasthecenterofthelargest
mumpsoutbreakin20yearsintheU.S.with
1,963confirmedandprobablecases.Priorto
2006,mostcasesweretypicallyimportedfrom
countrieswithendemicdisease.
Pertussis (Whooping cough)

PertussisiscausedbyBordetellapertussisand
causesepidemicseverythreetofiveyears.In
2010,therewere705confirmedandprobable
casesreportedtoIDPHor23.4casesforevery
100,000personsinIowa,whichaccountsfor
229percentincreaseinactivityoverthe
previousthreeyearsaverageand69%increase
overthepastfiveyearsaverage.Highlevelsof
activitylastoccurredin2004and2005(see
Figure3).

Themajority(57%)of2010casesoccurredin
childrenages514years,andespeciallychildren
ages1014.Fourpercentofpertussiscases
werehospitalized.

Themostcommonsymptomisparoxysms,or
fitsofcoughing,followedbyposttussive
vomiting,whooping,andapnea.Lesscommon,
butserioussecondaryconditionsreported
includepneumonia,encephalopathyand
seizures.

Thehighestnumbersofcaseswerereportedin
eastandcentralregionsofthestate.

Figure3.NumberofpertussiscasesreportedtoIDPH,Iowa,20032010

13

Iowa Department of Public Health

Respiratory Syncytial Virus (RSV)

Surveillanceforrespiratorysyncytialvirus
beganin2008.IDPHandSHLsolicitrapidRSV
testresultsfromclinicalandreferencelabs
throughoutthestatetodeterminethe
percentageofpositivetestresultsofthose
performed.Inaddition,variouslabsincluding
SHLreportPCRorcultureconfirmationofRSV
asameanstoverifythepresenceofRSVin
Iowa.ThetypicalRSVseasoninIowaextends
fromDecemberthroughMay.

Figure4.PercentofrapidRSVtestspositive
andnumberoftestsperformed,20102011
Nationally,RSVsurveillanceisconductedby
CDCusingdatafromtheNationalRespiratory
andEntericVirusSurveillanceSystem.Datais
reportedfrom19laboratoriesthroughoutthe
U.S. Recentresearchhashighlightedvariability
amongdifferentregionsandstatesintheUS 4.

example,in1995,38%(27)ofallreportedTB
caseswerefoundinnonU.S.bornpersons,
comparedto77%(37)in2010.Thisdisparityis
furtherillustratedbythefactthatpeopleborn
outsideoftheUnitedStatesaccountforonly
3.1%oftheIowapopulation.

ThedecreasingnumbersofU.S.borncasesare
duetoeffectiveTBcontrolpracticesinthis
country.Priorityforfollowupisgivenfornewly
arrivingrefugeesandimmigrantswithan
identifiedTBcondition.Stateandlocalhealth
departmentsdesignatethissubpopulationof
personsforfollowupmedicalevaluations.
Theseevaluationsplayamajorrolein
identifyingandtreatingthishighrisk
population.

StatelawrequiresactivecasesofTBtobe
reportedtoIDPH.IowahasoneofthelowestTB
caseratesinthecountry,thanksinpartto
contactinvestigations,directlyobserved
therapyforactivediseasecases,andthe
provisionofmedicationtoIowanswithlatent
tuberculosisinfection(LTBI).Bycompletingsix
toninemonthsoftherapy,thosewithlatentTB
reducetheirriskofdevelopingTBdiseaseby
7090percent.

Tuberculosis

In2010,48tuberculosis(TB)caseswere
reportedinIowa.Between2000and2010,Iowa
reported441casestoCDC;anaverageof43
caseseachyear.

TB,oncetheleadingcauseofdeathinIowaand
theUnitedStates,isstillamongtheleading
causesofdeathinmanypartsoftheworld.The
WorldHealthOrganizationestimatesthatone
thirdoftheworldspopulationisinfectedwith
TB,amajorreservoirforfutureTBdisease
cases.ImmigrationtotheUnitedStatesfrom
areasoftheworldwithhighTBprevalenceis
theleadingsourceofTBcasesreportedinthe
U.S.TheproportionofIowasreportedTBcases
innonU.S.bornpersonshasincreased
significantlyinthepasttwodecades.For
14

Figure5.NumberoflatentTBinfectionsbyyearinIowa,
20002010

Divisions of Acute Disease Prevention and Emergency Response, Environmental Health, and Behavioral Health

SummaryofSexuallyTransmitted
Diseases,HepatitisC,HIVandAIDS
HIV and AIDS
HIVdiagnoses,onaverage,havebeen
increasingattherateof3.5peryearsince2000,
althoughthereissomevariabilityfromyearto
year.Therewere112HIVdiagnosesin2010,a
decreaseof12(10%)fromthe124diagnoses
reportedin2009.Therewere3.7HIVdiagnoses
per100,000populationin2010,comparedto
4.1HIVdiagnosesper100,000populationin
2009and3.4HIVdiagnosesper100,000
populationin2008.

Figure6.Numberofnewlydiagnosedcasesof
HIVbyyear,20002010
Whilemaleshavealwaysaccountedforthe
majorityofHIVdiagnoses,thishasbecome
evenmorepronouncedsince2003.Males
accountedforeightyfourpercentofHIV
diagnosesin2010.Diagnosesamongmales
increasedsteadilyfrom2003to2007,from56
to105.Sincethentheyhavefluctuated
somewhat,andmayhavenowleveledoff.
Therewere94diagnosesamongmalesin2010.
Incontrast,thenumberofdiagnosesamong
femalesdecreasedfrom33in2003to19in
2006,wherethenumberhassincebeen
relativelysteady;18femaleswerediagnosedin
2010.Theproportionofdiagnosesinmaleshas
stabilizedataroundeightythreepercentmale
(aboutfivemalesforeveryfemale)since2007.
Thisisincontrasttoseventyfivepercentmale
(threemalestoonefemale)from2003through
2006.

DiagnosesofHIVamongtheforeignbornhave
declinedfromthe10yearhighrecordedin

15

2002when32(30%)ofthe108persons
diagnosedwithHIVwereforeignborn.By
comparison,20(18%)ofthe112persons
diagnosedin2010wereborninacountryother
thantheUnitedStatesoroneofits
dependencies.

ThegradualincreaseinHIVdiagnosessince
2003islargelyattributedtoincreasesin
diagnosesamongmales,andinparticular,
amongthose13to24yearsofageand45years
ofageandolder.Forthesecondyearinarow,
thereweremorethan20diagnosesamong
persons13to24yearsofage.Twentytwo
personsbetweentheagesof13to24years
werediagnosedin2010,similartothe24in
2009,andmorethanthreetimesthediagnoses
recordedin2003.

Thenumberofdiagnosesamongpersons45
yearsandolder,whichhadincreasedsteadily
from18in2003toapeakof39in2007,
numbered33in2010.Despitethis,diagnoses
amongpersons25to44yearsofagestill
accountedforhalfofalldiagnoses,with56
personsdiagnosedin2010.Therewasone
pediatricHIVdiagnosisin2010,achildbornto
anHIVinfectedmother.

Forpersons13yearsofageandolder(adults
andadolescents),themedianageatdiagnosis
in2010was35years.Foradult/adolescent
males,themedianwas35years;forfemales,it
was37years.

DiagnosesamongnonHispanicAfrican
Americans,whichhadaveraged19peryear
from2007through2009,rosesharplyin2010
to29.WhilenonHispanicAfricanAmericans
madeup2.9percentofIowaspopulationin
2010,theyaccountedfortwentysixpercentof
thenewHIVdiagnoses.Thisequatesto32.5
diagnosesper100,000nonHispanicAfrican
Americans.

Hispanicswerealsooverrepresentedamong
personsdiagnosedwithHIV.Whilemakingup5
percentofIowaspopulation,Hispanics
accountedfor8percentofnewHIVdiagnoses

Iowa Department of Public Health

in2010.AtotalofnineHispanicswere
diagnosedin2010,equatingto5.9per100,000
Hispanics.

Despitethedisparitiesindiagnosesamong
AfricanAmericansandHispanics,thelargest
proportionofnewdiagnosescontinuedtobe
amongnonHispanicwhite,accountingfor60
percentofnewHIVdiagnosesin2010.Atotal
of67nonHispanicwhitewerediagnosedin
2010,equatingto2.4per100,000population.
Whenthenumbersofpersonsdiagnosedper
100,000populationarecompared,nonHispanic
AfricanAmericanswere13.5timesmorelikely
tohavebeendiagnosedwithHIVin2010than
white,nonHispanics.Similarly,Hispanicswere
2.5timesmorelikelytohavebeendiagnosed
thannonHispanicwhite.Figure7showsthe
percentdistributionofnewHIVdiagnosesby
raceandethnicity.

Figure7.Percentdistributionofnewly
diagnosedHIVcasesbyraceandethnicity

Menwhohavesexwithmen(MSM)remained
theleadingcategoryformodeofexposureto
HIVinfection.DiagnosesamongMSMin2010
numbered63,comparedtoanaverageof66
from2007to2009.In2010,MSMaccounted
for56percentofallcases,inlinewiththe
threeyearaverageof57percent.Numbers
(andproportions)ofothermodesofHIV
exposurein2010wereasfollows:Injection
druguse(IDU),5(4%);menwhohavesexwith
menandinjectdrugs(MSM/IDU),8(7%);
heterosexualcontact,15(13%);andno

16

identifiedrisk(NIR),20(18%).Asnotedabove,
oneinfectionwaspassedfrommothertochild
duringpregnancyorlaboranddelivery.Such
infectionsaretermedperinatalorvertical
transmission.

