Dallas County Health and Human Services
Public Health
Preparedness Update
October 2006
Volume 2, Issue 9
It’s Fall—Time To Get Your Flu Shot
Fall has officially arrived, which
means flu season can’t be far behind.
Dallas County Health and Human Services (DCHHS) began offering flu vaccinations to adults Wednesday, September
27, 2006 from 8 a.m. to 4 p.m.
“DCHHS has placed an initial order
of 15,000 doses of the flu vaccine. Our
first shipment of 2,500 adult doses arrived last week,” said DCHHS Director
Zachary Thompson. “Unlike in previous years, the Centers for Disease Control and Prevention (CDC) has not restricted the flu vaccine to a priority
group, so we are encouraging all adults
to come in and get their flu shot,”
Thompson continued.
In September, the CDC announced
that influenza (flu) vaccine manufacturers are expecting to produce and distribute more than 100 million doses of
influenza vaccines in the United States
between now and January, 2007.
“Although the CDC did not identify
priority groups this year, we recommend those persons at high risk of complications from influenza and foreign
travelers get their shots early,” said Dr.
John Carlo, DCHHS Medical Director.
“The high risk group includes people
aged 65 years and older, anyone with
chronic health conditions, pregnant
women, health-care personnel who
provide direct patient care, household
contacts and out-of-home caregivers of
children less than 6 months of age, and
all children aged 6 to 59 months,”
Carlo continued. “Since the flu vaccine
takes about two weeks to become effective, we strongly advise high risk individuals to come in and get their flu
shots early to lessen their risk,” Carlo
said.
DCHHS is still awaiting shipment of
vaccine for infants aged 6 – 35 months
and children aged 36 to 59 months.
DCHHS will make a formal announcement when the infant and children vaccine becomes available.
DCHHS offers the flu shot for $20
for adults. Medicare is accepted for
adult shots. Shots are given from 8:00
a.m. to 4 p.m., Monday through Friday,
at the DCHHS building, 2377 N. Stemmons Freeway, Dallas, TX 75207. No
appointment is necessary. For more information, call 214-819-2163.
“The flu shot remains the most effective way to prevent influenza. We hope
that we will not see a repeat of shortages and shipping delays seen in the
past,” Thompson concluded.
Message from DCHHS Director Zachary Thompson
According to the Centers for Disease
Control (CDC) and the National Immunization Survey, Dallas County's 2005
immunization rates increased by 8 percent. The National Immunization Survey, conducted annually by the CDC,
assesses immunization levels among
preschool children. In 2005, Dallas
County’s immunization rate increased
from 67.1% to 72.8%.
This increase can be attributed to the
community-wide support of the medical
community: the Immunize Kids Dallas
Area Coalition, Dallas County Immunization Coalition, Parkland Health and
Hospital System, Community Council of
Greater Dallas, Texas Department of
State Health Services, and municipalities
in Dallas County, all area ISDs, Childcare facilities, Texas Medical Foundation, Dallas County Medical Society,
Blue Cross and Blue Shield Care Van,
the City of Dallas and the Dallas County
Department of Health and Human Services.
DCHHS strategies for improving
immunization rates in Dallas County
include:
• promoting the effective use of the
ImmTrac Immunization Registry;
• promoting the concept of the medical home by recruiting more providers into the Vaccines for Children Program; and
• conducting site visits to Texas Vaccines for Children Program (TVFC)
provider offices for training, education, follow up and technical assistance.
As a result of recruitment efforts by
DCHHS, numerous health care providers are enrolling in the TVFC. Through
the DCHHS TVFC program, vaccines are
made available to health care providers
at no cost. Dallas County continues to
be a leader in promoting childhood immunizations through these successful
collaborations with medical home private providers and the operation of our
own county-wide immunization and
well-child clinics. Our goal is to provide
barrier-free vaccines year round to help
protect the health and welfare of all infants and children in Dallas County.
