Disease Detectives Investigating Rare Strain of Salmonella

May 22nd, 2015 by Cara Christ No comments »

Salmonella questionnaireOur epidemiologists in the Office of Infectious Disease Services have been working with local and federal public health partners on an outbreak investigation of a rare strain of Salmonella, called Salmonella Paratyphi B.  Most ill people in Maricopa County report eating sushi containing raw minced or ground tuna at restaurants.  As of May 20, there are 51 cases nationally and 10 cases in Arizona linked to this outbreak.

Solving this outbreak requires communication and collaboration between epidemiologists, environmental health specialists, communicable disease investigators, and laboratory scientists, not only at ADHS, but also with our county public health partners and public health agencies throughout the country.

Once we are notified in public health that someone has Salmonella, a disease investigator contacts the person to ask about food, animals, and other exposures.  Our State Public Health Laboratory scientists analyze Salmonella specimens using DNA fingerprinting, allowing public health officials to link people from separate households (locally and nationwide) whose Salmonella DNA fingerprints were a match. This match tells us that the individuals likely got sick from the same source, triggering an outbreak investigation.

This outbreak investigation is ongoing, and we are continuing to interview ill people to gather more information about foods they might have eaten during the week before they got sick.  We are also working with regulatory partners such as the local Environmental Health Departments and the Food and Drug Administration to identify the exact source of illness and remove it from restaurants.

People who are at high risk for getting sick from Salmonella should not eat foods containing raw fish.  This includes pregnant women, people who are 65 or older, children under 5, and people with weakened immune systems.  People who have symptoms of Salmonella should see their health care provider.

Tackling Prescription Drug Abuse with “Awareness. Action. Outcomes!”

May 20th, 2015 by Cara Christ No comments »

painkillersArizona, like every state in the country, is battling an epidemic of people misusing and abusing prescription drugs.  We’ve been working with several partners on the Arizona Prescription Drug Misuse & Abuse Initiative since 2012 to reduce the problem in Arizona.

The Initiative team  recently developed a comprehensive toolkit designed to assist communities to tackle prescription drug abuse at the local level.  The Community Toolkit provides easy to use materials and guidance on implementing five major strategies of the Arizona Prescription Drug Misuse & Abuse Initiative with the theme of “Awareness. Action. Outcomes!”

We will host a free training session on the Community Toolkit next month  in Phoenix.  To attend, please register by June 11. Communities and interested groups can access the toolkits online or request a hard copy by contacting Danielle Dandreaux at 602-364-3321.

Last November we released the Arizona Opioid Prescribing Guidelines, developed with the help of health care partners across the state interested in promoting responsible, appropriate prescribing practices to reduce the misuse of opioid pain relievers.  To help clinicians incorporate these guidelines into practice, the University of Arizona is providing a free online training programSafe and Effective Opioid Prescribing While Managing Acute and Chronic Pain.  The program offers two free CME credits to prescribers.

The training is supported by a grant through the Governor’s Office for Children, Youth and Families and was developed in partnership with the Arizona Prescription Drug Misuse & Abuse Initiative, Arizona Department of Health Services, University of Arizona College of Public Health and University of Arizona College of Medicine. 

We encourage any clinician who prescribes opioids to take advantage of this opportunity to become more familiar with Arizona’s current guidelines for opioid prescribing, as well as learn more about non-opioid strategies for pain management.​

May is Hepatitis Awareness Month in Arizona

May 14th, 2015 by Cara Christ No comments »

docsAccording to the Centers for Disease Control and Prevention, more than 4 million Americans are living with viral hepatitis and more than 20,000 die every year from hepatitis-related infections.  Viral hepatitis is the leading cause of liver cancer and the most common reason for liver transplantation.

Two types of viral hepatitis, B and C, are the cause of a silent epidemic because people can have the virus for years and not know they are infected.  Hepatitis A and B can both be prevented by a vaccine.  While there is no vaccine for hepatitis C, new anti-viral treatments show promising results.

The CDC recommends people born from 1945-1965 should get tested for hepatitis C.  People born in Asia or the Pacific Islands or whose parents were born there should be tested for hepatitis B.  Take the CDC hepatitis risk assessment to find out if you should get tested for viral hepatitis.  It is important for people to know their overall health status because treating diseases such as hepatitis can be complex, so if you are in this higher risk group, you should get tested.

May 19th is National Hepatitis Testing Day, and you can visit the ADHS website to find out where to get tested.  Governor Doug Ducey signed a proclamation declaring May as Hepatitis Awareness Month in the State of Arizona.  There will be several events held across the state of Arizona to promote hepatitis awareness this month.  You can visit our new hepatitis website to learn more.

New Foods for WIC Families in Arizona

May 11th, 2015 by Cory Nelson No comments »

you do a lotGetting kids to eat healthy is hard, especially for busy moms.  The Arizona WIC program now offers new foods to help families provide nutritious meals.

