As pediatricians in South Florida continue to care for children with confirmed cases of Congenital Zika Syndrome and those who were exposed to the Zika virus in utero, additional education is needed regarding the known effects of the Zika virus on infants and children as well as the recommended screenings to be performed as the child develops.
To effectively expand upon the work completed through this project over the past couple years, FCAAP will host a FREE one‐day accredited educational conference for pediatric healthcare providers. Sessions will be led by South Florida area experts with experience caring for Zika exposed and infected children. Topics will include:
Serology, PCR Testing, and Interpretation – Dr. Samita Andreansky
How to Screen for Zika‐Related Audiological Defects – Dr. Robert Fifer
How to Screen for Zika‐Related Neurodevelopmental Defects – Dr. Roberto Lopez-Alberola
Local Radiological Research Findings Related to Zika‐Infected Children – Dr. Gaurav Saigal
Local Nephrological Research Findings Related to Zika‐Infected Children – Dr. Chryso Katsoufis
Local Cardiological Research Findings Related to Zika‐Infected Children – Dr. Juanita Hunter
End Organ Damage Correlation to Zika Exposure – Dr. Ivan Gonzalez
CME, CEU, and MOC Part 2 credits will be available.
Registration is now open. See the full conference agenda here. For more information, please contact Cheval Breggins at firstname.lastname@example.org.
Limited Partner Packages are available! View the Partner Prospectus, visit the event website, or contact Alicia Adams at email@example.com for more information.
FCAAP’s Medicaid Access Committee has persuaded Florida Medicaid to publish the Enhanced Medicaid Fee Schedule (i.e, the Medicare Equivalent Rates) on the AHCA website and to keep the fee schedule regularly updated. This will allow physicians eligible for the enhanced payment rate for seeing Medicaid children to know exactly what the various Medicaid MMAs should be paying them.
The Enhanced Fee Schedule can be found on the AHCA website.
Scroll down to “MPIP Rates for Children’s Primary Care Codes.” Since the rates on the AHCA website only show those codes not listed on the Medicare Site (that is, those that must be calculated), you can see all the codes here.
A message from Andrea Morrison, Vector-Borne Disease Surveillance Coordinator, Florida Department of Health, Division of Disease Control and Health Protection, Bureau of Epidemiology:
As we continue to see increased dengue virus activity in the Americas, now is the time for providers to consider dengue. This is also the time of year most at-risk for introduction into Florida. Both PCR and antibody testing is available commercially and PCR testing is the only way to definitively diagnose acute dengue infections. Patients who have been previously exposed to another dengue serotype may show elevated IgG titers and have transient or no elevated dengue IgM titers, making identification of such cases difficult without PCR testing on the acute sample. It will be important to also follow up on possible cases with positive dengue IgG results to determine if an acute infection consistent with dengue fever was reported. Additionally, patients with suspected dengue fever also should be evaluated, tested, and managed for possible Zika or chikungunya virus infection if travel was to areas where these viruses are present, as co-infection is possible.
Refer to the following information sheets for more information.
FDA Continues to Receive Reports of E-cigarette Users Having Seizures, More Information Needed to Determine Possible Causes
Since initially alerting the public on April 3 to reports of some e-cigarette users experiencing seizures, FDA has since received 118 new reports of similar incidents. In total, including those posted in April, the agency has received 127 reports of neurological events following e-cigarette use that occurred between 2010 and 2019. This does not necessarily indicate an increase in frequency or prevalence of such incidents.
At this time, FDA has not been able to identify any specific brand of tobacco product, or identifiable product problem, associated with these incidents. However, the agency remains concerned about the possibility of an association between e-cigarette use and seizures or other similar medical conditions and encourages the public, including e-cigarette users and medical professionals, to provide as much information as possible when reporting health or safety problems stemming from tobacco products through the online Safety Reporting Portal (SRP).
Healthcare providers in particular are reminded to ask patients about e-cigarette (or “vape” use), particularly when providing care following a neurological event. Healthcare providers are also encouraged to help patients to report any adverse experiences from tobacco use through the Safety Reporting Portal, such as referring patients to the website, making relevant medical records available, or submitting a report on a patient’s behalf. FDA has posted the full reports [PDF – 23MB], redacted in accordance with applicable laws, as a reference for those reporting seizures or other neurological symptoms following e-cigarette use.
Details about adverse experiences are important in helping FDA to identify concerning trends and clear patterns or causes for particular incidents. When reporting an adverse experience, please be sure to include as much information as possible about:
- The affected person (whether a user or nonuser)
- The name of the manufacturer
- The brand name, model, and serial number of the device or e-liquid, if applicable
- Where the device or e-liquid was purchased
- If the device or e-liquid was modified in any way or if the device malfunctioned
- Any use or exposure to other tobacco products, medications, supplements, substances of abuse or toxins around the same time
- Any other symptoms or warning before the adverse experience, such as nausea, vomiting, change in the user’s behavior, alertness, vision or hearing
- Details about the pattern of product use or exposure before the adverse experience (duration, amount and intensity of e-cigarette use) as well as the time between the latest use and the adverse experience
- Details about health effects, including specific areas of the body affected, how symptoms progressed, how long they lasted, the course of the recovery, and the medical testing or care and decisions rendered
- If you had testing for levels of nicotine, cotinine or other byproduct in your blood or urine, include results and the time between the last product use and the body fluid collection
- Underlying health conditions and health history, especially any history of seizures earlier in life and any blood relatives with a history of seizures
- Whether product use continued or not after the event and whether additional events occurred
- Whether you reported the event elsewhere, such as to a poison control center, the retailer, or the manufacturer
Safety Reporting Portal users can upload relevant medical records, photos, or other files that include or supplement this information. Providing follow-up information weeks, months, or years later that are linked to the initial report and give final outcomes can also be useful.
