HomeMy WebLinkAboutBOH PACKET 01_05_2026c.,
VARI{OUTH -IOIIN CLERK RE
DEC 30'25 p{2
8o.d ot Ho.tth
Hittard Boskey, M.D
Mary Craig
Chartes T. Holway
Laurance Venezia DVM
Erh Weston
A$lstant Heatth
Dirsctor
Barry Lewis
Town of Y.rmouih Board of Heatltr
1'146 Route 28, South Yarmouth, MA 02664
(508)S2231
BOARD OF HEALTH MEETING AGENDA
J8nuary 5, 2026 at 5:OO PM
2As meotingwitt be conducted in p€rson at th6 date. trme and tocation idenlafied rbove. This msans that 6t lsast a quorum
of the mombers of the publrc body will Sttend the meeting in p€rson and memb€rs o, the public are w€lcome to 6hend rn
person 8s wstl. As s counesy only, accsss to the me€ting rs also b€ing provided via ramote moans in accordaoce with
applicabte taw. Please note thatwhite an option tor remote atteodance and/or p€rticipation is b€rngprovrded as a cou(esy
to ths public, the meeting/hgaong will not b€ susp€nded or teminated if technologicat probt€ms intenupt the vtnuat
brogdcast or arrecl rcmots attendance oa ponacipation, untess otierwise required by Law- M€mbsrs ol th€ public with
panicular interest in any specrtic item on thas aSends, which jnc{udes an appticsnt ond its r€prcsontatives, shou{d make
ptans foa In-pslson vs. virtual anendanc6 accoadjrEty.
M6mb€rs of tho publicwho wlsh to att€nd tha meoting maydo so in rhe rollowing manner:
Pltoi.: I -253-215-8742 or 1 -312-626.6799 and enle, rhe 'neetlng lO 1871 152c 3955 r
To .€qu€st to sp€ak: Press '9 ond wait to be reaognized-
,iom W€blnrr:
,oin the mesting hosted in Zoom by uSiog tho tot{orviIlg lank: l,rtl'ir'luio?v;!b.rocm r\/t/8?t 1s?ilii955
Ihg moeting wU be broadcagt live, in r€al tms, vis a liva strsam or Yarmouth's YouTub€ Chanrol localed ot tho
tollolrving link: nrlpsr,'/vfl,,!.,'.icrrlut)c.cosrclsrlr.illilllQ I Qi li.'nl1{W5l.1z2PnWK 1rA,
It is recommended that phon€ psrticipsnlt 8ccoss malari&ls in advance of the mesting.
PlBaso note that for any h6m tist€d botow th3 Board of lteghh may take oficiat action inctuding votes.
1. Cett to order
2. Declaration of a Quorum3. Pubtic Comment
Thd open meeting law discoutogss public badi$ from discussing topica not listed on the agenda. fhe pubttc
should the!€fore not e\pect tha 8oa'd lo rcspod to questiors orsaatoments macte du ng the Public Comment
poftion of the meeting.
4. Kratom - Discussion
5. Nicotine Free Generation - Discussion
6. Review & Approve Minutes
a. Decemb€r 15,2025
7. NeMOtd Business
8. Adiournment
Y4
Town of Yarmouth Board of Health Regulation
Prohibiting the Manufacturing, Sale, and Distribution of Synthetic and
Naturally Derived Kratom Unregulated Novel Intoxicating Products
A, Authority:
This regulation is promulgated under the authority granted to local Boards of Health by
Massachusetts General Laws, Chapter 1 1 l, Sections 31 utd 122, which authorize Bomds of
Health to adopt reasonable health regulations and take action to protect the public from sources
of disease and health risks.
B. Statement of Purpose:
The Yarmouth Board of Health recognizes that the sale and distribution ofnatural and synthetic
unregulated psychoactive substances including but not limited to synthetically altered kratom
products pose an emerging tkeat to public health, particularly among youth and wlnerable
populations. These substances are often: manufactured without oversight, sold without proper
labeling, dosage guidelines, or ingredient transparency, associated with unpredictable or harmful
health effects, readily available in convenience stores, vape shops, and online with no safeguards.
C. Definitions:
For the purposes of this regulation, the following definitions shall apply
Board of Health: The Yarmouth Board of Health and its designated Board of Health Agents.
