; Iowa flu season arrives with a vengeance
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Iowa flu season arrives with a vengeance


  • pg 1
									                  IOW A           D E P A R T ME N T                OF     P U B LIC        H E A L TH

                             Iowa Health

 January 2004
                                              focus                                              WWW.IDPH.STATE.IA.US

Iowa flu season arrives with a vengeance
By Sarah Brend, MPH, Epidemiologist, Center for Acute Disease Epidemiology

        he flu season arrived
        in Iowa and the
        United States this
year earlier and with much
more severity than ex-
pected. Iowa reported its
first confirmed case of influ-
enza for the season on No-
vember 17. Since then, in-
fluenza has swept across
the state affecting people of
all ages. Iowa, along with
41 other states, is reporting
widespread influenza activ-
     Since October 1, the        Telling Iowans about the flu
University Hygienic Labora-              From left, Dr. Ray Webster, Principal Financial Group, Dr. Mary Davis, Wellmark
tory (UHL) in Iowa City has      Blue Cross and Blue Shield of Iowa, Tim Gibson, John Deere Health Care, Dr. Mary Min-
confirmed 188 influenza          cer Hansen, director of the Iowa Department of Public Health, Dr. Tom Boo, Iowa Depart-
cases through culture tests.     ment of Public Health/Centers for Disease Control and Prevention, and Sally Cunning-
All have been Influenza A        ham, Iowa Department of Human Services talk to the press last month on the flu in Iowa.
viruses, and 39 were sub-
typed as Influenza A               influenza tests in physicians’ offices and       that one of the strains of influenza in the
(H3N2) viruses. These are          are never reported to the state health           vaccine (A/Panama[H3N2]) does not
confirmed cases by UHL             department because influenza is not a            exactly match the strain circulating in the
only and is an underesti-          reportable disease in Iowa.                      United States (A/Fujian[H3N2]). Health
mate of the number of                   Like every year, this year’s influenza      officials do expect that the current influ-
cases in Iowa. Most cases          vaccine protects against three types of          enza vaccine will offer some cross-
are identified through rapid       influenza. Some media reports mention            protective immunity against the A/Fujian

Domestic violence movie trailer big success
                                                                                                      Inside this issue:
By Binnie LeHew, Violence Prevention Coordinator

                                                                                                     JEL observes          3
       he Domestic Vio-            and domestic violence pro-        around the state.               Great American
       lence movie trailer         gram staff were overwhelm-             In Davenport, domestic     Smokeout
       campaign                    ingly positive about the im-      violence prevention advo-       Report highlights     4
(highlighted in                                   pact of the        cates conducted a patron        nursing trends in
the October                                       trailer,” said     survey as moviegoers ex-        Iowa
2003 FOCUS)                                       Laws. The          ited a theater where the
was a big suc-                                    movie trailer      trailer was showing. The        Public health pulls   6
cess, reports                                     was a power-       vast majority of patrons re-    together to stop
project manager                                   ful public ser-    ported it got their attention   measles
Lynn Laws.                         vice announcement that ran        and they would use the in-
                                   throughout October in 48                                          Hepatitis A declin- 7
     “Surveys of movie pa-                                           formation to help someone       ing but still danger-
trons, theater managers,           participating movie theaters
                                                                         Continued on Page 2         ous
Iowa flu season arrives with a vengeance
By Sarah Brend, MPH, Epidemiologist, Center for Acute Disease Epidemiology
Continued from page 1                      due to illness. We have also been         nesses, long-term care facilities,
strain, as well as providing good pro-     informed of several influenza out-        day-care centers, health-care and
tection for the other two strains of flu   breaks in long-term care facilities. In   EMS settings, and schools. These
(A[H1N1] and B) found in this year's       December alone, there were over           recommendations, along with maps
vaccine and circulating in the United      250 reports from schools with absen-      and reports of Iowa’s current influ-
States. It is not yet known, which         tee rates greater than 10 percent         enza activity, can be found at
influenza A (H3N2) is circulating in       due to illness. Some schools have         http://www.idph.state.ia.us/eedo/flu.a
Iowa.                                      even closed because of illness.           sp . For additional information visit
                                                The Center for Acute Disease         the CDC's website at
    Since the first influenza case
                                           Epidemiology has developed recom-         http://www.cdc.gov/flu/ . For flu infor-
was identified, IDPH has received
                                           mendations to help stop transmis-         mation in Spanish, go to the CDC's
numerous reports from schools
                                           sion of influenza in several different    web site en Español:
across the state reporting an absen-
                                           settings, including at home, at busi-     http://www.cdc.gov/spanish/default.h
teeism rate greater than 10 percent
                                                                                     tm .

