Marin County Public Health Newsletter Volume 4 - Issue 5 - June 2017
In this Issue: Fair | CPR | Shigella | Fentanyl | Message from the Public Health Officer
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A message to physicians and other health care providers from Marin County's Public Health Officer.

A Healthy County Fair

County fairs are not known for healthy food and drink.  The Marin County Fair is an exception.  Visit June 30 - July 4 to see why ours was named the healthiest fair by the Western Fairs Association in 2015.  Reflecting local values in health, the fair is smoke-free, all food vendors offer at least one healthy option, alcohol use is controlled, and there are regular healthy activities for all ages.  The Marin team shared their healthy fair model in this Growing Healthy Events Guide.

Staying Alive 

On June 10, over 1,600 people were trained in life-saving skills in Sidewalk CPR and Stop the Bleed at 19 venues throughout Marin County.  Bystander response is a key determinant of survival in life-threatening emergencies, and these annual trainings ensure our Marin residents are better prepared every year.  Congratulations to our EMS staff and EMTs / paramedics, nurses, doctors and Marin Medical Reserve Corps volunteers who stepped up again to save lives.  Clinicians interested in volunteering at future events can contact Karrie Groves at  Patients can be directed to visit to watch the Hands-Only CPR instructional video.

Cipro Resistance - Shigella

Shigella isolates across the U.S. are showing new resistance to quinolones.  The CDC is now recommending clinicians order a stool culture and antimicrobial susceptibility testing when Shigella is suspected; reserve antibiotic therapy for patients for whom it is clinically indicated or when treatment is advised in an outbreak setting.   Marin County Public Health will communicate relevant local incidence and resistance patterns to you, our clinicians.  Quinolone-resistant strains are commonly resistant to other standard agents, including azithromycin, trimethoprim-sulfamethoxazole, amoxicillin-clavulanate and ampicillin.  For more information, visit the CDC's Health Alert Network.

Occupational Fentanyl Exposure

Very high potency opioids, such as fentanyl and carfentanil, may pose a contact hazard to medical personnel and first responders who may handle these compounds.  Recently in California, fentanyl and its analogs have been found in other drugs, including heroin, methamphetamine, cocaine, and counterfeit pills made to look like prescription medications, such as alprazolam (Xanax).  To address this concern, Marin County Public Health issued this communication last week to Emergency Medical Services providers.

Message from the Public Health Officer

Matthew Willis Marin County PHO HeadshotAs health care providers, we are facing uncertainty about the systems in which we provide care.  Pending federal decisions may significantly impact our capacity to care for all residents.  When access is threatened, the value of disease prevention is even more clear.  Regardless of the outcome in Washington, as stewards of health for our community, we will remain engaged and responsive to the needs of all in Marin.  Thank you for your excellent standards of care.
Warm Regards,
Matt Willis
HHS Website
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Copyright © 2017
Matthew Willis MD, MPH
Marin County Public Health Officer
(415) 473-4163
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Our mailing address is:
3240 Kerner Blvd.
San Rafael, CA 94901