Frequently Asked Questions

Answer goes here...

Answer goes here...

Answer goes here...

Answer goes here...

Answer goes here...

Answer goes here...

The flu usually comes on suddenly and may include these symptoms:

• Fever (usually high; over or at 101°F)
• Headache
• Extreme tiredness
• Dry cough
• Muscle aches/body aches
• Weakness
• Nausea, vomiting, and diarrhea can occur but are more common in children than adults.

Influenza causes mild to severe illness and can be fatal.

The flu spreads easily from person to person by coughing and sneezing. Most healthy adults may be able to infect others beginning one day before symptoms develop and up to five days after becoming sick. Children and immune-compromised people may pass the virus for longer than ten days. That means that a person may be able to pass on the flu to someone else before they feel ill, as well as during their illness. Some people can be infected with flu virus but have no symptoms. During this time, they can still spread influenza to others when they sneeze or cough.

The flu is unpredictable and can be severe, especially for older people, young kids, pregnant women and people with certain health conditions. These groups are at greater risk for serious complications if they get the flu, including:

• Bacterial pneumonia
• Ear infections
• Sinus infections
• Dehydration
• Worsening of chronic medical conditions (asthma, congestive heart failure, or diabetes).

It is recommended that all people six months of age or older get a flu vaccine. Everyone, every year!

• Because they are at high risk of serious flu-related complications or because they live with or care for high-risk persons, it is especially important for the following people to get an annual flu vaccine:
• Children 6 months through 6 years of age.
• Pregnant women
• Adults 50 years of age and older
• People of any age with chronic medical conditions
• People who live in long-term care facilities
• People with certain medical conditions, such as asthma, heart disease, chronic lung disease, blood, kidney, liver or neurologic disorders, weakened immune systems, endocrine disorders (such as diabetes),
• People who are more than 100 lbs. overweight
• American Indians/Alaska Natives
• People who live with or care for those at high risk for complications from flu, including:
  • Healthcare workers
  • Household contacts and caregivers of persons at high risk for complications from the flu
  • Caregivers and household contacts of children less than six months and persons over 50 years of age.

View a list of all the health and age factors that are known to increase a person's risk of getting serious flu complications.

Note: Please contact your doctor for more questions.

Asthma is a lung disease that inflames and narrows the airways. Asthma causes recurring periods of wheezing, chest tightness, shortness of breath, and coughing. Indoor and outdoor air pollutants, stress, changes in temperature, colds and other infections, and exercise can trigger asthma attacks.

Asthma is a chronic disease, like diabetes and high blood pressure. This means that once you develop asthma, you are likely to have it for a lifetime. Even when you are feeling just fine, the asthma is still there and can flare up at any time. A chronic condition like asthma requires daily attention.

It can be hard to tell if someone has asthma, especially in children under age 5. Having a doctor check how well your lungs work and check for allergies can help you find out if you have asthma.

The doctor will also do a breathing test, called spirometry, to find out how well your lungs are working. The doctor will use a computer with a mouthpiece to test how much air you can breathe out after taking a very deep breath. The spirometer can measure airflow before and after you use asthma medicine.

An asthma attack may include coughing, chest tightness, wheezing, and trouble breathing. The attack happens in your body’s airways, which are the paths that carry air to your lungs. As the air moves through your lungs, the airways become smaller, like the branches of a tree are smaller than the tree trunk. During an asthma attack, the sides of the airways in your lungs swell and the airways shrink. Less air gets in and out of your lungs, and mucus that your body makes clogs up the airways even more.

Allergens are substances that can cause you to have an allergic reaction. That is, in some people, the immune system sees them as “foreign” or “dangerous” and reacts in an exaggerated way to protect the body against them. Some common allergens are:

• Animal dander—scales or dried saliva from the hair, skin, or feathers of animals
• Dust mites—tiny bugs that thrive in mattresses, upholstered furniture, carpets, and stuffed animals
• Cockroach droppings
• Pollen from trees and grass
• Molds, both indoor and outdoor

Irritants are things in the environment that may irritate your lungs, such as:

• Cigarette smoke
• Air pollution, including ozone
• Cold air or changes in weather like freezing temperatures, high humidity, and thunderstorms
• Strong odors or sprays, such as perfumes, air fresheners, household cleaners, cooking fumes, paints, or varnishes

Most cases of campylobacteriosis are associated with eating raw or undercooked poultry (chicken, turkey, etc.). Even one drop of fluid from raw poultry could cause a person to become ill. One way people can become infected is through cross-contamination, for example, by cutting poultry on a cutting board and then using the inadequately washed cutting board or utensil to prepare vegetables or other raw foods. Infants may also become infected by contact with poultry packages in shopping carts.

Animals can become infected, and some people acquire infection from contact with the stool of an ill dog or cat, especially a young animal.

Campylobacteriosis usually occurs in single, sporadic cases, but it can occur in outbreaks, when a number of people become ill at one time. Outbreaks of campylobacteriosis are usually associated with unpasteurized milk, contaminated water, or improper cooking or handling of poultry. The organism does not usually spread from one person to another, but this can happen if the ill person is in diapers or is producing a large volume of diarrhea.

Most people who become ill with campylobacteriosis have diarrhea, cramping, abdominal pain, and fever. The diarrhea may be bloody and can be accompanied by nausea and vomiting. Some infected persons do not have any symptoms.

It is uncommon for Campylobacter infection to result in long-term consequences. However, Campylobacter occasionally spreads to the bloodstream and causes a serious life-threatening infection. Some people develop arthritis. Others may develop a rare condition called Guillain-Barré Syndrome.

(GBS) which begins several weeks after the diarrheal illness. GBS occurs when a person's immune system is "triggered" to attack the nerves, resulting in paralysis that lasts several weeks and usually requires intensive care. It is estimated that approximately one in every 1,000 reported Campylobacter illnesses leads to GBS. Campylobacteriosis is the most frequent cause of GBS.

Some simple food handling practices can help prevent Campylobacter infections.

• Wash hands with soap before preparing food.
• Wash hands with soap after handling raw foods of animal origin and before touching anything else.
• Prevent cross-contamination in the kitchen by using separate cutting boards for foods of animal origin and other foods. Carefully clean all cutting boards, countertops, and utensils with soap and hot water after preparing raw foods. Do not rinse poultry products prior to cooking them as this can lead to further contamination of kitchen surfaces through splashing.
• Cook all poultry products thoroughly. Make sure that the meat is no longer pink and that juices run clear. All poultry should be cooked to reach a minimum internal temperature of 165°F.
• If you are served undercooked poultry in a restaurant, send it back for further cooking.
• Avoid consuming unpasteurized milk and untreated surface water.
• Make sure that persons with diarrhea, especially children, wash their hands carefully and frequently with soap to reduce the risk of spreading illness.
• Wash hands with soap after contact with pet or bird feces.

The most common symptoms of chickenpox are rash, fever, headache, and loss of appetite. The rash usually develops on the trunk and face, and then spreads to the rest of the body. The rash first appears as many small, itchy, red bumps which turn into fluid-filled blisters. Several different groupings, or crops, of these blisters can appear over the following few days. Chickenpox illness lasts about five to ten days. Most children are uncomfortable for the duration of the disease. Children should be kept out of school or childcare until all blisters are dried and crusted over.

Persons with chickenpox are contagious for one to two days before the rash appears and continue to be contagious until all the blisters are crusted over, usually in four to seven days after rash onset.

It is spread from person to person by direct contact or through the air by coughing or sneezing. It is highly contagious. Direct contact spread of the virus occurs when a non-immune person is exposed to the fluid from blisters of a person who either has chickenpox or shingles. A person who has never had chickenpox will develop chickenpox when exposed to the virus for the first time, including exposure to shingles.

There is a special vaccination (VariZIG) that can be used to protect people at risk for complications who cannot be vaccinated using the traditional vaccine.

