{"id":10369,"date":"2025-03-01T14:07:47","date_gmt":"2025-03-01T19:07:47","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/dhan391\/"},"modified":"2025-03-02T00:53:58","modified_gmt":"2025-03-02T05:53:58","slug":"dhan391","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan391\/","title":{"rendered":"php\/alerts\/dhan391 ~  Division of Public Health &#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\/dhan391.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\"]-->391 <!--[END]--> <\/h1>\n\n      <h2> <!--[type=EDIT name=\"DHAN Date\"]-->August 3, 2018 11:15 am <!--[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\n\n\n\n\n\n\nAlert<!--[END]-->\n\n<br>\n\n<!--[type=EDIT name=\"DHAN Heading\"]-->\n\n\n\n\n\n\n\n\n\n\nOUTBREAK OF HEPATITIS A VIRUS (HAV) INFECTIONS AMONG PERSONS WHO USE DRUGS AND PERSONS EXPERIENCING HOMELESSNESS<!--[END]-->\n\n<\/h2>\n\n\n\n<!--[type=HTMLEDIT name=\"Content\"]-->\n\n\n\n\n\n\n\n\n\n\n<p>The Delaware Division of Public Health (DPH) is issuing this Health Alert to inform \n\n\n\n\n\nhealth care providers of an outbreak in multiple states among persons reporting drug use \n\n\n\n\n\nand\/or homelessness and their contacts and recommend action.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<h2>Summary<\/h2>\n\n\n\n\n\n<p>The Centers for Disease Control and Prevention (CDC) and state health departments are \n\n\n\n\n\ninvestigating hepatitis A virus (HAV) outbreaks in 10 states among persons reporting drug \n\n\n\n\n\nuse and\/or homelessness and their contacts. This Health Alert Network (HAN) notification \n\n\n\n\n\nalerts health care providers, facilities, and programs providing services to affected populations, \n\n\n\n\n\nabout these outbreaks of HAV infection and provides guidance to assist in identifying and \n\n\n\n\n\npreventing new infections.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>To date, Delaware does not have any reported HAV infections associated with this outbreak \n\n\n\n\n\nor with person-to-person transmission, but DPH is heightening surveillance and providing CDC \n\n\n\n\n\nrecommendations to medical providers.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<h2>Background<\/h2>\n\n\n\n\n\n<p>HAV infection is a vaccine-preventable illness. The primary means of HAV transmission in \n\n\n\n\n\nthe United States is typically person-to-person through the fecal-oral route. Symptoms include \n\n\n\n\n\nfever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored \n\n\n\n\n\nbowel movements, joint pain, and jaundice. Although rare, atypical extra hepatic manifestations \n\n\n\n\n\ninclude rash, pancreatitis, renal disease, arthritis, and anemia. Severe infections can result \n\n\n\n\n\nin cholestatic hepatitis, relapsing hepatitis, and fulminant hepatitis leading to death. Average \n\n\n\n\n\nincubation of HAV is 28 days, but illness can occur up to 50 days after exposure. An HAV-infected \n\n\n\n\n\nperson can be viremic up to six weeks through their clinical course and excrete virus in stool for \n\n\n\n\n\nup to two weeks prior to becoming symptomatic, making identifying exposures particularly difficult. \n\n\n\n\n\nIllness from HAV is typically acute and self-limited; however, when this disease affects populations \n\n\n\n\n\nwith already poor health (e.g., hepatitis B and C infections, chronic liver disease), infection can \n\n\n\n\n\nlead to serious outcomes, including death.