Public Health Alerts

Hepatitis A virus

There is an outbreak of Hepatitis A in Fayette County. Several cases have been identified are area schools. If you suspect Hepatitis A, based on clinical presentation, please perform an IgM anti-HAV diagnostic test and contact the Fayette County Health Department at 859-231-9791 and dial 0 for the operator to report the suspected case.

Since Hepatitis A is spread via the fecal-oral route, frequent and thorough hand washing should be stressed to all patients and their contacts.

Children with jaundice should be excluded from school or daycare for 5 school days.

Mumps Alert

The United States is experiencing the largest mumps epidemic in the last 25 years. Physicians may soon see mumps, a vaccine preventable viral disease, in patients seen for acute illnesses in their offices, in urgent care centers or emergency rooms across the Commonwealth.

Among cases with known immunization histories, 65% of the reported cases are in individuals that have been vaccinated with two doses of MMR. The vaccine effectiveness for one dose of MMR is 70-80% and 80-90% for two doses. Since no vaccine is 100 percent efficacious it is to be expected that there will be some cases of disease in individuals that have been vaccinated. The first reports of illness were in December 2005 at a university in Iowa. Since then 365 cases have been reported, with illness spreading to all but one state surrounding Iowa.

The clinical definition for mumps is an illness with acute onset of unilateral or bilateral tender, self-limiting swelling of the parotid or other salivary gland, lasting >2 days, and without other apparent case.

Laboratory criteria for diagnosis

• Positive serologic test for mumps immunoglobulin M (IgM) antibody, or 
• A four-fold rise between acute- and convalescent -phase titers in serum mumps immunoglobulin G (IgG) antibody level by any standard serologic assay, or 
• Isolation of mumps virus from clinical specimen, or 
• Detection of mumps viral RNA by reverse transcription polymerase chain reaction (RTPCR)
  

How do you protect patients at in your office?

Plan to separate coughing or ill patients in the waiting area or have a separate area designated.

Have a procedure or surgical masks for coughing patients readily available. Have disposable tissues readily available. Wear appropriate personal protective equipment (PPE) while performing exams, i.e. surgical masks with a coughing patient (to prevent droplet spread).

This is the ideal time to determine immune status of personnel, either documentation of two MMRs, a positive mumps IgG or history of physician diagnosed mumps, or birth before 1957. If vaccination status is not adequate, vaccinate with MMR unless contraindicated.

Screen individuals for mumps symptoms when calling-in for an appointment. If clinically compatible with mumps, do not allow them to sit in the waiting area for prolonged periods of time and keep them at least three feet from other patients. Request that they wear a procedure or surgical mask. When assessing a patient for possible mumps, staff should follow Standard and Droplet Precautions. Any staff member with signs and symptoms of mumps should be sent home and be off work for nine days.

Please contact SJHC Infection Control at 859.313.4715 if you have any questions or concerns. Thank you.