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The Health of Multnomah County: Communicable Diseases
Communicable Diseases
This summary provides data about several communicable diseases in Multnomah County. These
conditions include infections transmitted through casual contact, ingestion of contaminated food or
water, and intimate contact, such as sexual activity or other exposure to bodily fluids. This summary
includes:
•
•
•
•
Tuberculosis
Hepatitis A, B, and C
Selected vaccine-preventable diseases: pertussis (whooping cough), meningococcal disease
Diarrheal diseases related to: Campylobacter, E. coli, Salmonella, Giardia
For each disease, condition, or pathogen, we provide numbers of cases and rate per 100,000
Multnomah County residents over several years and compare these to the state-wide statistics. When
data are available, we also present the incidence rate by racial, ethnic, and gender groupings. Each
section begins with an overview of the organism(s) that cause the disease, how it is spread, and how it
may be prevented and treated.
Tuberculosis
Infectious agent: bacteria in the Mycobacterium tuberculosis complex of species
Transmission: airborne (inhalation of aerosolized saliva or mucus of infected person)
Prevention: controlling risk factors such as overcrowding, poverty, smoking, and diabetes;
immunization (not used in the U.S.)
Treatment: combination therapy of multiple antibiotic drugs
Figure 7.11
Tuberculosis Case Rates
Multnomah County, Oregon and U.S.
8
Rate per 100,000 Population
Figure 7.11 displays rates of tuberculosis
per 100,000 residents for Multnomah
County, Oregon, and the U.S. TB rates
in Multnomah County generally
declined from 2000-2010. Rates of TB
were higher among foreign-born
residents than among U.S.-born
residents; more than two-thirds of
Oregon TB cases were in people born
outside the United States (data not
shown).
7
Multnomah County
6.2
6
5
5.8
4.9
U.S.
3.6
4
3
2
3.5
Oregon
2.3
1
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
MULTNOMAH COUNTY HEALTH DEPARTMENT
Updated, February 2014
1
The Health of Multnomah County: Communicable Diseases
Hepatitis A, B, and C
Hepatitis B
Infectious agent: hepatitis B virus, a
hepadnavirus
Typical transmission: bloodborne
(contact with contaminated medical
equipment; vaginal or anal intercourse;
mother-to-child during gestation or
childbirth)
Prevention: use of barrier methods (e.g.,
condoms) during sexual contact; use of
sterile, single-use medical equipment;
immunization
Treatment: none from acute episode,
disease management for chronic cases
Multnomah Co.
Oregon
5
Rate per 100,000 population
In Multnomah County and statewide,
the yearly case rate of hepatitis A has
decreased since the early 2000s (Figure
7.12). In 2010, the hepatitis A rate was
down to 0.4 per 100,000 residents.
Figure 7.12
Hepatitis A Case Rates
4
3.1
3
2
1.1
1
0.4
0
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
Figure 7.13
Acute Hepatitis B Case Rates
12
Rate per 100,000 population
Hepatitis A
Infectious agent: hepatitis A virus, a
picornavirus
Transmission: fecal-oral (ingestion of fecal
matter of an infected person, usually
through contaminated food or water)
Prevention: sanitary infrastructure, food
handling regulations, hand washing;
immunization
Treatment: none, condition generally
resolves after acute episode
10
Multnomah County
Oregon
8.7
8
6
4
4.8
2
1.1
0
2001
2002
2003
2004
County rates of hepatitis B declined from
2001 on, and were at 1.1 per 100,000 residents in 2010 (Figure 7.13).
MULTNOMAH COUNTY HEALTH DEPARTMENT
Updated, February 2014
2
2005
2006
2007
2008
2009
2010
The Health of Multnomah County: Communicable Diseases
Figure 7.14
Acute Hepatitis C Case Rates
Multnomah County
1.2
Rate per 100,000 population
Hepatitis C
Infectious agent: hepatitis C virus, a
flavivirus
Typical transmission: bloodborne
(injection drug use; contact with
contaminated medical equipment; vaginal
or anal intercourse; mother-to-child
during gestation or childbirth)
Prevention: use of sterile, single-use
medical equipment; use of barrier
methods (e.g., condoms) during sexual
contact
Treatment: antiretroviral drugs (lessen
symptoms but rarely eliminate virus)
Oregon
1.0
0.8
0.7
0.5
0.6
0.4
0.4
0.3
0.2
0.0
2001-
2002-
2003-
2004-
2005-
2006-
2007-
2008-
2004
2005
2003
2006
2007
2008
2009
2010
In the early 2000s, rates of acute hepatitis
C were similar for the state (.4 per
100,000) and Multnomah County (.5 per 100,000). By 2003-2005, however, the rates diverged. Until
2008, Multnomah County had higher rates of acute hepatitis C than the rest of the state, peaking with
the 2004-2006 interval. After 2008, the county’s rate decreased to 0.3 per 100,000 residents, while the
state rate remained at 0.7 per 100,000.
