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MONTHLY REPORTS 1978 TO 1986 BOARD. OF HEALTH MONTHLY REPORTS 7/ 1978 TO 2/ 1986 [7BIOLOGICS INISTRATION MONTHLY REPORT Febr a' y 1986 i DISTRIBUTED AMOt?NT ) ANIMAL BITES REPORTED 4 1 ptheria jetanus & Pertussis 38 Vials Diptheria-Tetanus Tox. (under 6 yrs. ) ------ BURIAL PERMITS 49 _ Immune Serum Globulin 50 Vials INTERNATIONAL TRAVEL --- CERTIFICATES (CERTIFIED) 0 Measles (Clinic use only) --- MMR--Measles/Mumps/Rubella 50 Vials TOTAL CASH RECEIVED FROM LICENSES & PERMITS ISSUED Polio Vaccine 420 Doses $264.00 Tetanus & Diptheria (adult use) 32 Vials Tetanus Toxoid (absorbed) -'---- - - 1 P� - Tuberculin P.P.D. Ma 5 ML 5 Vial Typhoid Vaccine ------ SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL $107,914.34 $71 ,454.91 $36,459.43 _. EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (includes) ENCUMBERED $35,060.00 $24,236.60 $10,823.40 I 1221231241 ISM mains mom Fvw mom MIN i�iii�ii�iiii��ooiiiii�NIIN No WIN Ono mmmom K mom 0 ONE son mooning mom now IS monsoon 0 MENEM on 0 -mom s VISITING NURSE ASSOCIATION OF GREATER SALEM , INC. Ms. Linda A. Billows, R.N., M.S. Executive Director TO Salem Board of Health FROM: Ann Dominick, R.N. , B.S. DATE: February, 1986 RE Statistics Salmonella New Cases - 2 Carry Overs - 8 Discharges - 1 Referral to Salem Board of Health Sanitarium on one case Campylobacter Giardia New Cases - 0 New Cases - 0 • Carry Overs - 1 Carry Overs - 1 Shigella Yersinia New Cases - 3 New Cases - 0 Carry Overs - 4 Carry Overs - 1 Trichinosis Malaria New Cases - 0 New Cases - 0 Carry Overs - 2 Discharged - 1- Tuberculosis New Cases - 0 Mantoux Tests (PPD) - 11, Neg. - 9, Positive - 1. North Shore Pulmonary Clinic - 14 Lead Test Reports - --- I-1, Ia-5, II-4, III-3 High Rises Infant Report -1 i Josephs_ School '- Postural Screenings were done in grades 7 and 8. --Dr-_—.Rene Desjardins did physical examinations. He will continue to be available f'or Salem Board of Health duties, including next fall 's Flu program. 0 • .ADMINISTRATION MONTHLY REPORT January 1986 BIOLOGICS DISTRIBUTED i A"1)1 "T I ANIMAL BITES REPORTED 3 Diptheria,Tet anus & Pertussis 47 Diptheria-Tetanus Tox. (under 6 yrs, ) --- BURIAL PERMITS 53 Immune Serum Globulin 5 INTERNATIONAL TRAVEL CERTIFICATES (CERTIFIED) 0 Pleasles (Clinic use only) "-" -- - A,2iM--Measles/Mumps/Rubella 60 TOTAL CASH RECEIVED FROM LICENSES & PERMITS ISSUED $4961 .00 Polio Vaccine 180 Tetanus & Diptheria (adult use) 7 Tetanus Toxoid ab - 1 ML Tuberculin P.P.D. M 5 ML J38 Typhoid Vaccine --- SALARY REPORT: ALLOWED EXPENDED BALjUICE TO EI•iD OF FISCAL $107,914. 34 _- EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (includes) BNCUpMEFED $35,o6o.00 $21 ,378.81 $13 ,681,19 ' ��N�ci�F7��11�nnn��Il�� 1 VIIAVISITING NURSE ASSOCIATION OF GREATER SALEM , INC. Ms. Linda A. Billows, R.N., M.S. TO Salem Board-of Health Executive Director FROM: Ann Dominick, RN, BS DATE: January 1986 RE Statistics Salmonella New Cases - 0 Carryovers - 12 Discharges - 4 Even though we still have 8 active salmonella cases, it is interesting tQ note that of the 12 carryovers, . there were 5 different strains of salmonella and no common food site. Campylobacter New Cases - 1 Discharges - 1 Shigellasis Giardiasis • New Cases - 1 New Cases - 1 Carryovers - 4 Discharges - 1 Meningitis Trichinosis New Cases - 1 New Cases - 2 Carryovers - 1 Malaria Yersinia New Cases - 1 New Cases - 1 Tuberculosis Mantoux Tests - 25 Negative-18, Positive-4, No Show-3, North Shore Pulmonary Clinic-22 Lead Test Reports Ia - 1, II - 3, III - 5 Consultation with Board of Health housing inspector on one family. St. Joseph's School Vision and hearing testing and heights and weights are continuing at St, Joseph's . school. SHETLAND OFFICE PARK/27 CONGRESS STREET/SALEM, MA 01970/(617)745-9050 ..y r^ i TRICHINOSIS ram. Trichinosis is a parasitic infection of man and animals. Usually the organism enters the body by the ingestion of infected pork products which have been inadequately• cooked or treated. It is not very common in the U.S. , because most people obtain their pork from food sites that are under governmental regulations. Sometimes people have their own pigs slaughtered and there may not be proper handling and preparation of the food process. The sources of this infected pork are under investigation by the Mass. Department of Public Health. There are also 2 cases in Peabody related to our Salem cases. The family gathered at a private home over the holidays to prepare sausage from raw pork and ate some prior to cooking. Symptoms of Trichinosis may include: diarrhea, nausea and vomiting within 24 hours of ingestion; one to two weeks later they may notice generalized aches and pains, swelling (especially around the eyes) fever, cough, tiredness and some neurological or cardiac changes if parasite larvae migrates into these body parts. This parasite can be found in infected swine, dogs, cats, rats and many wild animals, including fox, wolf and bear; and can be spread by giving untreated infected garbage to animals. Proper cooking and freezing kills the larvae. The i diagnosis is made by blood tests and finding the larvae or, eggs/in muscle or the `V suspected food. • j • ADN TI �INYST MONTHLY REPORT December 1985 RA ON BIOLOGICS DISTRIBUTED AMOUNT ANIMAL BITES REPORTED 3 _ Diptheria,Tetanus & Pertussis 37 Vials Di.ptheria-Tetanus Tox. (under 6 yrs. ) ------- BURIAL PERMITS 42 Immune Serum Globulin INTERNATIONAL TRAVEL CERTIFICATES (CERTIFIED) ------ Measles (Clinic use and ------ - - ---- RIMR--Measles/Mumps/Rubella 160 Doses TOTAL CASH RECEIVED FROM LICENSES & PERMITS ISSUED Polio Vaccine 700 Doses $2805.00 Tetanus & Diptheria (adult use) 10 Vials Tetanus Toxoid (absorbed) 4 Vials _---- -- — - 1 ML Tuberculin P.P.D. Ma 5 ML 8 Vials Typhoid Vaccine ------- SALARY REPORT: ALLOWED EXPENDED BALANCE E TO END OF FISCAL $107,914.34 $52,535.02 $55,379. 32 P_ ENDED FREE CASH (includes) ENCUMBERED EXPENSE REPORT: ALLOWED EX $35,060.00 $18,092.55 $16,967.45 i i / _ �n000nno�n��■c�aF.� E.I=G� I VISITING NURSE ASSOCIATION OF GREATER SALEM , INC. i Ms. Linda A. Billows, R.N., M.S. Executive Director TO: Salem Board of Health FROM: Ann Dominick, RN, BS DATE: January 7, 1986 RE: STATISTICS- December 1985 Salmonella Shigellosis New Cases- 2 New Cases-2 Carryovers- 9 Carryovers- 2 Discharges- 1 Discharges- 0 Campylobactor New Cases- 0 Carryovers- 1 Discharges- 0 • Tuberculosis New Cases- 1 admitted to State TB bed at Salem Hospital for evaluation and treatment. Mantoux Tests- 18 Negative- 15 Positive- 2 N.S. - 1 North Shore Pulmonary Clinic is - Lead Elevation Reports- from July 1 , 1985, to December 31 , 1985 la- 18 reports on 16 children II- 19 reports on 9 children III- 7 reports on 2 children Attached is the annual report from July 1 , 11984 to June 30, 1985. ADMINISTRATION MONTHLY REPORT&,2 rP.rf ..._....._...__—. AMOUNT • I ANIb1AL BITES REPORTED 3 . BIOLOGICS DIS.TRIBL!TED Diptheria,Tet anus Pertussis 23 Vials Diptheria-Tetanus Tox. (under 6 yrs. ) -------- BtTRIAL PERMITS tMr�une Serum Globulin 25 Vials INTERNATIONAL TRAVEL CERTIFICATES (CERTIFIED) ------ Measles (Clinic use only) ------ t.w--measles/Mumps/Rubella 150 Doses TOTAL CASH RECEIVED FROM - — LICENSES & PERMITS ISSUED Polio Vaccine 110 Doses 1 $89.•00 Tetanus & Diptheria (adult use) 38 Vials Tetanus Toxoid 2 Vials - 1 ML Tuberculin P.P.D. (Ma 5 14L 5 Vials Typhoid Vaccine ALLOWED EXPENDED BALA14CE TO END OF FISCAL SALARY REPORT: $107,914. 34 $43,674.71 $64,239.63 _. . ALLOWED FREE CA.Stt (inc].udes) FP1Cir1•':e <` EXPENSE REPORT: o t 6 .41 $35,060. 0 $15 393.59 $ 9, 66 . � r VMVISITING NURSE ASSOCIATION OF GREATER SALEM INC . Ms. Linda A. Billows, R.N., M.S. Executive Director TO Salem Board of Health PROPI: Ann Dominick, RN, BS DATE: Decernber 3, 1.985 RE STATISTICS - NOVE:MBER 1985 Salmonella Shige.11os.i New Cases - 3 New Ca ff s - Carryovers- 17 Carryovers - 3 Discharges- 8 Discharges - 1 Campylobactor Giardiasis New Cases - 0 New Cases - 0 Carryovers- 1 Carryovers - 3 Discharges- 0 Discharges - 3 • iuherculosis t,lant;oux 'Pests - 13 Negative - 13 Positive - 0 North Shore Pulmonary Clinic - 8 Lead Elevation Reports - II-2, la-1 Hepatitis: New Cases - 1, Carryovers - 1, Discharges - 0 St. Joseph's School The he i?.ti, records oC new students have been rt v -t: ,?assac'nusett.s School Admittance requirements. The Mass. ,f' Public Health school regj i i rement Corm has been completed and sent Testing for vision and hearing deficits has been started. SHFTI A-N-0 nFFtr`F PARK / 27 CONGRESS STREET / SALEM. MA 01970 / (6171 745-9050 �f r.� ~ ENVIRONMENTAL HEALTH DIVISION MONTHLY REPORT — 198 0vE: (month) 1 2 13 14 15 16 17 18 19 2') 21 22I23124 .25 2 6 27 28 29 30 31 :0 _ 4 5 6 7 8 9 10 1 / ;anitar Code Enforce 1 3 S / I / "/ / _ Food Service Com Food Service Ins - u e Food Serv. xobil Markets . .. Retail 40usin -original LL `o He Water / General Nuisances Da Care Centers Da Cam s 0. Swimmin Pools 1 Beaches / ;? . Water Air Noise � Z SESD-Observation SESD-Co laints '- - 5. Rodent Control i 16. Lab Testin ; 7. Field Testin 1.Lead Testin 2.Perc. Test for Sew. S stem i I / L Licenses A Permits - 9. Court Hearin s ' ?0. Off. Consultation 3 / — Sessions 21. Referralsfrom Other Depart. 212. Housin Reins ect. _ '3. Food Serv. Com _� . Letter-Orders To owners* Reports - 25. Investigations 3 j 25. survey(Market/Rest _7 . Meetin s ` ti p4TNISTRATION MONTHLY REPORT October. 1985 BIOLOGICS DISTRIBUTED AMOUNT I ANIMAL BITES REPORTED 1 Diptheria,Tetanus & Pertussis 49 Vials Diptheria-Tetanus Tax. (under 6 yrs. ) BURIAL PERMITS 475 dune Serum Globulin 9 Vials INTERNATIONAL TRAVEL CERTIFICATES (CERTIFIED) 0 Measles (Clinic use onl --- M''M--Measles/Mumps/Rub ella 150 Doses TOTAL CASH RECEIVED FROM LICENSES & PERMITS ISSUED ------ Polio Vaccine 760 Doses Tetanus & Diptheria (adult use) 20 Vials 6 Vials :Tetanus Toxoid (absorbed - - 1, 1.1� 13 Vials Tuberculin P.P.D. (Mantoux) 5 I'� Typhoid. Vaccine ----- SALARY" REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL $107,914.34 $35,798.40 $72,115.94 __. _. .. EXPENSE REPORT: ALL041ED EXPENDED FREE CASH (includes) ENCUI I?B'' $ 35,060.00 12,898.50 $22,161 .50 VNAVISITING NURSE ASSOCIATION OF GREATER SALEM , INC. Ms. Linda A. Billows, R.N., M.S. Executive Director TO . Salem Board of Health FROM: Ann Dominick, RN, BS DATE: October 1985 RE STATISTICS Salmonella Shigella New Cases 8 New Cases . 2 Carryovers 8 Carryovers . 1 Discharges 2 Visits 4 Giardia Campylabacter New Cases 3 New Cases . 1 Aseptic Menigitis . New Cases 3 Follow-up by physician Tuberculosis North Shore Pulmonary Clinic : 19 Mantoux Tests . 14 - Positive 3, Negative 10, No Show 1 Lead Reports Ia-5, II-4, III-2 High Risk Infant Reports: 5 St. Joseph's School All children new to the school have had the required immunizations and health exams and the state forms have been completed and submitted to the Division of Communicable Diseases. • SHETLAND OFFICE PARK/27 CONGRESS STREET/SALEM, MA 01970/(617)745-9050 sea -oil oil -Amu aw -04 67W - a all HII-STEETWO OFF-UP-M! P.DMINIST RAT ION MONTHLY REPORT September 1985 BIOLOGICS IDISTRIBUTED AMOUNT I ANIMAL BITES REPORTED 3 Di.ptheria,Tetanus f, Pertussis 27 Vials Diptheria-Tetanus Tox. (.under 6 yrs. ) BURIAL PERMITS 37 V.mune Serum Globulin 44 Vials � INTERNATIONAL TRAVEL CERTIFICATES (CERTIFIED) 0 ?easles (Clinic use onl —1.1MR-14easles/Mumps/Rubella 40 doses i TOTAL CASH RECEIVED FROM LICENSES & PERMITS ISSUED $471 .00 Polio Vaccine 270 Doses Tetanus & Diptheria (adult use) 36 Vials Tetanus Toxoid (absorber 2 Vials _ ...__. 1 14L Tuberculin P.P.D. Ma 5 I4L 9 Vials Typhoid Vaccine ------ SALARY REPORT: ALLOWED EXPENDED BALANCE TO ENT) OF FISCAL $106, 120.00 $25,674.23 $80,445.77 EXPENSE REPORT: ALLO•IED EXPENDED FRET; CASH (includes) $ 35,060.00 $9,035.58 $26,024.42 "� ii�i�iiiiini■�iiiiini��i�iiii�■ �. iiiiiniieoi'uii'eiioiwe'ai■a T� VNAVISITING NURSE ASSOCIATION OF GREATER SALE M , INC. Ms. Linda A. Billows, R.N., M.S. Executive Director TO: Salem Board of Health FROM: Ann Dominick, R.N. , B.S. DATE: September 1985 RE: Statistics Salmonellia Shigellosis New Cases - 2 New Cases - 0 Carryovers - 6 Carryover - 1 Discharges - 5 Visits - 2 Campylobactor New Cases - 0 Carryovers - 1 Discharges - 1 Visits - 0 • Menningitis New Cases - 0 Discharged - 1 Tuberculosis New Cases - 1 North Shore Pulmonary Clinic - 15 Visits - 14 Mantoux Tests - 21 : Neg - 15 Pos - 4 N.S. - 2 Follow up is continuing on previous cases and contacts Lead Elevation Reports North Shore Children's Hospital Lead Poisioning I - 4 la - 6 II - 4 III - 1 Prevention Program did a door to door screening on Visits 7 about 150 children in the Point Area and 2 Children Lead Elevation (one was already known as a case) • SHETLAND OFFICE PARK/27 CONGRESS STREET/ SALEM, MA 01970/(617)745-9050 ADMINISTRATION MONTHLY REPORT Auaust BIOLOGICS DISTRIBUTED A110UNT I , ANIbfAL BITES REPORTED 2 Diptheria,Tetanus & Pertussis 56 vials Dipth BIMIAL PERMITS 48eria-Tetanus Tox. (under 6 yrs. ) mune Serum Globulin 46 vials INTERNATIONAL TRAVEL CERTIFICATES (CERTIFIED) 0 Measles (Clinic use onlLL__ MMR--Measles/Mumps/Rubella 140 doses TOTAL CASH RECEIVED FROM - _ LICENSES & PERMITS ISSUED $444.00 Polio Vaccine. 450 doses Tetanus & Diptheria (adult use) 69 vials Tetanus Toxoid (g sorbs 7 vials ___......._--.--... _ ...... ...___...------ .... _...- 1 ML Tuberculin P.P.D. Ma 5 1R, 17 vials Typhoid Vaccine SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL $106, 119.61 $17,769-. 12 $88,350.88 EXPENSE REPORT: ALLOTTED EXPENDED FREE CASH (includes) EllCCP-'23F!" • $ 35,060.00 $6,047.34 $29,012.66 n 4 r 1*6 VNAVISITING NURSE ASSOCIATION OF GREATER SALEM , INC. Ms. Linda A. Billows, R.N., M.S. Executive Director TO: Salem Board of Health FROM: Ann Dominick, R.N. , B.S. DATE: August 1985 RE: Statistics Salmonella New Cases - 6+ Investigation into 2 more cases Carryovers - 7 that revealed they no longer lived in Salem Discharges - 1 and had no recent connection with Salem so they ` Visits -16 were transferred to the Board of Health in their town. One other case was investigated because of a Salem connection, then transferred to their • Board of Health. Three referrals for site inspections were made to our, sanitariarns. Campylobactor SHIGELLOSIS New Cases - 1 New Cases - Carryovers - 2 Visits - 1 Discharges - 1 Visits - 1 Menningitis New Cases - 1 Tuberculosis New Cases - 0 North Shore Pulmonary Clinic Visits -22 Mantoux Tests - 39; Neg - 32; Pos - 2; N.S. - 5 Follow up is continuing out previous cases and contacts High-Risk Infants - 3 • St-iETLAND OFFICE PARK ; 27 CONGRESS S'i HL LI `; Li it;, 1AA 01970 i (617) 745-9050 1 L ENVIRONMENTAL HEALTH DIVISION MONTHLY REPORT ...ear) (month) 111 111 �a:�itary Code Enforce 1 2 3 4 1 6 7 8 9 110 Ill 2 13114115 16117118 19 20 21 22123 24i25 6 27 28 29 30 31 TOTALS Food Service Com 1. Food Service Insp. Mobile Food Serv. Retail Markets iiousin -Ori inal � No Heat/Hot Water General Nuisances - Day Care Centers ---- Day Camps -- :0. Swimming Pools _1. Beaches - . Water/Air/Noise _-- SESD-Observation SESD-Complaints 5. Rodent Control - 15. Lab Testing Field Testing l.Lead Testin _ 2 .Perc. Test for Sew. System Licenses & Permits 19. Court Hearings 44 1 _._ _0. Off. Consultation Sessions - -- 21 . Referrals to and ,p from Other Depart. Housing Reinspect. '3. Food Serv. Com 1. T '4. Letter-Orders To Owners; Reports - 23. Investigations 14 ' -- '5. Surve (Market/Rest), 7 . Meetings --- - ADMINISTRATION MONTHLY REPORT JULY 1985 BIOLOGICS DISTRIBUTED AMOUNT I ANIMAL BITES REPORTED 9 Residents 1 non-resident Diptheria,Tetanus & Per-tussis 41 viles BTJRIAL PERNQTS 46 Di pth eri a-Tetanus Tox. (untie r 6 yrs. ) mune Serum Globulin INTERNATIONAL TRAVEL ----- CERTIFICATES (CERTIFIED) ''easles (Clinic use only_) __ 20 doses TOTAL CASH RECEIVED FROM t`1•tR--N!ensles/?•lumps/Rubella $229 LICENSES & PFRMITS ISSIFT:D 250 doses Polio Vaccine _..._...-.— ---.•-----.---.--- . - 18 wiles Tetanus & Diptheria (adult use) - 51 viles , Tetanus Toxoid absorb — — 1 MI. 75. viles Tuberculin P.P.D. Ma 5 Typhoid Vaccine ^--1---- --'- EXPO D BALANCE TO rND Or FISC,,:_ SALARY REPORT: ALLOWED $106,119.61 $7,905.59 $96,255.60 _. _. EXPENSE REPORT: ALLOVTED EXPENDED FRET: CAS}{ ( inc:-u6es ) - $35,060.00 $3,047.98 $32,012.02 - �0��anGJ��<lC�0��lfc7FJ0�0B " : o�niiiiiiiiiiiiiiii��a�i�iip O��O��I1�F��L'7l�lF�I0WJ��N�El��E� VISITING NURSEASSOCIATION OF GREATER SALEM , INC. Ms. Linda A. Billows, R.N., M.S. Executive Director TO: Salem Board of Health FROM: Ann Dominick, R.N. , B.S. DATE: July 1985 RE: Statistics Salmonella Campy Lobacter New Cases - 1 New Cases - 2 Carryovers - 7 Carryovers - 1 Discharges - 2 Discharges - 1 Visits - 7 Hepatitis E. Coli (Hemolytic) • New Cases - 1 New Cases - 1 Carryover - 5 Discharges - 1 Discharges - 4 Visits - 3 Tuberculosis New Cases - 0 Visits - 36 Mantox Tests - 65, Neg - 59, N.S. - 2, Pos. - 4 LEAD Cases - III - 1, II - 4, I a - 5, I - 1 Visits - 3 • SHETLAND OFFICE PARK/ 27 CONGRESS STREET/ SALEM, MA 01970/ (617) 745-9050 i� rii�iiiiai�isi�i�i�a �s n. ADMINISTRATION MONTHLY REPORT JUNE 1985 e — ANIMAL BITES REPORTED BIOLOGICS-DISTRIBUTED . AMOUNT t Diptheria,Tetanus .& Pertussis Diptheria—Tetanus Tox. (under 6 yrs. ) ___ BURIAL PERMITS immune Serum Globulin --- INTERNATIONAL TRAVEL CERTIFICATES (CERTIFIED) Measles (Clinic use onl W- R-44easles/Mumps/Rubella TOTAL CASH RECEIVED FROM — LICENSES & PERMITS I8aI1ED Polio Vaccine 16nn doses _..._..._------�_—.__...:___ _.._........ .$50.5..00_-_.........._ _. Tetanus & Diptheria (adult use) , Tetanus Toxoid 1 ML Tuberculin P.P.D. ntoux) 5 14L Typhoid Vaccine --- SALARY REPORT: . ALLOWED EXPENDED BALANCE TO END OF FISCAL $82,916.00 $85,038.65 - EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (includes) EP1C(.1113T RF $34,473.00 32,417.79 --------- VISITING NURSE ASSOCIATION OF GREATER SALEM , INC. Ms. Linda A. Billows, R.N., M.S. Executive Director TO: Salem Board of Health FROM: Ann Dominick, R.N. , B.S. DATE: June 1985 RE: Statistics Salmonella Ciardiasis New Cases - 4 + 1 Transfer New Cases - 0 Carryovers - 4 Carryover - 1 Discharges - 1 Discharges- 1 Visits - 8 Hepatitis Campy Lobacter • New Cases - 1 New Cases - 1 Carryovers - 4 Discharged - 1 Visits - 1 + 1 VNA follow-up Tuberculosis Meningitis New Cases - 1 Carryover - 1 Visits -26 Discharges - 2 Mantoux Tests - 49; Neg - 33; Pos - 10; N.S. - 6 Lead Five home visits made and continuing coordination of follow-up services between the Salem Board of Health and the State Public Health Department. St. Joseph's Dr. Desjardins completed the physical exams on the children. SHETLAND OFFICE PARK/27 CONGRESS STREET/ SALEM, MA 01970/ (617)745-9050 ADMTNISTRATION MONTHLY REPORT MAY 1985 PIOLOGICS DISTRIBUTED AMOUNT I ANIMAL BITES REPORTED 1 resident Di.ptheria,Tetanus & Pertussis 270 doses) Diptheria-Tetanus Tox. (under 6 yrs. ) I BURIAL PERMITS �+� �A► mune Serum Globulin 7 vialsINTERNATIONAL TRAVEL 5 inquiries CERTIFICATES (CERTIFIED) Measles (Clinic use only) -- _t.W- --Tdeasles/?dumps/Rubella 40 doses TOTAL CASH RECEIVED FROM $844.00 LICENSES & PFR14ITS ISSUTsD Polio Vaccine -. 140 dose Tetanus & Diptheria (adult use) 130 dose Tetanus Toxoid 20 dose 1 ML 80 dose Tuberculin P.P.D. Ma 5 14L -- Typhoid. Vaccine -- SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL $82,916.00 $77,599.63 $5,316.37 EXPENSE REPORT: ALLOTTED EXPENDED FRrE nsii (includes) $34,473.00 $31,594.29 $2,878.71 eiiiinieiiiiii�■iiiniei�ii�"' VISITING N NURSE S GASSOCIATION OF GREATER SALEM, INC. Ms. Linda A. Billows, R.N., M.S. Executive Director y TO: Salem Board, of Health FROM: Ann Dominick, R.N. , B.S. ,. Public Health Nurse DATE: May 1985 j; RE: Statistics F T Salmonella New Cases 0 y Carryovers - 5 and 1 transferred to Beverly Hospital Discharges - 1 Visits - 5 Giardiases 3 New Cases - 0 Carryovers - 1 • t Hepatitis New Cases -�'.2 3 Carryovers - 2 Discharges - 1 (Dx. not hepatitis) Visits - 1 Meningitis New Cases 1 Carryovers ---2 Tuberculosis Mantoux .Tests - 11; Neg. -- 11; Positive - 0 Niorth Shore Pulmonary Clinic - 14 s Visits -26 New Cases - 0 TB Contact investigation and follow-up is actively continuing on the four-case cluster in our neighborhood, as well as'. on the other current TB patients. Our recent case thought to be TB has been_,revoked. . Tuberculosis retesting of contacts has started. No further cases have been found. • Lead Ia - 4;. II - 1; III - 1 Visits - 4 SHETLAND OFFICE PARK/27 CONGRESS STREET/ SALEM,MA 01970/(617)745-9050 •,VA *� St. Joseph's School • All testing as required by the Massachusetts Department of• Public Health has been completed and letters sent home to the parents of students needing further medical evaluation. The School Physician was into examine children in grades 3 and 7 who have no record of a physical exam this school year. He will visit again the first week of June. The Salem Visiting Nurse Association Physical Therapist came in two times to exam children referred by the Public Health Nurse for rescreening following the postural screening program::fur grades 5, 6, 7, and 8. Physician referral was made when indicated. Teaching about the diseases and the importance of compliance with the recommended ;? follow-up is a' major portion of the investigation of any infectious disease. • • • ADMINISTRATION MONTHLY REPORT APRIL 1985 PIOLOGICS DISTRIB=LD Ah1 UNT I ANIMAL BITES REPORTED 3 Residents - 2 Non-residents — Diptheria,Tetanus tc Pertussis 480 doses Diptheria-Tetanus Tox, (under 6 yrs. ) I BURIAL PE'RMLTS 58 Immune Serum Globulin -- INTERNATIONAL TRAVEL . CERTIFICATES (CERTIFIED) -- r,1e as 1 es Clinic use on lv t.94R--measles/?dumps/Rubella 900 doses TOTAL CASH RECEIVED FROid -0- --. LICENSES & PF'RMITS ISSUED Polio Vaccine Tetanus & Diptheria (adult use) 350 doses , _ Tetanus Toxoid ( b 10 doses .�� _. ..----.---.__- 1 14L 50 tests . Tuberculin P.P. D. (MantouV 5 ML - l'yphoid Vaccine --- SALARY REPORT: ALLOVTED EXPENDED BALANCE TO E!4D OF FISCAL $ $82,916.00 $69,273.11 $13,642.89 EXPENDED FREE CASH (includes) ENCUI- ir'R�, EXPENSE REPORT: ALLOWED _ $34,473.00 $29,123.38 $5,349.62 d , 4 VMVISITING NURSE ASSOCIATION OF GREATER SALEM , INC. Ms. Linda A. Billows, R.N., M.S. Executive Director TO: Salem Board of Health FROM: Ann Dominick, R.N. , B.S. DATE: April,' 1985 RE: Statistics SALMONELLA New Cases - 1 + Carryovers - 5 Discharges - 1 Visits - 3 CAMPYLOBACTER • None GIARDIASIS New Cases - 1 HEPATITIS New Cases - 1 Carryovers - 2 LISTERIOSIS New Cases - 1 TUBERCULOSIS New Cases - 2 Visits - 25 Mantoux Tests - Negative - 28 Positive - 8 No Show - 1 North Shore Pulmonary Clinic - 23 Giardiasis is an infectious protozoan infection of the small in- • testine. It occurs worldwide and children are more frequently infected. Drinking fecally contaminated water is the most common source and less often from fecally contaminated food. The disease may also be spread in day-care centers by improper handwashing and cleansing techniques. People who have SHETLAND OFFICE PARK / 27 CONGRESS STREET / SALEM, MA 01970 / (617) 745-9050 t ` ` Public Health Monthly Report - 2 - April 1985 the infection but no symptoms can infect others. It takes about two (2) weeks after exposure for the disease to appear and people can still spread • it as long as the organism remains in their body. They may have intestinal sysmptons such as chronic diarrhea, abdominal cramps, bloating, frequent loose, pale, greasy malodorous stools, and fatigue and weight loss.Preventa- tive measures most important in reducing the spread of this disease are: educating families, and personnel in institutions (especially day care centers) in personal hygiene, the proper disposal of feces, and protecting public water supplies against contamination with human or animal feces. An investigation of the contacts as well as the infected person is done to search for environmental contamination. Medicines used to treat this con- dition are Atabrine, Flagyl and Furozone. Listeriosis is a bacterial disease affecting the brain and spine. . Symptoms start quickly with fever, intense headache, nausea, vomiting and irritability - sometimes progressing to coma. Sometimes a mild illness occurs with Flu-like symptons, however the babies of pregnant women may be seriously affected. This is not a common infection, but may be found in domestic and wild mammals and fowl, as well as man. This bacteria may be found in water and mud and the use of such silage as fodder can infect animals. It can also be spread by eating or inhaling contaminated food or handling in- fectious materials, or -soil contaminated with infected animal feces. This + may result in a raised rash on the hands and arms. It takes from four (4) days to three (3) weeks to develop the symptoms. The most susceptible people are unborn and newborn babies and adults over forty (40) who have other debilitating illnesses, especially if • their immune system is damaged. Some antibiotics are effective in treating this illness. . This patient is still hospitalized and has other chronic illnesses causing his weakened condition. ADiTI'NISTRATION MONTHLY REPORT MARCH 1985 J?IOLOGICS DISTRIFi'� D —a— I AP10II! ' j ANIMAL BITES RFPOM'L,D 3 --- ^,ipr.hcria ,Tetanus 1, Iertussis 230 doses i i i 1 1 - BIJRInL 'I;rzrjgIT's 41 Dip'Lheria-Tetanus To_c. (under yrs . ) -- I Immune Serum Globulin 57 vial INTERNATIONAL TRAVEL 0 CFR`I'IFICATES CERTIFIED ''cesles (Clinic use on',y) __ asles/tdumps/Ruhel.lr., 572 doses TOTAL CASH RECTt;IVFD FRO?t __.._--•_--- ---------- --- LICENSES & FEM,ITS ISSM D $351.00 Folio Vaccine 262 doses . TetA.niis & Dipth eri a (adult use) 70 doses Tetanus Toxoid (4 1 Mh 550 tests Tuberculin P.P. D. ( M�n Typhoid Vaccine SALARY RBPO1 i , ALLOWEDF,XPL'NDFD �3C % $82,916.00- $61,014.09 $21,901.. 91 FYPENSE REPORT: ALLOTTED EXPENDED wIREC CASH OncLude0 /VC40649r�* $33,973.00 $25,773.48 $1 ,199.52 4/46 A • VMVISITING NURSE ASSOCIATION OF GREATER SALEM , INC. Ms. Linda A. Billows, R.N., M.S. Executive Director TO . Salem Board of Health FROM: Ann Dominick, R.N. , B.S. DATE: March 1985 RE Statistics SALMONELLA New Cases - 1 Carryovers'*- 5 Discharges - 1 Visits - 3 • CAMPYLOBACTER None HEPATITIS New Cases _ 2 TUBERCULOSIS New Cases - 0 Visits - 4 Mantoux Tests - Negative - 9 Positive - 1 No Show - 1 North Shore Pulmonary Clinic - 20 LEAD Class Ia - 1 Class II - 2 + one needs repeat venous to determine classification PREMATURE BIRTHS - 1 Follow up is continuing on the three previously reported Tuberculosis cases. Positive reactors have appointments at North Shore Pulmonary Clinic. No new cases have occurred this month. Some positive reactors have not kept • their clinic appointments so the Public Health Nurse makes direct contact with them to find out why and provide Tuberculosis Education and strong en- couragement on the importance of follow up with the clinic. Because many of the people do not speak English, it is necessary to get an interpreter. Several different languages are spoken. SHETLAND OFFICE PARK / 27 CONGRESS STREET/ SALEM, MA 01970 / (617) 745-9050 Page ,Two Publi6l'-! lth;,Monthly:Report. - ti Mrch .1985 • ` Because one of, the:people with Tuberculosis does not have medical. insurance,_. the.Public;HealtYi. Nurse,.w�11 =look-,into possible Medicaid eligibility = If this person is not eligible for. Medicaid, covefage`'and .has no` other-.'health' insurance; then the city and state are egiially.responsible for payment to-Salem-Hospital - according to law. • i�iiiiiiiii�i�iiiniir �ii�� ADMINISTRATION MONTHLY REPORT FEBRUARY 1985 BIOLOGICS DISTRIBUTED AMOUNT I ANIMAL BITES REPORTED 9 Residents Diptheria,Tetanus Pertussis 610 doses Diptheria-Tetanus Tox. (under 6 yrs. ) -- BURIAL PERMITS 44. _ Immune Serum Globulin 11 vials INTERNATIONAL TRAVEL CERTIFICATES (CERTIFIED) Measles (Clinic use onl r•fMR--14ensles/rdumps/Rubell.a 900 doses TOTAL CASH RECEIVED FROM $1800.00 LICENSES & PERMITS ISSUED Polio Vaccine 325 doses Tetanus & Diptheria (adult use) 160 dose Tetanus Toxoid (abgorb 1 ML 5 r� 160 test u ,Tuberculin P.P.D. Manto � Typhoid. Vaccine --- SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL 82,916.00 $51,364.46 $31,551.54 + longevity & Retro-active -- - EXPENSE REPORT: ALLOVED .. EXPENDED FREE CASH (includes) ENC(11.{F3F'.FF $33,973.00 $23,160.99 $10,812.01 n I I I VISITING NURSE ASSOCIATION OF GREATER SALEM , INC. Ms. Linda A. Billows, R.N., M.S. Mr. Peter V. Kent Executive Director President, Board of Directors TO: Salem Board of Health FROM: Ann Dominick, R.N. , B.S. DATE: February 1985 RE: Statistics Salmonella New Cases - 1 Carryovers - 5 Discharges - 0 visits - 1 Campylobacter New Cases - 0 Carryovers - 2 • Discharges - 2 visits - 0 Hepatitis - No Follow-Up Tuberculosis � New Cases - 0 visits -15 Mantoux Tests - Neg. - 32; Pos. - 13; N.S. - 4; North Shore Pulmonary Clinic - 28 See End Lead I - 1; Ia - 3 St. Joseph's School - Most mandatory vision and hearing testing and Height, weights and Blood Pressures have been completed the Public Health Nurse is reviewing records and sending notices home to the parents of children in Grades 3 & 7 who need Physical Exams. The State requires exams to be done when first entering school and then in Grades 3, 7, and 10. Dr. Desjardins is available to provide these physicals upon parent request and arrangements will be made shortly f.or him to come to the school . • 205 WASH INGTON STREET / SALEM, MA O1970 / (61 7) 745-9050 T.B. screenings, investigations and follow-ups are continuing on the cases • reported last month. No new cases have been found, but about one third of I the people being tested are discovered to be positive reactors and are I referred to the Pulmonary Clinic for Chest X-Rays and physician evaluations. The Public Health Nurse, as part of the Visiting Nurse Association of Greater Salem, Inc. , will be moving to Shetland Industry industrial Park, off Congress Street on March 8, 1985. The telephone number will remain the same 745-9050. I too Rml 111ME11111111111 Elm= iiioii�eiiiieiiiiiii■�ni�i�� m o EN ENVIRONMENTAL.HEALTH DIVISION MONTHLY REPORT r� •J (month) 1 I i tar Code Enforce 1 2 3 4 5 6 7 8 9 0 11 2 13 14 15116117118119 29 21 22123124j25 6 127128129130 31 TOTALS &jn _ ood Service Com 1. / Food Service Insp./ "Iobile Food Serv. -� t detail Markets 1" Housing- No Original `o Heat/Hot Water General Nuisances - Day Care Centers --- Da• Cams Swimming Pools L -- - - i Beaches water/Air/Noise _. SESD-Observation _-- SESD-CoTp laints —+- Rodent Control - -- Lab Testing Field Testing !.Lead Testing 2 .Perc. Test for 1 Sew. System 1 Licenses & Permits --- Court Hearings Off. Consultation i- Sessions ? Referrals to and from Other Depart. Housing Reins ect. t;. Food Serv. Com 1. Y -Orders To i ;/ Owners; Reports � / z Investigations - - Surve (Market/Rest). — - - - =- Meetings -- - �_ r • VISITING NURSE ASSOCIATION OF GREATER SALEM , INC. Ms. Linda A. Billows, R.N., M.S. Mr. Peter V. Kent Executive Director President, Board of Directors TO: Salem Board of Health FROM: Ann Dominick, R.N. , B.S. , Public Health Nurse DATE: February 4, 1985 RE: Statistics Salmonella '? New .Cases - 2 ' Carryovers 5 v-*�- 1- C�� .T4E Rta-(< f Discharges 2 �, `f.:�a 2.C�4 (�� to _/ ,.c�'7z� .7ti<fG�! '4 «/fir 0�}t .1 Visits - 3 t�l Campylobactor • New Cases - 4 Carryovers - 0 Discharges - 0 Visits' - 0 Hepatitis No Follow Up Tuberculosis New Cases 5* *One,,,U_Diagnosis is has changed to Actinomyeosis Visits -10 Mantoux tests - Neg - 19 Pos - 9+TB Testing at a work site North Shore Pulmonary Clinic -- ;2-.3 Lead I - 0, . Ia - 0, Ib - 0, II - 3, III - 1, IV - 0 r 205 WASHINGTON STREET/ SALEM, MA 01970/(617) 745-9050 Page 2 Extensive follow-up was needed in the Tuberculosis investigation of one of the • TB cases. Both social and work contacts were skin tested. Some of the person 's community contacts were tested at a Mantoux Clinic held at the Point Neighborhood Health Center, and other special time arrangements were made for the working people. Mantoux Testing was also done on over 100 people at the work site. A spanish speaking nurse and aide assisted with the screenings and community contact follow-up. The case was admitted to a state Tuberculosis bed at Salem Hospital. The Hospitalization charges are shared equally by the state and the city when there is no other health insurance. Two of the other reported cases this month involved children who lived in the household of the Index case and were admitted to North Shore Childrens Hospital under the Medicaid program. Strongly suspected cases of Tuberculosis are reported to the Board of Health right away so appropriate follow-up can begin immediately. Sometimes it can take weeks before a confirmation of the TB diagnosis is established or a revocation of the diagnosis is made. One of the cases reported as probable TB earlier this month has been changed to actinomyeosis, which resulted from dental abcsesses draining into the lungs causing infection and lung changes. The other reported case its a suspected Tuberculosis infection in a chronically ill person with other conditions. The usual length of hospitalization is now about 5 days in which testing is • done and the person placed on at least two Tuberculosis medications. Most often the medications are: INH (Isoniazid) , Rifampin, and EMB (Ethambutol ) for 9 to 18 months. The Public Health Nurse makes home visits for nursing assessments especially for any medication side effects, general health teaching and family support. As long as a person with Tuberculosis continues with his medication and treat- ment plan, he is no longer infectious and can return to work when feeling better and given a letter from the physician. No person can loose his job because of compliance with the Public Health Communicable Disease Protocol. The Public Health Nurse has reviewed the cases with the State Tuberculosis Supervision Nurse and Salem's Health Agent, Bob Blenkhorn, and both have been advised of the situation. I • i ADM! ISTRATION ??0?dT?1LY RF.P0R'.' DECEMBE'R 1984 i I I nrrl�vaL BITES }zr,PORTI�,� � BIOLOGICS DISTRIB17''ED A1�M,IT --- I ?)ipt,heria ,Tetanus & Pertussis 420 doses i ! BURIAL PERMTTS 56 ipth eri a-Tetanus TM (untie.r 6 y rs . ) Imnune Serum Globu'.in -__1 11 vials INTF,R11A'PI01dAL TRAVEL 3 inquiries i'P'I' T,.T CATES blasies ( Clinic use----- .on1v, - --------- . ---'- -i--------- 171 doses s ICT,",L Ci`Ii REM-.', ,�RM,! 1.:1.tR,.Measles/Mumps/r' r;e11H ------ --- __.---__---- - -- - I LICENSES & T'-P�R?,'.I'I'S I _,a;:!: $16 2.00 650 doses j Polio Vaccine ! Tetanus & Diptheria Wult use) 140 doses Tetanus Toxoid 70 doses. (�*��ol_b_��— - --- 1 1Q 90 tests Tuberculin P.P. D. �,njQ];Z 5 1f.T, 50 tests 1 "yphoid Vaccine - � 1 ---.------ ----- BALAYSE "n 1,NP OF i+L?,01'iFD FXPI?i1DL;?'i SALARY FFPOTtT: -- $82,916 $36,392.43 -- ---�4-6,523 59 FREE 13511 EXPENSE REPORT: ALLOW D MENDED _ $33,973 $33,973 $16,969.84 $17 ,003. 16 • VNAVISITING NURSE ASSOCIATION OF GREATER SALEM, INC. Ms. Linda A. Billows, R.N., M.S. Mr. Peter V. Kent Executive Director President, Board of Directors TO: Salem Board of Health FROM: Ann Dominick, R.N. , B.S. , Public Health Nurse DATE: December 1984 RE: Statistics Salmonella New Cases - 2 -- Carryovers - 6 Discharges - 1 Visits - 4 • Campylobactor New Cases - 0 Discharges - 2 Hepatitis New Cases - 0 Carryovers - 1 Visits - 2 Tuberculosis Mantoux Tests - 13 --Neg - 10; No Show - 3; Positive - 0 North Shore Pulmonary Clinic - 15 Visits - 3 New Cases - 0 Lead I - 1, Ia - 8, II - 1, III - 1 Visits - 3 Flu/Pneumonia Vaccinations • Vaccine was again offered to the Police and Fireman who may not have had the opportunity to receive it at our clinics, but no one responded. A few more home visits were made. The program is now completed. 205 WASHINGTON STREET/ SALEM, MA 01970/ (617) 745-9050 • The Public Health Nurse thinks it would be interesting to the Board of Health members to describe some of the more frequent public health nursing interven- tions in more detail than the monthly statistics indicates. Through contract between the Salem Board of Health and the Visiting Nurse Association of Greater Salem, Inc. , one registered nurse is appointed to provide the health services itemized in the contract for 28 hours a week. The hours are flexible to cover public health needs. The Visiting Nurse Agency responds to Public Health needs when the Public Health Nurse is not in the office. This month the Tuberculosis program is described. In other months other pro- grams will be highlighted. Tuberculosis follow-up, teaching, documentation and record keeping, are of utmost importance in preventing the spread of this disease. Salem is not considered by the Massachusetts Department of Public Health to be a high-risk community. The total number of TB cases reported in Massachusetts in 1983 was 389, and has dropped from 503 cases in 1982. In Salem, only 3 cases were reported in 1983. Tuberculosis is now a curable, even preventable disease; and deaths have sharply decreased because of effective medication usage and control programs. TB is not highly infectious and infection is usually from someone with unsuspected pulmonary TB. For a person to "catch" the disease, it is required to have close prolonged exposure to an infected person who is coughing out the germs into room air and these germs then need to be inhaled by a susceptible person. The lungs are most often effected by the TB germ. Diagnosis is made by finding the Tubercule 3acilli on culture, by abnormal chest x-rays, and by symptoms such as: fatigue, fever, weight loss, cough, chest pain, bloody sputum, or hoarseness♦nghtsweats. • in an effort to find infected, unsuspected tuberculosis cases,- screening clinics are offered to high-risk groups. On Tuesdays and Thursday mornings, Mantoux testing is done at the Salem VNA office. This provides Salem residents, or those who have some Salem connection, the opportunity to have a Mantoux skin test to determine tuberculosis exposure. Types of people tested are: contacts to people suspected or diagnosed with tuberculosis, health and school personnel, other high-risk people or just upon request. The test consists of injecting a small amount of P.P.D. serum into a persons forearm and observing it 2-3 days later for swelling at the site. If a certain sized swelling is noted, they are considered a positive reactor and an appointment is made for further evaluation and chest X-Ray at North Shore Pulmonary Clinic in Salem Hospital. This reaction does not mean that they have tuberculosis, but, that they have been exposed to the germ and the body has developed a response. At the Pulmonary Clinic they have an initial examination by the clinic physician and a chest X-Ray. Other diagnostic tests such as blood work, sputum cultures, and other X-Rays may be ordered. A person may be placed on one or several medica- tions. The physician indicates each person's treatment plan based on their individual needs and TB protocol. A report is sent to the Public Health Nurse after each visit and she does the necessary follow-up. Follow-up appointments are made at the Pulmonary Clinic and notification sent to each person. If people do not keep their clinic appointments, the Public Health Nurse is notified and every effort is made to reach them and determine what the problem is. • Telephone contact is helpful. Leters are also sent out stressing the importance of continuing their treatment and keeping clinic appointments. Home visits are made when necessary. Our Spanish speaking nurse is available to contact the Hispanic population and sometimes joint visits are made. 4 • As part of the follow-up of TB cases, Mantoux testing is done on household and close non-household people, including work sites if necessary. Boards of Health in other communities are notified if contacts live there. Repeat Mantoux tests must be done on all these contacts, because sometimes they may have a delayed reaction. Every effort is made to find out why this person has developed tuberculosis. The person with tuberculosis, their family, and associates need much health teaching and support. The Public Health Nurse also responds to requests from the community for information and from tested individuals who want reports of their Mantoux tests, and are constantly monitored. The Mass Department of Public Health is constantly monitoring the extent of the tuberculosis disease and assessing the effectiveness of medication usage and control programs. Changes are made which affect local programs and are implemented in our program. We maintain records on the hundreds of people who have passed through any of our Tuberculosis programs. In fact, the public health nursing program takes up quite a bit of space in the VNA office. The Public Health Nurse is also greatful to the administration staff for their support to the program. f • i • I I I i I 1 r General Nuisances AUMTNIST;RAT-ION MONTIfLY RFPOR`.0 NOVEMBER 1984 ANIMAL BITES, REPOWE'D -0- PIOLOGICS _DISTRIR.(71 ED ANIOTP1T - ---- 1, j,rh�ria,Tetgnus t Pertussis Aoses i 49 r7i Poi er.i a.-Tetanus Tox. (tinder 6 y rs.) - ; ! _ ASTS— _ ._....._..._ ` BURIAL PERT 58. . vials �m mUne. Serum Globulin INTERNATIONAL TRAVEL 4 inquiries CFRTIFICATEs (CFRTIT'IFn) Measles'` (Clinic use - ----- y� ---- - —.--------- ------- ---- 50 doses 1•'tdR 1�e.Asles:/1•fumps/Rubella TOTAL, CASH RECEIVED FROM -0- - LICENSES & PERMITS ISSUE _ —24 0 dose s .Polio Vaccine 'Yet anus : & :Dipth eri'a (adult use) 110. doses 70 doses Teta us"' - - ----- 1 ML. 10. tests A _tm Tuberculin 'P.P.D. �Mftn ?XZ_ 5 MI, 50 tests q rphoi'd,'Vaccine - ALLOWED EXPENDED TO ENT) OF FISC," `ALARY REPORT: $82,916.00 $30.,819.88 $52,096.12 - EYPF.NSE REPORT: ALLOWEDEXPE1dDED FR1;E CASH (includes) S35,600 $12,328.20 $21,644480 1600.00..Transfer - 1,627. 27.00 Perm.Rebate 31,973 • VISITING NURSE ASSOCIATION OF GREATER SALEM , INC. Ms. Linda A. Billows, R.N., M.S. Mr. Peter V. Kent Executive Director President, Board of Directors TO Salem Board of Health FROM: Ann Dominick, R.N. , B.S. , Public Health Nurse DATE: November 1984 RE Statistics Salmonella New Cases - 0 Transfers - 2 1 case moved from Beverly to Salem and 1 case Salem Health Facility - Lynn Resident Carryovers - 6 • Discharges - 1 Campylobacter New Cases - 1 Carryovers- 2 Discharges- 1 Hepatitis New Cases - 0 Carryover - 1 Tuberculosis Mantoux Tests - 24 Negative - 23 Positive - 1 North Shore Pulmonary Clinic - 14 Home Visits - 4 New Cases - 2 Case histories, contact screenings and Epidemiological investigations are being done on the two new cases of Tuberculosis. Flu Shots • Home Visits - 5 We have a limited number of doses of Flu & Pneumonia vaccine available for homebound people. 205 WASH INGTON STREET/ SALEM, MA 01970/ (617) 745-9050 f -2- • Lead 2 elevations - One child had a normal venous and other child will be retested by means of a venous blood sample. St. Joseph's School Immunization records have been checked and the report sent to the State. There were no exclusions from school. Hearing tests have been started and will continue into December. • I - ��■�.��■■��■ ■ ��■ nos AIi,t.miIST RAT ION MONTHLY REPORT OCTOBER 1984 I?IOLOGICS. DISTRIBI- P. — AflOilr(T L. ANIMAL BITES REPORTED 1 resident ?',9pkheria,Tetanus h Pertussis 47 doses Diptheria-Tetantis Tox. (under 6 yrs. ) j BURIAL PERMITS 46 :LMmune Serum Globulin 8 vial G � INTF.PNATIONAL TRAVEL CERTIFICATES' (CERTIT'IED) ' eFa?es —Clinic use 1•''1R--1?ecisles/Mumps/Ruhe.l,le __— 140 doses' TOTAL-.CASH RECEIVED PRO14 `------ — LICENSES & PFRMITS ISSITED $112.00 Polio Vaccine 700 doses . `?'etA.nus & Diptheria (adult use) 400 doses Tetanus Toxoid R?Z..,5-52.Lb.e�L).— _.. ... ... 1 RL 80 tests ^uberculin P.P. D. (Ma 5 14L 100 tests Typhoid Vaccine SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FIS`:'.:.. $82,916:00 $23,644.13 59 - I;XPFNSE REPORT: ALL04lED EXPENDED FREE CASH (includes ) $35,60m0 $11,268.97 $24,331.03 transfer 1,600.00 - 1,600.00 34,000.00 _ 22,7 '. (permit return) 22,704.63 VISITING NURSE ASSOCIATION OF GREATER SALEM , INC. Ms. Linda A. Billows, R.N., M.S. Mr. Peter V. Kent Executive Director President, Board of Directors TO: Salem Board of Health FROM: Ann Dominick, R.N. , B.S. , Public Health Nurse . DATE: October 1984 RE: Statistics Salmonella New Cases - 0 Transfers - 3' Carryovers - 5 Discharges - 0 . Visits - 1 . Campylobacter • New Cases - 2 Carryovers - 1 Discharges - 2 Hepatitis New Cases - 0 Carryovers - 1 Discharges - 0 TB Mantoux Tests - Neg - 35, Pos - 3, N.S. - 1 North Shore Pulmonary Clinic - 15 Home Visits - 14 Lead CL III - 1, CL II - 3, Ia - 1 • 205 WASH INGTON STREET/ SALEM, MA 01970/ (617) 745-9050 . s October was a very busy month. In addition to the usual Public Health work, the Board of Health nurse planned and implemented three flu/pneumonia • clinics. A total 1145 people received the flu vaccine and 55 people received the pneumonia vaccine. In addition, the Mass. Department of Public Health requires documentation by age group of the number of people who received flu shots. The Public health nurse responded to community questions regarding these vaccinations and distributed the vaccine to health providers upon request. Flu and pneumonia vaccine is also being given to homebound people by the Public Health Nurse. The Public Health Nurse would like to thank the many people who helped make our clinics successful: TO: Renee Lewis and her staff and senior citizens at the Council on Aging, Marcia DeCatur, R.N. , Council on Aging clinic nurse. Carol MacGown and the Housing Authority for their assistance and use of 27 Charter Street, Joanne Turco, R.N. , and her student nurses from Salem State, Dr. Rene Desjardins, Board of Health Physician, who was on site physician at the clinics. The VNA of GreaterSalem, who supported the Public Health Nurse in many ways such as: 1. Hiring Claire Bird, R.N. , who is experienced in work in flu clinics, for the three clinics. 2. Supervisory support throughout the planning and implementation. 3. Assigning staff R.N: 's to assist the Public Health Nurse in • clinics where more nursing help was needed. 4. Secretarial help, for directing the many calls about the flu clinic and performing necessary secretarial duties. The Board of Health Nurse expresses a special thank you to Ginny Moustakis, the Board oT' health Secretary, who provides her invaluable support and active participation in not only the flu clinic, but also other public health functions.: A complete report on the flu/pneumonia distribution will be available at the end of the year. �.� iiiiiNii�ii'eiiuiiesi��n is ADhRTA1IST RAT ION MONTHLY REPORT SEPTEMBER 1984 BIOLOGICS DISTRIB=.D AMOTPIT ANIMAL BITES REPORTED 5 f Di ptheria,Tetanus & Pertussis 620 doses 60 niptheria-Tetanus Tox. (under G yrs. ) BURIAL PERMITS Imnune Serum Globulin __ --� INTERNATIONAL TRAVEL 1 inquiry CERTIFICATES (CERTIFIED) 'ieasl.es (Clinic use only)---- —___— —_ -- 1•R•�P,--P4ensles/1dumps/Rubel2.ri 1 .. doh__ I TOTAL CASH RECEIVED PRO14 LICENSES & FR1QI`PS ISt;IR?1;' None Polio Vaccine 264 doses Tetaniis & Diptheria (adult use) 280 doses Tetanus ToxoidQr_b .�- 1 mL 40 10-tes is Tuberculin P.P. D. (Ma_alm 5 1�L, - Typhoid Vaccine SALARY REPORT: ALLOWED,, EXPENDED BALANCE TO END OF $82,916.00 $18,131.53 $64,784.47 ',EXPENDED F'R1?E (:(1�S?i ( inc]_�rdes) FI�r•1;,,,;,�. ::. EXPENSE REPORT:. ALLOI-TED -- - $35,600.00 $8,434.27 $27,165.73 VISITING NURSE ASSOCIATION OF GREATER SALEM , INC. Ms. Linda A. Billows, R.N., M.S. Mr. Peter V. Kent Executive Director President, Board of Directors To: Salem Board of Health From: Ann Dominick, R.N. , B.S. , Public Health Nurse Date: September, 1984 Re: Statistics Salmonella New Cases - 3 Carryovers - 5 Discharges - 3 visits - 4 Campylobacter New Cases - 1 Carryovers - 5 Discharges - 3 Giardiasis Discharges - 2 Meiringitis viral - 1 - Discharged H. Flu - New Case - 1 Discharged - 1 Hepatitis New Case - 1 Discharges - 1 TB North Shore Pulmonary Clinic - 16 Mantoux Tests - North Shore - 1,. Neg - 8, Positive - 1 (Neg chest X-ray) Lead • II-3 Flu Clinic at Charter St - 320 Doses Flu Clinic at Council on Aging - 408 doses ?nr. WACNIP1(;Tr)PJ CTRGC=T / GAI FHA AAA 0107rl / 19171 74r,_00rr1 i s J Wi Two Flu -Pneumo clinics were held the month of September. Over seven hundred • people attended the clinics. There will be another clinic on Thursday - October 18 from 10 - 12 at the Council on Aging. Dr. Desjardins administered most of the Flue shots, assisted by Salem State students and their instructor, the Public Health Nurse and Salem VNA nurses and volunteers from the Council I on Aging. i I The Public Health Department recommends the flu vaccine for those over 65 years j of age and people having chronic illness and people in. crowded situations and ! essential occupations most likely to contract the illness. This year there are I two new variations of the (Chile & USSR) yearly immunizations are needed. The pneumovax is also recommended for high risk people and one shot provides permanent immunity. I i I I i ENVIRONMENTAL HEALTH DIVISION MONTHLY REPORT _ar) (month) itar Code Enforce F' j 2 3 4 5 6 7 8 9 0 11 2 13 14 15 16 17 18 19 2 ) 21 22I23 24 25 6 � 27 28 29I30 31 TOI. Food Service Com 1. i �T-- _ -ood Service Insp. mobile Food Serv. --! - letail Markets Housin -Ori inal No Heat/Hot Water 1 f . General Nuisances v _ Day Care Centers Day Camps J0. Swimming Pools t-- Beaches 12 . Water/Air/Noise A. SESD-Observation - SESD-Com laints Rodent Control Lab Testing Field Testing 1.Lead Testing 2 .Perc. Test for Sew. System Licenses & Permits ' 9 . Court Hearings _' D. Off. Consultation I ` ` Sessions ( 1 1 . Referrals to and =rom Other Depart. Housing Reinspect. =� . Food Serv. Com 1. Letter-Orders To Owners; Reports Investigations `�. Surve (Market/Rest), Meetings 17 ADMTNISTRATION MONTHLY REPORT AUGUST 1984 BIOLOGICS DISTRIBI?TED Ab10171T I ANIMAL BITES REPORTED 12 Diptheria,Tetanus Ic Pertussis 420 doses Diptheria-Tetanus Tox. (under 6 yrs. ) - BURIAL PERMITS 62 Immune Serum Globulin - INTERNATIONAL TRAVEL 1 inquiry CERTIFICATES (CERTIFIED) 1leasles (Clinic use onl. f.fTR 14easles/Mumps/Rubella 800 doses TOTAL CASH RECEIVED FROM $330.00 LICENSES & PERMITS ISSUED 30 doses Polio Vaccine Tetanus & Diptheria (adult use) 110 doses Tetanus Toxoid ab s Q rb,Q d 117 doses 1 14L 50 doses _Tuberculin P.P.D. mot 5 ML Typhoid Vaccine i CALARY REPORT: ALLOWF'D EXPENDED BALANCE TO ENT) OF FISCAI, $82,916.00 $12,618.93 $70,297.07 _ EXPENSE REPORT: ALL OLI D EXPENDED F'R1,E ('ASH ( includes) E?iCllh �F' 'i 34,200.00 $35,600.00 $5,795.86 $29,804.14 ,.01 + 1,4004,)00 (VNA) 35,600.00 VNAVISITING NURSE ASSOCIATION . OF GREATER SALEM , INC. Ms. Linda A. Billows, R.N., M.S. Mr. Peter V. Kent Executive Director President, Board of Directors MONTHLY STATS-AUGUST Salmonella GIARDIASIS New Cases - 0 New Cases 1 Carryovers - 6 Carryover - 1 .Discharges - 1 Visits - 2 Compylobacter MENINGITIS New Cases - 4 Viral - 1 Carryovers - 1 Discharges - 0 Visits - 0 • Hepatitis New Cases - 0 Carryovers - I Discharges - o Visits _ p T.B. North Shore Pulmonary Clinic - 17 Mantoux Tests - 20 Misr 1 Neg - 16 Retest - 3 New Cases - 0 Lead Ia - '1, Ib - 1 205 WASHINGTON STREET/ SALEM, MA 01970 / (617) 745-9050 ,� =�sa�e`w°==i==iin=�=iiiii��is��s� ��i�iiii�ii�i�i�iii�n��ga ADMTNISTRATION MONTHLY REPORT JUNE 1984 BIOLOGICS DISTRIBITI ED AMOUNT � ANIMAL BITES REPORTED 8 resident' Diptheria,Tetanus P,. Pertussis 360 doses Diptheria-Tetanus Tox. (under 6 yrs. ) -- I BURIAL PERMITS 48 Imune Serum Globulin 12 vial INTERNATIONAL TRAVEL, CERTIFICATES (CERTIFIED) C Measles Clinic use on l.y_________`__________.___ t•?TTR--ITeasies/idumps/Rubella 115 doses TOTAL CASH RECEIVED FROM LICENSES & PERMITS ISSMIM $519.00 Polio Vaccine 190 doses) Tete.nus & Diptheria (adult use) 210 doses Tetanus Toxoid—(EL 310 doses 1 ML 60 tests - Tuberculin P.P. D.