{"id":10172,"date":"2025-03-01T14:02:59","date_gmt":"2025-03-01T19:02:59","guid":{"rendered":"https:\/\/www-test.dhss.delaware.gov\/dph\/dhan210\/"},"modified":"2025-03-02T00:49:19","modified_gmt":"2025-03-02T05:49:19","slug":"dhan210","status":"publish","type":"page","link":"https:\/\/www-test.dhss.delaware.gov\/dph\/php\/alerts\/dhan210\/","title":{"rendered":"php\/alerts\/dhan210 ~  Division of Public Health &#8211; &#8211; Health Alert  &#8211; Delaware Health and Social Services &#8211; State of Delaware"},"content":{"rendered":"<div data-swiftype-index=\"true\">\n\n\n\n  <br>\n\n\n\n  <div class=\"container\" id=\"main_header\"> \n\n    <!-- BEGIN readspeaker div -->\n\n    <div class=\"rs_skip rsbtn rs_preserve\" id=\"readspeaker_button1\">\n\n      <a accesskey=\"L\" class=\"rsbtn_play\" href=\"https:\/\/app-na.readspeaker.com\/cgi-bin\/rsent?customerid=7262&#038;lang=en_us&#038;readid=main_content&#038;url=https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan210.html\" title=\"Listen to this page using ReadSpeaker\">\n\n        <span class=\"rsbtn_left rsimg rspart\"><span class=\"rsbtn_text\"><span>Listen<\/span><\/span><\/span>\n\n        <span class=\"rsbtn_right rsimg rsplay rspart\"><\/span>\n\n      <\/a>\n\n    <\/div>\n\n    <!-- END readspeaker div -->\n\n\n\n    \n\n    <header class=\"pull-left\">\n\n      <h1>Delaware Health Alert Network #<!--[type=EDIT name=\"DHAN Number\"]-->210 <!--[END]--> <\/h1>\n\n      <h2> <!--[type=EDIT name=\"DHAN Date\"]-->November 20, 2009 10:10 am <!--[END]--> <\/h2>\n\n    <\/header>\n\n  <\/div><br>\n\n \n\n  <div class=\"container\">\n\n    <div class=\"row\">\n\n      <div class=\"col-md-3\" id=\"leftCol\">\n\n        <div class=\"panel-group\" id=\"accordion\">\n\n          <div class=\"panel sectionmenu_panel\">\n\n            <div class=\"panel-heading\">\n\n              <p class=\"panel-title\"><a class=\"agency_nav\" data-parent=\"#accordion\" data-toggle=\"collapse\" href=\"#collapseOne\"><strong><i class=\"fa fa-align-justify fa-fw\"><\/i> Public Health Menu<\/strong><\/a><\/p>\n\n            <\/div>\n\n\n\n            <div class=\"panel-collapse collapse in\" id=\"collapseOne\">\n\n              <div class=\"panel-body\" id=\"clf_nav\">\n\n                  <ul class=\"nav nav-stacked nav-pills-clf\" id=\"agency_sidebar\">\n    <li><a href=\"\/dph\/\"><h2>Home <i class=\"fa fa-home fa-fw\"><\/i><\/h2><\/a><\/li>\n    <li class=\"toplevel\"><a data-parent=\"#agency_sidebar\" data-toggle=\"collapse\" href=\"#HomeMenu\"><h2>About <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n      <ul class=\"panel-collapse collapse\" id=\"HomeMenu\">\n        <li><a href=\"\/dph\/about.html\">About DPH<\/a><\/li>\n        <li><a href=\"\/dph\/sections.html\">Sections &#038; Programs<\/a><\/li>\n        <li><a href=\"\/dph\/ofclocations.html\">Office Locations<\/a><\/li>\n        <li><a href=\"\/dph\/contact.html\">Contact Info<\/a><\/li>\n      \n        <li><a href=\"\/calendars.html\" target=\"_blank\">Calendar<\/a><\/li>\n      <\/ul>\n    <\/li>\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#ServicesMenu\"><h2>Services <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n      <ul class=\"panel-collapse collapse\" id=\"ServicesMenu\">\n        <li><a href=\"\/dph\/servicesaz.html\">A-Z Services<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/environmental.html\">Air &#038; Water Quality<\/a><\/li>\n        <li><a href=\"\/dph\/ss\/vitalstats.html\">Birth, Death, &#038; Marriage Records<\/a><\/li>\n        <li><a href=\"\/dph\/clinics.html\">Clinics<\/a><\/li>\n        <li><a href=\"\/dph\/healthdatastats.html\">Health Data &#038; Statistics<\/a><\/li>\n        <li><a href=\"\/dph\/php\/emsps.html\">Emergency Preparedness<\/a><\/li>\n        <li><a href=\"\/dph\/healthandwellness.html\">Health &#038; Wellness<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/healthyhomes.html\">Healthy Homes<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/healthywp.html\">Healthy Workplaces<\/a><\/li>\n        <li><a href=\"\/dph\/lab\/labs.html\">Laboratory<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/feir.html\">Restaurant Inspections<\/a><\/li>\n        <li><a href=\"\/dph\/screen.html\">Screening and Testing<\/a><\/li>\n        <li><a href=\"\/dph\/chca\/dphwichominf01.html\">WIC<\/a><\/li>\n        <li><a href=\"\/dph\/servicesadd.html\">Additional Services<\/a><\/li><li>\n      <\/li><\/ul>\n    <\/li>\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#InformationMenu\"><h2>Information <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n        <ul class=\"panel-collapse collapse\" id=\"InformationMenu\">\n        <li><a href=\"\/dph\/factsheetsaz.html\">A-Z Fact Sheets<\/a><\/li>\n        <li><a href=\"\/dph\/pubreportsaz.html\">A-Z Publications &#038; Reports<\/a><\/li>\n        <li><a href=\"\/dph\/diseasesandconditions.html\">Diseases &#038; Conditions<\/a><\/li>\n        <li><a href=\"\/dph\/faq.html\">FAQ&#8217;s<\/a><\/li>\n        <li><a href=\"\/dph\/php\/alerts.html\">Health Alerts<\/a><\/li>\n        <li><a href=\"\/dph\/healthylifestyles.html\">Healthy Lifestyles<\/a><\/li>\n        <li><a href=\"\/dph\/hipaa.html\">HIPAA<\/a><\/li>\n        <li><a href=\"\/dph\/regs.html\">Regulations<\/a><\/li>\n        <li><a href=\"\/dph\/forms.html\">Request Forms<\/a><\/li>\n        <li><a href=\"\/dph\/links.html\">Links &#038; Resources<\/a><\/li>\n        <li><a href=\"http:\/\/delaware.gov\/help\/foia_request.shtml\">FOIA Request Form<\/a><\/li>\n      <\/ul>\n    <\/li>\n    <li><a id=\"SocialMenuHeader\"><h2>Connect <i class=\"fa fa-thumbs-o-up fa-fw\"><\/i><\/h2><\/a>\n      <ul id=\"SocialMenu\">\n        <li class=\"facebook\"><a href=\"https:\/\/www.facebook.com\/DEPublicHealth\" target=\"_blank\" title=\"Division of Public Health Facebook Page\"><i class=\"fa fa-facebook-square fa-lg\"><\/i> Facebook<\/a><\/li>\n        <li class=\"twitter\"><a href=\"https:\/\/twitter.com\/Delaware_DHSS\" target=\"_blank\" title=\"Delaware Health and Social Services Twitter Account\"><i class=\"fa fa-twitter-square fa-lg\"><\/i> Twitter<\/a><\/li>\n        <!-- <li class=\"googleplus\"><a href=\"#\"><i class=\"fa fa-google-plus-square fa-lg\"><\/i> Google +<\/a><\/li>\n        <li class=\"flickr\"><a href=\"#\"><i class=\"fa fa-flickr fa-lg\"><\/i> Flickr<\/a><\/li>\n        <li class=\"youtube\"><a href=\"#\"><i class=\"fa fa-youtube-square fa-lg\"><\/i> Youtube<\/a><\/li>\n        <li class=\"instagram\"><a href=\"#\"><i class=\"fa fa-instagram fa-lg\"><\/i> Instagram<\/a><\/li>\n        <li class=\"linkedin\"><a href=\"#\"><i class=\"fa fa-linkedin-square fa-lg\"><\/i> Linkedin<\/a><\/li>\n        <li class=\"pinterest\"><a href=\"#\"><i class=\"fa fa-pinterest-square fa-lg\"><\/i> Pinterest<\/a><\/li> -->\n      <\/ul>\n    <\/li>\n  <\/ul>\n\n              <\/div>\n\n            <\/div>\n\n          <\/div>\n\n        <\/div><br>\n\n      <\/div>\n\n\n\n      <div class=\"col-md-9\" id=\"main_content\"> \n\n  \n\n<h2 class=\"center\">Health\n\n<!