SACCHO (State Association of County and City Health Officials)
Nebraska's Local Health Departments
Improve the health of Nebraskan's by strengthening Nebraska's public health system through collaboration among local health directors and external partners.
~~NEW ~~ DATA SOURCES ~~NEW ~~
Nebraska Local Health Departments
 Download a listing of all Nebraska Local Health DepartmentsMap of all Nebraska Local Health Departments |
 Kim Engel - Kay Oestmann - Terry Krohn
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Nebraska SACCHO Executive Committee
Kay Oestmann, Chair
Kim Engel, Vice-Chair
Terry Krohn, Secretary
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Are you a 2008 PHAN Member? CHECK HERE
~~ for Local Health Departments~~
Directed Health Measures Handbook:
Implementation Guidance for Local Health Departments
for the Prevention of Spread of Communicable Disease, Illness or Poisoning
This handbook was developed in response to the Nebraska local public health departments' need for guidance and accurate information on how to prepare for and implement quarantine and isolation quickly. The handbook, like most public health emergency preparedness documents, is a living document in which resources can be added and shared as they are developed. Download Handbook
Nebraska Health and Human Services System Regulations
regarding Directed Health Measures to Prevent or Limit the Spread of Communicable Disease, Illness or Poisoning
These regulations are enacted pursuant to Neb. Rev. Stat. 71-502, and 81-601 et seq. and apply to the exercise of authority by the Department to order Directed Health Measures necessary to prevent, limit, or slow the spread of communicable disease, illness, or poisoning - dated February 21, 2007. Download Regulations
PanFlu Template for Schools
Download the "Action Kit for Schools". Two Rivers Public Health Department has a comprehensive template for schools to use when doing their PanFlu Planning. http://www.tworiverspublichealth.com/PandemicInfluenza.htm
Pandemic Influenza (including Avian Influenza)
Interest in bird flu is on the rise. Three Nebraska state agencies are involved with this specific issue. Contact information is provided below:
Public Health Issues
Nebraska Health and Human Services System
Dianna Seiffert
Poultry
Nebraska Department of Agriculture
Christin Kamm, 402-471-2341
ckamm@agr.ne.gov
Migratory Birds
Nebraska Game and Parks Commission
Phil Richmond, 402-471-0641
phil.richmond@ngpc.ne.gov
The 'Get Ready' Campaign, sponsored by the American Public Health Association, provides information, resources and tools so that all individuals, families and communities in the United States are more prepared for a potential influenza pandemic, outbreak of an emerging infectious disease or other hazard or disaster.
The official U.S. government Web site for information on pandemic flu and avian influenza. http://www.pandemicflu.gov/
University of Minnesota Center for Infectious Disease Research & Policy:
OSHA updated guidance on avian flu:
Key Facts About Avian Influenza (Bird Flu) and Avian Influenza A (H5N1) Virus
Avian Influenza Infection in Humans
Transmission of Influenza A Viruses Between Animals and People
Spread of Avian Influenza Viruses among Birds
Information About Influenza Pandemics
Avian Influenza Vaccines
Avian Influenza A Viruses
Outbreaks in North America
Recent Avian Influenza Outbreaks in Asia and Europe
SEASONAL INFLUENZA INFORMATION
Cough Etiquette video
Nebraska influenza surveillance data -- http://www.hhs.state.ne.us/flu/report.htm
CDC Flu Activity Reports
This page includes information on:
Weekly U.S. flu reports Weekly influenza activity maps · International flu surveillance
UPDATES TO INFLUENZA INFORMATION AND GUIDANCE
Influenza Prevention Toolkit
This Flu Prevention Toolkit includes selected printable resources and supplemental materials addressing flu prevention. There are also anecdotes from real people with their respective flu related problems and corresponding solutions. http://www.cdc.gov/flu/toolkit/
Fact Sheet: What Everyone Should Know About Flu and the Flu Vaccine
This page has been updated to reflect current vaccine information, new vaccination recommendations and other prevention messages.
