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Notes: February 2011- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -Previous Notes

Flu Season is upon us

Flu cases have been confirmed in the State and in Garrett County, although the cases are few and the symptoms generally not very severe. Our cases have been Type A-H3 and Type B, both of which are included in this year's vaccine. It's certainly not too late to give protective immunization; continue to push immunization for all persons 2 years of age and older. Medscape has a helpful protocol on which ILI patients to test, which to treat, and a list of available rapid tests; click here for info from Medscape. All rapid tests need confirmation in at risk and hospitalized patients, and need for treatment must be determined clinically.

All Persons: one dose of Tdap to Boost Protection against Pertussis and Diptheria as well as Tetanus

California reports about 1000 cases of Pertussis so far this year, a four-fold increase from last year, and five deaths of infants under 3 months of age. We know that pertussis sustains itself in our own community (Garrett County) at low levels with occasional breakthrough of a clinical case.

Recently available vaccines formulated for older persons can now be used from age 7 to 65, or more, (Boosterix or Adacel), and can safely boost protective levels in these individuals and reduce carrier states and transmission. Young infants are at greatest risk of infection until they can develop their own protection from their infant immunizations. Thus teenagers and young adults all should receive a single dose of one of the new Tdap vaccines, as should all pre-pregnant women and their partners, and others involved in the care of young infants well before exposure of the newborn. Immunization during pregnancy is not contraindicated, but discretion of the physician is allowed. All persons age 7 to 65 and above can benefit from being sure they have maintained their immunity to pertussis.

Meningococcal Vaccine: Second Dose Recommended

The relatively new conjugate meningococcal vaccine (Menactra, Menveo) has been recommended for kids at age 11-12 with boosters at 5 year intervals when at continued risk of exposure. The latter would include as they go to college and encounter the school dormitory experience and risks.

Maryland Family Practice Residents to Come to Garrett County

This spring, the resident group will be coming to Garrett County for a “retreat”, and local providers will have an opportunity to share with them their experiences of living and practicing in Garrett County . In June a group will come again to learn options and express preferences for rotations in Garrett County over the next year. Each rotation will consist of 4 weeks of 4 days, with placement with preceptors or assignment to projects of their choosing. This enhancement of their residency experience is funded by an AHEC grant, obtained by a committee consisting of our hospital, health department, Mountain Laurel Medical Center, our Health Planning Council and the Western Maryland Health Education Center (AHEC). Bethany Browning is collecting information from physicians who might be interested in precepting a resident. All physicians will be invited to participate in activities while the residents are here.

Nationally the Estimated Number of Emergency Department Visits for Misuse or Abuse of Pharmaceuticals Nearly Doubles from 2004 to 2009

In Garrett County the relative numbers are similar. There has been no change in professional access to dispensing information in Maryland; there is no such registry in sight. If you have a patient who will accept referral, the health department addiction program, 301-334-7670, will give the person an appointment for intake and assistance, always within 2 weeks. Several treatment modalities are available after the initial evaluation.

Regular Reports: - - - - - - - - - - - - - - - - - - - - - - - - - - -- -Previous Reports

Infection Reports:
GCMH updated January 2010
WMHS Clinical Newsletter (January 2010) DNA Vaccines—A viable alternative?

References:

Advanced Directives/Living Wills

Avian Influenza

Quick Guideto Protecting Yourself and Your Family

Four Simple Things You Can Do to Protect You and Your family

Cancer Screening Guidelines

Disease Fact Sheets - CDC

GCMH Antibiogram, July 2006-June 2007

GCMH Antibiogram, July-December, 2007

Influenza

Immunization Schedules and State Regulations

Maryland Lead Follow-Up Recommendations

Pertussis Management

Reportable Diseases and Conditions

School Health

 

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Last Updated on: June 17, 2011

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