Communicable diseases are diseases that are spread from one person to another through ways that include contact with blood and bodily fluids, breathing in an airborne virus, or by being bitten by an insect.
Reporting and tracking cases of communicable disease is important for planning and evaluation of disease prevention and control programs, in the assurance of appropriate medical therapy, and in the detection of outbreaks. Healthcare providers and laboratories are required by state law to report certain diseases or conditions to their local health department.
Some examples of reportable communicable diseases include:
- Hepatitis A, B & C,
- Influenza, measles, and
- Salmonella and other food borne illnesses.
How do I report cases of a communicable disease?
To report communicable diseases, potential outbreaks and other conditions to the Dorchester County Health Department, call Pamela Quillen, RN, at (410) 228-3223.
- List of all Reportable Diseases in Maryland and Instructions for Reporting
- For Health Care Providers and Laboratory Directors: What to Report
How do communicable diseases spread?
It depends on the specific disease or infectious agent. Some ways in which communicable diseases spread are by:
- Physical contact with an infected person, such as through touch (e.g. staphylococcus), sexual intercourse (e.g. chlamydia, gonorrhea, syphilis, HIV), fecal/oral transmission (hepatitis A), or respiratory droplets (e.g. influenza, tuberculosis)
- Contact with a contaminated surface or object (e.g. Norwalk virus), food (e.g. salmonella, E. coli), blood e.g. (HIV, hepatitis B), or water (e.g. cholera);
- Bites from insects or animals capable of transmitting the disease (e.g. Zika Virus, West Nile Virus, Lyme Disease); and
- Travel through the air (e.g. tuberculosis, measles).
Disease Surveillance
The Dorchester County Health Department Communicable Disease Program:
- Monitors all reportable diseases within the county,
- Conducts disease investigation into all reportable diseases,
- Submits reports of these diseases to the Maryland Department of Health,
- Conducts contact investigation and follow-up as needed.
The communicable disease program plays an important role in the containment of outbreaks and is responsible for investigating the situation to determine the potential infectious agent and its transmission route and source. This is to control/prevent the further spread of the infection to others.
The program also serves as an important resource for healthcare providers, community organizations, and the public, providing information on various communicable diseases, disease transmission facts, and necessary precautions to limit the risk or reduce/eliminate the spread of communicable disease.
Adult immunizations are administered to decrease/eliminate vaccine-preventable diseases and maintain health. Individuals ages 18 and above are eligible for adult immunization services. Costs vary according to vaccine.
Adult immunizations are available Tuesdays, Wednesdays, and Fridays from 8:00 a.m. to 4:00 p.m. Appointments are preferred in order to have adequate vaccine supply available, but walk-ins are accepted based on schedule and vaccine availability.
These include:
- Annual influenza vaccine,
- Pneumonia vaccine,
- Hepatitis B vaccine,
- Measles, mumps & rubella (MMR),
- Tetanus, diphtheria & pertussis (Tdap or Td), and
- Varicella.
Rabies pre-exposure vaccine is also administered to high-risk individuals. These high-risk individuals include veterinary hospital staff, animal hunters/trappers, and individuals conducting research on wildlife.
Foreign travel vaccines are also administered to individuals traveling to at-risk areas of the world. These vaccines include the Hepatitis A vaccine and the Typhoid vaccine. Preventative measures to reduce risk exposure are discussed at the time of vaccination. All ages are eligible for foreign travel immunizations.
Employee health is also an important part of the communicable disease program. This includes annual PPD (tuberculosis) skin testing, review and update of employee immunizations, i.e., MMR, varicella, & tetanus, and employee bloodborne & tuberculosis initial training and annual review.
Flu is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness. Serious outcomes of flu infection can result in hospitalization or death. Some people, such as older people, young children, and people with certain health conditions, are at high risk for serious flu complications.
Flu is different from a cold and often comes on suddenly. People who have the flu often feel some or all of these symptoms:
- Fever* or feeling feverish/chills
- Cough
- Sore throat
- Runny or stuffy nose
- Muscle or body aches
- Headaches
- Fatigue (tiredness)
- Some people may have vomiting and diarrhea, though this is more common in children than adults.
* It’s important to note that not everyone with the flu will have a fever.
