September 23, 2014

Electronic medical records now linked up between Iowa and Nebraska

Iowans on the western side of the state should have an easier time when the go to doctor or hospital as the Iowa Health Information Network is now linked up with Nebraska’s Health Information Initiative. Deb Bass, the CEO of the Nebraska system, says the two states can now send and receive medical records electronically.

“It’s a direct secure email, and then we can send health information across state lines, so that somebody who is coming from a small community in Iowa to the Omaha area hospitals, their medical records can transfer with them using this secure email,” Bass says.

Bass says they have taken several steps to ensure the system is safe and secure. She says it’s a secure email product and they have also gone through the identification process of the person who is sending the email to verify who they are, and it goes to someone who is verified as being able to receive the information. “So, it’s from one known individual to another known individual, a secure exchange of email,” Bass says.

Bass says it is an important milestone to have the two states able to share this information. “Different states have different laws, so when you start crossing state’s borders, you have special challenges with that,” Bass explains.Bass says this is also one more step in the development of a national health care information exchange system.

By Karla James

Children’s Policy Coalition releases voter’s guides

A coalition of Iowa groups is releasing a voter guide that shows how the two major party candidates for governor responded to questions about child care, foster care, preschool and other kid-related topics.

“There are major child policy issues which must be addressed for children’s’ and Iowa’s prosperity into the future,” says Jerry Foxhoven, a spokesman for the Children’s Policy Coalition.

In the voter guide, Republican Governor Terry Branstad repeated his desire to limit state assistance for preschool to low-income Iowans, while Democratic challenger Jack Hatch supports state-sponsored preschool for all four-year-olds. Foxhoven says his coalition thinks preschool is “great for kids.”

“As much preschool as can be offered should be offered,” Foxhoven says. “Certainly there are resources that need to be devoted to children’s issues and we need to select which ones they are to be given to, but we would encourage preschool on a universal basis, if possible.”

Over 30 Iowa non-profit organizations are part of the Children’s Policy Coalition and the coalition plans to hold events in each of Iowa’s four congressional districts to call attention to where Iowa candidates for federal office stand on children’s issues as well. Despite efforts over the past two decades, Dr. Jennifer Groos, a Des Moines pediatrician, says about 20,000 Iowa kids still aren’t covered by health insurance and are at risk of developing long-term health problems.

“So it’s going to take all of us working together, reaching outside of what we can do in our realms, but working together find ways to improve the quality of care for children across our state,” Groos says.

No other state has a greater proportion of working parents — either both parents or the single parent who heads the household holding down a full-time job. Deann Cook, the executive director of Iowa’s United Way organizations, says candidates need to tell voters how they’ll work to ensure quality child care is affordable and available in Iowa.

“We regard this as keys to families providing economic security for their children and for nurturing children’s development in ways that contribute to their long-term educational success,” Cook says.

This Iowa coalition is part of a national effort to make children’s issues a greater national priority. According to the group’s news release, children make up 24 percent of Iowa’s population and “100 percent of its future.” Find links to the voter’s guides here.

Atlantic woman who faked daughter’s cancer denied bond reduction

A western Iowa woman, accused of faking her daughter’s cancer, has been denied a bond review. Police say 30-year-old Leatha Slauson of Atlantic lied about her 5-year-old daughter having cancer in order to solicit thousands of dollars in donations. Slauson entered a written plea of not guilty today to charges that include child endangerment and first-degree theft.

Slauson’s attorney, Jay Mez of Council Bluffs, proposed Slauson be released from jail and allowed to reside with her mother in Hampton. Cass County District Court Chief Judge Jeffrey Larson said Slauson continues to pose a risk to the community and agreed with Cass County Attorney Dan Feistner that her cash only bond remain at $35,000.

Slauson’s trial is set for November 12. Police say in addition to lying about the cancer, Slauson inserted a feeding tube into her daughter and injected her with cancer drugs she didn’t need.

