Washtenaw County Epi Update: Listeria Testing (7/23/14)

Washtenaw County Public Health (WCPH) received further guidance from MDCH and CDC regarding possible patient exposure to Listeria monocytogenes. Below is information from the CDC about testing for Listeria. Invasive listeriosis is most often diagnosed through blood or cerebrospinal fluid culture.

“Although the guidance document suggests stool culture as an option, it is important to note that stool testing for Listeria has not been evaluated as a screening tool for listeriosis and, in general, is not recommended for the diagnosis of listeriosis. Ingestion of Listeria occurs frequently because the bacterium is commonly present in the environment. Therefore, intermittent fecal carriage and shedding of Listeria is frequent (about 5% in unselected populations, but substantial variation exists) and rarely indicative of infection. Stool culture for Listeria may also have low sensitivity and, is not available in the vast majority of clinical laboratories.“ (CDC)

CDC Listeria website: http://www.cdc.gov/listeria/index.html

Washtenaw County Epi Update: Listeria (7/22/14)

Washtenaw County Public Health (WCPH) received several phone calls today from clinicians asking for guidance regarding possible patient exposure to Listeria monocytogenes.

Clinician reminder: If an individual has symptoms consistent with Listeria infection, please test and report positive cases to public health. Note that the incubation period is typically 3 weeks but ranges from 3 – 70 days.

Some fresh peaches, nectarines and other stone fruit are being recalled for possible contamination with Listeria monocytogenes. The recalled fruit is from a California packing company but it was distributed nationwide, including to several local retailers (Costco, Sam’s and Trader Joe’s). No human cases have been reported to date.

Recall notice: http://www.fda.gov/Safety/Recalls/ucm405943.htm

WCPH Listeriosis Fact Sheet: http://www.ewashtenaw.org/government/departments/public_health/disease_control/cd_fact_sheets/listeriosis.pdf

Reminder Mayoral Candidates Address Affordable Housing and Homelessness at Forum Tonight at 7 pm

The four Ann Arbor mayoral candidates—Sabra Briere, Stephen Kunselman, Sally Hart Petersen, and Christopher Taylor—will address issues of affordable housing and homelessness at a public forum hosted by St. Clare of Assisi Episcopal Church and Temple Beth Emeth on July 15 at 7 p.m. Candidates will speak briefly about housing and homelessness issues and address questions from the audience. The evening promises to be a great way for citizens to learn how the next mayor will approach these pressing issues. The forum will be followed by a reception, with time for informal conversation.

Date: Tuesday, July 15, 2014
Time: 7 p.m.
Location: Genesis of Ann Arbor, 2309 Packard Road

For more information: chrismodey@yahoo.com or shoshie@umich.edu

Mayoral Candidates Address Affordable Housing and Homelessness, Tuesday, July 15 at 7 p.m.

The four Ann Arbor mayoral candidates—Sabra Briere, Stephen Kunselman, Sally Hart Petersen, and Christopher Taylor—will address issues of affordable housing and homelessness at a public forum hosted by St. Clare of Assisi Episcopal Church and Temple Beth Emeth on July 15 at 7 p.m. Candidates will speak briefly about housing and homelessness issues and address questions from the audience. The evening promises to be a great way for citizens to learn how the next mayor will approach these pressing issues. The forum will be followed by a reception, with time for informal conversation.

Date: Tuesday, July 15, 2014
Time: 7 p.m.
Location: Genesis of Ann Arbor, 2309 Packard Road
For more information: chrismodey@yahoo.com or shoshie@umich.edu

https://www.facebook.com/events/316576878493357/

Highlights from the latest WCMS Legislative Update Meeting

Highlights from the WCMS Legislative Update Meeting include the following ongoing issues:

Scope of Practice Expansion, Senate Bill 2
Introduced by Senator Mark Jansen

Senate Bill 2 would amend the Public Health Code to provide for the licensure of advanced practice registered nurses (APRNs), who would include certified nurse midwives, nurse practitioners, and clinical nurse specialist-certifieds; and eliminate provisions regarding the specialty certification of nurse midwives and nurse practitioners. Senate Bill 2 proposes nurse practitioners can practice without the overview of physicians and authorizes a licensed APRN to possess, prescribe, and administer nonscheduled prescription drugs and controlled substances included in Schedule 2 through 5.

