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First Travis County resident dies of typhus
A middle-aged resident of Northeast Austin is the first person in Travis County reported to have died of typhus, a serious disease caused by a biting flea or tick, the Austin/Travis County Health and Human Services Department said today.
The death occurred this month, and the health department’s investigation concluded today, spokeswoman Carole Barasch wrote in an email. The department has no record of any other typhus deaths in Travis County, she said.
The death is one of two murine typhus cases the health department said it investigated this month. Local cases have tended to cluster in central and north central Travis County, but health officials said all residents should take precautions.
Until a few years ago, typhus was rare outside of South Texas, California and Hawaii. It is spread by fleas from rats, opossums, dogs, cats and raccoons. Humans contract it when an infected flea bites and leaves its feces on the bite wound. Symptoms can include high fever, headache, chills, vomiting, nausea, muscle pain and sometimes, a blotchy rash.
Typhus is not spread from person to person, and most people recover after two weeks with antibiotics.
To prevent infection, the health department recommends:
Keeping homes, yards and pets flea-free.
Eliminating outdoor pet food that can attract animals with infected ticks or fleas.
Avoiding places that may be infested with ticks or fleas.
Wearing long sleeves, slacks, socks and shoes and using insect repellant containing DEET.
Report typhus cases to the health department at 972-5555.
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Board withdraws rule to allow chiropractic specialty in acupuncture
Update 3:15 p.m.: Before a standing-room-only crowd of about 70 people, the Texas Board of Chiropractic Examiners unanimously voted to withdraw a proposed rule that would have allowed chiropractors to claim they are specialists in acupuncture with just 300 hours of training.
The board said it would meet with interested parties to work on a compromise, although many opponents who spoke to the board questioned why it wants to persist on the specialty designation.
Many chiropractors use acupuncture in their practices in Texas and are required to have 100 hours of training to be certified. However, they can’t call themselves specialists in that field.
Earlier: After an outcry from acupuncturists, a committee of the Texas Board of Chiropractic Examiners made a peace offering this morning, saying it will recommend that the board withdraw a proposed rule that would have allowed chiropractics to claim they are specialists in acupuncture after just 300 hours of training.
Acupuncturists receive 1,350 hours of training in Texas, much of it in a clinical setting with patients. They reacted vehemently to the proposed rule and some discussed their opposition in an article in today’s Statesman.
The full board meets at 1 p.m. today to consider the committee’s recommendation. A rally of acupuncturists and others is planned for noon today outside of the building where the board meets at 333 Guadalupe, said Wally Doggett, president of the Texas Association of Acupuncture and Oriental Medicine and owner of South Austin Community Acupuncture (in photo at right).
“Anytime you have the comments we had — the passionate comments … we heard it,” said rules committee Chairwoman Janette Kurban, a chiropractor in Arlington.
She said that by withdrawing the rule, the board could meet with acupuncturists and other interested parties to craft a new, improved proposal. “I don’t believe anyone on this board would intend to aggravate the profession of acupuncture,” she said.
“I agree,” said committee member Kenya Woodruff, a Dallas lawyer. “We just want to get it right and make sure the public has access to quality care.”
Kurban congratulated the acupuncturists — two of whom were at the committee meeting — on their zeal for the profession in which thin needles are placed in the skin to relieve pain. Doggett helped organize a petition with more than 2,000 signatures from opponents of the rule.
Kurban did not take public comments but said there would be an opportunity for acupuncturists and their supporters to speak to the full board this afternoon.
“It’s good they dropped that rule,” said Po Chang, an Austin acupuncturist.
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All boomers should get Hepatitis C test, CDC urges
Hepatitis C is so widespread, especially among my generation, that the U.S. Centers for Disease Control and Prevention proposed today that all baby boomers be tested for it.
More than 2 million baby boomers have hep C — the vast majority of the nation’s 3.2 million cases — and another 800,000 boomers are believed to have the disease but not know it. Identifying those people through widespread testing would allow for treatment and possibly prevent liver cancer or the need for a liver transplant, the CDC said in its announcement made on the eve of the first National Hepatitis Testing Day on Saturday.
“With increasingly effective treatments now available, we can prevent tens of thousands of deaths from hepatitis C,” said CDC Director Thomas R. Frieden, a physician.
Hepatitis C is a viral infection that is spread by contact with the blood of an infected person. Sharing needles is a major cause, but there are other causes and risks such as long-term kidney dialysis; regular contact with blood at work, such as working in a hospital; and sharing a toothbrush or razor with an infected person. Having unprotected sexual contact with a person who has hepatitis C is a low risk, but it increases for people who have had many sex partners or already have a sexually transmitted disease, according to the National Center for Biotechnology Information.