--[type=EDIT name=\"DHANType\"]-->\n\n\n\n   Advisory<!--[END]-->\n\n<br>\n\n<!--[type=EDIT name=\"DHAN Heading\"]-->\n\n\n\nPNEUMOCOCCAL VACCINATION RECOMMENDED TO HELP PREVENT SECONDARY INFECTIONS<!--[END]-->\n\n<\/h2>\n\n\n\n<!--[type=HTMLEDIT name=\"Content\"]-->\n\n\n\n<p>\n\n\n  The Delaware Division of Public Health is\u00a0forwarding this health alert from the Centers for Disease Control and Prevention. For more\n\n\n  information from the Division of Public Health, contact the immunization program at 1-800-282-8672.\n\n\n<\/p>\n\n\n<p>\n\n\n  <em><strong>Summary of Recommendations:<\/strong> CDC\u2019s Advisory Committee on Immunization Practices (ACIP) recommends a single dose\n\n\n  of pneumococcal polysaccharide vaccine (PPSV) for all people 65 years of age and older and for persons 2 through 64 years of age with\n\n\n  certain high-risk conditions. Among those with high-risk conditions for pneumococcal disease, most are also at high risk for severe\n\n\n  complications from influenza. <strong>Special emphasis should be placed on vaccinating adults under 65 years of age who have established\n\n\n  high-risk conditions for pneumococcal disease; PPSV coverage among this group is low and this group may be more likely to develop\n\n\n  secondary bacterial pneumonia after an influenza infection.<\/strong> All children younger than 5 years of age should continue to receive\n\n\n  pneumococcal conjugate vaccine (PCV7) according to existing recommendations.<\/em>\n\n\n<\/p>\n\n\n<h3>\n\n\n  Situation:\n\n\n<\/h3>\n\n\n<p>\n\n\n  <em>Streptococcus pneumoniae<\/em> (pneumococcus) remains a leading cause of vaccine-preventable illness and death in the United States.\n\n\n  Some of CDC&#8217;s Active Bacterial Core surveillance (ABCs) sites have seen greater than expected numbers of cases of invasive\n\n\n  pneumococcal disease coincident with increases in influenza-associated hospitalizations. A causal relationship between 2009 H1N1\n\n\n  influenza and this increase has not yet been established, but CDC is pursuing that question with state and local public health officials.\n\n\n<\/p>\n\n\n<p>\n\n\n  Influenza predisposes individuals to developing bacterial community-acquired pneumonia. During each of the influenza pandemics of the\n\n\n  20<sup>th<\/sup> century, secondary bacterial pneumonia was a frequent cause of illness and death and <em>S. pneumoniae<\/em> was reported\n\n\n  as the most common etiology. These findings also apply to seasonal influenza. Recently, pneumococcal infections have been identified as\n\n\n  an important complication in severe and fatal cases of 2009 H1N1 influenza virus infection. <strong>A key difference between this\n\n\n  pandemic and those of the past is that now we have two pneumococcal vaccines that may help to prevent these infections.<\/strong>\n\n\n<\/p>\n\n\n<h3>\n\n\n  Recommendations:\n\n\n<\/h3>\n\n\n<p>\n\n\n  During the 2009-2010 influenza season, pneumococcal vaccines can be useful in preventing secondary pneumococcal infections and reducing\n\n\n  illness and death among those infected with influenza viruses.