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MONTHLY REPORTS 1998 TO 2001 BOARD OF HEALTH MONTHLY REPORTS 3/ 1998 TO 12/2001 a ; , ,�cotvnrr CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR _ SALEM, MA 01970 TEL. 978-74 1-1 800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT PUBLIC HEALTH NURSE REPORT DECEMBER 2001 ACTIVITIES DISEASE PREVENTION • IN TOUCH WITH T.B. CLINIC AND FOLLOWING ACTIVE CASES AND CASE CONTACTS. • VACCINE INVENTORY MAINTAINED AND DISTRIBUTED. • INVESTIGATED COMMUNICABLE DISEASE CASES AND REPORTED TO THE M.D.P.H. MEETINGS AND CLINICS • • 1 2/4 VOCES FLU AND PNEUMONIA CLINIC HELD AT NORTH SHORE COMMUNITY HEALTH CENTER: 82 RESIDENTS VACCINATED.;ASSISTED BY DAWN MARIE CAMERON, R.N., JOANNE SCOTT,AND JOSE DIAZ. ; • 1 2/6 ATTENDED BIOTERRORISM SEMINAR WITH JOANNE SCOTT AND SANITARIANS. • 1 2/7 FLU CLINIC HELD AT SALEM POST OFFICE. 25 EMPLOYEES VACCINATED WITH FLU VACCINE PURCHASED BY POST OFFICE. • 1 2/1 2 ATTENDED MONTHLY HEALTH CARE ADVISORY MEETING. • 1 2/1 3 OFFICE VISITS (INCLUDED SALEM DISTRICT AND SUPERIOR COURT EMPLOYEES. - • HOME VISITS 4 - • A TOTAL OF 150 DOSES OF FLU VACCINE WERE DISTRIBUTED TO SALEM PROVIDERS FROM SALEM BOARD OF HEALTH ALLOTMENT. ST.JOSEPH'S SCHOOL • HEARING AND VISION SCREENINGS CONTINUE. PHOENIX SCHOOL • HEARING AND VISION SCREENINGS WILL BEGIN AFTER STUDENTS AT ST. • JOSEPH'S ARE COMPLETED. �xaNnrT CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH w + 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01 970 • 'tea TEL. 978-74 1-1 800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT MONTHLY REPORT OF COMMUNICABLE DISEASES December 2001 DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES: CASES: CASES: STATE: Campylobacter 0 0 0 0 • Giardia 0 1 0 0 Hepatitis 4 4 0 0 Lyme Disease 0 0 0 0 Meningitis 0 0 0 0 Pertussis 0 0 0 0 Salmonella 0 0 0 0 Shigella 0 0 0 0 Varicella 0 0 0 0 Reportable Diseases excluded from above have not been identified this month. i mn CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH } 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 0 a, TEL. 978-741-1 800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT Summary m ry of Communicable Diseases December 2001 2 Hepatitis C Antibody Positive. Letters sent to M.D. Awaiting response. 2 Chronic Hepatitis B Posititve. Will follow up with M.D. i ear-CM1171c MVWCV c-rrrQ Tn 'rUIC ROARn - ---- - - - --- -- --- - - --- - - - --- - -- ---- • VOLUME 72 January 8, 2002 EMERGENCY PLANNING Salem's Comprehensive Emergency Plan, required by the Massachusetts Emergency Management Agency, is undergoing its four- year update. This is good timing for us, given recent events. In fact, MEMA has just added a chapter on Terrorism. have been meeting with the Police and Fire Chiefs as part of this process. Tracy has been helping to gather the necessary information. This update should be complete within the next month or so. The information is than sent to MEMA who puts it together and sends us our plan. I will bring it to the Board when it is finished. Several Board of Health staff attended an MHOA seminar on bioterrorism. BOH MEETING FOLLOW-UP The Board asked me to check on two items, one was the storage facility on Highland Avenue, the other was the ownership of Baybridge Restaurant. I spoke with Tom Amanti, of the Highland Realty Company. He said that there have been no changes in the plan for this facility since it was before the Board in September 2000. There have been delays but the storage facility will be built as presented. I spoke with John Colantro, manager of Baybridge Restaurant, before the holidays. He told me that technically Gerald Marquis was still the owner of the establishment. However, at this point the establishment is open without a permit since Mr. Marquis did not renew his perrmit after December 31 st. We conducted a comprehensive inspection this week with no serious violations noted. am meeting with the new owners Monday to review the floor plan. I expect that we will be able to issue a permit then. ROOSEVELT'S RESTAURANT We had scheduled a hearina as requested by the owner of Roosevelt's following an order for that establishment to pay a fine because of non-compliance with the Board's restaurant smoking ban. • However, the owner was unable to make the time as scheduled. We will try to accommodate her with another date and time. Board of Health Administration Monthly Report DEC.-W CP/ Biologics Distributed * Amount in Doses Diptheria, Tetanus& Pertussis = 650 Burial Permits @ $5.00 $255.00 Dipthena,Tetanus Tox.(under6 yrs)= 0 Licenses&Permits(+copies) $6,625.00 Immune Serum Globulin= 4 VIALS Certificate of-Fitness@$25.00 $500.00 Measles/Mumps/Rubella= 250 Poha IPV= 510 Fines $250.00 Tet=_,nus& Diptheria (adult use)= 300 Total Monies Collected $7,630.00 0 Tuberculin PPU= 355 Animal Bites Repotted= 0 WE Titre:= Hepatitis B= 603 PPV 23 100 PC,,r 7 420 Annual Budget Expenses, Available Balance Salary/Longevity $360,621.00 $172,363.17 $188,257.83 Annual Budget Expenses Encumbered Available Balance Non-Personnel $15,100.00 $7,024.76 $2,851.19 $5,224.05 City Of Salem Environmental Health Division --- Inspection Monthly Summary • Month ---------------------------------------------- Type Jul 01 Aug 01 Sep 01 Oct 01 Nov 01 Dec 01 Count 0 0 0 1 0 0 1 BB 0 1 0 0 0 0 1 BP 0 2 0 0 0 0 2 CFI 49 46 40 55 55 11 256 CFR 0 0 0 1 4 0 5 CH 9 9 12 20 6 10 66 CON 10 10 3 5 2 3 33 CR 0 8 2 4 3 4 21 CT 0 3 3 5 1 3 15 EC 8 21 10 9 2 2 52 EPR 0 0 1 0 0 0 1 FC 1 1 - 2 4 1 1 10 FRH 1 1 1 1 1 1 6 FSD 3 6 6 9 1 3 28 FSI 16 23 26 32 18 18 133 FSR 9 30 23 29 16 13 120 GN 5 4 7 2 1 5 24 HI 13 6 12 8 10 7 56 HR 10 33 9 8 6 5 71 LPI 0 2 0 1 1 0 4 - MS 0 0 0 1 0 0 1 MT 5 10 7 12 7 4 45 MUP 1 0 0 1 0 0 2 G 11 6 1 6 0 0 24 RFD 0 1 1 1 0 0 3 RFI 5 6 13 4 5 10 43 RFR 1 6 4 3 5 6 25 RO 5 2 0 2 4 1 14 SB 71 56 12 0 0 0 139 SC 0 1 0 1 0 0 2 SM 0 1 2 1 1 1 6 ST 0 1 0 0 0 0 1 TFI 1 21 7 10 0 0 39 TR 85 109 89 47 29 24 383 VFI 0 0 0 1 0 0 1 Count 319 426 293 284 179 132 1633 City_. of Salem, Massachusett Environmental Health Division Inspection Input Form Inspect Date : Estab Name or Owner Name: Type : Location: Inspector: Inspection Types BP - Body Piercing FSI - Food Serv. Ins . 892* RFD - Ret .Food Disc . 6* CFI - Cert . Fit . 822* FSR - Food Serv. Rein. 194* RFI - Ret . Insp. 75* CFR - Cert . Fit .Reinsp105*GN Gen. Nuisance 41* RFR - Ret . Food Rein34* Court Hearing 93* HI - Housing Insp. 260* RO - Rodent Control 16* 0 N - Constable Serv. 65* HR - Housing Reinsp . 135* SC - Suntan 7* - Compliance Rev. 25* LPI - Lead Paint Insp. 6* SES - SESD Odor 0* CT Computer Time10* MS - Massage 6* SM - Seminars 36* EC - Envirn. Compl . 51* MW - Mark/Weights SP - Swim.Pools 16* EPR - Ext . Paint 95* MUP - Mobile Food Insp. 11* SB - Swim. Beaches 65* FC - Food Comp1 . 17* OS - Off . Sub. Insp. 6* ST - Soil/Septic 8* FRH - Food Hearings15* RC - Rec Camps 9* TFI - Temp. Food 112* FSD - Food Serv. Disc 53* MT - Meetings 65* TR - Trash 381* Salem Board of Health December Phone Log 2001 Total Answered *Answered Calls Saturday December 1, 2001 Barb = 167 Sunday December 2, 2001 Mary= 216 Monday December 3,2001 65 Sue= 217 Tuesday December 4,2001 47 Wednesday December 5, 2001 47 Thursday December 6,2001 1 41 *Calls Taken : Friday December 7,2001 36 Saturday December 8, 2001 Joanne = 132 Sunday December 9, 2001 Jeffrey = 71 Monday December 10, 2001 28 Sharon= 43 Tuesday December 11,2001 44 Jose = 38 Wednesday December 12, 2001 46 Pablo = 1 Thursday December 13, 2001 43 Tracy = 129 Friday December 14, 2001 8 Ginny = 2 Ah Saturday December 15, 2001 Barb = 54 Sunday December 16, 2001 Mary = 62 Monday December 17, 2001 26 Sue = 68 Tuesday December 18,2001 27 Wednesday December 19, 2001 41 Thursday December 20,2001 1 33 43 Office Hours Per Week Friday December 21,2001 8 *=19 Work Days Saturday December 22, 2001 35 Hour Work Week Sunday December 23, 2001 Monday December 24, 2001 7 (*1/2 Day) Tuesday December 25, 2001 Holiday Monday 8-4 Wednesday December 26, 2001 5 Tuesday 8-4 Thursday December 27, 2001 29 Wednesday 8-4 Friday December 28, 2001 10 Thursday 8-7 Saturday December 29, 2001 Frid.8-4 Sunday December 30, 2001 Monday December 31, 2001 9 (*1/2 Day) • Total 60= 0 City of Salem Board of Health "Monthly" Phone Logs • 1997 1998 1999 2000 2001 2002 January 760 705 854 1065 February 739 757 902 743 March 1038 1057 1140 952 April 924 897 869 883 May 864 966 892 987 1039 June 932 1070 1234 990 1143 July 975 1069 805 976 938 • August 758 870 998 1082 991 September 921 866 1043 1012 881 October 1124 953 1079 1227 1232 November 828 765 945 937 944 December 815 675 663 697 600 Totals 7217 10,695 11,075 11, 673 11,411 J • Executive Summary for CDC Interim Smallpox Response Plan and Guidelines In response to the potential use of biological agents against civilians, the Federal government has committed to upgrading preparedness, readiness, and national defenses against bio-terrorist weapons. The Centers for Disease Control and Prevention (CDC) has been designated as the lead agency for upgrading national public health capabilities for responding to biological terrorism. Many biological agents could be used to attack civilians, however, only a few, such as smallpox virus, have the ability to cause illness or panic to the extent that existing medical and public health systems would be overwhelmed. Although smallpox was globally eradicated by the late 1970's, there remains concern that stores of smallpox virus may exist in laboratories other than the two WHO designated repositories. If an outbreak of smallpox were to occur, several factors could contribute to a more rapid spread of smallpox than was routinely seen before this disease was eradicated. These factors include: 1)virtually non-existent immunity to smallpox in the absence of naturally occurring disease and the discontinuation of routine vaccination in the United States in the early 1970's, 2)potentially delayed recognition of smallpox by health personnel who are unfamiliar with the disease, and 3) increased mobility and crowding of the population. Because of these factors, a single case of smallpox would require an immediate and coordinated public health and medical response to contain • the outbreak and prevent further infection of susceptible individuals. The possibility for the use of smallpox virus as a bio-terrorism agent and the potential for its rapid spread,have prompted the updating of a response plan previously developed by the Centers for Disease Control and Prevention's (CDC) for responding to the potential importation of smallpox during the 1970's. This updated "Interim Smallpox Response Plan and Guidelines" incorporates, and extends, many of the concepts and approaches that were successfully employed 30 to 40 years ago to control smallpox outbreaks. These overall concepts for outbreak containment contributed greatly to the eventual global eradication of smallpox. Thus,while this document is an updated plan,many of the elements in the plan have been extensively and successfully utilized in prior decades. Overall,this document outlines the public health strategies and approaches that would guide the public health response to a smallpox emergency. This interim document also identifies many of the federal, state, and local public health activities that must be undertaken in a smallpox emergency. This plan, much of which has been in place for years, will be regularly updated to reflect changes in capacities and resources for responding to a smallpox emergency. Smallpox Variola virus is the etiological agent of smallpox. The only known reservoir for the virus during the smallpox era was humans; there were no known animal or insect . reservoirs or vectors. The most frequent mode of transmission is person-to-person spread via direct deposit of infective droplets onto the nasal, oral, or pharyngeal 1 • mucosal membranes, or the alveoli of the lungs from close, face-to-face contact with an infectious individual. Indirect spread(not requiring face-to-face contact with an infectious individual)via fine-particle aerosols or fomites containing the virus has been reported but is less common. Fine-particle aerosol spread appears to occur more commonly with severe forms of smallpox, such as hemorrhagic smallpox, where virus titers are very high and sustained, or in cases where a significant cough (which can generate fine-particle aerosols) is present in the first week of illness (when oropharyngeal viral shedding is typically highest). In the majority of cases, symptoms of disease usually begin within 12-14 days (range 7-17) following the exposure of a susceptible person to the virus and consists of a 2-3 day prodrome of high fever, malaise, and prostration with severe headache and backache. This pre-eruptive stage of the disease is then followed by the appearance of a maculopapular rash(eruptive stage)that progresses to papules (1-2 days after appearance of rash), vesicles (4-5`h day),pustules (by 7`h day), and finally scab lesions (14`h day). The rash generally appears first on the oral mucosa, face, and forearms, then spreads to the trunk and legs. Lesions are also seen on the palms of the hands and soles of the feet. The skin lesions of smallpox are deeply embedded in the dermis and feel like firm round objects embedded in the skin. As the skin lesions heal and the scabs separate, pitted scarring gradually develops. Smallpox patients are most infectious during the first week of the rash when the oral mucosa lesions • ulcerate and release the large amounts of virus into the saliva and are less infectious once the lesions have scabbed over. A patient is no longer infectious once all the scabs have separated(usually 3-4 weeks after the onset of the rash). The overall mortality rate associated with smallpox was approximately 30%. Other less common but more severe forms of smallpox include: 1) flat-type smallpox with a mortality rate >96%, characterized by severe toxemia and flat, velvety, confluent lesions that do not progress to the pustular stage, and 2)hemorrhagic-type smallpox, characterized by severe prodromal symptoms,toxemia, and a hemorrhagic rash that was almost always fatal with death usually occurring 5-6 days after the onset of the rash. (See Annex 1 — Overview of Smallpox and Medical Care of Smallpox Patients for a more complete discussion of smallpox) Smallpox Vaccine Smallpox vaccine is a highly effective immunizing agent. It is a live-virus vaccine composed of vaccinia virus, an orthopoxvirus that induces antibodies that also protect against smallpox. Its use in focused ring vaccination campaigns that utilized intensive surveillance and contact-tracing during the smallpox eradication program helped bring about the global eradication of smallpox. The last naturally-acquired case of smallpox occurred in Somalia in 1977. In May 1980, the World Health Assembly certified that the world was free of smallpox. Smallpox vaccine production ceased in the early 1980's and current supplies of smallpox vaccine are limited. However, it is expected that new cell-culture grown smallpox vaccines will become available for use • within the next 2-4 years. 2 • Although smallpox vaccine is considered a safe vaccine,post-vaccination adverse events can occur. These adverse events and their rates as determined in a 1968 10- state survey include: 1) inadvertent inoculation(529.2/million primary vaccinations), 2) generalized vaccinia(241.5/million primary vaccinations), 3) eczema vaccinatum (38.5/million vaccinations), 4)progressive vaccinia(1.5/million primary vaccinations), and 5)post-vaccinial encephalitis (12.3/million primary vaccinations). Death also occurs in about one per million primary vaccinations and is usually a result of progressive vaccinia,post-vaccinial encephalitis, or severe eczema vaccinatum. Several groups have been identified as having a higher risk for developing post- vaccination complications. These include: 1)persons with eczema(including a history of eczema) or other forms of chronic dermatitis, and 2)persons with altered immune states (e.g. HIV, AIDS, leukemia, lymphoma, immunosuppressive drugs, etc.). In addition,because of the small risk for fetal vaccinia, vaccination is not recommended during pregnancy. Children under 1 year of age, or older adolescents or young adults receiving primary vaccination may also have a greater risk of post- vaccination complications. Vaccinia Immune Globulin(VIG) is used to treat certain vaccine adverse reactions,however supplies of the VIG are also limited. CDC Interim Smallpox Response Plan and Guidelines • This Interim Smallpox Response Plan is a working document that is updated regularly. Since state and local health officials are at the heart of an effective response to a smallpox emergency, their input is currently being sought, and it is anticipated that this plan will be updated frequently in the coming months. The plan is,however, operational and would be implemented should a smallpox emergency occur. The CDC Director may implement all or portions of the CDC Smallpox Response Plan under the "Criteria for Implementation"that are found in the next section. As this plan illustrates, an effective response to a smallpox emergency will necessitate extensive involvement and coordination of CDC with state and local public health activities. This interim document thus identifies many of the federal, state, and local public health activities that must be undertaken in a smallpox emergency. This document is organized into multiple sections. These sections outline criteria for smallpox response plan implementation,notification procedures for suspected cases, CDC and state and local responsibilities and activities—including some that should take place prior to a smallpox emergency—and CDC vaccine and personnel mobilization. This plan also provides Guidelines and Annexes to assist federal, state, and local health officials in implementing the specific activities that are essential for the management of a smallpox emergency. The general response strategy and priority activities are outlined below. 3 Y t • General Strategy and Priority Activities for Smallpox Outbreak Containment As this plan states, the first and foremost public health priority during a smallpox outbreak is control of the epidemic. The following activities would be essential to accomplishing this goal. Ring Vaccination Any vaccination strategy for containing a smallpox outbreak should utilize the ring vaccination concept. This includes isolation of confirmed and suspected smallpox cases with tracing, vaccination, and close surveillance of contacts to these cases as well as vaccination of the household contacts of the contacts. Vaccinating and monitoring a"ring"of people around each case and contact will help to protect those at the greatest risk for contracting the disease as well as form a buffer of immune individuals to prevent the spread of disease. This strategy would be more desirable than an indiscriminate mass vaccination campaign for the following reasons: 1. Focused contact tracing and vaccination combined with extensive surveillance and isolation of cases was successful in stopping outbreaks of smallpox during • the eradication program without the need for indiscriminate vaccination. 2. Adverse events would be expected to be higher in an indiscriminate vaccination campaign due to vaccination of persons with unrecognized contraindications (e.g. undiagnosed immunosuppressive disorders such as HIV or AIDS). Careful screening for contraindications to vaccination would also be more difficult in a large scale vaccination campaign. The risks vs. benefits of vaccination ratio would be higher in such a campaign because of the inevitable vaccination of persons with high risk of adverse events and a low risk of smallpox. 3. Current supplies of VIG would not be sufficient to treat the number of expected adverse events that would occur with a large, indiscriminate vaccination campaign. 4. Current supplies of smallpox vaccine would be exhausted quickly if an indiscriminate campaign was utilized,potentially leaving no vaccine for use if smallpox cases continued to occur 5. Mass, indiscriminate vaccination of a large population would require a very large number of health-care/public health workers to perform vaccination and deal with the higher number of adverse events 6. Utilization of mass vaccination may lead to improper reliance on this strategy to control the outbreak with less focus on other essential outbreak control measure such as careful surveillance, contact tracing, and isolation of cases. This could also lead to inadequate supplies of vaccine for areas with the greatest need and potentially prolong the epidemic instead of controlling it. • 4 • Depending upon, 1) the option for outbreak control that is selected, 2) the size of the outbreak, 3)personnel resources,4) effectiveness of other outbreak control measures, and 4) vaccine availability,the size of the vaccinated"ring" of individuals surrounding a case or contact may be modified(expanded or contracted). However, the ring vaccination concept should be maintained overall. The determination of the initial vaccination ring size or alteration of subsequent vaccination ring sizes will be made jointly by Federal and State health officials. Identification of Priority Groups The following are considered high risk groups and should be prioritized for vaccination in a smallpox outbreak: 1. Face-to-face close contacts (<6.5 feet or 3 meters), or household contacts to smallpox patients after the onset of the smallpox patient's fever¶ 2. Persons exposed to the initial release of the virus (if the release was discovered during the first generation of cases and vaccination may still provide benefit) 3. Household members (without contraindications to vaccination) of contacts to smallpox patients' (to protect household contacts should smallpox case contacts develop disease while under fever surveillance at home) . 4. Persons involved in the direct medical care,public health evaluation% or transportation of confirmed or suspected smallpox patients 5. Laboratory personnel involved in the collection and/or processing of clinical specimens from suspected or confirmed smallpox patients 6. Other persons who have a high likelihood of exposure to infectious materials (e.g. personnel responsible for hospital waste disposal and disinfection) 7. Personnel involved in contact tracing and vaccination, or quarantine/isolation or enforcement, or law-enforcement interviews of suspected smallpox patients 8. Persons permitted to enter any facilities designated for the evaluation, treatment, or isolation of confirmed or suspected smallpox patients$ (only essential personnel should be allowed to enter such facilities) 9. Persons present in a facility or conveyance with a smallpox case if fine- particle aerosol transmission was likely during the time the case was present (e.g. hemorrhagic smallpox case and/or case with active coughing)§ ¶Although individuals with smallpox are not infectious until the onset of rash,vaccinating contacts from the time of the onset of fever helps provide a buffer and assures that contacts who may have been exposed at the early onset of rash,when the rash may have been faint and unrecognized,have been vaccinated. * Includes personnel whose public health activities involve direct patient contact such as case interviewing • t Household members of contacts who have contraindications to vaccination should be housed separately from the other vaccinated household members until the vaccination site scab has separated(—2 weeks)to prevent inadvertent transmission of vaccinia virus.They should be also 5 be housed separately from the contact until the incubation period for smallpox has passed and the contact is released from surveillance. $ Only personnel without contraindications to vaccination should be chosen for activities that would require vaccination for their protection.Personnel with contraindications should not perform duties that would place them at risk for smallpox exposure and should otherwise only be vaccinated if an exposure has already occurred. §Evaluation of the potential risk for aerosol transmission and initiation of vaccination for non- direct contacts will be done by CDC,state,and local public health personnel. The decision to offer vaccination to non-direct contacts of smallpox cases will be made jointly by Federal and the State health officials. Additional Groups that Would Be Considered for Voluntary Vaccination Federal, State, and Local response personnel not involved in direct patient or contact evaluation or care but whose uninterrupted support of response activities is deemed essential may be considered for voluntary vaccination. Vaccination of these personnel will be dependent upon the size of the outbreak, availability of vaccine,the assessed risk for unintentional or unrecognized contact with smallpox cases, and a careful assessment of the benefits vs. the risks of vaccination. Only personnel within these non-patient contact groups who have no contraindications will be considered for vaccination. Persons within these groups with contraindications should not be vaccinated. The decision to offer voluntary vaccination non-patient contact personnel will be made by the Director, CDC. These groups include,but are not limited to: 1. Public health personnel in the area involved in surveillance and epidemiological data analysis and reporting whose support of these public health activities must remain unhindered 2. Logistics/resource/emergency management personnel whose continued support of response activities must remain unhindered 3. Law enforcement, fire, and other personnel involved in other non-direct patient care response support activities such as crowd control, security, law enforcement, and firefighting/rescue operations Overview: Activities and Guidelines This Interim Smallpox Response Plan and Guidelines document outlines, and in some cases, describes in detail, many of the pre- and post-event activities that need to be, or would be undertaken, in response to a smallpox emergency. These include: Surveillance and Epidemiological Investigations: • Pre-event rash surveillance • Smallpox clinical presentations and differential diagnosis guidelines • • Smallpox case definitions • Notification procedures for suspected smallpox cases 6 T • Case and outbreak investigations General Vaccination activities: • CDC vaccine deployment • Clinic vaccination procedures and adverse event reporting • Rapid identification and vaccination of all priority groups (non-contact and contact) • Education and evaluation of vaccine responses with revaccination when needed • Education, recognition, and treatment of vaccine adverse events • Decontamination guidelines • Monitoring of vaccine utilization and supplies Quarantine/Isolation related activities: • Fever/rash surveillance and education of contacts (vaccinated and unvaccinated) • Isolation and care of smallpox patients during the infectious period Surveillance activities: • Identification and reporting of suspected smallpox cases through active surveillance at the local, state, national, and international levels • Surveillance of vaccine adverse events Epidemiology: • Epidemiological investigation of the outbreak to determine at-risk populations (contacts), source of outbreak, and risk factors for illness • Specimen collection and transportation guidelines Public/Media Communications: • Communications principles and guidelines • Pre-event communication education and information • Smallpox emergency communication operations and activities These inter-related, multifaceted activities are discussed in the Guides and Annexes that follow. In addition, this Interim Smallpox Plan identifies, and provides examples, of many of the specific activities, forms, and procedures that should be followed in preparation for, and in response to, a smallpox emergency. The CDC Interim Smallpox Response Plan and Guidelines is a draft document that will be updated as needed to reflect changes in capacities and resources for responding to a smallpox emergency. Public health authorities will be notified when updated drafts are available. • 7 �ca1D CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01 970 ! TEL. 978-74 1-1 800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT PUBLIC HEALTH NURSE REPORT NOVEMBER 2001 ACTIVITIES DISEASE PREVENTION • IN TOUCH WITH T.B. CLINIC AND FOLLOWING ACTIVE CASES AND CASE CONTACTS. • TWO PPD SCREENINGS DONE 1N OFFICE. • VACCINE INVENTORY MAINTAINED AND DISTRIBUTED. • INVESTIGATED COMMUNICABLE DISEASE.CASES AND REPORTED TO THE M.D.P.H. • MEETINGS AND CLINICS • 1 1/7 COUNCIL ON AGING FLU AND PNEUMONIA CLINIC 9-12 NOON. 734 VACCINATED. • 1 1/8 COUNCIL ON AGING FLU AND PNEUMONIA CLINIC 9-1 2 NOON. 315 VACCINATED. • 1 1 /13 SALEM HOUSING AUTHORITY CLINIC 9-12 NOON. 138 VACCINATED. • 1 1/14 PIONEER TERRACE CLINIC. 8-1 1 A.M. 102 VACCINATED. • 1 1 /15 POLICE AND FIRE FLU CLINICS. 44 VACCINATED. • 1 1/16 ST. JOSEPH`S FACULTY CLINIC. 16 VACCINATED. • 1 1 /20 CITY OF SALEM EMPLOYEE CLINIC 71 VACCINATED. • TOTAL OF 89 OFFICE VISITS • TOTAL OF 25 HOME VISITS • ATTENDED LEPC MEETING WITH JOANNE SCOTT. BIOTERRORISM PREPAREDNESS DISCUSSED_ ST.JOSEPH'S SCHOOL • HEARING AND VISION SCREENINGS CONTINUE. PHOENIX SCHOOL • • HEARING AND VISION SCREENINGS WILL BEGIN AFTER STUDENTS AT ST. JOSEPH'S ARE COMPLETED. ,...fee rr CITY OF SALEM, MASSACHUSET'TS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 t FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT PUBLIC HEALTH NURSE REPORT NOVEMBER 2001 ACTMTIES DISEASE PREVENTION • IN TOUCH WITH T.B.CLINIC AND FOLLOWING ACTIVE CASES AND CASE CONTACTS. • TWO PPD SCREENINGS DONE IN OFFICE. • VACCINE INVENTORY MAINTAINED AND DISTRIBUTED. • INVESTIGATED COMMUNICABLE DISEASE CASES AND REPORTED TO THE M.D.P.H. MEETINGS AND CLINICS • 1 1/7 COUNCIL ON AGING FLU AND PNEUMONIA CLINIC 9-1 2 NOON. 734 • VACCINATED. • 1 1/8 COUNCIL ON AGING FLU AND PNEUMONIA CLINIC 9-1 2 NOON. 315 VACCINATED. • 1 1/13 SALEM HOUSING AUTHORITY CLINIC 9-1 2 NOON. 138 VACCINATED. • 1 1/14 PIONEER TERRACE CLINIC. 8-1 1 A.M. 102 VACCINATED. • 1 1/15 POLICE AND FIRE FLU CLINICS. 44 VACCINATED. • 1 1/16 ST.JOSEPH`S FACULTY CLINIC. 16 VACCINATED. • 1 1/20 CITY OF SALEM EMPLOYEE CLINIC 71 VACCINATED. • TOTAL OF 89 OFFICE VISITS • TOTAL OF 25 HOME VISITS • ATTENDED LEPC MEETING WITH JOANNE SCOTT. BIOTERRORISM PREPAREDNESS DISCUSSED. ST.JOSEPH'S SCHOOL • HEARING AND VISION SCREENINGS CONTINUE. PHOENIX SCHOOL • HEARING AND VISION SCREENINGS WILL BEGIN AFTER STUDENTS AT ST.JOSEPH'S ARE COMPLETED. • Board of Health Administration Monthly Report NOV. 01 Biologics Distributed Amount in Doses Diptheria, Tetanus& Pertussis = 630 Burial Permits @ $&00 $295.00 Diptheria,Tetanus Tox.(under 6 yrs)= 0 Licenses &Permits(+copies) $1,549:20 immune Serum Globulin= 0 Certificate of Fitness@$25.00 $1,325..00 Measles/Mumps/Rubella= J0 Polio= 550 fines $160.00 Tetanus& Diptheria (adult use)= 300 Total Monies Collected $3,319.20 Tube-culin PPG= 0 HIB Titre= 400 Animal Bites Reported= _0 Hepa':itis B= 760 PPV 23 180 PCV 7 550 Annual Budget Expenses Available Balance Salar. /Longevity $360,621.00 $144,152.69 $216,468.31 Annual Budget Expenses Encumbered . Available Balance Non- personnel $15,100.00 $4,092.39 $3,316;10 $7,691.51 City Of Salem 0 Environmental Health Division --- Inspection Monthly Summary Month -------------------------------------- Type Jul 01 Aug 01 Sep 01 Oct 01 Nov 01 Count 0 0 0 1 0 1 BB 0 1 0 0 0 1 BP 0 2 0 0 0 2 CFI 49 46 40 55 55 245 CFR 0 0 0 1 4 5 CH 9 9 12 20 6 56 CON 10 10 3 5 2 30 CR 0 8 2 4 3 17 CT 0 3 3 5 1 12 EC 8 21 10 9 2 50 EPR 0 0 1 0 0 1 FC 1 1 2 4 1 9 FRH 1 1 1 1 1 5 FSD 3 6 6 9 1 25 FSI 16 23 26 32 18 115 FSR 9 30 23 29 16 107 GN 5 4 7 2 1 19 HI 13 6 12 8 10 49 HR 10 33 9 8 6 66 LPI 0 2 0 1 1 4 MS 0 0 0 1 0 1 MT 5 10 7 12 7 41 •MUP 1 0 0 1 0 2 )G 11 6 1 6 0 24 RFD 0 1 1 1 0 3 RFI 5 6 13 4 5 33 RFR 1 6 4 3 5 19 RO 5 2 0 2 4 13 SB 71 56 12 0 0 139 SC 0 1 0 1 0 2 SM 0 1 2 1 1 5 ST 0 1 0 0 0 1 TFI 1 21 7 10 0 39 TR 85 109 89 47 29 359 VFI 0 0 0 1 0 1 Count 319 426 293 284 179 1501 T-3-++ City of Salem, Massachusett Environmental Health Division Inspection Input Form Inspect Date : Estab Name or Owner Name : Type : Location: Inspector: Inspection Types (r2 - GaaF��r,'i BP - Body Piercing FSI - Food Serv. Ins . 892* RFD - Ret .Food Disc. 6* CFI - Cert . Fit . 822* FSR - Food Serv. Rein. 194* RFI - Ret . Insp. 75* CFR - Cert . Fit .Reinsp105*GN _ Gen. Nuisance 41* RFR - Ret . Food Rein34* O - Court Hearing 93* HI Housing Insp. 260* RO - Rodent Control 16, N - Constable Serv. 65* HR - Housing Reinsp. 135* SC - Suntan 7* CR - Compliance Rev. 25* LPI - Lead Paint Insp. 6* SES - SESD Odor 0* CT Computer Time10* MS - Massage 6* SM - Seminars 36* EC - Envirn. Compl . 51* MW - Mark/Weights SP - Swim.Pools 16* EPR - Ext . Paint 95* MUP - Mobile Food Insp. 11* SB - Swim. Beaches 65* FC - Food Compl . 17* OS - Off. Sub. Insp. 6* ST - Soil/Septic 8* FRH - Food Hearings15* RC - Rec Camps 9* TFI - Temp. Food 112* FSD - Food Serv. Disc 53* MT - Meetings 65* TR - Trash 381* AGENT'S NEWSLETTER TO THE BOARD VOLUME 71 December 11, 2001 BIOTERRORISM Since the day after the anthrax problem was discovered in Florida and we were notified that a Salem resident had been working in the building during the time of potential exposure, until today (Thursday) when five of our staff attended a seminar on the topic by MHOA, bioterrorism has been a priority for our department. There have been multiple meetings with the Police and Fire Chiefs developing and rewriting a protocol for handling 911 anthrax calls; there have been meetings with North Shore Medical Center and other communities; Tracy and I appeared on a WESX radio talk show on the topic; the State's leading epidemiologist presented information for Salem's providers and first responders; and I was asked to make a presentation to a neighborhood group with Detective Andreas of the Salem Police Department. In addition, a talk I was asked to give to the Senior Academy regarding Home Sanitation become a discussion • on anthrax and safe handling of the mail. During the initial anthrax scare, we were called to many scenes because of threatening letters and/or suspicious white powder. In fact, we closed the Salem District Court for a day because of such a letter and threat. All such scares have proven negative for anthrax. There have been positive outcomes from this threat. Our professional relationships with the Court, the Salem Police and Fire Departments, and the Massachusetts Department of Public Health have become stronger. There is a deeper understanding of the responsibilities and strengths of each of these groups. Salem's Comprehensive Emergency Management Plan is being updated with greater motivation and purpose. Deficiencies have been identified allowing them to be addressed in a more expedient manner. With the additional burden of bioterrorism we have still been carrying out our more traditional responsibilities such as housing and food establishment inspections and running flu clinics. However, I do think we have been stretched beyond the limit in terms of resources. N • SMOKING BAN Roosevelt's Restaurant denied access to the Tobacco Control inspectors during a compliance check following complaints of smoking in that establishment. Before the inspectors were told to leave, one did see a person smoking, so I have sent a violation letter. It is in your packets. I am following up the inspection issue with the legal department. Roosevelt's had been sent an order to pay a $50 fine because smoking was observed during the last compliance check. The owner requested a hearing. I held the hearing and upheld the fine. Bay Bridge was also allowing smoking. This is their third offense. We went to court with the owners this week because they had not paid the fines for the first and second offense. The hearing officer upheld our order to pay and so they did. BOARD OF HEALTH OBJECTIVES Included in your packet is the first quarter update of the Board's objectives for FY2002. This covers the months of July, August and September. Also included is a comparison of the numbers of inspections over the past several years. PARLEE STREET We have one presentation before the Board at this meeting. It is Paul Dibiase for Ledgwood Realty Trust. The template list of conditions is included in the packet. HAPPY HOLIDAYS TO YOU AND YOUR FAMILIES Salem Board of Health November Phone Logs 2001 Total Answered Answered Calls Thursday November 1,2001 44 Barb = 253 Friday November 2, 2001 33 1 Mary = 268 Saturday November 3, 2001 Sue = 423 Sunday November 4, 2001 Monday November 5,2001 71 Tuesday November 6,2001 59 Calls Taken Wednesday November 7,2001 58 Thursday November 8, 2001 70 Joanne = 171 Friday November 9, 2001 36 Jeffrey = 57 Saturday November 10,2001 Sharon= 35 Sunday November 11,2001 Jose = 52 r onday November 12,2001 Holiday Pablo = 11 Tuesday November 13, 2001 75 Tracy = 175 I Wednesday November 14,2001 58 Ginny = 5 Em i Thursday November 15,2001 49 Barb = 119 Friday November.16,2001 46 Mary = 121 Saturday November 17,2001 Sue = 198 Sunday November 18,2001 Monday November 19,2001 50 Tuesday November 20,2001 36 43 Office Hours Per Week Wednesday November 21,2001 31 * =20 Work Days Thursday November 22,2001 Holiday "Skeleton" Full Day© Monday 8-4 Friday November 23,2001 14 Saturday November 24,2001 Tuesday 8-4 Sunday November 25,2001 Wednesday 8-4 Monday November 26,2001 58 Thursday 8-7 Tuesday November 27,2001 54 Frid. 8-4 Ii Nednesday November 28,2001 44 Thursday November 29,2001 29 j Friday November 30,2001 29 i Total Calls*= 944 �M,CowNDn CITY OF SALEM, MASSACHUSE`f TS BOARD OF HEALTH !� 120 WASHINGTON STREET, 4TH FLOOR 9� SALEM, MA 01 970 TEL. 978-741-1 800, C FAX 978-745-0343 STANLEY LISOVICZ, JR. JOANNE SCOTT, MPH, IRS, CHO MAYOR HEALTH AGENT Public Health Nurse Report October 2001 Activities Disease Prevention • 10 3 Hepatitis B vaccination for 3 North/ p Shore Ambulance employees. • Influenza Clinic preparation. 1st allotment distributed to Salem Health Care Providers. Salem Board of Health will receive 1910 doses for our clinics. • Homebound residents received flu shots last half of October. Meetings and Clinics • Received telephone complaint of gastrointestinal illness from eating at Cilantros Restaurant. Accompanied Jose Diaz on Restaurant inspection. ' • 10/11 Kim Grant, representative from Massachusetts Department of Public Health Immunization program reviewed Salem Board of Health vaccine • management and security. • Public Health Forum held at Salem Police station for first responders and health care providers in Salem. Dr. Bela Matyas spoke about Anthrax and Smallpox. Approximately 60 attended. • 10/24 Responded to several "suspicious" package/letter calls with Joanne Scott. Salem District Court: approximately 250 contacts were identified. All 250 people were notified of State Lab results 48 hours after incident. • Responded to Salem State College "suspicious letter". • Responded to Horace Mann School for a "suspicious letter" no extraneous material was found. • Responded to Council on Aging for a "suspicous letter with powder". 3 contacts identified. All were notified of results. 9 10/25 Attended Health Advisory Council meeting at Salem High School. • 10/31 Attended Seminar on Flu Pandemic Planning with Joanne Scott. Seminar was held at Merrimac College in Andover. St. _ Joseph's School • Hearing and vision: Two classes have been screened. Phoenix School • 9 Hearing and vision will begin in December or January. �coNnrr CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR _ SALEM, MA 01970 • i�, °^" TEL. 978-741-1800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT MONTHLY REPORT OF COMMUNICABLE DISEASES OCTOBER 2007 DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES: CASES: CASES: STATE: CAMPYLOBACTER 2 O 2 2 • GIARDIA 1 0 1 1 HEPATITIS S 1 1 1 LYME DISEASE O O O O MENINGITIS 0 0 0 0 PERTUSSIS O O O O SALMONELLA O 0 O O SHIGELLA O O O 0 VARICELLA 0 O O O REPORTABLE DISEASES EXCLUDED FROM ABOVE HAVE NOT BEEN IDENTIFIED THIS MONTH. • cn� CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR • SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT SUMMARY OF COMMUNICABLE DISEASES FOR OCTOBER 2001 CAMPYLOBACTER: 2 CASES. BOTH NON-FOODHANDLERS. 40 Yl0 UNEMPLOYED FEMALE. HISTORY OF CROHN'S DISEASE. SHE DID NOT SEEK MEDICAL CARE FOR 3 WEEKS AFTER SYMPTOMS. FAMILY WAS ASYMPTOMATIC. PUBLIC HEALTH FACT • SHEET SENT. 53 YIO HOUSEWIFE. SHE CLAIMS SHE WAS ILL FROM EATING CHICKEN AT BUFFET KING. HOWEVER, HER SYMPTOMS STARTED THE DAY BEFORE SHE ATE THE CHICKEN. HOUSEHOLD CONTACTS ATE CHICKEN AND WERE NOT ILL. GIARDIA: 27 Y/O MALE. UNKNOWN CAUSE. NON FOODHANDLER. PARTNER IS NOT ILL, BUT WAS TESTED, AND RESULTS WERE PENDING AT TIME OF INTERVIEW. HEPATITIS A: NON-FOODHANDLER SYMPTOMS STARTED IN SEPTEMBER WHILE HE WAS IN INDIA. HIS CLOSE CONTACT (PARTNER) HAS SINCE LEFT THE COUNTRY. HE WAS GOING TO NOTIFY HIS PARTNER IN INDIA A SUSPECT CASE OF MUMPS WAS REPORTED BY SALEM HOSPITAL. EMERGENCY ROOM. ELISSA LEIGHTON FROM MDPH WAS NOTIFIED. IT WAS TREATED AS A CASE UNTIL LAB RESULTS WERE FINAL. IT ENDED UP TO BE UNCONFIRMED. PT NEVER RETURNED • TO DOCTOR FOR FOLLOW UP BLOOD WORK. Board of Health Administration Monthly Report OCT. 01 Biologics Distributed * Amount in Doses Diptheria, Tetar us& Pertussis = 560 Burial Permits g?$5.00 $435.00 Diptheria,Tetan ,s Tox.(under 6 yrs)= 10 Licenses& Permits(+copies) $1,280.00 Immune Serum 31obulin= 1 VIAL Certificate of Fitness@$25.00 $1,700.00 Measlos/Murnp�/Rubella= 400 Folio:= 500 Fines $825.00 1'etar[Lls & IDiptheria(adult use)= 406. Total Monies Collected $4,240.00 Tuberculin PPD= 130 FIIB Titre= 600 Animal Bites Reported= 1 Hepatitis B:= 60$ F'PV:?3 200 F'CV'7 300 Annual Budget Expenses Available Balance Salary/Longevity $360,621.00 $110,426.64 $250,194.36 Annual Budget Expenses Encumbered Available Balance Non-Personnel $15,100.00 $2,268.91 $1,795.53 $11,035.56 AGENT'S NEWSLETTER TO THE BOARD • VOLUME 69 September 11, 2001 OBJECTIVES FY 02 Enclosed in the packet are the proposed objectives for this fiscal year. The Board may want to review these for the meeting so they can be amended and accepted. SMOKING BAN The Board continues its efforts to make the smoking ban regional and statewide. In the packet is a letter to the Beverly Board of Health regarding a meeting of the two Boards in this regard. Bill Burke, Director of that Board says that his Board has indicated that they are also interested in meeting with us, on this and perhaps other issues. He will follow up with me on this early in the fall. In addition, I had the opportunity to meet State Senate President Tom Birmingham in Mayor Usovicz's office recently. I followed up on that meeting with the letter enclosed in the packet, requesting that Senator Birmingham consider supporting a statewide • smoking ban. A recent check of many of our establishments found that, at that time, there was a high compliance rate with the exception of Lonnie's Place. The owner of that establishment has requested a hearing before the Board regarding a fine received because of the noncompliance. That hearing will take place at the Board meeting at 8 PM. BEACHES The last beach analysis has taken place this week. At the meeting, I will have the final spread sheet on the entire season's sampling. STAFF Barbara remains out of work for health reasons. We have had a temporary clerk, Gail LaPointe, assisting us particularly during vacations. BOH COOK-OUT • Thank you to all who shared their good food and humor at this year's cook-out. It is so nice of the City to contribute a great fireworks display! City Of Salem Environmental Health Division --- Inspection Monthly Summary Month ------------------------------ Type Jul 01 Aug 01 Sep 01 Oct 01 Count 0 0 0 1 1 BB 0 1 0 0 1 BP 0 2 0 0 2 CFI 49 46 40 55 190 CFR 0 0 0 1 1 CH 9 9 12 20 50 CON 10 10 3 5 28 CR 0 8 2 4 14 CT 0 3 3 5 11 EC 8 21 10 9 48 EPR 0 0 1 0 1 FC 1 1 2 4 8 FRH 1 1 1 1 4 FSD 3 6 6 9 24 FSI 16 23 26 32 97 FSR 9 30 23 29 91 GN 5 4 7 2 18 HI 13 6 12 8 39 HR 10 33 9 8 60 LPI 0 2 0 1 3 MS 0 0 0 1 1 MT 5 10 7 12 34 MUP 1 0 0 1 2 JWG 11 6 1 6 24 FD 0 1 1 1 3 ' RFI 5 6 13 4 28 RFR 1 6 4 3 14 RO 5 2 0 2 9 SB 71 56 12 0 139 SC 0 1 0 1 2 SM 0 1 2 1 4 1 ST 0 1 0 0 1 TFI 1 21 7 10 39 TR 85 109 89 47 330 VFI 0 0 0 1 1 Count 319 426 293 284 1322 T++4% City of Salem, Massachusett Environmental Health Division Inspection Input Form Inspect Date — Estab Name or Owner Name : Type : Location: Inspector: Inspection Types Gn _ ��gf�(-;rri• BP - Body Piercing FSI - Food Serv. Ins . 892* RFD - Ret .Food Disc . 6* CFI - Cert . Fit . 822* FSR - Food Serv. Rein. 194* RFI - Ret . Insp. 75* CFR - Cert . Fit .Reinsp105*GN _ Gen. Nuisance 41* RFR - Ret . Food Rein34* H - Court Hearing 93* HI - Housing Insp. 260* RO - Rodent Control 16* N - Constable Serv. 65* HR - Housing Reinsp. 135* SC - Suntan 7* - Compliance Rev. 25* LPI - Lead Paint Insp. 6* SES - SESD Odor 0* CT Computer Time10* MS - Massage 6* SM - Seminars 36* EC - Envirn. Compl . 51* MW - Mark/Weights SP - Swim. Pools 16* EPR - Ext . Paint 95* MUP - Mobile Food Insp. 11* SB - Swim. Beaches 65* FC - Food Compl . 17* OS - Off . Sub. Insp. 6* ST - Soil/Septic 8* FRH - Food Hearings15* RC - Rec Camps 9* TFI - Temp. Food 112* FSD - Food Serv. Disc 53* MT - Meetings 65* TR - Trash 381* Salem Board of Health October Phone Log 2001 Total Answered *Answered Calls Monday October 1,2001 49 Barb = 207 Tuesday October 2, 2001 43 Mary= 451 Wednesday October 3, 2001 51 Sue= 574 Thursday October 4, 2001 52 Friday October 5,2001 36 Saturday October 6, 2001 *Calls Taken Sunday October 7, 2001 Monday October 8, 2001 Holiday Joanne = 287 Tuesday October 9, 2001 53 Jeffrey = 130 Wednesday October 10, 2001 52 Sharon 80 Thursday October 11, 2001 65 Jose = 52 Friday October 12, 2001 38 Pablo = 27 Saturday October 13, 2001 Tracy = 225 Sunday October 14, 2001 Ginny = 26 Monday October 15, 2001 69 Barb = 64 Tuesday October 16, 2001 50 Mary = 165 Wednesday October 17, 2001 50 Sue = 176 Thursday October 18,2001 72 Friday October 19, 2001 45 Saturday October 20, 2Wj 001 43 Office Hours Per Week Sunday October 21, 2001 "=22 Work Days Monday October 22, 2001 63 35 Hour Work Week Tuesday October 23, 2001 67 Wednesday October 24, 2001 57 Thursday October 25, 2001 79 Monday 8-4 Friday October 26, 2001 64 Tuesday 8-4 Saturday October 27, 2001 Wednesday 8-4 Thursday 8-7 Sunday October 28, 2001 Y Monday October 29, 2001 62 Frid.8-4 Tuesday October 30,2001 57 Wednesday October 31, 2001 58 Total = 1232 d CITY OF SALEM, MASSACHUSETTS � BOARD OF HEALTH • *. 120 WASHINGTON STREET, 4TH FLOOR • SALEM, MA 01970 .p� TEL. 978-741-1800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, IRS, CHO MAYOR HEALTH AGENT pC f k Public Health Nurse Report September 2001 Activities Disease Prevention • 9/25 211a Hepatitis B vaccination for 3 North Shore Ambulance employees. • Influenza Clinic preparation. 13t allotment distributed to Salem Health Care Providers. Meetings and Clinics • 9/25 North Shore Wellness Fair Meeting. The Fair will be scheduled for Sunday April 28,2002 from 10 a.m.to 4 p.m. • 9/24 Attended Seminar on Surveillance of Infectious Diseases by Massachusetts Department of Public Health held at Burlington Public Library from 9 a.m. to 3 p.m. St. Joseph's School • Attended Pre-K orientation at St.Joseph's School. Immunization records obtained from parents. • Hearing and vision will begin the first Monday in November. Phoenix School • Hearing and vision will begin in November. • CITY OF SALEM, MASSACHUSETTS * BOARD OF HEALTH " �7• 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-74 1-1 800 STANLEY USOVICZ, JR. FAx 978-745-0343 MAYOR JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT MONTHLY REPORT OF COMMUNICABLE DISEASES September 2001 DISEASE: NEW CARRY OVER DISCHARGED REP CASES. CASES: REPORT TO CASES: STATE: Campylobacter 0 0 0 0 Giardia 2 0 2 2 Hepatitis 1 1 1 1 Lyme Disease 1 0 1 1 Meningitis 0 0 0 0 Pertussis 0 0 0 0 Salmonella 0 0 0 0 ShigelIa 0 0 0 0 Varicella 0 0 0 0 • Reportable Diseases excluded from above have not been identified this month. .,rev—vl r i CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH y 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 • 7 r _ TEL. 978-74 1-1 800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT Summary of Communicable Disease for September 2001 Giardia: 2 cases. 40 y/o male. Traveled to Provincetown during incubation period. Source of infection unknown. Partner asymptomatic. Occupation: Non-Foodhandter. 34 y/o male. Traveled to Europe during incubation period. Italy, Amsterdam. He believed he was ill from drinking tap water. He was unsure if it was well water. No household contacts. Hepatitis A: 1 Case. Non-Foodhandler. Did not travel during incubation period. Risk History: Homosexual. Partner received Immune Globulin at M.D.within 24 hours after diagnosis. Public Health Fact Sheet sent to case. Lyme: 1 Case. Diagnosed 7/27/01 Case Report Received from MDPH on 9/18/01. case treated with antibiotics. Had erythema migrans(bull's eye rash) AGENT'S NEWSLETTER TO THE BOARD VOLUME 70 October 9, 2001 SMOKING BAN As you probably remember, Lonnie's was found in violation of the smoking ban during a recent compliance check by Tobacco Control. Lonnie's requested a hearing regarding the order to pay a fine. I conducted the hearing on September 28, 2001 and upheld the order. Lonnie's did pay the fine. In the most recent compliance check, Roosevelt's and Bay Bridge were found in violation of the regulation. Fine letters have been sent. Roosevelt's has requested a hearing. FOOD ESTABLISHMENTS Market Basket on Highland Avenue will probably open within the next month. College Roast Beef has re-opened as Niko's Roast Beef under new ownership. Knight of Cups, a bakery, is opening on High Street. • There are plans to open a new establishment on Canal Street and Asahi has presented plans for its new location. STAFF Barbara began working part time this week. HAUNTED HAPPENINGS Haunted Happenings begins this weekend. Our inspectors will be conducting inspections of the food carts throughout the event. City of Salem Board of Health "Monthly" Phone Logs 1997 1998 1999 2000 2001 2002 January 760 705 854 1065 February 739 757 902 743 March 1038 1057 1140 952 April 924 897 869 883 May 864 966 892 987 1039 June 932 1070 1234 990 1143. July 975 1069 805 976 938 August 758 870 998 1082 991 • September 921 866 1043 1012 881 October 1124 953 1079 1227 November 828 765 945 937 December 815 675 663 697 Totals 7217 10,695 11,075 1 11, 673 18,631 a/o 10-1 01 • F Salem Board of Health September Phone Log 2001 Total Answered *Answered Calls Saturday September 1, 2001 *Barb* = *64* Sunday September 2, 2001 Mary= 268 Monday September 3,2001 Holiday Sue= 479 Tuesday September 4, 2001 1 43 Wednesday September 5, 2001 49 Thursday September 6, 2001 61 *Calls Taken Friday September 7, 2001 ii Saturday September 8, 2001 Joanne = 242 Sunday September 9, 2001 Jeffreyii = 100 Monday September 10,2001 40 Sharon= 61 Tuesday September 11,2001 34 Jose = 31 Wednesday September 12,2001 30 Pablo = 23 • Thursday September 13,2001 48 Tracy = 105 Friday September 14,2001 28 Ginny = 12 Saturday September 15, 2001 Barb = 3 Sunday September 16, 2001 Mary = 101 Monday September 17, 2001 48 Sue = 133 Tuesday September 18,2001 33 Wednesday September 19,2001 41 Thursday September 20,2001 1 44 1 43 Office Hours Per Week Friday September 21,2001 26 *=19 Work Days Saturday September 22, 2001 35 Hour Work Week Sunday September 23, 2001 Monday September 24, 2001 55 Tuesday September 25,2001 53 Monday 8-4 Wednesday September 26,2001 37 Tuesday 8-4 Thursday September 27, 2001 1 46 1 Wednesday 8-4 Friday September 28,2001 38 Thursday 8-7 ISaturday September 29, 2001 Friday 8-4 . ISunday September 30, 2001 Total = 811 ��J City Of Salem Environmental Health Division --- Inspection Monthly Summary Month ---------------------- Type Jul 01 Aug 01 Sep 01 Count ----- ------ ------ ------ BB 0 1 0 1 BP 0 2 0 2 CFI 49 46 40 13S CH 9 9 12 30 CON 10 10 3 23 1 CR 0 8 2 10 CT 0 3 3 6 � EC 8 21 10 3y EPR 0 0 1 1 _ I FC 1 1 2 4 FRH 1 1 1 3 FSD 3 6 6 15 FSI 16 23 26. 65 FSR 9 30 23 62 GN 5 4 7 16 HI 13 6 12 31 hi( lu » 5 — LPI 0 2 0 2 MT 5 10 7 22 MUP 1 0 0 1 OG 11 6 1 18 RFD 0 1 1 2 RFI 5 6 13 24 RFR 1 6 4 11 RO 5 2 0 7 SB 71 .56 12 139 SC 0 1 0 1 SM 0 1 2 3 ST 0 1 0 1 TFI 1 21 7 29 TR 85 109 89 283 Count 319 426 293 1038 T+++ City_. of Salem, Massachusett Environmental Hearth Division Inspection Input Form Inspect Date : Estab Name or Owner Name: Type : Location: Inspector: Inspection Types BP - Body Piercing FSI - Food Serv. Ins . 892* RFD - Ret .Food Disc. 6* CFI - Cert . Fit . 822* FSR - Food Serv. Rein. 194* RFI - Ret . Insp.75* CFR - Cert . Fit .Reinsp105*GN Gen. Nuisance 41* RFR - Ret . Food Rein34* CH - Court Hearing 93* HI - Housing Insp. 260* RO - Rodent Control 16 CON - Constable Serv. 65* HR - Housing Reinsp. 135* SC - Suntan 7* CR - Compliance Rev. 25* LPI - Lead Paint Insp. 6* SES - SESD Odor 0* CT _ Computer Time10* MS - Massage 6* SM - Seminars 36* EC - Envirn. Compl . 51* MW - Mark/Weights SP - Swim.Pools 16* EPR - Ext . Paint 95* MUP - Mobile Food Insp. 11* SB - Swim. Beaches 65* FC - Food Compl . 17* OS - Off . Sub. Insp. 6* ST - Soil/Septic 8* FRH - Food Hearings15* RC - Rec Camps .9* TFI - Temp. Food 112* FSD - Food Serv. Disc 53* MT - Meetings 65* TR - Trash 381* Board of Health Administration Molhly Report Biologics Distributed September, 2001 * Amount in Doses Diptheria, Tetanus & Pertussis = 560 Burial Permits@$5.00 $190.0 Licenses & Permits +co ies) $270.00 Tetanus Tox. under 6 rs)= 0 ( p Dipthena, ( Y Immune Serum Globulin= 2 Certificate of Fitness@$25.00 $950.00 Measles/Mumps/Rubella= 410 Sealer Weights/Measures= Polio= 510 Fines $700-00 - Tetanus & Diptheria (adult use)= 1,080 - Total Monies Collected 1 $$,085.00 Tuberculin PPD= 100 Animal Bites Reported= HIB Titre- 600 0 Hepatitis B= 570 . PCV 7 (Prevnar) 675 PPV 23 1 200 Annual Budget Expenses Available Balance Salary/Longevity p Annual Budget Expenses Encumbered Available Balance Non-Personnel City Of Salem • Environmental Health Division - - Inspection Monthly Summary Month ---------------------- Type Jul 01 Aug 01 Sep 01 Count BB 0 1 0 1 BP 0 2 0 2 CFI 49 46 40 135 CH 9 9 12 30 CON 10 10 3 23 CR 0 8 2 10 CT 0 3 3 6 EC 8 21 10 39 EPR 0 0 1 1 FC 1 1 2 4 FRH 1 1 1 3 FSD 3 6 6 15 FSI 16 23 26 65 FSR 9 30 23 62 GN 5 4 7 16 HI 13 6 12 31 HR 10 33 9 52 LPI 0 2 0 2 MT 5 10 7 22 MUP 1 0 0 1 OG 11 6 1 18 RFD 0 1 1 2 • RFI 5 6 13 24 RFR 1 6 4 11 RO 5 2 0 7 SB 71 .56 12 139 SC 0 1 0 1 SM 0 1 2 3 ST 0 1 0 1 TFI 1 21 7 29 TR 85 109 89 283 Count 319 426 293 1038 City of Salem, Massachusett Environmental Health Division Inspection Input Form Inspect Date : Estab Name or Owner Name: Type : Location: Inspector: Inspection Types c. ' L,r/L - GaRF rr, BP - Body Piercing FSI - Food Serv. Ins . 892* RFD - Ret . Food Disc . 6* CFI - Cert . Fit . 822* FSR - Food Serv. Rein. 194* RFI - Ret . Insp. 75* CFR - Cert . Fit .Reinsp105*GN Gen. Nuisance 41* RFR - Ret . Food Rein34* • CH - Court Hearing 93* HI - Housing Insp. 260* RO - Rodent Control 16 CON - Constable Serv. 65* HR - Housing Reinsp. 135* SC - Suntan 7* CR - Compliance Rev. 25* LPI - Lead Paint Insp. 6* SES - SESD Odor 0* CT Computer Time10* MS - Massage 6* SM - Seminars 36* EC - Envirn. Compl . 51* MW - Mark/Weights SP - Swim. Pools 16* EPR - Ext . Paint 95* MUP - Mobile Food Insp. 11* SB - Swim. Beaches 65* FC - Food Compl . 17* OS - Off . Sub. insp. 6* ST - Soil/Septic 8* FRH - Food Hearings15* RC - Rec Camps 9* TFI - Temp. Food 112* FSD - Food Serv. Disc 53* MT - Meetings 65* TR - Trash 381* ND(T�i CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel: (978)741-1800 I! Fax: (978)740-9705 ii I Public Health Nurse Report August 2001 Activities i Disease Prevention • In touch with T.B. Clinic and following active cases and case contacts. • • Two PPD screenings done in office. • Vaccine inventory maintained and distributed. • Investigated communicable disease cases and reported to the M.D.P.H. Meetings and Clinics i • Office visits for Hepatitis B Vaccinations for North Shore Ambulance Employees. • Board of Health minutes prepared for July. i • Flu vaccine clinic preparation. St.Joseph's School • Immunization Letters sent to all incoming Pre-K students, Kindergarten, and ' Seventh Grade Ent ry. i PHOENIX SCHOOL I i , I i 1 7r • MONTHLY REPORT OF COMMUNICABLE DISEASES August 2001 DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES CASES CASES: STATE: Campylobacter 0 0 0 0 • Giardia 0 0 0 0 E.Coli 0157H7 0 0 0 0 Hepatitis 1 3 0 0 Lyme Disease 0 0 0 0 Meningitis 0 0 0 0 Pertussis 0 0 0 0 Salmonella 0 0 0 0 Shigella 0 0 0 0 Varicella 0 0 0 0 Reportable Diseases excluded from above have not been identified this . month. <Gt F , S'ummary of Communicable Disease for August 2001 Hepatitis R: One ch.ronir ease was renorted, • Board of Health Administration Monthly Report August-01 Biologics Distributed * Amount in Doses Diptheria, Tetanus & Pertussis = 460 Burial Permits@ $5.00 $315.00 Diptheria,Tetanus Tox.(under 6 yrs)= 0 Licenses & Permits(+copies) $662.40 Immune Serum Globulin= 0 Certificate of Fitness@$25.00 $1,450.00 Measles/Mumps/Rubella= 306 Sealer Weights/Measures= $630.00 Polio= 580 Fines= $775.00 Tetanus & Diptheria (adult use)= 810 Total Monies Collected = $3,832.40 Tuberculin PPD= 0 HIB Titre= 503 Animal Bites Reported= 0 Hepatitis B= 620 PCV 7 (Prevnar) 405 PPV 23 20 Annual Budget Expenses Available Balance Salary/Longevity $360,62, .00 $55,220.75 $305,400.25 Annual Budget Expenses Encumbered Available Balance Non-Personnel $15,100.00 $893.05 $14,206.95 • City Of Salem Environmental Health Division - - Inspection Monthly Summary Month ------------ Type Jul 01 Aug 01 Count BB 0 1 1 BP 0 2 2 CFI 49 46 9S CH 9 9 18 CON 10 10 20 CR 0 8 8 C1 0 3 3 EC 8 21 29 FC 1 1 2 FRH 1 1 2 FSD 3 6 9 FSI 16 23 39 FSR 9 30 39 GN 5 4 9 HI 13 6 19 HR 10 33 43 LPI 0 2 2 MT 5 10 15 MUP 1 0 1 OG 11 6 17 RFD 0 1 1 • RFI 5 6 1 7 RFR 1 6 7 RO 5 2 7 SB 71 56 127 SC 0 1 1 SM 0 1 1 ST 0 1 1 TFI 1 21 22 TR 85 109 194 Count 319 426 745 ++4 City of Salem, Massachusett Environmental Health Division Inspection Input Form Inspect Date: Estab Name or Owner Name : Type : Location: Inspector: Inspection Types U2 - 64'9f�(-;m' BP - Body Piercing FSI - Food Serv. Ins . 892* RFD - Ret . Food Disc . 6* CFI - Cert . Fit . 822* FSR - Food Serv. Rein. 194* RFI - Ret . Insp. 75* CFR - Cert . Fit .Reinsp105*GN _ Gen. Nuisance 41* RFR - Ret . Food Rein34 • CH - Court Hearing 93* HI - Housing Insp. 260* RO - Rodent Control 1 CON - Constable Serv. 65* HR - Housing Reinsp. 135* SC - Suntan 7* CR - Compliance Rev. 25* LPI - Lead Paint Insp. 6* SES - SESD Odor 0* CT _ Computer Time10* MS - Massage 6* SM - Seminars 36* EC - Envirn. Compl . 51* MW - Mark/Weights Sp - Swim. Pools 16* EPR - Ext . Paint 95* MUP - Mobile Food Insp. 11* SB - Swim. Beaches 65 FC - Food Compl . 17* OS - Off . Sub. Insp. 6* ST - Soil/Septic 8* FRH - Food Hearings15* RC - Rec Camps 9* TFI - Temp. Food 112* FSD - Food Serv. Disc 53* MT - Meetings 65* TR - 'gash 381* i • Salem Board of Health August Phone Logs 2001 Total Answered Answered Calls: Wednesday August 1,2001 44 Barb = 12 Thursday August 2,2001 50 Mary = 590 Friday August 3,2001 38 Sue = 389 SaturdayAugust 4, 2001 Sunda August 5, 2001 Monday August 6, 2001 53 Calls Taken Tuesday August 7,2001 57 Wednesday August 8, 2001 55 Joanne = 248 Thursday August 9,2001 51 Jeffrey = 137 Friday August 10,2001 17 Sharon 65 Saturday August 11, 2001 Jose = 47 Sunday August 12, 2001 EPablo = 11 Monday August 13,2001 59 Tracy = 117 uesday August 14,2001 49 Ginny = 34 Wednesday August 15,2001 -48 Barb = 1 Thursday August 16,2001 57 Mary = 178 Friday August 17,2001 18 Sue F 153 Saturday August 18,2001 Sunday August 19, 2001 Monday August 20, 2001 56 39 Office Hours Per Week Tuesday August 21,2001 54 =23 Work Days Wednesday August 22,2001 33 Thursday August 23,2001 53 Monday 8-4 Friday August 24,2001 . 29 Tuesday 8-4 Saturday August 25, 2001 Wednesday 8-4 Sunday August 26, 2001 Thursday 8-7 Monday August 27,2001 39 Frid. 8-12(summer hours) Tuesday August 28,2001 36 Wednesday August 29, 2001 38 _lThursday Au ust 30,2001 40 rida August 31, 2001 17 Total Calls *= 991 AGENT'S NEWSLETTER TO THE BOARD VOLUME 69 September 11, 2001 OBJECTIVES FY 02 Enclosed in the packet are the proposed objectives for this fiscal year. The Board may want to review these for the meeting so they can be amended and accepted. SMOKING BAN The Board continues its efforts to make the smoking ban regional and statewide. In the packet is a letter to the Beverly Board of Health regarding a meeting of the two Boards in this regard. Bill Burke, Director of that Board says that his Board has indicated that they are also interested in meeting with us, on this and perhaps other issues. He will follow up with me on this early in the fall. In addition, I had the opportunity to meet State Senate President Tom Birmingham in Mayor Usovicz's office recently. I followed up on that meeting with the letter enclosed in the packet, requesting that Senator Birmingham consider supporting a statewide ismoking ban. A recent check of many of our establishments found that, at that time, there was a high compliance rate with the exception of Lonnie's Place. The owner of that establishment has requested a hearing before the Board regarding a fine received because of the noncompliance. That hearing will take place at the Board meeting at 8 PM. BEACHES The last beach analysis has taken place this week. At the meeting, I will have the final spread sheet on the entire season's sampling. STAFF Barbara remains out of work for health reasons. We have had a temporary clerk, Gail LaPointe, assisting us particularly during vacations. BOH COOK-OUT • Thank you to all who shared their good food and humor at this year's cook-out. It is so nice of the City to contribute a great fireworks display! ******************************************************************************* AGENT'S NEWSLETTER TO THE BOARD VOLUME 68 August 14, 2001 GOALS &OBJECTIVES The fnal update for the Board of Health Objectives for FY01 are in the packet. Also included is a draft for FY 02 Objectives for the Board's review. VARIANCES There have been three requests for variances to the Food Code or Massage Regulation. Oh Buster will be before the Board requesting that he be allowed to keep his establishment's door open without a screen. Oh Buster is similar to an enclosed produce road stand. Elderly people have difficulty opening the door from the outside, particularly when they have a carriage. A letter is enclosed detailing the request. I would suggest granting the variance for a limited time, encouraging the owner to look into an alternative. Elder Nutrition is requesting a variance to the requirement that a certified food manager be at the dining sites. There is limited preparation at those locations and an off-site certified food manager will supervise it. Atlantic Muscular Therapy is requesting an extension of her operating hours. Elder Nutrition and Atlantic Therapy will not be at the meeting. Because the agenda was very full I suggested that they submit their request in writing for the Board's review and possible decision. I told them that the Board might ask them to appear at next month's meeting. BEACHES Our most recent beach testing indicates that the water quality is very good now. However, the month of July was a challenge as we attempted to discern the cause high numbers of bacteria in many of our samples. We investigated a number of potential sources including the SESD, storm water runoff, pollution from boats, and weather conditions. We conducted this'irlvestigation by repeating high samples, sampling both in our usual fashion and by boat farther from shore;taking samples over the SESD outfall pipe and at the diffuser area, as well as directly from the plant;interviewing boat owners and divers; examining weather patterns; and consulting with the DEP, Coast Guard,The National Oceanic and Atmospheric Administration. Our investigation continues. WILDLIFE The Board has been receiving calls of concern regarding the increased sitings of wildlife such as coyotes and fox in Salem. We have scheduled a suburban wildlife biologist,Trina Moruzzi,from the Division of Fisheries and Wildlife to speak to concerned residents and answer their questions. Ms. Moruzzi will be meeting here on Thursday,August 23`d, at 7 PM. HOUSEHOLD HAZARDOUS WASTE COLLECTION DAY HHWCD was HOT in many ways! We collected 323 tv's, 177 computer monitors,20 air conditioners, 18 microwaves, 131 propane tanks, and processed 321 full and 284 partial car loads of chemicals for disposal! Our staff, and that of Safety Clean, performed Herculean work dispite the searing heat. Special thanks go to our volunteers: Marion Winfrey, Christine and Dick Harrington, Mark Giarla, and Ed Moriarty. STAFF We are thrilled to have Sharon McCabe working with us. Sharon brings good sense and lots of expertise to her position here. Barbara has been out for several weeks with a back problem. It has been difficult keeping up with bills and other administrative tasks in her absence. We hope she will be back part time very soon. • BOARD OF HEALTH COOKOUT Our annual cookout is coming soon...August 18th at 6PM. As you may remember,we have named this event after Peter Saindon, our former Board member with the longest term to date. We look forward to seeing all our current and former Board members! }, NDIT,� Qj � z e C�jyINE CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel: (978)741-1800 Fax: (978) 740-9705 Public Health Nurse Report June 2001 Activities Disease Prevention • In touch with T.B. Clinic and following active cases and case contacts. • Vaccine inventory maintained and distributed. • Investigated communicable disease cases and reported to the M.D.P.H Meetings and Clinics • • 6/6/01 Attended staff meeting at Salem Board of Health. • 6/7/01 Hepatitis B Clinics to be held at Salem Board of Health for North Shore Ambulance employees. Employer purchased vaccine. 1st of 3 June 7tn • 6/11101 Collins Middle School Hepatitis B Clinic. 42 children received their 3`d vaccination. Administration record mailed to student's health care provider. • 6/12/01 St. Joseph's Hepatitis B Clinic. 5 Students received their 3rd vaccination. Administration record mailed to student's health care provider. • 6/12-6/18 Vacation. • 6/19/01 Salem State College Basketball, Soccer, and Hockey will not be permitted by Salem Board of Health for 2001. Please see attached information. • 6/20/01 Boys and Girls Club inspected by Jeff Vaughan and Tracy Giarla. CORI's reviewed, permit granted for 2001 season. • 6/21/01 Campfire Camp inspected by Jeff Vaughan and Tracy Giarla. Pool inspected by Jeff Vaughan. CORI's reviewed. Permit granted for 2001 season. • 6/28/01 Children's Island inspected. Permit issued on 7/25- CORI's are pending. • 9��C/MINB dp� CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel: (978)741-1800 Fax: (978) 740-9705 • 6/20/01 Meeting at Collins Middle School with Mary Egan, R.N., Debbie Alexander, R.N., Mary Manning, Principal. Discussed plans to notify parents: Alert letter mailed to 1250 students. Contact letters sent to all children and chaperone's who went on 8th grade New York City trip. Bus company notified. • 6/28/01 Camp Pinecrest inspected by Virginia Moustakis and Tracy ;arl�;. CORI's reviewed, camp permitted for 2001. Continuing Education: • Attending Salem State College Part time Evening Program. Attending Summer I course- Sociology. Monday and Wednesdays 6.30 p.m. to 9:30 • p.m. St. Joseph's • Hearing and vision has begun. Grades K-8 are completed. Letters for follow up mailed home. • Postural screenings performed 5-8. • Summer vacation Phoenix School • Hearing and vision completed. Letters for follow up mailed. • Postural screenings performed 5-8. • Summer vacation • i • MONTHLY REPORT OF COMMUNICABLE DISEASES JUNE 2001 DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES CASES CASES: STATE: Campylobacter 0 0 0 0 • Giardia 1 0 0 0 E.Coli 0157H7 0 0 0 0 Hepatitis 3 4 0 0 Lyme Disease 0 0 0 0 Meningitis 0 0 0 0 Pertussis 2 0 2 2 Salmonella 0 0 0 0 Shigella 0 0 0 0 Varicella 0 0 0 0 Reportable Diseases excluded from above have not been identified this • month. Pv��oNorrk! Q c g I �MIIYg CA CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel: (978)741-1800 Fax: (978) 740-9705 Summary of Communicable Diseases for June 2001 Giardia: 58y/o Non foodhandler. No children in household: Did not recently travel. Continues to see M.D. for symptoms. Public Health Fact Sheet sent. Jose Diaz interpreter for case investigation. • Hepatitis: 3 cases of chronic Hepatitis B reported. Pertussis- 2 Confirmed cases. Reported by Elissa Leighton, epidemiologist, MDPH. Case #1 14 y/o male. Attends 8 grade Collins Middle School. Cough Onset: 5/24 New York City Trip 5/30 Pertussis Alert letters mailed to all Middle School Students. Contact letter sent to NY trip students, chaperones. Hotel roomates were notified by letter and phone calls to parents. Bus company notified. 12 family and close friend contacts. Case #2 15 y/o male. Attends 8 grade CMS. Cough Onset: 4/28. Attended New York trip. 13 family and friend contacts. Roommates notified. • ��MINE SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel: (978) 741-1800 Fax: (978)740-9705 Public Health Nurse Report July 2001 Activities Disease Prevention • • In touch with T.B. Clinic and following active cases and case contacts. • Vaccine inventory maintained and distributed. • Investigated communicable disease cases and reported to the M.D.P.H Meetings and Clinics. 7/19 2nd Hepatitis B Clinic for North Shore Ambulance employees. St. Joseph's • Summer Vacation Phoenix School • Summer Vacation i • MONTHLY REPORT OF COMMUNICABLE DISEASES JULY 2001 DISEASE: NEW CARRY OVER DISCHARGED REPORT TO CASES CASES CASES: STATE: Campylobacter 0 0 0 0 • Giardia 0 0 0 0 E.Coli 0157H7 0 0 0 G Hepatitis 1 5 0 0 Lyme Disease 0 0 0 0 Meningitis 1 0 0 0 Pertussis 3 0 3 3 Salmonella 0 0 0 0 Shigella 0 0 0 0 Varicella 0 0 0 0 Reportable Diseases excluded from above have not been identified this • month. • Summary of Communicable Disease for July 2001 Hepatitis B: One case. Letter sent to M.D. Meningitis: One case. CDPtococcal meningitis. CryPtococci fungi is not transmittable person to person. According to MDPH Guide to P P g Surveillance and Reporting, Cryptococcal infection can be acquired worldwide and is reported to occur in 5% to 10% of adults with HIV • infection. Pertussis: 3 cases. Case #1 14 y/o female. 81h grade CMS. Cough nn set S/31 Softball team mates notified by phone. Tournament team: Pertussis Alert letter mailed. 39 Close contacts. Case #2 14 y/o male. 811, grade CMS. Cough onset: 6/5/01 This case was a symptomatic contact of June case #2. He was tested, and was positive. He did not attend New York trip. 6 close contacts notified. Case #3 14 y/o female. 8th grade CMS. Cough Onset: 6/25/01 Child attended Camp Rotary, a residential camp in Boxford from 6/23/01 to 7/14/01. Camp nurse, and camp director notified. Elissa Leighton, epidemiologist, MDPH notified. All contacts were notified by camp nurse Sharon Weaver. Alert letter and contact letters sent to camp. Family contacts refused to take antibiotics. Elissa Leighton notified. Streptococcal Pneumoniae: 4 y/o male. Also diagnosed with Mononucleosis, and Pneumococcal Pneumonia. Reported to Elissa • Leighton, MDPH. Child was admitted to MGH, recovered. The Commonwealth of Massachusetts Executive Office of Health and Human Services • �� Department of Public Health t r State Laboratory Institute 4 � 305 South Street, Jamaica Plain, MA 02130 ` BUREAU OF COMMUNICABLE DISEASE CONTROL S"k,j JANE SWIFT ® � GOVERNOR !�, WIILIAM D.O'LEARY ," SECRETARY Al 27 e. HOWARD K.KOH,MD,MPH COMMISSIONER GI'�'1 TH OEQTx TO: Boards of Health, and Other Interested Parties µEA- FROM: Ralph Timperi, Assistant Commissioner, Mass. Department of Public Health DATE: July 26, 2001 RE: Arbovirus Surveillance Weekly Reports Attached please find a weekly summary report for avian West Nile virus (WNV)testing for the 2001 arbovirus surveillance season. This avian surveillance report includes the test results for July 15, 2001 • to July 21,2001. This report contains the testing status for birds submitted during this period and for birds with prior pending test results. In addition,test results are posted each weekday to the MDPH WNV website, www.state.ma.us/dph/wnv/wnvl.htm. Positive test results are reported immediately to the Board of Health by telephone or other direct means of communication(as previously indicated by each Board of Health). While the reports on the website indicate location at the town level only,reports provided to Boards of Health will indicate the specific locations of the birds. Weekly mosquito surveillance reports are also posted on the website. Please note that the format of the weekly report has changed. Each town will receive results only.for birds submitted by that town. If specific avian address information is needed for neighboring towns, it is recommended that you contact the Boards of Health in those towns directly. The data contained in the weekly reports include: 1)city/town in which the bird was found;2)street or other specific address nearest to where the bird was found; 3)case number generated for each submitted bird;4)bird species as reported or identified upon receipt; 5)date when the bird was found (assumed to be the date of death); 6)date received at the State Laboratory Institute and 7)status..The status will indicate one of the following: a)positive(when WNV is identified); b)negative(when WNV is not identified); c)unsatisfactory(when the specimen is decomposed)and d)test results pending(when the specimen was received too late to complete testing before the weekly report was issued). If positive birds are identified in your town, it is recommended that you notify other appropriate officials in your town(for example,Animal Control Officers). Remember,bird deaths can be reported to the toll-free number at SLI, 1-866-MASS WNV(1-866- 627-7968);this toll-free information line can also be called for medical and general information. • Birds Submitted for West Nile Virus Testing from July 15 to July 21 Created on 7/26/01 City ! Address Case # Bird Species- _ Death Date— - Date Recd - Lab Id. _j _Status --- -------- Salem 7 Cleveland St _ 1830 Crow - 7/20/01 7/20/01 ZLO1 00516 Negative Salem Count 1 - The Commonwealth of Massachusetts Executive Office of Health and Human Services • Department of Public Health 250 Washington Street, Boston, MA.02108-4619 JANE SWIFT GOVERNOR WILLIAM D.O'LEARY SECRETARY HOWA M0,MPH CO COMMM ISSIOSSIO NER juN 1 4 2001 MEMORANDUM CITY OF SALEM HEALTH DEPT. TO: Executive Offices State Authorities FROM: Howard K. Koh,M.D., MPH Commissioner of Public Health RE: Regulation of State Facilities Under the State Sanitary Code • DATE: June 7, 2001 As you may know,the Department of Public Health("Department") is authorized,by G.L. c. 111, § 127A,to promulgate the State Sanitary Code which contains standards for certain activities (such as residential housing, including lead paint; swimming pools; recreational camps for children; food establishments; bathing beaches; family type camp grounds; and indoor skating rinks). Primary enforcement authority is placed with local boards of health. In response to a request from the Department concerning the authority of local boards of health to enforce the State Sanitary Code against state owned facilities, the Office of the Attorney General recently issued an opinion. While the opinion focused primarily on facilities at the University of Massachusetts, it concluded that the Commonwealth and its agencies are exempt from the State Sanitary Code and that local boards of health do not possess enforcement authority over state facilities. (A copy of the opinion is attached). The language of the opinion is broad enough to also conclude that the Department also has no authority to enforce the Sanitary Code against the Commonwealth and its agencies. We also conclude from the opinion that programs operated by private vendors or private programs leasing space from the Commonwealth are obligated to comply with the State Sanitary Code and local boards of health retain the authority to enforce against such vendors or programs. As the opinion points out,there is nothing to prevent officials in charge of state facilities from • voluntarily complying with the provisions of the Sanitary Code. In the past,the Department and local boards of health have worked cooperatively with many state agencies to achieve compliance wim THE COMMONWEALTH OF MASSAQHUSETTS; OFFICE OF THE ATTORNEY GENERAL ONE ASHBURTON PLACE BOSTON, MASSACHUSETTS 02108-1698 TOM REILLY ATTORNEY GENERAL (617)727-2200 No. 00/01-2 April 25, 2001 Howard W. Koh, MD, MPH Commissioner Department of Pu b lic Health 250 Washington Street Boston,MA 02108-4619 Dear Commissioner Koh: You have requested an opinion on whether local boards of health have jurisdiction to enforce the provisions-of the State Sanitary Code against state-owned facilities, indicating that your request was prompted by local boards' efforts to inspect swimming pools located at facilities of the University of Massachusetts. Consistent with the conclusions reached in a long line of Attorney General opinions, including one issued to the Secretary of Public Safety on October 30, 2000, I conclude that the Commonwealth and its agencies are exempt from G.L. c. 111, § 127A, the statute authorizing the Department of Public Health to promulgate the Sanitary Code, and that local boards of health do not possess enforcement authority over property owned by the University of Massachusetts with respect to the provisions of the Sanitary Code. I recognize, of course, the importance of ensuring that facilities owned by the Commonwealth or its agencies are maintained in a manner that protects the health and well-being of the public. Nothing in my conclusion would prevent the officials in control of such facilities from t� • responsibility." Id. Local boards of health "shall enforce said code in the same inaiv,u, ii, wmcn local health rules and regulations are enforced,but, if any such local boards fail after the lapse of a reasonable length of time to enforce the same, the department may in like manner enforce said code against any violator." Id. As noted above, several prior Attorney General opinions conclude that, absent a clear legislative directive to the contrary, the Commonwealth is to be considered exempt from a cable regulation promulgated.under the authority of statutes enacted b the generally apple �u r � y Y Legislature in the exercise of its police powers. See 2000 Op. Att'y Gen. No. 1 (Oct.30, 2000) (concluding that the State Fire Code promulgated under G.L. c. 148 does not apply to state- owned buildings) and opinions cited therein! This rule is closely related to the rule that the Commonwealth cannot be sued in its own courts except in strict accordance with statute. In that context also,"[t]he rules of construction governing statutory waivers of sovereign immunity are stringent. . . . Consent to suit must be expressed by the terms of a statute,or appear by necessary implication from them." Woodbridge v. Worcester State Hospital,384 Mass. 38,42 (1981); accord C &M Construction Co. v. Commonwealth, 396 Mass. 390, 392 (1985); see also Onoffio v. Department of Mental Health,411 Mass. 657, 659 (1992) (holding statute that waives public employers' exemption from liability,bars prejudgment interest, and is silent on.postjudgment interest does not permit award of postjudgment interest by necessary implication, given that such interest is not an element of damages). As with the doctrine to Waive of sovereign immunity, although the Legislature may 1 2 This principle does not apply to municipalities. See , 1965/66 Op. Att'y Gen. No. 12, Rep. A.G.,P.D.No. 12 at 361 (1966) (concluding that State Sanitary Code applies to public school cafeterias,where neither the statute nor,the Code exempts schools or cafeterias). • 3 implied where it is not present.") (internal quotation omitted). In marked contrast to Section 127A, Section 142E of G.L. c. I I I contains an express waiver of the Commonwealth's exemption from public health regulation. In Perez v. Boston Housing Authority, 368 Mass. at 338-39, the Supreme Judicial Court compared Sections 142E and 127N of G.L. c. H 1. With reference to air pollution control regulations promulgated pursuant to Section 142E of the statute, the Court stated that"when the Legislature did in fact determine to apply public health regulations, enacted pursuant to G.L. c. 111, to State agencies as well as other entities, it expanded the coverage . . . to include `[a]ll departments, agencies, commissions, authorities and political subdivisions."'Ld. at 338-39. By its terms, Section 142E creates a regulatory scheme that"is universally applicable to private and public entities." Cijy of Boston v. Massachusetts Port Authority, 364 Mass. 639, 658 (1974). The air pollution control • regulations are thus"enforceable against public bodies to the same extent that they are enforceable against individuals and private businesses." Id. at 653.4 Similarly, Section 150A of G.L. c. I I I contains an express waiver of the Commonwealth's exemption from regulation. In the context of the state-wide regulation of the siting of solid waste disposal facilities, the Legislature specified that the procedures regarding the Department of Environmental Protection's oversight of the location and operation of such facilities are applicable to facilities"owned or operated by an agency of the commonwealth." G.L. c. 111, § 150A. In like manner, G.L. c. 143, the statute that authorizes the promulgation and enforcement of a state-wide building code, contains an explicit waiver of the Commonwealth's 4 In particular,such regulations apply to the Port Authority given that the statute expressly includes authorities within its terms. Id. at 653, 657. • 5 relevant state agency as to state-owned property, while providing for local enforcement as to all other property, so as to avoid the potential for local interference with state work. For example, G.L. c. 143 vests inspectors in the Division of Inspections of the Department of Public Safety with authority to enforce the state building code as to buildings "owned by the commonwealth or any departments, commissions, agencies or authorities of the commonwealth,"while the statute vests local inspectors with authority to enforce the code as to all other buildings. G.L. c. 143, § 3A. Similarly, Section 150A of G.L. c. 111 vests the Department of Public Health with authority to determine whether to assign as a site for a solid waste disposal facility a place owned or operated by an agency of the Commonwealth,while the statute vests local boards of health with authority to make such determinations for any other place. Id. Local boards of health have primary responsibility for enforcing the Sanitary Code under G.L. c. 111, § 127A. The potential for local interference with state work is one of the grounds on which Massachusetts courts have found the Commonwealth and its agencies to be exempt from proscriptions set forth in a generally applicable statute enacted by the Legislature in the exercise of its police powers, absent explicit legislative directive to the contrary. See, e.g., Inspector of Buildings of Salem v. Salem State College, 28 Mass.App. Ct. at 97. It is significant in this regard that the University's enabling statute prevents interference with the Board of Trustees, in exercising its statutory authority to manage the University's affairs, from being"subject to, or superseded by,"state agencies or departments." G.L. c. 75, § 1. In light of that provision, it would be anomalous to suppose that the Legislature intended to subject the University to local • 7 AGENT'S NEWSLETTER TO THE BOARD VOLUME 67 June 12, 2001 MAYOR'S REQUEST The Mayor is receiving complaints weekly from restaurant/bar owners about the smoking ban. John Keenan has asked, on behalf of the Mayor, that the Board consider amending its regulation to allow smoking in establishments after a particular time of night, 10 PM for example. NEW LOCATION! We are unpacked and conducting business in our new space. The office is clean, bright, and professional. Our staff is happy here. We may be having a bit of a problem with our phones. If you call and no one answers please hang up and try again. We think some of our calls are being shunted into oblivion! We will offer a tour after our meeting on Tuesday. Jeff did a fabulous job organizing the move and Tracy led the way in packing! FY 2002 BUDGET Enclosed in the packet is the Mayor's 2001 Budget for the Board of Health. This will be submitted to the City Council for approval. The very good news is that no positions were cut. The Expenses portion has been cut significantly in some areas such as the Housing-San line item, down by $1000. Other areas were increased such as the furniture line item, although down from our request, up $500 over last year. The final step is the Council review and, I hope, approval without additional cuts. WEST NILE VIRUS Enclosed in the packet is the West Nile Virus Plan for your vote. Councillor Driscoll did call with a concern from a constituent regarding the effect of the larvicide used in storm drains on lobsters. I am discussing this with Walter Montgomery and will give you more information on Tuesday. SMOKING REGULATION I spoke with Cheryl Sbarra, MAHB attorney, regarding some of the changes in our regulation. Suggested wording is in the packet. Getty Gas has requested a hearing regarding its violation of selling cigarettes to a minor, for which it was fined. We have also requested that two other establishments appear before the Board for failure to pay a similar fine. THE SANITARIAN'S POSITION Four people will be in to interview with the Board for the open Sanitarian's position. The resumes are in the packet. WARD FOUR NEIGHBORHOOD ASSOCIATION The draft"Public Involvement Plan"for the Walgreen's site is in the packet. I have been working with this neighborhood group, progressing through the DEP's mechanism for public notification and input. • HOUSEHOLD HAZARDOUS WASTE DAY Household Hazardous Waste Day is scheduled for June 301h, from 8 AM to 1 PM. *************ANNUAL SAINDON BOARD OF HEALTH COO K-O UT************** Save the date: Saturday, August 18t'! F '^A t eoND m 3 � CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel: (978)741-1800 Fax:(978)740-9705 Public Health Nurse Report May 2001 Activities Disease Prevention • In touch with T.S. Clinic and following active cases and case contacts. • Vaccine inventory maintained and distributed. • Investigated communicable disease cases and reported to the M.D.P.H Meetings and Clinics • 5/2 Attended Rabies seminar at Beverly Hospital with Joanne Scott, • and Animal Control Officer Donald Famico Continuing Education: • Attending Salem State College Part time Evening Program. Statistics completed. 