No way to know how serious flu season will be this year; get your vaccine, which will be available soon, officials say

There is no way of predicting how far-reaching the flu will be this season, but this year's vaccine should be available soon, officials with the Kentucky Department for Public Health said today.

"As soon as you get the immunizations you can start administering them," Sherri Coles, Kentucky Vaccine Program assistant coordinator, told a physician during today's webinar on the subject.

Last flu season was very mild, particularly compared to the one before it, when the H1N1 flu virus was first found here. About 22,400 people nationwide were confirmed to have the flu last season. There were 26 lab-confirmed pediatric deaths caused by flu, but none were in Kentucky. Flu activity was only widespread for five weeks in Kentucky last season, in March and April.

Flu shots are recommended for everyone from 6 months of age and older. Children 6 months to 8 years of age getting the vaccine for the first time should get two doses administered at least one month apart.

The flu can be treated with antiviral drugs, Coles said, which can "lesson the symptoms and shorten the time you are sick by one or two days." The drugs should be taken within two days of getting sick, though starting them later can still be helpful for people who have a pre-existing health condition or are very sick from the flu. Tamiflu and Relenza are the two kinds of antiviral drugs available. Relenza can only be taken by people who do not have breathing problems like asthma or COPD.

As schools resume and prepare to follow new lunch rules, federal fruit and vegetable snack program is up for debate

Bloomberg photo by Ian Waldie

With students and teachers returning, school food-service directors are working to implement the new federal school lunch regulations that take effect this year. This would be a good story for local news media, since it affects almost every student.

As school resumes, another school food program is up for debate. Congress is deciding whether frozen, canned and dried produce should be included in the Fresh Fruit and Vegetable Program. House Republicans say yes, to save money and make a wider range of options available year round. But the Senate is pushing to keep the program limited to fresh fruit and vegetables only. The argument — or food fight, as Dina ElBoghdady of The Washington Post calls it — has trade and other groups weighing in.

"If the goal is to expand and improve upon childhood nutrition, it doesn't make sense to limit the kinds of fruit and vegetables that schools serve," said Corey Henry, a spokesman for the American Frozen Food Institute. "Let the schools decide." But Sandi Kaur, acting director of nutrition services at the California Department of Education, disagrees, saying "it's the fresh that makes this program unique."

More than 50,000 students in 125 Kentucky elementary schools benefit from the program, run by the U.S. Department of Agriculture. To see which schools participate, click here. The program allows schools to distribute fresh fruit and vegetables as snacks to students and has "raised consumption in participating schools by a quarter-cup per day, or 15 percent," ElBoghdady reports. "The increase did not contribute to weight gain, suggesting that the fruit and vegetables replaced other foods." Last year, USDA spent $150 million to pay for the snacks for 3 million children. (Read more)

More hospital-acquired infections are reported in patients cared for nurses who are overworked, study finds

Getty Images stock photo.

Overworked nurses dealing with heavy patient loads are associated with increases in hospital-acquired infections, say researchers with the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing.

"For each 10 percent jump in the proportion of nurses who logged high levels of burnout, there was roughly one additional catheter-associated urinary tract infection per 1,000 patients and almost two extra surgical site infections per 1,000," reports JoNel Aleccia for NBC News.

Researchers conducted a survey with 7,000 registered nurses at 161 Pennsylvania hospitals and matched that data with hospital infection rates and characteristics of hospitals nationwide. The study found more than a third of nurses said they feel high levels of burnout. They cared for an average of 5.7 patients each, and "when even one patient was added to that load, the result was an additional 1,351 infections within the hospital population studied," Aleccia reports.

The study, published in the American Journal of Infection Control, also found cutting down on burnout not only reduces infections but saves money. Cutting it by 30 percent decreased urinary tract infections by 4,000 and surgical site infections by more than 2,200, resulting in a savings of between $28 million and $69 million each year, researchers found.

