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Frequently Asked Questions

Condoms are not 100% effective at preventing HIV transmission. When used correctly and consistently, condoms are highly effective and reliable in reducing the risk of transmitting HIV and most sexually transmitted diseases (STDs). Condoms should be used EVERY TIME during sex when transmission of HIV (or other STDs) is possible. When condoms fail to work properly, it is most often because of improper and/or inconsistent use.

Condoms may not work as well against STDs spread through skin-to-skin touching, like herpes and genital warts, because condoms may not cover the infected areas.

Following these basic rules will reduce the already small chance of condom failure: - Experiment with different condoms and practice putting them on before intercourse. - Practice talking with your partner about your desire and intention to use condoms. - Use latex (rubber) or polyurethane (plastic) condoms. Avoid "natural skin" condoms, which have tiny holes, which may allow HIV and other STDs to be transmitted. - When using a male condom choose one that fits. Male condoms come in different sizes, shapes, and styles, but most condoms will fit most men. - Another choice is the Reality condom, which is made of polyurethane and is designed to fit inside the woman`s vagina for vaginal sex, and the anus for anal sex. Use the directions from the manufacturer that come with Reality condoms. - Open and handle condoms carefully. Never use a condom that is in a damaged package or is past its expiration date. Condoms should be stored loosely in a cool, dry place (not in your wallet or the glove compartment of your car) and kept where you can easily get them if you decide to have sex. - To reduce friction that can cause breakage, use plenty of water-based lubricant on the outside of the male latex condom and a small amount on the inside at the tip. With the Reality condom use plenty of lubricant on both the inside and outside. Some condoms come with lubricant, but often there is not enough, so additional lubricant is recommended. Never use oil-based lubricants like Vaseline, hand cream, Crisco, or mineral oil with latex condoms. Oil-based lubricants can rapidly break down latex and allow the virus to pass through. Water-based lubricants include K-Y Jelly, Slippery stuff, ForPlay, Astroglide, ID Lubricants and most contraceptive jellies. These can be found in grocery or drug stores next to the condoms. WARNING: Some lubricants contain nonoxynol 9, which can cause irritation. This irritation may increase the risk of HIV transmission. We do NOT advise the use of nonoxynol 9 or products containing it for STD and HIV prevention!

- The male condom should be put on after erection and before any sexual touch. Remember that pre-cum is also infected with HIV. The Reality condom should go in before sex - it can be inserted up to 8 hours before use. Never use the Reality and the male condoms together or two male condoms at the same time. - Some male condoms have a reservoir tip; some don`t. In either case, the tip of the condom should be squeezed while rolling it down onto the penis in order to leave an airless pocket to collect semen. If the penis is natural and has a foreskin, try pulling back the foreskin before unrolling the condom all the way down to the base of the penis. Some men don`t like to pull back the foreskin because they`ve found that the condom slides off when the foreskin is pulled back. If you have trouble with this, consider keeping the foreskin down before putting on the condom or try using a Reality condom with your partner. - After intercourse, withdraw the penis while still erect, holding the base of the condom to prevent it from slipping off or spilling semen. Remove the condom and wash the penis with soap and water. - Use a condom only once and dispose of it in the garbage; do not flush condoms down the toilet. Never reuse a condom. - Use a condom EVERY TIME during sex when transmission or acquisition of HIV is possible.

HIV is NOT transmitted by:

Casual Contact. HIV is a fragile virus outside the body. It quickly becomes inactive when exposed to air, soap and common disinfectants such as bleach.

There is no risk of getting HIV from: donating blood mosquito bites toilet seats shaking hands hugging sharing eating utensils or drinking containers food or objects handled by people with HIV or AIDS spending time in the same house, business or public place with people who have HIV or AIDS

How can HIV transmission from injection drug use be prevented?

The best way to avoid HIV infection (and other blood-borne infections like hepatitis B and C) from injection drug use is to stop injecting drugs. Drug treatment can help. If treatment is not available or you cannot quit on your own, use a brand new sterile syringe and needle every time you inject or divide drugs. Do not share drug using "works" with anyone else. This includes needles, syringes, cookers, cottons, mixing and bleaching water, and all other supplies. If you do not have new clean equipment, thoroughly disinfect all drug use tools with bleach before re-use. It is also important to dispose of used works safely. Discarding needles in the trash, on the street, or flushing them down the toilet is dangerous.

Drug use (including use of alcohol) can impair judgment and decision-making. This can increase risk for HIV, especially if you have sex while high. High or not, you can successfully use condoms and clean injection works. Plan ahead, carry condoms and stick to your prevention plan. *A person does not need a prescription to purchase syringes in Nevada. However, a pharmacist may refuse to sell to people based on their own judgment.

How can sexual transmission of HIV be prevented?

The only way to completely avoid the sexual transmission of HIV is to abstain from anal, oral and vaginal sexual. If you choose to have sex, it is safest when you practice monogamy with an uninfected partner. Monogamy is when two people have sex only with each other. For those with a new sex partner, both can abstain from sex, or use condoms every time during anal, vaginal and oral sex for at least 3 months and then get tested for HIV and other STDs. At that time, if both partners are HIV negative AND both partners are completely avoiding other risk behaviors (e.g., sharing needles or having other sex partners), then unprotected sex with each other is not a risk for HIV transmission. For someone with an HIV positive partner or a partner who does not know his/her HIV status or multiple sexual partners, touching, dry kissing, body rubbing, and mutual masturbation are the safest sexual activities. However, simple, skin-to-skin touching can spread other STDs. For any penetrative sex acts such as vaginal, anal or oral sex, condoms are highly effective at reducing the risk of HIV transmission when used consistently and correctly - every time, from beginning to end of each sex act. For more information on condom use see the answer to the question, "Do condoms provide 100% protection from HIV?"

Is there a cure for HIV and AIDS?

Not at this time. Medical providers have become much better at identifying, monitoring, and treating HIV infection and AIDS. In 1995, a new class of drugs known as protease inhibitors became available. These new medications, used in combination with other antiretroviral drugs, have dramatically improved the health and quality of life for many people living with HIV/AIDS. While there is not currently a cure or vaccine for HIV/AIDS, there are many things that people living with HIV/AIDS can do to remain healthy and to live longer. The first step for anyone who has HIV infection is to see a knowledgeable, experienced medical provider. This provider will be able to assess and monitor the infection, and, if appropriate, prescribe antiretroviral drugs. People at increased risk for HIV infection need to be tested for HIV antibodies every 3-6 months. This way they can seek medical care at the earliest possible opportunity if they become infected with HIV. Early detection can also reduce the chance of HIV transmission when people are most infectious. Although medical care and drugs are expensive, programs exist to ensure that people with HIV infection and AIDS can get the treatment and care they need.

What are the costs of an HIV test or STD exam at the Health Department?

Members of the community that access HIV and STD testing at the WCDHD are charged on a sliding fee scale, based on income. Charges are based on how much time is spent with the provider and what testing is done.

What are the symptoms of a new HIV infection?

Between 50-90% of people with new HIV infections have mild to severe "flu-like" symptoms 2 weeks to 3 months from the time of HIV exposure. Others do not have any symptoms. In general, symptoms are not a reliable way to tell if someone has been infected with HIV; the only way to know for sure is to get tested. Many of the symptoms of early HIV infection are the same as for other, less serious illnesses. People who may have been exposed to HIV should see a doctor promptly if the following symptoms occur within 3 months of the exposure: - A persistent fever of over 101 degrees that lasts more than 2 days without a known cause - Constant tiredness - Night sweats that soak your pajamas or sheets - A persistent rash of unknown cause - Persistent swollen glands (lumps under the skin) which occur in several places at once (especially the neck, armpits and groin) - Sore throat

What is AIDS?

AIDS (Acquired Immune Deficiency Syndrome) is a medical condition resulting from HIV infection, usually after many years. By the time a person is given an AIDS diagnosis by a doctor, HIV has seriously damaged the body`s immune system. There are effective treatments to prevent, as well as treat, these serious illnesses.

What is HIV?

Human Immunodeficiency Virus (HIV) is the virus that causes AIDS. HIV kills specific white blood cells (T cells), which are an important part of our immune systems. Without treatment, HIV gradually destroys the body`s defenses against disease (it takes an average of 8-10 years), leaving it vulnerable to many infections and cancers. But treatment with antiretroviral drugs can slow or stop the harmful effects of retroviruses like HIV, so that many people with HIV are living longer, healthier lives.

What is the "window period" for HIV?

It can take up to 3 months after HIV infection for enough antibodies to develop, therefore a negative test result is reliable only if the person has not had any sexual or needle-sharing risk behavior (or other exposure to infectious body fluids) during the 3 months prior to testing. Some people with recent risk behavior will test HIV antibody negative, yet may have actually been infected during the previous 3 months. Every exposure pushes the window period out another months.

What is the HIV Antibody Test?

There are several types of HIV antibody tests used today. All are highly accurate at detecting HIV antibodies (HIV antibodies are specific proteins made in response to an HIV infection). After infection with HIV, however, it can take up to 3 months for enough HIV antibodies to develop to be detected by the test.

A negative HIV antibody test result means that a person does not have detectable HIV antibodies at the time of the test. Since it can take up to 3 months after HIV infection for enough antibodies to develop, a negative test result is reliable only if the person has not had any sexual or needle-sharing risk behavior (or other exposure to infectious body fluids) during the 3 months prior to testing. Some people with recent risk behavior will test HIV antibody negative, yet may have actually been infected during the previous 3 months. These people will be highly contagious and may easily transmit HIV to their sex and needle-sharing partners. A high proportion of HIV transmission may occur when people are unaware of their infection. Finally, a negative test result does not mean that a person is safe from future HIV infection. People who test HIV antibody negative are urged to continue to follow HIV prevention guidelines to avoid becoming infected. People who continue risk behaviors are advised to re-test at least every 6 months.

A positive HIV antibody test result means that HIV antibodies are present because the virus is present - the person is infected with HIV (with the exception of newborn babies who are born with their mothers` antibodies). A positive test does not mean the person has AIDS, although many HIV-positive people may develop AIDS in the future. Anyone who tests HIV-positive can transmit the virus to others, regardless of how long they have been infected, whether they have AIDS or other symptoms, or whether their HIV infection is being treated with antiretroviral drugs. It is extremely important that HIV-positive people follow HIV prevention guidelines, not only to protect their partners from getting HIV infection, but also to protect themselves from other germs that could cause HIV/AIDS-related disease. People at increased risk of HIV infection should NEVER donate blood, plasma, or other organs, or go to such facilities to be tested.

Where else is HIV testing available in the community?

HIV testing is available from a variety of resources in the community:

Who is at risk for HIV infection?

Anyone can get HIV if they have unprotected sex or share injection drug equipment with someone who is infected. The virus does not discriminate - it can infect males or females, babies, teens, adults or senior citizens. You cannot look at someone and know they have HIV. In fact, as many as 1 out of 3 people who have HIV (33%) have no idea they are infected.

Who is eligible for HIV testing at the Washoe County District Health Department?

To reach those at higher risk for HIV infection and utilize the resources of the WCDHD the following populations are tested at the WCDHD:

- men who have sex with men - injecting drug users - partners of men who have sex with men - partners of injecting drug users - those who present with an opportunistic infection - contacts (partners) of HIV positive individuals - victims of sexual assault

Everyone is eligible and encouraged to seek education and information regarding HIV and STDs. Educational services are offered free of charge.

Air Quality +

How do I know if an air permit is required from the AQMD for my business?

Normally, a business which emits 2 pounds or more per day of criteria air pollutants or 1 pound per day or more of toxic air pollutants will require a permit to operate. Different types of air pollution control devices are also required for different processes depending upon the size of the operation for compliance with the AQMD regulations. Applications may be obtained by downloading from the District Health Department Web site. For further information, please contact one of our environmental engineers at 784-7200 for help with the necessary information for application submittal.

How do I register an air pollution complaint?

Just call 784-7200 (24 hours per day) and your complaint will be logged onto an official AQMD complaint form. After that, within "normal" hours of operation, an air quality specialist will investigate your concerns and determine if there is a violation of the AQMD regulations. If a violation exists, the person or business will be required to correct the problem. A Notice of Violation may also be issued.

What are the local asbestos regulations for commercial buildings?

The local asbestos regulations essentially mirrors the federal requirements. If you own a commercial building and want to do some remodeling, an asbestos survey will need to be completed by a certified consultant to determine the presence or absence of any asbestos materials. If present, a certified abatement contractor will need to remove the asbestos before the project can proceed. In addition, the property owner will need to obtain an asbestos acknowledgment form from the AQMD prior to obtaining a building permit from the local building departments. For further information, please call 784-7200.

When does the Air Pollution Control Hearing Board meet?

The Air Pollution Control Hearing Board (APCHB) is a fair and unbiased panel that hears appeals when a negotiated resolution cannot be achieved. The APCHB meets the first Tuesday of every month (as needed).

Can I have a wood burning stove or fireplace in Washoe County?

Wood stoves and fireplaces are regulated by the Washoe County District Health Department because they are major contributors to air pollution in the Truckee Meadows. Therefore before you make a purchase, it is important for you to spend some time researching whether it is legal to put a wood burning appliance in your home. To determine if you can install a wood burning stove or fireplace in your home, you need the following information, then call (775) 784-7200 (AQMD).

* What is your zip code? * What is your land-use zoning? * What is the net size of your property?

Antimicrobial Resistance +

What are bacteria?

Bacteria (singular: bacterium) are one-celled organisms visible only through a microscope. There are many types of bacteria, only some of which cause disease. Most are harmless and even some are helpful (good bacteria), by aiding digestion or breaking down rotting material. Bacteria are found almost everywhere.

What is an antibiotic?

An antibiotic is a powerful medication designed to kill bacteria or stop them from growing, such as an illness caused by strep throat. They cannot cure illnesses caused by viruses, such as a cold or the flu. Different antibiotics may be used for different types of bacterial infections. Your health care provider will determine what infection you have and if an antibiotic is appropriate to treat it.

How do antibiotics work?

Antibiotics either inhibit the growth of bacteria (bacteriostatic) or actually kill the bacteria (bacteriocidal). By stopping the growth of bacteria, it gives the body time to mount an immune response and allows the body to eliminate the bacteria. Drugs that kill the bacteria are the preferred choice when someone has a weakened immune system and whose body cannot destroy the bacteria on its own. Antibiotics are not effective against viruses.

Can antibiotics be harmful?

Unnecessary antibiotics can be harmful. Antibiotics only fight bacterial infections. They do nothing to help viral illnesses like colds or influenza (flu). If you take an antibiotic when it is not necessary, such as for a cold, you increase the risk of developing an infection caused by antibiotic-resistant bacteria. Antibiotics also destroy good bacteria in your body.

