health

Statement from Tom Allocco, New York Department of Health:

United Memorial Medical Center has properly reported its cases of Clostridium difficile (C. diff) to the State Health Department. The department has been working with United Memorial on the implementation of proper infection-control measures to help reduce the spread of illness. These include proper hand hygiene (simple, but probably the most important control measure), cleaning and disinfecting portions of the facility, and the separation of those who are infected from other patients. The department’s investigation of the outbreak continues. Once the investigation is finalized, the findings will be available. 

Additionally, the state health department has a public report on "Hospital Acquired Infections" that was released in late 2010 and covers data through 2009.

According to the report, in 2009, UMMC performed 28 colon procedures and of those, two patients contracted infections. That puts UMMC's infection rate at 7.1 (a number adjusted to calculate infections per 100 procedures to enable statewide comparisons). New York's infection rate for colon procedures in 2009 was 4.8.  

UMMC's rate of 7.1 is considered within the range of state average.

Strong Memorial's rate for 2009 was 5.5, also within the state average.

In 2008, UMMC's rate was 6.4, the state average was 4.4 and Strong was 4.8

In 2008, Strong performed 327 procedures and there were 16 infections. The following year, Strong performed 317 procedures and there were 17 infections.

Erie County Medical Center performed 86 colon procedures in 2008 and 98 in 2009 with three reported infections in each year. Numbers also fell within the statistical average at Highland Hospital in Rochester, while Women & Children's Hospital of Buffalo reported no infections, with about 50 procedures for each year. (For some reason, the report called W&C's zero-infection rate "statistically insignificant" and didn't give it a "blue star" on its report card).

For hip replacement surgery, UMMC's infection rate in 2008 was 3.1, and 2.5 in 2009. Both numbers fall within the range of the state average of 1.1. In 2008, UMMC performed 81 procedures with three infections and in 2009, 84 procedures with two infections. For the same procedure, Strong performed 50 operations in 2008 and 60 in 2009 with no infections.

A reporter from Rochester forwarded me this press release put out by Betsy McCaughey a couple of days ago. The message from the former Lt. Governor of New York and founder of the Committee to Reduce Infection Deaths seems particularly relevant and the information worth reading.

Hospital infections kill more Americans each year than AIDS, car accidents and breast cancer combined -- and researchers are searching for solutions. This week, a study of 153 Veterans Affairs hospitals shows that doing a simple swab test to identify and isolate the few patients carrying infection-causing bacteria can save lives. It's called screening, but even more important is cleaning. Studies are rolling in that hospitals need to be cleaner.

In fact, if you're visiting a friend or relative in the hospital, don't bring flowers or candy -- take gloves and a canister of bleach wipes.

Hospitals do an inadequate job of cleaning rooms -- so germs left behind by past patients are lying in wait. Patients are at far greater danger of infection when placed in a hospital room where a previous patient had an infection. Hospitals won't tell you who occupied the room before you.

Alarming research published in the Archives of Internal Medicine (March 28) demonstrates that a patient's risk of picking up the drug-resistant bug MRSA (methicillin-resistant Staphylococcus aureus) is much higher if the previous occupant of the hospital room had it.

Being placed in a room where the last patient had Clostridium difficile, or C. diff for short, more than doubles the risk of getting that dreaded infection, according to a new study in Infection Control and Hospital Epidemiology (March 2011). C. diff is the most common hospital infection in some parts of America.

Patients pick up invisible C. diff bacteria when they touch surfaces in their room, then eat a roll or cookie with their contaminated hands and swallow the bacteria along with the food.

C. diff causes life-threatening diarrhea -- wreaking havoc in your gastrointestinal system unless you have enough powerful "good" bacteria in your system to keep the C. diff under control. But patients on antibiotics often lack good bacteria. Some hospitals are treating desperately ill patients by giving them fecal enemas.

Pretty awful. Especially when it could be avoided by keeping the patient's room clean.

Dr. Robert Orenstein launched a cleanup campaign at the Mayo Clinic in Rochester, Minn. -- wiping the frequently touched surfaces around each patient's bed once a day with bleach-soaked wipes. The results: a 75- percent drop in C. diff infections.

