Sierra Leone | WHO-deployed health worker receiving care after testing positive for Ebola

WHO is working to ensure an international health worker who is deployed for the Organization in Sierra Leone and has contracted Ebola receives the best care possible including the option of medical evacuation to another care facility if necessary.

International health workers are an important part of this Ebola response. Even before the Ebola outbreak began, after years of conflict, the area of West Africa most affected by this disease suffered from a weakened and fragile health system with a shortage of health workers. Surge capacity of international health experts is essential to supplement the work of the local frontline workers in this response.

Since the beginning of the international response to the outbreak in March, WHO has deployed nearly 400 people from across the Organization and from partners in the Global Outbreak Alert and Response Network (GOARN) to help respond to the disease in Guinea, Liberia, Nigeria and Sierra Leone. This is the first time someone working under the aegis of WHO has fallen ill with the disease.

The Ebola virus is spread through contact with bodily fluids and people giving care or working around infected patients are known to be a high risk group. In the past six months of the outbreak, more than 225 health workers have fallen ill and nearly 130 have lost their lives to the disease they were working to contain.

WHO recognizes there is a risk for health workers who work around Ebola and takes many precautions before they deploy to help them protect themselves in the field. Once there, the Organization ensures those workers have access to appropriate medical advice and support.

Idaho | Alarming increase of whooping cough cases prompts renewed calls for vax

Nearly twice as many cases of whooping cough have been reported in Idaho so far this year, compared to 2012 and 2013’s already troubling case rates. Idaho public health officials are concerned about this significant increase over the past three years, especially now that the 2014-2015 school year will be starting in Idaho communities in the next few weeks.

“The best way to protect children and infants from pertussis is to get vaccinated so you are protected, and then you drastically reduce the risk of passing it on to extremely vulnerable infants,” said Mitch Scoggins, program manager for the Idaho Immunization Program. “Pregnant women, and those who come in contact with young children, including their siblings and other family members, should get vaccinated.”

During January through July of this year, 241 cases of whooping cough, also known as pertussis, have been reported to public health officials, compared with 122 cases reported during the same time last year and 129 in 2012. It’s particularly dangerous for babies. One Idaho infant has died this year because of pertussis.

Rates of pertussis this year are highest among Idaho children ages 5 to 17. These children and adolescents can unknowingly spread the infection to their younger siblings, relatives, and contacts in daycares and schools.

The best prevention for pertussis is vaccination. In Idaho, vaccination coverage rates are among the lowest in the country.  “Whooping cough can be life-threatening for small children and infants,” Scoggins said. “About half of babies younger than a year old who get the disease need hospitalization. To protect them, their family members and others who have contact with them need to get vaccinated so they don’t pass the disease along.”

About 1 in 20 infants with pertussis get pneumonia. About 1 in 100 infants will have convulsions. In rare cases, pertussis can be deadly, especially in infants younger than a year old. Many infants who get pertussis are infected by coughing siblings, parents, or other caregivers who might not know they have the disease.

Pertussis vaccines (DTaP for infants/children and Tdap for adolescents/adults) are available in many physicians’ offices, local public health district offices, and pharmacies. Babies should receive their first dose of DTaP during their doctor visit at two months of age, with additional doses at the 4, 6, and 15-18 month visits. The fifth and final DTaP dose is administered at 4 to 6 years of age, just before the child enters school.

Adolescents’ immune systems should be boosted with a dose of Tdap during their doctor visit when they are 11 or 12 years old, at the same time they are getting their vaccines against meningitis and human papilloma virus. Anyone older than 12 who hasn’t had a Tdap vaccine should get one immediately.

Pregnant women should talk to their doctors about receiving a Tdap vaccination during pregnancy because the mother can pass some protection against whooping cough along to the baby to help protect him until he’s 2 months old and able to be vaccinated.

New Mexico | UNM patient tests negative for Ebola virus disease

Laboratory tests conducted at the Centers for Disease Control and Prevention (CDC) confirmed that a 30-year-old woman hospitalized at UNM Hospital does not have Ebola Virus Disease. The New Mexico Department of Health received the results on Thursday.