What is antibiotic resistance?

Antibiotic resistance occurs when an antibiotic has lost its ability to effectively control or kill bacterial growth. These bacteria are considered to be resistant to an antibiotic. Overuse and misuse of antibiotics are the main reason for antibiotic resistance.

How do bacteria become resistant?

Some bacteria are naturally resistant to certain types of antibiotics. Bacteria can also become resistant by a genetic mutation or by acquiring resistance from another bacterium. Because bacteria can collect multiple resistance traits over time, they can become resistant to many different families of antibiotics, which allows the resistant bacteria to continue to live/and multiply even in the presence of antibiotic treatment.

Do people become resistant to antibiotics?

No, this is a common misconception. People may exhibit allergic reactions to antibiotics, but they are not resistant to them. It is the bacteria, not the person, which become resistant.

How do I catch an antibiotic-resistant infection?

There are three ways in which you can get an antibiotic-resistant infection:

* You can develop antibiotic-resistant infections when you take an antibiotic. The bacteria could figure out how to outsmart the antibiotic and stay alive. In that case, you can transmit these resistant bacteria to others and they too may become ill * You can catch antibiotic resistant-infections from people or objects around you that are infected with resistant bacteria. Not properly washing hands can increase your risk of catching all kinds of infections. * You can develop an antibiotic-resistant infection when the bacteria inside your body change; it mutates or acquires genes that allow them to resist antibiotic treatment.

Antibiotic-resistant bacteria can also develop in pigs, chickens, cattle and other farm animals, which are exposed to low doses of antibiotics in their daily feed. These resistant bacteria can then spread to humans, causing antibiotic-resistant infections. Guidelines are being developed to address this concern.

Does a cold or the flu need an antibiotic?

No. The common cold and the flu (influenza) are caused by viruses, not by bacteria.. Antibiotics do not work against viruses. Normal cold symptoms include sore throat, fever, cough, and/or a runny nose. A runny nose often starts out with clear drainage and then turns to a green or yellow color. This is a good sign that the body is fighting the virus. If your runny nose is not getting better after 10-14 days, please talk to your healthcare provider.

Does bronchitis need an antibiotic?

No. Viruses cause most bronchitis.

Do most sore throats need an antibiotic?

No. Viruses cause most sore throats. Only strep throat needs an antibiotic; it is caused by strep A bacteria.

Do ear infections need antibiotics?

Sometimes. Viruses and bacteria can cause ear infections. Your doctor may wait to see if the ear infection improves by itself before deciding to give antibiotics.

Do sinus infections need an antibiotic?

Sometimes. Bacteria or viruses cause sinus infections. Antibiotics are needed for bacterial sinus infections. A bacterial sinus infection may be present if cold symptoms do not improve after 10-14 days.

What can I do to feel better?

It is very important to have your body help itself. Get plenty of sleep, drink lots of fluids and eat healthy foods. Help decrease the symptoms by using a vaporizer or use over-the-counter medicines like saline nose drops, gargles or throat lozenges. Viral infections simply take time to get better.

Do antibacterial products (such as antibacterial soaps) prevent infections better than ordinary soaps?

For household use, antibacterial products are no better than ordinary soap for preventing infections. Hand washing for 15 seconds with ordinary soap and water will reduce the risk of most common infections and does not add to antibiotic resistance.

Are antibiotic-resistant bacteria a problem?

Yes. It is becoming a major public health concern. Each time you take an antibiotic unnecessarily or improperly, you increase your chance of developing drug-resistant bacteria. We could run out of ways to kill disease-causing bacteria.

You don't know who is carrying anti-biotic resistant bacteria and they may pass that resistant bacteria on to you and make you ill. This could mean stronger, more expensive antibiotics, hospitalization and, sometimes, death.

What can I do about antimicrobial resistance?

Reduce the need for antibiotics.

Wash your hands! Wash your hands! And, wash your hands! By washing your hands often and thoroughly with plain soap and water, you are helping to prevent disease and, therefore, the need for antibiotics.
Prevent food borne illnesses by properly refrigerating perishable foods, thoroughly cooking all food from animal sources, and avoiding cross-contamination of other foods.
Consider pets, even if not ill, as potential sources of infection.
Dispose of feces, urine, diapers and contaminated articles properly.

Also, you should take antibiotics only when necessary. Don't insist on an antibiotic when your doctor says, "no". Never take an antibiotic for a viral infection such as cold, cough, or flu. Take an antibiotic exactly as the doctor prescribes. And take the antibiotic until it is gone, even if you are feeling better. Never save the medication to treat yourself or others later.

Birth and Death Records +

How do I obtain a birth or death record/certificate?

If you are a qualified applicant, you can complete an application form and mail it along with a copy of your valid photo identification and a check or money order, payable to Washoe County Health District, or you can appear in person at the office which is located in the Washoe County Health District, 1001 E. Ninth Street, Reno, Building B, first floor, Birth and Death Records. Our hours are listed on the Vital Statistics Program page.

Who is a qualified applicant for a birth or death record?

Birth and death certificates are confidential in the State of Nevada and may only be released to a qualified applicant. A qualified applicant is defined as the registrant, or a direct family member by blood or marriage, his or her guardian (Must provide certified original court order appointing guardianship.), or his or her legal representative. For more information, refer to NRS 440.650 and NAC 440.070.

How much does it cost for a copy of a birth or death record?

The Vital Statistics Office provides certified copies of Washoe County birth and death certificates either at the office or by mail. Fees for certified copies are set by statute and are $20.00 per certified copy for birth certificates and death certificates.

Where can I go to obtain a copy of a birth or death certificate?

The office is located in the Washoe County Health District, 1001 E. Ninth Street, Reno, Building B, first floor, Birth & Death Records. Our hours are listed on the Vital Statistics Program page. For more information call (775) 328-2456.

What are the hours for Vital Statistics?

Our hours are listed on the Vital Statistics Program page.

How do I add the name of my child’s legal father to his or her birth certificate?

If there is no father listed on a child’s birth certificate, the name of the legal father can be added by making this request on a Declaration of Paternity form. This form contains detailed information about this process, although the following bullet points emphasize some of the most important items:

This procedure applies only to children born in Nevada. For a child born in another state, you need to follow the procedure for that particular state.
The Declaration of Paternity outlines the rights and responsibilities of the man signing the form. Be sure that you review and understand this information before signing the form.
If you want to change the child’s birth name (for example, change his or her last name to match that of the legal father), you may do so at this time in Section B of the form.
Both the mother and the legal father must sign the completed form.
If both parties are not willing to sign the form, a court order will have to be obtained and provided to the Nevada State Office of Vital Records.

Please mail the completed and signed form to: Nevada State Office of Vital Records 4150 Technology Way, Suite 104 Carson City, Nevada 89706

Include a check or money order for $40.00 made out to Nevada Vital Records to cover the costs of changing the birth certificate already on file. This fee includes a certified copy of the revised record, which will be mailed to the requester at the address listed on the form. Additional copies are $20.00 each.

If you have questions about this process, please call the Nevada State Office of Vital Records at 775.684.4242. If you need to make a correction to a birth or death record, fill out the Affidavit For Correction of Record form.

How do I make a correction on a birth or death record?

Fill out the Affidavit For Correction of Record to amend or correct information on a birth or death record. Direct questions and send completed forms to the Nevada State Health Division Office of Vital Statistics at http://health.nv.gov/VS.htm Adding a child's legal father to his or her birth certificate requires filling out a Declaration of Paternity form. Find the form and additional information at http://www.washoecounty.us/index/display_faq.html~details=1087#1087

Condoms and Foam +

What are Condoms and Foam?

Condoms and Foam work together to help protect you from pregnancy. Condoms help prevent diseases people get from having sex (Sexually Transmitted Diseases). Condoms fit over the man’s erect penis. Sperm are kept inside the condom and can’t get to the woman’s egg.

Condoms and Foam used together give extra protection. Condoms are made of strong latex or plastic. They help keep the man’s sperm out of the woman’s vagina. If the condom breaks or leaks, the foam will help kill the man’s sperm. Condoms also help protect the man and the woman from STDs. Always use condoms every time you have sex. Foam by itself will not protect you from STDs.

How well do Condoms and Foam work?

Used together, condoms and foam work very well to keep woman from getting pregnant. Between 2 to 15 women out of 100 who use condoms for one year get pregnant. If foam is used by itself, up to 29 women out of 100 may get pregnant.

When does fertility return when using Condoms and Foam?

There is no interruption in fertility with a woman.

Can condoms and foam be used by nursing mothers?

It is recommended for use by nursing mothers while breastfeeding.

What do some people like about using Condoms and Foam?

Condoms can help protect you from HIV (the AIDS virus) and other STDs. You can buy condoms and foam in any drug store or supermarket. They cause no serious health problems.

WARNING: Some lubricants contain nonoxynol 9, which can cause irritation. This irritation may increase the risk of HIV transmission. Don`t use nonoxynol 9 or products containing it!

What do some people dislike about using Condoms and Foam?

You must stop and put the condom on. They may irritate the vagina or penis. You must use a new condom and put in more foam every time you have sex.

How to use Condoms?

You must put on the condom before you put the penis in or near the vagina.
Hold the tip of the condom to squeeze out the air.
Roll the condom onto the erect penis.
After the man ejaculates (cums), hold onto the base of the condom as the penis is pulled out of the vagina.
Roll the condom off and throw it away.
If you want to have sex again, use a condom.

Things to remember:

Put a gel (like K-Y jelly) on the penis before you use the condom. It may make it more enjoyable.
Don’t use Vaseline or other oil-based products. It can damage the condom.
Store condoms in a cool, dry place.

How to use Foam?

Foam works best when you put it in just before you have sex. If it has been more than 15 minutes, you will need more foam.

Shake the can at least 20 times. Then fill the applicator with foam.
Put the applicator deep into the vagina. Press gently to push the foam up into the vagina.
Have sex right away.
Use more foam every time you have sex.

There are other methods that kill sperm.

Ask your Health Care professional to tell you about the birth control film, suppositories, cream and jelly. These can all be used with condoms, too.

Depo-Provera +

What is Depo-Provera?

Depo-Provera is used to prevent pregnancy. It is a medication similar to the female hormone progesterone. Similar hormones are also are used in birth control pills and for many medical therapies.

How is Depo-Provera used?

It is given as a shot once every 12 weeks. The shot may be in the arm or in the buttocks. Do not rub the injection site after the shot is given.

When is the shot first for Depo-Provera given?

Usually, the first shot is given within 5 days of the beginning of the period. In some cases, the first shot may be given at other times. After that, the shot is given once every 12 weeks.

How soon does Depo-Provera work?

The Depo shot works fastest if the shot is given by the fifth day of the period. A backup method of birth control (i.e. condoms) should be used for seven days after the first shot is given until it becomes fully effective.

How does Depo-Provera work?

It stops the ovaries from releasing eggs, causes the cervical mucus to become thick so that it is hard for sperm to reach an egg, changes the uterine lining, and affects the fallopian tubes.

How effective is Depo-Provera?

Approximately one out of every 400 women using this method becomes pregnant. It`s effectiveness rating is 99.6%. This means that it is more effective than sterilization.

When does fertility return after stopping Depo-Provera?

There may be a delay in return to fertility. Typically a woman will not be able to become pregnant for 6-12 months after the last shot (the average length of time is 10 months). It may take even longer for some women. If you stop receiving Depo and do not want to become pregnant, you should use another method of birth control.

Can Depo-Provera be used by nursing mothers?

Yes. It does not affect the amount or quality of breast milk. It can be given after 6 weeks of nursing, by which time lactation is well established. It is passed to the baby in the milk but it is not known to be harmful to the baby.

What are the benefits of using Depo-Provera?

In addition to being very effective and convenient, it may help decrease anemia and probably decreases your risk of ovarian and uterine cancer. It usually decreases the amount of menstrual blood loss and the amount of cramping with periods.

What are possible side effects of Depo-Provera?

Changes in the menstrual period. During the first year periods usually are irregular and often there is frequent bleeding. Periods can also be heavier/longer, and bleeding could last 30 days or more. After 6-12 months most women have fewer periods and many stop having periods altogether.
Pregnancy-like symptoms can occur. These include sore breasts, tiredness, nausea, and abdominal discomfort. These usually go away in 3-6 months.
Weight changes may occur because it may increase the appetite. Approximately 66% of women gain weight. However approximately 20% lose weight, and another 10% do not gain or lose weight. The typical weight gain is 5.4 pounds the first year and 8 pounds by the end of the second year. Weight gain can be controlled by diet and exercise.
Depression. This may become worse in women who have had problems with depression before. If you notice depression, contact a clinician to talk about the possible relation to Depo.
Depo-Provera may cause dark patches on the skin of your face. These patches may continue even after you stop getting the shot and may become worse with sun exposure.
Some other reactions that have been reported are headaches, dizziness, nervousness, loss of scalp hair, increase in body hair, and either an increase or a decrease in sex drive.

What are the risks of using Depo-Provera?

Women who use contraceptives with hormones (like the Depo shot) have an increased risk of blood clots or stroke. There is also an increased chance of ectopic pregnancy meaning that the fetus develops outside the uterus. Although possible, these events are rare.

Depo may cause bones to become thinner while you use the shot. This could increase your risk of a broken bone. It is important to get enough calcium in your diet while receiving Depo-Provera. When you stop taking Depo, your bones should return to their normal thickness.

Who cannot use Depo-Provera/DMPA?

Any woman who:

Is pregnant or suspects pregnancy
Has undiagnosed, irregular bleeding between periods
Has serious liver disease
Has ever had a liver tumor
Has ever had breast cancer
Has ever had a stroke
Has had blood clots in the legs, lungs, or eyes
Is allergic to Depo-Provera

E. coli +

What is E. coli O157:H7?

E. coli O157:H7 is one of hundreds of strains of the bacterium Escherichia coli. Although most strains are harmless and live in the intestines of healthy humans and animals, this strain produces a powerful toxin and can cause severe illness.

How does a person get E. coli?

One way E. coli can be contracted is when a person eats food that has been contaminated with animal waste or unsanitary water.

What are the symptoms of E. coli?

The main symptom is diarrhea, which is often bloody, accompanied by abdominal cramps. There also can be a mild fever.

How sick can E. coli make me?

In some persons, particularly children under five years of age and the elderly, the infection can also cause a complication called hemolytic uremic syndrome, in which the red blood cells are destroyed and the kidneys fail. About two to 7 percent of infections lead to this complication. In the United States, hemolytic uremic syndrome is the principal cause of acute kidney failure in children, and most cases of hemolytic uremic syndrome are caused by E. coli O157:H7.

