Cherokee Nation citizen Stacie Guthrie receives a flu shot from licensed practical nurse Sharon Morton at the Gadugi Health Clinic in Tahlequah, Okla. JAMI CUSTER/CHEROKE PHOENIX

Influenza hits CN but vaccines still available

Nationwide, during the week that ended on Jan. 12, 4.6 percent of patient visits reported to the U.S. Outpatient Influenza-like Illness Surveillance Network were due to influenza-like illness. This percentage is above the national baseline of 2.2 percent. CENTERS FOR DISEASE CONTROL By Jan. 12, the Centers for Disease Control reported that the flu had reached 48 states and influenza activity remained elevated in the United States. CENTERS FOR DISEASE CONTROL To help fight against influenza and inform people about the virus, Dr. Jorge Mera, of Cherokee Nation Health Services, provides a presentation on Jan. 18 in Tahlequah, Okla. TESINA JACKSON/CHEROKEE PHOENIX
Nationwide, during the week that ended on Jan. 12, 4.6 percent of patient visits reported to the U.S. Outpatient Influenza-like Illness Surveillance Network were due to influenza-like illness. This percentage is above the national baseline of 2.2 percent. CENTERS FOR DISEASE CONTROL
02/01/2013 08:01 AM
TAHLEQUAH, Okla. – With more than 230 people testing positive for influenza within the Cherokee Nation, officials say tribal health clinics have vaccines available and urge people to get one.

Flu is a contagious respiratory illness caused by viruses. It causes mild to severe illness, and at times, leads to death. Some people, such as older people, young children and people with certain health conditions, are higher risks for flu complications.

“The flu is a virus and viruses are very, very smart you might say,” Dr. Roger Montgomery, CN medical director, said. “They change themselves every year and try to morph themselves so they can have a better success of causing illness. And there are also different strains out there, and so the CDC tries to come up with an idea of what strains of virus will cause illness each year and the vaccine has three different kinds of strains of virus in it.”

According to the Centers for Disease Control, this flu season has produced a high outbreak with more than 3,600 people hospitalized since October, most of them older than 65, and at least 20 children’s deaths.

By Jan. 12, the CDC reported the flu had reached 48 states and activity remained elevated. On average, 5 percent to 20 percent of the population gets influenza. This season, it’s hit more than 30 percent.

According to the Oklahoma State Department of Health, flu season began on Sept. 30. Since then there have been more than 500 related hospitalizations and eight related deaths in the state.

There are three types of flu viruses: A, B and C. Types A and B cause the epidemics that have up to 20 percent of the population sniffling, aching, coughing and running fevers. Type C also causes flu, but its symptoms are less severe.

The Type A virus constantly changes and is spread by infected people. Type B flu may cause a less severe reaction, but occasionally it can still be harmful. Type C viruses are milder than type A and B. People generally do not become extremely ill from them and they do not cause epidemics.

The flu usually starts suddenly and may include fever or feeling feverish/chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, fatigue and tiredness. Some people have vomiting and diarrhea, though it’s more common in children.

Some complications caused by flu are pneumonia, dehydration and worsening of chronic medical conditions such as heart or lung disease, asthma or diabetes. Children may get sinus problems or ear infections.

“The deaths that you see reported are not really from the virus itself. They’re from the super-imposed illness that occurs after they’ve had influenza that causes them to develop respiratory failure and pneumonia,” Montgomery said.

The flu spreads by droplets released by coughing and sneezing. Occasionally touching something with a virus on it and then touching the mouth or nose may cause infection. People with the flu can spread it to others up to about six feet away.

“That’s why we emphasize if you’re out there going to work, going to public places, touching objects that other people touch don’t take your hand and rub your nose without first washing your hands thoroughly and wash them frequently,” Montgomery said.

People with flu are contagious and can infect others beginning one day before getting symptoms. Adults remain contagious up to seven days after getting sick, and children can remain contagious even longer.

“If you came in contact with the person who had the flu, you’ve contracted the virus,” Dr. Sohail Khan, of CN Health Services, said. “Within two days you will start to develop symptoms, and the important thing to remember is that you can be infectious for the next five to seven days.”