The Department of Health, in collaboration with the CDC, made the decision to conduct the laboratory tests out of an abundance of caution due to her travel history. The woman had been in Sierra Leone, Africa, and left there earlier this month. She had no history of contact with anyone who had been sick in Sierra Leone, including anyone with confirmed or suspected Ebola Virus Disease.

The 30-year-old Bernalillo County woman went to UNM Hospital last week with sore throat, headache, muscle aches and a history of fever at home. There is no indication that she has an infectious disease that can be spread from person to person. The New Mexico Department of Health only reports causes of an individual’s illness when there is a potential public health benefit.

Arizona | Agencies partner to provide relief to residents affected by recent monsoon flooding

The City of Phoenix, Maricopa County and the State of Arizona are opening a Recovery Information Center to offer resources for residents in the greater Phoenix area and Maricopa County who were affected by the recent monsoon storms.

The Recovery Information Center, located in the community room of Fire Station #57 at 1708 W. Dobbins Road, will be managed by the City of Phoenix Incident Management Team, in cooperation with Maricopa County and the State of Arizona.

Initial hours of operation will be noon to 6 p.m. Saturday, Aug. 23, 9 a.m. to 6 p.m. Sunday, Aug. 24, and 9 a.m. to 7 p.m. Monday, Aug. 25.

Arizona Volunteer Organizations Active in Disaster (AZVOAD) member organizations, such as Habitat for Humanity, Team Rubicon, American Red Cross Grand Canyon Chapter, Salvation Army, and Arizona Southern Baptist Disaster Relief, will be on site providing resources and information for residents who were affected by the storm.  The City of Phoenix Human Services, Neighborhood Services, Planning & Development, and Public Works departments also will be on site.

“Earlier this week homeowners showed me and other city officials the damage flood waters had done to their homes, and pointed out that they were having to pay for repairs out of their own pockets,” Mayor Greg Stanton said. “I’m pleased that we could bring together all these agencies to help homeowners recover from the storm.”

Councilwoman Kate Gallego, whose district was heavily affected by the flooding, added “many residents in the Laveen and South Mountain areas still have a long road ahead to recover from last week’s historic monsoon storm.  I appreciate city staff joining with Maricopa County and the State of Arizona to pull together this resource center as one more tool residents can use to coordinate recovery and repair efforts and identify resources to continue moving forward and repairing their homes.”

“In times of emergency, when real people suffer real loss, it is important that public and private resources come together to do what they can,” said Maricopa County Supervisor Marie Lopez Rogers.

On-site donations in the form of a check will be accepted at the Recovery Information Center, or residents can make donations to AZVOAD.  Please write “Monsoon 2014” in the memo section; payments can be sent to AZVOAD, 501c3, P.O. Box 97028, Phoenix, Arizona 85060.

- See more at: http://www.azein.gov/emergency-information/emergency-bulletin/agency-partner-provide-relief-residents-affected-recent#sthash.UoAzPpnB.dpuf

Louisiana | 10 new human WNv cases this week – 52 total cases for 2014

With the increasing numbers of West Nile virus cases in the state, the Louisiana Department of Health and Hospitals (DHH) is urging residents to be vigilant and protect themselves from mosquitoes.

This week, DHH confirmed 10 new cases of West Nile virus, of which seven were neuroinvasive disease cases, bringing this year’s total to 52 reported infections.

Prior to these new cases, according to the Centers for Disease Control and Prevention’s August 19, 2014 weekly West Nile Virus report, Louisiana had the second highest number of West Nile virus neuroinvasive disease cases.

DHH issues a weekly Arbovirus Surveillance Report that details cases detected thus far by parish. This week’s new infections include neuroinvasive disease cases in Ascension (1), East Baton Rouge (5) and Ouachita (1) parishes. There were three new asymptomatic cases in the state from Caddo (2) and Pointe Coupee (1) parishes. There were no new West Nile fever cases. This week’s cases can be found in the weekly West Nile virus Surveillance report by clicking here.

“Mosquitoes are out and biting and spreading West Nile virus,” said DHH State Epidemiologist Dr. Raoult Ratard. “Protecting yourself is very simple and it could spare you from getting this disease.”