Lax room-cleaning raises the risk of contracting other kinds of hospital infections, too. The No. 1 predictor of which patient picks up a drug-resistant bug called VRE (vancomycin-resistant Enterococcus) is who occupied the patient's room in the prior two weeks, according to Tufts University investigators. That two-week span could mean three or four patients ago.

A study of 36 hospitals from Boston to Washington, D.C., found that cleaners routinely overlook half the surfaces in patients' rooms. Toilet seats are cleaner than telephones and call buttons.

Doctors and nurses may clean their hands coming into the room -- but recontaminate them when they open the privacy curtain or rest their hands on the bedrail. Then they touch their patient, and germs enter the patient's body via an IV, urinary-tract catheter, wound or surgical incision.

For decades, hospital administrators and government agencies have shrugged off the notion that hospitals are dirty, saying, "germs are everywhere." They emphasize getting doctors and nurses to clean their hands -- which isn't enough.

The Joint Commission, which is responsible for accrediting most hospitals, just considers whether a hospital looks clean -- when infection-causing germs are invisible.

Food-processing plants routinely test surfaces for bacteria. Hospitals ought to meet at least the same standard.

www.HospitalInfection.org

We received an inquiry from a reader who said there was an outbreak of whooping cough -- or, pertussis -- at Genesee Community College.

We contacted Randy Garney, interim director of the Genesee County Health Department, who said no cases have been reported in Genesee County. However, he was aware of a case being reported in Wyoming County.

Laura Paolucci, public health administrator for Wyoming County, issued the following statement:

The Wyoming County Health Department has confirmed a case of pertussis for an individual that is a resident of Wyoming County and a student at GCC. The individual received appropriate treatment. The GCC Health Services Office was notified, provided information on pertussis and instructed to contact the health department with questions or concerns. There have been no further cases reported or identified.

Physicians are required to report diagnosed cases of pertussis to county health officials.

The exact words may not have been spoken, but the message was clear for Town of Batavia residents Wednesday evening: Get on public water.

No matter how much you like your well water, there's no way to guarantee it will remain safe.

"We want to be sure people understand that those are three tests and those are three bad contaminates (e-coli, coliform and nitrates), but there is a concern you should have on other items possibly getting in (your water)," said town engineer Steve Mountain.

The tests for e-coli, coliform and nitrates are quick and easy, but Mountain's message was, if those containments can reach well water, so can other contaminates.

Once a well is shown to be susceptible to contamination from surface water -- which the tests for those three substances prove -- then the well should really be considered unsafe.

Tests of wells around the town found that containments from manure as well as human waste is getting into the ground water, and when members of the 100-person audience at Wednesday's meeting wanted information on how to trace the source to agriculture, Town Supervisor Greg Post suggested, gently, they were looking in the wrong direction.

“If there’s a blend of both (human and agricutlure), it really doesn’t matter," Post said. "The water’s not safe.”

Of the 38 wells tested in the Bank Street Road, State Street Road, Batavia-Elba Townline Road area, 14 tested positive for bacteria and 11 of 13 tested positive for unsafe levels of nitrates.

In the rest of the town, 11 of 52 tested positive for bacteria and 28 of 47 for nitrates.

The results show that Town of Batavia wells are susceptible to contamination from surface water.

Illustrating the point from the audience Wednesday night was Harlo Towner, a Batavia-Elba Townline Road resident who said his well water is completely unusable. He showers at the YMCA or his daughter's house in West Batavia, and when he comes in from gardening, he goes through a regime of anti-bacterial hand washing.

It's been that way for years.

He blames, in part, pesticide planes from the airport.

He said growing up his daughters had stomach problems and rashes that went away when they left for college.

For the past five years, he's been battling cancer. He doesn't think it's a coincidence.

"It's a really bad situation," he said. "We really need water bad. I think everybody on the road signed up for it."

Part of tonight's presentation included Mountain explaining how residents can get on public water, which consists of creating water districts.

There are grants available to help pay for the creation of water districts, but residents can expect to pay in the neighborhood of $700 per year for public water once a district is created, Mountain said.

Photo: Towner is in the center of the picture.

UMMC has rescinded visitor guidelines put in effect in October 2009, during the height of concern over H1N1, that banned children from visiting patients.

