Environmental Health is concerned with protecting the public’s health and preventing disease, primarily through the regulation of those public facilities which can adversely affect the public by improper safety and hygienic practices. In Yavapai County, some of the establishments we regulate include restaurants, bars and certain food processors; public and semipublic swimming pools; hotels and motels; and school grounds. Additionally, we respond to situations involving mosquitoes, rodents and other animals which may be capable of spreading disease. Historically, Environmental Health is the oldest component of the public health movement and continues to be part of the county’s efforts building and maintaining healthier communities.
Yavapai County is served by a staff at locations in Prescott, Prescott Valley and Cottonwood. Click Here to view the appropriate contacts and staff for your area.
Most of the laws and codes Environmental Health enforces were written at the state level. It was long ago recognized that many health functions, such as inspecting restaurants, could be best done at the local level. Therefore, the state health department transfers many of its powers to us by entering into a delegation agreement with the Yavapai County Board of Supervisors. Some programs, such as food worker training, not specifically stipulated in the state health code, are the result of county ordinance.
In keeping with the wishes of the County administration, Environmental Health receives almost all of its funding from the fees we charge.
The fees we charge vary considerably and depend upon the type and size of the establishment. The exact fees for an establishment can be obtained by speaking with one of our employees. Our fees are designed to cover the costs of performing a given service and must include employee time in performing inspections, traveling and performing administrative tasks such as filing. Additionally, our fees must reflect other costs such as supplies, vehicles and office space. We periodically perform studies to determine how much time our employees spend working in different programs. These time studies as well as other considerations such as increases in employee and equipment costs are used to recommend new fees designed to more fairly and accurately reflect the cost of performing our services. The new fees are put into place by a vote of the Yavapai County Board of Supervisors. (See Environmental Health Fee Schedule)
Health inspectors must possess a credential as a Registered Sanitarian. Sanitarians are registered by the Arizona Department of Health Services. They can be contacted for more information at 602-364-3855. Registered Sanitarian candidates must have a significant background in college level sciences and then have to pass a comprehensive written examination. County job vacancies are posted in local newspapers and county buildings, and on-line.
No. Water and wastewater regulation (including septic tanks) is performed by Yavapai County Development Services – Environmental Unit. They issue septic permits, perform septic inspections and respond to citizen complaints about water and wastewater problems. They have all the county records on septic systems and are who to call if you want to know where your septic tank is located.
Call Yavapai County Community Health Services/Environmental Health. Inspectors are generally out of the office doing field work during the middle part of the day. The best time to try to contact an Inspector is early in the morning (8:00 to 9:00 am) or later in the afternoon (4:00 to 5:00 pm).
We do not have authority to perform any activities on Indian land. This includes Frontier Village in Prescott, which is administered by the Yavapai Prescott Tribe (928-445-8790 ext. 123), and Cliff Castle in Camp Verde, which is under the jurisdiction of the Indian Health Service (602-364-5039). Additionally, some program areas such as college and prison food service are not delegated to the county. Inquiries on these establishments can be directed to the Arizona Department of Health Services at 602-364-3131.
Food Handling - Training and Certification
A Food Worker Card is issued by the county to a food worker. It is documentation of the fact that the worker has received special training in basic food safety and has authorization to work with food in our county. Every employee who handles food or food-contact equipment is required to get one. This includes virtually every employee in a restaurant or bar with the possible exception of hostesses and bookkeepers provided they never handle food or utensils. Food Worker Cards are required by Yavapai County Ordinance as a way of ensuring that the people who serve food have a basic understanding of food safety and their role in keeping food safe and wholesome.
The Food Worker Card is offered for 2 different terms:
This fee is waived for persons whose contact with food is exclusively limited to performing volunteer work for a charitable organization.
We will honor cards from Coconino and Maricopa Counties in Arizona as well as Clark County, Nevada. However, the card must be transferred to Yavapai County. This can be done if the card is still valid. The Yavapai County Food Worker card will be issued for the original term of the card or not more than 2 years from the original issue date. A fee of $5.00 must be paid to Yavapai County for the transfer.
