Determinación de salinidad, pH, TDS, conductividad, turbidez

Communicable diseases are defined as any infectious disease that is transmissible (as from person to person) by direct contact with an infected individual or by indirect means (as by a vector). Madison County is well below the state totals for all reportable diseases for the reporting periods 1991 to 2010.

Figure 10. Total Reportable Disease Cases, Rolling 3-Year Rate per 100,000 Population, County and State, 1991-2010.

Data Source: FDOH, Bureau of Epidemiology.

Data Note(s): Includes all reportable diseases. Beginning in 2007, data includes the probable and confirmed cases.

Communicable disease surveillance is an important public health role in Florida, and the Florida Department of Health in Madison County works with area health care providers in reporting all communicable diseases within the county.

46 Madison County Community Health Assessment

Enteric Diseases

The National Institutes of Health (NIH) has determined that bacterial and viral infections of the gastrointestinal tract account for a greatly underappreciated burden of morbidity and mortality in the United States.

There were no enteric diseases cases in outbreaks in Madison County from 2009 to 2011 (the most current data available). There was a sharp increase in enteric disease rates in Madison County from 2009 to 2011, but the rate per 100,000

persons was lower than the state rate. In 2011, there were 6 enteric diseases each year (see data notes below figure for the enteric diseases reported through FDOH CHARTS). Salmonellosis accounted for 50% of the enteric diseases. There were no enteric diseases reported in Madison County in 2010.

Figure 11. Enteric Disease Rates, Madison County and Florida, 2009-2011.

Data Source: FDOH, CHARTS

Data Note(s): Includes: CAMPYLOBACTERIOSIS, CRYPTOSPORIDIOSIS, CYCLOSPORIASIS, E. COLI SHIGA TOXIN + (NOT SEROGROUPED), E. COLI SHIGA TOXIN + (SEROGROUP NON- O157), ENTEROHEMORRHAGIC E. COLI (EHEC), ESCHERICHIA COLI, SHIGA TOXIN

PRODUCING, GIARDIASIS, HEPATITIS A, SALMONELLOSIS, SHIGELLOSIS, TYPHOID FEVER. Beginning in 2007, data includes both probable and confirmed cases.

Madison County Community Health Assessment 47 In Madison County, the enteric disease cases in children under the age of six were below the state average per 100,000 children since 2005 (see Figure 11). The

Florida Department of Health, Bureau of Epidemiology reported that there was 1 enteric disease case in Madison County children under the age of six in 2011. This represents a rate of 71.8 per 100,000 population, which is below the state’s rate of 344.7.

Figure 11. Enteric Disease Cases in Children under 6, Rolling 3-Year Rate per 100,000 Population, County and State, 1992-2011.

Data Source: FDOH, CHARTS

Data Note(s): Includes: CAMPYLOBACTERIOSIS, CRYPTOSPORIDIOSIS, CYCLOSPORIASIS, E. COLI SHIGA TOXIN + (NOT SEROGROUPED), E. COLI SHIGA TOXIN + (SEROGROUP NON- O157), ENTEROHEMORRHAGIC E. COLI (EHEC), ESCHERICHIA COLI, SHIGA TOXIN

PRODUCING, GIARDIASIS, HEPATITIS A, SALMONELLOSIS, SHIGELLOSIS, TYPHOID FEVER. Beginning in 2007, data includes both probable and confirmed cases.

Enteric pathogens cause disease symptoms ranging from mild gastroenteritis to life-threatening systemic infections and severe dehydrating diarrhea.

48 Madison County Community Health Assessment

Vaccine Preventable Diseases

Vaccine preventable diseases include Diphtheria, Haemophilus Influenzae B (HiB), Hepatitis A and B, Measles, Mumps, Meningitis, Pneumonia, Polio, Pertussis,

Rotavirus, Rubella, Tetanus, and Varicella.

Despite a peak in 2003, Madison County is below the state rate for vaccine preventable diseases.

Figure 12. Selected Vaccine Preventable Disease Rate for All Ages, Rolling 3-Year Rate per 100,000 Population, County and State, 1991-2010.

Data Source: FDOH, CHARTS

Data Note(s): Includes: DIPHTHERIA, ACUTE HEPATITIS B, MEASLES, MUMPS, PERTUSSIS, RUBELLA, TETANUS, AND POLIO. Beginning in 2007, data includes both probable and confirmed cases.

