Download CDPHE 2017 Updates by Cathy White

CDPHE Update 2017
Cathy White, Public Health Nurse Consultant
Topics for Today
Infectious disease update
Public Health Agencies and youth substance abuse
prevention
Medication Take Back Program
Marijuana Research
Care Coordination collaboration with local Public Health
Infectious Disease Update: Fever
Defined as a temperature over 101°F orally in CDPHE’s guidance (see link)
No exclusion is necessary, unless the child has symptoms in addition to the fever, such
as a rash, sore throat, vomiting, diarrhea, behavior changes, stiff neck, difficulty
breathing, etc.**
Small differences in temperature due to different methods (such as a tympanic
thermometer) shouldn’t change actions
**https://www.colorado.gov/pacific/cdphe/infectious-disease-guidelines-schools-andchildcare-settings
Fever Guidance
CDPHE’s Infectious Diseases in Child Care and School Settings,
American Academy of Pediatrics Managing Infectious Disease in Child Care and
Schools,
Caring for Our Children National Health and Safety Performance Standards Guidelines
for Early Care and Education Programs.
A written policy shall be implemented for staff and children regarding symptoms of
illness that require exclusion from the child care facility. Guidance documents listed
in 7.10.1(C)(2) [above] should be used.**
**From: Rules and Regulations Governing the Health and Sanitation of Child Care Facilities
Fever guidance
Some variability exists between these guidance
documents, but the important issue is:
Have a policy based on standard guidance
Report outbreaks to your local health dept!
Mumps numbers are up
•CDC reports 5,311 cases for 2016 (Highest since 2010)
•Mumps cases have been higher in CO in 2016 (17) and so far in
2017 (14 as of 1/27/17)
•Several states are currently reporting outbreaks
–AR: 2,595 cases (as of 1/24/17)
–WA: 301 cases (as of 1/26/17)
Mumps numbers are up
•CDPHE and local health depts are currently
investigating an outbreak in Denver Metro
•Make sure kids and adults are vaccinated!
Mumps
•Transmission:
Direct contact with respiratory droplets or saliva
from an infected individual
•Incubation Period: Average: 16-18 days (Range: 12-25days)
•Infectious Period: Person is infectious 2 days before to 5 days
after onset of parotitis
Clinical Symptoms
•Swelling and tenderness of one more of the salivary glands
Unilateral or bilateral
•Low-grade fever
•Malaise
•Headache
Potential complications
Complications could include:
orchitis,
oophoritis,
encephalitis,
hearing loss,
mastitis,
pancreatitis
Prevention
•Up to date vaccinations (2 doses of MMR)
•Exclude sick person from work/school 5 days
after onset of parotitis
Varicella (Chicken Pox)
•Transmission
Contact with respiratory droplets
Direct contact with nasopharyngeal secretions or vesicular
fluids from lesions (prior to crusting)
•Incubation Period: Average: 14-16 days
(Range: 10-21days)
Varicella
•Infectious Period
Person is infectious 2 days before onset of rash and until
vesicles have formed scabs (approximately 5 days of rash
onset)
Breakthrough Varicella
When a vaccinated person develops varicella more than 42 days
after vaccination
Breakthrough infection is milder
Fewer lesions
More maculopapular rather than vesicular
May not have fever
Prevention
Up to date vaccinations
Exclude symptomatic person from school until
lesions have crusted over
Breakthrough varicella cases may be able to return to
normal activities earlier because of fewer lesions
Clinical Symptoms
•Acute onset of generalized, itchy rash
•Rapid progression from macules to papules to
vesicular lesions
•Prodrome includes fever and malaise
Medication Take-Back Program
Goal: establishing at least one permanent collection location in every Colorado
county.
All locations can accept prescribed controlled substances (e.g. Percocet, Vicodin,
Xanax, Ritalin and Adderall) along with other prescribed and over-the-counter
medications.
www.colorado.gov/pacific/cdphe/colorado-medication-take-back-program
Items that can be accepted
Prescription medications, including prescribed controlled substances
Over-the-counter medications.
