In-Stall Gazette

We publish and distribute a monthly paper called the "In-Stall Gazette."  We publish this to get important health related information out to the public.


April 2013

May 2013

June 2013

July 2013 

October 2013

November 2013

January 2014

March 2014

May 2014

June 2014

July 2014

January 2015

February 2015

April 2015

May 2015

June 2015

 July 2015

 August 2015

September 2015

October 2015

November 2015

December 2015

March 2016

HPV Vaccine Lowering Infection Rates Among Girls: CDC 

May 2014

The human papillomavirus (HPV) vaccine, given to young women between the ages of 14 and 19, has caused a 56-percent decline in the number of new HPV cases in the same age group, according to a new CDC study. HPV is the principal cause of cervical cancer but also can cause other genital organ and oral/throat cancers. 

“Herd immunity,” which means widespread vaccination that greatly decreases the number of infected people so it is less likely someone else could get it, may be the reason why the decline is so high. 

CDC Director Dr. Tom Frieden said the study results, which were higher than expected, are “striking” and demonstrate the need to “increase [HPV] vaccination rates, because we can protect the next generation of adolescents and young girls against cancer.” The United States’ vaccination rate is only one-third of young females, while some countries are reaching close to 80 percent vaccination coverage. Friedan argued that for every year the United States does not increase the vaccine coverage rate, 4,400 girls who would have otherwise been protected with the vaccine will get cervical cancer later in life. 

HPV is a highly contagious STD. Approximately 79 million Americans are thought to have HPV, which causes 19,000 cancers in women and 8,000 cancers in men each year. The vaccine has had some resistance in the United States, with parents reluctant to give their young daughters and sons a STD shot. Frieden says doctors also are responsible for low vaccination rates. “Providers are not consistently giving strong recommendations for the vaccine, and they are not encouraging vaccination at every encounter,” he said. The vaccine continues to prove its safety, with more than 56 million doses provided in the United States with no serious long-term problems reported.

For More information about the HPV Vaccine, please visit

Texas Vaccines For Children Program 

Since its inception in 1994, Texas has participated in the Federal Vaccines for Children (VFC) Program. Our version is called the Texas Vaccines for Children Program, or TVFC. The Program was initiated by the passage of the Omnibus Budget Reconciliation Act of 1993. This legislation guaranteed that vaccines would be available at no cost to providers, in order to immunize children who meet the eligibility requirements.

Today there are more than 6500 Texas providers enrolled in TVFC.  Texas leads the nation in the number of uninsured and underinsured children.  We also have over 3 million Texas children, 0-18 years, on Medicaid (FFY 2009).  Many of these children are not receiving the complete series of immunizations required to protect them from vaccine-preventable diseases.  Under the TFVC Program, the following groups of children should be receiving their vaccines for free:

·         uninsured or underinsured children,

·         children who are covered by CHIP,

·         children who are of Native American or Native Alaskan heritage, and

·         children on Medicaid.

A TVFC provider may not charge for the vaccine itself, but is permitted to charge a reasonable administration fee.

A fully immunized society is necessary to reach optimum eradication of vaccine-preventable infectious disease. With your help, we can reach these goals leading to a healthier Texas.

Brucellosis in Feral Hogs

Wild hogs destroy farmland and crops, compete with native wildlife for food and can spread disease to other animals and people.  Hunting wild hogs is a popular sport among hunters as well as a population control method supported by wildlife agencies.


There are more than 24 diseases that people can get from wild hogs.  Most of these diseases can make people sick when they eat uncooked meat or get blood, fluid or tissue of an infected hog into their nose, eyes, mouth or a cut in their skin.


The germs that cause Brucellosis are spread among hogs through fluids passed from hog to hog.  Infected hogs actually carry the germ for life and people may become infected when they come into contact with the hogs blood, fluids or tissues (such as muscle, liver or other organs).


Though there have been no reported cases in Milam County, I am taking this opportunity to educate people of the risk associated with hunting these animals.  Avoid contact with visible ill animals or those found dead.  Wear eye protection and rubber or latex gloves when handling carcasses.  Avoid direct contact (bare skin) with fluid or organs of the hog.  Wash hands as soon as possible with soap and warm water for 20 seconds or more.


If for some reason you do contract the disease you may begin to feel sick a week to months after actually coming into contact with the germs that cause Brucellosis.


The symptoms may include, but are not limited to: fever, chills, sweating, headache, low appetite, fatigue, joint pain and muscle pain.  Antibiotics can kill the germs that cause Brucellosis and should be taken as directed by your physician.


In conclusion, as a hunter, you can protect yourself as well as your family from this disease commonly found in feral hogs by following the easy steps listed above.  If you do become ill, just remember to see your physician immediately and tell your doctor that you have recently been hunting feral hogs.  Wild hog hunting can be fun, but remember to stay healthy while doing so.


What you should know about Pertussis before school starts!

August 2013

School will start on Monday August 26th and there is a growing threat that your child may get Pertussis, unless certain precautions are met.  In some cases, even with vaccination some persons will still contract Pertussis. If this does happen Milam county Public Health Department has outlined a few helpful tips to help with understanding it a little better.

Symptoms of Pertussis: The disease usually starts with cold-like symptoms and maybe a mild cough or fever. After 1 to 2 weeks, severe coughing can begin. Unlike the common cold, pertussis can become a series of coughing fits that continues for weeks.  In infants, the cough can be minimal or not even there. Infants may have a symptom known as "apnea." Apnea is a pause in the child’s breathing pattern. Pertussis is most dangerous for babies. More than half of infants younger than 1 year of age who get the disease must be hospitalized.

