{"id":10065,"date":"2025-03-01T14:02:36","date_gmt":"2025-03-01T19:02:36","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/dhan111\/"},"modified":"2025-03-02T00:46:22","modified_gmt":"2025-03-02T05:46:22","slug":"dhan111","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan111\/","title":{"rendered":"php\/alerts\/dhan111 ~  Division of Public Health &#8211; &#8211; Health Alert  &#8211; Delaware Health and Social Services &#8211; State of Delaware"},"content":{"rendered":"<div data-swiftype-index=\"true\">\n\n\n\n  <br>\n\n\n\n  <div class=\"container\" id=\"main_header\"> \n\n    <!-- BEGIN readspeaker div -->\n\n    <div class=\"rs_skip rsbtn rs_preserve\" id=\"readspeaker_button1\">\n\n      <a accesskey=\"L\" class=\"rsbtn_play\" href=\"https:\/\/app-na.readspeaker.com\/cgi-bin\/rsent?customerid=7262&#038;lang=en_us&#038;readid=main_content&#038;url=https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan111.html\" title=\"Listen to this page using ReadSpeaker\">\n\n        <span class=\"rsbtn_left rsimg rspart\"><span class=\"rsbtn_text\"><span>Listen<\/span><\/span><\/span>\n\n        <span class=\"rsbtn_right rsimg rsplay rspart\"><\/span>\n\n      <\/a>\n\n    <\/div>\n\n    <!-- END readspeaker div -->\n\n\n\n    \n\n    <header class=\"pull-left\">\n\n      <h1>Delaware Health Alert Network #<!--[type=EDIT name=\"DHAN Number\"]-->111 <!--[END]--> <\/h1>\n\n      <h2> <!--[type=EDIT name=\"DHAN Date\"]-->February 8, 2006 3:54 PM <!--[END]--> <\/h2>\n\n    <\/header>\n\n  <\/div><br>\n\n \n\n  <div class=\"container\">\n\n    <div class=\"row\">\n\n      <div class=\"col-md-3\" id=\"leftCol\">\n\n        <div class=\"panel-group\" id=\"accordion\">\n\n          <div class=\"panel sectionmenu_panel\">\n\n            <div class=\"panel-heading\">\n\n              <p class=\"panel-title\"><a class=\"agency_nav\" data-parent=\"#accordion\" data-toggle=\"collapse\" href=\"#collapseOne\"><strong><i class=\"fa fa-align-justify fa-fw\"><\/i> Public Health Menu<\/strong><\/a><\/p>\n\n            <\/div>\n\n\n\n            <div class=\"panel-collapse collapse in\" id=\"collapseOne\">\n\n              <div class=\"panel-body\" id=\"clf_nav\">\n\n                  <ul class=\"nav nav-stacked nav-pills-clf\" id=\"agency_sidebar\">\n    <li><a href=\"\/dph\/\"><h2>Home <i class=\"fa fa-home fa-fw\"><\/i><\/h2><\/a><\/li>\n    <li class=\"toplevel\"><a data-parent=\"#agency_sidebar\" data-toggle=\"collapse\" href=\"#HomeMenu\"><h2>About <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n      <ul class=\"panel-collapse collapse\" id=\"HomeMenu\">\n        <li><a href=\"\/dph\/about.html\">About DPH<\/a><\/li>\n        <li><a href=\"\/dph\/sections.html\">Sections &#038; Programs<\/a><\/li>\n        <li><a href=\"\/dph\/ofclocations.html\">Office Locations<\/a><\/li>\n        <li><a href=\"\/dph\/contact.html\">Contact Info<\/a><\/li>\n      \n        <li><a href=\"\/calendars.html\" target=\"_blank\">Calendar<\/a><\/li>\n      <\/ul>\n    <\/li>\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#ServicesMenu\"><h2>Services <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n      <ul class=\"panel-collapse collapse\" id=\"ServicesMenu\">\n        <li><a href=\"\/dph\/servicesaz.html\">A-Z Services<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/environmental.html\">Air &#038; Water Quality<\/a><\/li>\n        <li><a href=\"\/dph\/ss\/vitalstats.html\">Birth, Death, &#038; Marriage Records<\/a><\/li>\n        <li><a