MEETING PACKET JULY 2013 CFIX OF SALE
120WASHING-I'M STR1`E:T1 4111 l"LOOR Public Health
Tf.;]_ (978) 741-1800 (978) 745-0343)
DRISCOLL Irani din(a]salem.c(2-11,11 1113 JUL
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CITY CLE.R , SALEM,MASS.
NOTICE OF MEETING
You are hereby notified that the Salem Board of Health will hold its regularly scheduled meeting
Tuesday July 23, 2013 at 7.00 PM
City Hall Annex, 120 Washington St. Room 314
MEETING AGENDA
1. Call to order
2. Approval of Minutes from June 6, 2013
3. Introduction of new Board member Dr. Shama Alarn
4. Chairperson Announcements
• 5. .Public Health Announcements/Reports/Updates
a. Health Agent
b. Public Health Nurse Report
c. Administrative
d. Council Liaison
6. Discuss sales of tobacco violation notices
7. Miscellaneous
This notice posted on "Official Bulletin Board"
8. Adjournment City Hall Salem Mass on_-�71CLI,9 j /17, do13
at it; accordance with MGL Chap. 30A,
Sections 18-25.
L j
Larry a din
Health Agent
cc: Mayor Kimberley Driscoll, Board of Health, City Councilors
Next regularly scheduled meeting is September 10, 2013 at 7pm at City Hall Annex,
120 Washington Street Room 312
y&adin"��
•
Know your rights under the open meeting law MGL chapter 3" ss. 18-25 and City
Ordinance section 2-2028 through 2-2033
CITY OF SALEM
BOARD OF HEALTH
MEETING MINUTES
June 13, 2013
REMBERS PRESENT: Chairperson Dr. Poremba, Gayle Sullivan, Martin Fair, &Dr. Danielle Ledoux
OTHERS PRESENT: David Greenbaum, Sr. Sanitarian, &Justina Polvere, Public Health Nurse
EXCUSED: Larry Ramdin, health Agent & Councilor Furey
TOPIC DISCUSSION/ACTION
1. Call to Order 7:00pm
2. Minutes of Last Meeting Gayle Sullivan motioned to accept the draft minutes from May 14,
(May 14, 2013) 2013. 2nd Dr. Ledoux. Approved unanimously
3. Chairperson Announcements The Board of Health meeting will be held on July 23, 2013 at
7:00pm due to scheduling/vacation conflicts. All members are in
agreement with this date.
4. Monthly Reports-Updates
A. B. Health Agent Presented and approved. Copy available in BOH office.
• Report Due to the increase in rodent complaints money has been moved
into the Rodent Control account for the remaining fiscal year
budget, to keep up with baiting of the storm drains on city
property.
B. Public Health Nurse's Presented and approved. Copy available in BOH office.
Report Discussion on the Mass Immunization Information System(MIIS)
The goal of the MIIS is to give health care providers and families
a tool to help ensure that all individuals are immunized based on
the latest recommendations. This will establish a complete,
accurate, secure, real-time immunization record for residents of
MA of all ages.
C. Administrative A report will be provided at the next meeting.
Report
D. City Council Liaison Not Present
Updates
•
5. New Business
A. Hearing requested by Maria Harris of Discussion on open door policy and requirement of screen door or
Maria's Sweet Something installation of air curtain on high. Sr. Sanitarian David Greenbaum
• presented 6 citations for violation of the open door policy. Ms.
Harris has stated that a screen door is not allowed by the historical
committee. However, Larry Ramdin has investigated this an there
is no such limitation for having a screen door. However, Mr.
Ramdin has tried to find an alternative solution by using an air
curtain which will deter both rodents and insects.
Board approves Ms. Harris request for use of air curtain per Larry
Ramdin, Heath Agent details. Until otherwise determined by a site
visit, the air curtain is to run on the high setting. Ms. Harris also
agreed to install a screen door at the back entrance. Should Ms.
Harris not abide by these specifications, she was informed that he
license could be revoked.
7. MEETING ADJOURNED: 8:OOpm
Respectfully submitted,
Heather Lyons-Paul
�lerk of the Board
Next regularly scheduled meeting is July 23, 2013 at 7pm
At City Hall Annex, 120 Washington Street,Room 311 Salem.
