Minnesota Responds Needs You

If pandemic influenza occurred in West Central Minnesota, would you volunteer to help set up a mass dispensing site?

If a terroristic anthrax attack happened in our community, would you volunteer to help get pills into people within 48 hours?

If a tornado destroyed a neighboring community, would you volunteer to help set up temporary shelter to assist the victims?

If the same tornado displaced pets, would you volunteer to help keep the animals safe until returned to their families?

If you said yes to even one of the four questions…….you are the right person to become a Minnesota Responds Volunteer. MnResponds is a partnership integrating local, regional and statewide volunteers to assist Public Health in emergent incidents, community health events and exercises. MnResponds is part of the nationwide Medical Reserve Corps.

Your community needs you. Volunteers are valuable in many types of emergency responses. Registered and pre-trained volunteers are even more valuable.

When an incident occurs, time is often of the essence. If you are a registered volunteer your skills can be quickly matched up with the work that needs to be done. Pre-registration in MnResponds increases efficiency and volunteers have access to training courses before they are needed. Volunteers are notified when needed. You are not obligated to respond.

All types of people and skills are needed: non-medical people from all walks of life, nursing, healthcare, laboratory, veterinary, behavioral and mental health, office support, clergy and health education to name a few.

Being a volunteer can gain you personal satisfaction, make a difference in your community and prepare you for deployment.

Please consider becoming a MnResponds volunteer. Check it out and enroll at www.mnresponds.org or you can call Stevens Traverse Grant Public Health for more information at 320-208-6670.
Thank you from your
Public Health Preparedness Coordinator

It’s never too early to think immunizations for your baby. Pregnancy is a great time to learn about the vaccines your baby will need. Educate yourself about shots before the excitement of having a new baby.
There is a list of trusted sources at the end of this article.

The diseases vaccines protect against are very real and can be devastating. We’ve done such a good job of vaccinating children in the past that once-common diseases are seldom seen in the United States. So, it’s understandable that some parents may not have heard of some of the vaccines or the serious diseases they prevent. In fact, some doctors have never seen some of the diseases that vaccines prevent. And yet, many of those diseases are just a plane ride away.

An excellent place to start: Immunize Mom to Immunize Baby. There are certain vaccines pregnant women can get to help keep them healthy. The maternal antibodies passed to babies protect them until they are old enough to get vaccinated. Two vaccines pregnant women should always get are whooping cough (pertussis) and influenza. Getting Tdap (tetanus, diphtheria, pertussis) vaccine during (every) pregnancy makes it less likely a woman will have whooping cough during the time when her baby is most at risk, which is the first new months. 90% of whooping cough deaths are in infants younger than four months. Babies of women who received the flu vaccine during pregnancy are more likely to be born full-term and at a healthy weight. Once a child is old enough to be vaccinated (2 months), it is important to follow the recommended immunization schedule to continue that protection.

Parents need to vaccinate on time, every time. Delaying or skipping immunizations puts children at risk for serious disease. Vaccines are thoroughly tested before they can be recommended and used. They are continually monitored by doctors, researchers and public health officials after licensed and in use. Vaccine manufacturers have refined the process of making vaccine, which means that even though babies get more vaccines today, they actually get fewer antigens than they did decades ago.

Infants are exposed to thousands of germs every day. The antigens in vaccines are just a drop in the bucket compared to what their bodies handle on a daily basis. Some babies may experience side effects of a healthy immune response, such as low-grade fever or fussiness, but vaccines do not cause the severe illness of the disease itself. Severe side effects are extremely rare and study after study conducted over the past ten years has shown that vaccines do not cause autism.

Here are six excellent sources for more information regarding vaccines for pregnant women, infants and children. (Don’t forget teens and adults need vaccinations too.)
*American Academy of Pediatrics: www.aap.org
*Centers for Disease Control and Prevention: www.cdc.gov/vaccines
*Every Child By Two: www.vaccinateyourbaby.org
*National Network for Immunization Information: www.nnii.org
*Vaccine Education Center: www.vaccine.chop.edu
*Immunization Action Coalition: www.vaccineinformation.org

The Minnesota Vaccine for Children program has free vaccine for infants and children, if families qualify. Call Public Health at 320-208-6670, or your clinic, to get more information about vaccines and to see if your child qualifies for MnVFC.

Marcia Schroeder RN
Disease Prevention and Control
Stevens Traverse Grant Public Health

National Infant Immunization Week is April 20-27, 2013. “Immunization. Power to Portect.”

Meet Norovirus – The Perfect Infection
As Sheila’s “guest author” today, let me introduce myself. I’m Nora, officially known as norovirus. People sometimes mislabel me as stomach flu – a pet peeve; and I’m not even related to influenza! If you can’t remember my name, at least call me “acute gastroenteritis”, meaning a heck of a lot of vomiting, diarrhea, and abdominal cramping – my specialty. I’m here today to tell you why I’m the best darned virus that ever lived –from my perspective at least, although maybe not from yours!