—�? �141�x) 5 ML yphoid Vaccine SALARY REPORT: ALLOWEDEXPENDED BALANCE TO TENT) OF FISC(•.T_ $82,983.00 $80,118.08 $2,864.92. __ -. EXPENSE .REPORT: ALLOUED EXPENDED FREE, CASH (includes) $35,587 A5 $35,382.93 $204.22 • VMVISITING NURSE ASSOCIATION OF GREATER SALEM , INC. Ms. Linda A. Billows, R.N., M.S. Mr. Peter V. Kent Executive Director President, Board of Directors TO Salem Board of Health FROM: Ann Dominick, R.N. , B.S. , Public Health Nurse DATE: June, 1984 RE STATISTICS Salmonella New Cases - 2 Carryovers - 1 Discharges - 2 Visits - 2 • Hepatitis New Cases - 0 Carryovers - 1 Discharges - 0 Visits - 0 TB North Shore Pulmonary Clinic - 12 Mantoux Tests - 14 Negative - 12 Positive - 2 Referrals to NSPC - 2 New Cases - 1 Visits - 4 Lead Ia - P Ib - 1 II - 2 St. Joseph's School Screenings were completed. A Salem VNA physical therapist rescreened the students who failed the initial Postural Screening, this resulted in a few physician referrals. Other referrals were also made for • Vision and Hearing Deficits. �- .�N -2- • Sharon Carter, a registered nurse in charge of the lead poisoning program for the State Department of Public Health's Northeast Regional Office, visited us this month. She presented the current state lead program and the role of the Public Health Nurse in preventing the serious health problems for lead poisoned children. Sharon receives reports on all elevations and when contacts the child's physician regarding the appropriate follow-up. If the initial test was a fingerstick test then a venous test is requested within three weeks for confirmation of the elevation. State home inspectors are notified of elevations and they visit the child's home and test the paint for lead and explain what needs to be done to the environment. Sharon stressed that one of the most important functions of the local Public Health Nurse is Education and Education to the individual family and to the community. The VNA's Spanish speaking nurse, Erlinda Schweller, also attended the discussion. She has been very helpful in assisting the Hispanic population with medical and educational follow-up. Arrangements were made with North Shore Children's Hospital to offer another lead screening clinic this month at the Point Community Health Center on Congress St. North Shore Children's Hospital's lab technician, Jean Mazzola, and Mrs. Schweller, screened 15 children. Two children were referred for venous. confirmation. The Public. Health Nurse will follow up if elevated and coordinate with Sharon Carter at the Regional Health Office. On June 11, 1984, a discussion regarding reporting communicable diseases from the Emergency Service at Salem Hospital was held with their Nursing Supervisor, Martha Rooney, and some of her staff. The Public Health Nurse presented the • reporting requirements. Discussions were had regarding the most efficient ways of meeting those requirements. On the same day a similar discussion was held with Nursing Supervisor, Mary Alyard of the Out Patient Department. It is anticipated that ongoing .communication with Salem Hospital- will facillitate the reporting mechanism. • . : 'ivio�iiiii�' io ■�iriac� AI�MTNI�ST RAT ION MONTHLY REPORT MAY. 1984 _...._...._.._.__—.._ I ANIMAL BITES REPORTED - none BIOLOGICS DISTRIBUTED AMOUNT Diptheria,Tetanus & Pertussis 290 dose 51 Dipth eri a-Tetanus Tox. (under 6 y rs. ) BURIAL PERMITS Immune Serum Globulin 8 vial _ INTERNATiONAL TRAVEL none CERTIFICATES (CERTIFIED) Measles (Clinic use only-L_Measles — -- PdMR--Measles/Mumps/Rubella 30 dose TOTAL CASH RECEIVED FROM LICENSES & PERMITS ISSUED $ 111.00 Polio Vaccine -. 220 dose Tetanus & Diptheria (adult use) 110 dose Tetanus Toxoid (abs.orb��, 80 dose 1 ML 100 test Tuberculin P.P.D. (hSaou 5 IQ, 250 test Typtzoid Vaccine -- SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL $82,983.00 $72,858.03 $10 124.94 — EXPENSE .REPORT: ALLOWED EXPENDED FREE CASH (includes) EPiCLi;•`RFR ' $35,587.15 $32,898.51 $2,688.64 ENVIRONMENTAL HEALTH DIVISION MONTHLY REPORT :ear) (wont ) �anitary Code Enforce 1 2 3 4 5 1 6 7 8 9 110 111 12 1131 14 15 16117118 119 12)121122123 124 :25 6 127 28 29 30 31 TOTAL 1. Food Service Com 1. 3 2 '/ 2. Food Service Insp. - 3. Mobile Food Serv. 5 . Retail Markets I -- 3. Housing-Original No Heat/Hot Water - -� - . General Nuisances I I 1 I I Z 2 I I e � E Day Care Centers 9. Day Camps 10. Swimming Pools L 11. Beaches e 12. Water/Air/Noise c - 13. SESD-Observation 14. SESD-Complaints �. 15. Rodent Control a 16. Lab Testing 0 17. Field Testin , ! 1.Lead Testing ' 2.Perc. Test for p Sew. System 18. Licenses & Permits 19. Court Hearings / I -- 20. Off. Consultation 2 Sessions 21. Referrals to and from Other Depart. — 22. Housing Reinspect. 23. Food Serv. Com 1. I 0__ 24. Letter-Orders To 2 I r , / Z Owners; Reports 25. Investigations / ! 3 / 2 I I 17 26. Surve (Market/Rest), C— 27. Meetings i r VISITING NURSE ASSOCIATI JUN 4 1984 OF GREATER SALEM , INC. ci,1.y 1,EALTH L!;PT. Ms. Linda A. Billows, R.N., M.S. Mr. Peter V. Kent Executive Director President, Board of Directors TO . Salem Board of Health FROM: Ann Dominick, R.N. , B.S. , Public Health Nurse DATE: May, 1984 RE STATISTICS Salmonella New Cases - 0 Carryovers - 3 Discharges - 1 Visits - 0 Hepatitis • New Cases - 1 Carryovers - 1 Discharges - 1 Visits - 0 TB I North Shore Pulmonary Clinic - 23 Mantoux Tests - 14 Neg. 12 Pos. - 1 Retest - 1 Referrals to NSPC - 1 New Cases - 1 Visits - 14 Lead I- Ia - 2 Ib - 1 II - 5 North Shore Children' s Hospital in conjunction with Erlinda Schweller, bilingual nurse at Salem V.N.A. , held a lead screening clinic at the Point Community Center on May 22, 1984. Fourteen children were screened with one elevation. 205 WASH INGTON STREET/ SALEM, MA 01 970 / (61 7) 745-9050 Hypertension • • Screening of City Employees continued in May at the Police Department and City Hall for municipal employees. St. Joseph's School Postural screening was offered to Grades 5 and 7. Vision and hearing testing and retesting continued this month. A health presentation on hypertension was presented on station WESX. A cancer report will be presented at the June Board of Health meeting. • ADMIIlISTRATION MONTHLY REPORT APRIL 1984 -� I � 4 residents - 2non-residents BIOLOGICS DISTRIBUTED AMOUNT ANIMAL BITES REPORTED Diptheria.,Tetanus & Pertussis _. ---- _ ------- - _ ----- 1100^_.dose_s - Diptheria-Tetanus Tax, (under 6 yrs. ) BTJRIAL PERMITS 69 Iffl-mune Serum Globulin 25 vials 5 inquiries INTERNATIONAL TRAVEL CERTIFICATES (CERTIFIED) Measles (Clinic use only) l•!MR--Ideusles/Mumps/Rubella 110 doses TOTAL CASH RECEIVED FROM $285.00 LICENSES & PERMITS ISSUED Polio Vaccine 270 doses . Tetanus & Diptheria (adult use) 150 doses Tetanus Toxoid s _ ... _._.__._... 1 ?'ff 120 10-tests Tuberculin P.P.D. (Mantoua 5 14 Typhoid Vaccine --- SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL $82,983.00 $67,005.05 $15,977.95 EXPENSE REPORT: ALLO�TE,D EXPENDED FREE CASH (includes) Ell CTT,.�3ERF $35,587.15 $.30,430.62 $5,156.53 • VNAVISITING NURSE ASSOCIATION OF GREATER SALEM , INC. Ms. Linda A. Billows, R.N., M.S. Mr. Peter V. Kent Executive Director President, Board of Directors To: Salem Board of Health From: Ann Dominick, . . ,RN B.S. ,Public Health Nurse i MAI 4 W4 Re: April 1984, Monthly Report CITY OF SALEM HEALTH DEPT. Salmonella New Cases - 1 Carryovers - 2 Discharges - 0 Visits - 6 Follow up continued on two related Salmonella cases. These cases • involved contacts who were food handlers in local establishments. They were excluded from work until it was confirmed by laboratory tests on 2 stool specimens that they were no longer infectious. It is also important that these food handlers have no further contact with the cases until they are no longer communicable. A Home Health Aide was also excluded from work because of her contact with food preparation for a patient. We have received laboratory reports that one of these cases is cleared with 2 negative stools and we are awaiting results of a possible second negative stool on the other. No spread of this illness has been reported to the Salem Board of Health. Investigation by the State Department of Public Health and the Board of Health of the source city has resulted in changes in the operation of the food establishment. Hepatitis New Cases - 1 Carryovers - 3 Discharges - 4 Visits - 6 The Hepatitis investigation of a Salem food handler resulted in immune globulin administration to all employees by the Salem Hospital Emergency Service and improved cleanliness of the site • 205 WASHINGTON STREET/ SALEM, MA 01970/(617) 745-9050 i -2- • after a visit by the sanitarian and the Public Health Nurse. No new cases have been reported as a result of this case. TB NSPC visits - 20 Mantoux tests - 15 Neg. - 13 --- Pos. - 2 Referrals to NSPC - 2 This month a Salem resident, strongly suspected to have active Tuberculosis, was admitted to Salem Hospital under the State TB program. In this area, Salem Hospital is the site designated by the state for TB beds for the Diagnosis and Treatment of Active Tuberculosis patients under the state program. A Board of Health official for the town/city in which the person resides is requested to sign. the Application form for Hospital Admission of a Tuberculous patient_,to a state TB bed. This means that the town/city and the state are jointly (50-50) responsible for hospital charges over and above what the TB patient's insurance will pay. In this case, Medicare will probably cover most if not all of the;'hospital expenses. In addition, her laboratory report came back negative for TB. Lead • I - 2, Ia Linda Schweller, a bilingual nurse on the staff of the. Salem Visiting Nurses, has been most helpful to the Public Health Nurse in her follow up of infectious diseases and lead elevations in the Hispanic population. Not only is she invaluable in translations, but also for her knowledge of the families and the Hispanic culture. Salem Hospital's Infection Control Nurses and Dr. Hagele, Director of Emergency Services have been most cooperative in supplying necessary information. . Hypertension Screening was offered to Salem Firemen and Policemen. This will continue for city workers as time allows. • i�iin�iiiiiiii�ii�i�i��ii i�iaR ANITNISTRATION MONTHLY REPORT MARCH 1984 ANIMAL BITES REPORTED 3 residents — BIOLOGICS DISTRIB(,TED AMOUNT --- ZL. - - - tj Diptheria,Tetanus & Pertussis 270 doses � BrIRIAL PERMITS Diptheria—Tetanus Tox. (under 6 yrs.. ) --- IM.mune Serum Globulin 10 vials II.ITERNATIONAL TRAVEL 6 inquiries i CERTIFICATES (CERTIFIED) t•"easles (Clinic use only) --- T.2fi?--Me as1es/Mumps/Rub ella 40 doses TOTAL, CASH RECEIVED PRO14 LICENSES & PERMITS ISSUED $309.00 Polio Vaccine 210 doses Tetanus & Diptheria (adult use) 80 doses _ _Tetanus Toxoid (Absorbed) 30 doses ---- ----. . 1 14L 20 tests Tuberculin P.P.D. Ma 5 M Typhoid Vaccine SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL $82,983.00 $61,141.09 $21,841.91 EXPENSE REPORT: ALLOVTED EXPENDED FREE CASH ( includes) EPICiiF!I??? $34,200.00 $26,986.33 $8,600.32 + Transfer 492.15 + Transfer 895.00 35'3$T E5 • nns�o�nn-��n��n��s�n�n�oan�o�� r VISITING NURSE ASSOCIATION OF GREATER SALEM , INC. Ms. Linda A. Billows, R.N., M.S. Mr. Peter V. Kent Executive Director President, Board o/ Directors April 6, 1984 To: Salem Board of Health From: Ann Dominick, R.N. , B.S. , Public Health Nurse Re: March, 1984, Monthly Report Salmonella New cases - 2 Carryovers - 3 Discharges - 2 Visits - 6 Hepatitis • New cases - 2 Carryovers - . 2 Discharges - 1 Visits - 3 TB NSPC visits - 32 Mantoux Tests - 15 Neg. - 12 No shows - 3 Lead I - 1, Ia - 3, II - 3 The Salmonellosis investigation involved coordination with other Health Departments to trace the source of the disease and to prevent further spread through food establishments. Many specimen bottles were distributed by the Public Health Nurse. These will be sent to the State laboratory for processing. A referral was made to our Board of Health Sanitarium to investigate a food establishment as part of a Hepatitis follow up. All employees obtained gamma globulin to protect them from developing the disease. Visits were made to • 205 WASHINGTON STREET/SALEM, MA 01970/(617) 745-9050 I r -2- �\ St. Joseph's school to continue with testing, and heights, weights, • Pedicolosis checks are done as needed. Enclosed with this report are copies of the letter distributed to area physicians and health facilities and enclosures. • • �_ 0 • � . ADMTNISTRATION MONTHLY REPORT FEBRUARY 1984 BIOLOGICS DISTRIBL7iED AMOUNT I ANIMAL BITES REPORTED ' 0 ^Diptheria,Tetanus & Fertussis w 340 donor;: Diptheria-Tetanus Tox. (under 6 yrs. ) == I BURIAL PERMITS ' 2 validations -Z/r' mune Serum Globulin 35 visls INTERNATIONAL TRAVEL 3 inquiries CERTIFICATES (CERTIFIED) Ale as 1 es Clinic use 1•�1•[R--14easles/Mumps/Ruhe]_la 80 doses TOTAL CASH RECEIVED FROM -' LICENSES & PERMITS ISSUED $934.00 350 doses . Polio Vaccine Tetanus & Diptheria (adult use) 140 doses _ __ Tetan�Ls Toxoid (a�1 �� 360 doses - 1 is 1 10-test vial 5 1� 2 50-test vial Tuberculin P.P. D. Man Typhoid Vaccine -- SALARY. REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL $82,983.00 $53,788.10 $29,194.90 FREE CASH ( includes) E"1('�,r,•`j` ; '• EXPENSE REPORT: ALL0--ED EXPENDED $34,200.00 $23,641.47 $11,050.85 - �anre��no�o��n�a�r��n��n�n - iiiii6iis'eiiiiin i�is'ii��i� �.� ai0iuoiioiinniiviiiii::�o's�i� i i VISITING NURSE ASSOCIATION OF GREATER SALEM , INC. Ms. Linda A. Billows, R.N., M.S. Mr. Peter V. Kent Executive Director President, Board of Directors TO Salem Board of Health VM FROM: Ann Dominick, R.N. , Public Health -Nurse RE . February 1984, Monthly Report Salmonella Incidence - 0 Prevalence - 5 Campylobacter Incidence - 2 • Prevalence - 2 TB Incidence - 3 Prevalence - 8 Mantoux Test - negative - 21 positive - 4 Home Visits - 2 (referral to NSPC) Hepatitis Incidence - 3 Prevalence - 4 Home Visits - 6 Lead Class III Class II Class Ia Class Ib Incidence - 0 Incidence - 1 Incidence - 0 Incidence 0 Prevalence - 1 Prevalence - 5 Prevalence - 4 Prevalence 26 Immigrants - 2 Meningitis • Incidence - 1 Prevalence - 1 Home Visit - 1 St. Jose-ph's School - hearing screening completed on all grades - will retest failures and absentees in March. A Al tl'7C_L I a 1 71 7A 9Z_0nXZn - . In February, a case of Meningococcal Meningitis was reported to the Board of Health Nurse. Because of the urgency of immediate follow-up, this was reported by telephone. On the day of the onset of symptoms, the child had been in a day care center (not in Salem), that had contacts in 20 North Shore cities and towns and family contacts extending to New Hampshire. The Public Health Nurse contacted the Director of the day care center who then reached their 46 contacts. These people, as well as 11 other contacts, were in touch with their private physicians and most were given Rifampin within 24 hours of the original report. Everyone was very cooperative, including assistance from a teacher/trans lator:in the Salem School Department. The Public Health Nurse was in consultation with the State and Regional Health office. This disease was confined to this one case. Meningococcal meningitis is an acute bacterial disease characterized by sudden onset with fever, intense headache, nausea and often vomiting, stiff neck and frequently a rash. Delirium and coma may also appear. With early diagnosis and treatment the fatality rate is less than 10%, however, the disease can progress very rapidly and may not be recognized soon enough. Meningococcal infections are transmitted by direct contact, including discharges and airborn droplets from the nose and throat of infected persons more often from carriers than cases. It usually causes only an acute nasopharygitis or infection without obvious symptoms. It is rare to see such a severe case as this child had.' • Education on good personal hygiene and maintaining good general health habits reduces the risk of this and other communicable diseases. Good hand washing practices is an excellent barrier to inhabiting the spread of infection. ADMINISTRATION MONTHLY REPORT JANUARY 1984 ^^ BIOLOGICS DISTRIBUTED T I ANIMAL BITES REPORTED @ 2 Residents - 1 Non-resident i --- AMOUNT _ Diptheria,Teta,bus, & Pertussis i --.-..------------T-----_--------=-'------. __ _-_ -.______ .-4flQ-,-_-_rinses._ Di theria-Tetanus Tax. (under 6 yrs BURIAL PERMITS 49 P Y -Immune Serum Globulin 2 vials ' INTERNATIONAL TRAVEL 2 inquiries _ CERTIFICATES (CERTIFIED) Measles .(Clinic use only-Z-_-___ P1MR--Measles/Mumps/Rubella -_ 120 . .. doses TOTAL CASH RECEIVED FROM $3,790600 -_" LICENSES & PERMITS ISSUED Polio Vaccine 444 doses Tetanus & Diptheria (adult use) 120 doses Tetanus Toxoid (absorbed) 30 doses 1 14L 210 doses Tuberculin P.P.D. Mato 5 14L 600 doses Typhoid Vaccine - SALARY. REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL $82,983.-00 �'$47,924.14 $35,058.86 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (includes) ENC[RT1,FRU $34,200.00- $20,418.78 $14,273.37 b C ( 4 ENVIRONMENTAI: HEALTH DIVISION MONTHLY REPORT pflU� .Y l �anrta 3frle-a Enforce: 12. .3' 4 5`' 6 7 8" 9• 0 11 2. 13 14 15 .16 17 18 19 12-3 21122 .23 24 ' 25 . 6 27', 28 2� 31 TOTA 2. F e i '; 8 ondues � ces,. Z t y t � • 3 l�obi�e�� obdSe , 4: Retail,,Matkets A t 5: HousiAil WWI tY T: OX 10. $wimmia I. Beaches,-` 5 R 12.: Watet'/Ait Noise 13:>,SESD-Observation 14: :SESD=Co hints 15.: Rodent`Control., 4 16. :Lab Testin 17 Field Testii l 1.Lead.>Testia Test ,lfor ! stems 18. Licenses: =::Permits •19 X:Court�'Aeaiii s .x�,�: - - �Of Qf�.�;jCoasultat�oa e ...A•b.3! f�t—Ssessioas_ i','�RNd� G .21 Referxal$ from°BtTiera:De art:. t M. fs �4 kLett ep-Orders To 25 *ZTieBLY atiousa , ?6.,aSuive rkety/Rest a { 2.7 M , t s y5lN Rq:`.3. v,_' v�i°Y•� !,�'q,Ys+p Y Y. '_, . rv' ._ t i Eri r - I VMVISITING NURSE ASSOCIATION OF GREATER SALEM , INC. Ms. Linda A. Billows, R.N., M.S. Mr. Peter V. Kent Executive Director President, Board of Directors TO . Salem Board of Health FROM: Ann Dominick, R.N. , Public Health Nurse RE . January 1984, Monthly Report I i i This month, much Public Health Nursing effort was directed towards improving the communication of Communicable Disease reports and facilitating release of essential patient infor- mation to the Public Health Nurse who must meet state mandated follow-up protocol. A meeting with hospital personnel and the Public Health Nurse was held on January 16, 1984 at Salem i Hospital in response to the Public Health Nurse's concerns. j The following hospital personnel were present and agreed to work towards the solution of this problem: Mary Beth Brouillard, Director Medical Records Dr. Herbert Hagele, Chief Emergency Service Susan MacKenzie Dube, Assistant Director for Clinical Services Attorney David Wright, Hospital Lawyer I Linda Saunders and Veronica Shaw are also assisting through the Infection Control Committee. See the attached letter that was sent to the hospital summarizing the results of this meeting. • Dr. Hagele has been in touch with Dr. Fuimara and has issued a notice to Emergency Service Physicians, (See Enclosure) , and expects to see a 205 WASHINGTON STREET/ SALEM, MA 01970/(617) 745-9050 ,,age 'itao e- • rise in Communicarle Disease reports through the Emergency Service in February. In January the Board of Health did not receive any reports from Salem Hospital. In February, Dr. Reines and the Public i Health Nurse will send out a similar letter to area physicians and health facilities. I The Public Health Nurse discussed the current state position on pre- mature baby follow-up by the local boards of health with Dr. Wini Lewis, Director for Premie Information in the State Department of Public Health. Salem Hospital is reporting premature births direct- ly to the state. There is no longer mandatory follow-up by the local Boards of Health. It is a decision of each local board to determine the extent of their involvement. Referrals for direct nursing inter- vention can be made to the Visiting Nurse Associations. See the December 22, 1983 directives from Commissioner Bailus Walker. Salmonella Active Cases - 7 New Cases - 2 Discharges - 5 Home Visits - 7 Office Visits- 2 Hepatitis Active Cases - 3 New Cases - 1 Discharges - 2 Home Visits - 1 Tuberculosis Mantoux Tests - 2.2 Negative - 20 Positive - 2 (referred to North Shore Pulmonary Clinic) • New Cases - 2 North Shore Pulmonary Clinic - 18, No Shows - 13 Most of the no shows were in the Hispanic Neighborhood and the Public Health Nurse will follow-up with the bilingual nurse. P f Page Threc,y Tuberculosis cont. • Tuberculosis Home visits - 5 St. Joseph's School - hearing tests are in progress Lead Ia - 2 • • 'l3 _111 �0 `'AF��MINB IA�a CITY OF SALEM HEALTH DEPARTMENT BOARD OF.HEALTH Salem, Massachusetts 01970 ROBERT E. BLENKHORN 9 NORTH STREET HEALTH AGENT (617) 74 1-1800 February 7, 1984 Mary Beth Brouillard Director Medical Records Salem Hospital Salem, MA 01970 Dear Mary Beth, T would like to thank you for your prompt response to my request for assis- tance in obtaining recgizired Communicable Disease documentation on Salem residents treated at Salem Hospital. You shared my concerns and immediately • arranged for meeting with key hospital personnel to discuss this situation on January 16, 1984. Just a brief review of this meeting follows. The Public Health Nurse, Ann Dominick, presented the difficulties she has encountered in obtaining laboratory and other information necessary to com- plete state docu pntation requirements in follow-up Communicable Diseases. She also expressed her concerns that all reportable diseases may not have been reported to the Board of Health. During her investigations of a few Hepatitis cases she became aware of several current unreported Hepatitis cases who had been seen at Salem Hospital or treated by physicians connec- ted with Salem Hospital. A revised list of reportable Comrninicable Diseases was presented. The State Department of Public Health is currently reviewing the list of diseases and will issue a final list as soon as possible. A copy of Dr. TAiimara's directive to Hospital Superintendent and Record Room Adminis- trators concerning availability of Patient Records to local Health Departments was also distributed. The Public Health Nurse in conjunction with Dr. Fsric Reines, a member of the Salem Board of Health., will draft a letter to area physicians and medical facilities regarding these concerns. Susan MacKenzie Dube, Assistant Director for Clinical Services and responsible for quality care, will look into the matter further and assess how the hospital can best communicate the needed information to. the Board of Health. Mrs. D1ibe also offered her assistance to the Public Health Nurse to facilitate public health follow-up and to keep the Public Health Nurse advised of hospital pro- gress in resolving this issue. • • Dr. Herbert Hagele, Chief of Effergency Service, will. review the Conmmicable Disease reporting system used in the Fb-ergency Service and its interrelation- ship with other hospital departments. David Wright, the hospital lawyer, expressed his concerns for patient confi- dentiality and will not recommend Board of Health access to patient records, but encourages the Public Health Nurse to obtain this information from their physicians. Salem Hospital Infection Control Nurses, Linda Saunders and Veronica Shaw, have been most helpful in directing the Public Health Nurse through proper hospital channels and will work on this through their Infection Control Com- mittee . The Public Health Nurse thanks all the above people and other involved hospital personnel for their enthusiastic response to resolve this public health/com- munity problem. She can be reached at the Salem Visiting Nurse's Office, 205 Washington St. - 745-9050. Sincerely, Ann Dominick, R.N. , B.S. Salem Board of Health Nurse • AD/ab cc: Dr. E. Reines Michael Geaney, Jr. , Administrator Dr. Herbert Hagele, Chief, Emergency Service p' Susan MacKenzie Dube, Assistant Director for Clinical Services Veronica Shaw, Infection Control Linda Saunders, Infection Control Dr. Maurice Greenbaum, (Specialist in Infectious Diseases) Atty. David Wright i i • • MEMO TO: FROM: Ifcrbert C. M.D. Chief of the E-iner(7,ency Service DATE: January 30, 198.41 SUBJECT: REPORTING OF COJ�IMUNICABLE DISEASES The State Department of Public I-lealth is seeking our coop -r�_Ition, as individual 0 . reporting of communicable diseLs_'_S. physicians, regarding the Z in M La The list of reportable diseases is bcin(, revised; however, the only changes to C date are the deletion of Actinorny cases and the addition of AIDS, List1cria, Lyme Disease, and Yer.-inia. AIDS is reportable- directly to the Department • Of Public Health. There is major concern that A and B Hepatitis, Salmonella, and Shigella are not being adequately reported from the Salem area. These Cases require specific investigation by the Department of Public Health. All of these diseases, and animal bites, should be reported to the local Bo,-tr(I.- of Health using the cards provided. POSi-ive Gonorrhea CUItUre.S must be reported by the physician to the State Veneral Disease Clinic located at Beverly Hospital, using form. t, t`! appropriate Positve Serology results are reported directly to the Venereal Disease Clinic by the laboratory. Let us all strive for zero tolerance. This is a mandated responsibility and one that is easily monitored by the Department of Public [1_alt'n Harbert c. ll< Jr., M • ADmTNIST RAT ION MONTHLY REPOn DECEMBER 1983 D ( AMOUNT ANIMAL BITES REPORTED 3Residents 2 Non-residents 11TOLOGICS DISTRIB1 Di pf.lieria ,Tetanus '.: Pertusnis 30 I c _ . ----•-----....__...-- - - ... . _ . .... ._.... .�. _...1. .--..._.__..doses i i L' grin-T� eintu; `. os. ( ;nde; e: yrs . ) BURIAL PFRNTTS 4.6 r r, t Immune Serum Globulin61 vial ` INTERNATIONAL TRAVEL 5 inquiries CERTI FI CATFS (CFRTI T'IFD) r,'easles ( Clinic use on!-;) f•?t•1R-- ?ensles/"•iumPs/Ruhe].1.H 800 doseE TOTAL CASH RECEIVED PRO14 ---------- --- - --- =0- LICENSES & PERMITS ISSUED Polio Vaccine 243 dose TetA.nus & Diptheria (adult use) 260 dose A credit was received from. Wyeth Labs in the amount of $492.15. Tetanus Toxoid 360 dose 1 ML 5-10 test vial --Tuberculin P.P. D.-�I_` II .S2it1.1- 'I'yphoid Vaccine ;:1T,AT?Y RrPO?t'T'; AT,T,0ViFED ExplNDED BALANCE TO gran OF FISCAL $82,983,00 $41,610.00 $.41,373.00 - 1 :v1'F?;SE ItE;PG1"I': r;L].C)SII?Ti FY,I']?Pl D},D FRP,E CASH. (includes) FN('UPMF.RF.D $34 ,200.00 $1.6,41,5.82 $17 ,784,18 i- _ 492.1.5 (Wyeth Credit) 1R,276.33- • • • ENVIRONMENTAL HEALTH DIVISION MONTHLY REPORT ELI year) (month) 2 13 14 15 16 17 18 19 20 21 22 23 24 !25 6 27 28 29 30 31 TOTALS .anitar Code Enforce ' 1 2 3 4 5 6 7 8 9 0 11 / -7- / � Food Service Com 1. Food Service Insp. Mobile Food Serv. Retail Markets Housin -Ori inal No Heat/Hot Water General Nuisances 7. Day Care Centers Day Camps 10. Swimming Pools Ll. Beaches - 2. Water/Air/Noise 13. SESD-Observation SESD-Com laints 1.5. Rodent Control 16. Lab Test in 17 . Field Testing 1.Lead Testin 2.Perc. Test for j Sew. System / L3. Licenses & Permits 19 . Court Hearin s 20. Off. Consultation Sessions 21 . Referrals to and I_ from Other De art. » . Housin Reins ect. / =3. Food Serv. Com 1. 24. Letter-Orders To Owners; Re orts / 2 //// 25. Invest i ations -7_ 26. Surve (Market/Rest), -Ti/ _17 . Meetings cK,�� Div i VMVISITING NURSE ASSOCIATION. OF GREATER SAL.EM9 INC. Mr. Peter V. Kent Ms. Linda A. Billows, R.N., M.S. President, Board of Directors Executive Director I i TO . Salem Board of Health FROM: Ann Dominick, RN, Public Health Nurse RE . Decenber. 1983, Monthly Report As part of the Public Health- Nurses- follow-up of ccmmmicable diseases, contacts are made with area hospitals, clinics, physicians, laboratories, boards of health, the State Department of Public Health, the Regional • Health Office in -Tewksbury and others. A concerted effort is made to locate and inform people who need further follow-up according to Public Health regulations.:This may take several calls to the person or to those who might have pertinent information. Sometimes- it is necessary for intervention by our Spanish speaking nurse to provide general background information on the Hispanic community or specific information on families or individuals. The bilingual nurse and the Public Health Nurse work closely together to provide follow-up for non-english speaking people. She will setup appointments, interpret physician.i.nstructions and assist .the Public Health Nurse. with interviews and health teaching. r It is also necessary to be aware of the physicians treatment plan and • to coordinate our follow-up with .this plan and the Public Health Regula- tions. Herne visits are made when indicated and allowed by the person. • Much work can be done on the phone to gather documentation, however, this is not the best way to do health teaching or to encourage compliance with resistive people. Home visits are essential for environmental assessments of children with elevated lead elevations. Referrals are made to the Board i of Health Sanitarians when indicated. The Public Health nurse responds to requests that come in from the community for information on Communicable Diseases and is available for follo%%-up of people or situations within the scope of the Board of Health"Contract. Stats - December Salmonella Active cases - 12 New cases - 2 Discharges - 5 Home Visits - 6 Office Visits- 2 . Campylobacter Active case - 1 Discharged - 1 Giardiasis Active case - 1 Hepatitis Active cases - 2 (new) Discharges - 1 Hcme Visits - 2 Tuberculosis .: „ • Mantoux Clinics - 10 Negative - 9 Positive - 1 Referred to North Shore Pulmonary Clinic - 1 (negative chest x-ray) osis cont. • Fourteen people were seen at the North Shore, Pulmonary Clinic- the Public Health Nurse keeps track of who needs to be seen, makes appointment and sends out appointment letter to the person. She would follow-up on people who do not keep these appointments or our contacts. Lead Elevations: Home visits were made on two children. The bilingual nurse assisted with the Spanish speaking families. Referral was made to the Sanitarians for further follow-up. Contact was made with seven doctors offices and three labora- tories regarding follow-up on twenty. children. • St. Joseph's School: Review of student charts for compliance with state regulations necessitating physical examinations of children in kindergarten and grades 3 &..7 was completed. Letters were written to parents to comply with these regulations. It is encouraged that the children are examined by their own Pedia- trician, however, Dr.. Desjardins will be available -in January to do physicals on children who have not had them. • s w 0 n111rnI"TRA`r.Iors r101JTHLY Ri 'ORT NOVEMBER 1983 BI01,00ICS DISTRIBU'i'FD AMOIJP111 DOSE ANIMAL "RI` ES REPORTED 4 Resident 4 Non-resident Di.ptheria,Tetanus & Pertussis 630 44 ni ther�a-Tetanus Tox. (under 6 yrs. ) ___ - BURIAL PE;RT4TTS Iffune Serum Globulin 8 VIAL INTERNATIONAL TRAVET_, 6 inquiries CERTIFICATES (CFRTIP'IED) Measles (Clinic use only) - 1-W--1-4easles/Mumps/Rub ella _— 170 TOTAL CASH RECEIVED FROM "-- LICENSES & PERMITS ISS►IFD $231.00 Polio Vaccine 620 Tetanus & Diptheria (adu.1t use) 240 Tetanus Toxoid (absorbe. ---- 1 ML 1 10-test Tuberculin P.P.D. Ada ouy. 5 NIL 1 50-test Typhoid Vaccine SALARY REPORT: ALLOWEDEXPENDED BALANCE TO iIND OF FIS('AL $82,983. 00 $33,571.'15 $49,411.85 --- FXPFNSE REPORT: ALLO� !,D EXPENDED FREE, CASH (includes) RPI('til i`.' ;. $34,200.00 $13,999.42 $20,200.58 1 VMVISITING NURSE ASSOCIATION OF GREATER SALEM , INC. a Ms. Linda A. Billows, R.N., M.S. Mr. Peter V. Kent Executive Director President, Board of Directors TO . Salem Board of Health FROM: Ann Dominick, R.N. . Public .Health Nurse RE November 1983,.Monthly Report In November a makeup Pneumonia Clinic was held. Flu and pneumonia vaccinations are continuing to homebound people and those who could not receive-"the vaccine at our clinics for some reason. We expect to administer a few more flu doses and finish--by the end of the year. We still have forty (40) odd doses of pneumovax available through • Visiting Nurse Association purchase at $3.50 per dose. They are good until September of 1985. No new cases of Hepatitis were reported this month. Follow-up con- tinued.on the confirmed cases, During this investigation we became aware of ten (10) unconfirmed cases of Hepatitis. Two addresses were unknown on two of these people, and the rest were under treatment and/or no longer infected. This suggests-that same lines of reporting com- municable diseases to-the Salem Board of Health are not clear. We have contacted some physicians and laboratories and Linda Billows, Visiting Nurse-Association Director, has-discussed this-problem with Mr. Geaney, the Salem Hospital Administrator. We are in the process • of drawing up a letter regarding this issue which will go to Dr. Reines 205 WASHINGTON STREET/ SALEM, MA 01970/ (617) 745-9050 for his input and then distributed to area physicians, laboratories t' and health centers. In order to control the spread of communicable diseases it is essential that the Salem Board of Health is notified of all reportable diseases as soon as possible. I. Vaccination Program a. Council On Aging Clinic - November 10, 1983 Pneumonia - 39 doses Flu 6 doses b. Non clinic doses Pneumonia --11 doses Flu . - - 86 doses II. CxTmunicable .Disease a. Salmonella Active cases - 8 New cases - 1- Discharges - 4 Home visits 7 • b. - Campylobacter - 1 Home visits - 1 c. . Hepatitis Active cases - 1 New cases - 0 Discharges - 7 Home visits - 7 a Tuberculosis Mantoux clinics - 10 tests Negative - 8 Retest - 1 No show - 1 - 22 People seen at North Shore PulmonaryClinic Positive reactor follow-ups - 11 Class II follow-up - .9 Case follow-up - 1 Reactivated - 1 vis ts;were made -plus telephone follow-ups to increase - c Hance with treatment regime. Three 1 III. No new lead poisoning cases were reported. IV. St. Joseph's School a. Pediculosis follow-up continues. Because there were 6 cases reported, a head check has been, completed on, all children and an educational paper prepared and sent home with each student. contact - has been made with the parent of children with Pediculosis for follow-up information. b. The required yearly im unization record has been sent to the state. The school is in compliance with state regulations. 0: i i s V .t� sr '. +:rr Fi t.'."y,.t at„F, � s Ee. �. ... _.... ..�.3{`� � a. 5 f£ •�:'4 '{ .- -. - - - � iiiiii'siii��oaiiiiiniiiiiiii�i ADMINISTRATION MONTHLY REPORT OCTOBER 1983 --------- BIOLOGICS DISTRIBUTED Ah10UNT ' ANIMAL BITES REPORTED 3 Resident Di.ptheria,Tetanus & Pertussis 460 DOSE Diptheria-Tetanus Tox. (under 6 yrs. ) - BURIAL PERMITS 57 Inwine Serum Globulin 61 VIAL INTERNATIONAL TRAVEL 2 Certifications CERTIFICATES (CERTIFIED) 3 inquiries Measles (Clinic use only) _^ - ---- V_ - ___------------------------ ------ - --- ---._._._.. I-IMR--Measles/Mumps/Rubella 380 DOSE TOTAL CASH RECEIVED FROM LICENSES & PERMITS ISSUED None Polio Vaccine 380 DOSE Tetanus & Diptheria (adult use) 50 DOSE Tetanus Toxoid. absor 70 DOSE 1 I/M 4-10 test vial Tubercu]_in P.P.D. (Mantoux)_ 5 ML 1-50 Test vial Typhoid Vaccine - SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL $82,983.00 $27,184.07 $55,798.93 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (includes) EPTCLTNBERED $34,200.00 $11,357.28 $22,842.72 v iiiiii■iiiiiii'niiinii■iiiiiii I VISITING NURSE ASSOCIATION OF GREATER SALEM , INC. I Ms. Linda A. Billows, R.N., M.S. Mr. Peter V. Kent Executive Director President, Board of Directors TO Salem Board of Health I FROM: Ann Dominick, R.N. , B.S. RE October 1983 Public Health Summary In October three immunization clinics were offered to Salem residents. Flu vaccine was offered at all three. However, due to the increased response to the pneumiovax, we ran out of vaccine and have scheduled a makeup clinic in November. We were informed i by the Regional Office in Tewksbury that there is an increase in the requests for both pneumonia and flu vaccine due to the anticipated increase in cases this year. The vaccines are in short supply even on a purchase arrangement from drug companies. In September the Board of Health received 1,350 doses of flu vaccine from the Tewksbury Regional Office. Upon request, we received 250 more doses in October. The Salem V.N.A. purchased 190 doses of pneumonia vaccine. A fee of $3.50/dose is requested j from each person receiving the pneumonax. • i There is no charge for people unable to pay. For those who are not V.N.A. patients i and are homebound, the public health nurse is available to administer the vaccines under physician's order. For further information on pneumtovax 23 see the attached form. Last year's flu and pneumonia stats are also attached. NOV 141983 CITY OF 9ALEM HEALTH DEPT. • 205 WASHINGTON STREET/ SALEM, MA 01970/(617) 745-9050 l i j I. Salem Clinics - 1983 Flu PneLmiovax • Council on Aging 10-18-83 517 71 Charter Street 10-20-83 394 41 Council on Aqing 10-25-83 _283 0 ! 1,194 112 i II. Communicable Disease A. Salmonella Active cases - 15 New cases - 4 Discharged - 1 Referral to Saugus Board of Health - 1 B. Shigella Discharged - 1 C. Campylobacter , 1 D. Hepatitis , Active cases - 9 • New cases -• 1 Home visits - I I III. Lead Follow-up - Home Visit - 1 i i Ia - 1, Ib - 2, 1 awaiting results of news level conference and information on lead poisoning given to Salem State student. Ib - 15 appointments at North Shore Pulmonary. IV. Pediculosis f Head checks were done in two day care facilities and St. Joseph's School upon request from administrators following discovery of Pediculosis cases. Coordination with agency bilingual nurse is most helpful in the follow-up of the Hispanic population. I I I t • e I 1.4/8 i 7.983 Influenza and Pneumonia Immunization Program Tally • Pneumonia Salem Clinics Flu Vaccine Vaccine Council on. Aging (Oct. 18, 1983 517 71 Charter Street (Oct. 20, 1983) 394 41 Council on Aging (Oct. 25, 1983) 283 - Clinic Totals 1,194 112 Associated Group Homes 10 Betram Home for Aged Men 10 Dr. Desjardins 40 Home for Aged Women 25 Ivy Manor Rest Home 20 Newhall Nursing Home 50 Salem Pediatrics 10 Salem Visiting Nurse Association 110 Shaughnessy Hospital 110 Non-Clinic Total 385 TOTAL DOSES GIVEN TO DATE 11/14/83 1,579 112 (a final tally will be submitted when available) • ADMTNTSTRATION MONTHLY REPORT SEPTEMBER 1983 P.IOLOGICS DISTRIBT7-T.) AMOUNT I ANIMAL BITES REPORTED Residents 0 Non-residents 2 Diptheria,Tetanus p< Pertussis 370 doses Dip'th eri a-Tetanus T .cox, (under 6 yrs. ) ----y ' BURIAL PERMITS 55 IfFune Serum Globulin 59 vials INTERNATIONAL TRAVEL 4 inquiries --- I CERTIFICATES (CERTIFIED) 1 Certification ,F fls 1 es (Clinic use only) ------ - ----- -----------------.__.--------...__--------------------------- T.Tt•TR--Vensles/Miunps/Rubella _ 135 doses TOTAL CASH RECEIVED FROM $492.15 Credit from -- -__---y LICENSES & PERMITS ISGUED Wyeth Lab from 1981 Clinic Polio Vaccine 450 doses Tetanus ,& Diptheria (adult use) 50 doses Tetanus Toxoid a 20 doses_------------- 1 ML 10 tests ..- -- -- - 5 1� 250 tests Tuberculin P.P.D. Ma Typhoid Vaccine SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL $82,983.00 $20,836.99 $62,146.01 FXPFNSE REPORT: ALL04lED EXPENDED FRI?E CASH ( includes) FPT0TTMBFRF $34,200.00 $8,614.30 $20,706.03 ��■r��ns■��w-r�� own ��o■�n��nnn��■emu■��■■o�` VNAVISITING NURSE ASSOCIATION OF GREATER SALEM , INC. Ms. Linda A. Billows, R.N., M.S. Mr. Peter V. Kent Executive Director President, Board of Directors TO Salem Board of Health FROM: Cathy Solberg, RN, MPH RE September 1983 Public Health Summary 1. Communicable Disease A. Tuberculosis Twenty-seven people were tested at Mantoux clinics this month. Twenty-five results were negative. Two people did not return. October appointments were scheduled for thirteen North Shore Pulmonary Clinic patients. B. Salmonella • Three new Salmonella cases were reported this month and home visits made. Cases and contacts were interviewed. Health teaching in regard to the disease process and specimen collection was carried out. Follow-up will continue with these new cases as well as follow- up on eight previous cases. C. Shigella One case continues to be followed jointly with the bi-lingual nurse. II. Immigrant Services No new referrals received this month. III. Lead Paint Poisoning Four new cases reported in September. One Class 1B, 2 Class 1A, 1 Class II. Follow-up is being arranged on new cases as well as previous reported cases. IV. Premature Infant Services No new referrals received this month. V. School Health Service • Records are being reviewed for compliance with State regulations. Parents notified by telephone or letter regarding incomplete information. Public Health nurse working with the principal regarding this situation. Follow- up will continue. / 905 WASHINGTON STREET / SALEM. MA 01970 / (617) 745-9050 Y r� • VI. Planning for Flu Clinics Arrangements being worked on for the flu clinics in October. Scheduled dates are October 18 and 25 - 9:30-11:30 at the Salem Council on Aging, and October 20 - 9:30-11:30 at the Charter St. Housing complex. VII. Miscellaneous A new Public Health Nurse, Anne Dominick, was appointed on October 3, 1983. Ms. Dominicks' qualifications were discussed between Linda Billows and Robert Blenkhorn. Arrangements to be made for formal introduction to the Board of Health. • • ADMINISTRATION MONTHLY REPORT AUGUST 1983 _TM I BIOLOGICS DISTRIBUTED AMOUNT p ANIMAL BITES REPORTED 4 Resident Non-resident Diptheria,Tetanus & Pertussis 2301 Diptheria-Tetanus Tox. (under 6 yrs. ) - BURIAL PERMITS 72 Immune Serum Globulin 3 Vials _ INTERNATIONAL TRAVEL 5 inquiries CERTIFICATES (CERTIFIED) Measles _(Clinic use only _ - - _ -_-- -__ _--- -`--_------------__.___�.._.-_-_-- b'IMR-44easles/Mumps/Rubella 1_41 TOTAL CASH RECEIVED FROM - LICENSES & PERMITS ISSUED $217.00 Polio Vaccine 325 Tetanus & Diptheria (adult use) 150 Tetanus Toxoid. 760 _ ._. _._..._._. . 1 14L 30 tests Tuberculin P.P.D.- Ma 5 14L 200 tests Typhoid Vaccine 10 " SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL $82s983,00- $ 12,918J4 $70�'064R86 -_- EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (includes) ENCUMBERED $14 a,2w,00 �5916,30 $28,283,,.70 - n�u��e�or�oo��onoo��Fyuor��nra� f • VISITING NURSE ASSOCIATION OF GREATER SALEM, INC. Ms. Linda A. Billows, R.N., M.S. Mr. Peter V. Kent Executive Director President, Board of Directors TO Salem Board of Health FROM: Jeanne A. Kinhan R.N. , M.P.H. RE . August 1983 Public Health Summary I . Communicable Disease A. Tuberculosis • Twenty people were. tested at Mantoux. clinics this month. One person had a. positive reading and. was referred to North Shore Pulmonary .Clinic for medical evaluation. September appointments were scheduled for eight North Shore Pulmonary Clinic patients. Follow-up of two non-compliant patients was conducted by Public Health Nurse. B. Sa.l.monella Four new Salmonella cases were reported this. month. In addition, one case. of Shigella was reported. Home. visitafollow-up. of all cases was conducted by Public Health-Nurse. Follow-up will con- tinue for each case until two negative stool specimens have been obtained. II . Immigrant Services Follow-up of one immigrant. new to Salem was conducted this month. She was tested at mantoux. clinic and referred to Pulmonary Clinic for medical evaluation. Family is aware of health resources within the community. • 205 WASHINGTON STREET/SALEM. MA 01970/(6171 745-9050 r lage ,two Ili .: !Lead Poisoning Five Class .la, one Class- l-,- one Class II and three Class III lead reports were received this. month. Home .visits were made to most of: the. families to evaluate the. home environment and provide education to. the parents regarding retest schedule and nutritional needs. Public Health Nurse and. Point Neighborhood outreach nurse conducted a lead screening at the Point Neighborhood Community Center. in conjunction with. Department of Publi:c .Health Lead Poiso.niing Prevention Program. Thirty-two children ,attended the one-day session. One child was found to..have an elevated lead level necessitating hospitalization for treatment. Public Health Nurse is awaiting test results for the other children. IV, Premature Infant Services Reports of three. premature infant births were received this month. Both families have been.contacted by Public Health Nurse for health education and infant assessment. • • AD1,4TTJISTRATION MONTHLY REPORT JULY 1983 I101,00TCS DISTRIT)_77,T) — Ah1WIT I ANIMAL BITES REPORTED 4 RESIDENT NON RESIDENT 6 i)J.ptheria ,Tetanus ?< Pertussis 70 doses T:J.pCheria-Tetanus TVo_.. (uncles 6 yrs . ) BIMTAL PERMUS 48 I /,'-^une Serum G_loblz-in -- i b vials INTERNATIONAL TRAVEL 1 Certification ___ CERTIFICATES (CERTIFIED) 3 inquiries ? (C1inJ.c ^nl r�asl.es u�ci _ -- -.--- ---_-.. .. .- tet;sJ.es/14umps/Ruhell.a 20 doses TOTAL CASH RECEIVED FROM _0_ LICENSES & PERMITS ISSIJED 150 doses PO).J.O VaccJ.ne Tet;a.nus & Dipthei•ia (adult use) 50 doses Tetanus. Toxoid_(ftb. .nx_b_�� - ------------ 1 MI. 10 tests _ Tuberculin P.P. D. it� a _tQix) 5 t'IL _-50 tests typhoid Vaccine i SP.LARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAh $82,983.00 $6,352.44 $769630.56 EYPENSE REPOPT: ALT,04[ED EXPENDED FREE CASH (includes) $34,200.00 $21864.9.9 $311335.01 M IRIS - iiiiiiiiiiiiiiei'■ '■i'i"■'u'ii�i'iiii�� r VISITING NURSE ASSOCIATION OFGREATER SALEM, INC. Ms. Linda A Billows, R.N, M$. Y. Mrs. William H.K. Donaldson Executive Director _ President, Board of Directors TO ;.Salem _Board of Health' FROM; Jeanne A. Kinhan. R.N. , M.P H.:` :' ''.RE July.1983 Public Health Summary I. Communicable Disease A. Tuberculosis , Follow=up of two Class -III T+ B.: patients was continued this month. One patient was subsequentiyv•-cleared with negative sputum cultures. • August appointments were scheduled for sixteen (16) N.S. Pulmonary Clinic patients. Mantoux Clinic: Twelve (.12).'people were tested at mantoux clinics this month. The one positive .reactor was scheduled to attend N.S. Pulmonary Clinic for medical evaluation. B. Hepatitis One new case of hepatitis was reported this month. The patient remains hospitalized. P.H.N. will schedule a home visit for follow- up when patient is discharged: P.H.N. follow;up of a previously reported hepatitis case continued this month with home visits for health education and physical assessment. C. Salmonella One case of Salmone.11a. was reported this month for patient residing • in Salem N.H. Report sent to appropriate health department. One previously reported case of Salmonella has been cleared with two negative stool specs. 205 WASHINGTON STREET/SALEM, MA 01970/(617) 745-9050 Page Two Communicable Disease D. Campylobacter • One case of campylobacter reported this month. P.H.N. follow- up will continue for this patient. II. Premature Infants Reports of three (3) premature infant births were received this month. One is a .Salem N.H. resident and the information was sent to the N.H. health department. Home•visits have been made to the other two (2) infants and their families for physical and developmental assessments and health edu- cation. III. Lead Poisoning Two (2) Class Ia reports received (one new, one retest) indicating anemia. One Class III retest also received indicating need for medical and- public health evaluation and follow-up.- • P.H.N. follow-up of the three (3) cases has included consults with the pediatricians regarding treatment and health education for parents. P.H.N. has` been working with the bilingual V.N-. at Point Neighborhood Community Center for visits to Spanish speaking clients and to arrange for a lead screening at the Community Center next month. IV. School Health Services P.H.N. continues review of school records for physical examination and immunization needs. All students in. grades K, 3 and 7 are re- quired to have a physical exam this year. Parents have been notified. V. Miscellaneous Paul .Hunter from the D.P.H. Childhood Injury Prevention Program pre- sented information and demonstrated use of household safety equip- ment. . • Page Three Miscellaneous, cont. a 1 Home visit made to child for head lice check. No lice or nits • noted. Educational information presented to mother. Head check conducted twice at Camp Naumkeag as preventive measure to avoid rapid spread of pediculosis which has occurred in the past. Nits discovered on one child at second check; she was sent home and parents were informed of recommended treatment. No further problems. noted. • s ADMTNIST RAT ION MONTHLY REPORT JUNE 1983 T?IOLOGIC,S DISTRIB[?'CED AMOUNTI ANIMAL BITES REPORTED Residents 7 Non-Residents 6 Diptheria,Tetanus A< Pertussis 290 doses 67 Diptheria-Tetanus Tox. (under 6 yrs. ) -- BURIAL PERMITS Lrmune Serum Globulin INTERNATIONAL TRAVEL - — 2 inquiries CERTIFICATES (CERTIFIED) t,ieasles (Clinic use t•li•iP:--lTecsl.es/rium s T'uhe]_1_a—P TOTAL CASH RECEIVED FROM�=------- ----- ---hn dosed I $283.00 --- ----- LICE,'NSES & PERMITS ISSTUT D Folio VELccin 360 dosese _. _. Tetanus & Diptheria (adu_lt use) 60 doses Tetanus Toxoid 750 doses 1 ML 6 10-tests Tuberculin __..._Typhoid Vaccine- SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL $85,690.00 $85,690.00 $82,640.63 $3049.37 I EXPENSE REPORT: ALLQVMI D EXPENDED FREE CASH (includes ) '$32,670.00 $32,172.00 $498.00 p L,me k Folov"Ift con Ax Elm ONE-To m r i VNAVISITING NURSE ASSOCIATION OF GREATER SALEM , INC. Ms. Linda A. Billows, R.N., M.S. Executive Director TO . Salem Board of Health FROM: Jeanne A. Kinham, R.N. , M,P.H, RE June 1983 Public Health. Summary I. Communicable Disease i A. Hepatitis jt Last year at this time, 14 cases of Hepatitis: were. reported and inyestigated by, the P,HN. This month, one case. has been reported. i Y P. Hepatitis, an acute communicable disease affecting the liver, is endemic in many parts, of the world, including the U.S, and Canada. The P.H.N. is involved in case,-finding, investigation, teaching and follow-up care of patients and their families or other close contacts. Hepatitis is classified as A or� B depending upon the causative viral • agent. These two distinct diseases are.,similar in many ways but differ in etiology and in some epidemiological, immunological, clinical and pathological characteristics. Prevention and control of Hepatitis A' and B vary greatly. A third type of Hepatitis, that does not fit into either the A or B- category, is called non-tA, non,7B. Hep.atitis and appears to be caused by more than one virus. The Hepatitis A virus is found principally, in the stool specimens of infected persons and is- spread by the fecal--oral route. Control of Hepatitis- A is- bY y sanitary dis osal of sewage and thorough hand7- Y P g 8 washing. 4 Hepatitis B is found primarily in the blood of infected persons, but is present also in most of the other body secretion* and excretions. It is not found in stool specimens. The principal route of spread of this virus is through contact with infected blood and blood products and syringes or needles which have been used on an infected person and not sterilized before reuse. E The non-A, non-B viruses are also found in blood and appear to be spread via direct contact with the blood of an infected person. Almost all cases of viral Hepatitis that are acquired by a blood trans7 fusion are non-A, non-B Hepatitis. 