Saturday, January 25, 2020

Flu activity in Kentucky again drops a bit, but remains high, and nine more adults die from it in state; not too late to get a flu shot

Kentucky Health News

Nine more Kentucky adults have died from influenza, bringing the flu season's total to 30, two under the age of 18, according to the state Department for Public Health.

While flu activity remains high in the state, the latest weekly report shows the number of new cases dropped for the third week in a row. In the week ending Jan. 18, Kentucky counted 1,544 new cases. Not all cases are counted, because flu does not have to be reported.

At the same time last year, Kentucky's numbers were less concerning. The state had a total of 4,166 lab-confirmed cases and 13 deaths, one a minor. There have been 11,548 confirmed cases this season.

Health officials urge everyone six months and older to get a flu shot each year, and note that much of flu season remains.

Hotspots continued around the state. Perry and Pike counties continued to be hit hard by the flu in the week ending Jan. 18, with 76 new cases in Perry and 71 new cases in Pike, for respective totals of 715 and 523. Barren added 75 new cases, for a total of 475; Warren 65, for a total of 416; Bullitt 61, for a total of 527; and Allen 57, for a total of 179.

Friday, January 24, 2020

Senate President Stivers, long the key obstacle to medical marijuana in Kentucky, now says he sees 'a narrow path' for it

Senate President Robert Stivers
By Melissa Patrick
Kentucky Health News

The most important legislative opponent of legalizing medical marijuana in Kentucky said Friday that there is a "narrow path forward" for it. Senate President Robert Stivers said that the day after a medical-cannabis bill was filed in his chamber.

Senate Bill 107 has bipartisan sponsorship from 11 of the Senate's 38 members. It is a companion bill to House Bill 136, with 44 co-sponsors, including House Speaker David Osborne.

The House bill's prime sponsor, Rep. Jason Nemes, R-Louisville, told Tom Latek of Kentucky Today that most House Republicans support it and he is optimistic it will pass this year.

Stivers has said he wouldn't support a medical-marijuana bill without medical studies to back it up, but Friday he said it would be a balancing act to weigh the good and the bad of passing such a law.

"I know that Representative Nemes is trying hard and that he is modifying and amending, and I think there is a path, but it is a narrow path," he said.

Stivers said that in the 20-plus studies that have been delivered to him, he has found there are "statistically significant indicators" to use medical marijuana, such as nausea from chemotherapy, or spasticity in people with multiple sclerosis. But he cautioned that the studies were small and of short duration, and he said there are better medicines for glaucoma, an eye condition that many medical-cannabis supporters mention.

He also said that like all medicine, the good must outweigh the bad, noting "statistically significant indicators" in studies showing marijuana exposure to those under 25 hurts brain development; that prolonged exposure increases the likelihood of psychotic experiences; that it has 50 percent more carcinogens in it than tobacco; and can cause heart disease.

"So, it becomes a balancing test," he said. "And nobody has really come, in my opinion, to give us that good path forward."

He added, "Does anybody here in this chamber or the other chamber want to see individuals suffer? No, we don't. But we also don't want to exacerbate a drug problem or a problem with cancers, heart disease, anything like that."

The 160-page medical-marijuana bills offer a list of conditions for which cannabis can be prescribed, such as terminal illness and epilepsy, but don't limit prescribing to those conditions, and would allow physicians to prescribe marijuana to their patients as long as they have a "bona fide" relationship.

The 11 sponsors of SB 107 are Sens. C.B. Embry Jr., R-Morgantown; Perry Clark, D-Louisville; Denise Harper Angel, D-Louisville; Jimmy Higdon, R-Lebanon; Morgan McGarvey, D-Louisville; Gerald Neal, D-Louisville; Michael Nemes, R-Shepherdsville; Dennis Parrett; D-Elizabethtown; Reginald Thomas, D-Lexington; and Robin Webb, D-Grayson.

A medical-marijuana bill passed the House Judiciary Committee 16-1 last year, but with only five days left in the legislative session and opposition in the Senate, it did not get a vote in the full House.

This year's House bill awaits a hearing in the House Judiciary Committee. The Senate bill has not yet been placed in a committee.

Marijuana is legal medicine in 33 states and the District of Columbia. Recreational marijuana is legal in 10 states, most recently Illinois, the first bordering Kentucky.

If approved, the medical marijuana program would start Jan. 1, 2021.