href=\"\/dph\/clinics.html\">Clinics<\/a><\/li>\n        <li><a href=\"\/dph\/healthdatastats.html\">Health Data &#038; Statistics<\/a><\/li>\n        <li><a href=\"\/dph\/php\/emsps.html\">Emergency Preparedness<\/a><\/li>\n        <li><a href=\"\/dph\/healthandwellness.html\">Health &#038; Wellness<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/healthyhomes.html\">Healthy Homes<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/healthywp.html\">Healthy Workplaces<\/a><\/li>\n        <li><a href=\"\/dph\/lab\/labs.html\">Laboratory<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/feir.html\">Restaurant Inspections<\/a><\/li>\n        <li><a href=\"\/dph\/screen.html\">Screening and Testing<\/a><\/li>\n        <li><a href=\"\/dph\/chca\/dphwichominf01.html\">WIC<\/a><\/li>\n        <li><a href=\"\/dph\/servicesadd.html\">Additional Services<\/a><\/li><li>\n      <\/li><\/ul>\n    <\/li>\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#InformationMenu\"><h2>Information <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n        <ul class=\"panel-collapse collapse\" id=\"InformationMenu\">\n        <li><a href=\"\/dph\/factsheetsaz.html\">A-Z Fact Sheets<\/a><\/li>\n        <li><a href=\"\/dph\/pubreportsaz.html\">A-Z Publications &#038; Reports<\/a><\/li>\n        <li><a href=\"\/dph\/diseasesandconditions.html\">Diseases &#038; Conditions<\/a><\/li>\n        <li><a href=\"\/dph\/faq.html\">FAQ&#8217;s<\/a><\/li>\n        <li><a href=\"\/dph\/php\/alerts.html\">Health Alerts<\/a><\/li>\n        <li><a href=\"\/dph\/healthylifestyles.html\">Healthy Lifestyles<\/a><\/li>\n        <li><a href=\"\/dph\/hipaa.html\">HIPAA<\/a><\/li>\n        <li><a href=\"\/dph\/regs.html\">Regulations<\/a><\/li>\n        <li><a href=\"\/dph\/forms.html\">Request Forms<\/a><\/li>\n        <li><a href=\"\/dph\/links.html\">Links &#038; Resources<\/a><\/li>\n        <li><a href=\"http:\/\/delaware.gov\/help\/foia_request.shtml\">FOIA Request Form<\/a><\/li>\n      <\/ul>\n    <\/li>\n    <li><a id=\"SocialMenuHeader\"><h2>Connect <i class=\"fa fa-thumbs-o-up fa-fw\"><\/i><\/h2><\/a>\n      <ul id=\"SocialMenu\">\n        <li class=\"facebook\"><a href=\"https:\/\/www.facebook.com\/DEPublicHealth\" target=\"_blank\" title=\"Division of Public Health Facebook Page\"><i class=\"fa fa-facebook-square fa-lg\"><\/i> Facebook<\/a><\/li>\n        <li class=\"twitter\"><a href=\"https:\/\/twitter.com\/Delaware_DHSS\" target=\"_blank\" title=\"Delaware Health and Social Services Twitter Account\"><i class=\"fa fa-twitter-square fa-lg\"><\/i> Twitter<\/a><\/li>\n        <!-- <li class=\"googleplus\"><a href=\"#\"><i class=\"fa fa-google-plus-square fa-lg\"><\/i> Google +<\/a><\/li>\n        <li class=\"flickr\"><a href=\"#\"><i class=\"fa fa-flickr fa-lg\"><\/i> Flickr<\/a><\/li>\n        <li class=\"youtube\"><a href=\"#\"><i class=\"fa fa-youtube-square fa-lg\"><\/i> Youtube<\/a><\/li>\n        <li class=\"instagram\"><a href=\"#\"><i class=\"fa fa-instagram fa-lg\"><\/i> Instagram<\/a><\/li>\n        <li class=\"linkedin\"><a href=\"#\"><i class=\"fa fa-linkedin-square fa-lg\"><\/i> Linkedin<\/a><\/li>\n        <li class=\"pinterest\"><a href=\"#\"><i class=\"fa fa-pinterest-square fa-lg\"><\/i> Pinterest<\/a><\/li> -->\n      <\/ul>\n    <\/li>\n  <\/ul>\n\n              <\/div>\n\n            <\/div>\n\n          <\/div>\n\n        <\/div><br>\n\n      <\/div>\n\n\n\n      <div class=\"col-md-9\" id=\"main_content\"> \n\n  \n\n<h2 class=\"center\">Health\n\n<!