•
JUSTINA POLVERE RN,BSN
SALEM BOARD OF HEALTH
PUBLIC HEALTH NURSE
PUBLIC HEALTH NURSE ,REPORT
Reporting on June 4, 2013-July 16, 2013
Disease Prevention
■ Investigated 9 reportable diseases and reported case information to MDPH
■ In contact with North Shore Pulmonary Clinic on current active cases
• Health Promotion
o Blood pressure screenings/medication Q&A every Monday at the Salem Council on
Aging
o Farmer's Market health information table Thursdays 3-7pm
Topics covered thus far:
-Tick &mosquito safety
-Sun safety
-Heat stress &heat stroke awareness/tips
-Nutrition
-Hurricane Safety
-Emergency preparedness
*Information regarding "Emergency Preparedness Grab &Go"project held at Farmer's
Market—distributed bags to 7 Salem, Ma seniors as a result of this effort
Meetings/Clinics
• o June 6, 2013-North Shore React Meeting in Peabody, Ma
• o June 11, 2013- MIIS training
o June 17, 2013-Vaccine reimbursement training (not including influenza)
o June 18, 2013- Lynch Van Otterloo YMCA Summer Camp inspected and permitted for
the 2013 season— Christian's Law applies to this camp and they are currently submitting
weekly swim test results to the BOH
o June 19, 2013- Salem YMCA Summer Camp inspected and permitted for the 2013
season—Christian's Law applies to this camp and they are currently submitting weekly
swim test results to the BOH. *A re-inspection was conducted on June 26th, 2013
o June 20, 2013- Salem YMCA-Naumkeag Summer Camp inspected and permitted for
the 2013 season
o June 21, 2013-Home visit/well-being check of an at-risk senior and hoarder with David
Greenbaum, per request of Salem Police. Case was found to be inpatient at hospital.
o June 25, 2013- Camp Fire Summer Camp inspected and permitted for the 2013 season.
*A re-inspection was held on June 28th, 2013
o June 25, 2013- Children's Island Summer Camp inspected and permitted for the 2013
season—Christian's Law applies to this camp and they are currently submitting weekly
swim test results to the BOH. *A re-inspection was conducted on June 28th, 2013
o June 26, 2013- Rebel Shakespeare Summer Camp inspected and permitted for the 2013
season.
• o June 26, 2013-NSCAEP Coalition meeting
o June 27, 2013- Salem React Meeting
o June 27, 2013- Home visit/well-being check of an at-risk senior and hoarder with David
Greenbaum and Salem Police. Salem Fire was contacted and gained entrance to home.
Case's home condemned by the Salem BOH Senior Sanitarian David Greenbaum. Case
was removed from home by EMS and Salem Police. Referrals to NSES have been made.
o June 27, 2013- Boys and Girls Club Summer Camp inspected and permitted for the 2013
season— Christian's Law applies to this camp and they are currently submitting weekly
swim test results to the BOH.
o July 1, 2013- Salem State University Summer Camp inspected and permitted for the 2013
season
o July 101h , 2013- Home visit/well-being check with David Greenbaum per request of
Salem Police—returned on July 15, 2013 —referrals have been made as needed
o July 10, 2013- Home visit/well-being check of an at-risk senior and hoarder with David
Greenbaum per request of Salem Police. Case has not been home; follow-up with case's
family has been made.
o July 15, 2013- Home visit/well-being check of an at-risk senior and hoarder with David
Greenbaum and Salem Police. Referrals to NSES have been made.
o MAPHN monthly meeting (June 14, 2013 and July 12, 2013)
o June 19, 2013-TB skin testing of a New Arrival/Refugee—referral made to NSPPHC
i
i • TB
New active case as of June 27, 2013
DOT started June 28, 2013; DOT will be resumed by Boston Public Health Commission (case
works full time in Boston)
Contact investigation on-going in the Boston area; one Salem, Ma resident identified—clear
CXR and negative blood test for TB
Monthly Report of Communicable Disease
Disease Reported # Of Cases New Carry Over Discharged
Tuberculosis 2 2 0 1
Group B Strep 1 1 0 1
Campylobacter 3 3 0 3
Salmonella 12 2 0 2
He C- acute 11 1 0 0
•
Summary of Communicable Diseases
TB:
Case#1: Case had active TB; DOT by PHN starting June 28, 2013. Case is being followed by the
NSPPHC. Contact investigation in-progress and testing being conducted by DPH and BPHC.
