Management of Potentially Resistant Child in Dental Office by cgb19383


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									                                        A Bimonthly Newsletter From the Kittitas County     VOLUME 9, ISSUE 1
                                        Public Health Department
                                                                                            FEBRUARY 2006


Christie Waddington—Oral Health Coordinator and Jane
Wright—Assessment Coordinator dressing up for Dental Health                 Brusha, Brusha, Brusha

   The annual observance of children's dental health began as a one-day event in Cleveland,
   Ohio on February 3, 1941. During that year, February 3-7 was designated as Children's Den-
   tal Health Week in Akron, Ohio. The American Dental Association held the first national ob-
   servance of Children's Dental Health Day on February 8, 1949. This single day observance
   became a week-long event in 1955. In 1981, the program was extended to a month-long cele-
   bration known today as National Children's Dental Health Month. Since 1941, the observance
   has grown from a two-city event into a nationwide program. NCDHM messages reach millions
   of people in communities across the country and at numerous armed service bases abroad.
   Local observances often include poster, coloring, and essay contests, health fairs, free dental
   screenings, museum exhibits, classroom presentations and dental office tours. Down load
   free stuff:


  To Protect and Promote the Health and the Environment of the People of Kittitas County
   WIC Income Guidelines:                                   Does your patient qualify?
                                        Household Size *          Monthly Income

                                                      1       $1476
                                                      2       $1978
                                                      3       $2481
                                                      4       $2984
                                                      5       $3486
                                                      6       $3989
                                                 *unborn baby is counted
                                                      in family size

  Recipe courtesy Rachael Ray
  Show:   30 Minute Meals
  Episode: Instant Babysitter

                                S'Mores Sundaes

8 graham crackers, crushed or broken
2 pint rocky road ice cream
1 cup hot fudge sauce, from dessert topping aisle of market
Store bought prepared whipped cream in a spray canister
Chopped nuts and red cherries, optional

Place crushed grahams in the bottom of dessert bowls or sundae dishes.
Top with rocky road ice cream, 2 big scoops for each dessert.
Heat hot fudge in microwave and pour over ice cream.
Top with whipped cream, nuts and a cherry.

                                More Kid Friendly recipes can be found at

Kittitas County Child Health Notes
Promoting early identification and partnerships between families, primary health
care providers & the community

                                          OVERWEIGHT IN SPECIAL
  “Overweight” is
  defined as BMI for
  age >95th percen-                                  NEEDS CHILDREN
  tile in children
  over 2 years of       We’ve all heard about the epidemic of “obesity” in children. Consequences of being overweight during
  age                   childhood include lifelong obesity, early onset of type 2 diabetes, poor self esteem or psychological prob-
                        lems, orthopedic problems from wear and tear on joints, high blood pressure/high cholesterol. Chil-
                        dren with special needs may be more likely to become overweight than other children if their disability
                        causes them to be inactive. It may be difficult for them to move because of poor muscle tone, poor mo-
                        tor coordination or lack of motivation.
                                   Healthy eating and physical activity are the keys to prevention of overweight!
                                               HEALTHY EATING — TIPS FOR PARENTS

                                      Practice good eating habits yourself – children learn by imitating YOU!
                        INSTEAD OF…                            TRY TO…
                          Offering food at any time            Offer 3 nutritious meals and 2 healthy snacks at consistent
      New Food                                                  times each day--children do well with structure/routine.
                         Sending your child to school          Offer breakfast everyday—breakfast is especially important
       Pyramid                 without breakfast                                       for children.
                        Offering cookies, cake, chips, ice      Offer healthy snacks: fruit, whole grain breads/crackers,
                         cream, candy, pastries, fried         cereal; low-fat yogurt/pudding. After age 4: raw carrots,
                                       food                                        cheese chunks, nuts.
  “Make healthy-         Giving dessert only if a child        Have dessert as part of the meal, but in reasonable portions
  eating a family                finishes dinner
  affair” (Newsweek
  April 25, 2005)         Forcing your child to finish          Offer age-appropriate portions and allow your child to de-
                                                                       cide how much he will eat of what is served.
   “Drink water         Providing soda pop/soft drinks          Offer milk, water, 100% juice on occasion (whole milk till
  and stop the                                                        age 2, then low-fat or nonfat milk after age 2).
                        Offering food any place: at the        Eat together at the table-- this helps to separate eating from
                         TV or computer, in the car or            other activities. (Children eat more safely sitting, not
                                   bedroom                                            walking/lying.)
                            Using food as a reward               Offer verbal praise or special time with you as a reward.
                            Using food as a comfort             Comfort with attention, listening, hugs, stuffed animals.
                          Using food as a distraction                     Find other ways to fill children’s time.
                         Letting bad habits get set —          Start young! Baby’s first meals can be at the family table.
                        eating habits are learned early!       Follow your baby’s cues so that he learns to eat when hun-
                                                               gry, stop when full.