Starting yesterday, visitors over 14 are allowed to visit patients, with the exception of the Maternity Ward, where siblings of newborns are permited to visit with a responsible guardian.

The Hope Haven unit allows visitors of all ages.

Only two visitors per patient are allowed. Visiting hours are 9 a.m. to 9 p.m.

Full press release after the jump:

United Memorial instituted new visitor guidelines on Tuesday, April 27, 2010. Restricted visitor guidelines were issued in October 2009 based on the threat of the H1N1 virus.

The new guidelines rescind the ban on visitors under the age of 18 to the facility. The hospital’s current policy allows visitors over the age of 14 with the exception of Maternity, where siblings of newborns are permitted to visit with a responsible guardian. The Hope Haven unit allows visitors from all age groups when appropriate.

Only two visitors per patient are allowed at any one time. Visiting hours are from 9 am to 9 pm for most medical/surgical units. Visiting hours for Maternity are from 1 pm to 8:30 pm (significant others allowed at all times) and the Intensive Care Unit’s are from 9 am to 8 pm. Exceptions to the general visitors’ policy are made for the Hope Haven, Emergency, and Hospice/Comfort Care units and at the discretion of the attending physician when deemed appropriate by a patient’s condition.

Patients look forward to visitors and those visits are an important part of recovery. Rest is also a vital component of treatment, and it is the responsibility of the hospital to regulate visiting hours so as not to interfere with healing. 

United Memorial requests that all visitors cooperate in promoting the comfort and well-being of patients by trying to keep visits brief, using quiet tones, and not disturbing others. Any person with a cold, sore throat or other transmissible illness should not visit patients. Visitors under the age of 14 will be screened for illness and a log of their visit will be kept. Visitors over the age of 14 will be visually screened for illness by hospital staff and may be asked to use appropriate protective measures if necessary. If visiting patients who are on “isolation,” guests will be instructed by the nursing staff in proper protective guidelines.

All visitors are encouraged to wash their hands before and after visiting any patient.

Infection prevention is a priority at United Memorial, and as a result, we have one of the lowest infection rates among Western New York hospitals. Questions regarding changes to the visitors guidelines may be addressed by the Infection Prevention Department, Nursing Supervisors, or Community Relations Department.

A Rochester-based home-healthcare provider has completed its purchase of Genesee County's home nursing care program.

Home Care of Rochester, HCR, received what's known as a "certificate of need" from the State Department of Health, which is required for it to provide both long-term and short-term home nursing for Genesee County patients.

Since March of 2009, when HCR acquired the program from the county for $1.5 million, HCR has been operating in Genesee County under the county's certificate of need.

With the purchase, HCR replaces the county-owned program. HCR will now handle all acute, longer-term, therapy and home health-aide services for patients receiving insurance coverage via Medicare or Medicaid.

HCR also provides care through private insurance.

Genesee County will get its first urgent care clinic on July 1 when UMMC opens the new service at a location in Le Roy.

Currently, there is no urgent care clinic in Batavia or the surrounding towns and villages.

The facility is intended to provide services to residents in Le Roy and that part of the county, said UMMC spokeswoman Colleen Flynn, but any resident -- and anybody in the UMMC system -- can seek treatment at the Le Roy clinic.

No appointment will be necessary for patients seeking treatment for a range of non-life threatening injuries and illnesses.

"Urgent care fills a unique need in a community beyond what you can normally get at your doctor's office by having to make an appointment and then wait for that appointment if you're ill, or going to the emergency room with something that isn't really a life-threatening condition and having to wait long periods of time to be seen," Flynn told WBTA this morning.

UMMC officials say the clinic, which will be open from 11 a.m. to 9 p.m. seven days a week, will provide patients with a cost effective and convenient way to seek treatment.

For those covered by insurance, co-pays for urgent care treatment tend to be less than emergency room treatment, officials.

The new clinic will be located where UMMC currently operates the LeRoy Diagnostic Center and Tountas Family Care Clinic, at 3 Tountas Ave., next door to LeRoy Ambulance.

Flynn said the Le Roy clinic has been in the planning stages for months. As for a similar clinic opening in Batavia, Flynn said that remains a possibility.