When should I see a doctor?

If you have severe, prolonged or bloody diarrhea, you should seek medical attention.

How long will it take for me to get well from E. coli?

Symptoms usually resolve within five to 10 days.

Emergency Contraception Pill +

What is ECP (Emergency Contraception Pill)?

ECP is medication that is taken up to 120 hours (five days) after sex to prevent pregnancy. It contains a hormone called levonorgestrel that is similar to the hormone progestin, which is naturally made in the woman’s body.

How is the Emergency Contraception Pill used?

To reduce the risk of pregnancy, the first dose needs to be taken as soon as possible within 120 hours of unprotected sex. Depending on the type of ECP you take, you may need to take a second dose 12 hours later.

How does the Emergency Contraception Pill work?

The primary ways that ECPs work is to temporarily stop the ovaries from releasing eggs, and to prevent fertilization. It may also work to prevent implantation of a fertilized egg.

How effective is the Emergency Contraception Pill?

ECPs reduce the risk of pregnancy by at least 75% if begun within 72 hours after unprotected sex.

Does the Emergency Contraception Pill affect fertility?

No. ECPs will not affect your ability to get pregnant in the future.

Can nursing mothers use the Emergency Contraception Pill?

Although a small amount of hormone may be passed to the infant, there have been no problems found with the health, growth or development of the infant. ECPs do not affect the quality or quantity of the breast milk.

If the Emergency Contraception Pills don’t work and I become pregnant, will it hurt the fetus?

No. ECPs are not known to harm a developing fetus.

If I`m already pregnant will Emergency Contraception Pills affect the pregnancy?

No. ECPs do not work if you are already pregnant.

What are possible side effects of using Emergency Contraception Pills?

Side effects include breast tenderness, headache, nausea, dizziness, fatigue, vomiting, diarrhea, and abdominal pain.

You may also have a change in periods (lighter or heavier bleeding).

Who cannot use Emergency Contraception Pills?

Any woman who is pregnant or has undiagnosed, irregular bleeding between periods.

Environmental Health +

Do I still need a permit if I`m giving away food?

A permit is required if the food has been prepared in a commercial establishment. Food that is prepared in a private home and given away free of charge or consideration of any kind is exempt from the permitting requirement, unless it is given to a commercial food establishment. If you are not sure, it is best to contact the District Health Department at 328-2434.

Where do I make a complaint if I become sick from eating food at an event or restaurant?

If you believe that you became ill as a result of eating a meal prepared at a food establishment located in Washoe County, please call our office at (775) 328-2434 to report your illness.

Do I need a permit to drill or recondition an existing well?

A well construction permit must be obtained from the Washoe County District Health Department to construct, drill, recondition or plug a well. The permit applications are available and are processed at the District Health Department offices.

Family Planning Clinic +

Are there male or female nurses in the Family Planning clinic?

All of the nurses in the Family Planning clinic are female.

Does the Family Planning clinic accept insurance?

We do accept some insurance plans.
We accept Medicaid, but not NevadaCare or Health Plan of Nevada.

Does the Family Planning clinic have staff that speak Spanish?

Yes. We have staff that speak Spanish and interpret in the clinic. We also have a telephone interpreting service that can assist with interpretation in many other languages.

How do I pay for my Family Planning Clinic visit?

We accept cash, check, money orders and credit cards.

How long does it take to get a Family Planning clinic appointment?

The length of time that it takes to get an appointment. The longest wait is if you are a new client, which can vary from 6 to 8 weeks.

I am pregnant so where do I go to get checked (prenatal care)?

We provide pregnancy testing and proof of pregnancy if your test is positive. We do not provide prenatal care services: however, we will tell you where to receive those services.
The Washoe Pregnancy Center provides prenatal care services on a sliding scale. Their phone number is (775) 982-5640.

I just had sex and didn't use protection. I don't want to get pregnant. What can I do?

If you take an Emergency Contraception (the Plan B pill) within 5 days of unprotected sex you can reduce your chance of pregnancy by up to 75%. You need to be seen by a nurse to receive this medication. Call the clinic ASAP to make an appointment. For weekend, holiday or evening emergency contraception providers in the local area dial 1-888-NOT-2-LATE.

Is the Family Planning clinic appointment confidential?

Yes. All appointments are Confidential.

Is there a bus stop near the Family Planning clinic?

Yes. There are Citifare bus stops close to the Health Department along routes 2 and 12.

I`m pregnant and thinking about adoption, where can I go to find out more information?

Social Services has information on adoption.

I`ve been sexually assaulted and I am afraid to tell the police. What do I do?

Contact Sexual Assault Support Services Crisis Call Center at 784-8090 or 1-800-992-5757 and they will listen to you as well as give you information about resources in the community that may help.

What ages of women do you see in the Family Planning clinic?

We see women in their reproductive years, which means during the time in their lives when they are able to have children. When a woman reaches menopause (stops having her period) we refer her to a different clinic for annual exams.

What are the average costs for the Family Planning clinic?

Our fees are listed at http://www.washoecounty.us/health/ahs/fees-cchs.php#fp.

These charges are average, your charges could be more or less than what is listed above. For more detailed information see the Cost of Services link.

What are the hours for the Family Planning Clinic?

Hours for the Family Planning Clinic are at http://www.washoecounty.us/health/cchs/fpc.html#lah

Please call 328-2470 to schedule an appointment.

What do I need to bring to my Family Planning clinic visit?

· If it is your first visit, or if your income has changed, please bring proof of family income. For details see Cost of Services link. · If you are on medications, bring in your medications, or write down the names so a nurse can review them. This would also include any birth control pills that you did not receive from this clinic.

What does Family Planning Clinic mean?

The Family Planning clinic offers services to help you plan the size of your family. By using birth control methods a woman has more control over when she has children and how many children she has.

What is a Pap smear?

A Pap smear is a test that looks for changes of the cells on the cervix. If you would like to know more, please see the Pap Smear information sheet.

What is the phone number for the Family Planning clinic?

The number to the office clinic is (775) 328-2470. The phones are answered between the hours of 9am -12pm and 1pm - 4pm.

When do I pay for the visit to the Family Planning clinic?

You can pay for your visit on the day that you receive services, or we can put you on a payment plan.

Where can I find abortion services in the Reno/Sparks area?

The West End Women`s Medical Group provides abortion services. The phone number is 827-0616.

Where is the Family Planning Clinic located?

The Health Department is located at the corner of 9th Street and Wells Ave., just off the freeway and next to the fairgrounds. The address is 1001 East 9th Street, Building B. If you are traveling North on Wells, the entrance to the clinic is the first right (into the parking lot) after passing 9th Street. You can enter the door marked CLINIC SERVICES.

Flu +

How can I protect myself from getting the flu?

You can protect yourself from getting the flu by being vaccinated every year. There are two ways to be vaccinated against flu:

Flu shot Available for those in high risk groups (see below)
FluMist (delivered through the nose) - For healthy, non-pregnant people ages 5 to 49.

What does being at "high risk" mean?

Being at high-risk means that an individual is at high risk for developing life-threatening complications if he or she gets the flu. High risk does not mean that one is at greater risk for catching the flu.

How do I know if I`m in a high-risk group?

Those who are considered to be at high risk for developing complications from the flu and who are encouraged to get vaccinated include:

Healthy children age six months to four years
Persons age 50 years and older
Persons age 5 to 49 who have certain chronic medical conditions involving the heart, lungs, kidneys and/or liver, including asthma; those with metabolic, blood or immune system disorders such as diabetes, anemia or immunosuppression caused by medication, cancer treatment or human immunodeficiency virus (HIV); and neurological or neuromuscular disorders such as seizures or spinal cord injuries, which can compromise respiratory function or the handling of respiratory secretions or that can increase the risk for aspiration.
Pregnant women
Children and adolescents age five to 18 years, who are receiving long-term aspirin therapy, and therefore might be at risk for developing Reye syndrome after influenza infection
Residents of long-term care facilities

Annual seasonal flu vaccination also is recommended for those who can transmit seasonal influenza to high-risk individuals, including

Healthcare personnel who provide direct patient care
Household contacts, care givers and daycare providers of those at high risk.

When and where can I get a flu shot or FluMist?

Ask your healthcare provider. Also, you can access seasonal flu vaccination schedules by

Logging onto www.washoecounty.us/flu - links to schedules for major local providers are provided
Calling the Flu Hotline at (775) 328-3724.

How much does a flu shot or FluMist cost?

It depends on the type of vaccine used, the age of the client, and the type of insurance the client has.

It is best to

Check with your provider
Log onto www.washoecounty.us/flu - links to seasonal flu vaccination information for major local providers are provided

Will my insurance pay for my flu shot or FluMist?

Medicare Part B does cover the cost of an annual seasonal flu shot. If you have a senior HMO or another type of insurance or if you want to get FluMist, you should check with your insurance carrier.

What else will help people avoid getting the flu?

In addition to getting vaccinated against the flu, there are several simple, common sense actions people can take to decrease the chance of getting and transmitting the flu:

Wash your hands often with soap and water for at least 30 seconds to eliminate germs you may have picked up from touching things contaminated with the influenza virus. Carry waterless hand sanitizer for use when soap and water are not available.
Avoid touching your mouth and nose many germs, including influenza, enter the body through these openings.
Stay away from crowds. Influenza is transmitted via droplets, which enter the air from a cough or sneeze and can remain airborne for three to six feet. The closer you are to others, the greater your chance of coming into contact with infected airborne particles.
Cover your mouth and nose when you cough or sneeze to narrow the distance the droplets travel. Coughing/sneezing into your sleeve eliminates the need for using tissue and washing your hands afterwards.
Stay home from work, school and social gatherings as well as those in the high-risk category if you are not feeling well to avoid the spread of disease to others.

What are symptoms of the flu?

Contrary to popular belief, seasonal flu is not a stomach-related illness and, therefore, does not cause nausea, vomiting or diarrhea. Instead, seasonal flu is an illness involving the upper respiratory system. Symptoms generally include the following:

Seasonal influenza symptoms usually come on rapidly and can last for several days. Depending on age and general health status, people who have the flu can pass it along to others for several days before noticing the onset of symptoms and can remain contagious for several days after symptoms subside.

I never get sick, so why should I get a vaccinated for the flu?

Although most people who have the flu feel quite ill, some people who have the flu do not experience significant symptoms. But even if you dont have symptoms, you can spread the flu to others, including those at high risk for developing serious complications. Therefore, getting vaccinated protects both you and those around you from getting the flu.

I`ve gotten flu shots before, and then I got sick with the flu, so I don`t want to get a flu shot again.

Flu shots are made from killed virus, so getting a flu shot does not cause the flu.

It takes about two weeks for a flu shot to reach its maximum level of protection. So, if you were exposed to the flu before getting the shot or during the two weeks immediately thereafter, you could experience flu symptoms because you were not protected when you were exposed. Or you could have gotten a strain of the flu that was not included in the current year`s vaccine mix (each year`s mix includes only the three strains believed to be the most likely to circulate during the current season) or you may have gotten a different disease that has similar symptoms.

The most common side effect from the flu shot is soreness at the site of injection. This can be reduced by exercising your arm frequently within the first couple of hours after receiving the shot and throughout the day.

Who should not get vaccinated against flu?

Infants under 6 months of age because they are too young to receive flu vaccine.
Anyone who has ever had a severe allergic reaction to eggs or any components in flu vaccine.
Anyone who has had Guillain-Barre Syndrome, a neurological disorder.

What is the Northern Nevada Immunization Coalition?

The Northern Nevada Immunization Coalitions mission is to promote health and decrease the incidence of vaccine-preventable diseases in northern Nevada through community partnerships and education. Established in 1995, the non-profit, community-based coalition is comprised of leaders from various public and private organizations that are working together to improve statewide immunization rates.

The following members of Partners Promoting Adult Immunizations, a sub-group of the coalition, have made this years local flu shot events possible: Carson City Health and Human Services, Carson Tahoe Regional Healthcare, Dons Pharmacy, Incline Village Community Hospital, GlaxoSmithKline Vaccines, Maxim Healthcare Services, MedImmune, Merck, Nevada State Health Division, Northern Nevada Medical Center, North Lake Tahoe Fire Protection District, Novartis (formerly Chiron), Orvis Nursing Clinic, Raleys, REMSA, the Reno Gazette-Journal, Reno-Sparks Rotary Clubs, Renown (formerly Washoe Medical Center), Saint Marys, Sanofi Pasteur (formerly Aventis), UNR Student Health Services, and the Washoe County District Health Department.

How late in the season can I get a seasonal flu shot for it to still be effective?

While October and November are typically the months when most people get their flu shots, seasonal influenza can begin to increase as early as November or December, but has not reached peak levels in the majority of recent flu seasons in the United States until late December through early March. So getting a seasonal flu shot later than November can still provide protection against seasonal flu. Those in the high-risk category are encouraged to get vaccinated as early in the season as possible to maximize their protection against seasonal flu.

Will getting a seasonal flu shot protect me from "bird flu" or "pandemic influenza"?

No. Pandemic means that many people in many places are becoming ill with the same disease at the same time. A flu pandemic occurs with the emergence of a new flu virus which

Spreads easily from person to person
Is not yet preventable through vaccination, as a vaccine cannot be developed until after the new strain emerges.

There have been three flu pandemics in the last century. Experts say that we are due for another one. We just dont know when it will occur.

The bird flu or avian influenza virus has shown the ability to move from birds to people who are in close proximity to infected birds. However, the avian influenza virus of concern (H5N1) has not yet shown the ability to pass easily and sustainably from human to human. If the H5N1 virus mutates to spread easily from person to person to person, it could signal the beginning of a flu pandemic.

Food Services +

Are there any food permit exemptions?

Yes. Coffee (not latte/espresso), tea, prepackaged and unopened non-perishable snacks and candy, canned and bottled soft-drinks and water in original container, canned and bottled pasteurized juices in original container, and whole produce are all exempt from permit.

Can I prepare food for a Special Event at home?

Never. No storage, slicing, dicing, marinating, cooking or any process related to food preparation for any food item, dressing, garnish or other is allowed at a private residence for items served to the general public at a Special Event.

Do I still need a permit if I`m giving away food?

Is there a food permit fee exemption for veterans as in California?

No. County Finance has not passed any such exemptions for purchase of permits.

Is there a reduced food permit fee for non-profits?

Yes, with proof of non-profit status for a temporary food establishment that donates all proceeds to the non-profit agency. (See current Fee Schedule for Environmental Health Services, TEMPORARY FOOD SERVICE, NON-PROFIT.

