Rappahannock Area Health District News

January 14, 2020

Joe and Mary Wilson Community Benefit Fund of the Mary Washington Hospital Foundation Awards $100,000 Grant to the Rappahannock Area Health District

(Fredericksburg, Va.)— In January 2020, the Joe and Mary Wilson Community Benefit Fund of the Mary Washington Hospital Foundation awarded the Rappahannock Area Health District (RAHD) a $100,000 grant for its Complicated Obstetrical and High-Risk Maternity Care Program.

RAHD operates a large maternity program that provides outpatient prenatal care to hundreds of uninsured or underinsured pregnant women from all five of RAHD’s localities (City of Fredericksburg and the counties of Caroline, King George, Spotsylvania and Stafford). Many of these patients have medical, obstetrical or other conditions that make their pregnancies more complex or high-risk. The grant funding helps to provide more intensive case management to reduce infant and maternal fatalities, preventable emergency department visits and hospitalizations, premature births and low birth weight births.

According to RAHD Health Director Dr. Brooke Rossheim, “We are quite appreciative of this grant award from the Joe and Mary Wilson Community Benefit Fund of the Mary Washington Hospital Foundation. This will help support RAHD’s Maternity Program. The program, which began in 2009, treats a large number of high-risk patients, and this funding helps ensure these women receive the care they need. For years, the Mary Washington Hospital Foundation and Mary Washington Healthcare have been dedicated partners with the Rappahannock Area Health District to serve patients in need of these services.”

The grant award provides funding for the obstetrical clinicians who staff the Maternity Program that serves residents of the City of Fredericksburg and Spotsylvania, Stafford, King George and Caroline Counties.

For more information about the many programs the health district offers, visit www.vdh.virginia.gov/rappahannock/.

December 1-7, 2019

2019 National Influenza Vaccine Week

The Centers for Disease Control and Prevention (CDC) is celebrating National Influenza Vaccination Week (NIVW) this year from December 1-7, 2019, reminding everyone 6 months and older to get their flu shot.  Influenza activity can occur throughout the year, starting as early as October and persisting as far out as May. Peak influenza activity is typically from December through February; however, the CDC encourages individuals to get vaccinated as early as October.  Remember that it’s not too late for you to get your flu shot!

Influenza is mainly spread by droplets from the nose or throat that are released when an infected person coughs or sneezes. These droplets can travel as far as 6 feet and live on surfaces for up to 48 hours. Each year in the United States, it’s estimated that millions of people get influenza, approximately 100,000 to 900,000 people are hospitalized, and tens of thousands of people die from influenza-associated illnesses.  In short, influenza can be a serious illness, especially for people who are at high-risk of flu-related complications.

Getting vaccinated is the single best way to prevent influenza. Although immunization cannot guarantee that you don’t get the flu, it may prevent severe illness and hospitalization, in addition to decreasing the amount of time that you may be sick with the flu. The flu vaccine is especially important for high-risk individuals, such as infants, elderly people, pregnant women, or individuals with immune-compromising conditions. Vaccinating yourself can prevent spreading the flu to individuals who are at high risk of health complications; therefore, getting the flu shot can protect others in addition to yourself!

For more information about NIVW, please visit the online Digital Media Toolkit at https://www.cdc.gov/flu/resource-center/nivw/activities.htm. This includes CDC resources, vaccination messages, and activities. In addition, the Virginia Department of Health tracks up-to-date influenza activity throughout the state at http://www.vdh.virginia.gov/epidemiology/influenza-flu-in-virginia/influenza-surveillance/.

If you have concerns about influenza or influenza vaccines, please contact your healthcare provider.

We hope you will join us as we encourage everyone to protect themselves and their loved ones from the flu this season!

October 23, 2019

October is Breast Cancer Awareness Month

One in eight women in the United States will be diagnosed with breast cancer in her lifetime.  The Every Woman’s Life (EWL) Program helps low-income, uninsured women between the ages of 18-64 to get a FREE breast cancer screening. If these tests lead to a cancer diagnosis, successful treatment can increase dramatically with early detection. Find out if you are eligible for EWL, and schedule your annual screening today.

Learn more about Every Woman’s Life at: http://www.vdh.virginia.gov/every-womans-life/

September 15, 2019

National Child Passenger Safety Week is September 15-21, 2019. Take a moment to read an informative post on this subject, and find out what programs RAHD participates in for this cause.

