Posts Tagged ‘Sonora’

New Year, New MEDSIS

January 14th, 2013

Over the past two years, folks in ITS and Epidemiology and Disease Control have been working together to enhance our state’s electronic communicable disease surveillance system called MEDSIS.   This week the new version of MEDSIS went live. Major enhancements include the integration of tuberculosis reporting, case management and surveillance; expanded case management capabilities for all diseases; and additional functionality to better meet the needs of all users. This system isn’t just used by ADHS staff- it’s used by folks across the healthcare system. 

All 15 county health departments and four tribal public health organizations use MEDSIS to monitor cases of infectious disease and manage their case investigations; infection preventionists at hospitals enter infectious disease cases to satisfy our requirements for reporting selected infectious diseases; and laboratories electronically report positive test results directly into the system. There’s even a Spanish version of MEDSIS to allow us to share bi-national cases with our counterparts in Sonora to improve public health on both sides of the border. Thanks to all of those involved in making MEDSIS a success including Raghu Ramaswamy, Ravikumar Pitti, Sara Imholte, Lloyd Kalicki, Srinivasa Venkatesan, Paula Mattingly, Michael Conklin, Javed Mukarram, Arup Sinha, Teresa Jue, Jessica Rigler, and Shoana Anderson.

No comments »

Posted in General

Tags:

Valley Fever Season Peaking

January 8th, 2013

Valley Fever typically peaks in late fall and early winter with a minor peak from June to August (refer to the 2007-2011 Valley Fever Report). Those who’ve been in Arizona for a while may know that Valley Fever is a lung infection caused by a fungus that is common in the soil here. In most cases, people with Valley Fever have very mild symptoms like cough, fatigue and shortness of breath that they may confuse with the common cold. Sometimes people can have serious disease including meningitis (brain infection) and pneumonia (severe lung infection).  People can have symptoms for a long time or may need to be hospitalized–especially the elderly or those with weak immune systems. 

Arizona’s numbers for Valley Fever have increased significantly over the last decade. This increase could be because more people that have not been exposed to Valley Fever before are moving to or visiting the state and also because doctors and the public are more aware about Valley Fever and are testing more for it.  In addition, some folks think that increased exposure to dust, like being around construction or standing outside in a dust storm is maybe one of the reasons for the increase in Arizona. Our numbers this year have been lower than last year, and this may be due to the mild monsoon season this past summer. 

To help address this Arizona disease, we’ve been collaborating with the University of Arizona’s Valley Fever Center of Excellence to provide a free online training for clinicians in addition to a host of other interventions designed to raise awareness.   Our Office of Border Heath has also been working with colleagues from Sonora Secretaria de Salud Publica and other border states to collaborate and share our experiences.  Epidemiologists from Sonora have come to Arizona to participate in trainings and learn more about our surveillance system.  Last year, the CDC and Mexico’s federal partners conducted a training which enabled Sonora’s State laboratory to test for Valley Fever.  Together Arizona and Sonora will continue to work to better understand the burden of Valley Fever in the region.  For additional information, please visit: www.valleyfeverarizona.org.

 

No comments »

Posted in General

Tags:

Energize Our Borders

October 9th, 2012

I just got back from this year’s (30th annual) United States-Mexico Border Governor’s Conference in Albuquerque- called “Energize Our Borders”.  It was an opportunity to further strengthen the ties of friendship, security, and economic prosperity among the 10 states that comprise our United States-Mexico border region.  The Conference is made up of 7 worktables including Agriculture and Livestock; Competitiveness; Sustainable Development; Education; Logistics and International Crossings; Health and Emergency Management; and Border Security. 

As part of my job, I’m your delegate to the Health and Emergency Management Worktable. I worked with my counterpart and good friend, Dr. Bernardo Campillo, the Secretario de SaludPublica, for Sonora (along with delegates from the other 8 states) this week on action items for our 3 joint recommendations: 

  • Strengthen our relationship with the United States-Mexico Border Health Commission in order to better target the prevention of obesity among children and adolescents and to leverage their knowledge and experience in identifying best practices and promote them in the region.
  • Explore methods for program outreach and development related to reducing substance abuse through prevention and treatment programs and improving knowledge on healthy living; reducing vehicular childhood injuries; and highlighting opportunities to promote Medical Tourism.
  • Work with our federal authorities to establish a framework to support cross-border emergency mutual aid, and provide for the cooperation of states, counties and cities during emergencies and natural disasters.

We’ll execute the joint recommendations over the next year using specific action items.  For example: Arizona and Sonora have been focusing on reducing vehicular childhood injuries by exploring how we could use the Safe Kids model bi-nationally, since Safe Kids Mexico now exists and is actively looking at how to develop their state programs. Thursday I gave a presentation about how we use Safe Kids here in Arizona and perhaps how the work that Arizona and Sonora is doing could be used as a model for the other states along the border.

