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
BY TESINA JACKSON
Reporter
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 http://legislative.cherokee.org/StreamingEvents.aspx
and click on influenza presentation.

tesina-jackson@cherokee.org


918-453-5000, ext. 6139

Health

BY ASSOCIATED PRESS
09/22/2016 05:30 PM
OKLAHOMA CITY (AP) - A recently released report states Oklahoma has the eighth-highest adult obesity rate in the nation. A report from the Trust for America’s Health and the Robert Wood Johnson Foundation states almost 34 percent of adults in the state are obese. Louisiana is ranked No. 1, while West Virginia, Mississippi and Alabama tied for second place. Arkansas is ranked No. 6. The rankings are based on data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System. Adult obesity rates in Oklahoma remained stable since the last survey, The Oklahoman reports. Kansas and Kentucky saw their obesity rates increase. Richard Hamburg, Trust for America’s Health interim president and CEO, said “obesity remains one of the most significant epidemics our country has faced, contributing to millions of preventable illnesses and billions of dollars in avoidable health care costs.” According to the report, 17 percent of children in Oklahoman live in households that have limited access to adequate food and nutrition due to cost, proximity and other reasons. The report also said the 30 percent of high school students in the state reported drinking one or more cans of soda per day. To encourage fitness, 18 states, including Oklahoma, have set a minimum amount of time that elementary students must participate in physical education.
BY STAFF REPORTS
09/21/2016 05:00 PM
CLAREMORE, Okla. – The Claremore Indian Hospital will host an Affordable Care Act Outreach and Enrollment Fair from 9 a.m. to 3:30 p.m. on Oct. 20, less than two weeks before the Nov. 1 open enrollment. “Nov. 1, 2016, will mark the beginning of the fourth Open Enrollment Period for the ACA Health Insurance Marketplace,” Sheila Dishno, patient benefit coordinator, said. “Even though members of federally recognized tribes have a special monthly enrollment status, it is important for American Indian and Alaska Native individuals and families to learn about their insurance options. Whether it’s purchasing insurance through the Marketplace or qualifying for SoonerCare, knowing that you have quality coverage provides peace of mind.” Dishno said people who attend the fair should bring their Social Security cards, pay stubs, W-2 forms or wage and tax statements, policy numbers for any current health insurance and information about any health insurance they or their families could get from an employer. Also Blue Cross & Blue Shield of Oklahoma will attend to assist patients with signing up for free-to-low-cost health insurance. The hospital is located at 101 S. Moore Ave. For more information, call 918-342-6240.
BY STAFF REPORTS
09/13/2016 12:00 PM
CLAREMORE, Okla. – The Claremore Indian Hospital on Sept. 29 will sponsor a U.S. Veterans Affairs Enrollment Fair to assist Native American veteran patients in applying for eligibility for health care services through the VA. The fair is slated for 10 a.m. to 2 p.m. in its Large Conference Room as benefit coordinators and representatives from the VA and Disabled American Veterans assist with application processing. To enroll, veterans must bring financial information such as income and resources and their DD-214 military discharge papers. If already enrolled, call 918-342-6507, 918-342-6240 or 918-342-6559 to update your file. Also, the VA now requires all veterans to complete a MEANS test yearly. Veterans who have not completed tests in the past year, can complete them at the fair. The hospital is located at 101 S. Moore Ave.