Unanimous Senate sends female genital mutilation ban to House

By Melissa Patrick
Kentucky Health News

A bill to ban female genital mutilation in Kentucky unanimously passed the Senate Jan. 22 and went to the House Judiciary Committee for consideration.

Sen. Julie Raque Adams
The sponsor of Senate Bill 72, Majority Caucus Chair Julie Raque Adams of Louisville, told senators that FGM has no health benefits and  creates life-long physical and physiological harm. It is usually performed on girls between 4 and 14.

“Female genital mutilation is one of the most egregious forms of child abuse," Adams said. "It is internationally recognized as a violation of human rights and a form of discrimination against women."

Kentucky is one of 15 states where FGM is still legal. A federal ban that had been in place for more than two decades was found unconstitutional in 2018, putting the responsibility on states.

The United Nations Population Fund estimates that 200 million women and girls have suffered FGM. The federal Centers for Disease Control and Prevention estimates that 513,000 American females are at risk of FGM or have undergone it. In Kentucky, that number is estimated at 1,845, according to the Population Reference Bureau.

An FGM survivor named Jenny, who asked that her last name remain private, gave several reasons for the bill at the Jan. 15 Senate Health & Welfare Committee meeting.

She said a law banning the practice would offer support to women who are surrounded by people who still believe in it, but want to give their daughters "an out;" prompt women who have had FGM to ask questions, since many think it is done to all females; let people in other states know that Kentucky is not a "safe haven" for it; and promote badly needed education about it.

The bill would make FGM a felony if performed on a female under 18. It would ban trafficking girls across state lines for FGM, and revoke the licenses of medical providers convicted of the practice. It classifies FGM as a form of child abuse and would require mandatory reporting of it.

It would also mandate training for law enforcement and require the state Department for Public Health to produce and disseminate educational materials about it, and allow victims of the practice to file civil lawsuits up to 10 years after turning 18.

The bill had 12 sponsors, representing both parties. Click here for a fact sheet about FGM.

Thursday, January 23, 2020

Bill to raise legal age to purchase tobacco products from 18 to 21 passes state Senate 28-10, goes to House

By Melissa Patrick
Kentucky Health News

A bill to raise the legal age to purchase tobacco products, including electronic cigarettes, from 18 to 21 passed the state Senate 28-10 and went to the House.

Sen. Ralph Alvarado
Senate Bill 56, sponsored by Sen. Ralph Alvarado, R-Winchester, would bring Kentucky's statute in line with the new federal law raising the age to 21, which has already gone into effect.

It also removes status offenses for youth who purchase, use or possess tobacco products, which are often called PUP laws.

“The bottom line is this bill will reduce youth access to tobacco products, slash the number of kids who start using tobacco before age 18, decrease youth tobacco addiction and lead to lower tobacco-use rates overall as these teens grow and mature into adulthood,” said Alvarado, chair of the Senate Health and Welfare Committee.

The bill passed with a committee substitute adding language to make it better fit the federal law and remove penalties for 18- to 20-year-olds.

SB 56 allows the products to be confiscated and shifts the penalty to retailers who fail to adequately check buyers' identifications.

Senate Republican Caucus Chair Julie Raque Adams of Louisville praised the bipartisan bill, which is largely aimed at decreasing the epidemic of electronic-cigarette use among youth.

“We were so close to having nicotine be eliminated from one of the problems we had to add for our youth across the state," she said. "Unfortunately, with the introduction of vaping ... we now have an entire population that is addicted to nicotine once again.”

Between 2017 and 2019, e-cigarette use more than quadrupled among Kentucky's middle-school students and nearly doubled among its high-school students, with one in four high schoolers and one in five middle schoolers reporting monthly use; and one in 10 high school students reporting daily use.

A similar bill was introduced in the last legislative session, but tobacco-friendly senators blocked it. Some tobacco companies lobbied for it, and the federal change, to reduce pressure for regulation of electronic cigarettes.

Voting against Alvarado's bill were Sens. Matt Castlen, R-Owensboro; Perry Clark, D-Louisville; Stan Humphries, R-Cadiz; Robby Mills, R- Henderson; John Schickel, R-Union; Wil Schroder, R-Wilder; Damon Thayer, R-Georgetown; Robin Webb, D-Grayson; Stephen West, R-Paris; and Mike Wilson, R-Bowling Green.