Is there an annual permit to cover a full season for temporary foods?

No. There is an annual permit for certified produce vendors who wish to sample that applies only to sanctioned Farmer`s Markets. The Washoe County Health District permits and inspects every event separately.

If I already have a permit for my restaurant or mobile food do I need a temporary food permit?

Absolutely; a permit is not transferable from person to person or place to place and unless the operation is conducted from the mobile and contained within the mobile with a menu approval, a separated temporary food permit is required.

How far ahead of time must I purchase a Temporary Food Permit?

There is a late fee that applies if the permit is not purchased at least seven (7) calendar days ahead of time. The District Health Department discourages late applications and may deny applicants that are chronically late.

If I turn in a food permit application and pay the fee, have I been approved?

No. The application is subject to review and food service operations must comply with regulations. Incomplete applications may be rejected. Applications may also be rejected based on inability to contact the person in charge of food service, menu item restrictions, or operational concerns.

Can I prepare the food for a Special Event ahead of time at an approved facility?

Advanced preparation must be approved by the Health Department ahead of time as per application. Menu items, storage, transport, time and temperature will all be considered before such approval is granted. Cooking and cooling food items prior to an event is usually not allowed.

Green, Yellow, Red Burn Code Program +

What is the Green, Yellow, Red Burn Code Program?

In 1987, the Washoe County Air Quality Management Division (AQMD) developed this program to reduce the emissions from woodstoves and fireplaces during wintertime high pollution episodes. One of three burn code colors is issued each day based on the current and forecasted air quality. Each color lets you know if you can light your stove or fireplace. The Burn code address all solid fuels including wood, pellets, fire logs, coal, etc.

Green - When the Air Quality Index (AQI) is in the Good or low to mid Moderate range, the burn code is Green and that means it’s okay to light a fire in your stove or fireplace. But keep in mind that you should always burn seasoned wood.

Yellow - Slow down on the amount of wood you burn or stop burning altogether. When the AQI reaches the upper end of the Moderate range, the burn code switches to Yellow. This is still a voluntary stage, but if you stop burning wood now, it may be possible to avoid worse pollution tomorrow.

Red - When the AQI exceeds 100, it’s Red and that means stop all residential and commercial burning immediately. If weather forecasts show little chance of the temperature inversion lifting, the District Health Officer will call a Stage 1 Episode prohibiting burning for 24 hours, or until weather patterns change and the pollution levels decrease.

The program is in effect from November through February and applies to Southern Washoe County from Cold Springs to Washoe Valley.

What areas are affected by the Green, Yellow, Red Burn Code Program?

The Burn Code applies to businesses and residences located in the following ZIP codes:

89431, 89433, 89434, 89436, 89439, 89441, 89501, 89502, 89503, 89506, 89509, 89511, 89512, 89519, 89521, 89523, 89595, 89704

Why is the burn code restriction necessary?

In the Truckee Meadows, wood burning accounts for nearly 50 percent of wintertime fine particulate matter. The purpose of the Green, Yellow, Red Burn Code Program is to reduce the harmful emissions that come from wood burning. The Air Quality Management Division (AQMD) provides a daily burn code which tells residents when burning is restricted or prohibited during the months of November through February. We all breathe unhealthy air when weather conditions trap pollution close to the ground during the fall and winter months. It’s the AQMD’s responsibility to protect public health and achieve clean air goals.

What are the health effects of breathing fine particulate matter like wood smoke?

Fine particulate matter is a complex mixture that may contain soot, smoke, metals, nitrates, sulfates and dust. Studies have linked long-term exposure to particle pollution, especially fine particles, with serious health problems including decreased lung function, aggravated asthma, development of chronic respiratory disease in children (asthma), irregular heartbeat, nonfatal heart attacks, premature death in people with heart or lung disease and increased susceptibility to heart and vascular disease for post-menopausal women. In addition, new health studies have shown that breathing wood smoke reduces the blood's ability to clot, and specifically for children it lowers IQ and decreases memory. Children are more likely to suffer effects because their respiratory systems are developing and they breathe more air per pound of body weight.

How will these burn code restrictions affect me?

On days when the air quality is forecast to be unhealthy, residents and businesses in Washoe County are prohibited from using stoves and fireplaces that burn wood, pellets, manufactured logs, or any other type of solid fuel. In the winter of 2009-2010, the Air Quality Management Division issued ten Red burn codes.

Are there exemptions for the burn code?

The following exemptions apply to the Red burn code:

Homes in ZIP codes OUTSIDE the burn restriction area;
Homes where wood burning is the only available source of heat (Note: You must submit a sole source of heat declaration to the AQMD each winter season. Contact the AQMD at (775) 784-7200 for a declaration form or visit the Green, Yellow, Red Burn Code Program page.);
Fireplaces and stoves that operate exclusively with natural gas or propane;
Non-permitted cooking devices; and
Ceremonial fires related to specific religious activities.

How is the Red burn code enforced?

Enforcement will be through sightings of visible smoke by Air Quality Management Division (AQMD) enforcement staff. The locations to be observed are determined by complaints or AQMD surveillance routes. Violations of the burn ban can result in warnings and/or fines from the AQMD.

How will I know if I can or can't burn?

It is your responsibility to know the Green, Yellow, Red Burn Code Program. The Air Quality Management Divison (AQMD) provides five ways for you to find out the day’s burn status:

Call the air quality hotline at (775) 785-4110 for daily recorded burn status information;
Sign-up for a daily air quality update email by contacting the AQMD at (775) 784-7200;
Listen to television and radio weather forecasts;
Check the Reno-Gazette Journal's weather page; or
Visit the AQMD website at www.washoecounty.us/health

How do I report a complaint or suspected violation of the burn code?

Contact the Air Quality Management Division at (775) 784-7200.

Where can I get more information about the Green, Yellow, Red Burn Code Program, request a sole source of heat declaration, or other Air Quality Management Division related information?

Visit the Air Quality Management Division website at www.washoecounty.us/health, or contact the Air Quality Management Division at (775) 784-7200.

H1N1 Vaccine +

Is the novel H1N1 flu vaccine safe?

The novel H1N1 flu vaccine is made in the same way as vaccine for seasonal flu.
Tests have shown that the novel H1N1 vaccine is safe and effective in reducing your chances of getting and transmitting the novel H1N1 virus.
The most common reaction to getting vaccinated is soreness at the site of the shot, for people vaccinated by injection.

How long does it take for the novel H1N1 flu vaccine to become effective?

It takes the vaccine about 10 to 14 days to become fully effective.

Can I get the flu from being vaccinated?

You cannot get the flu from getting vaccinated.
If you were exposed to the novel H1N1 flu virus 24 hours or less prior to getting vaccinated or during the 10 to 14 day period immediately following vaccination, you could still get sick and/or pass along the illness to others.

Immunizations +

How much do vaccinations cost and what payment methods are accepted at the Health District?

Our administration fee for most childhood immunizations is based on income, insurance status, and the vaccines needed. We accept cash, checks, debit cards, Visa, and MasterCard. We do not accept any insurance plans.

For our current list of vaccines with current fees please visit our Immunization Fees for Children and Immunization Fees for Adults pages.

Will the Health District bill my insurance company for immunizations?

The Health District only bills Medicaid, Nevada Check-up, and Medicare. You will be provided a receipt to submit to your insurance company with your claim for reimbursement.

Does the Health District provide any adult shots?

The Health District provides a limited amount of vaccines for adults. For our current list of vaccines with current fees please visit the Immunization Fees for Adults page.

Will I need an appointment for an immunization or can I just come to the Health District?

Appointments are required for immunizations. We make appointments up to one week in advance. (Occasionally we can take walk-ins, depending on the schedule of that day.)

To make an appointment for immunizations, please call 775-328-2402 from 8 a.m. to 12 noon and 1 p.m. - 4:30 p.m. on Tuesday, Thursday, or Friday. Please be patient as our phone lines can be very busy!

Before we moved to Nevada, my doctor said my child's immunizations were up to date. Why is my school now telling me my child needs more shots?

States have different requirements for school entry. The following are required by Nevada State Law:

Tdap - All students entering 7th Grade must have a Tdap.
Varicella - Students new to Nevada schools, who have not had Chicken Pox Disease, must have two (2) Varicella doses. The second dose must be at four (4) years of age or older.
Polio - Students new to Nevada schools must have four (4) doses of Polio. The 4th dose must be at four (4) years of age or older.

Can grandparents bring their grandchildren in for his vaccinations?

A parent or legal guardian must be the person who receives the vaccine information sheet (VIS), HIPAA informational sheet, HIPAA consent form and completes the vaccine administration record for the child receiving shots. Vaccine Information Sheets (VIS).

Can I get the same vaccinations at my doctor's office that you offer at the Health District?

Many physicians and clinics offer both adult and childhood immunizations. Please check with your physician or clinic about their immunization policy.

How will I know when my child needs more shots?

Many shot records indicate when the next vaccinations are due. Parents can check with their physician's office or clinic. Complete childhood and adult immunization schedules are available at http://www.cdc.gov/vaccines/recs/schedules/. As a rule, children need baby shots at 2, 4, 6, and 12-15 months. Afterwards, immunizations are routinely given again at age four (4).

I am getting ready to do some international travel and need information about what shots are required.

For information about international travels requiring typhoid, yellow fever, and other such shots, contact St. Mary's Wellness at 775-770-7100 option 2 or Orvis Nursing Clinic at 775-327-5000.

What vaccinations are offered at the Health District?

For our current list of vaccines with current fees, please visit Immunization Fees for Children and Immunization Fees for Adults.

Medical Reserve Corps +

Why should I become a member of the Medical Reserve Corps?

In the event of an incident, time and resources are simply not available to process, train and manage spontaneous volunteers. The MRC registers and screens members, verifying medical licenses in advance to ensure a rapid, coordinated response. Spontaneous volunteers often present a hindrance to incident management and may be turned away. If you want to be part of disaster response effort, become a member of the MRC now so you can be deployed quickly when an emergency occurs.

How many people are expected to join the Washoe County Medical Reserve Corps? Must I be a healthcare professional to be a member of the Medical Reserve Corps?

Our original goal was to build our volunteer membership to 150 by the end of summer of 2010; we have already exceded that and hope to expand to 200 by the end of summer 2011.

The MRC welcomes individuals from medical and non-medical professions. Medical practitioners include physicians, pharmacists, nurse practitioners, nurses, mental health professionals, respiratory therapists, and veterinarians are needed to provide emergency services during disasters.

Public Health professionals, including administrators, epidemiologists, health educators, and communicable disease and environmental health specialists are needed to help promote community health during non-emergency situations, as well as during disasters.

Non-medical volunteers are needed to fill many key support roles, including managers, clerical personnel, interpreters, drivers, food service workers, messengers, security staff, and laborers.

Retirees from medical and non-medical careers fill both clinical and support roles in the MRC, as do medical and health professions students.

If I am deployed in response to an incident, what amount of time can I expect to commit as a member of the Medical Reserve Corps?

Depending upon the scope of the disaster, you should expect to work one 8 hour shift per each 24 hour period, for three to five days.

Exclusive of my deployment in response to an incident, what amount of time can I expect to commit as a member of the Medical Reserve Corps?

Members who will fill supervisory roles can expect to spend approximately 28 hours in training the first year. Members who will fill non-supervisory roles can expect to spend approximately 20 hours in training the first year (23 if they need CPR/First Aid training.) Training time in subsequent years will vary, depending upon the member`s role. Additionally, all members will be expected to participate in an eight-hour exercise each year.

Much of the training is in the form of online courses which can be completed on your home computer, at your own pace, at whatever time is convenient for you. All training is provided at no cost to the volunteer.

As a member of the Medical Reserve Corps, am I required to volunteer during an incident?

Membership is voluntary, and you are not required to assist in any particular response effort. Within a short period after an incident occurs, you may be contacted by MRC staff and asked to assist. Your ability to respond to a request will not affect your continued membership in the MRC.

How do I prepare my family for my possible Medical Reserve Corps deployment to assist in response efforts?

As part of the new member orientation, you will learn how to develop a disaster plan for your family. Family members should be included in planning and decision-making, preparing an emergency kit, and gathering appropriate resources to activate the plan in the event of an emergency.

What role can I expect to hold during a Medical Reserve Corps response effort?

A member’s role will depend upon the following factors:

Type, magnitude, duration, and severity of the incident
Roles identified by incident command staff as necessary for the response effort
Member’s skills, interests, and licensure

MRC staff will make role assignments based on resource needs and availability. You can be assured that you will not be asked to perform a role that you are not prepared for.

How do I protect myself from losing my job if I am deployed?

Each member is encouraged to have a signed memorandum of understanding with his or her employer to acknowledge that the employee has committed time to the MRC and the employer understands the employee may be unable to fulfill job responsibilities if deployed in response to an incident.

Will I have the opportunity to volunteer for Medical Reserve Corps response efforts outside of the local area?

The primary responsibility of the Washoe County MRC is to respond to local incidents. In the event of a regional or national incident, if a request is made for assistance from our units, members may be deployed elsewhere only when they are not needed locally.

How will I be contacted in the event of an incident?

When an incident occurs for which the MRC will be deployed, appropriate members will be contacted via e-mail and telephone. Notices will also be posted on this website.

What does the term, just-in-time training mean?

The concept of just-in-time training is to provide training at the time it is most needed. In emergency management, just-in-time training incorporates information specific to the type and magnitude of the incident. The MRC uses just-in-time training for its members immediately after deployment to issue assignments and equipment necessary for their role in the incident.

What are the potential risks of working in Medical Reserve Corps incident response efforts?

Potential risks depend upon the type, magnitude and duration of the incident. The orientation session, trainings, and exercises prepare MRC members to protect themselves while working in the response efforts. A member always has the opportunity to decline deployment if he or she is uncomfortable with the assignment, without affecting continued membership in the MRC.

What are the vaccination requirements for Washoe County MRC members?

The Washoe County MRC requires members to have current vaccinations for, or immunity to:

Influenza (seasonal)
Tetanus, diphtheria and pertussis
Measles, mumps, and rubella
Varicella (chickenpox)

Required vaccinations are provided at no cost to volunteers.

Hepatitis A and B vaccinations are recommended but not required for membership.

Why must I submit to a background check?

Background checks for all members, and licensure verification for healthcare practitioners are completed to protect both MRC members and the public they will be serving.

Minipill +

What is the Minipill?

The Minipill is a birth control pill that contains only the hormone progesterone. Most birth control pills contain two hormones, estrogen and progesterone.

How is the Minipill used?

The Minipill is taken at the same time every day. Every time you take a pill late, and especially if you miss a pill, you are more likely to get pregnant.