BY STAFF REPORTS
08/29/2016 12:00 PM
TAHLEQUAH, Okla. – The Cherokee Nation’s work creating healthier conditions for its citizens is now ranked among the best in the country, a first for any tribe. In late August, the CN Public Health received accreditation from the Public Health Accreditation Board. The PHAB serves as the national public health accrediting body. It is jointly supported by the U.S. Centers for Disease Control and Prevention and the Robert Wood Johnson Foundation. It sets standards for the nation’s nearly 3,000 governmental public health departments to improve the quality of their services and performance. Fewer than 200 public health agencies nationally have earned the title in the past five years. The CN is the first tribe to now hold that honor. “The Cherokee Nation joins the growing ranks of accredited health departments in a strong commitment to their public health mission,” PHAB President and CEO Kaye Bender said. “The peer-review process provides valuable feedback to inform health departments of their strengths and areas for improvement, so that they can better protect and promote the health of the people they serve in their communities. Residents of a community served by a nationally accredited health department can be assured that their health department has demonstrated the capacity to protect and promote the health of that community.” The Public Health team has worked on initiatives such as Zika Virus preparedness planning, launching community walking groups, funding school community gardens, implementing a cancer tumor registry database and conducting research with universities on issues such as triggers for childhood asthma. It also pays entry fees to 5K races and operates a gym with certified public health trainers for CN citizens and employees for free to promote healthier lifestyles. Public Health agencies, including the CN’s, promote healthy behavior; preventing diseases and injuries; ensuring access to safe food, water, clean air and life-saving immunizations; and responding to public health emergencies. The Oklahoma Department of Health, Oklahoma City-County Health Department, Tulsa Health Department, Comanche County Health Department and the CN are the only accredited entities statewide. “Our congratulations to the Cherokee Nation for achieving national public health accreditation,” Dr. Terry Cline, Oklahoma State Department of Health commissioner and Health and Human Services secretary, said. “As the first tribal nation in the country to achieve this accreditation, the Cherokee Nation continues a long tradition of excellence and quality in protecting and promoting health, and they are to be commended for this outstanding accomplishment.” According to the PHAB, a University of Chicago study found that more than 90 percent of health departments accredited for one year indicated that accreditation helped them better identify strengths and weaknesses and more than 80 percent found they improved accountability to stakeholders, while half reported it helped improve their chances for competitive funding. “Receiving national accreditation through the PHAB is a testament to the years of quality work by our public health team at the Cherokee Nation,” Connie Davis, Public Health executive director, said. “This seal of approval allows us to further improve upon our work in public health and on epidemiological issues.” Officials said Public Health leaders spent the past four years working on the accreditation, which involves meeting or exceeding a rigorous, peer-reviewed set of standards. “Achieving accreditation means we at the Cherokee Nation are cognizant of the crucial role of public health in our communities and demonstrates our ability to be a mutually-beneficial partner for all citizens,” Lisa Pivec, Public Health senior director, said. “We believe it communicates our serious commitment to both improving health and delivering quality public health services to all.”
BY STAFF REPORTS
08/29/2016 08:30 AM
TAHLEQUAH, Okla. – The Oklahoma Hospital Association recently recognized Cherokee Nation’s W.W. Hastings Hospital for vaccinating the majority of its staff with flu shots this past flu season. The hospital is among 49 in the state to meet the association’s challenge goal of a 96 percent or higher vaccination rate of health care staff for the 2015-16 flu season. More than 800 members of the Hastings staff received the vaccine this past flu season. “Cherokee Nation’s health department and our talented staff that operates the hospital and clinics routinely go above and beyond for the wellness of our tribal citizens,” said Secretary of State Chuck Hoskin Jr. “Administration and promotion of the annual flu shot means we are being proactive in ensuring our immunization rates trend positively. That’s important because every year the influenza virus often targets our most vulnerable Cherokee people, including elders and children.” OHA officials said influenza is associated with 36,000 deaths per year and commended the recognized hospitals with certificates for working diligently to protect their patients with vaccinations. “These hospitals have stepped up in ensuring their patients are protected and a number are joining a trend of hospitals nationwide in instituting mandatory vaccination policies,” LaWanna Halstead, OHA vice president of quality and clinical initiatives, said. Hastings Hospital was also recognized recently for receiving four out of five stars from the Centers for Medicare and Medicaid Services. This places Hastings in the top 4 percent of the more than 7,000 organizations it is compared with. The ratings come from patient satisfaction quality of inpatient care measures. Individuals can use Hospital Compare to compare more than 7,000 Medicare-certified hospitals across the country to compare the quality of care. “The W.W. Hastings Hospital health care providers and staff work tirelessly to ensure our patients receive the best health care possible,” Hastings Hospital CEO Brian Hail said. “Recognition of their efforts from organizations like the Oklahoma Hospital Association and high ratings from our patients on the Hospital Care system serve as validation of our staff’s dedication to first-class health care.” Hastings Hospital received more than 360,000 patient visits in fiscal year 2015. For more information, visit <a href="http://www.cherokee.org/services/health" target="_blank">www.cherokee.org/services/health</a>.
