 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
Healthcare Provider Information |
Influenza (Flu) Information
H1N1
Address:
Garrett Co. Health Dept.
1025 Memorial Drive
Oakland, MD 21550
Main Phone:
301-334-7777
or 301-895-3111
FAX: 301-334-7701
See department pages for individual phone numbers
E-Mail Webmaster
Special Medical Alerts: February 27, 2009
1) Maryland Pediatric Influenza-Associated Deaths
2) Chickenpox in a local community
1) Two influenza-associated pediatric deaths have occurred in Maryland over the past week.
The first case was a 13 year old Frederick County resident who tested positive for influenza B virus.
The second case was a 15 year old Howard County resident who also tested positive for influenza B virus.
Be aware that:
1. In the past several years, the CDC has reported an increase in Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA) pneumonia among children with influenza infection. Pediatricians and emergency physicians should be aware of the increased risk of bacterial co-infection among pediatric patients with influenza pneumonia. Consider testing and empiric treatment for MRSA pneumonia when confronting a suspected case.
2. It is recommended to vaccinate all children ages 6 months to 18 years for seasonal influenza.
3. Pediatric influenza-associated death is a reportable condition in Maryland. Please report such an event immediately to the Garrett County Health Department (301-334-7770).
For more information from CDC on this topic, see http://www2a.cdc.gov/HAN/ArchiveSys/ViewMsgV.asp?AlertNum=00268
Information you may wish to provide to your patients:
Please call the Garrett County Health Department (301-334-7770) if you have further questions about this or related topics.
2) Chickenpox has been identified in at least 9 children at a local elementary school. Several of these children had had at least one dose of Varicella vaccine, as required for school entry; others had been thought to already have had the disease. The current recommendation is that all children receive a second dose of Varicella vaccine after age 4, but this has not yet been incorporated as a school entry requirement. Physicians who treat infants and pregnant women should be particularly vigilant for early signs of this disease, as these populations are at elevated risk of infection and serious complications.
Notes: January-February 2009- - - - - - - - - - - - - - -Previous Notes
Salmonella Disease Associated with Peanut Butter Containing Products:
On November 25, 2008, an epidemiologic assessment began of a growing cluster of Salmonella serotype Typhimurium isolates that shared the same pulsed-field gel electrophoresis (PFGE) pattern in PulseNet (the national molecular subtyping network for foodborne disease surveillance).
As of January 28, 2009: 529 persons infected from 43 states 116 patients hospitalized , and eight associated deaths
CDC Recommendation : consult recall list and avoid recalled products, see your doctor if ill.
Maryland has had 8 cases; Garrett County 1.
This outbreak highlights the complexities of "ingredient-driven" outbreaks and the importance of food production facility sanitation, inspections with enforcement, and rapid outbreak detection and investigation.
Click here for CDC information on this topic
Influenza - Seasonal & Pandemic
GCMH Laboratory ran 59 tests in January, 2009, and 11 were positive for Type A, none for Type B. Influenza immunization of ALL children 6mo.-18 years now recommended. Under age 2, only the injectable vaccine can be used; limited injectable vaccine is available without the Thimerasol preservative.
Click here for CDC's Weekly Influenza Surveillance Report
Maryland incidence is still considered local.
Avian Influenza cases continue appear in humans in wide spread locations, with no pattern of human-to-human spread. Human cases have been reported in January & February in China, Indonesia, Viet Nam and Egypt. The concern about the potential for a future pandemic persists, and preparations continue. Work is now focused on developing vaccine production by cell-based and DNA-based methods in order to produce a type specific vaccine more readily. Adjuvants and allocation schemes are being studied. Stockpiles of antivirals have been established for treatment, and supplies for preventive therapy of primary care workers are now being considered. Rapid diagnostic methods continue to be improved. It has been found that survivors of the 1918 influenza pandemic retain some immunity to the H1N1 virus. It is also hoped that antibiotics may reduce deaths from superinfection with bacteria which are thought to have taken many lives in 1918.
Be alert also for the return of Respiratory Syncytial Virus which had peak occurrence in Jan-April of 2008. This January, the lab has reported 4 cases. The current issue of the NEJM contains a study showing RSV was wide-spread (15%) among previously healthy children attending a primary care office for respiratory infection. Unfortunately there is no vaccine for this virus, and many young children, not just those with high-risk conditions, require hospitalization for non-specific treatment of the "bronchiolitis" symptom complex. Synagis, a monoclonal antibody, is available for prevention but is extremely expensive.
Regular Reports: - - - - - - - - - - - - - - - - - - - - - - - - - - -- -Previous Reports
Infection Reports:
WMHS - updated Feb. 2008, GCMH updated March 2009
WMHS December 2008 Clinical Newsletter: Sputnik Mimivirus Mamavirus Part I: Defining "life"
References:
Advanced Directives/Living Wills
Quick Guideto Protecting Yourself and Your Family
Four Simple Things You Can Do to Protect You and Your family
GCMH Antibiogram, July 2006-June 2007
GCMH Antibiogram, July-December, 2007
Immunization Schedules and State Regulations
Maryland Lead Follow-Up Recommendations
