MRSA Could the Superbug be living in your super horse?

Volume 11, Issue 1 January - June 2008 MRSA Could the Superbug be living in your super horse? According to MayoClinic.com MRSA (pronounced by sounding out each letter M-R-S-A or as a word mersa ) is an infection caused by Staphyloccoccus arueous bacteria. It was one of the first germs to outwit all but the most powerful drugs. MRSA (also known as CA-MRSA and HA-MRSA) infection can be fatal. It first gained notoriety in the general population in 1990, (patients were usually infected during hospital stays) and steadily spread across all sections of the population. A new study by the national Center for Disease Control and Prevention found that in 2005 MRSA made an estimated 94,000 Americans seriously ill and killed almost 19,000, compared with 17,000 who died of AIDS. In Holland, MRSA has been found in pig farmers and pigs. Now MRSA is believed to be transmitted from humans to horses and from horses to humans. If you think you have a spider bite you may want to think twice, said Dr. Randy Scheen. Dr. Scheen is a Louisville dermatologist who participates in many of the race track health screenings held in Kentucky and is a racehorse owner. Of the people that I see with this type of a bug in my practice, most think they have a spider bite. Most times it appears on the face, the hand, the arm, the neck, or up on the scalp. Many times it turns out to be MRSA. So if you think you have a spider bite or any other wound that is not healing as it should, get it THE FUND CELEBRATES 30 YEARS The Kentucky Racing Health and Welfare Fund, Inc completed it 30 th year of service to Kentucky s race track workers in 2007. It was brought into existence in 1978 by a Kentucky state statute which allowed the creation of the non-profit, charitable organization to be funded from uncashed pari-mutuel tickets. Little did the horsemen and legislators, who had the foresight to create a fund to benefit backstretch at that time, realize the extent of the good work and longevity that would be accomplished by their efforts. During its first year of operation the Fund provided $26,344 in benefits to eligible applicants. In 2007, the Fund provided over $1.9 million in medical benefits and $250,000 in retirement contributions to the Kentucky Race Track Retirement Plan. The Fund assisted nearly1000 individuals and their family members, combining for total approved and paid contacts of over 4,500. In the past three decades, the Fund has provided medical benefits for Kentucky race track workers exceeding $29 million and retirement contributions of $3 million. Over the years the Fund s staff has grown to meet this demand. The Louisville Heywood Avenue office is home to five courteous and knowledgeable professionals, including two bi-lingual staff members. The Fund utilizes the service of several part time staff members who work at Kentucky s tracks and The Thoroughbred Center. Super Horse continued on page 5 In addition to the medical benefits, the family of services provided or sponsored by the Fund include: The Thoroughbred Addiction Council of Kentucky, The Kentucky Race Track Retirement Plan, The Old School Apartments, and The Kentucky Racing Health Services Center in partnership with University of Louisville School of Nursing.

