This chapter contains sections titled: Preventing Exposure to Ticks Preventing Infection after a Tick Bite Preventing Lyme Disease by Immunization References
Background: CMV causes at least 10% of congenital hearing loss but there is no standard newborn screening protocol. Consequently, many babies who are otherwise asymptomatic are at risk of not being diagnosed, and consequently not receiving early interventions. At least 40,000 babies are born annually at Northwell's 10 birth hospitals, which constitute about 1% of nationwide births. Methodology: We have developed a term-newborn pre-discharge targeted CMV testing program. Prior to our program, testing was inconsistent and driven by known maternal infection or symptomatic congenital CMV syndrome. In late 2016 we began a CMV awareness campaign in our hospitals across the health system. In early 2017 we met with audiologists, newborn unit nurses, neonatologists and pediatricians and proposed enhanced targeted testing of the following groups: all babies who fail their state-mandated hearing screen, babies with even mild symptoms, and babies born to mothers with suspicion of infection. Champion teams that included physicians and nurses were composed at all hospitals. Initially, we relied on nurses to prompt pediatricians to order PCR on urine for newborns who failed their hearing test. After we reviewed the efficacy of PCR on saliva, we implemented a
Purpose of review We review the resurgence of pertussis, including recent trends in epidemiology and reasons for the resurgence, as well as updated vaccination schedules and recommendations. Recent findings There has been a resurgence of pertussis in recent decades, in the United States and worldwide. This is a preventable cause of hospitalizations and deaths, especially among the infant population. Possible reasons for the resurgence include increased awareness via surveillance and reporting, diagnostic testing improvements, infant susceptibility coupled with exposure to infected caregivers, waning immunity despite complete vaccination, inferior long-term efficacy of acellular vaccines compared with whole-cell vaccines, circulating mutant strains of the bacterium, and parents refusing vaccination of their children. Progressively updated vaccine recommendations should be adhered to, as this is currently the only available tool to stem the public health challenge. Summary The resurgence of pertussis is a multifaceted problem, but the implementation of immunization for all age groups is of utmost importance.
Abstract This evidence-based clinical practice guideline for the prevention, diagnosis, and treatment of Lyme disease was developed by a multidisciplinary panel representing the Infectious Diseases Society of America (IDSA), the American Academy of Neurology (AAN), and the American College of Rheumatology (ACR). The scope of this guideline includes prevention of Lyme disease, and the diagnosis and treatment of Lyme disease presenting as erythema migrans, Lyme disease complicated by neurologic, cardiac, and rheumatologic manifestations, Eurasian manifestations of Lyme disease, and Lyme disease complicated by coinfection with other tick-borne pathogens. This guideline does not include comprehensive recommendations for babesiosis and tick-borne rickettsial infections, which are published in separate guidelines. The target audience for this guideline includes primary care physicians and specialists caring for this condition such as infectious diseases specialists, emergency physicians, internists, pediatricians, family physicians, neurologists, rheumatologists, cardiologists and dermatologists in North America.
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