Here's to Your Health

November 20th is the 33rd Great American Smokeout sponsored by the American Cancer Society.  Smokers are encouraged to stop smoking for at least one day, but, of course, the hope is that they will quit for good.  By now, everyone must be aware that smoking is a very dangerous habit with devastating health consequences.  Even the tobacco companies admit this. 

Among current U.S. adult smokers, 70% report that they want to quit completely.  In addition, more than 54% of current high school smokers in the U.S. have tried to quit smoking within the preceeding year.  If you are among either of these groups, please choose a quit date (the 20th would be a good choice) and join the ranks of former smokers.  Perhaps thinking of your loved ones will help motivate you or if nothing else, think of the money you are literally burning up.  Cigarettes cost an average of $5.86 in Wisconsin and it adds up fast.  Who couldn't use a few extra dollars in these economic times?  Whatever the motivation, please take the steps to quit whether it's for one day or a lifetime.  In all likelihood, you will appreciate the benefits of being a former smoker and want to continue on this path. 

There are some people who have a more difficult time quitting smoking than others.  Nicotine is a powerful drug and people respond differently.  However, there are more help aids now than ever before and people are achieving success.  In addition to different types of medications, counseling and other programming are available.  The important thing is to NOT give up if there is a relapse.  Set a new quit date with more determination and go at it again. Be sure to contact the Wisconsin Quit LIne (1-800-784-8669) to help increase your chance of success.

More information about quitting smoking is available at:

http://www.WiQuitLine.org          http://www.cancer.org          http://www.cdc.gov/Tobacco/media_communications/calendar/2008/nov_pressrelease.htm

The number of Americans (including children) developing type 2 diabetes is staggering and the toll is enormous.  In addition to high medical costs, the years of illness, disability, and life lost affect millions of families.  This is a disheartening situation because diabetes can often be prevented with minimal effort.  As with all chronic disease, it is so much better to prevent if possible then it is to treat after diagnosis.

It is never too late to choose a lifestyle that will protect and enhance your health and well-being.  At the top of the list is increasing physical activity.  This should not be too hard to do, even if you don't like to "exercise".  You simply need to make it a priority in your life to be more active and choose something that you like.  Be sure to start slowly with the goal of increasing to thirty minutes of activity on most days of the week.  A brief walk after dinner would be a great place to start.  Once a more active lifestyle becomes a habit, you will probably want to do even more because you will notice the overall benefits.

Of course, improving nutrition and maintaining a healthy weight are also key components in preventing type 2 diabetes.  Include more fruits and vegetables in your diet, the more colorful and varied the better.  Pay attention to portion size and lose weight if necessary.  Skip the fast food restaurants and junk food aisles at the grocery store.  Combining better nutrition with more activity will have you feeling energized and healthier in no time.

Take advantage of Diabetes Month to assess your current lifestyle and tweak it where possible.  You have everything to gain and absolutely nothing to lose. 

Checkout these links for more information about diabetes:

http://www.diabetes.org          http://www.cdc.gov/diabetes/consumer/index.htm          http://diabetes.webmd.com/default.htm

http://dhs.wisconsin.gov/health/diabetes/index.htm          http://www.mayoclinic.com/health/diabetes/DA99999   

There is still time to protect yourself from the flu and the North Shore Health Department has scheduled two additional clinics to help you out.

The first clinic is on Nov. 4, Election Day, so that it will be possible to protect your health after you cast your vote.  Just visit the Health Department in the Brown Deer Village Hall at 4800 W. Green Brook Drive anytime from 7:00 AM to 8:00 PM.  No appointment is necessary.

A second clinic has been scheduled for Wednesday, Nov. 12 from 8:30 AM to 6:00 PM.  This clinic is also at the Brown Deer Village Hall and, again, no appointment is necessary. 

Please call the Health Department at 371-2980 if neither of these clinic times fit your schedule.

The Centers for Disease Prevention and Control continues to recommend a flu shot for everyone over the age of six months and there is ample supply of flu vaccine this year.  The vaccine is considered to be a "good match" for the predominant influenza virus that is circulating.  Vaccination against the flu is a simple and very effective way to protect yourself from serious illness.  In addition, people around you will benefit because you won't be spreading the flu to others. 

Please take the time out of your very busy schedule to do something for your health.  It's more important than you might think!

October is Breast Cancer Awareness Month and October 17th is National Mammography Day.  If you are age 40 or older, it is recommended that you have a mammogram every year.  While mammograms can miss some cancers, they are still a very good way to find breast cancer.  Mammograms typically find cancer at an earlier stage when it is more treatable.  Regular screening could lead to many more lives being saved.  However, despite the advantages of having regular mammograms, some women are still not getting screened.  The month of October can be used as an incentive or reminder to schedule your annual mammogram or encourage someone you love to get screened. 

Mammograms are also recommended for women younger than age 40 if they have additional risk factors.  For example, if you have a mother, sister, or daughter who has had breast cancer, you would have higher risk for the disease and should be screened appropriately. 

If you are a woman between the ages of 50 and 65 who has no health insurance (or a high deductible) and who meets income requirements, you might be eligible for a mammogram paid for by the Wisconsin Well Woman Program.  Call the North Shore Health Department at 371-2980 if you think you may be eligible. 

In addition to regular screening, lifestyle habits can help lower risk for breast cancer.  Controlling weight and being physically active are important factors as well as limiting alcohol intake.  Educate yourself on the risks and benefits of hormone replacement therapy.  Also, it is important to know your family history of breast cancer and what you can do to lower your risk.

