Clinician Alert: CDC Highlights Monkeypox Case Finding and Awareness of Non-Classical Presentations

Clinician Alert: CDC Update Highlights Monkeypox Case Finding and Awareness of Non-Classical Presentations

June 15, 2022

Requested actions

• Be aware that monkeypox can mimic other rash illnesses with a similar appearance (e.g., varicella, he...

Clinician Alert: Monkeypox Specimen Collection Revisited

Clinician Alert 

Monkeypox Specimen Collection Revisited

June 2, 2022

This alert provides a brief update on specimen collection and submission.  Please refer to the Health District’s prior monkeypox alert issued May 23, 2022, for ...

Syphilis Transmission Increasing: Updated Screening Guidelines & Prevention of Congenital Syphilis

May 27, 2022

Clinician Alert

Syphilis Transmission Increasing: Updated Screening Guidelines & Prevention of Congenital Syphilis

Actions Requested 

• Recognize that syphilis transmission is increasing locally and that, although me...

Clinician Advisory: Paxlovid Rebound & Correction: Monkeypox Alert

Clinician Advisory: Paxlovid Rebound

May 24, 2022

Requested actions

• Be aware that cases of rebound in COVID-19 symptoms and/or viral test positivity have been reported, generally occurring 2-8 days after recovery. For further information, see the full text o...

Clinician Alert: Monkeypox in Europe and North America

Clinician Alert: Monkeypox in Europe and North America

May 23, 2022

Requested actions

• Be aware that multiple outbreaks of monkeypox have been detected in Europe and North America during the month of May, including a case diagnosed in a Massachusetts resident...

Clinician Advisory: Falling Immunization Coverage Among Children

May 12, 2022

Clinician Advisory: Falling Immunization Coverage Among Children

Call to Action for Reminding and Recalling Under-Immunized Patients

Requested action:

• Please use reminders and recall messaging directed toward parents and guardians in ord...

Treatments for Outpatients with Mild to Moderate COVID Who are at Increased Risk for Severe Outcomes

April 28, 2022

Clinician Advisory: Treatments for Outpatients with Mild to Moderate COVID-19 Who are at Increased Risk for Severe Outcomes of COVID-19

Requested Actions: 

• Encourage patients to be fully vaccinated and up-to-date with respect...

Recommendations: Adenovirus Testing & Reporting of Children with Acute Hepatitis of Unknown Etiology

Please see the advisory linked below regarding association of adenovirus 41 with severe hepatitis in pediatric patients and recommending testing for adenovirus by PCR on blood, stool, rectal swab and/or respiratory specimens. We ask that clinicians who di...

Reminder: Moderately-to-severely immunosuppressed people eligible for 3rd primary dose and booster

January 28, 2021 Clinician Advisory – COVID-19 

Reminder: Moderately-to-severely immunosuppressed people are eligible for third primary dose and booster 

Requested action: Reinforce COVID-19 vaccination recommendations f...

Clinician Advisory: Updated CDC STD Treatment Guidelines

Clinician AdvisoryCDC STD Treatment Guidelines

Updated November 18, 2021

The Centers for Disease Control and Prevention (CDC) recently released its Sexually Transmitted Infections Treatment Guidelines, 2021, providing current evidence-based diagnostic, mana...

Clinician Update-COVID-19: Pfizer’s Pediatric mRNA Vaccine Green Lighted for Implementation

November 3, 2021

Clinician Update--COVID-19: 

Pfizer’s Pediatric mRNA Vaccine Green Lighted for Implementation 

in Children 5-11 Years of Age

Requested Action

• Implement the Centers for Disease Control and Prevention&rs...

Clinician Advisory-COVID-19: WA DOH Updates Guidance on Use of Monoclonal Anti-SARS-CoV-2 Antibodies

November 3, 2021

Clinician Advisory--COVID-19: 

WA DOH Updates Guidance on Use of Monoclonal Anti-SARS-CoV-2 Antibodies

Note: This advisory modifies and supersedes previous guidance issued on this topic September 17, 2021.

Request...

Clinician Alert--COVID-19: Interim Triage of Limited Supply of Monoclonal Anti-SARS-CoV-2 Antibodies

September 17, 2021 

Clinician Alert--COVID-19:Interim Triage of Limited Supply of Monoclonal Anti-SARS-CoV-2 Antibodies

Note: This alert modifies implementation of previous guidance issued on this topic earlier in the week.