DISCLAIMER The Kentucky Racing Health & Welfare Fund is a non-profit charitable organization that receives no government funding or public tax revenue. It is not an insurance company and does not assume responsibility for any incurred charges nor does it guarantee approval for any request for assistance. This newsletter should not be construed as a policy and shall not be considered as an offer to extend assistance, benefits, coverage, payment or medical advice. The Fund s guidelines are changed at the sole discretion of the Fund and are modified, extended, altered, and revised from time to time without prior notice. Therefore, any information supplied in any form must not be construed or regarded as creating and express or implied right to the services, coverage, or benefits the Fund may offer. A copy of the Fund s current guidelines can be obtained by a written request submitted to the Fund. ALCOHOL OR DRUG ABUSE? T.A.C.K. CAN HELP! The Thoroughbred Addiction Council of Kentucky provides FREE on-track counseling and has access to no-fee or low-fee treatment and rehabilitation centers. For more information call: LOUISVILLE Mujahid Abdul-Rashid (502) 583-3951 LEXINGTON Jim Baum (859) 233-0441 ext. 218 FLORENCE Doretta Powell (859) 816-3446 HENDERSON & OTHER AREA S Ron McKiernan (502) 636-3386 The Horse s Mouth is published two times a year by the Kentucky Racing Health & Welfare Fund, Inc. KENTUCKY RACING HEALTH & WELFARE FUND, INC. A non-profit charitable organization Established 1978 Donald Ball - Chairman Rick Hiles - Vice Chairman Dr. Randy Scheen - Treasurer Carol Hebel - Secretary Frank Jones - Member Robert P. Benson, Jr. - Counsel Richard Riedel - Executive Director Marlisa Young - Director of Operations Karen Pehlke - Director of Finance Erika Lowe - Client Service Coordinator Manny Hernandez - Client Service Coordinator 422 HEYWOOD AVENUE LOUISVILLE, KY 40208 Phone (502) 636-2900 (800) 548-3662 Fax (502) 636-2955 Website Address: KYRACINGHEALTH.ORG Email Address: KRHWF@KYRACINGHEALTH.ORG OFFICE HOURS Monday - Friday 8:30 am - 3:30 pm Health benefits provided since 1978 $29.8 Million 2

KENTUCKY RACE TRACK RETIREMENT PLAN News Bulletin YES You Must Sign-up Every Year You must sign-up every year to be considered for each year s eligibility. Even if you feel that you may not be eligible you are urged to sign-up. Do not disqualify yourself for possible retirement benefits by not signing up each year. On the reverse side of this page you will find the complete schedule of sign-up opportunities during 2008. Always contact us regarding questions you may have about the Plan at (502) 636-2646, don t listen to rumors or hearsay. 2007 Earning Information is Required Earning information for 2007 will be required at the time of the 2008 sign-up for the Plan. Licensed Assistant Trainers and Stable Employees are required to submit a copy of their 2007 W2s or Form 1099s from trainers who made at least ten (10) Kentucky starts in 2007. Licensed Trainers are required to submit one of the following: a copy of your 2007 Federal Income Tax Return and Schedule C or, copies of 2007 1099s from your owners for Kentucky earnings that document at least $5,200 or, a signed statement of earnings from your tax preparer, on his/her professional letterhead, detailing income from your racing operation while racing in Kentucky during 2007 or, if licensed as a 2007 owner/trainer, a 2007 form 1099 from a Kentucky race track showing income of at least $5,200. YOU MUST PRESENT THIS INFORMATION AT THE TIME OF SIGN-UP! 2007 Sign-up The sign-up period for the Plan closed on November 15, 2007 with 374 eligible members being signed up who equally shared in the $250,000 contribution made to the Plan by the Kentucky Racing Health and Welfare Fund, Inc. In addition, 50 others had their accounts redistributed in 2007 as they had a Break in Service. Those redistributed accounts will be shared equally by the 374 eligible members who signed up during 2007. Summary Plan Description Booklet Available The current 2 nd Edition of the Summary Plan description dated January 1, 2004 is available. If you would like a copy, please contact (502) 636-2646. T he question isn t at what age I want to retire, it s at what income. So I m signing up for the Kentucky Race Track Retirement Plan! 3