HIV/AIDSprevalencecontinuestoincrease.As
ofDecember31,2010,therewere1,828
personslivingwithHIVorAIDSwhowereIowa
residentsattimeofdiagnosis,aprevalenceof
60per100,000people.Thiscomparesto1,733
personslivingwithHIV/AIDSonthesamedate
in2009,aprevalenceof58per100,000.Figure
8showstheupwardtrendintheestimated
numberofpersonslivingwithHIVorAIDS,as
documentedattheendofeachcalendaryear.
Thetoptierofthegraphrepresentsthe
estimatednumbersofundiagnosed/unreported
persons,basedonthesurveillanceprograms
estimateofthetimelinessofcasereportingand
onCDCsestimateofthenumberofpersons
whoareinfectedbuthavenotbeendiagnosed.
Whenthefigureof1,828isadjustedforunder
reporting(1%)ofdiagnosedHIVandAIDSand
forCDCsestimatedpercentageofundiagnosed
infections(21%),theremayhavebeenasmany
as2,337IowanslivingwithHIVorAIDSatthe
endof2010.

SeventyonepersonswerediagnosedwithAIDS
in2010,downfrom91(thehighestnumber
since1996)in2009.The71diagnosesin2010
weremoreinlinewiththeaverageof70forthe
threeyears2006through2008.Ofthose
diagnosedwithAIDSin2010,51(72%)were
alsonewlydiagnosedwithHIVandreceiveda
concurrentdiagnosisofAIDSorprogressedto
AIDSbytheendof2010.Thisfindingismorean
indicationofpreventionfailuresthanitisof
treatmentfailureoraccesstocare.

ForadetailedreportoftheHIV/AIDSstatistics
forthestateofIowa,pleasevisitourwebsite:
http://www.idph.state.ia.us/adper/hiv_aids_pr
ograms.asp#surveillance

Divisions of Acute Disease Prevention and Emergency Response, Environmental Health, and Behavioral Health

Figure8.EstimatednumberofpersonswithHIVorAIDSinIowa,19862010
Hepatitis C
Therewereanestimated4.1millioncasesof
hepatitisCintheUnitedStates;uptoeighty
fivepercentofthesecasesarechronic.
Accordingtothe2009censuspopulation
estimateforIowa,therewere3,007,856people
residinginthestate.CDCestimatethat1.8
percentofthestatespopulation,or54,141
Iowans,haspotentiallybeeninfectedwiththe
hepatitisCvirus.Todate,approximately10,630
casesofhepatitisChavebeenidentifiedby
IDPH.

HepatitisCdataarecollectedusingIDSS,the
stateswebbasedreportingsystem,toallow
forcollectionofriskinformation,testresults,
referralinformation,anddataonwhether
immunizationswereoffered.

Duetoalackoffunding,hepatitisCsurveillance
activitiesarenotperformedatthestatelevel.
IDPHisworkingtowardbeginningsurveillance
activitiesonJanuary2,2012.
Sexually Transmitted Diseases
TheBureauofHIV,sexuallytransmitted
diseases(STD),andHepatitisisresponsiblefor
trackingtheincidenceofsexuallytransmitted
diseases,includingChlamydia,gonorrhea,and
syphilis.

17

Inadditiontosurveillance,IDPHsupports
targetedvoluntaryscreeningat68publicsites
throughoutIowa.IDPHalsoworkswithprivate
healthcareproviderstoincreasescreeningin
thoseclinics.

IDPHprovidestreatmenttopersonswith
positivetestsatapublictestingsite,aswellto
theirsexualpartners.In2008,IowaCode139A
wasupdatedtoallowforpartnerdelivered
therapy.Thisstatuteallowshealthcare
practitionerstogivemedicationsor
prescriptionstotheirpatientsortopublic
healthprofessionalstopassalongtoexposed
partners.

Chlamydia
CDCestimatesthatabout40percentof
chlamydialinfectionsand50percentof
gonorrheainfectionsremainundiagnosedand
untreatedeachyear.Thismeansthatin2010,
anestimated10,135infectionswent
undiagnosedanduntreatedinIowa.

Chlamydiaandgonorrheaaremoreoften
diagnosedinwomenbecausewomenaremore
likelytohaveroutineSTDscreeningtests
performedduringannualexams,andbecause
theirinfectionsaremorelikelytocause
symptoms.Menaremorelikelytobetested

Iowa Department of Public Health

whentheirpartnershavetestedortheyare
symptomatic.
Therewere10,542chlamydialinfections
reportedtoIDPHin2010,whichequatesto350
casesforevery100,000people.Iowaremains
belowthenationalaverageof544casesfor
every100,000people.DiagnosesinIowaand
nationallyhavebeensteadilyincreasingforthe
pastthreedecades.Despitethis,datafrom
populationbasedstudiesnationallyindicate
thatthenumberofnewinfectionsisnot
increasing.Thisincreaseincases(i.e.,
diagnoses)isduetobettertestingtechnologies
andmorewidespreadtesting.

Themajorityofinfections,74%,werereported
inpersonsaged1524years.AlthoughAfrican
Americansaccountforonly2.9percentof
Iowaspopulation,18percentofallreported
chlamydialinfectionsareamongAfrican
Americans.

Gonorrhea
In2010,1,804casesofgonorrheawere
reportedtoIDPH,or60forevery100,000
Iowans.Thestatehasabouthalfasmanycases
forevery100,000peopleasthenational
averageof119cases.LikeChlamydia,
gonorrheamoststronglyimpactsthose1524
yearsofage;sixtytwopercentofgonorrhea
casesareamongpeopleofthisage.Disparities
amongAfricanAmericansarethemost
pronouncedforthisinfectiousdisease,with
fortyonepercentofgonorrheacasesbeing
reportedamongthispopulation.Thehighest
ratesofdiagnosesarefoundinBlackHawk,
Polk,DesMoines,andScottcounties.

Diagnosesofgonorrheahavebeenrelatively
steadyforthepastdecade.However,N.
gonorrhoeaehasprogressivelydeveloped
resistancetotheantibioticdrugsavailableto
treatit.Becauseofthis,dualtherapywitha
cephalosporinandeitherazithromycinor
doxycyclineisnowrecommended.Thisisto
addressthepotentialemergenceofresistance
tocephalosporins,theoneclassofantibiotics

18

thateffectivelytreatsgonorrhea.Thepotential
forthelossofthelasteffectiveclassof
antibiotics,thesteadynumberofcases,andthe
pronounceddisparitiesamongAfrican
Americansmakeimprovinggonorrhea
preventionanimportantgoalofIDPHandof
CDC.

Figure9.NumberofcasesofChlamydiaand
gonorrheabyyear,20002010

Syphilis
Therewere68totalcasesofsyphilisreportedin
2010,or2forevery100,000people.However,
sporadicclustersofcasesandspreadfrom
otherstatesmakeitchallengingtoeliminate
syphiliscompletelyfromIowa.Syphiliscases
werereportedprimarilyamongmales,ages20
55,andmostoftenamongmenwhohavesex
withmen.Therateofinfectionwashighest
amongAfricanAmericans,whoexperiencea
rateof26forevery100,000people.Clustersof
syphilisareseen,especiallyinearlystagesof
infectionandinurbanareas.

Figure10.Numberofcasesofsyphilisbyyear,
20002010

Divisions of Acute Disease Prevention and Emergency Response, Environmental Health, and Behavioral Health

SummaryofEntericDiseases
Outbreaksummarytablesareattheendofthisreport.

Campylobacteriosis

Thetotalnumberofcampylobacteriosiscasesreportedin2010was751.Campylobacteriosisincidence
was25.0casesforevery100,000peoplein2010.

Figure11.Campylobacteriosiscasesversusmaximumexpectedcasesorthresholdbymonth,2010
Campylobacteriosisactivitytypicallypeaksinearlysummer.Consumptionofraw,undercookedmeat,
rawmilk,contaminatedwater,andcontactwithinfectedanimalsarecommonsourcesofcampylobacter
infection.InJune2009,anewrapid,nonculturetestforcampylobacterwasintroduced.IDPHandSHL
areevaluatingwhetherthenewtestishavinganyeffectontheincreasednumberofreportedcases.
Cryptosporidiosis

Cryptosporidiosisactivityin2010increasedoveractivityin2009.Therewere13.2casesforevery
100,000Iowansin2010,comparedto7.7in2009.Mostcasesreportedeitherchildcareattendanceor
recreationalwaterexposure.TheCDCcasedefinitionusedforcryptosporidiosiscasesin2010now
includesepidemiologicallylinkedcases.Thosecasesarecurrentlybeingtrackedandreported.

Figure12.Cryptosporidiosiscasesversusmaximumexpectedcasesorthresholdbymonth,2010

19

Iowa Department of Public Health

E. coli O157:H7 and other shiga-toxin producing strains

TheincidenceofE.colishigatoxincasesinIowaincreasedslightlyto5.8cases/100,000personsin2010
from5.4cases/100,000personsin2009.In2010,IDPHassistedinthenationaloutbreakinvestigations
involvingrawcookiedoughandbladetenderizedsteak.Therewere173casesreportedin2010.