If you haven't gotten a flu shot yet, the Genesee County Health Department has scheduled three more clinics.

There is a clinic today for both seasonal and H1N1 vaccines from noon to 4 p.m. at County Building II.

Another clinic has been set for Jan. 21 from noon to 4 p.m., and an H1N1-only clinic is scheduled for 10 a.m. to 2 p.m. on Jan. 23 at Batavia City Centre. On Jan. 23, priority will be given to children under 9 who need a booster vaccine.

The clinics are open to everyone over 6-months old.

The Health Department can be reached at (585) 344-2580, extension 5000.

When people have flu-like symptoms, or a friend or relative does, the first thing they do is hop on Google to see if they can self-diagnose or learn more about the illness.

Those searches spike when there are a lot of people feeling sick.

Google has found that its search trends correlate to Center for Disease Control reports, but CDC lags Google's real-time results by about two weeks.

The current trends show minimal concern in the Buffalo and Rochester area (they don't break it down for Batavia specifically) about the flu this month. 

Learn more about how this works by clicking here.

Rain, sleet and snow didn't keep several hundred people from trying to get flu vaccinations today at County Building Number 2 in the Town of Batavia.

At one point, the line snaked outside and around the side of the building. Seniors, parents and children were waiting two or more hours for either a shot of the seasonal flu vaccine or the H1N1 nasal mist.

A winter storm of sorts started not long after the clinic doors opened, and by then the line  already stretched well outside the building.

"I was standing in the rain and snow out there a little while before and I was thinking, I'm going to get a flu shot to prevent getting sick and I'm going to get sick standing in line in the rain and the snow, so I wonder if it's really worth it," Walter Kershenski said. He also happens to be Stafford Town Clerk, and said he stood in line for more than two hours.

There were reports of people driving from Orleans, Monroe and even Chautauqua counties for the vaccinations, and apparently, nobody was being turned away for the free vaccines.

Interim Health Director Randy Garney said the Health Department was expecting to provide at least 500 doses of vaccine in two hours, but had received an extra shipment of seasonal flu and H1N1 vaccine just days ago.

"I figure, two hours, that's going to be about all we're going to be able to process, but we're going to keep the clinic open as long as there is a line," Garney said.

"With recent events that have taken place, we were expecting a large crowd," Garney said.

Rosemary Sero, of Oakfield, said all the reports of people getting sick with H1N1 and especially the death of a Pembroke student, has her feeling very cautious about taking care of her two young daughters.

"They're using a lot of hand sanitizer," she said. "They wash their hands a lot. I tell them not to touch their face."

If you haven't received a flu shot yet, you can do so today at County Building Number 2 on W. Main St. Road, Town of Batavia.

The walk-in clinic will be open from 2 to 4 p.m..

Seasonal flu vaccine is available for people 19 and older, and H1N1 vaccine is available for people 2 to 24 years of age, and for people 25 to 59 who care for or live with infants.

Vaccine supplies are limited.

People looking for extra protection against the H1N1 strain of flu -- commonly, though incorrectly, called "swine flu" -- will soon have the opportunity to be vaccinated, Randy Carney told WBTA this morning.

The first doses are expected to arrive in Genesee County later this week, the interim county health chief said.

The vaccine will be distributed through healthcare providers, but people without their own doctor will be able to receive the vaccine from the county health department.

But the supply is limited. The county will receive only about 100 to 200 doses this week, with more on the way. Federal officials assure citizens that there will be plenty of vaccine to go around.

Audio: Randy Garney talks about the vaccine (mp3).

I know a couple of people who have been pretty sick recently, and you probably do, too. The symptoms sound a lot like flu, and according Randy Garney, interim health director for Genesee County, if you have the flu this time of year, there's about a 90-percent chance it's H1N1, or "swine flu."

But, according to Garney, there have been no official cases of H1N1 reported recently in Genesee County.

Suspected flu cases are only tested, Garney said, if the sick person shows up at the hospital. 

We have a call into UMMC to see if they've been dealing with any suspected H1N1 cases and are waiting for a call back.

Garney said H1N1 is widespread throughout the Southeast, according to the National Center for Disease Control.

"At this point (outside of flu season) widespread activity is unheard of," Garney said. "To call it widespread is not normal at all."