 Domestic violence movie trailer big success
 By Binnie LeHew, Violence Prevention Coordinator
 Continued from page 1                         “If this type of support had been     use the trailer from the Wisconsin
they knew who might be in an abu-          available [years ago], maybe my           Women’s Foundation, which origi-
sive relationship.                         mother would still be alive…Family        nally developed it. If additional funds
                                                              and a ‘close’ friend   are available, another run of the an-
    In some                                                   turned my mother       nouncement may be scheduled this
theaters, do-                                                 down, [telling her]    spring or summer.
mestic vio-                                                   ‘you need to work it
lence pro-                                                                                If you have concerns or ques-
                                                              out….’ I am glad to    tions about domestic abuse, please
gram staff                                                    see now there is
overheard                                                                            contact the Iowa Domestic Violence
                                                              help for victims of    Hotline at 1 (800) 942-0333. For
positive com-                                                 this kind of abuse.”
ments from                                                                           more information about the movie
audience                                                     While the majority      trailer project, contact IDPH at (515)
members, including one person who          of comments were positive, there          281-5032 or ble-
clapped at the end of the trailer. A       were a few negative comments              hew@idph.state.ia.us.
majority of the anecdotal comments         about the “bias” that men are
received were positive, and several        the primary perpetrators of
indicated that the movie trailer had a     domestic abuse. As explained
direct impact on their own lives.          in the movie trailer brochure,
                                           the majority of perpetrators are
     In one case, a young woman            male.
who had seen the trailer was later
able to recognize “controlling” behav-         The domestic violence
iors in her boyfriend, like the ones       movie trailer project was a
highlighted in the announcement.           partnership among IDPH, Veri-
Another person wrote IDPH saying,          zon Wireless, and the Iowa
                                           Coalition Against Domestic
                                           Violence. Iowa bought the rights to

                                  Obtaining Past Issues
        Back issues of Iowa Health FOCUS are available on the Iowa Department
        of Public Health web site at www.idph.state.ia.us. The link is under Quick
        Links on the right side of our home page under Publications & Data.

                                                                                                                      Page 2
JEL observes Great American Smokeout
By Randi Huffman, JEL Coordinator

       ach year, the American Can-     moted Quitline Iowa, Iowa’s toll-free   strong tobacco control youth group
       cer Society holds its nation-   tobacco cessation hotline.              along with a comprehensive tobacco
       wide Great American Smoke-           “Many Iowa teens encounter         control program such as Iowa’s.
out. The event promotes quitting       nicotine addiction and don’t know            The Quitline Iowa is free and
among current tobacco users as well    where to find help,” said Kassie        available seven days a week. All
as cessation services locally and      Hobbs, JEL executive council mem-       calls are confidential. You may reach
statewide, and the importance of       ber. “JEL youth from all over Iowa      Quitline Iowa at 1-866-U-CAN-TRY
maintaining smoke free establish-      can promote the Quitline Iowa, not      (1-866-822-6879).
ments.                                 only at the state level but through
      On November 20, many Des         JEL, which is at the local level.”
Moines area residents woke up to            Youth engagement is important
tobacco control messages at busy       to reduce tobacco
traffic areas and pedestrian walk-     use within the state
ways. Over 60 members of Just          and nationwide.
Eliminate Lies (JEL) marched to        Data show that to-
Nolan Plaza during a Thursday lunch    bacco use among
hour. They handed out flyers with      youth decreases
hard candies attached, which pro-      when there is a

                                                                                                              Page 3
Report highlights nursing trends in Iowa
By Eileen Gloor, Center for Health Workforce Planning, Bureau of Health Care Access