Learn More Here.
Health Care Provider Information
Hepatitis A Public Health Emergency
Florida, like other parts of the United States, is experiencing a serious hepatitis A virus (HAV) outbreak. Since 2018, there have been more than 22,000 cases of HAV in the United States. In Florida, there have been more than 2500 cases since 2019 and more than 2,000 cases since January 2019. This outbreak has come at a personal cost to our residents, as 78% of individuals with HAV have been hospitalized and 31 individuals have died. In response, on August 1, 2019, with the support of Governor Ron DeSantis and Lieutenant Governor Jeanette Nuñez, Florida’s State Surgeon General declared a Public Health Emergency.
The key to controlling this outbreak is vaccinating individuals at highest risk for contracting HAV, which includes persons who use intravenous or non-intravenous drugs and the homeless population. In addition, individuals who are at risk for serious outcomes need to be vaccinated. The HAV vaccines are inactivated viruses and have an excellent safety profile. Two doses separated by six months are recommended; however, one dose is 93% effective. Information about HAV from the CDC is available HERE. Information specific to the Department of Health’s response and vaccination sites can be found HERE.
As a health care provider, please consider the following:
- If you are caring for individuals in the inpatient, outpatient, or emergency setting with intravenous or non-intravenous illicit drug use, who are homeless, or who are currently incarcerated, vaccinate them.
- If an individual is treated in an emergency room or other acute care setting after being administered an opioid antagonist, such as naloxone, vaccinate them prior to discharge
- Identify your patients with underlying liver disease and offer the HAV vaccine. If such individuals are hospitalized, consider vaccinating them prior to discharge.
- Individuals over 60-years-of-age with complex medical conditions, such as diabetes mellitus and cardiovascular disease, are at risk for serious complications or even death if they contract HAV. If you are in a critically impacted county as defined in the declaration, identify patients with serious medical conditions and offer the HAV vaccine. If such individuals are hospitalized, consider vaccinating them before discharge.
- Vaccinate men who have sex with men.
- Vaccinate individuals who work with persons with a history of drug abuse or homelessness in a non-health care setting.
- Hepatitis may present with non-specific flu-like and/or gastrointestinal symptoms. Health care providers are encouraged to screen for hepatitis A in patients with such symptoms by ordering liver function tests and transaminase levels (ALT/SGPT, AST/SGOT), in addition to hepatitis A serology. These tests should also be considered for individuals who present with jaundice, light-colored stools, or dark-colored urine.
- As always, use standard precautions when interacting with patients. Handwashing with soap and water by health care providers after contact with HAV-positive patients or high-risk populations is essential. Commonly used alcohol-based hand sanitizing products are NOT effective against HAV.
- All surfaces in restrooms and bathing areas should be disinfected at least once per day at your facilities. A standard ready-to-use 1 to 10 bleach solution applied to a surface for one minute is effective in destroying the virus on surfaces.
- Notify your county health department immediately when HAV infection is confirmed in your patients.
- Please contact the Department of Health at HepA@FLHealth.gov with questions and concerns.
Thank you for your commitment to public health in Florida.
2019 Election Results
Thank you to everyone who participated in the 2019 election for the FCAAP Board of Directors! Congratulations to the newly elected Board members who will be inducted to the Board on Saturday, August 31, 2019, during The Future of Pediatric Practice 2019 at Disney’s Yacht & Beach Club Resorts!
Region 1 Representative
Sarah Marsicek, MD, FAAP
Region 3 Representative
Juan Felipe Rico, MD, FAAP
Region 5 Representative
Robin Furlong Straus, MD, FAAP
Pediatric Subspecialist At Large Representative
Mark Hudak, MD, FAAP
Read the Summer 2019 Florida Pediatrician here! Featured articles include:
- Addressing Common Environmental Health Issues in Florida’s Children
- Assessing the Newborn Screening Status of Immigrant Children in Florida
- Putting Down the Phone: Evidence-Based Interventions to Prevent Distracted Driving in Teens
The Future of Pediatric Practice 2019 offers physicians 16.5 AMA PRA Category 1 Credit(s)™ and 16.5 MOC part 2 points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program. Nurses can earn up to 16.5 contact hours. Download the full accreditation statement here.
Register by July 1, 2019, for the best rate! Visit the conference website and register today!
Don’t forget to make your room reservation at Disney’s Yacht Club and purchase tickets to Walt Disney World’s theme parks after registering! Special room rates are available for conference attendees. Make your room reservation here. FPP2019 attendees may purchase specially priced tickets at the current rates until 4:00pm EST on Monday, July 15, 2019. After that date, new increased prices will go into effect. Purchase tickets here.
Rally with Gabby Giffords for Gun Violence Research in Orlando!
On Saturday, June 29th at 11am we’ll be at the rotunda in the Orlando Museum of Art for a rally to tell the Senate: Congress must fund gun violence research!
Why? It’s simple: The NRA has lobbied to keep gun violence research underfunded for the past 20 years. In fact, gun violence research is estimated to receive less than 2 percent of the funding it should based on the scope of the issue. We’re putting an end to that.
If we’re serious about making our country safer, we need to better understand the causes of gun violence. Funding federal research would vastly increase what is known about gun violence and support lifesaving policy reform.
The House allocated $50 million to study gun violence — the first dedicated funding in 20 years. We can’t let this vital funding be gutted by senators who care more about the gun lobby than public safety.
Will you join us June 29th? RSVP Here.
Please share this event on Facebook too!