OLYMPIA

“Tracking dead birds and West Nile virus gives people information they need to avoid getting sick,” said Maryanne Guichard, assistant secretary of Environmental Public Health. “Avoiding mosquito bites is the key to preventing West Nile virus. Nationally, last year saw the most reported West Nile virus illnesses since 2003, and it has made a few state residents sick in recent years, but it’s unpredictable. We don’t know how many people may be affected this year.”

The Centers for Disease Control and Prevention has just reported final data for the 2012 season, with 5,674 cases of West Nile virus disease in people in 48 states (excluding Alaska and Hawaii). That total includes 286 deaths.

Last year in Washington, two people acquired West Nile virus in-state and two more were likely exposed while traveling outside the state; none died.

West Nile virus can cause illness in people, birds, horses, and other mammals if bitten by an infected mosquito. Dead bird monitoring can help provide information on areas where the virus may be active.Washington residents may report dead birds online now through October. Crows, ravens, jays, magpies, and hawks are particularly important to report because they often die from West Nile virus infection.

Most people bitten by an infected mosquito carrying West Nile virus won’t get sick. Some may develop mild symptoms such as fever or headache that go away without treatment.

People with weak immune systems and those over 50 years old are more likely to develop serious illness, which may include meningitis or encephalitis. Some neurological effects can be permanent. West Nile virus disease can be fatal.

Small changes to the way we do things helps defend against West Nile virus. Staying indoors during dawn and dusk when mosquitoes are most active can help you avoid mosquito bites. Wearing long sleeves and long pants outdoors during these times is also good protection.

Make sure window and door screens are “bug tight,” or replace them — especially torn screens. Use an effective mosquito repellent on exposed skin to keep mosquitoes away. When using repellent on children, read the label and follow the instructions carefully.

Removing items around your home that can become mosquito habitat can help you avoid mosquito bites. Mosquitoes only need a small amount of water for breeding. Emptying stagnant water in flower pots, old tires, buckets, and other water-collecting items, can make it harder for mosquito larvae to grow into biting adults. Change water in birdbaths, animal troughs, and wading pools twice a week.

The online reporting system is active now. People without online access can contact their local health agency to report dead birds. Regular updates are available on the agency’s West Nile virus information line, 1-866-78-VIRUS (1-866-788-4787) and the West Nile virus website.

Somewhere between 13 and 20 percent of kids in the United States experience some sort of mental illness, according to a new report from the Centers for Disease Control and Prevention.

That adds up to millions of children suffering from disorders like ADHD, depression, autism and illicit drug use.

The total annual cost of the illnesses?

About $247 billion a year.

The CDC put together this handy infographic to chart the prevalence of various illnesses. ADHD is the most common diagnosis, followed by behavioral and conduct problems.

The study, published as part of the CDC’s weekly journal MMWR, is the first time that federal researchers have sought to compile estimates of how many children have specific mental disorders and describe federal efforts for monitoring the issue.

The prevalence of mental disorders in kids seems to have increased over the past 15 years as well (though the growth could reflect better monitoring and awareness, rather than more kids actually being sick).

And they seem to be sicker: inpatient hospital admissions for mental health and substance abuse issues increased by nearly a quarter from 2007-2010.

Suicide was the second leading cause of death for kids aged 12-17.

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

Washington state is in the vanguard nationally in building our state’s healthcare exchange. But costs are significant, time is short and many questions remain:

• What choices will local businesses face with the implementation of health care reform?

• What can we learn from Massachusetts’ reform efforts in 2006?

• How can the business community deal with health care reform proactively and provide transparency to employees?

Join us as we bring together business leaders and policy experts from Washington and Massachusetts to learn what’s happening on the ground in our state and how the Massachusetts experience can inform implementation of the Affordable Care Act in Puget Sound.

2013 Series Moderator:

Jean Enersen, KING 5

Panelists:

• Bill Baldwin, Board member, Washington Health Benefit Exchange, Partner, The Partners Group

• Maud Daudon, President & CEO,  Seattle Metropolitan Chamber of Commerce

• Phil Edmundson, Chairman and CEO, William Gallagher Associates, Founding Chairman, Affordable Care Today Coalition (Massachusetts)

• Jody Hall, Owner, Cupcake Royale, Leader, Main Street Alliance of Washington

Where:

Location: The Westin Hotel | 1900 Fifth Avenue, Seattle

When:

Doors Open: 11:30 a.m.

