Hot Topics
  
Subscribe to email notification of Alerts, Advisories and Updates posted to this page by emailing mricci@wakegov.com or by calling 919-250-4462.
 
 

 
Update Bar
 
General Communicable Disease Information  
 
 
 
These links provide additional information on communicable disease reporting, testing, treatment, staff contact information and patient education materials for:
 
     Syphilis
 
 
 
  
  
top of page
 
 
NC DEATHS ASSOCIATED WITH SYNTHETIC OPIOIDS
 
NC Department of Health and Human Services
 
 
 ZIKA VIRUS INFECTION
 
NC Division of Public Health
 
This memo is intended to provide information to NC clinicians regarding the US Zika Pregnancy Registry for enrolling all pregnant women with positive or indeterminate Zika virus test results.
 
Zika is a mosquito-borne virus that is currently causing outbreaks in many countries. Zika virus is transmitted by Aedes aegypti and A. albopictus mosquitoes. Since 2015, endemic transmission has been occurring in the Western hemisphere. Transmission of Zika Virus through sex and blood transmission has also been reported. Zika virus can be detected in saliva and urine; however, exposure to these fluids has not been linked to transmission.
 
 
 
CDC
 
  • This CDC Health Advisory includes information and recommendations about Zika virus clinical disease, diagnosis, and prevention, and provides travel guidance for pregnant women and women who are trying to become pregnant.
  • Healthcare providers are encouraged to report suspected Zika virus disease cases to their state health department to facilitate diagnosis and to mitigate the risk of local transmission. 

Wake County Human Services Public Health Division

Zika Fact Sheet

 
INFLUENZA
 
CDC 
 
 
 
This CDC Health Advisory urges rapid antiviral treatment of very ill and high risk suspect influenza patients without waiting for testing.
   
RELEASE OF PATIENT INFORMATION TO PUBLIC HEALTH OFFICIALS
 
NC DPH
 
(12-9-15) Release of Patient Information to Public Health is a memo that addresses questions health care providers frequently have about releasing patient information when requested by Public Health officials. It outlines a protocol approved by NC DHHS, The NC Association for Local Health Directors and the NC Hospital Association for proper identification of Public Health requests. Additionally it clarifies when, according to HIPAA, protected health information may be disclosed without individual authorization.
  
EBOLA
 
NC DPH
 
This memo: 
  • informs all NC health care providers of changes in public health monitoring for travelers from Guinea
  • provides guidance for management of ill travelers from countries with former widespread transmission of Ebola (Guinea, Sierra Leone and Liberia) and
  • encourages continued screening of patients for recent international travel
  
Wake County Human Services Public Health Division
 
Ebola Fact Sheet  (en español). Fact sheet is being revised. Please check back soon.
 
Related Resources
 
 
FENTANYL RELATED OVERDOSE FATALITIES
 
CDC
 
(10-26-15) The Centers for Disease Control and Prevention (CDC) and the Drug Enforcement Administration (DEA) are investigating recent increases in fentanyl-related unintentional overdose fatalities in multiple states across the U.S. The purpose of this HAN advisory is to:
  1. alert public health departments, health care providers, first responders, and medical examiners and coroners to the possibility of additional increases in other jurisdictions
  2. provide recommendations for improving detection of fentanyl-related overdose outbreaks
  3. encourage states to expand access to naloxone and training for administering naloxone to reduce opioid overdose deaths
 
NC DPH 
 
 
(9-14-15) This memo provides updated influenza guidance and information to NC clinicians including a reminder that physicians are required to report all influenza associated deaths (adult and pediatric) to their local health department.
 
Guidance may change as the influenza season progresses; updated information is available at www.flu.nc.gov.
  
 
 
 
MIDDLE EAST RESPIRATORY SYNDROME (MERS CoV)
 
CDC
(3-18-16)  The Saudi Arabia Ministry of Health has recently reported an increase in cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection. Healthcare providers should immediately report to their state or local health department any patient under investigation for MERS-CoV. 
 
