New Kentucky website provides data, maps and charts on how the environment affects human health, county by county

The website's address is Healthtracking.ky.gov.

The state Department for Public Health has launched a new resource for tracking a variety of topics that affect health in Kentucky. 

The website Healthtracking.ky.gov not only includes information and data about how the environment affects human health in a number of ways, but also presents data in map, chart or table formats for subcategories in each topic area. 

For example, under the category of heart disease and stroke, the site also provides information about the age-adjusted rate of hospitalization for heart attacks in each county, the crude rate of hospitalizations for heart attack in each county, and the number of hospitalizations for heart attack in each county. 

Other topics include: air quality, asthma, birth defects, cancer, childhood lead poisoning, chronic obstructive pulmonary disease (COPD), carbon-monoxide poisoning, climate and weather, drinking water, heat-related illness, radon (a naturally occuring, cancer-causing gas) and reproductive and birth outcomes. 

Data on the new site comes from several counrse, including the Centers for Disease Control and Prevention, the Environmental Protection Agency, the Kentucky Cancer Registry, state and local Health Departments and many others. Data can be examined at a state or county level.

The site also offers online maps with information about local health departments, prescription assistance, social vulnerability, and community vulnerability to Covid-19. It is managed by the health department's Environmental Public Health Tracking Program.

Teleconference on Tuesday, March 17, will cover prevention and treatment options for covid-19, the coronavirus disease

The Commonwealth Fund will host a teleconference briefing at 12:30 p.m. ET Tuesday, March 17 for journalists and policymakers to discuss prevention and treatment of the coronavirus disease, covid-19. The call will last about an hour. Register here.

Experts will cover these topics:

• What policy tools do the federal government and states have at their disposal to address the pandemic, and what actions have they taken so far? 
• How can we expand coverage and access to care through Medicaid, and how can we work with insurers so that no one is deterred from seeking needed treatment?
• What role could emergency federal powers play, and where could they fall short?

The call will be conducted by:

• Kevin Lucia, J.D., M.H.P., research professor, Georgetown University Center on Health Insurance Reforms
• Sara Rosenbaum, J.D., Harold and Jane Hirsh Professor of health law and policy, George Washington University Milken Institute School of Public Health
• Moderator: Rachel Nuzum, M.P.H., vice president, federal and state health policy, The Commonwealth Fund

The Commonwealth Fund is a nonprofit dedicated to improving health care and making it more affordable and accessible to all Americans.

Transport and fears of stigma and lack of confidentiality biggest barriers to accessing rural syringe exchanges, study concludes

Counties in study are in red; click on the image to enlarge it.

By Heather Chapman
Kentucky Health News

Rural residents who inject drugs say they are less likely to access syringe exchange programs because of transportation problems, inability to get to the service at times it's open, and concerns about stigma, lack of confidentiality, and law enforcement. So says a newly published study examining barriers that can prevent people who inject drugs (PWIDs) from accessing syringe service programs (SSPs) in Appalachian Kentucky.

The researchers surveyed 186 PWIDs who used their local health department SSPs in three rural counties in 2018: Clark, Knox and Owsley (though Clark is in a metropolitan area, much of it is rural). Kentucky leads the nation in the number of SSPs, partly because it has 120 counties. As of July 2019, it had 52 SSPs that aim to reduce the spread of HIV and hepatitis C by giving PWIDs clean needles and disposing of dirty ones, and often offer more information about addiction treatment services when the person is ready.

Among the study's participants, 53.2 percent were male, 92.5% were non-Hispanic whites, and 78.5% had Medicaid coverage. About 39% said they injected more than one drug; methamphetamine was the single most popular drug, with 45.2% reporting it as the primary drug they inject. The next most popular was non-prescribed buprenorphine, which is sold legally as Suboxone for drug treatment (25.8%), followed by heroin (16.1%), other non-prescribed opioids (11.3%), and various other drugs (1.6%).

The biggest barrier to SSP use was the lack of transportation, with 18.3% reporting it as the primary barrier. Other barriers were: inability to access the program during operating hours, which are often limited (12.9%); concerns about stigma, privacy, and/or law enforcement (9.1%), not enough syringes (5.4%); and the location of the program (4.8%).

