The Louisiana Department of Health (LDH) is issuing this Health Alert Network (HAN) Health Advisory 

to alert clinicians about risks of counterfeit or mishandled botulinum toxin (commonly called “Botox”)

injections. In August 2024, one suspected reaction was reported in Louisiana.

CDC, several state and local health departments, and the U.S. Food and Drug Administration (FDA) investigated reports of harmful reactions among people who received injections of counterfeit or mishandled botulinum toxin.  As of June 24, 2024, a total of 17 people from 9 states have reported harmful reactions after receiving injections with counterfeit products, products from unverified sources, or from individuals who were not following state or local requirements.

When botulinum toxin diffuses around the injection site, it can result in adverse effects. Botulism is the disease caused by botulinum toxin circulating in the blood and producing effects remotely from the injection site. There may be symptom overlap between the presentation of localized adverse effects from injection of botulinum toxin, especially in the head and neck, and the early symptoms of botulism. Information about the botulinum toxin injection (e.g., dose) can help distinguish between botulism and localized adverse effects but is challenging to obtain for counterfeit products. Clinicians should consider the possibility of adverse effects from botulinum toxin injections in patients presenting with localized paralysis.

Additional Information for healthcare providers:

Botulism is a rare and sometimes fatal illness caused by botulinum toxin. Initial botulism symptoms may include double or blurred vision, drooping eyelids, slurred speech, difficulty swallowing, and difficulty breathing. These symptoms may be followed by a descending, symmetric muscle weakness that progresses over hours to days. Administration of botulism antitoxin can neutralize toxin circulating in the blood; therefore, treating botulism patients with botulism antitoxin early in the course of disease can prevent the progression of paralysis and consequent complications. Administration of antitoxin is not indicated for local effects of low-dose injections of botulinum toxin preparations, because the low doses of injected toxin are not likely to reach circulation or produce botulism with its life-threatening manifestations.

Some localized paralytic effects, resulting from diffusion of the toxin around the injection site, are expected from botulinum toxin administration. Most individuals with localized symptoms (e.g., dysphagia after injection to the neck) following low-dose cosmetic or therapeutic injections using FDA-approved products will not require treatment with botulism antitoxin. Iatrogenic botulism can occur after cosmetic or therapeutic injections of botulinum toxin when the toxin circulates in the blood and produces effects remotely from the injection site. Iatrogenic botulism is rare; the most recent laboratory-confirmed domestic case occurred in 2017.

As of June 24, 2024, a total of 17 people from 9 states have reported harmful reactions after receiving injections with counterfeit products, products from unverified sources, or from individuals who were not following state or local requirements. More information about the counterfeit products 

The 17 people included in this investigation had reactions on dates ranging from November 4, 2023, through April 11, 2024. States that reported these reactions included California (2), Colorado (1), Florida (1), Illinois (2), Kentucky (1), New Jersey (1), New York (3), Tennessee (3), and Texas (3).

Overall, 13 (76%) people were hospitalized and 6 (35%) were treated with botulism antitoxin because of concerns that the botulinum toxin could have spread beyond the injection site. Among 7 people tested for botulism, all had negative results.

All reports came from people identifying as female, ranging in age from 25 to 67 years, with a median age of 43 years. Fifteen (88%) people reported receiving botulinum toxin injections for cosmetic purposes.

These adverse events have been linked to improper procurement and administration of botulinum toxin. Botulinum toxin should be administered only by licensed providers, using only recommended doses of FDA-approved botulinum toxin, preferably in a licensed or accredited healthcare setting. Providers should be trained in the proper administration of botulinum toxin, practicing in accordance with state and local requirements.

Adverse Effects Linked to Counterfeit or Mishandled Botox Injections

Increased Risk of Dengue Virus Infections in the United States.