Research has shown that breast self exam plays a small role in finding breast cancer compared with finding a lump by chance or simply being aware of what is normal for each woman.  Therefore, monthly breast self exam is considered an option for women but is no longer recommended.  The advantage of regular self exams is a sense of normal for each person. 

Unfortunately, men can also get breast cancer and there were 1,815 men diagnosed in 2004.  Like women, men should also be aware of how their breasts look and feel and notice any changes that might take place.  If changes are noted, consult with your doctor without delay.

More information on mammograms and breast cancer can be found at the following websites:

http://cdc.gov/features/breastcancerawareness          http://www.cancer.org/docroot/CRI/CRI_2_1x.asp?dt=5          http://dhs.wisconsin.gov/womenshealth/WWWP     

We are sure that at some point in life, everyone has heard someone say "Eat your fruits and vegetables".  Have you ever really stopped to think why?  A diet rich in fruits and vegetables has so many benefits.  People who eat more fruits and vegetables are likely to have less risk of chronic diseases, including stroke, heart disease, diabetes, and certain cancers.  Fruits and vegetables provide essential vitamins and minerals, fiber, and other substances that are so important for good health.  There is the added bonus of being naturally low in fat and calories as well as filling which will help maintain a healthy weight.  So why don't we eat more of them?

The average American eats just three servings of fruit and veggies a day (French fries probably don't count!)  However, the latest dietary guidelines call for five to thirteen servings (or two to six and a half cups) a day.  The federal government's "5 A Day" campaign has been changed to "Fruits and Veggies:  More Matters" in an effort to get Americans to eat more of the food that contributes to better health.

Fall is a perfect time of year to add more fruits and veggies to your family's diet.  Visit your local farmer's market to check out the summer's bounty.  Remember to think color because fruits and vegetables of different colors give your body a wider range of valuable nutrients.  And be sure to try something new.

It shouldn't be too difficult to add more of the good stuff to your daily food intake.  Do it for you and your family.  Research has suggested that children who see their parents eat more fruits and vegetables will likely do the same.  Try these tips to fit more fruits and vegetables into your day:

• Keep fruit out where you can see it.  You will be more likely to eat it if you see it.
• Eat some fruit or vegetables at every meal, every day.  Bonus points if you get some at snack time, too.
• Explore the produce aisle and choose something new.  Variety is the key to a healthy diet so don't get into a rut with the same old thing.
• Forget about the potatoes and choose other vegetables with more nutrients.
• Make it a meal.  Try some new recipes where vegetables are the main attraction.

Check out the following websites for more information on the value of eating more fruits and vegetables.  There is also a link to local farmers' markets.

http://dhs.wisconsin.gov/health/physicalactivity/F&V/brand.HTM          Http://www.cdc.gov/nccdphp/dnpa/nutrition/nutrition_for_everyone/fruits_vegetables/index.htm

http://www.ecommandos.com/farmers-markets.htm

It hardly seems possible, but it is already time to start thinking about protecting you and your family from the seasonal flu that comes around every year.  The Centers for Disease Control recommends a yearly flu shot as the first and most important step in protecting against this terrible disease.  

It is now recommended that ALL children between the ages of 6 months through 18 years be vaccinated against the flu.  It is especially important that children aged 6 months up to 5 years get vaccinated because this age group is at higher risk for complications compared with older children.  If your child is younger than 9 years old and has never had flu immunization, two doses would be needed spaced one month apart.  Infants younger than 6 months are too young to be vaccinated.  Therefore, all family members and close contacts (e.g., babysitter) of children younger than 6 months should be vaccinated in order to protect the infant.  Last year in the U.S., there were 65 pediatric deaths (including some healthy adolescents) related to influenza.

In general, anyone who wants to reduce the risk of getting the flu can get vaccinated.  However, there are specific groups of people who really SHOULD get vaccinated because they have a greater risk of complications.  In addition to young children, these include pregnant women, adults over age 50, people of any age with certain chronic medical conditions (asthma, diabetes, heart and lung disease) residents of nursing homes, and people who live with or care for those at high risk of complications. 

The flu mist vaccine (a nasal spray) can now be administered to healthy persons aged 2 through 49 years.  The previous recommendation was ages 5 through 49.  The trivalent inactivated flu vaccine can be used for anyone over the age of 6 months.  There is an all-time high supply of flu vaccine this year which makes it possible for more people than ever to seek protection from the flu.

We have already received some flu vaccine and have several options for those wanting immunization.  In addition to the "regular" vaccine and nasal spray mist, we have ordered a limited amount of thimerosal free vaccine (injectable only).  Thimerosal is a mercury preservative used in multi-dose vials.  Cost is $30-$35 depending on the type of vaccine and payment is by cash or check.  Medicare Part B will be billed if your card is shown and you are not enrolled in Hospice, Railroad Retirement, or a Medicare Advantage Plan. 

North Shore Health Department flu clinics have been scheduled at both the Brown Deer Village Hall and the North Shore Library:

3-6 pm, Wed., Oct.8 and 7:30-10:30 am, Thurs., Oct. 23 at Brown Deer Village Hall, 4800 W. Green Brook Drive, Brown Deer       

11 am-2 pm, Mon., Oct. 13 and 3-6 pm, Tues., Oct. 21 at North Shore Library, 6800 N. Port Washington Road, Glendale            

Children's flu vaccinations will be offered at the regular monthly immunization clinics.  There is a limited amount of free vaccine provided by the State for those children who qualify.

There is ample opportunity to protect yourself and family from the flu and we hope you will take the time to do so.  Please contact us (414-371-2980) if you have any questions or would like additional information about flu immunization.   