Requested Action...

Clinician Update--COVID-19: Use of Monoclonal Anti-SARS-CoV2 Antibodies

September 14, 2021

Clinician Update--COVID-19: 

Use of Monoclonal Anti-SARS-CoV2 Antibodies for Prevention of Severe Disease

Requested Actions

• Consider using monoclonal antibodies to treat eligible, high-risk patients with mild-to-moderate ...

Clinician Advisory: Vigilance for Measles & Polio in Afghan Arrivals

Clinician Advisory

Vigilance for Measles & Polio in Afghan Arrivals

Requested Actions

• Maintain awareness of immunization recommendations for people arriving from Afghanistan.
• Maintain vigilance for measles or&a...

Clinician Advisory: Vaccination and Masking Requirements

Clinician Advisory--COVID-19: 

Governor Requires Vaccination for Healthcare Personnel

Local Health Officer Issues Directive for Masking in Public Indoor Spaces

Requested Action

Advisory: Fifth COVID Wave Fueled by Delta Variant: Increase Vaccination; Mask in Public Indoors

July 28, 2021

Clinician Advisory

Fifth COVID-19 Wave Fueled by Delta Variant: 

Increase COVID-19 Vaccination

Mask-up in Public Indoor Places

Requested Actions

• If you are a health care worker and are not fully vaccinated, get vaccinated as soo...

Advisory: Updated EUA Fact Sheets Note Risk of Guillain-Barré after J&J COVID-19 Vaccination

Clinician Advisory

Updated EUA Fact Sheets Note Risk of Guillain-Barré 

after J&J COVID-19 Vaccination

Requested Actions

• Use the updated Janssen/J&J COVID-19 EUA fact sheet for patients.
• Report cases of Guillain-Barre Synd...

Clinician Update: Myocarditis-Pericarditis following Vaccination; Additional or Booster Doses

Clinician Update—COVID-19

Myocarditis-Pericarditis following Vaccination

Additional or Booster Doses of Vaccine

June 25, 2021

Actions Requested

• Be aware of the association of rare cases of myocarditis and/or pericarditis with mRNA COVID-19 ...

Clinician Advisory: Human Immunodeficiency Virus & Other Sexually Transmitted Infections

Clinician Advisory: 

Human Immunodeficiency Virus & Other Sexually Transmitted Infections

june 24, 2021

Actions Requested:

• Provide empiric treatment for bacterial sexually transmitted infections (STI) among patients presenting with comp...

Clinician Advisory: Continuing Education Addressing Evaluation & Management of Post-COVID Conditions

Clinician Advisory

June 22, 2021

Continuing Education Opportunity Addressing 

Evaluation & Management of Post-COVID Conditions

Actions Requested

• Become familiar with the clinical presentation and current recommended framework f...

Clinician Advisory: Myocarditis and pericarditis association in COVID-19 vaccine recipients

Clinician Advisory

Myocarditis and Pericarditis Association in COVID-19 Vaccine Recipients

May 28, 2021

Actions requested

1. For suspected cases of myocarditis or pericarditis occurring following COVID-19 vaccination:

1. get complete COVID-19 vaccination h...

Clinician Alert: Fax System Failure April 21-26, New Health District Voice Line for Clinicians

Clinician AlertFax System Failure April 21-26, New Health District Voice Line for Clinicians

April 26, 2021

Actions requested:

• Please resubmit any COVID/SARS-CoV-2 test results, other notifiable condition case reports or laboratory results, or any other mate...

Clinician Advisory: Students and Isolation-&-Quarantine Directives for COVID-19

Clinician Advisory: Students and Isolation-&-Quarantine Directives for COVID-19

Requested Actions

• Follow prevailing guidelines from the Centers for Disease Control & Prevention and the Washington State Department of Health when counseling families a...

Clinician Alert: Pause on Johnson & Johnson (J&J) COVID-19 Vaccine Use

Clinician Alert: Pause on Johnson & Johnson (J&J) COVID-19 Vaccine Use

Requested Actions

• Hold off on administering any J&J vaccine pending the outcome of a safety review by the Centers for Disease Control & Prevention (CDC) and the Food &...