The Louisiana Department of Health (LDH) is issuing this Health Alert Network (HAN) Health Advisory, modified from a CDC HAN, to inform clinicians and the public of an increased risk of dengue virus (DENV) infections in the United States in 2024. In 2024, 

 have reported a record-breaking number of dengue cases, exceeding the highest number ever recorded in a single year. Over 9 million cases have been reported between January 1 – June 24, 2024, twice as many as in all of 2023. In the United States, a higher-than-expected nu mber of dengue cases have been identified among U.S. travelers (745 cases), and Puerto Rico has already declared a public health emergency (1,498 cases). On average, Louisiana identifies 3 travel-associated dengue cases per year, but LDH has already investigated 6 travel-associated cases as of July 2, 2024. Cases are expected to continue to rise in Central and North America as the Northern Hemisphere enters peak mosquito season, and the number of travel-associated dengue cases are expected to continue to increase. The introduction of travel-associated cases also increases the risk for local disease transmission in Louisiana. In the setting of increased global and domestic incidence of dengue, healthcare providers are encouraged to take steps to prepare to identify, test, and manage dengue cases.

Additional Information for Healthcare Providers

 is the most common arboviral disease globally. It is caused by four distinct but closely related dengue viruses (DENV-1, -2, -3, and -4). DENVs are transmitted through bites of infected 

 species mosquito vectors, which are present throughout Louisiana and pose the risk for local disease transmission. Infection with one DENV generally induces life-long protection against infection from that specific DENV but on ly protects against other DENVs for several months to years. Six U.S. territories and freely associated states are classified as 

areas with frequent or continuous dengue transmission

: Puerto Rico, American Samoa, the U.S. Virgin Islands, the Federated States of Micronesia, the Republic of Marshall Islands, and the Republic of Palau. In the rest of the United States, local transmission of DENV has been limited, with sporadic cases or small outbreaks in Florida, Hawaii, and Texas. However, confirmed local DENV transmission has also been reported by Arizona and California over the past two years.

Approximately one in four DENV infections are symptomatic and can be mild or severe. Symptoms begin after an incubation period of 5–7 days (range 3–10 days) and present as fever accompanied by 

such as nausea, vomiting, rash, muscle aches, joint pain, bone pain, pain behind the eyes, headache, or low white blood cell counts. 

 are specific clinical findings that predict progression to severe disease. Warning signs include abdominal pain or tenderness, persistent vomiting, clinical fluid accumulation (e.g., ascites, pleural effusion), mucosal bleeding, lethargy or restlessness, progressive increase of hematocrit, or liver enlargement >2cm. Severe disease, with associated severe bleeding, shock or respiratory distress caused by plasma leakage, or end-organ impairment, develops in 1 in 20 people with symptomatic dengue. Infants aged ≤1 year, pregnant people, adults aged ≥65 years, and people with 

 are at increased risk of severe dengue. Although a second DENV infection (i.e., with a different DENV from the first infection) carries a higher risk of severe disease than a first, third, or fourth infection, any infection can lead to severe disease.

 with both molecular and serologic diagnostic tests. All patients with suspected DENV infection should be test ed with RT-PCR (i.e., a nucleic acid amplification test (NAAT)) or a NS1 antigen test, and also with IgM antibody test to confirm DENV infection. These tests can be considered regardless of the symptom onset date, although the test sensitivity of RT-PCR and NS1 antigen tests decrease after the first 7 days. IgG detection by enzyme-linked immunosorbent assay (ELISA) in a single serum sample should not be used to diagnose a patient with acute dengue because it does not distinguish between current and previous DENV infection.

There are no antiviral medications approved to treat dengue. Treatment is supportive and requires careful volume management. Appropriate 

 remain the most effective interventions to reduce dengue morbidity and mortality. Expectant management of patients at high risk for severe disease and rapid initiation of a standardized fluid replacement strategy recommended by the World Health Organization (WHO) can decrease mortality from 13% to <1%.

LDH will continue to work with healthcare providers and healthcare systems to identify and detect dengue cases in Louisiana. In addition to routine activities, LDH will be performing enhanced monitoring for dengue in Louisiana, including analyzing emergency department visit reports and requesting confirmatory testing for clinically compatible cases. This enhanced monitoring is meant to assist with case detection in order to initiate mitigation efforts to prevent disease transmission within the state.