First abortion bill of session clears committee; 2 more in hopper; Beshear administration lets Planned Parenthood apply for clinic

By Melissa Patrick
Kentucky Health News

A bill to require health care providers to do everything possible to save the life of a baby who is born alive has passed out of committee and now heads to the full Senate, where it is expected to pass.

Sen. Whitney Westerfield
The sponsor, Sen. Whitney Westerfield, R-Hopkinsville, paraphrased several Bible passages in his opening remarks, including one in which the prophet Jeremiah quotes God as telling him that "Before I formed you in the womb I knew you; before you were born I set you apart; I appointed you as a prophet to the nations."

Westerfield said, "Before we had a window into the womb through ultrasound, the Lord told us what was happening to that growing life -- for those who believe and follow God's word."

His Senate Bill 9 would require health-care providers give "medically appropriate and reasonable life-saving and life-sustaining medical care and treatment" to any infant born alive, including after a failed abortion, and would make it a felony for not doing so.

The bill, called the "Born Alive Infant Protection Act," passed Jan. 23 out of the Senate Veterans, Military Affairs and Public Protection Committee on a 9-0 vote, with all but one of them, Sen. Dennis Parrett, D-Elizabethtown, Republicans. None of the committee's Democrats were present. The other three Democrats on the committee were not present. 

Westerfield filed a similar bill last year that passed the Senate, but ran out of time in the House. Eighteen of the 38 senators are sponsoring this year's bill; one, Sen. Johnny Ray Turner, R-Prestonsburg, is a Democrat.

Westerfield told reporters after the committee meeting that he was not aware of any instances in which an infant was born alive in Kentucky from a failed abortion and that the measure is needed to "prevent it from ever happening," Bruce Schreiner reports for The Associated Press.

Westerfield added that he's concerned about situations such as late-term abortions that are allowed in some states where an infant might survive, Deoborah Yetter reports for the Louisville Courier Journal. Kentucky law prohibits abortions after 20 weeks, before a fetus is considered viable.

In a letter to members of the committee, Kate Miller, advocacy director of the American Civil Liberties Union Foundation of Kentucky, called the bill an "unnecessary and dangerous piece of legislation" that "has nothing to do with how abortion care actually works and is based on false claims. Bills like these perpetuate myths and lies about abortion care, patients who receive this care, and the doctors who care for them."

Westerfield told the committee that he hopes Democratic Gov. Andy Beshear would sign the bill or let it become law without his signature, but if he vetoes it, "I look forward to overriding that veto." Gubernatorial vetoes can be overridden by majorities in each chamber, and Republicans have supermajorities in both.

Two other anti-abortion bills have been filed in the legislative session that began Jan. 7.

House Bill 67, sponsored by Rep. Joseph Fischer, R-Ft. Thomas, would amend the state constitution to specify that it includes no protection for abortion rights. It has been assigned to the House Elections, Constitutional Amendments & Intergovernmental Affairs Committee.

House Bill 142, sponsored by Rep. Lynn Bechler, R-Marion, would prohibit public money from going to any entity that performs, induces, refers for or counsels in favor of abortions. It has been assigned to the House Appropriations and Revenue Committee.

Last year, the Republican-led General Assembly passed four anti-abortion bills. Two have been delayed by legal challenges, including one that bans abortion once a heartbeat is detected (usually around six weeks of pregnancy) and one banning abortion due to gender, race or disability of a fetus.

A law that bans the most common second-trimester abortion procedure is also being challenged in the courts. This law was struck down by a federal judge, a decision that was appealed by the administration of then-Gov. Matt Bevin, a Republican.

In a Jan. 3 letter, the Beshear administration informed Planned Parenthood of Indiana and Kentucky that it could apply for a license to provide abortions at its clinic in downtown Louisville, Deborah Yetter reports for the Courier Journal.

That would be the second abortion provider in the state, in addition to EMW Women's Surgical Center in Louisville. An abortion clinic in Lexington closed  in 2016 after enforcement action by Bevin's administration -- which also denied Planned Parenthood's application and accused it in court of providing 23 illegal abortions.

“Gov. Beshear’s administration recognized that our license had been wrongfully denied and that the previous administration didn’t follow the proper process," said Hannah Brass Greer, chief legal counsel for Planned Parenthood.