When it comes to nurse-to-patient ratios, no one seems to be tracking the averages, Aleccia reports. They can range from one nurse for every one or two patients in intensive care units or a one-to-five ratio, as mandated in surgical units in California. (Read more)

CDC: Ten swine flu cases reported last week were linked to Ohio's Butler County Fair; warns nation's fairgoers to be cautious

Centers for Disease Control officials in Atlanta say 29 human cases of the new strain of the H3N2 swine flu have been confirmed in the last year, including 12 last week. Ten of the new cases were linked to the Butler County Fair in southwest Ohio. Butler County is just north of Cincinnati's Hamilton County. The fair ended last weekend. None of the cases have been tied to human-to-human transmission and all 12 of the new patients had close contact with swine prior to getting sick. The two other new cases occurred in Hawaii and Indiana. (CBS News photo)

Health official told CBS News that because county and state fair season in full swing, attendees should avoid taking food and drinks into barns and to wash their hands after they have been near animals. Pregnant women, young children, the elderly and people with weakened immune systems are especially at risk for developing the flu strain. So far, the strain hasn't spread easily, and recent cases have been mild. (Read more)

Many more serious cases of West Nile virus reported this year, but only one in Kentucky

Though only one Kentuckian has been affected, more serious cases of people infected by the West Nile virus have been reported this year than any since 2004. Through July, 241 cases were reported in 22 states. The virus has caused four deaths. Nearly 150 cases have been in Texas, particularly in the Dallas area, reports Mike Stobbe for The Associated Press.

Of the 241 cases, 144 were considered serious, meaning the virus spread to the brain and nervous system, causing, among other ailments, encephalitis. Last year, less than 700 cases were reported.
Health officials blame the combination of a mild winter, early spring and hot summer, prime conditions for mosquitoes to breed. "Unless the weather changes dramatically, we'll see more cases (in 2012) than we have in the last couple of years," said Roger Nasci of the Centers for Disease Control and Prevention.

About 1 in 5 people who are infected with the virus get sick. One in 150 get severe symptoms, including neck stiffness, disorientation, coma and paralysis, Stobbe reports. (Read more)

Free webinars and annual forum to be hosted by Foundation for a Healthy Kentucky

The Foundation for a Healthy Kentucky will host several educational events in an effort to help communities improve their health.

On Wednesday, Aug. 8, the foundation will host a webinar about evidence-based policies and programs that improve health. The talk, called "Stop Reinventing the Wheel: A Useful Guide to Evidence-Based Health Programs," will be presented by Katherine Wilson, dissemination and implementation team leader with the Centers for Disease Control and Prevention. To register, click here. The deadline to register is Tuesday, Aug. 7.

An Aug. 29 webinar will look at ways communities can keep programs going when funding ends. Dr. Stephen Orton, deputy director of the Office of Executive Education with the North Carolina Institute for Public Health, will lead the talk. To register, click here. The deadline is Aug. 28.

On Sept. 17, the foundation will host its annual Howard L. Bost Memorial Health Policy Forum at the Embassy Suites in Lexington, with the theme "No Wrong Door: Integrating Care for Better Health." It will feature several speakers working at state and federal levels. Breakout sessions include:
• Respect: Working Across Disciplines for Patient-Centered Care
• Good Medicine is Good Business
• Health Home Opportunities, Focus on Outcomes
• Advocating for What You Need in the System You Have
The forum is free. Civic leaders, medical health and behavioral health providers, public officials, public-health professionals, business owners, policymakers, faith-based leaders, researchers and academics, coalitions and advocates are encouraged to attend. The forum runs from 9 a.m. to 3 p.m. Sept. 17. To register, click here.

Under scrutiny and criticism, cabinet changes way it handles reviews of children who die or nearly die from abuse or neglect

The Cabinet for Health and Family Services is now using a standard form when conducting internal reviews involving children who died or nearly died from abuse or neglect. Staff are now also being instructed to focus on specific topics in the reports. These are some of the ways the cabinet has changed how it handles the reviews since it came under "intense scrutiny from the state's largest newspapers," reports Beth Musgrave for the Lexington Herald-Leader.

A recent Herald-Leader analysis of 84 reviews from 2009 and 2010 showed there were vast disparities between how they were conducted in different parts of the state, with some of them lengthy and detailed and others just one-page reports that sometimes didn't even include the facts of a child's death.