Webinar: What Clinicians Need to Know about Dengue in the United States | CDC

Increased Risk of Dengue Virus Infections in the United States

Louisiana Physician Loan Repayment Program

Physicians serving in federally designated Health Professional Shortage Areas (HPSA) across the state may be eligible for the Louisiana Physician Loan Repayment Program. This program 

repays governmental or commercial educational loans

 in exchange for serving in underserved facilities. This loan repayment program offers 

 the opportunity to have their student loans repaid in exchange for practicing in underserved communities. 

 for a five-year commitment. Participants who complete their original 

 in compliance, remain in an eligible site in a HPSA, and still have educational loans to repay may be able to extend their commitment with a two-year renewal to receive $15,000 annually.

*Application submission does not guarantee funding. Additional qualifications are required.

Want to find out more?  Register to attend an info-session. Register 

After registering, you will receive a confirmation email containing information about joining the session.

Student Loan Repayment for Physicians in Louisiana

Student Load Repayment for Physician's in Louisiana

identification of two measles cases in the greater New Orleans area.

CONTACT LDH WITH ANY QUESTIONS OR CONCERNS!

Guidance for evaluating suspected measles cases

The Louisiana Department of Health (LDH) is reporting that two individuals were diagnosed with measles in the Greater New Orleans Area. These individuals were unvaccinated and recently returned from an out-of-state trip. A public health investigation has been initiated and we will provide additional updates as we are able to collect more information.

Healthcare providers in and around the City of New Orleans should proactively identify and update the immunity status of their patients and be vigilant for the possibility of additional cases of measles.

Importations of measles into communities with unvaccinated persons can lead to measles cases and outbreaks in the United States. Maintenance of high vaccination coverage, ensuring timely vaccination before travel, and early detection and isolation of cases are key factors to limit importations and the spread of disease.

Healthcare providers in Louisiana, and especially New Orleans should consider measles in patients who:

Healthcare providers should also consider measles when evaluating patients for other febrile rash illnesses, including 

If you suspect measles, do the following immediately:

Management of Patients with Febrile Rash Illness

Ideally, all patients with suspect measles should be placed immediately into a negative air pressure room. This greatly reduces the risk of transmission of measles to others in the facility and can minimize the post-exposure control measures required. The other steps listed below (e.g., masking patient, placing in a private room) may reduce the spread of measles, but usually do not eliminate the need for full post-exposure control measures.

The collection of clinical specimens for measles testing on all individuals with suspect measles is extremely important. Contact the LOPH epidemiology hotline (available 24/7) at 

 for technical guidance on specimen collection, necessary submission forms, and to arrange for transportation to the State Laboratory.

Post-Exposure Control Measures Should Cases be seen in Healthcare Facilities

Vaccinate all susceptible persons or provide immune globulin.

Post-exposure Prophylaxis with Immune Globulin (IG)

IG can prevent or modify measles in persons who are nonimmune if given within 6 days of exposure. There are three groups of patients at increased risk of severe disease from measles: infants <12 months; pregnant women without evidence of measles immunity; and severely immunocompromised individuals. The recommended dose of IG administered intramuscularly (IGIM) is 0.5 mL/kg of body weight (maximum dose = 15 mL) and the recommended dose of IG given intravenously (IGIV) is 400 mg/kg.

Identification of two measles cases in the greater New Orleans area

The February 19, 2024 meeting of the Louisiana State Board of Medical Examiners (the "Board") will be held via electronic means in compliance with La. R.S. 42:17.2. The anchor location, as required by La. R. S. 42:17.2(C)(1), is the 5

 Floor of the Board’s offices located at 630 Camp Street, New Orleans, La 70130. The Board will participate via zoom and the meeting will be live streamed to YouTube with a 20-second time delay.

Members of the public may attend the meeting in person at the anchor location or view online. To tune in, please check the website under "Board Meetings" and a link to the live streaming video will be provided immediately prior to the scheduled start of the meeting. Further, should any member of the public wish to comment on an agenda item, present a question to the Board, or present information to the Board, please send an email, attaching any pdf or recorded content needed, to the Board at: 

. Each public comment will be identified during the meeting. Videos and/or audio interactions with the public must be limited to no more than 3 minutes in length and the email size, with all content, must be less than 10 megabytes. Both requirements must be met, or the content will be refused by our system.

