Immunizations protect children from vaccine-preventable diseases such as measles, mumps, polio, rubella, pertussis (whooping cough), diphtheria, tetanus, Haemophilus influenza Type B (HIB disease), Hepatitis B, varicella (chicken pox) and pneumococcal infections which may cause meningitis and blood infections. Vaccines can prevent the debilitating and in some cases, fatal effects of infectious diseases.  The organisms which cause vaccine-preventable diseases have not disappeared, rather they have receded and will reemerge if the vaccination coverage rates drop.  Vaccines protect more that the vaccinated individual.  They also protect society.  When vaccination levels in a community are high, the few who cannot be vaccinated are often indirectly protected because of group immunity.

Serious reactions to vaccines are rare, but they do occur.  However, the risks of serious disease from not vaccinating are far greater than the risk of a reaction to
the vaccine.

Side effects may occur with vaccinations.  Slight fever or reactions at the site of the injection are the most common side effects.  Minor discomfort is normal and should
not cause alarm.  However, if you feel your child is experiencing a severe or persistent reaction, seek medical attention immediately.  Severe reactions may include a high fever, seizures, persistent crying lasting more that 3 hours, rash, hives, difficulty breathing and/or unresponsiveness.

Immunizations must begin at birth and most vaccinations are completed by age 2.
By immunizing your child on time, you can protect him or her from contracting a vaccine-preventable disease.

When your child receives a vaccine, you will be provided with a "shot" record.  The "shot" record helps you and your health care provider track what vaccines have been provided and what your child will need at the next visit.  The shot record will be started at birth and updated each time vaccines are received.  It is important to bring the record with you each time your child visits the health care provider or Immunization Clinic.  This information will help you if you move or when your child enrolls in a child care agency or a school.  It is recommended to keep the "shot" record in a safe place within your home.

No, the Manchester Health Department requires all food preparation occur in a licensed, commercial kitchen.   No home cooking is allowed.

Yes, the City of Manchester requires food safety training.

Food Service Training Requirements

 

Per Board of Health Policy, each food service facility in the City of Manchester must have at
least one supervisory staff member attend a food safety seminar to maintain a permit. The Department usually conducts seminars twice a year. Check our News tab for announcements of upcoming training. These two-hour seminars are held during the day with a choice of a morning or afternoon session. Successful completion of nationally recognized certification class, which demonstrates competency, is strongly encouraged.

 

What is ServSafe?

 

ServSafe is a comprehensive food safety and sanitation program offered by the National Restaurant Association. Upon successful completion of this course, a certificate is awarded.
This class and others that are approved by the Conference for Food Protection are strongly recommended to ensure a competent workforce.

 

Links to the following agency offer ServSafe training classes:

 

NH Lodging & Restaurant Association

 

UNH Cooperative Extension

Only when we receive complaints regarding standing water or mosquito breeding or other hazardous condition.

Food Establishment Inspection Scores are posted within one month after each quarter on our website. Click here to see the most recent inspection scores. 

The permit classification and associated annual fees are based upon a combination of seating and services provided. The permit is issued for one year, expiring on the last day of the month
in which it was issued. The permit is not transferable from person to person, entity to entity or from one location to another. Permit Application.

The number of inspections conducted in each establishment per year varies by size of the establishment, the clientele they serve as well as with rating scores. The Health Department conducts inspections of food service facilities on an unannounced basis during regular operating hours of the establishment, including preparation time, weekends and evenings. Normally, large operations are inspected four times a year and smaller operations twice a year. However, more frequent inspections may be conducted if any serious violations are found during a routine inspection.

Home-based Facilities

Although home-based establishments are allowed by the NH Bureau of Food Protection, in Manchester the operation of a home-based food service establishment is not allowed. Only those food service facilities that meet the minimum requirements as set forth in the New Hampshire Rules for the Sanitary Production and Distribution of Food (He-P 2300 sections 2031 through 2328), as adopted by the City of Manchester, are eligible for permitting in the City of Manchester.