KENTUCKY RACE TRACK RETIREMENT PLAN 2008 SIGN-UP SCHEDULE TRAINERS must have one of the following at time of sign-up: 2007 Federal Income Tax Return and Schedule C or 2007 Form 1099 form owner (s) you trained for in Kentucky during 2007 or A letter from your tax preparer stating your racing stable operation had gross revenues of at least $5,200 from racing in Kentucky during 2007 or If you are a licensed owner/trainer you can submit 1099(s) from Kentucky race tracks that documents income of at least $5,200 while racing in Kentucky during 2007 ASSITANT TRAINERS and STABLE EMPLOYEES must have one of the following at time of sign-up: 2007 Form W2(s) and/or 1099(s) from trainers you worked for in Kentucky or Self Employed pony people and those working as free-lance stable employees must provide a complete copy of their 2007 Federal Income Tax Return and written documentation (Day Book). Turfway Park Turfway Park March 12, 2008 March 19, 2008 Keeneland Keeneland Keeneland Tuesday April 8, 2008 April 16, 2008 April 17, 2008 Churchill Downs Churchill Downs May 14, 2008 May 15, 2008 Trackside Friday May 30, 2008 8:30 am - 11:30 am TTC TTC Tuesday June 10, 2008 June 11, 2008 Ellis Park July 23, 2008 LAST CHANCE (GRACE PERIOD) SIGN-UPS Ellis Park Ellis Park July 30, 2008 July 31,2008 Ellis Park August 20, 2008 Turfway Park Turfway Park September 17, 2008 September 18, 2008 TTC Tuesday October 7, 2008 Keeneland October 8, 2008 Churchill Downs November 6, 2008 9:00 am - 2:00 pm You may also sign-up at the Kentucky Racing Health & Welfare Fund, 422 Heywood Avenue, Louisville, KY 40208, from January 30, 2008 to November 17, 2008, Monday through Friday, 8:30 am - 3:30 pm. ALL DATES AND TIMES SUBJECT TO CHANGE! Call (502) 636-2646 if you have any questions. 4

SUPER HORSE continued checked out. Dr. Scheen reports that he has not seen any MRSA infections in his health screenings at Kentucky s racetracks, but expects that may change in the near future. Whitney Nash, Director of the Kentucky Racing Health Services Center said that she has seen the infection in several patients that the Center has treated. We have seen about 15 cases of MRSA since opening in April 2005. I don t know if horses are transmitting MRSA to horsemen, but we re seeing cases and folks need to be aware. The Kentucky Racing Health Services Center, located in The Old School at 422 Heywood Avenue in Louisville, provides free non-work related health screening and care for licensed race track personnel. It has experienced over 3400 patient visits since it opened. Recently the American Veterinary Medical Association issued a warning to those who come in frequent contact with horses to wash their hands and clean grooming tools after each use in order to reduce the risk of contracting MRSA. The bacteria frequently resides in the nasal passages, skin, and intestines of some horses. The warning states that MRSA can be transmitted from horse to human and from human to horse via direct contact with contaminated grooming or other tools. Probably the most important method for transmission from horse to human or human to horse is via hand contamination, said Paul Morley, DVM, Phd, director of biosecurity for the James L. Voss Veterinary Teaching Hospital at Colorado State University. The most important method of preventing transmission includes washing hands before and after contacting different horses and before you eat, or touch your face. Morley also recommended using disposable gloves when working with wounded horses that could be infected with MRSA. Veterinarians, farriers, and others with frequent contact with numerous horses and with immunocompromised (having an immune system that has been impaired by disease or treatment) horsekeepers are highest risk of horse to human MRSA transmission he said. Human Symptoms In humans the symptoms are more easily seen. Staph infections generally start as small red bumps that resemble pimples, shaving bumps, ingrown hairs, boils, or spider bites. These can quickly turn into deep, painful abscesses (the size of a tennis ball) that require surgical draining. Sometimes the bacteria remain confined to the skin, but they can also burrow deep into the body, causing potentially lifethreatening infection in bones, joints, surgical wounds, the bloodstream, heart values, and lungs. Treatment MRSA still respond to certain medications. Doctors generally rely on the antibiotic vancomycin to treat resistant germs. While vancomycin saves lives, some hospitals are already seeing outbreaks of vancomycin-resistant MRSA. To help reduce that threat, doctors may drain an abscess rather than treat the infection with drugs. Keep