Board Meeting- February 19, 2024

Board Meeting February 19, 2024

The OTCC invites you to provide public comments regarding the Data System Rules and the Rule on Definitions. The public comment period is for 30 days from November 8 – December 8, 2023. Anyone interested in reviewing and/or providing public comment can click the link to each document and follow the instructions for submitting comments. After considering public comments, the OTCC will hold a special meeting on January 11, 2024 to vote each of these rules. You can find a list of upcoming OTCC and OTCC Committee meetings on the OTCompact meetings page.

OTCC Draft Rules

elevated lead levels in WanaBana Apple Cinnamon Fruit Puree Pouches. 

*CONTACT LDH WITH ANY COMMENTS OR QUESTIONS*

The FDA is advising parents and caregivers not to buy or feed WanaBana apple cinnamon fruit puree pouches to children because the product may contain elevated levels of lead.

Childhood lead investigations in Western North Carolina revealed 4 children in 3 separate investigations with elevated lead linked back to WanaBana Fruit Puree Apple Cinnamon pouches. As part of their investigation, the North Carolina Department of Health and Human Services (NCDHHS) analyzed multiple lots of WanaBana apple cinnamon fruit puree, detecting extremely high concentrations of lead. The FDA has reviewed and supports NCDHHS’s analytical findings and found that analytical results at this level could result in acute toxicity.

Lead exposure in children is often difficult to see. Most children have no obvious immediate symptoms. If there’s suspicion that a child may have been exposed to lead, a blood test should be performed. Although lead can only be diagnosed through clinical testing, signs and symptoms of lead toxicity vary based on exposure.

Short term exposure to lead could result in the following symptoms: Headache; Abdominal pain/Colic; Vomiting; Anemia.

Longer term exposure could result in additional symptoms: Irritability; Lethargy; Fatigue; Muscle aches or muscle prickling/burning; Occasional abdominal discomfort; Constipation; Difficulty concentrating/Muscular exhaustibility; Headache; Tremor; Weight loss.

Louisiana providers who provide routine medical care for young children must screen children for lead in accordance with practices consistent with the current Centers for Disease Control and Prevention and Louisiana Medicaid guidelines and in compliance with Louisiana Administrative Code (LAC) 48: V 7005, 7007 and 7009. Medical providers and laboratories are required to report all blood lead levels to the Louisiana Childhood Lead Poisoning Prevention Program (LCLPPP) regardless of value. Blood lead levels 3.5 ug/dL or greater should be reported immediately. To report: Fax the completed 

 to the Louisiana Childhood Lead Poisoning Prevention Program at 225-242-0496. Follow this 

 for lead screening and follow up testing schedule. LCLPPP will provide case management services for those children with positive tests (confirmed venous blood lead level ≥3.5 µg/dL). Case management involves a lead hazard exposure assessment, health education and may include referral for a free environmental assessment of the child’s home.

Parents and caregivers should not buy or feed WanaBana Apple Cinnamon Fruit Puree Pouches to toddlers and young children because the product may contain elevated levels of lead. Parents and caregivers of toddlers and young children who may have consumed WanaBana apple cinnamon fruit puree pouches should contact their child’s healthcare provider about getting a blood test.

Elevated lead levels in WanaBana Apple Cinnamon Fruit Puree Pouches

limited availability of Nirsevimab throughout the United States and the recent release of interim Centers for Disease Control and Prevention (CDC) recommendations to protect infants from respiratory syncytial virus (RSV) during the 2023–2024 respiratory virus season. 

CONTACT LDH WITH ANY QUESTIONS OR CONCERNS

In July 2023, the Food and Drug Administration (FDA) approved 

nirsevimab (BeyfortusTM, Sanofi and AstraZeneca)

. On August 3, 2023, CDC’s Advisory Committee on Immunization Practices (ACIP) 

 nirsevimab for all infants aged <8 months who are born during or entering their first RSV season and for infants and children aged 8–19 months who are at increased risk for severe RSV disease and are entering their second RSV season.

