DPH Announces TB Response at Wilmington Long-Term Care Facility

x-ray picture of lungs and tuberculosis bacteria
close up of TB bacteria in lungs – courtesy Thinkstock

DOVER – The Division of Public Health (DPH) announced today that over 600 individuals may have been exposed to someone with active tuberculosis (TB) at the ManorCare Health Services Foulk Road facility during a nine-month period in 2017. Consistent with routine Division TB protocols, the agency is sending out letters to former residents and staff of the facility who may have been exposed to the infected individual between January and September 2017. DPH is also following up with phone calls to provide information on free testing and treatment at one of its three clinics in Newark, Dover, and Georgetown.

While the risk of transmission is usually not high, DPH is recommending that those who have been exposed, and test positive after a TB skin or blood test, receive further medical evaluation and treatment so they do not develop complications from TB disease. The Division is providing free screenings and treatment to former residents and employees of the facility receiving the letters. The facility is providing testing and treatment to current staff and residents who may have been exposed during January and September 2017.

To enable staff to reach the large number of individuals who may have been exposed, DPH is opening a call center at its State Health Operations Center in Smyrna. The call center staff will begin making follow-up calls and taking questions from concerned former residents and staff of the facility at 9 a.m. on Tuesday, May 29, 2018. Hours of operation will be 9 a.m. to 4 p.m. The call center will remain open until the bulk of concerns and questions have been addressed. Hours may be adjusted to accommodate for peak volume. Any changes will be communicated through press release and social media communications.

The call center number is 1-866-408-1899. As a reminder it will be available starting at 9 a.m., Tuesday May, 29, 2018.

“This is an all hands-on-deck approach for us,” said DPH Director Dr. Karyl Rattay. “The most important thing we want people to know is that TB is treatable. That’s why it’s so important for us to reach out to all former residents and staff, to encourage them to get tested as soon as possible. Manor house leadership is working closely with the DPH and taking every measure necessary to protecting the health of its residents and staff.”
DPH will offer three open testing days at its clinic at the Hudson State Service Center (HSSC), 501 Ogletown Road, Newark, as the overwhelming majority of former staff and residents live in New Castle County. The open testing dates are June 4, 5 and 6, 2018, from 8:30 a.m. to 11:30 a.m. and 1 p.m. to 3:30 p.m. Testing is for walk-ins only on these days.

Anyone who cannot come to one of the open testing dates should call the DPH Call Center at 1-866-408-1899. Additionally, former staff and residents who live in Kent or Sussex counties are also asked to contact the Call Center, and provide their contact information to staff. Residents in Kent County will receive a call back from Williams State Service Center staff in Dover to schedule an appointment there. Residents in Sussex will receive a call back from Adams State Service Center staff in Georgetown to schedule an appointment there.

Residents in all three counties are asked to bring the letter they received from DPH when they arrive at any site for testing. Any former resident whose mobility makes getting to the clinic sites a challenge, is also asked to call the DPH Call Center to discuss testing options.

Thirty-five former staff and residents are currently living in seven other states. In addition to sending these individuals letters, DPH is coordinating with the states’ public health agencies to ensure the individuals are provided information on the closest public health testing clinic to them.

TB is generally on the decline throughout the country – with 9,557 cases nationwide in 2015 – but vigilance is important. Delaware had 22 cases of TB disease (also known as “active TB”) in 2015, 16 in 2016, 16 in 2017, and seven to date in 2018. As opposed to the latent kind, TB disease cases are defined as having the symptoms of the illness and potentially being able to spread it to others.

TB is a bacterium that can be inhaled into the lungs of others when a nearby person with the active disease coughs, sneezes, sings or laughs. People with TB disease are most likely to spread the disease to people they spend time with every day, such as family or other household members, close friends and coworkers. Signs and symptoms of TB may include a progressively worsening cough that lasts more than two weeks, fatigue, weakness, weight loss, night sweats, fever, chills and chest pain. TB can affect any bodily organ but is infectious to others only when it occurs in the lungs or larynx (voice box).
Only people with TB symptoms can spread the disease. TB is not spread by casual or brief contact such as shaking hands, touching, sharing food or drink, utensils, bed linens or toilet seats, sharing toothbrushes or saliva from kissing.