Norovirus – the Perfect Design
Let me describe myself. I’m slim and trim at only 30 nanometers (0.03 microns) – svelte even for a virus. Influenza is three times my size! Compared to chunky bacteria like E coli at 1500 nanometers – well, I’m truly microscopic. My physique allows me to slip right through just about any water filtration system out there (only nanofiltration systems block me). Once in your water supply, filters rarely get me out!
I keep my figure because I lack a lipid envelope (lipids are fat, don’t you know?). Without lipids, alcohol based sanitizers and detergents don’t faze me. My peers in the germ family have tricked humans into believing that hand sanitizers replace hand washing. Well, hand sanitize all you want. I only worry when I see a sink and soap coming at me– they mean a long damp trip down the drain! But even then, I often sneak by. 80% of people report washing their hands according to recommendations (at least 20 seconds, all hand surfaces, good lather, and friction from rubbing – the stuff that gets rid of me), but hidden camera studies show only 18% actually do this. Good for me, but not for you!
Did I mention I’m tough? My job skills include high endurance and patience. I contentedly hang out on surfaces for weeks or longer, just waiting for a sucker to come along. Some of my favorite resting spots include anything in the bathroom, doorknobs, soiled linens, counter tops food, and food containers. When I spot a chance, I grab a hand, transfer to a mouth, and voilà – target reached!
I have very few mortal enemies. One is boiling water, and the other is bleach, but even then I put up a good fight. You’ll need 5-25 tablespoons of household bleach per gallon of water (5.25%) to kill me on a surface – even more if the solution sits around for more than a day. No wimpy bleach solutions can take me down! People target me with special bleach based cleaners as well, which seems silly. I freely confess that household bleach kills me, so why spend a bunch of money on something that might not work as well? Oh well – that’s capitalism for you!

Noroviruses are great team players. We’re good at infection; we infiltrate and make you sick with a team of only 10-100 viruses. Our methods are top-secret – in fact, no one has figured out how to grow us in a lab for study. I will reveal that we head for your gut and wreak havoc. First of all, we replicate, replicate, and replicate. In 12-48 hours, we make billions of copies of ourselves – no exaggeration! Then we party hardy. Noro, Norah, Norman, Norma, Noreen, Norris, Norbert, Northcliff (he’s visiting from Australia), and I literally bring you to your knees.
We convince your stomach and intestinal cells to dump large amounts of fluid into your gut, then trigger violent diarrhea and vomiting to get rid of it. We speed up passage from below, while simultaneously slowing down stomach emptying. You accumulate a nauseating volume of fluids and food before spewing out your mouth. It’s all pretty uncomfortable, but hang in there! At least we don’t cause much fever or respiratory symptoms.
Why this torture? It’s just a norovirus plot to take over the world. We dump billions of copies into your emesis and feces. When you “expel”, you help spread our copies around. The more violent your diarrhea or barfing, the more you splatter us around the bathroom (or wherever you may be). We have a special talent in creating small droplets of air bound vomit and virus, which travel quite a ways before settling on a new surface.
One recent success was a girls’ soccer team. While travelling, one girl got sick, was quickly isolated, and then sent home. A few days later, her teammates became ill, although they had no contact with her. Magical, you might say! Actually, there was a bag of snacks in her bathroom. Our aerosolized vomit contaminated the bag, and then just waited until the other girls had a snack attack a few days later.

Norovirus – a Considerate Virus
We try not to make you too sick. If we kill off our victims, who will pass us around? We make you miserable for 24-48 hours, and then move on. We don’t choose our targets – we attack whoever ingests us. Unfortunately, this can mean young children, elderly, or the chronically ill. They can’t handle fluid loss and sometimes need intravenous fluids. But give us credit –we kill very few compared to many viruses! 20% of you actually resist us, although the credit lies in your genetic code. The others can’t keep up with our mastery of disguises (rapid mutations and multiple variations). We infect you again and again.

Norovirus – Our Favorite People
I love people who refuse to stay home when sick. They voluntarily transport my viral team around restaurants, nursing facilities, hospitals, cruise ships, and schools. One sick kid in school (maybe mom lacks child care?) can infect everyone – kids are usually not very clean. A sick food handler can pass us to everyone eating there. Currently, we cause over 50% of food-borne illness in the United States. Pretty good for such a tiny thing – don’t you agree?
I love nurses and aides that spread us around facilities. Dedicated healthcare workers rarely stay home even when throwing up, let alone for 2-3 days after symptoms resolve. Our master plan includes sticking with victims several days after they feel better, just to continue shedding virus with every bathroom trip – pretty clever, eh? If they slack off on hand washing when symptoms improve, we still spread! Sick patients and sick caregivers happily transfer us from room to room. We sickened 265 healthcare workers in just one hospital in 2004.