205 WASHINGTON STREET/ SALEM, MA 01970/(617) 745-9050 I � t Page Two Communicable Disease There is no specific treatment for viral Hepatitis. Immune Serum Globulin (ISG) is effective in the prevention of Hepatitis A. Use of ISG is reserved for close 'contacts of known cases or • for persons who consumed food prepared by a known carrier of the virus. In order to be effective, ISG must be given within two weeks after exposure. ISG is not as effective in the prevention of Hepatitis B. Hepatitis B Immune .Globulin, which is very ex- pensive, may be given to a contact who had direct or extensive exposure to Hepatitis B. As with other infectious diseases, the most contagious period is before specific symptoms appear, thus increasing the incidence of spread before diagnosis and follow-up have been initiated. Prompt reporting of diagnosed cases and initiation- of preventive measures are important steps in control of Hepatitis. B. Salmonella One new case of Salmonella was reported this month. Investigation of contacts and health education follow-up was conducted by P.H.N. One case previously reported was cleared this month with two neg- ative stool cultures. Follow-up continues for six previously reported cases. C. Campylobacter • One new case of Campylobacter was reported. Clinically,,related to Salmonella, Campylobacter is investigated and followed in the same manner as Salmonella. Two negative stool cultures will be required of the patient and P.H.N. follow-up will continue. D. Tuberculosis Mantoux Clinic: Nineteen people were tested at mantoux clinics this month. All results were negative. July appointments were scheduled for 19 people at N.S. Ful- monary Clinic. Record-keeping and follow-up continues for new Pulmonary Clinic patients and those delinquent in keeping appointments. One Class III (.active) case of T.B. was reported this month. Home visits were conducted by P.H.N. to obtain health history information, provide educational instruction and conduct physical assessments. Six family contacts were given mantoux tests with three showing positive results. The positive 'reactors have been referred to N.S. Pulmonary Clinic for x-ray evaluation and 1 medical assessment. ` II. Lead Poisoning • 4 i Two Class Ia reports were received this month, indicating anemia. f 1 r � Page Three Lead Poisoning Retests for one child being followed by P.H.N. indicated Class III and Class IV results. Child was hospitalized for treatment. Home f visits were made by P.H.N. and bilingual V.N.to discuss with parents the home situation, environmental hazards, nutritional needs and follow-up protocols. i III. Premature Infant The births of two premature infants were reported this month. One {{ family was referred to V.N.A. by the attending physician and will be followed by V.N.A. One infant remains hospitalized and will be visited by P.H.N. upon discharge. Home visit follow-up of previously reported premature infant continues for physical assessment and health teaching. IV. School Health Postural screening was conducted by F,.H:.N.. th s� month for St, Joseph students in grades S and 7. Review of health records for physical examination and immunization needs will continue throughout the summer months. Parents delinquent in supplying necessary health information will be contacted before school begins. V. Miscellaneous • P.H.N. follow-up was requested by a Salem couple concerned that they had contracted a food-borne illness. Stool cultures were subsequently negative for Salmonella. Requests received for information concerning communicable diseases and T.B. evaluation resources. • ADMTNISTRATION MONTHLY REPORT MAY 31, 1983 PIOLOGICS DISTRIBUTED AMOUNT ANIMAL BITES REPORTED Residents 13 Non-Resident 1 Diptheria,Tetanus & Pertussis 790 dose$ Diptheria-Tetanus Tox. (under 6 yrs. ) - BURIAL PERMITS 50 _rMmune Serum Globulin 5 7 INTERNATIONAL TRAVEL 4 inquiries CERTIFICATES (CERTIFIED) "Measles (Clinic use only - . NMR_-Measles/Mumps/Rubella - 320 doselsTOTAL, CASH RECEIVED FROM LICENSES & PERMITS ISSUED $574.00 Polio Vaccine 635 dosels Tetanus & Diptheria (adult use) 170 doses _ Tetanus Toxoid 30 dose 1 ML 2 10-test Tuberculin P.P.D. Ma 5 14L -- Typhoid Vaccine .20 dose SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL Appropriation $87,190.00 Less transfer 1,500.00 = $85,690.00 $76,593.40 $9,096.60 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (includes) ENC1TI!3ERFD Appropriation $29,550.00 Plus Transfer 3,120.-00 $32,670.00 $29,356.82 $3,313.18 Vf p ' ■oni■oo��o��no long Moo- WMMIMI MEOW Mw I INNMM'02 - Ik so I= . 8 OWNERS MEN MIN no 00 won offloom Ito :: eiiiiiiii'eiiiiie■ c VNAVISITING NURSE ASSOCIATION OF GREATER -SALEM , INC. Ms. Linda A. Billows, R.N., M.S. Mrs. William H. K. Donaldson Executive Director President, Board of Directors TO Salem Board of Health FROM: Jeanne A. Kinhan R.N. , M.P.H. RE May 1983 Public Health Summary I. Community Programs MAY IS HIGH BLOOD PRESSURE MONTH Approximately 60 million Americans, over one fourth of the U.S. popula- tion, have high blood pressure. Individuals with high blood pressure develop approximately three times as much coronary heart disease; six times- as much congestive heart failure and seven times as many strokes • as do individuals with controlled or normal blood pressure. By properly treating their high blood pressure and thereby reducing it to recommended levels, hypertensives can reduce 'their risk of stroke, heart disease and kidney failure. Although there is no cure, hypertension is controllable. Treatment often includes medication, change in eating habits, weight reduction and decreased cigarette smoking. Recent data from the National Health Survey reveals that 32% of definite hypertensives are not aware that they have high blood pressure and the majority of hypertensives do not have their disease under control. Wide- spread detection and education efforts have made millions of Americans aware of the fact that they have high blood pressure. Planned detection activities provide a way of identifying people with undiag- nosed, uncontrolled and untreated hypertension. Detection is the initial step in the series of related activities for control of high blood pressure. i Detection alone, however, does not significantly increase the number of peo- ple with controlled hypertension unless referral and follow-up efforts com- plement the detection activity. As part of a nationwide focus on hypertension during High Blood Pressure Month, hypertension screening clinics were held at the Salem Police and Fire Stations and at City Hall. for employees of those departments. Twenty-eight police station employees, forty-two municipal. employees and sixty-seven fire • department employees were screened. Of the 137 people screened, 26 (1.9%) were found to have elevated blood pressure at initial. reading. 205 WASH INGTON STREET / SALEM, MA 01970 / (617) 745-9050 f `s Page ;Two Community Programs A YP diagnosis of hypertension cannot be made with just one blood pres- • g sure reading. Therefore, individuals found to have elevated blood pressure at initial screening are urged to have two or more readings taken within one to three months. Those found to have continued increased readings, or those known to have elevations over a period of time, are encouraged to seek medical follow-up. In addition, education is provided regarding treatment modalities, risk factors and medication regimes. II. Communicable Disease I A. Salmonella One new case of Salmonella was reported this month. Investiga- tion and health education follow-up was conducted by P.H.N. Follow-up of previously reported Salmonella and Shig.ella patients continues. B. Hepatitis One new case of hepatitis reported this month. Follow-up inves- tigation was conducted by P.H.N. through hospital and contact information although the patient .could not be located. D.P.H. • was notified. C. Meningitis Report received of one case of meningitis. Mother of infant was contacted for investigation .purposes; child had been released from Hospital at time of- P.H.N. contact. D. Tuberculosis .Mantoux Clinic: Eleven people. were tested at mantoux clinics this month. Of these, nine were negative., one was positive and one did not return for recheck. The positive reactor was referred to N.S. Pulmonary Clinic for x-ray and medical evaluation. June appointments were scheduled for eight N.S. Pulmonary Clinic patients. P.H.N. follow-up of new clinic patients continues. III. Premature Infant The birth of one premature infant was reported this month. The family has not been home for P.H.N. follow-up but will be contacted. • ' I i • IV. Lead Poisoning Three Class Ia reports were received this month, indicating anemia and need for physician evaluation. One Class II and one Class III lead level reports were also received. These levels indicate lead poisoning and need for P.H.N. and physician follow-up. . The pediatrician has been contacted and retests have been scheduled for both children. P.H.N. is attempting to contact the mothers for health education regarding prevention and treatment of lead poisoning. V. School Health Services P.H.N. conducted a Health Education class for 5th graders this month. . In addition, P.H.N. continues to check and update health records, and to confer with parents regarding physical exam and immunization needs of the students. VI. Miscellaneous Several requests for information received concerning such public health issues. as herpes-and lead poisoning. Appropriate health information was given and referrals for medical follow-up suggested as necessary. • • t 0 • . • ADMINISTRATION MONTHLY REPORT APRIL , 1983 BIOLOGICS DISTRIBUTED AMOUNT ANIMAL BITES REPORTED ... 6residents lnon-resident Diptheria,Tetanus & Pertussis 330 doses Dipth eri a-Tetanus Tax. (under 6 yrs. --- BURIAL PERMITS 48 _LA.mune Serum Globulin 27 vials INTERNATIONAL TRAVEL 5 inquiries — CERTIFICATES (CERTIFIED) Measles (Clinic use _P_IMR�-I9eusles/Mumps/Rubella 110 doses TOTAL CASH RECEIVED .FROM -0- - LICENSES & 1?ERMITS ISSUED Polio Vaccine 480 doses Tetanus & Diptheria (adult use) 70 doses Tetanus Toxoid a 500 doses 1 14L 10 doses Tuberculin P.P.D. 5 14L 50 doses ---Typhoid Vaccine --- SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL $87,190 less 1500.00 transwer = $85,690.00 x70,,256.32 $15,433.68 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (includes) EPICtMERF- � $31,170.00 plus $32,670.00 $26,025.94 $6,644.06 1,500. 00 transfer $32,670.00 P 11111111111111111111111111111111�I ' RECEEVEED MAY 9 1983 J VISITING NURSE ASSOCIATION CITY SALEM • OF GREATER SALEM , INC. HEALTH DEPT. Ms. Linda A. Billows, R.N., M.S. Mrs. William H. K. Donaldson Executive Director President, Board of Directors TO Salem Board of Health FROM: Jeanne A. Kinhan R.N. , M.P.H. RE April 1983 Public Health Summary I. School Health-Childhood Immunization M.D.P.H, recommends that Boards of Health promote or provide for the routine immunization of children and certain adults against polio, measles, mumps, rubella, diphtheria, tetanus, pertussis and other .diseases if deemed necessary. • This month, the P.H.N. continued to check student health records in order to identify students who need immunization "boosters" or MMR (Measles, Mumps, Rubella) vaccine. Parents are informed of im- munizations required for attendance at schooland that failure to comply with the Massachusetts Immunization Law will result in exclu- sion' from school. The Immunization Law (Chapter 76, Section 15) has recently been changed to require MMR immunizations for grades K-12 as a condition for school attendance, effective September 1, 1983. M.D.P.H. requires annual statistical information from all schools concerning the immunization status of students in grades K-12. An analysis of this survey is then published and officials of schools in which immunization levels were below 100% are contacted by the Division of Communicable and Venereal Disease. The incidence of preventable childhood diseases is continuing a downward trend that began at the end of 1977 after several years of steady increases. In March, 1982, M.D.P.H. reported that the Measles, Mumps and Rubella Immunization Programs, based on morbidity projec- tions and estimated costs, not only prevented illness and death but also saved the citizens of the Commonwealth approximately $17,865, 738. • 205 WASHINGTON STREET / SALEM, MA 01 970/ (61 7) 745-9050 School. Reaith Childhood Immunization .f However, vaccination levels in the U.S. population are lower in • minority groups and residents of large cities. In addition, pre- school children are more difficult to reach with immunization services than children in school. Not vaccinating a child until he is ready to start school keeps a child susceptible to disease during the first years of life when some of the diseases are most likely to strike, and when complications may be most severe. There- fore, parents must be informed of immunization services and schedules and encouraged to begin vaccinations early. Day care and preschool centers are also required to maintain health and immunization records . for enrolled children and promote timely immunization. At present in Salem, immunizations are given by private physicians, the Lydia Pinkham Clinic and North Shore Childrens Hospital. II. Communicable Disease A. Salmonella No new cases of Salmonella were reported this month. One case which P.H.N. has been .foliowing was cleared with two negative stool cultures. B. Shig ellosis • One case of Shigellosis was reported this month. The patient was contacted by P.H.N. for investigative information and in- struction regarding disease process and required follow-up procedures. This patient was subsequently cleared with two negative stool cultures. C. Tuberculosis Mantoux Clinic: Two people were tested at mantoux clinics this month. Both tests were negative. May appointments were scheduled for ten N.S. Pulmonary Clinic patients. Follow-up continues for new Pulmonary Clinic patients and patients delinquent in keeping appointments. • L M. Premature Infant The birth of one premature infant was reported this month. P.H.N. made home'.visits to the infant and mother for health assessment. Health education regarding developmental expectations, nutritional requirements, infant care and home safety was provided. P.H.N. will maintain contact with this mother to ensure compliance with medical appointments and to provide supportive counseling and health education. IV. Lead Poisoning i Two Class Ia reports were received for Salem residents. These test results indicate some degree of anemia rather than lead poisoning. The children.are to be followed by pediatricians and should be retested in three to six months. V. Miscellaneous Requests for immunization information and chest x-ray clinics were .received. Appropriate information was given and referrals made for medical follow-up. • A local preschool program requested a P.H.N. visit to check children for suspected head lice. Although P.H.N. was on vaca- tion, a V.N.A. nurse made the visit to check heads and discuss treatment and prevention measures with the staff. i i • Am-ITNIST�ATION MONTHLY REPORT MARCH 1983 P.IOLOGICS DISTRIBUTED AMOUNTANIMAL BITES REPORTED RESIDENTS 3 NON RESIDENT 1 390 doses Diptheria,Tetanus F, Pertussis Diptheria-Tetanus Tox. (under 6 yrs. ) --- BfJRIAL PERMITS 86 '�m.mune Serum Globulin 27 vials INTERNATIONAL TRAVEL 2 inquiries CERTIFICATES (CERTIFIED) ?Ieasles (Clinic use only) —_ 130 doses T`ttR--T-Aeasles/Mumps/Rubella TOTAL CASH RECEIVED FROM -0_ /PTO7dosesLICENSES & PERMITS ISST.ED Folio Vaccine .37 s Tetanus & Diptheria (adult use) 10 doses Tetanus Toxoid—(ab-aorbed) - .... __ .... 1 MI. -10 test vial none Tuberculin P.P.D. Ma 5 ML Typhoid Vaccine SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL $8.7,190.00 $59,203.93 $27,986.07 EXPENSE REPORT: ALL04TED EXPENDED FREE CASH (includes) EUCUNBERED 29,550. $31,170.00 $23,074.92 $8,095..08 7'R,WS F. + 1,620. $31,170. oa00000v��mm_a�a��m��m�m_mmm 4 VISITING NURSE ASSOCIATION OF GREATER SALEM , INC. Ms. Linda A. Billows, R.N., M.S. Mrs. William H. K. Donaldson Executive Director President, Board of Directors TO Salem Board of Health FROM: Jeanne A. Kinhan R.N. M.P.H. RE March 1983 Public Health Summary I. Immigrant Services Immigrants enter the United States at various ports of entry enroute to their final destination. D.P.H. notifies a city health department of immigrants who will reside in that community. Generally, the name and address and the immigrant can be located through this source. • D.P.H. requests that new immigrants be visited and introduced to avail- able health care systems in the area. (Prior to receiving a visa, the immigrants are examined for excludable communicable diseases (infec- tious leprosy, active tuberculosis and venereal diseases) by a panel of foreign physicians approved by the United States State Department) . During the visits, particular attention is paid to the immunization record of the children. Unless parents can show medical proof of im- munization with dates and physicians signatures, the children are con- sidered unimmunized and an immunization program must be initiated for them. If active tuberculosis has been excluded via chest x-ray, immigrants arriving in Salem are requested by the P.H.N. to attend Mantoux clinic. If the individual has entered the United States under Federal Immi- gration law #87-301 (pertaining to persons entering the country with a Probable Active Tuberculosis or an abnormal chest x-ray) the imrni- grant is required to have a medical examination. These immigrants are referred to N.S. Pulmonary Clinic for free evaluation. In the past few years, many refugees from Southeast Asia have arrived in Salem. Local sponsors have been most helpful in obtaining medical follow-up for these immigrants and assisting with employment and/or enrollment in school systems. School health personnel maintain health records and assure up-to-date immunization status of the children. . 205 WASH INGTON STREET / SALEM. MA 01970 / (617) 745-9050 I Page Two II. Communicable Disease • A. Salmonella Two new cases of Salmonella were reported this month. Inves- tigation of patients and contacts was conducted by the P.H.N. Instruction was provided regarding the disease process and required follow-up procedures. One household contact was removed from food handling position pending his relocation to another apartment or clearance of the patient with negative stool cultures. "B. Tuberculosis April appointments were scheduled for twenty-one N.S. Pulmo- nary Clinic patients. P.H.N. continues follow-up of persons delinquent in keeping clinic appointments. A referral was received from Salem Hospital for P.H.N. follow- up of a patient with question of T.B. A home visit was con- ducted by P.H.N. to obtain health history information, provide educational instruction and conduct a physical assessment. The patient and household member were given a mantoux test which • the patient reported as negative (neither were available for P.H.N. check) . Results of the patients' sputum culture indicate no active tuberculosis. The patient was referred to N.S. Pul- monary Clinic for further evaluation. C. Mantoux Clinic Nine people were tested at regularly scheduled mantoux clinics this month. A recertification mantoux clinic session was held at Newhall Nursing Home for eleven employees. Of the twenty people tested at clinics this month, eighteen were negative reactors, one did not return for test reading and one person reacted positively. This positive reactor was referred to N.S. Pulmonary Clinic for further evaluation. III. Lead Poisoning Two new and two repeat class Ia cases reported this month. These children will be followed by pediatricians and should be retested in a few months. • Page Three Ljad Poisoning s -.. Request for lead screening information was received and appro- • priate information and resource referral was given. i IV. . Premature Infants The birth of premature twins was reported this month. P.H.N. conducted home visits with this family and with a previously , reported family to assess physical development and provide health education. V. School Health Services Physical examinationswere given by Dr. Desjardins to twenty-five students in grades 3 and 7. School Health information packets were compiled by the P.H.N. and distributed to prospective students at Kindergarten registration this month. A new D.P.H. mandate requires that all. students in grades K-12 receive Measles, Mumps, Rubella (MMR) vaccine by September 1983. This has necessitated record check of all students above Grade 3. is of students who have not received this immunization will be notified. In addition, records are being checked this month for "booster" immunization needed by students in all grades. VI. Miscellaneous Blood pressure clinics were held weekly at the V.N.A. office for fire and police personnel found to have elevated BP readings in the past. Of the thirty-two people notified, one attended a clinic for BP check. Several telephone requests for information on a variety of health conditions received. Information was given and resource referrals made as appropriate. Check conducted by P.H.N. for head lice for one family exposed through school contacts. No evidence of lice or nits noticed. Prevention and treatment methods were reviewed. • • ! n.rmTrlIST RAT ION MONTHLY REPORT FEBRUARY 1983 11IOLOGICS DISTRIBiJ'I'ED AMO(1I`!T ' ANIMAL BITES REPORTED 5 RESIDENTS 5 NON-RESIDENTS T)9.ptheria,Tetanus & Pertussis 120 doses Diptheria-Tetanus Tox. (under 6 yrs. ) -- BURIAL PERMITS 39 mune Serum Globulin 25 vials INTERNATIONAL TRAVEL 2 inquiries CERTIFICATES (CERTIFIED) t•i e n s].e s Clinic use L'1•1R--T4erisles/Miunps/Rubella - —-- 50`- doses TOTAL CASH RECEIVED FROM $163.00 -- --- ------- — LICENSES & PER14ITS ISSUED Pclj.o Vaccine 100 doses Tetanus & Diptheria (adult use) 10 doses Tet_nnus Toxoid (abs 4r. 500 doses 1 bII, 10 test Tuberculin P.P.D.__Ltfa 5 350 tests Typhoid Vaccine -- SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL $87,190.00 $54,438.62 $32,751.38 -. _-. I XPFNSE REPORT: ALLOWED EXPENDED F'R1-,"F CASH (includes) ENClTM3F'RFP $31,170.00 $20,407.08 $10,762.92 p 11111111111111111111111111111111� VMVISITING N S G NURSE ASSOCIATION OF GREATER SALEM , INC. Ms. Linda A. Billows, R.N., M.S. Mrs. William H. K. Donaldson Executive Director President,Board of Directors TO: Salem Board of Health FROM: Jeanne A. Kinhan, R.N. , M.P.H. RE: February. 1983 Public Health Summary I. Communicable Disease A. Tuberculosis Tuberculosis is a communicable disease caused by the organisim Mycobacteruim Tuberculosis, Tuberculosis is most commonly_ spread through the air from a person with. the disease to other individuals in close contact with.,the infected person. Public protection against the disease is essential since the individual has little control • over inhaling`'air: contaminated with the tubercle bacillus. P.H.N. responsibilities for tuberculosis control includes surveil- lance, containment and management of cases and contacts. Reported cases of T.B. are investigated by- the P.H.N. to determine, if pos- sible, ..the source-of disease and to identify contacts of infected j persons. Follow-ug of these patients includes providing educational information, resource.,referrals and evaluation of compliance with f treatment regimes. Screening for tuberculosis consists of examining persons in defined groups to identify .those who may have tuberculosis infection or disease. The reduction in the incidence of tuberculosis has made routine screening':6f the general population unwarranted. However, using epidemiological data, it is possible to define groups in which there is a higher risk of tuberculosis or in which even a sporadic case would present a significant.lidzard, thus making organized screen- ing programs desirable. Weekly mantoux clinics for tuberculin skin testing are conducted by the P.H.N. Target population for these clinics include health care and school personnel, aliens and possible contacts of T.B. cases. Persons with positive mantoux test results are referred to North Shore Pulmonary Clinic for evaluation X-ray, M.D. examination and treatment as necessary. • I 205 WASHINGTON STREET/SALEM, MA 01970/(617) 745-9050 f UbG1'CUiOS:i5 Tuberculosis has become both curable and preventable since the in- • troduction of antituberculosis medications. Available chemothera- peutic regimens are effective, and full recovery is expected in patients who complete treatment. Chemotherapy not only cures disease but by rapidly decreasing infectiousness can also prevent the trans- mission of infection to others. The number of tuberculosis cases occuring each year in the U.S. has been steadily decreasing, and deaths from T.B. have decreased even more drastically. However, despite the success of current tubercu- losis control methods, tuberculosis is still an important health problem, and eradication will require continued effort for many years. Mantoux Clinic: Seven people were tested at mantoux clinics in February. Six had negative test results and one person did not return for reading. March appointments were scheduled for six North Shore Pulmonary clinic patients. Follow-up of two C1 III patients continues; one patient was cleared this month with negative culture results. P.H.N. continued consul- tation with the Point Neighborhood Outreach Nurse regarding new N.S.P.C. clinic patients and non-compliant families. B. Salmonella • One new case of samonella was reported this month. Investigation and health education follow-up was conducted by P.H.N. Follow-up of a previously reported case continues. Report of one neg- ative culture has been received and P.H.N. has instructed case to sub- mit a second culture to the state laboratory for analysis. II. Immigration Services Office visit was conducted with Southeast Asian Immigrant. Mantoux test was done, with negative results. Health care services and resources in the community were reviewed with the client and two family members. III. Lead Poisoning Four new class Ia cases were reported this month, indicating some degree of anemia. These children will be followed by private pediatricians and should be retested in a few months. This month the P.H.N. sponsored a Lead Poisoning inservice for area nurses. The speaker was Mary Jean Brown, R.N. , Public Health Nursing Advisor, D.P.H. Childhood Lead Paint Poisoning • Project. Topics of the seminar included: History and effects of lead poisoning, clinical management of • poisoned children, environmental enforcement and screening strategies. Twenty public health and pediatric nurses attended the three hour session. IV. Premature Infants Notices were received regarding the births of three premature infants (including a set of twins) this month. P.H.N. will schedule home visits for developmental assessments and health education. V. School Health Services Vision and hearing retests were conducted for kindergarten students this month. Conference was held with kindergarten teacher regarding one child. With the assistance of Salem State College Nursing students, heights and weights of students in grades 2,3,4,7,8. were recorded. In addition, blood pressure checks were conducted for students in t grades 3 and 7 as mandated. VI. Miscellaneous Home visit made to North Shore Retarded Citizens residence for group • education session regarding pinworms. Counselors and residents were I instructed by P.H.N. about identification, mode of transmission, communicability and methods of control. Medical treatment has been obtained. Conference conducted with Salem State College nursing student regarding P.H.N. responsibilities and Massachusetts mandates for school health 4 services. Letters sent to fire and police personnel regarding follow-up blood I pressure checks to be conducted at the V.N.A. next month. Target i population includes those who were found to have elevated blood pres- sure readings at blood pressure clinics last year. i m.i.71dI STRATI ON MONTHLY REPORT JANUARY 1983 I ANIMAL BITES REPORTED 6 RESIDENT fI?IOLOGICS DISTRIBUTED AMOUNT Di.ptheria,Tetanus & Pertussis 350 doses Dipt:}ieria-Tetanus Tor. (under 6 yrs. ) --- BURIAL PERMITS 39 " Immune Serum Globulin 25 vial INTERNATIONAL TRAVEL 2 Inquiries CERTIFICATES (CERTIF'IE )) Measles (Clinic use only) -- 5111R--Measles/Mumps/Rubella 70 TOTAL CASH RECEIVED FROM $627.00 - -- - -- LICENSES & PERMITS ISSIMLD Polio Vaccine 260 dose s. Tetanus & Dipth eri ft (adult use) 100 dose Tetanus Toxoid (absorb 260 dose - Tuberculin P.P.D. MAL-n Mxl 5 14L 3 50-test Typhoid Vaccine SALARY REPORT: ALLOWED BALIVZCE TO Ft1D OF FISCAL $8I gg ggll $47,969.78 $39,220.22 '(after transfers) Less 2 transfers $810. each) 'bZ0'00 — — . • - ------------- EXPENDED FRlF CASH ( includes) EXPENSE REPORT: ALLOWED + $29,550. trans.11/82 $17,690.78 $12,669.22 trans.1/83 + 810.00 (transfer from 30,360. 13,479.22 Salaries) + 810. $31,170. on I OVA mm m NUFA No HOW �m rARIMnm�no r� �nacr�i�nii��■iu iii ieai�iri��ii��nii�=�i�■m m��■m � 1111 SIN 1 • VISITING NURSE ASSOCIATION OF GREATER SALEM , INC. Ms. Linda A. Billows, R.N., M.S. Mrs. William H. K. Donaldson Executive Director President, Board of Directors TO . Salem Board of Health FROM: Jeanne A. Kinhan, R.N. , M.P.H. RE . January 1983 Public Health Summary I. Premature Infants Massachusetts law mandates reporting of. all premature infant births. Prematurity for public health purposes is defined as birth of an infant weighing less than 91 pounds. Approximately 7 out of 100 babies are born prematurily in the U.S. The P.H.N. receives notice from hospitals of premie infants • born to mothers residing in Salem. Following notification, the P.H.N. contacts a parent to schedule a home visit. If at ini- tial contact the mother refuses a home visit, a telephone as- sessment is made of family support systems and plans for medical follow-up. The pediatrician is informed that home visits will not be conducted and that a V.N.A. referral can be initiated if necessary at a later date. During home visits, the P.H.N. assesses the family environment, the Childs' physical condition and growth and development pat- terns. Education, supportive counseling and anticipatory guidance is provided regarding child care, nutrition, illness prevention and health care. Ongoing home visits are scheduled as necessary for physical evaluation of the infant and mother, health care referrals and health education. Since the V.N.A. receives hospital referrals for high risk in- fants,. the P.H.N. works closely with the V.N.A. to eliminate dup- lication of services. If, after P.H.N. home visits have been made, it is determined that more extensive services are needed (such as Home Health Aid assistance), the P.H.N. initiates a V.N.A. referral for the infant. This month, home visits for two families with premature infants . have been made by P.H.N. e Two i,remature�Infants Premature twins in one family are now thriving well after a recent hospitalization for bronchial disease. This family has required support and safety teaching as well as child care guidelines and infant assessment. Physical assessment of the other infant indicates that the child is thriving well at home and gaining weight as anti- cipated. Health teaching and development evaluation were provided at the home visit and follow-up pediatrician ap- pointment have been scheduled. II. Communicable Disease A. Tuberculosis Mantoux-Clinic: Twelve people were tested at regularly scheduled mantoux clinics. Thirteen employees of Solar- tareem 'Child Care Center were tested at a clinic session held at the Center. Of the twenty-five people tested for T.B. this month, • seventeen"were negative., one did not return for reading and seven were positive reactors. All positive reactors were scheduled for N.S. Pulmonary Clinic evaluation. February appointments were scheduled for twelve N.S.P.C. clinic patients. Follow-up continues for previously reported Class III T.B. patient. P.H.N. and Point Neighborhood Outreach Nurse have been consulting regularly and working closely with this patient and his family to schedule evaluation ap- pointments, provide health education and assure compliance with recommended treatment regime. B. Hepatitis One new case of hepatitis was reported by Salem Hospital. Attempts by P.H.N. to locate this patient have been unsuc- cessful. Consultation with Salem Hospital Infection control nurse and Director of- Infection Control has provided infor- mation for D.P.H. report. Request for information about hepatitis received from an • occupation health nurse. Disease process, mode of trans- mission, treatment and follow-up procedures explained. _age Three • C. Salmonella Two new cases of Salmonella were reported this month. Investi- gation of patients and contacts was conducted by P.H.N. Home and office visits were scheduled for health education regarding the disease process and required follow-up procedures. One household contact was removed from food handling position as required-by DPH pending clearance of patient with two negative stool cultures. III. Immi ration Services P.H.N. was notified by D.P.H. of two families who arrived in .Salem from'Rus-ia.'"The sponsor, Jewish Family Services, was contacted by P.H.N, and"confirmed that both families have been resettled in Lynn Immigration reports .were sent to Lynn Health Department. Notification was received from D.P.A. concerning arrival in Salem of..ref't"' from Southeast Asia who' will be contacted by P.H.N. for mantoux clinic appointment and referral to appropriate health sere- '-ices. Follow-up of another immigrant family continues as requested • by pediatrician. Although the family has not been available for home visits, P.H.N. has held conferences with school _nurses regard- ing two of the children. Confirmed immunization reports for one child have been received and the school.nurses will continue to evaluate the students for health and developmental needs. IV. School'Hea.lth Services Vision screening retests for grades K-8 and hearing screening re- tests for grades K-4 were conducted this month. Parents of twenty students were notified of need for further evaluation of visual acuity and/or change in glasses prescription. Conferences held with two mothers regarding vision testing results and follow-up evaluation procedures. Discussions with classroom teachers held regarding children referred for vision evaluation and recommendation made concerning preferential seating, use of glasses, etc. P.H.N. notified two mothers about physical complaints of their child- ren and plans were established for medical follow-up of these com- plaints. • age Four V. Miscellaneous Office visit from Sth grade student requesting tuberculosis in- formation for school report. Pamphlets, information and resource listings given by P.H.N. Request for information regarding x-ray certification received from N.S. Consortium. P.H.N. conferred with .N.S. Pulmonary Clinic and supplied .employee requirements information. Telephone discussion held .with D. Clohisy, D.P.H. Lead Poisoning Prevention P.roject,' ,concerning. prevention activities .on the North Shore: r : Discussion held with public health nurses from four area health departments.-regarding P.H.N._`activities, community services and screening clinics.. Preliminary plans made`.by P.H.N. with the Public"Health Nursing Advisor, D.P:H. .Lead Poisoning Project for an inservice"education session to be held in Salem: nnT dINISTPON MONTHLY REPORT DECE R 1982 3 I 1?IOLOGICS DISTRIBUTED AMOUNT ANIMAL BITES REPORTED RESIDENTS 5 NON-RESIDENTS 3 ' Diptheria,Tetanus & Pertussis 240 doses BURIAL PF'RMiTS 48. --- Diptheria-Tetanus Tox. (under 6 yrs. ) _ . -Nmune Serum Globulin 60 doses INTERNATIONAL TRAVEL 3 stamped CERTIFICATES (CERTIFIED) 1 inquiry Measles (Clinic use only--- --- - -- ._.— --- --- ------------- ---- I.TMR--T?easles/Mumps/Rubella 220 doses_ _ _ TOTAL CASH RECEIVED FROM $3,836.00 --�- --r LICENSES & PERMITS ISSUED . Polio Vaccine 350 doses Tetanus & Dipth eri a (adult use) 140 doses Tetanus Toxoid a .. .. .. .. . ...._. . _......... ------- 1 14L 3 -10 test vials,. Tuberculin P.P.D. Nia 5 14L 5 50 -test ,via s Typhoid Vaccine 20 doses SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL $88,000.00 $41,824.85 .$46,175.15 EXPENSE REPORT: ALLOYED EXPENDED FREE CASH (includes) ENCUP/3ERED $30,360.00 $15,037.10 $15,322.90 oo�ooavm��m��_ ., . . moon NONE NIM1111111111M 1MRSKII gin min No ninoffilil MIN" MIN No mom MW No 010111MMIN No Kom - M� 0 MOM MIN got Ml No Ml 0 No No No IM Ell 011MIMM mom WIN! �iiiiiiii uii■ '� n � . . mom� 1 1 t , VNAVISITING NURSE ASSOCIATION OF GREATER SALEM , INC. Ms. Linda A. Billows, R.N., M.S. Mrs. William H. K. Donaldson Executive Director President, Board of Directors TO Salem Board of Health FROM: Jeanne A. Kinhan, R.N. , M.P.H. RE December 1982 Public Health Summary Lead poisoning, which may permanently affect physical and mental development, is a serious problem in the United States among children 1 - 6 years of age. The Massachusetts Department of Public Health, Childhood Lead Poisoning Preventive Program reports: "According to the (1980) U.S. census, there are 2194 children in Salem ranging in age from six months to • five years. This is the age range we consider most at risk for childhood lead poisoning. Last year 36% of the children in this group had a fingerstick screen- ing test for lead. poisoning. Forty-one of the 798 children tested had either an elevated lead level (above 30 mcg/dl) and/or an. elevated erythrocyte pro- toporphyrin (EP) level (above 50 mcg/d1) . Since Salem has an anticipated elevation rate of 5%, if all chil- dren at risk were tested we could expect 110 to have elevation. Of the 110, approximately half would have elevated lead levels and half would have iron deficien- cy. Many of Salem's children are not being tested for lead poisoning." Tissues and organs most affected by lead poisoning are the bone marrow, kidney and brain. Lead poisoning may result in death, but more often results in mental retardation and learning disability. Since children with. lead poisoning treated only after signs and symptoms of neurologic involvement or incipient encephalopathy have about a 30% chance of permanent and gross brain damage, the goal of any program must be to discover and treat these children before they have any symptoms. Unfortunately, no one knows how much before obvious symptoms develop more severe brain damage is being produced. D.P.H. estimates that at least 25% of children with asymptomatic lead poisoning are handicapped by learning or behavior problems. 205 WASHINGTON STREET/SALEM, MA 01970/(617) 745-9050 Page Two Lead,Poisoning In Salem, blood-lead level screenings are performed primarily by private • physicians. The laboratory tests results are sent to the Public Health Nurse as well as to physicians. A verified blood lead concentration of over 29 mcg/dl is diagnostic of lead poisoning requiring further sur- veillance. A verified concentration over 49 requires further medical ob- servation testing of the child in accord with the recommendation of C.D.C. If the laboratory report indicates an elevation in blood-lead level, the P.H.N. contacts the attending physician to discuss plans for retests and follow-up. If warranted, the P.H.N. will contact the child's parents and schedule home visits to discuss the health situation, environmental hazards, and possible treatments. As mandated, the P.H.N. notifies the health department santarians of all cases of elevated lead levels so that property inspection can be carried out within the time frame accorded by Massachusetts law. Lead paint that is intact and on a flat surface which a child cannot chew is not considered anV, immediate hazard. If lead paint is peeling or chip- ping, or the underlying plaster is loose or has a hole in it, a hazard exists. Lead paint on window sills, porch railings, or any chewable sur- face below four feet from the ground or floor is a hazard, even when intact and in good condition. Old lead paint buried under several coats of non- lead paint is still dangerous. The paint used in and on many old houses contains so much lead that a child who eats a chip smaller than a fingernail repeatedly over the course of weeks can become poisoned. A one square cent- imeter chip of paint one layer thick with 10 percent lead will contain five to ten times the maximum daily safe intake for a child. If the child lives in an area with heavy automobile traffic, the danger of lead poisoning is • increased. Treatment for lead poisoning is use of medications that bind to the lead and cause it to be removed rapidly from the body. As with all medications, this treatment carries risks and discomforts. In addition to a course of painful injections, the child is hospitalized for up to a week for each treatment series. It is of utmost importance that the child be kept from further ex- posure to lead, since treatment can stop the progress of the disease, but cannot repair damage already done to the brain. I. Communicable Disease A. Tuberculosis January appointments were made for 14 people at North Shore Pulmonary Clinic. Follow-up of two Class III cases continues as well as follow- upo persons delinquent f p in keeping clinic appointments. Five people were tested at Mantoux Clinic this month. One reacted positively to the Mantoux test and was referred to North Shore Pulmonary Clinic for x-ray evaluation. B. Salmonella • One case has been cleared with two negative stool specimens. Follow-up continues for four previously reported cases. I Page Three Communic_?.ble Disease C. Pediculosis Home visit made at request of Salem family to check for pediculosis. Treatment information and prevention measures discussed with mother. II. Lead Poisoning Three Class Ia cases reported this month. These blood tests indicate that the children are anemic rather than lead poisoned and they will be followed by private pediatricians. III. Premature Infant Home visits have been made to the family of infant twins this month for assessment of growth and development and health teaching for the parents. Follow-up of another premature infant also continues for evaluation of growth and development. • • ADMINISTRATION MONTHLY REPORT NOVEMBER 1982 � BIOLOGICS DISTRIBUTED Ab10iJNT I ANIMAL BITES REPORTED RESIDENTS 3 NON-RESIDENTS 3 Diptheria,Tetanus & Pertussis - 450 doses Diptheria-Tetanus Tox. (under 6 yrs. ) -- BURIAL PERMITS 48 Immune Serum Globulin vial- INTERNATIONAL TRAVEL 2 inquiries CERTIFICATES (CERTIFIED) Measles (Clinic use on��_—_ - -A ?R---Measles/Mumps/Rubella 110 doses TOTAL CASH RECEIVED FROM $215.00 LICI'NSES & PERMITS ISSUED Polio Vaccine 490 doses Tetanus & Diptheria (adult use) 250 doses Tetanus Toxoid (absorbed) 50 doses 1 ML 70 tests Tuberculin_P.P.D. (Manto 5 50 — Typhoid Vaccine '- SALARY REPORT: ALLOWED EXPENDED BALANCE TO .END OF FISCAL $$,ff10.-00 $54,084.00 less transf Bid.00 $33,916.00 $0 EXPENSE REPORT: A.LLO�-JTFD EXPENDED FREE CASH (includes) ENCiTi�_ FFF 29,550.00 $12,132.22 $18,227.78 plus transf. 810.00 30,360.00 �( ��a��oE��.ao:�ni■rio��iii=� . 11111111111111 TO Salem Board of Health FROM: Jeanne A. Kinhan, R.N. , M.P.H. • RE November 1982, Public Health Summary This month, the Public Health Nurse attended the American Public Health Association annual meeting, held in Montreal on November 14 - 18th. The focus of the conference was International Perspectives on Aging and Public Health. In addition to health issues for the elderly, conference sessions dealt with such topics as public health law; environmental.health; maternal child health; community health planning; school health services and public health in a climate of diminishing resources. Of particular interest to the P.H.N. was information about illness preven- tion and health education programs for industry, elderly and high risk groups. The importance of successful marketing of public health services was stressed. Principles of community organization were discussed and pub- lic health nurses were encouraged to assess community needs and set priori- ties for services. Epidomiological and economic implications of public health interventions were analyzed and various health department programs were presented. An example of current public health programs are The San Bernardino County (California) D.P.H. Child Health Clinic campaigns. Inspired by mass media campaigns that have been successfully used in the private sector to attract large audiences, this program is utilizing the same techniques in clinic campaigns to reach its clientele. • A Poison Prevention campaign was chosen because the U.S. National Clearing- house for Poison Control Centers estimates that 500,000 to 1,000,000 children under five will ingest a dangerous or poisonous product each year. A Toy Safety campaign was conducted because the U.S. Consumer Product Safety Com- mission estimates over 500,000 children suffer toy-related injuries each year. Since automobile accidents are the leading cause of deaths. in the U.S. for persons aged 1-34 years, a car seat/seat belt campaign was developed to motivate parents to change their use of car seats and seat belts for their children. These campaigns, examples of heal A department programs developed to meet assessed needs of a county, highlight health concepts with a variety of visual, written and verbal messages. It is anticipated that evaluation of such programs will show statistically significant results for reduction of illness and accidental injury, j While specific programs and services vary from city to city, conference participants determined major activities of public health nurses to be in identifying community needs; recommending interventions; decreasing barriers to care; planning and providing nursing care, and monitoring preventive health care programs. Mobilization of community resources and building upon existing networks were stressed for successful program implementation. Evaluation of the programs presented at the conference indicates the cost- effective benefits of community-wide illness prevention and health promo- • tion efforts. Ilagor4Two < I. Communicable Disease • A. Tuberculosis Twenty-one people were tested at mantoux clinics during November.' Of these, twenty had negative test results and one person did not return for follow-up check. December appointments scheduled for eight people at North Shore Pulmonary Clinic. Follow-up of two clinic patients who missed appointments was conducted for health teaching. B. Salmonella Two new cases of Salmonella were reported for Salem residents. Both cases were contacted by P.H.N. for investigative information and health teaching. One previously reported case was cleared this month with two negative stool specimens. C. Rubella One case of rubella was reported. P.H.N. follow-up investigation has been conducted and report filed with the Regional Health Office. II. Lead Poisoning • One Class III lead level was reported. P.H.N. follow-up of this case in- cluded health education for the mother and discussions with the pediatri- cian. Retest of this child reveals the lead level has dropped to Class Ia, indicating anemia. III. Premature Infant Births of five premature infants (including one set of twins) were reported this month for Salem residents. One of these infants did not survive. One family was referred to V.N.A. by hospital coordinators and will be followed by V.N.A. Two families (three infants) have been contacted by P.H.N. Home visits are being conducted for assessment of the infants' growth and development, eval- uation of family situations and health promotion. IV. Immigrant Services A request was received from a pediatrician for P.H.N. to follow a Vietnamese immigrant family in Salem. P.H.N. is awaiting call from pediatrician to discuss health problems of this family and develop a care plan. • Page -W-iree < V. School Health Services Physical examination and immunization records for 32 transfer students • were obtained and reviewed by P.H.N. Hearing screening was conducted for Grades 2-5. Two children were iden- tified as needing further medical evaluation for hearing impairment. Parents of these children will be contacted and appropriate referrals initiated. VI. Miscellaneous One inquiry received regarding anti-malaria medication. Caller was ref- ferred to Logan Airport medical center and private physician for further information. One call received requesting information about Herpes, referred to Beverly Hospital V.D. Clinic and/or private physician. Education and treatment information was given to one family with a pedicu- losis problem. Communicable disease information was requested by Shaughnessy Hospital C.D. office. Booklets and other written information were sent for use at the hospital. • r • ADMINISTRATION MONTHLY REPORT OCTOBER 1982 BIOLOGICS DISTRIBUTED AMOUNT ' I ANIMAL BITES REPORTED -RESIDENTS 9 NON—RESIDENTS 7 Diptheria,Tetanus & Pe rtussis 110 doses 69 Diptheria—Tetanus Tox. (under 6 y rs. ) BURIAL PERMITS mune Serum Globulin 2 vials INTERNATIONAL TRAVEL 4 CERTIFIED CERTIFICATES (CERTIFIED). Measles (Clinic use only) h1MR--Measles/Mumps/Rubella 800 doses TOTAL CASH RECEIVED FROM -0- LICENSES & PERMITS ISSUED Polio Vaccine 251 doses Tetanus & Diptheria (adult use) 100 doses Tetanus Toxoid� 720 doses 1 ML 70 .tests Tuberculin P.P.D. Ma 5 ML -- Typhoid Vaccine SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL $88,810.00 $27,478.92 $61,331.08 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (includes) ENCUMBERED $29,550.00 $9-. 836.66 $19,713.34 .0 •_ -_ EN`VTRON'MrNTAL UrALTI! DIVISION MONTHLY RrPORT lyei�r) (month) 1 2 3 G 5 6 7 8 9 10 11 12 13 14 1516 17 18 19 20 1 22 23 4 25 26 27 2B ..^_91 1 TOTALS_ I TARY CODE ENFORCE. 2-1 — 1 ood Service Food Serv. Insp. Z' — Mobile Food Serv. Retail "lark e t s }(ous ine ?lo ea om ain Z i 2- 1 _General Nidsances ". Day Care Centers . Day Camps I �• SwimThinr Pools ! • Beaches t. SESD-Observation SFSD-Complaints �ti Dl?N'f' CONTROL ------ — -- - - TESTING: Laboratory Testing �1. Milk & Crean 2. Swab (Restaur. ) Well Water ! 4. Municipal Water 5. Bathin Pater �� 6. Sevare Water — — Field Testinc,� 1. Lead Testing 2. Perc.Test for 1 I ! Sew. System ?.?LENSES AND PERMITS: COURT ttEARINGS ---�-- jI, i,'. C0NSULJ'UNrION_SFSSjON. - -- — - — -- zo. 'LIIRALS TO e.ND FROM ^� — OTI!ER DEPARTI•IENTS L DIVISION OF COMMUNITY HEALTH SERVICES DENTAL PROGRAM - MONTHLY REPORT MONTH SCHOOL EXAMS i SCHOOL D /N!G DENTAL CLINIC =� /v6 7 O�g L, A C L'E> CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. D DENTAL HEALTH EDUCATION SCHOOL GRADES p PROGRAM So L TO Salem Board of..Health. • FROM: Jeanne. A. _Kinhan RA. , M.P.H. RE October'1982, Public .Health Summary According to Massachusetts law, local boards of health have authority and responsibility to. establish and maintain health clinics and conduct general education. relative to matters ,of public health in. connection with such clinics. Costs of health promotion activities are small in relation to the benefits to both taxpayers -and the .people served, since these- services reduce the need for certain other professional services and institutionalization. Influenza vaccine and pneumococcal vaccine was. made available to Salem elderly and high risk',groups at three clinics during the month of October. Several VNA Board members volunteered to assist at the flu clinics, as did the Board of Health secretary, Ginny Moustakis. Nursing students from Salem State College assisted Dr. Desjardins and the P.H.N. in administering the vaccine. Final tally for 1982 Clinics: INFLUENZA PNEUMONIA I Council .on Aging October 12 . 362 40 Charter Street . October 19 367 11 Council on Aging October 26 253 26 TOTAL :982 : :77 Although influenza epidemics are unpredictable, some '!flu" occurs each year. In very large epidemics, as' much as one=thirdlof the population have become sick and thousands have died. Because, influenza: is.usually.mild and,most;people recover fully, routine vaccinations of healthy children and adults is usually:.not emphasized. ` The risk of complication and death,,from influenza viruses is greatest for people with chronic .health problems or low resistance:,to infection and for.`ahose .over 65 years"of' age. Influenza vaccinejs composed of influenza viruses that.-have beenigfown an eggs; killed and purified. The. influenza vaccine developed this yeir`contains three influenza strains which recently caused disease in North America (A/Brazil, A/Bangkok, and B/Singapore). Chemical changes in influenza .viruses.make it possible for persons to get the "flu" even though immunity may have been developed against previous strains 'of influenza. Thus, having had-influenza or influenza vaccine in..past years may not prevent another flu infection. Page 2 Pneumococcal vaccine is _intended for people over two years of age with.chronic health problems'`;and. f - or .those over sixty years of age who are at risk. There are.;83 strains 'of pneumococcal bacteria which may cause lobar pneumonia.. The vaccine contains -14 .strains of pneumococci which account for 80 percent of all: pneumococcal disease in the United States. The pneumonia vaccine offers protection .agaist these strains of lobar -pneumonia for at least five years. I. Communicable Disease A. Tuberculosis November appointments were made for thirteen (13) people at North' Shore Pulmonary Clinic. Follow-up of persons delinquent in keeping clinic appointments was continued. Records for new and continuing T.B. patients were reviewed and updated. Mantoux Clinic: 21 people were tested at mantoux clinics this month. Two positive reactors were referred to North Shore Pulmonary Clinic for further evaluation.