Center of Excellence in Newcomer Health: January 2024

Center of Excellence in Newcomer Health

Center of Excellence in Newcomer Health 

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January 2024

The Minnesota Center of Excellence in Newcomer Health (MN COE) is dedicated to developing tools to support health care providers, public health professionals, and resettlement partners in their efforts to better serve immigrant and refugee families. We build on existing infrastructure and partners’ extensive experience to identify and monitor newcomer health issues and needs, contribute to evidence-based policies and guidance, and ultimately improve continuity of care and health outcomes for newcomers.


Pop quiz

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1. Which state welcomed the most refugees in fiscal year 2023?

A. Pennsylvania
B. California
C. New York
D. Texas

For our clinical audience…

An unvaccinated 4-year-old patient is newly arrived from Venezuela. They present with a 101°F fever starting 24 hours ago. Caregiver says the patient has been reluctant to eat and is very sleepy. Upon examination, you notice a rash on their back. Their rash appears to be a mix of red blotchy skin and blisters filled with a milky-colored substance.

2. What disease do you suspect?

A. Varicella (chickenpox)
B. Measles
C. Allergic reaction to new soap
D. Rotavirus

Answers at the bottom of this newsletter


Register for new COE webinar

EPIC, CareRef, & More: Optimizing Clinical Decision Support Tools

Thursday, Feb. 8, 2024
1–2 p.m. ET | noon–1 p.m. CT | 11 a.m.–noon MT | 10–11 a.m. PT

Teams webinar registration
EPIC, CareRef, and More: Optimizing Clinical Decision Support Tools

Learning objectives

  • Identify existing electronic clinical decision tools and available learning opportunities for newcomer health.
  • Employ clinical decision tools to perform appropriate screening and management actions for newly arrived newcomer patients.
  • Utilize newcomer health clinical decision tools to identify patients in need of outreach for completion of newcomer screening and management.
  • Understand how existing newcomer clinical decision support tools can be adapted to support broader populations.

Presenters

Jeremy Michel, MD

Jeremy Michel, MD
Clinical Informaticist and Attending Physician
Children’s Hospital of Philadelphia

Kailey Urban, MPH

Kailey Urban, MPH
Epidemiologist
Refugee Health Program
Minnesota Department of Health


Moderator

Sarah Kuech, MSc RN MCHES

Sarah Kuech, MSc RN MCHES
Refugee Health Planner
Center of Excellence in Newcomer Health
Minnesota Department of Health

 

Continuing education
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Minnesota Medical Association and Minnesota Department of Health. The Minnesota Medical Association (MMA) is accredited by the ACCME to provide continuing medical education for physicians.

The Minnesota Medical Association designates this live internet activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Other participants will receive a proof of attendance document from MDH following completion of a post-webinar evaluation and are responsible for determining if this training meets CE criteria for their professional organization.

Please forward this message to your colleagues who may be interested in attending.
Print or download a one-page promotional flyer:
EPIC, CareRef, and More: Optimizing Clinical Decision Support Tools (PDF)

Missed a webinar? Don’t sweat it!

The following recordings have recently been approved for accessibility and are posted on our website.

Center of Excellence in Newcomer Health: 2023 webinars

  • Strategies for Responding to the Psychosocial Needs of Afghan Communities
  • What Resettlement Partners Should Know About Public Health Reportable Conditions
  • Community-Based Approaches to Vaccine Confidence

The "Guidelines on Maternal Lead Screening for Immigrants and Refugees" recording will be posted as soon as it's available.


2024 ECHO Colorado Newcomer Health

In partnership with ECHO Colorado, the Minnesota Center of Excellence in Newcomer Health has been hosting a monthly training on newcomer health since Oct. 25, 2022; the trainings will continue until Dec. 3, 2024.

Register for the 2024 series on the ECHO Colorado Website! Please note that ECHO has a new website, so you may need to clear your internet history/cache before registering.

We heard your feedback and have changed the time of the series to make it easier to attend for folks on the west coast!

Sign up for the ongoing monthly ECHO sessions held virtually:

ECHO Colorado: Newcomer Health
Last Tuesday of each month
11 a.m. ET | 10 a.m. CT | 9 a.m. MT | 8 a.m. PT

Refer to Connect Troubleshooting Tips (PDF) if you have issues registering, joining, etc.

Promotional flyer: ECHO Colorado: Newcomer Health (PDF)

Access resources and previous sessions: Newcomer Health ECHO Resource Page

2024 ECHO Colorado Newcomer Health Series

MN COE guidance updates

We have been busy updating some guidance to include the recent Dear Colleague Letter 24-01 regarding changes to eligibility for benefits and services recently issued by the Office of Refugee Resettlement. Check out these changes on our Afghan Clinical Guidance and Ukrainian Clinical Guidance!

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CDC guidance updates and resources

Applesauce containing high levels of lead

CDC issued a Health Alert Network (HAN) update on Nov. 13, 2023, regarding recent reports of high blood lead levels in children consuming recalled cinnamon-containing applesauce products that have high levels of lead. State partners tested multiple lots of the reported products, and test results indicated the products contained extremely high levels of lead. WanaBana, Schnucks, and Weis have initiated voluntary recalls of certain lots of the following products:

  • WanaBana brand apple cinnamon fruit purée pouches
  • Schnucks brand cinnamon applesauce pouches
  • Weis brand cinnamon applesauce pouches

Additional information including clinical and public health guidance can be found at CDC: Lead and Chromium Poisoning Outbreak Linked to Cinnamon Applesauce Pouches.