5/17 Enrolled in Sociology course, Monday and Wednesday 6:30 p.m. to 9:30 p.m. St. Joseph's • Hearing and vision has begun. Grades K-8 are completed. Phoenix School • Hearing and vision K-8 completed. MOVE Preparing for move throughout the month of May. All medical documents were disposed of in compliance with the Retention Schedule. All confidential materials were shredded. • 7 3 � CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel: (978)741-1800 Fax: (978)740-9705 MONTHLY REPORT OF COMMUNICABLE DISEASES MAY 2001 DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES CASES CASES: STATE: Campylobacter 0 0 0 0 • Giardia 1 0 1 1 E.Coli 0157H7 0 0 0 0 Hepatitis 1 2 1 1 Lyme Disease 0 0 0 0 Meningitis 0 0 0 0 Pertussis 0 0 0 0 Salmonella 1 0 1 1 Shigella 0 0 0 0 Varicella 0 0 0 0 Reportable Diseases excluded from above have not been identified this • month. CONDIT CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel: (978)741-1800 Fax: (978)740-9705 Summary for Communicable Diseases May 2001 Giardia: Traveled to a Ski Resort. She drank water out of a stream, while cross country skiing. Non-Foodhandler. Hepatitis: One case of chronic Hepatitis B reported. • Salmonella: 55 y/o male. Culture obtained from Pancreatic Psuedocyst. Spoke to M.D., and epidemiologist Mike McGuill. • re. SEA1 AND ADJUSTMENT RECORD n; Fees and adjusting charges authonzeti by Sectioh 56 G.L.,-Chapter'98_as amended by Ci 338,AcE:of 1982.k Legal. A DEVICE sealing: Adjusted Sdaled - Not Sealed Condemned -'.-Charges ::Over 10,000 lbs 100.00 t. _ e�J 5,000 to 10,000 Ibs 45.00 r .' V J 1,000 to 5,000 Ibs 30.00 � �?�.z'a 100 to 1,000 Ibs. 20.00 8 /G 0 00 MORE THAN 10 LBS LESS THAN 100 LBS 10.00 m 10 Ibs.or less 5.00 f ,,Avoirdupois.. (Each) 1.00 �ro = .Metric (Each) 1.00 "`s"•.:0.Apothecary (Each) 1.00 - �:r .Troy (Each) 1.00 r , VencleTanks ` Eachlndicator' 10:00 >-w Each 0 Gals or: Fract4 Thereof 5.00 ra a cn. a. a ww Ligd U I.-Gallon or less- 2.00 `�" More.than 1 Gal(on 2.00 161ei1/2;orles f . Grease 6.00 fNetMore than:l/2 61" w GasolineT5:40 �'�' S?1Mex .r « ka� }nlAtmorethan1. �. �w w Vehicle Tank Pump x. 30.00 Vehicle,Tank.Gravlty 30.00 F -i BulkStorage Y;` '60.00 �{r Company Supplies Prover 30.00 k= a, Each Stop On Pump 2.00 'F E 'Taxi Meters ' 25.00, a to Odometer-Hubodometer 20.00 =V Leather.Meas(Semi an.)- _ 10.00 D,W Fabric;Measuring: 10.00 ; re-Rope-Cordage 10.00 :Wi "•Yard Sticks 3.00 Z'Q . }"y :La Tapes 3.00 i V .Milk Jars(per.gross) 25.00 Dry Measures_ 1.00 t'r Adlustmg Repairs Special Facddies .10.00 Charges yu l his is•to cerdty that L habe this day tested,adjusted sealed or gonde[nned the above described device in com p liance with the _ G L C(lapter 98 as most receritly amended.. . Inspector Sealer of W6ights and Measures Date a Salem Board of Health to May Phone Logs 2001 Total Answered Answered Calls Tuesday May 1, 2001 48 Barb = 146 Wednesday May 2, 2001 49 Mary = 341 Thursday May 3, 2001 53 Sue = 552 Friday May 4, 2001 36 Saturday May 5, 2001 Sunday May 6, 2001 Calls Taken Monday May 7, 2001 77 Tuesday May 8, 2001 54 Joanne = 285 Wednesday May 9, 2001 39 Jeffrey = 164 Thursday May 10, 2001 55 1 Mark = 20 Friday May 11, 2001 40 Jose = 56 Saturday May 12, 2001 Pablo = 14 Sunday May 13, 2001 Tracy = 98 onday May 14, 2001 46 Ginny = 46 Tuesday May 15, 2001 38 Barb = 59 Wednesday May 16, 2001 49 Mary = 140 Thursday May 17, 2001 19 Sue = 157 Friday May 18, 2001 28 Saturday May 19, 2001 Sunday May 20, 2001 43 Office Hours Per Week Monday May 21, 2001 54 !1 * =22 Work Days Tuesday May 22, 2001 54 Wednesday May 23, 2001 43 Monday 8-4 Thursday May 24, 2001 47 Tuesday 8-4 Friday May 25, 2001 38 Wednesday 8-4 Saturday May 26, 2001 Thursday 8-7 Sunday May 27, 2001 Frid. 8-4 Monday May 28, 2001 Holiday Tuesday May 29, 2001 58 Wednesday I May 30, 2001 51 Thursday May 31, 2001 E1d Total Calls *_ 1039 City Of Salem • Environmental Health Division --- Inspection Monthly Summary Month ------------------------------------------------------------------------------ Type Aug 00 Sep 00 Oct 00 Nov 00 Dec 00 Jan 01 Feb 01 Mar 01 Apr 01 May 01 Count ----- ------ ------ ------ ------ ------ ---- ------ ------ ------ ------ ---- CFI 70 66 49 77 50 41 70 35 58 66 582 CFR 4 2 1 0 1 1 3 0 0 0 12 CH 6 3 3 3 6 6 8 8 5 6 54 CON 10 5 8 0 0 6 2 4 4 3 42 CR 10 2 3 15 7 2 7 6 3 0 55 CT 2 3 4 2 1 1 1 2 1 2 19 EC 19 11 2 3 2 2 5 3 0 5 52 EPR 1 3 2 1 0 0 0 0 1 2 10 FC 0 1 3 3 4 2 3 1 1 5 23 FRH 3 2 0 3 1 0 1 2 1 1 14 FSD 10 6 6 4 3 3 6 7 2 5 52 FSI 24 18 20 36 9 16 31 33 23 17 227 FSR 12 16 7 11 11 8 13 17 14 15 124 GN 9 4 12 4 4 1 3 3 4 3 47 HI 46 10 7 13 8 7 9 8 53 79 240 HR 14 14 10 9 39 5 7 15 9 6 128 LPI 2 0 0 0 0 0 2 0 0 1 5 MS 1 0 1 0 0 0 1 0 0 1 4 MT 16 14 12 15 3 17 9 12 6 11 115 MUP 1 6 0 0 0 0 2 0 0 4 13 MW 4 0 0 13 3 7 2 4 2 0 35 OG 2 4 2 1 0 1 0 0 0 2 12 S 0 0 0 0 0 0 0 1 0 0 1 *-R-FR FI 9 8 5 7 1 5 7 6 1 3 52 3 4 2 2 1 3 7 1 1 1 25 RO 5 0 0 0 2 4 5 3 3 3 25 SB 74 15 0 0 0 0 0 0 0 0 89 SC 0 0 0 0 0 0 0 4 0 0 4 SM 2 2 0 0 1 0 0 1 1 0 7 SP 2 0 0 0 0 0 0 0 0 6 8 ST 1 4 0 0 0 0 0 0 0 0 5 TFI 14 0 53 0 0 0 0 0 0 0 67 TR 58 34 31 25 13 34 18 13 39 70 335 WM 0 6 15 0 0 0 0 0 0 0 21 Count 434 263 258 247 170 172 222 189 232 317 2504 Tr++ City of Salem, Massachusett Environmental Health Division Inspection Input Form Inspect Date : Estab Name or Owner Name : Type : Location: Inspector: Inspection Types BP - Body Piercing FSI - Food Serv. Ins . 892* RFD - Ret .Food Disc . 6* CFI - Cert . Fit . 822* FSR - Food Serv. Rein. 194* RFI - Ret . Insp. 75* CFR - Cert . Fit .Reinsp105*GN Gen. Nuisance 41* RFR - Ret . Food Rein34* - Court Hearing 93* HI - Housing Insp. 260* RO - Rodent Control 16* N - Constable Serv. 65* HR - Housing Reinsp. 135* SC _ Suntan 7* R - Compliance Rev. 25* LPI - Lead Paint Insp. 6* SES SESD Odor 0* CT Computer Time10* MS - Massage 6* SM - Seminars 36* EC - Envirn. Compl . 51* MW - Mark/Weights SP - Swim. Pools 16* EPR - Ext . Paint 95* MUP - Mobile Food Insp. 11* SB - Swim. Beaches 65* FC - Food Compl . 17* OS - Off . Sub. Insp. 6* ST - Soil/Septic 8* FRH - Food Hearings15* RC - Rec Camps 9* TFI - Temp. Food 112* FSD - Food Serv. Disc 53* MT - Meetings 65* TR - Trash 381* Ii AGENT'S NEWSLETTER TO THE BOARD VOLUME 66 May 8,2001 FY 2002 BUDGET There is a department head meeting scheduled for '18tn to discuss the budget. I haven't had an individual meeting with the Mayor. I will keep you updated. WEST NILE VIRUS Our public hearing will take place on the night of the meeting at 7:30 pm. Walter Montgomery, Superintendent of the Northeast Massachusetts Mosquito Control and Wetlands Management District,will be at the hearing to present the plan and answer any questions the public or Board members may have. We ran an ad in the Salem Evening News regarding the public hearing and offered the proposed plan. There were no responses so we may not have a large turnout for the hearing. SMOKING REGULATION The owner of Major Magleashe's was issued a fine letter following a compliance check that indicated that there were three patrons smoking, or about to smoke, in the establishment. The owner, Philip Shea, has requested a hearing before the Board to appeal the fine. Staff from the Tobacco Control Program will also be at the meeting. There have been some complaints that a few establishments are allowing smoking in their establishments later in the evening when there is little food service. The staff of the Tobacco • Control Program may be missing these violations because they are checking earlier in the evening. The Board could discuss inspection schedules with Joyce Redford, Director of the North Shore Tobacco Control Program,who will be at the meeting. There has been some discussion and rumor regarding the financial benefit for an establishment to disregard the regulation and pay the fine. 1 had a discussion with Cheryl Sbarra regarding this issue. She said we could amend the regulation to tie it into the issuance of a food establishment permit. Or, perhaps more simply, if there is an establishment that chronically violates the regulation,we could seek an injunctive order from Superior Court. If that order were violated the owner would be subject to extensive penalties and arrest. Attorneys from CAST, including Cheryl Sbarra, Howard Saxner, and Ed Sweeda, reviewed our regulation. They have suggested some changes that would clarify the regulation and make enforcement in court easier. Those proposed changes are written on the enclosed regulation. They do not think a public hearing is necessary or advised for these changes since the intent of the regulation is not altered. THE SANITARIAN'S POSITION There was some delay in posting the Sanitarian's position. However, it has been posted in the City and ads will run this Sunday in the Boston Globe and over the next few days in the Salem Evening News. I will also broadcast the position on the Mass Health Officers website. THE MOVE The staff has been doing an exemplary job of cleaning house in preparation for our move. By following the State's Record Retention Law,we have been able to discard a large amount of material. The projected date for the move has been changed to May 17cn WARD FOUR NEIGHBORHOOD ASSOCIATION This group continues to meet with the Licensed Site Professional working at the • Walgreen's location on Boston Street to remediate-some hazardous waste conditions that still exist there. The group asks me to attend the meetings. It has been an interesting and educational process because this site has been officially designated a"Public Involvement Plan" site. With the neighbors, I have learned the steps to have a lot, under DEP jurisdiction, 5 designated as a PIP. Board of Health Administration Monthly Report Apr-01 Biologics Distributed * Amount in Doses Diptheria, Tetanus&Pertussis = 165 Burial Permits @ $5.00 $345.00 Diptheria,Tetanus Tox.(under 6 yrs)= 20 Licenses & Permits(+copies) $375.00 Immune Serum Globulin= 0 Certificate of Fitness@$25.00 $1,325.00 Measles/Mumps/Rubella= 100 Sealer Weights/Measures= $170.00 Polio= 180 Fines $0.00 Tetanus & Diptheria (adult use)= 140 Total Monies Collected $2,215.00 Tuberculin PPD= 0 Total Monies Year to Date 38,899.80 HIB Titre= 128 Animal Bites Reported=F 2 Hepatitis B= 160 PPV 23 15 PCV 7 315 Annual Budget Expenses Available Balance Salary/Longevity $354,033.00 $284,864.34 $.69,168.66 Annual Budget Expenses Encumbered Available Balance Non-Personnel $20,023.00 $13,768.86 $1,466.59 $4,787.55 F9' • AGENT'S NEWSLETTER TO THE BOARD VOLUME 66 May 8,2001 FY 2002 BUDGET There is a department head meeting scheduled for April 18th to discuss the budget. I haven't had an individual meeting with the Mayor. I will keep you updated. WEST NILE VIRUS Our public hearing will take place on the night of the meeting at 7:30 pm. Walter Montgomery, Superintendent of the Northeast Massachusetts Mosquito Control and Wetlands Management District,will be at the hearing to present the plan and answer any questions the public or Board members may have. We ran an ad in the Salem Evening News regarding the public hearing and offered the proposed plan. There were no responses so we may not have a large turnout for the hearing. SMOKING REGULATION The owner of Major Magleashe's was issued a fine letter following a compliance check that indicated that there were three patrons smoking, or about to smoke, in the establishment. The owner, Philip Shea, has requested a hearing before the Board to appeal the fine. Staff from the Tobacco Control Program will also be at the meeting. There have been some complaints that a few establishments are allowing smoking in their establishments later in the evening when there is little food service. The staff of the Tobacco • Control Program may be missing these violations because they are checking earlier in the evening. The Board could discuss inspection schedules with Joyce Redford, Director of the North Shore Tobacco Control Program,who will be at the meeting. There has been some discussion and rumor regarding the financial benefit for an establishment to disregard the regulation and pay the fine. I had a discussion with Cheryl Sbarra regarding this issue. She said we could amend the regulation to tie it into the issuance of a food establishment permit. Or, perhaps more simply, if there is an establishment that chronically violates the regulation,we could seek an injunctive order from Superior Court. If that order were violated the owner would be subject to extensive penalties and arrest. Attorneys from CAST, including Cheryl Sbarra, Howard Saxner, and Ed Sweeda, reviewed our regulation. They have suggested some changes that would clarify the regulation and make enforcement in court easier. Those proposed changes are written on the enclosed regulation. They do not think a public hearing is necessary or advised for these changes since the intent of the regulation is not altered. THE SANITARIAN'S POSITION There was some delay in posting the Sanitarian's position. However, it has been posted in the City and ads will run this Sunday in the Boston Globe and over the next few days in the Salem Evening News. I will also broadcast the position on the Mass Health Officers website. THE MOVE The staff has been doing an exemplary job of cleaning house in preparation for our move. By following the State's Record Retention Law,we have been able to discard a large amount of material. The projected date for the move has been changed to May 17tn WARD FOUR NEIGHBORHOOD ASSOCIATION This group continues to meet with the Licensed Site Professional working at the Walgreen's location on Boston Street to remediate-some hazardous waste conditions that still exist there. The group asks me to attend the meetings. It has been an interesting and educational process because this site has been officially designated a"Public Involvement Plan" site. With the neighbors, I have learned the steps to have a lot, under DEP jurisdiction, designated as a PIP. Salem Board of Health April Phone Log 2001 • Total Answered AnsweredC Cal ls Sunday April 1, 2001 Barb = 229 Monday April 2, 2001 65 Mary= 341 Tuesday April 3, 2001 68 Sue= 313 Wednesday April 4, 2001 38 *= 883 Thursday April 5, 2001 1 43 Friday April 6, 2001 41 *Calls Taken Saturday April 7, 2001 Sunday April 8, 2001 Joanne = 229 Monday April 9, 2001 54 Jeffrey = 120 Tuesday April 10, 2001 50 Mark = 26 Wednesday April 11, 2001 34 Jose = 53 Thursday April 12, 2001 29 Pablo = 15 Friday April 13, 2001 6 (Close 11:30) Tracy = 112 Saturday April 14, 2001 Ginny = 51_ Sunday April 15, 2001 Barb = 82 • Monday April 16, 2001 Holiday Mary = 129 Tuesday April 17, 2001 37 Sue = 96 Wednesday April 18, 2001 51 Thursday April 19, 2001 62 Friday April 20, 2001 49 43 Office Hours Per Week Saturday April 21, 2001 *=19 Work Days Sunday April 22, 2001 35 Hour Work Week Monday April 23, 2001 71 Tuesday April 24, 2001 39 Wednesday April 25, 2001 38 Monday 8-4 Thursday April 26, 2001 1 47 Tuesday 8-4 Friday April 27, 2001 21 Wednesday 8-4 Saturday April 28, 2001 Thursday 8-7 Sunday April 29, 2001 Frid. 8-4 Monday April 30, 2001 40 • Total = 1 883 �OND(T 9 , . CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax: (978)740-9705 Public Health Nurse Report April 2001 Activities Disease Prevention • In touch with T.B. Clinic and following active cases and case contacts. • Vaccine inventory maintained and distributed. • Investigated communicable disease cases and reported to the M.D.P.H Meetings and Clinics 4/8 Wellness Fair. Approx. 2000 attended. 100 Exhibitors. Car Seat Safety check: 40 car seats evaluated. Beverly Board of Health would like to join the North Shore Wellness Committee in 2002 • 4/10 Attended West Nile Virus seminar at Holy Cross with Joanne. 4/11 Attended Health Advisory Council meeting at Salem High. Discussion included Grant updates, Teen Parent Program. • 4/23 Photo Eye Screenings held at Saltonstall Elementary. 16 Children screened. No referrals necessary. • Preparing for move! Continuing Education: • Attending Salem State College Part time Evening Program. Literature 1 Course completed. • 1/17 Enrolled in Statistics course Wednesdays, 7-9:20 p.m. St. Joseph's • Hearing and vision has begun. Grades K-5 are completed. Phoenix School • Hearing and vision will begin when St. Joe's is completed. • y • MONTHLY REPORT OF COMMUNICABLE DISEASES APRIL 2001 DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES: CASES: CASES: STATE: Campylobacter 0 0 0 0 • Giardia 0 0 0 0 E.Coli 0157H7 0 0 0 0 Hepatitis 3 0 1 1 Lyme Disease 0 0 0 0 Meningitis 0 0 0 0 Pertussis 1 0 1 1 Salmonella 0 0 0 0 Shigella 0 0 0 0 Varicella 0 0 0 0 Reportable Diseases excluded from above have not been identified this • month. =1 • Summary of Communicable Diseases for April 2001 Pertussis: 16 y/o female. Attends Salem High School. Cough onset was January 10th. 18 close contacts were notified. All contacts received prophylaxis. 4 contacts were symptomatic, and tested. Of the 4 tested, all results were negative. Employer notified. Pertussis Alert sheets were distributed to all high school students, and place of employment. School nurse will monitor for cough illnesses. s Hepatitis A: 64 y/o non-foodhandler. This case was asymptomatic. Nurse practitioner believes it may be a false postitive result. She will retest. Employed at Laundry. She handles dirty clothes and sheets. Does not eat out. Lives alone. Brother lives upstairs. He was notified to see physician for gamma globulin because he sometimes uses cases kitchen. He refused. Public Health Fact Sheet sent to both persons. Hepatitis C: One case. Letter sent to M.D. Hepatitis B: One case Hepatitis B. Letter sent to M.D. • } xrosr w'" e City Of Salem • Environmental Health Division --- Inspection Monthly Summary Month ---------------------------------------------------------------------- Type Aug 00 Sep 00 Oct 00 Nov 00 Dec 00 Jan 01 Feb 01 Mar 01 Apr 01 Count CFI 70 66 49 77 50 41 70 35 58 516 CFR 4 2 1 0 1 1 3 0 0 12 CH 6 3 3 3 6 6 8 8 5 48 CON 10 5 8 0 0 6 2 4 4 39 CR 10 2 3 15 7 2 7 6 3 55 CT 2 3 4 2 1 1 1 2 1 17 EC 19 11 2 3 2 2 5 3 0 47 EPR 1 3 2 1 0 0 0 0 1 8 FC 0 1 3 3 4 2 3 1 1 18 FRH 3 2 0 3 1 0 1 2 1 13 FSD 10 6 6 4 3 3 6 7 2 47 FSI 24 18 20 36 9 16 31 33 23 210 FSR 12 16 7 11 11 8 13 17 14 109 GN 9 4 12 4 4 1 3 3 4 44 HI 46 10 7 13 8 7 9 8 53 161 HR 14 14 10 9 39 5 7 15 9 122 LPI 2 0 0 0 0 0 2 0 0 4 MS 1 0 1 0 0 0 1 0 0 3 MT 16 14 12 15 3 17 9 12 6 104 MUP 1 6 0 0 0 0 2 0 0 9 MW 4 0 0 13 3 7 2 4 2 35 OG 2 4 2 1 0 1 0 0 0 10 OS 0 0 0 0 0 0 0 1 0 1 I 9 8 5 7 1 5 7 6 1 49 FR 3 4 2 2 1 3 7 1 1 24 RO 5 0 0 0 2 4 5 3 3 22 SB 74 15 0 0 0 0 0 0 0 89 SC 0 0 0 0 0 0 0 4 0 4 SM 2 2 0 0 1 0 0 1 1 7 Sp 2 0 0 0 0 0 0 0 0 2 ST 1 4 0 0 0 0 0 0 0 5 TFI 14 0 53 0 0 0 0 0 0 67 I TR 58 34 31 25 13 34 18 13 39 265 WM 0 6 15 0 0 0 0 0 0 21 Count 434 263 258 247 170 172 222 189 232 2187 ++-+ City- of Salem, Massachusett Environmental Health Division Inspection Input Form Inspect Date: Estab Name or Owner Name : Type : Location: Inspector: Inspection Types BP - Body Piercing FSI - Food Serv. Ins . 892* RFD - Ret .Food Disc. 6* CFI - Cert . Fit . 822* FSR - Food Serv. Rein. 194* RFI - Ret . Insp. 75* CFR - Cert . Fit .Reinsp105*GN Gen. Nuisance 41* RFR - Ret . Food Rein34* CH - Court Hearing 93* HI - Housing Insp. 260* RO - Rodent Control 16* - Constable Serv. 65* HR - Housing Reinsp. 135* SC - Suntan 7* Compliance Rev. 25* LPI - Lead 'Paint Insp. 6* SES - SESD Odor 0* CT Computer Time10* MS —Massage 6* SM - Seminars 36* EC - Envirn. Compl . 51* MW - Mark/Weights SP - Swim. Pools 16* EPR - Ext . Paint 95* MUP - Mobile Food Insp. 11* SB - Swim. Beaches 65* FC - Food Compl . 17* OS - Off . Sub. Insp. 6* ST - Soil/Septic 8* FRH - Food Hearings15* RC - Rec Camps 9* TFI - Temp. Food 112* FSD - Food Serv. Disc 53* MT - Meetings 65* TR - Trash 381* t z•�`f �KF,F•`F.?'y SYR'}Se,+i'a4'+l�l��a� iN t�i�g ,.n. -+�..d,. a. t s - a t'v �,►5 Y�F� t,� ryl� pia>€i M1r ,. '$ n � �i'°1^ �c �g 5 e yJ � 3�'•�z s. ,y tz+ �.� `SEAUNG�AND�ADJUSTMENT�RECORD�-r�' ?,• ''X�`,� �� "h,L ��. Lr Fees and adjusting charges,aiithorized by Section 56,G.L.,Chanter98 as amended byC.338,An .'Legal. - ,: - DEVICE seauriq Adjusted sdated . Not sailed Condemned Charges' Fees { 'Over 10,000 Ibs 100.00 �z.. on 5,000 to 10,000 Ibs 45.00 w UJ,N 1-1000 to 5,000 lbs 30.00 .z a 100 to 1 000 Ibs 20.00 0 0 MORE THAN IO LBS - ;" a LESS THAN 100 LBS 10.00 _ - m 10 Ibs or less 5.00 f -Avoirdupois- ' (Each) 1.00 " .,Metric (Each) 1.00 a Apothecary (Each) 1.00 s w ; , (Each) 1.00 .-t x. + VefticleTanks , : ach-,ndjcator 10.00 w ''Each TOP Gals•or c>> Ract oft Thereof 5.00 a<�n `a.w Liquid` w 0 2 1 Gallon ories's 2.00 Mote-than 1',Gallon 2.00 nlet 1/29 or less x OjI;,Grease 6.00 tia ��" C7 JMet more than:1./2�- 1 fw Z Gasoline T5i00 ,yam m� �uJ.w Vehicle Tank Pump xFi moo VehicleTank;Gravity r .30.00 K't{' Bulk'Storage .-- F 60.00 u3 , CompahiySupplies Pro' r:' 30.00 2.: .`Each stop On Pump 2.00 Taxi Meters 25.00 . �;.. N "Odometer-Hubodometer 20.00 LLJ ,_•v Leather.MeaS(Semi-an.). 10.00 t w :Fabric Measuring 10.00 . o . r;;Wije=Rope-Cordage 10.00 t N Yard"Sticks 3.00 ZZ:i W..Tapes .3.00 .'Milk Ja"rs(per gross) .25.00 w; U' — 3 N Dry Measures. 1.00 n, rAdlustjng Repairs Speaat f acildies, 10 b0 Cfiages Y Thjs is to certjfy that t have this day tested adjusted"seale'd.or /6fl Io.o condemned the above°described device incompliance with the. ` G L Chapter? as most recently amended; % Inspector'Sealer of Wejgtits andasures Date • Board of Health Administration Monthly Report --Feb=e1-- `V1nan 0 1 Biologics Distributed * Amount in Doses Diptheria, Tetanus & Pertussis = 630 Burial Permits @ $5.00 $310.00 Diptheria,Tetanus Tox.(under 6 yrs)= 30 Licenses & Permits(+copies) $607.00 Immune Serum Globulin= 0 Certificate of Fitness@$25.00 $1,075.00 Measles/Mumps/Rubella= 320 Sealer Weights/Measures=F $10.00 Polio= 420 Fines $800.00 Tetanus& Diptheria (adult use)= 670 Total Monies Collected $2,802.00 Tuberculin PPD= 120 Total Monies Year to Date 36,684.80 HIB Titre= 496 Animal Bites Reported= 1 Hepatitis B= 480 PPV 23 20 PCV 7 850 Annual Budget Expenses Available Balance Salary/Longevity $354,033.00 $258,724.70 $95,308.30 Annual Budget Expenses Encumbered Available Balance Non-Personnel $20,023.00 $12,900.51 $1,128.90 $5,993.59 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel: (978)741-1800 Public Health Nurse Report Fax:(978)740-9705 March 2001 Activities Disease Prevention • In touch with T.B. Clinic and following active cases and case contacts. • Following up on 5 Salem residents who were exposed to an active case of TB in Peabody. Will refer to North Shore Pulmonary Clinic for x- rays and possibility of prophylaxis. • One PPD test administered to an immigrant. Positive. Appointment made for Pulmonary clinic follow up. • Vaccine inventory maintained and distributed. • Investigated communicable disease cases and reported to the M.D.P.H Meetings and Clinics • • 3/1 Blood Pressure Clinic held for City Employees. 21 persons screened, no referrals. • 3/5 Blood Pressure Clinic held for Firefighters. 19 screened. • 3/13 Blood Pressure Clinic held for Firefighters. 23 screened. • 3/15 Wellness Meeting. Ongoing plans for fair. • 3/20 Assisted in first inspection of Purple Scorpion as a body art establishment. • Home visits for suspect Tuberculosis case continues for DOT. • 3/22 Blood Pressure Clinic held at Police Station for all employees. • 3/28 Attended Immunization Update 2001. Offered by the MDPH, CDC. Held at Tewksbury Hospital. Continuing Education: • Attending Salem State College Part time Evening Program. Literature 1 Course completed. • 1/17 Enrolled in Statistics course Wednesdays, 7-9:20 p.m. St. Joseph's • Hearing and vision has begun. Grades K-5 are completed. Phoenix School • Hearing and vision will begin when St. Joe's is completed. CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel: (978)741-1800 Fax: (978)740-9705 MONTHLY REPORT OF COMMUNICABLE DISEASES March 2001 DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES: CASES: CASES: STATE: Campylobacter 0 0 0 0 Giardia 0 0 0 0 E.Coli 0157H7 0 0 0 0 Hepatitis 1 0 4 4 Inv.,Group A Strep 1 0 1 1 Lyme Disease 0 0 0 0 Meningitis 0 0 0 0 Pertussis 0 0 0 0 Salmonella 0 0 0 0 Shigella 0 0 0 0 Varicella 0 0 0 0 Reportable Diseases excluded from above have not been identified this • month. M �n.. CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel: (978)741-1800 Fax: (978)740-9705 Summary of Communicable Diseases for March Invasive Group A Strep: This 38 y/o male was diagnosed with multiple • areas of necrotizing fasciitis, and cellulitis. He survived. No history of varicella in household. Case was not enrolled in school or day care. Hepatitis B: One case 4 carry over cases of Hepatitis were completed by their doctors and returned the information to me. They responded to letters, and have counseled patients on disease. Campylobacter: Restaurant complaint: Swampscott resident who was ill and hospitalized with confirmed campylobacter. This case was immunosuppressed. He believed he became ill from a triple cheeseburger purchased at Burger King on Highland Avenue. Burger was consumed on 2/19/01 symptom onset was 2/20/01 Incubation period for campylobacter is 1-10 days, but usually 2-5 days. Sanitarian Mark Tolman notified. Massachusetts Department of Public Health • Massachusetts Immunization Program (MIP) Vaccines Cost Money Massachusetts is one of only 15 states that distributes vaccines free of charge to all public and private pediatric providers for immunization of all children through 18 years of age. During 2000, the Massachusetts Immunization Program (MIP)purchased more than $49 million in vaccines on the Centers for Disease Control and Prevention (CDC) contract. In most other states, providers must privately purchase vaccines and seek reimbursement from an insurance carrier after administering the vaccines. Listed below are the current costs per dose of each vaccine purchased on the CDC contract,and the costs if purchased privately. The CDC contract prices below are effective through the end of March 2001. Vaccine Type CDC Contract Price Private Purchase Price Hep. B - pedi. (Recombivax) $9.00 $20.37 DTaP (Tripedia) $9.25 $17.12 IPV $7.75 $15.42 Hib (HibTiter) $5.25 $15.88 PCV7 (Prevnar) $45.99 $58.00 MMR $15.08 $28.19 Varicella $37.14 $45.56 Hep. A— pedi. (Havrix) $11.15 $29.73 The MIP wants to continue with the universal distribution of vaccine, and we need your help. Each vaccine provider needs to: • Store refrigerated vaccines at a temperature range between 350F and 460F (2°C and 8°C) • Account for each dose of vaccine Proper Vaccine Storage Refrigerated vaccines (all vaccines with the exception of varicella) need to be stored at 35°F to 46°F (2°C to 80C). Remember, colder is not better. For most vaccines requiring refrigeration, freezing destroys the antigen. In the past year.approximately 10%of provider sites have stored vaccine at a freezing temperature. Replacement of this vaccine is expensive to the state. A one month supply of vaccine for an average size pediatric provider would cost approximately $3,000 on the CDC contract. Imagine if providers had to replace this vaccine with their own funds! The proper storage temperature must be maintained and monitored by checking and recording the temperatures on a log sheet at the beginning and end of each workday. Vaccine Accountability Funding for vaccines comes from both the state and federal government. Providers need to account for the vaccines by documenting to which age groups each vaccine was administered on the Vaccine Usage Report. If vaccine doses are damaged, lost, or expired it is important to account for these doses on your Vaccine Order Form. If there is a percentage of vaccine unaccounted for, the MIP may lose funding to purchase vaccines the following year. In Massachusetts, we need to continue immunizing all our children against vaccine preventable diseases. As new vaccines become available (including combination vaccines) and as the price of existing vaccines increase, the MIP • needs to sustain funding to continue to purchase these vaccines and maintain a universal vaccine distribution program. Your cooperation in storing the vaccines properly, and documenting vaccine usage is a necessary part of this process. If you have questions. you can contact your regional inul1unization office, or call the Vaccine Management Department at (617) 983-6828 12/21/2000 S • Massachusetts Department of Public Health New Immunization Requirements for College Entry in the 2001 School Year Hepatitis B 3 doses for all health science students ; and all full-time freshmen ** Td 1 booster dose if 10 years since last dose MMR 2 doses measles 1 dose mumps 1 dose rubella College immunization requirements apply to: 1) all full-time undergraduate and graduate students; 2) all full-time and part-time health science students; and 3) any full-time or part-time student attending a post-secondary institution while on a student or other visa, including foreign students attending or visiting classes as part of a formal academic visitation exchange program. ** New requirement effective September 1 , 2001 : 3 doses of hepatitis B vaccine will be required for all full- time freshmen. It will continue to be required for all health science students (both full-time and part-time, undergraduate and graduate). This requirement will continue to be phased in incrementally and apply to sophomores in 2002, juniors in 2003, seniors in 2004, and graduate students in 2005. Serologic proof of immunity will be acceptable. MDPH January 2001 Massachusetts Department of Public Health Immunization Requirements for Entry in the 2001 School and College Year Daycare/ Kindergarten Grade 7 College Preschool Hepatitis B 3 doses 3 doses 3 doses 3 doses (health science students, and freshmen *) DTaP/DTP/ > 4 doses 5 doses 1 Td booster 1 Td booster DT/Td Polio > 3 doses 4 doses > 3 doses --- H i b > 3 doses --- --- --- MMR 1 dose measles 2 doses measles 2 doses measles 2 doses measles 1 dose mump 1 dose mumps 1 dose mumps 1 dose mumps 1 dose rubella 1 dose rubella 1 dose rubella 1 dose rubella Varicella 1 dose 1 dose < 13 yrs - 1 dose --- > 13 yrs - 2 doses * New requirement effective September 1 , 2001 : 3 doses of hepatitis B vaccine will be required for all full-time freshmen. It will continue to be required for all health science students (both full-time and part-time, undergraduate and graduate). This requirement will be phased in incrementally, and apply to freshmen through graduate students by September 1, 2005. MDPH Jaruary 2001 City Of Salem • Environmental Health Division --- Inspection Monthly Summary Month -------------------------------------------------------------- Type Aug 00 Sep 00 Oct 00 Nov 00 Dec 00 Jan 01 Feb 01 Mar 01 Count ----- ------ ------ ------ ------ ------ ------ ------ ------ ----- CFI 70 66 49 77 50 41 70 35 458 CFR 4 2 1 0 1 1 3 0 12 CH 6 3 3 3 6 6 8 8 43 CON 10 5 8 0 0 6 2 4 35 CR 10 2 3 15 7 2 7 6 52 CT 2 3 4 2 1 1 1 2 16 EC 19 11 2 3 2 2 5 3 47 EPR 1 3 2 1 0 0 0 0 7 FC 0 1 3 3 4 2 3 1 17 FRH 3 2 0 3 1 0 1 2 12 FSD 10 6 6 4 3 3 6 7 45 FSI 24 18 20 36 9 16 31 33 187 FSR 12 16 7 11 11 8 13 17 95 GN 9 4 12 4 4 1 3 3 40 HI 46 10 7 13 8 7 9 8 108 HR 14 14 10 9 39 5 7 15 113 LPI 2 0 0 0 0 0 2 0 4 MS 1 0 1 0 0 0 1 0 3 MT 16 14 12 15 3 17 9 12 98 MUP 1 6 0 0 0 0 2 0 9 MW 4 0 0 13 3 7 2 4 33 OG 2 4 2 1 0 1 0 0 10 OSO0 0 0 0 0 0 0 1 1 I 9 8 5 7 1 5 7 6 48 FR 3 4 2 2 1 3 7 1 23 RO 5 0 0 0 2 4 5 3 19 SB 74 15 0 0 0 0 0 0 89 SC 0 0 0 0 0 0 0 4 4 SM 2 2 0 0 1 0 0 1 6 SP 2 0 0 0 0 0 0 0 2 ST 1 4 0 0 0 0 0 0 5 TFI 14 0 53 0 0 0 0 0 67 TR 58 34 31 25 13 34 18 13 226 WM 0 6 15 0 0 0 0 0 21 Count 434 263 258 247 170 172 222 189 1955 T-r++ City of Salem, Massachusett Environmental Health Division Inspection Input_ Form Inspect Date : Estab Name or Owner Name : Type : Location: Inspector: Inspection Types BP - Body Piercing FSI - Food Serv. Ins . 892* RFD - Ret .Food Disc . 6* CFI - Cert. Fit . 822* FSR - Food Serv. Rein. 194* RFI - Ret . Insp. 75* CFR - Cert . Fit .Reinsp105*GN Gen. Nuisance 41* RFR - Ret . Food Rein34* H - Court Hearing 93* HI - Housing Insp. 260* RO - Rodent Control 16* N - Constable Serv. 65* HR - Housing Reinsp. 135* SC - Suntan 7* - Compliance Rev. 25* LPI - Lead Paint Insp. 6* SES - SESD Odor 0* CT _ Computer Time10* MS - Massage 6* SM - Seminars 36* EC - Envirn. Compl . 51* MW - Mark/Weights SP - Swim. Pools 16* EPR - Ext . Paint 95* MUP - Mobile Food Insp. 11* SB - Swim. Beaches 65* FC - Food Compl . 17* OS - Off . Sub. Insp. 6* ST - Soil/Septic 8* FRH - Food Hearings15* RC - Rec Camps 9* TFI - Temp. Food 112* FSD - Food Serv. 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- - - - ---e�lll�e�lleel�l�ellle��tiel .�. - - } ORE � } x Salem Board of Health March 2001 Total Answered *Answered Calls Thursday March 1, 2001 56 Barb = 178 Friday March 2, 2001 i Mary= 297 Saturday March 3, 2001 Sue= 478 Sunday March 4, 2001 iii Monday March 5, 2001 30 Tuesday March 6, 2001 "Closed Snow" *Calls Taken Wednesday March 7, 2001 27 Thursday March 8, 2001 1 42 1 Joanne = 277 Friday March 9, 2001 40 Jeffrey = 164 Saturday March 10, 2001 Mark = 28 Sunday March 11, 2001 Jose = 42 Monday March 12, 2001 51 Pablo = 14 Tuesday March 13, 2001 66 Tracy = 135 Wednesday March 14, 2001 46 - Ginny = 18 Thursday March 15, 2001 51 Barb = 68 Friday March 16, 2001 29 Mary 97 Saturday March 17, 2001 Sue = 133 Sunda March 18, 2001 Fran G= 1 MondayMarch 19, 2001 51 Tuesday March 20, 2001 58 43 Office Hours Per Week Wednesday March 21, 2001 39 *=21 Work Days Thursday March 22, 2001 53 35 Hour Work Week Friday March 23, 2001 42 Saturday March 24, 2001 Sunday March 25, 2001 Monday 8-4 Monday March 26, 2001 56 Tuesday 8-4 Tuesday March 27, 2001 53 Wednesday 8-4 Wednesday March 28, 2001 48 Thursday 8-7 Thursday March 29, 2001 44 Frid. 8-4 Friday March 30, 2001 33 ISaturday I March 31, 2001 i Total = 953 Board of Health Administration Monthly Report Feb-01 ,,Biologics Distributed * Amount in Doses Diptheria, Tetanus& Pertussis = 480 Burial Permits @ $5.00 $285.00 Diptheria,Tetanus Tox.(under 6 yrs)= 0 Licenses& Permits(+copies) $720.00 Immune Serum Globulin= 0 Certificate of Fitness@$25.00 $1,900.00 Measles/Mumps/Rubella= 100 Sealer Weights/Measures= $695.00 Polio= 390 Fines $500.00 Tetanus& Diptheria (adult use)= 135 Total Monies Collected $4,100.00 Tuberculin PPD= 120 Total Monies Year to.Date 33,882.80 HIB Titre= 416 Animal Bites Reported= 0 Hepatitis B= 470 PPV 23 0 PCV 7 850 Annual Budget Expenses Available Balance Salary/Longevity $354,033.00 $223,460.87 $130,572.13 Annual Budget Expenses Encumbered Available Balance Non-Personnel $20,023.00 $8,981.69 $1,369.24 $9,672.07 R , �v��OND1T � � w CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO Public Health Nurse Report NINE NORTH STREET HEALTH AGENT February 2001 Activities Tel: (978)741-1800 Fax: (978)740-9705 Disease Prevention • In touch with T.B. Clinic and following active cases and case contacts. • Vaccine inventory maintained and distributed. • Investigated communicable disease cases and reported to the M.D.P.H Meetings and Clinics • 2/6 Wellness Fair Meeting: 75 Exhibitors have signed up. An Exhibitor meeting will be held at Salem State Okeefe Center on 3/16 at 11:30 a.m. • 2/12 Annual Blood Pressure Clinic for Firemen. Group #2: 17 Firemen screened. 0 referrals necessary. • 2/13 Group #3: 13 Firemen screened. 0 referrals needed. • • 2/13 3 DPW workers received their 3rd Hepatitis B vaccine. • 2/15 Group #4: 12 Firemen screened. 0 referrals needed. • 2/20 Wellness Meeting. Ongoing plans for fair. • 2/26 Group #1 Fireman's Clinic postponed until March. • Home visits for suspect Tuberculosis case continues for DOT. • 2/21 Attending meeting at Salem High School with Mark Tolman regarding Mike Giardi's Baseball Academy. He may have a summer program, which would fall under the definition of a camp. He will review the regulations, and notify us if he holds it in the summer. Continuing Education: • Attending Salem State College Part time Evening Program. Literature 1 Course completed. • 1/17 Enrolled in Statistics course Wednesdays, 7-9:20 p.m. St. Joseph's • Hearing and vision has begun. Grades K-5 are completed. Phoenix School • Hearing and vision will begin when St. Joe's is completed. • 0. • MONTHLY REPORT OF COMMUNICABLE DISEASES February 2001 DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES: CASES: CASES: STATE: • Campylobacter 1 0 1 1 Giardia 0 0 0 0 E.Coli 0157H7 0 0 0 0 Hepatitis 2 0 3 3 Lyme Disease 0 0 0 0 Meningitis 0 0 0 0 Pertussis 0 0 0 0 Salmonella 0 0 0 0 Shigella 0 0 0 0 Varicella 0 0 0 0 Reportable Diseases excluded from above have not been identified this • month. Omni CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax: (978)740-9705 Summary of Communicable Diseases for February 2001 Campylobacter: 29 ylo male. Non-Foodhandler, Believed 'he became ill from raw chicken that was left in his refrigerator too long. He lives alone, Hepatitis C: One case. Chronic Hep B: One case. ..,P.a.,..... ...s �.,;� +.+. .y.ap.:1Fi. :.iei.5*l:i ,-.a ...F't�..�..r ri`a, .. :;��1�.p�, -�', ""• . ., .. .•.__ ... r^.+,K.--q_r.,.. �.�,.,� -,e.�r,"Ca+p.a«i•r'� City Of Salem • Environmental Health Division --- Inspection Monthly Summary Month ------------------------------------------------------ Type Aug 00 Sep 00 Oct 00 Nov 00 Dec 00 Jan 01 Feb 01 Count ----- ------ ------ ------ ------ ------ ------ ------ ----- CFI 70 66 49 77 50 41 70 423 CFR 4 2 1 0 1 1 3 12 CH 6 3 3 3 6 6 8 35 CON 10 5 8 0 0 6 2 31 CR 10 2 3 15 7 2 7 46 CT 2 3 4 2 1 1 1 14 EC 19 11 2 3 2 2 5 44 EPR 1 3 2 1 0 0 0 7 FC 0 1 3 3 4 2 3 16 FRH 3 2 0 3 1 0 1 10 FSD 10 6 6 4 3 3 6 38 FSI 24 18 20 36 9 16 31 154 FSR 12 16 7 11 11 8 13 78 GN 9 4 12 4 4 1 3 37 HI 46 10 7 13 8 7 9 100 HR 14 14 10 9 39 5 7 98 LPI 2 0 0 0 0 0 2 4 MS 1 0 1 0 0 0 1 3 MT 16 14 12 15 3 17 9 86 MUP 1 6 0 0 0 0 2 9 MW 4 0 0 13 3 7 2 29 OG 2 4 2 1 0 1 0 10 RFI 9 8 5 7 1 5 7 42 18FR 3 4 2 2 1 3 7 22 0 5 0 0 0 2 4 5 16 SB 74 15 0 0 0 0 0 89 SM 2 2 0 0 1 0 0 5 SP 2 0 0 0 0 0 0 2 I ST 1 4 0 0 0 0 0 5 I TFI 14 0 53 0 0 0 0 67 TR 58 34 31 25 13 34 18 213 WM 0 6 15 0 0 0 0 21 Count 434 263 258 247 170 172 222 1766 .+++ City of Salem, Massachusett Environmental Health Division Inspection Input Form Inspect Date : Estab Name or Owner Name : Type : Location: Inspector: Inspection Types BP - Body Piercing FSI - Food Serv. Ins . 892* RFD - Ret .Food Disc. 6* CFI - Cert . Fit . 822* FSR - Food Serv. Rein. 194* RFI - Ret . Insp. 75* CFR - Cert . Fit .Reinsp105*GN Gen. Nuisance 41* RFR - Ret . Food Rein34* CH - Court Hearing 93* HI - Housing Insp. 260* RO - Rodent Control 16* N - Constable Serv. 65* HR - Housing Reinsp. 135* SC - Suntan 7* - Compliance Rev.25* LPI - Lead Paint Insp. 6* SES - SESD Odor 0* CT _ Computer Time10* MS - Massage 6* SM - Seminars 36* EC - Envirn. Compl . 51* MW - Mark/Weights SP - Swim. Pools 16* EPR - Ext . Paint 95* MUP - Mobile Food Insp. 11* SB - Swim. Beaches 65* FC - Food Compl . 17* OS - Off . Sub. Insp. 6* ST - Soil/Septic 8* FRH - Food Hearings15* RC - Rec Camps 9* TFI - Temp. Food 112* FSD - Food Serv. Disc 53* MT - Meetings 65* TR - Trash 381* • AGENT'S NEWSLETTER TO THE BOARD VOLUME 65 March 13, 2001 FY 2002 BUDGET I met with Bruce Guy, Finance Director, regarding our budget as submitted. He described the fiscal situation in the City. Although there is an increase in revenue this year, there is also a significant increase in personnel expenses because of raises, increased health care costs, etc. He asked if we had expenses that he could ask Salem Hospital to reimburse. I did make some suggestions. He definitely recommends a review of our fee structure. I anticipate a meeting with the Mayor in the next couple of weeks. STAFF Mark Tolman has accepted a position as Health Agent for the Town of Hamilton. This is a wonderful opportunity for Mark and a good step in his professional development. Mark is not totally leaving yet however. He will continue acting as our Sealer of Weights & Measures until we know how we will handle the staffing changes. In the meantime, I would like to recommend that Jose Diaz move into Mark's position since it is a level higher. Virginia Moustakis will work some additional hours to help fill the gap. • We wish Mark great success in his new endeavor! SMOKING REGULATION In your packet are letters received regarding the removal of the variance clause in our smoking regulation. Included is a letter from Cheryl Sbara, legal council for the Mass Association of Boards of Health. BODY ART The City Council held a public hearing primarily regarding the zoning issues surrounding tattoo establishments. I was invited to attend by John Keenan, City Solicitor. Our regulation was circulated and I gave a brief overview of them. The Purple Scorpion is in the process of complying with our regulation so that they may begin tattooing. Once they call for an inspection and are found in compliance, we will issue their permits to practice tattooing, in addition to their ongoing body piercing. The zoning issue is still under consideration and is not under our jurisdiction. John Keenan agrees that the Board should not delay issuing permits because of the zoning questions still unresolved. WENHAM LAKE In your packet is DEP's response to our letter regarding the fly ash and other concerns about Wenham Lake. THE STORM In response to the threat of flooding from this week's storm, the Board of Health coordinated the opening of an emergency shelter, at the Collins Middle School, with the American Red Cross. 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Clinic and following active cases and case contacts. • Vaccine inventory maintained and distributed. • Investigated communicable disease cases and reported to the M.D.P.H Meetings and Clinics • 1/8 VOCES Flu and Pneumonia Clinic held at Salem Family Health Center 64 vaccinated. • 1/12 St. Joseph's 2nd Hep B Clinic. Four vaccinated. • 1/16 Flu Clinic held at Salem District Court. Vaccine was purchased by Judge Cornetta for his employees. 26 employees vaccinated. • 1/18 Wellness Meeting.. Ongoing plans for fair. Over 50 exhibitors • have reserved booths. • Three Office visits for Flu shots. • 1/18 Home visit: 63 y/o suspect active T.B. Directly Observed Therapy 3x wk, M-W-F. with ORW translating. Evaluated at Pulmonary Clinic. At this time lab results show three negative smears, awaiting culture results. (Up to 60 days for final culture results.) • 1/22 Attended sub committee meeting on body art regulations held at Salem Board of Health. • 1/25 Final Hepatitis B Clinic for Police Department. Seven police officers were vaccinated. Flu Shots were also offered at this clinic. 17 Police employees participated. Continuing Education: • Attending Salem State College Part time Evening Program. Literature 1 Course completed. • 1/17 Enrolled in Statistics course Wednesdays, 7-9:20 p.m. St. Joseph's • Hearing and vision has begun. Grades K-4 are completed. • 1/12 2nd Hepatitis B Clinic. Four students participated. • Phoenix School • Hearing and vision will begin when St. Joe's is completed. i • MONTHLY REPORT OF COMMUNICABLE DISEASES January 2001 DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES: CASES: CASES: STATE: Campylobacter 2 0 2 2 • Giardia 0 0 0 0 E.Coli 0157H7 0 0 0 0 Hepatitis 3 1 0 0 Lyme Disease 0 0 0 0 Meningitis 0 0 0 0 Pertussis 0 0 0 0 Salmonella 0 0 0 0 Shigella 0 0 0 0 Varicella 0 0 0 0 Reportable Diseases excluded from above have not been identified this month. • l N Summary of Communicable Diseases for January • Campylobacter: 3 cases Case #1 Foodhandler: 23 y/o male. Works at Hearthside Restaurant in Essex. Essex Board of Health notified. Returned to work after one negative stool culture >48 hours after completion of antibiotic. Case believes he was ill from chicken consumed at Foxboro Stadium. Foxboro Health Agent notified. Case #2 Non Foodhandler. Travel during incubation period in Dominican Republic. Consumed chicken. Son traveled with her. He was not ill. iCase #3 Non Foodhandler. Traveled to California just prior to onset of symptoms. Case report sent from California. Case believes she was ill from eating at Bankok Paradise. This does not coincide with incubation period. Reported to Jeff Vaughan. Companion that also ate at restaurant not ill. Hepatitis C: 3 Cases. Letters sent to M.D. r t� w • AGENT'S NEWSLETTER TO THE BOARD VOLUME 64 February 16,2001 SMOKING REGULATION Now that April 1st is approaching, we have received several calls from owners of food establishments either hoping that the Board will grant variances to its regulation or very concerned that the Board will grant them making the "playing field" uneven for smaller, older establishments. Enclosed in the packet is information from Cheryl Sbarra, attorney from the Mass Association of Boards of Health regarding the variance issue. I ask that the Board consider the issue of smoking outside of food establishments, including at outdoor dining areas. Recommendations regarding this are included on the same enclosure mentioned above. SMOKING AT BINGO We issue Food Establishments permits to places where bingo is played because this is where these organizations hold church suppers and other events. • At the last meeting the Board voted to include Bingo in its smoking ban in food establishments. Mr. Julien representing St. Joseph's and City Councillor Tom Furey representing St. James have asked to come before the Board to discuss the issue. Options regarding this are also enclosed. BODY ART REGULATIONS The Body Art Regulation presented to the Board for approval,did not include the change from the original two-year apprenticeship requirement for tattoo practitioners to one year as amended by the Board's subcommittee. Therefore the regulation presented to the Board and voted upon contained this mistake. I ask that the Board vote to amend the regulation to require the one- year apprenticeship. I apologize for the error. FY 2002 BUDGET The Budget Subcommittee, Martin Fair, Chris Harrington, and Dr. Ingraham, met with me to develop the budget presented to you. The date of filing for this budget with the Finance Director is this February 15th. • • WENHAM LAKE Jose Diaz attended the Salem City Council Committee on Public Health, Safety and Environment meeting where the Wenham Lake Watershed Association presented information regarding the migration of fly ash from the Vitale site into Wenham Lake itself. In addition, I attended the Beverly City Council meeting where public officials from Salem, Beverly and Wenham asked DEP, Water Board, and environmental consultants questions about the situation. Mayor Usovicz asked me to represent him at that meeting. Enclosed is my summary of that meeting. Also enclosed is a proposed letter to the DEP asking for their direct oversight, as well as the removal of fly ash from the site. I ask that the Board consider approving this letter. WEST NILE VIRUS I met with Walter Montgomery of the Northeast Mosquito Control District, and staff from the Lynn, Swampscott, and Peabody Boards of Health regarding Y p � Y 9 9 the upcoming mosquito season. Several birds infected with WNV were found within a two-mile radius of an intersection in Peabody.. Therefore, we would like to prepare for the coming season and coordinate our efforts in addressing any problems. We asked Walter to develop a protocol that he would send to us for • approval. I will keep you updated regarding this. • NON-CRIMINAL FINES ,i HEALTH DEPARTMENT DATE OF STREET AMOUNT PAID HEARING CITATION LAST NAME FIRST NAME # STREET NAME TICKET# OFFENSE OF FINE TOTAL DATE DATE COMMENTS 09/06/2000 CPT Realty Trust Collett,James P.O.Box 2098,Haverhill A2759 Trash Violation $ 25.00 $ 25.00 09/19/2000 09/18/2000 Hafey Caroline 4446 Winthrop St. A2376 Trash Violation $ 25.00 $ 25.00 09/18/2000 Long Eileena 1061 Rainbow Terrace A2777 Tobacco Products $ 25.00 $ 25.00 01/22/2001 Did not attend class not rescinded 09/11/2000 Brault T la 47 Prince St. A2776 Tobacco Products $ 25.00 $ 25.00 09/25/2000 Gomes Aksana 36 Boston Street#20 A2095 Trash Violation $ 50.00 $ 50.00 12/07/2000 11:00 AM 09/25/2000 Funtes Ninda 38 Boston Street#20 A2096 Trash Violation $ 50.00 $ 50.00 12/07/2000 11:00 AM 09/25/2000 Marshall Moni ue 38 Boston Street#30 A2097 Trash Violation $ 50.00 $ 50.00 12/07/2000 11:00 AM 09/26/2000 Crotty James 24 Arbella Street A2780 Tobacco Products $ 25.00 $ 25.00 10/17/2000 09/26/2000 Benea Kristy 15 Rockdale Avenue A2781 Tobacco Products $ 25.00 $ 25.00 10/17/2000 09/26/2000 Anderson Olivia 76 Essex St. A2779 Tobacco Products $ 25.00 $ 25.00 10/17/2000 09/28/2000 Chalupowski Chester 119 Water St.,#65,Beverly A2716 Trash Violation $ 50.00 $ 50.00 11/04/2000 09/28/2000 Trentsch Shane 11 March Street A1726 Tobacco Products $ 25.00 $ 25.00 09/29/2000 Brault T la 47 Prince St. A1727 Tobacco Products $ 50.00 $ 50.00 2nd offense 10/17/2000 Wiedmann Amanda 36 School St. A2782 Tobacco Products $ 25.00 $ 25.00 10/31/2000 Barnard Robert 249 Green St.,Marblehead A2098 Trash Violation $ 50.00 $ 50.00 11/16/2000 Devoe Jen 1 Mansell ParkwayA2784 Tobacco Products $ 25.00 $ 25.00 11/17/2000 11/02/2000 Caiazzo Stephen 73 Lafayette St. A20991 Trash Violation $ 106.00 $ 100.00 11/28/2000 11/27/2000 Reynolds Marlene 1911 Federal Street#31 A21001 Trash Violation $ 50.00 $ 50.00 11/27/2000 Gomes Aksana 361 Boston Street#20 A1761 Trash Violation $ 50.00 $ 50.00 2nd offense 11/27/2000 Douglass Elaina 361 Boston Street#21 A1752 Trash Violation .$ 50.00 $ 50.00 12/21/2000 Chen Edwin 127 Boston Street A2717 Misc.food violations $ 100.00 $ 100.00 12/18/2000 Gu Ryan 22 West Avenue I A2785 Tobacco Products $ 25.00 $ 25.00 12/27/2000 Bahal Arvinder P.O.Box 869,Salem A2760 Trash Violation $ 50.00 $ 50.00 01/01/2001 Salem Wax Museum 288 Derby Street A1753 No 2001 Food Permit $ 100.00 $ 100.00 01/02/2001 rj NON-CRIMIVFINES • r HEALTH DEPARTMENT DATE OF STREET AMOUNT PAID HEARING CITATION LAST NAME FIRST NAME # STREET NAME TICKET# OFFENSE OF FINE TOTAL DATE DATE COMMENTS 01/01/2001 Loyal Order of Moose 319 Highland Avenue A1754 No 2001 Food Permit $ 100.00 $ 100.00 01/01/2001 Mr.Mikes Mobil 92 Bridge Street A1755 No 2001 Food Permit $ 100.00 $ 100.00 01/11/2001 01/01/2000 Salem Shell 146 Boston Street A1756 No 2001 Food Permit $ 100.00 $ 100.00 12/27/2000 Barnard Robert 249 Green St.,Marblehead A1757 Trash Violation $ 50.00 $ 50.00 01/25/2001 01/01/2001 Baileys House of Sports 17 Canal Street A273 No 2001 Food Permit $ 100.00 $ 100.00 01/01/2001 Boston Street Variety 1221 Boston Street A2734 No 2001 Food Permit $ 100.00 $ 100.00 01/05/2001 01/01/2001 Brothers Restaurant 282 Derby Street A2735 No 2001 Food Permit $ 100.00 $ 100.00 01/01/2001 Giovanni P.Gravallese 133 Washington Street A2736 No 2001 Food Permit $ 100.00 $ 100.00 01/01/2001 Coach House Inn 2841 Lafayette St. A2737 No 2001 Food Permit $ 100.00 $ 100.00 01/01/2001 DeFrancesco& Sons 531 Mason Street A2738 No 2001 Food Permit $ 100.00 $ 100.00 01/01/2001 Dunkin Donuts Robert Jackson 105 North Street A2739 No 2001 Food Permit $ 100.00 $ 100.00 01/01/2001 Dunkin Donuts Robert Jackson 152 Washington Street A2740 No 2001 Food Permit $ 100.00 $ 100.00 01/01/2001 Fantasy Island Deb Lam 516 Loring Avenue A2741 No 2001 Food Permit $ 100.00 $ 100.00 01/12/2001 01/01/2001 I.C.Macaus 111 Canal Street A2745 No 2001 Food Permit $ 100.00 $ 100.00 01/01/2001 Kids Stop Indoor Play Center 400 Highland Avenue A2746 No 2001 Food Permit $ 100.00 $ 100.00 01/23/2001 01/01/2001 Luckey Store Le Cu 96 Boston Street A27471 No 2001 Food Permit $ 100.00 $ 100.00 01/08/2001 01/01/2001 Salem House of Pizza 23 Endicott Street A2748 No 2001 Food Permit $ 100.00 $ 100.00 01/07/2001 01/01/2001 Scuttlebutt's S.Caiazzo 73 Lafayette St. A2749 No 2001 Food Permit $ 100.00 $ 100.00 01/25/2001 01/01/2001 The Kitchen Table 35 Congress Street A2750 No 2001 Food Permit $ 100.00 $ 100.00 01/01/2001 Cima Supermarket 111-113 Lafayette St. A2761 No 2001 Food Permit $ 100.00 $ 100.00 01/01/2001 Kernwood Country_ Club 1 Kernwood Aveneu A2762 No 2001 Food Permit $ 100.00 $ 100.00 01/01/2001 Villa Grocerette T.T. Nguyen 235 Lafayette St. A2763 No 2001 Food Permit $ 100.00 $ 100.00 01/08/2001 01/01/2001 Tasty Foods II D.Nash 8 Essex St. A27641 No 20.01 Food Permit $ 100.00 $ 100.00 01/09/2001 01/01/2001 Witches Kettle John Keefel 431 Boston Street A27651 No 2001 Food Permit $ 100.00 $ 100.00 01/17/2001 a • •NON-CRIMI1CAiL FINES HEALTH DEPARTMENT DATE OF STREET AMOUNT PAID HEARING CITATION LAST NAME FIRST NAME # STREET NAME TICKET# OFFENSE OF FINE TOTAL DATE DATE COMMENTS 01/01/2001 Something Different 213 Essex St. A2767 No 2001 Food Permit $ 100.00 $ 100.00 01/09/2001 01/01/2001 Natures Gate Naturelly 282 R.Derby Street A2768 No 2001 Food Permit $ 100.00 $ 100.00 01/01/2001 Puddle Jumpers R.&J. Dick 400 Highland Avenue A2769 No 2001 Food Permit $ 100.00 $ 100.00 01/01/2001 Temptations Allen Winer 304 Essex Street A2770 No 20p1 Food Permit $ 100.00 $ 100.00 01/01/2001 The Rockmore Drydock 94 Wharf Street A27711 No 2001 Food Permit $ 100.00 $ 100.00 01/01/2001 Lena Original 101 Loring Avenue A27731 No 2001 Food Permit $ 100.00 $ 100.00 01/01/2001 Staples Office Superstore 17 Paradise Road A2774 No 2001 Food Permit $ 100.00 $ 100.00 01/19/2001 01/01/2001 West Coast Video 76 Lafayette Street A2775 No 2001 Food Permit $ 100.00 $ 100.00 01/08/2001 01/01/2001 Young World Nursery School 3 Greenledge Street A2772 No 2001 Food Permit $ 100.00 $ 100.00 Resinded per Joanne 1/8/2001 01/01/2001 Gourmet Fare J. Hatch 73-75 Wharf Street A2743 No 2001 Food Permit $ 100.00 $ 100.00 Rescinded per Joanne 1/8/2001 01/01/2001 Gold Star Coffee H.Georgilakis 51-A Bridge Street A2742 No 2001 Food Permit $ 100.00 $ 100.00 Rescinded per Joanne 1/8/2001 01/01/2001 Giovannes of New England 44 Jefferson Avenue A2766 No 2001 Food Permit $ 100.00 $ 100.00 Rescinded per Joanne 1/8/2001 01/01/2001 Honga Restaurant Hong Che 6 Boston Street A2744 No 2001 Food Permit $ 100.00 $ 100.00 Rescinded per Joanne 1/8/2001 12/21/2000 Sullivan Michael P. 43 Mason Street A1729 Tobacco Products $ 25.00 $ 25.00 01/02/2001 Sousa Kerrie 28 Perkins Street A1730 Tobacco Products $ 25.00 $ 25.00 01/30/2001 01/22/2001 Matthews Michael P. 349 Lafayette Street A1732 Tobacco Products $ 25.00 $ 25.00 02/01/2001 01/16/2001 Matthews Michael P. 349 Lafayette Street A1731 Tobacco Products I $ 25.00 1 $ 25.00 02/01/2001 01/26/2001 Freeman Deanna 37 Dunlap Street A27861 Tobacco Products I 25.00 2 3 000] Deb s Diner Boston St. 1 Aj//bj No hair res r in s • BUDGET CONSIDERATIONS Mayor's Priorities Neighborhoods, Economic Development, Education Targeted Appropriations Schools, Parks/Recreation, Electronic Government, Capital Improvements No overall target for each department. Last year we needed to aim for 3% overall increase. This year appropriations will be made based on the Mayor's priorities. Therefore, some departments will receive increases of various degrees, the budget of others will be cut. Added responsibilities within the past year: • West Nile Virus • Beach testing & notification • Tattoo regulations • Recreational Camps . • New Food Code Increases in Budget: • Rodent Control $65/extermination X 20 exterminations per year = 1300, therefore increase of 380 • In State Travel An additional $1400 for professional staff to attend seminars • Beach Testing Increase in number and costs of analysis is 1000 • Telephone Increase $500 to $4500 • Office Furnitue Desk chairs used by staff are aged and need replacing Enhanced Revenue Increase permit fees. A proposal will be presented at the meeting. E1/26/O CITY OF SALEM- FY 2001 OPERATING BUDGET (PROPOSED) Expenditures Adopted Budget Adjusted Budget Department Mayor City Council FY 2000 FY 2001 FY 2001 FY 2002 FY 2002 FY 2002 Health-Personnel 15101 5111 SALARIES-FULL TIME $333,327.39 $335,885.00 $335,885.00 3 y 3,10 50 15101 5113 SALARIES-PART TIME $4,397.08 $11,070.00 $11,070.00 15101 5131 OVERTIME(GENERAL) $3,150.15 $3,000.00 $3,000.00 15101 5141 LONGEVITY $300.00 $300.00 $300.00 15101 5150 FRINGE/STIPENDS $800.00 $800.00 $800.00 g 0o . 15101 5164 MERIT POOL $0.00 $2,978.00 $2,978.00 10, 590 Health-Personnel Total $341,974.62 $354,033.00 $354,033.00 3,� 9 Please Total Health-Expenses 15102 5306 ADVERTISING $595.19 $600.00 $600.00 (o 00 15102 5318 DENTAL/MEDICAL SERVI $9,890.64 $3,300.00 $3,300.00 3, 30 O 15102 5341 TELEPHONE $3,978.05 $4,000.00 $4,000.00 ,SOD 15102 5396 HOUSING-SAN $4,925.98 $6,000.00 $6,000.00 & OC)O 15102 5421 OFFICE SUPPLIES (GEN $1,783.18 $2,000.00 $2,000.00 .2, 000 15102 5710 INSTATE TRAVEL,MEE $993.12 $1,000.00 $1,000.00 a, Yo o 15102 5778 OTHER EXP-SEALER $2,177.54 $2,200.00 $2,200.00 a a 00 15102 5785 RRODENT CONTROL $0.00 $923.00 $923.00 1 ,300 Health-Expenses Totat�' $24,343.70 $20,023.00 $20,023.00 Please Total 120 510 Department Total $366,318.32 $374,056.00 $374,056.00 Please Total D.rcice. h�.+r 4urc 5o4D 3 93) �i31 -DQP�. � a �crt 55 3°�o I JJ r f a s-� Page: 15 City Of Salem • Environmental Health Division --- Inspection Monthly Summary Month ---------------------------------------------- Type Aug 00 Sep 00 Oct 00 Nov 00 Dec 00 Jan 01 Count CFI 70 66 49 77 so 41 353 CFR 4 2 1 0 1 1 9 CH 6 3 3 3 6 6 27 CON 10 5 8 0 0 6 29 CR 10 2 3 15 7 2 39 CT 2 3 4 2 1 1 13 EC 19 11 2 3 2 2 39 EPR 1 3 2 1 0 0 7 FC 0 1 3 3 4 2 13 FRH 3 2 0 3 1 0 9 FSD 10 6 6 4 3 3 32 FSI 24 18 20 36 9 16 123 FSR 12 16 7 11 11 8 65 GN 9 4 12 4 4 1 34 HI 46 10 7 13 8 7 91 HR 14 14 10 9 39 5 91 LPI 2 0 0 0 0 0 2 MS 1 0 1 0 0 0 2 MT 16 14 12 15 3 17 77 MUP 1 6 0 0 0 0 7 MW 4 0 0 13 3 7 27 OG 2 4 2 1 0 1 10 FI 9 8 5 7 1 5 35 3 4 2 2 1 3 15 RO 5 0 0 0 2 4 11 SB 74 15 0 0 0 0 89 SM 2 2 0 0 1 0 5 SP 2 0 0 0 0 0 2 ST 1 4 0 0 0 0 5 TFI 14 0 53 0 0 0 67 TR 58 34 31 25 13 34 195 WM 0 6 15 0 0 0 21 Count 434 263 258 247 170 172 1544 +++:' City, of Salem, Massachusett Environmental Health Division Inspection Input Form Inspect Date: Estab Name or Owner Name: Type: Location: Inspector: Inspection Types BP - Body Piercing FSI - Food Serv. Ins . 892* RFD - Ret.Food Disc. 6* CFI - Cert. Fit. 822* FSR - Food Serv. Rein. 194* RFI - Ret. Insp.75* CFR - Cert. Fit .Reinsp105*GN Gen. Nuisance 41* RFR - Ret. Food Rein34* 0 H - Court Hearing 93* HI - Housing Insp. 260* RO - Rodent Control 16* N - Constable Serv. 65* HR - Housing Reinsp. 135* SC - Suntan 7* R —Compliance Rev.25* LPI - Lead Paint Insp. 6* SES - SESD. Odor 0* CT _ Computer Time10* MS Massage 6* SM - Seminars 36* EC - Envirn. Compl. 51* MW - Mark/Weights SP - Swim.Pools 16* EPR - Ext. Paint 95* MUP - Mobile Food Insp. 11* SB - Swim. Beaches 65* FC - Food Compl .17* OS - Off. Sub. Insp. 6* ST - Soil/Septic 8* FRH - Food Hearings15* RC - Rec Camps 9* TFI - Temp. Food 112* FSD - Food Serv. Disc 53* MT - Meetings 65* TR - Trash 381* A—Adl-bd NS—Nol S.d.d S--S-a1id C-Condemned DEPARIman OF WEIGHTS AND MEASURES cote NAME OF PEHSON OH BOSINFSS Field CIMMCATE Issmm To Cartlr tO SCALES AND BALANCES CAPACITT MEASIIHES Number WEIGHTS VEHICLE Mom 5ma To 10.000 1.000 to 100 to Mere Than 10 p TANKS I�Oum DftT R L�JVev 20 e C WEASURES Poona. Pound. S.�o 1,000 L< Than Pbund. A.e rduao. wepK APe hecmy Fast Fa Add tle°d Pounds Pounds 100 Pounds Or Lee. lw Gallon. I Gallon Hers Th® A S US C A S US C A S N C A S NS C A S US C A S Teo Or L— p F—tio. 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Clinic and following active cases and case contacts. • Vaccine inventory maintained and distributed. • Investigated communicable disease cases and reported to the M.D.P.H • A Polio report was received by the Department of Public Health. Dr. Miaskiewicz was consulted, and the following community agencies and Physicians were notified by me in the following manner: • • Mass mailing to 95 physician offices in the city.. This included a P Y cover letter by Dr. Miaskiewicz. • Press release was placed in the Salem Evening News. • Mary Egan R.N. Nurse Coordinator was notified. Polio Alert was distributed to all children traveling to these areas. Dr. Mathieu was notified. St. Joseph and Phoenix were notified. Justo Grullon, VOCES was notified. Information was announced on Spanish Radio station, and Mr. Grullon announced it on his Saturday SATV program. Flyers were posted at VOCES. • Informational Flyers were disseminated to the latino population at 1/8/01 Flu Clinic held at Salem Family Health Center. • Mailing was sent to 19 Day Care Centers in Salem. • Polio Alert was sent to 5 Travel Agencies in Salem. During this outbreak, The Mass. Immunization Program will distribute Inactivated Polio Vaccine to all Adult Health Care Providers who request it. • Continuing contact with Elissa Leighton, epidemiologist at State Laboratory. She will be covering all inquiries and reports of suspect polio in the state. • �ONDIT • �M111�� CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Meetings and Clinics. Fax:(978)740-9705 • 12/6 Charter Street Flu Clinic. 201 residents vaccinated. • 12/7 Pioneer Terrace Flu Clinic. 75 residents vaccinated. • 12/13 Attended Tattoo Conference. • 12/14 Flu shots offered to St. Joseph's Faculty 6 vaccinated. • 12/19 City of Salem Employee Flu Clinic 64 St. Joseph's • Hearing and Vision has begun. Grades K-2 have been completed. Phoenix School • Phoenix School has moved to Peabody Block. Hearing and Vision will begin when St. doe's is completed. CONDl7 a CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH-AGENT - Tel:(978)741-1800 Fax:(978)740-9705 January 3, 2001 Dear Physician, Attached you will find information about the current polio outbreak in Cape Verde, West Africa, and the Dominican Republic and Haiti. In summary the MDPH recommends review of immunization status, to ensure that it is up to date for polio, for: ✓Patients who will or have traveled to the Dominican Republic, Haiti, Cape Verde, and West Africa; ✓All those with visitors from these areas; ✓All infants and children. It is further recommended that those traveling to or from these high risk • areas: ✓Receive a single booster dose of Inactivated Polio Vaccine (IPV) if they have already completed a 4-dose primary series (if they are children), or a 3-dose primary series (if they are adults); ✓Receive the accelerated IPV immunization series, completing as many doses as possible prior to departure, if they are unimmunized or incompletely immunized. This is described in the enclosed information under number 3. At this time, the Salem Board of Health will provide Inactivated Polio Vaccine to Adult Health Care Providers as well as Pediatric Health Care Providers. Oral Polio Vaccine is no longer available in the United States. Polio paralysis is usually more marked proximally. Polio can present as aseptic meningitis in 4% of patients. Please report all suspect cases to The Salem Board of Health at 978-741-1800 and the Massachusetts Immunization Program at 617-983-6800. For the Board of Health, Joseph Miaskiewicz • Physician to the Board OPOLIOVACCINE F_ - -I YOUNEED TO KN 1 L WHAT Who should get polio 7 vaccine and Polio is a disease caused by a virus. It enters a child's (or adult's)body through the mouth. Sometimes it does IPV is a shot,given in the leg or arm,depending on age. not cause serious illness. But sometimes it causes Polio vaccine may be given at the same time as other paralysis(can't move arm or leg). It can kill people who vaccines. get it,usually by paralyzing the muscles that help them Children breathe. Most people should get polio vaccine when they are Polio used to be very common in the United States. It children. Children get 4 doses of IPV,at these ages: paralyzed and killed thousands of people a year before we ✓A dose at 2 months ✓A dose at 6-18 months had a vaccine for it. ✓A dose at 4 months ✓A booster dose at 4-6 years © h get Adults Most adults do not need polio vaccine because they were Inactivated Polio Vaccine (IPV) can prevent polio. already vaccinated as children. But three groups of adults are at higher risk and should consider polio vaccination: History:A 1916 polio epidemic in the Unites States killed (1) people traveling to areas of the world where polio is • 6,000 people and paralyzed 27,000 more. In the early common, 1950's there were more than 20,000 cases of polio each (2) laboratory workers who might handle polio virus,and year. Polio vaccination was begun in 1955. By 1960 (3) health care workers treating patients who could have polio. the number of cases had dropped to about 3,000,and by 1979 there were only about 10. The success of polio Adults in these three groups who have never been vaccination in the U.S. and other countries sparked a vaccinated against polio should get 3 doses of IPV: world-wide effort to eliminate polio. ✓The first dose at any time, ✓The second dose 1 to 2 months later, Today:No wild polio has been reported in the United ✓The third dose 6 to 12 months after the second. States for over 20 years. But the disease is still common in some parts of the world. It would only take one case of Adults in these three groups who have had 1 or 2 doses polio from another country to bring the disease back if we of polio vaccine in the past should get the remaining 1 or 2 were not protected by vaccine. If the effort to eliminate doses. It doesn't matter how long it has been since the the disease from the world is successful,some day we earlier dose(s). won't need polio vaccine. Until then,we need to keep getting our children vaccinated. Adults in these three Oral Polio Vaccine: No longer recommended groups who have had Fvaccines are two kinds of polio vaccine:IPV,which is the shot recommended in the United States today, 3 or more doses of live,oral polio vaccine(OPV),which is drops that are swallowed. polio vaccine(either ecently OPV was recommended for most children in the United States. OPV helped us rid the IPV or OPV) in the of polio,and it is still used in many parts of the world. past may get a booster accines give immunity to polio,but OPV is better at keeping the disease from spreading to dose of IPV.eople.However,for a few people(about one in 2.4 million),OPV actually causes polio.Sincek of getting polio in the United States is now extremely low,experts believe that using oral Ask your health care vaccine is no longer worth the slight risk,except in limited circumstances which your doctorscribe.The polio shot(IPV)does not cause polio.If you or your child will be getting OPV,ask provider for more opy of the OPV supplemental Vaccine Information Statement. information. Polio - 1/1/2000 people • Tell your doctor what happened,the date and time it Some t happened,and when the vaccination was given. IF or should wait. These people should not get IPV: • Ask your doctor,nurse,or health department to file a Vaccine Adverse Event Reporting System (VAERS) • Anyone who has ever had a life-threatening allergic form,or call the VAERS toll-free number yourself at reaction to the antibiotics neomycin, streptomycin or 1-800-822-7967. polymyxin B should not get the polio shot. Reporting reactions helps experts learn about possible • Anyone who has a severe allergic reaction to a polio problems with vaccines. shot should not get another one. These people should wait: The National Vaccine Injury • Anyone who is moderately or severely ill at the time the Compensation shot is scheduled should usually wait until they recover before getting polio vaccine. People with minor In the rare event that you or your child has a serious illnesses,such as a cold,may be vaccinated. reaction to a vaccine,there is a federal program that can help pay for the care of those who have been harmed. Ask your health care provider for more information. For details about the National Vaccine Injury Compensation Program, call 1-800-338-2382 or visit the What are the risks© • ', program's website at http://www.hrsa.gov/bhpr/vicp r Some people who get IPV get a sore spot where the shot © How canX learn n• was given. The vaccine used today has never been • • Ask your doctor or,nurse. They can give you the known to cause any serious problems,and most people don't have any problems at all with it, vaccine package insert or suggest other sources of information. However,a vaccine,like any medicine,could cause serious problems,such as a severe allergic reaction. The Call your local or state health department's risk of a polio shot causing serious harm, or death, is immunization program. extremely small. • Contact the Centers for Disease Control and Prevention (CDC): -Call 1-800-232-2522 (English) What -Call 1-800-232-0233 (Espanol) reaction? -Visit the National Immunization Program's website at http://www.cdc.gov/nip What should I look for? Look for any unusual condition,such as a serious allergic reaction,high fever,or unusual behavior. If a serious allergic reaction occurred,it would happen within a few minutes to a few hours after the shot. Signs of a serious allergic reaction can include difficulty breathing, weakness, hoarseness or wheezing,a fast heart ' {�// CDC ccrrcERs FOR asEASE coR*Roy J beat,hives,dizziness,paleness,or swelling of the throat AIA PREVENl10N U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES What should I do? Centers for Disease Control and Prevention • Call a doctor,or get the person to a doctor right away. National Immunization Program Vaccine Information Statement Polio(1/1/2000) 42 U.S.C.§300aa-26 is Printed on recycled paper. • Massachusetts Department of Public Health PKETVIEDMassachusetts Immunization Program (MIP) • POLIO ALERT! CITY OF SALEM HFA+_TH np:PT, Polio Outbreaks in Cape Verde, and the Dominican Republic and Haiti December 13, 2000 Currently, there are 2 outbreaks of poliomyelitis: one in Cape Verde, West Africa, and the other in the Dominican Republic and Haiti (Hispaniola), which raise concerns about the possible introduction of poliovirus into Massachusetts. Please inform your patients about these outbreaks. 1. Outbreaks Cape Verde— Outbreak of Wild-type Poliovirus An outbreak of poliomyelitis has been reported in Cape Verde. To date, 33 cases of acute flaccid paralysis (AFP) have occurred between August 26 and October 17. 2000 (MMWR 2000: 49;1070). Preliminary laboratory results have identified wild-type 1 poliovirus among eight of the cases. Aggressive polio immunization efforts are underway with oral polio vaccine (OPV). Dominican Republic and Haiti - Outbreak of Vaccine-strain Poliovirus An outbreak of poliomyelitis has been reported on the island of Hispaniola. To date, 19 cases of • AFP, including six laboratory-confirmed cases of type 1 poliovirus, have been identified in the Dominican Republic. One case of type 1 poliovirus has been identified so far in Haiti. It appears that the outbreak virus is derived from OPV and that it has recovered the neurovirulence and transmissibility characteristics of wild-type 1 poliovirus. Such outbreaks can be controlled by OPV and aggressive immunization efforts have begun in these 2 countries (MMWR 2000: 49; 1094-1095). 2. Surveillance Paralytic poliomyelitis typically presents with rapid onset of flaccid paralysis and fever. Paralysis progresses to its maximal extent within a few days, and usually progresses no further once fever resolves. Paralysis is typically asymmetric, associated with decreased or complete loss of deep tendon reflexes and without involvement of sensory nerves. Paralysis is usually more marked proximally. In addition, polio can present as aseptic meningitis in 4% of patients. Please report all suspect cases. The CDC and MIP are encouraging health care providers to consider the diagnosis of poliomyelitis in all patients who present with AFP with fever or aseptic meningitis. A high level of clinical suspicion is especially important in cases who have traveled to or have been exposed to persons who have traveled from Cape Verde and other West Africans countries, the Dominican Republic and Haiti. If poliomyelitis is suspected, clinicians should promptly notify their local board of health and the M1P at 617-983-6800 or toll free at 888-658- 2850. We can provide guidance about the proper collection of stool samples, throat swabs, and • cerebrospinal fluid samples for viral culture as well as acute and convalescent serum samples for serologic testing. (over) Polio Alert CapeVerde DR Haiti 12-13-OO.doc ®Printed on recycled paper. 3. Immunization Recommendations The,CDC and the MIP recommend that health care providers assess the immunization status of: • 1) all patients who are traveling to Cape Verde and West Africa and the Dominican Republic and Haiti; 2) all those with visitors from these areas; and 3) all infants and children in their practice to ensure that they are up-to-date with their polio immunizations. It is recommended that travelers to these high-risk areas who have completed a 4-dose primary series (if they are children), or a 3-dose primary series (if they are adults), receive a single booster dose of inactivated polio vaccine (IPV). For those who are unimmunized or incompletely immunized and at risk of imminent exposure, please refer to the accelerated schedule below to complete as many doses as possible prior to departure: Accelerated IPV Immunization Schedule Weeks Available IPV Schedule* > 8 weeks 3 doses, 4 weeks apart 4 — 7 weeks 2 doses, 4 weeks apart < 4 weeks 1 dose *First dose may be given as early as 6 weeks of age. Please note: OPV is no longer available for use in the United States. Boards of Health: If your city or town has a significant Cape Verdean, Dominican or Haitian population, please disseminate this information to all health care providers and pertinent community agencies in your town. Community Agencies: Please inform your clients and community partners about this outbreak and urge all travelers to Cape Verde, the Dominican Republic or Haiti as well as those with visitors from these areas, to have their immunization status assessed by their health care provider. Please also ensure that all parents in your community know that their infants and children should be up-to-date with their polio immunization sel'ies. The following websites contain additional information about the outbreaks as well as general information about poliovirus and polio Vaccine Information Statements (VISs) in English, Portuguese or Spanish: Polio ape Verde) ttp: www.c c..ov mmwr preview mmwr tm lnm a tm Polio (Dominican Republic/Haiti) http://ww-w.cdc.gov/mmwr/pre\,,iew/mmwrhtml/mm4948a4.htm li MDPH Polio Public Health Fact Sheet http://www.state.ma.us/dpli/cdc/Fspoli.pdf CDC Polio VIS (English) http://ww-w.immunize.org/vis/ipv-00.P df CDC Polio VIS (Portuguese) llttp://www.immunize.org/vis/pr pol00.pdf CDC Polio VIS (Spanish) http://www.immunize.org/vis/sp aol00.pdf i I • If you have any questions regarding these recommendations or would like to order IPV or VISs, please call the MIP at 617-983-6800 or toll free at 888-658-2850. Polio Alert CapeVerde DR Haiti 12-13-OO.doc mKinm C��AN6 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO. NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 Polio Alert Polio Outbreak in Cape Verde, the Dominican Republic and Haiti The Center for Disease Control and the Massachusetts Department of Public Health recommend that those traveling to or from Cape Verde, the Dominican Republic and Haiti asses their immunization status. It is recommended that travelers to these high-risk areas who have completed a four or three dose primary polio series, receive a single booster dose of inactivated polio vaccine (IPV) If you have any questions, please contact your physician. Alerta de Polio Se han dado casos de Polio en Cabo Verde, la Republica Dominicana y Haiti El Center for Disease Control y el Massachusetts Department of Public Health Recomienda que aquellos que planean viajar a Cabo Verde, la Republica Dominicana y Haiti revisen el status de sus vacunas. Se rcomienda que aquellos que planean viajar a estos lugares de gran reisgo que ya han completado las tres o cuatro dosis de vacuna para la polio, reciban una dosis adicional de la vacuna inactiva para la polio (IPV). Si tienen alguna pregunta llamen a su medico. • .F CnNn L 6 Y��C Hart v CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 MONTHLY REPORT OF COMMUNICABLE DISEASES December 2000 DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES: CASES: CASES: STATE: Campylobacter 0 0 0 0 • Giardia 0 1 0 0 Hepatitis 2 2 0 2 Lyme Disease 0 0 0 0 Meningitis 0 0 0 0 Pertussis 0 0 0 0 Salmonella 0 0 0 0 Shigella 0 0 0 0 Varicella 0 0 0 0 Reportable Diseases excluded from above have not been identified this month. • coNDIT k T, i der: A_ '•,uIYf6 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 Two Hepatitis C Cases. These are suspect cases. No Liver tests were done at hospital. Letters will be sent to M.D. to verify diagnosis. Follow up continues with last months Giardia case. • • City Of Salem Environmental Health Division --- Inspection Monthly Summary • Month -------------------------------------- Type Aug 00 Sep 00 Oct 00 Nov 00 Dec 00 Count CFI 70 66 49 77 50 312 CPR 4 2 1 0 1 8 CH 6 3 3 3 6 21 CON 10 5 8 0 0 23 CR 10 2 3 15 7 37 CT 2 3 4 2 1 12 EC 19 11 2 3 2 37 EPR 1 3 2 1 0 7 PC 0 1 3 3 4 11 FRH 3 2 0 3 1 9 FSD 10 6 6 4 3 29 PSI 24 18 20 36 9 107 FSR 12 16 7 11 11 57 GN 9 4 12 4 4 33 HI 46 10 7 13 8 84 HR 14 14 10 9 39 86 LPI 2 0 0 0 0 2 MS 1 0 1 0 0 2 MT 16 14 12 15 3 60 MUP 1 6 0 0 0 7 MW 4 0 0 13 3 20 OG 2 4 2 1 0 9 RFI 9 8 5 7 1 30 �FR 3 4 2 2 1 12 0 5 0 0 0 2 7 SB 74 15 0 0 0 89 SM 2 2 0 0 1 5 Sp 2 0 0 0 0 2 ST 1 4 0 0 0 5 TFI 14 0 53 0 0 67 TR 58 34 31 25 13 161 WM 0 6 15 0 0 21 Count 434 263 258 247 170 1372 , r++ City of Salem, Massachusett Environmental Health Division Inspection Input Form Inspect Date : Estab Name or Owner Name: Type : Location: Inspector: Inspection Types BP - Body Piercing FSI - Food Serv. Ins . 892* RFD - Ret .Food Disc . 6* CFI - Cert . Fit . 822* FSR - Food Serv. Rein. 194* RFI - Ret . Insp. 75* CFR - Cert . Fit .Reinsp105*GN _ Gen. Nuisance 41* RFR - Ret . Food Rein34* CH - Court Hearing 93* HI - Housing Insp. 260* RO - Rodent Control 16* 0T N - Constable Serv. 65* HR - Housing Reinsp. 135* SC - Suntan 7* - Compliance Rev. 25* LPI - Lead Paint Insp. 6* SES - SESD Odor 0* _ Computer Time10* MS - Massage 6* SM - Seminars 36* EC Envirn. Compl . 51* MW -Mark/Weights SP - Swim.Pools 16* EPR - Ext . Paint 95* MUP - Mobile Food Insp. 11* SB - Swim. Beaches 65* FC - Food Compl . 17* OS - Off . Sub. Insp. 6* ST - Soil/Septic 8* FRH - Food Hearings15* RC - Rec Camps 9* TFI - Temp. Food 112* FSD - Food Serv. 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The manager will be at our meeting. COMMUNITY HEALTH ASSESSMENT The Assessment is finally here! BODY ART REGULATIONS Enclosed is a draft of body art regulations. This is a compilation from the current State's model, a model from the National Environmental Health Association, a draft from Williamstown, MA., our own Body Piercing Regulations, and Amesbury's regulation!! The type setting needs to be adjusted and there may be some repitition. I plan to edit it more over the week -end and I welcome any suggestions you may have before the meeting. I have combined body piercing into this reg so that we will have one "body art" regulation. There are several issues to consider: ✓Do we want to require TB testing? The state does not consider body art practitioners to be at high risk for TB. ✓How many hours do we want to require for apprenticeship? One year has been suggested by most for body piercers; two to three years, and 2000 to 3000 hours have been suggested. I have said 2000 in the draft but that can change if you want. ✓Do we want to require A&P of all body artists, or just piercers. The Murphy's of Purple Scorpion strongly urge that we do not require it for tattooists. They say piercing may involve many kinds of tissues but tattoing involves just the skin. I have included it in the draft for both. ✓I have regulated against tatooing of the face. This is because of the cranial nerves and the prevalence of sun damage that may be masked by inks. It is for discussion. ✓do we want to require a physical exam for body art practitioners prior to submission of an application or re-application? I didn't put it in but we could. s t 'i w SMOKING Regarding bingo: Danvers and Beverly do not allow smoking at bingo according to their regulation prohibiting smoking in public places. Danvers has not inspected to see if there is compliance with this, but their regs were widely publicized and they have no received any complaints about smoking at bingo. Beverly had three bingos. One was already smoke-free. After their regulation, one establishment stopped bingo and the other is doing very well. Peabody does prohibit smoking in public places, but exempted bingo from this requirement. Swampscott and Marblehead do not have bingo, but their regs would probably prohibit smoking there, if they did. Regarding smoking and outdoor dining: Beverly and Peabody allow outdoor smoking. I am not certain about the other communities. Joyce Redford • of Tobacco Control did say that establishments without outdoor dining have felt it unfair to allow smoking in outside dining areas. STAFF As you may have read the Board has a new staff member; Francis Grace. Frannie is paid through a grant so that our budget is not effected. For now Frannie's workstation will be in our break room area. Maybe we can get more space in our new location?! DEP MEETING The meeting we arranged between residents and the DEP to discuss the DEP's process for contaminated sites was well attended. It was video taped so you may be able to see it on SATV. Thank you to Len and Christina for coming. Salem Board of Health December Phone Log 2000 40 Total Answered *Answered Calls Friday December 1,2000 39 Barb = 233 Saturday December 2, 2000 Mary= 244 Sunday December 3, 2000 Sue= 220 Monday December 4, 2000 6" Tuesday December 5, 2000 46 Wednesday December 6, 2000 59 *Calls Taken Thursday December 7, 2000 38 Friday December 8, 2000 31 Joanne = 146 Saturday December 9, 2000 Jeffrey = 65 Sunday December 10, 2000 Mark = 70 Monday December 11, 2000 35 Jose = 24 Tuesday December 12, 2000 35 Pablo = 4 Wednesday December 13, 2000 43 Tracy = 131 Thursday December 14, 2000 40 Ginny = 33 Friday December 15, 2000 1 36 Barb = 97 Saturday December 16, 2000 Mary = 89 Sunday December 17, 2000 Sue = 53 Monday December 18, 2000 41 Tuesday December 19,2000 37 35 Hour Work Week Wednesday December 20, 2000 34 #43 Office Hours Per Week Thursday December 21, 2000 21 ' =19 Work Days Friday December 22, 2000 11 (1/2 Day 11:30) Saturday December 23, 2000 Sunday December 24, 2000 Monday December 25, 2000 Holiday Monday 8-4 Tuesday December 26, 2000 28 Tuesday 8-4 Wednesday December 27, 2000 38 Wednesday 8-4 Thursday December 28, 2000 14 Thursday 8-7 Friday December 29, 2000 1 11 (1/2 Day 11:30) Friday 8-4 Saturday December 30, 2000 Sunday December 31, 2000 VTotal Calls*_ 0'97= Board of Health Administration Month ly Report NOV. 00 Biologics Distributed * Amount in Doses Diptheria, Tetanus & Pertussis = 510 Burial Permits @ $5.00 $305.00 D iptheria,Tetanus Tox.