Clinician Advisory: Travelers from Ebola-affected Countries

Clinician Advisory

Travelers from Ebola-affected Countries

Requested actions

• Be aware that the Health District is currently monitoring travelers to Snohomish County from Guinea and the Democratic Republic of the Congo (DRC), where recent Ebola case...

Clinician Advisory: Identifying Cases for SARS-CoV-2 Sequencing to Detect Variants

Requested Actions:

• Please review recently updated CDC guidance on SARS-CoV-2 variants.
• Please contact the Health District at 425-339-3503 to prioritize any of the following types of COVID-19 cases for whole genome sequencing (WGS).

Background

• The Washington S...

Clinician Advisory: Updated Guidelines for Gonorrhea & Syphilis February 18, 2021

Clinician AdvisoryUpdated Guidelines for Gonorrhea & SyphilisFebruary 18, 2021

Gonorrhea Treatment Update

Requested action:

Please note and implement these updated recommendations for the treatment of uncomplicated gonococcal infections of the urogenital...

Clinician Update: COVID-19 Guidance February 12, 2021

Clinician UpdateCOVID-19 GuidanceFebruary 12, 2021

COVID-19 Situation Report

Requested Actions

• Maintain awareness of the level and trajectory of COVID-19 transmission in the community.
• Be able to direct patients and colleagues to guidance on Washington State&...

COVID-19 Update for Clinicians: December 2, 2020

Update for Clinicians

December 2, 2020

SUMMARY 

See this update for:

• Correcting Misinformation about Isolation and Quarantine 
• Re-infection and Re-testing for COVID-19
• Washington [COVID-19] Exposure Notifications (WA Notify)

 ...

Public Health Advisory: Increased Suicide Risk: November 18, 2020

 Public Health Advisory:  Increased Suicide Risk

November 18, 2020

Background

Since August of 2020, there have been four student suicides in Snohomish County reported to public health. These tragedies appear to be unrelated to one...

Update for Clinicians: November 4, 2020

SUMMARY 

See this health alert for:

• Approach to Influenza Season in the COVID-19 Era
• COVID-19 Quarantine and Negative SARS-CoV-2 Test Results

Approach to Influenza Season in the COVID-19 Era

Requested Actions

• Alw...

COVID-19 Update for Clinicians October 27, 2020

SUMMARY: See this health alert for:

• COVID-19 Vaccination Program Information
• Interim State COVID-19 Vaccine Distribution Plan Update
• Increased Risk of COVID-19 from Smoking

COVID-19 Vaccination Program Information

The Washington St...

Health Care Provider Alert: Wildfire Smoke & Unhealthy Air Quality

Ongoing wildfires in the Pacific Northwest region have caused a substantial decline in air quality that is expected to last through the coming weekend, with a forecast for improvement by the beginning of next week.  As you are aware, this may lea...

COVID-19 Updates for Clinicians: August 3, 2020

COVID-19 Update 

COVID-19 incidence continued to increase for the sixth consecutive week through July 25, with the most recent 2-week period being 97 confirmed cases per 100K*14days (see Figure 1 below). When this metric approaches or exceeds 100,...

Update on COVID-19 Testing for Healthcare Providers

Update on COVID-19 Testing for Healthcare Providersc/o Kathy Lofy, MD (State Health Officer, Washington State Department of Health [DOH])

Dear Provider,

We recently became aware of significant delays in obtaining COVID-19 test results from some of the large...

Update for Clinicians: COVID-19 Cases Increasing in Snohomish County

Update for CliniciansCOVID-19 Cases Increasing in Snohomish CountyJuly 7, 2020

Contents

• Requested Actions
• COVID-19 Data Summary
• Updated COVID-19 Testing Guidance for Healthcare Providers
• Employer Roles and Responsibilities

Requested Actions

• Be aware that COVID-1...

Isolation & Quarantine Referral Information for Health Care Providers

Snohomish County health care providers:If you identify someone who has tested positive for COVID-19 or has test results pending, does not need hospitalization, and cannot isolate themselves in a safe/secure environment, you can refer the person to Snohomi...

COVID-19 Update for Clinicians: May 19, 2020

SUMMARY: See this health alert for

• Augmented Case & Contact Investigations for COVID-19
• COVID-19 Clinical Trials
• Multi-System Inflammatory Syndrome in Children Associated with COVID-19
• COVID-19 Data

Augmented Case & Contact Investigations for ...