Norovirus Loves Disasters
I love disasters. Crowded shelters are like Candy Land – everyone living only a few feet apart and sharing limited bathrooms (if they even make it to the bathroom). Hand washing drops off the map midst the worries and cares – and people touch everything! In a mega shelter complex after Hurricane Katrina, we sickened 11,000 victims in 11 days (maybe more – they counted only clinic patients). A textbook example of person to person transmission!
Disasters provide us great access to your food. Cooking kills us, but we love hitching rides on fresh produce, shellfish, and ready-to-eat food. Communal kitchens and food distribution centers can distribute us as well – directly from food to your mouth. Just one volunteer with poor hygiene or sloppy cleaning allows food borne transmission – another favorite strategy!
Contaminated water provides another disaster hang-out. With sanitation off-line, people turn to things like plastic bag and bucket toilets or home-made latrines in the yard. We sneak from sewage disposal to near-by water sources, particularly if flood waters or rains help us along. Once in your water, boiling is the only way to kill us. Filters, disinfectants, and solar disinfection (SODIS) – not effective! Plus, if you rinse produce or dishes with infected water – we’re back on your food – a double whammy! (Side note – did you know we survive in ice cubes? Just another example of our superiority!

Norovirus – Keeping Me Away

If you don’t want to party with us, what can you do? Wash your hands – especially after using the toilet or changing diapers, and always before eating or preparing food. Do it right – hum Happy Birthday, Twinkle Twinkle, or another favorite ditty while scrubbing soap on every hand surface. Don’t touch the faucet or doorknob after washing – I’m waiting to jump back on. Keep a paper towel handy for those things. Hand sanitizers are better than nothing (at least you’ll kill some other germ buddies), but choose soap and water when possible. Always rinse fresh produce – who knows what it was irrigated with?

Norovirus – When You Are Sick
Despite your best efforts, I’ll still get you sooner or later. I’m pretty clever, and all it takes is one careless food preparer. Just keep the fluids up and you’ll be better soon. Young kids get screwed up chemistry with fluid loss, so give them oral rehydration fluids like Pedialyte when available. For adults, the type of fluid doesn’t matter as much – just avoid caffeine, alcohol, and sugary things which make diarrhea worse. Watch for signs of dehydration, like dizziness when standing, dry mouth, and decreased urination. Get thee to a doctor if these occur! I don’t want to kill you. It’s best to avoid medications for diarrhea or nausea unless prescribed by the doctor.
When sick, the best way to block my plan for world domination is isolation. Stick to one bathroom and one bed. Don’t share anything. Wash hands after every bathroom visit, and immediately disinfect contaminated surfaces with strong bleach solutions. Soiled clothing and linens should be washed immediately with detergent, using the longest cycle length and hottest water possible, followed by machine drying – remember, I’m a tough little bug. Wear gloves, and don’t agitate clothes (meaning don’t shake or throw them around, as opposed to getting them upset). This keeps me from flying around the room. When feeling better, go on a bleach cleaning spree.
Keep away from food preparation while sick and for several days afterwards. Don’t be a conscientious employee. Stay home a few more days and let others struggle without you (and me). Productivity will be higher with one sick employee than with many. Attention employers: paid sick days save you money in the long run if it keeps me from getting a foothold in your business!

Norovirus – Preventing Disaster Epidemics
In a disaster setting, drink only boiled or bottled water during diarrhea outbreaks. Use boiled water for hand washing, food preparation, and dish washing. Keep several bottles of bleach in your emergency stores for decontaminating surfaces touched by outsiders (or sick insiders). Try to avoid areas where others congregate during outbreaks.
For disaster workers or volunteers, your personal hygiene can make or break it for literally thousands. Wash your hands frequently. Don’t work during or for several days after diarrheal illness. No one is indispensable enough to warrant spreading my noros around a disaster scene. In shelters, health facilities, and food/water preparation or distribution areas, learn and practice procedures for controlling disease transmission. Shelters should have plans to isolate infected patients with separate sleeping areas and toilets. If written procedures aren’t available, listen for alarm bells in your head – this may not be a safe setting for disaster victims or for you, although my virus compatriots and I will love it.
Have I convinced you that norovirus is the perfect virus – nearly indestructible with a well thought out plan for conquering the world? Watch for us – we’ll be coming to hands near you soon!

Stay safe,
Sheila Sund, M.D.

Local Note: If you are not covered by one or more of the recommended vaccines mentioned below, please call Pubic Health. If your insurance will not cover the cost, the Minnesota Department of Health “Un and Underinsured Adult Vaccine program” may. Public Health has some vaccines for the cost of administration if you are eligible. Our Phone number is 320-208-6670.

(The following article was written by
Lisa Schnirring and posted Jan 29, 2013)

Coverage rates for recommended adult vaccines remain stubbornly low, except for modest gains in two: the tetanus diphtheria with pertussis vaccine (Tdap) and the human papillomavirus (HPV) vaccine in women. These are the new federal estimates.

The rates, from the US Centers for Disease Control and Prevention (CDC), covers six vaccines routinely targeted to certain adult groups and excludes the influenza vaccine, which was reported on earlier. The agency’s latest adult vaccination report compares 2011 coverage levels with those seen during 2010.

Howard Koh, MD, MPH, assistant secretary for health at the Department of Health and Human Services (HHS), said during a media telebriefing today that many adults have heeded recommendations this season to be immunized against flu, but he said health officials want to make sure adults are aware of other vaccines they should be getting, as well.