(under 6 yrs)= 0 Licenses& Permits(+copies) $1,214.00 Immune Serum Globulin= 0 Certificate of Fitness@$25.00 $1,875.00 Measles/Mumps/Rubella= 470 Sealer Weights/Measures= $560.00 Polio= 510 Fines $226.00 Tetanus & Diptheria (adult use)= 410 Total Monies Collected $4,179.00 Tuberculin PPD= 50 Total Monies Year to Date 14,502.20 HIB Titre= 412 Animal Bites Reported=F 0- Hepatitis B= 610 PPV 23 277 PCV 7 730 Annual Budget Expenses Available Balance Salary/Longevity $354,033.00 $107,574.82 $212,958.18 Annual Budget Expenses Encumbered Available Balance Non-Personnel $20,023.00 $3,996.03 $617.43 $10,465.22 Mun a 3 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 Public Health Nurse Report November 2000 Activities Disease Prevention • In touch with T.B. Clinic and following active cases and case contacts. • Vaccine inventory maintained and distributed. • Investigated communicable disease cases and reported to the M.D.P.H • Meetings and Clinics.. • 11/2 Wellness Meeting. Ongoing plans for April 2001 • 11/15-11/16 Home visits scheduled for Salem Residents. 29 residents received home visits for flu vaccination. • Office visits for Flu vaccination throughout November. 52 Residents were vaccinated. • 11/14 Council on Aging Annual Flu and Pneumonia Clinic. • 760 residents were >65 years old. • 87 residents were between the ages of 50-64 • 7 residents were between the ages of 30-49 • 1 resident was between the ages of 19-29 • 936 residents were vaccinated in the month of November. Christina Harrington, her six nursing students, Dr. Miaskiewicz, Joanne Scott, Barbara Sirois, Jose Diaz, Linda Elworthy, and many volunteers at COA are greatly appreciated for their time and effort. • 11/17 42 sixth grade students received the first series of Hepatitis B. Clinic was held at Collins Middle School. • 11/20 5 students participated in the Hepatitis B Clinic offered at St. Joseph's School. Attended Public Health Forum at Beverly Hospital. Hepatitis C Update. Speaker: Dr. Bela Matyas. • 11/29-11/30 Attended Massachusetts Emergency Management • Conference in Marlborough with Joanne. �v��on�nrr 3 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 St. Joseph's • Hearing and Vision will start on Dec. 1, 2000 Phoenix School • Phoenix School is in the process of moving to the Peabody Block. Will call first week in December to discuss Hearing and Vision. • • A �ONUIT i1 3 -'711YL CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, IRS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 MONTHLY REPORT OF COMMUNICABLE DISEASES November 2000 DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES: CASES: CASES: STATE: Campylobacter 0 0 0 0 • Giardia 1 0 0 0 E.Coli 0157H7 0 0 0 0 Hepatitis 1 1 1 1 Lyme Disease 0 0 0 0 Meningitis 0 0 0 0 Pertussis 0 0 0 0 Salmonella 0 0 0 0 Shigella 0 0 0 0 Varicella 0 0 0 0 Reportable Diseases excluded from above have not been identified this month. con�nrr CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 i JOANNE SCOTT, MPH, PIS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 Summary of Communicable Diseases for November • Giardia: 18m child. Will report on December report. • Hepatitis B: Chronic case. Letter sent. • Hepatitis C Massachusetts Department of Public Health Hepatitis C Virus (HCV) Infection • Caused by a virus distinct from • hepatitis A,B,E &G viruses • Causes liver disease. • Accounts for most of"non-A- non-B"hepatitis, 1 Features of Hepatitis C Virus Infection +6Q- �'S Incubation period Average 6-7 weeks Range 2-26 weeks Acute illness(jaundice) Mild(<200/6) Case fatality rate Low Chronic infection 750/6-85% Chronic hepatitis 70%(most asz) Cirrhosis 100/6-20% Mortality from CLD 1%-5% HCV Infection • No vaccine for HCV • • Limited treatments . —interferon+/-ribavirin —significant side effects • HCV outcomes: —17% -20% may develop cirrhosis —1% -5% may develop liver cancer Chronology of HCV Infection Progression to Exposure/Infection Awte(Symptomatic)20J0% Clear virus 15% Chronic Infection 85% l Stable 80%(68116 of original Cirrhosis 20%(178/6 of original Slowly Progressive 75% HCGrransplant 25e/6 (15%of original (4%of original . 2 Chronic Hepatitis C Factors Promoting Progression or Severity • Increased alcohol intake • Age>40 years at time of infection • HIV co-infection • ?Other —Male;gender —Other co-infections(e.g.,HBV) HCV Transmission • • Blood & body fluids • Sex • Perinatal Transmission: Risk Factors • Transfusion or transplant from infected donor(pre-June 1992) • Injecting drug use-ever Other recreational drug use(e.g. cocaine) • Hemodialysis(yrs.on tz) • Accidental injuries with needles • 3 -r Risk Factors,,cont. • Household exposure to infected person • Sex with HCV-infected partner • Birth to HCV-infected mother • Infection with an STD • ? body piercing Injecting Drug Use and HCV Transmission • • Highly efficient among injection drug users • Rapidly acquired after initiation • Four times more common than HIV • Prevalence 60-90% after 5 years Sexual Transmission of HCV • Occurs,but efficiency is low . —Rare between long-term steady partners —Factors that facilitate transmission between partners unknown(e g.,viral titer) • Accounts for 15-20%of acute and chronic infections in the United States —.Sea is a common behavior —Large chronic reservoir provides multiple opportunities for exposure to potentially Infectious partners 4 Permatai Transmission of HCV • Transmission only from women HCV- RNA positive at delivery —Average rate of infection 6% —Higher(179/6)if woman co-infected with HIV —Role of viral titer unclear • No association with —Delivery method —Breastfeeding • Infected infants do well —Severe hepatitis is rare Case-Control Studies of Acute Hepatitis C,U.S. Exposures Not Associated with Acquiring Disease, 1979-1985 Cases Controls .Exposure(prior 6 months) n7--148 n=200 Medical care procedures M.4% 29.5% Dental work 243% 23.5% Health care work(no blood contact) 4.1% 5.0% Ear piercing 2.7% 3.0% Tattooing 0.7% 0.5% Acupuncture 0 1.0% Foreign travel 4.1% 2.5% Military service 13% 4.9% spa:am Mlas:Sac.9r,JAMA 19s9;262:1201-& HCV Co-Infection with HIV • High prevalence among IDU w/HIV • High prevalence among hemophiliacs w/HIV • Greater risk of vertical transmission from co-infected mothers • Low prevalence among MSM w/HIV who are not members of other risk groups also(e.g.IDU) • KEY IS BLOOD TRANSMISSION • Tx for HIV&HCV may be incompatible 5 HCV Counseft Other Transmission Issues • HCV not spread by kissing,hugging, sneezing,coughing,food or water,sharing eating utensils or drinking glasses,or casual contact • Do not exclude from work,school,play, child-care or other settings based on HCV infection status HCW to Patient Transmission of HCV • Rare —In U.S.,none related to performing Invasive procedures • • Most appear related to HCW substance abuse —Reuse of needles or sharing narcotics used for self-injection —Reported mechanism for transmission of other bloodborne pathogens from some HCWs • No restrictions routinely recommended for HCV-infected HCWs Transmission to HCWs • Exposure to HCV generally not occupational —HCW prevalence of HCV infection not significantly elevated —needlesticks and sharps injuries can transmit HCV 6 Occupational Risk of HCV Infection • Case-control study: association with patient care/laboratory work • Seroprevalence of 14%among hospital- based HCWs and oral surgeons. - Case reports after percutaneaous exposures. • Two reports after conjunctival exposure. • Seroprevalence among hospital patients: 0.5-18%. Risk of HCV Transmission After Percutaneous Exposure • Seven published series: n=231 tested HCWs rate 3.5% range:0-10.3% Association of HIV and HCV Occupational Transmission • Longitudinal studies • Two cases of delayed HIV/HCV coinfection seroconversion • HCV viral titers higher in HIV-infected patients • Need for more data 7 Italian Health Care Worker Study Puro,et aL AJIC 1995:23:273 • 4 seroconversions in 646 HCW exposures • 4/331-hollow-bore needles; 0/105-solid sharp; 0/210-mucocutaneous • 2/202 HCV/HIV exposures • 2/444 HCV only exposures CDC NaSH Study: 6/95-5/99 • 22 hospitals • 5232 exposures • 1313(25%)-source status unknown 338(8.60/9)-HCV+only 261(6.7%)-HIV+only 147(3.89/6)-HN+/HCV+ CDC NaSH Study: 6/95-10/98 • 374 HCV exposures • Follow-up: —164(44%)at 3 mos. —109(291/6)at 6 mos. • 5 infections —415 source patient HIV+/HCV+ —4 hollow-bore needle,I scalpel blade;all blood+ 8 PEP for Hepatitis C-ACID Revised Recommendation,February 1994 "Recent studies indicate that IG does not protect against infection with HCV.Thus, available data do not support the use of IG for postezposure prophylaxis of hepatitis C.There are no data on the efficacy of IG for postexposure prophylaxis of other (non-HCV)parenterally-transmitted non- A,non-B hepatitis." PEP for Hepatitis C- Issues and Considerations for Recommendations • • No protective antibody response identified Prior studies of IG use to prevent post- transfusion hepatitis may not be relevant • IG prepared from high anti-HCV titer plasma did not prevent infection in chimpanzees Postexposure Management for HCV • IG,antivirals not recommended for prophylaxis • Follow-up after needlesticks,sharps,or mucosal exposures to HCV-positive blood —Test source for anti-HCV —Test worker if source anti-HCV positive •Anti-HCV and ALT at baseline and 46 months later •For earlier diagnosis,HCV RNA by PCR at 46 weeks —Confirm all anti-HCV results with RIBA • Refer infected worker to specialist for medical evaluation and management 9 ........... .......... .......... --- ...... ,:. :; :... rµt HCV Infection,United States New infections(cases)/year 1985-89 242,000(42,000) 1998 40,000(6,500) • Deaths from acute liver failure Rare Persons ever infected(1.8%) 3.9 million(3.1-4.8)• Persons with chronic infection 2.7 million(2.43.0)• Of chronic liver disease-HCV-related 40%-60% Deaths from chronic disease/year 8,00040,000 �ssu cmeamm um.d Estimated Incidence of Acute HCV Infection United States, 1960-1999 ■ ■ ■ °mp ums ■ ■ Dedlnein ■ bvndadon redcI em s somee:HepatoIW 2ooa,31:777-82;ttepatotogy t997,,26:szs6% • 10 .t • Sources of Infection for Persons with Hepatitis C Injecting drug use 60% Sexual 15% { } Transfusion 10% (before screening Other"5% Unknown 10% •Nosocomial;Health-care work;Perloatal Source:meters for Disease Control and Preventlon Epidemiology of HCV • Highest seroprevalence rates —current&former IDUs —inmates • —HIV positive persons • Populations/sites to screen —drug treatment sites —correctional institutions —HIV/AIDS&STD treatment sites —hemodialysis patients —pre-June 1992 transfusion recipients HCV Prevalence by Selected Groups United States Hemophilia ,liul Injecting drug users - Hemodialysis STD clients Gen population adults Surgeons,PSWs Pregoautwomen Military personnel s le zs s, w s. io 79 is is Average Percent Anti-HCV Positive • 11 S 1 • Prevalence of HCV Infection United States, 1988-1994 Anti-HCV Est.Infections Percent of Group Positive millions(95%CA Infections Total 1.80/1M 3.9(3.1-4.8) 100% Race/ethnicity White 1.5% 2.4(1.83.1) 61% Black 3.2% 0.8(0.6-1.0) 20% Mea American 2.1% 0.3(0.2-0.3) 7% Other 2.9% 0.5(0.3-1.0) 13% - Smvoa NSRS 199P,341:33662 Prevalence of HCV Infection by Age and Gender,United States,1988-1994 Males • , Total Females - Source:CDC,NHANES D HCV Burden, cont. • Accounts for up to 40% of chronic liver disease(alone or together with alcohol) • Is#1 cause of liver transplants in US • 12 i Primary Etiology of Chronic Liver Disease Mutually Exclusive Groups Jefferson County,Alabama,1989 Alcohol 24% Nepatltls C Virus and Alcohol 14% CryptogeNc 17-A Other 5% Hepatltls C Virus It Is S Virus(11%) 26% and Alcohol(3%) (n�40) 14% S.—CDC unouwwrd dm HCV Burden, cont. • In Massachusetts, estimate: • 90-110,000 people infected —about 200 deaths annually from cirrhosis and liver cancer HCV Prevalence & Incidence • Prevalent vs.incident cases • Incidence decreasing significantly • Most prevalent cases infectious • Have an epidemic of recognition —Le.,are recognizing an epidemic of the past(1960s &1970s) —lookback program(blood banks) 13 i Prevention of Hepatitis C • Screening of blood, organ,tissue donors • High-risk behavior modification • Blood and body fluid precautions Serologic Pattern of Acute HCV Infection with Recovery ant4HCV F 2!LALT 0 1 2 J 4 5 6 1 2 J 4 Months Years Time after Exposure Serologic Pattern of Acute HCV Infection with Progression to Chronic Infection anti-HCV s. F ALT 0 1 2 J 4 5 6 1 2 J 4 Months Years _ Time after Exposure 14 f Diagnosis of Hepatitis C • Diagnosis of HCV infection -anti-HCV positive,confirmed by supplemental test(RIBA,PCR, etc.), or —HCV Ag positive by PCR —Note: if high-risk,confirmation of anti-HCV not always necessary Diagnosis of HCV, coat. • Diagnosis of acute HCV • —clinical symptoms (jaundice and/or elevated LFTs), and —diagnosis of HCV infection, and —rule out acute HAV&HBV HCV Infection Testing Algorithm for Diagnosis of Asymptomatic Persons Negetive - 6s" `Oi TOP PoaLONe(�eatreedlveJ OR� Negad e Negaft Indefer a osd00ve POSAWO p�yoppp PouebeHGN, 1 Nw.er ur I t Serce:MMWR 19lS;e7 R(o.e!t t� • 15 1 • Proposed Case Defmitions • Acute Hepatitis C -Clinical criteria: •an acute illness with discreet onset of symptoms,and •jaundice or elevated serum aminotransferase levels Proposed Case Defmitions,cont. • Acute Hepatitis C — Laboratory criteria: •serum aminotransferase>2.5 times • normal,& •IgM anti-HAV negative,& . •IgM anti-HBc negative or HbsAg negative,& •evidence of HCV infection —anti-HCV positive,verified by suppl. test(RIBA,PCR,etc. or —HCV RNA positive by PCR Proposed Case Definitions,cont. • Acute Hepatitis C -Confirmed case: •meets the clinical case criteria& is lab confirmed • 16 i Proposed Case Definitions,cont. • Hepatitis C Virus Infection —Confirmed HCV infection •anti-HCV positive,verified by i suppl,test (RIBA,PCR,etc.) Suspect HCV infection •anti-HCV positive by EIA/ELISA only(not verified by suppl.test) Proposed Surveillance for HCV • For HCV Infection —laboratory reports(passive) • —no follow-up to confirm whether acute • For Acute Hepatitis C —referral physicians •ID,GI&hepatologists •enhanced passive/active HCV Case Management: Goals • Prevention of transmission —blood/organ donation —IV&recreational drug use (referrals for tx,as needed) —sex —sharing razors,toothbrushes,etc. • 17 i s - Goals, coat. • Liver harm reduction —alcohol&selected medications —HAV&HBV vaccines • Referral for HCV treatment -interferon+/-ribavirin • Reassurance HCV Case Management:Process • Case management checklist • Contact provider first,if identified • —by phoneif possible —by form fax/form letter —hepatitis C case report form —recommend and document verification if screening result —patient notification Process, coat. • Interview case: —to educate re: HCV —to refer for verification if screening result —to achieve case management goals —to complete case report form • 18 r i Process, cont. • Report case to MDPH • Prioritize cases for follow-up, e.g.: —acute»older chronic>newer chronic >>lab report only i MDPH Activities re:HCV • Funding sources: —state funds,CDC grant • —Tobacco Settlement Fund-RFRs • Hepatitis C.Advisory Committee • Public awareness efforts: —awareness poster,resource guide —revised MDPH fact sheet —education campaign MDPH Activities, cont. • Provider education efforts: audiotape for physicians —algorithm for diagnosis(handheld card) —reference.materials&resource guide —mailings in late 1999&in 2000 =new case investigation/control guidelines planned for year 2000 —other activities,per Advisory Cmt. 19 — SCHEDULE — Wednesday, November 29 2000 77ME EVENr WFfEIIE 7:30am -9:OOam Registration Hotel Lobby 9:OOam-9:30 am Program Introduction—Stephen J.McGrail, Director, Royal Ballroom Massachusetts Emergency Management Agency Salute&National Anthem—Marlboro Color Guard Greetings&Welcome—Mayor William J.Mauro,Jr.,City of Marlboro Welcome—Jane Perlov,Secretary, Massachusetts Executive Office of Public Safety 9:30am— 10:30am General Session - 21 Y Century Emergency Management-A National Perspective Royal Ballroom 10:30am— 10:45am Break—refreshments—VendorViewing Lobby Tables/ Inside and Outside Foyer Booths/Parking Lot 10:45am— 12:OOpm Breakout Sessions #I —School All Hazards Preparedness ........................................................ Marlboro Room #2—Water Shed Planning........................................................................... Duchess Room #3—National Guard Support to Communities............................................. Southboro Room #4—Energy Concerns ............................................................................... Seminar Room I #5—Communications ............................................................:.................. Westboro Room✓ #6—EMS 2000 ........................................................................................ Sterling Room • #7—Mutual Aid ......................................................................................... Princess Room 12:00pm-1:30pm Lunch w/Speaker—Hurricane Floyd,A Year Later Eric Tolbert,Director,North Carolina Emergency Management Royal Ballroom 1:30pm-2:45pm Breakout Sessions #8—Terrorism.......................................................................................... Princess Room #9—Federal&State Assistance................................................................... Seminar Room #10—Coastal&Maritime Emergencies....................................................... Southboro Room #I I —Federal Search&Rescue Response................................................... Sterling Room #12—School All Hazards —A Local Perspective......................................... Marlboro Room #13—Stress in Emergencies....................................................................... Westboro Room l #14—Special Needs in Emergencies........................................................... Duchess Room #15—The Future of Community Notification Systems................................. Sudbury Room 2:45pm-3:OOpm Break—refreshments—Vendor Viewing Inside and Outside Lobby Tables/ i Foyer Booths/Parking Lot 3:OOpm-4:OOpm Local Emergency Management Directors Meeting Marlboro Room • •Invitation Only••• 3:OOpm-4:OOpm State Police Support to Local Communities Princess Room 3:OOpm-4:OOpm Special Vendor Presentations Wayland,Huds on, Boxboro,Northboro Rooms-Outside 3:OOpm-6:OOpm Vendor Viewing-Inside and Outside Lobby Tables/ • Foyer Booths/Parking Lot 5:OOpm-6:OOpm State Director's Reception Courtyard 6:OOpm-8:OOpm Dinner and Awards Program Music by Jack D'Johns Royal Ballroom 2 r, r { r — SCHEDULE — • Thursday, November 30, 2000 nME EVFKr WFIERE 8:00am -9:00am Registration Hotel Lobby 8:00am-9:00 am Refreshments/Vendor Viewing-Inside and Outside Lobby Tables/ Foyer Booths 9:00am— 10:30am General Session — Major Emergency Operations, Two State Perspectives: Crash of Alaska Airlines Flight 261 Michael Guerin, California Office of Emergency Services May 11999 Oklahoma Tornado David Underwood Oklahoma Department of Civil Emergency Management Royal Ballroom 10:30am— 10:45am Break—refreshments—Vendor Viewing Lobby Tables/ I Foyer Booths 1 10:45am— 12:00pm Breakout Sessions #16-Public Health Issues .......................................................................... Marlboro Room #17-Nor'Easters&Winter Storms ........................................................... Seminar Room #18-Technology in Emergency Management .............................................. Westboro Room #19-Air Crash Emergencies...................................................................... Princess Room #20-Animals in Disasters.......................................................................... Duchess Room #21 -Debris Removal................................................................................ Southboro Room #22—National Flood Insurance Program .................................................... Sterling Room —Special Presentation— 12:00pm-1:30pm Lunch w/Speaker Panel-Working With The Media Royal Ballroom Dan Rea-Channel 4 TV Gail Huff-Channel 5 TV Carl Stevens-WBZ Radio John Monahan-Worcester Telegram&Gazette 1:30pm—2:00pm Wrap Up & Closing Comments Royal Ballroom Stephen J.McGrail,Director, Massachusetts Emergency Management Agency 1 I, 3 9 t r :i 3 v��ONU1T,� cc CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978) 741-1800 Fax:(978) 740-9705 December 11, 2000 Sherry Merrow Dean, Health Service Division Endicott College 376 Hale Street Beverly, MA 01915 Dear Dean Merrow, I would like to take this opportunity to thank Endicott College • Nursing Department for their outstanding assistance at Salem Board of Health annual Influenza and Pneumonia Clinics. Christina Harrington, Assistant Professor of Nursing, and the students listed below, contributed their professional knowledge, interpersonal skills and compassion for our elderly Salem residents. Our three large clinics that target high risk elders were a success, with over 1,120 residents vaccinated. The following students reflect a fine education provided by your institution. Lindsey Tatlock Melinda Grenier Liz Glazer Brooke King Dawn LaRoche Brianne LeMoigne Andrea McGrath Danielle Lucca Jess Burgess Jacqueline Penny Jay Young Jaclyn Squeglia Sincerely, • cc: Christine Harrington Tracy Giarla LPN Public Health Nurse Salem Board of Health Pv��oonln�r,�� Q 5 • � o CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS, CHO NINE NORTH STREET HEALTH AGENT Tel:(978) 741-1800 Fax:(978)740-9705 December 11, 2000 Christina Harrington Assistant Professor, Nursing Endicott College 376 Hale Street Beverly, MA 01915 Dear Christina, The Board of Health extends its appreciation to Endicott College, to you, and to your fine nursing students for their outstanding assistance at the Board's Annual Flu and Pneumonia Clinics. The collaboration with you and your nursing students was well organized and efficient. Other staff members, and of course our elders, enjoyed the students' dedication and enthusiasm. They are a credit to your school. It is encouraging to know that you are teaching our future nurses not only about the skills they must possess, but also about the compassion they must have, to become truly outstanding in their field. I will look forward to working with you and your students next flu season. For the Board of Health, Sincerely, Tracy Giarla LPN • Joanne Scott Public Health Nurse Health Agent Salem Board of Health City Of Salem • Environmental Health Division --- Inspection Monthly Summary Month --------- -------------------- Type Aug 00 Sep 00 Oct 00 Nov 00 Count CFI 70 66 49 77 262 CFR 4 2 1 0 7 CH 6 3 3 3 15 CON 10 5 8 0 23 CR 10 2 3 15 30 CT 2 3 4 2 11 EC 19 11 2 3 35 EPR 1 3 2 1 7 FC 0 1 3 3 7 FRH 3 2 0 3 8 FSD 10 6 6 4 26 FSI 24 18 20 36 98 FSR 12 16 7 11 46 GN 9 4 12 4 29 HI 46 10 7 13 76 HR 14 14 10 9 47 LPI 2 0 0 0 2 MS 1 0 1 0 2 MT 16 14 12 15 57 MUP 1 6 0 0 7 MW 4 0 0 13 17 OG 2 4 2 1 9 RFI 9 8 5 7 29 k FR 3 4 2 2 11 0 5 0 0 0 5 SB 74 15 0 0 89 SM 2 2 0 0 4 SP 2 0 0 0 2 ST 1 4 0 0 5 TFI 14 0 53 0 67 TR 58 34 31 25 148 WM 0 6 15 0 21 Count 434 263 258 247 1202 City of Salem, Massachusett Environmental Health Division Inspection Input Form Inspect Date : Estab Name or Owner Name : Type : Location: Inspector: Inspection Types BP - Body Piercing FSI - Food Serv. Ins . 892* RFD - Ret .Food Disc . 6* CFI - Cert . Fit . 822* FSR - Food Serv. Rein. 194* RFI - Ret . Insp. 75* CFR - Cert . Fit .Reinsp105*GN _ Gen. Nuisance 41* RFR - Ret . Food Rein34* CH - Court Hearing 93* HI - Housing Insp. 260* RO - Rodent Control 16* 0 N - Constable Serv. 65* HR - Housing Reinsp. 135* SC - Suntan 7* - Compliance Rev. 25* LPI - Lead Paint Insp. 6* SES - SESD Odor 0* CT Computer Time10* MS - Massage 6* SM - Seminars 36* EC - Envirn. Compl . 51* Mw - Mark/weights SP - Swim. Pools 16* EPR - Ext . Paint 95* MUP - Mobile Food Insp. 11* SB - Swim. Beaches 65* FC - Food Comp1 . 17* OS - Off . Sub. Insp. 6* ST - Soil/Septic 8* FRH - Food Hearings15* RC - Rec Camps 9* TFI - Temp. Food 112* FSD - Food Serv. 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I■■�■/ee�t3/■�eee■ /��//////�////�/�/�■fie■//■■//� l��Ill�ellliel��*el ■III�I ■■ee/eell�/��/■ //��/////■e/eee�/�■e/ee■e/ee■ �e■//�///Ill�elll�el�a` ��'; ■III ; �//��/��/�/ ■�e/e��■//i■/■e/e�e■/�/e/ee■e■ ■�eeeee■/e■Ill�illi��l .,, ■1� �7�111� �ee�ee�ee��/�■�■//��///�//�///■■■e/�■fie■ a■/■�eee/eeee/Ill�ilili ��Ir!'�lelll� 1e�11��■■et ��e�e��s�e�e��■ ///�//�■e■/■■/e■1110�1 el� �ilc�.._�111� ��ee�e�ei��e�e�■ ��ee��e��lll■ II��:J'��rt�.' ■ill�� I��e��e��ee�/ee/e/��//�! ■�e��e��/e�,��/�e��■ ■111ee111ee111�e11�� /■e■//ei�/�/■e��e//■ INN so /■■ �//�/�//�///�■e��e��■//��■ ��ill�illlielll�illlieill /�/��///�//�■ ■i!/111��111�e111lelll■ ►//ee/ e��/e/ ■/ ■ ■��s'��on Sol R/■��i��■��/e■//e/e/111��111��111�e111 ■Ille //et/�e��/�/�/e■ //��///�//�////�/�/�/��////�/■ if if ��Ille e��e�eee�■ ■//��//��//�/e//�/on�/��/ee■ �eee//e/e/111�ei11�e111 I�elllr` //ee/l��/■ e��i�e�e��e/��e��/!!■ ■e�0///�/e;/111�e111e�1 eelllielll� ■tee/e//��//��//�/�//�/11■ ■��i��/��Itl�ii 11�/111�e111� eell��e��oe��e�ee�l ■/et///e�//�eee/■ Ili�lll��lll��lli�� ie��/��S��e/�� e�l�/��e��ee��e��■ e/e/Ill�elll�milleelli/elll �ll��e��/��■ ��/�e��l/��e�e��ee��/i�/� ■��eelll��llle�lll��lli�■ � �//ee/��/e/�/■ ■��;��e��on 1111 0 e��e ■ee�eee�tlil�eilli�ilt Illy I//e��/�/�■ /e/e��//es//�/e/ee/i/e/��■ ■��e��i11��i11■ ■eltleelll�i I11oe�/�■ ■//e//�eee/eeeeelll�ell �111��111/�111lI ■leeee��e��'��■ ■�/��//ee��/e�/�/111■ li�illeelll�0111e1 ►//ee/ee�� ■/�eeeeee� Now ■��e�/�/��e��e /ili��llle�lll�elll�l ►//�e/�e��/e///e/e/ ■/��/eeeee�e//e/eeneeee/eee ��®�III��IIIeel11��111��11 �a��o��/��■ e��///�//e/e/��// I/N//= ■eeeeeeelll�eillielli■ lei ��■ ■��e/�eee;elll��lll■ ■Ille�lliel AGENT'S NEWSLETTER TO THE BOARD VOLUME 62 December 12, 2000 Is' QUARTER UPDATE ON BOARD OF HEALTH OBJECTIVES The report for the Board's Objectives for the first quarter of FY 2001, Which includes information for July August and September, is in your packet. THE VITALE SITE A group of concerned citizens have concerns that contamination from this site is posing an imminent hazard to Wenham Lake and the water supplied by the Salem-Beverly Water Board. Abbie Winston, a Salem resident and member of this group, has asked to present her concerns to the Board. This site was a gravel pit in the 1950's. In the 1960's, the owner allowed fly ash, a waste of coal combustion at the Salem Power Plant, to be buried at the location. The owner subsequently lost the property through tax default to the City of Beverly. Beverly gave the property to the Beverly Conservation Commission. The site has been under a 21 E or DEP Massachusetts Contingency Plan investigation for the past two years, according to Tom Knowlton of the Salem-Beverly Water Board. I am contacting the Beverly Conservation Commission and the Licensed Site Professional for this site to obtain more information and to ask if the LSP could come to our meeting. • POWER PLANT Dr. Valberg is scheduled to attend our January meeting, although this has not been completely confirmed. Last month's packets contained the Valberg Critique, as well as Dr. Levy's response to that. In your packet this month is some additional information: a repeat of Dr. Levy's response to the Cambridge Environmental Critique (the Valberg Report), as well as Dr. Levy's response to the Earth Tech Critique. I do not have the original Earth Tech Critique. I am requesting a copy from the Power Plant, and hope to have it available to you on Tuesday. TOBACCO COMPLIANCE Seventeen Salem establishments sold cigarettes to an under age individual during the last round of compliance checks. Fine letters have gone to the owners of these establishments. Most have paid the fine. Barbara will have a current update for you at the meeting. COMMUNITY HEALTH ASSESSMENT The Assessment is at the printers! We should have it available to you at the meeting. STAFF • Congratulations to Mark for becoming certified as the Sealer of Weights & Measures. Thank you to Tracy for a job well done during this flu clinic period when delivery of vaccine was so unreliable. I r , • FY2001 I" Quarter Update INSPECTIONAL SERVICES The Board of Health sanitarians and inspectors will: ♦ Provide educational materials for landlords and tenants regarding housing code requirements. 260 letters to landlords regarding their responsibilities regarding the state lead law. ♦ Vigorously enforce trash regulations. Trash(TR) 125 Intervened in dumping situation at the Salvation Army, Highland Avenue. ♦ Provide housing inspections in accordance with the State Sanitary Code. Housing Inspections (HI,HR) 142 Completed follow-up on property at 8 Felt Street and 8 Irving Street. • ♦ Provide Certificate of Inspection inspections for vacant apartments in accordance with City.Ordinance. Certificate of Fitness Inspections (CFI,CFR) 213 ♦ Inspect rooming units annually. ♦ Inspect all food establishments at least once every six months and ensure that establishments are in compliance with the Food Manager Certification requirement. Food Establishment Inspections (FSI,FSR,RFI,RFR) 121 Food Complaints (FC) 4 Reviewed plans or discussed violations with the following establishments: Oh Buster, Engine House, Dunkin Donuts, Carmine's, Grenquist Emporium, Crosby's. ♦ Inspect bathing beaches, swimming pools, recreational camps and suntanning facilities at least once a year. Beaches (SB) 114 Pools (SP) 2 Camps (RC) 1 ♦ Inspect massage establishments at least once a year. Massage Establishment Inspections (MS) 6 ♦ Inspect body piercing establishments at least once a year. ♦ Investigate complaints regarding any permitted facility. ♦ Inspect offensive substance transporters at least once a year. ♦ Inspect and review septic systems in accordance with Title V. Septic Inspections (ST) 6 ♦ Decrease the incidence of odor emissions at the South Essex Sewerage District through vigilant investigation and follow-up of all odor complaints. • ♦ Provide sanitary inspections of neighborhoods when requested in order to limit residents' exposure to disease carrying animals. Rodent Control (RO) 6 • ♦ Employ the use of a professional pest control operator as a consultant and to control rodents in public areas. A-1 Exterminators provided services 4 times. ♦ Provide weights and measures inspections. Inspections (WM) 13 MEDICAL SERVICES The Board of Health Nurse will: ♦ Follow the State's guidelines regarding the follow-up of reported contagious diseases. ♦ Investigate foodborne illnesses reports with the inspectional staff. ♦ Investigate reports of unsanitary conditions related to housing with the inspectional staff. ♦ Obtain immunizations from the State in order to maintain an inventory to be distributed to the City's primary care providers. ♦ Provide nursing services for the school children at St. Joseph's and the Phoenix School including; hearing and vision screening, postural screening;physical examinations, and other screenings as needed, i.e. pediculosis screening; height & weight measurements, review of immunization& medical records; hold clinics, such as for hepatitis b, as • needed. Immunization letters sent to all parents at St. Joseph's and Phoenix School. Immunization letters reviewed. ♦ Sponsor an annual influenza(and pneumonia) clinics, and make home visits to the City's elderly and at risk residents for the purpose of immunizing against flu and pneumonia. ♦ Develop and implement blood pressure clinics for Police, Fire and City personnel, making referrals as needed. ♦ Inspect medical facilities/records of summer camps for compliance with State Codes. Inspected Salem State College Basketball Camp, House of Seven Gables Camp, Camp Pinecrest, Campfire Boys & Girls, Boys & Girls Club Day Camp, Children's Island Day Camp with an inspector. ♦ Perform annual TB testing for North Shore ambulance employees and other city residents upon request. ♦ Conduct hepatitis B clinics for Police, North Shore Ambulance employees and other City employees in conjunction with their contracts. Salem Police Dept. HepatitisB Clinic. 27 officers vaccinated. ♦ Provide clinics for non-contagious diseases as determined by need and feasibility. Photo Eye Screenings for Salem pre-school children assisted by Lions Club member Tom O'Connor. 47 children screened. 34 referrals. Attended North Shore Wellness Fair Committee meetings to discuss April 2001 fair. Participated in the Massachusetts Department of Public Health Local Public Health Preparedness Survey. • The Board of Health Doctor will: ♦ Supervise the medical activities of the Board and its Nurse, including screening clinics, • flu clinics, school child assessments, etc. ♦ Authorize the obtaining and distribution of all vaccines given in Salem. ♦ Perform physicals as required at St. Joseph's and the Phoenix School. ♦ Attend the flu clinics. ♦ Attend the Board's monthly meetings. Dr. Miaskiewicz attended meetings in July and August. The August meeting was cancelled. ♦ Consult with the Health Agent and Nurse regarding communicable diseases and other medical issues of concern to the Board. ADMINISTRATION The Health Agent will: ♦ Maintain a working relationship with the Point community by regularly attending community events. ♦ Represent the Board in presentations to the Mayor and City Council and communicate to the Board proposals and recommendations by the Mayor and City Council. Attended City Council meeting regarding the Willows Recreational Area. Attended City Council meeting regarding composting operation on Swampscott Road. Assisted in food preparation at the Mayor's City-wide Picnic. Attended meeting with Mayor's Aid regarding non-criminal disposition ticketing. • Attended public hearing with City Council and Board members regarding the Power Plant. Attended department heads' meeting with the Mayor. ♦ Provide the office staff with the opportunity to attend educational seminars as offered by the state and other public health associations and organizations. Jeff, Mark,Jose, Joanne attended MHOA Food Seminar(two days). Pablo attended a seminar regarding the State's Lead Law. Jeff attended the Yankee Conference of the New England Environmental Health Association(one day). Mark attended seminar for Sealer of Weights &Measures (two days). Tracy &Joanne attended seminar on West Nile Virus. Jeff, Jose and Joanne attained a limited Pest Control operator's License to apply certain pesticides in response to West Nile Virus. Joanne attended Certified Health officers Board of Registration meetings. Conducted weekly sanitarian staff meetings. Reviewed new food code with staff. ♦ Be a member of Salem's Local Emergency Planning Committee. Continued to organize the Local Emergency Plan. ♦ Insure compliance with directives issued during hearings with developers/contractors. ♦ Insure compliance with tobacco sale and use regulations. ♦ Reassess Salem High School's tobacco ticketing program. Attended meetings with high School principal and vice-principals regarding enforcement of the regulation. • ♦ Provide computer training for the staff. ♦ Continue to purchase computer equipment as necessary and allowed by the budget. ♦ Encourage networking among the inspectors and the staff of the Massachusetts tl • Department of Public Health and the Department of Environmental Protection and other health professionals. Attended interview, with Tracy, regarding the City's abilities to address an emergency. ♦ Maintain membership in the North Shore Boards of Health Collaborative for the purpose of administering its tobacco control grant, as well as for information sharing. Attended meetings. ♦ Develop plan for dental screening. Wrote letter of support for the Family Health Center's application for a state grant. ♦ Gather information through public health publications, computer services or any other means and disseminate that information to the staff and Board. ♦ Maintain the Board's memberships in related professional organizations. ♦ Review health status indicators to prioritize possible interventions. Completed preliminary report with Harvard University School of Public Health student, on Salem's Community Health Assessment. Began planning of 2001 Wellness Fair. ♦ Continue development of a process and procedures book. ♦ Be responsible for and supervise the overall operation of the Board of Health, and provide quarterly reports on these objectives. • • City Of Salem • Environmental Health Division --- Inspection Monthly Summary Month ---------------------- Type Jul 00 Aug 00 Sep 00 Count CFI 70 70 66 206 CFR 1 4 2 7 CH 7 6 3 16 CON 8 10 5 23 CR 3 10 2 15 CT 1 2 3 6 EC 5 19 11 35 EPR 1 1 3 5 FC 3 0 1 4 FRH 1 3 2 6 FSD 3 10 6 19 FSI 13 24 18 55 FSR 11 12 16 39 GN 9 9 4 22 HI 50 46 10 106 HR 8 14 14 36 LPI 1 2 0 3 MS 5 1 0 i MT 12 16 14 42 MUP 2 1 6 9 MW 3 4 0 OG 0 2 4 6 RC 1 0 0 1; FI 3 9 8 20 RFR 0 3 4 7 RO 1 5 0 6 SB 25 74 15 -14 SM 3 2 2 7 SP 0 2 0 2 ST 1 1 4 6 TFI 6 14 0 20 TR 33 58 34 125 WM 0 0 6 �� 6; Count 290 434 263 987 • 12/06/2000 r iRodent Control (RO) 6 ♦ Employ the use of a professional pest control operator as a consultant and to control rodents in public areas. A-1 Exterminators provided services 4 times. ♦ Provide weights and measures inspections. Inspections (WM) 13 MEDICAL SERVICES The Board of Health Nurse will: ♦ Follow the State's guidelines regarding the follow-up of reported contagious diseases. Campylobacter 13 E.coli 1 Pertussis 3 Giardia 5 Salmonella 11 Meningitis 2 Hepatitis 39 Shigella 2 Encephalitis 1 Lyme 8 ♦ Investigate foodborne illnesses reports with the inspectional staff. ♦ Investigate reports of unsanitary conditions related to housing with the inspectional staff. ♦ Obtain immunizations from the State in order to maintain an inventory to be distributed to the City's primary care providers. • MMR 5992 DPT 7660 DT 70 Influenza 7520 OPV 3570 HiB 5330 HepB 8232 Pneumonia 824 IPV 1975 PPD 6190 IGG. 19 vials PCV7 2250 Td 1470 ♦ Provide nursing services for the school children at St. Joseph's and the Phoenix School including; hearing and vision screening, postural screening, physical examinations, and other screenings as needed, i.e. pediculosis screening; height & weight measurements, review of immunization & medical records; hold clinics, such as for hepatitis b, as needed. Immunization letters sent to all parents at St. Joseph's and Phoenix School. Immunization letters reviewed. ♦ Sponsor an annual influenza(and pneumonia) clinics, and make home visits to the City's elderly and at risk residents for the purpose of immunizing against flu and pneumonia. ♦ Develop and implement blood pressure clinics for Police, Fire and City personnel, making referrals as needed. ♦ Inspect medical facilities/records of summer camps for compliance with State Codes. Inspected Salem State College Basketball Camp, House of Seven Gables Camp, Camp Pinecrest, Campfire Boys & Girls, Boys & Girls Club Day Camp, Children's Island Day Camp with an inspector. ♦ Perform annual TB testing for North Shore ambulance employees and other city residents upon request. ♦ Conduct hepatitis B clinics for Police, North Shore Ambulance employees and other City • employees in conjunction with their contracts. Salem Police Dept. HepatitisB Clinic. 27 officers vaccinated. City Of Salem • Environmental Health Division --- Inspection Monthly Summary Month ---------------------- Type Jul 00 Aug 00 Sep 00 Count CFI 70 70 66 206 CFR 1 4 2 7 CH 7 6 3 16 CON 8 10 5 23 CR 3 10 2 15 CT 1 2 3 6 EC 5 19 11 35 EPR 1 1 3 5 FC 3 0 1 4 FRH 1 3 2 6 FSD 3 10 6 19 FSI 13 24 18 55 FSR 11 12 16 39 GN 9 9 4 22 HI 50 46 10 106 HR 8 14 14 36 LPI 1 2 0 3 MS 5 1 0 5 MT 12 16 14 42 MUP 2 1 6 9 MW 3 4 0 ki OG 0 2 4 6 RC 1 0 0 lj OFI 3 9 8 20 FR 0 3 4 7 RO 1 5 0 6 SB 25 74 15 14 SM 3 2 2 7 SP 0 2 0 2 ST 1 1 4 6 TFI 6 14 0 20 TR 33 58 34 125 WM 0 0 6 0 ----- ------ ------ ------ ----- ----- ------ ------ ------ ----- Count 290 434 263 987 • 12/06/2000 • Rodent Control (RO) 6 ♦ Employ the use of a professional pest control operator as a consultant and to control rodents in public areas. A-1 Exterminators provided services 4 times. ♦ Provide weights and measures inspections. Inspections (WM) 13 MEDICAL SERVICES The Board of Health Nurse will: ♦ Follow the State's guidelines regarding the follow-up of reported contagious diseases. Campylobacter 13 E.coli 1 Pertussis 3 Giardia 5 Salmonella 11 Meningitis 2 Hepatitis 39 Shigella 2 Encephalitis 1 Lyme 8 j ♦ Investigate foodborne illnesses reports with the inspectional staff. ♦ Investigate reports of unsanitary conditions related to housing with the inspectional staff. ♦ Obtain immunizations from the State in order to maintain an inventory to be distributed • to the City's primary care providers. MMR 5992 DPT 7660 DT 70 Influenza 7520 OPV 3570 HiB 5330 HepB 8232 Pneumonia 824 IPV 1975 PPD 6190 IGG 19 vials PCV7 2250 Td 1470 ♦ Provide nursing services for the school children at St. Joseph's and the Phoenix School including; hearing and vision screening, postural screening,physical examinations, and other screenings as needed, i.e. pediculosis screening; height &weight measurements, review of immunization&medical records; hold clinics, such as for hepatitis b, as needed. Immunization letters sent to all parents at St. Joseph's and Phoenix School. Immunization letters reviewed. ♦ Sponsor an annual influenza(and pneumonia) clinics, and make home visits to the City's elderly and at risk residents for the purpose of immunizing against flu and pneumonia. ♦ Develop and implement blood pressure clinics for Police, Fire and City personnel, making referrals as needed. ♦ Inspect medical facilities/records of summer camps for compliance with State Codes. Inspected Salem State College Basketball Camp, House of Seven Gables Camp, Camp Pinecrest, Campfire Boys & Girls, Boys & Girls Club Day Camp, Children's Island Day Camp with an inspector. ♦ Perform annual TB testing for North Shore ambulance employees and other city residents upon request. ♦ Conduct hepatitis B clinics for Police,North Shore Ambulance employees and other City • employees in conjunction with their contracts. Salem Police Dept. HepatitisB Clinic. 27 officers vaccinated. i Salem Board of Health November Phone Log 2000 Total Answered *Answered Calls Wednesday November 1, 2000 32 Barb = 233 Thursday November 2,2000 45 Mary= 303 Friday November 3, 2000 29 Sue= 386 Saturday November 4, 2000 Sunday November 5, 2000 Monday November 6,2000 66 *Calls Taken Tuesday November 7,2000 44 Wednesday November 8,2000 39 Joanne = 170 Thursday November 9,2000 46 *Close 4:00 Jeffrey = 68 Friday November 10, 2000 Holiday Mark = 82 Saturday November 11, 2000 Jose = 30 Sunday November 12, 2000 Pablo = 13 Monday November 13,2000 65 Tracy = 174 Tuesday November 14, 2000 59 Ginny = 12 Wednesday November 15,2000 69 Barb = 111 • Thursday November 16, 2000 34 Mary = 126 Friday November 17,2000 36 Sue = 151 Saturday November 18, 2000 Sunday November 19, 2000 Monday November 20,2000 56 43 Office Hours Per Week Tuesday November 21, 2000 39 *=20 Work Days Wednesday November 22,2000 32 35 Hour Work Week Thursday November 23, 2000 Holiday Friday November 24, 2000 7 (comp-holiday) Saturday November 25, 2000 Monday 8-4 Sunday November 26, 2000 Tuesday 8-4 Monday November 27, 2000 66 Wednesday 8-4 TuesdayNovember 28,2000 43 Thursday 8-7 Y Wednesday November 29,2000 55 Friday 8-4 Thursday November 30, 2000 60 • Total Calls*= 937 13oard of Health Administration Monthly Report OCT. 00 BiolOgics Distributed * Amount in Doses 420 t::liptberia, Ttitanus F, Pertussis = Burial Permits @ $5.00 $ 30.00 I:;iiptheria,Tetanus Tox.(under 6 yrs)= 0 Licenses &Permits(+copies)� $1,160.Ob 1-iiiriune Serfim Globulin= 0 Certificate of Fitness@$25.00 $1,725.0b t h�le� sl �s,'Muinps/Rubella= 400 Sealer Weights/Measures= $270.00 430 Total Monies Collected $3,485.00 1'�.anus& giiptheria (adult use)= 490 Total Monies Year to Date $10,323.20 Uo9rciulin P'PD= 40 l l•Ill,t Tilre= 420 Animal Bites Reported= -1- 1 lepatitis B= 480 PIP V 23 100 7 705 Annual Budget Expenses Available Balance :)alalylongevity $354,033.00 $107,574,82 $246,458.18 Annual Budget Expenses Encumbered Available Balance Non-Porsonnel $20,023.00 $3,996.03 $1,714.95 $14,312.02 �- �oNnrr 'ILI ""WYlS CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, IRS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 Public Health Nurse Report October 2000 Activities Disease Prevention a In touch with T.B. Clinic and following active cases and case contacts. two PPD screenings administered to immigrants arriving in Salem. Both tested positive. Referrals were made to North Shore Pulmonary Clinic. Both were seen and are on medication a Vaccine inventory maintained and distributed. a Investigated communicable disease cases and reported to the M.D.P.H • Meetings and Clinics. a 10/12 meeting with Linda Elworthy to discuss Flu clinic. a 10/12 Wellness Mtg. Bagel World. Sponsor letter drafted. a 10/17 Head Start Eye Screenings 15 children screened, results are pending. a 10/19 Bentley pre-school eye screenings: 147 children screened, results are pending. a 10/26 MDPH sent Alert notifying Boards of Health of vaccine delays. Salem Housing Authority and Pioneer Terrace clinics postponed until more vaccine is available. Consulted with Dr. Miaskiewicz about new clinic dates. Newspaper and cable adds modified. Press release sent to Salem Evening News. Arranged new clinics with Council on Aging. a 10/26 Attended Infectious Disease Emergency Preparedness Seminar with Joanne Scott. St. Joseph's • Phoenix School Il r • MONTHLY REPORT OF COMMUNICABLE DISEASES October 2000 DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES: CASES: CASES: STATE: Campylobacter 0 0 0 0 • Giardia 0 0 0 0 E.Coli 0157H7 0 0 0 0 Hepatitis 1 1 1 1 Lyme Disease 0 0 0 0 Meningitis 0 0 0 0 Pertussis 0 0 0 0 Salmonella 0 0 0 0 Shigella 0 0 0 0 Varicella 0 0 0 0 Reportable Diseases excluded from above have not been identified this month. • i M • Summary of Communicable Disease for October Hepatitis C: One Case reported. Attempting to contact. • C BUREAU OF COMMUNICABLE DISEASE CONTROL Massachusetts Department of Public Health 305 South Street, Jamaica Plain, MA 02130 PARTICIPANT CONTACT HOURS Awarded t Ali J Social Security Number Title: Infectious Disease Emergency Preparedness Location: Andover, Massachusetts Date: October 26, 2000 This program has been offered by the Massachusetts Department of Public Health, Bureau of Communicable Disease Control. Nursing contact hours for this program will be provided in accordance with the Board of Registration in Nursing regulations governing continuing education (CMR 244 5.00). This offering carries a maximum of 6.0 contact hours. Amount awarded 6.0 1 Signature of Adri istratively Responsible Person DPH REG OFC NE Fax:508-851-sw Oct 26 '00 15:35 P.03iO3 • Massachusetts Department of Public Health W B�rcau of Communicable Disease Control o I Division of Epidemiology and Immunization �� 2 6 200� 617 983-6800 CITY OF SALEM HEALTH DEPT. To: Local Health Departments and Health Care Providers From: Massachusetts Immunization Program(MIP) Vaccine Unit Date: October 25, 2000 Alert! Influenza Vaccine Further Delayed The MIP Vaccine Unit has been notified that there will be further delays in the delivery of influenza vaccine,resulting in temporary shortages across the United States. In Massachusetts, all local health departments and health care providers have received at least 404/a of their initial allocation of state-supplied vaccine. The tinning of future shipments of state-supplier.vaccine is not known at this time,but is not expected until late November or early December. • Because of the delays in vaccine delivery, all local health departments and other agencies conducting influenza vaccination clinics should implement the following strategies. Schedule initial clinics based only on the amount of influenza vaccine they already have on hand. Target vaccination clinics only to those at highest risk of complications from influenza,including those 65 years of Age and older and younger people with chronic medical conditions. Schedule additional clinics in December,pending receipt of further vaccine. • Encourage healthy people younger than 65 years of age to wait until December or later to seek influenza vaccine for themselves. The MIP Vaccine Unit will notify local health departments and health care providers when additional state-supplied influenza vaccine becomes available. Providers who are awaiting privately-purchased vaccine should contact their vaccine supplier to determine the status of their order. Remember: k is essential that all available influenza vaccine be administered to those most at risk for complications from influenza. • • A2 Friday,November 3,2000 The Evening News, Salem,Mass. Two flu c ' 'cs postponed SALEM — The Board of Housing Authority Nov.15 and Health is postponing two of its Pioneer Terrace on Nov.16. • three scheduled flu clinics be The Council on Aging clinic cause of a shortage of vaccine.. will still be held Tuesday,Nova The state Department of, 44,from 9 a.m.to noon. Public Health has notified city . This clinic is intended for officials there will be further. .residents who are at.highest delays.in the'delivery of in- risk for complications from in- fluenza vaccine,resulting in a fluenza, including those 65 temporary shortage. years or older;or who have a Because of the delays, the chronic disease or other med- Board of Health is.postponing, ical complication. Proof of until further notice,two clinics Salem residency will.be re- scheduled for the Salem quired at the clinic: . • s • Workshop Speakers David Ozonoff, MD, MPH, received his Bachelors of Science degree in mathematics from the University of Wisconsin(Madison) in 1962, his medical degree from Cornell University Medical College in 1967, and his Masters in Public Health degree from Johns Hopkins School of Hygiene and Public Health in 1968. In 1977 he became the first chair of the Department of Environmental Health in the new School of Public Health at Boston University. He has been there since, and now holds the rank of Professor in the School of Public Health and Professor in the School of Medicine. His research work centers on health effects on communities of various kinds of toxic exposures. Bela T. Matyas, MD, MPH, is currently the Medical Director of the Epidemiology Program in the Massachusetts Department of Public Health. He previously served for four years as the Medical Director of Disease Control and State Epidemiologist for the Rhode Island Department of Health(RIDH), after serving for three years as the Chief of Environmental Health Risk Assessment for the RIDH. Dr. Matyas received his medical degree from the University of California, San Diego School of Medicine and completed a residency in Occupational Medicine/Preventive Medicine at the Harvard School of Public Health, where he also received a Master of Science degree in Epidemiology and a Master of Public Health degree. • Alfred DeMaria,Jr., MD, is Assistant Commissioner of the Massachusetts Department Public Health (MDPH). He is the Director of the Bureau of Communicable Disease Control and State Epidemiologist. Dr. DeMaria is board certified in Internal Medicine and Infectious Diseases. He received his medical degree from Harvard Medical School and trained at Montefiore Hospital in the Bronx and Boston City Hospital. Prior to joining MDPH, Dr. DeMaria was in practice as a consultant in infectious diseases and was on the faculty of the Boston University School of Medicine. David Ladd, represents the Massachusetts Department of Fire Services (DFS). DFS consists of the Mass. Firefighting Academy, Hazardous Materials Response Division, the Office of the State Fire Marshal and Administrative Services Division. DFS is a department under the Executive Office of Public Safety of the Commonwealth and is under the direction of State Fire Marshal Stephen D. Coan. As the State Hazmat Response Director, David Ladd has been with DFS for a year and a half. He comes to the department with 25 years in emergency services, concentrating in emergency medical and disaster planning and response. He has served in a wide array of planning and field positions at the local, state and federal levels and has substantial end user experience in field operations. • • Guidelines for Healthcare Facilities and Resources Management During an Influenza Pandemic Draft-04/12/00 Background Influenza There are three types influenza viruses: A, B, and C. Influenza A and B viruses cause yearly outbreaks of disease, primarily during the months of October through March,that are responsible for approximately 20,000 to 40,000 excess deaths and 130,000 to 170,000 influenza related hospitalizations in the United States. These viruses continue to cause disease year after year because they are constantly changing; therefore,the human immune system cannot recognize the new variant even though it may have seen a related strain circulating the year before. This constant evolution (primarily changes in the 2 surface proteins known as hemagglutinin and neuraminidase) is known as antigenic drift. The potential impact of an influenza virus on humans depends on whether there is protective immunity in the population, the virus' ability to be passed from person to person, and its virulence (ability to cause severe illness or death). Annual influenza vaccination is the most effective way to reduce the impact of influenza. The U.S. Public . Health Service (PHS)meets annually to decide which strains of influenza are most likely to circulate widely in the following year and to recommend the influenza strains which should be included in the vaccine. Vaccine production occurs over a several month period and requires careful coordination between PHS and the four vaccine manufacturers licensed in the United States. Pandemic Influenza In addition to antigenic drift, influenza type A viruses can undergo a more dramatic and abrupt type of antigenic change called an antigenic shift, which occurs when viruses belonging to a new influenza A subtype bearing either a novel hemagglutinin protein or novel hemagglutinin and neuraminidase proteins begin circulating among people. ' Antigenic shift may be the result of an exchange of genetic material between two different influenza viruses or changes in an influenza virus that previously infected only animals that allows that virus be transmitted to people. When antigenic shift does occur, a large proportion, or even all, of the world's population has no antibody against the new virus. If the new virus can cause disease in people and can be transmitted easily from person to person, a pandemic can occur. Pandemics of influenza have been recognized since the 1500s. During this century, pandemics occurred in 1918, 1957, and 1968 and caused widespread illness, death, and social disruption. The 1918-1919 Spanish Influenza pandemic is the catastrophe against which all modern pandemics are measured. In addition to millions of deaths, 20%-40%of • the worldwide population became severely ill. There were approximately 20 million deaths worldwide including 500,000 deaths in the United States. This virus was DRAFT-4nvoo CAMy Documents\dlazorikNy Documents\Flu Pandemic planning\Guidelines-HCF.doc - 1 - especially quick to kill. Many people who felt well in the morning became sick by noon, • and were dead by nightfall. Those who did not succumb to the disease within the first few days often died of complications of the flu caused by bacterial illnesses such as pneumonia. There's no simple answer to the question of how serious the next pandemic might be. It depends on how virulent and transmissible the virus is. Since our world today is vastly more populated than it was during previous pandemics, and people travel the globe with ease,the spread of a next pandemic could be more rapid than that of previous pandemics. CDC estimates that the next pandemic could cause between 89,000 and 207,000 deaths, between 314,000 and 733,000 hospitalizations, and between 18 million and 42 million outpatient visits. Morbidity and mortality patterns during a pandemic differ from those seen during non-pandemic years when primarily the elderly and persons with a compromised immune system are most at risk for serious disease and death. During the three pandemics of the 20th century, a substantial amount of the total mortality occurred among persons less than 65 years of age who would not be considered high risk during non-pandemic years. Throughout the Department of Health and Human Services, experts in public health and vaccine development are working to ensure that the United States is prepared to respond to the next influenza pandemic. Pandemic planning at the national level has involved federal, State, and local agencies,medical, public health, volunteer, and trade • organizations, national advisory committees,various consumer groups, the World Health Organization, and Ministries or Departments of Health from a number of foreign countries. A. Institution-level Guidelines These guidelines were created in order to assist health care institutions to maximize staffed beds and resources available during an influenza pandemic. The greatest challenge is expected to be the management of high census in the face of reduced professional, ancillary, and housekeeping staff. Many hospitals already have high census protocols and emergency preparedness plans that may be adapted to pandemic planning. Those plans should be updated with special consideration given to the following: ■ Staffing: Take steps to reduce staff absenteeism during a pandemic. 1. Sponsor local immunization programs for all staff members,physicians, and their families, as well as other at-risk members of the community. 2. Ensure that the facility's time-off policies and procedures adequately consider staffing needs in periods of clinical crisis. Facility policies and employee union • DRAFT-4/ivoo CAMy Documents\dlazorik\My Documents\Flu Pandemic planning\Guidelines-HCF.doc -2- • contracts should incorporate language that allows flexibility to achieve adequate staffing during a pandemic. Unplanned staff or family member illness and previously granted vacation requests may complicate adequate staffing. 3. Consider or expand hospital-sponsored sick care services for the children of hospital staff. 4. Within reasonable limits of clinical competency, consider use of registered nurses and other health care providers currently serving in administrative positions to provide patient care. 5. Preferentially use immunized staff to care for those with suspected or confirmed influenza infection. ■ Discharge: Ensure expeditious patient discharge. 1. Consider appointment of a triage officer to manage patient flow. Utilization review activities have increased importance during a pandemic, when normal continuity of care may be disrupted because of staffing shortages and turnover due to illness. 2. Ensure that the facility has effective rules for expediting patient discharge during • periods of anticipated high demand. These rules might include allocation of a sufficient number of triage physicians and nurses to the appropriate services and procedures for discharge and transfer of patients to home, a skilled nursing facility, or other facilities. 3. Review guidelines and policies allowing expeditious transfer of patients between units, especially from critical care units, when indicated. 4. Develop transportation plans and policies to expeditiously transport discharged patients home or to other facilities. 5. Consider creating a patient discharge holding area or discharge lounge to free up bed space. ■ Emergency Department: Ensure that the Emergency Department is prepared for high patient volume. 1. Pre-plan space needs for flexible use of alternative space for emergency care. Urgent care or fast track areas in or adjacent to the ED may need to be converted to patient treatment areas. • 2. Review policies and procedures addressing adequate physicians, nurses and ancillary staff in the ED and critical ancillary areas. DRAFT--4n2/oo CAMy Documents\dlazoriMy Documents\Flu Pandemic planning\Guidelines-HCF.doc -3- r • 3. Consider appointment of a triage officer to manage patient flow, including appropriate patient referral to other clinics within the facility or to local physicians' offices or nontraditional care settings when ED care is not required. ■ Elective Procedures: Review policies for admitting and scheduling elective procedures and consider how and when to implement contingency plans such as limiting elective admissions and surgery. l. Elective utilization of health care facilities should be limited as much as possible during a pandemic. In addition to allowing re-distribution of staff and equipment, reducing the number of elective visits to health care facilities may decrease a person's exposure to influenza infected patients receiving care in the facility and may also reduce the risk of influenza infection complications in these patients. Consideration should be given to performing any necessary surgeries in a surgical ambulatory care center to reduce the likelihood of patient exposure to influenza infected patients receiving treatment in facilities providing medical care. 2. The need for home health care visits may increase during a pandemic. When feasible, however, the number of visits to a patient's home and the number of homes visited should be limited to reduce the risk of introducing influenza to the home care patient who is likely to be at high risk of complications. Home heath • workers and home health patients should receive influenza vaccine annually and should receive the pandemic strain vaccine once it is available. 3. Many persons are dependent on certain health care procedures or treatments (e.g., dialysis)that must continue during a pandemic. In these situations it is especially important that both the health care worker and the patient receive annual influenza vaccine and that pandemic strain vaccine be administered when it is available. ■ Equipment/Supplies: Plan for the limited availability and increased need for ` allocation of equipment and supplies such as respirators, gurneys and supply carts within the facility and for potential disruption in the normal delivery of supplies and repair services during the pandemic. ■ Patient Placement: Isolation plans for use during a pandemic should be developed in advance. Under ideal circumstances, patients with suspected or diagnosed influenza should be in a private room. Special ventilation is not necessary but the room door should remain closed. During a pandemic, private rooms are unlikely to be available. and containment of infection is likely to be difficult. Consideration should be given to cohorting patients with active influenza infection (during a pandemic all influenza infection is likely to be with the same influenza strain). Isolation procedures for other pathogens, including use of a private room, should continue to be utilized. • DRAFT—Anvoo CAMy Documents\dlazorik\My Documents\Flu Pandemic planning\Guidelines-HCF.doe -4- i • The period of greatest communicability of inter-pandemic influenza is the first 3 days of illness but the virus can be shed before onset of symptoms and up to seven or more days after illness. It is possible that more prolonged shedding could occur with pandemic influenza since the immune system would not have prior experience with related strains. Therefore, all influenza specific bed management measures should be maintained for at least 7 days after onset of illness or longer if symptoms persist. B. Community-level Guidelines A community-wide coordinated response will be essential. Communication with local physicians,physician's groups, urgent care centers, community clinics, and home health care agencies is essential to develop joint contingency plans and to determine their availability during peak periods. Planning should involve healthcare facilities, EMS, and other first responders to ensure that there is coordinated distribution of scarce critical resources. Creating a Task Force: In order to effectively respond to an influenza pandemic, communities will need to coordinate many health care related activities. Because so many different perspectives will need to be considered during this process, it is recommended that a Community Health Care Task Force be created that engages all the necessary parties. The Task Force should include, at a minimum, representatives from hospitals, physician groups, the public health sector, including home health care, and emergency response groups. Roles of the Task Force: The Task Force should be responsible for coordinating health care activities from a community perspective during a pandemic. The following are suggestions of activities the Task Force should consider. 1. Working with the local health department to issue public health advisories as needed regarding the pandemic crisis and the use of the emergency department(ED) vs. clinics and urgent care centers. 2. Research and define community regulations pertaining to crisis management,the responsibilities of hospitals and other health care facilities,the responsibilities of the public health sector, and any other regulations relevant to pandemic-type situations. 3. Work with hospitals to ensure that adequate protocols for bed management across facilities. These protocols should address how and when the decision will be made to utilize alternative facilities for patient care (see Guidelines for Utilization of Non- Traditional Settings for Delivery of Medical Care During and Influenza Pandemic). 4. Initiate a tracking system for monitoring the impact of the pandemic on hospitals in the community. This tracking system should collect the following types of data: • • Number of available ICU beds (adult and pediatric); • Number of available medical ward beds (adult and pediatric); DRAFT-4iivoo CAMy Documents\dlazoriMy Documents\Flu Pandemic planning\Guidelines-HCF.doc -$- <a • Number of available ED beds (total); • • Number of available ED monitored beds; • Number of available ED non-monitored beds; • Number of patients in the ED waiting to be seen; • Number of patients waiting for inpatient beds (in ED, clinic, recovery, etc); • Average waiting time for non-ambulatory patients to be seen in ED; • Average waiting time for ambulatory patients to be seen in ED; • Number of hospitals on ED diversion*, and; • Morgue capacity. *The Task Force is encouraged to consider the value of allowing ambulances to divert from their emergency departments when it is obvious that each hospital in the community is equally impacted by the pandemic. It may be necessary to reevaluate this issue every 24 hours during the crisis. 5. Work with hospitals that are experiencing unusually heavy patient volumes by giving transfer priority when: • Hospital is in danger of exceeding bed capacity; • Hospital has already performed"in-patient triage" in order to free up as many ICU and ward beds as possible; • Hospital is currently on emergency department diversion; • Hospital has implemented procedures to obtain additional staff, and; • Hospital is unable to provide/obtain needed medical equipment or services due to overwhelming conditions. 6. Formulate a plan for expediting the patient transfer between hospitals when appropriate. 7. When a hospital has exhausted its medical supplies, a mechanism should be in place for allocating urgently needed equipment(e.g. ventilators). Since several hospitals in the community are likely to concurrently experience this problem, it is recommended that one distribution center be responsible for coordinating requests for additional equipment and supplies. 8. Formulate a plan to coordinate the transport of supplies from one hospital to another when appropriate. 9. Permit ambulances to honor ED diversion and transport patients to the next closest facility provided that it is within 15 minutes of an open facility. 10. Develop a plan for management of bodies when morgue capacity has been exceeded. 11. Develop a plan for continuity of home health care services and the delivery of medical supplies to home health care patients. • DRAFT—aiivoo CAMy Documents\dlazorik\My Documents\Flu Pandemic planning\Guidelines-HCF.doc -6- Guidelines for Administration of Pandemic Influenza Vaccine in Short Supply • DRAFT--04/03/00 Adapted for Massachusetts 10/00 Background Influenza , Influenza epidemics occur nearly every year and usually peak during December through March in temperate regions of the Northern Hemisphere. In the United States, annual influenza epidemics are associated with an average of 20,000 excess deaths and 110,000 excess hospitalizations. The potential impact of influenza on humans depends on the degree of protective in.munity in the population, the virus' ability to be passed from person-to-person, and its virulence (ability to cause severe illness or death). There are two types of influenza that cause epidemic disease in humans: influenza type A and influenza type B. Influenza A viruses are further classified into subtypes on the basis of two surface antigens: hemagglutinin(H) and neuraminidase (l). Both types A and B viruses undergo continual antigenic change (i.e. antigenic drift) resulting in the emergence of new strains. Antibody against one type or subtype confers little or no protection against another influenza type or subtype. And, antibody to one strain of influenza may not protect against a distantly related strain. The constant development of antigenic variants through antigenic drift is • the basis for seasonal epidemics and the reason that the influenza vaccine is updated yearly. Annual influenza vaccination is the most effective way to reduce the impact of influenza. The U.S. Public Health Service (PHS)meets annually to decide which strains of influenza are most likely to circulate widely in the following year and to recommend the influenza strains that should be included in the vaccine. Vaccine production occurs over a several month period and requires careful coordination between PHS and the four vaccine manufacturers licensed in the United States. Pandemic Influenza In addition to antigenic drift, influenza type A viruses can undergo a more dramatic and abrupt type of antigenic change called antigenic shift, which occurs when viruses belonging to a new ` influenza A subtype bearing either a novel hemagglutinin protein or novel hemagglutinin and neuraminidase proteins begin circulating among people. Antigenic shift may be the result of an exchange of genetic material between two different influenza viruses or changes in an influenza virus that previously infected only animals that allows that virus be transmitted to people. When antigenic shift does occur, a large proportion, or even all, of the world's population would not have antibody against the new virus. If the new virus can cause disease in people and can be transmitted easily from person to person, a pandemic can occur. • Pandemics of influenza have been recognized since the 1500s. During this century,pandemics occurred in 1918, 1957, and 1968 and caused widespread illness, death, and social disruption. 1 C:\WINDOW SWEPOMHORTS-I.WPD DRAFT-April 3,2000 The 1918-1919 Spanish Influenza pandemic is the catastrophe against which all modern pandemics are measured. In addition to millions of deaths, 20%-40% of the worldwide • population became severely ill. There were approximately 20 million deaths worldwide including 500,000 deaths in the United States. This virus was especially quick to kill. Many people who felt well in the morning became sick by noon, and were dead by nightfall. Those who did not succumb to the disease within the first few days often died of complications of the flu caused by bacterial illnesses such as pneumonia. There's no simple answer to the question of how serious the next pandemic might be. It depends on how virulent and transmissible the virus is. Since our world today is vastly more populated than it was during previous pandemics, and people travel the globe with ease, the spread of a next pandemic could be more rapid than that of previous pandemics. CDC estimates that the next pandemic could cause between 89,000 and 207,000 deaths, between 314,000 and 733,000 hospitalizations, and between 18 million and 42 million outpatient visits. Morbidity and mortality patterns during a pandemic differ from those seen during non-pandemic years when primarily the elderly and persons with a compromised immune system are most at risk for serious disease and death. During the three pandemics of the 20th century, a substantial amount of the total mortality occurred among persons less than 65 years of age who would not be considered high risk during non-pandemic years. Throughout the Department of Health and Human Services, experts in public health and vaccine development are working to ensure that the United States is prepared to respond to the next • influenza pandemic. Pandemic planning at the national level has involved federal, state, and local agencies,medical, public health, volunteer, and trade organizations, national advisory committees,various consumer groups, the World Health Organization, and ministries or departments of health from a number of foreign countries. Influenza Vaccine Production The current vaccine production system is characterized by dependency on egg availability and a time lag between identification of a novel virus, initiation of production, and vaccine distribution. This time lag results from the lengthy processes of identifying vaccine candidate strains, preparing seed lots,testing and licensing vaccine, and manufacturing the needed number of doses. Despite ongoing efforts to shorten the vaccine production process, it is anticipated that initial vaccine supplies will not be sufficient to immunize the entire population. The initial shortage of vaccine necessitates a predetermined mechanism to decide who would receive vaccine first. On of the assumptions made for planning purposes is that addressing criteria for prioritization now, and modifying them based on specific epidemiologic data available at the time of a pandemic, would result in a more informed decision. 2 CAWIND0WS\TEMP\SH0RTS-1.WPD DRAFT-April 3,2000 4 Example Guidelines for Vaccine Priority Groups • The goal of the pandemic response(limit the impact of a pandemic by limiting the burden of disease,minimizing social disruption, and reducing economic losses) can best be achieved by vaccinating the entire population. However, vaccine production limitations may result in limited quantities of vaccine being available during the early stages of the pandemic. Therefore, priorities for vaccination will need to be established. The following prioritized groups are offered as planning guidance but will need to be reexamined at the time of a pandemic alert when epidemiologic data about the pandemic virus are available. Each state will need to adapt the priority group guidelines according to local infrastructure implications. For example, the role of public transportation will vary greatly from community to community and may therefore have very different priority implications in each community. Note: Estimated numbers for Massachusetts were calculated by multiplying the estimated national numbers by 2.3%. Priority Group 1: Health Care Workers who care for patients in acute and long term care facilities and in home care settings and Public Health Workers who are participating in vaccine delivery efforts. (est. 170,000 in Mass.) Rationale: This group represents our first line of defense and the implementation of the response plan is dependent on this sector continuing to function. In addition, it is anticipated that morbidity and mortality from • all diseases and illnesses will increase during a Pandemic making Health Care and Public Health workers even more critical. Priority Group 2: Firefighters, police,National Guard, military personnel, ambulance drivers and other first responders (est. 280,000 in Mass.) Rationale: These essential personnel must be in place to maintain the national defense and assist in the vaccination effort. It is anticipated that the National Guard would be an integral component of most state response plans. Priority Group 3: Persons at High Risk to Develop Severe Outcomes following influenza infection. (est. 1.7 million in Mass.) Rationale: In order to meet our objective of reducing mortality we must address the most vulnerable citizens. The Advisory Committee on Immunization Practice has generally identified the following groups as those at highest risk. Their relevant order could vary depending on the specific strain of the virus encountered and further subdivision may be possible. A) Persons with high-risk medical conditions. B) Pregnant women • C) Persons in nursing homes and long-term care facilities 3 C:\WINDOW S\TEMP\SHORTS-1.WPD DRAFT-April 3,2000. D) Persons> 65 years of age living independently, and not included in"3- A" • E) Infants 6 months to 1 year of age, if supported by epidemiologic data Priority Group 4: Household Contacts of persons with high-risk medical conditions. (est. 440,000 in Mass.) Rationale: These individuals should be immunized.to reduce the likelihood that they will expose the vulnerable and, since many health care facilities may be overwhelmed,to assist in home care. Priority Group 5: Essential Service Providers (est. 70,000 in Mass.) Rationale: Our ability to mount an effective pandemic response can be highly dependent on these kinds of personnel being in place to maintain key community services. Each State plan will need to determine their own priorities,but they are likely to include: * Utility workers (water, gas, electricity and telephone and other essential communications systems) * Funeral service personnel * Personnel who work with institutionalized populations * Persons who are employed in public transportation and the transportation of essential goods (i.e., food) Priority Group 6: Healthy adults younger than 65 years of age (est. 2.1 million in Mass.) • Rationale: They are at a lower risk of developing severe outcomes from disease but they represent the most significant segment of the population from an economic impact perspective. Priority Group 7: Healthy persons one to 18 years of age (est. 1.6 million in Mass.) Rationale: They are at the lowest risk of developing severe outcomes from disease but play a significant role in the spread of the disease. • 4 C:\W1ND0WS\TEMP\SH0RTS-l.WPD DRAFT-April 3,2000 Q CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS, CHO NINE NORTH STREET HEALTH AGENT Tel:(978) 741-1800 Fax:(978)740-9705 Salem Board of Health Annual Flu and Pneumonia Clinics. Council on Aging 5 Broad Street Tuesday, November 14, 2000 9 a.m. to 12 noon PROOF OF RESIDENCY WILL BE REQUIRED AT DOOR. Salem Housing Authority POSTPONED UNTIL MORE VACCINE BECOMES AVAILABLE • Pioneer Terrace POSTPONED UNTIL MORE VACCINE BECOMES AVAILABLE Our clinics are intended for people at highest risk for complications from influenza, and who therefore will be the first priority for receipt of influenza vaccine at our clinics: • All residents 65 years or older • All residents with chronic pulmonary or cardiovascular disease, including asthma. • All residents who have required regular medical follow-up or hospitalization during the preceding year because of: • Chronic metabolic diseases (including diabetes) • Renal dysfunction • HIV infection • Immunosuppression caused by other diseases, medications or treatments. • Residents who will be in their second or third trimester of pregnancy. Homebound residents, or for more information, please call Tracy • Giarla LPN, Public Health Nurse at 741-1800 All Vaccines are Free ! i A list of issues and problems raised in the case scenarios or possible in a similar situation in MA communities 1. Events happen very quickly-time frame a very compressed and quick action is essential. 2. Failure of FBI to alert health authorities 3. Clinical clues missed 4. Failure to identify Bacillus species when first isolated 5. Ill initially in many different locations and health emergency not detected l 6. Media coverage adds to confusion and public anxiety 7. Health facilities inundated with ill patients 8. Isolation not began early enough had it been flu 9. Hospital staff confused and demoralized 10. Specter of bioterrorism raised which was previously unanticipated 11. Recommended isolation protocols not followed 12. Uncertainty regarding other attacks in other places 13. Common source exposure not identified early 14. Didn't have any treatment guidelines for anthrax 15. Confusion over who to treat 16. Patient triage 17. Identification of antibiotic sensitivities-possible use of Penicillin if not resistant 18. Dealing with worried well and determining who are really at risk 19. Management of dead bodies 20. No clear source of drug supply 21. No prior planning for estimation of drug needs 22. No prior planning for rapid mass distribution of antibiotics 23. Need for after hours notification system 24. No prior planning for accommodating volume of ill patients 25. No prior plan for keeping public order and limiting unrest 26. No control of media—need good relationship with the media-Press conferences early on would be useful 27. Public misinformation contributing to panic 28. Security of antibiotic stocks at distribution points 29. Workforce depleted through absenteeism and illness 30. Failure to anticipate public unrest and control looting. • AGENT'S NEWSLETTER TO THE BOARD VOLUME 61 November 14,2000 POWER PLANT We have asked Dr. Valberg, who wrote the Power Plant's reply to the Harvard/Levy Study, to come to the Board's meeting in December or January. In your packets is his reply and Dr. Levy's reply to Dr. Valberg's reply! SENIOR ACADEMY You may remember, I was asked to speak to seniors about Home Sanitation. This experience was very enjoyable. Enclosed is the information I presented. WALGREEN'S- BOSTON STREET Last month I mentioned that the Ward Four Neighborhood Association had questions regarding environmental testing now being done at this location, after the store has been built and opened. To date, there have been two meetings on this topic. I attended both, as did the Licensed Site Professional for Walgreen's. He has given good information regarding cont[nued contamination in the soil and ground water. His analyses continue. He is planning to report next week on air monitoring samples within the building. After the analyses are finished, he will be • writing a plan to remediate the site. I don't see any risk of exposure at this time. Through these meetings I have been made aware of some programs offered to communities by the DEP. One is called "PIP." This stands for Public Involvement Plan. In the packet is a letter sent to the owner of record of the site requesting that it be designated as a PIP site. This will require that the Licensed Site Professional meet with concerned residents, present information to them as it becomes available to them, and solicit their input regarding any plans that are written. This is similar to what is happening now with the Licensed Site Professional (LSP.) This process just makes it formal and mandatory. An engineer from the DEP will be coming to a meeting in December or January to explain the idea of the "Brownfields Legislation." I will keep the Board informed in case you would like to attend. SALVATION ARMY Len has been working as Hearing Officer to resolve the difficult situation at the Highland Avenue Salvation Army. You will see a complaint in your file regarding that location, as well as our latest communication outlining the required conditions for collections to occur. SWAMPSCOTT ROAD LANDSCAPING COMPANY A subcommittee of the City Council had a meeting to discuss the composting problems at this location. The Board of Health required them to shut • down operations one day in October because of a tremendous odor problem created by the moving and grinding of compost. This problem is contingent upon the wind direction. The City Council will keep this matter open for further study. 1st QUARTER UPDATE ON BOARD OF HEALTH OBJECTIVES This update should be ready for the meeting. City Of Salem • Environmental Health Division --- Inspection Monthly Summary Month ---------------------- Type Aug 00 Sep 00 Oct 00 Count CFI 70 66 49 185 CFR 4 2 1 7 CH 6 3 3 12 CON 10 5 8 23 CR 10 2 3 15 CT 2 3 4 9 EC 19 11 2 32 EPR 1 3 2 6 FC 0 1 3 4 FRH 3 2 0 5 FSD 10 6 6 22 FSI 24 18 20 62 FSR 12 16 7 35 GN 9 4 12 25 HI 46 10 7 63 HR 14 14 10 38 LPI 2 0 0 2 MS 1 0 1 2 MT 16 14 12 42 MUP 1 6 0 7 MW 4 0 0 4 OG 2 4 2 8 RFI 9 8 5 22 �FR 3 4 2 9 O 5 0 0 5 SB 74 15 0 89 SM 2 2 0 4 SP 2 0 0 2 ST 1 4 0 5 TFI 14 0 53 67 TR 58 34 31 123 W lh A 40- WM 0 6 15 21 rye W t" Count 434 263 258 955 Sn �L'J ( /{'��5��) .++4 City of Salem, Massachusett Environmental Health Division Inspection Input Form Inspect Date : Estab Name or Owner Name : Type : Location: Inspector: Inspection Types BP - Body Piercing FSI - Food Serv. Ins . 