MEETING PACKET OCTOBER 2016 Health Agent report October 2016
Announcements/Updates
• Janice Orta, started her duties as a Sanitarian on September 17.
• Nikeeta Patel Intern completed her internship with the Department and she has indicated
that it was invaluable to her in developing skills as a public health practitioner. Also, she
wishes to continue to participate as an intern although she has met her program
requirements,because she is learning a lot from the experience. We have accepted her
offer to continue.
• The amendments to the Food Establishment regulations were received and accepted by
the Public Health Council on October 20, as well as proposed changes to the Recreational
Camp regulations. The regulation changes are out for public comment and there will be
public meetings scheduled to hear comment as well as written comment will be accepted
as well.
Community Outreach
• The Hungry Heart Movie was screened at the visitor center on October 12, 2016, the film
dealt with a Pediatrician in Vermont and his Suboxone practice. A panel discussion
followed with Dr. Damian Archer, Salem Family Health Center, Wendy Kent, MAOPC
. Program Manager, and an individual in recovery. The program was well received by
those in attendance.
Meetings and Trainings
• Met with organizers of Christmas in Salem to discuss vending options and procedures to
support a mini holiday market on the common, during the Christmas in Salem event
• Larry Ramdin attended a Zika And Tickborne disease presentation threat was put on by
the Department of Public Health and hosted by the Rotary club
• Attended a webinar hosted by the Bureau of Substance Abuse Services titled`Be
Involved: Creative Strategies for Community Engagement in the Opioid Epidemic".
Based on the information provided I am happy to report that we in Salem are ahead of the
curve in all we are doing to address the substance use issue.
Environmental Health Activities
• The EH unit was engaged in in conducting food inspections for haunted Happenings
• Trash complaints continue unabated and we continue to deal with improper placement
and disposal of large items
• Conducted a site visit at Deacon Giles Distillery to advise on setting up establishment to
serve food.
•
I
Inspections
Item Monthly Total YTD 2015 Total
Certificate of Fitness 43 424 534
Inspection
Certificate of Fitness 2 35 4
re-inspection
Food Inspection 115 223 263
Food Re-inspections 3 30 55
Retail Food 0 14 18
Inspections
Retail Food 0 11 1
re-inspection
General Nuisance 5 17 25
Inspections
Food— 0 2 0
Administrative
Hearings
Housing Inspections 5 79 181
Housing re- 0 23 37
inspections
Rodent Complaints 0 24 19
Court 0 3 7
Hearings/filings
Trash Inspections 55 434 138
f
Orders served by 0 3 7
wConstable
Tanning Inspections 0 0 7
Body Art 0 0 1
Swimming pools 0 9 17
Bathing Beach 0 108 106
Inspection/testing
Recreational Camps 0 6 12
Lead Determination 0 2 1
Septic Abandonment 0 0 0
•
Septic System Plan 0 0 0
Review
Soil Evaluation 0 0 0
Percolation tests 0 0 0
Total 156 1419 1433
t
CITY OF SALEM
BOARD OF HEALTH
MEETING MINUTES
September 13, 2016
DRAFT
MEMBERS PRESENT: Paul Kirby, Chairman, Nancy Crowder&Janet Greene
OTHERS PRESENT: Larry Ramdin, Health Agent, Suzanne Doty, Public Health Nurse &Heather Lyons-Paul
Clerk of the Board, Joyce Redford Dir. NSTACP
EXCUSED: Dr. Shama Alam &Jeremy Schiller
TOPIC DISCUSSION/ACTION
1. Call to Order Paul Kirby, Chair called meeting to order at 7:06pm
J. Greene motioned to take the agenda out of order to hear
item 5'first 2nd N. Crowder All in Favor. Motion passed
2. Minutes of Last Meeting J. Greene motioned to approve minutes. N. Crowder 2nd All
(July 19, 2016) in favor. Motion passed.
3. Chairperson Announcements Thank you from the Board to Dr. Shama Alam for her work as a
member and a chair.
4. Monthly Reports-Updates
• A. Public Health Nurse's Copy available at the BOH office
Report
B. Health Agent's Report * Interviewing soon for the fulltime sanitarian position.
* Salem will not be spraying for mosquitoes at this time
* Dumpster at PEM garage is being monitored
* Discussion about adopting the 2013 food code
* Overdose discussion-November 6th vigil walk in Salem
Copy available at the BOH office
C. Administrative Report Copy available at the BOH office
J. Greene motioned to accept the reports. N. Crowder 2nd
Motion passed.