\n\n\n<\/p>\n\n\n<p>\n\n\n  CDC\u2019s Advisory Committee on Immunization Practices (ACIP) recommends a single dose of pneumococcal polysaccharide vaccine (PPSV)\n\n\n  for all people 65 years of age and older and for persons 2 through 64 years of age with certain high-risk conditions. For those 19\n\n\n  through 64 years of age, these include: having asthma or smoking cigarettes. For those 2 through 64 years of age, high-risk conditions\n\n\n  include: chronic cardiovascular disease (congestive heart failure and cardiomyopathies), chronic pulmonary disease (including chronic\n\n\n  obstructive pulmonary disease and emphysema), diabetes mellitus, alcoholism, chronic liver disease (including cirrhosis), cerebrospinal\n\n\n  fluid leaks, cochlear implant, functional or anatomic asplenia including sickle cell disease and splenectomy, immunocompromising\n\n\n  conditions including HIV infection, leukemia, lymphoma, Hodgkin\u2019s disease, multiple myeloma, generalized malignancy, chronic renal\n\n\n  failure, nephrotic syndrome; those receiving immunosuppressive chemotherapy (including corticosteroids); and those who have received an\n\n\n  organ or bone marrow transplant, and residents of nursing homes or long-term care facilities.\n\n\n<\/p>\n\n\n<p>\n\n\n  Among those with high-risk conditions for pneumococcal disease, most are also at high risk for severe complications from influenza.A\n\n\n  single pneumococcal revaccination at least five years after initial vaccination is recommended for people 65 years and older who were\n\n\n  first vaccinated before age 65 years. A single pneumococcal revaccination also is recommended for people at highest risk of disease, such\n\n\n  as those who have functional and anatomical asplenia, and those who have HIV infection, AIDS or malignancy and have at least five years\n\n\n  elapsed from receipt of first vaccination.\n\n\n<\/p>\n\n\n<p>\n\n\n  All people who have existing indications for PPSV should continue to be vaccinated according to current ACIP recommendations during the\n\n\n  2009 H1N1 influenza pandemic. <strong>Special emphasis should be placed on vaccinating adults under 65 years of age who have established\n\n\n  high-risk conditions for pneumococcal disease; PPSV coverage among this group is low and this group may be more likely to develop\n\n\n  secondary bacterial pneumonia after an influenza infection.<\/strong> PPSV is available for ordering through the usual process; ordering\n\n\n  PPSV is not linked to placing orders for monovalent 2009 H1N1 influenza vaccine.\n\n\n<\/p>\n\n\n<p>\n\n\n  Use of PPSV among people without current indications for vaccination is not recommended at this time.\n\n\n<\/p>\n\n\n<p>\n\n\n  All children younger than 5 years of age should continue to receive pneumococcal conjugate vaccine (PCV7) according to existing\n\n\n  recommendations.\n\n\n<\/p>\n\n\n<p>\n\n\n  According to existing guidelines, the use of a commercially available urine antigen test (Binax NOW\u00ae) is recommended for the\n\n\n  diagnosis of pneumococcal pneumonia in adults. Such testing, along with blood cultures and testing for influenza infection, can assist\n\n\n  clinicians in determining whether secondary pneumococcal pneumonia is occurring.