This silent epidemic claims about 15,000 lives a year, and deaths have been climbing steadily for more than a decade, the CDC said.
Most boomers,however, don’t think they are at risk for hep C and are not tested. By the time symptoms appear, however, cirrhosis might have already developed, the CDC said.
CDC’s proposed testing recommendation will be available for a public comment period from May 22 to June 8.
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Health board gets first peek at 2013 budget
The board of Central Health, the taxing authority for health services provided to needy Travis County residents, got an early preview of a 2013 draft budget from its staff.
The staff proposes spending $114.9 million in 2013, which is $10.6 million less than the current $125.5 million budget.
It also keeps the property tax rate of 7.89 cents per $100 of assessed value unchanged, although the board could decide to raise or lower the rate before it becomes final in September..
If Central Health sticks with the same tax rate, it would receive about $3.8 million more in property tax revenue than it currently collects, a total of $78.9 million in 2013. The increase is the result of rising assessments and the addition of new property to the rolls.
To bring in the same amount of property tax revenue as this year, the rate would need to drop to 7.67 cents, said John Stephens, Central Health’s chief financial officer, pictured at right.
“My recommendation would be that we leave the tax rate at what it is this year,” Stephens told the board, which asked him to develop more spending projections using his recommended rate.
The budget essentially continues services at similar funding levels to 2012. But Stephens asked the board not to “take the numbers as final because … there will be changes going forward.”
A “structural imbalance” in the budget in which spending exceeds the dollars coming in persists and will require the board to draw from its reserves, like it did this year, Stephens said. But the amount needed from reserves won’t be as much.
That’s because the board’s health plan for Medicaid patients, Sendero Health Plans, won’t need another $12.5 million, the amount the board set aside from its reserves in the current budget for Sendero, which launched March 1.
Stephens said he is hopeful Texas’ participation in the streamlining of Medicaid as part of a federal waiver program will boost Central Health’s bottom line and help alleviate the imbalance in the budget. A complication, however, is Central Health doesn’t know yet how much it might gain under the 1115 waiver, so named because it waives provisions of the federal Social Security law that cover certain Medicaid requirements.
In the coming months, Central Health will continue working on the budget before presenting it to the public for comment and to the Travis County Commissioners Court for final approval.
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UPDATED: H-E-B recalls Asian Ready-to-Eat meals at 40 Texas stores
UPDATED with information about Central Texas stores, below:
After receiving a complaint from a consumer, H-E-B announced this evening it is voluntarily recalling 19 Asian Ready-to-Eat meals at 40 of its stores, including three in Central Texas, because the chicken could be undercooked.
A news release from H-E-B says no confirmed illnesses are related to the recall, although undercooked chicken can be contaminated with salmonella bacteria, which can cause a sometimes severe or even fatal infection.
The meals are sold in the Grab ‘N Go deli sections at H-E-B, including the following stores in Central Texas: the one in Lockhart, one at Parmer and I-35 and the No. 2 store in Pflugerville.
H-E-B sent this list of contaminated products and their UPC codes:
- GENERAL JOES CHICKEN ENTREE 0026966900000
- LEMON CHICKEN ENTREE 0026967000000
- LEMON GRASS CHICKEN ENTREE 0026967100000
- SESAME CHICKEN ENTREE 0026960600000
- SWEET SOUR CHICKEN ENTREE 0026967200000
- HE BOWL GENERAL JOES CHICKEN 0026967400000
- HE BOWL LEMON CHICKEN 0026967500000
- HE BOWL LEMON GRASS CHICKEN 0026967600000
- HE BOWL SESAME CHICKEN 0026967700000
- HE BOWL SWEET SOUR CHICKEN 0026967800000
- GENERAL JOES CHICKEN - HEX 0026520900000
- SESAME CHICKEN-RETAIL PACK 0026521900000
- LEMON CHICKEN- RETAIL PACK 0026521700000
- LEMON GRASS CHICKEN-RETAIL PAC 0026521800000
- GENERAL JOES CHICKEN - FS COLD 0026703700000
- SESAME CHICKEN 0026704500000
- SWEET AND SOUR CHICKEN 0026705000000
- LEMON CHICKEN 0026705100000
- LEMON GRASS CHICKEN 0026705200000
The recall was done “in an abundance of caution,” H-E-B officials said.
Any product sold before Thursday is affected and should be returned to any H-E-B store for a full refund. For information, call 800-432-3113 between 8 a.m. and 5 p.m., Monday through Friday.