TB disease is treatable and curable, usually by taking several medications for six to nine months. About 5 percent to 10 percent of persons infected with TB if untreated will develop the disease at some time in their lives; most within the first two years after the infection occurs.

In most people who breathe in TB bacteria and become infected, the body is able to fight the bacteria to stop them from growing. The bacteria become inactive, but they remain alive in the body and can become active later. This is called latent TB infection. People with latent TB infection cannot spread TB bacteria to others. People who have latent TB infection can be treated to prevent TB disease from developing.

For additional information on tuberculosis, visit the Centers for Disease Control and Prevention website at: https://www.cdc.gov/tb/default.htm. For more information on DPH’s tuberculosis Elimination Program visit: http://dhss.delaware.gov/dhss/dph/dpc/tbservices.html.

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.


Delaware’s Dr. Vibha Sanwal Receives CDC’s Childhood Immunization Champion Award

Picture of Dr. Vibha Sanwal
Dr. Vibha Sanwal

Dover Dr. Vibha Sanwal[/caption] – Vibha Sanwal, MD, from Rainbow Pediatrics of Georgetown & Lewes, has been named a Centers for Disease Control and Prevention (CDC) Childhood Immunization Champion for her outstanding efforts to promote childhood immunizations in her clinic offices. The Division of Public Health’s (DPH) Immunization Program nominated the pediatrician for the award.

Dr. Sanwal is recognized for embracing the Assessment, Feedback, Incentive & eXchange (AFIX) assessment process by reviewing patient charts against the Immunization Information System (IIS) and updating individual immunization records as patients came in during their scheduled office visits. Her clinic staff also reviewed their patient roster to ensure that the roster in the IIS matched the patient roster in their Electronic Medical Record (EMR) system. This process enables the IIS to reflect her clinic’s true coverage rates for all the vaccine-preventable diseases and provides a roadmap to ensure all her patients get each of the vaccines needed to stay healthy.

“Through the Childhood Immunization Champion awards, CDC and Delaware proudly acknowledge Dr. Sanwal’s passion, hard work and commitment to children’s health by working to eliminate vaccine preventable diseases in our state,” said DPH Director Dr. Karyl Rattay.

“I am honored to be recognized as the Immunization Champion for Delaware,” Dr. Sanwal said. “Vaccinations prevent disease and reduce suffering, improve our quality of life, and help our children live long, fulfilling lives. We will continue to work hard to improve the immunization rate of our population at Rainbow Pediatrics.”

National Infant Immunization Week (NIIW), April 21 to 28, 2018, is an annual observance to highlight the importance of protecting infants from vaccine-preventable diseases and to celebrate the achievements of immunization programs in promoting healthy communities throughout the United States. Each year during NIIW, the CDC Foundation honors health professionals and community leaders from around the country with the CDC Childhood Immunization Champion awards. These awards acknowledge the outstanding efforts of those individuals who strive to ensure that children in their communities are fully immunized against 14 preventable diseases before the age of two.

“The tremendous success of CDC’s immunization programs to protect the nation’s children from vaccine-preventable diseases is a direct result of the efforts of childhood immunization champions,” said Dr. Nancy Messonnier, Director of the National Center for Immunization and Respiratory Diseases at the CDC. “We cannot overstate the value of the dedication our Champions have shown, which ultimately protects our children, schools, and communities from serious diseases.”

CDC Childhood Immunization Champions were selected from a pool of health professionals, coalition members, community advocates and other immunization leaders. State Immunization Programs coordinated the nomination process and submitted nominees to CDC. One winner was selected in each of the 50 participating states and the District of Columbia.

For profiles of other CDC Childhood Immunization Champion award winners, visit https://www.cdc.gov/vaccines/champions.

For information on immunization schedules for infants and children, visit: http://www.dhss.delaware.gov/dph/dpc/immunize-children.html.

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.


24 Locations in Delaware to Participate in Drug Take-Back Day, April 28, 2018

DOVER — Delaware will hold its 16th Drug Take-Back Day on Saturday, April 28, 2018, to help reduce the risk of prescription medications being diverted for misuse. Delawareans can discard their expired or unused medications at 24 locations statewide between 10 a.m. and 2 p.m.