National Respiratory and Enteric Virus Surveillance System

 (NREVSS), a national laboratory-based surveillance network, indicate RSV transmission has increased to seasonal epidemic levels in the Southern regions of the United States and is expected to continue to increase in the rest of the country within the next 1–2 months.

 a limited supply of nirsevimab, particularly the 100mg dose prefilled syringes used for infants weighing ≥5 kg. Based on manufacturing capacity and currently available stock, there are not sufficient 100mg dose prefilled syringes of nirsevimab to protect all eligible infants weighing ≥5 kg during the current RSV season. Additionally, supply of the 50mg dose prefilled syringes may be limited during the current RSV season.

Nirsevimab and the Vaccines for Children Program

Nirsevimab is available for inclusion in the Louisiana Vaccines for Children (VFC) Program. However, ordering is currently restricted due to robust demand and limited inventory at the manufacturer. CDC has informed the Louisiana Immunization Program that capped allocations will be put in place to ensure equitable distribution nationwide. The Louisiana VFC Program will alert providers when allocations have been replenished and providers can resume placing VFC orders. Facilities/providers may also receive less inventory than ordered, due to quantity restrictions during this time of limited nirsevimab supply.

Interim CDC Recommendations for Providers

In palivizumab-eligible children aged 8–19 months, suspend using nirsevimab for the 2023–2024 RSV season. These children should receive palivizumab per 

Continue offering nirsevimab to American Indian and Alaska Native children aged 8–19 months who are not palivizumab-eligible and who live in remote regions, where transporting children with severe RSV for escalation of medical care may be challenging, or in communities with known high rates of severe RSV among older infants and toddlers.

 for palivizumab-eligible infants aged <8 months when the appropriate dose of nirsevimab is not available.

Avoid using two 50mg doses for infants weighing ≥5 kilograms (≥11 pounds), because 50mg doses should be reserved only for infants weighing <5 kilograms (<11 pounds), for example those born during the season who will be at increased risk for severe RSV illness because of their young age. Furthermore, providers should be aware that some insurers may not cover the cost of two 50mg doses for an individual infant.

Providers should encourage pregnant people to receive RSVpreF vaccine (Abrysvo, Pfizer) during 32 weeks’ gestation through 36 weeks and 6 days’ gestation to prevent RSV-associated lower respiratory tract disease in infants. Only the Pfizer RSVpreF vaccine (Abrysvo) is approved and recommended for use in pregnant people. The GSK RSVpreF3 vaccine (Arexvy) should 

Either RSVpreF vaccination or nirsevimab immunization for infants is recommended to prevent RSV-associated lower respiratory tract disease in infants, but 

Additional Information for Healthcare Providers:

Limited availability of Nirsevimab throughout the United States

This message is from LDH regarding the recent 

authorization by the US Food and Drug Administration (FDA) for the use of the updated Novavax COVID-19 vaccine to target newer variants of the COVID-19 virus. 

Any questions or comments regarding this information should be sent to the LDH Office of Public Health.

The U.S. Food and Drug Administration (FDA) has issued an Emergency Use Authorization (EUA) for the use of Novavax COVID-19 Vaccine, Adjuvanted (2023-2024 Formula). This vaccine is for active immunization to prevent coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in individuals 12 years of age and older.

The Centers for Disease Control and Prevention (CDC) included the updated Novavax vaccine in the same recommendation it issued last month for updated COVID-19 vaccines from Pfizer and Moderna. This newly updated Novavax COVID-19 vaccine provides patients the choice of a protein-based non-mRNA vaccine and is expected to become available soon.  T his Novavax COVID-19 vaccine, a monovalent vaccine, has been updated to include the spike protein from the SARS-CoV-2 Omicron variant lineage XBB.1.5 (2023-2024 formula). The vaccine is authorized for use in individuals 12 years of age and older as follows:

Dosage and Administration of Novavax COVID-19 Vaccine, Adjuvanted (2023-2024 Formula)

Individuals 12 Years of Age and Older Previously Vaccinated with Any COVID-19 Vaccine:

The updated Novavax COVID-19 Vaccine is administered intramuscularly as a single 0.5 

mL dose at least 2 months after receipt of the last previous dose of COVID-19 vaccine.

Individuals 12 Years of Age and Older Not Previously Vaccinated with Any COVID-19 Vaccine:

The updated Novavax COVID-19 Vaccine is administered intramuscularly as a series of two doses (0.5 mL each) 3 weeks apart.

