The United States is currently experiencing a large, multi-state outbreak of measles linked to an amusement park in California. More than 100 people from 14 states in the U.S. (AZ, CA, CO, IL, MI, MN, NE, NY, OR, PA, SD, TX, UT, WA) have been confirmed as having measles. As of February 5, 2015, there are no confirmed measles cases in Iowa.
“This national measles outbreak has brought the protection provided by vaccinations back into the spotlight,” said Chickasaw County Public Health Director, Kathy Babcock, RN, BSN “It’s always important to keep your vaccinations up-to-date, but during times like this, when we know a virus is circulating in many states, it’s especially critical to check with your health care provider to be sure you and your family’s vaccinations are current.”The best way to prevent measles is to get the measles-mumps-rubella shot (called MMR). Two doses of MMR will provide more than 99 percent of people lifelong protection against measles.
Two doses of MMR are required for elementary and secondary school entry in Iowa. The first dose should be given at 12 months of age and the second dose can be administered as soon as 28 days later (however the second dose is usually administered as part of the kindergarten shots given between 4-6 years of age). Generally, persons who started elementary school in Iowa after 1991 and were up-to-date on all school entry vaccine requirements have received two doses of MMR vaccine.
It is recommended that adults born in 1957 or later receive at least one dose of MMR vaccine, or have a laboratory test proving that they are immune and are protected. It is assumed that persons born in the U.S. prior to 1957 were likely infected with the measles virus and therefore have presumptive immunity. In addition, two doses of MMR is recommended for adults of all ages who work or volunteer in health care facilities, travel internationally, or are students in a post-secondary institution, if they do not have laboratory proof of immunity.
Giving vaccines to those who may have already had measles or may have already received the recommended vaccination is not harmful; it only boosts immunity. Therefore, if someone is unable to verify prior vaccination or history of illness, the easiest, quickest and most appropriate thing to do is to vaccinate the individual.
Measles starts with a high fever. Soon after, it causes a cough, runny nose, and red eyes. Three to seven days after the fever, a rash of tiny, red spots breaks out. It usually starts at the head and spreads to the rest of the body. The rash can last for a week, and coughing can last for 10 days.
Measles is one of the most infectious diseases on earth; this is why Chickasaw County Public Health and local public health agencies statewide work with the Iowa Department of Public Health to immediately alert the public about possible exposure to measles if a person is confirmed to have this disease. If a resident of Chickasaw County would have measles, all residents would be notified of places, times and locations where they could have been exposed, as well as locations of emergency vaccination clinics.
Three Strains of Influenza Currently Circulating in Iowa
Flu vaccination is still best protection against illness
The Iowa Department of Public Health (IDPH) says all three flu viruses covered by this year’s vaccine - A(H3N2), A(H1N1) and B - are currently circulating in Iowa. Nationally, an additional A(H3N2) strain is accounting for about half the illness seen across the country so far this year. The CDC today announced the current influenza vaccine does not offer as effective protection against this strain. So far, this ‘drifted’ strain of the A(H3N2) virus has not been confirmed by testing in Iowa.
The Iowa Department of Public Health (IDPH) and CDC remind Iowans the influenza vaccine is still the best way to protect against the flu. Additionally, Iowans should be reminded that anti-viral medications are an important second line of defense to treat the flu.
“In years when A(H3N2) viruses dominate, we tend to have more severe flu seasons with more hospitalizations and death,” said IDPH Medical Director, Dr. Patricia Quinlisk. “Since antiviral medications only work well if taken very early in the illness – usually within 48 hours - it is even more important to see your doctor right away if you have flu symptoms so you can begin the medications.” This is especially true for the very young, very old, women who are pregnant, and those with chronic diseases like heart or lung disease. These individuals are more likely to be at risk for severe complications of the flu, including being hospitalized and dying.
Many people assume there is no treatment for the flu beyond over-the-counter medications and rest. There are actually two anti-viral medications a doctor can prescribe which make flu illness milder, shorter, and reduce the risk of ending up in the hospital or dying from influenza. Antivirals work best if started within 48 hours or sooner of when flu symptoms begin.
