By Journal Staff
The Revere Board of Health (BoH) held its regular monthly meeting this past Thursday, May 28, in the Revere City Hall City Council Chambers. On hand for the session were chair Dr. Drew Bunker and fellow members Kathleen Savage and Viviana Catano. Also in attendance were Director of Public Health Lauren Buck, Health Agent/Director of Inspectional Services Michael Wells, and Board of Health Clerk Paula Sepulveda.
Buck presented the Communicable Disease monthly report. She said that there was a “relatively low threshold” of communicable diseases in May, with only 13 reported cases of flu, several for COVID, and one for Lyme Disease.
Buck also spoke about the Ebola outbreak in Central Africa and that the “trajectory remains deeply concerning. All signs point to widespread and community transmission. Compared to previous outbreaks, the spread of infection is very fast. If you have travel plans to this region, it is time to cancel them now. However, the risk in the United States remains very low.”
Buck also spoke briefly about the hantavirus outbreak that originated on a cruise ship and that has been in the news lately, noting that the 18 American travelers who are still quarantined in the U.S. continue to test negative. However, symptoms of the virus may take up to 45 days to manifest from initial exposure.
Buck also discussed swim safety and outlined the safety precautions swimmers must take, especially during rip current conditions. She added that weekly testing for bacterial conditions at local beaches has begun.
Buck also noted that mosquito season is here and individual homeowners may request spraying from the Northeast Mosquito Control and Wetlands Management District for which there is a link on the City of Revere website.
Buck said that with many visitors expected to come to Revere for the upcoming World Cup, residents should be prepared for large crowds.
Buck finally mentioned that the Health Dept. is sponsoring its first “Baby Shower” in June and is asking for donations of diapers and baby wipes through June 15 at Revere City Hall and the public library that will be provided to the most vulnerable members of our community.
Wells presented the monthly report of the Inspectional Services Dept. Wells said that in the past month, ISD issued 30 certificates of fitness for housing units; performed 40 reinspections; and received 16 interior complaints. There also were 16 pool and spa inspections
In the food department, ISD performed 47 routine food inspections, six reinspections, nine complaint inspections, one pre-opening inspection, and five temporary food inspections.
In the exterior sanitation division, ISD agents issued 504 total citations for trash violations; 53 for overflowing dumpsters; 20 for junk heaps, dumps, and automobile graveyards; eight for multiple unregistered motor vehicles, and 50 violations for unclean and unsanitary land, which is overgrowth.
The board heard a presentation by the Research Study Team of Mass. General Brigham (MGB) on the relationship between transmission of HIV and Incarceration.
Dr. Alysse Wurcel, an Associate Professor at the B.U. School of Medicine who specializes in addiction and infectious diseases at the Boston Medical Center and who has been providing healthcare in Massachusetts jails for about 15 years, spoke to the board about a program that is known as Status Neutral HIV Care in the Suffolk County jails at South Bay and Nashua St.
Wurcel said that HIV outbreaks that have occurred in the past decade across the state have occurred primarily through sexual transmission, but also through shared needles by persons who inject illegal drugs.
Wurcel displayed a graph that showed that Chelsea had the highest rate of HIV infection in Suffolk County for the years 2022-24 with 19.6 cases per 1000 of population, followed by Boston at 17.4, Revere at 9.1, and Winthrop with five cases in total.
However, only about two-thirds of persons with HIV diagnoses are suppressing the disease with treatment.
Male-to-male sex accounted for 56 percent of the cases in Revere. Injection drug use accounted for eight percent of cases in the city, and about 16 percent of cases were attributable to heterosexual sex. There was no identified risk for 18 percent of infections.
Wurcel discussed the relatively new drugs, known as PrEP — Pre-Exposure Prophylaxis — that prevent HIV. “We really want to get people who are at risk on these medicines, which is why HIV testing is important in our jails,” said Wurcel, noting that in the past, those who tested negative in the jails were not offered HIV prevention treatments.
“However, in Massachusetts, the use of PrEP, especially in jails, is very limited,” said Wurcel, adding that testing for HIV in jails faces a number of hurdles.
However, Wurcel noted that her program, which has 18 team members from numerous institutions, including Tufts, MGH, UMass, the BMC, B.C, and Cornell, has received federal funding because of the high level of transmission in Suffolk County.
Wurcel said the overall goal of the program is to increase both testing for HIV (as well as for syphilis and hepatitis C) and access to PrEP during both incarceration and post-incarceration.
The final matter on the agenda was a review of the draft regulations for the sale of kratom products in the city that the BoH has been working on for the past few months. Kratom is a natural substance derived from a tree in Southeast Asia that many use for relaxation and pain management. Natural kratom generally is regarded as safe.
However, synthetic kratom products, which are not regulated at either the federal or state level, have been linked to serious physical and mental health issues, especially in young people.
Buck briefly summarized the draft regulations, which call for a total ban on the sale of all kratom products in the city.
Claire Inzerillo, a Policy Writer and Analyst with the City Solicitor’s office, which reviewed the draft regulations, told the members that they have three options: to do nothing, to ban it, or to allow the natural leaf to be sold but to ban the synthetic products (as some communities in Massachusetts have done).
Inzerillo also mentioned that legislation is pending in the Mass. House and Senate, which range from a hybrid-regulatory scheme (for natural vs. synthetic), to an outright ban, to a full-on criminalization scheme that would classify kratom as a Class A drug similar to heroin.
She added that if the state legislature were to pass a law at some later point, the city would have to adjust its regulations to reflect whatever the state law mandates.
After Inzerillo’s succinct and excellent presentation, Bunker asked for public input. Allison Smith, who lives in Washington, D.C. and is the Director of Government Affairs for the Global Kratom Coalition, a non-profit organization that works to implement regulations for the sale of kratom and to ban synthetic substances and drugs, spoke against the blanket ban of kratom. .
“This is a serious issue as far as access to these unregulated, high-potency substances that are dangerous and need to be addressed,” said Smith. “However, there have been thousands of studies about natural kratom that have shown that adverse events are extremely rare and overwhelmingly are tied to poly-substance use or a pre-existing medical condition. Natural kratom is a botanical product from Southeast Asia that was introduced to America by Vietnam War veterans in the 1970s and today, 23 million Americans use natural kratom safely.
“It is the highly-concentrated, synthetic versions that are making headlines for addiction, overdoses, and the so-called ‘gas station heroin’,” Smith continued. “These products (known as 7-OH) are chemically-manipulated, extremely potent, and openly marketed with a heroin-style branding.”
Sepulveda noted that the board had received only one letter in support of the ban, but had received 14 in opposition.
The members then discussed the proposed ban. Bunker said that at the present time, there is no way of knowing what exactly is in the products that are being sold because they are not FDA-regulated. He also noted that a family friend recently had passed away from a kratom overdose.
“As a physician, I think this is very important. We need to do something and we need to act because lives are at stake,” said Bunker, who pointed out that none of the letters that had been received in opposition to the new regulations came from Revere residents.
“Our job is to protect the public health in Revere and I cannot in good conscience allow kratom to be sold in Revere,” Bunker added.
Both Savage and Catano agreed with Bunker’s comments, noting that as a practical matter, city health and inspectional officials would be unable at the present time to assess and evaluate products on the shelves of local stores.
The board will take a vote in the proposed ban at its June meeting.