Figure13.E.coliO157:H7andothershigatoxinproducingstrainscasesversusmaximumexpected
casesorthresholdbymonth,2010
Giardiasis

Giardiasisisoneoftheleadingwaterbornediseases.Ittypicallypeaksinlatesummerorearlyfall.
In2010,therewere284casesinIowa.Diaperedchildrenandthoseinchildcarearemostlikelyto
becomeinfectedwithgiardia.Twentythreepercentofcaseswereagefiveandunder.Therewere9.4
casesforevery100,000Iowanscomparedto9.7/100,000inthepreviousyear.

Figure14.Giardiasiscasesversusmaximumexpectedcasesorthresholdbymonth,2010

20

Divisions of Acute Disease Prevention and Emergency Response, Environmental Health, and Behavioral Health

Hepatitis A

In2010,therewere11casesofhepatitisAreportedinIowa.Thisrepresentsaseventyninepercent
reductionoverthepreviousthreeyearaverageof52.Casesrangedfrom17to85yearsofage,withonly
threecasesyoungerthan25.Sixtyfourpercentofcasesweremale.Noneoftheillnesseswere
associatedwithoutbreaks.

Figure15.HepatitisAcasesversusmaximumexpectedcasesorthresholdbymonth,2010

Listeriosis

TherewerethreecasesofListeriamontocytogenesinfectionreportedin2010.Noneofthesecaseswere
associatedwithknownListeriaoutbreaks.
Salmonellosis

Salmonellosisincidencein2010increasedto17.6casesper100,000personsfrom13.6casesper
100,000personsin2009.Thetotalnumberofcasesreportedwas530.Astatewideoutbreakof
SalmonellaNewportassociatedwithguacamoleproductssoldatcommunityeventsoccurredinJuly.In
August2010,IDPHparticipatedinanefforttoidentifySalmonellaenteriditisfromshelleggsproducedin
Iowa;however,nooutbreakswereidentifiedduetotheshelleggs.

Figure16.Salmonellosiscasesversusmaximumexpectedcasesorthresholdbymonth,2010

21

Iowa Department of Public Health

Shigellosis

In2010,therewere57casesofShigellainIowa.Thiswasanapproximatelya45percentdecreaseover
theaveragenumberofcasesforthepastthreeyears.Shigellainfectionswerereportedinallareasof
thestate.Approximately26percentcaseswereunder5yearsold;approximately33percentinpersons
aged2464years.Thiscorrespondstochildrenandtheirparentsorcaretakersbeingatmostrisk.

Figure17.Shigellosiscasesversusmaximumexpectedcasesorthresholdbymonth,2010

22

Divisions of Acute Disease Prevention and Emergency Response, Environmental Health, and Behavioral Health

SummaryofZoonoticDiseases
Dengue fever

In2010,twocasesofdenguefeverwere
reportedtoIDPH;bothwithrecent
internationaltraveltocountrieswheredengue
virusisendemic.
Ehrlichiosis/Anaplasmosis

Thereareatleastthreespeciesofbacteria
responsibleforehrlichiosis/anaplasmosisinthe
UnitedStates:Ehrlichiachaffeensis,Anaplasma
phagocytophilum,andEhrlichiaewingii.The
clinicalsignsofdiseasethatresultfrom
infectionwiththeseagentsaresimilar.
In2010,thereweretwocasesofehrlichiosis/
anaplasmosisreportedtoIDPH.Medianageof
thecaseswas83.5years.
Hantavirus

Therewerenoreportsofhantaviruspulmonary
syndrome(HPS)caseinIowain2010.

TherehavebeensevencasesofHPSreportedin
Iowasincethediseasewasfirstidentifiedin
1993.Substantialrodentexposurewas
identifiedinmostcases.

Lyme disease
LymediseaseiscausedbythebacteriumBorrelia
burgdorferiandistransmittedtohumansbythe
siteofaninfectedtick,specificallythe
blackleggedtick.SymptomsofLymedisease
includefever,headache,fatigue,andskinrash
alsoknownaserythemamigrans.Therewere87
casesofLymediseasereportedtoIDPHin2010.
The2010IowacaserateforLymediseasewas
2.9per100,000.Casesrangedfromagesthreeto
84.

Figure18.Confirmedandprobablecasesof
LymediseasereportedtoIDPH,20002010
Malaria

Fourteencasesofmalariawereidentifiedin
Iowain2010;sixpatientshadrecently
immigratedtotheUnitedStates.Threecases
weredeterminedtohavePlasmodium
malariae;eightcaseshadPlasmodium
falciparuminfections;threewereunknown.

Rabies, Animal

In2010,27casesofanimalrabieswere
reportedinIowa,whichisaslightdecrease
from2009(seetablebelow).Rabieswas
identifiedmostfrequentlyinwildlifespecies
including13skunks,10bats,andonefox.Two
caseswerediagnosedincompanionanimals
includingonecatandonedog.Onecowalso
testedpositive.
Table3.Numberofanimalspositiveforrabies
virusbyspecies,2010
Species
Dogs
Cow
Cat
Bat
Fox
Skunk

23

Positive TotalTested
1
322
1
72
1
425
10
444
1
6
13
27

%Positive
0.31%
1.39%
0.24%
2.25%
16.67%
48.15%

Iowa Department of Public Health

During2010,1479animalsinIowaweretested
forrabiesand27wereconfirmedpositive
(1.83%).Thepercentpositivevariesgreatlyby
species,seeTable3.Itisimportanttonotethat
thepercentpositveisgreatlyinfluencedbythe
numberofanimalstested.Manyanimalsare
testedbecausetheyexhibitunusualbehavioror
clinicalsigns,makingthemmorelikelytobe
infectedwiththerabiesvirus.Forthese
reasons,thepercentagesshouldnotbe
consideredrepresentativeofthetrue
distributionofthisdiseasewithintheanimal
populationinIowa.

Therearetworabiesstrainsthatcommonly
circulateinIowa(batandskunk);many
differenttypesofanimalscanbeinfectedwith
thesestrains.Inanimalsamplesthatare
stronglypositiveforrabies,the
StateHygienicLaboratory(SHL)can
differentiatetherabiesstrainthatinfectedthe
animal.In2010,SHLwasabletoidentifythe
rabiesstrainin22ofthe27positiverabies
cases;14wereskunkstrainand8werebat
strain.Skunkstrainrabieswasidentifiedin12
skunks,1cat,and1fox.Batstrainrabieswas
identifiedin8bats.

Iowasmostrecenthumanrabiescaseoccurred
in2002,andwascausedbythebatstrain.Prior
tothat,thelastreportedhumancaseoccurred
in1951.

Whiletheexactnumberofpeoplewhoreceive
rabiespostexposureprophylaxiseachyearin
theUnitedStatesisunknown,itisestimatedto
beabout40,000people.BaseduponIowas
population,itisestimatedthatapproximately
390Iowansreceivepreventativetreatment
eachyear.

Rocky Mountain Spotted Fever (RMSF)

In2010,therewere5casesofRockyMountain
SpottedFever(RMSF)reportedinIowa.
AmericandogticksarecarriersofRickettsia
rickettsii,thebacteriumthatcausesRMSF.The
Americandogtickisthemostcommonspecies
oftickinIowaandcanbefoundineverycounty
inthestate.ThetickisactivelateMarch
throughAugust 5.IowaRMSFcasesin2010had
symptomonsetdatesfromApriltoAugust.
Casesrangedfromage48to76,withamedian
ageof43.Allthefivecasesaremale.

Rabies, Human

Table4.Numberofanimalspositiveforrabiesvirusbyspeciesandyear,20012010

Species
2001
2002
2003
2004
2005
2006
2007 2008 2009 2010 Total
Bat
31
27
47
47
60
28
13
11
11
10
285
Skunk
28
27
38
28
33
13
5
7
13
13
205
Cat
10
7
8
11
5
7
7
9
3
1
68
Cow
10
12
3
10
7
4
0
1
5
1
53
Dog
2
3
6
3
2
2
5
1
2
1
27
Horse
3
2
3
0
1
3
1
0
0
0
13
Fox
1
0
0
1
0
0
0
0
0
1
3
Squirrel
0
0
0
0
0
0
0
0
1
0
1
Badger
0
0
1
0
0
0
0
0
0
0
1
Total
85
78
106
100
108
57
31
29
35
27
656

24

Divisions of Acute Disease Prevention and Emergency Response, Environmental Health, and Behavioral Health

West Nile Virus

TherewereninehumancasesofWestNilevirus
reportedtoIDPHin2010.Sevenofthenine
caseswerehospitalized;twopersonsdied.One
deathwasreportedinanelderlyman(86years
ofage)fromeasternIowa,theotherdeathwas
reportedinanelderlywoman(95yearsofage)
fromcentralIowa.

