Category Archives: Poisoning & Environmental Health

Pollution halts Vaughn Bay shellfish harvest: 14 other areas threatened

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Pollution to close shellfish harvest in one area; 14 others listed as threatened
Fecal bacteria levels force new restrictions to protect shellfish consumers

From the Washington State Department of health:

Alert Icon with Exclamation Point!OLYMPIA — The state Department of Health has closed harvesting in part of Vaughn Bay in Pierce County due to high levels of fecal bacteria. Health officials also identified 14 more of Washington’s 101 commercial shellfish growing areas that could be closed in the future if fecal pollution continues to get worse.

“The good news is that the pollution problems in almost all these areas can be found and fixed,” said Bob Woolrich, Growing Area section manager. “There have been many successful pollution correction projects using partnerships with local and state agencies, Tribes, and others.”

The agency shellfish program evaluates the state’s shellfish growing areas every year to see if water quality is approaching unsafe limits. If so, areas are listed as “threatened” with closure.

Shellfish harvesting areas threatened with closure include:

Continue reading

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App lets you determine your neighborhood’s radon risk

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Screen Shot 2014-01-21 at 11.28.29From the Washington State Department of Health

Olympia, January 21, 2014 – Washington residents now have a new online map to check and see if their neighborhood has a geological risk for the cancer-causing gas, radon, using a new state app. The new app is offered by the state Department of Health’s Washington Tracking Network.

Some areas of the state, such as Spokane and Clark counties, are well-known for having higher levels of radon, but the new online map shows that there are some areas around the Puget Sound such as Pierce and King counties that might come as a surprise.  Continue reading

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Over-the-counter pills left out of FDA acetaminophen limits

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red-and-white-capsules

By Jeff Gerth and T. Christian Miller
ProPublica

January 16, 2014 – Earlier this week, the U.S. Food and Drug Administration urged health care providers to stop writing prescriptions for pain relievers containing more than 325 milligrams of acetaminophen, the active ingredient in Tylenol.

The agency’s announcement was aimed primarily at popular prescription medicines that combine acetaminophen with a more powerful opioid such as hydrocodone.

Agency officials said they had determined that “there are no available data” to show that the benefits of having more than 325 milligrams of acetaminophen in a single pill outweighed the risks from taking too much of the drug. Continue reading

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Don’t use grills or gas generators in enclosed areas – Department of Health warns

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From the Washington State Department of Health

Power outages may raise risk of carbon monoxide poisoning

Charcoal grillDon’t use grills or gas generators in enclosed areas

January 10, 2014 – Barbecue grills and gas generators may seem like they could double as an indoor furnace during a power outage, but that can be downright dangerous.

Neither should be used inside to heat homes, as families could get sick and even die from carbon monoxide poisoning.

Carbon monoxide, or CO, is a poisonous gas that can’t be seen or smelled and can kill a person in minutes. Carbon monoxide is produced whenever any fuel such as gas, oil, kerosene, wood, or charcoal is burned. It can quickly build up to unsafe levels in enclosed or semi-enclosed areas.  Continue reading

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Seattle Children’s doctor offers tips to keep kids safe this holiday season

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Photo courtesy of Jay-Simmons

Photo courtesy of Jay Simmons

From Seattle Children’s On the Pulse blog

Tis the season for mistletoe, gingerbread and carefully strung lights. It’s the most wonderful time of the year, but also a potentially dangerous one for children. And although festivities, candles and garland may make the holiday season more cheerful, with them come some serious safety concerns.

Tony Woodward, MD, MBA, medical director of emergency medicine at Seattle Children’s Hospital, says the most important thing to remember this holiday season is supervision.

“The holidays are a fun and exciting time, but there are a few more things inserted into the environment, like holiday plants, electrical cables, new toys and festive beverages, which are potentially dangerous,” says Woodward.

Holiday safety tips

To keep kids out of the emergency room this year, Woodward recommends some basic safety tips to ensure an injury-free, but still festive holiday season.

Lights, trees and décor. Sparkly ornaments, shiny holiday decorations and small holiday figurines are potential choking hazards for small children. If an object can fit through a toilet paper tube, it can obstruct the airway of a small child and prevent breathing.

“Think like a child,” says Woodward. “Get down on your hands and knees and look around the house. If something looks shiny and enticing, a child may want to put it in their mouth. Keep decorations high and out of reach.”

Make sure trees and decorations are properly secured, either by a sturdy stand or to the wall. Also, talk to children about holiday decorations and explain that they are not toys. Set limits and supervise children.

Poisoning potential. Holiday plants like mistletoe, holly and poinsettias are commonly used as decorations, but they can be hazardous to children. These plants are considered potentially poisonous and should be kept away from children and out of reach. If a child ingests any part of these plants call a pediatrician or the Poison Help Line immediately at (800) 222-1222. Symptoms from poisoning may include vomiting, diarrhea, nausea or rash.

Medicines and vitamins can also be hazardous for children. Keep an eye out for medicine, vitamins and other personal products found in purses or suitcases that guests visiting for the holidays may bring into the home. Also, be aware when visiting other houses this holiday with your family, especially households without young children because the house may not be child proofed.

Be cautious of raw or undercooked foods during the holidays. Wash hands frequently when handling raw meat or eggs, and don’t leave foods out in reach of children.

Holiday parties. Hosting a holiday gathering this year? Plan for a party’s youngest guests first. Take small children into consideration when planning a party’s food and beverage menu, and before adorning the home with festive décor.

