{"id":10343,"date":"2025-03-01T14:07:42","date_gmt":"2025-03-01T19:07:42","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/dhan368\/"},"modified":"2025-03-02T00:53:22","modified_gmt":"2025-03-02T05:53:22","slug":"dhan368","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan368\/","title":{"rendered":"php\/alerts\/dhan368 ~  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\/dhan368.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\"]-->368 <!--[END]--> <\/h1>\n\n      <h2> <!--[type=EDIT name=\"DHAN Date\"]-->August 30, 2016 4:02 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; 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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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DPH has recently been notified of several\n\n\n  infections occurring in intravenous drug users in New Castle County.\n\n\n<\/p>\n\n\n<h3>\n\n\n  Background\n\n\n<\/h3>\n\n\n<p>\n\n\n  Between July 2016 and August 2016, DPH was notified of four cases of <em>B. cereus<\/em> bacteremia. While a common cause of foodborne\n\n\n  illness, <em>B. cereus<\/em> rarely causes bacteremia. Three of the four cases of <em>B. cereus<\/em> bacteremia reported to DPH occurred\n\n\n  in individuals who are intravenous (IV) drug users and currently use heroin. Two of these described the heroin they used as having the\n\n\n  street name \u201cButter\u201d and having an image of a butterfly stamped on the packaging. The heroin was allegedly purchased from a\n\n\n  dealer in the Wilmington area. However, any heroin or illicit IV drug use could carry risk of a variety of infections regardless of where\n\n\n  it is purchased. Infections that are easily transmitted during use of illicit IV drugs include Hepatitis C virus and HIV among others.\n\n\n<\/p>\n\n\n<p>\n\n\n  Complications of <em>B. cereus<\/em> bacteremia that have been reported in medical literature include ocular infection (including\n\n\n  endophthalmitis and panophthalmitis) with the risk of blindness, endocarditis of native or prosthetic valves, and musculoskeletal,\n\n\n  respiratory, and central nervous system infections (among others).\n\n\n<\/p>\n\n\n<p>\n\n\n  Most <em>B. cereus<\/em> isolates produce B-lactamase and are resistant to B-lactam antibiotics. There have been a number of case reports\n\n\n  in which intravenous vancomycin was successfully used to treat <em>B. cereus<\/em> bacteremia. In addition, <em>B. cereus<\/em> is\n\n\n  considered susceptible to aminoglycosides, carbapenems, and fluoroquinolones, and newer agents like linezolid, daptomycin, and telavancin\n\n\n  may have activity against <em>B. cereus.<\/em>\n\n\n<\/p>\n\n\n<h3>\n\n\n  Recommendations\/Reporting\n\n\n<\/h3>\n\n\n<p>\n\n\n  Health care providers are encouraged to consider <em>B. cereus<\/em> bacteremia in the differential diagnosis for IV drug users who\n\n\n  present with evidence of acute systemic infection. Antibiotics should be started promptly after blood cultures are drawn and\n\n\n  consideration should be given for including antibiotics that are active against <em>B. cereus<\/em> as part of the empiric therapy.\n\n\n<\/p>\n\n\n<p>\n\n\n  If <em>B. cereus<\/em> bacteremia is identified in any patient (IV drug user or not), providers are urged to obtain consultation with\n\n\n  infectious diseases physicians early in the course of patient care as some of the cases of <em>B. cereus<\/em> bacteremia reported in the\n\n\n  literature have shown persistent bacteremia requiring prolonged antibiotic therapy. In addition, complications are not uncommon with\n\n\n  <em>B. cereus<\/em> bacteremia.\n\n\n<\/p>\n\n\n<p>\n\n\n  If <em>B. cereus<\/em> bacteremia is identified in any patient (IV drug users or not), providers are encouraged to contact DPH\u2019s\n\n\n  Office of Infectious Disease Epidemiology at 888-295-5156 or 302-744-4990 to report.\n\n\n<\/p>\n\n\n<p>\n\n\n  For laboratories that are not able to identify Bacillus bacteria to the species level, call DPH\u2019s Office of Infectious Disease\n\n\n  Epidemiology at 888-295-5156 or 302-744-4990 to discuss and to arrange for further testing if bacteremia caused by Bacillus species is\n\n\n  identified in a patient.\n\n\n<\/p>\n\n\n<h3>\n\n\n  Additional Information\n\n\n<\/h3>\n\n\n<p>\n\n\n  Outbreak of <em>B. cereus<\/em> in San Diego <a href=\"http:\/\/wwwnc.cdc.gov\/eid\/article\/22\/9\/15-0647_article\">http:\/\/wwwnc.cdc.gov\/eid\/article\/22\/9\/15-0647_article<\/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 #368 August 30, 2016 4:02 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-10343","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10343","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=10343"}],"version-history":[{"count":1,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10343\/revisions"}],"predecessor-version":[{"id":11519,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10343\/revisions\/11519"}],"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=10343"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}