Planned Parenthood has denied that it provided illegal abortions, saying it was acting on instructions of the former administration led by then-Gov. Steve Beshear, Andy Beshear's father, who advised it to offer the procedure in order to be inspected for final action on the license.

The current Beshear administration has dropped the lawsuit, stating there was no failure to comply with the law, Yetter reports.

Mental health first-aid training bill passes state House

By Melissa Patrick
Kentucky Health News

A bill to create a training program for mental-health first aid has unanimously passed the state House and is in the Senate.

Rep. Kim Moser
House Bill 153, sponsored by Rep. Kim Moser, R-Taylor Mill, would train people in how to best address the needs of someone experiencing a mental-health or substance-use crisis.

“The Mental Health First Aid Act will put this evidence-based training program in the hands of educators, law enforcement, first responders, military personnel, our faith leaders—really anyone who interacts with the general public and anyone at risk,” said Moser, who chairs the House Health and Family Services Committee.

Moser noted that mental health is the underlying cause of many issues in society, such as substance-use disorder, suicide and violence.

To that point, she said Kentucky has a high rate of substance misuse and addiction problems, with 1,333 people dying from a drug overdose in 2019. She added that in 2017, 766 Kentuckians died by suicide and noted that suicide is the second leading cause of death for people ages 15 to 34 and the U.S. suicide rate for veterans is 17 per day.

She said the objectives of the program are to build mental health and substance use literacy and to help the public identify, understand and respond to the early signs of mental health issues.

The curriculum is already being used in pockets of the state and this program will take it statewide, she said. She added that the certification does not replace a licensed counselor and is not mandated.

The training would be administered by the Cabinet for Health and Family Services and would be paid for through a trust, funded with state and federal appropriations, grants and private donations.

“Any money in this trust fund would be used specifically for this training program or suicide prevention programs,” she said.

Rep. Mary Lou Marzian, D-Louisville, a nurse, praised the legislation, but voiced concern that there was no funding allocated for it. She called on the lawmakers to find a way to fund it other than "begging for donations and handouts."

"I think that is a very poor way to try to fund one of the most important pieces of legislation [for] the neediest of our citizens with substance abuse issues and mental illness," Marzian said.

Editorial in Frankfort's newspaper says drug addiction should be treated as a health issue, not a crime

The State Journal

With rising inmate populations and crumbling prison infrastructure depleting the state of much-needed funding, it is time to stop treating drug addiction as a crime and start regarding it as the public health issue that it is.

We agree with the Kentucky Chamber of Commerce that reclassifying drug possession charges to misdemeanors and investing in treatment over incarceration will serve a dual purpose — save the state money on prison costs, which grew 15.9 percent between 2016 and 2020, and help to break the cycle of drug addiction through education and treatment.

The cost to incarcerate a state inmate in Kentucky is $18,406 per year. The approximately 4,500 inmates in prison for drug offenses in 2016 cost taxpayers more than $82 million per year.

According to data from the Criminal Justice Policy Assessment Council, a working group established by former Gov. Matt Bevin charged with developing “fiscally-sound, data-driven criminal justice policies,” the number of offenders imprisoned for drug trafficking between 2012 and 2016 jumped 25.6% (1,525 in 2012 to 1,916 in 2016). However, there was a 101.5% increase in the number of offenders (911 in 2012 to 1,836 in 2016) jailed on drug possession charges.

In fact, it was a year ago this week that a Franklin County Regional Jail inmate was discovered dead in his cell after what a lawsuit alleges were days without treatment for withdrawal symptoms related to drug use.

Dylan Stratton, 21, was booked into the jail Jan. 17, 2019, on a drug charge and was placed in the detox holding cell for observation. According to the lawsuit, he refused meals and began vomiting. A day later he had a seizure, reportedly from benzodiazepine withdrawal, and died.

This case is just one of many that illustrate how Kentucky’s jails are ill-equipped to handle drug addicts. Instead of spending money to punish drug users, the state should increase funding for substance abuse treatment.

Database shows the basics of each rural hospital's finances

Want to check the financial history of your local hospital? There's a quick and easy way to get the fundamental figures, thanks to a reporting project last year on rural hospitals by GateHouse Media, which has absorbed Gannett Co. and taken its name. The database built for the project now resides on the USA Today Network site.