--[type=EDIT name=\"DHANType\"]-->\n\n\n\n   Advisory<!--[END]-->\n\n<br>\n\n<!--[type=EDIT name=\"DHAN Heading\"]-->\n\n\n\nCOMMUNITY-ACQUIRED METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS (CA-MRSA)<!--[END]-->\n\n<\/h2>\n\n\n\n<!--[type=HTMLEDIT name=\"Content\"]-->\n\n\n\n<p>\n\n\n  DPH has been alerted of <em>Staphylococcus aureus<\/em> infections, some of which are confirmed\u00a0Community Acquired Methicillin\n\n\n  Resistant (MRSA), apparently transmitted among school sports teams, primarily wrestlers. DPH is currently working with the Department of\n\n\n  Education to further characterize the problem and implement control measures.\n\n\n<\/p>\n\n\n<p>\n\n\n  Healthcare providers are advised that DPH issued the following recommendations to the Department of Education. These recommendations are\n\n\n  in the process of being implemented. Further, healthcare providers are urged to manage undiagnosed lesions suspected of being\n\n\n  <em>Staphylococcus aureus<\/em> infections, among patients who participate in school athletic programs, as MRSA until culture confirmation\n\n\n  is received.\n\n\n<\/p>\n\n\n<h3 class=\"text-center\">\n\n\n  Recommendations for Management of Rash Illnesses \/ Skin Lesions<br>\n\n\n  -Sports Teams \/ Athletes-\n\n\n<\/h3>\n\n\n<ol>\n\n\n  <li>Initial Screening\n\n\n    <ul>\n\n\n      <li>All athletes\/sports team members should be assessed daily for the presence of rash illnesses and\/or skin lesions. This can be\n\n\n      conducted by the coach and\/or athletic director.\n\n\n      <\/li>\n\n\n      <li>Any individual that exhibits a rash illness and\/or skin lesion should be referred to the school nurse\/wellness center provider or\n\n\n      primary care physician.\n\n\n      <\/li>\n\n\n      <li>Rash illnesses, skin lesions, draining wounds or uncultured wounds\/lesions should be treated as a potential MRSA\n\n\n      infection&#8212;culture collected and treatment initiated immediately.\n\n\n      <\/li>\n\n\n    <\/ul>\n\n\n  <\/li>\n\n\n  <li>Culture collection \/ Treatment<br>\n\n\n    \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <strong>Collection of culture:<\/strong>\n\n\n    <ul>\n\n\n      <li>Utilize standard precautions for collecting and handling all specimens.\n\n\n      <\/li>\n\n\n      <li>Whenever possible, collect culture specimens prior to administration of antimicrobial agents.\n\n\n      <\/li>\n\n\n      <li>Deliver all specimens to the laboratory as soon as possible after collection. Specimens for bacterial culture should be\n\n\n      transported at room temperature.\n\n\n      <\/li>\n\n\n      <li>Specimens should be contained in tightly sealed, leakproof containers and transported in sealable, leakproof plastic bags.\n\n\n      <\/li>\n\n\n      <li>Abscess \u2013 Tissue or aspirates are always superior to swab specimens. Remove surface exudates by wiping with sterile saline\n\n\n      or 70% alcohol. Aspirate with needle and syringe. For superficial ulcers, cleanse surface with sterile saline and collect material\n\n\n      from below the surface. Cleanse rubber stopper of transport device with alcohol; push needle through septum and inject all abscess\n\n\n      material on top of agar. It a swab is used, pass the swab deep into the base of the lesion to firmly sample the fresh border.\n\n\n      Specimens should be received at the laboratory as soon as possible.