Category Archives: Public Health

Zika quarantine? Good idea or bad?

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Public Health — Seattle & King County expert weighs in

By Dr. Jeff Duchin, MD
Health Officer and Chief of Communicable Disease Epidemiology & Immunizations

DuchinExperts are still learning about Zika virus, and in this time of uncertainty, some some are calling for a quarantine on travelers from areas affected by Zika.

I don’t think it’s a good idea.

This is a transmission electron micrograph (TEM) of Zika virus, which is a member of the family Flaviviridae. Virus particles are 40 nm in diameter, with an outer envelope, and an inner dense core. Additional Information:“Zika virus is spread to people through mosquito bites. The most common symptoms of Zika virus disease are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting from several days to a week. Severe disease requiring hospitalization is uncommon.”For more information on the Zika virus, follow the link below.

Zika virus — Cynthia Goldsmith/CDC

Quarantine of travelers exposed to Zika virus is neither appropriate nor feasible, and would likely have no meaningful impact on the spread on the disease – but would result in significant negative unintended consequences on travel, commerce, individuals and families.

Quarantine of returning travelers would be costly and complicated to carry out for no real benefit. Although Zika poses a real threat of continued global spread, continuing measures to protect travelers and control the outbreaks where they are occurring, although imperfect, are more appropriate responses.

This is true for a number of reasons.

  1. There is no practical way to identify or screen for who is infected with Zika and potentially capable of transmitting infection. Most infections are asymptomatic and there is no rapid diagnostic test.
  2. In addition, everything we know suggests the threat to the US is not large. Based on experience with other viruses, like dengue and chikungunya, that are transmitted by the same mosquito vectors and have reached the US after large scale epidemics expanded globally, the risk for ongoing transmission or large outbreaks in the US is thought to be low. (In much of the country including the Pacific Northwest, we don’t have the type of mosquitoes that transmit Zika, dengue and chikungunya.) In contrast, the number of persons traveling to and from Zika-affected areas would be extremely large and enter the US at many points, making implementation of quarantine unrealistic even if it was potentially useful.
  3. And, it’s likely that Zika, as dengue and chickungunya viruses have done, will become established in much of the world, meaning that quarantine would need to be continued on an ongoing basis.

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Texas tries to repair damage it has inflicted on its family planning services

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By Wade Goodwyn
200px-Flag-map_of_TexasNPR

For the past five years, the Texas Legislature has done everything in its power to defund Planned Parenthood. But it’s not so easy to target that organization without hurting family planning clinics around the state generally.

The researchers found that two years after the cuts, Texas’ women’s health program managed to serve fewer than half the number of women it had before.

The Legislature’s own researchers predicted that more than 20,000 resulting unplanned births would cost taxpayers more than a quarter of a billion dollars in federal and state Medicaid support.

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New Washington State plan outlines impact of suicide, proposes solutions

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From the Washington State Department of Health

Suicide is preventable – and everyone has a role in stopping it

More than 5,000 people in Washington took their own lives during the five-year period of 2010 to 2014.

Washington’s new Suicide Prevention Plan aims to reduce that toll through unified efforts involving people and groups across the state.

For many years, the state’s suicide rate has been above the national average, prompting Governor Jay Inslee to address the tragedy of suicide in an executive order last week.

“We can stop these tragic deaths, but it’ll take coordination and cooperation,” said Washington’s Secretary of Health John Wiesman. “We know there are ways we can make a difference and this plan maps out strategies to save lives in our state.”

“Suicide is a preventable public health problem, not a personal weakness or family failure,” asserts the first core principle in the plan, which the Washington State Department of Health created in response to 2014 legislation. “Everyone in Washington has a role in suicide prevention. Suicide prevention is not the responsibility of the health system alone.”

Other core principles include:

  • Silence and stigma create harm by isolating people at risk and discouraging help- seeking.
  • Suicide prevention requires changing contributing factors such as childhood trauma, isolation, access to lethal means, and lack of access to appropriate behavioral health care.
  • Suicide doesn’t affect all communities equally, so prevention programs need to address local needs and cultures.
  • People experiencing issues associated with suicide deserve dignity, respect and the right to make decisions about their care.

The plan divides the work of suicide prevention into four strategic directions based on the National Strategy for Suicide Prevention.

Those are:

    • Empowering people, families and communities to understand their roles in preventing suicide “upstream,” before a crisis.
    • Directing suicide prevention programs toward those who need them most, helping identify people at risk and keeping them safe.
    • Making treatment accessible, appropriate and respectful for people at risk.
    • Using research, data and evaluation as a basis for suicide prevention work.

Washington has already made headway in battling suicide with a network of coalitions, student- led clubs, support groups, behavioral health treatment, culturally tailored initiatives, trainers, and community leaders.

The state has groundbreaking suicide prevention training requirements for health professionals. The Department of Health has been involved in youth suicide prevention work for more than two decades.The new plan builds on that base to address a problem that claims an average of three lives in Washington each day.

The intent of the plan is to use data and community input to customize short- and long-term prevention and intervention tactics to best serve specific populations, avoiding a one-size-fits-all approach.

Toward that end, a broad range of contributors and steering committee members participated in drafting, reviewing and completing the plan. As the document makes clear, suicide is a serious public health problem that everyone can play a role in solving.

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Advocates push public health campaign to combat gun violence

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GunWhat if we treated gun violence as a public health issue the way there were campaigns against drunk driving? Or safer sex practices during the HIV/AIDS pandemic?

NPR’s Kelly McEvers talks with Daniel Webster, director of the Johns Hopkins Center for Gun Policy and Research about what this would look like, and the political and personal challenges to doing research on gun violence.