WCMS does not support the passing of this Bill, and continues to strive for a teamwork approach in medical care with APRNs, exercising direct contact with a supervising physician on site. The length of medical training required for general practitioners, specialists and nurse practitioners versus education and training required of physicians was also discussed.

Nurse Anesthetist Expansion, Senate Bill 180
Introduced by Senator Mike Green

Senate Bill 180 would amend the Public Health Code to include the administration of anesthesia by a nurse anesthetist in the definition of “practice of nursing” and could administer anesthesia without supervision.

WCMS discussed the issues with this bill which led to further discussion on the “Patients Right to Know Act,” that is currently in the House of Representatives. This Act would require clear identification of MDs, nurse practitioners, and physician’s assistants. This bill is receiving resistance from hospitals and chambers of commerce. Representative David Rutledge will speak to Representative Haines about the “Patients Right to Know Act,” and what needs to be done to have this bill pass the House.

Graduate Medical Education

The Michigan legislature kept GME at the current fiscal year levels.

Michigan Essential Health Provider Program Expansion, Senate Bill 648

Senate Bill 648 modifies Part 27 of the Public Health Code regarding the Michigan Essential Health Provider Program, related to the State Loan Repayment Program. The State Loan Repayment Program is a state/federal program to assist primary care providers in the repayment of medical education loans, in exchange for service in designated health professional shortage areas for 2 to 4 years.

Senate Bill 648 would:
• Allow eligible dentists to participate
• Revise the maximum annual state loan repayment amount per participant to $40K, rather than an increasing scale of $25K to $28,940
• Remove a 4-year maximum for participation in the program
• Establish a maximum total loan repayment amount of $200K per participant.
• Limit provider group specialty areas that may be given preference by the Department of Community Health when enrolling participants in the state loan repayment program to general practice, family practice, obstetrics, pediatrics, or internal medicine.

Expedited Partner Therapy, House Bill 4736
Sponsored by Representative George Darany

Expedited Partner Therapy (EPT) is the clinical practice of treating sex partners of patients diagnosed with a sexually transmitted disease without clinical assessment of the partners. This is typically done by clinicians providing prescriptions or medications to the patient to give to his/her partner. Under Michigan law, a physician or authorized prescriber may only write a prescription for his or her patient.

House Bill 4736 would:
• Authorize expedited partner therapy to protect individuals from the spread of sexually transmitted infections
• Require the Department of Community Health to include a separate list of sexually transmitted infections appropriate for EPT in its list of reportable diseases and infections
• Allow health professionals to provide EPT if certain conditions were met, including prescribing or dispensing medication to the patient’s partner without an examination
• Grant immunity to health professionals providing EPT from civil and administrative actions, except for gross negligence.

Rapid Diagnostic Testing in Pharmacies

Ferris State University College of Pharmacy is offering a pilot program that trains pharmacists on rapid diagnostic testing. This program allows pharmacists to test, diagnose, and treat for strep and influenza. This is happening in 26 pharmacies and mainly in Meijer stores. A letter from our Legislative Chair, and MSMS District Director #14, James Mitchiner, MD, was sent to the Bureau of Health Professions for action.

Upcoming Issues:


Reinstatement of the Helmet Law

WCMS has requested to legislators the re-instatement of the helmet law. In response, Senator Rebekah Warren has requested their Legislative Service Bureau draft a bill to reinstate Michigan’s mandatory motorcycle helmet law. WCMS will be following the progression of this bill.

Legislation Regarding Voting Among Elderly Population with Dementia

During the MSMS House of Delegates meeting, Board Action Report 8-13 – Resolution 57-13 – Voting Rights for Patients with Dementia – was approved as amended.

The resolution requests MSMS present legislation mandating that patients who have been declared legally incompetent to manage their finances and medical care be prohibited from voting in all local, state, and national elections; to have their names removed from the statewide qualified voter list (to prevent voting fraud by absentee ballot); and MSMS provide education to physicians to report legally declared incompetent patients to the Michigan Secretary of State.

WCMS encourages legislators to consider this legislation when presented,and suggests an evaluation on an elderly individual’s mental capacity be assessed at the time of commitment or guardianship.

Join us for the next meeting scheduled for Monday, September 15, at the Society Office, 7:30 a.m. – 9 a.m.

