WE HAVE AN EXCEPTIONAL MEDICAL TEAM

Mercy Medical Center, Cedar Rapids, Iowa is now offering $3,000 to anyone who refers a qualified physician that is hired to practice within Mercy Medical Center or its affiliated clinics. There are many physician opportunities at Mercy.

Visit www.mercycare.org/employment/physician-opportunities/ to find out what they are!

Together, we can continue to build an even stronger health care community.

STEPS TO COMPLETE PROCESSSTEP 1: The person referring the physician must fill out the Physician Referral Program Submission Form located at the website noted above.

STEP 2: The referring person must send the completed form AND attach the physician candidate's resume or CV (curriculum vitae) for approval to:

Mercy Physician Recruitment Department, 701 10th Street SE, Cedar Rapids, IA 52403

STEP 3: Tell the physician candidate to use your name as the person who referred them when contacted by Mercy’s Physician Recruitment Department.

• Approval will only be granted if the Resume or CV is provided and the person’s name that is referring the physician is shared with Mercy’s Physician Recruitment Department by the physician candidate.

PAYMENT STRUCTUREIf the physician candidate accepts a position, you will be notified by Mercy’s Physician Recruitment Department and will receive:

$3,000 after they complete one year of employment. Please note - this is TAXABLE income for all Mercyaffiliated employees. For non-Mercy employees, you would be required to complete a W-9; a 1099 would be provided to you for reporting purposes.

You can take part in helping it grow: refer a physician and earn $3,000.

GUIDELINES • All open physician

positions are eligible to be included in the program.

• Physician candidates must not be currently employed by Mercy Medical Center, Cedar Rapids, Iowa or its affiliated clinics to include, Mercy Home Care and Mercy Hospice.

• If more than one person refers a physician and more than one person is referenced on the application, cover letter, or phone screen, the referral bonus will be divided equally among the referring people.

• Individuals with direct input in the interview and selection process of the applicant are not eligible for the referral bonus program.

• To be eligible for the reward, please refer to the steps required above.

C E D A R R A P I D S

2015-2016 Residents Faculty 26-May-15

Cedar Rapids Medical Education Foundation

2015-2016 Family Medicine Residency Program

(Effective 06-22-15)

Resident I

Safa Y. Abukhalil, M.D. Chirajeevi P. Siddagunta, M.D. Zachary M. Hood, M.D. Brian E. Thatcher, M.D. Prachi Jindal, M.D. Bradley J. Willis, M.D. Rose I. Schabilion, M.D.

Resident II

Rafael Bayramgalin, M.D. Ramya K. Maturu, M.D. Neel G. Bhalala, M.D. Sara D. Snitker, D.O. David M. Byrne, M.D. Kristen A. Steidl, M.D. Jerimiah C. Johnson, M.D.

Resident III

Albert T. Chmielewski, M.D. Ravneet Kaur, M.D. Christopher J. Goetzinger, M.D. Ola M. Khraiwesh, M.D.(becomes R-3 on 7/6/15)

Maris L. Hoke, M.D. Aleksandra F. Siwkiewicz, M.D.

2015 Resident Graduates (Final day of Residency is June 28, 2015 – unless otherwise noted below)

Jason M. Ellis, D.O. Gagandeep Singh, M.D. (effective 02/26/16)

Angela C. Fults, D.O. (effective 07/14/15) Timothy M. Volk, M.D. David R. Sheff, M.D. (effective 12/15/15)

Family Medicine Residency M.D. FacultyJennifer Holmes Latterell, D.O., Ex Dir Kiran Khanolkar, M.D. Donal K. Gordon, M.D., Program Dir Donald A. Nelson, M.D. (part-time) Robert A. Beck, M.D. Ronald Reider, M.D. Jennifer A. Donovan, M.D. Ann K. Soenen, D.O. Jason M. Ellis, D.O. Sujan K. Vadarevu, M.D. (part-time)

