Allen County Combined Health District flu caseload by benbenzhou


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									                                        Allen County Combined
                                                                                                                    219 E MARKET STREET
                                                                                                                    LIMA, OHIO 45801

                                                                                                                    PHONE: 419-228-4457

                                            Health District
                                                                                                                    FAX: 419-224-4161


                                            Public Health Planning and Preparedness
                                             From the Health Commissioner….
                                             I continue to be amazed when       allow for spread from person to     our combined efforts focused on
                                             I stop and realize how local       person. Even if this virus is not   the points highlighted below.
                                             public health has changed and      the “big one”, we are told it is       We clearly have much to do
                                             continues to change since          just a matter of time before        to be adequately prepared, and
                                             September 11, 2001. We have        another influenza organism          so our work must and will
                                             been given responsibility for      develops the capability of          continue. To be successful, we
                                             preparing ourselves for a great    tr i gge rin g a wor ld wi de       need your support by learning
                                             variety of public health           pandemic.                           what you can do as an
                                             emergencies including terrorist                                        individual, and how to protect
                                             attacks, damaging weather,                                             your family, your workplace,
                                             and naturally occurring                                                and your neighbors. For more
                                             diseases. During 2005, our                                             information as it is updated,
                                             focus turned toward Pandemic                                           please check our website
                                             Influenza because of the                                     
                                             continued spread of Avian                                              and the Centers for Disease
                                             Influenza, or bird flu, in                                             Control pandemic flu website

                                             several countries. A pandemic          In response to warnings of
                                             is defined as a worldwide          this new threat, much of our
                                             disease outbreak. While the        planning last year was in
                                             United States has been spared      concert with our local partner
                                             thus far, our communicable         organizations including Mental
                                             disease experts continue to        Health, Red Cross, hospitals,
                                             warn us that this particular flu   our Emergency Management
                                             virus could sicken and kill a      Agency, and more.           With    David L. Rosebrock, MPH
                                             large portion of the world’s       general guidance from federal       Health Commissioner
                                             population should it mutate to     and state public health agencies,

                                            Allen County Health Department Points of Preparedness
                                            With general guidance from federal and state agencies, we focused on the
                                            following preparedness efforts during 2005:                                     Inside this issue:
                                              �� Assuring adequate means to communicate with county partners
                                              �� Educating our citizens on flu prevention, protection, and recovery         Board of Health               2
                                              �� Strengthening and testing plans to rapidly detect disease
                                              �� Monitoring disease progress, and rapidly communicating outbreak            Financial Report              3
                                                 information to health providers
                                              �� Determining how to manage human and material resources during a            Vital Statistics              4
                                                 disease outbreak
                                              �� Training first responders in areas of health and safety during an          WIC Program                   4
                                              �� Preparing and disseminating emergency information to our residents         Environmental Division        5
                                              �� Citizen protection including evacuation and in-place sheltering
                                              �� Assuring safe and sanitary shelters, food and water supplies               Health Education Division     6
                                              �� Limiting the spread of disease through education, maintaining
                                                 distance between the sick and the well, plus the use of medications        Nursing Division              7
                                                 and vaccines where possible
Page 2                                                                                                     A N N U A L RE P O R T 2 0 0 5