Table5.IowaWestNilevirusactivitybyspeciesandoutcome,20022010

2002
2003
2004
2005
2006
2007
Humancases
54
147
23
37
37
30
Humandeaths
2
6
2
2
0
3
Sentinelchickens
31
15
9
19
18
18
Mosquitopools
8
27
0
7
15
5
Horses
1142
96
18
15
12
10

25

2008
2009
5
5
1
0
3
6
5
9
4
3

2010
9
2
14
7
2

Iowa Department of Public Health

SummaryofRareandUnusual
Diseases
Hansensdisease(Leprosy)
In2010,onecaseofHansensdiseasewas
reportedinIowa.Thecasewasa40yearsof
agemalelivingoutsideofU.S.

Legionellosis
TheaveragenumberofLegionellacasesforthe
pastthreeyearsis19cases.Therewere16
casesoflegionellosisreportedtoIDPHin2010.
Ofthe16cases,14werehospitalizedand5died
fromthedisease.

ToxicShockSyndrome
TherewasonecaseofToxicShockSyndrome
reportedtoIDPHin2010,whichoccurredina
19yearoldfemale.

Tetanus
TherewasonecaseoftetanusreportedtoIDPH
in2010ina7yearoldboy.

Therewerenocasesofhumanillness
reportedforthefollowingdiseases:
HepatitisE
Psittacosis
YellowFever
Tularemia

26

Divisions of Acute Disease Prevention and Emergency Response, Environmental Health, and Behavioral Health

SummaryofEnvironmentalHealth
Conditions

Carbonmonoxidepoisonings

25

Carbon Monoxide (CO) Poisoning


Surveillance

Table6.Genderofcaseswithcarbon
monoxidepoisoningmeetingcasedefinition,
2010

Numberofcases
Male
27
Female
20
Total
47*
*genderwasnotspecifiedfor3cases

10
5

7
3

Fatal

Moderate

Minor

NoEffect

Undetermined

SeverityofHealthImpact

Figure19.Severityofhealthimpactamong
casepatientswithcarbonmonoxidepoisoning,
2010
FatalPatientdiedduetoCarbonmonoxidepoisoning
ModeratePatientexperiencedmoderatesymptomssuch
asnausea,vomiting,confusion
MinorPatientexperiencedminorsymptomssuchas
headache,dizziness
NoEffectPatientexperiencednosymptomsconsistent
withCOexposure

35

33

30
25
20
15
10
5

0
Fire

Vehicle

Fixed
Appliance

Mobile
Appliance

Other

Unidentified

Locationofexposure

Figure20.Sourcesofexposureamongcase
patientswithcarbonmonoxidepoisoning,
2010
Vehiclesincludeautomobilesandotherfuelpowered
recreationalvehicles(i.e.boats,fourwheelers,Zamboni,
etc).
Fixedappliancesincludefuelburningequipmentthatis
typicallystationary(i.e.furnaces,gaswaterheaters,gas
stovesorfireplaces,etc).
Mobileappliancesincludegenerators,spaceheaters,and
othersmallpowerequipment(i.e.powerwashers,lawn
mowers,chainsaws,etc).

27

16
15

Carbonmonoxidepoisonings

Eachyear,accordingtotheCDC,morethan400
AmericansdiefromunintentionalCOpoisoning,
morethan20,000visittheemergencyroom
andmorethan4,000arehospitalizedduetoCO
poisoning.FatalityishighestamongAmericans
65andolder.IDPHcollectsreportsofCO
poisoningandCOexposurefromhealthcare
providersandfacilities,andtheIowaStatewide
PoisonControlCenter.COpoisoningisdefined
inIowaas:
Abloodcarbonmonoxidelevelequaltoor
greaterthan10%carboxyhemoglobinorits
equivalentwithabreathanalyzertestor;
Aclinicaldiagnosisofcarbonmonoxide
poisoningregardlessofanytestresult.
Informationcollectedincludesbasic
demographics(age,gender,countyof
residence),diagnosis,bloodcarboxyhemoglobin
testresults,exposure(circumstance,source,
location),andseverityofhealthimpact.
Reportsarereviewedtoidentifyclustersand
possibleoccupationalexposuresforfurther
investigation.

In2010,therewere3reporteddeathsfromCO
exposureinIowa.Sixtyfour(64)individual
reportsofCOexposurewerereceivedbyIDPH.
Fifty(50)ofthesereportsmetthecase
definitionforcarbonmonoxidepoisoning.

21
20

Iowa Department of Public Health

Methemoglobinemia

Methemoglobinemiaisablooddisordercaused
whennitriteinteractswiththehemoglobinin
redbloodcells,reducingtheabilitytocarry
sufficientoxygentoindividualbodycells.
Infantsundersixmonthsofagearetheprimary
populationatrisk,theydevelopaconditionalso
knownasBluebabysyndrome.

Sourcesofnitriteincludenitratein
contaminateddrinkingwaterorfrom
preservativesinfood,somedrugs,orother
sources.

Therewere6casesofMethemoglobinemia
reportedinIowain2010.Noneofthecases
wereinfants.

Heavy Metal Poisoning (Non-Lead)

Numberofcases

IDPHconductssurveillanceforthreeother
heavymetalsinadditiontolead:arsenic,
cadmium,andmercury.Casesofpoisoningfrom
thesethreeheavymetalsarerareinIowa,and
manyexposuresarerelatedtoindustrialor
hobby/smallmarketworkinindustriesthat
utilizethesemetals.Outsideofindustrialuse,
thepossibilityofarseniccontaminationof,
moonshine,herbalpreparations,andnutritional
supplementsalsomustbeconsideredasa
sourceofexposure.Otherpotentialsourcesof
mercuryexposureincludeconsumptionoflarge
amountsofcontaminatedfishandseafood;or
frombrokenthermometers,barometers,
fluorescentlightbulbs,electricalswitchesor
someherbalpreparations.
5
4
3
2
1
0

4
2
1

Arsenic

Mercury

Cadmium

Metal

Figure21.ReportedcasesofArsenic,Cadmium
andMercurypoisoninginIowa,2010
Childhood lead poisoning

Leadhasadverseeffectsonnearlyallorgan
systemsinthebody.Itisespeciallyharmfulto
28

thedevelopingbrainsandnervoussystemsof
childrenundertheageof6years.Atveryhigh
bloodleadlevels,childrencanhavesevere
braindamageorevendie.Atbloodleadlevels
aslowas10microgramsperdeciliter(g/dL),
childrensintelligence,hearing,andgrowthare
affected.Thisdamagecanbeminimizedifa
childsleadexposureisreduced.However,the
damagecannotbereversed.Achildis
consideredtobeleadpoisonedatabloodlead
levelof10g/dL.

In2002,researchersestimatedthattheaverage
decreaseinlifetimeearningsofachildwitha
bloodleadlevelof10g/dLwouldbeatleast
$40,000andthattheaveragedecreasefora
childwithabloodleadlevelof20g/dLwould
beatleast$80,0007.

Iowa'schildrenaremostcommonlypoisonedby
leadbasedpaintfoundinhomesbuiltbefore
1950.Leadbasedpaintinahomebecomesa
leadhazardasitdeterioratesandleadbased
paintchipsenduponthefloorsandinwindow
wellsthroughoutthehome,aswellasinthesoil
aroundtheexteriorofahome.Since1992,
IDPHhasrecommendedthatallchildrenunder
theageofsixyearsbetestedforleadpoisoning
throughabloodtestandhasalsohasrequired
theresultsofallbloodleadtestingtobe
reportedtoIDPH.Stateandfederallaws
mandateleadtestingforchildrenreceiving
Medicaid.Since2008,Iowalawhasrequired
thatallchildrenhaveproofofabloodleadtest
whenenrollinginkindergarten.

IDPHreportstherateofbloodleadtesting
amongchildrenandtheprevalenceoflead
poisoningbybirthcohort.Abirthcohortisa
groupofchildrenbornduringaspecificyear.
IDPHhascompletedataforchildrenbornin
1991through2004.Duringthattime,the
percentageofchildrentestedforleadpoisoning
hasincreasedfrom26percentto97.7percent.

InIowa,theprevalenceofleadpoisoning
amongchildrenundertheageofsixyearsis4.3
percent(combinedbirthcohorts).Thisis
approximatelyseventimesthenationalaverage
of0.6percent.DatacollectedbyIDPHinclude

Divisions of Acute Disease Prevention and Emergency Response, Environmental Health, and Behavioral Health

thenumberandpercentageofchildrenbornin
averagebloodleadlevelfornewcaseswas19
2004whoweretestedforleadpoisoning,the
g/dL,witharangeof1092g/dL.Ofthenew
numberandpercentageofallchildrentested
cases,107(67%)wereabletobeclassifiedby
whowereidentifiedasleadpoisonedaswellas
theiroccupationalindustry,with50%ofthenew
thenumberandpercentageofchildrenwho
casescomingfromtheleadbattery
weretestedforleadpoisoningandidentifiedas
manufacturingindustry.
leadpoisonedbyMedicaidandWICstatus(see