Participants' concerns varied based on the degree of their county's rurality. In Clark and Knox counties, the least rural, transportation was the most frequently cited barrier. But in Owsley, the most rural county, fear of stigma and lack of confidentiality ranked highest.

Rurality also factored into participants' consistency in accessing the SSPs. Participants in Knox and Owsley were more likely to consistently use the program than participants in Clark. The researchers believe the more consistent uptake in rural areas is because people in rural areas tend to have higher residential stability. However, Clark County participants may be less likely to consistently use SSPs because they're more likely to have an alternate means of accessing clean needles.

The study is part of a larger National Institutes of Health-funded effort to learn about SSP uptake in rural areas. This study's authors recently published another study about PWIDs in the same three counties, focused on what kind of interventions are most effective and which drug users are most likely to seek treatment.

Studies conclude that abstinence pledges do little to cut youth sexual activity, pregnancies, sexually transmitted diseases

Abstinence pledges—sometimes called purity pledges—don't keep young people from engaging in sex, contracting sexually transmitted diseases or avoiding pregnancy, according to a pair of studies, Denise-Marie Ordway reports for Journalist's Resource. The main problem is that students are not receiving enough sex education. A federal Centers for Disease Control and Prevention report from December 2015 found that "fewer than half of high schools and only a fifth of middle schools teach all 16 topics recommended by CDC as essential components of sexual health education."(CDC graphic)

A 2005 study by Yale and Columbia universities found that 88 percent of youth who take the abstinence pledge engage in pre-marital sex, Ordway writes. "The study found that pledgers were just as likely to get STDs as those who never made a pledge of virginity."

A more recent study, published in April in the Journal of Marriage and Family, found that among students in grades 7 to 12, "as a whole, young women who did not take abstinence pledges and those who did but broke them were equally likely to acquire HPV, a common STD," Ordway writes. "Approximately 27 percent of each group tested positive for HPV. Of the young women who had two or more sex partners, pledge breakers were more likely to have HPV. The difference was largest among women who had between six and 10 sex partners. One-third of women who had not taken a pledge and had six to 10 sex partners tested positive for HPV. Meanwhile, 51 percent of pledgers who had six to 10 sex partners acquired HPV. About 30 percent of pledgers and 18 percent of non-pledgers became pregnant within six years after they began having sexual intercourse outside of marriage."

"In the U.S, the teen pregnancy rate is higher than in any other western industrialized country, according to the CDC," Ordway writes. "At the same time, a growing number of American teens and young adults have been diagnosed with sexually transmitted diseases (STDs). While individuals aged 15 to 24 make up 27 percent of the U.S. population that is sexually active, the CDC estimates that they account for half of the 20 million new infections occurring annually."

Kentucky led the nation in hepatitis C cases in 2013; state's rate rose 357 percent from 2007 to 2011

By Tim Mandell
Kentucky Health News

Kentucky had the nation's highest rate of hepatitis C in 2013, with 5.1 cases per every 100,000 people, says a report by the federal Centers for Disease Control and Prevention. As many as 3.5 million people in the U.S. have hepatitis C and more than 56,000 Kentucky resident may have chronic hepatitis C infection, according to the state Cabinet for Health and Family Services. The main cause of hepatitis C is shared needles among intravenous drug users.

Hepatitis C cases rose 364 percent in Kentucky, Tennessee, Virginia and West Virginia from 2006 to 2012. The big increase was in 2007-11, when the rate rose 357 percent, a CDC state health profile says.

"Of the cases that have been reported and researchers gathered data about potential risk factors, 73.1 percent reported injecting drugs," Brian Wu reports for Science Times. Among new cases, 44.8 percent were people under 30.

While officials said HIV rates are low in the four Appalachian states, they said they fear that the increase in hepatitis C cases could lead to a rise in HIV cases, Wu writes. Officials said needle-exchange programs are key to reduce the number of potential HIV cases. Kentucky recently authorized such programs if local officials agree to them.

"About 4.5 million Americans older than 12 abused prescription painkillers in 2013 and 289,000 used heroin, according to the Substance Abuse and Mental Health Services Administration," Liz Szabo reports for USA Today. "About 75 percent of new heroin users previously abused opioid painkillers. The number of first-time heroin users grew from 90,000 people in 2006 to 156,000 in 2012, according to the CDC."