The best way to prevent the flu is vaccination. The vaccination rate for the American Indian/Alaskan Native population is 29 percent, according to Indian Health Services.

“I think as a group, because the prevalent of diabetes is so great, that it’s just recommended broadly that all Native Americans be vaccinated,” Montgomery said.

According to WebMD, the vaccine is highly effective for preventing the flu, though not 100 percent. People can get the flu despite getting vaccinated, although it’s usually less severe and resolves quicker. According to the CDC, vaccines given this year appear to be about 62 percent effective overall. Of people who got the flu, 32 percent were vaccinated.

“It can either completely eliminate you from having any symptoms at all or it can, the word we use is, attenuate,” Montgomery said. “It can lessen the severity of the duration of symptoms that you have.”

There are two types of vaccines: the shot and nasal spray. The shot is contains a dead virus that’s given with a needle. The shot given in the muscle is for people older than 6 months, including healthy people and people with chronic medical conditions. The shot given below the skin is for 18- to 64-year-olds.

The nasal spray vaccine contains live, weakened viruses. It’s for healthy people ages 2 to 49 who are not pregnant. Neither vaccine causes the flu.

It takes about two weeks for antibodies to develop that protect against infection for the entire year. Flu vaccines will not protect against illnesses caused by other viruses such as the common cold.

If positive for flu, there are antiviral drugs that can be used to treat the illness.

“The main one that most people have heard about is called Tamiflu,” Montgomery said. “It’s most effective if you start it within 48 hours of the onset of your symptoms.”

Annual vaccination is recommended for everyone regardless of past vaccination status or flu infection. Vaccination should begin in September or as soon as the vaccine is available and continue throughout the flu season, which can last as late as May.

To view a CN Health Services flu presentation, visit
and click on influenza presentation.