Emergency warning signs in children that need urgent medical attention include:
- Fast breathing or trouble breathing
- Bluish skin color (for fair tones) and grayish skin color (for darker tones)
- Not drinking enough fluids
- Not waking up or not interacting
- Being so irritable that the child does not want to be held
- Flu-like symptoms improve but then return with fever and worse cough
- Fever with a rash
Emergency warning signs in adults that need urgent medical attention include:
- Difficulty breathing or shortness of breath
- Pain or pressure in the chest or abdomen
- Sudden dizziness or confusion
- Severe or persistent vomiting
- Flu-like symptoms improve but then return with fever and worse cough
Prevention
A yearly flu vaccine is the first and most important step in protecting against flu viruses. While there are many different flu viruses, a flu vaccine protects against the viruses that research suggests will be most common that year. Flu vaccination can reduce flu illnesses, doctors’ visits, and missed work and school due to flu, as well as prevent flu-related hospitalizations.
Everyone 6 months of age and older should get a flu vaccine every year before flu activity begins in their community. CDC recommends getting vaccinated by the end of October, if possible.
In addition to getting a yearly flu vaccine the following preventive actions can help stop the spread of germs:
- Try to avoid close contact with sick people.
- While sick, limit contact with others, as much as possible, to keep from infecting them.
- If you are sick with a flu-like illness, CDC recommends that you stay home for at least 24 hours after your fever is gone, except to get medical care or for other necessities.
- Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
- Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.
- Avoid touching your eyes, nose and mouth. Germs spread this way.
- Clean and disinfect surfaces and objects that may be contaminated with germs.
Flu vaccines are available through your primary care provider, at most pharmacies and at the health department. Flu and other vaccines are required to be covered by your health insurance without charging a copayment or coinsurance. But, be sure to check with your insurance company to find out if you must go to a specific facility to receive the vaccine. Some insurance plans only cover vaccines given by your doctor or at a limited set of locations.
For more information about flu, visit the Centers for Disease Control flu page.
Care & Treatment
If you get sick, CDC recommends you stay home from work or school and limit contact with others.
DO NOT send sick children to school “to get checked by the school nurse.” You may call the school nurse with questions; however, we urge you to call your child’s healthcare provider with specific concerns.
Remember to plan for sick child-care ahead of time, and keep canned soups, bottled juices and frozen juice pops on hand for when someone becomes ill. Keep age-appropriate fever-reducing medication on hand (check expiration dates).
DO NOT GIVE ASPIRIN (OR ASPIRIN CONTAINING PRODUCTS) TO CHILDREN OF ANY AGE (unless instructed by a doctor), due to risk of Reye’s Syndrome, which can result from taking aspirin when a child has a virus.
For Individuals with Special Health Care Needs, please be sure to have all medications and supplies on hand. Check the expiration dates and replace as needed.
PLEASE NOTE: People at high risk for influenza complications that become ill with influenza-like illness, should speak to their healthcare provider as soon as possible. Early treatment with antiviral medications is very important. This includes those who are pregnant, have asthma, diabetes, neuromuscular disorders or a compromised immune system.
Prevention of Tick-borne Diseases
Look for ticks in late spring through early fall, when they are most active.
Limit direct contact with ticks by avoiding wooded and brushy areas with high grass and leaf litter. Also, walk in the center of trails.
Wear long pants and long sleeves to help keep ticks off your body.
Tuck shirts into pants, and pants into socks, to keep ticks on the outside of clothing.
Wear light colored clothing to help spot ticks more easily.
Use Environmental Protection Agency (EPA) registered insect repellents containing:
- DEET,
- picaridin,
- IR3535,
- Oil of Lemon Eucalyptus (OLE),
- Paraomenthane-diol (PMD), or
- 2-undecanone.
Use repellent on exposed skin for protection that lasts several hours. Always follow product instructions.
Parents should apply repellent to their children, avoiding hands, eyes, and mouth.
Clothing may be pre-treated by using products that contain permethrin.
Treat clothing and gear, such as boots, pants, socks and tents with products containing 0.5% permethrin, which remains protective through several washings.
Alternatively, clothing pre-treated with permethrin may be purchased.
After You Come Indoors
Check your clothing for ticks. Ticks may be carried into the house on clothing. Any ticks that are found should be removed. Tumble dry clothes in a dryer on high heat for 10 minutes to kill ticks on dry clothing after you come indoors. If the clothes are damp, additional time may be needed. If the clothes require washing first, hot water is recommended. Cold and medium temperature water will not kill ticks.
