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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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Influenza vaccine, Fatal gastrointestinal mucormycosis

Today’s topics:

  • Influenza vaccine
  • Fatal gastrointestinal mucormycosis

Influenza Vaccine

Action requested: Be aware that live attenuated influenza vaccine (LAIV) remains a recommended option for vaccination, despite recent evidence that it is not effective against 2009 H1N1.

Background & Recommendations

Influenza has been confirmed in Washington, but is not yet circulating widely.  Now is an opportune time for everyone to get vaccinated.  There are multiple vaccine formulations available.  The Centers for Disease Control & Prevention (CDC) considers all as appropriate and recommends that vaccination should not be delayed to procure a specific vaccine formulation.

Based on data showing that LAIV offered superior protection against influenza virus infection compared to inactivated influenza vaccine in young children, last year CDC recommended LAIV for young children.  However, recent data suggest that LAIV may not be effective against 2009 H1N1, but is effective against the other viruses circulating this season.  Given that very little 2009 H1N1 is circulating this year (none has been identified in Washington), CDC continues to recommend LAIV for children 2 through 8 years of age when LAIV is immediately available and when there are no contraindications against getting that vaccine.

For more information, see http://www.doh.wa.gov/ForPublicHealthandHealthcareProviders/PublicHealthSystemResourcesandServices/Immunization/InfluenzaFluInformation#recommendation.

 

Fatal Gastrointestinal Mucormycosis

Action requested: Be aware of fatal gastrointestinal mucormycosis in an infant following ingestion of contaminated dietary supplement, ABC Dophilus® Powder, and report suspected cases.

Background: The Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), and Connecticut Departments of Public Health and Consumer Protection are investigating a fatal case of gastrointestinal (GI) mucormycosis caused by Rhizopus oryzae in a premature infant. The infant received ABC Dophilus® Powder, a dietary supplement product containing viable microbial ingredients purchased from Solgar, Inc., Leonia, New Jersey. The product claimed to have “probiotic” properties and is marketed for infants and children. Subsequent testing of the same lot of unopened Solgar ABC Dophilus® Powder revealed contamination with Rhizopus oryzae.  On November 14, 2014, Solgar Inc. issued a voluntary recall (http://www.fda.gov/Safety/Recalls/ucm423219.htm) of ABC Dophilus® Powder lots 074024-01R1, 074024-01, and 074024-02 (all with expiration dates of 7/31/15).

Recommendations:

  • Consider mucormycosis & ask about use of supplements when evaluating infants for necrotizing enterocolitis or infants who have signs or symptoms of gastrointestinal mucormycosis such as abdominal pain, abdominal distension, nausea, or vomiting.
  • Report to the Health District (425-339-5278) any confirmed or suspected cases of infants with gastrointestinal mucormycosis (diagnosed via culture or histopathology) or unexplained infant deaths within 30 days after ingesting Solgar ABC Dophilus® Powder.

For more information, see http://www.cdc.gov/fungal/rhizopus-investigation.html.

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