Suicide Prevention Programs Launched in North Dakota

In an effort to reduce suicide rates in the state, the North Dakota Department of Health (NDDoH) is expanding their community education programs to educate citizens on how to recognize the warning signs of suicide. Suicide is a condition that affects people of all races, ages and socioeconomic status.

“One of the best ways to reduce suicide rates is to increase community awareness of the prevalence of suicide in North Dakota. Most people who are experiencing suicidal thoughts do not want to die; they only want their pain to end. Offering to talk to people about their thoughts of suicide and referring them to other people who can help is one way to end the pain without ending a life,” says Micki Savelkoul, Suicide Prevention Program Director at the North Dakota Department of Health.

Suicide numbers continue to climb both nationally — 40,600 in 2012 — and within North Dakota — 138 in 2013, which is the most recent data.  In 2013, North Dakotans between the ages of 35 and 44 had the highest rate of suicide in North Dakota at 31.9 per 100,000, followed closely by people ages 25 to 34 with a suicide rate of 29.8 per 100,000. Community education programs focus on teaching people how to identify warning signs and how to ask about suicidal thoughts, as well as provide resources for those thinking of suicide. These trainings are known as “gatekeeper” trainings.  A gatekeeper is someone who is able to recognize warning signs of emotional distress and crisis. Gatekeepers can include a variety of community members, from parents and friends to caseworkers and firefighters.

North Dakota Department of Health is offering two community education programs free to communities upon request. The programs are SafeTALK and QPR.

SafeTALK- SafeTALK is presented in a three-hour, classroom-style training that focuses on how to identify warning signs that people who are experiencing suicidal thoughts exhibit when thinking about suicide. SafeTALK also teaches participants how to connect people experiencing suicidal thoughts to resources that can help.

Question, Persuade, Refer (QPR) – QPR is presented in a 1- to 2-hour training session. Participants in this training will learn how to identify warning signs of suicide, how to ask the question of suicide, how to persuade that person to get help, and how to refer someone to a higher level of care.

If you are interested in one of these community programs being held in your community or other suicide prevention programs and activities, contact Micki Savelkoul, North Dakota Department of Health, at 701.328.4580.

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North Dakota Physicians Testing for Measles

Department of Health Reminds North Dakotans of the Importance of Measles Vaccination

Although no measles cases have yet been identified in North Dakota this year, physicians in North Dakota have identified three suspect cases and have submitted samples to the North Dakota Department of Health (NDDoH) for testing.  Two have tested negative and results are pending on the other. The pending case is under investigation by the North Dakota Department of Health and has been advised to avoid contact with the community.

Since the recent outbreak of measles related to Disney properties in California was identified, the NDDoH has been working with local public health units and private health care providers to raise awareness of this disease, which has become so rare that many physicians have never seen a case in their practice. As a result of this outreach, North Dakota physicians have been alerted to consider the disease as a diagnosis in patients with symptoms consistent with measles. In the event a positive case would be identified, NDDoH is prepared to work with the health care provider and local public health to investigate contacts, and recommend or implement isolation or quarantine.

“Measles is a virus that causes rash, cough, runny nose, eye irritation and fever,” said Amy Schwartz, immunization surveillance coordinator for the North Dakota Department of Health. “It can lead to ear infection, pneumonia, seizures, brain damage and death. Parents who suspect their child may have measles or adults who are symptomatic should contact their primary care provider before presenting to a clinic or emergency department, in an effort to prevent the spread of the disease in those settings.”

“Measles is highly contagious; ninety percent of unvaccinated people that are exposed to measles will go on to develop the disease,” said Schwartz. “Two doses of MMR vaccine are 97 percent effective at preventing measles.” All children are recommended to be vaccinated against measles at ages 12 to 15 months and 4 to 6 years. Measles is included in a combination vaccine with mumps and rubella (known as MMR vaccine). Adults at high risk for measles, including health-care workers, international travelers and college students, should have two doses of MMR vaccine or laboratory evidence of immunity to measles, regardless of age. All other adults born in 1957 or later should have at least one dose of MMR vaccine. Adults born before 1957 are presumed to be immune to measles because the disease was so widespread then that it is likely they were exposed or had the disease. Booster doses of MMR vaccine are not recommended for adults who are not at high risk for measles who have already had at least one dose of MMR vaccine or who were born prior to 1957.