Board of Health Aeent: Any person designated by the Yarmouth Board of Health or the
Yarmouth Health Depaxtment to carry out and enforce the provisions of this regulation. A Board
of Health Agent shall have all powers assigned under Massachusetts General Laws, including
inspection authority, issuance oforders, and initiation of enforcement actions.
Kratom: Any part of the plant Mitrag)na speciosa
Natural Raw Kratom: Any unadulterated form of the plart Mitragyna speciosa, including its
leaves (whole, crushed, or powdered), stems, or other plant parts, that have not been chemically
altered, synthesized, or had their alkaloid concentrations artificially increased or mixed with any
other ingredients.
Novel Intoxicatine Products (NIPs): New or emerging substances sold for intoxication that are
I
not well regulated.
t
Syntheticallv Derived Kratom: Any kratom product that has been altered fiom its natural plant
form through chemical synthesis or the use of synthetic alkaloid analogs or concentrates beyond
what occurs naturally in the plant.
Permit Holder: Any person or entity that holds a permit with the Town of Yarmouth Health
Department.
Person: Any individual, firm, partnership, association, corporation, company, or organization of
any kind, including, but not limited to an owner, operator, manager, proprietor, or person in
charge ofany establishment, business, cultivation property, or retail store.
Retail Establishment: Any store, kiosk, gas station, vape shop, convenience store, smoke shop, or
other physical location engaged in the sale of consumer goods.
Unrequlated Novel Intoxicatine Products: Any substance, compound, or mixture, whether
natural, synthetic, or semi-synthetic, that is intended for human consumption or ingestion,
inhalation, absorption, or any other method of introduction into the human body, that:
1. Has psychoactive, intoxicating, or mood-altering effects;
2. Is not approved by the U.S. Food and Drug Administration for such use; and
3. Is not otherwise regulated or scheduled under Massachusetts or federal law.
D. Prohibition:
No person, business, or other entity shall sell, offer for sale, distribute, or otherwise provide for
human consumption any of the following within the Town of Yarmouth:
I. Natural or Synthetic Kratom -Any kratom products that contain natural kratom,
synthetic, or serni-synthetic alkaloids, chemical analogs, or derivates naturally or
not naturally occurring in the kratom planl (Mitragyna speciosa).
IL Unregulated Novel Intoxicating Products -As defined in section "Definitions",
any nafural, synthetic, or semi-synthetic substance, compound, or mixture with
psychoactive, intoxicating, or mood-altering effects, not approved by the U.S.
Food and Drug Administration, and not otherwise regulated or scheduled under
Massachusetts or federal law.
E. Enforcement and Penalties:
1. Any person or entity charged with violating this regulation shall receive a notice of violation
from the Yarmouth Board of Health or its designated agent.
2. It shall be the responsibility ofthe establishment owner and/or the manager or business agent
to ensure compliance with this regulation. In the case of a violation, the violator shall
receive:
2
lll.
In the case ofa first violation, a fine ofone thousand dollars ($1,000.00);
In the case of a second violation within thirty-six (36) months ofa previous
violation, a fine ofone thousand dolla$ ($1,000.00), and a suspension ofany
permit issued by the Board, including but not limited to a permit to sell tobacco
products, for seven (7) consecutive business days; or not limited;
In the case ofthree (3) or more violations within a thirty-six (36) month period, a
fine ofone thousand dollars ($1,000.00), and a suspension ofany permit issued by
the Board including but not limited to a permit to sell tobacco products, for thirty
(30) consecutive business days.
3. Every day that a violation exists shall be deemed to be a separate offense. Separate but
simultaneous violations shall be treated as separate violations. Multiple permit suspensions
may not be served concurrently.
4. Any person who receives notice ofa violation ofthis regulation may request a hearing before
the Board of Health. The request must be made in writing and filed within seven (7) days of
the date the violation was received.
5. The authority to inspect establishments for compliance and to enforce this regulation shall be
held by the Yarmouth Board of Health and its desigrees and the Yarmouth Police
Department.
6. Any person may register a complaint pursuant to this regulation to initiate an investigation
and enforcement with the Yarmouth Board of Health and its designees.
7. Upon accrual of four (4) violations of this regulation within a thirty-six (36) month period, or
upon the commission of two (2) or more egregious violations of this regulation with thirty-
six (36) months as determined by the Board, the Board may issue a notice of intent to revoke
and shall hold a hearing in accordance with this regulation and, after such hearing, may
permanently revoke any permits held by the violator, including any permits to sell tobacco
products in Yarmouth.
