{"id":10306,"date":"2025-03-01T14:07:34","date_gmt":"2025-03-01T19:07:34","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/dhan333\/"},"modified":"2025-03-02T00:52:24","modified_gmt":"2025-03-02T05:52:24","slug":"dhan333","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan333\/","title":{"rendered":"php\/alerts\/dhan333 ~  Division of Public Health &#8212; 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\/dhan333.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\"]-->333 <!--[END]--> <\/h1>\n\n      <h2> <!--[type=EDIT name=\"DHAN Date\"]-->August 16, 2014 2:38pm <!--[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; 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In support of HHS and DHS activities, the Centers for Disease Control and Prevention (CDC) is\n\n\n  providing consultation on medical screening, surveillance, and public health response when requested.\n\n\n<\/p>\n\n\n<p>\n\n\n  CDC believes the unaccompanied children arriving from Central America pose little risk of spreading infectious diseases to the general\n\n\n  public. While this is generally the case, certain people providing direct care to these vulnerable children should take proper\n\n\n  precautions. The majority of health issues being reported from DHS at the border stations are associated with the difficult journey or\n\n\n  the crowded, unsanitary, and environmental conditions the children endured before they arrived. The illnesses associated with this\n\n\n  population in these conditions include scabies, lice, rash illness, respiratory infections, and diarrhea.\n\n\n<\/p>\n\n\n<h3>\n\n\n  Primary Health Issues\n\n\n<\/h3>\n\n\n<p>\n\n\n  HHS\u2019s Office of Refugee Resettlement (ORR) manages the routine medical screening and data collected on illnesses from the\n\n\n  unaccompanied children. The following list includes some of the interventions, illnesses, and relevant websites that have been identified\n\n\n  for the unaccompanied children arriving from Central America.\n\n\n<\/p>\n\n\n<h4>\n\n\n  Vaccinations\n\n\n<\/h4>\n\n\n<p>\n\n\n  Children from Central America often participate in childhood vaccination programs, similar to those in the United States, and many will\n\n\n  have received vaccines against vaccine-preventable diseases. However, a few vaccines are not offered, have not been available for very\n\n\n  long, or are not widely used, such as chickenpox, influenza, and pneumococcal vaccines. To be cautious, ORR recommends children without\n\n\n  vaccine documents receive vaccinations according to the Advisory Committee on Immunization Practices (ACIP) catch-up immunization\n\n\n  schedule. Children are vaccinated with multiple vaccines before they are released from the ORR-funded program into a community.\n\n\n<\/p>\n\n\n<p>\n\n\n  Typically, these include:\n\n\n<\/p>\n\n\n<ul>\n\n\n  <li>Tdap or DTaP (tetanus, diphtheria, pertussis)\n\n\n  <\/li>\n\n\n  <li>MCV4 (meningococcal disease)\n\n\n  <\/li>\n\n\n  <li>MMR or MMRV (measles, mumps, rubella)\n\n\n  <\/li>\n\n\n  <li>Varicella (chickenpox)\n\n\n  <\/li>\n\n\n  <li>Influenza (routinely during flu season, and since July 11 in CBP processing centers and in the ORR temporary shelters)\n\n\n  <\/li>\n\n\n  <li>PCV13 (pneumococcal conjugate vaccine, since July 18)\n\n\n  <\/li>\n\n\n  <li>IPV (inactivated polio vaccine)\n\n\n  <\/li>\n\n\n  <li>Hepatitis A\n\n\n  <\/li>\n\n\n  <li>Hepatitis B\n\n\n  <\/li>\n\n\n<\/ul>\n\n\n<h4>\n\n\n  Lice and Scabies\n\n\n<\/h4>\n\n\n<p>\n\n\n  DHS has been reporting head lice and scabies in unaccompanied children during the visual screening at border stations. Any child found to\n\n\n  have lice or scabies is treated right away, before going to a shelter. Scabies and head lice can spread rapidly in crowded conditions\n\n\n  where close body and skin contact is frequent. Institutions such as nursing homes, extended-care facilities, and prisons are often sites\n\n\n  of scabies outbreaks. Children living in shelters very close to one another can easily transmit scabies and lice to each other. Scabies\n\n\n  and lice are easily treated, and DHS staff have been treating both when identified in the children.