Transcript Document

R7 HCC EPI UPDATE
EBOLA, FLU & MEASLES
J a c k i e D aw s o n , P h D
Public Health Epi
Chelan, Douglas,
Grant, Kittitas and
O ka n o g a n C o u n t i e s
509-886-6428
jacqueline.dawson@
c d h d . wa . g ov
EBOLA CASE COUNT
JAN 12, 2015
www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/case-counts.html
www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/distribution-map.html
AMERICAN NURSE EXPOSED TO EBOLA
DECEMBER 2014
 Dec 19, 2014: Nurse exposed to Ebola while
volunteering in Sierra Leone was released from NIH
 No clinical or laboratory evidence of Ebola infection
 21 days of monitoring at a private residence in Virginia
under the direction of the VA Department of Health
US HCW ARRIVES AT NE MEDICAL
CENTER, JAN 4, 2015
www.washingtonpost.com/news/post-nation/wp/2015/01/04/u-s-health-care-worker-exposed-to-ebola-to-arrive-in-nebraska-for-observation/
NE MED CENTER TRANSPORT & SECURIT Y
TRANSPORT & SECURIT Y
SCOTTISH NURSE ILL WITH EVD
DECEMBER 29, 2014
 39-year-old nurse volunteered for “Save the Children” in
Sierra Leone.
 Traveled home to Scotland via Casablanca, Morocco, and
London.
 Initially screened at Heathrow, where her temperature was
normal, despite telling officials that she felt unwell.
 Her temperature was taken a further six times within 30
minutes, but it was normal each time and she was cleared
to fly on to Scotland.
 Transported back to London for medical care after testing
positive.
 Treated with experimental drugs and has received blood
plasma from another British nurse who recovered from an
Ebola infection last year.
 No longer critically ill with Ebola
REGION 7 EVD EMS PLAN & NEW CDC GUIDANCE
EMS
Transport own patients inside Region 7
Transport own patients outside Region 7
Contact
Ballard
Yes
Yes if rig available at time of request.
Mike Battis or Shawn Ballard
CMC
Yes
No
Brian Pulse
LCCH
Yes
Possibly if rig available at the time of request
Ray Eickmeyer or Karl Johnson
Lifeline
Yes, but only dry patients
Possibly if rig available at the time of request
Wayne Walker
www.cdc.gov/vhf/ebola/pdf/ems-911-patients-with-possible-ebola.pdf
EVD MONITORING IN WA
47 individuals monitored in WA
during holidays
King Co to Chelan Co- HCW
NV to Okanogan Co- mine worker
EVD MONITORING IN WATRAVELERS FROM MALI
Up to 50% of travelers, monitored in WA, are
from Mali
Many Malians work on fishing boats out of WA
harbors.
CDC just removed Mali from the list of countries
whose travelers will be screened/monitored, so
the number of people being monitored will
decline.
Currently 20 people being monitored in WA.
Travelers from Mali will complete their 21 day
monitoring period.
FRONTLINE HEALTHCARE FACILITIES
Most U.S. acute care facilities that are
equipped for emergency care (such as
hospital-based emergency departments
and other emergency care settings
including urgent care clinics, and critical
access hospitals) are in this tier.
Frontline healthcare facilities do not
include primary care offices and other
non-emergent ambulatory care settings.
http://www.cdc.gov/vhf/ebola/hcp/preparing-ebola-treatment-centers.html
EVD HCF IN WA
WA Treatment Centers:
Harborview
Seattle Children’s Hospital
Multicare
Sacred Heart Medical Center
NIH AND GLAXOSMITHKLINE
www.forbes.com/sites/kerryadolan/2015/01/12/the-art-of-saving-a-life-an-ebola-drug-trial-in-mali/
INFLUENZA
 USA: 68.4% A/H3N2 = Switzerland strain not included in the
2014-15 Northern Hemisphere influenza vaccine.
INFLUENZA WEEK 53
INFLUENZA UTD WEEK 53 DEATHS
AVIAN INFLUENZA IN WA
JANUARY 2015
 Eggs, poultry, and poultry products from domestic flocks can't be
moved out of the Tri-Cities because of an emergency quarantine to
limit the spread of avian flu, H5N2.
 WSDA quarantine took effect 7 Jan 2015 and covers about 20
miles near 2 Benton County locations where backyard flocks of
chickens, turkeys, ducks, and guinea fowl were found to have
avian influenza.
 Same strain, H5N2, found in a wild pintail duck in Whatcom
County and in outbreaks in Canada .
 No evidence of HPAI H5N2 or H5N8-related illness in humans, but
it is deadly to birds.
 Quarantine could be in effect for up to 8 months .
 May be related to an HPAIV H5N8 previously known to have
circulated during 2014 among wild birds and poultry in Asia and
Western Europe.
DISNEYLAND VISITORS BRING
MEASLES HOME TO WA
 2014-N=32; 2013-N=4; 2012-N=0; 2011-N=4
 Disneyland Dec 17-18, 2014
 Unimmunized woman in her 20s flew from CA to SeaTac
Airport on December 29, stayed with family in
Snohomish County paid a visit to Vancouver, B.C. and
flew out of SeaTac airport on January 3 to return home.
The traveler was contagious for measles during her
entire trip.
 Case in Grays Harbor County-2015
 Cases in CA, UT, CO
 CDC calls measles the “most deadly of all childhood
rash/fever illnesses”
COMPLICATIONS OF MEASLES
< 5 Y E A R S A N D > 2 0 Y E A R S O F AG E A R E M O R E L I K E LY T O S U F F E R
 Common:
 Ear infections: 1 in 10 children permanent hearing loss
 Diarrhea: <1 in 10 people
 Severe:
 Pneumonia: 1 in 20 children- most common cause of death in young children
 Encephalitis: 1 in 1,000 children- can lead to convulsions and leave the child
deaf or mentally challenged
 Death: 1 or 2 in 1,000 children
 Pregnant woman: give birth prematurely or low -birth-weight baby
 Long-term: Subacute sclerosing panencephalitis (SSPE) is a very
rare, but fatal disease of the central nervous system that results
from a measles virus infection acquired earlier in life.
 Develops 7 to 10 years after disease even though the person “fully
recovered”
 1989-1991: 4 to 11 in 100,000 at risk
 SSPE may be higher for a person who gets measles before they are 2 years
www.cdc.gov/measles/about/complications.html