How is the Minipill started?

It is best to take your first pill on the first day of your menstrual period, but it can be started at other times.

How soon does the Minipill work?

Use a backup method of birth control every time you have sex during the first seven days after you take your first pill.

How does the Minipill work?

The Minipill stops the ovaries from releasing eggs in about half of the cycles. It makes the cervical mucus at the entrance to the uterus thick so that it is hard for sperm to reach the egg. They also affect other hormones, the fallopian tubes and the lining of the uterus.

How effective is the Minipill?

About 1 out of every 200 women using the Minipill will get pregnant in the first year if they take it every day at the same time. For women who occasionally miss taking pills or don`t take them at the same time every day, 1 out of every 20 will get pregnant.

When does fertility return after stopping the Minipill?

Immediately. The Minipill does not delay your ability to get pregnant after you stop taking it.

Can the Minipill be used by nursing mothers?

Yes. The Minipill will not affect the quality or amount of your breast milk or the health of your nursing baby. If you are breastfeeding you may start the Minipill 6 weeks after delivery (after your postpartum checkup). The Minipill works most effectively for mothers that are exclusively breastfeeding (not giving your baby food or formula).

What do I do if I miss a pill?

If you miss taking one or two pills, or are more than 3 hours late taking your pill follow these steps:

Take a missed pill/pills as soon as you remember that you missed it.
Go back to taking your pills at your regular time.
Use a backup method of birth control (like condoms) every time you have sex for the next 48 hours.

If you miss more than two pills do not take your missed pills. Continue taking your pills as normal, and use a back-up method until you can talk to your health care provider.

What are the benefits of using the Minipill?

The Minipill is recommended for breastfeeding women, and because it has less serious side effects than the regular birth control pills, it can be taken by women who should not use estrogen (women who have high blood pressure, and smokers over age 35).

What are the possible side effects of the Minipill?

Changes in menstrual period. You may have spotting, irregular periods or no periods.

You may experience tender breasts.

The Minipill may cause dark patches on the skin of your face. These patches may continue even after you stop using the Minipill and may become worse with sun exposure.

What are the risks of using the Minipill?

Women who use contraceptives with hormones (like the Minipill) have an increased risk of blood clots or stroke. There is also an increased chance of ectopic pregnancy meaning that the fetus develops outside the uterus. Although possible, these events are rare.

Women using the Minipill also have an increased chance of developing ovarian cysts.

Who should not use the Minipill?

Any woman who:

Is pregnant or suspects pregnancy
Has undiagnosed, irregular bleeding between periods
Has liver disease or liver tumors
Has or suspects breast or uterine cancer

Mirena +

What is the Mirena?

Mirena is a flexible T-shaped unit that is placed inside the uterus, where it stays until removed by a health care professional. It contains a progestin hormone that is constantly released in the uterus. It is used to prevent pregnancy and can do so for five years, or until it is removed.

How is Mirena inserted?

A health care professional will clean your vagina and cervix and then insert a thin tube of flexible plastic into your uterus. Inside the tube is the Mirena. When Mirena is in place in the uterus, the tube will be removed. Most women experience some discomfort during insertion. Insertion takes only a few minutes.

How does Mirena work?

There is no single explanation of how Mirena works. It may stop release of your egg from your ovary, but this is not the way it works in most cases. It may block sperm from reaching or fertilizing your egg. It may make the lining of your uterus thin. We do not know which of these actions is most important for preventing pregnancy and most likely all of them work together.

How soon does Mirena work?

Mirena is effective at preventing pregnancy as soon as it is inserted, although a back-up method (like condoms) is recommended until the IUD check 4-6 weeks after insertion.

How effective is Mirena?

Less that 1 out of every 100 women using Mirena become pregnant while using it.

Will Mirena affect my period?

Yes. For the first 3 to 6 months you will have frequent spotting or light bleeding in addition to your period. Your period may become irregular in the first 6 months, and a few women have heavy periods that last longer than normal.

After your body adjusts, your periods get shorter and you may even stop having periods. This is not harmful to your body.

When does fertility return after stopping Mirena?

Your normal ability to become pregnant returns as soon as Mirena is removed. Your health care professional can remove Mirena at any time.

Can Mirena be used by nursing mothers?

Yes. Mirena is thought to be safe for breastfeeding women.

What are the benefits of using the Mirena?

Mirena is effective for 5 years. It can decrease the blood loss, cramping and length of periods. It can also decrease anemia, or low iron levels in the blood.

What are the possible side effects of Mirena?

There are many side effects of Mirena. The most common are: changes in your period, lower abdominal pain, acne or other skin problems, back pain, breast tenderness, headache, mood changes, and nausea.

Other side effects are possible. Talk with your nurse for more information.

What are the risks of using Mirena?

Although rare, some Mirena users get a serious pelvic infection called Pelvic Inflammatory Disease (PID). PID can cause serious problems like infertility, ectopic pregnancy or constant pelvic pain.

Mirena may go through the uterus, which would require surgery to remove it.

Ovarian cysts have been diagnosed in about 12% of Mirena users. These usually go away on their own in a few months, but they can cause pain and sometimes require surgery.

Mirena may also come out of place by itself. You could get pregnant if this happens.

Other risks of using Mirena include cramps, dizziness and faintness with insertion; increased chance of a pregnancy outside of the uterus if a pregnancy does occur, and severe and life-threatening infection after insertion.

Who cannot use Mirena?

Any woman who:

Is pregnant or suspects pregnancy
Might have cancer of the uterus or cervix
Has undiagnosed, irregular bleeding between periods
Has serious liver disease or tumor
Has ever had breast cancer
Has had pelvic inflammatory disease
Has an untreated pelvic infection now

Natural Family Planning +

What are Fertility Awareness Methods (FAM)?

A woman is fertile (able to get pregnant) only for a rather short time during each menstrual cycle. For most of the cycle, she should be infertile (not able to get pregnant). A woman or couple may learn how to tell fertile days from infertile days by checking the woman’s bodily signs daily and keeping a chart of the changes.

FAM consist of those methods used by women to estimate the time of month they are most fertile (about seven days in length) this is the time when you could get pregnant. Some women choose to avoid sexual intercourse during the time of the month when they are most likely to become pregnant. This is called periodic abstinence. Other women choose to use one or more contraceptive methods during their fertile time. FAMs are named after the method a woman uses to recognize her fertile days. These include: Natural family planning, Sympto-Thermal Method, Ovulation method, Mucus/Temperature and/or Rhythm.

How do Fertility Awareness Methods work?

It is based on the fact that a woman is fertile only around the time of ovulation (the release of a ripe egg from an ovary). It relies on the following beliefs:

An egg is usually released each cycle
The egg is released about 14 days before the menstruation cycle
The egg lives 12-24 hours, and after the sperm get into a woman’s reproductive system, they might be able to fertilize (join) an egg for up to five days

This means that a woman is fertile for as long as five days before ovulation due to sperm life and after ovulation she is considered fertile for two to three days. This means that the woman is fertile for seven to eight days of her cycle each month. The remaining days are not believed to be fertile days, and intercourse during that part of the cycle should not result in pregnancy. The aim of FAM is to recognize when the ovulation is approaching (fertile phase begins) and when it has passed (fertile phase ends).

How effective are Fertility Awareness Methods?

Pregnancy rates vary depending on whether one method or combinations of methods of FAM are used, or whether barrier methods are added during the fertile time. FAM is most effective with no intercourse during the fertile phase. About 24 out of 100 who are average users and rely on FAM with periodic abstinence may become pregnant each year.

Careful and consistent use can give better results. To make the method work best for you, you should talk to your healthcare professional.

What are the benefits of using Fertility Awareness Methods?

The method has no health risks or side effects for the woman.
It can be used to prevent or to plan a pregnancy.
It can be quite effective if used correctly and consistently, especially if you have regular periods.
It is acceptable for couples with religious concerns about birth control.
The method is free, except for a thermometer (and possibly a class fee and purchased charts).
It can lead to greater awareness and understanding of the body.
Couples may develop greater communication, cooperation and responsibility.
Barrier methods that have very few side effects may be uses with FAM during the fertile period to increase the effectiveness of pregnancy prevention.

What are possible disadvantages of Fertility Awareness Methods?

Even with correct use, the failure rate is often higher than with other methods. If the method is not used correctly and consistently, pregnancy is risked.
Learning the method takes time and effort.
Using the method requires considerable commitment, calculations and self-control.
Both the woman and her partner must use self-control, unless a barrier method is added during the fertile period.
If the woman or her partner has other sexual partners there is the risk of transmitting (passing on) a sexually transmitted disease.

ParaGard +

What is the ParaGard?

ParaGard is a flexible T-shaped unit that is placed inside the uterus, where it stays until removed by a health care professional. It is used to prevent pregnancy and can do so for ten years, or until it is removed.

How is ParaGard inserted?

A health care professional will clean your vagina and cervix and insert a thin tube of flexible plastic into your uterus. Inside the tube is the ParaGard. When ParaGard is in place in the uterus, the tube will be removed. Most women experience some discomfort during insertion. Insertion takes only a few minutes.

How does ParaGard work?

ParaGard contains copper, which is released slowly all the time it is in the uterus. Currently, how ParaGard prevents pregnancy is not completely understood. Several theories have been suggested, including interference with sperm transport, fertilization and implantation.

How soon does ParaGard work?

ParaGard is effective at preventing pregnancy as soon as it is inserted, although a back-up method (like condoms) is recommended until the IUD check 4-6 weeks after insertion.

How effective is ParaGard?

Less that 1 out of every 100 women using ParaGard become pregnant while using it.

Will ParaGard affect my period?

Possibly. Some women have bleeding between their periods, especially during the first 6 months. Some women have heavy periods that last longer than normal.

When does fertility return after stopping ParaGard?

Your normal ability to become pregnant returns as soon as ParaGard is removed. Your health care professional can remove ParaGard at any time.

Can ParaGard be used by nursing mothers?

Yes. ParaGard is thought to be safe for breastfeeding women.

What are the benefits of using the ParaGard?

ParaGard is effective for 10 years. There are no hormonal side effects that are found with other methods.

What are possible side effects of ParaGard?

There are many side effects of ParaGard, such as lower abdominal pain, back pain, fainting and pain at time of insertion, pain when having sex, and increased vaginal discharge.

Other side effects are possible. Talk with your nurse for more information.

What are the risks of using ParaGard?

Some ParaGard users get a serious pelvic infection called pelvic inflammatory disease (PID). PID can cause serious problems like infertility, ectopic pregnancy or constant pelvic pain.

ParaGard may go through the uterus, which would require surgery to remove it.

ParaGard may also come out by itself. You could get pregnant if this happens.

Other risks of using ParaGard include cramps, dizziness and faintness with insertion; increased chance of a pregnancy outside of the uterus if a pregnancy does occur, and severe pain after insertion with life-threatening infection.

Who cannot use ParaGard?

Any woman who:

Is pregnant or suspects pregnancy
Has undiagnosed, irregular vaginal bleeding
Has had pelvic inflammatory disease
Has an untreated pelvic infection now

PDF Files +

How do I read PDF files?

PDF files require Adobe Reader. It can be found at http://www.adobe.com.

Public Health Nurse Home Visitation Program +

Do I qualify for Public Health Nurse Home Visitation Program services?

If you live in Washoe County and are pregnant or parenting, you may qualify for services.

Who should I contact for more information regarding the Public Health Nurse Home Visitation Program?

For more information, please contact Candy Hunter at (775)328-2628.

What will Home Visitation Program services cost me?

Services provided by PHNs in the Home Visitation Program are absolutely free! They meet with you at your convenience and you decide how long you want to work with them.

What is the cost to the client for Home Visitation Program services?

Services provided by PHN`s in the Home Visitation Program are absolutely free! The PHN meets with the client at the clients convenience and the client decides how long they want to work with the PHN.

Who can I refer for Home Visitation Program services?

Any parent who is pregnant or parenting and assessed to be in need to public health nursing visits may be referred for services.

How do I make a referral to the Public Health Nurse Home Visitation Program?

To make a referral click on the link located on the Service Providers page for the referral form. Contact information is included on the form.

Salmonellosis +

What is Salmonellosis?

Salmonellosis is an illness with symptoms that usually begin in the intestines. It is caused by a bacterium called Salmonella.

How common is Salmonellosis?

About 40,000 cases are reported in the United States each year (actual number may be significantly higher, as many milder cases are not diagnosed or reported.
About 400 people with acute Salmonella die each year.
It is more common in the summer than in the winter.
Children are the most likely to get Salmonella.

Is Salmonellosis required to be reported to health authorities?

Yes.

What are the symptoms of Salmonellosis?

Diarrhea, fever, abdominal cramps.

How is Salmonellosis transmitted?

Through the feces of people or animals including birds and especially reptiles (this includes turtles) to other people or animals, usually through food that has been contaminated, either though direct contact with infected feces or through unwashed hands of an infected food handler (didn’t wash hands after using the bathroom).

What is the incubation period (the time from exposure to Salmonellosis until the time symptoms occur)?

Symptoms develop within 12 to 72 hours after infection.

How long does a person infected with Salmonellosis stay ill?

Usually five to seven days.

How long does the Salmonellosis bacteria survive in the environment?

Depends on environmental conditions.

How is Salmonellosis diagnosed?

Through fecal specimens sent to a testing laboratory.

How long does it take for Salmonellosis test results to be available?

At least 72 hours, as testing involves growing a culture.

How sick can a person infected with Salmonellosis get?

Most infected persons recover without treatment.
Some develop severe diarrhea, leading to dehydration and hospitalization for rehydration with intravenous fluids.
In some cases, the infection can spread from the intestines to the bloodstream, then to other body sites. In these cases, death can result unless the infected person is treated promptly with antibiotics.
A small number of people go on to develop Reiter’s syndrome (pains in joints, irritation of the eyes and painful urination), which can last for months or years and can lead to chronic arthritis.
Young children, the elderly and the immunocompromised are the most likely to have severe infections.

How is Salmonellosis treated?

Most infected persons recover without treatment unless the person becomes severely dehydrated.
Antibiotics usually are not necessary unless the infection spreads beyond the intestines.

What are steps for avoiding disease transmission/getting Salmonellosis?

Currently, there is no vaccine to prevent Salmonella.
The primary method of prevention is to thoroughly wash your hands
- After using the bathroom
- After having contact with animal feces
- After handling reptiles or birds
Avoid cross-contamination by
- Thoroughly washing your hands before handling any food and between handling different types of food
- Keeping uncooked meats separate from produce, cooked foods and ready-to-eat foods
- Thoroughly wash hands and cutting boards, counters, knives and other utensils used to prepare uncooked foods of animal origin.
Do not eat or drink raw or undercooked foods of animal origin (e.g., eggs, poultry or meat or unpasteurized milk).
Thoroughly wash produce before eating.
If you have Salmonella, do not prepare food or pour water for others until you have been shown to no longer be carrying the Salmonella bacterium.

