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Black Maternal Health Week
Black Maternal Health Week, founded by the Black Mamas Matter Alliance, is observed Apr. 11-17 and honors the resilience of Black mothers while highlighting the need for everyone to have a fair and just opportunity for a healthy pregnancy. This year’s theme is, “Healing Legacies: Strengthening Black Maternal Health Through Collective Action and Advocacy.”
Clinicians play a vital role in improving maternal health and preventing pregnancy-related deaths. Despite advances in maternal care, Texas’ pregnancy-related mortality ratio for Black women was roughly twice the average for all races in 2019-2020, while ratios fell below average for non-Hispanic White women and Hispanic women. By age group, women ages 40 and older had a ratio 4.6 times greater than the average in 2019-2020. These findings mirror national 2023 data.
In Texas, over 80% of these deaths are preventable. Contributing factors for preventable deaths were distributed among the provider (31%), systems of care (27%), facility (17%), patient and family (14%) and community (11%) action levels.
For best practices and resources for improving maternal health, click here for a Provider Letter from Metro Health’s Medical Director and Local Health Authority, Junda Woo.
When providers actively listen and validate Black women’s concerns by repeating back statements and asking clarifying questions, this helps ensure that issues are addressed and reassures patients that they are being heard. Texas’ Maternal Mortality and Morbidity Review Committee encourages providers to engage patients’ identified support networks in their care plan.
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Child Abuse Prevention Month
April is National Child Abuse Prevention Month, and Metro Health is proud to take part in ChildSafe’s Cardboard Kids awareness campaign. Started in 2014, the campaign aims to spark discussions on how to prevent child abuse in our community, while reminding us that each child’s story is unique. Your team can participate by picking up one of the 2-foot cardboard figures, decorating it and displaying it in a highly visible area. Each figure represents one of the thousands of children that are abused and neglected each year.
Metro Health’s Triple P – Positive Parenting Program offers free courses in-person and online for parents who struggle to regulate emotions or who may be at risk of harming their children physically or emotionally. The program can be completed in a group or individually and offers new approaches to parenting and anger management.
Texas requires anyone with a "reasonable cause to believe" that a child is being abused or neglected to report it. Healthcare and other mandated professionals must report within 48 hours. This duty may not be delegated (Texas Family Code, Section 261.101). Reporting online is fastest, and oral reports no longer need to be followed with a written report. In an emergency, call 911 first, and then the 24/7 Texas Department of Family and Protective Services (DFPS) Abuse Hotline at 1-800-252-5400.
Additional resources:
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Cervical Precancers Plummet with HPV Vaccine
Since the inception of the HPV vaccine in the U.S. in 2006, vaccination rates have grown, with many vaccinated individuals now reaching screening age. Through the Human Papillomavirus Vaccine Impact Monitoring Project, CDC tracked precancerous cervical lesions to show that cervical precancer rates declined by 79% among screened women aged 20–24, and higher-grade precancers (CIN3+) fell by 80%. Among women aged 25–29, CIN3+ rates dropped by 37%. These declines highlight the vaccine’s effectiveness in preventing precancers and support CDC’s existing recommendations to vaccinate routinely for HPV at 11–12 years old (as early as 9), with catch-up through age 26. Read the MMWR here.
Read CDC’s HPV vaccination recommendations here, or sign up for a free HPV vaccination refresher with your Metro Health Clinician Ambassadors here. You can find resources from immunize.org on HPV vaccination here and from the American Academy of Pediatrics here. Metro Health pop-ups continue to offer FREE vaccines to uninsured and underinsured children.
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Texas Measles Outbreak
CDC issued a Health Alert Network (HAN) Health Advisory on the continued measles outbreak in Texas. DSHS updates its data twice a week here. Recommendations for clinicians:
- Consider measles in patients presenting with the following symptoms, particularly those who traveled abroad or had contact with known measles cases:
- Fever ≥101°F (38.3°C) AND
- Generalized maculopapular rash lasting ≥3 days AND rash begins at the hairline/scalp and progresses down the body
- Cough, runny nose, or conjunctivitis OR Koplik spots (bluish-white specks or a red-rose background appearing on the buccal and labial mucosa usually opposite the molars)
- Perform throat swabs (preferred) or nasopharyngeal or oral swabs. Confirmatory testing, including PCR and genotyping, is available through DSHS and recommended with highly suspected cases. Please contact Metro Health Epidemiology for guidance and authorization. View DSHS specimen collection and handling requirements here and here.
- Continue to promote MMR vaccination, which is 93%-97% effective. Children vaccinated outside of recommended intervals (DSHS table) will need re-vaccination at the recommended times to meet Texas Administrative Code rules for schools and kindergartens.
- MMR vaccine (within 72 hours of exposure) or immunoglobulin (within six days of exposure) can be administered as post-exposure prophylaxis—read more here.
Resources:
Measles is a reportable condition—notify Metro Health Epidemiology immediately about suspected, probable or confirmed cases at 210-207-8876 (24/7 line).
Influenza Composition Selected for 2025-2025 Season
After review of global and U.S. surveillance data, the FDA has selected virus strains for the upcoming 2025-2025 flu season. Just like last year, the FDA recommended a trivalent vaccine (two influenza A subtype viruses and one influenza type B virus), after meeting with experts at CDC and Department of Defense. Read the FDA article here.