D. City Council Liaison Wed committee meeting— the plastic bag ban discussion is on
Updates the agenda.
Smoking ban in Public Parks and Beaches discussion. Dr.
Schiller emailed Larry about receiving communications from
Salem residents on prohibiting smoking in parks and beaches
0.Tobacco regulation update—Public Letters of supporting for flavor restrictions were read into record
comment - DJ Wilson, MA Tobacco Control by Larry Ramdin Health Agent.
Director and Public Health Liaison&Joyce DJ Wilson gave the Board members handouts of Massachusetts
Redford, Director of NSCAATCP communities that have implemented flavor restrictions.
MAHB has a list of tobacco products that are considered
flavored tobacco.
' Amjad Chaudhry owner, Salem 7 Food Store. 126 North St.
Mr. Chaudhry had concerns about what the goal was of the
Board to remove flavored tobacco. He added that we are allowed
to vote at 18 and we can fight for this country at 18. We are
already restricting the age limit to 21 years of age to purchase.
This restriction on flavor will have a great impact on shops that
are not restricting people under 21 to enter.
J. Green responded that the Board's goals are to reduce the
number of young people attracted to tobacco products and that
these flavored products are directly link to attracting youth to
tobacco.
Chairman P. Kirby asked if there are no more comments from
the audience that there be a motion to close the public comment
section of this meeting
J. Green motioned to close the public comment section of the
meeting. 2"d N Crowder All in favor. Motion passed
6. New Business/Scheduling of future Continue discussion and vote on tobacco regulation.
agenda items Food Code 2013 Adoption
North Shore Medical Hospital Working group update.
7. MEETING ADJOURNED: J. Greene motioned to adjourn the meeting. 2"d N. Crowder
All in favor. Motion passed
8:40pm
spectfully submitted,
Heather Lyons-Paul
Clerk of the Board
Next regularly scheduled meeting is October 12, 2016 at 7pm
At City Hall Annex, 120 Washington Street,Room 313 Salem.
Suzanne Doty RN BSN
Salem Board of Health
Public Health Nurse
Public Health Nurse Report
Reporting on September 7, 2016 through October 4`h, 2016
Disease Prevention and Health Promotion
• Investigated reportable diseases and reported case information to MDPH.
• Coordinating follow up with North Shore Pulmonary Clinic on 1 current active
tuberculosis cases.
Meetings/Trainings
• Continued modules and Working On Wellness webinars,the beginning steps of creating
a program on wellness for city employees. Sent out employee survey and coordinated
wellness committee meeting to meet on October 5, 2016.
• Continued community outreach at the Farmer's Market on Thursday afternoons,
providing materials for overdose awareness and blood pressure screenings as well as
additional material for the themes of the month such as personal preparedness in
September as well as Flu and Women's Health.
• September 1 P attended the Tuberculosis Response and Refugee Health Update provided
by the Department of Public Health.
• September 20'attended the North Shore Public Health Nurses meeting, topics included
Massachusetts Immunization Information System updates and Flu clinic planning and
staffmg.
• September 281h provided Flu Vaccine at the Council on Aging Wellness Fair from 9am to
noon, 45 doses of vaccine were given to seniors.