an eye on minor skin problems pimples, insect bites, cuts and scrapes. If wounds become infected see your doctor and ask to have any skin infection tested for MRSA before starting antibiotic therapy. Prevention Avoid contact with people who have open wounds. Use caution in public pools and while playing sports. Avoid sharing towels, razors, or clothing, and athletic equipment. Avoid living in crowded or unsanitary conditions. People who are in close contact with health care workers are at increased risk of serious staph infections. Wash your hands frequently for at least 15 seconds then dry with a disposable towel. Carry a small bottle of hand sanitizer containing at least 62 percent alcohol for times when you don t have access to soap and water. Keep wounds clean and covered with sterile dry bandages until they heal. Thoroughly wash and dry your grooming brushes and other tools in an antibacterial soap each day. You may want to consider different brushes and rub rags for each horse. Think twice before planting a kiss on the big horse s nose. Most infected horses frequently show no clinical signs of the disease, but when signs are visible they appear as a wound with redness, pain, swelling, heat, and drainage. 5

POSSIBLE WAYs TO LOSE YOUR BENEFITS Once an individual applies to the Fund for assistance, the Fund will conduct a routine inquiry into the accuracy of the information provided by the applicant. If the applicant has provided inaccurate or false information pertaining, but not limited, to: Work related injuries False KHRA license information Insurance or other benefit coverage (if eligible the Fund will consider deductibles & copays) Employment Identities Transferring benefits the following action will be taken: First Offense 1. No benefits until the Fund has been paid for all benefits received under false pretenses. 2. Loss of benefits for six (6) months once the Fund has been repaid. 3. Future benefits will be provided on a reimbursement basis for six (6) months. Second Offense Complete loss of benefits for a two (2) year period. Third Office Complete and indefinite loss of all benefits. GUIDELINE CHANGES The following changes were made to the Fund s guidelines by the Fund s Board of Directors effective January 1, 2008. Dental Sealants The Fund will provide a maximum of $7 per sealant for eligible dependent children up to the age of 15. This benefit is limited to eight (8) teeth per child and is a one time, lifetime benefit per child. Gardasil Vaccine (Cervical Cancer Vaccine) benefits for Gardasil vaccines for clients and eligible dependents shall be made on a reimbursement basis after each shot provided that the shots are completed in the prescribed monthly installment. Clients and/or their dependent wife or daughter are to be between the ages of 9 and 26. Request for clients and/or their dependents over the age of 26 must present a letter of medical necessity from their physician. The limit per vaccine is $145, or whatever the current health department fee is, with a limit of $50 for the office visit, or whatever the current health department fee is. Prescription Medication - $5 co-pay on all non narcotic pain medication and $10 co-pay on all narcotic pain medication. Clients and their dependents with health insurance will be exempt from these co-pays. Prescription Medication for the treatment of Hepatitis C The Fund will allow up to a maximum of 90 days of assistance for prescription medication for the treatment of Hepatitis C. Referrals will be made to the Health Department and to the drug manufacturer s charity programs. In the Greater Metro Lexington area the Fund utilizes Bluegrass Farm Workers Health Center. Charges incurred without a referral from Bluegrass Farm Workers Health Center will be subject to a $25 co-pay and lab s will be limited to $13 each. In the Greater Metro Louisville area the Fund utilizes the Kentucky Racing Health Service Center. Charges incurred without a referral from Kentucky Racing Health Service Center will be subject to a $25 co-pay and lab s will be limited to $13 each. Charges incurred at an out-of-network hospital will not be paid at 100%. (Please see the Guideline Booklet for a list of network providers or contact the Fund) Non-emergency hospital charges will be subject to a $50 copay. 6

