Infectious Disease

Though healthcare providers are very familiar with the meningococcal serotypes A, C, W, Y (MenACWY) vaccine, many healthcare providers are unaware of a recently developed vaccine for meningococcal serotype B disease (MenB). To add to the confusion, the United States Advisory Committee on Immunization Practices (ACIP) designates Category A & Category B recommendations for use of MenB vaccines based on assessment of individual risk and provider-patient clinical decision making. Contrary, ACIP designates MenACWY vaccine as a Category A recommendation for all in the appropriate age group. Because many adolescents and young adults are vaccinated against meningococcal A, C, W, Y serotypes, the United States is seeing a rise in serotype B disease – especially on college campuses. This CE activity reviews the definitions of Category A & B recommendations, which individuals should receive MenB vaccine, and strategies to overcome provider and patient barriers to receiving this important vaccination.

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Despite guidelines from the Centers for Disease Control and Prevention and the United States Preventive Services Task Force that advocate for universal opt-out HIV testing of adolescents and adults, recent evidence suggests that these recommendations are not routinely followed in clinical practice. Indeed, an estimated 13 percent of the 1.2 million individuals living with HIV in the United States are undiagnosed and, therefore, unable to receive the care and education they need to reduce the risk of transmission and HIV-related morbidity and mortality. In addition, 34 percent of patients with HIV are not engaged in HIV medical care following diagnosis. Screening for HIV and linking newly diagnosed individuals into HIV medical care are relevant challenges for primary care providers, who face increasing demands due to a growing patient population and shortage of HIV specialists.

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Immunizations have been listed as one of the greatest public health achievements of the 20th Century. Immunizations are one of the greatest preventive measures that Nurse Practitioners can incorporate to prevent diseases in individuals at all ages. Navigating the immunization schedule and updates can seem daunting. This presentation provides the most up-to-date information on current immunization recommendations for all ages, provides information on travel vaccines and discusses new vaccines on the horizon. In addition, strategies are shared for communicating with vaccine hesitant individuals and tips for improving and incorporating immunization services, regardless of your practice specialty.

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Mumps is a viral infectious disease that historically was a common childhood illness. The mumps vaccine, first licensed in 1967, has successfully decreased the number of cases to the point that mumps is no longer a frequently encountered disease. Prior to the mumps vaccine program, approximately 186,000 cases of mumps were reported each year in the United Stated (US). Even with the sporadic clusters of re-emergence, there has been a 99% decrease in the number of reported cases since the inception of the vaccination program. As of July 15, 2017, there have been 3,886 cases of mumps reported this year in 45 states, making it a clinically relevant, though not prevalent, illness. Although not a new illness, many healthcare providers may not have diagnosed or treated patients diagnosed with mumps. Here, we provide vital information to nurse practitioners, so they may adequately diagnose and treat mumps as well as remain vigilant in their surveillance of such an old virus that continues to infect individuals today.

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Pre-exposure prophylaxis (PrEP) is an effective tool for preventing HIV infection making primary care the ideal setting for use and management. This presentation provides information about PrEP including basic pharmacology; safety and efficacy; why it should be used in primary care as a method of HIV prevention; how to safely prescribe to patients as well as the recommended evaluation and follow-up for patients to receive PrEP.

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The Centers for Disease Control and Prevention (CDC) estimates that there were 37,600 new HIV infections in 2014. Pre-exposure prophylaxis (PrEP) is a highly effective tool for the prevention of new HIV infections that was approved by the FDA in 2012. PrEP is largely underutilized by primary care providers. This clinical feature addresses provider barriers that impede prescribing PrEP to high-risk patients and provides a straightforward approach for nurse practitioners to offer PrEP in the primary care setting.

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