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Texas adds newborn test for immune disease
Texas will begin testing newborns for severe combined immunodeficiency, or SCID, in September.
The test will use the same blood samples collected at birth to check for 28 other disorders, the Texas Department of State Health Services said today.
SCID is a group of genetic disorders that causes profound defects of the immune system, which protects the body from infections, and occurs in about 1-in-40,000 to 1-in-100,000 newborns. If untreated, most affected children die within a year, the health agency said.
“While SCID is an extremely serious condition, it can be treated successfully if it is detected early,” agency Commissioner Dr. David Lakey said. “Adding this screening will help give Texas babies with SCID the opportunity to live normal, healthy lives.”
The blood tested by the state lab is drawn from the heel at birth and one to two weeks later.
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Medicare offers new comparisons on home health agencies
Need a home health agency to take care of a loved one but don’t know where to turn?
The Centers for Medicare and Medicaid Services offers consumers a website that might be helpful in choosing an agency. It takes patience to use the site, and it’s a bit clunky, but once you get the hang of it, you can compare agencies to one another and to state and national benchmarks.
Called Home Health Compare, the site recently added patient satisfaction survey results to the quality of care indicators. Home Health Compare is similar to Medicare’s comparison sites for nursing homes, hospitals and dialysis facilities. Like the others, consumers can check up to three companies at a time and see the state and national comparisons on the same page.
On patient satisfaction, survey results of home health agencies give percentages of patients who would recommend the agency, who said the staff communicated well with them and who found the care to be professional, among other measures.
The quality of care measures report the percentage of patients who improved at managing their daily activities and had their pain well managed, among other things. It also rates how good a job the staff does at preventing bed sores and falls and seeing that medicine is taken safely. One category rates the agency’s ability to keep patients well so they don’t make unplanned trips to the hospital.
I put Austin in the search box and got 86 home health agencies, some of which were in San Antonio, Houston and other cities. I thought that was odd. Next, I tried the 78704 Zip code and while that search narrowed the number to 46, the list still included of out-of-town agencies. Hmm.
You’ll need that dose of patience.
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UPDATED: Health plan for small Central Texas businesses faces cash crunch
UPDATED: Comments from Texas Department of Insurance included, as well as new comments from Jim Rodriguez
A low-cost health plan for small-business workers, TexHealth Central Texas, is seeking to avert cash flow problems because of a months-long delay in receiving payments from the state: $381,000, to be precise, officials said.
The Central Health board Wednesday night agreed to provide TexHealth the money, if it’s needed, to pay claims. TexHealth still expects to receive money from the state and pay back Central Health if it uses the money, said Jim Rodriguez, president and CEO of TexHealth. But future funding from the Texas Department of Insurance is uncertain, said Christie Garbe, a spokeswoman for Central Health.
Department of Insurance spokesman John Greeley said the Legislature appropriated $422,000 per year to TexHealth and three similar health plans. Lawmakers also said the four health plans could split a second pool of money: fines and penalties assessed to health insurers by the department up to $1.5 million per year. The problem is: No fines or penalties have been assessed so far this year, resulting in a payment shortfall, Greeley said.
Rodriguez said that he was confident the money was there and that a solution has been worked out. The health plan is “on solid footing,” he said, adding that the payment delay “is not their fault. It’s an administrative thing.”
The Department of Insurance has made all payments to date on “qualified invoices” for which it has funds, a total of $185,440 split among the four plans, Greeley said.
“The remaining $305,404 will be paid on a monthly basis, according to the availability of funds appropriated by the Legislature and TexHealth Coalition reported expenditures from previous months,” an email from Greeley said.
He also said he could not comment on future funding for the program because it depended on what the Legislature does.
TexHealth, created in 2009 with help from Central Health, hasn’t submitted invoices going back to the start of the budget year, September 2011, because it was waiting for the Department of Insurance to resolve the funding question, Rodriguez said. TexHealth now plans to submit those, he said.
The plan serves 990 adults who work for businesses in Central Texas that have between two and 50 employees, Rodriguez said. About 78 percent of the employees are eligible for a subsidy because they make less than $33,510 a year, said Patricia Young Brown, president and CEO of Central Health. Although covering an individual would normally cost $269 a month, some employees pay as little as $9.50 a month with the subsidy, Young Brown said.
TexHealth is the largest of the four “three-share plans” in Texas. They are called three-share because the employer contributes to the coverage premium, along with the employee and public sources that help with the subsidy. That’s why the state aid is so important.