\n\n\n      <\/li>\n\n\n      <li>Superficial ulcers \u2013 Cleanse surface with sterile saline and collect material from below the surface. Cleanse rubber\n\n\n      stopper of transport device with alcohol; push needle through the septum and inject all abscess material on top of agar. If a swab\n\n\n      must be used, pass the swab deep into the base of the lesion to firmly sample the fresh border. Specimens should be received at the\n\n\n      laboratory as soon as possible.\n\n\n      <\/li>\n\n\n      <li>Other dermal lesion \u2013 Obtain either a small biopsy of skin or drainage from the infected site after debriding the surface\n\n\n      and cleansing with sterile saline. Cleanse rubber stopper of transport device with alcohol; push needle through the septum and inject\n\n\n      all abscess material on top of agar. If a swab must be used, pass the swab deep into the base of the lesion to firmly sample the\n\n\n      fresh border. Specimens should be received at the laboratory as soon as possible.\n\n\n      <\/li>\n\n\n      <li>Further questions may be referred to the Division of Public Health Laboratory (Microbiology department): 302-223-1520.<br>\n\n\n        <strong>Antimicrobial therapy:<\/strong>\n\n\n      <\/li>\n\n\n      <li>MRSA bacteria are resistant to many types of antibiotics and it is important to make sure that a culture from the infected area\n\n\n      is obtained.\n\n\n      <\/li>\n\n\n      <li>Laboratories can do sensitivity testing to find out which antibiotics will be effective in killing the bacteria. This will ensure\n\n\n      that the correct antibiotic is given for the treatment of the infection.\n\n\n      <\/li>\n\n\n      <li>Trimethoprim\/Sulfamethoxazole (TMP-SMX) is considered the drug of choice. Recommended dosage: 160mg\/800mg twice daily x 10-14\n\n\n      days.\n\n\n      <\/li>\n\n\n      <li>For individuals with sulfa allergies, Doxycycline\/minocycline 100mg twice daily x 10-14 days is an acceptable alternative.\n\n\n      <\/li>\n\n\n      <li>Rifampin is useful as adjunctive therapy (with TMP-SMX or Doxycycline), but does have the potential for significant toxicity and\n\n\n      drug interactions.\n\n\n      <\/li>\n\n\n    <\/ul>\n\n\n  <\/li>\n\n\n  <li>Reporting\n\n\n    <ul>\n\n\n      <li>Each facility should introduce an internal policy to assure that all rash illnesses and\/or skin lesions are reported and\n\n\n      evaluated by a healthcare provider.\n\n\n      <\/li>\n\n\n      <li>Participants should be excluded from further participation until evaluation and treatment by a healthcare provider. (Note: If\n\n\n      referring a student athlete to their primary care physician, it is advisable to send culture\/treatment recommendations)\n\n\n      <\/li>\n\n\n      <li>By communicable disease regulation, MRSA is reportable to DPH. Primary care physicians, Wellness Center providers and school\n\n\n      nurses are all obligated to report under this regulation (888-295-5156).\n\n\n      <\/li>\n\n\n      <li>School nurses are responsible for conducting passive\/active surveillance for the presence of any communicable disease and report\n\n\n      unusual findings to DPH Epidemiology (888-295-5156). This includes suspected outbreaks among athletic teams, etc.\n\n\n      <\/li>\n\n\n    <\/ul>\n\n\n  <\/li>\n\n\n  <li>Exclusion and Return\n\n\n    <ul>\n\n\n      <li>Any athlete\/sports team member presenting to the coach\/school nurse and\/or Wellness Center with any type of rash illness and\/or\n\n\n      skin lesion should be excluded from further athletic activity. This includes, but is not limited to, practices\/games\/matches\n\n\n      involving person-to-person contact and use of any shared athletic equipment (i.e., weight room equipment, wrestling mats, and\n\n\n      protective gear).