Kentucky has the third highest drug overdose mortality rate in the U.S., with 23.6 deaths per 100,000 people, says the 2013 report "Prescription Drug Abuse: Strategies to Stop the Epidemic," reports Trust for America's Health. "The number of drug overdose deaths—a majority of which are from prescription drugs—in Kentucky quadrupled since 1999 when the rate was 4.9 per 100,000."

Americans do need to worry about Ebola: not about daily risk, but about the future if it is not contained, expert says

The Ebola virus isn't a risk to Americans now, but will be "down the road" if the epidemic is not contained, says a crisis communication consultant who's been working for decades on how people and government officials respond to disease outbreaks.

Peter Sandman assured Nancy Shute of NPR that the risk to Americans does not approach any of the current hype, saying that "even if we have 10 Ebola cases a month," the U.S. can handle it.

The real risk is in the future, Sandman said. If the epidemic in West Africa is not placed under control, "a lot of sparks fly and ignite epidemics in other parts of the world" that lack health systems to handle it.

Sandman said it's normal to personalize and localize a new worry, but he would rather see Americans worry about the larger risk and work to do something about it. He also suggested that the people who are telling Americans to stop worrying should instead use this as a "teachable moment."

"If they succeed in getting people to stop worrying, they will regret it, because there's a lot to worry about it," he said. "Calming us down shouldn't be a goal."

Sandman offers four suggestions to stop the "sparks" from flying:
1. Put pressure on the government to push harder on vaccine research.
2. Make a personal contribution or urge the government to contribute toward "spark suppression."
3. Volunteer, either with your time or money.
4. Tell the CDC that you don't want 20 CDC experts in New York, you want 20 CDC experts in Nigeria to help get ready to put out the next spark and the one after that and the one after that.

"You have reason to worry that your daily life a year or two from now could be significantly worse if Ebola is all over the world," he told Shute. "And you have reason to work to prevent that, and reason to prepare for it. But what should you do in your daily life now to protect yourself against catching Ebola, assuming you're not a health care worker with an Ebola patient? Absolutely nothing. The risk to the U.S. isn't now, it's down the road."

As for the recent decisions by governors who are trying to impose quarantines on returning health-care workers, which drew open disagreement from the CDC and the White House, Sandman said, "There's certainly a case to be made that quarantine is excessive, that active monitoring would be good enough. But it seems to me to be a pretty open debate on whether quarantine is excessive or appropriate, and it depends on how cautious you want to be. Saying that the science proves incontrovertibly that quarantine is wrong — it's bad communication and it's bad science."

As of October 31, New York,  New Jersey Maine, Georgia, Illinois, California, Connecticut, Michigan, Florida, Delaware, Minnesota and Texas have varying policies on Ebola quarantines, with other states like Alaska and Kentucky still working on their policies, reports Julie Watson of the Lexington Herald-Leader.

"Kentucky officials are still hammering out an Ebola protocol but said it would likely be unnecessary given the small number of people who arrive to the state from affected countries," Watson reports.

How contagious is ebola? Not very, experts say

This story was updated Monday, Oct. 13
Several days ago, Thomas Eric Duncan died from ebola after arriving in Dallas from Liberia. He didn't appear to be ill during his journey or soon after he arrived. "Various news outlets are reporting that travelers arriving in the United States from West Africa would have their temperatures taken and be asked to answer questionnaires ascertaining any possible exposure," Kris Hickman writes for the Association of Health Care Journalists.

This story, among other ideas circling the news, has caused worry, but do people really have a reason to panic? Contagion potential is indicated by the reproduction number, which refers to the number of individuals to whom an infected person is likely to pass a disease. Epidemiologists have estimated that ebola's reproduction number is between 1.5 and 2. Measles, one of the most contagious diseases in the world, has a reproduction number of 18, and HIV has a reproduction number of 4.

The calculations are based on how long infected individuals are contagious and how much of the virus is needed to pass the diseases, among other factors, "but these data indicate that ebola is, in fact, controllable with appropriate and timely responses from the public health sector," Hickman writes.