               Chlamydia Rates Climbing in Kittitas County
                                By Bonnie Corns, BS, CHES                           Conditions Reported
                            Community Health Services Manager
                           Kittitas County Public Health Department
                                                                                    to the Kittitas County
                                                                                          Public Health
             Outbreaks of STDs are identified by the STD Surveillance Unit of              Department
     the Washington State Department of Health (DOH). Case report data
     are reviewed monthly, quarterly and on a year-to-year basis by the DOH
     STD program staff.                                                                                       Nov 1
            According to the DOH STD Program, Kittitas County rates for                                      Dec 31,
     chlamydia are increasing. Surveillance for chlamydia cases is dependent                                   2006
     on reporting by health care providers. Providers are required to report         Active TB Infection       0
     new STD infections to their local health jurisdiction (LHJ) within 3 work-
     days.                                                                          Campylobacteriosis         0

             The threshold for a chlamydia outbreak in a county is a 50% in-             Chlamydia             33
     crease in a quarter compared to a six-quarter average or other signifi-          Cryptosporidiosis        0
     cant event. In 2005 Kittitas County reported 155 cases of chlamydia
     cases in contrast to 2004 in which 95 cases were reported. This indi-             E. coli 0157.H7         1
     cates a 65% increase. When the data are adjusted to discount the CWU                 Giardia              1
     population, the same increase is shown. This means that the cases are
     not directly related to the CWU population, but rather the Kittitas County          Gonorrhea             1
     population in general.                                                              Hepatitis A           0
              So, what can we do now? The Kittitas County Public Health De-              Hepatitis B           0
     partment is reminding providers to remember to report notifiable condi-
     tions, including STD’s. We are asking providers to be sure to do partner      Hepatitis C (new cases)     2
     notification and treatment whenever possible. If you or your staff would             Herpes               6
     like additional training in Contact Investigation the State STD Program is
     available to assist you. Please contact Alex Popov at 509-249-6531. He          Latent TB Infection       6
     is located out of DOH’s Yakima office and will travel to Kittitas County to           Lyme                0
     assist in staff development.
                                                                                       N. meningitidis         0

                                                                                          Pertussis            0

     Who’s new at Kittitas County Public                                               Salmonellosis           0

                  Health Department?                                                      Syphilis             0
                                                                                          Typhoid              0
☺   Cathy Bambrick—Environmental Health Manager
☺   Melissa Schumaier—Environmental Health Specialist II,
    Food Safety, Vector, Public Pools and Spas

☺   Dacia Carver—Environmental Health Specialist II, On
    Site Sewage

☺   Kris Proszek—Health Educator,
    Shape Up Initiative, Food Handler

            Kittitas County Makes Plan for Pandemic Flu
                                     By Jerry Harris, RN, BSN
                            Local Emergency Response Coordinator