MMR vaccine is required for childcare, school, and college entry in North Dakota. “If a case of measles occurs in a school in North Dakota, the case would be kept out of school until four days after rash onset. All unvaccinated children in that school would be kept out of school for 21 days (incubation period for measles) as a precaution, since they would be likely to develop measles and cases are contagious prior to having a rash,” said Schwartz.

MMR vaccine is available by contacting your primary care provider or Fargo Cass Public Health at 241-1383. For additional information about measles or MMR vaccination, visit

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Department of Health Urges Caregivers to Register Car Seats During Child Passenger Safety Month

As part of Child Passenger Safety Month in February, the North Dakota Department of Health (NDDoH) emphasizes the importance of registering car seats and reminds caregivers that unregulated products should not be used with their car seats.

“Registering a car seat is very easy to do and essential to a child’s safety,” said Dawn Mayer with the Division of Injury Prevention and Control. “It is also important to use best practices with car seats, which includes not modifying them or adding items that may affect their integrity or ability to prevent injury in an accident.”

There were numerous car seat recalls that occurred in 2014, which emphasized the need for caregivers to register car seats. Registration of car seats makes it possible for manufacturers to notify consumers if there is a safety issue with their car seat. Car seats, by federal law, are sold with a registration card that the consumer should use to register their seat.

If consumers do not register the seat, they may not hear of a recall, which may put children at risk. Data collected from car seat checkups conducted by the department in 2014 showed that 40 percent of the car seats checked had not been registered with the car seat manufacturer. These consumers would not have been notified if their seat had been recalled. Consumers, who want to register their car seats now can visit or contact the car seat manufacturer directly.

The Department of Health would also like to remind consumers that they should not use unregulated products with their car seats, because they may affect the integrity of the safety features of the seat.  Examples of products that should not be added to car seats include head pillows/body blankets, harness covers, vehicle seat protectors, mirrors and extra padding.

According to data collected from the same car seat check-ups in 2014, approximately 20 percent of the seats checked had an unsafe product added.  Of the 20 percent that were found, only 61 percent of the caregivers removed the unsafe product.

NDDoH recommends following these best practices when it comes to transporting children:

  • Children younger than 13 should ride in the back seat.
  • REAR-FACING: Children should ride rear-facing until at least 2 years of age (following car seat instructions)
  • FORWARD-FACING: When children are at least 2 years of age or have outgrown      the highest rear-facing limits of their car seat, they may ride forward-facing in a car seat with a harness. Use the seat until the child reaches the harness’s highest weight limit allowed by the manufacturer.
  • BOOSTERS: When children have outgrown the harness in their forward-facing car seat, they may be moved to a booster. The child should be at least 40 pounds and at least 4 years of age.  Keep the child in the booster until about 4’9” tall.
  • SEAT BELT: Children should use a seat belt when it fits over the body correctly. For a seat belt to fit properly, the lap belt must lie snugly across the upper thighs and be snug across the shoulder and chest. It should not lie on the stomach or across the neck.
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ND Department of Health Reminds Residents to Test for Radon

During National Radon Action Month in January, the North Dakota Department of Health (NDDoH) reminds residents that January and other cooler weather months are a great time to test their home for radon, a leading cause of lung cancer among non-smokers.

“Radon is a cancer-causing, naturally-occurring radioactive gas that you can’t see, smell or taste, and it is found throughout the soil in North Dakota,” said Justin Otto, Indoor Air Quality and Radon Program Coordinator for NDDoH. “Its presence in the home can pose a danger to a family’s health.”

Radon is harmlessly dispersed in outdoor air at low levels, but when trapped in buildings, it can be harmful, especially at elevated levels. “The good news is that radon is a problem that can be managed,” said Otto. “By installing a radon mitigation system, homeowners can effectively lower the level of radon in their homes. These systems use many common building materials and require few specialized tools to install.”

