Information for Healthcare Providers

Below are links to public health alerts, advisories and updates as well communicable disease prevention information and resources you need.

COVID-19

NC Division of Public Health

CDC

COVID-19 Vaccination

1.26.21 NC DHHS 1.26.21 Vaccine Strategy And Process
1.11.21 NC Immunization Branch CVMS Provider Enrollment Portal Information

NC DHHS Vaccination Information for Providers

Wake County COVID-19 Vaccine Information for Healthcare Providers

Public Health Alerts, Advisories and Updates

Alerts

Public health information that is vital, time sensitive and specific to an incident or situation. Information posted here warrants immediate action or attention.

There are no alerts as of 12.03.2020.

Advisories

Public health information that is specific to an incident or situation. Information contains recommendations or actionable items. Advisory information may not require immediate attention.

11-15-2021 NC Division of Public Health Statewide Increase in Syphilis Infections

This public health advisory describes the continuing increase in syphilis infections in North Carolina, outlines actions for clinicians and provides links to relevant resources.

Statewide Increase in Syphilis Infections

2021 Syphilis Increase Alert.pdf

10-14-21 NC Division of Public Health 2021-2022 Influenza Season: Update for NC Clinicians

This memo provides information and guidance to NC clinicians regarding updates for the 2021-22 influenza season. As guidance may change during the influenza season, up to date information can be found at flu.nc.gov.

2021-22 Influenza Season: Update for NC Clinicians

Flu_Clinicians Update_2021-22.pdf

9.29.21 CDC Health Advisory COVID-19 Vaccination for Pregnant People to Prevent Serious Illness, Deaths, and Adverse Pregnancy Outcomes from COVID-19

The Centers for Disease Control and Prevention (CDC) recommends urgent action to increase Coronavirus Disease 2019 (COVID-19) vaccination among people who are pregnant, recently pregnant (including those who are lactating), who are trying to become pregnant now, or who might become pregnant in the future.

7/30/21 NC Division of Public Health Out of Season Increases in RSV

This memo provides information and guidance to providers on out of season increases in cases of respiratory syncytial virus (RSV) in North Carolina and on Medicaid coverage of Palivizumab (Synagis) in high-risk infants for passive immunoprophylaxis against RSV.

Memo: Out of Season Increases in RSV

6-16-21 NC Division of Public Health

Genetic Sequencing of SARS-CoV-2 Respiratory Samples (replaces version dated February 12, 2021)

This memo provides updated information about SARS-CoV-2 genomic sequencing and guidance to laboratories and clinicians for requesting sequencing and reporting vaccine breakthrough cases and variants of interest to the North Carolina Division of Public Health.

https://covid19.ncdhhs.gov/media/1134/download

5-6-2021 NC Division of Public Health

Coronavirus Disease 2019 (replaces version dated October 27, 2020)

https://covid19.ncdhhs.gov/media/393/open

This memo provides updated guidance for:

Testing (including antigen testing for SARS-CoV-2, at-home testing and detection of variants)
Clinical care
Reporting

Guidance for providers regarding COVID-19 vaccines is available at https://covid19.ncdhhs.gov/vaccines/providers.

4-21-21 Wake County Health & Human Services/Public Health Division

COVID-19 Vaccine Dose intervals and Completion of Vaccine Series

4-19-21 NC Division of Public Health, Increase in Disseminated Gonococcal Infections

This memo:

describes an increase in confirmed disseminated gonococcal infections (DGI) in North Carolina between January 1 and December 31, 2020
describes DGI
includes recommendations for clinicians
includes recommendations for local, clinical and commercial laboratories

DGI Health Alert - Increase in Disseminated Gonococcal Infections

4-13-21 Centers for Disease Control and Prevention and Food and Drug Administration

4-27-21 Updated Recommendations from the Advisory Committee on Immunization Practices for use of the Janssen (Johnson & Johnson) Vaccine After Reports of Thrombosis with Thrombocytopenia Syndrome Among Vaccine Recipients-United States, April 2021. https://www.cdc.gov/mmwr/volumes/70/wr/mm7017e4.htm?s_cid=mm7017e4_e&ACSTrackingID=USCDC_921-DM55766&ACSTrackingLabel=MMWR%20Early%20Release%20-%20Vol.%2070%2C%20April%2027%2C%202021&deliveryName=USCDC_921-DM55766

4-13-21 CDC Health Alert: Cases of Cerebral Venous Sinus Thrombosis with Thrombocytopenia after Receipt of the Johnson & Johnson COVID-19 Vaccine
https://emergency.cdc.gov/han/2021/han00442.asp