Inside This Issue
DCHHS Presents Mass Mortality
Workshop During National Preparedness Month
DCHHS Lab Now Offering Quantiferon
2
2
Update on Syphilis in Dallas County
3
DCHHS Recognizes National Breast
Cancer Awareness Month
National Recovery Month Celebration
4
4
Page 2
Volume 2, Issue 9
DCHHS Presents Mass Mortality Workshop During
National Preparedness Month
Monday, September 11th, marked
the fifth anniversary of the attack on
the World Trade Center. To commemorate this tragic event in American
history, Dallas County Health and Human Services (DCHHS) conducted a
Mass Mortality Workshop featuring
Dr. Louis Cataldie, Louisiana State
Medical Examiner. During the Hurricane Katrina aftermath, Dr. Cataldie
was the commander of the triage area
surrounding the Superdome and the
International Airport. Once evacuation
of the city was complete, he coordinated
the remains recovery effort. His team
identified over 1,400 sets of remains
and reunited over 13,000 family members.
The Mass Mortality Workshop, held
on September 18, 2006, brought together 100 first responders representing
various disciplines such as medical examiners, funeral directors, morticians,
coroners, forensic scientists, forensic
investigators, field investigators, forensic dentists, chaplaincy, and emergency
management. Dr. Cataldie’s lecture was
followed by a tabletop exercise examin-
ing the impact of Pandemic Influenza
on Dallas County. Funding for this
workshop was made possible by a generous donation from The Meadows
Foundation and the Texas Department
of State Health Services.
“Dr. Cataldie shared his unedited
experiences from ground zero,” said Lee
Arning, DCHHS Assistant Director for
Public Health Preparedness. “Dr.
Cataldie’s first hand account of his lessons learned in a situation where all
systems failed, allowed DCHHS and our
strategic partners the capability to use
his experiences to better prepare our
community for times of disaster.”
“September 11th changed our view
of the world and altered our own sense
of safety,” said Zachary Thompson, Director, DCHHS. “As we honor the five
year anniversary of this tragic event, we
should be reminded that each community must be prepared to act on its own
during either a natural or man-made
disaster,” Thompson continued. “Each
household, each business owner should
ask themselves, ‘Am I prepared?’ ‘Have
I taken all the necessary steps to ensure
the welfare of my family and employees?’ Dallas County Health ad Human
Services is busy, on a daily basis, working with our many stakeholders to safeguard our community,” Thompson continued.
Personal preparedness is critical to
surviving any man-made or natural
disaster. Dallas County residents are
urged to develop their personal preparedness plans to be ready for any emergency situation. Information on developing plans can be found on our website at www.dallascounty.org.
DCHHS Laboratory Now Offering Quantiferon Testing
The Dallas County Health and
Human Services (DCHHS) Public
Health Laboratory has initiated
Quantiferon testing. This sensitive and accurate blood test can
be used in lieu of the Tuberculosis (TB) skin test to screen patients for TB infection. “DCHHS
is pleased to announce that our
lab testing capabilities have again
been expanded to include Quantiferon testing,” said Zachary
Thompson, DCHHS Director.
“This important test will greatly enhance our efforts to detect and treat
tuberculosis in Dallas County.”
“The TB skin test requires two client
visits to determine infection and patients often fail to come back for the
second visit,” said Dr. Edward
Bannister, DCHHS Laboratory Director.
“Quantiferon testing will increase our
ability to diagnose and treat TB infection by eliminating the need for two
visits.” Quantiferon test results are
available within 24 hours.
In recent years, DCHHS has
expanded its TB detection network.
Twice a week, TB staff visits homeless
shelters to test the homeless population
for TB. The TB staff also works with
Parkland Hospital and other
service providers to provide
health and TB screenings and
immunizations for newly arrived refugees in Dallas County.
DCHHS’ TB Prevention Program offers Quantiferon testing
Monday thru Thursday, and
PPD skin testing each weekday
(except Thursday) from 8 a.m.
to 11 a.m. and 1 p.m. to 3 p.m.
at the DCHHS building at 2377
N. Stemmons Freeway. Chest
x-rays are also available weekdays by
appointment only. For more information on the DCHHS TB Prevention Program, call 214-819-2071 or visit
www.dallascounty.org.
