Healthcare Provider Information
Notes: May 2010- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -Previous Notes
The event of the month would have to be the mercury exposure that occurred at Southern High School this last month. A preliminary summary is as follows:
Six children were initially identified as having high risk exposure, but further review of contacts raised that total to 21 students. All these were offered blood level testing but only 11 accepted. None reached the level of 5 micrograms/ml that the state considers a significant level and only one was over 2. Many personal items were found to carry contamination and most were discarded as hazardous waste. The environmental cleanup was started by a state contractor, and then completed by two other contractors under federal EPA supervision.
Providers also need to remember that a history of regular fish intake is important when evaluating exposed children, and that normal body clearance of elemental mercury is expected in one or two weeks.
The health department encountered some difficulty in collecting all information from local medical offices because of “HIPAA” privacy concerns. The Privacy Rule expressly permits disclosures without individual authorization to public health authorities authorized by law to collect or receive the information for the purpose of preventing or controlling disease, injury or disability, including but not limited to public health surveillance, investigation, and intervention. We will look at how we identify ourselves to medical offices to obtain such information, so that the medical office is assured that it is the health department making the request in line with our official duties.
Use of Combination Measles, Mumps, Rubella, and Varicella Vaccine
New Recommendations of the Advisory Committee on Immunization Practices -
For the first dose of measles, mumps, rubella, and varicella vaccines at age 12–47 months, either measles, mumps, and rubella (MMR) vaccine and varicella vaccine or the combination MMRV vaccine may be used. Unless the parent or caregiver expresses a preference for MMRV vaccine, CDC recommends that MMR vaccine and varicella vaccine should be administered for the first dose for this age group. For the second dose at any age (15 months–12 years) and for the first dose at age >48 months, use of MMRV vaccine generally is preferred over separate injections of MMR and varicella vaccines.
Either Rotarix or Rotatec can now be safely used, after review of data by FDA.
This charitable group has made a donation of $20,000 to the health department cancer screening programs so that payment to our consultants can continue even as our state grant funds may run out as we approach the end of our grant year. This group is also inviting any providers that would be interested to join them for a tour of the new cancer diagnostic and treatment facilities at the Western Maryland Health System Hospital on Wednesday, May 19, 2-4 p.m. Please let me know if you plan to join us (wwpope@dhmh.state.md.us).
Pre-School Registration has been completed, the health department screening 130 children. All but 1 had insurance of some kind; 43% had medical assistance. 48% need additional immunizations; only 8 children were immunized at the registration clinics. Serious chronic medical conditions were minimal; one child requires a walker.
Type A H1N1 Influenza Winds Down
The 2009 Type A H1N1 virus continues to circulate at low levels nationally and around the world, including in the Southern Hemisphere, although a few cases and deaths are still occurring even in the U.S.
Extension of current rates will expire May 31, 2010. The rates of payment in our cancer screening programs follow the Medicare rates, but also are carried forward at the annual contract rate, so that contracts signed now will be reimbursed at current rates.
GCMH now is offering an ADA-recognized Diabetes Basic Education course through their Wound Care Center , as Kendra Thayer, R.N. has gained certification as a Diabetes Educator. She will be assisted by Wendy Wakefield, hospital dietician.
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
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
