County of Marin Health and Human Services

Public Health Newsletter, July 2019

Public Health Newsletter, July 2019
Marin County Public Health Newsletter Volume 7 - Issue 7 - July 2019
In this Issue: Flaccid Myelitis | PPD | Ebola | Foster Homes | Rabies | Message from the Deputy Public Health Officer
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A message to physicians and other health care providers from Marin County's Public Health Officer.

Acute Flaccid Myelitis 

Acute flaccid myelitis (AFM) is a rare but serious syndrome that causes muscle weakness or paralysis, mostly in children.  Three national outbreaks have occurred since 2014.  Most patients developed AFM in late summer or early fall.  AFM typically presents with limb weakness one week after a viral infection.  The Centers for Disease Control and Prevention (CDC) believes viruses, including enteroviruses, play a role in AFM.  Marin County health care providers should contact Marin County Communicable Disease Prevention and Control (CDPC) if they suspect AFM at 415-473-4163.  CDPC will coordinate specimen collection and laboratory testing.  The AFM Physician Consult and Support Portal provides clinicians with access to 24/7 neurologist consultation. 

PPD Shortage 

Due to an expected shortage of APLISOL, the Centers for Disease Control and Prevention (CDC) is recommending that providers:
 - Substitute IGRA blood tests for TSTs. 
 - Substitute TUBERSOL for APLISOL for skin testing.
Please notify Marin County Tuberculosis Control Program if you have any difficulty screening for LTBI (by phone at 415-473-4163 or email  LTBI screening and treatment is a key component of "Getting to Zero" TB cases in California and nationwide.  For more information, visit the Marin County Tuberculosis Control Program's website.


After an outbreak-related case of Ebola was reported in Uganda, the Director-General of the World Health Organization (WHO) declared the current Ebola outbreak in the Democratic Republic of the Congo a Public Health Emergency of International Concern.   As of July 28, 2019, there have been 2,687 confirmed and probable EVD cases and 1,803 deaths connected to this outbreak.  While the threat of disease spread to California remains very low, the California Department of Public Health (CDPH) is closely monitoring the outbreak.  Health care providers should ask all persons who present with suspected infectious diseases about any travel, domestic or international.

Foster Our Future

Each year, approximately 80 children in Marin County need temporary (foster) homes, but we only have 35 approved homes.  Individuals with medical experience, those who can welcome siblings together, and those who are Spanish-speaking are especially needed.  Attend an orientation with a social worker and an experienced foster parent to learn more.  The next orientation is scheduled for Thursday, August 22, from 7:00 to 8:30 pm at the Marin Health and Wellness Campus (3240 Kerner Blvd., San Rafael, CA  94901).  Visit the Foster Our Future Marin website or call 415-473-2200 for more information.

Public Health Program Spotlight:  Rabies Control Program

The Rabies Control Program is one of Marin County's mandated communicable disease prevention and control programs.  Annually, 10-12% of captured bats in Marin County test positive for rabies.  Most human rabies cases in the United States have been caused by bat bites that were unrecognized or undetected due to bats' extremely fine teeth.  Human rabies can be prevented by providing rabies pre-exposure prophylaxis (if indicated), prompt local treatment of bite wounds, and/or appropriate rabies post-exposure prophylaxis.  Marin County Public Health works closely with Marin Humane, WildCare and other community partners to prevent human rabies.  Visit the Marin Rabies Information Page to access a Bite Report and the rabies Post-Exposure Prophylaxis Algorithm.

Message from the Deputy Public Health Officer

Last month, we informed readers about the risk of extended power outages (3 - 5 days) due to the launch of PG&E's Public Safety Power Shutoffs (PSPS) program.  Wildfire season is now here.  In addition to preparing your family, neighbors, and patients for extended power outages, it is time to organize your wildfire preparedness efforts.  Visit FireSafe Marin and make sure you are Ready to Go.  We also encourage health care providers to join the Marin Medical Reserve Corps today.  The time and energy you invest in preparedness will increase our community's overall resilience.  Thank you!

Warm Regards,
Lisa Santora, MD, MPH
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Copyright (c) 2019
Matthew Willis MD, MPH
Marin County Public Health Officer
(415) 473-4163
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Our mailing address is:
3240 Kerner Blvd.
San Rafael, CA 94901

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