Archive for the ‘Prevention’ category

Rocky Mountain Spotted Fever

July 23rd, 2014

rocky-mountain1The monsoon season marks the tick season here in Arizona, and one of most important tick-borne disease threats in the state is Rocky Mountain spotted fever.  The symptoms usually start with a fever of two or more days and can lead to a nasty “spotted” rash (although the rash is not always present in the cases seen in Arizona).  Early treatment with the correct antibiotic is critical because delayed or untreated cases are often fatal.

The hard part about this disease is that doctors need to use patient symptoms to diagnose the disease rather than wait for lab results – which can take weeks to complete.  Public health officials and doctors have worked together to create special protocols in high-risk areas to make sure people who might have been exposed to ticks are treated correctly in order to prevent deaths caused by this disease.

You can take steps to protect yourself, your family, and your pets from Rocky Mountain spotted fever.  Dogs should be treated with tick control products year-round, and pets and people should be checked for ticks after being in rural or wilderness areas.  If ticks are found, they should be removed carefully with tweezers, grasping close to the skin’s surface and to the tick’s mouthparts, and pulling straight up without twisting or jerking.  Weeds and grass should also be trimmed and any debris should be regularly removed to get rid of tick habitats.  If ticks are found around homes, it might be necessary to treat the area with pesticides.

AZ Losing Traction on Vaccine Front

July 21st, 2014

Boy getting an injection.Arizona law requires kids to get certain vaccines in order to attend school unless a doctor signs a medical exemption form or a parent signs a religious or personal belief exemption form.  There’s been an increasing number of parents who are signing personal belief exemption forms- putting herd immunity at risk.

Every year we examine our exemption rates…which gives us information about how we’re doing and where we need to focus our efforts.  This year’s analysis found that exemption rates increased again.  Childcare exemption rates went from 3.8% to 4.1% over the last 2 school years.  Kindergarten exemption rates went from 3.9% to 4.7%.  For some perspective-in 2004 only 1.6% of school kids in Arizona were vaccine exempt.

This year’s report shows a noticeable difference in exemption rates between school types.  Public, charter, and private schools all reported higher exemption rates than last year…but exemptions are much higher in charter & private schools than in public schools.  More than 9% of charter school kindergartners were exempted by their parents.  Likewise, 7.5% of private school kindergartners were exempted by their parents (compared to 3.6% of public school kindergartners).

Over the last 18 months we’ve been working with partners using data collected by the U of A to stem the tide.  Last year’s initiatives included implementation of our Action Plan to Address Vaccine Exemptions which included updating the vaccine exemption form (which reinforces to parents know how important it is to vaccinate their kids and the consequences if they don’t).  The form also makes it clear that if there’s an outbreak of a vaccine-preventable disease in a school and their child isn’t vaccinated, he or she may not be allowed to attend school for up to 3 weeks or until the risk period ends.

We’ve also been working with partners to increase information about what vaccines are needed and how the public can find the needed vaccines easily.  We also created a reference and resource document to help schools and childcare facilities better understand the requirements.  We’ll be analyzing this year’s report to identify additional evidence-based strategies to combat this troubling trend toward lower vaccination rates in our schools.

With school about to start, it’s a great time to make an appointment and talk to your healthcare provider to see if your child needs any vaccinations and pick up a copy of those records for the school.

Long-Term Care Infection Prevention and Control Collaborative

July 18th, 2014

hospital settingOur Licensing, Preparedness and Healthcare-Associated Infections shops joined forces with APIC Consulting Inc. to provide a free day-long event to provide training to skilled nursing facilities about how to prevent  healthcare-associated infections.  The training will be based on the Infection Preventionist’s Guide to Long-Term Care.

The goals are to help healthcare providers to:  1) identify infection prevention challenges in the long-term care setting; 2) teach the basics of infection prevention; 3) better understand the essential components of an effective infection prevention program; and 4) better understand the management of multidrug-resistant organisms.

Infection Preventionists from skilled nursing facilities will learn key concepts and basic principles for infection prevention and how to deliver tools and evidence-based interventions to reduce risk in healthcare facilities…helping us to achieve targeted improvements in public health outcomes as part of our strategic plan.

The 2014 Arizona Long-Term Care Infection Prevention and Control Collaborative is scheduled for today at the Black Canyon Conference Center.  The event will highlight Division of Licensing data and opportunities, ADHS Outbreak and Exposure Protocol, surveillance, isolation precautions, seasonal influenza, best practices to prevent infections, environment and equipment to name a few.  It’s a great opportunity for you to connect with partners and exchange information and knowledge of current infectious disease topics.

