{"id":10373,"date":"2025-03-01T14:07:49","date_gmt":"2025-03-01T19:07:49","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/dhan396\/"},"modified":"2025-03-02T00:54:32","modified_gmt":"2025-03-02T05:54:32","slug":"dhan396","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan396\/","title":{"rendered":"php\/alerts\/dhan396 ~  Division of Public Health  &#8211; Delaware Health and Social Services &#8211; State of Delaware"},"content":{"rendered":"<div data-swiftype-index=\"true\">\n\n\n\n\n\n  <br>\n\n\n\n\n\n  <div class=\"container\" id=\"main_header\"> \n\n\n    <!-- BEGIN readspeaker div -->\n\n\n    <div class=\"rs_skip rsbtn rs_preserve\" id=\"readspeaker_button1\">\n\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\/dhan396.html\" title=\"Listen to this page using ReadSpeaker\">\n\n\n        <span class=\"rsbtn_left rsimg rspart\"><span class=\"rsbtn_text\"><span>Listen<\/span><\/span><\/span>\n\n\n        <span class=\"rsbtn_right rsimg rsplay rspart\"><\/span>\n\n\n      <\/a>\n\n\n    <\/div>\n\n\n    <!-- END readspeaker div -->\n\n\n\n\n\n    \n\n\n    <header class=\"pull-left\">\n\n\n      <h1>Delaware Health Alert Network #<!--[type=EDIT name=\"DHAN Number\"]-->396 <!--[END]--> <\/h1>\n\n\n      <h2> <!--[type=EDIT name=\"DHAN Date\"]-->December 3, 2018 3:26 pm <!--[END]--> <\/h2>\n\n\n    <\/header>\n\n\n  <\/div><br>\n\n\n \n\n\n  <div class=\"container\">\n\n\n    <div class=\"row\">\n\n\n      <div class=\"col-md-3\" id=\"leftCol\">\n\n\n        <div class=\"panel-group\" id=\"accordion\">\n\n\n          <div class=\"panel sectionmenu_panel\">\n\n\n            <div class=\"panel-heading\">\n\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\n            <\/div>\n\n\n\n\n\n            <div class=\"panel-collapse collapse in\" id=\"collapseOne\">\n\n\n              <div class=\"panel-body\" id=\"clf_nav\">\n\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\n              <\/div>\n\n\n            <\/div>\n\n\n          <\/div>\n\n\n        <\/div><br>\n\n\n      <\/div>\n\n\n\n\n\n      <div class=\"col-md-9\" id=\"main_content\"> \n\n\n  \n\n\n<h2 class=\"center\">Health\n\n\n<!--[type=EDIT name=\"DHANType\"]-->\n\n\n\n\n\n\n\n\n\nAdvisory<!--[END]-->\n\n\n<br>\n\n\n<!--[type=EDIT name=\"DHAN Heading\"]-->\n\n\n\n\n\n\n\n\n\nHEPATITIS A OUTBREAK IN PENNSYLVANIA: INCREASE VACCINATION OF HIGH RISK PATIENTS TO PREVENT AND CONTROL TRANSMISSION<!--[END]-->\n\n\n<\/h2>\n\n\n\n\n\n<!--[type=HTMLEDIT name=\"Content\"]-->\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p>The Delaware Division of Public Health (DPH) is issuing this health advisory to advise health care providers \n\n\n\n\n\nof an ongoing outbreak in multiple states among persons reporting drug use and\/or homelessness and their contacts.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<h2>Summary<\/h2>\n\n\n\n\n\n<p>Across the United States, several states, including West Virginia and Ohio, continue to experience large, ongoing \n\n\n\n\n\nHepatitis A Virus (HAV) outbreaks primarily among people who use drugs and\/or are experiencing homelessness. An HAV \n\n\n\n\n\noutbreak was recently declared in Pennsylvania, as an 80 percent increase in reported HAV cases among persons with \n\n\n\n\n\nand without specific risk factors has occurred statewide in 2018. Allegheny County in western Pennsylvania experienced \n\n\n\n\n\na sudden case increase last month. In Philadelphia, HAV transmission has been elevated since July 2017, with the majority \n\n\n\n\n\nof cases (21 of 38, or 55 percent) occurring among men who have sex with men (MSM).<\/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 the United States is typically \n\n\n\n\n\nperson-to-person through the fecal-oral route. Symptoms include fever, fatigue, loss of appetite, nausea, vomiting, abdominal \n\n\n\n\n\npain, dark urine, clay-colored bowel 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 in cholestatic hepatitis, \n\n\n\n\n\nrelapsing hepatitis, and fulminant hepatitis leading to death. Average incubation of HAV is 28 days, but illness can occur up \n\n\n\n\n\nto 50 days after exposure. An HAV-infected person can be viremic up to six weeks through their clinical course and excrete \n\n\n\n\n\nvirus in stool for up to two weeks prior to becoming symptomatic, making identifying exposures particularly difficult. Illness \n\n\n\n\n\nfrom HAV is typically acute and self-limited; however, when this disease affects populations with already poor health (e.g., \n\n\n\n\n\nhepatitis B and C infections, chronic liver disease), infection can lead to serious outcomes, including death.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>The sudden HAV increases in western Pennsylvania along with ongoing outbreaks across the U.S. highlight the potential for \n\n\n\n\n\nadditional HAV increases in Philadelphia as well as Delaware due to proximity to larger outbreaks and\/or expanded transmission \n\n\n\n\n\namong risk groups, especially people who use drugs and\/or are homeless.