8. Before suspending or revoking any permit issued by the Board, including a permit to sell
tobacco products, the Board shall provide notice ofthe intent to suspend or revoke such
permit, which notice shall contain the reasons therefor and shall establish a time and date for
a hearing, to be held no earlier than seven (7) days from the date of the notice. The permit
holder or their designee shall have the opportunity to be heard and shall be notified of the
Board's decision and the reasons therefore in writing. Ifafter hearing, the Board funds that
violation of this regulation occurred, the Board shall suspend or revoke the subject permit.
For purposes ofsuch suspensions or revocations, the Board shall make the determination
i.
11.
notwithstanding any separate criminal or non-criminal proceedings conceming the same
offense. Upon suspension or revocation ofa permit, a1l permitted products must be removed
{iom the retail establishment. Failure to remove such products shall constitute a separate
violation of this regulation.
9. Failure to comply with the terms of a permit suspension imposed pursuant to this regulation
may subject the permit holder to an additional suspension ofall Board-issued permits for
thirty (30) consecutive business days.
F. Severability:
Ifany provision of this regulation is declared invalid or unenforceable, all other provisions shall
not be affected thereby but shall be in full force and effect.
Date approved by Town ofYarmouth Board of Health -
Hillard Boskey, M.D.
Chairman
Mary Craig
Vice Chair
Charles T. Holway
Clerk
Laurance Venezia DVM
4
Eric Weston
Io
TOWN OF YARMOUTH
II46 ROUTE 28, SOUTHYARMOUTH, MASSACHUSETTS 02664.24451
Telephone (508) 398-2231, ext. l24l
Fax (508) 760-3472
Health
Division
BOARD OF HEALTH MEETING MINUTES
1146 Route 28, South Yarmouth
December 15, 2025
Board Members Present: Hillard Boskey, M.D., Laurance Venezia DVM, Mary Craig, Eric Weston
Absent: Charles T. Holway
Others Present: Barry Lewis, Assistant Health Director, Riley Niederberger, Division Assistant
l. Call to Order
The meeting was called to order at 5:00 p.m.
2. Declaration of a Quorum
Quorum Present
3, Public Comment
None.
4. Variance - Yarmouth Wastewrter Pumping Station 280 Route 28
Yarmouth Wastewater Project is seeking variance for the temporary relocation ofthe leaching field at 280
Route 28. Michael Guidice of CDM Smith attended the meeting as a representative of the Comprehensive
Wastewater Management Plan (CWMP). A Phase 1 wastewater pumping station is proposed to be
constructed at 280 Roule 28, the site of Bellew Tile & Marble, within the limits ofthe leaching field for the
parcel. To facilitate construction ofthe Town's pumping station, the leachhg field will need to be
permanently taken out of service. To provide ternporary service to the building during construction, the
Town is proposing to install a temporary six hundred (600) gallon leach pit adjacent to the pumping station
site. The existing pressure pipe from the building's pump chamber will be connected to the leach pit to
provide service to the building's one (l) bathroom for approximately one (1) to one and a half(1.5) years.
Once construction of the pumping station is completed the building will be connected to the pumping
station, which will provide permanent sewer service for the property. The building has limited employees,
and Barry stated a leaching pit will be sufficient for the average flow ofthe system.
Motion: Mary Craig moved to approve the variances requested at 280 Route 28, West Yarmouth, MA
02673.
Second: Laurance Venezia
All in favor
5. Kratom - Discussion
Recently the Town of Boume passed a new regulation restricting the sale and distribution of synthetically
derived cannabinoids and Kratom. The Board discussed concem for safety, proper testing, and quality
control ofproducts marketed as Kratom that may be hybrid or synthetic products.
Board of
Health
I
Mary would like the Board to review options to possibly amend a Synthetic Cannabinoid Regulation to
include a Kratom and 7-OH section. Hillard noted he is unaware ofany medical research that proves if
Narcan is effective for a Kratom overdose. The Board will review further research on surrounding
municipal regulations and educational materials. This item will be discussed at the next meeting.
No action required by the Board at this time
6. Review & Approve of Minutes
Motion: Laurance Venezia moved to approve the December l, 2025 minutes as written
Second: Mary Craig
All in favor
7. NedOld Business
The Health Department hosted a successful giving initiative thmugh the Yarmouth Holiday Giving Tree,
the community donated gifts for thirty-five (35) local shrdents and one (1) family. All gifts will be
delivered to the schools before the holiday break. The Health Department and Board showed their
appreciation for all who participated and thanked Sara, Debra, and fuley ofthe Health Department for
supporting the event.
