Universal Masking - At Threshold!

As of today (11/20/24), we are at threshold for our RSV indicator on our Respiratory Illness Dashboard. This means that we are seeing higher levels of emergency department visits related to RSV. 

• Snohomish County Respiratory Illness Dashboard

As a reminder, when any one of the respiratory virus indicators meets threshold, we recommend implementing universal staff surgical masking in healthcare settings.

Respiratory Virus season and Gi illness 

Here are a couple reminders and resources during the winter months:

• Reporting: In addition to COVID-19 cases and outbreaks, you can fulfill county reporting for Influenza, RSV, and GI Illness outbreaks through the REDCap Healthcare Facility Outbreak Notification Tool.
  • All Influenza and COVID-19 resident deaths are reportable. Your facility is responsible for reporting to us, in addition to any notification we may receive from the hospital.
  • Influenza Outbreak Definition: ≥ 1 or more confirmed resident cases OR a sudden increase in acute febrile respiratory illness over the normal background rate (e.g., 2 or more cases of acute respiratory illness occurring within 72 hours of each other).
  • COVID-19 Outbreak Definition: ≥2 cases of probable or confirmed resident cases OR ≥2 cases of suspect, probable or confirmed COVID-19 among HCP AND ≥1 case of probable or confirmed COVID-19 among residents, with epi-linkage, AND no other more likely sources of exposure for at least 1 of the cases.
• Outbreak Response: 
  • CDC has a nice comprehensive page for responding to any respiratory virus in your facility [CDC Viral Respiratory Pathogens Toolkit for Nursing Homes].
  • For norovirus-like illness, I recommend WA DOH's Norovirus in LTC Checklist

Candida Auris 

Great news, King County no longer has any active outbreaks of C. auris! 

However, the time is now to prepare ahead of time to care for a resident with C. auris and strengthen interfacility communication practices. As we see more cases in our state, we will need more SNFs to be willing to care for these vulnerable individuals and help them transition out of the hospital. We have seen SNFs successfully care for residents with C. auris without transmission. 

I would love to work with you on any pieces of education I can provide. This can include:

• An ICAR and in-person discussion on preparing your facility for C. auris
• A presentation on MDROs/C. auris at your all staff or focused staff meeting
  • Presenting directly to your staff can help quell fears and answer questions
• A presentation on MDROs/C. auris for your Admissions team 
• Anything else you identify you need

Here are the recordings from the C. auris trainings King County and I collaborated on:

Pertussis

Our county has noted an uptick of Pertussis cases in our community. Please keep a look out for signs and symptoms in your residents. This includes early symptoms of runny nose, sneezing, and cough. After about a week, the cough typically worsens, and people often experience coughing fits. Individuals sometimes feel otherwise healthy besides a cough. 

It is important to know that vaccinated individuals can become infected and transmit pertussis as the protection from the vaccine wanes over time. Previously vaccinated individuals will almost always have milder illness (cough may not be as severe and may not have "whoop" sound) than those who are unvaccinated. Residents experiencing a prolonged cough, or that have been in contact with someone with pertussis, should be tested.