Teresa James, acting commissioner of the Department for Community Based Services, said the standard form allows for "a greater amount of consistency." Recommendations that stem from the reviews, which are meant to zero in on ways the cabinet could have helped avoid the outcome, will also now require action plans.

Terry Brooks, executive director of Kentucky Youth Advocates, praised the effort. "This is a critical and significant step forward in terms of accountability, transparency and quality assurance," he said. (Read more)

Rural hospital coalition urges Congress to spare Medicare programs that shore up rural health care

A coalition of rural hospitals are lobbying Congress to keep two Medicare programs that the National Rural Health Association says are vital to keep hundreds of smaller hospitals going. The Medicare Dependent Hospital designation and the Low-Volume Hospital Adjuster, which date to the 1980s, help keep low-volume rural hospitals' doors open with the Medicare payment adjustments they provide, according to the NRHA.

Both programs could end Oct. 1 without Congressional action. "Rural facilities do not have the financial background to weather all of these cuts," said Lance Keilers, NRHA president and administrator of Ballinger Memorial Hospital in San Angelo, Tex., told Brendon Nafziger of DOTmed News, an online magazine serving the medical and medical equipment industry.

More than 200 hospitals have the Medicare Dependent designation. To qualify, a hospital must have fewer than 100 beds and Medicare patients must make up 60 percent of its inpatient days or discharges. Low-volume hospitals must be at least 15 miles from another hospital and provide care for fewer than 1,600 Medicare beneficiaries a year. (Read more)

Next phase of health reform: New and renewed insurance policies will have to cover birth control, other preventive care for women

Even though the decision was widely expected, as part of health care reform, the news is still what Julie Rovner of National Public Radio termed "a pretty big deal." Earlier this week, she reports, the Department of Health and Human Services adopted in full the women's health recommendations issued two weeks ago by the independent Institute of Medicine. "Since birth control is the most common drug prescribed to women ages 18-44, insurance plans should cover it," said HHS Secretary Kathleen Sebelius in a press briefing. "Not doing it would be like not covering flu shots, or any of the other basic preventive services that millions of other Americans count on every day."

The upshot: Starting a year from now, most new health insurance policies, and eventually almost every policy, will have to offer a comprehensive list of women's preventive health services with no co-pay or deductible, including all forms of prescription contraception approved by the Food and Drug Administration. These services include: Screening for gestational diabetes; counseling about sexually-transmitted infections; support for breast-feeding, including supplies and counseling; and domestic violence screening and counseling.

Rovner reports that "The new rules do take into account the complaints from some conservative and religious groups, by allowing religious organizations that provide health insurance to refrain from offering contraceptive coverage 'if that is inconsistent with their tenets.' HHS says that part of its proposal is modeled on the most common exemption used by the 28 states that already require contraceptive coverage to be offered in health insurance policies. The department, however, is specifically asking the public to comment on that portion of the rules, 'as we work to strike the balance between providing access to proven prevention and respecting religious beliefs.' Already the reactions are pouring in. Some people object to the religious exemption." (Read more)

Smoke Free Kentucky Coalition's multi-city tour launches push for statewide smoking ban in 2013 legislature

Backers of an effort to ban smoking in all public places in Kentucky took their message on the road this week in hopes of getting legislation passed in the 2013 General Assembly. The Smoke Free Kentucky Coalition swept through the state's largest cities to gather support for a final punch to be delivered at the annual Fancy Farm Picnic in Graves County on Saturday. Beth Musgrave of the Lexington Herald-Leader reports that one of the week's first stops was at the Kentucky Chamber of Commerce, a longtime supporter of the statewide smoking ban. "We know that a majority of Kentuckians support a smoke-free Kentucky," said Amy Barkley, chairwoman of the coalition. (KRT graphic)

Rep. Susan Westrom, D-Lexington, has sponsored a statewide smoking ban for several years. During the 2012 legislative session, the House Health and Welfare Committee passed the measure, but the full House did not vote on it. Westrom told the Herald-Leader that said she did not aggressively pursue the matter during the 2012 session because all 100 members of the House are up for re-election in November. "But we've had several members who have said that they will be co-sponsors" next year, she said.