(Reporting by Mark Saylor, KJAN, Atlantic)

Diseases spread by insects impact Iowans in a ‘notable number’

The Iowa Department of Public Health’s (IDPH) annual report for 2013 shows the number of reported cases of vaccine-preventable diseases decreased when compared to the previous three-year average. The report shows diseases spread by insects continue to impact Iowans — with a “notable number” of these diseases reported to IDPH including: Dengue fever, Lyme disease, malaria, Rocky Mountain spotted fever, and West Nile virus.

IDPH medical director Patricia Quinlisk says two species of mosquitoes that carry the disease are especially active this time of year. “While most people notice mosquitoes in the summer, those are the so-called nuisance mosquitoes, while they bite and give you itchy spots, they don’t carry disease. But this time of year, most of the nuisance mosquitoes are gone, but the mosquitoes that are still around, unfortunately can carry diseases like West Nile,” according to Quinlisk.

She says it’s very important to take measures to prevent being bitten if you are outdoors. “We’ve had 11 cases confirmed, right now wear are still investigating a couple of more,” Quinlisk says. “So far this year we have not had any deaths — but we have had some people hospitalized.”

Deputy State Epidemiologist Ann Garvey says another disease has showed up for the first time in Iowa. “Chikungunya, while the name sounds exotic, it’s been around for a long time. What’s changed is that it’s spread to parts of the world where Americans travel more commonly, so it’s spread to the Caribbean. That just happened last year,” Garvey says.

Chikungunya is spread by mosquitoes in other countries. She says people travel to those locations and get bitten by mosquitoes and then get ill after returning home. There have been some 800 cases in the U.S. this year. Garvey says Chikungunya cases are likely to go up here as Iowans travel to have some fun in the sun.

“Most of our neighboring states have all had imported Chikungunya cases. We had our first case a couple of weeks ago. We expect will more cases as we enter the winter months and we Iowans travel to the warmer locations in the Caribbean,” Garvey says. “We are encouraging the folks that are traveling to make sure they take the same measures they take to avoid West Nile at home, to take those same measures in the locations where they are traveling to.” Those measures include wearing bug repellent and avoiding being outside when the mosquitoes are most active. Garvey says you should also sleep under a mosquitoes net in those countries where Chikungunya is prevalent.

The annual report outlines the summer outbreak of Cyclosporiasis, where 136 Iowans from 35 counties were diagnosed in a multi-state outbreak linked to consumption of a bagged salad mix. Only 10 cases of Cyclospora had been reported in Iowa prior to 2013. Other significant elements of the 2013 report include an increase in enteric or diarrheal diseases, which are typically associated with contaminated food or water. For instance, there were 342 cases of Shigellosis reported to IDPH last year, an increase of 518 percent from 2012, when 91 cases were reported.

Enterovirus not causing any major concerns in Iowa

Deputy State Epidemiologist Ann Garvey.

Deputy State Epidemiologist Ann Garvey.

A state health official says Iowa has not seen any big changes involving the outbreak of a virus that has hit over one dozen states. Deputy State Epidemiologist, Ann Garvey, says the enterovirus is common this time of year, but this particular strain known as D-68 has caused concern in other states.

“Here in Iowa we know that this strain is circulating — we are hearing about respiratory illnesses across the state — but we are not hearing that any of our health care community is overwhelmed with cases, unable to meet patient need,” Garvey explains. “While it’s circulating we’re not seeing the numbers that some of our neighboring states are seeing.”

Enterovirus is not a disease that the state or federal health officials track, so Garvey says they don’t have a concrete set up numbers on the cases. “We’re still getting calls from health care providers, just anecdotally we’re hearing some of the health care providers are seeing the cases slow. But that’s just few of the locations that we’ve spoke to,” Garvey says.

Garvey says the impact of viruses is always hard to determine, and this one is no different. “As far as why we are having less activity, there’s not a way to predict that or tell you why. We’re just not seeing it,” Garvey says.