Volume 2, Issue 9
Page 3
Update On Syphilis in Dallas County
Syphilis is a bacterial infection and
can be deadly if it's left untreated.
Syphilis is passed from person to person through direct contact with a
syphilis sore. Sores occur mainly on the
external genitals, vagina, anus, or in
the rectum. Sores also can occur on the
lips and in the mouth. Transmission of
the organism occurs during direct sexual contact. Pregnant women with the
disease can pass it to the babies they are
carrying. Syphilis cannot be spread
through contact with toilet seats, doorknobs, swimming pools, hot tubs, bathtubs, shared clothing, or eating utensils.
The first symptom is often a painless
open sore where the person came into
contact with the bacteria. Several
weeks later those infected may develop
a skin rash. The disease then may go
into a latent stage, producing no symptoms for months or years. In the final
stage, syphilis can damage the nervous system, heart, eyes and can cause
death.
“People may not even know they
have it,'' said Dr. John Carlo, Dallas
County Health and Human Services
Medical Director. “That's the important
thing. If people think they may have
been exposed, they need to get tested,”
Carlo said. The disease can be treated
easily with penicillin or other antibiotics.
In October 1999, the Centers for
Disease Control and Prevention (CDC),
in collaboration with federal, state, local, and non-governmental partners,
launched the National Plan to Eliminate
Syphilis. In this plan, CDC identified
key strategies needed for successful
elimination of syphilis from the United
States: expanded surveillance and outbreak response activities, rapid screening and treatment in and out of medical
settings, expanded laboratory services,
strengthened community involvement
and agency partnerships, and enhanced health promotion.
In the six years since its establishment, numerous gains have been made
in reducing disease incidence in key
groups, raising professional and public
awareness of syphilis, increasing financial investment into public Sexually
Transmitted Disease (STD) clinic ser-
vices, and building local public health
and community capacity to fight this
devastating disease.
However, new challenges have
emerged. After reaching a low point in
2001, diagnoses of primary and secondary syphilis are again on the increase.
Today, more than 60% of new infections are diagnosed in men who have
sex with men (MSM).
This pattern has been repeated in
Dallas County. During the first six
months of 2006, 113 people in the
county were treated for primary and
secondary syphilis, the most infectious
stage of the disease. In 2005, the number was 170. That number has continued to increase slightly over the last
several years, following a national
trend. Statewide numbers are showing
a similar rise: 514 cases through June,
compared with 879 last year.
“We’re not certain why we are seeing an increase in the number of cases,
but believe there are a number of contributing factors, such as an increase in
awareness and in the number of people
getting screened and seeking treatment
as a result of the elimination campaign's messages as well as an increase
in the area’s population,” said Dr. Steven Wilson, Director of the Sexually
Transmitted Disease division at Dallas
County Health and Human Services
(DCHHS).
Dallas County is also seeing trends
in younger patients seeking treatment.
About 30 percent of total cases are men
and women younger than 25.
DCHHS founded the Dallas County
Syphilis Elimination Coalition in 1999.
The LaSima Foundation and Resource
Center of Dallas are long-time partners
and are key community-based organizations (CBOs). DCHHS has a team of
Disease Intervention Specialists whose
primary function is to go out into the
field to identify and interview patients
and those at risk of becoming infected
with syphilis for sexual contacts to ensure that they receive appropriate referrals, medical examination and treatment. These frontline workers conduct aggressive, ongoing field surveillance while serving as liaison between
DCHHS and the private sector to make
certain there is a consolidated effort in
reporting and controlling the various
sexually transmitted diseases.
“DCHHS surveillance team is out in
the community every day conducting
aggressive surveillance activities identify those at risk, bring them into our
clinic for testing, treatment and counseling,” said Zachary Thompson,
DCHHS Director.