• The majority of people with type 2 diabetes initially had prediabetes, meaning that their blood glucose levels were higher than normal, but not high enough to indicate a diabetes diagnosis.
• People with pre-diabetes have an increased risk of developing type 2 diabetes, heart disease, and stroke.
• Take this test to find out if you are at risk for pre-diabetes

• Anyone aged 45 years or older should consider getting tested for diabetes, especially if you are overweight
• If you are younger than 45 but are overweight or obese, you should also consider getting teste

• Thirstiness
• Unexplained weight loss
• Extreme hunger
• Sudden vision changes
• Tingling or numbness in hands or feet
• Very dry skin
• Sores that are slow to heal
• More infections than normal
• Type 1 diabetes is also known as insulin-dependent diabetes or juvenile-onset diabetes. It accounts for 5% of all diagnosed cases.
• Type 2 diabetes is also known as non-insulin-dependent diabetes or adult-onset diabetes. It accounts for about 90-95% of all diagnoses cases.
• Gestational Diabetes is a type of diabetes that only pregnant women get.

Anyone of any age can become infected with STEC, but the very young and the elderly are more likely to develop serious complications. Even healthy older children and young adults can become seriously ill.

Shiga toxin-producing E coli can be acquired by eating contaminated food. These bacteria live in the intestines of some healthy cattle and contamination of their meat may occur during the slaughtering process. Sheep, deer, and other hoofed animals may also be infected with the organism. Improper handling of these meats or eating meat that is rare or inadequately cooked is a common way of becoming infected. Contaminated fresh vegetables, unpasteurized fruit juices, and raw milk have also caused STEC infections.

Person-to-person transmission, especially in childcare settings, can occur if infected people do not wash their hands thoroughly after using the toilet or after diapering children ill with diarrhea.

In addition, drinking contaminated water and swimming in contaminated lakes may cause infection. Infections have also resulted from direct contact with farm animals or their living areas.

Some infected people have mild diarrhea or no symptoms at all. Most identified cases develop severe diarrhea (which is often bloody), abdominal cramps and vomiting. Usually little or no fever is present. Persons who experience these symptoms should contact a healthcare provider.

The time between ingesting STEC bacteria and feeling sick is usually three to four days after an exposure

but may be as short as one day or as long as ten days.

In some people, particularly children under five years of age, the infection can cause a complication called hemolytic uremic syndrome (HUS), which affects the kidneys. Transfusions of blood or blood clotting factors, as well as kidney dialysis, may be necessary to treat this syndrome. HUS, if it occurs, develops an average of seven days after the first symptoms, when the diarrhea is improving. A prolonged hospital stay is often required. Most people with HUS recover completely, but it can be fatal.

• Cook meats thoroughly. Ground beef and meats that have been needle-tenderized, e.g. pound steak,
• should be cooked to a temperature of at least 160°F/70 ̊C. It is best to use a thermometer as color is not a reliable indicator of doneness.
• Prevent cross contamination in food preparation areas by thoroughly washing hands, counters, cutting boards, and utensils after they touch raw meat or their juices.
• Avoid raw milk, unpasteurized dairy products, and unpasteurized juices, like fresh apple cider.
• Wash your hands thoroughly after using the bathroom or changing diapers and before preparing or eating food.
• Wash your hands after contact with animals or their environments – at farms, petting zoos, fairs, and at home.
• AVOID swallowing water when swimming or playing in lakes, ponds, streams, swimming pools, and “kiddie” pools.

• Contact Grant County Health District, (509) 766-7960, for information about monitoring, especially if you:
  • were in an area with an Ebola outbreak, particularly if you were in contact with blood or body fluids or items that have come in contact with blood or body fluids.
  • visited a hospital or clinic where Ebola patients were being treated or you participated in burial rituals/practices.
  • had contact with wild animals or raw meat.
• Seek medical care immediately if you develop a fever (temperature of 100.4°F/ 38.0°C) and any of the following symptoms: headache, muscle pain, diarrhea, vomiting, stomach pain, or unexplained bruising or bleeding.
• Tell your doctor about your recent travel and your symptoms before you go to the office or emergency room. Advance notice will help your doctor care for you and protect other people who may be in the  same medical setting.

• Fever (greater than 38°C or 100.4°F)
• Severe headache
• Muscle pain
• Weakness
• Diarrhea
• Vomiting
• Abdominal (stomach) pain
• Unexplained hemorrhage (bleeding or bruising)

Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola, but the average is 8 to 10 days.

Recovery from Ebola depends on the patient’s immune response. Once someone recovers from Ebola, they can no longer spread the virus. However, the Ebola virus has been found in semen for up to three months. People who recover from Ebola are advised to abstain from sex or use condoms for three months.

People who recover from Ebola infection develop antibodies that last for at least 10 years.

Giardia is found in the feces of infected animals or humans. To become infected, a person must consume contaminated food or water including drinking from streams or rivers.

In Washington State, 700 to 900 cases of giardiasis are reported annually. The most common exposures reported by Washington residents include recreational water exposure and international travel.

Anyone can get giardiasis. Persons more likely to become infected include:

• People who drink water or use ice made from contaminated sources (e.g., lakes, streams, shallow or
• poorly monitored or maintained wells). Contaminated water may include water that has not been boiled, filtered, or disinfected with chemicals.
• People who swallow contaminated water while swimming, especially in lakes, rivers, springs, ponds,
• and streams. Several community-wide outbreaks have been linked to recreational water or drinking water contaminated with Giardia.
• People who eat uncooked food that contains Giardia organisms.
• Children in childcare settings.
• Close contacts (such as those in the same family or in the same household or childcare setting) or caregivers of infected people.
• International travelers.
• People exposed to human feces through sexual contact.

Giardia infection can cause a variety of intestinal signs or symptoms, which include:

• Diarrhea
• Gas or flatulence
• Greasy or foul smelling stools
• Stomach or abdominal cramps
• Upset stomach or nausea

These symptoms may lead to weight loss and dehydration. Some people with Giardia infection have no symptoms at all.  Symptoms may last 2 to 6 weeks, but can sometimes last longer. Medications can help decrease the amount of time symptoms last.

Anything that comes in contact with feces from infected humans or animals can become contaminated with the Giardia parasite. People become infected when they swallow the parasite. Giardiasis is commonly spread person to person when the ill person does not adequately wash their hands after using the toilet and then contaminates another person’s food or drink. Lastly, Giardia is sometimes found in water or on surfaces, or soil contaminated with the feces from infected humans or animals.

Symptoms of giardiasis can begin between 3 to 25 days after becoming infected, with the average being between 7 to 10 days.

Giardia infection can cause lingering symptoms and complications, especially in infants and children under 5. The most common complications include:

• Dehydration. Often a result of severe diarrhea, dehydration occurs when the body doesn’t have
• enough water to carry out its normal functions.
• Failure to thrive. Chronic diarrhea from Giardia infection can lead to malnutrition and harm a child’s
• physical and mental development.
• Lactose intolerance. Many people with Giardia infection develop lactose intolerance — the inability to properly digest milk sugar. The problem may persist long after the infection has cleared, leading to weight loss in some people.

HFMD typically affects children under the age of five. Adults may sometimes become infected with the virus. HFMD is most common in children in childcare settings because of frequent diaper changes and potty training, and because little children often put their hands in their mouths. HFMD is not transmitted to or from pets or other animals.

Initial symptoms of HFMD include fever, poor appetite, a general feeling of being unwell, and sore throat. One or two days after fever starts, painful sores often develop in the mouth. They begin as small red spots that blister, often becoming ulcers. Next, a non-itchy rash with flat or raised red spots, sometimes with blisters, will develop over one to two days. The rash typically appears on the palms of hands and bottoms of feet and can also appear on the knees, buttocks, elbows or genital area. Persons infected with the viruses that cause HFMD may not get all the symptoms. They may only get mouth sores or skin rash.

HFMD is moderately contagious and is spread from person to person by direct contact with nose and throat secretions (such as saliva, sputum or nasal mucus), fluid from blisters, and stool (feces) of the infected person. The virus may be spread when infected persons touch objects and surfaces that are then touched by others.

People infected with the virus are most contagious during the first week of their illness. The virus that causes HFMD can remain in the body for weeks after a person’s symptoms have gone away. This means infected people can still pass the virus to others even though they appear well. Also, some infected people, including most adults, may have no symptoms but still shed the virus.