Friday, January 23,2026, from 10:30 a.m. to 3:00 p.m. at the Lorusso Lodge at Flax Pond, the Health
Department in partnership with the American Red Cross invites the community to participate in a Blood
Drive in recognition of National Blood Donor Month. Walk-ins are welcome and appointments can be
scheduled through the American Red Cross website, "Find a Drive", and enter the sponsor code
YARMOUTHREC.
Friday, February 6,2026, from l:00p.m. 3:00p.m. at the Hearing Room, Town Hall l146Route28,
South Yarmouth the VNA will be providing a Fall fusk Assessment Clinic. Spaces are limited, to register
contact \rNA Public Health and Wellness at 508-957-7423.
Hillard announced there are currently one thousand nine hundred ( I ,900) reported cases of Measles in the
U.S. Hillard urged the community to speak with their healthcare providers ifthey have concems about
vaccinations for their childron and emphasized the dangers of Hepatitis B as carriers can be asymptomatic,
but ultimately complications of Hepatitis B can include liver infection, liver cancer, or liver failure.
Larry spoke from his years of Veterinarian experience, observing the impact ofvaccinations clinically
reducing incidence of several diseases.
Mary recommended that the community review information on mass.gov and speak with their healthcare
providers ifthey have public health or medical concems.
Next Meeting: January 5,2026
8. Adjournment 5:53
Motion: Laurance Venezia
Second: Eric Weston
All in favor
2
YARMOUTH BOARD OF HEALTH
REGULATION PROHIBITING THE SALE OF SYNTHETIC PSYCHOACTIVE
SUBSTANCES
Date of Publication: FEBRUARY 2, 2017
A. Statement of Purpose
WHEREAS, it has been reported by various agencies that synthetic psychoactive substances
including cannabinoids, cathinones, stimulants, depressants, opioids and hallucinogens have
been linked to serious physical effects resulting in hospitalization and death when ingested,
inhaled or otherwise introduced into the human body. These substances pose health, safety and
welfare issues for the residents of Yarmouth.
B. Authority
This regulation is promulgated pursuant to the authority granted to the Yarmouth Board of
Health by Massachusetts General Laws, Chapter 111, Section 31 that “Boards of Health may
make reasonable health regulations.”
C. Definitions
As used in this regulation, the following terms shall have the meaning ascribed to them below:
Synthetic: A substance made by chemical synthesis, the production of chemical compounds by
reaction from simpler materials.
Person: An individual, corporation, partnership, wholesaler, retailer or a licensed or unlicensed
business.
Consumed: Introduced into the human body by any manner including, but not limited to,
inhalation, ingestion or injection.
D. Prohibited Activities
1. No person shall sell, offer to sell, distribute, gift or publicly display for sale any synthetic
psychoactive substances, including, but not limited to, synthetic cannabinoids, cathinones,
stimulants, depressants, opioids and hallucinogens that has been chemically treated and are
possessed, sold or purchased with the intent that despite any labeling to the contrary, said
substances will be consumed by humans for the purpose of intoxication, which if consumed may
induce effect or effects of intoxication similar to a controlled substance or imitation controlled
substance, that include but not limited to:
Page 1 of 3
elation, euphoria, dizziness, impaired judgement, excitement, irrational behavior, exhilaration,
paralysis, stupefaction, dulling of the senses or nervous system, weakness, tremors,
sleeplessness, feelings of relaxation, disorientation, muscle spasms, confusion, loss of
coordination, hallucinations and changes in sensory perceptions (including sight, smell, sound,
shapes, touch, time and body image) feeling of detachment from self and environment, memory
loss, psychological distress (including feeling of extreme panic, agitation, fear, anxiety, paranoia,
invulnerability, exaggerated strength and aggression), physical distress including extreme
changes in heart rate, respiration and body temperature.
2. This regulation shall apply regardless of whether the substance is marketed for the
purpose of being smoked, ingested or injected, and is marked “Not for Human Consumption.”
E. Penalty for Violation
Any person violating these provisions will be ordered to appear before the Board of Health at a
public hearing. If a violation is found to have occurred, the Board of Health may impose the
following penalties to be paid within ten (10) days or as otherwise determined by the Board of
Health:
(1) In the case of a first violation, a fine of three hundred dollars ($300.00).