Humans contract West Nile when they are bitten by mosquitoes infected with the virus. When people are infected with West Nile, the virus will affect them one of three ways. West Nile neuroinvasive disease is the most serious type, infecting the brain and spinal cord. Neuroinvasive disease can lead to death, paralysis and brain damage. The milder viral infection is West Nile fever, in which people experience flu-like symptoms. The majority of people who contract West Nile will be asymptomatic, which means they show no symptoms. These cases are typically detected through blood donations or in the course of other routine medical tests.

About 90 percent of all cases are asymptomatic, while about 10 percent will develop West Nile fever. Only a very small number of infected individuals will show the serious symptoms associated with the neuroinvasive disease. Residents who are 65 years old and older are at higher risk for complications, but everyone is at risk for infection.

Last year, Louisiana saw 34 cases of West Nile virus neuroinvasive disease in the state, which was down from 2002′s high of 204 cases of West Nile virus neuroinvasive disease. DHH has been tracking West Nile Virus for more than a decade, and statistics about its occurrence in Louisiana can be found online at www.dhh.louisiana.gov/fightthebite.

SAFETY TIPS

Protecting Yourself

  • If you will be outside, you should wear a mosquito repellent containing DEET. The American Academy of Pediatrics (AAP) recommends that repellents should contain no more than 30 percent DEET when used on children. Insect repellents also are not recommended for children younger than 2 months of age. CDC recommends that you always follow the recommendations appearing on the product label when using repellent.
  • Apply repellent on exposed skin and clothing. Do not apply under your clothes or on broken skin.
  • To apply repellent to your face, spray on your hands and then rub on your face, avoiding your eyes.
  • Adults should always apply repellent to children.
  • Wear long-sleeved shirts and pants when outdoors for long periods of time.
  • Avoid perfumes and colognes when outdoors for extended periods of time.
  • Make sure that your house has tight-fitting windows and doors, and that all screens are free of holes.

Protecting Your Home

  • Reduce the mosquito population by eliminating standing water around your home, which is where mosquitoes breed.
  • Dispose of tin cans, ceramic pots and other unnecessary containers that have accumulated on your property. Turn over wheelbarrows, plastic wading pools, buckets, trash cans, children’s toys or anything that could collect water.
  • Drill holes in the bottom of outdoor recycling containers. Drainage holes that are located on the container sides collect enough water for mosquitoes to breed.
  • Check and clean roof gutters routinely. They are often overlooked, but can produce millions of mosquitoes each season.
  • Aerate ornamental pools or stock them with fish. Water gardens can become major mosquito producers if they are allowed to stagnate.
  • Clean and chlorinate swimming pools that are not being used. A swimming pool that is left untended by a family for a month can produce enough mosquitoes to result in neighborhood-wide complaints. Be aware that mosquitoes may even breed in the water that collects on swimming pool covers.

Chikungunya Fever/Dengue Fever

DHH continues to monitor chikungunya fever and dengue fever, and include any reported cases in its weekly Arbovirus Surveillance Summary.  This week, there are two new cases of chikungunya fever, and no new cases of dengue fever in Louisiana. So far this year, there have been 10 cases of chikungunya fever and one case of dengue fever. All of the Louisiana’s reported chikungunya fever and dengue fever infections took place while the individuals were outside of the United States.

TRAVEL PRECAUTIONS

Anyone traveling abroad should also take the precautions listed above to protect themselves from mosquitoes in other countries. Mosquitoes in other parts of the world including the Caribbean, South America, Asia, Africa or Europe might infect you with chikungunya or dengue fever. For more information about these diseases, visit the CDC’s website by clicking here.

Indiana | Indy EMS receives Fed grant funding for AED placement

IndyCARES, a division of Indianapolis Emergency Medical Services (IEMS) received notification last week that a grant submitted to the US Department of Health and Human Services; Health Resources and Services Administration, for AED placement and compression only CPR training in Indianapolis has been awarded.