To: AllMercyCareStaff

From: BradArcher,MD

Date: June12,2015

Subject: MercyCareAlberts/CahalanMovingto600MedicalPark

EffectiveJune15,2015,Dr.WayneAlbertsandSusanCahalan,PA‐C,willbeginseeingpatientsintheirnewlocationatthe600MedicalParkindowntownCedarRapids,connectedbyskywalktoMercyMedicalCenter.Theclinic’snewaddresswillbe:

MercyCareAlberts/Cahalan6007thStreetSECedarRapids,Iowa52403

Movingtothefirstfloorofthe600MedicalParkwillimprovethelevelofcareDr.AlbertsandSusan’spatientsreceiveduetoeasieraccessandmoreupdatedfacilities.Theofficephonenumbers,hoursofoperationandstaffwillremainthesame.Pleasejoinmeincongratulatingthisteamonthegrowthandsuccessthatmadethismovepossible.

 

Wood tick adult size

Deer tick at nymph and adult sizes

In the United States, some ticks

carry pathogens that can cause hu-

man disease. Of these illnesses,

Lyme disease, Rocky Mountain

spotted fever and Ehrlichiosis are

some of the more popular tick-borne

diseases.

Different Ticks, cause different dis-

eases and tend to be prevalent in

regions where that species of tick is

most commonly found.

Lyme disease is caused by deer

ticks, primarily in “nymph” stage.

They are tiny, only about the size of

a poppy seed. The incubation period

is 3-30 days.

Rocky Mountain Spotted Fever is

associated with wood and dog

ticks. Incubation period is 2-14

days.

Ehrlichiosis is transmitted by the

Lone Star tick with an incubation

period of 1-2 weeks.

These illness have many similar

clinical presentations including

headache, muscle pain, malaise,

fever and chills. Rash is not al-

ways a symptom, but can be a

distinguishing sign in certain ill-

nesses such as Lyme disease,

where an occasional red ring-like

rash may appear around the bite.

TICKS and MOSQUITOS ARE HUNGRY…..

Are you on the menu?

Spray before you work or play!!!

Most mosquito bites do not result

in disease, but it’s a good idea to

watch for early symptoms of some

of the more commonly encoun-

tered mosquito-transmitted diseas-

es.

West Nile Virus is the most

well known mosquito-

transmitted disease with an

incubation period of 3-14 days.

Usually, this disease is asymp-

tomatic, but 20 % of those

infected will develop symp-

toms that include, sudden fever,

anorexia, malaise, severe muscle

weakness, headache, nausea, vom-

iting or change in mental status.

Treatment is supportive and in-

cludes rest, fluids and over the

counter analgesics.

Malaria, Dengue and Chikungunya

are three mosquito-transmitted

illnesses that don’t commonly

occur in the US, but are prevalent

throughout the world. So….

KEEP IN MIND, if traveling

abroad during peak mosquito

times, PREVENTION is really the

best medicine. See side bar for

Reduce Your Risk tips.

Visit the CDC’s Division of Vec-

tor-Borne Diseases for detailed

recommendations and guidelines

regarding specific tick and mos-

quito-transmitted illnesses and

their treatment.

www.cdc.gov/ncezid/dvbd/

Mercy Medical Center

June 2015

Bugs N Drugs

REDUCE YOUR RISK:

Use repellant containing

DEET on skin and spray

clothing, hats, shoes, camp-

ing gear with permethrin

chemical for added protec-

tion. Re-apply as directed

Wear long- sleeved shirts,

socks and long pants

Perform whole body checks

for ticks throughout the day

(including belly-buttons and

ears) Showering within 2

hrs of being in tick-infested

areas is known to reduce

disease risk

Use Veterinary –approved

tick protection on family

pets

Empty standing water

around your home and envi-

ronment to decrease mos-

quito larvae population

Remove tick immediately by

grasping with fine tweezers

at base of tick and pulling

firmly in an upward motion.

Cleanse site with soap and

water.