Systems may be installed by a homeowner or a radon mitigation contractor.  A list of contractors is available on the North Dakota Department of Health, Division of Air Quality’s website at Once in place, a properly installed mitigation system will reduce radon gas and safely vent it outside.

Radon-related illness claims more than 21,000 lives in the United States annually, according to Otto. “In North Dakota, 63 percent of homes have an elevated level of radon above the U.S. Environmental Protection Agency’s (EPA) ‘Action Level’ of 4.0 picocuries per liter (pCi/L),” said Otto. “In fact, the EPA lists North Dakota as Zone 1, meaning the entire state has the highest potential for elevated radon levels.”

The EPA has launched a new series of television, radio and print public service announcements encouraging people to test their homes for radon and fix any problems. During January, events nationwide will focus on testing and fixing problems in homes with a radon level of 4.0 pCi/L or higher.

Radon test kits are available by emailing Justin Otto at and including a mailing address.  The radon test kits are available at no cost to the general public and they include all mailing and laboratory-analysis fees. The test kits are very easy to use and come with easy-to-follow directions, says Otto. Test kits also may be available for purchase at local hardware stores, building supply stores, local public health units or call the American Lung Association in North Dakota at 1.800.252.6325.

For more information about radon, visit , or call contact Justin Otto, North Dakota Department of Health, at 701.328.5188.

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January is Cervical Health Awareness Month

The North Dakota Department of Health is reminding women to get screened for cervical cancer. According to the Centers for Disease Control and Prevention (CDC) each year approximately 12,000 women in the United States get cervical cancer and over 4,000 women die from the disease. As many as 93% of cervical cancers cases could be prevented through cervical cancer screening and HPV vaccination.

The main cause of cervical cancer is the human papillomavirus (HPV), the most common sexually transmitted infection in the United States. Most people with HPV do not even know they have it because they never have symptoms or problems. Usually the body’s immune system will fight off the infection, and it goes away on its own. But sometimes an HPV infection does not go away, and this can cause abnormal changes in the cells of the cervix. If that happens, treatment may be needed. If left untreated, these abnormal changes eventually can lead to cervical cancer.

You can prevent cervical cancer with regular screening tests, like the Pap test and the HPV test. The Pap test is a screening test that can detect the abnormal changes in the cervical cells before they become cancer.  If cancer does occur, the Pap test can find it early when it is easier to treat. An HPV test can find any of the types of HPV that can cause the abnormal cell changes on the cervix. The HPV test is done at the same time as the Pap test.

Current guidelines recommend that women should have a Pap test every three years beginning at age 21. These guidelines also recommend that women ages 30 to 65 should have a Pap test along with an HPV test every five years or a Pap test alone every three years. Women with certain risk factors may need to have more frequent screening or to continue screening beyond age 65.

Vaccines also have the potential to protect people from the HPV infections that can cause cancer. There are currently two vaccines available for people 11 to 26 years old. Both protect against HPV strains 16 and 18, the two main types of HPV that cause approximately 70 percent of all cervical cancers.   However, women who have been vaccinated still should get regular Pap tests.

“Unfortunately, many women do not get regular Pap tests because they are uninsured or underinsured,” said Barb Steiner with the North Dakota Department of Health. “The good news is that Women’s Way may be able to help women pay for their Pap and HPV test.

Women’s Way, North Dakota’s Breast and Cervical Cancer Early Detection Program, is available to eligible North Dakota women ages 40 through 64. Women’s Way may provide a way to pay for pelvic exams, Pap test, clinical breast exams and mammograms. Women’s Way is also available to women ages 21 to 39 who meet specific eligibility requirements. To learn more about Women’s Way or to see if you are eligible, call 1.800.44 WOMEN or visit

Another option is the North Dakota Family Planning Program, which provides reproductive health services to women, including Pap tests, pelvic exams and breast exams. Clients are charged for services according to their household income and family size. The Fargo Cass Public Health Clinic offers these services. For more information, or to schedule call appointment, call 701-241-1383 or go to

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Health Department Reports Widespread Influenza Activity

The North Dakota Department of Health (NDDoH) is reporting widespread influenza activity for North Dakota. As of December 13, 332 cases of laboratory-confirmed influenza have been reported, with a large increase in the number of cases reported in the last two weeks. Several community outbreaks have also been reported in recent weeks.