There is no specific treatment for HFMD. Over-the-counter medications can be useful for fever and mouth pain.

• If you are concerned about your symptoms you should contact your health care provider.

Good hand washing is important to reduce the spread of HFMD. Children and adults should use proper hand hygiene, especially after using the toilet and changing diapers.

Excluding children from school and child care during the first few days of the infection will reduce the spread of the virus. In home and child care settings, thorough cleaning and disinfection of contaminated surfaces and items with a diluted bleach solution (1 part bleach to 10 parts water) is an effective way to reduce the spread of viruses.

• International travelers, particularly those traveling to developing countries.
• People who live with or have sex with an infected person.
• People living in areas where children are not routinely vaccinated against Hepatitis A, where outbreaks are more likely.
• Employees and children at day care centers during outbreaks.
• Have sexual contact with someone who has HAV including men who have sex with men.
• Users of recreational drugs, injection or other.
• Have clotting factor disorders, such as hemophilia.

Hepatitis A usually spreads when a person unknowingly ingests the virus from objects, food, or drinks contaminated by small, undetected amounts of stool from an infected person. Hepatitis A can also spread from close personal contact with an infected person such as through sex or caring for someone who is ill.

If symptoms occur, they usually start appearing 4 weeks after exposure, but can occur as early as 2 and as late as 7 weeks after exposure. Symptoms usually develop over a period of several days.

Symptoms usually last less than 2 months, although some people (10% to 15%) with hepatitis A can have symptoms for as long as 6 months.

Yes. Many people, especially children, have no symptoms. In addition, a person can transmit the virus to others up to 2 weeks before symptoms appear

Older children and adults typically have symptoms. If symptoms develop, they can appear abruptly and can include:

• Fever
• Fatigue
• Loss of appetite
• Nausea
• Vomiting
• Abdominal pain
• Dark urine
• Clay-colored stools
• Joint pain
• Jaundice (yellowing of the skin and eyes)

Most children younger than age 6 do not have symptoms when they have hepatitis A. When symptoms are present, young children typically do not have jaundice but most older children and adults with hepatitis A have jaundice.

• Infants born to infected mothers
• Sex partners of infected persons
• Sexually active persons who are not in a long-term, mutually monogamous relationship (e.g., >1 sex partner during the previous 6 months)
• Men who have sex with men
• Injection drug users
• Household contacts of persons with chronic Hepatitis B infection
• Health care and public safety workers at risk for occupational exposure to blood or blood-contaminated body fluids
• Hemodialysis patients
• Residents and staff of facilities for developmentally disabled persons
• Travelers to countries with intermediate or high prevalence of Hepatitis B infection

The virus is transmitted through contact with the blood, semen, or other body fluids of an infected person.

Transmission can happen through:

• Sexual contact
• Sharing needles, syringes, or other drug-injection equipment
• From mother to baby at birth
• Sharing items such as razors or toothbrushes with an infected person
• Direct contact with the blood or open sores of an infected person

Transmission does not occur by:

• Sharing eating utensils
• Breastfeeding
• Coughing or sneezing
• Hugging, kissing, holding hands, or other casual contact
• Hepatitis B virus is not found in urine or feces

On average, symptoms appear 90 days (three months) after exposure, but they can appear any time between six weeks and six months after exposure.

Infection with Hepatitis B can lead to immunity – if you recover from acute infection and the infection does not progress to chronic infection. The younger a person is when infected with Hepatitis B , the greater their chance of developing chronic Hepatitis B. Once you recover from Hepatitis B, you must get tested by your provider to see if you have developed immunity. Being free from symptoms does not mean that your immune system fought off the infection.

Chronic Hepatitis B is a serious disease that can result in long term health problems, including liver damage, liver failure, liver cancer, or even death. Approximately 2,000 to 4,000 people die every year from Hepatitis B-related liver disease in the United States.

The presence of signs and symptoms varies by age. Most children under age 5 years and newly infected immunosuppressed adults are asymptomatic. When present, signs and symptoms can include:

• Fever
• Fatigue
• Loss of appetite
• Nausea
• Vomiting
• Abdominal pain
• Dark urine
• Clay-colored bowel movements
• Joint pain
• Jaundice

The following persons are at known to be at increased risk:

• Current or former injection drug users, including those who injected only once many years ago
• Recipients of clotting factor concentrates made before 1987, when more advanced methods for manufacturing those products were developed
• Recipients of blood transfusions or solid organ transplants before July 1992, when better testing of blood donors became available
• Chronic hemodialysis patients
• Persons with known exposures to Hepatitis C, such as
  • health care workers after needle sticks involving Hepatitis C positive blood
  • recipients of blood or organs from a donor who tested Hepatitis C-positive
• Persons with HIV infection
• Children born to Hepatitis C-positive mothers

Hepatitis C is transmitted primarily through large or repeated percutaneous (i.e., passage through the skin) exposures to infectious blood, such as:

• Injection drug use (currently the most common means transmission in the United States)
• Receipt of donated blood, blood products, and organs (once a common means of transmission but now rare in the United States since blood screening became available in 1992)
• Needle stick injuries in health care settings
• Birth to an Hepatitis C-infected mother

Hepatitis C can also be spread infrequently through:

• Sex with a Hepatitis C infected person (an inefficient means of transmission)
• Sharing personal items contaminated with infectious blood, such as razors or toothbrushes (also inefficient vectors of transmission)
• Other health care procedures that involve invasive procedures, such as injections (usually recognized in the context of outbreaks)

Transmission does not occur by:

• Sharing eating utensils
• Breastfeeding
• Hugging, kissing, holding hands, coughing, sneezing, or other casual contact
• Hepatitis C virus is not found in urine or feces
• Through food or water

Infection with Hepatitis C can lead to immunity - if you recover from acute infection and the infection does not progress to chronic infection. Approximately 75-85% of people acutely infected will go on to develop a chronic infection.

Once you recover from Hepatitis C, you must get tested by your provider to see if you have cleared the virus. Being free from symptoms does not mean that your immune system fought off the infection.

Chronic Hepatitis C is a serious disease that can result in long term health problems, including liver damage, liver failure, liver cancer, or even death. Approximately 8,000 to 10,000 people die every year from Hepatitis C-related liver disease in the United States.

Persons with newly acquired Hepatitis C infection usually are asymptomatic or have mild symptoms that are unlikely to prompt a visit to a health care professional. When symptoms occur, they can include:

• Fever
• Fatigue
• Dark urine
• Clay-colored stool
• Abdominal pain
• Loss of appetite
• Nausea
• Vomiting
• Joint pain
• Jaundice

• Through vaginal, anal or oral sex with a person who has the virus
• HPV can be transmitted even when an infected person has no signs or symptoms

• There is no test to find out a person’s HPV status
• Instead, there are HPV tests that can be used to screen for cervical cancer. These are typically for women aged 30 years or older.
• Most infected people do not know they are infected and never develop symptoms or health problem. Others find out they have HPV when they develop genital warts or an abnormal Pap test result.

Measles is a highly-contagious respiratory disease caused by a virus. It spreads easily through coughing and sneezing. Measles starts with a fever, runny nose, cough, red eyes, and sore throat, and is followed by a rash that spreads all over the body. It spreads so easily that someone who is not protected through being immunized or having had measles in the past, can get it if they walk into a room where someone with the disease has been in the past couple of hours.

Measles is a very serious disease. About one out of 10 children with measles also gets an ear infection, which can result in hearing loss, and up to one out of 20 gets pneumonia. One or two out of 1,000 die from measles complications. Measles can also cause pregnant woman to give birth prematurely or have a low birth weight baby. Complications from measles are very common among children younger than five and adults older than 20.

Measles spreads so easily that anyone who is exposed to it and is not immune (for example, someone who has not been vaccinated) will probably get the disease.

Anyone who hasn’t been immunized or had measles in the past is at risk. Babies younger than 12 months are at risk because most are too young to have been vaccinated yet. Pregnant women, young kids, and people with weakened immune systems are at highest risk for complications from measles.