Joint CDC and FDA Statement on Johnson & Johnson COVID-19 Vaccine. https://www.cdc.gov/media/releases/2021/s0413-JJ-vaccine.html

Joint CDC and FDA Statement on Johnson & Johnson COVID-19 Vaccine

The following statement is attributed to Dr. Anne Schuchat, Principal Deputy Director of the CDC and Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research

Media Statement

For Immediate Release: Tuesday, April 13, 2021

Contact: Media Relations

(404) 639-3286

As of April 12, more than 6.8 million doses of the Johnson & Johnson (Janssen ) vaccine have been administered in the U.S. CDC and FDA are reviewing data involving six reported U.S. cases of a rare and severe type of blood clot in individuals after receiving the J&J vaccine. In these cases, a type of blood clot called cerebral venous sinus thrombosis (CVST) was seen in combination with low levels of blood platelets (thrombocytopenia). All six cases occurred among women between the ages of 18 and 48, and symptoms occurred 6 to 13 days after vaccination. Treatment of this specific type of blood clot is different from the treatment that might typically be administered. Usually, an anticoagulant drug called heparin is used to treat blood clots. In this setting, administration of heparin may be dangerous, and alternative treatments need to be given.

CDC will convene a meeting of the Advisory Committee on Immunization Practices (ACIP) on Wednesday to further review these cases and assess their potential significance. FDA will review that analysis as it also investigates these cases. Until that process is complete, we are recommending a pause in the use of this vaccine out of an abundance of caution. This is important, in part, to ensure that the health care provider community is aware of the potential for these adverse events and can plan for proper recognition and management due to the unique treatment required with this type of blood clot.

Right now, these adverse events appear to be extremely rare. COVID-19 vaccine safety is a top priority for the federal government, and we take all reports of health problems following COVID-19 vaccination very seriously. People who have received the J&J vaccine who develop severe headache, abdominal pain, leg pain, or shortness of breath within three weeks after vaccination should contact their health care provider. Health care providers are asked to report adverse events to the Vaccine Adverse Event Reporting System at https://vaers.hhs.gov/reportevent.html.

CDC and FDA will provide additional information and answer questions later today at a media briefing https://www.cdc.gov/media/releases/2021/0106-covid-19-Update.html. A recording of that media call will be available on the FDA’s YouTube channel.

### U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Johnson and Johnson vaccine recipients who develop severe headache, abdominal pain, leg pain, or shortness of breath within three weeks after vaccination should contact their health care provider. Health care providers are asked to report adverse events to the Vaccine Adverse Event Reporting System at https://vaers.hhs.gov/reportevent.htmlexternal icon.

12-01-2020 NC Department of Health and Human Services

Multisystem Inflammatory Syndrome in Children Associated with COVID-19 (MIS-C)
(replaces version dated 05.14.2020)

This memo updates May 14, 2020 guidance intended to provide information about identification and reporting of Multisystem Inflammatory Syndrome in Children (MIS-C) potentially linked to COVID-19.

10-30-2020 NC Department of Health and Human Services

Extension of Temporary Suspension of Immunization and School Health Assessment Requirements due to the COVID-19 Pandemic (Update from July 16)

The temporary suspension of requirements to provide certificates of immunization and school health assessments is extended through November 30, 2020.

10-30-2020 Wake County Health & Human Services Public Health Division

FBI, CISA, and HHS Warn of Ransomware Activity Targeting the Healthcare and Public Health Sector

10-27-2020 Wake County Health & Human Services Public Health Division

Wake County health care providers: Reporting COVID-19 test results

In North Carolina, clinicians and laboratories are required to report all results for both COVID-19 molecular (PCR) and antigen tests. Because not all commercial laboratories and point of care results automatically feed to State Public Health, we rely heavily on Wake County providers to assure notification of the Wake County Health Department and that providers have a good process in place for rapid reporting of positives, as well as routine reporting of negative results.

Report positive COVID-19 test results on the Confidential Communicable Disease Report-Part 1 form.

Fax results to 919-743-7362. Send lab report and visit notes with the completed Confidential Communicable Disease Report - Part 1 form.

Report negative COVID-19 test results. Submit weekly totals of negative results each Friday (or last business day of the week). No special form is needed, simply provide the number of negative tests and time frame of results. (example: 50 negatives, October 5-9, 2020)

Fax: results to 919-743-7362 OR
mailto: [email protected]

Prompt reporting allows our investigation team to quickly follow up with COVID infected persons and trace their contacts and helps us provide timely and accurate data. Visit the following NCDHHS web link for NC DHHS Guidance for Reporting of COVID-19 Diagnostic Test Results.