      he number, age and education       practitioners.                             unprecedented need to recruit and
      of nurses in Iowa have                  Reflecting national trends, it is     retain qualified faculty members to
      changed over the past 20           likely that the need for nurses in         accommodate increasing enroll-
years. Trends provide important in-      Iowa will peak between 2008 and            ments in Iowa’s 77 programs. They
formation about the work force re-       2010 when many experienced                 include: 1 doctoral, 4 post-
quired to meet the health needs of       nurses will retire.                        master’s/academic master’s, 1 pro-
Iowans. The Center for Health                                                       fessional master’s, 13 baccalaure-
Workforce Planning has posted on              The largest percentage of both        ate, 26 associate degree and 28
the IDPH web site a report that de-      RNs and LPNs in Iowa are between           practical nursing.
scribes the changing registered          43 and 52 years of age. Sixty per-
                                         cent of licensed RNs who are active             In 2003, the nursing programs
nurse (RN) and licensed practical                                                   reported over 70 faculty vacancies in
nurse (LPN) work force.                  are 43 years of age or older. Fifty-
                                         six percent of licensed LPNs who are       the areas of medical, surgical, pedi-
    In a series of 17 charts and         active are 43 years of age or older.       atric, obstetric, mental health, geriat-
graphs, the report provides a visual                                                ric, community health and critical
history of nursing. The information is       Between 1986 and 2002, an in-          care nursing. Because eight stu-
being used to compare Iowa RN and        creasing number of RNs received            dents are generally assigned to a
LPN data with national projections       associate or baccalaureate degrees         single faculty member, vacant faculty
and develop recommendations for          prior to licensure. While the greatest     positions may exclude as many as
policy change. The report is avail-      increase was found among those             560 students from clinical courses.
able to the public at                    who earned an associate degree in
                                         nursing, Iowa nurses continue to pro-           Important recommendations for
    http://www.idph.state.ia.us/ch/      gress steadily in receiving baccalau-      policy change and legislative action
PDF/workforce/nursing_trends.pdf         reate, masters and doctoral degrees.       have come from the trend report.
    The number of RNs increased                                                     They address loan repayment pro-
                                              The number of graduates from          grams, faculty preparation, recruit-
from 29,649 in 1986 to 38,137 in         nursing programs in Iowa declined in
2002. The trend reflected steady                                                    ment of under-represented racial and
                                         the late 1980s. An increase in the         ethnic minorities into the nursing field
growth until 2000. Between 2000          early 1990s peaked for both RNs
and 2002, there was a net loss of                                                   and opportunities to impact eco-
                                         and LPNs in 1995 and 1996. After           nomic development in Iowa. The
702 RNs. The number of LPNs de-          another decline, the number grew
creased from 10,435 in 1986 to                                                      recommendations are available in
                                         again in 2001. During the last year,       white papers and issue briefs posted
9,622 in 2002, a net loss of 813.        1,835 students were admitted to
Included in these numbers are over                                                  on the center web site at
                                         Iowa RN programs, a 27 percent             http://www.idph.state.ia.us/ch/health
600 people who hold both RN and          increase over the previous year.
LPN licensure.                                                                      _care_access_content/workforcesho
                                         During the same time, 1,426 stu-           rtage/reports.htm For more informa-
    The number of Advanced Regis-        dents were admitted to LPN pro-            tion, contact Eileen Gloor at (515)
tered Nurse Practitioners (ARNP) in      grams, an increase of 12 percent           281-8309 or egloor@idph.state.ia.us.
Iowa increased in all categories be-     over the previous year.
tween 1986 and 2002. The greatest            This growth has given rise to an
increase occurred among nurse

                                                             Hochstedler wins excellence award
                                                                    Beth Hochstedler was awarded the Board of
                                                                Regents Staff Excellence Award at the University
                                                                of Iowa.
                                                                    Beth has worked with the Iowa Department of
                                                                Public Health on Bioterrorism and the Governor’s
                                                                Conference on Public Health, Barn Raising III
                                                                and IV.
                                                                    At left is Mary Gilchrist, director of the Univer-
                                                                sity of Iowa Hygenic Laboratory, Beth, and David
                                                                Skorton, president of the University of Iowa.

                                                                                                                    Page 4
Prepare Iowa offers innovative online training
By Debra Venzke, Office of Communications, The University of Iowa College of Public Health

       o respond to emerging health       and track courses completed and          to-face trainings to strengthen skills.
       threats ranging from SARS to       training programs attended. The sys-          The system can be accessed 24
       bio-terrorism, public health       tem is a joint effort of the Iowa De-    hours a day, and students are able
workers require ongoing training. But     partment of Public Health and the        to work at their own pace, taking up
finding the time, and the budget, to      Iowa Center for Public Health Pre-       to six months to complete a class.
attend courses can be a challenge.        paredness at the University of Iowa      Current course topics focus on bio-
     For many, distance learning of-      College of Public Health.                terrorism/emergency preparedness
fers a convenient                                                                                  and core public health
and economical way                                                                                 competencies. Other
to fulfill continuing                                                                              competency areas will
education needs. A                                                                                 be added as the sys-
new tool, the Pre-                                                                                 tem expands.
pare Iowa Learning                                                                               Prepare Iowa invites
Management Sys-                                                                                  you to explore this
tem, now offers                                                                                  innovative system
Iowa’s public health                                                                             designed to enhance
work force an online                                                                             professional skills and
training and educa-                                                                              knowledge in public
tion resource for pro-                                                             health readiness.
fessional development.                          Once registered with the Prepare
                                          Iowa web site, users fill out a self-         For more information, contact
    Located at                                                                     Tim Beachy, Iowa Center for Public
www.prepareiowa.com, the Prepare          assessment on selected public
                                          health competencies. Based on that       Health Preparedness, at (319) 353-
Iowa Learning Management System                                                    5955 or tim-beachy@uiowa.edu; or
allows users to assess their compe-       assessment, the system generates a
                                          list of recommended courses from         Dena Fife, Iowa Department of Pub-
tency in various areas of public                                                   lic Health, at (515) 242-5165 or
health, enroll in online courses, ac-     the course catalog. Users can enroll
                                          in these online courses or find face-    dfife@idph.state.ia.us.
cess a calendar of training events,