918-453-5000, ext. 6139


Special Correspondent
05/27/2016 09:00 AM
TAHLEQUAH, Okla. – With international health officials sounding the alarm, Cherokee Nation Public Health officials are preparing for the Zika virus. Earlier this year, the CN was one of three tribes to participate in the Centers for Disease Control’s Zika summit in Atlanta. Lisa Pivec, Public Health senior director, said while the CN’s jurisdiction is considered to be a low risk for an outbreak, plans and partnerships with the Oklahoma Department of Health and the CDC are in place as a proactive measure. “The most important thing for us right now is getting a process in place,” she said. “The CDC has been great about helping us with that. We’ve seen what they’ve done with other infectious diseases, and they’re great about helping us get that done at the local level.” For now that process involves keeping current information available to the public through and maintaining regular contact among epidemiologists, communications professionals and environmental health specialists with all three entities. As part of that partnership, any testing for the virus conducted at the tribe’s facilities is at no cost to the CN. Samples taken for testing are sent to the state health department’s offices in Oklahoma City and to the CDC in Atlanta where the actual test will be conducted. So far, no tests have been submitted from a CN health facility, but Dr. David Gahn, Public Health medical director, said the tribe would be immediately notified if that changes. According to the Oklahoma Department of Health, as of May 5, four cases of Zika had been reported statewide. All four were caused by travel to one of the more than 40 countries with a reported case of the virus. The most common symptoms are fever, rash, joint pain, muscle pain, headaches and conjunctivitis. However, with the incubation period estimated at up to seven days, only 20 percent to 25 percent of those infected with the virus show any symptoms. No vaccine is available. The people highest at risk of contracting the virus are men and women who have traveled to one of the countries or U.S. territories on the CDC’s advisory list. Pregnant women are considered particularly vulnerable due to the virus’ link to birth defects, including microcephaly, stunted fetal growth, vision problems and hearing problems. “Most people who get Zika don’t really get ill,” Gahn said. “Among those who do, it’s very rare for even children to need hospitalization.” The virus is also linked to an increased risk for Guillian-Barre syndrome, a disorder in which the body’s immune system attacks part of the peripheral nervous system. However, the CDC and other epidemiologists have not determined what causes the connection or which populations are more likely to be at risk of developing Guillian-Barre as a side effect of the Zika virus. “We don’t know what’s the risk yet, as in how many people who are infected with Zika will get and which ones,” Gahn said. “We just don’t know the risk factors yet. Does it go after older people? Men? Women? Teenagers?” Although the virus can also be spread through unprotected sexual contact with an infected man, many of the preventative measures being touted to the public are aimed at its other means of transmission: mosquitoes. As a mosquito-borne virus, many measures used to curb the spread of the West Nile virus are equally effective against Zika. Along with the use of an EPA-registered insect repellant, wear long-sleeved shirts and long pants whenever possible and citizens are encouraged to not leave doors and windows propped open unless covered with a properly maintained screen. Additionally, mosquitoes can be kept at bay by not leaving standing water around the home. Birdbaths, rainwater collectors, kiddie pools, trash cans and other containers that could potentially hold water should be emptied out at least weekly, as mosquitoes lay eggs in standing water. Cracks or gaps in septic tanks should be patched and any exposed vents or plumbing pipes should be covered. More preventative measures are available at <a href="" target="_blank"></a>. The two main species of mosquito that carry Zika, Aedes aegypti and Aedes albopictus, are generally not found in Oklahoma. However, that has not deterred officials with tribe’s health department from encouraging CN citizens from taking a proactive approach to prevent Oklahoma’s first mosquito-borne case from arising in the jurisdiction. “For us, it’s about putting together the best plans we can based on risk levels and being as responsive as possible without creating worry or concerns that are not warranted,” Pivec said. “We know that we’re prepared if the situation changes.”
Senior Reporter – @cp_jmurphy
05/23/2016 04:00 PM
TAHLEQUAH, Okla. – At the May 16 Health Committee meeting, Tribal Councilors questioned Health Services Director Connie Davis and Brett Hayes, who oversees the tribe’s contract health department, about contract health referral reductions for the rest of the fiscal year and the department’s shortfalls. According to an emailed letter from Health Services Executive Medical Director Dr. Roger Montgomery to Davis, who then forwarded it to Tribal Councilors, each year the tribe overspends its contract health budget and he recommends “people cut back on the referrals they write.” “People don’t really cut back all that much and administration makes up the difference with collections from the clinics, etc., so we don’t end up having to push the issue,” Montgomery states. “This year, with the implementation of a new electronic health record leading to reduced clinic schedules, and the addition of approximately 10,000 patient