“Cover Your Cough” (a poster / flyer)
Serious respiratory illnesses like influenza, respiratory syncytial virus (RSV), whooping cough, and severe acute respiratory syndrome (SARS) are spread by coughing or sneezing and/or unclean hands. The flyer is now available in English and Vietnamese.
Colds and Flu: What to do if you Get Sick
Updated to include information on distinguishing colds from flu.
Questions & Answers: Cold Versus Flu
Public/patient education page designed to help distinguish between cold and flu symptoms.
Concealed Weapons
Concealed Handgun Sign (Spanish) from Central District Health Department
Concealed Weapon Sign - Nebraska State Patrol
Concealed Weapon Sign (Spanish) from East Central District Health Department
Mumps
Title 173 - Control of Communicable Disease - Chapter 3 - School Health, Communicable Disease Control, and Physical Examination and Immunization Standards
Copies of previous messages that have been sent out and guidelines for ordering labs are located at:
West Nile Virus
Nebraska HHSS Website on WNV - http://www.hhs.state.ne.us/puh/epi/wnv/healthpros.htm
CDC West Nile Virus Page
Provides the latest details about WNV. This page includes general facts, Q&A’s, case counts, and maps of WNV activity.
West Nile Virus: Updates to Statistics, Surveillance, and Control
CDC information about WNV in Spanish
¡No se deje picar!
Evite las picaduras de mosquitos para evitar la infección Cuando se trata del Virus del Nilo Occidental, la prevención es la mejor apuesta. No dejarse picar por los mosquitos reduce el riesgo de contraer esta enfermedad y otras transmitidas por los mosquitos.
Rabies Update
The Univ. of Nebraska has translated the 'Rabies in Nebraska' document into Spanish. his reference explains rabies transmission and how certain animal species act when they are infected.
This is the address for the Spanish format. La rabia en Nebraska
The 'Rabies in Nebraska' English language address is:
The Rabies NebFact Sheet
The Nebraska Health and Human Services System and the University of Nebraska Lincoln have collaborated on writing and releasing a NebFact on Rabies. The NebFact can be accessed from the following link:
CDC links to Rabies information
SARS
Frequently Asked Questions about SARS
UPDATED information on the most frequently asked questions addressing severe acute respiratory syndrome.
Smallpox Response Plan and Guidelines (Version 3.0)
This document outlines the public health strategies that would guide the public health response to a smallpox emergency and many of the federal, state, and local public health activities that must be undertaken in a smallpox outbreak. http://www.bt.cdc.gov/agent/smallpox/response-plan/index.asp
Monkeypox
CDC Monkeypox Website
http://www.cdc.gov/ncidod/monkeypox/ provide information on the outbreak.
Environmental
EPA's consolidated Spanish site, visit: http://www.epa.gov/espanol
Algal Blooms (North Carolina fact sheet)
For more information contact:
Public Health Veterinarian
Health and Human Services System
PO Box 95007
Lincoln, NE 68509
Phone 402-471-1374
Nebraska Public Water Systems Link
Check out this link!!! It will take you to a Nebraska Public Water Systems Search page. Click on the following link within that page to take you a county map of Nebraska - "Click Here for the County Map of Nebraska". Then click on a county and see a list of all the public water systems within that county. Within that list you can click on the water system number to see contact people for that system. Use the Help feature to determine what the various codes mean. http://www3.hhs.state.ne.us/Sdwis_State
The Groundwater Foundation
The Groundwater Foundation has public awareness tools on their website. To access these tools click: www.groundwater.org/pe/pack.html or www.groundwater.org/
Anhydrous ammonia leaks and spills
Public Health Actions
The public health department may not have a primary role in the response. However, the situation can evolve into a much larger situation. Depending on resources, public health’s role may be mainly a provider of information and coordination of services if requested. Emergency agencies are encouraged to notify their local health department if these types of events occur.