Ebola is transmitted through contact with bodily fluids, but only when the patient is showing symptoms. The fatality rate is approximately 50 percent, particularly without proper treatment. "Reporters tapping into public health experts who can explain the concept of reproduction number should be able to show how containable the disease is and put it into proper perspective," Hickman writes.

While it is well-documented and understood how e-bola is spread, Peter Jahrling, chief scientist at the National Institute of Allergy and Infectious Diseases, is concerned that the disease has mutated to become more contagious, Julia Belluz reports for Vox.

Jahrling is worried that the "mutations of the virus that are circulating now look to be more contagious than the ones that have turned up in the past, " Belluz writes.  His Liberian team has found that the patients in Liberia have a much higher "viral load," which means that they have more virus in their blood - and that could make them more contagious. He told Bulluz that they were continuing to run test on their patients in Liberia, and they continued to show high "viral loads." When asked what this means, he said, "Right now, we just don't know."

The state Department for Public Health has prepared materials to" help hospitals, public-health agencies, health-care organizations and other coalitions in their preparedness for Ebola, Jack Brammer reports for the Lexington Herald-Leader. The materials are online at www.Kyha.com/kha-ebola-updates.

First Kentuckian gets Caribbean virus, chikungunya or CHIK-V

State officials have confirmed Kentucky's first case of the Caribbean virus chikungunya—or CHIK-V. The first case is an Anderson County man who recently went to Haiti. Though CHIK-V is not native to Kentucky and doesn't usually result in death, officials encourage those who have recently visited the Caribbean and who may be experiencing symptoms to visit the doctor to make sure they don't have the disease, Josh James reports for WUKY-FM.

The mosquito-borne disease occurs most often in Africa, East Asia and the Caribbean islands, but the federal Centers for Disease Control has been observing the spread of the virus hoping that it won't become a significant issue in the United States like the West Nile did more than 10 years ago, Val Willingham reports for CNN. Several weeks ago, the number of cases in the Caribbean exceeded 170,000, and the number of deaths from the disease was 14, Lisa Schnirring reports for Center for Infectious Disease Research and Policy. 

The disease can cause joint pain and arthritis-like symptoms, and those with weak immune systems are especially at risk for worse symptoms. The disease is transmitted from mosquito to human and from human to mosquito. Though about 25 to 28 travelers bring CHIK-V to the U.S. every year, "We haven't had any locally transmitted cases in the U.S. thus far," said Roger Nasci, chief of the CDC's Arboviral Disease Branch in the Division of Vector-Borne Diseases.

"Someone would have to be bitten by an infected insect to become ill. Person to person contact does not spread the disease," Kevin Hall of the Lexington-Fayette County Health Department said, James writes. However, it's worth noting that Kentucky is "home to both species of mosquito known to carry the virus," James reports.

Does gum disease indicate future joint problems? Study links gum-disease bacterium to collagen-caused rheumatoid arthritis

Although researchers and clinicians have long known about an association between two prevalent chronic inflammatory diseases - periodontal disease and rheumatoid arthritis - the microbiological links have been unclear; a new study suggests this link is causative and that the bacteria responsible for gum disease leads to a faster progression of rheumatoid arthritis.

In a recent article published in PLoS Pathogens by University of Louisville School of Dentistry researchers say, "The bacterium responsible for periodontal disease, Porphyromonas gingivalis, worsens rheumatoid athritis by leading to earlier onset, faster progression and greater severity of the disease, including increased bone and cartilage destruction," according to a U of L news release.

The study says the bacterium produces an enzyme that worsens collagen-induced arthritis, a form of arthritis similar to rheumatoid arthritis produced in the laboratory.

The study was led by Oral Health and Systemic Diseases Group researcher Dr. Jan Potempa and a team that also studied another oral bacterium for the same effect, and found it did not affect collagen-induced arthritis or suggest a link to rheumatoid arthritis.

“This ground-breaking conclusion will need to be verified with further research,” said Potempa. Although the specific cause for the disease remains unknown, Potempa said he hopes these findings will shed new light on the treatment and prevention of rheumatoid arthritis.

An estimated 294,000 children under age 18 have some form of arthritis or rheumatic condition, says 2010 data from the Center for Disease Control and Prevention; this represents approximately 1 in every 250 children in the U.S. An estimated 1.5 million adults had rheumatoid arthritis in 2007. Click here for more information from the CDC.