892* RFD - Ret .Food Disc . 6* CFI - Cert . Fit . 822* FSR - Food Serv. Rein. 194* RFI - Ret . Insp. 75* CFR - Cert . Fit .Reinsp105*GN _ Gen. Nuisance 41* RFR - Ret . Food Rein34* CH - Court Hearing 93* HI - Housing Insp. 260* RO - Rodent Control 16* ti N - Constable Serv. 65* HR - Housing Reinsp. 135* SC - Suntan 7* Compliance Rev.25* LPI - Lead Paint Insp. 6* SES - SESD Odor 0* CT _ Computer Time10* MS - Massage 6* SM - Seminars 36* EC Envirn. Compl . 51* MW - Mark/Weights SP - Swim. Pools 16* EPR - Ext . Paint 95* MUP - Mobile Food Insp. 11* SB - Swim. Beaches 65* FC - Food Compl ..17* OS - Off. Sub. Insp. 6* ST - Soil/Septic 8* FRH - -Food Hearingsl5* RC - Rec Camps 9* TFI - Temp. Food 112* FSD - Food Serv. Disc 53* MT - Meetings 65* TR - Trash 381* oG - ove-26atawr/! 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Date: 5/12/2000 To: Barabara Sirois, Clerk for the Board of Health Cc: Joanne Scott,Board of Health Agent From: Len Milaszewski;Chairman Board of Health RE Agendas and Packets Please submit proposed Board of Health Meeting Agendas, by fax or hand, to me no later than the close of the business on the Wednesday prior to a regularly scheduled Board of Health Meeting. This is for comments and/or approval. • Please have Board of Health members' "packets" ready no later than the close of business on the Thursday prior to a regularly scheduled Board of Health Meeting. Distribution of "packets" should be completed on the Friday prior to a regularly scheduled Board of Health Meeting. Of course, there may be a rare occasion when this may be difficult to do and changes may need to be made. However, I feel that by following the above schedule,,- we will be better prepared to deal with any last minute changes. Please change the Agenda of the Board of Health Meeting for May 9, 2000 to show that a Public Hearing was scheduled at 7:30 PM and include this change in next month's"packet'. 5112J2000 05/12/00 FRI 07:00 FAX 978 744 5846 Len Milaszewski lj�002 5/12/2000 MEMO:Agendas and Packets • If you have any questions or need additional information, please feel free to contact me. Thanks. Regards, Leona J. Milasz ski Chairman Board of Health for the City of Salem Im11m • • Board of Health Administration Monthly Report SEPT. 00 Biologics Distributed * Amount in Doses Diptheria, Tetanus& Pertussis = 435 Burial Permits @ $5.00 $235.00 D iptheria,Tetanus Tox.(under 6 yrs)= 0 Licenses& Permits(+copies) $285.00 Immune Serum Globulin= 0 Certificate of Fitness@$25.00 $1,225.00 Measles/Mumps/Rubella= 560 Sealer Weights/Measures= $152.00 Polio= 460 Total Monies Collected $1,897.00 Tetanus&Diptheria (adult use)= 1065 Total Monies Year to Date $6,838.20 Tuberculin PPD= 10 HIB Titre= 392 Animal Bites Reported= -1- Hepatitis B= 965 PPV 23 100 PCV 7 700 Annual Budget Expenses Available Balance Salary/Longevity $354,033.00 $105,405.60 $248,627.40 Annual Budget Expenses Encumbered Available Balance Non-Personnel $20,023.00 $2,000.88 $2,258.83 $15,763.29 �oND n ,a a � • 9��C/^D1VE dD CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 Public Health Nurse Report September 2000 Activities Disease Prevention • In touch with T.B. Clinic and following active cases and case contacts. • Two PPD screenings done in office. • Vaccine inventory maintained and distributed. • Investigated communicable disease cases and reported to the M.D.P.H Meetipgs and Clinics. • 9/6 3 DPW workers received their 2nd Hepatitis B vaccination. • 9/7 18 Police completed the Hepatitis B vaccination. • 9/14 Attended Wellness Fair committee meeting. • • 9/15 Attended West Nile Virus Public Health Forum with Joanne Scott. Speaker: Bela Matyas, MD, MPH • 9/26 Lions Club member Tom O'Connor provided Photo Eye Screener. 27 students participated in the screening. St. Joseph's • 9/8 Attended Pre-School Orientation for Parents. Obtained all pre-K immunization records. Letters were sent to parents who have not submitted proper immunization records, or physicals. • 9/11 Reviewed all immunization records for students K-8. Letters sent to parents who have not submitted proper immunization records, or physicals. Phoenix School 9/22 Reviewed all immunization records for students K-8. betters letters sent to parents who have not submitted proper immunization records, or physicals. • • MON THLY ART OF COMMUNICABLE DISEASES Seytember 2000 DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES: CASES: CASES: STATE: • Campylobacter 2 0 2 2 Diardia 0 0 0 0 1 .Coli 0157H7 0 0 0 0 Hepatitis . 2 2 1 1 Lyme Disease 0 0 0 0 Meningitis 0 0 0 0 pertussis 0 0 0 0 Salmonella 0 0 0 0 Shigella 0 0 0 0 Varicella 0 0 0 0 Reportable Diseases excluded from above have not been identified this • month. 1 • Summary of Communicable Diseases September 2000 Campylobacter: 76 y/o Ft. did not have gastrointestinal symptoms. He was admitted to the hospital tvith a loin grade temperature, and a wound on his leg. This patient had bacteremia. Species: Campylobacter fetus. This man currently has lymphoma. 41 y/o Non-Foodhandler. Has had symptoms for 3months. History of irritable bowel syndrome. She was finally tested in September. Daughter had mild symptoms, and was encouraged to be tested. • Hepatitis: 2 Hepatitis C cases. 1 Hepatitis H (duplicate report) • AU 7 2a00 CITY OF SALEM NORTHEAST HOSPITAL CORPORATION HEALTH DEP� Public Health Forum Target Audience: Public Heath Directors & Nurses, Infection Control personnel, NHC Medical Staff & Employees Date: 9/15/00 TO REGISTER: e-mail tketchop@nhs-healthlink.org or call the Community Relations Department at Beverly Hospital (978) 922-3000, extension 2480. Time: 11:30 am-1:00 pm 11:30-12:00 noon: lunch 12:00- 1:00 pm: program Location: Lecture Hall, Beverly Hospital, 85 Herrick Street, • Beverly, Massachusetts TOPIC: "West Nile Virus: Prevention & Control" COST: Employees: Free Non-employees: Free Affiliates: Free CONTACT HOURS: 1.2 hours SPEAKER: Bela Matyas MD, MPH Medical Director, Epidemiology Program MDPH COORDINATOR: Barb McCarthy RN, MPH, CIC, CPHQ Director, PI & Standards OBJECTIVES: 1. Update the epidemiology & incidence of West Nile virus in the state/local area 2. Review West Nile testing procedures (animal & human) 3. Identify prevention & control strategies including routes of disease transmission. • • West Nile Virus: A Risk to .Horses in Massachusetts? Massachusetts Department of Public Health,305 South Street,Jamaica Plain,MA 02130 Massachusetts Department of Food and Agriculture,251 Causeway Street,Boston,MA 02114 What is West Nile virus (WNV) disease? West Nile virus (WNV) disease is a rare disease caused by a virus. In a small percentage of people infected by the virus,the disease can be serious, even fatal. The virus that causes WNV disease occurs in Europe,Africa,Australia and Asia. It was first identified in the United States during the summer of 1999. WNV grows in birds,and it is transmitted from bird to bird and from birds to humans by mosquitoes. Horses bitten by mosquitoes carrying WNV can also become sick. How many horses have been infected with WNV in the United States? During.the 1999 New York outbreak,25 horses had clinical signs of WNV disease,and 9 of these(36 %) died or were euthanized. Blood tests on horses in the affected area showed that • up to half of those tested may have been infected, suggesting that the vast majority of infected horses do not develop clinical illness. What are the signs of WNW disease in horses? Clinical signs in horses with West Nile virus disease vary. Most affected horses develop an unsteady gait, generalized weakness, and muscle weakness of the hind limbs. Fever is not usually present. A small number of horses develop muscle weakness progressing to paralysis of all four limbs,recumbency, and death or euthanasia within 2 to 9 days. Animals that recover do so without any significant consequences. If my horse is infected with WNV,do I have to euthanize or quarantine it? Horses affected by WNV do not need to be euthanized. Horses are humanely euthanized only when they are suffering from illness from which they will not be able to recover. Also, since infected horses do not appear to be carriers for the infection, it's unlikely a quarantine would be necessary. If my horse is infected with WNV,is there a risk that I will become infected or my other horses will become infected? There is no documented evidence of animal-to-person or animal-to-animal transmission of WNV, so someone caring for an infected horse is very unlikely to get infected with WNV. Also,a horse infected with WNV is very unlikely to infect horses.in neighboring stalls. Is the Eastern Equine Encephalitis (EEE)vaccine protective against WNV? No. If your horse is vaccinated against EEE virus,unfortunately it will not be protected against WNV infection. Although EEE virus is also carried by birds and transmitted by mosquitoes,it belongs to another family of viruses for which there is no cross-protection. There is no approved vaccine currently for WNV for horses or for people. What steps can.I take to protect my horse from infection with WNV? . Horse owners can take steps to reduce the chances that their horses will be exposed to WNV. The best way to do this is by removing any potential sources of stagnant water in which mosquitoes can breed. • Dispose of or regularly empty any water-holding containers on your property. • Dispose of any discarded tires. • Drill holes in the bottom of recycling containers that are left outdoors. • Clean clogged roof gutters. • Turn over plastic wading pools or wheelbarrows when not'in use,. • Do not allow water to stagnate in birdbaths,and aerate ornamental pools or stock them with fish. • Clean and properly chlorinate swimming pools that are not in use, and be aware that mosquitoes can breed in the water.that collects on swimming pool covers. • Use landscaping to eliminate stagnant water that collects on your property; mosquitoes can breed in any puddle that lasts more than 4 days. • . Thoroughly clean watering troughs on a monthly basis. What should I do if I suspect my horse is infected with WNV? WNV is only one of many possible causes of nervous system disease in horses. If your horse has any of the signs associated with WNV infection,you should contact your veterinarian immediately. The Massachusetts Department of Public Health P will test specimens � � P from horses with signs suggestive of WNV disease Veterinarians � . gg V termanans that suspect WNV disease • in horses should contact MDPH at(617) 983-6800 and the Massachusetts Department of Food and Agriculture at(617) 626-1741. What is the risk that WNV will affect horses,birds,or people in Massachusetts this season? On July 26,2000, a bird infected with WNV was found in Boston. Although we can not predict how severely WNV might affect people,horses, and birds based on this finding,it is possible that WNV could seriously affect people,birds, and horses this summer and fall. MDPH will be posting weekly updates on the results of testing for WNV on its web site at www.state.ma.us/dph. ' For more information on WNV Additional information about WNV infection in horses: Massachusetts Department of Food and Agriculture (617) 626-1795 Additional information about WNV and people and about testing of horses for WNV Massachusetts Department of Public Health (617) 983-6800 Websites with information about WNV and people and horses: U.S.Department of Agriculture www.usda.gov Centers for Infection Control and Prevention www.cdc.gov Massachusetts Department of Public Health www.state.ma.us/dph • July 2000 Steps You Can Take To Prevent West Nile Virus Encephalitis Massachusetts Department of Public Health, 305 South Street, Jamaica Plain, MA 02130 How can I protect myself and my family from mosquito bites? There is no vaccine for West Nile virus (WNV). The only way to protect yourself is to keep mosquitoes from biting you. Follow these steps every summer if you live in or visit an area with mosquitoes: • Avoid outdoor activities between dusk and dawn, if possible, since this is the time when mosquitoes are most active. • If you must be outdoors when mosquitoes are active, wear a long-sleeved shirt and long pants. • Use a mosquito repellent that contains DEET(the chemical N-N-diethyl-meta-toluamide) and follow the directions on the label. DEET can be toxic if overused. Never use DEET on infants. Avoid using repellents with DEET concentrations above 10-15%for children and with concentrations above 30-35%for adults. Cream, lotion or stick formulas are best. Avoid products with high amounts of alcohol. • Most mosquito repellents will remain effective for many hours, so it is not necessary to reapply the repellent. Once inside,wash off insect repellents thoroughly with soap and water. • Take special care to cover up the arms and legs of children playing outdoors. When you bring a baby outdoors, cover the baby's carriage or playpen with mosquito netting. • • Fix any holes in your screens and make sure they are tightly attached to all your doors and windows How can I reduce the number of mosquitoes around my home and neighborhood? To reduce mosquito populations around your home and neighborhood, get rid of any standing water that is available for mosquito breeding. Mosquitoes will breed in any puddle or standing water that lasts for more than four days. Here are some simple steps you can take: • Dispose.of or regularly empty any metal cans,plastic containers,,ceramic pots, and other water- holding containers(including trash cans)on your property. • Pay special attention to discarded tires that may have collected on your property. Tires are a common place for mosquitoes to breed. • Drill holes in the bottom of recycling containers that are left outdoors,to let water drain out. • Clean clogged roof gutters; remove leaves and debris that may prevent drainage of rainwater. • Turn over plastic wading pools and wheelbarrows when not in use. • Do not allow water to stagnate in birdbaths; aerate ornamental ponds or stock them with fish. • Keep swimming pools clean and properly chlorinated; remove standing water from pool covers. • Use landscaping to eliminate standing water that collects on your property. April 2000 PUBLIC HEALTH FACT SKEET West Nile Virus Encephalitis Massachusetts Department of Public Health, 305 South Street, Jamaica Plain, MA 02130 What is West Nile Virus(WNV)Encephalitis? West Nile virus(WNV)encephalitis is a rare disease caused by a virus. In a small percentage of people infected by the virus,the disease can be serious,even fatal. The virus that causes WNV encephalitis occurs in Europe,Africa and Asia. It was first identified in the United States during the summer of 1999. It is not known how WNV got to the U.S. WNV grows in birds,and it is transmitted from bird to bird and from birds to humans by mosquitoes. Horses bitten by mosquitoes carrying WNV can also become sick. What are the symptoms of WNV Encephalitis? Mild WNV infections cause fever,headache and body aches,often with a skin rash and swollen lymph glands. More severe infections can cause headache,high fever,neck stiffness, stupor, disorientation,coma,tremors,convulsions,P Y aral sis and sometimes death. Is there treatment for WNV Encephalitis? There is no treatment for WNV infection. Doctors can treat the symptoms of WNV encephalitis. However, about 7%of people who become sick enough from the infection to be hospitalized die - from it. • How is WNV spread? WNV is spread only by adult mosquitoes that are infected with the virus. People and horses that have WNV infection cannot spread the disease without mosquitoes.The risk of getting WNV encephalitis is highest from late July through September. There is no evidence that a person can get WNV from handling live or dead infected birds. Still,you should avoid bare-handed contact when handling dead animals, including birds. If you must handle dead birds,use gloves or double plastic bags. If you notice unusual numbers of dead birds in your area,call your local board of health or the Massachusetts Department of Public Health. How common is WNV in Massachusetts? Until recently,there have been no documented cases of WNV encephalitis in birds, horses,or human residents of Massachusetts. On July 26,2000,a bird from Boston was found to be infected with WNV. There have been no WNV infected mosquitoes found in Massachusetts to date.The mosquitoes that carry this virus are common throughout the state,and these mosquitoes are found in the city as well as in the woods and other less populated places. For up-to-date information on West Nile virus in Massachusetts, visit the Massachusetts Department of Public Health's web site at www.state.ma.us/dph. What can you do to protect yourself? There is no vaccine for WNV. The only way to protect yourself is to keep mosquitoes from biting you. Follow these steps every summer if you live in or visit an area with mosquitoes: • Avoid outdoor activities between dusk and dawn,if possible, as this is the time of greatest mosquito activity. • If you must be outdoors when mosquitoes are active,wear a long-sleeved shirt and long pants. Use a mosquito repellent that contains DEET(the chemical N-N-diethyl-meta-toluamide) and follow the directions on the label. DEET can be poisonous if overused. Never use DEET on s Frequently Asked Questions About West Nile Virus Infection Massachusetts Department of Public Health, 305 South Street, Jamaica Plain, MA 02130 1. What is West Nile Viru s Infection? West Nile Virus infection is caused by West Nile virus (WNV), a flavivirus previously found only in Africa, Eastern Europe, Australia, and West Asia. WNV is closely related to St. Louis encephalitis virus (SLEV), which is found in the United States, and to Kunjin virus (KV), which is found in Australia, some Western Pacific islands and parts of Southeast Asia. 2. What are the symptoms of WNV infection? The case-morbidity rate for WNV infection is about 2-5%. Mild infections are common and include fever, headache,and body aches,often with skin rash and swollen lymph glands.Headache,high fever,neck stiffness, stupor, disorientation, coma, tremors, occasional convulsions, paralysis, encephalitis and possibly death mark more severe infection. 3. What is the incubation period of a WNV infection? The incubation period of a WNV infection is usually five to fifteen days. 4. How is WNV infection diagnosed? Diagnosis of WNV infection is based on either isolation of virus; demonstration of antibody to WNV;or demonstration of WN viral genomic sequences in tissue,blood,CSF or other body fluids. If you have a suspect case of WNV encephalitis,please call the MDPH Division of Epidemiology and Immunization at(617)983- 6800. 5. What is the mortality rate of WNV infection? Historically, the WNV infection case-fatality rate ranges from 3% to 15% of clinically apparent cases (the higher rates are among the elderly). 6. How many cases of WNV infection occur in the United States? Prior to 1999,no WNV infections had been reported to have been acquired in the United States. 7. How could WNV have entered the United States? The WNV may have entered the United States in infected mosquitoes,birds or persons. 8. Was the 1999 New York encephalitis outbreak caused by WNV? Yes. The Centers for Disease Control and Prevention(CDC)has since confirmed that the outbreak was caused by the Israel strain of WNV,rather than either KV or SLEV. 9. How many confirmed cases of human WNV infection have there been in the United States? During the 1999 New York encephalitis outbreak, there were 62 human cases (55 confirmed and 7 probable) and seven deaths. All of the cases were in New York City or its immediate suburbs in New York State. Exotic zoo birds, North American crows, and horses also were affected and had high death rates. The majority of human cases had an onset of illness during the last three weeks of August. The New York City Department of • Health investigated 680 reports of possible WNV infection.The median age of cases was 71 years(range 5-90); 60% of cases occurred among adults aged 65 years or older. Fifty-one percent of cases were male. All seven fatalities occurred among persons aged 75 years or older. while not clinically ill, were tested and shown to be serologically positive for WNV antibodies, thereby. demonstrating they had been infected. _ 21. What is the basic transmission cycle? Taking a blood meal from birds infected with WNV initially infects mosquitoes. Those.mosquitoes then transmit WNV to humans and other animals when taking a blood meal. Vertical transmission (adult->eggs- >larvae->adult)of WNV has been demonstrated in mosquitoes. 22. Do birds naturally infected with WNW die or become ill? In the 1999 outbreak, large numbers of North American crows and other birds were observed becoming seriously ill and dying. 23.What about migrating birds? State and federal officials believe that WNV infected birds probably have migrated from the New York City area to other parts of the United States, since infected birds can be infectious for feeding mosquitoes for 20 to 100 days. Even though it is not yet known how far WNV will ultimately spread in the United States, Massachusetts is preparing for a possible VINE disease outbreak in the summer or fall of 2000. In 1999, a laboratory confirmed WNV-positive bird was reported from Albany,New York,which is immediately adjacent to the western border of Massachusetts. 24. What about ticks? Since ticks have been found infected with WNV in Europe and Asia and since infection was transmitted vertically (adult->eggs->larvae->nymphs->adults), the CDC also tested ticks for WNV in the 1999 New York outbreak area. Although no WNV was isolated from ticks in the US during the 1999 outbreak,ticks may prove to be vectors of WNV transmission in the future. It is important to realize that infected ticks cannot be killed by aerial insecticide spraying like mosquitoes can, and that infected ticks, therefore, may prove to be a very important vector in the possible future spread of WNV in the United States. 25. Will WNV successfully over-winter? Yes. In March 2000, WNV was isolated from mosquitoes over-wintering in the sewer and drainage systems of New York City and from a red-tailed hawk that died in Westchester County,New York. It is likely that other infected mosquitoes, which hibernate and over-winter in sheltered areas, will emerge in the spring and further continue the spread of WNV. - 26. How can the number of mosquitoes around the home and neighborhood be reduced? Populations of the primary WNV mosquito vector species Culex spp. (container breeders), and the risk of infected mosquitoes, can be significantly decreased in an area by reducing the amount of standing water available for mosquito breeding. • Dispose of or regularly empty any metal cans,plastic containers,ceramic pots and other water holding containers(including trash cans)on your property. • Pay special attention to discarded tires that may have collected on your property.Tires are a common place for mosquitoes to breed. • Drill holes in the bottom of recycling containers that are left outdoors, so that water can drain out. • Clean clogged roof gutters;remove leaves and debris that may prevent drainage of rainwater. • Turn over plastic wading pools and wheelbarrows when not in use. • Do not allow water to stagnate in birdbaths;aerate ornamental ponds or stock them with fish. • Keep swimming pools clean and properly chlorinated;remove standing water from pool covers. • Use landscaping to eliminate standing water that collects on your property. • May 2000 3 The Commonwealth of Massachusetts Executive Office of Health and Human Services ' Department of Public Health State Laboratory Institute ARGEO PAUL CELLUCCI 305 South Street, Jamaica Plain, MA 02130 J GOVERNOR BUREAU OF COMMUNICABLE DISEASE CONTROL JANE SWIFT LIEUTENANT GOVERNOR WILLIAM D.O'LEARY SECRETARY a� j T?rr 1 HOWARD K.KOH,MD,MPH COMMISSIONER MEMORANDUM i TO: Local Departments/Boards of Health NFAI FROM: Sue Etkind, RN, MS, Director Edward Nardell, MD, Tuberculosis Control Officer Division of Tuberculosis Prevention and Control DATE: June 30, 2000 • RE: Policy for tuberculosis testing and distribution of PPD Effective September 1, 2000, the Division of Tuberculosis Prevention and Control will be limiting distribution of PPD for use in specific populations designated to be at high risk for tuberculosis. This is in accordance with new American Thoracic Society (ATS) and federal Centers for Disease Control and Prevention (CDC) guidelines for "Targeted Testing and Treatment of Latent TB Infection" (American Journal of Respiratory Care and Critical Care Medicine, Vol. 161, no. 4, April 2000). The purpose of this new policy is to ensure targeted, priority screening for low income, uninsured, high-risk populations. Testing of low risk populations is no longer recommended and is certain to result in false positive reactions, primarily due to crossover hypersensitivity to environmental mycobacteria. Enclosed you will find a list of the specific populations for whom testing is recommended ("Who to Test for TB"). The Division will continue PPD distribution through local-health departments / boards of health. Therefore, given public health mandate and new recommendations, PPD distribution will be limited. The following categories of public health and healthcare providers will be the only providers eligible to receive TB Division supplied PPD: • • Local health departments / boards of health, or other agency acting for the board of health, for their own usage in testing high-risk persons • Community / neighborhood health centers r. • Homeless shelters • • Health services for migrant/seasonal farm workers • Substance abuse treatment sites • Health service providers in jails that are not required by contract to purchase PPD for screening inmates The followingwill no longer be eligible for TB Division supplied PPD: g g PP • All other healthcare facilities, except where indicated above • Health service providers in correctional institutions that are required by contract to purchase PPD for screening inmates • Employers who are required by OSHA to screen employees for TB. This is the responsibility of the employer and/or respective institution • Testing for routine* employment and licensure • Testing as part of routine* school-based screening * NOTE: "Routine TB screening" for persons at low risk is no longer recommended. In Massachusetts, some outdated legislation still requires screening for teachers and other low risk populations. Efforts to repeal these laws have yet to be successful. Appended are the following: - "Who to Test for TB" fact sheet • - "Targeted Testing and Treatment of Latent TB Infection" fact sheet - A simplified PPD usage/reporting form with instructions - A memorandum you may wish to use that is addressed to employers who send employees to your office for routine TB skin testing All current recipients of PPD will also receive written notification of the new procedures and guidelines during June. Our intention is to update providers regarding targeted testing, and to inform them about their eligibility for TB Division supplied PPD. We look forward to working with you as we implement this new system. We know that there will be questions and concerns, but by working together this new system will better meet the needs of those we serve. It is also hoped that by prioritizing activities, local health departments will have some of the current PPD distribution burden relieved. We welcome your comments and questions as we move forward. Please feel free to call your regional Tuberculosis Surveillance Area office or the central office staff(617-983-6970). • City Of Salem Environmental Health Division --- Inspection Monthly Summary Month ---------------------- Type Jul 00 Aug 00 Sep 00 Count CFI 70 70 63 203 CFR 1 4 2 7 CH 7 6 3 16 CON 8 10 5 23 CR 3 10 2 15 CT 1 2 3 6 EC 5 19 11 35 EPR 1 1 3 5 PC 3 0 1 4 FRH 1 3 2 6 FSD 3 10 6 19 FSI 13 24 18 55 FSR 11 12 16 39 GN 9 9 4 22 HI 50 46 10 106 HR 8 14 14 36 LPI 1 2 0 3 MS 5 1 0 6 MT 12 16 14 42 MUP 2 1 6 9 MW 3 4 0 7 OG 0 2 4 6 RC 1 0 0 1 0I 3 9 8 20 R 0 3 4 7 RO 1 5 0 6 SB 25 74 15 114 SM 3 2 2 7 SP 0 2 0 2 ST 1 1 4 6 TFI 6 14 0 20 TR 33 58 34 125 WM 0 0 6 6 Count 290 434 260 984 , t++ City of Salem, Massachusett, Environmental Health Division Inspection Input Form Inspect Date : Estab Name or Owner Name : Type : Location: Inspector: Inspection Types BP - Body Piercing FSI - Food Serv. Ins . 892* RFD - Ret . Food Disc . 6* CFI - Cert . Fit . 822* FSR - Food Serv. Rein. 194* RFI - Ret . Insp. 75* CFR - Cert . Fit .Reinsp105*GN Gen. Nuisance 41* RFR - Ret . Food Rein34* CH - Court Hearing 93* HI - Housing Insp. 260* RO - Rodent Control 16* CON - Constable Serv. 65* HR - Housing Reinsp. 135* SC - Suntan 7* 10 - Compliance Rev. 25* LPI - Lead Paint Insp. 6* SES - SESD Odor 0* Computer Time10* MS - Massage 6* SM - Seminars 36* EC - Envirn. Compl . 51* MW - Mark/Weights SP - Swim.Pools 16* EPR - Ext . Paint 95* MUP - Mobile Food Insp. 11* SB - Swim. Beaches 65* FC - Food Compl . 17* OS - Off . Sub. Insp. 6* ST - Soil/Septic 8* FRH - Food Hearings15* RC - Rec Camps 9* TFI - Temp. Food 112* FSD - Food Serv. Disc 53* MT - Meetings 65* TR - Trash 381* :i • 0 A—Adjusted NS—Not Sealed Sealed C—Condemned DEPARTMENT OF WEIGHTS AND MEASURES Dote NAME OF PERSON OR BUSINESS Field CAPACITY MEASURES Certificate SCALES AND BALANCES WEIGHTS VEHICLE DRY Issued CERTIFICATE ISSUED TO Number TANKS UQUID UEASUAES Over 5.000 To 1.000 to 100 to More Than 10 i0 Apothecary First Ea.Additional I Gallon More Than 10.000 10,000 5,000 1,000 Less Than Pou Troy nds Avoirdupois Metric t00 Gallons 100 Gallons 5e 'v�n\1t?� � (.pp Pounds Pounds Pounds Pounds 100 Pounds Or Less Or Less Or Fraction Or Less I Gallon A S NS C A S I NS C A S NSI C A S NS C A I S NS C A S N C A S NS C A S NS C A S NS C A S NS C A S NS C A S INS IC A S INS C A S NS IC 11 `ckL e ' vt.— Ole ,� o ? 8 ji cl`\ 11 oc� 3. 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Some spraying did take place in the Ward Four area, as well as at McGrath Field, the high school fields, and Bertram Field. Because of the cool weather and the decrease in mosquito activity, the spraying was limited. West Nile is probably here to stay and increase over time. Bayla Matyas, Epidemiologist for the MDPH, gave the following comparison of WNV to Eastern Equine Encephalitis; EEE is most prevalent in mosquitoes which are found in less populated areas. Therefore, although the rate of complications from the illness is high, the incidence is low. The mosquitoes that carry WNV are found in densely populated areas. So, although serious complications are rare, the incidence is high. We will be consulting with the Mosquito Control Program over the next several months to prepare for next spring. • POWER PLANT The City Council is planning to continue its meeting, regarding the Power Plant studies, at the Visitor's Center. The date has not been set. Kevin Harvey wants to open it to the public for comment and questions. I will keep the Board informed regarding the date. The MDPH convened its task force for the first time last week. The Health Agents/Directors from Beverly, Marblehead, and Swampscott attended, as did three Salem citizen representatives, Rep. Doug Petersen, a Marblehead citizen representative, a staff member from Rep. Michael Cahill's office, several MDPH staff, and a consultant hired by MDPH. The consultant delineated his proposal for follow-up to the original Marblehead/Swampscott Cancer Study. The goal of the study is to determine if there are significantly elevated deposits in the soil from the plant's operation between 1951 through 1982. If there are, what are the potential health concerns from those deposits. In addition, the follow-up will determine if there are current releases, particularly from the coal pile, contributing significantly to exterior dust burdens. The study design calls for collection of dust and soil samples, with analysis of those samples compared to control samples. The sampling is scheduled to begin in late spring. The entire study will probably take two years. The MDPH will send a copy of the proposal for comments. Please let me know if you would like to have input. • SENIOR ACADEMY I have been asked to speak at the Senior Academy on "Home Sanitation." It will be like telling my mother how to keep her home clean! r .rz,_j i i WALGREENS- BOSTON STREET The Ward Four Neighborhood Association had questions regarding environmental testing now being done at this location, after the store has been built and opened. I arranged a meeting with the Licensed Site Professional (LSP), working for Walgreen's consultant, to meet with the association to explain what has been happening and what will happen. Parts of the parcel of land, not including the actual footprint of the store, are under DEP requirements for further ground water and soil analyses and possible remediation, depending on the results of those analyses. The neighbors were polite and persistent in their questions and the LSP was open and honest with his responses. The group will meet again with the LSP following receipt of the analyses. The group's major concern was potential human exposure to contaminants. I don't think that there is a problem with exposure. However, some residents report noting an unusual odor in the area on a couple of occasions. I have asked them to call the LSP or me if they notice that odor again. I spoke with an engineer from the DEP who told me that one major tenet of the "Brownfields" legislation is to encourage development of contaminated areas even before they are cleaned up. The reasoning is that allowing such development creates an incentive for cleaning the site. In this way areas, which have been abandoned for years, may become productive and on the tax roll. There are specific time frames for clean-up under the DEP regulations. SALVATION ARMY We have had multiple, on-going problems with the Salvation Arm p 9 P 9 Y property on Highland Avenue. The basic problem is that people are using their collection area, particularly on weekends, to dump unusable household items and junk. I have had several conversations with them regarding this problem. In addition, I had a meeting with several Salvation Army officials and other City personnel from the Building and Planning Departments. The problem persisted resulting in the enclosed letter ordering them to stop their collection operation. NEW FOOD CODE The process of learning and adapting to the New Food Code is tedious and time consuming. There will be a "learning curve" for this to happen with our inspectors and me. I expect our schedule of food inspections may suffer for the next few months because of that and then we should be back on track. y 1 t i Salem Board of Health September Phone Log 2000 Total Answered *Answered Calls Friday September 1, 2000 34 Barb = 286 Saturday September 2, 2000 Mary= 231 Sunday September 3, 2000 Sue= 450 Monday September 4, 2000 "Holiday Tuesday September 5, 2000 57 Wednesday September 6, 2000 49 *Calls Taken Thursday September 7, 2000 53 Friday September 8, 2000 37 1 Joanne = 306 Saturday September 9, 2000 Jeffrey = 163 Sunday September 10, 2000 Mark = 95 Monday September 11, 2000 75 Jose = 60 Tuesday September 12, 2000 59 Pablo = 13 Wednesday September 13, 2000 48 Tracy = 145 Thursday September 14, 2000 62 Ginny = 9 • Friday September 15,2000 65 Barb = 88 Saturday September 16, 2000 Mary = 77 Sunday September 17, 2000 Sue = 101 Monday September 18,2000 55 Tuesday September 19, 2000 53 Wednesday September 20,2000 52 43 Office Hours Per Week Thursday September 21, 2000 56 *=20 Work Days Friday September 22, 2000 53 35 Hour Work Week Saturday September 23, 2000 Sunday September 24, 2000 Monday September 25, 2000 50 Monday 8-4 Tuesday September 26, 2000 38 Tuesday 8-4 Wednesday September 27, 2000 47 Wednesday 8-4 Thursday September 28,2000 29 Thursday 8-7 Friday September 29,2000 40 Frid. 8-4* Winter Hours Saturday September 30, 2000 Total Calls *_ s i • Board of Health Administration Monthly Report Aug-00 Biologics Distributed Amount in Doses Diptheria, Tetanus& Pertussis = 360 Burial Permits @$5.00 $285.00 Diptheria,Tetanus Tox.(under 6 yrs)= 0 Licenses& Permits(+copies) $304.20 Immune Serum Globulin= 0 Certificate of Fitness@$25.00 $1,950.00 Measles/Mumps/Rubella= 398 Sealer Weights/Measures= $30.00 Polio= 400 Total Monies Collected $2,569.20 Tetanus & Diptheria (adult use)= 475 Total Monies Year to Date $4,941.20 Tuberculin PPD= 510 HIB Titre= 240 Animal Bites Reported= 0 Hepatitis B= 990 PPV 23 45 PCV 7 390 Annual Budget Expenses Available Balance Sala ry/Longevity $354,033.00 $72,034.26 $281,998.74 Annual Budget Expenses Encumbered Available Balance Non-Personnel $20,023.00 $1,457.77 $1,823.00 $16,742.23 eONUIT CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, IRS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 Public Health Nurse Report August 2000 Activities Disease Prevention In touch with T.B. Clinic and following active cases and case contacts. Two PPD screenings done in office. Vaccine inventory maintained and distributed. • Investigated communicable disease cases and reported to the M.D.P.H Meetings and Clinics. 8/3 Participated in the Mass Department of Public Health, Local Public Health Preparedness Survey held at Salem Police Station. Other • participants included a representative from Salem Fire Department, Police, North Shore Ambulance, Salem Hospital Infection Control. 8/9-8/14 Vacation 8/24 Hepatitis B Clinic for 6 Police held at Salem Police Station. 8/29 Wellness Fair Meeting, 9:00 a.m. Swampscott Public Health Nurse June Blake, and Marblehead Public Health Nurse Rochelle Bartlett will join the Wellness Fair Committee. The 2001 Wellness Fair will be "North Shore Wellness Fair." St. Joseph's • Summer Vacation Letters sent to all children entering Pre-K, Kindergarten and Seventh Grade reminding parents to send updated immunization records. Phoenix School • Summer Vacation Letters sent to all children entering Pre-K, Kindergarten and Seventh • Grade reminding parents to send updated immunization records. KOND1T , • C/p�dp CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 MONTHLY REPORT OF COMMUNICABLE DISEASES August 2000 DISEASE: NEW CARRY OVER DISCHARGED REPORT TO CASES: CASES: CASES: STATE: Campylobacter 0 0 0 0 • Giardia 1 0 1 0 E.Coli 0157H7 0 0 0 0 Hepatitis 3 1 2 2 Lyme Disease 3 0 3 3 Meningitis 0 0 0 0 Pertussis 1 0 1 1 Salmonella 0 0 0 0 Shigella 0 0 0 0 Varicella 0 0 0 0 Reportable Diseases excluded from above have not been identified this • month. • I Sum=ary of Communicable Diseases for August 2000 Giardia 51y/o male. Hx of Diarrhea for 4 weeks. This case was drinking water from a stream behind his camp in Vermont. He believes that he did not boil the water long enough. Hepatitis B one case. Hepatitis C two cases. &Xme Disease. 3 cases S y/o male. Child was seen by M.D. when rash appeared on upper arm. Treated with Amoxcillin. • 64 o male. His torn was bull' ye as s e rash y/ only symptom m y p on arm. Treated with Doxycycline for three weeks. 16 y/o male. Communicable Disease letter sent on August 31. Pertussis• 51 y/o female. Cough onset was July 3rd. Case was not diagnosed until August 11, 2000. This case was investigated by Elissa Leighton, epidemiologist, MDPH. Household and work contacts were not symptomatic. a Massachusetts Department of Public Health 1 Massachusetts Immunization Program Memorandum D %SAVE O To: Providers WC 2 2 2000 From: Robert Mom-son, Manager g HEALTH DEEPT.PT. son, Vaccine Mana CITY S Marie E. O'Donnell, VFC Coordinator Date: August 9, 2000 Subject: Delays in Influenza Vaccine Delivery and Potential Vaccine Shortages Anticipated for 2000-2001 Flu Season As a result of difficulties in growing this year's influenza A (H3N2) vaccine component and other manufacturing problems, there will be a substantial delay in the distribution of influenza vaccine and possibly substantially fewer doses of vaccine than last year. The Massachusetts Immunization Program (MIP)Vaccine Unit planned to purchase 745,000 doses of influenza vaccine from Aventis Pasteur. Because of the manufacturing problems, we have been notified by Aventis that the MIP's vaccine order will be cut.The MIP now expects to receive approximately 657,000 • doses, which is 88,000 fewer doses than anticipated. In addition, we have been informed by Aventis that we will receive our influenza vaccine order in increments, and it is likely that the first supply will not be received until mid-October. In May of this year, the MIP notified all providers of the number of doses of influenza vaccine allocated to your offices. In light of the expected shortage, it is likely that your initial allocation will have to be reduced by up to 10%: In addition, your vaccine allocation will be available incrementally as the MIP receives vaccine from the manufacturer. Also, many providers submitted requests for additional doses of influenza vaccine. Unfortunately, the MIP is unable to process any of these requests for additional doses at this time. If more influenza vaccine becomes available later in the season, these requests for additional doses will be processed. Your vaccine distributor will contact you in October regarding vaccine availability. Due to the influenza vaccine shortage and delay this year, there have been significant changes to the recommendations for use of influenza vaccine, which are unique to this season. The enclosed document, Revised Prioritization of Influenza Vaccine in Response to Anticipated Vaccine Shortage, replaces all previously dated influenza vaccine prioritization lists. This revised document outlines: • the prioritization of influenza vaccine in light of the anticipated shortage • a timeline to assist you with scheduling your influenza immunization efforts. If you have any questions, you may call the Vaccine Management Unit at 617-983-6828. Updated information about vaccine availability and other recommendations will also be available on the MDPH web site at www.state.ma.us/dph . • Updated InfluenzaVaccineAl location Info August 9,2000 ®Printed onrcr/ciedPaOev 1v1dJJdU1UJGrtJ ricpdru[tent of ruouc neann Immunization Program(NUP) t S Revised Prioritization of Influenza Vaccine • I❑ Response to Anticipated Vaccine Shortages 2000-2001 Influenza Season Due to problems in the manufacturing process, there will be shortages of influenza vaccine and the vaccine will likely be delivered in partial shipments over the course of the flu season. Facilities should develop contingency plans to ensure that both state-supplied and privately-purchased influenza vaccines are administered first to people at highest risk of complications from influenza. This guidance replaces previous recommendations concerning the use of influenza vaccine. Administer influenza vaccine according to the following schedule: By September: 2 Develop facility-specific contingency plans. 2 Identify high-risk patients. In October and November, as soon as vaccine is available: 2 Vaccinate people in the high-risk groups listed below. • All adults > 65 years of age. • Residents of any age in long-term care facilities housing persons with chronic medical conditions. • People 6 months through 64 years of age: With chronic pulmonary or cardiovascular disease, including asthma. Who have required regular medical follow-up or hospitalization during the preceding year because of: chronic metabolic diseases (including diabetes); renal dysfunction; hemoglobinopathies; HIV infection; or immunosuppression caused by other diseases, medications or treatments. • Children and teenagers(aged 6 months to 18 years)receiving long-term aspirin therapy. • Women who will be in the second or third trimester of pregnancy during the flu season. In November: 2 Hold organized immunization clinics for people in the high-risk groups listed above. 2 Even after November, vaccination of high-risk people should be considered the priority and should continue as long as vaccine is available. 2 If you receive state-supplied vaccine and all your high-risk patients have been vaccinated, please return unused state-supplied vaccine to your local vaccine distributor for redistribution and administration to others at high-risk. In December: 2 Vaccinate household contacts (including children), health care workers and other caregivers of people in high-risk groups. 2 Continue to vaccinate people in the high-risk groups. 2 Depending upon vaccine supplies, you may be able to begin vaccinating non-high-risk people. • After December and throughout the flu season, if vaccine is available: 2 Vaccinate people who do not fall into the high-risk groups listed above, but who wish to receive influenza vaccine. FLUvax Priority2000 2 doc August 2000 Q ADDITIONAL RECOMMENDATIONS FOR THE 2000-2001 INFLUENZA SEASON • 1. Prioritize Vaccine: Because of anticipated delays in influenza vaccine delivery, large organized immunization clinics should not be scheduled until November. Residents of long-term care facilities and high-risk patients who are seen for routine care or who are hospitalized should be immunized as soon as vaccine is available. This is particularly important for young high-risk children who are receiving influenza vaccine for the first time and thus require two doses. 2. Vaccinate Throughout the Flu Season: In New England, influenza season does not usually begin until December and does not peak until February. Influenza vaccine can and should be administered throughout the influenza season. 3. Manage Vaccine Supplies Carefully: Refrain from over-ordering or hoarding vaccine and return any unused state-supplied vaccine to your local vaccine distributor for redistribution. 4. Administer Pneumococcal Vaccine to People at Risk for Pneumococcal Disease: People at risk for pneumococcal disease include everyone 65 years of age and older, people younger than 65 with certain chronic medical conditions, and residents of long-term care facilities. Pneumococcal vaccine is effective in preventing invasive pneumococcal disease, a common complication of influenza, and is available free from the MIP for all patients at risk for pneumococcal disease. You can order pneumococcal vaccine monthly, throughout the year. • The voluntary cooperation p tion of health care providers and the public is essential to minimize the adverse impact of an influenza vaccine shortage by ensuring that influenza vaccine is administered to those who need it most. Check the MDPH web site www.state.ma.us/dph for updated information on the availability of influenza vaccine. • FLUvax Pnonty2000_'doc August 2000 r T -✓uy Immunization Program(MIP).•yu•u Revised Prioritization of Influenza Vaccine In Response to Anticipated Vaccine Shortages • 2000-2001 Influenza Season Due to problems in the manufacturing process, there will be shortages of influenza vaccine and the vaccine will likely be delivered in partial shipments over the course of the flu season. Facilities should develop contingency plans to ensure that both state-supplied and privately-purchased influenza vaccines are administered first to people at highest risk of complications from influenza. This guidance replaces previous recommendations concerning the use of influenza vaccine. Administer influenza vaccine according to the following schedule: By September: 2 Develop facility-specific contingency plans. 2 Identify high-risk patients. In October and November, as soon as vaccine is available: 2 Vaccinate people in the high-risk groups listed below. • All adults> 65 years of age. • Residents of any age in long-term care facilities housing persons with chronic medical conditions. • People 6 months through 64 years of age: With chronic pulmonary or cardiovascular disease, including asthma. • Who have required regular medical follow-up or hospitalization during the preceding year because of: chronic metabolic diseases(including diabetes); renal dysfunction; hemoglobinopathies; HIV infection; or immunosuppression caused by other diseases, medications or treatments. • Children and teenagers (aged 6 months to 18 years) receiving long-term aspirin therapy. • Women who will be in the second or third trimester of pregnancy during the flu season. In November: 2 Hold organized immunization clinics for people in the high-risk groups listed above. 2 Even after November, vaccination of high-risk people should be considered the priority and should continue as long as vaccine is available. 2 If you receive state-supplied vaccine and all your high-risk patients have been vaccinated, please return unused state-supplied vaccine to your local vaccine distributor for redistribution and administration to others at high-risk. In December: 2 Vaccinate household contacts (including children), health care workers and other caregivers of people in high-risk groups. 2 Continue to vaccinate people in the high-risk groups. 2 Depending upon vaccine supplies, you may be able to begin vaccinating non-high-risk people. After December and throughout the flu season, if vaccine is available: 2 Vaccinate people who do not fall into the high-risk groups listed above, but who wish to receive influenza vaccine. FLUvax Pnority2000 2.doc August 2000 ADDITIONAL RECOMMENDATIONS FOR THE 2000-2001 INFLUENZA SEASON 01. Prioritize Vaccine: Because of anticipated delays in influenza vaccine delivery, g organized large g nized immunization clinics should not be scheduled until November. Residents of long-term care facilities and high-risk patients who are seen for routine care or who are hospitalized should be immunized as soon as vaccine is available. This is particularly important for young high-risk children who are receiving influenza vaccine for the first time and thus require two doses. 2. Vaccinate Throughout the Flu Season: In New England, influenza season does not usually begin until December and does not peak until February. Influenza vaccine can and should be administered throughout the influenza season. 3. Manage Vaccine Supplies Carefully: Refrain from over-ordering or hoarding vaccine and return any unused state-supplied vaccine to your local vaccine distributor for redistribution. 4. Administer Pneumococcal Vaccine to People at Risk for Pneumococcal Disease: People at risk for pneumococcal disease include everyone 65 years of age and older, people younger than 65 with certain chronic medical conditions, and residents of long-term care facilities. Pneumococcal vaccine is effective in preventing invasive pneumococcal disease, a common complication of influenza, and is available free from the MIP for all patients at risk for pneumococcal disease. You can order pneumococcal vaccine monthly, throughout the year. The voluntary cooperation of health care providers and the publi c Is essential to minimize the adverse impact of an influenza vaccine shortage by ensuring that influenza vaccine is administered to those who need it most. Check the MDPH web site www.state.ma.us/dnh for updated information on the availability of influenza vaccine. FLUvax Prion y2000 2 doc August 2000 The Commonwealth of Massachusetts Executive Office of Health and Human Services Department of Public Health 250 Washington Street, Boston, MA 02108-4619 up ARGEO CELLUCCI GOVERNOR JANE SWIFT LIEUTENANT GOVERNOR J11A` On) 2n WILLIAM D.OL' EARY V�4 [ iJ lJ SECRETARY CITY OF SALEM HOWARD K.KOH,MD,MPH HEALTH nEPT. COMMISSIONER June 23, 2000 Dear Local Health official/Department Director/Agent: The Massachusetts Department of Public Health(MDPH),in cooperation with the US Centers for Disease Control and Prevention(CDC) and the US Department of Justice(DOJ), is embarking-on a -survey process that will help federal, state, and local officials determine the needs and capacities of our systems to respond to the threat of biological, chemical, and radiological emergencies. • The survey contains questions pertaining to infectious disease control, computer and Internet usage, and coordination of emergency response. We are requesting your leadership and cooperation in setting up a date and time for MDPH staff to meet with you together with representatives of other pertinent local services or functions including those responsible for: Infectious disease follow-up Interactive technology(IT) Public health nursing Municipal disaster coordination Fire Department first responder coordination Police Department first responder coordination Emergency Medical Services (EMS) Local hospital administration To assist in the completion of this survey, staff from the MDPH Bureau.of Communicable Disease Control will be calling you within the next week or two to set up a meeting at your location with you and the other local representatives listed above. The survey process takes up to three hours to complete, and is designed to help determine the type and amount of resources, education, and technical assistance that may be needed to plan for a biological • terrorism event or infectious disease emergency. In addition to aiding you in developing the local planning process, the survey process is important,both statewide and locally, for the following reasons: • • Health departments from municipalities that complete the survey will be 1) prioritized for training sessions in infectious disease emergency preparedness and response, and 2) eligible for state- supported Internet access for local infectious disease control staff; • Municipalities that participate in the survey process will be prioritized for participation in the MDPH Rapid Broadcast Communication System which will enable immediate notification during infectious disease emergencies and quick access to information about health alerts; and • States that achieve full participation in the survey process will be prioritized by the Department of Justice for the release of funds for the purchase of emergency responder equipment. Enclosed please find the demographic portion of the survey. Completing these pages prior to the meeting with MDPH staff will shorten the time needed for the survey interview considerably, so I urge you to do so. If you have any questions prior to being contacted by our staff,please do not hesitate to contact Tim Broadbent or Mary Sheryl Horine in the Bureau of Communicable Disease Control at (617) 983-6800. -Thank you in advance for your cooperation in helping us fulfill this state's responsibility to complete this survey process. I am confident that this effort will provide information that is so essential for us to • go forward in planning and building both our Health Alert Network and our state and local system of infectious disease emergency preparedness. Sincerely, Paul Jacobs Deputy Commissioner Alfred DeMaria,MD, Assistant Commissioner for Communicable Disease Control Mary Sheryl Horine,MPH, Bioterrorism Preparedness, Communicable Disease Control Timothy Broadbent,MPA, Massachusetts Health Alert Network • • Hepatitis C Case Investigation Checklist The Massachusetts Department of Public Health has created the following checklist to assist investigations of hepatitis C (HCV) cases by local boards of health in Massachusetts. It suggests a sequence in which investigations should be approached, the recommended elements of investigations, and the information that should be reviewed with each case. This checklist is for Board of Health use only—it is not required and does not need to be submitted with the case report, although you may wish to keep it in your file to document your investigation.For more information on the background and rationale for this process,please refer to the chapter on HCV in the Surveillance Manual. Upon receiving a report of HCV from a lab or medical provider,please follow the process detailed below. Always prioritize the investigation of acute hepatitis C cases over chronic infections. 1. Contacting the case's medical provider(do this first) O Attempt to contact by phone first O If no response after 2 or more attempts send a form fax or letter(sample letter attached) If a letter needs to be sent...IL Q The letter should include the following: • Q Case's name O Description of your responsibility to notify and educate the case Q Indication that you have been trying to reach the provider Q Timeline of when you intend to contact the case(unless the provider selects an alternate time) -Q That it is strongly preferred that the provider inform the case of her/his _. diagnosis 0 Information on how the provider can contact you O Include a copy of the hepatitis C case report form with the fax or letter and indicate the sections the provider should fill out O Include a self-addressed envelope in which the hepatitis C case report may be returned 2. Once you have contacted the case's provider Q Explain that the information obtained is strictly confidential, discuss purpose of surveillance as necessary 13 Confirm the report and diagnosis •Obtain copies of any additional related labs that are available 0 EIA—HCV screening antibody(e.g. ELISA) O Immunoblot assay(e.g. RIBA, SIA) O HCV RNA(e.g. RT-PCR,b-DNA) 0 Liver function tests—e.g. SGOT, SGPT(only needed for acute cases) Q Obtain as much information for the case report as possible—if the provider refuses to provide risk-related information, attempt to get demographic information and laboratory results(listed • above), in particular for any acute cases Depends on departmental policy Hepatitis C Investigation Checklist—Page 2 Q Inform the provider that they should discuss this report with the case; the provider should inform the case that someone from the Board of Health will contact them to discuss the report 0 Find out when it will be possible for you to contact the case directly (how much time does the provider need to contact the case?) 3. Contacting the case Use whatever method(s)you normally use to contact the case.`* This might include attempting to contact the case via phone first. If there is no phone number available or if there is no answer after 3 tries over at least one week,a home visit can be conducted, if feasible. Alternatively, a letter can be sent to the case's address(sample letter attached). If a letter needs to be sent...ie Q Ask in the letter what the best way for you to contact the case would be;then follow the rest of the investigation as indicated below Q If no contact is made with the case 4 weeks after having sent the certified letter,please. fax or mail all information obtained on the case at that point to MDPH(include a copy of the lab results) 4. Once you have contacted the case Q Explain confidentiality and the purpose for obtaining the requested information • C3 Inform the case that the information that will be discussed is highly personal and that it is asked of every person with hepatitis C Q Ask the case if they have any questions about HCV or surveillance;refer the case to MDPH if they have questions and need additional information Q Determine if a provider is currently treating the case, and what that provider's specialty is If the case is not currently in medical care... ie O Suggest that they contact a primary care doctor for treatment evaluation 13 As necessary,provide a referral to a primary care provider C3 Discuss the benefits of being assessed by a specialist with the case as necessary Q Review HCV transmission with the case—risks,behaviors, and prevention;use the report form to guide your discussion 0 If the case is actively injecting drugs, refer the case to treatment programs and needle exchange programs Q Discuss the risks of alcohol consumption with the case Q Assess whether the case currently drinks alcohol If the currently drinks alcohol... ie l3 Recommend elimination of any alcohol consumption—refer to alcohol treatment/support as necessary • Contacting the case may not be necessary in specific situations where a relationship between the board of health and a provider or a group of providers exists and includes having them undertake the case education.Please refer to your departmental policies. • Hepatitis C Investigation Checklist—Page 3 Q Recommend that the case discuss any medication use (including alternative/herbal medications)with a provider to ensure that they are not going to damage their liver Q Determine if the case is at risk for either hepatitis A or B. If so,provide referral so that the case may receive the vaccines Q Discuss the potential for sexual transmission with the case If the case is concerned about sexual transmission... ie 0 Recommend considering condom use to reduce the likelihood of exposing sexual partners to HCV 0 Offer to forward information on proper condom use as necessary Q Fill out the hepatitis C case report form based on your discussion with the case—if there are additional sections that you require information on, query the case directly—fill in information that was not obtained from the medical provider to the extent possible •Provide the case with a fact sheet on HCV and any other relevant materials Q Provide a phone number for the case to call to get additional information later, if needed 5. Reporting to MDPH • Q Attach a copy of ALL relevant lab reports to the hepatitis C case report form Q Mail or fax(617-983-6813)the report form and attached lab reports to MDPH Address: Surveillance Program, Room 511 MA Department of Public Health 305 South Street Jamaica Plain,MA 02130 0 Call MDPH if there are any questions about reporting (617-983-6800) 11/10/99 • Y Sample Letter For Contacting Cases For Hepatitis C Case Investigations (Print on Board of Health Letterhead) [Date] [Name of Case] [Address] Dear [Name of Case]: I am writing to you in regards to some recent lab results that you should have received. I work with the [name of town/city] Board of Health. As part of my job,I provide information and answer questions about certain diseases that are reportable to us. I would like to speak to you about your recent lab tests to provide this information to you as well as to obtain some additional information about your results. I have left several phone messages for you, and have not been able to speak to you directly regarding this matter up to this point. All of the information that we receive from you or your healthcare provider is STRICTLY CONFIDENTIAL. The purpose of us collecting this information is to educate patients and to collect information for public health planning. Massachusetts General Law(MGL), Chapterl 11, Sections 6, 7, Ill and 112 give the • Massachusetts Department of Public Health(MDPH) authority to define what diseases shall be regarded as dangerous to the public health and to require the reporting of such diseases. Under this authority the MDPH has established regulations making certain diseases reportable to local boards of health(105 CMR 300.000:Isolation and Quarantine Regulations). These regulations outline reporting requirements and control measures that.apply to both confirmed cases of such diseases and contacts of confirmed cases. The local board of health is required to collect information for the MDPH and implement control measures. Please contact me at your earliest convenience so that we may discuss this matter further. If your health care provider has not yet discussed this with you, I would encourage you to make an appointment with them as soon as possible. I can be contacted at [your number(s) here], on [include any relevant schedule information]. I look forward to discussing this matter with you and will be happy to answer any questions that you may have. Sincerely, [Your name and signature] • 1 1 • Sample Letter For Contacting Healthcare Providers For Hepatitis C Case Investigations (Print on Board of Health Letterhead) [Date] [Name of Healthcare Provider] [Address] Dear [title and name of provider]: I am writing to you in regards to your patient, [name of patient]. The [name of town/city] Board of Health recently received notice that this patient may be diagnosed with hepatitis C infection. As you are aware,hepatitis C is a reportable illness in Massachusetts, and the state requires the confirmation of each,case of hepatitis C. This allows the board of health to contact the patient to provide education, referrals and support to each person diagnosed with hepatitis C in the Commonwealth. In order to do this, I would like to speak to you regarding the laboratory results and risk historyof this patient. I have left several hone messages for you, and have not been P P g able to speak to you directly regarding this matter up to this point. Massachusetts General Law(MGL), Chapter 111, Sections 6, 7, 111 and 112 give the Massachusetts Department of Public Health(MDPH) authority to define what diseases shall be regarded as dangerous to the public health and to require the reporting of such • diseases. Under this authority the MDPH has established regulations making certain diseases reportable to local boards of health(105 CMR 300.000: Isolation and Quarantine Regulations). g reporting These regulations outline re ortin requirements and control measures that apply to both confirmed cases of such diseases and contacts of confirmed cases. The local board of health is required to collect information for the MDPH and implement control measures. Please contact me at your earliest convenience so that we may obtain the information required for this report. If it is more convenient for you to fill out the report form on your own and send it to me,please feel free to. I have enclosed a copy of the form with this letter. I would also like to remind you that since hepatitis C investigations include contacting the case directly, it is strongly recommended that you contact the case prior to the Board of Health to discuss this diagnosis and inform them of this investigation. I will be attempting to reach [name of patient] on [date 3 weeks from date on letter]. Please make an effort to provide the diagnosis to the case prior to that time. If you would like more time with which to discuss this with the case,please contact me and I will be happy to set an alternate time. All of the information that we obtain from either you or your patient is STRICTLY CONFIDENTIAL. I can be contacted at [your number(s) here], on [include any relevant schedule information]. I look forward to discussing this matter with you and will be happy to answer any questions that you may have regarding this investigation at that time. • Sincerely, [Your name and signature] HEPATITIS Adopted by the Massachusetts Department of Public Health 1 I from the NIH Consensus Development Conference Statement EVU enzyme immunoassay,enzyme-Iinked immunosorbent assay(EUSA) ImmunnWnt assay:such as RIBA,SIA,etc. , • - • • &J&HCLVRN1A:*assay of RNA by tests such as RTPCR,bDNA,etc.ve or elevated KM not elevated INDETER:indeterminate Obtain risk history to determine likelihood of past exposure to HCV. LOW-RISK PATIENTS 1 • Blood donor Any or • • Test at patient request �bi receipt Any or all: ' • - - - •• • Receipt of blood or blood products before June 1992 . • • Injection drug use, ever ® POS rol 1°� ' ' • Multiple sexual partners or known HCV+ sex partner • Other identified risk factors • - • - • Clinical or laboratory evidence of liver disease ° • POS Hepatitis C infection can be prevented ® • Avoid sharing injection equipment if using drugs; refer to drug treatment and needle exchange program • When having sex, use a latex condom for any and all anal and vaginal sex with a person who is HCV'infected or whose HCV status you do not know(consistent and correct use of condoms prevents the transmission of other diseases as well) •• • Casual contact(e.g., kissing, shaking hands, sneezing, • ° • hugging, sharing food) does not put them at risk SJ e • Consider referral to specialist for treatment evaluation _m • If HIV-infected, make sure health care provider treating UPI t - them for HIV infection is aware L' 'I If pregnant, ensure prenatal care provider is aware "C Y 1�0U n • Consult health care provider before using any medications (including over-the-counter) ® • Avoid sharing syringes, cookers, other injection equipment, Counseling Evaluate for other or straws if using drugs; refer to drug treatment and needle as required causes of liver disease, exchange program if evidence present • practice safer sex (e.g., latex condom for any and all anal and vaginal sex) • • Avoid drinking alcohol • Evaluation/referral • Do not donate body organs or blood, semen, or other Repeat in for treatment body fluids 6 months • HCV genotyping or • Do not share household items (such as toothbrushes, serotyping razors, needles, or nail clippers) that can be contaminated • Quantitative HCV RNA with blood or other body fluids • Counseling as required g q • Vaccinate patient aqainst hepatitis A and B, unless already • • • Chronology of HCV Infection Progression k to Exposure/Infection 20-30% Acute (Symptomatic) Zoo 15% Clear virus 85% Chronic Infection 80% Stable (68%of original) 20% Cirrhosis (17%of original) 75%Slowly Progressive 25% HCC/Transplant 30+ years (13% of original) (4% of original) City Of Salem Environmental Health Division --- Inspection Monthly Summary Month -------------- Type Jul 00 Aug 00 Count CFI 70 70 140 CFR 1 4 5 CH 7 6 13 CON 8 10 18 CR 3 10 13 CT 1 2 3 EC 5 19 24 EPR 1 1 2 FC 3 0 3 FRH 1 3 4 FSD 3 10 13 FSI 13 24 37 FSR 11 12 23 GN 9 9 18 HI 50 46 96 HR 8 14 22 LPI 1 2 3 MS 5 1 6 MT 12 16 28 MUP 2 1 3 MW 3 4 7 OG 0 2 2 RC 1 0 1 I 3 9 12 R 0 3 3 RO 1 5 6 SB 25 74 99 SM 3 2 5 SP 0 2 2 ST 1 1 2 TFI 6 14 20 TR 33 58 91 Count 290 434 724 +++++ City of Salem, Massachusetts Environmental Health Division Inspection Input Form Inspect Date : Estab Name or Owner Name : Type : Location: Inspector: Inspection Types BP - Body Piercing FSI - Food Serv. Ins . 892* RFD - Ret . Food Disc . 6* CFI - Cert . Fit . 822* FSR - Food Serv. Rein. 194.* RFI - Ret . Insp. 75* CFR - Cert . Fit .Reinsp105*GN _ Gen. Nuisance 41* RFR - Ret . Food Rein34* CH - Court Hearing 93* HI - Housing Insp. 260* RO - Rodent Control 16* - Constable Serv. 65* HR - Housing Reinsp. 135* SC - Suntan 7* Compliance Rev. 25* LPI - Lead Paint Insp. 6* SES - SESD Odor 0* CT _ Computer Time10* MS - Massage 6* SM - Seminars 36* EC - Envirn. Compl . 51* MW - Mark/Weights SP - Swim. Pools 16* EPR - Ext . Paint 95* MUP - Mobile Food Insp. 11* SB - Swim. Beaches 65* FC - Food Compl . 17* OS - Off . Sub. Insp. 6* ST - Soil/Septic 8* FRH - Food Hearings15* RC - Rec Camps 9* TFI - Temp. Food 112* FSD - Food Serv. Disc 53* MT - Meetings 65* TR - Trash 381* •r 1 E R AGENT'S NEWSLETTER TO THE BOARD VOLUME 59 September 12,2000 BOARD OF HEALTH OBJECTIVES Enclosed in the packet is the latest draft of the Board's 2001 Objectives. Marion suggested several amendments that have been incorporated into this last version. WEST NILE VIRUS The Board staff has been active in the West Nile Virus situation. Northeast Massachusetts Mosquito Control Program has been a wonderful resource for us during this time. This group receives a certain amount of money from the "cherry sheets" each year for each community it serves. Salem, through the DPW, has utilized this group in the maintenance of certain ditches thus suppressing mosquito breeding. This year the Program has been sampling and treating storm drains for mosquito larvae. The species, Culex, which carries WNV, breeds in very polluted water such as found in storm drains and other containers holding stagnant water. • This Program and the MDPH suggested that several municipal employees apply for a limited license that would allow them to treat storm drains if positive mosquitoes were found in Salem and the Program became overwhelmed. Jeff, Jose and I did take the training and received the limited license. Fortunately, we have not had to use it. It is commonly accepted that WNV is here to stay so we want to be prepared for a logical approach to the problem for next year. Therefore, I hope to meet with the Program and someone from the DPW to devise next year's plan. Our office, in cooperation with the Animal Control Officer and the New England Veterinary Clinic, has submitted several birds for testing. To date all the results have been negative. However, as you know, two birds did test positive in Peabody near Salem. The plan was to ground spray the two-mile radius of the dead bird location, which overlapped into Sale. However, because of weather constraints, the spraying was possible only around McGrath Field. I will update you further at the meeting. POWER PLANT The MDPH has set the date for the first meeting of its Advisory Committee for the Salem Power Plant Environmental Study for the end of the September. I will be on the committee and submitted the names of three people from Salem who were interested in joining the group. They are Gary Stirgwolt, Abigail • Winston, and Kathrin Simmons. I will also ask Sheila Billings if she is interested. Originally, I understood that the meetings would be in the daytime and Sheila i • would not be able to attend. However, since they are at night, she might want to be involved. An attorney from the power plant requested that the Board or I listen to a presentation of its study (the Valberg Study) done in response to the original power plant study (the Harvard Study). I spoke to Len about this and he would like me to contact Kim Driscoll regarding a follow-up to the previous combined BOH-City Council meeting. I will update you at the meeting regarding this. HIGH SCHOOL TICKETING The High School Principal and Vice-Principals will be at the meeting so that the Board may designate them as "Special Agents to the Board for the Purpose of Enforcing its Rules and Regulations affecting the Use or Possession of Tobacco Products on School Property." Enclosed in the packet is information I gave to the Principal so that the whole process may go smoothly. LEAD PAINT LAW The lead paint law, regarding required screening of children, is changing. It will no longer be mandated that all four-year-olds be screened for lead poisoning. Only those children living in particular communities will continue with this requirement. These communities are considered high risk for lead poisoning • because of several factors. Enclosed in the packet is the list of high -risk communities and their data. The actual rate of poisoning in Salem is lower than the State's rate (2.5 vs. 3.1) and the percentage of children screened is higher than the State (102% vs. 70%). However, Salem's percentage of pre-1950 housing is much higher than the State's (64% vs. 47%) and the percent of low-income households is higher than the State's (43% vs. 37%). Therefore, Salem's "adjusted rate" of 3.9 is higher than the State's rate of 3.1. so Salem is considered a high-risk community and mandatory screening of four-year-olds will continue. THANKS TO ALL FOR A FUN COOKOUT. 0000000000000000000 • f • 3 r � CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 I September 1, 2000 To His Honor, Stanley J. Usovicz,Jr., Mayor of Salem and the Honorable City Council: I respectfully submit the Annual Report of the Sealer of Weights and Measures for the fiscal year July 1, • 1999 to June 30,2000. As of May 1, 1999,the Board of Health has assumed all Sealer of Weights and Measures duties that were previously enforced by the City of Salem Police Department. The Office of Sealer of Weights and Measures performed numerous functions as required by the National Bureau of Standards, directed by the Department of Commerce,the General Laws of Massachusetts as related to Weights and Measures and the rules and regulations of the State Division of Standards and the City Ordinances. Administrative and laboratory functions were performed at the Board of Health office. Mechanical and supervisory functions were performed at various industrial, commercial plants,and stores in the City of Salem. Numerous inspections were made at the North Shore Medical Center, Salem Family Health Center and the Salem Public Schools. • .�o v� CITY OF SALEM HEALTH DEPARTMENT Nine North Street Salem, Massachusetts 01970 Annual Report Sealer of Weights and Measures Page 2 Scalessealed ............................................................ .......................... 66 Scalesnot sealed..................................................................................... 3 Weightssealed............................_......................................................... 0 GasPumps sealed.................................................................................... 168 FuelTrucks sealed................................................................................... I 1 Fuel Trucks not sealed.............................................................................. i • Leather sealed........................................................................................ 0 Christmas Tree permits.............................................................................. 3 Complaints received and/or Investigated.......................................................... 8 Total number of units sealed/not sealed............................................................ 475 Totalrevenue.......................................................................................... $3,771.00 Respectfully Submitted, WEIGHTS AND MEASURES Mark F. Tolman Sanitarian/Sealer MT/bas Effective May 1, 1999 Is High Risk Communities+l for Childhood Lead Poisoning July 1, 1994 through June 30, 1999 - r o/a 0 % 5 y Rate: Low /oPre- Adjusted /o Community Cases Casesx1000 Income 1950 Rate Screened Boston 861 6.3 48% 67% 11.6 89% Brockton 265 10.2 46% 46% 12.4 75% Cambridge 44 2.9 40% 71% 4.7 74% Chelsea 62 4.6 48% 64% 8A 124% Everett 28 3.6 45% 76% 7.0 75% Fall River 62 2.7 56% 66% 5.7 69% Fitchburg 56., 7.5 . .50% 62% 13.3 . 55% Haverhill 108 8.0 39% 55% 9.8 68% Holyoke 89 6.7 53% 53% 10.8 72% Lawrence 246 10.7 62% 58% 22.1 68% Lowell 160 5.9 50% 53% 9.0 64% Lynn 170 6.0 50% 66% 11.3 96% Malden 47 4.4 40% 59% 5.9 65% Medford 38 3.8 35% 71% . 5.4 72% New Bedford 156 6.1 56% 66% 13.0 77% • Pittsfield 28 2.5 45% 61% 3.9 85% Revere 30 2.9 45% 44% 3.3 81% Salem 28 2.5 430/6 64% 3.9 102% Somerville 66 4.3 42% 79% 8.2 88% Springfield 227.., 6.6 50%• 52% 10.1 55% Worcester 216 6.1 49% 58% 10.0 66% MA High Risk 2,987 6.0 63% 76% Massachusetts 4,002 3.1 37% 47% 70% �. ) Only those communities with at least 20cases and with their Adjusted Rate no less than the state rate of 3.1 for this five year period have been included In previous years,the average incidence rate was based on confirmed cases with blood lead levels >= 25 mcg/dL,which levei continues to define by regulation,childhood lead poisoning. 5-yr Cases = Number of newly confirmed cases with blood lead levels >=20mcg/dL(children 6 months to 6 years) identified between July 1, 1994 and June 30, 1999 Rate: Casesx1000 = Number of cases per 1,000 children screened during this period %Low Income = Percentage of households with low or moderate income %Pre-1950 = Percentage of housing units built prior to 1950 • Adjusted Rate = (Ratet) * ( %LowIncome /37) * ( %Pre-1950/47) %Screened = Percent of children 9 months to 4 years of age tested for lead poisoning during this period using 1995 population estimates (* some communities have a percentage above 100 because the population is underestimated). 07/31/2000 hr_rpt.prg/hr20_scr.frx Prepared by the Childhood Lead Poisoning Prevention Program Salem Board of Health August Phone Log 2000 Total Answered *Answered Calls Tuesday August 1, 2000 29 Barb = 216 Wednesday August 2,2000 46 Mary= 400 Thursday August 3, 2000 65 Sue= 416 Friday August 4, 2000 23 Saturday August 5, 2000 Sunday August 6, 2000 *Calls Taken Monday August 7, 2000 62 Tuesday August 8, 2000 36 Joanne = 239 Wednesday August 9, 2000 47 Jeffrey = 146 Thursday August 10, 2000 47 Mark = 134 Friday August 11, 2000 21 Jose = 48 Saturday August 12, 2000 Pablo = 41 Sunday August 13, 2000 sm Tracy = 96 Monday August 14, 2000 51 Ginny = 17 Tuesday August 15, 2000 52 Barb = 74 • Wednesday August 16, 2000 34 Mary = 139 Thursday August 17, 2000 65 Sue = 98 Friday August 18, 2000 35 Saturday August 19, 2000 Sunday August 20, 2000 39 Office Hours Per Week Monday August 21, 2000 45 *=23 Work Days Tuesday August 22, 2000 49 Wednesday August 23, 2000 46 Thursday August 24, 2000 44 Friday August 25, 2000 27 Monday 8-4 Saturday August 26, 2000 Tuesday 8-4 Sunday August 27, 2000 Wednesday 8-4 Monday August 28, 2000 62 Thursday 8-7 Tuesday August 29, 2000 64 * Friday 8-12 Wednesday August 30, 2000 41 (summer hours) Thursday August 31, 2000 41 • Total Calls*_ 103 Board of Health Administration Monthly Report Jul-00 Biologics Distributed * Amount in Doses Diptheria, Tetanus& Pertussis = 360 Burial Permits @$5.00 $260.00 Diptheria,Tetanus Tox.(under 6 yrs)= 0 Licenses& Permits(+copies) $487.00 Immune Serum Globulin= 5 Certificate of Fitness@$25.00 $1,625.00 Measles/Mumps/Rubella= 388 Sealer Weights/Measures= $0.00 Polio= 400 Total Monies Collected $2,372.00 Tetanus & Diptheria (adult use)= 510 Total Monies Year to Date $2,372.00 Tuberculin PPD= 450 HIB Titre= 240 Animal Bites Reported= 0 Hepatitis B= 900 PPV 23 10 PCV 7 360 Annual Budget Expenses Available Balance Salary/Longevity $354,033.00 $45,082.42 $308,950.58 Annual Budget Expenses Encumbered Available Balance Non-Personnel $20,023.00 $712.95 $900.00 $18,410.05 �v��on�nr7,k0 m s9ec'�E� CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978) 741-1800 Fax:(978)740-9705 Public Health Nurse Report July 2000 Activities Disease Prevention • In touch with T.B. Clinic and following active cases and case contacts. • Three PPD screenings done in office. • Vaccine inventory maintained and distributed. • • Investigated communicable disease cases and reported to the M.D.P.H Meeti Lags and Clinics. • 7/2 Hepatitis B Clinic, Salem Police Station. Second series for 6 officers. • 3 DPW employees received 1st Hepatitis B vaccination. • Salem State College Sports Camps inspected by Jeff Vaughan. Medical policies reviewed. Camp Licensed for 2000 St. Joseph's • Summer Vacation Phoenix School • Summer Vacation • J �OND►T�Qi .c • �9�C�M►NE apN' CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 MONTHLY REPORT OF COMMUNICABLE DISEASES July 2000 i DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES: CASES: CASES: STATE: • Campylobacter 1 0 1 1 Giardia 1 0 1 0 E.Coli 0157H7 0 0 0 0 Hepatitis 2 3 2 2 Lyrae Disease 0 0 0 0 Meningitis 0 0 0 0 Pertussis 0 0 0 0 Salmonella 2 0 2 2 Shigella 0 0 0 0 Varicella 0 0 0 0 Reportable Diseases excluded from above have not been identified this month. • v��coNnrT,kQ! n - CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 Summary of Communicable Diseases July 2000 Campylobacter• 79 y/o male. Suspects meatloaf dinner he ate at Salem Diner. He rarely eats out. He and his wife eat the same meals at home. This falls in incubation period. Jeff Vaughan notified. Wife is not ill. • Giardia• 32 y/o male. Unemployed. Suspect food unknown. Complains that he went to M.D. several times with complaints of symptoms, but was not tested until recently. Hepatitis: 2 Hepatitis C cases. Salmonella: 2 cases. 43 y/o male. Non Foodhandler. Family has pet snake. He cleans the cage. Public Health Fact Sheet Sent: Salmonella and Reptiles. 34 y/o female. Non Foodhandler. Strongly feels she became ill from Potato Salad she purchased at Stop and Shop in Beverly. No other family members ate salad. Beverly Board of Health notified. City Of Salem Environmental Health Division --- Inspection Monthly Summary Month Type Jul 00 Count CFI 70 70 CFR 1 1 CH 7 7 CON 8 8 CR 3 3 CT 1 1 EC 5 5 EPR 1 1 FC 3 3 FRH 1 1 FSD 3 3 FSI 13 13 FSR 11 11 GN 9 9 HI 50 50 HR 8 8 LPI 1 1 MS 5 5 MT 12 12 MUP 2 2 MW 3 3 RC 1 1 • RFI 3 3 RO 1 1 SB 25 25 SM 3 3 ST 1 1 TFI 6 6 TR 33 33 Count 290 290 +++++ City of Salem, Massachusetts Environmental Health Division Inspection Input Form Inspect Date : Estab Name or Owner Name : Type : Location: Inspector: Inspection Types BP - Body Piercing FSI - Food Serv. Ins . 892* RFD - Ret .Food Disc . 6* CFI - Cert . Fit . 822* FSR - Food Serv. Rein. 194* RFI - Ret . InsP. 75* CFR - Cert . Fit .Reinsp105*GN _ Gen. Nuisance 41* RFR - Ret . Food Rein34* CH - Court Hearing 93* HI Housing Insp. 260* RO - Rodent Control 16* - Constable Serv. 65* HR - Housing Reinsp. 135* SC - Suntan 7* - Compliance Rev. 25* LPI - Lead Paint Insp. 6* SES - SESD Odor 0* CT _ Computer Time10* MS - Massage 6* SM - Seminars 36* EC - Envirn. Compl . 51* MW - Mark/Weights SP - Swim. Pools 16* EPR - Ext . Paint 95* MUP - Mobile Food Insp. 11* SB - Swim. Beaches 65* FC - Food Compl . 