In order to ensure food safety at events in the City, a temporary license is required in both cases. Fee structures are based on whether you represent a for-profit or a not-for-profit entity.
In some cases you may be required to complete an Event Coordinator application form as well. Temporary Food Service Permit Application.

There are two awards given, a Food Safety Achievement award and a Food Safety Excellence award.

 

 A Food Safety Achievement award is earned by establishments that have been in existence
for a full calendar year, have consistently met high standards (with scores of greater than
90 and no critical item violations), no substantiated food borne illness complaints and have
had staff attend the Manchester Health Departments’ Food Safety Seminar. The Food Safety Excellence award is conferred when the above criteria have been met and there are employees that are ServSafe certified (or equivalent).

A private party at one’s household is not subject to inspection or licensure by the Health Department. When selecting a caterer, one should look to see copies of their current food
permit and a copy of their last few inspections. If you have any questions, feel free to contact
the caterer’s licensing agency for clarification of the reports.

1.  There exits a sewage backup
2.  There is a complete lack of hot and cold water under pressure
3.   Electrical service is not available on the premises
4.   Following a fire or a fire suppression system discharge
5.   When there is a complete lack of appropriate refrigeration

If you watch more than 3 unrelated children in a dwelling you would fall under the licensing guidelines of the Department of Health and Human Services Bureau of Childcare Licensing (DHHS). Contact them at 271-3466 for more information.

If you serve meals to a group of more than 12 children you would be required to be licensed
as a food service facility by the Health Department and subject to the facility and food service requirements of He-P 2300. Some restrictions may apply (see the FAQ above.) 

Lead poisoning is a serious disease, particularly in children.  Lead is a naturally occurring element and its use dates far back in history.  Lead is highly toxic and can affect many systems and organs within the body.  Lead is highly toxic and can affect many systems and organs within the body.  Young children and unborn babies are most vulnerable to lead poisoning, as lead is particularly harmful to the developing brain and nervous system.  One and two year old children are at greatest risk for lead poisoning as they have increased mobility and engage in hand-to-mouth activity. Coma, seizures and death may be related to very high levels of lead.  At lower levels, lead may cause adverse effect on the kidneys, circulatory system and central nervous disabilities, hyperactivity and learning and behavior problems.  Lead poisoning is preventable!

Many children may have no symptoms of lead poisoning.  When symptoms do occur
a child may complain of upset stomach, fatigue or irritability.  A parent may mistake the symptoms for another illness.  A child may show no sign of illness, yet enough lead in
his body to damage his brain, kidneys or nervous system.  A lead screening is the only
way to determine if a child has an elevated lead level.

All Manchester children should be screened at one and two years of age. Children ages
36-72 months of age should receive a lead screening if not screened previously. Parents
should call their health care provider to schedule an appointment for a lead screening. 
The Manchester Health Department provides lead screenings at no charge Monday-Friday
8:00 am-5:00 pm. No appointment is necessary.

• Wash your child's hands and face often, expecially before meals and snacks,
  after playing outdoors or near old windows and before naps and bedtime.
  
• Wash toys and pacifiers often.
  
• Wet mop floors, windowsills and window wells, woodword, etc. with water and
  detergent at least 1-2 times per week.
  
• Provide meals and snacks high in iron and calicum.
  
• Avoid letting children play in the soil alongside older buildings.
  
• Keep children away from peeling and chipping paint and objects that may
  be painted with lead-based paint such as old windows, furniture, toys and crips.
  
• If you work with lead or engage in hobbies using lead (arts and crafts, doldering,
  automotive work, etc.), shower and change clothes before coming into contact
  with children.
  
• Store and serve food in glass or plastic containers.  Avoid storing food in ceramic
  ware, pottery, pewter and silver.
  
• Improper renovations or lead-paint removal can create hazardous levels of dust
  and fumes.  Before beginning renovations or removal of paint, contact your local
  health department.

Lead paint can be a serious problem when not properly maintained. It is important to note that lead poisoning is preventable! The presence of lead paint alone is not a hazard. Loose, flaking and chipping lead paint is a hazard. The City of Manchester building code requires paint in rental property to be maintained in sound condition at all times. Issues with peeling, chipping, flaking, or other wise loose paint should be reported the landlord or to the City Building Department Housing Standards Division at 624-6475.