Table15).
Femalesaccountedfor10.6%(78)ofthe736

EBLs,withanaveragebloodleadlevelof18
g/dL.Womenofchildbearingage(1644
Adultleadpoisoning
yearsofageorthosebornin1965orlater)
In2010,atotalof4,998bloodleadlevel(BLL)
accountedfor24ofthe78femalecases(31%),
testresultson2,905adultIowanswere
and8ofthe78ofEBLsfemales(10%)were35
recordedbytheIowaAdultBloodLead
yearsofageoryounger.Thebloodleadlevels
EpidemiologyandSurveillance(ABLES)
forEBLfemalesrangedfrom1034g/dL.Itis
program.AllbloodleadtestresultsforIowa
unknownifanyofthesewomenwerepregnant
residentsarereportabletoIDPHunderIowa
atthetimeoftheirexposure.Mostofthe
AdministrativeCode641,Chapter1.
femaleswithEBLsworkintheleadbattery

manufacturingindustry.
Bloodleadtestsof10g/dLorhigherare

currentlydefinedasanelevatedbloodlead
Iowashighestriskindustriesin2010remain
level(EBL).In2010,therewere736people
consistentwithpreviousyears;themajority
(25%ofthosetested)whohadBLLsof10g/dL
(84%)ofEBLadultsworkinginmanufacturing
orhigher.Ofthem,14peoplehadbloodled
plantsthatuseleadormetalproductsthat
levelsof40g/dLorhigher,159hadbloodlead
containlead.Additionalcasesin2010include
levelsof2539g/dL,and563hadbloodlead
exposuresfromindoorfiringranges(workand
levelsof1024g/dL.
hobbyactivity),foundryworkers,dyeand

pigmentmanufacturing,automotiverepair,
Ofthe736EBLs,159(21.6%)wereclassifiedas
artisanssuchasleadedglassworkers,and
newcases;thatis,theydidnothaveablood
workersinresidentialconstructionor
leadlevelsof10g/dLorhigherin2009per
remodeling.
recordsintheIowaABLESdatabase.The

Table7.IowaAdultBloodLeadTestsResult,20092010andChangesfrom2009to2010
IAABLESDATA

NumberofIowa
AdultsTested
2009BLL

BLL40g/dLorhigher
BLL2539g/dL
BLL1024g/dL
BLL09g/dL
AllBLL10+(TotalEBLS)
TotalIndividualsTested

13
172
509
1711
694
2405

NumberofIowa
2010change
AdultsTested
from2009
2010BLL
14
159
563
2169
736
2905

+1
13
+54
+458
+42
+500

Percentof
AdultsTested
2009byBLL
Range
0.5%
7.2%
21.2%
71.1%
28.9%

Percentof
AdultsTested
2010byBLL
Range
0.5%
5.5%
19.4%
74.7%
25.3%

Adults:Persons16yearsofageorolderasofdateofbloodtest.
IowaAdultData:TestresultsforpersonswithanIowaresidentialaddressasofdateofbloodtest.Bloodleadtestreportsreceived
withoutaddressdataorwitharesidentialaddressoutsideofIowaarenotincludedinthisreport.Reportreflectsdataindatabaseas
ofFebruary28,2011.Laterdataentriesarenotincludedatthistime.

29

Iowa Department of Public Health

30

informationcanbefoundathttp://www.public
health.uiowa.edu/face/.

100

86

93

80

89

90

79

78
Numberofcases

TraumaticWorkRelatedFatalitiesSurveillance
TheIDPHOccupationalHealthandSafety
SurveillanceProgram(OHSSP)includestheIowa
FatalityAssessmentandControlEvaluation
(FACE)program,whichissubcontractedtothe
UniversityofIowaCollegeofPublicHealth
InjuryPreventionResearchCenter(UIIPRC).
Theprogramisacollaborationbetweenthe
OHSSP,theIowaOfficeoftheStateMedical
Examiner,andUIIPRCthroughfunding
providedbytheNationalInstituteof
OccupationalSafetyandHealth(NIOSH).Iowa
FACEhasidentified69workrelatedfatalities
for2010(preliminarydata),whichisbelowthe
tenyearaverageof79cases,andthethird
lowestnumberofworkrelatedfatalitiessince
theIAFACEprogrambeganin1995.Motor
vehiclecrashesonpublicroadwaysarethe
largestsingleeventcausingworkrelated
fatalitiesinIowa(26/6938%).Farmingor
agriculturalactivitiesinvolved17ofthe69
deaths(25%),including4ofthepublicroadway
motorvehiclecrashes.Constructionincidents
accountedfor7deaths(10%).

ForfatalitiestobeincludedasaFACEcase,
theincidentcausingtheworkrelateddeathhas
tooccurinIowa(residentornonresident),and
betraumaticinnature.Casesincludework
relateddeathsofpersonsregardlessof
compensationstatus,thatis,volunteersor
familymemberswhoareworkingregardlessof
payment.Deathsthatoccurwhilecommuting
toorfromworkdonotqualify.Iowaworkers
killedwhileworkingoutofstatearenot
included.

Somepotentialcasesmaynotbeidentifieddue
tolackofsurveillancedata,especiallyfor
individualskilledinmotorvehiclecrasheswhen
itisunknownthatthepersonwastravelingas
partoftheirjobduties(otherthancommuting).
Forthisreason,somecasesarenotidentified
untilmonthsaftertheincident.Forthese
reasons,totalcasenumbersmaydifferbetween
thosereportedbyotherprograms,suchasthe
USBureauofLaborStatisticsCensusofFatal
OccupationalInjuries(CFOI)ortheIowaWorker
MemorialDayobservance.Additional

76

68

69

60
60

40

20

0
2001

2002

2003

2004

2005

2006

2007

2008

Year

*Preliminarydata

Figure22.IowaFACEworkrelateddeath

2009

2010*

Divisions of Acute Disease Prevention and Emergency Response, Environmental Health, and Behavioral Health

OutbreakSummaries
Table8.FoodborneOutbreaks,2010
Type

Nature
ofEpisode

Event/Place

Foodborne

Vomiting,
Watery
Diarrhea,
Abdominal
Cramps
Diarrhea,
Abdominal
Cramps
Diarrhea,
Abdominal
Cramps
Diarrhea,
Abdominal
Cramps
Diarrhea,
Nausea,
Abdominal
Cramps
Diarrhea,
Nausea,
Vomiting,
Headache,
Chills,
Fever,
Diarrhea,
Abdominal
Cramps,
Vomiting
Diarrhea,
Abdominal
Cramps

School

Foodborne

Foodborne

Foodborne

Foodborne

Foodborne

Foodborne

Foodborne

31

Locationof
Food
Preparation
Locker/Cater
er

Locationof
Food
Consumption
School

Region

Month

NumberAffected

FoodVehicleof
Transmission

Agent Involved

June

32/50

BBQPork

Clostridium
perfringens

Restaurant

Restaurant

Restaurant

June

Unknown

Salmonella
baildon

Restaurant

Restaurant

Restaurant

June/July

Unknown

Salmonella
enteriditis

Farmers
Market

Restaurant

Farmers
Market/Home

July

39conf,5epilink

Guacamole

Salmonella
newport

Anniversary
Party

Church

Church

4conf,1epilink

Unknown

Teachers
Luncheon

Home

School

August

48/133

Unknown

Clostridium
perfringens

Baptism

Home

Home

October

6/99

PorkMeat

Salmonella
infantis

Restaurant

Restaurant

Restaurant

October

Unknown

Salmonella
Thompson

July
August

Salmonella
I4(5):i;
(monophasic)

Iowa Department of Public Health

Table9.NonfoodborneorUnknownCauseOutbreaks,2010
Type

Natureof
Episode

Event/Place

Region

Month

Number
Affected

Vehicleof
Transmission

Agent Involved

PersontoPerson

PersontoPerson

PersontoPerson

PersontoPerson

PersontoPerson

PersontoPerson

PersontoPerson

PersontoPerson

Diarrhea,
Vomiting
Diarrhea,
Vomiting
Diarrhea,
Vomiting
Diarrhea,
Vomiting
URI,coughing,
Pneumonia
Diarrhea,
Vomiting
Diarrhea,
Vomiting
Diarrhea,
Vomiting,
Nausea,Chills
Vomiting,
Nausea,
Abdominal
Cramps
ParotidGland
Swelling

Restaurant

January

7/9

PersontoPerson

Norovirus 3

Skating
Competition
DrillTeam
Event
Hospital
Potluck
LCTF

January

30/100

PersontoPerson

Norovirus4

March

4/400

PersontoPerson

Norovirus3

March

27/35

PersontoPerson

Norovirus

March

PersontoPerson

HumanMetapneumovirus

Congregate
Meal
School

March

41/125
+staff
7/40

PersontoPerson

Norovirus4

April

4/24

PersontoPerson

Norovirus2

Funeral
Luncheon

April

23/51

PersontoPerson

Norovirus3

School

April

42/400

PersontoPerson

Suspect Norovirus

College

May

PersontoPerson

Mumps

Vomiting,
Diarrhea,
Cramps
Vomiting,
Diarrhea
Diarrhea,
Abdominal
Cramps
Fever,Sore
Throat,Coughs,

School

June

41

PersontoPerson

Viral

Wedding
Reception
ChildCare

June

30/210

PersontoPerson

Norovirus2

July

PersontoPerson

E.coliO157:H7

SportsTeam

July

PersontoPerson

SeasonalFluAH3

PersontoPerson

Vaccine
Preventable

PersontoPerson

PersontoPerson

PersontoPerson

Vaccine
Preventable
32

Divisions of Acute Disease Prevention and Emergency Response, Environmental Health, and Behavioral Health

