Worst States Based on Infectious Disease Incidence

A state’s infectious disease incidence provides insight into the effectiveness of its public health system.

As a call to action for both communities and individuals, the United Health Foundation recently issued its “America’s Health Rankings Annual Report,” a state-by-state analysis of factors affecting the health of society. Some of these factors included rates of smoking, childhood immunizations, preventable hospitalizations, and infectious diseases.

While US health policy is geared toward addressing prevention and management of chronic conditions, infectious diseases also pose a major threat to vulnerable populations such as the very young and very old. This threat is made worse by increasing antimicrobial resistance.

The 3 specific infectious diseases considered in the United Health Foundation’s report were chlamydia, pertussis, and Salmonella. These diseases were selected because they are common and represent different transmission mechanisms, and therefore different prevention and treatment options.

Here are the state rankings for each of these 3 infectious diseases:

Chlamydia

Around 1.4 million cases of chlamydia were reported in 2014, which is a 2.8% increase from 2013 figures, according to the US Centers for Disease Control and Prevention (CDC).

The 5 worst states based on the number of new cases of chlamydia are:

• Alaska (789.4 cases per 100,000 individuals)
• Louisiana (624.5 cases per 100,000 individuals)
• Alabama (611.0 cases per 100,000 individuals)
• New Mexico (587.3 cases per 100,000 individuals)
• Mississippi (585.1 cases per 100,000 individuals)

Pharmacists’ close and frequent contact with patients makes them ideal candidates for providing education and counseling to those with sexually transmitted diseases (STDs) and promote adherence to STD treatment.

The issue of adherence is of particular concern for asymptomatic chlamydia patients because they may not understand the important of treatment in the absence of obvious signs of a health issue.

Pertussis

The United States has seen a resurgence of pertussis, as the number of confirmed cases reported since 2012 is the highest seen since the 1950s.

The 5 worst states ranked by number of new cases of pertussis are:

• Montana (66 cases per 100,000 individuals)
• Utah (45.8 cases per 100,000 individuals)
• Alaska (43.3 cases per 100,000 individuals)
• New Mexico (29.4 cases per 100,000 individuals)
• Colorado (27.3 cases per 100,000 individuals)

Amid these rising rates of pertussis, pharmacists should familiarized themselves with the CDC Advisory Committee on Immunization Practice’s guidelines for the use of the combined diphtheria and tetanus toxoids and acellular pertussis adsorbed and inactivated poliovirus vaccine (DTaP-IPV) as a booster dose.

The FDA approved this vaccine for children aged 4 to 6 years in March 2015.

Salmonella

An estimated 1.2 million Salmonella infections occur annually, and 1 million of those infections are caused by food consumed in the United States.

The 5 worst states based on the number of new cases of Salmonella are:

• Florida (31.7 cases per 100,000 individuals)
• Mississippi (30.7 cases per 100,000 individuals)
• Louisiana (27.9 cases per 100,000 individuals)
• Hawaii (25.1 cases per 100,000 individuals)
• South Carolina (24.1 cases per 100,000 individuals)

It’s important for pharmacists to remember that patients seeking OTC remedies for gastrointestinal distress could be infected with Salmonella. Pharmacists should stay abreast of any FDA warnings about Salmonella and be aware of any widespread contamination that could be affecting patients.

Salmonella infection normally clears up on its own within 4 to 7 days.