Case#2: Case is a new arrival, with a positive TST. Case referred to the NSPPHC;no evidence of active
TB disease—LTBI
Group B Strep:
Case#1: Case treated in-patient and sent home with VNA. Case did no out-of-state or out-of-country
travel during incubation period. Case does not work at a supervised care setting, or a school setting. Case
is not a food handler or health care worker. Case recovered.
Campylobacter:
Case#1: Case did no out-of-state or out-of-country travel during incubation period. Case has no close
contacts that are ill. Case does not work at a supervised care setting, or a school setting. Case is not a food
• handler or health care worker. Case recovered. Full investigation conducted; no identifiable cause noted.
Case#2: Case traveled to Cuba during her incubation period, and believed that the water or something
• eaten there may have caused this. Case traveled with 28 other people and no other persons have reported
being ill. Case does not work at a supervised care setting, or a school setting. Case is not a food handler or
health care worker. Case recovered.
Case#3: Case did no out-of-state or out-of-country travel during incubation period. Case has no close
contacts that are ill. Case does not work at a supervised care setting, or a school setting. Case is not a food
handler or health care worker. Case recovered. Full investigation conducted; no identifiable cause noted.
Salmonella:
Case#1: Revoked. This is a Peabody, Ma case.
Case#2: Case#3: Case did no out-of-state or out-of-country travel during incubation period. Case has no
close contacts that are ill. Case does not work at a supervised care setting, or a school setting. Case is not
a food handler or health care worker. Case recovered. Full investigation conducted; no identifiable cause
noted.
Hep C acute:
Case#1: In-progress
Miscellaneous
Investigated a squirrel bite report; no rabies vaccination recommended by case's PCP or Salem
BOH.
Massachusetts Department of Public Health
Division of Epidemiology and Immunization
• a and
The Boston Public Health Commission
CLINICAL ADVISORY
Middle East Respiratory Syndrome Coronavirus(MERS-CoV)
June 14,2013
SUMMARY
1. As of June 12, 2013, over 50 cases of MERS-CoV have been reported and 32 of these
people have died. So far,there are no reports of anyone in the United States getting
infected with MERS-CoV.
2. Most people with recognized MERS-CoV infection had severe acute respiratory
illness with symptoms of fever, cough, and shortness of breath, but some people were
reported with mild respiratory illness.
3. There is evidence of human-to-human transmission with close contact. Standard,
contact and airborne precautions are recommended for management of hospitalized
patients with known or suspected MERS-CoV infection.
4. Diagnostic testing to detect MERS-CoV is available at the MDPH Hinton State
Laboratory Institute.
5. Clinicians should consider MERS-CoV in patients with an acute respiratory infection
and history of travel to the Arabian Peninsula or neighboring countries* in the 14
• days prior to onset of symptoms.
6. Providers can call their local health department and/or the Massachusetts Department
of Public Health (MDPH) for further guidance.
7. There is no vaccine for prevention of MERS-CoV infection and no specific therapy
has been studied or identified.
Background
Over the past year, cases of serious respiratory infection have occurred due to a newly emergent
coronavirus similar to, but distinct from,the severe acute respiratory syndrome coronavirus
(SARS-CoV)that emerged in 2003. This novel coronavirus,now designated the Middle East
respiratory syndrome coronavirus (MERS-CoV), seems to have had its origins in the Arabian
Peninsula. Thus far, over 50 cases have been documented in the Middle East and Europe, with
all European introductions related to exposure in the Middle East.
For more detailed and up-to-date information go to the Centers for Disease Control and
Prevention(CDC)MERS-CoV web page at: http://www.cdc.gov/coronavirus/mers/
Similar to the SARS-CoV,the MERS-CoV is capable of causing severe lower respiratory tract
infection. Milder illness has also been described. The MERS-CoV is most similar to a
coronavirus found in bats, but as in the case of the SARS-CoV, exposure to other intermediate
animals may be a source of MERS-CoV infection. The exact nature of exposure causing
infection is not known, but human-to-human transmission has been observed, including in
healthcare facilities. There have been three healthcare associated clusters of infection described.
Reporting
We ask that clinicians report the following to their local health departments and MDPH.
Providers in Boston are required to notify the Boston Public Health Commission (BPHC): •
• A person with an acute respiratory infection which may include fever(>_38°C, 100.4°F)and
cough; AND
• suspicion of pulmonary parenchymal disease (e.g.,pneumonia or acute respiratory distress
syndrome based on clinical or radiological evidence of consolidation);AND
• history of travel from countries in the Arabian Peninsula or neighboring countries* within 14
days; AND
• not already explained by any other infection or etiology, including all clinically indicated
tests for community-acquired pneumonia.