Additional information about the seasonal flu is available at these websites:

http://www.cdc.gov/flu                    http://dhs.wisconsin.gov/communicable/influenza/information.htm   

This is the time of year that we get a fair number of calls about head lice (formally known as pediculosis).  Head lice are parasitic insects that are found worldwide.  Anyone can become infested with head lice but in the U.S., infestations are most common among preschool children attending day care, elementary school children, and the household members of infested children.  Infestation of head lice is NOT related to standards of personal hygiene.  Head lice are more or less a nuisance and are not known to spread disease. 

Head lice live close to the human scalp and feed on blood several times a day.  They move by crawling (they do not hop or fly) and are easily spread from person to person by direct contact.  Although not very common, head lice can also be spread by indirect contact with lice carrying objects such as combs, brushes, hats, or scarves. 

A head lice infestation usually has all three forms of lice -- the egg (or nit), the nymph (the immature adult), and the adult.  An adult female lays about six nits a day near the base of the hair shaft.  Nits are very small and firmly attached to the hair and take 8-9 days to hatch.  They might resemble a small piece of dandruff but can not be shaken off the hair shaft like dandruff can.  Nymphs mature into adults about 9-12 days after hatching and look like smaller versions of adult lice.  Adult lice will live about 30 days on a person's head but will die within one or two days if they crawl off. 

Usually, the first indication of a lice infestation is itching and this often occurs around the ears or at the base of the skull.  It may take 2-3 weeks after infestation for itching symptoms to appear.  The itching is caused by a reaction to the bite (kind of like a mosquito bite).  It is possible to get a secondary infection of the scalp resulting from scratching.

There are several over-the-counter medicated shampoos that can be used to treat head lice.  However, these are insecticides and should be used only as directed as they can be toxic.  In addition, because treatment will not kill all the eggs, it is necessary to manually remove the nits to eliminate the infestation.  (You may have heard of the term, "nitpicking"!)   This is tedious and time consuming work but it is also the most effective method.  The effectiveness of "home remedies" such as mayonnaise is unclear.  Kerosene, gasoline, and other flammable products should NEVER be used to treat head lice.  It is recommended that all family members of an infested child be checked for lice.

A dermatologist in California has developed a nontoxic treatment using the liquid cleanser, Cetaphil.  Although this is not an endorsement of his method, you may want to read more about it at http://www.nuvoforheadlice.com/method_explained.htm

There are supplemental measures that can be taken but since lice don't live very long off of a person's head, you don't need to spend a lot of time or money on housecleaning activities.  You can machine wash bed linens and clothing in hot water and the high heat drying cycle.  Place stuffed animals in a sealed plastic bag and store for two weeks.  Soak combs and brushes in hot water for 5-10 minutes.  Vacuum the floor and furniture and remember to include the car seat. 

Unfortunately, head lice are here to stay.  If you want to learn more about them, check out these websites:

http://www.cdc.gov/lice/head/factsheet.html          http://www.cdc.gov/lice/head/faqs_treat.html          http://www.nlm.nih.gov/medlineplus/headlice.html   

As much as we would like to deny it, the end of summer is fast approaching and that means school will soon be starting.  We want to remind you to include a review of your child's immunization record in your preparation for school.  There have been some changes in the Wisconsin immunization requirements for the coming school year and your child may need some booster shots. 

The first change is that a second dose of varicella vaccine for chicken pox is now required for five year old kindergarten, sixth grade, and twelfth grade.  As children in the other grades move on, they, too, will be required to have the second dose.  This change resulted from "breakthrough" cases of chicken pox that have occurred after immunization.  A similar situation occurred with the measles, mumps, and rubella (MMR) immunization in the past and now two MMR doses are required by the time a child enters kindergarten.  Of course, if your child has ever had chicken pox disease, no vaccination is needed because there is natural immunity.

A second change to the immunization requirements involves a relatively new vaccine called Tdap.  This is a combination of the regular tetanus/diptheria vaccine and acellular pertussis (whooping cough) vaccine.  You may recall the recent pertussis outbreaks in the last year or two that resulted from waning immunity in adolescents and young adults. Unfortunately, pertussis is an infection that does not result in permanent immunity and it was decided that additional immunizations are needed.  A single dose of Tdap is required for students in the sixth, ninth, and twelfth grades.  However, if your child has had a tetanus (Td) booster shot (without the pertussis) in the last five years, Tdap is not required at this time. 

It is also recommended that adults get one dose of Tdap, especially if they have close contact with infants.  Pertussis can be dangerous for the very young and the elderly.  If you have contact with an infant, you can get a Tdap shot as early as two years after a tetanus booster.  Normally, a tetanus booster is recommended every ten years unless there is an injury after five years. 

You can get any needed immunizations at one of the three monthly North Shore Health Department clinics (call 371-2980 for clinic information or if you have questions) or you can call your family doctor.  Just please make sure your children are properly immunized.  Even though the number of cases of many diseases has been drastically reduced since the development of vaccines, these diseases are still "out there" and can result in serious complications.

Visit these websites for more information (the CDC website has some very good links):

http://cdc.gov/vaccinesafety/basic/parents.htm          http://dhs.wisconsin.gov/immunization/pdf/parent_fs.pdf

http://dhs.wisconsin.gov/immunization/pdf/PPH4021_02_08.pdf

State health officials are reminding all Wisconsin residents to use caution around wild animals to protect against rabies, a viral disease transmitted by bites from infected animals.  Bats and skunks are the most likely to carry the rabies virus, but dogs, cats, raccoons, and foxes can also transmit the disease.