Polio vaccine

CDC has received a number of inquiries regarding the recently published Morbidity and Mortality Weekly Report (MMWR), Use of Inactivated Polio Vaccine Among U.S. Adults: Updated Recommendations of the Advisory Committee on Immunization Practices — United States, 2023. This publication summarizes evidence considered by the advisory committee on immunization practices (ACIP) to recommend that all U.S. adults 18 years and older who are known or suspected to be unvaccinated or incompletely vaccinated against polio complete a primary polio vaccination series with inactivated polio vaccine (IPV), and adults who have received a primary series of trivalent oral polio vaccine (tOPV) or IPV in any combination and who are at increased risk for exposure to poliovirus may receive another dose of IPV.

To that end, they would like to clarify that CDC’s Guidance for Evaluating and Updating Immunizations during the Domestic Medical Examination for Newly Arrived Refugees has not changed. Per the guidance, vaccinations, including polio vaccinations, should be given in accordance with ACIP recommendations.

Additionally, CDC’s Overseas Refugee Health Guidance remains unchanged. Per that guidance, polio vaccines are routinely given to U.S.-bound refugees and Visa 93 (V93) applicants 6 weeks of age to under 18 years old; while those 18 years and older are vaccinated only in countries where the WHO has determined the risk of international spread of poliovirus to be a public health emergency of international concern (PHEIC). Additional information can be found in CDC's Addendum to Technical Instructions for Vaccinations: Polio.

Tuberculosis

The 2024 Tuberculosis Technical Instructions for Panel Physicians (TB TIs) have been posted on the CDC website and are effective as of Jan. 24, 2024, with major changes to testing to be implemented no later than Oct. 1, 2024.

Major revisions in the 2024 TB TIs that go into effect on Oct. 1, 2024, include:

  • Panel physicians must perform an interferon-gamma release assay (IGRA) on all applicants 2 years of age and older in countries with a World Health Organization (WHO)-estimated tuberculosis incidence rate of ≥20 cases per 100,000 population, to begin no later than Oct. 1, 2024. Children in these countries have been required to receive IGRA testing since 2018. Note that applicants 15 years and older in these countries will continue to receive a chest x-ray regardless of IGRA results. Panel physicians will now be allowed to use WHO-approved IGRA tests in addition to U.S. Food and Drug Administration (FDA)-approved tests to improve availability and potentially lower costs.
  • Panel physicians must perform a molecular test in addition to sputum smears and culture. The molecular test must be a nucleic acid amplification test (NAAT) and must be performed on the first respiratory specimen from all applicants requiring sputum collection for initial diagnosis. Panel physicians must begin using a molecular test no later than Oct. 1, 2024.
  • Please refer to TB TIs for other minor revisions.

Updates to the Tuberculosis Technical Instructions for Civil Surgeons for examination of applicants within the United States will be posted in the coming weeks, and additional information will be provided at that time. If you have any questions regarding the 2024 TB TIs for panel physicians, you may contact the CDC Quality Assessment Program (QAP) at cdcqap@cdc.gov.


NARHC 2024

The 2024 North American Refugee Health Conference (NARHC) will be held in Minneapolis, Minnesota, Aug. 5-7, 2024!

Their call for abstracts is open. Read the abstract guidelines and make sure to submit by April 1, 2024.

Register now at Society of Refugee Healthcare Providers: NARHC Conference!

2024 North American Refugee Health Conference: Submit your abstract today!

Take a listen: Healthcare for Humans podcast

The Healthcare for Humans podcast is a show dedicated to educating you on how to care for culturally diverse communities so we can be better healers. Examples of past episode topics include Advancing Healthcare Equity, Mental Health in Immigrant Communities, and Filipinos – Cuisine & Culture.

Listen to the podcast: Healthcare for Humans

Colorado COE in Newcomer Health

Center of Excellence in Newcomer Health Colorado

Did you know that we are one of two centers established by support from the Centers for Disease Control and Prevention? Visit our partner site: Colorado COE in Newcomer Health!

The Colorado team leads data/epidemiology and public health navigation initiatives through partnerships with states and sites across the country. Their primary goal is to maintain a data repository to identify and respond to the changing landscape of newcomer health, with a focus on domestic medical exams and long-term health follow-up data.

Additionally, they support public health teams in ensuring that all populations are included in public health responses, regardless of culture or language. They develop best practices, toolkit resources, and capacity-building trainings for navigators and public health teams.

Colorado Newsletter Distribution List (or scan the QR code!)
Sign up for bimonthly updates for sharing data-related outputs, resources, and invitations to join projects with us. 

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Contact

You are receiving this email because you are subscribed to MDH's COE or CareRef updates, Refugee Health Quarterly, or you have attended a past training. Please subscribe now if you are not already subscribed to Center of Excellence in Newcomer Health Updates and wish to receive future editions.

For more information or questions, please contact the Minnesota Department of Health Refugee Health Program at refugeehealth@state.mn.us or 651-201-5414.

The Center of Excellence in Newcomer Health is supported by NU50CK000563 (MN) from the U.S. Centers for Disease Control and Prevention.