The Bureau for Public Health, in collaboration with local and federal partners, is responding to an increase in newly diagnosed cases of HIV among persons who inject drugs (PWID) in West Virginia. Public health partnerships, expanded HIV testing, early diagnosis and linkage to care, harm reduction services, and initiation of or referral to substance use disorder recovery as applicable are all critical to preventing and addressing HIV in the community. Thanks to new and better treatments, people with HIV who remain in care are now living longer – and with a better quality of life – than ever before.
HEALTH ADVISORY #157 Measles
The Centers for Disease Control and Prevention (CDC) has identified an increased number of measles cases and outbreaks in the United States since January 1, 2019. The last case of measles reported in West Virginia was in 2009 following international travel. Clinicians are encouraged to continue vigilance for cases of measles among all age groups and to report suspected cases of measles immediately to their local health department (LHD) as per the West Virginia Reportable Disease Rule (64 CSR 7). Additionally, clinicians should take this opportunity to ensure patients are up-to-date on measles vaccination (MMR). MMR information can be found at https://www.cdc.gov/vaccines/vpd/measles/index.html.
Health Advisory
NEW recommendations for ALL health providers on HIV screening, testing, and follow-up care.
HEALTH ALERT #156 Acute Flaccid Myelitis
West Virginia has confirmed a case of Acute Flaccid Myelitis (AFM). AFM is a rare but serious condition that affects the nervous system, causing muscles and reflexes in the body to become weak. The last confirmed case of AFM in West Virginia was in 2016. The Centers for Disease Control and Prevention (CDC) recognized AFM in 2014 as a syndrome following increased reports of acute limb weakness and began surveillance for this condition. Clinicians are encouraged to continue vigilance for cases of AFM among all age groups and to immediately report suspected cases of AFM to their local health department (LHD) as per the West Virginia Reportable Disease Rule (64 CSR 7).
HEALTH ADVISORY #155 Increase in New HIV infections Among Persons Who Inject Drugs
The West Virginia Bureau for Public Health is investigating an increase in newly diagnosed human immunodeficiency virus (HIV) cases in the state among persons who inject drugs (PWID). Historically, male-to-male sexual contact has been the predominant reported risk factor for becoming infected with HIV. Since 2018, we have seen an increase in the number of newly diagnosed cases of HIV with injection drug use (IDU) reported as a risk factor statewide.
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Update—Outbreak of Life-threatening Coagulopathy Associated with Synthetic Cannabinoids Use
The Centers for Disease Control and Prevention (CDC) is providing information on: 1) the current status of a multistate outbreak of coagulopathy from exposure to synthetic cannabinoid products containing a vitamin K-epoxide cycle antagonist, brodifacoum; 2) the emergence of 2 new clinical scenarios; and 3) recommendations to help clinicians make decisions related to these 2 new clinical scenarios.
This is an update to the Health Alert Network (HAN) advisory released on May 25, 2018 titled Outbreak of Life-threatening Coagulopathy Associated with Synthetic Cannabinoids Use (https://emergency.cdc.gov/han/han00410.asp).
HEALTH ADVISORY #153 Update on Supply of Hepatitis A Vaccine, Prioritization for State- Supplied Vaccine, and Clinical Considerations
The supply of adult hepatitis A vaccine continues to be constrained nationally due to the hepatitis A outbreak among adults in several states resulting in substantially increased demand for adult hepatitis A vaccine. There are, however, adequate supplies of the pediatric formulation of hepatitis A vaccine, so routine vaccination of all children is strongly encouraged to prevent transmission of hepatitis A virus (HAV) to children.
HEALTH ADVISORY #152 Cluster of Legionnaire’s Disease in Northern Panhandle
Since late September 2018, six (6) cases of confirmed Legionella pneumonia (also known as Legionnaire’s Disease) have been reported among persons that work at a facility in the Northern Panhandle. These cases are tightly clustered in time and there may be potentially associated cases that have not yet been identified. To date, the common occupational exposure remains the only epidemiologic link between cases. Federal, state and local public health officials are closely working to identify potential sources of exposure and to mitigate risk of additional cases.
