“This has been the worst thing we’ve ever experienced,” said Schwartz’s wife, Ann-Marie Magne’, her voice cracking with emotion. “Our 26th anniversary is this month, and he’s going to be in the hospital.”

Officials with the Alachua County Health Department have confirmed that tickborne illnesses, including Ehrlichiosis (er-lick-ee-O-sis), Lyme disease and Rocky Mountain Spotted Fever, are on the rise this year, citing the early and warm spring as the possible cause for a boom in the tick population.

“For me, I’m seeing an increase, but I know to look for it,” said Dr. Kimberly Kaye, a physician with Haile Medical Group who specializes in tickborne illnesses. “I think that tickborne illnesses are under-recognized, so I think not many people are knowing to check for it.”

According to the Florida Department of Health, flu-like symptoms are similar for all three diseases, but Lyme disease often shows a “bull’s-eye” rash around the bite area three to 30 days after being bitten. if not treated, Lyme disease can spread to the joints, heart and nervous system.

With Rocky Mountain Spotted Fever, some patients get a rash on the arms, legs, hands and feet. Three percent to 5 percent of patients die from RMSF.

According to the CDC, symptoms of Ehrlichiosis include:

– Nausea / Vomiting / Diarrhea.

– Conjunctival injection (red eyes).

Rash (in up to 60 percent of children, less than 30 percent of adults).

The health department has four probable cases on record of Ehrlichiosis so far this year. There was one confirmed case and two probable cases in all of last year.

Experts agree that the weather could be the culprit in increased tick numbers.

“The early spring may be playing a role,” said Phillip Kaufman, a veterinary entomologist at the University of Florida.

Tick disease can be difficult to diagnosis definitively — blood work needs to be done, and it can take weeks to get results, Kaye said.

“Once you start looking and realizing how prevalent it is, you start associating it with symptoms I’ve seen for years,” Kaye said. “Things that you don’t understand fully or completely then make sense.”

Doctors are awaiting official word from the Centers for Disease Control and Prevention that Schwartz was infected with Ehrlichiosis, but he is responding to treatment for the disease. other antibiotics had not helped.

Magne’ said Schwartz was bitten by a tick around April 30, probably as he worked in their garden adjacent to San Felasco Hammock Preserve State Park. Within two weeks, he was running a fever of 103, his feet and ankles were swollen, and he was throwing up. Magne’ said it took doctors at North Florida Regional days to figure out what was wrong with Schwartz, ruling out first an infection and then lymphoma.

Kaufman, the entomologist, said the lone star tick is probably the culprit behind Schwartz’s Ehrlichiosis, as it matures in the spring and summer. the black-legged tick also carries Ehrlichiosis, but it matures in the fall. both feed on deer, which can carry the disease.

According to the Centers for Disease Control and Prevention, Ehrlichiosis was first recognized as a disease in the late 1980s. Cases have shot up from almost non-existent in the mid-1990s, when it was not required to be reported, to more than 1,000 cases in 2008, the last year for which data are available. nearly 4 percent of people who contracted the bacterial infection in 2003 died as a result — but fatality percentages are declining. may, June, July and August are the top months for contracting it.

North Florida Regional ICU nurse Evelyn Ormsbee, 60, was the one confirmed case last year. She was bitten by a tick in November and by Thanksgiving weekend had to check herself into the hospital after antibiotics had failed to bring down her high fever.

“The public needs to be aware of this so they can go to the doctor, because if they don’t, it could be devastating,” Ormsbee said. “It’s horrible — you can have brain damage, kidney failure, all kinds of horrible stuff.”

Ehrlichiosis is a serious illness that can be fatal if not treated correctly, even in previously healthy people, according to the CDC.

Schwartz has suffered from kidney and liver failure, along with disseminated intravascular coagulation, which leads to the formation of small blood clots inside the blood vessels throughout the body, disrupting normal coagulation and normal blood flow to the organs, and causing abnormal bleeding from the skin. Schwartz was on a ventilator for a week and continues with dialysis. while he is getting better nearly seven weeks after being bitten by a tick, Schwartz is still very sick.

According to the Florida Department of Health, there are no vaccines that prevent tickborne diseases. Avoiding tick bites is the best way to reduce the risk of becoming ill. Ticks live in moist and humid environments, particularly in or near wooded or grassy areas. You might come into contact with ticks during outdoor activities around your home or when walking through vegetation such as leaf litter or shrubs.

Kaufman said if you find a tick on you or are bitten by one, it takes hours — sometimes as much as 24 hours — before the pathogen is passed on to the host. Most people remove the bug before the disease is transmitted. in fact, Kaufman said, few people who are bitten fall ill.