Persons who are exposed to anhydrous ammonia require urgent medical attention. If a hospital becomes overwhelmed, the public health department may be able to assist by coordinating with a local emergency response group, such as a metropolitan medical response system, or asking the state health department for assistance. Other issues may also come up, such as contamination of water supplies or public water systems. Also it is possible that fish may die off if the contamination is large enough. The greatest danger of anhydrous ammonia is direct exposure to the gas by inhalation or contact with skin.
Anhydrous Ammonia is a Commonly Used Fertilizer
Anhydrous ammonia (“ammonia without water”) is an inexpensive chemical used commonly in agriculture as a fertilizer. Above its boiling point of minus 28 degrees Fahrenheit, it is artificially kept in a compressed liquid state at high pressure for ease of transport, storage, and application. Tanks are pulled by tractors and ammonia is sprayed directly onto fields. Exposures to workers can occur during spraying or during connection and disconnection of spraying equipment.
Exposure to Anhydrous Ammonia May Cause Severe Burns and Death Due to Suffocation
Anhydrous ammonia can cause severe burns and death due to its powerful corrosive action on tissue. Inhalation of high concentrations causes death due to bronchoconstriction, edema, and inflammation of the airway walls. Exposure to lower concentrations for longer periods can also be fatal as the gas reaches deeper parts of the lung. Chronic fibrosis of the lung may occur if the victim survives the initial insult. Direct contact with the ammonia in liquid form causes severe burns to skin and mucous membranes.
Due to its high water solubility and alkalinity, it causes necrosis of the tissue and can penetrate deeply. Severe corneal burns may result from contact with the eyes. If contact occurs as anhydrous ammonia liquid escapes from a container, vaporization can cause freezing burns of the skin and eyes due to rapid heat loss.
National and State Data on Injuries, Illnesses, and Deaths Due to Anhydrous Ammonia
Eight fatalities were identified in CFOI (U.S. Census of Fatal Occupational Injuries) surveillance system during the six-year period 1992-1997 related to work with anhydrous ammonia [NIOSH 2001c]. The majority of the cases were due to exposure to anhydrous ammonia gas. Explosions involving anhydrous ammonia were also identified. During 1997, injuries and illnesses where the source was identified as anhydrous ammonia resulted in a median of 20 days away from work; 66% of the 88 cases resulted in more than 10 days away from work [BLS 1999b].
The Iowa State University Extension reported that between 1990 and 1992, 55 Iowans were injured in
incidents involving anhydrous ammonia, 19 of which required hospitalization for burns, loss of eyesight, and respiratory problems [Schwab et al. 1993]. During 1985, one-third of all emergency department visits due to agricultural chemicals in a 21-county area in Nebraska were caused by anhydrous ammonia fertilizer [Rettig et al 1987]. Other deaths and severe injuries caused by exposure to anhydrous ammonia have been reported in the literature.
Requirements for the Safe Storage and Handling of Anhydrous Ammonia
Because of the dangerous properties of anhydrous ammonia, a national standard exists for safe storage, transportation, and handling of the chemical. According to the standard, only properly trained personnel who are familiar with its physical properties should handle anhydrous ammonia. Because it must be stored at high pressure, any leak will cause the ammonia to spray and quickly vaporize. Anhydrous ammonia quickly reacts with any moisture, including moisture in skin and mucous membranes, causing severe dehydration, cell destruction, and chemical burns. Handlers of anhydrous ammonia must wear appropriate personal protective equipment, including eye protection such as tight-fitting, chemical-proof goggles or an approved full-face respirator. Proper use of specially approved equipment must be followed [ANSI 1999; Shutske 1994]. In the event of an emergency, handlers should be able to act by shutting off the flow of gas and coordinating evacuation.
