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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 2 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 P 9 9 Y 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 3 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 4 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. 5 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. • Signature • Print Name David Carlston, Ph.D., Chair, Scott Plowman,Vice-Chair, or Kirk Harlow, Ph.D., Secretary WFWC Public Health Board Title 6