“Decorating the home with garland and strung beads may look great for the holidays, but children can mistake the brightly colored beads and floral arrangements for candy or food, which may cause choking or poisoning,” says Woodward.

Alcohol is another common risk for children around the holidays and during holiday gatherings.

“Kids see adults drinking alcohol and become curious. If glasses are left sitting out in reach of children they may ingest the alcohol, which even in small amounts can be dangerous to kids. Use common sense and always keep an eye on children,” says Dr. Woodward.

Also, stay home from parties or gatherings if children aren’t feeling well. Don’t risk spreading germs to others. Talk to children about proper hand washing and coughing techniques. Germs are easily spread, but these techniques can help prevent the transmission of germs from one person to another.

Fire safety. Keep decorations and trees away from heat sources within the home, which includes fireplaces, radiators, space heaters or electrical outlets. Also, avoid using candles if there are small children in the home.

When buying an artificial tree, make sure it is “fire retardant,” and also make sure a child’s sleepwear is labeled “fire retardant” as well. Be sure to also remove dry trees after the holiday season to reduce fire risk.

Use socket covers to baby-proof electrical outlets and make sure extension cords are well hidden and out of reach. Ensure cords are all the way in the outlets so kids don’t get shocked. Also, do not have water around outlets and wires.

Cooking is the leading cause of home fires in the U.S. Try to keep small children out of the kitchen while cooking or preparing food. Turn pot handles in so they can’t be accidently knocked over and stay in the kitchen while frying, grilling and broiling.

Toy safety. Many toys and holiday decorations require button batteries, which can pose fatal risks for young kids. Be sure batteries cannot be removed easily from toys and gadgets. If a battery is swallowed, it can cause life-threatening injuries. Also, avoid magnets. Toys that contain small magnets are especially dangerous for young kids. If swallowed, magnets can attract to one another in a child’s intestine and cause serious complications and even death.

“Make sure toys are appropriate for the age of a child, but also think about other children,” says Woodward. “Think about the worst case scenario. If a 1-year-old or 2-year-old will be in the home visiting for the holidays, ask if there are toys that could potentially be harmful to them.”

Just like checking a food’s ingredient list, parents should read toy and product labels. Avoid toys and products that contain PVC plastic, xylene, toluene or dibutyl phthalate.

Cold weather. With temperatures dropping, make sure children are properly dressed for the weather with hands, feet and heads covered. Dress children in layers and make sure they come in out of the cold periodically. The nose, ears, feet and hands are at the biggest risk of frostbite if temperatures are below freezing.

Supervise children while they play. Activities like sledding can be dangerous without proper supervision and safety gear. Also, be extremely cautious around water. Never allow children to walk across frozen lakes or ponds.

Lastly, wear sunscreen. It may be cold, but children are still at risk for sunburn.

The holidays are a time for celebration and fun. By following these simple safety tips, families can enjoy the holiday season without injury. Happy Holidays!

Photograph courtesy of Jay Simmons

Resources:

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When temperatures dip, air quality often does as well

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Illustration of the lungs in blueFrom the Washington State Department of Health

You may have noticed spectacular evening skies this winter, yet those sunsets frequently are a sign of air quality problems that occur this time of year. Winter weather patterns can trap air pollution – especially from wood stoves and fireplaces – near the ground, where it can build-up and may threaten people’s health.

The state Department of Health is reminding people air pollution can be harmful to their health. It can be especially harmful for people who have a lung condition like asthma, chronic obstructive pulmonary disorder (COPD), or with heart disease.

Air pollution has fine particles that can cause immediate and long-term health effects when inhaled. It’s a good idea to check local air conditions and limit outdoor activities when air quality conditions are poor.

The amount of air pollution that causes immediate health problems varies from person-to-person. For people who are sensitive to air pollution, even a short outdoor stroll can cause wheezing or shortness of breath.

Others may not have problems until they do more strenuous activities like yard work, running, or shoveling snow. Kids and adults over 65 are among those who should limit their activity during periods of poor air quality.

Air pollution often can’t be seen or smelled, but the state Department of Ecology monitors air conditions and posts them online across the state. More information and statistics on air quality in your community can be found on our website.

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FDA warns of rare acetaminophen risk

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A Consumer Update from the US Food and Drug Administration

ucm363013Acetaminophen, a fever and pain reliever that is one of the most widely used medicines in the U.S., can cause rare but serious skin reactions, warns the Food and Drug Administration (FDA).

Although rare, possible reactions to acetaminophen include three serious skin diseases whose symptoms can include rash, blisters and, in the worst case, widespread damage to the surface of skin.

If you are taking acetaminophen and develop a rash or other skin reaction, stop taking the product immediately and seek medical attention right away.

Used for decades by millions of people, acetaminophen is the generic name of a common active ingredient included in numerous prescription and non-prescription medicines.

Tylenol is one brand name of the pain reliever sold over the counter, but acetaminophen is also available as a generic under various names.

It is also used in combination with other medicines, including opioids for pain and medicines to treat colds, coughs, allergy, headaches and trouble sleeping.

“This new information is not intended to worry consumers or health care professionals, nor is it meant to encourage them to choose other medications,” says Sharon Hertz, M.D., deputy director of FDA’s Division of Anesthesia, Analgesia and Addiction. “However, it is extremely important that people recognize and react quickly to the initial symptoms of these rare but serious, side effects, which are potentially fatal.”

Other drugs used to treat fever and pain, such as nonsteroidal anti-inflammatory drugs including ibuprofen and naproxen, already carry warnings about the risk of serious skin reactions.

Advil and Motrin are among the common brand names that include ibuprofen as an active ingredient. Aleve and Midol Extended Relief are among the best-known brand names that include naproxen as an active ingredient.

