Two ways to be SAFE in 2014

Resolve to be Ready 2014
Roughly half of all Americans make New Year’s resolutions. In 2014, FEMA and local Public Health are encouraging you to Resolve to be Ready for potential emergencies, by committing to make preparedness a year-round family activity. The campaign focuses on “Family Connection” to reinforce the importance of parents including their children in preparedness conversations before disasters strike.
After the holiday festivities end, get a head start on disaster preparations for you and your family with FEMA’s Are You Ready? Guide. This interactive course provides information on specific hazards including steps to not only be reactive but proactive in response to them. The guide also teaches you about evacuation, emergency public shelters, animals in disasters and more.
By taking a few simples steps to prepare in advance, you can minimize the impact an emergency could have on your family or community. For more information about this exciting new campaign visit Ready.gov.
Wishing you a safe and happy New Year!

What Goes Up…
Taking down the Christmas tree may not be as fun as putting it up but keeping a dried-out tree in your home or stored in a garage is a fire hazard! When it comes to tree disposal, do you know your options? After the holidays, don’t throw your Christmas tree in the trash. Real Christmas trees are recyclable. Typically, there are several environmentally sound ways to dispose of your tree. These options include:
• Curbside-pick up for recycling;
• A drop off recycling center; and
• Mulching programs.
Never dispose of your tree by burning it in a fireplace or wood stove. Doing so may result in a chimney fire. Pine and fir trees produce a lot of creosote when burning and may lead to deposits in your chimney. A burning tree is also hard to control and may burn faster than expected.
Safety First.

Football and the Flu

Football season is in full swing. Flu season is just starting.

What do the two have in common? You might be surprised at the correlation or should I say at the metaphorical reference which can be made?

A successful football team practices, does endurance training, does sprints, lifts weights, studies their play book, and practices some more. Based on all their hard work, the team hopes they will have a winning season.

BUT if the team could somehow get and study the play books of their opponents, winning games would be so much easier.

A successful, healthy flu season starts with good and frequent hand washing, covering your cough, discarding tissues in a waste container, eating right, getting enough sleep and staying home when you are sick. Did I mention hand washing?

BUT if you also get a flu shot or the flu mist, it’s like getting your hands on the opposing teams’ play book. You’ve got the best edge you can get. We know the flu vaccine isn’t perfect, but it is perfectly safe and it is the best tool we have to guard against getting influenza.

Getting a flu shot is like getting your hands on the other team’s play book. In conjunction with all the non-pharmaceutical interventions you’ve got a definite edge against catching the flu. Get your flu vaccine and be responsible for your own fight against the opponent-the flu.

Do You Have a Preparedness Barrier?

Consider this question. Are you suffering from one of these Preparedness Barriers?

Apathy: “It won’t happen here.” “I won’t worry about this until a threat is imminent.”
Fatalism: “Whatever I do won’t make a difference in the event of a big disaster.”
Not on My Radar: “I just haven’t thought about that.”
Avoidance: “I don’t like to think about that.”
Lack of Information: “I don’t know how to do this.”
Lack of Resources: “I don’t have the money/time.” “I’m unable to do this.”

Now consider this: The likelihood that you and your family will recover from a disaster or emergency event tomorrow often depends on the planning and preparation done today.

Factors such as number of injuries, communication failures and even road blockages can prevent First Responders from being able to reach you. That is why being prepared is so important. Being responsible for knowing what to do before, during and after a disaster enables you to stay safe during the event and allows first responders to assist those in greatest need.

Data shows 90 percent of disaster survivors are rescued by a neighbor. Talk to your neighbors and plan for how you will work together to ensure everyone stays safe in the event of an emergency.

Americans also travel more than ever before. They travel to areas impacted by hazards they may not be at risk for at home. Knowing what to do before, during and after any emergency is a critical part of being prepared and may make all the difference when seconds count, whether you are at home or traveling.

Learn about potential hazardous events both at home and the places you travel to. Familiarize yourself with the signs of events that come without warning and know the local advance alerts and warnings and how you will receive them. Knowing about the local emergency plans for shelter and evacuation, and local emergency contacts will help you prepare for an event.

Prepare a family communications plan, so your children will know how to contact you in case communications between home and school/college are disrupted. Make an emergency information list of names, phone numbers and locations of family members, doctors, medical insurance and other important resources.

It’s important to have the supplies you need to keep you, your family and your pets comfortable and safe in the immediate aftermath of a disaster. Having a preparedness kit in each of the places you spend most of your time will allow you to grab the essentials quickly, if you need to evacuate or even shelter in place. Places like your home, office, school, and vehicle.

You may need to survive on your own after an emergency. This means having your own food, water and other supplies in sufficient quantity to last for at least 72 hours. Local officials and relief workers will be on the scene after a disaster but they cannot reach everyone immediately. You could get help in hours, but it might take days.

