Region 2 Public Health
Clallam County Health & Human Services
Expedited Partner Therapy
Region 2 Public Health and the Washington State Department of Health have initiated a program to help ensure the treatment of partners of people diagnosed with Gonorrhea and/or Chlamydia. The program includes the following elements:
►New partner treatment recommendations Persons with Gonorrhea or Chlamydia should be offered medications at the time of their diagnoses to give to their sex partners. ►Free medication for partner treatment Public Health is providing all clinicians in Region 2 access to free medications to give to patients for their sex partners. ►Referral of high risk patients Public Health asks that providers refer selected high-risk patients to local Public Health to receive assistance notifying partners. ►New case report forms Providers are asked to indicate on new case report forms how patient’s partners have been managed.
Beginning in 2006 the Washington State Department of Health (DOH) issued new guidelines for treating the sex partners of persons diagnosed with Gonorrhea or Chlamydia infection. As part of these guidelines, Public Health recommends that all patients be offered medications to give to their sex partners if the diagnosing clinician cannot otherwise be certain that partners will be evaluated and treated. This treatment method is called Expedited Partner Therapy(EPT). All persons the patient has had sexual contact with for a period of 60 days preceding their diagnosis will require treatment. Guidance issued by the DOH for the use of EPT is supported by the Washington State Medical Association and has been reviewed by the Washington State Board of Medical Quality Assurance along with the Washington State Pharmacy Board. In order to help you ensure that your patients’ sex partners are treated, the Department of Health and Region 2 Public Health are providing free medications for all partners who need treatment. Medications will be available at selected pharmacies. Attached is a list of local pharmacies stocking these medications or go to www.doh.wa.gov/cfh/std/ept.htm . Prescription forms for your use when faxing prescription requests to pharmacies are included with the case report form. To prescribe medication through one of these pharmacies, simply call or fax the prescription form to one of the listed pharmacies. When phoning in prescriptions, please let the pharmacy know that you would like to prescribe the “free Public Health partner management medications.”
Because some patients need help ensuring their partners’ treatment, Public Health staff would like to speak with patients that indicate any of the following risk factors:
1. All persons who report having more than one sex partner in the last sixty
2. Persons with a partner they do not think they will have sex with again. 3. Men who have sex with men.
If your patient indicates any of the above risk factors, please note on the case report form that you would like Public Health to assume responsibility for their partner’s treatment (option #1). This will be done with the utmost sensitivity and commitment to patient privacy. If a patient indicates that they will give medications to one partner but not to another, please provide them with medications or a prescription for the one partner they are able to help get treated. Please discard all old case report forms. Public Health is now using new case report forms. A sample form is included in this binder and can be identified by the Partner Management Plan (gray box) on the left side. Thank you for your ongoing commitment to treating and preventing sexually transmitted infections in our community. If you have any questions regarding the Partner Management Program please the contact below in your county: Clallam – Christina Hurst at (360) 417-2364 or Nancy Schiedermayer, CHN at (360) 417-3121 Jefferson – Carol Burwell, PHN at (360) 385-9446 or Denis Langlois, ARNP at (360) 385-9421 Kitsap – Beth Phipps, RN, BSN at (360) 307-4309
For more background information on the initiative to treat partners of people diagnosed with Gonorrhea and/or Chlamydia go to www.doh.wa.gov/cfh/std/Pub/DOHPDPTGuidlines2004.pdf Clallam County Participating Pharmacies Jefferson County Participating Pharmacies Kitsap County Participating Pharmacies FAX Page 1 To: Kitsap Public Health District 360 337-5241 (Confidential FAX Line) CONFIDENTIAL SEXUALLY TRANSMITTED DISEASE CASE REPORT
Kitsap Public Health District: STD Program
FROM PHONE #
Kitsap County health care providers and health care facilities should use this form to report Sexually Transmitted Disease (STD). Report STDs within three work days (see WAC 246-101-101/301). All information will be strictly managed confidentially. Your cooperation is both encouraged and appreciated.
PATIENT INFORMATION LAST NAME FIRST NAME MIDDLE INITIAL: TELEPHONE REASON FOR EXAM (Check one) CITY/TOWN STATE ZIP DATE OF DIAGNOSIS DATE OF BIRTH ETHNICITY RACE – Check all that apply GENDER OF SEX PARTNERS DIAGNOSIS – DISEASE GONORRHEA (lab confirmed) SYPHILIS DIAGNOSIS - only one SITE(S) - all that apply TREATMENT - all given/prescription(s)
Primary (Chancre, etc.) Secondary (Rash, etc.)
RX GIVEN: ________________ DATE TESTED: _________________
Other: _______________ *Quinolones not recommended as first choice for GC DATE RX: _________________
treatment; see treatment guidelines. DATE RX: ___________________________ CHLAMYDIA TRACHOMATIS (lab confirmed) HERPES SIMPLEX DIAGNOSIS - only one SITE(S) - all that apply TREATMENT - all given/prescription(s)
Genital (initial infection only) Neonatal
DATE TESTED: _________________
Other: _______________ DATE RX: ______________ DIAGNOSING CLINICIAN PERSON COMPLETING FORM FACILITY NAME TELEPHONE PARTNER MANAGEMENT PLAN( Select method of ensuring partner treatment) 1.