701 10th Street SE Cedar Rapids, IA 52403-1292 (319) 398-6011

PHYSICIAN MEMO

DATE: June 17, 2015

FROM: Shawn Steffen, Senior Director of Revenue Cycle

CONTACT: 319-221-8419 or ssteffen@mercycare.org

SUBJECT: ICD-10 and Epic Diagnosis Calculator RecentlyyouprobablyhavenoticedtheadditionalEpicdiagnosisbuttonsavailabletomakeyourselecteddiagnosismorespecificwhencompletingtheProblemListorVisitDiagnosis.ThisEpicfunctionalityiscalledthe“DiagnosisCalculator.”Manyprovidershavealreadystartedtousethistoolandhavefoundittobevaluableinmakingthediagnosismorespecific.ThecurrentoptionaluseoftheDiagnosisCalculatormakestheICD‐9diagnosismorespecific,butthiscalculatorwillhelpyouselectthespecificICD‐10diagnosesafterOctober1,2015.Youwillseeagreenbarwhenthediagnosisisspecificenoughforbillingrequirements.InordertoprepareforthenecessaryspecificICD‐10coding,thiscalculatorwithassociateddiagnosisspecificitywillberequiredforICD‐9inearlyAugust.Someproviderswhenusingthediagnosiscalculatorhaveaskedaboutthespecificmeaningof“Initial,”“Subsequent,”or“Sequela.”Belowaredefinitionstohelpwiththeselectioncriteria.Ifyouhavequestionspleasedonothesitatetoreachouttome.FromAAPC(AmericanAssociationofProfessionalCoders):“Initial”IsaSubtleConceptinICD‐10Thereisawrinkle:TheICD‐10‐CMdefinitionofinitialismorecomplicatedthantheusualunderstandingoftheword.Specifically,guidelinesstatethataseventhcharacterAis“usedfortheinitialencounterfortheinjuryorconditionwhilethepatientisreceivingactivetreatmentfortheinjury.Examplesofactivetreatmentare:surgicaltreatment,emergencydepartmentencounter,andevaluationandtreatmentbyanewphysician”[emphasisadded].

Thestatement“evaluationandtreatmentbyanewphysician”canbeasourceofconfusion,butyouwillcodecorrectlyifyouareabletoanswerthebasicquestion,“Hasthepatientpreviouslyreceivedactivetreatmentforthisconditioninanysettingorbyanyprovider?”Forexample:Thepatientisevaluatedintheemergencyroom(ER)foradisplacedtransversefractureoftheleftulnathatcannotbemanagedatthistime.TheERappliesimmobilizationandiceandinstructsthepatienttofollowupwithorthopedicsinthemorning.ThiswouldbereportedusingS52.222ADisplacedtransversefractureoftheleftulna,initialencounterforclosedfracture.Whentheorthopedistevaluatesthepatientandreducesthefracturethenextday,thepatientisreceivinginitialactivetreatmentforthisfracture.Thatis,thisisthefirstencounteratwhichthepatientreceivesdefinitivecare(theERwasabletoapplycomfortcareonly).PerICD‐10guidelines,youwouldagainreportS52.222Aforaninitialencounter.Now,let’schangethescenario:Thepatienthasagreenstickfractureoftheshaftoftheleftulna,whichisdefinitivelymanagedintheERwithacastorsplint.YouwouldreportthiswithS52.212AGreenstickfractureoftheshaftofleftulna,initialencounterforclosedfracture.Whenthepatientisevaluatedfortheinjuryintheorthopedicofficeatalaterdate,itisasubsequentencounter(fromthepatient’spointofview).ThisistrueevenifthecastorsplintisremovedandanewoneisappliedbecausethepatientalreadyreceiveddefinitivefracturecareintheER.SubsequentIsSimpleICD‐10‐CMdefinessubsequentencountersas“encountersafterthepatienthasreceivedactivetreatmentoftheinjuryandisreceivingroutinecarefortheinjuryduringthehealingorrecoveryphase.Examplesofsubsequentcareare:castchangeorremoval,removalofexternalorinternalfixationdevice,medicationadjustment,otheraftercareandfollowupvisitsfollowinginjurytreatment.”Continuingwithourexample:Ifthefractureishealingasitshould,theorthopedicofficewouldreportS52.212DGreenstickfractureoftheshaftofleftulna,subsequentencounterforfracturewithroutinehealing.WhatIsSequela?ICD‐10‐CMsaystheseventhcharacterSis“foruseforcomplicationsorconditionsthatariseasadirectresultofaninjury,suchasscarformationafteraburn.Thescarsaresequelaeoftheburn.”Inotherwords,sequelaarethelateeffectsofaninjury.Perhapsthemostcommonsequelaispain.Manypatientsreceivetreatmentlongafteraninjuryhashealedasaresultofpain.Somepatientsmightneverhavebeentreatedfortheinjuryatall.Astimepasses,thepainbecomesintolerableandthepatientseeksapainremedy.Forexample:Apatientsuffersalowbackinjurythathealsonitsown.Thepatientisn’tseekinginterventionfortheinitialinjury,butforthepainthatpersistslongafter.The