Ormsbee and Kaufman said if you are bitten by a tick, you should put it in some alcohol and save it for 30 days. if you are symptom-free after that time, you can get rid of it. But if you develop symptoms, the tick should be taken to a doctor to determine what you might have because different ticks carry different pathogens.

Both Magne’ and Ormsbee urge that you call your doctor right away if you think you might have a tickborne disease.

“Our neighbor took a tick off her shirt last weekend,” Magne’ said. “It could happen anywhere.”

Contact Kimberly Moore Wilmoth at 374-5036 or .

In an effort to jump-start the electronic health record process, Sen. Dick Durbin announced that the Department of Health and Human Services had awarded $360,000 in funds to the Illinois Health Information Technology Regional Extension Center located at Northern Illinois University. to speed up the implementation process, Franklin Hospital’s Director of Information Technology, David Williams, said the hospital had been working toward the goal of electronic health records for the past six years. A lack of funding to bring the system to the state coupled with the cost of hardware and software to feed information to physicians regardless of the location of their patient continues to hamper the project. Williams said as work continues to digitize electronic health records, hospital staff are working to implement additional technology. “the hospital has a number of specialists who come on site to treat patients,” he said. “We have been working to create tele-health between the patient and the provider.” Williams said cameras connected to computers enable physicians to see a patient in one room while conversing with that patient from another room. “This is very reliable and will be better for our patients,” he said. as technology advances, Williams said the field of medicine advances. “Physicians used to be taught hands-on practices in medicine,” he said. “the physician had to touch a patient to determine symptoms but that is changing. Physicians are now being taught to use a computer monitor to interact with a patient. the physician may be in the next room or many miles away but the patient receives state of the art health care.” Williams said the nursing staff is accustomed to utilizing a different way of prescribing medicine. “They now enter information onto a computer instead of a paper chart,” he said. “This guides the physician on how to treat patients. the records follow the patient, meaning more accurate testing and eliminates the duplication of services.” Williams said the use of electronic health records means a patient would not undergo the same tests in different medical settings. “without that system in place, a patient may have the same tests in more than one medical facility. I may have tests ran in Franklin Hospital, for example, but be referred to another medical facility hundreds of miles away. the same tests could be performed in the other medical setting,” he said. Williams said the duplication of services means increased cost to the insurance provider and the patient who typically pays a portion of the cost. Durbin said the funding would help achieve President Obama’s goal of adopting a nationwide health information technology infrastructure. Hospital clinic manager Mike Budnick said the Health Information Technology for Economic and Clinical Health Act authorized incentive payments through Medicare and Medicaid to clinicians and hospitals when they use electronic health records. “HITECH’s goal is not only to adopt the use of these records but to tie payments specifically to the advancement of health care processes and outcomes,” he said. “HITECH calls on the secretary of health and human services to develop meaningful use objectives. “the meaningful use objectives range from recording patient demographics to vital signs and chart changes,” Budnick said. “the system enables physicians to monitor medications and drug interactions while protecting patient privacy.” Williams said the hospital has implemented life-saving programs including Heart STAT and Stroke STAT. “if a patient is suffering a heart attack, the hospital staff is prepared to monitor the patient and make arrangements to transport that patient to a cath lab setting,” he said. “the same is true if a patient is suffering symptoms of a stroke. “Stroke symptoms are often difficult to detect,” Williams said. “While a patient may think he or she is suffering a stroke, it may be a case of indigestion. We have a program in place to monitor the patient and prevent an unnecessary trip to a different medical facility, should the patient’s symptoms be indigestion instead of a stroke. In either case, seconds count and our team is trained to respond.” Business development manager Dennis O’Connor said the hospital is working with the Illinois Health Information Technology Regional Extension Center in Sauget. “This group is working through Northern Illinois University and covers the southern portion of the state,” he said. “the Extension Center is receiving the grant, not the hospital directly. “the funding will offset the costs of providing the service to the hospitals as they evaluate where the hospital is in the electronic health record conversion process and what is needed to reach meaningful use.”

On the heels of increased flu reports in Indiana, cases of the illness are under-reported on campus and in Vigo County.

the CDC currently lists Indiana as one of 30 states in which cases of the flu have been widespread. In the month of January, the Indiana Department of Health reported over 900 documented cases of the flu.

Dr. Kenneth Spicklemire, one of the physicians at the health center, said that students who present symptoms of the flu often stay in their rooms and wait it out or don’t know that they have the flu at all. Even so, more than 40 students have been diagnosed at the health center with the flu, which he says is a very significant number.

