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HomeMy WebLinkAbout1997/04/03 - Board of HealthMASON COUNTY BOARD OF HEALTH April 3, 1997 The Board of Health was called to order at 10:00 a.m. by Board Member Olsen with Board Member Bolender in attendance. ATTENDANCE: Cindy Olsen, Board Member John Bolender, Board Member Dr. Mark E. Trucksess, Health Officer Brad Banner, Director of Health Services Steve Kutz, Personal Health Director Carla Huyck, Health Educator Brent Long, Board of Health Clerk CORRESPONDENCE Information dated March 18, 1997, concerning the new Drinking Water State Revolving Fund Program was received from the Department of Health. APPROVAL OF MINUTES Action on the March 6, 1997, meeting minutes was delayed until the May meeting. HEALTH OFFICER'S REPORT Dr. Mark E. Trucksess, Health Officer, presented a communicable disease report for the month of February, 1997. There were two cases of camplyobactor, one case of hepatitis B, one case of pertussis, and one case of rabies which was discussed in detail at the last meeting. There were also six cases of chlamydia which is a sexually transmitted disease. During the month of March, there was one case of pertussis, one case of camplyobactor, and two cases of hepatitis A. Both hepatitis cases were related to the drug -use community, with one receiving exposure through a minor hepatitis A outbreak in Kitsap County. In addition, there were hepatitis B and C cases combined with the hepatitis A cases. It is common for people in the drug -use community to have multiple types of hepatitis. In fact, some people test positive for all three types. Hepatitis A usually lasts for several months and then resolves itself and does not result in any chronic hepatitis or liver disease. On the contrary, hepatitis B and C are both associated with chronic hepatitis, sclerosis of the liver, and with cancer. Children entering school for the first time this fall will be facing new immunization requirements. It is important for parents to get this information now because it takes three doses of hepatitis B vaccine to be fully immunized, and doses are given over a period of six months. Children entering or in sixth grade will be required to have a booster of MMR (measles/mumps/rubella). Pertussis has not been required in the past for children entering school, but it will be now. Even though it was not required, it has been given to children along with their diphtheria and tetanus vaccines. However, if a child has a bad reaction to the pertussis vaccine, the pertussis immunizations are not continued. The newer pertussis vaccine, which is acellular, should not cause a reaction. Unfortunately, this vaccine costs more and is not generally used. The state will MASON COUNTY BOARD OF HEALTH April 3, 1997 - Page 2 of 4 begin using this vaccine as soon as it becomes practical to do so. Most cases of active pertussis, in the last couple of years, have been seen in adults. It appears that the immunizations wane with time. Health specialists are speculating about giving adults a booster dose of the acellular vaccine. In response to a question posed to the Board earlier, Dr. Trucksess explained that the Center for Disease Control can verify which animal transmitted rabies to a human. Each rabies virus is specific to a species because the protein sequencing on the surface of the virus is different for each species. Even if a bat bit a dog and the dog became infected and bit a human, it could still be traced back to the bat. The two human cases of bat rabies in Washington State since 1995 were not associated with any obvious bite. This is a new phenomenon in terms of rabies. In the 1930's there were over 1,000 dogs tested positive for rabies. Since 1960, no dogs have tested positive for rabies in Washington State except for dogs acquiring the virus out of state. Likewise, no cats have tested positive since the late 1970's. The last cat tested positive in Mason County was in 1976. Bats are the only known source of rabies in this county. There may be some transmission of rabies through the air. This has been proven to occur but only in very specific circumstances. One such circumstance is in a popular spelunking cave located in Texas. It is suspected that spelunkers have contracted the virus after investigating the cave which is heavily infested with bats, even though they have no recollection of having been bitten: A dog and a cat were placed in a cage with fine mesh and lowered into the cave. The mesh of the cage did not allow bats to bite the animals, but both animals died of rabies. This has proven that rabies can be transmitted via the air to humans under special circumstances. In Eastern Washington, during the past month, several bats were brought to school for show -and - tell. A number of children