\n\n\n      <\/li>\n\n\n      <li>All rash illnesses and\/or skin lesions should be treated as a potential MRSA infection, cultured, and appropriate antimicrobial\n\n\n      therapy instituted.\n\n\n      <\/li>\n\n\n      <li>If MRSA is culture-confirmed, <em>at a minimum<\/em>, the athlete\/sports team member should be excluded for 48 hours after\n\n\n      antimicrobial therapy was begun. However, clinical assessment is paramount to determine if the participant\u2019s return is\n\n\n      appropriate for his\/her specific sport. As a general rule, participant\u2019s who have culture-confirmed MRSA should be excluded\n\n\n      until their rash\/skin lesion is fully dry and healed.\n\n\n      <\/li>\n\n\n      <li>If the healthcare practitioner chooses <em>not<\/em> to culture the rash and\/or skin lesion, the participant should not return\n\n\n      until their rash\/skin lesion is fully dry and healed.\n\n\n      <\/li>\n\n\n    <\/ul>\n\n\n  <\/li>\n\n\n  <li>Rescreening Process for Culture-confirmed MRSA\n\n\n    <ul>\n\n\n      <li>Any participant with culture-confirmed MRSA shall be rescreened by the school nurse and\/or Wellness Center provider (if\n\n\n      available) prior to returning to sporting activities.\n\n\n      <\/li>\n\n\n      <li>This screening should occur whether or not the participant has received a note from his\/her Primary Care Provider stating he\/she\n\n\n      may return.\n\n\n      <\/li>\n\n\n      <li>As a general rule, participant\u2019s who have culture-confirmed MRSA should be excluded until their rash\/skin lesion is fully\n\n\n      dry and healed.\n\n\n      <\/li>\n\n\n    <\/ul>\n\n\n  <\/li>\n\n\n  <li>Prevention Strategies<br>\n\n\n    \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <strong>Personal hygiene:<\/strong>\n\n\n    <ul>\n\n\n      <li>Handwashing is the single most important behavior in preventing infectious disease. Encourage frequent handwashing with warm\n\n\n      water\/soap during the course of practices\/games\/matches.\n\n\n      <\/li>\n\n\n      <li>When hand-washing facilities are not readily available, provide alcohol-based sanitizers and encourage frequent use.\n\n\n      <\/li>\n\n\n      <li>Do not share personal care items (i.e., towels, soap, razors, and water bottles). This includes sideline towels and drinking\n\n\n      reservoirs.\n\n\n      <\/li>\n\n\n      <li>Encourage all participants to shower as soon as possible after direct contact sports using a clean, dry towel.\n\n\n      <\/li>\n\n\n      <li>Do not share any topical preparations (i.e., ointments, salves, antibiotic creams)\n\n\n      <\/li>\n\n\n      <li>Laundry: Wash towels, uniforms, etc. and any other soiled items using hot water, ordinary detergent, and dry on the hottest cycle\n\n\n      after each use. Prewash or rinse any item that has been contaminated with body fluids. Laundry should be contained in an impervious\n\n\n      container or sealed plastic bag for transport home.<br>\n\n\n        <strong>Environmental sanitation:<\/strong>\n\n\n      <\/li>\n\n\n      <li>Establish and enforce routine cleaning schedules for all athletic areas or equipment (i.e., shared protective gear, weight rooms,\n\n\n      locker rooms, wrestling mats, etc.)