Individuals 12 Years of Age and Older with Certain Kinds of Immunocompromise:

For individuals with certain kinds of immunocompromise (have undergone solid organ transplantation or who are diagnosed with conditions that are considered to have an equivalent level of immunocompromise), an additional 0.5 mL dose may be administered    intramuscularly at least 2 months following the last dose of a COVID-19 vaccine (2023-2024 Formula). Additional doses may be administered intramuscularly as a 0.5 mL dose at the discretion of the healthcare provider, taking into consideration the individual’s clinical circumstances.

The original Novavax COVID-19 Vaccine, Adjuvanted is no longer authorized for use in the United States and should not be administered. Providers with existing stock should dispose of the vaccine in accordance with local regulations and processes currently in place to dispose of regulated medical waste. Disposed vaccines must be recorded as wasted doses in LINKS if ordered through the Louisiana COVID-19 Vaccine Program.

Commercialization and Patient Access to Novavax COVID-19 Vaccine

Despite the recent commercialization of updated COVID-19 vaccines, most Louisiana residents can still receive a COVID-19 vaccine for free. Most health insurance plans cover COVID-19 vaccine at no cost. Individuals with insurance can identify vaccination sites, including many retail pharmacies, which offer updated COVID-19 vaccines by visiting 

As part of the federal Bridge Access Program, select providers offer free COVID-19 vaccines to individuals without health insurance or with health plans that do not cover the vaccine. Many retail pharmacies throughout the state, including national Bridge Access Program partners CVS and Walgreens, offer free updated COVID-19 vaccinations to uninsured and underinsured adults. Eligible individuals can visit 

. After entering your zip code and selecting vaccine option, see “Participating in Bridge Access Program.”

Children eligible for the Vaccines for Children (VFC) program may also receive the vaccine at no cost from a provider enrolled in the VFC program. VFC sites offering the updated COVID-19 vaccines can also be identified by visiting 

Do not administer the Novavax COVID-19 Vaccine, Adjuvanted to individuals with a known history of severe allergic reaction (e.g., anaphylaxis) to any component of the Novavax COVID-19 Vaccine, Adjuvanted or to individuals who have had a severe allergic reaction (e.g., anaphylaxis) following a previous dose of a Novavax COVID-19 Vaccine, Adjuvanted.

CDC interim clinical guidance is expected to be updated to include the Novavax, Adjuvanted (2023-2024 formula) and can be accessed by visiting 

https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html

LDH reminds providers to report possible vaccine-related adverse events to the FDA/CDC Vaccine Adverse Event Reporting System (VAERS) at 

Any possible severe adverse events (those resulting in hospitalization, death, or persistent disability) should be immediately reported to the LDH Office Public Health (OPH) Infectious Disease/Epidemiology Hotline at 1-800-256-2748.

FDA Authorizes Updated Novavax COVID-19 Vaccine

This message is from the Louisiana Department of Health Emergency Operations Center (LDH EOC)  regarding 

Severe Vibrio vulnificus Infections in the United States Associated with Warming Coastal Waters Notice from the CDC, modified to include Louisiana-specific information.

The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to:

are bacteria that cause an estimated 80,000 illnesses each year in the United States. About a dozen species of 

 causes the most infections in the United States, accounting for about 40% of reported cases of vibriosis, followed by 

 , which accounts for about 20%. Most people with 

 infection have diarrhea. Some people might also have stomach cramping, nausea, vomiting, fever, and chills. One species,

 , is known to cause life-threatening infections. About 150–200 

 infections are reported to CDC each year and about one in five people with this infection die—sometimes within 1–2 days of becoming ill.

naturally live in coastal waters, including salt water and brackish water, which is a mixture of salt water and fresh water. Most people get infected with 

 by eating raw or undercooked shellfish, particularly oysters. Some people get infected when an open wound is exposed to salt water or brackish water containing 

[1]. People can also get infected if an open wound comes in contact with raw or undercooked seafood. Open wounds include those from a recent surgery, piercing, tattoo, and other cuts or scrapes—including those acquired during aquatic activity. Extreme weather events, such as coastal floods, hurricanes, and storm surges, can force coastal waters into inland areas, putting people that are exposed to these waters—especially evacuees who are older or have underlying health conditions—at increased risk for 

wound infections. This effect was observed in Florida after Hurricane Ian in 2022 [2].