Pertussis can cause violent and rapid coughing, over and over, until the air is gone from the lungs and you are forced to inhale with a loud "whooping" sound. This extreme coughing can cause you to throw up and be very tired. The "whoop" is often not there and the infection is generally milder (less severe) in teens and adults, especially those who have been vaccinated.

How is pertussis spread? Pertussis bacteria are spread through droplets produced during coughing or sneezing. These droplets don’t travel very far through the air and usually only infect persons nearby.

How long should someone with pertussis stay home from childcare, school, or work? Persons with pertussis should stay home from child care, school, work, and other activities until they have finished 5 days of antibiotics, unless they have already been coughing for 3 or more weeks.

Prevention: The best way to prevent pertussis (whooping cough) among infants, children, teens, and adults is to get vaccinated. Also, keep infants and other people at high risk for pertussis complications away from infected people.

To read more about Pertussis please go the or visit the Milam County Health Department site at


Milam County WIC will celebrate World Breastfeeding Month on August 23, 2013.  WIC will hold a reception at 211 South Houston Cameron, Texas from 10am to 12pm.  The World Breastfeeding Month 2013 theme is "Breastfeeding Support: Close to Mothers."  This year's theme highlights Breastfeeding peer Counseling.  Traditionally, support is provided by the family.  As societies change, however, in particular with urbanization, support for mothers from a wider circle is needed, whether it is provided by trained health workers, lactation consultants, community leaders, or from friends who are also mothers, and/or from fathers/partners.

The Peer Counseling Program is a cost effective and highly productive way to reach a larger number of mothers more frequently.  Peer Counselors can be anyone from the community who is trained to learn to support mothers.  Trained Peer Counselors, readily available in the community become the lifeline for mothers with breastfeeding questions and issues.  "The key to best breastfeeding practices is continued day-to-day support for the breastfeeding mother within her home and community."

Every ounce of breast milk given to a baby improves health of the mother and baby.  Breastfeeding offers advantages for your baby that cannot be matched by any other form of feeding.  The benefits of breastfeeding begin from the first moments after your baby's birth and last for many years.

This is an equal opportunity provider.


January 2013

January is “Cervical Cancer Awareness” month.  Cervical cancer is one of several types of cancer caused by HPV infection and is one of the most common cancers affecting women. Each year, 12,000 women are diagnosed with cervical cancer and about 4,200 die from the disease.

Each year, about 7,000 HPV-associated cancers in men in the United States may be prevented by vaccination. 

Cervical cancer is most commonly caused by long-lasting infection with HPV types 16 or 18. Because the HPV vaccine protects against these two types of HPV, girls and young women age 9 through 26 years are recommended to get the HPV vaccine.  HPV vaccines offer the greatest health benefit to persons who receive all 3 doses before exposure to HPV through sexual activity.  Routine HPV vaccination is recommended for girls and boys at age 11 or 12 years.  Vaccination also is recommended for females through age 26 years and for males through 21 years who have not been vaccinated previously.  Any man who has sex with other men, and men with compromised immune systems (including human immunodeficiency virus infection), also may be vaccinated through age 26 years.  Information about the HPV vaccines is available at  If you have any further questions, please contact the Milam County Health Department at 254-697-7039.

Cervical Cancer is highly preventable because screening tests for cervical cancer and vaccines to prevent human papillomavirus (HPV), which is the main cause of cervical cancer, are available.  The Milam County Health Department does not provide screening tests for cervical cancer, but does provide vaccines under the State guidelines.  Half of cervical cancers occur among women rarely or never screened for cancer, and another 10% - 20% of cancers occur among women who were screened but did not receive adequate follow-up care.  When cervical cancer is found early, it is highly treatable and associated with long survival and good quality of life.  For women aged 21-65 years, regular cervical cancer screening can help prevent cancer.  The Pap test detects precancers, which are cell changes on the cervix that might become cancerous if they are not treated appropriately.  Women should start getting Pap tests at age 21 years and every 3 years thereafter.  Women who are aged greater than 30 years may choose to have an HPV test along with the Pap test.  If both test results are normal, additional testing is not needed for 5 years.   

HPV vaccine is a strong weapon in prevention. These safe, effective vaccines are available to protect females and males against some of the most common HPV types and the health problems that the virus can cause.  For the HPV vaccine to work best, it is very important for preteens to get all 3 doses (shots) long before any sexual activity with another person begins. It is possible to be infected with HPV the very first time they have sexual contact with another person. Also, the vaccine produces higher antibody that fights infection when given at this age compared to older ages.  3 doses (shots) are recommended over six months. CDC recommends that the second dose be given one to two months after the first, and the third dose be given six months after the first dose.  In recognition of “Cervical Cancer Awareness” month, this edition of “Ask the VEC” features the question and answer page.  Go to to ask a question or see what others are asking about HPV and the vaccine.
During January, check with the young women in your life to be sure they are aware of the HPV vaccine as a way to prevent cervical cancer.
Check your immunization record and if you have not received this vaccine, contact the Milam County Health Department or your private physician.  Take responsibility and be pro-active in preventing cervical cancer.


January 2013

High Flu Activity Means People Should Get Vaccinated, Seek Treatment 

With reports of flu widespread across Texas, state health officials urge people to get a flu shot now and take other steps to protect themselves from the flu and its possible complications.

