Category Archives: Public Health

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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Public Health asks court to stop two hookah bars from violating smoking law

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Hookah

Photo courtesy of Solix via Wikipedia

From Public Health – Seattle & King County

Public Health – Seattle & King County has filed papers in King County Superior Court asking the court to stop two hookah bars for exposing employees and the public to tobacco smoke in violation of Washington’s Smoking in Public Places Act and local Board of Health Code.

The request for an injunction was filed against The Night Owl in Seattle’s University District and Medina Hookah Lounge in south Seattle.

A hookah is a glass pipe filled with water that is used for smoking flavored tobacco, often by several people at once.

During a typical 45-minute session of hookah use, a person may inhale as much smoke, tobacco and carcinogens as smoking 100 cigarettes or more.

Smoking in public places law

Washington’s Smoking in Public Places law was passed by voters in 2005 and prohibits smoking in public places and places of employment. The local Board of Health code mirrors the state law and includes provisions that prohibit the use of electronic smoking devices.

Hookah bars have claimed that they are exempt from the indoor smoking law because they are private clubs. However, smoking is prohibited by law if an establishment has employees and/or the club is open to the public.

A previous ruling by a King County Hearing Examiner on February 12, 2014 found that both the Night Owl and Medina are open to the public, operating similarly to night clubs that charge a cover for admission.

“Hookah smoke is as addictive as traditional cigarettes”, said Patty Hayes, Interim Director, Public Health- Seattle & King County. “Asking the court for an injunction is a measure of last resort, but it is necessary now to ensure all our businesses are protecting the health of employees and the public.” 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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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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Public health appoints new interim Local Health Officer

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Duchin

Jeffrey Duchin

Dr. Jeffrey Duchin, MD, was appointed today as Interim Local Health Officer for Public Health – Seattle & King County.

Duchin is a familiar figure in the health field, having held the position of chief of the department’s Communicable Disease Epidemiology and Immunization Section since 1999 and frequently serving as a department spokesperson.

In his new role, Duchin will provide leadership in developing priorities and setting strategies for the health department, with a particular role as the key science advisor on program and policy development.

Duchin will split time between his Health Officer duties and his continued direction of communicable disease and immunization activities. He will also maintain an affiliation with the University of Washington as a Professor of Medicine.

As part of his Health Officer duties, he will work with other health officers in Washington State on health issues that cross county borders.

In addition, Duchin will represent Public Health – Seattle & King County on external committees, task forces, and as a liaison to regional and national professional organizations.

Duchin’s is currently the Chair of the Public Health Committee of the Infectious Disease Society of America and has served in many other advisory roles, including the CDC’s Advisory Committee on Immunization Practices and the Institute of Medicine.

The Interim Local Health Officer reports to Patty Hayes, Interim Director of Public Health – Seattle & King County.  Prior to Duchin, the position was held by the previous Director, Dr. David Fleming.

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Locking up firearms to prevent suicide

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GunBy Tony Gomez, BS, RS, Manager, Violence and Injury Prevention
Public Health — Seattle & King County

I’ve worked on Violence and Injury Prevention for over thirty years. I consistently notice in the media and in conversations about firearms that usually the discussion focuses on tragic homicides.

But, the truth is that most firearm deaths are suicides—often hidden from the public conversation. In King County, nearly 70% of firearm deaths being suicides, it’s crucial we come together despite different ideologies.

The truth is that most firearm deaths are suicides.

There are numerous entities including King County that have a deep commitment to suicide prevention and are working together to address this “silent” killer of our residents.

With firearm ownership so prevalent in King County (~25%) – and some estimated 30,000 households that keep at least one firearm loaded and unlocked – we can’t afford to wait any longer to get those easily stolen and accessed firearms locked up.

We know that impulsivity plays a significant role in suicide attempts; easy access to highly lethal means, such as firearms, increases risk.  Strong evidence exists, both in the United States and abroad, that restricting access to lethal means is an effective way to reduce suicide.

Suicide prevention efforts in King County and elsewhere in the United States now champion safe storage of firearms. 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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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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Teen prescription opioid abuse, cigarette, and alcohol use down, but e-cigarette use up

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Two white tabletsFrom the US Department of Health and Human Services

Use of cigarettes, alcohol, and abuse of prescription pain relievers among teens has declined since 2013 while marijuana use rates were stable, according to the 2014 Monitoring the Future (MTF) survey, released today by the National Institute on Drug Abuse (NIDA). However, use of e-cigarettes, measured in the report for the first time, is high.

These 2014 results are part of an overall two-decade trend among the nation’s youth. The MTF survey measures drug use and attitudes among eighth, 10th, and 12th graders, is funded by NIDA, and is conducted by researchers at the University of Michigan at Ann Arbor. NIDA is part of the National Institutes of Health.

“With the rates of many drugs decreasing, and the rates of marijuana use appearing to level off, it is possible that prevention efforts are having an effect,” said NIDA Director Nora D. Volkow, M.D.

Continue reading

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Texting, talking and walking – distracted pedestrian injuries jump

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texting walking iPhone cell phone mobileBy Tim Henderson
Stateline

They walk in front of cars, and into tree limbs and street signs. They fall off curbs and bridges into wet cement and creek beds.