FDA is requiring that a warning about these skin reactions be added to the labels of all prescription medicines containing acetaminophen.

FDA will work with manufacturers to get the warnings added to the labels of over-the-counter (OTC) medicines containing acetaminophen.

On OTC medicines, the word “acetaminophen” appears on the front of the package and on the Drug Facts label’s “active ingredients” section.

On prescription medications, the label may spell out the ingredient or use a shortened version such as “APAP,” “acet,” “acetamin” or “acetaminoph.”

Ingredient Linked to Several Conditions

Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) are the two most serious skin reactions linked in rare cases to acetaminophen. They usually require hospitalization and can cause death.

Problems usually begin with flu-like symptoms followed by rash, blistering and extensive damage to the surfaces of the skin. Recovery can take weeks or months, and possible complications include scarring, changes in skin pigmentation, blindness and damage to internal organs.

A third skin reaction, acute generalized exanthematous pustulosis (AGEP), usually resolves within two weeks of stopping the medication that caused the problem.

A serious skin reaction can occur at any time, even if you’ve taken acetaminophen previously without a problem. There is currently no way of predicting who might be at higher risk.

If you’ve ever had a skin reaction when taking acetaminophen, don’t take the drug again and discuss alternate pain relievers/fever reducers with your health care professional.

Evidence of Link

Prior to deciding to add a warning about skin reactions to products containing acetaminophen, FDA reviewed medical literature and its own database, the FDA Adverse Event Reporting System (FAERS).

A search of FAERS uncovered 107 cases from 1969 to 2012, resulting in 67 hospitalizations and 12 deaths. Most cases involved single-ingredient acetaminophen products; the cases were categorized as either probable or possible cases associated with acetaminophen.

A small number of cases, just over two dozen, are documented in medical literature, with cases involving people of various ages.

FDA has examined—and continues to examine—acetaminophen for safety issues, just as it does with all approved drugs. The warning comes two years after FDA took new steps to reduce the risk of liver injury from acetaminophen.

In that case, FDA asked all makers of prescription products to limit acetaminophen to 325 milligrams per tablet or capsule. FDA also required all prescription acetaminophen products to include a Boxed Warning—FDA’s strongest warning, used for calling attention to serious risks.

The agency continues to consider the benefits of this medication to outweigh the risks.

“FDA’s actions should be viewed within the context of the millions who, over generations, have benefited from acetaminophen,” says Hertz. “Nonetheless, given the severity of the risk, it is important for patients and health care providers to be aware of it.”

This article appears on FDA’s Consumer Updates page, which features the latest on all FDA-regulated products.

August 1, 2013

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Blue sky and white clouds (Panorama)

Hot weather: How to stay cool and safe

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Blue sky and white clouds (Panorama)

Hot weather tips from Public Health – Seattle & King County

When outside temperatures are very high, the danger for heat-related illnesses rises. People’s bodies are not able to cool themselves quickly enough, and they overheat.

In severe instances, people can suffer heat stroke, which can cause death or permanent disability if emergency treatment is not provided.

Older adults, young children, and people with mental illness and chronic diseases are at highest risk for heat-related illness. But even young and healthy individuals can suffer in heat if they participate in strenuous physical activities during hot weather.

You can protect yourself and loved ones against very hot temperatures by following these recommendations:

Stay cool

  • Spend more time in air conditioned places. If you don’t have air conditioning, consider visiting a mall, movie theater or other cool public places.
  • Cover windows that receive morning or afternoon sun.
  • Dress in lightweight clothing.
  • Take a cool shower or bath, or place cool washcloths on your skin.
  • Check up on your elderly neighbors and relatives to take these precautions too.

Drink liquids:

  • Drink plenty of water. Avoid drinks with caffeine, alcohol and large amounts of sugar because they can actually de-hydrate your body.
  • Have a beverage with you at all times, and sip or drink frequently. Don’t wait until you’re thirsty to drink.

If you go outside:

  • Limit the time you’re in direct sunlight.
  • Do not leave infants, children, people with mobility challenges and pets in a parked car, even with the window rolled down.
  • Avoid or reduce doing activities that are tiring, or take a lot of energy.
  • Do outdoor activities in the cooler morning and evening hours.
  • Avoid sunburn. Use a sunscreen lotion with a high SPF (sun protection factor) rating.

Water safety:

Some people turn to local rivers to cool off, but drowning is a real concern. Please use caution and wear a personal flotation device (PFD) on the water. Find deals on affordable lifejackets. And if you want to swim, choose a safer location – visit a local pool or lifeguarded beach instead.

Certain medications may increase sensitivity to the heat. If you are concerned about the heat and the medications you are taking, check with your doctor. Do not take salt tablets unless your doctor tells you to.

Hot Weather fact sheets in other languages by the Washington State Dept. of Health:

Recognizing heat exhaustion and heat stroke

When people’s bodies can’t cool themselves quickly enough it can cause heat exhaustion. Symptoms of heat exhaustion include muscle cramps, weakness, dizziness, headache, nausea and vomiting.

If you see someone with signs of overheating, move the person to a cooler location, have them rest for a few minutes and then slowly drink a cool beverage. Get medical attention for them immediately if they do not feel better.

Heat exhaustion can lead to heat stroke, which can cause death or permanent disability unless treated immediately. Symptoms of heat stroke include:

  • An extremely high body temperature (above 103°F)
  • Red, hot, and dry skin
  • Rapid, strong pulse
  • Nausea, confusion and unconsciousness

For more information, visit these websites:

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Photo by Sanja Gjenero

Salmonella in eggs: An unwelcome summer visitor

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Photo by Sanja Gjenero

Photo by Sanja Gjenero

CDC Features

Eggs and summer go together: deviled eggs, homemade ice cream, and potato salad.