The program will be administered by the Health and Hospital Corporation of Marion County with leadership and direction provided by Dr. Dan O’Donnell MD, and the Indiana University School of Medicine.

The grant provides $145,013.00 in funding for the first year of the AED placement and use program. Additional recommended funding by the grant includes $146,997.00 for year two and $149,040.00 for year three. Funding for years two and three are contingent on availability of funding and satisfactory progress of the proposed project. These figures represent 100 percent funding for the program with no local or state matching monies required.

The Indianapolis Targeted Cardiac Arrest Survival Program’s goal is to improve cardiac arrest survival in high risk areas around Indianapolis. This program aims to tailor CPR and AED education to the unique needs of local communities. Goals of the program are to expand the current community education provided by IndyCARES including recognizing the signs and symptoms of cardiac arrest, teaching chest compression only CPR, and appropriate application and use of an AED by the layperson.

Without rapid bystander intervention using CPR and an AED, the chances for Return of Spontaneous Circulation (ROSC) diminish greatly. Dr. Charles Miramonti MD, chief of IEMS indicated that “studies have shown a positive impact when cardiac arrest is recognized early and when intervention is rapid in the form of immediate CPR and defibrillation.” Miramonti also emphasized that working with Indianapolis Department of Public Safety to help identify areas where education and placement will be made is the next step moving forward. The search will focus on at risk populations where out-of-hospital cardiac arrest events are the highest and outcomes are the poorest.

Once high impact areas are identified, program leadership will engage local community leaders and partners on establishing a high impact CPR and AED education program unique to the specific community. Upon completion of this program, AED’s will be placed by IEMS. Additionally, the location will be recorded in the Computer Aided Dispatch (CAD) System. This will enable 9-1-1 dispatchers to let callers know where an AED is located in the event of a cardiac arrest. According to Dr. Dan O’Donnell MD, deputy medical director with IEMS, “Identification and engagement of key stakeholders in the identified high risk areas will be crucial to the success of the program.” An initial report is expected in early 2015 that will identify the locations that will best serve the population of Indianapolis.

The team at IndyCARES defines program success as training 500 citizens per year in citizen CPR and the placement of 20 AED’s annually for a period of three years. IEMS Public Information Officer, Carl Rochelle III, reports that over 4,000 citizens of Indianapolis have been trained in chest compression only CPR since IndyCARES inception in June 2011. These combined efforts can save lives as well as lead to improved patient outcome when followed by rapid AED use and treatment by first response emergency medical services. This program is a joint effort undertaken by the Health and Hospital Corporation of Marion County, the Indiana University School of Medicine Department of Emergency Medicine, Indianapolis Department of Public Safety and IEMS.

Indiana | Indy public safety agencies meet sombre Narcan milestone with resolve

Over the weekend, paramedics from Indianapolis Emergency Medical Services (IEMS) administered naloxone for the 630th time in 2014.  The significance of this number is that it surpasses the total number of persons receiving naloxone during the entire year of 2013.

Through a joint pilot program, Indianapolis Metropolitan Police Department and IEMS began to train and supply police officers with the medication that can stop a heroin overdose in minutes.

According to Dr. Dan O’Donnell MD, deputy medical director with IEMS, “the administration of naloxone is critical to life saving efforts, immediately halting the effects of heroin.”  While naloxone is critical to stopping an overdose it does not prevent addiction.

Recently, Troy Riggs, director of Indianapolis Department of Public Safety cited Mayor Greg Ballard’s Early Education and Public Safety Initiative as a key step in moving forward.  Riggs also reinforced that one of the primary missions of the agencies under Indianapolis DPS is preservation of life, “we value human life and will not give up on our citizens.” Part of the plan moving forward, Riggs added “are community outreach programs to help with rehabilitation.”

“Indianapolis continues to set the pace in the nation for recognition and intervention related to heroin.” according to Dr. Charles Miramonti, chief of IEMS, “Getting the information, training and medication in the hands of first responders is a crucial first step.”

Based in large part on the efforts in Indianapolis and the Indiana University School of Medicine, the state legislature recently passed a bill allowing emergency medical technicians (EMT’s) the ability to administer naloxone in the field. Soon, EMT’s with the Indianapolis Fire Department (IFD) will have access to naloxone on all of their response apparatus, increasing the chances of saving a life from heroin overdose.

