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Health Alerts

The Snohomish Health District Health Officer Dr. Gary Goldbaum sends alerts via email to local health care providers. Alerts cover current local, regional or national health threats and important updates on medical care and protocols. Alerts are written as needed to cover urgent or emergent health issues.

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Listeria and Dengue & Chikungunya

Action requested: Be aware that specific lots of some fruits have been recalled due to potential Listeria contamination.

Background

Wawona Packing Company of Cutler, California, is voluntarily recalling certain lots of whole peaches (white and yellow), nectarines (white and yellow), plums, and pluots packed between June 1, 2014 through July 12,2014 due to the potential of the products being contaminated with Listeria monocytogenes.  Although no illnesses have been linked to this recall to date, persons at elevated risk for invasive listeriosis may seek medical care because of concern that they have been exposed to listeria.

Recommendations

  • Advise anyone who has the recalled products in their possession to discard them.  Information for consumers is available at http://www.fda.gov/Safety/Recalls/ucm405943.htm
  • Be familiar with guidance for assessment and medical management of symptomatic and asymptomatic pregnant women and other persons at elevated risk for invasive listeriosis and who have been exposed to Listeria monocytogenes.  In general, asymptomatic patients and patients with mild symptoms can be observed.  High risk patients with symptoms consistent with invasive disease should be cultured and treated with antibiotics pending test results.

For more information about listeria, see http://www.cdc.gov/listeria/.

 

DENGUE & CHIKUNGUNYA

Action requested: Be aware that increasing numbers of cases of dengue and chikungunya have been reported in the U.S.

Background

The mosquito-borne dengue and chikungunya infections are increasingly reported in the U.S., usually following international travel.  These arborviruses can cause acute fevers, rashes, hemorrhage, polyarthritis and acute central nervous system illness.  Locally acquired chikungunya infection has now been reported in Florida.  Recognized in the Caribbean in late 2013, chikungunya had been limited to Africa, Asia, and a few countries in Europe.  The vector mosquitoes, Aedes aegypti and Aedes albopictus, are the same for chikungunya and dengue, so both infections should be considered if either is suspected.

Recommendations

  • Always inquire about international travel when evaluating febrile illness.
  • Consider both dengue and chikungunya infections when either is possible.  Testing may include reverse transcriptase polymerase chain reaction (RT-PCR), ELISA or IFA for IgM or IgG antibodies, or viral culture.  Contact the Health District at 425-339-5210 for guidance.
  • Chikungunya management is supportive; fevers should be treated with acetaminophen until dengue can be ruled out since aspirin and other NSAIDs can increase the risk of hemorrhage in dengue patients. For dengue clinical management guidelines, see http://whqlibdoc.who.int/publications/2009/9789241547871_eng.pdf.
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Communicable Disease

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Health alerts include information about diseases or other health risks or issues that affect Snohomish County.