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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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Mumps testing recommendations; Tuberculosis testing guidelines

Today’s topics:

  • Mumps testing recommendations
  • Tuberculosis testing guidelines

 

Mumps testing recommendations

Action requested:  Consider carefully before testing for mumps.

Background & Recommendations

Although the number of mumps cases is at a ten-year high nationally and clusters have been reported in several Washington counties, we have not had any cases in Snohomish County.  Clinicians are clearly aware and are considering mumps in the differential when patients present with lymphadenopathy.  Consequently, Health District staff are responding to a high volume of calls about mumps and mumps testing, with more than 40 calls from clinicians in the last week, often inquiring about patients presenting sore throats with lymphadenopathy.  Although many cases of mumps may be subclinical or with limited symptoms, mumps remains uncommon, even in the current situation.  Because most sore throats with lymphadenopathy are not caused by mumps, we offer the following recommendations to help clinicians determine when to test for mumps. 

  • Before testing for mumps, please confirm that your patient has parotitis (not simply lymphadenitis).
  • If you suspect mumps and want guidance or want to test through public health, please call the Communicable Disease Surveillance and Response program at 425-339-5278 (after hours hit 1 to be connected to our answering service).  Please call while the patient is at your facility.
  • For detailed information about mumps, including specific testing guidance, please refer to the Washington State Department of Health mumps protocol at  http://www.doh.wa.gov/Portals/1/Documents/5100/420-065-Guideline-Mumps.pdf

 

Tuberculosis testing guidelines

Action requested:  Be aware of updated guidelines for testing persons at risk for tuberculosis.

Background & Recommendations

A task force supported by the supported by the American Thoracic Society, Centers for Disease Control & Prevention (CDC), and the Infectious Diseases Society of America (IDSA) has issued updated evidence-based guidelines for testing persons for tuberculosis infection.  Prominent is a general preference for use of the interferon-γ release assay (IGRA) rather than tuberculin skin testing, except among children <5 years old.  Access the guidelines at 2016 Clinical Practice Guidelines for Diagnosis of Tuberculosis in Adults and Children.

Clinicians should consider testing patients who have a higher-risk for TB infection, including patients who were born in or who frequently travel to countries where TB disease is common; patients who live or have lived in large group settings, such as homeless shelters or prisons and jails; or those with other risk factors, as described in the guidelines. Note that in all cases the diagnosis of active tuberculosis must be excluded prior to embarking on treatment for latent tuberculosis infection. 

 

Gary Goldbaum, MD, MPH | Health Officer & Director | Administration

3020 Rucker Avenue, Ste 306 | Everett, WA 98201 | 425.339.5210 | ggoldbaum@snohd.org

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