Alabama Administrative Code
Title 410 - STATE HEALTH PLANNING AND DEVELOPMENT AGENCY
Chapter 410-2-2 - HEALTH PRIORITIES
Section 410-2-2-.05 - Diseases - Prevention And Management
Universal Citation: AL Admin Code R 410-2-2-.05
Current through Register Vol. 43, No. 02, November 27, 2024
(1) Preventable Diseases
(a) Vaccine Preventable Diseases (Measles,
Pertussis, HPV, Influenza, Shingles, etc.). With a more local and global
transient population, diseases are resurfacing due to a lack of, and failure to
immunize for childhood and seasonal diseases such as influenza.
1. Influenza Problem. Seasonal epidemics of
influenza occur every year in the United States, beginning in the fall.
Typically, the epidemics cause thousands to tens of thousands of deaths and
approximately 200,000 hospitalizations annually.
(i) Since the 1940s, a vaccine has been
available to prevent influenza; unfortunately, the vaccine is not used as much
as it should be. To prevent hospitalizations and deaths caused annually by the
influenza virus, the Centers for Disease Control and Prevention ("CDC") has
recommended that all U. S. Citizens more than six (6) months of age receive the
influenza vaccine.
(ii) The rate of
vaccination is low (25% - 45%).
(iii) The cost of vaccination is minimal ($10
- $18), depending on type (injection vs. nasal).
(iv) Side effects are minimal.
(v) Influenza causes children to miss school,
usually up to one week, which in some cases can cause parents to miss
work.
(vi) Recommendations:
(I) Consider adding the influenza vaccine to
the required immunization schedule outlined in Ala. Admin. Code r
420-6-1-.03.
(II) Vaccinating school aged children would
keep more kids in school and potentially save the state millions of
dollars.
(2) Adult and Childhood Diseases Preventable with Immunizations. Childhood diseases, such as measles, chicken pox, etc. are once again on the rise due to a mobile society and a failure to vaccinate. Vaccinations continue to be developed to prevent diseases such as shingles, HPV, etc.
(a) The State shall encourage
compliance with the recommended vaccination schedules of the American Academy
of Pediatrics and the CDC Advisory Council on Immunization Practices ("ACIP")
to ensure Alabamians are protected from recognized and costly preventable
diseases with a vaccination option.
(3) Obesity
(a) Discussion (source:
www.cdc.gov)
1. In 2016, the prevalence of obesity
(BMI> or = 30) among U.S. Adults was 39.8%. By contrast, the prevalence of
obesity in 2000 was 30.5%.
2. An
estimated 300,000 deaths per year in the United States may be attributable to
obesity.
3. In 2017, Alabama was
one of only seven (7) states with an adult obesity prevalence of over
35%.
4. Even moderate weight excess
(10 to 20 pounds for a person of average height) increases the risk of death,
particularly among adults aged thirty (30) to sixty-four (64) years.
5. Overweight and obesity are associated with
heart disease, certain types of cancer, type 2 diabetes, stroke, arthritis,
breathing problems, and psychological disorders, such as depression.
(4) Diabetes
(a) Discussion (sources:
www.adph.org and www.cdc.gov)
1.
Twelve percent (12%) of people in Alabama were diagnosed with diabetes in 2015.
Thousands are unaware that they have the disease.
2. The increased incidence of diabetes often
leads to obesity and kidney disease related issues, requiring additional
dialysis centers and services for treatment.
(5) Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS)
(a)
The Problem
1. By December 2019, transmission
of the AIDS virus occurs through sexual contact with an infected person,
exposure to infected blood or blood products, and perinatally from mother to
baby. Transmission patterns of the HIV virus have shifted over time. As of
2017, homosexual/bisexual men account for 66% of adult AIDS cases, with 3%
occurring in homosexual/bisexual men who use intravenous drugs. Diagnoses
attributable to injectable drug use alone have declined significantly over time
and accounted for only 6% of new diagnoses in 2017. Twenty-four percent (24%)
of new diagnoses come from among heterosexuals who have had sexual contact with
infected partners. Unfortunately, as of 2016, 15% of people infected with HIV
are unaware of their status, and 38% of new HIV infections resulted from
individuals who were unaware of their HIV-positive status.
2. By the end of 2016, Alabama had reported
13,437 AIDS cases. Of these, 13,397 were in adults and adolescents and 40 were
in children less than age 13. Alabama's AIDS cases by reported risk behavior
are as follows: 45.3% homosexual/bisexual male; 3.3% homosexual/bisexual with
IV drug user; 5.6% IV drug abuse; 0.2% transfusion related/hemophiliac; 19.9%
hetero-sexual contact with an infected person; and 24.9% were reported as
undetermined. Additionally, according to the Alabama Department of Public
Health, an estimated 1 in 6 people living with HIV in Alabama are unaware of
their infection. Based on the current prevalence rate, this means that
approximately 2,430 Alabama residents may have been infected and unaware of
their positive HIV status at the end of 2016.