Comprehensive cancer control working to fight obesity
By Heidi Petersen, Mercy Cancer Center-Des Moines

          besity increases the risk of         The Obesity Prevention Imple-       obesity and cancer risk along with
          some cancers in both men        mentation Group of the Iowa Consor-      healthful lifestyle hints will be devel-
          and women. Increasing evi-      tium for Comprehensive Cancer            oped by the workgroup. The sheets
dence particularly links obesity to the   Control is working to address this       will be distributed to the team cap-
risk of post-menopausal breast can-       problem. The group is composed of        tains for Lighten Up Iowa.
cer, and also supports increased risk     33 people representing cancer cen-            Another project that the Obesity
of cancers of the colon, prostate,        ters from across the state, the Iowa     Prevention Implementation Group is
endometrium, kidney and esophagus         Department of Public Health, Iowa        working on is a packet of information
(AICR, 2001).                             State University Extension, Iowa         to be provided to family-care physi-
     Compared to other states, obe-       Parish Nurse Association, Ecumeni-       cians. The group is partnering with
sity is a significant problem in Iowa.    cal Ministries of Iowa, and others.      the Iowa Dietetic Association on this
There are only 11 states with higher           The goal is to support Lighten      project.
obesity rates than Iowa. Data from        Up Iowa, a statewide campaign to              For more information on the
the 2001 BRFSS show that almost           reduce the prevalence of overweight      Obesity Prevention Implementation
23 percent of Iowans are obese,           and obesity among Iowans by in-          Group of the Iowa Consortium for
higher than the national median of        creasing physical activity and im-       Comprehensive Cancer Control,
21 percent. An additional 37 percent      proving food choices. Registered         please contact Heidi Petersen at
of Iowans are overweight.                 dietitians from cancer centers across    515-643-8206 or
      The percentage of Iowans who        Iowa will be promoting the Lighten       hpetersen@mercydesmoines.org.
are overweight and obese has stead-       Up Iowa program within their institu-
ily increased over the past 10 years.     tions.
                                               An informational sheet linking

                                                                                                                    Page 5
Public health pulls together to stop measles
By Patricia Quinlisk, State Epidemiologist and Terri Thornton, Nurse Consultant for Immunization