Examine gear and pets. Ticks can ride into the home on clothing and pets, then attach to a person later, so carefully examine pets, coats, and daypacks.
Shower soon after being outdoors. Showering within two hours of coming indoors has been shown to reduce your risk of getting Lyme disease and may be effective in reducing the risk of other tickborne diseases. Showering may help wash off unattached ticks and it is a good opportunity to do a tick check.
Check your body for ticks after being outdoors. Conduct a full body check upon return from potentially tick-infested areas, including your own backyard. Use a hand-held or full-length mirror to view all parts of your body. Check these parts of your body and your child’s body for ticks:
- Under the arms
- In and around the ears
- Inside belly button
- Back of the knees
- In and around the hair
- Between the legs
- Around the waist
Wash Your Clothes
To ensure elimination of ticks from clothing:
- Wash clothing in hot water.
- Cold and medium temperature water will not kill ticks effectively.
- If it is not possible to wash clothes in hot water then tumble dry on low heat for 90 minutes or high heat for 60 minutes.
- For dry clothing, tumble dry clothes in a dryer on high heat for 10 minutes to kill ticks.
- If the clothes are damp, additional drying time may be needed. The clothes should be warm and completely dry.
Removing Ticks
- Use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible.
- Pull upward with steady, even pressure. Don’t twist or jerk the tick; this can cause the mouth parts to break off and remain in the skin. If this happens, remove the mouth-parts with tweezers. If you are unable to remove the mouth easily with clean tweezers, leave it alone and let the skin heal.
- After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water.
- Dispose of a live tick by submersing it in alcohol, placing it in a sealed bag/container, wrapping it tightly in tape, or flusing it down the toilet. Never crush a tick with your fingers.
- If you develop a rash or fever within several weeks of remvoing a tick, see your health care provider.
- Tell the health care provider about your recent tick bite, when the bite occured, and where you most likely acquired the tick.
Symptoms of Tick-Borne Disease
Early symptoms of a tick-borne disease include fever, headache, fatigue and possible rash. See your healthcare provider if you have any of these symptoms after visiting potentially tick infested areas or getting a tick bite.
Tick-borne Diseases
- Alpha-gal Allergy
- Babesiosis
- Ehrlichiosis and Anaplasmosis
- Lyme disease
- Powassan Virus
- Rocky Mountain Spotted Fever
- Southern Tick-Associated Rash Illness (STARI)
- Tularemia
For more information, go to:
https://www.cdc.gov/ticks/index.html
https://health.maryland.gov/phpa/OIDEOR/CZVBD/Pages/tick%20dz_prevention.aspx
Information from CDC and MDH.
Testing
Screening for tuberculosis is done with PPD skin testing. Sputum specimens are obtained and chest x-rays are done at the local hospital to R/O active TB disease.
PPD skin testing for employment and school requirements is offered 8am-4pm Tuesdays, Wednesdays, and Fridays at a cost of $30. Insurance can not be billed for this.
Treatment
Tuberculosis medications are given under (DOT) Direct Observed Therapy for active TB patients, where TB staff observe each pill being taken by the patient. This ensures compliance with the necessary treatment.
Contact investigation is conducted on every active tuberculosis patient. Each contact is then screened with a PPD skin test, sent for a chest x-ray if they have a positive PPD to rule out active disease, and then they are offered preventative treatment if their chest x-ray is negative for active disease
Preventative treatment is also available for those with latent TB infection (inactive-non contagious) Tuberculosis.
Treatment Eligibility
Treatment for tuberculosis (active disease) is provided by the program and coordinated with the patient’s healthcare provider if they have one.
Treatment for active disease and their contacts is provided free of charge. Patients requesting PPD skin testing with a subsequent positive result will be sent for a follow-up chest x-ray. The cost of this chest x-ray is covered by the TB program for any individual not having health insurance.
For more information, please contact Pamela Quillen, RN, at (410) 228-3223.
Additional Information:
- MDH | Prevention and Health Promotion Administration
- CDC
- Vaccine Information
- Immunization Action Coalition
What is monkeypox?
A rare disease caused by infection with the monkeypox virus. Monkeypox is a public health concern because the illness is similar to smallpox and can be spread from infected humans, animals and materials contaminated with the virus. Monkeypox is less transmissible and usually less severe than smallpox.