“In the last three weeks, we’ve gotten five to 10 cases a day,” he said. “The numbers are variable from day to day, but that is still a significant number.”

Spicklemire said that flu prevention is fairly simple and boils down to “good hygiene and good sense.” the CDC advises people to use tissues when coughing and sneezing, avoid touching their eyes, nose, and mouth, and to wash their hands frequently. it also suggests that people get a flu vaccination if they can.

Flu shots are still available on campus at the Student Health Center. the immunization does take two weeks to “kick in,” Spicklemire said, because the antibodies that resist the influenza virus need to build up in the body, so getting the vaccination after you think you already have the flu isn’t going to help.

if you already have the flu, however, there are a few things that you can do.

“We can give students Tamiflu,” Spicklemire said. “We have enough for people who need it, and it’s only 20 dollars. It’s only proven to be effective, though, if administered during the first 48 hours. after that, we just have to treat the symptoms.”

Spicklemire said he has not yet advised any students with the flu not to go to class. He does urge them to take care not to cough or sneeze on people and to maintain a regimen of common sense and good hygiene.

Some cases of the flu may require a student to stay in their room or apartment, though. For students who are too sick to care for themselves or do not have a roommate who is able or willing to help take care of them, Spicklemire suggests that they do have someone come pick them up to take them home.

if you think you may have the flu, go to the Student Health Center. 

“It’s better to come in when you start presenting symptoms than to wait three days before you go to see a doctor,” Spicklemire said.

State and federal health authorities urged doctors and patients on Friday to make greater use of a booster vaccine for pertussis because of a high rate of the coughing disease in Minnesota and other parts of the country.

Pertussis, also called whooping cough, is rarely fatal but can be quite serious, especially in infants.

In Minnesota, more than 1,000 cases a year have been reported since 2008.

The disease tends to peak in the population every three to four years, but lately, "what we’ve seen is that those peaks are like an escalating roller coaster," said Kristen Ehresmann, who heads the vaccine program at the state Department of Health. Peaks are higher and last longer, and the valleys between them are not as low, she said.

"Our [per capita] rates are about as high as you’d see in California," where pertussis killed 10 infants last year, she said.

Minnesota has had no deaths from the disease in the past three years, Ehresmann said, and in general, patients are hospitalized in about 2 percent of reported cases.

The first symptoms of pertussis resemble those of a cold: sneezing, a runny nose and a cough. after one or two weeks, the cough worsens, coming in uncontrollable bursts, often accompanied by a high-pitched whooping sound.

A booster vaccine has been recommended for children entering 7th grade and adults who need a tetanus booster, but health authorities suspect that it’s not as widely used as it should be.

The booster, called Tdap (tetanus-diphtheria-acellular-pertussis), was introduced in 2005 after health officials learned that the effectiveness of a primary vaccine series, usually given to children under 7, wears off as kids reach their teens.

New recommendations issued Friday by the federal Centers for Disease Control and Prevention (CDC) say that:

• Adults and teens may get the Tdap vaccine regardless of when they last got a tetanus-diphtheria shot.

• Tdap may be given to children ages 7-10 who have not received or completed a primary series of vaccinations against tetanus, diphtheria and pertussis.

• Seniors who work with young children should get Tdap.

Health authorities said patients should ask for the shot, if needed, at their next clinic visit.

For more information about pertussis, go to health.state.mn.us/divs/idepc/diseases/pertussis.

Sarah Lemagie • 952-882-9016

MYFOXNY.COM – Parishioners and other faithful who received Holy Communion during Christmas mass at a church on Long Island may have been exposed to hepatitis A, according to the Nassau County Department of Health.

Health officials urged anyone who received Communion at the 10:30 am and 12 p.m. masses on December 25, 2010, at Our Lady of Lourdes Church at Massapequa Park to get vaccinated as soon as possible.

The Nassau Health Department is offering immune globulin or hepatitis A vaccine to those potentially exposed to hepatitis A, officials said.

Officials did not offer details on the source of the potential contamination, but said that the hepatitis A virus can be spread by consuming food or drink that has been handled by an infected person.

Just sitting in the church during mass would not put churchgoers at risk, officials said.

The symptoms usually appear within 28 days of exposure, with a range of 15 to 50 days, Nassau health officials said.

Symptoms include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored bowel movements, joint pain, and jaundice, the CDC says. some patients exhibit no symptoms at all.

Once symptoms appear, no medication can be used to treat a patient; bed rest is usually all that is needed, health officials said.

