WC CWF Health District Board Minutes - 10/25/2013 I
WICHITA FALLS-WICHITA COUNTY PUBLIC HEALTH BOARD MINUTES
October 25, 2013
PITY CLERK''s r;ti 7 ;fit-.Wichita Falls-Wichita County Public Health District
DATE: /2"1-4_i3 1700 Third Street- Parker Conference Room
BY: _ 4 __ ,. ��n 8.3 .4H Wichita Falls, Texas
MEMBERS PRESENT: Board Members
Scott Plowman, Vice-Chair
Kirk Harlow, Ph.D., Secretary
Clay Clark, D.V.M.
Tracy Hill, D.D.S. ,
Jane Leach, Ph.D.
MEMBERS ABSENCE EXCUSED:
David Carlston, Ph.D., Chair
Michael Lamar, M.D.
Lou Kreidler, R.N., B.S.N. Director of Health
Amy K. Fagan, M.P.A. Assistant Director of Health
Dr. Glen Minter Associate Health Authority
Kevin Hugman Assistant City Manager
Ben Hoover Council Liaison
Ray Gonzalez County Commissioner
I. CALL TO ORDER
Scott Plowman called the Health Board meeting to order at 12:00 pm after a quorum of members
was attained.
II. APPROVAL OF MINUTES AND ABSENCES
Scott Plowman called for the review and approval of minutes from the meeting held on August 23,
2013. Dr. Leach introduced a motion to approve the minutes as presented and Dr. Hill seconded
the motion. Motion passed unanimously.
At this time it was noted the excused absence of Dr. Carlston and Dr. Lamar.
III. MRSA Update-West Nile-Rabies
Katrena Mitchell, Animal Services Administrator introduced Dr. Shelley Stonecipher a
Zoonosis Control Veterinarian with the Department of State Health Services (DSHS) in
Arlington, Texas to discuss Rabies, West Nile, and MRSA.
Dr. Stonecipher stated Texas has 150 zoonosis the diseases transmitted from animals to
humans with Rabies the most common and primary health concern of the Zoonosis
program. Rabies is a virus disease of the central nervous system that can be transmitted
by the bite of a rabid animal, or through the saliva of a rabid animal being introduced into
a fresh scratch or similar skin break, and rarely by other route. All warm-blooded
animals, only the unvaccinated pets, and humans are susceptible to rabies. The disease
develops in the domestic animals along with the threat of transferring the infection to
other pets and humans. Children because of close association with the pets are most
often the human victims. Since 1955 rabies in domestic dogs and cats declined due to
vaccinations and Animal Control at the city and county levels. Animal Control needs to
be notified any time an animal bites a human being due to the danger that the animal is
rabid, when not reported a human exposure results in death.
The clinical course of the disease is divided into three states; 1st incubation period, 2nd
clinical signs, and 3rd paralysis terminating in death. The incubation period is the time it
takes clinical signs to develop after exposure to a rabid animal. The average incubation
period in humans and animals is 3-8 weeks. A biting domestic animal must be placed in
quarantine until the end of a 10-day observation period that starts at the time of the bite
incident. If the animal was infective at the time of the bite, signs of rabies usually follow
rather quickly within the 10 days. Clinical signs of rabies vary by animal any abnormal
behavior; passive, wobbly, aggressive, vocalization due to difficulty swallowing, followed
by death. An animal for humane reasons that shows signs during the 10 day quarantine
would be euthanized before they die because the symptoms are so dramatic. Quarantine
is mandatory by Texas State law but depends on the local ordinance whether housed at
the Animal Shelter, Veterinarians, or possibly home depending on the circumstances
when criteria met.
Most people that die of rabies now die from bat bites it does not matter how small or large
the bite with potential unrecognized exposure while sleeping, intoxicated, mentally
impaired, or an unattended child. Formerly, hazards connected with taking anti-rabies
treatment were considerable; however, the rabies vaccine and anti-serum in current use
have excellent safety records. Since the chances of developing the disease are so much
greater than the chances of adverse reaction to the vaccine, anti-rabies treatment should
be administered in all cases of known or uncertain exposure.