A Very Real Threat to Your Health: Antibiotic Resistance
WARNING: Unnecessary use of                    subcommittee that focuses on             face serious infections and disease.
WARNING: Unnecessary You of
antibiotics CAN be harmful! use do             developing educational material to          What can you do? Resist the urge
not need antibiotics harmful!a You do
antibiotics CAN be to fight cold or            promote appropriate antibiotic use in    to demand antibiotics from your
the flu. Illnesses like colds orcold flu
not need antibiotics to fight a the or         Ohio.                                    doctor for a sore throat, a child’s ear
the not be like colds the by
willflu. Illnesseshelped at orall flu              Why the concern?          Taking     infection, and other ailments. In
will not             helped at
antibiotics. be On the otherall by     hand,   antibiotics unnecessarily can lead to    reality, the great majority of upper
antibiotics.       On bacteria, hand,
illnesses caused by the othersuch as           the development of antibiotic-           respiratory infections, sore throats,
illnesses caused by bacteria, such as
strep throat, can be treated effectively       resistant bacteria. This resistance      and many ear infections are viral and
strep antibiotics.
with throat, can be treated effectively
                          Antibiotics kill     occurs when bacteria survive             antibiotics do nothing for viral
bacteria, not viruses. Antibiotics kill
with antibiotics.                              treatment and continue to multiply       infections. The more antibiotics that
bacteria, not viruses. is part of a
    This message                               causing a disease or infection that is   are used, the greater the pressure we
    This called           is
campaign messageOHIO part of –    CAREs a      difficult to treat. Because of this      put on the bacteria to become
campaign called OHIO CAREs –
Coalition for Antibiotic Resistance            resistance, drug choices for treating    resistant.       If antibiotics are
Coalition This group is Resistance
Education. for Antibiotic made up of           common infections will become            prescribed, however, do take them
Education.          i d i v i is a l s a d
d e d i c a t e dThisngroup d umade upnof      increasingly limited, expensive, and     exactly the way your doctor tells you.
organizations from private a l s public
d e d i c a t e d i n d i v i d u and a n d    in the worst case – nonexistent! In      Finish the entire course of
organizations from private and public
health care, veterinary medicine, the          other words, taking antibiotics when     medication, do not save it for another
health care, veterinary medicine, the
pharmaceutical industry, and others.           you do not need them can cause           time or share it with others.
pharmaceutical n i c a b l e D s e a s e
O u r C o m m uindustry, and iothers.          antibiotics not to work when you do         To learn more, visit the Ohio
O u r C o m Tami Niemeyer, s e a e
Coordinator, m u n i c a b l e D iRN, sis      need them!          Physicians and       Department of Health website,
Coordinator, Tami Niemeyer, RN, is
part of this statewide effort.                 prescribing nurse practitioners are or our website,
part of this she sits on a
Additionally, statewide effort.                left with fewer weapons against
Additionally, she sits on a                    disease, and we are all more likely to

Health Department Staff Trained on The National Incident Management System
Emergencies occur every day                    responses that reached across all        Health Department successfully
somewhere in the United States.                levels of government and emergency       trained almost all employees on
Each incident requires some kind of            response agencies.        In 2003,       NIMS. This means that local public
response. The people who respond               President Bush signed the Homeland       health employees are able to
need to be able to work together,              Security Presidential Directive-5        fu n c tio n we ll be sid e ot he r
whether they’re from different                 which authorized the Secretary of        responders should there be a public
departments of the same local                  Homeland Security to develop this        health emergency or any other
agency, from different local agencies          national incident response system.       incident where public health would
or from state or federal partners.             NIMS has several components that         be involved. Keeping the staff up to
The National Incident Management               work together to provide a national      date on training will be an on-going
System (NIMS) is a comprehensive,              framework for preparing for,             priority for the Health Department in
national approach to managing these            preventing, responding to, and           the years ahead.
incidents. Until recently, there were          recovering from domestic incidents.
no standards for domestic incident                During 2005, the Allen County

The 2005 Board of Health
As established in Ohio law, the                President; Dr. Wilfred Ellis; Harry      mayors, township trustees, and
seven member Board of Health is                Flanagan; Tom Redding; Jon               county commissioners of Allen
our policy-making body with                    Neuman and Janis Carse. Richard          County.       The seventh Board
authority to adopt regulations and             Williams, who was appointed by the       member is appointed by the Health
establish programs to promote                  Health District Licensing Council as     District Licensing Council.    The
public health within the district.             an alternate for Jon Neuman, serves      Board meets monthly at 8:00 a.m. on
Board members during 2005                      on the Board when Mr. Neuman is          the second Friday of each month.
included Dr. Charles Thompson,                 unavailable. Six of the seven Board      Board meetings are open to the
President; Don Schweingruber, Vice             members are appointed by the             public.
ANNUAL REPORT 2005                                                                   Page 3

