Michigan Dept of Health & Human Services sent this bulletin at 02/23/2024 02:00 PM EST
The Michigan Update
Vaccinations for First Responders
Author: Jennifer Crooker, BSPH, CHES®, MDHHS Division of Immunization
First responders are the first line of protection for the community and therefore also at a higher risk for disease. To best protect themselves and their communities, first responders should ensure they are up to date on all their vaccines.
Infectious disease places EMS workers, law enforcement, fire fighters, and first responders at risk of becoming ill along with their families and community members. An outbreak of infectious disease among first responders can also hamper response efforts by increasing absenteeism and compounding staffing shortages. Vaccination is an important way to mitigate these risks.
Two vaccines are currently recommended for disaster responders by the Centers for Disease Control and Prevention (CDC): Tetanus is recommended for all first responders and hepatitis B is recommended for those who may come into contact with bodily fluids (CDC, 2019).
Tetanus (also called lockjaw) is caused by bacteria called Clostridium tetani which is found in the environment including soil, manure, and other surfaces and can be introduced into the body through wounds that break the skin. Tetanus can cause seizures, muscle spasms, and death. Tetanus vaccination is part of the routine childhood immunization schedule and is recommended for adults as well. For adults, CDC recommends that persons aged ≥19 years who have never received a dose of Tdap should receive one dose of Tdap, regardless of the interval since their last tetanus or diphtheria toxoid–containing vaccine. To ensure continued protection, booster doses of either Td or Tdap should be administered every 10 years throughout life (CDC, 2023b).
Hepatitis B is a liver infection caused by the hepatitis B virus that can result in long-term chronic disease including life-threatening complications. It is spread through bodily fluids and is a particular risk for EMS workers who are at high risk of needle sticks (Bitely, Glauser, & Miller, 2019). The Occupational Safety and Health Administration (OSHA) “requires employers to offer the (hepatitis B) vaccination series to all workers who have occupational exposure” at no cost (OSHA, 2011). CDC now recommends hepatitis B (HepB) vaccination among all adults aged 19–59 years and adults > 60 years with risk factors for hepatitis B or without identified risk factors but seeking protection.
Healthcare workers are also strongly advised by CDC’s Advisory Committee on Immunization Practices (ACIP) to stay up to date on these vaccines: hepatitis B, influenza, tetanus/ diphtheria/pertussis (Tdap) or tetanus/diphtheria (Td), measles/mumps/rubella (MMR), varicella (chickenpox), and COVID-19 (CDC, 2011, 2023a).
Seasonal upper respiratory illnesses including influenza, respiratory syncytial virus (RSV), and COVID-19 are also risks for first responders as they work in their communities. As one EMS provider writes in EMS1 Magazine, “It’s easy to groan when the pager squawks out yet another ‘sick person, possible flu’ call, but these folks can be really ill, and they need our help. But they can also easily spread that illness to us and our families” (Fraley, 2019).
COVID-19 has hit first responders particularly hard. Data from 2020 indicate that workers in “protective service” occupations- police, firefighters, fire inspectors, correctional officers, private detectives, security guards, and probation officers- had the highest death rate from COVID-19 that year of all occupational groups (60.3 per 100,000), more than double the overall rate for all workers (28.6 per 100,000) and almost double that of healthcare workers (31.2 per 200,000) (Kekatos, 2022).
According to the Officer Down Memorial Page, 62% of officer deaths in 2020 (284 officers) and over 70% (501 officers) in 2021 were due to COVID-19 (Officer Down Memorial Page, 2024).
According to the U.S. Fire Administration, in 2021 of the 141 firefighters that died while on duty, 63 died from COVID-19 (U.S. Fire Administration, 2021).
For best protection, first responders should ensure they are up to date on flu, COVID-19, and RSV vaccines, especially as respiratory viruses are still circling. Routine annual influenza vaccination is recommended for all persons aged ≥6 months who do not have contraindications. Further, CDC recommends the 2023–2024 updated COVID-19 vaccines to protect against serious illness from COVID-19.
Advisory Committee on Immunization Practices, & Centers for Disease Control and Prevention (CDC). (2011). Immunization of health-care personnel: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. Recommendations and Reports / January 12, 2018 / 67(1);1–31
Dengue activity in the Americas already outpacing last year's surge
Lisa Schnirring, Center for Infectious Disease Research and Policy (CIDRAP) University of Minnesota, Fe
After record dengue activity in 2023 in the Americas, the brisk pace of new infections showed no let-up in the first 5 weeks of the new year, with 11 countries reporting rising cases and Brazil among the hardest-hit nations.