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Hospital step up to help seniors avoid falls

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By Susan Jaffe
KHN

Daphne Brown, 65, was putting away the dishes in her Washington kitchen when she fell to the floor. Jane Bulla, 82, fell at home in Laurel, Maryland, but managed to call for help with the cellphone in her pocket.

Susan Le, 63, who has trouble walking due to arthritis, hurt her leg when she tripped on a pile of leaves in Silver Spring. And late one night when no one was around, Jean Esquivel, 72, slipped on the ice in the parking lot outside her Silver Spring apartment.

Falls are the leading cause of injuries for adults 65 and older, and 2.5 million of them end up in hospital emergency departments for treatment every year, according to the Centers for Disease Control and Prevention.

The consequences can range from bruises, fractured hips and head injuries to irreversible calamities that can lead to death. And older adults who fall once are twice as likely as their peers to fall again.

Despite these scary statistics, a dangerous fall does not have to be an inevitable part of aging. Risk-reduction programs are offered around the country. Continue reading

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Inslee calls for public health approach to gun violence

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GunFrom the Office of the Governor

Gov. Jay Inslee today signed an executive order that launches a statewide public health initiative to reduce and prevent gun-related fatalities and injuries.

The order uses the same data-driven public health approach that has significantly reduced motor vehicle deaths over the past two decades.

The initiative will help the state understand the people and places most at risk of gun violence or suicide, determine the best approaches to reducing gun violence and work with its partners to develop strategies and actions to prevent gun violence.

“This will be a data-driven approach that helps us identify the people and places most susceptible to gun crime and suicide,” Inslee said. “Gun crime is a scourge that has scarred thousands of families in every corner of our state. It’s a scourge we can, should and will help prevent.”

Between 2012 and 2014, 665 people died in Washington state from firearm injuries, compared to 497 deaths from automobile accidents. Approximately 80 percent of the firearm deaths were suicides.

Inslee’s order requires the Department of Health and the Department of Social and Health Services, in collaboration with the University of Washington and other state and local agencies to collect, review and disseminate data on deaths and injury hospitalizations related to firearms, as well as recommend strategies to reduce firearm-related fatalities and serious injuries.

Inslee said he also wants to further strengthen the background check law approved by Washingtonians in 2014. He is directing the state Office of Financial Management to analyze the effectiveness of information sharing between state agencies, the courts, local jurisdictions, law enforcement and other entities to determine if there are ways to improve the effectiveness of the system.

He is also requesting the Attorney General’s office to analyze current enforcement practices to make sure those attempting to purchase a firearm illegally are held accountable.

He is also asking them to update a 2007 white paper regarding access to firearms for those with mental illness. The white paper included recommendations that have yet to be implemented such as a centralized background check system.

Inslee is directing agencies to submit recommendations by October of 2016. Continue reading

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E-cigarette ads reach nearly 7 in 10 middle and high-school students

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From the US Centers for Disease Control and Prevention

About 7 in 10 middle and high school students – more than 18 million young people – see e-cigarette advertising in stores, online, in newspapers and magazines, or on television and in movies, according to a new CDC Vital Signs report.

E-cigarette ads use many of the same themes – independence, rebellion, and sex – used to sell cigarettes and other conventional tobacco products.

Advertising of tobacco products has been shown to cause youth to start using those products.

The unrestricted marketing of e-cigarettes and dramatic increases in their use by youth could reverse decades of progress in preventing tobacco use among youth.

“The same advertising tactics the tobacco industry used years ago to get kids addicted to nicotine are now being used to entice a new generation of young people to use e-cigarettes,” said CDC Director Tom Frieden, M.D., M.P.H. “I hope all can agree that kids should not use e-cigarettes.” Continue reading

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States where pot is legal struggle with ‘drugged driving’

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Cannabis_leaf_marijuana_potBy Sarah Breitenbach
Stateline

Washington State Patrol Sgt. Mark Crandall half-jokingly says he can tell a driver is under the influence of marijuana during a traffic stop when the motorist becomes overly familiar and is calling him “dude.”

The truth in the joke, Crandall says, is that attitude and speech patterns can be effective markers for drugged driving. Continue reading

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Rich, White and Refusing Vaccinations – The New York Times

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Boy gets shot vaccine injectionThe people most likely to refuse to have their children vaccinated tend to be white, well-educated and affluent, researchers report.

A study published in the January issue of the American Journal of Public Health used California state government data on “personal belief exemptions,” or opting out of vaccinations for nonmedical reasons.

Researchers found the exemption percentages were generally higher in regions with higher income, higher levels of education, and predominantly white populations.

In private schools, 5.43 percent of children were exempt, compared with 2.88 percent in public schools.

Source: Rich, White and Refusing Vaccinations – The New York Times

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How I almost poisoned my family with holiday leftovers

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white-bean-and-ham-soupBy 
Public Health – Seattle & King County

A white bean and vegetable soup seemed the perfect use of the last of the remaining ham from the holidays. I felt pretty pleased with myself for cooking it two days before parents came for a visit–that would give it the right amount of time to reach full flavor, and it would be ready to heat when I got home from work.

By shutting the soup in the cooler, I had created the perfect laboratory for toxins to form.

When I finished cooking, I realized that I didn’t have room in the fridge for the enormous pot of soup. But the outside temperature was plenty cold, so I decided to store it on the outside deck, protecting it from raccoons by putting it inside a cooler. I once again felt pleased with my cleverness as I shut the cooler lid tightly with my soup safe inside.

Second thoughts

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