Hard-hitting TV ads against smoking do motivate smokers, like one mother from Elizabethtown, to quit

Hancock with CDC Director Tom Frieden

A 38-year-old Elizabethtown mother's response to a federally funded anti-smoking advertising campaign has been featured in national news this week, showing that these graphic ads can motivate smokers to quit.

Lisha Hancock's decision to stop her two-decade smoking habit was sparked by her viewing of a Centers for Disease Control and Prevention’s “Tips from Former Smokers” campaign commercial, reports Sarah Bennett of The News-Enterprise in Elizabethtown.

Hancock's husband often urged her to quit, and several of her relatives died from smoking, but she still didn't quit. She continuously had a sore throat and clogged sinuses, but she still didn't quit. Then, she saw the commercial.

The advertisement featured raw images of Terrie Hall, a North Carolina woman who was diagnosed with throat and oral cancers at age 40, getting ready in the morning by putting on a wig, artificial teeth an an artificial voice box inside a small hole in her neck, since throat cancer forced her to have her larynx removed.

TV spokeswoman Terrie Hall with grandson's picture

"The only voice my grandson’s ever heard is this one,” Hall says in a robot-like voice, displaying his picture. UPDATE: Hall died Sept. 16.

The ad made a lasting impression on Hancock, who told Bennett she decided to quit smoking after watching the ad with her son: “One time my son asked me, ‘Mom, why does her voice sound like that?’ I said, ‘Because she smoked.’ Then he asked, ‘So you’ll sound like that?’”

Hancock said she had tried to quit before, but "There's nothing that touched me like Terrie's ad. It definitely impacted my life and, in return, impacted my family's life. We all live happier and healthier now."

Hancock started to quit eight months ago. Using nicotine lozenges and a combination of exercise and healthful eating, she's been able to go without even one cigarette, reports Anahad O'Conner of The New York Times.

Others have also been struck by this hard-hitting campaign, which may have prompted more than 100,000 Americans to quit smoking permanently, says a new CDC study published in The Lancet, the leading British medical journal. The CDC says an estimated 1.6 million U.S. smokers attempted to quit this past year after viewing campaign materials funded by the Affordable Care Act.

"Hard-hitting ads work," said CDC Director Dr. Tom Frieden. The agency paid approximately $50 million to produce and place the spots, the first time the federal government funded a nationwide tobacco-education ad campaign, reports Jonathan Serrie of Fox News.

"The impact is huge because a smoker costs about $2,000 more [per year] than a non-smoker, and about $1,000 more than an ex-smoker, to care for," Frieden said. "And if you do the math, this program pays for itself in a year or two in reduced health-care and societal expenditures."

The campaign also saved an estimated 300,000 years of life that smoking-related diseases would have taken, reports Brady Dennis of The Washington Post. Smoking remains the leading cause of preventable death in the United States, killing more than 1,200 Americans each day, says the CDC.

Click here for the CDC ads and other smoking-cessation resources.

Growing up on farm helps immune system, study of pigs shows

For the first time, there is conclusive evidence that growing up on a farm is good for the immune system. Researchers from the University of Bristol's veterinary sciences school have published a study showing that "spending early life in a complex farm environment" increases the number of T-cells one has, reports Sarah Muirhead of Feedstuffs. T-cells have been identified as universal regulators of immune systems, with low numbers increasing risk of developing allergies, autoimmune and inflammatory diseases. Researcher Marie Lewis said it wasn't previously known whether farm life increased immunity to allergies, or if people more prone to allergies weren't living on farms.

Piglets were used in the study since they share many aspects of human physiology, metabolism, genetics and immunity. Some of the piglets were nursed by their mother on the farm, while the others were kept in an isolator unit under hygenic conditions and fed formula milk to reflect the "extremes of environment" in which many humans are raised. Farm-raised piglets had increased levels of T-cells compared to those raised in the isolator. Lewis said it's not clear yet exactly what caused the increase in T-cells in farm-reared piglets, but said previous work shows that intestinal bacteria "plays a pivotal role." (Read more)

State health commissioner retiring after seven years in the job, fighting for public health and expanding its role

By Tara Kaprowy
Kentucky Health News

After dealing with the aftermath of 9/11, an anthrax scare, H1N1 flu, the worst ice storm in Kentucky's history and a series of budget cuts, it's been a busy decade for Dr. William Hacker at the state health department. But after 10 years at the agency, seven as its boss, Hacker will retire at the end of the month.

