Archive for the ‘Preparedness’ category

More Arizona Parents Choosing Not to Vaccinate their Kids

April 11th, 2014

Vac2_031.jpgAs I mentioned in a blog post last year, more AZ parents are choosing not to vaccinate their kids- using “personal exemptions” when they enroll their kids in school.  This has jeopardized our immunization rates enough that this week’s measles case in Maricopa County could spread.  We’ll know in a couple of weeks.

Vaccinating yourself and your kids is more about community protection than personal protection.  We need just about everybody to participate and get vaccinated in order to get the herd immunity we all need to prevent the spread of diseases like measles.   It’s a social contract that we have with each other to keep all of us healthy- just like it’s everyone’s responsibility to be a Good Samaritan when you see a car crash.

Last year we asked the UA’s Mel and Enid Zuckerman’s College of Public Health to conduct a Study Summary and provide Recommendations to overcome the trend toward increased vaccine exemptions.  Using the study results, we developed and implemented an Action Plan to Address Vaccine Exemptions last year.  Here’s a link to our Action Plan Summary with the details of the key interventions we’ve conducted over the last year.

Epidemiologists: Public Health’s Smoke-Jumpers

April 10th, 2014

MeaslesLike a hotshot team, a rapid response by public health is essential to stopping the spread of measles in unvaccinated persons… and disease detectives in Maricopa County are currently working to squash a measles outbreak right now.

Last week a person with measles visited a restaurant, church and airport in Arizona, exposing over a thousand people to measles.  Press releases and health alerts have gone out- and epidemiologists, public health nurses, and healthcare providers have been dispatched by Maricopa County Public Health to identify, isolate and control further cases.  Time will tell if their efforts pay off.  We should know in a couple of weeks (the incubation period for measles is 10 – 18 days).

Measles seeks out the unvaccinated like fire seeks a dry branch – the chance of an unvaccinated contact getting measles is 90% once exposed.   If you’re not vaccinated against measles, you can get it just by being in a room with someone who has measles.  A measles vaccine can prevent infection if given within 72 hours of exposure as an emergency control measure for unvaccinated folks…  but herd immunity is what keeps the community from getting burned.


March 31st, 2014

ebolaIf you’re like me, your introduction to Ebola virus came in the 1990s with the bestseller nonfiction thriller The Hot Zone and loosely-based film Outbreak.  The descriptions of a deadly hemorrhagic fever that quickly spread through the population were terrifying, as were the life-threatening dangers posed to the intervening infectious disease personnel.

The Guinea Ministry of Health has a total of 103 suspect and confirmed cases with 66 deaths.  They announced today that the disease has spread to the capital, Conakry.  Also, reports of suspected cases in neighboring countries are being investigated: Liberia reported to the WHO 8 suspected cases, including 6 deaths, in individuals with recent travel history to Guinea. Sierra Leone has reported 6 suspected cases, including 5 deaths.

Bats appear to be a reservoir and hosts for the ebolavirus. Initial infections in humans result from contact with an infected bat or other wild animal. Ebola spreads by contact with other patients’ infectious secretions and from consuming the meat of infected animals.  For Guinea’s particular strain, the fatality rate is nearly 90%, and is heralded by fevers and internal bleeding.   Doctors Without Borders and WHO both have teams in Guinea, working with the Health Ministry to contain the spread.

In countries with weak medical infrastructures, an outbreak like this can be devastating.  Historically, countries with poorer infrastructures and health status suffer far worse than more bolstered nations.  So while Arizona is under no threat from Ebola, maintenance of a strong public health and emergency preparedness program remains a top priority.

2014-2015 Influenza Vaccine Recommendation

March 20th, 2014

Every year the World Health Organization holds a meeting with worldwide experts to make recommendations for the next season’s Northern Hemisphere flu vaccine. It seems strange to plan for next season when we’re still in the midst of the current flu season, but the vaccine-making process still takes about 6 months. Influenza season generally ramps up around September or October, so starting the process now ensures that there’ll be a good supply of vaccine for folks to get protected from flu before the next season hits. 

At last week’s meeting in Geneva, the WHO panel recommended that the components in next season’s vaccine remain the same as this year’s. Even though the vaccine components will stay the same, it’s still important to get vaccinated every year. Immunity wanes over time, so the best way to protect yourself is to get vaccinated every year.


A Key Measure of Preparedness Improves in AZ

March 18th, 2014

During a major crisis, such as an influenza pandemic, we might need to take extraordinary steps to ensure that healthcare workers have the medicines and supplies on hand to treat patients.  State, local, and federal agencies all participate in the Strategic National Stockpile program to help ensure that these critical resources are available during disaster situations.

The main purpose of our Strategic National Stockpile program is to distribute medicines, vaccine, and supplies during all types of public health emergencies.  This year, we improved that capability once again.  Scores for our state and local programs rose this year according to the CDC’s annual Technical Assistance Review.  Every year, the CDC looks at key “functional areas” across the state and in select local jurisdictions.  The Review score rose up to 97%, Maricopa County maintained its high mark of 99%, and Pinal County achieved a 100% in all 12 areas. 