No comments »

Posted in General

Tags:

Sonoran Public Health Department & ADHS Snag the Paul Fannin Award

June 11th, 2012

 The Secretario de Salud Publica & the ADHS jointly received the Arizona Mexico Commission’s Paul Fannin award for our public health collaborations last Friday night.  This is a top award for the Commission- with the award going to “… an organization that has demonstrated acts of goodwill and support toward the development of the Arizona-Sonora relationship.”  It’s named after the AMC’s founder, Governor Paul Fannin.  This is the first Fannin award that has gone to binational recipients.  ASU and UA got a joint award as did ADOT and the Yuma Port Authority a few years ago…  but this is the first one with binational recipients. 

 

We were jointly recognized for our awesome collaboration on things like valley fever surveillance and interventions, real-time infections bi-national disease reporting, TB case and treatment coordination, collaboration during the H1N1 pandemic, laboratory science teamwork, teen pregnancy and substance abuse prevention, collaboration on assisted living standards, and much more.  Thanks to all of you who have made our relationship with Salud Sonora a success!

 

No comments »

Posted in Behavioral Health, General, Licensing, Preparedness, Prevention

Tags:

Arizona Mexico Commission Progress

February 10th, 2012

I’m writing this from my hotel room in Rocky Point- after a long day (and night) of the inter Plenary Session.  The 2 day conference started Thursday and goes through tonight.  We meet twice a year- it’s basically an opportunity for us to form partnerships across the border and to develop regional approaches to things like valley fever surveillance, burn patient infrastructure, substance abuse, TB, border first aid, farmworker health, and Sonora’s efforts to provide licensing and quality assurance services for assisted living in Sonora (and how we can partner with them as they set up their program). 

During last summer’s Session we signed a bi-national Declaration to develop regional surveillance for valley fever.  We’ve made a lot of progress in the last 6 months, and tomorrow we’ll be following up on that initiative at Sonora’s public health laboratory, checking out the lab instruments and equipment that we were able buy (with federal funds) and indefinitely post in Hermosillo in their lab. We’ll also be setting up some joint training sessions. There are lots of other examples of what we do through the Commission on health- this is just an example. 

The Arizona Mexico Commission was started by then Arizona Governor Paul Fannin in 1959 to improve partnering between Arizona and Sonora in a wide range of areas.  It’s evolved over the years to become a premiere and unique cross-border nonprofit organization whose mission is to improve the well-being and quality of life for residents of Arizona by promoting a strong, cooperative relationship with Mexico and Latin America through advocacy, trade, networking and information.  The Commission has 14 bi-national committees that act as industry and community advocates in partnership with the Commission Sonora-Arizona (from Sonora, Mexico) to facilitate cross-border trade, business and community networking and bi-national information sharing.  Our link is through the Health Services Committee.

Click here to see some of the public health facilities and an ambulance they use on the beach.

No comments »

Posted in General

Tags:

Building a Healthier Border

October 28th, 2011

You can think of the border public health advocacy network as a binational matrix of public health partners that collaborate to improve conditions along the US-Mexico border.  The network includes national organizations like the U.S.-Mexico Border Health Commission along with state based partnerships like the Arizona-Mexico Commission and the annual U.S.-Mexico Border Governor’s Conference.  Community based binational partnerships are also a key component for setting public health priorities and implementing effective interventions.  The acronym, COBINAS, stands for Consejos Binacionales de Salud, or Binational Health Councils, in English.  Our partnerships span the full width of public health- from infectious disease work (like TB control), to substance abuse, physical activity & nutrition (like Cinco Pasos), tobacco cessation, environmental disease work (likeValley Fever), prescription drug misuse, lab capacity- even developing regional licensing standards. 

As part of my job as the Director, I’m a member of the U.S.-Mexico Border Health Commission, whose mission is to provide international leadership to optimize health along the U.S.-México border.  The Commission is comprised of the federal secretaries of health, the lead health officers of the ten border states, and prominent community health professionals from both nations. As a member, I help to educate folks (including policy-makers) about the unique challenges at the border through outreach efforts and conduct joint collaborative public health initiatives with public and private partners in the border health community.  The primary goal of the Arizona Delegation is to strengthen and support bi-national public health projects and programs along the Arizona-Sonora border.  

I was fortunate to be able to spend a couple of days this week for a meeting of the U.S.-Mexico Border Health Commission Arizona and Sonora Delegation Outreach Offices.  The COBINAS workshop meetings (in Magdelena de Kino, Sonora) developed community priorities and updated program developments within the binational health councils.  We’ll also be using their input as we develop our work plans through the November 7, 8 US-Mexico Border Health Commission meeting, as well as the December Arizona-Mexico Commission, and next year’s U.S.-Mexico Border Governor’s Health Worktable joint resolutions.  By the way, the 3 local COBINAS for the AZ-Sonora region are San Luis Rio Colorado, Sonora/Yuma County; Ambos Nogales; and Noreste de Sonora/Cochise County, Arizona and the Tohono O’odham Nation/Western Pima County/Sasabe, Caborca, and Sonoyta, Sonora binational community health council.