The following may also be considered for evaluation for MERS-CoV infection:
• Persons who develop severe acute lower respiratory illness of known etiology within 14
days after traveling from the countries in the Arabian Peninsula and neighboring countries*,
but who do not respond to appropriate therapy; OR
• Persons who develop severe acute lower respiratory illness who are close contacts of a
symptomatic traveler who developed fever and acute respiratory illness within 14 days after
travel from the Arabian Peninsular and neighboring countries*.
* Bahrain, Iran, Iraq, Israel, Jordan, Kuwait, Lebanon, Palestinian territories, Oman, Qatar, Saudi
Arabia, Syria,the United Arab Emirates (UAE), and Yemen
Infection control •
Standard,contact and airborne precautions are recommended for management of hospitalized
patients with known or suspected MERS-CoV infection. These recommendations are consistent
with those recommended for the coronavirus that caused SARS in 2003. The recommendations
are based on available information (as of June 10, 2013)and will be re-evaluated and updated as
needed when new information becomes available. (see
http://www.cdc.jzov/coronavirus/mers/downloads/Isolation2OO7.pdfl.
Testing
The MDPH William A. Hinton State Laboratory Institute is certified to perform FDA-approved
emergency use testing with the CDC Novel Coronavirus 2012 Real-time RT-PCR Assay for the
presumptive detection of MERS-CoV. After consultation with your local health department
and/or MDPH,testing will only be performed on patients meeting specific travel and symptom
criteria. Label each specimen with the patient's ID number,specimen type and the date the
sample was collected. Consider lower respiratory tract specimens a priority for collection
and PCR testing. Stool and serum specimens are of lower priority.
Specimen Type and Priority Laboratory Testing
To increase the likelihood of detecting infection, submit specimens from multiple sites including
lower respiratory samples such as sputum, broncheoalveolar lavage (BAL), bronchial wash or
tracheal aspirate, and nasopharyngeal and/or oropharyngeal swabs in viral transport media.
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The Commonwealth of Massachusetts
Executive Office of Health and Human Services
Department of Public Health
• Registry of Vital Records and Statistics
DEVAL L.PATRICK 150 Mount Vernon Street, 1st Floor
GOVERNOR
TIMOTHY P.MURRAY Dorchester, MA 02125-3105
LIEUTENANT GOVERNOR
JUDYANN BIGBY,MD
SECRETARY
JOHN AUERBACH Circular Letter 2012-04
COMMISSIONER
To: Massachusetts Licensed Physicians
From: Stanley E.'Nyberg, Ph.D., M.B.A.
Registrar of Vital Records and Statistics
Re: IMPORTANT INFORMATION ABOUT CHANGES TO THE DEATH CERTIFICATE PROCESS
Date: November 8,2012
Next year, Massachusetts will transition the current paper death certificate process to an electronic death
registration system,commonly known as an "EDRS."As you will be an integral user of this new system, it is
essential that you are aware of the important changes that will be coming soon.
This year,the Massachusetts Department of Public Health, Registry of Vital Records and Statistics(RVRS), has
• successfully implemented phase one,the birth registration component,of the web-based Vitals Information
Partnership(VIP)system. Phase two,the EDRS,will enable authorized physicians,funeral directors, hospitals,
nursing homes, hospice centers, medical personnel, boards of health,and city/town clerks to complete,
register and amend death certificates through a secure online system.
EDRS will benefit all partners in the death certificate process, as well as the families of decedents. EDRS will:
• Save time and effort with online cause-of-death entry and certification
• Enable a paperless workflow,with the option to certify records by fax
• Improve accuracy of death certificates through instant edits and online help
• Significantly improve timeliness of data available for surveillance and research from months to days
• Prevent fraud through secure user authentication, immediate validation of social security numbers,
birth/death matching, and prevention of loss and forgery of paper certificates
The VIP EDRS is being built upon a proven framework, using at its core a death registration system being used
by a number of other states and jurisdictions.While the core system already exists, RVRS is currently working
with the vendor and a working group of our vital records partners,including physician representatives,to
customize the application for Massachusetts. At the same time, implementation, marketing,training and
roll-out plans are being developed.