The adult immunization report covers Tdap, pneumococcal, hepatitis A, hepatitis B, HPV, and herpes zoster. “Far too few adults are vaccinated against these important diseases,” he said, adding that decreasing the burden of the diseases is critical to the health of the country.

He also said the CDC’s analysis detected racial disparities in adult vaccinations, with whites having higher levels than other groups.

Koh said healthcare reform measures offer support for adult vaccination by ensuring that there is no cost sharing for patients who get them through new group or private insurance plans. “We encourage all adults to talk to their doctors about what vaccines are appropriate for them,” he said.

In another effort to raise adult vaccination rates, Koh announced the release of a new tool called Adult Vaccine Finder, powered by HealthMap, a data source based at Boston Children’s Hospital. Koh said the tool is similar to the flu vaccine locator and can be found on the Vaccines.gov Web site.

Carolyn Bridges, MD, associate director for adult immunization with the CDC’s National Center for Immunization and Respiratory Diseases, said the results in today’s report are based on a 2011 National Health Interview Survey, a cross-sectional randomized in-person survey conducted by US Census Bureau workers.

Overall, Tdap coverage increased 4.3% from 2010 to 2011, pushing the coverage total to 12.5%, according to the report. Bridges pointed out that the coverage level for adults living with infants, who are too young to be vaccinated against pertussis, rose by 11% to 22%. The CDC has said that preliminary data suggest that in 2012 the United States had the highest number of pertussis cases in a single year since 1955.

Coverage for one or more dose of HPV vaccine in young women grew from 20.7% in 2010 to 29.5% in 2011, according to the CDC. However, the level in Hispanic women lagged.

For the other vaccines, which showed little growth, coverage level increases were: 1.6% for the pneumococcal vaccine, 1.8% for hepatitis A, 2.1% for hepatitis B, and 1.4% for herpes zoster.

“While we’re please to see increases, these numbers remain low overall, and racial disparities remain,” Bridges said.

Targets for three of the vaccines—pneumococcal, herpes zoster, and hepatitis B for healthcare workers—are included in the Healthy People 2020 report, and the coverage levels that the CDC is seeing for all of them are well below the goals, she said.

The lack of progress in herpes zoster vaccine coverage could relate to problems with supply of the vaccine, and health officials may see that number rise now that there are fewer difficulties with availability, Bridges said.

State agencies urge steps to stay safe at home over the holidays — and throughout the winter season
Minnesota Department Public Safety and Department of Health officials are urging Minnesotans to be aware of safety hazards in the home as they celebrate the holidays and settle in for the winter.
Fires, unsafe toys and carbon monoxide are among the biggest concerns this time of year, said Dr. Ed Ehlinger, Minnesota Commissioner of Health.
“The holiday season and the beginning of winter are a time for joy and celebration, but they also pose special risks,” Dr. Ehlinger said. “As people alter their normal routines for the holidays and begin spending more time indoors, they should take steps to protect themselves and their families.”
Fires
According to State Fire Marshal Jerry Rosendahl, 80 percent of the 56 fire deaths in Minnesota during 2011 occurred in the home – and residential fires occur most frequently during the holiday season. Last year, 166 home fires were reported between Dec. 24 and Jan. 1.
Every year, the leading causes of fires are cooking incidents, candles or other open flames, and heating problems. Careless smoking is the leading cause of fire deaths.
The State Fire Marshal offers these safety tips:
• Holiday Decorations: If you have a real tree, water it daily. Do not combine more than three light strings unless the product directions say you can. Do not overload electrical outlets. Keep wiring for lights hidden from children – it poses an injury risk, and may also contain lead.
• Candles: Place candles on a solid base, away from decorations and other flammable materials. Do not leave burning candles unattended, and keep them away from children. Consider using flameless (battery-powered) candles; they’re attractive, safe – even scented – and priced much like their wax counterparts.
• Heating and Fireplaces: Make sure your central heating system is clean and working properly. Use space heaters carefully – follow directions and keep them away from combustible materials. If you have a fireplace, keep the chimney clean and free of creosote. NEVER burn wrapping paper in your fireplace.
• Cooking: Stay on top of things when you cook! Never leave the stove unattended. Don’t try to cook if you’re sleepy, taking medications, using alcohol or otherwise impaired. Keep pressurized containers and flammable materials – including cleaning products – away from the stove. Keep your stovetop clean and free of grease. If you have a grease fire, DO NOT try to put it out with water; water will spread the flames. Don’t move the cooking vessel. Instead, smother the fire with a lid or cookie sheet and turn off the burner.
• Smoking: Quitting now will reduce long-term health risks and eliminate a serious fire hazard. Don’t smoke when you’re tired, on medication, using alcohol or otherwise impaired. When you finish a cigarette, put it out completely in an appropriate, stable container. Remember that the peat material in planters is flammable, and cigarettes deposited there may smolder until they start a fire.
Unsafe Toys
Last year, the U.S. Consumer Products Safety Commission (CPSC) issued 30 recalls of unsafe toys, and 15 have been issued to-date in 2012. In most cases, the potential risks were burns, choking or injuries, but exposure to lead or lead paint continues to be a possibility.
“It can be difficult to determine whether a toy poses a lead hazard,” said Randi Callahan, State Lead Case Monitor. “Older toys, home-made toys and toys with red or orange paint are more likely to contain lead; having toys tested is the best protection.”
Callahan encouraged people to take advantage of lead screening events scheduled for 1-3 p.m. Dec. 14 at Summit Academy, 935 Olson Memorial Highway, Minneapolis, and 11 a.m.-3 p.m. Dec. 18 at Fond du Lac Early Head Start, 41 University Road, Cloquet. The Sustainable Resources Center, Minneapolis, will be offering free testing of toys and other consumer products at both locations.
She also suggested checking the CPSC website for possible recalls at http://www.cpsc.gov/cgi-bin/prod.aspx.
Carbon Monoxide
Carbon monoxide (CO) problems tend to spike during the winter; in 2011, nearly one-third of incidents reported to Minnesota fire departments – 472 out of 1,732 – occurred in January and December.
These precautions will help protect you and people you live or work with from CO poisoning:
• All homes should have CO alarms and smoke detectors; both can be purchased at discount hardware and building supply stores.
• Have a qualified technician inspect your furnace and check fuel-burning appliances in the fall. Make sure all fuel-burning appliances are adequately vented and properly maintained.
• When using a fireplace, wood stove or space heater, provide adequate ventilation.
• Portable propane camping equipment and gas barbecues are approved for outdoor use only. They should never be used inside cabins, tents, fish houses, recreational vehicles or boats. Read labels on recreational appliances and follow manufacturers’ operating instructions.
• If your car is stuck in the snow, clear the tail pipe of snow before starting the engine. Keep it clear if you use the engine for heat. Watch for symptoms of carbon monoxide poisoning.
• During power outages, do not use gasoline engines or burn charcoal in enclosed spaces, including a garage, even if the door is open. Do not use gas stoves or ovens to heat living areas.
FOR MORE INFORMATION: Visit the Minnesota Department of Public Safety State Fire Marshal Division website at www.fire.state.mn.us or the Minnesota Department of Health Healthy Homes website at www.health.state.mn.us/divs/eh/homes.
Additional Information about Winter and Holiday Safety
• Holiday Structure Fire Incident Summary (statistics on fires during holidays):

