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

2. 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.

3. Report all suspect measles cases immediately to local public health

4. 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

7. 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

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

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

11. 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

12. 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

13. 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

15. 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

16. Questions?