“Texas, like much of the country, saw an early start to the flu season and continues to experience a high level of flu and flu-like illness,” said Texas Department of State Health Services Commissioner Dr. David Lakey. “The best thing people can do to protect themselves is to get a dose of flu vaccine now. There is plenty of vaccine available.” 

Each season’s vaccine provides protection against three strains of flu. Researchers with the U.S. Centers for Disease Control and Prevention say this year’s vaccine is well matched with the strains now circulating. While the number of flu cases in Texas is high, DSHS has no indication that cases have been more severe than usual this season.

DSHS recommends vaccination for everyone six months old and older. It’s especially important for those in high-risk groups like children, people 65 and older, pregnant women and people with chronic health conditions. People in those groups are more likely to experience serious or life-threatening complications from flu such as bacterial pneumonia, ear and sinus infections, dehydration and worsening of chronic conditions like congestive heart failure, asthma or diabetes.

Flu symptoms usually start abruptly and include fever, body aches, chills, a dry cough, sore throat, runny nose and extreme fatigue and can last a week or longer. There is an adequate supply of antiviral medications that can help lessen the severity and duration of the flu when started within 48 hours after symptoms appear.

“I encourage people who have a sudden onset of fever along with a cough or sore throat to talk to their doctor as soon as they can about possible treatment,” Lakey said.

In addition to getting vaccinated, people should remember to protect themselves and others from flu and other respiratory illnesses by washing their hands frequently, covering all coughs and sneezes and staying home if they’re sick.

There is more information on the flu, including a vaccine finder, at People can also contact the Milam County Health Department – 254-697-7039 or their health care provider to get a flu shot.

During week 52 which ended December 29, 2012, the following Influenza Like Illness (ILI) activity levels were experienced:

·         New York City and 29 states experienced high ILI activity (Alabama, Arkansas, Colorado, Florida, Georgia, Illinois, Indiana, Kansas, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, and Wyoming).

·         Nine states experienced moderate ILI activity (Alaska, Arizona, Delaware, Iowa, Nebraska, North Dakota, Oregon, Washington, and West Virginia).

·         Four states experienced low ILI activity (Kentucky, New Hampshire, South Dakota, and Wisconsin).

·         Six states experienced minimal ILI activity (California, Connecticut, Hawaii, Maine, Montana, and Nevada).

·         Data was insufficient to calculate an ILI activity level for the District of Columbia and 2 states (Idaho and Maryland).

Two influenza-associated pediatric deaths were reported as of December 29, 2012.   One was associated with an influenza A (H3) virus and one was associated with influenza A virus for which the subtype was not determined.  The first death occurred during week 52 (week ending December 29, 2012) in a 17-year-old child. The second death was in a 6-year-old child and occurred during week 48 (week ending December 1, 2012). Specimens collected from both children were positive for influenza B by PCR test. Neither child had received an influenza vaccination during the current season. Five influenza-associated pediatric deaths have been reported in Texas during the 2012-2013 influenza season. There has been a total of 20 pediatric deaths throughout the United States.

Between October 1, 2012 and January 5, 2013, 3,710 laboratory-confirmed influenza-associated hospitalizations were reported.  The most affected group is people ≥65 years. Among all hospitalizations, 3,198 (86.2%) were associated with influenza A and 484 (13.0%) with influenza B. There was no virus type information for 22 (0.6%) hospitalizations.  The most commonly reported underlying medical conditions among hospitalized adults were metabolic disorders, cardiovascular disease, obesity, and chronic lung disease (excluding asthma). Among 55 hospitalized women of childbearing age (15-44 years), 10 were pregnant. The most commonly reported underlying medical conditions in hospitalized children were asthma, neurologic disorders, and immune suppression. More than 40% of hospitalized children had no identified underlying medical conditions.

So, as you can see, flu is rapidly spreading throughout the United States and has been at an earlier time this year.  Let’s not have the flu to dominate our life, take the precautions as mentioned and GET A FLU SHOT!  Thus if you have not received a flu shot, please do so as soon as possible.  Remember it is “NEVER TOO LATE”. 



The Milam County Health Department would like to remind citizens that a maintenance contract with a certified maintenance provider is required on ALL aerobic septic systems.  As per Title 30 TAC Chapter 285.7(d) (2) it is the owner’s responsibility (not the maintenance provider) to submit a signed copy of the maintenance contract to the permitting authority.  The permitting authority for Milam County is the Milam County Health Department.    In order for the contract to be valid it MUST be signed by both the homeowner and the maintenance provider.  There are other things that are required to be on the maintenance contract. 

As per Title 30 Chapter 285.7 (d) (1) OSSF Maintenance Contracts shall, at a minimum:

(A) List items that are covered by the contract;

(B) Specify a time frame in which the maintenance provider or maintenance technician will visit the property in response to a complaint by the property owner regarding the operation of the system;

(C) Specify the name of the maintenance provider who is responsible for fulfilling the terms of the maintenance contract (must be an individual, TCEQ no longer recognizes maintenance companies)

(D) Identify the frequency of routine maintenance and the frequency of the required testing and reporting;

(E) Identify who is responsible for maintaining the disinfection unit; and

(F) Indicate the business physical address and telephone number for the maintenance provider.

When signing a contract with a maintenance provider please review it first.  If the above things at a minimum are not listed on the contract then the contract is not valid and you can therefore be cited for not having a valid contract.  You should have the provider add these things to the contract before signing it.

Please also make sure that the person you have contacted is a certified maintenance provider.  You can visit the Milam County Health Department website and click on the TCEQ link to find out the status of any maintenance provider or installer.  The Health Department website is just click on the environmental protection link.

Failure to keep a current maintenance contract on file with the permitting authority is a Class C misdemeanor punishable by a fine of up to $500/each day.


Maintenance for aerobic systems must be performed by a State Certified Maintenance Provider.  All maintenance providers are required to send inspection reports to the permitting authority and owner within 14 days after the date the test is performed.  The maintenance provider must comply with inspection reports as outlined in the contract.  An inspection must be completed and an inspection report must be submitted once every 4 months at a minimum.  Failure to inspect the system or provide an inspection report to the permitting authority is a Class C misdemeanor punishable by a fine of up to $500/each day for the first offense.  The maintenance provider could also face civil and administrative penalties, including losing their license.

If you have any questions about maintenance contracts or other issues please feel free to contact the TCEQ Designated Representative for Milam County, Kenny Schneebeli, at the Milam County Health Department, at (254) 697-7039. 

Celebrate World Breastfeeding Month

Milam County WIC will celebrate World Breastfeeding Month on August 24, 2012 with a reception at 313 North Main, Rockdale, Texas from 10 A.M. to 12 Noon.  In Texas, the World Breastfeeding Month 2012 theme is “Connecting communities: Strengthening support for breastfeeding moms.”  Every ounce of breast milk given to a baby improves health of the mother and baby. Breastfeeding offers advantages for your baby that cannot be matched by any other form of feeding. The benefits of breastfeeding begin from the first moments after you baby’s birth and last for many years.

This institution is an equal-opportunity provider.


JULY 2012

School is out, but it is never too late to start planning for next school year.  If you have a child who will be entering a Texas college or university this fall, please remember that they will need to have a meningococcal vaccine before they enter college.  Bacterial meningitis (meningococcal disease) is not common but can be life-threatening—especially to adolescents and young adults. It is caused by the bacteria Neisseria meningitidis.  Infection can cause brain damage, hearing loss, learning disabilities and even death. The bacteria can cause meningitis, an infection of the covering of the brain and spinal cord. It can also infect the blood stream, a condition called meningococcemia. One in seven adolescents and young adults who contract the disease will die from it.  About 1,000 – 1,200 people get meningococcal disease each year in the United States.  Even when they are treated with antibiotics, 10-15% of these people die.  Of those who live, another 11% - 19% lose their arms or legs, have problems with their nervous systems, become deaf or mentally retarded, or suffer seizures or strokes.

REQUIREMENT:  As of January 1, 2012, all entering college and university students are required to show proof of an initial meningococcal vaccination or a booster dose during the five-year period before enrolling. They must get the vaccine at least 10 days before the semester begins. (Chapter 21, Subchapter T, Sections 21.610 through 21.614)


Who is an entering college student?

·         a first-time student of an institution of higher education or private or independent institution of higher education

·         a transfer student

·         a student who previously attended an institution of higher education before January 1, 2012, who is enrolling in the same or another institution of higher education following a break in enrollment of at least one fall or spring semester


Which students are not required to comply with this vaccine requirement?

The following students are exempt from the vaccine requirement:

·         a student 30 years of age or older by the first day of the start of the semester

·         a student enrolled only in online or other distance education courses

·         a student enrolled in a continuing education course or program that is less than 360 contact hours, or continuing education corporate training

·         a student enrolled in a dual credit course which is taught at a public or private K-12 facility not located on a higher education institution campus

·         a student incarcerated in a Texas prison

VACCINE COST: The vaccine can cost more than $100.00. Insurance coverage is changing and now many insurance plans cover the cost of the vaccine. Please check with your insurance carrier to see if they cover the cost of the vaccine. In addition, patients who are 18 years of age or younger, without private insurance, may be eligible to participate in the Texas Vaccines for Children Program.  

MORE INFORMATION:  For more information: go to or call the Texas Immunization Information Line at 1-800-252-9152.


June 2012


In the wake of dwindling public health funding, local and state health officials hope a new committee established this past legislative session under Senate Bill 969 by Senator Jane Nelson (R-Flower Mound) will help local health departments and DSHS (Department of State Health Services) develop new policies and funding mechanisms to improve support for the public health system.  Our Texas Commissioner, Dr. David Lakey, appointed nine members to the committee as follows:

  • Two regional health directors, each of whom is serving as a health authority

  • One local health department representative of a county with a population of 50,000 or less

  • One local health department representative of a county with a population greater that 50,000 but less than 250,000

  • One local health department representative of a county with a population with a populations of at least 250,000

  • Two local health department representatives serving as a health authorities

  • Two representatives of a school of public health at an institution of higher education in this state


Those appointed were: Craig Blakely, College Station; Sandra Guerra, San Antonio; Mark Guidry, Galveston; Richard Kurz, Fort Worth; Deb McCullough, Andrews County; Paul McGaha, Tyler; William "Chip" Riggins, Georgetown; Stephen Williams, Chairperson, Houston; and Victoria Yeatts, Garland.


Senate Bill 969 amends the Health and Safety code to establish the Public Health Funding and Policy Committee within DSHS.  The committee's first charge is to define the core public health services and to establish a common definition for what should be funded.


In 1999, Texas became the first state to codify into law 10 essential public health services to provide a working definition for local public health systems.  These 10 essential Public Health Services are as follows:

  1. Monitor health status to identify and solve community health problems

  2. Diagnose and investigate health problems and health hazards in the community

  3. Inform, educate and empower people about health issues

  4. Mobilize community partnerships and action to identify and solve health problems

  5. Develop policies and plans that support individual and community health efforts

  6. Enforce laws and regulations that protect health and ensure safety

  7. Link people to needed personal health services an assure the provision of health care when otherwise unavailable

  8. Assure a competent public and personal health care workforce

  9. Evaluate effectiveness, accessibility and quality of personal and population-based health services

  10. Research new insights and innovative solutions to health problems


Next, the committee will evaluate the state's public health system in relation to those services and identify areas for improvement.  The committee also will identify all funding sources available for use by local health entities to perform the core public health policy priorities.


Each year, the committee will present a report on its activities to the legislature that includes recommendations on the use and allocation of funds, ways to improve the overall health of Texans and the contracting process for local public health services while sustaining a collaborative relationship between DSHS and local public health departments.


Therefore, in closing, Public Health Departments look forward to improved communization between funding entities and other situations that arise in the Public Health World.



March 2012


Tuberculosis also referred as “TB” is a disease caused by a bacterium called Mycobacterium tuberculosis.  The bacteria usually attack the lungs, but TB bacteria can attack any part of the body such as the kidney, spine, and brain.   If not treated properly, TB disease can be fatal.  TB is spread through the air from one person to another.  The TB bacteria are put into the air when a person with active TB disease of the lungs or throat coughs, sneezes, speaks, or sings.  People nearby may breathe in these bacteria and become infected.  TB is NOT spread by shaking someone’s hand, sharing food or drink, touching bed linens or toilet seats, sharing toothbrushes or kissing. 


Sometimes we wonder about technology…but the Milam County Health Department has just received a multi-purpose incubator that will be very helpful for our Tuberculosis Program.   The incubator is called Cultura which will assist in the Quantiferon Testing process.   This incubator was provided to our department from the Region 7 Department of State Health Services office in Temple.  The Quantiferon test is a whole-blood test for use as an aid in diagnosing Mycobacterium tuberculosis infection, including latent tuberculosis infection and tuberculosis disease.  This test was approved by the U.S. Food and Drug Administration in 2005.  The advantages of the new testing procedure are:

  • Requires a single patient visit to draw a blood sample

  • Results can be available within 24 hours if in the metro areas, but in rural areas the results are received in a timely matter

  • Does not boost responses measured by subsequent tests, which can happen with tuberculin skin tests

  • Is not subject to errors in measuring results that can occur with tuberculosis skin test

  • Is not affected by prior BCG (bacilli Calmette-Guerin) vaccination.


The normal testing for Tuberculosis will not change with the use of the Quantiferon Testing.  Patients are screened for TB by symptom review and TB test or Quantiferon testing in several situations:

  • Patients that are contacts to active TB cases or suspects, patients with current disease and patients with a diagnosis pending.

  • Other situations are individuals with medical risk factors such as HIV, diabetes, chronic renal failure, renal dialysis, cancer, silicosis, malnutrition and immunosuppressive medications

  • Homeless individuals

  • Residents of high-risk congregate settings such as shelters, nursing homes, jails, substance abuse treatment facilities

  • Injection drug users

  • Organ transplant patients (before transplant if possible)


February 2012

The Department of State Health Services has developed policy changes to the Vaccines for Children childhood vaccine program in response to reduction in state and federal immunization funds, increased federal accountability for public funded vaccines, as well as increases in prices for some vaccines.  Due to the new law, it is illegal to give a federally funded vaccine to a child that is not qualified to receive the vaccine. 

Here is a brief explanation of the cost of mandatory vaccines for children ages – birth to 18 year of age.

  • In 1985, there were 7 vaccines and the cost was $45.00
  • In 1995, there were 10 vaccines and the cost was $155.00
  • In 2001, there were 12 vaccines and the cost was $369.00
  • In 2005, there were 15 vaccines and the cost was $630.00
  • In 2010, there were 16 vaccines and the cost was $1,483.00

As of January 1, 2012, the following criteria has been made mandatory:

·         Children who have private insurance that covers vaccines will no longer be eligible for immunizations at the Milam County Health Department.  Children will have to be seen in a private medical doctor’s office or providers that carry private paid vaccines.

Children, birth through 18 years of age, who meet at least one of the following criteria, are eligible to receive vaccines at the Milam County Health Department.

·         A child who has Medicaid Coverage

·         A child who has No Insurance

·         American Indian or Alaskan Native

·         A child enrolled in CHIP Insurance

·         Underinsured

Due to the reduction in federal and state funds, the adults who are seen in our clinic are also going to be affected.  As of January 1, 2012, Adults who are not covered by insurance can only receive the following vaccines: Hepatitis B, Measles/Mumps/Rubella (MMR), Tetanus/Diphtheria/Acellular Pertussis (Tdap), and Tetanus/Diphtheria (Td).   The Milam County Health Department does have available Hepatitis A, Hepatitis B and Pneumonia for a fee.  If you have any questions regarding the new vaccine laws, please contact the Milam County Health Department at 254-697-7039.


November 2011

Flu season is here, believe it or not.  Flu is a contagious disease.  It is caused by the influenza virus, which can be spread by coughing, sneezing, or nasal secretions.  Anyone can get influenza, but rates of infection are highest among children.  Young children, people 65 and older, pregnant women and people with certain health conditions – such as heart, lung or kidney disease or a weakened immune system – can get much sicker.  All people 6 months of age and older should get flu vaccine. 

