A couple of new pearls added!
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The ACIP 2016 Update is out for Adult Immunizations. Note the expanded recommendations for asplenia/functional asplenia and immunosuppression, especially the convoluted (not ACIP’s fault) recommendations for dosing the two available pneumococcal vaccines, and the addition of the serogroup B meningococcal vaccine. Download the charts here:
The news about Zika virus and a marked association with microcephaly is all pretty disturbing, and I have gotten questions about whether we could have a problem in Florida. I think we have an idea from what’s happened with dengue & Chikungunya, which are spread by the same Aedes mosquitos. Chikungunya (another virus from Africa) also spread very quickly through South & Central America & the Caribbean over the last few years.
In U.S. territories, Dengue is endemic in Puerto Rico, Hawaii now, and has established limited local transmission in the Keys, based on antibody screening of that population. About 10% of FL Keys residents surveyed in 2009 had dengue antibodies. Chikungunya has also occurred in very very limited fashion in FL compared to the Caribbean & Puerto Rico.
In 2015, there was 1 locally acquired dengue & 0 Chikungunya in Florida; Puerto Rico had 198 cases of Chikungunya. Contrast this with 2014: 12 locally acquired cases in Florida, 4242 in Puerto Rico, and 38 in the U.S. Virgin Islands. I expect these numbers should be just as low for Zika virus with enhanced surveillance and mosquito control efforts.
Reasons none of these is widespread in the U.S.:
CDC has issued Interim Guidelines for Pregnant Women and an Enhanced Precautions Travel Alert. I suggest to avoid the lower Keys (my own opinion), Caribbean, Central & South America if you are trying to become pregnant and through delivery.
Follow what’s happening weekly with all Arboviruses in FL here.
Share this brochure with friends and neighbors about reducing mosquito breeding around your residence & preventing bites. DEET, picaridin, and IR3535 are safe for use in pregnancy—follow label directions. These are day and night biting mosquitos. Enhanced mosquito avoidance measures are always a good idea in Florida anyway, because we have encephalitis viruses seasonally.
As a healthcare professional and Florida constituent, I ask you to please voice support to your legislators for our (or wherever you live, your) mosquito control programs. In 2011, Florida mosquito control programs lost almost half their state funding, & state funding for mosquito control research was eliminated. The public is just not aware of how very deep a debt of gratitude we owe these programs for making Florida such a lovely state to live in.
All the best,