The Rabies postexposure prophylasix (PEP) for humans essential components of animal
bite wound management are prompt thorough cleansing of wounds and immunization
administration in most instances of both human rabies immune globulin (HRIG) and
human diploid-cell vaccine (HDCV) known as the rabies biologicals. After cleansing of
wounds treatment for individuals; not previously vaccinated the HRIG infiltrated into and
around the wound, HDCV day 0 (first day of treatment), 3, 7, and 14, and previously
vaccinated only HDCV on day 0 and 3. The Department of State Health Services
(DSHS) enables the Wichita Falls-Wichita County Health Department to dispense HRIG
and HDCV because of the remote location and expense so few facilities stock the rabies
biologicals.
In the State of Texas by State law a Local Rabies Control Authority (LRCA) is designated
by the City Council or County Commissioner Court for every jurisdiction even the small
county populations with a responsibility to follow up on bites and scratches. It is
important and by law that any potential rabies exposure or bite be reported and the LRCA
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to respond. Wichita Falls LRCA is Steve Dodge the Animal Control Supervisor at the
Animal Service Center. Rabies is an epidemic not going away each bite needs to be
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evaluated on a per incident basis. All bites need to be reported to authorities for
quarantine and rabies post-exposure considered. There are rabies deaths most every
time exposures are not reported and rabies is a preventable disease.
Effective community control of rabies is possible with an informed and cooperative public.
Community control can be accomplished by; immunization, registration, and licensing of
all owned dogs and cats, impoundment and elimination of all stray animals, and
quarantine of rabies suspects.
Lou Kreidler stated Wichita County had a second case of West Nile in a 27 year old
female that made frequent trips to Ft Worth she did not report any amount of time spent
outside or in parks she was hospitalized for several days then released. In previous
years everyone had underlining medical issues with a difference this year that one was
28 years old and the other early 50's being relatively young, healthy individuals, and no
underlining health issues.
Dr. Stonechiper added it is not known why now West Nile effects the healthy younger
population while previously it was in the 50 and older.
Dr Stonechiper went into discussion from the veterinarian and public health perspective
of Methicillin-resistant Staphylococcus aureus (MRSA). MRSA is called a methicillian-
resistant a term that should be changed to multi-drug resistant. MRSA is common in
human skin, less common in animal skin that is a merging health problem because of the
resistance to antibiotics. An interesting finding was it is much more likely to carry MRSA
in the nose, throat, or skin a colonized bacteria but not necessarily being ill with the
bacteria. Individuals working in a health care setting have pets with higher rates of
colonized MRSA bacteria. Still undetermined with continued studies it is thought
individuals in the human medical setting, veterinarians, nursing homes, funeral homes,
hospitals maybe colonized. Most individuals are going to acquire MRSA in a medical
setting workplace from other ill individuals it has been found people do not usually get
MRSA from the dog or cat, it can happen, but they are getting it from other people. Once
a pet acquires MRSA it begins the transmission cycle to human to animal back to human
with that cycle going on in a household at that point the physician treats the human and
problems continue then it is needed to look at the dog in terms if that animal is
contributing to the cycle to have the veterinarian test and treat the dog and the physician
work on the human at the same time. Also know is if pets are colonized they have the
bacteria on the skin or nose but no signs of illness they can surface in people and there
currently is no method toward decolonizing. Transmission is going to be the same skin
contact if the person has an open or draining skin wound, cover it with bandages, it can
be spread by kissing or nuzzling your pet especially true if in a medical setting, nursing
home, or funeral home. Recommendations are when coming home from a medical
setting to remove your clothes wash them wash your hands as well before you handle the
pet, it is possible that pets can give MRSA but it is not common in dogs. If MRSA is
present it will appear as a skin wound the veterinarian will tell you to wear gloves, use
household disinfectant or chlorine bleach and avoid touching the dogs eyes, nose,
mouth, wash hands thoroughly the same with veterinarians. The symptoms are the same
skin infections with pets possibly ear infections it needs to be appropriately diagnosed the
same as with people but they do not want to spend the money on the culture and