                                        2005 Financial Report

BALANCE January 1, 2005                                         $144,718.00

                                         2005 RECEIPTS
                                                                    Amount     Percentage
Townships, Villages, and Cities                                  715,600.00        18.3%
County Commissioners                                              37,721.00         1.0%
Grants                                                          1,647,145.00       42.2%
Permit and Service Fees                                         1,284,594.00       32.9%

Medicaid Reimbursement                                           182,402.00         4.7%
State Subsidy                                                     33,034.00         0.9%

TOTAL                                                           3,900,496.00     100.0%
BALANCE AND RECEIPTS                                            4,045,214.00

                                          2005 EXPENSES
Salaries and Benefits                                           2,890,702.00       76.0%
Clinic Supplies                                                   47,936.00         1.3%
Other Supplies                                                   109,030.00         2.9%
Lab Expenses                                                      19,830.00         0.5%
Rent/Occupancy Costs                                             176,367.00         4.6%
Equipment/Equipment Repair/Service Contracts                     120,736.00         3.2%
Training/Continuing Education                                      8,448.00         0.2%
Transportation                                                    32,756.00         0.9%
Contractual Services                                              79,347.00         2.1%
Other (Insurance, audits, payments to state, etc.)               317,416.00         8.3%

TOTAL                                                           3,802,568.00     100.0%

Ending BALANCE December 31, 2005                                 242,646.00
Page 4                                                                                                                       A N N U A L RE P O R T 2 0 0 5

                Allen County Resident                                               Vital Statistics
                  Births and Deaths                                                 The Vital Statistics office files records for births and
                                                                                    deaths that occur in Lima and Allen County. Our
                                 2005            2004             2003
                                                                                    files date back to December 1908, when the filing
Total Births                      1,412           1,416           1,431             system for the State of Ohio began. In 2005 we
                                                                                    issued 15,863 copies of birth and death records.
Total Deaths                       907            1,199           1,253                 Certified copies are now issued on security paper
                                                                                    which insures the protection of information on the
            Leading Causes of Death                                                 document, and cannot be easily reproduced. In
                                                                                    addition, the Sate of Ohio no longer allows the
Heart Disease                      264             340             353              issuance of the smaller laminated birth registration
                                                                                    cards due to potential fraud issues. Persons requesting
Cancer                             226             172             207              birth or death certificates must allow adequate time
                                                                                    for processing documents. A copy ordered before
Stroke                              59              54                 71           3:00 pm will be available in one hour, however, a
                                                                                    copy ordered after 3:00 pm will be ready the
COPD*                               44              36                 36           following business day.
                                                                                        Ohio law only allows for the issuance of certified
Accidents                           19              16                 18           documents statewide at this time; uncertified copies
                                                                                    are no longer available. Certified copies of birth and
Suicide                             11               2                 6
                                                                                    death certificates can be obtained for a fee of $22.00
                                    4                3                 2            per copy in Allen County.

         Residents—persons residing in Allen County at time of death                 The Allen County Health Department Mission: To protect and
* Respiratory Disease (Chronic Obstructive Pulmonary Disease)                          improve the health of all citizens by preventing disease,
                                                                                       promoting good health and access to quality health care.

Two WIC Dietitians Receive Certification as Lactation Counselors
In October 2005, two WIC staff, Lori Nester, RD,
LD, CLC and Karla Boop, RD, LD, CLC became                                          Residents Served Monthly by
Certified Lactation Counselors through a State                                          WIC Program—2005
sponsored training. These two dietitians learned
skills necessary for enhancing their effectiveness in
breastfeeding counseling. Counseling skills and                                            Women         Infants       Children           TOTAL
strategies, critical areas of breastfeeding support,                        White             657           746           1,266             2,669
and sociological and psychological issues which
impact breastfeeding were just a few topics covered                         Black             175           241            477                893
in the week-long training.
    Both newly certified lactation counselors are                           Hispanic          19             34             50                103
already utilizing their new skills.       Successful
breastfeeding is an important goal of the WIC                               American
program. “Doing what we’re supposed to do and                               Indian             2             0              2                   4
doing it well” is top priority for the Allen County                         Asian              3             3              5                  11
WIC Program. The Allen County WIC Program
caseload increased again in 2005 as it continues its                        Other             10             53             44                107
mission to improve the health and nutrition of
infants and          children, and pregnant and                             TOTAL             866         1,077           1,844             3,787
breastfeeding moms through education.
 ANNUAL REPORT 2005                                                                                              Page 5