         t 1:30 pm on December 24,        an easy task because the people            to vaccinate them also. They were
         the Chicago Department of        from these groups were either not at       also asked to educate everyone on
         Public Health (CDPH) con-        home, were out shopping, or had            the signs and symptoms of measles.
tacted the Iowa Department of Public      already traveled to another state to            In all, six doses of MMR were
Health regarding a measles investi-       celebrate Christmas with relatives.        given. IG was ready but not needed
gation.                                        Meticulous work by local public       due to the quick investigations at the
      A 6-month-old female adoptee        health also found that another per-        local level. Incubation period for
arrived at Chicago O’Hare airport         son from Iowa was on the plane, not        measles is about 7-18 days, usually
from Frankfurt, Germany on Decem-         listed on the plane roster. (This is a     14 days. We will continue to be on
ber 21 and was confirmed with mea-        good reminder of why it is so impor-       heightened surveillance for two incu-
sles (with a positive IgM test) on De-    tant to fill out those personal informa-   bation cycles.
cember 23. She had been experienc-        tion cards that the airlines give you           Measles should be suspected if
ing rash since December 17, with          when you board for an international        anyone has the three “C”s (cough,
cough and runny nose. On examina-         flight!)                                   coryza - a runny nose - and con-
tion on December 22, the Koplik                Since we were not sure that all       junctivitis) and a rash. If suspected, a
spots were not seen, and tempera-         the people in these groups would be        measles IgM test should be done
ture was only 99.6 F, but the clinician   located before the 72-hour window of       quickly via the University Hygienic
felt fairly certain this was measles.     opportunity for vaccination closed,        Lab. It is free of charge to the pa-
      The child’s final destination was   immuneglobulin (which can be used          tient, and the patient should be told
Milwaukee. The investigation started      for prophylaxis for up to 6 days after     to stay home until results are avail-
with locating all persons aboard the      exposure to measles) was hand-             able. It usually takes a couple of
international flight with the child.      delivered to two local health depart-      hours once the blood arrives at UHL.
Three Iowa parties, from Perry,           ments, Perry and Waterloo. Finding              All suspected cases should be
Sioux City and Waterloo, were noted       people on Christmas Eve to drive the       Immediately reported to your health
on the air carrier manifest.              IG to the health departments was           department. IDPH can be reached
      County health departments re-       “interesting,” but we had an amazing       24 hours a day, 7 days a week at 1-
sponded quickly to locate these           number of volunteers.                      800-362-2736.
groups. That was important since it            Local public health personnel              IDPH thanks all the local health
was still in the 72-hour window when      were also asked to determine               department personnel and the dis-
prophylactic measles vaccination          whether all family members who de-         ease prevention specialists who
would be effective in stopping the        veloped measles had either two             worked so hard on Christmas Eve to
contacts from coming down with            documented doses of MMR or a               ensure the health of these Iowans
measles (if they were not already         good history of measles, and deter-        during this public health emergency.
immune - i.e., either had two doses       mine who might be exposed to the
of measles vaccine already or had         members of the groups on the
already had measles.) This was not        planes. If needed, they were asked

Buena Vista County department gets big award
By Cheryl Lyon, Buena Vista Cancer Awareness and Screening Project Coordinator

      he Buena Vista Cancer and           link women with a primary medical          than a 12th grade education. In ad-
      Awareness Screening Project         provider for continued care.               dition, the incidence of breast cancer
      coordinated by the Buena                 Research shows that minority-         in the county is reported to be 107.8,
Vista County Public Health Depart-        status, low income, and low educa-         well above the state rate of 86.5
ment was awarded a $47,083 Well-          tion levels are factors in failure to      (rate of 1 per 100,000 population,
mark Foundation grant in December         seek routine cancer screening. Ap-         Facits 2000). A significant number
2003.                                     proximately 1,200 Hispanic women           of women in the county fall into these
    This project is designed to pro-      and 850 Asian women live in Buena          categories that are factors in failure
vide free pap smear and mammogra-         Vista county, and nearly 35 percent        to seek routine cancer screening.
phy screening to 100 underinsured         of households report an annual in-              The partner organizations in this
and uninsured women between the           come below $25,000 (Census 2000).          grant will be working to link the par-
ages of 40 and 55 years, in addition           Almost 20 percent of the popula-      ticipants with a primary care pro-
to educational opportunities through-     tion of Buena Vista county has less        vider, a key to assuring continued
out the county. The grant will also                                                  health care.

                                                                                                                      Page 6
Hepatitis A declining but still dangerous
 By Judy Goddard, Center for Acute Disease Epidemiology