Reminder, when leasing, buying/selling, or renting property, a Lead Disclosure form must be provided to tenants/buyers, as well as the lead brochure entitled “Protect Your Family from Lead in Your Home”. Both are available at the Manchester Health Department. 

In addition, if you would like someone to walk-through your home to help identify
possible lead hazards, “The Way Home” (a not for profit community partner) may be 
able to accommodate you. They can be reached at 647-3491. This non-profit group works with tenants and property owners to minimize lead hazards in homes. The only sure way to assess risk is to have a licensed lead risk assessor test the property. A list of qualified individuals can be found at the New Hampshire Department of Health and Human Services (NH DHHS). 

Lead disclosures as well as other lead information materials are available at the Health Department or by clicking here.

The Health Department does not have the capacity to test for lead. Properties built before 1950 are very likely to contain lead in them. Properties constructed before 1978 may have lead paint in them Over 46% of rental property in Manchester were built before 1950. The only sure way to assess lead hazard risk is to have it inspected by a licensed lead risk assessor. 

The Health Department maintains records on properties that have housed children with elevated blood lead levels. These records are not all inclusive! . Information on past incidents is available at the Department (pre-1997). Incidents post-1997 are housed at the NH Childhood Lead Poisoning Prevention Program. They can be reached at 271-4786.

First, any work done with the purpose of removing lead requires the use of a specially licensed contractor. Second, any remodeling or repairs that disturbs more than two square feet requires pre notification of the work to all the tenants and the distribution of a disclosure and informational materials to all tenants. It is worth noting that more than a third of all children poisoned by lead reside in dwellings that have been renovated within the previous six months. It is essential that all renovations employ lead safe renovating practices and proper containment at every step of the process.

Exterior or interior abrasive paint removal such as sand blasting is prohibited without a valid permit from the Health Department. Due care must be made to minimize the exposure to lead and lead dust to workers and abutters. Proper safety and containment standards must be maintained during the course of the work and inspections of the work-site will be made by the Health Department to ensure compliance. 

Other risky activities such as power washing and dry scraping must be done in a manner that minimizes exposure and maximizes containment. 

The health of the public is something we often take for granted but the recent attacks on the World Trade Centers and the subsequent Anthrax scares has made Public Health front page news. 
Public Health is not centered on individuals, but on the community at large.  Public Health

• prevents epidemics and the spread of disease
• protects against environmental hazards
• prevents injuries
• promotes and encourages healthy behaviors
• responds to disasters and assists communities in recovery
• assures the quality and accessibility of health services

Some of the ways the Manchester Health Department works to assure the health of the Manchester community is providing immunization services to all Manchester children, making home visits to patients with infectious disease, inspecting all Manchester restaurants for proper food handling practices and working through local organizations to decrease teen pregnancy.  The Manchester Health Department also employs the school nurses who serve children in city schools.

At the Manchester Health Department we employ community health nurses, school nurses,
public health specialists, environmentalists, epidemiologists, toxicologists, interpreters and administrative staff who work under the direction of the Public Health Director. Workers may work in the schools teaching children about smoking cessation, or appear on TV teaching about the hazards of drug and alcohol abuse.  Often we work closely with Police and Fire should there be a chemical spill or participate in a community coalition to prevent lead poisoning in children.  Public Health Workers are like detectives tracing down the source of a community health problem and then involving the community in taking steps to remedy the problem. 

Although Chickenpox is now a vaccine preventable illness, we do occasionally still see
children with this viral disease. Initially children may feel tired, have a runny nose or slight
fever. A rash usually develops on the chest and back and spreads over several days to other areas of the body. The rash starts as red spots that soon blister and then scab over as blisters break. Chickenpox is considered contagious from 5 days before until 6 days after rash appears. Children with chickenpox must be excluded from school for 7 days after rash
appears or until ALL blisters have crusted over.

