Page 24 - Volume 69, Number 4
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Washtenaw County Public Health (WCPH)
Medical Director Report
By Jessie Marshall, MD, MPH
SUBSTANCE ABUSE: The Opioid and Heroin Epidemic Washtenaw County, like other communities, continues to grapple with the opioid epidemic. The number of weekly opioid related overdoses for Washtenaw County residents has more than doubled since 2015. In 2015, there were three overdoses every week; in 2016, there were five overdoses every week; in 2017 (through July) there have been seven overdoses every week, i.e., Washtenaw County has an opioid related overdose every day. Fentanyl or other synthetic opioids were involved in nearly two thirds (63%) of the 2017 deaths. Cocaine was involved in 27% and alcohol was involved in 14% of the deaths. Average age for all Washtenaw County residents’ opioid related overdoses remained steady at 35 years of age.
MENTAL HEALTH: Suicide 2017
Suicide Prevention: A support group has been created for parents caring for children (middle-school aged to 25yo) with suicidal thoughts and behavior. This support group is a collaboration between WCPH, National Alliance on Mental Illness-Washtenaw County (NAMI- WC), University of Michigan Depression Center, Washtenaw County Mental Health, and Washtenaw Intermediate School District. Contact Alison Paine (NAMI-WC group facilitator) at alisonpaine21@hotmail. com for more information.
West Nile Virus (WNV):
The first WNV cases for 2017 were recently confirmed and none were Washtenaw county residents. For more information:
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Influenza: 2016-2017: Washtenaw County had the best rate of flu vaccination for Michigan in 2016-17, as measured by the Michigan Care Improvement Registry (MCIR). Overall, 39% of Washtenaw residents 6 months and older were vaccinated against flu, compared to 26% statewide. Although Washtenaw County is the highest in the state for vaccinating children against flu, the current rate of vaccination in 5 – 12 year olds (41%) has fallen from the 2013-14 flu season when the rate was 50% locally.
The 2016-2017 flu season was moderately severe and was dominated by influenza A/H3. Influenza B viruses circulated as well, especially in March and April 2017. Flu season activity remained low until January 2017, reached peak levels in late February and March, and finally slowed in May 2017. During late Summer/early Fall 2017, a cluster of influenza A/H3 infections were diagnosed in university students in Washtenaw County.
Other sporadic cases have being reported in the county over last several weeks.
2017-2018 Reminder: it’s time to vaccinate! Everyone 6 months and older needs a flu vaccine this year. Many formulations of vaccine are available this year. Again, the Live Attenuated Influenza Vaccine (LAIV), i.e. FluMist, is not recommended for use in any population for 2017-18. Washtenaw County Public Health (WCPH) began its annual flu surveillance October 2, 2017. WCPH is currently working with both of our health care systems to become a part of the Influenza Hospital Surveillance Project (a CDC/MDHHS initiative).
Note: WCPH would like to be notified of any unusual flu activity by calling: (734) 544-6700.
Vaccine Preventable Diseases:
House Bills (HB) 4425 and 4426, which went before the House Education Reform Committee in Lansing on May 25, 2017, did not make it out of the Committee due to a lack of votes to pass each bill. Four Republicans and all the Democrats on the committee indicated their opposition. These bills sought to rescind local public health officers’ ability to exclude un-vaccinated children from school during times of outbreaks of vaccine- preventable diseases and to rescind the requirement of a vaccine-waiver education session with local public health for those parents/care-givers who decline vaccines for their children.
Hepatitis A:
Southeastern Michigan continues to experience a Hepatitis A outbreak. Transmission appears to be through direct person-to-person spread and illicit drug use. There have been 376 cases of hepatitis A diagnosed in Southeast Michigan since August 2016, a sixteen-fold increase compared to the previous year. Washtenaw County Public Health (WCPH) has confirmed a case of hepatitis A in a local restaurant worker. The diagnosed individual works at Cardamom restaurant located at 1739 Plymouth Road in Ann Arbor. Anyone who ate at the restaurant or had carry-out food between September 16 and October 3 may have been exposed. Post-exposure prophylaxis (with Hepatitis A vaccine and/or Immune Globulin, as appropriate) is of benefit within 14 days of exposure to an individual with a Hepatitis A infection.
As of October 12, 2017, Washtenaw County has not been identified as a part of this outbreak. It is not yet known if this currently diagnosed case is related to the outbreak. Learn more about the Southeast Michigan outbreak at
24 Washtenaw County Medical Society BULLETIN OCTOBER / NOVEMBER / DECEMBER 2017

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