New Sewage Rules                                                  Environmental Division
                                                                 2005 Inspections and Investigations
Ohio is now on a fast track to adopt new
Household Sewage Treatment System rules                                                    Sites       Inspections
as a result of recent legislation requiring the   New Private Water Systems                 136            155
Ohio Department of Health to update their
rules.                                            New Private Sewage Systems                143            312
    The goal is to reduce the amount of
                                                  Recreational Parks and Camps                9            26
pollution caused by sewage treatment
system discharges and bring Ohio into             Manufactured Home Parks                    26            171
better compliance with Federal Clean
                                                  Public Swimming Pools and Spas             56            229
Water Acts.
    As currently written, the proposed rules      Open Bathing Areas                          6             7
place severe restrictions on Northwest
Ohio, including Allen County, due to our          Solid and Infectious Waste                 56            131
heavy clay soils and seasonally high water        Demolition Waste                            1            60
table. The rules can be viewed on the Ohio
Department of Health’s web site at                Schools                                    60            150 The Allen County             New Plumbing Systems                      586           2,015
Health Department           provided written
comments to the state to request a reduction      Food Service Operations                   526           1,879
in unnecessary restrictions and costs to          Retail Food Establishments                187            476
property owners. Although the rules are
still in a draft stage, the Environmental         Food Vending                              194            203
Division is preparing to implement changes        Animal Bites                              234            430
in our sewage program which will help
improve the environment and health for our        Environmental Complaints                  172            513
                                                                             GIS Technology Added
          The Allen County Health Department is an equal                     The Allen County Health Department
          opportunity employer and provider of services.                     has begun        using Geographical
                                                                             Information Systems (GIS) software for
                                                                             a variety of programs. Some examples
 Allen County Health Department Pilots                                       include tracking new and existing water
                                                                             wells and sewage systems on maps of
 Expanded School Building Inspections                                        the county and the West Nile Virus
 Ohio law currently requires semi-annual inspections of all primary and      mosquito trapping program.          An
 secondary schools by the local Board of Health. On March 19, 2006,          example of a GIS map to show the
 Jarod’s Law goes into effect. This legislation was prompted by the          location of mosquito traps placed in
 death of Jarod Bennett, a six year old killed in a school by a falling      2005 is shown below.
 cafeteria table. The law calls for an expanded annual inspection of each
 school. During 2005, the Allen County Health Department was one of
 twelve health departments in the state to conduct inspections using the
 new draft rules that resulted from this legislation. The draft guidelines
 now cover an expanded list of points to inspect, including more detailed
 inspections of specialty classrooms such as science labs and art rooms.
 They also require health department staff to review school policies
 regarding a variety of issues, from bloodborne pathogens to radon
 testing. Schools and health departments from around the state will
 participate in the final writing of school environment inspection
 requirements that will begin across the State of Ohio in the near future.
Page 6                                                                                                                                      A N N U A L RE P O R T 2 0 0 5

County-wide Hand Washing Campaign Kicked Off in 2005
  Make a clean break from illness.                                             We have heard            county-wide hand washing campaign in September.
                                                                               parents, teachers,       To date, approximately 1,200 posters have been
                                                                               and others tell us,      distributed to public agencies, organizations, and
                                                                               “ WAS H       YOUR       private businesses. A separate poster was developed
                                                                               HANDS!” over and         with children in mind and approximately 1,000
                                                                               over again.        We    posters were distributed to schools. Our hope is to see
             WASH YOUR HANDS!!                                                 have probably heard      these posters in restrooms across the county to remind
       Handwashing is the best way to stop the
                 spread of germs.
                                                                               it so much that we       people of the importance of good personal hygiene.
 Wash your hands after:                Here’s how:                             tend to think it’s not     Hands should be washed after using the
                                                                               such a big deal. The
      (and before) Handling food or    1. Wet your hands with warm, running
                                                                                                        bathroom; changing diapers; sneezing, blowing
      eating.                              water.
      Using the bathroom.              2. Add soap and rub hands together,