He is getting great reviews for his work as commissioner, which has included expanding the role of public health beyond its traditional roles, including disaster response and prevention.

"Dr. Hacker has always provided quality leadership," said Scott Lockard, president of the Kentucky Public Health Association. "He has been a great advocate for public health. He has been well respected both in state and on the national level and he will be deeply missed."

"Dr. William Hacker has been an exemplary leader for public health and has led by example with his professional and genteel leadership style," said Linda Sims, director of the Lincoln Trail District Health Department and president of the Kentucky Health Department Association. "Dr. Hacker has been instrumental in helping local health departments during budgetary challenges with guidance and support. The development of new services and screenings for children have increased under his efforts that will make a difference for many years to come."

Hacker, a native of Manchester, joined the department in February 2001 to work in the maternal and child health division. He'd practiced as a pediatrician in Corbin for 18 years and subsequently spent six years with Appalachian Regional Health Care.

Just eight months after he came on board at the health department, his role expanded drastically. "On 9/11, we were asked how many burn beds we had available in Kentucky because they felt they would be flying burn victims to us," he said. "We had never had funding to establish the ability to actually track the beds available. Public health did not have a role to play in critical health care. But they called on public health that day."

Three weeks later, suspicious white powder started appearing in the mail, and public health offices nationwide were called again. Though anthrax spores were not found in Kentucky, envelopes containing white powder were, and they needed to be tested by public-health officials.

Dr. Rice Leach, then the commissioner, asked Hacker to establish the Public Health Preparedness Branch of the Division of Epidemiology and Health Planning, marking a major shift for the department. Traditionally, public health had not been involved in incident management, which occurs when first responders are sent in to handle a crisis. "We were the backup to deal with consequence management," Hacker said. "But when you're dealing with bioterrorism, public health needs to step in. There was a lot of learning that went on between law enforcement, emergency medical services and public health. That was a cultural shift. We were forced through the natural evolution of events to step up to the plate."

In 2004, following Leach's retirement, Republican Gov. Ernie Fletcher named Hacker commissioner. He established the Kentucky Outreach and Information Network, which expanded the department's ability to reach vulnerable populations like senior citizens and people with language, hearing or motor difficulties. Partnerships are still in place with other state agencies, Family Resource Youth Service Centers, literacy programs and faith-based organizations such as the Christian Appalachian Project. "We'd say, 'Here's the message we need to get out, whether we were talking about a hot weather advisory or how long is it safe to eat food out of your refrigerator if your electricity is out," he said.

In 2005, Hurricane Katrina struck New Orleans, prompting several thousand people to come to Kentucky. "We had to figure out how to take care of these people without any resources and many times without any family connections," Hacker said. Hurricanes Gustav and Ike followed, presenting similar challenges.

The next major disaster was the 2009 ice storm. The role of public health was to provide shelter, which Hacker called "a major challenge." But emergency stockpiles obtained by the Public Health Preparedness Branch proved useful. "We use cots, satellite radios and generators that were supposed to be used for an inflatable hospital," he said. "That provided power in Elizabethtown."

Emergency stockpiles were also tapped for items like face masks in 2009-10, when people started getting sick with H1N1. "We responded efficiently because of the training we had been planning for," Hacker said. In 2006, department officials prepared extensively for a bird flu "that is still smoldering," Hacker said, but has never reached the ability to spread quickly from person to person.

In the middle of all this, the state changed governors, but not health commissioners. Democratic Gov. Steve Beshear, who took office in December 2007, appointed a new secretary of the Cabinet for Health and Family Services, but showed confidence in Hacker by keeping him as commissioner of the cabinet's Department of Public Health. "I was prepared for Gov. Beshear to select someone else, but I was very pleased when he gave me the opportunity to continue to serve," Hacker said. Apart from Leach and Dr. Carlos Hernandez, Hacker has served one of the longest terms of any commissioner in the past 40 years.

