Health Alert: Measles in Monterey County - May 22, 2013

May 22, 2013

Measles in Monterey County

           Measles has been identified in an international traveler visiting Monterey County. Measles is highly contagious, and vaccine personal belief exceptions are relatively common in some areas of Monterey County. Please protect patients, visitors, and staff!

 Keep an Eye Out for Measles Symptoms

Suspect measles in patients with:

• Fever and rash.
• History of international travel (particularly to Europe or Asia) and/or contact with international visitors in the prior 3 weeks.

The course of measles is usually:

1. Onset of a mild to moderate fever accompanied by cough, coryza, and conjunctivitis.
2. Two to three days later Koplik's spots (tiny blue/white spots on the bright red background of the buccal mucosa) may appear.
3. The fever spikes, often as high as 104-105°F, at this time.
4. Concurrent with the fever spikes a red blotchy maculopapular rash appears, usually first on the face, along the hairline, and behind the ears. This slightly itchy rash rapidly spreads downward to the chest and back and, finally, to the thighs and feet.
5. In approximately one week, the rash fades in the same sequence that it appeared.

 Act Immediately If You Suspect Measles

• Implement airborne infection control precautions immediately. Mask and isolate the patient. Use a negative pressure room if available.
• Call the Monterey County Health Department immediately (831-755-4521).
• Permit only staff immune to measles to be near the patient.
• Expedite measles testing (both IgM and IgG serology and PCR) through the Monterey County Public Health Laboratory (831-755-4516). Use of commercial labs may delay diagnosis.
• Do not refer suspect measles patients to other locations for clinical evaluation or laboratory testing unless appropriate infection control measures can be implemented at those locations.
• Do not use any regular exam room for at least 2 hours after a suspected measles patient has left the room.

 Encourage Your Patients to Get Vaccinated

Children should get 2 doses of MMR vaccine: the first at 12-15 months of age and the second at 4-6 years of age. One dose is recommended prior to international travel for unvaccinated children ages 6 to 11 months.

Some adults should also get MMR vaccine. Generally, anyone 18 years of age or older who was born after 1956 should get at least one dose of MMR vaccine unless they are certain they had the diseases. Two doses are recommended for healthcare workers, students, educators, and international travelers. 

EMS Week 2013 Event

The Monterey County EMS Agency welcomes the public to attend the EMS Week event on Wednesday, May 22, 2013 from 10:00 a.m. to 1:00 p.m.  The EMS Week event will be held at the Monterey County Health Dept., 1270 Natividad Road, Salinas.  The event is free and open to the public.  The event will demonstrate this year’s theme of “EMS: One Mission. One Team.” 

Media Advisory: Celebrate the Best at Fruit and Veggie Fest

The Network for a Healthy California and Grocers Statewide Help Shoppers Get Healthy

WHAT: Each May the Network for a Healthy California (Network), and its grocery store partners statewide, hold Fruit and Veggie Fest events to encourage shoppers to fill their carts with the best healthy foods for their families and to learn healthy habits like filling half of every plate with fruits and vegetables. During the free events shoppers can take advantage of special promotions on fruits and vegetables, talk with nutrition experts and go on store tours to learn about the healthy choices in every aisle.

In Salinas, La Princesa Market has partnered with the Network for more than a decade to make their shoppers’ health a top priority by providing healthy cooking demonstrations and giving away Network educational materials.

WHEN: Fruit and Veggie Fest Salinas -- Saturday, May 18th from 10:00am to 6:00pm

WHERE: La Princesa Market, 614 Williams Road, Salinas, CA 93905

WHO: Network nutrition experts and Local Champions for Change

WHY: California’s grocers are on the frontlines of the obesity epidemic, which is why the Network works with more than 700 stores to help shoppers put healthy food in their carts and on their tables. Activities like Fruit and Veggie Fest are critical in the battle against obesity, particularly among low-income Californians who are at greater risk. Surveys show that retail promotions can have a positive impact on how shoppers spend their food dollars and CalFresh benefits.