Central Health provided $900,000 in startup money to TexHealth. Startup money also was contributed by other government entities, including Hays and Burnet counties. The Texas Health and Human Services Commission still pays the plan between $200,000 and $300,000 a month, said commission spokeswoman Stephanie Goodman.
The commission payments, which are on time, vary based on how many people are enrolled in the plan, she said. About 250 business are enrolled, but that number has fluctuated widely as companies drop in and out. Some federal money was used in the program, too, but it is being phased out, Young Brown said.
“Even with a very affordable plan like this, it is still a struggle” for many smaller businesses, she said.
After more than an hour in closed session to discuss the issue with its attorney, the Central Health board agreed to help out, with several members saying TexHealth has been a good program.
“This program has been, I think, very successful, and it’s done a lot of good for individuals and businesses who could not otherwise afford it,” said Dr. Tom Coopwood, a member of the Central Health board. “Unfortunately, state and federal funds have dried up.”
Coopwood and other board members said other funding sources need to be considered to help with subsidies.
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Texas Medical Board poised to act on proposed stem cell rule
After more than a year of work, the Texas Medical Board plans to act Friday morning on a proposed rule governing stem cell treatments in Texas.
The board has received a variety of comments on the rule and expects to hear additional testimony tomorrow before it either approves or pulls down the proposed rule, spokeswoman Leigh Hopper said.
The rule would require doctors to get informed consent from patients before using adult stem cells, as well as approval from an institutional review board, which seek to protect patients in research studies and are overseen by the U.S. Food and Drug Administration.
The agenda for the open, public meeting indicates that action on stem cells, called “investigational agents,” and other rules will start at 10:30 a.m. in the Hobby Building, 333 Guadalupe St., Tower 2.
A University of Minnesota professor who in February complained to the FDA about CellTex Therapeutics Corp., the company that stored adult stem cells for a back pain treatment on Gov. Rick Perry last year, is concerned about the rule.
“Approval of these guidelines in their current form risks compromising the safety of patients and research subjects in Texas,” Leigh Turner, an associate professor in the school’s Center for Bioethics & School of Public Health, wrote to the board Sunday.
Turner, at right, contends the rule does not adequately define stem cells or protect the public financially. The proposed rule, 198.3, “fails to provide clear guidance concerning regulation of adult stem cells at a time when numerous businesses in Texas are marketing stem cells,” he wrote.
The guidelines should clearly say that research subjects should not pay for participating in clinical studies, he wrote. They also should say that the use of adult stem stem cells “cannot be reviewed and approved by private, for-profit Institutional Review Boards.”
He is concerned, he wrote in an email to me this week, that Texas “could become a state that attracts companies and clinicians offering stem cell interventions that are expensive, clinically unproven, and possibly dangerous.” He also thinks Texas could be trying to avoid federal rules by adopting its own.
“It looks as thought Texas is trying to make this a state’s rights issue,” he said in an interview with me earlier this week.
Medical board Chairman Dr. Irvin Zeitler said in a statement that “the Board has absolutely no intent to circumvent federal law. The board simply wants to ensure that the use of an investigational agent is safe for the patient. The rules are written with the understanding that they may become moot under new federal regulation. But for now, the rules provide a framework for protecting the patients of Texas.”
MedRebels Foundation, an Austin-based group funded mainly by a company that develops stem cell therapies, hopes the board will make the rule less stringent. It plans to deliver a petition to the medical board that had more than 2,500 signatures as of last week, its spokesmen said. The Statesman ran a story about the petition drive last week.
MedRebels is asking the board not to put any additional restrictions on adult stem cells that are obtained from a patient’s own body, provided they are used in the same medical procedure and not extensively processed or grown outside the body, frozen or stored.
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Seton medical cards with personal data go astray
A company working with the Seton Healthcare Family mistakenly mailed to the wrong addresses about 555 Seton Health Plan member cards that included names and birth dates, Seton said today.
The March 9 mailing by HealthLOGIX of Troy, Mich., came to Seton’s attention a week later when members of the Medicaid health plan called about receiving the wrong cards.
“We’re terribly sorry to inconvenience our members,” Seton spokeswoman Adrienne Lallo said.
The plan has 7,561 enrollees, and the wrongly mailed cards were sent out in one batch after a computer error, she said.
The Seton Health Plan and HealthLOGIX are offering a year of identity theft protection to all affected health plan enrollees through another company, CSID, Lallo said. She estimated the cost of the protection at $30,000.
Seton Health Plan members enrolled in the STAR/Medicaid plan can call toll-free at 877-451-5601, weekdays from 8 a.m. to 5 p.m., if they have questions.