For the third season in a row, influenza activity is starting earlier than is typical,” said Jill Baber, influenza surveillance coordinator for NDDoH. “Because the influenza season may very well continue for weeks, it’s important that everyone take precautions to avoid spreading the flu, including getting the flu vaccine.”  

It is common for different types of flu strains to circulate each season. Nationwide, the majority of flu cases have been caused by Influenza A H3N2 this season. However, this circulating A H3N2 strain has changed a little (or drifted) from the A H3N2 strain used to make the vaccine. “At this time, no cases of the drifted strain have been identified in North Dakota, but it is likely that it is present in the state,” said Baber. “We want to reiterate that vaccination is still advised.”  The vaccine is effective against other influenza strains circulating in the country and may still provide some protection against the drifted strain.

In years when the circulating influenza viruses differ from the vaccine components, treatment with influenza antivirals becomes especially important. Treatment with antivirals works best when begun within 48 hours of getting sick. For this reason, it is important people receive prompt medical attention if they think they may have the flu. Antivirals may also be given to people at risk of severe complications of flu if they know they have been exposed to someone diagnosed with flu.

Influenza can be a serious illness for some people. Complications of influenza and pneumonia contribute to the deaths of over 400 North Dakotans annually, most of whom are older than 64. However, a large number of influenza cases occur in children younger than 10, many of whom require hospitalization. “You should talk to your doctor promptly if you think you may have symptoms of influenza,” said Baber. “Common signs and symptoms of influenza include abrupt onset of fever, muscle aches, sore throat and cough.”

To help prevent the spread of influenza, the Department of Health urges everyone to:

  • Get a flu vaccine as soon as possible if you have not had one this season. Immunization is the best way to prevent influenza. As a reminder, it takes about two weeks for the vaccine to be effective.
  • Wash hands frequently with soap and water. Hand washing is one of the best ways to prevent all diseases, including influenza.
  • Use good respiratory manners. Cover your mouth and nose with a tissue when sneezing or coughing.
  • Stay home from work, school or recreational activities when you are ill. This will help prevent the spread of influenza to your friends, coworkers and family.

For more information about influenza activity in North Dakota, visit Flu vaccine is available at Fargo Cass Public Health.  Call 241-1383 to schedule an appointment.


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National Influenza Vaccination Week Highlights the Importance of Flu Vaccination

The North Dakota Department of Health is reminding all North Dakotans of the importance of receiving flu vaccine as part of National Influenza Vaccination Week, observed Dec. 7 – 13, 2014.

“Despite some initial delays, there is more than enough flu vaccine available this year for anyone who wants to be vaccinated,” said Amy Schwartz, Immunization Surveillance Coordinator for the North Dakota Department of Health. “Everyone ages 6 months and older is recommended to be vaccinated, regardless of age or health status. It’s important to remember that getting vaccinated not only protects you, but everyone around you as well.”

Influenza vaccinations are available at physician offices, local public health units and pharmacies. Sixty-eight cases of influenza have been reported to the North Dakota Department of Health so far this season. The flu season typically does not peak in North Dakota until after the New Year, but the last two seasons have had early influenza activity. Now is a great time for people to get vaccinated if they have not done so already.

“The flu vaccine protects against flu viruses that research indicates will cause the most illness that year,” said Schwartz. “Protection from vaccination declines over time, so it’s important to get vaccinated again this season. Getting vaccinated each year is the best way to protect yourself and your family each flu season.”

The U.S. Centers for Disease Control and Prevention recommends that everyone be vaccinated against the flu, especially the following at-risk groups:

  • All children ages 6 months through 18 years
  • All adults ages 50 and older
  • Residents of long-term care facilities
  • Pregnant women
  • American Indians
  • People of any age who have long-term health problems, such as:
    • Heart disease
    • Lung disease
    • Kidney disease
    • Diabetes
    • Asthma
    • Anemia
    • Weakened immune systems due to HIV/AIDS and cancer treatments
    • Breathing problems due to neuromuscular disorders
    • Morbid obesity

People who could spread the disease to those at high risk – such as health-care workers, people who care for family members or other sick people in their home, and household contacts – also should be vaccinated.

