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Hot Topics Region 7 HCC April 16, 2015 Jackie Dawson, PhD Region 7 Public Health Epidemiologist 88606428 Jacqueline.Dawson@cdhd.wa.gov

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Measles Long-term Complications Subacute sclerosing panencephalitis (SSPE) is a very rare, but fatal disease of the CNS that results from a measles infection. SSPE generally develops 7 to 10 years after a person has measles From 1989 -1991, 4 to 11 out of every 100,000 were estimated to be at risk for developing SSPE. Risk may be higher for a person who gets measles before two years of age.

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Report all suspect measles cases immediately to local public health

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Measles From January 1 to April 10, 2015, 159 people from 18 states and the District of Columbia were reported to have measles AZ (7), CA (101), CO (1), DC (2), DE (1), GA (1), IL (15), MI (1), MN (1), NE (2), NJ (1), NY (3), NV (9), OK (1), PA (1), SD (2) TX (1), UT (2), WA (7) 74% are linked to Disneyland

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Measles in WA Grays Harbor County genotype B3 Clallam County genotype D9 Clallam County 2 nd incubation period over Apr 19 th Clallam County UTD $200,000

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Influenza 2014-14 season- week 13 www.doh.wa.gov/Portals/1/Documents/5100/420-100-FluUpdate.pdf

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www.cdc.gov/flu/weekly/weeklyarchives2014-2015/images/image132.gif

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Chickenpox People who may have more severe symptoms and may be at high risk for complications include: Infants Adolescents Adults Pregnant women People with weakened immune systems because of illness or medications

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Chickenpox-Complications Hospitalization pneumonia infection or inflammation of the brain (encephalitis, cerebellar ataxia) bacterial infections of the skin and soft tissues in children including Group A strep infections blood stream infections (sepsis) toxic shock syndrome bone infections joint infections death

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Meningococcal Disease Fever, headache and stiff neck in meningococcal meningitis cases, and sepsis and rash in meningococcemia. Neisseria meningitidis (mostly serogroups B, C, and Y in USA) Fatal: 10%-15% 11%-19% have permanent hearing loss, mental retardation, or loss of limbs N. meningitidis colonizes mucosal surfaces of nasopharynx Transmission= direct contact with large droplet respiratory secretions from patients or asymptomatic carriers http://www.cdc.gov/meningococcal/clinical-info.html

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Local Meningococcal Response 34 people received post-exposure meds Ciprofloxacin, rifampin, ceftriaxone Ballard EMS X2, Wenatchee Fire Work contacts (marijuana) Extended Family X4 Other healthcare workers at hospital

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Questions?