Musgrave notes that even Westrom is unsure how the the Republican-led Senate will vote. Senate President David Williams has said he supports the idea of a statewide smoking ban, while opponents of the proposal have said it represents an overreach of government power. "There are personal property rights that are being trampled," Rep. Ben Waide, R-Madisonville, said when he voted against a statewide smoking ban in March.

You can do this, too: Lexington church's fresh food program reaches out to lower income neighbors with deep discount

Rick Courtney loads tomatoes into a crate bound
for Fresh Stop (Herald-Leader photo by Charles Bertram)

Fresh produce comes to the church-goers of Fresh Presbyterian Church of Lexington every Sunday through Fresh Stop, a community-supported agriculture program. But it's not your typical CSA program; this one comes with a charitable twist. Sure, members sign up to receive fresh produce weekly during the summer growing season but, writes Mary Meehan of the Lexington Herald-Leader, here 25 percent of the members pay a nominal amount because they live in a "food desert," where fresh food is hard to come by, and have lower incomes. To cover the difference, explains Meehan, the other 75 percent of members pay slightly more than a CSA normally would cost. "That's the key," said Libby Iverson, a church member and Fresh Stop member. "We need to share. That's very important."

The farm-to-table non-profit supplies tomatoes and cabbage, sweet peppers and onions that fill a table last Sunday were literally gleaming with freshness. All were picked from farmer Rick Courtney's Harrison County field just the day before, Meehan notes. It was all the brainchild of student Julia Hofmeister, who, armed with a major in sustainable agriculture at the University of Kentucky and having been part of the local Community Farm Alliance, set out in 2009 to find a farmer. Courtney was a tobacco farmer in Cynthiana, now a section of his farm on the South Fork of the Licking River is filled with vegetables.

Many of the low-income families served by the program are referred by Habitat for Humanity and Kentucky Refugee Ministries. Wheeler said one of the biggest concerns in expanding the program is that families often don't know what to do with all the produce they receive. Hofmeister thinks the program can be made to work elsewhere. "It is so transferrable," she said. (Read more)

Research suggests dental therapists could provide care to Medicaid-eligible kids at terrific savings

The recent revitalization of the Kentucky Oral Health Coalition was a reminder that our state ranks 49th in dental health, behind only West Virginia. So was the news then Tuesday from the University of Connecticut, where research suggests that adding a new kind of health provider -- dental therapists -- to clinics known as federally qualified health centers could significantly expand the availability of care for millions of American children. (Pew Center photo)

The white paper from the Pew Children's Dental Campaign of the Pew Center on the States notes that, "In particular, by including dental therapists as providers in school-based programs operated by FQHCs, the researchers estimated states could provide access to care for 6.7 million Medicaid-eligible children, nationwide." The analysis also suggests that this significant increase in access could be realized for a cost of approximately $1.8 billion or just one half of 1 percent of combined state and federal 2009 Medicaid spending. To read the full Pew report, go here.

Nationwide, 830,000 emergency room visits in 2009 were due to preventable dental problems, according to the center, many of those in rural areas. Most of the children lacking care don't have insurance, live in areas without enough dentists or can't find doctors who accept Medicaid. Problems accessing dentists could grow in 2014, when 5 million more children are expected to get dental insurance under the federal healthcare reform law.

Despite the undisputed need, not everyone is behind the concept. The American Dental Association argues that dental therapists lack the training and education needed to perform irreversible surgical procedures and to identify patients' other medical problems, writes Anna Gorman in the Los Angeles Times. Therapists would be properly educated and would help close vast gaps in care that can lead to costly emergency room visits for dental problems, said Shelly Gehshan, director of the Children's Dental Campaign. In 2005, Alaska became the first state to try out the new dental care model, when therapists began treating native populations. Minnesota authorized the new tier of practitioner in 2009, and the first graduates of dental therapy programs began practicing last year.