THINK BEFORE YOU INK: ARE TATTOOS SAFE? Reprinted from the U. S. Food and Drug Administration website As the popularity of tattoos continues to grow, so does the concern about potential risks. Some risks, such as the spread of infections through the use of unsterilized needles, have long been known. But what isn't clear is the safety of tattoo inks. Permanent tattoos are made by using needles to inject colored ink below the skin's surface. Permanent make-up is considered a permanent tattoo that mimics the results of cosmetic products such as an eyebrow pencil, lip liner, eyeliner, or blush. While state and local authorities oversee the practice of tattooing, ink and ink colorings (pigments) used in tattoos are subject to FDA regulation as cosmetics and color additives. However, because of other public health priorities and a previous lack of evidence of safety concerns, FDA has not traditionally regulated tattoo inks or the pigments used in them. The FDA has received reports of bad reactions to tattoo inks right after tattooing or even years later. Some people report itchy or inflamed skin around their tattoos in the summer when they've been out in the sun. Recent reports associated with permanent make-up inks have prompted FDA to study tattoo ink safety. "Our hope is to get a better understanding of the body's response to tattoos and their impact on human health, and to identify products at greatest risk," says Linda Katz, M.D., M.P.H., Director of FDA's Office of Cosmetics and Colors in the Center for Food Safety and Applied Nutrition. What are the Risks? Infection Dirty needles can pass infections, like hepatitis and HIV, from one person to another. Allergies Allergies to various ink pigments in temporary tattoos have been reported and can cause problems. Scarring Unwanted scar tissue may form when getting or removing a tattoo. Granulomas These small knots or bumps may form around material that the body perceives as foreign, such as particles of tattoo pigment. MRI complications People may have swelling or burning in the tattoo when they have magnetic resonance imaging (MRI). This happens rarely and does not last long. For the complete report go to www.fda.gov/consumer/ features/tattoos120607.html KENTUCKY RACING HEALTH SERVICE CENTER 422 Heywood Avenue Louisville, KY 40208 (502) 636-3133 MONDAY 10:30 am - 3:30 pm FREE WEDNESDAY FRIDAY 4:00 pm - 7:00 pm 10:30 am - 3:30 pm NO APPOINTMENT NECESSARY A joint initiative between the Kentucky Racing Health & Welfare Fund and the University of Louisville. 7 Closed Most Holidays

THE OLD SCHOOL APARTMENTS 422 Heywood Avenue Louisville, KY 40208 (502) 636-5950 OFFICE HOURS Monday,, Friday 8:00 am - 4:00 pm Contact: BRIDGEDA GOFFNER Studio Apartment - $323 1 Bedroom Apartment - $357 All utilities included in rent On-site laundry facility Appliances furnished with carpet & blinds Must be 55 or older or disabled; income eligible KENTUCKY JOINS FIGHT AGAINST BIRTH DEFECTS Birth defects affect about 120,000 babies born in the United States each year The Kentucky Birth Surveillance Registry (KBSR) is joining the National Birth Defects Prevention Network to share the message that a mother s health before, during and after pregnancy is an important foundation to having a healthy baby. Preventing Infections in Pregnancy is the theme of National Birth Defects Prevention Month during January 2008. The Network is working with doctors and other health care providers around the country to encourage better education for women about infections that can harm a baby before it s born. Women should talk with their doctors about testing for infections like group B strep and hepatitis B. Good health habits include knowing your family history and genetic risks, seeing a doctor, taking care to not expose yourself to diseases and managing health problems. These habits should also include taking a multivitamin with 400 mcg of folic acid daily starting before pregnancy. GONE. BUT NOT FORGOTTEN The Kentucky Racing Health and Welfare Fund pays tribute to the following dedicated individuals who have recently passed away after dedicating many years in the Kentucky racing industry: William H. Berry - Asst. Starter Mark Cowan - Asst. Starter Gino Deets - Stable Employee Anne Marvin - Stable Employee Hulon Womack - Trainer Women who are pregnant or planning to get pregnant need to be especially careful, said Steve Davis, M.D., deputy commissioner of the Kentucky Department for Public Health (DPH). Good habits to avoid infection include frequent hand washing, careful handling of raw meats, staying away from dirty cat litter, and not handling pet rodents or their bedding. 8