Health Alerts

The following urgent health information is distributed through the North Dakota Health Alert Network.

Health alerts are announcements released by local, state or federal public health authorities to inform public health and medical professionals about likely or imminent dangers to the health of the community.

Categories of Health Alert messages:

  • Health Alert: conveys the highest level of importance; warrants immediate action or attention.
  • Health Advisory: provides important information for a specific incident or situation; may not require immediate action.
  • Health Update: provides updated information regarding an incident or situation; no immediate action necessary.
  • HAN Information: is used to distribute general correspondence which is not necessarily considered to be of an emergent nature.

Health Alert messages are distributed by the NDHAN to local public health units, clinics, hospitals, physicians, tribal health, and statewide health associations, including the North Dakota Nurses Association, the North Dakota Healthcare Association and the North Dakota Medical Association.

Alerts:

Increased Pertussis Cases Reported in Ward County (11/17/2018)
The North Dakota Department of Health (NDDoH) is seeing a rise in pertussis cases, mostly in school-aged children in Ward County. So far in 2018, 41 cases have been reported to the NDDoH. Three of these cases have reported in Ward County in the last month. The NDDoH reminds providers to suspect pertussis in patients with prolonged coughs or coughs accompanied by paroxysms, post-tussive vomiting, inspiratory whoop or apnea (in infants younger than 12 months). If pertussis is suspected, the patient should be treated appropriately and excluded from school and other group activities until five days after the start of effective antimicrobial treatment. Providers should not wait for laboratory results to treat, and suspected pertussis cases must be reported immediately to the NDDoH at 701.328.2378.
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Healthcare Providers Urged to Maintain a High Awareness for Tuberculosis (10/31/2018)
The North Dakota Department of Health asks healthcare providers, especially those in Northeastern North Dakota, to maintain a high vigilance for tuberculosis (TB). The NDDoH is currently investigating a person diagnosed with TB disease who is linked to an outbreak first identified in 2010. A second case is pending confirmation, but may also be linked to this same outbreak. Since March 2010, 37 people with TB have been reported due to this outbreak. Because TB cases relating to this outbreak continue to occur, it is possible these individuals were not indicated/found for testing during previous investigations in the community. The majority of people associated with this outbreak have been identified in Grand Forks County; however, there are reports from other areas of the state.
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Please Report Possible Cases of Acute Flaccid Myelitis to the NDDoH (10/18/2018)
The North Dakota Department of Health (NDDoH) encourages providers to be aware of acute flaccid myelitis (AFM) symptoms. Resources are provided in this Health Advisory to help with the identification and reporting of suspected AFM cases and specimen collection. AFM is an illness characterized by acute onset of flaccid limb weakness and magnetic resonance imaging (MRI) showing lesions in the gray matter of the spinal cord. AFM has been under investigation by the NDDoH and the Centers for Disease Control and Prevention (CDC) for the past four years. Surveillance has shown that AFM cases generally peak in the months of September and October. In the last four years, the majority of cases were reported in 2014 and 2016, and smaller numbers reported in 2015 and 2017 throughout the United States. If this pattern continues, an increase in AFM cases in 2018 may be expected. In October 2018 a cluster of AFM in children was identified in Minnesota. Other states have also reported AFM cases in 2018.
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NDHAN: 09051801 Health Care Providers Urged to Maintain a High Awareness for Measles (9/5/2018)
On Tuesday, September 4, 2018 a case of measles was reported to the North Dakota Department of Health (NDDoH). This individual was active in the Bismarck area during their contagious period. The NDDoH is currently working on contacting exposed individuals and educating the public who may have also been exposed on the signs and symptoms of measles.
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Fentanyl Safety Recommendations for First Responders (8/30/2018)
The increased prevalence of fentanyl (and other synthetic opioids) in the illicit drug market means that first responders need to understand how to protect themselves from exposure in the field. Law enforcement, fire, rescue, and emergency medical services (EMS) personnel must balance safety with mobility and efficiency when responding to scenes where the presence of fentanyl is suspected. As a result, the Whitehouse recently updated fentanyl safety recommendations.
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Consider Variant Influenza when Assessing Patients with Acute Respiratory Illness During the Summer Months (7/24/2018)