Additionally, basic services such as electricity, gas, water, sewage treatment and telephones may be cut off for days, weeks, or longer. Your supply kit should contain items to help you manage during these outages. Find more information on how to build a kit and the essential supplies you should consider at www.ready.gov/build-a-kit

If you have a child going off to college, give their preparedness safety some thought too. Being prepared will help your college student remain safe and calmly deal with emergency situations. They too can have a disaster readiness kit. This can be as simple as a backpack containing items like a flashlight, a small radio, extra batteries, a solar powered or hand-cranked cell phone charger, energy bars, water and first aid supplies. Advise your student to keep their kit in an easily accessible place, like under the bed or on the top shelf of a closet.

Most colleges have emergency plans. Contact the admissions office to get a copy and confirm your child is registered on the emergency notification system, or check the college website.

September is National Preparedness Month.
Make a plan
Build a Kit
Stay informed
Get involved

Break through your Preparedness Barrier!

Make Your Child’s Shots Less Stressful

Vaccines help protect babies and young children against 14 serious diseases. Even though you are keeping your children safe from diseases, it’s hard to see them cry when they get their shots. You can take some steps before, during and after a vaccine visit to ease the pain and stress of getting shots.

Pack a favorite toy, book, blanket or other comfort item. For older children, be honest-shots can pinch or sting, but not for long. Remind them that shots help keep them from getting sick.

Distract your child with a toy, a story, a song, or something interesting in the room. Make eye contact with your child and smile, talk softly or sing. Hold your child tightly on your lap if you can. After the shots, hug, cuddle and praise your child. For babies, swaddling, breastfeeding or a bottle may offer quick relief.

Read about the shots your child will get in advance. Write down any questions you have about the vaccines, so you’ll remember to ask your healthcare provider before the shots. Bring your child’s vaccine record to the appointment, so it can be updated.

Read the Vaccine Information Sheet that you receive from the shot nurse so you know what to expect afterwards.
For instance, some children have a rash, a slight fever or swelling where a shot was given. These reactions are usually mild and resolve on their own without needing treatment.

If you notice redness, soreness or swelling from the shot, place a clean, cool washcloth on the area. If your child runs a fever, try a cool sponge bath. You can also use a non-aspirin pain reliever if your doctor says it’s OK. Some children eat less, sleep more, or act fussy for a day after they get shots. Make sure your child gets plenty to drink.

If you are worried about anything, call your doctor.
Shots can be stressful, but you can ease your children’s discomfort. Keeping up-to-date on vaccines is the best way to protect against vaccine-preventable diseases. Learn more about childhood vaccines at www.cdc.gov/vaccines/parents or call 1-800-232-4636.
You can also call Stevens Traverse Grant Public Health for more information. The number is 320-208-6670.

MOLD: A Problem in Your Home?

Mold in Homes

Given the amount of rain from recent storms, I thought some tips on how to protect your home and ultimately yourself and your family from mold would be helpful.

You will find more complete information on the Minnesota Department of Health (MDH) website. Go to www.health.state.mn.us click on “Topics,” click on “Environments and Your Health.” Scroll down and click on “Healthy Homes in Minnesota, and then “Mold and Moisture.” There are many other topic areas you may find helpful as well.

So what are the Health Concerns of Mold?
Health effects from exposure to mold can vary greatly depending on the person and the amount of mold in their home. Health symptoms that may occur include coughing, wheezing, nasal and throat conditions. People with asthma or allergies who are sensitive to mold may notice their asthma or allergy symptoms worsen. Individuals with severely weakened immune system who are exposed to moldy environments are at risk of developing serious fungal respiratory infections. However the long term presence of indoor mold growth may eventually become unhealthy for anyone. MDH recommends that people consult a medical professional if they are concerned about the effects of a moldy environment on their health.

Are some molds more hazardous than others?
Many molds can produce potentially harmful substances, whether it’s allergens, mycotoxins, or other compounds. Hence, all indoor mold growth should be removed promptly, no matter what type(s) of mold is present or whether it can produce toxins.

How do I tell if I have a mold problem?
Investigate don’t test. The most practical way to find a mold problem is by using your eyes to look for mold growth and by using your nose to locate the source of a suspicious odor. If you see mold or if there is an earthy or musty smell, you should assume a mold problem exist. Mold often appears as discoloration, staining, or fuzzy growth on the surface of building materials or furnishings. Look for signs of excess moisture or water damage: leaks, standing water, water stains or condensation problems. Search behind and under carpeting, wallpaper, vinyl flooring, sinks, furniture or stored items-especially things placed near outside walls or on cold floors.

MDH does not recommend testing for mold. Instead you should simply assume there is a problem whenever you see mold or smell mold odors.

The following information about mold clean-up is lengthy but thorough. To clean up and remove indoor mold growth, follow steps 1-6 as they apply to your home.