chronicpainissequelaoftheinjury.SuchavisitmaybereportedasG89.21ChronicpainduetotraumaandS39.002SUnspecifiedinjuryofmuscle,fasciaandtendonoflowerback,sequela.Thebottomline:WithICD‐10CM,it’simportanttostayfocusedonthepatient’sdiagnosesandcodeonlyfromthatperspective.http://news.aapc.com/initial‐subsequent‐or‐se‐quela‐encounter/FromICD‐10Monitor:EpisodeofCareTheepisode‐of‐careseventhcharactersareusedprimarilyforinjuries,poisoningsandotherconsequencesofexternalcauses;therearethreeseventh‐characterextensionsformostoftheseconditions,withtheexceptionoffractures.Theseinclude:Initialencounter(“A”):initialencounterisdefinedastheperiodwhenapatientisreceivingactivetreatmentforaninjury,poisoningorotherconsequencesofanexternalcause.An“A”maybeassignedonmorethanoneclaim.Forexample,considerapatientseenintheemergencydepartment(ED)foraheadinjurythatfirstisevaluatedbyanEDphysician.IftheEDphysicianrequestsaCTscanthatsubsequentlyisreadbyaradiologistandaneurologist,theseventhcharacter“A”isusedbyallthreephysiciansandalsoreportedontheEDclaim.Ifthepatientrequiredadmissiontoanacute‐carehospital,theseventhcharacterwouldbereportedfortheentireacute‐carehospitalstaybecause“A”isusedfortheentireperiodwhenthepatientreceivesactivetreatment.Subsequentencounter(“D”):thisisanencounteroccurringaftertheactivephaseoftreatment,whenapatientisreceivingroutinecareduringaperiodofhealingorrecovery.Forexample,apatientwithananklesprainmayreturntotheofficetohavejointstabilityre‐evaluatedtoensurethattheinjuryishealingproperly.Inthiscase,theseventhcharacter“D”wouldbeassigned.Sequela(“S”):theseventh‐characterextension“S”isassignedforcomplicationsorconditionsarisingasadirectresultofaninjury.Anexampleofasequelaisascarresultingfromaburn.http://www.icd10monitor.com/index.php?option=com_content&view=article&id=259%3Aunderstanding..&showall=1

COMING THIS SUMMER:

WELCOME TO CEDAR RAPIDS!

Brian Cheney, M.D.

Linn County Anesthesiologists, P.C.

grew up in Ames, Iowa and received his B.S. in neuroscience from Brigham Young University in Provo, Utah. After graduating, he worked at the National Institutes of Health in Bethesda, Maryland for a year before moving back to Iowa for medical school and then anesthesia residency at the University of Iowa. Dr. Cheney and his family are very excited to be staying in Iowa as he joins LCA in July.

Aaron Schmidt, M.D.is originally from Wisconsin and received his B.S. from the University of Wisconsin-Madison. He moved to Iowa for medical school at the University of Iowa, and stayed at the University of Iowa for his anesthesia residency training. He and his wife, Nicole, and their son, Theodore, are excited for their future in eastern Iowa. His interests include all things Wisconsin Badgers and Packers, golfing, and spending time with his family. He will be starting with LCA in July.