 is primarily transmitted through open-wound contact with salt water or brackish water, but occasionally (in approximately 10% of cases) the bacteria also can infect people if they eat raw or undercooked shellfish. Person-to-person transmission has not been reported. People at higher risk for wound infection include those with underlying health conditions such as liver disease, diabetes, and immunocompromising conditions [3]. 

wound infections have a short incubation period and are characterized by necrotizing skin and soft tissue infection

 , with or without hemorrhagic bullae. Many people with 

 wound infection require intensive care or surgical tissue removal.

bacteria thrive in warmer waters—especially during the summer months (May to October) and in low-salt marine environments like estuaries

infections have been most commonly reported by Gulf Coast states. However, 

 infections in the Eastern United States increased eightfold from 1988–2018, and the northern geographic range of infections has increased 48 km per year [4]. During July–August 2023, the United States has experienced above-average coastal sea surface temperatures and widespread heat waves [5]. During the same period, several East Coast states, including 

 infections. Many of these infections were acquired after an open wound was exposed to coastal waters in those states. Some of these infections were associated with consumption of raw or undercooked seafood or had unclear etiology.

At this time, Louisiana has not seen an increase in reported cases of 

 have been reported year-to-date during 2023 in Louisiana. An average of 13 cases were reported each year during the previous 5 years.

Amid increasing water temperatures and extreme weather events (e.g., heat waves, flooding, and severe storms) associated with climate change [6], 

 infection should exercise caution when engaging in coastal water activities 

Prompt treatment is crucial to reduce mortality from severe 

Recommendations for Healthcare Professionals

This guidance pertains to managing severe 

Taking the following steps can help keep you safe:

Learn more about how you can help protect yourself from 

The Centers for Disease Control and Prevention (CDC) protects people's health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national, and international organizations.

Severe Vibrio vulnificus Infections in the United States Associated with Warming Coastal Waters

New Orleans, LA 8/30/2023 – Today, Louisiana State Board of Medical Examiners announced it has been recognized as a Wellbeing First Champion for 2023 by ALL IN: Wellbeing First for Healthcare. As a Wellbeing First Champion, LSBME has verified that licensure/renewal applications are free from intrusive and stigmatizing language around mental health care and treatment. This means that health workers at LSBME can seek the needed care without fear of losing their license.

WellBeing First for Healthcare Champion

This message is from the Office of Public Health Immunization Program regarding Heat Poisoning.  Contact OPH with any comments or concerns. 

Heat poisoning, also known as heat-related illness or heat exhaustion, is a serious condition that occurs when the body overheats due to prolonged exposure to high temperatures. This can happen when the body's ability to regulate its internal temperature is compromised. Click 

 for the full OPH Immunization Update Issue 121.

What is heat poisoning?

What is heat poisoning

recommendations on the use of respiratory syncytial virus (RSV) monoclonal antibodies to protect infants from illnesses caused by RSV. 

Advisory Committee on Immunization Practices (ACIP), the Centers for Disease Control and Prevention (CDC)

 is recommending the use of a new immunization, nirsevimab, to help protect all infants under 8 months and some older babies from severe illnesses caused by RSV.

Nirsevimab, trade name BeyfortusTM, is a long-acting monoclonal antibody product, which has been shown to reduce the risk of both hospitalizations and healthcare visits for RSV in infants by about 80 percent.

Nirsevimab, which was approved last month by the U.S. Food and Drug Administration (FDA), is administered as an injection and provides infants and toddlers with antibodies to protect against severe RSV illness. It provides critical protection during a baby’s first RSV season, when they’re most at risk for severe illness.

RSV is one of the most common causes of childhood respiratory illness and results in annual outbreaks of respiratory illnesses in all age groups. It is the leading cause of hospitalizations for infants and older babies.

According to CDC, nirsevimab is expected to be available this fall for RSV season. There are many factors affecting the implementation rollout of this new medication that are currently being addressed at the national level, before it begins arriving to local hospitals and doctors’ offices. Once implementation hurdles are cleared, AstraZeneca and Sanofi have indicated they are prepared to meet public demand and make nirsevimab available to providers.