17* OS - Off . Sub. Insp. 6* ST - Soil/Septic 8* FRH - Food Hearings15* RC - Rec Camps 9* TFI - Temp. Food 112* FSD - Food Serv. Disc 53* MT - Meetings 65* TR - Trash 381* t� A—Adjusted NS—Not Sealed S—S.aled C�—Condemned DEPARTMENT OF WIIGHM AND MEASURES Date NAME OF PERSON OR BUSINESS Field CAPACITY MEASURES Issued CERTIFTCATE ISSUED TO CNumbere SCALES AND BALANCES WEIGHTS VEHICLE LIQUID DRY TANKS UFASURES Over 5,000 To 1,000 to 100 to More Than 10 10 A thec Fast Ea.Additional 1000 10,000 Less Than Pounds Avoirdupois Metric arY 100 Gallons 100 Gallons 1 Gallon More Than 5,000 1,000 Po' J Pounds Pounds 100 Pounds Or Less Troy Or Less 1 Gallon (� Pounds Pounds Or Leas Or Fraction A I S I NS C A S I NS C A 3 N C A S NS C A S NS C A S NS C A S NS C A S NS C A S NS I C A I S NS C A S NS C A S NS C A S INS C A S NS I C -- Wliclogs a io 9 i tx ros Iry to rx st srµwgs OFFICE RECORD AND LEDGER LIQUID MEASURING METERS LINEAR MISC. FEES AND CHARGES INLET ONE INCH INLET MORE THAN ONE MORE PUMPS OTHER DEVICES MEASURES OR LESS INCH I70T MORE THAN THAN 4 INCH FOUR INCHES GASOLINE OIL VEHICLE BULK Each Taxi Odometer Leather Fabric Rope Ya-d Legal Allowable 'Mire Milk Fees Fsea GREASE TANK STORAGE Stop Meters Hubodometer Measuring Measuring Cordage Sticks Tapes cars Sealing Adjustment Total - Fees Charge. Pal Unpaid A S NS C A S NS IC A S N A S N C A S N C A S NS C A S NS C A S NS C A S NS C A S NS C A S NS C A S NS C A S NS C A S NS C -------------------- 00 ---------------- --------------- H-tt t,—41-1 I+.— I it I I FO M ]3 NEVI D Y,IY . lft. t. V.tl ME41 INN IN INN 111 I I1 11 logo nomilmoollon III I � ■ � loollonsi�INEENIN logo loss IN ism 0 monnisilloollismilin 11 ENIIINII on In _M ■ ■n �■� ■i��u■ � m�iun ��■��■gym A—Adlustod NS—Not Sealed Sealed C—Condemned DEPARTMENT OF WEIGHTS AND MEASURES NAME OF PERSON OR BUSINESS Field CAPACITY MEASURES Date HI Issued Certificate SCALES AND BALANCES WEIGHTS VECLE LIQUm DRY CEHTgTCATE ISSIIED TO Number TANKS MEASURES Over 5,000 To 1.000 to 100 to More Than 10 10 Apothecary Feet Ea.Additional I Gallon More Than 10.000 10.000 5,000 1,000 Less Than Pounds Avoirdupois Metric I00 G Troy allons 100 Gallons Aqu�k �O Pounds Pounds Pounds Pounds 100 Pounds Or Less Or Less Or Fraction Or Less 1 Gallon A S NS C A S NS C A S NSI C A S NS C A S NS C A S NSI C A S NS C A S NS C A S NS C 11 A S NS C A S NS C A S NS I C A S NS C A S NS I C Q p �g 0 93 1 F n1 io ?q S ' m ros ur rs mot srµsugs E OFFICE RECORD AND LEDGER LIQUID MEASURING METERS INLET ONE INCH INLET MORE THAN ONE MORE PUMPS OTHER DEVICES LINEAR OR LESS INCH NOT MORE THAN THAN MEASURES MISC. FEES AND CHARGES 4 INCH FOUR INCHES OQ. VEHICLE Odometer Leather Fabric Yard Milk Legal Allawable Fees Fees GASOLINE BULK Each Taxi Rope GREASE TANK STORAGE Stop Meters Hubodometer MeasuringMeasuring Ire Tapes Sealing Adjustment Total 9 Cordage Sticks lms Fees Charges Paid Unpaid _ A S NS C A S NS C Al S N A S N C A S N C A S NS C A S NS C A S NS C A S NS C A S NS C A S NS C A S NS C A S NS C A S NS C n O 6 0 00 1-71 FFT +H --------------------------- 00 FO M 33 NEVI D Y,14 N • AN ., UNLI MENS I Salem Board of Health July 2000 Phone Log Total Answered Monday July 3, 2000 24 *Answered Calls Tuesday July 4, 2000 Holiday Barb= 237 Wednesday July 5, 2000 44 Mary= 307 Thursday July 6, 2000 52 Sue= 432 Friday July 7, 2000 22 Saturday July 8, 2000 *Calls Taken Sunday July 9, 2000min= Joanne= 162 Monday July 10, 2000 57 Jeffrey= 159 Tuesday July 11, 2000 51 Mark= 96 Wednesday July 12, 2000 54 Jose= 89 Thursday July 13, 2000 59 Pablo= 19 Friday July 14, 2000 32 Tracy= 120 Saturday July 15, 2000 Ginny= 35 Sunday July 16, 2000 Barb= 79 nday July 17, 2000 60 Mary= 115 Tuesday July 18, 2000 62 Sue= 102 Wednesday July 19, 2000 54 *39 Office Hours Per Week Thursday July 20, 2000 49 * = 20 Work Days Friday July 21, 2000 23 Saturday July 22, 2000 Sunday July 23, 2000 Monday 8-4 Monday July 24, 2000 53 Tuesday 8-4 Tuesday July 25, 2000 55 Wednesday 8-4 Wednesday July 26, 2000 58 Thursday 8-7 Thursday July 27, 2000 76 Friday 8-12 *Summer Hours Friday July 28, 2000 29 Saturday July 29, 2000 Sunday July 30, 2000 Monday July 31, 2000 62 Total = 976 • • • Board of Health Administration Monthly Report Jun-00 Biologics Distributed Amount in Doses Diptheria, Tetanus & Pertussis = 525 Burial Permits @ $5.00 $295.00 Diptheria,Tetanus Tox.(under 6 yrs)= 0 Licenses & Perm its(+copies) $2,125.00 Immune Serum Globulin= 0 Certificate of Fitness@$25.00 $2,000.00 Measles/Mumps/Rubella= 360 Sealer Weights/Measures= $40.00 Polio= 475 Tetanus & Diptheria (adult use 390 Tuberculin PPD= 750 HIB Titre= 310 Animal Bites Reported= -1- Hepatitis B= 686 PPV 23 1 20 PCV 7 500 Annual Budget Expenses Available Balance Salary/LongeVlty .$344,061.00 $340,644.07 $3,416.93 Annual Budget Expenses Encumbered Available Balance Non-Personnel $19,100.00 $24,677.79 $798.21 $499.35 $6,875.35 s t Nnrrt,t� Q ff S CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, IRS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 Public Health Nurse Report June 2000 Activities Disease Prevention i In touch with T.B. Clinic and following active cases and case contacts. • 5 PPD screenings done in office. • Vaccine inventory maintained and distributed. • Investigated communicable disease cases and reported to the M.D.P.H. case of T.B. • Meetings and Clinics 6/6 Collins Middle School Hepatitis B vaccinations administered to 40 students. Assisted by Mary Eagan RN, and Deborah Alexander RN, school nurse. 6/7 St. Joseph's Third Hepatitis B vaccinations administered to 5 students. Students pediatricians were mailed immunization record at parents request. 6/7 Phoenix School third Hepatitis B vaccination administered to 1 student. Students immunization record mailed to pediatrician at parents request. 6/13 Camp inspection of Boys and Girls Club assisted by Jeff Vaughan. Medical records reviewed for first session. CORIS reviewed. Camp licensed for summer 2000 6/15 Police Hepatitis B Clinic at Salem Police Station. 6 officers received the 1s series. The next scheduled clinic is July 20, 2000 6/20 Camp inspection of Campfire Summer Camp. Assisted by Mark Tolman. All Medical policies and procedures reviewed. CORIS reviewed. Camp licensed for summer 2000 6/21 Attended a seminar at Tewksbury Holiday Inn. "What Boards of Health Should Know about Hepatitis." 6/22 Camp inspection of Children's Island. Immunizations reviewed. Medical policies isand procedures reviewed. CORIS are pending. Fire prevention has not been to camp for inspection. r . • 6/27 Camp inspection of Camp Pinecrest. Immunizations reviewed. Medical policies and procedures reviewed. CORI'S reviewed. Assisted by Virginia Moustakis. Camp licensed for summer 2000 6/29 New ca*np:}Eou4&of Seve vgatge. ,Ca.mp. Camp is located at 54 Turner Street on the grounds of House of Seven Gables. Susan Bowditch is the director. This is a small camp with 6 campers and two counselors. CORPS are pending. Camp licensed for 2000. St. Joseph's School: Recorded Heights and Weights, postural, Hearing and Vision information into charts. School is out for summer. Phoenix School: Recorded heights &weights, postural, hearing and vision information into charts. School is out for summer. • • J . �o r CITY OF SALEM HEALTH DEPARTMENT • S �,a Nine North Street Salem, Massachusetts 01970 MONTHLY REPORT OF COMMUNICABLE DISEASES June 2000 DISEASE: NEW CARRY OVER DISCHARGED REPORT TO CASES: CASES: CASES: STATE: Campylobacter 1 0 1 1 • Giardia 0 0 0 0 Hepatitis 2 2 2 2 Ly me Disease 0 Y 0 0 0 Meningitis 0 0 0 0 Pertussis 0 0 0 0 Salmonella 1 0 1 1 Shigella 0 0 0 0 Varicella 0 0 0 0 Reportable Diseases excluded from above have not been identified this month. • y i I ryo t CITY OF SALEM HEALTH DEPARTMENT • a,�tii9rAo Nine North Street �:__ Salem, Massachusetts 01970 Summary of Communicable Disease June 2000 Campylobacter: 67 y/o male. Non Foodhandler. Traveled 5/31 to 6/5 to Spain. He is a vegetarian. His wife traveled with him. She Is asymptomatic. Suspect food or drink purchased in Spain unknown. Hepatitis: One Hepatitis B case One Hepatitis C case Salmonella: 40 y/o female. Suspects she became ill from eating eggs at Bickford's Restaurant in Peabody. Peabody Board of Health Notified, and an inspection was coducted. • • • City Of Salem -- Environmental Health Division - Inspection Monthly Summary Month ---- ------------------------------ Type Jul 99 Aug 99 Sep 99 Oct 99 Nov 99 Dec 99 Jan 00 Feb 00 Mar 00 Apr 00 May 00 Jun 00 Count 2 3 0 0 0 0 0 0 0 0 0 0 5 CFI 60 91 80 69 50 76 56 77 67 52 65 74 817 CFR 12 0 13 16 0 15 5 13 8 8 8 7 105 CH 8 10 6 18 8 12 3 4 8 4 8 4 93 CON 3 9 3 5 8 2 13 3 5 7 1 6 65 CR 3 5 1 1 4 1 2 1 0 1 4 2 25 CT 0 0 1 0 2 1 1 1 1 3 0 0 10 EC 5 11 4 3 0 3 4 1 5 2 4 9 51 EH 0 1 0 0 0 0 0 0 0 0 0 0 1 EPR 0 3 1 0 4 0 0 0 0 0 0 1 9 FC 0 3 0 1 1 0 0 2 3 2 2 3 17 FRH 4 3 1 1 0 1 0 0 1 0 3 1 15 FSC 0 0 0 0 1 0 0 0 0 0 0 0 FSD 3 6 1 3 6 7 5 3 5 8 3 3 53 FSI 19 17 14 28 28 24 26 33 27 24 20 29 289 FSR 6 13 7 19 24 20 18 16 20 14 21 16 194 GN 4 7 7 3 3 1 3 1 2 5 2 3 41 GN/TR 2 0 0 0 0 0 0 0 0 0 0 0 2 HI 12 16 16 17 32 10 19 10 12 51 32 33 260 FIR 7 14 15 18 7 10 10 19 17 4 1 13 135 HR/CFI 0 1 0 0 0 0 0 0 0 0 0 0 1 LPI 0 0 1 0 1 0 2 0 1 1 0 0 6 0 0 0 0 0 0 0 0 0 0 2 4 6 WS 0 0 0 0 9 10 8 2 11 10 6 9 65 MUP 0 1 1 0 0 0 0 2 0 4 3 0 11 OG 0 0 0 2 0 0 0 0 0 0 0 0 2 OS 0 0 0 0 0 0 0 0 5 0 0 1 6 RC 1 1 0 0 0 0 0 0 1 1 0 5 9 RFD 1 1 0 0 2 0 0 0 1 0 1 0 6 RFI 5 8 4 7 11 11 2 5 5 2 7 8 75 RFR 1 1 3 3 3 6 8 0 3 2 3 1 34 RO 1 3 0 0 4 0 1 0 2 4 1 0 16 RRH 1 0 0 0 0 0 0. 0 0 0 0 0 1 SB 2 12 11 0 0 0 0 0 0 1 0 39 65 SC 0 0 0 0 0 0 0 4 1 2 0 0 7 SM 5 10 9 6 0 0 0 3 0 1 2 0 36 Sp 1 1 0 1 0 0 0 0 0 1 5 7 16 ST 0 0 0 0 1 0 0 2 4 0 1 0 8 TFI 0 28 0 84 0 0 0 0 0 0 0 0 112 TR 38 37 26 21 30 27 21 20 53 49 26 32 380 TR/GN 1 0 0 0 0 0 0 0 0 0 0 0 1 ------ ------ ------ ------ - Count 207 316 225 326 239 237 207 222 268 263 231 310 3051 BP - Body Piercing2* FSI - Food Serv. Ins.262* RFD - Retail Food Disc. CFI - Cert. Fit.711* FSR - Food Serv. - Rein.110* RFI - Ret. Insp.66* CFR - Cert . Fit.Reinsp73* GN. _ Gen. Nuisance_61* - RFR - Ret. Food- Rein24* CH —Court Hearing 143* HI - Housing Insp. 242* RO - Rodent Control 25 CON - Constable Serv.80* HR - Housing Reinsp.153* SC - Suntan 6* •CR - Compliance Rev.57* LPI - Lead Paint Insp. 6* SES - SESD Odor 7* CT _ Computer Time MS - Massage 8* SM - Seminars 78* EC - Envirn. Compl.113* MUP - Mobile Food Insp. 13* SP - Swim. Pools 8 EPR - Ext. Paint 15* OG - Overgrowth . SB - Swim. Beaches 132 FC - Food Compl. 13* OS - Off. --Sub. ' Insp. 25* ST - Soil/Septic 6* FRH - Food Hearings RC - Rec Camps 7* TFI - Temp. Food58* FSD - Food Serv. Disc.17* MT - Meetings TR - Trash 747* Salem Board of Health June 2000 Phone Log Total Answered Thursday June 1, 2000 74 *Answered Calls Friday June 2, 2000 48 Barb= 287 Saturday June 3, 2000 Mary= 250 Sunday June 4, 2000 Sue= 453 Monday June 5, 2000 39 Tuesday June 6, 2000 60 *Calls Taken Wednesday June 7, 2000 42 Joanne= 212 Thursday June 8, 2000 46 Jeffrey= 134 Friday June 9, 2000 42 Mark= 95 Saturday June 10, 2000 Jose= 64 Sunday June 11, 2000 Pablo= 11 Monday June 12, 2000 58 Tracy= 111 Tuesday June 13, 2000 50 Ginny= 26 "Vednesday June 14, 2000- 45 Barb= 123 hursday June 15, 2000 54 Mary= 103 Friday June 16, 2000 35 Sue= 111 Saturday June 17, 2000 *43 Office Hours Per Week Sunday June 18, 2000 = 22 Work Days Monday June 19, 2000 53 Tuesday June 20, 2000 48 Wednesday June 21, 2000 30 Monday 8-4 Thursday June 22, 2000 44 Tuesday 8-4 Friday June 23, 2000 22 Wednesday 8-4 Saturday June 24, 2000 Thursday 8-7 Sunday June 25, 2000 im Friday 8-4*Winter Hours Monday June 26, 2000 29 Tuesday June 27, 2000 44 Wednesday June 28, 2000 46 Thursday June 29, 2000 52 riday June 30, 2000 29 *Effective July 7, 2000 *Summer Hours Close Noon Fridays Total = 990 Board of Health Administration Monthly Report May-00 Biologics Distributed Amount in Doses Diptheria, Tetanus & Pertussis = 480 Burial Permits @ $5.00 $280.00 Diptheria,Tetanus Tox.(under 6 yrs)= 10 Licenses& Permits(+copies) $2,120.00 Immune Serum Globulin= 0 Certificate of Fitness@$25.00 $1,800.00 Measles/Mumps/Rubella= 420 Sealer Weights/Measures= $120.00 Polio= 370 Tetanus & Diptheria (adult use)= 705 Tuberculin PPD= 480 HIB Titre= 420 Animal Bites Reported= 0 Hepatitis B= 480 Annual Budget Expenses Available Balance Salary/Longevity $344,061.00 $302,049.52 $42,011.48 Annual Budget Expenses Encumbered Available Balance Non-Personnel $19,100.00 $13,626.05 $11,051.74 $1,297.56 $6,875.35 t �FoN� 7�J CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts �01970-3928 JOANNE SCOTT, MPH, IRS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 Public Health Nurse Report May 2000 Activities Disease Prevention • In touch with T.B. Clinic and following active cases and case contacts. • • Two PPD screenings done in office. • Vaccine inventory maintained and distributed. • Investigated communicable disease cases and reported to the M.D.P.H • Hepatitis B series 2 administered to two police officers. Meetings and Clinics. • 5/5 Public Health Nurse Conference. Holiday Inn, Worcester 8:30 a.m. to 4:00 p.m. St.Joseph's School • 5/18 Postural Screenings for girls. No referrals. • 5/25 Postural Screenings for boys. No referrals. Phoenix School I } CONDIT • 7a CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 MONTHLY REPORT OF COMMUNICABLE DISEASES May 2000 DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES: CASES: CASES: STATE: Campylobacter 1 0 1 1 • Encephalitis 1 0 1 1 Giardia 1 0 1 1 E.Coli 0157H7 0 0 0 0 Hepatitis 5 4 2 2 Lyme Disease 1 0 1 1 Meningitis 0 0 0 0 Pertussis 0 .0 0 0 Salmonella 1 0 1 1 Shigella 0 0 0 0 Varicella 0 0 0 0 Reportable Diseases excluded from above have not been identified this • month. i r CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 Summary of Communicable Diseases for May 2000 Campylobacter: One case. 55 y/o disabled male. Suspected chicken sandwich purchased at Buchie's in Salem. He was ill two hours after eating the sandwich. Incubation period for Campylobacter is 1-10 days. Sanitarian notified. No recent travel, was not cooperative with other possible food sources. Encephalitis: Reported on 5/4/00. Patient expired on 5/500. Positive for HSV Type I and IL Primary cause of death on death certificate was lung cancer. Giardia: 6 year old male. Mother states the child has had no appetite for months and had begun to lose weight. After seeing doctor several times,a stool sample was obtained. They had traveled to Puerto Rico in December 1999. Symptoms: fatigue,weight loss, poor appetite. Hepatitis: 1 Hepatitis B case 4 Hepatitis C cases. Salmonella: 14 month male. Traveled to Dominican Republic with family 5/12 to 5/23. Symptom onset: 5/22. Suspect food unknown. This child was confirmed to have Campylobacter in March after traveling to Dominican with family. Public Health Fact Sheet sent. y •.... x t ';j R„{. b •t ,. .i s .-7• 1r r e•'c+t k 2K' City Of Salem • Environmental Health Division --- Inspection Monthly Summary Month -------------------------------------------------------------------------------------- Type Jul 99 Aug 99 Sep 99 Oct 99 Nov 99 Dec 99 Jan 00 Feb 00 Mar 00 Apr 00 May 00 Count 2 3 0 0 0 0 0 0 0 0 0 5 CFI 60 91 80 69 50 76 56 77 67 52 65 743 CFR 12 0 13 16 0 15 5 13 8 8 8 98 CH 8 10 6 18 8 12 3 4 8 4 8 89 CON 3 9 3 5 8 2 13 3 5 7 1 59 CR 3 5 1 1 4 1 2 1 0 1 4 23 CT 0 0 1 0 2 1 1 1 1 3 0 10 EC 5 11 4 3 0 3 4 1 5 2 4 42 EH 0 1 0 0 0 0 0 0 0 0 0 1 EPR 0 3 1 0 4 0 0 0 0 0 0 8 FC 0 3 0 1 1 0 0 2 3 2 2 14 FRH 4 3 1 1 0 1 0 0 1 0 3 14 FSC 0 0 0 0 1 0 0 0 0 0 0 1 FSD 3 6 1 3 6 7 5 3 5 8 3 50 FSI 19 17 14 28 28 24 26 33 27 24 20 260 FSR 6 13 7 19 24 20 18 16 20 14 21 178 GN 4 7 7 3 3 1 3 1 2 5 2 38 GN/TR 2 0 0 0 0 0 0 0 0 0 0 2 HI 12 16 16 17 32 10 19 10 12 51 32 227 HR 7 14 15 18 7 10 10 19 17 4 1 122 HR/CFI 0 1 0 0 0 0 0 0 0 0 0 1 LPI 0 0 1 0 1 0 2 0 1 1 0 6 0 0 0 0 0 0 0 0 0 0 2 2 0 0 0 0 9 10 8 2 11 - 10 6 56 0 1 1 0 0 0 0 2 0 4 3 11 OG 0 0 0 2 0 0 0 0 0 0 0 2 OS 0 0 0 0 0 0 0 0 5 0 0 5 RC 1 1 0 0 0 0 0 0 1 1 0 4 RFD 1 1 0 0 2 0 0 0 1 0 1 6 RFI 5 8 4 7 11 11 2 5 5 2 7 67 RFR 1 1 3 3 3 6 8 0 3 2 3 33 RO 1 3 0 0 4 0 1 0 2 4 1 16 RRH 1 0 0 0 0 0 0 0 0 0 0 1 SB 2 12 11 0 0 0 0 0 0 1 0 26 SC 0 0 0 0 0 0 0 4 1 2 0 7 SM 5 10 9 6 0 0 0 3 0 1 2 36 SP 1 1 0 1 0 0 0 0 0 1 5 9 ST 0 0 0 0 1 0 0 2 4 0 1 8 TFI 0 28 0 84 0 0 0 0 0 0 0 112 TR 38 37 26 21 30 27 21 20 53 49 26 348 TR/GN 1 0 0 0 0 0 0 0 0 0 0 1 -1,_, Count 207 316 225 326 239 237` 207 222 268 263 231 2741 BP - Body Piercing2*: FSI - Food:;-Sere. lns 262* RFD = Retail Food -Disc: CFI - :Cert...- Fit 7 1* FSR Food Sery Rein.110* RFI Ret Insp 66* CFR - Cert ;F1t. 2einsp73* GN: _ Gen Nu�san�e 6� * _____ RFR Ret._ F`oad-Rein24*- --- F-- -- CH - Court' Hear g 143* HI - Housing 'Iri�sp, 24 2* RO' Roderit' Control' 25' CON - Constable `Serv.80* HR - Housing Reinsp;.1'S3* SC Suntan 6* - •CR - Complacence-R PI. - Lead _Paint: Insp .6* SES SESD Odor -7* CT _ Computer' Tme MS .: Massage 8*. SM Semiriars 78*,. EC - EnVlrn Co-4 113* MOP Mobile Food Insp. 13* SP Swim ; Poolsr8 EPR - Ext Paint' 15* big Overgrowth SB, SwimHeaches h FC - Food`Comp1 s13*" OS #Off Sub 3%n pF: 2 5* ST SW /S�p'R Q FRH - Food =Hearings , RC' rRee , antis_ , * f.. TFI Temp Food58* FSD Food YSery Disc lit MT yMeet zgls ': TR' Trash:'7,4�7* l��dress a 4 _ Type Bu6iness16AS S SEALING AND ADJUSTMENT RECORD' Fees and adjusting charges authorized by Section 56,G.L.,Chapter 98 as amended by C.338,Act of 1982 Legal ut DEVICE Sealing Adjusted Sealed Not Sealed Condemned Charges 1 Fees Over 10,000 Ibs 100.00 ea 5,000 to 10,000 Ibs 45.00 w w 1,000 to 5,000 Ibs 30.00 z a 100 to 1,000 lbs 20.00 QIt SS THAN 100 LBS 10.00 00 10 Ibs or less 5.00 Avoirdupois (Each) 1.00 Metric (Each) 1.00 a Apothecary (Each) 1.00 � Troy (Each) 1.00 VehicleTanks Each Indicator 10.00 w Each 100 Gals or Fraction Thereof 5.00 Q Liquid V 2 1 Gallon or less 2.00 More than 1 Gallon 2.00 Inlet 1/2"or less Oil,Grease 6.00 a Inlet more than 1/2"to V. Gasoline 15.00 JA / 0 00 0 ul Inlet more than 1" WVehicle Tank Pump 30.00 CJ Vehicle Tank Gravity 30.00 - . Bulk Storage 60.00 Company Supplies Prover 30.00 EE Each Stop On Pump 2.00 a Taxi Meters 25.00 N Odometer-Hubodometer 20.00 �w =v Leather Meas(Semi-an.) 10.00 0 w Fabric Measuring 10.00 Wire-Rppe-Cordage 10.00 ui. Yard Sticks 3.00 ,:3 W Tapes 3.00 I � Milk Jars(per gross) 25.00 Dry Measures 1.00 Adjusting-Repairs-Special Facilities; 10.00 Charges /A 00 This is to certify that I have this day tested,adjusted,sealed or vanderrined the abovadescribed device in compliance with the /`10.a a Chapter 98 as most recently amended. %��PtihP S wlev Inspector SealerofWeights.and Measures atex�% 4Nt i �'.Sk t }4 Received,Paymenttnspectl7r Sealerof Weights and'Meas�ures^,` $ + 1 Y t E APPROVED BY,TNE DIRECTOR OF STANDARDS _ " rw r ,�7z � < Type Business G►aS S�i9�toH ` E �" SEALING AND ADJUSTMENT RECORDYj: Adwes and adjusting charges authorized by Section 56,G.L.,Chapter 98 as amended by C:338;Act of 1982.. IMF Legal DEVICE sealing Adjusted sealed Not sealed Condemned Charges Fees Over 10,000 Ibs 100.00 od 5,000 to 10,000 Ibs 45.00 - w W 1,000to5,000lbs 30.00 z Ja 100 to 1,000lbs 20.00 J N MSS THAN 100 L.S 10.00 Q 0° 10 Ibs or less 5.00 Avoirdupois (Each) 1.00 Metric (Each) 1.00 a Apothecary (Each) 1.00 LU Troy (Each) 1.00 VehicleTanks Each Indicator 10.00 +, W Each 100 Gals or Q Fraction Thereof 5.00 a w Liquid 02 1 Gallon or less 2.00 More than 1 Gallon 2.00 Inlet 1/2"or less : Oil,Grease. 6.00 ° tj nlet more than 1/2"to 1 p� Gasoline 15.00 Q 00 tin w Inlet more than 1" LLJ Lu Vehicle Tank Pump 30.00 C1 Vehicle Tank Gravity 30.00 Bulk Storage 60.00 Company Supplies Prover 30.00 EE Each Stop On Pump 2.00 Taxi Meters 25.0 to Odometer-Hubodometer 20.00 =v Leather Meas(Semi-an.) 10.00 ~O w Fabric Measuring 10.00 Wire-Rope-Cordage 10.00 4 vs Yard Sticks 3.00, s w Tapes 3.00, Milk Jeri.(per gross). ,25.00 rn Dry Measures -1.00 � s s {�� Adjusting Repairs:Special Facillt�esA.410.00 Charges. _ t #. Thls`is to certify,that I Have this'day tested adjusted sealed or c lied the, bo a"la8t riged c evr a in compliance with the R Chapters98 as most recently amendedr y1QIOItQ4Nt►1i1h! tO �E`�`ey', :F 'a �L ;It1Sp eights and MeasjJjes 2� q t Date fi t • ' �t " ';`gyp , ' u'Y{ ,ds k �., ��, � Recelved[Pi y t s" elghfsaCt 2a$CJ�e$ � VEBY'CkiE:DIRE�T.bR;O� TA ARDS I J k } ."�f.`k}•r ro 7��,1�a 7}'•.•t'e r e� .. y `8 i ?< ° xX '� r d- k Type Busjnass d ILi„�,' t `SEALING AND'ADJUSTMENT s, Fees and adjusting charges authorized by Section 56;:G:L ,Chapter 98 as'amended,'6y C 338?Act "Legal DEVICE' Seating Adjusted Sealed Not Sealed ,Condemned Charge r Fees Over 10,000 lbs` 100.00 5,000 to 10,000 lbs 45.00 Y: *7� w w 1,00049 5,000 lbs 30.00 � z Q 100 to 1,000 Ibs 20.00 LESS THAN 100 LBS '- 10.00 ?• k x�' Q 00 101bs or less 5.00 Avardupols"' (Each) 1:00 Cn Metric (Each) 1.00 0 Apothecary (Each) 1.00 ; �v .. Troy (Each) 1.00 ' VehicleTanks Each Indicator 10.00 w' w Each 106 Gals or Fractiori Thereof. 5.00 a Q Liquid: w �?,M 1 Gallo* or less 2.00 j, More than 1 Gallon 2.00 r' _.._ 7, IMet 1/2"or less Oil,Grease " 6.00 f `� 0 • Inlet.more:than 1/2'to 1" Gasoline 95.00 t_ . rf ' InYe[more than t°: 6R + F s; � w w Vehicle Tank Pump' 30.00 fs" _ Vehicle Tank Gravity moo i s � Bulk Stora a 60.00 t' 9- d Compahy.:Suppiies Prover 30.00 + E Each Stop Ori Pump' 2.00 ` rr Taxi Meters 25.0.0 'y , N Odometer-Hubodo6ieter _ 20.00: , cc w:v Leather.Meas(Semi-an.) 10.00 0 w Fabric Measuring 10.00 , % f �k • Wire-Rope=Cordage 10.00 r Yard•Sticks 3 00 J W p 3.00 t abr 1 'i Ta es c v Milk Jars(pergross) . • °25.00 kA ,x 4. F N Dry;Measures. ,1 00 1 Y}" r - Adjusijng Reparrs-Spedjal FaOjljtjes 10 0 Charges This is to ceitify�thaf havetti�s iiaytested adjusted`sealed ors } , y £ , mil 'a1 �k ,t . t s_i w y }"!rn 4•"t `t,ksai; condemneclthQ bov d �c(tbgd gJoe in comp iance�With the ChaptQN $aS mq'sftoC!~1�tT afiended p.G zyw k f �hnl f tG ' , Mtiuz ygi d�t 5 r S i> , x3 rim .r.r�S 3.�•S #(". 4 L.`?s+s7fi k�, '"tS 41'FP,r1 ra iA r3•E.u ''ad 2, 1\ya t ] } Ft:i prss'� '�(' j }''�� .. 7 '" ; j'S'r• at f "ttx�. -'� K y purl' .0 .t�'r 1a• pjH, ; WOE J t•*. q.. x a a:.. +, ; e �•t.p gn , �.r a• r a �t+'d� ate':1 �"�y3 5. � Recenrisd Prrt nti4sp a er`t}f _ d e`Sure l�l�.: �' I c �,, '�• t +- xa , x yxf .x'"+" jr� t! nN"+'tea ti t r +'.{�,� -:+ri �,f " 3 �'d6PiL7"p t'ip . TypeBusine-ss /�kdlCpk� SEALING.AND ADJUSTMENT RECORD Fees aid adjusting charges authorized by.Section 56,G..L.,Chapter 98 as•,amended by 6 338,Act of 1.982 F DEVICE_' seanng Adjusted Sealed Not Sealed condemned Charges Fees Over 10,000,lbs 100.00 elf -5,000 to 10,000 lbs - 45.00Cn W w 1,,000 to 5 0.00:lbs 30.00 z Q 106to.1,0001.bs 20.00 Z p QN M SS-THAN N700 LB3 10.00 ,.,�'`•. in 101bs:or less 5.00 y k Avoirdupois (Each) 100 J H ;.metnc Each), i.d0 c7 `Apothecary (Each) 1.00 <+` n w � Troy,; (Each) 1.00 VehicleTanks' - Each Indicator 10.00 . }W EkhF Ib0 Gals or . Fraction Thereof 5.00 t; a U uid -Q'W U 1 Gallon of lessx. 2.00 More than 1:Gallon: 2.00x fH Inlet 1YL"or less 6j1';Grease Inlet more than t!2"toa Gasoline 15.00 (b.W Inle'trnore than 1" ??R :W'w VeFiicle Tank.Pump 30.00 icle TariK Gravity. 30.00 Bulk Storage 60.00 y : Company Supplies Prover 30,00 j. ,K a Each';Stop.bll:Pump 2.00 ` L,n E TaxrMeters, 25.00 t, i N Odometer Hutiodomeier 20.00 { Cc W -W_v Leatfier as{Semi=an.) 10.00 ~O W Fabrie Measuring 10.00. .'� Wire-Rolle.Cordage 10.00 ' fr 1�' Yard Sticks 3 00 Z'w TapeS, :300777 4.. MJIk Jars(per`;gross) 25 00 _ -to •1 00 ` 4 C Di`yNlelsures ,,,� Adlusting Repalfsy Special Faci6tles 10 00 Charges �p r p p vThisistocertifjrrfhE)'11t"a4�4his;¢aytested adf sted seaYeO-fqr'",« ' ,y d�n? },tav �c�escrladdevice in corripliapcerwi{ th� � n�C +Ir` rs" � a r F! t Chaptb� $as m6 rcehtiamended i y ;t+� <� f i r b m " ': •s`%,y r 1 ' i F ! ' r !x 'r �` 'r '� i 0 r`r ,Ja'yr �55r ya s*�S J•'.�,tt„ � i r r � +F'rtr: Y �k �. jf^4 a S '�y' +,i 1 T 6 1" i anti•! o f # .1f a :y y�d,�'-..� S i s : f�J y4`'-v ty b z i i FX"91 y Ai'l ✓i^�a eaSlyre.S'if� i�i"-w�r� etrM48" 6� ak#per � tdP �'" v ``' taAx �`ra:^^ Yf'"7ri�' i,.5 i '•t`�'�, Y. II'.� t`f4�4 A 4[ �7' f`(4ie�i.�T v* -�E. .Z�'t. r tt•rrR'!�,�' fry`il " Y 3 i iY�. . k iecalf;d ' y t r speS ;aer�ofWcic escis't�a} i r lu ; "'x•�f x �' n Y k rf9 g, P' * �3 � lam 9 , Warne i9'errm` t Address LaFaVe> - M .f r 'Npe Business 6aS SfAfi2A a ' SEALING AND ADJUSTMENT RECORD t Wes and adjusting charges authorized by Section 56,G.L.,Chapter 98 as amended by C.338,Act of 1982. i Legal' DEVICE Sealing Adjusted Sealed Not Sealed Condemned Chargea Fees Over 10,000 Ibs 100.00 ca 5,000 to 10,000 Ibs 45.00 w w 1,000 to 5,000 Ibs 30.00 z a 100 to 1,000 Ibs 20.00 QQ V MORE THAN 10 LBS LESS THAN 100 LBS 10•00 m 10 Ibs or less 5.00 Avoirdupois (Each) 1.00 Metric (Each) 1.00 a Apothecary (Each) 1.00 Troy (Each) 1.00 Vehicle Tanks Each Indicator 10.00 H w Each 100 Gals or Ts a CS Fraction Thereof 5.00 a w Liquid 02 1 Gallon or less 2.00 i More than 1 Gallon 2.00 ;.., Inlet 1/2"or less Oil,Grease 6.00 s I Inlet more than 1/2"to 1" z 'Y 2 y Gasoline 15.00 /a 0.w Inlet more than 1" T`--. LU LU Vehicle Tank Pump 30.00 Vehicle Tank Gravity 30.00 Bulk Storage 60.00 , Company Supplies Prover 30.00 ; EE Each Stop On Pump 2.00 Taxi Meters 25.00 ;t M N Odometer-Hubodometer 20.00 =V Leather Meas(Semi-an.) 10.00 ~ w O Fabric Measuring 10.00 Wire-Rope-Cordage 10.00 V Yard Sticks 3.00 r w Tapes 3.00 ci Milk Jars(per gross) 25.00 N Dry Measures 1.00 - Adjusting-Repairs-Special Facilities; 10.00 Charges x to certify.that I have this day tested,adjusted,sealed or s f mned the above described device in compliance.with the G.L.,Chapter 98 as most recently amended. M Inspector Sealer of Weights and Measures % .a' r ,,Address oe,rhy S� 1 Type Business G,4 c t SEALING AND ADJUSTMENT RECORD Fees and adjusting charges authorized by Section 56,G.L.,Chapter 98 as amended by C.338,Act of 1982. Legal DEVICE Sealing Adjusted Sealed Not Sealed Condemned Charges Fees Over 10,000 Ibs 100.00 oil 5,000 to 10,000 Ibs 45.00 _ VW 1,000 to 5,000 Ibs 30.00 Z a 100 to 1,000 Ibs 20.00 JV MORE THAN 10 LBS - Q y LESS THAN 100 LBS 10.00 - m 10 Ibs or less 5.00 Avoirdupois (Each) 1.00 Metric (Each) 1.00 a Apothecary (Each) 1.00 Troy (Each) 1.00 VehicleTanks Each Indicator 10.00 W Each 100 Gals or Q M Fraction Thereof 5.00 W Liquid 02 1 Gallon or less 2.00 More than 1 Gallon 2.00 Inlet 1/2"or less ` •' Oil,Grease 6.00 C7 Inlet more than 1/2"to 1" fi Gasoline 15.00 to w Inlet more than 1" UJI III Vehicle Tank Pump 30.00 O Vehicle Tank Gravity 30.00 M . Bulk Storage 60.00 Company Supplies Prover 30.00 E Each Stop On Pump 2.00 Taxi Meters 25.00 rn Odometer-Hubodometer 20.00 cc= V Leather Meas(Semi-an.) 10.00 0 w Fabric Measuring 10.00 Wire-RQpe-Cordage 10.00 Vj Yard Sticks 3.00 J W Tapes 3.00 v Milk Jars(per gross) 25.00 1 N Dry Measures 1.00 ' Adjusting-Repairs-Special Facilities; 10.00 Charges `• ,d This is to certify'that I have this day tested,adjusted,sealed or co demned the above described device in compliance with the hapfer 98 as most recently amended. A R K I�� IM►4Y� Sewle�r : .5�3�00 ��'�� .�,�`;-�;� inspector Sealer-of Weights and Measures zu y`�Date`; Received Payment Inspector-Sealer of Weights and Measures „r7HIS FORM APPROVED BY THE DIRECTOR.OF STANDARDSy, r r AGENT'S NEWSLETTER TO THE BOARD VOLUME 58 JUNE 13, 2000 POWER PLANT MEETING One of the author's of the Harvard Study has agreed to attend the combined meeting of the Board of Health and City Council next Wednesday. So the meeting is set for June 14th, 6 PM at City Hall, Council Chambers. TICKETING FOR SMOKING VIOLATIONS AT HIGH SCHOOL The Subcommittee considering the regulation allowing ticketing for high school smoking violations, met with School Committee members, Claudia Chuber, Norene Gachignard, and Peg Voss, as well as Mickey Ward. Long term effects for students who do not pay fines were discussed. An agreement for the final draft of the proposed regulation was reached. That draft is in your packets. Consideration of that proposed regulation is scheduled for this meeting. TOBACCO VENDOR VIOLATIONS The Tobacco Control Program recently conducted a compliance check of our tobacco vendors. A 16 year old boy was used in the operation. By some • accounts, he looks older than his age. We issued $100 fines to the violators. Of the six violators, four paid the fine, one requested a hearing regarding the fine, and one did not respond. Therefore, we have invited the last two to come before the Board on Tuesday. HHWCD 2000 DONE! Nearly 700 residents were able to dispose of tires, propane tanks, computers, televisions, hazardous paints, pesticides, and other chemicals. In addition, the School and Highway Departments were able to discard paints, biological specimens, and chemicals. So, overall Salem is a safer, more environmentally sound community. Hats off to Jeff Vaughan for organizing this massive event, and special thanks to our Chairman, Len, for lightening our load considerably Y that day. COUNCIL BUDGET REVIEW I met with the City Council Subcommittee on Administration and Finance, chaired by Joan Lovely. Non-committee Council members were there also, as was the Mayor's Chief of Staff, and Finance Director. It was a cordial meeting with quite a few questions about our car situation. I did not get the impression that the subcommittee was intent on making additional reductions to our budget. • -w • SPEAKING OF CARS We received a mid 90's recycled police car this week. Pablo will drive it. This is helpful since now Pablo and I do not have to share a car. We still have the three late 80's cars, all of which are in tough condition. I have been told that when the Building Inspector receives the Fire Chiefs car, I will get the one he has been using. When that happens, I will turn in one of the older cars. COMMUNITY HEALTH ASSESSMENT REPORT Paul Giadroni, our student from the Harvard School of Public Health, will present his report to the Board at our July meeting. We hope to invite some community leaders and other people who showed an interest in the report NEW-OFFICE UPDATE I have been scheduled to meet with the architect for the Peabody Block office building to discuss our space needs. This is encouraging. Perhaps he will agree that the Board of Health does require a bit more room than what has been allocated to us. BATHING BEACHES Jeff, Jose, and I did a survey of our beaches this week and collected our first set of water samples. This will be the first year that we will use enterococci as our indicator organism. Our lab has agreed to analyze for the fecal coliform • this year, as well, so that we may make some historical comparisons to our analysis over the past several years. Jeff and I attended an EPA/DEP/DPH seminar recently regarding water quality and indicator organisms. The DPH is promulgating regulations requiring a switch in indicators from Total /Fecal Coliforms to Enterococci, effective in 2001. Once again, the Salem Board of Health is a step ahead of the State!! We will be posting some signs on beaches where storm drain run-off could be attractive to small children. We are also ordering the beach advisory signs which will be required next year. MISCELLANEOUS With the Board's approval, I plan to take two weeks vacation at the end of July and into the first week of July. The Salem Wellness Fair may be expanding next year to become the North Shore Wellness Fair. The towns of Marblehead and Swampscott have indicated that they are interested in joining the City of Salem and Salem State College in our endeavors in this area. SAVE THE DATE: BOARD OF HEALTH COOK-OUT • SATURDAY, AUGUST 19TH Salem - Board of Health Ay. 2000 Phone Log Total Answered Monday May 1, 2000 61 *Answered Calls Tuesday May 2, 2000 56 Barb= 264 Wednesday May 3, 2000- 51 Mary= 315 Thursday May 4, 200.0 42 Sue= 408 Friday May 5, 2000 30 Saturday May 6,2000 *Calls Taken Sunday May 7,2000 Joanne= 277 Monday May 8,2000 50 Jeffrey= 75 Tuesday May 9, 2000 47 Mark= 119 Wednesday May 10, 2000 39 Jose= 62 Thursday May 11, 2000 42 Pablo= 14 Friday May 12, 2000 24 Tracy= 107 aturday May 13,2000 Ginny= 22 Sunday May 14,2000 Barb= 103 Monday May 15,2000 47 Mary= 98 Tuesday May 16, 2000 39 Sue= 110 Wednesday May 17,2000 55 *43 Office Hours Per Week Thursday May 18, 2000 40 * = 22 Work Days Friday May 19, 2000 030 . Saturday May 20,2000 Sunday May 21,2000 Monday 8-4 Monday May 22, 2000 51 Tuesday 8-4 Tuesday May 23, 2000 46 Wednesday 8-4 Wednesday May 24, 2000 43 Thursday 8-7 Thursday May 25, 2000 43 Friday 8-4 *Winter Hours Friday May 26, 2000 26 Saturday May 27,2000. Sunday May 28,2000 *Office'Hours Summer Monday May 29, 2000 Holida v, BegIn Friday;July 7,2000 ill _ -- - - Tuesday May 30, 2000 63 Wednesday May 31, 2000 1 62 Thursdays All Staff till 7:00 P.M. Q 7 Fridays All Staff out 12:00 Noon Total = 9V I Winter Hours 9/8/00 • 7 f f f { Board of Health Administration Monthly Report Apr-00 , I t 1 Biologics Distributed Amount in Doses Diptheria, Tetanus & Pertussis = 465 Burial Permits @ $5.00 $210.00 Diptheria,Tetanus Tox.(under 6 yrs)= 0 Licenses & Permits(+copies) $2,615.00 j Immune Serum Globulin= 0 Certificate of Fitness@$25.00 $1,325.00 t i Measles/Mumps/Rubella= 440 Sealer Weights/Measures= $700.00 Polio= 330 Tetanus& Diptheria (adult use)= 670 Tuberculin PPD= 230 HIB Titre= 290 Animal Bites Reported= 0 Hepatitis B= 630 Annual Budget Expenses Available Balance Salary/Longevity $344,061.00 $275,946.21 $68,114.7.9 Annual Budget Expenses Encumbered Available Balance Non-Personnel $19,100.00 $12,440.18 $9,809.87 $3,725.30 I if • 3 " CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(976)741-1800 Fax:(978)740-9705 Public Health Nurse Report April 2000 Activities Disease Prevention • In touch with T.B.Clinic and following active cases and case contacts. • Four PPD screenings done in office. • Vaccine inventory maintained and distributed. • Investigated communicable disease cases and reported to the M.D.P.H. Continuing Education • 1/22 Attending Salem State evening LPN to BSN program. Enrolled in World Civilization II, Saturdays, 8:00 a.m.to 10:30 a.m.,Chemistry Mondays 4:30 p.m to 9:30 p.m. Meetings and Clinics. • 4/5 WESX A.M.Radio Show will Kendall Buhl,Joe Dunne,Officer Charlie Reed. To promote Salem Wellness Fair. • 4/6 Hepatitis B Clinic,Salem Police Station. 18 Officers received 2°d vaccination.2 Officers received I'vaccination. • 4/94/10 Salem Wellness Fair. Approximately 2000 attended. 94 Exhibitors participated this year. • 4/14 Meeting at House of Seven Gables with Jeff Vaughn,and Susan Bowditch,Regarding House of Seven Gable's Summer Camp 2000. Regulations reviewed. • 4/18,4/19 4/20 Vacation St.Joseph's School Phoenix School • Hearing and Vision Screenings: 74 students tested, 1 student to have hearing re tested. • 2 students to have vision re tested. • 4/28 Postural Screenings for grades 5-8.no referrals needed r CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS, CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 MONTHLY REPORT OF COMMUNICABLE DISEASES April 2000 DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES: CASES: CASES: STATE: • Campylobacter 0 0 0 0 Giardia 0 0 0 0 E.Coli 0157H7 0 0 0 0 Hepatitis 3 6 2 2 Lyme Disease 0 0 0 0 Meningitis 0 0 0 0 Pertussis 1 0 1 1 Salmonella 0 0 0 0 Shigella 0 0 0 0 Varicella 0 0 0 0 • Reportable Diseases excluded from above have not been identified this month. • Summary of Communicable Diseases April 2000 Hepatitis 2 cases of Hepatitis B 1 case of Hepatitis C Pertussis 1 case. 15 y/o Salem High School student. Reported to Salem Board of Health on 4/11/00 from M.D.P.H. Occupation: none Sports: none. 4 Household contacts. 18 Close contacts. All contacts were prophylaxed on antibiotics. 1 contact was symptomatic with cold symptoms, and was excluded from school for 5 days per M.D.P.H. guidelines. • Yr-r- +rrav�r+�+n< •..ra �..- •g ----.-',"*"-'r•�ro".r'Trxai.. * City Of Salem • Environmental Health Division --- Inspection Monthly Summary Month ------------------------------------------------------------------------------ Type Jul 99 Aug 99 Sep 99 Oct 99 Nov 99 Dec 99 Jan 00 Feb 00 Mar 00 Apr 00 Count 2 3 0 0 0 0 0 0 0 0 5 CFI 60 91 80 69 50 76 56 77 67 52 678 CFR 12 0 13 16 0 15 5 13 8 8 90 CH 8 10 6 18 8 12 3 4 8 4 81 CON 3 9 3 5 8 2 13 3 5 7 58 CR 3 5 1 1 4 1 2 1 0 1 19 CT 0 0 1 0 2 1 1 1 1 3 10 EC 5 11 4 3 0 3 4 1 5 2 38 EH 0 1 0 0 0 0 0 0 0 0 1 EPR 0 3 1 0 4 0 0 0 0 0 8 FC 0 3 0 1 1 0 0 2 3 2 12 FRH 4 3 1 1 0 1 0 0 1 0 11 FSC 0 0 0 0 1 0 0 0 0 0 1 FSD 3 6 1 3 6 7 5 3 5 8 47 FSI 19 17 14 28 28 24 26 33 27 24 240 FSR 6 13 7 19 24 20 18 16 20 14 157 GN 4 7 7 3 3 1 3 1 2 5 36 GN/TR 2 0 0 0 0 0 0 0 0 0 2 HI 12 16 16 17 32 10 19 10 12 51 195 HR 7 14 15 18 7 10 10 19 17 4 121 HR/CFI 0 1 0 0 0 0 0 0 0 0 1 LPI 0 0 1 0 1 0 2 0 1 1 6 0 0 0 0 9 10 8 2 11 10 50 0 1 1 0 0 0 0 2 0 4 8 OG 0 0 0 2 0 0 0 0 0 0 2 OS 0 0 0 0 0 0 0 0 5 0 5 RC 1 1 0 0 0 0 0 0 1 1 4 a. RFD 1 1 0 0 2 0 0 0 1 0 5 RFI 5 8 4 7 11 11 2 5 5 2 60 RFR 1 1 3 3 3 6 8 0 3 2 30 RO 1 3 0 0 4 0 1 0 2 4 15 RRH 1 0 0 0 0 0 0 0 0 0 1 SB 2 12 11 0 0 0 0 0 0 1 26 SC 0 0 0 0 0 0 0 4 1 2 7 SM 5 10 9 6 0 0 0 3 0 1 34 SP 1 1 0 1 0 0 0 0 0 1 4 ST 0 0 0 0 1 0 0 2 4 0 7 TFI 0 28 0 84 0 0 0 0 0 0 112 TR 38 37 26 21 30 27 21 20 53 49 322 TR/GN 1 0 0 0 0 0 0 0 0 0 1 Count 207 316 225 326 239 237 207 222 268 263 2510 BP - Body Piercing2* FSI, - Food Serv., -Ins:262* RFD - Retail Food Disc.- CFI Cert. Fit 711* FSR Food $ery Rein�110* RFI Ret -Insp:66* CFR - Cert F1t Reinsp73*_ GN _Gen Nuisae_51* 24* - _ RFR Ret.-Food_Rein . CH - Court °Hearing 143* HI Housing Insp;` 242* R0` Rodent Control 25 CON - Constable ;ServA0* HR Housing Reinsp.l53* SC - Suntan' 6*' CR - Compliance :,tev.57*�_ LP.I - Lead Paint Irisp: . 6* SES SESD-.i3Odor 7* CT _ Computer Time MS Massage 8* SM Seminars 18* EC - Envirn Compl-113* MUP - Mobile Food Insp. l3* SP Swim Pools 8 PR - Ext Paint 15*. OG. Overgrowth: SB $wim sBeaches. 1_32 FC - Food, Compl,13:* oS. Off Sub Insp.; 25* ST - Soil/Septic 6* FRH - Food.Hearings RC = Rec Camps '7* TFI - Temp F6od58* FSD - Food Serv. Disc.17* MT Meet ng3.. -.- TR - Trash`'747* 05/04/2000 _ kwu A AGENT'S NEWSLETTER TO THE BOARD VOLUME 56 April 11,2000 TOBACCO REGULATION The packet contains some follow-up comments regarding the smoking ban regulation. I will be meeting with Dot Flaherty, of Tobacco Control, and Ellen DiGeronimo, of the Chamber of Commerce, to discuss what we can do to promote dining in Salem and to assist establishments in complying with the regulation. TICKETING FOR SMOKING VIOLATIONS AT HIGH SCHOOL The principal of Salem High School will appear before the Board of Health to request that the Board enact regulations allowing designated agents at the high school to issue tickets to students for smoking on school premises. A similar request was heard before the Board in June 1998. In order for you to understand the process if this request were allowed, I have enclosed a draft regulations and procedure. • WELLNESS FAIR 2000 As you know, Tracy and I have been planning this year's Fair with people from other city departments and Salem State. We hope to see you there: Sunday from 11AM to 3 PM and Monday from 10 AM to 2 PM. The Red Cross will be conducting a blood drive on Monday. SKIN CANCER PREVENTION GRANT Tracy and I are applying for a small grant from the MAHB to conduct some fun educational sessions, at Forest River Pool, regarding sun safety. I hope to have the final application ready for you at the meeting. BUDGET REVIEW I have a meeting scheduled for Wednesday with the mayor and finance director to discuss our budget. BOH AUTOMOLE UPDATE Mark is still without a vehicle and the one Pablo and are have been driving is having some problems. Len has told Stan Bornstein that we will accept the 1980's vehicle previously offered to us if the directionals are fixed and the car can be locked. I am also waiting for the car, mentioned in last month's newsletter, promised by Mr. Bornstein once the inspector of buildings' car is available. I hope to have some more information available to you at the • meeting. • AGENT'S NEWSLETTER TO THE BOARD VOLUME 57 May 9,2000 TICKETING FOR SMOKING VIOLATIONS AT HIGH SCHOOL Enclosed in the packet is the draft regulation written by the Board subcommittee. The Public Hearing is scheduled for 7:30 PM. It will follow the same format as the last one. Each speaker will be allowed a certain length of time to give his or her own opinion regarding the regulation. Unless the Board decides to do so, there won't be debate or discussion of the regulation with the audience. The subcommittee may want to meet again before the June meeting to finalize its presentation to the Board as a whole. In June, the Board could discuss and perhaps vote on the regulation if that is what is decided. The subcommittee had asked me to invite the court's clerk or hearing officer to the hearing. However, the Clerk Magistrate, Mr. Arena, does not want his staff attending. He feels that it would blur the line between the judicial branch and legislative branch of government. In my conversation with the clerk's assistant, Mr. Grant, he did tell me that any child under 17 years old must be assigned to the Juvenile.Court if a hearing is required. I spoke with the Clerk of • the Juvenile Court, Judy Brennan, who agreed. She also said that the child must be accompanied by his or her parent/guardian in court. The subcommittee also asked that a Police Department representative attend the hearing. Officer Butler, who is assigned to the High School, is on Yp vacation next week. Captain Comeau, in charge of uniformed officers, is discussing the request with the Juvenile Officer and the Dare Officer. I haven't heard back from him yet. HHWCD 2000 This year's Household Hazardous Waste Day will take place on Saturday, June 3rd, 8AM to 1 PM, at Salem High School. Please let me know if you would like to attend, even for a brief time, so that I may include you in our T-shirt order! COMMUNITY HEALTH ASSESSMENT REPORT Paul Giadroni, our student from the Harvard School of Public Health, is planning to present his report on the Community Health Assessment at the June meeting. BODY ART Enclosed in the packet are two articles regarding Body Art, one recently in Newsweek, the other in this month's Journal of Environmental Health. The owners of the Purple Scorpion are attending our meeting to discuss the pending • legislation which would lift the tattoo ban in Massachusetts. They are concerned that there may be a period between the lifting of the ban, which may include all types of Body Art, and the enactment of regulation protecting the public. By the • time of the meeting I will have more information regarding the status of that .Legislation. The owners also will be petitioning the Board to allow them to do genital piercing. BUDGET REVIEW I met with-the Mayor regarding our Budget. Since we were able to stay within the 3% cap, he did not require any additional reductions. He does think that we will have to reduce staff next year to stay within our budget. He is correct since I doubt if we can sustain any more decreases in our expense line items. The Mayor compares us to the Building Department who employs two instead of three clerks. It is difficult for me to make a comparison when I don't know the volume of calls and paperwork at that department. He suggested that there might be a sharing of resources when both departments are located in the same building. NEW-OFFICE UPDATE I met with a Planning Department committee to discuss our space in the new city building. We are being allotted about 1800 sq. ft., similar to what we have now. Th is is down from the original allotment of 2 500-s . ft. because q , according to the City Planner, the City Council decreased the lease space. I did try to petition for a bit more sq.ft., since the Public Health Nurse does require • more room than the average employee. I don't think I was successful. Salem Board of Health • April 2000 Phone Log Total Answered Monday April 3, 2000 63 *Answered Calls Tuesday April 4, 2000 45 Barb= 236 Wednesday April 5, 2000 49 Mary= 301 Thursday April 6, 2000 54 Sue=l 332 Friday April 7, 2000 51 Saturday April 8, 2000 *Calls Taken Sunday April 9,2000 Joanne= 173 Monday April 10, 2000 60 Jeffrey= 169 Tuesday April 11, 2000 53 Mark= 97 Wednesday April 12, 2000 56 Jose= 47 Thursday April 13, 2000 53 Pablo= 6 Friday April 14, 2000 37 Tracy= 125 Saturday April 15,2000 Ginny= 10 day April 16,2000 Barb= 81 Monday April 17, 2000 Holiday Mary= 84 Tuesday April 18, 2000 54 Sue= 78 Wednesday April 19, 2000 22 *43 Office Hours Per Week Thursday April 20, 2000 36 * = 20 Work Days Friday April 21, 2000 8 Saturday April 22, 2000 alum Sunday April 23,2000 Monday 8-4 Monday April 24, 2000 57 Tuesday 8-4 Tuesday April 25, 2000 38 Wednesday 8-4 Wednesday April 26, 2000 42 Thursday 8-7 Thursday April 27, 2000 50 Friday 8-4*Winter Hours Friday April 28, 2000 41 Saturday April 29, 2000 REARM Sunday April 30, 2000 Total = 869 E • i ADMINISTRATION - MONTHLY REPORT MARCH 2O00 AMOUNT IN DOSES AMOUNT BIOLOGICS DISTRIBUTED f Diptheria, Tetanus & Pertussis 540 BURIAL PERMITS 68 @ $5.00 = $340.00 1} Diptheria-Tetanus Tox. (under 6 yrs. ) -0- LICENSES AND PERMITS $6,835.00- Immune Serum Globulin 2V CERTIFICATE OF FITNESS 74@ $25.00 $1,850.00 Measles/Mumps/Rubella 232 SEALER OF WEIGHTS & MEASURES $390.00 Polio 400 Tetanus & Diptheria (adult use) 150 Tuberculin PPD 20 4 HIB Titre 250 ANIMAL BITES REPORTED Hepatitis B 420 I 1i t k( 1 SALARY/LONGEVITY: ANNUAL BUDGET YTD EXPENSES AVAILABLE BUP(3ET $344,061.00 $249,067.16 $94,993.84 i NON-PERSONNEL: ANNUAL BUDGET YTD EXPENSES ENCUMBRANCES AVAILABLE BUDGET $19,100.00 $8,014.84 $12,226.50 $5,734.01 6,875.35 SUPP. APPR. 3 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 Public Health Nurse Report March 2000 Activities Disease Prevention • In touch with T.B. Clinic and following active cases and case contacts. • Four PPD screenings done in office. • Vaccine inventory maintained and distributed. • Investigated communicable disease cases and reported to the M.D.P.H. case of T.B. • Continuing Education • 1/22 Attending Salem State evening LPN to BSN program. Enrolled in World Civilization II, Saturdays, 8:00 a.m. to 10:30 a.m., Chemistry Mondays 4:30 p.m to 9:30 p.m. Meetings and Clinics. • 3/2/00 Hepatitis B Clinic #1 held at Police Station. 18 Police Officers participated. Another Clinic will held when more vaccine is available from MDPH. • 3/16 Wellness Fair Committee meeting held at Salem Board of Health. • 3/23 Wellness Fair Committee meeting held at Salem Board of Health. • 3/30 Met with Jeff Vaughn and John Giardis, Director of Athletics at Salem State College to discuss camp regulations. Salem State College Sport Camps will be licensed by the Salem Board of Health as of summer 2000 St.Joseph's School • Hearing and Vision Screenings completed. 238 students hearing and vision tested. 9 students failed vision screenings. Referral letters mailed on 3/22/00 3 students failed hearing screenings. Referral letters mailed on 3/22/00 • Second Hep B vaccination administered to 1 students participating in the Hep B clinic. 3rd vaccination will be scheduled for an office appointment in July. • PHOENIX SCHOOL • Hearing and Vision Screenings will begin after Students at St. Joseph's are completed. MONTHLY REPORT OF COMMUNICABLE DISEASES March 2000 DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES: CASES: CASES: STATE: • Campylobacter 2 0 2 2 Hepatitis 6 2 2 2 Lyme Disease 1 0 1 1 Salmonella 1 0 1 1 Reportable Diseases excluded from above have not been identified this month. • r� • Communicable Disease SummaryMarch 2000 Campylobacter: 2 Cases: • 50 y/o male. Non foodhandler. He believes he became ill after traveling to London, March 4-11th Symptom Onset: 3/11 • 1 y/o male. Traveled to Dominican Republic with family 2/21 to 3/6 Symptom Onset: 3/1 Hepatitis: 6 new Cases: 5 Hepatitis C cases 1 Hepatitis B case Lyme Disease_ ' One Case: • 8 y/o female. Only symptom: Bells Palsy. Child treated with antibiotics. Bells Palsy resolved after 1 week. Salmonella: One Case: 54 y/o female. She states she has been ill since Late November 99. She had seen her physician numerous times since November. She is being treated with antibiotics. She suspects she • was ill from thanksgiving dinner visiting in Florida. No one else was ill. Her husband is asymptomatic. She is a housewife. City Of Salem Environmental Health Division --- Inspection Monthly Summary • Month ---------------------------------------------------------------------- Type Jul 99 Aug 99 Sep 99 Oct 99 Nov 99 Dec 99 Jan 00 Feb 00 Mar 00 Count 2 3 0 0 0 0 0 0 0 5 CFI 60 91 80 69 50 76 56 77 67 626 CFR 12 0 13 16 0 15 5 13 8 82 CH 8 10 6 18 8 12 3 4 8 77 CON 3 9 3 5 8 2 13 3 5 51 CR 3 5 1 1 4 1 2 1 0 18 CT 0 0 1 0 2 1 1 1 1 7 EC 5 11 4 3 0 3 4 1 5 36 EH 0 1 0 0 0 0 0 0 0 1 EPR 0 3 1 0 4 0 0 0 0 8 FC 0 3 0 1 1 0 0 2 3 10 FRH 4 3 1 1 0 1 0 0 1 11 FSC 0 0 0 0 1 0 0 0 0 1 FSD 3 6 1 3 6 7 5 3 5 39 FSI 19 17 14 28 28 24 26 33 27 216 FSR 6 13 7 19 24 20 18 16 20 143 GN 4 7 7 3 2 1 3 1 2 30 GN/TR 2 0 0 0 0 0 0 0 0 2 HI 12 16 16 17 32 10 19 10 12 144 HR 7 14 15 18 7 10 10 19 17 117 HR/CFI 0 1 0 0 0 0 0 0 0 1 LPI 0 0 1 0 1 0 2 0 1 5 MT 0 0 0 0 9 10 8 2 11 40 MUP 0 1 1 0 0 0 0 2 0 4 0 0 0 0 2 0 0 0 0 0 2 0 0 0 0 0 0 0 0 5 5 RC 1 1 0 0 0 0 0 0 1 3 RFD 1 1 0 0 2 0 0 0 1 5 RFI 5 8 4 7 11 11 2 5 5 58 RFR 1 1 3 3 3 6 8 0 3 28 ro 1 3 0 0 4 0 1 0 2 11 RRH 1 0 0 0 0 0 0 0 0 1 SB 2 12 11 0 0 0 0 0 0 25 SC 0 0 0 0 0 0 0 4 1 5 SM 5 10 9 6 0 0 0 3 0 33 SP 1 1 0 1 0 0 0 0 0 3 ST 0 0 0 0 1 0 0 2 4 7 TFI 0 28 0 84 0 0 0 0 0 112 TR 38 37 26 21 30 27 21 20 53 273 TR/GN 1 0 0 0 0 0 0 0 0 1 Count 207 316 225 326 238 237 207 222 268 2246 BP - Body Piercing2* FSI - Food Serv. In.s;'i262* RFD - Retail Food Disc CFI -, -Cert. Fit.711* FSR - Food Sery Ref ;,110* RFI Ret. Insp. 6 * _C_F_R" - _Cert: .Fit_Reinsp73*: GN." —__-RFR_—motet-__FoAc-Rein24*_ CH - Court ;Hearing "143* HI - Housing Insp , 242* RO - Rodent" Control 251 CON - ConstabI _i.Seiv 80* HR - Housing Reinsp 153* SC - Suntan 6"*"` CR - Compliance :Rev.57* LPI - Lead. Paint Iisp: 6* SES - SESD Odor 7* CT _ Computer Time MS - Massage 8* SM Seminars 78* OEE, C - Envirn. Compl -113* MUP - MobileFoodInsp. 13* SP - Swim. PoolS" 8 PR - Ext: :.Paint 15* OG - Overgrowth . , SB = _Swim: Beaches 1.32! FC - Food Compl.l3* OS - Off. Sub: ` It's p`.. " 25* _ ST - S6il/Septic- 6* FRH - Food Hearings RC - Rec C amps` 7* TFI - Temp F66d58* FSD - Food Serv. Disc.17* MT - Meeting`s TR - Trash 747*` , 0i/07/20o0 r - t A—,A Usw NS—Not Sewed S—S@aW c- md.ma.d DEPARTMENT OF WEIGHTS AND MEASURES Date NAME OF PERSON OR BUSINESS Field Certificate SCALES AND BALANCES WEIGHTS IuV�d CERTIFICATE ISSUED TO Number VEHICLE TANKS Over 5.000 To 1,000 to 100 to More Than 10 10 Apothecary First Ea.f MM 10,000 10,000 5,000 1,000 Less Than Pounds Avoirdupois Metric l00 Gallons 100 rC aDbD Pounds Pounds Pounds Pounds 100 Pounds Or Less Troy Or Leu Or A S NS C A S NS C A 3 N C A S NS I C A S NS C A S NSI C A I S NS C A S NS C A S NS C A S NS C A �16 104 VS - p o a a to � &o ova kr c\\ lap( rs ros srr u v rr si srµtaugs • • • OFFICE RECORD AND LEDGER LIQUID MEASURING METERS INLET ONE RICH INLET MORE THAN ONE MORE PUMPSF OTHER DEVICES LINEAR MISC. PEES AND CHARGES OR LESS INCH NOT MOPE THAN THAN MEASURES INCH FOUR INCHES GASOLINE on. VETRCLE PUIZ EocE Tmi Odometer L""' FobAe Win Tmd Tapes Milk le e,n,,,.�a Pw Pw� GREASETANK STORAGE Siop Melme H.I domeler Mewurleq Memurl., Cordage S. ton I— �EOM/ Told Pbdd u A S NS C A S HS C A S I N I A S I W. C A S I N C A S NS C A S NS C A 6 NS C A 6 NS C A S NS C A 6 NS C A S NS C I A S NS C A P NS C r � 6 eo � b 0 ao 00 jIs ..I—. a.- TTTT�FHFII 0 Oe a i0 M St ;�x 1 AGENTS NEWSLETTER TO THE BOARD VOLUME 55 March 14, 2000 TOBACCO REGULATION The General Council of the Mass Department of Public Health and the Mass Association of Boards of Health will be at the meeting to present information and/or be available to the Board members for questions regarding the Board's authority to promulgate a smoking regulation. An attorney from the Tobacco Resource Center of Northeastern University has sent a memo to the Board regarding the same issue. It is in the packet, as is an addendum from the City Solicitor. RODENTS AT SALEM'S VISITOR CENTER The Board received notice that there were rodents coming into the Visitor's Center by way of the toilets. We contacted a pest control operator and the DPW and met on site with the park ranger. The Center was closed for a few days while the problem was brought under control. The rodents appeared at the time-of demolition for the Pickering Wharf Hotel. However, there has been • ongoing extermination at that site for a couple of years, which was increased prior to demolition, and continues. ROBINSON ROAD This is the street off Swampscott Road where the well water of four residences was found to contain MTBE. Since the last meeting, the DEP did analyze the well water from the junkyard next door and the result for MTBE was below the guideline level. The owner of the residences is connecting a temporary water line to a city line on. Swampscott Road that will be supplying water probably by the time of our meeting. In addition, he is having plans drawn for a permanent water and sewer connection to city services. We had an informational meeting for the residents, attended by the owner and the DEP engineer. I have included some information in that regard in the packet. SCUTTLEBUTTS The architect representing the owner of the building in which Scuttlebutts is located, has asked to come before the Board to discuss some continuing - roblerxas4heunews=hav wtesestaurant -Eosed irr-the ticket arE Eachicornp[aint s generated ar inspection-,-a-repo4_4is#fhg any-violations -and a 26 - - -follow-tip inspection. The-majo boncern-+of the architeet-seems to be-a-chronic leaking problem.into the first floor-business space.- -Any observable floor • problems that could result in leaking into floors below have been noted by our sanitarians and listed as violations to be corrected. All such violations were corrected. We have offered to be available at any time to observe overflowing of a i • toilets, etc., and to take corrective action against the restaurant owner if such occurrences have been observed. The Building Department has said that it is a plumbing problem with the restaurant. I suggested that that department take further action since they have the expertise, through their building and plumbing inspectors, to better determine exact causes of the problem and so would have better standing in court if a complaint was filed. HIGH SCHOOL TICKETING FOR SMOKING VIOLATIONS The new administration at the High School is asking the Board to reconsider its previous position regarding a Board of Health regulation allowing .ticketing of students found smoking on school property. Enclosed in the packet is some information regarding that proposition. The Principal and Comprehensive Health Coordinator would like to come before the Board to discuss this. I suggested that I present their information to the Board initially. COMMUNITY HEALTH ASSESSMENT Paul Giaidrone has included in the packet additional information regarding our Community Health Assessment. Paul is also studying the statistics from the • State regarding cancer incidence in preparation for including that information in the assessment. FY 2001 BUDGET The Board of Health's proposed FY 2001 Budget is enclosed. Len O'Leary was correct in his quick overview of the budget presented at the last meeting. That budget had left out an overtime line item. We reinstated that line item at $500 less than last year, decreased Virginia Moustakis' hours by two per week, and included a $923 line item for rodent control. Thus we are not including money for professional membership, increasing our in gtate travel line item or t fully funding rodent control. However, the budget as submitted is within the 3% increase over last year's approved budget as required by the Mayor of all departments. BOH VEHICLES I have not heard back from the Mayor regarding a FY 2000 budget supplemental request allowing the Board to purchase two vehicles. Councillor Y .,,,O'Keefe did, however, ask me to contact Stanfey Bornstein again--regarding r JS says.-there.are a couple of vehd_es that=_: ill be available_ in two.;weeks: He.said - ---- --- - --we-will get one, So between two-actions hope-that-we will liave-some-success. - - ---- - • Salem Board of Health March Phone Logs 2000 Total. Answered Answered Calls Wednesday March 1, 2000 42 Barb = 182 Thursday March 2, 2000 42 Mary = 420 Friday March 3, 2000 29 Sue = 538 Saturday March 4, 2000 Sunday March 5, 2000 Monday March 6, 2000 59 Calls Taken Tuesday March 7, 2000 39 Wednesday March 8, 2000 62 Joanne = 288 Thursday March 9, 2000 63 Jeffrey = 186 Friday March 10, 2000 37 Mark = 90 tun day March 11, 2000 Jose = 103 6 ay March 12, 2000 Pablo = 10 Monday March 13, 2000 64 Tracy = 106 Tuesday March 14, 2000 76 Ginny = 21 Wednesday March 15, 2000 50 Barb = 76 Thursday March 16, 2000 48 Mary = 150 Friday March 17, 2000 38 Sue = 110 Saturday March 18, 2000 Sunday March 19, 2000 Monday March 20, 2000 57 43 Office Hours Per Week Tuesday March 21, 2000 53 * =23 Work Days Wednesday March 22, 2000 53 Thursday March 23, 2000 51 Monday 8-4 Friday March 24, 2000 16 Tuesday 8-4 Saturday March 25, 2000 Wednesday 8-4 Sunday March 26, 2000 Thursday 8-7 Monday March 27, 2000 64 Frid. 8-4'Winter Hours Tuesday March 28, 2000 35 ednesday March 29, 2000 46 Thursday March 30, 2000 73 Friday March 31, 2000 43 Total Calls *_ t �i Board of Health . ; Administration Monthly Report February-00 Biologics Distributed A. Amount in Doses „q. Diptheria, Tetanus & Pertussis = 585 Burial Permits@ $5.00 $310.00 Diptheria,Tetanus T.,,qix (u er 6;Yrs)= 0 Licenses & Permits(+copies) $186.00 Immune Serum Globulin 4 vials Certificate of Fitness@$25.00 $2,200.00 Measles/Mumps/Rubella=.,;' 390 Sealer Weights/Measures= $'30.00 Polio= r ;' 590 $2,726.00 525 Tetanus & Diptheri'' (ayuE �- Tuberculin PPD= itir 800 HIB Titre= eft 420 Animal Bites Reported= 0 Hepatitis B= 300 Annual Budget Expenses Available Balance Salary/Long. it (%l $344,061.00 $138,817.04 Annual Budget Expenses Encumbered Available Balance Non-Personnel :' l; „ $19,100.00 $10,013.30 . .Fy 6{q i. • • 3 � CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 Public Health Nurse Report February, 2000 Activities Dl--ease Prevention • In touch with T.B. Clinic and following active cases and case contacts. • • Two PPD screenings done in office. • Vaccine inventory maintained and distributed. • Investigated communicable disease cases and reported to the M.D.P.H. Continuing Education • 1/22 Attending Salem State evening LPN to BSN program. Enrolled in Worid Civilization II, Saturdays, 8:00 a.m. to 10:30 am., Chemistry Mondays 4:30 p.m to 9:30 p.m. Meetings and Clinics • 2/7 Blood Pressure Screenings offered for Salem Fire Dept. Division 1 , • 2/9 Blood Pressure Screenings offered for Salem Fire Dept. Division 2 • 2/10 Blood Pressure Screenings offered for City of Salem Employees • 2/17 Blood Pressure Screenings offered for Police Department • 2/22 Blood Pressure Screenings offered for Salem Fire Dept. Division 4 2/28 Blood Pressure Screenings offered for Salem Fire Dept. Division 3 79 employees participated in the screenings, one re€erred to his PrInaaryy Ceram Physician. —_-- t_ oatbnair --_ RfihT ""arr 11� t'�Sa1em ll St�`ft=�CoIl be ft�update 6nwdii �ns�`oi • 9th and 1011, • 2/29 Wellness Fair Mtg. At Salem State College CITY OF SALEM HEALTH DEPARTMENT Nine North Street Salem, Massachusetts 01970 St.Joseph's f cliool E Hearing and Vision Screenings for Grades Pre IC-8 at the school on Thursdays and Fridays. PHOENIX SCHOOL • Hearing and Vision Screenings will begin after Students at St. ,ioseph**s are completed. • _ -_ - _..if-.- 1. +>�' .� '''°S: `• ,o"`` =y�'7's r• ..G_.,. .:�:s 3,....,.E+5e':r,t1"a�,.,;:,. " CITY OF SALEM HEALTH DEPARTMENT Nine North Street Salem, Massachusetts 01970 MONTHLY REPORT OF CO MUXICAULE DISEA&ES F ebruaay 2000 YIS i E': NEW CARRY VV ER LIS RGE IRE R i a V CASES: CASES: CASES: STATE: • Camp ylobacter 0 0 0 0 Giardia 0 0 0 0 E.Coli 0157H7 0 0 0 0 Hepatitis 4 2 1 1 Lyme Disease 0 0 0 0 Meningitis 1 0 1 1 Pertussis 1 0 1 1 Salmonella 1 0 1 1 SYulla l 0 Cella .-0 — 0 0 Reportable Diseases excluded from above have not been identified this month. a - CITY OF SALEM HEALTH DEPARTMENT Nine North Street Salem, Massachusetts 01970 Summary vi, Coaaamunka.10 aD isOascs i i epaa.a,is: 2 Hepatitis B. Cases. 2 Hepatitis C Cases. 1V%,M07.7 er is LVk%—L ngitldij 22 y/o female. This case was confirmed on Sunday, February' 6. It Vvas reported by phone to MDPH Epidemiologist Mary Cheryl Hervine. Alert • letters were sent to her employment in Danvers by epidemiologist. 2 Household contacts, and boy=friend were started on Antibiotics. i e�ua�iS` f7 y/o female. Student at Beverly High School. This case recently moved to Salem from Beverly. She does not have any contacts in Salem. Beverly High l`:LA notified all school contacts. 6 Family: members went on antibiotics. Shigella• Translated through Pablo Valdez. She has not recently traveled. She did Not recently eat out. Her husband was not ill. • City Of Salem -- Environmental Health Division - Inspection Monthly Summary Month ------------------------------------------------------------- Type Jul 99 Aug 99 Sep 99 Oct 99 Nov 99 Dec 99 Jan 00 Feb 00 Count 2 3 0 0 0 0 0 0 S CFI 60 91 80 69 50 76 56 77 559 CPR 12 0 13 16 0 15 5 13 74 CH 8 10 6 18 8 12 3 4 69 CON 3 9 3 5 8 2 13 3 46 CR 3 5 1 1 4 1 2 1 18 CT 0 0 1 0 2 1 1 1 6 EC 5 11 4 3 0 3 4 1 31 EH 0 1 0 0 0 0 0 0 i EPR 0 3 1 0 4 0 0 0 8 FC 0 3 0 1 1 0 0 2 7 FRH 4 3 11 1 0 1 0 0 10 FSC 0 0 0 0 1 0 0 0 1 FSD 3 6 1 3 6 7 5 3 34 FSI 19 17 14 28 28 24 26 33 189 FSR 6 13 7 19 24 20 18 16 123 GN 4 7 7 3 2 1 3 1 28 GN/TR 2 0 0 0 0 0 0 0 2 HI 12 16 16 17 32 10 19 10 132 HR 7 14 15 18 7 10 10 19 100 HR/CFI 0 1 0 0 0 0 0 0 •LPI 0 0 1 0 1 0 2 0 9 MT 0 0 0 0 9 10 8 2 29 MUP 0 1 1 0 0 0 0 2 4 OG 0 0 0 2 0 0 0 0 2 RC 1 1 0 0 0 0 0 0 2 RFD 1 _ 0 0 2 0 0 0 4 RFI 5 8 4 7 11 11 2 5 53 RFR 1 1 3 3 3 6 8 0 25 RO i 3 0 0 4 0 1 0 9 RRH 1 0 0 0 0 0 0 0 1 SB 2 12 11 0 0 0 0 0 25 SC 0 0 0 0 0 0 0 4 4 SM 5 10 9 6 0 0 0 3 33 SP 1 _ 0 1 0 0 0 0 3 ST 0 0 0 0 1 0 0 2 3 TFI 0 28 0 84 0 0 0 0 112 TR 38 37 26 21 30 27 21 20 220 TR/GN 1 0 0 0 0 0 0 0 1 ------ ------ ------ ------ ------ ------ ------ ------ ------ ----- Count 207 316 225 326 238 237 207 222 1978 BP - Body P-iercing2* FSI - Food Serv. Ins . 262* RFD - Retail Food Disc . CFI - Cert . Fit . 711* - FSR - Food Serv. Rein.-110* RFI - Ret . Insp. 66* CFR - _-.Cert . Fit ..Reinsp7-T.t GN:— _ ,Gen .;__Nuis.anee..63* RFR _�Re-t . Food Re ri24* rta eang - . 42* . Rodent , ControlsingInsp.CH 25 CON - Constable Serv. 80-t - -HR - Housing Reinsp. 153* SC - Suntan- 6* CR - Compliance Rev. 57* LPI - Lead Paint Insp . 6* SES - SESD Odor 7* . CT Computer Time MS - Massage 8* SM - Seminars 78�*w�� C _ Envirn. Compl . 113* MUP - Mobile Food Insp. 13* SP - Swim. Pools 8 PR - Ext . Paint 15* OG - Overgrowth SB - Swim. Beaches 132* FC - Food Compl . 13* OS - Off . Sub. Insp . 25* ST - Soil/Septic 6* FRH - Food Hearings RC - Rec Camps 7* TFI - Temp . Food58* FSD - Food Serv. Disc . 17* MT - Meetings TR - Trash 747* 03/10/2000 • AGENT'S NEWSLETTER TO THE BOARD VOLUME 54 FEBRUARY 15, 2000 FY 20001 BUDGET CANCER INCIDENCE property of Hutchinson Enclosed in the packet is a INFORMATION junkyard, which is uphill from proposal for the Board's 2001 MDPH has sent a partial response the wells in question and could budget. The Mayor has allowed a to our inquiry regarding those be the source of 3% increase in departments' cancers of increased incidence in contamination. This property budgets compared to last year's Salem. A quick look shows that is now under the control of the adopted budget. Most of this most individuals with cancer of the City, taken in land court increase is used by the union lung/bronchus and oral because of back taxes. I increases in salaries. However, cavity/pharynx are current called John Keenan to let him there was an additional $3,923 for smokers. More detail is needed to know of DEP's concern and our expenses line items. I proposemake reasonable assumptions desire to test well water at the .� $20000 for rodent control, $800 for regarding the information so far. I junkyard. John has said that professional memberships, and an have requested more information he has no problem with the $1123 increase in our in state from the DPH. Paul Giadrone and DEP's request. I will go with travel line item. Our budget is due I will be studying the information the DEP engineer on in the Finance Department by carefully as part of the Community Thursday. February 17th. Health Assessment. FELT STREET PROPERTY . NON CRIMINAL PART TIME SALARY We have lifted the TICKETING The Board has in its current condemnation order on the Kim Driscoll, Ward 5 City budget a part time personnel line house on Felt Street. The Councillor, is suggesting an item for Virginia Moustakis. We owner had complied with increase in fines for tickets issued has scheduled Ginny to work 14 the original Board of Health by the Board of Health. Currently, hours per week. She has been orders which were we issue trash tickets with the working a bit less than that, so we reinforced by Housing potential of incremental increases have some extra money in the line. Court orders. The Court up to $100. Other tickets issued I request that the Board hire Paul has ordered follow-up for are for fines of$25 and may be Giadrone to work 4 hours per week six months including used for violations of the Food at$12 per hour for a total of$48. mandatory professional Code, and several other per house cleaning and regulations or ordinances. Ms. ROBINSON ROAD monthly Board of health Driscoll recommends ticketing for A housing complaint has inspections. st nd the 1 offense of$50 the 2 �d , resulted in a determination by $150 the 3 $300. I have s oken HOUSEHOLD � the DES that two wells on HAZARDOUS WASTE with her and suggested that we Robinson Road are use language that says, "up to," so contaminared with MTBE. DAY that the sanitarians have some These wells provide drinking We usually plan to hold our discretion when deciding on an water for four residences. The Household Hazardous appropriate fine. I would also like landlord has been ordered to Waste Collection Day in to recommend to the Board that provide potable drinking water June. If the Board would we adopt all of the chapters of the to the affected tenants. In like us to conduct it this State Sanitary Code as a "local addition, he has been ordered year, we would begin regulation," so that we could use to connect to city services as planning very soon. The the ticketing process as another soon as possible and has been money is not in our budget. tool in our enforcement efforts. working toward that goal. In I believe it is in the DPW • the meantime, the DEP wants budget again this year. to test well water on the * 0 * • February 15, 2000 To: Board Members From: Jose L. Diaz I am writing to you to give you an update on my progress in obtaining enough science courses so that I may be qualified to take the Registered Sanitarian Exam. In order for me to take this exam,I need to take five more courses in the field of science. So far,I have completed one course and I plan on enrolling in the summer session to take some classes Sincerely, • J Jose L. Diaz • • Salem Board of Health February Phone Logs 2000 Answered Calls Total Answered Tuesday February 1, 2000 58 Barb= 194 Wednesday February 2, 2000 53 Mary= 365 Thursday February 3, 2000 55 Sue= 343 Friday February 4, 2000 25 Saturday February 5,2000 Calls Taken Sunday February 6, 2000 =1 Joanne= 255 Monday February 7, 2000 53 Ginny= 22 Tuesday February 8, 2000 41 Jeffrey= 99 Wednesday February 9, 2000 3-9 Mark= 90 Thursday February 10, 2000 57 Pablo 10 Friday February 11, 2000 29 Jose= 58 • Saturday February 12,2000 Tracy= 76 Sunday February 13, 2000 Barb= 82 Monday February 14, 2000 37 Mary= 124 Tuesday February 15, 2000 54 Sue K=. 86 Wednesday February 16, 2000 34 Thursday February 17, 2000 53 * =19 Work Days Friday February 18, 2000 34 * =43 Hours Per Week Saturday February 19,2000 Sunday February 20, 2000 Monday 8-4 Monday February 21,2000 Holiday Tuesday 8-4 Tuesday February 22, 2000 55 Wednesday 8-4 Wednesday February 23, 2000 60 Thursday 8-7 Thursday February 24, 2000 41 Friday 8-4 * Winter Hours Friday Februa :25, 2000 17 - S:aturday - - - — - Monday FebrtA Z8;2000 56= • Tuesday February 29, 2000 51 i Total = 902 a f ... ii. JANUARY 2 0 kcl ,s DIINISTRATO 'J MONTHLY REPORT AMOUNTr AMOUNT IN DOSES ' s BIOLOGICS DS2RIBUTED , 525 BURIAL PERMITS 72 @ $5.00 = 360.0. theria; Tetanus & Pertussis p 49 26` rs k LICENSES AND PERMITS L DiptheriArTetranus Tox. (under 6 yrs. ) 0 �k Immune Serum 41bbulin 0 CERTIFICATE OF FITNESS 56@ $25.00 14001OD r a Measles/Mumps it, 100 SEALER OF WEIGHTS & MEASURES.S a ; Polio 260 Eadult use) h + Tetanus & Diptheria ( 455 x � 360 t' Tub`erculi,n PP�D F YL y�arY,p,HIB Titre , � ANIMAL BITES REPORTED 460 s � Hepatitis Bfw� 500 M �S ;r JyF 1•f sl AVAILABLE BALANCE ANNUAL BUDGET EXPENSESr S' ARY/4LONGEVITY $154,929.57 fin; '$�344,061.00 AVAILABLE BALANCE! NON PERSONNEL EXPENSES ENCUMBERED wr ANNUAL BUDGET x $8,779.22 *` 19,100,00.: K w CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 lie Health Nurse Revert Jaguar 2000 Activities Disease Prevention In toulch with T.B. Chic and-fallowing active cases and case contacts. Four PPD screenings done in ace. V • s Vaccine inventory maintained and distnibuAed_ Investigated communicable disease cases and reported to the M.D.P.n. c c'£'F'.n. CoI1t111ging 1'ducagon 1122 Attending Salem State evening LPN to BSN-Program- Enrolled in World Civilization 11, Saturdays, 8:00 am, to 10:30 am., Chemistry Mondays 4:30 p.m to 9:30 n.m. St.Joseph's School a Hearing and Vision Screenings for Grades Pre K-8 at the school on Thursdays and Fridays. • Second Hen B vaccination administered to 5 students narticiDating in the Her- B clinic. Third vaccine will be held m June. PHOENIX SCHOOL i Hearin,-and Vision Screenings will begin after Students at St. Joseph's are completed. 5 Second Hep B vaccination administered to one student. Third series will be administered in June. • • MONTHLY REPORT OF COMMUNICABLE DISEASES iiawAO 2OW DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES: CASES: CASES: STATE: • Campylobacter 1 0 1 1 Giardia 0 0 0 0 R.Coli 0157H7 0 0 0 0 Hepatitis 1 3 1 1 Lyme Disease 0 0 0 0 Meningitis 0 0 0 0 Pertussis 0 0 0 0 Salmonella 0 0 0 0 Shigella 0 0 0 0 Varicella 0 0 0 0 • Reportable Diseases excluded from above have not been identified this month. J • Summary of Communicable Diseases January 2000. • Campylobacter: 27 yj o male. Non-Foodhandler. Suspect food or drink unknown. He has not recently traveled. • Hepatitis Q Received January 31. Letter sent to case. • Swampscott Board of Health reported a Swampscott resident with Campylobacter. The resident suspected a chicken sandwich she consumed at The Lyceum Restaurant. Incubation Period for • Campylobacter is 1-10 days. Her symptom onset was 12 hours after eating the sandwich. This was reported to Jeff Vaughan, and an inspection was conducted by him. • • City Of Salem Environmental Health Division - - Inspection Monthly Summary i Month ------------------------------------------------------ Type Jul 99 Aug 99 Sep 99 Oct 99 Nov 99 Dec 99 Jan 00 Count 2 3 0 0 0 0 0 5 CFI 60 91 80 69 50 76 56 482 CFR 12 0 13 16 0 15 5 61 CH 8 10 6 18 8 12 3 65 CON 3 9 3 5 8 2 13 43 CR 3 5 _ 1 4 1 2 17 CT 0 0 i 0 2 1 1 5 EC 5 11 4 3 0 3 4 30 EH 0 1 0 0 0 0 0 1 EPR 0 3 1 0 4 0 0 8 FC 0 3 0 1 1 0 0 5 FRH 4 3 _ 1 0 1 0 10 FSC 0 0 0 0 1 0 0 1 FSD 3 6 1 3 6 7 5 31 FSI 19 17 14 28 28 24 26 156 FSR 6 13 7 19 24 20 18 107 GN 4 7 7 3 2 1 3 27 GN/TR 2 0 0 0 0 0 0 2 HI 12 16 16 17 32 10 19 122 HR 7 14 15 18 7 10 10 81 HR/CFI 0 1 0 0 0 0 0 1 O'P' 0 0 i 0 1 0 2 4 0 0 0 0 9 10 8 27 0 1 1 0 0 0 0 2 OG 0 0 0 2 0 0 0 2 RC 1 i 0 0 0 0 0 2 RFD 1 1 0 0 2 0 0 4 RFI 5 8 4 7 11 11 2 48 RFR i i 3 3 3 6 8 25 RO 1 3 0 0 4 0 1 9 RRH 1 0 0 0 0 0 0 1 SB 2 12 11 0 0 0 0 25 SM 5 10 9 6 0 0 0 30 SP i 1 0 1 0 0 0 3 ST 0 0 0 0 1 0 0 1 TFI 0 28 0 84 0 0 0 112 TR 38 37 26 21 30 27 21 200 TR/GN 1 0 0 0 0 0 0 1 Count 207 316 225 326 238 237 207 1756 BP - Body Piercing2* FSI - Food Serv:. Ins.. 262* RFD - Retail Food Disc. CFI - Cert. Fit.711* FSR - Food Sexes 13-0 RFI RFI - Ret. Insp.66* - C CFR ert. Fit Reinsp73*_ GN.___ -__Gen N111sance -_..Ret..-_._Food..-.Rein24* _ - --- - CH - Court. Hearing 143* HI - Housing Insp. 2242* RO - Rodent Control 25' CON - Constable Sery A0* HR - Housing Reinsp_:153'* SC - Suntan 6* CR - Compliance Rev.57* LPI - Lead Paint Insp. 6* SES - SESD Odor 7* •CT _ Computer Time MS . - Massage 8* SM - Seminars 78* EC - Envirn. Compl.113* MUP - Mobile Food' Insp. 13* SP - Swim. Pools 8 EPR - Ext. Paint 15* OG - Overgrowth . SB = Swim. Beaches 132' FC - Food Comp1.13* OS - Off. Sub .In' 25* ST - Soil/Septic 6* FRH - Food Hearings 'RC - Rec .Cam' 7* TFI - Temp. Food58* FSD - Food Serv. Disc-17* MT - Meetings,,. . TR - Trash 747* .... .. .. ... .. ._ -.,....-..�.n _ ME ��#- i • AGENT'S N EWSLET UR TO THE BOARD - VOLUME 53 JANUARY 11, 2000 BODY PIERCING them. The most important REGULATION changes include requiring NEW COMPUTERS Enclosed in the packet are sampling for enterococci As part of the city-wide plan to changes to the Body Piercing instead of total or fecal network departments and to make Regulation as suggested by my coliform, and a sampling their records available to each meeting with Dr. Miaskiewicz. If frequency of at least once per other and the citizens, we have the Board votes to change the week instead of every other acquired three new computers; regulation, I will publish a summary week. The DPH will, however, one for me, one for the inspectors, of the changes in the NEWS as formally allow enterococci to one for Sue. They are a pleasure required. be an alternative indicator to work on. You may note, organism for next summer. I however, that my"newsletter' SMOKING REGULATION will incorporate a line item in format is not quite as formal as Enclosed in the packet are several our next budget for beach before. items, seen in previous packets, sampling. concerned with the proposed NEW FEDERAL Q & A smoking regulation, as well as STREET SCHOOL The year 2000 is here and our some fresh input from Owen Q&A programs are generally Meegan, the Cancer Society, etc. PLANS OK!! That is quite a relief. We The architect for the City can now gradually change our 0 ORGANIZATIONAL has presented plans to me records over to ACCESS so that MEETING for the new Federal Street they will be compatible with the You will note on the agenda that it School. As you remember, city hall programs. is time to vote for the Board's this school will be built into Chairperson, Clerk, and to the front slope in front of BOH DENTIST reappoint the Health Agent, all to the High School. I am There hasn't been much serve the Board during this pressing for a minimal progress made with calendar year. amount of carpeting to be implementing our volunteer used in the building and dental screening program. I will MEETING WITH THE carefully reviewing the spend more time following up MAYOR cafeteria plans for with the two dentists who were compliance with the State interested. As seen in the packet, the Mayor Sanitary Code. requested a meeting to discuss goals for the remainder of this FELT STREET fiscal year. I met with him on PROPERTY December 22 and gave him an update for those goals as listed on You may have read an our FY 2000 budget. I have article in the Salem Evening enclosed that information as well. News regarding our O condemnation of the house BEACH REGULATIONS on Felt Street. Our records The Department of Public Health is regarding this property are "public record," and so the proposing new regulations for public, including newspaper bathing beaches. These • reporters, may have access regulations will probably take effect to them. in January 2001 in order to give communities more time to plan for Salem Board of Health Phone Log January 2000 Total Answered Monday January 3, 2000 51 *Answered Calls Tuesday January 4, 2000 56 Barb= 80 Wednesday January 5, 2000 56 Mary= 281 Thursday January 6, 2000 47 Sue= 493 Friday January 7, 2000 35 Saturday January 8, 2000 *Calls Taken Sunday January 9, 2000 Joanne= 243 Monday January 10, 2000 58 Jeffrey= 108 Tuesday January 11, 2000 53 Mark= 50 Wednesday January 12, 2000 38 Jose= 60 Thursday January 13, 2000 38 Pablo= 12 Friday January 14,O2000 34 Tracy= 108 aturday January 15, 2000 Ginny= 12 unday January 16, 2000 Barb= 29 Monday January 17, 2000 Holiday Mary= 99 Tuesday January 18, 2000 58 Sue= 133 Wednesday January 19, 2000 33 *43 Office Hours Per Week Thursday January 20, 2000 43 * = 20 Work Days Friday January 21, 2000 27 Saturday January 22, 2000 0 Sunday January 23, 2000 Monday 8-4 Monday January 24, 2000 53 Tuesday 8-4 Tuesday January 26, 2000 21 Wednesday 8-4 Wednesday January 26, 2000 21 Thursday 8-7 Thursday January 27, 2000 47 Friday 8-4*Winter Hours Friday January 28, 2000 36 Saturday January 29, 2000 Sunday January 30, 2000. onday January 31, 2000 49 Total = 854 • Board of Health Administration Monthly Report December-99 Biologics Distributed Amount in Doses Diptheria, Tetanus & Pertussis = 560 Burial Permits@ $5.00 $255.00 Diptheria,Tetanus Tox.(under 6 yrs)= 0 Licenses & Permits(+copies) $13.40 Immune Serum Globulin= 0 Certificate of Fitness@$25.00 $2,075.00 Measles/Mumps/Rubella= 410 Sealer Weights/Measures= $260.00 Polio= 230 Total = $2,603.40 Tetanus & Diptheria (adult use)= 840 Tuberculin PPD= 670 HIB Titre= 500 Animal Bites Reported= 2 Hepatitis B= 430 Annual Budget Expenses Available Balance Salary/Longevity $344,061.00 Annual Budget Expenses Encumbered Available Balance Non-Personnel $19,100.00 • 3 5� , n� CITY OF SALEM BOARD OF HEALTH n Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 Public Health Nurse Re>aort December 1999 Activities Disease Prevention • In touch with T.B. Clinic and following active cases and case contacts. • Two PPD screenings done in office. • Vaccine inventory maintained and distributed. • Investigated communicable diseases and reported to the M.D.P.H. • Continuing Education • Wednesday Evenings: Attending Salem State evening LPN to BSN program. Enrolled in World Civilization 1, English Comp II this semester. Meetings and Clinics: 12/3 Assisted Dawn Marie Cameron at Saltonstall School Science Night. Our table included Handwashing demonstrations, literature on communicable diseases, and the importance of childhood immunizations. 12/9 Attended Health Advisory Council Meeting at Salem High School. 12/21 Collins Middle School Hepatitis B Clinic, second series of three. 40 students vaccinated. 12/21 Attended Wellness Fair meeting at Salem Police Station. Exhibitor meeting will be held on January 6, 2000 at Salem Police Station. St. Joseph's School Hearing and vision will begin in January. • Phoenix School Hearing and vision will begin in January. • MONTHLY REPORT OF COMMUNICA13LE DISEASES December, 199 DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES: CASES: CASES: STATE: • Campylobacter 0 0 0 0 Giardia 0 0 0 0 E.Coli0157H7 0 0 0 0 Entamoeba Hystolytica 1 0 1 1 Hepatitis 1 3 1 1 Lyme Disease 0 0 0 0 Meningitis 0 0 0 0 Pertussis 0 0 0 0 Salmonella 1 0 1 1 Shigella 0 0 0 0 • Varicella 0 0 0 0 r Summary of Communicable Diseases for December, 1999 Entamoeba Histolytica: 33 y/o female. Non-Foodhandler. She had recently traveled to Puerto Rico to visit family. Her family has a well for drinking water. Household contact was to be tested at Physicians office. She was treated with antibiotics and is asymptomatic. Public Health Fact Sheet Sent. Hepatitis C: one case Salmonella: 6 y/o male. Mother believes the child was ill from eating chicken at Home Town Buffet. Reported to Peabody Board of • Health. Family has one Iguana, and a 10 foot snake at home. Public Health Fact Sheet Sent informing mother about Salmonella and Reptile's. City Of Salem • Environmental Health Division --- Inspection Monthly Summary Month ------------------------------------------------------ Type Jul 99 Aug 99 Sep 99 Oct 99 Nov 99 Dec 99 Jan 00 Count ------ ------ ------ ------ ------ ------ ------ ------ 2 3 0 0 0 0 0 5 CFI 60 91 80 69 50 76 0 426 CFR 12 0 13 16 0 15 0 56 CH 8 10 6 18 8 12 0 62 CON 3 9 3 5 8 2 0 30 CR 3 5 1 1 4 1 1 16 CT 0 0 1 0 2 1 0 4 EC 5 11 4 3 0 3 0 26 EH 0 1 0 0 0 0 0 1 EPR 0 3 1 0 4 0 0 8 FC 0 3 0 1 1 0 0 5 FRH 4 3 1 1 0 1 0 10 FSC 0 0 0 0 1 0 0 1 FSD 3 6 1 3 6 7 0 26 FSI 19 17 14 28 28 24 0 130 FSR 6 13 7 19 24 20 0 89 GN 4 7 7 3 2 1 0 24 GN/TR 2 0 0 0 0 0 0 2 HI 12 16 16 17 32 10 0 103 HR 7 14 15 18 7 10 0 71 HR/CFI 0 1 0 0 0 0 0 1 LPI 0 0 1 0 1 0 0 2 MT 0 0 0 0 9 10 0 19 WP 0 1 1 0 0 0 0 2 G 0 0 0 2 0 0 0 2 RC 1 1 0 0 0 0 0 2 RFD 1 1 0 0 2 0 0 4 RFI 5 8 4 7 11 11 0 46 RFR 1 1 3 3 3 6 0 17 RO 1 3 0 0 4 0 0 8 RRH 1 0 0 0 0 0 0 1 SB 2 A 11 0 0 0 0 25 SM 5 10 9 6 0 0 0 30 SP 1 1 0 1 0 0 0 3 ST 0 0 0 0 1 0 0 1 TFI 0 28 0 84 0 0 0 112 TR 38 37 26 21 30 27 0 179 TR/GN 1 0 0 0 0 0 0 1 Count 207 316 225 326 238 237 1 1550 BP - Body Piercing2* FSI - Food Serv. Ins .262* RFD - Retail Food Disc. CFI - Cert . Fit . 711* FSR - Food Serv. Rein. 110* RFI - Ret. Insp. 66* CFR - Cert . Fit .Reinsp73* GN _ Gen. Nuisance 61* RFR - Ret. Food Rein24* CH - Court Hearing 143* HI - Housing Insp. 242* RO - Rodent Control 25* CON - Constable Serv. 80* HR - Housing Reinsp. 153* SC - Suntan 6* CR - Compliance Rev. 57* LPI - Lead Paint Insp. 6* SES - SESD Odor 7* CT _ Computer Time MS - Massage 8* SM - Seminars 78* C - Envirn. Compl . 113* MUP - Mobile Food Insp. 13* SP - Swim. Pools 8 R - Ext . Paint 15* OG - Overgrowth SB - Swim. Beaches 132* C - Food Compl . 13* OS - Off. Sub. - Insp. 25* ST - Soil/Septic 6* FRH - Food Hearings RC - Rec Camps 7* TFI - Temp. Food58* FSD - Food Serv. Disc . 17* MT - Meeting's TR - Trash 747* 01/07/2000 iAr. • NEWSLETIER 52 December 14, 1999 AGENT'S REPORT TO THE BOARDOD with the inspectors to discuss report covered 1987-1994. this and any other issues of This report is for the period TOBACCO concern. I have enclosed my 1990-1995. I have enclosed a REGULATIONS follow-up memo to that summary sheet of those A separate packet has been meeting for your information. cancers where there was an prepared for you with notes I ask the Board to consider increased incidence in Salem and information from the revising the part of our Food as compared to the State...for public hearing, and written Manager Certification both of those time periods. comments received since the regulation which requires hearing. You will note a letter "recertification." Initial TOBACCO from the City Solicitor certification added to our COMPLIANCE requesting a delay in the review of procedures during The owner of an Board's action on this inspections appears to be establishment, where regulation. Len has agreed to sufficient. cigarettes were sold to •delay final deliberation on the someone under 18 during a regulation until January. Also REQUEST FOR compliance check, is coming in the packet is a listing of V`,�IANCE✓ before the Board for a options regarding the Board's An establishment is hearing. We have issued a decision about the regulation. coming before the board to fine of $100 for that violation It is not meant to be all request a variance to the food to our regulation. inclusiae, but meant to aid manager certification the board in its review of requirement The son of the ADVISORY GROUP FOR possibilites. owner has taken the exam two FOLLOW-UP TO POWER FEDERAL FOOD CODE 4 times and has failed it both PLANT STUDY® The Department of Public times. According to the owner Suzanne Condon of the Health is conducting hearings the establishment is under a DPH is appearing before the in preparation of its adoption purchase t sale agreement Board to discuss the proposed of the Federal Food Code as and will be closing within the follow-up study to the report its own State Sanitary Code next few months. I have which investigated the effect for Food Establishments. In enclosed that part of the of the Salem Power Plant on the long run this will be a federal food code regarding increased incidence of certain positive move in protecting this type of situation. cancers in Marblehead and the public from food borne Swampscott, Suzanne is illnesses. In the short run it CANCER INCIDENCE proposing to establish an •will involve some retraining of REPORT® advisory group made up of ourselves and establishment The Department of Public health agents/directors and owners regarding any new Health recently released its concerned citizens from the requirements. I have begun updated City S&Town Cancer several communities which more formal weekly meetings Incidence Report. The last may be or have been effected residents. The mission of the Health by the plant. I ask the Board's center complements the mission of permission to be on this advisory the Board of Health to improve health • committee. In addition, I ask the status indicators in the community. I Board's recommendation for others estimate two to three work hours are who would be appropriate for this given to this endeavor. committee. Two years ago, Stephen O'Grady asked me to be a member of the FELT STREET Boys & Girls Club Board of Directors. A house at 18 Felt Street was I am now the secretary. Like the condemned because of severe Family Health Center, this sanitary code violations. I did inform organization primarily serves the Len of the action. However, after neediest of children. Its first attending the MAHB seminar a objective was to target children from couple of weeks ago, I now know the point. The Club now has a that I need a vote of the Board to branch at Rainbow Terrace, runs agree with that action. after school programs at two THE MAHB CONFERENCE schools, and transports children to Christina Harrington and I the main location from most attended the MAHB conference a elementary schools. It also serves couple of Saturdays ago. It was very high school age children in the P Y g rY 9 9 informative. I have since learned evening. I spend about one to two that the attorney for the MAHB, Marc work hours per month in this service. Boutin, upon whom I have relied for I am the chairman of the planning great legal advice in the past, is subcommittee of the Local • leaving that position. He will be Emergency Planning committee. missed. Our objective is to devise a written NEW DATABASE ESTIMATE plan, in compliance with State I have enclosed in the packet the requirements, for responding to a estimate of the cost to develop the chemical release disaster. new database as discussed at the Eventually, the plan will be more last meeting. It comes to about comprehensive and cover a broader $9000.00! 