The North Dakota Department of Health (NDDoH) would like to remind clinicians to consider influenza viruses, including variant influenza, as a possible diagnosis when evaluating patients with acute respiratory illness. Influenza viruses are called variant when a virus normally found in pigs is found in a human. Recent examples of variant viruses include A H3N2v, A H1N1v, and A H1N2v. Fast detection and characterization of these novel influenza viruses remain important components of national efforts to ensure these viruses are not being transmitted in an efficient and ongoing way in humans, and to limit further exposure of humans to infected animals. Last summer, two cases of H3N2v were associated with swine exposure at a fair in North Dakota. The NDDoH offers the following recommendations for North Dakota providers.
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Recommendation for Syphilis Screening Among Pregnant Women (7/13/2018)
The North Dakota Department of Health (NDDoH) is alerting healthcare providers in North Dakota about the rise of syphilis infections across all areas of the state. There was a 24% increase in cases from 2016 to 2017. As the total case counts have increased, so has the proportion of cases among women, especially those of childbearing age. In 2016 and 2017, women accounted for 15% and 22% of all syphilis cases. So far in 2018, women have accounted for 28% (12 cases) of all reported syphilis cases. The increase of cases among women is of concern due to the possibility of transmission to an unborn child (congenital syphilis), which can result in serious complications or death of the baby. Many of these women did not know they were at risk for syphilis due to unknown risk factors of their partners. Nationwide, congenital syphilis cases have increased 86.9% from 2012 to 2016, with 628 reported cases, including 41 syphilitic stillbirths in 2016.
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Escherichia coli O157:H7 Infections Associated with the Consumption of Romaine Lettuce (4/30/2018)
The Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA) and the United States Department of Agriculture (USDA) continue to work with state and local health officials investigating a nationwide outbreak of illness due to Escherichia coli O157:H7 (E. coli O157:H7). This outbreak has been linked to the consumption of romaine lettuce. As of April 27, 98 illnesses have been reported from 22 states with 46 hospitalizations
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NDHAN:04261801 CDC COCA Clinical Advisory Report Released: Potential Vitamin K-Dependent Antagonist Coagulopathy Associated with Synthetic Cannabinoids Use (4/26/2018)
CDC Health Advisory for Potential Vitamin K-Dependent Antagonist Coagulopathy Associated with Synthetic Cannabinoids Use
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Antivirals for the Treatment and Prevention of Influenza (12/29/2017)
The Centers for Disease Control and Prevention (CDC) has issued the following recommendations and guidance as a reminder to providers of the role of antivirals in the treatment and prevention of influenza. In addition to the federal guidance, the North Dakota Department of Health (NDDoH) reminds providers and encourages medical directors of institutions to use antivirals for treatment of or the prophylaxis against influenza in these settings.
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Kingella kingae Infections Among Child-care Attendees (12/21/2017)
Monday, Dec. 18, the North Dakota Department of Health (NDDoH) received a report from a physician regarding one confirmed case and one suspected case of osteomyelitis caused by the gram-negative bacteria Kingella kingae. Both cases attend the same child-care center located in Valley City.
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Nationwide IV Solution/Bag Shortage Video Conference (11/24/2017)
The North Dakota Department of Health (NDDoH) is offering a free video conference to provide updated information about the nationwide IV solution/bag shortage and the implications for healthcare providers in North Dakota.
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Increasing Syphilis Infections and Anonymous Contacts in North Dakota (11/15/2017)
The North Dakota Department of Health (NDDoH) is alerting all healthcare providers in North Dakota about the rise of syphilis infections. Many recent cases are reporting the use of websites and online applications, or “apps” that are designed to meet sex partners, often anonymously. Traditionally, NDDoH field epidemiologists are able to follow up with individuals who test positive for syphilis, or other STDs, to identify their recent sex partners and alert the contacts of their exposure. However, this is no longer adequate, as many cases are unaware of their sex partners and are unable to provide any contact information.
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Varicella Outbreak and Required Reporting of Chickenpox (11/7/2017)
North Dakota Department of Health reminds health care providers that all cases of chickenpox (varicella) must be reported and recommends confirming diagnoses with laboratory testing
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Updated Zika Guidance (10/24/2017)
Updated Zika Guidance: Management of infants with possible congenital Zika virus infection and instruction for the evaluation of women and children who may have been displaced from Caribbean Islands due to hurricanes and other weather-related events
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Brucellosis Associated with Raw Milk Consumption (9/20/2017)