Jay Diaz-Parlet, M.D. grew up in Minneapolis, Minnesota where he completed his undergraduate studies in biochemistry followed by medical school at the University of Minnesota. He completed an internship at the Naval Medical Center San Diego after which he spent four years caring for our Navy’s diving teams and submariners before resuming training at the University of Iowa where he completed Anesthesia residency. He enjoys spending time with his two children, playing basketball, biking and traveling. He will be joining LCA in July.

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Medication Management Committee Mercy Medical Center

Cedar Rapids, Iowa Volume 16 June 2015

Formulary Additions Emtricitabine (Emtriva) (for use with the SANE protocol) Tenofovir (Viread) (for use with the SANE protocol) Prevnar 13

Policy Updates Medication Formulary Policy

Sepsis Order Set Changes

Alert Space Suppressions Order Set Suppression

o MMC IP Anes PACU POST

o Change frequency on severe pain

meds to “as needed” and add verbiage

of “administer every 10 min as needed”

in the admin instructions

Duplicate Therapy Allowances – Increase

allowance to 1

o Selective Serotonin 5-HT3 Antagonists

o Anti-Anxiety Agents

o Peptic Ulcer Agents

o Local Anesthetics-Parenteral

o Multivitamins

o Plasma Proteins

o Topical Corticosteroids

o Antipsychotics & Antipsychotics,

Atypical

o Stimulant Laxatives

Duplicate Medication

o Sodium Chloride 0.9%/Lactated

Ringers, suppress at medication level

Membership Fadi Yacoub, Chair Vincent Reid, MD

Susan Schima, MD Mark Valliere, MD

Asma Al-Zougbi, MD Usha Renganathan, MD

Martin Cearras, MD Mary Brobst

Lauren Cumings Sarah Schloss, ARNP

Stephanie Hoenig, ARNP Jamie Sinclair

Becky Prier Stacy Pohlman

Lisa Ridge Jen Goings

Amber Straw Megan Standish

Kathy Swift Andrea Bennet

Ariel Loring

Don Hilliard, MD* Chris Walsh, MD*

Matt Aucutt, MD* Dan McGrail, MD*

Donal Gordon, MD* Brandon Bourgeous, MD*

Wendy Sanders* Sarah Kearney*

I N S I D E T H I S I S S U E

Formulary Additions

Policy Updates

Alert Space Suppressions

P a g e | 1

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Medication Management Committee Mercy Medical Center

Cedar Rapids, Iowa Volume 15 May 2015

Formulary Interchanges Medication Ordered Interchanged To

Levemir / NPH Insulin Lantus

Policy Updates Pneumococcal and Influenza Vaccination – Inpatient

Population

Medications Supplied by Patients, Families, or

Licensed Independent Practitioners

Alert Space Suppressions Inactive ingredient warning for providers, would still

fire for pharmacy

Increase duplicate order allowance for non-narcotic

analgesics / antipruritic, non-salicylates to one

Good Catch Program Increase reporting in the MIDAS system as a way

to identify potential system problems to better

improve patient safety.

Defined as an event of circumstance that has

potential to cause an incident but did not due to

corrective action or timely intervention.

Increase in Medication Cost S: Valent Pharmaceuticals International Inc. purchased

the rights to nitroprusside (Nitropress) and

isoproterenol (Isuprel) in February 2015.

B: These Medications have been on the market for

decades and are the latest to be part of the “sole

source” prince increases occurring in the

pharmaceutical industry. Nitroprusside is used for

hypertensive crisis, acute decompensated heart failure,

and during some surgical procedures to induce

hypotension to reduce bleeding. Isoproterenol is largely

used to treat heart block, bradycardia, and in some

diagnostic studies.

A:

Medication Cost prior to Feb Current Cost

Nitroprusside $205 $617

Isoproterenol $209 $1254

R: Assess areas of current utilization and identify if

there are areas of opportunity to limit use. Educate

prescribers on the cost impact of this acquisition.

