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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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Zika virus transmission & testing; Tuberculosis guidelines; and Breastfeeding & treatment for opioid addiction

Today’s topics:

  • Zika virus transmission & testing
  • Tuberculosis guidelines
  • Breastfeeding & treatment for opioid addiction

Zika virus transmission, testing, & management

Action requested:  Be aware of local Zika virus transmission in Florida and that commercial laboratory testing for Zika virus is available.

Background & Recommendations

In addition to widespread mosquito-borne transmission of Zika Virus in Puerto Rico, such transmission has been confirmed in two neighborhood of Miami, Florida.  Pregnant women should avoid travel to this area.  Anyone traveling to the area should take special care to avoid mosquito bites.  If a person meeting clinical testing criteria traveled to this location since June 15th, testing can be offered.  For further guidance, see

LabCorp is now offering IgM ELISA testing. LabCorp will follow CDC’s testing algorithm, and any specimens that test positive/equivocal/indeterminate will be forwarded directly from LabCorp to CDC for confirmation. LabCorp will report positive, equivocal, indeterminate, and negative results to local health jurisdictions.

The Centers for Disease Control & Prevention (CDC) has updated its interim guidance for health care providers caring for infants born to mothers with possible Zika virus infection during pregnancy.  For details, see,

Tuberculosis guidelines

Action requested:  Be aware of new guidelines for managing active tuberculosis.

Background & Recommendations

The American Thoracic Society, Centers for Disease Control & Prevention, and the Infectious Diseases Society of America have issued new guidelines for managing drug-susceptible tuberculosis in well-resourced settings.  The guidelines update those previously published in 2003.  The guidelines provide recommendations on the management of patients who are co-infected with TB disease and HIV, as well as sections on TB disease in special situations, such as extra pulmonary TB, culture-negative pulmonary TB, and TB during pregnancy and breastfeeding.  Access the guidelines at


Breastfeeding & treatment for opioid addiction

Action requested:  Consider attending an upcoming mini-forum on issues of interest to those who care for women who are breastfeeding while being treated for addiction.

Background & Recommendations

The Snohomish Health District is sponsoring a mini-forum on how to advise women who are breastfeeding while being treated for opioid addiction.  Dr. Jim Walsh, Director of Swedish Addiction Recovery Service, will discuss the safety of breastfeeding for mothers in treatment, as well as the role of methadone and buprenorphine in addiction treatment.  Cleo Harris, Alcohol & Other Drugs Treatment Specialist with Snohomish County Human Services, will provide an overview of naloxone and how it is used in Snohomish County to stop overdoses.  This free event will be 8:30 – 10 AM on Thursday, September 8, 2016, in the auditorium at the Snohomish Health District (3020 Rucker Avenue, Everett, WA 98201).  Register at


You can find my recent health alerts posted on the Provider pages of our website, at

Gary Goldbaum, MD, MPH | Health Officer & Director | Administration

3020 Rucker Avenue, Ste 306 | Everett, WA 98201 | 425.339.5210 |


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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.