September 1, 2019

September is National Food Safety Education Month. The CDC estimates that each year 48 million people get sick from a foodborne illness, 128,000 are hospitalized, and 3,000 die. Illnesses are caused by foods contaminated with bacteria, viruses, or parasites. Foodborne illness can also be caused by toxins or chemical contamination of foods. Environmental Health (EH) Specialists with the Rappahannock Area Health District work with food service managers and employees during inspections to help prevent foodborne illness by focusing on these five risk factors: Poor Employee Health & Hygiene, Food from Unsafe Sources, Improper Cooking Temperatures, Improper Cold & Hot Holding Temperatures, and Contaminated Equipment & Utensils. https://www.cdc.gov/foodsafety/education-month.html.

Many foodborne illnesses go unreported because people recover quickly and don’t go to the doctor for testing and treatment. Did you know that VDH has a foodborne illness reporting portal called My Meal Detective? http://www.vdh.virginia.gov/environmental-health/foodborne-illness-report/. Individuals can complete and submit the information via the internet and the local health department will receive a copy of the report. Upon receipt, the EH Supervisor or EH Manager will assign the complaint to an EH Specialist for investigation. The reports can also be used to determine if a trend is occurring and possibly detect a foodborne illness outbreak.

August 1, 2019

World Breastfeeding Week 2019 is August 1-7 and the theme this year is “Empower Parents, Enable Breastfeeding.” The slogan was chosen to be inclusive of all types of parents in today’s world. Focusing on supporting both parents to be empowered is vital in order to realize their breastfeeding goals. Empowerment is a process that requires evidence-based unbiased information and support to create the enabling environment where mothers can breastfeed optimally. Breastfeeding is in the mother’s domain and when fathers, partners, families, workplaces, and communities support her, breastfeeding improves. We can all support this process, as breastfeeding is a team effort. To enable breastfeeding we all need to protect, promote and support it. Virginia Department of Health (VDH) supports breastfeeding by hiring Breastfeeding Peer Counselors to contact WIC mothers during their pregnancies and breastfeeding journeys. They are available outside of normal business hours to help moms with whatever problems or questions arise. They also teach breastfeeding classes to pregnant moms. Additionally, the WIC program provides breast pumps to mothers who are struggling with breastfeeding and to those returning to work so that they may continue breastfeeding longer. To learn more about how VDH supports breastfeeding and World Breastfeeding Week 2019, please visit the following sites:



August 1,2019

August is National Immunization Awareness Month (NIAM): Vaccines are safe and effective at preventing specific diseases, and RAHD holds walk-in immunization clinics each week at each health department. Please take a moment to learn more about vaccines in an informative post written by our Immunization Coordinator, Carolyn Garcia.

July 10, 2019

Maternity Care Program: The Rappahannock Area Health District’s (RAHD) Maternity Care Program provides prenatal care for all women, including uninsured and underinsured women, at each of our five health departments. In the Rappahannock Region, there is a shortage of prenatal care services for low-income, uninsured or underinsured women.  According to the U.S. Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB), babies born to mothers who receive no prenatal care are three times more likely to be born at low birth weight and five times more likely to die than those whose mothers received prenatal care (MCHB, 2016). RAHD’s maternity care program helps to bridge the clinical gap by providing outpatient prenatal care services in all five RAHD localities. Our team of experienced doctors, nurse practitioners, certified nurse midwives, and public health nurses provide high quality care that includes case management, referrals, screenings, community resource information, and postpartum care. These patients are provided a seamless transition into our Family Planning services.

Family Planning Program

Family Planning services at RAHD help reduce unintended pregnancy and improve pregnancy spacing and outcomes by providing comprehensive, high quality family planning and reproductive health services. Our services are confidential, low-cost, and accessible to all people in the Rappahannock Area Health District. Services include:

  • Birth control information, counseling, and supplies, including long-acting reversible contraceptives (LARCs) such as IUDs and implants,
  • Emergency contraception,
  • Pregnancy testing and options counseling,
  • Reproductive health exams,
  • Cervical and breast cancer screening
  • Sexually Transmitted Infection testing and treatment,
  • Health education and counseling, including information about abstinence,
  • Basic infertility services,
  • and referrals to other health and social services.

These services are available to any teen or adult, no matter what race, sexual orientation, gender identity, income or residency status, regardless of ability to pay. Services are offered on a sliding scale based on income. Patients will NOT be turned away due to inability to pay.  See the following video at https://youtu.be/4ali6b2RIn0.

June 27, 2019

National HIV Testing Day (NHTD) is June 27. On this annual observance, we encourage people to get tested for HIV, know their status, and get into treatment right away if they have HIV.

