THIS IS AN OFFICIAL WEST VIRGINIA HEALTH ADVISORY NUMBER WV0068-05-29-2013
Distributed via the WV Health Alert Network – May 29, 2013
HEALTH ADVISORY
# 73
Clusters of Salmonella and Shiga Toxin-Producing Escherichia coli (E Coli)
TO:
West Virginia Healthcare Providers, School Officials, and Healthcare Facilities
FROM: Marian L. Swinker, MD, MPH, Commissioner for Public Health and State Health Officer,
WVDHHR, Bureau for Public Health
DATE:
May 29, 2013
LOCAL HEALTH DEPARTMENTS: PLEASE DISTRIBUTE TO COMMUNITY HEALTH PROVIDERS,
HOSPITAL-BASED PHYSICIANS, INFECTION CONTROL PREVENTIONISTS, LABORATORY
DIRECTORS, SCHOOLS (PRINCIPALS, SCHOOL NURSES, COACHES AND ATHLETIC DIRECTORS)
AND OTHER APPLICABLE PARTNERS
OTHER RECIPIENTS: PLEASE DISTRIBUTE TO ASSOCIATION MEMBERS, STAFF, ETC.
West Virginia Bureau for Public Health, Division of Infectious Disease Epidemiology (DIDE) is collaborating
with the local health departments and Centers for Disease Control and Prevention (CDC) in investigating
clusters of Salmonella and Shiga toxin-producing E coli as part of multi-state outbreaks
Laboratory testing is critical to guide proper treatment of patients with community-acquired diarrhea
as outlined in the table below. Providers should consider obtaining a stool specimen from patients
presenting with diarrhea accompanied by fever or other signs of severe illness (e.g. dehydration, bloody
stool) or diarrhea lasting more than 24 hours.
Species Type
Campylobacter species
Escherichia coli Enterohemorrhagic (STEC)
Treatment Recommendations
Erythromycin or Azithromycin can shorten duration
Antibiotic treatment NOT recommended because of
increased risk of hemolytic uremic syndrome. Avoid
antimotility drugs.
Non-typhi species of Salmonella
Antibiotics may prolong bacterial carriage. Ampicillin,
Amoxicillin or TMP-SMZ are recommended only for
cases at high risk for invasive disease or complications
Shigella species
Ampicillin or TMP-SMZ useful for shortening duration of
symptoms and shedding
Complete guidelines for management of infectious diarrhea can be found at
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5304a1.htm. Also, a CME presentation for physicians is found
at http://www.bt.cdc.gov/coca/calls/2010/callinfo_091610.asp . General information can be found at
http://www.cdc.gov/ecoli/. http://www.cdc.gov/salmonella/
For more information, please contact please contact your local health department or DIDE at (800)-423-1271,
ext. 1 or (304)-558-5358, ext. 1.DIDE
This message was directly distributed by the West Virginia Bureau for Public Health to local health departments and professional associations. Receiving entities are
responsible for further disseminating the information as appropriate to the target audience.
Categories of Health Alert messages:
Health Alert: Conveys the highest level of importance, warrants immediate action or attention.
Health Advisory: Provides important information for a specific incident or situation. May not require immediate action.
Health Update: Provides updated information regarding an incident or situation. Unlikely to require immediate action.
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West Virginia Health Advisory Number WV0073-05-29-13