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>From January 2017 to April 2018, the CDC received more than 2,500 reports of HAV infections \n\n\n\n\n\nassociated with person-to-person transmission from multiple states. Of the more than 1,900 reports \n\n\n\n\n\nfor which risk factors are known, more than 1,300 (68 percent) of the infected persons report drug \n\n\n\n\n\nuse (injection and non-injection), homelessness, or both. As of July 6, health departments in 10 states \n\n\n\n\n\nreported 3,793 cases, including 2,445 hospitalizations and 57 deaths. State response to the outbreaks \n\n\n\n\n\nincreased vaccine demand resulting in constrained supplies but vaccine is now more readily available. \n\n\n\n\n\nThe CDC and vaccine manufacturers continue to monitor demand for adult hepatitis A vaccine.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>DPH is increasing surveillance, monitoring high risk populations, contacting homeless shelters to \n\n\n\n\n\nadvise them of the outbreak and implementing a risk-based plan for vaccination.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<h2>Recommendations<\/h2>\n\n\n\n\n\n<ol>\n\n\n\n\n\n<li>Consider HAV as a diagnosis in anyone with jaundice and clinically compatible symptoms.<\/li>\n\n\n\n\n\n<li>Encourage persons who have been exposed recently to HAV and who have not been vaccinated to be \n\n\n\n\n\nadministered one dose of single-antigen hepatitis A vaccine or immune globulin (IG) as soon as possible, \n\n\n\n\n\nwithin two weeks after exposure. Guidelines vary by age and health status \n\n\n\n\n\n(see <a href=\"https:\/\/www.cdc.gov\/hepatitis\/outbreaks\/InterimOutbreakGuidance-HAV-VaccineAdmin.htm\">https:\/\/www.cdc.gov\/hepatitis\/outbreaks\/InterimOutbreakGuidance-HAV-VaccineAdmin.htm<\/a> for additional information).<\/li>\n\n\n\n\n\n<li>Consider saving serum samples for additional testing to assist public health officials in the \n\n\n\n\n\ninvestigation of transmission (i.e., confirmation of antibody test, HAV RNA test, genotyping, and sequencing). \n\n\n\n\n\nContact DPH for assistance with submitting specimens for molecular characterization.<\/li>\n\n\n\n\n\n<li>Ensure all persons diagnosed with hepatitis A are reported to DPH in a timely manner:\n\n\n\n\n\n<ol type=\"a\">\n\n\n\n\n\n<li>Call 302-744-4990 during regular hours or toll-free at 1-888-295-5156 (available 24\/7)<\/li>\n\n\n\n\n\n<li>Fax: 302-223-1540<\/li>\n\n\n\n\n\n<li>Lab reports also reach DPH electronically via DERSS\n\n\n\n\n\n<\/li><\/ol>\n\n\n\n\n\n<\/li><li>Encourage hepatitis A vaccination for homeless individuals in areas where hepatitis A outbreaks are occurring.<\/li><li>Encourage hepatitis A vaccination for persons who report drug use or other risk factors for hepatitis A.<\/li><li>CDC recommends the following groups be vaccinated against hepatitis A:\n\n\n\n\n\n<ol type=\"a\">\n\n\n\n\n\n<li>All children at age 1 year<\/li>\n\n\n\n\n\n<li>Persons who are at increased risk for infection:\n\n\n\n\n\n<ul>\n\n\n\n\n\n<li>Persons traveling to, or working in, countries that have high or intermediate endemicity of hepatitis A;<\/li>\n\n\n\n\n\n<li>Men who have sex with men;<\/li>\n\n\n\n\n\n<li>Persons who use injection and non-injection drugs;<\/li>\n\n\n\n\n\n<li>Persons who have occupational risk for infection;<\/li>\n\n\n\n\n\n<li>Persons who have chronic liver disease;<\/li>\n\n\n\n\n\n<li>Persons who have clotting-factor disorders;<\/li>\n\n\n\n\n\n<li>Household members and other close personal contacts or adopted children newly arriving from countries with \n\n\n\n\n\nhigh or intermediate hepatitis A endemicity; and<\/li>\n\n\n\n\n\n<li>Persons with direct contact with persons who have hepatitis A.<\/li>\n\n\n\n\n\n<li>Persons who are at increased risk for complications from hepatitis A, including people with chronic liver \n\n\n\n\n\ndiseases, such as hepatitis B or hepatitis C.<\/li>\n\n\n\n\n\n<li>Any person wishing to obtain immunity.