Infection Prevention and PPE Guidance for Dental Healthcare Professionals: May 14, 2020

In this advisory:

• Dentistry and COVID-19 transmission
• Patient care, staff screening, and cleaning
• Current PPE availability and requesting resources
• Infection control and PPE recommendations

*Guidance is compiled from CDC and ADA sources. See Resources section ...

COVID-19 Update for Veterinarians: May 5, 2020

COVID-19 Update for VeterinariansMay 5, 2020

SUMMARY: See this health alert for

• COVID-19 Guidance for Veterinarians
• Caring for a pet from a household where a person has suspected or confirmed COVID-19
•  Testing for SARS-CoV-2
• Managing a pet th...

COVID-19 Update for Clinicians, May 1, 2020

SUMMARY: See this health alert for 

• Updated Guidelines for SARS-CoV2 Testing 
• SARS-CoV2 Testing Survey 
• Health District Not a Venue for SARS-CoV2 Serology 
• HRSA Launches COVID-19 Uninsured Program 
• COVID-19 in 2020 ...

Isolation & Quarantine Referral Process Update: April 27, 2020

Please note that the referral process for the isolation-and-quarantine (I&Q) facility at Angel of the Winds Arena has been simplified. To launch a referral, please just contact the I&Q facility directly at 425-238-3439. Criteria for eligibility ar...

COVID-19 Update for Clinicians: April 24, 2020

SUMMARY: See this health alert for

• Health District After-Hours Calls
• How to Sign Up for Health Advisories
• Serologic Testing

Health District After-Hours Calls

Our after-hours communicable disease (CD) reporting line (425-339-5278) prompts clinicians to...

COVID-19 Update for Clinicians: April 13, 2020

COVID-19 Update for CliniciansApril 13, 2020

Contents

• Isolation & Quarantine Site Update
• Syndromic Management of STD during COVID-19
• COVID-19 Data
• Isolation and Quarantine Supplemental Materials

Isolation & Quarantine Site Update

Requested Actions:

• Please...

COVID-19 Update for Clinicians April 7, 2020

In this update:

• COVID-19 Data Update
• Snohomish County Isolation & Quarantine Facility
• HIPAA & Telehealth during COVID-19 Emergency
• Cloth Face Coverings

Summary

Taken together, these data provisionally suggest that COVID-19 transmission is decreasing in ...

COVID-19 Update for Clinicians March 27, 2020

COVID-19 Data Update

Summary

Taken together, these data suggest that COVID-19 transmission is increasing in the community and that an increasing proportion of emergency department visits and hospital admissions for febrile respiratory disease over the past ...

COVID-19 Update for Clinicians March 22, 2020

SUMMARY: See this health alert for

• Brief Epidemiologic Update
• Updated Guidance from the Washington State Department of Health
• Requested Action
• Background
• Isolation – Healthcare Workers and First Responders
• Quarantine – Healthcare Wo...

March 19 Updated COVID-19 Guidance for Clinicians

COVID-19 Updated Guidance for CliniciansMarch 19, 2020

Summary: Please review this health alert for:

• Situation update
• Future projections and care standards planning
• Testing guidelines update
• Personal protective equipment (PPE)
• Long term care facilities
• Kidney ce...

March 9 COVID-19 Updated Guidance for Clinicians

COVID-19 Updated Guidance for Clinicians March 9, 2020 

SUMMARY: Please review this health alert for: 

• Situation update 
• Laboratory testing guidance 
• Infection Prevention for Outpatient Settings 
• Directions for Pati...

Outpatient Guidance for COVID-19: March 5, 2020

The attached outpatient guidance for the COVID-19 response is being shared from Washington Department of Health and Snohomish Health District. 

Please see the DOH document here: https://alertsenseadmin.blob.core.windows.net/snohomish-county-wa/Out...

March 3 COVID-19 Updated Guidance for Clinicians

•    Surveillance data through March 2, 2020

• Updated tool for patient triage attached.
• COVID-19 testing is now commercially available through the University of Washington 
  • Information page:  https://testguide.labm...

COVID-19 Update for Health Care Systems Mitigating COVID-19 Impacts

Requested Actions: 

• Please review SHD’s recent updates for clinicians from February 28 and March 1 and follow those guidelines for determining eligibility for COVID-19 testing. Visit http://www.snohd.org/304/HealthAlerts 
• Put sys...