Liquid medications (small amounts in original, non-leaking containers).
Medicated patches (Used Fentanyl and Duragesic® patches are extremely hazardous. They
may be folded in half, sticky-side together, and flushed down the toilet.)
Medication samples. Medicated ointments. Vitamins. Pet medications.
Unused drug injection cartridges, e.g. unused EpiPens® and insulin pens (must be
unused with needle still protected inside)
Cannot be accepted
Marijuana.
Illicit drugs (e.g. DEA Schedule I drugs like heroin, LSD, etc).
Chemotherapy drugs.
Medical tools and supplies. Bloody or infectious waste. Personal care products.
Thermometers. Empty containers. Needles, syringes, and other sharps.
Medication wastes generated by health care facilities, including nursing homes.
Community Health Assessments
Community Health Assessments
What does that mean for you?
Data
Schools should be at the stakeholder table
Public Health Improvement Health Plans follow
Completing New Community Health Assessments
Alamosa,
Boulder
Clear Creek,
Conejos,
Costilla,
Delta,
Eagle,
Silver Thread District (Mineral & Hinsdale),
Jefferson,
Lake,
Mesa,
Montrose,
Routt,
Moffat,
Jackson,
Ouray,
Rio Grande, Saguache, San Juan Basin,
San Miguel,
Tri County
Weld
Planning to Complete Health Assessment
Cheyenne,
Fremont,
Grand,
NorthEast, (Logan, Morgan, Sedgwick, Washington, Yuma, Phillips),
Summit
Teller
Youth Substance Use Prevention
Communities That Care (CTC) is a prevention system, grounded in science that
gives communities the tools to address their adolescent health and behavior
problems through a focus on empirically identified risk and protective factors.
engaging community stakeholders & establishing a shared community vision,
tools for assessing & Prioritizing levels of risk and protection in communities,
setting specific, measurable, community goals.
guides the coalition to create a strategic community prevention plan
Youth Substance Use Prevention
Alamosa, Boulder, Broomfield, Chaffee,
Cheyenne, Clear Creek, Costilla, Denver, Eagle,
El Paso, Fremont, Grand, Gunnison, Hinsdale, Mineral,
Jefferson, Lake, Larimer, Las Animas-Huerfano, Mesa,
Routt, Moffat, Jackson, Otero, Ouray, Pueblo, Rio Grande,Saguache,
San Juan Basin, Summit, Teller, Tri County, Weld
Medical Marijuana Research Grants
Marijuana use in Adolescents and Young Adults with Inflammatory Bowel Disease
Tolerability and Efficacy of Cannabidiol (CBD) on Tremor in Parkinson's Disease
Treating PTSD with Marijuana
Cannabidiol (CBD) and Pediatric Epilepsy
Medical Marijuana in the Pediatric Brain Tumor Population (palliative care)
Medicinal Cannabinoids as Adjunctive Treatment for pediatric epilepsy
Medical Marijuana Research Grant
Safety and Efficacy of Smoked Marijuana in 76 Veterans with Resistant Post
Traumatic Stress Disorder (PTSD)
Comparing the Analgesic Efficacy of Cannabis versus Oxycodone
Efficacy, Safety, and Usage Patterns of Medical Marijuana for Sleep
Marijuana Public Health Research Grants
Comparative Assessment of Driving Impairment in Occasional Versus Heavy Marijuana Users
Acute Effects of Dabbing on Marijuana Intoxication, Driving Impairment & cognitive functioning
Duration of marijuana concentration in Breast Milk
Older Coloradoans and Marijuana: A Public Health Problem or Policy alternative
The Adverse Effects of Edible Cannabis Products
Analysis of Data from before and after implementation of Recreational marijuana in Colorado
Cardiovascular effects of Marijuana in at risk patients
Questions?
Cathy White, RN, MSN
[email protected]