Frequently Asked Questions

Birth and Death Certificates

How do I obtain a copy of a Birth or Death Certificate?
You can get a copy of the application for either on this web site. Fill it out and bring to the Andrew County Health Department.

Are vital record open in Missouri?
In the State of Missouri, vital records are not open to the general public and can only be obtained by the individual, guardian or other legal party.

How far back does Birth and Death Certificates go?
Missouri birth, death, marriage and divorce records are maintained by the Department of Health and Senior Services Bureau of Vital Records. Missouri central registry for birth and death reported from January 1, 1910 to the present.
What are the costs for Birth and Death Certificates? Fees for copies of vital records will be collected by the local agency providing the document. Fees are the same as those charged by the Bureau of Vital Records.

How do I obtain a birth certificate from earlier than 1910?
Although it wasn't a law until 1910 that all birth and death records be registered in the state, Missouri Bureau of Vital Records does have some birth and death records prior to 1910. The same process applies as ordering records for events occurring after 1910. For events prior to 1910 where no record is registered, the customer should contact the Missouri State Archives to see what years they have available. Their telephone number is 573-751-3280

Flu Vaccines:

How contagious is seasonal flu?
Influenza is a highly contagious viral respiratory illness that affects the health of large numbers of people every year. Most people recover within a week, but a cough and tiredness can last two weeks or longer. Some of the complications caused by influenza include bacterial pneumonia, dehydration, and worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes. Children may get sinus problems and ear infections as complications from the flu. Those aged 65 years and older, children under age 2, and persons of any age with chronic medical conditions are at highest risk for serious complications of flu. The most common complication is pneumonia. In the United States, influenza and pneumonia combined is among the top 10 leading causes of death. On average, influenza is annually associated with more than 36,000 deaths and more than 200,000 hospitalizations. In Missouri, influenza and pneumonia are associated with approximately 1,500 - 3,000 deaths per year. The economic impact of influenza illness is staggering. Studies have shown that in an average year, direct and indirect medical costs in the U.S. are in the billions

How effective is the flu vaccine?
Studies have indicated that influenza vaccine efficiency is approximately 70%-90% effective in preventing illness among persons 65 years of age or less. It is 30%-40% effective among the frail elderly, 50%-60% effective in preventing hospitalization, and approximately 80% effective in preventing death. The degree of effectiveness is dependent on a good match between the circulating influenza strains and the components included in the influenza vaccine each year. It also depends on the ability of each person’s immune system to effectively produce an antibody against the virus.

Who should get inactivated flu vaccine?
All Children 6 months and older and all older adults:

• All children from 6 months through 18 years of age
• Anyone 50 years of age or older
• Anyone who is a risk of complications from influenza, or more likely to require
  medical care
• Anyone with a weakened immune system
  

Folic Acid

Folic acid key to good health; particularly for childbearing women

Folic acid has been shown to drastically reduce the incidence of certain birth defects as well as prevent a number of chronic diseases

What is Folic Acid?
Folic acid is a B vitamin that is very important for everyone in maintaining good health, particularly women of childbearing age. Insufficient folic acid is a major cause of birth defects. The natural form of folic acid is called folate and occurs in certain foods including leafy dark green vegetables, legumes (dried beans and peas), citrus fruits and juices, and most berries.

Is a synthetic form of Folic Acid easier to absorb?
Synthetic form more easily absorbed more readily. The synthetic form of folic acid, which is more easily absorbed by the body, is found in multivitamin supplements, enriched and fortified bread and grain products such as breakfast cereals, and in folic acid prescriptions given to women at increased risk for spina bifida.

Should women of childbearing age take Folic Acid?
Studies have shown that if all women of childbearing age took 400 micrograms of folic acid daily, starting before pregnancy, the occurrence of neural tube defects, birth defects which involve the incomplete development of the brain, spinal cord and/or protective coverings for these organs, could be reduced by 50 to 70 percent.

Can taking Folic Acid help prevent birth defects?
The most common of the birth defects that folic acid can prevent is spina bifida, which is the failure of the spine to close properly during the first month of pregnancy, often before a woman even knows she is pregnant. This defect now occurs in approximately one out of every 1000 pregnancies in the U.S., according to the Spina Bifida Association of America.

Some research has shown that folic acid may help protect your baby from other birth defects of the heart, limbs and face. In addition, studies show that folic acid may also help protect women and men from heart disease, cervical and colon cancer, and possibly, breast cancer.

Tetanus (Lockjaw)

What is Tetanus?
Tetanus is a vaccine-preventable disease caused by the bacterium Clostridium tetani, which releases toxin that affects the brain and spinal cord. The bacteria live in the soil and are found worldwide. The organism is a harmless inhabitant in the intestines and feces of horses, sheep, cattle, dogs, cats, rats, guinea pigs, and chickens. In the soil, they can remain infectious for more than 40 years. The disease is characterized by generalized rigidity and convulsive spasms of skeletal muscles. Tetanus is not communicable from person to person.