The best method of prevention is to use caution around unfamiliar animals -- domestic or wild.  If you are bitten by an animal, wash the wound immediately with plenty of soap and water.  Contact your physician and local health department to report the bite.  If you can do so safely, capture and confine the animal so it can be tested for rabies.  Oftentimes, the animal is turned loose or destroyed and cannot be tested.  In such a situation, the person who was bitten (or exposed if young children are involved) must undergo anti-rabies shots which is a series of five shots plus one immune globulin shot at the time of the bite.  If the animal is available for testing or observation, no anti-rabies treatment is needed in the majority of cases.  However, since rabies is usually a fatal disease (there is only one known human survivor), it is not worth the risk of assuming the animal does not have rabies and treatment is not needed.  Every animal bite by an unfamiliar animal should be followed up appropriately.

To help avoid possible exposure to rabies:

• Avoid contact with wild animals.  Do not try to nurse a sick animal back to health.  Call an animal control official or a wildlife rehabilitator if you find a sick animal.
• Never touch unfamiliar or wild animals and teach children to do the same.  Stray cats and dogs may not be accustomed to being handled and are more likely to bite.
• Never adopt wild animals or bring them into your home.  Even baby animals can carry rabies.
• Walk your dog on a leash and do not let it roam freely where wild animals may be present.
• Secure trash cans and pet foods so they do not attract wild animals.
• Keep bats out of living areas by securing open or loose fitting doors, attics, unscreened windows, and chimneys. 
• Be sure to have your pets vaccinated against rabies and keep current with booster shots.

While human rabies cases in the U.S. are rare, they do occur and the results are usually fatal.  In Wisconsin, the most recent cases of human rabies were in 2000 and 2004 with both cases resulting from a bite from an infected bat.  For more information on rabies, visit these websites:

http://dhs.wisconsin.gov/communicable/factsheets/Rabies.htm           http://www.cdc.gov/rabies

We are in the middle of the peak months for the risk of Lyme disease so it is a good time for a reminder alerting us to the presence of ticks and the possibility of infection.  June, July, and August are the months with the highest incidence of Lyme disease.  Last year in Wisconsin, there were 1,819 diagnosed cases which is a significant increase over reported cases in 2006 when there were 1,456 cases.  Although most of the cases were in the northwest and west central regions of the state, it has been reported in many other areas.  Many people vacation all over the state and everyone should be on the lookout for ticks that can cause Lyme disease. 

Anyone can get Lyme disease which is caused by bacteria that is carried by small (blacklegged) deer ticks and transmitted to humans by a tick bite.  The tick must be attached to a person's skin for at least 24 hours before it can transmit the bacteria.  This is why it is so important to check for ticks after you have been in a wooded area.  If an attached tick is removed promptly, there is a greatly reduced chance for disease.  There was a vaccine against Lyme disease but it is no longer marketed because there was little demand for it. 

As with all disease, prevention is best whenever possible.  There are many things you can do to prevent tick bites: 

• Avoid wooded and bushy areas with high grass and a lot of leaf litter.  If you are hiking in an area like this, try to stay in the middle of the trail.
• Wear clothes that will help shield you from ticks -- long-sleeved shirt, long pants tucked into socks to creat a "tick-barrier".  Ticks are easier to spot on light colored clothing.
• Use effective tick repellents (containing 20-30% DEET) on exposed skin and clothing.  Repellents containing permethrin can also be used on clothing.
• Perform daily tick checks after being outdoors, even in your own yard.  Carefully inspect all parts of your body including armpits, scalp, and groin. 
• Remove an attached tick immediately using fine-tipped tweezers.  Grasp it as close to the skin as possible and pull upward and out with a firm steady tension.  Be careful not to squeeze, crush, or puncture the body of the tick as it may contain infectious fluids.  Do not use folk remedies like petroleum jelly, nail polish remover, or burning matches as these methods are neither safe nor effective.

Lyme disease can cause symptoms that affect the skin, nervous system, heart, and/or joints.  Early symptoms usually begin within a month of exposure. Later arthritic, cardiac, and neurologic problems can take weeks or months to appear.  The illness often (but not always) starts with a circular, reddish rash around the site of the bite.  During the rash stage, fever, headache, fatigue, stiff neck, muscle and/or joint pain may occur and last several weeks.  If left untreated, complications such as meningitis, facial palsy, heart abnormalities, and arthritis may occur. 

Lyme disease is treated with antibiotics.  Past infection provides only short-lived immunity and it is possible to get infected more than once.

Check out these websites for more information about Lyme disease: 

http://dhs.wisconsin.gov/communicable/LymeDisease/links.htm          http://www.cdc.gov/ncidod/dvbid/lyme/index.htm                   

If you were unlucky and had a basement full of water during the recent heavy storms, you may have an ideal habitat for mold to grow.  Mold needs water to survive and begins to grow when spores land on a wet or damp surface.  While molds are part of the natural environment and are everywhere, they have the potential to cause health problems such as an allergic reaction or aggravation of asthma symptoms when they begin to grow indoors.  So if your basement was flooded, it is very important to dry it out as fast as possible and monitor for mold growth. 

To reduce the opportunity for mold growth, you can:

• Completely dry affected areas but do not rely on evaporation alone.  Use a dehumidifier and provide good air circulation for fast, adequate drying. 
• Carpets, furniture, drywall, and anything absorbent that got wet should be discarded.  (Hopefully these first two steps have already been completed.)
• Make sure the moisture problem is eliminated and repair any cracks in the basement walls.
• Regularly clean and empty the drip pans in the dehumidifier.
• Be sure your home has adequate ventilation.
• Clean hard surfaces with detergent and water to prevent mold.  Bleach is used for mold removal.

