Good Idea to get Immunized for Measles

With the recent measles outbreak in Clark County, Dr. Wood, the Thurston County Health Officer reminds us to: Get the facts about measles, then be sure you’re immunized.

Learn More About Thurston County Syringe Services

The Syringe Services Program provides many community benefits:

• Minimize disease transmission
• Provide harm reduction services
• Provide case management and linkage to treatment
• Provide referral to services and supports
• Provide resources for opioid overdose response and naloxone administration

In fact, the bottom line for this program is that it means more people are alive and in recovery. 

Learn more here:
http://www.thurstontalk.com/2018/11/29/what-you-should-know-about-the-thurston-county-syringe-services-program/

Families and Flocks--How to Avoid Salmonella

Salmonella is a bacteria that can cause serious illness. One way people can become infected is through handling their backyard chickens. According to the Washington State Health Department, there have been 23 cases of salmonella in the state that have been linked to live poultry--the largest increase in several years. They add, "you can get the infection from a variety of sources, including eating contaminated food or drinking water, touching infected animals and not washing your hands. While anyone can get a Salmonella infection, children are especially at risk of illness because they are less likely to wash their hands and have more frequent hand-to-mouth contact than adults."

Check out this article by Dr. Rachel Wood, our Thurston County Health Officer, to learn more! It can be a great learning experience and a lot of fun to have a flock of your own, but there are important things to remember to protect yourself and your family from salmonella infection. 

Flu Season 101 For Caretakers

Every year we have an influenza (flu) season. In the U.S. the number of people getting sick with the flu peaks between November–March. If you are caring for someone who is sick, whether a child or an older adult, there are a few things you should know.

First, these are the symptoms of flu versus a cold.

Second, consider contacting a health care provider if:

• They have flu symptoms.
• They are at higher risk for complications from the flu, this includes young children and adults age 65+.
• They are very sick or worried about being sick.

Third, seek care through an emergency room if you see these signs.

·         In children

o   Fast breathing or trouble breathing.

o   Bluish skin color.

o   Not drinking enough fluids.

o   Not waking up or not interacting.

o   Being so irritable that the child does not want to be held.

o   Flu-like symptoms improve but then return with fever and worse cough.

o   Fever with rash.

o   In addition to these, get medical help right away for infants who:

§  Are unable to eat.

§  Have trouble breathing.

§  Have no tears when crying.

§  Significantly fewer wet diapers than normal.

·         In adults

o   Difficulty breathing or shortness of breath.

o   Pain or pressure in the chest or abdomen.

o   Sudden dizziness.

o   Confusion.

o   Severe or persistent vomiting.

o   Flu-like symptoms improve but then return with fever and worse cough.

Finally, as a caretaker here are a few important things for you to do to keep yourself and others healthy.

• Wash your hands often with soap and water, especially after you cough or sneeze.
• Try not to touch your eyes, nose or mouth. Germs can spread this way.
• Clean and disinfect frequently touched surfaces, especially when someone is ill.
• Keep the sick person home and away from crowds. This helps prevent further spread of illness. 
• If you have not gotten a flu shot, do it now. It is not too late.

--Post by Mary Ann O'Garro, Epidemiologist

Hepatitis A: What You Should Know

Hepatitis A, a highly contagious infection that affects the liver, has been cropping up more in the news over the last few years, but many may not know much about the disease. The effects of this viral infection can vary, from a mild sickness that lasts a few weeks, to a much more severe illness lasting multiple months. Most people recover completely without any lasting issues, but while rare, Hepatitis A can cause death in some people. Hepatitis A is spread when a person accidentally ingests the virus, which is present in the fecal matter of an infected person.

Symptoms of Hepatitis A may start appearing roughly 2 to 4 weeks after exposure, but can appear as late as 7 weeks later. These symptoms include: Fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored stools, joint pain, and jaundice (yellowing of the skin and eyes). Anyone who believes they may have been exposed to Hepatitis A, or who has symptoms such as jaundice, should seek medical care.

Groups at higher risk for infection include people who have direct contact with an infected person, drug users, men who have sex with men, and people who travel to countries where Hepatitis A is common. Hepatitis A can spread quickly among homeless populations where people have less access to medical care, may be less likely to seek medical care, and may have fewer resources.

People who identify themselves as being in one of these high-risk groups, and who have not been previously vaccinated should get the Hepatitis A vaccine. The vaccine is a 2-shot series, effective if given within two weeks of exposure. Your pharmacy may be able to provide the vaccine, but you should call first to find out for certain. 

What you should know about Pertussis (Whooping Cough)

Since the school year began about a month ago, there has been five reported cases of pertussis in Thurston County.

While typically a relatively mild illness for older children and adults, pertussis can be life threatening for infants and young children, and dangerous for pregnant women.

Pertussis is spread through the air and by secretions of the nose and throat in the same manner as a cold. The illness starts with mild cold symptoms, followed in 4 to 5 days by a cough. The cough can become severe, causing children to vomit or have difficulty breathing. Difficulty breathing causes the characteristic “whoop” sound in children with severe illness. Most children are immunized during infancy and preschool years and are protected while they are the most vulnerable. Immunity wanes over time leaving older children and adults susceptible to the illness.

Pertussis containing vaccine is available for older children and adults. The recommendation is that all individuals 11 years of age and older receive one dose of Tdap (Tetanus, diphtheria, pertussis) vaccine. Vaccine for children is available from their health care provider and most pharmacies will vaccinate older children and adults.

The three most important ways to prevent the spread of pertussis as well as many other illnesses are:

     1. Frequent hand washing.

     2. Cover your nose and mouth when coughing and sneezing.

     3. You and your child stay home when ill.

If you or your child has a severe or persistent cough, or one that lasts longer than a week, please see your family health care provider for an evaluation. If you have questions, please contact your healthcare provider or school nurse.

Cluster of E. coli cases in Washington and Oregon

An outbreak of E. coli cases in Washington and Oregon has led to the voluntary closure of Chipotle restaurants. While the source of the contamination is still under investigation, the outbreak may be linked to the popular restaurant chain.

Consult your healthcare provider if you ate at a Chipotle restaurant between October 15 and 31 and have symptoms that may include bloody diarrhea, abdominal cramps, fever, and vomiting. In some cases, E. coli can be severe and life-threatening. Young children and the elderly are at higher risk to become severely ill from E. coli infection.

General food safety guidance:
Using safe food handling techniques can reduce the risk of foodborne illness. Be sure to have a clean space for handling food, wash hands thoroughly before and during food handling, and wash produce well. Keep raw meats separate from other foods. Always cook food to the safe minimum cooking temperatures and refrigerate or chill foods right away.  Check out these food safety videos that show how to clean, separate, cook, and chill properly.

World Rabies Day

Rabies is not usually the first thing that comes to mind when people think of public health issues. In the United States the threat of the disease has been greatly reduced over the years due to successful public health efforts. However, it is by no means eradicated. Each year about 40,000 Americans receive post-exposure prophylaxis (PEP) shots because of possible rabies exposure, and one or two people will die from the disease. Altogether, the disease costs $300 million annually in this country. The good news is that it is entirely preventable and progress is being made each year. World Rabies Day was created in 2007 to draw attention both to the danger of rabies and the progress that has been made in bringing it under control in the United States and around the globe.

In 2013 there was a 4.8% decrease in rabies cases from the previous year and canine rabies has been almost entirely eradicated in the United States. Domestic animals now make up only eight percent of all cases nationwide. Cats are actually the greatest domestic animal threat, making up 53% of all domestic animal cases. Responsible pet owners can continue to help make that number drop by taking a few simple steps to keep their pets safe and healthy.

• Bring your dog or cat to a veterinarian each year to be sure they are up-to-date on their rabies vaccination. Dogs and cats that have potentially been exposed to rabies and are not up-to-date on their vaccination will need to be quarantined for six months or put down, so please vaccinate your pet!

• If your pet is not spayed or neutered, consider doing so. Spaying and neutering helps to reduce the number of stray dogs and cats, which are at high risk of contracting and spreading rabies.

Besides protecting your pets, take steps to protect yourself and your family too. If you have children, teach them to never handle wild or unfamiliar animals, even if the animal looks friendly. Keep food or water inside for your pets since the food and water kept outside could attract wild animals in your area. Always keep your garbage can securely covered as well. The best way to protect yourself might also be the most obvious – stay away from unfamiliar animals, including dogs and cats that you do not know, and do not attempt to feed, pet, or pick them up.

The vast majority of rabies cases involve wildlife, with raccoons, bats, skunks, and foxes being the primary culprits. In Washington, bats have been the only wild animal to carry rabies since the 1920s. Bats are very beneficial to us because they eat many insects. But bats can be a hazard when they mistakenly end up in our homes. If you have a bat in your house, do your best to safely capture or contain it and call your local public health department; we may want to test the bat to make sure you or your family were not exposed to rabies.

Outside of Washington, bats and skunks are responsible for most rabies cases. Many different types of animals can be infected, however, and if you encounter any animal acting strangely or displaying any of the following signs of possible rabies infection, please contact animal control as soon as possible.

• General sickly appearance
• Significant saliva or drooling
• Problems swallowing
• Difficulty moving or paralysis
• Biting at everything
• Appearing more tame than you would expect

When traveling, especially internationally, take any animal bite very seriously and seek medical attention. Talk with your health care provider about travel-related vaccinations before you leave and see if rabies vaccine would be advised.

Together, public health professionals, veterinarians, and YOU can continue to take steps to reduce the threat of rabies and keep ourselves, our pets, and our families healthy and safe!

Wash Away Those Back-to-School Germs

By Kateri Wimsett, Education and Outreach Specialist

September is here once again back to school time here in the South Sound. Kids and parents are adjusting to new schedules and new teachers. As kids go back to school they share close contact with other kids and teachers all day, five days a week. That means they are exposed to lots and lots of germs and can bring illnesses home with them. So right now is the perfect time to talk to your kids about effective handwashing. Handwashing has been called the single most effective way to keep from getting sick. This would depend on how well hands are actually washed.

As a mom of two, the main focus of my efforts is to cease the “rinse and run” my children are inclined to do. They often resort to “washing their hands” by running their soap-less hands quickly under water while running for the door. Because of this I’ve instituted the happy birthday song rule - after soaping they’ve got to sing “Happy Birthday” twice while scrubbing their hands. We’ve talked about how it’s the rubbing and scrubbing of your hands that actually is the most important step to get the germs off of your hands. I’m happy to report that as they’ve gotten older they appreciate the grossness of not washing their hands and are coming along in their efforts. 

A note about hand sanitizer, washing hands with soap and water really is better and advised.  If you are in a place where soap and water are not available and you have to use hand sanitizer use an alcohol based one with at least 60% alcohol (check the label).  Hand sanitizers do not eliminate all type of germs, nor do they remove the chemicals that may be on our hands .  They also are not as effective when hands are visibly dirty or greasy. 

It sounds kind of silly, but learning when and how to properly wash hands and making it a habit is important.  Remind your kids to always wash their hands:

• After they use the bathroom.
• Before they eat.
• After touching animals or animal poop.
• When they come into contact with someone who is sick.
• When they come in from being outside.
• When their hands are dirty.

According to the Centers for Disease Control and Prevention (CDC) the “right way to wash your hands” includes:

• Wetting your hands with clean running water and using soap. There is no need to use antibacterial soap. Regular bar or liquid soap works best.
• Rub hands together, lathering or scrubbing for 20 seconds. Make sure to scrub between fingers, the backs of your hands, and under your nails. (As a side note it takes about 20 second for the scrubbing action to dislodge and remove germs.)
• Rinse your hands under clean running water.
• Dry your hands using a clean towel or air dry them.

Interested in the science behind this? Check out the CDC's "Show Me the Science-- How to Wash your Hands" web page.

Washing Your Hands – It’s really as important as they say!

By Elisa Sparkman, Education and Outreach Specialist

Since I was a small child, the importance of washing your hands was emphasized. It was part of a routine. After using the restroom and before eating hand washing was almost robotic. There were no questions about it.

If there is one thing that I can say I have learned since I began working for this public health department it is that washing your hands is really as important as they say. Actually I would say that it is even more important than they say! And I will answer the question you are probably thinking, No, I am not germophobic. I finally understand and appreciate how much hand washing does for us.

The fact that washing your hands well can reduce the spread of disease is probably not new to you. Bacteria gets on our hands easily from touching everyday items like hand rails, gas pumps, crosswalk buttons, toys, raw unwashed food, and our pets.

Did you know that frequent and thorough hand washing can also reduce your exposure to toxic chemicals? Toxic chemicals and metals from pollution float around in the air and make their way into dirt and into indoor air and dust. Toxic chemicals from agricultural, industrial, and residential pesticide application also make their way into homes as dust. Think about all of the dusty or dirt-covered items you touch each day. There is a good chance that toxic chemicals wind up on your hands and on many items you touch. We touch our faces, our lips, our water bottles, our phones, our computers, our food... you see where I am going with this? Washing your hands is important.