At right is a screen grab of the financials of Breckinridge Memorial Hospital in Hardinsburg, Ky., which Kentucky Health News reported last year typically had a week's worth of cash flow on hand after it failed to persuade county officials to impose a property tax to subsidize it. The top part shows the hospital's gross revenues by year; the bottom part shows its net income, revealing years of increasing losses. Another chart, not seen here, shows each year's net profits.

William Heisel of the Center for Health Journalism at the University of Southern California wrote about using the database, and wants to hear results from other users.

Wednesday, January 22, 2020

Ads touting McConnell's record on surprise billing, Medicare for All could be a surprise of their own, since they confuse the issues

This ad promoting Sen. Mitch McConnell conflates the issues of surprise billing and Medicare for All.
Analysis by Al Cross
Kentucky Health News

A conservative group has started television and radio commercials in Kentucky and other states thanking Senate Majority Leader Mitch McConnell and others in Congress for blocking legislation that would offer consumers some protection from surprise medical bills.

While that may not sound politically advantageous to the senator's re-election campaign, the ads conflate and confuse the surprise-billing issue with the much more prominent "Medicare for All" proposal, which is favored by the most liberal Democratic presidential candidates.

The TV ad says, "Some politicians are too scared to stand up to the special interests. But not Mitch McConnell. He fights for us, like on health care and surprise medical billing. Special-interest groups have tried to use the issue to implement a government-run Medicare for All scheme, putting our hospitals and care at risk. But Mitch said NO, because he knows how devastating that would be, for us and our children. So, thank you, Mitch McConnell, for putting patients first."

The Taxpayers Protection Alliance said that in December, McConnell "and legislative allies halted attempts by members of Congress such as Sen. Lamar Alexander (R-Tenn.) and Rep. Frank Pallone (D-N.J.) to have the government impose rate-setting in cases of surprise medical billing. Surprise bills occur when patients receive unwanted and unexpected healthcare bills in the mail days or even weeks after a hospital room visit."

Yes, but the surprise-billing issue has little if anything to do with "Medicare for All," one possible exception being that proponents of the latter cite the former as one problem it would solve. TPA says the two are related this way: "Surprise medical billing is only an issue because of rampant government intervention in the medical sector due to Obamacare and Medicare’s disastrous rural price controls. This is a problem that was specifically caused by misguided government intervention. In fact, three-quarters of Obamacare networks are now considered ‘narrow’ with few choices for patients, leading to many patients receiving ‘surprise bills.’"

TPA says its campaign in Kentucky, Kansas, Texas, and New York is intended to thank McConnell "and like-minded lawmakers for standing up for patients and opposing the federal government dictating health-care prices across the country."

The proposed legislation "doesn’t set actually set rates for out-of-network procedures, but instead sets benchmarks for how much out-of-network providers can collect if a surprise bill shows up," health journalist Trudy Lieberman notes. "But in a TV ad that lasts a few seconds, how would the viewer be able to make that distinction?"

This isn't the first time that a group with undisclosed sources of money has tried to mischaracterize the issue of surprise billing. Last summer, a "dark money" group called Doctor Patient Unity ran an ad campaign in Kentucky and other states saying that Alexander's bill would hurt patients and help insurance companies. The campaign targeted McConnell, Sen. Rand Paul and six other senators.

Tuesday, January 21, 2020

Catholic hospital near Ashland to close, costing 1,000 jobs

Our Lady of Bellefonte Hospital opened in 1953. (Ashland Daily Independent photo)
Our Lady of Bellefonte Hospital in the Ashland suburb of Russell will close by Sept. 30, says the Bon Secours Health System, which operates it. The 214-bed hospital opened in 1953, when Ashland and Russell were booming with steel, railroad and petrochemcial industries.

Now, the hospital cannot "effectively operate in an environment that has multiple acute care facilities competing for the same patients, providers and services," according to a Bon Secours press release paraphrased by Aaron Snyder of The Daily Independent in Ashland. The Ashland hospital market is dominated by 486-bed King's Daughters Medical Center.

"Approximately 1,000 employees are affected," Snyder reports. "There are no immediate job cuts, according to OLBH."

State Rep. Danny Bentley, a Republican from Russell, called it “devastating news for our community. We have so many critical health care needs that are best met by a local facility. I served as a volunteer hospital board member for nine years under its previous ownership and I have seen first-hand the impact this facility makes on Greenup County. My greatest fear is that if we can’t find a way to prevent it from closing, we will never see it reopen.”