• 7 to 21 days after exposure: mild to moderate fever, cough, runny nose, red eyes, and sore throat.
• 2 to 4 days after symptoms begin: tiny white spots may appear inside the mouth.
• 3 to 5 days after symptoms begin: a red or reddish-brown raised rash that feels like sandpaper appears, usually beginning on the face. The rash rapidly spreads down the neck, upper arms, and chest. Later, it spreads over the back, abdomen, the rest of the arms, thighs, legs, and feet. When the rash appears, a person’s fever may spike to more than 104 degrees Fahrenheit.

Symptoms usually last seven to 10 days.

Call your doctor, nurse or clinic right away. Before you go to the provider’s office, call to tell them that you or your family member might have measles. This will allow them to take steps to avoid exposing other people. Try to stay away from other people until at least four days after the rash starts or a test proves it’s not measles.

The symptoms of measles generally appear about seven to 14 days after a person is infected.

Measles typically begins with:

• high fever,
• cough,
• runny nose (coryza), and
• red, watery eyes (conjunctivitis)

Two or three days after symptoms begin, tiny white spots (Koplik spots) may appear inside the mouth.

Three to five days after the start of symptoms, a red or reddish-brown rash appears. The rash usually begins on a person's face at the hairline and spreads downward to the neck, trunk, arms, legs, and feet.

When the rash appears, a person's fever may spike to more than 104° F. After a few days, the fever subsides and the rash fades.

This organism is spread by direct contact with nasal or throat secretions of a carrier or ill person. Transmission can occur by sharing saliva via eating utensils, glassware, cigarettes, toothbrushes or kisses, and when people sleep near each other or share a household.

Meningitis symptoms include sudden onset of fever, headache, and stiff neck. There are often other symptoms, such as:

• Nausea
• Vomiting
• Photophobia (increased sensitivity to light)
• Altered mental status (confusion)

In newborns and babies, the meningitis symptoms of fever, headache, and neck stiffness may be absent or difficult to notice. The baby may be irritable, vomit, feed poorly, or appear to be slow or inactive. In young babies, doctors may also look for a bulging fontanelle (soft spot on infant's head) or abnormal reflexes. If you think your baby or child has any of these symptoms, call the doctor right away.

Symptoms of bacterial meningitis can appear quickly or over several days. Typically they develop within 3 to 7 days after exposure.

The viruses which most often cause meningitis (enteroviruses) are spread through direct contact with the respiratory secretions of an infected person. This usually happens by shaking hands with an infected person or touching something they have handled, and then rubbing one’s own nose, mouth or eyes. These viruses can also be found in the stool of persons who are infected and can be spread to anyone who helps with toileting or handles the diapers of an infected person.

Viral meningitis symptoms usually begin between three to seven days after becoming infected with an enterovirus. These symptoms usually last from seven to ten days and the patient recovers completely. It should be noted that only a small percentage of people who become infected with an enterovirus will develop viral meningitis.

A person infected with viral meningitis is contagious for about one week after symptoms develop.

Viral meningitis is an illness that usually goes away on its own without treatment or complications.

Common symptoms in babies:

• Fever
• Irritability
• Poor eating
• Sleepiness or trouble waking up from sleep
• Lethargy (a lack of energy)

Common symptoms in adults:

• Fever
• Headache
• Stiff neck
• Sensitivity to bright light
• Sleepiness or trouble waking up from sleep
• Nausea
• Vomiting
• Lack of appetite
• Lethargy (a lack of energy)

Anyone can get MRSA on their body from contact with an infected wound or by sharing personal items, such as towels or razors, that have touched infected skin.

MRSA infection risk can be increased when a person is in activities or places that involve crowding, skin-to-skin contact, and shared equipment or supplies. People including athletes, daycare and school students, military personnel in barracks, and those who recently received inpatient medical care are at higher risk.

Sometimes, people with MRSA skin infections first think they have a spider bite. However, unless a spider is actually seen, the irritation is likely not a spider bite. Most staph skin infections, including MRSA, appear as a bump or infected area on the skin that might be:

• Red
• Swollen
• Painful
• Warm to the touch
• Full of pus or other drainage
• Accompanied by a fever

Mumps is a disease caused by a virus. It typically starts with a few days of fever, headache, muscle aches, tiredness, and a loss of appetite.  However, mumps is best known for the facial jaw and swelling (one or both cheeks may look swollen) . Symptoms may appear 12-25 days after exposure, usually 16- 18 days after exposure. Mumps usually goes away on its own in about 10 days. But in some cases, it can cause complications that affect the brain, the testicles, the ovaries, or the pancreas.

• Swelling of the cheeks and jaw (one or both cheeks may look swollen)
• Fever
• Headache, earache, sore throat, and pain when they swallow or open their mouth
• Pain when eating sour foods or drink sour liquids, such as fruit or juice
• Feeling tired
• Poor appetite
• Testicular pain (males) or pelvic discomfort (females)

A person with mumps can spread the virus by coughing, sneezing, or spraying saliva while talking. It can also be spread by sharing cups or eating utensils, and by touching objects or surfaces with unwashed hands that are then touched by others.

It's especially important for you to take precautions when traveling to a county where mump cases have been reported. Avoid kissing, hugging and other close contact with anyone who is suspected of having mumps.

• Infants who are too young to receive MMR vaccine (under 1 year of age).
• Children over 1 year of age who have not received at least 1 dose of MMR (2 doses are required for school-aged children).
• Children should get two doses of MMR vaccine, starting with the first dose at 12 to 15 months of age, and the second dose at 4 to 6 years of age.
• Teenagers and adults should also be up to date on their MMR vaccination (2 doses of MMR vaccine or a blood test that can prove immunity to mumps).
• Adults born in or after 1957 who have not been vaccinated or have not previously had mumps.
• Unvaccinated individuals who are unsuitable candidates for vaccination (e.g., those with health care provider-documented severe allergic reaction to a vaccine component, immunocompromised, or pregnant).
• If you are unsure whether you or your child have been vaccinated, please contact your healthcare provider.

Note: Persons born before 1957 likely had mumps as children and are usually considered immune, unless they work in healthcare. Healthcare workers should receive the vaccination.

• If you were born in or after 1957, it’s very important that you check your records for immunization against mumps. You likely received at least one dose of MMR vaccine during your routine childhood vaccinations.
•  If you have not received MMR vaccine before or if you are unsure, please get vaccinated at your healthcare provider’s office or visit your local pharmacy.
• Pregnant women cannot receive the MMR vaccine; if you are pregnant, please speak with your healthcare provider.
• You can also ask your healthcare provider for a blood test (called a titer) that can prove immunity to mumps.

• Make sure you and your children are up to date on MMR vaccine. Your healthcare provider's office has the vaccine in supply. Adults can also contact their local pharmacy to schedule an appointment. Most health insurance plans cover the cost of the vaccine.
  • Where can you get the MMR Shot in Grant County? Visit the Health Map Finder and type in your zip code
  • If you don't have a healthcare provider, call GCHD 509-766-7960 or the Family Health Hotline at 800-322-2588.
• You can also ask your healthcare provider for a blood test (called a titer) that can prove immunity to mumps.
• Stay away from anyone who has mumps.
• Wash your hands often with soap and water.
• Avoid sharing drinks or utensils used for eating.
• Disinfect frequently touched surfaces, such as toys, doorknobs, tables, and counters.

• If you or your child has symptoms of mumps (fever, headache, muscle aches, tiredness, loss of appetite, and swollen cheeks or jaw), call your healthcare provider immediately.
• If anyone in your home feels sick with mumps, healthcare providers need you to do these things below:
  • Stay inside your home as much as you can. Do not go on a plane or bus. Do not go to restaurants, stores or church. Do not go to school or work.
  • Call the health department and healthcare provider. Please call the health department at 509-766-7960. Please call your healthcare provider. We can help you if you have mumps. We can help your family not get sick.
  • Do not cough near others. Wash your hands with soap and water frequently. Cover your coughs/sneezes so other people do not get your germs. Do not share drinks. Do not share forks or spoons.