https://dps.mn.gov/divisions/sfm/mfirs/Documents/HolidayFireIncidentSummary.pdf

• Smoke Alarm Safety at Home:

http://www.nfpa.org/assets/files/PDF/Research/SmokeAlarmsSafetyTips.pdf

• Carbon Monoxide Alarms:

https://dps.mn.gov/divisions/sfm/public-education/Documents/Home%20Fire%20Safety%20Information/CarbonMonoxideAlarmInfoSheet072909.pdf

• Holiday and Christmas Tree Fire Safety:

http://www.usfa.fema.gov/citizens/home_fire_prev/holiday-seasonal/holiday.shtm

• Candles:

http://www.nfpa.org/categoryList.asp?categoryID=638&URL=Research%20&%20Reports/Fact%20sheets/Home%20safety/Candle%20safety&cookie%5Ftest=1

• Fireplace and Home Fire Safety:

http://www.usfa.fema.gov/citizens/home_fire_prev/heating/fireplace.shtm

• Cooking Fire Safety:

http://www.usfa.fema.gov/citizens/home_fire_prev/cooking.shtm

Ole and Lena’s Christmas Dinner

Ole and Lena’s Christmas plans usually start with some great ideas but end up with them looking at each other with “what happened?” expressions. Recently they both joined Minnesota Responds so they could volunteer for public health emergencies. Since they have been working on their MN Responds volunteer online trainings, Ole and Lena decided to use the Incident Command System to manage Christmas. This would ensure the holiday had obtainable objectives, functional grouping of activities and avoid duplication of efforts (and hopefully not end with the dog stealing the day’s lutefisk.)

Lena took the role of the Incident Commander. She wants family and friends to gather on Christmas Day at noon on the homestead for lutefisk, lefse, krumkake and all the trimmings. Their family gift exchange is to be followed by games for the kids and plenty of recliners in the garage for the men-folk to watch the games. She set these goals the SMART way: specific, measureable, action oriented, realistic and time sensitive. And then she got on the horn and rallied the team.

First, she told Ole what was going to happen. He volunteered to be the Finance Section Chief and pay for it all if he was allowed to watch the Vikings undisturbed. Lena agreed.

Lena’s daughter Inga is the most organized of the bunch and will be the Planning Section Chief. She’ll make sure the menu is set, arrange the seating and decide the timeline for the preparations and “game day.” She’s tracking the status of the resources and anticipating future needs in her notebook…just in case the power goes out and she can’t recharge her smart phone.

Sven’s wife Holda is the best cook of the lot. She’ll serve as the Operations Section Chief and dish out assignments, appoint someone to entertain the kids and make sure the men stay in the garage. She’ll handle all the tactical details of the day to make sure the lutefisk is perfectly cooked. She’ll need to recruit some of the others (volunteers) as needed, to help.

