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Health Alerts

The Snohomish Health District Health Officer Dr. Gary Goldbaum sends alerts via email to local health care providers. Alerts cover current local, regional or national health threats and important updates on medical care and protocols. Alerts are written as needed to cover urgent or emergent health issues.

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Immunizations & Travel Services & Sexually Transmitted Infections & Pertussis & Duodenoscopes

Today’s topics:

  • Immunizations & Travel Services
  • Sexually Transmitted Infections
  • Pertussis
  • Duodenoscopes


Immunizations & Travel Services

As funding for public health has declined dramatically since 2008, the Health District has been compelled to redirect existing resources.  Because immunizations and travel services are available in the community, the Board of Health has approved plans to permanently close by the end of June our clinics offering these services. This move follows the recent relocation of these services solely to the Lynnwood site following water damage at the Everett location. Alternative providers of travel services have been identified and will be posted to our website in June.  Providers who have referred patients to the Health District for other special services (such as the complete pediatric vaccination series for adults following stem cell transplants) will need to arrange for alternatives in the community.  This transition will allow the Health District to better focus on efforts to increase awareness of the need for immunizations, as well as to provide other public health services that are not readily available in the community.  For more information about the clinic closure and current referral resources, see

Although the immunization and travel clinics will be closing, other services will remain at the Everett location. The Health District will continue to provide HIV testing and STD referrals, communicable disease surveillance and monitoring, tuberculosis treatment, and support to providers who offer immunizations. The WIC, First Steps, and Refugee Health programs are also not impacted by this closure. Residents needing immunization records after June 30 will be able to request them through the Vital Records section. More detailed information can be found at

Sexually Transmitted Infections
Background & Recommendations

Gonorrhea and syphilis cases have been increasing over the past year.  In 2014, we received 402 reports of gonorrhea and 66 reports of syphilis, compared with 249 reports of gonorrhea and 35 reports of syphilis for 2013.   Although the incidence of infections among heterosexuals has increased significantly, men who have sex with men remain at highest risk.

To assist providers, the Health District recently added a useful webpage to our website:  Included is information about screening, treatment, expedited partner therapy, and training opportunities, as well as an updated case report form.  Providers offering HIV pre-exposure prophylaxis (PrEP) to MSM will find a chart (STD Screening Chart for MSM) of recommended STD screening guidelines for MSM (part of the 3 month PrEP follow up for any MSM patients).  Also note our PrEP webpage, where you can download information for clients, along with the current PrEP provider list:

Background & Recommendations

The number of confirmed pertussis cases reported has increased dramatically in Washington this year.  For 2015 to date, 158 cases have been reported across the state, compared to 24 for the same period in 2014.  In Snohomish County, 15 cases have been reported this year to date, compared to 23 for all of 2014.  Although treatment is important, it is critical that providers do everything they can to assure that all patients ages 6 months and older have been appropriately vaccinated.  Note that pregnant women should be vaccinated with every pregnancy.  For vaccination guidelines, see


In response to recent outbreaks of infections with multi-drug resistant bacteria associated with flexible esophagogastroduodenoscopy (EGD) duodenoscopes despite following the manufacturer’s guidelines for reprocessing, CDC today posted interim protocols for conducting surveillance cultures of EGD duodenoscopes in healthcare facilities. Healthcare facilities are urged to implement a surveillance program for monitoring adequacy of EGD scope reprocessing.


  • Have a comprehensive quality program in place for reprocessing duodenoscopes.
  • Before initiating surveillance cultures, involve key staff (including the clinical laboratory director, clinical staff, infection prevention staff, hospital epidemiologists, and risk management staff) to develop a plan for implementation and response (e.g., patient notification) to surveillance culture results.  For guidance, see
  • If you suspect that a duodenoscope may be associated with a patient infection, take it out of service and meticulously clean and disinfect it until it is verified to be free of pathogens.
  • Inform patients of the benefits and risks associated with ERCP procedures, including the risk of possible infection.
  • Discuss with your patients what they should expect following the ERCP procedure and what symptoms (such as fever or chills, chest pain, severe abdominal pain, trouble swallowing or breathing, nausea and vomiting, or black or tarry stools) should prompt additional follow up.
  • Submit a report to the manufacturer and to the FDA via MedWatch if you suspect problems have led to patient infections.
  • Report outbreaks (2 or more cases) to the Communicable Disease team at 425-339-5278.

For additional information, see:


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Communicable Disease


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Health alerts include information about diseases or other health risks or issues that affect Snohomish County.