Public Health Alerts
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
Children with jaundice should be excluded from school or
daycare for 5 school days.
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
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,
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.