The Centers for Disease Control and Prevention from Atlanta, Georgia reported that the current flu season has low flu activity making this the perfect time to get vaccinated.  It takes about two weeks after vaccination for the body’s immune response to fully kick in.  It’s best to get vaccinated before activity begins so that you’ll be protected once flu season starts.  CDC routinely monitors influenza activity in the United States year-round with a system that determines when and where influenza activity is occurring, determines what influenza viruses are circulating and detects changes in influenza viruses.  The system also measures the burden of influenza disease in the United States, including tracking influenza related illness, hospitalizations and deaths.  CDC receives reports from international, state and local participants and within 48 hours compiles and analyzes that data to produce a report that provides comprehensive situational awareness regarding influenza activity in the United States.  

The Milam County Health Department receives reports of lab confirmed cases along with reports of flu like illnesses from the hospitals, doctor’s offices and schools in Milam County on a weekly basis.  This report is then sent to our Region office in Temple and then the information is submitted to the Centers for Disease Control in Atlanta, Georgia.   Each week, the health department compiles an accurate number of illnesses and cases in Milam County.

More than 110 million doses of vaccine had been delivered in the United States as of the end of September, with manufacturers projecting total production of between 166 and 173 million doses.  This is the most flu vaccine ever produced for the United States market.   Stop the spread of flu by vaccination.  The Milam County Health Department in Cameron administers the flu vaccine on Mondays and Wednesdays from 8am to 5pm and in Rockdale on Tuesdays and Thursdays from 9am to 4:30pm.  The cost is $20.00 for the Adult vaccine and if you are on Medicare, the vaccine is free.  The Health Department is also offering the children’s flu vaccine for free.  So, let’s protect ourselves this year by getting our flu shot NOW!


October 2011

Technology has come a long way in our society today.  As I became aware of the following program that supports moms by providing accurate, text-length health information and resources in a format that is personal and timely, I thought it would be beneficial to share this information with our Moms and Moms-to-be.  Despite decades of public health outreach and education, more than 500,000 babies are born prematurely and an estimated 28,000 children die before their first birthday each year in the United States.  To help more pregnant women and new moms get information about caring for their health and giving their babies the best possible start in life, the National Healthy Mothers, Healthy Babies Coalition launched text4baby, the first free health text messaging service in the U.S.   Over 85% of Americans own a cell phone and 72% of cell users send or receive text messages.  Text4baby was launched nationally on February 4, 2010.

Thanks to the support of CTIA – the Wireless Foundation and participating mobile operators, all messages you receive from text4baby are free!  Even individuals without a text messaging plan can get these messages for free.  If someone has limited texts per month, text4baby won’t take away from that limit.  As long as you have service with one of these carriers – such as AT & T, Assurance Wireless, Bluegrass Cellular, Boost Mobile, Cellular South, Cellcom, Centennial Cellular, Cincinnati Bell, Cricket, Metro PCS, N-Telos, Nex-Tech Wireless, Sprint Nextel, T-Mobile, U. S. Cellular, Verizon Wireless and Virgin Mobile USA – text4baby is free for you. 

Registration is easy and can be done online or from your cell phone.  Use your cell phone to text the word BABY or BEBE for Spanish t the number 511411.  You’ll be asked to enter your baby’s due date or your baby’s birthday and your zip code.  Once registered, you will start receiving free messages with tips for your pregnancy or caring for your baby.  These messages are timed to your due date or your baby’s birth date.  If you are pregnant and your due date changes, text UPDATE to 511411 to enter your new due date.  Once you have your baby, be sure to text in UPDATE with your baby’s birthday so you keep getting messages through baby’s first year.  You will receive approximately three messages per week.  Urgent alerts or breaking news might mean you see a few additional messages once in a while.  The text4baby messages are not personalized, but the information is relevant to where you are in your pregnancy or what your baby is going through at particular states of development.  Text4baby is a one-way educational program, so you can’t text questions or communicate back with the program.  However, if you have specific questions, you can call the phone numbers you find in the messages.  The messages will continue throughout your pregnancy and your baby’s first year. If you want to stop receiving messages from text4baby, text STOP to 511411. 

The text4baby service includes over 250 messages addressing topics such as:  Prenatal Care, Safe Sleep, Immunization, Breastfeeding, Diabetes, Nutrition, Oral health, Family Violence, Physical Activity, Safety, Injury Prevention, Mental Health, Substance Abuse, Developmental Milestones, Labor & Delivery, Care Seat Safety and Exercise.

If you would like to register online or receive more information about this program, please go to

World Rabies Day

 September 2011

Rabies has been on the rise this year.  Rabies cases usually occur in the spring because there are more opportunities for transmissions during the spring mating season.  Rabies does occur through the entire year in Texas in both wild and domestic animals.  Rabies in bats occurs mostly in the warmer months.  As of August 31, 2011, there have been 333 cases in the Central Texas area compared to 258 in 2010 for the same period of time.  Milam County has had 5 cases (4 skunks and 1 horse) of Rabies.  Every year 55,000 people will die from rabies throughout the world, almost one person every ten minutes. It is estimated that every year 30,000-40,000 US residents are potentially exposed to rabies requiring human rabies post-exposure prophylaxis. 

What is Rabies?

Rabies is a virus disease of the central nervous system (the brain and nerves).  It 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 routes.  Saliva in contact with unbroken skin – or even on a scratch wound over 24 hours old, one where a scab has formed-usually will not require anti-rabies treatment.  You should definitely see a doctor if you think the animal could be rabid. 