Strep throat and scarlet fever are both bacterial infections caused by the streptococcus bacteria. Both infections usually cause a child to feel quite ill.  Symptoms may include a sore throat, fever, tender swollen neck glands, headache and stomachache. Scarlet fever is accompanied by a rash and strawberry appearance of the tongue.
 

A health care provider based on throat culture results or other testing makes diagnosis of strep throat and scarlet fever.  Treatment requires antibiotic therapy for a specifically prescribed period of time in order for the infection to be cured.  Analgesics such as acetaminophen or ibuprofen for fever and cold drinks and soft foods may ease sore throat.

 
Strep throat and scarlet fever are both contagious Children must be excluded from school until they have been taking medication for at least 24 hours and are fever free.

Fifth disease is a common childhood viral illness with rash symptoms.  The illness typically begins with a slight fever and feeling of tiredness.  A red rash appears usually appears within the next week.  The rash has a “slapped cheek” appearance on the face, and a “lacey” pattern on the neck, arms, legs, and trunk of the body.  The rash may recur for several weeks brought on by exposure to sunlight, heat, exercise, or stress.  Fifth disease is contagious in the time period before the rash appears but the illness is usually diagnosed only after the rash appears.  Frequently, the classic rash is not present, and the mild illness resolves without ever being diagnosed. 

Adults can also get fifth disease but most adults already have immunity from previous exposure.  Pregnant women who are exposed to fifth disease should consult with their health care provider.  Frequent and thorough hand washing and tissue disposal are effective means of minimizing the spread of fifth disease.

Children are no longer contagious when the rash appears so they do not need to be excluded from school.

 How long should I keep my child out of school with impetigo?

Impetigo is a common infection on the skin caused by bacteria. Impetigo appears as a raised pink rash, which becomes crusted and then oozes a clear yellowish fluid. The rash usually occurs in localized areas such as around the mouth and nose or other areas of the face arms and hands.  Impetigo is especially contagious among school children and their family members while the rash is oozing.  The rash can spread to healthy skin areas as well as to other individuals.

Treatment for impetigo includes the soaking and removal of crusts on the lesion and applying an antibiotic ointment to the affected areas until infection is no longer present.  In some cases of extensive infection a health care provider may prescribe antibiotics to be taken by mouth for a longer period of time.  Bed linen and clothing of the infected individual should be changed daily and washed in hot water.  To prevent the spread of infection household members should use separate washcloths and towels.  Frequent hand washing is the best method of preventing the spread of impetigo. 

Children with impetigo must be excluded from school until they have been taking their medication for at least 48 hours. 

How long should I keep my child out of school with conjunctivitis? 

Redness of the white parts of the eye with some crusting and yellow or greenish mucous around the eyelids are the characteristic signs of bacterial conjunctivitis.  Other causes of conjunctivitis such as allergies or viruses that do not result in red or draining eyes do not require exclusion from school.  Parents should consult with their health care provider for appropriate diagnosis and treatment.

Cool moist face clothes or gauze soaked in water may help relieve the itchiness and discomfort associated with conjunctivitis.  As with other contagious conditions, frequent hand washing and disposal of tissues is important in preventing the spread of infection.

Bacterial conjunctivitis in school children is contagious and children with symptoms must be excluded from school until they have been treated with antibiotic eye drops or ointment for 24 hours.

This fungus infection on the skin begins as a small red circle that progressively becomes larger.  The boarder of the rash is elevated and usually scaly and dry, or moist and crusted.  The center of the circle starts to clear as the area becomes larger. Itchiness and scaling occur at the site. Ringworm on the skin is contagious and requires treatment with an antifungal medication, in either ointment or pill form taken.

Ringworm can be spread by direct contact with an infected individual.  Cats, dogs and cattle can also be infected with ringworm and can be a source of infection to people.   Ringworm can also be spread indirectly by sharing clothing, bedding, shower stalls, barber clippers and other items with an infected individual.

Children with ringworm must begin treatment and have rash covered before returning to school.