(2) In the case of a second violation, a fine of five hundred dollars ($500.00) and
loss of tobacco license for seven (7) days.
(3) In the case of a third violation, a fine of one thousand dollars ($1,000.00) and
loss of tobacco license for thirty (30) days.
(4) In the case of any violation, the Board may suspend or revoke the tobacco permit
or any other permit or license issued by the Board of Health and held by the
violator.
F. Enforcement
(1) Enforcement of this regulation shall be by the Yarmouth Health Department or its
designee, including the Yarmouth Police Department.
(2) This regulation may be enforced by filing a criminal complaint in the District
Court.
(3) Any resident who desires to register a complaint pursuant to the regulation may
do so by contacting the Yarmouth Board of Health or its designee and the Board
shall investigate.
(4) All substances, found in plain view, being used in violation of this regulation will
be seized, transferred to the Yarmouth Police Department and held until final
adjudication whereupon they will be destroyed by the Yarmouth Police
Department in accordance with its procedures.
Page 2 of 3
G. Severability
If any provision of this regulation is declared invalid or unenforceable, the other
provisions shall not be effected thereby but shall continue in full force and effect.
H. Effective Date
This regulation shall take effect immediately upon publication of a summary in a
newspaper of general circulation in the Town of Yarmouth, which date shall be posted on
the front page of this regulation.
Adopted______JANUARY 23, 2017__________
Effective______FEBRUARY 2, 2017_________
YARMOUTH BOARD OF HEALTH
___________________________________ ____________________________________
Hillard Boskey, Chair Tanya Daigneault
___________________________________ ____________________________________
Mary Craig, Vice Chair Charles Holway
___________________________________
Debra Bruinooge
Page 3 of 3
I IIB BOSTON GLO
TI'ESDAY, DECEMBER 9, IOII
By trsttrerine GergeD Barnett
Ey\lacctonfngthmu& a dsk-bas€d sEat€gr, the
medical establishmeEt was missiDg pmt€ction of
lage nunbeJs ofinfrtrts stil at risk and hAsfitis B
vss lD&cting f6,000 dil&€n unaler agE l0 annualS
C€06 b s{cl€nilg aDd d€tection occ1lrred fur iDftot
bortr to $omen who bad inadeqoate sccess to pltnt
tal car€ 8trd scrr€uitr& whce trrb vere done in s
viuilowb€fole inftdiotr, or\tro xlExt @os€dto
hcpditis B yiros iD the flst yEar of lifu fton s€€mint
V inno.los hous€hold itams slch as toothbrurh€8
or Dsil dippr$ duDtoowitrsbiuftded people. S
the Uded Stes adopteat utriy€sal raccination tur
@itis B of nadoms in 1991, an estiEded
6m,00o cLiLlhood i*rtions ard 9o,l0o dildhood
deafns heebem pt€vrtrtld, analttre t"tes ofHBViD
ftctiosE itr diHteo aod teens hrve plonneteat by 9!
PEc€[t
B&ies bom in Massad$€trs wfl trot),Etbe d-
ftctrdb'ytle newCDCrEcoEm€ndstiou. Massar,hu.
sdts a l six oth€f, Norheast states will coDtinue to
recmnend tbat ercry ctrild receive rhe raocination I
birth" Emtr, as my colleagues anil I lnowall too
wdl,poorhfolmdioDalo€sDotstop8tst8tebod€rtl.
the msnriDg confirsiotr al(utrdtle HBv\accim
for iffiats witl inevitably (l€ste neiy gnps in protec-
tlo& allowingtor risinglal€s of inftdotrs. Public
health eryerts mil physiciars have a responsib ityb
our pcimts anal comm!.nities to help Suide people
tbrmd this oonfirsiotr. But we can[ot do it alone. B$
eryoue has 8 qitical mle to pl8y,
ltere are s€ryeral lcy el€m€nts to this patu€rshtt
! Co[ve$atioDs about vaccination cannot be
rushed Proyid€m must resist the alrive towad €6-
ciency in metlical visits and take the time to list€n
wittr Esp€ct and wittroutjudgEment to pdi€nts' co
cems a[d ftaIs qf vaEciDatiotr, I€cogtriziDg that the*
ftars are tuiv€n by love and wantitrg ttre H br ther
idtrts. At ev€ry mdical encountsr, plvvidets have
an opporhrnity to build sbard h€alth Soals with por:
ti€nts.I Hieuts a l ftmilies, iD tuIn" tre€d to come
r€ady to share t}€h conc€ros and questions rtrile bd
ing opm to infurmatiotr about the dsks of h€pstitis t
anal the ben€fts ofthe \accine for infalts aDd ttre
commuDitlat It{rst€d commudty yoices 8re qfical itr tb,s
rodl Connecting to trust€d messeugers wtere peo.
