WellCommons

By John Milburn, Associated Press

TOPEKA — Kansas residents will be able to return their expired or unused medication to pharmacies for disposal under a policy change announced Thursday that health officials hope will prevent the drugs from being accidentally ingested or flushed down the toilet.

Dr. Robert Moser, secretary of the Kansas Department of Health and Environment, said that changes in agency policy interpretation will allow for establishing medication collection centers such places as pharmacies, law enforcement stations. Or, they can have the pills picked up as hazardous waste, similar to the way some people dispose of paint cans.

"Storing unwanted or expired medications in the home poses a significant health risk to Kansas families. Children can be injured or even die from accidental ingestion," Moser said.

The program is in conjunction with the Board of Pharmacy, as well as KDHE's Bureau of Hazardous Waste.

Debra Billingsley, executive secretary of the Board of Pharmacy, said pharmacists have for years disposed of unused and expired medication from their own store supplies, nursing homes and hospitals, but lacked the authority to accept them back from customers once they left the pharmacy.

"They understand that medications are powerful and that should be discarded with care," she said. "The Kansas pharmacists they do want to provide this service to the customers. They view this as a public service to the community."

Moser said allowing pharmacies, law enforcement and household hazardous waste centers to collect and safely dispose of the medication will reduce the number of accidental poisonings of children. The non-narcotic medication will be taken by pharmacists and placed in secure containers behind the counter and kept for proper disposal.

The program also will prevent contamination of water supplies that can occur when the medications are flushed or poured into municipal sewer systems.

Moser said most municipal waste water treatment plants cannot completely filter the chemicals in medication from the sewage, leading to contamination of water supplies. That can lead to harmful side effects in humans and wildlife.

Moser said Kansas had experienced a 150 percent increase since 2000 in the hospital discharge rate for unintentional drug poisoning. Children ages 5 and younger had the highest rate of emergency room visits for unintentional drug poisonings among all age groups, he said.

Legislators said that there had been measures introduced in recent years that would have established similar programs through changes in state statutes. However, Rep. Tom Sloan, a Lawrence Republican, said those efforts frequently were mired in committees, leading to the agencies to take action.

"This is how government ought to work," he said.

TOPEKA (AP) — Kansas health officials say 13 rabies cases have been confirmed so far this year, a 300 percent increase over the same time period last year.

The Kansas Department of Health and Environment says it had only four confirmed rabies cases in the same time period in 2011. Kansas has averaged 68 confirmed cases of rabies a year since 2007.

WIBW reports state health officials have confirmed rabies in a coyote, a raccoon, four skunks, two bats, two horses, two cows, and one cat.

KDHE officials say the cases are most prevalent in skunks. They encourage the public to watch their pets and livestock and be aware of wild animals. And they encourage owners to vaccinate their animals against rabies.

Abortions in Kansas declined last year according to a report released by the Kansas Department of Health and Environment.

There were 7,851 abortions reported in 2011, down 6 percent from 2010, when 8,373 were reported.

Out-of-state residents slightly outnumbered in-state residents, 3,939 reported abortions to 3,912. Of the out-of-state residents who obtained abortions in Kansas, 98 percent were Missouri residents.

State law requires that physicians, hospitals and ambulatory surgical centers report abortions to KDHE. The Women’s Right-to-Know Act requires physicians who perform abortions to provide certain information, to meet individually with women seeking an abortion and to report to KDHE the number of informed-consent certifications received by women.

Here’s a look at the number of abortions by age:

• 9 — under age 14.

• 23 — age 14.

• 55 — age 15.

• 254 — 16-17 years old.

• 683 — 18-19 years old.

• 2,623 — 20-24 years old.

• 2,016 — 25-29 years old.

• 1,244 — 30-34 years old.

• 675 — 35-39 years old.

• 256 — 40-44 years old.

• 13 — 45 or older.

Other findings:

• 1,148 — were married.

• 6,683 — were not married.

• 20 — didn’t report marital status.

• 262 — Douglas County residents.

• 30 — Franklin County residents.

• 20 — Jefferson County residents.

• 1,051 — Johnson County residents.

• 46 — Miami County residents.

• 15 — Osage County residents.

• 278 — Shawnee County residents.

During the past 40 years, 1973 had the highest number of abortions at 12,612. Of those, 7,695 were out-of-state residents and 4,917 were from Kansas.

For the full report visit, www.kdheks.gov/hci/absumm.html.

Skunks dig for grubs and can even take up residence on your property under your porch or garden shed. To avoid this, spray your lawn with a grub-treating product and secure any opening underneath your porch or around your foundation. Skunks are the most common animal to get rabies and often pass the infection to other animals such as cats, dogs and horses.

There has been an increase in rabid animals in Kansas this year, and health officials are warning residents to get their pets vaccinated and to stay away from wild animals.

So far this year, 13 animals have tested positive for rabies, according to the Kansas Department of Health and Environment: four skunks, two bats, two horses, two cows, one cat, one coyote and one raccoon. None of the domestic animals were vaccinated against rabies.

During the same period in 2011, there were four rabid animals. Since 2007, there have been an average of 68 cases per year.

Ingrid Garrison, KDHE state public health veterinarian, said animal rabies is common in Kansas, and skunks are the animals most likely to have the disease. However, skunks can pass the virus to other animals, such as dogs, cats, cattle and horses.

Garrison said human rabies can be prevented by vaccinating pets, staying away from stray and wild animals, and getting prompt treatment if exposed.

“Vaccinating animals against rabies not only protects our pets, but our families as well,” Garrison said.

The last case of rabies in Douglas County was reported in 2004 and it was a bat.

Kim Ens, director of clinical services for the Lawrence-Douglas County Health Department, said, “We haven’t had any animals that have shown positive but that doesn’t mean that they are not out there.”

She said humans can get rabies through a bite or scratch from an infected animal. If a person is bitten or scratched, he or she should contact a doctor and police. If possible, health professionals prefer to locate the animal and monitor it for 10 days to see whether it has rabies. If it does, then they will start a series of four shots to treat the infection in the person. If the animal can’t be located, then a doctor will discuss the case and determine whether treatment needs to be given.

Ens said if a person wakes up and sees a bat in the room, he or she should call a doctor. She said bats have such tiny teeth that a person wouldn’t feel a bite.

“Bats do tend to be pretty high carriers of rabies, so anytime a person wakes up with a bat in their room we generally would recommend starting them on the vaccine, especially if it’s a child in a room,” she said. “So, people need to keep bats out of their house. They are nasty.”

Ens said human rabies are very rare but generally fatal. The period between infection and the first flu-like symptoms is normally two to 12 weeks, but can be as long as two years.

“Don’t take any chances,” Ens said, advising people to stay away from wild and stray animals, to teach children to stay away from them, and to get pets vaccinated, especially if you live in the country.

For more information about rabies, contact the Lawrence health department clinic at 843-0721 or KDHE at 877-427-7317.

Two bats roost together from a clematis inside a garden arbor in the front yard of an east Lawrence house. by Mike Yoder

The Kansas Department of Health and Environment is promoting Colorectal Cancer Awareness Month by reminding residents to get preventive screenings.

Colon cancer is the third leading cause of cancer-related deaths in the U.S. and it is expected to cause about 51,690 deaths this year.

In Kansas, 489 people died from colon cancer in 2010. There are about 1,440 new invasive colorectal cancer cases diagnosed annually.

“Colon cancer is preventable and curable. If colon cancer is caught in its earliest stages, it can be cured in almost 90 percent of the cases. To prevent this disease or to discover it in its earliest stages, Kansans need to participate in the screening process.”

— Dr. Robert Moser, KDHE Secretary and state health officer

For an average risk patient, a screening colonoscopy is recommended after the age of 50. This is an examination of the colon with a videoscope so the physician can see any abnormalities, such as a polyp or a cancer. At the time of the colonoscopy, polyps can be removed to prevent a cancer from developing.

If a person is in a high-risk category for colon cancer, then a colonoscopy may be performed sooner than age 50. Any person with a close relative — parent or sibling — who has had colon cancer should have a colonoscopy approximately 10 years prior to the age of diagnosis of that particular relative.

Several screening methods are available for colorectal cancer screening, including the Fecal Occult Blood Test, sigmoidoscopy and colonoscopy.

Screening is covered by Medicare and most health insurance plans. People without insurance who need financial assistance with screening can locate a safety net clinic at the Kansas Association for the Medically Underserved's website:  http://www.kamuonline.org/find.php.  

“Some studies suggest that people may reduce their risk of developing colorectal cancer by increasing physical activity, eating fruits and vegetables, limiting alcohol consumption and avoiding tobacco,” Moser said.

Logo by kbritt

Call the American Cancer Society toll-free number, 800-227-2345, for more information about colorectal cancer.  To find a Kansas Association of Gastroenterologists screening facility in Kansas, visit www.StopColonCancerNow.com/kansas. For other Kansas cancer information and resources, visit www.cancerkansas.org.

Latest report on flu activity from CDC. by kbritt

Flu activity has steadily increased during the past several weeks in Kansas and has reached its highest level so far this season, according to the Kansas Department of Health and Environment.

Dr. Robert Moser, state health officer and KDHE secretary, said influenza will continue to circulate through the spring, and encourages Kansans to get their vaccine if they haven't received one.

"There is still time for people to get a flu vaccination to protect themselves, their families and the community,” he said. “The seasonal influenza types we’ve seen in Kansas are covered by the current vaccine.”

KDHE identified the first laboratory-confirmed influenza cases of this season on Dec. 21. Symptoms of influenza include fever, headache, extreme tiredness, dry cough and muscle aches. Complications can include pneumonia, ear and sinus infections, and dehydration; influenza may also worsen chronic conditions.

According to KDHE, vaccination is effective for reducing the chances of getting sick and spreading influenza to others. Anyone who is 6 months and older is recommended to receive a vaccine. This is especially important for anyone at high risk of complications or who is caring for, or in regular contact with, an infant less than 6 months of age. Babies this age are too young to be vaccinated and are more vulnerable to complications from influenza disease. 

The flu vaccine is available at the Lawrence-Douglas County Health Department’s clinic, 200 Maine. The cost is $23 for children, ages 6 months to 3, and $28 for anyone older than 3.

Charlotte Marthaler, assistant director of the local health department, said they haven’t seen or heard of an uptick in flu activity in Douglas County, but said it’s not unusual for there to be a rise this time of year.

To avoid spreading flu, Marthaler encourages residents to cover coughs and sneezes, wash hands, and stay home when sick— even if it means canceling a spring break trip.”If you are not feeling well, stay home,” she said.

To avoid getting the flu, she encourages plenty of rest, eating well and limiting alcohol consumption — all atypical of spring break vacations and St. Patrick’s Day festivities.

On average, five to 20 percent of the U.S. population contracts influenza yearly and more than 200,000 people are hospitalized with complications. Serious complications of the influenza can lead to pneumonia and even death.

A new report from the Surgeon General has found that 90 percent of smokers try their first cigarette by age 18. Ninety-nine percent of smokers start by age 26.

For every tobacco-related death, two young people will become regular smokers. Nearly 90 percent of these smokers try their first cigarette by age 18.

Today, U.S. Surgeon General Regina Benjamin called on states to invest in programs and policies to prevent youth tobacco use. After years of steady progress, declines in the use of tobacco by youth have slowed for smoking and stalled for smokeless tobacco use.

“The addictive power of nicotine makes tobacco use much more than a passing phase for most teens. We now know smoking causes immediate physical damage, some of which is permanent,” Benjamin said in a news release. "We don't want our children to start something now that they won't be able to change later in life."

The surgeon general released a new 858-page report “Preventing Tobacco Use Among Youth and Young Adults” that details the scope, health consequences and influences that lead to youth tobacco use.

Among the report’s statistics:

• 600,000 — middle school students smoke.

• 3 million — high school students smoke.

• One in four — high school seniors have smoked during the past 30 days.

• One in 10 — high school senior males are smokeless tobacco users.

• One in five — high school senior males smoke cigars.

• 99 — percent of smokers start by age 26.

• $27 million — spent on marketing and promotion of tobacco products per day.

• 1,200 — Americans die every day from tobacco use.

While the long-term health effects of tobacco use are well-known, this report — the last one was done in 1994 — concludes that smoking early in life has substantial health risks that begin immediately in young smokers. These include serious early cardiovascular damage and a reduction in lung functionality. The lung damage is permanent, causes shortness of breath immediately and increases the risk of pulmonary diseases later in life.

The Kansas Department of Health and Environment is working to prevent youth tobacco use through a variety of programs, said Ginger Park, communications manager for the Bureau of Health Promotions. In addition to providing education, it is advocating for tobacco-free school grounds. During the past year, KDHE added a free online smoking cessation resource because youths said they preferred using a computer versus calling a quit line.

“We still have a long way to go. Our work is not done by any means,” Park said.

In Kansas:

• 14 — percent of high school students smoke.

• 14 — percent of high school males use smokeless tobacco.

• 23 — percent of young adults, ages 18 to 24, smoke.

On average, Kansas spends $2.5 million a year on tobacco prevention, but the Centers for Disease Control and Prevention recommends that the state spend $32.1 million. The report concludes that if states begin to invest in programs, youth tobacco use can be cut in half in just six years.

KDHE's website. by kbritt

The Kansas Department of Health and Environment launched its newly-designed website today.

The new website — www.kdheks.gov — was developed by the agency’s in-house webmaster. KDHE estimates it has avoided a cost of more than $200,000 by not contracting with an outside vendor for the redesign of the site’s nearly 10,000 unique web pages.

“The goal with building a new KDHE website was to create a more user-friendly online resource while giving the site a fresh look. We want to make sure people are getting the most out of KDHE’s online presence and ask for feedback to ensure we’re meeting the mark.”

— Dr. Robert Moser, KDHE secretary and state health officer

The new website features:

• Streamlined navigation.

• Fresh colors and page design.

• Rotating “billboard” in prominent location to highlight KDHE programs and feature timely announcements.

• Twitter widget on the home page.

• Consolidated list of agency-wide data, reports and statistics.

Check it out — www.kdheks.gov!

A detail of what a new record form looks like at LMH. Besides keeping track of a patient’s health and medication history, the electronic records can help cut down on medical errors such as dangerous drug interactions. by Richard Gwin

The Kansas Department of Health and Environment announced this week that health care providers can apply for Electronic Health Record incentive payments through its Health Information Technology and Health Information Exchange website.

The payments are being provided through the Kansas Medicaid Incentive Program.

“Kansas health professionals who have invested in meaningful use of electronic health records can apply for incentive payments from the federal government. It is a major milestone in implementing HIT/HIE in the State of Kansas. The use of EHRs (electronic health records) contributes to the safety of patients."

— Kari Bruffett, division director for Health Care Finance

Simply put, she said "meaningful use" means providers need to show that they’re using certified technology in ways that can be measured significantly in quality and in quantity. Meaningful use criteria includes enrolling in the Kansas Immunization Registry.

Providers must first register on the national Centers for Medicare and Medicaid Registration and Attestation website at: http://www.cms.gov/EHRIncentivePrograms/20_RegistrationandAttestation.asp.  

Once that is complete, eligible professionals can apply for Kansas Medicaid EHR payments online at: http://www.kdheks.gov/hcf/hite/default.htm.

Cottonwood Inc. employee Yvette Bell, left, shows KU women's basketball player Keena Mays, of Arlington, Texas, how to package gift bags Thursday, Jan. 13, 2011. Cottonwood employs people with developmental disabilities. by Mike Yoder

Two disability programs at the Kansas Department of Health and Environment have teamed up to bring disability awareness and education to students at Kansas University Medical Center this semester.

The Disability and Health Program and the Children and Youth with Special Health Care Needs Program partnered with the KUMC to offer a two-hour elective course for graduate-level students titled, “Caring for People with Disabilities.”

It's the first time a comprehensive disability awareness course has been offered in Kansas.

The course provides an opportunity for health care providers to learn how to effectively communicate with and care for a person with a disability in a health care setting and to address disability civil rights. It also provides a basic understanding of a variety of disability conditions and resources available for independent living.

The course was made possible through two federal grants from the Centers for Disease Control and Prevention and the Health Resources and Services Administration.

The programs are in the planning process of making the course and all its components available to any nursing school.

For more information about the course or the Injury and Disability Prevention Programs at KDHE, visit  http://www.kdheks.gov/idp/index.html.

Center's logo uploaded by kbritt

The Kansas Department of Health and Environment's Center for Health Equity is seeking entries for its "Voices for Health Equity" project.

It wants to hear how organizations are working to achieve equity in health among groups of people living in Kansas communities. Submissions may come from health departments, federally-qualified health centers, tribal health and Indian Health Service clinics, partnering organizations and community coalitions in Kansas.

The three main objectives for this project are:

• Create awareness of the factors which influence equity and the health of Kansans.

• Engage a diverse mixture of Kansans and provide a platform for their voices to be heard.

• Start a conversation about the ways we can make Kansas a healthier place for everyone.  

“We want to know what you’re doing to create health equity where you live and work. We want to help you spread the word so we can learn from each other."

— Aiko Allen, director of KDHE’s Center for Health Equity

The deadline is March 1. Five winning stories will be made into Digital Stories, presented across the state and online. Winners will receive $200 each for participating. To compete the application, visit www.healthequityks.org.

Kansas Department of Health and Environment Secretary Robert Moser talks about his experiences as a family doctor in Tribune, Kansas, during an interview Friday, April 8, 2011, in Topeka. He recently outlined his priorities for 2012 and obesity is his top concern. by Richard Gwin

Infant mortality, injuries and deaths from vehicle accidents and lack of immunizations are among issues the state’s top health official wants to address in 2012. But, his top priority is obesity.

Dr. Robert Moser, secretary of the Kansas Department of Health and Environment, said the number of adolescents and adults who are overweight has steadily increased during the past 15 years. It’s concerning because of the number of health conditions related to weight gain: high blood pressure, high cholesterol, increased risk of diabetes and arthritis.

“The obesity epidemic in Kansas is a complex issue that’s going to have to be addressed from a number of different directions,” he said.

Moser said the state has to address physical activity and healthy food options in schools and workplaces, where people spend about half of their time.

“Studies are out there in multitudes that demonstrate a healthy workforce costs a lot less for the employer down the road and increases productivity as well,” he said.

The state also will encourage organizations and businesses to offer more activities.

“We know that people do better maintaining a healthy lifestyle when they partner up with others to do that, including spouses and children as well as colleagues and friends,” he said. “It’s going to take a community effort to make it work.”

A look at the obesity rate in America. by kbritt

Moser’s other health priorities for 2012 are:

• Continue to work toward accreditation. He said the Public Health Accreditation Board has been developing an accreditation process for state health offices and local health departments for the past three years. He said the process will define what core services need to be provided and how well they are doing their jobs.

Moser believes the accreditation process will help standardize public health across the state. Currently, each local health department is responsible for its own safety and health issues and some may not have the resources that others have.

“It’s a little bit more organized approach to looking at where the problems are and how do we go about addressing them,” he said. Moser has seen more collaboration between health departments and communities as they work toward accreditation and he hopes that increases.

Moving toward accreditation is a voluntary process, but Moser believes having accreditation will help departments garner grants in the future.

• Increased collaboration among providers. He wants all health care providers to address behavioral risk factors — smoking, exercise and preventive care — in a more timely manner. For example, he said, if a woman uses a local health department to get a vaccine, staff should take a few minutes to ask about her routine preventive exams. Has she had a breast exam? What about a mammogram or colonoscopy?

Moser also wants more health care providers to do a better job of measuring how they’re doing. As a primary care doctor in western Kansas, Moser said he thought he did a good job of reminding his patients to take all of the preventive measures, but when they looked at the clinic’s patient population, they found they weren’t doing such a good job.

“If you don’t measure it, you can’t manage it,” he said.

• Decrease in infant mortality. The rate has declined the last couple of years, but not enough. He said there are a number of things that help decrease infant mortality including practicing healthy habits like exercising and not smoking while pregnant and breastfeeding babies for at least six months after birth. He said babies who are breastfed have fewer respiratory ailments, are healthier and less likely to be obese.

• Increase in immunizations. Moser said there has been a slight decline in the number of adults and adolescents who are getting their recommended immunizations. The state’s 2010 Healthy Kansas goal was to have more than 90 percent of children getting their immunizations, instead it’s in the 80 to 85 percent range.

He said scientific research has proven that vaccines are effective and safe; yet he spends a lot of talking about it. He believes it’s because Kansans are a couple of generations removed from seeing a great deal of vaccine-preventable diseases.

During his first year of residency in 1985, he saw children who suffered neurological deficits because of haemophilus influenza. He said it was not unusual to do three or four spinal taps a day in the winter months. By the time he finished medical school, he didn’t do any spinal taps.

“It was a very vivid example of how effective a vaccination can be for a disease that can cause serious health concerns and long-term problems,” he said.

The flu shot vaccine is filled into a syringe. by Kevin Anderson

• Decrease in vehicle accidents. Moser said the highest rate of accidents occurs among Kansans between the ages of 15 and 24, and he believes it’s often because they are distracted — because of a passenger, changing the radio station or using a cell phone.

Moser said when Kansas implemented the mandatory seat belt law and the graduated license law, there was a significant drop in accidents.

“It was effective,” he said.

He said there could be a bill introduced at the state level in regards to cell phone use, but he questions how well law enforcement could monitor it.

“Our law enforcement folks have a great deal of other things to keep them busy, so it will be interesting to see what happens,” he said.

Moser said the state would be monitoring what happens in other states and at the federal level.

• Less tobacco use. The slight decline in tobacco use among adults has leveled off while there has been a slight rise in the number of adolescents who are using tobacco, he said. He believes the state needs to be more innovative in its approach.

“We’ve been doing some of the same things for a long period of time,” he said.

Moser said, for example, health department staff may need to speak up when they see a client carrying a pack of cigarettes even though they aren’t the person’s primary care provider and the client is there for a flu shot. He said they need to provide some education about tobacco use and resources to get help.

“There’s not a smoker or tobacco user out there that will tell you they don’t know that tobacco is bad for them, but finding a way to help them find the willpower, motivation and the ability to quit is going to take a little bit of a different approach over time,” he said. “We all have a role to play in helping those who want to quit.”

Janelle Martin, executive director of the Community Health Improvement Partnership, provided information about the ill effects of smoking on the heart during the Healthy Hearts Fair on Saturday, Feb. 12, 2011, at Lawrence Memorial Hospital. by Karrey Britt

Sitting on the step of the family van, Evan Liakos, 8, gets his flu shot from volunteer Nola Bienoff under the watchful eye of his twin brother Conner. Evan received a free flu shot during a drive-thru flu shot clinic Saturday, Oct. 8, 2011, that was organized by the Lawrence-Douglas County Health Department. by Kevin Anderson

The Kansas Department of Health and Environment reported Friday that it has identified the first cases of flu this season.

The cases were two adults from northwest Kansas who are in the same workplace and who did not receive a vaccination. Five co-workers also were ill with symptoms of the flu.

KDHE Secretary and state health officer Robert Moser urges everyone to get a flu vaccination, noting that it’s not too late.

“Although flu activity is now low, it normally rises during the holidays before peaking around February,” he said. “Influenza can continue to circulate through spring, and the flu can be unpredictable.”

Anyone 6 months and older is recommended to receive an annual flu vaccination. Additional ways to avoid spreading influenza include covering coughs and sneezes, washing your hands and staying home when sick.

Flu symptoms include fever, headache, extreme tiredness, dry cough and muscle aches. Complications can include pneumonia, ear and sinus infections and dehydration; influenza may also worsen other chronic conditions.

Older people, pregnant women, young children, and people with certain health conditions are at high risk for serious complications from the flu.

Influenza was documented as a cause of death for 31 Kansans in the 2009-2010 flu season and for 14 last year. However, flu is often not listed on death certificates because laboratory tests may not show flu by the time pneumonia or other complications develop, state epidemiologist Charles Hunt said.

“The actual numbers of influenza-related deaths are likely much higher and can vary substantially from year to year,” Hunt said.

For more information, visit www.kdheks.gov/flu, or contact the Lawrence-Douglas County Health Department at 843-0721.

Conner Liakos, 8, waits for the stick of the needle from volunteer Nola Bienoff. The Lawrence-Douglas County Health Department organized the drive-thru flu shot clinic Saturday, Oct. 8, 2011, as part of a training exercise to test the community public health emergency response plans. Health department director Dan Partridge said he doesn't anticipate having a drive-thru clinic in 2012 due to costs. by Kevin Anderson

It’s not too late.

That’s the message that Kansas health officials are delivering this week to folks who have procrastinated about getting a flu shot.

Thousands of people already have been vaccinated this year in Douglas County. But Lawrence-Douglas County Health Department spokeswoman Lisa Horn is asking those who haven’t received one to get a shot now.

“That way, they will have immunity by the time Christmas rolls around when they are mingling with friends and family,” Horn said.

And the flu shot will provide protection later in the season, too, when flu activity is at its highest.

Here are some numbers to gauge how this year’s flu season is shaping up:

2,124

The number of people who have received flu shots from the Lawrence-Douglas County Health Department since Sept. 1.

2,055

The number of people who received flu shots from the Lawrence-Douglas County Health Department during the 2010-2011 flu season.

6

The number of clinics the Lawrence-Douglas County Health Department held for flu vaccines this year.

2

The number of weeks it takes before a flu shot provides optimal protection.

46.2 percent

The vaccine coverage area the Centers for Disease Control and Prevention reported for Kansas residents during the 2010-2011 flu season.

200,000

The number of people in the United States hospitalized each year with flu complications, according to the Kansas Department of Health and Environment.

14

Number of Kansans who died from influenza during the 2010-11 flu season. The year before, 31 people died, according to KDHE.

5 to 20

The percent of population that contracts the flu yearly.

29

The number of states where sporadic influenza activity has been reported, according to the CDC’s weekly influenza surveillance report. Nearby states include Colorado, Nebraska, Iowa, Illinois, Arkansas and Texas.

21

The number of states where no flu activity has been reported as of the Nov. 26 CDC report. Kansas is among those states.

6 months and older

Who the CDC recommends should get a flu shot.

$28

The cost of a flu shot at the Lawrence-Douglas County Health Department for people 3 and older. Shots are available during regular clinic hours. For more information and to print out forms, go to www.ldchealth.org/flu.htm.

$23

The cost of a flu shot at the Lawrence Douglas County Health Department for people between the ages of 6 months and 35 months.

The Kansas Department of Health and Environment will host a live Twitter chat about flu prevention from 3 p.m. to 4 p.m. Tuesday. You can follow @KDHE and search for the hashtag #KSflu, where you can get information about flu vaccines, prevention methods and symptoms.

In 2008, 3,014 Kansas babies, or 7.2 percent, were born weighing less than 5 pounds, 8 ounces, which is considered a healthy birth weight. These babies are more likely to face health problems.

Data from the giant statewide report card was released Thursday. Known as the Summary of Vital Statistics, the report tracks information on residents’ births, deaths, marriages and divorces. The data, compiled by the Kansas Department of Health and Environment, is from 2010. Here are some of the highlights:

40,439

Number of live births in Kansas.

3.4 percent

Decrease in Kansas birth rate from 2009, which was at 14.7 per 1,000, to 2010, which was at 14.2.

1,263

Number of births in Douglas County, which is 27 more births than last year.

7.5 percent

Increase in Douglas County birth rate from 2009, which was at 10.6 per 1,000, to 2010, which was at 11.4.

4,183

Number of abortions performed in Kansas on Kansas residents.

4,150

Number of abortions performed in Kansas on out-of-state residents.

4,501

Number of pregnancies in Kansas for mothers under 20.

23.1 per 1,000

The pregnancy rate for Kansas teenage girls. It’s the lowest rate in the past 20 years.

70

Number of pregnancies in Douglas County for mothers under 20.

12.6 per 1,000

The pregnancy rate for Douglas County teenage girls.

24,428

Number of deaths in Kansas, which is a 1.8 percent increase from 2009.

627

Number of deaths in Douglas County.

74.1

Average age of death in Kansas.

75

Average age of death in Douglas County.

5,404

Number of people in Kansas who died from heart disease, the leading cause of death in the state. Cancer and chronic lower respiratory disease were the second and third.

409

The number of Kansans who committed suicide. It’s an 8.8 percent increase from 2009.

470

The number of Kansans who died from a motor vehicle accident.

18,150

Number of marriages in Kansas.

10,579

Number of marriage dissolutions in Kansas.

6.4 per 1,000

The marriage rate in Kansas. It’s the lowest rate in the past 20 years.

25.1

Average age of women marrying for the first time.

26.9

Average age of men marrying for the first time.

773

Number of marriages in Douglas County.

291

Number of marriage dissolutions in Douglas County.

Kansas Department of Health and Environment Secretary Robert Moser announced today the resignation of Andy Allison, director of the Division of Health Care Finance.

Allison has accepted a job as Arkansas’ Division of Medicaid Services director. Kari Bruffett, KDHE’s assistant secretary for Policy and External Affairs, will serve as interim director of Health Care Finance.

“Andy has served the State of Kansas admirably and we wish him the best,” Moser said in a news release. “This agency has benefited greatly from his nearly 20 years of Medicaid experience.”

Andy Allison

Allison was the executive director of the Kansas Health Policy Authority before the agency merged with KDHE on July 1.

“The reforms Kansas announced last week are the right direction for Kansas and those receiving services. Implementing KanCare’s essential reforms will ensure long-term stability of the program through improved outcomes for Kansans,” Allison said. “The opportunity to work near family in my wife’s home state of Arkansas is an opportunity I could not let pass.”

Allison’s last day with KDHE is Nov. 22. He plans to begin work in Little Rock on Dec. 5. Bruffett will maintain her role as assistant secretary while also serving as interim director for Health Care Finance until the agency finds a permanent replacement for Allison. 

Kari Bruffett

Kansas now has seven cases of listeriosis, including two deaths, definitively linked to the multi-state outbreak involving Rocky Ford cantaloupes from Jensen Farms.

Typically, Kansas reports fewer than six cases of listeriosis per year, according to the Kansas Department of Health and Environment.

Listeriosis primarily occurs among older adults, persons with weakened immune systems, pregnant women and newborns. Symptoms include fever, muscle aches, diarrhea and vomiting. People with these symptoms should consult a physician. 

Symptoms typically occur three to 70 days after exposure.

KDHE has not released any information about where these cases have occurred.

For more information, visit the CDC multi-state food-borne illness outbreak page at http://www.cdc.gov/outbreaknet/outbreaks.html.

The Kansas Department of Health and Environment reported today that at least five cases of listeriosis in Kansas are part of the multi-state outbreak involving Rocky Ford cantaloupe.

It was notified by the Centers for Disease Control and Prevention.

So far, 55 people from 14 states have been infected with the four outbreak-associated strains of Listeria monocytogenes, a bacterium that can cause serious illness. All illnesses started on or after Aug. 4.

Kansas has eight cases of listeriosis reported since Aug. 26, with five cases now matching the multi-state outbreak. Two of these eight patients have died and the causes of death are being investigated. Typically, Kansas reports fewer than six cases of listeriosis per year.

CDC recommends consumers and especially persons at high risk for listeriosis, including older adults, persons with weakened immune systems, and pregnant women, to not eat cantaloupes marketed from Jensen Farms in the Rocky Ford region of Colorado because of potential contamination with Listeria monocytogenes.

Rocky Ford cantaloupes from Jensen Farms were distributed in Kansas. The cantaloupe may be labeled: Colorado Grown, Distributed by Frontera Produce, USA, Pesticide Free, Jensenfarms.com, Sweet Rocky Fords. Some cantaloupes may also have been unlabeled.

Jensen Farms issued a voluntary recall of Rocky Ford Cantaloupe on Sept.14.

Symptoms of listeriosis include fever, muscle aches, diarrhea and vomiting. People with these symptoms should consult a physician. Symptoms typically occur three to 70 days after exposure. 

For more information, visit the CDC multi-state food-borne illness outbreak page at http://www.cdc.gov/outbreaknet/outbreaks.html.

The Kansas Department of Health and Environment is warning residents to not eat cantaloupes marketed as coming from the Rocky Ford region of Colorado because of potential contamination with Listeria monocytogenes, a bacterium that can cause severe illness.

KDHE announced this afternoon that it is collaborating with the Centers for Disease Control and Prevention, the U.S. Food and Drug Administration, the Kansas Department of Agriculture and health officials in other states to investigate a multi-state outbreak of listeriosis associated with consumption of Rocky Ford cantaloupes.

Kansas has had six cases of listeriosis reported since Aug. 26. None of these cases has been definitively linked to the outbreak, but investigations are under way and additional laboratory testing is pending.

Typically, Kansas reports fewer than six cases of listeriosis per year. There have been seven cases this year, including the six cases under investigation.

Lisa Horn, of the Lawrence-Douglas County Health Department, said there have been no cases reported in Douglas County.

Rocky Ford cantaloupes were distributed in Kansas, including Lawrence. One farm, Jensen Farms of Holly, Colo., issued a voluntary recall of Rocky Ford cantaloupe on Sept. 14.

According to KDHE, listeriosis primarily occurs among older adults, people with weakened immune systems, pregnant women and newborns. 

Symptoms include fever, muscle aches, diarrhea and vomiting. People with these symptoms should consult a physician. Symptoms typically occur three to 70 days after exposure.   Rocky Ford cantaloupes should be disposed of in a closed plastic bag placed in a sealed trash can to prevent people or animals from eating them.

For more information regarding this outbreak, visit the CDC’s outbreak page at http://www.cdc.gov/outbreaknet/outbreaks.html.

U.S. Secretary of Health and Human Services Kathleen Sebelius speaks at a round table discussion with area seniors on the benefits of the Affordable Care Act, Thursday, June 30, 2011 in Cincinnati. On Wednesday, she announced $40 million in grant funding, partly funded by the Affordable Care Act, to boost public health infrastructure and boost the public health work force.

Health and Human Services Secretary Kathleen Sebelius announced today $40 million in grant funding to enhance the nation’s public health infrastructure and strengthen the public health work force.

Nearly every state received funding, which is partly supported by the Affordable Care Act.

The Kansas Department of Health and Environment received $300,000.

“These funds will help health departments around the country maximize the impact of the essential services they provide every day and build the public health work force to ensure we’re ready to meet the public health challenges of tomorrow."

— HHS Secretary Kathleen Sebelius

The grants will fund key state and local public health programs in Kansas supported through the Centers for Disease Control and Prevention. Most of these grant dollars come from the Prevention and Public Health Fund created by the Affordable Care Act. 

This is the second year of CDC’s 5-year program known as the National Public Health Improvement Initiative (NPHII) Strengthening Public Health Infrastructure for Improved Health Outcomes grant program. More than 100 people across the country have already been hired through the NPHII, and additional positions are expected to be filled through the awards.

For a full list of grantees, visit: www.hhs.gov/news/press/2011pres/08/state_workforce_grants.html.

Immunizations are not just important for children as they head back to school — they’re important for adults, too.

The Kansas Department of Health and Environment is reminding families about the importance of vaccines as part of National Immunization Awareness Month.

Each year, immunizations:

• Save 42,000 lives.

• Prevent 20 million cases of disease.

• Save $13.6 billion in direct costs.

“We all need a variety of immunizations to not only help protect us throughout our lifetime, but to also help protect those around us,” said Mike Parsons, immunization outreach coordinator with KDHE’s Bureau of Disease Control and Prevention.

Everyone over age 6 months needs to be vaccinated against seasonal flu every year. Other vaccinations work best when they are given at certain ages.

Here are some general guidelines:

• Children need a series of vaccinations from birth to age 6.

• Pre-teens need recommended vaccinations at age 11 or 12, as well as teenagers as they enter into high school and college.

• All adults need a variety of vaccinations to prevent diseases such as whooping cough, pneumonia, flu, shingles and more.

Carole Rehder, a retired nurse, gives Leslie Ostronic, 9, her second dose of the H1N1 flu vaccine in January at the Lawrence-Douglas County Health Department clinic. In the background is Leslie’s mother, Laurie, who is holding siblings Brecken, 4, and Dallas, 5. The children all received an immunization. by Richard Gwin

There are new immunization requirements for the 2011-2012 school year. According to the Lawrence-Douglas County Health Department, they are:

• Kindergartners, first-graders, second-graders and seventh-graders must have two chicken pox shots or a written note from their physician stating that they have had chicken pox.

• Seventh-graders must have a Tdap (tetanus, diphtheria and pertussis) vaccine.

For the latest immunization requirements, visit www.kdheks.gov/immunize or call your local health care provider.

The health department offers vaccines in its clinic at 200 Maine on a walk-in basis. Prices vary depending on health insurance and possible qualifications for low-income programs. For more information contact the health department at 843-0721.

Jane Shirley

The Kansas Department of Health and Environment announced Monday that it has hired Jane Shirley as the director of local health for the Bureau of Community Health Systems.

Shirley, a registered nurse, has worked in the KDHE’s Bureau of Health Promotion since 2008, following 20 years of working for the Jefferson County Health Department.

The Bureau of Community Health Systems includes public health preparedness, special populations health, local health, primary care, rural health and trauma programs. These programs support the state’s communities to ensure that quality services are accessible for all Kansans.

The bureau provides leadership in public health emergency situations, whether caused by natural events or acts of terrorism. Cooperation with public health system partners, community-based primary care clinics, hospitals and a wide array of local, state and federal agencies and organizations is a core activity within the bureau.

Ken Wade, operations project manager for the U.S. Army Corps of Engineers, Kansas City district, talked July 17 about the high-levels of blue green algae officials found at Perry Lake. Several portions of the lake were closed, but now have reopened. by Shaun Hittle

The Kansas Department of Health and Environment has lifted a public health advisory at Perry Lake.

On July 15, KDHE issued a warning that indicated the water conditions were unsafe for wading, skiing and swimming.

Staff continued to conduct weekly tests, and hazardous conditions at the lake on July 21 were downgraded to an advisory. Today, the advisory has been lifted, but KDHE staff urges visitors to be cautious.

“Our testing showed that there are no high areas of concern at the moment,” said Tom Langer, director for the Bureau of Environmental Health. “That said, if you see any green material floating in the water, you, and especially your pets, should avoid it. Areas like Rock Creek could potentially develop small clusters of blue green algae.”

For the latest advisories and warnings, visit www.kdheks.gov/algae-illness/algae_advisories.htm.

Kansas Department of Health and Environment Secretary Robert Moser talks about his experiences as a family doctor in Tribune, Kansas, during an interview Friday, April 8, 2011, in Topeka. by Richard Gwin

Topeka — Connector. Motivator. Administrator.

Those are the three words that Dr. Robert Moser used to describe his job as secretary of the Kansas Department of Health and Environment.

After 22 years as a small-town family doctor in western Kansas, Moser believes he can serve as the connection between communities and the agency. He also wants to open the communication lines within the agency.

Moser, 52, is enthusiastic about his role at KDHE, which has 1,061 employees.

“It’s very challenging, exciting and stimulating,” he said.

That’s because he is taking over during a time of great change in the health care industry, thanks to the Affordable Care Act.

Also, KDHE is adding a new division, Health Care Finance, which includes Medicaid, the state employee health benefits package, state workers’ compensation and the State Children’s Health Insurance Program. That division needs to be in place by July 1.

“I feel like I’m back in medical school because of the volume of stuff I take home at night to get comfortable with what the programs are doing and how they are funded.”

In an hourlong one-on-one interview, Moser fondly recalled his upbringing and career as a doctor.

He also talked about topics such as health reform, electronic medical records, obesity, safety net clinics and his dedication to the Jayhawks.

The football- and basketball-season ticketholder will no longer have to drive six hours — one way — to watch the Jayhawks.

Lawrence is his new home.

His family

Moser grew up in Tribune, a town of 740 people. His father owned a garage and body shop and his mom was an accountant.

“My dad was probably my best teacher,” he said.

He would repair someone’s car to keep it running even if they didn’t have the money to pay for it — often exchanging his work for things like piano lessons for one of his five children.

That’s why Moser said he charged his patients based on their ability to pay.

“I just didn’t want people not coming to see me because they didn’t have the money,” he said. “It’s much cheaper to take care of it now than it would be if you kept putting it off.”

Moser graduated from the KU School of Pharmacy in 1981, the KU School of Medicine in 1985, and completed his residency at Smoky Hill Family Practice in Salina. He returned to Tribune to fulfill his obligation with the Kansas Medical Student Loan Program. The program paid for his tuition if he served in a rural Kansas area.

He figured he would practice for four years in his hometown and then move elsewhere.

“It just never seemed to be the right time to make any changes,” he said, especially since he started a family.

He and his wife, Dalene, also a “Tribune townie,” raised daughters Lauren and Madison. Lauren is a senior at Southwestern University in Winfield, and Madison is a KU freshman.

His practice

When Moser started practicing in Greeley County in 1988, there was one doctor who had been there for 30 years. In two years, he retired.

“All of a sudden, I was the only doctor,” Moser said.

Eight months later, a longtime doctor in adjacent Wallace County also retired, and so Moser took on even more patients.

Moser saw patients in the clinic, hospital, emergency room and in long-term care. He was the county health officer, medical director for Emergency Medical Services, and county coroner.

He survived three years alone — seeing about 40 people in the clinic each day, before Dr. Wendel Ellis was recruited to join him.

Now, there are four doctors and three midlevel providers who cover two hospitals and three clinics in Greeley, Wallace and Hamilton counties.

“I think I left it in better shape than I found it,” he said.

In August, he left Tribune to become director of Rural Health and Outreach at KU School of Medicine-Wichita. It served as a stepping stone for him.

“I truly believe things happen for a reason,” Moser said. “If I had come from private practice right into this position, it would have been overwhelming.”

His priorities, concerns

• Lack of primary care doctors.

He said Kansas needs about 600 more primary care doctors.

“We really do have a shortage,” he said.

Studies show that the more primary care providers you have per capita, the better the health outcomes and the lower the costs for health care.

Moser said the biggest problem is that primary doctors aren’t paid enough, and that’s why we’ve ended up with a health system that’s made up of 70 percent specialists compared with 30 percent primary care. He said it should at least be 50-50, especially as more patients are developing chronic conditions, like diabetes, arthritis and high blood pressure.

• Health reform

Moser seemed to have mixed feelings about the effects of the Affordable Care Act and is taking a wait-and-see approach.

For example, he asked, if more people become insured should the government continue to fund safety net clinics? Or, should the funding be used to train more primary care doctors?

“There are a lot of policy questions and obviously a lot of current discussion going on — not only in our state but across the country,” he said.

He clearly supports the Health Information Exchange. He said KDHE will receive more robust data and faster, which will allow it to know where problems exist and more quickly design an intervention.

He described the Medicaid reimbursement increase for primary doctors as a half-hearted effort because it’s only for two years.

• Environment

Moser admits he’s not an “environmental scientist,” but he has some experience.

As county health officer, he took calls about standing water, rabid dogs and dilapidated structures.

He was on the economic development board in Greeley County when the possibility of a new coal-fired power plant in nearby Holcomb was being hotly debated. Moser said the plant provides an opportunity to have transmissions lines go through western Kansas that would allow the development of wind energy.

“If you don’t have another reason to build those transmission lines, wind energy doesn’t produce the kind of revenues that a community could build just to do it,” he said.

Moser supports building the plant because he believes it complies with state and federal air quality requirements.

What’s the top environmental challenge for Kansas?

“I think a lot of things are in line with where we need to go,” he replied.

• Public health

Without hesitation, Moser said obesity is the top health challenge.

“Our communities are not designed to encourage walking or bicycling, so we really do have to look at that seriously,” he said.

He also thinks fewer families know how to grow a garden and eat healthy. Moser said he’s as guilty as anyone.

“It’s much easier to run home and grab something off the shelf, out of box, that’s processed, and fix it than it is to make it from scratch,” he said.

For exercise, he runs twice a week and lifts weights.

“I am certainly not trying to look like He-Man,” he said, laughing. “It’s just something that makes me break out in a sweat and huff and puff, if I can’t be out running.”

Moser said he’s good at counseling patients and then not following his own advice.

“I’ve always told my patients to eat healthy, be active — active like I am telling you, not like I am doing because you don’t want to have my sleep habits. You don’t want my eating habits,” he said.

Dr. Robert Moser's Bio

Age: 52

Residence: Lawrence

Job: Kansas Department of Health and Environment secretary

Education: KU School of Pharmacy, 1981; KU School of Medicine, 1985; residency in family medicine at the Smoky Hill Family Practice Residency in Salina, 1988.

Career: Family doctor in Tribune for 22 years; director of Rural Health and Outreach at KU School of Medicine-Wichita from August until January.

Memberships: Kansas Academy of Family Physicians, American Medical Association, Kansas Medical Society, American Geriatric Society, American Medical Directors Association and National Rural Health Association. Awards: National Health Services Corps. director, 1998; KUMC Rainbow finalist, 2000; and Kansas Academy Family Physician of the Year, 2006.

Family: Wife, Dalene, of 29 years, and two daughters, Lauren and Madison.

Dr. Robert Moser

I am looking forward to Friday afternoon’s one-on-one interview with Dr. Robert Moser, secretary of the Kansas Department of Health and Environment.

Moser previously was director of Rural Health and Outreach at the KU School of Medicine-Wichita, a job he began in September 2010. Prior to that, he was medical director of Greeley County Health Services. I am told that he has some “good” stories from his days of practicing in western Kansas.

Moser was the 2006 Kansas Family Physician of the Year and has served on several state task forces that have studied various rural and primary health care issues.

I will be asking Moser about his career and his goals for Kansas. I am curious as to what you would like to ask him. If you have a question, e-mail it to me at kbritt@ljworld.com by 11 a.m. Friday, or put your question in the comments below.

Barbara Thomas, a former West Junior High School teacher, gives a congratulatory high-five to ninth-grade student T.J. Everett, during a visit by Thomas to the school's farmers' market Monday, Aug. 2, 2010. So far, T.J. and five other students have worked on the garden this summer and made $1,700 through sales of produce and products. The money goes back into the garden. by Mike Yoder

It’s full steam ahead on school gardens

Nancy O’Connor, education and outreach coordinator at The Merc, provided me with an update on a few school garden projects that she is coordinating.

The West Junior High School garden will include fruit trees and small fruits this year! There also will be a strong spring garden — if Mother Nature cooperates — that will provide food for the cafeteria before summer break.

Congrats to T.J. Everett and Karen Schneck, who have been hired by The Merc to serve as mentor gardeners during the upcoming season. They were among six student gardeners last year. More students will be hired this spring after an application process.

The students also will be growing volume crops at a farm in Lone Star that is owned by Lynn Byczynski and Dan Nagengast.

There will be a new demonstration plot in front of The Merc, where students will be growing food and customers will be able to watch the progress.

There also will be new gardens at Hillcrest and Sunset Hill schools.

Produce from all of the gardens will be sold at weekly markets. O’Connor said they are planning to have two markets per week: one at WJHS and the other at the Lawrence Farmers’ Market at Sixth Street and Wakarusa Drive.

First, they need your help. They have scheduled work days for the gardens:

• WJHS — 8 a.m. to 4 p.m. Saturday, March 12; and 3 p.m. until dark Tuesday, March 15.

• Sunset Hill and Hillcrest — 8 a.m. to 4 p.m. Saturday, April 2.

Interested volunteers should contact Lily Siebert at The Merc at 843-8544 or by e-mail at lily@themerc.coop.

Kelly Woodson, left, and Max Buckmann, work at The Koffee Korner, a new coffee shop located across from the gift shop in Lawrence Memorial Hospital. Both are managers of the shop, which is open from 7 a.m. to 7 p.m. weekdays. by Karrey Britt

Koffee Korner is open for business

A coffee shop — Koffee Korner — opened Feb. 1 across from the gift shop at Lawrence Memorial Hospital.

It is open from 7 a.m. to 7 p.m. weekdays and offers a variety of hot and iced coffees and other drinks. Its menu and prices are comparable to other coffee shops in town.

Kelly Woodson, manager and barista, said business has been good and they plan to offer baked goods and other snack items soon.

Dietitian to offer tips on calcium

Lawrence Memorial Hospital’s free Nutrition Roundtable series will focus on calcium this month.

Dietitian Patty Metzler will talk about how daily calcium intake patterns affect your health. She also will present creative ways to ensure a diet of sufficient calcium.

The roundtable will be:

• from 6:30 p.m. to 7:30 p.m. Thursday, Feb. 17.

• at Lawrence Memorial Hospital, 325 Maine.

Space is limited so advance registration is requested. To reserve a seat call LMH ConnectCare at 749-5800 or visit lmh.org.

Know the signs of heart attack

Heart attacks are the cause of about one in three heart disease deaths, and an estimated 78,000 adults in Kansas have had one.