As usual, Garney warned that people who are sick need to stay home in "social isolation" to avoid spreading the virus.

If you have a fever of 100 degrees, you probably have the flu. You should wait at least 24 hours after the fever has abated (not counting taking medications to reduce the fever) before mixing in public.

He called the virus a mild form of the flu.

"I use mild very gently because the people I’ve talked to, the epidemiologists I’ve talked to, (say) it may be mild, but you’re going to be very sick," Garney said.  "You’re going to be very achy, you’re going to be in bed, but you’re going to recover with no ramifications."

The New York Department of Health recommends:

It's that time of year -- time to start planning on flu shots.

The County Health Department issued a press release today notifying residents that flu shot clinics are in the works.

The first one is tentatively scheduled for Sept. 18.

Tentatively because only about 1/4 of the needed vaccine has been delivered to the county so far.  The remaining doses should arrive in September or October.

Full press release after the jump:

The Genesee County Health Department has tentatively scheduled Seasonal Influenza/Pneumococcal Clinics pending receipt of vaccine. One-fourth of the vaccine has been received, while the remaining doses are scheduled for delivery during the months of September and October.  Updates will be published and broadcast through the Daily News, WBTA, the Batavian, and the Genesee County Health Department website at www.co.genesee.ny.us.  Verification of flu clinics can also be obtained by contacting the Health Department at (585) 344-2580, extension 5000.

Friday, September 18        10:00 am.-  2:00 pm    County Building #2, 3837 West Main St. Rd., Batavia
Thursday, September 24     4:00 pm –  7:00 pm    County Building #2, 3837 West Main St. Rd., Batavia
Thursday, October 15         9:00 am – 11:00 am    Office for the Aging, 2 Bank St., Batavia
Monday, October 26        10:00 am –  1:00 pm    Batavia Downs Casino, 8315 Park Road, Batavia

The Health Department can bill Medicare Part B, American Progressive, MVP (Preferred Care), Independent Health, Excellus, Blue Cross of WNY and Univera.  Empire (State Insurance Fund) cannot be accepted.  Clients are responsible for co-pays or unpaid claims. For all others, the cost at time of vaccination is  $35.00 for Influenza and $55.00 for Pneumococcal vaccination.

The New York State Department of Health (NYSDOH) recommends that all persons, including school-aged children, who want to reduce the risk of becoming ill with influenza or of transmitting influenza to others should get the flu vaccine.  In other words, when there is an adequate supply everyone should get the seasonal flu vaccine.  According to the Centers for Disease Control (CDC), those individuals at greatest risk for serious complications, close contacts, and those most likely to get or spread the flu, should get the seasonal flu vaccines in September or as soon as vaccine is available. It is not too early to get the flu vaccine as the protection will not wear off before the flu season is over. Those at high risk include:

•    Children aged 6 months up to their 19th birthday.
•    Persons aged 50 years or older.
•    Children and adolescents receiving long-term aspirin therapy.
•    Women who will be pregnant during the fu season.
•    Adults and children with chronic lung, heart, kidney, liver, blood or metabolic disorders (including diabetes) or any condition that can compromise respiratory function.
•    Residents of nursing homes and other chronic-care facilities.
•    Health care personnel.
•    Healthy household contacts and caregivers of children aged 59 months or younger or persons with medical conditions that put them at higher risk for severe complications from influenza.

The CDC clarifies that the annual flu vaccines contain a seasonal Influenza A (H1N1) virus which is not the new 2009 H1N1 influenza virus (Swine Flu) that has caused the current pandemic. The persons prioritized for initial doses of H1N1 vaccine are not the same groups that seasonal influenza vaccine is targeted for.  The seasonal flu vaccine is not expected to protect against infection of 2009 H1N1 influenza virus. The CDC is very clear regarding the targeted group for H1N1 vaccination; however, availability and demand can be unpredictable, and there is the possibility that initially the vaccine will be available in limited quantities. In this setting, that target group would be initially reduced to a priority group to include those most at risk.

The Genesee County Health Department is committed to offering information to the community as it becomes available.  Future news releases will be provided as further information regarding clinics for seasonal influenza and H1N1 (Swine Flu) become available.