Poison ivy rash occurs in reaction to exposure to poison ivy resin from direct contact with the plant or from pollen or even from smoke from the burning leaves.  Exposure to plant resin remaining on clothing or shoes can also be a source of poison ivy reaction.  The typical case of poison ivy involves a rash consisting of reddening, swelling and blistering of the exposed skin within 6 hours to 6 days after exposure. Itching and burning sensations are characteristic. 

Wear long sleeves and slacks if working in underbrush and wash clothing immediately. Sweating may aggravate the itching and discomfort of the poison ivy rash. Avoid strenuous activities, which may increase sweating and itching.  Plain calamine or caladryl lotion applied to the skin rash can reduce itching.  Antihistamines taken by mouth can decrease itching but may cause drowsiness in some children. Hydrocortisone cream can accelerate healing and reduce inflammation.  Severe reactions especially those involving the face and mouth may require more intensive medical treatment and a health care provider should be contacted. 

Contact with fluid from the poison ivy skin blister is NOT contagious to others.  Children with poison ivy do not need to be excluded from school.  They may attend school as long as they are comfortable enough to do so. 

If you notice any wet/damp areas in the yard, excessive areas of lush plant growth, or have back-ups into the house you may want to contact a licensed septic hauler to pump your septic tank. If the situation continues, you may have a failed system and should contact the health department and a licensed septic designer to inspect your system.

The Department has septic plans on file for most systems build after 1980. Before that time we may or may not have plans depending on the regulations that were in effect at the time. We have very few plans before 1970.   The State Department of Environmental Services may also have information on your individual septic system.

If your current system was State approved and is on file, you may qualify for an “in-kind” replacement (restrictions apply). (Note: This option may not meet current loading and design criteria and may result in the system to be undersized). Contact the Health Department for permit application procedures.

You must get Health Department approval before obtaining a building permit. The Health Department has a form that must be filled out and is available on-line (septic system release for building/dwelling change form). If you are adding any bedrooms or increasing the loading you must have a new septic design completed by a licensed septic designer. You do not need to install a new system at this time, but must show that the parcel can accommodate increased loading.

Other issues to be aware of include building and structure setback requirements that can be discussed with the Department at any time.

If the land will be serviced by private septic systems, approval must be obtained by the Health Department. Test pits need to be conducted to establish adequate leaching areas for the lots proposed. These test pits must be witnessed by Health Department representatives. Lot sizes are determined by soil type and slope. A chart is provided at our web site. Other factors, which affect lot size, include wet soils, ledge outcroppings and municipal water service availability. Contact the Planning Department at 624-6450 for other requirements of the subdivision process.

A failed septic system is defined by sewage effluent surfacing on the ground or backing up into the house. If a system fails after a short period the cause could by one of many things. The following is a list of questions to ask:  

1. Do you have a garbage grinder? If so, is your system designed for such use? Ground up effluent can compromise the settling process in the septic tank allowing solids to clog the field.
2. Does your home have a water filtration device and does it back wash into the system? The treatment of water may affect bacterial growth in the system.
3. If you have a pool or spa, does it backwash into the system? This too can affect the system. 
4. Is more water being used than the system can handle (was designed for)? Are there any leaking fixtures in the home?
5. Has anything driven over your system (cars, landscaping vehicles)?
6. Are you dumping chemicals down the drain? Hobbies such as painting and certain crafts can kill bacteria in the system affecting its operation. If these questions do not solve your problem, contact a licensed septic designer or a certified septic inspector for assistance. 

If your home was built after 1980 we likely have a plan on file at the health department. If your home was built prior we may have a plan on file (see "I need a copy of my septic plan where can I obtain one?"and "Can I replace the exact system that I currently have?" above).  

TB infection:  The TB germ is alive in your body but not making you sick, and you will not spread the germ to anyone else.  Your immune system traps the TB germ.

TB disease:   The germ becomes active.  It can attack the lungs or other parts of the body.  The individual can become very sick and even die.  If it attacks the lungs, it can then be spread to others.

A skin test is the only way to tell if you have TB infection.

A physical exam, a chest x-ray, and special lab test, will assist your doctor in making
the diagnosis.