DCHHS participates in local community health fairs on late nights and
weekends and participates in community forums, presentations and trainings targeting high risk populations. A
public awareness media campaign has
been launched and includes television
advertising, bus and rail signage, billboards, posters and other public education materials. All materials have been
produced in English and Spanish.
The STD Program offers rapid
testing, treatment and partner
notification for over 20,000 Dallas
County residents annually in order to
decrease the spread of STDs. For more
information or to schedule an appointment, call (214) 819-1819.
DCHHS Mobile Medical Clinic
travels to various locations around the
County and offers free testing for HIV,
syphilis, gonorrhea and Chlamydia
with results for HIV and syphilis
available within the hour. Treatment
for syphilis and other STDs may be
available on site. The mobile clinic is
al so avai labl e f or commu nit y
screenings and health fairs with prior
arrangement. For more information on
the Mobile Medical Clinic or the Dallas
County Syphilis Elimination program,
call Monica M. Tunstle Garrett, First
Line Supervisor, Syphilis Coalition
Coordinator, (214) 819-2132 or visit
our website at www.dallascounty.org.
Volume 2, Issue 9
Page 4
DCHHS Recognizes National Breast Cancer Awareness Month
October
is
National
Breast
Cancer Awareness
Month (NBCAM).
Since the program
began in 1985,
mammography
rates have more
than doubled for
women age 50 and
older and breast cancer deaths have
declined.
This is exciting progress, but there
are still women who do not take advantage of early detection and others who
do not get mammograms and clinical
breast exams at regular intervals.
• Women age 65 and older are less
likely to get mammograms than
younger women, even though
breast cancer risk increases with
age.
• Hispanic women have fewer mam-
mograms than Caucasian women
and African American women.
• Women below poverty level are less
likely than women at higher incomes to have had a mammogram
within the past two years.
“If all women age 40 and older took
advantage of early detection methods –
mammography plus clinical breast
exam – current breast cancer death
rates would drop up to 30 percent,”
says Dr. John Carlo, Medical Director,
Dallas County Health and Human Services. “The key to mammography
screening is that it has to be done routinely – once is not enough.”
For more information about
NBCAM, please visit www.nbcam.org.
For additional information, please call
one of the following toll-free numbers:
American Cancer Society, (800) 2272345, or the National Cancer Institute
(NCI), (800) 4-CANCER.
Public Health Preparedness Update is published monthly by:
Dallas County Health and Human Services
2377 North Stemmons Freeway
Dallas, TX 75207
214-819-2100
www.dallascounty.org
Dallas County Health and Human Services
Public Health Preparedness and Response Division
2377 North Stemmons Freeway
Dallas, TX 75207
Dallas County Judge
Hon. Margaret Keliher
Dallas County Commissioners:
Hon. Maurine Dickey
Dallas County Commissioner
District 1
Hon. Mike Cantrell
Dallas County Commissioner
District 2
Hon. John Wiley Price
Dallas County Commissioner
District 3
Hon. Kenneth Mayfield
Dallas County Commissioner
District 4
National Recovery
Month Celebration
September 2006 marked the 17th observance of National Alcohol and Drug
Addiction Recovery Month. Recovery
Month is sponsored by the Substance
Abuse and Mental Health Services
Administration’s Center for Substance
Abuse Treatment/Center Substance
Abuse Treatment (CSAT), within the
Department of Health and Human Services (HHS). Recovery Month celebrates
and promotes the message of recovery,
applauds the courage of people seeking
or in recovery, and shows the benefits of
successful faces and voices of long term
recovery. Locally, the Association of
Persons Affected by Recovery Community Support Project, served as a planning partner of Recovery Month. For
more information, please visit the Recovery Month website at
www.recoverymonth.gov or phone
214-634-APAA.
Zachary S. Thompson, M.A., Director
John T. Carlo, M.D., M.S.E., Medical Director/
Health Authority
For more information on articles published in DCHHS’ Public Health
Preparedness Update, contact: Jacqueline M. Bell, M.S., DCHHS Public
Information Officer at 214-819-6329 or [email protected].