They are distracted walkers who, while calling or texting on mobile phones, have suffered cuts and bruises, sustained serious head injuries or even been killed.

As many cities and states promote walkable neighborhoods, in part to attract more young people, some also are levying fines on distracted walkers and lowering speed limits to make streets gentler for the inattentive.

Pedestrian injuries due to cell phone use are up 35 percent since 2010, according to federal emergency room data reviewed by Stateline, and some researchers blame at least 10 percent of the 78,000 pedestrian injuries in the U.S. in 2012 on mobile device distraction.

texting walking graphic

The federal Fatality Analysis Reporting system attributes about a half-dozen pedestrians deaths a year to “portable electronic devices,” including phones and music players.

Continue reading

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Urban parks and trails most cost-effective ways to promote exercise

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small__13075606504By Sharyn Alden
Health Behavior News Service

Providing public parks and walking and biking trails is the most cost-effective strategy to increase physical activity among large populations in urban areas, according to a new study in the American Journal of Health Promotion.

Virpi Kuvja-Kollner, lead author of the review, noted that although public budgets for health care and other services are tighter than ever, the most cost-effective approach to increase physical activity among large urban populations is to make changes to the structural environment.

Creation of more outdoor exercise opportunities, such as “pedestrian or bicycle trails en route to public transportation stations or providing public parks in densely populated areas,” can require a substantial public investment but have long life spans.

“The main focus in promoting physical activity should be to get people who are not active to get moving instead of just promoting more exercise to those who are already active.”

“The main focus in promoting physical activity should be to get people who are not active to get moving instead of just promoting more exercise to those who are already active,” added Kuvja-Kollner, a researcher/instructor and doctoral candidate at the University of Eastern Finland. Continue reading

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Video chat tops quarantine to combat TB

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TBBy Fred Mogul, WNYC

Thirty-four-year-old Karim works long days as an investment adviser, and when he doesn’t burn the midnight oil, he plays basketball or goes to the gym, hangs out with friends, or heads to coffee shops. You wouldn’t know he has an especially tough-to-treat illness.

“I have multiple-drug-resistant tuberculosis,” he explains.

It’s called that, because at least two of the most potent drugs conventionally used to squelch the tuberculosis bacterium don’t work on the strain of the illness that Karim has. So he needs to take a combination of drugs, with harsher side effects, for 18 months. That’s two to three times longer than the traditional treatment for tuberculosis.

While Americans debate whether we should quarantine people who might have Ebola but clearly aren’t contagious, others wander among us who are infected with tuberculosis, which is.

“It has been a very stressful treatment process and a lot to deal with, but, thank God, it’s all going really, really well,” says Karim, who requested that NPR not use his full name out of concern he could be stigmatized for being a carrier of a disease that many people don’t understand.

While Americans debate whether we should quarantine people who might have Ebola but clearly aren’t contagious, others wander among us who are infected with tuberculosis — another disease that’s highly communicable in some forms. Close to 10,000 people in the United States have TB. Continue reading

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More than half of U.S. infants sleep with unsafe bedding

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From the National Institutes of Health

NIH, CDC study shows unsafe infant bedding use still common, despite warnings

Alert IconNearly 55 percent of U.S. infants are placed to sleep with bedding that increases the risk of sudden infant death syndrome, or SIDS, despite recommendations against the practice, report researchers at the National Institutes of Health, the Centers for Disease Control and Prevention, and other institutions.

Soft objects and loose bedding — such as thick blankets, quilts, and pillows — can obstruct an infant’s airway and pose a suffocation risk, according to the NIH’s Safe to Sleep campaign.

Soft bedding has also been shown to increase the risk of SIDS Infants should be placed to sleep alone, on their backs, on a firm sleep surface, such as in a mattress in a safety-approved crib, covered by a fitted sheet. Soft objects, toys, crib bumpers, quilts, comforters and loose bedding should be kept out of the baby’s sleep area.

Parents have good intentions but may not understand that blankets, quilts and pillows increase a baby’s risk of SIDS and accidental suffocation.”—Carrie K. Shapiro-Mendoza, Ph.D.

Based on responses from nearly 20,000 caregivers, the researchers reported that, although such potentially unsafe bedding use declined from 85.9 percent in 1993-1995, it still remained high, at 54.7 percent, in 2008-2010.

“Parents have good intentions but may not understand that blankets, quilts and pillows increase a baby’s risk of SIDS and accidental suffocation,” said the study’s first author, Carrie K. Shapiro-Mendoza, Ph.D., M.P.H., senior scientist in the CDC’s Division of Reproductive Health in Atlanta.  Continue reading

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Sign up to receive Flood Alerts! Or get the app!

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King County Flood Alert App

King County is offering free Flood Alerts to help keep you informed of flood conditions you can sign up for phone or text messages — or get an app.

  • Get Alerts by e-mail and/or phone (voice or text messages)
  • Select the rivers that affect you
  • Select the flood phase levels of interest to you.

 Make sure you get alerted in an emergency!

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