Bentley, a pharmacist, said he has asked Democratic Gov. Andy Beshear to work with him and local officials to keep the hospital open.

Bon Secours, whose name is French for "safe harbors," owns Lourdes Hospital in Paducah and Marcum and Wallace Memorial Hospital in Irvine. It acquired those hospitals when it absorbed Mercy Health, another Catholic chain, in a merger less than two years ago.

Jason Asic, OLBH’s interim president, said in the release, “We will work closely with area employers to identify opportunities close to home. In addition, we are establishing partnerships across the Tri-State to help those who may want to explore a different career.”

Kristie Whitlatch, president and CEO of King’s Daughters, said in a statement, “King’s Daughters and Our Lady of Bellefonte hospitals have served eastern Kentucky and southern Ohio for a very long time and we are deeply saddened by today’s news. Their employees, physicians and volunteers are our friends, relatives and neighbors. King’s Daughters will work with Our Lady of Bellefonte, its leadership and team to find any and all opportunities to keep jobs and health care local. We will provide more information related to both very soon. Making sure our community has access to quality healthcare services now and in the future is our No. 1 priority.”

Monday, January 20, 2020

Dentist gives warning signs of oral cancer, 'not always definitive'

By Dr. Shelley Shearer

There are nearly 50,000 new cases of oral cancer in the United States each year, accounting for 3 percent of all cancer diagnoses. Most are discovered in a dental office.

Oral cancer is caused by the uncontrolled growth and reproduction of cells in some regions of the mouth. It can occur inside the cheeks, under the middle and front of the tongue, or on the tissue lining of the mouth or gum. That’s why it is worthwhile to ensure that people know the symptoms, causes and risk factors.

Shelley Shearer
Early detection and treatment of oral cancer can help prevent the cancer from developing further or spreading to other areas. Be sure to tell your dentist is you have experienced any of the following for more than two weeks:
• difficulty chewing or swallowing
• a lump or sore area in the mouth, throat or on the lips
• a white or red patch in the mouth
• difficulty moving the tongue or jaw
• unexpected weight loss
• a sore or ulcer that does not heal or bleeds
• tenderness, pain, or lumps anywhere in the mouth or on the lips.

These are not always definitive signs of oral cancer and may be caused by other conditions, such as an allergy or an infection. But it’s better to check out these occurrences before it’s too late.

Patients often ask what causes oral cancer so they can try to avoid it. Here are some of the main causes and risk factors:
• Tobacco and alcohol use: Any form of tobacco use involves carcinogenic substances entering the mouth, which significantly increases the risk for oral cancer. Excessive alcohol use can also increase the risk.
• Age: The risk of oral cancer increases with age, with the average age of diagnosis at 62 years old.
• Human papillomavirus (HPV): This is a sexually transmitted infection that has strong associations with several forms of oral cancer.
• Sun exposure: The sun emits rays that can burn the lips and trigger the development of oral cancer.
• Gender: Males are more than twice as likely to develop oral cancer than women. Researchers have yet to discover a reason why.

As with most other cancers, it is not always possible to prevent oral cancer. Some risk factors for oral cancer, such as being male or aging, are not preventable. However, consider some lifestyle factors that can reduce the risk of oral cancer such as:
• avoiding tobacco
• consuming alcohol in moderation
• maintaining a healthy diet
• using screen around the mouth and a balm on the lips when exposed to sun
• exercising regularly
• maintaining good oral hygiene by brushing and flossing twice a day
• regularly visiting a dentist for check-ups.

Conduct Your Own Self-Check: Just as women take time for a monthly breast self-exam, those with oral cancer risk factors should conduct their own self-check.

First, look at and feel your head and neck in a mirror. Do the left and right sides of the face have the same shape? Are there any lumps, bumps, or swellings that are only on one side of your face? Also view the skin on your face for changes in color or size, sores, moles or growths. To check the neck, press along the sides and front of the neck for tenderness or lumps.

Lips and cheeks can reveal much as well. Pull your lower lip down and check for sores or color changes. Then use your thumb and forefinger to feel the lip for lumps, bumps, or changes in texture. Repeat this on your upper lip. Examine your inner cheek for red, white, or dark patches. Put your index finger on the inside of your cheek and your thumb on the outside. Gently squeeze and roll your both sides of your cheeks between your fingers to check for any lumps or areas of tenderness.