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<h2>Recommendations<\/h2>\n\n\n\n\n\n<p>To prevent further HAV increases, area providers should increase efforts to provide HAV vaccine during health care visits. \n\n\n\n\n\nIn addition to routine vaccination for all children ages 12 to 23 months, providers should routinely screen and offer HAV to \n\n\n\n\n\nhigh-risk children and adults, including:<\/p>\n\n\n\n\n\n<ul>\n\n\n\n\n\n<li>Patients ages 12 months and older who are currently homeless or who have had periods of homelessness in the past \n\n\n\n\n\n<em>(newly-approved Advisory Committee on Immunization Practices&#8217; [ACIP] recommendation)<\/em><\/li>\n\n\n\n\n\n<li>Patients who use injection or non-injection drugs<\/li>\n\n\n\n\n\n<li>Patients who identify as MSM or who have a sex partner identifying as MSM<\/li>\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n<p>Safe and highly effective HAV vaccines are available for persons ages 12 months and older and should be administered \n\n\n\n\n\nin accordance with ACIP recommendations (two doses given 6 to 18 months apart).<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>While Delaware has not seen an increase in HAV infections to date, DPH is encouraging those at risk to seek HAV vaccination \n\n\n\n\n\nand offering free vaccine to high-risk individuals in homeless shelters:<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>Those without insurance can receive the HAV vaccine at the DPH clinics listed below.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>New Castle County:<\/p>\n\n\n\n\n\n<ul>\n\n\n\n\n\n<li>Porter State Service Center, 509 W. 8th St., Wilmington, DE 19801 302-777-2860<\/li>\n\n\n\n\n\n<li>Hudson State Service Center, 501 Ogletown Road, Newark, DE 19711 302-283-7587<\/li>\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n<p>Kent County:<\/p>\n\n\n\n\n\n<ul>\n\n\n\n\n\n<li>Williams State Service Center, 805 River Road, Dover, DE 19901, 302-857-5140<\/li>\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n<p>Sussex County:<\/p>\n\n\n\n\n\n<ul>\n\n\n\n\n\n<li>Thurman Adams State Service Center, 544 S. Bedford St., Georgetown, DE 19947, 302-515-3220<\/li>\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n<p>Prompt recognition of HAV is important to control transmission and allow time-sensitive administration of post-exposure \n\n\n\n\n\nprophylaxis (PEP) to exposed contacts.<\/p>\n\n\n\n\n\n<ul>\n\n\n\n\n\n<li>Consider HAV for patients, particularly those who are high risk, who present with fever, fatigue, and \n\n\n\n\n\nsigns of liver damage \u2014 dark urine, clay colored or pale stools, jaundice, abdominal pain, nausea, and vomiting.<\/li>\n\n\n\n\n\n<li>Test serum from suspected, symptomatic cases for HAV IgM and perform liver function tests.<\/li>\n\n\n\n\n\n<li>Educate HAV cases on measures to prevent transmission (i.e., handwashing, safe sex practices, etc.).<\/li>\n\n\n\n\n\n<li>Recommend HAV Post-Exposure Prophylaxis for susceptible, close contacts (i.e., household members, sex partners). Updated \n\n\n\n\n\nguidance from CDC is available at: <a href=\"https:\/\/www.cdc.gov\/mmwr\/volumes\/67\/wr\/mm6743a5.htm?s_cid=mm6743a5_e\">https:\/\/www.cdc.gov\/mmwr\/volumes\/67\/wr\/mm6743a5.htm?s_cid=mm6743a5_e<\/a>.<\/li>\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n<h2>Reporting<\/h2>\n\n\n\n\n\n<ul>\n\n\n\n\n\n<li>Promptly report acute HAV cases to DPH by calling 302-744-4990 (after hours, call 1-888-295-5156).<\/li>\n\n\n\n\n\n<\/ul>\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<br>\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\n\n        <div class=\"panel panel-danger\">\n\n\n          <div class=\"panel-heading\">    \n\n\n      <h2>Categories of Health Alert messages:<\/h2>\n\n\n       <\/div>\n\n\n       <div class=\"panel-body\">\n\n\n      <ul>\n\n\n        <li><strong>Health Alert:<\/strong> Conveys the highest level of importance; warrants immediate action or attention.<\/li>\n\n\n        <li><strong>Health Advisory:<\/strong> Provides important information for a specific incident or situation; may not require immediate action.<\/li>\n\n\n        <li><strong>Health Update:<\/strong> Provides updated information regarding an incident or situation; unlikely to require immediate action.<\/li>\n\n\n            <\/ul>\n\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\n          <\/div> \n\n\n        <\/div><br>  \n\n\n\n\n\n      <\/div>\n\n\n    <\/div>\n\n\n  <\/div><!-- \/container -->\n\n\n  <\/div>","protected":false},"excerpt":{"rendered":"<p>Listen Delaware Health Alert Network #396 December 3, 2018 3:26 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-10373","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10373","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=10373"}],"version-history":[{"count":1,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10373\/revisions"}],"predecessor-version":[{"id":11549,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10373\/revisions\/11549"}],"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=10373"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}