Clinical

Cases of measles and chickenpox are spreading in North Carolina and South Carolina, respectively, leading public health officials in both states to urge residents to get themselves and their children vaccinated. At least 12 students have been diagnosed with chickenpox at a single private school in Asheville, NC. Buncome County, which includes Asheville, has North Carolina’s highest rate of kindergarteners who have not been immunized because of religious exemptions. Without immunization, chickenpox is highly contagious. …

Fewer young children are getting vaccination against many diseases than in years past, opening the door for preventable disease outbreaks, according to new data from the Centers for Disease Control and Prevention. The threat is especially acute in uninsured and Medicaid-insured children. The CDC report, Vaccination Coverage Among Children Aged 19–35 Months—United States, 2018, notes that children under 2 years of age, in particular, are less likely to receive all the recommended vaccinations than in …

Using pooled data from state and local health departments across the country, the Centers for Disease Control and Prevention reports that 2017 saw a record number of medical visits due to tick-borne disease in the United States. Including cases of Lyme disease, anaplasmosis/ehrlichiosis, spotted fever rickettsiosis (including Rocky Mountain spotted fever), babesiosis, tularemia, and Powassan virus disease, there were 59,349 visits last year—a 22% increase from 2016. The CDC noted that there were probably far …

The Centers for Disease Control and Prevention is alerting healthcare providers that confirmed cases of mumps are becoming more prevalent, with 142 cases reported across the U.S. That’s already more than were seen in all of 2018. Michigan and New York are seeing a disproportionate number of those cases, based on data from local and state health officials there. Michigan already has more cases this year (15) than it has seen in any full calendar …

It’s painfully clear, from the frenzied media reports to your case load, that we’re heading into the heart of influenza season. A new report from Columbia University’s Department of Environmental Health Sciences, published in PLOS Pathogens, claims there’s a seasonality to many other infectious disease states as well, however. Many of those identified in the report are likely to present to urgent care centers. The paper identifies 69 diseases that have a fairly distinct “season,” …

Urgent care operators and occupational medicine providers alike should be aware that prescription opioids continue to be found to blame more often than other substances in overdose deaths in the United States. The Drug Enforcement Administration’s just-released 2018 National Drug Threat Assessment reveals that controlled prescription drugs are the second most commonly abused substance, making the number of deaths slightly out of proportion to the incidence of abuse. The DEA report shows fentanyl and other …

The Centers for Disease Control and Prevention is devoting more resources to gathering and sharing intelligence about acute flaccid myelitis (AFM) as the number of cases continues to rise across the United States. Next up in the CDC’s information campaign will be a Clinician Outreach and Communication Activity (COCA) call next Tuesday, November 13, 2 to 3 pm Eastern. AFM, whose symptoms have been likened to a number of other viruses, including polio, tends to …

Antibiotic stewardship has become something of a buzz phrase in many healthcare settings. Don’t forget what it really means or what’s at stake, though. According to the latest data from the Centers for Disease Control and Prevention, at least 30% of antibiotics in the United States are prescribed unnecessarily. And for every misguided script, the risk of antibiotic resistance increases. At least 2 million people become infected with bacteria that are resistant to antibiotics every …

Patients in 29 states have been diagnosed with Salmonella infection attributed to consuming tainted chicken products. Worse, public health officials say testing shows this particular strain to be resistant to multiple antibiotics often used to treat patients with severe Salmonella infections. No deaths have been reported, but scores of patients have been hospitalized. Ask patients who present with diarrhea, fever, and abdominal cramps what they’ve eaten in the past 12–72 hours, and consider giving a …

For the first time in two decades, the Food and Drug Administration has approved use of a new drug to treat acute uncomplicated influenza in patients 12 years of age and older who have been symptomatic for ≤48 hours. While that’s great news in the wake of last year’s rough flu season, urgent care providers must be aware of the need for timely diagnosis—and pass that message along to patients. With less than 2 days …