What are the symptoms for Tetanus?
Symptoms for tetanus usually appear within two weeks of infection and may include:

• Spasms and tightening of the jaw muscle or "lockjaw"
  Stiffness and spasms of muscles
  
  Neck muscles
  Chest muscles
  Abdominal muscles
  Back muscles, often causing arching
• Seizures
• Irritability
• Fever
• Excessive sweating
• Difficulty swallowing
  
  Without treatment, one out of three affected people dies. The mortality rate for newborns with untreated tetanus is even higher: two out of three. With proper treatment, less than 10 percent of infected patients die, but the muscle spasms make for a long recovery.
  
  Is Tetanus preventable?
  Tetanus is completely preventable with tetanus immunization. Children six weeks through six years of age should be given tetanus immunization in combination with diphtheria and pertussis vaccines (DTaP). A tetanus/diphtheria (Td) or tetanus/diphtheria/pertussis (Tdap) booster follows five to ten years later, followed by a booster every ten years throughout life.

Varicella (Chickenpox)

What is Chickenpox?
Varicella, or chickenpox, is a vaccine preventable virus caused by varicella zoster and is one of the classic childhood diseases, occurring in children under the age of ten. It is also one of the most contagious. Chickenpox consists of hundreds of itchy, fluid-filled blisters throughout the surface of the body. The blisters eventually burst and can scar the skin. Sometimes complications may arise, such as skin infections or pneumonia, causing hospitalization. In the United States, there are less than 4 million cases of chickenpox annually with approximately 4,000 to 9,000 cases that have serious complications, causing about 100 deaths. These deaths usually occur in individuals with weak immune systems, newborns, and adults. Chickenpox cases are more severe in adults and, although it is rare for adults to get the chickenpox, they account for over half the deaths. In adults, the varicella virus can also cause shingles, which is the re-emerging of chickenpox after many years.

Is chickenpox (Varicella) contagious?
Since many people are now vaccinated for varicella, the number of cases has been decreasing, but chickenpox has not been eliminated. Chickenpox is highly contagious and can be spread very easily by direct contact and droplet/airborne transmission, such as coughing or sneezing. The period of contagiousness begins approximately 1 to 2 days before onset of rash and ends when all lesions have crusted over. Once contracted, the symptoms begin to appear in about two weeks, but an individual may be symptom free for up to 21 days.

What are the symptoms?
Symptoms that occur a few days before the pox outbreak include:

• Fever
• Headache
• Stomach ache
• Loss of appetite
  
  The average child develops 250 to 500 small, blistery red spots on the skin, usually on the face, trunk, or scalp and spread from there. In a few days, the original red spots will scab over as new spots arise. Most pox will not leave scars unless they become infected from scratching. If vaccinated, it is still possible to develop a mild case of chickenpox, but recovery time and the number of pox are reduced.
  
  What is the best practice to prevent Chickenpox?
  It is hard to prevent the contraction of the chickenpox because individuals are contagious and can spread the virus before any symptoms or blisters appear. The best preventative measure that can be taken is to be vaccinated. The vaccine is routinely recommended for children over 12 months of age and other susceptible individuals. People over 13 years of age should receive 2 doses of vaccine, separated by at least 4 weeks
  
  Can Chickenpox return after having it?
  Once a person has had chickenpox, the virus usually remains in the body for a lifetime, but is repressed by the immune system. If the immune system becomes weak or there is a period of high stress, the chickenpox can re-emerge as shingles in about 1 in 10 adults.
  

WIC

Day Care

What is the process of opening a day care center in my home?
The Bureau of Child Care (BCC) maintains a website that contains copies of the current licensing rules, frequently asked questions and has a subsection that is titled "How do I get licensed?" You can access the site at http://www.dhss.mo.gov/ChildCare/index.html.

Who inspects Day Cares?
The Andrew County Health Department inspects Day Care Centers in Andrew and Buchanan Counties.

Where do I report a complaint against a hospital, physician, nursing home, restaurant, child care center?

For a complaint against a hospital, contact the Bureau of Health Services Regulation, PO Box 570, Jefferson City, Missouri 65102; 573-751-6303 or info@dhss.mo.gov.

For a complaint against a physician, contact the Office of Professional Registration, PO Box 1335, Jefferson City, Missouri 65102; 573-751-0293 or profreg@pr.mo.gov.

For a complaint against a nursing home, contact the Elder Abuse & Neglect Hotline, PO Box 570, Jefferson City, Missouri 65102; 800-392-0210 or info@dhss.mo.gov.

For a complaint against a restaurant, contact the Bureau of Environmental Regulations and Licensure, PO Box 570, Jefferson City, Missouri 65102; 573-751-6090 or info@dhss.mo.gov.

For a complaint against a child care center, contact the Bureau of Child Care, PO Box 570, Jefferson City, Missouri 65102; 573-751-2450 or info@dhss.mo.gov.

Hand Washing

5th Guy Campaign

There's nothing like a clean set of hands.

They smell nice. They look nice. They prevent the spread of viruses, like the flu. Below are a few tips on keeping your hands clean and sanitized.

When should I wash my hands?