visits this year, there are no additional collections to pad Contract Health’s overruns.” Montgomery states that in the first seven months of FY 2016 the tribe spent $25 million of its $35 million contract health budget. “That leaves $10 million available for the last five months of the fiscal year and no expected increased collections to cover the remainder. If payments for transfers out continue at the same pace of about $200,000 per month, it actually leaves $9 million for everything else,” he writes. At the meeting, Davis said She said the lack of in-house procedures because of referrals has caused contract health spending to get out of control. “So we’ve asked our docs to do a better job managing patients within our own health centers and not sending them out for things like knee injections, shoulder injections or casting,” she said. She added that the health system had grown by about 10 percent annually since she’s led Health Services and that has impacted spending. “We’ve budgeted a flat budget with contract health all these years, and so it’s obvious that there’s at some point that we’re going to have to slow some of the (referrals),” she said. Many referrals are approved now that historically hadn’t always been approved, including pain management and orthopedic procedures, Hayes said. Montgomery states that to solve overspending for the rest of FY 2016 requires referral reductions. “Because of our three chance appeals process, the only real way to ensure not spending money on a referral is to not write the referral at all. In our case, this means reducing the number of referrals written by as much as 50 percent. Contract Health money is and was traditionally earmarked only for urgent and emergent care. It was never intended for elective care,” he states. “It was never intended for routine follow-ups in patients not having further issues. It was never intended for things we could do ourselves, even if it meant waiting a bit for the care. We added money in the past in programs such as Back to Work to help pay for some of the elective procedures. However, when that money was no longer available, we never dropped those new service lines.” <strong>Referrals that could be reduced included in Montgomery’s statement were:</strong> • Dizziness workups that were instigated by a vendor apart from the original reason for the referral, • Prophylactic mastectomy that could be performed at Hastings, • Circumcision revisions for cosmetic purposes, • Dermatology: simple excisions, punch biopsies, actinic and seborrheic keratosis treatments and skin tag removals, • Simple wound care, • Elective gallbladders, hernias, hysterectomies, etc., that could be performed at Hastings, • Cardiac clearance by cardiologists that can be done in-house, • Varicose veins, • Long-term follow-ups for benign or distant conditions, • Elective orthopedics-joint replacements, • Elective repairs, • Injections at outside vendors, • Non-elective orthopedics-simple casting, • PET scans that don’t change treatment, • Cataracts before Medicare kicks in, and • Allergy testing and reduction mammoplasty. Not all non-urgent, non-emergency procedures are included in the list. The list was in reference to one day’s referrals, according to Montgomery’s statement. Montgomery also states that providers would have to “police themselves” when writing referrals. “If your case manager is writing all your referrals for you without any real discussion, you will need to halt this practice…Another option is to advocate to your patients the importance of signing up for available resources, such as insurance from the Affordable Care Act, Medicaid, and Medicare Part B,” Montgomery states. “We can pay for 5 insured referrals for every one uninsured referral. This also brings money into your individual clinics, which allows you to pay for raises, new providers, and creates the cushion that Contract Health used to use when there are overruns. Explain to your patients that signing up for these things are a huge help to Cherokee Nation Health. Ask them if they can afford to and are willing to help.” Montgomery states that if these options were unsuccessful each clinic would be given a budget to work from and be required to review their referrals daily and work within that budget. “If we still aren’t getting under budget, more drastic action would need to be taken,” he states.
05/20/2016 04:00 PM
CLAREMORE, Okla. – The Claremore Indian Hospital will host its second annual “Kids Summer Safety Fest” from 9:30 a.m. to noon on June 4. The event will take place outdoors at 101 S. Moore and is geared toward school-aged children and will include games and fun educational learning activities created by local agencies and businesses. Door prize drawings will take place at 11:30 a.m. Safe Kids Coalition Tulsa, with the assistance of the Claremore Fire Department, will conduct a car seat safety checkup event in which nationally certified technicians will show caregivers how to properly install car seats and check those already installed. Also, there will be a limited number of car seats provided to those in need at no cost. Grand River Dam Authority officials will provide education about water safety. City of Claremore Lights and Power officials will have an interactive electrical safety booth. Operations Lifesavers will perform education activities surrounding the importance of railroad safety, while Will Rogers Masonic Lodge No. 53 will provide a free child identification program that consists of height and weight measurements, dental impressions with DNA, scent, fingerprints, photos and recording for child’s voice recognition. This package will be given