Membership Fadi Yacoub, Chair Vincent Reid, MD

Susan Schima, MD Mark Valliere, MD

Asma Al-Zougbi, MD Usha Renganathan, MD

Martin Cearras, MD Mary Brobst

Lauren Cumings Sarah Schloss, ARNP

Stephanie Hoenig, ARNP Jamie Sinclair

Becky Prier Stacy Pohlman

Lisa Ridge Jen Goings

Amber Straw Megan Standish

Kathy Swift Andrea Bennet

Ariel Loring

Don Hilliard, MD* Chris Walsh, MD*

Matt Aucutt, MD* Dan McGrail, MD*

Donal Gordon, MD* Brandon Bourgeous, MD*

Wendy Sanders* Sarah Kearney*

I N S I D E T H I S I S S U E

Policy Updates

Therapeutic Interchange

Increase in Medication Cost

Good Catch Program

Alert Space Suppressions

A PARTNERSHIPUNITY POINT-ST. LUKE’S HOSPITAL • MERCY MEDICAL CENTER • PHYSICIANS’ CLINIC OF IOWA

Dear Mercy Staff,

Please see following this letter the new EISC Referral Order for providers, scheduling staff and nursing. It is also located on our website at www.eisleep.com/forms.

Please note the changes to the referral order:

• Reduced boxes. Documentation for sleep symptoms and added conditions are now required by insurance to be IN THE ORDERING PROVIDER’S NOTES. Therefore checking off the symptoms on the Order is not enough for insurances.

• DX OSA is the majority of what is requested; so multiple other DX were removed.

• Codes for the study types are listed for pre-authorizations.

• New code for Home Study.

• A new section for the patient to be seen by a Sleep Medicine Specialist, if the sleep study(s) shows a sleep disorder, is now an option! If this new area is checked by the ordering provider, EISC will forward a copy of the results as normal to original ordering provider and will also forward the request to the selected sleep provider for the patient to be followed up and managed for their sleep disorder only.

EISC hopes these changes help your staff and patients for a smooth scheduling process. Also getting access to Sleep Medicine providers just got easier.

Any questions, please let me know.

Lisa A. Gleason, EISC Business Manager

www.eiSleep.com600 7th Street SE, 2nd flrCedar Rapids, IA 52401Office (319)362-4433 Fax (319)362-4466

A PARTNERSHIP UNITYPOINT-ST. LUKE’S HOSPITAL • MERCY MEDICAL CENTER • PHYSICIANS’ CLINIC OF IOWA

600 7th Street SE • Cedar Rapids, IA 52401phone.319.362.4433 • tollfree.877.361.4433 fax.319.362.4466

EISC Use Only – Thank you!

Scheduled Date/Time:

EISC Dr. signature:

EISC Approval/Date: CO2: Y N

EISC No:

PATIENT PERSONAL INFORMATION

First name: ______________________________________________ Last name: __________________________________________________

Address: ________________________________________________City: _______________________State: _______ Zip: ______________

Cell phone: ___________________________ Home phone: ___________________________Work phone: ___________________________

DOB: _______________________ Gender: M F Weight __________Height _______________ Neck circumference __________ inches

Sleep hours: o Night o Day o Shift work o Other hours ________________________________________

Special needs:oOxygen o Wheelchair o Walker o Other _______________________________________

INSURANCE INFORMATION: Please provide front and back for card(s)Primary Secondary Pre- AuthInsurance: _____________________________Insurance: _________________________________Form/ #: ____________________________

ATTACH ORDERING PROVIDER NOTES – Per insurance requirements medical necessity must be established prior to the study and documented in the patient medical record. Medical necessity includes, but not limited to two sleep symptoms: snoring, witnessed apnea, choking or gasping during sleep, morning headaches, excessive daytime sleepiness, disturbed/restless sleep. Any added information such as: co-morbid conditions, validated Epworth Sleepiness Scale, duration of sleep symptoms, BMI, neck circumference, focused cardiopulmonary and upper airway system evaluation and other factors as appropriate.