` B. Salmonella One new case of Salmonella reported this month. Follow-up of patient • and family has been conducted by P.H.N. ; Follow-up of four previously reported cases continues. One case cleared with two negative- cultures. C. Meningitis One new case of mening�tis was reported this month. Patient is hospitalized. P.H.N. has conducted follow-up investigation with Salem Hospital Communicable Disease department, Patient is still hospitalized. Patient lives alone and has no known contacts. II. Lead Poisoning One Class III lead level has been reported this month. P.H.N. .has begun follow- up and has discussed this case with the attending physician. One report received with questionable .lead level. Test is to .be repeated before P.H.N. follow-up begins. III. - Premature ,Infants Three reports of premature infants born to Salem residents p p esi ents were received. One family .was:_contacted by P.H.N. for health care education and referral. Follow- �• up .of. the other two infants will be conducted after discharge from hospital. rake � IV. Pediculosis P.H.N.' conducted .head: check .and treatment education to familyseeking rea g t t ment with- pediculosid...problem.` Child was -found-free of infestation and school. was notified. Two calls received regarding crab lice. P.H.N. provided educational infor- mation and treatment resource referral. V. School Vision screening was completed for all grades. :Hearing screening was con- ducted for grades K-1. Physical and immunization forms were checked for all new and transfer students - and State immunization reports were completed. • • AMBER 1982 ADMINISTRATION MONTHLY REPORT ANIMAL BITES REPORTED 15 RESIDENT 7 NON-RESIDENT i BIOLOGICS DISTRIBUTED ( AMOUNT - -- Diptheria,Tetanus & Pertussis 56 vials Li pth eri a-Tetanus Tox.. (under 6 yrs. ) 0 BURIAL PERMITS 33 ITMW ur,e Serum Globulin 3 vials INTERNATIONAL TRAVEL 5 inquiries CERTIFICATES (CERTIFIED) Measles Clinic use only_------------------- _-.._.._..�__.--------------------------------- — *'�!?.--Measles/mumps/Rubella —— _ 270 doses TOTAL CASH RECEIVED FROM -0- --- LICENSES & PFR14ITS ISSUED Polio Vaccine 122 doses Tetanus & Diptheria (adult use) 23 vial-s Tetanus Toxoid (a 1 vialbsQ�?�,).------ - ......... .. 1 14L 6 10 tests 3 50 tests Tuberculin P.P.D. U!�a_ nnmL-&L_._._ 5 14L Typhoid Vaccine SALARY IT.FOIT,-: ALL0WED EXPENDED BALANCE TO END OF FISCAL $88,810.00 $19,570.07 $69,239.93 ALLOVED EXPENDED. FREE CASH (includes) E?iCLR'BER F:fPFNSE REPORT: - $29,550.00 $ 79588.03 $21,961.97 WORM -1. Mobile Food Serv- o0v��u�c�r��n�or�a■��noon��onn�� 5. MINIM MINION no 0 mv Minn WA mom" 7. neral Nuisances mom mom 9. Day Camps mmm on ::i OWN!iiiiio:�i i mom WI 2. Air ,7� Noise Poll. IMM OEM NONE No ],-or)ENT CONTROL Laboratory Testin_& istaur. MINIM WIN 2 wab (Re IN 3. Well Water �oiiiii�iiii�ii��i 6. Sewage Water �aiioi�ooiio i�ioiii 1. Lead Testing NIM No 2. Perc.Test for 0 Sew. System LTCP.ISES AND PERMITS:Amm loom Mon mom IWINI 11111111�N11 I...y TO Salem Board of Health i FROM: Jeanne A. Kinhan R.N. , M.P.H. RE September, 1982 Public Health Summary SCHOOL HEALTH With school back in session, the Public Health nurse resumed school health responsibilities at St. Joseph school. School health activities include super- vising required immunization and physical examinations, treating student ill- nesses and injuries, and conducting mandated screenings. Schools are required by law to collect health history information, including immunization data and records of physical examinations. Additional information is usually obtained on a health history in order to: 1) identify children with acute or chronic health conditions who require evaluation and monitoring by the school nurse and, 2) identify children with health problems that require assess- ment, management and referral to other health care providers. The state mandates that children have a physical exam by a physician at kinder- garten and every 3-4 years thereafter, or if they are transfer students without records of a recent physical. No child may be admitted to school without a physician's certification that the child has been immunized against diphtheria, pertussus, tetanus, measles, mumps, i rubella and polio. A child may be exempted from this rule if: 1) the child's • physician certifies that the child's health would be endangered by such immuniza- tion or, 2) in the absence of an. emergency or epidemic of disease, the parent or guardian states in writing that vaccination or immunization conflicts with his/her sincere religious beliefs. Presently, the state mandates that all grades K - 12 be screened yearly for vision and hearing. The highest incidence of hearing impairment occurs in the preschool and early elementary years, particularly due to the frequent occurence of middle ear disease during this age group. Most visual problems or the highest incidence of visual impairment also occurs in these same years due to the anatomical growth changes of the eye structure and the incremental demands put on children to increase their visual skills and gain mastery of the school reading program. New vision problems continue to develop in significant numbers later into the school years than do hearing difficulties. I. Communicable Disease The following reports of communicable disease among Salem residents were received this month: A.- Salmonella One new case of Salmonella was reported. One person cleared with two negative specimens. • Pag- Two Communicable Disease (cont.) B. Tuberculosis 29 people were tested at Mantoux clinics this month, 25 had negative • results, 3 tested positive for T.B. and were referred to North Shore Pulmonary Clinic for x-ray evaluation and treatment. One person did not return for test result reading. October appointments made for 7 people at North Shore Pulmonary Clinic. C. Legionellosis One case of Legionellosis was reported by Salem Hospital. Patient is deceased. No other cases of Legionellosis have been found in Salem to date. D. Hepatitis One case of Hepatitis B reported for Salem Resident. Patient currently hospitalized. PHN follow-up has been completed. E. Miscellaneous Communicable Disease One case of chickenpox reported. One case of campylobacter reported. At this time, there is no required follow-up for these diseases. • II. School Review of immunization and physical examination records for all students continues. Initial vision screening for grades K - 2 (96 students) has been done. III. Premature Infant One report of premature birth for Salem resident received. The family has been referred by the hospital to V.N.A. for assessment and follow-up. Miscellaneous Planning activities for the annual influenza immunization clinics continue. Three clinic dates are scheduled: Tuesday, October 12 and October 26, Council On Aging Tuesday, October 19 Charter Street All clinics will be held from 9:30 a.m. - 11:30 a.m. • L • DID YOU KNOW. . . . . .. . The Salem Health Department, through contractual agreement with the Visiting Nurse Association of Greater Salem, Inc. , has a PUBLIC HEALTH NURSE, The PUBLIC HEALTH NURSE provides many services for residents of Salem: Tuberculosis testing and follow-up: Mantoux clinics- every Tuesday 8-9:30 am, follow-up clinics on Thursday, held at the Visiting Nurse of- fice, 205 Washington St. (.call for appointment: 745-9050) Communicable disease control, prevention and follow-up. Immigration information and referrals. • Lead Poisoning education and follow-up. School Health nursing for St. Joseph's school. Travel immunization information. Premature infant home visits. Annual influenza immunization clinics. Screening clinics and programs: Hearing Vision Blood Pressure Community Health Education. The PUBLIC HEALTH NURSE can be contacted from 8am-4pm at 745-9050. • E % • s 3�rOl IU�STRA7i Lgrl MONTHLY REPORT AUGUST 1982 ` , � ANIMAL BITES REPORTED Residents 11 Non-residents 2 7'iOLOGICS D'rSIT RIB, u 7�D AMOUNT D-�ptheria,TetaTr-,s Pertussis 25 vials BURIAL PERMITS 51 7 mmune Serum Glob'tili 15 vials —_ ( INTERNATIONAL TRAVEL 3 inquiries CERTIFICATE', (CERTIFIED) ................. 60 dosps TOTAL CASH RECEIVED FROM NONE 7PTI .,--Measles/Mumr)s/Rubella ------- LICENSES & PFRMITS ISSUED Polio Vaccirie -.252-J-0-se 111etanus & Diptheria (adult use)-__,[ 5 -vials COMMUNICABLE DISEASES Residents 6 Non-residents 3 Tetanus Toxo.id kabso bed) 76 vials 1 14L 1 10-test -4L iabercu'lin P.P.D. _Q 5 1 Typhoid Vaccine EXPENDED BALANCE TO END OF FISCAL, SALAPY REPORT: ALLOWED $75,577..01 $88,810.00 $13,232.99 E)TEN DED FREE CASH (includes) ,F,,rp7NSE R;7ORT: ALLOWED $29,550-00 $5,113.39 $24,436.61 TAI, IMALT!! DTVT-STON MONTHLY rr,!'PT?,T • 082 (month) 1 2 5 6 7 8 9 ICO 11 7 12 13 1411516 17 18 19 20 122�23 �4 125 26 27 28 21 0 1 TOTALC food Serv. TnSD,———— Food Serv. T;i rk e t s 11,-CF7F�7, comp rairic-11 G v-,Ii - i 'Nuisances I 2 2 / l 3 2 'I I .Z �___�~3 I � . ca i-,i D:av Care Centers -j I r� i � I�, pay CtqD)s- Swim nine Pools K.Aboravory Testing ( ! � � 17- Cream 2? AD (Restaur. ) 3. Water 4. '-IIun4,.cJ-qaI Water —71 5. 6. Sewage Water YNIV Testing 21 1 /0 ,r! Testing - V. !AcAest for Sow. System tlPTD PERYITS: CO"RT HURINGS ASSTONd _ z — 3 — -- — z'� — 1 ! /i--- ! —!I! j—�� -T.,s 'TOI I , i -�UAAT,'ENTIS j —LL h DIVISION OF CO*MNITY HEALTH SERVICES DENTAL PROGRAM - MONTHLY REPORf MONTH SCHOOL EXAMS SCHOOL DENTAL CLINIC U CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. 1 �- 7 -3 DENTAL HEALTH EDUC4TION fe SCHOOL GRADES PROGRAM • °r ADMINISTRATION MONTHLY REPORT JULY 1982 ------ ---- ANIMAL BITES REPORTED 10 resident 12 non-resident BIOLOGICS DISTRIBUTED AMOUNT -___ � ----- Diptheria,Tetanus & Pertussis 12 vials Diptheria-Tetanus Tox. (under 6 yrs. ) -- j BURIAL PERMITS 58 ;rune Serum Globulin 36 vials INTERNATIONAL TRAVEL 6 inquiries 1 validati.on CERTIFICATES (CERTIFIED) Measles (Clinic use only 1h2�R--I,'easles/Mumps/Rubella A!_ -0`� TOTAL CASH RECEIVED FROM $175.00 — -- LICENSES & PERMITS ISSTED Polio Vaccine 130 doses Tetanus & Dipth.eria (adult use) 6 vials Tetanus To_xoid (absorb 25 vials 1 14L 3 vials Tuberculin P.P.D. (Mant 5 1� 2 vials Typhoid Vaccine 0 �, ALLOWED EXPENDED BALANCE TO END OF FISCAL SALARY REPORT: - $88. 810. CIG $3,652.37 $81,914..09 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (includes) ETiCUABERED $29.,550..00 -0 $29,550.00 No WIN m Wl Orem .Ol.RCN.N��"n..�CCa...mom .---,Nmmmm MINIM WINIMIN MINIM mm mmm woomm MINOW mom= No om .. :mAL oo... .... ..�"� MINIM IN I MINION Dili oMEMO ' mom MINION . : MEMO�NI11111mi01i0ll I1� TO Salem Board of Health FROM: Jeanne A. Kinhan, R.N. , M.P.H. RE July 1982, Public Health Summary Health education is a major function of public health and the public health nursing position. Health education generally means gaining new knowledge, having knowledge already acquired reinforced and having ideas learned previously presented in a new or different way so that they are more understandable and usable. The intention of this education is to help people make informed health decisions, develop more positive health-related attitudes and adopt certain health behaviors. Thus, health education seeks to facilitate volun- tary behavior change. Changing habits and life-styles is a long process, influenced by such factors as peer pressure, family support, self-image and social trends. The impact of a health education effort is directly related to the immediate relevance of the topic as perceived by .the .individda_l. Infor- mation must therefore be provided in a manner that encourages. the indi- vidual to examine and discuss health beliefs, values and behaviors. Health education plays an important role in all aspects of public health nursing, from communicable disease control to decreasinghealth risks s s for premature infants. To encourage change, two-way communication is most useful. Direct contact. between the nurse and client, in the form • of home, office or worksite visits is an effective means of assessing health knowledge, imparting information and establishing credibility for the health system. Countless opportunities exist to inform and motivate people of all ages, and to encourage and reinforce individual efforts that are already occurring. In fiscal year 1982-83, the public health nurse will continue involvement in many aspects of health education in the community. Press releases, media events, screening clinics and direct contact with the public will continue to provide information to assist individuals make informed choices about factors affecting health. I. Communicable Disease The following communicable disease reports were received for Salem Residents: A. Hepatitis Two new cases of hepatitis reported. One type B Hepatitis. One type unspecified. I B. Salmonella Three new cases reported. • Follow up continues for four previously reported cases. C. Tuberculosis Thirteen people tested at Mantoux clinics. Eight negative results. Two did not return for follow-up reading. Three positive results; all referred to Pulmonary Clinic for evaluation X-ray. Appointments made for fourteen poeple at N.S. Pulmonary Clinic. II. Immigrant Services One new arrival reported by D.P.H.; child is living with local sponsor. Family visited by P.H.N. for explanation of immuniza- tion needs; T.B. clinic and available health resources. Appoint- ments have been scheduled for chest X-ray and medical evaluation. III. Lead Poisoning Four new Class la lead levels reported, indicating iron deficien- cy anemia. Children to be retested within six months. IV. Premature Infant One report of premature infant birth received. Mother contacted • for assessment of condition. Availability of PHN for follow-up was explained. V. Miscellaneous PHN conducted two screenings for pediculosis at Camp Naumkeag. Education session was held for campers & counselors to stress prevention of pediculosis outbreak. Hypertension clinic follow-up activities continue. • ADMINISTRATION MONTHLY REPORT JUNE 1982 BIOLOGICS DISTRIBUTED AMOUNT ANIMAL BITES REPORTED 6 Residents 2 Non-residents Di.ptheria,Tetanus & Pertussis 77 vials BURIAL PERMITS Diptheria-Tetanus Tox. (under 6 yrs. ) -- ,immune Serum Globulin 66 vials INTERNATIONAL TRAVEL 4 inquiries CERTIFICATES (CERTIFIED) Measles (Clinic use only____ tWM Measles/Mumps/Rubella 148 doses TOTAL CASH RECEIVED FROM $319.00 LICENSES & PERMITS ISSIMM Polio Vaccine 690 doses Tetanus & Diptheria (adult use) 11 vials COMMUNICABLE DISEASES 14 Tetanus Toxoid 40 vials 1 14L _6 -i0 tests Tuberculin P.P.D. (Mart 5 14 1 —50 test Typhoid Vaccine 1 vial SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL $ 85,o94.02 $79,145.00 $5,949.02 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (includes) ENCUMBERED $41,170.00 $38,344.98 $2,825.02 Fl�%!T,O' ENTAL 1IT-Al.7-11 r�,IST.ON MONTHLY RETIORT Ai. NM (month) — 2 1 2 111 12 13 14 1.5.16 17 18 19 21122 23 4 25 27 128 22. o TOTAT 3 4 5 6 7 8 9 10 ood colill mohilt-, Food Serv. Rnt-_L'_l Markets—. e Centers Car Cnin Ds Pools ry ii L i.oii 1)t 'STiNG, !.aborntory Testing Cream 2. (Re-scaur. ) 3. Water -junicipal Water V 22— ater 6 _;eyage Water T lesrin& Lead Testing Y'drc.Test for y%.l. System j_,js7.5 AND PERMITS: 111HARINGS —7-1 - - (-- i--- TO ANM FROM 7nA.RT!-fENTS • - 0 Salem Board of Health FROM: Jeanne A. Kinhan,, R.N. , M.P.H. RE June 1982, Public Health Summary I . Communicable Disease A. Tuberculosis July appointments made for three people at North Shore Pulmonary Clinic. Nine people tested..at Mantoux clinics this month. Eight had negative results.. One person tested showed-. positive results and was referred to Pulmonary Clinic for x-ray. B. Salmonella Two new cases of Salmonella reported this month. P.H.N. follow- up for health teaching and specimen collection continues for two previously reported cases. C. Meningitis One new case of meningitis reported. D. Varicella Cases of chickenpox are followed by private physicians. Official report to the health department is not ordinarily justifiable since infect-ion wi•h varicella virus is nearly universal . Control measures include axcludirgchildren from school for one weelr after .;; appearance of chickenpox lesions and .avoidance .of contact with,• : . .. . :. susceptible people. One case of varicella was reported to P.N.N. this month by the . :. ---: . patient's mother. E. Hepatitis Fourteen hepatitis cases were reported this month by hospitals, physicians, and patients themselves. P.H.N. investigation reveals that all but one case appears to be linked with a common source of infection. D.P.H. has been notified and P.H.N. is working with health departments in other cities to eliminiate sources of infection Household and restaurant employee contacts of all cases have been notified to obtain Immune Serum Globulin immunization. _ - 1 44 • 11 . Immigrant Services Home visit made to two new. immigrants who have joined other family members in Salem. Both have s,:t appointments for physical examinations, immunization. upd3te, and mantoux testing. III . Lead Poisoning Ten Class I lead levels reported. One report received with questionable lead level result. One new Class II lead level report received. Repeat lead level tests for five children followed by P.H.N. indicate . that three children have Class I levels, one level remains- Class II and one level remains Class III . P.H.N. follow-up continues. IV. Premature Infants One report of premature infant birth received P.H.N. will con act family and arrange for home visit when infant is released from hospital . School Seventy-one students participated in the postural screening program. Eleven students referred for medical evaluation of screening results. • Classes ended for the summer. Parents of all- students to be enrolled in V,_W_e$ K, 3, 7, will be notified of physical exam requirements. P.H.N. met with school faculty to explain changes in next year's schedule and to hand-out written communicable disease information. Miscellaneous i Meetings with V.N.A. supervisor continue. At staff request, P. H.N. visited Solartarezm Day Care Center to check for pediculosis and educate staff concerning this problem. Recommendations were made by P.H.N. for parent education, treatment, and elimination of pediculosis from the center. I DIVISION OF CO*L`1UNITY HEALTH SERVICES DENTAL PROGRAM - MONTHLY REPORT JUNE 1982 MONTH SCHOOL EXAMS SCHOOL HORACE MANN NORTH - all HORACE MANN SOUTH - kindergarten, 1, 2, 3 and 4 HARVARD DENTAL SCHOOL - Examination by Dr. Weindraub and associates to compare Salem, Holyoke, Worcester etc. INITIAL RESULTS - SALEM - Very good dental health DENTAL CLINIC CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. I 8 3 4 8 - DENTAL HEALTH EDUCATION during examination SCHOOL GRADES PROGRAM HORACE MANN NORTH• all TOOTHBRUSHING QORACE MANN SOUTH Kindg. , 1,2,3,4 (1) When (2) How y Ito • ADMINISTRATION MONTHLY REPORT MAY 1982 . IOLOGIn CS DDISTRIBUTEDi AMOUNT I ANIMAL BITES REPORTED RESIDENTS 9 NON-RESIDENTS 8 Di,ptheria,Tetanus & Pertussis 50 vials BURIAL PERMITS 60. Diptheria-Tetanus Tox. (under 6 yrs. ) -_---__ _.___._._..._. ._.. Immune Serum Globulin 8 vials INTERNATIONAL TRAVEL 1 CERTIFICATES (CERTIFIED)- Measles (Clinic use onl _ p.24R _Measles/Mumps/Rubella 80 doses TOTAL CASH RECEIVED FROM $172.00 -- "" LICENSES & PERMITS ISSUED Polio Vaccine 480 doses Tetanus & Diptheria (adult use) 11 vials COMMUNICABLE DISEASES RESIDENTS 2 NON-RESIDENTS 3 _ Tetanus Toxoid (absorbed) 57 vials 1 ML 4-:10 .tests Tuberculin P.P.D. (Mantoux) 5 ML Typhoid Vaccine EXPENDED BALANCE TO END_ OF FISCAL PORT: ALLOWED SALARY RE $8 �0 .G2_ $73:i6g,,1cL $11,394.92 — -- — . . EYPENSE REPORT: ALLOWED EXPENDED FREE CASH (includes) ENCUMBERED $41,170.00 $31 ,556•86 $9 ,613.14 .m'1.■i'aiinOioGiP■ iiConCCSi'C■�C now IN WIMIN iimiON mom OEM 0 mom ml� iii�' mm NIMMMINIMMIMMIMMINION MIMIM mmmmommommi�� mm� mmmmmmmmm M MEMO mm 10=0 moon mom g ou m mmosiommm NOON■inn NINE gnomon �i� Noil= nommon 0 11010001 melm no On mom ONO mi I�IIIIIIIIINiIIi NIII� TO Salem Board of Health FROM: Jeanne A. Kinhan, R.N. , M.P.H. RE May 1982, Public Health Summary I. Communicable Disease A. Tuberculosis June appointments made for 19 people at North Shore Pulmonary Clinic. Four people tested at Mantoux Clinic. H.V. follow-up of family of 9 immigrants to encourage compliance with T.B. treatment and evaluation —at-Pulmonary Clinic. B. Salmonella Four new cases of Salmonella reported this month. Home visits made for health teaching and specimen collection. • Thirty-four employees of Tiki Kai have been notified to send stool specimens to state laboratory for Salmonella check. Twenty-five results obtained thus far, all negative. C. Varicella One new case of chickenpox reported. D. Meningitis Home visit made for continued follow-up of last month's meningitis case. Patient is now well. All family members have been seen by M.D. for - health evaluation. II. Lead Poisoning Repeat lead tests of three children followed by P.H.N. indicate lead levels decreased to Class I. One repeat test indicates Class II lead level. III. Travel/Immigration One request for travel immunization information. IV. School . Vision and hearing re-screenings conducted. Three children referred for medical evaluation. Several cases of head lice found. Parents contacted for health teaching, support and continued follow-up of treatment procedures. Weekly meetings of the nutrition and diet club continue. f �IJ ConL 'd t ` 5co iosis screening for Grades 5-8 set for June 3. Fari., `oLiti d. S P.N.N. taught health class to Grad(. 5 girls. V. Miscellaneous Hypertension screening clinics held at Fire and Police Stations. Nine clinics were held during May. A total of 52 policemen and 63 firemen have been checked for hypertension. One more clinic will be held in June. P.H.N. spoke to 6 staff members of the Salem/Danvers Early Intervention Program about lead paint poisoning in the community; including symptoms, treatment, and follow-up procedures. P.H.N. attended a Hypertension Training and Education workshop sponsored by the Massachusetts Department of Public Health. Conducted by the Citizen Involvement Training Project, the workshop focused on Hypertension risk factor reduction and was most informative. . P.H.N. spoke on WESX radio about Public Health in Salem. Topics included: P.H.N. responsibility, availability, and mandated duties. • ADMINI "I'RATION MONTHLY REPORT MARCH 1982 RESIDENTS NON-RESIDENTS BIOLOGICS DISTRIBUTED AMOUNT ANIMAL BITES REPORTED 6 3 Di_ptheria,Tetanus & Pertussis 150 doses Di.ptheria-Tetanus Tox. (unc3er 6 yrs. ) BURIAL PERI4ITS ISSUED 70 Irnimme `serum Globulin _1 vial _—_ INTERNATIONAL TRAVEL I CLIT:CIFICATES (CERTIFIED) 2 inquiries Measles (Cl-inic use onl ) -- �T--t�es.sles/Mu.m.ps/Rubella 70 doses— TOTAL CASH RECEIVED FROM $360.00 LICENSES & PERMITS ISSUED Folio Vaccine -- Tetanus & Diptheria (adult use) 180 COMMUNICABLE DISEASES = 5 RESIDENTS Tetanus Toroid ( x�j� 80 ----- 1 4-10 tests Tuberculin P.P D, 5 p,R, 1-50 test Ma..._t,"x) Typhoid Vaccine SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL $85 ,094.02. $59,224.10 $25 ,869 .92_---- F'TI'I?NSE REPORT: ALLOWED EXPENDED FREE_ CASH (includes) rN(;TJP )1,J:1'P $41,170.00 $25 ,766.23 $15 ,403.77 DIVISION OF COIMNITY }HEALTH SERVICES DENTAL PROGRAM - MONTHLY REPORT MONTH SCHOOL EXAMS SCHOOL At DENTAL .CLINIC CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. D DENTAL HEALTH EDUCATION , SCHOOL GRADES PROGRAM • ENVTRON1UNTAL VEALTII OSTON MONTIIT.y REPORT • 1992 1`-1 (yeilr.) (month) 1 2 3 4 5F677 8 9 10 11 12 13 1�F 1516 17 18 19 20 1 22 23 4 25 26 27 28 29� 0 1 TOTALS I' ,,.,d Servi-ce cnmpl.JA 5 T'oocl Serv. Tnsp. i. Mobi.le. Food Serv. Z Z, . Retiii.l Markets 5. liousi.n, / —L— 7. G,a11 eil N,ii.sances .Z 2 2. 2- '2 I 8. Day Care Centers J. D?' y camps 10. Swimin.i.n Pools I l . l;eache � to T T790-ise PO.I.T. L — -------- -- I — TESTItdG T.aboracorx Testing 1. Milk h Cream 2. Swab (Restaur.') 3. Well Water. _ 4. 1"1_uni.ca. al Water 5. Bathing 6'ater 6. Sew ace Water -14 i�1 eld esting �1.�Leac1 'resting 1'. Per.c.Tesc for Sew. System � � I-TCENSES AND PERMITS: 1� 24 COURT HEARINGS — (i,, C --- i TO AND FROM O'N!Flf DUARTPfENTS ; G�L�GGL J V[ti��e p11.4.4CGG<l1Gd,,l O ' eater Salem, <=, 11G. 205 WASHL-ZGTON STREET, S 1LEM, MASSACHUSETTS 01970 • (617) '.'45-9050 TO: Salem Board of Health FROM: Jeanne A. Kinhan, R.N. , M.P.H. RE: March, 1982, Public Health Surrmary I . Communicable Diseace: A. Tuberculosis April appointments made for nine people at North Shore Pulmonary Clinic . ,Updated records for new and continuing T.B. clinic patients. Continued follow-up of persons delinquent in keep inq clinic appointments. Continued follow-up of C1 . 111 T. B. patient. Mantuox Clinic: Seven people tested at clinic. One positive reactor was referred to North Shore Pulmonary Clinic for further evaluation. B. Salmonella • __ .. R One new case of Salmonella reported. - Patient is currently hospit- alized; family members have been contacted by Public Health Nurse, and follow up procedures explained. Continued follow-up of two cases. One person cleared with two negative specimens. C. Varicella Two cases of chickenpox reported. Follow-up by Public Health Nurse to explain communicability and school health requirements. II . Lead Poisoning Six Class I lead levels reported. One report received with question- able lead level results. One Class 11 level reported Two Class III lead level reports received. Public Health Nurse follow-- up of these cases. continues. Ill . Premature Infants Public Health Nurse follow-up of family with premature twins continues. One new birth reported. Public Health Nurse made home visit for assess ment of infant 's growth and development, and health care education and referral for parents.__ IV. School � Public Health Nurse taught nutrition classes for Grades 1 ,3,7 and eight. ti F• Follow-up continues for children referred for M.D. vision check. Conferences held with individual teachers regarding children with apparent health problems. -2- School (cont.inued) . Pre-school registration held for new kindergarten students and transfers. Public Health Nurse explained to parents school health requirements and procedures. Health history questionnaires obtained for new students. V. Miscellaneous Update meetings with Visiting Nurse Association supervisor continues. Letters sent to fifty-two local physicians explaining communicable disease reporting mandates and requesting cooperation in this area. J 7 ADMINISTRATION MONTHLY REPORT APRTr. y4Rp - - I ANIMAL BITES REPORTED RESIDENTS 4 NON-RESIDENTS 2 BIOLOGICS DISTRIBT.7 D AMOt NIT Dipther -a,Tetanus & Pertussis 36 vials Piptheria-Tetanus Tox, (u.nder. 6 yrs. ) --' BURIAL PERMITS 51 _-Immune Serum Globulin 9 vials INTERNATIONAL TRAVEL p CERTIFICATES (CERTIFIED) Measles ( Clinic use on'-Y) _._---_---_—_-- - _-----------__._._.---_..___---__.--- D4Ifi�--measles/Plumps/P.uhe'.la 110 doses I TOTAL CASH RECEIVED FROM LICENSES & PSRPAITS ISSUED $423.00 -Polio Vaccine i _225 _dn�PG -- Tetanus & Diptheris. use 7 vials COMMUNICABLE DISEASES: RESIDENTS - 2 Tetanus T o x 53 vials l Pam, 17 vials ",ubnrcu].in P.P.D. (Mar��tn� !; I'R� 1 vial Typhoid Vaccine -- SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL $85,09)-1 .02 $66,244.70 $18,849.32 FY,PENSF REPORT: A.LT 017,,D EXPFNDFD FREE CASH (includes) ENCUKE3F.RET) $41,170.00 $28,607.62 $12,562.38 Boom==,C�� vuiim won mm mmmm mea:m:Ce. Em ism Altttl4e C__4Jj0CLaILOK a tealet cSaLetff, J11C. 205 i Y ASEMNGTON STREET, SALEM, MASSACHUSETTS 01970 (617) 7 45-9050 TO Salem Board of Health FROM: Jeanne A. Kinhan, R.N. , M.P.H. RE April 1982, Public Health Summary I. Communicable Disease A. Tuberculosis May appointments made for 13 people at North Shore Pulmonary Clinic. Continued record keeping and update of TB records for N.S.P.C. patients. — — - Mantoux Clinic: 7 people tested at clinic. B. Salmonella One new case of Salmonella reported. Continued follow-up of four cases; all cleared this month with two negative specimens. C. Varicella One new case of chickenpox reported. D. Hepatitis Two cases of hepatitis reported. P.H.N. follow-up of patients and contacts continues. E. Meningitis One new case of meningitis reported. F. Mononucleosis - --------- - One new case reported. II. Lead Poisoning Two new Class I lead level reports received. Retests of four children followed by P.H.N. indicate lead levels decreased to Cl. I. One new Class II lead level reported. III. Pediculosis P.H.N. conducted health teaching for family with a child sent home from • school for pediculosis. No further problems reported. �• -2- IV. Premature Births One new premature birth reported. .Mother is current V.N.A. case; V.N.A. follow-up will continue. P.H.N. follow-up of family with premature twins continues for health care education and assessment of resources. V. School " Hearing screening conducted for grades 1-8. Weekly diet and nutrition club held at school for all students interested in this topic, including weight control. Bike safety class taught by Salem State College 'pursing students to 4th grade. P.H.N. attended postural screening workshop offered by D.P.H. VI. Miscellaneous Instruction and resource information regarding communicable diseases requested by North Shore Association for Retarded Citizens. Meetings with V.N.A. supervisor continue. • h • ADMINISTRATION MONTHLY REPORT FEBRJARY 1982 — I ANIMAL BITES REPORTED 7 Resident 4 Non-resident BIOLOGICS DISTRIBUTED AMOUNT Diptheria,Tetanus & Pertussis 330 doses Di_ptheria-Tetanus Tox. (under 6 yrs. ) - BURIAL PERMITS 58 Immune Serum Globulin �5 vials INTERNATIONAL TRAVEL 2 inquiries CERTIFICATES (CERTIFIED) Measles (Clinic use only--__--_ —__ — __.___ ._._.__.__---�..--_------__�_._.____—__ Mt4R--Measles/Mumps/Rubella —_ _ 80 doses TOTAL CASH RECEIVED FROM $1 ,671.00 LICENSES & PERMITS ISST.E�D Polio Vaccine 266 doses Tetanus & Diptheria (adult use) 70 doses COMMUNICABLE DISEASES 4 Residents 3 Non-residents Tetanus Toxoid (absorbed) 500 doses 1 ML 2 10-tes Tuberculin P.P.D. (M_DIS=� 5 r'T' 3 50-tes Typhoid Vaccine - SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL $79 ,o48.00 + $61,o46.02 $85,o94.o2 $51,936.81 $33,157.21 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (includes) ENCUMBFRFD $41,170.00 $22,431.13 $18,738.87 iii MEN iiiiii omii�i��i�iiii�� mmm . ' . . . coo �� n��o� ■ ■ �■�� . , . 1�11111�11111111111111 �11 1 _ 4 i GtG J Vff GL'G�e �� LG aCG �COK a Salem,�eate� C�/ KC. (/G� K 205 WASHr4GTON STREET, SALEM, MASSACHUSETTS 01970 (617) 745-9050 • TO: Salem Board of Health From: Jeanne Kinhan, RN,►IPH - Re: .February 1982. Puhlic: Health Surm ary I. r'a m u licable Disease A. Tuberculosis March appointments made for twelve neonle at North Shore Pulmonary ('linic_ ContinueA follow up -f p-rsnns delinquent in keeping clinic appointments. Updated TB records for new and r-ontinuincy clinic patients. Mantoux Clinic: -,ix neonle tested at clinic - one positive reactor - referred to North Shore Pulmonary Clinic R. Hepatitis Report of one new case of hepatitis received. Patient cannot be located. C. Salmonella One new case of Sabannella rep-rt,-d, public wealth Nurse fellow un in coniunc- tion with primary visiting nurse. Continued follow up of two cases previpusly reported. IT. IPad poinsonin- _ r Tw^ new class T lead levels reported Two reports received with questionable lead level results Public Health Nurse to await retest Visit made to recently deleaded apartment for evaluation and health teaching of mother with two children IIT. Premature Infants €1 Visit to family with premature twins for infant assessment and health care teaching. 'Follow »p cnntinues for assessment of growth and development. f IV. School Retests for visual acuity romnleted �evPn notices sent home recommending M.D. follow UP Blood Pressure screening nonducted for (Irades 3 and 7 Three week nutritinn unit began by Public Health Nurse with Grade I students. ; 3 t C.: I i 1Q. -2- v V. Miscellaneous __ - • Update meetings with Visiting Nurse Association Sunervisor continue. Teachina to Salem State Colleae nursing Gtudents regarding Public Health Nurse role. Instruction and resource information regarding cmmunicable disease given to North Shore Association for Retarded Citizens. Attended Legislative Clearinghouse Information Day at Massachusetts State House, focused on current health and social welfare issues. I i i i. (i I i� i i i . i II ? JAY Al NIS*TION MONTHLY REPORT NUARY 1982, BIOLOGICS DISTRIBUTED A ANIMAL BITES REPORTED RESIDENTS 4 NON RESIDENTS 6 MOUNT Diptheria,Tetanus & Pertus:sis 320 doses - BURIAL PERMITS` 42 Diptheria-Tetanus .Tox. (under 6 yrs. ) - Immune Serum Globulin 52 vials INTERNATIONAL TRAVEL 2 inquiries CERTIFICATES (CERTIFIED) Measles (Clinic use only) A'MR--Measles/Mumps/Rubella 50 doses TOTAL CASK; RECEIVED FROM $TT3.00 — LICENSES &: PERMITS ISSUED Polio Vaccine 250 doses 60 doses COMMUNICABLE DISEASES . RESIDENTS 2 NON RESIDENTS 1 Tetanus & Diptheria (adult use) 210 doses Tetanus Toxoid - ^ 1 P21, 1 10-test Tuberculin P.P.D. Ma 5 .ML 1 50-test Typhoid Vaccine EXPENDED BALANCE TO END OF FISCAL SALARY REPORT: $79_;048:00 ALLOWED . . 6,o46;02 $85,o94.02 $46 ,659:42 $38,434.60 EXPENDED FREE CASH (includes) ENCUMBERED EXPENSE REPORT: ALLOWED - - " $41,170.00 $20,060.31 $21,1o9.61 ,. - " iiiii�iiiiiiiiiiii�ii�iiiiiii�iiii�i� i�i i�i%��iiiiCiii��ii��ii��i Aat-4e c::4.j-4ociatian a teatet cSale w 9 Jpic. 205 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 (617) 745-9050 • To: Salem Board of Health From: Jeanne A. -Kinhan, R.N. ,M.P.H. Re: January 1982, Public Health Summary + I. Contagious Disease A. Tuberculosis PHN follow up of one Cl. III T.B. patient and .contacts continues. February appointments made for twelve people at North Shore Pulmonary Clinic. Mantoux Clinic - four people tested, all negative B. Hepatitis i- Follow up of reported hepatitis cases continues. One person cleared � I of hepatitis by physician report. One new case of hepatitis reported. C. Salmonella No new reports of Salmonella received. One case cleared with two negative specimens. Follow up of two cases continues. II. Lead Poisoning Two new Cl.. I lead levels reported. One new Cl.II case reported. - Retests of four children followed by PHN indicate that two levels continue to be Cl. II and two levels remain Cl. III. IV. Miscellaneous Weekly meetings with V.N.A. Supervisor continue. Follow up letters and questionnaries sent to 110 police and fire department personnel .screened for hypertension,in 1g81: _. .,:... ., ..... ...: } ADMINISTRATION MONTHLY REPORT DlEMBER 1981 BIOLOGICS DISTRIBUTED AM OUNT ) ANIMAL BITES REPORTED -- NON RESIDENT 1 Diptheria,Tet anus & Pertussis 460 doses Diptheria-Tetanus Tox. (under 6 yrs. ) - BURIAL PERMITS 43 430 doses -- Immune Serum Globulin INTERNATIONAL TRAVEL 4 inquiries _ CERTIFICATES (CERTIFIED) Measles (Clinic use only) -= ------ AM--Measles/Mumps/Rubella 60 doses TOTAL CASH RECEIVED FROM - LICENSES & PERMITS ISSUED $1,577.00 Polio Vaccine 471 doses Tetanus & Diptheria (adult use) '110 doses COMMUNICABLE DISEASES 40 doses SALEM RESIDENTS 1 NON RESIDENTS 2 Tetanus Toxoid 1 14L 2 10. Test vials _. .._...--------------____ Tuberculin P' P D a5 ML 1 50 test via (Mantotz.�c) ' Typhoid Vaccine EXPENDED BALANCE TO END OF FISCAL SALARY REPORT: ALLOWED - (3 ,, 7 $78,148.o0 85,094.02 $40,?+05.61 $44,788.41 . 900.00 4- EXPENSE REPORT: ALLOWED EXPENDED FREE-_CASH (includes) EPICm/BERED $41,170.00 $16,777.14 $24,392.86 VL•�G�LK GL��B ��CGL6L�LOK a �eatet <Sale"tq 205 WASHINGTON STREET, SALEM, MASSACHUSE= 01970 If (617) 745-9050 - C:TY OF: SA.LE�ti•] T0: Salem Board of. Health HEALTH DEPT. FROM: Jeanne A. Kinhan, R.N. ,M..P.H. Re: December 1981 , Public Health Summary I. Contagious Disease .A. Tuberculosis Two reports of Class III T.B. received. One case has apparently moved and therefore cannot be contacted. North Shore Pulmonary Clinic will contact Public Health Nurse following patient's next appointment. One T.B. case is currently hospitalized, Public .Health Nurse follow up has been initiated: January appointments made for eleven people at North Shore Pulmonary Clinic. Continued record-keeping and update of T.B. records for North Shore Pulmonary Clinic patients. Mantoux Clinic: Two people tested, both negative. • B. Hepatitis Reports of two new hepatitis cases received. Public Health Nurse follow up has been initiated. Continued follow up of cases reported last month. C. Salmonella - No new reports of Salmonella. Continued follow up of three cases. D. Meningitis One case of meningitis reported. Follow up has been initiated by Public Health Nurse. II. Lead Poisoning Retests of two children followed by Public Health Nurse indicates lead levels remain Class II . Public Health Nurse attended North Shore Children's Hospital Social Service Advisory Committee meeting to discuss lead paint reporting protocols and Board of Health follow up. • 1 r i I 1981 Influenza and Pneumonia Clinic Tally Clinics Flu Vaccine Pneumonia Vaccine* Gables Settlement House Oct. 13, 1981 128 24 Charter Street Housing Oct. 15, 1981 404 42 Council on Aging Oct. 20, 1981 411 84 Shaughnessy Clinic Nov. 12, 1981 59 27 Salem Clinics TOTAL 1,002 177 Salem Visiting Nurse Association 126 20 Ivy Manor Rest Home 20 Home for Aged Women 30 _ Newhall Nursing Home 50 _ Shaughnessy Hospital 22 Dr. Desjardins 20 TOTAL 1,270 197 • • NONEiii DIVISION OF COMMUNITY HEALTH SERVICES DENTAL PROGRAM - MONTHLY REPORT MONTH 'e C tG rh SCHOOL EXAMS /n e4 w; - - FT �CHOOL CARLTON BENTLEY (11 1 D D i— 5T. JOSEPH 1'►'1 11) D L C Sc /t D" H c n�+c M 6 n/n/ rt//.' DENTAL CLINIC 4 PERM. CLIENTS ALLOY CEMENT :D,- EXT. EXAM. & CHART PROPHYLAX. DISC DENTAL HEALTH EDUCATION SCHOOL GRADES PROGRAM Dental Health education conducted with all dental examinations plus tooth brushing . expertise. Crest Program--Educational and nutritional information accompanied with film strip and distribution of Dental Kits at St. Joseph School. i Al)-INISTP,ATION MONTHLY REPORT NOVEMBER 1981 �- ANI!4AL BITES REPORTED 5 residents 7 non-resideni P OT-OG-T C" I17 S R :51TLT,D Ai!OT'^IT Di pther:i_njQtnru s ?< Pertt.>ssi s 34 vials [`i_ptheri.a--'I'raanus 'I'ox. (iznn^r 6 yrs. ) -- BTMIAL PERMITS 69 1 3 Immune Serw Globulinrr .' _— TNTT'RI`dA7 TONAL 2 inquiries CFRTTFICA,TT'S ( �T�RTTT;'Ii?i�) "ie ns', r�s (Clinic use c;n1•') '- _ -__--- __. . ..__ _ tP,TR--T'Fas7.es/ARtzmras/I?ur�>71a 60 doses TOTAL CASH RECEIVED FROF, _—__-- LICENSES & PERMITS ISSi1hD none Polio Vaccine 250 rr Communicable Diseases 3 Tetanus -& DipthYer�a ( adult use) _ 11 _vial, Tetanus Toxo i�dl._(_a_'b s_ rb 4��)--- -- -- — 4 " 1 ML 2-10 test vials Tuberculin 5 ML 1-50 test vial i ___.. n r REPORT: A.i-,Low ,D EXPENDEDBALANCE To END OF FISrAT, (�-ti046.02) (. 900.00) $78,148.00 (6046.02) $35,317.58 $48,876,44 EXPENDED FRrI' CASH (includes) I?X:'F'idSE REPORT: AL,LOr'�n _ -- ---'� $41470.00 $13,747.47 $27,422• 53 MW on MUMIS .10MIMM"Irms Know IMMIUMMI RW-u isi�iai� �• � MIN ii MINIMIMIN moon am Mol am SW imam-% man 16*1 no NINE 0 MEN �0�i��i0 1� ■ 1� 111111 IU • c�ctcH�f ��rt��e c�=f-.�<sacc�zttact o� 1�1��.� 'e; — <t�e�s2, a' r�c. 205 `'VASHLNCTON S'rREET, SALEM, MAS/SACH SETTS 01970 (617) 745-9050 TO: Salem Board of Health • FROM: Jeanne A. Kinhan, R.N. , M.P. H. ` RE: November, 1981 , Public Health Summary I . Contagious Disease A. Tuberculosis December appointments made with North Shore Pulmonary Clinic for 12 people. Continued follow-up of persons delinquent in keeping clinic appointments. Updated TB records and continued record keeping. Mantoux Clinic: Five people tested , all negative. B. Hepatitis Continued follow-up of two cases reported last month. Reports of two. new hepatitis cases received. Immune Serum Globulin administered by PHN to five residents of North Shore Association for Retarded Citizens group home who were exposed to Hepatitis B. C. Salmonella • One new case of Salmonella reported. Continued follow-up of three cases. One case cleared with two negative stool specimens. D. Pertussis Continued follow-up of case reported last month. Final diagnosis for this case is non-pertussis virus. it . Lead Poisoning Three new Class I lead levels reported. One new Class II reported. Retest of one child being followed by P. H.N. ' indicates that the lead level remains Class II . Two cases being followed by P.H.N. continue with Class III lead levels. Meeting with State Lead Paint Program Inspector regarding D. P. H. regulations for lead poisoning prevention and control . Meetings with Health Agent and Sanitarian to discuss current lead cases. III . Pediculosis Referral from truant officer and Middle School Vice Principal regarding family of seven. P.H. N. intervention for pediculosis treatment provided. IV. School , Vision and hearing screening continues. D.P. H. Immunization Report filed for grades 1-8. Kindergarten children excluded from school last month have submitted immunization records and returned to school . V. Immigrant Report received from D.P.H. concerning alien requiring T. B. examination.. N.S._P. C. notified; patient did not keep scheduled appointment. Home visit made by P. H.N. Family has moved from Salem, current address unknown. D.P. H. notified. VI . Miscellaneous Update meetings with VNA supervisor continue. Home visit. made to administer flu vaccine. A final influenza clinic was held at Shaughnessy Hospital . Fifty-nine influenza immunizations and twenty-seven • --pneumococ-ca-l—i-tea nizatio^s—were administered. DI'. : SIGN OF C01ITMIUNITY HEALTH DENTAL PROGRAM - MONTHLY R1-P0!_',T MONTH v SCHOOL EXAMS 7- SCHOOL . ..... ON BENTLEY 6T. J05tPF, fV A/ DENTAL CLINIC • PER11. CLIENTS ALLOY CEMENT bfff:N EXT. EXAM. & CHART PROPHYLkX. DISC DENTAL HEALTH EDUCATION SCHOOL GRADES PROGRAM Dental Health education conducted with, all dental examinations plus tooth brushing expertise. Crest Program--Educational and nutritional information accompanied with film strip and distribution of Dental Kits at St. Joseph School. e12 ADMINISTRATION MONTHLY REPORT OCRER 1981 BIOLOGICS DISTRIBUTED AMOUNT ANIMAL BITES REPORTED 5 Resident 2 Non-Resident Diptheria,Tetanus & Pertussis 450 doses RESIDENT NON-RESIDENT ..._._ BURIAL PERMITS 117 �0 Diptheria-Tetanus Tox. (under 6 yrs. ) - - __..__.__�—`---.---------- ----- - Immune Serum Globulin INTERNATIONAL TRAVEL - - CERTIFICATES (CERTIFIED) Measles (Clinic use only) DUMB--Measles/Mumps/Rubella 70 doses TOTAL CASH RECEIVED FROM $78.00 LICENSES & PERMITS ISSUED Polio Vaccine 530 doses Tetanus & Diptheria (adult use) 9 vials Communicable Diseases Residents 2 Non Resident 2 Tetanus Toxoid 52 vials --- - --- - - 1 14L 5 10-test Tuberculin P.P.D. 5 ML 2 50-test Typhoid Vaccine - SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL $78,148.00 +6o46.02 $30,26o.64 $47,887. 36 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (includes) ENCUMBERED $411,170.00 $11,273. 51 $29,896.49 General. Nuisances 111 11111111111 1 111 (/G•�G�GK Altaje jj4OCGa1G0'1t a leSale"tJuc, a � a � , 205 WASAINGTON STREET, SALEM, MASSACHUSEITS 01970 (617) 745-9050 - I TO: Salem Board of Health FROM: Jeanne A. Kinhan, R.N. , M.P.H. RE: October, 1981 , Public Health Summary I. Contagious Disease A. Tuberculosis November appointments made for 13 people at- North Shore Pulmonary Clinic. Continued record-keeping and update of TB records for North Shore Pulmonary Clinic patients. Follow-up of people delinquent in keeping clinic appoint- ments continues. Mantoux Clinic: Six people tested, one.with positive results referred to North Shore Pulmonary Clinic. B. Hepatitis • Reports of two cases of hepatitis received. One patient hospitalized in Rhode Island. P.H.N. has been unable to contact one patient. C. Pertuss is One report of pertussis received. P.H.N. follow-up has begun and will continue for DPH report. D. Meningitis One report of meningitis received_. P.H.N. follow-up has ► been ,conducted and report has been sent to Regional Health Office. Patient is now free of disease and has returned to .school . E. Salmonella One patient who has been followed by P.H.W. was cleared of Salmonella by two negative stool cultures. Four new ca%es - of Salmonella reported. One case cannot be located by P.H.N. or physician. Three_. cases are being followed by P.H.N. Home visits have been made and R.H.O. reports filed. i JL • 11 . Lead Poisoning I Four new Class I lead levels reported. No. P.H.N. follow- up indicated. Retest.of one child being followed by P.H.N. indicates lead level is decreasing . One Class II lead level reported; M.D. requests that. P.H.N. await retest before follow-up. One Class III level report. Home visit made 'by P.H.N. for assessment of home situation and health teaching. Retest . indicates lead level is decreasing. III . Premature Infant No reports of premature births this month. Follow-up visits . , made to three families for continued assessment of infant growth and development. IV. School Vision and hearing screening continues. 25 children seen by P.H.N. for illness or injury. D.P.H. Kindergarten Immunization report filed. Two children. (siblings) have not submitted immunization reports -,and have, therefore, been excluded from school . P.H.N. follow-up attempts continue. V. Immigrant P.H.N. has contacted local sponsor regarding family of 9 Southeast Asian refugees. All of the children have been to immunization clinic and are. being followed by Dr.'..Louden. The adults have been seen. at Salem Hospital Outpatient Department. The children are enrolled in school . P. H.N. will continue - contact with sponsor. VI . Miscellaneous Update meetings with VNA supervisor.conti.nue. Three home visits made to shut-ins to administer flu vaccine. Three influenza and pneumococal immunization clinicss were held with the following attendance rates: Influenza. Pneumonia Gables Settlement House 12 Charter Street 404 42 Counc i l' on Aging 411 84' Total 9 33 150 Several VNA Board members volunteered time and energy to assist at the flu clinics. In addition, Salem State College nursing students assisted Dr. Desjardins and P.H.N. in administering the vaccine. Due to the large number of requests for additional • clinic time, a last clinic will be held Thursday, November 12, 1981 , 9:30- 12:00 noon at Shaughnessy Hospital . DIVISION OF COMLRJNI ITY HEALTH SERVICES DENTAL PROGRAM — MONTHLY REPORT • MONTH •f - �C_ J_%��C-J�. �/`" SCHOOL EXAMS SCHOOL c - DENTAL CLINIC PERM. CLIENTS ALLOY CEMENT I EXT. EXAM. & CHART PROPHYLA.C. DT DENTAL HEALTH EDUCATION SCHOOL GRADES PROGRAM Dental Health education conducted with all dental examinations plus tooth brushing expertise. Crest Program--Educational and nutritional information accompanied with film strip and distribution of Dental Kits at St. Joseph School. ADMINISTRATION, R10N`I EIN REPORT—— SEPTEMBER 1981 !tt',OilhT ANIMAT, BITFS RFPORVED b resident 3 non-resident K 1)1,1 ari.n,Tetanus P_ s 350 oses r,4JaD N'7 NON-TtESIDT?M, 1,11('.:':Ltl.--'t f 'l;t'!,jit!,`i Tax. (under T ( V t'., i IMBIAL I1FP1'+1T'I"7 27 �9 rnr.0 c f_'erun Globulin Y�a1s . NTERNA TONAL TPA. '�L, r` c r t 1 inquiry CERTIF�':I.CAI' S ( i'RIT1�',E ) ..doses TO`?'PiL CASK RTC:F,:I:VI?1) IilJl'F ------ _ 1� Ii LICENSES & PEI?MITR 1;>SUD Polio Mccine, TaKanurs & Diptheria (adult use)------------- lI -vials_ 1. vc 2 (10's) `.'l l}7 e r c u l.i_n P.P.D. G h n t- ]"A SAT.,_ — I', pboi d Vac ci------------- ne MENDED F�Ar,�rlt;F �, �5, SALARY REPORT . $78,1118.00 $181849.45 $59 ,290. 55 h, ;.d; �, ,,r,:c EVENDE1) $41,170.00 $ 8,4o1.23 $32,768.77 ENVIRON11rNTAL HEALTH DIVISION MONTIrLY REPORT r) (month) -- -- - - _._ 20 22 23 4 25 2b 27 28 2 30 I 1 2F34 S 6 7 � 9 I O I I 12 I3 l�i I S 6 17' l f� 13 10 1 �'; i'i'1RY Ct�DF L_i�1��1Rc;P. 1 GOd Sery Irl�;n. ._._ I - - - -- —I— j -i- -- I -- -- -- --- f— Food Serv, j .0 c �i i Ha r k e t itea ,on aIn s i ,-�:,_ra7. 'nuisances / �- / ,z Day Care Centers C :)a ' C�I1r, s C� Swimmins Pools Beaches -S ------ SESD-Comm _aint` - - — ht: j- -- - �j i Z - CONTROL z / ,!)oratory Testing g I i.l.k f, Cream ` is (Restaur. ) 11 Water . i I n — ---r---p -- ici al. eater 5. hing Later --+-- —. 'a. Se,wa;e Water i .9 T-4- 1 Leld Testes Lead Te_stingr�, ?, rerc.Test for Sew. System M F-1iI'AR'NC S T C PY ,l ""n ON `�F�,S:,IOPd`�.. !.-tI-ALS TO A.� R DI;:�AR=�fE�dTS � � �— _ �-. �. � � � I � I � � � t � j ?07 �VASFIINGTON STREET, SALEM, -'1ASSACI USETTS 01970 (617) 745-9050 • TO Salem Board of Health FROM: Jeanne A. Kinhan, R.N. , M.P.H. RE September, 1981, Public Health Summary I. Contagious Disease A. Tuberculosis October appointments made with North Shore Pulmonary Clinic for 29 people. Continued follow-up of persons delinquent in keeping clinic appointments. Updated TB records of North Shore Pulmonary Clinic. Mantoux clinic: 14 people tested, three with positive mantoux results. B. Salmonella Two new Salmonella cases reported. P.H.N. follow-up also continues for two previously reported cases. C. Hepatitis . One report of hepatitis received. P.H.N. is attempting follow-up, however, patient has not been home. II. Pediculosis H.t'. made to check four children and one adult. No evidence of lice or nits. School and day care notified to permit attendance. Mother informed of treatment and prevention of pediculosis. III. Lead Poisoning Two follow-up reports received for child treated last month indicating lead level is decreasing. Two reports of retests received indicating lead level unchanged. P.H.N. follow-up continues. IV. Premature Infants Three reports of premature births received this month. Two families visited by P.E.N. for infant assessment and health cure instruction. A home assessment visit has been scheduled -ith one family_ . n• V. School Screening has begun for vision, hearing, height, weight, • and B.P. P.H.N. and teachers consult regarding screening procedures and results. VI. Miscellaneous Update meetings with V.N.A. supervisor continue. Two telephone requests for immunization information. One request for information regarding impetigo. Two follow-up home visits to family of five for health care instruction regarding intestinal parasites. P.H.N. attended training sessions for certification in vision and hearing screening of school children. Planning for influenza and pneumococcal clinics continue. Clinic sites have been confirmed; posters have been distributed and publicity information submitted to Health Agent. The clinics will be held 10:00 a.m. to 12:00 noon at the following sites: House of Seven Gables Settlement House - October 13, 1981 Charter Street Housing - October 15, 1981 Council on Aging - October 20, 1981 3 DIVISION 0 CO'f"L:: Si r , DF^:TA-11 PROGFA'11 - .. —.F.PO::T MONTH SCHOOL EY-�SS SCHOOL J ; � ___` i� '�/ �,"t`C• f � --- .`.._.... _ .. !, DENTAL CLINIC Pam? '. CLIENTS ALLO'i CEMENT EXT. EXAM. & CHART PROP ii`'i_',X. ;J DENTAL rEALTi? EDUCi,TIOI - / l SCHOOL GRADES PROGR-kl Dental Healt_. education conducted Witii all dental plus tcoth brushing exi)ertise. Crest :'� �_a ;.--��cat lOnal and. nutritiona_ 1 t-rLlctiC P.ccoirpanied With f -I- strip and distribuziol? of Dental hits at St. Joseph Sc'hocl. � fir: DIVISEIO ; OF ADMINISl'RATION MOIdTHLY REPOF�`, MT'1tTTH T •m p A140 UNT ANIMAL BITES REPORTED 6 resident 3 non-residents t,heria, Tetanus & Pertussis 130 doses RESIDENT NON-RESIDENT theri.a-Tetanus Tox. (under 6 yrs. . __ BURIAL PERMITS ISSUED line Sertur. Globulin 6 vials sles (Clinic Use Only) __ INTERNATIONAL TRAVEL 4 inquiries CERTIFICATES (CERTIFIED) sles/;'wraps/Rubella 60 doses i_o Vaccine 181 doses TOTAL CASH RECEIVED FROM 116 LICENSES & PERMITS ISSUED anus & Diptheria (Adult Use) 1 vial anus Toxoid (absorbed) 50 vials 1 ML. 0 tests crculin P.P.D. (Mantoux) 5 ML. 50 tests hoid Vaccine BALANCE TO END SALARY REPORT: ALLOWED EXPENDED OF FISCAL DIV. OF ADMINISTRATION $30,389.00 $ 4,990.22 $25,398•78 DIV. OF COD,114UNITY HEALTFI $12,963.00 2,100.83 10,592.17 DIV. OF ENVIRONP 'NTAL HEALTH $35,066.00 5,777. 32 29,288.68 FREE CASH (includes I?