       fter a spike in cases between
       1996 and 2000, the incidence
       of hepatitis A in Iowa has re-
mained steady. However, it remains
a common infectious disease that
                                                      Reported Cases of Hepatitis A,
can often be avoided by simple,
practical steps.
                                                            Iowa 1994-2003
     Hepatitis A is a liver disease                600
caused by the hepatitis A virus. The
virus is spread from person to per-                500                                490
son by fecal-oral transmission, plac-
ing something in the mouth that is                 400                                        400
contaminated with the stool of a per-                                         346
son with hepatitis A. A person with                300
hepatitis A virus infection can cause              200
infection in others from the latter half                                                              161
of their incubation period to a few                100               106
days after yellowing of the skin and                         64                                               67              72
                                                                                                                      41             39
eyes has developed.                                  0
     Most infections result from con-                    1994     1995     1996     1997    1998    1999    2000   2001    2002    2003
tact with a household member or sex
partner who has the hepatitis A virus
infection. The average time from ac-           Source: IDPH
quiring the virus to symptoms of dis-                                                                countries with high rates of hepati-
                                           reported, the person is interviewed
ease (incubation period) is 28 days.                                                                 tis A, such as those located in Cen-
                                           by a local public health agency.
This ranges from 15-50 days.                                                                         tral or South America, the Carib-
                                           Family members and other at-risk
    Because of the long incubation         contacts are offered immune globu-                        bean, Mexico, Asia (except Japan),
period, many individual cases cannot       lin to decrease their risk of develop-                    Africa, and southern or eastern
be traced back to a definitive expo-       ing disease.                                              Europe. The vaccine series should
sure. Large outbreaks are usually                                                                    be started at least one month be-
                                               To be effective this must be
due to a food that is not cooked and                                                                 fore traveling. People who live in
                                           done within 14 days of their expo-
has been contaminated with the                                                                       communities that have prolonged
                                           sure. If a reported person is a food-
stool of an infected food preparer,                                                                  outbreaks of hepatitis A should get
                                           service worker, health or day-care
thus potentially putting large num-                                                                  hepatitis A vaccine.
                                           provider, more information is gath-
bers of people at risk.                                                                        •     People who live in communities
                                           ered to decide if additional contacts
    Persons with hepatitis A virus         need to receive immune globulin.                          with high rates of hepatitis A: for
infection may not have any signs or                                                                  example, American Indian, Alaska
                                               To prevent hepatitis A, always
symptoms of disease. As long as                                                                      Native, and Pacific Islander com-
                                           wash your hands after using the
asymptomatic person practices good                                                                   munities and some religious com-
                                           bathroom, changing a diaper, or be-
hand hygiene it would be unlikely                                                                    munities.
                                           fore preparing or eating food.
they would spread the disease to
                                                Two products can be used to                    •     Men who have sex with men.
                                           prevent hepatitis A virus infection.                •     People who use street drugs.
     If symptoms are present they
                                           Immune globulin can be given within
usually come on quickly and may                                                                •     People with chronic liver disease.
                                           14 days of a person’s exposure to
include fever, tiredness, loss of ap-                                                          •     People who receive clotting factor
                                           hepatitis A to decrease their risk of
petite, nausea, abdominal discom-                                                                    concentrates.
                                           developing disease. Hepatitis A vac-
fort, dark urine and yellowing of the
                                           cine can be given to people 2 years
skin and eyes (jaundice). A blood
                                           of age or older who wish to lower                        Two doses of the vaccine, given
test for hepatitis A Iantibodies is nec-
                                           their risk of getting disease. It is rec-           at least six months apart, are needed
essary to know if symptoms are be-
                                           ommended for:                                       for lasting protection. Hepatitis A vac-
ing caused by the hepatitis A virus.
                                                                                               cine may be given at the same time as
   Hepatitis A is a reportable dis-                                                            other vaccines.
                                           •   People traveling or working in
ease in Iowa. Once the disease is

                                                                                                                                          Page 7
Epidemiology Notes
From the Center for Acute Disease Epidemiology, Iowa Department of Public Health, 1 800 362-2736 (24-hour number)