\n\n\n      <\/li>\n\n\n      <li>Locker rooms and weight rooms should be cleansed at least once weekly using a commercial phenol-containing disinfectant, or a\n\n\n      fresh mixture of 1:100 bleach solutions (1 tablespoon bleach in one quart of water).\n\n\n      <\/li>\n\n\n      <li>If a single case of MRSA is diagnosed, cleaning should be increased to at least twice weekly.\n\n\n      <\/li>\n\n\n      <li>Shared athletic equipment (i.e., wrestling mats, protective gear, etc.) should be cleansed after each use using a commercial\n\n\n      phenol-containing disinfectant, or a fresh mixture of 1:100 bleach solution (1 tablespoon bleach in one quart of water).\n\n\n      <\/li>\n\n\n    <\/ul>\n\n\n  <\/li>\n\n\n<\/ol>\n\n\n<p>\n\n\n  To view the DPH fact sheet regarding CA-MRSA and <em>Staphylococcus aureus<\/em> among sports teams and\/or athletes, please go\n\n\n  to:\u00a0<a href=\"\/wp-content\/uploads\/sites\/10\/dph\/pdf\/mrsa.pdf\">http:\/\/www.dhss.delaware.gov\/dph\/files\/mrsa.pdf<\/a>\n\n\n<\/p>\n\n\n<p>\n\n\n  To view CDC\u2019s general CA-MRSA fact sheets, please go to: <a href=\"http:\/\/www.cdc.gov\/ncidod\/dhqp\/ar_mrsa_ca.html\">http:\/\/www.cdc.gov\/ncidod\/dhqp\/ar_mrsa_ca.html<\/a>\n\n\n<\/p>\n\n\n<p>\n\n\n  Please contact Delaware Division of Public Health at 1-888-295-5156 with any questions or concerns related to these recommendations.\n\n\n<\/p><!--[END]-->\n\n  \n\n        <div class=\"panel panel-danger\">\n\n          <div class=\"panel-heading\">    \n\n      <h2>Categories of Health Alert messages:<\/h2>\n\n       <\/div>\n\n       <div class=\"panel-body\">\n\n      <ul>\n\n        <li><strong>Health Alert:<\/strong> Conveys the highest level of importance; warrants immediate action or attention.<\/li>\n\n        <li><strong>Health Advisory:<\/strong> Provides important information for a specific incident or situation; may not require immediate action.<\/li>\n\n        <li><strong>Health Update:<\/strong> Provides updated information regarding an incident or situation; unlikely to require immediate action.<\/li>\n\n            <\/ul>\n\n         <div><strong>NOTE: This page is for informational purposes only and dated material (e.g. temporary websites) may not be available.<\/strong><\/div>\n\n          <\/div> \n\n        <\/div><br>  \n\n\n\n      <\/div>\n\n    <\/div>\n\n  <\/div><!-- \/container -->\n\n  <\/div>","protected":false},"excerpt":{"rendered":"<p>Listen Delaware Health Alert Network #111 February 8, 2006 3:54 PM Public Health Menu Home About About DPH Sections &#038; Programs Office Locations Contact Info Calendar Services A-Z Services Air &#038; Water Quality Birth, Death, &#038; Marriage Records Clinics Health Data &#038; Statistics Emergency Preparedness Health &#038; Wellness Healthy Homes Healthy Workplaces Laboratory Restaurant Inspections [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":0,"parent":9294,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-10065","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10065","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/comments?post=10065"}],"version-history":[{"count":1,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10065\/revisions"}],"predecessor-version":[{"id":11241,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10065\/revisions\/11241"}],"up":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/9294"}],"wp:attachment":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/media?parent=10065"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}