Monkeypox is not a new virus. It was first identified in 1958. Historically, cases typically occur in Western Africa. When cases have been identified outside this region, including in the U.S., they have been related to international travel or the importation of animals. Recently, there has been a significant increase in reported cases worldwide, many of which are due to community transmission.
How does monkeypox spread?
It spreads through close prolonged contact with an infected person. This may include coming into contact with skin lesions or body fluids, sharing clothes or other materials, such as bed linens or towels that have been used by an infected person, or inhaling respiratory droplets during prolonged face-to-face contact.
While monkeypox can infect anyone, many of the recent cases in 2022 have occurred among persons self-identifying as men who have sex with men (MSM), individuals who have anonymous sex, and sex workers.
Monkeypox can be spread through:
- Direct skin-to-skin contact with rash lesions
- Sexual/intimate contact, including kissing
- Living in a house and sharing a bed with someone
- Sharing towels or unwashed clothing
- Respiratory secretions through prolonged face-to-face interactions (mainly happens when living with or caring for someone who has monkeypox)
Monkeypox is NOT spread through:
- Casual conversations
- Walking by someone with monkeypox, like in a grocery store
- Touching items like doorknobs
Symptoms
Monkeypox may start with symptoms like the flu, such as a fever, low energy, swollen lymph nodes and general body aches. Within 5 to 12 days after the appearance of fever, the person can develop a rash or sores. Sores will go through several stages, including scabs, before healing. They can look like pimples or blisters and may be painful and itchy.
Other symptoms may include:
- Fever
- Chills
- Body aches
- Headaches
- Sores/Rash
Please call your medical provider if you think you may have been exposed to monkeypox and are showing signs and symptoms.
Treatment
In most cases, monkeypox will resolve on its own. There are no treatments specifically for monkeypox virus infections. However, monkeypox and smallpox viruses are genetically similar, which means antiviral drugs and vaccines developed to protect against smallpox may be used to prevent and treat monkeypox virus infections.
Antivirals, such as tecovirimat (TPOXX), may be recommended for people who are more likely to get severely ill, like patients with weakened immune systems.
Prevention
There are a number of ways to prevent spreading monkeypox:
- Talk to sexual partners about any recent illness and be aware of new or unexplained sores or rashes on you or your partner’s body.
- Limit the number of sexual partners.
- Avoid close contact, including sex of any kind (oral, anal, vaginal) and kissing or touching each others bodies, with people with symptoms like sores or rashes.
- Practice safe sex by using condoms or other barrier methods the right way and using a new condom or other barrier method every time you have sex. Order a Safe Sex Kit.
- Practice good hand hygiene.
- Isolate infected persons until symptoms, including rash, have gone away completely
- Use appropriate personal protective equipment (PPE), like a mask, gown and gloves, when caring for others with symptoms.
- Avoid contact with infected materials, such as towels, clothing, sheets, fetish gear, sex toys and toothbrushes.
- Avoid contact with infected animals.
Vaccines
On Sept. 19, 2022, the Maryland Department of Health monkeypox (MPX) vaccine operational guidance was revised, providing parameters for providing MPX vaccine among higher-risk individuals as outlined in federal guidance. The CDC recommends the JYNNEOS vaccine for pre-exposure prophylaxis for individuals identified as being high risk.
MPX Vaccine Administration in Maryland
- Post-exposure prophylaxis (PEP)
- Individuals requiring vaccination following exposure to MPX to help prevent illness, including contacts of confirmed or probable MPX cases.
- Expanded post-exposure prophylaxis (ePEP)
- Individuals with certain risk factors who are more likely to have been recently exposed to MPX (does not have to be documented).
- Pre-exposure prophylaxis (PrEP) for individuals at high risk for MPX:
- Lab workers who handle specimens
- Individuals with presumed or potential sexually associated exposure
- Individuals who are immunocompromised or have HIVIndividuals of communities at higher risk, including gay, bisexual, and men who have sex with men (MSM) (GBMSM)
- Individuals who are not monogamous and who are sexually active with multiple partners.
The Dorchester County Health Department continues to work closely with the Maryland Department of Health to keep updated on eligibility requirements. Vaccination will be done by appointment only after an eligibility screening is completed and the vaccine is deemed appropriate.
Call us at (410) 228-3223 and ask to speak with someone about your eligibility for an MPX vaccination. For those eligible for an MPX vaccination, appointments are available Monday through Friday from 8:00 a.m. to 4:30 p.m.