The supplies like ingredients, decorations and games are the responsibility of Greta, Lena’s other daughter. Greta is the Logistics Section Chief, meaning she’s in charge of all the “stuff” necessary for the day. She lives in the big city so she can find everything and have it there early. She is coming home to the country the Saturday before. She may need to have all the grandkids help get things ready for the big day at the homestead.

Sven always finds the most comfortable chair to watch all the goings-on. He’s monitoring the safety of the situation as the Safety Officer.

The big day arrived and so did a few extras! The table was easily expanded with those who didn’t RSVP like they were supposed to but there’s always extra pie. Everyone knew what was going on, who was in charge of what, and the jobs to be done. Lena kept a watchful eye on her brood as they briefed her and each other throughout the day.

By the end of the day, bellies were full, left-overs divided and the presents were opened. Lena and Ole thought it was a grand day. They decided to use ICS to plan all their future family holidays!

If you are interested in learning more about Incident Command and joining MN Responds, visit MnResponds.org or call your local Public Health Office. Informed, willing volunteers are the answer to healthy, prepared communities.

(Thanks and credit for the original idea of this article to Martha Wagaman.)

The Minnesota Department of Health says
Minnesota teens’ immunization rates improved in 2010, but too many (teens) are still unprotected.
Markedly greater numbers of Minnesota teens are receiving vaccines recommended during adolescence, according to results of a national survey released today. But the rates are still not as high as state health officials would like.

According to the National Immunization Survey – Teen, conducted by the Centers for Disease Control and Prevention (CDC), immunization rates for the tetanus-diphtheria-pertussis booster (Tdap) increased from 52 percent in 2009 to 70.3 percent in 2010. Similarly, immunization with meningococcal vaccine, which protects against a serious form of meningitis, increased from 43.9 percent to 57.0 percent. And 37.8 percent of adolescent girls had completed the three-dose series of human papilloma virus (HPV) vaccine, which prevents cervical cancer, up from 27.0 percent in the prior year. Nationally, coverage with each of the vaccines rose at a pace similar to Minnesota’s.

“We’re pleased that Minnesota continues to show improvement in coverage rates for these important vaccines,” said Kristen Ehresmann, director of Infectious Disease, Epidemiology, Prevention and Control for the Minnesota Department of Health (MDH). “We’re making progress, but these results also tell us we still have much work to do before we can say our young people are sufficiently protected from these diseases.”

It’s important that adolescents get these vaccines, Ehresmann explained, because they provide protection against diseases at a time when teens and young adults are at risk. Also, the adolescent health check-up recommended at 11 or 12 years of age provides a convenient time to receive these vaccines while adolescents are still visiting their health care providers regularly.

Pertussis, or whooping cough, is part of the standard childhood vaccine series, but recent studies have revealed that immunity begins to wane in pre- to early adolescence. Students entering seventh grade should receive Tdap if they haven’t already, even though Minnesota’s school immunization requirements haven’t yet been updated to specify this vaccine instead of the older tetanus-only version.Tdap is also strongly recommended for anyone who will be spending time around infants –who are most at risk for serious complications from pertussis and are too young to receive the vaccine. “So teens, who are potential babysitters, as well as moms, dads, and grandparents of new babies, should get Tdap to protect not just themselves, but those who are vulnerable around them,” Ehresmann said. “Tdap is for everyone 7 years of age and older.”

It’s important for 11 and 12 year olds to get a first dose of meningococcal vaccine to prevent meningococcal infection, which is a rare but serious cause of meningitis and blood infections. A new recommendation calls for a booster dose at 16, when teens’ risk starts going up markedly.

With the HPV vaccine, the main goal is to prevent cervical cancer in women. The HPV vaccine provides almost 100 percent protection against the two forms of human papilloma virus that cause most cases of cervical cancer. The vaccine also protects against related cancers and genital warts, so it has benefits for both sexes, and can be given to both girls and boys.

“The virus is transmitted from person to person through sexual contact, but we know that it’s important that teens receive the vaccine before they become sexually active as a way to maximize the protection and minimize the risk,” Ehresmann said. “When someone becomes sexually active, male or female, their chances of getting HPV within the first few months are extremely high. Getting the vaccine after sexual activity has begun may be too late.”

“All three of these vaccines are important at this age,” Ehresmann said. “They can be given at the same appointment to minimize inconvenience for teens and their parents.”

CDC officials expressed concern that HPV vaccination rates are not growing as fast as the rates for other adolescent vaccines. In Minnesota as well as in the nation as a whole, the trajectory of increase is somewhat lower for HPV than for other vaccines.

Making improvements in immunization coverage rates requires a concerted effort by all the parties involved, Ehresmann said. “Parents need to ask their health care provider about the vaccines; providers need to recommend to parents that their teens get the vaccines; public health needs to make the recommendations clear and simple and provide the resources for parents and providers to understand their importance; and manufacturers need to make sure the supply of vaccine is consistently adequate. In this way, we can achieve our goal of significantly reducing these diseases through increased immunization rates.”

More information about immunizations, including a link to the NIS data, can be found on the MDH website at www.health.state.mn.us/immunize.