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sensitivity. It is possible to drain the wound to rid the infection but if not then treated with
the antibiotics that is part of the problem but must be used. The only time a pet should
be screened for MRSA is when symptoms reoccur in one of the family members, look at
the other family members and the physician should swab nostrils, skin surface at the
same time the veterinarian swabs nostrils, skin surface of the pet. MRSA has been found
in horses, pigs, birds, and livestock usually acquired from human handlers this is a
continually changing situation. A big concern is in therapy animals because they can pick
MRSA up in a nursing home setting and bring it back. Now there are guidelines for
therapy animals on what should be done in the Journal of the American Veterinary
Medical Association. Although animals in therapy programs may carry pathogens such
as MRSA those associated with healthcare facilities appears to be uncommon now
because there has not been much research done. Therapy animals are going to be
exposed every time they go even if you get a negative one time you cannot say they go
back the next time and not pick it up. In veterinary medicine there are guidelines from the
National Association for Health Veterinarians on Veterinary Standard Precautions based
on what is done in human medicine. Some basic guidelines now exist.
IV. ANIMAL ORDINANCE
Lou Kreidler presented the Animal Control ordinance changes set to go to Council and
would like to have a recommendation by the Board. In January two years ago at the
Strategic Planning session the main premise was the mandatory spay and neuter
ordinance on all animals in the City of Wichita Falls at the time Council and the Mayor
was not in favor. They felt it punished the pecple who kept care of their animals for those
that have a female or male dog at home that never got exposed or pregnant they should
not be forced to spay or neuter their dog to live inside the City of Wichita Falls so they
tasked us with coming up with a different approach. This past year proposed to
mandatory spay and neuter will be done on animals brought into the Animal Reclaim
Center with a recommendation from Council to be done only when it was the second
impoundment so the last addition in the Animal Control ordinance is requirements when
your animal has been picked up for the second time for being at large it will be required to
be spayed or neutered at that point. They will have to go to their veterinarian pay for the
procedure make an appointment bring that paper back to the Animal Services Center
then will release their animal to them because we do not want cost to be a barrier to them
doing that we are going to waive the reclaim and impound fees for that. We realize we
have a lot of people who do not have the money to get the animal out of jail and spay or
neuter we felt like that would be an incentive even though we are requiring you to do this
we are going to waive our fees. In presentation to Council it will be that the first time the
animal is impounded that we offer to waive impound and reclaim fees if they will have the
animal spayed or neutered. They will have up to 30 days afterwards we recognize that
we may need to work with some vets but the standard will be 30 days to bring proof of
spay or neuter back to the Animal Services Center (ASC) at that point if they have not
done that then we will start enforcement action. A visit to the home will be made with
inquiry to the deadline date of the animals spay or neuter, some will have the proof but
never went back to the ASC and some will not have it done so they will be ticketed and
charged the fees waived for not having it done.
In addition to that are 3 additional permits; Sellers, Stud, and Litter permits. The Sellers
permit at $250 is intended for those that breed their animal to make a profit.
The Litter permit at $50 per litter is in part of making people responsible for their pets
even if the pet gets out and gets pregnant. Whether the Sellers or Litter permit it will
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have to be posted in all ads which is closely to the type of permits larger cities as San
Antonio, Austin, Dallas, and Fort Worth established. The Stud permit at $50 is for those
with a male dog that they intend to stud. The other change is if you have a pet shop
permit then you currently do not have to have the sellers permit in that our current
ordinance includes flea markets as a pet shop and we believe that is a misclassification
the vision of a pet shop is as a business with an owner they have animals in that shop
that belong to them that they are selling to someone else when you have a flea market
people can come in our flea market they currently have a pet shop permit and anybody
can walk in with a litter of dogs do not have to have a permit sit up in there and sell or
give away dogs. So we do feel that is the intent of a pet shop permit we want to change
that specifically not to include flea markets.