PROVIDER ORDERS:DX: OSA (unless otherwise indicated) DX: ____________________________ DX: _________________________

o Diagnostic PSG 95810 & 95811 (polysomnogram) w/ split night or second night titration, if indicatedo Diagnostic PSG 95810 (polysomnogram) ONLY, no additional testingo PAP (re)titration with CPAP or BiPAP (including autoSV and AVAPS)o Consider CO2 monitoringo Home sleep test 95806 (High pre-test OSA ONLY) o Maintenance of Wakefulness Test MWT (Concerns about patient ability to stay awake)For MSLT, Actigraphy and/or specialized sleep issues please see Sleep Medicine Provider first.

Previous study done at:

Sleep Aid: None: ____ Zaleplon(Sonata) _____ mg Zolpidem(Ambien) _____ mg Eszopiclone(Lunesta) ______mg Other: ______________

IF YOU HAVE PROVIDED YOUR PATIENT WITH A SLEEP AID, PLEASE INSTRUCT THEM TO BRING THE FILLED PRESCRIPTION WITH THEM TO THE SLEEP STUDY. THE SLEEP TECHNICIAN WILL INFORM YOUR PATIENT WHEN THE SLEEP AID SHOULD BE TAKEN.

Referring Provider _____________________________________ Phone:_________________________ Fax: ___________________________

Referring Provider Signature: _________________________________________________________ Date: _____________________________

PCP (if different): ___________________________________________________________________ Phone: ___________________________

(Print)

Select one of the following should the patient have a sleep disorder:o Send the patient for follow up and treatment to a Sleep Medicine Provider: o PCI Sleep Medicine Provider o UnityPoint Sleep Medicine Provider o No preference

o I will follow up with the patient regarding the test results.

Do not return to daycare

as an employee or at-

tendee, work in food

handling/prep environ-

ments, or work in health

care setting until ap-

proved by local Public

Health Dept. via a re-

peat stool sample.

Wash hands before and

after handling food,

after using the bath-

room or after changing

diapers (wash baby’s

hands, too)

Make sure children

wash hands thoroughly

Properly dispose of

diapers and disinfect

the changing area

Never prepare food if

you have diarrhea

Do not swim in pools

or lakes if you have

diarrhea.

Talking Points For Prevention

Shigellosis develops when

a person is infected with

the Shigella bacteria.

This bacteria causes

about 500,000 cases of

diarrhea in the United

States annually.

So far in 2015, Linn

County has reported

more than 50 cases. Typ-

ically, there are only 4-5

cases/year in Linn Co.

SOOOO…...

How Is Shigella

spread?

These germs are present

in the stool of infected

persons and can remain

up to 2 weeks after the

diarrhea is gone. Shigel-

la is VERY contagious.

Even a tiny amount of

contaminated fecal mat-

ter —too small to see–

can cause infection via

the fecal-oral route.

Examples of fecal-oral

transmission include,

eating food contami-

nated with shigella,

improper hand wash-

ing after diaper

changes, esp. in day-

care settings, or in-

gesting water con-

taminated with shi-

gella bacteria from

pools or lakes.

Symptoms of Shi-

gellosis:

Watery diarrhea

Fever

Abdominal Pain/

cramping

Nausea and Vomiting

More severe symp-

toms include, high

fevers, very sever di-

arrhea/dehydration or

convulsions.

Most people infected

with Shigella bacteria

become ill within 1-2

days after exposure.

Symptoms usually

last 5-7 days.

Persons with mild

cases of Shigellosis

usually recover on

their own without

medication. However,

antibiotics can be pre-

scribed in more se-

vere cases.

Those with high fever

or prolonged/bloody

diarrhea should con-

tact their doctor.

Hospitalization may

be required to man-

age more severe Shi-

gellosis.

BUGS n DRUGS

Shigellosis

4 Species of Shigella:

Shigella sonnei (most

commonly found in in-

dustrialized countries)

Shigella flexneri (prevails

in developing countries)

Shigella boydii

(uncommon)

Shigella dysenteriae (most

uncommon)

M erc y M ed ica l Cen te r June 2015 For M ore In fo - vis i t : www .cdc .gov/sh ige l l a