Make a phone call to your clinic or to your local Public Health to see if your adolescent needs immunizations. The phone number for Stevens Traverse Grant Public Health is 320-208-6670.

Please consider becoming a MN Responds Volunteer.
Minnesota Responds is a partnership that integrates local, regional and statewide volunteers. At this time new volunteers are being recruited. Stevens Traverse Grant Public Health has the lead role in accepting local volunteers, offering trainings and mobilizing in times of need. (Just as Douglas and Pope County Public Health Agencies do in their Counties.)
Men and women with health-related backgrounds are especially encouraged to enroll in MNResponds, but people from all walks of life are needed. There are opportunities in disasters and/or in public health events that use skills and talents of every kind. For example, you may be asked to help at a mass dispensing clinic should the area be at risk for pandemic flu , or when education and prevention measures are needed, or you may be asked to help should a tornado hit a local community and large numbers of people are injured.
Volunteering to help before an event is important. Pre-registering of volunteers increases the efficiency of making volunteer assignments and reduces the work of processing volunteers at the disaster site. Pre-registering also gives volunteers the opportunity to be trained in areas like incident command and psychological first aid before they are needed.
Becoming a volunteer is easy. You can register on line at: www.health.state.mn.us/minnesotaresponds.
Even if you do register on line, you are invited to come to our Stevens Traverse Grant Public Health “Volunteer Appreciation and Recruitment Event” on Tuesday, September 18, 2012 from 5 to 7 p.m. We are welcoming new volunteers and saying thanks to present volunteers at our office at 10 East Hwy 28, Morris, MN. You can register for a $20 gas card, have a Subway boxed meal, get your picture taken for badging purposes and view fellow volunteers in action during a recent full scale exercise at Camp Ripley. MN Responds volunteers can also get a free influenza shot.
Like events are being held the same day and time in Douglas County at 725 Elm Street, Suite 1200 in Alexandria and 211 East MN Avenue in Glenwood.
If you’d like to visit about becoming a MN Responds volunteer, call your MN Responds Coordinator at your local county public health office. In Stevens Traverse and Grant Counties that is Marcia Schroeder. The number is 320-208-6670.
In a public health emergency, we’ll need you!

The following story is one we can all learn from about the uncomfortable subject of bed bugs.

Last month, one of my daughters called me on the phone, panicked. “Dad, I think I’ve got bed bugs!” It turned out to be more than a couple of bed bugs. She had a full blown infestation.

Over the years my children have mostly just tolerated, if not ignored, my entomological passions. But this daughter is no slouch. She knew a few things about bed bugs. Like many people it just never occurred to her that bed bugs could happen to her.

The bites she’d started to notice in the morning? Probably mosquitoes. The little red spots on the bedding? Probably from the mosquito bites. It wasn’t till she saw two bed bugs frolicking on the sheets at night that it finally clicked…”Of course! How dense can I be? My dad taught me better than that!” (I added that last part)

Small blood spots on sheets are easily dismissed by someone not familiar with bed bugs. Blood spots are a more sure diagnostic sign of bed bugs than just “bites”.

A visit to her apartment the next day revealed 200 to 300 bed bugs happily tucked away in the corners of the fitted sheets, dust ruffle and box spring cover of her bed. We did some thinking back and concluded that we had probably introduced the bed bugs last February when she retrieved her mattress and box spring from a friend living in a (nice) uptown Dallas apartment. She had loaned the bed to friend during a transition period when she was living at home after graduation. I say “we” introduced the bed bugs because I helped her move the bed from friend’s apartment to her new home in Fort Worth. I didn’t notice anything out of the ordinary at the time, but I wasn’t really thinking bed bugs either.

Of course my daughter’s first concern was where to sleep. As with all of us, ignorance is bliss. The night before her discovery it was OK to sleep in her infested bed. But now that she knew her bed was crawling with unwanted vampire bugs, it just wasn’t the place for a restful sleep. I can’t say I blamed her.

It’s times like these that both she and I appreciated the availability of a pest control professional at the other end of the phone. In her case, the landlord was supportive and had a pest control company ready to come out and treat her apartment. The problem was, what to do in the meantime.

In general it’s not a good idea to abandon one’s bed as a solution to bed bugs. The problem is that once you start sleeping on the couch, it’s just a matter of time before the bed bugs figure out where supper has moved and you end up with bed bugs in another room of the home. But for at least one night I counseled her to sleep on the couch and I would be over the next day to help.

A dis-infested bed ready for clean sheets is now a relative oasis from bed bugs until the PMP arrives.

Because I wanted her to get back in her own bed as quickly as possible, we opted to make her bed safe while waiting for the professionals to arrive. With the generous help of friends at Target Specialty Products, I was quickly supplied with Mattress Safe® bed encasements, a set of Climbup® Bed Bug Interceptors, and a can of Zenprox® aerosol insecticide. Vacuum at hand, we removed as many bed bugs as possible from the mattress, sheets and dust ruffle, box spring, and bed (At this point, long-suffering daughter had to put up with a dad who, every couple of minutes, had to stop and take closeup pictures to document the infestation–a small price to pay, I kept reminding her). After slipping the mattress and box spring into their encasements, we continued vacuuming and tearing down the bed. Once disassembled, I treated bed cracks and crevices with Zenprox, reassembled the bed and put Climbup® traps under the bed posts. To keep anything from touching the floor, except the bed posts, we eliminated the dust ruffle. All sheets and bedding were immediately stuffed into garbage bags and sealed tightly for transport to the laundry.