Fargo Cass Public Health has vaccine. Call 241-1383 to schedule and appointment.  Walk-ins welcomed.  For information about influenza, visit


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World AIDS Day: Free HIV Testing at FCPH

Dec. 1 is World AIDS Day and Fargo Cass Public Health (FCPH) encourages Cass County residents to take advantage of free HIV testing at Fargo Cass Public Health. The Centers for Disease Control and Prevention (CDC) recommends that people ages 13 – 64 get tested for HIV at least once during their lifetime. Those at higher risk should get tested at least once every year.

According to the CDC, the estimated incidence of HIV has remained stable overall in recent years at about 50,000 new HIV infections per year. In 2012, an estimated 47,989 people were diagnosed with HIV infection in the United States. In that same year, an estimated 27,928 people were diagnosed with AIDS. Overall, an estimated 1,170,989 people in the United States have been diagnosed with AIDS.

According to the North Dakota Department of Health, 24 North Dakota residents have been diagnosed with HIV/ AIDS so far this year; up from 16 cases in 2012.

North Dakota is one of the few states which began HIV/AIDS monitoring 30 years ago in 1984. Since then, more than 600 cases have been reported to the North Dakota Department of Health with approximately 373 individuals currently living with HIV/AIDS in North Dakota. Nearly 66 percent of those individuals have an HIV status, proving that early detection and treatment can help those who have HIV not only live longer but with a better quality of life, more than ever before.

In the United States, HIV is most commonly spread through body fluids during unprotected sex, sharing needles, or other drug equipment. In addition, a mother can pass HIV to her baby during pregnancy, during labor, through breastfeeding, or by pre-chewing her baby’s food.

Larry Anenson, health promotion and protection director at FCPH, says that getting tested is easy, “Fargo Cass Public Health is committed to the health of our community. HIV testing at FCPH is simple, free of charge, confidential, and the results are available within 25 minutes. Testing is the first step in protecting yourself and others from infection.”

The HIV antibody test detects the presence of antibodies to the HIV virus by using a simple blood test. This is not a test for AIDS. The test does not tell you if you have AIDS; it does show if you have been infected with the virus which can cause AIDS.

For more information on HIV testing call 701-241-1383, or go to


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ND Department of Health Provides Advice on African Travel

The North Dakota Department of Health (NDDoH) has advice to help keep those who plan to travel to Africa in the near future and their loved ones safe in light of the current Ebola outbreak.

“We want to make sure that everyone is as safe as possible without hindering their ability to travel as they wish,” according to Michelle Feist, Program Manager at the NDDoH’s Division of Disease Control.  “One of the challenges with travel is that we do not know from week to week what the situation will be in terms of where the outbreak may spread, what services might be available if someone became ill in another country, and what kind of restrictions might be in place when people come back to the U.S.   Travel to and from the vast majority of African countries is safe and unrestricted, though we advise following routine recommendations for foreign travel.  However, travelers should be aware of potential issues when traveling to West Africa or Democratic Republic of the Congo.”

The Centers for Disease Control and Prevention (CDC) warns against travel to Guinea, Sierra Leone, and Liberia except for those who provide essential medical and humanitarian services and has issued a travel alert for Mali. The NDDoH recognizes that medical workers are necessary to stop the outbreak in Africa and thereby protect the U.S. against Ebola.  However, NDDoH advises that church and other humanitarian groups avoid or postpone travel to the affected countries unless they are providing medical services under the auspices of a larger humanitarian or governmental group.  Anyone not directly involved in medical work should not travel to these countries until the outbreak is contained and travel restrictions are lifted.

The CDC has not issued travel warnings for other countries in West Africa.  However, if transmission were to occur in another country while a person was traveling, their return circumstances may change substantially and may provide a threat to their health.  In an abundance of caution, NDDoH advises that such travel be considered carefully and postponed, if possible, until the outbreak is over.  The remaining countries in West Africa are Benin, Burkina Faso, Ivory Coast, Cape Verde, Gambia, Ghana, Guinea-Bissau, Mauritania, Niger, Senegal, and Togo.