Often the roof of the mouth is an indicator that something is off. Tilt your head back and open your mouth wide to look for any lumps and see if the color is different than usual. Touch the roof of your mouth to feel for lumps. Extend your tongue and look at the top surface, sides and underneath for lumps, swelling or changes in color and texture.

Tell your dentist if you suspect anything unusual in your mouth. Catching oral cancer early can save time, money and most importantly, your life.

Shelley Shearer is founder of Shearer Family and Cosmetic Dentistry in Florence, and wrote this for the Northern Kentucky Tribune and KyForward.

Saturday, January 18, 2020

Flu cases dip a bit in new year, are still much higher than last season; 21 have died from flu in Kentucky; a shot still protects

By Melissa Patrick
Kentucky Health News

Influenza has killed 21 people in Kentucky this season, two under the age of 18, according to the state Department for Public Health.

The latest weekly report shows that the flu activity in the state has dropped a bit in the first two weeks of the year, compared to the last two weeks of 2019, when the state was reporting more than 2,000 new cases each week.

In the week ending Jan. 11, the last week for which the state has issued a report, Kentucky had 1,898 new cases. During the flu season, which can last through May, 10,004 cases have been confirmed in Kentucky.

At the same time last year, Kentucky's flu statistics were much less concerning; the state had 3,148 lab-confirmed cases and nine deaths, one of a minor.

The number of flu cases in Kentucky is higher than the confirmed number since the surveillance report only shows a sampling of cases throughout the state, and 10 of the state's 120 county health departments did not report.

Because flu is not a disease that has to be reported, the state relies on reporting from "sentinel sites," a network of doctors' offices, hospitals and health departments that voluntarily submit their flu data, so the state does not track every case of flu in Kentucky, said Beth Fisher, a spokeswoman for the state Cabinet for Health and Family Services, said in an email.

A health department fact sheet says, "The sampling represents only a small percentage of influenza cases for the state, but contributes to the ongoing assessment of flu activity in Kentucky and helps determine the level of flu activity in the state each week.

So far, most of Kentucky's cases have been in children between the ages of 1 and 10, likely because a strain of the virus called type B/Victoria has been the predominant virus this season, and children are highly vulnerable to it, according to the Centers for Disease Control and Prevention. The B/Victoria strain normally doesn't show up until March or April.

The CDC says that in recent weeks, approximately equal number of type B/Victoria and type A (H1N1) viruses have been reported.

The health department's Troi Cunningham urged Kentuckians to get a flu vaccine, which is the best defense against it. "It is not too late to get the flu shot," she said in an e-mail. "Get it now. It takes two weeks for it to full take effect."

The CDC says everyone over six months old should get a flu shot each year.

Cunningham particularly urged pregnant women to be diligent in getting their flu shot because the immunity is transmitted to their infant while the baby is still in the womb and can protect them at birth. "CDC research shows a child's risk of dying from the flu can be reduced by 50 percent or more by getting the vaccine," she said.

Four Eastern Kentucky schools canceled classes last week due to widespread illness. Wolfe, Owsley and Lawrence county schools were closed Jan. 15-17. Beth Musgrave reports for the Lexington Herald-Leader. Pike County schools were closed Friday, Jan. 16, Hazard's WYMT-TV reports. Classes were scheduled to resume on Tuesday, Jan. 21, after the Martin Luther King Jr. holiday. The schools did not say what the illness was, but flu is widespread throughout the state.

On Jan. 16, acting in response to the flu, the University of Kentucky restricted visitation at its hospitals, including: no visitors under age 12; none under 18 in the bone-marrow transplant area; only two visitors per patient room at a time; no visitors with flu-like symptoms; and some visitors may be asked to wear a mask or other protective clothing while visiting.

Compassionate exceptions will be made case by casem and additional restrictions may be in place in some units, a UK HealthCare news release said.

The Herald-Leader reports that Eastern State Hospital also implemented visitation restrictions.

Pike County continued to be among the hotspots for flu in the week ending Jan. 11, with 101 new cases, for a total of 452. Perry County, a major hotspot this season, had 44 more cases during the week, for a total of 639. Adjoining and less populous Leslie County added 25 for a total of 208. Warren added 84 and Barren 58, for respective totals of 351 and 400.

MMWR is the Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.