BY JAMI MURPHY
Senior Reporter – @cp_jmurphy
08/25/2016 08:15 AM
TAHLEQUAH, Okla. – Cherokee Nation citizen Pam Turtle will spend the rest of her life taking medication to help her live with a transplanted kidney. The transplant was needed because she’s had polycystic kidney disease since she was 24. Turtle, 49, is from Stilwell but lived in Kansas, Oklahoma, until five years ago. That’s when she got extremely sick and doctors told her the disease had progressed enough to necessitate dialysis. So she and her husband Mike Turtle moved to Tahlequah to be closer to a dialysis center. PKD causes cysts to take the place of normal tissue. They enlarge the kidneys and make them work poorly, leading to kidney failure. The disease also runs in families. As a child, Pam watched her mother suffer from PKD, so Pam carried a lot of responsibility, including helping keep the house and family together. “My mom was sick the whole time I grew up. In fact, I had to miss some school to take my mom to dialysis and to drive her back. When I was 24 years old I was going to donate a kidney to my mother. I had just had my second child – my last child – and they told me I couldn’t. They told me I had the same disease that my mom had,” Pam said. “They had found cysts bilaterally on my kidneys, and they told me that I would have to start seeing a doctor.” Pam said the disease progresses slowly and affects the whole body. “It took 20 years for this disease to progress. That’s the best thing about this disease, is that it takes years and years and years for it to become a problem.” As the years passed, Pam’s blood pressure increased to where she had to take several pills a day. Still her symptoms and disease progressed. About five years before her kidneys failed, she was referred to a nephrologist in Muskogee. “It got to where I would see him once a year, and then I saw him every six months. Then I saw him every three months, and then I saw him every month. It was just a process I had to go through,” she said. Then one day her nephrologist told her she needed a fistula and dialysis. A fistula is an abnormal connection between two body parts, usually the result of an injury or surgery. “So in November of 2010, I got my first fistula. It’s dead now. I have really bad veins, so they had to harvest a vein and pull it over so that I could use it,” she said. After a year of dialysis in that location, it clotted. “So they sent me to go get a catheter, and it would go straight into my heart, and I took treatment on it for eight months, and while I had this in they did another surgery and put a graft in my arm,” Pam said. The plan was to do dialysis off the graft, but six months later it too had clotted. So she was sent for vascular surgery. After cleaning that vein, it too died and again she had to have catheter. “In eight months I had 13 catheters put in. It’s really hard to do a treatment with them. You’re really prone to infection, and if you get an infection here it goes straight to your heart,” she said. “I’ve watched two people die on dialysis using a catheter.” After dialysis, she said her life changed greatly. “I did it three days a week. I went at 5:30 in the morning. I got through by 9 (a.m.)…There were things we couldn’t eat,” she said. Pam said the disease has a process, and that’s what she was going through. Her mother, grandmother, two uncles, two aunts as well as Pam’s daughter and granddaughter were diagnosed with PKD. Aside from one aunt, her mother, daughter and grandchild, the rest died from complications. “They all passed away with that disease. My aunt has a transplant. My mom’s transplant is the same age as my daughter. My daughter is 26 years old. Mine is four years old…I got it on Dec. 21, 2012,” she said. She said she and her family members with the disease wouldn’t be alive without the transplants. The organ donations, she said, gave her a new start because the disease doesn’t attack the new kidney. Pam said her daughter, Shaye, is 26 and was diagnosed when she was 10. “She hurts a lot and she has very high blood pressure. A migraine can set her back for days. She sees a doctor every six months for her kidney disease and dialysis is just around the corner,” Pam said. “My granddaughter was diagnosed while in the womb. She sees a nephrologist every year. She has some pain issues, but she’s doing great.” Pam said eventually they would need dialysis and transplants. “I encourage donation. If everyone could just understand what it means to donate. There’s a lot of misconception about donation. You don’t have to die to donate, and living donors are the best for kidney donation because they work immediately,” she said.