Organized nationally, by the Drug Enforcement Administration (DEA) and locally, by the Division of Public Health (DPH), the twice-a-year event has resulted in 76,474 pounds of medication being collected in 15 events since 2010. Properly discarding unused medications is an important ongoing event in the effort to address the nationwide opioid epidemic. Doing so reduces the risk of addiction by keeping prescription medications out of the hands of people who may misuse, abuse, or sell them, and helps reduce the risk of drug overdoses. Proper disposal also protects our groundwater from medications being flushed down the toilet.

“I am grateful to the citizens across our state who take seriously their responsibility to rid their homes of expired, unwanted or unnecessary medications,” Governor John Carney said. “To reduce the toll that addiction is having on our state, we are combining education and prevention efforts like the Drug Take-Back Day efforts, with strong law enforcement and control measures, and an expanding treatment and recovery system.”

“Unwanted, expired or unused prescription medications are often an unintended catalyst for addiction,” said DPH Director Dr. Karyl Rattay. “Participating in Drug Take-Back Days provides the average person a concrete way they can make a difference in the ongoing opioid epidemic our state is facing. By taking the important step of cleaning out medicine cabinets, you can make your home safe from potential prescription drug abuse or theft.”

According to the 2015 National Survey on Drug Use and Health, 6.4 million Americans abused controlled prescription drugs. Additionally, national studies show that almost two-thirds of people who misuse prescription drugs get them from friends and family, including by raiding medicine cabinets, purses and drawers. DPH reported to the Centers for Disease Control and Prevention that 293 people died in Delaware from drug overdoses in 2016, compared to 214 in 2015.

In addition to the 24 sites participating in Drug Take-Back Day activities, there are 21 permanent medicine drop-off locations across the state available year-round. Six of Delaware’s permanent drop-off sites are in Walgreens pharmacies and the other 15 are located in local law enforcement agencies.

Delawareans seeking help for drug addiction, medical providers seeking information on patient education and treatment resources, or individuals searching for information about naloxone training classes and how to use the medicine, can visit www.HelpIsHereDE.com. The website, Delaware’s one-stop-shopping resource for information about education, prevention and treatment options for addiction, also features short testimonial videos from Delawareans in long-term recovery, parents who lost adult children to overdoses, and others.

On Drug Take-Back Day, drugs for disposal must be in a container such as a pill bottle, box, blister pack, or zipped plastic bag, with personal information removed. Liquid medications must be in their original containers. Needles, aerosols, biohazard materials, medical equipment and batteries will not be accepted.
For more details and a list of permanent collection sites, visit DPH at dhss.delaware.gov/dph/hsp/hhdrugtakeback.html or call 302-744-4546, ext. 4.
Delaware’s Drug Take-Back Day sites for April 28, 2018 from 10 a.m. to 2 p.m. are

New Castle County

  • Christiana Care Surgical Center, 4755 Ogletown Stanton Road, Newark
  • Delaware City Police Department, 407 Clinton St., Delaware City
  • Delaware State Police Troop 2, 100 La Grange Ave., Newark
  • Middletown Police Department, 130 Hampden Road, Middletown
  • New Castle County Airport, 151 N. DuPont Highway, New Castle
  • New Castle County Police Department, 3601 N. DuPont Highway (permanent collection site)
  • Shipley Manor Nursing Home, 2723 Shipley Road, Wilmington
  • Wilmington VA Medical Center, 1601 Kirkwood Highway, Wilmington

Kent County

  • Atlantic Apothecary, 103. S. Dupont Blvd., Suite 2, Smyrna
  • Camden Police Department, 1783 Friends Way, Camden (permanent collection site)
  • Cheswold Police Department, 691 Main St., Cheswold
  • Delaware State Police Troop 3, 3759 S. State St.
  • Felton Police Department, 24 E. Sewell St., Felton (permanent collection site)
  • Milford Police Department, 400 NE Front St., Milford (permanent collection site)

