Director of Health Michael Fine, MD declared today that influenza is widespread again in Rhode Island. This declaration triggers the requirement that healthcare workers who have not been vaccinated against the flu wear surgical masks during direct patient contact. The masking requirement will stay in place until the declaration of widespread influenza has been lifted.
The Rhode Island Department of Health (HEALTH) Division of Infectious Disease and Epidemiology has received reports of pertussis outbreaks at schools in multiple communities, including the Moses Brown School in Providence (5 cases), Cole Middle School in East Greenwich (7 cases), and Randall Holden Elementary School in Warwick (4 cases).
The following communities are also reporting sporadic cases in school and household settings: Bristol, Central Falls, Hopkinton, Johnston, Lincoln, North Providence, Providence, Smithfield, Tiverton, and Pawtucket.
Letters are being sent by school authorities and activity directors to parents of students and to school staff, with advice to be vigilant for cough illness and to encourage age-appropriate vaccinations. These notices might prompt calls to area healthcare providers.
An influenza strain, different from the flu strain that is most common this season, is causing an increase in the flu in Rhode Island. This latest strain, H3, causes more severe illness and outbreaks, and has a greater impact on the elderly. This year's flu vaccine protects against both these strains of the flu. HEALTH is working with the media to urge Rhode Islanders to get vaccinated against the flu. As a result, Rhode Island healthcare providers and pharmacies might experience an increase in requests for flu vaccinations.
The Rhode Island Department of Health (HEALTH) is working with Rhode Island Hospital and Roger Williams Medical Center to notify patients who may have been exposed to a person with measles who was in both of these facilities last week. The first potential exposure took place on February 25th at Roger Williams Medical Center, where a man was treated for a sore throat and fever. On February 28th that person developed a rash and was seen at the CVS Minute Clinic in North Attleboro, Massachusetts and the possibility of measles was recognized. He was referred to the Rhode Island Hospital Emergency Department, where he was until early on March 1st.
CDC Health Alert Network Advisory #00359 Summary: From November through December 2013, CDC has received a number of reports of severe respiratory illness among young and middle-aged adults, many of whom were infected with influenza A (H1N1) pdm09 (pH1N1) virus. Multiple pH1N1-associated hospitalizations, including many requiring intensive care unit (ICU) admission, and some fatalities have been reported. The pH1N1 virus that emerged in 2009 caused more illness in children and young adults, compared to older adults, although severe illness was seen in all age groups. While it is not possible to predict which influenza viruses will predominate during the entire 2013-14 influenza season, pH1N1 has been the predominant circulating virus so far. For the 2013-14 season, if pH1N1 virus continues to circulate widely, illness that disproportionately affects young and middle-aged adults may occur.
The Rhode Island Department of Health (HEALTH) Division of Infectious Disease and Epidemiology has received reports that three students of Ponaganset High School (Foster-Glocester School District) have a prolonged cough illness that resembles pertussis. Parents of students have been advised by letter to be vigilant for cough illness, and this notice might prompt calls to area healthcare providers.
QIAGEN Inc., the Valencia, CA-based manufacturer of the QuantiFERON-TB Gold (QFT) mitogen Indeterminate Test, has issued additional guidance for handling, in response to inquiries from users of the test who observed an increase in the rate of mitogen indeterminate results.
On Sept. 24, the Rhode Island Department of Health (HEALTH) reported that a 33-year-old Exeter resident was diagnosed with viral meningitis caused by West Nile Virus (WNV). General guidance for physicians about mosquito-borne illness may be viewed at: http://us2.campaign-archive2.com/?u=ece9b1661b3bf3b864a6894d1&id=d3b26cb8b5
The Rhode Island Department of Health (HEALTH) conducts seasonal surveillance for West Nile Virus (WNV), Eastern Equine Encephalitis (EEE) and other arboviral neuroinvasive disease and provides laboratory and case management support for physicians in diagnosing mosquito-borne diseases. Since late summer, mosquito-borne diseases have been detected in communities from sample test pools as follows...
The Rhode Island Department of Health (HEALTH) Division of Infectious Disease and Epidemiology has released new guidance for Rhode Island clinicians that includes the latest updates and recommendations for adapting to the ongoing nationwide shortage of tuberculin used for tuberculosis skin testing. The shortage involves both commercial products: TUBERSOL® (Sanofi Pasteur Limited), and APLISOL® (JHP Pharmaceuticals, LLC). These recommendations are consistent with guidance from the Centers for Disease Control and Prevention (CDC) and are in effect until the tuberculin shortage resolves.
Summary: CDC now has an expanded access investigational new drug (IND) protocol in effect with the Food and Drug Administration (FDA) to make miltefosine available directly from CDC to clinicians for treatment of free-living ameba (FLA) infections in the United States. Recommendations: Clinicians who suspect they have a patient with FLA infection who could benefit from treatment with miltefosine should contact CDC to consult with an FLA expert. Click on the link above for more information.
The Department of Environmental Management (DEM) announced last week that a sample of human-biting mosquitoes collected in Providence had tested positive for West Nile Virus (WNV). All healthcare providers should: (1) Maintain a high index of suspicion for West Nile Viral disease, especially among the elderly and immuno-suppressed individuals who are at higher risk for the neuroinvasive disease. (2) Call 401-222-2577 to report suspected diagnosis of any patient you are attending with clinical diagnosis of viral Encephalitis, aseptic or suspect viral meningitis (CSF pleocytosis of 10 cells or more) in persons 17 years of age or older, and Guillain-Barré syndrome. (3) Review Clinical Specimen Submission Guidance and more information on the HEALTH website (health.ri.gov/disease/carriers/mosquitoes/for/providers). Read the complete press release at: http://www.ri.gov/press/view/20019