In a follow-up on a report concerning influenza activity in California, California Department of Public Health (CDPH) State Public Health Officer Dr. Karen Smith reported today that the state is experiencing widespread influenza activity that is more severe than last year due to significantly higher numbers of hospitalizations and outbreaks throughout the state. CDPH has also received the first report of a death associated with influenza in a child younger than 18 years of age. The death occurred in Riverside County.
“This is a tragic reminder that the flu is a serious illness for people of all ages and kills thousands of Americans each year,” said Dr. Smith. “If you haven’t been immunized yet this season, getting flu shots for you and your family now can still help protect you this winter.”
Since the beginning of the influenza season, CDPH has received reports of 14 influenza-associated deaths, including the child in Riverside. This count represents a fraction of the total flu deaths statewide because only deaths in people younger than 65 are reported to the state and not all influenza-related deaths are easily attributable to influenza.
Hospitals statewide have been impacted by a surge in influenza patients, and hospitalizations for pneumonia and influenza at Kaiser Permanente hospitals in Northern California during the week ending January 7 reached 10.2 percent, the highest level recorded in 10 years. CDPH has also received reports of 83 influenza outbreaks, mostly in long-term care facilities, more than twice the reports received in recent years.
“We are closely monitoring the impact of influenza on health care facilities,” said Dr. Smith. “Some acute care hospitals in California are full and have diverted patients to other facilities.”
In Los Angeles County, Jeffrey Gunzenhauser, MD, MPH, Interim Health Officer has mandated that all acute care hospitals and skilled nursing facilities in the county report carbapenem-resistant Enterobacteriaceae (CRE) cases to the Los Angeles County Department of Public Health (Public Health).
“In order for Public Health to better address the emerging threat of CRE and other multi-drug resistant organisms, I am issuing an order that CRE be reported by all acute care hospitals and skilled nursing facilities in Los Angeles County,” said Dr. Gunzenhauser. “Public Health will use this information to prevent the spread of CRE and other antimicrobial resistant organisms by monitoring trends, developing guidance and interventions for healthcare facilities, and by identifying and responding to outbreaks.”
The Health Officer Order also requires that facilities submit an annual antibiogram documenting drug-resistance for CRE and other bacterial pathogens. Antibiograms offer additional information on overall resistance trends in facilities that will be aggregated across the county to identify geographic areas that may have higher resistance, and need assistance from public health to address these rates. In addition to CRE, Public Health monitors several types of healthcare associated infections, tracks data on antimicrobial resistance patterns across the County, and evaluates infection control practices and addressing identified gaps.
The cities of Long Beach and Pasadena will issue similar orders regarding CRE reporting.
“Reporting CRE in Long Beach is an important step in preventing healthcare associated infections and antibiotic resistance, and allows the City to ensure adequate infection control practices,” said Anissa Davis, MD, MPH, Health Officer, City of Long Beach. “We welcome the opportunity to partner with the County of Los Angeles to provide consistency in reporting throughout our county’s healthcare facilities.”
“The Pasadena Public Health Department is pleased to join forces with our neighboring public health jurisdictions to better understand antimicrobial resistance in our communities and identify ways to address this growing public health problem,” said Ying-Ying Goh, MD, MSHS, Pasadena Health Officer.
The measles outbreak in Southern California has reached 20, primarily in LA County, since the state vaccine law went into effect on Jul. 1, 2016. According to a San Diego Union Tribune report, At least 15 of the 18 L.A. County patients either knew one another or had a clear social connection, said Dr. Jeffrey Gunzenhauser and none could provide proof of vaccination.
LA County health officials say that the outbreak has affected the county’s Orthodox Jewish community. Hershy Z. Ten, who runs the Jewish healthcare foundation Bikur Cholim convened a panel last week to discuss steps that Jewish day schools and synagogues could take to stem the outbreak and ensure unvaccinated children are immunized.
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