Type

PersontoPerson

PersontoPerson

PersontoPerson

Waterborne

Waterborne

Waterborne

PersontoPerson

PersontoPerson

PersontoPerson

PersontoPerson

PersontoPerson

33

Natureof
Episode
BodyAches,
Congestion
Diarrhea,
Vomiting,
Nausea,Chills
Diarrhea,
Vomiting
Diarrhea,
Vomiting,
Nausea
Diarrhea,
Vomiting,
Dehydration
Diarrhea,
Nausea,
Abdominal
Cramps
Diarrhea,
Nausea,
Abdominal
Cramps
Diarrhea
Diarrhea,
Vomiting
Diarrhea,
Nausea,
Vomiting,
Abdominal
Cramps
Fever,
Vomiting,
Diarrhea
Nausea,
Vomiting,
Diarrhea,

Event/Place

Region

Month

Number
Affected

Vehicleof
Transmission

Agent Involved

Wedding

July

28/200

PersontoPerson

Norovirus1

Restaurant

July

8/15

PersontoPerson

Suspect C.perfringens

Wedding

July

11/200

PersontoPerson

Norovirus2

DayCamp

JulyAug

Waterborne

Cryptosporidium

ChildCare
Center

August

4
confirmed,
3epilinks
5
confirmed,
8epilinks

Waterborne

Cryptosporidium

Waterpark

Statewide

July
August

13confirme
d,2epi
links

Waterborne

Cryptosporidium

Restaurant

September

PersontoPerson

HepatitisA

AfterSchool
ChildCare
ChildCare

September

1
confirmed
13/54

PersontoPerson

SuspectNorovirus.

September

4/8

PersontoPerson

SalmonellaHartford

School

October

100/425

PersontoPerson

Norovirus3

Funeral
Reception

November

35/175

PersontoPerson

Norovirus2

Iowa Department of Public Health

Type

PersontoPerson

Natureof
Episode
Abdominal
Cramps
Nausea,
Diarrhea,
Abdominal
Cramps
Nausea,
Vomiting,
Diarrhea,
Abdominal
Cramps

PersontoPerson

PersontoPerson Diarrhea,

Vomiting
PersontoPerson

34

Event/Place

Region

Month

Number
Affected

Vehicleof
Transmission

Agent Involved

LongTermCare
Facility

November

29/100

PersontoPerson

SuspectNorovirus

Hospital

December

48ill

PersontoPerson

Norovirus3

AssistedLiving

December

30/70

PersontoPerson

SuspectNorovirus

Restaurant

December

25/51

PersontoPerson

Norovirus5

Divisions of Acute Disease Prevention and Emergency Response, Environmental Health, and Behavioral Health

Table10.Casesandratesper100,000populationfor2010byagegroup
0to4
Disease Cases Rate

5to19

20to29

30to39

40to64

>64

Unk

Total

Cases

Rate

Cases

Rate

Cases

Rate

Cases

Rate

Cases

Rate

Cases

Cases

Rate

AIDS(diagnoses)

0.0

0.0

15

3.5

23

6.6

32

3.3

0.2

71

2.4

Botulism,infant

0.0

0.0

0.0

0.0

0.0

0.0

0.0

Campy

85

41.7

129

21.4

114

26.9

94

26.9

221

22.5

108

24.3

751

25.0

Chlamydia

15

7.4

3661

606.9

5823

1376.5

864

246.8

179

18.2

0.0

10542

350.5

Cryptosporidiosis

64

31.4

109

18.1

54

12.8

57

16.3

63

6.4

50

11.3

397

13.2

Denguefever

0.0

0.0

0.2

0.3

0.0

0.0

0.1

E.colishgt
Ehrlichiosis/anaplasmsis
Giardiasis

44
0

21.6
0.0

61
0

10.1
0.0

16
0

3.8
0.0

10
0

2.9
0.0

26
0

2.6
0.0

16
2

3.6
0.5

0
0

173
2

5.8
0.1

63

30.9

58

9.6

31

7.3

38

10.9

73

7.4

21

4.7

284

9.4

Gonorrhea

1.5

549

91.0

917

216.8

255

72.8

77

7.8

0.7

1804

60.0

Hemolyticuremicsyndrome

1.5

0.0

0.0

0.0

0.2

0.0

0.2

0
0
5
1
0
6
0
1
4
99
0
0
85
15
0
0
1
0

0.0
0.0
2.5
0.5
0.0
2.9
0.0
0.5
2.0
48.5
0.0
0.0
41.7
7.4
0.0
0.0
0.5
0.0

1
0
10
4
0
24
5
0
16
449
0
0
72
18
2
0
0
0

0.2
0.0
1.7
0.7
0.0
4.0
0.8
0.0
2.7
74.4
0.0
0.0
11.9
3.0
0.3
0.0
0.0
0.0

3
2
36
34
0
14
5
2
11
38
0
0
68
6
13
0
1
0

0.7
0.5
8.5
8.0
0.0
3.3
1.2
0.5
2.6
9.0
0.0
0.0
16.1
1.4
3.1
0.0
0.2
0.0

2
6
48
29
0
6
2
2
3
41
0
0
63
5
18
0
1
2

0.6
1.7
13.7
8.3
0.0
1.7
0.6
0.6
0.9
11.7
0.0
0.0
18.0
1.4
5.1
0.0
0.3
0.6

4
5
74
44
7
28
2
4
4
65
3
3
163
10
31
0
0
3

0.4
0.5
7.5
4.5
0.7
2.8
0.2
0.4
0.4
6.6
0.3
0.3
16.6
1.0
3.2
0.0
0.0
0.3

1
2
10
0
9
9
0
1
0
13
1
2
79
3
4
0
0
4

0.2
0.5
2.3
0.0
2.0
2.0
0.0
0.2
0.0
2.9
0.2
0.5
17.8
0.7
0.9
0.0
0.0
0.9

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

11
15
183
112
16
87
14
10
38
705
4
5
530
57
68
0
3
9

0.4
0.5
6.1
3.7
0.5
2.9
0.5
0.3
1.3
23.4
0.1
0.2
17.6
1.9
2.3
0.0
0.1
0.3

HepatitisA
HepatitisB,acute
HepatitisB,chronic
HIV(diagnoses)
Legionellosis
Lyme
Malaria
MeningococcalInv.Disease
Mumps
Pertussis
Qfever
RockyMountainSpottedFever
Salmonellosis
Shigellosis
Syphilis
Tuberculosis
TyphoidFever
WestNileVirus

35

Iowa Department of Public Health

Table11.Casesandratesper100,000populationfor2010bySEX,IOWA

Sex
Disease
AIDS(diagnosis)
Campylobacteriosis
Chlamydia
Cryptosporidiosis
E.coliandothershigatoxinproducing
Ehrlichiosis(HME)
Giardia
Gonorrhea
Hemolyticuremicsyndrome
HepatitisA
HepatitisB,acute
HepatitisB,chronic
HIV(diagnoses)
Legionellosis
Listeriosis
Lymedisease
Meningococcalinvasivedisease
Mumps
Pertussis(whoopingcough)
RockyMountainSpottedFever
Salmonellosis
Shigellosis
Syphilis

36

Female
Cases
Rate

Male
Cases
Rate

9
312
7612
203
83
0
125
1180
3
4
6
76
18
10
3
28
3
11
379
0
282
37
21

62
436
2930
194
90
2
157
624
2
7
9
107
94
6
0
59
7
27
322
5
248
19
47

0.6
20.5
500.1
13.3
5.5
0.0
8.2
77.5
0.2
0.3
0.4
5.0
1.2
0.7
0.2
1.8
0.2
0.7
24.9
0.0
18.5
2.4
1.4

4.2
29.3
197.2
13.1
6.1
0.1
10.6
42.0
0.1
0.5
0.6
7.2
6.3
0.4
0.0
4.0
0.5
1.8
21.7
0.3
16.7
1.3
3.2

Unk
Cases
0
3
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
4
0
0
1
0

Total
Cases
Rate
71
751
10542
397
173
2
284
1804
5
11
15
183
112
16
3
87
10
38
705
5
530
57
68

2.4
25.0
350.5
13.2
5.8
0.1
9.4
60.0
0.2
0.4
0.5
6.1
3.7
0.5
0.1
2.9
0.3
1.3
23.4
0.2
17.6
1.9
2.3

Divisions of Acute Disease Prevention and Emergency Response, Environmental Health, and Behavioral Health

Table12.Notifiablediseasesbyyear,19912010
Notifiable
diseases
AIDS (diagnosis)

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

76

117

157

103

110

104

97

75

60

77

80

80

75

75

70

78

79

68

64

91

71

Anthrax
Botulism
Brucellosis
(Undulant Fever)
Campylobacteriosis

1
3

388

333

260

292

280

274

339

425

455

467

6125

5214

5412

5088

4165

4906

5173

5511

Chlamydia
Cholera

Cryptosporidiosis

71

1
2

499

467

427

458

559

537

449

524

591

552

751

5989

5716

6241

6462

6958

7390

8399

8643

9372

9406

10542
397

1
21

Cyclospora

75

71

66

56

77

82

49

122

90

122

230

610

284

232

Dengue Fever

Diphtheria
Ehrlichiosis
Encephalitis
(arboviral except
WNV)
Escherichia coli
0157:H7 (includes
HUS & Shiga-toxin
producing)
Giardiasis
Gonorrhea
Haemophilus
influenzae Type B
Hansen's Disease
(Leprosy)
Hantavirus
Syndromes
Hepatitis A (Viral,
infectious)
Hepatitis B
(Serum) Acute /
Chronic
Hepatitis B
(Perinatal)
Hepatitis C or
unspecified