The Centers for Disease Control and Prevention and the Texas Department of Health are investigating several cases of brucellosis caused by Brucella RB51 associated with the consumption of raw milk. Federal and Texas health officials have reported, and the North Dakota Department of Health (NDDoH) has confirmed that some North Dakota residents were exposed to the raw milk while traveling to Texas.
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CDC Updated Interim Guidance for U.S. Healthcare Providers Caring for Pregnant Women with Possible Zika Virus Exposure (9/8/2017)
This Health Update outlines the revised Centers for Disease Control and Prevention (CDC) recommendations for pregnant women with possible Zika virus exposure. Possible Zika virus exposure includes travel to or residence in an area with risk of mosquito-borne Zika virus transmission, or sex without a condom with a partner who has traveled to or resides in an area with risk of mosquito-borne Zika virus transmission.
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First Responder PPE and Decontamination Recommendations for Fentanyl (8/28/2017)
The InterAgency Board for Equipment Standardization and Interoperability (IAB) recently published recommendations on selection and use of personal protective equipment and decontamination products for first responders against exposure hazards to synthetic opioids, including fentanyl and fentanyl analogues.
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Evaluation of Patients Returning from the Hajj (8/21/2017)
The annual Hajj or pilgrimage to Mecca, Saudi Arabia, will take place in 2017 from approximately August 30 to September 4. In previous years, state and local health departments have seen an increase in patients under investigation (PUIs) for MERS two to three weeks following the completion of Hajj as travelers return to the US. Healthcare providers should routinely ask patients about their travel history and evaluate patients for MERS-CoV infection if they have both clinical features and an epidemiologic risk for being a PUI. Providers should immediately contact the North Dakota Department of Health (NDDoH) about any patient who meets the criteria for a PUI.
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Presumptive Influenza A H3N2 Variant Positive (8/4/2017)
The North Dakota Department of Health (NDDoH) has identified one presumptive influenza A H3N2 variant positive in a person who attended the North Dakota State Fair in Minot this year. The North Dakota suspect case is currently being confirmed by the Centers for Disease Control and Prevention.
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Transporting Patients to Sanford Hospital Locations in Fargo (7/25/2017)
Effective July 25, 2017, Sanford Health is operating three hospitals in Fargo. In addition to the new hospital located at 5225 23rd Ave. S., Fargo, the existing hospitals located on Broadway and South University Drive will remain open. The most significant change for EMS providers to note is the relocation of Sanford’s Emergency Department.
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Increased Risk of Invasive Meningococcal Disease for Patients Treated with Eculizamab (7/14/2017)
The Centers for Disease Control and Prevention (CDC) have issued an advisory regarding increased risk of invasive meningococcal disease among patients who are being treated with Eculizamab (Soliris®).
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Ongoing Cyber Threat Impacting Health Care (6/30/2017)
The United States Computer Emergency Readiness Team has been monitoring an international ransomware campaign, referred to as “WannaCry 2.0 or Petya” in the media that has affected critical infrastructure sectors including health care and public sector assets in the U.S., as well as the transportation sector. Please contact the North Dakota Department of Health at 701.328.2270 and let them know if your health care facility has been impacted (either directly or indirectly) by this incident.
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Free West Nile Virus Testing Offered Through September 30, 2017 (6/1/2017)
The North Dakota Department of Health (NDDoH) offers free human West Nile Virus (WNV) testing through September 30, 2017, on specimens from patients meeting certain criteria.
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Potential for Falsely Low Blood Lead Test Results from LeadCare® Analyzers (5/17/2017)
The U.S. Food and Drug Administration (FDA) has issued a safety communication warning about the use of Magellan Diagnostics’ LeadCare® analyzers (LeadCare, LeadCare II, LeadCare Ultra and LeadCare Plus) with venous blood samples because they might result in falsely low test results. FDA is now advising that Magellan Diagnostics’ LeadCare® analyzers should no longer be used with venous blood samples. The safety alert does not apply to capillary blood lead test results collected by finger stick or heel stick. The purpose of this Health Advisory is to notify state and local health departments, healthcare providers, and laboratories about CDC’s re-testing guidance in light of the safety alert.
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CDC Update on Continued Shortage of Bicillin L-A® (4/27/2017)
Please plan and forecast demand in your facility based on the rate of increase of syphilis cases in your jurisdiction. Report any shortages to the North Dakota Department of Health (NDDoH) when inventory is less than two months of product based on projected use. Contacting Pfizer may also help your agency find wholesalers with available supply. Pfizer can be contacted at 800.533.4535.