New HIV Cases Increase in Washtenaw County

YPSILANTI, Mich., June 26, 2014 – New HIV cases in Washtenaw County are at a 15 year high. A total of 33 new cases were reported in 2013, up 37% from 24 cases in 2012. This is the highest number of cases seen in the County since 1999. National HIV Testing Day is Friday, June 27th. Washtenaw County Public Health and the HIV/AIDS Resource Center (HARC) urge residents to know their HIV status.

“Testing is important. Know your status.” says Cathy Wilczynski, nurse practitioner and program supervisor with Washtenaw County Public Health. “Get others you know to test. If you have sex, use a condom. It’s that simple.”

New HIV Cases in Washtenaw County are Overwhelmingly Young, Male
The majority of new cases (73%) are among young people, under the age of 30. Most are men. The age range of new cases is 18 to 59 years. Black residents are disproportionately affected, representing 55% of new infections. In Washtenaw County, the most frequently-reported risk factor among new cases is men who have sex with men (79% of all new cases). Additional information about HIV and other sexually transmitted infections reported in Washtenaw County is available at: http://www.ewashtenaw.org/government/departments/public_health/adult_health/ph_hltstdst.html

HIV Testing
Public Health and HARC offer free and confidential or anonymous testing. Results from rapid HIV testing are available within 30 minutes.

Washtenaw County Public Health is located at 555 Towner Street in Ypsilanti. HIV testing is available by appointment, call 734-544-6840. Walk in for HIV testing on Thursdays 1-4 pm.

HARC is located at 3075 Clark Road, Suite 203, in Ypsilanti. HARC provides testing, counseling and referral services in Ypsilanti, on the University of Michigan Campus and at various community locations. Call 734-572-9355 for an HIV testing appointment.

“It is important to know your HIV status,” says HARC president and CEO Jimena Loveluck. “If you don’t know your HIV status, take advantage of National HIV Testing Day and get a free rapid HIV test during HARC’s mobile testing tour with three locations throughout the day in our community. Encourage others to get tested and to get educated, especially our youth,” Loveluck added.

Locations scheduled for Friday, June 27:

Walgreens
2170 Washtenaw Ave
Ypsilanti, MI 48197
11am-1:30pm

Safe Sex Store (S3)
1209 S. University Ave
Ann Arbor, MI 48104
3:30pm-5:30pm

Harmony House Motel
615 E. Michigan Ave
Ypsilanti, MI 48198
3:30pm-5:30pm

Michigan Theater
603 E. Liberty
Ann Arbor, MI 48104
10:00 p.m.-1:00 a.m.

Contact Leon Golson at HARC for further information (734) 572-9355.

MICHIGAN DELEGATION MAKES AN IMPACT AT AMA ANNUAL MEETING

CME for gun violence prevention, increased STEM education, and encouraging physicians to be political candidates were among the topics of MSMS resolutions that were supported at the AMA Annual Meeting in Chicago on June 7-11.

Of the 16 Michigan resolutions submitted to the AMA from the MSMS House of Delegates, 10 were amended or referred to the AMA Board for study, one was not adopted, and five were reaffirmed as existing policy, which resets the “sunset clock” on those policies for another 10 years.

The 22-member Michigan Delegation held a private session with AMA EVP James Madara, MD, and chief lobbyist Richard Deem on the first day of the meeting. Deem thanked MSMS for its effective partnership with the AMA on Capitol Hill. “The Michigan congressional delegation is very important to the AMA,” he said. “We hold up Michigan physicians as a model across the country” for having a strong voice with its policy makers.

Tucker Carlson from Fox News, who was the guest speaker at the AMPAC luncheon, also noted that physicians have a unique voice in Washington and should use it with vigor. He said physicians are respected by legislators “because you are thoughtful people who also save lives.”

The uniqueness of physicians also was highlighted by new AMA President Robert Wah, MD, who has been close to the Michigan Delegation for many years. “We have the ability to convene all parties to come to the table and work on solutions to the challenges physicians face today,” he said in his inaugural address.

Alternate delegate John G. Bizon, MD, served on Reference Committee A, Medical Service. Bassam Nasr, MD, also an alternate delegate, served on Reference Committee F, Finance and Board of Trustees. Medical student Nicolas Fletcher received an AMA Foundation Minority Scholars Award for $10,000 based on academic achievement and commitment to the elimination of health disparities. He said the award was in large part due to the ongoing support of medical students by MSMS and the Michigan Delegation.

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