No comments »

Posted in General

Tags:

Guillain Barré Investigation Update

August 5th, 2011

Last month I told you about a rare cluster of Guillain-Barré Syndrome (GBS) along the US-Mexico border near Yuma, AZ.  Since then, we’ve identified 8 more cases for a total of 24 (7 in AZ, 17 in Sonora).  GBS is a rare condition that results in paralysis of the legs, but can sometimes affect the arms and face.  While the exact cause of GBS is not well understood, the condition usually occurs after an infection, most commonly from a diarrheal illness caused by the bacteria, Campylobacter.  Even with this association between Campylobacter and GBS, only one in 1,000 cases of Campylobacter infection develops GBS and outbreaks of GBS are extremely rare. 

 We pulled in a team of experts from county, state, and federal levels in both Arizona and Sonora to investigate this outbreak, with unprecedented collaboration on both sides of the border.  These dedicated folks have been working with the people who got sick as well as those who aren’t sick (called controls) about their exposures and risk factors – they interview healthy folks to help us identify foods or activities that are more common in sick people and may be causing infections. 

 The team interviewed over 100 people – now they are analyzing the data.  Initial signs indicate that there may have been an outbreak of diarrheal illness due to reduced water quality.  Chlorine levels have been increased throughout the water system and additional studies are being done to see if we can identify how Campylobacter may have made it into the water system.  It looks like the steps we are taking to stop the outbreak are working since we haven’t had any new cases since the beginning of July and cases of diarrhea have decreased.

No comments »

Posted in General

Tags:

Border Health Partnerships

July 12th, 2011

A few weeks ago I blogged about the June plenary session of the Arizona Mexico Commission called Arizona & Sonora: Gateway for Innovation.  The conference provided an opportunity to move forward a bi-national agenda supported by Arizona and Sonora.  The health committee discussed regional approaches to valley fever surveillance, burn patient infrastructure, substance abuse, TB, border first aid services and Sonora’s upcoming efforts to provide licensing and quality assurance services for assisted living in Sonora (and how we can partner with them as they set up their program).

 A couple of weeks ago I was in Washington DC working on another border partnership called the US-Mexico Border Health Commission.  The Commission was created in July 2000 and is comprised of the federal secretaries of health, the health officers of the 10 border states and appointed community health professionals from both nations. The Commission provides a unique opportunity to bring together the two countries and its border states to solve border health problems.

 Each year the Commission establishes strategic objectives.  This year’s priority areas include TB, physical activity and nutrition, infectious disease and public health emergencies, access to care, data collection, and academic alliances.  We develop action items for each of the strategic objectives.  Through the Commission, each of our border states are able to directly communicate with our respective federal agencies so that we can better align federal priorities with our border strategic objectives.  A couple of weeks ago we were able to meet with several sub-cabinet agency decision-makers as well as several members of the House of Representatives and made real progress toward synchronizing federal policy with our strategic objectives for the border.

No comments »

Posted in General, Licensing, Preparedness, Prevention

Tags:

Guillain Barre

July 11th, 2011

A couple of folks from the CDC have been in Arizona this week to help us (and Sonora) to investigate an unusual number of cases (8 in Arizona and 8 in Sonora) of Guillain Barre syndrome

.  The Arizona cases are in the Yuma area.  It’s a rare condition that rarely (but occasionally) happens several days after a person has been sick with diarrhea- often from a foodborne bacteria called Campylobacter jejuni.  The illness happens when person’s own immune system damages the nerves, causing muscle weakness and sometimes paralysis.  Most people recover fully from it but some people have nerve damage that doesn’t go away.

Our epidemiology team is working with folks from the CDC and Yuma County to track down the cause.  Most of the work is gumshoe type epidemiology and includes reviewing medical records to confirm diagnoses meeting with hospital staff and neurologists to discuss clinical signs and symptoms (they have already reviewed 3 records and are currently reviewing a fourth case at a second hospital), and interviewing patients and family members to determine exposure history, particularly related to foodborne illnesses.

2 comments »

Posted in General

Tags:

Baja Health Tourism

February 22nd, 2010


The Mexican Federal Government announced a new policy this week to promote medical tourism in Mexico. Medical tourism is when you go abroad for medical care.  Their goal is to encourage U.S. residents (with an initial focus on the uninsured) to travel to Mexico for their medical needs, generating jobs and investment.  Another objective is to use the additional revenue to continue the expansion of the medical infrastructure in Mexico.

Phase I of the policy is to set up the infrastructure for basic and intermediate procedures- with a focus on drawing down folks that are uninsured in the US for things like orthopedics, heart, cancer, dental, ophthalmology and plastic surgery. The goal for Phase II is to get US Citizens (especially Arizonans and Californians) to consider treatment in Mexico for advanced medical services.

Health tourism is also a main priority for the new Governor of Sonora (Padrés Elías) http://www.sonora.gob.mx/ for several reasons, not the least of which is Sonora’s close proximity to large populations in Arizona and California, and that fact that the Hospital CIMA Hermosillo in Hermosillo is certified by the Joint Commission (the largest certification and accreditation of the United States), and it has the capacity to provide high-quality services.  In all, there are 8 hospitals in Mexico that are accredited by the Joint Commission http://www.jointcommissioninternational.org/JCI-Accredited-Organizations/.

No comments »

Posted in General

Tags: