In this issue:

Headlines

• VDH Responds to Flu Activity in Virginia

In the news

• VDH Helps Sponsor Martinsville Health Fair and Dental Clinic
• Get Smart Virginia!
• Consultants Protect Children in Childcare Settings
• Every Woman’s Life Program Awards Contracts to Additional Provider Sites

Your Community

• Thomas Jefferson Health District Reaches Out to Non-Native English Speakers
• Total Woman Screening Day
• Crater Health District Partners With
  Hopewell Volunteers On Flu Shot Campaign

VDH Responds to Widespread Flu Activity in Virginia

Michelle Stoll

Flu season arrived earlier than usual in 2003. Cases of influenza were reported as early as October, and by December, the U.S. Centers for Disease Control and Prevention listed Virginia as having widespread flu activity.

Since the early activity began, the Virginia Department of Health has urged Virginia residents, especially those at high risk, to be vaccinated against influenza.

Residents responded to the public health message. In fact, more Americans appear to have been vaccinated against flu sooner in 2003 than in years past. By the second week of December, Virginia local health departments had already distributed between 80-100 thousand doses of the vaccine and were reporting exhausted supplies.

“Distribution of the vaccine through local health departments nearly tripled, suggesting that more of our population has been vaccinated than is usually vaccinated this time of year. The earlier increase in vaccination caused supplies to run low sooner in the season,” said State Health Commissioner, Robert B. Stroube, M.D., M.P.H.

Virginia received about 2,400 more doses from CDC and began distribution on Monday December 15. VDH recommended to local health districts that those at high risk of complications from the flu receive first priority in receiving the flu vaccine. An additional infusion of pediatric vaccine is expected in January, as well as an estimated 3-4 thousand adult doses from CDC.

Healthy people between the ages of 5 and 49 may opt for an alternative flu vaccine. FluMist, a nasal vaccine remains available throughout Virginia.

“We are encouraged that people are taking the flu seriously and are getting themselves and their families vaccinated early,” said Dr. Stroube. “To further prevent the spread of flu, people should be sure to wash their hands frequently, practice proper respiratory etiquette, and stay home from work or school if they are having flu-like symptoms.”

In addition to getting vaccinated against the flu, the Virginia Department of Health offers the following suggestions to reduce the spread of influenza:

• Use a tissue to cover your nose and mouth when coughing or sneezing; dispose of the tissue immediately and wash hands thoroughly.
• Wash hands with soap and hot water for at least 20 seconds.
• Rinse and dry hands with a disposable towel. Use towel to turn off the faucet.
• Stay home from work or school for 5-7 days if you have flu like symptoms
• In addition, hospitals and clinicians should continue to report any clusters of respiratory illness to the local health department.

For more information on flu or guidelines for flu vaccines, go to www.vdh.virginia.gov.

VDH Helps Sponsor Martinsville Health Fair and Dental Clinic

Mike Stater

Over 2,000 people received a variety of medical and dental services November 21-22 at the Martinsville Health Fair and Dental Clinic, sponsored by the Virginia Department of Health and the Virginia Dental Association and a large group of public and private organizations.

The concept of the event was spearheaded by Governor Mark Warner, who attended a similar event in the summer in Wise County. The governor was especially concerned about the residents of the Martinsville and Danville areas and other localities in Southside who have been hit hard recently by numerous layoffs at textile and furniture plants.

Nearly half of those attending the event took advantage of the free dental clinic which had about 43 dental chairs and about 200 dental professionals providing services.

Another 73 medical volunteers provided services which included: screenings for blood pressure, body mass index, blood sugar, cholesterol, glucose, hemoglobin, vision, asthma, alcohol abuse and depression. Attendees also had access to mammograms, flu and pneumonia vaccinations and foot exams. Health education services included information about dental health, diabetes, tobacco and alcohol use, STDs, physical fitness, nutrition, safe food handling, poison prevention, Social Security disability information, Medicaid, primary care, mental health and pharmaceutical assistance programs.

Governor Warner joined Secretary of Health and Human Services Jane Woods at the Saturday session and kicked off the new “Walk Smart, Virginia!” campaign. Secretary Woods distributed free pedometers at Martinsville Middle School on Friday and she joined the governor on Saturday in introducing the program designed to stem obesity and inactivity trends among children in the Commonwealth.

“It is everyone’s interest – health care providers, health plans, government, schools, businesses – to actively promote healthy lifestyles, including proper nutrition and fitness, in order to improve personal health and control health care costs – costs that affect us all,” Governor Warner said.

Get Smart, Virginia!

Trina Lee

The Virginia Department of Health joined Anthem Blue Cross and Blue Shield and the Medical Society of Virginia to kick off the “Get Smart Virginia” campaign on December 2, 2003. The goal is to inform parents and children of the risks and consequences of improper and over use of antibiotics.

The event featured a special appearance by Stella the Superbug at the St. Thomas Day School in Richmond to teach children about keeping antibiotics strong for us all. Stella spoke to the kids about how to keep from getting sick this cold and flu season, plus what to do if we become sick.

The emphasis on awareness is the result of surveillance conducted by the U.S. Centers for Disease Control and Prevention, which finds that up to 30 percent of the bacteria which cause ear infections, pneumonia and meningitis are resistant to one or more antibiotics.

“Antibiotics can actually be harmful to children’s health if they are not used correctly,” explained State Health Commissioner, Robert B. Stroube, M.D., M.P.H. “Taking antibiotics when they are not needed can cause some bacteria to become resistant to that antibiotic, and can result in the need for additional treatment – and possibly a stay in the hospital.”

Anthem Blue Cross and Blue Shield is donating $250,000 to the Get Smart Virginia campaign to help make sure all of Virginia's parents and children get the message and understand the seriousness of taking antibiotics correctly.

“By teaming up with the Virginia Department of Health and using Anthem's Stan the Superbug mascot, we will work to engage children in a creative way to help teach them about the dangers of antibiotic resistance,” said Dr. Richardson Grinnan, Anthem's senior medical director.

Most illnesses are caused by two kinds of germs: bacteria and viruses. Bacteria cause illnesses, such as strep throat, some pneumonia and sinus infections. Viruses cause illnesses, such as the common cold and the flu. Antibiotics are effective for bacterial infections, but they don’t fight the viruses that cause cold and flu. Using antibiotics for a virus will not cure the illness, stop the spread of illness or help children to feel better.

Misuse of antibiotics jeopardizes the usefulness of these essential drugs, leading to significant complications for people who have infections that were once easily treatable with antibiotics. When antibiotics fail to work the consequences are longer lasting illnesses, more doctor visits or extended hospital stays and the need for additional treatment and more expensive medications.

For more information about the proper use of antibiotics, go the Get Smart Virginia Web site at www.vdh.state.va.us/epi/getsmart/index.asp.

Consultants Protect Children in Childcare Settings

Bethany Geldmaker

In 2001, the Virginia Department of Health (VDH) launched a proactive program to help protect the health and safety of children in day care centers and other childcare settings. The program is part of a national effort through the U. S. Maternal Child Health Bureau and the American Academy of Pediatrics around issues of health and safety that were not being addressed in out-of-home childcare.

“In Virginia, approximately 82 percent of children age five and under are placed in full time out-of-home care at some point in their life,” said Bethany Geldmaker, Ph.D., manager of VDH’s Early Childhood Health Program.

The Healthy Child Care Virginia program has trained 120 Child Care Health Consultants who work with childcare providers and provide them with expert guidance and technical assistance on a wide range of health and safety topics. There are approximately 12,000 childcare providers in Virginia. The Department of Social Services licenses about 2,000 of them.

“Our consultants work to ensure that child day care centers and providers in other child care settings follow quality health and safety practices,” Geldmaker said. The consultants now cover about 75 percent of the state. Ninety percent of the consultants are public health nurses. Others include environmental specialists, licensing inspectors, social workers and health educators.

Seven of the consultants have completed a six-month Master Trainer course at the University of North Carolina at Chapel Hill. They in turn help train and mentor the other consultants.

“Our focus is on the health and safety of children in child care settings,” said Geldmaker. “Children deserve to have their health and safety protected at a level that goes well beyond the minimum standards acceptable in child care licensing.” Virginia’s Child Care Health Consultants partner with providers to:

• Assess health and safety needs and practices
• Care for children with special health needs
• Establish policies and procedures for emergencies
• Provide health screenings and health education and wellness programs
• Manage injuries or infectious diseases
• Connect caregivers and families with health care resources and experts
• Offer hands-on support via telephone and regular on-site visits
• Conduct child care staff training
• Provide information on the latest guidelines and policies on child health and safety

Five New Sites Offer Greater Access to Breast and Cervical Cancer Screening

Beth Ehrensberger

Uninsured and underinsured women in Virginia now have greater access to free screenings for breast and cervical cancer.

The Virginia Department of Health’s Every Woman’s Life program awarded contracts to five additional provider sites in October. With the new additions, there are now 26 breast and cervical cancer screening contracts located statewide. The new sites are: West Piedmont Health District, Pittsylvania Danville Health District, Southside Health District, Western Tidewater Health District and Riverside Hospital, in Newport News.

"The Virginia Department of Health is very excited about adding five new provider sites to the South Central region of the state,” said State Health Commissioner Robert B. Stroube, M.D., M.P.H. “This area has a high breast cancer mortality rate and high incidence of cervical cancer.”

All contractors provide participants in the Every Woman’s Life program with free clinical breast exams, free mammograms, free pelvic exams, and free Pap tests. In addition, diagnostic services are provided at no cost to the patients. If cancer is detected, the screening sites will assure treatment to Every Woman’s Life patients.

“Our goal has always been to provide statewide coverage so that all uninsured and underinsured women have the opportunity to have a mammogram and Pap test. This is a positive step toward accomplishing our goal of controlling breast and cervical cancer," said Kathleen Heise, R.D., M.P.H., project director of the Every Woman’s Life program. The goal of the Every Woman’s Life program is to screen 4,500 women statewide in the next year.

The Every Woman’s Life program provides free screening to women who have household incomes under 200 percent of the federal poverty level. All women must claim Virginia as their primary place of residence. In addition, to qualify, women must be 50-64 years of age. If appointments are available, women 40-49 years of age may also be eligible for free screening services, through the Every Woman’s Life program.

To schedule an appointment, women should call the American Cancer Society at 1-800-ACS-2345 and ask for the telephone number of the closest Every Woman’s Life breast and cervical cancer screening site. For more information about breast and cervical cancer and the Every Woman’s Life program visit www.vahealth.org/breastcancer.

Thomas Jefferson Health District Reaches Out to Non-Native English Speakers

Peggy Paviour

Good communication is key to providing quality customer service. So, what do you do if the customer doesn’t speak the same language? The Thomas Jefferson Health District has spent the past two years trying to address that dilemma.

Spearheaded by the appointed LEP (Limited English Proficiency) Committee, this health district in the Charlottesville area has taken a series of steps to address the needs of customers who have difficulty communicating in English. The bottom line is that it’s the law.

As its first step, the committee decided that it should acquaint itself with federal Civil Rights policy and requirements for which the health district would be accountable. For that reason it invited Paul Cushing with the U.S. Department of Health and Human Services' Office for Civil Rights to make a presentation to staff. The committee drafted a policy, ultimately reviewed and approved by District management, that laid out expectations of staff in dealing with LEP customers. At the same time, it took steps to support staff in meeting those expectations.

