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

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

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

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         

January is National Radon Action Month as designated by the U.S. Environmental Protection Agency.  So this is as good a time as any to evaluate your exposure risk to radon.  In addition to learning more about radon and spreading the word about what you have learned, it is recommended that you test your home, buy a radon resistant home if moving, and attend a National Radon Action Month event in your community.

There has been a fair amount of publicity about radon exposure in recent years so we may have a vague familiarity with the term.  However, since radon is the first leading cause of lung cancer in nonsmokers, it would benefit all of us to become better informed and act on our new understanding.

Radon is a naturally occurring radioactive gas that enters buildings from the soil.  It is colorless, odorless, and tasteless and is found all over the U.S. in all types of buildings.  Radon can enter a building through any opening between the building and soil such as openings around water pipes, sump pumps and drains as well as visible cracks.  The only way to know if your home has a high level of radon is to test for it.

Radon is a Class A carcinogen which means it is known to cause cancer in humans.  Radon enters the lungs and decays into radioactive particles that can get trapped, damaging lung tissue and leading to lung cancer over the course of life. 

Testing for radon is not difficult or expensive and takes only a few minutes.  Each house should be tested as outcome is not determined by a neighbor's results.  If the result is high, steps can be taken to fix the problem.  Even though MIlwaukee County is in a zone with low potential of radon exposure, it is still recommended that all homes be tested as affected homes have been found in all the zones.

The North Shore Health Department does have some radon testing kits available through participation in a radon grant.  There is a $5.00 charge for the kit.  Please contact the Health Department at 371-2980 if you would like to pick up a kit.

For more information about radon, visit these websites:   http://www.dhfs.wisconsin.gov/dph_beh/radonprot/ or http://www.epa.gov/radon/pubs/citguide.html or http://www.epa.gov/radon/pubs/consguid.html  or http://www.epa.gov/region5/air/radon/radon.html or call the North Shore Health Department.

We have had several potential human rabies exposures in just the past few weeks. These have involved bites from a cat, two dogs, and three bats. We had the cat and bats tested for rabies, and none of them were infected.

In the United States, most human rabies cases are caused by rabies virus from bats. If you have been bitten, wash the wound with soap and water and seek immediate medical attention. If you don’t know whether someone was bitten (for example, if you find a bat in a room where people have been sleeping or in a room with very young children), seek immediate medical attention anyway. In either case, if it is possible, SAFELY capture the bat for rabies testing.

Whenever there is a potential exposure, it is ALWAYS better to have the animal available for testing or quarantine. If the bat is tested and does not have rabies, this spares people the expense and inconvenience of rabies shots. If the animal is not available for testing, then it is recommended that the exposed person get rabies vaccine shots to prevent the disease.

Call us if you have concerns about a possible bat bite. We will submit any captured bats suspected of biting humans to the State Laboratory of Hygiene for testing.

Rabies vaccine is available from most hospital emergency rooms.

For additional information on rabies and how to “bat-proof” your home, check out the Centers for Disease Control rabies website at: www.cdc.gov/ncidod/dvrd/rabies or http://dhfs.wisconsin.gov/communicable/factsheets/Rabies.htm

Also, remember to make sure your pets have their rabies shots! In recognition of World Rabies Day, the Wisconsin Humane Society is offering rabies vaccine to those who meet income criteria. Clinics will be held from 8/29 – 9/8 except Labor Day.