1 wanted the Board to see range of potential disasters. this before I submit the supplemental I have been asked to serve on funds as voted at the last meeting. several state organizations but have BOARDS I'M ON ■ refused with one exception. There is Len asked me to remind the so much to do in Salem that I do not Board about any boards on which I want to spend time away from the serve. I am the President of North City. The one exception is the Board Shore Community Health, Inc. A few of Registration of Health Officers, years ago I was asked to join the which I discussed with the Board last board of this organization which in spring. I am now the secretary of Salem acts as the Salem Family that Board. I spend about two hours Health Center. I asked and received per month in that service. permission from the Board and the Mayor. The mission of this Thank you for your organization is to provide quality consideration of these • medical care primarily to those most items—it's a long report! in need. Its location in the Point neighborhood, its employment of translators, and its extensive outreach makes this an ideal source of primary care for many Salem • Salem Board of Health December Phone Logs 1999 Total Answered Answered Calls: Wednesday December 1, 1999 53 Barb = 160 Thursday December 2, 1999 42 Mary = 284 Friday December 3, 1999 1 38 Sue = 219 Saturday December 4, 1999 Sunday December 5, 1999 Monday December 6, 1999 47 Calls Taken Tuesday December 7, 1999 25 Wednesday December 8, 1999 36 Joanne = 164 Thursday December 9, 1999 36 Jeffrey = 75 Friday December 10, 19991 27 Mark = 59 Saturday December 11, 1999 Jose = 35 Sunday December 12, 1999 Pablo = 18 onday December 13, 1999 32 Tracy = 62 esday December 14, 1999 36 Ginny = 12 Wednesday December 15, 1999 35 Barb = 83 Thursday December 16, 1999 44 Mary = 100 Friday December 17, 1999 30 Sue = 55 Saturday December 18, 1999 Sunday December 19, 1999 Monday December 20, 1999 57 43 Office Hours Per Week Tuesday December 21, 1999 30 *=20 Work Days Wednesday December 22, 1999 17 Thursday December 23, 1999 4 *(1/2 Day) Monday 8-4 Friday December 24, 19991 Holiday I Tuesday 8-4 Saturday December 25, 1999 Wednesday 8-4 - Sunday December 26, 1999 = Thursday 8-7 Monday December 27, 1999 24 Frid. 8-4* (Winter Hours) Tuesday December 28, 1999 16 Wednesday December 29, 1999 17 A�Lhursday December 30, 1999 17 *(1/2 Day) rids December 31, 1999 Holiday Total Calls *= 6637 Y !J • o _ r � CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 Public Health Nurse Report November 1999 Activities Disease Prevention • In touch with T.B. Clinic and following active cases and case contacts. • Two PPD screenings done in office. • Vaccine inventory maintained and distributed. • Investigated communicable disease cases and reported to the M.D.P.H. • 11 Office visits for Flu Shots • • 5 Home Visits for Flu Shots Continuing Education • Wednesday Evenings: Attending Salem State evening LPN to BSN program. Enrolled in World Civilization 1, English Comp H this semester. • Discussed upcoming flu clinics with Dr. Miaskiewicz. Meetings and Clinics: • 11/4 11:00a.m.-2:00p.m. City of Salem Employee Flu Clinic. 85 Employees vaccinated. • 11/4 5:00-8:00p.m. VOCES Flu Clinic. 110 residents vaccinated. Salem Board of Health has administered 1,820 Flu vaccinations to the 1 community this season. We have also administered 102 Pneumonia vaccinations. • 11/9 Meeting with Salem Wellness Committee to discuss plans for 2000 Wellness Fair. Fair will be held April 9 and April 10th at Okeefe Center. • 11/16 A Flu Clinic was requested by Judge Cornetta for Salem District Court Employees. Judge Cornetta purchased Flu vaccine through a Vaccine Distributor. A Clinic was held at Salem District Court. 30 Flu shots were administered to his employees. i Y 0 CITY OF SALEM HEALTH DEPARTMENT • m f Nine North Street , Salem, Massachusetts 01970 Meetings and Clinics (continued) • 11/19 Collins Middle School Hepatitis B Clinic. 39 Students were vaccinated, and will receive the series at school. Hepatitis B vaccination is now required by M.D.P.H. prior to entry into seventh grade. St.Josevh's School • 3 cases of pediculosis (siblings). Letters were sent home to all parents about pediculosis, control measures, and surveillance of their children's hair. (attached). 75 Children in grades 2, 5 and 6 were checked, and 1 more case was noted. Salem Public School"no nit" policy was enforced. • 11/23 Hepatitis B Clinic offered for all sixth grade students. 6 students will receive the series at school. • Phoenix School • Betsy Sargent was notified of the increase in pediculosis in the schools. She will Call me if she has any concerns in her school. • 11/23 Hepatitis B Clinic offered for all sixth grade students. 1 student will receive series at school. • .0 CITY OF SALEM HEALTH DEPARTMENT • a Nine North Street Salem, Massachusetts 01970 MONTHLY REPORT OF COMMUNICABLE DISEASES November, 1999 DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES: CASES: CASES: STATE: • Campylobacter 0 0 0 0 Giardia 1 0 1 1 E.Coli 0157H7 0 0 0 0 Hepatitis 4 2 3 3 Lyme Disease 0 0 0 0 Meningitis 1 0 1 1 Pertussis 0 0 0 0 Salmonella 1 0 1 1 Shigella 0 0 0 0 Varicella 6 0 0 6 • Reportable Diseases excluded from above have not been identified this month. 1 • Communicable Disease Summary November 1999 • Giardia 2 y/o male. Mother came to U.S. from Albania. She had recently traveled to Albania with child. His only symptom was weight loss. He has been treated, and is not in day care. Handwashing was emphasized. • Hepatitis Hepatitis A and C. 30y/o non-food assembly worker. He was hospitalized. He had 1 close contact that was informed by patients M.D. to have IGG. • • Hepatitis B. One case, attempting to contact by mail. No phone number provided, no Primary Care Physician. Case was seen in Emergency Room. • Hepatitis B. One case attempting to contact by telephone. • Salmonella. Non-Food handler. He suspected a Dunkin' Donuts egg sandwich, which he consumed 3 hours prior to symptoms. He was not cooperative with investigating other food sources. His one household contact is asymptomatic. • Varicella. Six cases reported from Saltonstall school nurse. • Head lice infestations continue to be a problem in our community. Lice are highly communicable and difficult to prevent, but if every parent will take the responsibility to CHECK A HEAD and screen the entire family often, these parasites can be ?revented or detected early and controlled. This is often a frustrating problem to deal with, but the following information should help you to identify and treat your child for head lice safely and thoroughly. I How Do You Get lice? throughout the hair, but are most often located at the Head lice have been a parasite of humans since recorded nape of the neck, behind the ears, and at the crown. It time Many people associate lice with unclean people or helps to use a magnifying glass and natural light when homes. This is not true in the case of head lice Frequent looking for them. Distinguishing dead nits from live nits bathing or shampooing will not prevent lice nor eliminate is non-productive since the presence of ten dead nits them once'they are established. Lice cannot jump or fly, does not guarantee that the eleventh won't be viable and are usually transmitted by contact with infested per- sons, their clothing, or their comb or brush. Children should be warned against sharing hats, clothing or Symptoms of Infestation grooming aids with others. Household pets do not The itching that occurs when lice bite and suck blood transmit lice from the scalp is a primary symptom of infestation, although not everyone will experience the itching. Children seen scratching their heads should be examined *what To Look For at once Often red bite marks or scratch marks can be Lice are small insects about the size of a sesame seed. seen on the scalp and neck. In severe infestations, a They are usually light brown but can vary in color. They child may develop swollen glands in the neck or under move quickly and shy away from the light, making them the arms. difficult to see Diagnosis is more often made on the basis of finding nits (eggs). Nits are ti-iy, yellowish-white oval Treatment of the Individual eggs attached to the hairshafts. Note: The old quarter-inch from the scalp rule has given way to new evidence sug- Safety must come first.when using pesticides. Before one gesting thaXiable (live) nits m-ay be found at any distance family member is treated, all should be examined. Only from the scalp. As she deposits her eggs (3-5 per day), the those showing evidence of infestation should be treated. female louse cements them to the hairs. and unlike lint or Treat them at the same time to prevent reinfesiation from dandruff. they will not wash off or blow away. Haircasts one family member to another. Individual treatment in- or pseudo-nits are often mistaken for lice eggs. (Photo on volves the use of a pediculicidal product and the use of a reverse shows the difference) Nits may be found combing tool manufactured for the purpose of nit removal. Proceed as follows. 1. Remove child's shirt and provide a towel to protect the eyes. Do not treat in the bathtub or shower, but have k " q, the child lean over the sink (this confines the lice product to the scalp/neck.) 2. Use one of several louse remedies available at your pharmacy. Some are available by prescription-,* some over the counter. Consult your physician if you are • pregnant or nursing(whether creating yourself or others). Consult your physician before creating anyone with extensive cuts or scratches on the head or neck. or anyone who is ill or using medications. Consult your physician if lice nits are found in the eyebrows or eyelashes. No pesticide should be used in the eye area. Wu It icmaic i��usi on icunhalts—hip, .. ma�n,tiru 9 DO NOT USE THESE PRODUCTS ON INFANTS** TREATMENT OF PERSONAL ARnCLES AND AVOID PERSONAL AND ENVIRONMENTAL ENVIRONMENT PESTICIDE SPRAYS. READ ALL PACKAGE INFOR- I %Machine +wash all clothin- and IbM linens which have MATION BEFORE USING THESE PRODUCTS!*** been in contact with the infestedperson during the last three days. Articles should the washcd in hot water 1Although it can take time and sometimes be difficult. and dried in a hot dryer. Non-washables can he remove all nits to insure complete treatment and to Vacuumed or dn• cleaned. comply with No Nit Policies.'*** Louse products do not kill all the nits. and survivors will hatch into crawl- ing lice within 7-10 days. generating a cycle of self- ' Bagging' is not necessary. Rugs;. upholstered furniture. reinfestation. Ewen dead nits will cling to the hair and mattresses, and car seats (and any personal items that cannot be cause uncertainty about reinfestation. Nit removal can +washed. c.o. stuffed animals. can he carefully vacuumed to pick up living hce or nits attached to be accomplished with a special combing tool or b+ fallen hairs. The use of insefticcWal sprays is not picking them out with the fingernails. Nits can also be recommended and strongly &iscouraged by the cut out with small safety scissors. NPA and the Centers For Disease Control because Note: Some so-called lice combs are actually cradle they may be harm family m harmful to famiembers and pets cap combs and are ineffective against nits. Nit combing and are of questionable benefit. is best accomplished with hair which is slightly damp. Tote: Even if your lice comb fails as a nit removal tool it can be used to screen for.adult lice and is particular- Reporting Cases 1)• helpful for the person screening him or herself. Notify your child's school (daycare setting. etc.' so other parents can be alerted to a possible outbre4. Also notify 4. Following nit removal, have child put on clean clothing your child's playmates parents. Parental cooperation -will and let hair air dry. help protect all children including your o-wn. 5. A daily nit check is advisable for at least 10 days following treatment and then checking should become { part of routine hygiene You may have to retreat in 7-10 '"` • days if there is evidence of new nits or newly-hatched lice (Regardless of precautions taken at home. ° reinfestation from others can still take place) Treat- ment itself can cause itching; do not retreat on the *The prescription product K\vell Shampoo and its basis of itchiness alone generic counterparts contain the controversial pesticide, Lindane. The NPA discourages its use as a pediculicide- *Manual/mechanical removal of lice and eg s is a non-pesticidal alternative for infants. pregnant women. etc. `Package directions for NIX suggrsts it is not Fib; 1-actual Nit.Oval or rear-shaped.attached to side of hairshalt necessary to remove nits. The NPA recommends nit removal following treatmene -sh all products. 4 . **"The No Nit Policy is an administrative, ptiiblic� Ltcs` health policy for control and prevention of head lice outbreaks. 01983. 1985, 198i. 1990 NATIONAL. PEDICULOSIS ii; '-Pscudo-Nu or Hvrcasi Ohlon,or rectan_ular-shaped cncuchn ASSOCIATION, P.O. BOX 149. NIRVION. PIA 02161 hainhau t617-449-NITS, FAX 617-449-8129) • r t _!VY i4 n. CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOT MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 Dear parent or guardian: A student in your child's classroom has head lice. Your child has head lice. Please do not be alarmed,as this is a common occurrence in schools.Head lice are not a sign of unclean people or hom,:s. Please take these precautions: 1.Check your child's hair for eggs(also called nits). 2.If you suspect your child has head lice,ask your health care provider to diagnose the problem and recommend appro- priate treatment. 3.Tell us if your child is diagnosed as having head lice. 4.If your child is diagnosed with lice,the child must be examined by the school nurse prior Information about head lice: to returning to the classroom, and must be "nit free"to return to school • What are they?Head lice are tiny insects that live only on people's scalp and hair.They hatch from small eggs(nits)that are firmly attached to the individual hairs near the scalp and cannot be easily moved up or down the hair(as can specks of dandruff).They look like grains of sand.Nits may be found throughout the hair but are most often located at the back of the scalp,behind the ears,and at the top of the head.The eggs hatch in about 10 days,with new lice reaching adulthood in about 2 weeks.The female louse,about the size of a sesame seed,can live for 20 to 30 days and can lay about six eggs a day.The lice live by biting and sucking blood from the scalp.Lice can survive up to 8 hours between feedings and can do so off the body.Until a person with head lice is treated they can transmit them to others. How should you check for head lice?You probably will not see the lice,only the eggs.These are tiny,pearl-gray,oval- shaped specks attached to the hair near the scalp.Look carefully,using a magnifying glass and natural light.Search for nits at the back of the neck,behind the ears,and at the top of the head. How does a person get head lice?Anyone who has close contact with an infested person or shares personal items can become infested.Lice are spread only by crawling from person to person directly or onto shared personal items,such as combs,brushes,head coverings,clothing,bedding,or towels. What should you do about head lice?If your child does have head lice,your health care provider may want to treat every- one in your family.Everyone should be checked,and anyone with nits should definitely be treated. If your child has head lice, please call your child's physician to be properly treated. 1. Use a medicine that your health care provider prescribes or recommends.Use any of these products very carefully, and consult a physician before treating infants,pregnant or nursing women,or people with extensive cuts or scratches on the head or neck. 2.After appropriate treatment,removal of.nits is not necessary to prevent spread,although sometimes removal is done for aesthetic reasons.Removal is a difficult and time-consuming process because nits have such a firm grip on the hair. A solution of vinegar and water may help loosen nits so you can remove them with a special,fine-toothed,nit-removal comb. 3.Check for nits daily for the next 10-14 days.Then repeat the treatment to kill any newly hatched lice. 4.Clean personal items and surroundings: —Machine wash all washable and possibly infested items in Hot water.Dry them in a Hot dryer. —Put nonwashable items(furry toys or pillows)in a Hot dryer for 20 minutes or dry clean them. —Seal items that cannot be washed or dried in a plastic bag for 10 days(any eggs or lice present will die in this time) —Soak combs and brushes for 10 minutes,or wash them with a shampoo-approved to kill lice. —Thoroughly vacuum rugs,upholstered furniture,and mattresses. —Do not use insecticide sprays because they can be harmful to people and animals. �" r"..+. _:.�... �T-?�t�+ � �r --+i +.+�?-•^��.2*`s':! .:;tr'S .J.v1� 2" 'M ."5` +i,L11.idY4'�'1"S 's�-.r—_ -.,..o jy,t � � 't•t'. 6 1 X- 7� • Grittt Court of top Tommunwratt4 :45istrid Tourt 41, Iwo CCU no I on is NINON ONE son monommoom 0 ONE ■ Monson ■■ ■and■■n�■■�■■■■■�■■�■n■�■■■n■■nm■■i■m mommommo s- IF monism moons No on IN m No MEMO 0 ONE ONION on on on MEMNON ON I on ONE men ON moo I MEMO -mommimm Simon IN In No 0 11 mommossomm-no sonsomm ��C�C�■iiiiiinwlin iiiiiiiisiin��iiiiiii� �ui�AiiuiiiWN n NONE i�iwi�niiis MONISM iiiiiiiiii ii�� 3` no niiiiiiiiNniiv■n■�iI OMEN i ■iiiiiiiiiiiiiiiiiiii ��■■■■■■ ■o■■os■on■mu■N NONE■�■iiiniiiii�iiiiiiiiiiiiioa �011 I FEES AND CRARGES ��o �oo��o omoivomoovoovomoovmvoo ovv000�moov�nu■gym■�m■■nu�m� 1111111 JillINS sommign 0 on IN sonsioll �� B �W GAS■III P��1!'�■III■ ten■■■ �,■ ■i■■■ ■■■■■�■■■■�■■■ ■�■■u■ �� i ■i►��■i��9■m� �� A �N�� N��NII��111��111��111■■111� =��Ap�■�� ■�� ■I�fl��N��••��••��BII��III��111��111�l111� , ��■��■mignon■N■■=�■MINIM IN Jim III on ■�■��■■�nNii�■�■■=u■■��=�■�■■��■a■�i��miiiiiiiiiiiiiii ■u �In1110m��iii slummium 100111 ��iii�■■me ��...�A�■N�l.�■�.�.��I�l�B■■�I■11��1■■NI■■111■�III� 1 0 u■■ Il SIMMONS � ■1 MINIM�i� • a �■logo ENIIINNIIIN' on■■0 0 �■ ��i�i� m■■mom NMI �n■��n�100110 No No ��nw-- ■ -'� 1M ■ �� a��i��ni��n�nn■■�� .. • NEWSILETTER 51 November 9, 1999 AGENT'S REPORT TO THE BOARDOo discuss the Department's consulting with the findings regarding the Power Department's attorneys, said PUBLIC HEARING ,f Plant and its proposals for that this law would prohibit Our public hearing follow-up to its study. On people from buying needles regarding the proposed October 30th I will be meeting through a piercing regulation requiring 100% non- with Suzanne, and other establishment, catalogue, or smoking in dining areas of Health Agents/Directors in the any other source unless they restaurants and separate area, about the Power Plant are licensed or permitted. The ventilation and physical and residents' health concerns woman from Food & Drug was barriers for bar areas which regarding the Plant. interested in this and said it allow smoking is scheduled for TOBACCO COMPLIANCE opens a whole can of worms! 7:30 at One Salem Green. It During a recent compliance It certainly could become an should be well attended with check, Mr. Mike's on Bridge issue for a body piercer in a non-smoking advocates and Street sold cigarettes to a community which does not business people in person under age. Enclosed regulate it. It is illegal for them •attendance. We mailed a copy in the packet is the letter to to obtain, receive or purchase of the proposed regs to all Peterborough Oil regarding the needles. restaurants and published an that sale and the resultant fine. COMPUTER SOFTWARE ■ add in the Wednesday Salem Peterborough paid the fine. Data Processing sent a section of the News alerting PIERCING NEEDLES t memo that the company people to the hearing and the I spoke with the MDPH, making the program which availability of the regs for Health Quality Management Mary uses for all our permits review. Bureau, and the Division of and certificates of fitness and The format of the hearing is Food & Drugs. Mass General which the environmental report to allow speakers 3 minutes Law C 94C, section 27A states uses, Q&A, may not be Y2K each to give their opinion. The that no person other than a compliant and that we Board will listen to the large group of exceptions such immediately switch everything speakers but discuss the as doctors, etc. shall have in to Microsoft Access. We are regulation at its next meeting. their possession, " a in the process of initiating this Len will inform those attending hypodermic syringe, work with the City's software of the format. Additional hypodermic needle, or any contractor. It is very time written comments may be sent instrument adapted for the consuming process and it may to the Board for its administration of a controlled be expensive. The memo said consideration until December substance." The other we were to pay for it from our 3rd. exception is, "unless they are own budget. That won't be MDPH & POWER PLANT o licensed by the Department or possible. I will let the Board Suzanne Condon, Director local board of health." know how much it will cost and of the Environmental Health Therefore, the Purple Scorpion if we need to submit a Assessment Division of the is OK because they have a supplemental request. MDPH will be attending the permit from us. But the December board meeting to woman from HQMB, after f Salem Board of Health November Phone Log 1999 i Total Answered *Answered Calls Monday November 1, 1999 45 Barb = 198 Tuesday November 2, 1999 57 Mary= 338 Wednesday November 3, 1999 57 Sue= 409 Thursday November 4, 1999 58 Friday November 5, 1999 1 45 Saturday November 6, 1999 *Calls Taken : Sunday November 7, 1999 Im. Monday November 8, 1999 48 Joanne = 256 Tuesday November 9, 1999 58 Jeffrey = 101 Wednesday November 10, 1999 50 Mark = 76 Thursday November 11, 1999 Holiday Jose = 67 Friday November 12, 1999 31 Pablo = 3 Saturday November 13, 1999 Tracy = 148 Sunday November 14, 1999 NGinny = 5 Monday November 15, 1999 54 Barb = 91 • Tuesday November 16, 1999 27 Mary = 106 Wednesday November 17, 1999 48 Sue = 92 Thursday November 18, 1999 61 Friday November 19, 1999 40 Saturday November 20, 1999 43 Office Hours Per Week Sunday November 21, 1999 *=20 Work Days Monday November 22, 1999 58 35 Hour Work Week Tuesday November 23, 1999 60 Wednesday November 24, 1999 32 Thursday November 25, 1999 Holiday Monday 8-4 Friday November 26, 1999 13 Tuesday 8-4 Saturday November 27, 1999 Wednesday 8-4 Sunda November 28, 1999 Thursday 8-7 Y Y Monday November 29, 1999 57 Frid.8-4*Winter Hours Tuesday November 30, 1999 46 • Total Calls*= 945 aua e " .A r • p , OCTOBER 1� s x� MONTHLY REPORT > > ,�►DIt•NISTRATr N RM T hMOUNTs�' r vy J�u� _ t AMOUN IN DOSES �.,�BIOLOGICS" D��S�RIBUTED , �}n' BURIAL PERMITS 53 @ $5.00 = $265 0 Tetanus' &. Pertussis 525 v� r i a, }` 'Di� theria Tetanus Tox. (under 6 yrs. ) 10 LICENSES AND PERMITS $640 < pY ^7't mmune Serum Globulin 2 CERTIFICATE OF FITNESS 69@ $25.00 $1,725} 0 S. R G''y. . $80 k r s 0(� Measaes/Mumps .Rubella 4000 SEAL.Eg' OF WEIGHTS & MEASURES.S 1 r } Polio OPV — 20 IPV — 510 sic '°Tetanus b'>Diptheria (adult use) 885 V�Tub�erculin 'PD;r, 5`40 # � i HIB 'Tit`re "y1t'd 610 ANIMAL BITES REPORTED , ;titisu � 570 Hepa Q,h r , �� fy— r . AVAILABLE BALAN. ` 'J i ANNUAL BUDGET EXPENSES ` S ARYfLONGEVITY., <F $291,048.72 ;�, $53,012.28 .k $^344,061.00 3 M EXPENSES ENCUMBERED AVAILABLE BALANCE" NON PERSONNEL. ANNUAL BUDGET $15,427.10 „{+, $19;100.;Q0 $1,722.90 $1,950.00r. E t wi. s 3 • �alp. . jlP r� CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 i Public Health Nurse Report October 1999 Activities Disease Prevention • In touch with T.B. Clinic and following active cases and case contacts. • Seven PPD screenings done in office. • Vaccine inventory maintained and distributed. • • Investigated communicable disease cases and reported to the M.D.P.H. case of T.B. • 23 Office visits for Flu Shots • 19 Home Visits for Flu Shots Continuing Education • Wednesday Evenings: Attending Salem State evening LPN to BSN program. Enrolled in World Civilization 1, English Comp II this semester. • Discussed upcoming flu clinics with Dr. Miasldewicz. Meetings and Clinics: • October 12 on the radio with Al Needham to discuss upcoming clinics. • October 14 Council on Aging 868 vaccinated • October 27 Salem Housing Authority 27.Charter Street 500 vaccinated • October 28 Pioneer Terrace Community Room 185 vaccinated St.Joseph's School • 12 Flu Shots administered to teachers PHOENIX SCHOOL • • 2 Flu Shots administered to teachers • Communicable Disease Summary for October 1999 Hepatitis 5 new cases: 3 Hepatitis C cases 2 Hepatitis B cases Salmonella 3 cases Case #1 77 year old female. Case suspected chicken she purchased at a local market. She boiled the chicken before she ate it. This chicken Coincided with incubation period. Reported to Jeff Vaughan for follow up. Case #2 80 y/o male. Husband of above case. He became ill approx 1 week after wife's onset. His physician believes he became ill from his wife. Both have recovered. • Case #3 1.5 y/o male. Traveled to Dominican Republic and became Symptomatic upon returning to U.S. Eats Table Food. Family members Were not ill. Meningitis: (Viral) 1 Case recovered. Went to E.R. with high temp and Headache. • .�0 ?.. CITY OF SALEM HEALTH DEPARTMENT Nine North Street • Salem, Massachusetts 01970 MONTHLY REPORT OF COMMUNICABLE DISEASES October 1999 DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES: CASES: CASES: STATE: • Campylobacter 0 0 0 0 Giardia 0 0 0 0 E.Coli 0157H7 0 0 0 0 Hepatitis 5 0 2 2 Lyme Disease 0 0 0 0 Meningitis 1 0 1 1 Pertussis 0 0 0 0 Salmonella 3 0 3 3 Shigella 0 0 0 0 Varicella .._ 0 0 0 _ 0 • Reportable Diseases excluded from above have not been identified this month. City Of Salem Environmental Health Division --- Inspection Monthly Summary • Month ------------------------------ Type Jul 99 Aug 99 Sep 99 Oct 99 Count 2 3 0 0 `5 CFI 60 91 80 69 300 CFR 12 0 13 16 41 CH 8 10 6 18 42 CON 3 9 3 5 20 CR 3 5 1 1 10 CT 0 0 1 0 1 EC 5 11 4 3 23 EH 0 1 0 0 1 EPR 0 3 1 0 4 FC 0 3 0 1 4 FRH 4 3 1 1 9 FSD 3 6 1 3 13 FSI 19 17 14 28 78 FSR 6 13 7 19 45 GN 4 7 7 3 21 GN/TR 2 0 0 0 2 HI 12 16 16 17 61 HR 7 14 15 18 54 HR/CFI 0 1 0 0 1 LPI 0 0 1 0 1 MUP 0 1 1 0 2 OG 0 0 0 2 2 0RC1 1 0 0 2 D 1 1 0 0 2 RFI 5 8 4 7 24 RFR 1 1 3 3 8 RO 1 3 0 0 4 RRH 1 0 0 0 1 SB 2 12 it 0 25 SM 5 10 9 6 30 Sp 1 1 0 1 3 TFI 0 28 0 84 112 TR 38 37 26 21 122 TR/GN 1 0 0 0 1 Count 207 316 225 326 1074 BP - Body Pierc1ng2* FSI - ' Food Serv. Ins.262* RFD Retail Food---- Disc. CFI - Cert . Fit. 711* FSR Food Serv. Rein.110* RFI - Ret . Insp. 66* CFR - Cert . Fit .Reinsp73* GN _ Gen. Nuisance_61 RFR - Ret . Food Rein24* CH - Court Hearing 143* HI - Housing Insp-. 242* RO - Rodent Control 25* CON - Constable Serv. 80* HR -. Housing Reinsp. 153* SC - Suntan 6* CR - Compliance Rev.57* LPI - Lead Pa" 'rt Insp. 6* SES - SESD Odor 7* CT - 'Computer Time MS - Massage `8*. SM - Seminars 78* EC' -.. Envirn.' Compl . 113* MUP - Mobile Food Insp. 13* SP Swim. Pools 8 EPR - Ext . Paint 15* OG - Overgrowth SB - Swim. Beaches 132* FC - Food Compl .13* OS , � , - .Off. Sub. Insp. 25* ST - Soil/Septic 6* FRH - Food Hearings RC - Rec Camps- 7* TFI - Temp. Food58* •D - Food Se,rv.. Disc. 17* MT - Meetings TR _ Trash 747* 11/4/99 1p; 11111111w, Ip! 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The study did meeting, the owners of the schedule the public hearing not find any direct correlation Purple scorpion are regarding the Board's between the plant and those suggesting several changes to proposed tobacco regulations cancers. the Board's Body Piercing for November. This was at the The DPH is following up on Regulations. Enclosed is a request of Tobacco Control that investigation with a further memo to the Board outlining who will be asking a look at the patterns of settling those suggestions. representative from the Mass of emissions of the Plant over Municipal Association and the the years. The purpose of this MAYOR'S PICNIC Mass Association of Boards of investigation is to determine if I assisted at the Mayor's Health to attend. there have been other, non- picnic on Winter Island by • The State had submitted an cancer related, illness cooking the hot dogs and ad for the Salem Evening associated with the plant. I ensuring general food safety! News which ran recently. I can discuss-this further at the have enclosed a copy. The ad meeting. I had asked the DPH LEPC b was mistaken in its to attend our Board meeting. The Local Emergency representation of Salem's They are not able to come for Planning Committee continues current restrictions on tobacco. the October meeting but could to meet to develop an Also enclosed is a letter from be available in November or emergency plan. The task is Len to the DPH responding to earlier if the Board would like daunting at times although I that ad. to set up a subcommittee on am beginning to see some Beverly has passed this issue. progress. smoking regulation restricting smoking by not allowing it in SALEM NOW a IN MEMORY OF STEVEV dining areas and allowing it in You may have noticed a Our staff was deeply bar areas if the bar is enclosed familiar face or two if you saddened by the death of and has separate ventilation. scanned by SATV channel 3 Stephen O'Grady, the That regulation will take effect over the past month. Leo Executive Director of the Boys in September 2000. Jodoin of Salem Now & Salem & Girls Club, Little League Now on the Road filmed two Coach, and fine human being. POWER PLANT STUDY d' one hour episodes on the In his memory we have I attended a meeting of the Board of Health. He made a donation to the B&G yI interviewed me on the show Club. • combined Marblehead/Swampscott and also accompanied Ginny Boars of Health when the DPH and Mark on an inspection of released its results of a study Crosby's and Jose on a investigating the possibility of housing inspection. • OBJEaii MS FY 2000 INSPECTIONAL SERVICES The Board of Health sanitarians and inspectors will: ♦ Provide educational materials for landlords and tenants regarding housing code requirements. Lead paint notification requirements; with orders to correct housing violations 20 with certificate of fitness letters 176 ♦ Vigorously enforce the Housing Code and trash regulations. • Trash Inspections (TR) 101 ♦ Provide housing inspections in accordance with the State Sanitary Code. Housing Inspections (HI) 44 Housing Reinspections (HR) 36 ♦ Provide Certificate of Inspection inspections for vacant apartments in accordance with City Ordinance. ♦ CF Inspections (CFI) 231 ♦ CF Reinspections (CFR) 25 ♦ Inspect rooming units annually. ♦ Rooming House Inspections ♦ Inspect all food establishments at least once every six months and ensure that establishments are in compliance with the Food Manager Certification requirement. Food Inspections (FSI+RFI) 67 Food reinspections (FSR+RFR) 31 Temporary Food Inspections at the Blues Festival, BFD, Maritime Festival, Hispanic Festival, Christmas in July, Chowder Festival, Children's Night, Downtown Festival, Taste of the North Shore ♦ Inspect swimming pools, recreational camps and suntanning facilities at least once a year. Beaches (SB) 25 Rec Camp (RC) 2 ♦ Inspect massage establishments at least once a year. ♦ Inspect body piercing establishments at least once a year. ♦ Investigate complaints regarding any permitted facility. • ♦ Inspect offensive substance transporters at least once a year. ♦ Inspect and review septic systems in accordance with Title V. • ♦ Decrease the incidence of odor emissions at the South Essex Sewerage District through vigilant investigation and follow-up of all odor complaints. Continued work with special attorney regarding breach of Memorandum of Understanding ♦ Provide sanitary inspections of neighborhoods when requested in order to limit residents' exposure to raccoons and rodents. Environmental Inspections (EC) 20 ♦ Employ the use of a professional pest control operator as a consultant and to control rodents in public areas. 13 MEDICAL SERVICES The Board of Health Nurse will: i ♦ Follow the State's guidelines regarding the follow-up of reported contagious diseases. Campylobacter 4 E.coli 1 Giardia 1 Salmonella 1 Hepatitis 8 Shigella 1 Lyme 3 ♦ Investigate foodborne illnesses reports with the inspectional staff. ♦ Investigate reports of unsanitary conditions related to housing with the inspectional staff. • ♦ Obtain immunizations from the State in order to maintain an inventory to be distributed to the City's primary care providers. MMR 1370 DPT 1590 DT 20 OPV 1150 HiB 870 HepB 1356 IPV 1665 PPD 1340 IGG 6 vials ♦ Provide nursing services for the school children at St. Joseph's and the Phoenix School including; hearing and vision screening, postural screening, physical examinations, and other screenings as needed, i.e. pediculosis screening; height&weight measurements, review of immunization& medical records; hold clinics, such as for hepatitis b, as needed. Imminization records reviewed and organized at St. Joseph's & Phoenix School. ♦ Sponsor an annual influenza( and pneumonia) clinics, and make home visitsto the City's elderly and at risk residents for the purpose of immunizing against flu and pneumonia. ♦ Develop and implement blood pressure clinics for Police, Fire and City personnel, making referrals as needed. ♦ Perform annual TB testing for North Shore ambulance employees and other city residents upon request. & PPD performed in the office. ♦ Conduct hepatitis B clinics for Police,North Shore Ambulance employees and other City employees in conjunction with their contracts. Completed hepatitis B series for 60 Firefighters. • ♦ Provide clinics for non-contagious diseases as determined by need and feasibility. G y • The Board of Health Doctor will: ♦ Supervise the medical activities of the Board and its Nurse, including screening clinics, flu clinics, school child assessments, etc. ♦ Authorize the obtaining and distribution of all vaccines given in Salem. Authorization given to Public Health Nurse ♦ Perform physicals as required at St. Joseph's and the Phoenix School. ♦ Attend the flu clinics. ♦ Attend the Board's monthly meetings. Attended July and September meeting. August meeting was cancelled ♦ Consult with the Health Agent and Nurse regarding communicable diseases and other medical issues of concern to the Board. Discussed Public Health Nurse's report of communicable diseases before each meeting. Available for consultation. The Board of Health dentist will: ♦ offer screening to the City's school children, through eigth grade, for dental problems. A letter requeting dental screening services through the Board of Health was sent to all Salem dentists listed in the yellow pages of the phone book(21). A response was received from two practices totalling 5 dentists who are willing to volunteer their services. ADMINISTRATION The Health Agent will: ♦ Maintain a working relationship with the Point community by regularly attending community events. Continued as president of the North Shore Community Health, Inc., of which the Salem Family Health center is one of two sites. ♦ Be an active member of the Mayor's Neighborhood Improvement Task Force. ♦ Represent the Board in presentations to the Mayor and City Council and communicate to the Board proposals and recommendations by the Mayor and City Council. Assisted at the Mayor's Picnic and its planning. ♦ Provide the office staff with the opportunity to attend educational seminars as offered by the State and other public health associations and organizations. Jeffrey Vaughan and Mark Tolman attended MHOA meeting in Plymouth ♦ Be a member.of Salem's Local Emergency Planning Committee. Continued_to.attend monthly meetings. ♦ Provide computer training for the staff. Mary Page was instructed in use of Excell for tracking Sealer of Weights & Measures information. • Barbara Sirois received training on use of new city-wide computer software program, Munis, for use with requistions and warrants. • ♦ Continue to purchase computer equipment as necessary and allowed by the budget. ♦ Encourage networking among the inspectors and the staff of the Massachusetts Department of Public Health and the Department of Environmental Protection and other health professionals. ♦ Maintain membership in the North Shore Boards of Health Collaborative for the purpose of administering its tobacco control grant, as well as for information sharing. Attended monthly meetings. ♦ Gather information through public health publications, computer services or any other means and disseminate that information to the staff and Board. Information fowarded to Public Health Nurse through the Morbidity&Mortality Weekly Report. Circulated copies of The Journal of the American Public Health Association, and the Journal of Environmental Health. ♦ Maintain the Board's memberships in related professional organizations. Maintained membership in the Mass Association of Health Boards. ♦ Review health status indicators to prioritize possible interventions. Reviewed indicators as part of the ongoing Community Health Assessment being done in conjunction with the Harvard School of Public Health. ♦ Continue development of a process and procedures book. Added sections on "Recycling Computers," and "Ticket Rescinding and • Procedures." ♦ Perform assessment of clerical support staff and review descriptions of jobs. ♦ Be responsible for and supervise the overall operation of the Board of Health, and provide quarterly reports on these objectives. ♦ In Addition: Plan review of the following establishments: Chamelion, K-Mart, Tasty Foods, Catholic Charities, Agora, AOH. • Salem Board of Health • October 1999 Phone Log Total Answered Friday October 1, 1999 20 *Answered Calls Saturday October 2, 1999 Barb= 200 Sunday October 3, 1999 Mary= 374 Monday October 4, 1999 51 Sue= 505 Tuesday October 5, 1999 60 Wednesday October 6, 1999 53 *Calls Taken Thursday October 7, 1999 76 Joanne= 269 Friday October 8, 1999 43 Jeffrey= 51 Saturday October 9, 1999 Mark= 108 Sunday October 10, 1999 Jose= 49 Monday October 11, 1999 Holiday Pablo= 14 MM'I Tuesday October 12, 1999 73 Tracy= 175 Wednesday October 13, 1999 68 Ginny= 11 ursday October 14, 1999 71 Barb= 98 riday October 15, 1999 35 Mary= 148 Saturday October 16, 1999 Sue= 156 Sunday October 17, 1999 *43 Office Hours Per Week Monday October 18, 1999 69 * = 20 Work Days Tuesday October 19, 1999 56 Wednesday October 20, 1999 37 Thursday October 21, 1999 58 Monday 8-4 Friday October 22, 1999 35 Tuesday 8-4 Saturday October 23, 1999 Wednesday 8-4 Sunday October 24, 1999 Thursday 8-7 Monday October 25, 1999 52 Friday 8-4*Winter Hours Tuesday October 26, 1999 64 Wednesday October 27, 1999 51 Thursday October 28, 1999 66 Friday October 29, 1999 41 • Total Call,- 079 'F SEPTEMBER 1999 t& � ADMINISTRATION - MONTHLY REPORT rc^ AMOU N T � '�.. AMOUNT IN DOSES 'I { BIOLOGICS DISTRIBUTED 1 @ $6.00 '. 'Ditheria, Tetanus & Pertussis 525 BURIAL PERMITS ' 47 @ $5.00 .= $241 OOk €, t#1 P " 4*' Diptheria-Tetanus Tox. (under 6 yrs. ) 10 LICENSES AND PERMITS $300 00 , ° + Immune Serum Globulin0 CERTIFICATE OF FITNESS90 @ $25.00 $2,250 . r, 4 Measles/Mumps/Rubella SEALER OF WEIGHTS & MEASURES -0 a, e3sG+�re� �: f• �s. Polio OPV = 20 IPV = 510 VfI ., T.6 anus & Diptheria (adult use) 855 4 ` Tuberculin PPD 300 #` p yr HIB Titre 580 ANIMAL BITES REPORTED ° «•,. ' x Hepatitis B 480 : ,F SN. AVAILABLE BAL`AN r ; EXPENSES }�uSALARY/LONGEVITY: ANNUAL BUDGET �.. 061.00 $291,048.72 $344, $53,012.28 F; . AVAILABLE BALANCE . ` a. ANNUAL BUDGET NEL: EXPENSES ENCUMBERED "NON-PERSON 1 ^ $15,4 2 7.10 $19,100.00 $1,722.90 $1,950.00 EpR S�. Z7� z • �ONQIT CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO HEALTH AGENT NINE NORTH STREET Tel:(978)741-1800 Fax:(078)740-9705 Public Health Nurse Report September 1999 Activities Disease Prevention • • In touch with T.B. Clinic and following active cases and case contacts. • Two PPD screenings done in office. • Vaccine inventory maintained and distributed. • Investigated communicable case of T.B. disease cases and reported to the M.D.P.H. • Influenza and Pneumonia Clinic Preparation: Doses allotted for City of Salem: 7520 Doses allotted for Salem Board of Health Clinics: 1820 Continuing Education • 9/8 Attending Salem State evening LPN to BSN program. Enrolled in World Civilization 1, English Comp II this semester. • 9/15 Attended MHOA seminar"preparing for the Flu Pandemic' at Vinny Testa's in Dedham. St-Joseph's School Immunization Records reviewed., New immunization guidelines for pre-k, Kindergarten and Seventh Grade. PHOENIX SCHOOL • Immunization Records review ed. New immunization guidelines for students Pre-K, K, and Seventh Grades. .,rt .:_. &yk sa s r Y - 4 ".s3 �,f.A✓a `' -3 .N' '�ro'` .d"'�("�''F 1' .,k s �r .:ri._ - f CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO HEALTH AGENT NINE NORTH STREET Tel: 978 ( )741-18 00 Fax:(978)740-9705 MONTHLY REPORT OF COMMUNICABLE DISEASES September 1999 DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES: CASES: CASES: STATE: Campylobacter 1 0 0 p Giardia 1 0. 1 1 E.Coli0157H7 0 0 0 0 Hepatitis 4 2 0 0 Lyme Disease 0 0 0 0 Meningitis 0 0 0 0 Pertussis 0 0 0 0 Salmonella 0 0 0 0 Y- � rH Shigella 0 0 0 0 Varicella 0 0 0 0 • Reportable Diseases excluded from above have not been identified this month. City Of Salem Environmental Health Division --- Inspection Monthly Summary • Month ------------------------------ Type Jul 98 Aug 98 Sep 98 Oct 98 Count ----- ------ ------ ------ ------ CFI 79 55 83 60 277 CFR 5 6 4 2 17 CH 7 8 2 4 21 CON 14 8 8 6 36 CR 2 1 5 6 14 EC 20 7 5 7 39 EPR 2 1 3 4 10 FC 1 0 2 0 3 FSD 0 0 2 1 3 FSI 23 15 27 29 94 FSR 6 5 7 9 27 GN 8 8 4 2 22 HI 14 23 13 8 58 HR 11 14 11 24 60 MS 0 1 0 0 1 MUP 2 0 0 2 4 OS 1 0 12 0 13 RC 2 0 0 0 2 RFI 5 3 9 7 24 RFR 2 1 2 5 10 RO 2 0 0 0 2 SB 62 36 13 0 ill SES 2 0 0 0 2 OF1 3 2 3 9 I 13 0 0 16 29 TR 48 74 59 106 287 Count 332 269 273 301 1175 Inspection Types aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa BB - Bed/Break . 2 FSI - Food Serv. Ins . 243* RFD - Retail Food Disc . CFI - Cert . Fit . 890* FSR - Food Serv. Rein. 11l* RFI - Ret . Insp. 100* CFR - Cert . Fit .Reinsp. GN _ Gen. Nuisance 44* RFR - Retail Food Rein. CH - Court Hearing 44* HI - Housing Insp. 312* RO - Rodent Control 13* CON - Constable Serv. HR Housing ns Rei . 172* SC - Suntan 5 P CR - Compliance Rev. LPI - Lead Paint Insp. 26* SES - SESD Odor 3* CT _ Computer Time MS - Massage 7 SM - Seminars/Meetings EC Envirn. Compl . 85* MUP - Mobile Food Insp . 13* SP - Swim. Pools 14 EPR - Ext . Paint 5* OG - Overgrowth SB - Swim. Beaches 111* FC - Food Compl . 22* OS - Off . Sub . Insp. 10* ST - Soil Test/Septic FRH - Food Related Hear. RC - Rec . Camp 5 TFI - Temp . Food 65* FSD - Food Serv. Disc . RFC - Retail Food Compl . TR - Trash 758* aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa 11/10/98 �`. Ad� k.K"d`�a5 i.�+ "1- { •i t ..,,,1t•„ t, �.. .w � +e., L y .,C xv rtiw.a 'kc t,r _ { "6• Ll �..-' 34x +X�`L' ty�s d 'S �t ``!°•."� -�• � ;t�- � ' ��.`��'.�`"'"`s',:'3} t x :'«�� * ��•�'i�� - itl�:.'�° '`+ j+t 1a..•�'.s`� ��a�`•, � ,� �F.^ d.� c,aa, .it'��?�•y'" � 3r^ l w Sepumbw, 1999 Ca 340 acftr 38 yl&mat&. SVGW attemptuuj t co iardizv 2 7 y/o-norvfin rraveled/to-Costw IZCow Ju*t&d.rouq4 .Au t. Sym torwom&wa - Cn july, but did.n4OCWkl medicab atG.�He u�nt'aiAu�t. at' 1 }fepattrwB ccL4& 3 new ff epattrwC caR*recewed o-wSepte LIxr 291"v ^ f n 7 "' `. City Of Salem Environmental Health Division --- Inspection Monthly Summary • Month --------------- Type Jul 99 Aug 99 Sep 99 Count ------ ------ ------ ------ 2 3 0 5 CFI 60 91 80 231 CFR 12 0 13 25 CH 8 10 6 24 CON 3 9 3 15 CR 3 5 1 9 CT 0 0 1 1 EC 5 11 4 20 EH 0 1 0 1 EPR 0 3 1 4 FC 0 3 0 3 FRH 4 3 1 8 FSD 3 6 1 10 FSI 19 17 14 50 FSR 6 13 7 26 GN 4 7 7 18 . GN/TR 2 0 0 2 HI. 12 16 16 44 HR 7 14 15 36 HR/CFI 0 1 0 1 LPI 0 0 1 1 MUP. 0 1 1 .2 RC. ., 1 1 0 2 1 1 0 2 B: 8 .4 17 RFR 1 1 3. 5 RO 1 3 0 4 RRH 1 0 0 1, SB 2 12 11 25 SM. 5 10. 9 24 Sp 1 1 0. 2 TFI 0 28 0 28 TR 38 37 .26 101 TR/GN 1 0 0 1 Count 207 316 225 748 BP - Body Piercing2* -FSI - Food Serv. Ins . 262* RFD - Retail Food Disc 'CFI - Cert . Fit . 711* FSR - Food Serv. .Rein. 110* RFI - Ret . Insp. 66* CFR - Cert. Fit.Reinsp73* GN Gen. Nuisance 61* RFR - Ret . Food Rein24* CH - Court:. Hearing 143* HI Housing Insp. 242* RO - Rodent Control 25* CON Constable Serv. 80* HR - Housing Reinsp. 153* SC - Suntan 6* CR - ' Compliance Rev. 57* LPI - Lead Paint Insp. 6* SES - SESD Odor 7* CT. Computer .Time MS - Massage 8* SM Seminars 78* EC . Envi.rn. Compl .113* MUP - Mobile Food Insp. 13* SP —Swim. Pools 8 Ext.-Paint 15* OG - Overgrowth SB - Swim. Beaches 132* . , Food Compl. 13* OS - Off . Sub. Insp. 25* ST - Soil/Septic 6* '. FRH - `:Food-Hearings RC - Rec Camps 7* TFI - Temp. Food58* FSD - Food Serv. Disc. 17* MT - Meetings TR - Trash 747* 10/17/99 ContnI 9 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 LIST OF SEALER OF WEIGHTS AND MEASURE INSPECTED AS OF OCTOBER 8, 1999 Salem Family Health Salem Pop Warner Lake N Surf Sport Shop The Lynn WIC Program Bonfanti Leather Crosby's Market,426 Canal Street Joe's Auto Laundry • Eastern Pulmonary Salem Transfer Station Shaws Stop&Shop Merit Gas Station A-Plus Sunoco • • NEWSLETTER 49 September 14,1999 AGENT'S REPORT TO THE BOARDOa and the Licensing Board BODY PIERCING I regarding our permitting of Judy Murphy of the Purple PLANNING DOCUMENTI the temporary food Scorpion is appearing before Enclosed in the packet is establishments. It is slightly the Board to request two the 4th and final update to different than what was variances of our regulation, our FY 99 objectives, as well outlined in the packet. i and suggesting some changes. as some comparison think it will give us good She has some good, practical information. Also enclosed is assurance of compliance with experience with the regs and a copy of the entire FY 99 the food codes and our maybe helpful to the Board, Planning Document including regulation regarding food particularly regarding her the Vision, Mission, Goals, managers. suggestions. and Objectives. I apologize for giving you this to review CONTRACTOR HARBOR DREDGING and revise for FY 2000 at INFORMATION 0 I attended the July public *such a late date. We are . We have had some meeting regarding disposal of already into our 3rd month of difficulty in obtaining dredge material in Salem FY 2000! information regarding the Harbor. It was a very hot individual responsible for meeting in many ways! There SCHOOL DENTISTS ® developments once we have was another meeting this past In the packet is the letter approved a plan before the week which I was unable to and information sent to Board. I have arranged with attend. I am attempting to Salem dentists requesting the Building De view the tape of that meeting their services so that our send their print-out of and to speak with CZM and school dentists program may permits issued. That should will give the Board an update continue. I have received two give me the information on this matter at the meeting. responses equaling the necessary to follow-up on our services of five dentists. I conditions and to address any MISCELLANEOUS would appreciate any complaints regarding the We have obtained one suggestions you may have construction activities. recycled automobile. It is regarding this program. I beautiful! But we still need plan to meet with these SESD SL LEGAL to re dentists within the next ACTION 'a a hurry month to discuss their Enclosed is the draft letter The Salem Family Health responsibilities. from the Mayor to the SESD, center is getting stronger than • developed by our legal ever and has opened a branch HAUNTED council, regarding the odor in Peabody. HAPPENINGS M issues. Thank you for making our We have worked out a cook-out so much fun! protocol with the committees Salem Board of Health • September Phone Log 1999 Total Answered *Answered Calls Wednesday September 1, 1999 45 Barb = 210 Thursday September 2, 1999 41 Mary= 418 Friday September 3,1999 1 23 Sue= 415 Saturday September 4, 1999 Sunday September 5, 1999 Monday September 6, 1999 Holiday *Calls Taken : Tuesday September 7, 1999 64 Wednesday September 8, 1999 34 Joanne = 277 Thursday September 9, 1999 53 Jeffrey = 138 Friday September 10, 1999 31 Mark = 82 Saturday September 11, 1999 Jose = 58 Sunday September 12, 1999 Pablo = 10 Monday September 13, 1999 !61!!j Tracy = 160 Tuesday September 14, 1999 44 Ginny = 4 • Wednesday September 15, 1999 44 Barb = 80 Thursday September 16, 1999 41 Mary = 136 Friday September 17, 1999 35 Sue = 98 Saturday September 18, 1999 Sunday September 19, 1999 Monday September 20, 1999 69 43 Office Hours Per Week Tuesday September 21, 1999 64 *=21 Work Days Wednesday September 22, 1999 61 35 Hour Work Week Thursday September 23, 1999 55 Friday September 24,1999 1 41 Saturday September 25, 1999 Monday 8-4 Sunday September 26, 1999 Tuesday 8-4 Monday September 27, 1999 79 Wednesday 8-4 Tuesday September 28, 1999 65 Thursday 8-7 Wednesday September 29, 1999 54 Frid.8-4*Winter Hours Thursday September 30, 1999 39 • Total Calls*_ 1043 MONTHLY REPORT AUGUST 1999 �ADIIIISTRATION y 1 R AMOUNT' IN .DOSES " �r2 ;�, $,IOLOGICS DYSTRIBUTED BURIAL PERMITS 68 @ $5.00 .a 3 F Vv! N<fut34zn� 3. ' ' Diptheria Tetanus . 6 Pertussis 585 �� < 10 LICENSES AND PERMITS $260 :' r Diptheria-TetAnus Tox. (under 6 yrs. ) Immune.Seruin Globulin S VIALS CERTIFICATE OF FITNESS 88@ $25.00 $2,2.0 . } SEALER OF WEIGHTS & MEASURES f. Measles:/Mumps/.Rubella 449 =s� ,Pdlio OPV 250 IPV 270 F rt ------------- ther'ia (adult use) Tetanus 6' Dip 855 Tuberculin PPD . 400 ` HIB,,.Titre 220 ANIMAL BITES REPORTED ry,_ s HepaEitis B 466 ur , i � f� f AVAILABLE 8AL k rig a ;ANNUAL BUDGET EXPENSES SALARY./LONGEVITY,::. $322,402 66, , $344,061.00 $21,658.34' �. T ENCUMBERED AVAILABLE BALD ;r EXPENSES ' NON PERSONNEL: ANNUAL BUDGET - rtW $19,100.00 $421.42 $1,620.00 n 1 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Public Health Nurse Report Fax:(978)740-9705 August 1999 Disease Prevention • In touch with T.B. Clinic and following active cases and case contacts. • 2 PPD screenings in office. • Vaccine Inventory maintained and distributed. • • Investigated Communicable disease cases and reported to the State. Meetings and Clinics 8/5 Hepatitis B Clinic held for Salem Firefighters, Division 4 series #3 8/ 17 Attended meeting with Joanne Scott, Dee Dee Morton RN, Infection Control Nurse, NSMC, and Wendy Krauss RN, Infection Control Nurse. St. Joseph's School • Letters sent to parents regarding new immunization requirements for Children entering Pre-K, K, and Seventh grades. • Current records reviewed. Letters sent to parents if updated physicals were needed. Phoenix School • • New immunization requirements sent home to parents with Phoenix School newsletter. w w��ONDfT ' g CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 MONTHLY REPORT OF COMMUNICABLE DISEASES August 1999 i DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES: CASES: CASES: STATE: Campylobacter 1 0 1 1 Giardia 0 0 0 0 E.Coh 0157H7 1 0 1 1 Hepatitis 0 2 2 2 Lyme Disease 0 0 0 0 Meningitis 0 0 0 0 Pertussis 0 0 0 0 Salmonella 1 0 1 1 Shigella 1 .0 1 1 Varicella 0 0 0 0 • Reportable Diseases excluded from above have not been identified this month. • C ��P�S�Gi1Y1A'f7,A/''y Au wV1999 Cam�y�e�+Uact�-: • 18 y/o male. Non Foodhandler. Case believes he was ill from eating chicken at a BBQ with friends at Salem Willows. No one else at the Party was ill. F. COW 0157f(7: • 30 o female. Non foodhandler. Case went tent camping Y/ p g in New ! Hampshire with 35 other people. She was the only one ill. She did not eat meat. She did eat Corn on the Cob from a roadside farm. They did not wash the corn prior to grilling it with the husk on. No one else was ill. C�icwd%a�i�r: • 40 y/o female. Non foodhandler. Colorado Rafting trip and Camping in the Grand Canyon during incubation period. Swam in the Colorado River. Expedition company supplied filtered water to drink during the trip. Husband was not ill. • 2 carry over cases sent to state. S • 40 y/o male. Non foodhandler. Case suspects the chicken he BBQ'd at home. He defrosted the frozen chicken on the counter all afternoon, and he did not think it was cooked enough, but he ate it anyway. Daughter had a few bites, but was not ill. • 35 y/o male. Non foodhandler. Case states he was ill for one month before seeking medical attention. Incubation range for Shigella is 12- • 96 hours. Suspect food or drink: Unknown. mmul � c "• 011 1� N may.t NOW I - 92 • City Of Salem Environmental Health Division --- Inspection Monthly Summary Month -------------- Type Jul 99 Aug 99 Count 2 3 5 CFI 60 91 151 CFR 12 0 12 CH 8 10 18 CON 3 9 12 CR 3 5 8 EC 5 11 16 EH 0 1 1 EPR 0 3 3 FC 0 3 3 FRH 4 3 7 FSD 3 6 9 FSI 19 17 35 FSR 6 13 13 GN 4 7 11 GN/TR 2 0 2 HI 12 16 28 HR 7 14 21 • HR/CFI 0 1 1 - MUP 0 1 RC 1 1 2 RFD 1 2 "1 5 8 13 RFR 1 1 2 RO 1 3 4 RRH 1, 0 1 SB 2 12 14 SM 5 10 15 SP 1 1 2 TFI 0 28 28 ` A TR 38 37 75 TR/GN 1 0 1 Count 207 316 523 .., BB - Bed/Break. FSI - Food Serv. Ins. RFD - Retail Food Disc. CFI - Cert. Fit,: FSR - Food Serv. Rein.:: RFI - Ret : Insp. CFR - Cert. Fit.Reinsp. GN _ Gen. Nuisance RFR - Retail `Food. Rein: CH . Court Hearing HI - Housing Insp. RO - Rodent Control !j CON Const-16- Serv. HR - Housing Reinsp. SC - Suntan CR Coapliance 'Rev. LPI - Lead :Paint Insp. SES SE9D Odor .- CT Computer Time. MS_ Massage SM - Seminars/Meetings EC Envirn Compl. MUP - Mobile Food - Insp. SP - Swim Poo3s' 4PR Ext Paint OG - Overgrpwth - \ SB Swim. IBeaches C Food Cgmpl , OS - Off. Sub. Ins FRH Food Related Hear. RC,. - Rec. . Gam p $T Soil Test/Septic. P� TFI Temp Food. FSD` Food Sery °;Disc.' RFC - Retail Food Compl. TR - Trash I • Salem Board of Health August Phone Logs 1999 Total Answered Answered Calls Monday August 2, 1999 53 Barb = 163 Tuesday August 3, 1999 52 Mary = 286 Wednesday August 4, 1999 46 Sue = 649 Thursday August 5, 1999 43 Friday August 6, 1999 21 Saturday August 7, 1999 Calls Taken : Sunday August 8, 1999 Monday August 9, 1999 71 Joanne =214 Tuesday August 10, 1999 43 Jeffrey =192 Wednesday August 11, 1999 46 Mark =100 Thursday August 12, 1999 53 Jose =76Y 9 day August 13 1999 23 Pablo = 16 aturday . August 14, 1999 Tracy = 110 Sunday August 15, 1999 Ginny =10 Monday August 16, 1999 53 Barb = 70 Tuesday August 17, 1999 54 Mary =82 Wednesday August 18, 1999 47 Sue = 128 Thursday August 19, 1999 58 Friday August 20, 11999 1 30 Saturday August 21, 1999 35 Office Hours Per Week Sunday August 22, 1999 *=22 Work Days Monday August 23, 1999 71 Tuesday August 24, 1999 52 Monday 8-4 Wednesday August 25, 1999 58 Tuesday 8-4 Thursday August ust 26 1999 .41 Wednesday 8-4 Friday August 27, 1999 21 Thursday 8-7 SaturdayAu gust 28, 1999 Frid. 8-12"Summer Hours Sunday August 29, 1999 nday August 30, 1999 30 Tuesday August 31, 1999 31 Total Calls*_ DULY 1999x x K' + ADMINI:STRATION MONTHLY REPORT °t f ^Sft1k f!tvk h C F k V. AMOUNT IN DOSES "BIOLOG.ICS DISTRIBUTED = � BURIAL PERMITS 45 @ $5.00 _ . $225 a, Diptheria, Tetanus & Pertussis 480 .hrt ptheria Tetanus, Tox. (under 6 yrs. ) -o- LICENSES AND PERMITS Y,�s{ rlmmune Serum Glob.ulin -0- CERTIFICATE OF FITNESS 68 @ $25.00 170000 ' Measles/Mumps+/Rubella 530 SEALER OF WEIGHTS AND MEASURES $40.0-, n - 3 Polio" 100 z, Vie,* Tetanus 6 Dipthe"ria (adult use) 690 � c7Tubercun PPD „ 640 li s 2 HIBTitre 70 2 slat ANIMAL BITES REPORTED s � . 410 ' Jf r g�+„fkw�, Z AVAILABLE BALANCE, aa"k; EXPENSES ��rx xSALARY/LONGEVITY ANNUAL BUDGET $344,061.00 $344,061.00 M ! ? AVAILABLE BALANCE EXPENSES ENCUMBERED 8 r ' NON-PERSONNEL: ANNUAL BUDGET r $19,100.00cis $19,100.00 --- ---- ' asp ! �c �{ 4 k ittShk:�{Y'�' 4 tl"Y w �ONDIT • ii' r., A ,O CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO Public Health Nurse Report NINE NORTH STREET HEALTH AGENT Jul 1999 P Tel:(978)741-1800 Fax:(978)740-9705 Disease Prevention In touch with T.B. Clinic and following active cases and case contacts. • 3 PPD screenings in office. 1 positive PPD. Client referred to North Shore Pulmonary Clinic for further evaluation. • • Vaccine Inyentory maintained and distributed. • Investigated Communicable disease cases and reported to the State. Meetings and Clinics 7/16 Hepatitis B Clinic held for Salem Firefighters, Division 2 series #3 7/22 Hepatitis B_Clinic held for Salem Firefighters, Division 1 series #3 7/27 Hepatitis B Clinic held for Salem Firefighters, Division 3 series #3 7/2 CORI'S reviewed at Boys and Girls Club with Steve O'Grady. 7/23 CORI'S reviewed at Marblehead YMCA for Children's Island with Chris Grant, Assistant Director. 7/30 Essex County D.A.R.E. Camp inspection conducted with Jeff Vaughan. Permit issued, CORPS reviewed with Peter Baglioni, • Director. w �CjMINE�� CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 MONTHLY REPORT OF COMMUNICABLE DISEASES July 1999 DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES: CASES: CASES: STATE: • I Campylobacter 2 0 2 2 Giardia 0 0 0 0 E.Coli 0157H7 0 0 0 0 Hepatitis 2 4 0 0 Lyme Disease 3 0 3 0 Meningitis 0 0 0 0 Pertussis 0 0 0 0 Salmonella 0 0 0 0 Shigella 0 .0 0 0 Varicella 0 0 0 0 • Reportable Diseases excluded from above have not been identified this month. CITY OF SALEM HEALTH DEPARTMENT Nine North Street • Salem, Massachusetts 01970 July 1999 Cam��yU�+Ua+cter • 63 y/o male. Non foodhandler. Case suspects hot dog he ordered at Maria's Restaurant. His wife ordered same lunch, but did not eat it Because she thought the hot dog tasted unusual. This was reported To Jeff Vaughan. Case has recovered. • 43 y/o male. Occupation: Priest. He was traveling with wife to a Pennsylvania monastery before and during incubation period. He believes he became ill from eating at the monastery. A second stool sample was obtained 48 hours after antibiotic completion. It was • negative. This case was discussed with epidemiologist on call Dr. Marcash. ' • Hepatitis B. 91 y/o female. Admitted to hospital for other medical Reasons. Patient died. Hepatitis was not the primary cause of death. • Hepatitis B.- 43 y/o female. Office Manager. Diagnosed in 1995. Son Was also tested in 1995, and was positive. She had an emergency blood transfusion while pregnant in Africa in 1975. • 51 y/o female. Confirmed by lab results. • 45 y/o male. Confirmed by lab results. • 53 y/o male. Confirmed by lab results. • • City Of Salem Environmental Health Division - - Inspection Monthly Summary Month ---------------------------------------------------------------------------------------------- Type Jul 98 Aug 98 Sep 98 Oct 98 Nov 98 Dec 98 Jan 99 Feb 99 Mar 99 Apr 99 May 99 Jun 99 Count ------------- ------ ------ ------ ------ ------ ------ ------ ------ ------ ------ ------ ------ ===== 0 0 0 0 0 0 0 0 0 0 0 1 1 BB 0 0 0 0 0 0 0 1 3 0 1 0 5 CFI 79 55 83 60 59 59 43 48 54 41 62 68 711 CFR 5 6 4 2 1 5 0 10 1 8 5 26 73 CH 7 8 2 4 3 20 16 19 16 32 8 8 143 CON 14 8 8 6 0 4 2 7 2 12 6 11 80 CR 2 1 5 6 6 1 5 3 12 5 4 4 54 CRI 0 0 0 0 0 0 0 0 0 0 0 3 3 EC 20 7 5 7 19 14 20 3 6 3 6 3 113 EPR 2 1 3 4 0 0 0 0 1 3 0 1 15 FC 1 0 2 0 2 5 0 0 0 1 1 1 13 FRH 0 0 0 0 0 0 2 0 0 0 0 1 3 FSD 0 0 2 1 3 1 0 3 4 1 2 0 17 FSI 23 15 27 29 13 9 16 26 28 25 24 27 262 FSR 6 5 7 9 14 6 5 9 13 14 12 10 110 GN 8 8 4 2 1 4 0 1 6 4 13 10 61 HI 14 23 13 8 11 11 14 16 57 35 30 10 242 HR 11 14 11 24 7 21 10 7 22 10 8 7 152 HRI 0 0 0 0 1 0 0 0 0 0 0 0 1 LPI 0 0 0 0 0 1 0 0 2 0 0 3 6 MS 0 1 0 0 0 5 0 0 1 0 0 1 8 �P 2 0 0 2 0 1 0 1 0 4 3 0 13 0 0 0 0 0 0 0 0 0 0 0 1 1 OS 1 0 12 0 0 0 0 0 0 11 1 0 25 OWNER NO SHOW 0 0 0 0 0 0 0 0 0 0 0 1 1 RC 2 0 0 0 0 0 0 0 0 0 0 4 6 RC/SP 0 0 0 0 0 0 0 0 0 0 0 1 1 RFI 5 3 9 7 9 3 2 3 5 3 5 11 65 RFL 0 0 0 0 0 0 0 0 0 0 0 1 1 RFR 2 1 2 5 3 0 4 2 1 1 2 1 24 RO 2 0 0 0 0 0 2 6 2 5 6 2 25 SB 62 36 13 0 0 0 0 0 0 0 0 21 132 SC 0 0 0 0 0 0 5 0 0 0 0 0 5 SES 2 0 0 0 0 2 0 0 0 1 2 0 7 SM 1 3 2 3 8 2 6 3 17 11 15 7 78 SP 0 0 0 0 0 0 0 0 0 0 6 2 8 v� ST 0 0 0 0 2 0 0 1 1. 1 1 0 6 TFI 13 0 0 16 0 0 0 0 0 0 14 15 58 TR 48 74 59 106 21 40 78 48 73 81 70 49 747 Count 332 269 273 301 183 214 230 217 327 312 307 311 3276 BB - Bed/Break. 2 FSI - Food Serv.. Ins.243* RFD - Retail Food Disc. CFI - Cert. Fit.890* FSR - Food Serv. Rein.:lll* ,RFI - Ret: Insp.100*- CFR - Cert- �Fit.Reinsp. GN Gen. Nuisance 44* RFR - Retail -Food' Rein. CH _ - Court Hearing .44-,# HI - Housing Insp. 312* RO - Rodent Control7..13* CON - Constable Serv. HR - Housing Reinsp.172* SC - Suntan 5 - Compliance Rev. LPI Lead Paint-Insp. 26* SES - SESD Odor. 3* . Computer.;Time MS ,," - Massage -7 SM - Seminars/Meetings':.- EC - Envirn Comp1.85* MUP —Mobile Food Insp. 13* SP - Swim. Pools 14 EPR - Ext. Paint '5* OG Overgrpwth. SB - Swim.' Beaches 111* FC - Food Co6p1.22* OS - Off. Sub I•nsp 10* ' ST - Soil� Test/Septic. FRH - Food Related-Hear.' RC Rec. Camp,�5 ' . TFI - Temp Food 65* FSD - Food Sdrv. Disc. RFC -• Retail Food Compl. TR - Trash 75:8* _..._ r Salem Board of Health • July 1999 Phone Log Total Answered Thursday July 1, 1999 54 *Answered Calls Friday July 2, 1999 24 Barb= 120 Saturday July 3, 1999 Mary= 374 Sunday July 4, 1999 Sue= 311 MondayJul 5, 1999 T II Tuesday July 6, 1999 41 *Calls Taken Wednesday July 7, 1999 49 Joanne= 160 Thursday July 8, 1999 46 Jeffrey= 177 Friday July 9, 1999 12 Mark= 59 Saturday July 10, 1999 Jose= 47 Sunday July 11, 1999 Pablo= 13 Monday July 12, 1999 71 Tracy= 123 Tuesday July 13, 1999 52 Ginny= 8 ednesday July 14, 1999 39 Barb= 40 Thursday July 16, 1999 32 Mary= 125 Friday July 16, 1999 16 Sue= 53 Saturday, July 17, 1999 *35 Office Hours Per Week Sunday July 18, 1999 * = 21 Work Days Monday July 19, 1999 37 Tuesday July 20, 1999 36 Wednesday July 21, 1999 29 Monday 8-4 Thursday July 22, 1999 48 Tuesday 8-4 Friday July 23, 1999 11 Wednesday 8-4 Saturday July 24, 1999 Thursday 8-7 Sunday July 25, 1999 Friday 8-12*Summer Hours Monday July 26, 1999 34 Tuesday July 27, 1999 58 Wednesday July 28, 1999 37 hursday July 29, 1999 63 Tiday July 30, 1999 16 ISaturday I July 31, 1999 Total Calls= 806 0 ADMINISTRATION - MONTHLY REPORT JUNE 1999 AMOUNT BIOLOGICS DISTRIBUTED AMOUNT IN DOSES Dipcheria , Tetanus & Pertussis 510 BURIAL PERMITS 53 @ $5.00 $265.00 = Dipcheria-Tetanus Tox . (under 6 yrs . ) $1,265.00 10 LICENSES AND PERMITS Immune Serum Globulin 2 vials CERTIFICATE OF FITNESS 69@ $25.00 $1,725.00 Measles/Mumps/Rubella SEALER OF WEIGHTS & MEASURES $130.00 280 Polio OPV — 20 IPV — 650 Tetanus & Dipcheria (adult use) 750 Tuberculin PPD 500 —1— HIB Ticre 340 ANIMAL BITES REPORTED Hepatitis B 290 AVAILABLE BALANCE ALARY/LONGEVITY : ANNUAL BUDGET EXPENSES$371,430.08 $5,699.05 $329,827 .00 46,408.15 supp. appr. 893.98 TRANS. NON-PERSONNEL . �NNUAL_BJDGET EXPENSES ENCUMBERED AVAILABLE BALANCE $23,500.06 ---- $499.94 $21 ,800.00 2,200.00 TRANS. I 1 4 �v��ONDfT�i n � 3 I�8 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 Public Health Nurse Report June 1999 Activities Disease Prevention • In touch with T.B. Clinic and following active cases and case contacts. • 2 PPD screenings done in office. • Vaccine inventory maintained and distributed. • Investigated communicable disease cases and reported to the M.D.P.H. case of T.B. • Meetings and Clinics 6/4 St. Joseph's Third Hepatitis B vaccinations administered to 7 students. 6/8 Attended TB case management meeting held at Salem Hospital, to discuss suspect active, or active TB cases in the North Shore region. 6/9 Attended mandatory sexual harassment seminar at Salem Police Station for City of Salem Employees. 6/10 Camp Inspection of Boy's and Girls Club with Jeff Vaughn. CORIS reviewed, Camp licensed for 1999 e 6/11 Third Hepatitis B vaccine administered to two Phoenix School students. 6/11 Attended Public Health Nurse meeting at Tewksbury,Hospital. The meeting included a presentation by Dennis Michaud, from the MDPH, about the Computer Software for the Massachusetts Immunization Information System. The system will improve immunization tracking and vaccine inventory management. 6/14 6/21, 6/22 Preschool Eyescreenings at Bentley School. 106 children screened • 15 children referred. w v��ONUlT 3 run.e CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 6/15 Mantoux testing for 20 employees at Morgan Memorial Mentally Retarded Day Care center. Department of Mental Health recommends yearly testing of their Employees. 6/17 All employees were negative. 6/19 Attended Household Hazardous Waste Day. 6/22 Camp inspection of Campfire Camp with Jeff Vaughn. CORPS are pending. Pool inspected, camp is licensed for 1999 6/24 Camp inspection of Children's Island with Jeff Vaughn. CORI'S are pending. Pool inspected, camp is licensed for 1999 • 6/28 Camp inspection of Camp Pine Crest with Virginia Moustakis. CORPS reviewed, camp is licensed for 1999 • • 'v • MONTHLY REPORT OF COMMUNICABLE DISEASES June 1999 DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES: CASES: CASES. STATE: • Campylobacter 1 0 1 1 Giardia 2 0 2 2 E.Coli 0157H7 1 0 1 1 Hepatitis 2 4 0 0 Lyme Disease 1 0 0 0 Meningitis 0 0 0 0 Pertussis 0 0 0 0 Salmonella 1 0 0 0 Shigella 0 0 0 0 Varicella 0 0 0 0 • Reportable Diseases excluded from above have not been identified this month. • Syindvia Qf C D� June 19 9 9 Campylobacter: 18 y/o male. According to his mother, he is not a Foodhandler. Does not recall any food prior to onset of symptoms. Case has not returned my • phone calls. Giardia: 2 cases. 1 y/o female, 4 y/o male. Both children were adopted from Krafnodar Orphanage in Russia. Both children were asymptomatic. Stool samples were obtained by physician as part of their routine physical upon arrival to the U.S. Children do not attend Day Care. E.Coli O157H7 12 y/o female. Suspect food: Rare Hamburgers Consumed on 5/28, 5/29, 5/30 on a camping trip with a Friend's family. No one else was ill Child's mother states Her daughter eats hamburger very rare. Public health i Fact sheet sent to mother regarding E.Coli 0157H7 Child was not hospitalized, and has recovered. Lyme Disease: 2 Cases. Will be on Jul report. ym Y Hepatitis C: 2 Cases. Salmonella: 1 Will be on July report. • • • s City Of Salem Environmental Health Division - - Inspection Monthly Summary Month ---------------------------------------------------------------------------------------------- Type Jul 98 Aug 98 Sep 98 Oct 98 Nov 98 Dec 98 Jan 99 Feb 99 Mar 99 Apr 99 May 99 Jun 99 Count ------------- ------ ------ ------ ------ ------ ------ ---- 0 0 0 0 0 U V 0 0 0 0 1 1 BB 0 0 0 0 0 0 0 1 3 0 1 0 5 CFI 79 55 83 60 59 59 43 48 54 41 62 68 711 CFR 5 6 4 2 1 5 0 10 1 8 5 26 73 CH 7 8 2 4 3 20 16 19 16 32 8 8 143 t CON 14 8 8 6 0 4 2 7 2 12 6 11 80 CR 2 1 5 6 6 1 5 3 12 5 4 4 54 CRI U 0 0 0 0 0 0 0 0 0 0 3 3 EC 20 7 5 7 19 14 20 3 6 3 6 3 113 EPR 2 1 3 4 0 0 0 0 1 3 0 1 15 q= FC 1 0 2 0 2 5 0 0 0 1 1 1 13 FRH 0 0 0 0 0 0 2 0 0 0 0 1 3 FSD 0 0 2 1 3 1 0 3 4 1 2 0 17 FSI 23 15 27 29 13 9 16 26 28 25 24 27 262 , FSR 6 5 7 9 14 6 5 9 13 14 12 10 110 GN 8 8 4 2 1 4 0 1 6 4 13 10 61 HI 14 23 13 8 11 11 14 16 57 35 30 10 242 HR 11 14 11 24 7 21 10 7 22 10 8 7 152 HRI 0 0 0 0 1 0 0 0 0 0 0 0 1 LPI 0 0 0 0 0 1 0 0 2 0 0 3 6 MS 0 1 0 0 0 5 0 0 1 0 0 1 8 MUP 2 0 0 2 0 1 0 1 0 4 3 0 13 NC 0 0 0 0 0 0 0 0 0 0 0 1 1 OS 1 0 12 0 0 0 0 0 0 11 1 0 25 OWNER NO SHOW 0 0 0 0 0 0 0 0 0 0 0 1 1 RC 2 0 0 0 0 0 0 0 0 0 0 4 6 RC/SP 0 0 0 0 0 0 0 0 0 0 0 1 1 RFI 5 3 9 7 9 3 2 3 5 3 5 11 65 RFL 0 0 0 0 0 0 0 0 0 0 0 1 1 RFR 2 1 2 5 3 0 4 2 1 1 2 1 24 RO 2 0 0 0 0 0 2 6 2 5 6 2 25 SB 62 36 13 0 0 0 0 0 0 0 . 0 21 132 SC 0 0 0 0 0 0 5 0 0 0 0 0 5 SES 2 0 0 0 0 2 0 0 0 1 2 0 7 SM 1 3 2 3 8 2 6 3 17 11 15 7 78 Sp 0 0 0 0 0 0 0 0 0 0 6 2 8 ST 0 0 0 0 2 0 0 1 1 1 1 0 6 TFI 13 0 0 16 0 0 0 0 0 0 14 3 46 TR 48 74 59 106 21 40 78 48 73 81 70 49 747 Count 332 269 273 301 183 214 230 217 327 312 307 299 3264 BB - Bed/Break. 2 FSI - Food Serv. Ins . 243* RFD - Retail Food Disc . CFI - Cert . Fit . 890* FSR - Food Serv. Rein. 11l* RFI - Ret . Insp . 100* CFR - Cert . Fit .Reinsp. GN _ Gen. Nuisance 44* RFR - Retail Food Rein. CH - Court Hearing 44* HI - Housing Insp. 312* RO - Rodent Control 13* CON - Constable Serv. HR - Housing Reinsp. 172* SC - Suntan 5 CR - Compliance Rev. LPI - Lead Paint Insp. 26* SES - SESD Odor 3* CT _ Computer Time MS - Massage 7 SM - Seminars/Meetings EC - Envirn. Compl . 85* MUP - Mobile Food Insp. 13* SP - Swim. Pools 14 EPR - Ext . Paint 5* OG - Overgrowth SB - Swim. Beaches 111* FC - Food Compl . 22* OS - Off . Sub. Insp. 10* ST - Soil Test/Septic FRH - Food Related Hear. RC - Rec . Camp 5 TFI - Temp. Food 65* FSD - Food Serv. Disc . RFC - Retail Food Compl . TR - Trash 758* 71 • NEWSLETTER 48 July 13, 1999 AGENT'S REPORT TO THE BOARDOo the SESD consultant's responses and has about a preliminary report on the 20% return rate to date. Dot HHWCD* condition of the outfall pipe. Flaherty, of Tobacco Control, About 675 cars attended Overall, the report is positive is sending a second mailing the Household Hazardous about the condition of the now which may increase the Waste Collection Day. pipe. There are a couple of return rate. Everyone seemed happy with areas of concern: If one joint the service, particularly was not installed correctly in FOREST RIVER POOL because it also included tires, the original installation, were We have permitted the propane tanks, and electronic there others installed new pool. The filtration equipment. incorrectly? What caused the system is fantastic. I would injury to the diffuser? Why encourage you to view the l Y Y g MAHB SEMINARS% was a large portion of the quality of the water, Included in the packet is outfall, near the channel, particularly if you had seen it Oinformation regarding Iris uncovered? The complete before. Association of Health Boards report is expected by the end seminars in the fall. This of July. HOME DEPOT seminar is presented CONSTRUCTIONS specifically for Board of CZM DREDGING PLAN 2 A rock crushing operation Health members. I have . Enclosed is a summary page at the Home Depot attended two and would of the CZM (Coastal Zone construction site had caused a highly recommend them. Management) screening severe dust nuisance for There is one in Marlborough outcome for potential harbor residents in the Traders Way on November 13th and one in dredging disposal sites. Len area. Enclosed is a copy of a Lowell on November 20th. has invited the executive cease and desist order we sent Let me know if you would director of Salem Sound 2000 in response to complaints and like to attend. to the meeting to discuss that our investigation. As a result, organization's view of the the operation was moved to a BOARD plan. different location on site, at a CONSIDERATIONI greater distance from I have included memos in COMMUNITY HEALTH residents. the packet requesting Board ASSESSMENTn action on several matters. Paul has summarized BOH COOKOUTO Thank you for your some the "professional" survey Don't forget...August 14th. consideration. results whiGh-4ave been Invitations will be sent. received to date. That 0000 SESD OUTFALL PIPED summary is in the packet. Enclosed in the packet is Tobacco Control has been receiving the residents' survey I T • Salem Board of Health June Phone Logs 1999 Total Answered Answered Calls Tuesday June 1, 1999 68 Barb = 268 Wednesday June 2, 1999 63 Mary= 422 Thursday June 3, 1999 70 Sue= 644 Friday June 4, 1999 32 Saturday June 5, 1999 Sunday June 6, 1999 Calls Taken Monday June 7, 1999 51 Tuesday June 8, 1999 54 Joanne = 349 Wednesday June 9, 1999 57 Jeffrey = 143 Thursday June 10, 1999 60 Mark = 92 Friday June 11, 1999 30 Jose = 75 0unturday June 12, 1999 Pablo = 15 day June 13, 1999 Tracy = 179 Monday June 14, 1999 53 Ginny = 31 Tuesday June 15, 1999 52 Barb = 97 Wednesday June 16, 1999 51 Mary = 135 Thursday June 17, 1999 83 Sue = 117 Friday June 18, 1999 44 Saturday June 19, 1999 Sunday June 20, 1999 38 Office Hours Per Week Monday June 21, 1999 62 *=22 Work Days Tuesday June 22, 1999 49 Wednesday June 23, 1999 55 Monday 84 Thursday June 24, 1999 62 Tuesday 84 Friday June 25, 1999 26 Wednesday 84 Saturday June 26, 1999 Thursday 8-7 Sunday June 27, 1999 Friday 84 Monday June 28, 1999 77 esday June 29, 1999 62 Wednesday June 30, 1999 73 Total Calls*_ � � - . . ,\:.4 -+r:.r• . ti_. }'y'�ay,.. ya.'.."°-�i.�a"_`tk.^a ;'vr;»—�s�i -- —'-- BOH Telephone Log Record Month Total # Calls # Days Worked May-97 864 21 June-97 932 21 July-97 975 22 August-97 758 21 September-97 921 21 October-97 1124 22 November-97 828 17 1/2 December-97 815 20 1/2 January-98 760 20 February-98 739 19 March-98 1038 22 April-98 924 20 1/2 May-98 966 20 June-98 1070 22 July-98 1069 22 August-98 870 21 September-98 866 21 October-98 963 21 November-98 765 18 1/2 December-98 675 21 January-99 705 19 February-99 757 19 March-99 1057 23 April-99 897 20 1/2 May-99 892 20 Jun-99 1234 22 • ADMINISTRATION - MONTHLY REPORT MAY 1999 { AMOUNT _ s AMOUNT IN DOSES BIOLOGICS DISTRIBUTED $260.00 Diptheria , Tetanus & Pertussis -� 540 BURIAL PERMITS 52 @ $5.00 = Diptheria-Tetanus Tox. (under 6 yrs . ) 40 LICENSES AND PERMITS $805.00 Immune Serum Globulin 11 CERTIFICATE OF FITNESS 63@ $25.00 $1,575.00 i Measles/Mumps/Rubella 267 SEALER OF WEIGHTS & MEASURES $70.00 Polio OPV - 150 IPV -150 Tetanus & Diptheria (adult use) 705 r Tuberculin PPD 1020 } HIB Titre 450 ANIMAL BITES REPORTED -2- a Hepatitis B 324 i 1 } f S EXPENSES SALARY/LONGEVITY : ANNUALAVAILABLE BALANCE { BUDGET $43,922.40 $282,206.73 $329,827.00 46,408.15 - SUPP. APPR. 1,893.98 - TRANFERS NON-PERSONNEL: ANNUAL BUDGET EXPENSES ENCUMBERED AVAILABLE BALANCE $17,484.68 $1,922.16 $2,710.89 $21 ,800.00 1,200.00 - SEALER } City Of Salem • Environmental Health Division --- Inspection Monthly Summary Month -------------------------------------------------------------------------------------- Type Jul 98 Aug 98 Sep 96 Oct 98 Nov 98 Dec 98 Jan 99 Feb 99 Mar 99 Apr 99 May 99 Count BB 0 0 0 0 0 0 0 1 3 0 1 5 CFI 79 55 83 60 59 59 43 48 54 41 62 643 CFR 5 6 4 2 1 5 0 10 1 8 5 47 CH 7 8 2 4 3 20 16 19 16 32 8 135 CON 14 8 8 6 0 4 2 7 2 12 6 69 CR 2 1 5 6 6 1 5 3 12 5 4 50 EC 20 7 5 7 19 14 20 3 6 3 6 110 EPR 2 1 3 4 0. 0 0 0 1 3 0 14 FC 1 0 2 0 2 5 0 0 0 1 1 12 FRH 0 0 0 0 0 0 2 0 0 0 0 2 FSD 0 0 2 1 3 1 0 3 4 1 2 17 FSI 23 15 27 29 13 9 16 26 28 25 24 235 FSR 6 5 7 9 14 6 5 9 13 14 12 100 GN 8 8 4 2 1 4 0 1 6 4 13 51 HI 14 23 13 8 11 11 14 16 57 35 30 232 HR 11 14 11 24 7 21 10 7 22 10 8 145 HRI 0 0 0 0 1 0 0 0 0 0 0 1 LPI 0 0 0 0 0 1 0 0 2 0 0 3 MS 0 1 0 0 0 5 0 0 1 0 0 7 MUP 2 0 0 2 0 1 0 1 0 4 3 13 OS 1 0 12 0 0 0 0 0 0 11 1 25 RC 2 0 0 0 0 0 0 0 0 0 0 2 �FI 5 3 9 7 9 3 2 3 5 3 5 54 FR 2 1 2 5 3 0 4 2 1 1 2 23 RO 2 0 0 0 0 0 2 6 2 5 6 23 SB 62 36 13 0 0 0 0 0 0 0 0 ill SC 0 0 0 0 0 0 5 0 0 0 0 5 SES 2 0 0 0 0 2 0 0 0 1 2 7 SM 1 3 2 3 8 2 6 3 17 11 15 71 SP 0 0 0 0 0 0 0 0 0 0 6 6 ST 0 0 0 0 2 0 0 1 1 1 1 6 TFI 13 0 0 16 0 0 0 0 0 0 14 43 TR 48 74 59 106 21 40 78 48 73 81 70 698 Count 332 269 273 301 183 214 230 217 327 312 307 2965 BB - Bed/Break. 2 FSI - Food Serv. Ins . 243* RFD - Retail Food Disc . CFI - Cert . Fit . 890* FSR - Food Serv. Rein. 11l* RFI - Ret . Insp. 100* CFR - Cert . Fit .Reinsp. GN _ Gen. Nuisance 44* RFR - Retail Food Rein. CH - Court Hearing 44* HI - Housing Insp. 312* RO - Rodent Control 13* CON - Constable Serv. HR - Housing Reinsp. 172* SC - Suntan 5 CR - Compliance Rev. LPI - Lead Paint Insp. 26* SES - SESD Odor 3* I CT _ Computer Time MS - Massage 7 SM - Seminars/Meetings i EC - Envirn. Compl . 85* MUP - Mobile Food Insp. 13* SP - Swim. Pools 14 EPR - Ext . Paint 5* OG - Overgrowth SB - Swim. Beaches 111* FC - Food Compl . 22* OS - Off . Sub. Insp. 10* ST - Soil Test/Septic H - Food Related Hear. RC - Rec . Camp 5 TFI - Temp.Food 65* D - Food Serv. Disc . RFC - Retail Food Compl . TR - Trash 758* 6/4/99 Salem Board of Health May 1999 Phone Log Total Answered Answered Calls Monday May 3, 1999 40 Tuesday May 4, 1999 42 Barb= 190 Wednesday May 5, 1999 51 Mary=326, Thursday May 6, 1999 41 Sue =376 Friday May 7, 1999 32 Saturday May 8, 1999 Calls Taken Sunday May 9, 1999 Joanne =262 Monday May 10, 1999 59 Jeffrey =109 Tuesday May 11, 1999 62 Mark=96 Wednesday May 12, 1999 48 Jose=59 Thursday May 13, 1999 54 Pablo=8 Friday May 14, 1999 32 Tracy=105 • Saturday May 15, 1999 Ginny=35 Sunday May 16, 1999 Barb=45 Monday May 17, 1999 P53 Mary=88 Tuesday May 18, 1999 40 Sue =85 Wednesday May 19, 1999 49 *38 Office Hours Per Week Thursday May 20, 1999 43 * =20 Work Days Friday May 21, 1999 28 Saturday May 22, 1999 Sunday May 23, 1999 56 Monday 8-4 Monday May 24, 1999 Tuesday 8-4 Tuesday May 25, 1999 38 Wednesday 8-4 Wednesday May 26, 1999 45 Thursday 8-7 Thursday May 27, 1999 40 Friday 8-4 Friday May 28, 1999 39 Saturday May 29, 1999 Sunday May 30, 1999 • Monday May 31, 1999 Holiday Total Calls * =892 • 0 ADMINISTATION - MONTHLY REPORT APRIL 1999 R AMOUNT — BIOLOGICS DISTRIBUTED AMOUNT IN DOSES BURIAL PERMITS 45 @ $5.00 = $225.00 , Diptheria , TPranus 6 Pertussis 465 Diptheria-Tetanus Tox . (under 6 yrs . ) LICENSES AND PERMITS $998.40 70 Immune Serum Globulin -0. CERTIFICATE OF FITNESS58 @ $25.00 $1,450.00 Measles/Mumps/Rubella 193 Polio opv - 30 ipv - 120 Tetanus 6 Diptheria (adult use) 460 Tuberculin PPD 560 HIB Titre 420 ANIMAL BITES REPORTED 1 Hepatitis B 340 z r YR` 8I flfi EXPENSES AVAILABLE BALANCE SALARY/LONGEVITY : ANNUAL BUDGET $329,827 .00 $308,206.73 $69,922.40 46,408.15 - SUPP. APPR. 1,893.98 - TRANSFERS EXPENSES ENCUMBERED AVAILABLE BALANCE NON-PERSONNEL: ANNUAL BUDGET $17,778.77 $2,216.25 $3,004.98 $21 ,800.00 1,200.00 - SEALER ��ONUIT,�s CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 Public Health Nurse Report April 1999 Activities Disease Prevention i • In touch with T.B. Clinic and following active cases and case contacts. • Three PPD screenings done in office. • Vaccine inventory maintained and distributed. • • Investigated communicable disease cases and reported to the M.D.P.H. case of T.B. Meetings and Clinics 4/6 Salem Police Blood Pressure Screening 17 Screened,no referrals. 4/11-12 Salem Wellness Fair. Approximately 1,000 attended. 4/9 Discussed recent nursing activities and active cases with Dr. Miaskiewicz. St. Joseph's Physicals will be held May 13, 1999 St.Joseph's School : Letters sent to parents for permission/refusals for physicals PHOENIX SCHOOL Letters sent to parents for permission/refusals for postural screenings On May 14, 1999 • I s • MONTHLY REPORT OF COMMUNICABLE DISEASES April 1999 DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES: CASES: CASES: STATE: • Campylobacter 0 0 0 0 Giardia 0 0 0 0 Hepatitis 3 5 2 2 Lyme Disease 0 0 0 0 Meningitis 0 0 0 0 Pertussis 0 0 0 0 Salmonella 1 0 1 1 Shigella 0 0 0 0 Varicella 0 0 0 0 Reportable Diseases excluded from above have not been identified this • month. r M r • Summary of Communicable Diseases in Salem April 1999 Three new cases of Hepatitis C reported. There are still 5 carry over Cases that I have not been able to contact by phone, or by mail. Salmonella: 25 year old male. He is employed at a mattress factory. He feels he was ill from eating at Portside Diner in Danvers. The time Correlates with incubation period. The Danvers Health Dept. was • Notified. According to patient he was hospitalized for four days. Lives with girlfriend who is asymptomatic, and not a f000dhandler. • �&ORDIT, c CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT May 4, 1999 Tel:(978)741-1800 Fax:(978)740-9705 Tom O'Connor PO Box 157 Beverly, MA., 01915 Dear Tom, Below is a list of dates for the Pre-school eye screenings: These particular school dates have been confirmed: • May loth House of Seven Gables 9:00am 33 Students • • May l lth Salem YMCA 9:00am 36 Students • May 17th Young World 9:00am 77 Students • May 24th Salem State College 9:00am 30 Students • May 25th St. Joseph's 9:00am 30 Students • June lst Catholic Charities 9:00am 49 Students • June 7th Run-a-muck 9:00am 80 Students • HeadStart No date as of May 4, 1999 > • Early Childhood Center No date as of May 4, 1999 Please call me if you have any problems with the above dates. Our first screening at Salem Point Child Care was a success. Thank you for Volunteering so much time and effort for the little residents of Salem. • Tracy Giarla LPN City Of Salem • Environmental Health Division --- Inspection Monthly Summary __ ----------- --.. ..Month- Type Jul 98 Aug 98 Sep 98 Oct 98 Nov 98 Dec 98 Jan 99 Feb 99 Count - - -ew�— e o - - - — - _._ .CFR 5-.. .6 .._ . 4 2 1 5 0 10 -- _.. _1. --3-4 ._- CH 7 8 2 4 3 20 16 19 -=16 95 CON 14 8 8 6 0 4 2 7 2 51 CR 2 1 5 6 6 1 5 3 12 41 EC 20 7 5 7 19 14 20 3 6 101 EPR 2 1 3 4 00 0 - 0 1 11 FC 1 0 2 0 2 5 0 0 0 10 FRH 0 0 0 0 0 0 2 0 0 2 FSD 0 0 2 1 3 1 0 3 4 14 FSI 23 15 27 29 13 9 16 26 28 186 FSR 6 5 7 9 14 6 5 9 13 74 GN 8 8 4 2 1 4 0 1 6 34 I HI 14 23 13 8 11 11 14 16 57 .167 HR 11 14 11 24 7 21 10 7 22 127 HRI 0 0 0 0 1 0 0 0 0 1 LPI 0 0 0 0 0 1 0 0 2 3 MS 0 1 0 0 0 5 0 0 1 7 MUP 2 0 0 2 0 1 0 1 0 6 OS 1 0 12 0 0 0 0 0 0 13. RC 2 0 0 0 0 0 0 0 0 2 •RFI 5 3 9 7 9 3 2 3 5 46 , RFR 2 1 2 5 3 0 4 2 1 20 RO 2 0 0 0 0 0 2 6 .. 2 12 SB 62 36 13 0 0 0 0 0 0 ill SC 0 0 0 0 0 0 5 0 0 5 SES 2 0 0 0 0 2 0 0 0 4 SA 1 3 2 3 8 2 6 3 17 45 ST 0 0 0 0 2 0 0 1 1 4 TFI 13 0 0 16 0 0 0 0 0 29 TR 48 74 59 106 21 40 78 --- 48 ---_73 547 Count 332 269 273 301 183 214 230 217 327 2346 BB - Bed/Break. 2 FSI - Food Serv. Ins .243* RFD - Retail Food Disc . CFI - Cert . Fit, 890* FSR - Food Serv. Rein. 11l* RFI - Ret . Insp. 100* CFR - Cert . Fit".Reinsp. GN _ Gen. Nuisance 44* RFR - Retail Food Rein. CH - Court Hearing 44* HI - Housing Insp. 312* RO - Rodent Control 13* CON —Constable Serv. HR - Housing Reinsp. 172* SC - Suntan 5 CR - Compliance' Rev. LPI - Lead Paint Insp. 26* SES - SESD Odor 3* CT _ Computer Time MS - Massage 7 SM - Seminars/Meetings EC - Envirn. Compl . 85* MUP - Mobile Food Insp. 13* SP - Swim. Pools 14 EPR - Ext . Paint 5* OG - Overgrowth SB - Swim. Beaches 111* FC - Food Compl . 22* OS - - Sub. Insp. 10* ST - Soil Test/Septic qkH - Food Related Hear. RC - Rec . Camp 5 TFI - Temp.Food 65* D - Food Serv. Disc . RFC - Retail Food Compl . TR - Trash 758* 4/8/99 • City Of Salem Environmental Health Division - - Inspection Monthly Summary Month Type Jul 98 Aug 98 Sep 98 Oct 98 Nov 98 Dec 98 Jan 99 Feb 99 Mar 99 Apr 99 Count BB 0 0 0 0 0 0 0 1 3 0 4 CFI 79 55 83 60 59 59 43 48 54 41 581 CFR 5 6 4 2 1 5 0 10 1 8 42 CH 7 8 2 4 3 20 16 19 16 32 127 CON 14 8 8 6 0 4 2 7 2 12 63 CR 2 1 5 6 6 1 5 3 12 5 46 EC 20 7 5 7 19 14 20 3 6 3 104 EPR 2 1 3 4 0 0 0 0 1 3 14 FC 1 0 2 0 2 5 0 0 0 1 11 FRH 0 0 0 0 0 0 2 0 0 0 2 FSD 0 0 2 1 3 1 0 3 4 1 15 FSI 23 15 27 29 13 9 16 26 28 25 211 FSR 6 5 7 9 14 6 5 9 13 14 88 GN 8 8 4 2 1 4 0 1 6 4 38 HI 14 23 13 8 11 11 14 16 57 35 202 HR 11 14 11 24 7 21 10 7 22 10 137 HRI 0 0 0 0 1 0 0 0 0 0 1 LPI 0 0 0 0 0 1 0 0 2 0 3 MS 0 1 0 0 0 5 0 0 1 0 7 MUP 2 0 0 2 0 1 0 1 0 4 10 OS 1 0 12 0 0 0 0 0 0 11 24 RC 2 0 0 0 0 0 0 0 0 0 2 • RFI 5 3 9 7 9 3 2 3 5 3 49 RFR 2 1 2 5 3 0 4 2 1 1 21 RO 2 0 0 0 0 0 2 6 2 5 17 SB 62 36 13 0 0 0 0 0 0 0 ill SC 0 0 0 0 0 0 5 0 0 0 5 SES 2 0 0 0 0 2 0 0 0 1 5 SM 1 3 2 3 8 2 6 3 17 11 56 ST 0 0 0 0 2 0 0 1 1 1 5 TFI 13 0 0 16 0 0 0 0 0 0 29 TR 48 74 59 106 21 40 78 48 73 81 628 Count 332 269 273 301 183 214 230 217 327 312 2658 BB - Bed/Break. 2 FSI - Faod Serv. Ins . 243* RFD - Retail Food Disc . CFI - Cert . Fi€t . 890* FSR - Food Serv. Rein. 11l* RFI - Ret . Insp. 100* CFR - Cert . Fit:Reinsp. GN _ Gen. Nuisance 44* RFR - Retail Food Rein. CH - Court Hearing 44* HI - Housing Insp. 312* RO - Rodent Control 13, CON - Constable Serv. HR - Housing Reinsp. 172* SC - Suntan 5 CR - Compliance Rev. LPI - Lead Paint Insp. 26* SES - SESD Odor 3*. CT _ Computer Time MS - Massage 7 SM - Seminars/Meetings EC - Envirn. Compl . 