Ladders: Useful But Potentially Hazardous

July 11th, 2014

ambulanceI’ve fallen off ladders at my house twice in the last month which has inspired me to do a post about falls and injuries. The #1 reason people show up in Arizona emergency rooms is from slipping, tripping or stumbling on something.  Falls are the #2 cause of accidental death in Arizona…with 870 deaths recorded last year (overdoses from prescription painkillers is the leading cause of accidental death). Last year there were 122,187 visits to AZ emergency departments from falls.  According to the CDC 20% – 30% percent of people who fall suffer moderate to severe injuries such as fractures, head traumas and lacerations.

Ladder falls are a persistent source of injury in many jobs and in the home. Falls are the number one cause of construction-worker fatalities, with falls from ladders a common yet preventable construction injury.  Health services and the wholesale and retail industries have the largest number of non-fatal fall-related injuries.

Ladder accidents are common during home maintenance and repair when people access higher places in the home such as cutting away trees and prepping for the monsoon season (I fell while turning off my cooler for the season and trimming mesquite branches off of our internet connection wire). It’s no surprise that in Arizona men between 45 and 65 are responsible for 77% of ladder falls (so I’ve done my part for the year).

The National Institute for Occupational Safety and Health released its first smart phone app for mobile devices aimed at improving extension ladder safety by providing real-time safety information delivered via the latest technology.  The AZ Stop Falls Coalition helps coordinate existing efforts, provides technical assistance and increases the opportunities for older adults to enhance their quality of life.  You can also take a look at these tips from the U.S. Consumer Product Safety Commission about how to use a ladder safely… or simply use some good old-fashioned common sense.

Staying Healthy & Reducing Cost- Preventive Health Services

July 10th, 2014

docsIn recent years, a prevention model of health has woven its way into the fabric of traditional models of care. With the passage of the Affordable Care Act the role preventive services has expanded significantly in the US health care delivery system.  Preventive health care services prevent diseases and illnesses from happening in the first place rather than treating them after they happen.

Category A & B” preventive services recommended by the United States Preventive Services Task Force are now included (at no cost to consumers) in all Qualified Health Plans offered on the marketplace. In addition, many employer-based and government-sponsored health plans have included Category A & B preventive services in the health insurance plans they offer to their respective members.

Currently, the United States Preventive Services Task Force recommends 54 Category A & B preventive services that include screening tests, counseling, immunizations, and preventive medications for adults, adolescents, and children.  The Task Force operates within the Agency for Healthcare Research and Quality.  The Task Force consists of a panel of experts representing public health, primary care, family medicine, and academia.  They update the list of recommended services by reviewing best practices research conducted across a wide range of disciplines.

An AZ Monsoon Staple: the Scorpion

July 8th, 2014

Desert Hairy Scorpion (Hadrurus arizonensis).My wife has been disturbed by the number of scorpions she’s seen around our house and garage over the last couple of weeks which has inspired me to do this scorpion post.  Arizona has more than 56 species of scorpions but the bark scorpion is the biggie.  Since you live in the bark scorpion’s territory, you probably have them around or maybe even inside your house or garage too.  The Arizona Poison and Drug Information Center and Banner Good Samaritan Poison & Drug Information Center answer thousands of calls every year about scorpion stings.  Last year they recorded 10,000 scorpion stings in Arizona.  Each year there are about 200 kids in Arizona that need intensive medical treatment.

A recent study by the Banner Good Samaritan Poison and Drug Information Center showed that 33% of scorpion stings happen in the bedroom, 24% in the living room, and 6% in bathroom.  Males tend to get stung more than females and the most common sites of stings are of course hands and feet.

Scorpion stings are super painful but usually don’t require special medical treatment.  Washing the sting area and using a cool compress along with over the counter pain medication handles the injury. The pain and numbness can last several days.  Sometimes a scorpion sting causes severe symptoms that require fast and expert medical care.  Symptoms to look for are difficulty breathing, uncontrolled jerking, drooling and wild eye movements.  Small kids are the highest risk group for severe reactions.

OK… but what should you do in scorpion season?  Here are some simple precautions:

  • Seal cracks at the bottom of your exterior doors;
  • Roll back bed linens and check for scorpions before getting into bed;
  • Shake clothes and shoes before putting them on;
  • Keep clothes off the floor;
  • Move furniture and beds away from the walls;
  • Wear shoes when outdoors, especially at night around swimming pools;
  • Be especially careful of wet/damp towels in the bathroom and pool area; and
  • For infants: move the crib away from the wall and take off any crib skirts that reach to the floor.

While scorpions get into your house, that’s not their natural habitat.  Their natural habitat is in your yard, in bushes, brick wall cracks and in landscaping like that loose brown stuff on palm trees.  Some people say that their scorpion problems are worse after people do yard work which messes up the scorpions natural habitat.