If you have already noticed some mold growing and have eliminated the source of moisture, you can begin the cleaning efforts.  However, if the mold covers a large area, you may want to consider professional mold removal.  If it is a small area and you are tackling the job yourself, you can:

• Be sure to control any dust associated with clean-up.  You don't want mold spores to spread over a wider area and begin to grow.
• Open windows and doors to ventilate.
• Wear non-porous gloves and protective eye wear.
• Use a solution of one cup of bleach to one gallon of water to remove visible mold from hard surfaces.  Use a stiff brush on rough surfaces such as concrete.  Leave bleach solution on affected area for 15 minutes before rinsing.  Do NOT mix bleach with ammonia or other cleaning products as this may produce a toxic vapor.
• Discard food contaminated by flood water.  Undamaged cans can be washed in a bleach solution of one cup bleach to five gallons water and relabeled with a marker.

Additional information on mold and its removal is available at the following websites:

http://dhfs.wisconsin.gov/eh/mold          http://www.epa.gov/mold/moldresources.html          http://www.epa.gov/mold/flood/index.html

http://www.bt.cdc.gov/disasters/floods          http://www.bt.cdc.gov/disasters/mold/protect.asp     

The severe weather over the weekend has created havoc for many families as they deal with the aftermath.  If you have been affected by a flooded basement or sewage backup, there are safety precautions you can take to reduce your risk of infection while cleaning up.

• Avoid contact with contaminated surfaces by wearing rubber boots, rubber gloves, and eye protection.
• Make sure your tetanus immunization is current -- within the past ten years.
• Clean all hard surfaces with hot water and laundry or dish detergent then disinfect with a solution of one cup chlorine bleach in five gallons of water.
• Discard items that cannot be washed and disinfected (for example, mattresses, carpeting, rugs, upholstered furniture, toys, stuffed animals, etc.)
• Remove and discard drywall and insulation that has been contaminated.
• Help the drying process by using fans, air conditioning, and dehumidifiers to prevent mold.
• Allow the home to dry completely before installing new materials.
• Wash hands thoroughly after cleanup.
• Contaminated clothes should be washed in hot water and detergent.
• Keep children and pets away from the affected area.

You can call us at the Health Department (371-2980) if you need a tetanus booster or would like additional information about cleanup of flood water.  You can also check out the following websites:

http://www.bt.cdc.gov/disasters/floods          http://www.epa.gov/mold/flood          http://dhfs.wisconsin.gov/eh/DisasterHealthSafety/flooding.htm

Summer is almost here and outside activities beckon.  And the mosquitoes are just waiting for us!  Should we be concerned?

West Nile infection is caused by the West Nile virus and is spread to people by the bite of a mosquito infected with the virus.  The mosquito becomes infected by feeding on an infected bird.  The West Nile virus was first detected in the U.S. in 1999 and has since spread across the country.  The first human infections in Wisconsin were documented in 2002. 

About 80% of people infected by West Nile virus will not get sick.  Most of the remaining 20% will have a mild illness that can present with fever, headache, body aches, swollen lymph nodes, nausea and vomiting, or a rash on the chest, stomach, and back.  Less than 1% of infected people become seriously ill with symptoms that can include imflammation of the brain, paralysis, coma, and death.  People over the age of 50 are at greater risk of developing severe illness.  Symptoms typically occur 3-14 days after a bite by an infected mosquito.  There is no specific treatment for West Nile infection but treatment can be given to relieve symptoms.

While the risk of contracting severe illness from West Nile virus is low, the consequences for some people and their families are devastating.  Much can be done to prevent exposure and reduce risk of West Nile.

Personal protective measures include:

• Limit time spent outside at dawn and dusk when mosquitoes are most active.
• Wear protective clothing when outdoors.
• Use insect repellents containing an Environmental Protection Agency registered ingredient, such as DEET, on your skin and clothes.
• Do not use more than a 10 percent concentration of DEET on children.
• Make sure home window and door screens are in good repair.

Reducing mosquito populations will also reduce the number of mosquito bites.  Mosquitoes lay their eggs in standing water and removing such sites from your property will help reduce the number of mosquitoes.  Steps to take are:

• Landscape to prevent water from pooling in low-lying areas.
• Drain water from pool covers and change water in birdbaths at least every three days.
• Do not allow water to accumulate in ceramic pots, wheelbarrows, plastic containers.
• Clean roof gutters and downspouts for proper drainage.
• Trim tall grass, weeds, and vines since mosquitoes use these areas to rest during hot daylight hours. 

Birds also become sick from West Nile Virus and can die.  Oftentimes, this is the first clue that West Nile virus is present in an area and is an indication that people should take precautions to avoid mosquito bites.  State health officials have activated the statewide toll-free Dead Bird Reporting Hotline to track the virus.  Hotline staff can answer questions about dead birds and provide information on safe handling and disposal.  People should not use their bare hands to handle a dead bird.  The Hotline number is:  1-800-433-1610.

More information about West Nile virus is available at the following websites:

http://www.cdc.gov/ncidod/dvbid/westnile          http://www.nlm.nih.gov/medlineplus/westnilevirus.html     

http://dhfs.wisconsin.gov/communicable/WestNileVirus/Resources.htm           

May has been designated as Skin Cancer Awareness Month.  One would think this is an attempt to get people to think about their sun exposure during the upcoming summer months and change their behavior.  And they should do just that!  There are more than ONE MILLION cases of skin cancer diagnosed every year in the U.S.  It is the most common type of cancer and can be easily prevented.

There are several different types of skin cancer.  Basal cell and squamous cell cancers are highly curable while melanoma is much more dangerous, especially for young people.  But melanoma is also curable if detected in its early stages.  It is estimated that 8,110 people died from melanoma in 2007 and 58,940 were newly diagnosed.   Other types of skin cancer claimed 2,740 lives. 

Exposure to the sun's ultraviolet (UV) rays appears to be the most important environmental factor involved in the development of skin cancer.  People with certain risk factors are more likely than others to develop skin cancer.  Risk factors include:

• unprotected and/or excessive exposure to UV radiation by the sun or tanning bed
• family/personal history of skin cancer 
• a history of sunburns as a child
• fair complexion or skin that burns, freckles, reddens easily, or becomes painful in the sun
• blue or green eyes, blond or red hair
• certain types and a large number of moles

The best ways to reduce the risk of skin cancer are to avoid intense sunlight for long periods of time and to practice sun safety.  The American Cancer Society recommends these sun protection habits:

• Avoid the sun between 10 a.m. and 4 p.m.
• Seek shade.  Teach your children the "shadow rule".  If your shadow is shorter than you, the sun's rays are at their strongest.
• Slip on a shirt and cover up to protect exposed skin.
• Slop on sunscreen with a sun protection factor (SPF) of 15 or higher.  Use it even on overcast days and re-apply it throughout the day.
• Slap on a hat, preferably a wide-brimmed hat.  If choosing a baseball cap, remember to use sunscreen on your ears and neck.
• Wrap on sunglasses to protect your eyes.  Make sure they offer 99%-100% protection from both UVA and UVB rays.
• Avoid other sources of UV light.  Rays from tanning beds and sun lamps are as dangerous as those from the sun.

Infants should be kept out of direct sunlight.  The American Academy of Pediatrics recommends using sunscreen on infants for small areas such as the face and back of hands where protection from clothing is inadequate.  Teach your children sun safety practices because they will be exposed to UV radiation their entire lives.  Pediatric melanoma is increasing about 3% a year. 

Everyone should wear sunscreen, even people with darker skin who might not get sunburned as easily as those with lighter skin.  Skin damage from excessive sun exposure can occur even though the skin does not burn.  Unfortunately, cases of skin cancer in those with darker skin are often not detected until later stages which provides all the more reason to use sunscreen. 

Remember to examine your skin regularly to look for changes, especially in the size or color of a mole or other darkly pigmented growth or spot, or a new growth.  Check for scaliness, oozing, bleeding, or change in the appearance of a bump or nodule.  The spread of dark coloring beyond the edge of a mole or mark could be a warning sign.  And note any change in sensation, itchiness, tenderness, or pain.  Any of these signs should be reported to your doctor. 

Take steps today and everyday to reduce your risk of skin cancer.  For more information, check out these websites:

http://www.cancer.gov/cancertopics/wyntk/skin          http://www.cancer.gov/cancertopics/types/melanoma          http://www.aad.org/media/psa/index.html

http://www.nlm.nih.gov/medlineplus/skincancer.html          http://www.cancer.org/docroot/PED/content/ped_7_1_Skin_Cancer_Detection_What_You_Can_Do.asp

About 780,000 people in the U.S. will have a stroke in 2008.  Of these, 150,000 will die and 15%--30% of stroke survivors will be permanently disabled.  Stroke is the third leading cause of death, behind heart disease and cancer.  About 25% of strokes occur in people younger than 65 years of age.  The toll it takes on everyone is staggering.

A stroke occurs when the blood supply to the brain is cut off.  This can happen when a clot forms to block a blood vessel (ischemic stroke -- the most common type) or  when an artery in the brain bursts (hemorrhagic stroke).  Either way, the blood supply is disrupted and there is damage to the cells.  There is also something called a TIA (transient ischemic attack) which is a "mini-stroke".  It starts just like a stroke but symptoms clear up in 24 hours.  A mini-stroke is a warning that the person is at risk for a more serious stroke and medical attention should be sought immediately.

Everyone can take steps to lower risk factors for stroke, with the exception of modifying age or genetics.  Nevertheless, there is still much you can do.  You can (once again, no surprise here!):

• Be physically active at least 30 minutes a day.
• Maintain a healthy weight.
• Eat a healthy diet -- more fruits and vegetables, less fat and salt.
• Prevent and control high blood pressure and high cholesterol.
• Do not smoke tobacco.
• Prevent and control diabetes.
• Treat atrial fibrillation, an irregular heartbeat in which the heart's upper chambers quiver instead of beating which allows the blood to pool and perhaps clot.
• Do not drink excessive amounts of alcohol.

If a stroke occurs, it is extremely important to act fast so that the risk of death or disability can be reduced.  Warning signs and symptoms to look for:

• Sudden numbness or weakness of the face, arms, or legs.  Can the person raise both arms?
• Sudden confusion or trouble speaking or understanding others.  Is the person's speech slurred or face droopy, do the words make sense?
• Sudden trouble seeing in one or both eyes.  Is vision clear or blurry, double vision, or only part of the visual field?
• Sudden trouble walking, dizziness, or loss of balance or coordination.  Does the person lean or slump to one side, drag a foot while walking?
• Sudden severe headache with no known cause.  Does the person normally have headaches?

Despite all the efforts to educate, research still shows that the general public continues to be unaware of stroke's warning signs and the need for immediate medical attention, even if the symptoms subside.  If you think someone might be having a stroke, call 911 immediately.