85* MUP - Mobile Food Insp. 13* SP - Swim. Pools 14 EPR - Ext . Paint 5* OG - Overgrowth SB Swim. Beaches 111 FC - Food Compl . 22* OS - Off—Sub. Insp. 10* ST - Soil Test/Septic &RH - Food Related Hear. RC - Rec. Camp 5 TFI - Temp.Food 65* FSD - Food Serv. Disc. RFC - Retail Food Compl . TR - Trash 758* 5/7/99 • NEWSLETTER 46 May 11, 1999 AGENT'S REPORT TO THE BOARDOD may have regarding this on- Paul Giadrone from the going case. Harvard School of Public 3RD QUARTER UPDATEI CITY-WIDE CLEAN-UP O Health, and I continue to Enclosed is a draft of the Tim Jenkins organized a work on the Community 3rd Quarter Update of the city-wide clean-up last Health Assessment project. Board's Objectives. Saturday. Mary Page, Jose, Enclosed you will find our Information on the number of and I worked in the Point Mission, Goals Sz Objectives, exterminations needs to be neighborhood. and a timeline. Also enclosed updated, as does the section HHWCD* is a very rough draft of the on "Medical Services." Tracy We are in the final community survey and was extremely busy this week planning stage for this year's community leader's survey on a special project, and I did Household Hazardous Waste This is more time consuming not give her enough notice to Collection Day. The same than I had expected, but the finish her section for the contractor as last year will be end result should be worth • packet. The final version will emplyed, although unde= the investment. be available at the meeting. different corporate name: BOARD OF HEALTH PHOTO EYE Safety-I teen. Once again, DENTISTa SCREENINCA we will be collecting the usual I spoke with Dr. Ryan by Tracy is organizing eye wastes, including water and telephone, followed by the screening for pre-school oil based.paints, motor oil, enclosed letter, regarding the children. Enclosed is the and pesticides. Like last year, elimination of the stipend for schedule. It is a wonderful, we will be accepting tires and the Board of Health dentist. cooperative effort with the propane tanks. New this year ATTORNEY FOR SESD Lions Club. Tracy will tell is the collection of electronic COMPLAINTS you about it at the meeting. equipment, such as tv's and After many telephone 8 WYMAN AVENUE n computer equipment. The mesages, the attorney hired Enclosed is a letter from State will not be accepting by the City to represent-t-he the attorney for [he owners of any equipment with.cathode Board against the SESD this property requesting more rays as of next September. regarding odors called two time because of possible These are found in tv's and weeks ago saying he was developments with the City's computer monitors. The sending something for my sewer line. I have required contractor will take all the review by the end of that that the owners submit a equipment, and off set week. I still have not received contract with the septic charges for disposing of those it. I will leave another hauler outlining weekly two items with money gained message on his machine. But pumping until the DPW by recycling some of the other the "odor season" is upon us decides if that line is components. and without legal assistance definately going in. I would COMMUNITY HEALTH our actions have no clout. appreciate any feed back you ASSESSMENT I MEMORANDUM Date: 05/11/99 To: Board of Health Members T ' From:Joanne Scotli-� RE: May Meeting Tonight, my daughter is a guest at the N.S. Chamber of Commerce banquet for honors students. It was Sunday that I realized that this event coincided with the monthly board meeting. I know my attendance at these meetings is critical. Please accept my regrets. Fortunately, no one is scheduled to appear. There were several items I wanted to bring before the Board and have discussed these with our Chairman. The most critical is the ongoing odor concerns at the SESD. I faxed and mailed a letter to Attorney Nylen on Friday. Today I left a voice message saying that the Board was meeting tonight and requesting that he call back and let me know the status of his representation of the Board. Barbara will distribute the letter to Attorney Nylen, with odor complaints received last Thursday, as well as the updated version of the past quarter's Objectives. Thank you for your patience in my absence. PJ • 1 ky� Iwo 0BJEa1VWj1WW na y� $tX`PLI P 3RD QUARTER UPDATE INSPECTIONAL SERVICES The Board of Health sanitarians and inspectors will: ♦ Provide educational materials for landlords and tenants regarding housing code requirements. Lead paint notification requirements: with orders to correct housing violations 14 with Certificate of Fitness letters 95 ♦ Vigorously enforce the Housing Code and trash regulations. Trash Inspections (TR) 547 ♦ Provide housing inspections in accordance with the State Sanitary Code. Housing Inspections(HI) 167 Housing Reinspections (HR) 128 ♦ Provide Certificate of Fitness inspections for vacant apartments in accordance with City Ordinance. CFI Inspections 540 CFR Reinspections 34 ♦ Inspect rooming units annually. Rooming House Inspections 8 ♦ Inspect all food establishments at least once every six months and ensure that establishments are in compliance with the Food Manager Certification requirement. Food inspections (FSI+RFI) 232 Food reinspections (FSR+RFR) 94 'Temporary Food inspections at the Blues Festival, Maritime Festival, Polish Picnic, Hispanic Festival, SHS Carnival, Haunted Happenings. (TFI) 29 ♦ Inspect swimming pools, recreational camps and suntanning facilities at least once a year. Beaches (SB) 111 Maintained " swim at your own risk" signs. Rec Camp(RC) 2 ♦ Inspect massage establishments at least once a year. • Massage(MS) 7 ♦ Inspect body piercing establishments at least once a year. Body Piercing establishment 1 • ♦ Investigate complaints regarding any permitted facility. ♦ Inspect offensive substance transporters at least once a year. Inspections (OS) 13 ♦ Inspect and review septic systems in accordance with Title V. Inspections (ST) 4 ♦ Decrease the incidence of odor emissions at the South Essex Sewerage District through vigilant investigation and follow-up of all odor complaints. Discussed odor violations with City Solicitor and attorney hired as consultant. Odor Inspections (SES) 4 ♦ Provide sanitary inspections of neighborhoods when requested in order to limit residents' exposure to raccoons and rodents. Environmental Inspections (EC) 101 ♦ Employ the use of a professional pest control operator as a consultant and to control rodents in public areas -1 performed 17 investigations/applica io b• o e u c1a�}cd b ry,ee4 i-+�MEDICAL SERVICES P The Board of Health Nurse will: ♦ Follow the State's guidelines regarding the follow-up of reported contagious diseases. Campylobacter 7 E.Coli 3 TB 0 Giardia 1 Hepatitis 23 Lyme 4 Meningitis 4 Salmonella 5 Pertussis 0 Shigella 2 Varicella 0 ♦ Investigate foodborne illnesses reports with the inspectional staff. ♦ Investigate reports of unsanitary conditions related to housing with the inspectional staff. Home visit made following telephone complaint of unsanitary conditions. Collaboration with DSS for services. Made follow-up visit. ♦ Obtain immunizations from the State in order to maintain an inventory to be distributed to the City's primary care providers. MMR 1569 DTP 2760 Td 4815 OPV 1380 HiB 2240 HepB 3717 IPV 330 PPD 2990 Pneumo 1258 GammaGlobulin 18 ♦ Follow the State's requirements for the school children at St. Joseph's and the Phoenix School including; hearing and vision screening, postural screening, physical • examinations, and other screenings as needed, i.e. pediculosis screening; height&weight measurements, review of immunization& medical records; hold clinics, such as for hepatitis b, as needed. 1 • Immunization records reviewed, including new students, at St. Joseph's. Hearing/vision screening started at St. Joseph's Hep B clinic at St. Joseph's ♦ Sponsor an annual influenza( and pneumonia) clinics, and make home visits the City's elderly and at risk residents for the purpose of immunizing against flu and pneumonia. 1,611 residents vaccinated Appeared as guest on WESX with Al Needham to discuss flu/pneumonia clinic. ♦ Develop and implement blood pressure clinics for Police, Fire and City personnel, making referrals as needed. ♦ Perform annual TB testing for North Shore ambulance employees and other city residents upon request. 14 city residents tested in office. ♦ Conduct hepatitis B clinics for Police,North Shore Ambulance employees and other City employees in conjunction with their contracts. Hep B clinic for 13 DPW workers ♦ Provide clinics for non-contagious diseases as determined by need and feasibility. • The Board of Health Doctor will: ♦ Supervise the medical activities of the Board and its Nurse, including screening clinics, flu clinics, school child assessments, etc. Voluntary services of Dr. Leonard Dumas Joseph Miaskiewicz appointed as Board of Health Doctor ♦ Authorize the obtaining and distribution of all vaccines given in Salem. Voluntary services of Dr. Leonard Dumas ♦ Perform physicals as required at St. Joseph's and the Phoenix School. ♦ Attend the flu clinics. Voluntary services of Dr. Leonard Dumas ♦ Attend the Board's monthly meetings. Voluntary services of Dr. Leonard Dumas Dr. Miaskiewicz attended December meeting. ♦ Consult with the Health Agent and Nurse regarding communicable diseases and other medical issues of concern to the Board. The Board of Health dentist will: ♦ offer screening to the City's school children,through eight grade, for dental problems. 348 children to date, Bentley 168 to date. • • ADMINISTRATION The Health Agent will: ♦ Maintain a working relationship with the Point community by regularly attending community events. Continued to attend meetings of Board of the Salem Family Health Center, including interviewing candidates for the position of executive director. Elected President of Family Health Center Board. ♦ Be an active member of the Mayor's Neighborhood Improvement Task Force. Sent representative to September, January and March meeting of task force and attended October, December, February meetings. (November meeting not held because of Thanksgiving.) ♦ Represent the Board in presentations to the Mayor and City Council and communicate to the Board proposals and recommendations by the Mayor and City Council. Presented information to the Mayor regarding the BOH Doctor, overtime, and the part time inspector's position. Attended City Council subcommittee meeting with Chairman to discuss these. Participated in the Mayor's Family Picnic. Developed action plan and time line to address issues raised by the auditor's report. Completed several actions including; discussion of ticket process with city • clerk, discussion of fee schedule with Board, submission of food establishment ranking system to MDPH, inspection of massage establishments,ticket accountability, data processing and made two additions to the office's "Procedure" book including "filing of complaints in district court," and "inspector's responsibilities." Reformatted Board's Operational Review Action Plan in accordance with request by Finance Director. Attended seven of Mayor's management seminars. Maintained office hours on Friday afternoon at Mayor's request. Inspect Federal Street School for air quality issues and asbestos. Involved Mayor with public relations for Wellness Fair, including submission of letter in Salem Evening News insert, and opening ceremony for the Fair. Cooperated with the Government Relations Committee, chaired by Mary Usovicz, by submitting request for barrel requirement and incremental ticket fines to the Board for review. Submitted request for incremental fines to the Mayor. .Instructed staff to carefully observe outside of food establishment premises during inspections. Reviewed proposed FY 2000 budget with Board subcommittee to comply with budget cut required by the Mayor. Met with Mayor and Board Chair to discuss proposed cuts. Submitted request for continuation of City vehicles for inspectors, with a draft "circle check" of those vehicles. At the Mayor's request, the Board assumed the responsibilites of the position of • "Sealer of Weights & Measures." ♦ Provide the office staff with the opportunity to attend educational seminars as offered by the State and other public health associations and organizations. i .. _ .. ... .'_S..•x..-:+.nS:?awserr • Health Agent& Public Health Nurse attended seminars "Medical Response to Terrorism" and "Epi-Info." Health Agent, Sanitarians attended seminars, "hoarding" and "Food& Drug Q&A." ♦ Be a member of Salem's Local Emergency Planning Committee. Attended three meetings. Health Agent Chair of Plans Development Committee. ♦ Provide computer training for the staff. ♦ Continue to purchase computer equipment as necessary and allowed by the budget. Purchase clerks computer with septic management grant. Apply for and receive nurse's computer from MDPH ♦ Encourage networking among the inspectors and the staff of the Massachusetts Department of Public Health and the Department of Environmental Protection and other health professionals. Jeffrey Vaughan attended meeting with staff of salem Sound 2000 to discuss water quality in the Sound and-how it is impacted by occurances on land. ♦ Maintain membership in the North Shore Boards of Health Collaborative for the purpose of administering its tobacco control grant, as well as for information sharing. Attended two meeting,including one regarding media relations with David • Marcus, EditorSalem Evening News. ♦ Provide secretarial services to the Animal Control Officer in order to ensure that pets potentially exposed to rabies are properly quarantined. 19 potential exposures Because of budget cut, the animal control officer is not a Board of Health employee, and no longer maintains formal quarantine records. ♦ Gather information through public health publications, computer services or any other means and disseminate that information to the staff and Board. Information gained via internet concerning a-coli remedies in cattle. Circulated issues of The Journal of the American Public Health Association, The Journal of the National Environmental Health Association. ♦ Maintain the Board's memberships in related professional organizations. Renewed Board's membership in NACCHO, NEHA, MEHA. ♦ Review health status indicators to prioritize possible interventions. Initiate Community Health Assessment, based on APEX model, in conjunction with graduate student from the Harvard School of Public Health. Plan Community Wellness Fair with the public health nurse, school and police departments and Salem State College. ♦ Develop a process and procedures book. Addition of food establishment inspection protocol, correct name of organization, filing of complaints in district court, and inspector's responsibilities. • ♦ Perform assessment of clerical support staff and review descriptions of jobs. Received job descriptions from three clerks ♦ Be responsible for and supervise the overall operation of the Board of Health, and provide quarterly reports on these objectives. • Submission of 1 st and 2nd quarter updates to the Board and Mayor. Reorganize inspector's responsibilites following changes in positions among employees, and addition of sealer of weights & Measures responsibilities. ♦ In addition: Closely monitored SESD's broken pipe situation and appeared on WESX with the Chairman regarding this and other board issues. Responded to lack of odor control at the SESD. Plan review for new/renovated establishments; The Point, Deke's, Cima Supermarket, Baybridge, Tin Whistle, Bella Pizza, IC Mccaw's, Crypt Cafe, Goldbuck's, Kitchen Table, Lunchbox, Hamilton Hall, Scuttlebutts, Dunkin Donuts Paradise Road, Bluepoint, Giogio's, Bates School, Lucky Store, Tasty Foods, Ally's on the Green, Kwik Shop, East End Sea Food, Lunchbox (again). • • I • Salem Board of Health April Phone Logs 1999 Total Answered * = 897 Answered Calls Thursday April 1, 1999 55 Barb= 202 Friday April 2, 1999 33 (*1/2 Holiday) Mary=478 Saturday April 3, 1999 Sue =217 Sunday Aril 4, 1999 I= Monday Aril 5, 1999 36 Calls Taken Tuesday Aril 6, 1999 33 Wednesday April 7, 1999 34 Joanne=251 Thursday April 8, 1999 43 Ginny=13 Friday April 9, 1999 26 Jeffrey=97 ZnSaturday April 10, 1999 Mark=131 day April 11, 1999 PabIo=13 Monday April 12, 1999 54 Jose=75 Tuesday April 13, 1999 59 Tracy=99 Wednesday April 14, 1999 39 Barb=56 Thursday April 15, 1999 52 Mary=129 Friday April 16, 1999 29 Sue K =33 Saturday Aril 17, 1999 Sunday April 18, 1999 * =20 1/2 Work Days Monday Aril 19, 1999 Holiday * =38 Hours Per Week Tuesday Aril 20, 1999 52 Wednesday Aril 21, 1999 47 Monday 8-4 Thursday Aril 22, 1999 45 Tuesday 8-4 Friday A nl 23, 1999 27 Wednesday 8-4 SaturdayAril 24, 1999 Thursday 8-7 Sunda Aril 25, 1999 Friday 8-4 Monday Aril 26, 1999 49 Tuesday Aril 27, 1999 40 Wednesday Aril 28, 1999 52 Iursda Aril 29, 1999 48 R iFrida Aril 30, 1999 43 • FEBRUARY 1999 • • ADMINISTRATION - MONTHLY REPORT AMOUNT — BIOLOGICS DISTRIBUTED AMOUNT IN DOSES 830 BURIAL PERMITS 50 @ $5.00 = $250.00 Dipcheria , Tetanus 6 Percussis _ Dipcheria-Tetanus Tox . (under 6 yrs . ) 10 LICENSES AND PERMITS $891 .40 Immune Serum Globulin 0 CERTIFICATE OF FITNESS 36@ $25.00 $900.00 Measles/Mumps/Rubella 259 Polio 90 opv 340 ipv Tetanus b Dipcheria (adult use) 190 Tuberculin PPD 170 RIB Ticre ANIMAL BITES REPORTED —0- 390 Hepatitis B 260 $ALARY/LONGEVITY : ANNUAL BUDGET EXPENSES AVAILABLE BALANCE $329,827 .00 $250,259.09 $110,817.80 29,980.91 - SUPP. APPR. 1,268.98 — TRANSFERS NON-PERSONNEL: ANNUAL BUDGET EXPENSES ENCUMBERED AVAILABLE BALANCE $21 ,800.00 $14,062.97 $4,892.70 $2,844.33 W v��ONUIT 'r • y F C CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH, RS, CHO NINE NORTH STREET HEALTH AGENT Public Health Nurse Report Tel: (978)741-1800 Disease Prevention February 1999 Activities Fax:(978)740-9705 In touch with T.B. Clinic and following active cases and case contacts. Five PPD screenings done in office. Vaccine inventory maintained and distributed. Investigated communicable disease cases and reported to the M.D.P.H. Directly observed therapy administered Tuesday through Friday for a suspect active case of T.B. PPD testing of 4 household contacts. 2 positive readings referred to NSPC for follow up. Meetings and Clinics 2/1/99 Hepatitis B Clinic, Salem Firefighters. Division 3, first •' Series of three. 2/2/99 Hepatitis B Clinic, Salem Firefighters. Division 4, first series of three. 2/9/99 Discussed recent nursing activities and active cases with Dr. Maisldewicz. 2/16/99 Attended TB case management meeting held at Northshore Medical Center. Convened by Nancy Taylor Flynn R.N., to Discuss all North Shore Area suspect and active cases. 2/23 Wellness Fair Meeting: Ongoing plans for Wellness Fair 1999 Blood Pressure Clinic Held at Fire Headquarters. 2/23 12 Screened: 0 Hypertensive readings noted. 2/25 8 Screened: 1 B/P 166/90 Pt is under a physician care for Hypertension, and is taking anti hypertensive meds. 2/26 5 Screened: 0 Hypertesive readings noted. ST. JOSEPHS SCHOOL Hearing and Vision Continues. PHOENIX SCHOOL • Hearing and Vision Continues. • V CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax: (978)740-9705 MONTHLY REPORT OF COMMUNICABLE DISEASES February 1999 DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES: CASES: CASES: STATE: • Campylobacter 0 0 0 0 Giardia 0 0 0 0 Hepatitis 1 3 2 2 Lyme Disease 0 0 0 0 Meningitis 0 0 0 0 Pertussis 0 0 0 0 Salmonella 0 0 0 0 Shigella 0 0 0 0 Varicella 0 0 0 0 Reportable Diseases excluded from above have not been identified this month. • TWIT CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 Summary of Communicable Diseases for February 1999 Hepatitis C: Unknown exposure. Occupation: � . P Unemployed. !�r0 ANNUAL BLOOD PRESSURE SCREENING Ise, aka 110 FOR CITY OF SALEM EMPLOYEES MARCH 22, 1999 11 AM TO 1 PM 110 ONE SALEM GREEN CONFERENCE ROOM i ro Yo Sponsored by: Salem Board of Health. For further information, 1/0 Please contact: Tracy Giarla, Public Health Nurse at 741-1800 90 I(avoid caffeine and smoking one half hour before screening) i City Of Salem • Environmental Health Division - - Inspection Monthly Summary Month ------------------------------------------------------------- Type Jul 98 Aug 98 Sep 98 Oct 98 Nov 98 Dec 98 Jan 99 Feb 99 Count BB 0 0 0 0 0 0 0 1 1 CFI 79 55 83 60 59 59 43 48 486 CFR 5 6 4 2 1 5 0 10 33 CH 7 8 2 4 3 20 16 19 79 CON 14 8 8 6 0 4 2 7 49 CR 2 1 5 6 6 1 5 3 29 EC 20 7 5 7 19 14 20 3 95 EPR 2 1 3 4 0 0 0 0 10 FC 1 0 2 0 2 5 0 0 10 FRH 0 0 0 0 0 0 2 0 2 FSD 0 0 2 1 3 1 0 3 10 FSI 23 15 27 29 13 9 16 26 158 FSR 6 5 7 9 14 6 5 9 61 GN 8 8 4 2 1 4 0 1 28 HI 14 23 13 8 11 11 14 16 110 HR 11 14 11 24 7 21 10 7 105 HRI 0 0 0 0 1 0 0 0 1 LPI 0 0 0 0 0 1 0 0 1 MS 0 1 0 0 0 5 0 0 6 MUP 2 0 0 2 0 1 0 1 6 OS 1 0 12 0 0 0 0 0 13 RC 2 0 0 0 0 0 0 0 2 • RFI 5 3 9 7 9 3 2 3 41 RFR 2 1 2 5 3 0 4 2 19 RO 2 0 0 0 0 0 2 6 10 SB 62 36 13 0 0 0 0 0 ill SC 0 0 0 0 0 0 5 0 5 SES 2 0 0 0 0 2 0 0 4 SM 1 3 2 3 8 2 6 3 28 ST 0 0 0 0 2 0 0 1 3 TFI 13 0 0 16 0 0 0 0 29 TR 48 74 59 106 21 40 78 48 474 Count 332 269 273 301 183 214 230 217 2019 BB - Bed/Break. 2 FSI - Food Serv. Ins . 243* RFD - Retail Food Disc . CFI - Cert . Fit . 890* FSR — Food Serv. Rein. 11l* RFI - Ret . Insp. 100* CFR - Cert . Fit .Reinsp. GN _ Gen. Nuisance 44* RFR - Retail Food Rein. CH - Court Hearing 44* HI - Housing Insp. 312* RO - Rodent Control 13 CON - Constable Serv. HR - Housing Reinsp. 172* SC - Suntan 5 CR - Compliance Rev. LPI - Lead Paint Insp. 26* SES - SESD Odor 3* CT _ Computer Time MS - Massage 7 SM - Seminars/Meetings EC - Envirn. Compl . 85* MUP - Mobile Food Insp. 13* SP - Swim. Pools 14 EPR - Ext . Paint 5* OG - Overgrowth SB - Swim. Beaches 111 FC - Food Compl . 22* OS - Off . Sub. Insp . 10* ST - Soil Test/Septic FRH - Food Related Hear. RC - Rec. Camp 5 TFI - Temp. Food 65* •FSD - Food Serv. Disc . RFC - Retail Food Compl . TR - Trash 758* 3/5/99 NEWSLETTER 44 March 9, 1999 AGENT'S REPORT TO THE BOARDOo grace. Jose is up to speed on endeavor and think it will be BOARD MEMBERS = food establishment the best fair ever. A reminder: The Mayor has chosen to inspections. Mark is learning It will be held on Sunday, appoint Dr. Mike more about the Sealer of April loth from 12 to 4 and I<antorosinski to replace Weights SL Measures duties. Monday, April 1 Ith from 10 Owen Meegan on the Board. Pablo is doing trash to 4, at the O'Keefe complex, In addition, Mary Madore's inspections in Ward Four. Salem State. There will be position will be filled by Tracy is doing well in school. about 80 exhibitors inside Christina Harrington. We And Barbara, Mary, Sue and I and a number of will miss Owen and Mary are keeping busy as usual! demonstrations outside, as very much and wish them the SEALER OF WEIGHTS & well as the Lions Eye Mobile. best in their future endeavors. MEASURES 2 Tracy will be on Al We welcome our two new Speaking oo€ -he Needham's show on April 9th, members and hope they enjoy Sealer...Beth Rennard is and I will be on SATV on their service on the Board. finding out how to have the March 23rd, to promote the FY 99 BUDGET U $5000 for these duties fair. The enclosed budget was transferred to our budget. (I 435 LAFAYETTE finalized after consulting with did include that in the new STREET n Owen and Mary. It was budget.) That money will be At the last meeting, the ,submitted to Bruce Guy, City used to upgrade Mark's job Board tabled discussion on Auditor, in accordance with category and pay for supplies this project. The his schedule. Bruce will necessary for the work. I am Conservation Commission review it and forward it to the asking the Board to vote to denied the special permit, Mayor with his appoint Mark as the Sealer. delaying any action we have recommendations. The The Mayor will also appoint to take. Mayor will then review it him. Then we will submit his SESD I with me. Since Owen and name to the State so he may The SESD reported that Mary are no longer on the begin training. the a joint clamp had broken Board, it may be beneficial to SALEM WELLNESS on its pipe and it has been request a new budget FAIR A repaired. I've requested that subcommittee. Tracy and I have been they come to the April STAFF O working with Maureen Carr meeting to discuss their The rotation of staff has and Charlie Reed from the consultant's review of the been working out very well: City, as well as Pam pipe. That letter is enclosed. • Ginny is working full days Padovanni and Joe Dunn of I have no further information on Tuesdays and Salem State, on preparations on the odor follow-up, but Wednesdays. Jeff has been for the Wellness Fair. We are hope to by the meeting. adjusting to his added very excited about this responsibilities with skill and combined City/Salem State • Salem Board of Health February Phone Logs 1999 Total Answered * = 757 Answered Calls Monday February 1, 1999 51 Barb= 124 Tuesday February 2, 1999 42 Mary=238 Wednesday February 3, 1999 45 Sue= 395 Thursday February 4, 1999 52 Friday February 5, 1999 23 Calls Taken Saturday February 6, 1999 Joanne 237 Sunday February 7, 1999 Ginny 37 Monday February 8, 1999 340 Jeffrey 83 Tuesday February 9, 1999 47 Mark 67 ednesday February 10, 1999 43 Pablo 36 Thursday February 11, 1999 36 1 Jose 59 Friday February 12, 19991 30 Tracy 74 Saturday February 13, 1999 Barb 31 Sunday February 14, 1999 Mary 53 Monday February 15, 1999 Holiday Sue K 80 Tuesday February 16, 1999 41 Wednesday February 17, 1999 36 =19 Work Days Thursday February 18, 1999 28 * =38 Hours Per Week Friday February 19, 1999 26 Saturday February 20, 1999 49 Monday 8-4 Sunda February21, 1999 Tuesday 8-4 MondayFebruary22, 1999 Wednesday 8-4 Tuesday February 23, 1999 50 Thursday 8-7 Wednesday February 24, 1999 51 Friday 8-4 Thursday February 25, 1999 *41 *Closed 4:00 Snow Friday February 26, 1999 32 ,giiaturday February 27, 1999 Iglunday ebrua 28, 1999 M JANUARY 1999 ADMINISTRATION - MONTHLY REPORT j AMOUNT BIOLOGICS DISTRIBUTED AMOUNT IN DOSES BURIAL PERMITS 53 @ $5.00 = $265.00 Diptheria , Tetanus 6 Pertussis h75 - -- 1 Diptheria-Tetanus Tox . (under 6 yrs . ) 40 LICENSES AND PERMITS $2,119.00 E Immune Serum Globulin CERTIFICATE OF FITNESS 49@ $25.00 $1,225.00 6 I Measles/Mumps/Rubella 156 i Polio OPV — 250 IPV — 450 Tetanus 6 Diptheria (adult use) 330 Tuberculin PPD 220 3 HIB Titre 530 ANIMAL BITES REPORTED I Hepatitis B 1,090-- f SALARY/LONGEVITY : ANNUAL BUDGET EXPENSES AVAILABLE BALANCE $329,827 .00 $209,086.81 $151,990.08 1 21,380.91 — SUPP. APPR. 1,268.98 — TRANSFERS NON -PERSONNEL: ANNUAL BUDGET EXPENSES ENCUMBERED AVAILABLE BALANCE $21 ,800.00 $10,956.81 $2,583.16 $8,260.03 i i v��ONy�yDI�Tw_i6� • �tl'V Hove.o F CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 PUBLIC HEALTH NURSE REPORT January 1999 ACTIVITIES DISEASE PREVENTION In touch with T.B. Clinic and following active cases and case contacts. four PPD screenings done in office. vaccine inventory maintained and distributed. Notified all Health care Providers who received DTAP Lot#0196490 Please see attached memorandum from M.D.P.H. • Investigated communicable disease cases and reported to the M.D.P.H. MEETINGS AND CLINICS: 1/4 Hepatitis B Clinic, St.Joseph's School. Second Series of Three. 1/7 Health Fair Meeting: Ongoing Plans for Wellness Fair 1999 1/11 Hepatitis B Clinic, Phoenix School. Second Series of Three. 1/20 Hepatitis B Clinic Salem Firefighters, Division 1. 16 Fire fighters received the first of three series. 1/21 Hepatitis B Clinic Salem Firefighters, Division 2. 15 Firefighters received the first of three series. 1/25 Attending Salem State College every Monday evening 4:30 pm-9:30 pm College Algebra and English Comp Prerequisite Courses. 1/26 PPD testing at North Shore Ambulance for 15 employees. ST. JOSEPH'S SCHOOL 12/8 Hearing and vision screening started for grades K-8 Screenings will be held on Tuesdays and Fridays until complete. PHOENIX SCHOOI • 1 /29 Hearing and Vision Started for Phoenix School, Grades K-8 L ��ONUIT CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 MONTHLY REPORT OF COMMUNICABLE DISEASES JANUARY 1999 DISEASE: NEW CARRYOVER DISCHARGED REPORT TO CASES: CASES: CASES: STATE: • Campylobacter 0 0 0 0 Giardia 0 0 0 0 Hepatitis 4 5 5 5 Lyme Disease 0 0 0 0 Meningitis 0 0 0 0 Pertussis 0 0 0 0 Salmonella 0 0 0 0 Shigella 0 0 0 0 Varicella 0 0 0 0 Reportable Diseases excluded from above have not been identified this month. • f v �ONUIT's CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 Summary Of Communicable Diseases Hepatitis: 4 New cases. • Hepatitis B: 2 new cases. Currently under investigation. Hepatitis C: 1 New case. Currently under investigation. Hep atitis A: 1 Cas e.se. 41 p/o male. Employed as a Food Supervisor For Blueberry Hill Nursing Home. Immediately Removed from work. Mary Sheryl Hervine, Epidemiologist from MDPH notified. Bill Burke and Beverly Public Health Nurse were notified. 15 Dietary co- workers were vaccinated with Gamma Globulin by Pauly LeBlanc of Blueberry Hill Nursing Home. All Dietery employees received an inservice on Foodborne illness, and proper handwashing. Case denies sexual contacts, or household contacts. He is being followed by M.D. • V CIP PASTEUR MERIEUX CONNAUGHT P,h'OlUF-POULENC GROUP PASTEUR MERIEUX CONNAUGHT USA January 27, 1999 DISCOVERY DRIVE SWIFTWATER,PENNSYLVANIA 18370-0187 TELEPHONE:570-839-7187 — URGENT VACCINE RECALL— Dear Healthcare Provider: Sub4ect• Voluntary Recall of Tripedia@(Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed) 15 Dose Vial Lot number 0916490 (Expiration date 6/8/99) A key goal of Pasteur Merieux Connaught is to communicate effectively with our customers whenever corrective action is required.This letter is to notify you of a voluntary recall of a single lot of our Tripedia vaccine. In the course of routine stability testing,we recently learned that the potency of the diphtheria component in a single lot of Tripedia had fallen below specification.Although this product met all specifications at the time of release,the potency of the diphtheria component fell below specification prior to the product's expiration date. The potency of the tetanus and pertussis components continues to be satisfactory. Our records indicate that you received product from this particular lot.We are initiating a voluntary recall of Tripedia lot number 0916490 and we will replace any remaining inventory that you have on hand or that you may have distributed to other healthcare providers. Please stop using this lot immediately and return all remaining inventories. No other Tripedia lots are affected. • Because diphtheria is very rare in the U.S.,we believe that the health risk to patients who have received the subpotent lot is minimal. Recommendations concerning special populations of children who might receive a supplemental dose of vaccine will be forthcoming in the next few days.We request that physicians be especially diligent in ensuring that children who received this lot of Tripedia are administered subsequent doses of DTaP vaccine on the regular schedule and in a timely manner. Our Medical Affairs department is available at 1-800-325-7709 to address any medical inquiries that you may have in this regard. Please examine your inventory and indicate on the enclosed reply card whether or not you have any remaining inventory of the above referenced lot. In the event that you do have inventory, do not use these doses and please contact us at 1-800-350-6984 so that we can promptly replace any such product with a new lot of Tripedia. Please return the card whether or not you have remaining inventory of this lot to help us determine that all existing stocks have been returned. Enclosed with this letter are a postage-paid shipping label and a packing list with instructions on how to return the product. We can also provide you with additional quantities of these materials to enable you to disseminate this notice to any healthcare providers who received material from this particular lot. Alternatively, we can send this notice directly to these providers if you prefer. Please contact us at 1-800-350-6984 and we will be glad to assist you in this effort. This voluntary recall is being conducted with the knowledge of the U.S. Food and Drug Administration. You are a valued Pasteur Merieux Connaught customer and we greatly appreciate your cooperation in these efforts. Your Pasteur Merieux Connaught representative is also available to provide any assistance you may desire to facilitate your return and replacement activities. Our greatest concerns remain meeting your needs and ensuring that your patients receive the highest levels of immunization. Once again, feel free to contact our Medical Affairs department(1-800-325-7709) if you have questions. Please accept our apologies for any inconvenience we may have caused. Pasteur Merieux Connaught is committed to supplying our customers with products that are safe and effective, properly labeled and produced to meet appropriate standards of potency, purity and safety. Whenever we fall • short of our goal, we will take prompt corrective action. Very truly yours, Carlton Meschievitz, M.D. Vice President Scientific& Medical Affairs CONNAUGHT LABORATORIES INC..A PASTEUR MERIEUX CONNAUGHT COMPANY V The Commonwealth of Massachusetts Executive Office of Health and Human Services Q Department of Public Health State Laboratory Institute F".� ) - 1999 ARCED PAM CEWXCI 305 South Street, Jamaica Plain, MA 02130 S GOVERNOR 617-983-6800, Fax 617-983-6924 HiEA TH »p WIWAMD.OIEARr Bureau of SECRETARY Communicable HOWARO K.KOK M.O.,MP.H. Disease contro COMMISSIONER Massachusetts Immunization Program Memoraikun To: Vaccine Distributors Vaccine Providers From: Robert W. Morriso Vaccine Manager Date: January 29, 1999 Subject: Recall of Lot#0916490-Tripedia®(Diptheria,Tetanus, acellular Pertussis) • Enclosed is a letter from Pasteur Merieux Connaught indicating there is a recall of a specific lot of Tripedia®(diptheria, tetanus, and acellular pertussis)vaccine. The lot number,is 0916490 and has an expiration date of 6/8/99. This DTaP vaccine was purchased by the Massachusetts Immunization Program(MEP) in February 1998, and was distributed to you through our regional offices, or local vaccine distributor, from March through July 1998. If you have this lot of DTaP vaccine in your inventory, do NOT distribute or administer it. Although the manufacturer provided instructions for returning the vaccine, disregard them. The vaccine must be returned to your local vaccine distributor or regional immunization office for replacement as soon as possible. Please complete the vaccine Recall Packing List included in the mailing, by indicating the number of vials you are returning, your provider identification number, and your site name and address. The NUP will return the vaccine directly to the manufacturer. As soon as more information is available regarding recommendations of possible revaccination for patients who were administered this vaccine, an advisory will be sent directly to all vaccine providers. If you have any questions regarding revaccination, please call Pasteur Merieux Connaught's Medical Affairs department at 1-800-325-7709, or the MEP at(617) 983-6800. If you have questions regarding the return of unused vaccine, please call your regional immunization office. Thank you for your assistance with this matter. i dtap recall 199.doc 02/01/99 fP PASTEUR MER/EUX CONNAUGHT RIP 37, T-IM! PASTEUR MERIEUX CONNAUGHT USA DISCOVERY DRIVE ;:I? SWIFIWATER,PENNSYLVANIA 18370-0187 TELEPHONE:570-839-7187 FAX:570-839-7235 Subiect: Additional Medical Information Regarding The HFAI-" DEPT• Voluntary Recall of Tripedia®(Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed) 15 Dose Vial. Lot number 0916490 (Expiration date 6/8/99) January 29, 1999 Dear Healthcare Provider, On January 27, 1999, we sent you a letter with information regarding our voluntary recall of a single lot of Tripedia® (Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed). Pasteur Merieux Connaught is voluntarily recalling lot number 0916490 as a result of routine testing that detected suboptimal potency of the diphtheria component. As stated in that letter, it is our medical opinion that any health risk to patients who were immunized from the affected lot is minimal due to the low levels of diphtheria present in the U.S. Therefore, children who are remaining in the U.S. until the fourth dose of DTaP do not require • any supplemental immunization. Under certain conditions, children who will be travelling outside the U.S. before the fourth dose should receive a supplemental immunization. The attached medical recommendations provide additional information concerning the supplemental immunization of infants and children who may be at increased risk of exposure to diphtheria as a result of travel. These recommendations were prepared by the U.S. Centers for Disease Control and Prevention with full concurrence of the American Academy of Pediatrics and the American Academy of Family Physicians. Following your review of these recommendations, if you decide a child in your practice previously immunized with the recalled lot of Tripedia requires supplemental immunization, Pasteur Merieux Connaught will provide Diphtheria and Tetanus Toxoids Adsorbed USP (For Pediatric Use), DT, free of charge by calling 1-800-VACCINE (822-2463). If you have any medical questions about these recommendations, please contact our Medical Affairs department at 1-800-325-7709. The U.S. Food and Drug Administration has been fully informed of all aspects of this action and concurs with the steps we are taking. At Pasteur Merieux Connaught we are committed to supplying products that are safe and effective. We remain available to assist in your vaccine return efforts (1-800-350-6984) and to answer any medical questions (1-800-325-7709). Very Truly Yours, Carlton Meschievitz, M.D. Vice President, Scientific & Medical Affairs CONNAI I(SHT I ARORATORIFS INC A PACTFI IR MFRIFI IY(.ONNAI it HT(V)MPANY City Of Salem • Environmental Health Division --- Inspection Monthly Summary Month ------------------------------------------------------ Type Jul 98 Aug 98 Sep 98 Oct 98 Nov 98 Dec 98 Jan 99 Count ----- ------ ------ ------ ------ ------ ------ ------ CFI 79 55 83 60 59 59 43 438 CFR 5 6 4 2 1 5 0 23 CH 7 8 2 4 3 20 16 60 CON 14 B 8 6 0 4 2 42 CR 2 1 S 6 6 1 5 26 EC 20 7 5 7 19 14 20 92 EPR 2 1 3 4 0 0 0 10 FC 1 0 2 0 2 5 0 10 FRH 0 0 0 0 0 0 2 2 FSD 0 0 2 1 3 1 0 7 FSI 23 15 27 29 13 9 16 132 FSR 6 5 7 9 14 6 5 52 GN 8 8 4 2 1 4 0 27 HI 14 23 13 8 11 11 14 94 HR 11 14 11 24 7 21 10 98 HRI 0 0 0 0 1 0 0 1 LPI 0 0 0 0 0 1 0 1 MS 0 1 0 0 0 5 0 6 MUP 2 0 0 2 0 1 0 5 OS 1 0 12 0 0 0 0 13 RC 2 0 0 0 0 0 0 2 RFI 5 3 9 7 9 3 2 38 RFR 2 1 2 5 3 0 4 17 2 0 0 0 0 0 2 4 Ws" 62 36 13 0 0 0 0 ill SC 0 0 0 0 0 0 5 5 SES 2 0 0 0 0 2 0 4 SM 1 3 2 3 8 2 6 2S ST 0 0 0 0 2 0 0 2 TFI 13 0 0 16 0 0 0 29 TR 48 74 59 106 21 40 78 426 Count 332 269 273 301 183 214 230 1802 BB - Bed/Break. 2 FSI - Food Serv. Ins . 243* RFD - Retail Food Disc . CFI - Cert . Fit . 890* FSR - Food Serv. Rein. 11l* RFI - Ret . Insp. 100* CFR - Cert . Fit .Reinsp. GN _ Gen. Nuisance 44* RFR - Retail Food Rein. CH - Court Hearing 44* HI - Housing Insp . 312* RO - Rodent Control 13* CON - Constable Serv. HR - Housing Reinsp. 172* SC - Suntan 5 CR - Compliance Rev. LPI - Lead Paint Insp. 26* SES - SESD Odor 3* CT _ Computer Time MS - Massage 7 SM - Seminars/Meetings EC - Envirn. Compl . 85* MUP - Mobile Food Insp. 13* SP - Swim. Pools 14 EPR - Ext . Paint 5* OG - Overgrowth SB - Swim. Beaches 111* FC - Food Compl . 22* OS - Off . Sub. Insp. 10* ST - Soil Test/Septic FR - Food Related Hear. RC - Rec . Camp 5 TFI - Temp. Food 65* FSD - Food Serv. Disc . RFC - Retail Food Compl . TR - Trash 758* • 2/S/99 • NEWS1 ETTER 43 February 9, 1999 AGENT'S REPORT TO THE BOARDj& SESD OUTEALL PIPE , At the same time he was looking bills I submit to him in a timely Raymond Bouchard, SESD for a way to move the position of way. The event is scheduled for Executive Director, reported a Sealer of Weights & Measures out June 19, 1999. break in the outfall pipe about of the Police Department. The 1500 feet off Juniper Point. Ray timing was such that we were TOBACCO CONTROL X has been invited to our meeting. instructed to incorporate that Dot Flaherty, the new Tobacco The EPA and DEP and the position while maintaining the Control Coordinator will be at our Department of Marine Fisheries senior sanitarian position. meeting to introduce herself to the have been notified. There was a$5000.00 stipend Board. given to the Police Department. SESD ODOR O Beth suggested changing the job BOH OBJECTIVES wo Owen and I met with the City description of one of the Marion and I met to discuss • Solicitor, Bill Lundregan, and sanitarians to include the sealer ways to improve the quarterly another attorney, regarding responsibilities and to increase the objectives review both in format continuing odor problems at the grade level. Mark has agreed to and in execution of the Board's SESD. There is support from the become the Sealer so that he will objectives. Marion suggested we administration to pursue the issue. move from a Grade XX to XXII. address the objective of educating According to the Police Officer landlords regarding the housing 1999 BUDGET n who was the Sealer, the job code, by including materials in We are required to submit the requires about 15-20 hours per packages we routinely mail to the 1999 Budget to the Auditor by week. That will mean a net loss landlords. The staff and I will be February 18th. I will have my of 1/2 position from the Board's assembling such information to proposal to you by the meeting. work, but that is better than include with our order letters and loosing a full position. All this other correspondence. STAFF ® was discussed with Owen as Now that we have our The Sanitarians position was events evolved. positions in place, I have asked posted for two weeks within the the sanitarians to think about their City and Jose was the only HOUSEHOLD HAZARDOUS personal educational goals and applicant. So now the Inspectors WASTE COLLECTION DAYn will be developing a plan with have finished playing musical We have been asked by Al them to meet theirs and the chairs with Jose as Jeff, Jeff as Viselli and Stanley Bornstein to Board's objectives. Ginny, Ginny as Jose! organize the Household I will include my inspections Hazardous Waste Day, although and reviews in the monthly • SEALER OF WEIGHTS & the money is in the DPW budget. environmental report, as MEASURES ✓ I'm a bit concerned about this suggested by Marion, and will After the last meeting, I was since I will not have direct control discuss planning ideas with Tracy told by Beth Rennard that the over paying the bills generated by and Dr. Miaskiewicz. Mayor was considering not filling this event. Stan Bornstein has the senior sanitarians's position. assured me that he will pay any �r�k Salem Board of Health • January Phone Logs 1999 Total Answered Answered Calls Friday January 1, 1999 Holiday Barb= 83 Saturday January 2, 1999 Mary=280 Sunday January 3, 1999 Sue= 342 Monday January 4, 1999 37 Tuesday January 5, 1999 37 Calls Taken Wednesday January 6, 1999 41 Joanne 184 Thursday January 7, 1999 41 Ginny 46 Friday January 8, 1999 33 Jeffrey 74 Saturday Janua 9, 1999 Mark 54 Sunday January 10, 1999 Pablo 8 Monday January 11, 1999 36 Jose 70 Tuesday Janua ry12, 1999 37 Tracy 110 . Wednesday January 13, 1999 19 Barb 25 Thursday January 14, 1999 28 Mary 54 Friday January 15, 1999 28 Sue K 70 Saturday January 16, 1999 Sunday January 17, 1999 Monday January 18, 1999 Holiday Tuesday January 19, 1999 51 Wednesday January 20, 1999 43 Thursday January 21, 1999 41 Friday January 22, 1999 43 Saturday Janua 23, 1999 Sunday January 24, 1999 Monday January 25, 1999 52 Tuesday January 26, 1999 45 Wednesday January 27, 1999 30 -Thursday January 28, 1999 39 Friday January 29, 1999 24 Saturday January 30, 1999 • Sunday January 31, 1999 Total Calls *705 i i • A,DMi�`' ISTRl',T iU�" - "0:�,.�";, �• RE°O RT DECEMBER 1998 _ AMOUNT — BIOLOGICS DSTRiBUTED_ — rUMOUNT IN DOSES Dipcheria , Tecanus b Percussis 585 BURIAL PERMITS 66 @ $5 .00 = $330.00 $7,790.00 Dipcheria-Tecanus Tox . (under 6 yrs . ) _0_ LICENSES AND PERMITS Immune Serum Globulin 2 CERTIFICATE OF FITNESS 60 @ $25 .00 1 500.00 Measles/MumFs/Rubella 154 Polio 230 (aCulC use, Tecanus b :pcneria 650 i Tubercui -'� PD 490 _ ----- ANIMA I. BITES REPORTED HIB Ticre 370 i —1— i ------ 943 - — Hepacicis EXPENSES AVAILABLE BALANCE SALARY/LONGEVITY : �NNUA BUDGET $170,516.23 $329 827 00 $181 ,960.66 $ 21 ,380.91 — SUPP. APPR. $ 1 ,268.98 — TRANSFERS P``,S:_7S ENCUMBERED AVAILABLE BALANCE NG?�-PERSO'�NEL : �.?�NUA� BLDGE' $21 ,800.UU $8,431.62 $3,596.45 $9,771.93 u ��ONUIT,l,9 5� e� �'cin�oA CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel: (978)741-1800 Fax: (978)740-9705 PUBLIC HEALTH NURSE REPORT DECEMBER ACTIVITIES DISEASE PREVENTION in touch with T.B. Clinic and following active cases and case contacts. four PPD screenings done in office. Vaccine inventory maintained and distributed. Investigated all communicable disease cases and reported to the M.D.P.H. MEETINGS AND CLINICS: • 12/3 Office visits for Flu shots.This is the last of our vaccine.. 12/4 Health Fair Mtg: Ongoing plans for Wellness Fair 1999 12/10 Meeting with Lt. Dionne of Salem Fire Department to discuss upcoming Clinic for 60 Salem Firefighters. 12/17 Assisted with Hepatitis B Clinic @ Collins Middle School. 108 students vaccinated. ST. JOSEPH'S SCHOOL 12/8 Hearing and vision screening started for grades K-8 Screenings will be held on Tuesdays and Thursdays until complete. PHOENIX SCHOOL 12/3 Hepatitis B vaccine offered for Phoenix School. 2 children will receive series. • . ��CONDIT CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax: (978)740-9705 MONTHLY REPORT OF COMMUNICABLE DISEASES FOR THE MONTH OF DECEMBER 1998 *DISEASE NEW CARRY OVER DISCHARGED REPORTS TO CASES CASES CASES STATE CAMPYLOBACTER 1 0 0 0 GIARDIA 0 0 0 0 • HEPATITIS 6 4 0 0 LYME DISEASE 2 0 1 1 MENINGITIS 0 0 0 0 MUMPS 0 0 0 0 PERTUSSIS 0 0 0 0 SALMONELLA 0 0 0 0 SHIGELLA 0 0 0 0 TUBERCULOSIS 0 0 0 0 VARICELLA 0 0 0 0 *THOSE DISEASES EXCLUDED FROM ABOVE HAVE NOT BEEN IDENTIFIED DURING THIS MONTH. Tracy L.Giarla L.P.N. Public Health Nurse For the Board of Health • �CO ' v CITY OF SALEM HEALTH DEPARTMENT f � Nine North Street . Salem, Massachusetts 01970 Summary of Communicable Diseases for December1998 Campvlobacter: College Student living on campus. Originally from Maryland. Student eats take out all the time. Symptoms started at home in Maryland after Thanksgiving. Hepatitis: 6 New cases being investigated. 4 carry over cases from last month. Lyme Disease 1 . 46 y/o female. Case went to M.D. with symptoms of Bell's Palsy. 2. 34 y/o male. Spoke to M.D. Doctor to discuss Dx with his patient. Tuberculosis (suspect) this case is back to work at his two jobs. He is receiving Directly Observed Therapy at the Nursing Home where he works. City Of Salem Environmental Health Division --- Inspection Monthly Summary Month ---------------------------------------------- Type Jul 98 Aug 98 Sep 98 Oct 98 Nov 98 Dec 98 Count -'yl� ----- ------ ------ ------ ------ ------ ------ -___- / 0 CFI 79 55 83 60 59 59 395 CFR 5 6 4 2 1 5 23 CH 7 8 2 4 3 20 44 CON 14 8 8 6 0 4 40 CR 2 1 5 6 6 1 21 EC 20 7 5 7 19 14 72 EPR 2 1 3 4 0 0 10 FC 1 0 2 0 2 5 10 FSD 0 0 2 1 3 1 7 FSI 23 15 27 29 13 9 116 FSR 6 5 7 9 14 6 47 GN 8 8 4 2 1 4 27 HI 14 23 13 8 11 11 80 HR 11 14 11 24 7 21 88 HRI 0 0 0 0 1 0 1 LP, 0 0 0 0 - 0 1 1 MS 0 1 0 0 0 5 6 MUP 2 0 0 2 0 1 5 OS 1 0 12 0 0 0 13 RC 2 0 0 0 0 0 2 RFL 5 3 9 7 9 3 36 0FR 2 1 2 5 3 0 13 10 2 0 0 0 0 0 2 SB 62 36 13 0 0 0 111 SES 2 0 0 0 0 0 2 SM 1 3 2 3 8 2 19 ST 0 0 0 0 2 0 2 TFI 13 0 0 16 0 0 29 TR 48 74 59 106 21 40 348 ----- ------ ------ ------ ------ ------ ------ ----- ----- ------ ------ ------ ------ ------ ------ ----- Cour,t 332 269 273 301 183 212 1570 BB - Bed/Break . 2 FSI - Food Serv. Ins . 243* RFD - Retail Food Disc . * - in. 11l* RFI - Ret . Insp . 100* CFI - Cert . Fit . a�0 FSR Food Serv. Re CFR - Cert . Fit . Reinsp . GN Gen . Nuisance 44* RFR - Retail Food Rein. CH - Court Hearing 44* HI - Housing Insp . 312* RO - Rodent Control 13* CON - Constable Serv . HR - Housing Reinsp . 172* SC - Suntan 5 CR - Compliance Rev . LPI - Lead Paint Insp . 26* SES - SESD Odor 3* CT _ Computer Time MS - Massage 7 SM - Seminars/Meetings EC Envirn . Compl . 85* MUP - Mobile Food Insp . 13* Sp - Swim. Pools 14 EPR - Ext . Paint 5* OG - Overgrowth SB - Swim . Beaches Ill* FC - Food Compl . 22 * OS - Off . Sub . Insp . 10* ST - Soil Test/Septic FRH - Food Related Hear . RC - Rec . Camp 5 TFI - Temp . Food 55* 0D - Food Serv . Disc . RFC - Retail Food Comp1 . TR - Trash 758* 1/12/99 ^J Salem Board of Health Review and Evaluation of First Quarter Performance • Goals and Objectives July 1, 1998 through October 30, 1998 In accordance with the Mission Statement of the Salem Board of Health (SBH), and as requested by Board Chairperson Owen Meegan, the following review and evaluation is presented of the agency's first quarter performance in relation to the goals and objectives established by the Board of Directors. It should be noted that the objectives were recently revised and therefore may not be completely congruent with established reporting procedures. Inspectional Services Accomplishments: • Establishment of a priority system for inspecting and monitoring food establishments(submitted to MDPH 9/16/98)to facilitate meeting the goal of complying with MDPH inspection schedules. • 1175 inspections occurred during the first quarter. The majority of inspections involved Trash(TR)which equaled 287 or 24.4% of all inspections,while 277 or 23.6%of all inspections involved Cert.Fit.(CFI). Combined,these two inspection categories totaled 564 or nearly one-half of all inspections(48%). The third most frequently occurring inspection was Swim Beaches(SB) which equaled 111 or a very distant 9.4%. Indeed,the SB number may itself be atypically high due to increased inspections necessitated by a broken sewer pipe. • The following chart offers a projection of the total number of individual inspections this year if first quarter numbers are considered"typical." (Note: Some inspections are seasonal such as Swimming Pools,Beaches,and Mobile Food eateries.). First One Year Inspection Quarter Projection Totals CFI 277 1108 CFR 17 68 CH 21 84 CON 36 144 • CR 14 56 EC 39 156 EPR 10 40 FC 3 12 FSD 3 12 FSI 94 376 FSR 27 108 GN 22 88 Hl 58 232 HR 60 240 MS 1 4 MUP 4 16 OS 13 52 RC 2 8 RFI 24 96 RFR 10 40 RO 2 8 SB ill 444 SES 2 8 SM 9 36 TFI 29 116 TR 287 1148 TOTALS 1175 4700 Concern: • Not all notations are reported by the Inspection Monthly Summary distributed. For example,BB,CT,HRI,FRH, OG,RFC, RFD, SC, and ST are not reported in the Inspection Monthly Summary,they are only cited in the legend. Some of these • omissions may be due to non-generation of violations,however,the abbreviations BB has the number 2 next to it,and SC the number 5. The abbreviations HRI and PC remain unexplained. From the Objectives Report COF Inspections and Reinspections are enumerated,but the abbreviation COF is not explained,nor do these abbreviations appear in the Monthly Summary legend. Recommendations for considerations:Include all inspections in all reports for completeness of reporting and to discover priorities. Make sure all abbreviations are explained and that there is congruence between reports and the statistics presented. Concern: • The Inspection Monthly Summary reports only two SESD odor inspections this quarter(both in July). This would appear to indicate a decrease in odor incidence,yet Board of Health meeting minutes and actions reflect otherwise. • Recommendations for considerations: I am not sure if citations initiated by the Board of Directors and the Health Agent are factored into Inspection Monthly Summary statistics. If not,they should be,otherwise the actions of the Board of Directors may appear out of proportion to the statistics that we are keeping. Concern: • There is no record of having provided educational materials to landlords and tenants regarding housing code requirements. I believe that this is probably done when building permits are obtained, inspections occur,and/or when a violation is cited. Such routine disbursement of health code information may decrease repeated citations. Also,if repeated citations occur,the Board's case is strengthened if it is documented that the violator had received educational material regarding their citation. Recommendations to consider: When violations are cited document the fact that material was provided to the violator regarding house code requirements. This could be as simple as a check off box or notation. Accordingly,the number of violations would then equal the number of times educational material was distributed plus other disbursement methods such as seminars and meetings. Do inspectors carry such material with them at all times to facilitate education? Should they? Medical Services Accomplishments • Despite difficulties in terms of obtaining the services of a physician,the medical services of the SBH moved ahead without curtailment. This is most likely due to the stability of the nursing staff and diligent adherence to state guidelines. • Procurement of the services of a new physician,Dr.Joseph J.Miaskiewicz,whose effectiveness will need to be evaluated in subsequent reports. Concern: • None at this time,only a suggestion. Consider including in subsequent medical reports(by the nurse,physician,or both)written suggestions for changes in our clinic offerings and other medical services-essentially an evaluation of the efficacy of the medical services we render. The inclusion of these brief statements to existing reports seem most appropriate at this time given the stability of the medical personnel now that the hiring of both a nurse and physician has been accomplished. This addition to • existing reports would naturally result from focused discussions among SBH's nurse,physician, and Health Agent who are in a position to render their opinion and recommendations to the Board of Directors. This would also foster collaboration, assist in bringing Dr.Miaskiewicz"up to speed,"and provide a firmer basis for funding requests and Board of Director decisions. Administration Accomplishments • The Health Agent continues to energetically carry out her duties and responsibilities in particular, interfacing with City of Salem officials and citizens on a variety of issues. It is evident that Ms. Scott continues to be an excellent example of how to effectively juggle MDPH requirements, SBH objectives,and available resources. She continues to evaluate the efficacy of the services delivered by the SBH, and not just supervise the activities of her staff. In particular I applaud her efforts to provide continuing education materials to staff for professional development purposes. • Obtained additional computer software and hardware. Concern: • Currently no formal continuing education plan for the Health Agent and staff of the SBE has been fully articulated(and there has been discussion in Board of Director meeting concerning staff qualifications) Recommendations for considerations:Development of a continuing education plan based upon the mission,goals,and objectives of the SBH,in concert with MDPH requirements. Included in plan development should be projections of future needs(who should have what certifications etc.)and funding considerations. Accordingly,this plan should be a collaborative effort involving the entire SBH and it's Board of Directors. Overall Statement The stated objectives of the SBH are being accomplished. Significant achievements include stabilization of medical personnel,acquisition of computer equipment, developing a priority system for providing food inspection services,performing over 1100 inspections,and the effective rendering of medical services despite personnel issues. There remains a need to collaboratively develop and implement an ongoing continuing education plan for SBH personnel,reconsideration of the presentation of some Otatistical information, and the submission of written reports by medical personnel which evaluates the efficacy of our medical services. Finally,a method for accurately describing health code education should also be developed. Respectfully Submitted,Marion E. Winfrey Member, Salem Board of Health January 12, 1999 I 41 • OBJEaNES 2ND QUARTER UPDATE INSPECTIONAL SERVICES The Board of Health sanitarians and inspectors will: ♦ Provide educational materials for landlords and tenants regarding housing code requirements. ♦ Vigorously enforce the Housing Code and trash regulations. Trash Inspections (TR) 348 ♦ Provide housing inspections in accordance with the State Sanitary Code. • Housing Inspections (HI) 80 Housing Reinspections (HR) 88 ♦ Provide Certificate of Fitness inspections for vacant apartments.in accordance with City Ordinance. CFI Inspections 395 CFR Reinspections 23 ♦ Inspect rooming units annually. ♦ Inspect all food establishments at least once every six months and ensure that establishments are in compliance with the Food Manager Certification requirement. Food inspections (FSI+RFI) 152 Food reinspections (FSR+RFR) 60 Temporary Food inspections at the Blues Festival, Maritime Festival, Polish Picnic, Hispanic Festival, SHS Carnival, Haunted Happenings. (TFI) 29 ♦ Inspect swimming pools, recreational camps and suntanning facilities at least once a year. Beaches (SB) 111 Maintained " swim at your own risk" signs. Rec Camp(RC) 2 ♦ Inspect massage establishments at least once a year. Massage (MS) 6 ♦ Inspect body piercing establishments at least once a year. Body Piercing establishment 1 ♦ Investigate complaints regarding any permitted facility. • ♦ Inspect offensive substance transporters at least once a year. Inspections (OS) 13 • ♦ Inspect and review septic systems in accordance with Title V. Inspections (ST) 2 ♦ Decrease the incidence of odor emissions at the South Essex Sewerage District through vigilant investigation and follow-up of all odor complaints. Odor Inspections (SES) 2 ♦ Provide sanitary inspections of neighborhoods when requested in order to limit residents' exposure to raccoons and rodents. Environmental Inspections (EC) 72 ♦ Employ the use of a professional pest control operator as a consultant and to control rodents in public areas. A-1 performed 17 investigations/applications. MEDICAL SERVICES The Board of Health Nurse will: ♦ Follow the State's guidelines regarding the follow-up of reported contagious diseases. • Campylobacter 7 E.Coli 3 TB 0 Giardia 1 Hepatitis 23 Lyme 4 Meningitis 4 Salmonella 5 Pertussis 0 Shigella 2 Varicella 0 ♦ Investigate foodborne illnesses reports with the inspectional staff. ♦ Investigate reports of unsanitary conditions related to housing with the inspectional staff. Home visit made following telephone complaint of unsanitary conditions. Collaboration with DSS for services. Made follow-up visit. ♦ Obtain immunizations from the State in order to maintain an inventory to be distributed to the City's primary care providers. MMR 1569 DTP 2760 Td 4815 OPV 1380 HiB 2240 HepB 3717 IPV 330 PPD 2990 Pneumo 1258 GammaGlobulin 18 ♦ Follow the State's requirements for the school children at St. Joseph's and the Phoenix School including; hearing and vision screening, postural screening, physical examinations, and other screenings as needed, i.e. pediculosis screening; height & weight measurements, review of immunization & medical records; hold clinics, such as for hepatitis b, as needed. Immunization records reviewed, including new students, at St. Joseph's. Hearing/vision screening started at St. Joseph's • Hep B clinic at St. Joseph's ♦ Sponsor an annual influenza( and pneumonia) clinics, and make home visits the City's elderly and at risk residents for the purpose of immunizing against flu and pneumonia. • 1,611 residents vaccinated Appeared as guest on WESX with Al Needham to discuss flu/pneumonia clinic. ♦ Develop and implement blood pressure clinics for Police, Fire and City personnel, making referrals as needed. ♦ Perform annual TB testing for North Shore ambulance employees and other city residents upon request. 14 city residents tested in office. ♦ Conduct hepatitis B clinics for Police, North Shore Ambulance employees and other City employees in conjunction with their contracts. Hep B clinic for 13 DPW workers ♦ Provide clinics for non-contagious diseases as determined by need and feasibility. The Board of Health Doctor will: ♦ Supervise the medical activities of the Board and its Nurse, including screening clinics, flu clinics, school child assessments, etc. Voluntary services of Dr. Leonard Dumas Joseph Miaskiwicz appointed as Board of Health Doctor • ♦ Authorize the obtaining and distribution of all vaccines given in Salem. Voluntary services of Dr. Leonard Dumas ♦ Perform physicals as required at St. Joseph's and the Phoenix School. ♦ Attend the flu clinics. Voluntary services of dr. Leonard Dumas ♦ Attend the Board's monthly meetings. Voluntary services of Dr. Leonard Dumas Dr. Miaskiwicz attended December meeting ♦ Consult with the Health Agent and Nurse regarding communicable diseases and other medical issues of concern to the Board. The Board of Health dentist will: ♦ offer screening to the City's school children, through eight grade, for dental problems. 348 chilren to date, Bentley 168 to date. ADMINISTRATION The Health Agent will: ♦ Maintain a working relationship with the Point community by regularly attending is community events. Continued to attend meetings of board of the Salem Family Health Center, including interviewing candidates for the position of executive director. 40 • Elected President of Family Health Center Board. ♦ Be an active member of the Mayor's Neighborhood Improvement Task Force. Sent representative to September meeting of task force and attended October and December meetings. (November meeting not held because of Thanksgiving.) ♦ Represent the Board in presentations to the Mayor and City Council and communicate to the Board proposals and recommendations by the Mayor and City Council. Presented information to the Mayor regarding the BOH Doctor, overtime, and the art time inspector's position. Attended City Council subcommittee meeting with p p P Y g Chairman to discuss these. Participated in the Mayor's Family Picnic. Developed action plan and time line to address issues raised by the auditor's report. Completed several actions including; discussion of ticket process with city clerk, discussion of fee schedule with Board, submission of food establishment ranking system to MDPH, inspection of massage establishments, ticket accountability, and data processing. Attended four of Mayor's management seminars. Maintained office hours on Friday afternoon at Mayor's request. Inspect Federal Street School for air quality issues and asbestos. ♦ Provide the office staff with the opportunity to attend educational seminars as offered by the State and other public health associations and organizations. • Health Agent& Public Health Nurse attended "Medical Response to Biological Terrorism." Health Agent, Sanitarians attended "hoarding" seminar ♦ Be a member of Salem's Local Emergency Planning Committee. Attended two meetings. ♦ Provide computer training for the staff. ♦ Continue to purchase computer equipment as necessary and allowed by the budget. Purchase clerk's computer with septic management grant. Apply for and receive nurse's computer from MDPH ♦ Encourage networking among the inspectors and the staff of the Massachusetts Department of Public Health and the Department of Environmental Protection and other health professionals. ♦ Maintain membership in the North Shore Boards of Health Collaborative for the purpose of administering its tobacco control grant, as well as for information sharing. Attended two meeting, including one regarding media relations with David Marcus, EditorSalem Evening News. ♦ Provide secretarial services to the Animal Control Officer in order to ensure that pets potentially exposed to rabies are properly quarantined. 18 potential exposures ♦ Gather information through public health publications, computer services or any other means and disseminate that information to the staff and Board. • Information gained via internet concerning e-coli remedies in cattle. Circulated issues of The Journal of the American Public Health Association, The Journal of the National Environmental Health Association. t i • ♦ Maintain the Board's memberships in related professional organizations. Renewed Board's membership in NACCHO, NEHA, MEHA. ♦ Review health status indicators to prioritize possible interventions. ♦ Develop a process and procedures book. Addition of food establishment inspection protocol, correct name of organization. ♦ Perform assessment of clerical support staff and review descriptions of jobs. Received job descriptions from three clerks ♦ Be responsible for and supervise the overall operation of the Board of Health, and provide quarterly reports on these objectives. Submission of 1st quarter update to the Board and Mayor. ♦ In addition: Closely monitored SESD's broken pipe situation and appeared on WESX with the Chairman regarding this and other board issues. Responded to lack of odor control at the SESD. Plan review for new/renovated establishments; The Point, Deke's, Cima Supermarket, Baybridge, Tin Whistle, Bella Pizza, IC Mccaw's, Crypt Cafe, Goldbuck's, Kitchen Table, Lunchbox, Hamilton Hall, Scuttlebutts, Dunkin Donuts Paradise Road, Bluepoint, Giogio's, Bates School. • • Salem Board of Health • December Phone Logs 1998 Total Answered Answered Calls Monday November 30, 1998 Tuesday December 1, 1998 46 Barb=136 Wednesday December 2, 1998 46 Mary=256 Thursday December 3, 1998 33 Sue=283 Friday December 4, 1998 1ii Saturday December 5, 1998 Calls Taken Sunday December 6, 1998 Joanne 143 Monday December 7, 1998 65 Ginny 116 Tuesday December 8, 1998 48 Jeffrey 20 Wednesday December 9, 1998 29 Mark 91 Thursday December 10, 1998 36 Pablo 13 Friday December 11, 1998 20 Jose 24 SaturdayDecember 12, 1998 Tracy 84 Sunda December 13, 1998 Barb 42 • Monday December 14, 1998 38 Mary 80 Tuesday December 15, 1998 35 Sue K. 62 Wednesday December 16, 1998 40 Thursday December 17, 19981 33 1 * =21 Work Days FridayDecember 18, 1998 14 * =38 Hours Per Week SaturdayDecember 19, 1998 Sunda December 20, 1998 Monday 8-4 Monday December 21, 1998 28 Tuesday 8-4 Tuesday December 22, 1998 22 Wednesday 8-4 Wednesday December 23, 1998 7 Thursday 8-7 Thursday December 24, 1998 9 Friday 8-4 FridayDecember 25, 1998 Holida Saturday December 26, 1998 Sunday December 27, 1998 Monday December 28, 1998 30 Tuesday December 29, 1998 31 Wednesday December 30, 1998 16 Thursday December 31, 1998 10 • Total Calls * =675 i ADMINISTRATION - MONTHLY REPORT NOVEMBER 1998 AMOUNT BIOLOGICS DISTRIBUTED AMOUNT IN DOSES Diptheria , Tetanus b Perrussis 645 BURIAL PERMITS 58 @ $5.00 = $200.00 Diptheria-Tetanus Tox . (under 6 yrs . ) —0— LICENSES AND PERMITS 82•80 l Immune Serum Globulin —0— CERTIFICATE OF FITNESS 62@::2 50(03 $1,550.00 i Measles/Mumps/Rubella 330 Polio OPV — 460 — IPV — 240 I Tetanus b Diptheria (adult use) 1460 Tuberculin PPD 260 RIB Titre 530 ANIMAL BITES REPORTED —1 Hepatitis B 330 { r 4 SALARY/LONGEVITY : ANNUAL BUDGET EXPENSES AVAILABLE BALANCE $329,827.00 $121,055.30 $208,771.70 i NON-PERSONNEL: ANNUAL BUDGET EXPENSES ENCUMBERED AVAILABLE BALANCE $21 ,800.00 $4,518.09 $6,243.05 $11,038.86 i i i l i L ��ONI1fT,(9 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 PUBLIC HEALTH NURSE REPORT November Activities DISEASE PREVENTION In touch with T.B. Clinic and following active cases and case contacts. four PPD screenings done in office. Vaccine inventory maintained and distributed. Investigated all communicable disease cases and reported to the M.D.P.H. MEETINGS AND CLINICS: • 11/2-4 Home visits for elderly home bound residents. 11/5 City Employees Flu Clinic, one Salem Green: 46 Employees Vaccinated. 11/5 VoceS Flu Clinic: 100 residents vaccinated. 11/17 Health Fair Mtg: Ongoing plans for Wellness Fair 1999 11/17 VOCES Flu Clinic: 84 residents vaccinated. TOTAL AMOUNT OF RESIDENTS VACCINATED BY SALEM BOARD OF HEALTH 1,611 (OFFICE APPOINTMENTS ARE STILL BEING OFFERED) 11/19 Participated in Science and Technology Night at Saltonstall School. Presented educational materials about communicable diseases,and a demonstration about the importance of proper hand washing. 11/25 Home Visit: Suspect active Tuberculosis case. Directly Observed Therapy will be used for this patient. ST. JOSEPH'S SCHOOL 11/24 Hepatitis B Clinic: 7 Students vaccinated with the first of the three shot series. PHOENIX SCHOOL • 11/23 Immunization records reviewed. y • Summary of Communicable Diseases November 1998 Cryptosporidium: 33 y/o male. Unemployed. Case was currently in the hospital. Incubation period coinsides with his traveling to Denver. He is currently on IV antibiotics, and is still symptomatic. • . . Hepatitis: 2 Hepatitis B cases. 3 Hepatitis C cases. 4 cases reported from Center for Addictive Behavior, Methadone Clinic. No response from cases at Clinic. I spoke to Palma Caron at MDPH Surveillance. All Boards f Health may forward case report to CAB. Councelors will interview • y r clients when they come to the clinic, and send information to Public Health Nurses. Tuberculosis (suspect) : 30 y/o male. All suspect cases are treated as active cases until final sputum culture. There are 10 close contacts. He works at a Nursing Home in Danvers. Work contacts are being tested by employers. He is asymptomatic at this time. I am working with the Outreach Worker from the State. We have implemented Directly Observed Therapy for this case. I will see the client on Tuesdays and Thursdays at his home. This case is a contact of a past active case. ,r N • MONTHLY REPORT OF COMMUNICABLE DISEASES FOR THE MONTH OF NOVEMBER 1998 *DISEASE NEW CARRY OVER DISCHARGED REPORTS TO CASES CASES CASES STATE CAMPYLOBACTER 0 0 0 0 CRYPTOSORIDIUM 1 0 0 0 • GIARDIA 0 0 0 0 HEPATITIS 5 1 0 0 LYME DISEASE 0 0 0 0 MENINGITIS 0 0 0 0 MUMPS 0 0 0 0 PERTUSSIS 0 0 0 0 SALMONELLA 0 0 0 0 SHIGELLA 0 0 0 0 TUBERCULOSIS 0 0 0 0 VARICELLA 0 0 0 0 *THOSE DISEASES EXCLUDED FROM ABOVE HAVE NOT BEEN IDENTIFIED DURING THIS MONTH. Tracy L. Giarla L.P.N. • Public Health Nurse For the Board of Health • City Of Salem Environmental Health Division - - Inspection Monthly Summary Month -------------------------------------- Type Jul 98 Aug 98 Sep 98 Oct 98 Nov 98 Count CFI 79 55 83 60 59 336 CFR 5 6 4 2 1 18 CH 7 8 2 4 3 24 CON 14 8 8 6 0 36 CR 2 1 5 6 6 20 ' EC 20 7 5 7 19 58 EPR 2 1 3 4 0 10 FC 1 0 2 0 2 5 FSD 0 0 2 1 3 6 FSI 23 15 27 29 13 107 FSR 6 5 7 9 14 41 GN 8 8 4 2 1 23 HI 14 23 13 8 11 69 HR 11 14 11 24 7 67 HRI 0 0 0 0 1 1 MS 0 1 0 0 0 1 MUP 2 0 0 2 0 4 0S 1 0 12 0 0 13 RC 2 0 0 0 0 2 RFI 5 3 9 7 9 33 RFR 2 1 2 5 3 13 0 2 0 0 0 0 2 B 62 36 13 0 0 111 SES 2 0 0 0 0 2 SM 1 3 2 3 8 17 ST 0 0 0 0 2 2 TFI 13 0 0 16 0 29 TR 48 74 59 106 21 308 Court. 332 269 273 301 1B3 1358 BB - Bed/Break . 2 FSI - Food Serv. Ins . 243* RFD - Retail Food Disc . CFI - Cert . Fit . 890* FSR - Food Serv. Rein. 11l* RFI - Ret . Insp. 100* CFR - Cert . Fit . Reinsp . GN Gen . Nuisance 44* RFR - Retail Food Rein . _ CH - Court Hearing 44* HI Housing Insp . 312* RO - Rodent Control 13* CON - Constable Serv . HR - Housing Reinsp . 172* SC - Suntan 5 CR - Compliance Rev . LPI - Lead Paint Insp . 26* SES - SESD Odor 3* CT Computer Time MS - Massage 7 SM - Seminars/Meetings EC - Envirn . Compl . 85* MUP - Mobile Food Insp . 13* SP - Swim. Pools 14 EPR - Ext . Paint 5* OG - Overgrowth SB - Swim. Beaches ill* PC - Food Compl . 22* OS - Off . Sub. Insp . 10* ST - Soil Test/Septic FRH - Food Related Hear . RC - Rec . Camp 5 TFI - Temp . Food 65* FSD - Food Serv . Disc . RFC - Retail Food Compl . TR - Trash 758* • 12!2/98 • NEWSLETTER 42 December 8, 1998 AGENT'S REPORT TO THE BOARDOD would no longer be valid after system. The owner's December 31 st. That letter is BOARD OF HEALTH attorney has said he will in the packet. Someone from DOCTORM' present a plan for a tight tank the SESD and/or the trucking Joseph Miaskiewicz has as a temporary solution. The company will probably come agreed to become our Board attorney also says he is before the Board to discuss of Health doctor. I had a attempting to connect to the the truck covers. conversation with him and Salem sewer line. This idea Also in the packet, is a have sent him written had been investigated draft of a letter to the SESD, materials regarding his previously and was found to which Owen would like you responsibilities. Dr. be cost prohibitive. I have to consider regarding Miaskiewicz has Thursdays asked the attorney and continued odor nuisances. off and has requested that owners to attend our meeting any physicals/clinics we want to update us regarding that . FY 98 OBJECTIVES1 him to attend be scheduled system. I have ordered Owen has requested that *On that day of the week. In pumping of the system as Marion review our completed addition, he asked that h4ri-- often as necessary to prevent report regarding last fiscal presence at the Board meeting "breakthrough" of the sewage year's objectives and present be required from 7 to 8 pm, to the surface. However, her findings to the Board. unless there is a special item since this appeal could take under consideration requiring months, an order requiring STOP & SHOPS his continued attendance. I that they block sewage The new Stop & Shop will told him that I didn't think distribution from the septic probably open next Thursday. there would be a problem tank ( effectively turning it We have had an extensive with his requests. He will into a small tight tank) may review of plans and I receive our packet and should be warranted. conducted a preliminary be at our meeting. It seems In addition, there is a plan inspection this week. that the City Council has before the Board for another approved a stipend of $3200 property at 8 Cedar Crest SEMINARS% for Dr. Miaskiewicz. I will Road, requesting variances to Marion and I attended the have confirmation of that by Title V. MAHB seminar recently. Tuesday. Martin has reviewed those In addition, David plans. Marcus, Editor of the Salem TITLE V0 Evening News conducted a The DEP has informed me SESDE seminar for the collaborative •that the occupants at 8 The Board instructed me regarding media relations. It Wyman Avenue have to inform the SESD that the Was very interesting. appealed its decision denying previously granted variance JyAmpy iYO&BA` A the alternative mounded for the sludge hauling trucks, Salem Board of Health • November Phone Logs 1998 Total Answered Answered Calls Monday November 2, 1998 53 Barb=143 Tuesday November 3, 1998 45 Mary=301 Wednesday November 4, 1998 39 Sue=321 Thursday November 5 1998 48 Friday November 6, 1998 28 Saturday November 7,]1998 Calls Taken Sunda November 8, Joanne 150 Monday November 9, 1998 41 Ginny 147 Tuesday November 10, 1998 43 Jeffrey 14 Wednesday November 11, 1998 Holiday Mark 60 Thursday November 12, 1998 50 Pablo 3 Friday November 13, 1998 19 Jose 41 Saturday November 14, 1998 Tracy 156 Sunday November 15, 1998 Barb 46 Monday November 16, 1998 55 Mary 81 Tuesday November 17, 1998 42 Sue K. 67 Wednesday November 18, 1998 37 Thursday November 19, 1998 49 1 18 1/2 Work Days Friday November 20, 1998 2 NJ * =38 Hours Per Week Saturday November 21, 1998 Sunday November 22, 1998 Monday 8-4 Monday November 23, 1998 36 Tuesday 8-4 Tuesday November 24, 1998 54 Wednesday 8-4 Wednesday November 25, 1998 48 Thursday 8-7 Thursday November 26, 1998 Holiday Friday 8-4 Friday November 27, 1998 5 Saturday November 28, E99 Sunda November 29, • Monday November 30, 1998 51 Total Calls * = 765 PO' OCTOBER 1998 D:`1iN T Si T. AMOUNT _ S E.S`.. _ MOUNT IN DOSES I -- G I'J L'v G =G S., � ---- -- D±pCher .a , Teccanus o Percussis 525 BURIAL PERMITS 47 @ $5.00 = $235,00 i 20 $668.20 Dip�her ±a- Tetanus ;cx . ;uneer 6 >•rs • � LICENSES AND PERMITS Irunune Seru-, G'-obul' 2 VIALS CERTIFICATE OF FITNESS 64 @ $25.001 $1,600.00 " 360 easies/`?_:' ps!Ruoe. 330 c - '_L aCt.lC Jse � pc.,e: 800 uberc 1 PD 460 ' TB e 370 ANIMAL BITES REPORTED e p a c ±' i s E __-_--- --_ PEDI - 570 11-19 YRS= 280 EXPENSES AVAILABLE BALANCE $329,527 .00 $89,926.44 $239,900.56 A�NNUA= i3 ?� i: i+ EL- - UDG EXPENSES ENCUMBERED AVAILABLE BALANCE N 0 N- s0 i: $21 ,800. 00 $2,771.08 $5,360.81 $13,668.11 f � � e e ( CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH, IRS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 PUBLIC HEALTH NURSE REPORT October Activities DISEASE PREVENTION In touch with T.B. Clinic and following active cases and case contacts. four PPD screenings done in office. vaccine inventory maintained and distributed. Investigated all communicable disease cases and reported to the M.D.P.H. • MEETINGS AND CONFERENCES 10/1 Health Fair Meeting 10/5 "On the Air" with Al Needham WESX. Announced Flu Clinics, discussed influenza and the elderly. 10/13 Meeting with Salem State Nursing Students to discuss Council on Aging Flu Clinic. 10/14 Council on Aging Flu Clinic: 797 people vaccinated. This clinic was held 9 a.m. to 12 noon. 10/15 Home visits offered to all Salem Homebound residents. 10 residents received the flu vaccine. 10/21 North Shore Ambulance Flu Clinic: 18 Staff members vaccinated. 10/28 Charter Street Flu Clinic: 423 people were vaccinated. 10/29 Pioneer Terrace: 123 people vaccinated. Office visits for flu shots are offered to any resident working during the day on Thursday evenings. Approx 15 visits this month. Flu Total for October: 1,376 people vaccinated. i • Summary of Communicable Diseases October 1998 Campylobacter: 42 g e/o female. She suspects she of ill from the water at her Y P vacation home in New Hampshire. Water Supply is a Public well. I notified Health Agent in that area. Acording to Health Agent, there were no other cases of campylobacter recently. She also ate breakfast at Century House for breakfast with 7 friends. No one else was ill. Both suspect places coincide with incubation period. Peabody Health Dept. notified. • This case is a nurse. She has returned to work after 1 negative stool results Hepatitis: 2 Hepatitis B cases. 4 Hepatitis C cases. 4 cases reported from Center for Addictive Behavior, Methadone Clinic. According to Deborah Henry, charge nurse at the clinic, a new policy for the clinic is to screen all new patients for Hepatitis. I have sent letters to all cases, awaiting response. ��ONUIT,Ia • 9�� aF CjMINE�`" CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 MONTHLY REPORT OF COMMUNICABLE DISEASES FOR THE MONTH OF OCTOBER 1998 *DISEASE NEW CARRY OVER DISCHARGED REPORTS TO CASES CASES CASES STATE CAMPYLOBACTER 1 0 1 1 E.COLI 0157 0 0 0 0 GIARDIA 0 0 0 0 HEPATITIS 6 1 0 0 LYME DISEASE 0 0 0 0 MENINGITIS 0 0 0 0 MUMPS 0 0 0 0 PERTUSSIS 0 0 0 0 SALMONELLA 0 0 0 0 SHIGELLA 0 0 0 0 TUBERCULOSIS 0 0 0 0 VARICELLA 0 0 0 0 *THOSE DISEASES EXCLUDED FROM ABOVE HAVE NOT BEEN IDENTIFIED DURING THIS MONTH. Tracy L. Giarla L.P.N. Public Health Nurse For the Board of Health f • NEWSLETTER 41 November 10, 1998 AGENT'S REPORT TO THE BOARDO BOARD OF HEALTH regulations regarding body DOCTORw program is Access. So Mary will piercers and piercing Dr. Murray has called to say be learning that new program establishments. he is unable to accept the position soon. Regarding body piercing, of city physician or board of Judy Murphy, owner of the Purple health doctor. He said he thought COMPUTERS® Scorpion, has suggested a couple about it for quite a while. The Speaking of Mary, we were of changes to our regulations. position in the community sounds able to purchase a new computer She recommends that we prohibit very interesting to him and he for her with money from the the sale of piercing needles in any wishes he could accept. septic management grant. establishment. She claims that However, one of his partners left The MDPH is also "loaning" stores that sell the jewelry also his already very busy practice in computers to public health nurses sell these do-it-yourself July so he doesn't have any time for reporting and tracking of instruments. Also, she advises • to spare. I informed Al Viselli. communicable diseases. This that we require that threaded would be a three year loan and replacement jewelry be 1st QUARTERLY UPDATE would include training and ultrasonically cleaned prior to sale OF THE BOARD'S maintenance. We have applied for in order to remove any OBJECTIVES✓ one. manufacturing debris that is on Although it may seem that you the jewelry such as metal just saw the final version of the MANAGEMENT splinters. board's FY99 Objectives, it is SEMINARS% already time for the first update. The Mayor has arranged for HAUNTED HAPPENINGS® It is enclosed.in your packet for department heads to attend There were many temporary review. I think we are on track. management training held at the food establishments set up for Police Station ever other Friday Haunted Happenings. Jose did Y Y TICKETINGO morning. There have been three most of the inspections. The staff As I mentioned at the last seminars to date, including topics and I appreciate the Board's meeting, the City Clerk is unable such as team building and conflict regulation regarding food to continue tracking our tickets resolution. manager certification, not only at for trash, food violations, etc., for events such as this, but whenever payments and court dates. BODY PIERCING i we are discussing code issues Mary has taken over the clerk's There was an article in the with food handlers. Now we function and her computer Salem State newspaper regarding speak "the same language" with program too! The only problem the availability of mobile body them more often! • is that the program used by the piercing outside the student clerk , and incidentally also by center. We notified the director Mary for all her permit tracking, of the student center that this was CONGRATS TO MARK. CHO! is being phased out by Data not allowed in Salem and that the O Processing. The preferred Board of Health has stringent � Z � � ` . � \� / � � � � } ; ; � � � � \ 7 } � � � 2 ! ' � � � . , 7 z / : � } ; � : � ; ' | � � \ } � i � � � � � � � \ ) ! f : � , ! ; ' � \ ! � / ! � ; � } | ( } \ . � � . \ \ \ } d � � \ � � ! - ; z . . � } | � \ : � . ! � � : ` � � � / � � ; : | ` � . : . � • VtSION STATEMW The Salem Board of Health is responsible for the stewardship of the Public Health . This is accomplished through the enforcement of Environmental and Sanitary Codes, State Statutes and local regulations; promotion of sound public health practices, education and disease prevention. • f so p� .--� arc... Wn ... .c.. n i,... ..