Expectant parents and parents of infants under the age of 8 months, as well as those with older babies, should talk with their healthcare providers to request this added layer of protection against RSV this season and inquire when they expect have supply on hand.

optimal timing for nirsevimab administration is shortly before the season

 , nirsevimab may be given at any time during the RSV season for age-eligible infants and children who have not yet received a dose.

Nirsevimab should be administered within one week of birth

. Administration can be during the birth hospitalization or in the outpatient setting. Infants with prolonged birth hospitalizations due to prematurity or other causes should receive nirsevimab shortly before or promptly after discharge.

In most regions of the United States and other areas with similar climates, RSV season typically starts during the fall and peaks in the winter. Tropical climates may have seasonality that differs from most of the continental United States or is unpredictable. Providers in these jurisdictions should consult state, local or territorial guidance on timing of nirsevimab administration. Within Louisiana, reports of RSV and other viral respiratory disease activity can be found 

children who have received nirsevimab should not receive palivizumab for the same RSV season

Coadministration with routine childhood vaccines

Children aged 8–19 months who should receive nirsevimab when entering their second RSV season because of increased risk of severe disease, include:

ACIP voted to include nirsevimab in the Vaccines for Children program, which provides recommended vaccines and immunizations at no cost to about half of the nation’s children.

CDC is currently working to make nirsevimab available through the Vaccines for Children program. Healthcare providers will be a key partner in CDC’s outreach efforts. Additional clinical guidance and healthcare provider education material will be provided by CDC in the coming months.

CDC recommends the use of a new monoclonal antibody to protect infants and children from Respiratory Syncytial Virus

Any questions or objections regarding the below should be addressed to the office of public health within LDH.

This message is from the Louisiana Health Alert Network (LA HAN) regarding - 

CDC makes recommendations on the use of Respiratory Syncytial Virus vaccines in older adults. 

Following a review by their Advisory Committee on Immunization Practices (ACIP), the Centers for Disease Control and Prevention (CDC)

is recommending the use of a single dose of recently approved vaccines by GSK and Pfizer for respiratory syncytial virus (RSV).

The vaccines have been shown to prevent RSV lower respiratory tract disease (LRTD) for use in adults aged ≥60 years. For both the GSK and Pfizer vaccines, a single RSV dose demonstrated efficacy in preventing symptomatic RSV-associated LRTD among adults aged ≥60 years. CDC actions follow an earlier approval of these vaccines by the U.S. Food and Drug Administration (FDA).

This HAN provides clinical guidance for the use of RSV vaccines in adults aged ≥60 years. 

RSV vaccines have demonstrated efficacy in preventing RSV-associated lower respiratory tract disease and have the potential to prevent substantial morbidity and mortality among older adults.

In the U.S., RSV causes seasonal epidemics of respiratory illness. Each season, RSV causes substantial morbidity and mortality in older adults, including lower respiratory tract disease (LRTD), hospitalization, and death. Most adult RSV disease cases occur among older adults with an estimated 60,000 – 160,000 hospitalizations and 6,000–10,000 deaths annually among adults aged ≥65 years.

CDC recommends that adults 60 and older may receive an RSV vaccine, using shared clinical decision-making.

Unlike routine and risk-based vaccine recommendations, recommendations based on shared clinical decision-making do not target all persons in a particular age group or an identifiable risk group. The decision to vaccinate a patient should be based on a discussion between the health care provider and the patient, guided by the patient’s risk for disease and their characteristics, values and preferences, the provider’s clinical discretion and the characteristics of the vaccine.

Providers and patients should consider the patient’s risk for severe RSV-associated disease. Epidemiologic evidence indicates that persons aged ≥60 years who are at highest risk for severe RSV disease and who might be most likely to benefit from vaccination include:

• Patients with chronic medical conditions such as lung diseases, including chronic obstructive pulmonary disease and asthma.

• Patients with cardiovascular diseases such as congestive heart failure and coronary artery disease.

• Those with moderate or severe immune compromise (either attributable to a medical condition or receipt of immunosuppressive medications or treatment).

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