But, just a few hours outside of the refrigerator and your eggs can create lasting memories that you’d rather forget.

This summer, make sure that eggs carrying Salmonella don’t come to your next outing.

Summer is the perfect season for Salmonella, a germ that commonly causes foodborne illness–sometimes called food poisoning.

Warm weather and unrefrigerated eggs or food made from raw or undercooked eggs create ideal conditions for Salmonella to grow.

Many germs grow to high numbers in just a few hours at room temperature.

Although anyone can get Salmonella food poisoning, older adults, infants, and people with weakened immune systems are at increased risk for serious illness.

A person infected with Salmonella usually has a fever, abdominal cramps, and diarrhea beginning 12 to 72 hours after consuming a contaminated food or beverage.

The illness usually lasts 4 to 7 days, and most people recover without antibiotic treatment. But, in rare cases, people become seriously ill.

In the United States, Salmonella infection causes more hospitalizations and deaths than any other germ found in food, resulting in $365 million in direct medical costs annually.

Wondering if you haveSalmonella food poisoning?

salmonella on cultured human cells

Salmonella / CDC

See your doctor or healthcare provider if you have:

  • Diarrhea along with a temperature over 101.5°F
  • Diarrhea for more than 3 days that is not improving
  • Bloody stools
  • Prolonged vomiting that prevents you from keeping liquids down
  • Signs of dehydration, such as
    • Making very little urine
    • Dry mouth and throat, and
    • Dizziness when standing up

Salmonella can be sneaky

You can get Salmonella from perfectly normal-looking eggs. Salmonella can live on both the outside and inside of eggs that appear to be normal. Chicken feces on the outside of egg shells used to be a common cause of Salmonella contamination. To counter that, regulators in the 1970s put strict procedures into place for cleaning and inspecting eggs. Now, Salmonella is sometimes found on the inside of eggs; it gets there as the egg is forming.

Good news for egg lovers

Professionals from public health, government, and the food industry are continually working to reduce the risks of Salmonella in eggs. Here are just a few contributions made thus far:

Be proactive. Reduce your risk.

Did You Know?

Eating raw or undercooked eggs can be especially dangerous for young children, pregnant women, older adults, and those with weakened immune systems.

Salmonella can contaminate more than poultry and eggs. It sneaks its way into many foods—ground beef, pork, tomatoes, sprouts—even peanut butter. Here are six tips to make eggs and other foods safer to eat.

  1. Like other perishable foods, keep eggs refrigerated at or below 40° F (4° C) at all times. Buy eggs only from stores or other suppliers that keep them refrigerated.
  2. Discard cracked or dirty eggs.
  3. Do not keep eggs or other foods warm or at room temperature for more than two hours.
  4. Refrigerate unused or leftover foods promptly.
  5. Avoid restaurant dishes made with raw or lightly cooked unpasteurized eggs. Although restaurants should use pasteurized eggs in any recipe containing raw or lightly cooked eggs –such as Hollandaise sauce or Caesar salad dressing—ask to be sure.
  6. Consider buying and using shell eggs and egg products that are pasteurized. These are available for purchase from certain stores and suppliers.

 Photo of eggs courtesy of Sanja Gjenero

More Information

For more information about Salmonella, foodborne illness, and food safety, call 1-800-CDC-INFO, e-mail cdcinfo@cdc.gov, or visit these web sites:

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Safety begins at home – National Public Health Week article

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Ensuring a Safe, Healthy Home for Your Family

The American Public Health Association is marking National Public Health Week with a series of articles about what you can do to improve your and your family’s health and safety. 

homePublic health is in every corner of our homes. It’s in the safe food in the fridge, the carbon monoxide and smoke detectors affixed to the ceiling, and the child-proof latches that keep dangerous chemicals out of little hands. Home is also where we learn healthy behaviors, such as eating right and exercising. Good prevention starts at home.

Did You Know?

  • The majority of fire-related deaths happen at home. In 2010 in the United States, someone died in a fire every 169 minutes and someone was injured every 30 minutes. About two-thirds of home fire deaths happened in homes without working  smoke alarms.
  • Falls are the leading cause of injury-related deaths among people ages 65 and older. Each year, one out of every three adults ages 65 and older experiences a fall. In 2010, falls resulted in $30 billion in direct medical costs.
  • Nine out of every 10 childhood poison exposures happens at home, with medications being among the top culprits.
  • More than half of all swimming pool drownings among children could have been prevented with appropriate fencing that completely separates the pool from the house and yard.
  • Many more efforts are needed to help all families and households adequately prepare for natural disasters and other emergencies, such as having a three-day supply of water and a written evacuation plan.
  • Fewer than 15 percent of adults and 10 percent of adolescents eat the recommended amounts of fruits and vegetables each day.

What Public Health Teaches Us

Start small…

  • Smoke alarms can double your chance of surviving a fire, so install alarms on every floor of your home and test that they’re working monthly. While you’re at it, install a carbon monoxide alarm on every floor of your home as well.
  • Help prevent fires — as well as serious health problems and chronic diseases — by making your home tobacco- and smoke-free.
  • Keep potentially dangerous household products, such as cleaning products, cosmetics and prescription medications, locked up and out of children’s reach. Also, never store household chemicals in old food containers or in the same place you keep food items. Learn more atwww.upandaway.org.
  • Gather your household for a night of emergency preparedness: Make plans for putting together an emergency stockpile kit, create a crisis communication plan, designate an emergency meeting place and hold household emergency drills.
  • Put this number on your fridge and in your cell phone: 1-800-222-1222. It will automatically connect you to your regional poison control center and often life-saving information.
  • Put up four-sided fencing that’s at least five feet high with self-latching gates around swimming pools to protect children from injury
  • Assess your home, or the home of a loved one, for factors that could contribute to a fall, such as poor lighting, uneven flooring and clutter.
  • Stock your kitchen with plenty of fresh fruits and vegetables and cut down on high-sugar and high-fat items.
  • Learn about proper food handling and cooking techniques to avoid food-borne illness.
  • Learn how to properly dispose of unused medications.
  • Tell your friends and online followers how you and your household are celebrating National Public Health Week. Keep a journal of the changes you’ve made on your blog or other social media accounts or send a letter to the editor to your local newspaper. Let others know how easy — and fun — it can be to make public health and prevention a part of our lives.

Think big…

  • Help organize a yoga or Tai Chi class for older adults to help improve balance and prevent falls.
  • Organize a community fire safety event with the local fire department.
  • Get involved in community efforts addressing the growing epidemic of prescription drug abuse, such as promoting drug take-back events.
  • Spread the word about emergency preparedness at your children’s school, your parents’ retirement community and the other places you spend time. Volunteer to help these places assess their readiness and start planning.
  • Promote awareness of how local public health systems keep communities healthy at home, such as keeping our food and water safe. Encourage residents and leaders to take a moment to imagine how dramatically our lives would change if that system disappeared. Let your key decision-makers know that you support public health and prevention.

There is much more you can do to ensure a safe and healthy home for you and your family. To learn more about putting prevention to work at home, visitwww.cdc.gov/homeandrecreationalsafety.

To learn more about public health visit the American Public Health Association’s website.

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State health officials want you to send them your ticks

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Female western black-legged tick, Ixodes pacificus, can transmit Borrelia burgdorferi, the bacteria that causes Lyme disease. These ticks are mainly found in western Washington and live in forested or brushy areas. Photo: James Gathany, CDC

Female western black-legged tick, Ixodes pacificus, can transmit Borrelia burgdorferi, the bacteria that causes Lyme disease. These ticks are mainly found in western Washington and live in forested or brushy areas. Photo: James Gathany, CDCr

The Department of Health invites people all over the state to send ticks to the agency for a project to learn more about what types of ticks live in Washington.

Washington has relatively few cases of tick-borne disease, yet each year a few cases of relapsing fever, Lyme disease, and Rocky Mountain spotted fever are reported to state health officials.

“Different types of ticks carry different diseases,” said Liz Dykstra, public health entomologist for the Department of Health. “We’re asking people to help us learn more by sending us ticks for identification so we understand the risks for disease in different areas.”

Information about sending ticks to the Department of Health and on preventing tick bites is on our tick webpage or contact us by e-mail or phone, 1-877-485-7316.

More about ticks:

Female western black-legged tick, Ixodes pacificus, can transmit Borrelia burgdorferi, the bacteria that causes Lyme disease. These ticks are mainly found in western Washington and live in forested or brushy areas.  Photo: James Gathany, CDCTicks are small blood-feeding parasites that can transmit diseases to people. Some types of ticks perch on the edge of low-lying vegetation and grab onto animals, and people, as they brush past.

Other ticks are associated with rodents and their nests and may only come out at night to feed. Once aboard, ticks crawl until they find a good spot to feed, then burrow their mouthparts into the skin for a blood meal.

Their bodies slowly enlarge to accommodate the amount of blood ingested. Ticks feed anywhere from several minutes to several days depending on their species, life stage, and type of host.

Avoiding Tick Bites

Information from the Washington State Department of Health’s Zoonotic Disease Program

Outdoor Activities

When working, camping, or walking in a tick habitat – wooded, brushy, or grassy places – a few simple precautions can reduce your chance of being bitten.

  • Wear long pants and a long-sleeved shirt. Tuck your pant legs into socks or boots and shirt into pants. This can help keep ticks on the outside of your clothing where they can be more easily spotted and removed.
  • Wear light colored, tightly woven clothing which will allow the dark tick to be seen more easily. The tight weave makes it harder for the tick to attach itself.
  • Use tick repellent when necessary, and carefully follow instructions on the label. Products containing DEET or permethrin are very effective in repelling ticks. Take special care when using repellents on children.
  • Check yourself, your children, and pets thoroughly for ticks. Carefully inspect areas around the head, neck, ears, under arms, between legs, and back of knees. Look for what may appear like a new freckle or speck of dirt.
  • Shower or bathe (preferably within two hours after being in tick habitat) to wash off and more easily find ticks that are crawling on you.

Cabins and Rodents

When staying in summer cabins or vacation homes, especially in eastern Washington, make sure rodents, and their ticks, aren’t spending the night with you. Practice rodent control by not attracting rodents, sealing them out of your living areas, trapping rodents, and properly cleaning up rodent-contaminated areas.

Around the Home Management

Focus your management of tick habitat to areas frequently used by your family, not necessarily your entire property.