In its latest epidemiologic alert, the Pan American Health Organization (PAHO) said cases have increased 157% compared to the same period in 2023 and are 225% above the 5-year average.
Rising cases in 11 countries
After reporting record cases that topped 4.5 million last year, countries in the Americas have already recorded more than 673,000 dengue infections in the first 5 weeks of 2024, including 700 severe cases and 102 deaths. Countries reporting increases this year are Argentina, Brazil, Colombia, Costa Rica, Guatemala, Guadeloupe, French Guiana, Martinique, Mexico, Paraguay, and Peru.
Two thirds of this year's cases are from Brazil, where more than 455,000 dengue infections have been reported.
All four serotypes are circulating in the Americas region this year, with proportions that vary by country. However, Brazil, Costa Rica, Honduras, and Mexico are seeing circulating of all four serotypes.
Brazil doubles dengue test order
In January, Brazil's health ministry announced the details of a plan to launch dengue vaccination through its public health system, the first country in the world to do so. The country is using the Qdenga vaccine, which is made by Takeda. The campaign will target 3.2 million people with two doses of the vaccine.
In related news, the Fiocruz Institute today announced that it has doubled the production of dengue tests, based on a request from Brazil's health ministry. Along with 300,000 tests slated for delivery throughout the year, Fiocruz will deliver another 300,000 in the first few months of 2024.
The tests can confirm all four dengue serotypes, as well as chikungunya and Zika viruses.
Hots spots in Mexico, some Caribbean islands
Other hot spots in the region include Mexico, where cases are running 368% higher than the same period last year. Most of the country's cases are in three states: Quintana Roo, Tabasco, and Guerrero, all in the south.
In the Caribbean subregion, cases are up 741% from a year ago, mainly in non-Latin areas.
Alongside Brazil, other Southern Cone countries reporting dengue surges include Paraguay, especially in Central, Asunción, and Itapúa departments in the south.
In its latest alert, PAHO urged countries to intensify efforts to control Aedes aegypti mosquitoes, boost surveillance, and ensure prompt diagnosis and treatment.
Global health concern on the rising dengue and chikungunya cases in the American regions: Countermeasures and preparedness
Abstract
Severe morbidity and mortality due to seasonal infectious diseases are common global public health issues. Vector‐borne viral illnesses like dengue and chikungunya overload the healthcare systems leading to critical financial burden to manage them. There is no effective drug or vaccine currently available to control these two diseases.
The Centers of Excellence in Public Health and Homelessness Toolkit for State and Local Health Departments is designed to assist health departments and other public health organizations in their efforts to support public health for people experiencing homelessness (PEH) in their jurisdictions. This toolkit, created in partnership between the CDC and the CDC Foundation, provides tools, templates, program blueprints and strategies to assist health departments in understanding, planning and implementing program activities and objectives.
A Racial Equity Impact Assessment (REIA) is a vital tool for analyzing how different racial and ethnic groups will likely be affected by a proposed action or decision. Use of an REIA, such as this one, minimizes unanticipated adverse consequences in a variety of contexts, including the analysis of proposed policies, institutional practices, programs, plans and budgetary decisions. It also provides the opportunity to prevent institutional racism and identify new options to remedy long-standing inequities.
February Strategic National Stockpile (SNS) Office Hours
Register today for the next monthly SNS Office Hours, scheduled for February 28 from 4-5 p.m. ET. This one-hour session features SNS health scientists who will provide the most recent SNS science updates and answer questions on SNS formulary topics. For more information or for questions, please contact the SNS Office of State, Local, Tribal, Territorial (SLTT) Preparedness email address: sns-sltt@hhs.gov.
NACCHO's 2024 summit will be held March 25-28, in Cleveland, Ohio. This year’s theme, “Public Health, Healthcare, and Emergency Management: Aligning to Address Cascading Challenges,” will provide an opportunity for sectors to come together, align missions, and discover better ways to work as true partners to meet the challenges of today and tomorrow. Join this national conference on public health preparedness to share resources and strategies with colleagues across sectors.
The Great Plains ADA Center and the ADA National Network are excited to launch the 2024 National ADA Symposium in a virtual format. This three-day training event offers 36 sessions covering all areas of the Americans with Disabilities Act presented by nationally recognized experts in issues related to the ADA.
All sessions will have live captions and ASL interpreters.
The Guardian of Public Health is a monthly newsletter from the Bureau of Emergency Preparedness, EMS and Systems of Care (BEPESoC), within the Michigan Department of Health and Human Services (MDHHS). The Guardian aims to provide readers with relevant content on topics that affect the public health of Michigan's citizens and communities.
This publication was supported by Cooperative Agreement number 1NU90TP922062-01-00, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.
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