Hepatitis A is a liver disease caused by the hepatitis A virus, according to the Centers for Disease Control and Prevention. it is what is called a “self-limiting disease,” which doesn’t become a chronic infection or chronic liver disease, according to the CDC website.

For more information on the potential hepatitis A exposure at Our Lady of Lourdes Church, you can contact the Nassau County Department of Health at 516-227-9496.

The Nassau County Health Department is offering immune globulin or the Hep A vaccine for those who may have been exposed to the virus at Our Lady of Lourdes Church auditorium, 855 Carmans Road, Massapequa Park, N.Y.

Tuesday, January 4, 2011 – 3 pm to 8 pm Wednesday, January 5, 2011 – 9 am to 3 pm

• NASSAU HEALTH DEPARTMENT
• CDC

The state health department released its first draft of medical-marijuana rules late Thursday, providing a glimpse at how the program may work in Arizona.

The rules spell out who may qualify for medical marijuana, establish operating criteria for dispensaries and provide strict guidelines for doctors who may recommend marijuana.

Read the draft rules Send your opinion on rules to the state

The release kicks off a three-week public-comment period, but the Arizona Department of Health Services will have final say on how to implement a medical-marijuana program in the state.

In November, voters passed Proposition 203, which will allow qualifying patients with certain debilitating medical conditions to receive up to 2?1/2 ounces of marijuana every two weeks from dispensaries or cultivate up to 12 marijuana plants if they live 25 miles or farther from a dispensary.

The state health department must finish drafting the rules by April 13. The agency will then review applications from people who want to use medical marijuana or operate a dispensary. The program should be fully functioning by summer 2011, when dispensaries have had time to grow the plants.

ADHS Director Will Humble said the department had two goals: Make the rules strict enough to prohibit people who don’t have serious medical conditions from abusing the system without impeding patients’ access to marijuana, and ensure that medical experts are deeply involved in the process of patients obtaining and using marijuana.

“I’m taking this seriously that this is the medical-marijuana act, not the recreational-marijuana act,” Humble said.

The rules cover everything from the definition of “current photograph” for identification cards to the number of hand-washing sinks a dispensary must have.

ADHS officials spent the past four weeks writing the 47-page draft, which is available on the department’s website.

Staffers researched other states’ medical-marijuana rules and reviewed rules for other state programs.

But because the medical-marijuana program is unlike any other existing program, officials used their creativity and their personal experience of crafting other state protocol, said Tom Salow, acting manager of administrative counsel and rules at ADHS.

Doctor involvement

According to Prop. 203, qualified patients or their designated caregivers could get a doctor’s recommendation to receive medical marijuana.

Doctors must certify in writing that their patient likely will benefit from using marijuana as a medicine to treat his or her debilitating disease. these conditions include cancer, HIV/AIDS, hepatitis C and multiple sclerosis.

Marijuana is not a federally-approved medicine. But department officials drafted rules so that doctors would oversee the program and be held accountable for patients’ access to marijuana, Humble said.

Here are some key proposals related to physician involvement in the program:

-?Requires a medical director.

ADHS wants all dispensaries to hire a medical director who will be on-call or on-site at the facility.

Medical directors would make sure patients or their caregivers document changes in their symptoms and track their marijuana usage. They also would ensure dispensaries provide educational materials, such as how to administer marijuana safely, signs of substance abuse or dependency, and possible side effects.

Medical directors would not be allowed to write medical-marijuana recommendations for patients.

-?Defines physician-patient relationship.

The department wants to require doctors to have an ongoing physician-patient relationship before they recommend marijuana.

That means the patient would need to have seen the doctor for at least one year and had at least four visits for the debilitating condition, or the doctor assumes primary responsibility for managing the patient’s debilitating condition and for providing routine care.

-?Specifies “severe and chronic pain.”

Medical-marijuana opponents have expressed concern that Prop. 203 lists “severe and chronic pain” as a symptom that would qualify a patient to receive medical-marijuana recommendations.

The department’s proposal specifies the patient must have severe and chronic pain as a result of a chronic or debilitating disease or its treatment.

-?Holds physicians accountable.

Physicians will be the “gatekeepers” of Arizona’s medical-marijuana program, Humble said. The department wants physicians to thoroughly assess the risks and benefits of their patient’s marijuana use and make sure only patients who truly need marijuana for medical use have access to it.

The department’s proposal does not require doctors to provide proof, such as MRIs and X-rays to prove chronic pain, in addition to their medical-marijuana recommendations. this means the rules “put the onus on the physician to practice ethical procedures,” said Laura Nelson, ADHS chief medical officer.

