Johnson County Health Department - EPI Update Newsletter

BCG (bacille Calmette-Guerin) is a vaccine made of a live, weakened strain of Tuberculosis bacteria. It is often given to very young children in countries with high rates of TB because it can prevent more serious forms of the disease from developing in children. However, there has been some confusion as to how to read the TB test on those who have received the BCG.
If a person has been vaccinated with BCG, a tuberculin skin test is not contraindicated. A positive reaction may occur. This reaction may be due to the BCG vaccine or due to infection with the TB bacteria.

Treatment of latent TB infection should be considered if:

• The skin test reaction is 10 mm or greater (according to their risk factors, i.e. healthcare workers) and they are from an area of the world where TB infection is very common (Africa, Asia, Eastern Europe and Latin America).
• The skin reaction is 5mm or greater and the patient has been identified as a close contact to someone who has infectious TB.
• It has been longer than five years since receiving BCG vaccine.
• The patient has spent time where TB disease is common (homeless shelters, migrant farm camps, drug-treatment centers, etc.).

If there are questions regarding the accuracy of a positive skin test, a laboratory test, QuantiFERON, is available to differentiate between BCG vaccine and Latent TB Infection.

The new Kansas Immunization Registry is an electronic immunization records data system accessed via a secured Internet access point. The registry connects local providers and health departments in a central database and provides substantial benefits to private individuals as well as healthcare providers. It serves as a complete and reliable source of immunization data and as an initiative to increase immunization rates across Kansas. This system enables providers to issue reminders and recalls for children who may be late on vaccinations; this system provides accuracy and speed of use.

The new statewide system allows export of immunization records to any provider ensuring the patients do not receive the same vaccine from different providers. All healthcare providers enrolled in the program, including school nurses and private providers, have access to the immunization data. This system also helps manage vaccine supplies and reduces waste through the use of an automated vaccine inventory management module capable of tracking vaccine expiration dates and dosage counts. Reports and warnings on adverse reactions to a vaccine can be expedited via the Internet to all providers providing everyone access to the most recent information.

The registry will gather the immunization data from both public and private providers of immunizations without increasing their workload. It also allows providers to consolidate immunization information from other state agencies and programs as well as private providers, making the workload for all providers smaller.

Johnson County Health Department (JCHD) is implementing the program this summer. Interested providers can contact KDHE to enroll in the program.

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Gloria Herron has worked as a Program Aide with the Emergency Program since December 2006. Before moving to the program, she worked a year and a half as a prenatal clerk in the Olathe clinic. Before that, she worked at Bank of Blue Valley in the internet mortgage department.
As a Program Aide, Gloria splits her time between the preparedness and immunizations/disease containment teams. Her duties include creating and updating TB charts, updating the private and state vaccine databases, updating preparedness contact lists, and providing overall support for the disease containment team.

Animal Bite Care and Prevention

Animal bites and scratches that break the skin can cause infection. Domestic pets cause most animal bites. Bites from nonimmunized domestic animals and wild animals carry the risk of rabies. Rabies is more common in raccoons, skunks, bats and foxes than in cats and dogs.

For minor wounds. If the bite barely breaks the skin and there is no danger of rabies, treat it as a minor wound. Wash the wound thoroughly with soap and water. Apply an antibiotic cream to prevent infection and cover the bite with a clean bandage.

For deep wounds. If the animal bite creates a deep puncture of the skin or the skin is badly torn and bleeding, apply pressure with a clean, dry cloth to stop the bleeding and see your doctor.

For infection. If you notice signs of infection such as swelling, redness, increased pain or oozing, see your doctor immediately.

For suspected rabies. If you suspect the bite was caused by an animal that might carry rabies — any bite from a wild or domestic animal of unknown immunization status — see your doctor immediately.

Think Prevention! Many animal bites are preventable. Always supervise young children around animals, even pets. Teach kids to handle pets gently and to never tease them. Stay away from and don’t feed wild or stray animals.

Doctors recommend getting a tetanus shot every 10 years. If the last tetanus shot was more than five years ago and the wound is deep or dirty, your doctor may recommend a booster. You should have the booster within 48 hours of the injury. Report any animal bites to your local Health Department.

Disease Reporting Notes:

If you have any questions about the monthly Epi Update, or any other disease surveillance or containment questions, please contact Nancy Tausz, RN, BSN, Director of the Disease Containment Division, at (913) 477-8362 or by email at: Nancy.Tausz@jocogov.org.

Communicable disease reporting is the cornerstone of public health surveillance and disease control. Please remember to maintain an index of suspicion for bioterrorism and reportable disease, and give the Disease Containment staff a call if you have any questions or concerns at (913) 826-1303. On behalf of the Johnson County Health Department, thank you for your continued support.

Johnson County government does not discriminate on the basis of race, color, national origin, gender, religion, age and handicapped status in employment or the provision of programs and services.