ple e8r, l€artr, Dr.y, rcceive haircue, aud puciase
bealtyproducb is esotial {or ketpins cc,DmudtiJ
heaftry.
I We must allos.for the power of stodes. People
wi6e livB hsve b€.n up€Dded Dy chroEic hrDarif8
4 reho Aoe not only fre medical consequcnoes oftl*
itrdion h also the attactred stigD& areb€giDniql
to sp€ak out. Th6e Yoic€s Eatl€r.
'We camd &rd to lose tblle d€cad€s of FDllc
healttr advarces. The sl(s of h@itis B ale tm gIeA
We hsve the m€dicol aDd pub.lic h€alth tools, but it
wil take all of us to Eot€ct newboms aud fuure gdr
adiotrs.
BE
i_]_
CDC's hepatitis B
reversal puts
neuiborns
back at rfuk
Dt Kdl@rin ceryatblte* awciaopqwrS
fwau rnauriru d Bo&an t@ Ototuno&
Ao&tia,. gwl oI Md{tt,E, rrie clwir d prbnuy.
ffivitpt.r,orion &fratsvmdbt a nom Aelldfui, @d @rrwurtiDrdji{/lB 7"Aoro a nAtoy Aui@Mtra
tiou
couDsel mypdimts on dozms of itens otr howto
k@ theDselv€s atrd their babies uft and healtty, itl.
cluding avoialiDg e[viroDD€ntal @osul€s sud as !t
t'eneheat, the dsl(s ofertain foods atrd medic&-
tions, and the impad ofgestational tliabetrs, hyper.
tension, anil mrtemal depEssion" In my tsD decaildl
ofmedical Eactice, I hsve not encouutercd questiotd
or ftar about the rcutine use ofttre hepatitis B vims
yaccirc at bii}. This is about to dange.
IatH€elqttreC€ ers for Dis€ase Contol atrd
Hepatitis B is a viral infection
that attacks the liver, causing
both acute and chronicliver
disease.
PI€yetrdon's advisory panel yotld to dlop the mutifl
annint<E tion oftle HBV iacciDe to all idasts. TE
r€comm€trddion com)ds ole ofttre g€destpubl,
b€atb vidori€s oftte past 30 yea$.
H@tr'tis B is s virsl inftctior thd atrad(s the lirtt,
csusmg both a.rIte and cbmuic liyer disease. Whfle
hepatitis B can betanmitted ftom the bLthiDg pon
€nt (hown as ?diratal tznsnision"), infrub cad
also conrnai h€pdtis B ftom cargivers, housrholil
cotrtacts with hc,s,tr or utrloo$m hepaftis B iDftc-
tiou, orfrom surhces anal obje* conhrin*edwitt
blmd containing hQatitis B vinrs (knowu as .hori-
zonhl taosmisdoD"). lDout 90 percent ofhfants
$,ho are itrected witt HBV delelop chrcnic HEVinr
ftctioa an ctften ikrasuing and iDcrrable dis€sse
that l€ads to iuc'r,eased risks ofcirhosis, livq camef
atrd prematue de8rh. Irp to a quarttr of p€ople iD-
ftdeal dbirttr wil die pnmaurelyfrom ttre rliseasa
The EBvvscdm was first apFoved bythe Food
anitDrwAdministation iu 1981 and wasinitially .
oDlyartrninirt€Fd to loou! hig[-risk populatioru,
inelualing n€M,bom iDf8trts bom to HBv-positi,e
moftrels. Howev€r, ntes ofviral infections werc sbtr
inqeosing, induding thoussndE r,*oo,16o had
trot contacted h€patitis B atlir&.
s afimt medicine pfrSnicia& I bave *
pri@e of caring for pdimts filom thl
eadiest drys of pregDaDcy contampla-
tbmugh prcgnanry and pGtpaftta
nentom care In this oitical timdi I