There are so many ways to get tested for HIV – at home, at the doctor’s office, with a friend. Find the best way for YOU. #DoingItMyWay #HIVTestingDay #NHTD

Hay muchas maneras para hacerte la prueba del VIH– en casa, en la oficina del médico, con un amigo. Encuentra la mejor manera para TI. #HaciéndoloAMiManera #DíaNacionalDeLaPruebaDelVIH

June 20th, 2019

World Refugee Day (June 20) is a day in which the world commemorates both the hardships and resilience that refugees experience. Take a moment today to read about the history of the term, and the health services a refugee may need to access.

May 5, 2019

The Benefits of Handwashing: Take a few minutes to learn about one of the most basic public health measures, hand washing, in an informative memo written by RAHD’s Director, Dr. Brooke Rossheim.

May 1, 2019

Travelers’ Health: On top of all of the planning, packing, and preparation required for traveling abroad, it can be easy to forget the vaccines, medical advice, and communicable disease prevention that is necessary for your trip. For example, if you are traveling to a place where there is a Measles outbreak, you will want to ensure that you have received your MMR (measles, mumps, and rubella) vaccine.  Depending on the location, you may want to consider bringing a travelers’ diarrhea antibiotic, an altitude sickness medicine, medicine to prevent malaria, or mosquito repellents.  What other vaccines should you consider, and how soon should you receive them before traveling? Below are some steps that you may want to consider before travel, so that you are fully prepared and have a safe trip:

  1. Reach out to your healthcare provider at least 4-6 weeks prior to any planned vacation abroad so that you can allow time for any necessary health-related preparation. Make sure to inform them of: Where you are traveling within a country
    1. The length of your trip
    2. What types of activities you might do
    3. Other personal matters, such as your age, medical and vaccine history, and current medical state
  2. Have a discussion with your doctor about the vaccinations and medications you will need in advance, in addition to the preventive materials you should bring on your trip.
  3. Where will you be traveling to? Are there any outbreaks currently occurring in that location?
  4. What kind of traveler are you? Special precautions may need to be taken depending on your situation, for example if you are:
    1. An individual with a chronic disease
    2. Immune-compromised
    3. A pregnant woman
  5. Talk with your doctor about preparing or obtaining a “Healthy Travel Packing List.” It is best to be prepared to prevent and treat common illnesses and injuries!
  6. Know what to do if you become sick after returning home from travel. For example, if you have a fever within a month after visiting a country with malaria, see a doctor immediately. You may also want to seek medical care is you develop any skin problems or persistent diarrhea. See the CDC’s web page, Getting Sick after Travel, for more information.

The CDC has a very resourceful web page for Travelers’ Health, which not only provides tips and “checklists” to complete before travel, but also provides the latest updates on Measles, Yellow Fever, and Zika virus. More information can be found on the Travel Health Notices web page.

April 4, 2019

Birth, Marriage, Divorce, & Death Certificates now Available at Your Local Health Department. Visit our website to find information about vital records, food, nutrition, and other services we provide.

Birth, Marriage, and Divorce Certificates

  • Certified copies of these certificates are available at all local health departments if the birth, marriage, or divorce occurred in Virginia.

Death Certificates

  • Death certificates can be files, and certified copies can be obtained, at any health department in Virginia, regardless of where the death occurred.
  • If it is less than 30 days since the filing of death, you can only get a copy of the death certificate from the city/county where it was originally filed.
  • Certified copies are available upon request to eligible people.

Who Can Get Copies of Birth, Marriage, Divorce, and Death Certificates?

  • Only immediate family members (mother, father, current spouse, husband, wife, child, brother, sister, or grandparents) can get copies of birth, marriage, death, and divorce certificates, and they must provide a valid ID.
  • Legal guardians must provide custody papers in order to get a certificate.
  • Aunts, uncles, cousins, in-laws, former spouses, etc. cannot get any copies.

Fees for All Certificates 

  • $12 for each certificate and/or search of a vital record
  • Cash, check, money orders, VISA, or MasterCard are accepted

April 2, 2019

April is STD Awareness Month: Syphilis Strikes Back is a campaign devoted exclusively to promoting the prevention, diagnosis, and treatment of syphilis. Syphilis is a systemic disease caused by the bacteria Treponema pallidum. It is transmitted primarily through sexual encounters or from mother to child during pregnancy. Symptoms of syphilis may include a painless sore called a chancre, rash, swollen glands, headache, fever or tiredness. It is important for at risk individuals to get tested for syphilis regularly, as the infection is curable with antibiotics. At risk individuals are sexually active people who have unprotected vaginal, anal, or oral sex and are a man who has sex with men; are living with HIV; or have partner(s) who have tested positive for syphilis. All pregnant women should be tested for syphilis at their first prenatal visit. If untreated, syphilis can lead to serious medical complications.

