Healthcare Professionals Newsletter

📈 Measles Cases on the Rise

Domestic and global measles cases have increased. Please ensure patients aged 6 months and older are up to date on MMR vaccinations before traveling internationally.

Resources:

✅ The American Academy of Pediatrics has a handout to guide your practice in caring for patients who present with a febrile rash illness. 

✅ The American College of Obstetricians and Gynecologists has a webpage for managing obstetric-gynecologic patients during a measles outbreak. 

📣 Meningococcal Outbreak in Virginia

CDC is reporting an increase in invasive meningococcal disease. The strain responsible for the majority of the cases is the same strain contributing to Virginia’s ongoing outbreak.

Healthcare providers should:  

✅ Maintain increased suspicion for meningococcal disease.

✅ Be aware that patients may not have typical meningitis symptoms. 

✅ Make sure that people recommended for meningococcal vaccination, including people with HIV, are up to date with MenACWY vaccine.

📣 Congenital Syphilis Rates Increase

Congenital syphilis (CS) rates have increased significantly in Virginia and nationally. Timely testing and treatment would have prevented nine out of 10 cases of CS in 2022.

CDC has strengthened their recommendations for screening and treating pregnant and reproductive-age patients for syphilis in areas of high syphilis incidence.

VDH recommends: 

✅ In counties with high syphilis rates, offer syphilis testing to all sexually active people ages 15-44. 

✅ Continue to screen all pregnant women for syphilis during the first trimester, early in the third trimester, and again at delivery if living in a county with high syphilis rates or otherwise at higher risk. 

✅ For patients not living in a county with high syphilis rates, continue to assess individual risk factors to determine screening needs.

📣 Highly Pathogenic Avian Influenza A (H5N1) Infection Reported in a Person in the U.S.

On April 5, 2024, CDC sent a health alert regarding a person with exposure to dairy cattle in Texas who tested positive for highly pathogenic avian influenza (HPAI). The patient was treated with antivirals and is recovering.

Risk to the general public remains low, but those with close or prolonged, unprotected exposure to infected birds, livestock or to their contaminated environments are at greater risk.

Clinicians should: 

✅ Consider the possibility of HPAI virus infection in persons showing signs or symptoms of acute respiratory illness or conjunctivitis who have relevant exposure history and take the appropriate steps for infection control, testing and treatment.  

💡 Prepare Now for Increase in Mpox Cases

• Mpox cases in Virginia continue to increase with 17 reported cases in 2024 as of April 9. Getting both JYNNEOS vaccine doses is the best way for people at risk for mpox to protect themselves.  
• Because of the large outbreak in the Democratic Republic of Congo caused by Clade I Monkeypox virus (MPXV), providers are advised to prepare now for the potential introduction of Clade I MPXV into the U.S. and more severe cases.   
• All mpox diagnostic samples and clinical waste can now be managed as Category B infectious substances unless they contain or are contaminated with cultures of Clade I MPXV.  

💡 Mpox Vaccine Commercialization

• As of April 2, 2024, the JYNNEOS vaccine has started transitioning to the commercial market. This means that the vaccine will shift from the Strategic National Stockpile to the commercial sector; this process will likely occur over several months.  
• For more information about commercialization and ordering, please visit the VDH Mpox Vaccine Webpage for Healthcare Professionals.

💡 DoxyPEP for STI Prevention

Rates of sexually transmitted infections have increased in the past several years in Virginia and nationally. Increases in syphilis are of the utmost concern. Preliminary data from 2023 show increases in syphilis diagnoses in nearly all Virginia health regions.

"DoxyPEP," which is doxycycline, administered as 200mg within 24–72 hours of condomless sex has been shown to significantly reduce the acquisition of syphilis, chlamydia, and gonorrhea among men who have sex with men and transgender women. Consider DoxyPEP in these populations, as clinically appropriate.

Resources: 

✅ Clinical considerations for the use of Doxycycline Post-Exposure Prophylaxis 

✅ Patient fact sheet (English and Spanish)

💡FDA Issues EUA for Pemgarda

On March 22, 2024, FDA issued an emergency use authorization for a monoclonal antibody, Pemgarda (pemivibart), for the prevention of COVID-19 in certain adults and adolescents aged 12 years and older who: 

• Are not currently infected with SARS-CoV-2 and who've not had a known recent exposure to an individual infected with SARS-CoV-2 AND   
• Have moderate-to-severe immune compromise due to a medical condition or due to taking immunosuppressive medications or treatment 

For more information about Pemgarda, including an FDA black box warning, please see the resources available on the FDA’s Emergency Use Authorization webpage. 

💡Important Vaccines for Those Living with HIV 

As a recent letter to Ryan White clinical providers indicated, people living with HIV in Virginia will benefit from several vaccines that prevent serious illnesses to which they may be particularly vulnerable.

Encourage patients to receive the following vaccines:

✅ Meningococcal disease 

✅ Mpox

✅ Influenza

✅ COVID-19

🔗 Resources for Clinicians

🔗 Respiratory Disease in Virginia 

🔗 Mpox for Healthcare Providers 

🔗 Syphilis Information for Healthcare Providers 

Virginia COVID-19 Information Center
1-877-VAX-IN-VA  |  1-877-829-4682  |  Mon-Fri 8am-5pm

Manage Preferences  |  Unsubscribe  |  Subscriber Help