>;PTs dSE REPORT: ALLOWED EXPENDED ENCU14BERED :):C V. OF ADMINISTRATION DIV. OF CObL%IUNITY HEALTH (Held up because of proposed merger) DIV. OF ENVIRONMENTAL HEALTH i tttfe C=4.focialian al Cjtealet 9 Atic. 05 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 (G 17) 745-9050 • TO Salem Board of Health FROM: Jeanne Kinhan, RN, MPH RE August, 1981 Public Health Summary I . Contagious Disease A. Tuberculosis North Shore Pulmonary Clinic appointments were made for 12 people for the month of September. Continued follow-up of persons delinquent in keeping clinic appointments and continued update of TB records for NSPC patients have been conducted. Contact was made with two class II converters for medication teaching and to encourage mantoux test for family members. One person tested at Mantoux Clinic. Meeting with M. Clynne, RN, North Shore Pulmonary clinic, to review clinic procedures and follow-up. B. Salmonella • Two new salmonella cases reported. Home visits made and information obtained for State Communicable Disease Reports. P.H.N. follow-up continues. C. Pertussis Communicable disease notice received for patient reported last month. Child resides in Lynn; Lynn Board of Health notified. D. Meningitis One follow-up report discussed with M.D. and sent to Regional Health Office. II . Pediculosis P.H.N. was contacted by the director of Camp Naumkeag after four children at camp were thought to have pediculosis. Ten children and five .adults associated with the camp were checked by P.N.N. , with no evidence of lice or nits. Instruction regarding pediculosis treatment and prevention were given to parents. Approximately thirty children and adults were checked for pediculosis by P.N.N. before attending an overnight- camp reunion; no problems detected. One telephone call received regarding a recurring case of Phthiris pubis; instructions given regarding treatment, control Y and prevention. -2- - III . Lead Poisoning Reports received on three children being followed by P.H.N. indicating • decreased lead levels. Two new lead level reports received, both class I . One retest indicating lead level remains class II . Home visit made by P.H.N. for teaching regarding lead poisoning, illness prevention and health promotion. One retest indicating lead level increased to class IV. Physician and mother notified and child , hospitalized for treatment. Family is moving to another apartment and child will be followed by V.N.A. upon discharge from hospital . IV. Premature Infants Three new reports of premature births received this month. Two families referred by- hospital to V.N.A. for evaluation and follow-up. ' F e One family visited by P.H.N. for infant assessment and health care instruction.. Home visit to family of infant born in June for continued health care promotion. c V. Miscellaneous Two reports of strep throat received. Patients being followed by M.D. Meeting with Manchester P.H.N. to discuss Public Health Protocols • and school health educat ion .programs. Four calls requesting ' immun'ization information; 'P.H.N. explained immunization regulations and procedures for obtaining record. Referral received from physician regarding noncompliant family of five diagnosed to have Trichiurea (whipworm) . Home visits to family made by P.N.N. ; follow-up :to continue to encourage specimen collection; evaluate health status and promote hea -th .care.. Meetingswith Bob Blenkhorn, Linda Billows and Betty Poirier to plan 1981 influenza and pneumococcal clinics. opom M. , Immumunu seesaw iiiiMiiiiO�N'Vi�C�iio5n=- Una iWNW ! WIn�n`niio�io�uii�v�ia��innnr��iIN MCI _•- WIN IMMIMMIN EMMMIMMIMMIM . . i iii iiimiiiimiiiii�l IMIMM IN IN WIN WIN ii=i�eiiiiiioi=iimioi WIIN N � MINIMUMiiii�9�n�=�Q 0 1111111111111 SIN DIVISION OF M-11y"UNITY HFALTI? DENTAL PROGRAM — MONTHLY REPORT MONTH SCHOOL E}A_"SS �) I C -c �s SCHOOL DENTAL CLINIC PERTs. CLIENTS ALLOY CEMENT W'fI�D,- EXT. EXAM. & CHART PROPIiYLA\. I� DENTAL HEALTH EDUCATION . SCHOOL GRADES PROGR.LM Dental Health education conducted with all dental examinations plus tooth brushing expertise. Crest Program--Educational and nutritional information accompanied with filch strip and distribution of Dental Kits at St. Joseph School. DIVISION OF ADMINISTRATION MONTHLY REPORT MONTH juLy 1981 Ah BIOLOGICS DISTRIBUTED AMO UNT ANIMAL BITES REPORTED 1 Resident '7 Non-residents Diptheria, Tetanus & Pertussis 220 doses RE)18DENT NON-RESIDENT Diptheria-Tetanus Tox. (under 6 yrs. . BURIAL PERMITS ISSUED 34 Immune Serum Globulin [Measles (Clinic Use Only) INTERNATIONAL TRAVEL 1 validation CERTIFICATES (CERTIFIED) 3 inquiries MMR Measles/Mumps/Rubella 70 doses Polio Vaccine 240 doses TOTAL CASH RECEIVED FROM $213.00 LICENSES & PERMITS ISSUED Tetanus & Diptheria (Adult Use) 10 doses Tetanus Toxoid (absorbed) 10 doses 1 ML. 20 Tests Tuberculin P.P.D. (Mantoux) 5 ML. -- Typhoid Vaccine R - BALANCE TO END SALARY REPORT: ALLOWED EXPENDED OF FISCAL DIV. OF ADMINISTRATION $30,389.00 $2,669.18 $27,719.82 DIV. OF COMMUNITY HEALTH 125693.00 15127.91 11,565.09 DIV. OF ENVIRONMENTAL HEALTH 35,066.00 35090.20 31,05.80 FREE CASH (includes EXPENSE REPORT: ALLOWED EXPENDED ENCUMBERED DIV. OF ADMINISTRATION (Held up because of proposed merger) DIV. OF COMMUNITY HEALTH DIV. OF ENVIRONMENTAL HEALTH L MIN OMNI MIN m ESSER no mom MIN INININNINNINININIMMIN WINNOW W �o�i'�ie�ieiiiie�iii�io n ■_ ammon,lonsMENEM on MEMNON MEN ii�i� H� � 111 1111111111 �111 VT iXIt Aatie ='f-j:saciatcan a realer =Sa emr Aic. ff 205 VVASHINGTON STREET, SALEM, MASSACHUSETTS 01970 (617) 745-9050 • TO Salem Board of Health FROM: Jeanne Kinhan, RN, M.P. H. RE July, 1981 Public Health Summary I . Contagious Disease A. Tuberculosis North Shore Pulmonary Clinic appointments made for 27 persons for month of August. Continued follow-up of persons delinquent in keeping clinic appointments. Updated TB records for new and continuing clinic patients. PHN contact made with two Class II patients who have history of non- compliance, to explain importance of continuing with medications and clinic evaluations. Mantoux Clinic: Three people tested, no positive test results. One request received for previous certification results. * R Visit to NSPC to meet clinic personnel and discuss appointments. Meeting with Joanne Corcoran , R.N. , DPH Tuberculosis Program Specialist to review TB information , local public health responsibilities and nursing protocols. B. Salmonella No further information received regarding two Salem residents seen by private physicians in May for Salmonella. Communicable disease notice requested by PHN not received from physicians. One resident cleared of Salmonella with two negative stool cultures. C. Pertitss i s One case reported by laboratory. Communicable disease notice requested twice from physician, not received. D. Pediculosis Call received from Salem YMCA camp director regarding possible pediculosis infestation at Camp Creighton, located in Middleton. Referred to Middleton Board of Health. II . Lead Poisoning Two new lead level reports received, both to be retested by M. D. prior to PHN follow-up per request of physician. Ilk - 14 Five retests with lower levels reported. One retest indicates level remains Class I , no need for PHN follow-up. One retest reported indicating that levels remain essentially unchanged. M. D. notified and PHN follow-up to continue. Home visit made to parent of Class II patient for teaching regarding lead poisoning, illness prevention and health promotion. Referral made to sanitarians for house lead testing. III . Premature Infants Report of three premature infants received, all being followed by Salem V.N.A. Contact made with mother of premature infant born last month and discharged to home at six weeks of age. Home visit appointment scheduled. IV. Miscellaneous Visit to Temple Early Intervention Day Care program to check child with infected sore on arm. No follow-up treatment necessary. Family has been referred to V.N.A. One walk-in visit to PHN, woman complaining of intermittent dizziness. B.P. low, health history reviewed. Patient referred to private M. D. for follow-up. One week of orientation for new PHN including meeting with Health Agent and review of Public Health protocols. D-VISTON OF i1EA1.,T11 S1.-1P` IC DENTAT, PROGRIk.M MONTHLY REPOPT MONTH SCHOOL EXMS - ----- JAL,-, k,H,00L ARL T BENTLEY bT. JOStPH ,Pj fjIVIV DENTAL CLINIC PERM. CLIENTS ALLOY CEMENT bE01:D; EXT. EXAM. & CHART PROPhYLAX. DIS( DENTAL HEALTH EDUCATION OT Clio L, GRADES PROGRAM . Dental Health education conducted with. all dental examinations plus tooth brushing xperti se. -Crest Prograr-i--l-Educational and nutritional information accompanied with film -trip and distribution of Dental Kits at St. Joseph School. DIVISION OF ADKINISTRA'T'ION =NTHLY REPORT MONTH JUIrE 19bi 4 - .' ')GICS DISTRIBUTED AMOUNT ANIMAL BITES REPORTED 8 Resident 9 non resident feria, Tetanus & Pertussis 610 doses RESIDENT NON-RESIDENT +eria-Tetanus Tox. (under 6 yrs. . BURIAL PERMITS ISSUED 15 21 is SerLut: Globulin 19 vials __es (Clinic Use Only) -- INTERNATIONAL TRAVEL 2 inquiries CERTIFICATES (CERTIFIED) _es/Mumps/Rubella 120 doses Vaccine 231 doses TOTAL CASH RECEIVED FROM LICENSES & PERMITS ISSUED $208.00 ius & Diptheria (Adult Use) 240 doses ius Toxoid (absorbed) 310 doses COMMUNICABLE DISEASES Resident - 4 1 ML. 110 doses Non-resident - 2 -culin P.P.D. (Mantoux) 5 ML. 100 doses )id Vaccine -- -- BALANCE TO END kLARY REPORT: ALLOWED EXPENDED OF FISCAL IV. OF ADMINISTRATION $62,961.00 $59,127.99 $3,833.01 IV. OF COMMUNITY HEALTH 26,747.00 $26,993.64 - 246.64 IV. OF ENVIRONMENTAL HEALTH 71,796.00 65,535.05 6,260.95 FREE CASH (includes ,TEPISE REPORT: ALLOWED EXPENDED ENCUMBERED DIV. OF ADMINISTRATION 2,400.00 1,643.39 756.61 DIV. OF COMMUNITY HEALTII 45,710.00 5,291.41 3917.02 DIV. OF ENVIRONMENTAL HEALTH 4,950.00 4,578.97 - 371.03 v\ i DIVISION OF COKMUNITY HEALTH SERVICES DENTAL PROGR%IM - MONTHLY REPORT - • MONTH 2,AY 1981 -- SCHOOL EXAMS SCHOOL ENDICOTT completed WITCHCRAFT 3 ( incomplete 3 3 DENTAL CLINIC CLIENTS ALLOY CEMENT DECID. EXT. EXAM. S CHART PROPHYLAX. lei / ;7- DENTAL HEALTH EDUCATION SCHOOL GRADES PROGRAM Bates 3 Crest Program Endicott 3 and Crest Frogram Witchcraft 3 Crest Program • V7N m m Iwo�G�Gi �G'uiiG='ni �■ ��'. MIN WIN -• � s�-ammmmmmmmm iio�i�iii�iii�iiii� moon mmmml OMNI OMNI Olson 0 0 sollso mal . . . , . ��i i��a■ Sit 11111111111 11111 1 V G��Gl2 J UGL"t�e 4=74jociatian a teatet Salem, J14C. � 205 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 (617) 745-9050 • TO Salem Board of Health FROM: Lucy Beths, RN,BS RE June, 1981, Public Health Summary I. Contagious Disease A. Tuberculosis Continued appointment arrangements for North Shore Pulmonary Clinic and follow-up of persons deliquent in keeping. clinic appointments. Update of TB records for new and regular clinic patients. Mantoux clinic: 915 people tested', one with positive test results. r B. Salmonella Two residents being seen by private MD for salmonella. Formal communicable disease notice requested from physicians, but not received. One Salem resident continues stool testing for child. f C. Pediculosis • Following complaint of neighboring resident, family visited by PHN and sanitarian to provide skilled observation,. teaching and materials. D. Chickenpox Two cases reported - 1 formal communicable disease notice from physician received. II. Premature Infants Reports of four new Salem infants - all mothers contacted by PHN. All infants doing well and repeat follow-up by PHN not required. III. Lead Poisoning Reports of three levels received; children to be checked for ' iron deficiency anemia. Reports of three improving lead levels also received. IV. Miscellaneous Boston Guild for the Hard of Hearing Screening July, 1980. ' The PHN has completed follow-up for the 72 persons failing the hearing and requiring PHN contact. Persons still requiring further testing have been referred to appropriate community resources. • The high percentage of those requiring medical attention indicated the value of .the screening program for Salem residents. - w ^/ -2- V. School The school year ended this month and the PHN has spent time • preparing new school nurse log records for next years students. Next September's Kindergarden, 3rd and 7th graders' parents were sent memos regarding physical examinations and immunization needs. Sick Log: 5 injuries 6 illnesses 11 reported to school nurse ti f MAY -L 9 O.L OLOGICS DISTRIBUTED AMOUNT '3I'17'F.S7z RFPORT-ED 9 ptheria, Tetan'-s & Pertussis 220 dose RESIDENT !vO"j ptheria---etanus Tox. (under 06 y rs BURIAL PERMITS ISSUED 32 29 mune Serlwn Globulin 26 vial asle-s- (-C-Linic ',2se Only) - INTEM.ATION".1, TRAVEL C--:7.r.I F I C AT-.":S (C= RT I FI E D 3 inquiries it as.;,-es qn docies D FTROi- c c n e 80 doses --C-AL R-:,C $223-00 PER:.:I'rS 13SUED Lanus 1`4 -- iT)theria (Adull, -*se) 170 doses T ta!ius '-cxoid (ab-sorlbed) 230 doses 1 40 tests (:-'antoux) 5 0 4 C.'. cc 4-ne I 80 doses 3- ,".LANCE TO GPM F "AJ,i -Y -- ','P0R'7 : ALL 0',-1 E D O FISCAL T V. D'.:!.-.'1 1,.T 1 01V. $62,961.00 $565132.92 63, I A 7 828.o8 .1 V. 31 OF C0:---,RT:ITY HEAL"" $26,747-00 74,693.91 . 1,o80.17 IV. C,- 1VI R T AL 'TEALTH $71,796.00 619670.27 10,125-73 FREE CASH (includes -.1:,:PEN'S--:7' REPORT: ALLOWED EXPEN DE D ENCU12ERED DIV. OF ADI-IINISTRATION $2,,400.00 $ 1*182.29 $1,217-71 DIV. OF COIP.M ITY HEALTH 45,710.00 $36,501-57 $9,208.43 DIV. OF EINVIR0111-1ENTAL HEALTH $4,950-00 $ 3,866-50 $110083- 50 mom M Mom �ww nwN wwwonwK all* IMEMMMOMM mom ONE MEMO 0 . monsoons@ . /11111111 !II v _ DIVISION OF COKMUNITY HEALTH SERVICES , DENTAL PROGRAM - MONTHLY REPORT • MONTH MAY 1981 SCHOOL EXAMS SCHOOL ENDICOTT completed WITCHCRAFT incomplete DENTAL CLINIC CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. DENTAL HEALTH EDUCATION SCHOOL GRADES PROGRAM Bates 3 Crest Program Endicott 3 and 4 Crest Program Witchcraft 3 Crest Program • J r TO Board of Health Salem VNA Director . �V� 2 1981 FROM: Lucy Beths, RN Gi I Y OF SALEM RE May, 1981 , Public Health Summary HEALTH DEPT. I . Contagious Disease A. Tuberculosis Continued appointment arrangements for North Shore Pulmonary Clinic and follow-up of persons delinquent in keeping clinic appointments. Update of TB records for new and regular , clinic patients. Mantoux Clinic: 14 people tested, none with positive test results. B. Salmonella Five cases being followed. Two cleared of disease; three Salem residents continue testing. C. Chickenpox Three cases reported. No communicable disease notice from physicians received. II . Lead Poisoning ' Three new lead levels reported on Salem residents. Two cases • continuing follow-up of lead levels. III . Premature Infants Reports of four new Salem infants - two required follow-up by PHN. IV. Immigrant Adequate assistance provided by sponsor; PHN intervention not necessary. V. Miscellaneous i A. Teaching to Northeastern and Salem State Nursing students regarding Public Health Nurse role. B. Update meetings with VNA supervisor throughout month. VI . Pediculosis A. Repeat visit by PHN to early Intervention Day Care Program for pediculosis check on one child; negative findings. B. Repeat referral from Salem High School nurses regarding non- compliant family. PHN intervention provided. VII . Blood Pressure Screening • Weekly hypertension screening program carried out for police and fire department personnel of Salem, during month of May which is National Hypertension Month. -2- VIII . School J A. Scoliosis Screening done for students grades 5-8. . Results: -117 students screened • 30 students referred for'MD examination Involves preparation, screening, record keeping and follow- up by PHN. B. Sick log: 6 injuries 1 referred to MD for treatment yr • 1 BLOOD PRESSURE SCREENING RESULTS r POLICE DEPARTMENT FIRE DEPARTMENT Employees 76 Employees 110 Screened 60 (80q) Screened 50 (45%) Age Range: 20 - 70 years Age Range: 20 - 70 years FINDINGS: FINDINGS: A. Do not have own physician - 26 A. Do not have own physician - 22 B. High risk factors: B. High risk factors: I , Smoking: 1 + PPD -.16 1 . Smoking: l + PPD - 5 2 + PPD - 6 2 + PPD - 5 3 + PPD - 3 3 + PPD - 0 25 10 2. Overweight: 2. Overweight: Between 10 - 30 lbs. - 31 Between 10 - 30 lbs. - 31 3. Family History of Hypertension: 19 3. Family History of Hypertension: . 16 4. High Blood Pressure & Unaware - 9 4. High Blood Pressure & Unaware - 11 High Blood Pressure aware-but High Blood Pressure aware-but untreated - 3 untreated - 1 Blood Pressure treated but Blood Pressure treated but inadequately controlled - 5 inadequately controlled Receiving treatment and Receiving treatment and controlled - 7 controlled - C. Referred to physician: 10 C.. Referred to physician: 8 D. PHN follow-up: 11 D. PHN follow-up: 9 E. Plan E. Plan 1 . Six month Blood Pressure follow-up 1 . Six month Blood Pressure follow-up of all persons with elevated of all persons with elevated blood pressure. blood pressure. 2. Annual - Hypertensive risk factor 2. Annual - Hypertensive risk factor reduction program. reduction program. ' • 19 ; 00 . 0 IMM Sol 11 1 ENO on monsoons m MOMEMOMMOMMOMMEN MEiiiie�e�ii • DIVISION OF ADMINISTRATION • MONTHLY REPORT MONTH APB 1981 r 'BIOLOGICS DI, TRIBUTED AMOUNT I ANIMAL BITES REPORTED 5 Diptheria, 'Tetanus & Pertussis 550 doses :ON- DiDtheria-Tetanus Tox. (under 6 yrs. . BURIAL PERMETS ISSUED 36 28 Ii,,unune Serwi Globulin 47 vials Measles (Clinic Use Only) INTERNATIONAL TRAVEL CERTIFICATES (CERTIFIED) 3 inquiries -easles/'lumps/Rubella 0 doses Po:.i.c. .'accine _ 1 39 TOTAL CASH RECEIVED FROM LICE':SES & PER.",TITS ISSUED $503.00 "elanus & Diptheria (Adult -se) 480 doses nus oxoid'et:z �'_ 1abSOrUed 230 doses erculin P.P.D. (:dantoux) ,H .� 50 tests Communicable Diseases 2 :`.--ncid Vaccine 5 vials ALATNCE TO END SP-,:CRY REPO:=': ALLOWED EXPENDED OF FISCAL Dl . . OF ADrI';ISTRA Io . $62,961.oo 525263.49 ;(40 97.51 DIV. OF COM:4711TITY HEALTI' $26,747.00 22,752.o6 3,994.94 DIV. OF FNVIROIdr�'rdTA.L HEALTH $71,796.00 35,536.55 36,259.45 FREE CASH (includes L}'ENSE REPORT: ALLOWED EXPENDED E1;CU1•'1BERED DIV. OF ADMINISTRATION $2,400.00 $1,105.04 $1,294.96 DIV. OF COKIMUNITY HEALTH $45,710.00 $33,582.24 $12,127. 76 DIV. OF ENVIRONMENTAL HEALTH $4,950.00 $3,742.85 $13,207.15 DIVISION OF COMMUNITY HEALTH SERi'ICES • DENTAL PROGRAM - MONTHLY REPORT MONTH March, 1981 SCHOOL EXAMS SCHOOL. .. CARLTON BENTLEY BOWDITCH SALTONSTALL ST. JOSPPH PHILLIPS • DENTAL CLINIC PERM. CLIENTS ALLOY CEMENT WM4N EXT. EXAM. & CHART PROPHYLAIIX. DIS 8 1 8 8 DENTAL HEALTH EDUCATION . SCHOOL GRADES PROGRAM Dental Health education conducted with all dental examinations plus tooth brushing _ expertise. Crest Program--Educational and nutritional information accompanied with film strip and distribution of Dental Kits at St. Joseph School. • L l (/c��itir�g Vci tie ��vccatiaH o qualet Salewq <`4 c. , 0 205 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 (617) 745-9050 • TO Salem Board of Health Salem V.N.A. Director FROM: Lucy Beths, RN RE April , 1981 , Public Health Summary I. CONTAGIOUS DISEASE ` A. Tuberculosis North Shore Pulmonary Clinic appointment arrangements for 25 persons for the month of May. Continued follow- up of persons deliquent in keeping clinic appointments. Continued update of TB records for new clinic patients and those requiring follow-up. Mantoux clinic: 10 people tested, none with positive test results. B. Salmonella Two new salmonella cases in Salem. • Follow-up continued by PHN. II. LEAD POISONING Receipt of .follow-up lead level reports on Salem residents. No new families this month. III . PREMATURE INFANT One family seen for health promotion for mother and child. Reports of two new Salem infants. PHN follow-up not required. IV. MISCELLANEOUS A. Worked in conjunction with Regional Health Office for follow through on reports of communicable diseases. B. Teaching to individual Salem State College, students regarding Public Health Nurse role. C. Update meetings with V.N.A.. supervisors and board of health Health Agent throughout month. D. Preparation and planning for future events include: 1 . Scoliosis screening for St. Joseph' s 5-8th grade students in May. 2. Blood pressure screening for Salem Police and Fire • Department employees during May, which is blood pressure month. - r 1 � i 3. Hearing screening for Salem residents -during Heritage week. (month of August) 4. Follow-up on Salem residents who failed the hearing • screening done in conjunction with the Boston Guild for Hard of Hearing. V. SCHOOL A. Two one hour sex education classes for 7th and 8th grade girls by PHN by request of school principal . B. Regular nurse/teacher consults regarding student health. C. Four half hour nutrition classes to first grade students. D. Student Sick Log 10 accidents (1 referred to MD) 5 illness (2 referred to MD) \ 15 reported to school nurse , • i { i 1.11[ 1;:.� ,�' � l(�St `.-T.f.f.'LLcZ�Ci.'li C•'�j ^�t'�l�E` �_. �Z�E'111� `:� �11C• c , ?OJ \VASH:\CTO\ STREET, SALEM. NIASSACHUSLTTS 019i0 017) 745-9050 Arpil 29, 1981 Chief James Brennan Sale Fire Department 48 Lafayette Street Salem, MA 01970 Dear Chief Brennan: As you know, May, 1981, is National High Blood Pressure Month. During this month, greater efforts are made to inform the lay and professional public of the dangers of uncontrolled high blood pressure. High blood pressure month offers a good opportunity to highlight local high blood pressure problems and possible solutions. The Salem Health Department in conjunction with the Salem Visiting Nurse Association will conduct blood pressure screening programs during the month of May for Salem Fire Department and Police Department personnel . I thank you for your assistance in providing a screening area in the Lafayette Fire Station, and encourage as many of your employees as possible to participate in the program. The dates and hours will be: Wednesday May 6 10:00 a.m. - 1 :00 p.m. Wednesday May 13 10:00 a.m. - 1 :00 p.m. Wednesday May 20 10:00 a.m. - 1 :00 p.m. Wednesday May 27 10:00 a .m. - 1 :00 p.m. Enclosed are posters giving screening information which you may post for your employees . Thank you, Lucy Beths, RN Robert E. Blenkhorn Public Health Nurse Health Department Salem. MA Salem, MA LB;%1 a mom MWE WE is iiiiWIMi�iiiMINI INMi MINNINIM MORE ��i�■�' W Olson I I loll ON WINNOMM IMMIMMI No MISSION mom No on 0 1 MIN Nori iom ��l�i� iii�iC" ii ■ loll mom D1 VI S 10 T OF AD11,11N ISTRATION MONTHLY 1,,EPOPT MONTH MARCH P, in — (Resident) (NoTPwRe—sident) I M.1 ,)Iol DGICE, D I'.,T-1-1,13 T-* 0UNT A Dip tl-eria, '-"etanus F. Pertussi.-; j 430 doses F, S I DE f i 'M-REST_ :T D. -) - I- 'E Iutheria--'etanus (under j 1�'I L PIE R114,I I J 1 Seru-,i; Glo, lit -' n j 260 doses :-:eagles ise ')nl— !"A J, 30 doses I r! 1180 doses $161.00 -L L 1�2 f U 530 doses 270 doses OTHER COMMUNICABLE DISEASES (Resident) (Non-Resident) 70 tests 300 tests of Vacci!�e "ALA"CE TO L T D"; E D D.-I D OF F!3 C.h L IV. U F $62,961.00 $46,859.69 $ l6t101. 31 1 V. OF -3 26,747-00 20,2-9-76 6,507.24 T 0 F TAL 71,796.00 52,451.69 jo 144- 31 FREE CASH (includes A-LL0*dTM 714-CUI-T-ERED DIV. OF $ 2,400.00 $ 948-05 $ 1,1151.95 DIV. OF 1101MENUNr-'Y HEALTI; 45,710-00 29 J-11.60 15,996.40 DIV. OF Ell VI RO'l.%:EINTAL 4,9510.00 3,467.81 lt482.19 DIVISION OF ADMINISTRATION MONTHLY REPORT MONTH MARCH 1981 (Resident) %Iro-n4ks—i UWE BIOLOGICS DISTRIBUTED AMOUNT ANIMAL BITES REPORTED 7 11 Di theria, Tetanus & Pertussis 430 doses RESIDENT NON-RESIDE^;T Diptheria-Tetanus Tox. (under o yrs. - BURIAL PERMITS ISSUED Immune Ser?up. Globulin 260 doses :•ieasles (Clinic- Jse Only} - IhTTERdATIOIiAL TRA.'. 'L 1 CERTIFICATES (CER 'IFIED) •tTR� :Measles,%:Iunps/huoel'_a 30 doses o=_o 7accir_e 480 doses TOTAL C-ISH RECEIVED FRO!,: LICE'.SES & PER.SIT. IS-'-SUED $161.00 etanus a iptheria (Adu1. se) 530 doses e anus ol:oi (a s:reed} 270 doses OTHER COMIINNICABLE DISEASES (Resident) (Non-Resident) 70 tests -_uberculin P.P. (::antcu:x) 5 '•:L.I 300 tests J -yp:.oid Vaccine - BALANCE TO END . ALhI?Y RE'POR': ALLOWED E, 4TE'IDED OF FISCAL DIV. OF $62,961.00 $46*859.69 $ 165,101.31 DIV. OF C01-24U;ITTY HEAL 26,747.00 20*239.76 6,507.24 DIV. 0. EPTVIRO1T'-'✓,TAL -IEALTH 71,796.00 52,451.69 19,344.31 FREE CASH (includes EXPENSE REPORT: ALLOWED EXPENDED ENCUMEERED DIV. OF ADMINISTRATIONt $ 2,400.00 $ 948.05 $ 15451.95 DIV. OF COM4UNITY HEALTH 45,710.00 29,T?3.60 15,996.40 DIV. OF ENVIRONMENTAL HEALTH 4,950.00 3,467.81 1,482.19 i DIVISION OF C0M14UNITY HEALTH SERVICES DENTAL PROGRAM - MONTHLY REPORT MONTH Harch, 1981 SCHOOL EXAMS SCHOOL CARLTON BENTLEY BOWDITCH SALTONSTALL ST. JOStPH PHILLIPS ! DENTAL CLINIC PERM. CLIENTS ALLOY CEMENT I:D% EXT. EXAM. & CHART PROPHYLAX. DI 8 1 8 8 DENTAL HEALTH EDUCATION SCHOOL GRADES PROGR.AIM Dental Health education conducted with all dental examinations plus tooth brushing expertise. Crest Program--Educational and nutritional information accompanied with film strip and distribution of Dental Kits at St. Joseph School. i r t I VL•�[�GKg J UIL��B ��JCGL.Z�LCK 0l realet cSa ems AIC, r U _ 205 WASHINGTON STREET, SALEM, !v1ASSACHUS=S 01970 (617) 745-9050 • i i TO Salem Board of Health Salem V.N.A. Director FROM: Lucy Beths, RN RE March 1981 Summary 1 . Contagious Disease A. Tuberculosis North Shore Pulmonary Clinic appointment arrangements for approximately 15 persons for April . Continued follow-up of persons delinquent in clinic appointments. Mantoux Clinic: 22 people tested - Two referred to North Shore Pulmonary Clinic with positive test results. Two referred to North Shore Pulmonary Clinic due to familial contact with TBC. Continued record keeping of interagency referral forms for North Shore Pulmonary Clinic. B. Salmonella • Three new Salmonella cases in Salem. Teaching and follow-up to be continued by Public Health Nurse. Two cleared from disease with negative testing. II . Lead Poisoning Continue to receive follow-up reports on Salem residents. No new families this month. 111 . Immigrants Follow-up to new refugee family for immunization check and Salem Health care system introduction. • IV. Miscellaneous A. "Tuberculosis update" seminar attended by PHN. B. Child care conference attended at North Shore Children's Hospital for PHN input regarding case. C. Hepatitus viral , infectious - unable to locate new Salem resident case - private M.D. will file report for PHN. D. Teaching to individual Salem State College students regarding Public Health Nurse role. . 1 V. School A. Completed student testing for height , weight, blood pressure, hearing and vision screening. One child found to have defective vision and referred to M.D. for further testing. B. Pre-school registration - involves record preparation and consult to 20 parents regarding immunization and school nurse expectation. All pre-school children tested for hearing and vision - one child referred for eye exam follow-up. Student Sick Log 20 accidents 5 illness 25 reported to school nurse 7 referred to emergency room or private M.D. for treatment Regular nurse/teacher consults occur regarding health of students and screening results. it f i i d ;a 1 Immu Ban mm Asti . � MINIONiliiilil ili��lii 1111 DIVISION OF ADMINISTRATION MONTHLY REPORT MONTH FFBRj'TA.pA&9pl • BIOLOGICS DISTRIBUTED A2MOUNT ANIMAL BITES REPORTED 3 F 4 NON-RESIDEW i Di theria, Tetanus & Pertussis 18 vials RESIDENT NON-RESIDENT Di theria-Tetanus Tox. (under 6 yrs.) BURIAL PERMITS ISSUED 36 23 Immune Serum Globulin 30 vials Measles (Clinic Use Only) --- INTERNATIONAL TRAVEL 1 CERTIFICATES (CERTIFIED) INI R Measles/i-`.u.mps/Rubella 70 doses Polio :'accine 160 doses TOTAL CASH RECEIV= FRO:: t112.00 LICENSES & PER%ITS I SU D etanus & Diptheria (Adult Use 7 vials Letanus Toxoid (absorbed) 32 vials COMMUNICABLE DISEASFS 2 vials Tuberculi__ P.P.D. (i-iantoux) 5 6 vials Typhoid Vaccine I --- `, LI_:CE TO E14D Sr1LF?y REPORT LL0,1 E:�3ENTDED OF FISCAL DIV. 0= ADMINISTRATION t62,961.00 $41,640. 31 t,21,320.69 DIV. OF COMMUNI`1'Y HEALTH $26,747.00 $18,205.20 8,541.Ro DIV. 0_ EPIVIRONN2:ITAL HEALTH $71,796.00 $48,368. 39 $23,427.61 FREE CASH (includes =ENS= REPORT: ALLOWED EXPENDED ENCUMEERED DIV. OF ADMINISTRATION $ 2,400.00 $ 651.77 1,748.23 DIV. OF COMMUNITY HEALTH $45,710.00 $26,643.90 $19,066.10 DIV. OF ENVIRONMENTAL HEALTH $4,050.00 $ 3,255.20 $ 1,694.80 0 t� r DIVISION OF CO`24UNITY HEALTH SERVICES DENTAL PROGRAM - MONTHLY REPORT • MONTH FEBRUARY, 1981 SCHOOL EXAMINATIONS SCHOOL . CARLTON COMPLETED GRADES Kdg. 1 - 5 BENTLEY " if Kdg. 1 - 5 BOWDITCH It it 5 - 8 SALTONSTALL It Kdg. 1 - 8, Bi-Ling. PHILLIPS INCOMPLETE 6 - 8, Special Aft Continuous Dental Health Education was the dominant topic for this month. February being _ observed nation wide as "Dental Health Month", the dental department worked vigorously with teachers in the lower grades emphasizing good nutrition (including school snacks) , developing good toothbrushing habits (using a chart in school with student names on it to check off) , and also stressing dental office visits. In addition, because of Dental Month, Special Class Students. came in for prophylaxis. CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. DI' 3 8 5 DENTAL HEALTH EDUCATION SCHOOL GRADES PROGRAM SALTONSTALL 3 and. .Kdg. Crest, "Tooth Town U.S.A." BENTLEY 3 and Kdg. It CARLTON 3, Kdg. , and 4 Crest and "Tooth Tom U.S.A." A 205 MAYSACM st_nls 01.970 Oil T t 7 15-9 0 5 0 TO Salem Cord of Health Salem V.,N'.A. Direc'.t.c.r F R Lucy Deth_, , R,,',.l RE F�Lruary 1. 36-11 SijivMary I C t g'i C,u s [); i-et 2 A 7-u be r c.ul o s i E North Sh,_-)Fr, F, C.- -1 r o x ma Personal C. 3 P Po i i i t i�-1 �n 's L C c)n t 1 r i u-,J11 i d, C C r 1) y i r.c.--.r a g e.n cy --.;-rrts N SIPC w i t h pc s 71 t v c, i roj One new rc Ferral of Furth,:C rr�p.ort to fol y Lead P()i's c)r, i r Cont i n.L.,e t r) e,.e ve f o'I I o-.-r L,p re P_.-is Sri S No n E%,tv fan!il ies tf, iS [r,()rl t[-j PM iD s s I s t ci,),e c._1 s t c,,,�, In i ri 17 c)r rr.a'L i F) d I c case for S E:11 F m a�jyC:r . T v s s hc, 1 J wi it 1:1 L i pea t ed rion-su-:,-e ilil v I i s f r P i is he,-, t�I f c-,I I i-)v�i by PH'N: t V it c t a c: I I he Vi%tnaeSe sponsor wi bc., contacLed. lV. scel lane._) s A. Not is e Of :i`eripox c:-,-c e.-, B. Notice c) bD c t e r I a ricr�n ',r,n, s c a 2! -o'er;t. Fc.I I ow -e r i I r e.di 1�,,, P 2 s r;:-F r a I s, t' C rin I E:,S t. i,rj D CPR c V. Premature Want Two families Man7s are sKII in i5tensive care in Boston Hospitals. PHN will follow progrubs Uri WAI Men home in future when infort's are discharge6. On home visit follow-up for novel reported premature birch. A . School February Schedula: 93 students tested for height , ueight , bleed pr2SSU-e, hao; jn�l and vision screcNig, Three sludems found to ha%e Afective vision and referred no MD for further testinj. Ten children found to bw overweight . A rood for M! and nutritional teaching is evident. Stutnt Sick Kg 13 accKents 9 nesS 2 Four referred to Fmarpency room with parent ; ono scot Kv no 11 Regul ar nurse/tnaAer consul to Qncur regDA ;n: nos! th c F itudev-s and screening results , PHN home visit fDr CORE evalwWan A Yth grajo studazt . DIVISION OF ADMINISTRATION MONTHLY REPORT 'MONTH •BIOLOGICS DISTRIBUTED A1,1OUNT A11I1,-AT, BITES REPORTED 3 S Di theria, Tetanus & Pertussis 32 vials RESIDENT - NON-RESIDE:,-T Dintheria- etanus ^ox_. (under o rs.� 0 K-RIA.L P ER:•!ITS ISSUED 43 23 Ir.LTMune Sertur Gic,'--ul n 25 vials :•.easles u� _ ric se Only; T1_ti-T„ER A_IONAL TRAYEEL C-FTIFICA"ES (CERTIFIED) 1 Telephone inquiries 2 easies,'-=.ps =_M`e=-a 10 doses ?o' _o _ccir_e ?nanges ---'--A:, C:-SL R ECEI= FRO"-' 1600.00 -=2- � _.oES x PERMITS ISSUED $ -antis 6 vials e Carus -cxoi =- 23 2 vials C0M:-IUI\TICABLE DISE'AS'S 2 =u erc __. F.= ._ . ::an-. - 2 vials :oid -race__e ( 0 BALA_iCE TO EPVJ :TE:7DFD OF FISCAL V. OF s_�_�_: _ = �62 ,96i.00 " 7 054.26 - 3 � t25,906.74 r V. 'CF CC - --- _-_— - �'26,747.00i5,R7n. ti41M76. 36 7)Iv. h71,796.00 ",142,4o4.lo 129,39 -?1 0 FREE CASH (includes i�'E";CE RE-?0 LLOilED ?Y-P DE ENCUiF?EP.ED DIV. OF 2,400.00 547. 34 1,852. 66 DIV. OF COiT-:j=:ITY HEATT: "45,710.00 "22,733.15 Y 22,796. 85 DIV. OF __:iV PO:;.•r :iTAL �',�.LTH t 4,950.00 2,871. 53 2,078.47 l_ - r 0/ Jolt,.< <s < < r� 205 WAsr,iNG'I' v Srrr ,r, SAt.r.nr, NlAss.\(:irusi,r'rs 01-970 TO Salem Board of Health, Salem V.N.A. Director FROM: Lucy Beths, RN RE January 1981 Summary I . CONTAGIOUS DISEASE A. Tuberculosis North Shore Pulmonary Cl inic appointnienL arrangements for 35 persons. Home visit and formal notification procedure of class III TB resident . Continued record keeping of North Shore PU11110nary Clinic interagency referral forms of December and January clients. Mantoux Clinic - Ten people tested for job certification. Certification results - four requests for past-certification results to be sent to new place of employment for client. • B. Salmonella One resident still having positive specimens. Unable to contact two positive testing clients. C. Pediculosis , Recall by school nurse to visit teenager at home for assess- ment. Child returned to school after treatment by mother at home. D. Hepatitis - Viral One newly reported case. Person not found at home of frequent visits - did not answer note left . 11 . LEAD POISIONING One new case of elevated lead level within family of two children with elevated lead levels. Five blood level reports received with elevated levels in children. Approximately one dozen families reside in Salem with reported class II - III .lead levels for 1980. To be recontacted for • follow-up confirmation in 1981 . -2- III . IMMIGRANTS - VIETNAMESE • Home visits to these families . Health assessment , immunization record update , community resource information relayed to families. Repre-ated home visits to four homes for purpose of health assess- ment and tuhcrculotii , medication management . Persons not at home. Continued attempts to"contact family will be made by PHN. IV. MISCELLANEOUS A. ' Record search for two past hearing t(•titing results for Salem residents. B. Hearing testing and referral for St. . Jc)tipeh School employee. C. Conference with social worker regarding assessment of known Salem family for homecoming of infant post-op from Massachusetts General Hospital . D. Referral to Lynn PHN of six week old child with diagnosis of varicilla. E. Information retrieved by PHN for North Shore Association for retarded citizens regarding enterobiasis. • V. PREMATURE INFANT Two newly reported premature infant births, PHN follow-up completed. VI . SCHOOL January Schedule : 171 students tested for height , weight , blood pressure, hearing, and vision sc rocn i net. Two students found to have defective vision. Two Students rnirn(i to hive defective hear iric�. Both referred to M. D. for further testing. Ten children found to be overweight with corresponding increase in blood pressure. A need for diet and nutritional teaching is evident . Student Sick Log: 12 accidents 20 illness TOTAL 32 6 sent home 13 exact same viral symptoms 1 incident scarlet fever • V i .r -3- r SCHOOL (continued) Teacher/Nurse Consults • Regarding student needs: A. Dental inspection and teaching for kindergarden children demonstrating pica, increasing absence and slow learning process. B. Follow-up on lead levels for two kindergarden children. C. Recurrent absenteeism of two students. D. Future diabetic testing of fourth grader,; by PHN after blood pressure, vision and hearing screening completed and parent conferred with. E. Social service referral for CORE evalUalion of third grade. student. F. Reporting and consult with teachers and administrators regarding screening results and children sent home. • 1 oe000avmm� ., ' ' � MEN'oa6'iai ■•Sii�oi DIVISION OF CWL`1UNITY 11F.AL'm SERVICES • DENTAL PROGRAM _ ,MONTHLY REPORT MONTH January, 1981 SCHOOL EXAMINATIONS DENTAL SCREENINGS SCHOOL CARLTON BENTLEY ALL GRADES COMPLETED BOWDITCH SALTONSTALL Continuous Dental health Education is conducted with all dental examinations. In the classroom demonstration of proper tooth brushing is held with student participation. The three rules of oral prevention are always stressed. CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. I DENTAL HEALTH EDUCATION Crest Film Strip with educational materials "Tooth Town, U.S.A." SCHOOL GRADES PROGRAM SALTONSTALL 3 CREST SALTONSTALL 4 and Kdg. "Tooth Town, U.S.A." BENTLEY ? "Tooth Town, U.S.A." V o�oo...00�oo..00.oa.■�v�o�.�oo� mucuun mime wbTI-STOR age NEI MEME11101, 511001 soonii MOMMEMEME No soon =1 mommollommals I loons 1011 ' ieineiii�ii0��n�rinieie . 1� IIIIIININ IIIN 111111/11 DIVISION OF COMMUNITY 11EALT11 SE'RVICP.S • DENTAL PROGRAM_ MONTHLY PEP010' MONTH PECEM17T, 19,90 SCHOOL EXAMS f SCHOOL Carlton School Screening by Dentist and Dental_ 7ygienist. Bent lep Bowditch Continuous Dental Health Education conducted. during all Saltonstall examinations and correct tooth brushing in classes before screening. Pmphasis is placed, on proper nutrition., snacks and. habits and semi-annual visits to dentist. Confer with school nurse and parent on needed care. DENTAL CLINIC CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. 9 3 1 6 4 5 i DENTAL HEALTH EDUCATION SCHOOL CRADES PPOCRAM_ Carlton 2-3-4-5 See below Bentley 2-3-4 I have been working with a new film strip with cassette based on country music western-style • called "Tooth Town U.S.A.". This great film strip is enjoyed by students and teachers alike because of the animated figures used to represent teeth and emphasizes the factor that all ages observe the old rule decay prevention is guided by the frequency of sugar consumption. DIVISION OF ADMINISTRATION MONTHLY REPORT MONTH DECEMBER 1980 BIOLOGICS DISTRIBUTED AMOUNT I ANI1yL4L BITES REPORT-ED Di =theria, Tetanus & Pertussis 49 vials ! BESIDE! T ON-R SIDJ -T DiDuheria-Tetanus Tox. (under 6yrs�. - BL !AL PERMITS ISSUED 38 27 I:- ane Sera.^^_ Globulin 25 vials! easles lini c Use Only - I:__ AIO�+AL TRA` L 3 ^'�LR1 inquiries C_-T=FICA"_ES (CERTIFIED' :`easles %:i� us/Rubela 194 doses 753 doses -OTAL CASZ-: RECEIL17 _ _ ' �_G�_.SEJ � PE `',l�IIT J 1J LSD _;rtheria 1t 22 vials __.� _c a _',e µ �E vials' OT�r R COrdICABLE DISEA ES (Salem Res. ) 2 w r - vials ! -t t mn �"_',DED Or FISCAL 1T^ RA IS _G=. T -T $62,961.00 $31,342.53 $31,618.47 . __ _ :;7 V. OF CO•XUMITY HEALTH $26,747.00 $13,327.44 $13,419. 56 =7. OF --" VIR0I1_,NTAL H_. H $71,796.00 $35,536.55 $36,259.45 FREE CASH (includes E:,3EN0` REPORT: ALLO`flE''D Ei0?ENDED EIdC LP,•f?ERED DIV. OF A.DIIINISTRATION $ 2,4C0.00 $ 469.84 $ 1,930.16 DIV. OF COM1410ITY HEALTH 45,710.00 19,729.82 25,980.18 DIV. OF ETIVIRON?iENTAL HEALTH 4,950.00 676.90 4,273.10 n T;'4X1'L "I' Attie �_Af.foctaItoil O reedet Salon if C* 205 WASIIINGTON STBEET, SALFNM, \IASSACIIUSETTS 01970 (617) 745-9050 • TO: Salem Board of Health FROM: Lucy Beths, RN RE: December 1980 Summary s 1. Contagious Disease A. Tuberculosis: Record keeping for approximately 75 Salem residents seen at North Shore Pulmonary Clinic. Appointments scheduled for 37 Salem residents for NSPC. Mantoux Clinic 18 people tested 12 job certifications 4 active contacts 2 positive reactors referred to NSPC One tuberculosis case in Salem - PHN awaiting sputum reports for determination of active/non-active diagnosis. Approximately 15 persons did not keep North Shore Pulilmnary .Cl.inic appointments. PHN was to find and contact the person, make appointment at NSPC and inform person. B. Salmnella Three residents still having positive specimens. C. Pediculosis Follow up and consult with teenager referred by public school nurse. Student seen by PHN, teaching and revisits made; to be observed in school by..school nurse. D. Viral Hepatitis Two newly reported cases followed by PHN - both have private doctors. F N -2- j 11. Lead Poisioning Three new cases of elevated lead levels in children. One new level suggestive of iron deficiency. Five families continue to be. followed for teaching; consult. '11ao families failed to keep appointments; PEN needed to locate them and encourage follow up. 111. Immigrants Notification of two families and eight family members requiring hmmization follow up and health assessment and promotion. Language barrier (Vietnamese) is a major problem and makes these cases difficult and time consuuninc, 1V. Premature Infant Two newly reported premature infant births. PHN follow up completed. V. School Health Sick Call - 25 students to. school nurse for accidents/illness.. 1. Four sent home - 2 head injury 2 illness 2. One referred for arm x-rays 3. Three ill with pneumonia 4. Fourteen accidents; eleven illnesses • Thirty-six students received health physicals and necessary inr-Lmi- zations by Dr. Desjardins and PHN. -- - Vision and hearing testing of eight 3rd grade pupils and vision testing of 28 1st grade pupils - two retests necessary. Teaching of first aid measures for two cub scouts' projects. ' Consult re: Health of certain kindergarten, 1st and 2nd grade pupils with teachers, 8th grade pupils-eye/ear testing requested by mother. Plan for January Schedule for testing recording, retesting and follow up of height, weight, B/P, vision and hearing on remaining pupils in all grades. Vl. . Miscellaneous A. Vision and hearing testing certificaiton by State authorities for PI IN B. Meetings with VNA Supervisor and BOH agent. C. Social Worker referral re: non compliant teenager with Veneral Disease. Q3 i T 1980 t NOVE;iBER EA+VIRONIjM TAL 1IEALTIi DIVISION MONTHLY REPORT (year) (ninth) � 1 2 3 4 5 6 7 8 1 9 10 11 12 133 14� 15 6117 18 19 2 1 22 23 4 25 26127128 2 0 I TOTALS .-Vv ITARY CODE ENFORCE. I. Food Service comnl. - i 6_ 2. Food Serv. Ins 1 3 1 14 4. Retail 'Markets 1 1 1 l 1 { 5 5 I otrsin' 6 1 1' .2 .3 1 -3 .4. 3 2 _.l 2 5 4 1 7 40 6. `,o: -ea o a n s 1 2 2 3 1 1 . .,_.2 3 1 18 7. General Nuisances 3 2 6 2 1 ' 2 2 I 7 1 1 1 1 29 8. Day Care Centers ! 111 1 0 ' 9. .Da Campq I 1 ! 0 10. SviaaaiiiB -Pools I f I ' 1i• Beaches 1 I ± i 0 12. = N : oise o 1 1 17 2 13. SESD-Observa.ti on ' ! 0 14 SESD-Con-ilaints W� j :"DENT CONTROL ! 2 { 2 3 1 1 9 Laboratory Testing 0 1. Milk 6 Crean 2. Swab (Restaur.} 1 ! ' ! ' 0 3. We11 dater 1 � ! i ► I i I - if 1 4. Municipal Water 5. Ba«hin t+ater � 6. Sewage Water i Field Testing Lead Testingl i 2 j 1 ; j 1 { 2 1 ! 1 1� 1 2 3 2 22 i 2. Perc.Test for Sew. S ste- i T { { 5 C ( 1651 72 2 L_Cc 2SES AN-D PERMITS; f f { 4 COURT IMaINGS OFF.C-ONSUL'TATION SESSION ' 2 1 5 REFEUULS TO AND .FROM OTHER DEPARTMENTS 4 4 { i 2 �. 2 1 2 1 12 r DIVISION OF COMMUNITY 11F.ALT11 SERVICI,:S J • DENTAL PROGRAM _ MONTHLY REPORT MONTH NOVEDIBER, 1980 SCHOOL EXAMS SCHOOL. Carlton. Completed Bowditch Completed Bentley Completed Saltonstall Incomplete . DENTAL CLINIC CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. 1 5 6 6 2 6 DENTAL HEALTH EDUCATION SCHOOL GRADES PROGRAM Carlton 3 and Special Crest teaching materials Bentley 3 Crest teaching materials • New film strip - "Tooth Town U.S.A." sl�BIOLOGICS DISTRIBUTED ANIMAL BITES REPORTED (Salem Residents) 3 AMOUNT Di theria, Tetanus & Pertussis 35 ESIDENT :uON-RESIDENT Diptheria-Tetanus Tox. (under 6 y rs. . -- BURIAL PEF_•aTS =: SUED 26 17 Immune Serum Globulin 35 i Measles (Clinic Use Only) -- IN=RNATIC. AI =�.. 7- a CEP."__FICA^ES ( E- 'TFT�`') 2 i• :R 20 1; Measles/:`nips/Rubella Polio Vaccine 280 T �OT� C ti R_C_= . _ ROV $1, 148.00 Fe anus Di_ntberia du. se; 4 i+ etanus =oxoid (absorbed; 40 OTHER COi KCABLE DISEASES (Salem Res.) 3 - - •i 7 Tuberculin P.P.D. ':•ar_toux) - Typhoid Vaccine -- R ALA NCE TO E .� SALARY REPORT: ALLOWED E''PE IDED 0 FISCAL y DIV. OF ADMI.,IS= ^^TO_: $62,961.00 $25,656.48 $37,304.52 r DIV. OF CO Ti-� T II':Y HEAL^ti $26,747.00 $11,092.88 $15,654. 12 DIV. OF E"iVIDOI_•`✓"ITAL HEATH $71,796.00 $29,942.51 $41,853.49 I FREE CASH (includes EXPENSE REPORT: ALLOWED EXP EPIDED '�C U?• ERED I DIV. OF ADP.ffNISTRATIO_i $2,400.00 IE23. 3�+ 1,976.66 ll DIV. OF COI'2,UNITY HEALTH $45,710.00 $16,579.69 t29,130. 31 DIV. OF EPiVIRO_ii :iTAL ? ELT $4,950.00 650.70 ,299.30 li ij A.,tje C4 kccatcan a Ceatet Salem, Anc. 205 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 • (617) 745-9050 TO Salem Board of Health FROM: Lucy Beths, RN RE November 1980 Summary 1 . YEARLY FLU AND PNEUMONIA CLINIC- 1980 TALLY DOSE FLU VACCINE Saletn Visiting Nurse Association 116 Salem Clinics 1160 Shaughnessy Hospital 160 Home for Aged Women 30 Newhall Nursing Home 60 Ivy Manor Rest Home 20 Dr. Desjardins 30 Bertram Home -for Aged Men 4 Beverly Health Department 220 1— r • DOSE PNEUMONIA VACCINE Salem Visiting Nurse Association 85 Shaughnessy Hospital 10 Home for Aged Women 5 Salem Clinics 700 SALEM FLU AND PNEUMONIA CLINICS • . Flu Pneumonia Date Time Location Vaccine Vaccine 10/28/80 10 am - 12 noon Elderly Clinic 510 325 Tuesday 5 Broad Street 10/30/80 10 am - 12 noon Charter Street 280 235 Thursday Housing f 11/06/80 10 am - 12 'noon Elderly Center 200 140 Th'urisday 5 Broad Street 11/13/80 10 am.- 11 am Kaplan Health 170 Thursday Center 1160 700 r ` Page 2 II . CONTAGIOUS DISEASE • A. Salmonella 1 . Reported new case involving food handler and a Somerville Restaurant as probable contact. Person seen by PHN for follow-up, teaching and referred to Sanitarians. 2, Continued visits to family with three positive Salmonella cases of children. Two converters, two negative, one child still positive age 6 months. MD consultation included. 3. PHN contact to another family for reminder and teaching regarding need for continued specimen collection. B. Scabies 1 . Referral of hospitalized patient 's contact source of scabies. Family contact found to have moved. Follow-up by hospital coordinator for V.N.A. and PHN to continue. C. Pertussis 1 . Final home visit to family s/p pertussis of infant. D. Menningitis 1 . PHN visit for observation of infant with status post menningitis (?type) E. Impetigo • 1 . Consultation with MD, parents regarding children with impetigo of scalp. Observation of two involved school children and included clas's•room pupils by PHN. This is situation where more health teaching for the whole student population would be appropriate. III . LEAD POISONING Home visits of two new reported high lead levels Class II requiring teaching and follow-up. Both required home lead testing. Continued follow up on two previous and continued high lead test results . (class III 611V) Involve's telephone aA( in person counseling IV. PREMATURE INFANT I A. One infant to. belfollowed by visiting nurse for health maintenance - post partum teaching to mother. rz B. Three home visits by PHN for newborn premature infants with return visits for baby weight gain check, and post partum and newborn assistance and teaching. V. SCHOOL HEALTH rrw e A. Sick Call '1 Fifteen students were seen by the school/public health nurse for various,.injuriessand ailments. One child refer're8'.to family dentist for loose teeth after injury. • One child's parents instructed to bring child for x-ray for possible arm fracture. One child sent home with virus symptoms. Page 3 \ B. Kindergarten Hearing and Vision Testing 36 pupils tested by school nurse according to state requirements for hearing and vision. Results: 1 . One child seen by family opthamologist - to begin wearing eye glasses. 2. One child will be seen by MD for hearing testing after showing significant hearing defecit. Included conferences with parents of both children, kindergarten teacher and title I teacher. Repeat testing of six children was necessary with one consult to parents of child regarding eye glass prescription change. C. School Yearly Physicals 1 . Scheduling with Dr. Desjardins for yearly school physicals of 36 pupils. December 2, 1980 Tuesday 10:00 - 11 :00 a.m. and December ; 1980 Thursday 10:00 - 11 :00 a.m. 2. Pre-notification sent to parents for permission for immunization and physicals to all third and seventh grade children plus new and transfer students requiring physicals. School record preparation and pre-physical preparation by school/ public health nurse includes blood pressure, height , weight and recording vision and hearing testing of all pupils. Assistance of three Salem State students and teacher afforded for pre-testing of 21 seventh grade pupils. Results: Six children overweight for age group - follow-up by PHN Necessary Two hearing failures - retests to be done One sight test failure - retest to be done Nurse/teacher consultation concerning above children followed testing. D. Students receiving physicals and immunization are in grades Kindergarten, 2, 3, 4, 5, 7. VI . TUBERCULOSIS Activities: A. Telephone calls for negligent clinic appointments. Setting up new appointments. B. Mantoux testing (10) C. Meeting with J. Corcoran, T.B. Coordinator. D. Record Keeping E. Communication with .pulmonary clinic personnel for patient appointments and T. B. protocol . VII . MISCELLANEOUS A. Meeting with V.N.A. supervisor and Board of Health agent. B. Meeting with C. Hourihan, Director of Care at Home Nursing Services re: mantoux testing of all employees in future Mantoux • clinics (approximately 200) . ., ' Page 4 I N. • C. Numerous phone calls for Salem residents regarding: • 1 . Flu clinics and requests for vaccine 2. Child's hearing testing 3. Public school teachers regarding records of transfer students. 4°. Regarding casefinding from two social workers for high risk mothers and new babies. One family seen by PHN for high lead level ; the other in process of address search. D. Regarding contact with state and school nurses to attend up- coming audiometric certification class. E. Updating and requesting publication material for public health assistance and teaching to Salem new mothers and premature babies. F. Meeting with Ms. C. Newman, coordinator North Shore U.N.A. regarding. public health procedures and management. s I, :.: _ ...:. .. ... w"..r-.^.-Wit...-....,r..-.-.-.�....r-.,.. ,�,,..�,,. DIVISION OF ADMINISTRATION MONTHLY REPORT MONTH OCTOBER. 1980 (Salem Residents) BIOLOGIC DISTRIBUTED AMOUNT ANIMAL BITES REPORTED 9 OTHER DISEASES 5 1� T 1 Di theriaj, Tetanus & Pertussis PQ Iri j RESIDENT NON-RESIDENT Di ptheria-Tetanus Tox. (under 6 yrs. . BL?I L PERMITS ISSUED 20 25 Immune Serum Globulin 22 vials I Measles Clinic Use Only) I�T`_'ER'_.,ATIONAL TRAVEL 3 I -;ERTIFiCATES (CERTIFIED) N211R i 'Measles/ 'u:Lus/Rubella ` 210 i i Polio Vaccine -14o do =CGT. -` CASH RECEIVED FROM $27.00 # LICE:-.SES & PERMITS ISSUED Tetanus - iptneria (Adult ::se) Tetan-us -oxoid (a_z-sor-_ed) 21 vials - - 7 vials ubercu'-n _ .P. ,antcux) ==,. Typhoid vaccine BALANCE TO EPJ 3 AR' ?_PICK=: ALLOWED "`='ENDED OF FISCAL DIV. OF __D'�T,:2,:.TIO_: $62,961.o0 $21,070.43 41 8 0 $ 9 .57 DIV. OF COI,rMUJITY HE,".LTH $26,747.00 $ 9,058. 32 $17,688.68 DIV. OF E1TVIRO:i'_W^tTAL HEALTH $71,796.0o $24,448.47 $47 347- 53 ** Less transfer of 1 FREE CASH (includes ; E',TENSE REPORT: ALLOWED EXPENDED ENCUMBERED DIV. OF ADMINISTRATION $2,40o.00 $ 389.41 $22010.59 DIV. OF COMMUNITY HEALTH $45,710.00 $11,695.92 $34,014.08 DIV. OF ENVIRONMENTAL HEALTH $4,950.00 $527.22 $4,422.78 ** *Includes -transfer of $13,960.00 from L Community Health Salaries to Community s J ,Health Visiting Nurse Expens— account. � DIVISION OF COIMJNI'fY HEALTH SkRVIUS - __ • DENTAL PROGRA'i - MONTHLY REPORT MONTH OCTOBER, 1980 SCHOOL EXAMS SCHOOL GRADES CARLTON KDG. , SP.CLASS 1-5 COMPLETED BOWDITCH 5 - 8 COMPLETED BENTLEY KDG. , 1 - 5 INCOMPLETE Aok DENTAL CLINIC CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. DENTAL HEALTH EDUCATION SCHOOL GRADES PROGRAM CARLTON 3 and 4 Crest Film Strip • 1980 OCABER ENVIRONMENTAL HEALTH VISION MONTHLY REPORT • (year9 (month) p 1 2 3 4 5 6 7 8 9 10 11 12 13 14 1 6 17 1 18119 2 1. 22 23 P4 25 26127 28 2 0 1 SANJTARY -CODE ENFORCE. TOTALS 1. Food Service comml. 1 1 2 2. Food Serv. Ins . 3 2 1 1 3 3 1 1 1 16 3. Mobile Food Serv, 4. Retail Markets 2 1 1 1 1 0 7 5. Housin& 4 5 4 7 2 1 1 41 2 6 4 1 2 2 1 5 71 3 12 1 1 3 a 69 6. I o _ a om 2 1 3 1 1 5 5 5 2 1 7. G ain s General Nuisances 3 2 31 1 1 2 2 2 1 11 1 1 1 3 2 1 4 2 1 2 1 3 36 8. Day Care Centers g x 9. Da • Cams 10. SwimminS Pools 11. Beaches 12. Air & Nois`7737i. 2j ill 5 13. SESO-Observation s l ! 1 1 _J1 2 14. SESD-Complaints 2 ' ! d { 1' 3 RODENT CONTROL 1 1 1 1 (} 3 "ESTING: , a Laboratory Testing I 1. I�,ilk 6 Crean 2. Swab (Restaur.) 