To be sure you are washing your hands well follow these simple rules.

• Rub and scrub with soap for 20 seconds (singing the ABCs or Happy Birthday twice).
• Use warm water.
• Tip hands downward so water rinses the suds and yucky stuff off of your hands.
• If possible, turn the faucet off with a paper towel.
• At home, sanitize faucet handles often.

So when anybody asks me what the one thing is that I've learned since I started working at the health department I say, “Washing your hands is really as important, if not, more important, than they say!”

Ebola: Get the facts

Over the past few months, the Ebola virus has been a top news story. It’s only natural to be concerned. The best action you can take is to get the facts. Be aware that there is misinformation on the Internet. The most reliable information you can get on the Ebola situation nationally and locally will be from the Centers for Disease Control, the Washington State Department of Health, and your local health department.

What you need to know:

• Those most at risk of getting Ebola are healthcare workers and family members caring for someone who is sick with Ebola; the risk to the general public is very low. 
• There are no confirmed cases in Washington State. 
• Ebola can only be spread by direct contact with the bodily fluids (like blood, vomit, urine, feces, semen, sweat, saliva) of someone who is sick with the disease. 
• You do not get Ebola from casual contact with others, air, water or food that is commercially available in the U.S. 
• A person with Ebola is only contagious when they are showing symptoms.

More information about Ebola:

• Washington State Department of Health Factsheet (English and Spanish): Help spread the Facts about Ebola 
• CDC Factsheet: What you need to know about Ebola 
• Washington State Department of Health Factsheet: Ebola

Bleach: When do I use it and how much?

By Kateri Wimsett, Education & Outreach Specialist

As a mom of young children, I try to be careful with hazardous products in and around my home. I do my best to keep household hazardous items, such as cleaners and polishes, locked and in upper cabinets so they are out of reach of my little people’s busy hands. And because I want to limit their chemical exposures, for daily cleaning projects I use non-toxic, green cleaning methods.  It costs less, it’s safer, and it gets the job done.

But there are situations when I need not just to clean, but to sanitize or disinfect.  If you’ve had a kid down with the flu, or even worse if your whole household has been down with the flu, you can appreciate where I’m coming from.  Cleaning has to do with removing dirt, dust, and spills. This can be accomplished with soap and water. But sanitizing and disinfecting are about killing germs and in many homes this means using bleach. 

Bleach is a common household chemical. It is used widely in the home in laundry as a whitener and elsewhere as a disinfectant and sanitizer.  If used correctly bleach is both an economical and an effective way of killing harmful bacteria and viruses.  But we need to remember that bleach is a hazardous product. There is nothing worse than holes in your clothing or getting bleach, which is harmfully corrosive, in your eyes or on your skin—yikes! 

How much bleach do I need?

Bleach is powerful stuff —but add too little and it won’t do the job, add too much and you expose yourself and your family to harmful irritants. 

Sanitizing: for anything that has contact with food – this means refrigerators, freezers, countertops, high chair trays, or my favorite, toys that have been or are likely to be mouthed

• ¼ teaspoon of bleach per 1 quart of water (1 teaspoon of bleach per 1 gallon of water)  

 Disinfecting: for anything like a diapering area and a hand washing area

• 1 tablespoon of bleach per quart of water (¼ cup of bleach per 1 gallon of water) 

And let’s not forget the final step (this is a biggie) — once you apply the bleach solution let it air dry.  If you can’t wait until it is completely dry, wait at least two minutes then wipe dry.  If you don’t wait the appropriate time, the bleach won’t adequately kill the germs.

Tips for using bleach:

• NEVER (Notice the bold and underline here!) mix bleach with any other household or cleaning product.  Mixing it can cause poisonous gasses to be released. 
• Wear gloves and eye protection when mixing bleach.
• Add bleach to the water, not water to the bleach.
• Mix bleach with room temperature water.
• Purchase fragrance-free, regular strength bleach.
• When using bleach at home, open doors and windows to let fresh air in.
• Clean surfaces with soap and water first.  If an area is dirty it stops the disinfectant from working properly.  Rinse the area with clean water, then sanitize or disinfect.