Noroviruses are found in the stool or vomit of infected people. People can become infected by:

• Having direct contact with an ill person.
• Eating foods or drinking liquids that are contaminated with Noroviruses.
• Touching surfaces or objects contaminated with Noroviruses and then touching their own mouth.

Norovirus can spread quickly in closed places like daycare centers, nursing homes, schools, and cruise ships. Most norovirus outbreaks happen from November to April in the United States.

Norovirus causes inflammation of the stomach intestines or both. This is called acute gastroenteritis.

The most common symptoms include:

• diarrhea
• throwing up
• nausea
• stomach pain
• fever
• headache
• body aches

A person usually develops symptoms 12 to 48 hours after being exposed to norovirus. Most people with norovirus illness get better within 1 to 3 days.

If you have norovirus illness, you can feel extremely ill and throw up or have diarrhea many times a day. This can lead to dehydration, especially in young children, older adults, and people with other illnesses.

Symptoms of dehydration:

• decrease in urination
• dry mouth and throat
• feeling dizzy when standing up

Children who are dehydrated may cry with few or no tears and be unusually sleepy or fussy.

The symptoms of pink eye may vary depending on the cause but usually include:

• Redness or swelling of the white of the eye or inside the eyelids
• Discomfort, scratchy feeling, itching, or pain in the eye
• Increased amount of tears
• Eye discharge which may be clear, yellow, white or green
• Itchy, irritated, and/or burning eyes
• Increased sensitivity to light
• White of the eye may appear pink or red, sometimes with visible blood vessels
• Crusting of the eyelids or lashes

If someone has a viral infection, the discharge from the eye will usually appear watery and clear. Discharge from a bacterial infection will often appear thick and white, yellow, or green in color. Infectious pink eye, either viral or bacterial, may begin in one eye and move to the other eye. Pink eye caused by allergies or other irritants will often arise in both eyes at once.

The incubation period for viral conjunctivitis is up to a week. The infection may last up to two weeks. In bacterial pink eye, the incubation period can be as little as a few days. A bacterial infection typically lasts up to a week when treated with antibiotics.

It is important to seek medical advice and treatment if a child has symptoms of pink eye, whether the infection is viral or bacterial. If the child complains of severe pain, changes in eyesight, or sensitivity to light, seek medical attention immediately, even if treatment has been completed.

Typical treatment for pink eye from a viral infection is a cool water compress which may soothe the discomfort.

Treatment for bacterial infections usually includes the use of an antibiotic. A child with a bacterial infection will need to be kept at home and treated with the antibiotic for one full day before returning to school or childcare. A cold compress also relieves symptoms of bacterial infections.

Pink eye from allergies and irritants often is treated with lubricant and antihistamine eye drops.

Children at risk:

• Children younger than 2 years old
• Children in group child care
• Children who have certain illnesses (sickle cell disease, HIV infection, chronic heart or lung conditions)
• Children with cochlear implants or cerebrospinal fluid leaks.
• Some American Indian, Alaska Native and African American children may be at an increased risk for the disease.

Adults at risk:

• Adults 65 years or older
• Adults with chronic illnesses (lung, heart, liver or kidney disease, asthma, diabetes and alcoholism)
• Adults living in nursing homes or any other long-term care facility
• Adults with cochlear implants or cerebrospinal fluid (CSF) leaks
• Adults who smoke cigarettes

There are many types of pneumococcal disease. Symptoms and complications depend on the part of the body that is infected.

Lung Infection

Pneumococcal pneumonia (lung infection) is the most common serious form of pneumococcal disease. Symptoms include:

• Fever and chills
• Cough
• Rapid breathing or difficulty breathing
• Chest pain

Older adults with pneumococcal pneumonia may experience confusion or low alertness, rather than the more common symptoms listed above.

Meningitis

Pneumococcal meningitis is an infection of the tissue covering the brain and spinal cord. Symptoms include:

• Stiff neck
• Fever
• Headache
• Photophobia (eyes being more sensitive to light)
• Confusion

In babies, meningitis may cause poor eating and drinking, low alertness, and vomiting.

Blood Infections

Pneumococcal bacteremia is a blood infection. Symptoms include:

• Fever
• Chills
• Low alertness

Sepsis

Sepsis is a complication caused by the body's overwhelming and life-threatening response to an infection, which can lead to tissue damage, organ failure, and death. Symptoms include:

• Confusion or disorientation
• Shortness of breath
• High heart rate
• Fever, shivering, or feeling very cold
• Extreme pain or discomfort
• Clammy or sweaty skin

Ear Infections

Pneumococcus bacteria cause up to half of middle ear infections (otitis media). Symptoms include:

• Ear pain
• A red, swollen ear drum
• Fever
• Sleepiness

Infants and Young Children

• Premature infants
• Very young infants, especially those 6 months and younger
• Children younger than 2 years old with chronic lung disease
• Children younger than 2 years old with chronic heart disease
• Children with weakened immune systems
• Children who have neuromuscular disorders, including those who have difficulty swallowing or clearing mucus secretions

Older Adults

• Older adults, especially those 65 years and older
• Adults with chronic heart or lung disease
• Adults with weakened immune systems

RSV can spread when an infected person coughs or sneezes. Coughing and sneezing send virus-containing droplets into the air, where they can infect a person who inhales the droplets.

Infection can also result from direct and indirect contact with nasal or oral secretions from infected persons. Direct contact with the virus can occur, for example, by kissing the face of a child with RSV. Indirect contact can occur if the virus gets on an environmental surface, such as a doorknob, that is then touched by other people. Direct and indirect transmission of the virus usually occurs when people touch a contaminated surface and then touch their eyes, mouth, or nose

Symptoms of RSV infection usually include:

• Runny nose
• Decrease in appetite
• Coughing
• Sneezing
• Fever
• Wheezing

Rotavirus is most common in infants and young children, but older children and adults can become with rotavirus as well.

Rotavirus spreads easily among infants and young children. Children can spread the virus both before and after they become sick with diarrhea. They can also pass rotavirus to family members and other people with whom they have close contact. Rotavirus can be spread by contaminated:

• Hands
• Objects (toys, surfaces)
• Food
• Water

Children are most likely to get rotavirus in the winter and spring (December through June).

Children who get infected may have severe watery diarrhea, often with vomiting, fever, and abdominal pain. Vomiting and watery diarrhea can last from 3 to 8 days. Additional symptoms may include loss of appetite and dehydration (loss of body fluids), which can be especially dangerous for infants and young children.

Symptoms of dehydration include:

• decrease in urination
• dry mouth and throat
• feeling dizzy when standing up

A dehydrated child may also:

• cry with few or no tears
• be unusually sleepy or fussy.

Adults who get rotavirus disease tend to have milder symptoms.

Anyone of any age can become infected with Salmonella bacteria, but children are at the greatest risk. Children under the age of 5 have higher rates of Salmonella infection compared to other age group. However, others at high risks include:

• Young children,
• older adults,
• and people with weakened immune systems

People typically become infected by eating contaminated food or by having contact with an infected person or animal. Salmonellosis is typically a food-borne illness acquired from contaminated raw or undercooked poultry, eggs, sprouts, and unpasteurized juice.

Fresh fruits and vegetables also can become contaminated with Salmonella. Other sources include contact with infected pets and livestock, such as cats, cattle, reptiles (including turtles, frogs, lizards and snakes), and poultry (including chickens, ducks, geese and turkeys).

Symptoms can include severe diarrhea, bloody diarrhea, fever, chills, abdominal discomfort (cramps), and occasionally vomiting. The symptoms generally appear one to three days after exposure. Serious bloodstream infections can occur, particularly in the very young or elderly.

Symptoms begin one to three days after being infected. Illness usually lasts four to seven days, and most persons recover without treatment. Young children, the elderly, and those who are immune-compromised, are the most likely to have severe infections.

Passing infection to another person is possible as long as bacteria are being shed in the stool. Anyone, especially a young child, may shed the bacteria for weeks to months. Those who have been treated with oral antibiotics tend to shed the bacteria longer, so use of antibiotics is based on the severity of the illness. Excellent hand washing is helpful in preventing the spread of illness.