Rabies – sometimes called “hydrophobia” has its roots in antiquity.  Centuries before the birth of Christ, it was recognized in both animals and man.  Cases were described with amazing clinical accuracy during the lifetime of Aristotle.  The name hydrophobia, meaning “fear of water” was given to it at that time because the ancient Greeks observed rabid animals’ aversion to water.  Actually, the truth is that they cannot drink because of throat paralysis.  It is this fact which produces the classic picture of a beast with foam-flecked jaws.  Saliva accumulates in the paralyzed throat and drools from the corners of the mouth, giving the impression of mad-dog foam.  Certainly it isn’t hard to understand why those ancient people were terror stricken by such a sight, and even thought the animal was demon-possessed.  Through the years, a wall of superstition was built.  The wall has never been completely torn down.  Even today, many people believe that the bite of a civet cat, a small spotted skunk, invariably leads to rabies.  Actually, while all skunks are susceptible to rabies, laboratory studies have proved it is wrong to assume all civet cats are rabid. 

All warm-blooded animals, including humans, are susceptible to rabies.  In Texas, skunks, bats, coyotes, raccoons and foxes are the most commonly infected animals.   Domestic dogs, cats, and livestock usually acquire rabies infections from wild animals; while the numbers of rabid domestic animals are fewer; their danger is greater because of their close association with humans. 

A person cannot tell if an animal has rabies by looking at it.  Sometimes rabid animals act friendly or tame.  They are no longer shy or afraid of people.  You may try to hand-feed or pet an animal that looks harmless and, in the process, expose yourself to rabies.  Rabid animals might also be having a hard time walking, flying, eating, or drinking.  Animals that are usually active at night, such as bats, skunks, and raccoons may be seen during the daytime if they are rabid.  If you see an animal acting strangely, do not touch it.  Call for help.  Avoid contact with wild animals.  Do not try to hand-feed them.  Do not try to keep wild animals as pets.  Do not touch sick, injured, or dead animals.    Have your pets vaccinated against rabies by a veterinarian.  Restrain them and do not allow them to roam.   

Signs of rabies include:

  • Animals that have a change in behavior
  • Wild animals which seem to be friendly or tame.
  • Wild animals – coyotes, foxes, bats, skunks, and raccoons – which you do not usually see in the daytime.
  • Animals that have a hard time walking, eating, or drinking
  • Excitement or meanness in animals
  • Animals that bite or scratch at an old wound until it bleeds.

If a bite occurs, the following precautions should be taken:

  • Identify the animal.  Most animals that have bitten a person must either be quarantined and observed for signs of rabies or tested for rabies.  If the animal is to be tested, a qualified person, such as a Veterinarian should separate the animal head from the body and submit the head (or whole body of a bat or rodent) for laboratory testing.
  • Immediately wash the wound thoroughly with soap and water, plus an antiseptic if available, as a first aid procedure.
  • Consult a physician as soon as possible to determine whether post-exposure treatment is needed.

What is Quarantine?

Quarantine means placing the animal in a facility that provides:

  • Absolute security (no escape possible)
  • No contact with other animals or people except for contact necessary for its care
  • Observation twice daily by a qualified person

Quarantine facilities include:

  • Facilities licensed by the Texas Department of State Health Services
  • Veterinary Clinic operated by a veterinarian
  • Home confinement if approved the Local Rabies Control Authority

There is much information regarding rabies, but the last item that is very important is the Texas State Law regarding Rabies vaccination.  Texas state law requires pet owners to vaccinate their dogs and cats against rabies by 4 months of age.  Based on the type of vaccine used, plus requirements established in state law and local ordinance, the veterinarian responsible for administering the vaccine will determine a vaccination schedule for each animal.  Therefore, if you have not vaccinated your animals, please do so immediately.  Please join us in promoting rabies prevention awareness and education in Milam County, therefore if you have any questions concerning Rabies, please do not hesitate to contact the Milam County Health Department at 254-697-7039. 


 June 2011

During the last few months, there has been much information about measles outbreaks on a worldwide scale.  Therefore, I would like to inform our community regarding measles. 

First, here is a brief history of measles.  One of the earliest written descriptions of measles as a disease was provided by an Arab physician in the 9th century who described differences between measles and smallpox in his medical notes.  A Scottish physician, Francis Home, demonstrated in 1757 that measles was caused by an infectious agent present in the blood of patients.  In 1954 the virus that causes measles was isolated in Boston, Massachusetts, by John F. Enders and Thomas C. Peebles.  Before measles vaccine, nearly all children got measles by the time they were 15 years of age.  Each year in the United States about 450-500 people died because of measles, 48,000 were hospitalized, 7,000 had seizures, and about 1,000 suffered permanent brain damage or deafness.  Today there are only about 50 cases a year reported in the United States, and most of these originate outside the country. 

Measles is a highly contagious respiratory disease caused by a virus.  The disease of measles and the virus that causes it share the same name.  The disease is also called rubeola.  Measles virus normally grows in the cells that line the back of the throat and lungs.  Measles causes fever, runny nose, cough and a rash all over the body.  About one out of 10 children with measles also gets an ear infection, and up to one out of 20 gets pneumonia.  For every 1,000 children who get measles, one or two will die.   The number of measles cases has been increasing in the United States and cannot compare to the numbers that have been lower in the past.   