  • Use brick, paving, decking, gravel, container plantings, and low water requirement plants to encourage bright sunny areas immediately around your home – open sunny areas are less likely to harbor ticks.
  • Keep grass mowed, shrubs trimmed, and restrict the use of groundcover in family or pet areas.
  • Keep dogs and cats out of the woods to keep them from bringing home ticks. Tick control products are available for pets – follow label instructions and talk to your veterinarian if you have questions.
  • Widen woodland trails.
  • Move swing sets, sand boxes, and other children play areas away from the edge of woods and place them on a wood chip or mulch foundation.
  • Use plantings that don’t attract deer or exclude deer through fencing.
  • Practice rodent control to discourage rodent activity in and around your home.

Removing a Tick

  • Promptly remove the tick using fine-tipped tweezers. Grasp the tick as close to the skin surface as possible and pull upward with steady, even pressure. Avoid removing the tick with bare hands. Don’t twist or jerk the tick — this may cause the mouthparts to break off and remain in the skin. If this happens, remove the mouthparts with tweezers.
  • After removing the tick, disinfect the bite site and wash your hands.
  • Note the date that you found the tick attached to you, just in case you become ill. If a fever, rash, or flu-like illness occurs within a month, let your doctor know that you were bitten by a tick. This information may assist your doctor in diagnosing your illness.

Avoid Folk Remedies to Remove a Tick

Hot matches or coating the tick’s body with petroleum jelly, soap, or nail polish do little to encourage a tick to detach from skin. In fact, they may make matters worse by irritating the tick and causing it to release additional saliva, increasing the chance of transmitting disease. These methods of tick removal should be avoided.

Identifying Ticks

Neither the Washington State Public Health Laboratory nor the CDC test ticks for disease. We can, however, identify ticks to species. Because different tick species transmit different pathogens, knowing the tick species may help a health care provider diagnose an illness that could be associated with a tick bite.

  • Healthcare providers and local health departments investigating a possible human tick-borne disease case should submit a tick for identification using the Microbiology Submission Form (PDF). Mark “Parasitology” and indicate the tick exposure location under the “Comments” section.
  • Ticks found on you, a family member, or a pet can be submitted for identification using the Tick Identification Submission Form (PDF).

Diseases Spread by Ticks

Washington has relatively few tick-borne disease cases reported each year in comparison to some areas of the United States. If you think you have symptoms of a tick-borne disease, contact your doctor. Doctors are asked to notify local health department of suspected or confirmed cases of tick-borne disease (see Notifiable Conditions). The following diseases can be transmitted by a tick bite in Washington.

Lyme Disease

The first sign of Lyme disease is usually an expanding circular rash which starts at the site of the tick bite. The rash may have a target-shape or “bull’s-eye” appearance. Fever, headache, muscle aches, and joint pain may also occur. If left untreated, later symptoms can include recurring joint pain, heart disease, and nervous system disorders. Lyme disease is the most common tick-borne disease in the United States, but is rare in Washington. Only 0 to 3 Lyme disease cases per year are reported to be infected in Washington. Lyme disease is caused by theBorrelia burgdorferi bacteria, which can be transmitted through the bite of a western black-legged tick, Ixodes pacificus. Western black-legged ticks pick up the bacteria after feeding on infected rodents. These ticks live in forested or brushy areas of western Washington. Learn more about Lyme disease.

Tick-borne Relapsing Fever

Symptoms include relapsing (recurrent) periods of fever lasting for 2 to 7 days, disappearing for about 4 to 14 days, and then reoccurring. One to 12 cases of tick-borne relapsing fever are reported each year in Washington. Most people become infected while staying in rural, mountainous cabins of eastern Washington during the summer months. The soft tick, Ornithodorus hermsi, typically feeds on rodents, which is where they pick up the Borrelia hermsii bacteria. The infected tick can then transmit the bacteria by feeding on a person for short periods of time while they are sleeping. Since these ticks are associated with rodent burrows and nests, it’s important to keep rodents out of cabins and other sleeping areas. Learn more about tick-borne relapsing fever.

Rocky Mountain Spotted Fever

Initial symptoms of Rocky Mountain spotted fever may include fever, nausea, vomiting, muscle pain, lack of appetite, and severe headache. A rash generally, but not always, appears a few days later. Abdominal pain, joint pain, and diarrhea can also occur. Each year, 0 to 3 cases of Rocky Mountain spotted fever are identified in Washington. Some of the cases are infected in Washington, some are infected elsewhere. The bacteria that causes Rocky Mountain spotted fever is transmitted by the bite of an infected American dog tick, Dermacentor variabilis, or Rocky Mountain wood tick, D. andersoni. These ticks are found throughout the state and prefer woodland areas, medium height grasses and shrubs between wetlands and woods, and sunny or open areas around woods. They are especially common in eastern Washington. Learn more aboutRocky Mountain Spotted Fever, CDC.

Tick Paralysis

Tick paralysis is caused by a neurotoxin from an attached tick. This condition is characterized by a progressive paralysis that usually starts in the legs with muscle weakness, loss of coordination, numbness, and difficulty standing or walking. The symptoms progress upwards to the abdomen, back, and chest. If the tick is not removed, paralysis of the chest muscles can lead to respiratory failure and death within 24 to 48 hours after symptoms begin. Prompt removal of the tick usually leads to a complete recovery. Twelve cases of tick paralysis have been reported in Washington from 1990 through 2011. Ticks associated with tick paralysis include Ixodes and Dermacentor species that live in forested and brushy areas or along edges between open grassy areas and woods. See Tick Paralysis Case Report, CDC.

