1. Jackie Dawson, PhD Public Health Epi Chelan, Douglas, Grant, Kittitas and Okanogan Counties 509-886-6428 jacqueline.dawson@ cdhd.wa.gov R7 HCC EPI UPDATE EBOLA, FLU & MEASLES

2. EBOLA CASE COUNT JAN 12, 2015 www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/distribution-map.html www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/case-counts.html

3.  Dec 19, 2014: Nurse exposed to Ebola while volunteering in Sierra Leone was released from NIH  No clinical or laboratory evidence of Ebola infection  21 days of monitoring at a private residence in Virginia under the direction of the VA Department of Health AMERICAN NURSE EXPOSED TO EBOLA DECEMBER 2014

4. US HCW ARRIVES AT NE MEDICAL CENTER, JAN 4, 2015 www.washingtonpost.com/news/post-nation/wp/2015/01/04/u-s-health-care-worker-exposed-to-ebola-to-arrive-in-nebraska-for-observation/

5. NE MED CENTER TRANSPORT & SECURITY

6. TRANSPORT & SECURITY

7.  39-year-old nurse volunteered for “Save the Children” in Sierra Leone.  Traveled home to Scotland via Casablanca, Morocco, and London.  Initially screened at Heathrow, where her temperature was normal, despite telling officials that she felt unwell.  Her temperature was taken a further six times within 30 minutes, but it was normal each time and she was cleared to fly on to Scotland.  Transported back to London for medical care after testing positive.  Treated with experimental drugs and has received blood plasma from another British nurse who recovered from an Ebola infection last year.  No longer critically ill with Ebola SCOTTISH NURSE ILL WITH EVD DECEMBER 29, 2014

8. REGION 7 EVD EMS PLAN & NEW CDC GUIDANCE EMSTransport own patients inside Region 7Transport own patients outside Region 7Contact BallardYesYes if rig available at time of request.Mike Battis or Shawn Ballard CMCYesNoBrian Pulse LCCHYesPossibly if rig available at the time of requestRay Eickmeyer or Karl Johnson LifelineYes, but only dry patientsPossibly if rig available at the time of requestWayne Walker www.cdc.gov/vhf/ebola/pdf/ems-911-patients-with-possible-ebola.pdf

9.  47 individuals monitored in WA during holidays  King Co to Chelan Co- HCW  NV to Okanogan Co- mine worker EVD MONITORING IN WA

10.  Up to 50% of travelers, monitored in WA, are from Mali  Many Malians work on fishing boats out of WA harbors.  CDC just removed Mali from the list of countries whose travelers will be screened/monitored, so the number of people being monitored will decline.  Currently 20 people being monitored in WA.  Travelers from Mali will complete their 21 day monitoring period. EVD MONITORING IN WA- TRAVELERS FROM MALI

11.  Most U.S. acute care facilities that are equipped for emergency care (such as hospital-based emergency departments and other emergency care settings including urgent care clinics, and critical access hospitals) are in this tier.  Frontline healthcare facilities do not include primary care offices and other non-emergent ambulatory care settings. FRONTLINE HEALTHCARE FACILITIES

12. http://www.cdc.gov/vhf/ebola/hcp/preparing-ebola-treatment-centers.html

13.  WA Treatment Centers:  Harborview  Seattle Children’s Hospital  Multicare  Sacred Heart Medical Center EVD HCF IN WA

14. NIH AND GLAXOSMITHKLINE www.forbes.com/sites/kerryadolan/2015/01/12/the-art-of-saving-a-life-an-ebola-drug-trial-in-mali/

15. INFLUENZA

16.  USA: 68.4% A/H3N2 = Switzerland strain not included in the 2014-15 Northern Hemisphere influenza vaccine.

18. INFLUENZA WEEK 53

19. INFLUENZA UTD WEEK 53 DEATHS

20.  Eggs, poultry, and poultry products from domestic flocks can't be moved out of the Tri-Cities because of an emergency quarantine to limit the spread of avian flu, H5N2.  WSDA quarantine took effect 7 Jan 2015 and covers about 20 miles near 2 Benton County locations where backyard flocks of chickens, turkeys, ducks, and guinea fowl were found to have avian influenza.  Same strain, H5N2, found in a wild pintail duck in Whatcom County and in outbreaks in Canada.  No evidence of HPAI H5N2 or H5N8-related illness in humans, but it is deadly to birds.  Quarantine could be in effect for up to 8 months.  May be related to an HPAIV H5N8 previously known to have circulated during 2014 among wild birds and poultry in Asia and Western Europe. AVIAN INFLUENZA IN WA JANUARY 2015

21.  2014-N=32; 2013-N=4; 2012-N=0; 2011-N=4  Disneyland Dec 17-18, 2014  Unimmunized woman in her 20s flew from CA to SeaTac Airport on December 29, stayed with family in Snohomish County paid a visit to Vancouver, B.C. and flew out of SeaTac airport on January 3 to return home. The traveler was contagious for measles during her entire trip.  Case in Grays Harbor County-2015  Cases in CA, UT, CO  CDC calls measles the “most deadly of all childhood rash/fever illnesses” DISNEYLAND VISITORS BRING MEASLES HOME TO WA

22.  Common:  Ear infections: 1 in 10 children permanent hearing loss  Diarrhea: <1 in 10 people  Severe:  Pneumonia: 1 in 20 children- most common cause of death in young children  Encephalitis: 1 in 1,000 children- can lead to convulsions and leave the child deaf or mentally challenged  Death: 1 or 2 in 1,000 children  Pregnant woman: give birth prematurely or low-birth-weight baby  Long-term: Subacute sclerosing panencephalitis (SSPE) is a very rare, but fatal disease of the central nervous system that results from a measles virus infection acquired earlier in life.  Develops 7 to 10 years after disease even though the person “fully recovered”  1989-1991: 4 to 11 in 100,000 at risk  SSPE may be higher for a person who gets measles before they are 2 years COMPLICATIONS OF MEASLES 20 YEARS OF AGE ARE MORE LIKELY TO SUFFER www.cdc.gov/measles/about/complications.html