During the months of January thru May, 2011, there have been a total of 118 cases of measles reported in the United States this year and the annual average is about 50.  Texas has had 6 of these cases, but none has been reported for Milam County.  105 of these cases were associated with importation from other countries, which includes 34 among U. S. residents traveling abroad and 12 among foreign visitors.  All 105 people were unvaccinated and these are some of the reasons: claimed a religious or personal exemption, missed opportunities for vaccination, and declined vaccination because of philosophical objections to vaccination.  Centers for Disease Control are recommending children as young as 6 months of age receive an MMR vaccine if they are traveling abroad.   Measles outbreaks in the European region are large and spreading between countries and to other parts of the world.  So far this year, 24 of 53 countries in the European region have reported measles cases, with the largest outbreak occurring in France, which reported 3,749 cases in January and February.  

Children and adults who remain unvaccinated and develop measles also put others in their community at risk.  For infants too young for routine vaccination (age < 12 months) and persons with medical conditions that contraindicate measles immunization, the risk for measles complications is particularly high.  These persons depend on high MMR vaccination coverage among those around them to protect them from exposure.   

MMR vaccine is safe and highly effective in preventing measles and its complications.  MMR vaccine is recommended routinely for all children at age 12-15 months, with a second dose at age 4-6 years.  For adults with no evidence of immunity to measles, one dose of MMR vaccine is recommended unless the adult is in a high-risk group in which two doses are recommended.    Measles vaccination is very important, especially if you are traveling, so please check your immunization record.  If you have any questions regarding this vaccination, please contact the Milam County Health Department at 254-697-7039.


 May 2011

May is Hepatitis B Awareness month and May 19th is World Hepatitis Day.   What is Hepatitis?  “Hepatitis” means inflammation of the liver.  Toxins, certain drugs, some diseases, heavy alcohol use, and bacterial and viral infections can all cause hepatitis.  Hepatitis is also the name of a family of viral infections that affect the liver; the most common types are Hepatitis A, Hepatitis B, and Hepatitis C. 

Differences between Hepatitis A, B & C…Hepatitis A, Hepatitis B, and Hepatitis C are diseases caused by three different viruses.  Although each can cause similar symptoms, they have different modes of transmission and can affect the liver differently.  Hepatitis A appears only as an acute or newly occurring infection and does not become chronic.  People with Hepatitis A usually improve without treatment.  Hepatitis B and Hepatitis C can also begin as acute infections, but in some people, the virus remains in the body, resulting in chronic disease and long-term liver problems.  There are vaccines to prevent Hepatitis A and B; however, there is not one for Hepatitis C.  If a person has had one type of viral hepatitis in the past, it is still possible to get the other types. 

Hepatitis A is found in the stool of person with hepatitis A.  It is usually spread by close personal contact and sometimes by eating food or drinking water containing the hepatitis A virus.  Hepatitis A can cause mild “flu-like” illness, jaundice(yellow skin or eyes) and severe stomach pains and diarrhea.  Sometimes, people die as a result of Hepatitis A (about 3-5 deaths per 1,000 cases). 

Hepatitis B is usually spread when blood, semen, or another body fluid from a person infected with the Hepatitis B virus enters the body of someone who is not infected.  This can happen through sexual contact with an infected person or sharing  razors, toothbrushes ,needles, syringes, or other drug-injection equipment and also direct contact with blood or open sores.   Hepatitis B can also be passed from an infected mother to her baby at birth.  In the United States, an estimated 800,000 to 1.4 million persons have chronic Hepatitis B virus infection and about 350 million people globally and this disease contributes to an estimated 620,000 deaths worldwide each year.   

Hepatitis C (HCV) is transmitted when the infected blood of one person gets into the blood stream of another person. Prior to 1992, persons receiving blood transfusions or other blood products were at risk. New screening tests have been used in the United States since 1992 to screen blood. The majority of HCV is currently transmitted through the sharing of needles and needle sharing equipment (works). Health care workers who have been stuck by a needle or cut with other contaminated instruments may be at risk, although the risk is fairly low. Studies show the transmission of HCV through sexual intercourse is possible, but less common than direct exposure to HCV infected blood. The virus can also be passed to a baby during pregnancy or delivery.

The Incubation period is two to twenty five weeks although the average is six to nine weeks.

Most people who are infected with the hepatitis C virus do not have symptoms and lead normal lives. If symptoms are present they are generally mild flu-like symptoms, dark urine, light stools, jaundice, fatigue, and fever.

If you would like to know more information about the Hepatitis viruses, please contact the Milam County Health Department at 254-697-7039. 


Sexually transmitted diseases or STD's cases are still on the rise in the United States. Even with the discovery of HIV/ AIDS many people still have unprotected sex. Currently 1 in 5 people has an STD, with 1 in 4 people having had an STD during his or her lifetime. Many STD's have mild symptoms while most people positive for STD's have had no symptoms at all. Bacterial STD's like gonorrhea, syphilis and Chlamydia cause mild burning and itching during urination, discharge, small sores or blisters and /or flu-like symptoms. Bacterial STD's may be treated with antibiotics. Viral STD's, such as HIV, Hepatitis C and Herpes are caused by viruses and have no cure, while HPV and Hepatitis B are preventable with vaccines. Symptoms of viral STD's are less obvious and do not show up until months after having sex. Symptoms include warts, blisters, flu-like symptoms, tiredness and jaundice. If STD's are left untreated, you may pass the disease to your child during childbirth or may be unable to become pregnant. These diseases may also cause blindness, heart problems or even death. If you believe you were exposed to an STD visit your doctor or the health department.  Visit for information on free testing and treatment or call the Milam County Health Department at 254-697-7039.






 Milam County Health Department