More information and references
Contact the Regional Poison Control Center. They are a critical information linkage to all emergency rooms, hazmat team, ambulance and fire department. Once notified, they can alert emergency rooms in the area concerning incoming patients. They have preprinted information they will fax to effected emergency rooms concerning appropriate care. They are also a partner with the Nebraska Health Alert Network and can inform Key individuals at the State Health and Human Services System when needed.
Nebraska Regional Poison Center phone numbers:
Tel: 402-955-5555 (24 hour)
1-800-222-1222 (National poison center number)
Fax: 402-384-4050
Business mailing address:
Nebraska Regional Poison Center
8401 W. Dodge Rd.
Suite #115
Omaha, NE 68114
ANSI (American National Standards Institute) [1999]. American national standard: safety requirements for the storage and handling of anhydrous ammonia. New York, NY: American National Standards Institute, ANSI K61.1-1999.
BLS (Bureau of Labor Statistics) [1999b]. Occupational injuries and illnesses: counts, rates, and characteristics (1997). Washington, DC: U.S. Department of Labor, Bureau of Labor Statistics.
Minnesota Department of Agriculture. Hazards of Anhydrous Ammonia When Used in the Illegal Production of Methamphetamine. January 2000. http://www.mda.state.mn.us/appd/nh3/aa_lab.pdf
NIOSH [2001c]. Unpublished analyses of the 1992-1997 Census of Fatal Occupational Injuries Research File provided to NIOSH by the Bureau of Labor Statistics. Morgantown, WV: Division of Safety Research, NIOSH.
Rettig BA, Klein DK, Sniezek JE [1987]. The incidence of hospitalizations and emergency room visits resulting from exposure to chemicals used in agriculture. Nebr Med J; July, 1987:215-219.
Schwab CV, Hanna M, Miller L [1993]. Play it safe with anhydrous ammonia. Iowa State University Extension, Ames IA. Fact Sheet Pm-1518d.
Shutske J [1994]. Using anhydrous ammonia safely on the farm. St. Paul, MN. University of Minnesota Extension Service Publication No. FO-2326-C. http://www.extension.umn.edu/distribution/cropsystems/DC2326.html
U.S. Department of Labor. Storage and Handling of Anhydrous Ammonia. http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9757
Foodborne Illnesses
The Centers for Disease Control and Prevention's computer-based case study, “Gastroenteritis at a University in Texas.” Based on a real-life outbreak investigation, this self-instructional, interactive exercise teaches epidemiologic skills in outbreak investigation and allows students to apply and practice those skills.
Case studies can be downloaded for free or purchased on CD-ROM through the Epidemiologic Case Studies website at http://www.cdc.gov/epicasestudies/.
Nebraska's Local Health Departments
Local Health Department Websites
Listed below are links to county and district health departments.
Central District Health DepartmentNational Association of County and City Health Officials (NACCHO)
LinksTHE 10 / 20 / 30 RULE OF POWERPOINT PRESENTATIONS
The 10 / 20 / 30 rule of PowerPoint says a PowerPoint presentation should have ten slides, last no more than twenty minutes, and contain no font smaller than thirty points.
Information on the risk of animal exposure at county fairs: Animals at Fairs and Festivals
Information on immunization guidelines: the definitive source!
THE PUBLIC HEALTH DISPARITIES GEOCODING PROJECT MONOGRAPH
Available at: http://www.hsph.harvard.edu/thegeocodingproject
PLAGUE TRAINING MODULE
This web-based module is designed to teach the natural epidemiology of plague and how to manage it as both a natural disease and an intentional attack. The content is presented in a series of eight lessons to be completed in the order that they appear. http://www.bt.cdc.gov/agent/plague/trainingmodule
PUBLIC HEALTH PREPAREDNESS
Continuation Guidance for Cooperative Agreement on Public Health
Preparedness and Response for Bioterrorism –
Provides UPDATED links to Notice and Guidance documents for the
Cooperative Agreement on Public Health Preparedness and Response for
bioterrorism.
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