37

13

19

15

20

27

54

64

123

114

93

114

180

81

122

103

124

108

161

185

208

163

173

435

422

351

340

339

391

410

358

429

377

420

345

315

277

301

280

302

301

326

291

284

1653

1824

1645

1723

1144

1309

1615

1365

1394

1424

1496

1544

1249

1606

1981

1928

1700

1658

1804

23

15
1

1
2

277

48

53

58

64

106

346

490

400

161

67

41

72

40

50

22

13

48

109

38

11

54

42

33

36

27

46

74

44

54

44

38

24

20

27

17

32

21/35

269

25/226

293

15/183

1
17

14

12

12

25

43

1
262

156

Iowa Department of Public Health

Notifiable
diseases

2004

2005

2006

2007

2008

2009

2010

105

89

105

113

107

125

101

124

112

13

12

13

12

21

24

16

42

58

56

91

97

124

109

108

87

12

10

14

15

19

16

10

1,963

27

24

15

38

342

150

257

235

705

35

27

1991

1992

1993

1994

1995

1996

1997

1998
99

Legionellosis
Listeria
monocytogens

12

18

19

34

21

11

12

11
2

Lyme Disease

16

22

33

17

16

19

27

24

34

36

Malaria

10

11

Measles (Rubeola)
Meningococcal
Inv. Disease

26

17

15

18

28

25

31

56

47

46

42

37

32

29

28

17

19

20

Mumps
Pertussis
(Whooping Cough)

22

23

13

11

16

11

10

11

20

26

11

38

23

11

32

207

78

111

67

167

230

182

1066

1106

HIV (diagnosis)

1999

2003

1990

2000

2001

2002

85

92

96

17

15

Plague

Poliomyelitis

Psittacosis

155

175

78

Rabies (Animal)
Rabies (Human)
Rocky Mountain
Spotted Fever
Rubella (German
Measles)

215

3
90

141

237

160

153

159

81

83

1
74

105

100

108

57

31

Salmonellosis

314

304

339

242

404

433

335

296

375

260

373

339

509

413

435

410

475

477

425

408

530

Shigellosis

51

33

46

68

338

351

151

90

69

74

569

367

122

93

64

103

134

109

214

53

57

154

175

235

171

91

65

25

31

54

43

56

46

36

28

88

27

75

65

68

49

58

66

67

70

74

55

58

37

42

Tetanus
Toxic Shock
Syndrome

10

Trichinosis

79

Tuberculosis

72

71

30

17

31

40

47

55

Typhoid Fever
West Nile Virus
Yellow Fever

36

2
52

147

23

37

1
2

46

42

48

Tularemia

38

Syphilis

29

37

30

3
5
2

Divisions of Acute Disease Prevention and Emergency Response, Environmental Health, and Behavioral Health

Table13.Salmonellaserotypesreported2010

SalmonellaSerotypesbyFrequency
Salmonella

Serotype

Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella

Agona
Anatum
Arizonae
Baildon
Baildon
Baranquilla
Bareilly
Berta

Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella

Bovismorbificans
Braenderup
Bruck
Cubana
Derby
Dublin
Edinburg
Enteritidis
GroupB
GroupC
GroupD
Hadar
Hartford
Havana
Heidelberg
Infantis
Javiana
Johannesburg

39

Cases

Serotype

Cases

5
1
1
1
1
1
1
4

Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella

Meleagridis
Miami
Monophasic
Monschaui
Montevideo
Muenchen
Muenster
Newport

1
1
47
1
13
7
1
65

1
9
1
3
2
3
1
121
7
1
1
2
12
1
6
12
4
1

Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella
Salmonella

Ohio
Oranienburg
Oslo
ParatyphiA
ParatyphiBvarJava
Pomona
Poona
Preston
Saintpaul
Sandiego
Senftenberg
Species
SubspeciesI
SubspeciesIIIa
SubspeciesIIIb
SubspeciesIV
Thompson
Typhi

1
4
1
2
19
1
2
1
9
1
1
6
6
1
1
2
10
1

Iowa Department of Public Health

Salmonella
Salmonella

Kentucky
Lexington

1
1

Salmonella
Salmonella

Salmonella
Salmonella

Litchfield
Mbandaka

3
1

Salmonella

Total

Typhimurium
TyphimuriumVar
Copenhagen
Uganda
Unknown

48
39
1
28
530

Table14.Shigellaserogroups19912010
Shigella
Serogroups

1991

1992

1993

1994

Boydii
Dysenteriae

Flexneri

1995

1996

1998

1999

13

12

Group C

1
24

33

50

2002

10

11

2003

2004

2005

2006

2007

2008

2009

2010

15

11

7
3

199

119

116

1
62

44

1
55

Unknown

40

2001

Group D

TOTAL CASES

2000

Group B

Sonnei

1997

33

46

68

338

351

151

90

69

74

514

306

63

62

41

58

110

97

136

45

49

41

46

46

25

12

569

365

122

93

64

78

134

109

214

53

57

Divisions of Acute Disease Prevention and Emergency Response, Environmental Health, and Behavioral Health

Table15.Iowachildrenbornin2004andtestedforbloodleadlevelsbeforetheageof6yearsbycounty(asof12/31/2010)
COUNTY

2004BIRTHS TESTED %TESTED

>=10G/dl

%>=10G/dl

COUNTY

2004BIRTHS

TESTED

%TESTED

>=10G/dl

%>=10G/dl

Adair

60

60

100.0

1.7

DesMoines

523

523

100.0

47

9.0

Adams

38

38

100.0

5.3

Dickinson

178

178

100.0

0.0

Allamakee

205

205

100.0

11

5.4

Dubuque

1203

1123

93.3

28

2.5

Appanoose

145

127

87.6

3.1

Emmet

129

129

100.0

3.9

Audubon

46

46

100.0

6.5

Fayette

209

209

100.0

4.3

Benton

315

315

100.0

2.5

Floyd

197

196

99.5

4.6

BlackHawk

1715

1715

100.0

84

4.9

Franklin

133

133

100.0

12

9.0

Boone

287

287

100.0

13

4.5

Fremont

74

74

100.0

1.4

Bremer

232

232

100.0

3.0

Greene

100

100

100.0

6.0

Buchanan

290

253

87.2

14

5.5

Grundy

112

112

100.0

1.8

BuenaVista

268

268

100.0

16

6.0

Guthrie

106

106

100.0

2.8

Butler

179

158

88.3

3.8

Hamilton

201

187

93.0

4.8

Calhoun

115

115

100.0

4.3

Hancock

117

117

100.0

3.4

Carroll

260

260

100.0

13

5.0

Hardin

200

200

100.0

15

7.5

Cass

151

151

100.0

1.3

Harrison

136

126

92.6

4.8

Cedar

205

205

100.0

3.9

Henry

255

255

100.0

17

6.7

CerroGordo

500

500

100.0

26

5.2

Howard

119

113

95.0

5.3

Cherokee

113

113

100.0

7.1

Humboldt

143

121

84.6

3.3

Chickasaw

131

131

100.0

5.3

Ida

80

62

77.5

9.7

Clarke

124

124

100.0

3.2

Iowa

190

190

100.0

4.7

41

Clay

209

209

100.0

1.9

Jackson

193

193

100.0

4.7

Clayton

207

203

98.1

3.9

Jasper

421

402

95.5

17

4.2

Clinton

599

599

100.0

27

4.5

Jefferson

152

142

93.4

4.9

Crawford

244

244

100.0

2.9

Johnson

1514

1339

88.4

22

1.6

Dallas

655

655

100.0

21

3.2

Jones

219

217

99.1

4.1

Davis

118

101

85.6

2.0

Keokuk

133

116

87.2

10

8.6

Decatur

103

97

94.2

4.1

Kossuth

175

175

100.0

1.1

Delaware

189

173

91.5

3.5

Lee

385

385

100.0

16

4.2

Iowa Department of Public Health

COUNTY

%TESTED

>=10G/dl

%>=10G/dl

COUNTY

%TESTED

>=10G/dl

%>=10G/dl

Linn

2004BIRTHS TESTED
2760

2691

97.5

83

3.1

Poweshiek

2004BIRTHS TESTED
183

183

100.0

10

5.5

Louisa

164

157

95.7

10

6.4

Ringgold

57

48

84.2

2.1

Lucas

89

89

100.0

10.1

Sac

123

123

100.0

5.7

Lyon

144

109

75.7

3.7

Scott

2292

2278

99.4

103

4.5

Madison

196

192

98.0

0.5

Shelby

115

115

100.0

1.7

Mahaska

268

268

100.0

17

6.3

Sioux

464

464

100.0

20

4.3

Marion

398

398

100.0

1.5

Story

902

902

100.0

23

2.5

Marshall

642

642

100.0

45

7.0

Tama

237

237

100.0

12

5.1

Mills

183

162

88.5

1.2

Taylor

68

68

100.0

10

14.7

Mitchell

111

81

73.0

6.2

Union

143

143

100.0

17

11.9

Monona

103

103

100.0

14

13.6

VanBuren

88

73

83.0

6.8

Monroe

82

82

100.0

2.4

Wapello

476

476

100.0

33

6.9

Montgomery

125

125

100.0

7.2

Warren

507

507

100.0

1.4

Muscatine

587

587

100.0

22

3.7

Washington

290

245

84.5

12

4.9

O'Brien
Osceola

171
80

171
64

100.0
80.0

10
2

5.8
3.1

Wayne
Webster

81
491

81
491

100.0
100.0

5
15

6.2
3.1

Page

168

168

100.0

11

6.5

Winnebago

101

101

100.0

4.0

PaloAlto

105

105

100.0

5.7

Winneshiek

186

186

100.0

2.7

Plymouth

324

324

100.0

10

3.1

Woodbury

1634

1634

100.0

106

6.5

Pocahontas

74

66

89.2

0.0

Worth

74

74

100.0

9.5

Polk

6320

6320

100.0

108

1.7

Wright

186

183

98.4

2.7

Pottawattamie

1221

967

79.2

17

1.8

TOTALS

38,357

37,482

97.7

1,405

3.7

42

Divisions of Acute Disease Prevention and Emergency Response, Environmental Health, and Behavioral Health

