Undoubtedly, you’ve heard how the Magic Kingdom turned into a public health hotspot in January when officials determined Disneyland was the nexus of a measles outbreak. By month’s end, health agencies across several states were tracking thousands of people who were potentially exposed to the contagious disease.
This isn’t the first time national and local officials have issued notices regarding measles. It is, however, the first outbreak of 2015.
As a locum tenens professional agreeing to care for patients in different cities and states, you may encounter diseases or illnesses not common to your home region. There’s also the chance you could find yourself in the midst of an outbreak, be it airborne, food-borne, or culturally based, such as emergency department (ED) visits related to edible marijuana.
Here is a quick overview of some of the outbreaks from the past year and the states with the highest incident rates.
Measles. By the end of February of this year, there were more than 100 cases of measles allegedly linked to Disneyland. In addition to California, Arizona, Colorado, Utah, Washington, Oregon, and Nebraska also registered measles patients.
But that’s only a fraction of the cases recorded last year. According to the Centers for Disease Control and Prevention (CDC), there were more than 20 outbreaks in 2014, accounting for 644 cases. Measles clusters were found in 27 states, including Wisconsin, New York, Illinois, Minnesota, Texas, and Pennsylvania.
Enterovirus D68. Although the enterovirus D68 outbreak last fall was widespread across most of the country, certain regions were harder hit than others. Healthmap.org revealed large clusters on the East Coast, predominantly in New Jersey, New York, and Connecticut. Michigan also reported a large number of confirmed cases, including several that progressed into paralysis.
Mumps. Between May and July last year, public health agencies registered more than 440 individuals who had contracted mumps, as reported by Cleveland.com. Investigators tied most of the cases to Ohio State University. Similar phenomena occurred in 2013 at Loyola University in Maryland, and in 2011, on the campus of the University of California, Berkeley.
Pneumonic & Bubonic Plague. A mere four cases in one state may not qualify as an outbreak; however, when it comes to pneumonic plague, it’s noteworthy. Last July, Colorado officials documented four cases of pneumonic plague, as reported by Colorado Public Radio, all of which appeared to be connected to a dog that was most likely infected by plague-carrying fleas from wild rodents. Also in Colorado last year, there were two known cases of bubonic plague and another two in New Mexico.
Although rare, the highest risk comes from dwellings with a persistent rodent infestation or having contact with infected wildlife from recreational activities, especially rabbit hunting. Since 2006, most incidents of humans contracting the plague have occurred in New Mexico, Colorado, California, Texas, and Arizona.
Edible Marijuana. Since Colorado voters approved legislation to legalize recreational sale and use of marijuana in 2012 (Washington, Oregon, and Alaska also have legalized recreational sales and use), anecdotal evidence indicates a growing number of ED patients experiencing negative effects from ingesting marijuana in products such as cookies, chocolates, and candy.
In 2013, Children’s Hospital Colorado in Aurora stated it treated a total of eight cases of high levels of ingested marijuana. By May 2014, according to TIME.com, the hospital recorded another nine cases.
Beginning in February, marijuana edibles in Colorado must now be individually wrapped or demarked in increments of 10 mg or less of THC and packaging must be more child-resistant.
Colorado isn’t the only state experiencing increasing numbers of high levels of marijuana ingestion. A study published in the Annals of Emergency Medicine last June reported that between 2005 and 2011, states with laws decriminalizing aspects of marijuana use recorded a 30 percent increase in poison control calls involving children consuming marijuana edibles. Geriatricians also have issued warnings about treating more cases of older individuals falling after consuming such products.
Of course, predicting when and where the next public health outbreak will occur is difficult. But before you pack for your next locum tenens opportunity, check out the area’s health status. Sites such as www.cdc.gov and www.healthmap.org will paint a public health picture so you arrive with an informed insight into what you might encounter on the job.
