Based on an epidemiological link and results of laboratory testing, the Centers for Disease Control and Prevention (CDC) has combined the Salmonella Bareilly investigation with an ongoing multi-state outbreak investigation of Salmonella serotype Nchanga infections, according to the CDC. The two associated PFGE patterns have been grouped together as the "outbreak strains." A total of 258 persons infected with the outbreak strains of Salmonella Bareilly (247 persons) or Salmonella Nchanga (11 persons) have been reported from 24 states and the District of Columbia, including six cases in Rhode Island of the Salmonella Bareilly strain, according to the latest CDC updated on May 2, 2012. Read the complete CDC update: http://www.cdc.gov/salmonella/bareilly-04-12/index.html

This week the Food and Drug Administration (FDA) received a report from a hospital that 16 patients had developed colonization or infection with the bacteria Pseudomonas aeruginosa. Each of these patients were examined with transesophageal ultrasound probes using Other-Sonic Generic Ultrasound Transmission Gel. Upon investigation, the ultrasound gel was found to be contaminated with the bacteria Pseudomonas aeruginosa and Klebsiella oxytoca. The product, Other-Sonic Generic Ultrasound Transmission Gel, is not labeled as sterile. It is NOT sterile. At this time, the FDA is concerned about contamination of Other-Sonic Generic Ultrasound Transmission Gel lot numbers 060111 through 120111. Read the complete FDA announcement: http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm299409.htm

Updated April 11, 2012: The Centers for Disease Control and Prevention (CDC) is collaborating with public health officials across the United States to investigate a multistate outbreak of Salmonella serotype Bareilly infections. Rhode Island physicians should maintain a high index of suspicion for patients with diarrheal illness compatible with Salmonella gastroenteritis, especially if the patient has a history of consumption of sushi or sashimi in the week prior to illness onset, according to the CDC. Stool cultures should be ordered in keeping with standard practice guidelines. UPDATE: As of April 11, Rhode Island has reported five cases of illness identified with the outbreak strain of Salmonella Bareilly. A total of 116 individuals infected with the outbreak strain so far have been reported from 20 states, including Rhode Island, and the District of Columbia.

Beginning April 5, parents of children who attend Lincoln Central Elementary School in Lincoln, Rhode Island are being informed by letter of two cases of pertussis that have occurred a few weeks apart. This notification may prompt additional calls to healthcare providers with questions or concerns about the situation and about early childhood vaccinations for pertussis (DTaP). The Rhode Island Department of Health (HEALTH) is working as is routine to identify close contacts and assure prophylaxis.

Due to a recent increase in sporadic varicella (chickenpox) cases at elementary schools and day care centers in four communities, the Rhode Island Department of Health (HEALTH) is issuing a press release on Thursday, March 15, to remind parents about the importance of early childhood vaccinations. As a result of media coverage, physicians throughout Rhode Island may experience an increase in requests for varicella vaccinations for children, especially ages birth to 5. View the press release at http://www.ri.gov/press/view/16100.

Parents of daycare children in the Yearlings Room, Toddler Room and Little Learners Room at the YWCA of Northern Rhode Island in Woonsocket are being notified about a single case of varicella (chickenpox) involving a daycare student. The daycare children in these three groups will be required to receive all up-to-date varicella vaccinations, to complete a two-dose schedule. As a result, area physicians primarily in the Woonsocket area may experience an increase in requests for varicella vaccinations for children ages birth to 5.

Please be advised that beginning March 1, parents of children who attend a daycare facility called "Totally Kids Daycare" in Warwick, Rhode Island are being notified about a single case of varicella (chickenpox) in a three-year-old student. As a result, area physicians primarily in the West Bay area may experience an increase in requests for varicella vaccinations for children ages birth to 5 years old.

Please be advised that beginning Feb. 15, parents of children who attend the daycare facility "A Child's University Early Childhood School" in Lincoln, Rhode Island are being notified about a single case of pertussis involving a two-year old student. The Rhode Island Department of Health (HEALTH) is working with the daycare center to review immunization records and identify close contacts among daycare students and staff. HEALTH, as well as the daycare facility nurse, are directly contacting all parents and primary care providers of these potentially exposed students and staff. A school-wide notification letter to all other parents also has been sent and may prompt additional calls to other healthcare providers with questions or concerns about the situation and about early childhood vaccinations for pertussis (DTaP). The complete advisory may be viewed at http://www.health.ri.gov/publications/guidelines/treatmentmanagementandreporting/022012AdvisoryLincolnPertussis.pdf

On February 7, 2012, the Centers for Disease Control and Prevention (CDC) announced that CDC guidance on the use of influenza antiviral medications remains unchanged after careful review of evidence. The CDC reviewed randomized clinical trial data for the influenza neuraminidase inhibitor antiviral medications published by the Cochrane Collaboration, and two related commentaries ["Rethinking credible evidence synthesis" and "Questions Remain over safety and effectiveness of oseltamivir"] published in the British Medical Journal, which had raised questions about the value of antiviral medications for the prevention and treatment of influenza. To read the complete announcement, visit: http://www.cdc.gov/media/haveyouheard/stories/Influenza_antiviral.html

Any Barrington residents ages 10 and up (except pregnant women) who have never received the Tdap vaccination may participate in the pertussis vaccination clinic organized by HEALTH and Barrington Public Schools. WHERE: Barrington High School Cafeteria, 220 Lincoln Ave., Barrington, 02806. WHEN: 7 p.m., Thursday, Jan. 12 and Friday, Jan. 13. COST: Those with health insurance should bring proof of insurance, however anyone without health insurance may participate at no out-of-pocket cost. Healthcare providers should encourage vaccination for all Barrington residents...

The Division of Infectious Disease & Epidemiology has confirmed four cases of pertussis among Barrington children since December and five additional cases remain under investigation. Providers should be vigilant for new cases, and follow guidelines for testing, treatment, prophylaxis, and reporting.

Physicians are advised to report selected cases and write orders to have an aliquot of CSF (as much as feasible) and serum (3ml) sent to the State Lab for suspect cases of aseptic/viral meningitis, encephalitis and Guillain-Barre Syndrome.