Category Archives: Public Health Risks

Floodwater May Be Muddy but Health Threats Are Clear

By Hui Xie-Zukauskas

Flood danger_chbdc.govt.nz w-CPDFirst of all, our hearts go out to the victims and people suffering from Hurricane Harvey.

What can we learn from this catastrophic storm – especially for residents living in flood-prone areas?

I address this question, because the danger of flooding is not just drowning. Health hazards under seemingly calm floodwater cannot be taken lightly, and they will persist, in some cases, for a long time.

Therefore, I’m going to highlight what health hazards come with flooding and how your preparedness can help avoid them.

Let’s start with – Types of Health Hazards and Risks

  1. Bacteria and infections: Bacteria can cause infectious diseases. Exposure to contaminated water (e.g. from pathogens, chemicals or wastes) can result in infection and put a risk for other health problems.
  2. Injury: Cuts and harm result from invisible sharp glass or metal fragments.
  3. Stress: Tension is overwhelming, from devastated loss, upset, anxiety, exhaustion and sleep deprivation, etc. Stress may progress to mental health problems such as post-traumatic stress disorder and depression. Inevitably, the emergency responders experience stress as well.
  4. Mosquitoes: Warm, stagnant water is their breeding bed, which increase the prevalence of mosquito-borne diseases such as Zika, West Nile and dengue.
  5. Mold: Mold from water-soaked homes/walls can be harmful because it not only causes allergic reactions but also may worsen other existing health problems.

Next, Strategies and Actions You Can Take (in acronym P.I.C.)

#1 Prepare and Plan prior to flood

The key to effective preparedness is to plan ahead, protect assets, and get everything ready. Never wait till the last minute then act. Here are things you can do:

For care of vulnerable populations

  • Make sure to take care of necessities for babies and pregnant women.
  • Have enough back-up medications for folks with chronic diseases or health problems, and ensure the medications kept in a safe, water- and heat-proof place (e.g. cooler). Likewise, watch over personal medical device safety.
  • Make sure elderly, fragile folks stay in a dependable home/facility. 

For general population

  • Keep a prevention-mindset. Your health is your most valuable asset, as you cannot expect to take all your possessions with you.
  • Have your family’s emergency package/kit ready-to-go.
  • While securing some belongings is essential, it’s important to guard some critical documents such as insurance, health and immunization records.
  • If possible, consider getting the vaccine for TDAP – tetanus, diphtheria and pertussis in case of unforeseen injury.

#2 Implement during and post flood

  • Execute your plan, and ensure vital items at hand when evacuation.
  • Turn off power to avoid any incident from getting electrocuted.
  • Take good care of open wounds to prevent infection, esp. avoid direct contact in water.
  • Pay attention to folks in poor health, because they are at a great risk of heat-related death due to power outage and resultant lack of air conditioning.
  • Always make sure that your drinking water is safe.
  • Maintain hygiene and food safety. Discard any moldy, rotten or illness-risky foods.
  • When cleaning up floodwater, avoid injury. And clean everything in direct contact with water.
  • Clean mold thoroughly, but take caution to the cleaning chemicals because of their potential harm to your body. If necessary, ask for professional help.

#3 Communicate for management and support

Be informed. Follow the instructions or updates on mass flooding from federal or state government and communities. Keep your families and friends posted about your well-being. Support each other in every way possible. 

Final point:

To my knowledge, there is no direct evidence whether Hurricane Harvey is caused by climate change. However, as we all understand, global warming can add to warmer or hotter air, build up more humidity and more moisture, which will increase the intensity of hurricane and consequential damage. Hence, climate change does play a role in deadly storms or weather-related natural disasters.

So, let’s face the reality, take responsible actions to protect the earth and future generations.

 

Image credit: Chbdc.govt.nz and CPD

Lifestyle Interventions in the Midst of Three Health Crises

By Hui Xie-Zukauskas Healthy Lifestyle in Right direction_CPD-Clipart combo

As a nation, we are facing three health crises: (1) Chronic diseases, (2) Obesity, and (3) Opioid epidemic.

The facts and figures below tell a sad story.

Impact of three health crises in the U.S. (estimated in 2016)

 

 

Morbidity

 

Mortality

% of All Death

Chronic diseases 25% of adults had two/more chronic health conditions. 595,690 deaths (cancer);  610,000~ deaths (heart disease) 48%
Obesity epidemic 36.5% of adults were obese; 35.6%, overweight. 300,000+ deaths (obesity attributable) 18%
Opioid overdose   59,000 – 60,000 deaths  

*Data compiled from CDC, NIH and other health institutes.

Chronic diseases not only affect health and quality of life, they also add economical and social burdens. Specifically, about 86 percent of all health care spending goes towards treating individuals with one or more chronic conditions.

On the bright side, just eliminating three risk factors – poor diet, inactivity, and smoking – would prevent: 80% of heart disease and stroke, 80% of type 2 diabetes, and 40% of cancer, according to the Centers for Disease Control and Prevention (CDC).

It’s clear that poor lifestyle choices are key contributors in developing preventable chronic diseases such as cardiovascular disease, hypertension, diabetes, several types of cancer, and obesity. Lifestyle modification or intervention is not something new. However, it’s quite challenging to achieve and sustain success. So, here I will emphasize some key strategies and points you can use to fight these health crises personally.  

1. Keep a healthy diet. Intake a diet rich in vegetables, fruits, fish, beans, whole grains, nuts and other nutrients.

-          Reduce fats, sugar and salt in your diet, which may be packed as hidden ingredients in processed foods.

-          Reduce red meat, animal meats consumption too.