      A Big “Thank You” from the                detect or provide alert for CO.         halt the epidemic of obesity in this
Staff of CADE:                              •   Tree decorations pose multiple          country.’ He noted that nearly two
      CADE would like to formally thank         hazards including bubble lights         out of three adults are overweight
all health-care workers in Iowa, in-            (filled with alcohol or other sol-      and that parental obesity is a strong
cluding physicians, nurses, clinics,            vents), ornaments (can cause            predictor of childhood obesity. Dr.
local health department, hospitals,             choking and/or intestinal block-        McGinnis also noted that it is critical
schools and laboratorians, for report-          age), and snow sprays (contain          for doctors to be skilled in obesity
ing diseases and assisting in public            chemicals that are harmful when         prevention, screening, and treat-
health responses. It goes without               inhaled). To prevent children and       ment.
saying that nothing much can happen             pets from these hazards, place               As part of a major campaign in
here on our end without your help.              small ornaments higher on the tree      Iowa, the Iowa Department of Public
      Don’t hesitate to call with sugges-       and store snow sprays out of reach      Health is urging physicians to rec-
tions if we can be of additional ser-           of children and use in well-            ommend their patients join a Lighten
vice. The toll free telephone number            ventilated areas. If small children     Up Iowa team to increase their
is 800- 362-2736.                               are in the house, consider not us-      physical activity and improve their
      Seasonal Hazards from the                 ing bubble lights.                      diet. The program is a partnership
Iowa Statewide Poison Control                                                           between the Iowa Department of
Center “Top Ten” List:                      •   Antifreeze / deicers contain the
                                                                                        Public Health, the Iowa Games, and
                                                highly toxic chemicals methanol
      The Iowa Statewide Poison Con-                                                    Iowa State University Extension.
                                                and ethylene glycol. Ingestion of
trol Center has compiled a “Top Ten”                                                    The web site for Lighten Up Iowa is
                                                very small amount may be life
list of hazards that are most fre-                                                      www.lightenupiowa.org.
                                                threatening and require rapid diag-
quently involved in poisonings during                                                        BSE or “Mad Cow Disease”
                                                nosis and treatment. Store out of
the winter months. Some of the haz-                                                     web sites:
                                                reach of children and use appropri-
ards included are:                                                                           Here are web sites to access
•   Ice melting salt, which may pro-                                                    information on the BSE investiga-
                                                If you need information about any       tion:
    duce poisoning especially in            product or suspect a poisoning has
    young children. Store out of                                                        DOH www.doh.wa.gov
                                            occurred, contact the Iowa Statewide
    reach of children and use appro-                                                    USDA www.usda.gov
                                            Poison Control Center at 800-222-
    priately.                               1222.                                       FDA
•   Plants including Holly, Mistletoe,                                                  www.fda.gov/oc/opacom/hottopics/b
                                                  Clinical Resource on Managing
    Jerusalem cherry, and Rhododen-                                                     se.html
    dron can be toxic and if ingested,           The AMA has announced the re-          CDC
    warrant a call to the poison con-       lease of a new comprehensive guide to       www.cdc.gov/ncidod/diseases/cjd/cj
    trol center (1-800-222-1222). Dis-      help physicians identify and treat obe-     d.htm
    play these plants out of reach of       sity in their adult patients. The Assess-   WSDA
    children and pets. Poinsettias,         ment and Management of Adult                www.agr.wa.gov/FoodAnimal/Anima
    contrary to popular belief, are not     Obesity Primer for Physicians is now        lFeed/BSE.htm
    toxic.                                  available online at www.ama-
                                                                                        Health Canada www.hc-
•   Carbon monoxide poisoning may           assn.org/go roadmaps.
    mimic the flu with symptoms of               The primer, funded by a grant from     html
    vomiting, headache, malaise, and        The Robert Wood Johnson Founda-
    fatigue. Sources are many and                                                       WHO
                                            tion, was developed in partnership with
    include faulty heating systems,                                                     www.who.int/health_topics/encephal
                                            the US Department of Health and Hu-
    fireplace with faulty flue, and                                                     opathy_bovine_spongiform/en
                                            man Services.
    charcoal and wood burning                                                           Office International des Epizooties
    stoves. Every home should have               Michael McGinnis, MD, MPP, sen-
    a CO detector and alarm; remem-         ior vice president of The Robert Wood
    ber most smoke detectors do not         Foundation, said, ‘This primer is an
                                            important tool in helping physicians

                                                                                                                         Page 8
Des Moines Register features IDPH lead program

        n December 14, the Des             lead poisoning as other children in       •   Ink used on wrappers for candy
        Moines Register had a multi-       the state.                                    or food.
        page special report on lead
                                               The report highlighted sources of     •   Any house built before 1978,
poisoning among Latino children in
                                           lead, where to get help, effects of           which can have lead-based
Iowa. The report included quotes by
                                           lead poisoning, housing factors, and          paint. Houses built before 1960
Rita Gergely, chief of the Bureau of
                                           prevention of lead poisoning.                 have more layers of lead-based
Lead Poisoning Prevention, Connie
Montover, director or the Lead Poi-            Sources of lead include:                  paint than newer houses.
soning Prevention Program in Mar-          •   Folk remedies, including one          •   Lead based paint. Children can
shalltown, Sara Pauley, director of            called Azarcon or Greta, which is         be exposed when they put paint
the Lead Poisoning Prevention Pro-             commonly used to relieve stom-            chips in their mouth, chew on
gram in Crawford County, and Julie             achaches.                                 surfaces painted with lead-based
Curry of the Iowa Department of                                                          paint, or put dusty dirty hands,
Education.                                 •   Spices, fruits or chilies dried us-       toys, bottles or pacifiers in their
                                               ing motors that run on leaded             mouths.
     The report discussed sources of           gasoline.
lead that have made the state’s rate                                                     For more information about lead
of lead poisoning in children four         •   Candies and snacks that some-         poisoning, call the Iowa Department
times the national average. IDPH               times contain powdered chilies.       of Public Health Lead Prevention
estimates that Latino children living      •   Lead-glazed ceramic pots used         Program at (800) 972-2026. Bilin-
in Iowa are twice as likely to have            for food.                             gual representatives are available to
                                                                                     answer questions.

