Marin County Public Health Newsletter Volume 5 - Issue 1 - March 2017
In this Issue: Disaster Triage | Antibiotic of Last Resort | Drug Overdose | Pertussis | Message from the Deputy Public Health Officer
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A message to physicians and other health care providers from Marin County's Public Health Officer.

Disaster Triage and Treatment - Free CME 

Hosted by the Marin Medical Reserve Corps (MMRC) Foundation

Saturday, April 29, 2017
9:00 am - 12:00 pm
Marin General Hospital, 250 Bon Air Road, Greenbrae, CA
West Wing, 1st Floor Conference Center

This free CME presentation (3.0 AMA PRA Category 1 Credit™) presentation is designed to provide new information to physicians and nurses who will choose to or may be expected to respond to disasters in neighborhoods or designated alternative treatment sites.  This program will provide you with key skills for emergent medical triage in your own office practice or as part of a County disaster event or even a personal emergency.

Keynote Speaker:  Jan Horn, MD

Please register today at 

Antibiotic of Last Resort

In 2015, scientists reported the emergence of the plasmid-encoded mcr-1 gene, conferring bacterial resistance to the antibiotic colistin, signaling potential emergence of a pandrug-resistant bacterium.  The mcr-1 gene makes bacteria resistant to the antibiotic, colistin.  Colistin is one of the few "last resort" antibiotics available to treat bacteria that are resistant to many other antibiotics, such as carbapenem-resistant Enterobacteriaceae (CRE).  The Centers for Disease Control and Prevention (CDC) Get Smart program offers resources for Marin County heath care providers, including evidence-based adult and pediatric treatment guidelines, to promote antibiotic stewardship.

95 Drug Overdose Deaths in Marin County Between 2012 and 2014

Patients on high doses of opioids are at increased risk of overdose and diminishing function.  Tapering a patient, weaning them from higher opioid doses, can be an important first step to reducing overdose risk and improving function.  It is also helpful to maintain on-going communication with your patient about your concern for their well-being and your commitment to safe prescribing.  The California Department of Public Health (CDPH) is promoting a variety of tools on the prescriber resource sheet, including a tapering pocket guide, telephone consultation services, and an opioid overdose toolkit.   

Vaccine-Preventable Deaths - Pertussis

In 2016, California reported two pertussis infant deaths.  One of these deaths was in a healthy, full-term Hispanic baby; Hispanic infants are 40% more likely to be reported with pertussis in comparison to non-Hispanic, white infants in California.  These deaths are a devastating reminder that all prenatal care providers should ensure that all pregnant women are immunized with Tdap at the earliest opportunity, between 27-36 weeks gestation of every pregnancy regardless of the mother's Tdap history.  Postpartum Tdap vaccination and cocooning do not provide direct protection to the infant.   

Message from the Deputy Public Health Officer

The American Health Care Act ("AHCA"), the legislation intended to "repeal and replace" the Affordable Care Act ("ACA"), was shelved on Friday, March 24, 2017.  The ACA is working in Marin County and in California.  The uninsured rate in Marin County fell from 12% in 2013 to a historic low of 8% in 2016.  Covered California, the state's health insurance marketplace, provides a competitive health insurance marketplace for approximately 12,000 Marin County residents.  By remaining vigilant, informed and engaged, we can improve the ACA, not dismantle or neglect it. 
Warm Regards,
Lisa Santora
HHS Website
HHS Youtube
Copyright © 2017
Matthew Willis MD, MPH
Marin County Public Health Officer
(415) 473-4163
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3240 Kerner Boulevard
San Rafael, CA 94901