Some are sudden and intense, but most start slowly, with mild pain or discomfort.

Often people don’t realize what’s wrong and wait too long before receiving help, according to Dr. Robert Moser, acting state health officer for the Kansas Department of Health and Environment.

In Kansas, more than half of heart disease deaths occur before reaching a hospital, clinic or medical center. Recognize the following signs and symptoms and call 911 immediately at the first sign of a heart attack:

• Chest pain or discomfort — Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness, or pain.

• Discomfort in other areas of the body — Symptoms can include pain or discomfort in one or both arms, shoulder, back, neck, jaw or stomach.

• Shortness of breath — May occur with or without chest discomfort.

• Feeling weak, light-headed, or faint — This may include breaking out in a cold sweat, nausea or vomiting.

Michelle Derusseau, Lawrence, and her mother Sue Lavery, Lenexa, attend the Go Red For Women luncheon, Friday, Feb. 11, 2011, at The Oread Hotel. Derusseau, 47, was the passion speaker during the event. She suffered a heart attack at age 39 in April 2003. by Karrey Britt

Lawrence resident Michelle Derusseau had a heart attack at 39. She shared her story during the Go Red For Women luncheon on Friday. She talked about how she didn’t recognize the symptoms until her arm went numb.

Dental hygenist Holly Blick fills out paperwork Tuesday during a free fluoride varnish treatment clinic for low-income children at the Lawrence-Douglas County Health Department. The walk-in clinic, which was sponsored the health department and Douglas County Dental Clinic, provided care for eight children — all of whom needed dental work and were referred to the community's resources. . by Kevin Anderson

Dental hygienist Holly Blick applied fluoride varnish to eight children’s teeth during a free treatment clinic this week at the Lawrence-Douglas County Health Department.

The varnish is a sticky coating of fluoride that is applied to teeth to help prevent decay.

“It offers a more concentrated delivery of fluoride to the tooth’s surface,” said Dr. Cheryl Biesterfeld, a Lawrence dentist with Douglas County Dental Clinic, which co-sponsored the clinic. The clinic serves uninsured, low-income residents.

Biesterfeld said tooth decay is “incredibly common” among her patients. She thinks it’s because their diets are high in sugar and acid. If left untreated, they can lose their teeth.

The fluoride treatment clinic follows a recommendation earlier this month by the U.S. Department of Health and Human Services to lower the level of fluoride in drinking water. Its proposed recommendation to the Environmental Protection Agency is 0.7 milligrams of fluoride per liter of water — a level the city of Lawrence has maintained for decades. The current recommendation is 0.7 to 1.2 milligrams per liter.

The HHS proposal is meant to reduce the possibility of children, ages 8 and younger, receiving too much fluoride during tooth development — known as fluorosis.

According to HHS, dental fluorosis in the United States appears mostly in the mild form, which is barely visible white spots or streaks. Severe forms — staining or pitting of the tooth surface — is rare.

The U.S. Centers for Disease Control and Prevention found a 9 percent higher prevalence of dental fluorosis in children than was found in a similar survey 20 years ago.

Another recent government study found that 41 percent of children, ages 12 to 15, have tooth streaking or spottiness because of too much fluoride.

Biesterfeld said she rarely sees patients with fluorosis, but admitted she has a mild case of it that has not caused problems.

Fluoride regulations

A total of 63 — or 7 percent — of 895 water systems in Kansas are fluoridating the water, according to the state’s health and environment department.

Katie Ingels, department spokeswoman, said the agency encourages the new HHS recommendation. It does quarterly checks on the fluoridating systems.

She said the EPA requires a water system exceeding 2 milligrams per liter to inform it customers, but the system is not in violation of the law until its yearly average exceeds 4 mg/L.

Ingels noted that it’s not difficult for cities to adjust fluoride levels and can be done almost immediately.

KDHE does not have data on the incidence of fluorosis in Kansas, but it has plenty on tooth decay. A 2004 survey of third-graders found one in four had untreated dental decay. KDHE is planning a new survey next fall.

Last year, the agency did a survey of children in Douglas County, which has mostly flouridated water, and Sedgwick County, which mostly doesn’t. The percentage of children who had been treated for decay was 33 percent in Douglas compared to 43 percent in Sedgwick. The percentage of children with untreated decay was 18 percent in both places.

Opponent’s view

Albert Burgstahler, retired professor emeritus of chemistry at Kansas University, believes fluoridations does more harm than good.

Burgstahler, 82, of Lawrence, co-wrote “Fluoridation: The Great Dilemma,” serves as editor of the quarterly journal “Fluoride” and was a founding member of the anti-fluoridation Fluoride Action Network.

He said he became involved with the issue in 1965 when he had developed a low thyroid condition that caused him excessive thirst, bloating and headaches. While he was working on research, he came across information about how too much fluoride in drinking water — 4 to 5 mg/L — might cause his condition. He switched to distilled water.

“I was absolutely amazed,” he said of the results. The symptoms vanished. Since then, he has been a staunch opponent of fluoridation. He has been fighting it at the national and local level.

“The public health service still maintains that fluoridation has a real important role to help reduce tooth decay, and that is where the real nub comes in. Not only does it cause harm such as what I describe in my own case, but other problems,” he said.

Burgstahler said research has linked fluoride to Down syndrome, neurological problems and arthritis, among other things.

He said his five children and wife also switched to drinking nonflouridated water, and as a result his wife’s back pain went away and his daughter’s hearing loss was reversed. He said his children did not have cavities.

“These are facts, and no amount of calling them unsubstantiated anecdotal reports can alter their reality and association with the Lawrence city fluoridated water,” he said.

According to KDHE and CDC, peer-reviewed evidence does not support an association between water fluoridation and any adverse health effect or systemic disorder.

But, the EPA released two new reviews of research. One of the studies found that prolonged, high intake of fluoride can increase the risk of brittle bones, fractures and crippling bone abnormalities.

Recommended usage

Biesterfeld, who has been a dentist for nine years, said the amount of fluoride needed varies by patient.

If someone is at risk for decay, she recommends additional fluoride treatment, such as a prescription toothpaste or the fluoride varnish.

If a patient is not at risk, she doesn’t recommend anything beyond what’s already in drinking water, toothpaste, soft drinks, juices, and other products — well, maybe a rinse after brushing.

“It’s nice to do a fluoride application after cleaning for everyone just because we remove probably a few microns of the fluoride-rich outer layer of enamel with polishing, so it is nice to replenish that.”

KDHE study

The Kansas Department of Environment and Health has a screening program that includes oral health. Last school year, it looked at children in Sedgwick County, which mostly has unfluoridated water, and Douglas County, which has mostly fluoridated water.

It surveyed 1,200 children in Douglas County and 20,842 in Sedgwick. The results:

• Children who already had restorative treatment due to decay — Douglas, 33 percent; Sedgwick, 43 percent.

• Children with untreated decay — Douglas, 18.8 percent; Sedgwick, 18.5.

• Children with urgent care needs — Douglas, 1.8 percent; Sedgwick, 3.4 percent.

The state health officer wants to reduce the demand for medical services: tests, doctors and hospitals.

That would mean Kansans are living healthier, more productive and longer lives. It also would relieve the growing burden of health care costs on taxpayers, insurance payers and everyone else.

“As a country, we’ve got a bigger burden than anyone else in the world in having to cover that cost, which is a sixth of our whole economy,” said Dr. Jason Eberhart-Phillips, also health director of the Kansas Department of Health and Environment.

The good news is that there’s a lot public health can do at the local and state levels to reduce demand.

Here’s what he considers the Top 10 health challenges — in no specific order — in Kansas, and how they can be addressed:

Kansas State Health Officer Dr. Jason Eberhart-Phillips on Dec. 13, 2010, holds a cigarette during a news conference on a new government report that shows the immediate health risks linked to smoking. He said everytime a Kansan lights up they should ask him or herself if this is the cigarette that will give them a deadly disease. by Scott Rothschild

1. Tobacco use

One in six Kansans are addicted to tobacco.

Eberhart-Phillips would like to see more activism and advocacy in protecting youth from developing the addiction.