3. Well Crater 4. Municipal Water 5. Bathins Slater 6. Sewage Water Field Testing 1. Lead Testin, ( 1 1 1 1 if 1 3 2 1 1 1 1 ' 1 1 1 ; 15 2. Perc.Test for Sew. S• stem i { E LICENSES AND PERMITS: � � 21 �� 1 COURT BEARINGS 1 1 2 OFF.CONSUL"PATION SESSIONS 1 1 REFERRALS TO AND FROM 1 OTHER DEPARTMENTS 2 2 1 9 s Alfft'fe �.IJOC izlialz a �eate�t iaL111 9 �K co - � U 205 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 (G 17) 745-9050 TO Salem Board of Health NOV 5 1980 FROM: Lucy Beths, RN CfTY OF SALEM RE October 1980 Summary --• .ALTH DEPT. 1 . Yearly Flu and Pneumonia Clinic From clinics involving seven hours arranged for months of October and November. Two successful clinics were held on October 28th and October 30th for Salem residents and employees: Flu Vaccine 1 ,000 Pneumonia Vaccine 665 A. Public Health Nurse involvement 1 . Ordering of flue vaccine; 2. Scheduling and arranging for clinic site and personnel ; 3. News media and community publicity arrangements; 4. Administration of vaccine at clinics with Dr. Desjardins and public health nurse; 5. Meetings with Linda Billows, Director, V.N.A. of Greater Salem; and Betty Poirier, Supervisor, V.N.A. of Greater Salem; and Robert Blenkhorn, Health Agent, regarding • clinic protocol and progress; 6. Response to numerous phone calls from public inquiries regarding vaccine and clinics. II . Contagious Disease - ,t A. Tuberculosis 1 . Home visits for follow-up (7) 2. Telephone calls - for negligent clinic appointments, new appointments, and follow-up 3. Mantoux testing (11 ) 4. Meeting with J. Corcoran from Massachusetts Department of Public Health (T.B. Coordinator) . 5. Record Keeping B. Salmonella Teaching follow-up for family with positive testings. No new cases reported to Public Health Nurse month of October. C. Menningitis One reported 'case - follow-up reveals child under pediatric care and no other involved contacts. D. Pertussis • Two home visits for follow-up and teaching to young parents. $�°.[ .�."',s":..�..�*,.'a`""w'.�Y.-S:?$ti$.i�..:w. ,F. .r,:$:�=:'dor'.:. !. r ]t 417!!&�'*.•..,+ ^+rinnxremrrw+�^u5c+ : .•,.awwvr.rwees»iwvrrr.ere=n>»nwr.,.enray.�..,.....,.,„..., + -2- E. Vmpetigo Two students at St . Joseph's School requiring treatment and follow-up by public health nurse. , III . Premature Infant Three new premature births reported with home visits by public health nurse. One young mother continues to receive weekly public health nurse visit for maternal child health teaching, infant nutrition .and weight gain monitoring. V. Lead Poisoning Updated lead guidelines sent to area pediatricians. Four newly reported cases. Two requiring sanitarian house lead testing and two with pediatrician follow-up not requiring public health nurse visit . Continued follow-up on seven previous and continued high lead test results. Involves telephone and in person parent counseling. VI . School Health A. Immunization Successful immunization of 196 students for state immunization requirements. One student exemption which was promptly vaccinated to comply with regulation. Public health nurse involvement included a great deal of communication with parents to • accomplish the immunization of these students. B. Sick Call 1 . Twenty-two students were seen by school health nurse for various injuries and ailments. 2. Three children referred by teachers for structural•` defect and eye examination; follow-up will be carried out by public health nurse. 3• Nurse/teacher conference included referral to student 's own M.D. with final diagnosis of fracture of finger. 4•. Communications sent to parents in preparation for yearly school physicals of third and seventh grade. students. VII . Miscellaneous- A. Resource person for Salem State College students re: 1 . Dental class presentation to third graders; 2. Flu and 'pneumonia vaccination clinic involvement; 3. Community health project. B. Bi-weekly home visits for health promotion and observation of child with congenital defect of reported high risk family. C. Telephone calls and drop in visits from Salem residents regarding disease contact, and overseas immunization. • D. Weekly meetings with Robert Blenkhorn, Health Agent and Betty Poirier, Supervisor, V.N.A. for clarification and orientation to new public health nurse. T.4 lifty Autie c:74.4ocialion al teatet Salifftq �Aac',' 205 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 (G 17) 745-9050 • RECEIVED TO Salem Board of Health NOV 51980 FROM: Lucq Beths, RN CITY OF SALEM RE October 1980 Summary i-,C:ALTH DEPT. I . Yearly Flu and Pneumonia Clinic From clinics involving seven hours arranged for months of October and November. Two successful clinics were held on October 28th and October 30th for Salem residents and employees: Flu Vaccine 1 ,000 Pneumonia Vaccine 665 A. Public Health Nurse involvement 1 . Ordering of flue vaccine; 2. Scheduling and arranging for clinic site and personnel ; 3. News media and community publicity arrangements; 4. Administration of vaccine at clinics with Dr. Desjardins and public health nurse; 5• Meetings with Linda Billows, Director, V.N.A. of Greater Salem; and Betty Poirier, Supervisor, V.N.A. of Greater • Salem; and Robert Blenkhorn, Health Agent, regarding clinic protocol and progress, 6. Response to numerous phone calls from public inquiries regarding vaccine and clinics. II . Contagious Disease ` A. Tuberculosis 1 . Home visits for follow-up (7) 2. Telephone calls - for negligent clinic appointments, new appointments, and follow-up 3. Mantoux testing (11 ) 4. Meeting with J. Corcoran from Massachusetts Department of Public Health (T.B. Coordinator).. 5. Record Keeping B. Salmonella Teaching follow-up for family with positive testings. No new cases reported to Public Health Nurse month of October. C. Menningitis One reported.'case - follow-up reveals child under pediatric care and no other involved contacts. D. Pertussis • Two home visits for follow-up and teaching to young parents. ...�'may .:Zr, - .�_.. ... „3is4�"'"+ls _:,.'F� :i.Mle s.yuh•.'..:,.,�ib.. :.. ..... ai ..I�.M`r ��$"'��'-"...Tr""�—"""�'".ZP?19S'4�ip'^�.;..dl'�"''t�74r,. `,",."':^'r9'7!i°"°'X,4:^.'^P^'..(�„'"X"•- -2- E. Impetigo r Two students at St. Joseph's School requiring treatment • and follow-up by public health nurse. Ill . Premature Infant Three new premature births reported with home visits by public health nurse. One young mother continues to receive weekly public health nurse visit for maternal child health teaching, infant nutrition and weight gain monitoring. V. Lead Poisoning Updated lead guidelines sent to area pediatricians. Four newly reported cases. Two requiring sanitarian house lead testing and two with pediatrician follow-up not requiring public health nurse visit. Continued follow-up on seven previous and continued high 'lead test results. Involves telephone and in person parent counseling. VI . School Health A. Immunization Successful immunization of 196 students for state immunization requirements. One student exemption which was promptly vaccinated to comply with regulation. Public health nurse involvement included a great deal of communication with parents to • accomplish the immunization of these students. B. Sick Call I . Twenty-two students were seen by school health nurse for various injuries and ailments. 2. Three children referred by teachers for structural-` defect and eye examination; follow-up will be carried out by public health nurse. 3. Nurse/teacher conference included referral to student 's own M.D. with final diagnosis of fracture of finger. 4.. Communications sent to parents in preparation for yearly school physicals of third and seventh grade.students. , VII, Miscellaneous- A. Resource person for Salem State College students re: 1 . Dental class presentation to third graders; 2. Flu and 'pneumonia vaccination clinic involvement ; 3. Community health project. B. Bi-weekly home visits for health promotion and observation of child with congenital defect of reported high risk family. C. Telephone calls and drop in visits from Salem residents regarding disease contact, and overseas immunization. • D. Weekly meetings with Robert Blenkhorn, Health Agent and Betty Poirier, Supervisor, V.N.A. for clarification and orientation to new public health nurse. �"�' j+gwbitl�i�s.!;i^7a''Hi�?I1w^°"-M�+nF...�y9�M#..... ,x+.�Wx;:q"�.�..�r..rnq,....,�;...y�u�lrrur•Mxa�+^ - +room...+,.........,.,........__,.,�,r..p,.rwa.rM�"„+EFlat '[Ina� � av�oo�■�v0000��oovvv��o��oaau; v�oo��voo�o��000��anr�t�aeaaa��r�� IIIIIIIIIIIIIIN1111111111111111 DIVISION OF ADMINISTRATION MONTHLY REPORT MONTH SEPTEMBER 1980 Adilk BIOLOGICS DISTRIBUTED � ,AM0UNT ANIMAL BITES REPORTED 20 Di theria, Tetanus & Pertussis 450 doses RESIDENT NON-RESIDENT Di theria-Tetanus Tox. (under 6 yrs. --- BL-_ I.AL PER-',!ITS ISSUED 28 30 Immune Serum Globulin 60 " Measles (Clinic L'se Only) --- I:�TE^'dATIOidAL TRAVEL 4 CERTIFICATES (CERTIFIED) ,; rr 130 easles/: =0s/3ube=.a Po':o `rac c i ne 360 ^C='Pr' CASH RECEIVED FROif L-CE:1_3ES & PERKETS ISSUED $54.00 80 rr =e nUS ,1Ptheria r.CUlt Se 50 " Tetanus -cxoic (acs=" ec) Other Communicable Diseases 7 l --_• 10 tests ifc=_"culi^ '.P. . -_antoux) 5 :-:_. 50 tests BALANCE To END SALARY EPOR^ �LLC: ' E��IDED OF FISCAL -IV. 0-7AD_•�:,-5 TO:; $62,961.00 $15,358.70 $47,602. 30 DIV. OF COM14U<I`T_ HEAL-= $40,707.00 6,515.12 $34,191.88 ..'IV. OF ETT11T_Ro°l'e:TTAL 'AL H $71,796.0o 17,580.92 $54,215.08 FREE CASH (includes .EXPENSE REPORT: ALLOWED E'MDED ENCUMBERED DIV. OF ADMINISTRIATIo:I $2,400.00 $ 87.93 $ 2,312.07 DIV. OF COM 1,1UNITY HEALTH $31,750.00 8,692.59 23,057.41 DIV. OF ENVIROMI'•.-NTAL HEALTH $ 4,950.00 410.57 4,539.43 top z n � , DIVISION OF CO'MUNITY HEALTH SERVICES DENTAL. PROGRAM - MONTHLY REPORT MONTH September 1980 SCHOOL EXAMS SCHOOL i BoWditch Grades 5-8 Incomplete Carlton Grades Kdg. 1-5 Special Complete DENTAL CLINIC CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. 1 DENTAL HEALTH EDUCATION SCHOOL GRADES PROGRAM Carlton 3 Film strip and Teaching P.laterials. Discussion on good eating habits and proper Called several parents about problem in their snacks. children's mouth and referred them to their dentist. Y - 1 VL•��lt jpat.4e c:744OGLa160K 0, gtealet Salem, J14 ce 205 WASHINGTON STREET, SALEM, MASSACHus s 01970 • (G 17) 745-9050 t TO Membersof the Salem Board of Health FROM: Lucy Beths, RN, PHN . Marilyn Reynolds, RN. PHN RE September Summary 1 . CONTAGIOUS DISEASE FOLLOW-UP. - A. Tuberculosis 1 . Home Visits - continue on people with class 11 and class 111 diagnosis to teach about their medication and disease and encourage folA,ow-up.. . Examples: - home visit to encouraqe mantouxing all family members of a recent converter - home visit on a twenty year old Spanish speaking man (via family interpreter) who stopped takinq medication and stopped keeping clinic appointments. Visit was to • encourage follow-up and teach (he returned and restarted on meds) 2. Mantoux Clinics - continue weekly Tuesday with follow-up on Thursday. Nineteen people were tested. 3. Contact with North Shore Pulmonary Clinic to: a. continue good communications with our providing clinic. b, follow-up on appointments. c. have new .PHN meet with clinic personnel . 4. Meeting with Mrs. Blum, RN, and Mrs. Corcoran, RN, Northeastern Regional nursing director and tuberculosis coordinator, to review tuberculosis protocol and any questions encountered. B. Salmonella 1 . Five new cases were reported and followed up by home visit. Contact to get information and to teach about disease and proper treatment and future prevention. This included: a. . one family with two family contacts who were positive. b. outbreak"at a Danvers restau rant that required referral to Danver's health department for. further follow-up. 2. Three old cases still are being followed because of continued positive specimens. Teaching is still in process. 3. Follow-up .communi:cation with Mr. Albaneso', Northeastern Contagious Disease Control director on five old cases.__ - f -2- s ' C. . Meningitis • . •I . One new case reported, follow-up revealed asceptic meningitis. Child under care of pediatri.cian and is seen reqularly. Family contacts were instructed in appropriate care. or 2. One old case for continued attempts in contacts. This has required PHN to contact hospital contagious disease control nurse. D. Lice 1 . One new case - required two visits to help mother de-louse - child and instruct in preventative measures. 2. One old case - to examine and review preventative treatment before started. 11. IMMIGRANTS A. Follow-up home visit made on Vietnamese family with interpreter to continue tuberculosis teachinq and health guidance. 111 . PREMATURE A. Three new premature cases were reported and followed up by home visits. Two were referred to the V.N.A. for more intensive and comprehensive following.. • I'V. LEAD POISONING FOLLOW-UP •A. Nine newly reported lead poisoning cases were reported in September. Six were in the dangerously high levels. All were followed up by PHN. Home visits were made to do health teaching including nutritional guidance, lead poisoning_ preven.tion, and safety promotion. Referrals were made to the san.itarians for home paint screenings. All doctors were also contacted to set up appropriate follow- up on child and sibblings. Several cases included: 1 . Two cases with pregnant mothers who will have to relocate for their entire family's health while home deleading is in process. 2. One child who was admitted to North Shore Children's Hospital for deleading. 3. One child to be deleaded at home. V. SCHOOL HEALTH (Student population - 296 K-8) A. Maintanence of student records 1 . Immunization record review for all students. - 2. Communication sent to all r n pa a is of students needing updated immunizations. 3. Needs sheets made on all students including old defects, chronic disease. B. Health Promotion 1 . Discussion with principal regarding upcoming year aKd needs of students. 2. Review with head luncheon personnel to review adequate and nutritious meals and snacks. 3. Review with title 1 teachers several high risk students and their early follow-up. 4. Discussion and conference and hand out of lists to each teacher regarding students who need special observation, have def-inite or potential learning disabilities, and chronic disease or defect. C. Conferences Nurse/Student 5 Nurse/Teacher 5 Nurse/Parent 6 D. Seen on Referral • Illness 9 Injury 7 (one sent to ER, one sent to own MD) E. Miscellaneous 1 . Contact with state to set up audiometric and visual certification for new PHN. 2. Scoliosis training to start 9/30/80 for both PHN 3. Medical supplies updated. V . MISCELLANEOUS ' A. Meeting with Mr. Blenkhorn, Ms. Billows, RN,MS, Mrs. Poirier, RN, Ms. Beths, RN and Ms. Reynolds, RN to review plans for 1980 influenza and pneumococcal clinics. B. Referral from recent hearing screenings done in Salem by the . Guild for the Hard of Hearing - 81 people need follow-up by the nurses. C. Two day care contacts requesting heal.th forms and information. • fr ��■��000a��■o��o�oo��oeoo��i�� in iimom DIVISION OF ADMINISTRATION MOUTHLY =Q,F T. pq(,1NtgH. AUGUST 1980 BIOLOGICS DISTRIBUTED AMOUNT ANIMAL BITES REPORTED Di theria, Tetanus & Pertussis RESIDENT NON-RESIDE'_�T Di theria-Tetanus Tox. (under 6 yrs. -- BURIAL PERMITS ISSUED 23 22 Immune Serum Globulin 270 dos' es Measles (Clinic Use Only) __ INTERNATIONAL --RAVEL 4 CERTIFICATES (CERTIFIED) MP•ZR Measles/Mum-bs/Rubella 1 230 doses Polio Vaccine 280 doses TOTAL CASH RECEIVED FRO:._ $72.00 LICENSES & PER✓STS ISSUED Tetanus & Dipt^eria (Adult Use) 170 doses Tetanus Toxoid (absorbed) � 600 doses 1 1L• 30 Tests � i -Tuberculin P.P.D. (�`_antouxi Typhoid Vaccine � 1 SALARY �.EPORT: <<. OIFS EXPO.DE'D OF FISC:_L DIV. OF $62,961.o0 $10,072.65 $52,888. 35 DIV. OF Co:•uMsrlTY HEALT- 4o,707.00 4,480.56 36,226.44 DIV. OF ENVIRONMENTAL 'H AL H 71,796.00 12,086. 88 59,709.12 FREE CASH (includes EY2ENSE REPORT: AILO,PM EXPENDED ENC'UTeEFED • DIV. OF ADAaNISTRATION $ 2,400.o0 $ 71.68 $ 2,328. 32 DIV. OF COlv=TY HEALTH 31,750.00 4,342.16 27,407.84 DIV. OF ENVIRONMENTAL HEALTH 4,950.00 42.00 4,908.00 DIVISION OF CO*LMUNITY HEALTH SERVICES • • DENTAL PROGRAM _ MONTHLY REPORT MONTH A l laueT h R SCHOOL EXAMS SCHOOL. Working on schedule for screenings for coming year. Compiling and filing of information relative to above. Inventory and ordering of supplies re qui re d.' DENTAL CLINIC CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. E 51 16 5 6 51 35 CONIPLETEn ANT) nISL' -45 DENTAL HEALTH EDUCATION SCHOOL GRADES PROGRAM • I � 'i� "'iation 01 �teate� Salem, Jnc, 205 WASMNGTON STREET, SALEM, MASSAcixusErn 01970 • (617) 745-9050 TO Members ,of the Board of Health FROM: Jane Walton, RN Marilyn Reynolds, RN RE August Summary I. Immigration Follow-Up Vietnamese Family (3) 25 Roslyn Street Vietnamese Family (3) 12 Roslyn Street Vietnamese Family (4) Essex Street Three Vietnamese Families (8) River Street TOTAL (18) Health promotion was initiated for these families. • Immunizations and well-baby appointments were arranged through private pediatrician or North Shore Children's Hospital Well-Child Clinic. Tuberculosis follow-up was done on three children at the River Street residence. The Language barrier is difficult and Mai Thi My Nhung of 25 Roslyn Street graciously offers her services as interpreter. II. Premature/Maternal Health Follow-Up This has involved follow-up of a single mother and her high-risk infant. The infant was born with both cleft lip and palate,- and needs frequent medical visits with both surgeon, pediatrician and public health nurse. III. St. Joseph's School A. Record organization and preparation of new admittances to school are in the process of being completed. B. Emergency first aide equipment and procedures have I been evaluated. C. Initial contact with Northeastern Regicaal office to set up scoliosis screening was made. • - i A -2- IV, Lead Poisoning Follow-Up Two referrals have been referred for follow-up. One class 3; • one class 4. The private doctors have been contacted for further evaluation of the children and their young sibblings; and the sanitarians will be requested to do home lead eval- uations on the two homes. Home visits will be made to review lead poisoning prevention if repeat levels- continue to be elevated. V. Contagious Disease A. Scabies An outbreak of scabies occured at Camp Naumkeag. Five cases were confirmed. All families were contacted, by letter to notify them that their child had been exposed to scabies. Symptoms to look for and proper treatment were reviewed in the letter. All 70 campers were notified and 30 counsellors. Several home visits were made to the original suspected case to review scabies treatment and care. Numerious phone calls from parents who had received the letter were taken to offer education, support and reassurance. Procedures were reviewed with the camp directors for appropriate follow- up care. B. Meningitis Continued follow-up is being done by contacting M.D. and hospital on the reported meningitis case. • C. Salmonellosis Three newly reported cases have been followed-up. One family had three young children with positive stool cultures. Visits have been made on all three families to teach proper salmonella prevention and good food storage, preparation and handling and good hygiene. Stool culture kits have been distributed to all contacts. Close contact has been made with Dr. Higgins who is the main doctor involved in the case of the three young children. Letters have been sent to Bethesda Naval Hospital, New Haven and Rumney, New Hampshire for further contact follow-up there. The other two are residents of Salem, but obtained the illness out of state. D. Pertussis Continued visits every two weeks have been made to this family with the four month old child with pertussis to monitor nutrition and weight gain and to teach and support the young mother in child care areas. E. Lice Continued visits have been made to the family with head lice to teach and monitor effective treatment. -3- F. Tuberculosis 1. Mantoux screening clinics were held every Tuesday with • follow-up on Thursday. Eleven people were screened. ' 2. Two special clinics were held to do total screenings , of the personnel of Brooks Home for the Aged Women and the Visiting Nurses. Forty-five people have been tested and nine people with positive reactiobs have . been referred to North Shore Pulmonary clinic for further follow-up. 3. A meeting was arranged between the PHN's and the pulmonary clinic RN to establish good lines of communication, protocol and appropriate district PHN follow-up. 4. A list of patients was made for district PHN to follow by home contact. These people were considered high risk for tuberculosis by the age, contact or level of infection. Three to four dozen people will be followed by home contact by us. Home visits are being made to these people to offer information and support and review of the tuberculosis disease process and appropriate treatment. Close contact with North Shore Pulmonary clinic is being maintained. Continued clinic appointments have been made by the PHN for these patients. Examples of people visited so far: • a. A young mother, one week post partum, was started in INH. Her many questions were clarified. b. Two Vietnamese children never continued on INH after one month. With the help of an inter- preter, the importance of preventative treatment ' of one year of INH was emphasized. c. A young boy's probation officier was notified of the need to continue INH and keep regular appointments. d. A young mother with three children under the age of four who had active tuberculosis in 1977 and never completed two years of medication was visited. Much time was spent reviewing the need for consistent follow-up and treatment and the need to have youngsters tested. Close contact has been maintained with their pediatrician. e. Three contacts to two cases of active tuberculosis who stopped taking medication were visited and urged to continue treatment. f. A woman .from Jamaica who had a positive skin test and stopped medication because she was confused about why she was taking it was visited. Again the tuberculosis disease process and treatment was reviewed and the woman was also referred to a local internist for other complaints. Follow-up will continue on these and other families in September. TOTAL - 12 t -4- VI. Miscellaneous Meetings with public health advisors: • A. Madeline McDonough discussed contagious disease forms and: the need for updating immunizations. B. Joanne Corcoran presented updated tuberculosis forms. C. Dick Albanese reviewed appropriate protocol to handle: 1. Uncooperative contagious disease case, and; 2. Out of state contacts to contagious disease case. • • one Mangum My-T-W WA ■iiiiiS=eis�'iiiuTinsi=adiCiC �o�:n� mum NOMINEES 1111111101111100� WWI ei�i■'iiniiiii■'�ieiiiGG��iii�iii� THE ADMINISTRATION MONTHLY REPORT - MONT�.�II�Y 1980 k C'S DISTRIBUTED OSES AMOUNT ANIMAL BITES REPORTED 15 Tetanus & PertussisRESIDENT lus NON—RESIDENT —Tetanus Tox. (under 6 rs.) BURIAL PERMITS ISSUED2 Total um Globulinlinic Use Onl ) INTERNATIONAL TRAVEL CERTIFICATES (CERTIFIED) 2 um s & Rubella 190 .olio Vaccine 354 TOTAL CASH RECEIVED FROM LICENSES & PERMITS ISSUED $140.00 letanus & Diphtheria (Adult Use) 50 letanus Toxoid. (Adsorbed) 600 Other Comm. Disease 1 ML. (Salem Resident) uberculin P.P.D. (Mantoux) 5 �. TESTS 40 Chicken Pox 1 Aseptic Meningitis 1 hoid Vaccine 0 SALARY REPORT: - ALLOWED EXPENDED BALANCE TO END OF FISCAL DIV. OF ADMINISTRATION $62,961.00 $4,811.46 $58,149.54 DIV. OF COMMUNITY HEALTH 40,707.00 1,937.36 38,769..64 DIV. OF ENVIRONMENTAL HEALTH 71,796.00 5 ,219.33 66,576.67 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (INCLUDES ENCUMBERED) DIV. OF ADMINISTRATION $ 2,400.00 $ 44.32 $ 2,355.68 DIV. OF COMMUNITY HEALTH 31,750.00 1,492.83 30,257.17 DIV. OF ENVIRONMENTAL HEALTH 4,950.00 0000 4,950-00 TO Board of Health �. FROM: Marilyn Reynolds, RN Jane Walton, RN. ir RE July Summary Two Week Transition Period: Relocation of nursing service from Health Department to Salem Visiting Nurse Association office. 1. Reviewing and transferring appropriate records, forms and . materials to visiting nurses office. 2. Meeting with Mr. Blenkhorn to establish appropriate communication standards. 3. Meeting with Mrs. Margaret Blum and Mrs. Joanne Corcoran, Northeast Regional District coordinators to review local public health responsibilities and establish nursing priorities. Future visit set up to meet with tuberculosis coordinator of Massachusetts to review responsibilities. 4. Meeting with Mrs. Mary Skeinkrauss and Mrs. Corcoran, state tuberculosis nurses to review all records, requirements, and establish priorities of patient care and appropriate nursing follow-up. There are approximately 30 cases who needed home visits. 5. Meeting with Madeline McDounough, RN, Northeast Regional district • coordinator to review local public health responsibilities and new protocols for infectious disease follow-up. A future date has been set up to review all infectious disease forms with new public health nurse in August. 6. Contact with North Shore Pulmonary Clinic RN, Maryanne Kline to review clinic requirements and establish communication with agency. 7. Second meeting with Joanne Corcoran, RN and Jane Walton, RN to review tuberculosis protocol and mandated written communication. 8. Meeting with V.N.A. coordinators to establish appropriate premature follow-up. TUBERCULOSIS FOLLOW-UP 1. Record review and update of all active and inactive cases since 1977. All have been properly categorized. This has taken 40 hours. 2. Appointments made for August for North Shore Pulmonary Clinic and patients were notified. 3. Home visits started on patients who are class III and class II who need medication, disease teaching and reinforcement of importance of clinic appointments. 4. Home visit contact with class III suspect of 3/80 to follow-up • with contact testing and medication and disease teaching. 5. Mantoux clinics for certification - every Tuesday/Thursday - 11 people tested. -2- OTHER CONTAGIOUS DISEASE 1. One case highly contagious salmonella - person is food handler with two close contacts. Two visits .for teaching and stool collection - .Contact with state medical director regarding case. 2. One case of menigitis. 3. One case of scabies. 4. Three cases of bed bugs and referral to sanitarians for housing inspection. 5. Four families with body/head lice - instruction and proper treatment and equipment distributed. 6. One case pertussis - RN has started following family weekly secondary to multi-problems. PREMATURE VISIT 1. One family referred to V.N.A. for more intensive follow-up. 2. One family followed by P.H.N. . REFUGEE 1. Two visits to 1 Vietamese family to assess medical and social needs - follow-up scheduled to meet these needs. • MISCELLANEOUS: 1. Two calls about overseas travel immunization needs. 2. Communication with Atlanta CDC to get weekly MMR and internal travel laws. 3. One call from MD requesting information on VD clinics available. 4. One call from woman requesting premarital testing. 5. Two calls from day cares requesting immunization laws and papers. 6. One call from Salem Hospital Maternity requesting health records on immunizations to give out to new mothers. 7. Four calls from St. Joseph's parents requesting information on required immunization. DIVISION OF CO*MNITY IIEALT11 SERVICES DENTAL PROGRAM - t10NTIILY REPORT MONTH JULY 1080 SCHOOL EXAMS SCHOOL Compiled annual report and submitted. Working on schedule screenings for coming school year. DENTAL CLINIC CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. 25 20 5 5 57 32 DENTAL HEALTH EDUCATION SCHOOL GRADES PROGRAM J • (/e��itiK Vci��e e -��aciatioH a �eate �a�eriz, =AC, 205 WASHINGTON .STREET, .SALT M, MASSACHUSETTS 01970 • (617). 745-9050 RECEIVED SCHOOL HEALTH - ST. JOSEPH'S SCHOOL JUN 161980 C11Y OF,SALF.M ANNUAL REPORT - Fiscal Year: July 1, 1979 to June 30, 19${-ALFH DEPT. The majority of time provided by the Visiting Nurse Association of Greater Salem through Marilyn Reynolds, RN, has been devoted to school health at St. Joseph's School. Activities have included: - Establishing scoliosis screening program - Updating physical exams and immunization records of children entering kindergarten - Establishing a better'nutrition program by changing snacks at school - Assisting teachers in setting up nutrition teaching in the curriculum - Assisting physician with physical exams for grades kindergarten, 3, 7, 11 - Safety teaching to fourth grade students • - Participation in core evaluation process - Home visits to follow-up on chronic defects - Conferences with parents and teachers regarding student health - Vision and hearing screening - Counselling Junior High students - Teaching classes on Family Life and Dental Health - Working with student nurses from Salem State college as part of their public health rotation - Assisting a Vietnamese family become established in the community - Health record up-date on new students - Attending accidents as they occurred at school - Tuberculin testing for new school personnel - Discussion of implementing a CPR program at the high school level - Establishing emergency protocol for the school Respectfully submitted, • Marilyn Reynolds, P N ea AJ4�j El Beth A. Po irier, RN, BS Acting Director (/tattuz ivatie c-,-;4- jocta1;an a Ptealet <SaCem jnc. 205 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 • (617) 745-9050 PUBLIC HEALTH During the months of December through March, fifteen more hours were given to the Salem Health Department by the Visiting Nurse Association of Greater Salem for public health nursing. The nurse's responsibilities and activities have included: - Tuberculosis testing and follow-up with positive reactors and contacts - Contagious disease follow-up, including salmonella, amoebic dysentary, meningitis, and hepatitis - Influenza immunizations - Long term care facility licensure - Premature infant follow-up - Vision and hearing testing • - Setting up protocols for the nursing department for safe standards of practice - Immunization program for a Vietnamese family The statistics for the nurse's activities are broken down in the monthly reports already submitted. Respectfully submitted, Marilyn Reynolds, PHN +Elzabeth A. Poirier, RN, BS Acting Director I, • i CITY OF SALEM HEALTH DEPARTMENT • BOARD OF HEALTH Dr. Israel Kaplan Public Health Center Off Jefferson Avenue Salem, Massachusetts 01970 PHILIP H.SAINDON ROBERT E. BLENKHORN JOSEPH R. RICHARD T HEALTH HEAL AGENT M. MARCIA COUNTIE, R.N. ( AL 74AGEN MILDRED C.MOULTON, R.N. 5-9000 EFFIE MACDONALD ROBERT C. BONIN DIVISION OF COMMUNITY HEALTH JULY, 1979 REPORT: PUBLIC HEALTH NURSING SECTION Infectious disease control: Salmonellosis 2, strep throat 1, scabies information and instruction to N.S. Elderly Services, Pul. TB 1 Immigrant and refugee follow-up for person to person contact and interview in regard to immunization status and health needs proved fruitless. Neighborhood • hearsay: "moved to Chinatown in Boston". Heritage Day Hearing Test poster designed and mailed to Heritage Day committee, Chamber of Commerce etc. Fully cognizant of changing patterns and diminishing expectations in public health, review and planning of health services has begun since the delivery system can op- erate only-within the context of social and economic factors relative to actual programs. Consultation with Mrs. Blum(RHO) relative to school health segment. Bi-monthly tuberculin test clinics held as scheduled included job certification requirements as well as contact testing. Clinic appointments arranged, and intra- agency reports completed. Pul. TB case reported, and clinical history obtained. Family, close relatives and co-workers skin tested. Immediate family placed on medication. Mantoux .test will be repeated at proper interval for possible converters. Standard follow-up. Lead poisoning test for children 1-6 yrs also has been arranged to operate during Heritage Days. Co-sponsors are: Mass. D.P.H. Lead Paint Poison Prevention and the Lynn Community Health Center. Test-mobile available Wednesday, August 15, 1979 at Palmer's Cove and again on Friday, August 17, 1979 at Salem Mall, E. India Sq. • Testing hours for both days: 9:30 AM - 3:00 PM. SALEM HE IT o.kWrm i.:N I' 13,0AR-D 0F TIL, I K off J01,111STI Ave-nine Sd it_,III, M:tSS',Whusetts 01 .170 poLtEiRTU. DLPJKH0rAN •vlll 11 %AINDON H L A 1 TH A G r.,14 T G.,I P;I R. R i C H A R D 161-71 745-9MO t. MAHCI A COUN rIL. It N. WLOPIED C. MOULTON. R.N. EFFIE MACDONALD ROBCRT C. FICININ Aucum, 1979 ON OF WV,'M' jjrq,L'Y jjF'Njjjj N, ,)�S -r10N U� Nc, FC tracking unsuccessful although 3-4 leads obtained Vi.(-,:min refug(!e (2 fLimiHOS� "don't know," from neighbors were strenuously followed. Usual responses were: or. "moved Lo Chinatown , Boston" , . . . lend Paint Poison Prevention and Hearing Test posters designed and distributed thu C-it-Y- SLrategI-c Poster placement, outl-r.acIA plus good weather PrG"JidC0 for N.1011 ,itLondod llenith Department clinics, during Ileritage • T e F,t.e d Re s u I t s .Io 1,1evations 3) (4) "n P".q�lorl-other ear Fai led. e 68 13 2 52 30--,;q 140-49 50-59 160-69 70+ Total i ted 2 3 13 24 26 68 1�'Mj VACC-1 INE' ---&'signated for the following Rroups: 65yrs and over, high risk ,-ind chronic disease w.11.1. hr, Available from the Div. Comm. & Venereal Dis. S.D.H. Specific data compiled and available for processing order. 0 j,remature. infant follow'- 2 acts( reactors) Total Certification Coilev 22�L- 14,antoux testing: e 55 15 14 t95 0- -, 0+ 2 7 �,.c,utirie TB follow, and record maintainance f.t i s salmonollb,,;Is 2 t ious Disc--Ise. Cori t ro I.: Iq CITY OF SALEM HEALTH DEPARTMENT BOARD OF HEALTH Dr. Israel Kaplan Public Health Center Off Jefferson Avenue Salem, Massachusetts 01970 PHILIP H.SAINDON JOSEPH R. RICHARD ROBERT E. BLENKHORN M.MARCIA COUNTIE, R.N. HEALTH AGENT MILDRED C.MOULTON, R.N. (617) 745-9000 EFFIE MACDONALD ROBERT C. BONIN SEPTEMBER, 1979 DIVISION OF COMMUNITY HEALTH: PUBLIC HEALTH NURSING SECTION The 1979 influenza vaccine A/Brazil, A/Texas, B/Honk; Kong according to D.P.H. 10/1/79 presumably will be available by mid-October. Clinic dates will be determined at time of vaccine arrival. The 2000 dose order placed with R.H.O. was based on the following age distribution. 55-59 60-64 65-69 70-74 75-79 80-85 85+ 60+ _ 2267 2226 2033 1670 1150 813 580 8472 Customary bi-monthly PPD clinics held for certification purposes as well as reported positive reactors. Clinical histories obtained on latter. Appropriate appointments made and cleared with pulmonary clinic and individual. Follow-up of. September clinic appointments and absentees rescheduled. Assessment of Salem Health Department's Dental Program when compared with a recent non participant observation of a neighboring city/town dental program follows: Unsatisfactory 1 2 3 4 5 Excellent Work ethic examination re Justice in Health for the two polarized group recipients (elderly & children) seems to reveal the following current doer's style of health service delivery: self-centered motives with a corresponding dimunition of a rational, tolerant attitude rejecting the rational process of humanization. In effect, such health service delivery appears to show a noticeable trend from helping and doing to an unbearable allergy towards work to the exploitive level of "gum-beating". Individual contact with immigrants (Jewish & Indonesian) . Skin tests and x-rays arranged :with pulmonary clinic. Lynn family referred to Lynn pulmonary clinic for proper Follow-up. Notice of reported lead elevation referred to Environmental Health Section for related follow-up. Infectious Disease: Asceptic and or Viral Meningitis: -1 1-4 5-10 Strep. throat: 1 (21/2 yrs) CITY OF SALEM.HEALTH DEPARTMENT BOARD OF HEALTH • ® Dr. Israel Kaplan Public Health Center Off Jefferson Avenue Salem, Massachusetts 01970 PHILIP H. SAINDON ROBERT E. BLENKHORN JOSEPH R. RICHARD _ HEALTH AGENT M.MARCIA COUNTIE, R.N. MILDRED C. MOULTON, R.N. (617) 745-9000 EFFIE MACDONALD ROBERT C. BONIN OCTOBER, 1979 DIVISION OF COMMUNITY HEALTH: PUBLIC HEALTH NURSING SECTION - DENTAL HEALTH PROGRAM Bi-monthly Mantoux testing and certification: home health agencies, school and day care personnel. Tuberculosis follow-up continues at customary pace; i.e. evaluation, x-ray and absentee appointments/rescheduliAg, and record maintainance as well. Strep throat: 1. Asceptic Meningitis: 1. Surveillance and standard protective measures for control of all infectious diseases. Lead follow-up remains a priority and lead poisoning cases (state lab reports)relative to home inspections are referred to the Environmental Health Section on a routine basis. je'@�'he Health Department annual Flu Immunization Program is scheduled for Nov. 6, 8, 15. Target groups remain the same: handicapped, elderly, high risk and city employees. Strategy decisions reasonably straight forward to assure coverage of the desired population participation, efficient operation within constraints of time, available work space and limited personnel. Program function responsibility: (1) procurement of vaccine, (2) syringes and related supplies, (3) security measures, (4) publicity & promotion, (5) facilities, (7) catchment areas, (8) communication, and (9) transportation. DENTAL PROGRAM SCHOOL EXAMS SCHOOL St. Joseph Dental Screening Continuous Alternative Dental Screening Continuous DENTAL CLINIC Clients I Prophylaxis 16 16 Checked on students screened the past school year - 50% have been completed. HEALTH DEARTMENT DIVISION OF ADMINISTRATION MONTHLY REPORT MONTH JUNE 1980 C`\ . Y 14 BIOLOGICS DISTRIBUTED I AMOUNT ANIMAL BITES REPORTED ,i htheria, Tetanus & Pertussis 290 doses RESIDENT NON-RESIDENT 4htheria-Tetanus Tox. (under 6yrs. ) BURIAL PERMITS ISSUED 19 32 immune Serum Globulin 90 doses leasles (Clinic Use Only) INTERNATIONAL TRAVEL 2 2 telephone inquiries CERTIFICATES (CERTIFIED) /M/R ieasles Mumps & Rubella 150 doses olio Vaccine 186 doses TOTAL CASH•RECEIVED FROM $36.7.00 LICENSES & PERMITS ISSUED letanus & Diphtheria (Adult Use) 80 doses Tetanus Toxoid. (Adsorbed) 590 doses COMMUNICABLE DISEASE CASES 6 1 ML. ------- REPORTED kberculin P.P.D. (Mantoux) 5 n. 20 tests hoid Vaccine _yp SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL DIV. OF ADMINISTRATION $59 ,307.34 $55 ,539 .82 $3,767.52 DIV. OF COMMUNITY HEALTH $56,483.39 $56 ,367.50 115.89 DIV. OF ENVIRONMENTAL HEALTH $78,996.48 { $67,857.00 11,139.48 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (INCLUDES ENCUMBERED) �s• 2 5.53 35 .57 DiV. OF ADMINISTRATION 2 , 00.00 DIV. OF COMMUNITY HEALTH 34 ,650.00 31,275 .60 3,374.40 DIV. OF ENVIRONMENTAL HEALTH 4 ,950.00 4 ,370.78 579.22 *Traxasfer made from E.H.salaries to Unpaid Hospital Bill 1977 of $1 ,511.28. • 'his'�iGe��e��e =�'�'i�i'�'is ��..�■� . �� ■■o��■��■pia r T;Jili"Y A"tJe ��OCG6Lt�OK a Irealet <Sa ew, =Ac. 205 WASHINGTON STREET, SALEM, MASSACHUSEM 01970 (617) 745-9050 • TO: Members of the Board of Health FROM: Marilyn Reynolds RE . June, 1980 REPORT School Follow-Up Hearing and Vision.Follow-Up: Defects corrected: 17 Conference with parents: 13 Conference with teachers: 2 Retested: 7 Conferences: Nurse/Parent: 23 • Nurse/Teacher: 17 Nurse/Private MD: 6 Nurse/Student: 43 Seen of Referral: Illness: 37 Injury: 45 Miscellaneous: 1. immunization follow-up on new students and transfers 2. review with principal over move and appropriate placement of nurse 3. conference with public school nurse supervisor regarding screenings 4. individual teaching - 4 5. contact with incoming student's parents regarding require- ments for physicals and immunization 6. meeting with director and North Shore Region Coordinator regarding public health needs 7. chronic disease follow-up: 57 • ,y DIVISION OF CO' UNITY HEALTH SERVICES : • DENTAL PROGWUH - MONTHLY REPORT MONTH June 1980 -- SCHOOL EXAMS SCHOOL Horace Mann North Dental Screenings Completed Horace Mann South Dental Screenings Completed DENTAL CLINIC CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. DI! 6 3 2 3 6 6 1 DENTAL HEALTH EDUCATION SCHOOL GRADES PROGRAM Saltonstall 3 and BI. Lingual Crest program, Film strip, • Phillips 3 Special Classes, lecture , Nutrition Emphasis on snacks for summer. 9 HEALTH DE"ARTMENT DIVISION OF ADMINISTRATION MONTHLY REPORT MONTH MAY 1980 BIOLOGICS DISTRIBUTED i AMOUI`TT ANIMAL BITES REPORTED 13 i htheria, Tetanus & Pertussis 230 doses RESIDENT NON-RESIDENT i�h-heria-Tetanus Tox. (under 6 yrs. ) - BURIAL PERMITS ISSUED 17 22 mmune Serum Globulin - easles (Clinic Use Only) - INTERNATIONAL TRAVEL CERTIFICATES (CERTIFIED) 3 /M/R 60 doses easles Mumps & Rubella olio Vaccine 250 doses TOTAL CASH RECEIVED FROM $95.00 LICENSES & PERMITS ISSUED etanus & Diphtheria (Adult Use) 130 doses etanus Toxoid. (Adsorbed) 30 doses CONWUNICABLE DISEASES: 5 1 ML. il _ uberculin P.P.D. (Mantoux) S m,. hoid Vaccine SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL DIV. OF ADMINISTRATION $59,307. 34 $50,456.04 $8,851.30 DIV. OF COMMUNITY HEALTH 56,483. 39 52,006.4o 4,476.99 DIV. OF ENVIRONMENTAL HEALTH 80,507. 76 60,989.00 19,5i8•76 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (INCLUDES ENCUMBERED) DIV. OF ADMINISTRATION 2,800.00 2,128.00 672.00 DIV. OF COMMUNITY HEALTH 34 ,650.00 29,419.11 5,230.89 incl. Cr. DIV. OF ENVIRONMENTAL HEALTH 4,950.00 4,300.03 649.97 o��o�vv��ooaoo��mmo0o■��oAoat� no��000aA��oOono��so��A��e��ss�i 1�111111111111111111111111111111 s - DIVISION OF CON24UNITY HEALTH SERVICES • DENTAL PROGRAM - MONTHLY REPORT MONTH MAY 1980 SCHOOL EXAMS Alternative Dental Screening completed SCHOOL St.Josephs ifit " Sheridan it " Bates if " Horace Mann North " continuing Horace Mann South " continuing St.Joseph' s Kdg. Registration DENTAL CLINIC CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. DI. Continuos Dental Health Education is conducted during all DENTAL HEALTH EDUCATION dental screenings. Proper nutrition, tooth brushing and control of sweets as snacks.is stressed. The following schools had a Dental Health Education Program with a lecture and film: SCHOOL Alternative, St.Joseph, Bentley, *Bates, Sheridan, Oliver, Phillip''s Special Classes, Carlton, Horace Mann North and Special Classes and Horace Mann South. (CREST PROGRAM) Crest program continued with use of materials supplied. All students received -a crest kit and educational pam} hets to.take home. A question and answer_.period _is__held; • The following schools had a program on Toothtown U.S.A. : Wichcraft, Carlton, Horace Mann North and Horace Mann South. A new film strip used in grades three, four and five, suppled students on brushing, flossing and snacks providing them with information needec to make intelligent choices. i V G�G�GK J V K't�8 ��OCLQ�GOK O ea let Q t e"t9 Ance , 205 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 S (617) :745-9050 ' I. TO Members of the Board of Health FROM: Marilyn Reynolds RE . May, 1980 Report SCHOOL FOLLOW-UP Hearing and Vision Follow-Up Defects corrected 12 Home Visit 1 Conference with parents 2 Conference with teachers: 2 Home Visits and School Related: Conferences: Nurse/Parent 11 Nurse/Teacher 5 Nurse/Private MD: 4 Nurse/Student 6 Seen on Referral Illness: 22 Injury : 19 Miscellaneous 1. Hearing Inservice from guild for Hard of Hearing 4 2. Record completion and follow-up, incoming kindergarten grades kindergarten - 12 Respectfully Submitted, Marilyn Reynolds, PHN 'L46 Suzanne Friedley, RtS, Executive Director DIVISION OF ADMINISTRATION • MONTHLY REPORT MONTH APR 98o HE o j� � ._ HEALTH DE. ARTME BIOLOGICS DISTRIBUTED I AMOUNT ANIMAL'°BITES REPORTED 8 _ohtheria Tetanus & Pertussis 0 dos RESIDENT NON-RESIDENT ��hrheria-Tetanus Tox. (under 6yrs.) I none BURIAL PERMITS ISSUED 32 21 • une Serum Globulin none 4 telephone inquiries asles (Clinic Use Only) not availab INTERNATIONAL TRAVEL CM/R CERTIFICATES (CERTIFIED) easles Mumps & Rubella 110 doses �lio Vaccine 413 doses TOTAL CASH RECEIVED FROM $321.00 LICENSES & PERMITS ISSUED Ltanus & Diphtheria (Adult Use) 210 doses �etanus Toxoid. (Adsorbed) 1 ML. 20 tests REPORTS OF COMMUNICABLE DISEASE: uberculin P.P.D. (Mantoux) Hepatitis 1 5 ML. 100 tests Chicken Pox 2 �vphoid Vaccine none Asceptic Meningitis 1 SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAI. DIV. OF ADMINISTRATION $59,307.34 $45,o94.41 $14,412.93 h DIV. OF COMMUNITY HEALTH $56,483.30 $49,558.00 $ 6,925.39 DIV. OF ENVIRONMENTAL HEALTH $80,507.76 $54,611.95 $25,895.81 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (INCLUDES ENCUMBERED) DIV. OF ADMINISTRATION 2,800.00 2,0 9.79 $ 730.21 DIV. OF COMMUNITY HEALTH $34,650.00 $23,301.84 $11,348.16 (cr. INCL DIV. OF ENVIRONMENTAL HEALTH $ 4,950.00 $ 3,451.E+8 $ 1,498.52 DIVISION OF CO`MNITY HEALTH SERVICES DENTAL PROGR AM - MONTHLY REPORT • MONTH April 1980 SCHOOL EXAMS SCHOOL DENTAL SCREENINGS GRADES St. Jose,ph's Completed KDG. , 1-8 Alternative Completed KDG. , 1-6 Sheridan Completed KDG. , 1-3 Bates Completed KDG. , 1-8 Horace '.Mann South Continuing KDG. , 'l-6 Horace Mann North Continuing 1-8 Thru Miss Southwick a representative of Grace Church of Salem a newly established Vietnamese family was accommodated. They were given a dental exam, oral phrophlaxis and then referred to a private dentist of their choice. DENTAL CLINIC CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROP1R LAX. DI 8 8 8 8 DENTAL HEALTH EDUCATION SCHOOL GRADES PROGRAM Oliver School 3 Class Lectures Crest utilized. Film Carlton School 3 strip, crest kits, pamphlets emphasis Horace Mann North Sp placed on tooth brushing with pupil participation. Review proper f for good snacks. Returned in we time for evaluation and comprehension of students. eo��ana��0000n��oonr��■�■ MINI 11111111111111111111111 f Y • T-4ilittg ' tie �f-��occatcoH o teatet Sale"tq Jnc. 0 205 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 • (617) 745-9050 TO: Members of the Board of Health FROM: Marilyn Reynolds, RN RE: April Report SCHOOL FOLLOW UP Vision Testing: 89 Elementary Students tested 12 retested 5 referred 6 have gone for further evaluation Hearing Testing: 153 elementary students tested 9 referred 2 have gone to follow up Seen on Referral: • Accidents and illness: 43 counselling: 6 Classes Taught: 2 classes-family life- 17 present eighth grade girls 1 class- dental health-• 33 present- third grade Miscellaneous: Nurse/teacher conferences: 7 �• Parent/ nurse conferences: 14 Salem State Nursing Student orientation to school health every Thursday ro Respectfully submitted, Marilyn Reynolds, RN 1 HEALTH DEP TMENT DIVISION OF ADMINISTRATION MONTHLY REPORT MONTH MARCH 0 BIOLOGICS DISTRIBUTED AMOUNT ANIMAL BITES REPORTED 13 i htheria Tetanus & Pertussis 640 doses RESIDENT NON-RESIDENT iphtheria-Tetanus Tox. (under 6yrs.) ------- BURIAL PERMITS ISSUED 31 32 L-mmune Serum Globulin 230 " feasles (Clinic Use Only) ------ INTERNATIONAL TRAVEL 2 inquiries 1./M/R CERTIFICATES (CERTIFIED) 'jeasles Mumps & Rubella 90 " Polio Vaccine 929 TOTAL CASH RECEIVED FROM $157.00 LICENSES & PERMITS ISSUED Tetanus & Diphtheria (Adult Use) 120 " Tetanus Toxoid. (Adsorbed) 400 " 1 ML. 40 tests Tuberculin P.P.D. (Mantoux) 5 ML. 200 hoid Vaccine ------- SALARY REPORT: 1 ALLOWED EXPENDED BALANCE TO END OF FISCAL DIV. OF ADMINISTRATION ' $59,307.34 $40,788.44 $18,-518.90 DIV. OF COMMUNITY HEALTH 56,483.39 47,599.28 8,884. 11 DIV. OF ENVIRONMENTAL HEALTH 80,507.76 49,510.31 30,997.45 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (INCLUDES ENCUMBERED) DIV. OF ADMINISTRATION $ 2,800.00 $ 292.80 $791.62 DIV. OF COMMUNITY HEALTH $34,650.00 4,372.85 13,350.97 DIV. OF ENVIRONTMENTAL HEALTH $ 4,950.00 3,291.78 1,658.22 r i _ =minuo�uinn�o��i�nib DIVISION OF COML LAITY HEALTH SERVICES • DENTAL PROGRAM - MONTHLY REPORT MONTH March 1980 SCHOOL EXAMS SCHOOL Alternative Dental Screenings School completed �St. Joseph's Dental Screenings Completed Sheridan Dental Screenings Completed Bates Dental Screenings Contineing Horace Mann Next on Agenda DENTAL CLINIC CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. D7 13 8 3 1 13 7 7 DENTAL HEALTH EDUCATION SCHOOL GRADES PROGRAM St. Josephs Crest program conducted in the third grades The school supplys.'�!-,jm Alternative strip machine plus record player for my use. This requires making Bently appointments for equipment to be used thru the media dept. plus time • Bates available thru principal and teachers of classes I will work in. The return is very satisfying 100%. There were about 10 referrals thru parents and students requiring special attention. .� t �l� yI' VL•��[2 VGG't�� OCLLlt6�lt O tea let: <Sa em, =KC. • 205 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 (617) 745 9050 M Members of the Board of Directors FROM: Marilyn Reynolds, RN, PHN RE March Report CONTAGIOUS DISEASE FOLLOW-UP One tuberculosis clinic held - 14 people tested - 3 job certifications - 11 active contacts - 1 referred for positive reaction to North Shore Pulmonary Clinic 2 active tuberculosis cases and contacts Continued to have follow-up contact by Public Health Nurse visits to teach use of medication and understanding of disease. 1 Measles case at Salem State College • Contacted state and college nurses to continue follovT--up on this case. LONG TFWi CARE HOME - LICENSING Bertram Home evaluation was done. Recommendations were made to superintendents for betterment of care and meeting state requirements. Examples of recanmendations: - baseline data for each patient - increase milk and decrease breads in diet - more coordinated activities offered PREMATURE FOLLOW--UP One case continued to visit. Baby is stabilizing and family teaching ti done. Family is understanding medical treatment and taking infant to physician on scheduled basis. HEALTH EVALUATION Three home visits were made for referral to evaluate health/ safety of a Salem resident. Y i f -2- SCHOOL FOLIDW-UP , • Vision Testing: - 94 high school students 19 referred for MD follow-up - 253 elementary students 22 referred for MD follow-up Hearing Testing: - 94 high school students 4 referred for MD follow-up - 225 elementary students 6 referred for MD follow-up Height & Weight: - 94 high school students 10 counselled for adequate nutritional needs - 302 elementary students 15 counselled individually 125 counselled in groups regarding appropriate nutritional intake for breakfast Seen on Referral: • - Accidents: 63 - Illness: 41 - Counselling: 7 Preparation for class education: - 2 classes - 8th grade continued Miscellaneous: Nurse/teacher conference - 22 Nurse/parent conference - 10 Tuberculin testing on new school personnel - 3 Salem State Nursing student orientation every Thursday Respectfully submitted, l Marilyn Reynolds, RN, PHN Suzanne Friedley, RN, MS { • Executive Director r . MASSACHLISETTS Dear Doctor: Date As you know, our school children have recently been screened for visual defects via the Massachusetts Vision Test procedures. Parents of those children failing the test have been asked to take the children to their own eye specialist. In order that we may provide any educational adjustments you recommend, will you please fill out the form below and return it to me. Very truly yours, Public Health Nurse Child's name Date School Grade Brief summary of significant findings: • Diagnosis: Treatment: Prognosis: Return visit recommended in months. I advise the following educational adjustments for the child: ( ) 1. None at present ( ) 2. Preferential seating in the classroom Front Rear ( ) 3. Glasses for full-time use in school ( ) 4. Glasses for part-time use in school ( ) 5. Sight-saving classes ( ) 6. Other recommendations S; '7 ,r t Signed r Address , PH-M-25. 60M-6-72-051600 ii�s�ie�i��s�i�ii��s�iii��riiiiiiii�ii�ii - : _ �iiiiiiiiiieiiiiiiiii�ii'eiiiiiiis khtheria E''ARTMENT DIVISION OF ADMINISTRATION MONTHLY REPORT MONTH FEBRUARY 1980 S DISTRIBUTED ; AMOUNT ANIMAL BITES REPORTED 2 Tetanus b Pertussis 280 doses RESIDENT NON-RESIDENT TTox. (under 6 rs. ) - BURIAL PERMITS ISSUED 37m Globulin 230 doses INTERNATIONAL- TRAVEL 1 telephone inquiry asles (Clinic Use Only) CERTIFICATES (CERTIFIED) /M/R asles Mumps S Rubella 13 doses olio Vaccine 129 doses TOTAL CASH RECEIVED FROM $165.00 LICENSES 6 PERMITS ISSUED tanus b Diphtheria (Adult Use) 10 doses etanus Toxoid. (Adsorbed) 40 doses 1 ML. 10 doses uberculin P.P.D. (Mantoux) 5 ML. hoid Vaccine 100 doses SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL DIV. OF ADMINISTRATION $ 59,307. 