Salt Lake City-County Health Department staff celebrated news that communicable diseases significantly decreased locally during 1997.
The communicable disease index measures eight diseases to determine the general health and well-being of the community. The new score, determined by a complicated formula, is 97 of 100, compared to 85 last year."This year's index may signify the turning point for the Salt Lake metro area and Utah, which has acquired an unfortunate reputation for poor hygiene, low immunization rates and major infectious disease outbreaks," said department director Dr. Thomas Schlenker during a news conference Tues-day.
But he cautioned the good news could disappear "overnight" if community and officials' care is not maintained. "If we revert to complacency and neglect . . . I think we will fall right back to where we've been."
The biggest improvements were in controlling the spread of the hygiene-related diseases hepatitis A, salmonella and shigella.
Hepatitis A cases decreased 67 percent from 1996 to 1997. According to Schlenker, this is the first year that the local rate of hepatitis A infection has not been above the U.S. average. Last year, it was eight times the national rate. "It's a dramatic turnaround," he said, adding that infection among preschool-age children is the "engine that drives hepatitis A in this community."
Salmonella cases fell 40 percent over the year.
Shigella saw the greatest decrease, 79 percent. Shigella is a group of bacteria that causes gastrointestinal illness, which usually includes fever, diarrhea and abdominal pain. Much of the decrease can be credited to improved hygiene practices at day-care centers, "shigella's favorite site." The department has offered a "more effective inspection and education process," Schlenker said.
There were no significant outbreaks of food-borne illness in 1997, either. The previous year, there were numerous cases.
A health department campaign to inform the public - and especially day-care workers and restaurant staff - about the importance of hand washing has been very effective, he said.
The index also tracks sexually transmitted diseases. In 1997, those continued at very low rates compared to the rest of the United States, although the actual number of cases for gonorrhea, syphilis and chlamydia remained fairly stagnant.
Schlenker said the department has embarked on a campaign to provide information to populations that are at-risk for sexually transmitted diseases. "This is an area that needs constant vigilance. . . . Unfortunately, in Salt Lake we know that there are plenty of high-risk behaviors."
The report's other bright spot was a sharp increase in immunization rates among preschool-age children. Of the more than 5,000 preschoolers seen at the department's public health centers, 86 percent are up-to-date on immunizations.
And there were fewer cases of tuberculosis - 20 - recorded in 1997 than any other time this decade.
Ilene Risk, director of the Bureau of Epidemiology, credited much of the good news contained in the report to "rapid reporting and prompt investigation" of problems.
"Our lifestyle, the food we buy and how we prepare that food can really make a difference," she added.
The count was based on selected diseases within the confines of Salt Lake County, with its roughly 816,000 people, Schlenker said, during the 1997 calendar year.
The department hopes to further eliminate hepatitis A outbreaks by targeting two inner-city ZIP codes where the illness is most common in the county. "If we can vaccinate all the children in these two ZIP codes, we can have an effect for the entire state," he said.
Communicable disease indictors
Disease Cases Cases
Hepatitis A 677 226
Salmonella 169 101
Shigella 124 26
Sexually Transmitted Diseases
HIV+ 91 64
Syphilis (primary & secondary) 2 4
Gonorrhea 233 219
Penicillin-resistant gonorrhea 11 3
Chlamydia 1,036 1,051
Vaccine preventable diseases
Measles (indigenous & imported) 2 0
Pertussis 7 11
Children 24 months of age not up-to-date
for coverage of DPT4, OPV3, MMR1 & Hib3 5,268 4,263
Shool coverage grades K-12 with second dose MMR 9 10
Tuberculosis 36 20
Source: Salt Lake City/County Health Department