3. There are at least one million Americans
silently infected with HIV. Most of them will get sick during the next decade.
Nationally, over 700,000 people with AIDS have died since the beginning of the
epidemic. Fifty-two percent (52%) of Alabama's reported AIDS cases have died.
The development of antiretroviral therapy (ART) has substantially reduced
AIDS-related morbidity and mortality and has improved long-term outcomes for
people with HIV. According to the Kaiser Family Foundation, the age-adjusted
HIV death rate has dropped by more than 80% since its peak in 1995. Because of
this, people already diagnosed with the disease are living much longer. This,
combined with the fact that new infections continue to occur, and more people
are diagnosed with HIV than die from complications due to the disease, means
that more people are living with the HIV virus than ever before.
4. In November 1987, the Alabama Department
of Public Health designated HIV infection reportable by provider and patient
name and identifiers. By the end of 2016, ADPH had received reports of 7,460
persons who tested positive for HIV and 5,977 additional persons whose
infection had advanced to Stage 3 (AIDS). Each one of these individuals is
potentially capable of transmitting the virus to someone else and will
ultimately have his/ her life shortened due to virus infection.
5. The lowest cost has been identified in
areas, which have strong out-of-hospital support networks to provide services
to AIDS and HIV positive patients. In addition to the obvious personal loss
experienced by families and friends, the loss of productivity due to deaths of
individuals with AIDS represents an economic cost to the state of more than
$800 million.
(b)
Recommendations
1. The state needs to pursue
three primary goals to deal with the problem of HIV/AIDS infection:
(i) The elimination of HIV transmission from
the infected population of Alabama to the uninfected population.
(ii) The provision of HIV services, both to
prevent infection and to provide care in an environment free of discrimination
and stigmatization.
(iii) The
provision of appropriate and necessary health care to infected
individuals.
2. The State
began participation in seroprevalence surveys with the Center for Disease
Control (CDC) in 1987. Data from these surveys indicate that the State needs to
continue to monitor the prevalence of infection in targeted at-risk
individuals, such as homosexual/ bisexual men, IV drug users, clients in
Sexually Transmitted Diseases (STD) and Tuberculosis (TB) clinics, and women
seeking prenatal and family planning services. Data collected in seroprevalence
surveys should be used to target populations and geographic areas in need of
HIV/AIDS prevention and educational efforts.
3. The State needs to establish interventions
to prevent the transmission of HIV from infected individuals to their sexual
and/or needle sharing partners. This need can be addressed by HIV
counseling/testing and partner notification services.
4. Since AIDS is only the end of a spectrum
of viral infection, the State needs to continue to monitor HIV infection
through established reporting mechanisms. Physicians, laboratories, and others
required by law to report should do so promptly to the Alabama Department of
Public Health.
5. Even if a vaccine
were available for HIV/AIDS, efforts to prevent transmission of the HIV virus
must rely heavily on education. Educational efforts must be targeted at the
general community as well as to designated at-risk individuals and populations.
Targeted educational messages must be specific, culturally sensitive and stress
how the virus is transmitted and ways to reduce or eliminate the risk of
transmission. Information directed at the general populace should not only
focus on how the virus is transmitted and ways to reduce individual risk, but
also stress how the virus is not transmitted so that discrimination,
stigmatization and ostracism of infected individuals are eliminated. The
Alabama Department of Public Health should serve as the focal point for
HIV/AIDS educational and informational activities.
6. The Alabama Department of Public Health
has established a multi-agency task force (Alabama AIDS Prevention Network)
which should serve to evaluate the effect of HIV/AIDS infection on the health
care needs of Alabama and its impact on the state's health care resources. A
system of community-based care for infected individuals must be established and
maintained utilizing home health services, Medicaid waiver programs, long-term
care facilities, hospice programs, and volunteer agencies.
7. Legislation defining the right of access
to HIV information for individuals who have a compelling need to know was
passed in late 1991. The State needs to continue to monitor and refine this
legislation in order to allow exchange of "needed" information, but in a
manner, which will protect confidentiality and prevent discrimination against
the HIV infected.
Author: Statewide Health Coordinating Council (SHCC)
Statutory Authority: Code of Ala. 1975, § 22-21-260(4).
Disclaimer: These regulations may not be the most recent version. Alabama may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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