Kitsap Public Health District to assume responsibility for partner treatment. Health Department assistance only recommended if:
Patient has had 2 or more sex partners in the last 60 days, or
Patient does not think he/she will have sex again with sex partners from the last 60 days, or INSTRUCTIONS
Patient is unable or unwilling to contact one or more partner, or
Patient is a man who has sex with other men.
Provider will ensure all partners treated (FREE medications available). Indicate number to be treated (______).
All partners have been treated. Indicated number treated (______).
PRIVILEGED AND CONFIDENTIAL COMMUNICATIONS: The information contained in this message is privileged, confidential, or otherwise exempt from disclosure and is intended solely for the use of the individual(s) named above. If you are not the intended recipient, you are hereby advised that any dissemination, distribution, or copying of this communication is prohibited. If you have received this facsimile in error, please immediately notify the sender by telephone and destroy the original facsimile. (01/02/2009) PARTNER MANAGEMENT PLAN INSTRUCTIONS Gonorrhea or Chlamydial Infection: Partner Treatment All partners should be treated as if they are infected. If the provider takes responsibility to ensure partner treatment, the provider should examine and treat all patient’s sex partners from the previous 60 days.
If this is not possible, patients should be offered medication to give to as many of their sex partners as they are able to contact and/or should be referred to Kitsap County Health District for partner notification assistance. Free medication is available for your patient’s partner(s). To obtain FREE medication for your patient’s partner(s), call or fax a prescription to one of the pharmacies participating in your area.
For a prescription FAX form and list of participating pharmacies, call Kitsap Public Health District: 360 337-5235 Note: Only participating pharmacies have stocks of FREEPublic Health medication to dispense to patients for their partner(s).
Kitsap Public Health District may also provide free medication to your patient to give to his or her partner(s).
The Kitsap Public Health District recommends that you refer patients with any one or more of the following risks to the health department for help notifying their partners:
Patient with 2 or more sex partners in the last 60 days , or
Patient does not think he/she will have sex again with sex partners from the last 60 days, or
Patient is unable/unwilling to contact one or more partner(s), or
Patient is a man who has sex with other men
Although the Health Department requests that you refer patients with these risks to us, we also ask that you make every effort to help patients with these risks assure that their partners are treated, either by seeing the partners yourself or by offering patients free medication to give to their partners.
Complete the partner management plan on the Confidential Sexually Transmitted Disease Case Report FAX form to define a partner management plan.
For copies of this case report or questions on how to fill it out, call the Kitsap Public Health District: 360 337-5235. Other STDs: Partner Treatment
All patients with infectious syphilis, chancroid, LGV or granuloma inguinale are routinely contacted by Kitsap County Health District. Patients diagnosed with genital herpes should be advised to notify their sex partners and should be informed that their partners should contact their provider for testing.
RECOMMENDED REGIMENS FOR ANTIMICROBIALS LISTED ON CASE REPORTS* Gonorrhea (uncomplicated):
Ceftriaxone . 125-250 mg IM, single dose,
Alternatives: Azithromycin . 2g PO as a single dose (additional chlamydia therapy not needed) Health care providers should no longer use fluroquinolones (Levofloxacin or Ciprofloxacin) as first line therapy due to increased prevalence of quinolone-resistant Neisseria gonorrhoeae (QRNG). Plus, if Chlamydia infection is NOT ruled out Chlamydia Trachomatis (uncomplicated):
Erythromycin . (base 500 mg PO QID for 7 days, OR
(ethylsuccinate) 800 mg PO QID for 7 days, OR
Syphilis (primary, secondary or early latent < 1 year)
Benzathine penacillin G . 2.4 million units IM in a single dose
Syphilis (latent > 1 year, latent of unknown duration, tertiary [not neurosyphilis])
Benzathine penicillin G . 2.4 million units IM for 3 doses at 1 week intervals
*Refer to “STD Diagnostic and Treatment Guidelines” or CDC website: www.cdc/gov/std/treatment for further information on treating pregnant patients, infections of the pharynx, treatment of infants and other details.
C O L E G I O D E A R Q U I T E C T O S D E L A P R O V I N C I A D E S A N T A F E DIRECTORIO SUPERIOR PROVINCIAL - LEY Nº 10.653 ADHERIDO A LA FEDERACION ARGENTINA DE ENTIDADES DE ARQUITECTURA (FADEA) SEDE COLEGIO PROVINCIAL: Av. Belgrano 650 P.A. (C.P. 2000) ROSARIO Pcia. SANTA FE R. ARGENTINA Tel./Fax: (0341) 449-2389 / 480-3915 RESOLUCIÓN DSP – CAPSF Nº 059/94 ARANCEL de TR
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