Visit the following websites for more detailed information about stroke:

http://www.cdc.gov/stroke          http://www.strokeassociation.org          http://www.stroke.org          http://www.ninds.nih.gov      

The U.S. has one of the safest public water supplies in the world and Drinking Water Week provides a good opportunity for appreciation of that fact.  Instead, most Americans probably take clean tap water for granted and rarely give it much thought -- except when they don't have it!  However, since less than 1% of the earth's water is suitable for drinking, it is increasingly important for everyone to do what they can to preserve a clean water supply. 

Take a moment to consider all that tap water delivers for us:

• Public health protection -- Worldwide, three million people die every year from preventable waterborne disease.  Our water system allows us to drink from virtually any public tap with a high assurance of safety.
• Fire protection -- A well maintained water system is critical in protecting our communities from the ever present threat of fire.
• Support for the economy -- Businesses or housing developments do not succeed without a safe and sustainable water supply.
• The overall quality of life in the U.S. -- Any measure of a successful society -- low mortality rates, economic diversity, productivity, and public safety -- is in some way related to access to safe water.

Individuals can do many things to help ensure the sustainability of a reliable water supply.

• First and foremost, recognize what a valuable resource clean water is and take steps to protect and conserve it.
• Be thoughtful in your use of water and don't waste it.
• Ask yourself if bottled water is necessary and consider its negative environmental effects.
• Do not flush unused medications down the toilet or sink.
• Dispose of hazardous materials and pet waste properly.
• Reduce or do not use pesticides and fertilizers on your lawn.
• Do not water your lawn excessively.
• Repair leaky faucets and pipes and install water-efficient appliances.
• Run the dishwasher and washing machine fully loaded only.
• Place rain barrels beneath your downspouts and plant a rain garden.
• Become an informed advocate for clean water and set a good example.

Visit the following websites to learn more about the importance of preserving and conserving clean water:

http://www.epa.gov/safewater/wot/pdfs/book_waterontap_full.pdf          http://awwa.org          http://www.dnr.wi.gov

Spring will truly be here someday soon!  People will be doing home projects, yard work, and gardening.   They will be out with their pets.  As the temperature gets even warmer, shoes and socks will come off.  Everyone will be enjoying the seasons of spring and summer.  They will also be increasing their risk of exposure to the disease of tetanus, commonly known as lockjaw. 

Tetanus is caused by a poison that is produced by bacteria and attacks the nervous system.   The bacteria live in the soil and enter the body through a break in the skin.  Most people associate tetanus with rusty nails and puncture wounds.  However, it can also be caused by animal scratches and bites, splinters, bug bites, burns, cuts and scrapes, etc.  It is not transferred from person to person. 

Although there are under fifty cases of tetanus in the U.S. every year, almost all of them occur in people who have not been vaccinated or who have not had a booster immunization in the past ten years.  There was an 18% fatality rate in the U.S. from 1998-2000.  Most deaths occur in people over 60 years of age.  Unfortunately, less than fifty percent of the adult population is current with tetanus booster shots which are needed every ten years for life.  If there is an injury after five years, evaluation for a booster shot is recommended as soon as possible.  Infants and children are protected from tetanus by their "baby shots" if they have had the complete series.

It is very fortunate that tetanus can be prevented with a safe and effective vaccine.  The tetanus vaccine also protects against diphtheria which is a dangerous respiratory infection.  There is a new tetanus vaccine available for adults that includes protection against pertussis (whooping cough), another potentially dangerous respiratory infection.  This vaccine was developed after frequent outbreaks of pertussis in the adolescent/adult population over the past several years.  It is recommended that every adult under the age of 65 get one dose of the tetanus vaccine that includes pertussis. 

Tetanus vaccine for adults is available at the North Shore Health Department for a cost of $15.00.  You can attend one of three monthly clinics or schedule an appointment if the clinics are not convenient.   Contact us at 371-2980.

You will be ready for spring only after you have checked your immunization record and received a tetanus booster if one is needed.  Then you can really enjoy the outdoors knowing you are protected against tetanus. 

Check out these websites for more information about tetanus:

http://www.immunize.org/catg.d/p4220.pdf           http://www.mayoclinic.com/health/tetanus/DS00227/DSECTION=1

http://www.nlm.nih.gov/medlineplus/tetanus.html#cat1

One might wonder what the relationship is between public health and Earth Day.  Just look around and you will have the answer.  Do you enjoy clean water, clean air, a relatively toxin-free environment, a healthy community?  All of these environmental concerns fall under the umbrella of public health.

When Earth Day was first recognized in 1970, rivers were catching on fire, air pollution was commonly accepted as a sign of prosperity, and pesticides were more freely used.  How healthy can a population be if there is no clean water or air?  How healthy can a population be if the environment is laden with dangerous pesticides and other toxins which we now know are harmful to all living things?  Who wants to go back to that place in time? 

It is important to keep in mind that there is only one planet upon which all the people of the world depend and there is a direct relationship between a "healthy" planet and the health of its population.  Individual observation of Earth Day can occur every day with attentive behavior that is respectful of the planet and immediate environment. This is a shared responsibility and it is important to recognize that even "baby steps" by individuals will eventually lead to a healthier environment for everyone and improve the public's health.   While there is progress, there is still much to be done.    