There is no treatment for enterovirus other than rest. “So we’re just trying to recommend that Iowans take those kind of common sense measures that we use with all respiratory viruses like influenza,” Garvey says. “Wash your hands frequently with soap and water, get plenty of rest, and if we are ill, stay home.”

Garvey says most people who come down with the virus will not have serious symptoms.


Hospitals expect an increase in births

Hospitals around the state are projecting a slight increase in birth rates. Nurse Deborah Tell at Iowa Methodist Medical Center in Des Moines says the economy is finally stable enough for people to have children. “You know I do think it has increased, especially here at our hospital. You know I look at the national statistics that have said the last few years the birth rates went down, but now they are coming back up again,” Tell says.

Tell says the weather in the winter months at the start of the year can sometimes have an impact on the birthrate. “We can look back and see when there was maybe a major storm and schools were closed and businesses were closed — or if it’s extra cold and people don’t go out as much,” according to Tell.

The 8th and 9th months of the year, August and September, are known for having some of the highest birth rates of the year.

IDPH doctor says many factors have made the Ebola outbreak tough to control

Dr. Samir Koirala.

Dr. Samir Koirala.

A doctor who just returned from Sierra Leone says a poor health care system, local customs, rumors and misinformation have all helped fuel the spread of the Ebola virus in West Africa. Dr. Samir Koirala has been working with the Iowa Department of Public Health in a fellowship program and volunteered to leave Iowa to help with the Ebola outbreak.

Koirala says there are only treatment centers in two districts of the country and everyone infected with Ebola is taken to them for treatment, but there are few records kept of the process.

“If the patient is being transferred and if they die on the way to the treatment center, they will be buried in those districts and the family members won’t be informed about it. So there were a lot of people who didn’t hear anything back from the treatment centers, or from the government,” Koirala explains. He says the burial team does not keep any information on the dead person to send to the family.

Dr. Koirala in Sieraa Leone.

Dr. Koirala in Sieraa Leone.

Koirala says the bodies were buried immediately because local custom is to wash a body before burial, but Ebola is spread through physical contact and washing the body would increase the chances of others getting infected. He says without proper records to track Ebola patients, people became afraid to get treated.

“The people know that if they are positive the will be transferred to treatment centers and then (their family) is not going to hear anything back from them,” Koirala says. “So that fear was among them. That was the reason people were not going to health care facilities (for treatment), instead they were hiding in the community and then escaping away from health care providers.”

Koirala’s job was to try and sort out the information on patients and create a database to keep track of those who were infected. He says the doctors are also fighting the stigma associated with the disease. “Once your are tagged with Ebola, then family members and the community are accepting the person,” according to Koirala.”Even if you are diagnosed with Ebola, treated successfully, cured and discharged, then when you come back to your community, your family members and community are not accepting.”

District of Bo where Dr. Koirala worked in Sierra Leone.

District of Bo where Dr. Koirala worked in Sierra Leone.

Koirala says the situation is further complicated by diseases common to the country — such as malaria and typhoid — which have some of the same symptoms as Ebola. He says people become afraid they might have Ebola when they get the symptoms and don’t want to go in to be treated.

Koirala says misinformation on the disease also runs rampant and hampers the treatment. “Initially there were a lot of rumors, they were not taking Ebola as real. But then one of the most popular doctors died of Ebola and that changed everything for them — they thought this is real — this is not just a rumor going around. And they started taking this thing seriously,” Koirala says.

He heard some of the rumors himself. “There was one rumor saying that there was not Ebola, the health care providers were killing people to sell their blood or organs,” Koirala says. Koirala didn’t work directly with patients, so he says he did not fear for his own safety. But, he says he did take precautions to keep from getting infected.

Koirala is originally from Nepal and is in Iowa on a two-year fellowship with the Iowa Department of Public Health. He was in Siere Leone for 25 days.

Sierra Leone photos courtesy of IDPH.