From January 1 to March 17, 2016, the Ministry reported 66 cases in Saudi Arabia; 39 of those were reported during the last 17 days. Some of the most recent cases were part of a healthcare-associated cluster in Buraidah, in Qassim Region. The Ministry also recently reported additional cases in the Riyadh, Makkah, Najran, Asir, and Hail regions of Saudi Arabia.
This increase in MERS activity serves as a reminder that healthcare providers should immediately report to their state or local health department any patient under investigation for MERS-CoV infection. The CDC MERS-CoV website also has guidelines for collecting and testing specimens  for MERS-CoV infection from patients under investigation for MERS. Additionally it emphasizes that healthcare professionals should collect the following specimen types, if possible, for submission to the appropriate state public health laboratory or CDC:
  • a lower respiratory specimen (e.g., sputum, broncheoalveolar lavage fluid, or tracheal  aspirate), and
  • an upper respiratory specimen (e.g., nasopharygeal/oropharygeal (NP/OP) swab), and
  • serum
Reporting or Questions:

Wake County: Wake County Human Services Communicable Disease Program    
919-250-4462

NC Division of Public Health: Communicable Disease Branch 919-733-3419
 
 
SYPHILIS
 
NC Division of Public Health
(9-22-15) Continued Rise of Early Syphilis Cases In North Carolina. This advisory asks all healthcare providers to assist in dealing with a worsening syphilis epidemic by incorporating the outlined screening and treatment recommendations into your clinical practices.
 
 
NC Division of Public Health
 
(9-15-16) This memo replaces the version dated October 26, 2015 and provides updated information regarding identification and management of suspected acute flaccid myelitis cases and to request reporting of such cases to public health.
 
 
INFLUENZA
 
 NC Division of Public Health
 
NC Weekly Influenza Update (weekly surveillance summary)
 
NC Flu Update (web page)
 
 
 
Reporting:
Physicians, school administrators and child care operators, medical facilities and operators of restaurants and other food or drink establishments (G.S. § 130A-135 through 130A-139) must report cases or suspected cases of reportable diseases to their local health department.
 
Where to report communicable diseases in Wake County:
Wake County Human Services Public Health Division
Communicable Disease Surveillance Team
Phone    919-250-4462
Fax        919-212-9291
  
Resources for Communicable Disease Reporting:
2012 CRE Toolkit. (updated 3-5-13) Centers for Disease Control and Prevention Important guidance for health care providers on the control of carbapenem-resistant Enterobacteriaceae (CRE)
 
Wake County Human Services Public Health Division
Communicable Disease Surveillance Team contact information:
 
​Mark Werdel, RN ​919-212-7289
​Nancy Phillips, RN ​919-212-9679
Mercy Anagbogu, RN 919-212-8474
   
 
 
 
 
Reporting:
Wake County Human Services Public Health Division
Communicable Disease Surveillance Team
Phone    919-250-4462
Fax        919-212-9291
 
Resources:
 
HIV/AIDS/STD Program contact information:
Juanita McClaston
Phone    919-250-4717
Fax        919-212-7400
 
Disease Intervention Specialists   
Darvlyn McLean 919-250-4422
​Martha Smith, RN ​919-212-9552
​Luke Keeler ​919-250-3114
 

Syphilis Information for Medical Providers

 Test patients for syphilis if they: syphilis test treat teach.png
  • Have genital, oral or rectal ulcers or chancres
  • Have a rash
  • Have alopecia
  • Have unprotected sex
  • Have multiple or anonymous sex partners
  • Are infected with HIV
  • Are pregnant
Treat patients and their partners immediately per the CDC treatment guidelines for syphilis.
 
Be sure to test for HIV, all patients who are suspected or confirmed of having syphilis (unless they are already known to be HIV positive).
 
In Wake County, report diagnosed syphilis cases within 24 hours. Call 919-250-4462 to report.
 
Wake County, like other counties in North Carolina and across the U.S., is seeing a dramatic rise in the number of early syphilis cases (infected in the last 12 months). 
 
 syphilis cases rates.png
 
Change in NC early syphilis cases between 2013 and 2014
NC syphilis map.png 
 
More syphilis information: 
 
Syphilis: A Public Health Advisory - Powerpoint Presentation (Wake County)
 
Contact Us!
 
