Category Archives: Infections

Q & A about Public Health’s investigation of an endoscope associated outbreak

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Tcrehe Seattle Times reported this morning that there had been an outbreak of multidrug-resistant “superbug” infections spread by contaminated endoscopes between 2012 and 2014 in which at least 32 patients at Virginia Mason Medical Center were infected .

Neither the hospital nor health officials notified patients or the public, the Seattle Times reported.

In response to the paper’s report, Public Health – Seattle & King County has posted the following  Q & A on its Public Health Insider blog:

Q & A about Public Health’s investigation of an endoscope associated outbreak

Voluntary reporting by Virginia Mason Medical Center led to identification of an outbreak of multidrug resistant bacterial infections in 2013. After months of investigative work, Public Health—working with Virginia Mason Medical Center, Washington State Department of Health and the Centers for Disease Control Prevention (CDC)—linked the outbreak to a procedure called endoscopic retrograde cholanCREgiopancreatography (ERCP). Since discovering the risk from this procedure, our Communicable Disease Epidemiology staff has taken a leadership role in drawing national attention to this issue in the medical community. Dr. Jeff Duchin, Interim Health Officer and Chief of Communicable Disease Epidemiology answered questions about this outbreak.

What is an ERCP used for?

The ERCP procedure uses a scope, or tube, that goes through a patient’s mouth and throat to reach their upper small bowel and bile duct system. ERCP is used in persons with serious medical problems including cancers and other diseases that cause obstruction or narrowing of the bile ducts.

What kind of bacteria caused the infections?

Infections were caused by two closely-related types of bacteria that are resistant to many antibiotics. In some cases, the bacteria were also resistant to powerful antibiotics called carbapenems.  These bacteria are referred to as CRE (carbapenem resistant Enterobacteriaceae).

Was the outbreak caused by a CRE “superbug?”

No. The type of CRE that has caused outbreaks in other healthcare facilities has been referred to as a “CRE superbug.” It usually produces an enzyme that inactivates carbapenem antibiotics. The outbreak we investigated was not caused by this type of CRE, which did not have a carbapenemase enzyme.

What is the role of Public Health in this investigation? Continue reading

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Listeria outbreak linked to Latin-style soft cheeses

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Pregnant women, newborns and adults with weakened immune systems most at risk

cheeseWashington State health and agriculture officials are working with the Centers for Disease Control and Prevention and the U.S. Food and Drug Administration on an ongoing outbreak of Listeria monocytogenes infections linked to consumption of Latin-style soft cheese produced by Queseria Bendita, a Yakima, Washington firm. 

As of January 16, 2015, a total of three cases have been identified from Washington in King, Pierce and Yakima counties. One illness was pregnancy-associated, two people were hospitalized and one death was reported.

The affected products made by the Yakima-based Queseria Bendita are subject to a voluntary recall and the firm has stopped producing cheese.

Health officials are warning consumers who may have purchased these three Queseria Bendita brand cheeses: Queso Fresco, Panela, and Requeson and still have it in their refrigerators to throw the product away and not eat it. Grocery stores and distributors should pull and not sell these products.  Continue reading

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Where do we stand in the fight against Ebola?

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 A Conversation with CDC Director Tom Frieden



On Tuesday, January 13, the Kaiser Family Foundation and the Center for Strategic and International Studies (CSIS) held a conversation with Tom Frieden, M.D., M.P.H., director of the Centers for Disease Control and Prevention (CDC), to discuss his recent trip to assess the Ebola outbreak in Sierra Leone, Liberia and Guinea.

The discussion focused on efforts to contain the Ebola outbreak in West Africa and the ongoing response by the U.S. government.

Josh Michaud, associate director of global health policy at the Kaiser Family Foundation, made opening remarks, and Stephen Morrison, senior vice president and director, global health policy center at CSIS, moderated the conversation.

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U.S. still unprepared for epidemics – Modern Healthcare

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Ebola NIAIDLocal health departments cut about 4,400 positions in 2013, according to an April report from the National Association of County & City Health Officials. Since 2008, more than 48,000 jobs in local health departments have been eliminated through layoffs and attrition.

The cuts have left state and local health departments stretched thin to provide services such as vaccinations and HIV/AIDS education, and have limited their ability to recruit personnel who can help detect and identify disease threats.

via U.S. still unprepared for epidemics – Modern Healthcare.

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“Disneyland” measles case visited Puget Sound, passed through Sea-Tac Airport

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Case in Grays Harbor also linked to the Disneyland measles outbreak

disneyland

A person with measles traveled to Sea-Tac Airport and visited several public areas in King and Snohomish counties while contagious.

Public health officials say an out-of-state, unimmunized woman in her 20s became contagious with measles on December 28, 2014 after visiting Disneyland in southern California in December.