Madison County Community Health Assessment 49

Sexually Transmitted Diseases

The CDC reports that sexually transmitted diseases (STDs) are among the most common communicable diseases in the United States. In 2011, there were more than 20 identified and reportable STDs that affected more than 13 million

Americans.

Madison County had a lower rate per 100,000 people for Syphilis cases than the state rate for the 2009-2011 reporting period. The rate for Bacterial STDs in women ages 15-34 and Chlamydia was higher than the state rate from 2009 to 2011. In contrast, Madison County’s rate per 100,000 for Gonorrhea was lower than the associated state rate in 2011. Table 8 summarizes the rates for 2006 to 2010. Table 8. Sexually Transmitted Diseases, Single Year Rates per 100,000 Population, County and State, 2009 to 2011.

Bacterial STDs

(Women 15-34)

Chlamydia Gonorrhea Infectious Syphilis

Madison County Florida Madison County Florida Madison County Florida Madison County Florida 2009 4545.5 2607.1 665.9 389.7 160 111.6 0.0 5.6 2010 5009.2 2600.1 614.4 397 260.3 107.1 0.0 6.3 2011 3979.6 2602.7 502.1 401.3 93.2 104 0.0 6.6

Data Source: FDOH, CHARTS

* New testing procedure was used which account for some increase in rate between 2005-2007 and 2008-2010.

50 Madison County Community Health Assessment

Hepatitis

Hepatitis is a group of viral infections that result in the inflammation of the liver. In Madison County, the number of non-A and non-B hepatitis cases not

associated with blood products has been consistently lower than the state rolling three-year rate per 100,000 population from 1991 to 2010 as displayed in Figure 13. Figure 13. Hepatitis Non-A, Non-B Not Associate with Blood Products, Rolling 3-Year Rate per 100,000 population, County and State, 2006-2010.

Data Source: FDOH, CHARTS

Data Note(s): Beginning in 2007, data includes both probable and confirmed cases.

Madison County Community Health Assessment 51

HIV/AIDS

The Centers for Disease Control and Prevention estimates there are an additional 56,300 new infections each year nationwide. As the number of persons infected each year continues to grow, Florida must find the resources to provide ongoing systems of care to meet the needs of persons living with HIV/AIDS.

Madison County had two cases of AIDS reported in 2009 and 2010, and no

reported cases of AIDS in 2011. Madison County had two reported cases of HIV in 2009, five reported cases in 2010, and two reported cases in 2011. Madison

County is below the state rate for both reported AIDS and HIV cases during the 2009 to 2011 period.

Figure 14. HIV Cases, 3-Year Rolling Rate per 100,000 Population, County and State, 2006-2010

Data Source: FDOH, CHARTS

According to the 2010 BRFSS survey, 51.2% of Madison County adults under the age of 65 had received an HIV test, which is similar to the statewide rate of 48.4%. In addition, 7.9% of adults under age 65 had received an HIV test in the past year, compared with 7% statewide.

52 Madison County Community Health Assessment

However, the HIV/AIDS age-adjusted death rate for Madison County has been higher than the state rate for the 2006-2008 to 2009-2011 periods for both males and females. FDOH CHARTS indicates all HIV/AIDS deaths in Madison County were among Black residents.

Table 9. HIV/AIDS Age-Adjusted Death Rate, 3-Year Rolling Rates, Sex, Madison County and Florida.

HIV/AIDS Age-Adjusted Death Rate, 3-Year Rolling Rates

Madison State

Male Female Male Female

Years Count Rate Count Rate Count Rate Count Rate

2005-07 2 7.6 1 4.2 3,345 12.4 1,632 6.1

2006-08 4 15.2 1 4.1 3,177 11.5 1,505 5.6

2007-09 5 18.5 2 9 2,824 10.1 1,344 4.9

2008-10 4 13.9 2 10.1 2,540 8.9 1,168 4.2

2009-11 3 10.8 4 17.5 2,224 7.6 1,079 3.8

Data Source: FDOH, CHARTS

Florida has one of the largest publicly funded HIV testing programs in the U.S.; over 400,000 HIV tests were provided in 2010.

Madison County Community Health Assessment 53