Luncheon & Program: Noon – 1:30 p.m.

Price:

Luncheon Prices:

CityClub Members – $40 | Guests & Co-Promoters – $45 | General Public – $50

Coffee & Dessert Only Prices:

CityClub Members – $12 | Guests & Co-Promoters – $15 | General Public – $18

To register go to here or call 206.682.7395

Hepatitis B is common in many parts of the world, with an estimated 350 million people living with the disease worldwide. In the US, an estimated 1.2 million Americans are infected.

However, hepatitis B disproportionately affects Asian Americans and Pacific Islanders because it is especially common in many Asian and Pacific Island countries.

While AAPIs make up less than 5% of the total U.S. population, they account for more than 50% of Americans living with chronic hepatitis B.

Hepatitis B is serious

People can live with hepatitis B without having any symptoms or feeling sick. Many people with chronic hepatitis B got infected as infants or young children. It is usually spread when someone comes into contact with blood from someone who has the virus.

As many as 2 in 3 AAPIs living with the virus do not know they are infected. Often, people do not know they have hepatitis B until they have been tested.

Who should get tested for Hepatitis B?

• Anyone born in Asia or the Pacific Islands (except New Zealand and Australia)
• Anyone born in the United States, who was not vaccinated at birth, and has at least one parent born in East or Southeast Asia (except Japan) or the Pacific Islands (except New Zealand and Australia)

Hepatitis B testing identifies people living with chronic hepatitis B so they can get medical care to help prevent serious liver damage. Testing also helps to find other people who may not have hepatitis B, but are at risk for getting infected. This can include people living with someone with hepatitis B.

For more information, talk to a doctor about getting tested for Hepatitis B.

More Information

• Hepatitis B and Asian American/Pacific Islanders
• Hepatitis Risk Assessment
• Hepatitis B General Information
• CDC’s Viral Hepatitis Website
• CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention

By Michael Ollove
Stateline Staff Write

TULSA, Okla. – University of Tulsa law professor Marguerite Chapman has been studying end-of-life issues in Oklahoma for three decades and has come to a conclusion: “It’s getting almost to the point that you need a government permit in order to die in this state.”

Certainly, dying has gotten a lot more complicated here, the result of a unique measure passed by the Oklahoma legislature and signed into law last month by Republican Gov. Mary Fallin.

Modeled after legislation written by the National Right to Life Committee, the law says that patients who are disabled, elderly or terminally ill cannot be denied life-preserving treatments if they or their health proxies want it.

The law also prohibits health care providers from making medical decisions based on the assumption that “extending the life of an elderly, disabled, or terminally ill individual (is) of lower value than extending the life of an individual who is younger, nondisabled, or not terminally ill.”

Idaho is the only state with a similar law, but with a crucial distinction. It says the wishes of the patient or proxy must be followed “unless such care would be futile.” The Oklahoma law contains no such qualifier.

Critics counter that it will inhibit doctors from discussing the full range of options to patients near the end of life, raising the likelihood that they will undergo invasive, costly and often futile medical interventions with the pain and risks those procedures entail.

At the other end of the spectrum from Oklahoma, the Vermont legislature this month passed a bill legalizing physician-assisted suicide. Oregon and Washington have similar laws, the result of ballot initiatives approved by voters.

Philosophical Divide

Although the Oklahoma law received little attention at home and has gone virtually unnoticed elsewhere, it revisits a philosophical divide that has periodically gripped the nation.

On the one side is the palliative and hospice care movement which holds that terminally ill patients should be able to forgo high-risk, low-odds treatments in favor of comfort care at the end of life. On the other side is a branch of the right-to-life movement which believes that doctors are inclined to withhold life-preserving treatments when, in their opinion, a patient’s life has lost its “value.”

Spearheading the effort to pass the law was Tony Lauinger, the courtly, frosty-haired chairman of Oklahomans for Life, who is regarded by even his political opponents as being the consummate gentleman with considerable influence in the Oklahoma legislature.