Illinois | New state law requires high schools to train athletic directors and coaches on concussion reduction

Governor Pat Quinn signed legislation to help reduce and prevent concussions among high school athletes. The law requires training on concussion awareness and reduction for high school athletic directors and coaches. 

“Sports play a big role in the lives of many young people across our state,” Governor Quinn said. “While we want to ensure all children have the opportunity to play sports, we must also protect the health of our young athletes from potentially life-changing damage. This new law will help ensure that coaches will be better prepared to address and prevent concussions among their student athletes.”

House Bill 5431, sponsored by State Representative Carol Sente (D-Lincolnshire) and State Senator Dan Kotowski (D-Park Ridge), requires the Illinois High School Association to develop and implement an online training program on concussion awareness and reduction for all coaching personnel and athletic directors. The legislation was written in response to recent increases in concussions among adolescents, especially student athletes.

“I sponsored House Bill 5431 because I absolutely believe this can make a difference in our schools and help protect more young athletes this coming school season,” Rep. Sente said. “It’s important that our coaches and athletic directors in every sport are certified and they hold discussions with their players so young adults know the effects and potential harm of repetitive concussions and hits to the head.”

“We appreciate the confidence Governor Quinn and Representative Sente placed in the IHSA to work with respected medical professionals to develop and administer a top-tier program,” IHSA executive Director Marty Hickman said. “Risk minimization for student-athletes, especially as it relates to concussions, will continue to be a top priority for the IHSA.”

The online training will focus on concussion recognition and prevention, what to do when a player may have a concussion and education on the long-term effects of repetitive head trauma. Completion of the training and certification will be mandatory for all high school coaching staff. Student athletes will also receive concussion awareness education. The law goes into effect immediately.

“Today, we know more about the negative impact concussions have on student athletes than ever before,” Senator Kotowski said. “We have to ensure that coaches are informed about the consequences of traumatic head injuries and take steps to reduce their frequency and keep our kids safe.”

According to the Centers for Disease Control, a concussion can result from a blow to the head or body which causes the head to move violently. It can affect the athlete mentally or physically, causing light and noise sensitivity, concentration problems or confusion, balance problems and other symptoms. It is a type of traumatic brain injury (TBI). For more information on recognizing a concussion, please visit http://www.cdc.gov/concussion/sports/recognize.html.

Governor Quinn is committed to protecting and improving the health of young people in Illinois schools. Earlier this month the Governor signed legislation strengthening the Young Adult Heroin Use Task Force originally created by the Governor and the General Assembly in 2013 to address the growing problem of heroin use in Illinois High Schools.

This year the Governor signed legislation allowing trained school personnel to administer potentially life-saving epinephrine injections to help against serious allergic reactions. In June he signed a law that requires CPR and automated external defibrillator (AED) training for students in all Illinois high schools.

In 2013, Governor Quinn convened a School Safety Summit that included more than 50 top experts from across the state to develop short- and long-term actions to further safeguard Illinois schools and signed Rocky’s Law, which required schools to insure student athletes.

Illinois | First human WNv case confirmed for 2014

The Illinois Department of Public Health (IDPH) has confirmed the first human West Nile virus case reported in Illinois for 2014. The Chicago Department of Public Health reported a woman in her 70’s became ill in July.

“This first human case is a good reminder that we all need to take precautions,” said Illinois Department of Public Health Director Dr. LaMar Hasbrouck. “The mosquitoes that typically carry West Nile virus, commonly called the house mosquito, are not as noticeable as the swarms of floodwater mosquitoes we see with the heavy rains. Even if it does not look like there are a lot of mosquitoes outdoors, house mosquitoes are stealthy biters so make sure to use insect repellent when you’re outside.”

A bird collected in Henry County on May 29, 2014 and a mosquito sample collected in Madison County on May 30, 2014 were the first West Nile virus positive results this year. To date, West Nile virus has been reported in birds, mosquitoes and/or human case in 32 counties. At this time last, year, West Nile virus was reported in 49 counties.