handled the bats which required all the children to receive rabies prophylactic. It is important for a community to know that bats are dangerous from the standpoint that people are getting rabies without clearly knowing how. Mr. Kutz commented that there are potential financial implications to the health department and the county revolving around these issues. Treatment is expensive, and not every one has billable insurance. Not only would there be vaccine costs, but also significant staff time would be required. Dr. Trucksess noted that if a person is exposed, they would receive rabies immune globulin which is an antibody which gives them passive immunity for a short period of time to help prevent them from getting rabies. The second part would be the regular vaccination against rabies to stimulate a person's immune system to be immune to rabies. The immune globulin is one dose. The other is a series of five shots over a period of 28 days. These are given inter -muscularly and are not as painful as they once were. In regards to unexpected costs that a health department may have to assume, an article in the Tacoma News -Tribune this date, related a story of a Thurston County man jailed because he refused to take his tuberculosis therapy. The only way to control this man was to put him in jail. The cost to the Thurston County Health Department is $68 a day for this man's internment in jail MASON COUNTY BOARD OF HEALTH April 3, 1997 - Page 3 of 4 while he receives treatment for tuberculosis. Mr. Kutz stated that the outreach nurse attempted therapy. A motel room was even rented for this person in order to give him a place to receive treatment. In spite of this, the individual left the motel and an alert was issued. The Thurston County Health Department was facing thousands of dollars of potential liability. Pursuant to state law, counties are responsible to ensure that these people receive treatment. Dr. Trucksess commented that there is a possibility that this could happen to any county at any time. A non -compliant patient who refuses to take their anti -tuberculosis medicine means that the community has to be protected from that individual. The policy here has been that if someone is suspected of having tuberculosis, staff attempts to have them remain in their own home and the patient is visited there for diagnostic work up. Protective gear would be worn by the health professional. If a person has active TB, the only other alternative is to have the patient placed in a special room designed for this purpose at St. Peters Hospital. The price tag for this room is about $1,000 per day, at the minimum. Treatment would last a minimum of two weeks. After discharge, therapy is needed for an extended period of time, usually a year. The patient would be seen once a week for their medicine or the medicine would be brought to them at their house. The health department would be responsible for bearing the cost if the person was indigent. Board Member Bolender wondered why a person would refuse treatment. Mr. Kutz replied that many times these people are homeless, perhaps on alcohol and/or drugs, and may have an inability to reason. Board Member Olsen asked if the hepatitis A outbreak seen recently in school lunch programs affected any Washington State schools. Mr. Kutz replied that sales of the affected strawberries had not been tracked to our state. Mr. Banner agreed, noting that the outbreak had been isolated. DECLARATION OF PUBLIC HEALTH WEEK Brad Banner, Health Services Director, announced that April 7 through 13 has been designated as National Public Health Week. The theme for 1997 is "An Investment in Your Future." A special Proclamation was read aloud by Mr. Banner which urged Mason County citizens to join in the observance of Public Health Week by seeking knowledge and understanding of public health care. Board Members Bolender/Olsen moved/seconded that the Board sign the Proclamation declaring April 7 through 13, 1997 as Public Health Week. Motion carried. Vote: B: yes; O:yes; C:absent. HEALTH EDUCATOR INTRODUCED The newly hired Mason County Health Educator, Carla Huyck was introduced to the Board by Mr. Kutz. Ms. Huyck has been a Health Educator with Grays Harbor County for the past six years, and comes to Mason County highly recommended. OTHER BUSINESS Board Member Olsen called for other business. Mr. Banner submitted copies of waivers to the Board. MASON COUNTY BOARD OF HEALTH April 3, 1997 - Page 4 of 4 MEETING ADJOURNED Board Members Olsen/Bolender moved/seconded that the Board of Health meeting be adjourned at 10:28 a.m. Motion carried. Vote: O:yes; B:yes; C:absent. MASON COUNTY BOARD OF HEALTH (absent) Mary Jo Cady, Chairperson a-Cw.6 John Bolender, Board Member u Cindy 0 en, Board Member Respectfully submitted, Lorraine Coots