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2024-25 COVID Vaccine Moderately Effective
Interim vaccine effectiveness data on the 2024-25 COVID-19 vaccine based on 137,543 emergency department and urgent care (ED/UC) encounters showed 33% protection against COVID-associated ED/UC visits by all adults, 45%–46% protection against hospitalization in immunocompetent older adults, and 40% protection against hospitalization in immunocompromised adults ≥ 65 years. The vaccine helped prevent an estimated 68,000 hospitalizations during the 2023–24 respiratory season. The 2024-25 vaccine, which targets Omicron JN.1 sublineages, remains recommended for everyone ages 6 months and up. Vaccine effectiveness against critical illness was precluded due to both lower hospitalization rates and lower vaccination rates. Read the MMWR here. Read CDC interim clinical considerations here.
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Bexar County continues to see sporadic mpox cases. The STOMP trial is no longer enrolling participants, as most people with mpox recover well with supportive care and pain management. For people with severe disease or severe immunocompromise, tecovirimat (TPOXX) remains available through the CDC’s Expanded Access Investigational New Drug (EA-IND) protocol. Study sites include Metro Health and other local infectious diseases clinics. Providers can learn more and sign up here.
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Q4T (Quality for Teens)
Q4T (Quality for Teens) is a quality improvement package from the National Association of Community Health Centers to enhance adolescent sexual and reproductive health services. The package offers clinical and youth-friendly goals and strategies to reduce unintended pregnancy, STIs and other unwanted sexual health consequences for teens.
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EDUCATIONAL OPPORTUNITIES
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Syphilis 201: Case Study Analyses
Join your Metro Health Clinician Ambassadors Apr. 9, from 12 p.m. to 1 p.m. for an interactive analysis of syphilis case studies in diverse populations, where attendees can apply their knowledge of syphilis testing, staging, treatment and follow-up. Grab your lunch and be ready to follow along! Register here. (1.00 hour CME/CNE available.)
High-Quality Primary Care: A Path to Healthy Communities
Join experts on Apr. 9, 11 a.m. to 12 p.m., to explore how high-quality primary care improves health outcomes and reduces costs by managing chronic conditions, preventing disease, and enabling early detection. Register here.
AIDS Seminar Presents: The Latest in Starting and Switching Antiretroviral Therapy
Listen in on a virtual session covering the latest in antiretroviral therapy on Mon. Apr. 14, 11:30 a.m. to 12:30 p.m. This training will cover the latest guidelines on when to start or modify therapy, strategies for virologically suppressed patients, and updates on emerging treatments. CME and CNE offered. Register here.
Trauma and Tresses: The Connection Between ACEs and Alopecia
In a session on Apr. 23, 1 p.m. to 2 p.m., from University Health’s Institute for Trauma Informed Care, Dr. Stephanie L. Anderson, The Alopecia Advocate, will explain three evidence-based links between Adverse Childhood Experiences (ACEs), autoimmune disorders and alopecia. No CME. Register here.
Hepatitis C Update
UT Health San Antonio’s Barbara Taylor and the South-Central AIDS Education Training Center will share the latest on Hepatitis C diagnosis and management on Apr. 25, 11 a.m. to noon. (1.0 hrs CME available.) Register here.
Advancing Health Equity for Sexual Minority Women: Recognizing risk and improving preventive care
Enhance your understanding of health care for lesbian and bisexual women with The Fenway Insitute’s webinar presented by Dr. Shail Maingi and Dr. Gabrielle Mayer. Learn strategies to optimize health outcomes, build patient trust, and improve engagement and well-being, May 7, from 12 p.m. to 1 p.m. Register here.
Upcoming Psychiatry Access Network Sessions
Join the Texas Child Psychiatry Access Network (CPAN) and Texas Perinatal Psychiatry Access Network (PeriPan) from 12 p.m. to 1 p.m. for free lunchtime CME (1.0 hrs). Build your skills and gain practical insights to support your patients.
Apr. 15 – Behavioral Strategies and Psychotherapeutic Models of Care for Perinatal Anxiety and Depression
May 20 – Introduction to Maternal Mental Health Conditions and Their Prevalence
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Fetal Infant Morbidity Review Board on Congenital Syphilis (FIMR-S)
During this review, case summaries of congenital syphilis or perinatal HIV diagnoses are reviewed and discussed to identify potential missed opportunities for disease intervention and barriers to medical care engagement. Providers and healthcare staff are encouraged to attend – registration is required for confidentiality purposes. The in-person workshop takes place at the Phil Hardberger Urban Ecology Center from 1 p.m. – 4 p.m.
May 6 – Register here.
Aug. 5 – Register here.
Nov. 6 – Register here.
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| Your Clinician Ambassadors
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Lucinda Lundy Zeinelabdin, MSN, APRN, FNP-C
Clinician Ambassador, Family Nurse Practitioner
Lucinda.Zeinelabdin2@sanantonio.gov
210-207-2407
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Diana Morales, BSN, RN
Clinician Ambassador, Public Health Nurse
Diana.Morales1@sanantonio.gov
210-207-5102
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For health alerts from Metro Health text "DOCALERT" to 1-844-824-COSA (2672)
By participating, you consent to receive up to 4 text messages per month from Metro Health. Message and data rates may apply.
SCAN HERE
You can now self-schedule your virtual academic
detailing sessions with the Clinician Ambassador team!
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