Selected vaccine-preventable diseases
Pertussis (whooping cough)
Infectious agent: Bordetella pertussis bacteria
Typical transmission: airborne
Prevention: immunization
Treatment: antibiotics to prevent spread to others
Table 7.1
Selected Vaccine-preventable Diseases,
Multnomah County
Rate per 100,000 Population
Pertussis
From 2000 through 2007, 62% of the pertussis cases
in Oregon were in people aged 10 years or older
(data not shown). The rate of pertussis in the county
has fluctuated since 2002, with peaking at12.9 per
100,000 in 2005 and dropping to 3.2 in 2007. There
were 51 cases of pertussis reported in Multnomah
County in 2010, with a rate of 6.9 cases per 100,000
(Table 7.1).
Meningococcal
Disease
Year
2002
Rate
3.7
Cases
25
Rate
1.0
Cases
7
2003
8.8
60
1.3
9
2004
4.0
27
1.0
7
2005
12.9
87
1.3
9
2006
3.4
23
0.9
6
2007
3.2
22
0.7
5
2008
5.2
37
1.1
8
2009
6.7
49
1.1
8
2010
6.9
51
** too few cases to report
MULTNOMAH COUNTY HEALTH DEPARTMENT
Updated, February 2014
3
**
The Health of Multnomah County: Communicable Diseases
Meningococcal Disease
Infectious agent: Neisseria meningitidis bacteria
Typical transmission: contact with infected saliva
Prevention: immunization
Treatment: antibiotics
For the past several years, rates of meningococcal disease in Multnomah County have hovered around
one case for every 100,000 residents (Table 7.1).
Diarrheal Diseases
The most common causes of diarrheal diseases in Multnomah County include the organisms
Campylobacter, E. coli, Salmonella, and Giardia.
Rate per 100,000 population
Rates of most of these diarrheal
Figure 7.15
diseases have increased in recent
Diarrheal Disease Rates, Multnomah County
years (Figure 7.15). The 2010
30
Campylobacter
E. Coli
Giardia
Salmonella
rate of campylobacteriosis (27.2
per 100,000) did not achieve the
25
21.9
Healthy People 2020 standard of
8.5 cases per 100,000.
20
16.5
Salmonellosis, at 15.1 cases per
100,000 residents in 2010, also
15
12.1
failed to meet the Healthy
10
People 2020 threshold of 11.4.
However, Multnomah County’s
5
rate of 0.4 cases of Shiga toxin1.7
producing E. coli (STEC) per
0
100,000 residents in 2010 met
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
the Healthy People 2020
standard of 0.6. The federal government does not set a standard for giardiasis, but Multnomah County
(24.3 per 100,000) and Oregon (12.5) had higher rates than the national rate of 7.4 in 2008.
Data Sources
Data about case reports were obtained from the Oregon Health Authority’s Acute and Communicable
Disease Prevention and Tuberculosis Programs. Population estimates were obtained from the National
Center for Health Statistics. To stabilize rates and observe trends in situations with small numbers of
cases, some rates were aggregated into rolling averages using three-year intervals instead of singleyear counts. In some instances, we are unable to present the rate or number of cases because reporting
small numbers could compromise confidentiality and/or accuracy. We used statistical techniques to
assess if those changes were significant, meaning that the differences were real and did not happen by
chance alone.
MULTNOMAH COUNTY HEALTH DEPARTMENT
Updated, February 2014
4
27.2
24.3
15.1
0.4
2010
The Health of Multnomah County: Communicable Diseases
MULTNOMAH COUNTY HEALTH DEPARTMENT
Updated, February 2014
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