March 1, 2020 COVID-19 Updated Guidance for Clinicians

• The February 28 update contained an error of omission in the definition of a person under investigation (PUI) eligible for testing.  The phrase “…requiring hospitalization” was missing from the second row addressing...

February 28, 2020 COVID-19 Updated Guidance for Clinicians

Corrected March 1, 2020

Clinical Guidance & Requested Actions

• Sustained person-to-person transmission of COVID-19 in large numbers has been established in nations near to and far from China, including South Korea (1766), Italy (528), Iran (245), and Jap...

Novel Coronavirus (2019-nCoV) Respiratory Infection Updated Guidance for Health Care Providers 2/6

Health Alert: Novel Coronavirus (2019-nCoV) Respiratory Infection Updated Guidance for Health Care Providers February 6, 2020 

Update: 

• 18 days have passed since 2019-nCoV was confirmed in a Snohomish Country traveler returning from Wuhan,...

Novel Coronavirus (2019-nCoV) Respiratory Infection Updated Guidance for Health Care Providers

Requested Actions 

• Be aware that 
  • 2019-nCoV has been confirmed in a traveler who returned to Snohomish County from Wuhan, China, on January 15; and 
  • approximately 50 contacts from health care and occupational settings are being mon...

Novel Coronavirus (2019-nCoV) Respiratory Infection Wuhan City, China & Snohomish County

Action requested:

• Be aware that 2019-nCoV has been confirmed in a traveler who recently returned to Snohomish County from Wuhan, China.
• Obtain a detailed travel history for patients being evaluated with fever and acute respiratory illness.
• 2019-nCoV should b...

Health Advisory: Hepatitis A Outbreak in Snohomish County

Actions requested:  

• Health care providers, particularly hospital emergency departments and urgent care centers, should offer hepatitis A vaccines to all patients who are homeless, users of injection or non-injection illicit drugs, infected with h...

Influenza Circulating in Snohomish County

Action requested: 

• Be aware that influenza is now circulating in the community (see Figure 1 below). 
• Encourage unvaccinated patients to get vaccinated as soon as possible, particularly those predisposed to severe illness or complications ...

Rabies Post Exposure Prophylaxis Reporting, Assessment & Vaccine Availability

Action requested:   

• Immediately notify the Snohomish Health District Communicable Disease Surveillance and Response Program (SHD CD) at 425.339.5278 to report suspected human rabies exposures due to a bite from or other exposure to an an...

Vaping-Associated Lung Injury: Clinician Guidelines, State Board of Health Emergency Rule

Background: 

The Centers for Disease Control and Prevention, U.S. Food and Drug Administration, state and local health departments, and other clinical and public health partners are investigating a multistate outbreak of vaping-related lung injury...

Outbreak of Severe Lung Disease Associated with E-cigarette Use or Vaping

Health Alert: Outbreak of Severe Lung Disease Associated with E-cigarette Use or Vaping

Three Cases Identified in Washington State

Key Actions Requested: 

• Be aware of reports of severe pulmonary disease associated with vaping from multiple U.S. stat...

Health Advisories: Hepatitis A Case, Vaping-associated Illness, and Upcoming Training

Hepatitis A Case in Snohomish County

Actions requested: 

• Be aware of a confirmed case of hepatitis A in a foodworker at Ashiya Teriyaki located at 1233 164th St SW in Lynnwood. People who ate at this restaurant between August 2 and August 15 may be...

Health Advisory: Hepatitis A Outbreak in Washington State

August 6, 2019 

Situation: 

Washington State Department of Health (DOH) has announced the outbreak of Hepatitis A within Washington State.  Multiple states across the country have reported outbreaks of Hepatitis A, primarily among...

Health Advisory: Measles Outbreak in Clark County, Washington — Jan. 28, 2019

Key Messages:

• According to Washington Department of Health, 34 people in Clark County and 1 adult in King County, and 1 person in Multnomah County, Oregon have been confirmed as measles.
• Report all patients with suspected measles immediately to the Snohomis...

Health Advisory: Measles Outbreak in Clark County, Washington — Jan. 24, 2019

Key Messages:

• According to Washington Department of Health, 23 people in Clark County and 1 adult in King County have been confirmed as measles, with 3 suspect cases also children, and over 1,000 contacts.
• Consider the diagnosis of measles among persons pre...