The CDC has issued an advisory to practice enhanced precautions when traveling in Democratic Republic of the Congo because of an outbreak of Ebola that is unrelated to the outbreak in West Africa.  NDDoH advises that such travel be considered carefully as to its necessity, and postponed, if possible, until the outbreak is over.

Travelers going to the other countries in Africa should follow the precautions routinely recommended for people traveling to those areas.  Travelers returning from countries not experiencing an Ebola outbreak have no need to self-monitor following their return.

NDDoH asks that a person traveling to Guinea, Sierra Leone, Mali or Liberia

  • Inform the NDDoH prior to traveling
  • Inform their employer of their travel plans
  • Coordinate travel with a well-established group (consult USAID at or an experienced umbrella group, such as Doctors Without Borders) that routinely operates in these countries
  • Follow all recommendations of the CDC for protecting their health
  • Inform the NDDoH of their expected return date
  • Review their health insurance policy to make sure that medical care and transport home would be covered in the event of illness or injury

Upon a traveler’s return to North Dakota, we ask that they

  • Comply with all CDC entry procedures
  • Follow all CDC protocols for monitoring their health
  • Contact the NDDoH as soon as  they return to the state to coordinate their 21 day monitoring period

The NDDoH contact phone number for those who are traveling is 1.800.211.4451.

General information about Ebola is available on the NDDoH website at  This page also contains access to the CDC website, which is updated regularly.  NDDoH also posts information on their Facebook page at and on their Twitter page at Use #NDEbolaInfo.

For more information, contact Michelle Feist, North Dakota Department of Health, at 701.328.2378.

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Great American Smokeout emphasizes need for tobacco prevention

The 39th annual Great American Smokeout, which will take place on Nov. 20, encourages everyone to lead tobacco-free lives to prevent tobacco-related diseases and improve overall health and quality of life. The event is traditionally aimed at getting smokers to quit, but Fargo Cass Public Health and the North Dakota Center for Tobacco Prevention and Control Policy (the Center) are using the opportunity educate on the best ways to prevent tobacco use among our kids.

Tobacco prevention efforts are more important than ever because tobacco companies are finding new ways to market their products to youth, which increases youth rates of tobacco use.

According to the 2014 Surgeon General’s Report, “Advertising and promotional activities by the tobacco companies cause the onset and continuation of smoking among adolescents and young adults.” Tobacco companies frequently use brightly-colored packaging and fruit-flavored tobacco products that look and taste like candy to entice kids to try tobacco.

“In the 1998 tobacco settlement lawsuit, tobacco companies promised to stop marketing to our kids, but they have not kept their word,” said Melissa Markegard with Fargo Cass Public Health. “Today, it’s not just about cigarettes, but includes tobacco’s expanding products that include fruit- or candy-flavored cigars, smokeless tobacco and other nicotine-based products, such as electronic cigarettes.”

Another effective way to reduce youth smoking is to increase the price of tobacco products.  According to the 2014 Surgeon General’s Report, “increases in the prices of tobacco, including those resulting from excise tax increases . . . reduce the prevalence and intensity of tobacco use among youth and adults.”

In an attempt to keep prices low, tobacco companies use special discounts and promotions that make their products cheap to buy. Tobacco companies also make sure their addictive products are placed in highly visible areas that appeal to youth, such as near candy displays or at the checkout counter.

“Tobacco companies are using whatever tricks they can to get kids to try their products,” said Jeanne Prom, executive director for the Center. “Tobacco is big business and the industry works hard to replace the thousands of customers who die each year.”

Prom noted that tobacco prevention programs are essential in keeping the next generation tobacco free. “Nearly nine out of ten smokers had their first cigarette before age 18. That means if we can keep our kids tobacco free before age 18, most will never start to use tobacco,” Prom said.

To learn more about tobacco prevention contact Fargo Cass Public Health at 701-476-4083 or visit

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