to the caregiver for utilization if their child is ever missing. Pete Goltra, of the Akdar Shriner Tulsa, will also attend with his popcorn truck providing snacks. American Red Cross will attend with its emergency response vehicle with its water station. Tulsa Life Flight will be on scene with its helicopter for kids to sit inside. Contech Inc. will have heavy machinery on site to teach about the dangers of playing on construction sites. The Claremore Fire Department will have a fire truck available for children to take tours. Pafford EMS will also provide tours of an ambulance. Claremore Indian Health Service will provide various games and education from its dental, dietary, pharmacy, benefit coordinators and emergency department. Tulsa Emergency Infant Services will provide information regarding the services that it provides along with a diaper giveaway. Safenet Emergency Services will have games teaching children how to address bullying. Claremore Auto Parts has provided a wrecked car to stress the importance of using seat belts. Also, Nabatak Outdoors will give away a life jacket and fishing pole, and other agencies attending with booth and activities include Saint Francis Children’s Hospital, Claremore Hillcrest Hospital and Rogers County Sheriff’s Department K9 unit.
05/10/2016 03:30 PM
WAGONER, Okla. – To curb prescription drug abuse, the Cherokee Nation is encouraging the public to drop off any unused prescriptions on Saturday during the Wagoner Family Fun Day in Maple Park. The tribe’s regional prevention coordinators will have an “Rx Take Back” booth at the event from 10 a.m. to 2 p.m. for those who want to safely dispose of prescriptions that are no longer needed. Wagoner County ranks among the highest in the state for prescription overdose deaths related to painkillers, according to state data. “The Cherokee Nation knows the importance of not only physical health, but mental health, and is working to ensure our communities and citizens are healthy and safe,” CN certified prevention specialist Coleman Cox said. “Painkillers such as hydrocodone, oxycodone and codeine, are some of the most abused prescription drugs in our 14-counties. That’s why it’s important to have safe drop off bags and locations to get these no longer used drugs out of medicine cabinets and homes.” The CN is using a grant from the Oklahoma Department of Mental Health and Substance Abuse Services and the Substance Abuse and Mental Health Services Administration to raise awareness of the problem and create prevention plans. The CN regional prevention coordinators who work through the tribe’s Behavioral Health department routinely drop bags at pharmacies with information on safe use, safe storage and safe disposal of prescription drugs. In Wagoner County, Owl Drug on Main Street gives the bags out to raise awareness. “We like the prescription take back bags and handing them out with some prescriptions,” pharmacist Matthew Villandry said. “We think it helps and have also seen a decrease in hydrocodone use because we now ask customers to fill another prescription along with it.” Residents can dispose of prescriptions at the booth on Saturday or at any time at the Wagoner County Sheriff’s Office at 307 E. Cherokee St., Wagoner Police Department at 105 S. Casaver Ave. or the Coweta Police Department at 212 N. Broadway, where each has disposal bins. For more information email <a href="mailto:"></a>.
05/03/2016 04:00 PM
TULSA, Okla. – The Indian Health Care Resource Center is offering various camps this summer, including a Wellness Adventures Camp, Culture Camp and Sports & Fitness Camp. The Wellness Adventures Camp is offered to children who have completed grades 2-9. Youths participate in low and high elements of a challenge course and learn problem-solving skills, communication and teamwork, an IHCRC release states. The Culture Camp helps expose Indian youth to Native culture with field trips to Cherokee and Osage nations as well as the Will Rogers and Woolaroc museums. The Sports & Fitness Camp provides opportunities for physical activities, games, experiential learning and enhancing sports skills. For more information, visit <a href="" target="_blank"></a>.
Senior Reporter – @cp_jmurphy
05/03/2016 08:00 AM
LAKE ANDES, S.D. – The Native American Women’s Health Education Resource Center recently released its workbook for Native American females titled “What To Do When You Are Raped, An ABC Handbook For Native Girls.” The book, Cherokee Nation citizen Pam Kingfisher said, is a resource aimed at answering questions women face following a sexual assault. “From thinking through buying emergency contraception, to getting tested for STDS, to who to turn to for support,” she said. Comanche Nation citizen Charon Asetoyer, who is also the Native American Women’s Health Education Resource Center’s CEO, said the book is a woman-to-woman, woman-to-girl, girl-to-girl community response in regards to sexual assault. “Sharing with them, providing support, letting them know they are not alone. That this is not their fault and they shouldn’t blame themselves. The book instructs them on how to report if they choose to,” Asetoyer said. “It talks to them about going in for STD exam and also access to emergency contraceptive Plan B.” Kingfisher and Asetoyer joined Elizabeth Black Bull and Donna Haukaas to co-write the book. [BLOCKQUOTE]Asetoyer said she was asked by a young mother on the Yankton Sioux Reservation in Lake Andes what she should do if her daughter was raped. Asetoyer said that when a mother puts it as when, not if, her daughter is raped, there is a realization that the problem is worse than originally thought. Asetoyer