Where can I get more information on Salmonellosis?

Log onto www.cdc.gov/salmonella or www.fda.gov
Locally, calls can be directed to 775.328.2447.

Smoking Ban +

Why was the smoking ban passed?

The ban was passed in order to protect the public from secondhand smoke. Secondhand smoke, also called environmental tobacco smoke, is a combination of smoke from the burning end of a cigarette, cigar or pipe and the smoke exhaled by smokers.

The U.S. Environmental Protection Agency (EPA) reports that secondhand smoke contains more than 4,000 substances, many of which are known to cause cancer in humans. In 2006, the U.S. Surgeon General released a comprehensive report stating that there is no risk-free level of secondhand smoke exposure.

When did the smoking ban go into effect?

The smoking ban, known as the Nevada Clean Indoor Air Act (NCIAA), became statewide law on December 8, 2006.

What changes does the smoking ban make?

As a result of the voters' mandate, smoking tobacco in any form now is prohibited within indoor places of employment, including, but not limited to: childcare facilities, movie theatres, video arcades; government buildings and public places; malls and retail establishments; all areas of grocery stores; all indoor areas within restaurants; and within school buildings and on school property.

Smoking tobacco is not prohibited in areas within casinos where loitering by minors is already prohibited by state law; stand-alone bars, taverns, and saloons that do not require a permit to serve food; strip clubs and brothels; retail tobacco stores; private residences, including those which may serve as an office workplace, except if used as a childcare, an adult day care or a health care facility; and hotel and motel rooms, if allowed by the facility operator.

See the full wording of the smoking ban.

How do I comply with the smoking ban if I am a bar?

Please see the guide for restaurants and bars (PDF, 109 KB) for information on compliance.

How do I comply with the smoking ban if I am a childcare facility?

Please see the guide for childcare facilities (PDF, 108 KB) for information on compliance.

How do I comply with the smoking ban if I am an employer?

Please see the guide for employers (PDF, 111 KB) for information on compliance.

How do I comply with the smoking ban if I am a restaurant?

Please see the guide for restaurants and bars (PDF, 109 KB) for information on compliance.

Where can I get a printable no smoking sign?

Download a printable no smoking sign (PDF, 26 KB).

Whom do I contact to complain about smoking violations?

Please contact Environmental Health Services at 775-328-2434 or fill out the smoking complaint form.

How will the smoking ban be enforced?

Compliance with the ban is the responsibility of the owner, manager or operator of an area where smoking is prohibited. A reasonable effort to prevent smoking should be made by this individual or group of individuals. Health authorities, police officers of cities or towns, sheriffs and their deputies shall, within their respective jurisdictions, enforce the provisions of the ban and shall issue citations for violations of the ban.

What are the penalties of violating the smoking ban?

A person who is found to violate the ban is guilty of a misdemeanor, which generally carries a fine imposed by a judge. In addition, a person who violates this ban is liable for a civil penalty of $100 for each violation.

What if I have more questions about the smoking ban?

Please contact Environmental Health Services at 775-328-2434 with any questions you may have about enforcement and compliance.

For questions about the public health impact of the ban, call 775-328-2442.

Where can I get more information on quitting smoking?

If you smoke and want to quit, see the list of local stop smoking programs.

What is happening with the court cases against the smoking ban?

On December 5, 2006, a group of 20 businesses in Clark County (primarily bar owners and casinos) filed a complaint against the smoking ban in the Eighth Judicial District Court. A temporary restraining order (TRO) was issued that prohibited the Southern Nevada Health District from enforcing the smoking ban at those 20 businesses. The TRO did not cancel the law. The TRO was lifted on December 19, 2006. On January 23, 2007, at the request of the state Attorney General, the Eighth Judicial District Court held a hearing on the constitutionality of the smoking ban. The Court ruled that the smoking ban is constitutional. However, the Court removed the law's criminal penalties in Clark County only. In the rest of Nevada, it is legal to implement the law with both civil and criminal penalties.

At this time, the only way the law would change at a statewide level is through the State Supreme Court.

How will the ban improve the health of Washoe County?

Exposure to secondhand smoke has been linked to numerous life-threatening diseases such as heart attack, stroke, and cancer. Eliminating smoking in indoor spaces reduces exposure to secondhand smoke, thereby reducing the occurrence of these chronic illnesses. Research in communities that have implemented indoor smoking bans shows significant improvement to public health after the ban goes into effect. For example, hospital admissions for heart attacks dropped 40 percent in the six months following an indoor smoking ban in Helena, Montana; and, in Pueblo, Colorado, heart attacks declined 30 percent in 18 months after smoking was banned indoors.

How have smoking bans in other communities affected business owners?

Banning smoking in indoor spaces has been shown to have a positive impact for business owners in addition to the general community. Studies have shown that banning smoking in restaurants and bars can boost revenues and increase employment. For example, taxable sales receipts for bars and restaurants have increased every year in California since their smoking ban took effect in 2002. In New York City, tax receipts for restaurant and bars increased 8.7 percent, and employment increased by 10,600 jobs since their 2003 smoking ban went into effect; and, in Florida, retail sales for restaurants, lunchrooms, and catering services increased by 7.3 percent after a 2003 smoking ban. Floridas sales and employment in the hotel, restaurant, and tourism industries also were not hurt. Smoking bans in places of employment also have been shown to lower employee sick leave usage, health insurance costs, fire insurance rates, and cleaning costs.

Many studies have been conducted about the business impact of indoor smoking bans. For more information about these studies, please visit: www.tobaccoscam.ucsf.edu.

What will it cost business owners to comply with the smoking ban?

The cost to comply with the law will vary for each business, but, in general, there are minimal costs. Employers must clearly and conspicuously post "No Smoking" signs in their facilities at every entrance. They also are required to remove all ashtrays and other smoking paraphernalia from any area where smoking is prohibited. For some businesses, additional costs may be associated with the removal of built-in ashtrays or other smoking-related items.

What do I do if someone is smoking indoors in a facility where smoking is now illegal?

If you see someone smoking indoors in a facility where smoking is now illegal, you should immediately inform the owner and/or manager of the facility. It is the business's responsibility to enforce the new law in their establishment. If the business owner/manager does not respond to your compliant, you also may file a formal compliant with the Health Department. You will need to know the name and address of the location where the violation occurred, and you also will need to provide your name and contact information, as anonymous complaints are not currently accepted.

Where can I get more information about tobacco and secondhand smoke?

For more information about tobacco and secondhand smoke, please visit: http://www.washoecounty.us/health/cchs/tobacco.html or call (775) 328-2442.

I smoke, so how does the smoking ban apply to me?

Smokers play an important role in helping to implement the new law. First and foremost, it is now illegal for you to smoke indoors in a facility where smoking has been banned. Even if a "No Smoking" sign is not displayed there, you are still required by law to refrain from smoking. You should also not bring any ashtrays or items used as ashtrays into a facility where smoking is now banned. You may still smoke anywhere outside of a facility where smoking is now banned indoors. You may also still smoke indoors at the following types of businesses:

Areas within casinos where loitering by minors is already prohibited by state law;
Stand-alone bars, taverns, and saloons that do not require a permit to serve food;
Strip clubs and brothels;
Retail tobacco stores;
Private residences, including those which may serve as an office workplace, except if used as a childcare, an adult day care, or a health care facility; and
Hotel and motel rooms, but only if allowed by the facility operator, so please ask the operator first before smoking there.

If you are uncertain about being able to smoke indoors, please ask the owner and/or manager of the facility first before smoking there. Your compliance with the new law helps protect non-smokers and children from the dangers of secondhand smoke. Your compliance also helps merchants meet their responsibilities under the new law. If you are asked by a representative of the business to refrain from smoking inside their facility, please do as they ask. It is the business's responsibility to enforce the new law in their establishment; if you are found smoking indoors at a location where smoking is now banned, then the business itself could be cited and required to pay a fine. You, too, could be found guilty of a misdemeanor, which generally carries a fine imposed by a judge. A person who violates this ban is also liable for a civil penalty of $100 for each violation.

Why is the Health Department involved in the smoking ban?

Sec. 2 (7) of the new law states that Health authorities, police officers of cities or towns, sheriffs and their deputies shall, within their respective jurisdictions, enforce the provisions of this Act and shall issue citations for violations of this Act[.] The District Health Department is the health authority for Washoe County (per NRS 202.2485). Therefore, the District Health Department is required by law to enforce the smoking ban.

If the law refers to "public places," then why is smoking banned in businesses that are privately owned?

Sec. 2 (9) (d) of the new law defines "public places" as "any enclosed areas to which the public is invited or in which the public is permitted." If a business meets this definition, then smoking must be banned there indoors, regardless of how the facility is owned. The law also defines a "place of employment" in Sec. 2 (9) (i) as "any enclosed area under the control of a public or private employer which employees frequent during the course of employment including, but not limited to, work areas, restrooms, hallways, employee lounges, cafeterias, conference and meeting rooms, lobbies and reception areas." Again, if a business meets this definition, then smoking must be banned indoors as described, regardless of how the facility is owned. The law does make an exception in Sec. 2 (3) (e) for private residences that serve as workplaces, except if they are being used as a childcare, adult day care, or health care facility.

What is "smoking-related paraphernalia"?

Ashtrays or any items being used as an ashtray (e.g., beer bottles, coffee mugs, discarded trash, etc.) are considered smoking-related paraphernalia and must be removed from any area where smoking is prohibited. Merchants may still sell tobacco products.

Are businesses in Washoe County complying with the smoking ban?

Staff from the Environmental Health Services Division of the District Health Department have been conducting smoking ban compliance surveys during routine inspections since December 19, 2006. To date, an average 96.5% of permitted facilities were in compliance with the requirements set forth in the NCIAA during routine Environmental Health Services permit inspections.

Can a business allow smoking during certain times of the day?

No. The NCIAA states: Smoking tobacco in any form is prohibited within indoor places of employment including, but not limited to, the following:

There are no provisions for allowing smoking, at any time, in any of the above locations.

Four ways to ask smokers to "take it outside":

Asking strangers, and sometimes even friends and family, to smoke outside can sometimes be stressful. It is important to remember that the vast majority of people are respectful and will abide by the law, if they are aware and reminded of it. Below are 4 ways to ask people who smoke to "take it outside". It may not be easy at first but you have the right and the responsibility to avoid secondhand smoke.

As the business owner/manager to enforce the law: I thought this was a non-smoking business. Would you please ask them to smoke outside?
Remind them of the law: Maybe you didn`t know, but Nevada law prohibits smoking in this area/building/business. Smoking is allowed outside.
Be polite: I would like to ask a favor. Would you mind smoking outside? This is a non-smoking area.
It is the smoke, not the smoker that is the problem: Would you not smoke right now? I`d really appreciate it.

Solid Waste Management Plan +

What is solid waste?

Solid waste is anything you would throw away or discard such as garbage or trash.

What if I don't understand some of the terms in the Solid Waste Management Plan?

There is a glossary in the beginning of the Plan. The EPA website also has a helpful glossary of terms at http://www.epa.gov/OCEPATERMS/ .

STD +

What is the address of the STD clinic?

The clinic address is 1001 E. 9th Street Bldg. B on the 1st Floor under Clinic Services. This is the county complex on the corner of 9th and Wells.

What are STDs?

Sexually Transmitted Diseases (STDs) are diseases that are spread through anal, oral or vaginal intercourse. Sharing drug injection equipment can also transmit some STDs such as HIV and Hepatitis B. Common STDs include: Chlamydia, Gonorrhea, Hepatitis A Virus (HAV), Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), Herpes Simplex Virus (Herpes), Human Immunodeficiency Virus (HIV), Human Papilloma Virus (Genital Warts), Molluscum Contagiosum, Pelvic Inflammatory Disease (PID), Pubic Lice, Scabies, Syphilis, and Trichomoniasis.

Consequences of STDs.

Some STDs are easily treated and some STDs stay with you for life. Other STDs are more of a nuisance than a health risk. Pubic lice, or `crabs,` for example, itch a lot but don`t do any permanent damage. If you get an infection and you want to know how serious it could be, talk with your health care provider. There are four serious health consequences of some STDs: § Blockage of the fallopian tubes which can lead to infertility and ectopic pregnancy § Pregnancy loss and increased newborn deaths caused by transmission of the infection to the infant during pregnancy and childbirth § Genital cancers for males and females § Enhanced transmission of HIV/AIDS Social and Psychological Consequences: The psychological impact of having a sexually transmitted disease can be severe. Some persons become depressed or anxious. They fear recurrent outbreaks, transmission to sex partners, and difficulties in developing new relationships. Fortunately, proper treatment and knowledge about the true risks can greatly lessen all these effects.

What is HIV?

What is AIDS?

How is HIV transmitted?

HIV can be transmitted when blood, semen (including pre-seminal fluid or pre-cum), vaginal fluids, or breast milk from an infected person enters the body of an uninfected person. HIV must get into the bloodstream or body in order to cause infection. Transmission most often occurs during unprotected sex or during injection drug use when equipment is shared. An infected woman who becomes pregnant can transmit HIV to her baby during pregnancy or during birth, but this risk is significantly less if the woman takes antiretroviral drugs. She can also pass HIV to her newborn if she breastfeeds. Anyone infected with HIV can transmit it, whether or not they appear sick, have an AIDS diagnosis, or are successfully treating their infection with antiretroviral drugs. HIV is spread in the following ways: Unprotected anal, vaginal or oral sex HIV can enter the body during sex through the anus, vagina, opening at the end of the penis or mouth and through cuts, sores and abrasions on the skin. Unprotected anal and vaginal sex have the highest risk of infection. There are a growing number of reported cases where HIV has been transmitted during oral sex (mouth to genital contact), but oral sex is much less risky than anal or vaginal sex.

Anyone having unprotected sex (inserting or receiving partner) with an infected person is at risk of getting HIV. The person most at risk is the receiving partner. Heterosexually, women are at higher risk than men.

Blood exposure. Sharing needles or drug injection equipment can transmit HIV (and other viruses like hepatitis). After use, small amounts of blood can remain in the used needles, syringes, cookers, cottons, and water. This remaining blood can enter the body of the next user when any of these items are shared. If this blood is HIV infected, transmission can easily occur.