Monthly Report of Communicable Diseases: August 2016
Disease New Carry Over Discharged/ Total# Of Running Total for Total for
Reported Cases this Total for2015t ';
Closed Month 2016tti
Tuberculosis 0 1 0 1 5 =`
(Active)
Latent 0 1 0 1 25
' r5 � +31
Tuberculosis* ,";
Arbovirus* 0 0 0 0 0
i
abesiosis 0 0 0 0 1 1 0
alicivirus/No 0 0 0 0 0 1 1
rovirus
Campylobacte 3 0 3 3 13 11 10
riosis
Chikungunya 0 0 0 0 0 0 1
Dengue* 0 0 0 0 1 0 0
Ehrlichiosis 0 0 0 0 0 0 1
Enterovirus 0 0 0 0 0 1 0
Giardiasis 2 0 2 2 5 2 0
Group A 0 0 0 0 0 4 2
Streptococcus
Group B* 0 0 0 0 1 7 6
Streptococcus
Human 0 0 0 0 2 1 0
anulocytic
Anaplasmosis
Haemophilus 0 0 0 0 1 1 0
Influenzae
Hansen's 0 0 0 0 0 0 0
Disease
Hepatitis A 0 0 0 0 0 0 0
Hepatitis B* 0 0 0 0 8 0 2
Hepatitis C* 12 0 12 12 52 29 37
Influenza* 0 0 0 0 16 29 27
Legionellosis 0 0 0 0 0 1 0
Lyme 1 0 1 1 26** 2 7
Disease*
10 Malaria 0 0 0 0 0 0 l
i
C
sles 0 0 0 0 1ngitis 0 0 0 0 0 0 2
Mumps 0 0 0 0 2 0 0
Pertussis 0 0 0 0 0 1 2
Rocky 0 0 0 0 1 0 0
Mountain
Spotted Fever
Salmonellosis 3 0 3 3 10 6 3
Shigatoxin 0 0 0 0 0 0 1
Producing
Organism
Shigellosis 0 0 0 0 1 0 4
Streptococcus 0 0 0 0 7 3 2
Pneumoniae*
Varicella* 0 0 0 0 1 0 3
i
0—Vi7brio 0 0 0 0 1 0 0
West Nile 0 0 0 0 0 0 0
Yersoniosis 0 0 0 0 0 1 0
Zika Virus 0 0 0 0 1 0 0
Infection
Total 21 2 21 23 181 98 148
August 2016
*Notifications only, LBOH not required to follow up or investigate per DPH.
**Total reflects cases that have also been reported as suspect cases.
All Communicable disease totals above are subject to change in the event that the follow-up investigation
results in the revocation of the diagnosis.
i
Summary of Current Communicable Diseases
Active Tuberculosis:
Case 1:DOT started 6/6/16. 3 contacts had TB Skin Tests administered. 1 contact has been
referred for further follow up. Second round of contact testing completed, no further follow up for
contacts required.
Suspect LTBI Arrival:Follow up requested by DPH regarding to refugee who will be arriving in Salem
whom had a positive PPD test and negative chest x-ray prior to departure. Patient is being followed by
Pulmonary clinic for LTBI treatment.
Campylobacteriosis:
Case 1: Case denies work as food handler or in daycare setting. Case unable to identify a suspect
food. Case is closed.
Case 2: Case denies work as food handler or in daycare setting as well. Case unable to identify a
suspect food but states during incubation was away with friends and no known contacts are ill.
No further follow up necessary, case is closed.
Case 3: Case denies work as food handler or in daycare setting. Case unable to identify a suspect
' food. Is currently completing antibiotic treatment and teaching was done to prevent spread within
household as well as monitoring for symptoms. No further follow up necessary, Case is closed.
Giardia:
Case 1: Case screened as routine for a new refugee arrival, did not have symptoms. It was
determined that the Giardia was acquired prior to arrival in the United States. Case and all
members of household have been treated.
Case 2: Case is a second member of the same household, screened as routine for a new refugee
arrival, did not have symptoms. It was determined that the Giardia was acquired prior to arrival in
the United States. Case and all members of household have been treated.
Salmonellosis:
Case 1: Case is retired, no ill contacts. Genetics testing of the Salmonella linked this case to a
cluster of other cases per the Department of Public Health. Food history obtained and submitted
to DPH and the Center for Disease Control.No further updates at this time, patient completed
treatment and has recovered. No further follow-up required, case is closed.
Case 2: Case denies working as food handler or in daycare setting. Case unable to identify a
suspect food or any known ill contacts. Case has is being followed by a gastrointestinal specialist
for ongoing issues making it difficult to identify timeline for suspect food. Treated for
Salmonella. No further follow up required, case is closed.
i
Case 3: Case denies working as a food handler or in a daycare setting.No known ill contacts but
was able to identify a suspect food, the Food Protection Program and inspectional services where
this food was purchased have been notified for further follow up.
Zika Virus Infection:
26 cases of Zika Virus Infection previously listed as cases have been revoked after lab tests.
Confirmed Case(June 2016): Case not pregnant at time of diagnosis. Case traveled to
Dominican Republic and reported symptoms of fever and rash.
l
Health Dept. Clerical Report FY
Burial Permits Permits Plan Reviews Certificate of Copies / Fines Revenue Permit Fees
$25 Fitness $50 a
July-16 $475.00 $775.00 $1,300.00 $200.00 $2,750.00 Food Service Est. <25seats s140
August $875.00 $1,065.00 $1,500.00 $3,440.00 25"99 seats $28o >99 seats $420
. v
September $900.00 $4,325.71 $1,550.00 $6,775.71 Retail Food <l000sq' s7o
October $0.00 1000-10,000 $280 >10,000 $420 .