Sussex County

  • City of Lewes Board of Public Works, 129 Schley Ave., Lewes
  • Dagsboro Police Department, 33134 Main St., Dagsboro
  • Delaware State Police Troop 7, 18006 Coastal Highway, Lewes
  • Laurel Police Department, 205 Mechanic St., Laurel (permanent collection site)
  • Milton Police Department, 101 Federal St., Milton
  • Ocean View Police Department, 201 Central Ave., Ocean View, (permanent collection site)
  • CVS Pharmacy, 36252 Lighthouse Road, Selbyville
  • Lewes Ferry Terminal, 43 Cape Henlopen Road, Lewes
  • Rehoboth Police Department, 229 Rehoboth Ave., Rehoboth Beach
  • Selbyville Town Hall, 68 W. Church St., Selbyville (permanent collection site)

For further information on addiction recognition, prevention and treatment, visit www.helpisherede.com.

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.


DPH Advises Parents, Teachers of New E-Cigarette Trend Among Teens: JUULing

DOVER – The Division of Public Health (DPH) is advising parents and teachers to be aware of a recent trend among youth known as “JUULing.” JUUL is a brand of e-cigarette that looks similar to a flash drive and can be charged in the USB port of a computer.

JUULs can be appealing to youth for a variety of reasons. Pods come in a variety of fruit and candy flavors, the devices can be difficult to distinguish from a real flash drive, and the vapor dissipates quickly instead of hanging in the air like a smoke trail. This has caused concern am

ong school administrators across the country as youth have taken to “JUULing” on school property, even in class.

CDC Infographic:  https://bit.ly/2IPiMVE

A Truth Initiative study found that 37 percent of 15 to 24-year-old JUUL users are uncertain whether the product contains nicotine. The study also found that JUUL users don’t refer to use of these products as “e-cigarette use” or “vaping” but rather as “JUULing, which leads them to believe it is safer.

“There is no safe form of tobacco,” said DPH Director Dr. Karyl Rattay. “Students are under the impression that “JUULing” is safe and that these products don’t have nicotine, however, that is not the case. We believe it is important to educate parents and teachers about this trend, and e-cigarettes in general, and that it is critical that students understand the dangers posed by JUULs and nicotine as well.”

According to the product label, just one pod used in a JUUL allows for 200 puffs and contains the same amount of nicotine as one pack of cigarettes. Nicotine is highly addictive and can affect the developing brains of youth. In less than five years, e-cigarettes and vape products have become the fastest-growing sector of the American tobacco industry. Nationally and in Delaware, e-cigarettes are the most commonly used tobacco product among youth.

Among teenagers, experimentation with electronic or e-cigarettes became popular in 2015. According to the 2015 Delaware Youth Risk Behavior Survey (YRBS), 23.5 percent of public high school students had used e-cigarettes in the past month, and 2.3 percent were smoking or “vaping” e-cigarettes daily. Dual use of tobacco products is also a concern. In Delaware, 32.5 percent of high school e-cigarette users reported also using cigars, and 27 percent reported also using cigarettes. In addition, 37 percent of e-cigarette users reported never smoking cigarettes before starting to use e-cigarettes.

In 2014, Delaware banned the sale of e-cigarettes to minors, and a year later the state expanded the Delaware Clean Indoor Air Act to include prohibiting the use of e-cigarettes and other electronic vapor devices in workplaces and indoor public place.

While research is under way to determine the health effects of e-cigarette usage, the aerosol from e-cigarettes contains harmful substances such as nicotine, lead products and cancer-causing agents, according to the Centers for Disease Control and Prevention (CDC).

DPH is reaching out to schools, school nurses and wellness centers, and pediatrician’s offices with a Health Alert on the topic of “JUULing” and has increased social media messaging around the issue. The Division has previously developed targeted outreach campaigns to address e-cigarette use overall, and will continue to provide education in schools and the community. For more information on “JUULing” visit Tobacco Free Kids at: Tobacco-Free Kids on “JUULing”:  https://www.tobaccofreekids.org/assets/factsheets/0394.pdf. For more information e-cigarettes, visit https://www.cdc.gov/tobacco/basic_information/e-cigarettes/index.htm or for more information on what Delaware is doing to address youth tobacco and e-cigarette use, visit http://www.thedirtytruth.com or https://www.healthydelaware.org/Individuals/Tobacco/Vaping.

