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Rabies post-exposure prophylaxis (PEP), an expensive and time-consuming series of treatments, can often be avoided in situations where the animal is available for testing or observation. Rabies PEP is a medical urgency, not an emergency, and does not need to be started in most cases* after an exposure, allowing time to determine if PEP is necessary based on the animal’s rabies status. Rabies testing can only be performed on the brain tissue of deceased animals.

Many providers assume laboratory reporting of notifiable conditions is automatic and comprehensive, eliminating the need for reporting from provider offices. While that is true in many instances, it is important to be aware of reporting requirements. Public health uses notifiable conditions information to aid in investigations, detect outbreaks, and for surveillance purposes, among other things.

Syphilis infections (Treponema pallidum) continue to be reported at a high rate, both nationally as well as in Spokane County. Unless a person is symptomatic with primary lesions present on exam, syphilis must be confirmed through serologic testing. Unfortunately, there is no singular diagnostic test available for syphilis. Instead, we rely on multiple serologic tests in combination to confirm a syphilis diagnosis. Historically, two testing algorithms have been used (see table below). SRHD recommends the reverse algorithm for screening and initial diagnosis of syphilis. This means the treponemal test (EIA, TPPA, or FTA) will be run initially, and if reactive, it will reflex to the non-treponemal RPR (rapid plasma reagin) with titer. If two of the three tests are reactive, it is likely a case of syphilis and a clinician should consider treatment. If a patient has a history of syphilis, an RPR titer is all that is needed because the treponemal tests will likely remain reactive for life.

The Washington State Public Health Lab (WA PHL) is a laboratory operated by the Washington State Department of Health in Shoreline, WA. In addition to standard newborn screening and testing for biohazardous materials, WA PHL offers testing for a wide variety of organisms of public health concern. Both public health practitioners and medical providers can order testing through WA PHL; however, specimens to be shipped to WA PHL by medical providers must first obtain approval from their local health department prior to shipping. Spokane Regional Health District (SRHD) Epidemiology staff can be reached at 509.324.1442 during normal business hours and 509.869.3133 after hours.

With the definitions of sensitivity and specificity often erroneously used interchangeably, it is easy to forget their true meaning. It is important to take into account a test’s sensitivity and specificity, as well as positive and negative predictive values, when making testing decisions and subsequent diagnoses.

Agencies placing emphasis on maternal smoking and continuing to lower rates.

Spokane County adult is first reported Eastern Washington flu death, second state death

Spokane Regional Opioid Task Force, NEWESD 101 offering Oct. 20, Oct. 27 public events

Successful HIV treatment with antiretroviral therapy prevents sexual transmission.

Flu is beginning to circulate, SRHD recommending individuals get their flu shots now.