Because of recent outbreaks of Serogroup B Meningococcal Disease at Princeton Unversity and University of California, Santa Barbara, students from these universities may return to San Francisco for the holidays and present themselves to local medical providers for care.
The following may be helpful in making the diagnosis:
While any individual finding does not necessarily indicate IMD, the constellation of findings warrants closer scrutiny and consideration of antibiotic therapy. Antibiotic treatment should not be delayed to obtain diagnostic specimens.
Based on the California Department of Public Health (CDPH) surveillance data as of 11/1/2013, statewide and nationwide influenza activity continues to be sporadic. It is not yet known which influenza strains will predominate during the 2013-2014 influenza season.
2013-14 U.S. trivalent influenza vaccines contain an A/California/7/2009 (H1N1) -like virus, an A/Victoria/361/2011 (H3N2) -like virus, and a B/Massachusetts/2/2012-like virus. Quadrivalent vaccines are newly available this year, and also include a B/Brisbane/60/2008-like virus. Two other new formulations include Flucelvax, grown in canine kidney cells rather than eggs, and FluBlok, a trivalent recombinant vaccine. Intranasal, high-dose, and intradermal formulations continue to be available. A complete listing of 2013-14 flu vaccine products is posted at http://sfcdcp.org/fluvaccine.html.
If your facility does not offer flu vaccine, patients can be referred to the AITC Immunization and Travel Clinic (TravelClinicSF.org) at SFDPH.
Note for Health Care Workers: By order of the San Francisco Health Officer dated 10/4/13, all hospitals, skilled nursing, and other long term care facilities in the City and County of San Francisco must require their health care workers to receive an annual flu vaccination or, if they decline, to wear a mask in patient care areas during the influenza season. In addition, CA law (Health & Safety Code §1288.7 / Cal OSHA §5199) mandates either flu vaccination or the signing of a declination form for all acute-care hospital workers and most health care personnel including clinic and office- based staff.
For updates, forms and FAQs about influenza, visit http://sfcdcp.org/flu.html.
September 20, 2013
TWO CASES OF MENINGOCOCCAL DISEASE IN SRO RESIDENTS IN THE TENDERLOIN
Two cases of invasive meningococcal disease (IMD) have been diagnosed in females staying in single room occupancy hotels (SROs) in the Tenderloin neighborhood of San Francisco, with onset of symptoms on 9/14/13 and 9/16/13. So far these cases have not been directly linked to one another. However, there may be additional cases of meningococcal disease occurring in this population. Because this infection is associated with altered mental status that can initially appear to be due to drug use or other causes, we request that clinicians be alert for additional cases.
Eight cases of presumptive Escherichia coli O157 have been reported to the San Francisco Department of Public Health (SFDPH) during the past week. All of the reported cases have presented with bloody diarrhea, and one has progressed to hemolytic-uremic syndrome (HUS).
SFDPH is working with the California Department of Public Health (CDPH) and the California Emerging Infections Program (CEIP) to monitor the spread of disease, confirm the E. coli strain(s) involved, gather information from clinicians and interviews with patients, and determine whether the cases may be linked or share a common source. To date the cases have not been linked to each other or to a common source.
In order to identify any additional cases of E. coli O157 in San Francisco residents, SFDPH is conducting surveillance for illnesses that may be related to the outbreak.
San Francisco Physicians are asked to:
June 5, 2013
In 2012 a novel coronavirus was identified, later named Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in an individual who died with an acute respiratory distress syndrome in Saudi Arabia. As of June 5, 2013, case clusters have been reported in Saudi Arabia (40), the United Kingdom (3), France (2), Italy (3), Jordan (2), Qatar (2), the United Arab Emirates (1) and Tunisia (2), for a total of 55 individuals, 30 of whom have died. No patients with MERS-CoV have been identified in the U.S. The U.S. Centers for Disease Control & Prevention (CDC) has posted case counts, clinical and laboratory guidance, questions and answers, and additional information at cdc.gov/coronavirus/mers/index.html.
Many infections have been health care-associated—almost half of the recognized cases are part of one health care cluster in Saudi Arabia. One person in France became infected after sharing a hospital room with another infected person. There is clear evidence of person-to-person transmission, though the efficiency of transmission and the modes and routes of transmission are still under investigation.
No travel warnings or restrictions are in effect for the Arabian Peninsula or neighboring countries.
For more information about health alerts, advisories, and updates from the San Francisco Department of Public Health, please visit http://www.sfcdcp.org/healthalerts.html.