Marin County public health officials have quarantined two senior residential care centers and a preschool because of an outbreak of a flu-like illness.

The suspected culprit is norovirus, a gastrointestinal illness that causes nausea, vomiting, diarrhea and stomach cramps. Most people who are infected recover in two to three days without hospitalization and with no long-term health effects. But deaths have occurred in some cases. The greatest risk is dehydration because of vomiting and diarrhea in the very young and elderly.

So far, 36 people, including patients and staff members, have fallen ill at Aegis Living of San Rafael at 111 Merrydale Road, which has 70 beds, said Shanna Cronan, a nurse speaking on behalf of the Marin County Division of Public Health Services. At Aegis Living in Corte Madera at 5555 Paradise Drive, 37 people have become sick, Cronan said. The quarantine at the San Rafael center might be lifted Tuesday.

Cronan said Public Health Services didn’t learn of the outbreak at the preschool until Monday, even though it began on Jan. 13. So far, 16 children and adults have become ill at the preschool, which she declined to identify.

She said not enough test samples have been collected yet to determine the cause of any of the outbreaks. Norovirus is suspected, however, based on the symptoms being displayed.

The outbreak at the San Rafael facility began Jan. 14, and the first illness at the Corte Madera facility occurred on Thursday, Cronan said. Both are owned by Aegis Senior Communities, a limited liability corporation.

Cronan said Aegis waited until Friday to notify Public Health Services of both outbreaks. She said notification should have occurred sooner because facilities are required to contact the county within 48 hours once they have two or more “cases with acute onset of vomiting or diarrhea, or one lab-confirmed case.”

A Novato resident who has a family member living at Aegis Living of San Rafael said the management there never notified her of the outbreak. The woman, who asked that she not be identified, said she learned of the quarantine only when the family member phoned her.

Mary Crowe, the executive director of Aegis Living of San Rafael, said relatives of the people living at the San Rafael center were notified of the outbreak on Friday.

“We are taking preventative measures, which means we are asking people not to visit. It’s very standard,” Crowe said. “We haven’t had any new cases in 24 hours so I think we’re pretty clear.”

Crowe said the two Aegis facilities do share some employees. “There are a couple that work part-time that go back and forth,” she said. Diane Savard, the administrator of Aegis Living in Corte Madera, was unavailable for comment.

Rebecca Ng, chief of Marin County’s Division of Environmental Health Services, said she first learned of the three new outbreaks when she was contacted by the Independent Journal on Monday. Ng said normally her department is notified immediately when gastrointestinal illnesses occur so the facilities’ kitchens can be inspected for possible sources of contamination. But Marin County’s public health officer, Dr. Jason Eberhart-Phillips, said he personally sent Ng an email on Friday informing her of the outbreaks at the Aegis facilities.

Environmental Health Services was not notified in November when a norovirus outbreak at Country Villa Novato Healthcare Center in Novato resulted in at least 80 residents and staff members becoming ill. Cronan said the norovirus outbreak at Country Villa was one of three at Marin County nursing homes that month; each resulted in a county-mandated quarantine. But Cronan would not identify where the other outbreaks occurred.

Eberhart-Phillips said that if the county were to make public the names of facilities where outbreaks occur, managers there would be less likely to notify the county. Officials, however, have confirmed the sites of local outbreaks when specifically asked about them by the Independent Journal.

Pat McGinnis, executive director of California Advocates for Nursing Home Reform, a statewide nonprofit advocacy organization, said the county’s refusal to identify the locations of all outbreaks “is very unusual. It’s a county public health department. It’s supposed to be public information.”

Contact Richard Halstead via e-mail at

Acute prostatitis is a bacterial infection that affects the prostate gland. This is a medical emergency. it is different from the other forms of prostatitis. Some of the signs and symptoms of this disease includes chills, fever, urinary frequency, painful urination, frequency of urination at night and pain in the groin area. This infection is easy to diagnose because of its infection. the micro organism may be found in the urine and blood. Comon bacteria that cause this infection are Pseudomonas, Enterobacter, Escherichia coli and Staphylococcus aureus. if this bacterial infection is untreated it may lead one to hospitalization. the patient will be treated with intravenous antibiotics. the physician may recommend for complete blood count where the platelet levels are evaluated. one with bacterial infection will have elevated levels of white blood cells.