--r �»....... __ '0..._ ..... ♦ The Board of Health will continually review objectives and goals for relevance and realism for the purpose of determining appropriate resource allocation. ♦ The Board shall strive for an improvement in the "Health Status Indicators" as presented by the Massachusetts Department of Public Health. ♦ The Board, in all actions and considerations, will exhibit sensitivity toward culturally diverse populations. • ♦ The Board will strive to make Salem a healthier, more attractive place to live, visit, and work. .l ti "t , 4 • aAJLS INSPECTIONAL SERVICES ♦ Prioritize the prevention, detection, and amelioration of serious housing and trash violations to high population density areas and non-owner occupied dwellings. ♦ Comply with the Massachusetts Department of Public Health regulations regarding inspection frequency of food service, retail food establishments, and other permitted establishments. ♦ Establish a more knowledgeable force of food workers in order to avoid critical violations of the food code. ♦ Respond to residents' public health concerns. ♦ Monitor the South Essex Sewerage District, and respond to neighborhood complaints and • concerns regarding its operations. ♦ Limit exposure to diseased animals. MEDICAL SERVICES ♦ Limit the exposure and incidence of contagious diseases through investigation, detection, and prevention. ♦ Respond to residents' concerns regarding illness and sanitation issues. ♦ Maintain an inventory of vaccines and biologics required by the City's hospital, clinics and physicians. ♦ Provide selected nursing services to St. Joseph's Elementary School and the Phoenix School. ♦ Provide immunization clinics and educational seminars as determined by the Board. ♦ Provide dental screening to Salem's school children. ADMINISTRATION ♦ Remain aware of and responsive to the public health concerns of the City's citizenry. ♦ Maintain and strengthen effective working relationships with other City departments. • ♦ Maintain and strengthen collaboration between the Board and the Mayor and City Council. ♦ Ensure the continued professional development of the Department's staff. ♦ Maintain preparedness for public health emergencies. J • ♦ Expand the office's capabilities regarding computers. ♦ Review objectives of the Board regarding tobacco control. ♦ Continue the use of the media as a tool for disseminating information regarding public health concerns and education. ♦ Continue to maintain a current base of public health information ♦ Formalize methods of departmental operations. • • Y J y • OBJEaNES INSPECTIONAL SERVICES The Board of Health sanitarians and inspectors will: ♦ Provide educational materials for landlords and tenants regarding housing code requirements. ♦ Vigorously enforce the Housing Code and trash regulations. ♦ Provide housing inspections in accordance with the State Sanitary Code. ♦ Provide Certificate of Inspection inspections for vacant apartments in accordance with City Ordinance. ♦ Inspect rooming units annually. ♦ Inspect all food establishments at least once every six months and ensure that establishments are in compliance with the Food Manager Certification requirement. • ♦ Inspect swimming pools, recreational camps and suntanning facilities at least once a year. ♦ Inspect massage establishments at least once a year. ♦ Inspect body piercing establishments at least once a year. ♦ Investigate complaints regarding any permitted facility. ♦ Inspect offensive substance transporters at least once a year. ♦ Inspect and review septic systems in accordance with Title V. ♦ Decrease the incidence of odor emissions at the South Essex Sewerage District through vigilant investigation and follow-up of all odor complaints. ♦ Provide sanitary inspections of neighborhoods when requested in order to limit residents' exposure to raccoons and rodents. ♦ Employ the use of a professional pest control operator as a consultant and to control rodents in public areas. MEDICAL SERVICES The Board of Health Nurse will: ♦ Follow the State's guidelines regarding the follow-up of reported contagious diseases. ♦ Investigate foodborne illnesses reports with the inspectional staff. ♦ Investigate reports of unsanitary conditions related to housing with the inspectional staff. ♦ Obtain immunizations from the State in order to maintain an inventory to be distributed to the City's primary care providers. ♦ Follow the State's requirements for the school children at St. Joseph's and the Phoenix School including; hearing and vision screening, postural screening, physical examinations, and other screenings as needed, i.e. pediculosis screening; height & weight • measurements,review of immunization& medical records; hold clinics, such as for hepatitis b, as needed. ♦ Sponsor an annual influenza(and pneumonia) clinics, and make home visitsto the City's elderly and at risk residents for the purpose of immunizing against flu and pneumonia. ♦ Develop and implement blood pressure clinics for Police, Fire and City personnel, making referrals as needed. ♦ Perform annual TB testing for North Shore ambulance employees and other city residents upon request. ♦ Conduct hepatitis B clinics for Police,North Shore Ambulance employees and other City employees in conjunction with their contracts. ♦ Provide clinics for non-contagious diseases as determined by need and feasibility. The Board of Health Doctor will: ♦ Supervise the medical activities of the Board and its Nurse, including screening clinics, flu clinics, school child assessments, etc. ♦ Authorize the obtaining and distribution of all vaccines given in Salem. ♦ Perform physicals as required at St. Joseph's and the Phoenix School. ♦ Attend the flu clinics. ♦ Attend the Board's monthly meetings. ♦ Consult with the Health Agent and Nurse regarding communicable diseases and other • medical issues of concern to the Board. The Board of Health dentist will: ♦ offer screening to the City's school children, through eigth grade, for dental problems. ADMINISTRATION The Health Agent will: ♦ Maintain a working relationship with the Point community by regularly attending community events. ♦ Be an active member of the Mayor's Neighborhood Improvement Task Force. ♦ Represent the Board in presentations to the Mayor and City Council and communicate to the Board proposals and recommendations by the Mayor and City Council. ♦ Provide the office staff with the opportunity to attend educational seminars as offered by the State and other public health associations and organizations. ♦ Be a member of Salem's Local Emergency Planning Committee. ♦ Provide computer training for the staff. ♦ Continue to purchase computer equipment as necessary and allowed by the budget. ♦ Encourage networking among the inspectors and the staff of the Massachusetts Department of Public Health and the Department of Environmental Protection and other • health professionals. ♦ Maintain membership in the North Shore Boards of Health Collaborative for the purpose of administering its tobacco control grant, as well as for information sharing. S ♦ Provide secretarial services to the Animal Control Officer in order to ensure that pets potentially exposed to rabies are properly quarantined. ♦ Gather information through public health publications, computer services or any other means and disseminate that information to the staff and Board. ♦ Maintain the Board's memberships in related professional organizations. ♦ Review health status indicators to prioritize possible interventions. ♦ Develop a process and procedures book. ♦ Perform assessment of clerical support staff and review descriptions of jobs. ♦ Be responsible for and supervise the overall operation of the Board of Health, and provide quarterly reports on these objectives. • • w • OBJECTNES I ST QUARTER UPDATE INSPECTIONAL SERVICES The Board of Health sanitarians and inspectors will: ♦ Provide educational materials for landlords and tenants regarding housing code requirements. ♦ Vigorously enforce the Housing Code and trash regulations. Trash Inspections 180 ♦ Provide housing inspections in accordance with the State Sanitary Code. • Housing Inspections 49 Housing Reinspections 36 ♦ Provide Certificate of Fitness inspections for vacant apartments in accordance with City Ordinance. COF Inspections 217 COF Reinspections 15 ♦ Inspect rooming units annually. ♦ Inspect all food establishments at least once every six months and ensure that establishments are in compliance with the Food Manager Certification requirement. Food inspections 95 Food reinspections 23 Temporary Food inspections at the Blues Festival, Maritime Festival, Polish Picnic, Hispanic Festival. ♦ Inspect swimming pools, recreational camps and suntanning facilities at least once a year. Beaches 111 Maintained " swim at your own risk" signs. Rec Camp 2 ♦ Inspect massage establishments at least once a year. Massage 1 ♦ Inspect body piercing establishments at least once a year. ♦ Investigate complaints regarding any permitted facility. ♦ Inspect offensive substance transporters at least once a year. • Inspections 13 ♦ Inspect and review septic systems in accordance with Title V. ♦ Decrease the incidence of odor emissions at the South Essex Sewerage District through s f • vigilant investigation and follow-up of all od6r complaints. Odor Inspections 2 ♦ Provide sanitary inspections of neighborhoods when requested in order to limit residents' exposure to raccoons and rodents. Environmental Inspections 32 ♦ Employ the use of a professional pest control operator as a consultant and to control rodents in public areas. A-1 performed 10 investigations/applications. MEDICAL SERVICES The Board of Health Nurse will: ♦ Follow the State's guidelines regarding the follow-up of reported contagious diseases. Campylobacter 5 E.Coli 3 TB 0 Giardia 1 Hepatitis 6 Lyme 2 Meningitis 4 Salmonella 5 Pertussis 0 Shigella 2 Varicella 0 • ♦ Investigate foodborne illnesses reports with the inspectional staff. ♦ Investigate reports of unsanitary conditions related to housing with the inspectional staff. Home visit made following telephone complaint of unsanitary conditions. Collaboration with DSS for services. Made follow-up visit. ♦ Obtain immunizations from the State in order to maintain an inventory to be distributed to the City's primary care providers. MMR 725 DTP 1005 Td 1905 OPV 590 HiB 970 HepB 1874 IPV 90 PPD 1780 Pneumo 690 GammaGlobulin 14 ♦ Follow the State's requirements for the school children at St. Joseph's and the Phoenix School including; hearing and vision screening, postural screening, physical examinations, and other screenings as needed, i.e. pediculosis screening; height& weight measurements, review of immunization & medical records; hold clinics, such as for hepatitis b, as needed. Immunization records reviewed, including new students, at St. Joseph's. ♦ Sponsor an annual influenza( and pneumonia ) clinics, and make home visits the City's elderly and at risk residents for the purpose of immunizing against flu and pneumonia. ♦ Develop and implement blood pressure clinics for Police, Fire and City personnel, making referrals as needed. ♦ Perform annual TB testing for North Shore ambulance employees and other city residents • upon request. 14 city residents tested in office. ♦ Conduct hepatitis B clinics for Police, North Shore Ambulance employees and other City • employees in conjunction with their contracts. J ♦ Provide clinics for non-contagious diseases as determined by need and feasibility. The Board of Health Doctor will: ♦ Supervise the medical activities of the Board and its Nurse, including screening clinics, flu clinics, school child assessments, etc. Voluntary services of Dr. Leonard Dumas ♦ Authorize the obtaining and distribution of all vaccines given in Salem. Voluntary services of Dr. Leonard Dumas ♦ Perform physicals as required at St. Joseph's and the Phoenix School. ♦ Attend the flu clinics. Voluntary services of dr. Leonard Dumas ♦ Attend the Board's monthly meetings. Voluntary services of dr. Leonard Dumas ♦ Consult with the Health Agent and Nurse regarding communicable diseases and other medical issues of concern to the Board. • The Board of Health dentist will: ♦ offer screening to the City's school children, through eight grade, for dental problems. ADMINISTRATION The Health Agent will: ♦ Maintain a working relationship with the Point community by regularly attending community events. Continued to attend meetings of board of the Salem Family Health Center, including interviewing candidates for the position of executive director. ♦ Be an active member of the Mayor's Neighborhood Improvement Task Force. Sent representative to September meeting of task force. ♦ Represent the Board in presentations to the Mayor and City Council and communicate to the Board proposals and recommendations by the Mayor and City Council. Presented information to the Mayor regarding the BOH Doctor, overtime, and the part time inspector's position. Attended City Council subcommittee meeting with Chairman to discuss these. Participated in the Mayor's Family Picnic. Developed action plan and time line to address issues raised by the auditor's • report. Completed several actions including; discussion of ticket process with city clerk, discussion of fee schedule with Board, submission of food establishment ranking system to MDPH. Attended first of Mayor's management seminars. ♦ Provide the office staff with the opportunity to attend educational seminars as offered by the State and other public health associations and organizations. Health Agent& Public Health Nurse attended "Medical Response to Biological Terrorism." ♦ Be a member of Salem's Local"Emergency Planning Committee. Attended two meetings. ♦ Provide computer training for the staff. ♦ Continue to purchase computer equipment as necessary_and allowed by the budget. ♦ Encourage networking among the inspectors and the staff of the Massachusetts Department of Public Health and the Department of Environmental Protection and other health professionals. ♦ Maintain membership in the North Shore Boards of Health Collaborative for the purpose of administering its tobacco control grant, as well as for information sharing. Attended one meeting. ♦ Provide secretarial services to the Animal Control Officer in order to ensure that pets potentially exposed to rabies are properly quarantined. 15 potential exposures ♦ Gather information through public health publications, computer services or any other means and disseminate that information to the staff and Board. Information gained via internet concerning e-coli remedies in cattle. iCirculated issues of The Journal of the American Public Health Association, The Journal of the National Environmental Health Association. ♦ Maintain the Board's memberships in related professional organizations. Renewed Board's membership in NACCHO, NEHA, MEHA. ♦ Review health status indicators to prioritize possible interventions. ♦ Develop a process and procedures book. ♦ Perform assessment of clerical support staff and review descriptions of jobs. Received job descriptions from two clerks ♦ Be responsible for and supervise the overall operation of the Board of Health, and provide quarterly reports on these objectives. ♦ In addition: Closely monitored SESD's broken pipe situation and appeared on WESX with the Chairman regarding this and other board issues. Responded to lack of odor control at the SESD. Plan review for new establishments; The Point, Deke's, Cima Supermarket, Baybridge, Tin Whistle, Bella Pizza, IC Mccaw's, Crypt Cafe, Goldbuck's, Lunchbox, Hamilton Hall, Scuttlebutts. ��ONDfT� a 9 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, IRS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Telephone Records - October 1998 Fax:(978)740-9705 21 Work Days Telephone Calls = 953 Answered by 3 Secretaries Barb = 171 Mary = 316 Susan = 466 M- 8-4 T- 8-4 W- (8-4) TH- (8-7) F_(8.4) • 10-1=46 10-2=23 10-5=54 10-6=53 10-7=53 10-8=64 10-9= 23 10-12=Holiday 10-13=73 10-14=68 10-15=41 10-16=27 10-19= 40 10-20=48 10-21=36 10-22=54 10-23=18 10-26=36 10-27=56 10-28=62 10-29=57 10-30=21 Messages for or calls taken, complaints assigned, handled by office staff etc...... Joanne= 217 Tracy G. = 146 Ginny = 137 Pablo = 8 Mark T.= 59 Barb S. -72 Jeffrey V. =34 Mary = 102 • Jose =33 Sue K. =145 • EMBER 1998 • • ADMINISTRATION - MONTHLY REPORT SEPT AMOUNT _ BIOLOGICS DISTRIBUTED AMOUNT IN DOSES 495 BURIAL PERMITS @ $5.00 = $265.00 Diptheria , Tetanus Percussis Diptheria-Tetanus Tox . (under 6 yrs . ) —0— LICENSES AND PERMITS $130.00 Immune Serum Globulin 8 CERTIFICATE OF FITNESS 78@ $25.00 $1,950.00 Measles/Mumps/Rubella 365 Polio 340 Tetanus 6 Dipt'neria (adult use) 615 Tuberculin PPD 790 —0 HIB Titre 500 ANIMAL BITES REPORTED Hepatitis B PEDI — 402 ADOL. — 360 SALARY/LONGEVITY : ANNUAL BUDGET EXPENSES AVAILABLE BALANCE $329 ,827 .00 $89,926.44 $239,900.56 NON-PERSONNEL: ANNUAL BUDGET EXPE*1SES ENCUMBERED AVAILABLE BALANCE $21 ,800.00 $2,771.08 $5,360.81 $13,668.11 v��ONUIT�! ClMjryg d� CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH, IRS,CHO NINE NORTH STREET HEALTH AGENT Tel: (978)741-1800 Fax:(978)740-9705 PUBLIC HEALTH NURSE REPORT September Activities DISEASE PREVENTION in touch with T.B. Clinic and following active cases and case contacts. four PPD screenings done in office. Vaccine inventory maintained and distributed. • Investigated all communicable disease cases and reported to the M.D.P.H. MEETINGS AND CONFERENCES 9/5 Attended TB orientation for new Public Health Nurses held at Methuen Board of Health by Nancy Taylor Flynn, R.N., Tuberculosis Surveillance Nurse. 9/18 Attended Health Fair meeting with Joanne Scott, Maureen Carr R.N. and Charlie Reed. Discussed plans to combine City Wellnes fair with Salem State College Wellness Fair for Spring of 1999 9/22-9/24 Attended 3 day course with Joanne Scott: Medical Response to Biological Warfare and Terrorism. Held at the State Laboratory by U.S. Army Medical Research Institute of Infectious Disease, CDC, FDA and the Public Health Training Network. 9/25 Health Fair Meeting Flu Clinic Preparation: Salem BOH was allotted 8,300 doses of Influenza vaccine, and 720 doses of Pneumonia from The Massachusetts Immunization Program. More than 6,000 doses were distributed to Health Care Providers in the city. 2,000 doses of Flu and 300 Pneumonia vaccines will be used for the Board of Health Clinics. Board of Health Clinic schedule attached. St. Joseph's 9/3 Attended Kindergarten Orientation for parents and students. • 9/8 Attended Pre-K orientation for parents and students. Phoenix School • Summary of Communicable Diseases September 1998 E. Coli 0157H7 • 16 y/o male. Hospitalized for 24 hours. He is a vegetarian. Case's impression of cause, a salad he purchased at Salem House of Pizza. Jeff Vaughn notified. 3 household contacts were asymptomatic. This case was discussed with Epidemiologist, Jocelyn Isadore at the MDPH. • 3 y/o male. Not hospitalized. According to his mother, the child rarely eats meat. He attends a Day Care in Peabody. The Director was notified. She sent notification to all parents. Peabody Health Agent notified. This case was discussed with Jocelyn Isadore. Case recovered at home. 2 household contacts asymptomatic. 51 y/o grandmother of above case. She had attempted to toilet train him the week the child had symptoms. He was diagnosed 1 week later . She is a non-foodhandler. This case was discussed with Jocelyn Isadore. Hepatitis C • 44 y/o male with immune deficiency. Past history of IV drug abuse. He is under the care of a physician. • Attempted to contact this case by mail. No phone number listed. Will attempt once more. l • MENINGITIS 30 y/o viral menigitis. C/O severe Headache, afebrile. Recovered SHIGELLA • 23 y/o male. Traveled to India. Case's impression of cause: He was very careful not to drink water, but accidentally swallowed water while taking a shower. y • MONTHLY REPORT OF COMMUNICABLE DISEASES FOR THE MONTH OF SEPTEMBER 1998 *DISEASE NEW CARRY OVER DISCHARGED REPORTS TO CASES CASES CASES STATE CAMPYLOBACTER 0 0 0 0 E.COLI0157 3 0 3 3 GIARDIA 0 0 0 0 • HEPATITIS 2 0 2 2 LYME DISEASE 1 0 1 1 MENINGITIS 1 0 1 1 MUMPS 0 0 0 0 PERTUSSIS 0 0 0 0 SALMONELLA 0 0 0 0 SHIGELLA 1 0 1 1 TUBERCULOSIS 0 0 0 0 VARICELLA 0 0 0 0 *THOSE DISEASES EXCLUDED FROM ABOVE HAVE NOT BEEN IDENTIFIED DURING THIS MONTH. Tracy L. Giarta L.P.N. Public Health Nurse • For the Board of Health • FLU & PNEUMONIA CLINIC SPONSORED BY : CITY OF SALEM - BOARD OF HEALTH Wednesday,October 14, 1998 Council On Aging, 5 Broad Street 9:00 A.M. to 12:00 Noon Wednesday, October 28, 1998 Housing Authority, 27 Charter Street 9:00 A.M. to 12:00 Noon Thursday, October 29, 1998 Pioneer Terrace, Community Room 9:00 A.M. to 12:00 Noon Thursday, November 5, 1998 - "City of Salem Employees Only" One Salem Green 2nd. Floor Conference Room 11 :00 A.M. - 2:00 P.M. All vaccines are Free. Influenza vaccination is recommended for all individuals 65 years or older, those with chronic heart and lung conditions, weakened immune systems, chronic medical problems that place them at increased risk for the complications of influenza, and household members of any age providing home care to anyone in the high risk categories. Homebound, or for more information please contact Tracy Giarla, Public Health Nurse at (978) 741 -1800. i f City Of Salem Environmental Health Division --- Inspection Monthly Summary • Month ---------------------- Type Jul 98 Aug 98 Sep 98 Count CFI 79 55 83 217 CFR 5 6 4 15 CH 7 8 2 17 CON 14 8 8 30 CR 2 1 5 8 EC 20 7 5 32 EPR 2 1 3 6 FC 1 0 2 3 FSD 0 0 2 2 FSI 23 15 27 65 FSR 6 5 7 18 GN 8 8 4 20 HI 14 23 12 49 HR 11 14 11 36 MS 0 1 0 1 MUP 2 0 0 2 OS 1 0 12 13 RC 2 0 0 2 RFI 5 3 9 17 RFR 2 1 2 5 RO 2 0 0 2 SB 62 36 13 ill SES 2 0 0 2 �SM 1 3 2 6 FI 13 0 0 13 TR 48 74 58 180 Count 332 269 271 872 BB - Bed/Break. 2 FSI - Food Serv. Ins . 243* RFD - Retail Food Disc . CFI - Cert . Fit . 890* FSR - Food Serv. Rein. 11l* RFI - Ret . Insp . 100* CFR - Cert . Fit .Reinsp . GN _ Gen. Nuisance 44* RFR - Retail Food Rein. CH - Court Hearing 44* HI - Housing Insp. 312* RO - Rodent Control 131 CON - Constable Serv. HR - Housing Reinsp. 172* SC - Suntan 5 CR - Compliance Rev. LPI - Lead Paint Insp. 26* SES - SESD Odor 3* CT _ Computer Time MS - Massage 7 SM - Seminars/Meetings EC - Envirn. Compl . 85* MUP - Mobile Food Insp. 13* SP - Swim. Pools 14 EPR - Ext . Paint 5* OG - Overgrowth SB - Swim. Beaches 111,1 FC - Food Compl . 22* OS - Off . Sub. Insp. 10* ST - Soil Test/Septic FRH - Food Related Hear. RC - Rec. Camp 5 TFI - Temp. Food 65* FSD - Food Serv. Disc . RFC - Retail Food Compl . TR - Trash 758* 10/8/98 • NEWSLETTER 40 October 13, 1998 AGENT'S REPORT TO THE BOARDOD US Army. The Army brass believe that the likelihood of such TOBACCO VENDOR✓ a terrorist incident within our The tobacco vendor, who country approaches 100%. THE MAYOR'S FAMILY appeared before the Board last A frightening difference PICNIC* month, paid the $100 fine for between biological terrorism and The Mayor's family picnic selling cigarettes to a person chemical terrorism is that the took place recently on Winter under 18 years old. effects may not be felt for several Island. I helped for a little while days following exposure to an sanitizing watermelons! Mr. HEALTH FAIR@ agent. By that time many people Crosby said that is how he knew The City of Salem and Salem could be infected, treatment may who I was! State College are collaborating on be ineffective, and victims could the Health Fair this year. The be widely dispersed. BOARD OF HEALTH Fair will take place at the O'Keefe DOCTORow Center on Sunday, April 11 th and Jeff, Mark and I attended a Although I have been unable •Monday, April 12th. Both seminar on "hoarding." Hoarding to reach Dr. Murray by telephone, organizations have had separate is an obsessive/compulsive I wrote to him, inviting him to fairs over the last two years. With disorder where a person's identity our meeting. the synergy of combined energy and comfort are completely and resources, this Fair should be aligned with objects. It could be SESD ODOR-a a very successful and objects such as newspapers, The.Mass Department of comprehensive community event. magazines, animals, etc. The Environmental Protection problem arises when their conducted an on site inspection at TOBACCO CONTROL hoarding activity impinges on the the SESD on August 31 st, at our PROGRAMD health and safety of others. We request. They are requiring that The Collaborative has hired a have just such a case in court the SESD appear before them at a new director for its tobacco now. meeting to explain the problems control program. Her name is Solutions are difficult to find that they are having with odor Dorothy (Dot) Flaherty. Dot has for this disorder. Several people control. In addition, the DEP worked in a smaller tobacco have had decent results by wants a definitive timeline control program and has excellent developing a team approach. regarding the successful operation recommendations. Such a team could consist of a of the odor equipment. person from the board of health, social service agency, police, fire, HAPPY SEMINARS® and elder services. HAUNTED This is the seminar season! HAPPENINGS!! • Tracy and I attended a very OBJECTIVES '99® interesting one concerning The final version will be medical response to biological available at the meeting, if you 0 terrorism. The seminar was wish to vote on it. presented by the CDC and the ��ONUIT� • n ,e 9 � CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH, IRS,CHO NINE NORTH STREET HEALTH AGENT Tel: (978)741-1800 Fax:(978)740-9705 Telephone Records - September 1998 21 Work Days . Telephone Calls = 866 Answered by 3 Secretaries Barb = 156 Mary = 297 Susan = 413 M- 8-4 T- (8-4) W-(8-4) TH- (8-7) F-(8-4) • 9-1 -41 9-2=5 7 9-3=59 9-4=23 9-7=Holiday 9-8=35 9-9=56 9-10= 33 9-11= 18 9-14=50 9-15=40 9-16=47 9-17=49 9-18=22 9-21= 48 9-22=44 9-23= 50 9-24= 40 9-25=23 9-28= 52 9-29=45 9-30=44 Messages for or calls taken, complaints assigned, handled by office staff etc...... Joanne= 191 Tracy G. = 121 Ginny =118 Pablo =10 Mark T.= 72 Barb S. = 53 Jeffrey V. =49 Mary= 75 • Jose = 51 Sue K. = 125 ,MINISTRATION - MONTHLY REPORT AUGUST 1998 AMOUNT — BIOLOGICS DISTRIBUTED AMOUNT IN DOSES e BUR IAL PERMITS 52 @ $5 .00 = I $260.00 Tetanus b Per rCussis 300 Dip[heria ' Tetanus Tox . (under 6 yrs . ) LICENSES AND PERMITS $560.00 Dip[her _a- : 10 it Immune Serum Globulin 6 CERTIFICATE OF FITNESS 59@ $25.00 $1 ,475.00 Measles/Mumps/Rubella 200 Polio OPV - 100 IPV - -0- Tetanus & Dip[heria (adult use) 940 - Tuberculin PPD 380 HIB Ticre I 350 ANIMAL BITES REPORTED -1 Hepatitis B PEDI - 576 HIGH RISK - 120 EXPENSES AVAILABLE BALANCE SALARY/LONG E�'iTY ; ANNUAL BUDGET $265,385.01 $329,827 .00 $64,441.99 EXPENSES ENCUMBERED AVAILABLE BALANCE NON-PERSONNEL: ANNUAL BUDGET $14,208.21 $21 ,800.00 $1,226.00 $6;365.79 • City Of Salem Environmental Health Division --- Inspection Monthly Summary Month -------------- Type Jul 98 Aug 98 Count CFI 79 55 134 CFR 5 6 11 CH 7 8 15 CON 14 8 22 CR 2 1 3 EC 20 7 27 EPR 2 1 3 FC 1 0 1 FSI 23 15 38 FSR 6 5 11 GN 8 8 16 HI 14 22 36 HR 11 13 24 MS 0 1 1 MUP 2 0 2 OS 1 0 1 RC 2 0 2 RPI 5 3 8 RFR 2 1 3 RO 2 0 2 B 62 36 98 10,ES 2 0 2 SM 1 3 4 TFI 13 0 13 TR 48 74 122 Count 332 267 599 FSI'ood Serv. Ins . 243* RFD - Retail Food Disc . gg - Bed/Break . 2 * FS1Food Serv. Rein. 11l* RFI - Ret . Insp. 100* CFI - Cert . Fit . 890 Gen . Nuisance 44* RFR - Retail Food Rein . CFR - Cert . Fit . Reinsp . GN Housing Insp . 312* RO - Rodent Control 13* CH - Court Hearing 44* HI HousingReinsp . 172* SC - Suntan 5 CON - Constable Serv . HT Lead Paint Insp . 26* SES - SESD Odor 3* CR - Compliance Rev . L Massage 7 SM - Seminars/Meetings CT Computer Time Mobile Food Insp . 13* Sp - Swim. Pools 14 EC Envirn . Comp1 . 85* _ r Overgrowth SB - Swim. Beaches 111* EPR - Ext . Paint 5* - Off . Sub . Insp . 10* ST - Soil Test/Septic FC - Food Compl . 22* - Rec . Camp 5 TFI - Temp . Food 65* FRH - Food Related Hear . _ Retail Food Compl . TR - Trash 758* FSD - Food Serv . Disc . • 9/8/93 CONDITi(e CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, IRS,CHO NINE NORTH STREET HEALTH AGENT Tel: (978)741-1800 Fax: (978)740-9705 PUBLIC HEALTH NURSE REPORT August 1998 ACTIVITIES DISEASE PREVENTION In touch with T.B. Clinic and following active cases and case contacts. four PPD screenings done in office. Vaccine inventory maintained and distributed. • Investigated all communicable disease cases and reported to the M.D.P.H. 8/17 Hepatitis B Clinic held at D.P.W. for 13 Water and Sewerage employees. This is the second of three to complete series. MEETINGS AND CONFERENCES 8/28 A home visit was made upon a telephone workers complaint of neglected children and unsanitary conditions in an apartment in Salem. An inspection was conducted by Tracy Giarla and Pablo Valdez. Department of Social Services was notified, a social worker will follow this family with services. A reinspection was conducted on 8/31. Conditions were improved. I will follow this family with periodic home visits, and I will keep in touch with the social worker following this case. se St. Joseph's p 8/20 Immunization records were reviewed at the school. Letters were sent to all new students at St. Joseph's for immunization documentation and recent physicals. • Phoenix School t 3 � � CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 MONTHLY REPORT OF COMMUNICABLE DISEASES FOR THE MONTH OF AUGUST 1998 *DISEASE NEW CARRY OVER DISCHARGED REPORTS TO CASES CASES CASES STATE CAMPYLOBACTER 3 0 2 2 • E.COLI 0157 0 0 0 0 GIARDIA 0 0 0 0 HEPATITIS 3 0 1 1 LYME DISEASE 1 0 1 1 MENINGITIS 1 0 1 1 MUMPS 0 0 0 0 PERTUSSIS 0 0 0 0 SALMONELLA 0 0 0 0 SHIGELLA 0 0 0 0 TUBERCULOSIS 0 0 0 0 VARICELLA 0 0 0 0 *THOSE DISEASES EXCLUDED FROM ABOVE HAVE NOT BEEN IDENTIFIED DURING THIS MONTH. • Tracy L. Giarla L.P.N. Public Health Nurse l summary of communicable Diseases August 1998 Camp y/obacter • 26 y/o female. Had Lobster rolls at a home dinner party. She is a nurse. Infection control was notified. 2nd Stool results are pending. • 32 y/o female. She is a home maker. Case has no impression of cause. She has only had home cooked food that the family had shared. Household is asymptomatic. • Case received on 8/31 Hepatitis Hepatitis C 44 y/o male. Past Hx of IVDA. His spouse is aware of DX. Public Fact Sheet Sent to case. • Hepatitis C No phone number provided. Communicable disease letter sent. No response. • Hepatitis C No reply to letter sent on 8/25 Will send second notice. L yme Disease 7 y/o female. Onset of symptoms: Early June, case was complaining of painful joints, fatigue. Child visited Cranes Beach • Bird Sanctuary, Ipswich in April 98 • Menin itis g Neisseria Meningitidis Sero group c 20 y/o female. Symptoms included headache, high fever. Prophylaxis of Rifampin for 13 contacts. Occupation: Waitress CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, IRS,CHO NINE NORTH STREET HEALTH AGENT Tel: (978)741-1800 Fax: (978)740-9705 Telephone Records - August 1998 21 Work Days Telephone Calls = 870 Answered by 3 Secretaries : Barbara = 144 Mary = 355 Susan= 371 • M - (8-4) T - (8-4) w- (8-4) TH - (8-7) F- 8-3= 42 8-4=43 8-5=41 8-6=61 8-7= 20 8-10=74 8-11=35 8-12=38 8-13=38 8-14= 10 8-17=35 8-18= 31 8-19= 32 8-20=44 8-21=19 8-24= 56 8-25=51 8-26=48 8-27=60 8-29=29 8-31=63 Messages for or calls taken, complaints assigned, handled by office staff etc...... Joanne= 172 Tracy G. =75 Ginny = 138 Pablo = 22 Mark T.= 94 Barb S. = 37 Jeffrey V. =62 Mary = 95 • Jose = 86 Sue K. = 89 *Tracy Giarla covered the telephones on alternating weeks of vacation for secretaries. • NEWSLETTER 39 September 8, 1998 AGENT'S REPORT TO THE BOMA& order letter requiring the I have developed an action SESD to cease creating a plan and time line to address FY 99 GOALS & public health nuisance. Mr. other issues raised by the OBJECTIVES ,a Lundregan was planning to audit. Enclosed in the packet are consult with the Mayor to FY 98 BUDGET N the proposed Goals Sz determine if the Board should The Mayor has removed Objectives for FY 99. continue with the criminal the Board of Health's Changes from last year's are process. obligation to Bass River by minor. BOH DOCTOR,. paying that agency through a I have sent a copy to the The Mayor has said that community development Mayor's office asking for Dr**,-Thomas Murray will be block grant. The Director of input. the City Physician, and so be Bass River was pleased with PUBLIC HEALTH available to the Board as its the new arrangement. I have NURSE♦ Board of Health Physician. requested that the remaining • A letter has been sent to The Mayor had me ask for a $2000 be used as rodent Civil Service asking that we special appropriation of control money be allowed to reject the - =0, or approximately OVERTIME $ Nurse's list. By telephone, $125 for 25 hours of service The City Council our request was denied. to the Board. That request subcommittee on However, I have not received will probably be before the Administration SL Finance has anything in writing. In City Council at its next asked me to come before it addition, Civil Service has meeting. tomorrow night to discuss our just instituted a new AUDIT REPORT ® overtime budget request. procedure for being placed on Enclosed in the packet is This was the supplemental the list. Tracy's name should the report of the audit as appropriation approved by appear on the new list within requested by the Mayor. One the Mayor following the a couple of weeks. I have issue to be addressed by the conversation he had with been in touch with Beth Board is that of"revenue Owen and me. Rennard regarding this. Enhancement." The auditor MANAGEMENT Because Tracy is a member of is recommending an increase EVALUATION the union, she will also ask in permit fees of at least ten The mayor plans to the union attornev how to dollars. A recommendation is evaluate me, with the help of proceed. also made to do an evaluation Owen I believe, in October. ODOR SL THE SESD O to determine the feasibility of • The odor conditions increasing fees. The Board persist at the SESD. Owen did do an evaluation, hold a and I had a meetings the public hearing, and increase City Solicitor, William most fees from $25 to $40 in Lundregan, regarding our early 1996. ADMINISTRATION - MONTHLY REPORT JULY 1998 AMOUNT IN DOSES AMOUNT _ BIOLOGICS DISTRIBUTED Diptheria , Tetanus 6 PercussiS 210 BURIAL PERMITS 40 @ $5.00 = $200.00 Diptheria-Tetanus Tox . (under 6 yrs . ) 10 LICENSES AND PERMITS $1,029.10 Immune Serum Globulin 0 CERTIFICATE OF FITNESS 79@ $25.00 $1,975.00 Measles/Mumps/Rubella 160 Polio OPV = 90 IPV = 90 Tetanus b Diptheria (adult use) 350 Tuberculin PPD 610 —0— HIB Titre 120 ANIMAL BITES REPORTED Hepatitis B PEDI = 336 HIGH RISK = 80 SALARY/LONGEVITY : ANNUAL BUDGET EXPENSES AVAILABLE BALANCE $329,827 .00 $39,563.15 $290,263.85 NON-PERSONNEL : ANNUAL BUDGET EXPENSES ENCUMBERED AVAILABLE BALANCE $21 ,800.00 $106.37 $7,232.72 $14,460.91 • City Of Salem Environmental Health Division --- Inspection Monthly Summary Month -------------- Type Jul 98 Aug 98 Count CFI 79 55 134 CFR 5 6 11 CH 7 8 15 CON 14 8 22 CR 2 1 3 EC 20 7 27 EPR 2 1 3 FC 1 0 1 FSI 23 15 38 FSR 6 5 11 GN 8 8 16 HI 14 22 36 HR 11 13 24 MS 0 1 1 MUP 2 0 2 OS 1 0 1 RC 2 0 2 RFI 5 3 8 RFR 2 1 3 RO 2 0 2 IDB 62 36 98 ES 2 0 2 SM 1 3 4 TFI 13 0 13 TR 48 74 122 Count 332 267 599 FSI'ood Serv. Ins . 243* RFD - Retail Food Disc . gg - Bed/Break- 2 * FSJFood Serv. Rein . 11l* RFI - Ret . Insp. 100* CFI - Cert . Fit . 890 Gen. Nuisance 44* RFR - Retail Food Rein . CFR - Cert . Fit . Reinsp - GN Housing Insp . 312* RO - Rodent Control 13* CH - Court Hearing 44* HIHousing Reinsp . 172* SC - Suntan 5 CON - Constable Serv. Lead Paint Insp . 26 * SES - SESD Odor 3* CR - Compliance Rev . N Massage 7 SM - Seminars/Meetings CT _ Computer Time Mobile Food Insp . 13 * SP - Swim . Pools 14 - Envirn . Comp1 . 85* EC g P Over rowth SB - Swim. Beaches 111* EPR - Ext . Paint 5* Off . Sub. Insp . 10* ST - Soil Test/Septic FC - Food Compl . 22* - Rec . Camp 5 TFI - Temp . Food 65* FRH - Food Related Hear . _ Retail Food Compl . TR - Trash 758* FSD - Food Serv . Disc . • 9/8/98 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 PUBLIC HEALTH NURSE REPORT July 1998 ACTIVITIES DISEASE PREVENTION In touch with T.B. Clinic and following active cases and case contacts. Six PPD screenings done in office. vaccine inventory maintained and distributed. • Flu and Pneumonia orders for all providers sent to M.D.P.H. Investigated all communicable disease cases and reported to the M.D.P.H. 7/13 Hepatitis B Clinic held at D.P.W. for 13 Water and Sewerage employees. This is the first of three to complete series. MEETINGS AND CONFERENCES 7/1 Reinspection of Purple Scorpion to inspect autoclavable piercing instruments, sterile glove supply, revised consent form, and post piercing care instructions. Recreational Camps for Children: New additions to the regulations include that the operator of the camp conduct background checks on all of their staff. These checks are required for any person who may have unsupervised contact with a camper, and is older than 17 years. Criminal Offender Record Information (CORI) must be checked annually. As Boards of Health license recreational camps for children, CORI reports on camp employees are reviewed, to verify whether or not camps have conducted appropriate background checks on their employees. 7/7 Criminal Offender Record Information ( "CORI") checks were conducted for Camp Pine Crest employees ages 17 and older. 7/7 CORI checks were conducted on all Campfire Camp employees ages 17 and older. 7/14 CORI checks were conducted on all Boys and Girls Club employees ages 17 and older. • St. Joseph's and Phoenix School closed for summer vacation. C 3 � � CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 MONTHLY REPORT OF COMMUNICABLE DISEASES FOR THE MONTH OF JULY 1998 *DISEASE NEW CARRY OVER DISCHARGED REPORTS TO CASES CASES CASES STATE CAMPYLOBACTER 2 0 2 2 • E.COLI 0157 0 0 0 0 GIARUTA 1 0 1 1 HEPATITIS 1 0 1 1 LYME DISEASE 0 0 0 0 MENINGITIS 2 0 ? 2 MUMPS 0 0 0 0 PERTUSSIS 0 0 0 0 SALMONELLA 5 0 5 5 SHIGELLA 1 0 1 1 TUBERCULOSIS 0 0 0 0 VARICELLA 0 0 0 0 *THOSE DISEASES EXCLUDED FROM ABOVE HAVE NOT BEEN IDENTIFIED DURINC THIS MONTH. • Tracy L. Giarla L.P.N. Public Health Nurse J summary of communicable Diseases Ju/y 1998 Camp y/obacter • 2 y/o female visiting from Europe. Family stayed at the Brimblecomb Inn, Marblehead. Marblehead Board of Health notified. Child visited Todd Farm in Ipswich, ate strawberries "off the vine." Ipswich Health Dept. notified. Child has returned to Europe. • 2 y/o male. Mother suspects steak tips, (Store purchased unknown) 4 other family members consumed steak. Mother then became • symptomatic. Physician prescribed her antibiotics, but did not test her. Giardia • 22 y/o male. Traveled extensively from February to June. Contaminated water is suspect, Tailand was his last destination prior to returning to U.S.. Occupation: Non-Food handler. Hepatitis B • 55 y/o male. Case was asymptomatic. All sexual contacts are in the Dominican Republic. one daughter was advised to visit M.D. Children in household have received their Hep B Series. He was moving to Dominican Republic soon. This case was translated by Jose Diaz. Occupation: Unemployed. Benin itis g • 59 y/o male with recurrent pneumoccocal meningitis. upon interviewing case, his past medical history includes a head injury. Occupation: none 4 month female infant. Recovered from viral meningitis. Salmonella • 53 y/o female. Traveled on a cruise ship. Case felt she ate bad shrimp on the ship. Her friend was ill, but did not get tested. She also had a Caesar Salad at Ground Round, which was closer to incubation period of Salmonella. Sanitarian Jeff Vaughn notified, and inspected Ground Round salad prep area, and dressing. FDA in Boston Notified regarding cruise ship. Occupation: Non-Foodhandler. 11 y/o male. Lives in Southern state. Father believed son was ill from a hot dog he bought at the Brown Derby at Fanuel Hall in Boston. Boston Health Dept. notified. Family traveled via car from the South, to Salem. They are back home now. • 37 y/o male. Case impression of cause: He brought cooked eggs from home to work and left them on his desk for "hours." Family consumed eggs left in refrigerator, no one else was ill. Occupation: Non-Foodhandler • salmonella Cont'd • 24 y/o male. Case feels he became ill after eating a chicken pot pie he purchased at Shaws Supermarket. He didn't recall brand of pie, but said it was in a "yellow box". He is asymptomatic now, and he was in the process of moving at interview. Occupation: Unemployed. 21 y/o female. Suspected food unknown. She never cooks at home, and eats out "7 days a week, 2 meals a day" She eats a lot of chicken dishes. Source of infection unknown. Occupation: Non-Food handler. Shige//a • 65 y/o female. Went to the Dominican Republic for the month of May. Her symptoms started in early May, and continued until she sought medical attention in July. She feels illness was caused by drinking the water in the Dominican Republic. This case was translated by Jose Diaz. SNAX CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 Telephone Records - July 1998 22 Work Days Telephone Calls = 1069 Answered by 3 Secretaries Barb = 256 Mary = 494 Susan = 319 M- 8-4 T- (8-4) W- (8-4) TH(88-7) F-(8-12) • 7-1= 45 7-2= 40 7-3=Holiday 7-6=60 7-7= 67 7-8= 45 7-9= 59 7-10=19 7-13=56 7-14= 46 7-15=49 7-16=66 7-17=30 7-20=53 7-21=49 7-22=57 7-23= 57 7-24=18 7-27=59 7-28= 49 7-29=55 7-30=62 7-31=28 Messages for or calls taken, complaints assigned, handled by office staff etc...... Joanne= 310 Tracy G. =85 Ginny = 72 Pablo = 4 Mark T.= 95 Barb S. = 96 Jeffrey V. = 67 Mary = 152 • Jose = 102 Sue K. = 86 • NEWSLETTER 38 July 14, 1998 AGENT'S REPORT TO THE BOARDOD regulations. The Mass problems with fan ballbearings. Department of Public Health is SPECIAL MEETING WITH Once these problems are solved, attempting to regionalize anti- SESD balancing and coordindating of all smoking regulations. Therefore, The Board met with several the equipment will be done. It the purpose of the meeting was to officials from the SESD, was Mr. Newhall's estimate that encourage board of health including Executive Director the equipment will not be fully members from our region to pass Raymond Bouchard, , Assistant operational until the end of the "100% no smoking in restaurant" Director of Facilities Harold summer. regulations. Several of our Newhall, and Attorney John neighboring communities have Darling. Salem's representaive to NURSE'S POSITION done that or will soon. Our the SESD Board, DPW Director A letter has been sent to the regulations require 60% non- Stanlet Borenstein, as well as Mass Civil Service regarding the smoking seats. many residents, were also in Board's not accepting the two Speaking at the meeting was attendance. candidates interviewed from the former MDPH Commissioner The Board of Health had list. I was told that there shouldn't Hugh Mulligan, who now serves • requested the meeting with the be a problem with accepting a on the Boston Health SESD to discuss the broken candidate outside the list. I will Commission. As you may know, outfall pipe and continuing odor keep the Board informed. Boston has recently passed such problems. regulations. Replacement sections of the HHWCD pipe are scheduled to arrive by This year's Household WESX July 14th and fittings by July Hazardous Waste Collection Day Owen made his debut on 21 st. However, the replacement was a success. We serviced over WESX radio last week during a of the broken section will take 500 cars, many of which broadcast with me on Al some time. Therefore, the contained wastes from whole Needham's partyline show. beaches will probably remain, neighborhoods. Because Primarily, we discussed the "swim at your own risk" all everyone didn't come at the very situation at our beaches. summer. The Board voted to beginning, there were very few However, as usual with Al, the request Mr. Borenstein to ask the delays for our residents. topics were far ranging and SESD for mitigation relief from The final quantities are being included protection from ticks to this problem in the form of tabulated. Thanks to Jeff for a potential e. coli in hamburgers on alternative recreational water great job organizing the event. the grill. activities for Salem families and children during this summer. I COLLABORATIVE FINAL UPDATE OF have been informed by Mr. MEETING REGARDING BOARD'S '98 GOALS & Borenstein that the SESD board SMOKING OBJECTIVES. • voted to give $25,000 to the City Owen, George and I attended I plan to have the final update for the repair of the Forest River the North Shore Area Boards of of the Board's objectives for fiscal pool. Health Collaborative dinner and year 1998 available at meeting Mr. Newhall described the meeting regarding smoking time. Vendor Number: 915801 Check Amount" i 99.71 Cry OF SALEM Specify Date Of needed within 5 c��er days) Year. Payable To: Month: r— BOARD OF HEALTH 9 NORTH STREET SALEM MA o1970 Address )( Send 8y U.S. Mail: (Attach Original Documentation To Be Matted And A copY for AocounBng.) Do Not Mail-Department Will Pick Up Will Vendor Be Used Again? y X N (Note, Attach Copy of Documentation For AceounUnO.) �-- For check pick-Up. is This An Employee? Y — N X Call Extension MARYJANE THOMAS if payment is labor or service related-the following (Print Na") is required: (Refer to additional instructions) Social Security# (Print Name ff other Than Prepared BY} Or Federal Tax 1.0. (Complete Signature•No initials) •Purpose(Brfef Description) SECRETARIAL SERVICES FOR THE NORTH SHORE c.� phone Extension)3513 UNE 1998 (Date) 7Jv v J e art Account DisMbution(10 Digits) PULMONARY CLINJC. Responsibility R Rep Orr = 35.49 Amom A VISJTS: 7 s 99.71 3.38 = 64.22 29390291220 $ g VISITS: 19 a TOTAL S 99.71 3 Total(H More Than One AA:w.%�#} $ Per override 1008 Set Up: y N Reviewed BY: Approved By: invoice#: 1 Invoice Date; Check#: P.O.#: Check Date: Date Received by Accouotin8= Check Received By: Name/Date 'i (Rov June 20,1907) I I ADMINISTRATION - MONTHLY REPORT DUNE 1998 BIOLOGICS DISTRIBUTED AMOUNT IN DOSES AMOUNT Diptheria, Tetanus & Pertussis 885 BURIAL PERMITS ISSUED 59 @ $5.004 $295.00 Diptheria-Tetanus Tox. (under 6 yrs. ) -0- ANIMAL BITES REPORTED -0- Immune Serum Globulin $525.00 2V CEIVED - LICENSES & PERMITS Measles/Mumps/Rubella 610 CERTIFICATE OF FITNESS - Polio OPV=580 IPV=280 _...80_ _. _ INSPECTIONS X $25.00 = $2,000.00 .. _ Tetanus & Diptheria (adult use) 400 Tuberculin PPD 420 HIB Titre 700 Hepatitis B PEDI=528 HIGH RISK=420 e ALARY/LONGEVITY: ANNUAL BUDGET EXPENSES YTD EXPENSES ENCUMBERED AVAILABLE BALANCE $327 ,329 .00 $32,525.08 --- --- $5,925.08 10,552.23 425.00 NON-PERSONNEL: ANNUAL BUDGET EXPENSES YTD EXPENSES ENCUMBERED AVAILABLE BALANCE $55,300.00 $20,832.35 --- $32,662.99 $1,804.66 35/BAS t tij• -SGL�=," re'.t+'y.,air L..,S ✓ g E `"` i � 3,---.�. c -. ;c, i_,_ .,ig _ IA.� .. .:<.k City Of Salem Environmental Health Division --- Inspection Monthly Summary Month ---------------------------------------------------------------------------------------------- Type Jul 96 Aug 96 Sep 96 Oct 96 Nov 96 Dec 96 Jan 97 Feb 97 Mar 97 Apr 97 May 97 Jun 97 Count ------ ------ ------ ------ ------ ------ ------ ------ ------ ------ ------ ------ 3 1 0 0 0 0 0 0 3 0. 0 0 7 OS 0 0 0 0 0 0 0 0 1 0 0 0 1 BB 1 0 0 0 0 1 1 0 0 0 0 0 3 CFI 93 88 74 129 50 65 57 72 73 63 68 58 890 CFI/HR 1 0 0 0 0 0 0 0 0 0 0 0 1 CFR 8 S 7 5 0 0 3 2 0 9 1 4 44 CH 1 2 2 0 7 6 4 3 5 1 6 4 41 CON 7 19 7 29 13 4 6 10 5 5 13 19 137 CR 22 2 7 9 2 1 4 6 3 3 3 6 68 CRF 0 0 0 0 0 0 0 0 1 0 0 0 1 DC 1 0 0 0 0 0 0 0 0 0 0 0 1 EC 11 14 13 4 3 7 6 12 5 1 4 7 87 EPR 1 0 0 0 0 0 0 0 0 0 2 2 5 FC 1 6 1 4 0 0 1 2 1 3 2 2 23 FCQ 1 0 0 0 0 0 0 0 0 0 A o 1 FRH 0 0 0 2 0 1 0 0 1 0 0 1 5 FSD 1 1 2 6 1 1 3 2 3 2 0 1 23 FSI 2S 16 22 28 13 14 30 16 44 14 11 12 24S FSR 17 11 7 21 6 6 11 13 1 12 5 1 C1� N 7 9 1 2 1 1 2 3 3 2 7 6 44 I 14 22 22 31 63 10 70 15 36 5 17 11 316 HR 9 14 21 19. 14 16 15 8 13 18 13 13 173 LPC 1 0 0 '0 0 0 0 0 0 0 0 0 1 LPI 3 5 2 3 4 0 3 2 0 2 2 0 26 MS 1 0 0 0 0 0 0 0 1 0 0 0 2 MUC 1 0 0 0 0 1 0 0 0 0 0 0 2 MUP 0 1 0 0 1 2 0 0 0 4 3 2 (3—; OS 0 0 0 0 0 1 7 0 1 0 1 0 10 RO 1 0 0 0 0 0 0 0 0 0 0 0 1 RC 0 2 0 1 1 2 0 0 1 0 1 5 13 RFC 0 0 0 0 1 0 0 1 0 0 1 0 3 RFD 0 0 0 1 1 0 1 0 0 0 0 0 3 RFI 4 4 5 5 7 9 5 6 8 1 5 5 64 RFR 3 5 0 3 3 3 2 3 3 1 1 0 r'27 RO 3 2 1 1 0 0 2 2 i 0 7 2 21 SB 26 45 14 0 0 0 0 0 0 0 0 26 i11 SC 0 0 1 0 2 0 3 5 0 2 0 13 SES 0 3 0 0 0 0 0 0 0 0 (: _ 3 SM 11 10 12 13 11 20 7 9 8 12 SP 4 1 0 0 0 0 9 1 0 0 ST 1 0 0 1 0 0 0 0 TFI 2 28 0 4 0 0 0 0 0 0 24 TR 91 76 51 57 28 35 43 98 78 46 83 Count 376 392 272 378 232 206 295 291 299 206 296 28; 3527 • City Of Salem Environmental Health Division --- Inspection Monthly Summary • Month ---------------------------------------------------------------------------------------------- Type Jul 97 Aug 97 Sep 97 Oct 97 Nov 97 Dec 97 Jan 98 Feb 98 Mar 98 Apr 98 May 98 Jun 98 Count ------ ------ ------ ------ ------ ------ ------ ------ ------ ------ ------ ------ ------ BB 0 0 0 0 1 0 0 2 4 0 0 0 7 CFI 122 73 82 66 29 71 \ 45 58 50 76 82 71 825 CFR 0 5 11 15 7 5 0 3 10 0 12 6 74 CH 2 10 5 3 7 17 5 1 5 2 5 2 64 CON 17 11 5 9 1 4 1 9 7 4 11 9 88 CR 3 4 4 4 2 4 2 0 0 2 4 0 29 EC 13 1 3 6 5 3 1 5 1 7 8 14 67 EC/GN 1 0 0 0 0 0 0 0 0 0 0 0 1 EPR 0 3 0 0 1 0 0 0 0 1 0 1 6 FC 0 3 3 0 0 0 1 0 2 1 2 1 13 FRH 0 0 1 0 0 0 0 0 0 1 1 2 5 FSD 0 0 0 0 0 0 1 0 2 1 5 1 10 FSI 26 15 26 19 10 17 21 13 24 23 29 21 244 FSR 2 10 4 3 0 1 6 2 12 8 12 5 65 GN 9 10 6 3 7 0 2 2 2 6 6 5 58 GN/CON 1 0 0 0 0 0 0 0 0 0 0 0 1 HI 8 18 16 9 42 75 54 42 35 45 9 21 374 HR 9 9 17 11 18 13 23 12 15 13 26 11 177 HRI 2 1 0 0 0 0 0 0 0 0 0 0 3 JPI 0 0 0 0 0 0 1 0 0 0 0 0 1 LPI 0 0 0 0 1 0 2 2 0 2 0 2 9 MS 0 0 0 0 0 0 0 1 0 0 0 0 1 MUP 0 0 0 0 0 0 1 1 1 3 4 2 12 0 0 0 1 0 0 4 6 1 0 0 0 12 0 0 0 0 0 0 0 0 0 0 1 5 6 RFI 5 7 4 8 8 6 3 3 4 7 4 4 63 RFR 2 1 3 0 3 1 0 1 2 2 3 0 18 RO 1 1 0 0 2 2 1 0 1 0 2 1 11 SB 18 19 0 0 0 0 0 0 0 0 0 32 69 SC 0 0 1 1 0 4 5 1 0 0 0 0 12 SES 1 0 0 0 0 0 0 0 0 0 0 0 1 SM 8 2 10 6 3 6 11 6 10 9 9 8 88 SP 2 0 0 0 0 1 0 0 4 0 7 4 18 ST 0 0 0 0 1 1 1 0 1 1 1 0 6 TFI 0 39 1 40 0 0 0 0 0 0 43 0 123 TR 68 80 105 80 31 46 47 20 79 70 76 40 742 TR/GN 0 1 0 0 0 0 0 0 0 0 0 0 i Count 320 323 307 284 179 277 238 190 272 284 362 268 3304 BB - Bed/Break. 2 FSI - Food Serv. Ins . 243* RFD - Retail Food Disc . CFI - Cert . Fit . 890* FSR - Food Serv. Rein. 11l* RFI - Ret . Insp. 100* CFR - Cert . Fit .Re_nsp . GN _ Gen. Nuisance 44* RFR - Retail Food Rein. CH - Court Hearing 44* HI - Housing Insp. 312* RO - Rodent Control 13* CON - Constable Serv. HR - Housing Reinsp. 172* SC - Suntan 5 CR - Compliance Rev. LPI - Lead Paint Insp. 26* SES - SESD Odor 3* CT _ Computer Time MS - Massage 7 SM - Seminars/Meetings EC - Envirn. Compl . 85* MUP - Mobile Food Insp. 13* SP - Swim. Pools 14 EPR - Ext . Paint 5* OG - Overgrowth SB - Swim. Beaches 111* *k - Food Compl . 22* OS - Off . Sub. Insp. 10* ST - Soil Test/Septic - Food Related Hear. RC - Rec . Camp 5 TFI - Temp . Food 65* D - Food Serv. Disc . RFC - Retail Food Compl . TR - Trash 758* 7/13/98 3 i CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 PUBLIC HEALTH NURSE REPORT JUNE 1998 ACTIVITIES DISEASE PREVENTION In touch with T.B. Clinic and following active cases and case contacts. Several PPD,screenings done in office. Maintained vaccine inventory and distributed biologics citywide. Investigated all communicable disease cases and reported to the M.D.P.H. 6/1;98 PPD testing offered for all North Shore Ambulance Employees. Preparation started for Flu Clinic MEETINGS AND CONFERENCES June 16 Campfire Camp Inspection: Virginia Moustakis and Tracy Giarla June 17 Boys and Girls Club Summer Day Camp Inspection: Virginia Moustakis and Tracy Giarla June 18 Camp Pine Crest Inspection: Virginia Moustakis and Tracy Giarla June 25 Childrens Island Camp Inspection: Joanne Scott,Jeffrey Vaughan,and Tracy Giarla ST. JOSEPH'S SCHOOL School closed for summer vacation PHOENIX SCHOOL School closed for summer vacation • 3 � Ps CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTr, MPH, RS, CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 MONTHLY REPORT OF COMMUNICABLE DISEASES FOR THE MONTH OF JUNE 1998 *DISEASE NEW CARRY OVER DISCHARGED REPORTS TO CASES CASES CASES STATE CAMPYLOBACTER 0 0 0 0 • E.COLI 0157 0 0 0 0 GIARDIA 0 0 0 0 HEPATITIS 0 0 0 0 LYME DISEASE 0 0 0 0 MENINGITIS 0 0 0 0 MUMPS 0 0 0 0 PERTUSSIS 0 0 0 0 SALMONELLA 1 0 0 0 SHIGELLA 0 0 0 0 TUBERCULOSIS 0 0 0 0 VARICELLA 0 0 0 0 *THOSE DISEASES EXCLUDED FROM ABOVE HAVE NOT BEEN IDENTIFIED DURING THIS MONTH. • Tracy L. Giarla L.P.N. Public Health Nurse a rc • 3S rr CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 Telephone Records - June 1998 22 Work Days Telephone Calls = 1070 Answered by 3 Secretaries; Barb = 207 Mary = 476 Susan = 387 M - 8-4 T- 8-4 W- (8-4) TH -(8-71 F-(8-12)= • 6-1=43 6-2=49 6-3= 67 6-4= 55 6-5= 16 6-8=61 6-9=46 6-10= 54 6-11=43 6-12=29 6-15=61 6-16= 56 6-17=62 6-18=49 6-19=30 6-22=58 6-23=64 6-24=38 6-25= 51 6-26= 30 6-29=66 6-30= 42 Messages for or calls taken, complaints assigned, handled by office staff etc...... Joanne= 333 Tracy G = 125 Ginny = 118 Pablo = 3 Mark T.=84 Barb S. = 58 Jeffrey V. =51 Mary = 127 Jose = 84 Sue K. = 87 4 flo"EaVED j u l- 1 - 1998 CITY OF SALENI Vendor Number: 915801 Check Amount: $ 135,20 Payable To: CITY OF SA'LEM Specify Date (Nneeded m fdtin 5 calendar days) BOARD OF HEALTH Month: Day: Year 9 NORTH STREET SALEM MA 01970 NONE= Address X Send By U.S. Mail: (Attach original Documentation To Be Malled And A copy for Accounting.) Do Not Mail-Department Will Pick Up Will Vendor Be Used Again? Y X N (Note: Attach Copy d Documentation For Accounting.) Is This An Employee? Y N X Call Extension For Check Pick-Up. it payment is tabor or service related,the following MARY JANE THOMAS is required: (Refer to additional instructions) (Print Name) i ? I •Social Security# IMMKOMM nt Name If Other Than Prepared By) Or Federal Tax I.D. # Purpose(Brief Description) (complete signal We-No Initials) SECRETARIAL SERVICES FOR THE NORTH SHORE PULMONARY CLINIC: May-98 (Phone Extension)3573 Responsibility Report Account Distribution (10 Digits) A VISITS: 14 @ 5.07 = 70.98 Account# AJtr°unt' B VISITS. 19 @ 3.38 = 64.22 2939029120 S 135.20 TOTAL $ 135.20 $ S Total(If More Than One Account 11) $ Per Override Approved B 1099 Set Up: Y N Reviewed By: APP Y invoice#: Invoice Date: Check#: P.O.#: Check Date: Date Received by Acwunting: • Check Received By: Name/Date (Rev June 20,f997) ADMINISTRATION - MONTHLY REPORT MAY 1998 BIOLOGICS DISTRIBUTED AMOUNT IN DOSES AMOUNT i Tetanus & Pertussis Diptl-feria, 490 BURIAL PERMITS ISSUED x 5 � . Diptheria-Tetanus Tox . (under 6 yrs . ) O ANIMAL BITES REPORTED Immune Serum Globulin it 0 RECEIVED - LICENSES & PERMITS , F Measles/Mumps/Rubella CERTIFICATE OF FITNESS - Polio INSPECTIONS X $25.00 = { v � Tetanus & Diptheria (adult use) Tuberculin PPD 2,50 HIB Titre 2 LO Hepatitis B r s i /LONGEVITY : ANNUAL BUDGET EXPENSES YTD EXPENSES ENCUMBERED AVAILABLE BALANCE o27 Cl40.38 3 8, 34 $327 , 329 .00 10 ,552 . 23 ` Y 425 .00 a ?ERSONNEL: ANNUAL BUDGET EXPENSES YTD EXPENSES ENCUMBERED AVAILABLE BALANCE $55 , 300 . 00 p2,0� IO9,rp` 94 } 1 ' S 4 - 3S CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 PUBLIC HEALTH NURSE REPORT MAY 1998 ACTIVITIES DISEASE PREVENTION In touch with T.B. Clinic and following active cases and case contacts. Several PPD screenings done in office. Maintained vaccine inventory and distributed biologics citywide. Investigated all communicable disease cases and reported to the M.D.P.H. • Pertussis Investigation and Surveillance continued with I confirmed case at Salem High School. MEETINGS AND CONFERENCES 5115 Attended the second annual Public Health Nursing Conference. This year the conference was held at the Royal Plaza Hotel in Marlborough 5/20 Accompanied Jeff Vaughan to and Mark Tolman on an inspection of Crombie Street Shelter. Interviewed a client of the shelter who had a confirmed case of campylobacter. 5/21 Assisted with administering Hep B vaccine for the last of three series,to 6`h graders at Collins Middle School with Gayle Sullivan,R.N. and Maureen Carr R.N. (90 students were innoculated.) 5/21 Accompanied Jeff Vaughan and Mark Tolman on an inspection of Fred's Boat Yard. 5/22 Accompanied Joanne Scott C.H.O. on an inspection of Fred's Boat Yard. Jim Walker from Salem Police was also present. 5/26 Reviewed all immunization records of employees and attendees of Run-a-muck Day Care Center, due to the possible suspect case of Rubella. (163 Records were reviewed) ST. JOSEPH'S SCHOOL 5111 6`h graders received the last of three Hep B Series. 5/27 Physicals were offered for all 3`d and 7`h grade students PHOENIX SCHOOL • 5/20 Postural Screenings were performed on grades 5-8 1 child received the last of the Hep B series y c� CITY OF SALEM HEALTH DEPARTMENT Nine North Street • , Salem, Massachusetts 01970 SUMMARY OF COMMUNICABLE DISEASES Campylobacter 28 y/o female,frequents Crombie St. Shelter for meals. Upon interviewing her at the shelter in the presence of Lisa Clark,R.N. for Salem VNA, it was learned that she lives down Fred's Boat Yard. She uses a"Porta-Potty" and lives in a trailer at the boat yard. She stated her boyfriend dumps it at a campsite in N.H. Occupation: Disabled. Hepatitis B This case was received on May 291h,communicable disease letter sent. • Pertussis 16 y/o Salem High School Female. 7 Close Contacts were notified immediately and Prophylaxed. Occupation: none Salmonella: 2 cases: 13 v/o female. I Interviewed father. Suspect food unknown. Child ate at home during incubation period, had a Pretzel with nacho cheese at North Shore Mall. She is now asymptomatic. 39 y/o hispanic male. Interviewed girlfriend of case, due to language barrier. Case recalls eating chicken the day symptoms started. He usually brings a bagged lunch to work. Occupation: General Buffum. • MINB CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 MONTHLY REPORT OF COMMUNICABLE DISEASES FOR THE MONTH OF MAY 1998 *DISEASE NEW CARRY OVER DISCHARGED REPORTS TO CASES CASES CASES STATE i i CAMPYLOBACTER 1 0 1 1 • E.COLI0157 0 0 0 0 GIARDIA 0 0 0 0 HEPATITIS 1 0 0 0 LYME DISEASE 0 0 0 0 MENINGITIS 0 0 0 0 MUMPS 0 0 0 0 PERTUSSIS 1 0 1 1 SALMONELLA 2 0 2 2 SHIGELLA 0 0 0 0 TUBERCULOSIS 0 0 0 0 VARICELLA 0 0 0 0 *THOSE DISEASES EXCLUDED FROM ABOVE HAVE NOT BEEN IDENTIFIED DURING THIS MONTH. Tracy L.Giarla L.P.N. Public Health Nurse s.ex.° .�Ai^�Mf' tY ++c. 'E-ram rt a..3, "4 r +�hsta•�saR�.�+ it+2x _4 ,3.,,,Y � Pf'ras' T _ • City Of Salem Environmental Health Division - - Inspection Monthly Summary Month -------------------------------------------------------------------------------------- Type Jul 97 Aug 97 Sep 97 Oct 97 Nov 97 Dec 97 Jan 98 Feb 98 Mar 98 Apr 98 May 98 Count BB 0 0 0 0 1 0 0 2 4 0 0 • 7 CFI 122 73 82 66 29 71 45 58 50 76 82 754 CFR 0 5 11 15 7 5 0 3 10 0 12 68 CH 2 10 5 3 7 17 5 1 5 2 5 62 CON 17 11 5 9 1 4 1 9 7 4 it 79 CR 3 4 4 4 2 4 2 0 0 2 4 29 EC 13 1 3 6 5 3 1 5 1 7 8 53 EC/GN 1 0 0 0 0 0 0 0 0 0 0 1 EPR 0 3 0 0 1 0 0 0 0 1 0 5 FC 0 3 3 0 0 0 1 0 2 1 2 12 FRH 0 0 1 0 0 0 0 0 0 1 1 3 FSD 0 0 0 0 0 0 1 0 2 1 5 9 FSI 26 15 26 19 10 17 21 13 24 23 29 223 FSR 2 10 4 3 0 1 6 2 12 8 12 60 GN 9 10 6 3 7 0 2 2 2 6 b 53 GN/CON 1 0 0 0 0 0 0 0 0 0 0 1 HI 8 18 16 9 42 75 54 42 35 45 9 353 HR 9 9 17 it 18 13 23 12 15 13 26 166 HRI 2 1 0 0 0 0 0 0 0 0 0 3 JPI 0 0 0 0 0 0 1 0 0 0 0 1 LPI 0 0 0 0 1 0 2 2 0 2 0 7 WMS 0 0 0 0 0 0 0 1 0 0 0 1 P 0 0 0 0 0 0 1 1 1 3 4 10 S 0 0 0 1 0 0 4 6 1 0 0 12 RC 0 0 0 0 0 0 0 0 0 0 1 1 RFI 5 7 4 8 8 6 3 3 4 7 4 59 RFR 2 1 3 0 3 1 0 1 2 2 3 18 RO 1 1 0 0 2 2 1 0 1 0 2 10 SB 18 19 0 0 0 0 0 0 0 0 0 37 SC 0 0 1 1 0 4 5 1 0 0 0 12 SES 1 0 0 0 0 0 0 0 0 0 0 1 SM 8 2 10 6 3 6 11 6 10 9 9 80 SP 2 0 0 0 0 1 0 0 4 0 7 14 ST 0 0 0 0 1 1 1 0 1 1 1 6 TFI 0 39 1 40 0 0 0 0 0 0 43 123 TR 68 80 105 80 31 46 47 20 79 70 76 702 TR/GN 0 1 0 0 0 0 0 0 0 0 0 1 Count 320 323 307 284 179 277 238 190 272 284 362 3036 Inspection Types aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa BB - Bed/Break. 2 FSI - Food Serv. Ins . 243* RFD - Retail Food Disc . CFI - Cert . Fit . 890* FSR - Food Serv. Rein. 11l* RFI - Ret . Insp. 100* CFR - Cert . Fit .Reinsp. GN _ Gen. Nuisance 44* RFR - Retail Food Rein. CH - Court Hearing 44* HI Housing Insp. 312* RO - Rodent Control 13* CON - Constable Serv. HR - Housing Reinsp. 172* SC - Suntan 5 - Compliance Rev. LPI - Lead Paint Insp. 26* SES - SESD Odor 3* _ Computer Time MS - Massage 7 SM - Seminars/Meetings EC - Envirn. Compl . 85* MUP - Mobile Food Insp. 13* SP - Swim. Pools 14 EPR - Ext. Paint 5* OG - Overgrowth SB - Swim. Beaches 111* FC - Food Compl . 22* OS - Off . Sub. Insp. 10* ST - Soil Test/Septic FRH - Food Related Hear. RC - Rec . Camp 5 TFI - Temp. Food 65* FSD - Food Serv. Disc . RFC - Retail Food Compl . TR - Trash 758* • NEWSLETTER 37 May 12, 1998 AGENT'S REPORT TO THE BOARDOD morning! We were then 3RD QUARTER UPDATE treated to a very nice lunch at OF OBJECTIVES✓ SALEM COMMUNITY the High School. My student Enclosed in the packet is WELLNESS FAIR* was a High school senior who the 3rd quarter update of the The 2nd Annual Salem might become an attorney. Board's objectives. We are Community Wellness Fair making good progress in most was held on May 1 st &_2nd. PUBLIC HEALTH NURSE areas. However, I do need to While Dawn Marie was still POSITION✓ concentrate more on the here, she organized the event We have received four "procedures" book. with Maureen Carr and resumes for the Nurse's Charlie Reed. position. George will be COMMUNITY SEPTIC The Health Department asking for a subcommittee to MANAGEMENT PLANQ had a booth devoted to the conduct interviews. Enclosed in the packet is a benfits of handwashing and proposed application form for the diseases spread by the FOREST RIVER POOLS septic betterment loan •hands. It appears that the Forest money. Owen has considered The fair was professionally River 13m*will be receiving a the priority setting as well. If setup. It looked very complete makeover before the the Board approves the professional. The attendence summer. The Department of application and Plan, we was fairly good, but we hope Public Health has just could begin advertising the it will increase next year. promulgated new pool availabilty of the loan money.. regulations.. I have not seen STUDENT the plan yet, but hope to 1999 PLANNING GOVERNMENT DAY% receive it in time to review it DOCUMENT It was a pleasure to carefully to be sure that it will The fiscal year begins JuTy participate in Student be in compliance. 1 st. The board may want to Government Day, and to be consider a subcommittee to accompanied by a "student POINT CLEAN-UPn develop the next planning Health Agent." We We will be joining VOCES document for that date. conducted an opening and the Salem Harbor CDC inspection for a new food again this year to clean and 1999 BUDGET® establishment, inspected the sweep the Point I had a meeting with the residence of an elderly woman neighborhood. It will be done Mayor regarding our budget. returning from the hospital to on June 6th so that it will According to the Auditor, he ea newly renovated living area, coincide with a City-wide will be sending us a copy of and attended a pre-trial clean-up event. our budget which he will be conference regarding a proposing to the Council. I complaint in Disrict Court will keep the Board informed. against a landlord. All in the *CONRATS TO JEFF, R.S.* Vendor Number.' 91580f FqkAmonunt : $ 190.97 J UN i 1996 Specify Date (if needed within 5 calendar days) Payable To: CITY of Sa!-EM Month: Day: Year: BOARD OF HEALTH CITY OF SAI Ek' #NORTH STREET HFAI_TLI F)FP T, SALEM MA 01970 Address mom i X Send By U:S. Mail: (Attach OrtlOal pocumentalW To fie Maned And A copy for Accounting.) po Not Mail-Department Will Pick Up Mrf! Vendor Be Used Again? y X N (Note: Aftaoh Copy of Documentation For Aocounting.) Is This An Employee? Y N X Call Extension For Check Pick-Up. t=7=:::: if payment is labor or service related,the following is required: (Refer to additional instructions)ocial Security# (Print Name nOltw anPreparsd BY) Or Federal Tax 1.D. # Purpose(Brfef Desmption) (Complete Signature-No lnftiais) SECRETARIAL SERVICES FOR THE NORTH SHORE PULMONARY CLINIC: Apr-98 (pate) S (Phone Extension)3513 Responsibility Report Account Distribution(10 Digits) A VISITS: 19 5.07 = 96.33 ce mou u 3.38 = 94,64 2939029120 $ 190.97 B VISITS: 28 @ $ TOTAL 190.97 $ 3 $ Total(if More Than One Account a) $ Per Override 1099 setup: Y N __ Reviewed By: Approved By: Invoice#: Invoice Date ( i Check 0: P.O.#: Check Date: Date Received by Accounting: Check Received By: Name/Date i• {Ravrune:a,tarn) CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 Telephone Records - May 1998 20 Work Days Telephone Calls = 966 Answered by 3 Secretaries Barb = 185 Mary = 319 Susan = 462 M- 8-4 T- 8-4 W- 8-4 TH- 8-7 F- 8-4 5-1 = 24 5-4=59 5-5=37 5-6=59 5-7=53 5-8= 33 5-11=44 5-12=57 5-13= 44 5-14=63 5-15=43 5-18=64 5-19= 46 5-20=55 5-21= 64 5-22=31 5-25= Holiday 5-26=62 5-27=53 5-28= 41 5-29= 34 Messages for or calls taken, complaints assigned, handled by office staff etc...... Joanne= 324 Tracy G. = 109 GIY nn =88 Pablo = 10 Mark T.= 96 Barb S. = 51 Jeffrey V. =40 Mary= 76 • Jose =60 Sue K. = 112 • ADMINISTRATION - MONTHLY REPORT APRIL 1998 BIOLOGICS DISTRIBUTED AMOUNT IN DOSES AMOUNT Diptheria, Tetanus & Pertussi•s 420 BURIAL PERMITS ISSUED 50 $250.00 Diptheria-Tetanus Tox. (under 6 yrs. ) 20 ANIMAL BITES REPORTED -0- Immune Serum Globulin 9 DECEIVED FOR LICENSES & PERMITS $991.62 Measles/Mumps/Rubella 140 CERTIFICATE OF FITNESS - Polio OPV - 150 IPV - 70 75 INSPECTIONS X $25.00 = $1,875.00 Tetanus & Diptheria (adult use) 330 Tuberculin PPD 580 HIB Titre 230 Hepatitis B PEDI -318 ADOL - 270 ;ALARM/LONGEVITY: ANNUAL BUDGET EXPENSES YTD EXPENSES ENCUMBERED AVAILABLE BALANCE $327 ,329.00 --- $274,609.27 --- $63,696.96 10,552.23 425.00 NON-PERSONNEL: ANNUAL BUDGET EXPENSES YTD EXPENSES ENCUMBERED AVAILABLE BALANCE $55,300.00 $18,869.91 $3,249.87 $33,180.22 95/BAS f 3 � CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 PUBLIC HEALTH NURSE REPORT APRIL 1998 ACTIVITIES DISEASE PREVENTION In touch with T.B. Clinic and following active cases and case contacts. Several PPD screenings done in office. Maintained vaccine inventory and distributed biologics citywide. • Investigated all communicable disease cases and reported to the M.D.P.H. Pertussis Investigation and Surveillance continued with 2 confirmed cases at Collins Middle School. PPD screenings were administered to employees of Salem Point Child Care. MEETINGS AND CONFERENCES 4/13 Meeting at Collins Middle School with Brian Riley M.A.,M.P.H. Epidemiologist and Gayle Sullivan,R.N.to discuss current outbreak of Pertussis,and continued Surveillance of all students. ST.JOSEPH'S SCHOOL 4/14 Postural screenings were performed on 109 students,Grades 5-8 1 Student was referred to his physician for postural abnormalities. Consent letters were sent to third and seventh grade parents regarding Physical Exams that will be held at St. Joseph's on May 27 performed by Dr. Dumas. Letters were sent informing parents of the next Hepatitis B clinic that will be held on May 11 PHOENIX SCHOOL i i 3 r� CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 MONTHLY REPORT OF COMMUNICABLE DISEASES FOR THE MONTH OF APRIL 1998 *DISEASE NEW CARRY OVER DISCHARGED REPORTS TO CASES CASES CASES STATE CAMPYLOBACTER 0 0 0 0 • E.COLI0157 0 0 0 0 GIARDIA 1 0 1 1 HEPATITIS 0 0 0 0 LYME DISEASE 0 0 0 0 MENINGITIS 0 0 0 0 MUMPS 0 0 0 0 PERTUSSIS 2 0 5 5 SALMONELLA 1 0 1 1 SHIGELLA 0 0 0 0 TUBERCULOSIS 0 0 0 0 VARICELLA 0 0 0 0 *THOSE DISEASES EXCLUDED FROM ABOVE HAVE NOT BEEN IDENTIFIED DURING THIS MONTH. • TracyLiarla L.P.N..G Public Health Nurse V t • SUMMARY OF COMMUNICABLE DISEASES APRIL 1998 Giardia 35 y/o female Case interviewed. Cases impression of cause: Bottled water purchased in Danvers. Case does not remember name brand of water,or name of store were she purchased it. Treated with antibiotics. 1 household contact asymptomatic.Because case is unable to remember were she purchased water,it could not be further investigated. Occupation: Police Officer Salmonella • 43y/o female Case interviewed. Cases impression of cause: ? caesar chicken salad purchased at a grocery store in Danvers. Danvers Board of Health was notified on April 14. She was treated with antibiotics. 1 Household contact asymptomatic Occupation: Claims Analyst Pertussis: 2 new cases Case#1 12 y/o male. Collins Middle School. This case had a total of 20 close contacts. They were all treated with antibiotics. Of the twenty,7 were from a church group in Peabody. Peabody Health Dept.was notified. Pertussis alert letters were sent to notify all church members. Case#2 13y/o female. Collins Middle School. This case had a total of 27 contacts. All were CMS students,or family members. She does not participate in sports or extracurricular activities. Note: There was one contact of case#I whose parent did not have insurance. This childs prophylaxis was delayed until the mother could buy the antibiotic with cash (which she said cost$75.00)I notified Brian Riley about this incident. He is not aware of any funds for this situation, but he is going to look into it further. • z ec.- ( ec 4 City Of Salem Environmental Health Division --- Inspection Monthly Summary Month ----------------- �,t° Type Jul 97 Aug 97 Sep 97 Oct 97 Nov 97 Dec 97 Jan 98 Feb 98 Mar 98 Apr 98 Count BB 0 0 0 0 1 0 0 CFI 12 4 0 7 0 73 82 66 29 71 45 S8 SO 76 672 CFR 0 5 11 15 7 5 0 3 10 0 56 CH 2 10 5 3 7 17 S 1 5 2 57 CON 17 11 5 9 1 4 CR 3 4 4 4 2 4 1 9 7 4 68 EC 13 1 3 6 5 3 2 0 0 2 25 EC/GN 1 p 0 0 0 1 S 1 7 95 EPR 0 3 0 0 0 0 0 0 0 1 1 p FC 0 3 3 0 0 0 0 0 1 S 0 FRH 0 p 1 0 0 1 p 2 1 10 FSD 0 0 0 0 0 0 0 1 2 0 0 0 1 FSI 26 15 26 19 FSR 2 10 4 3 10 17 21 13 24 23 199 G 0 1 6 2 12 8 48 N 9 10 6 3 7 GN/CON 1 0 0 0 0 2 2 2 6 47 p 0 0 HI 8 18 16 0 0 0 1 9 42 75 S9 42 35 95 344 HR 9 9 17 11 18 13 HRI 2 1 0 0 0 23 12 15 13 140 JPI 0 0 0 0 0 0 0 p 3 0 LPI p 0 0 0 0 1 0 0 0 1 0 1 MS '0 0 0 MUP p 0 0 0 0 p 1 0 0 1 0 OS 0 0 0 0 0 1 1 1 3 6 1 0 0 RFI 5 7 4 8 8 4 6 1 0 12 RFR 2 1 3 6 3 3 4 7 SS 0 3 0 1 0 1 2 2 15 RO 1 1 0 SB 18 19 p 2 2 1 0 1 0 8 0 0 0 SC 0 0 1 1 0 0 O 0 37 SES 1 0 0 0 4 S 1 0 0 12 0 p SM g 2 10 6 3 0 0 0 p 0 L SP 2 0 0 0 0 6 11 6 10 9 71 ST 0 0 0 L 0 0 4 0 7 0 "CFI 0 39 L 90 1 1 1 0 1 S 0 0 0 0 0 80 TR 68 80 LOS 80 31 0 26 TR/GN 0 1 0 46 47 20 79 70 626 30-1 284 179 277 233 L90 272 284 2674 Inspection Types aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa BB - Bed/Break . 2 FSI - Food Serv . Ins . 243 * CFI - Cert . Fit . 890* FSR - Food Serv . Rei_n . 11l* RFD - Retail- CPI Food Disc . CFR - Cert . Fit . Reinsp . GN Gen . Nuisance 44 * RFI - Ret . l Food CH - Court Hearing 44 * HI - Housing Insp . 312* RFR - Retail Food Rein . CON - Constable Serv . HR - HousingReins * RO - Rodent Control 13 CR - Compliance Rev . P172 SC - Suntan 5 LPI - Lead Paint Insp . 2.6* SES - SESD Odor 3 * _ Computer Time MS - Massage 7 orc - Envirn. Compl . 85* MUP - Mobile Food Ins * SM - Seminars/Meetings EPR - Ext . Paint 5* P - 13 SP - Swim. Pools 14 PC - Food Com 1 . 22* OG - Overgrowth SB - Swim. Beaches ill FRH P OS - Off . Sub . Insp . 10* ST - Soil Test/Septic - Food Related Hear . RC -- Rec . Camp 5 FSD - Food Serv. Disc . RFC - Retail Food Com 1 . TFI - Temp rash758 65* aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa NEWSLETTER 36 April 14, 1998 AGENT'S REPORT TO THE BOARDOD and inspections. meeting. Residents of bakers The Chase House owner and a Island have been invited to the PERTUSSIS B chef are currently enrolled in the meeting to hear the presentation. There have been five food manager certification course. And a member of the Trustees of confirmed cases of pertussis, four This is in addition to a member of the Reservations will request in the Middle School, one in the their staff who is currently permission to install a composting High School. Tracy has been certified. toilet at the island working diligently with the Jose is also enrolled in a Middle School nurse, following certification class. This will be an BUDGET FY 97% up these cases in accordance with excellent foundation for him to Mayor L>sovicz is requesting the State requirements. Pertussis become more involved in food that Department heads be careful is difficult to control because a inspections. in the final months of FY 97 and person is in the contagious stage Mom and Me, an establishment spend only when necessary. He is two weeks prior to the onset of a at Pickering Wharf, was closed requiring his approval of cough and three weeks following. for one day because they did not expenditures greater than • Therefore, a person is contagious have a current permit and ignored $1000.00 and of filling personnel and may have no symptoms at all. all our attempts to have them vacancies. Therefore, in the Although small children are obtain one. package you will see two such immunized, the protection We are entering the festival requests, one for the Household diminishes during adolescence. season in Salem. We have Hazardous Waste day, the other to There is no approved vaccination notified all previous food vendors hire a Public Health Nurse. for this age group, although one is and event coordinators of the being investigated as a booster. Certiified Food Manager requirement. We have alerted SCHOOL SCREENINGS® them that a vendor will not be Dawn Marie is a certified allowed to participate at an event, trainer for teaching scoliosis and if there is not a certified food hearing & vision screening. manager employed. Therefore she will train Tracy so that Tracy will be able to do the COMMUNITY SEPTIC school screenings. Of course, that MANAGEMENT PLANn does depend on if the pertussis The Community Septic outbreak subsides. management Plan has been completed. Stone Environmental FOOD INSPECTIONS./ began working with us on that last The inspectors and I are August. Bruce Douglas of Stone reviewing food establishment environmental will present the • inspections at least every other plan to the Board at its meeting. week at a staff meeting. I am In addition, Bruce and I are more carefully tracking the reviewing the plan with residents reports and any follow up actions of tinkers Island before the 3r C2a, I fR�r Telephone Records - April 1998 20 1/2 Work Days Telephone Calls = 924 Answered by 3 Secretaries Barb = 164 Mary = 344 Susan = 416 M- (8-4) T_ (8.4) W- (8-4) TH- (8-7) -4) • 4-1=47 4-2=47 4-3=32 4-6=49 4-7=44 4-8=59 4-9=42 4-10= (1/2)=13 4-13=66 4-14=44 4-15= 44 4-16=48 4-17=17 4-20= Holiday 4-21=59 4-22=37 4-23=46 4-24=27 4-27=59 4-28=43 4-29=52 4-30=49 Messages for or calls taken, complaints assigned, handled by office staff etc...... Joanne= 246 Tracy G. = 81 Ginny = 128 Pablo =9 Mark T.= 76 Barb S. =66 Jeffrey V. = 69 Mary = 78 • Jose = 75 Sue K. = 96 ADMINISTRATION - MONTHLY REPORT MARCH 1998 • • BIOLOGICS DISTRIBUTED AMOUNT IN DOSES AMOUNT Diptheria, Tetanus & Pertussis 615 BURIAL PERMITS ISSUED 52 $260.00 Diptheria-Tetanus Tox. (under 6 yrs.) _0_ -0- ANIMAL BITES REPORTED Immune Serum Globulin 4 VIALS CASH RECEIVED - LICENSES & PERMITS $735.00 Measles/Mumps/Rubella 40 CERTIFICATE OF FITNESS - .CASH Polio 58 INSPECTIONS X $25.00 - OPV = 110 IPV = 30 - $1,450.00 Tetanus & Diptheria (adult use) 510 Tuberculin PPD 110 HIB Titre 350 Hepatitis B PED = 270 ADOLESCENT = 120 SALARY/LONGEVITY: ANNUAL BUDGET EXPENSES YTD EXPENSES ENCUMBERED AVAILABLE BALANCE $327,329.00 $218,651.14 $119,230.09 10,552.23 - SUPP. APPR. NON-PERSONNEL: ANNUAL BUDGET EXPENSES YTD EXPENSES ENCUMBERED AVAILABLE BALANCE $55,300.00 $12,950. 13 $4,552.12 $35,650.13 995/BAS t • Memorandum To: Board of Health Members From: Dawn Marie Cameron Date: February 26, 1998 Re: Resignation Just a note to say thanks for all of your help and guidance over the past 3.5 years. It has been a pleasure working for the Health Department and I am truly grateful for the valuable experience that I have gained as the Public Health • Nurse. I wish you all the best. • 1 J i R• CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS, CHO NINE NORTH STREET HEALTH AGENT PUBLIC HEALTH NURSE REPORT Tel:(978)741-1800 FEBRUARY 1998 ACTIVITIES Fax:(978)740-97 05 DISEASE PREVENTION In touch with T.B. Clinic and following active cases and case contacts. Several vaccinations and/or PPD screenings done in office. Maintained vaccine inventory and distributed biologics citywide. Investigated all communicable disease cases and reported to the M.D.P.H. Teaching to general public as needed. MEETINGS AND CONFERENCES Feb. 3-Mtg with Dave Lodge at Salem News re: Health Fair. Feb. 6- Mtg with Maureen Carr and Charlie Reed re: Health Fair. • Feb. 24- Mtg with Joanne Scott re: P.H.N. activities/job. Feb. 25- Sexual Harassment Seminar. Feb. 25- Mtg with Tracy Giarla re: P.H.N. activities/job. Feb. 26- Mtg at S.H.S. re: Health Fair. Feb.26- Mtg at Police Station re: Health Fair. ST.JOSEPH'S SCHOOL PHOENIX SCHOOL OTHER BP Clinics at Fire Headquarters on Feb. 9, 12, 13, and 24. BP Clinic at Council Chambers on Feb. 19. BP Clinic at Police Station on Feb. 27. • J vQ' r CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 MONTHLY REPORT OF COMMUNICABLE DISEASES Fax:(978)740-9705 FOR THE MONTH OF FEBRUARY 1998 *DISEASE NEW CARRY OVER DISCHARGED REPORTS TO CASES CASES CASES STATE CAMPYLOBACTER 0 0 0 0 E.COLI 0157 0 0 0 0 GIARDIA 0 0 0 0 HEPATITIS 0 0 0 0 • LYME DISEASE 0 0 0 0 MENINGITIS 0 0 0 0 MUMPS 0 0 0 0 SALMONELLA 1 0 1 1 SHIGELLA l 0 l 1 TUBERCULOSIS 0 0 0 0 VARICELLA 0 0 0 0 *THOSE DISEASES EXCLUDED FROM ABOVE HAVE NOT BEEN IDENTIFIED DURING THIS MONTH. Dawn Marie Cameron,R.N., M.S.N. Public Health Nurse For the Board of Health • ,r SUMMARY OF COMMUNICABLE DISEASES-FEBRUARY 1998 Salmonella: One New Case- a 42 y.o. male, non-foodhandler- exposure unknown- treated for abdominal cramps and diarrhea with lomotil prn Shigella: One New Case- an 8 y.o. male- unable to locate patient to investigate- incomplete case report sent to state • • • 4 Upham Street Salem, MA 01970 February 13, 1998 Mr. George Levesque Chairman of the B.O.H. 6 Adams Street Salem, MA 01970 Dear George and Board Members: As you know, my ongoing financial struggles have forced me to seek a higher-paying position. I have been offered and have accepted a full-time school nursing position at the Saltonstall Elementary School. As the Public Health Nurse, I have enjoyed working with the children at both Saint Joseph's School and the Phoenix School. Although I am excited about the new challenges ahead, at the same time, I am sad to leave my friends here at the Health Department. Over the past 3.5 years, I have grown both personally and professionally. For the opportunities I have been provided, for the experience I have gained, and for the support and kindness I have received from the Health Department staff/ Board Members, I am very grateful. Please accept my resignation, along with my sincere appreciation, effective on Friday, February 27, 1998. Sincerely, Dawn Marie Cameron i City Of Salem Environmental Health Division --- Inspection Monthly Summary Month ---------------------------------------------------------------------- Type Jul 97 Alg 97 Sep 97 Oct 97 Nov 97 Dec 97 Jan 98 Feb 98 Mar 98 Count ------ ------ ------ ------ ------ ------ ------ ------ ------ ------ BB 0 0 0 0 1 0 0 2 4 7 CFI 122 73 82 66 29 71 45 58 50 596 CPR 0 5 11 15 7 5 0 3 10 56 CH 2 10 5 3 7 17 5 1 5 55 CON 17 11 5 9 1 4 1 9 7 64 CR 3 4 4 4 2 4 2 0 0 23 EC 13 1 3 6 5 3 1 5 1 38 ,. EC/GN 1 0 0 0 0 0 0 0 0 1 / �V-Y EPR 0 3 0 0 1 0 0 0 0 4 }A /' '„c PC 0 3 3 0 0 0 1 0 2 9 FRH 0 0 1 0 0 0 0 0 0 1 FSD 0 0 0 0 0 0 1 0 2 3 n FSI 26 15 26 19 10 17 21 13 �_V 171 FSR 2 10 4 3 0 1 6 2 �� 40 r E GN 9 10 6 3 7 0 2 2 2 41 �.1`� J/�,•� GN/CON 1 0 0 0 0 0 0 0 0 1 a HI 8 18 16 9 42 75 54 42 35 299 ra HR 9 9 17 11 18 13 23 12 15 127 ` �• HRI 2 1 0 0 0 0 0 0 0 3 "( JPI 0 0 0, 0 0 0 1 0 0 1 z� LPI 0 0 0 0 1 0 2 2 0 5 MS 0 0 0 0 0 0 0 1 0 1 ' MUP 0 0 0 0 0 0 1 1 1 3 0 0 0 1 0 0 4 6 1 12 5 7 4 8 8 6 3 3 4 48 RFR 2 1 3 0 3 1 0 1 2 13 RO 1 1 0 0 2 2 1 0 1 8 SB 18 19 0 0 0 0 0 0 0 37 SC 0 0 1 1 0 4 5 1 0 12 SES 1 0 0 0 0 0 0 0 0 1 SM 8 2 10 6 3 6 11 6 10 62 SP 2 0 0 0 0 1 0 0 4 7 ST 0 0 0 0 1 1 1 0 1 4 TFI 0 39 1 40 0 0 0 0 0 80 TR 68 80 105 80 31 46 47 20 79 556 TR/GN 0 1 0 0 0 0 0 0 0 1 Count 320 323 307 284 179 277 238 190 272 2390 BB - Bed/Break. 2 FSI - Food Serv. Ins . 243* RFD - Retail Food Disc . CFI - Cert . Fit . 890* FSR - Food Serv. Rein. 11l* RFI - Ret . Insp. 100* CFR - Cert . Fit .Reinsp . GN _ Gen. Nuisance 44* RFR - Retail Food Rein. CH - Court Hearing 44* HI - Housing Insp. 312* RO - Rodent Control 13* CON - Constable Serv. HR - Housing Reinsp. 172* SC - Suntan 5 CR - Compliance Rev. LPI - Lead Paint Insp . 26* SES - SESD Odor 3* CT _ Computer Time MS - Massage 7 SM - Seminars/Meetings EC - Envirn. Compl . 85* MUP - Mobile Food Insp. 13* SP - Swim. Pools 14 EPR - Ext . Paint 5* OG - Overgrowth SB - Swim. Beaches 111* FC - Food Compl . 22* OS - Off . Sub. Insp . 10* ST - Soil Test/Septic - Food Related Hear. RC - Rec . Camp 5 TFI - Temp. Food 65* Food Serv. Disc . RFC - Retail Food Compl . TR - Trash 758* 4/8/98 • NEWSILETTER • March 10 35 , 1998 AGENT'S REPORT TO THE BOARDOu contract for those services added the objective through a private nursing concerning our Animal NURSE POSITION agency. Money remaining Control Officer. The Dawn Marie has begun from dawn Marie's position submitted version is in your her new position as school should cover the costs. packet. nurse at the Saltonstall School. We wish her WARD ONE TRASHO happiness and lots of shiny George has asked me to FOODBORNE red apples! speak with Councillor OUTBREAKO We are extremely Paskowski about changing the We received notification fortunate to have Tracy day of trash pick-up, from Beverly Hospital of an Giarla filling in temporarily as particularly in the tourist elderly woman admitted our nurse while we go through section of ward One. because of dehydration the hiring process. Tracy had Councillor Paskowski resulting from foodborne • the same position here when I agrees with that idea and will illness. She had eaten began four years ago. She is be at the board meeting to Sunday brunch with 15 experienced and has speak with you about it. members of her family at a wonderful skills. Salem restaurant. Seven Beth Rennard felt it was FOOD PERMITS people became ill with best to go through the civil I have required three symptoms of foodborne service list for this position. establishments to come before illness. She has begun the process of the Board to explain why.they We did food histories on requesting the list. did not return their food all family members, service applications until conducted inspections of the March 6th, despite repeated establishment, and complied SCHOOL SCREENINGSO notification. I have enclosed with all recommendations Tracy is able to work from in the packet copies of those from the State regarding one to three days per week. notifications. One follow-up of this situation. At this time of year we begin establishment still does not During the inspection it planning for the scoliosis, have a 98 permit. was observed that there was hearing &vision screenings at no sanitizing occurring in the St. Joseph's and the Phoenix establishment at all. The schools. However, Tracv is FY98 BUDGET® `/ dishwasher was not operating not certified to do those The budget has been with a sanitizer, there were no • screenings. We will be asking submitted to the Finance solutions in the food prep when the next training is for Director. We requested that area or anywhere else, the those screenings so that she Mary Jane Thomas also be handwashing sinks in the prep can become certified. In the allowed to work 20 hours, as area had no soap or paper meantime, I would like to we did with Jose. Also, I towels. Therefore, the establishment was closed Health Department permits. until all code violations were SWIMMING POOL corrected, which was one day. SEMINAR* FOREST RIVER POOL* . We would have closed the IEnclosed please note a There had been some establishment because of form I am forwarding to disagreement over purchasing these violations regardless of Mayor Usovicz. The Mayor issues and the contract to the outbreak. has asked that department evaluate the Forest River We received early heads submit such requests Pool. it seemed to be notification of this problem for time away from the office between the engineering because the woman was for seminars, etc. Whenever I department and the hospitalized. (She has since sent one to him I will also Purchasing Agent. However, I been released.) Otherwise, we include it in the packet for have. received a,copy of an would be sent lab results, if your information. opinion from*the�City tests are taken, a week or Solicitor indicating that the more later. This means that SESD ODOR MEETINGSD engineering evaluation will be it is possible that we may hear The SESD has published a conducted. of more cases next week. report regarding its interim Jeffrey and Tracy have odor control. I will have a been conducting this copy of that report at the investigation in a professional meeting. I am continuing to and extremely competent meet with the SESD manner. This began on regarding odor control. Most Tracy's first day!! final control devises are on •' line now, with the last to be operating within the next six SALVATION ARMY / weeks. This summer should CHILD CENTER./ ✓ be a good test of the Owen had read in the effectiveness of the new News that the Salvation Army systems. i F was beginning an after school drop in center at its location BODY PIERCING PR<- on North Street.; There was Included in your packets concern because of the are reprints of articles from condition of the facilities. the Northshore Sunday. The I have contacted the editorial is interesting. .agency which licenses such centers. I was told that the MASSAGE✓ Salvation Army had not The woman in the vellow applied for a permit or for an pages who had not been exemption. She is permitted to conduct massage investigating. I should have now has her necessary more information at the permits. She had gone to the � meeting. Zoning Board of Appeals for a variance, which was granted. She was not told, nor was she aware, that she also needed a CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH,RS,CHO NINE NORTH STREET HEALTH AGENT _'Il:.,`i`1 Tel:(978)741-1800 Fax:(978)740-9705 t Telephone Records - February 1998 19 Work Days :Telephone Calls = 739 Answered by 3 Secretaries : Barbara = 111 Mary = 290 Susan= 338 M - 8-4 T - (8-4) W- (8-4) TH - (8-7) F- 8-4 s 2-2=26 2-3=31 2-4=59 2-5=48 2-6= 30 2-9=39 2-10=35 2-11=37 2-12=50 2-13=28 2-16=Holiday 2-17= 44 2-18=38 2-19=47 2-20=39 2-23= 43 2-24= 46 2-25=34 2-26=35 2-27=22 Messages for or calls taken, complaints assigned, handled by office staff etc...... a Joanne= 243 Dawn Marie =87 Ginny = 118 Pablo = 6 Mark T.= 33 Barb S. = 45 Jeffrey V. = 47 Mary = 75 Jose = 30 Sue K. = 75