Worth Noting
Advancing Public Health: Meeting the Challenge
         The 2004 Public Health Conference will be held March 30 and 31, 2004 at the Scheman Center in Ames. This
conference is jointly sponsored by the Iowa Public Health Association (IPHA), the Iowa Environmental Health Associa-
tion (IEHA), University of Iowa College of Public Health, Child Health Specialty Clinics, and the Iowa Department of Pub-
lic Health, Bureau of Family Health, Oral Health Bureau, Bureau of Nutrition, Bureau of Health Care Access, and Center
for Local Public Health Services and Health Improvement.
         For more information, please visit www.ieha.net or www.iowapha.org.

Board of Health January 14
          The Iowa State Board of Health will be meeting January 14 at 10 a.m. in the Lucas State Office Building, Des

New grants.gov web site offers one stop when applying for federal grants
         HHS Secretary Tommy G. Thompson has unveiled a single, comprehensive web site that will contain information
about finding and applying for all federal grant programs. The web site, grants.gov, makes it easier for organizations to
learn about and apply for federal grants. For more information visit www.grants.gov.

Food and fitness craze
        A Food and Fitness Craze bulletin was developed by ISU Extension to help promote the 'Go the Dis-
tance' Youth portion of Lighten Up Iowa. The bulletin is full of ideas for youth groups to use when they are think-
ing about nutrition and physical activity. The bulletin has a full year (one per month) of suggestions as a re-
source for leaders . If you are interested in accessing a copy of this colorful bulletin you can contact your local
ISU Extension office (to find the closest location go to www.extension.iastate.edu/Counties/state.html) or you can
order online at www.extension.iastate.edu/pubs/Order.html The order number is PM 1944.

Wellmark Foundation announces new priority areas for 2004 grants
         The Wellmark Foundation is changing its focus of giving to the following areas in 2004: asthma, diabetes, heart
failure and cardiovascular risk factors, major depression, and end-of-life care (with an emphasis on pain control). For
those interested in applying, the first cycle grant teleconference in Iowa is scheduled for Wednesday, January 28, 10:00
a.m. to 11:30 a.m. For more information visit www.wellmark.com.

                                                                                                                      Page 9
Worth Noting
 Des Moines University to offer medical school courses to the public
      Many adults wish they had chosen a medical career or wish they had paid a little more attention in science classes
 when they were in school.
     For those who barely survived high school biology, and feel lost in today's terminology and technology, and the sci-
 ence buffs who want a refresher course or more information about what is happening in the field of medicine, Des
 Moines University is now enrolling for its spring mini medical school course.
     The six-week course will feature classes on several topics, including: explanations of procedures during a doctor's
 office visit, explanations of medical terminology, obesity, infectious diseases, cardiovascular health, diabetes, and
 women's health. Classes will be taught by local experts in their fields and will be explained on a level that common
 people can understand. Each class will include an hour on the evening's topic, followed by a question-and-answer pe-
 riod with local providers.
     Classes will start on Tuesday, Feb. 3 and will go through Tuesday, March 9, and will meet from 6:30 to 8:30 p.m.
 The cost for the six-week course is $25 and includes all materials for the class. Please visit
 www.dmu.edu/minimedicalschool or contact Nancy Thompson at 515-271-1374 or nancy.thompson@dmu.edu for
 more information.

 Second round of communication workshops under way
     Two new communication workshops have been scheduled by the Iowa Department of Public Health, Office of
 Communications and Public Health Education. They are scheduled for January 16 in Mt Pleasant and January 27 in
 Creston from 9 a.m. to 3 p.m. The workshops are designed to help public information officers or those charged with
 managing, planning and implementing risk communication make the best possible decision during a crisis situation.
 They also provide information that allows an individual, stakeholder or an entire community to make such decisions.
 Participants receive a crisis, emergency, and risk communication resource binder and a copy of the CDCynergy CD-
 ROM, which addresses topics critical to successful communication during an emergency. It includes a practical what-
 to-do and how-to-do guide.
     For more information on the workshops, contact Dena Fife at dfife@idph.state.ia.us or Kevin Teale at

      Iowa Dept. of Public Health
      Lucas State Office Building
      321 E. 12th Street                                      FOCUS Editor: Sarah Taylor
      Des Moines, IA 50319-0075
      Phone: 515 281-5787                                     What would you like to see in the Iowa Health
                                                              FOCUS? Send your suggestions for future articles,
                                                              letters to the editor, upcoming events, or to add
                                                              names to the mailing list by e-mailing us at
      Check out our web site                                  staylor@idph.state.ia.us.

      at www.idph.state.ia.us

Page 10

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