With the hindsight of history and a scientific     and in storage of food and medical supplies.
eye focused on the news, the reasons for        Kittitas County is the proud home of many
concern about a possible pandemic flu are       small businesses and practices that serve
numerous and very real. It has been thirty      our residents faithfully. In the face of such a
six years since the last pandemic-putting us    long term, overwhelming event as a flu pan-
almost a decade beyond the historical pat-      demic, all difficult situations can not be
tern of occurrence.                             avoided. However, many needs can be an-
With Avian flu spreading among bird flocks      ticipated and plans fortified, based on histori-
in many parts of the world, the medical com- cal statistics of numbers ill and deaths asso-
munity holds it breath in wait for the next lo- ciated with such a disease occurrence. It
cation of human illness to erupt. To date,      will not serve us well to avoid or delay plan-
human to human transmission is the factor       ning for a pandemic.
that is missing to define the possibility of a  Our community will look to business and
pandemic.                                       medical leaders to give guidance in the face
Seattle/King County has become a leader in         of such a situation. It is time now to follow
the country as far as making plans for a pan-      suit with King County and develop business
demic. They have developed an excellent            and medical plans to maximize our health
flu plan and are working feverishly with their     and wellness opportunities through a poten-
business communities to educate, inform,           tially devastating time.
and call to action this new group of partici-   Kittitas County Emergency Management as
pants in planning for health care and well-     well as Public Health and Kittitas Valley
ness.                                           Community Hospital are involved with the
The focus is on responsible staffing plan-      First Responder communities in making
ning, preparation for alternative methods of such plans. Your interest and participation
accomplishing work usually done in the of-      is crucial in supporting these conversations.
fice setting, and storage of supplies for busi- Please contact any of these organizations to
ness to continue in perhaps a different envi- obtain information or to become involved in
ronment than ‘business as usual’. The plans disaster planning.
call for individual responsibility in planning

         The Community Kitchen in
         Evanston, Illinois delivered hot
         meals to sick families during
         the 1918 Flu Epidemic.

              Influenza Update
CDC Issues Recommendation Against the Use of Amantadine and Rimantidine for Prophy-
laxis or Treatment of Influenza for the Remainder of the 2005-2006 Season
On January 14th, 2006, the Centers for Disease Control and Prevention (CDC) issued a Health Advi-
sory recommending that Amantadine and Rimantidine not be used for either the treatment or prophy-
laxis of influenza for the remainder of the 2005-2006 influenza season. They issued this recommenda-
tion after tests at the CDC indicated that a high proportion of currently circulating Influenza A
(H3N2) viruses in the United States were resistant to both amantadine and rimantidine.
Amantadine is also used to treat the symptoms of Parkinson's disease, and should continue to be used
for this indication.
At the time of the announcement, 120 influenza A (H3N2) viruses isolated from patients in 23 states,
during the 2005-2006 season, had been tested at CDC; 109 of the isolates (91 percent) were resistant
to amantadine and rimantadine. Only three influenza A (H1N1) viruses had been tested and demon-
strated susceptibility to these drugs. All influenza viruses from the United States that have been
screened for antiviral resistance at CDC have demonstrated susceptibility to the neuraminidase inhibi-
tors (i.e., oseltamivir and zanamivir). During this period, oseltamivir or zanamivir should be selected if
an antiviral medication is used for the treatment or prophylaxis of influenza. Specific information re-
garding the use of the neuraminidase inhibitors is available at:
The CDC will continue testing influenza isolates for resistance to antivirals throughout the 2005-06
influenza season, and recommendations will be updated as needed. Annual influenza vaccination re-
mains the primary means of preventing morbidity and mortality associated with influenza.
The full Health Advisory statement can be found at:

The following is a partial list of the
   harmful ingredients found in a to-
   bacco cigarette. You will be im-
   pressed how much they can fit into
   such a small package!
Acetic acid: Used in vinegar and insecti-
Acetone: Nail polish remover
Ammonia: Household cleaning solution
Arsenic: Weed killer. Human carcinogen
Benzene: Motor vehicle exhaust. Human
   carcinogen (1987)
Cadmium: Batteries. Human carcinogen         Free, Personalized Help.
Formaldehyde: Embalming fluid. Human                    Just For You
   carcinogen (2004)
Naphthalene: Moth repellant. Possible           Call the Tobacco Quit
   human carcinogen (2002)
Nickel: Electroplate. Human carcinogen
Phenol: Disinfectants and plastics
                                            Quit Line hours
Styrene: Disposable cups. Possible hu-
   man carcinogen (1987)                    Monday - Sunday: 5 a.m. to 9 p.m.
Vinyl chloride: Garbage bags. Human
   carcinogen (1987)
                                            Tobacco cessation specialist will give clients:
                                               • Private counseling and support
                                               • Advice on designing a quit plan
                                               • Problem-solving ideas to help you

ADMINISTRATION                    Environmental Health
Community Health Services
                                  411 North Ruby Street, Ste 3
Health Promotion Services
                                  Ellensburg, WA 98926
507 N. Nanum Street, Ste 102
                                  Phone (509) 962-7698
Ellensburg, WA 98926              Fax (509) 962-7052
Phone: (509) 962-7515



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