To ensure LEP customers easy access to health department and interpretater services, the district:

• Provided English/Spanish signage in critical areas

• Developed a Spanish phone message line in its Charlottesville/Albemarle office

• Translated and catalogued over 30 essential documents in Spanish and other languages as deemed necessary

• Posted Language Assistance posters at entrance points for customers;

• Distributed “I Speak” language cards to staff for use when they do not know the language of the customer

• Hired several bilingual staff. Those providing on-going interpretation are requested to attend a medical interpretation certification course

• Developed an Memorandum of Agreement with a local vender to provide live interpretation in several languages

• Contracted with a well-regarded phone interpretation service

• Updated a list of community volunteers who are will to interpret

• Instituted use of identifying labels on charts of non-English speaking customers to ensure that staff are prepared to provide interpretation assistance

The district developed and provided staff guidelines for when to use live versus phone interpretation, conducted training for all teams on LEP policy, and instituted a new training as part of orientation for new employees.

Staff are committed to refining and improving the methods to provide the best possible customer service for LEP clients.

Total Women Screening Day

David P. Goodfriend

On Wednesday, October 22, 2003, the Loudoun County Health District hosted the 10th annual Total Woman’s Screening Day under a grant from the Virginia Department of Health, Every Woman’s Life’s funding from the U.S. Centers for Disease Control.

A total of 32 women received a free breast exam, pap smear and skin screening for cancer, and their mammogram. The on-site mammograms were provided by The University of Virginia Health System Mobile Mammography van. Nila Saliba, Cancer Control Coordinator, Mary Rutledge, Mammography Tech, Edna Peebles, Volunteer and William Peebles, Driver of the van staffed the mammovan.

The 32 women received physical examinations from multiple health care providers from the local community and as far away as Fort Belvoir.

As the women proceeded through the screening they received health education on breast self-exams and the importance of annual health screenings. Participants were between the ages of 50 and 64, and residents of Loudoun County

A survey of the women during the event found that having the mammovan on site was well received, since they did not have to go to another visit for the mammogram.

Crater Health District Partners With
Hopewell Volunteers On Flu Shot Campaign

Matthew Killorin

The Hopewell Health Department and volunteers from throughout the Hopewell area worked together to conduct two large community flu shot clinics on November 4 and 8. The clinics were the culmination of the Hopewell Immunization Partnership’s (HIP) “Vaccinate and Vote!” awareness campaign that highlighted the importance of adult immunizations, especially for flu and pneumonia. Volunteers from the Retired Senior Volunteer Program-Southside Inc., the Hopewell Senior Citizen Advisory Commission, and many other local organizations helped make the clinics possible.

In early October, Hopewell Mayor James W. Patterson, Sr. officially kicked off the “Vaccinate and Vote!” campaign when he proclaimed October 12-18 as Adult Immunization Week in the City of Hopewell during a ceremony at John Randolph Medical Center. Dr. Michael Royster, M.D., M.P.H., Director of the Crater Health District thanked Mayor Patterson for his support of immunizations on behalf of the HIP coalition. Also during the event, the Immunization Partnership announced plans for the health department’s two major flu shot clinics.

On Election Day, while health department nurses were administering hundreds of shots, volunteers helped customers fill out paperwork and distributed educational material on adult immunizations. The Hopewell Department of Recreation and Parks generously donated the use of the city’s community center for both clinics. While the Election Day clinic was in progress, volunteers were also handing out flyers to voters at each of the city’s polling sites. The flyers reminded people of the importance of getting their flu shot along with the time and place of the clinics.

This is the second consecutive year that the “Vaccinate and Vote!” campaign has been conducted in Hopewell. At this year’s edition, 588 people were vaccinated for the flu, which is a six percent increase over the same period last year. According to long-time staff, that’s a record two-day total for the Hopewell Health Department. Tommy Wells, chairman of the city’s Senior Citizen Advisory Commission, and one of the clinic volunteers, expressed his group’s support of the campaign. “Hopewell has a large senior population and we’ve always encouraged those over 50 to get the flu shot every year. Our volunteers are glad to assist the health department in such a worthwhile cause.” With the success of the “Vaccinate and Vote!” campaign in Hopewell over the last two years, Crater Health District staff are looking forward to expanding the initiative to other localities in the district next year.