The County of Orange Health Care Agency's Medical Reserve Corps (MRC) is presently recruiting and registering medical and non-medical volunteers who can be called upon during an actual disaster-related event that might overwhelm Agency resources.

MRC units have been formed or planned across the nation and thousands of medical and public health volunteers have joined local units in response to the national MRC program launched in July 2002 by President Bush. The program identifies the MRC as a specialized component of the Citizen Corps, a national network of volunteers dedicated to making sure their families, homes and communities are safe from terrorism, crime and disasters of all kinds.

MRC volunteers include medical and public health professions such as physicians, nurses, pharmacists, emergency medical technicians, dentists, epidemiologists and infectious disease specialists. Other key support positions include interpreters, chaplains, amateur radio operators, logistics experts and legal advisors.

Individuals interested in becoming MRC volunteers will train and drill with County staff to prepare for a health emergency response that might be needed in a large epidemic, disaster or terrorist event.

Please encourage those you know who are 18 years of age or older to register as an MRC volunteer. Interested individuals can call 714-834-2335 or email Peggy McCormick at pmccormick@ochca.com for an application or for more information.

SCHOLARSHIPS AVAILABLE!

Hearing loss is the most common congenital condition in the United States. Every day 33 infants are born with some degree of hearing loss and increasingly, the benefits of early identification and treatment on child health outcomes are being proven. Through the online PediaLink(R) module Childhood Hearing: A Sound Foundation in the Medical Home participants will learn about the importance of early recognition and ongoing surveillance, screening methods for hearing loss, medical and genetic risk factors, and the role of medical home in hearing screening. The module content was developed by nationally and internationally renowned pediatricians and audiologists, and is presented in an interactive and informative manner, including engaging vignettes, multimedia, and resources you can personalize and download for your own office.

In an effort to promote the concept of "just in time" learning - providing educational tools, materials, and resources just in time that a primary care professional needs them - the Academy will be offering scholarships for this PediaLink(R) module to the pediatric health care providers who are identified as having a child in their practice that has been diagnosed with confirmed hearing loss.

HOW DO I REGISTER? Registration if FREE! To register, contact Holly Noteboom, Screening Assistant, at 800-433-9016 ext 7081 or screening@aap.org.

A limited number of scholarships are available, so take advantage of this opportunity today!

Orange County is now participating in one of 10 regional State and Federally supported immunization registries. California Statewide Immunization Information System The first sites started in March 2005 and as of August 31, 2005 there were 17 sites with 25,751 children enrolled. At this time, most of these sites are health department and community clinics although providers not associated with these clinics can also participate. These registries allow for efficient tracking of complicated immunization schedule information and saves valuable staff time in terms of record keeping. The national Healthy People 2010 goal is 95% of children less than 6 years of age will be enrolled in a confidential computerized registry by 2010. Even with our slow start, by August 31, 2005 Orange County had achieved 4% of this goal.

To participate in this web-based system, our staff must do an initial assessment and training. We encourage pediatricians and clinics to contact us to find out how they can become involved.

For more information, please call Orange County Health Care Agency Family Health Division Medical Director Troy A. Jacobs, MD, MPH, FAAP at 714-834- 8330 or Immunization Registry Coordinator Linda Scott at 714-834-8095.

Influenza: Orange County Epidemiology has already begun receiving reports of influenza in our community. Surveillance for influenza and influenza-like illness is important to monitor the impact of influenza and guide prevention and control activities, including selection of next season's vaccine strains. In addition, influenza surveillance may help detect when novel, potentially pandemic influenza strains enter California. As children are often infected with influenza and play a major role in the transmission of influenza, pediatricians are critical in our surveillance efforts. We are looking for volunteers to participate in our surveillance, which only takes a few minutes a week. In return, sentinel providers will receive specimen kits to submit specimens to our public health laboratory for viral isolation, rapid flu testing kits, weekly reports of influenza activity, and subscriptions to the CDC's Morbidity and Mortality Weekly Report and Emerging Infectious Diseases journals. For more information about surveillance, please contact Michele Cheung, MD, MPH, at 714-834-7729 or mcheung@ocha.com. For more information about influenza including flyers and brochures for the office and for patients.

As of October 10, 2005, 117 human cases of avian influenza H5N1 and 60 deaths have been reported from Vietnam, Thailand, Indonesia, and Cambodia since avian outbreaks of this strain began in winter 2003. Infected wild birds and poultry continue to be detected in these countries as well as China, Siberian Russia, Kazakhstan, and Mongolia. Attempts to eliminate H5N1 from the area through culling of birds have been unsuccessful and additional avian outbreaks and human cases are expected to continue. Thus far, most human cases have been linked to contact with poultry or poultry products and only limited person-to-person transmission has occurred in close contacts. Please see for the latest updates.

Early identification of the importation of avian influenza H5N1 into the United States is critical and depends on health care providers such as yourself to identify patients with the appropriate exposure history who may have avian influenza.

Recommendations for surveillance, diagnostic evaluation, and infection control precautions: These guidelines have not changed since our last communication in 2004. We ask that all clinicians maintain a high index of suspicion for influenza A (H5N1) infection in patients who meet the following criteria and contact Orange County Epidemiology at 714-834-8180 for assistance with evaluation and specimen submission:

1) Hospitalized patients with:

• radiographically confirmed pneumonia, acute respiratory distress syndrome (ARDS), or other unexplained severe respiratory illness, AND
• history of travel to or immigration from a country with documented H5N1 avian influenza infections in poultry or humans within 10 days of symptom onset. (for current information on affected countries);

2) Hospitalized or ambulatory patients with:

• documented temperature >38degreesC (>100.4degreesF), AND
• cough, sore throat, and/or shortness of breath, AND
• history of contact with poultry (e.g., visited a poultry farm, a household raising poultry, or a bird market) in an H5N1-affected country or with a known or suspected human case of influenza A (H5N1) within 10 days of symptom onset

Testing for influenza A (H5N1) infection will be performed on all patients meeting both criteria under (1) above and on select patients meeting all three criteria under (2). Respiratory viral cultures should NOT be ordered or performed locally on patients suspected of having H5N1 infection because of laboratory safety requirements. Commercial antigen detection testing can be conducted at hospital laboratories but specimens should ALSO be sent to the Orange County Public Health Laboratory for polymerase chain reaction (PCR) testing. Please contact Epidemiology at 714-834-8180 to arrange for testing.

Hospitalized patients diagnosed with or under evaluation for influenza A (H5N1) should be isolated using airborne, contact, and standard precautions, as well as eye protection within 3 feet, for 14 days after onset of symptoms unless an alternative diagnosis is established and/or influenza infection is excluded. ALL health care facilities should follow the CDC's Respiratory Hygiene/Cough Etiquette guidelines to prevent the spread of respiratory infections within health care settings. Outpatients or discharged patients should be isolated in the home setting for the same period. For more detailed guidelines, contact Epidemiology at 714-834-8180.

2-1-1 is a telephone number that will have a positive impact throughout the system of health and human services.

It is a free, accessible 3-digit telephone number that will enable everyone to access the vital community health and human services that they need.

2-1-1 is to social services, what 9-1-1 is to emergency services.

email: ca4aap@sbcglobal.net

phone: 714/971-0695

web: http://www.aapca4.org