There is a very small but real risk of health care workers getting HIV from infected patients as a result of needle stick accidents or when blood gets into a worker`s open cut or a mucous membrane in their eyes, mouth or nose. The risk for health care workers is greatly reduced when universal precautions are carefully followed, such as safe disposal of sharps, wearing latex gloves, etc. Universal precautions also protect patients.

Very rarely in this country is HIV transmitted when receiving a blood transfusion, blood clotting factors, an organ or tissue transplant (the risk of acquiring HIV from a blood transfusion is approximately 1 in a million). Before 1985, there were no tests to screen blood and organ donations for HIV. Now, blood, organ and tissue banks extensively test all specimens for HIV and other blood-borne germs.

Mother to child If a woman is infected with HIV, she can give it to her baby during pregnancy, during birth, or by breastfeeding. Early in the epidemic, 25% (1 out of 4) of babies born to HIV-infected women in this country became infected with HIV. Now, in developed countries where early detection of HIV is possible, treatment with the latest antiretroviral medications can reduce this rate to about 1% (1 out of 100). All pregnant women should see a doctor, be tested for HIV, and if infected, obtain the best treatment.

HIV is not transmitted by..?

Casual Contact. HIV is a fragile virus outside the body. It quickly becomes inactive when exposed to air, soap and common disinfectants such as bleach.

There is no risk of getting HIV from: donating blood, mosquito bites, toilet seats, shaking hands, hugging, sharing eating utensils or drinking containers, food or objects handled by people with HIV or AIDS, spending time in the same house, and business or public place with people who have HIV or AIDS

Who is at risk for HIV infection?

Who is eligible for HIV testing at the Washoe County Health District?

The following populations are tested at the WCHD:

Anyone over the age of 12 considered at risk for HIV infections, sexually active individuals, those with current or history of STDs and their partners, men who have sex with men, injecting drug users, partners of men who have sex with men, partners of injecting drug users, those who present with an opportunistic infection, contacts (partners) of HIV positive individuals, and victims of sexual assault.

For an HIV appointment at the District Health Department, call 328-2470.

Everyone is eligible and encouraged to seek education and information regarding HIV and STDs. Educational services are offered free of charge.

What are the costs of an HIV test or STD exam at the Health Department?

Members of the community that access HIV and STD testing at the WCDHD are charged on a sliding fee scale, based on income. Charges are based on how much time is spent with the nurse and what testing is done.

Where else is HIV testing available in the community?

HIV testing is available from a variety of resources in the community:

-Private health care provider

-Nevada Urban Indians 788-7600

-Planned Parenthood Mar Monte 688-5555

-Northern Nevada HOPES 786-4673

How can HIV transmission from injection drug use be prevented?

The best way to avoid HIV infection (and other blood-borne infections like hepatitis B and C) from injection drug use is to stop injecting drugs. Drug treatment can help. If treatment is not available or you cannot quit on your own, use a brand new sterile syringe and needle every time you inject or divide drugs. Do not share drug using "works" with anyone else. This includes needles, syringes, cookers, cottons, mixing and bleaching water, and all other supplies. If you do not have new clean equipment, thoroughly disinfect all drug use tools with bleach before re-use. It is also important to dispose of used works safely. Discarding needles in the trash, on the street, or flushing them down the toilet is dangerous.

Drug use (including use of alcohol) can impair judgment and decision-making. This can increase risk for HIV, especially if you have sex while high. High or not, you can successfully use condoms and clean injection works. Plan ahead, carry condoms and stick to your prevention plan. A person does not need a prescription to purchase syringes in Nevada. However, a pharmacist may refuse to sell to people based on their own judgment.

How can sexual transmission of HIV be prevented?

The only way to completely avoid the sexual transmission of HIV is to abstain from anal, oral and vaginal sexual.

If you choose to have sex, it is safest when you practice monogamy with an uninfected partner. Monogamy is when two people have sex only with each other.

For those with a new sex partner, both can abstain from sex, or use condoms every time during anal, vaginal and oral sex for at least 3 months and then get tested for HIV and other STDs. At that time, if both partners are HIV negative AND both partners are completely avoiding other risk behaviors (e.g., sharing needles or having other sex partners), then unprotected sex with each other is not a risk for HIV transmission.

For someone with an HIV positive partner or a partner who does not know his/her HIV status or multiple sexual partners, touching, dry kissing, body rubbing, and mutual masturbation are the safest sexual activities. However, simple, skin-to-skin touching can spread other STDs.

For any penetrative sex acts such as vaginal, anal or oral sex, condoms are highly effective at reducing the risk of HIV transmission when used consistently and correctly - every time, from beginning to end of each sex act.

For more information on condom use see the answer to the question, "Do condoms provide 100% protection from HIV?"

What is the HIV Antibody Test?

What is the "window period" for HIV?

Do condoms provide 100% protection from HIV?

Condoms are not 100% effective at preventing HIV transmission. When used correctly and consistently, condoms are highly effective and reliable in reducing the risk of transmitting HIV and most sexually transmitted diseases (STDs). Condoms should be used EVERY TIME during sex when transmission of HIV (or other STDs) is possible. When condoms fail to work properly, it is most often because of improper and/or inconsistent use.

Condoms may not work as well against STDs spread through skin-to-skin touching, like herpes and genital warts, because condoms may not cover the infected areas.

Following these basic rules will reduce the already small chance of condom failure:

-Experiment with different condoms and practice putting them on before intercourse.

-Practice talking with your partner about your desire and intention to use condoms.

-Use latex (rubber) or polyurethane (plastic) condoms. Avoid "natural skin" condoms, which have tiny holes, which may allow HIV and other STDs to be transmitted.

-When using a male condom choose one that fits. Male condoms come in different sizes, shapes, and styles, but most condoms will fit most men.

-Another choice is the Reality condom, which is made of polyurethane and is designed to fit inside the woman`s vagina for vaginal sex, and the anus for anal sex. Use the directions from the manufacturer that come with Reality condoms.

-Open and handle condoms carefully. Never use a condom that is in a damaged package or is past its expiration date. Condoms should be stored loosely in a cool, dry place (not in your wallet or the glove compartment of your car) and kept where you can easily get them if you decide to have sex.

-To reduce friction that can cause breakage, use plenty of water-based lubricant on the outside of the male latex condom and a small amount on the inside at the tip. With the Reality condom use plenty of lubricant on both the inside and outside. Some condoms come with lubricant, but often there is not enough, so additional lubricant is recommended. Never use oil-based lubricants like Vaseline, hand cream, Crisco, or mineral oil with latex condoms. Oil-based lubricants can rapidly break down latex and allow the virus to pass through. Water-based lubricants include K-Y Jelly, Slippery stuff, ForPlay, Astroglide, ID Lubricants and most contraceptive jellies. These can be found in grocery or drug stores next to the condoms.

WARNING: Some lubricants contain nonoxynol 9, which can cause irritation. This irritation may increase the risk of HIV transmission. Don`t use nonoxynol 9 or products containing it!

-The male condom should be put on after erection and before any sexual touch. Remember that pre-cum is also infected with HIV. The Reality condom should go in before sex - it can be inserted up to 8 hours before use. Never use the Reality and the male condoms together or two male condoms at the same time.

-Some male condoms have a reservoir tip; some don`t. In either case, the tip of the condom should be squeezed while rolling it down onto the penis in order to leave an airless pocket to collect semen. If the penis is natural and has a foreskin, try pulling back the foreskin before unrolling the condom all the way down to the base of the penis. Some men don`t like to pull back the foreskin because they`ve found that the condom slides off when the foreskin is pulled back. If you have trouble with this, consider keeping the foreskin down before putting on the condom or try using a Reality condom with your partner.

-After intercourse, withdraw the penis while still erect, holding the base of the condom to prevent it from slipping off or spilling semen. Remove the condom and wash the penis with soap and water.

-Use a condom only once and dispose of it in the garbage; do not flush condoms down the toilet. Never reuse a condom.

-Use a condom EVERY TIME during sex when transmission or acquisition of HIV is possible.

What are the symptoms of a new HIV infection?

Between 50-90% of people with new HIV infections have mild to severe "flu-like" symptoms 2 weeks to 3 months from the time of HIV exposure. Others do not have any symptoms. In general, symptoms are not a reliable way to tell if someone has been infected with HIV; the only way to know for sure is to get tested. Many of the symptoms of early HIV infection are the same as for other, less serious illnesses. People who may have been exposed to HIV should see a doctor promptly if the following symptoms occur within 3 months of the exposure: -A persistent fever of over 101 degrees that lasts more than 2 days without a known cause -Constant tiredness -Night sweats that soak your pajamas or sheets -A persistent rash of unknown cause -Persistent swollen glands (lumps under the skin) which occur in several places at once (especially the neck, armpits and groin) -Sore throat

Is there a cure for HIV and AIDS?

Teen Health Mall +

Are there male or female nurses in the Teen Health Mall clinic?

All of the nurses in the Teen Health Mall and Family Planning clinic are female.

Does the Teen Health Mall accept insurance?

· We do accept some insurance plans. · We accept Medicaid, but not NevadaCare or Health Plan of Nevada.

Does the Teen Health Mall have staff that speak Spanish?

Yes. We have staff that speak Spanish and interpret in the clinic. We also have a telephone interpreting service that can assist with interpretation in many other languages.

How long does it take to get a Teen Health Mall appointment?

The length of time that it takes varies. The longest wait is if you are a new client which can be a wait of up to 4 weeks.

I am pregnant so where do I go to get checked (prenatal care)?

We provide pregnancy testing and proof of pregnancy if your test is positive. We do not provide prenatal care services: however, we will tell you where to receive those services.
The Washoe Pregnancy Center provides prenatal care services on a sliding scale. Their phone number is (775) 982-5640.

I just had sex and didn't use protection. I don't want to get pregnant. What can I do?

If you take an Emergency Contraception (the Plan B pill) within 5 days of unprotected sex you can reduce your chance of pregnancy by 75%. You need to be seen by a nurse to receive this medication. Call the clinic ASAP to make an appointment. For weekend, holiday or evening Emergency Contraception providers in the local area dial 1-888-NOT-2-LATE

Is the Teen Health Mall appointment confidential?

Yes. All appointments are Confidential.

Is there a bus stop near the Teen Health Mall clinic?

Yes. There are Citifare bus stops close to the Health Department along routes 2 and 12.

I`m pregnant and thinking about adoption, where can I go to find out more information?

Social Services has information on adoption.

I`ve been sexually assaulted and I am afraid to tell the police. What do I do?

Contact Sexual Assault Support Services Crisis Call Center at 784-8090 or 1-800-992-5757 and they will listen to you as well as give you information about resources in the community that may help.

What are the average costs of the Teen Health Mall?

See Teen Health Mall Cost of Services.

What are the hours of the Teen Health Mall?

Hours for the Teen Health Mall are at http://www.washoecounty.us/health/cchs/thm.html#lah

Please call 328-2470 to schedule an appointment.

What do I need to bring to my first Teen Health Mall visit?

· If it is your first visit, or if your income has changed, please bring proof of family income. Please see Cost of Services. · If you are on medications, bring in your medications, or write down the names so a nurse can review them. This would also include any birth control pills that you did not receive from this clinic.

What does it mean to receive family planning services?

The Teen Health Mall offers family planning services to help you plan the size of your family. By using birth control methods a woman has more control over when she has children and how many children she has.

What is a Pap smear?

A Pap Smear is a test that looks for changes of the cells on the cervix. If you would like to know more, please see the Pap Smear information sheet.

What is the Teen Health Mall phone number?

The number to the office clinic is (775) 328-2470. The phones are answered between the hours of 9am - 12pm and 1pm - 4pm.

What will happen at my first Teen Health Mall visit?

You will fill out paperwork.
An aide will obtain your weight and height, measure your blood pressure, and check your iron level (in some cases).
The Advanced Practitioner of Nursing will review your medical history and determine what services you need (birth control, STD testing etc.).
If you are interested in birth control you may get it on the day of your visit; however, in some instances you will need to return to receive your method of birth control.
You may or may not receive a pelvic exam (having a nurse look and feel inside your vagina) and Pap smear on your first visit. If you receive birth control you will need to have a pelvic exam within 3 months.

When do I pay for the Teen Health Mall visit?

You can pay for your visit on the day that you receive services, or we can put you on a payment plan.

Where can I find abortion services in the Reno/Sparks area?

The West End Women`s Medical Group provides abortion services. The phone number is 827-0616.

Where is the Teen Health Mall Clinic located?

The Health Department is located at the corner of 9th Street and Wells Ave., just off the freeway and next to the fairgrounds. The address is 1001 East 9th Street. If you are traveling North on Wells, the entrance to the clinic is the first right (into the parking lot) after passing 9th Street. You can enter the door marked clinic services.

The Pill +

What is the Pill?

The Pill is a medication that is taken daily to prevent pregnancy. It contains two types of hormones called estrogen and progesterone. The hormones in the Pill are similar to those naturally made in women`s bodies.

How is the Pill used?

The Pill needs to be taken daily for it to be fully effective. By taking the Pill at the same time each day, you can best maintain the level of hormones in the body necessary to prevent pregnancy.

How is the Pill started?

There are several ways to begin the Pill. One way is to take your first Pill on the first Sunday after your period starts. If your period starts on Sunday, take your first pill that day. Another way to start your pills on the first day of your period. If the nurse believes you are unlikely to be pregnant, she may tell you to start right away.

After finishing your first pack of pills immediately start the next pack. Do not skip any days between packages. You may be on your period when you start your next pack.

How soon does the Pill work?

If the Pill is started on the first day of the period, it is effective immediately. If the Pill is not started on the first day of the period, another method of birth control (like condoms) is needed for one week (7 days).

How does the Pill work?

The primary way in which the hormones in the Pill work is to stop the ovaries from releasing eggs. They can also cause the cervical mucus to become thick so that it is hard for sperm to reach an egg, and can prevent implantation.

How effective is the Pill?

The Pill is most effective when it is taken exactly as directed (taken every day at about the same time). Approximately 3 out of every 100 women who take the Pill for one year will become pregnant while using it.

When does fertility return after stopping the Pill?

After stopping the Pill, it normally takes women two months before they can get pregnant, although some women get pregnant right away.

Can the Pill be used by nursing mothers?

The Pill is usually not recommended for nursing mothers. A similar medication referred to as the “Minipill” is like the Pill, but has less hormones. It is recommended for use while breastfeeding.

What do I do if I miss a pill?

One missed pill – take the pill as soon as you remember and then take the next pill at your regular time (this means that you may have to take 2 pills in one day). * Use a back up method (like condoms) for 7 days if you miss the first pill of package.
Two missed pills – Take two pills on the day you remember and two pills the next day. After that continue to take pills as normal (one each day). * Use a back up method (like condoms) for 7 days
If you miss two or more pills in the third week of the pack, or three pills at any time of the month call the clinic. Until you talk to a nurse continue to take your pills and use a back-up method of birth control (like condoms).

