The heat has claimed nine lives already in Missouri this year, and the soaring temperatures aren’t expected to let up for another few days. The Department of Health has some advice on staying cool, and staying safe.

Lori Franklin-Harris, an epidemiologist with the Department of Health, says to keep a close eye on the very old and the very young. The elderly might suffer circulatory problems that make them unaware of how hot they’re getting … children often don’t spot the warning signs either. Both tend to become dehydrated more easily.

She says to stay in air conditioning, and if you don’t have it in your home, visit stores and public places that do during the heat of the day.

Heat indexes are in the triple digits and Harris-Franklin says there are two separate illnesses to watch for in these conditions: heat exhaustion and heat stroke. (Click to see symptoms, etc.)

She says those suffering from heat exhaustion need to rest in a cool place, loosen clothing, cool down with wet towels or a cool shower and drink non-alcoholic and caffeine free beverages to rehydrate. If you suspect heat stroke, call an ambulance.

Heat stroke is when the sweating stops, skin turns red and is hot to the touch and the heart rate becomes rapid. Often the headaches will intensify and vomiting and unconciousness can follow.

The department reports 11 Missourians died from heat-related causes last year, and there have been nine deaths already this year. Seven of those deaths occurred in the St. Louis and Kansas City metro areas, but two of them were children who were accidentally locked in an unattended car in Southern Missouri.

Harris-Franklin says while the very young, the elderly and the chronically ill are at greatest risk of heat-related illness, summer temperatures can take a toll on healthy young and middle-aged adults, too, she says.

Of the 11 Missourians who died from heat-related causes last year, eight were 25 to 64 years of age. Only three were age 65 or older.

The elderly and the chronically ill perspire less and are more likely to be taking medication that can impair the body’s response to heat or that make them more sensitive to the heat.

Those medications include antihistamines, over-the-counter sleeping pills, antidepressants, heart drugs, antipsychotics, major tranquilizers and some medications for Parkinson’s disease. People should check with their doctor or pharmacist to find out if their medications make them more sensitive to summer’s high temperatures.

Seniors citizens on fixed incomes often do not have air conditioning or feel they cannot afford the extra expense of running it. Since many seniors live alone, Missourians should check on elderly family members and neighbors regularly to be sure they are not suffering from the effects of the heat.

Missourians can call the state’s toll-free abuse and neglect hotline at 1-800-392-0210 to report senior citizens or adults with disabilities suffering from the heat and needing assistance. The hotline operates 8 a.m. to 8 p.m. seven days a week.

Young children are also sensitive to heat and must rely on adults to regulate their environments to prevent heat-related illness.

Infants and children should not be left unattended in hot environments, especially in cars, even with the air conditioner running. A car’s interior can reach oven-like temperatures in minutes, putting anyone inside at risk of overheating. Children also should not be allowed to play in or around cars. Small children can become trapped because they are not big enough to open the door or roll down the window to get out. They also can fall asleep inside a hot vehicle or play or hide in the trunk of a car.

Children also can become dehydrated very quickly. Small children often do not drink as much liquid as they should and can become dehydrated. Adults need to encourage children to drink plenty of fluids every day.

View the Health Department’s site on hyperthermia and heat precaustions.

Locate a cooling center near you where seniors and other people at risk of heat related illness can go to cool down.

Missouri is the only state that conducts on-going statewide surveillance for hot weather-related illnesses and deaths. Health care providers are required to report cases of hyperthermia to the Missouri Department of Health and Senior Services.

An excessive heat warning is in effect for Missouri until Thursday night, and authorities are reminding people about the dangers of the heat.

The Missouri Department of Transportation is helping the Children’s Trust Fund spread the word at rest stops throughout the state with its “Not even for a minute” campaign.

Officials say the interior of a car left in the sun can reach 140 degrees or more when temperatures are this high.

MODOT has placed posters supporting the public-awareness campaign in its 28 rest area locations in Missouri. The campaign encourages parents and caregivers not to leave children alone in or around vehicles. Left alone in a vehicle, even for a short time, a child is in danger of dehydration, injury, abduction or death. This important message will also scroll across approximately 66 electronic message boards along Interstates 70, 44, 55, 29 and 35 and on U.S. Route 60, through the end of August.

According to Safe Kids USA, from 1998 to 2009, 443 children died from heat stroke while unattended in a car, and 88 percent of children who die from heat stroke are ages three and younger.

“Keeping Missourians safe is our top priority, and we are pleased to help the Children’s Trust Fund remind folks never to leave children alone in or around cars,” said MODOT Interim Director Kevin Keith. “We estimate almost 20 million people visit our rest areas every year so they are certainly prime locations to convey this important message.”

“We’re reaching them in the vehicles they’re traveling in,” added MoDOT Community Relations Manager Sally Oxenhandler. “A lot of travelers will probably stop at our rest areas along the way, and those are prime locations, the message boards and the rest areas, where we can get out this important message not to leave children unattended in vehicles.”

“It’s a car accident you can prevent”:

— Never leave children unattended in or around an automobile.

— Teach your children the dangers of a car and let them know it is not a toy or playground.

— Keep car doors and trunks locked so children cannot play in them. Keep keys and remote entry keyfobs out of children’s reach. Kids may be able to use a remote entry keyfob to unlock a car from inside a house leaving an unlocked car for others to enter.

— Make your child as visible as possible. Place rear-facing car seats in the middle of the back seat.

— Establish a routine of checking the back seat every time you exit the car to ensure no one is left behind. Do not overlook sleeping infants.

— Try to plan ahead when you have errands. Run errands when your spouse, trusted neighbor or friend can watch your child.

— Remember to use the drive-through convenience provided by banks, dry cleaners, pharmacies, restaurants and other businesses.

— Use your debit or credit card at the gas pump.

— Place your cell phone, PDA, purse, briefcase, gym bag, or lunch bag on the floor in front of your child’s car seat to give you an additional reason to check the back seat. Be sure it is something that you always carry with you.

— Set your cell phone or your daily calendar in Outlook at the same time each day to remind you that the baby should have been dropped off at daycare. Many tragedies have happened as the caregiver drove on to work instead of stopping at daycare.

— Keep a special toy in your child’s empty car seat when the child is not with you. Bring that toy to the front seat when the child is in the car seat to serve as a constant, visible reminder of your child’s presence in the car.

— Call 911 if you see children unattended in a car. The first responders tell us they would rather have those calls so they can determine if the child is at risk than have the emergency call later when a child is in deep trouble.

— When a child is missing, check vehicles and trunks immediately.