<\/li>\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n<\/li>\n\n\n\n\n\n<\/ol>\n\n\n\n\n\n<\/li><\/ol>\n\n\n\n\n\n\n\n\n\n\n\n<h2>Additional Information<\/h2>\n\n\n\n\n\n<ul>\n\n\n\n\n\n<li>Centers for Disease Control and Prevention. Division of Viral Hepatitis A Outbreak Website.<br>\n\n\n\n\n\n<a href=\"https:\/\/www.cdc.gov\/hepatitis\/outbreaks\/2017March-HepatitisA.htm\">https:\/\/www.cdc.gov\/hepatitis\/outbreaks\/2017March-HepatitisA.htm<\/a><\/li>\n\n\n\n\n\n<li>Centers for Disease Control and Prevention&#8217;s Hepatitis A Virus Website.<br>\n\n\n\n\n\n<a href=\"https:\/\/www.cdc.gov\/hepatitis\/hav\/index.htm\">https:\/\/www.cdc.gov\/hepatitis\/hav\/index.htm<\/a><\/li>\n\n\n\n\n\n<li>Centers for Disease Control and Prevention. Viral Hepatitis Surveillance \u2013 United States, 2016.<br>\n\n\n\n\n\n<a href=\"https:\/\/www.cdc.gov\/hepatitis\/statistics\/2016surveillance\/pdfs\/2016HepSurveillanceRpt.pdf\">https:\/\/www.cdc.gov\/hepatitis\/statistics\/2016surveillance\/pdfs\/2016HepSurveillanceRpt.pdf<\/a><\/li>\n\n\n\n\n\n<li>Centers for Disease Control and Prevention. Hepatitis A General Information Fact Sheet.<br>\n\n\n\n\n\n<a href=\"https:\/\/www.cdc.gov\/hepatitis\/hav\/pdfs\/hepageneralfactsheet.pdf\">https:\/\/www.cdc.gov\/hepatitis\/hav\/pdfs\/hepageneralfactsheet.pdf<\/a><\/li>\n\n\n\n\n\n<li>Centers for Disease Control and Prevention. The Pink Book. Chapter 9: Hepatitis A.<br>\n\n\n\n\n\n<a href=\"https:\/\/www.cdc.gov\/vaccines\/pubs\/pinkbook\/downloads\/hepa.pdf\">https:\/\/www.cdc.gov\/vaccines\/pubs\/pinkbook\/downloads\/hepa.pdf<\/a><\/li>\n\n\n\n\n\n<li>Delaware Adult Viral Hepatitis Program<br>\n\n\n\n\n\n<a href=\"http:\/\/www.dhss.delaware.gov\/dph\/dpc\/hepatitis.html\">http:\/\/www.dhss.delaware.gov\/dph\/dpc\/hepatitis.html<\/a><\/li>\n\n\n\n\n\n<li>Delaware Immunization Program<br>\n\n\n\n\n\n<a href=\"http:\/\/www.dhss.delaware.gov\/dph\/dpc\/immunize.html\">http:\/\/www.dhss.delaware.gov\/dph\/dpc\/immunize.html<\/a><\/li>\n\n\n\n\n\n<li>Call DPH Bureau of Communicable Diseases 302-744-1050<\/li>\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n<p>************************************<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>You are receiving this email because you are a registered member of the Delaware Health Alert Network.\n\n\n\n\n\nIf you are not a member and would like to subscribe, please register at <a href=\"https:\/\/healthalertde.org\">https:\/\/healthalertde.org<\/a><\/p>\n\n\n\n\n\n\n\n\n\n\n\n<br>\n\n\n\n\n\n<br>\n\n\n\n\n\n<p class=\"smalltext\"><a href=\"http:\/\/www.adobe.com\/products\/acrobat\/readstep2.html\"><img loading=\"lazy\" decoding=\"async\" alt=\"Download Adobe Acrobat Reader\" height=\"21\" src=\"\/wp-content\/uploads\/dhss\/img\/getacro60.gif\" width=\"60\"><\/a> Please note: Some of the files available on this page are in Adobe PDF format which requires Adobe Acrobat Reader.  A free copy of Adobe Acrobat Reader can be downloaded directly from <a href=\"http:\/\/www.adobe.com\/products\/acrobat\/readstep2.html\">Adobe <\/a>. If you are using an assistive technology unable to read Adobe PDF, please either view the corresponding text only version (if available) or visit Adobe&#8217;s <a href=\"http:\/\/access.adobe.com\">Accessibility Tools page<\/a>.<\/p>\n<!--[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 #391 August 3, 2018 11:15 am 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-10369","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10369","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=10369"}],"version-history":[{"count":1,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10369\/revisions"}],"predecessor-version":[{"id":11545,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10369\/revisions\/11545"}],"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=10369"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}