Yogurt, whole wheat pasta, and new brands of cereal and baby foods for older babies are now available through the WIC program.  The full list of foods includes many fresh, frozen and canned vegetables, milks, cheeses, and cereals.  WIC foods are healthy for moms, babies, and preschoolers and are approved by the United States Department of Agriculture.

Helping choose healthy foods is only one of the ways WIC helps families.  WIC moms learn what to eat while pregnant or breastfeeding and how to feed their growing kids, especially picky eaters.  Moms get WIC checks that can be used at grocery stores and farmers’ markets to buy healthy foods for their family.  WIC helps moms with breastfeeding, too.

Moms do a lot and WIC is there to help a little.  Many families do not realize they can participate in the WIC program, even after their baby turns one.  Spread the word, encourage all the moms you know with kids under age five to visit www.azwic.gov today and find out if they are eligible.

Setting Public Health Grant Spending Priorities

May 8th, 2015 by Cory Nelson 1 comment »

family 1Public health has reach into many areas that you may not think about.

Currently we’re working to reduce the number of prescription drug overdoses and deaths.  The misuse of prescription drugs is a national epidemic.  We’re working with the Arizona Criminal Justice Commission to attack the problem here.  The funding for our prevention efforts comes from the Preventive Health and Health Services Block Grant from the CDC.

The block grant has provided strong support to states since the 1980s; the way Arizona invests the funds changes over time based on the public health needs in our state.  Right now,  in addition to the prescription drug initiative, we use the funding for skin cancer prevention through the SunWise program, to fund and provide assistance to county health departments to improve and protect the health of the public by advancing the quality and performance of services in their respective jurisdictions, sexual assault prevention  programs, and to provide meaningful and timely Arizona health status reports using health data that is collected by the Agency.

Every year ADHS, along with the Block Grant Advisory Committee and County Health Directors, reviews data and priorities as the grant work plan is developed.  We have a meeting set up where we describe the plans for investing the funding for the next year.

You are invited to attend and express your ideas for future funding; the meeting is Wednesday, May 13, at 12:30 p.m. at 150 N. 18th Avenue.​

Empowering Habits, Empowering Lives: Superheroes Empowering Arizona!

May 5th, 2015 by Cory Nelson 2 comments »

CaraChrist_EmpowerThis past weekend, we held the fourth annual “Empowering Habits and Empowering Lives” Empower Conference. More than 250 Early Care and Education professionals from all over Arizona participated in the all-day meeting. Conference participants explored the Empower Program’s 10 Standards to Empower Children to Live Healthy Lives and learned how to be more effective through developing cultural competency and inclusiveness.

The conference included fun and interactive sessions presented by state and national experts. Dr. Cara Christ, Deputy Director and Chief Medical Officer of the Arizona Department of Health Services, kick-started the event held at the Desert Willow Conference Center in Phoenix.

The child care providers attending had a chance to participate in high-energy sessions to find out how to “Krunch Out Tooth Decay,” be a sun safety “Superstar,” play nutrition and breastfeeding “Jeopardy,” and ignite physical activity sparks for all families. A “Superstar” photo booth and  resource-rich exhibits were popular places.

The 10 Empower Standards were developed for Empower Child Care Facilities in Arizona. More than 2,500 child care providers from across the state participate in the Empower Program, reaching over 200,000 children in Arizona.  Check out the conference presentations and see pictures of the Superstars from all around Arizona.

Surviving Triple Digits in Arizona

May 1st, 2015 by Cory Nelson 2 comments »

extreme-heatIn Arizona it doesn’t have to be summer for the temperatures to soar.  With the first 100 degree day in Phoenix today, we know the scorching heat is right around the corner.  High outdoor temperatures aren’t just an inconvenience; they’re dangerous. Heat is the number one killer weather-related cause of death in Arizona and across the country.  In 2013, there were 101 deaths in Arizona due to exposure to excessive natural heat, and on average, 121 people died every year in Arizona from the heat from 2001 to 2013.  Preliminary numbers for 2014 show 86 people died of heat-associated causes.

Fortunately, you can protect yourself during extreme heat with a few simple steps – stay cool, stay hydrated, and stay informed.  Whenever you can, avoid spending time outside during the warmest hours of the day, usually 10am-4pm.  If you do go out, stop frequently at air-conditioned places and cool off.

Drink lots of water, especially if you plan to be out during the hot part of the day.  If you know you’re going to be out, start hydrating the night before.

Being alert to the signs and symptoms of heat-related illness is another way to protect yourself and others.  You can find more information on preventing, recognizing, and treating heat-related illness here.  The Heat Relief Network coordinates hydration stations, refuge locations, and donation sites throughout the Valley.  You can visit one of these spots to get relief from the heat.  Another way to stay safe is to be informed by signing up to receive heat alert notifications.  These alerts will notify you when temperatures are forecasted to be particularly dangerous.