\n\n\n<\/p>\n\n\n<p>\n\n\n  For more information about head lice, visit <a href=\"http:\/\/www.cdc.gov\/parasites\/lice\/head\">www.cdc.gov\/parasites\/lice\/head<\/a>.\n\n\n<\/p>\n\n\n<p>\n\n\n  For more information about scabies, visit <a href=\"http:\/\/www.cdc.gov\/parasites\/scabies\">www.cdc.gov\/parasites\/scabies<\/a>.\n\n\n<\/p>\n\n\n<h4>\n\n\n  Chickenpox\n\n\n<\/h4>\n\n\n<p>\n\n\n  Cases of chickenpox have been identified (varicella vaccine is not routinely offered in Central America). DHS and HHS\u2019s ORR have\n\n\n  protocols in place for responding to chickenpox to limit spread.\n\n\n<\/p>\n\n\n<p>\n\n\n  For more information about chickenpox, visit <a href=\"http:\/\/www.cdc.gov\/chickenpox\">www.cdc.gov\/chickenpox<\/a>.\n\n\n<\/p>\n\n\n<h4>\n\n\n  Influenza (flu)\n\n\n<\/h4>\n\n\n<p>\n\n\n  There have been some confirmed infections caused by seasonal influenza B and H1N1 viruses among the children arriving from Central\n\n\n  America. These are common human seasonal flu viruses. No novel or variant (\u201cswine flu\u201d) viruses have been detected.\n\n\n<\/p>\n\n\n<p>\n\n\n  In Central America, the flu season has already started and CDC expects that flu activity will increase in these countries, probably\n\n\n  peaking in late summer.\n\n\n<\/p>\n\n\n<ul>\n\n\n  <li>Seasonal influenza A (H3N2) and influenza B viruses are the primary flu viruses circulating in Central America at this time.\n\n\n  <\/li>\n\n\n  <li>CDC expects to see some children in the shelters sick with H3N2 flu as well.\n\n\n  <\/li>\n\n\n  <li>Information about flu activity levels in the Southern Hemisphere is available through the Pan American Health Organization.\n\n\n  <\/li>\n\n\n<\/ul>\n\n\n<p>\n\n\n  The U.S. flu season begins in the fall, but flu viruses circulate year-round, though at low levels in the summer. Seasonal flu vaccine is\n\n\n  usually available from July or August of one year to June of the following year. The current seasonal flu vaccine given in the United\n\n\n  States includes components to protect against H1N1, H3N2, and flu B viruses. To help provide flu vaccines for the unaccompanied children\n\n\n  in between U.S. flu seasons, CDC worked with the U.S. Food and Drug Administration to obtain approval to use CDC\u2019s remaining supply\n\n\n  of the 2013-14 flu vaccine to vaccinate the children in large crowded settings until the 2014-15 vaccine is available. The extended\n\n\n  expiration date has been given to IIV formulations for which 12- or 18-month stability data are available. Use of this 2013-2014 vaccine\n\n\n  does not pose any added safety concerns.\n\n\n<\/p>\n\n\n<p>\n\n\n  CDC also has recommended that staff working closely with the children remain up-to-date on their seasonal flu vaccination. This is\n\n\n  consistent with longstanding CDC recommendations for flu vaccination.\n\n\n<\/p>\n\n\n<p>\n\n\n  For more information about flu, visit <a href=\"http:\/\/www.cdc.gov\/flu\">www.cdc.gov\/flu<\/a>.\n\n\n<\/p>\n\n\n<h4>\n\n\n  Tuberculosis\n\n\n<\/h4>\n\n\n<p>\n\n\n  During the screening conducted by ORR, (i.e., tuberculin skin test, Interferon-Gamma Release Assays, chest X-ray, and follow-up) a small\n\n\n  of number of cases of TB have been identified. Given that the children are from countries with higher rates of TB (about 25-60 cases of\n\n\n  TB per 100,000 people) than the United States, public health officials would expect to find TB in some of these children. This is why TB\n\n\n  screening is a part of ORR\u2019s routine medical screening process. Children found to have TB disease are sent to shelters that have\n\n\n  the capacity to care for them. They are separated from other children and appropriately treated until they are no longer considered to be\n\n\n  infectious. The appropriate state and local health departments are notified. Once a child is no longer considered infectious, she or he\n\n\n  may be released to a sponsor, and will be referred to health departments to continue their TB treatment.