                                                                               fact is that hand
      Changing diapers.
      Sneezing, blowing your nose or
                                          front and back, between fingers
                                          and under nails for about 20                                  your nose or coughing; touching a cut or open sore;
      Touching a cut or open sore.
                                          seconds (how long it takes to sing
                                          Happy Birthday two times).           washing       greatly    playing outside and petting animals. Also, it is
                                                                               affects your ability
 ��   Playing outside.                 3. Rinse. When paper towels are
 ��   Petting animals.                    available, use them to dry hands.
                                       4. Turn off water with a paper towel                             important to wash your hands before handling food
                                          before throwing it away.
                                                                               to stay healthy!         or eating.
    As we look at ways to defend ourselves from many                                                       Additional posters are available through the Health
 potential illnesses and infections, including some of the                                              Education division, or via our website at
 new threats in the world like avian influenza, washing our                                   
 hands is the most powerful defense we have. For this
 reason, the Allen County Health Department kicked off a

Breast and Cervical Cancer Early                                                                        Family Planning Begins Title X
Detection Program                                                                                       Funding
The Women’s Preventive Healthcare Project is a federally                                                The goal of the Family Planning Program is making
funded grant program from the Centers for Disease Control                                               every child a wanted child. In 2005, this program was
and Prevention and administered through the Ohio                                                        awarded Title X (10) funding. As a result, we can
Department of Health. It is known as the Breast and                                                     take advantage of special pricing offered to Title X
Cervical Cancer Early Detection Program and pays for Pap                                                programs. The cost allows more contraceptive options
tests, clinical breast exams, and pelvic exams for women                                                for our clients including a wider variety of oral and
who are at least 40 years of age, and mammograms for                                                    injectable contraceptives. Women and men can
women 50 years of age and over. Women must meet                                                         receive reproductive health services such as annual
income guidelines and have no health insurance to qualify.                                              screenings and education by calling 419-228-6154 or
Women’s Preventive Healthcare Project (known as Region                                                  visiting the office at 1644 North Main Street.
3) includes Allen, Auglaize, Hancock, Hardin, Mercer,
Putnam, and Van Wert Counties.
    Women’s Preventive Healthcare Project has received                                                          Breast and Cervical Cancer
annual grants from the Northwest Ohio Affiliate of the                                                              Program Statistics
Susan G. Komen Breast Cancer Foundation each of the last
five years. The foundation funds screening mammograms
                                                                                                                 Spring 1994– June 2005
for women in their 40’s as the Breast and Cervical Cancer                                                Services Provided                                 Total
Project does not fund routine screening for women in this                                                Women receiving a funded service                  2,284
age category.
    Early detection screenings are very important. Cervical                                              Pap tests                                         5,556
cancer is very treatable when detected early through an
annual Pap test. Mammography screening provides the                                                      Mammograms                                        4,347
best chance of discovering breast cancer at an early stage.
Early detection saves lives and increases treatment options.                                             Breast Cancers diagnosed                             48
                                                                                                         Cervical Dysplasia                                   64
                                                                                                         Invasive Cervical Cancer                              3
ANNUAL REPORT 2005                                                                                                    Page 7