We’ve been working to prepare and protect Arizonans from the dangers of extreme heat and other weather hazards.  The Arizona Extreme Weather and Public Health Program Website  offers valuable resources and information to help you stay safe during the heat season, including toolkits designed to protect those who may be most vulnerable to the effects of extreme heat, such as older adults, outdoor workers, and school children.

High temperatures are also a reminder to have a plan to make sure you don’t leave anyone in a hot car.  Temperatures in cars climb dramatically in the sun.  Senior citizens, young children, and pets often cannot help themselves and leave a vehicle when the temperature becomes unbearable.

Grant Funding Helps Homeless Across Arizona

April 30th, 2015 by Cory Nelson No comments »

iStock_000041434018_blogAt the end of March, the men’s overflow shelter closed in downtown Phoenix.  The shelter housed up to 350 homeless men at full capacity. The city condemned the building for asbestos.

We’re one of many community partners responding to the housing needs of vulnerable people in Arizona.  Our permanent supportive housing program will provide an additional 425 housing units this year to people with serious mental illness.  We also have two grants which fund homeless outreach.

Project for Assistance in Transition for Homelessness (PATH) is a grant Arizona receives every year.  Our current target area is Maricopa, Pima, Cochise, Coconino, and Yavapai Counties.  The PATH grant’s goal is to reduce or eliminate homelessness for people with serious mental illness or co-occurring serious mental illness and substance use disorder who are homelessness or are at imminent risk of becoming homelessness.  PATH grant funds provide a menu of allowable services, including street outreach, case management, and services which are not supported by mainstream mental health programs.

The Cooperative Agreement to Benefit Homeless Individuals (CABHI) is a three-year grant currently targeted in Coconino and Yavapai Counties.  The goal is to enhance or develop state infrastructure and systems to increase accessible, effective, comprehensive, coordinated/integrated and evidence-based treatment services; the grant also expects to increase permanent supportive housing.  The target population is people who experience chronic homelessness with substance use disorders or co-occurring substance use and mental disorders.

You can learn more about the grants on our website.

Vaccine Exemptions – Turning the Tide?

April 24th, 2015 by Cory Nelson No comments »

PVaccines are scientifically proven to be the best way to prevent the spread of many communicable diseases.  Yet, through the last decade, Arizona along with the rest of the country has seen an increase in the number of families choosing not to vaccinate their children.  A recent outbreak that started at Disneyland created a firestorm of interest in vaccinations, especially since it produced the largest number of cases since measles was considered eliminated from the U.S. in 2000.

In Arizona parents and guardians can choose to exempt their children from required childcare and school vaccinations for personal belief or religious reasons, or if the child has a medical issue that makes vaccination dangerous.  We’ve been tracking exemption rates among Arizona children enrolled in childcare, kindergarten, and 6th grade to determine how protected our communities are against vaccine-preventable diseases.  In the last decade, we’ve seen exemption rates rise, with 4.1% of childcare-attending children and 4.7% of kindergarteners and 6th graders exempt from vaccines last school year.

Today we posted the reports for vaccine coverage and exemption levels for the current (2014-2015) school year.  For the first time in more than a decade, non-medical exemption rates went down in childcares and kindergartens in Arizona!  In childcare settings exemption rates have decreased 0.5% this year to 3.6%; in kindergartens, exemption rates are down 0.1% to 4.6%.  Exemption rates in Arizona 6th grades remain at 4.7% for the 2014-2015 school year.  You can visit our website to find specific coverage and exemption levels for schools in your area.

This good news might be a fluke or in may be a change in the mindset of families.  We hope the trend continues next year.  If we do, it might be due to the work we’ve been doing for the last few years or because of concerns after the large measles outbreak this year.  No matter the cause, public health will keep watching and working to help our state reach herd immunity against all vaccine-preventable diseases.






Community Paramedicine Survey Results Coming Soon

April 23rd, 2015 by Cory Nelson No comments »

PThe Bureau of Emergency Medical Services (EMS) and Trauma System  recently surveyed nearly 200 EMS agencies across the state to determine (1) whether they had or intended to begin a community paramedicine program, (2) if so, which medical conditions they intend to focus on and (3) what type of services they intend to provide.

The data is still being collected, but with 30 percent of the responses in, we can give a brief snapshot — 39 Community Paramedicine programs are in the planning/development, pilot or operational stage.  The clinical conditions most targeted are chronic conditions like congestive heart failure, cardiovascular and respiratory disease or sepsis prevention, and wound and injury care.  Services that are most likely to be provided include medication reconciliation, patient education, welfare visits, home hazard checks, post hospital discharge follow-up, community services referral and identifying alternative treatment destinations.

We will be posting the survey results on our website soon.