“Our message to Iowans is clear,” said Dr. Quinlisk. “The best way to prevent the flu is the influenza vaccine. The best way to lessen complications of the flu is antiviral medication. The best way to prevent the spread of flu is to stay home when ill.”
The flu is a respiratory illness caused by viruses. The flu comes on suddenly and symptoms may include fever, headache, tiredness, cough, sore throat, nasal congestion, and body aches. Illness typically lasts two to seven days. Influenza may cause severe illness or even death.
IDPH conducts year-round influenza surveillance through the Iowa Influenza Surveillance Network, and posts a flu report weekly. For more information about where and what kind of influenza is in Iowa, go to www.idph.state.ia.us/Cade/Influenza.aspx?pg=FluHome.
Ebola preparedness continues
IDPH continues to work diligently to ensure public health and the state health care system are prepared should a case of Ebola be reported in Iowa. There are currently no confirmed or suspected cases of Ebola in Iowa and none of the individuals currently under Ebola-related health orders are exhibiting symptoms of Ebola. All individuals under orders are cooperative. IDPH continues to conduct weekly briefing webinars for local public health, hospitals, and EMS, in addition to working closely with the Iowa Hospital Association and state agency partners. Links to guidance, checklists, and factsheets are available on the IDPH Ebola web page.
ACA healthcare reform impact study
As uninsured Iowans become enrolled in new health plan options available through the Iowa Health and Wellness Plan (IHAWP) and the Marketplace, IDPH anticipates that some healthcare services the Department has historically funded may become covered benefits under new plans, changing the demand for IDPH-funded services.IDPH contracted with the Milliman actuarial firm to better understand the impact of state-level healthcare reform on certain IDPH programs and healthcare services. While the exact impacts of the ACA remain complex and difficult to predict, this ACA Impact Study represents an initial step in understanding the multiple complex considerations IDPH has identified related to the direct healthcare services the Department has historically funded, and will help IDPH quantify likely changes in the demand for its services and related program and funding implications. A summary of the Milliman study will be posted to the IDPH web page soon.
Check your inbox
The Title V Needs Assessment Prioritization Survey is now open for public input and will close December 8th. To ensure a comprehensive assessment of the Maternal and Child Health (MCH) population needs, we are soliciting input from a wide variety of stakeholders. A survey link will be emailed to stakeholders this week. Participants will be provided with links to Data Detail Sheets to assist in learning about each topic area and the needs statements. Each need statement will be ranked using six criteria selected by the needs assessment team. Results of the prioritization survey will be used to direct the MCH and Child Health Specialty Clinic (CHSC) programs for the next five-year project period.
The Iowa Department of Public Health’s Iowa Get Screened: Colorectal Cancer program, the American Cancer Society, and the Iowa Cancer Consortium have launched a free online training to teach providers and healthcare professionals how to engage their entire staff, implement policy and system changes, utilize a continuous improvement model to measure practice progress, and receive useful tools and resources to help increase cancer screening rates in busy practices. This training uses interactive, audiovisual demonstrations to show providers how they can engage their entire staff to identify appropriate patients, provide recommended screenings and encourage timely follow-up for recommended cancer screenings.
Quality improvement success
The IDPH Ryan White Part B program kicked off its formal Quality Management Program by hosting the first quality management team meeting. The team will meet quarterly, and will examine performance measures and continuous quality improvement activities for the Ryan White Part B program.
All Title V contractors with a school-based dental sealant program will now use the same data recording system to submit standardized data to the IDPH Bureau of Oral and Health Delivery Systems (Oral Health Center).This system was initially developed for sealant contractors in order to allow IDPH to have consistent reporting of the program results, oral health status, and other indicators. The data recording system has been fine-tuned and by extending it to the additional programs, it will provide a more comprehensive, statewide review about the program benefit and the oral health of Iowa schoolchildren.
IDPH and Iowa State University Extension and Outreach have received the Iowa Chapter of the American Planning Association’s (APA) award for the I-WALK program. I-WALK has helped more than 30 Iowa communities assess their walkability infrastructure with the ultimate goal of initiating improvements.