Jackson county health department

Ted Westmeier, RS, MPH Donald Lawrenchuk, MD, MPH Director Pertussis Immunization Update
In October 2010 the Advisory Council on 1. Pertussis Immunization Update Immunization Practices (ACIP) voted to broaden 3. Children’s Special Health Care recommendations for the use of Tdap based on the current increases in pertussis cases in the US. In January 2011, the following new Tdap guidelines were published in the MMWR: • Tdap can be administered regardless of the interval since the last Td vaccine was given. • All adolescents and adults ages 11 through 64 years who have not received a dose of Tdap or whose vaccination status is unknown should receive a single dose of Tdap as soon as feasible. • Adults age 65 years and older who have not previously received Tdap, and who have or who anticipate having close contact with a child younger than age 12 months, should receive a single dose of Tdap to reduce the likelihood of transmitting pertussis to an infant. Other adults age 65 years and older who have not previously received Tdap may be given a single dose of Tdap in place of Td (tetanus and diphtheria toxoid). • Children ages 7 through 10 years who did not complete a primary series of pertussis-containing vaccine (DTaP) should receive a single dose of Tdap as part of their catch-up schedule. • Though giving Tdap vaccine to people 7 through 9 years and 65 years and older is off-label use, CDC recommends use of the vaccine regardless. Additionally, in October 2010 the ACIP voted to enhance protection against meningitis by recommending a booster dose. The new recommendations include: • Give MCV4 #1 routinely at age 11 through 12 years and a booster dose at age 16 years.
• Give MCV4 to all unvaccinated teens ages 13 through 18yrs; if vaccinated at age 13–15 years, give
• Vaccinate all college freshmen living in dorms who have not been vaccinated. • Vaccinate all children age 2 years and older who have any of the following risk factors: ™ Anatomic or functional asplenia, persistent complement component deficiency, or HIV infection; ™ Travel to or reside in countries in which meningococcal disease is hyperendemic or epidemic (e.g., the “meningitis belt” of Sub-Saharan Africa). (CONTINUED ON NEXT PAGE)
Jackson County Health Department
1715 Lansing Avenue, Ste. 221, Jackson MI 49202 ™ If previously vaccinated with MPSV4 or MCV4 and risk of meningococcal disease persists, revaccinate with Menactra in 3 years (if first dose given at age 2 through 6years) or revaccinate with either brand of MCV4 in 5 years (if previous dose given at age 7 years or older). Then, give additional booster doses every 5 years if risk continues. Note: Use MPSV4 ONLY if there is a permanent contraindication or precaution to MCV4.
These changes have been highlighted in the January 2011 publication of Needle Tips. To access the changes on line go. For questions or additional information, contact the JCHD Immunization Program at 768-1631. STD Update
The Sexually Transmitted Diseases Treatment Guidelines, 2010 were published in the CDC December 17, 2010 issue of the Morbidity and Mortality Weekly Report (MMWR) Recommendations and Reports. The Guidelines include the following; • Expanded STD prevention recommendations, including HPV vaccination, • Revised gonorrhea treatment regimens, • New treatment regimens for genital warts and bacterial vaginosis, • The role of Mycoplasma genitalium and trichomoniasis in the evaluation of urethritis and cervicitis and treatment-related implications, and • Revised guidance on the diagnostic evaluation and management of syphilis Incorrect dosage information was published in the initial Guidelines. Two significant corrections pertain to the recommended regimens for gonococcal infections, which include gonococcal dual therapy, and the alternative regimes for bacterial vaginosis. The corrected dosages are highlighted in the two boxes below: Uncomplicated Gonococcal Infections of the Cervix, Urethra, and Rectum
Recommended Regimens
Ceftriaxone 250 mg IM in a single dose
Cefixime 400 mg orally in a single dose
Single-dose injectible cephalosporin regimens
Azithromycin 1g orally in a single dose
Doxycycline 100 mg orally twice a day for 7 days
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Jackson County Health Department
1715 Lansing Avenue, Ste. 221, Jackson MI 49202 Bacterial Vaginosis
Alternative Regimens
Tinidazole 2 g orally once daily for 2 days
Tinidazole 1 g orally once daily for 5 days
Clindamycin 300 mg orally twice daily for 7 days
Clindamycin ovules 100 mg intravaginally once at bedtime for 3 days
CDC recommends that clients testing positive for N. Gonnorhea and Chlamydia Trachomatis be retested approximately 3 months after treatment. Providers are strongly encouraged to retest all clients treated for these infections whenever they seek medical care within the following 12 months to rule out re-infection. Retesting should be done regardless of whether the client believes his or her sex partners were treated. These clients and their sex partners should be tested for syphilis and HIV as well. A copy of the Guidelines can be obtained at As a reminder, Michigan’s public health laws require that all cases of Gonnorhea, Chlamydia, Syphilis and HIV are to be reported to the local public health department. For questions or reporting requirements, contact the JCHD STD Program at 788-4477. Children’s Special Health Care Services
There have been a couple of changes to Children’s Special Health Care Services (CSHCS) that we wanted to make you aware of: • On October 1, 2010 transportation assistance was reinstated to all recipients of CSHCS. This can be mileage reimbursement or actual rides to the out of town specialist if the family has no other way to get there. • On November 1, 2010 a new policy was started. If a CSHCS recipient appears to be eligible for MIChild or Medicaid based on the income information submitted with their application they will be required to apply for MIChild/Medicaid. Recipient’s will be given 3 months of eligibility and then must complete the MIChild/Medicaid application during that time. We are available at the local CSHCS office at 788-4422 to assist families with the application. Jackson County Health Department
1715 Lansing Avenue, Ste. 221, Jackson MI 49202

Source: http://www.co.jackson.mi.us/Agencies/HD/public_health_updates/docs/PHU_February_2011.pdf