We encourage you to stay current on developments and welcome those of you who wish to participate in the
development and planning processes. In the coming weeks, RVRS will begin posting status information from
a link on.our home page http://mass.gov/dph/rvrs and reaching out through various other methods to all of
our partners in the death certificate process. If you have any questions,comments or suggestions regarding
the new VIP EDRS, please contact the VIP Project Team at vipprojectteam@massmail.state.ma.us. In the
meantime, please feel free to share the enclosed brochure.
r
Memo JUN24
?013
c�
Date: June 13,2013 B�q D of y CEM
To: Larry Ram ft Health Agent ��TN
cc:Robert St.Pierre,Chairman of the Licensing Board
From: Joyce Redford,Director
RE: Salem Tobacco Compliance Checks
On Thursday June 11t'&13'h,2013,the North Shore/Cape Ann Tobacco Alcohol Policy
Program conducted tobacco compliance checks in the City of Salem. In addition to Joyce
Redford,Director and Peter King,Inspector,three under aged youth participated in these
checks. Twenty-two(22)establishments were checked and nine(9)sales occurred,
statistically an alarming compliance rate of only 59%was achieved.
Violations occurred in the following establishments:
Establishment: Address: Offense: Fine:
Your Neighborhood Mkt 103 School Street ist $100.00
• Salem Liquor 128 North Street 1st $100.00
Quality Liquors 5 Gedney Street 1st $100.00
Kwik Shop of Salem 10 Jefferson Ave ist $100.00
Global 200 Canal Street ist $100.00
Hess 295 Derby Street is $100.00
Tropicana Market 24 Palmer Street ist $100.00
NYFC Food Market 21 Salem Street ist $100.00
7-Eleven 28 Norman Street 1st $100.00
• Please note an alarming trend of violations occurring in Liquor Licensed
establishments,which have been highlighted in red. These violations are especially
concerning because their primary business is selling age restricted products and
therefore all staff should practice a heighten vigilance in checking identification.
• An addition violation of the cigar package and pricing Section F.,1.
7-Eleven 28 Norman Street end $200.00
Enclosed you will find a copy of the violation notices that were issued to each establishment at
• the time of the compliance check
Should you have any questions regarding these checks please do not hesitate to contact me at
781-586-6821
•
Memo
Date: June 25,2013
To: Larry Ram&n,Health Agent
From: Joyce Redford,Director
RE: Salem Tobacco Compliance Checks
On Monday June 24,2013,the North Shore/Cape Ann Tobacco Alcohol Policy Program
conducted tobacco compliance checks in the City of Salem. In addition to Joyce Redford,
Director,one under aged youth participated in these.checks. The final four(4)
establishments were checked and two(2)sales occurred,this adds to the overall rate from the
earlier checks conducted on June 11th&13th for a rate of 58%was achieved.
Violations occurred in the following establishments:
Establishment: Address: Violation: Fine:
White Dove 59 Loring Ave 1st Offense $100.00
Circle K 323 Highland Ave 1st Offense $100.00
Enclosed you will find a copy of the violation notices that were issued to each establishment at
the time of the compliance check
Should you have any questions regarding these checks please do not hesitate to contact me at
781-586-6821
Health Dept Clerical Rep rt FY 2013 •
Burial Permits $25 Permits Certificate of Fitness $50 Copies / Fines Revenue
July-12 $675.00 $2,125.00 $2,850.00 $5,650.00
August $750.00 $2,950.00 $1,250.00 $4,950.00
September $750.00 $2,350.00 $1,950.00 $139.50 $5,189.50
October $1,050.00 $6,922.00 $2,050.00 $300.00 $10,322.00
November $1,125.00 $3,265.00 $2,700.00 $7,090.00
December $300.00 $18,319.00 $1,200.00 $53.00 $19,872.00
January-13 $1,600.00 $55,315.00 $2,000.00 $58,915.00
February $1,625.00 $2,210.00 $4,200.00 $8,035.00
March $1,050.00 $2,050.00 $1,900.00 $1,125.00 $6,125.00
April $1,165.00 $2,065.00 $2,150.00 $5,380.00
May $1,165.00 $2,065.00 $2,050.00 $5,280.00
June $750.00 $1,785.00 $1,200.00 $7.00 $3,742.00
Total $12,005.00 $101,421.00 $25,500.00 $1,624.50 $140,550.50
Fiscal Year 2013 Balances
Starting Ending
Salary $359,198.00 $3,416.78
Expenses $15,600.00 $1,330.86