34 $ 35,849.14 $ 23,458.20 j DIV. OF COMMUNITY HEALTH $ 569483.39 $ 45,640.56 $ 10-,842.83 DIV. OF ENVIRONMENTAL HEALTH $ 80,507.76 $ 44,408.67 $ 369099.09 EXPENSE REPORT: . ALLOWED EXPENDED FREE CASH (INCLUDES ENCUMBERED) DIV. OF ADMINISTRATION $ 2,800.00 $ 1,715.58 $ 1,084.42 DIV. OF COMMUNITY HEALTH $ 34,650.00 $16,926.18 $ 17,723.82 . DIV. OF ENVIRONMENTAL HEALTH $ 4,950.00 2,781.26 $ 2,168.74 DIVISION OF COMMUNITY HEALTH SERVICES r • DENTAL PROGRAM - MONTHLY REPORT MONTH February, 1980 SCHOOL EXAMS SCHOOL. - Dental Screening . Grades St. Joseph Completed Kdg., 1-8 Alternative Completed Kdg. , 1-6 Sheridan Completed Kdg.,. 1-2 Bates Continuing 2-8 St. Joseph Kdg. Registration DENTAL CLINIC Perm. Ext. CLIENTS ALLOY CEMENT _ DECID. EXT. EXAM. & CHART PROPHYLAX. DI: 25 6 3 3 25 18 . 15 DENTAL HEALTH EDUCATION Continuous Dental Health Education conducted during all examinations, in classes before screening reinforcing the importance of both daily nenta . SCHOOL GRADES PROGRAM St. Joseph 3,4.,.5 Film Strip-Crest Kits, Combination classes Pamphelts. Alternative 3,4,5 & 3,4 Film Strip-Crest Kits Take-home booklet, and Dental. Health Quiz. Bentley 3rd. grade, 2 classes Film Strip, Record and Educational Materials. 4 CITY OF SALEM HEALTH DEPARTMENT ,BOARD OF,HEALTH • Dr. IsraeixK plan Public Health Center �s . off Jefferson Avenue Salem;}MassaChusetis 01§70 PHILIP H.SAINDON ROBERT E. BLENKHORN JOSEPH R. RICHARD M.MARCIA COUNTIE,R.N. HEALTH AGENT 16171 745-9000 MILDRED C.MOULTON,R.N. EFFIE MACDONALD ROBERT C.BONIN February Summary; This month has been a hectic month at school as well as for other Public Health activities. No new cases of tuberculosis have occurred, but much of my time has gone to further follow up on the two reported cases in January. One has over 100 contacts• all have had at least one test and are due for their second test in March. All have tested negative. The other case has over 50 close contacts and most have been tested. Both cases are doing well under medication. A new case of measles was reported at Salem State College and follow up will be started there with record review and an immunization clinic if necessary. I held two mantoux clinics and tested twenty-one people. One had to be referred. During school vacation, I did my first rest home mandatory evaluation. I spent four days observing the home and evaluating the residents' care. This was through residents' record review, personnell policies, menu and meal preparation,personnell coverage, physical layout of the rooms and bathrooms and conferences with the residents. I was able to observe meal time, talk to all the residents and employees. There were some concerns to patient care such as each patient not having a good baseline evaluate (physical limitations, ability to do own care, goals,etc.) and that only two of the employees had adequate contagious disease screening for tuberculosis. I held a tuberculosis clinic on Friday, February 22, and Monday, February 25, and tested the remaining seven people. On the whole the residents were receiving excellent care and the administrators seemed willing to make chages that were recommended. I will re-visit in several months to evaluate how they are doing on• the recommendations. Two more rest homes need to be evaluated. This is very time consuming. s .rlCITY OF SALEM HEALTH DEPARTMENT i4 DR. ISRAEL KAPLAN PUBLIC HEALTH CENTER � y, OFF JEFFERSON AVENUE ` A TRI SALEM, MA 01970 (2) At school, we had pre-registration for kindergarten with the help of the State Lead Screening Lab and the Salem Dental Hygienist and the Public Health sccretary, we interviewed and screened 28 children. Parents were asked their concerns and were informed of .required testings. I have spent most of the rest of my school time finishing screenings and referals on the High School students. On February 7 and 8, the elementary school was closed on account of illness. 100 students each day were absent. The number out sick is less each day since. We have had several incidences with particular students and are working closely with protective service and their doctors. The State Lead Lab has agreed to help screen the fourteen Day Care centers in Salem in the spring. They will await our contact. This will require much time as some day cares have a capacity for as many as 130 students. I also followed up on a new premature baby with congenital dis- located hips. Both parents seem well informed and caring. They had adequate coverage form their pediatrician and orthopedic. . I • left my name and number for them to call with any questions or problems. Plans for March: 1. Teach female anatomy class-8th grade. 2. Start scoliosis screening training. 3. Finish school screenings and follow up. • f . , o000000a�m�m�m ., - �oov��a�o�A��v��oa��n�oo��c.■��I • � �� ' ; ' Rio■�oa�o��■��o��oo�■�■��I - �111�1'�1111111111��111111�11�� 1' DIVISION OF COMMUNITY HEALTH SERVICES DENTAL PROGRAM - MONTHLY REPORT - MONTH January 1980 ._ SCHOOL EXAMS SCHOOL Alternative Dental Screenings Kdg. 1-6 Completed St. Joseph Dental Screenings Kdg. 1-8 Completed Sheridan Dental Screenings Kdg. 1=3 Completed Bates Dental Screenings Continuing DENTAL CLINIC CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. D 4 4 4 1 DENTAL HEALTH EDUCATION SCHOOL- St. Joseph GRADES_ 3,4, 5 PROGRAM _ Crest educational program conducted in Grades 3,4,5. Slide projector is used a record. After this is shown a discussion is conducted in' each class, ,with stressing the needs of mouth hygiene, nutrition, and dental. office visits. Emphasis is made on prevention and how to maintain good oral hygiene. Each student takes home a dental kit provided by the Crest people plus a pamphlet for parents. Met with school nurse at schools ogXeened on n;nq --t-„rlA„+-- in aental care. Also contacted parents concerning visual Ineeds in deciduous teeth. Fhther E'ARTMENT DIVISION OF ADMINISTRATION MONTHLY REPORT MONTH JANUARY 1980 DISTRIBUTED I AMOUNT ANIMAL BITES REPORTED 7 Tetanus & Pertussis RESIDENT NON—RESIDENT etanus Tox. (under 6 yrs.) BURIAL PERMITS ISSUED 19 23 Globulin lasles Clinic Use Only) _ INTERNATIONAL TRAVEL 3 inquiries M/R CERTIFICATES (CERTIFIED) _asles Mumps & Rubella 160 doses olio Vaccine 240 doses TOTAL CASH RECEIVED FROM LICENSES & PERMITS ISSUED $25.00 _tanus & Diphtheria (Adult Use) 80 doses �tanus Toxoid. (Adsorbed) 160 doses 1 ML. 2 vials berculin P.P.D. (Mantoux) 5 ML. _ �hoid Vaccine 50 doses ALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL DIV. OF ADMINISTRATION 59,307.34 26,181.54 33,125.80 DIV. OF COMMUNITY HEALTH 560483.39 28,536.80 27,946.59 DIV. OF ENVIRONMENTAL HEALTH 80,507.76 32,953.60 47,554.16 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (INCLUDES ENCUMBERED) DIV. OF ADMINISTRATION 2,800.00 1,524.89 1,275.11 DIV. OF-COMMUNITY HEALTH 349650.00 15,041.93 19,608.07 2 071.66 2 878.34 DIV. OF ENVIRONMENTAL HEALTH 4,950.00 , , HEALTH DEPARTMENT DIVISION OF ADMINISTRATION MONTHLY REPORT MONTH DECEMBMBER 1979 BIOLOGICS DISTRIBUTED I AMOUNT ANIMAL BITES REPORTED 6 1htheria, Tetanus & Pertussis 210 • RESIDENT NON-RESIDENT htheria-Tetanus Tox.,(under 6yrs.) - BURIAL PERMITS ISSUED 31 14 liune Serum Globulin 10 lisles (Clinic Use Only) - INTERNATIONAL TRAVEL 2 telephone inquiries /R CERTIFICATES (CERTIFIED) sles Mumps & Rubella 130 io Vaccine 340 TOTAL CASH RECEIVED FROM $1,235.00 LICENSES & PERMITS ISSUED anus & Diphtheria (Adult Use) 80 tanus Toxoid. (Adsorbed) 360 1 ML. - erculin P.P.D. (Mantoux) 5 ME• 1 v hoid Vaccine 0 LARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL. DIV. OF ADMINISTRATION $59,307. 34 $26,181.54 $33,125. 80 DIV. OF COMMUNITY HEALTH 56,483. 39 $28,536.80 27,946.59 DIV. OF ENVIRONMENTAL HEALTH 80,507. 76 32,953.60 47,554. 16 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (INCLUDES ENCUMBERED) DIV. OF ADMINISTRATION $2,800.00 $1,367.68 $1,4 32.32 DIV. OF COMMUNITY HEALTH $34,650.00 $13,218.27 $21,431. 73 DIV. OF ENVIRONMENTAL HEALTH 4,950.00 2,033. 74 2,916.26 ' DIVISION OF COMMUNITY HEALTH SERVICES DENTAL PROGRAM - MONTHLY REPORT MONTH December, 1979 SCHOOL EXAMS SCHOOL Alternative Dental Screening St. -Joseph Dental Screening Bates Dental Screening DENTAL CLINIC CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX.. DIS I 8 13 2 ---- 8 8 2 DENTAL HEALTH EDUCATION Continuous dental health education conducted with small grou s & in classroom SCHOOL GRADES PROGRAM ram. / 1 11111111111111111111111111!1111 HEALTH DE. ARTMENT DIVISION OF ADMINISTRATION MONTHLY REPORT MONTH NOVEMBER 1979 � 1 BIOLOGICS DISTRIBUTED AMOUNT ANIMAL BITES REPORTED htheria Tetanus & Pertussis 310 doses RESIDENT NON-RESIDENT h�heria-Tetanus Tox. (under 6 yrs.) -- BURIAL PERMITS ISSUED 15 26 une Serum Globulin 110 doses sles (Clinic Use Only) -- INTERNATIONAL TRAVEL 4 inquiries CERTIFICATES (CERTIFIED) �M/R 150 doses asles, Mumps & Rubella �lio Vaccine 320 doses TOTAL CASH RECEIVED FROM None LICENSES & PERMITS ISSUED :tanus & Diphtheria (Adult Use) 130 doses tanus Toxoid. (Adsorbed) 320 doses REPORTS OF COMMUNICABLE DISEASE 4 1 ML. 50 berculin P.P.D. (Mantoux) 5 ML. Ir hoid Vaccine �ALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL DIV. OF ADMINISTRATION $ 59,307.34 $ 20,675.57 $ 38,631.77 IiDIV. OF COMMUNITY HEALTH $ 56,483.39 $ 23,469.60 $ 33,013.79 DIV. OF ENVIRONMENTAL HEALTH $ 80,507.76 $ 27,799.20 $ 52,608.56 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (INCLUDES ENCUMBERED) DIV. OF ADMINISTRATION $2,800.00 713.18 2,086.82 DIV. OF COMMUNITY HEALTH 34,650.00 10,295.56 24,354.44 DIV. OF ENVIRONMENTAL HEALTH 4,950.00 910.17 4,039.83 • • • / 7 ti CITY OF SALtM HEALTH DEPARTMENT • BOARD OF HEALTH Ur. Israel Kaplan Public Health Center 'Off.Jefferson Avenue Salem, N1,issachusetts 01970 s'HiLIPH.SAINDON ROBERT E. BLENKHORN .;OSEPH R. RICHARD HEALTH AGENT M.MARCIA COUNTIE,R.N. (617) 745-9000 MILDRED C.MOULTON,R.N. EFFIE MACDONALD ROBERT C. BONIN i REDERICK M.PiECEWICZ,M.D. NOVEPBER, 1979 DIVISION OF COM1,WITY HEALTH: PUBLIC HEALTH NURSING SECTION REPORT Ages of Mankind: The infant-parent-grandparent, all make their contributions to the life of the community; and all three have certain inalienable rights, - a reasonable quality of health or wellness and an environment (s) which is allowed to properly respond to the needs of its most complex and highly developed form of life--mankind itself. Advocates of justice in health concerned that the average American family spent abput $215.00 for health care in 1978 feel that one of the cheapest and most effective ways • to put a cap on spiraling health costs is through greater self-care. Most illnesses run their own course and seldom are life threatening, permitting most people to provide themselves and their families with rudimentary health care. Better health education (local newspapers and radio) so that people know the best way to treat common illnesses themselves and, the best time to see a physician - certainly could improve the effectiveness of this resource. About 5,000,000,000 in the United States now belong to physical or mental self help groups of some kind including everything from A.A. to feminist health collectives. Organized self care programs have proven effective among those suffering from chronic illness which represent a growing portion of diseases affecting Americans. Herbert Benson, M.D. (Harvard Medical School and current recipient of a $150,000.00 Fleishmann Foundation grant for a "placebo effect" study) states that modern emphasis on technology in medicine may have obscured some valuable healing techniques such as the "placebo effect" (N.E.J.M. 21 June '79) which unlike other remedies is safe and inexpensive. Dr. Benson authored Relaxation Response and The Mind-Body Effect. Infectious Disease: Amebiosis: 1, Hepatitis: 1; Salmonellosis: 2; Strep.Throat: 1. T. B. Control: Bi-Monthly tuberculin test clinics held as scheduled - included job certification requirements as well as contact testing. Clinic appointments arranged, • and intra agency reports completed. / 7 ��uu�..s wu�crillYexlv`;�v �1auu�. wuFr . .+1,4au•.�w�y..W!��+�.µ.L,syw.J...1^K.�rwAr�t_,;_u.�. _� �._....�-.-._..M. -m-<;,;rs..,�- ,�_�....w._.._,. ,G0.L L v CITY OF SALEM HEALTH DEPARTMENT DR. ISRAEL•KAPLAN PUBLIC HEALTH CENTER A.4 OFF JCFFLRSON AVENUE SALEM. MA 01970 '-" November, 1979 2 - Division of Community Health Inspections: Newhall Nursing Home: License renewal. Premature Infants: -- Flu immunization: + 1154 doses administered. Final tabulation incomplete. No adverse reactions reported as of 30 November, 1979. Opinion poll (clinic days) revealed that approximately 69% of the group immunized against influenza would be interested in receiving pneumonia vaccine. K. Morgan P.H.N. D. Bradley P.H.N. • COLk ' CITY OF SALEM HEALTH DEPARTMENT ' a „ 4 DR. ISRAEL KAPLAN PUBLIC HEALTH CENTER l OFF JEFFERSON AVENUE SALEM. MA 01970 �kFcr:m'F. • VISITING NURSE ASSOCIATION OF GREATER SALEM, INC. MONTHLY REPORT UNAVAILABLE AT THIS TIME. • • • DIVISION OF COMMUNITY HEALTH SERVICES • DENTAL PROGRAM - MONTHLY REPORT MONTH November, 1979 SCHOOL EXAMS SCHOOL . Alternative Dental Screening Kdg. 1-6 St. Joseph. Dental Screening Kdg. 1-8 Continuous education and evaluation conducted. Consultation iii regard to dental needs with school nurses at Endicott and Horace Mann Schools and directing them to private —Dentists when they could afford it and to -our- clinic. DENTAL CLINIC CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX.. DIS 5 8 - 2 - 5 DENTAL HEALTH EDUCATION , . SCHOOL GRADES PROGRAM Crest program will start in January of 1980 in all third Graders and special classes. • •Al VL•�L�GK J VGL'�Je ��OCGLLtGUK O Ceale't Salem., Atc, 205 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 • (617) 745-9050 December 4, 1979 NOVEMBER 1979 Summary: This has been a month to continue with the routine screenings of vision, hearing, <and heights and weights. Parents and teachers are being notified of the pupils who had abnormal findings. Much of this month has been used to prepare for the early December physicals and immunization clinics. I have had several junior high pupils referred to me for `.counselling, and I have been seeing them on a casual, but routine basis. I have been following up on two extensive contagious disease cases along with the sanitarians. We have been trying to isolate the positive cultures. Plans for next month for school will be to continue with the routine screenings and run �the physical : id immunization clinics. I also plan to set up a date for the scoliosis clinic. I will be increasing my hours for the month of December to help with the contagious disease control and follow up of the health department. Sincerely, / ) F Marilyn 1eynolds,RN I 17 111�1111111111111111111111111111� NTH OCTOBER 1979 phtheria- DISTRIBUTED AMOUNT ANIMAL BITES REPORTED 5 i Tetanus & Pertussis 78 vialsRESIDENT NON-RESIDENT Tetanus Tox. (under 6yrs.) - BURIAL PERMITS ISSUED 35 mmune Serum Globulin - iseasles (Clinic Use Only) 2 doses INTERNATIONAL TRAVEL 1 /M/R CERTIFICATES (CERTIFIED) easles Mumps & Rubella 150 doses olio Vaccine 231 doses TOTAL CASH RECEIVED FROM $52.00 LICENSES & PERMITS ISSUED etanus & Diphtheria (Adult Use) 4 vials letanus Toxoid. (Adsorbed) 31 vials 1 ML. COMMUNICABLE DISEASES : ube.culin P.P.D. (Mantoux) 5 ML 2' vials -1 ML Aseptic Meningitis 3 hoid Vaccine - Strep Throat 2 SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL DIV. OF ADMINISTRATION 59,307. 34 15,397.27 43,910.07 DIV. OF COMMUNITY HEALTH 56,483. 39 18,135.60 38,347.79 DIV. OF ENVIRONMENTAL HEALTH 80,507. 76 21,481.20 59,026.56 DENSE REPORT: ALLOWED EXPENDED FREE CASH (INCLUDES ENCUMBERED) DID'. OF ADMINISTRATION 2800.00 . 527.83 2272.17 IV. OF COMMUNITY HEALTH 34,650.00 7,948.89 26,701.11 "- WV. OF ENVIRONMENTAL HEALTH 4,950.00 910.17 42-039.83 CITY OF SALEM HEALTH DEPARTMENT • BOARD OF HEALTH Dr. Israel Kaplan Public Health Center Off Jefferson Avenue Salem, Massachusetts 01970 PHILIP H.SAINDON ROBERT E. BLENKHORN JOSEPH R. RICHARD M.MARCIA COUNTIE,R.N. HEALTH AGENT (617) 745-9000 MILDRED C. MOULTON, R.N. EFFIE MACDONALD ROBERTC.BONIN OCTOBER, 1979 DIVISION OF COMMUNITY HEALTH: PUBLIC HEALTH NURSING SECTION - DENTAL HEALTH PROGRAM Bi-monthly Mantoux testing and certification: home health agencies, school and day care personnel. Tuberculosis follow-up continues at customary pace; i.e. evaluation, x-ray and absentee appointments/rescheduling, and record maintainance as well. Strep throat: 1. Asceptic Meningitis: 1. Surveillance and standard protective measures for control of all infectious diseases. Lead follow-up remains a priority and lead poisoning cases '(state lab reports)relative to home inspections are referred to the Environmental Health Section on a routine basis. • The Health Department annual Flu Immunization Program is scheduled for Nov. 6, 8, 15. Target groups remain the same: handicapped, elderly, high risk and city employees. Strategy decisions reasonably straight forward to assure coverage of the desired population participation, efficient operation within constraints of time, available work space and limited personnel. Program function responsibility: (1) procurement of vaccine, (2) syringes and related supplies, (3) security measures, (4) publicity & promotion, (5) facilities, (7) catchment areas, (8) communication, and (9) transportation. DENTAL PROGRAM SCHOOL EXAMS SCHOOL St. Joseph Dental Screening Continuous Alternative Dental Screening Continuous DENTAL CLINIC • Clients. ( Prophylaxis 16 16 Checked on students screened the past school year - 50% have been completed. V G�G��l2 J V a tie c-,40,c;alGOK vPteaterSalem., AIC. 205 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 (617) 745-9050 • October 31 , 1979 w October Summary: The school health program is conitnuing the programs n September. Vision and hearing screenings are in started 1 S to P g g process. The parents have been notified of the children who have failed and the teachers have also been made aware of those students. I have had conferences with the title I coordinator and will be starting a more active part in the core evaluations of the students in the parochial school. In most cases it is appropriate for the school nurse to do the home and school health evaluation. The nutrition education seminar is completed and the teachers who went to it have already started to incorporate • some of the information into their classes. I will be working with the other teachers to help them use the --aterials and information that I obtained. 'Physicals have been set up for early December. I also hope to have had the basic scoliosis training by then. I awaiting a specific have had contact with Ms Munn and am v ar g p date. I am still keeping statistics of the children seen by me and have found some correlation between activities, age, and playground safety. We are working on increased safety. Much of the time has been spent reviewing the pupils records I' � and trying to get immunization and Health records on the new pupils in the school. There are 59 new students in the two schools. This information and the immunization update must be by November 9, 1979• For non-school activities I am responsible for obtaining ! the epidemiological data for the city of Salem for a state wide !! influenza survey. This will require weekly contact with the • nurses of Severals schools and of Sylvania. sincerely, 1 ��ieiiiii�iii��iiii■��eee��i■ee . .,. 11111111 � 11111111111111111111 , : : . . . ; I1111�11�11111111111111111111�11 111!1111111111111111111111111111 • �eiiieiiieeiiiiiiisiiii��ieiiii� ... . . - . .. - 111lllllllllllllllilllllllilllilt 11111111111111111111111111111111 DIVISION OF COMMUNITY HEALTH SEaVICES DENTAL PROGRAM - MONTHLY REPORT MONTH SEPTEMBER 1979 SCHOOL EXAMS SCHOOL Schools resumed sessions. St. Josephs School screening Kdg.l - 8 DENTAL CLINIC , CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. DIS 5 3 - 1 5 _ 5 DENTAL HEALTH EDUCATION SCHOOL GRADES PROGRAM Prophylaxis Program resumed. C Reviewed follow up of student reports relative to dental health status. • l� . - .., 11111111111111111111111111111111� 11111111111111111111111111111111- " HEALTH DEPARTMENT DIVISION OF ADMINISTRATION MONTHLY REPORT MONTH_ Pry 1q�q A BIOLOGICS DISTRIBUTED I AMOUNT ANIMAL BITES REPORTED (Salem residents) 7 Di htheria Tetanus & Pertussis 53 vials RESIDENT NON-RESIDENT Diphtheria-Tetanus Tox. (under 6yrs.) ------- BURIAL PERMITS ISSUED 19 20 Immune Serum Globulin 9 Keasles (Clinic Use Only) ------- INTERNATIONAL TRAVEL 2 CERTIFICATES (CERTIFIED) M/M/R Measles Mumps & Rubella 200 doses Polio Vaccine 400 " TOTAL CASH RECEIVED FROM $64.00 LICENSES & PERMITS ISSUED Tetanus & Di htheria .(Adult Use) 13 vials Tetanus Toxoid (Adsorbed) 51 ItOTHER DISEASES (Salem residents) 6 1 ML, 20 tests Tuberculin P.P.D. (Mantoux)' - 5 ML. 150 Typhoid Vaccine SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCA DIV. OF ADMINISTRATION $59,307.34 $11 802.17 $47,505.17 DIV. OF COMMUNITY HEALTH $56,483.39 $13,868.40 $42,614:99 DIV. OF ENVIRONMENTAL HEALTH $80,507. 76 $16,426.80 $64,.080..91; EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (INCLUDES ENCUMBERED) DIV. OF ADMINISTRATION $ 2,800.00 $ 20.69 $ 2,779.31 DIV. OF COMMUNITY HEALTH $34,650.00 $ 2,331.06 $32,318.94 DIV. OF ENVIRONMENTAL HEALTH $ 4,950.00 $ 623.75 $ 4,326.25 r CITY OF SALEM HEALTH DEPARTMENT • BOARD OF HEALTH Dr. Israel Kaplan Public Health Center Off Jefferson Avenue Salem, Massachusetts 01970 PHILIP H.SAINDON ROBERT E. BLENKHORN JOSEPH R. RICHARD T HEALTH AGENT M.MARCIA COUNTIE,R.N. (HEAL AL 74AGEN MILDRED C.MOULTON, R.N. 5-9000 EFFIE MACDONALD ROBERT C. BONIN SEPTEMBER, 1979 DIVISION OF COMMUNITY HEALTH: PUBLIC HEALTH NURSING SECTION The 1979 influenza vaccine A/Brazil, A/Texas, B/Hong Kong according to D.P.H. 10/1/79 presumably will be available by mid-October. Clinic dates will be determined at time of vaccine Arrival. The 2000 dose order placed with R.H.O. was based on the following age distribution. 55-59 60-64 1, 65-69 70-74 75-79 80-85 85+, i -60+_ 2267 2226 2033 1670 1150 813 580 8472 Customary bi-monthly PPD clinics held for certification purposes as well as reported • positive reactors. Clinical histories obtained on latter. Appropriate appointments made and cleared with pulmonary clinic and individual. Follow-up of September clinic appointments and absentees rescheduled. Assessment of Salem Health Department's Dental Program when compared with a recent non participant observation of a neighboring city/town dental program-follows: 41 Unsatisfactory 1 2 3 4 5 Excellent Work ethic examination re Justice in Health for the two polarized group recipients (elderly & children) seems to reveal the following current doer's style of health service delivery.: self-centered motives with a corresponding dimunition of a rational, tolerant attitude rejecting the rational process of humanization. In effect, such health service delivery appears to show a noticeable trend from helping and doing to an unbearable allergy towards work to the exploitive level of "gum-beating". Individual contact with immigrants (Jewish & Indonesian) . Skin tests and x-rays arranged with pulmonary clinic. Lynn family referred to Lynn pulmonary clinic for proper follow-up. Notice of reported lead elevation referred to Environmental Health Section for related follow-up. Infectious Disease: Asceptic and or Viral Meningitis: -1 1-4 5-10 • Strep. throat: 1 (21/2 yrs) 1� 4 + V V,J�ti�l i V{L lidL �./ / J3V�.�K tLV•'L VPtealet cS— QLmll, Ail Ca 205 `VASHINGTON STREET, SALEM, MASSACHUSETTS 01970 • (617) 745-9050 ,"October 2, 1979 Septe-aber Summary: IXAs '�ias been an active beginni.n�; of the school year. Enroll-ment :.as increased to 310 pupils in tr.e elementary school from 271", last year. The hisg-h school has 97 students. ' he are t.Zi rty-nine new kindergarten children. I have had contact wit'.z all of their parents and am in the process of -'eating their 7,andated physicals and immunization records. This .s required b-, October 1 , 'tie new :principal of the elementary school, Sister Rita, and I will be wor':inc_ closel;r to-ether in chanr ing the nutri- CD tional environment in t-,e school. Snacks sold at school have been cnanFed from potato cups a-nd candy and juice to nuts, raisins, fres'i fruits and l.il ;. I -ioy)e to suople:aent ,'_1is with nutritional classes. i ar :rese_t17,1 to rinL; a seminar wit-�i t ao of the teachers. • i'^1s is bein-; ta��;�t by the _;ort_Ieast reL;lonal nutrition center to help educators '.now the resource :,aterials available on lzutrl- ti on and :�el-:: -t,em establish it in t.,_eir sc1lool cui-riculur:. it is n- desire .- .at each clas ;:111 zave i1'.i trltional -''eac'li_1,- as ;)art of t_.eir traininE, t 11 ;ear. Sltartin in i:nid- ;e,)te:7ber one Salem �tate nursin-- -tudent has started rlor_:inE; with me. This is part of4 curricul(-m.. Jve L seven wee IIs , a new student will be involved. T -ie students ' ir1- structor and I have %%or,red out goals for each stud.erlt to rea.c_ as ;)art of her health :promotion experience. Dart of the el peri- ence will be an option of teac`iing a class, ti:or'�.in,_ with me on the new screenings(like scoliosis� and later on, working ;;itla ' me on group meetings and teac_zer conferences. T':zere have been manor children referred to me for accidents. I am presently collecting data as to the types of referrals/ injuries to see if there is a common problem (i.e. hard play, broken glass, insect bites, carelessness) . ile hope to benefit from this data to make our environment and activities safer, where possible. The junior hiFh teachers and I have :gad a meeting with the ?Iemorial Hospital staff re _,arding a student we have in seventh grade eith severe hemophilia. They gave us updated information • on problems and observations ire needed to be aware of with this student. I plan to r-_een close contact with them and the fa;nil,r. 10` rM 1 • f �" L� �r,�� .� /lf`%�e `i��oc�atcott ealec z:-- cap, v/'/Ica r • W'i iVASIIINGTON STREET, SALEM, NIAf S CJM sE�rs O1970 (617) 745-0050 '.'e also ia-.-e '-iad t,_e benefit of . avi,_`; t e `.;ale.. ealt , Depart.ment Dental perso.,.nel. '�-'ney Nave started oral screenin--. zis vjill be co l.i.lued throu_:': October and will be available for all the students in t',e elementary schools. The neat no-__t_-i v.,ill 'je t.ie continuance of c Le i)ror_ra ns men— tioned and tie start-in- of confere-nces each teacaer about out>ils w;,o need follor, u-D. • i_ a ilti -eynoids, • )0,Q HEALTH DEPARTMENT DIVISION OF ADMINISTRATION MONTHLY REPORT MO'ITH AUGUST 1979 BIOLOGICS DISTRIBUTED Ai10UNT ANIMAL BITES REPORTED 9 i t rshtheria Tetanus & Pertussis j 22 vials RESIDENT NON-RESIDENT htheria-Tetanus Tox. (under 6 rs.) i 2 vials BURIAL PERMITS ISSUED 19 19 i mune Serum Globulin i 10 vials INTERNATIONAL TRAVEL 4 asles (Clinic Use Onl ) -- CERTIFICATES (CERTIFIED) �t,R csleS Mumps & Rubella 150 doses Iio Vaccine lno doses TOTAL CASH RFCEIVED FROM $205.00 LICENSES & PERMITS ISSUED Lanus & Diphtheria (Adult Use) 3 vials _tanus Toxoid (Adsorbed) _ 30 vials 1 2 4 vials .berculin P.P.D. (Mantoux),., 5 1 vial •rhoid Vaccine 4 AL ARY REPORT ALLOWED EXPENDED BALANCE TO END OF FISCAL DIV. OF ADMINISTRATION $ 599 307. 34 $ 7,699.59 $ 51,607.75- _ DIV. OF COMMUNITY HEALTH 56,483. 39 9,901.20 46,582. 19 DIV. OF ENVIRONMENTAL HEALTH 801,50 7. 76 11, 772.40 68,735. 36 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (INCLUDES ENCUMBERED) DIV. OF ADMINISTRATION $ 2,800.00 6.75 2,793.25 DIV. OF COMMUNITY HEALTH $ 34,650.00 1,907.16 32,742.84 DIV. OF ENVIRONMENTAL HEALTH $ 4,950.00 68. 78 4,881.22 CITY OF SALEM HAT "�"krt Gid E ,tiOAR") OF fiLr,, Dt. Israel kaplo Public W enter Off 3effeltk�n Avenile Salem, Massachusetts 01970 i .LIP H. SAINDON 3iGi£EA C E. �3iIGfVK3iQ�l t JOSEPH R. RICHARD NI M.MARCIA COUNTIE, R.N. HEALTH AGENT MILDRED C. MOULTON, R.N. (617) 745.9000 EFFIE MACDONALD ROBERT C. BONIN AUGUST 1979 DIVISION OF COMMUNITY HEALTH REPORT: PUBLIC HEALTH NURSING SECTION Vietman refugee (2 families) tracking unsuccessful although 3--4 leads obtained from neighbors were strenuously followed. Usual responses were: "don't know," or "moved to Chinatown, Boston", . . . Lead Paint Poison Prevention and Hearing Test posters designed and distributed throughout the city. Strategic poster placement, outreach plus good weather provided the stimuli for well. attended Health Department clinics during Heritage ! Days. • Lead Screening: Tested Results 66 No Elevations Hearing Mobile Test Results: Tested Passed Passed_other ear prob. - -- Failed 132 52 12 68 U 29 30-39 40-49 50-59 60-6; 70+ Total Passed-vithi other prob.1. 2 ; 3 l 12 1 Failed I 2 A 3 --- I 26 9 68 i FLU VACCINE: ---designated for the following groups: 65yrs and over, high risk and chronic disease will he available from the Div. Comm. & Venereal ills. SW AH. Specific data compiled and available For processing order. I Pr ature :infant follow: 2 f Mancoux testing: Certification College Contacts(pos. reactors) Total i 7 3 55 _.� 15 ,_._..._. Routine TB follow and record maintainance ln[ectious Disease Control: Meningitis Heyati.ti_s Salmonellosis 4 _. __ __ 1.T__ _ 2 _.__ _ DIVISION OF COMMUNITY HEALTH SEVICES • DENTAL PROGRAM - MONTHLY REPORT Q MONTH AUGUST 1979 SCHOOL EXAMS SCHOOL All .schools observing summer vacation. DENTAL CLINIC Combination CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. DI 37 9 7 1 27 25 27 DENTAL HEALTH EDUCATION . SCHOOL GRADES PROGRAM School recess • I (/c�ctc�c cc��e �jjacial;akt a water. <Saleot� =Ac. 205 WASTITNGTnN STljl?r:T, SALEM, MASSACTIUSETTS 01.970 (617) 745-9050 f September 4, 1979 August summary: j School activities Pat Malloy, the nutritionist in charge of the Northeast Regional district, met with us and reviewed resource materials and plans to help me incorporate a nutritional program for all grade levels. She will be teaching a class for teachers and health professionals in September. I plan to ask several interested teachers at St. Joseph to attend this with me. A new school program is being reviewed by the Red Cross Asso- ciation. Once it has been organized, Mary Manning will contact me and start the program at St. Joseph' s. We have had several meetings about the school ' s basic needs, and the program will be geared towards this . I was able to continue contacting some of the families of the children who hadn' t had their physical defects evaluated during the year. Several kindergarten records came in and I was able to start working on them. Public health I Much of my time went to contagious disease follow up and assisting with the hearing screenings sponsored by the health department during Heritage Days. Over 130 people took advantage of the thorough screening exam, and over one half of these people needed referrals for further evaluation. With contagious disease: two cases of salmonella, four cases of meningitis, and one of hepatitis were reported for Salem residents . All were appropri- ately followed. I also assisted with the public health nurses ' i P s routine tuberculosis clinics. I September plans Most of September will be starting the school year. All new children and kindergarten students have to have the reguired immunizations and health records . The teachers also have to be notified of the students who have special medical needs . I also hope to have the time set up for the scoliosis screening, and plan to attend the nutrition program. O Respectfully submitted, ) / Marilyn Reynolds, RN �/ ENVIRONMENTAL HEALTH DIVISION MONTITLY REPORT 1979 August TOTALS ikCITARY CODE 1. Food .. 2. Mobile Food Serv. .3. Retail Markets MOMMOMMMOMMOMM, 4. Housing ■,rara��rao�ov��aoo�o��r��ci��w��a��i 5. General Nuisances M.. Air & Noise Poll May Care Centers* 9. ches RODENT- CONTROL:Swimming Pools . 111�10�IIIN00�1111111I11l11111 Cream 11111111111111111111111N1111111� 111111111111111111111111111111I� f CITY OF SALEM HEALTH DEPARTMENT BOARD OF HEALTH Dr. Israel Kaplan Public Health Center Off Jefferson Avenue Salem, Massachusetts 01970 PHILIP H.SAINDON ROBERT E. BLENKHORN JOSEPH R. RICHARD M.MARCIA COUNTIE,R.N. HEALTH AGENT (617) 745-9000 MILDRED C.MOULTON, R.N. EFFIE MACDONALD ROBERT C. BONIN DIVISION OF COMMUNITY HEALTH JULY, 1979 REPORT: PUBLIC HEALTH NURSING SECTION Infectious disease control: Salmonellosis 2, strep throat 1, scabies information and instruction to N.S. Elderly Services, Pul. TB 1 Immigrant and refugee follow-up for person to person contact and interview in regard to immunization status and h.ealth. needs proved fruitless. Neighborhood • hearsay: "moved to Chinatown in Boston". Heritage Day Hearing Test poster designed and mailed to Heritage Day committee, Chamber of Commerce etc. Fully cognizant of changing patterns. and diminishing expectations in public health, review and planning of health services has begun since the delivery system can op- erate only-within the context of social and economic factors relative to actual programs. Consultation with Mrs. Blum(RHO) relative to school health segment. Bi-monthly tuberculin test clinics held as scheduled included job certification requirements as well as contact testing. Clinic appointments arranged, and intra- agency reports completed. Pul. TB case reported, and clinical history obtained. Family, close relatives and co-workers skin tested. Immediate family placed on medication. Mantoux test will be repeated at proper interval for possible converters. Standard follow-up. ' Lead poisoning test for children 1-6 yrs also has been arranged to operate during Heritage Days. Co-sponsors are: Mass. D.P.H. Lead Paint Poison Prevention and the Lynn Community Health Center. Test-mobile available Wednesday, August 15, 1979 at Palmer's Cove and again on Friday, August 17, 1979 at Salem Mall, E. India Sq. • Testing hours for both days: 9:30 AM - 3:00 PM. r DIVISION OF COMMUNITY HEALTH SERVICES • DENTAL PROGRAM - MONTHLY REPORT f MONTH JULY 1979 SCHOOL EXAMS SCHOOL SALEM PUBLIC SCHOOLS ENJOYING SUMMER RECESS DENTAL CLINIC CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. DI 20 35 5 6 20 15 DENTAL HEALTH EDUCATION SCHOOL GRADES PROGRAM GREAT DEAL OF TIME CONSUMED IN MAKING TELEPHONE APPOINTMENTS FOR SUMMER PROPHYLAXIS • PROGRAM. THE HOT SUMMER HAS INTERFERED. THE PERCENTAGE SHOULD SHOW AN INCREASE WITH SCHOOLS REOPENING. <Z7,4accalcatt a teate'r, Salepa, =-Jfc, 205 WASHINGTON STREET, S_LEM, MASSACHUSETTS 01970 (617) 745-9050 July Summary. Much of this month has been used to establish a school health program for 1979-080. Firs. Peg Kum, RN, from the Northshore Regional office met w-7-th us arc, provided us with information on scoZiosis screening and contact people for nutrition and hypertension screenings. -^ future ure date wWZ be Trade for actual scOZiosis screening supervision in September. 1 have oontooted unj to ed to r ss roe pen le in of 2ep ageasies h(;i.nd i ng. ✓aave1 _ 3eg iona...7 rd✓Ntional Center, Won Red C�.•s r e aid i, ,.r.i.v tie Vera meat of `entaZ He.aZth to establish h res ✓rce people and material On nutrition, sa G'.y accident prevention,,on ame2, py r""'r, pressi re ` i"� aria �YR. 1 pZan ic conk. ne iJvAi g on E :2TJ Ttc pr` 1 ' Tor e l c' O�O�O. , J" t n� sCY10iJ ..lY>... a--c continue setting up G, teaching/training schedule 'Or the SaWn State Nmrsing students who wl have G seven week rotation ;it y me for part Of their heath pro%not::on e.xGc:i"t,en'e. Aere has been some time t0 contact some students who havonot had appropriate follow-up for v' sion and hearing defects in school. I plan to call and visit some) of the families to urge fo?"ow-up during the summer and to ascertain if they need any help. Pant of the time I have assisted the primary public health nurses with the mantoux clinics and contagious disease foZZow-up. Respectfully submitted, C Marilyn Reynolds, RN • .. �iii�i■■iii�i��iiiiiiiiiiiii�ei �moo�s��oavo��00000��e0000��Ani ��00oo��ovAvo��o�000��o�o�A��ooi : . - ... - 1;11��IIe�11111111111111�1111��1 1111111111111111111111111111111I r1UNTULY MUNlri /7 BIOLOGICS DISTRIBUTED AMOUNT ANIMAL BITES REPORTED 16 Diphtheria, Tetanus & Pertussis 270 doses RESIDENT NON-RESIDENT Diphtheria-Tetanus Tox. (under 6 rs.) 30 BURIAL PERMITS ISSUED 10 21 Immune Serum Globulin 290 " ^� Keasles (Clinic Use Only) - - - - - INTERNATIONAL TRAVEL 2 inquiries M/M/R CERTIFICATES (CERTIFIED) 140 doses Measles Mumps & Rubella n Polio Vaccine 292 TOTAL CASH RECEIVED FROM Tetanus & Diphtheria (Adult Use) 80 LICENSES & PERMITS ISSUED $252.00 Tetanus Toxoid (Adsorbed) 640 " 1 ML• OTHER COMMUNICABLE DISEASES 8 Tuberculin P.P.D. (Mantoux)'.- 5 ML. 20 tests Typhoid Vaccine - - - - - SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISC DIV. OF ADMINISTRATION $ 54,720.00 $ 3,134.38 $ 51,585.62 DIV. OF COMMUNITY HEALTH $ 53,176.00 $ 4,013.76 $ 49,162.24 DIV. OF ENVIRONMENTAL HEALTH $ 74,323.00, $ 4,665.64 $ 69,657.36 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (INCLUDES ENCUMBERED) DIV. OF ADMINISTRATION $ 2,800.00 $ 55.38 $ 2,744.62 DIV. OF COMMUNITY HEALTH $ 34,650.00 $ 1,809.06 $ 32,840.94 DIV. OF ENVIRONMENTAL HEALTH $ 4,950.00 $ 47. 34 $ 4,902.66 tjt•.[iLlfl LGYHitlLP1L'►YL LlV1J1Vatl. Vr !►LJa'alaYLJli�t►L1Wr a'aVa�Laaa ♦ lu:ava�L riwtiln _111N� Zy/y fl BIOLOGICS DISTRIBUTED AMOUNT ANIMAL BITES REPORTED 11 Diphtheria, Tetanus & Pertussis 9 vials RESIDENT NON-RESIDENT Diphtheria-Tetanus Tox. under 6yrs.) - BURIAL PERMITS ISSUED 24 21 Immune Serum Globulin 32 vials 5 inquiries I issued Keasles (Clinic Use Only) - INTERNATIONAL TRAVEL M/M/R CERTIFICATES (CERTIFIED) Measles Mumps & Rubella 30 doses Polio Vaccine dnApA TOTAL CASH RECEIVED FROM $248.00 LICENSES & PERMITS ISSUED Tetanus & Diphtheria (Adult Use) 1 via Tetanus Toxoid (Adsorbed) Communicable Diseases--9 1 ML. 1 Tuberculin P.P.D. (Mantoux)'.- 5 ML. 6 Typhoid Vaccine - SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCA DIV. OF ADMINISTRATION $54,818.12 $52,957.22 $1,860.90 DIV. OF COMMUNITY HEALTH $53,375.53 53,355.24 - 20.29 6,603.16 DIV. OF ENVIRONMENTAL HEALTH $71,173.14 64,569.98 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (INCLUDES ENCUMBERED) DIV. OF ADMINISTRATION $ 3,150.00 $ 3,030.62 $ 119.38 DIV. OF COMMUNITY HEALTH 31,985.00 28,758.59 3,226.81 DIV. OF ENVIRONMENTAL HEALTH 10,100.00 6,231.80 3,868.20 rLEM CITY OF SE LTH DEPARTMENT • ` i tBOARD OPT}HEALT1. H+5 Dr.;kia'el Kaplan Public Health Center t Off Jefferson Avenue Salem, Massachusetts 01970 PHILIP H.SAINDON •` e ROBERT E. BLENKHORN JOSEPH R.RICHARD HEALTH AGENT M.MARCIA COUNTIE,R.N. (617) 745-9000 MILDRED C.MOULTON,R.N. June 1979 EFFIE MACDONALD ROBERT C.BONIN DIVISION OF COMMUNITY HEALTH REPORT: PUBLIC HEALTH NURSING SECTION Bi-monthly PPD clinics- certification of Nursing Home Personnel. Close contacts of Positive Reactors were tested. Those who had positive tests were referred to the North Shore Pulmonary Clinic for chest x-ray, if negitive by x-ray and under age 35, they are placed on anti-tuberculastic medication- INH for one year and followed every three months during that period. Class III (Tuberculosis with In- fection with Desease) and Class II (Tuberculosis with No D;sease-positive reactors) • are followed by the Public Health Nurses and monthly appointments for evaluation and chest x-rays are scheduled, and appointments mailed. Maintenance of records is continuous and rescheduling of delinquents. II Lead Poisoning cases Have been reported by private pediatricians. Both children, one twenty months of age the other twenty one mont s, have received treatment at North Shore Childrens Hospital and will be folle&15y their family pediatrician until lead and EP levels return to normal. Home inspections for lead paint were made by the Environmental Health Section. Assisted Nurse from the Regional Health Office,in her survey of three children born in 1976-in regard to Immunization. We shall also be making home visits,as requested by Dr. Fiumara, State Department of Public Health, to refugees from South East Asia who will be living in Salem. Prior to issuance of visa, they have been examined for tuberculosis, infectious leprosy and venereal desease by a panel of forgign physicians approved by the U.S. State Department. Our visit will be to introduce them to the Health Care system in our area and to check on their Immunization. Immunization (1979-1980 school year) Information obtained and will be sent to Salem Day Care Centers. June reports of premature infants born and follow up for financial need; Reportable deseases, Enteric, Hepatitis are being followed and case histories completed. Prepqration for Mobile Unit for hearing tests for Heritage Days are continuing. • DIVISION OF COMMUNITY HEALTH SERVICES • DENTAL PROGRAM - MONTHLY REPORT - MONTH JUNE 1979 -" SCHOOL EXAMS SCHOOL Witchcraft Heights Dental Screenings Kindergarten, Grades 1-6 Completed DENTAL CLINIC. CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. DI: 39 7 3 5 39 29 24 DENTAL HEALTH EDUCATION SCHOOL GRADES PROGRAM Horace Mann North 3-4 Crest program conducted with use of film strip and teaching record: �orace Mann South 3- Tooth brushing drill with students participating. Also nutrition, basic foods and stressing good between meal snacks. - J ra��uro�ao��oo��o��onaoo ■��osesA��i . .. = 11111111111111111111111111111111 . . ■��e�■e��■��■e� iWON Emil ll 1111111111111111111111111111111 • July 6, 1979 Summary for June, 1979: I was on vacation until June I8. School closed for the summer that week. The last two weeks of June were used to order supplies, contact Tewksbury to set up a scoliosis screening clinic, and finish required paper work. Other responsibilites have included: mantoux clinic, 6/25/79; contagious disease follow up by screening calls and home visiting for one two year old child with salmonella. Sincerely, Marilyn Reynolds, RN/ July 6, 1979 Summary for June, 1979: I was on vacation until June I8. School closed for the summer that week. The last two weeks of June were used to order supplies, contact Tewksbury to set up a scoliosis screening clinic, and finish required paper work. Other responsibilites have included: mantoux clinic, 6/25/79; contagious disease follow up by screening calls and home visiting for one two year old child with salmonella. • Sincerely, • Marilyn Reynolds, RN • • HEALTH DESMLNT DIVISION OF ADMINISTRATION • MONTHLY REPORT MONTH MAY/ 9 BIOLOGICS DISTRIBUTED AMOUNT ANIMAL BITES REPORTED 11 Dog Bites Diphtheria, Tetanus & Pertussis 39 vials RESIDENT NON-RESIDENT Dit,tithoria-Tetanus Tox. (under 6yrs.) -------- BURIAL PERMITS ISSUED 31 23 Immune Serum Globulin 15 vials Keasles (Clinic Use Only) ----- INTERNATIONAL TRAVEL 1 Telephone Inquiry CERTIFICATES (CERTIFIED) I Certificate stamped M/M/R 100 doses Measles Mumps & Rubella Polio Vaccine 294 doses TOTAL CASH RECEIVED FROM $206.00 LICENSES & PERMITS ISSUED Tetanus & Diphtheria (Adult Use) 7 vials Tetanus Toxoid (Adsorbed) _ 30 vials (5TU) 1 ML. 2 vials COMMUNICABLE DISEASES 3 Tuberculin P.P.D. (Mantoux) '.(5TU) 5 ML. -------- Typhoid Vaccine SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISC DIV. OF ADMINISTRATION $ 54,818.12 $ 48,258.99 $ 6,559. 13 DIV. OF COMMUNITY HEALTH $ 53,375.53 $.48,337.55 $ 5,037.98 DIV. OF ENVIRONMENTAL HEALTH $ 71,173, 14 $ 58,737.93 $ 12,535.21 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (INCLUDES ENCUMBERED) DIV. OF ADMINISTRATION $ 3,150.00 $ 2,037.58 $ 1,112.42 DIV. OF COMMUNITY HEALTH $ 31,985.40 22,215.14 9,770.26 DIV. OF ENVIRONNMNTAL HEALTH $ 10,10.0.00 3,664.30 6,435. 70 CITY OF SA'LEM.HEALTH DEPARTMENT ,t; 7 iBOARD OF HEALTH.s Dr. Israel Kaolin Public Health Center Off Je.fferson Avenue '' .r, i S``alem;',,Massachusetts'01970 PHILIP H.SAINDON � "� '�j ROBERT E. BLENKHORN JOSEPH R.RICHARD T HEALTH AGENT M.MARCIA COUNTIE,R.N. HEAL EAL 74AGEN MILDRED C.MOULTON,R.N. 5-9000 EFFIE MACDONALD ROBERTC.BONIN MAY, 1979 DIVISION OF COMMUNITY HEALTH REPORT: PUBLIC HEALTH NURSING SECTION Request for payment of hospitalization of premature infant*submitted and family financial status determined at interview with parent. Parent referred to Medicaid for assistance but application was denied. Contrary to public opinion TB is far from a disease of the past. At least 30,000 cases were reported in 1978, 25%-30% in largest cities, and 20% in cities of inter- mediate size. Thus a little more than half of all the cases are distributed in communities of less than 100,000 population - in the non-urban and rural areas. TB may be compared to a time bomb- since some people who are exposed develop clin- ,: _. • ical illness immediately while another group will not. Then, sometime- weeks, months or years later some of the latter develop the disease (TB) . Approximately 7% of the total population of 220 million U.S. people are infected. Thus identifi- cation of patients, contacts and investigation of environment , as well as rigid and continuous follow-up is crucial to control of this disease. Follow-up briefly described and summarized; correspondencelhome visits and or tracking out of state transfers and delinquent cases, rescheduling cancelled clinic appointments, monthly day/night clinic notices, plus case, contact, health & school employee record maintainance. Asst. Housing Inspector, Luis Gil has helped immeasurably with the Hispanic clients. Salmonellosis quiesant at the moment; one strep throat case investigated. Response to May Wendesday lead screening clinics was surprisingly good. Total tested during this period was 27. Many of these children were absent from the day care centers during 9/78-4/79 program. Salem day care directors have been most cooperative and appreciative of the health department service and so also have the pediatricians and parents. lOf the group tested one child bad borderline 49 (repeat test)- copy of report mailed private physician.] *premature. infant law- attached P (/c��iti�e Vc��e ��aciatiaK a eat / o l� � e� Salem, �/'n c. 205 WASMNGTON STREET, SALEM, MASSACHUSETTS 01970 • (617) 745-9050 May Summary May 25, Z979 This month has been used to finish all follow-up work since I'll be on vacation the first two weeks of June. The records and health questionnaires have been completed. Out of the 4Z4 students, Z23 have aome .ehronic defeat whether-it be as minor as hayfever or as serious as hemophilia, grand mat seizures or Osgood SchZatter's disease. I have tried to have phone contact with all the parents especially of the pupils who have major ailments to insure that these students are,foZZowed regularly by their own physician and that the school is updated on any physicaZ restrictions or medications. The teachers and school personnel were all screened for tuberculosis by mantoux testing. All were negative. The first grade students were screened with tine tests.. They too-were all negative. .Most of the pupils (75-80%) who faiZed their vision and hearing tests have gone for foZZow-up and the others will be contacted by me throughout the summer to encourage follow-up. . I was able. to evaluate the school lunch program. The meats were nutritionally balanced and offered a good variety. The person preparing . the menus was weZZ-versed in the nutritional requirement and ingredients of foods. This month has been a month of illnesses and accidents. Two students had emergency appendectomies and one was hospitalized for observation. Several while in gym or recess broke or badly sprained hands, and" ankles. This leads me to feel that one of my priorities for next year is to establish an emergency protocol (especially when I'm not present) and to teach various teachers first aide and CPR. I have also had contact with Barbara Munn, who is the.-supervisor of the Salem school nurses. She gave me some contact people and agencies for scoZiosis screening and blood pressure screening. Through the cooperation of the Health Department, it is my plan to start working of these areas in June. Sincerely.,,�- Mari Zyn :Reyno Zds, RN DIVISION OF COMMUNITY HEALTH SERVICES • DENTAL PROGRAM - MONTHLY REPORT - MONTH May 1979 SCHOOL EXAMS SCHOOL Alternative Dental Screening Completed Witchcraft Heights Dental Screening Incomplete DENTAL CLINIC CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. DI 5 7 3 3 5 5 DENTAL HEALTH EDUCATION SCHOOL GRADES PROGRAM In the process of collecting permission slips for prophylaxis. Project for summer months. ,r . . - 1111111111111111111111111111111 1111111111111111111111111111111I� HEALTH DEPARTMENT DIVISION OF ADMINISTRATION MONTHLY REPORT MONTH APRIL 1979 BIOLOGICS DISTRIBUTED AMOUNT ANIMAL BITES REPORTED 17 Diphtheria, Tetanus & Pertussis 26 vials RESIDENT NON-RESIDENT Diphtheria-Tetanus Tox. (under 6yrs.) - BURIAL PERMITS ISSUED 22 23 Immune Serum Globulin 5 vials Keasles (Clinic Use Only) 2 doses INTERNATIONAL TRAVEL 3 telephone inquiries M/M/R CERTIFICATES (CERTIFIED) Measles Mumps & Rubella 82 doses Polio Vaccine 227 doses TOTAL CASH RECEIVED FROM $259.00 LICENSES & PERMITS ISSUED Tetanus & Diphtheria (Adult Use) 13 vials 6 vials COMMUNICABLE DISEASES Tetanus Toxoid (Adsorbed) Chicken Pox 2 Probable Tuberculosis 1 ML• l vial Hepatitis _ ._ 1 Osteomyelitis 1 Tuberculin P.P.D. (Mantoux)'.-.- 5 ML. 2 vials Salmonellosis 3 Strep Throat 1 TOTAL: 8 Typhoid Vaccine 1 vial SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCA DIV. OF ADMINISTRATION $ 54,818.12 $ 44,505.58 $ 10,312.54 DI.V. OF COMMUNITY HEALTH 53,375.53 44,323.79 9,051. 74 DIV. OF ENVIRONMENTAL HEALTH 71,173.14 54,072.29 17,100.85 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (INCLUDES ENCUMBERED) DIV. OF ADMINISTRATION $ 3,150.00 $ 1,984.12 $ 1,165.88 DIV. OF COMMUNITY HEALTH 31,985.40 220215.14 9,770.26 DIV. OF ENVIRONMENTAL HEALTH 10,100.00 1,853.37 8,246.63 CITY OF SALEM HEALTH DEPARTMENT • ;'' BOARD OF HEALTH: i Dr. Israel Kaplan Public Health Center Off Jefferson Avenue 'Salem;Massachusetts 01970 PHILIP H.sAINDON ROBERT E. BLENKHORN JOSEPH R. RICHARD HEALTH AGENT M.MARCIA COUNTIE,R.N. MILDRED C.MOULTON,R.N. (617)7459000 EFFIE MACDONALD ROBERTC.BONIN APRIL, 1979 DIVISION OF COMMUNITY HEALTH REPORT: PUBLIC HEALTH NURSING SECTION TB Register:on-going record reorganization,reports, appointments, cancellations rescheduled, interviews and histories, and VA out of state transfer case-home visit. Bi-monthly Mantoux testing and certification. St. Joseph School tuberculosis screening for faculty, employees, new entrants to school and all students whose records fail to show documentation for Tine test should be completed during May. Permission slips will be sent to parents of the students for participation in this annual program. 4• Participatory assistance during Dr. Desjardins' physical examinations of both St. Joseph elementary and high school students, and immunization of absentees from previous clinics. Task Force meeting: (1) Student internship (assistance: i.e. clean-up, landscaping, shopping, etc. High School program described and promoted by Michael Ward (guidance dept.) (2) Coping with weekend coverage (3) Screening to eliminate individual'agency hopping' for extra services. Lead screening tests were held at Living and Learning Day Care Centre and 55 children participated. Copy of Lead Test results were mailed to the day care Director. All children with the exception of six were within the normal range. These six children had elevated EP counts; two of which also; had lead levels of 30 and were referred to the family pediatrician and Lynn Lead Program. Elevated EP levels (50mg+) should be investigated for iron deficiency anemia by their pediatrician New General Guidelines for Those Conducting Blood Lead Screening for the De- tection of Undue Lead Absorption from the Mass. Dept. of Publib Health have been mailed to all pediatricians in Salem, No. Shore Childrens Hosp. , etc. Infectious Disease: Rubella, Measles, Hepatitis and Salmonellosis: (1) invetigated (2) histories (3) culture outfits and recommendations to case and contacts . • Seminar: N.E. Memorial Hosp. THE HANDICAPPED CHILD:CARDIAC & SEIZURE DISORDERS: nursing assessment & follow-up care for infants & children in the communuty. R.H.O. SSI INFORMATION: CHILDREN IN NEED OF SERVICES. DIVISION OF COMMUNITY HEALTH SERVICES DENTAL PROGRAM. - MONTHLY REPORT MONTH APRIL 1979 SCHOOL EXAMS SCHOOL. . Bowditch Dental Screening Completed Grades 5-8 Endicott Dental Screening Completed Grades K-4 Sheridan Dental Screening Completed Grades K-2 Alternative -. Dental Screening Grades. K-3 Bates Dental Screening Grades K-6 Distributed information leaflets pertaining to our dental services available for the Salem students in Kindergarten and 1-8 grades. Prophylaxis is available to anyone who requests it. Restorative treatment will be assessed on the basis of obvious need plus referral. Schools' forms distributed to: Alternative Carlton Bentley Endicott Remaining- schools to be given forms the following week. Bowditch Oliver CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLA\. DL DENTAL HEALTH EDUCATION I have been attending courses offered by the Forsyth Dental rHnists in Boston--l-Nutrition; 2-Hypertension; 3-Child Abuse. OL GRADES PROGK*1 native K-2 Exercise continuous. 