The Current: Communicable disease updates from Island County Public Health and Free CME - July 2022

Monthly communicable disease updates & free continuing medical education (CME) for Island County healthcare providers.

July 2022

Monkeypox in Our Region

FREE CME

• Pri-Med is offering a free Primer on Monkeypox web-based course - 0.25 CME/CE Credit.
• StatPearls offers a continuing education article review activity through PubMed, with CME.

Clinical Recognition

Monkeypox virus is a DNA virus in the genus Orthopox, and anyone who has been in close contact with someone who has monkeypox is at risk. The CDC currently assesses community risk as low. We are urging healthcare providers to be alert for patients who have rash illnesses consistent with monkeypox, which has a similar clinical course to ordinary discrete smallpox.

Signs & Symptoms

• Incubation period of approximately 1-2 weeks.
• Initial symptoms (fever, malaise, headache, weakness) marks the beginning of the prodromal period, which does not occur in all cases. Unlike smallpox, monkeypox typically involves the development of swollen lymph nodes (lymphadenopathy).
• The deep-seated, well-circumscribed firm discrete rash develops 1-3 days after prodromal symptoms (if prodromal symptoms were present). Lesions often, but not always, start on the face and then spread to other body areas, particularly the extremities.
• Lesions progress through four stages—macular, papular, vesicular, to pustular—before scabbing over and resolving. Once all scabs fall off the person is no longer contagious.
• The illness typically lasts 2-4 weeks, with severity dependent on the health of the individual, the route of exposure, and the strain of the infecting virus. West African monkeypox is associated with milder diseases and limited transmission.

Disease Reporting

Healthcare providers, healthcare facilities, and laboratories:

• Immediately notifiable to Island County Public Health. Contact Dr. Shawn Morris at 360-914-0837 or Melanie Davis, RN at 360-499-4023.  Use the Suspect Monkeypox Intake Form for reporting.
• For further information, please see this guidance from WA DOH, as well as the CDC guideline on assessing infection risk and monkeypox guidance.

Current status

• In the United States: View the latest update from the CDC.
• In Washington state: Update 6/29/2022: Six people in King County have tested positive for orthopoxvirus. All positive cases of orthopoxvirus are considered likely monkeypox.  Visit WA DOH to learn more.

Syphilis is Rising

FREE CME

For a refresher on testing, diagnosis, and treatment, the National STD Curriculum offers a FREE web-based course on Syphilis and other sexually transmitted infections (STIs) eligible for CME credits.

Syphilis cases are on the rise locally and across Washington State. Of concern, rates of congenital syphilis are rising statewide, though no cases have been reported in Island County. Congenital syphilis is a severe disease that can lead to stillbirth, neonatal death, prematurity, and long-term health outcomes.

Recent Trends

Syphilis rates for both cisgender women and heterosexual men have been increasing statewide since 2015. Rates increased dramatically between 2020 and 2021, with the 2021 rate nearly twice as high as 2020, and 8 times higher than 2012. Many recent cases were not identified during early stages.

Changing Guidelines

To decrease this rising syphilis epidemic, Seattle King County and WA State Department Of Health (DOH) updated syphilis screening recommendations to include routine screening of some cisgender women and men. A summary of the screening recommendations is available from DOH here.

Other Communicable Disease Updates

• Tuberculosis: Visit the Island County Public Health Tuberculosis Program webpage for provider resources.  The CDC has a free course with CME on diagnosing and treating latent TB infection and TB disease. 
• Acute Pediatric Hepatitis: The CDC is investigating cases of pediatric hepatitis with unknown etiology. A recent CDC study found that the number of children hospitalized for hepatitis of unknown cause has not increased compared to before the COVID-19 pandemic. Find out more here. For current data and information visit this CDC webpage.
• Avian influenza: A strain of H5N1 has been detected in wild and domestic birds in many parts of the U.S. and Washington State. No humans with highly pathogenic avian influenza have been identified in Washington state. For up-to-date information visit the Washington State Department of Health website.
• For COVID-19 pediatric vaccine resources & guidelines, visit the ICPH COVID webpage.

Social Media Outreach

Please consider sharing the following social media graphics and posts.  This month, we’re focusing on:

• Improving access to resources for Ukrainian refugee arrivals to Island County, and
• Preventing sexually transmitted infections (STIs) by raising community awareness and increasing access to testing/treatment

Resources for Refugees

Island County Public Health created this virtual resource center to help connect families with services. Please share on social media.  

STI Prevention

Prepare Before You’re There! is a CDC campaign promoting sexual health and STI prevention. Use the sample posts and graphics below, or visit the CDC website here for campaign materials. If you offer testing and/or treatment, add a link to your services in the posts.

For Facebook:

Don’t roll the dice with your #SexualHealth! Prepare before you’re there with a #SaferSexGamePlan. https://go.usa.gov/xtQtu

For Twitter and Instagram:

Prepare Before You’re There!  1. Take a quiz to see if you’re at risk for an #STI, and 2. Access resources to make a #SaferSexGamePlan before you go out or swipe right. https://go.usa.gov/xtQzg #STDWeek

Conversation Badges for Facebook/Twitter/Instagram:

Need a #SexualHealth conversation icebreaker? Add the NEW Conversation Badge to your dating profile to signal that STI prevention and sexual wellness matters to you: https://go.usa.gov/xtQzj #SaferSexGamePlan

Have a topic suggestion? Get in touch! Send your ideas and feedback to s.morrisnd@islandcountywa.gov.