VISUALS: Activities include:

• Local Champion Moms who will share tips and ideas to help shoppers learn about healthy and affordable food options
• Sample delicious nutritious recipes featuring in-season fruits and vegetables
• Sample tasty smoothies from smoothie bike

CONTACT: Charmaine Kaplan, Network for a Healthy California, (831)796-2863,  This e-mail address is being protected from spambots. You need JavaScript enabled to view it

                    Sandra Levy, Citizen Relations, (562)391-1516,   This e-mail address is being protected from spambots. You need JavaScript enabled to view it

For CalFresh information, call 877-847-3663. Funded by USDA SNAP, an equal opportunity provider and employer.
Visit www.cachampionsforchange.net for healthy tips. •California Department of Public Health 

Health Advisory: Local Increase in Sexually Transmitted Diseases - May 15, 2013

Health Advisory

May 15, 2013

Local Increase in Sexually Transmitted Diseases

Monterey County Health Officials Urge Thorough Screening and Reporting 

Current Situation

Monterey County is currently experiencing a surge in reported cases of sexually transmitted diseases (STDs), particularly gonorrhea and syphilis. In 2012, there were 195 cases of gonorrhea reported, which was more than twice the number reported in 2011. Most of these cases occurred during the last quarter of 2012. This trend continues in 2013, with over 130 cases reported between January 1^st and May 10^th. In 2012, there were 39 cases of syphilis reported among Monterey County residents, 22 of which were early syphilis (primary, secondary, or early latent). This represented a 56% increase in the total number of reported cases from 2011. To date in 2013, there have been 35 syphilis cases reported. Chlamydia continues to be the most commonly reported disease among Monterey County residents.

Recommendations

At this time, the Health Department recommends that all medical providers:

1.      Screen high-risk individuals regularly:

• Take a detailed sexual history to identify which anatomical sites should be including during screening.
• Perform a complete physical examination to include genital, oral, and anal areas.
• Order the following screening tests at the initial visit and at least yearly thereafter (repeated at 3-6 month intervals for those with multiple sex partners, anonymous partners, or who have sex in conjunction with drug use).
  • Gonorrhea and chlamydia from all sites with potential exposure (urethral, pharyngeal, and/or rectal).
  • Serological testing:
    • Syphilis (RPR with titer and reflexive treponemal test if RPR is reactive), and
    • HIV (unless known positive), and
    • Hepatitis C virus (unless known positive).

2.      Initiate empiric treatment without delay using the most current treatment guidelines:

Additional treatment recommendations for patients with contraindications to the recommended regimen, pregnant women, and HIV co-infected individuals can be found at: http://www.cdph.ca.gov/pubsforms/Guidelines/Documents/CA-STD-Tx-Guidelines-BW.pdf.

 3.      Promptly report all suspected cases of chlamydia, gonorrhea, syphilis, and pelvic inflammatory disease.

• Submit a Confidential Morbidity Report form to the Communicable Disease Unit (phone: 831-755-4521 or fax: 831-754-6682).
• Please include as much information as possible include race/ethnicity, pregnancy status, gender of sex partner(s), and treatment information.

Additional Information

For more information about STDs, required Title 17 reporting, or to obtain syphilis testing and treatment history on your patients, contact the Communicable Disease Unit at 831-755-4521. To download a Confidential Morbidity Report form, visit: www.mtyhd.org/cd and click on “Report a CD”.

To view local STD morbidity data, visit: http://www.mtyhd.org/index.php?option=com_content&view=article&id=1096&Itemid=809

To review the California STD Screening Recommendations, visit: http://www.cdph.ca.gov/pubsforms/Guidelines/Documents/CA-STD-Screening-Recommendations.pdf.

For a two-page summary of California STD treatment guidelines, visit: http://www.cdph.ca.gov/pubsforms/Guidelines/Documents/CA-STD-Tx-Guidelines-BW.pdf.

For guidance on Expedited Patient-Delivered Partner Therapy, visit: http://www.cdph.ca.gov/pubsforms/Guidelines/Documents/CA-STD-PDPT-Guidelines.pdf.

For more information on STDs, visit the Centers for Disease Control and Prevention’s website at www.cdc.gov/std.