The Yavapai County Health Code, which was adopted in Arizona in 2004, requires that every food establishment has at least one person who has obtained more extensive training in food safety. While the county does not offer this more advanced training, it is readily available through a number of private sources. Yavapai County Community Health Services will recognize any certificate from a test approved by the Conference for Food Protection.
Manager Certification is a much longer course of study than the one-hour Food Worker class. It involves greater depth and detail. Individuals who successfully complete the Manager Certification should be better equipped to successfully supervise a food service facility.
Food Service Reviews
If you are taking over an existing licensed establishment, you simply need to contact your Inspector and arrange for an opening inspection and new license application. If you are planning on performing a remodel of the existing business, you need to call your Inspector and discuss the project. If the remodel is significant, it may be necessary for you to file a plan review application. This is something for your Inspector to determine after consulting with you. If the establishment has been closed for a significant period of time (more than 30 days) or if you plan on starting an entirely new business in a facility which did not have that use before, you will need to do a plan review application. The plan review process involves providing Community Health Services with a set of plans, particularly the equipment layout, along with an application that details your menu and the nature of your operation. The Inspector reviews the application and determines if the proposal is in compliance with the Health Codes. If so, an Approval to Construct is issued and the applicant is notified by mail. If there are problems with the plans, the Inspector will be in contact with the applicant to work out a solution. Once the Approval to Construct is granted, and other necessary approvals from other agencies such as the Building Permit have been obtained, the applicant is authorized to proceed. We typically perform at least one interim construction visit when one of our inspectors is in that area. When the owner/applicant is ready to open for business, he or she should call our office about 3 working days before and we will arrange to meet with the owners at the business, perform an opening inspection and take care of all the paperwork for the operating license. A Construction Guide booklet is available from our offices and it offers a great deal of information about what is required and how the process works.
Yes. The plan review process is designed to evaluate your operation and its facility needs. If you are offering an extensive menu with a great deal of food processing, your equipment needs will be greater. If your operation is going to be limited, the equipment needs will be much reduced. The Construction Guide offers assistance in determining what your equipment needs will be. Additionally, if you have any questions they can be answered by contacting the Inspector who handles your district (contact Environmental Services).
This is a tough question because each establishment needs to be individually evaluated based upon the amount of food served and the types of food preparation processes involved. In general, though, the absolute minimum equipment needed for any food or beverage establishment is a hand wash sink in each work station, a three-compartment sink indirectly drained into a floor sink, a mop sink, sufficient hot and cold equipment for the operation, and all surfaces such as walls and ceiling need to be made of a smooth, durable, easily cleanable, light-colored material. Floors need to be smooth, easily cleanable and non-absorbent. If produce is to be washed or other food is to be prepared in a sink, then a separate food sink is needed and this also needs to be indirectly drained into a floor sink. The three-compartment sink is reserved for dishwashing and each compartment needs to be large enough to accommodate the biggest piece of equipment that will be washed.
All of our licenses are only valid for the original applicant. When any establishment changes hands, the new owner must obtain a new operating license. If there is no change in the facility or the nature of the business, the new owner needs to call our office and arrange for an inspection and paperwork application review. If the new owner plans on expanding the operation or remodeling, he should contact us as soon as possible to discuss what needs to be done. It may be necessary to file plans for review on the intended changes. No one should take over an existing establishment without first contacting our department and obtaining a valid operating license.
The Health Codes prohibit vending of foods unless made in a licensed commercial kitchen facility. It is not lawful to sell foods made in a home kitchen. We cannot issue licenses for home kitchens even if an attempt is made to bring them up to commercial standards because the Health Codes call for a complete separation of living quarters from commercial kitchens. A home kitchen cannot be considered suitable for commercial food preparation because it is typically not possible to segregate the kitchen from children, pets and other extraneous people or things. If you wish to get a license to make and sell an item such as salsa, you should call one of our Inspectors to obtain guidance. One option worth considering is to get a written commissary agreement with a Community Health Services Licensed Facility giving you the right to use their kitchen for your operation.
Potlucks in private homes, churches and offices are not regulated by Community Health Services. Information on proper handling of food at private potlucks can be obtained from the Arizona Cooperative Extension Service in Prescott. Any food service which is open to the general public falls under our regulations. Because Health Codes prohibit serving food to the public which is not produced in a licensed commercial kitchen, the use of homemade foods at a potluck held in a public facility is not allowed.
Bake sales are allowed and do not require Community Health Services notification provided that no potentially hazardous foods are sold. This means that most cakes, cookies, breads and fruit pies are OK. Items like cheesecake and cream pies are not. As for dinners, the event organizer should call our office and speak to an inspector to make arrangements. The degree of Community Health Services involvement will depend upon the type of food proposed and the duration of the event. Organizations wanting to do fundraising dinners on a routine basis will need to work out of a commercial kitchen and obtain an operating permit. One other option might be to contract with a licensed commercial caterer to provide food for your event.
Once you have received your letter informing you of the Approval to Construct, you are free to begin construction. If you have any questions or would like an interim inspection, you may call our office and we will be glad to help. We generally like to perform at least one construction inspection for every newly built facility. When your facility is built and the equipment is all in place, you should call our office about 3 working days prior to your opening date to arrange a meeting with your Inspector. At that time, we will perform an “opening” inspection and work with the owner to complete all application paperwork. If the owner or manager has not yet completed a Food Safety Plan, it must be completed, submitted, and approved before approval to operate will be given.
Food served at concerts, festivals, fairs and the like come under our regulation. If you are organizing such an event or wish to serve food there, you should contact your Inspector to discuss your plans and what will be required. For short events (under 4 hours duration including set-up and take-down) with limited food service (hot dogs, burgers, etc.), a special event permit is necessary but a fee may not be required.
For longer events and those with more extensive food service, a Special Event permit is required. We have a Special Event Coordinator Application for the event organizer to complete which requires information about the event and its participants. We also have a Special Event Vendor Application for each individual vendor to describe their menu and operation. All of these applications must be completed and turned in to Community Health Services and approved prior to the event. If vendor applications are not received 48 hours prior to the start of the event, a late fee will be assessed (Fee Schedule). These application packets may be obtained by calling one of our offices.
If you want to operate your mobile food unit at a single event in our county, you can submit a one-time Special Event Vendor Application. The application requires you to describe your menu, facility and operations. If you wish to operate in Yavapai County on a more routine basis, you may obtain an annual operating license with us. This first requires you to file a set of plans with a Plan Review Application and fee, which we must review and approve to make sure your facility meets the minimum requirements of the Food Code.
If you are going to be building the mobile unit yourself, you must have our approval on the plans before you begin. If your mobile is a commercially manufactured model, you will still need to provide plans for review; however, you can simply provide us with the manufacturer’s plans. Once the plan review has been done and construction approval granted, the process works the same as with any other licensed facility. When the construction is done or the mobile has been purchased, one of our Inspectors needs to physically examine the unit and make sure it meets the codes and then operating license paperwork must be completed. All MFUs must operate from an approved commissary in Yavapai County.
Food Service Inspection
To ensure that minimum health and safety standards are met. Also, being in food establishments on a regular basis gives our staff opportunities to offer suggestions for improving safety and operating efficiency. We look upon each inspection not only as a regulatory tool but also to open dialogue and increase understanding and communication. We feel very strongly that our role in inspecting isn’t simply to find problems and demand correction. It is equally important to identify areas in which operators are doing quality work and to provide positive feedback and encouragement.
The short answer is, “All sorts of things.” The Food Code is quite extensive and covers everything from food handling practices to the quality of the food itself to the condition of the physical premises. Under the Food Code, we focus on those situations which have a direct bearing upon food safety. Examples of our highest priorities include food temperatures, hand washing and proper use of chemicals including sanitizers. Cleanliness of food contact surfaces such as cutting boards is considered very important. Cleanliness of the floors and walls is of less importance since these surfaces do not come into direct contact with food and are far less likely to contribute to a foodborne illness.
Each food service establishment is given a rating based upon its menu, extent of food handling and overall food safety risk. Based upon the potential risk, each establishment is given from 2 to 3 routine inspections per year. For example, a large restaurant that prepares a variety of foods using complicated recipes might be inspected 3 or even 4 times per year while a convenience store that only serves hot dogs might only see an inspection twice a year. More frequent inspections are done for new establishments, when complaints are received or when an operation has had a history of unsatisfactory inspection reports.
Inspections are considered a form of sampling. We cannot be in all restaurants at all times so we conduct inspections to take a sort of “snapshot” of the restaurant operation. By examining this snapshot, we are able to draw conclusions about the way the restaurant is operated on a daily basis. For example, if employees are not washing their hands during our inspection, it is reasonable to conclude that adequate hand washing is not routinely done. One of the things that make inspecting a challenge is trying to discern what is a one-time occurrence from what is a routine problem. Because our time in each restaurant is limited, the ultimate responsibility for food safety rests squarely with each restaurant’s management team.
When we perform scheduled inspections, people tend to have the place “spiffed up” and display their best behavior. Because of this, scheduled inspections don’t tend to give us a good feel for the way a restaurant operates on a routine basis. One of our most effective regulatory tools, other than education, is the notion that we could show up at any time. This encourages employees to be doing their best all the time.
A violation is documented on the inspection form and it is brought to the attention of the owner or manager. If the violation is minor, the Inspector will give the owner a reasonable time frame for correction, usually no more than 90 days. If the violation is serious and might potentially contribute to a foodborne illness, then an escalated schedule of responses is put into place. The first and best response is for the restaurant management to correct the problem right then and there. If this happens, the Inspector will mark the item as corrected on the inspection report. If more time is needed, the Inspector will give anywhere from 1 to 10 days for correction, depending upon the nature of the violation, and perform a follow-up inspection to determine compliance. If the reinspection is good, the establishment is placed back on a regular inspection schedule. If the problem was not corrected, a second follow-up inspection is scheduled and a Program Compliance Reinspection fee is charged to the license holder (Fee Schedule). All subsequent follow-up inspections are billed the reinspection fee as well. Restaurant operators who are not able to achieve compliance through the reinspection process are referred to the Environmental Health Unit Manager for further administrative action that may lead to license revocation. Restaurants that experience repeated violations over an extended period of time may also be subject to such action.
Different foods tend to be susceptible to different kinds of bacteria and require different procedures. For example, chicken and other poultry products are at a higher risk of carrying Salmonella and Campylobacter than other foods. Ground meats are associated with higher risk of transmitting E. coli O157:H7 infections. Therefore, these products have higher cooking temperatures.
Here is a quick guide to some of the more important cooking temperatures:
In addition to these cooking temperatures, there are a few other important temperatures to remember.
The Food Code allows most establishments to decide for itself whether to do this. Many restaurant owners and managers have made a decision to simply refuse all such requests and to only serve meats which have been cooked thoroughly (to “medium well” or better). Other food establishments that wish to honor their customers’ requests may do so only if they post a disclaimer statement on the menus or at the tables advising customers that consumption of undercooked foods increases their chances of contracting a foodborne illness. If this disclaimer statement is posted and customers order undercooked food, they do so at their own risk and assume liability for it.
The new Food Code emphasizes safe food handling practices and places less concern on the restaurant’s physical facility. Most food establishments are required to employ at least one person who has obtained special certification and this “certified” manager is expected to oversee and be responsible for the safety of food. New establishments (those opened in 2001 or later) must develop and use a written Food Safety Plan. This generally involves the use of established procedures for safe food handling and keeping temperature charts on all critical pieces of equipment. The temperature for cold holding has been reduced from 45 to 41 degrees. Cooling of foods must now be achieved more rapidly during the first 2 hours of a 6 hour period. Direct bare hand contact with ready to eat foods (those not receiving additional cooking) is now prohibited. All repackaged and prepared foods held more than 1 day must be labeled as to contents and the date made. The new Food Code also established the use of the consumer advisory language advising patrons of the risks of consuming undercooked foods.
We found that ratings could be misleading. For example, an establishment operating with good food handling practices in an older building could rack up enough minor facility deductions to score in the 80’s (grade “B”) yet be a very safe bet for dining. Another establishment could have had many foods at bad temperatures and this would have only cost them 5 points for an acceptable sounding score of 95 (in the grade “A” range).
Regardless of the method used, cooling must be done as quickly as possible. The first stage of cooling, from 130 down to 70 degrees or less must be achieved within the first two hours. The second step, from 70 degrees to 41 degrees or less must be completed within 4 additional hours. There are a variety of cooling methods which, when used properly, can effectively cool foods within the prescribed time. These methods include ice baths and chilling devices which are frozen and then inserted into the food. When simple refrigeration is used for cooling, the food must be transferred to shallow containers (preferably metal) and placed uncovered in the refrigerator with lots of air circulation available around the container. The depth of the food should never be greater than 3 inches. Thick foods such as refried beans or mashed potatoes may need to be placed into containers to a depth of only 1 or 2 inches. Once the food has cooled, you should place a cover and date label on it. Hot foods should never be placed at room temperature “to get the steam off” for more than a few minutes before going into a proper cooling procedure. Cooling should always be done in commercial equipment which has sufficient cooling capacity, never in home-style or beverage refrigerators.
Never on a counter at room temperature and never in warm or standing water. The best way to safely thaw frozen foods is to place them in a refrigerator. This generally requires a little advance planning. When a quicker thawing process is needed, it can safely be done by placing the food item into a clean container and allowing cold water to continually run over it with proper drainage for the overflow. Finally, foods can be thawed as part of a cooking procedure, using a microwave oven or stovetop, if the product goes from frozen to fully-cooked in one continuous process.
Hotel and Motel Inspections
Proper cleanliness and sanitary practices in hotels and motels are important in preventing disease and parasites from being spread. By licensing and inspecting hotels and motels, Community Health Services monitors these facilities for safe operation and cleanliness.
Overall cleanliness and soundness of construction, proper laundering of bed and bath linens, proper washing of cups and glasses, the absence of insects and rodents, and proper handling of trash.
At least one regular inspection is done each year. Additional inspections may be performed throughout the year in response to complaints from the public.
The construction of a hotel or motel must be evaluated by the City or County Building Department for conformance to Building Codes. A plan review must also be performed by Community Health Services to determine compliance with the Health Codes. Once a plan review is done, approval to construct is granted and the construction is completed, an inspection with our department is arranged and, if the construction is approved, an application for an operating license is submitted.
Swimming Pool Inspections
Community Health Services is required to inspect public and semipublic pools and to ensure they are safe to use. Public pools are those operated by cities and towns for the community’s use. Semipublic pools are those operated by health clubs, hotels, apartment complexes and the like which are available to a select segment of the public.
Checking the chemistry of the pool’s water is very important. The pH level must be between 7.2 to 7.8. The disinfectant level (chlorine, typically) must be between 1 and 3 parts per million (PPM) for pools and between 3 and 5 PPM for spas. If the chlorine level is not high enough, bacterial and algal growth can occur. If the pH is too high (8.0 or above), then the chlorine is prevented from properly doing its job. We also look at the temperature in the spa. It must not exceed 104 °F. Temperatures hotter than 104 °F can potentially cause health problems. We also examine the cleanliness and physical condition of the pool. We look for safety equipment such as the ring buoy and gates, which should always be self-closing and self latching.
Public pools are inspected once per month during their active season. Semi-public pools which are open year round are inspected every 2 months. Semi-public pools that are open seasonally are inspected every 2 months during the time they are open.
All proposed public and semipublic swimming pools must undergo plan review. In Yavapai County, this is the Environmental Unit of the Development Services Department. Once Development Services has issued an approval, and construction is completed, the applicant should call Development Services and Community Health Services-Environmental Health Unit. Both agencies need to be present to conduct construction evaluations and to assist with the license application paperwork.
Yavapai County does not have a swimming pool operator certification program and no certificate is required. However, we encourage pool operators to obtain as much training/certification as they can from private sources.
Other Health Inspections
General cleanliness and soundness of construction of drinking fountains, classrooms and/or sleeping quarters, locker rooms and rest rooms, proper use of cleaning and sanitizing compounds, safety of grounds and play equipment, adequate ventilation, and insect and rodent infestation.
Public Health Complaints
Anyone may file a complaint by simply calling the Environmental Health Unit of Community Health Services and informing us of the details. The complaint should involve a violation of the Health Codes. We sometimes get complaints about a restaurant’s prices or slow service but these are not public health issues and should be taken up with the establishment’s management.
An Inspector will generally visit the business and conduct an investigation. Depending on the alleged situation, this may be done anywhere from 1 to 30 days after the complaint call is received. If the complaint is determined to be valid, a corrective course of action will be required.
Contact Environmental Health. One of our most basic goals is to prevent foodborne illnesses. If there is reason to believe that a foodborne illness has occurred we want to know. We will ask the caller a number of questions such as what they ate, when they ate, when they became ill and whether anyone else they dined with become ill. We will promptly respond and take corrective action if we find problems in the restaurant. The reason we ask such detailed questions of the complainant is to gather information to help us with our investigation. Very often a person will want to blame the restaurant they ate at only an hour before their symptoms began. It is extremely unlikely this restaurant was the culprit because most foodborne illnesses require at least four hours to develop in the body before they start causing symptoms. The incubation period can be as much as 48 hours or longer. By taking a detailed history of foods eaten the few days prior to the illness, we can identify other possible sources of the infection. About one-half of all foodborne illnesses in this country originate in the home. Important Note: Foodborne illnesses can become serious, especially for the very young, the elderly and the immune compromised. We therefore strongly recommend that people in those groups or anyone in the general community seek prompt medical care if their condition becomes serious or lasts an unusually long time.
The answer is somewhat complicated and depends upon where the animal is located. Dead animals on private property are the responsibility of the property owner. When a dead animal is on a government-maintained road or road easement, the agency responsible for that road can be called. Numbered highways such as I-17 and 89A are administered by the Arizona Department of Transportation (ADOT). Dead animals on county roads can be removed by calling Yavapai County Public Works in Prescott at 928-771-3430. If the animal is on a city or town road, you may call your city hall or local animal control for a response. Community Health Services does not have the means to collect and dispose of dead animals.
The first line of action in such situations should be to file a complaint with your city or town. If you live in Yavapai County, call Development Services.
We lack the resources, equipment and legal authority to conduct neighborhood spraying. However, we can respond on a complaint basis if there is reason to believe a property owner is allowing standing water on his property to breed mosquitoes and that problem is of sufficient scope to create a nuisance for the neighborhood.
The laws and codes we enforce do not define odor alone as a public health nuisance. We therefore lack the ability to meaningfully respond even if the odor is alleged to be causing health issues for the neighbors. Town and cities usually have codes to deal with odors. Contact your town or city government. If you live in the County contact the Arizona Department of Environmental Quality (1-800-234-5677), Air Quality Division, which takes and investigates air quality complaints including objectionable odors. For more information on complaints, visit our Environmental Health – Complaints page.
A small amount of dog droppings may be unpleasant but does not necessarily constitute a public health nuisance. However, town and cities usually have codes to deal with odors. If the problem is substantial we recommend filing a complaint with your local city or town government. If you live in the County, you may call Development Services. For more information on complaints, visit our Environmental Health – Complaints page.
Unfortunately, there is little Community Health Services can do. The laws and codes we enforce do not cover what goes on inside of private structures and we have no jurisdiction there. The only response you may have is to seek civil remediation through the court system. Information and a copy of the Arizona Landlord-Tenant Law can be obtained from any office of the Yavapai County Justice Court. Visit AZLawHelp.org for other sources of information on legal rights and responsibilities.
Community Health Services does not have the expertise or legal authority to respond to mold complaints. If the problem exists with someone who rents or leases, we recommend seeking legal action through the Arizona Landlord-Tenant Act. If the owner wants testing and remediation, he should contact a private mold expert.
Tuberculosis (TB) Control
TB is usually an infection of the lungs. It is spread by sharing air with someone who is suffering from TB disease. If you are healthy, your body puts the TB germs to sleep. The germs are kept asleep forever unless your body becomes weak with age, disease or medical treatments. If the TB germs wake up, they can start to do damage to the body. When the damage starts, then you may have symptoms and spread the germs to others.
People with TB usually have more than one of these symptoms and the symptoms continue if not treated.
Health care providers must submit reports within one working day when a suspect or case is diagnosed, treated, or detected.
Children under age 6 with a positive TB test must also be reported within one working day.
Medical providers can call the Disease Prevention Unit of Yavapai County Community Health Services to report, or fax a Communicable Disease Report. All reports are confidential under HIPAA rules.
TB presents in two ways – TB infection and TB disease.
People with TB infection are healthy and able to keep the TB germs “asleep”. These folks cannot spread the TB germs. They may never develop TB disease.
People with TB disease are suffering from TB disease. The TB germs are “awake” and doing damage to lungs or other organs of the body. They can spread TB germs when they cough, sing or sneeze.
We can lessen the spread of TB and other germs with good respiratory hygiene.
For more information, please visit the following website: Centers for Disease Control and Prevention (CDC) – Tuberculosis.
No, your private health care provider can also give you clearance.
Yes, if your chest x-ray is normal and you do not have symptoms of TB.
No, the CDC recommends chest x-rays when:
Our county does not have very many cases of TB, so our clinics do not have doctors on staff to evaluate the TB histories and skin test results. Our contracted physicians provide monthly review of the histories, x-rays and lab work done. Following these reviews we follow up with patients as needed.
Not necessarily. The BCG vaccine (a TB vaccine given in many foreign countries) can produce a positive skin test result, but this fades after 5 years of receiving the vaccine. Many people with previous BCG vaccination will often have a negative TB result. People with a history of BCG are often from countries where TB is more common. BCG reduces the rate of severe forms of TB disease in children and overall might reduce the risk for progression from infection to TB disease. BCG is not thought to prevent TB infection. Test results for TB infection for those with a history of BCG should be interpreted by using the same diagnostic points used for those without a history of BCG vaccination.
West Nile Virus
West Nile Virus (WNV) is transmitted by mosquitoes that feed off birds infected with the virus. After mosquitoes have been infected with WNV, they may then infect humans, birds, horses, and other animals by biting for blood. Although the majority of people and animals infected with WNV do not show any symptoms, it has the potential to cause mild to severe illness. The virus may cause illness known as West Nile encephalitis (inflammation of the brain).
Historically, the WNV has been commonly found in Africa, Eastern Europe, West Asia, and the Middle East. Until 1999, WNV was not known to be present in the United States. Though scientists are not sure when the virus came to the U.S., they estimate that it was around summer of 1999 on the East Coast.
WNV case information changes daily. Check the CDC website for updated information.
West Nile Virus is transmitted by mosquitoes that have become infected by feeding on infectious birds. Mosquitoes may then infect humans and animals while biting for blood. Most people infected with WNV do not have any symptoms. Some people may develop mild or moderate flu-like symptoms such as headache, fever, and body aches. Severe symptoms include high fever, neck stiffness, and inflammation of the brain (encephalitis). People age 50 and older are at highest risk for serious illness.
After West Nile virus has been transmitted to humans/animals, the virus multiplies in the blood system and travels to the brain. This may cause inflammation of the brain tissue (encephalitis). Encephalitis may lead to death in some cases.
Less than 1 percent of the people infected with West Nile virus will develop severe illness as a result. Fatality rates for those with severe illness caused by West Nile virus are highest in people age 50 and over.
West Nile virus is transmitted by mosquitoes. There is no evidence of person-to-person or animal-to-person transmission of West Nile virus. There is a potential for donated blood or organs to carry the virus. Lab testing is routinely done to minimize the chances of this happening.
Any resident of an area where West Nile virus has been documented is at risk of getting West Nile virus; however, precautions can be taken to avoid mosquito bites (see recommendations below). Most people who do become infected will have either no symptoms, or only mild ones. Persons age 50 years or older have the highest risk of severe disease caused by the virus.
Because West Nile virus is spread by mosquitoes, the best way to prevent infection is to prevent mosquito bites.
No. At this time, the best way to prevent infection of WNV is to avoid mosquito bites.
Since the fall of 2003, West Nile virus has been found in mosquitoes, birds, horses and humans throughout Arizona. In Yavapai County, West Nile virus has been confirmed in most communities. Check the CDC case information maps for the latest updates on the affected states.
Arizona has a surveillance program in place to detect virus activity in mosquitoes, chicken flocks, dead birds, sick horses and humans. The surveillance program will aid in detection of and response to the WNV in Arizona.