Together, We Can Disrupt Syphilis.
The good news is there are a number of ways to prevent syphilis and other STDs. The most reliable way is to not have sex (vaginal, oral, or anal), but there are many other tried-and-true options: talking openly with partners and healthcare providers about STDs, testing, and sexual health; using condoms the right way from start to finish; and reducing your number of sexual partners. Those who test positive for syphilis should get treated right away – and be sure their partner is also treated to lower the risk of getting infected again (CDC, 2019).For more information on assessing your risk for syphilis, visit: https://www.cdc.gov/std/syphilis/stdfact-syphilis.htm or speak with your doctor. Testing for sexual transmitted infections can be performed at the Fredericksburg Health Department, Mondays and Thursdays from 12:30 pm – 2:30 pm (Walk-ins only).

March 21, 2019

World TB Day: On March 24, 1882, Dr. Robert Koch announced at conference in Germany that he had discovered the cause of tuberculosis—the bacterium Mycobacterium tuberculosis. Dr. Koch’s work, in many ways, formed the basis for the modern practice of Infectious Disease medicine as we know it. This was a substantial advancement in medical knowledge and in 1905 Dr. Koch was awarded the Nobel Prize in medicine. More than 100+ years later, tuberculosis is still with us and public health and society at large continue to do battle with this illness.According to National Jewish Health in Colorado, genetic studies suggest TB has been present for at least 15,000 years (see https://www.nationaljewish.org/conditions/tuberculosis-tb/history).

Over the last 100+ years, much progress has been made against tuberculosis. In the past, there were no medicines to treat TB disease and about two thirds of patients died within 5 years. Between 1943 and 1951, three medications (streptomycin, para-aminosalicylate and isoniazid) to treat TB were developed and cure rates of 80-90% could be achieved. People had to take anti-TB medications for 18-24 months and medication side effects were a notable problem.While much progress has been made regarding tuberculosis, there is still much more work to do. Current data from the World Health Organization show that TB is one of the top ten causes of death worldwide; in 2017, 1.6 million people died from TB and TB is a leading killer among people who have HIV disease (see https://www.who.int/en/news-room/fact-sheets/detail/tuberculosis). In the United States, TB is not an endemic illness, but it is one that public health remains concerned about and is working on eradicating. According to the Centers for Disease Control and Prevention (CDC), in 2017, 9105 cases of tuberculosis were reported.

Over the years, the number of reported TB cases in the US has declined, but tuberculosis disease that is resistant to anti-TB drugs has gradually emerged. The CDC has established a goal of eliminating TB from the US, but notes that the rate of TB decline in the US remains too slow to achieve TB elimination in this century (see https://www.cdc.gov/tb/publications/factsheets/statistics/tbtrends.htm). Sunday, March 24, 2019 is World TB Day. We encourage you to learn more about both active tuberculosis disease and latent tuberculosis infection at the CDC’s website at the following link: https://www.cdc.gov/tb/default.htm.

March 1, 2019

National Nutrition Month: March is National Nutrition Month, so here are some tips to help keep you happy and healthy. There’s no one diet that’s right for everyone, so it’s important to follow a healthful eating plan that’s packed with tasty foods, and that keeps your unique lifestyle in mind. If you eat most of your meals on the run, keep nutritious foods close by, like fruits, low-sodium soups, canned tuna, or peanut butter on whole grain bread. For athletes, give your bodies the fuel it needs with low-fat yogurt and fresh fruit, graham crackers with peanut butter, or cereal with low-fat milk. Vegetarians and vegans should include protein-rich foods like beans, lentils, peas, nuts and soy products. And parents, save time by cooking extra portions of lean meats, brown rice, beans and vegetables, while saving leftovers for a second meal. Whatever your lifestyle, a Registered Dietitian can help develop a personal eating plan that fits your unique lifestyle, needs, and tastes. If you have questions about nutrition, please reach out to one of the Nutritionists or Dietitians working at the health department. To find an RD in your area, visit the Academy of Nutrition and Dietetics at www.eatright.org. Eat right, your way, every day!