\n\n\n<\/p>\n\n\n<p>\n\n\n  CDC recommends a yearly seasonal influenza vaccine as the first and most important step in protecting against seasonal influenza. Annual\n\n\n  influenza vaccination is especially important for people at high risk of serious influenza complications, including young children,\n\n\n  pregnant women, older adults, and people with certain chronic health conditions such as asthma, diabetes, heart or lung disease, and\n\n\n  neurologic conditions [including disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy, epilepsy\n\n\n  (seizure disorders), stroke, intellectual disability (mental retardation), moderate to severe developmental delay, muscular dystrophy, or\n\n\n  spinal cord injury]. Seasonal influenza vaccine also is important for health care workers and other people who live with or care for high\n\n\n  risk people to prevent giving the influenza to those at high risk.\n\n\n<\/p>\n\n\n<p>\n\n\n  A new monovalent vaccine against 2009 H1N1 influenza is available and is our best option for prevention of 2009 H1N1 infection. People at\n\n\n  greatest risk for 2009 H1N1 infection or serious complications and recommended to receive the first available doses of vaccine include\n\n\n  children, young adults age 19-24, pregnant women, and people age 25-64 with chronic health conditions. Monovalent 2009 H1N1 influenza\n\n\n  vaccine is important for close contacts of infants younger than 6 months of age and health care and emergency medical services personnel.\n\n\n  While vaccine supply is currently less than demand, additional doses are becoming available daily and supply will increase through\n\n\n  November and December.\n\n\n<\/p>\n\n\n<p>\n\n\n  In communities where 2009 H1N1 is circulating, treatment with influenza antiviral agents is recommended for all hospitalized patients\n\n\n  with confirmed, probable or suspected 2009 H1N1 or seasonal influenza and for outpatients who are at higher risk for influenza-related\n\n\n  complications. Empiric treatment of patients hospitalized with community acquired pneumonia should include both influenza antiviral\n\n\n  agents and appropriate antibiotic therapy. For more information on treatment of influenza, see <a href=\"http:\/\/www.cdc.gov\/h1n1flu\/recommendations.htm\" title=\"http:\/\/www.cdc.gov\/h1n1flu\/recommendations.htm\">http:\/\/www.cdc.gov\/h1n1flu\/recommendations.htm<\/a>.\n\n\n<\/p>\n\n\n<h3>\n\n\n  For More Information:\n\n\n<\/h3>\n\n\n<ul>\n\n\n  <li>For Clinicians: Prevention Of Pneumococcal Infections Secondary To Seasonal And 2009 H1N1 Influenza Viruses Infection (<a href=\"http:\/\/www.cdc.gov\/h1n1flu\/vaccination\/provider\/provider_pneumococcal.htm\" title=\"http:\/\/www.cdc.gov\/h1n1flu\/vaccination\/provider\/provider_pneumococcal.htm\">http:\/\/www.cdc.gov\/h1n1flu\/vaccination\/provider\/provider_pneumococcal.htm<\/a>)\n\n\n  <\/li>\n\n\n  <li>Pneumococcal Vaccine Website (<a href=\"http:\/\/www.cdc.gov\/vaccines\/vpd-vac\/pneumo\/default.htm\" title=\"http:\/\/www.cdc.gov\/vaccines\/vpd-vac\/pneumo\/default.htm\">http:\/\/www.cdc.gov\/vaccines\/vpd-vac\/pneumo\/default.htm<\/a>)\n\n\n  <\/li>\n\n\n  <li>Interim guidance for use of 23-valent pneumococcal polysaccharide vaccine during novel influenza A (H1N1) outbreak (<a href=\"http:\/\/www.cdc.gov\/h1n1flu\/guidance\/ppsv_h1n1.htm\" title=\"http:\/\/www.cdc.gov\/h1n1flu\/guidance\/ppsv_h1n1.htm\">http:\/\/www.cdc.gov\/h1n1flu\/guidance\/ppsv_h1n1.htm<\/a>)\n\n\n  <\/li>\n\n\n  <li>Nov 10 Letter to Providers Promoting PPSV for Adults (<a href=\"http:\/\/www.cdc.gov\/h1n1flu\/vaccination\/provider\/lettertoprovider.htm\" title=\"http:\/\/www.cdc.gov\/h1n1flu\/vaccination\/provider\/lettertoprovider.htm\">http:\/\/www.cdc.gov\/h1n1flu\/vaccination\/provider\/lettertoprovider.htm<\/a>)\u00a0\n\n\n  <\/li>\n\n\n  <li>CDC&#8217;s Morbidity and Mortality Weekly Report (MMWR):<br>\n\n\n    Letter to Providers Promoting PPSV for AdultsPolysaccharide Vaccine (Bacterial Coinfections in Lung Tissue Specimens from Fatal Cases\n\n\n    of 2009 Pandemic Influenza A (H1N1) &#8212; United States, May&#8211;August 2009; September 29, 2009 \/ 58(Early Release);1-4 (<a href=\"\/wp-content\/uploads\/sites\/10\/dph\/pdf\/mm5838.pdf\">http:\/\/www.cdc.gov\/mmwr\/PDF\/wk\/mm5838.pdf<\/a>)\n\n\n  <\/li>\n\n\n  <li>Table: ACIP Recommendations for Use of Pneumococcal Polysaccharide Vaccine (<a class=\"anchors_link\" href=\"http:\/\/www.cdc.gov\/h1n1flu\/vaccination\/provider\/provider_pneumococcal.htm#table1\" title=\"http:\/\/www.cdc.gov\/h1n1flu\/vaccination\/provider\/provider_pneumococcal.htm#table1\">http:\/\/www.cdc.gov\/h1n1flu\/vaccination\/provider\/provider_pneumococcal.htm#table1<\/a>)\n\n\n  <\/li>\n\n\n  <li>Infectious Diseases Society of America\/American Thoracic Society Consensus Guidelines on the Management of Community-Acquired\n\n\n  Pneumonia in Adults (<a href=\"http:\/\/www.journals.uchicago.edu\/doi\/pdf\/10.1086\/511159\" title=\"http:\/\/www.journals.uchicago.edu\/doi\/pdf\/10.1086\/511159\">http:\/\/www.journals.uchicago.edu\/doi\/pdf\/10.1086\/511159<\/a>?)\n\n\n  <\/li>\n\n\n  <li>Preventing Seasonal Flu With Vaccination (<a href=\"http:\/\/www.cdc.gov\/flu\/protect\/vaccine\/index.htm\" title=\"http:\/\/www.cdc.gov\/flu\/protect\/vaccine\/index.htm\">http:\/\/www.cdc.gov\/flu\/protect\/vaccine\/index.htm<\/a>)\n\n\n  <\/li>\n\n\n  <li>General Information About 2009 H1N1 Vaccines (<a href=\"http:\/\/www.cdc.gov\/h1n1flu\/vaccination\/general.htm\" title=\"http:\/\/www.cdc.gov\/h1n1flu\/vaccination\/general.htm\">http:\/\/www.cdc.gov\/h1n1flu\/vaccination\/general.htm<\/a>)\n\n\n  <\/li>\n\n\n  <li>Updated Interim Recommendations for the Use of Antiviral Medications in the Treatment and Prevention of Influenza for the 2009-2010\n\n\n  Season (<a href=\"http:\/\/www.cdc.gov\/h1n1flu\/recommendations.htm\" title=\"http:\/\/www.cdc.gov\/h1n1flu\/recommendations.htm\">http:\/\/www.cdc.gov\/h1n1flu\/recommendations.htm<\/a>)\n\n\n  <\/li>\n\n\n  <li>Interim Recommendations for Clinical Use of Influenza Diagnostic Tests During the 2009-10 Influenza Season (<a href=\"http:\/\/www.cdc.gov\/h1n1flu\/guidance\/diagnostic_tests.htm\" title=\"http:\/\/www.cdc.gov\/h1n1flu\/guidance\/diagnostic_tests.htm\">http:\/\/www.cdc.gov\/h1n1flu\/guidance\/diagnostic_tests.htm<\/a>)\n\n\n  <\/li>\n\n\n  <li>Active Bacterial Core surveillance (<a href=\"http:\/\/www.cdc.gov\/abcs\" title=\"http:\/\/www.cdc.gov\/abcs\">http:\/\/www.cdc.gov\/abcs<\/a>)\n\n\n  <\/li>\n\n\n<\/ul>\n\n\n<p class=\"text-center\">\n\n\n  ****\n\n\n<\/p>\n\n\n<p>\n\n\n  You are receiving this email because you are a registered member of the Delaware Health Alert Network.\n\n\n<\/p>\n\n\n<p>\n\n\n  If you are not a member and would like to subscribe, please complete the form found online at:\u00a0 <a href=\"\/main\/mailforms\/dph_hanform.aspx\">http:\/\/dhss.delaware.gov\/main\/mailforms\/dph_hanform.aspx<\/a>.