1. Identify and Fix the Moisture Problem – the most important step in solving a mold problem
is to identify and correct the moisture source(s) that allowed the growth in the first place. Common indoor moisture sources include:
Flooding
Condensation (caused by indoor humidity that is too high or surfaces that are too cold)
Roof and plumbing leaks
Firewood stored indoors
Humidifier use
Inadequate venting of kitchen and bath humidity
Improper venting of combustion appliances
Failure to vent clothes dryer exhaust outdoors (including electric dryers)
Clothes line drying indoors

To keep indoor surfaces as dry as possible, try to maintain the home’s relative humidity between 20-40 percent in the winter and less than 60 percent the rest of the year. You can purchase devices to measure relative humidity at some home supply stores. Ventilation, air circulation near cold surfaces, dehumidification, and efforts to minimize the production of moisture in the home are all very important in controlling high humidity that frequently causes mold growth in our cold climate.

2. Begin Drying All Wet Materials – as soon as possible after becoming wet. For severe moisture problems, use fans and dehumidifiers and move wet items away from walls and off floors. Check with equipment rental companies or restoration firms for additional equipment or contracting options.

3. Remove and Dispose of Mold Contaminated Materials – items which have absorbed moisture (porous materials) and have mold growing on them need to be removed, bagged and thrown out. Such materials may include dry wall, insulation, plaster, carpet/carpet pad, ceiling tiles, wood products (other than solid wood), and paper products. Likewise, any such porous materials that have been in contact with sewage should also be thrown away. Non-porous and semi-porous materials with surface mold growth may be saved if they are structurally sound (see step 4).

Take Steps to Protect Yourself – the amount of mold particles in air can increase greatly when mold is disturbed. Consider using protective equipment when handling or working around mold contaminated materials. The following equipment can help minimize exposure to mold:
Rubber gloves
Eye goggles
Outer clothing (long sleeves and long pants) that can be easily removed in the work area and laundered or discarded
At a minimum, you should use an N95 or a N100 type disposable respirator. Where mold growth is very heavy or covers an extensive area or if you are sensitive to airborne contaminants, greater respiratory protection may be more appropriate. More protective options include half-face negative-air respirators with a HEPA filter (i.e., N100, P100).

Take Steps to Protect Others – plan and perform all work to minimize the amount of dust generated. Where possible, consider the following actions to help minimize the spread of mold spores:
Enclose or contain all moldy materials in plastic (bags or sheets) before carrying through the home.
Hang plastic sheeting to separate the work area from the rest of the home.
Cover supply and return vents in the work area.
Place fans in windows of work area to pull contaminated air out of the work area and exhaust it to the outdoors.
Operate an air scrubber, which can be rented at cleaning supply companies.
Remove outer layer of work clothing in the work area and wash separately or bag
Damp clean the entire work area to pick up settled mold spores in dust.

4. Clean Surfaces – surface mold growing on non-porous or semi-porous materials such as hard plastic, concrete, glass, metal, and solid wood can usually be cleaned. Cleaning to remove and capture all mold contamination, is very
important because dead spores and mold particles may cause health problems if they are left in place.
Thoroughly scrub all contaminated surfaces using a stiff brush, hot water and a non-ammonia soap/ detergent or commercial cleaner.
Collect excess cleaning liquid with a wet/dry vacuum, mop or sponge
Rinse area with clean water and collect excess rinse water.

5. Disinfect Surfaces (if desired) – after cleaning has removed all visible mold and other soiling from contaminated surfaces, a disinfectant may be used to kill mold missed by the cleaning. In the case of sewage contamination, disinfection is strongly suggested–contact the Minnesota Department of Health for appropriate advice.
Mix 1/4 to 1/2 cup bleach per gallon of water and apply to surfaces where mold growth was visible before cleaning. Apply the solution with a sponge or by other methods that do not over saturate or flood the surface area.
Collect any run-off of bleach solution with a clean and filtered wet/dry vacuum, sponge or mop. However, do not rinse or wipe the bleach solution off the areas being treated — allow it to dry on the surface.

Always handle bleach with caution. Never mix bleach with ammonia — toxic chlorine gas may result. Bleach can irritate the eyes, nose, throat, and skin. Provide fresh air (for example, open a window or door). Protect skin and eyes from contact with bleach. Test solution on a small area before treatment, since bleach is very corrosive and may damage some materials.

6. Remain on MOLD ALERT – Continue looking for signs of moisture problems or return of mold growth. Be particularly alert to moisture in areas of past growth. If mold returns, repeat cleaning steps and consider using a stronger solution to disinfect the area again. Regrowth may signal that the material should be removed or that moisture is not yet controlled.

When can we rebuild?
Rebuilding and refurnishing must wait until all affected materials have dried completely. It may take several days or weeks for building materials to fully dry and return to prior moisture conditions. A moisture meter may help measure drying progress.

Voluteer! Who, Me?

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

Immunization. Power to Protect.

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.”

“Nora” (the) Virus

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.

CDC Sees Little Growth in Adult Vaccine Coverage

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.

Holiday and Winter Safety

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