February 12, 2019

1918 Flu Pandemic and This Year’s Flu Season:  Members: The 2018-2019 influenza season is currently underway. According to estimates from the Centers for Disease Control and Prevention (CDC), influenza has caused between 9.2 and 60.8 million illnesses and 140,000 to 710,000 hospitalizations in the U.S. to date. CDC estimates that influenza has caused 12,000 to 56,000 deaths in the U.S. each year since 2010.1 Last year (2018) marked the 100th anniversary of the 1918 Flu Pandemic, known as the “Spanish Flu,” which was the most severe pandemic known in recent history. It originated from the Influenza H1N1 virus, which is currently the most prevalent influenza strain in the United States. During 1918 and 1919, the pandemic spread around the world infecting 500 million individuals, or one-third of the world population, and leading to approximately 675,000 deaths in the U.S.2 The most recent influenza pandemic was in 2009 and also caused by an H1N1 influenza virus.

What can you do to prevent the flu?

  • Get Vaccinated – Put simply, the influenza vaccine is THE single best defense against getting influenza. All people 6 months of age and older are recommended to receive a flu vaccine each year as long as they do not have a medical reason why they cannot be vaccinated. Very few people have such a medical reason. The flu vaccine can not only prevent you from getting sick, but it can also prevent transmission in your household, school, and work environments. The Rappahannock Area Health District offers weekly immunizations clinics at each of our local health departments: Stafford, Fredericksburg City, Spotsylvania, King George, and Caroline County. Contact your local health department for information on flu clinic hours.
  • If you’re experiencing symptoms of influenza-like illness, such as fever, fatigue, cough, or other respiratory symptoms, stay home from work, school, or social activities for at least 24 hours after your symptoms resolve. This helps prevent transmission to others.
  • Practice good hand and respiratory hygiene: Thoroughly wash your hands for at least 20 seconds with warm water and soap. Carry hand-sanitizer with you if you are not able to wash your hands when needed, but remember that hand-sanitizer does not kill germs as effectively as soap and water! Cough or sneeze into your elbow rather than into your hands. Finally, stay a safe distance away from people who are experiencing influenza-like illness. Again, these methods help prevent transmission of influenza virus.
  • Visit the Virginia Department of Health website for weekly reports of Influenza-Like-Illness (ILI), in addition to other resources about flu prevention, vaccination, diagnosis, and treatment.
      • Fredericksburg Health Department    | 540-899-4142 |
      • Stafford Health Department               | 540-659-3101 |
      • Spotsylvania Health Department        | 540-507-7400 |
      • King George Health Department        | 540-775-3111|
      • Caroline County Health Department  | 804-633-5465 |


February 5, 2019

Rappahannock Area Health District is Awarded Two Grants for Programs Serving Vulnerable Community Members: Recently the Rappahannock Area Health District received two awards from the Joe and Mary Wilson Community Benefit Fund of the Mary Washington Hospital Foundation. The district received $100,000 from the Foundation for its Complicated Obstetrical and High-Risk Maternity Care Program that serves primarily uninsured or underinsured pregnant women in city of Fredericksburg and the counties of Caroline, King George, Spotsylvania and Stafford. Thanks to the many Public Health Nurses, Office Services Specialists and other staff members too numerous to name, who have made this program a success. In addition, RAHD received $15,972 in grant funding from the Foundation for an Outreach Worker for its Every Woman’s Life Program which provides breast and cervical cancer screenings exclusively for uninsured or underinsured, low-income women. This program sees a notable amount of patients — more than 250 each year and has been serving the community for years. Thanks to EWL Outreach Worker Kamryn Hines, OSS Latachia Lewis, Nurse Practitioner Sheila Mathis and EWL Nurse Coordinator Michelle Clayton. Congratulations to the staff at RAHD for successfully winning grants to fund these important services for their residents.

January, 2019

Acute Flaccid Myelitis: Acute flaccid myelitis (AFM) is a rare but serious condition affecting the nervous system, specifically the area of the spinal cord called gray matter.  The most common symptoms include limb weakness and loss of muscle tone and reflexes. Other symptoms may include facial droop or weakness, drooping eyelids, difficulty moving the eyes, or difficulty swallowing/slurred speech. Respiratory failure is rare, but may occur if the muscles involved with breathing are affected. AFM is not a new condition, but the Centers for Disease Control and Prevention (CDC) has seen an increase in cases since 2014. The causes of AFM are currently unknown, although an infectious process or environmental toxins may be involved. For more information on AFM, please refer to the CDC AFM website at https://www.cdc.gov/acute-flaccid-myelitis/.