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.


Mumps Cases Increase to 11; Possible Link to Second Mexican Dance Event at Chase Center

DOVER – The Delaware Division of Public Health (DPH) is now confirming 11 cases of the mumps as part of its ongoing investigation of an outbreak among attendees at a February dance festival in New Castle County. Seven of the 11 confirmed cases either attended, or lived with persons who attended, a social dance (Baile Mejicano or Mexican Dance) that took place at the Chase Center on the Riverfront in Wilmington on Feb.10, 2018. An eighth person was working at another Baile Mejicano dance, held at the same location, which occurred on March 3, 2018. DPH is still investigating the source of three people’s exposure to the mumps virus.

DPH is now recommending that anyone who attended either the Feb. 10 or March 3, 2018, dances contact their primary care physician to determine if they may have contracted mumps and if they and their family or close contacts need to receive vaccination against mumps.

“With a confirmed case of mumps showing up in someone involved in a second – more recent – social dance in such a short period of time, we are stepping up our outreach to attendees, whether or not they developed symptoms, and those living with persons who are confirmed to have mumps, to contact their primary care provider as soon as possible for evaluation for mumps and vaccination where recommended,” said DPH Medical Director Dr. Awele Maduka-Ezeh.

Mumps is an acute viral infection spread through saliva or mucus from the mouth, nose, or throat. An infected person can spread the virus by coughing, sneezing, or talking, sharing items, such as cups or eating utensils, with others, and touching objects or surfaces with unwashed hands that are then touched by others. The Centers for Disease Control and Prevention (CDC) notes that a substantial increase in the number of mumps outbreaks and outbreak-associated cases have occurred in the United States since late 2015.

Symptoms typically start with a few days of fever, headache, muscle aches, tiredness, and loss of appetite, followed by swollen salivary glands, which results in puffy cheeks and a swollen jaw. Symptoms typically appear 16 to 18 days after infection, but can range from 12 to 25 days after infection. Some people with mumps may not have any symptoms.

Those patients who attended the Baile Mejicano event, or who live with someone who attended and subsequently developed mumps, and who do not have health insurance or whose insurance does not cover the mumps/measles/rubella vaccine (MMR), should call one of the following DPH clinics: In New Castle County, call the Hudson State Service Center Immunization Clinic at 302-283-7587, (and select option #2) for an appointment to get an MMR vaccine; patients who live in Kent County and need vaccination may call DPH’s Kent County Immunization Clinic at 302-857-5140, and those in Sussex County may call DPH’s Georgetown Immunization Clinic at 302-515-3220.

People known or suspected to have mumps should stay away from school or work until five days after the onset of swollen salivary glands, as there is no specific treatment for mumps.

Some people who get mumps have very mild or no symptoms, and often they do not know they have the disease. Most people with mumps recover completely in a few weeks. However, mumps can occasionally cause complications, especially in adults. Complications include:

  • inflammation of the testicles (orchitis) in males who have reached puberty; rarely does this lead to fertility problems
  • inflammation of the brain (encephalitis)
  • inflammation of the tissue covering the brain and spinal cord (meningitis)
  • inflammation of the ovaries (oophoritis) and/or breast tissue (mastitis)
  • deafness

The CDC recommends children get two doses of MMR vaccine, starting with the first dose at 12 to 15 months of age, and the second dose at 4 to 6 years of age. Teens and adults who did not get the recommended MMR vaccines per the above schedule should be vaccinated so they are up to date. During outbreaks, CDC also recommends that those at highest risk due to exposure to people with mumps, should receive a third dose of MMR.

Mumps is a reportable disease in Delaware. Suspected cases of mumps should be reported to DPH via fax at 302-223-1540; email at reportdisease@delaware.gov; or phone, 302-744-4990. Providers are asked not to wait for laboratory test results to return before reporting.

Espanol: https://news.delaware.gov/2018/03/29/los-casos-de-paperas-aumentan-posible-vinculo-con-un-segundo-evento-de-baile-mexicano-en-el-chase-center-wilmington/

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.