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Groups warn of common medical tests you should resist
Doctors take an oath to “do no harm.” But unnecessary medical tests and treatments can be harmful — and not just to your wallet.
Unnecessary tests can lead to finding some tumors and other “abnormalities” that would not pose problems if left alone. Treatment can bring on side effects, exposure to radiation, surgeries, emotional distress and even more serious problems.
In case you missed it, an important story came out this week on this issue. The American Board of Internal Medicine Foundation, along with nine doctors’ groups, warned consumers to be aware of 45 commonly done medical tests that doctors should order less and consumers should question more.
The Statesman carried a blurb about the warnings; other news organizations, including The New York Times, ran more extensive pieces.
The recommendations — the top five from each group — are incredibly helpful, and if more people followed them, they could make a dent in reducing unnecessary treatments and reining in health care costs. Those are two huge deals.
Here are some highlights:
The American Academy of Family Physicians says you should not get an MRI for back pain in the first six weeks, unless there are red flags, such as “severe or progressive neurological deficits or when serious underlying conditions” exist. The academy also said doctors should not order ECGs or other cardiac screening for low-risk patients without symptoms, nor should Pap smears be done on women under 21 or women who have had a hysterectomy for reasons other than cancer.
The American College of Cardiology advises against stenting in various circumstances and heart imaging in patients without symptoms or high-risk indicators. It also advises against cardiac imaging in patients undergoing a low-risk noncardiac surgery.
The American Academy of Allergy, Asthma & Immunology says you should not need a CT scan or antibiotics for an uncomplicated sinus infection. Patients also should insist on a spirometry test to confirm asthma before letting your doctor manage suspected asthma.
The American College of Radiology recommends against imaging for uncomplicated headaches as well as routine chest X-rays before admitting most patients.
The American Society of Clinical Oncology recommends against PET, CT, and radionuclide bone scans when staging early prostate cancer or breast cancer.
The American Gastroenterological Association says most patients who have a colonoscopy that shows no problems do not need any kind of colorectal screening for 10 years.
The American Society of Nephrology recommends against routine cancer screening of dialysis patients with limited life expectancy and against use of nonsteroidal anti-inflammatory drugs in people who have hypertension, heart failure or chronic kidney disease, regardless of the cause, including diabetes.
This fall, eight new medical groups will join the campaign, which also includes Consumers Union.
Meanwhile, have fun probing your doctor.
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3 Texans sick from rare salmonella straing among 93 nationwide, state says
A salmonella outbreak that has sickened 93 people in 19 states, including the District of Columbia, has affected three so far in Texas, according to Chris Van Deusen, spokesman for the Texas Department of State Health Services.
Van Deusen said he could not provide any information Wednesday about where in Texas the people fell ill.
Although some news outlets have fingered sushi as the contaminated food, the U.S. Centers for Disease Control and Prevention said it on its website Wednesday that it had not confirmed the food source for the unusual Salmonella Bareilly infections. People who have fallen ill so far were infected between Jan. 28 and March 23, the CDC said. New York had the most cases, at 23, the CDC reported.
Permalink | | Categories: Food safety
Latest comments
My wife got typhus last year from a dead possum in the back yard. She wasen’t feeling well for a couple of days but when her temperature spiked to 104 one afternoon I rushed her to the hospital. She was in the hospital for a week and it took another
... read the full comment by Virgil | Comment on First Travis County resident dies of typhus Read First Travis County resident dies of typhus
Chiropractors need to adhere to their scope of practice.
VERTEBRAL SUBLUXATION CORRECTION. NOTHING MORE. NOTHING LESS. NOTHING ELSE.
I did not make that up. Got that language from a letter sent out by the International Federation of
... read the full comment by Rama Chittajallu M.S.O.T.R., L.Ac. | Comment on Board withdraws rule to allow chiropractic specialty in acupuncture Read Board withdraws rule to allow chiropractic specialty in acupuncture
Two friends of mine in Austin are just recovering from typhus and were recently hospitalized for several days. There is more of it around than you might suspect. It is a very dangerous illness and it will make you sick for a long time.
... read the full comment by darlavogt | Comment on First Travis County resident dies of typhus Read First Travis County resident dies of typhus
I would just like to point out that acupuncture is used for better overall health and maintenance, it can be used for various health issues such as digestion issues, stroke recovery, allergies, migraines, recovery from surgery, stress. depression, as
... read the full comment by Ruby Comstock, LAc | Comment on Board withdraws rule to allow chiropractic specialty in acupuncture Read Board withdraws rule to allow chiropractic specialty in acupuncture
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