Health Alerts > 6/22/09 Gardisil, Scabies, H1N1
Gardasil
Our department has recently been allowed to order more Gardasil vaccine to provide and the age range has been expanded to include those 19 years to 26 years. If you have patients (or children) who are in need of the vaccine or who are going off to college please feel free to refer to our Immunization clinic. The vaccine is a three dose series injected at the following schedule: 0, 2 months, 6 months. Our clinic hours are 8:30 to 11:30 a.m. and 1 to 4 p.m. Wed. and Fri. Phone number is 449-7529
http://www.cdc.gov/vaccines/Pubs/vis/downloads/vis-hpv.pdf
Nestle Toll House Cookie Recall
The US Food and Drug Administration (FDA) warned consumers today not to eat Nestle Toll House refrigerated raw cookie dough, as state and federal officials investigate 66 Escherichia coli O157:H7 illnesses, many of them children, across 28 states that they suspect are linked to the product. The FDA said that, of the 66 illnesses reported, 25 people were hospitalized and 7 developed HUS. No fatalities have been reported
The FDA, in a statement, advised consumers that cooking the dough could still present a cross-contamination risk and that they should throw away any prepackaged Nestle dough they have in their homes. The recall applies to all varieties of its Toll house refrigerated cookie, brownie, and bar dough that is packaged in rectangular packages, tubes, and tubs.
E coli O157:H7 outbreaks are most often associated with ground beef and, in recent years, fresh produce. The strain produces a toxin that causes diarrhea—often bloody—and abdominal cramps but typically no fever. The illness usually resolves in 5 to 10 days, but it can cause hemolytic uremic syndrome (HUS), a potentially fatal kidney condition, in 2% to 7% of patients. Please keep this in mind when seeing patients.
http://www.cidrap.umn.edu/cidrap/content/fs/food-disease/news/jun1909dough-jw.html
Scabies
Thanks to everyone for assisting with this outbreak. Usually we do not get involved with Scabies issue, but due to the number involved and the nature of physical services provided, we did to aggressively contain the infestation. I did receive a few tips from a local dermatologist, who often sees eczema mistakenly diagnosed with scabies. The usual pattern of rash/itch is as below. Skin scraping is the most common procedure used to diagnose scabies. Burrows and unexcoriated papules are located with the help of a hand lens. A scalpel blade is used to scrape the skin. The scraping material is then transferred to a glass slide for review under the microscope. Also, this doctor has had good response with using Ivermectin versus Permethrin cream. The dose is as follows:
Adult and children greater than 5 years: 150-200 mcg/kg/d PO as single dose
Usual Distribution of Scabies Rash: http://www.stanford.edu/class/humbio103/ParaSites2004/Scabies/Scabies%20Home.htm
H1N1
National: the number of cases is 21,449 with 87 deaths. Indiana has identified 223 cases with 26 hospitalizations and no deaths. Allen County has had 6 cases.
Deb McMahan, MD