California health officials have identified about a dozen confirmed and suspected cases of measles in people who recently visited the California theme park last month.

 

Most people in our state are immune to measles, so public risk is low except for people who are not vaccinated.

The visit was during a time when others who later got measles were at the park.

Measles is highly contagious and can cause severe illness with rash, fever, cough, eye irritation, and can be fatal.

The contagious traveler flew from Orange County, CA to Sea-Tac on December 29 and flew out of Sea-Tac airport on January 3 to return home. She stayed with family in Snohomish County.

Anyone who was in one of the following locations during the indicated times may have been exposed to measles: Continue reading

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A Guide To Handling Flu Season – WBUR

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Flu virus - courtesy of NAIAD

Flu virus – courtesy of NAIAD

The flu season is upon us, and the Centers for Disease Control has announced that influenza has officially reached epidemic proportions across the U.S.

Dr. Anita Barry, director of the Boston Health Commission’s infectious disease bureau, joined WBUR’s Morning Edition to discuss the flu strain and how the Boston is coping.

Listen below to Barry’s full conversation with WBUR’s Bob Oakes.

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Snohomish County offers free flu shot clinic for low-income and uninsured adults

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Flu virus - courtesy of NAIAD

Flu virus – courtesy of NAIAD

Snohomish County will be offering a free flu vaccination clinics, Jan. 10 & 14

Vaccinations will be first come, first served and offered only to low-income and uninsured adults.

Uninsured and low-income adults can take advantage of two upcoming vaccination clinics for flu, whooping cough, and pneumonia in Everett, Wash.
Continue reading

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Washington scores four out of 10 on key indicators related to preventing and responding to infectious disease outbreaks

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From Trust for America’s Health and the Robert Wood Johnson Foundation 

Washington scored only four out of 10 on key indicators related to preventing, detecting, diagnosing and responding to outbreaks, like Ebola, Enterovirus and antibiotic-resistant Superbugs.

Some key Washington findings include:

No. Indicator Washington Number of States Receiving Points
A “Y” means the state received a point for that indicator
1 Public Health Funding: Increased or maintained level of funding for public health services from FY 2012-13 to FY 2013-14. N 28
2 Preparing for Emerging Threats: State scored equal to or higher than the national average on the Incident & Information Management domain of the National Health Security Preparedness Index. Y 27 + D.C.
3 Vaccinations: Met the Healthy People 2020 target of 90 percent of children ages 19-35 months receiving recommended ≥3 doses of HBV vaccine. N 35 + D.C.
4 Vaccinations: Vaccinated at least half of their population (ages 6 months and older) for the seasonal flu for fall 2013 to spring 2014. N 14
5 Climate Change: State currently has completed climate change adaption plans – including the impact on human health. Y 15
6 Healthcare-acquired Infections: State performed better than the national standardized infection ratio (SIR) for central line-associated bloodstream infections. N 16
7 Healthcare-acquired Infections: Between 2011 and 2012, state reduced the number of central line-associated blood stream infections. N 10
8 Preparing for Emerging Threats: From July 1, 2013 to June 30, 2014, public health lab reports conducting an exercise or utilizing a real event to evaluate the time for sentinel clinical laboratories to acknowledge receipt of an urgent message from laboratory. N 47 + D.C.
9 HIV/AIDS: State requires reporting of all CD4 and HIV viral load data to their state HIV surveillance program. Y 37 + D.C.
10 Food Safety: State met the national performance target of testing 90 percent of reported Escherichia coli (E. coli) O157 cases within four days. Y 38 + D.C.
Total  4

 Read the full report here.

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Snoqualmie Ice Cream Voluntary Recall

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snoqualmieSnoqualmie Gourmet Ice Cream, Inc. has issued a voluntary recall of all ice cream, gelato, custard and sorbet for all flavors and container sizes produced on or after January 1, 2014 until December 15, 2014 because these products have the potential to be contaminated with Listeria monocytogenes.

Listeria monocytogenes is an organism that can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Although healthy individuals may suffer only short-term symptoms such as high fever, severe headache, stiffness, nausea, abdominal pain and diarrhea, Listeria infection can cause miscarriages and stillbirths among pregnant women.

The ice cream, gelato, custard and sorbet were distributed in Arizona, Idaho, California, Oregon, and Washington may have been further distributed and sold in various retail outlets in Alaska, Colorado, Montana, Nevada, New Mexico, North Dakota, Texas, Utah, and Wyoming. Continue reading

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Avoid raw milk, it’s just not worth the risk, says CDC

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Photo by Maciej Lewandowski

Photo by Maciej Lewandowski

From the US Centers for Disease Control and Prevention

Raw milk can carry harmful germs that can make you very sick or kill you. If you’re thinking about drinking raw milk because you believe it has health benefits, consider other options.