5-6 Nutrition and developing tooth brushing techniques fundamental for good all ` around physical health. 1 (/c��itic� Vc��e /�soccatio�i o / teatet �adertir., Anc. • 205 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 } (617) 745-9050 / April Summary This month has been a month to' complete all projects. The rest of the + school physicals were done in grades k, 3, 7, and 11. Eighty-two pupils had their physical examinations in. school and six were referred for further follow up. . All of the school personnel in the elementary school have had their mandated tuberculosis screening with mantoux. All have been negative. The high school screening is set up for 4/30/79. Notes are also being sent out to the children in the school for the first time who need to have tine tests. K Several Salem State Nursing students have been oriented to the school health program; we are planning on developing a regular seven week rotation. through the school next year for interested nursing students. • Much of the follow up work needed to be done on the pupils' health records was completed during spring break. Follow up on the pupils who have not at present gone for vision, •hearing, and physical examination defects is being done. This will be the goal for next month. Y, Sincerely, Marilyn Reynolds, RN mf c :1 11111111111111111111111111111111� HEALTH DEPARTMENT DIVISION OF ADMINISTRATION MONTHLY REPORT MONTH MARCH 1979 15 dog bites j BIOLOGICS DISTRIBUTED AMOUNT ANIMAL BITES REPORTED 1 cat bite i IDi htheria Tetanus & Pertussi.s 27 vial RESIDENT NON-RESIDENT ' Diphtheria-Tetanus Tox. under 6yrs. 0 BURIAL PERMITS ISSUED 23 25 ; Er=une Serum Globulin 59 vial 1 Certificate Stamped Measles (Clinic Use Only) 20 doses INTERNATIONAL TRAVEL 2 telephone inquiries CERTIFICATES (CERTIFIED) M/M/R Measles Mum s & Rubella 160 doses Polio- Vaccine 330 doses TOTAL CASH RECEIVED FROM $134.00 LICENSES & PERMITS ISSUED Tetanus & Diphtheria (Adult Use) 22 vials-. .- Tetanus Toxoid (Adsorbed) 55 vials COMMUNICABLE DISEASE CASES REPORTED 7 1 ML. 4 Tuberculin P.P.D. (Mantoux) -.- 5 ML. 0 Typhoid Vaccine 0 SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISC DIV. OF ADMINISTRATION $ 54,818.12 $ 40,588.53 $ 14,229.59 DIV. OF COMMUNITY HEALTH $ 53,375.53. $ 40,310.03 $ 13,065.50 DIV. OF ENVIRONMENTAL HEALTH $ 71,173.14 $ 49,406.65 $ 21,766.49_ EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (INCLUDES ENCUMBERED) DIV. OF ADMINISTRATION $ 3,150.00 $ 1,898.11 $ 1,251.89 DIV. OF COMMUNITY HEALTH $ 31,985.40 $ 20,639.04 $ 11,346.36 DIV. OF ENVIRONMENTAL HEALTH $ 10,100.00 $ 1,167.04 $ 8,932.96 r C. • M tt� ' sF.� � CITY OF SALEM HEALTH.DEPARTMENT }:BOARD OF,'HEALTH Dr. Lsrael Kaplan Public Health Center Off.Jefferson Avenue " ., Salem,`Massachusetts 01970' PHILIP H.SAINDON �y+ to q ROBERT E. BLENKHORN JOSEPH R. RICHARD ""' HEALTH AGENT M.MARCIA COUNTIE,R.N. 1617)745-9000 MILDRED C.MOULTON,R.N. EFFIE MACDONALD ROBERTC.BONIN MARCH, 1979 . DIVISION OF COMMUNITY HEALTH REPORT: PUBLIC HEALTH NURSING SECTION Continued concern with the dangerous and disabling public health hazard of lead poisoning, lead screening tests were held by the department's public health nurses and lab technician at both the Children Center day care and St. Joseph School. Seventy-six preschool and school children under six years of age participated. All lead test reports returned with normal E.P. Highlights of the initial Task Force meeting held at the Council on Aging were as follows: (1) reasonable quality of life for aging residents in need, (2)inter- agency communication, interaction and referral, (3) assisting and supporting one another in obtaining/holding funding. The collective agencies responded enthusiastically to C.O.A. .Dir. John Hardie's interesting and provocative description of the Task Force future goals. -Hearing mobile reservation confirmed with Boston Guild for the Hard of Hearing. Hearing test date notices will be sent to key city personnel. PPD skin testing with certification for nurses, teachers and other health related occupation personnel. All day care employees' records are being reviewed for current tuberculin cer- tification. Communicable disease summary: (1) Measles: 2 cases: ages 6 and 9. These new residents received measles vaccine in Canada. (2) Rubella: 2 cases: young adult Salem State School of Nursing students. Classmembers had titres dram and all positives received MMR vaccine. (3) Salmonellosis: 1 case: routine investigative procedure followed. (4) Tuberculosis: 1 case: previously reported positive. Diagnosis REVOKED. • a DIVISION OF COMMUNITY HEALTH SERVICES DENTAL PROGRAM - MONTHLY REPORT - MONTH MARCH 1979 SCHOOL EXAMS SCHOOL Bowditch Dental Screening Grades 5 - 8 Endicott Dental Screening ..Grades K-, 1 - 4 Saltonstall Dental Screening Kindergarten St. Joseph Dental Screening Kindergarten.Registrat_ion DENTAL CLINIC - During the month of April all school children. from None this month. kindergarten through the 8th grade will be taking home a notice to their parents. The notice informs them of the services offered by the Salem Health Department Dental Clinic. A copy of the notice is enclosed. . CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. Dl� DENTAL HEALTH EDUCATION SCHOOL GRADES PROGRAM Bowditch Grade 5 Conducted. nutrition and prevention program in relation!.- ship for a healthy mouth. Also Correct toothbrushing technique CITY OF SA;,,EN HEALTH DEPARTMENT BOARD OF HEALTH DR. ISRAEL KtPLAN PUBLIC HEALTH CENTER • OFF JEFFERSON AVENUE SALEM, ,tA.SSACHUSET;.S 01970 DENTAL CLINIC PHILIP H. SAINDON ROBERT E. BLENKHORN JOSEPH R. RICHARD HEALTH AGENT M. MARCIA COUNTIE, R.I . 745-9000 Ext. 204 ITILDRED C. MOULTON, R.N. EFFIE MACDONALD ROBERT C. BONIN Dear Parent: Dental services are available to Salem students, kindergartens and grades o--,(- through eight, with parental approval. The first visit will consist of a routine cleaning and evaluation to determine their needs. Recommendation is based on the following: 1. Referral by School Nurse. • 2. Referral by Principal or. Teacher. 3. Obvious dental need. 4. Financial need. I desire to participate in the Salem Health Department Dental Clinic. Date Parent's signature Student's name Age Address Telephone School Grade FOR THE BOARD OF HEALTH ROBERT E. BLENKHORN HEALTH AGENT • VL•��LGbt A-t.4e <=4.41000alion 0 qualet Salew Juc. 205 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 r • (617) 745-9050 i 4 March Summary: Hearing tests have been completed. Twenty-eight children required referral to a specialist and thirty-eight other students had a slight difficulty with the-screening. M 'The teachers were notified of these i students and were asked to make special observations. Routine physicals are in the process of being done in school on grades 1,3;7,11. Dr. Desjardin is coming the last week of March and the first week of April to complete the physicals. Two-thirds of the students in mentioned grades opted to have physicals in school. ¢ Registration was held 3/14/79 and twenty two new pupils were enrolled for �. kindergarten. With the help of the other public huaIth nurses and and the dental hygienist and the Tab technician tOwe°new children had a dental exam and ,a lead screening test. The present kindergarten and first grade students were also retested for lead levels. I was able to have an individual conference with each child's parent(s) . Each parent was told • about the present health program and requirements and what they could expect in school from R.N. Parental concerns were discussed. Parents of the students who did not pass the vision exam and have not returned M.D. notes to me have contacted by letter and urged to follow through. I am also still following up on the health questionnaires and students with chronic illnesses. I have made several home visits and had several conferences with other disciplines in regards to some- children with particular school problems. An average of four children see me daily for illness, accidents or counselling follow-up. I have started reviewing another school health program to help me start sending for materials that would help in setting up a consistent school health program. Next Month: 1. ,- .Finish physicals 2. Continue defect follow-up of hearing, vision, and chronic illness. 3. Start conferences with each teacher for further high risk child case finding and prevention. Respectfully Submitted: Marilyn Reynolds, RN mm smug OMNI Hi�iline��eisiEni� 00MMiiMMONOWN0"a MMOififMM/IM0017 �D�IEt� WWWOMMMMOMMI N1 oil I�111111111111111 11111 111= lotiiiiiiiiiiii�i E 0 Omni iiiiiEmom moo on oil iii��iis MEN ONO NIEMEN m oil 11111111111111111111111111111111� `HEALTH DE P TMiENT DIVISION OF ADMINISTRATION MONTHLY REPORT MONTH FEBRUA2mYhll979 • { BIOLOGICS DISTRIBUTED AMOUNT ANIMAL BITES REPORTED 6 Dog and Cat Bites Diphtheria, Tetanus & Pertussis 13 vials RESIDENT NON-RESIDENT Diphtheria-Tetanus Tox. (under 6yrs.) ------ BURIAL PERMITS ISSUED 32 29 Immune Serum Globulin ------ Keasles (Clinic Use Only) ------ INTERNATIONAL TRAVEL 4 Telephone Inquiries CERTIFICATES (CERTIFIED) M/M/R Measles Mumps & Rubella 80 doses Polio Vaccine 210 doses TOTAL CASH RECEIVED FROM $ 87.00 LICENSES & PERMITS ISSUED . Tetanus & Diphtheria (Adult Use) 2 vials Tetanus Toxoid (Adsorbed) 1 vial 1 ML. ----- Tuberculin P.P.D. (Mantoux)'•- 5 mL„ ----- Typhoid Vaccine 1 vial SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCA DIV. OF ADMINISTRATION $ 54,818.12 $ 35,013.05 $ 19,805.07 DIV. OF COMMUNITY HEALTH $ 53075.53 $ 35,292.83 $ 18,082.70 DIV. OF ENVIRONMENTAL HEALTH $ 71,173.14 $ 43,574.60 $ 27,598.54 EXPENSE REPORT: ALLOWED EX PENDED FREE CASH (INCLUDES ENCUMBERED) DIV. OF ADMINISTRATION $ 3,150.00 $ 1,616.35 $ 1,533.65 DIV. OF COMMUNITY. HEALTH $ 31,985.40 $ 18,255.36 $ 13,730.04 DIV. OF ENVIRONMENTAL HEALTH $ 10,1GO.00 $ 1,062.81 $ 9,031.19. I DIVISION OF COMMUNITY HEALTH REPORT: PUBLIC HEALTH NURSING SECTION FEBRUARY, 1979 TB case (hosp. adm.) reported to the Department from N.S.P.C. -.with customary • possibility of future revocation of diagnosis. Case and contact register being reviewed and reorganized in the direction of sim- plification and ease of processing. Clinic referral reports recorded and appropriately filed. Required appointments arranged with N.S.P.C. for the following: (1)pre-scheduled clinic visits, (2)department's bi-monthly clinic positive PPD's and (3)Shaughnessy Hospital positive reactors. Follow-up continuous on new cases, patients on drug therapy, industrial group recently tested and all positive contacts. certification testing:. all Health Care -Field employees(facilities, homes, clinics etc.) and all involved in the school Setting(nurses, teachers,instructors, aides, media, cafeteria, custodians, maintainance etc.) Mass. Dept. P.H. annual immunization started - partial data obtained. Strep throat follow-up: increase in incidence among children and young adults not uncommon for this time of the year. Salmonella: one case closed and another referred. Site visit for day care enrolees lead screening. Lead test permission forms & State Lab forms reviewed axed readied for following day clinic. Test reports from State Lead Lab showed results within normal range: Results recorded. Information forwarded to all parent specified pedi.atriciaris & the *day care 'center. Total tested: 24. Included in total were 2 from the prescribed catchment area. Dept. lead screening clinic scheduled for school vacation week. Discussion with Salem Hosp. dietitian relative to community program during National Nutrition Week 3/4-10. ' Due to limited time available decision was made to involve only Rehab. Hosp. day care group. Several days involvement with term paper projects of Salem State and Boston College undergraduate students:.informing, describing and explaining the scope and magnitude of health dept. involvement in the day to day lives of entire community from birth to death. Repeat contact made with Tom Ryan concerning flu vaccine refund due from Parke Davis. Student 'holistic' health information voluntary questionaire designed, completed and delivered to St. Joseph School for individual student parents for the purpose of up- dating p their child's school 1 health record. School health student 'recommended TINE and required PHYSICAL EXAM. permission forms revised and. made available for. St. Joseph School students. Heritage Days- Annual Detection/Conservation Hearing Test Program-t. (Mobile Unit) August 15.16.17.1979. 55-59 60-64 65-69 70-74 75-79 80-85 85+ 60 vrs.+ 2267 2153 1924 1571 1087 740 507 7980 In 1973 an age distribution similar to the one above prompted the Department to in- stitute the annual detection/conservation hearing test program. Approximately 10%-15% • of the population are troubled with hearing disorders and most can lead full,active -lives if they seek help at an early stage. This program does just that by providing the testing opportunity and directing those who fail the test to appropriate--medical resources. The Department in this worthwhile role makes available to the community a basic component^of"�'a 'reasonable- quality of life'. Department cost: 3 days- $225.00 Testee cost $2.00 1 day - $185.00 " FEBRUARY REPORT: Marilyn Reynolds, .R.N. This month has been primarily used to continue with the routine screenings of vision and hearing and heights -and weights. Vision has been completed and follow-up of the children who failed is still being done. Heights and weights have been done the over/underweight children have been identified and talked to. Hearing screening has been completed for the elementary school and re-testing has been started this week. During winter vacation, I used the time to follow-up on the new information obtained from the health questionnaires we asked the parents to complete. Two thirds of the students have returned the forms. Also, during vacation I helped the other PHNL s a lead screening clinic. Thanks to Mr. Blenkhorn, we ,have started a new program with interested Salem State nursing students. Several students were able to observe and participate in our school program. This has provided them a preventative health experience and given them a chance to-work in the community. Through..this program two classes on basic nutrition were taught to the fourth grade. We hope to continue this on a more routine basis. Plans for next month: 1. Finish hearing screenings. 2. Physical examination at school for 1, 3, 7, 11 at end of March, early April. 3. Continue follow-up on health questionnaires and hearing and vision defects. • • DIVISION OF COMMUNITY.HEALTH SERVICES • DENTAL PROGRAM - MONTHLY REPORT - MONTH FEBRUARY/1979 SCHOOL EXAMS SCHOOL -SHERIDAN DENTAL SCREENING GRADES KDG. , 1 .- 2 Specials BOWDITCH DENTAL SCREENING GRADES S- 8 ENDICOTT DENTAL SCREENING GRADES KDG. , 1-4 BATES COMPLETED A field program was conducted with the Carlton School third grades and Special Classes. They visited us at the Shaughness, Center and were greeted by Dr. Ryan, Mr. Blenkhorn and Mr. Saindon. The teachers and students were taken. on a tour DENTAL CLINIC of the second floor, the first floor, also, the dental operatory. We also showed them a movie on dental health. CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. DI; 2 2 1 1 DENTAL HEALTH EDUCATION SCHOOL GRADES PROGRAM SHERIDAN GRADES 1 + 2 Conducted nutrition program CARLTON 3 and 4 plus 2 Special in relationship to diet for a Classes healthy mouth. Tooth brush• drill. 1111111111111111111111111111111I� ADMINISTRATION MONTHLY REPORT February 1986 BIOLOGICS DISTRIBUTED AMOtTNT I ANIMAL BITES REPORTED 4 Diptheria,Tetanus & Pertussis 38 Vials Diptheria-Tetanus Tox. (under 6 yrs. ) --- BURIAL PERMITS 49 --- Immune Serum Globulin 50 Vials INTERNATIONAL TRAVEL CERTIFICATES (CERTIFIED) Measles (Clinic use only) ------ -- ----0 " MMR--Measle s/Mumps/Rubella 50 Vials TOTAL CASH RECEIVED FROM LICENSES & PERMITS ISSUED Polio Vaccine 420 Doses $264.00 Tetanus & Diptheria (adult use) 32 Vials Tetanus Toxoid (absorbed) ------ 1 r4L Tuberculin P.P.D. Ma 5 ML 5 Vial Typhoid Vaccine ------ ------------ SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAL $107,914.34 $71 ,454.91 _ $36,459.43 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (includes) ENCUMBERED $35,060.00 $24,236.60 $10,823.40 ��nc�c�n��F��■D�i7L/vi7F�� VNAVISITING NURSE ASSOCIATION OF GREATER SALEM , INC. Ms. Linda A. Billows, R.N., M.S. Executive Director TO . Salem Board of Health FROM: Ann Dominick, R.N. , B.S. t DATE: February, 1986 RE Statistics Salmonella New Cases - 2 Carry Overs - 8 Discharges - 1 Referral to Salem Board of Health Sanitarium on one case i Campylobacter Giardia New Cases - 0 New Cases - 0 Carry Overs - 1 Carry Overs - 1 Shigella Yersinia New Cases - 3 New Cases - 0 Carry Overs - 4 Carry Overs - 1 Trichinosis Malaria New Cases - 0 New Cases - 0 Carry Overs - 2 Discharged - 1 Tuberculosis New Cases - 0 l Mantoux Tests (PPD) - 11, Neg. - 9, Positive - 1. North Shore Pulmonary Clinic - 14 Lead Test Reports I-1, Ia-5, II-4, III High RisK Infant Report -1 St. Joseph's School Postural Screenings were done in grades 7 and 8. Dr. Rene Desjardins did physical examinations. lie will continue to be available for Salem Board of Health duties, including next fall 's Flu program. • SHETLAND OFFICE PARK / 27 CONGRESS STREET/ SALEM, MA 01970/ (617) 745-9050 r DIVISION OF COMMUNITY HEALTH REPORT: P.H.N. ; JANUARY 1979 • The health service delivery system under the aegis of the Salem Health Department stresses the collective health of individual persons in the community. Day care facilities as well as the catchment areas are specific targets for the Department's lead screening program. Program planning and schedule has been completed for this period. Importance of the lazy eye test is also emphasized at clinic time and arrangements are made with facilities' operator(s) to contact the Department for test-failure retesting prior to referral. Surveillance and standard protective measures for control of infectious disease encompasses the following: (1) TB skin testing:- positive reactors referred for evaluation and x-ray as indicated, (2) salmoneliosis:- several cases, one of whom with family member restaurant employee. Latter entailed intensive follow-up, (3) streptococcal sore throats contacted and informed of the necessity of completing prescribed course of antibiotic therapy and questioned relative to possible foodhandling employment. Results of surveillance and containment of tuberculosis(business. establishment case monthly �. report 12/78) described in following table: Employee Contacts .I Tested 1 Negative "Positive Refused .Moved _.. 77 69 65 4 7 i. ..... _.. 5 .... .... (ca..s. . e inch..) • *referred to private physician School health record annual review and analysis requires cosiderable time and effort but with combined assistance from other Health Department employees and the new nurse Marilyn Reynolds, the task was minimized. Dr. Desjardins immunized all students needing specific communicable disease protection for the school year September 1978 to June 1979. Health agent Robert Blenkhorn and K.Morgan ? fit were also present at both clinics to furnish assistance. In an effort to provide uniform school health services within the city a health-history questionnaire will be sent to parents of- students at St. Joseph's schools. Information gathered will not only benefit the student but the school nurse, the principal and the teacher as well. Planning and arrangements for the Boston Guild hearing mobile screening unit provided annually by the Department in conjunction with Heritage Days festival (including clearance with Mr. Kehoe, Heritage Days Chairman) have been finalized for Aug. 15, 16, 17, 1979. Department cost:$225.00 . . . . . . .Testee cost: $2.00. 1978 Flu Vaccine Report: Parke Davis and Merck Sharp & Dhome vaccines used. .Doses 5-19 yrs 20-44 yrs 45-64 yrs 65+ yrs age unk. • 1679 1 87 376 775 440 OF UEALT,. DE,PXRT-121,,T DR- KiO?Lm SALE,' M'A Qj 1 0, OLT-d 11111STORY QUESTIONNATUE.- orr t- o-- he f��'Uce rig irs- ":, -L ,- is de,-Ugned to update the record aud irls�,,re tbai- yosir child's health `5 aad rezaiaz 4t hkighest level 41.11 order to g;E.t the ruv-3t fau'.1- of School- Child Grade, Date Other lariguage(s) apoken is the Date 0i Birth 2,. Father-. 0--c-upat-.121on Place, Of Late of Birth 3e Mothers Occupation Place of Birtl— OLDER `ram IN FAMULY YOUNGER 0 3 9 5, Name of pr4"r=-ry Pboysician 0-, health agency care: 6. Name of dentist or dental Providing de;.Itgl care: 7. lxlealtb Care Coverage., IRILe Cross arkl Blw Shield- 91.qc, Croas and Alue Shie-ld Ma -�,f, er S. Medicaid Other �ffealtb! 11-as'u-,.Sr�ce 9. IN EXERGEMC;Y notifyn (l) NAM ABI)RE, ATITRVI;s P-L, 64-0- NAM 14X D 11RE s arza- N."o, A. MED I C AL, 111-51 TON W� H e a I h T- i I 1, Operations! a) R M- oval of tonsils and adencids yes • `k(b) Hernia Yes N 0 (c) Apperdix li, Yes kR') 2, &ny history of: (a) serious accident es No k W fractured (brokeal bones I ""'es NG 'c) Serious 'Read iT)j jury Ye!" convulai-ons Yes his ta) Hospital Admissior, for over 24 boors ye;cm; NO M e A, No g Poor eating habits NO (h) Allergies Urcll;ding insect loites and bee gti"s) yes No (1) chickim Pow Yes '10 (J) Are there any foods your child should not eat if so, please liat (k) D081� Your Child take any pillst mz4t�;Jxrle, shots or treatmento, either on a regular or part-time baais? If, so, please Specify Does yo-%,�r child use any at these o ids? Contact Itna Ye's NN 0 Eyeglassee 8- N C- Hearir;g Aid rs Nci cru tc"--as e 5 o' Leg or arm brace Yes No Dental Plato -,.'e$'� No 0 t it'a r Yes No Doea Your child have any trouble with, speech, aapecia'A.1y Stuttering? yes No Dogs -your child have a bears,mumur? Yes No (0) Car, befshe in all 6chwal activities? Yee N"0 Famllv Histor'. Please circle any of the following dl8eaaes that -11his clhilld'zs parente., ggraadparents' aunts, uncles, brothers, sister have lad: A8thma Allergi Art�ritia D ia 1"a t e$ G"a.U C'e'r Tuberculosis cygtic Fibrosis Stroke Reart Attack Epilepsy Blood DJ.Sease Kidney 'Froblem 'Ce.rebz'a_' PI-11157 Mental Retardation FOP, 'TRE BOARD, OF HEAL131-H BERT' E BLERMHORN ZAL TH A G E NT Autie , C::,-j' jjOC;a6ak1 Ogte4detcSaG., t9 j,1C. • 205 WASHINGTON .STREET, SALEM, 'MASSACHUSETI'S 01970 (617) 745-9050 January, Su=a.ry: I9�9 This month has been focused on finishing the inmtunization needs and starting routine screenings and meeting with the teachers and parents. All, of the children now in St. Joseph's School are adeauateZy immunized by the state law of Massachusetts. A second immunization clinic was held 1122179 and those pupils not immunized by their own doctor were updated by the school physician, Dr. Rene Desjardin. Parents and, teachers have been very co-operative. Vision testing has been completed on all but a handful of students. Notices have been sent to the parents of the 59 students who failed the vision test asking them to foZZow-up with an opthamologist. Teachers have also been notified of these students so that they can observe and help the student. • A letter to the parents has been written by me asking for an update on their chiZdrens' health (i.e. chronic diseases, medication, physical limitations). This will be sent out as soon as it is approved by the %,eaZth agent. Next month I plan to continue with the screenings and height and weights and hearing screenings wiZZ be started. A notice to the parents of children needing physicals wiZZ be sent and follow-up will be continued on the vision defects and responses to the health update letter. I have seen an average of 2 students per day on referral for iZZness and accidents. Respectfully submitted, MariZyn Reynolds, RN • HEALTH DEPARTMENT DIVISION OF ADMINISTRATION MONTHLY REPORT MONTH JANUARY/1979 Q BIOLOGICS DISTRIBUTED AMOUNT ANIMAL BITES REPORTED 12 Dog and Cat Bites i htheria Tetanus & Pertussis 17 vials RESIDENT NON-RESIDENT i htheria-Tetanus Tox. (under 6yrs.) --------- BURIAL PERMITS ISSUED 41 35 mmune Serum Globulin 21 vials feasles (Clinic Use Only) 13 doses INTERNATIONAL TRAVEL 4 Telephone Inquiries CERTIFICATES (CERTIFIED) f/M/R 270 doses feasles Mumps & Rubella olio Vaccine 450 doses TOTAL CASH RECEIVED FROM LICENSES & PERMITS ISSUED $ 1,658.10 Tetanus & Diphtheria (Adult Use) 22 vials Tetanus Toxoid (Adsorbed) 50 vials COMMUNICABLE DISEASE 1 ML. 3 vials CASES REPORTED 8 Tuberculin P.P.D. (Mantoux)•.- 5 ML 7 vials T hoid Vaccine -------- SALARY REPORT: BALANCE TO END OF FISCAI ALLOWED EXPENDED DIV% OF ADMINISTRATION $ 54,818.12 $ 31,096.00 $ 819.97 DIV. OF COMMUNITY HEALTH $ 53,375.53 31,279.07 20.29 DIV. OF ENVIRONMENTAL HEALTH $ 71,173.14 38,157.67 1,844.99 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (INCLUDES ENCUMBERED) DIV. OF ADMINISTRATION $ 3,150.00 $ 1,431.11 $1,559.71 DIV. OF COMMUNITY HEALTH $ 31,985.40 15,800.20 5,771.39 DIV. OF ENVIRONMENTAL HEALTH $ 10,100.00 1,058.52 8,708.12 DIVISION OF CO'.PdUNITY HEALTH SERVICES • DENTAL PROGRAM - MONTHLY REPORT MONTH JANUARY / 1979 SCHOOL EXAMS SCHOOL ENDICOTT DENTAL SCREENING Kdgs. 2 Grade I BATES DENTAL SCREENING Kdgs. 2 BOWDITCH DENTAL SCREENING Grade 8 SHERIDAN DENTAL SCREENING Grade I i DENTAL CLINIC CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. DISC 4 7 7 --- --- -- 1 Dental Health talks conducted during all examinations and DENTAL HEALTH EDUCATION in the classroom before screening. Emphasis is placed on good nutrition and daily dental hygiene. SCHOOL GRADES PROGRAM OLIVER 3 Crest Program with slide projector and Record • BATES 3 Lecture and review all materials Crest Kit distributed to all. Returned Permission slips. (year) (month) 12 IL--- 7 1J8 non 0 1�9 1 L2 1279 3 14LI5,16 11 120 23 124 25 2�8 133 TOTALS IL firAms big • MENINE�sMeN��liwi�i�eiemmiiININININNIN WIN mmmmmmommaj 3 �ome � �� 4556 29 moommomommmmmmmm its IN low 0 mmmm OWN I logo MEN in In NON, 111111111 1111OMEN MINN 11111111111111111111111111111111 J REPORT: December/1978 NURSING 'SECTION roily Health Services; Premature interview & guidance 7 Vision test and referral 4 Hearing threshold and referral 1 Control of Communicable Disease: Spec. mantoux Cl. at place. of business TB - Class III 1 61 tested PPD Clinic - tested 19 7 absent read 10 Pos. reactors Scabies 2 Salmonella (new) 1 Salmonella (old) 4 follow up continues Health immunization histories 22 Flu vac. info. 16 Pneumonia vac. info. 4 Community Health Flu Vac administered 15 . . .Of the estimated million+ Americans having undetected TB germs in their bodies prime candidates for breaking down with .TB, -One young female in this city was so _ diagnosed recently. All the employee's contacts were tuberculin tested and will be • retested following the incubation period. All positive reactions have been X-rayed. . . V.D. Referral 4 Lead information 1 Lead elevations & follow up Other.- Tel. calls 167 Correspondence 28 Reports: State & Local Evaluation & x-Yay appointments 15 booked and mailed TB information, instruction and 80 reassurance Meeting/conversation: Health Agent 35 Long Term Care Facility inspection 1 Day .Care observation Health Record scanning/interpretation 2 technique School Health Rec. processing 110 • Ili HEALTH DEPARTMENT DIVISION OF ADMINISTRATION MONTHLY REPORT MONTH D CE BIOLOGICS DISTRIBUTED AMOUNT ANIMAL BITES REPORTED 4 Dog and Cat. Bites Diphtheria, Tetanus & Pertussis 30 vials RESIDENT NON-RESIDENT Diphtheria-Tetanus Tox. (under 6 yrs.) 1 vial BURIAL PERMITS ISSUED 20 32 Immune Serum Globulin 21 vials 20 vials INTERNATIONAL TRAVEL 6 Phone inquiries Measles (Clinic Use Only) CERTIFICATES (CERTIFIED) M/M/R #440 70 doses.. Measles Mum s & Rubella doses TOTAL CASH RECEIVED FROM Polio Vaccine LICENSES & PERMITS ISSUED v $2,259.00 Tetanus & Diphtheria (Adult Use) 65 ials 22 vials Tetanus Toxoid (Adsorbed) COMMUNICABLE DISEASE 1 ML" CASES: REPORTED 1 Tuberculin P.P.D. (Mantoux) '_ 5 mL. 45 vials T hoid Vaccine SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISC. DIV. OF AD`INISTRATION $54,818.12 $ 27,178.95 $ 27,639.17 DIV. OF COMMUNITY HEALTH $53,375.53 27,265.31 26,110.22 DIV. OF ENVIRONMENTAL HEALTH $71,173.14 32,538.59 38,634.55 EXPENSE REPORT: EXPENDED FREE CASH (INCLUDES ENCUMBERED) ALLOWED $ 2,090.50 j DIV. OF ADMINISTRATION $ 3,150.00 $ 1,059.50 DIV. OF COMMUNITY HEALTH $29,485.40 13,442.76 16,042.64 839.42 9,260.58 DIV. OF ENVIRONMENTAL HEALTH $10,100.00 1 p i OEM SANITARY CODE ENFORCE. : MINN 3. Retail Markets mmmmmmmmNMI 4, Housing 5. General Nuisances 6. Air & Noise Poll. mom 7. Day Care Centers Mom= 9. Swimming Pools IN mmomm No MINN ml 0 RODENT.CONTROL: mmi mom 0 WIN —mmmm No wommm of ON ONE . . • �I�A��Ae11��1�11��111111s�At11 IIIIIIIIIIIIIIIilllllllllllilll! DIVISION OF C0124UNITY HEALTH SERVICES DENTAL PROGRAM - MONTHLY REPORT - - MONTH . DECEMBER/1978 SCHOOL EXAMS SCHOOL • DENTAL •SCREENING -GRADES . . PHILLIPS ABSENTEES ALL .GRADES COMPLETED BENTLEY ABSENTEES ALL: GRADES COMPLETED CARLTON SCREENINGS KGN.., & GR. 1-4 OLIVER SCREENINGS GRADES 1 - 4 DENTAL CLINIC CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. DIS( 15 9 --- --- 7 6 2 CONTINUOUS DENTAL HEALTH EDUCATION IS CONDUCTED DURING ALL DENTAL HEALTH EDUCATION EXAMINATIONS AND IN CLASSES BEFORE SCREENING REINFORCING THE IMPORTANCE OF BOTH DAILY DENTAL HYGIENE PLUS PRESCRIBED ROUTINE DENTAL APPOINTMENTS. SCHOOL GRADES PROGRAM BENTLY GRADES 3 CREST PROGRAM SLIDE PROJECTOR REVIEWED TAKE HOME PAMPHLET - • CREST.KIT T ` VISITING NURSE ASSOCIATION OF GREATER SALEM INC. • 81 Highland AvenLIU Salem, Massachusetts 0I970 (61.7) 74.1-1649 Job: Maximum of 15 hours to establish and provide health coverage for the 400+ pupils in the Salem parochial school system. Goal #1: All students shall be at their optimum level of. physical and and psychological health for maximum participation in school. Plan: 1) Update and maintain health records for each student containing information on all chronic illnesses, debilitating diseases, immunization status, and routine screening exam . . results. 2) Provide routine state mandated screenings such as vision, hearing, and establish non-mandated screenings when appropriate such as dental, scoliosis. 3) Communicate with each teacher regarding special needs students. i.e. special seating preference due to hearing ' or vision difficulty. 4) Encourage private MD examination on all students in the mandated grades to provide maximum and consistent health coverage. Provide physical exan► at school when needed. 5) Participate in all student's 766 evaluations. • 6) Routine follow up on all students who have above mentioned special needs. 7) Close follow up on ,:ill students who are ill or who had serious accidents. Goal #2: School will have adequate emergency and general health coverage. 1 Evaluate need for First aid training within the school. I ) g 2 Establish emergency protocol and train schoolpersonnel, ) g Y P to function adequately in an emergency situation without RN present. 3) . Provide first aid.when present in school. . 4) Evaluate school's environment for safety needs and health hazards. Goal #3: Each grade level shall. have a.health curriculum established to meet the need of age level so when the student graduates from school. he will have been exposed to qualities of good healthful living. 1) Evaluate existing health curriculum. 2) Consult with teachers and establish health curriculum over the next two years. 3) Gather resource material and people for areas of health • education. `.' Page 2 Goal #4: The students within the school shall be free from the risk of contagious disease contact. 1) Insure that all students are at the maximum mandated level of immunization. 2) Evaluate need to screen for pediculosis, VD, and teach proper hygiene. 3) Exclude any pupil with contagious disease until infectious stage is over. Goal DES: Insure .that the school has the maximum use• of the RN's time and skill. . 1) Train school paraprofessionals to help with basic paper- work and screening. 2) Establish regular consultation t1ines with each teacher regarding his students to pick up on high risk students quickly. 3) Provide outreach home visits to families with high risk students to evaluate home environment. .... JPORT : November, 1978 TURSING SECTION----------CURRENTLY ONE(1) PHN FOR A CITY OF 40,000+ RESIDENTS Family Health Services: Premature infants - 9 2 of whom have had financial clearance Vision test and referral- 1 Control of Communicable Disease: PPD Clinic - tested read reactors. Referred to N.Shore Pul. Cl. & followed by Public Health Nurse. Scabies 3 2 re€-erred to.;Lynn -.r,,iin .c Salmonella ,-3= - >_- --_ -_ . 5 follow up Health immunization histories 10 Pneumonia vac. info. 11 referred to priv. phys. or his colleague Community Health • Flu Vac. make-up Clinic-Nov. 9,- 1978 176 received vaccine Post clinic walk-ins during:November . . 17 Total. immunized as of 11/30/78 1682 Lead information _ 2 Lead elevations & follow up 1 Other: Tel-calls 178 Correspondence 6 Reports: State & Local 3 Evaluation & .,x-ray appointments 10 booked and mailed TB information; instruction and reassurance 17 Meeting/conversation:Healtli Agent 23 ' Reports = 7 Long Term Care Facility inspection 1 Day Care observation 0 `ems.-rc • DIVISION OF CO?•L%1UNITY HEALTH SERVICES DENTAL PROGR. -Ml - MONTHLY REPORT - MONTH NOVEMBER/I978 -" SCHOOL EXAMS . . SCHOOL PHILLIPS SCHOOL DENTAL SCREENING GRADES 5 THRU .8 COMPLETE SPECIALS-2 GRADES COMPLETE DENTAL CLINIC CLIENTS ALLOY CEMENT DECID., EXT. EXAM. & CHART PROPHYLAX. DIE 5 2 5 3 1 DENTAL HEALTH EDUCATION CONTINUOUS DENTAL HEALTH CONDUCTED DURING EXAMINATIONS; ALSO IN CLASSES BEFORE SCREENING IS BEGUN. SCHOOL GRADES PROGRAM ILLIPS SCHOOL 5 - 8 GROUP LECTURES �� SPECIALS 2 GRADES GROUP LECTURES O�D�OOOOm� , tim- 1�11111111111111111111111111111 HEALTH DEPARTMENT DIVISION OF ADMINISTRATION MONTHLY REPORT MONTH NOVEMBER/1978 BIOLOGICS DISTRIBUTED AMOUNT ANIMAL BITES REPORTED 5 Dog and Cat Bites i htheria, Tetanus & Pertussis 32 vials ' RESIDENT NON-RESIDENT :�h.theria-Tetanus Tox. (under 6yrs.) ---- BURIAL PERMITS. ISSUED 28 23 unune Serum Globulin 5 vials =asles (Clinic Use Onl ) 20 doses INTERNATIONAL TRAVEL 3 Phone inquires /M/R CERTIFICATES (CERTIFIED) 180 doses easles Mumps & Rubella 9 470 doses TOTAL. CASH RECEIVED FROM olio Vaccine LICENSES & PERMITS ISSUED $. 77.00 etanus & Diphtheria (Adult Use) 36 vials 3 vials etanus Toxoid (Adsorbed) j 1 ML. 5 vials.. COMMUNICABLE DISEASE uberculin P..P.D. (Mantoux)'.' 5 M 3 vials CASES REPORTED 3 hoid Vaccine ------- ADDITIONAL FLU VACCINATIONS 319 SALARY REPORT: BALANCE TO END OF FISCAI ALLOWED EXPENDED DIV. OF ADMINISTRATION $ 54,818.12 $ 21,570.14 $ 33,247.98 DIV. OF COMMUNITY HEALTH 53,375.53. . 22,248.11 31,127.42 DIV. OF ENVIRONMENTAL HEALTH 71,173.1.4 26,827.24 , 44,345.90 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (INCLUDES ENCUMBERED) DIV: OF ADMINISTRATION $ 3,150:00 yS 970.16 $ 2,179.84 r i DIV. OF COMMUNITY HEALTH 29,485.40 119746.56 17,733.84 DIV. OF ENVIRONMENTAL HEALTH 10,100.00 394.79 9,705.21 HL'ALTH DEPIfMEN'I DIVISION OF ADMINISTRATION MONTHLY REPORT MONTH OCTOBER/1978 _9 'WOLOGICS DISTRIBUTED AMOUNT ANIMAL BITES REPORTED 9 Dog and Cat Bites i htheria, Tetanus & Pertussis 42 vials RESIDENT NON-RESIDENT Diphtheria-Tetanus Tox. (under 6yrs.) ----- BURIAL PERMITS ISSUED 24 24 Immune Serum Globulin 21 vials ------- INTERNATIONAL TRAVEL 5 Phone inquires Measles (Clinic Use Only) CERTIFICATES (CERTIFIED) M/M/R 132 doses Measles mumps & Rubella Polio Vaccine 330 doses TOTAL CASH .RECEIVED FROM LICENSES & PERMITS ISSUED $ 87.00 Tetanus & Diphtheria (Adult Use) 17 vials Tetanus Toxoid (Adsorbed) 50 vials COMMUNICABLE DISEASE 1 ML. CASES REPORTED 3 Tuberculin P.P.D. (Mantoux)'.'- 5 ,. ------ ` 2 vials FLU VACCINATIONS 1,353 Typhoid Vaccine. SALARY REPORT: BALANCE TO END OF FISCA ALLOWED EXPENDED DIV. OF ADMINISTRATION $ 54,818.12 $ 17,253.09 $ 37,565.03 DIV. OF COMMUNITY HEALTH 53,. 375.53 17,434.35'; 35,941.18 � 508.54 74 22,158.16 ** 52,350.38 DIV. OF ENVIRONMENTAL HEALTH . EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (INCLUDES ENCUMBERED) DIV. OF ADMINISTRATION $ 3,150.00 $ 792.41 $ 2,357.59 DIV. OF COMMUNITY HEALTH 26,150.00 109008.32 ** 16,141.68 DIV. OF ENVIRONMENTAL HEALTH 10,100.00 286.33 9,813.67 (**DOES NOT REFLECT T NSFE APPROVAL OF 10/31/78) 10/31/78----TRANSFER APPROVED $3,335.40 FROM DIV. OF ENVIRONMENTAL HEALTH SALARIES TO DIV. OF COMrMLINITY HEALTH EXPENSE FOR THE SERVICES OF THE VNA FOR 15 HOURS PER WEEK AT THE RATE OF $98.10 PER WEEK. - 3A REPORT OCTOBER, 1L978 NURSING SECTION • Family Health Services: Lead screening. 23 _ Premature interview & guidance 04 Vision test and referral 0 Hearing threshold and referral 01 Control of Communicable Disease: PPD Clinic - tested 11 read 11 O1pos,reactoAs) Referred to Followed by Public Health Nurse. Scabies OL Salmonella new cases. 02 Salmonella follow -up 06 - Health immunization histories 04 Flu-vac. inquiries - - 51 Pneumonia vac. info. 10 Travel info. 07 Community Health The Health Dept's annual Influenza immunization program was held Oct. 10.11.12 for the following target .groups: _Salem resident elderly, handicapped, high risk and city employees. Strategy decisions were..-reasonably straightforward to' assure coverage of the desired p lation participation, efficient operation within constraints of time, available work sp` and limited personnel, Program function responsibilities entailed:(1)vaccine & syringes (2)related supplies (3)publicity & promotion .(4).printing (5)facili.ties (6)training (7)communications (8)transportation. No. doses -administered: 1353 Hypertension Clinic 02 Lead information 11 Lead elevations & follow up 0 Other: Tel-calls 238 Correspondence 87 Reports: State & Local 39 - Evaluation & ..-k-ray appointments 17 booked and mailed TB information_ ;. instruction and 22 reassurance . Meeting/conversation:Healtii Ageizt 23 Reports 03 Long Term Care Facility inspection 01 . Day Care observation - 02 • 3 !3 �e -noun moll iiiMEiiiiiiWon . .--•---Ate.--.-.mmmmmm �,�...�.o.o....� immmmomm mom 010011110mm gloom mom ONO MEN NOISOME ONE NMI mom mom 11 . . .. . I�SSSSIIt��A11A��SAl1ial 111111l.� DIVISION OF CWUvRMITY HEALTH SERVICES DENTAL PROGRAM - MONTHLY REPORT _ _ • MONTH OCTOBER/1978 SCHOOL EXAMS SCHOOL Bentley School Dental Screening Grades Kindergarten ttiru Grade 4 COMPLETEI Phillips School Dental Screening Grades 5 thru 8 + Special Classes w. DENTAL CLINIC CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. DIS DENTAL HEALTH EDUCATION SCHOOL GRADES PROGRAM Bentley School Kdg. 1 3 Group Lectures Phillips School 5 - 8 & Special Classes Group Lectures 3 --C" lHEALTH DEPARTMENT DIVISION OF ADMINISTRATION MONTHLY REPORT MONTH SEPTEMBER/1978 BIOLOGICS DISTRIBUTED AMOUNT ANIMAL BITES REPORTED 15 Dog and Cat Bites. iphtheria, Tetanus & Pertussis 52 vials RESIDENT NON-RESIDENT Diphtheria-Tetanus Tox. (under 6 rs.) ------ BURIAL PERMITS ISSUED 28 36 Immune Serum Globulin 16 vials Keasles (Clinic Use Only) ------ INTERNATIONAL TRAVEL 1 (4 Phone inquiries CERTIFICATES (CERTIFIED) MJM/R Measles Mumps & Rubella 101 doses Polio Vaccine 460 doses TOTAL CASH RECEIVED FROM LICENSES & PERMITS ISSUED $ 2.00 Tetanus & Diphtheria (Adult Use) 26 vials Tetanus Toxoid (Adsorbed) 20 vials COMMUNICABLE DISEASE 1 ML• 2 vials CASES REPORTED 9 Tuberculin P.P.D. (Mantoux)'.. 5 M„ 1 vial Typhoid Vaccine ----- SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISC DIV. OF ADMINISTRATION $ 54,818.12 $ 13,336.04 $ 41,482.08 DIV. OF COMMUNITY HEALTH 53,375.53 13,420.59 39,954.94 DIV. OF ENVIRONMENTAL HEALTH 74,508.54 17,589.08 56,919.46 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (INCLUDES ENCUMBERED) DIV. OF ADMINISTRATION $ 3,150.00 $ 590.02 $ 2,559.98 DIV. OF COMMUNITY HEALTH . _ 26,150.00 8,317.32 17,832.68 DIV. OF ENVIRONMENTAL HEALTH 10,100.00 266.98 9,833.02 DATE e e b 1 4 5 6 7 8 Ill 12 113 .14 15 18 19 20 21 22 25 26 127 28 29 1 - SANITARY. CODE ENFORCEINTENTS 2 6 2 '7 5 11 11 10 5 6 6 2 8 7 7 5 1 6 5 4 W W ct RODENT CONTROL 3 2 2 0 4 1 1 r 1 _ TESTING 114 14 18 18 20 20 18 18 LICENSES AND PERMITS ISSUED 1 COURT HEARINGS 1 2 1 1 CORRESPONDENCE 4 1 1 1 2 1 2 6 4 2 4 3 REFERRALS TO AND FROM OTHER DEPARTMENTS 2 2 1 3 2 1 2 1 2 1 3 TELEPHONE INQUIRIES. 3 3 5 5 4 3 3 3 8 1 4 2 5 4 2 1 GENERAL COTITLAINTS 11 4 3 7 6 4 8 5 9 4 2 3 3 5 3 4 5 ORAL COMPLAINTS SANITARY CODE ENFORCEI-HENTS: Day camps, swimming pools, beaches, .air and noise pollution, housing inspections, food service establishments, retail markets, dwellings, etc. RODENT, CONTROL: Baiting, etc. TESTING: Bathing water temperatures, swab test, lead test, drinking water, well water, municipal water, recreational waters, pollution studies, sewerage testing, soil test for subsurface sewerage disposal systems, etc. GENERAL COMPLAINTS: Nuisances, odors, rubbish, illegal dumping, etc. a iREPORT SEPTEMBER/1978 NURSING SECTION 46Family Health Services: Lead screening Premature interview& guidance Vision test and referral Hearing threshold and referral 1 Control of Communicable Disease: PPD Clinic - tested read po. reactors. Referred to Followed by Public Health '_Nurse. Scabies 9 Salmonella situa-tion'subsided 2 follow up continues Salmonella non-related to above 3 Health immunization histories -Flu :vac. inquiries -- 51 Pneumonia vac. ' info. 10 = Community Health The Health Dept.'s annual Influenza immunization program was held Oct-. . 10,11, 12 for the *11owing- target groups:. -Salem.,resident elderly , handicapped, high risk and city employees. rategy decisions were reasonably straightforward to assure coverage of the desired population participation, efficient operation within constraints of time, available work space and limited personnel. Program function responsibili-ties entailed: (1) vaccine. and syringes (2) related. supplies: (3)- publicity and promotion (4) p'rinting (5) facilities (6) training (7) communications (8) transportation. Hypertension Clinic 2 Lead information Lead elevations & follow up Lead Poisoning Prev. Clinics Other: Tel,,calls 238 Correspondence 87_ Reports: State & Local 39 _ Evaluation & X-ray appointments posted and mailed TB information_ ; instruction and reassurance Meeting/conversation:HeaktH Agent 23' Reports (monthly & state) 3 Long Term Care Facility inspection 1 2 Day Care observation r DIVISION OF COMMUNITY HEALTH SERVICES DENTAL PROGRAM - MONTHLY REPORT MONTH SEPTEMBER/1978 SCHOOL EXAMS SCHOOL Bentley School Dental Screening in Grades Kindergarten thru Grade 4. Phillips School Dental Screening in Grades 5 thru 8 + special classes DENTAL CLINIC CLIENTS ALLOY CEMENT DECID. EXT. EXAM. & CHART PROPHYLAX. DISC. 11 17 11 2 7 4 3 DENTAL HEALTH EDUCATION SCHOOL GRADES PROGRAM Bentley School Kdg. 1 — 3 Group Lectures Phillips School 5 - 8 & Special Classes Group Lectures • COUNTY COMMISSIONERS � G esex OCfilll c� OJ GGCIj JOHN L. DANEHY, CAM BRIDGE ` = CHAIRMAN '�. MIGHAEL E. McLAUGHUN, LOV`7ELL % u� ^• 4elo 5&oaal S. LESTER RALPH. SOMERV.LLE DR.GEORGE J. KARAM ola=_cTca September 22, 1978 _ Dear Friends: Effective immediately, tuberculosis Mantoux skin testing will. ba: done at this hospital on Monday through Wednesday from 12:30 P.M: to 4:00 P.M.. This will afford teachers and school personnel additional hours as these daps to cone for the test. On Thursday and Fridays we will be open from 12:30 P.M. to 4:00 P.M. for rea-dinng the test only. A"an_t Sou' -for your cooperation. - Sincerely, 6John A. Hammond, R. N. Director, Outpatient Services" JAq:cem I t. i .a L Q f HECI i-Y ALTH DEPARiN1ENT 1Cu:"\1 L1V1J LVV% Vt E'1L 11 -41101♦VLL,J,.va• �'�" ^ ""'�""s -'- BIOLOGICS DISTRIBUTED AMOUNT ANIMAL BITES REPORTED 15 Diphtheria, Tetanus & Pertussis 30 vials RESIDENT NON-RES ZDE:r' i Dip'irhoria-Tetanus Tox. (under 6yrs.) ------ BURIAL PERMITS ISSUED (51) 27 24 Immune Serum Globulin 5 vials 'ueasles (Clinic Use Only) ------ INTERNATIONAL TRAVEL TELEPHONE ' CERTIFICATES (CERTIFIED) 1 INQUIRIES 10 MfM/R 100 doses ,Measles dumps & Rubella 320 doses TOTAL CASH RECEIVED FROM Polio Vaccine $156.00 20 vials LICENSES & PERMITS ISSUED Tetanus & Diphtheria (Adult Use) 37 vials LTetanus Toxoid (Adsorbed) 1 ML• 10 vials COMMUNICABLE DISEASE Tuberculin P.P.D. (Mantoux)••- 5 �„ 2 vials CASES REPORTED 18 Typhoid Vaccine 2 vials SALARY REPORT: AT.iAWF:D EXPENDED BALANCE TO END OF FISC. DIV. OF ADMINISTRATION $ 54,818.12 $ 7,760.56 $ 47,057.56 DIV. OF CO;LMI1\ITY HEALTH $ 53,375.53 $ 8,403.39 $ 44 972.14 DIV, OF ENVIRONMENTAL HEALTH $ 74,508.54 $11,126.44 $ 63,382.10 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (INCLUDES ENCUMBERED DIV. OF ADMINISTRATION $ 3,150.00 $ 274.53 $ 2,875.47 DIV. OF COMMUNITY HEALTH $ 26,150.00 $ 3,410.21 $ 22,739.79 DIV. OF ENVIRONMENTAL HEALTH $ 10,100.00 $ 198.20 $ 9,901.80 J • REPORT AUGUST 1978 NURSING SECTION *Family Health Services: Lead screening 11 Premature interview & guidance 5 Vision test and referral 1 Control of Communicable Disease: PPD Clinic - tested 11 read 11 2 pos. reactors. Referred to N.S.P.C. for x-ray. Followed by Public Health Nurse Scabies 2 Salmonella situation subsided 13 follow up continues Salmonella non-related to above 4 Health immunization histories 3 Pertussis call referral 1 Pneumonia vac. info. 8 Viral suspect history 1 Community Health Reevaluation of priorities in programming for the next period exclusive of mandatory services has more or less been determined. The importance of health promotion and disease prevention will continue to be stressed. Flu vaccine program (delayed at Federal level) is tentatively scheduled for early/mid October. Nothing specific until arrival of vaccine. Hypertension Clinic 9 Lead information 7 Lead elevations & follow up 2 Other: Tel-calls 215 Correspondence 80 Reports: State & Local 30 July x-ray reports had to be done in August Evaluation & x-ray appointments 11 booked and mailed TB information; instruction and reassurance 7 A Meetings and conversation/Health Agent 17 Annual report 3 days Long Term Care Facility inspection 1/2 completed y 0 DIVISI011 OF CO`DMIU?IIITY HENT.TH SERVICES DF74ML PROGRAM — MONTHLY REPORT MONTH AUGUST/1978 *E-1-10OLEXIAIIIS NO SCHOOL EXAMS JULY AND AUGUST ,• # #2 0 #4 Notice Expect. #Work #Under Ca: SCHOOL Exam Class Class Class Class Sent Return Compl. Rx Follo; / up i zz� 1ARKS: COMPLETED ANNUAL REPORT, STERILIZE AFTER USE OF DENTAL CLINIC, TELEPHONE CALLS 15 DENTAL HEALTH EVALUATION 25 DENTAL. CLINIC AUGUST /1978 r xam. � 9f CLIENTS }t Comb. Ext. Prophylaxis Disch. Remarks Dat Fillings Chart 30 42 30 - -- 25 25 Totals DENTAL HEALTH EDUCATION SCHOOL GRADES PROGRAM ,M #1 Class — No apparent defects. {`2 Class - Requires minimum dental care. 3 Class - Requires prompt dental care. #4 Class -• No apparent dental defect* but need prophylaxis. 'Kay Despotopulos, Dental Hygienist Ysvh' 1 DATE 1 .3 4 / C 7 ll! 11 14 lb 1/ 1 16 L1 I LL 1 L3 24 j 25 128 29 30 3 SANITARY CODE ENFORCEMENTS 7 8 9 8 6 1 4 5 3 6 9 7 2 4 6 8 9 7 8 4 12 9 RODENT CONTROL 4 1 2 1 2 3 2 3 1 TESTING 9 4 , 5 11 11 11 2 1 GENERAL COMPLAINTS { 4 2 6 3 2 5 4- 2 2 4 3 6 8 4 2 2 3 2 5 2 6 4 3 REFERRALS TO OTHER DEPARTMENTS 2 1 1 2 2 1 -i TELEPHONE INQUIRIES 7 8 11 9 13 10 18 13 116 112 11 14 7 15 9 15 12 17 15 10 17 114 9 7 CORRESPONDENCE =' 2 1 5 5 2 1 2 1 2 1 1 4 3 4 11 7 1 i.3 COURT HEARINGS 1 1 1 1 LICENSES AND PERMITS ISSUED 2 1 1 13 1 1 1 i WRITTEN COMPLAINTS ORAL COMPLAINTS 1 TELEPHONE COMPLAINTS 8 3 6 5 3 7 7 4 15 1 4 13 16 19 14 4 1 2 2 3 2 1 5 2 6 4 3 SANITARY CODE ENFORCEMENTS: Day camps, swimming pools, beaches, air and noise pollution, housing inspections, food service establishments, retail markets, dwellings, etc. RODENT CONTROL: baiting, etc. TESTING: bathing water temperatures, swab test, lead test, drinking water, well water, municipal water, ,.recreational waters, pollution studies, sewerage testing, soil test for subsurface sewerage disposal systems, etc. GENERAL COMPLAINTS: nuisances, odors, rubbish, illegal dumping, etc. kBIOLOGICS_ DULY 978ALTH DEP4 NT DIVISION OF ADMINISTRATION MONTHLY REPORT MONTH DISTRIBUTED AMOUNT ANIMAL BITES REPORTED 25 Dog and Cat Bites Lphtheria. Tetanus & Pertussis 32 vials RESIDENT NON-RESIDENT Lb"heria-Tetanus Tox. (under 6yrs.) --- BURIAL PERMITS ISSUED 28 20 Immune Serum Globulin 6 vials Lasles (Clinic Use Only) ll. doses INTERNATIONAL TRAVEL 2 (5 Phone inquiries) CERTIFICATES (CERTIFIED) �easles, /M/R 153 doses Mumps & Rubella olio Vaccine 392 doses TOTAL CASH RECEIVED FROM $179.50 LICENSES & PERMITS ISSUED Tetanus & Diphtheria (Adult Use) 1 7 vials �etanus Toxoid (Adsorbed) .75 vials 1 ML. --- COMMUNICABLE DISEASE Tuberculin P.P.D. (Mantoux)'.- 5 mL„ --- CASES REPORTED 20 Typhoid Vaccine 1 vial SALARY REPORT: ALLOWED EXPENDED BALANCE TO END OF FISCAI DIV. OF ADMINISTRATION $ 54,818.12 $ 3,843.51 $ 50,974.61 DIV. OF COMMUNITY HEALTH $ 53,375.53 $ 4,389.63 .. $ 48,985.90 DIV. OF ENVIRONMENTAL HEALTH $ . 74,508.54 $ 5,555.64 $ 68,952.90 EXPENSE REPORT: ALLOWED EXPENDED FREE CASH (INCLUDES ENCUMBERED) DIV. OF ADMINISTRATION $ 3,150.00 $. 60.39 $ 3,089.61 DIV. OF COMMUNITY HEALTH $ 26,150.00 $ 1,500.00 $ 24,650.00 DIV. OF ENVIRONMENTAL HEALTH $ 10,100.00 $ 79.68 $ 10,020.32 J DIVISION OF COMMUNITY HEALTH REPORT - JULY 1978 NURSING SECTION 1. Family Health Services: Lead 3 Premature 2 Epilepsy 1 2. Control of Communicable Disease:. . PPD Clinic - tested 7 read Adult Rubella Vac./- 1 Gyn.consult. Measles Vac./- MD consult Travel Info. 9 College student- Rubella ,-follow-up case histories 11 Hepatitis 4 3• Community Health: Heritage Day Program 4 (days) Planning,-.Developing, Publicity & Contact Promotion Lead Testing Shaughnessy-Hospital will concurrently offer Diabetic screening, Hypertention detection and Weight Readings Hearing Mobile Testing site - Salem Common Faciliti s Pneumonia Vac. Program Procurement instructions given to Salem Long Term Care Hypertension Clinic 11 4, Other: Tel. calls 147 Correspondence 59 Reports: State & Local 5 Notices 7 Inspection form revrA. l Meetings with Health Agent 4 Inventory & supply reorder 1 Health Record Forms to Day Care Centers 3 Annual Report - part time Long Term Care 'Facility inspection 3 (days) plus report Item clarification report for Board of Health relative to Long Term Care Facility license renewal inspection report Infectious disease problem J DIVISION OF COMMUNITY HEALTH DENTAL CLINIC REPORT JULY/1978 ANNUAL REPORT 13 SUMMARY - CREST 2 STERILIZATION 14 TELEPHONE (IN-COMING/OUT-GOING) 47 INVENTORY 1 DENTAL HEALTH EDUCATION 11 ti CHART PROPHYLAXIS FILLINGS COMPLE PATIENTS 11 10 11 5 r DULY/,19 78 .°c DAT% 7 3 7 4 7 5 7 6 7 7 17/11/11 7 1 7 1 7 14 -1 L4/287/31 SANITARY COD ENFORCFMENTS 5 7 2 6 6 12 13 13 12 16 10 1 RODENT CONTROL 1 1 2 2 1 4 TESTING 2 1 3 1 2 6 6 11 1 .11 11 CORRESPONDENCE 2 4 3 5 2 4 6 2 3 5 1 4 6 1 5 10 . 3 2 6 1 REFERRALS TO 3 2 3 3 4 2 3 5 3 3 4 3 3 3 2 6 3 5 2 OTHER DEPARTMENTS TELEPHONE 11 10 13 10 12 16 9 11 12 11 10 9 12 15 14 16 12 11 10 10 INQUIRIES GENERAL COMPLAINTS 4 4 3 4 5 4 3 4 2 6 4 4 4 3 2 4 5 6 4 3 COURT HEARINGS 1 1 1 1 LICENSES AND PERMITS ISSUED 2 1 5 3 2 2 2 WRITTEN COi�PLAINTS ORAL COMPLAINTS TELEPHONE COMPLAINTS 18 16 19 17 21 22 15 20 17 20 18 16 19 21 18 26 120 22 16 13 SANITARY CODE ENFORCEMENTS: Day camps, swimming pools, beaches, air and noise pollution, housing inspections, food service establishments, retail markets, dwellings, etc. RODENT CONTROL: baiting, etc. TESTING: bathing water temperatures, swab test, lead test, drinking water, well water, municipal water, recreational waters, Pollution studies, sewerage testing,- soil test for subsurface sewerage disposal systems, etc. GENE-RAL COMPLAINTS: nuisances, odors, rubbish, illegal dumping, etc.