said the book sends a message to women and helps them realize it is not their fault. “There are other women out there. You’re not alone, and turn to them for help,” she said. Kingfisher said the project was personal and that she’s worked with Asetoyer on the book for about four years. “I think it’s so important that we advocate for our health and for our women. As a young girl who was assaulted and didn’t know anything…and later became pregnant and was forced to give up a child for adoption, I didn’t know any of these things. Nobody talked. These conversations didn’t happen at the kitchen table or even around girlfriends,” Kingfisher said. She added that she and Asetoyer, as well as other advocates fighting against sexual assault, want to make this issue real. “For me it’s important that we serve that matriarchal role of being good aunties, being good grandmas, being big sisters and helping,” she said. According to the Rape, Abuse and Incest National Network, one of the nation’s largest anti-sexual assault organizations, during an American Indian or Alaskan woman’s lifetime she is at a 34.1 percent chance of suffering from rape or attempted rape, the most of any other race. And about 3 percent of American men have experienced an attempted or completed rape in their lifetimes. The book is available for download at <a href="" target="_blank"></a> Kingfisher said hardcopy bulk orders would be available in the future. <strong>Women</strong> • 1 out of every 6 American women has been the victim of an attempted or completed rape in her lifetime (14.8 percent completed rape; 2.8 percent attempted rape). • 17.7 million American women have been victims of attempted or completed rape. • 9 of every 10 rape victims were female in 2003. <strong>Lifetime rate of rape/attempted rape for women by race:</strong> All: 17.6 percent White: 17.7 percent Black: 18.8 percent Asian Pacific Islander: 6.8 percent American Indian/Alaskan: 34.1 percent Mixed race: 24.4 percent <strong>Men</strong> • About 3 percent of American men have experienced an attempted or completed rape in their lifetime. • From 1995-2010, 9 percent of rape and sexual assault victims were male. • 2.78 million men in the U.S. have been victims of sexual assault or rape. <strong>Children</strong> • 15 percent of sexual assault and rape victims are under age 12. • 29 percent are ages 12-17. • 44 percent are under age 18. • 80 percent are under age 30. • Ages 12-34 are the highest-risk years. • Girls ages 16-19 are 4 times more likely than the general population to be victims of rape, attempted rape, or sexual assault. • 7 percent of girls in grades 5-8 and 12 percent of girls in grades 9-12 said they had been sexually abused. • 3 percent of boys grades 5-8 and 5 percent of boys in grades 9-12 said they had been sexually abused. • 82 percent of all juvenile victims are female. • The year in a male’s life when he is most likely to be the victim of a sexual assault is age 4. A female’s year of greatest risk is age 14. • 1 in 9 girls and 1 in 53 boys under the age of 18 experience sexual abuse or assault at the hands of an adult. • In 1995, local child protection service agencies identified 126,000 children who were victims of either substantiated or indicated sexual abuse. • Of these, 75 percent were girls. • Nearly 30 percent of child victims were between ages 4-7. <strong>Every 8 minutes, Child Protective Service responds to a report of sexual abuse.</strong> • 93 percent of juvenile sexual assault victims know their attacker. • 34.2 percent of attackers were family members. • 58.7 percent were acquaintances. • Only 7 percent of the perpetrators were strangers to the victim. • For 80 percent of juvenile victims, the perpetrator was a parent. 6 percent were other relatives. 4 percent were unmarried partners of a parent. 5 percent were “other” (from siblings to strangers). <strong>American Indians</strong> • On average during 1992-2001, American Indians age 12 or older experienced annually an estimated 5,900 rapes or sexual assaults. • American Indians were twice as likely to experience a rape/sexual assault compared to all races. • Sexual violence makes up 5 percent of all violent crime committed against Indians (about the same as for other races). • Offender/victim relationship: 41 percent stranger; 34 percent acquaintance; 25 percent intimate or family member. <strong>Campus Sexual Violence</strong> • Women 18-24 who are enrolled in college are 3 times more likely than women in general to suffer from sexual violence. Females of the same age who are not enrolled in college are 4 times more likely. • Male college-aged students are 78 percent more likely than nonstudents to be a victim of rape or sexual assault. • Female college-aged students are 20 percent less likely than nonstudents to be a victim of rape or sexual assault. • Only 20 percent of female student survivors age 18-24 report to law enforcement. In comparison, 33 percent of female nonstudent survivors aged 18-24 report to law enforcement. • 72 percent of campus law enforcement agencies have a staff member responsible for survivor response and assistance. • 8 percent of all sexual assaults occur while victim is attending school. <strong>Victims of sexual assault are:</strong> 3 times more likely to suffer from depression. 6 times more likely to suffer from post-traumatic stress disorder. 13 times more likely to abuse alcohol. 26 times more likely to abuse drugs. 4 times more likely to contemplate suicide. The preceding statistics were taken from the Rape, Abuse and Incest National Network. To see these and other information regarding sexual assault, visit <a href="" target="_blank"></a>.