HEALTH ADVISORY #151 Influenza Season 2018-2019
September 30, 2018 officially began the 2018-2019 influenza season. Since the 2017-2018 influenza season was one of the most severe seen in several years, it is important to be prepared for the upcoming season. The West Virginia Bureau for Public Health would like to remind stakeholders of the mandatory reporting requirements for the 2018-2019 season.
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HEALTH ADVISORY #150 Vigilance for Cases of Acute Flaccid Myelitis
Since acute flaccid myelitis (AFM) was first recognized in the United States in 2014, only two confirmed cases have been reported in West Virginia (both in 2016). Though no cases have been reported since then, healthcare providers are encouraged to continue vigilance for cases of AFM among all age groups and report suspected cases of AFM to their local health department (LHD) as per the WV Reportable Disease Rule (64 CSR 7).
AFM is characterized by a sudden onset of weakness in one or more limbs following a respiratory or febrile illness. Magnetic resonance imaging (MRI) reveals distinct abnormalities of the spinal cord gray matter.
Advice to Clinicians about Leptospirosis in U.S. Travelers Returning from Northern Israel
The Israeli Ministry of Health is reporting an outbreak of leptospirosis in persons with exposure to natural water sources in the Golan Heights region of northern Israel after July 1, 2018. As of September 6, 2018, three persons with leptospirosis who traveled to Israel have been identified in the United States, with additional suspected cases reported and under investigation. Early symptoms of leptospirosis include fever, headache, chills, muscle aches, vomiting, diarrhea, cough, conjunctival suffusion (conjunctival redness without exudates), jaundice, and sometimes a rash. Clinicians should consider leptospirosis as a diagnosis in any patient who develops an acute febrile illness within 4 weeks of travel to one of the areas in northern Israel listed below since July 1, 2018.
KCHD recommends Hep A vaccinations for Lee Street Lounge cookout patrons
Patrons of the Lee Street Lounge, located at 1111 Lee St., E., in Charleston, who ate food and had beverages during a Monday, Aug. 6, cookout at the facility may have been exposed to hepatitis A and should be vaccinated by Aug. 20. Vaccinations received within two weeks of exposure can prevent the liver disease. Those who participated in cookouts held July 23 and July 30 should monitor for symptoms. An individual associated with preparing the food has been diagnosed with Hepatitis A
HEALTH ADVISORY #149 Information for Healthcare Providers and Emergency Departments on the Hepatitis A Outbreak
The West Virginia Bureau for Public Health (BPH) continues to investigate cases of hepatitis A as part of the multi-state outbreak that is occurring nationally. Persons who use injection and non-injection drugs, persons with unstable housing or are homeless, persons with recent history of incarceration, and men who have sex with men (MSM) are at considerable risk for infection. There is continued transmission of hepatitis A in West Virginia due to increasing case counts and the long incubation period of the disease.
Suggestions offered for dealing with mosquito-borne illnesses
As summer takes hold, residents are becoming more concerned about the annual mosquito-borne illness problem. According to Christina Hinkle, RN, Kanawha-Charleston Health Department’s director of clinic services, “West Nile virus is a mosquito-borne illness that causes no symptoms in approximately 80 percent of the people who are infected.”
As many as 20 percent of those infected with West Nile virus will have symptoms including body aches, fever, headaches, nausea, vomiting and sometimes swollen lymph glands or skin rashes on the stomach or back. About 1 in 150 people develop more severe illnesses that may cause neurological impairment.
HEALTH ADVISORY #148 Voluntary NonOpioid Advanced Directive
The purpose of this Health Advisory is to provide guidance regarding the Voluntary NonOpioid Advanced Directive (VNOAD) form as established in Senate Bill 273, the Opioid Reduction Act of 2017 (“Act”), specifically W.Va. Code §16-54-2.