What can individuals do to help the planet?  For starters:

• Take the time to educate yourself about the issues facing the planet and become an advocate
• Reduce, reuse, and recycle -- pay attention to product packaging and be less wasteful
• Change some incandescent light bulbs to compact fluorescent bulbs
• Adjust your thermostat -- cooler in winter, warmer in summer
• Replace old appliances with more energy efficient models 
• Don't leave computers, TVs and other electronics on "standby"
• Bike and walk more, drive less
• Do not buy bottled water
• Use less hot water
• Do not contaminate the water supply by disposing of old medications in the toilet
• Calculate your "carbon footprint" to see how your choices affect the planet and climate change

Check out the following websites to learn more about Earth Day and what you can do to help make a difference.

http://www.earthday.gov          http://epa.gov/climatechange/wycd/actionsteps.html          http://www.nature.org/earthday      

http://www.epa.gov/climatechange/emissions/individual.html         

The recent cases of measles in Milwaukee provide a timely lead in to National Infant Immunization Week, April 19-26, 2008.  Measles is a highly infectious disease that is vaccine preventable.  Before the measles vaccine was available, there were approximately 450,000 cases of measles every year and an average of 450 measles associated deaths a year in the U.S.  Americans are fortunate to have a 99% reduction in measles cases since the vaccine was developed. 

Measles is just one of fourteen potentially serious diseases that can be prevented by vaccines.  Even though vaccine preventable diseases are at an all time low in the U.S., these diseases still exist and can cause an outbreak with unnecessary and heartbreaking consequences.  Some of the diseases that are rare in the U.S. are common in other parts of the world and are only a plane ride away.  It would be a mistake to assume that a child is completely safe from these diseases just because they are not common in the U.S.

Infants are particularly vulnerable to infectious disease which is why it is so important to protect them through immunization. Granted, the risk of exposure might be low.  But if there would be an exposure, there is a good chance that they would get the disease because they would be unprotected.  They could get mildly ill, very sick resulting in hospitalization, or at the very worst, they could die.  Parents need to ask themselves if their child's health is worth the risk.

Immunizations are one of the most important ways parents can protect their children.  Infant vaccines are very safe and 90-99% effective.  Like any medicine, they can occasionally cause a mild reaction.  A serious reaction would be rare.  The most comprehensive scientific studies and reviews have not found a link between vaccines and autism.  Children's vaccines do not contain thimerosal, a mercury derivative used as a preservative.  It may help to remember that getting the disease is much more risky than getting the vaccine.  In addition to protecting the immunized child, vaccines protect the larger community by preventing and reducing the spread of infectious diseases. 

Approximately one million children in the U.S. are not fully immunized by the age of two.  Don't let your child be one of the them.  For maximum protection, follow the recommended guidelines for childhood immunizations. 

The North Shore Health Department has three immunization clinics every month: 

• Clinics at the Health Department:  2nd Tuesday from 10:00 - 11:00 AM; 3rd Wednesday from 3:30 -- 4:30 PM
• Clinic at the North Shore Library:  Last Tuesday from 4:00 -- 5:00 PM

 There is no charge for children's vaccines as they are provided through the Vaccine for Children (VFC) program.

Also, please keep in mind that adolescents and adults need immunizations throughout life, too, many of which are available at the Health Department for a fee.

Check out these websites for more information on immunizations:

http://www.cdc.gov/vaccines               http://dhfs.wisconsin.gov/immunization/index.htm               http://wwwn.cdc.gov/travel/contentVaccinations.aspx

Public Health Week is April 7 - 13.  So what is public health and what does it mean to you?

Public health in America has a vision of healthy people in healthy communities.  The mission of public health is to promote physical and mental health and prevent disease, injury, and disability.  Public health truly is everywhere.  It shapes our world and everyone is affected every single day. 

The 2008 theme for Public Health Week is:  Climate Change:  Our Health in the Balance.  There is a direct connection between climate change and the health of our nation.  Yet few Americans are aware of the consequences of our changing climate on our communities, our families, and our children.  Public health intends to join the conversation about climate change and help make the connection between the way we live, our impact on the planet, and the planet's impact on our health.  By choosing this theme, the public health community can ignite a major shift in how society addresses this unprecedented challenge.  Stay tuned!

While everyone should be concerned about the "big picture" of climate change and take appropriate action on a personal level, public health on a local level is also very important to your community.  The North Shore Health Department serves the communities of Bayside, Brown Deer, Fox Point, Glendale, and River Hills and is a valuable resource for each community. 

Health Department activities include:  communicable disease control (Remember last year's pertussis/whooping cough outbreak?), immunizations for children (free - provided by the state) and adults (cost varies), blood pressure and cholesterol clinics, tobacco control, radon test kits, follow up of animal bites (in some of the communities), beach water testing, mosquito control, health education and consultation, worksite wellness program, etc.  The Health Department joined with the Shorewood Health Department to form the North Shore Environmental Health Consortium.  The sanitarian for the Consortium inspects and licenses restaurants, swimming pools, and hotels.  The sanitarian also follows up on all restaurant and environmental complaints and human health hazards.  The Health Department collaborates with the other members of the Southeast Region to develop a plan for Public Health Emergency Preparedness.

As you can see, the North Shore Health Department works hard to ensure that your community provides a healthy environment for you and your family.  Tune in to the daily news and see how many public health issues are mentioned on a daily basis (For example:  clean air and water issues, communicable disease, vaccine safety, foodborne illness, bird flu, dirty restaurants, environmental disaster, and on and on).  You will probably be surprised at how many there are.

So, please, take a moment during Public Health Week to acknowledge and celebrate all the good things that are done to enhance your well-being.  Also, please do whatever you can to help reduce and prevent climate change.  Even small actions will add up to help the environment and everyone in it.

Visit these websites to learn more about public health.  

http://www.wpha.org         http://www.apha.org