WELCOME TO THE PROVIDER PULSEThis newsletter is about strengthening regular communication between the Snohomish County Health Department and medical providers. These quarterly newsletters will include up-to-date information regarding clinical best practices, current trends or emerging information, new resources, and relevant opportunities for providers and staff from all teams within the Prevention Services Division of the Health Department. |
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Health AlertsThe Snohomish County Health Department Health Officer issues health alerts via email to local healthcare providers. These alerts provide timely information on local, regional, and national health threats, along with essential updates on medical care and protocols. Alerts are dispatched as needed to address urgent or emergent health issues, ensuring that healthcare providers have the most current information to protect public health. Health Alerts Page Covid Updates: The Snohomish County Health Department will continue to require masking in clinic areas. While we are currently below the threshold for mandatory masking, we are still observing elevated COVID transmission within the community. Masking in healthcare and other high-risk settings, including indoor crowded spaces, is strongly encouraged at this time. We are following the masking recommendations issued by the Northwest Regional Healthcare Network (NWHRN) in collaboration with multiple health systems and public health departments, including Snohomish County. These guidelines are based on syndromic surveillance of COVID, influenza, and RSV. As long as we remain below the thresholds for these illnesses, masks can be removed in clinical settings. However, if any of the three—COVID, flu, or RSV—exceeds the threshold, masking will be required and will remain in place until all three illnesses are below the threshold for two consecutive weeks. For more information, please refer to the NWHRN masking consensus statement here, and to monitor current conditions, visit the Snohomish County respiratory illness dashboard. |
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Communicable DiseaseSummer Lovin and RabiesWith warmer weather in the Pacific Northwest, more people are spending time outside and enjoying the beautiful long days. Summer is also associated with higher incidence of bat exposure and Post-exposure prophylaxis (PEP) administration. Bats are necessary to the ecosystem and are generally healthy. Yet, bats are the most common rabies reservoir in Washington State and though relatively low risk, of the tested bats following human exposures, 3-10% were found rabid (Washington State Department of Health, 2018). Most individuals reporting bat exposures describe finding a bat in an unexpected place. And though a bat can be found anywhere due to several reasons, a sick bat will exhibit unusual behaviors, such as making noise, unable to fly, and flying during the day (Washington State Department of Health, 2022). Rabies in humans is preventable with prompt medical treatment, thus any bat exposure in Washington state should be reported to the local health department and appropriate treatment recommendations followed for PEP. When determining rabies exposure risk and the start of PEP, patients should be assessed for visible bites or scratches, the type and activity of the animal, the nature and location of exposure and if the animal is available for testing. Rabies cannot be transmitted by touching blood, urine or feces, or by touching fur. Please find further rabies reference and resources on the Washington State Department of Health website or the CDC website. Additional questions regarding testing and PEP treatment should be directed to the Communicable Disease team at 425-339-3503.
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Immunizations and Vaccine Preventable DiseasesTime for Back to School! This is the busy season for vaccines. Here are a few friendly reminders:- Recommended age to give the 2nd dose of MMR and Varicella, booster dose of DTaP and final dose of IPV is 4 years old, so give them to your rising Kindergarteners.
- The DOH updated the recommended HPV age to 9 years old in January 2023. If you want more information on the only cancer preventing vaccine, please visit HPV-9 at 9 - WA DoH
- Don’t forget your EMR may interface with the state information database (WAIIS). Encourage staff to update patient records and offer families a printed CIS to give to their school for registration!
- The start of school is not the only time to vaccinate. Check their status at every visit as you don’t want to miss an opportunity!
- Have a new patient with that is not on the regular schedule? Here is the quick and easy link to the CDC Catch-Up Schedule. Catch-up Immunization Schedule
- Questions about Certificates of Exemption (COE) Forms. See the Reference Guide towards the bottom of the page: School and Child Care Immunizations Information for Families | Washington State Department of Health
Want to stay up to date? Don’t miss new information. Join the Power of Providers! Power of Providers Webinars | Washington State Department of Health Rapid QI Opportunity: Interested in collaborating with other Pediatric and Family Medicine clinics throughout the state on improving adolescent vaccination rates? Please refer to this QI Opportunity through the Washington Chapter of the AAP. COVID-19 update: There are currently no updates from the CDC on the roll out of the 2024-25 vaccine. Stay tuned! |
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STI ProgramWhat is a DIS and what do they do? Have you had a call from a DIS inquiring about a mutual patient and wondered what is a DIS? Highly trained public health professionals known as disease intervention specialists (DIS) are at the forefront of disease intervention work. While DIS primarily work with STIs, they also assist during urgent outbreak situations. DIS use contact tracing and case investigation to prevent and control infectious diseases. DIS use partner services to assist in identifying individuals at risk for STIs, increasing STI awareness, and providing timely treatment. These services are offered to people with STIs, their partners and social contacts. In Snohomish County we have 7 DIS that work in the STI/HIV Program that investigate the STIs for the county. The team attempts to reach all reported case of STIs to ensure the patient and their partner(s) receive timely and appropriate treatment to stop disease transmission. The team completes extensive research and case investigation, utilizes multiple contact attempt methods including home visits and are persistent to reach clients, their partner(s) or other who may benefit from STI/HIV testing services. DIS work closely with the Nurse Practitioner in clinic who can provide examinations, treatment or referrals to other medical providers in the county, as needed. Please feel free to reach out to the team with questions or concerns. How to Make an AppointmentLocated at 3020 Rucker Avenue, Suite 100, Everett, WA 98201 Appointments available Monday- Friday, 8 a.m. to 3:30 p.m. To make an appointment, call the clinic at 425-339-5261. Appointments are recommended but are not required. Walk-ins will be seen if time allows and insurance is not required. More information on the Snohomish County STI Clinic can be found here.
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TUBERculosisRoutine Testing ReminderAre you testing patients born outside the U.S. for TB? National data shows half of healthcare providers are considering TB for non-U.S.-born patients. Identifying and overcoming barriers to TB testing and treatment is crucial. Anyone born outside the U.S. or Western Europe should be tested for TB at least once. For positive results, contact the health department for guidance at 425.339.5225. Let's work together to reduce TB transmission in Snohomish County. Key Points to Remember: Think TB if patients have symptoms like a persistent cough, fever, unexplained weight loss, night sweats, or related radiological findings. High-Risk Groups include: - Close contacts of active TB cases
- Those with a history of residence or travel to TB-endemic regions (refer to the WHO table)
- Children under 5 with a positive TB test
- Individuals with a history of latent TB infection (LTBI), especially if diagnosed in the past 2 years
- Residents or workers in shelters, correctional, or long-term care facilities
- People with HIV, diabetes, or other immunocompromising conditions
TB-Endemic Regions (2019 Data from WHO list of high burden countries): - Severely Endemic (500+ cases/100,000): Central African Republic, Gabon, Lesotho, South Africa; DPR Korea; Philippines.
- Highly Endemic (300-499 cases/100,000): Angola, Congo, Democratic Republic of Congo, Eswatini, Guinea-Bissau, Liberia, Mozambique, Namibia, Zambia; Indonesia, Myanmar, Timor-Leste; Kiribati, Marshall Islands, Mongolia, Papua New Guinea.
- Endemic (100-299 cases/100,000): Various regions in Africa, the Americas, Eastern Mediterranean, Europe, South-East Asia, Western Pacific.
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