• Every time you use the restroom
• Before meals
• After meals
• After handling garbage
• After handling any food
• After touching a pet
• After changing a diaper
• After blowing your nose

What's the best way to wash my hands?
Use soap and warm water, and scrub every nook and cranny you can, rubbing your hands together for at least 20 seconds. Get in between your fingers, cover the entire palm, and wash all the way down to the wrist on both sides. Some people say their ABCs and rinse when you get to Z. And try to avoid using your newly clean hands to touch the faucet or doorknob. Use a paper towel if available. Many a "Fifth Guy" may have preceded you.

What kind of problems can regular hand washing prevent?

• Influenza (the flu)
• The common cold
• Strep throat
• Intestinal disorders, including diarrhea
• Pneumonia

MRSA (Methicillin-Resistant Staphylococcus aureus)

What is Staphylococcus aureus and MRSA?
Staphylococcus aureus, often called "staph" is a type of bacteria commonly found on the skin or in the nose of healthy people. Approximately 30% of people have staph in their noses and do not have any symptoms. MRSA which stands for Methicillin-Resistant Staphylococcus aureus is staph that is resistant to commonly used antibiotics such as penicillins and currently available cephalosporins. In the past, MRSA was found only in healthcare facilities and caused infection in people who were sick. More recently, MRSA has emerged in the community and can cause infections in otherwise healthy people.

What types of infections does MRSA cause?
In the community, most MRSA infections are minor skin infections that may appear as sores or boils that often are red, swollen, painful, or have pus or other drainage. These skin infections commonly occur either at sites of breaks in the skin such as cuts and abrasions, and areas of the body covered by hair (for example, the back of the neck, groin, buttock, armpit, or beard area of men).

Almost all MRSA skin infections can effectively be treated in the outpatient setting by drainage of the pus by a healthcare provider with or without antibiotics. More serious infections such as pneumonia, blood or bone infections are rare in healthy people who get MRSA skin infections.

Which athletes are most at-risk for MRSA skin infections?
Skin infections including MRSA have been reported mostly in high-physical-contact sports such as wrestling, football, and rugby. However, MRSA infections have been reported among athletes in other sports such as soccer, basketball, field hockey, volleyball, rowing, martial arts, fencing, and baseball.

Even though little physical contact occurs in some sports during participation, skin contact or activities that may lead to spread of MRSA skin infections may take place before or after participation such as in the locker room. Therefore, anyone participating in organized or recreational sports should be aware of the signs of possible skin infections and follow prevention measures.

Advice for Athletes and Parents

How do I protect myself from getting MRSA and other skin infections?

Practice good personal hygiene

• Keep your hands clean by washing frequently with soap and water or using an alcohol-based hand rub.
  • At a minimum, hands should be cleaned before and after playing sports and activities such as using shared weight-training equipment, when
    caring for wounds including changing bandages, and after using the toilet.
    
  • Both plain and antimicrobial soap are effective for hand washing, but liquid soap is preferred over bar soap in these settings to limit sharing.
    
  • If hands are not visibly dirty and sinks are not available for hand washing, for example, while on the field of play or in the weight-room, alcohol-based hand rubs and sanitizers can be used. Alcohol-based hand rubs with at least 60% alcohol content are preferred.
• Shower immediately after exercise. Do not share bar soap and towels.
• Wash your uniform and clothing after each use. Follow the clothing label's instructions for washing and drying. Drying clothes completely in a dryer is preferred.
  
  Take care of your skin
  
• Wear protective clothing or gear designed to prevent skin abrasions or cuts.
• Cover skin abrasions and cuts with clean dry bandages or other dressings recommended by your team’s healthcare provider (e.g., athletic trainer, team doctor) until healed.
  • Follow your healthcare provider’s instructions for when and how often to change your bandages and dressings.

Do not share items that come into contact with your skin

• Avoid sharing personal items such as towels and razors that contact your bare skin.
• Do not share ointments that are applied by placing your hands into an open-container.
• Use a barrier (such as clothing or a towel) between your skin and shared equipment like weight-training, sauna and steam-room benches.

Should athletes with MRSA skin infections be excluded from participation?

• If sport-specific rules do not exist, in general, athletes should be excluded if wounds cannot be properly covered during participation.
  • The term "properly covered" means that the skin infection is covered by a securely attached bandage or dressing that will contain all drainage and will remain intact throughout the activity. If wounds can be properly covered, good hygiene measures should be stressed to the athlete such as performing hand hygiene before and after changing bandages and throwing used bandages in the trash.
• A healthcare provider might exclude an athlete if the activity poses a risk to the health of the infected athlete (such as injury to the infected area), even though the infection can be properly covered.
• Athletes with active infections or open wounds should not use whirlpools or therapy pools not cleaned between athletes and other common-use water facilities like swimming pools until infections and wounds are healed.

Advice for team healthcare providers

• Use Standard Precautions, including hand hygiene before and after contact and after removing gloves when caring for non-intact skin or possible infections.
• If hands are not visibly dirty and no sinks are available for hand washing, for example, while on the field of play, alcohol-based hand rubs and sanitizers can be used to improve hand hygiene
• Ensure infected wounds on athletes are properly covered.
• Encourage athletes to cover acute, non-infected wounds (e.g., abrasions, blisters, lacerations) until healed to prevent infection.