​Wake County Communicable Disease Report and Information Line 919-250-4462​
​Wake County Human Services Disease Intervention Specialists ​919-250-4422
​NC Communicable Disease Branch Intervention Specialists ​919-715-4283
                                           
 
 
 
Reporting:
Wake County Human Services Public Health Division
Communicable Disease Surveillance Team
Phone​
919-250-4462​
Fax ​919-212-9291
 
Resources:
 
 Educational Material for Patients:

 

Wake County Human Services Public Health Division
Communicable Disease Surveillance Team contact information:
Mark Werdel, RN ​919-212-7289
​Nancy Phillips, RN ​919-212-9679
​Mercy Anagbogu, RN ​919-212-8474
          
 
 
 
 
 
 
Reporting:
Wake County Human Services Public Health Division
Communicable Disease Surveillance Team
Phone​
919-250-4462​
​Fax ​919-212-9291
 
Resources:
 
 
Wake County Human Services Public Health Division
Communicable Disease Surveillance Team contact information:
Mark Werdel 919-212-7289
​Nancy Phillips ​919-212-9679
Mercy Anagbogu ​919-212-8474
          
 
 
 
 
 
Reporting:
Wake County Human Services Public Health Division
Communicable Disease Surveillance Team
Phone ​919-250-4462
​Fax ​919-212-9291
 

Resources:

Wake County Tuberculosis Control Team contact information:
Darlene Farmer ​919-250-1228
Kursten Lyon  919-212-9508
FREQUENTLY ASKED QUESTIONS ABOUT TB SKIN TESTING AND REPORTING
 
 
Does my office need to report positive PPDs (skin tests) to Wake County?
No, you do not need to report a positive PPD (skin test) to Wake County, unless you need help evaluating the result of the test or if the chest x-ray is abnormal suggesting active TB.
 
Does my office need to report confirmed or suspected cases of active TB disease to Wake County?
Any confirmed or suspected case of active TB disease is required by law to be reported within one working day to the TB Control program by telephone at 919-250-1228 or by fax at 919-250-3961. DO NOT wait for laboratory results to confirm the diagnosis prior to reporting. A suspected case of TB is anyone who has symptoms of active TB disease (see below) OR who has an abnormal chest X-ray after a positive PPD (skin test).
 
In accordance with North Carolina law, all cases of active TB disease must be treated by the local health department.
 
All patients with active TB disease being discharged from the hospital or transferred to another healthcare facility require prior approval by Wake County's TB Control program.
 
What services does the Wake County TB Control program offer to patients?
The Wake County Human Services TB Control program provides:
  • consultation
  • directly observed therapy
  • case management and
  • clinical services for patients with TB infection and/or disease
Every person with active TB disease is investigated to find out who might have been exposed, provide testing and follow-up for contacts, assess sites of potential transmission and promote patient adherence.
 
When should I suspect TB?
Think tuberculosis (TB) in patients with:
  • Chronic cough (≥ 3 weeks)
  • Unexplained weight loss
  • Fever, chills or night sweats
  • Coughing up blood
  • Fatigue

Remember: Active TB rates are highest among:

  • Foreign-born persons from areas with a high prevalence of TB
  • Homeless and marginally housed persons
  • Residents of long-term care facilities (including correctional facilities)
 
The risk of developing TB disease increases when the patient has other medical conditions such as diabetes, HIV or other medical conditions that weaken the immune system.
 
Whenever TB symptoms are present, TB disease should always be ruled out with a chest X-ray, sputum smears and culture, and careful clinical evaluation. Suspected cases of TB should be referred to the Wake County TB Control program. If symptoms are absent and active TB is ruled out, preventive treatment should be prioritized for these individuals.
 
What if a patient has a positive TB skin test and a negative chest X-ray?
Unless TB disease is suspected, providers do not need to report positive TB skin tests with negative chest X-rays.
 
The Wake County TB Control program is available to assist providers with  preventive treatment for their patients with latent tuberculosis infection (LTBI). Alternatively, patients can  be referred to the Wake County TB Control Program for LTBI  management, provided at no charge to the patient. Please call 919-250-1228 or 919-212-9508 for more information or assistance.
 
Should my office place a TB skin test if my patient was vaccinated with BCG (Bacille Calmette-Guérin)?
Yes, TB skin tests can be placed even though the patient was previously vaccinated with BCG. TB skin tests may be interpreted using the current guidelines for interpretation of TB skin tests.
 
What should my office do if we are unsure of how to interpret a TB skin test?
Please call 919-250-1228 to schedule an appointment for your patient to visit our office to read their TB skin test.
 
 
 
Immunizations and Foreign Travel
919-250-3900
 
Immunization Outreach & NC Immunization Registry
JoAnn Douglas:     919-250-4518
 
 
Refugee Health
Lisa Hower:     919-250-3894