Approved Minutes of June 26, 2024

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MINUTES ORANGE COUNTY BOARD OF HEALTH June 26, 2024 to share his perspective, as Mr. Wallace assisted the communicable disease team with presentation slides on syphilis. According to Mr. Wallace, syphilis rates are trending up nationwide (-50% increase nationally since 2018)while the southern states are seeing an 80-90% increase. Looking within North Carolina, that he compared syphilis incidence between Orange and Rowan counties (as they are comparable in population size and demographics) and found that Orange is seeing about 25-50 cases per year, while Rowan is seeing 50-75 cases per year. Currently, there are no CDC guidelines for syphilis testing at the national level; Mr. Wallace suggested that the state or a county could set their own guidelines for syphilis testing. • In response to Mr. Bagby's question about the upward trend in syphilis cases, Mr. Wallace explained that poverty and STIs tend to be comorbid, and a higher poverty rate typically reduces access to sexual health resources and thus increases STI incidence. • Congenital syphilis cases typically occur when prenatal care is delayed, absent, or incomplete, or when the newborn is incorrectly evaluated for syphilis. It is a goal to target education and communication campaigns promoting prenatal care for patients and congenital syphilis testing for providers. • On August 91h, the health department is hosting a Measles Symposium for Healthcare Providers to help provide measles education. The event will be hosted in the Donna Baker Meeting Room at Whitted Human Services Center. • The number of children with vaccine exemptions is increasing, though there is not a noticeable increase in medical exemptions. Mr. Bagby asked if children can enroll in public schools without receiving their vaccines, to which Ms. Julian replied that students are permitted to enroll, but they must either get in vaccine compliance or apply for an exemption within 30 days. In response to Dr. Pickett's question, Ms. Julian explained that she is unsure about what all the nonmedical exemptions are, but they include both religious and ideological exemptions. Dr. Pickett clarified that individuals do not have to be a member of a specific religion to claim religious exemption. • Dr. Stuebe mentioned a recent paper that explores the relationship between substance use and congenital syphilis, saying that individuals who use opioids or other illicit substances have significantly higher rates of congenital syphilis largely because their use of substances leads them to delay or avoid prenatal care in an effort to avoid having their substance use detected, which causes the syphilis to also go undetected. She added that poverty, homelessness, substance use, and poor health outcomes such as stillbirth are all intertwined. Vill. Reports and Discussion with Possible Action A. Ad Hoc Committee: Local Well Rules On behalf of Chair Jonnal, Dr. Stuebe called for the formation of an ad hoc committee to review and evaluate the Orange County local well rules as follow up to the recent adjudication hearing. Dr. Baldwin, Mr. Whitaker, and Dr. Crandell volunteered to serve on the committee. Because Dr. Rodgers had previously expressed interest in the well rules, it was suggested that Ms. Stewart invite her to serve on the committee as well. Motion to form the committee with the aforementioned volunteers was made by Commissioner Amy Fowler, seconded by Dr. Bruce Baldwin, and carried without dissent. S:\Managers Working Files\BOH\Agendas &Abstracts\2024 Agenda and Abstracts/ June Page 8