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Health Care Providers Urged to Maintain a High Awareness for Measles (4/26/2017)
Outbreaks of measles are occurring in Europe and the United States. Minnesota, specifically Hennepin County, is currently experiencing an outbreak of measles. As of April 24, 2017, there have been 20 confirmed cases in Somali children ages 0 to 5 years, 10 of whom have been hospitalized. So far, 16 of the 20 cases have been confirmed to be unvaccinated; the vaccination status of the remaining four cases has not yet been determined. Health care providers should maintain a high awareness for measles among febrile patients with rash, especially in those without two documented doses of MMR. If health care providers suspect measles, the case should be isolated following airborne precautions and reported to the NDDoH immediately.
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CDC Recommendations for Diagnosing and Managing Shigella Strains with Possible Reduced Susceptibility to Ciprofloxacin (4/20/2017)
This Health Advisory outlines new Centers for Disease Control and Prevention (CDC) recommendations for diagnosing and managing Shigella strains with possible reduced susceptibility to ciprofloxacin.
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Potential Contamination of Organ Preservation Solution, United States Update (1/31/2017)
The Centers for Disease Control and Prevention (CDC), Health Resources Services Administration (HRSA), and the Food and Drug Administration (FDA) continue to investigate bacterial contamination of SPS-1, an organ preservation solution distributed by Organ Recovery Systems (ORS).
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North Dakota Department of Health Reports an Increase in Pertussis Cases (1/24/2017)
The North Dakota Department of Health (NDDoH) is beginning to see a rise in pertussis cases in school-aged children in North Dakota. So far in 2017, five confirmed cases have been reported to the NDDoH. Pertussis incidence typically peaks every three to five years, and the last peak in North Dakota was in 2012 with 214 cases. The NDDoH is reminding providers that if pertussis is suspected, the patient should be treated and excluded from group activities until five days after the start of effective antimicrobial treatment. Providers should not wait for laboratory results to treat, and suspected pertussis cases must be reported immediately to the NDDoH at 701.328.2378.
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North Dakota Department of Health Reminds Providers of Current Mumps Outbreaks in the United States and Canada (1/23/2017)
Mumps is a contagious vaccine-preventable disease that is uncommon in the United States due to the Measles, Mumps, and Rubella (MMR) vaccine. In the past year, however, mumps outbreaks have been occurring across the United States and in Manitoba. As of December 2016, 5,311 cases have been reported in the United States, many occurring on college campuses. So far this year, three suspected cases of mumps have been reported to the NDDoH.
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ND HAN: 193071602 Best Practices for Using PCR to Diagnose Haemophilus influenzae and Neisseria meningitidis and Identify Serotype or Serogroup (7/11/2016)
The North Dakota Department of Health (NDDoH) is forwarding the following information from the Centers for Disease Control and Prevention (CDC) regarding best practices for using PCR to diagnose Haemophilus influenzae and Neisseria meningitidis and identify serotype or serogroup.
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ND HAN: 1781601 Multi-State Outbreak of Burkholderia cepacia (6/27/2016)
Outbreak of Burkholdia cepacia
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'ND HAN: 1781602 Use of Flumist (6/27/2016)
Advisory against the use of Flumist
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Mumps in ND (3/16/2016)
Information on Mumps in North Dakota
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Zika Virus Testing and Surveillance Updates (2/26/2016)
This health update addresses the following topics: Increased surveillance for Zika virus infections. Testing infants and children for evidence of Zika virus infection. Updates on sexual transmission of Zika virus and the availability of RT-PCR testing at the North Dakota Department of Health.
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Zika Virus Guidance (2/5/2016)
The purpose of this health update is to give health care providers additional information about Zika virus, sexual transmission of the virus, updated recommendations for pregnant women, and interim guidance for infants. Although this HAN provides a high level summary of the guidance, providers are encouraged to read the guidance documents in their entirety.
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Zika Virus Guidance (1/20/2016)
The Centers for Disease Control and Prevention has developed information and guidance regarding the Zika virus epidemic in the Americas, including clinical considerations for travelers. This mosquito-borne virus is currently being transmitted in several areas in Mexico, Central and South America, as well as in the Caribbean.
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HAN Alert Legionnaires Disease (11/6/2015)
The North Dakota Department of Health (NDDoH) is investigating two possible travel-related cases of Legionnaires’ disease.
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