Sepsis due to prostatitis is very rare. it may occur in some immunocompromised patients. High fever and malaise indicate the need for a blood culture. Blood culture proves to be positive for those with sepsis. it is not advisable to do a proastate massage who is suffering from bacterial prostatitis since it may lead to sepsis. Since the bacteria can be found in the urine and blood, massage is not required to diagnose the infection. the physician might perform a rectal examination. On examination of the rectum, the physician might find enlarged, exquisitely tender, swollen prostate gland. the prostate gland might be firm, warm and uneven to on palpation.Increased level of PSA has been associated with acute prostatitis. the PSA level goes down as the acute prostatitis gets cured. Antibiotics are usually given to treat the infections in prostate gland. Acute prostatitis gets resolved in a short period of time. Using antibiotics for the appropriate bacterial infection can help o destroy the bacteria and reduce the infection in short period of time. Antibiotics such as Ciproflaxacin helps to fight the bacteria that causes infection. Patients who are severely ill require hospitalization while the Nero toxic patients are treated with bed rest, analgesics, stool softeners and hydration.

DECATUR – Earlier this month, the Macon County Health Departmentreported an increase in pertussis, commonly known as whoopingcough. According to a recent news release, threelaboratory-confirmed cases and two probable cases were identifiedin early December, a trend that holds true in Illinois and otherstates.

As of the beginning of December, 813 cases of pertussis had beenreported in Illinois for 2010 – 165 more than were seen in all of2009. According to the release, California has reported 10 infantdeaths from pertussis this year.

Pertussis is especially dangerous to infants, who cannot bevaccinated. They experience more serious illness and are morelikely to require hospitalization or have serious complications,the release said.

The illness, which begins with a cough and symptoms similar tothose of a cold, can occur between five and 21 days after exposure.According to the health department, after initially appearing, thesymptoms worsen over a period of weeks and can cause coughingspasms and the characteristic “whoop” of breathing inafterwards.

“Some adolescents and adults may demonstrate a milder form ofthe illness, so mild they don’t even know they are sick,” therelease stated.

The health department’s communicable disease department isimplementing a variety of strategies designed to reduce the spreadof the disease. One initiative involves educating medical providersabout the importance of recognizing pertussis symptoms early andfollowing up with proper tests, treatments and reporting.

Advising those who have been in close contact with reportedpertussis cases and reminding those with symptoms to stay home andaway from those at risk of complications are among the otherelements of the department’s effort.

The health department also advises that parents and caregiversof infants and those who have never received a tetanus, diphtheriaand pertussis (Tdap) vaccination do so to help protect those athigh risk of complications and themselves.

The Macon County Health Department will provide the Tdap vaccineat no charge for adult caregivers and parents of WIC infantsthrough Dec. 29. the vaccine also is available at many area medicalproviders’ offices or at the health department from 1 to 3:30 p.m.Wednesdays for $53, according to the release.

For more information, call 423-6988 or visitmaconcountyhealth.org.

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Ottawa Public Health is confirming that a person who contracted the measles while travelling has spread the disease to four more people in the Ottawa area.

The city’s health authority said last month one person reported contracting the disease in early December after travelling internationally. it was the first reported case of the measles in the city since 2002.

While most people have been immunized from the measles, Ottawa Public Health has urged residents to ensure their immunization is up to date.

The disease spreads through coughing, sneezing or talking, Ottawa Public Health said. Symptoms include fever, cough and tiny white spots on the mouth, followed by a severe rash.

Dr. Vera Etches, Ottawa Public Health’s associate medical officer of health, said the rarity of the disease makes it more difficult to recognize.

“It often starts with feeling like a bad cold…then moving a couple days later into a rash that starts on the head and spreads downwards,” said Etches.

“It is something that did result in hospitalization for the first case that came into the country, and it is something that makes people feel very sick. sometimes there can be infection of the brain, so it is something we want to prevent,” she said.

Etches said anyone who was born after 1970 and has not had two doses of the measles vaccine after their first birthday are susceptible to the disease.

Pregnant women, people with compromised immune systems, and children under the age of one are most at risk from the disease. Ottawa Public Health is encouraging anyone who believes they may have come in contact with the disease to notify a physician.