Table16.Adult1BloodLead2010Data2SummaryshowingPercentChangeofNumberofAdultsTestedandNumberofAdultLeadExposureCases3
forCountieswithanaverageof4ormorecasesin20072009

County

3yrAverage20072009:
NumberAdultsTested

2010:NumberAdults
Tested

PercentChange:
NumberAdultsTested

3yrAverage20072009:
NumberAdultLeadCases

2010:Number
AdultLeadCases

PercentChange:Number
AdultLeadCases

Audubon
Monroe
Johnson
VanBuren
Muscatine
Clinton
Decatur
Woodbury
BlackHawk
Polk
Jones
Page
Jackson
Lucas
Wapello
Jefferson
Mahaska
Fayette
Linn
Scott
Cass
Appanoose
Montgomery
Buchanan
Clayton
Wayne
Dubuque
Delaware

13
9
63
11
42
89
9
61
78
223
21
20
24
18
46
35
59
31
168
237
44
33
54
65
60
112
162
293

6
6
58
5
34
110
12
62
106
247
17
18
21
30
42
31
57
41
158
273
21
48
37
83
64
116
158
256

54%
33%
7%
56%
19%
23%
29%
1%
36%
11%
18%
10%
13%
67%
9%
12%
3%
31%
6%
15%
53%
44%
31%
28%
7%
4%
3%
13%

4
4
4
4
4
5
5
6
7
8
8
10
11
12
13
13
13
14
17
18
20
25
30
32
52
91
102
267

1
2
3
2
3
5
8
3
9
5
4
9
8
21
12
9
12
10
19
14
10
32
25
31
45
89
92
217

73%
45%
18%
50%
25%
7%
60%
47%
29%
38%
52%
7%
27%
75%
5%
33%
10%
29%
10%
22%
50%
30%
17%
4%
14%
3%
10%
19%

StateTotal4

2834

2905

3%

850

737

13%

Adultdataincludesindividualswhowere16yearsofageorolderattimeoftest.Theperson'shighestbloodleadlevel(BLL)inthecalendaryearwasusedforthisreport.
DataisonlyreportedforindividualswithanIowaresidentialaddressatthetimeofthetest.
3
LeadExposureCasesareconsideredtobeadultswithavenousbloodleadlevelof10g/dL(microgramsperdeciliter).
4
Totalincludesforcountiesnotshowninthetable.

Thepercentchangeiscalculatedbysubtractingthe3yearaveragefromthe2010dataanddividingbytheabsolutevalueofthe3yearaverage
2

43

Iowa Department of Public Health

44

Campy

Cryptosporidiosis

E.coli shgt

Ehrlichiosis

Giardia

Gonorrhea

Huremics

Hepatitis A

Hepatitis B

Legionellosis

Listeriosis

Lyme

Meningococcal

Mumps

Pertussis

Rabies animal

RMSF

Salmonellosis

Shigellosis

Syphilis

TB

West Nine Virus

ADAMS

ALLAMAKEE

14

28

APPANOOSE

21

AUDUBON

22

BENTON

11

45

BLACK HAWK

24

944

14

198

12

12

10

19

BOONE

51

11

BREMER

49

BUCHANAN

10

35

BUENA VISTA

67

Hepatitis B,
chronic

HIV (diagnosis)

ADAIR

Chlamydia

AIDS (diagnosis)

Table17.Commonnotifiablediseasesbycounty,2010

BUTLER

27

CALHOUN

19

CARROLL

32

CASS

31

26

CEDAR

31

CERRO GORDO

113

CHEROKEE

15

CHICKASAW

19

CLARKE

18

CLAY

13

47

CLAYTON

13

15

10

CLINTON

166

22

61

10

CRAWFORD

64

DALLAS

16

126

15

17

45

Campy

Cryptosporidiosis

E.coli shgt

Ehrlichiosis

Giardia

Gonorrhea

Huremics

Hepatitis A

Hepatitis B

Legionellosis

Listeriosis

Lyme

Meningococcal

Mumps

Pertussis

Rabies animal

RMSF

Salmonellosis

Shigellosis

Syphilis

TB

West Nine Virus

22

DELAWARE

11

23

DES MOINES

253

44

11

DICKINSON

27

DUBUQUE

40

288

11

14

13

64

15

16

EMMET

34

FAYETTE

16

45

Hepatitis B,
chronic

HIV (diagnosis)

DAVIS
DECATUR

Chlamydia

AIDS (diagnosis)

Divisions of Acute Disease Prevention and Emergency Response, Environmental Health, and Behavioral Health

FLOYD

47

FRANKLIN

30

FREMONT

10

GREENE

23

GRUNDY

17

GUTHRIE

13

HAMILTON

37

HANCOCK

17

HARDIN

50

HARRISON

17

HENRY

61

HOWARD

16

HUMBOLDT

19

IDA

12

IOWA

40

JACKSON

48

JASPER

73

12

Legionellosis

Listeriosis

Meningococcal

Mumps

Pertussis

Rabies animal

RMSF

Shigellosis

Syphilis

TB

West Nine Virus

13

69

25

25

24

12

33

JONES

11

36

KEOKUK

15

KOSSUTH

21

LEE

119

LINN

47

862

49

28

235

16

13

83

49

LOUISA

23

LUCAS

12

28

LYON

10

MADISON

30

MAHASKA

76

19

MARION

52

11

MARSHALL

153

MILLS

19

15

MITCHELL

MONONA

16

MONROE

12

MONTGOMERY

12

MUSCATINE

155

21

O'BRIEN

14

OSCEOLA

PAGE

17

PALO ALTO

13

PLYMOUTH

13

49

13

13

46

Campy

Salmonellosis

Hepatitis A

36

Lyme

Huremics

684

Hepatitis B,
chronic

Gonorrhea

23

22

Hepatitis B

Ehrlichiosis

10

Giardia

E.coli shgt

Chlamydia

JOHNSON

HIV (diagnosis)

JEFFERSON

AIDS (diagnosis)

Cryptosporidiosis

Iowa Department of Public Health

Meningococcal

Mumps

Pertussis

Rabies animal

RMSF

TB

West Nine Virus

63

519

47

46

44

60

28

12

POTTAWATTAMIE

13

319

10

53

41

POWESHIEK

60

RINGGOLD

SAC

SCOTT

11

22

945

11

12

276

178

11

SHELBY

17

Campy

SIOUX

12

30

13

18

23

STORY

15

299

10

34

11

11

14

TAMA

10

63

TAYLOR

15

UNION

25

VAN BUREN

WAPELLO

133

19

11

WARREN

10

84

61

WASHINGTON

48

WAYNE

WEBSTER

179

20

WINNEBAGO

14

WINNESHIEK

12

31

WOODBURY

17

476

10

65

14

26

WORTH

12

WRIGHT

27

Total

71

112

751

10542

397

173

284

1804

11

198

171

16

87

10

38

705

27

530

57

68

48

*intheHIV(diagnoses)columnindicatesonly13HIVdiagnosesreportedforthatcounty

47

Syphilis

Lyme

Shigellosis

Listeriosis

14

Salmonellosis

Legionellosis

51

Hepatitis B,
chronic

Hepatitis A

2076

Hepatitis B

Huremics

12

85

Giardia

36

Ehrlichiosis

25

E.coli shgt

POLK

Chlamydia

POCAHONTAS

HIV (diagnosis)

Gonorrhea

Cryptosporidiosis

AIDS (diagnosis)

Divisions of Acute Disease Prevention and Emergency Response, Environmental Health, and Behavioral Health

Iowa Department of Public Health

References
1

DiseasesreportabletoIowaDepartmentofPublicHealth.IowaAdministrativeCode[641]Chapter1.
HIV/AIDSProgramInformation.http://www.idph.state.ia.us/adper/hiv_aids_programs.asp#surveillance
3
RecommendationsoftheAdvisoryCommitteeonImmunizationPractices.PreventionandControlofMeningococcalDisease.MMWR,May27,2005,54(RR07);121.
4
PanozzoCA.Pediatrics.2010;126:e116e123.

48