Healthcare Provider Information
Notes: September 2011- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -Previous Notes
Third-year UM Family Practice Residents Come to Garrett County
The first resident came for a “community medicine” rotation during the period 7/25-8/21. This enhancement of their residency experience is funded by a grant to AHEC, obtained by a committee consisting of Western Maryland Health Education Center (AHEC), our hospital, health department, Mountain Laurel Medical Cente, and our Health Planning Council. Bethany Browning coordinates the private practice placements of the residents. Their time is split with about 6 days at each site: Health Department, Mountain Laurel Medical Center, and a private family practice setting. The next resident, Eva DiCocco, will be here September 19 to October 16.
“Begin Annual Mammograms at Age 40 Years”: ACOG Statement
The updated ACOG guidelines agree with recommendations issued by the American College of Radiology (ACR), the Society of Breast Imaging, the American Cancer Society , and the American Society of Breast Disease . However, all of these differ from those of the United States Preventive Services Task Force (USPSTF). The USPSTF states that among women 40 to 49 years, only those with a family history of breast cancer or other high-risk factors should be screened and that women 50 to 74 years should be screened every 2 years. The Maryland Breast and Cervical Cancer program encourages and supports screening annually from age 40.
Flu Vaccination Season Returns!
It is time to begin offering flu vaccine to all persons in your practice over the age of 6 months. The only contraindications would be for persons who have had an anaphylactic reaction to flu vaccine, or developed Guillain Barre within 6 months after a previous flu immunization.
The vaccine this year is identical to the preparation that was recommended last year. Most persons should receive a single dose of vaccine, except children under 8 years, who should receive two doses if they haven't previously received any flu vaccine, or only received a single dose as a first-time immunization against flu last year.
In addition to the standard IM preparation, the vaccine is also available as:
- a nasal spray (only for ages 2-49)
- an IM preparation that is more highly concentrated, designed for persons =>65 who may have more difficulty boosting their immune system
- a small volume preparation designed for intradermal administration. 18-64
The Health department will have some of each of these preparations available.
Health Department community clinics for vaccine administration will be announced later but will begin in October.
The Health Department will have clinics to administer nasal spray vaccine in each of the HeadStart, preschool classes and elementary schools during the week of September 26. Notices, schedules and permission forms will be distributed from the schools in the next week or two. Second doses when indicated will be given at the schools four weeks later. This will be the sixth year we have offered this service in the schools; participation has run at about 40%.
Health Department charges: The nasal spray in the schools will be free. Immunization in community clinics will probably be $25. The only insurances which we are able to bill for flu shots are Medicare and a couple of the Medicare D plans. No person is denied service at these clinics for inability to pay.
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.
Lead Poisoning a Continuing Threat to Garrett County Children
Because of our older housing, all of Garrett County is considered a high risk area for exposure of infants and toddlers to lead poisoning. However, that is not the only point source for such poisoning. We are now following a child exposed because of a pottery glazing hobby of a relative. Current standards are to test lead levels in all children at age one and at age two. If levels are elevated, a report should go to the Health Department so that an environmental evaluation can be made, information shared, treatment recommendations made, and follow up measures scheduled. We are currently acting on levels =>10, although we realize some children can be affected by lower levels.
Unusual Complications after Joplin, MO, Tornado Takes 5 Lives.
5 persons died of necrotizing soft-tissue infections and several more were hospitalized with cutaneous mucormycosis. This is a rare infection that can be seen after tornado injuries and is caused by fungi of the order Mucorales. These fungi are typically found in soil and decaying wood and other organic matter. Health-care providers should consider environmental fungi as potential causes of in patients injured during tornados and initiate early treatment for suspected infections. Additional information is available at http://www.cdc.gov/mucormycosis.
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