\n\n\n<\/p>\n\n\n<p>\n\n\n  Children found to have latent TB infection (LTBI) receive treatment if they will be in custody with ORR long enough to complete their\n\n\n  treatment. When a child who has been diagnosed with LTBI but not given LTBI treatment is released to a sponsor, the sponsor is notified\n\n\n  and the child is referred to the health department in the sponsor\u2019s community for LTBI follow-up.\n\n\n<\/p>\n\n\n<p>\n\n\n  For more information about tuberculosis, visit <a href=\"http:\/\/www.cdc.gov\/tb\">www.cdc.gov\/tb<\/a>.\n\n\n<\/p>\n\n\n<h4>\n\n\n  Pneumonia and Pneumococcal disease\n\n\n<\/h4>\n\n\n<p>\n\n\n  Pneumonia and pneumococcal disease have been found in some of the children in the shelters, and CDC is currently investigating these\n\n\n  clusters of cases. CDC recently issued interim guidance to ORR recommending that all unaccompanied children receive a single dose of\n\n\n  pneumococcal conjugate vaccine (PCV13).\n\n\n<\/p>\n\n\n<p>\n\n\n  Although vaccines to protect against pneumococcal disease have been part of routine immunization in Central America for several years,\n\n\n  many of the older children arriving in the United States may not have been vaccinated for pneumococcal disease in their home countries.\n\n\n<\/p>\n\n\n<p>\n\n\n  For more information about pneumonia, visit <a href=\"http:\/\/www.cdc.gov\/pneumonia\">www.cdc.gov\/pneumonia<\/a>.\n\n\n<\/p>\n\n\n<p>\n\n\n  For more information about pneumococcal disease, visit <a href=\"http:\/\/www.cdc.gov\/pneumococcal\">www.cdc.gov\/pneumococcal<\/a>.\n\n\n<\/p>\n\n\n<h3>\n\n\n  <em>For Public Health Partners in Delaware<\/em>\n\n\n<\/h3>\n\n\n<h4>\n\n\n  <em>Tuberculosis:<\/em>\n\n\n<\/h4>\n\n\n<p>\n\n\n  If you suspect a case of tuberculosis, or have further questions regarding tuberculosis in these unaccompanied children, call the\n\n\n  tuberculosis control program at 302-744-1050 or call the tuberculosis clinic in your county:\n\n\n<\/p>\n\n\n<ul>\n\n\n  <li>New Castle: 302-283-7588\n\n\n  <\/li>\n\n\n  <li>Kent: 302-857-5130\n\n\n  <\/li>\n\n\n  <li>Sussex: 302-856-5119\n\n\n  <\/li>\n\n\n<\/ul>\n\n\n<h4>\n\n\n  <em>Vaccine Preventable Diseases \/ Immunizations:<\/em>\n\n\n<\/h4>\n\n\n<p>\n\n\n  For questions regarding immunizations for these children, call the Immunization program at 302-744-1060.\n\n\n<\/p>\n\n\n<p>\n\n\n  To report a confirmed or suspected vaccine preventable disease, call the Office of Infectious Disease epidemiology at 302-744-1033.\n\n\n<\/p>\n\n\n<p>\n\n\n  ************************************\n\n\n<\/p>\n\n\n<p>\n\n\n  You are receiving this email because you are a registered member of the Delaware Health Alert Network. If you are not a member and would\n\n\n  like to subscribe, please register at <a href=\"https:\/\/healthalertde.org\">https:\/\/healthalertde.org<\/a>\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 #333 August 16, 2014 2:38pm 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 Screening [&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-10306","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10306","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=10306"}],"version-history":[{"count":1,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10306\/revisions"}],"predecessor-version":[{"id":11482,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10306\/revisions\/11482"}],"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=10306"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}