In 2013, a total of 76 counties in Illinois reported West Nile virus. Last year there were 117 human cases, including 11 deaths.

West Nile virus is transmitted through the bite of a mosquito that has picked up the virus by feeding on an infected bird. Common West Nile virus symptoms include fever, nausea, headache and muscle aches. Symptoms may last from a few days to a few weeks. However, four out of five people infected with West Nile virus will not show any symptoms. In rare cases, severe illness including meningitis or encephalitis, or even death, can occur. People older than 50 are at higher risk for severe illness from West Nile virus.

The best way to prevent West Nile disease or any other mosquito-borne illness is to reduce the number of mosquitoes around your home and to take personal precautions to avoid mosquito bites. Precautions include practicing the three “R’s” – reduce, repel and report.

  • REDUCE exposure – avoid being outdoors when mosquitoes are most active, especially between dusk and dawn.
    • Make sure doors and windows have tight-fitting screens. Repair or replace screens that have tears or other openings. Try to keep doors and windows shut, especially at night.
    • ­ Eliminate all sources of standing water where mosquitoes can breed, including water in bird baths, ponds, flowerpots, wading pools, old tires and any other receptacles.
  • REPEL – when outdoors, wear shoes and socks, long pants and a long-sleeved shirt, and apply insect repellent that contains DEET, picaridin, oil of lemon eucalyptus or IR 3535, according to label instructions. Consult a physician before using repellents on infants.
  • REPORT – In communities where there are organized mosquito control programs, contact your municipal government to report dead birds and areas of stagnant water in roadside ditches, flooded yards and similar locations that may produce mosquitoes.

Additional information about West Nile virus can be found on the Illinois Department of Public Health’s website at www.idph.state.il.us/envhealth/wnv.htm. Surveillance numbers are updated every Wednesday afternoon http://www.idph.state.il.us/envhealth/wnvsurveillance14.htm.

Kansas | First human WNv case reported for 2014

The Kansas Department of Health and Environment (KDHE) has announced the first reported case of West Nile virus for 2014. The individual that tested positive is an adult from Republic County.

West Nile virus can be spread to people through bites from infected mosquitoes, but it is not contagious from person to person. Symptoms range from a slight headache and low-grade fever to swelling of the brain or brain tissue and in rare cases, death. People who have had West Nile virus before are considered immune.

KDHE recommends the following precautions to protect against West Nile virus:

  • When you are outdoors, use insect repellent containing an EPA-registered active ingredient on skin and clothing, including DEET, picaridin, oil of lemon eucalyptus, or IR3535. Follow the directions on the package.
  • Many mosquitoes are most active at dusk and dawn. Be sure to use insect repellent and wear long sleeves and pants at these times or consider staying indoors during these hours.
  • Make sure you have good screens on your windows and doors to keep mosquitoes out.
  • Get rid of mosquito breeding sites by emptying standing water from flower pots, buckets and barrels. Change the water in pet dishes and replace the water in bird baths weekly. Drill holes in tire swings so water drains out. Keep children’s wading pools empty and on their sides when they aren’t being used.

West Nile virus cases are most common in the late summer and early fall months. In 2013, there were 92 cases of West Nile virus in Kansas. In addition to tracking cases of human illnesses caused by West Nile virus, KDHE assesses the potential for West Nile virus by conducting limited mosquito surveillance, including laboratory testing. At this time, there has not been a positive mosquito sample in Kansas.

Birds are not tested for West Nile virus in Kansas and KDHE will not be collecting information about dead birds. If you find a dead bird, KDHE recommends that you wear gloves, place the bird in a plastic bag, and dispose of it in the garbage.

The Centers for Disease Control and Prevention provides this web page with additional information about West Nile virus and preventing mosquito bites: http://www.cdc.gov/features/StopMosquitoes/ or visit the KDHE website: http://www.kdheks.gov/epi/arboviral_disease.htm

West Nile virus case counts are updated each Tuesday on our website here: http://www.kdheks.gov/epi/case_reports_by_county.htm

Be well. Practice big medicine.