The key to keeping them out of your house is to seal the cracks at the bottom of your doors and keep things like doggie doors shut this time of year.  The bottom line is that the monsoon is the harvest season for scorpions so stay on the lookout.

New Return on Investment Calculator

July 7th, 2014

budgetplanIconHHS’ Agency for Healthcare Research and Quality just released the Asthma Return-on-Investment (ROI) Calculator for exploring potential financial returns from quality improvement and disease management programs for populations diagnosed with asthma. The tool provides estimates based on an analysis of 52 research studies on improving asthma care and what those studies imply for cost savings.

Another return on investment tool accessible via the Agency for Healthcare Research and Quality website is the Center for Health Care Strategies ROI Forecasting Calculator. This Forecasting Calculator provides value by determining the impact investments in program interventions may have on improving health outcomes by understanding the relationships among the intervention, the target population, service utilization, program costs, and discount rates.

These tools pair well with the CDC’s Chronic Disease Cost Calculator.  In addition to providing state-level estimates of medical expenditures and absenteeism costs for asthma, the CDC Version 2 tool can be employed to address other chronic diseases such as arthritis, cancer, cardiovascular diseases, depression, and diabetes.

Combined, these three cost estimate/return-on-investment tools may assist public health departments in capturing the effect the investments they make in public health prevention programming have on improving population health.

Monsoon Food Safety

July 4th, 2014

dust-stormWith the monsoon comes an increase in foodborne illnesses in Arizona.  While outdoor pool parties, barbeques, and family gatherings are cool, it’s important to remember some tips for handling food safely to protect your family and guests from a nasty bout of foodborne illnesses.  According to the CDC, reducing foodborne illness by just 10% would keep 5 million Americans from getting sick each year.

CDC and recommend that you check your steps. Clean, separate, cook, and chill to protect yourself and your family from food poisoning. Visit to see some great videos on each of the steps and follow the tips to keep you and your family safe this summer.  If you’re a thumbnail guy like me, just remember to keep cold foods cold, hot foods hot, and food surfaces and hands clean.

Mankind’s Nemesis- the Mosquito

July 3rd, 2014

fight-the-biteSummer’s here, and we know what that means…West Nile virus season. West Nile virus is most commonly spread by the bite of an infected mosquito. However, not every mosquito can carry West Nile virus. There are 40 different species of mosquitoes in Arizona, but only 2 transmit West Nile virus (WNV) to humans effectively, Culex tarsalis and Culex quinquefasciatus (try saying that 3 times fast).

The more we know about what they like to eat and where they breed, the better our prevention measures can be to stop the transmission of West Nile virus. Both species like to feed on birds and humans between the hours of dusk and dawn, and they like to lay their eggs in waters ranging from waste water areas to bird baths, old tires, or any container that holds water. If the water evaporates (or is poured out) before the eggs hatch or the larvae complete their life cycle, then they die.

Last year, we didn’t have very many West Nile virus human cases compared to previous years. However, about 80% of people infected with West Nile virus do not develop any symptoms and those cases don’t get counted. 1 in 5 people who catch West Nile virus will develop a fever and possibly other flu-like symptoms. Less than 1% of people who are infected with West Nile virus will get neurological symptoms.

The most severe form of the disease, called West Nile neuroinvasive disease is rare.  Last year Arizona was one of the states with higher rates of the most severe form. The risk of developing the neuroinvasive form of West Nile virus greatly increases with age. For the younger people, less than 1 in 700 will develop neurological symptoms, but it’s 1 in 50 in people over 60.  Underlying health conditions such as hypertension, diabetes, cancer, and renal disease can also increase the risk of developing the more severe form. About 10 percent of people who do develop West Nile neuroinvasive disease will die. This is why avoiding mosquito bites, mosquito-proofing your home, and eliminating breeding sites for mosquitoes is so important. Fight the bite, Arizona.

FDA Extends E-cigarette Regulation Comment Period

July 1st, 2014

Hand with electronic cigaretteIn April the FDA released proposed regulations for electronic cigarettes and asked for your input.  Last week it extended the comment period by 30 days. The proposed rule focuses on FDA’s regulatory approach to electronic cigarettes and other tobacco products, proposed options for the regulation of cigars, pathways to market for proposed deemed tobacco products, and compliance dates for certain provisions, among other issues.

The proposed new regulations wouldn’t restrict or ban the sale of fruit and chocolate flavored e-cigarettes that some believe are designed to attract and hook young people. They also wouldn’t restrict TV advertising or online sales. People and organizations can submit comments electronically through
August 8.