• Wash your hands with soap and warm water before and after handling foods, after using the bathroom or changing a baby’s diaper, and after contact with animals.
• Wash and sanitize all cutting boards, surfaces, and utensils after they have touched raw eggs, poultry or meat.
• Thoroughly wash hands after handling raw eggs, poultry or meat and before handling other food products.
• Do not eat raw or undercooked eggs, poultry or meat. Be aware that there may be raw eggs in homemade sauces, salad dressings, and desserts.
• People infected with salmonellosis should avoid cooking or serving food or drinks to others.
  • Never prepare food for other people if you have diarrhea.
• Anyone who handles animals especially baby animals, reptiles and animals with  diarrhea, should wash their hands immediately afterwards. Children who handle animals may require close supervision to ensure that they have washed thoroughly.
  • Avoid direct and indirect contact between reptiles and infants or immunocompromised persons.
• Do not swim in pools or lakes if you have diarrhea.

• Crusted scabies is a severe form of scabies that can occur in some persons who are immunocompromised (have a weak immune system), elderly, disabled, or debilitated. It is also called Norwegian scabies. Persons with crusted scabies have thick crusts of skin that contain large numbers of scabies mites and eggs
• Persons with crusted scabies are very contagious to other persons and can spread the infestation easily both by direct skin-to-skin contact and by contamination of items such as their clothing, bedding, and furniture.
• Persons with crusted scabies should receive quick and aggressive medical treatment for their infestation to prevent outbreaks of scabies.

Infestation is common, found worldwide, and affects people of all ethnic backgrounds and social classes. Because scabies spreads easily under crowded conditions where close body and skin contact is common, institutions such as nursing homes, extended-care facilities, childcare facilities, and prisons are often sites of scabies outbreaks. In  addition, household members and sexual partners of infested people are also at high risk.

• Scabies usually is spread by direct, prolonged, skin-to-skin contact with a person who has scabies. Contact generally must be prolonged; a quick handshake or hug usually will not spread scabies.
• Scabies is spread easily to sexual partners and household members. Scabies in adults frequently is sexually acquired. 
•  An infested person can spread scabies even if he or she has no symptoms.
• Household pets and other animals do not spread the human form of scabies.

• Itching. Itching is caused by an allergic reaction to the proteins and feces of the mite. Severe itching, especially at night, is the earliest and most common symptom of scabies.
• Rash. A pimple-like itchy rash is common and may affect much of the body or be limited to common sites such as between the fingers, wrist, elbow, armpit, penis, nipple, waist, buttocks, and belt-line. The head, face, neck, palms, and soles are often infested in infants and very young children, but usually not in adults and older children.
• Burrows. Tiny burrows are sometimes seen on the skin. These are caused by the female scabies mite tunneling just beneath the surface of the skin. Burrows appear as tiny raised and crooked grayish-white or skin-colored lines on the skin surface. Because mites are often few in numbers, these burrows may be difficult to find.

People with crusted scabies may not show the usual signs and symptoms of scabies such as the characteristic rash or itching.

Anyone who has had chickenpox can get shingles. Shingles is more common in persons with depressed immune systems and in persons over the age of 50, but it can also occur in children. Typically, the symptoms in children are milder than in adults. People with weakened immune systems may have more severe disease.

• Shingles cannot be passed from one person to another. However, the virus that causes shingles, the varicella zoster virus, can spread from a person with active shingles to cause chickenpox in someone who had never had chickenpox  or received chickenpox vaccine.
• The virus is spread through direct contact with fluid from the rash blisters caused by shingles.
• A person with active shingles can spread the virus when the rash is in the blister-phase. A person is not infectious before the blisters appear. Once the rash has developed crusts, the person is no longer infectious.
• Shingles is less contagious than chickenpox and the risk of a person with shingles spreading the virus is low if the rash is covered.

Shingles is a painful rash that develops on one side of the face or body. The rash consists of blisters that typically scab over in 7 to 10 days. The rash usually clears up within 2 to 4 weeks. Before the rash develops, people often have pain, itching, or tingling in the area where the rash will develop. This may happen anywhere from 1 to 5 days before the rash appears. Most commonly, the rash occurs in a single stripe around either the left or the right side of the body. In other cases, the rash occurs on one side of the face. In rare cases (usually among people with weakened immune systems), the rash may be more widespread and look similar to a chickenpox rash. Shingles can affect the eye and cause loss of vision.

Other symptoms of shingles can include:

• Fever
• Headache
• Chills
• Upset stomach

Whooping cough is very serious, especially for babies and young kids. Whooping cough can cause pneumonia, seizures, brain damage, and death. Babies younger than one year of age who get whooping cough may be hospitalized or even die.

Symptoms of pertussis usually develop within 5 to 10 days; but can present up to 3 weeks following exposure.

Early Symptoms

Early symptoms can last for 1 to 2 weeks and usually include:

• Runny nose
• Low-grade fever (generally minimal throughout the course of the disease)
• Mild, occasional cough
• Apnea - a pause in breathing (in babies)

Because pertussis in its early stages appears to be nothing more than the common cold, it is often not suspected or diagnosed until the more severe symptoms appear.

Late symptoms

After 1 to 2 weeks and as the disease progresses, the traditional symptoms of pertussis may appear and include:

• Long series of coughs ("coughing fits")
• Rapid coughs followed by a high-pitched "whoop"
• Vomiting during or after coughing fits
• Turning blue or difficulty catching breath during or after coughing fits
• Exhaustion after coughing fits

Whooping cough is generally treated with antibiotics. It’s important to start treatment as soon as possible to help keep from spreading the disease to others. Early treatment can also make the symptoms end sooner and be less severe.

Getting vaccinated is the best way to lower the risk of getting whooping cough. It’s important to wash your hands, cover your cough, and stay home whenever you’re sick.

People at greatest risk from whooping cough include:

• Infants under one year old.
• Pregnant women (especially in the third trimester).
• People that have a chronic respiratory illness.

Yes. You can have whooping cough without realizing it and infect others. It's especially important for people who are going to be around babies or pregnant women to know. They should make sure they are vaccinated and stay away from high risk people when they have a runny nose or cough.

Please make sure that you and your family are all properly vaccinated with pertussis vaccines. A pertussis (Tdap) shot is recommended for all who are not up to date. The vaccine reduces the chance that a person will become sick with pertussis. Getting pertussis does not prevent one from getting it again in the future.

• DTaP pertussis vaccine is only given to children under age 7 years;
• Tdap vaccine can be given at or after 7 years of age if your child is not properly vaccinated.
• Tdap is also given to all children around 11 to 12 years of age per routine vaccination schedule.
  • If you have children less than 7 years of age who have not been completely immunized against pertussis (particularly infants under one year) we recommend you talk to your child's doctor about the benefits of vaccination.
  • Talk to your doctor if they are older than 11 and have not yet received their routine Tdap.

Please note: Adults should have a Tdap (Pertussis) vaccine at least once in their adult life, while pregnant women are recommended to have Tdap each pregnancy. Tdap can be given no matter when Td (tetanus and diphtheria vaccine) was last received.

Basically, anyone with cough of more than 2 weeks duration should be evaluated for pertussis or other reasons for their cough.

• Zika virus is transmitted to people primarily through the bite of an infected Aedes species mosquito.
  • CDC Zika transmission information
• Zika virus can be passed from a mother to her baby during pregnancy or birth.
• CDC reports Zika virus can be transmitted through infected blood or sexual contact.
• To date, there are no reports of infants getting Zika through breastfeeding. Because of the benefits of breastfeeding, mothers are encouraged to breastfeed even if they have traveled to an area where Zika virus is being transmitted.

Symptoms of Zika are generally mild and include fever, rash, joint pain and redness of the eyes. Symptoms typically begin two to seven days after being bitten by an infected mosquito. Many people who get Zika have no symptoms at all. There is no vaccine to prevent infection or medicine to treat Zika. The recommended treatment is to hydrate, rest, and take acetaminophen to alleviate symptoms.