Tularemia

A tick bite is one way people can get tularemia. Symptoms of tularemia following a tick bite include sudden fever, headache, swollen lymph nodes, and a skin ulcer near the bite. One to 10 cases of tularemia are reported each year in Washington – only some of these are due to tick bites and some cases are acquired in other states. Ticks that can transmit tularemia in Washington are the American dog tick,Dermacentor variabilis, and the Rocky Mountain wood tick, D. andersoni. These ticks are found throughout the state and prefer woodland areas, medium height grasses and shrubs between wetlands and woods, and sunny or open areas along the edge of woods. Find out more at Tularemia, CDC.

Anaplasmosis

Symptoms of anaplasmosis include headache, fever, chills, and muscle aches. No human cases have been reported in Washington, however, anaplasmosis has been diagnosed in numerous dogs in our state. Western black-legged ticks, Ixodes pacificus, can carry the bacteria that cause anaplasmosis and are found in the western part of the state living in forested or brushy areas. Learn more about Anaplasmosis, CDC.

Babesiosis

Symptoms of babesiosis include fever, chills, fatigue, muscle pain, and anemia. Since 1990, only 2 cases have been reported as contracting the disease in Washington. The western black-legged tick, Ixodes pacificus, is considered the vector of this disease in Washington. This tick is found in forested or brushy areas of western Washington. See Babesiosis, CDC.

Content Source: Zoonotic Disease Program

 

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Poison logo

Poison prevention tips from the American Academy of Pediatrics

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From the American Academy of Pediatrics

National Poison Prevention Week, March 18 – 24, 2012

Each year, approximately 2.4 million people – more than half under age 6 – swallow or have contact with a poisonous substance. The American Academy of Pediatrics (AAP) has some important tips to prevent and to treat exposures to poison.

To poison proof your home:

Poison logoMost poisonings occur when parents or caregivers are home but not paying attention. The most dangerous potential poisons are medicines, cleaning products, antifreeze, windshield wiper fluid, pesticides, furniture polish, gasoline, kerosene and lamp oil.

Be especially vigilant when there is a change in routine. Holidays, visits to and from grandparents’ homes, and other special events may bring greater risk of poisoning if the usual safeguards are defeated or not in place.

  • Store medicine, cleaners, paints/varnishes and pesticides in their original packaging in locked cabinets or containers, out of sight and reach of children.
  • Install a safety latch – that locks when you close the door – on child-accessible cabinets containing harmful products.
  • Purchase and keep all medicines in containers with safety caps and keep out of reach of children. Discard unused medication.
  • Never refer to medicine as “candy” or another appealing name.
  • Check the label each time you give a child medicine to ensure proper dosage.
  • Never place poisonous products in food or drink containers.
  • Keep coal, wood or kerosene stoves in safe working order.
  • Maintain working smoke and carbon monoxide detectors.
  • Secure remote controls, key fobs, greeting cards, and musical children’s books. These and other devices may contain small button-cell batteries that can cause injury if ingested.

Treatment

If your child is unconscious, not breathing, or having convulsions or seizures due to poison contact or ingestion, call 911 or your local emergency number immediately.

If your child has come in contact with poison or you suspect that your child may have swallowed a button-cell battery, and has mild or no symptoms, call your poison control center at 1-800-222-1222

Different types and methods of poisoning require different, immediate treatment:

  • Swallowed poison – Remove the item from the child, and have the child spit out any remaining substance. Do not make your child vomit. Do not use syrup of ipecac.
  • Skin poison — Remove the child’s clothes and rinse the skin with lukewarm water for at least 15 minutes.
  • Eye poison — Flush the child’s eye by holding the eyelid open and pouring a steady stream of room temperature water into the inner corner for 15 minutes.
  • Poisonous fumes – Take the child outside or into fresh air immediately. If the child has stopped breathing, start cardiopulmonary resuscitation (CPR) and do not stop until the child breathes on his or her own, or until someone can take over.
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Know the active ingredients in your child’s meds – FDA

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Read the Drug Facts Label: Active ingredients, which make a medicine effective against the illness it is treating, are listed first on the product's Drug Facts label.

Read the Drug Facts Label: Active ingredients, which make a medicine effective against the illness it is treating, are listed first on the product’s Drug Facts label.

FDA Consumer Update

Ah-choo!

If your child is sneezing up a storm, it must be allergy season once more.

And if your child is taking more than one medication at the same time, there could be dangerous health consequences if those medicines have the same active ingredient, according to Hari Cheryl Sachs, M.D., a pediatrician at the Food and Drug Administration (FDA).

A medicine is made of many components. Some are “inactive” and only help it to taste better or dissolve faster, while others are active.

An active ingredient in a medicine is the component that makes it pharmaceutically active—it makes the medicine effective against the illness or condition it is treating.

Active ingredients are listed first on a medicine’s Drug Facts label for over-the-counter (OTC) products. For prescription medicines, they are listed in a patient package insert or consumer information sheet provided by the pharmacist.

Many medicines have just one active ingredient. But combination medicines, such as those for allergy, cough, or fever and congestion, may have more than one.

Take antihistamines taken for allergies. “Too much antihistamine can cause sedation and—paradoxically—agitation. In rare cases, it can cause breathing problems, including decreased oxygen or increased carbon dioxide in the blood, Sachs says.

“We’re just starting allergy season,” says Sachs. “Many parents may be giving their children at least one product with an antihistamine in it.”

Over-the-counter (OTC) antihistamines (with brand name examples) include diphenhydramine (Benadryl), chlorpheniramine (Chlor-Trimeton), clemastine (Tavist), fexofenadine (Allegra), loratadine (Claritin, Alavert), and cetirizine (Zyrtec).

But parents may also be treating their children for a separate ailment, such as a cough or cold. What they need to realize is that more than one combination medicine may be one too many.