Wake County physicians should continue to report cases or suspected cases of ALL OTHER reportable diseases to Wake County Health & Human Services Public Health Communicable Disease Surveillance team:

Phone: 919-250-4462
Fax: 919-212-9291

Thank you for your work to curb the spread of COVID-19 in our community!

10-08-2020 NC Division of Public Health

Antigen Testing (Update from September 1, 2020)

Using, Interpreting, and Responding to COVID-19 Antigen Tests

This memo provides updated guidance on antigen testing for providers and laboratories. Updates to this guidance include:

Use of antigen tests
Evaluation of antigen test results
Steps to take after a positive or negative test result
Reporting requirements and methods

7-06-2020 NC Division of Public Health

Coronavirus 2019

This memo updates previous guidance shared on June 9, 2020. It is intended to provide the latest information to all North Carolina clinicians and laboratory staff regarding the Coronavirus Disease 2019 (COVID-19). Please read thoroughly as there are several updates, including:

Added link to Steps for People to Take After COVID-19 Testing (Spanish) for patients undergoing testing due to symptoms or known or a suspected exposure

7-31-20 NC Division of Public Health

Antigen Testing (Update from July 16)

This memo provides updated guidance on antigen testing for providers and laboratories. The updated guidance covers:

Background on antigen testing
Populations and settings in which antigen testing should be considered
Populations and settings in which antigen testing should not be considered
Steps to takes after a positive or negative test result
Reporting requirements

7-6-20 NC Division of Public Health

Coronavirus 2019

Steps for People to Take After COVID-19 Testing for patients undergoing testing due to symptoms or known or a suspected exposure:

COVID19 Home IQ Guidelines and Directives Packet [English]
COVID19 Home IQ Guidelines and Directives Packet [Spanish]

5-20-20 NC Division of Public Health

Call for Cases: Clinician-suspected SARS-CoV-2 reinfection among COVID-19 cases

This memo is intended to provide information and request reporting of clinician-suspected SARS-CoV-2 reinfection among COVID-19 cases.

5-16-20 Wake County Health & Human Services Division of Public Health

COVID-19 Antibody Testing

This memo addresses questions being asked by the public and patients about COVID-19 antibody testing and immunity. 

5-14-20 Centers for Disease Control and Prevention (CDC)

CDC Health Advisory: 
Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with Coronavirus Disease 2019 (COVID-19)

The Centers for Disease Control and Prevention (CDC) is providing:

background information on several cases of a recently reported multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19); and 
a case definition for this syndrome. CDC recommends healthcare providers report any patient who meets the case definition to local, state, and territorial health departments to enhance knowledge of risk factors, pathogenesis, clinical course, and treatment of this syndrome.

5-14-20 NC Division of Public Health

Multisystem Inflammatory Syndrome in Children Associated with COVID-19

This memo is intended to provide information regarding identification and reporting of a pediatric multisystem inflammatory syndrome potentially linked to COVID-19.

4-13-20 NC Division of Public Health, Epi/CD/TB Control

Deferring Baseline Tuberculosis Screening for New Hires

This memo describes, in order to maintain social distancing, groups for whom the NC Tuberculosis Control Program recommends deferred baseline TB screening. 

4-9-20 NC Division of Public Health

 NC EDSS COVID-19 Reporting From --Part 2

Updates

Updated public health information specific to an incident or situation. Information posted here is unlikely to require immediate action.

There are no updates as of 8.12.20

Communicable Disease Resources

Communicable Disease Reporting

What communicable diseases must be reported?
- Reportable diseases and conditions in North Carolina
Who must report communicable diseases?
- 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.
How do you report communicable diseases in Wake County?
- Report communicable diseases to Wake County Health & Human Services Communicable Disease Surveillance Team
  Call: 919-250-4462
  Fax: 919-212-9291
  - Non-urgent reports. Non urgent reports can be made outside of normal business hours, on weekends or holidays by leaving a message on the Communicable Disease Line, 919-250-4462. Please provide a contact name and number for the CD Nurse to call you back the following business day. This number is checked during weekends and holidays at 9 a.m., 1 p.m. and 5 p.m.
  - Urgent reports. Should you need to alert us of an immediate Public Health threat, specifically as it relates to suspicion or confirmation of the conditions or events noted below, the Emergency CD Line 919-404-7575 will be answered immediately or will return your call within 15 minutes:
    - Novel and/or highly infectious diseases (measles, mumps, Ebola, Middle Eastern Respiratory Syndrome)
    - Biologic toxins, hazardous chemicals or mass casualties