Zika infection is a very serious concern for pregnant women because of its link with a birth defect in newborns called microcephaly, an abnormally small brain and skull, and other poor pregnancy outcomes. Zika is also linked to Guillan-Barré Syndrome, a problem marked by muscle weakness and sometimes paralysis.

Protect yourself and your family from mosquito bites when traveling to an area with ongoing Zika virus transmission. Visit the CDC Travelers' Health site for updated information and travel alerts. View CDC Zika prevention information.

No vaccine or medication is currently available to treat the virus. The best way to prevent the virus is to protect against mosquito bites. Pregnant women in any trimester should consider postponing travel to the areas where Zika is spreading. Pregnant women, or those trying to become pregnant, who do travel to one of these areas should talk to their doctor or other healthcare provider first and strictly follow the steps below during the trip:

• Apply EPA-registered insect repellants (homemade repellants may not offer protection)
• Wear long sleeve shirts, pants, and closed-toed shoes
• Use bed nets
• Avoid wearing perfume
• Wear Permethrin-treated clothing

The Zika Virus can be spread from a man to his sex partners. The correct use of condoms can prevent transmission. Condoms should be used every time you have sex if you or your partner are pregnant, or plan to become pregnant.

HIV is spread primarily by:

• Not using a condom when having sex with a person who has HIV. All unprotected sex with someone who has HIV contains some risk. However:
  • Unprotected anal sex is riskier than unprotected vaginal sex.
  • Among men who have sex with other men, unprotected receptive anal sex is riskier than unprotected insertive anal sex.
• Having multiple sex partners or the presence of other sexually transmitted infections (STIs) can increase the risk of infection during sex. Unprotected oral sex can also be a risk for HIV transmission, but it is a much lower risk than anal or vaginal sex.
• Sharing needles, syringes, rinse water, or other equipment used to prepare illicit drugs for injection.
• Being born to an infected mother- HIV can be passed from mother to child during pregnancy, birth, or breast-feeding.

The most common type of cyanobacteria blooms in Grant County looks like green paint floating on the water.  Algae blooms can also be blue/green, red, or brown.  Not all algae blooms produce toxins and there is no way to tell if a bloom is toxic just by looking at it. One way to tell a blue-green algae scum from other types of algae or plants is with a “stick test”. If you can use a stick to pick up the mat or scum, and it has a stringy look, it is most likely filamentous algae or another aquatic plant. If you can’t pick up the algae or it just swirls in the water, it is likely blue-green algae. Below are examples of blue-green algae blooms from Grant County.

• Sudden and unexplained sickness or death of a dog or cat who has recently been in contact with fresh water such as a lake or pond, especially if it has algae on its mouth, legs or feet.
• Large number of dead fish, birds, or other animals.
• Skin rash on people after being in the water

As soon as you see a bloom or possible signs of exposure:

• Avoid all contact with the water.
• Keep pets and livestock away from the water.
• Call the Grant County Health District at 509-766-7960 and report the location.

Symptoms of toxic algae exposure may take 30 minutes to 24 hours to appear, depending upon the size of the person or animal, and the amount and type of toxin consumed. C Microsystin is a hepatotoxin (liver toxin). Exposure symptoms can occur hours or days after exposure:

• Skin rashes
• Nausea
• Vomiting
• Stomach cramps
• Jaundice (yellowing of skin and/or eyes)
• Severe thirst

Anatoxin or Saxitoxin are neurotoxins (nerve toxin). Exposure symptoms generally occur within 15 to 30 minutes, but may take longer to appear:

• Skin rashes
• Numbness of lips, tingling in fingers and toes, dizziness, stomach pain, diarrhea, and vomiting.
• Abdominal pain
• Nausea
• Vomiting
• Weakness
• Rapid/weak pulse
• Death

There are 3 kinds of signs GCHD posts for harmful algae blooms:

• There is an informational sign that may be posted at waterbodies that have a history of blue-green algae blooms.  These signs stay up year-round even, if when there are no harmful algae blooms on the lake.
• The first advisory sign is a Warning Sign.  Warning signs are posted when sampling results show the algae bloom has toxin levels above recreational guidelines. This means the water is unsafe for people and pets and you should avoid contact with the lake including swimming, wading, skiing, or tubing.
• The second advisory sign is a Danger Sign. Danger signs are posted when GCHD gets confirmed reports of people getting sick from cyanobacteria toxins. Danger signs will also be posted if there is a confirmed report of the death of a pet. Danger signs mean the lake is closed to all recreation.

GCHD relies on the public to notify us if they see blooms of Blue-Green Algae in waterbodies in Grant County. If you want to report a harmful algae bloom anywhere in Grant County, you can email pictures to us.  Please include when and where the photos were taken. When a harmful algae bloom (HAB) is verified, we take samples of the bloom.  GCHD staff can take samples or we can coordinate sampling with CSCUM. 

CSCUM stands for Cyanobacteria Surveillance by Citizens, Users, and Managers. It is a citizen group coordinated by GCHD for the purpose of monitoring Blue-Green algae. Samples are collected on Mondays or Tuesdays and sent out for testing at the King County Environmental Laboratory. The samples are shipped out the same day they are taken and we usually have results by Friday. All results are posted on this page when we get them (see table in Observations and Advisories Section). If results from sampling show that toxin levels are above the Washington Department of Health's Recreational Guidance Levels, GCHD will post advisory signs along the waterbody at public access areas such as swim beaches and boat launches, as well as updating information on our webpage. GCHD may also notify the public through media releases and social media. The advisory won't be lifted until 2 consecutive samples show toxin levels are below the guidance levels.

As soon as you see a bloom or possible signs of exposure:

• Avoid all contact with the water.
• Keep pets and livestock away from the water.
• Call the Grant County Health District at 509-766-7960 and report the location.

GCHD partners with Kuo to provide bottles to test your own drinking water for coliform bacteria and nitrates. Please call our office at 509-766-7960 for more information on bottle pick-up and drop-off times. 

If you choose to use KUO lab, you can pick up bottles to sample from the box outside our office doors in Moses Lake. You must collect the water sample the same day you bring the sample back to our office. After you collect the water, the bottles can be dropped off at GCHD where the lab will pick them up to test the water. You can contact the labs for the costs of the tests and you are responsible to pay the lab for the test. Testing your water only shows a snapshot of the water quality at the time of testing, it does not guarantee future quality.

The CYSHCN Program promotes an integrated system of services for infants, children and youth ages Birth up to 18 years who are newly diagnosed with a complex health condition or are at risk for chronic physical, developmental, behavioral, or emotional conditions that require health and related services of a type or amount beyond what is generally needed.

Our CYSHCN Coordinators are knowledgeable about local support and services and dedicated to helping families of Children and Youth with Special Heath Care Needs by providing the following services:

(This service is provided to families regardless of income and there is no charge to the family for services)

• Care coordination with your child’s health care and other service providers
• Educate and counsel families about their child’s health condition
• Link families to a medical home, insurance and community programs and services including family support and health information
• Organize a network of services and providers

Who can make a referral: parents, doctor offices, hospitals, community organizations.

Note: If you suspect child neglect or abuse, you should make a referral to Social Work. It is not appropriate to make a CYSHCN referral to assess abuse when that possibility has already been identified. It is appropriate to also make a CYSHCN referral on these children, with a note that CPS referral has been made; the coordinator will make every effort to coordinate with the CPS caseworker.

Get to know you public health partners in your own community.  Speak out to government officials. Get involved with your community leaders. Join your own professional organization and work with them to initiate change.

Access to Baby and Child Dentistry (ABCD) is a system of care in Washington state that connects Apple Health (Medicaid) insured children from birth up to age six with specially trained dentists in their communities. The program includes children with a Developmental Disabilities Administration (DDA) indicator through age twelve. It’s important that young children get care early, as a child with dental disease may have oral health problems throughout life. Cavities can be painful and interfere with a child’s ability to focus and learn in school, eat, speak and even play. Yet, cavities are almost entirely preventable, and prevention saves money for everyone.  

The ABCD program in Grant County is coordinated by Grant County Health District under the direction of the state Health Care Authority. 