“It’s important not to inadvertently give your child a double dose,” Sachs says.

Other Health Complications

The same goes for other active ingredients, often found in combination products for allergies but also used to treat other symptoms, such as fever, headache or nasal congestion:

  • Acetaminophen (in Tylenol and many other products), a pain reliever often used to treat fevers, mild pain or headache. Taking too much can cause liver damage.
  • Ibuprofen (for example, Advil or Motrin), another common medicine for relieving mild to moderate pain from headaches, sinus pressure, muscle aches and flu, as well as to reduce fever. Too much ibuprofen can cause nausea, vomiting, diarrhea, severe stomach pain, even kidney failure.
  • Decongestants such as pseudoephedrine or phenylephrine (found in brand name drugs such as Actifed and Sudafed) taken in large amounts can cause excessive drowsiness in children. They can also cause heart rhythm disturbances, especially if combined with products and foods containing caffeine. In the form of nasal sprays and nose drops, these products, as well as oxymetazoline (the active ingredients in products such as Afrin), can cause “rebound” congestion, in which the nose remains stuffy or gets even worse.

Any of the above symptoms may indicate a need for immediate medical attention. “The bottom line is that neither you, nor your children, should take multiple combination medicines at the same time without checking the active ingredients and consulting your health care professional first,” recommends Sachs.

Furthermore, two different active ingredients may serve the same purpose, Sachs says. For example, both acetaminophen and ibuprofen help reduce pain and fever. So there’s generally no need to give your child both medicines for the same symptoms.

Write It All Down

Whether you’re treating your child’s condition with OTC medicines from the drug store or ones prescribed by your doctor, it’s essential that you keep track of every medicine and the active ingredients each contains, Sachs says.

“It’s easy to forget which medicines you’re giving your child,” Sachs says. “And if you have more than one child, it can get even more complicated.” She recommends making it a habit to write down the name of any medicine you give your child, whether it’s OTC or prescription (download a daily medicine records template).

“It’s really a good idea to carry that list with you when you go to see your pediatrician or even when you go to the pharmacy,” she adds. You should also note whatever vitamins or supplements your child is taking, as these can interact unfavorably with certain medicines, too.

Most importantly, Sachs says parents should always read the Drug Facts label on OTC products, and the patient package insert or consumer information sheet that comes with prescription medicines, every time they’re considering a medication for their child, even if they think they already know the ingredients.

They should know that the ingredients can change without an obvious change in the packaging. And they should contact their health care professional with any questions.

This article appears on FDA’s Consumer Updates page, which features the latest on all FDA-regulated products.

March 12, 2013

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Accidental poisonings leading cause of deaths at home

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A jumble of pill bottles

Photo by Erin DeMay via Flickr

By Stephanie Stephens, HBNS Contributing Writer
Research Source: American Journal of Preventive Medicine

An increasing number of people are dying from unintentional injury at home, with more than 30,000 deaths occurring between 2000 and 2008, finds a new study in the American Journal of Preventive Medicine. Poisoning, falls and fire/burn injuries caused the most fatalities, respectively.

The study reveals that poisonings were the leading cause of unintentional home injury deaths for those ages 15 to 59 years, largely resulting from unintentional drug overdoses of narcotics, hallucinogens and other drugs.

Additionally, more men and boys died from home injury than women and girls did and adults 80 years and older had higher rates of injury-related in-home death than other ages.

“These injuries are predictable and preventable,” said lead author Karin Mack, Ph.D. of the National Center for Injury Prevention and Control of the Centers for Disease Control and Prevention.

Mack and her colleagues called for more research to develop effective interventions to modify the home like smoke alarms, limiting access to non-prescription drugs, and closer supervision of children.

Other helps would be broader dissemination of prevention messages to specific audiences including healthcare and education providers, law enforcement and policymakers, and media, they said.

The researchers used combined state-specific death certificate data from the National Vital Statistics System, an inter-governmental public health database. New Mexico had the highest rates of unintentional home injury death during the study period with the lowest in Massachusetts.

Mack said that despite the uptick in home injury during the study period, she was encouraged by momentum occurring in the field of healthy homes, citing two publications that helped spark national interest in home safety: a 2009 report, “The Surgeon General’s Call to Action to Promote Healthy Homes,” and a 2011 report from the American Public Health Association, “Healthy & Safe Homes: Research, Practice, and Policy”.

Much more needs to be done, said Carol W. Runyan, M.P.H., Ph.D., a professor of epidemiology and community and behavioral health at the Colorado School of Public Health.

“The increases in poisoning, largely due to prescription pain medication, have been most dramatic over the past decade, signaling a need to rethink how pain medications are prescribed and used,” she said.

Falls continue to be the major source of fatal home injury in older adults and suffocation the leading cause for infants, Runyan said.

“As the authors note, most of these injuries are preventable through changes in the home environment and safety practices. Unfortunately, this enormous and costly public health problem has not received the national attention it deserves. Funding to understand and address the problem is a pittance compared to other health problems and many health professionals are poorly trained to address these challenges,” she said.

Runyan said the deaths are not inevitable results of uncontrollable or accidental circumstances. “Hopefully this paper will stimulate a shift in the national attention and support for prevention,” she said.
Health Behavior News Service is part of the Center for Advancing Health

The Health Behavior News Service disseminates news stories on the latest findings from peer-reviewed research journals. HBNS covers both new studies and systematic reviews of studies on (1) the effects of behavior on health, (2) health disparities data and (3) patient engagement research. The goal of HBNS stories is to present the facts for readers to understand and use for themselves to make informed choices about health and health care.

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