Regulating system

Even before Election Day, entrepreneurs looking to cash in on the state’s medical-marijuana industry had been preparing to open non-profit dispensaries.

Prop. 203 caps the number of dispensaries in the state: only one dispensary is allowed for every 10 pharmacies.

The department’s rules do not specify how it will review and approve dispensary applications, but officials expect to decide on a process by the time they begin accepting applications.

The rules are designed to provide oversight on dispensaries. Requirements include:

-?The department will require an electronic security system that consists of panic buttons and video surveillance that ADHS can access and monitor at any time.

-?Dispensary applicants must provide a slew of documents and records, including security policies; floor plans drawn to scale locating each hand-washing sink, panic button and video camera; a business plan that details the dispensary’s ongoing viability; and even whether a dispensary board member has any unpaid court-ordered child support.

-?A dispensary must grow at least 70 percent of the marijuana it provides patients. It may not acquire from or sell to other dispensaries more than 30 percent of its marijuana.

-?Dispensaries also must follow specific guidelines for inventory control. a dispensary agent must document at the beginning and end of each day how much marijuana the dispensary acquires, harvests, sells, disposes of and disburses. Among other requirements, the agent must specify the date and method of disposal, date and amount of harvested pot, and the estimated amount of marijuana infused in edible products.

Looking forward

The public-comment period ends Jan. 7. The department will release a new draft of the rules Jan. 31 and hold public meetings mid-February.

Prop. 203 requires the department to develop an electronic data and verification system to keep track of patient and dispensary information. Law-enforcement and dispensary agents must be able to access this system at any time.

The department will focus on developing this system starting next week.

Salow said he hopes a wide variety of people submit their opinions, especially those who opposed Prop. 203. he said department officials will read and review every comment.

Humble said he is open to changing any part of the initial draft, as long as the suggestion fits under the department’s goals for the program.

“We’re not going to change our goal, period, no matter what anyone comments. Our overall goal is to make this a medical-marijuana law. so whatever comments that we get in have to fit within that framework,” Humble said.

Precautionary signs permanently posted at a hospital in Hong Kong, a city at the forefront of 2003 SARS epidemic. STORY HIGHLIGHTS

• Health officials urge the public to take precautions
• A woman was hospitalized in serious condition after a trip to mainland China
• Her illness was diagnosed as influenza a (H5), a variant of bird flu
• Hong Kong health officials have stepped up surveillance

Hong Kong, China (CNN) — the first human case of bird flu in seven years has been diagnosed in Hong Kong, health officials said Thursday, urging the public to take precautions.

A 59-year-old woman was hospitalized in serious condition after a trip to mainland China, the Hong Kong Department of Health said.

Her illness was diagnosed as influenza a (H5), a variant of bird flu. it was unclear where she had contracted the disease. she did not have any contact with live poultry and did not visit farms while in China, Hong Kong health officials said.

Her 60-year-old husband developed possible symptoms of bird flu, but has recovered.

Hong Kong health officials have stepped up surveillance by testing patients with severe pneumonia for bird flu. they also have launched a hotline to answer questions from the public, and are working with health officials in mainland China to monitor any occurrences.

2009: Bird flu deaths in China 2005: Bird flu lessons

Avian influenza does not normally infect species other than birds and pigs. but humans came down with bird flu in Hong Kong in 1997, with the H5N1 strain infecting 18 humans, six of whom died.

Then, people became infected after coming into close contact with live infected poultry. Genetic studies showed the virus had jumped from birds to humans, and caused severe illness with high mortality.

Hong Kong’s entire poultry population, estimated at 1.5 million birds, was destroyed within three days. That is thought to have averted a pandemic.

When humans came down with H5N1 bird flu in Hong Kong in 1997, patients developed symptoms of fever, sore throat, cough and, in several of the fatal cases, severe respiratory distress secondary to viral pneumonia.

Antiviral drugs can be used to treat and prevent bird flu in humans, but it can take months to develop a vaccine in significant quantities for a new virus subtype, according to the World Health Organization.

All birds are thought to be susceptible to the avian influenza, though some species, such as wild ducks, are more resistant than others. Domesticated poultry, such as chickens or turkeys, are particularly susceptible.

Infection triggers a wide spectrum of symptoms in birds, ranging from mild illness to a highly contagious and rapidly fatal disease resulting in epidemics. in severe cases, the flu is characterized by a sudden onset of severe illness, and rapid death, with a mortality that can approach 100 percent.