Developing a healthy lifestyle requires you to make many decisions. One step you might be thinking about is adding raw milk to your diet. Raw milk is milk that has not been pasteurized (heating to a specific temperature for a set amount of time to kill harmful germs). Germs include bacteria, viruses, and parasites.

Making milk safe
Milk and products made from milk need minimal processing, called pasteurization. This process includes:

  • Heating the milk briefly (for example, heating it to 161°F for about 15 seconds)
  • Rapidly cooling the milk
  • Practicing sanitary handling
  • Storing milk in clean, closed containers at 40°F or below

While it is possible to get foodborne illnesses from many different foods, raw milk is one of the riskiest of all.

When milk is pasteurized, disease-causing germs are killed. Harmful germs usually don’t change the look, taste, or smell of milk, so you can only be confident that these germs are not present when milk has been pasteurized.

Remember, you cannot look at, smell, or taste a bottle of raw milk and tell if it’s safe to drink.

Risks of drinking raw milk

Raw milk can carry harmful bacteria and other germs that can make you very sick or even kill you. While it is possible to get foodborne illnesses from many different foods, raw milk is one of the riskiest of all. Getting sick from raw milk can mean many days of diarrhea, stomach cramping, and vomiting. Less commonly, it can mean kidney failure, paralysis, chronic disorders, and even death.

Continue reading

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Food inspection grades: A – B – C , easy as 1 – 2 – 3 … or is it?

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EatBy hilarykaraszkc
Public Health Insider: Behind-the-scenes of the agency protecting the health and well-being of all people in Seattle & King County

New York City has them, so does L.A. Even Toronto has them. So why aren’t there food safety inspection grades posted outside of restaurants in King County?

The answer? Food safety performance placarding is coming, and when it does, it will give patrons and establishments alike information that is meaningful, clear, and motivating.

Diners need to know actual risk

There’s a lot on the line: Studies show that restaurant placards influence consumer behavior. But research on the systems that give A-B-C grades shows that A-B-C placards don’t communicate what consumers are expect. Continue reading

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Flu on the rise in King County

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Flu virusesFlu is here—and it’s a nasty one!

By Meredith Li-Vollmer
Public Health – Seattle & King County

Influenza is noticeably on the rise in King County, according the Public Health – Seattle & King County” sCommunicable Disease and Epidemiology unit.

Last week, the number of laboratory tests for flu rose sharply and a handful of schools, daycare programs, and long-term care facilities reported flu outbreaks.

A severe flu forecast

The flu season has only just begun, but the CDC is finding that so far, seasonal influenza A H3N2 viruses have been the most common flu viruses circulating. What’s the significance? In flu seasons in which H3N2 viruses predominate, there often are more severe flu illnesses, hospitalizations, and deaths.

On top of that, roughly half of the H3N2 viruses that the CDC analyzed to date are drift variants: viruses with genetic changes that make them different from this season’s vaccine virus. This means the vaccine’s ability to protect against those viruses may be reduced.

So should you still get this year’s flu vaccine? Continue reading

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Illnesses due to raw milk on the rise

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From the US Centers for Disease Control and Prevention 

Photo by Maciej Lewandowski

Photo by Maciej Lewandowski

The average annual number of outbreaks due to drinking raw (unpasteurized) milk have more than quadrupled – from an average of three outbreaks per year during 1993-2006 to 13 per year during 2007-2012. Overall, there were 81 outbreaks in 26 states from 2007 to 2012.

As more states have allowed the legal sale of raw milk, there has been a rapid increase in the number of raw milk-associated outbreaks.The outbreaks, which accounted for about 5 percent of all food-borne outbreaks with a known food source, sickened nearly 1,000 people and sent 73 to the hospital. More than 80 percent of the outbreaks occurred in states where selling raw milk was legal.

As more states have allowed the legal sale of raw milk, there has been a rapid increase in the number of raw milk-associated outbreaks.

Continue reading

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US provides immunity to Ebola vaccine developers

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 Secretary of Health & Human Services Sylvia Mathews BurwellHealth and Human Services Secretary Sylvia M. Burwell today announced a declaration under the Public Readiness and Emergency Preparedness (PREP) Act to facilitate the development and availability of experimental Ebola vaccines.

This declaration is intended to assist in the global community’s effort to help combat the current epidemic in West Africa and help prevent future outbreaks there, the HHS said.

The declaration provides immunity under United States law against legal claims related to the manufacturing, testing, development, distribution, and administration of three vaccines for Ebola virus disease. It does not, generally, provide immunity for a claim brought in a court outside the United States.

Past declarations have covered vaccines used in H5N1 pandemic influenza clinical trials in 2008, products related to the H1N1 influenza pandemic in 2009, and the development and manufacturing of antitoxins to treat botulism in 2008.

Here are more details about the action from the HHS release:

Continue reading

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