ACDC Highlights for Infection Preventionists July 14, 2014 NHSN Monthly Conference Call (1:00-2:00 pm) Aug 13, Sept 10, Oct 8, Nov 12, Dec 10, 2014. Toll free number: 1-866-917-0441 Passcode: 1570139. If you would like to be added to the email distribution list, please email Vicki Keller with your request at [email protected] Chikungunya Alert Chikungunya virus infection, transmitted via the Aedes aegypti and Ae. albopictus mosquitoes has been deemed probable in two Los Angeles County (LAC) residents returning from travel in the Caribbean islands. To date, 10 probable/confirmed cases have been reported in California. Chikungunya infection should be considered in the differential diagnosis in patients with acute onset of fever and polyarthralgia, who have recently returned from the Caribbean and other areas with known virus transmission. Given the concern for potential local transmission of chikungunya and dengue in or near areas where Ae. egypti and Ae. albopictus mosquitos have been found, suspect cases of chikungunya and dengue should be reported promptly to LAC DPH as an “unusual disease” at this time. Long Beach and Pasadena residents should be reported to their respective health departments (Long Beach Health Department: (562) 570-4302, Pasadena Health Department (626) 744-6000). The CDC reports that chikungunya will become a nationally reportable disease by January 2015. Pertussis Epidemic Update and Infant Death From January 1 to July 8, 2014, a total of 5,393 cases of pertussis (950 cases in LAC) were reported to CDPH, for a statewide incidence of 14.1 cases per 100,000 population. Of these cases in California, 90% occurred in patients 18 years or younger, and out of 156 hospitalizations, 62% were in infants 4 months or younger. In 2014, 3 infants have died of pertussis although 2 of those will be attributed to last year’s count because they initially became ill last year. Young infants remain vulnerable to severe disease and the most important prevention strategies remain vaccination for this age group, as well as for pregnant women, optimally in the third trimester of each pregnancy. Providers are reminded to notify the LAC Immunization Program if a pertussis case is suspected. For additional information on the CA pertussis epidemic, please visit: http:// www.cdph.ca.gov/programs/immunize/Documents/Pertussis_Report_7-8-2014.pdf West Nile Virus (WNV) Update As of July 11, 2014, 9 human cases of WNV illness have been reported in several Northern California health jurisdictions. The median age is 65 years, 6 of the cases are male, and 89% had neuro-invasive illness. No fatalities have been reported to date in 2014. Nationally, there have been 18 human cases of WNV illness reported from 7 states, with one fatality. LAC WNV surveillance to date includes 5 positive dead birds, 12 positive mosquito pools, and I positive sentinel chicken, with no reports of human cases of WNV illness. ACDC recommends that physicians and medical providers order WNV screening tests for all patients with aseptic meningitis, encephalitis, or acute flaccid paralysis and are asked to order WNV screening tests for those who are experiencing a nonspecific illness compatible with WNV fever during the WNV season (late spring through November) in California. A standard Confidential Morbidity Report (CMR) can be used to file a report: http://publichealth.lacounty.gov/acd/reports/cmr-h-794.pdf . Cases can also be reported via webCMR, as well as by phone during business hours at (888) 397-3993. MERS Guidance ACDC has recently distributed an updated version of the MERS alert flyer to infection preventionists. The main case definition has not changed; however, the testing guidelines have expanded to include those who have been inside (patient, worker, visitor) a healthcare facility where recent healthcare-associated spread of MERS has been identified. Infection control recommendations remain the same.