November $0.00 Temp.Food 1-3 days s3oo
December $0.00 4-7 days s600 >7 days $
t
January-17 Example of>7 day tempfood permit:
$0.00 1 14(da s)divided b 7=2 x$boo=$12oo
February $0.00 Frozen Desserts $25
�r
March ' $0.00 Mobile Food $210
April A` $0.00 Plan Reviews New s18o
$0
May Remodel sgo
.00
June Catering s25 pereventl$2oo
$0.00 catering kitchen
Body Art Est $315
Total $2,250.00 $6,165.71 $0.00 $4,350.00 $200.00 . $12,965.71 Body Art Practitioner 135
Review Plans $180
Fiscal Year Budget 2014 Suntan Est. s140
Rec.Day Camp $10
Salaa Starting Ending Expenses Ext.Paint Removal $35
Full Time $362,039.00 $338,217.62 Starting Ending Transport Off.Subst. s1o5
Part Time $28,306.00 $27,509.16 $16,500.00 $14,248.00 Tobacco Vendors $135
Overtime $2,000.00 $1,471.89 Swimming Pools Seasonal $140
Balance $392,345.00 $367,198.67 Health Clinic Revolving Account Annual$210 Nonprofit$40
$8,554.13 Title V Review s18o
Well Application s18o
Disposal works s22SI18o
grow CITY OF PEABODY BOARD OF HEALTH
_ �►� DEPARTMENT OF HUMAN SERVICES BERNARD H.HOROWITZ,CHAIRMAN
a 24 Lowell Street STEPHEN S.KALIVAS,R.Ph.
-- Peabody,Massachusetts 01960 LEIGH ANN MANSBERGER,MD,MPH
• N (978)538-5926 SHARON CAMERON
Fax: (978)538-5990 DIRECTOR
�`►PEAe1
September 19, 2016
Ms. Suzanne Doty, RN
Salem Health Department
120 Washington Street
Salem MA 01970
Dear Ms. Doty:
On behalf of the Peabody Health Department, I am writing to express our gratitude for your recent support of
our emergency vaccination clinic following the identification of a food handler with Hepatitis A. As you know,
we had a very short period of time to ensure the vaccination of dozens of food handlers who had been exposed
to the ill individual, as they would otherwise have to be excluded from work.
Our Public Health Nurse realized that the most effective way to prevent widespread employee exclusion would
be to offer an on-site vaccination clinic at the affected restaurant. She reached out to you with a request that you
assist her with vaccinating staff at a clinic the next morning, and you were able to arrange your schedule to
•provide this support. A number of employees had concerns about the exposure and what it could mean for their
own families, and having a team of public health nurses on-site who were able to speak with knowledge and
authority on this subject was a tremendous benefit and very much appreciated by the restaurant.
Thanks to your willingness to support this vaccination clinic, we were able to vaccinate 47 employees and
verify immunity for the remainder in less than 24 hours. Not only did this coordinated effort help avoid a
potential outbreak, it also prevented loss of business for an establishment that employs many workers from our
local communities.
Thank you again for partnering with us to ensure an effective response to this infectious disease emergency.
Sincerely,
9—tAx
Sharon Cameron
Director of Health and Human Services
City of Peabody
cc: Peabody Board of Health
Salem Board of Health
•
1
:C
CITY OF SALEM MASSACHUSETTS
BOARD OF HEALTH lu
120 WASHINGTON• STREET 4�'FLOOR PublicHealth� Prevent.Promote.Protect.
TEL. (978) 741-1800 FAx(978) 745-0343
KIMBERLEY DRISCOLL health&salem.com
LARRY RAMDIN,RS/1t1HS,CHO,CP-FS
MAYOR HEALTH AGENT
September 28, 2016
Larry Leibowitz and Tim Haigh
Ragazza Restaurant Group dba Bambolina
288 Derby Street
Salem, MA 01970
RE: Board of Health Meeting request
Dear Larry and Tim,
The Board of Health requests your attendance at their regularly scheduled meeting to be held on October 11 at 7:00
pm in Room 313, 120 Washington Street, Salem MA.
The purpose of requesting your attendance is to explore ways of improving communication with the Board of Health
0d the Health Agent with respect to changes in your establishment's operations.
Please feel free to contact me at 978-741-1800 if you have questions
Yours Very truly
Larry Ramdin, MPH, MA REHS, CP-FS HHS, CHO
Health Agent