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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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Opioid addiction treatment resource, Transmission of Zika virus in the US, Antibiotic-resistant gonorrhea, Health Officer transition

Today’s topics:

  • Opioid addiction treatment resource
  • Transmission of Zika virus in the US
  • Antibiotic-resistant gonorrhea
  • Health Officer transition


Opioid addiction treatment resource

Actions requested:  Be aware of expanded local opioid treatment resources.


Like many other counties, Snohomish County lacks sufficient capacity to treat opioid addiction, particularly for persons with Medicaid coverage.  A new resource has just become available.  Ideal Option is a private group of physicians who offer an array of addiction treatment services, focusing on opioid dependency through Medication Assisted Treatment with Suboxone. The Ideal Option protocol requires patients to be seen twice a week for the first two weeks, then once a week the next three weeks.  Patients deemed stable by their provider can then be seen every two weeks. At every appointment, patients get a urine drug test, plus any necessary blood work.  The group has opened an office at 3624 Colby Avenue (Suite B) in Everett.  The office accepts referrals from outside providers via fax at 509-491-3031. To reach Ideal Option directly by phone, call 509-222-1275.  For more information about this service, see


Transmission of Zika virus in the US

Actions requested:  Advise pregnant women to avoid travel to the Miami Beach area.

Background & Recommendations

See prior Health Alerts for background on and recommendations about Zika virus.  Because our understanding of Zika virus is evolving, recommendations of the Centers for Disease Control and Prevention (CDC) are changing frequently.  Active Zika virus transmission previously documented in a limited area near Miami Beach has now been documented in a wider area, leading to a broader recommendation that pregnant women avoid travel to the Miami Beach area.  For current travel advisories and other guidance about Zika virus, see


Antibiotic-resistant gonorrhea

Actions requested:  Treat uncomplicated gonorrhea with both ceftriaxone and azithromycin, and advise the patient to avoid sex for at least seven days following treatment and until all sex partners have been adequately treated.

Background & Recommendations

The Health District recently investigated a case of gonorrhea that was treated with only ceftriaxone and the patient was advised that using a condom would be sufficient following treatment.  Given resistance documented to oral cephalosporins (notably cefixime) and tetracyclines, CDC now recommends that uncomplicated gonorrhea be treated with dual therapy: ceftriaxone 250 mg IM in a single dose plus azithromycin 1 g orally in a single dose.  Moreover, condoms are not sufficient protection when gonorrhea has been diagnosed—patients should be advised to abstain from sex for at least seven days following treatment and until all sex partners have been adequately treated.  For more guidance, refer to the 2015 Sexually Transmitted Diseases Treatment Guidelines at


Health Officer transitions

Effective the end of March, 2017, I’ll be retiring from my role as Health Officer and Director of the Snohomish Health District.  I will have served you and all the residents of Snohomish County for ten rewarding years.  I’m looking forward to spending more time with family, more time traveling, and even some time to continue promoting public health as a “civilian”.  However, until then, I intend to remain fully engaged in the essential work of public health here in Snohomish County!


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.