  Communicable Disease Reporting: Limiting the spread of disease
 Communicable diseases are illnesses caused by germs that
 are spread from an infected person or animal to another
 person or animal. These diseases are passed by direct or
 indirect contact with infected persons or their excretions.
 Most diseases are spread through contact because the
 problem bacteria or viruses are airborne; i.e., they can
 come from an infected person’s nose and mouth and be
 inhaled by someone else. Such diseases include whooping
 cough, flu, and smallpox. Some infectious diseases can be
 spread only indirectly, usually through contaminated food
 or water, e.g., typhoid, cholera, Hepatitis A. Other
 organisms require special routes for transmission, e.g.,
 syphilis and gonorrhea enter the body through sexual
 contact, and tetanus enters the body with infected soil or       Source: Public Health Images Library, CDC/James Gathany
 dirt through a break in the skin. Still other infections are
 introduced into the body by animal or insect carriers, i.e.,
 rabies or West Nile Virus.                                       Animals may carry germs
     In an effort to protect the public, Ohio law mandates        We are all aware of diseases spread by animals such
 that 100 specific diseases be reported to local health           as West Nile Virus by mosquitoes, and rabies,
 departments.      Ohio Administrative Code 3701-3-02             which can be spread by bats. However, human
 mandates all physicians, hospitals, and labs report on a         illness occurs more frequently as a result of just
 timely basis. Reporting timelines vary based on the              handling animals and pets. Hands can become
 seriousness of the illness and how contagious the germs          contaminated with viruses, bacteria, and parasites.
 are. Most importantly, whenever these diseases are               Salmonella and E. Coli infections occur in people
 reported, the local health department tracks and follows-        each year as a result of contact with reptiles,
 up on each of them through a Communicable Disease                animals in petting zoos, or being around livestock or
 Coordinator, a Registered Nurse.                                 any number of other pets or wild animals people
     This nurse contacts each patient by phone, mail, or a        touch. Handwashing after contact with any animal is
 home visit. At that point, the patient is treated, if not done   always recommended to protect your health.
 so already. The nurse also works closely with the
 physician(s) depending on the severity of the disease. The
 patient receives education about the disease and how to                      2005 Nursing Clinics
 control it, and/or how not to get it back again. Education
 about how to protect their families and others is also                                            New             Visits
 provided. If needed, the nurse helps determine how they                                          Patients
 got the disease and if any other contacts need to be             Family Planning                   616            8,059
 treated. Education is the key to stopping the spread of          Clinic
                                                                  Prenatal Clinic                   234             887
        2005 Immunization Statistics
                                                                  Child Health Clinic               288            1,867
 Vaccine/Testing                                 Total
 Flu Vaccine                                     2,928            Sexually Transmitted              796             823
                                                                  Disease Clinic
 TB Skin Testing                                 1,152
 Total Childhood Immunizations                  17,952                                             Tests         Positive
                                             State Goal:
                                                                  HIV (AIDS virus)                 1,077             10
 Childhood 4th DTaP by 2 years old              90%
    2004 Health Department Rate                  62%
                                                                  Cumulative since                 13,350            96
    2005 Health Department Rate                  67%              1987
Page 8                                                                                  A N N U A L RE P O R T 2 0 0 5

                                   Schedule of Services
                                         Allen County Health Department
                                219 E Market St., PO Box 1503, Lima, OH 45802
                                                FAX: 419-224-4161
                               Office Hours: 8:00 a.m. - 4:30 p.m. Monday—Friday
         Blood Pressure Testing                               Monday-Friday          8:00-9:00 a.m.
                                                                                     3:00-4:00 p.m.
         T.B. Testing                                  Monday, Tuesday, and Friday   8:00-9:00 a.m.
                                                                 ONLY                3:00-4:00 p.m.
         Pregnancy Testing                              Wednesdays & Fridays only    8:00-9:00 a.m.

         HIV Testing                                             Tuesday             4:00-5:00 p.m.
                                                                  Friday             2:30-3:30 p.m.
                                                            And by appointment
         STD Clinic (Sexually Transmitted Disease)               Tuesday             4:00-5:00 p.m.

         Immunizations                                         Wednesday             1:30-3:30 p.m.
                                                                Thursday             8:30-10:30 a.m.
         Prenatal Clinic (Maternity)                          By appointment         419-228-4457

         Child Health Clinic                                  By appointment         419-228-4457

         Environmental Health: permits                        419-228-4457
         inspections, complaints, rabies control
         Health Education: AIDS, Cardiovascular               419-228-4457
         Health, Tobacco, Organ Donation

         Birth and Death Certificates                         419-228-4457

         WIC Supplemental Food Program                        419-224-8200
         940 N. Cable Road, Suite 4, Lima

         Family Planning                                      419-228-6154
         1644 N. Main Street, Lima
         Women’s Preventive Health Care Project,             419-224-4500 or
         300 S. Elizabeth Street, Lima                       1-800-901-9727

         West Central Ohio Health
         Ministries Program                                   419-227-0753
         129 S. Pierce Street, Lima

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