These outstanding scores demonstrate our statewide commitment to the Strategic National Stockpile program, and highlight the extraordinary efforts of our public health preparedness teams.  Here’s how to learn more about the Strategic National Stockpile program.


AZ Trauma System Continues to Mature

March 17th, 2014

I’ve often written about the importance of a mature trauma system and how it’s important to the rural/tribal areas of Arizona for better access to care for injured patients.  Since my last blog on trauma, we’ve welcomed Banner Del Webb Medical Center, Payson Regional Medical Center, Mt. Graham Medical Center, and Yavapai Regional Medical Center as Level IV trauma centers.   

Chandler Regional Medical Center will go live with their trauma program later this month as a “provisional status” Level I trauma center in the East valley area. For quite some time, East valley community leaders have expressed the need for a high level trauma center there to accommodate the large growth in population and this new Level I facility will help satisfy their community need.

AZ EMS Jobs for Veterans

February 18th, 2014

Around the Country, State Emergency Medical Services offices are looking for ways to help returning Veterans with medical experience find employment in the EMS industry.  We’ll be making it a priority in 2014 to engage more Veterans with EMS experience to use their skills in Arizona’s progressive EMS and Trauma System.  

We have a couple big things working in our favor for this initiative.  The Armed Forces began to require enlisted personnel providing medical care to the troops to take Emergency Medical Care Technician courses (the same ones used in the non-military world) and then to pass the certification exam provided by the National Registry of EMT’s. That’s great because it means that the Armed Forces requirements align with our state requirements for certification. 

In AZ, a coalition of stakeholders including the Arizona Fire Districts Association, the Professional Fire Fighters of Arizona and the Arizona Ambulance Association worked to pass legislation allowing individuals that are currently certified by a national organization (like the National Registry of EMT’s) to obtain Arizona certification.  Together, these two things are helping to ensure that our returning Veterans have an additional career opportunity and that our EMS team here in Arizona is benefitting from their strong training and extensive experience.

AZ Aces Latest CDC Public Health Preparedness Report Card

February 3rd, 2014

Arizona continues to score high marks on preparedness according to a CDC report released this week.  We got a perfect score this year for biological laboratory testing, and we’ve kept our excellent performance measures for incident management, public information, and medical countermeasures.  Our response times for activating our emergency operation center have been well above the national target for the last three years, and our chemical laboratory detection capabilities have been fully “demonstrated” and “passed” for two years running.  

Our state’s Strategic National Stockpile program received a special mention on page 18 of the report.  ADHS, along with Maricopa and Pinal Counties, conducted a full-scale exercise to distribute life-saving medications to the public.  This national recognition demonstrates the hard work of our preparedness staff and our local health department partners. Thanks to all of you for your hard work through the years to get us to this stage of readiness. 

You can view this year’s National Snapshot report to see how Arizona compares to the rest of the nation.  You can take steps to make sure your family is prepared too – check out my blog from last Spring – the Family is the First Responder.

What’s the Medical “Standard of Care” in an Emergency?

January 23rd, 2014

Good question.  Disasters and public health emergencies can stress health care systems to the breaking point and disrupt delivery of vital medical services. For example-  hospitals and long-term care facilities may be without power; trained staff, ambulances, medical supplies, and beds could be in short supply; and alternate care facilities may need to be used. 

You can imagine how difficult it would be to set alternative standards of care in the middle of an emergency- which is why we’ve been working with a statewide Crisis Standards of Care planning group since last January.  Our Public Health Emergency Preparedness team has been working with healthcare, public health, emergency management, and legal experts to develop a plan and a set of standards to guide the delivery of healthcare during the most catastrophic disasters- providing guidance for managing scarce resources (both people and stuff) in an emergency. 

A key resource is a landmark crisis standards of care report developed by the Institute of Medicine- which examines indicators and triggers that guide the implementation of crisis standards of care and provides a toolkit to help stakeholders establish indicators and triggers for their own communities.  The IOM report has toolkits for behavioral health, emergency management, emergency medical services, hospital care and public health.

Special Needs Emergency Preparedness Manual

January 22nd, 2014

The first link in the chain of survival during a public health disaster is people taking responsibility for their own family’s safety.  Being prepared at home is the first line of defense.  Families that have family members with special needs sometimes need to have more detailed plans to ensure that their needs will be met during those critical first hours after a public health emergency. 

Recognizing the need for a more detailed toolkit for special needs families was needed, the Arizona Developmental Disabilities Planning CouncilArizona Statewide Independent Living Council, our Bureau of Emergency Preparedness & Response partnered to put together an Emergency Preparedness Manual to provide a step-by-step planning guide to help folks become more prepared.  Special thanks go out to Ray Morris, the CEO and Founder of Dads4SpecialKids for his work- which served as a foundation for the new Emergency Preparedness Manual.  Check it out and put the Manual on your to-do- list for 2014.