• Help families find a dental office and schedule appointments
• Assist families in overcoming barriers to dental care such as finances, transportation and interpretation
• Provide oral health information
• Attend community outreach events and deliver oral health presentations

Any child 0 to 6 years of age on Washington Apple Health Insurance (Medicaid) is eligible for this program. 

• Three fluoride varnish applications per year
• Two dental examinations per year
• Two parent education sessions per year
• Two oral health screenings and fluoride varnish at a school or WIC clinic
• Dental care as needed including cleanings and treatment

Find an ABCD Provider!

Several dental offices in our area are ABCD providers. These offices have been trained to provide dental care for ABCD-eligible children. Call 509-771-7250 for more information.

• Learn more about the Dentist Directory (PDF)
• Aprenda más sobre el directorio de dentistas (PDF)
• Дізнайтеся більше про Каталог стоматологів (PDF)

Food establishments are inspected to check for compliance with food safety rules which helps ensure they are safe places to eat. The inspection reports are used as tools to measure compliance with the food safety rules, highlight areas to educate the operators, and guide corrective actions to help prevent foodborne illness.

Food Safety Inspectors look at many things during inspections, however, they focus on the high risk factors.  These are things most likely to make people sick if they are done incorrectly and are shown on the inspection report as a  “red violations”. Examples of red violations are food workers not washing their hands properly, handling ready-to-eat food with bare their hands, and food temperature violations.

“Blue violations” are the lower risk items such as cleaning and maintenance of the equipment and facilities.  This could include things like not having the sanitizer mixed correctly, floors that need to be cleaned, or evidence of rodents or insects.

Each violation the inspector observes is recorded on the inspection report and assigned a pre-determined point value. The inspection “score” is the total of all violation points found during the inspection.  A perfect inspection is zero points. The total of “red violation” points determines whether a food establishment needs a reinspection or not.  The inspection will also say if a reinspection is required.

If an imminent health threat is found to be occurring, a food establishment will be closed.  Imminent health hazards are:

• No water supply
• No hot water
• No electricity
• Sewage backing up into the establishment
• A fire
• The establishment is suspected to be the source of an ongoing foodborne illness outbreak

Occasionally, food establishments are required to close due to repeated failing inspections. A food establishment can have up to three reinspections.  If they do not pass the third reinspection, they will be closed and asked to meet with GCHD Food Safety staff to develop a plan to stay in compliance with food safety rules.

Yes! It is important to understand that inspection reports are “snapshots” of food handling practices at the establishment during the time of inspection. Conditions may be different when you visit. The inspections follow food safety practices and sanitation rules of the Washington State Retail Food Code (WAC 246-215), and do not address such items as taste, popularity, or any details about the business ethics of a food establishment. Online inspections are available for the last six years. If you need inspection reports older than that, you may request a copy of any inspections of licensed food establishments through a Public Records Request.

View online inspection reports for all annually licensed food establishments.

Our goal is to minimize foodborne illness by spending the most time in establishments that pose the greatest risks, through education and enforcement. The risk-based system will better reflect the time dedicated to each facility.

Risk categories are based on the number risk factors occurring within the establishment. Please see the risk factors above.

If you feel your assigned risk level is inaccurate, please contact us before the end of the year so we can discuss your risk factors and, if appropriate, make changes to your risk level before you pay for your permit—Although risk levels can be increased throughout the year, risk level-decreases are only available when the permit is renewed.

More information on food establishment categories and fees can be found on the food permit application page. You can also call our office and talk to someone in the food program (509) 766-7960.

If you don’t know where your septic system is, there are two ways you can get a copy.  You will need to know your address and parcel number to find the records.  To get a copy of the record:

1. Request a copy of your As-Built Record Drawing by submitting a Public Records Request. If we have it in our files, we can send you a copy.
2. You can also look in our online septic records portal.

That depends on what kind of septic system you have:

• A gravity OSS system, that consists of just a septic tank and a drainfield, should be inspected every 3 years.
• A more complex OSS system, like one that has a pump and pressure tank should be inspected every year.
• We recommend having your tank pumped every 5 years.

Some common signs of OSS failure are:

• Standing water or damp spots near the septic tank or drainfield.
• Bad odors around the septic tank or drainfield.
• Bright green, spongy lush grass over the septic tank or drainfield, even during dry weather.
• Water and sewage from toilets, drains, and sinks are backing up into the home.
• Bathtubs, showers, and sinks drain very slowly.
• Gurgling sounds in the plumbing system.

If you notice any of these things, call a septic professional to inspect your septic system.

GCHD keeps a list of certified septic professionals who do work in Grant County. The list is updated if new providers are added. You can find the list on our On-Site Septic Service Providers webpage by clicking here.

Opioids bind to specific receptors in the brain that reduce the transmission of pain signals throughout the body. Opioids include:

• Heroin
• Prescription pain medications like:
  • Hydrocodone (Vicodin)
  • Hydromorphone (Dilaudid)
  • Meperidine (Demerol)
  • Morphine (MS Contin)
  • Oxycodone (OxyContin, Percocet)
  • Codeine
  • Fentanyl
  • Methadone

Xylazine is not opioid, but is increasingly being found in the U.S. illicit drug supply and linked to overdose deaths. What You Should Know About Xylazine.

When there is too much opioid in the body, a person can lose consciousness and stop breathing – this is an overdose. An opioid overdose can happen suddenly or come on slowly over a few hours. Without oxygen, a person can die.

Risks for an opioid overdose include:

• Using opioids again after your tolerance has dropped (e.g., like after being in treatment, a hospital, or jail). After a break from opioids, the body can’t handle as much as it did before.
• Taking prescription pain medication more often or in higher doses than prescribed-or using someone else’s prescription pain medication. The dose could be too much.
• Using heroin or pills bought on the street. Heroin and street pills often contain other substances that can be dangerously toxic.
• Using opioids with alcohol or other drugs including sleeping pills, benzodiazepines (“benzos” like Valium and Xanax), cocaine and methamphetamine.
• Any current or chronic illness that weakens the heart or makes it harder to breathe.
• Using opioids alone. You are more likely to die from an overdose if no one is there to help.
• Previous overdose. A person who has overdosed before is more likely to overdose again.

No! We are flexible with participation and understand the time commitment is challenging.

No! We will always have hybrid options for those who can’t be here in person.

You can participate in whatever way you have capacity to, from simply attending meetings and offering expertise, to having a significant role in the planning and implementation of the CHIP.

Check air quality conditions daily. Follow health recommendations found on the Air Quality Index. 

• Close windows and doors unless it is too hot to maintain safe temperatures.
• Avoid activities that increase indoor air pollution. 
  • Burning candles, fireplaces, or gas stoves can increase indoor pollution. Vacuuming stirs up particles already inside your home, contributing to indoor pollution.
• Run an air conditioner if you have one. Keep the fresh-air intake closed and the filter clean to prevent outdoor smoke from getting inside. If you do not have an air conditioner and it is too warm to stay inside with the windows closed, seek shelter in a designated evacuation center or away from the affected area.
  • NCW libraries operate as clean-air shelters when smoke is in the air.

Learn how to create a clean air room! Visit the resources below. 

• Create a clean-air room
• DIY Air Filter (PDF)

If you have asthma or other lung-related illnesses, talk to your healthcare provider about medication and a respiratory management plan. Consider evacuating the area if you have trouble breathing. Talk with your provider if symptoms get worse.

An N95 mask may provide some protection against wildfire smoke. View this fact sheet (PDF) to ensure you are wearing your mask correctly. A dust or surgical mask will not protect you from the fine particles found in wildfire smoke.

N95 masks are available for free during the 2025 wildfire season at the following locations: 

Grant County has an annual Burn Ban from June 1 through Sept 30. When recreational fires are permitted be sure to extinguish campfires safely. Comply with local regulations if you plan to burn trash or debris.

Subscribe to Nixle to receive emergency evacuation notices from the Grant County Sheriff’s Department. Know the evacuation levels:

• Level 1: Ready. There is no immediate danger, but the fire may be moving toward you.
• Level 2: Set. There is significant danger to your area and the fire is moving toward you.
• Level 3: Go! You are in immediate danger and should go now!