In an interview, Lauinger expressed deep suspicions about physicians, even though he is married to one, the father of another, and the father-in-law of a third. “In many states,” the one-time seminarian said, “this phenomenon has become more prevalent, with people saying they want life-preserving care being overridden by providers who, I guess, feel they know best.”

Lauinger didn’t mention any actual cases in Oklahoma where a doctor had refused life-preserving treatment despite the protestations of the patient or family members. The bill’s chief sponsor in the House, Rep. Dennis Johnson, a Republican, talked about an Oklahoma doctor wanting to take an elderly patient off a ventilator despite his wife’s protests.

Despite sharply divided opinions during the bill’s debate, the measure passed easily, 41-2 in the Senate and 85-11 in the House.

“We are starting to see a trend nationwide,” Johnson said. He said that the law’s origins go back to the case of Terri Schiavo, the Florida woman in a vegetative state whose husband and parents battled in court for seven years over his desire to remove her feeding tube.

The husband prevailed and the feeding tube was removed in March 2005 to the consternation of activists in the pro-life and disability movements. Schiavo died within days.

Is Law Pro-Life?

Despite Lauinger’s involvement, some who identify themselves as anti-abortion say they are unhappy with the law that they regard as contrary to compassionate medical treatment at the end of life.

“Endorsing futile care in the name of being pro-life is to me the antithesis of pro-life,” said Donna Spivey, a medical social worker with the palliative care team at Hillcrest Medical Center in Tulsa who considers herself resolutely anti-abortion. “This law is not going to benefit them; it will cause harm to them.”

While the Oklahoma State Medical Association remained neutral on the final bill, Jennifer Clark, palliative care director at the University of Oklahoma’s School of Community Medicine here, emerged as the leading medical opponent of the legislation.

The law, she said, is based on a faulty premise about a doctor’s role at the end of life. “Palliative care medicine elicits a person’s goals and value systems and works with that patient and the patient’s providers to determine what the best options are to meet those goals and values in the context of the medical situation,” Clark said.

Her concern, she said, is that the law will force doctors to perform surgeries with extremely low chances of success but high risk for death or further harm to patients already in fragile condition.

“There are situations where we cannot take that person to surgery because we think it’s certain death, but under this law, we’d have no choice,” Clark said. “It asks us to violate our primary oath which is first to do no harm.”

Inhibiting Doctors

Palliative care experts fear the new law will prevent doctors from having honest and candid conversations with patients at the end of life to make the medical condition completely clear and the various options and the ramifications of each.

Elise Dunitz Brennan, a prominent health care attorney in Tulsa, said she fears doctors will now refuse to inform patients or their proxies of the true risks of some of those procedures for fear of being seen as violating the law.

“If you try to educate a health proxy about the alternatives, when does it become going against the proxy’s wishes versus trying to provide education?” Brennan said. “This law totally interferes with the collaborative decision-making process.” She said she now would advise her physician clients not to raise objections to risky surgeries if that’s what a patient or proxy wants.

At the urging of the state’s medical association, the bill’s sponsors agreed to an amendment that says that injunctions granted against doctors for violations under the act cannot be construed as an automatic finding of negligence against that doctor. Brennan said, however, that the provision won’t protect doctors from negligence lawsuits from family members.

Will Doctors Leave?

Although supporters of the bill said the law will not interfere with advance directives in which patients specify what treatments they want or don’t want in dire medical circumstances, Brennan said she doesn’t believe those documents will guarantee that proxies won’t use the new law to override the patient’s wishes if the patient can’t communicate.

In her argument against the law, Clark of the University of Oklahoma said that she fears it will prompt doctors to leave the state, which already ranks among the 10 states with the lowest number of doctors per resident.

Frank Gaffney, a Tulsa cardiologist, said he is thinking of leaving because of the law. The previous week he had had a very sick patient with a poor chance of survival. He told the patient’s family that the man had a very slim chance of surviving an invasive cardiac procedure that Gaffney believed offered the merest chance of saving his life and a high risk of ending it.

The family insisted on the surgery. “If you’re not allowed to say this might be futile, you put a physician in the position of murdering someone,” Gaffney said. He performed the surgery; the patient died.

Stateline is a nonpartisan, nonprofit news service of the Pew Center on the States that provides daily reporting and analysis on trends in state policy.