Beshear told Kentucky Health News in July 2011, "Dr. Hacker’s commitment to public health and education is unassailable, and he provided great leadership and vision for our Department of Public Health. Dr. Hacker built teams, mentored, encouraged and connected organizations and people to achieve better outcomes for Kentuckians’ health. His success is largely driven by his belief in inclusion -- that bringing together many organizations can improve health in Kentucky. Kentucky will miss him."

Beshear's retention of Hacker greatly pleased Al Smith, who had just concluded 33 years as producer and founding host of "Comment on Kentucky" on KET. A former newspaper publisher in London and Western Kentucky, Smith helped Hacker campaign for a comprehensive hospital to serve Corbin and London. "He was ahead of his time, as usual, and we lost the political game," Smith recalled. "Fortunately, his great gifts have been appreciated by the state and other health providers who have kept him in leadership for many years. I hope there will be other opportunities for his influence and service at another time. . . . In or out of public service, Dr. Bill Hacker is a leader who always seeks the best for Kentucky."

Asked his biggest accomplishment, Hacker named two: leaving behind a capable team and establishing the Preparedness Branch, which he said is now deeply embedded. "I have a personal relationship with senior FBI agents that did not exist before," he said. "We have a very close partnership with emergency management officials. And we're close with the Department of Agriculture because of the correlation between animal diseases and human diseases. All those partnerships have positioned Kentucky's government entities to be more responsive."

That responsiveness, however, has a lot to do with funding, which Hacker said is his biggest worry, because public health tends to be invisible. "If you ask, most people think public health just takes care of poor people. We, in fact, take care of all forms of people. It's just we do our jobs well and so it's invisible to those folks unless they need a public health service."

Already, Hacker has dealt with several rounds of budget cuts and is worried that "political leaders and the public don't really understand the impact of what the future may look like" with a less well funded public health system. "It could mean slower response to diseases, slower response to disasters, less cervical cancer screening, less prenatal care. There's a whole host of services being provided but they cost money," he said.

Still, though it's not without concern for the future of the department, Hacker, 64, said it's time to head home. He will continue to live in Lexington. "My wife has some health problems and for 44 years she's made sacrifices to support my career. I think the time has come to reverse the equation," he said. "My decision to leave was a difficult one because I love the mission of public health. But it became clear to me that this was the right time to transition from employment to retirement. I will continue to support the mission of public health in any way I can contribute."

Dr. Steve Davis, longtime deputy commissioner of the department, will take over as interim commissioner Aug. 1. He called Hacker "a good doc and a good man. Simply put, we have been blessed to have him for many years."

Fight is on against mosquitoes, West Nile virus after flooding

The fight is on to rid Western Kentucky of a mosquito infestation  worsened by recent flooding. Treatment to kill adult mosquitoes began Wednesday night, The Gleaner of Henderson reports.

The effort is partly to prevent the spread of the West Nile virus, a potentially serious illness. Mild infection can result in fever, headache, body ache and a skin rash. Severe infection, which affects about 1 in 150 infected people, can lead to high fever, disorientation, sleepiness and even coma, paralysis and death. Mosquitoes can transmit the infection to humans with a bite. (Centers for Disease Control and Prevention diagram)

The state's plan is a two-part process, killing adult mosquitoes and their larvae. It uses aerial spraying over 700,000 acres in Western Kentucky, concentrating on areas along or near waterways where flooding was most problematic. Planes will spray from dusk until after midnight until treatment is complete. Afterward, ground crews with the Transportation Cabinet will treat against mosquito larvae in standing water. The state Department of Agriculture will also spray ditch lines along roads. Chemicals used in the treatments are only harmful to mosquitoes, gnats and black flies, a state press release reads. It is safe for humans, pets and livestock.

Residents are asked to eliminate standing water in containers on their property and wear insect repellent and long-sleeved clothing. (Read more)

Flu is now widespread in Kentucky

Flu activity is now widespread in Kentucky, WKYT-TV reports.

"It has just reached the category of widespread," Kentucky Health Commissioner Dr. William Hacker told the Lexington station. "It can be a problem until April or May. So I still recommend a flu vaccine for those who have not had one." (Read more)