He is hoping the state, with the help of new Gov. Sam Brownback, will increase cigarette taxes to discourage kids from smoking and to give adult smokers the nudge that they need to quit smoking. He has talked to Missouri’s state health officer, who plans to push for a cigarette tax increase as well. Missouri has the lowest cigarette tax in the country.

Also, “we need to preserve, protect and potentially enhance the Indoor Clean Air legislation, and really make it embedded in our culture that public places are not places to release toxic chemicals,” Eberhart-Phillips said.

2. Obesity and the chronic diseases associated with it

Sixty-two percent of Kansas adults are overweight or obese, and one of the most common diseases related to being overweight is diabetes.

“What ought to be a relatively rare disease now affects as many as one in seven Kansas adults,” Eberhart-Phillips said. A new study projects that will increase to one in three by 2050.

He said it can be addressed by improving access to healthy foods at schools, workplaces and restaurants, and by creating infrastructure that encourages walking and bicycling.

“We need more development like Massachusetts Street and less like 23rd Street in our cities, or South Iowa even gets me more annoyed. I cannot go from one store to another unless I first get in my car, even though everything I need is down there,” he said.

Kansas is in the top third of states for adult obesity rates, according to a survey released in June 2010.

3. Fatal injuries

Too many Kansans die before they reach retirement age because of injuries, he said.

He said increased seat-belt use, helmet use and suicide prevention are a few efforts that could help reduce the problem.

In some states, he said, seat-belt use is 90 to 95 percent. In Kansas, it’s 75 to 85 percent.

“In our rural communities where the risks are the highest and the deaths are the most common, it’s much lower than that,” he said.

About one Kansan dies every day from suicide.

“Lawrence has a lot of activists in the area, and they are right,” he said. “This is a problem that we’ve neglected for too long, and it really is going to take some cultural change.”

Karen Smart, Lawrence, talks about her late son Jacob Wessel after attending a National Survivors of Suicide Day event Saturday, Nov. 20, 2010, in downtown Lawrence. Her son died by suicide on April 19, 2010, at age 15. She made a mini-collage of Jacob's pictures, at left. by Richard Gwin

4. Environment

Eberhart-Phillips said childhood lead poisoning and prairie burning are concerns.

“We had 140 cases of lead poisoning in our most recent year: 2008. Two-thirds of those were under age 2, when it’s going to have the most lifelong impact on their brain development and ability to learn,” he said.

He said the seasonal, controlled prairie fires can push air quality measures to unsafe levels. The state is studying the issue to see if it is a health risk, especially for people with asthma, heart disease or other illnesses.

“We want to make sure we are not adversely affecting people’s health and find maybe better ways to do that,” he said.

5. Infant mortality

Eberhart-Phillips said the United States has a higher infant mortality rate than other developed countries.

To make matters worse, Kansas’ rate is high among the states.

“We used to do better than the rest of country, and now we are 20 percent higher than the rest of the country,” he said. “That’s pretty alarming.”

Gabriel Bush is held by his father, Russ Bush of Lawrence, Oct. 14, 2010, at Lawrence Memorial Hospital. LMH is part of a statewide collaborative effort to educate parents and caregivers about safe sleep habits for infants. It encourages parents to watch a new video, "ABC's of Safe Sleep." The video talks about the importance of placing an infant alone, on its back, and in a crib for safe sleep. by Kevin Anderson

6. HIV and STDs

Eberhart-Phillips said there have been significant increases in HIV cases and sexually transmitted diseases.

Ninety new HIV cases were reported in 2008, a 34 percent increase from four years earlier.

There have been 7,700 cases of chlamydia — an STD that can cause infertility and other problems — among young adults, ages 15 to 24, per year.

“A lot of work needs to go into it preventing this,” he said.

7. Immunization

Kansas has gone from ninth worst in the country when it comes to immunization rates to seventh best.

Still, he said, there are a lot of unimmunized children, and that can lead to outbreaks. For example, in some parts of the country, whooping cough has surged to levels not seen in 50 years.

“It could well come to Kansas,” he said.

He said the state is “woefully insufficient” in adult vaccination. He is especially disturbed by the number of health providers who don’t receive a flu shot.

“Of all people, they ought to know better,” he said. “So, that certainly is an area of concern.”

Nancy Reese, center, and her husband, Jim, stopped to get their flu shots from volunteer Barbara Schnitker Saturday, Oct. 16, 2010, during Lawrence's first drive-through flu shot clinic. by Kevin Anderson

8. Oral health

One in four Kansas children suffer from untreated tooth decay, which hinders their ability to perform well in school.

“We are one of the worst states in the nation in terms of fluoridating our water, which would be a cheap and effective way to undo much of that decay,” Eberhart-Phillips said.

Only 44 percent of Kansans get fluoridated water in their homes. City of Lawrence residents get fluoridated water.

Also, many communities lack primary care dental services. Fourteen counties don’t have a dentist, and another 14 don’t have enough dentists to serve their populations.

Dr. Cheryl Biesterfeld, left, and dental assistant Kristin Parrish work on 11-year-old Ethan Bryan, Lawrence, at the Douglas County Dental Clinic on Thursday, Dec. 12, 2010. The clinic helps fill a need in the region by accepting Medicaid patients because so few dentists do. by Kevin Anderson

9. Health care-associated infections

Every year, Americans contract 1.7 million infections while being treated in hospitals. These infections cost the country between $30 and $40 billion per year.

They are associated with about 99,000 deaths annually.

If these were counted as a cause of death, Eberhart-Phillips said it would be the sixth leading cause of death and largely preventable.

“We are going to find out how many there are in Kansas for certain types with a voluntary surveillance system that’s being set up now,” he said.

10. Access to quality care

One in eight Kansans have no health insurance. This doesn’t include those who are underinsured.

“The under-insurance problem, in some ways, is even bigger in that they are not counted as uninsured but they may as well be because the costs are preventing them from getting the care that they need,” Eberhart-Phillips said.

He said the Affordable Care Act’s goal of getting more Americans insured won’t work unless demand for medical services is reduced.

“We can’t add 32 million people if we are all going to be as sick as we are in 2010, because there isn’t enough money to pay for the health care,” Eberhart-Phillips said.

“We have to make it so you have less reason to use hospital services and you get more treatment on an outpatient basis, or you simply don’t need it at all because your environment has so well supported you in your active living and healthy eating and smoke-free lifestyle that you don’t come down with the diseases that are costing us so much now.”

Lawrence resident Ansib Chaudhry has his vitals taken by Health Care Access volunteer Nan Wang before being checked out by a doctor for some potentially fractured facial bones Tuesday, Dec. 14, 2010, at Health Care Access, 330 Maine. The clinic provides medical care for low-income, uninsured Douglas County residents. by Nick Krug

That nasty seasonal flu bug has arrived in Kansas.

The Kansas Department of Health and Environment reported two confirmed cases on Monday. One is in northeast Kansas, but not Douglas County, and the other is in the southcentral portion of the state.

Dr. Jason Eberhart-Phillips, state health officer, encourages Kansans to get their yearly vaccination against the flu, if they haven’t already done so.

“Although flu activity is normally highest around February and influenza can continue to circulate through spring, the flu can be unpredictable. Now is an excellent time for everyone to get vaccinated to protect themselves, their loved ones and the community.”

— Eberhart-Phillips

The Centers for Disease Control and Prevention recommends that people 6 months and older get a vaccination.

Flu is a serious disease that can lead to complications such as pneumonia and even death. Symptoms include: fever, headache, extreme tiredness, dry cough and muscle aches. Complications can include pneumonia, ear and sinus infections, dehydration, and worsening of other chronic conditions.

Every year, between 5 percent and 20 percent of the population gets the flu; more than 200,000 people are hospitalized from flu complications, and about 36,000 people die.

Officials with the Lawrence-Douglas County Health Department and Lawrence public schools say they haven’t seen any cases of flu — yet.

But, they encourage residents to take these preventative measures:

• Get a vaccination.

• Cover coughs and sneezes.

• Wash hands.

• Stay home when sick.

U.S. flu activity by kbritt

FLU SHOTS

Seasonal flu vaccines are available at the Lawrence-Douglas County Health Department's clinic, 200 Maine.

The cost is $26 for anyone older than 3, and $22 for anyone between 3 and 6 months. But people aren’t turned away because of inability to pay. For more information, call the health department at 843-0721.

The vaccine is available at a number of Lawrence pharmacies and doctors’ offices as well.