What are the benefits of using the Pill?

In addition to being very effective and convenient, it may provide other benefits such as:

Decreasing your risk of ovarian and uterine cancer
Regular periods with less bleeding and cramping
Less anemia (low iron level in the blood)
Improvement in skin (less acne)

What are possible side effects of the Pill?

Side effects include breast tenderness, headache, nausea, dizziness, eye problems (difficulty with contact lenses), and a delay in having your period after you stop taking the Pill.

You may also have spotting between periods, very light or missed periods.

Weight changes may occur (increase or decrease in weight).

The Pill may cause dark patches on the skin of your face. These patches may continue even after you stop using the Pill and may become worse with sun exposure.

Other side effects are possible. Talk with your nurse for more information.

What are the risks of using the Pill?

Women who use contraceptives with hormones (like the Pill) have an increased risk of blood clots or stroke. This risk is higher if you smoke and are over 35 years old.

Other risks of using the Pill include high blood pressure, liver problems (including liver tumors), and gall bladder disease.

What medication can make the Pill less effective?

Rifampin
St. John’s Wort
Possibly some antibiotics and anticonvulsants

Who cannot use the Pill?

Any woman who:

Is pregnant or suspects pregnancy
Heart disease or clotting disorders
Has serious liver disease or tumor
Has ever had breast cancer
Has had blood clots in the legs
Has undiagnosed, irregular vaginal bleeding
Migraine headaches with certain symptoms
Diabetes with involvement of the blood vessels
Disease of the heart valves with complications
Jaundice (yellowing) in pregnancy or when using hormones in the past

Tuberculosis (TB) +

Where can I get a TB test? (Skin test or Blood test)

TB Test for Employment or School: (not available at Washoe County TB Clinic)

Call one of these medical clinics for an appointment:

Full-time enrolled UNR Students Only - UNR Student Health Center- Nell J. Redfield Building, Mail Stop 196, Reno, 784-6598
Call your private health care provider's office - ask them if they provide TB testing
St. Mary's Health & Wellness:
1625 E. Prater Way, Ste.102, Sparks
770-7100 for appointment
St. Mary's Clinics in Wal-Mart (no appointment necessary), open Monday-Friday: 8am-8pm, Saturday: 9am-7pm, Sunday: 10am-6pm:
- 4855 Kietzke Lane, Reno
- 5065 Pyramid Lake Rd., Sparks (clinics are open seven days a week)
Concentra Medical Centers (no appointment necessary):
- 255 Glendale Ave, Sparks, 356-8181
- 1530 East 6th St., Reno, 322-5757
HAWC Clinic - 1055 South Wells Ave, Ste 110, Reno 329-6300
Carson City Health Dept. Clinic (open to residents of all counties) - 900 E. Long St., Carson City 887-2190 Thursdays Only

There`s a blood test for TB?

Yes. The FDA has approved blood tests that can be used in place of the tuberculin skin test. The blood test requires only one visit to have your blood drawn, instead of the two visits needed to have a skin test placed and then read 48-72 hours later. It will not give a false positive result if a person has ever received BCG. (BCG is a vaccine given in many countries with high rates of TB).

What if my TB test is positive?

You will need to have a chest x-ray. If your chest x-ray is normal, this means you have been infected with the TB bacteria but your immune system has "walled off" the bacteria and is protecting you from getting sick. Your doctor may recommend that you take medication to kill the bacteria so you will lower your risk of ever developing active TB disease. If your chest x-ray is abnormal and/or you have symptoms of TB disease your doctor will order additional tests to see if you have active disease. Sputum (phlegm) samples will be collected to see if you are contagious. Persons with TB of the lungs or throat are usually contagious until they have taken TB medication for several weeks.

What if I had BCG vaccination for TB?

BCG is a vaccine for tuberculosis. It is often given to infants and young children in countries with high rates of tuberculosis. It protects children and babies from developing severe forms of tuberculosis , like meningitis or miliary TB. It is not used routinely in the United States. Your skin test may be positive because of BCG vaccination.

However, a positive skin test is most likely due to infection with TB bacteria if:

You recently spent time with a person who has active TB disease
You are from an area of the world where active TB is very common (Africa, Latin America, Asia, Eastern Europe and Russia)
You spend time where TB disease is common (homeless shelters, migrant farm camps, drug treatment centers, health care clinics. jails or prisons)
You were vaccinated more than 5-10 years ago
Your skin test is greater than 20 mm

What is TB?

Tuberculosis (TB) is caused by a bacteria called Mycobacterium Tuberculosis (M. tuberculosis). TB usually attack the lungs. Sometimes TB bacteria attack other parts of the body such as, the kidney, spine or brain. TB disease is a serious illness, but with proper treatment it can be cured.

What are the symptoms of TB disease?

Symptoms of TB disease can include any or all of the following:

See your doctor if you have these symptoms.

How is TB spread?

When a person with active TB disease coughs or sneezes tiny droplets that contain TB bacteria are released into the air. If another person breathes air containing these droplets, they may become infected with the TB bacteria. However, not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions exist: Latent TB infection (LTBI) and Active TB disease - both of which are treatable and curable.

What is the difference between latent TB infection and TB disease?

A Person with Latent TB Infection

Usually has a skin test or a blood test result indicating TB infection*
Usually has a normal chest x-ray
Has TB bacteria in their body that are alive but inactive
Has no symptoms
Does not feel sick
Cannot spread TB to others
Should consider treatment for LTBI to stop active TB disease from spreading

A Person with Active TB Disease

Usually has a skin test or a blood test result indicating TB infection*
Usually has a normal chest x-ray
Has TB bacteria in their body
Usually feels sick and experiences symptoms
May spread TB to others
Needs treatment to cure the active TB disease

*A positive tuberculin skin test (TST) or a positive blood test only shows that you have been infected with the TB bacteria. Neither test can tell if you have TB disease, only if the TB bacteria are in your body.

How is latent TB infection treated?

Treating latent TB infection is essential to controlling and eliminating TB in the United States, because it substantially reduces the risk that the infection will progress to TB disease.

A person with TB infection can take medication called Isoniazid or Rifampin. This will kill the TB bacteria and greatly reduce the risk of TB disease from developing. Your doctor will decide which medicine is best for you. It is important to have health monitoring every month while taking either of these medications to be sure that you are not developing any harmful side effects. Your health care provider may order blood tests during your treatment.

There is now a shorter regimen available called the 12-dose regimen that became available in 2011. The 12-dose regimen reduces treatment from 270 daily doses over 9 months, to 12 once-weekly doses over 3 months. It is a combination regimen of isoniazid and rifapentine; two of the most effective medications available for TB treatment.

It is recommended for otherwise healthy people aged 12 and older who are at an increased risk of developing TB disease
Close patient monitoring and the utilization of Direct Observed Therapy (DOT) in which a health care worker observes a person taking the treatment and monitors side effects is required for each of the 12 doses

How is TB disease treated?

It takes a long time to kill all the TB bacteria. A person with TB disease typically must take 4 different medicines for 2 months:

Isoniazid
Rifampin
Pyrazinamide
Ethambutol

Then take Isoniazid and Rifampin for another 4-7 months depending on how much damage the bacteria have caused.

This treatment has been successful in treating TB disease for many years. In recent years, some TB bacteria strains have become resistant, (the medicines no longer kill the TB bacteria) to one or more of these drugs.

Multi-drug resistant (MDR) TB is resistant to the two strongest TB medicines, Rifampin and Isoniazid. The most common cause of drug resistance occurs when TB medications are not taken long enough and/or in the right amounts. Drug resistant TB is much more difficult and expensive to successfully treat. One case of multi-drug resistant TB can cost more than $1 million to treat. The Center for Disease Control and Prevention urges all health care practitioners to use directly observed therapy (DOT) in the treatment of tuberculosis.

What is directly observed therapy (DOT)?

To increase the success of TB disease treatment and decrease the risk of drug resistance, a health care worker observes each dose of TB medication taken.

Most persons believe they are able to take their medication without help. But 6 - 9 months is a long time to take antibiotics, especially after you start to feel better. Health care workers who provide DOT offer encouragement to complete treatment. People are human and humans are sometimes forgetful. DOT health care providers help people remember to take their medicine. They also check for harmful side effects and make sure the medicines are working as expected.

Who is most likely to get TB?

Some people are more likely to be infected with the latent form of TB. These include:

persons who were born in a foreign country with high rates of TB
persons who have lived in a foreign country with high rates of TB
persons who have spent time with someone with active TB disease
persons who live or spend a lot of time in crowded places

Some people who are infected with latent TB have a greater risk of progressing to active TB disease. These include:

persons who became infected with TB in the last 2 years
children under 5 years of age
new immigrants from countries with high rates of TB - persons who have been in the United States for less than 5 years
persons with weakened immune systems
persons with certain kinds of lung disease, such as silicosis
persons with diabetes
persons who have had stomach or bowel surgery
persons who take certain medications for arthritis
persons who take prednisone or other steroids
persons who have had cancer of the head, neck or leukemia
persons with end stage renal disease
persons who are extremely underweight (10% or more below ideal body weight)
persons with an abnormal chest x-ray suggestive of old healed TB disease
persons who had TB disease in the past but did not receive adequate treatment
persons with HIV infection. Persons with HIV infection have the greatest risk of progressing to active TB disease.

Where can I learn more about TB?

The Washoe County District Health Department`s Tuberculosis Prevention and Control Program staff welcomes questions about tuberculosis. They can be reached at 775-785-4785.
There are many informative websites available:
Centers for Disease Control and Prevention - www.cdc.gov/tb
American Lung Association - www.lungusa.org
Stop TB partnership - www.stoptb.org
National Prevention Information Network - www.cdcnpin.org

Vasectomy +

What is a vasectomy?

A vasectomy is a sterilization operation for men. This means that after the operation a man cannot get a woman pregnant.

Can a vasectomy be reversed if I change my mind afterwards?

A vasectomy is a permanent operation. Some doctors try to undo a vasectomy with surgery, but it is expensive and many times does not work. Make sure that you do not want to father any more children before you have a vasectomy.

Are there other ways to prevent pregnancy besides a vasectomy?

Yes, there are several temporary ways to prevent pregnancy. A man can use a condom or a woman can use methods like birth control pills, the Depo shot, the patch, an IUD as well as others. If you would like more information about these and other temporary ways to prevent pregnancy, talk to your health care provider.

How do they do a vasectomy?

A vasectomy is done in a doctor’s office or clinic. The doctor numbs the area and then makes a small cut in the scrotum (skin around the testicles) to get to the tubes that carry the sperm (sperm ducts). The doctor then closes off the sperm ducts so that sperm cannot get into the semen (what comes out during an orgasm). When there are no sperm in the semen, you cannot cause a pregnancy.

Illustration showing the location of the sperm duct (tube), seminal vesicle (where sperm is stored), the closed off tube of a vasectomy, the testicle, and the scrotum.

Illustration showing the location of the sperm duct (tube), seminal vesicle (where sperm is stored), the closed off tube of a vasectomy, the testicle, and the scrotum.

What are the benefits of a vasectomy?

With a vasectomy you don’t have to worry about making a woman pregnant and you don’t have to use a temporary method of family planning again (like birth control pills for women, condoms to prevent pregnancy, etc). However, the procedure will not protect you against STDs. A condom is still the best method for STD prevention.

What are the risks of a vasectomy?

Vasectomy is a safe and simple operation, but there is a small chance you could have problems afterwards. Some of the problems include:

You may have temporary swelling around the area of the skin that was cut.
You may have bruising that usually goes away on its own.
You may get an infection on the skin or inside the scrotum.
The operation may not make you sterile. A small number of men who have the operation will still be able to get a woman pregnant. The vasectomy is more than 99% effective.

Will I still be able to have sex after a vasectomy?

Yes. A vasectomy will not alter your sex drive. Your erections and orgasms will be the same. You will have the same amount of ejaculate (semen), but it will not contain sperm.

Waste Reduction, Recycling, and Disposal +

How do I get my recyclables picked up at the curbside in my neighborhood?

The residential recycling program in Reno, Sparks, and Washoe County is voluntary. You must contact Waste Management Inc., at 329-8822 to request recycling bins. They will be delivered to your home. Also, dont forget to request a pickup schedule for recycled items. Your pickup day may be different that the regular garbage pickup.

Can I recycle yard clippings and other "green wastes"?

At this time, there is not a green waste program. However, you can build a compost pile from yard wastes that will provide nourishment and fertilizer for the garden and landscape.

For more information on how to construct a compost pile, consult your local nursery or the Master Gardener Program through the University of Nevada Cooperative Extension Office at 784-4848.

How do I get rid of old paint?

In Washoe County, there are several ways to dispose of household paint. First, remove the lids from the paint cans and let the contents dry to a solid form. If there is more than ½ inch of paint, add kitty litter to absorb it. When the material is solidified, you can dispose of it your household trash. Or, secondly, you may pour the paint directly on to plastic tarps being careful not to spill on to the ground; let it harden, and then roll up the tarps and place in your household trash.

The other option is to take the paint to Clean Harbors Inc. in Sparks. For a fee, based on pounds, your paint will be disposed of properly. Contact Clean Harbors at 331-9400.

How can I dispose of household products containing hazardous materials or chemicals?

The best way to prevent this disposal dilemma is to not purchase products that contain hazardous materials or chemicals. However, if you cannot share the product or donate it for use by others, please take it to Clean Harbors Inc. in Sparks. For a small fee the leftover product will be disposed of in a safe manner, according to Nevada Environmental Laws. Contact Clean Harbors at 331-9400.

How do I dispose of old computers?

If you are a homeowner, you should first try to donate the unit or turn it in to one of the used computer retailers in the area. The last and least attractive alternative is to dispose of it in the trash. If you are a business, your computers cannot be landfilled!

Where can I dispose of used motor oil?

Most oil recycling centers will accept up to five gallons of used oil free-of-charge. Many of the large auto parts retailers in Washoe County will take motor oil from local residents. Make sure when transporting the oil, that it is in a secured container and is free of contamination by lubricants, gasoline, or antifreeze.

In other Northern Nevada Counties, call the State of Nevada Recycling Hotline at 1-800-597-5865.

How can I start a waste reduction, recycling and a buy-recycled program in my work place?

Contact the Nevada Small Business Development Center's "Business Environmental Program" at 1-800-882-3233, or 689-6699, or contact EPA for the free "Business Guide for Reducing Solid Waste" at www.epa.gov.