Kevin Hugman asked with the litter permit is there any fear that will lead to more dumping
of dogs out in the rural areas because they do want to pay $50 for a permit to get rid of
puppies they had not planned on.
Lou Kreidler replied if they do not want to pay the permit it allows the puppies to be
turned over to Animal Services without any fee required to turn them and the adult in at
the same time. It is something that will work with people but we have not done anything
in this community to make pet owners responsible which one of the largest issues that we
have with the pet population is the number of animals in our community that are not
spayed or neutered. This is not a quick fix we will put this in place and see a drop it is a
long term solution to a problem. I cannot tell you how many full blood animals end up in the
shelter fortunately Katrena has worked well with rescue groups and give her at a boy through her
pro work this year our euthanasia numbers has dropped down another 2% that may not sound
like a lot but that is 4% since the opening of the Animal Shelter I think we are making great
process.
Dr. Clark added from the veterinarian side Katrena is doing a great job he thanked her since no one
present is on the other side of the fence that we are appreciative this is so everybody else can know.
Katrena if you have a litter of puppies and you give them just to family and friends there are statistics that
show out of a littler of 10 that 6 of those puppies are going to be continuously impound and end up in a
shelter regardless how wonderful you think your family and friends are that statistics show it happens so
our goal is to keep that from happening and keep them out of the shelter. Euthanasia rate is at 62% this
past year 6 out of 10 dogs are euthanized.
Lou we are having to deal with a lot of the issues they are out there, it will take some extra man time we
have the Animal Control Officers it will be one more duty added to them and the shelter up front it will be
a lot more work but in the end hopefully see less animals in our community that are at large or unwanted
that is a very long term goal it is not something achieved short term in any numbers we will be able to
track but long term the best solution we have come up with p th so far. When they put those ads in the paper
we will do like we do with anything else we will see the ad in the paper go out educate them let them
know you have this animal for sale this is the permit you need to get and give them the opportunity to
come into compliance if they do not come into compliance then we will write then a tickets. We always
whether it is chaining, loose dog we give them the opportunity to come into compliance before we start
enforcement action.
Katrena already monitors craigslist, facebook, the trading post we receive complaints about the sites if
you cruise any the numbers of ads for free kittens, puppies, etc. is tremendous we get over 350 dogs and
cats every month. A large part of what Katrena does is social media spending time on those web site.
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Katrena does think there our good ethical responsible breeders in our community because we need them
to produce good, healthy, temperamental puppies and kittens they probably are not going to have a big
issue with it because they are doing the right thing it is the backyard breeders.
Lou none of these permits are in place this is brand new. All of the permits have an educational
component to them so when they come in to get the permit they will be required to go through an
educational course. There are several good courses that other cities use that we can use and the course
will be free that is part of their permit fee. Hopefully through doing that we can provide education to them
and hope they can understand why we are doing what we are doing.
Lou asked for a recommendation to go forward or not go forward with the ordinance.
Scott Plowman asked for a motion. Dr. Clark personally felt he was not ready to vote he would like to
review the ordinance. Scott Plowman asked if we could table it for the next meeting.
Lou replied you can, historically the December meeting has been moved into January but if you would
like to meet the first Friday in December instead of end of December we could do that. If you would like
to look over the Ordinance and meet December 6 the first Friday would be good. The ordinance will be
sent out to Council that will give them time to review and comment back to us.
Scott Plowman asked for a motion to table the ordinance. The motion was made by Dr. Hill and
seconded by Dr. Clark. Motion passed unanimously to table the ordinance until the next meeting.
V. NEXT MEETING DATE
December 6, 2013
VI. ADJOURN
Scott Plowman requested a motion to adjourn. The motion was made by Dr. Leach and
seconded by Dr. Hill the motion carried and the meeting was adjourned at 1:20 pm.
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Signature
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Print Name
David Carlston, Ph.D., Chair, Scott Plowman,Vice-Chair, or Kirk Harlow, Ph.D., Secretary
WFWC Public Health Board
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