To make a long story short, daughter returned to sleep in her own bed that night, and after a month reports no more bed bugs. Of course the PMP arrived the next day and undoubtedly deserves much of the credit for successfully keeping the infestation from spreading.

Don’t think that just because a person has an advanced case of bed bugs that they willfully allowed the situation to progress. Many people experience mild to zero reactions to bed bug bites, and have no idea that they are feeding dozens to hundreds of bed bugs. A recent, informal study of Orkin employee reactions to bed bug bites reported by Ron Harrison at the NCUE found that less than one in 20 people showed any noticeable reaction to bed bug bites.

Because many people think bed bugs will never happen to them, they tend to overlook bed bug clues that, in retrospect, are obvious.

People need guidance in how to survive the waiting period between bed bug discovery and when service can be provided. Many pest control companies respond to bed bug calls with next day service, but inevitably there will be customers who will have to wait two or more days. Providing landlords with a variety of sizes of mattress encasements, Climbup® or similar traps for bed posts, and vacuuming instructions ahead of time can help renters survive the agonizing wait for service. By creating an oasis of safety in the midst of an infested apartment, you allow the customer a chance to sleep comfortably in their own bed without running the risk of spreading bed bugs to other parts of the apartment or home.

The earlier an infestation is caught, the better the chances of bringing it under control quickly.

Use bed post interceptors wherever feasible. Even after treatment these devices provide a way to monitor the effectiveness of control. In my daughter’s case, not all bed bugs were killed with the initial treatment, as evidenced by several more bed bugs being caught in the Climbup® cups in the succeeding weeks.

Plywood beds or rough wooden bed slats are especially favored places for bed bugs to lay eggs. Study of closeup photographs of the wooden slats on my daughter’s bed after I treated showed me dozens of eggs I didn’t see on inspection. Even though these slats were treated by me and by the PMP with insecticide and steam, we opted to remove the slats (they weren’t necessary for supporting the box spring anyway) afterwards.

While I recommend bed bug-proof encasements as a less expensive (and more effective) alternative to throwing away infested mattresses and boxsprings, throwing away plywood bed stands or other types of rough wooden beds might be a good idea for some customers. Replacing such beds with a metal, or smoothly finished wooden four post bed, or an inexpensive metal bed frame on wheels, will allow you to create a safe, bed bug oasis even in the midst of a bed room that still harbors live bed bugs.

My final, take-home lesson in all this is to not loan your bed and mattress to anyone. Even if your dad’s an entomologist.

An early Spring has already given us tornado and severe thunderstorm warnings. As we get into May and June we can expect more warnings. Hopefully, we will escape without a scratch but being prepared is key should a weather related disaster strike. Do you have a plan for your family? Does your family have a plan for your pets?

First a Family Plan. A good resource to start with is www.CodeReady.org It walks you through the steps of making a plan for your family. Things like meeting places if you are separated, food to have on hand, how much water you need, emergency services etc. You can complete your plan right online and print it off. It can be bare bones or extensive. But it is a start and it helps you think through the process of family emergency preparedness.

Second a Plan for your Pets. Preparing for your family is vitally important, but the focus of this information is going to be on your pets. More and more pets are becoming like family members. So how do you protect your pets in an emergency?

Plan. Know in advance what you will do with your pet in an emergency.
• Plan to take your pet with you in an evacuation, if practical. Decide where you will go, realizing that pets may not be allowed in some shelters. Hotels that allow pets or perhaps a pet boarding location are also options.
• Just as you would for a child, designate a family member or friend who can take care of your pet in your absence (a “pet care buddy”). Have specific locations for food and other emergency supplies that are easily located by others.
• Talk to your veterinarian about your emergency plans and also for other tips to add into your plans. Talk about where you can bring your pet for emergency treatment as well.

Prepare. Gather necessary supplies for your pet.
• Food, water, medications for 5 days
• Medical records
• Collar WITH ID tag
• Leash
• A picture of you and your pet together for proof of ownership, in case you are separated
• Familiar items: toys, bones, other items for comfort

Practice. Take action now to be calm later!
• Research the hotels or pet boarding locations in advance so you know what options you have in your area.
• Put your “pet care buddy’s” name and phone number on your pet’s ID tag, so that if you’re out of town, someone can still be contacted if your pet is found.
• If you have a room that can be designated as a “safe room” for your pet, put your pet’s carrier, food, and some water there so it is ready to go if needed.

Stay Informed. See below for resources for more information.

Resources.
? ReadyAmerica: http://www.ready.gov/america/_downloads/pets.pdf
? Humane Society of the United States: http://www.hsus.org
? FEMA: http://www.fema.gov/plan/prepare/animals.shtm