Infectious Tidbits
The Quarterly Infectious Disease Newsletter from Tri-County Health Department
Fall 2019
~ Immunization and Vaccination Information
~ One Health: We're All Connected
~ World Rabies Day - September 28, 2019
~ Hepatitis A Outbreak Update
Immunizations and Vaccinations
With measles in the news, combined with Colorado’s low rate of measles-mumps-rubella (MMR) vaccinations for kindergarteners, it’s more important than ever to give Colorado’s children a shot at success by ensuring that they receive all recommended immunizations. 

Statewide data from the 2018-2019 school year show that kindergartners’ rates for four of the five school-required vaccines decreased from 2017-18:
  • MMR vaccination rates dropped from 88.7% to 87.4%. This represents a 1.3% decrease from the school year and ranks Colorado as the worst state in the nation.
  • Hepatitis B dropped from 92% to 90.8%.
  • Polio dropped from 88.6% to 87.2%.
  • Chickenpox dropped from 87.7% to 86.5%.

We have Governor Polis’ attention, particularly around Colorado’s low MMR rates. On June 13, 2019, the Governor issued an Executive Order to improve Colorado’s kindergarten vaccination rates and directed public health to take immediate action. A goal was set to increase MMR rates in Colorado from 87.4% to 90% by June 2020 and to protect Coloradoans from measles.

Public Health needs your help to make this happen! The Colorado Department of Public Health and Environment recently released a broad media campaign to improve vaccination rates called Spread The Vax Facts ” which addresses vaccine hesitant parents’ concerns. We urge you to take part in this effort.

Here’s what different community partners can do to help join us in our fight to keep measles out of Colorado:

Talk to parents

The back-to-school rush, although hectic, is a prime time to encourage parents to locate their child’s vaccination records and to give them information about convenient places to get vaccinations.
Follow the school immunization law

Colorado Board of Health Rules require schools to have an up-to-date certificate of immunization, an exemption, or an in-process plan on file for each enrolled student. Students who do not have one of these documents on file are not permitted to attend school and can be excluded.
  • The Colorado Children’s Immunization Coalition has district-level information that can help you understand your community’s level of protection, where schools are succeeding, and where schools might improve. Visit for more information.
  • Schools can report and publicize MMR vaccination data in effort to increase awareness for parents and the school community.
  • Colorado Board of Health rule 6 CCR 1009-2 requires most schools and child care facilities in Colorado to report immunization and exemption data to the state health department annually. Please ensure your schools are reporting their data and look for more information from TCHD about the reporting process. 
Share facts, not diseases

In Colorado, we’ve made it easy for parents to get the information they need. We need your help in getting these tools into the hands of Colorado parents.
  • directs people on how to request vaccination records for their children.
  • helps parents look up vaccination and exemption rates for schools and child care facilities in Colorado so they can make the best decision for their children.
  • guides people through information and misinformation about vaccines with advice from Colorado doctors who also are parents.
  • helps people find out if their kids are eligible for low- or no-cost vaccines and helps them find a provider who gives them.
  • Planning a trip outside the U.S.? Find out if you need measles vaccine
One Health: We're All Connected
One Health  is the idea that the health of people is connected to the health of animals and our shared environment. Learn why One Health is important and how, by working together, we can achieve the best health for everyone.

Many diseases are passed between animals to humans, and our work in public health is to minimize the risk of disease in the populations we serve. For example, TCHD has a robust rabies prevention program ensuring that humans and domestic animals who have been exposed to rabies get treatment to prevent disease.  

Further efforts to prevent spread between animals and humans extends beyond our pets. On July 31 st , 2019, TCHD was notified of a prairie dog die off impacting the open space areas around Dicks Sporting Goods Park and the Prairie Gateway Open Space in Commerce City, as well as areas adjacent to the Rocky Mountain Arsenal Wildlife Refuge, which also had plague-affected areas on its property. Prairie dogs and the fleas remaining on the mounds tested positive for plague. Once the prairie dog dies, the fleas, which carry the bacterium, Yersinia Pestis , look for a new ‘host’ such as a human, a dog, or cat to attach to. This could be a potential exposure to plague. TCHD worked closely with the Rocky Mountain Wildlife Refuge and the city of Commerce City to close off the plague-infected areas to human activity until there was no longer a concern of putting people and pets at risk.
World Rabies Day: September 28, 2019 
Rabies is a fatal virus transmitted to people through the bite or scratch of an infected animal. In Colorado, rabies is regularly found in bats and skunks. The Colorado Department of Public Health and Environment conducts rabies testing of wildlife in certain situations, as well as domestic animals with illness suggestive of rabies. Check out our TCHD map of rabies positive animals within Adams, Arapahoe, and Douglas counties!

Since 1/1/19, seven animals have tested positive within TCHD's jurisdiction – 6 skunks and 1 bat. Additionally, TCHD’s Communicable Disease Epidemiology staff have recommended that 35 individuals receive rabies post-exposure prophylaxis due to exposures to wildlife or suspect domestic animals. TCHD also monitors the health of animals that have been exposed to wildlife that can potentially carry rabies. Since 1/1/19, 71 domestic pets have been put under a 45-day observation, 120-day observation, or euthanized due to such exposures. No domestic animals have tested positive for rabies within TCHD's jurisdiction in 2019.  

For more information on animals that have tested positive within the State of Colorado, go to Colorado Department of Public Health and Environment’s website .
Hepatitis A Outbreak Update
What you need to know:

  • Since October 2018, Colorado has been experiencing an outbreak of hepatitis A virus (HAV) affecting people experiencing homelessness and/or using street drugs, men who have sex with men, and people currently or recently incarcerated; this is part of a national outbreak.
  • Since the nationwide outbreaks were first identified in 2016, and as of 9/20/19, 30 states have reported 26,013 cases, 15,643 hospitalizations and 262 deaths.
  • In Colorado, since 10/16/18, and as of 9/18/19, there have been 173 reported cases, 126 hospitalizations and one death in eight different counties. Check here for updates in Colorado.
  • Case counts have continued to rise, and the City and County of Denver has seen the largest increase in the number of cases over the past couple of months.
  • As of 9/18/19, there have been four confirmed hepatitis A cases associated with the outbreak in TCHD’s jurisdiction - one in Douglas County and three in Arapahoe County.
  • TCHD is partnering with neighboring local public health agencies to collaborate on outreach efforts addressing barriers for reaching our high risk population. This includes performing case investigations, locating cases, identifying case contacts, and providing post exposure prophylaxis when necessary.
  • TCHD is collaborating with community partners, who serve our high risk population, providing targeted messaging on prevention of HAV and encouraging vaccinations.
  • TCHD is also supporting outreach and vaccination for high-risk individuals at resource centers, jails, and encampments as well as piloting prevention efforts in hospital emergency departments.
Thank you to our community partners, including providers and laboratories, for support in the timely reporting of reportable conditions which is critical to our prompt and effective response to outbreaks to protect the communities we serve!
Eleven offices along the Colorado front range serving the residents of Adams, Arapahoe and Douglas Counties

Administration Office:
6162 S. Willow Drive, Suite 100
Greenwood Village, CO 80111
Phone: 303-220-9200
Fax: 303-220-9208
Contact Information:

Report infectious diseases or outbreaks to TCHD immediately to help prevent the further spread of illness!

Call Communicable Disease at:
After Hours: 720-200-1486