\n\n\n<\/p><br>\n\n\n<br>\n\n\n<p class=\"smalltext\"><a href=\"http:\/\/www.adobe.com\/products\/acrobat\/readstep2.html\"><img loading=\"lazy\" decoding=\"async\" alt=\"Download Adobe Acrobat Reader\" height=\"21\" src=\"\/wp-content\/uploads\/dhss\/img\/getacro60.gif\" width=\"60\"><\/a> Please note: Some of the files available on this page are in Adobe PDF format which requires Adobe Acrobat Reader.  A free copy of Adobe Acrobat Reader can be downloaded directly from <a href=\"http:\/\/www.adobe.com\/products\/acrobat\/readstep2.html\">Adobe <\/a>. If you are using an assistive technology unable to read Adobe PDF, please either view the corresponding text only version (if available) or visit Adobe&#8217;s <a href=\"http:\/\/access.adobe.com\">Accessibility Tools page<\/a>.<\/p>\n\n\n\n<!--[END]-->\n\n  \n\n        <div class=\"panel panel-danger\">\n\n          <div class=\"panel-heading\">    \n\n      <h2>Categories of Health Alert messages:<\/h2>\n\n       <\/div>\n\n       <div class=\"panel-body\">\n\n      <ul>\n\n        <li><strong>Health Alert:<\/strong> Conveys the highest level of importance; warrants immediate action or attention.<\/li>\n\n        <li><strong>Health Advisory:<\/strong> Provides important information for a specific incident or situation; may not require immediate action.<\/li>\n\n        <li><strong>Health Update:<\/strong> Provides updated information regarding an incident or situation; unlikely to require immediate action.<\/li>\n\n            <\/ul>\n\n         <div><strong>NOTE: This page is for informational purposes only and dated material (e.g. temporary websites) may not be available.<\/strong><\/div>\n\n          <\/div> \n\n        <\/div><br>  \n\n\n\n      <\/div>\n\n    <\/div>\n\n  <\/div><!-- \/container -->\n\n  <\/div>","protected":false},"excerpt":{"rendered":"<p>Listen Delaware Health Alert Network #210 November 20, 2009 10:10 am Public Health Menu Home About About DPH Sections &#038; Programs Office Locations Contact Info Calendar Services A-Z Services Air &#038; Water Quality Birth, Death, &#038; Marriage Records Clinics Health Data &#038; Statistics Emergency Preparedness Health &#038; Wellness Healthy Homes Healthy Workplaces Laboratory Restaurant Inspections [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":0,"parent":9294,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-10172","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/www-test.dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10172","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www-test.dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www-test.dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www-test.dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/www-test.dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/comments?post=10172"}],"version-history":[{"count":1,"href":"https:\/\/www-test.dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10172\/revisions"}],"predecessor-version":[{"id":11348,"href":"https:\/\/www-test.dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10172\/revisions\/11348"}],"up":[{"embeddable":true,"href":"https:\/\/www-test.dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/9294"}],"wp:attachment":[{"href":"https:\/\/www-test.dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/media?parent=10172"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}