2. Participate in physical activity. Aim for a minimum of 150 minute exercise each week.

A combination of diet and exercise is effective in maintaining healthy weight. Take advantage of summer outdoor activities (e.g. swimming, walking, or playing at beach).

3. Quit or avoid addictive behavior such as tobacco, alcohol and illicit drug use.

-          Tobacco smoking takes more than 480,000 lives each year.

-          Rather than seeking substances as a mean for momentary pleasure, living a healthy lifestyle is an excellent regimen for meeting one’s physical, emotional, and social needs.

4. Maintain healthy weight. Weight control is about energy balance, i.e. Energy In = Energy Out. When energy intake exceeds energy expenditure, weight gain occurs.

-          Do eat good breakfast, and consume enough fibers and proteins.

-          Avoid emotional eating.

-          Yes, it’s not easy to make a big change. One step at a time. Don’t go it alone, lock arms for support and motivation.

5. Manage stress. There are many techniques to relieve stress, but the best ones are enjoyable, self-help ways that work for you.

-          Importantly, keep counting your blessings, because gratitude is a secret to happiness.

6. Get a good night’s sleep. Many people overlook this issue.

-          Lack of sleep for a long time may increase your risk of obesity, diabetes, and cardiovascular disease.

-          Sleep hygiene is essential to getting sound sleep (see previous article)

All of above healthy habits will effectively reduce triglyceride levels, cut blood sugar levels, minimize waist circumference, and lower blood pressure. As a result, most chronic conditions and obesity are preventable, and some can even be reversed.

So, go for a healthy, vibrant lifestyle!

 

Image credits: https://openclipart.org/; CPD

5 Reasons for a Higher Awareness of Zika

By Hui Xie-Zukauskas

Zika_Pt.2_CPDZika virus continuously poses a public health threat in the U.S.. Since my last post “Zika Virus Infection and Cancer Care Indication”, as of August 24th, 29 people in Florida have been infected with Zika virus through local mosquito transmission, along with 2,487 travel-related cases across the country, according to the CDC.

This is a more alarming reality than that presented three months ago when all 544 Zika cases in the U.S. were travel-related. Regions along the Gulf Coast are at an elevated risk for Zika outbreak, especially Louisiana, because of recent devastating flooding.

Pregnant women are particularly vulnerable to the Zika crisis. Of importance is to avoid traveling to Zika outbreak areas and stay self-protected to prevent mosquito bites. I won’t get into details here because plenty of information or guidance is available elsewhere.

Based on some new research and clinical findings, I’d like to emphasize FIVE reasons why we need a higher alert and responsiveness to Zika infection. Here goes:

1.      There are various ways for Zika virus transmission.

A person who has acquired the Zika infection could pass virus along through mosquito bites, maternal-fetal and/or sexual transmission. Unmistakably, blood transfusion also becomes a major concern as Zika-positive blood donation is evident. That’s why the FDA recently recommended nationwide screening of blood donations for Zika virus. Thank about it – why is it necessary to run such a costly and time-consuming testing for a massive blood donation system? Remember that people infected with Zika virus could be symptomless.

2.      Zika virus can damage not only a baby’s brain but also an adult’s brain cells.

Painful scan images have shown that Zika infects a fetus, causes brain calcification, and destroys a baby’s brain. Severe brain damage may bring about long-term developmental problems or neurological complications affecting vision, movement and epilepsy. On the other hand, new research reveals that Zika virus impacts a different area of adult mice’s brain, such as a specific neural cell, and it could affect long-term memory in some adults.

3.      Zika virus affects the immune response, particularly in those whose immune system has been compromised due to a chronic disease or cancer therapy.

Infections by viruses can suppress the immune system. Moreover, a person’s inflammatory response to mosquito bites may augment the severity of arbovirus infection (e.g. Zika). Studies suggest that mosquito bites, especially in individuals hypersensitive to mosquito bites, may be linked to cancer development through activating cancer cellular pathways by mosquito-feeding, and/or through influencing human metabolic pathways leading to the initiation of cancer.

4.      It’s challenging to control mosquitoes.

Mosquito population is measured in the millions, and usually in the hundreds of millions. There is no way to distinguish Zika-infected mosquitoes from the rest uninfected. It’s virtually impossible to eradicate them all. But it doesn’t mean we should give up our effort.

Aerial spraying and backpack fogging carried out by the professionals can help reduce mosquito populations in epidemic areas. There are also effect measures that individual citizens can take right at home or the backyard with little or no cost. For instance, the best ways to control local mosquito population is to eliminate the places where mosquitoes breed, such as water-filled buckets, flowerpots, containers, puddles or pools of standing water outdoors.

Using pesticides to kill mosquitoes is delicate. Be cautious about unintended consequence, because pesticides often contain some toxic chemicals that can be harmful to human health if inhaled or ingested. 

5.      Finally, keep in mind those young women whose newborns suffering from microcephaly, neurological abnormalities and birth defects. What would their hardship be? – raising their ill babies, caring for the infants with various disabilities, and likely dealing with their own stress, anxiety, depression or quality of life.

 

Image credit: physio-pedia.com and CPD

Zika Virus Infection and Cancer Care Indication

By Hui Xie-Zukauskas

Zika in USA map_smAre you worried about Zika virus infection? Are you ready for Zika outbreak?

Consider again − after learning the public health threat highlighted here with eyes on the U.S. region.

Let’s start with a snapshot on the crucial timeline to see how Zika epidemic has been evolved after the 1st Zika case identified in Brazil in April 2015.

Snapshot on Timeline of Zika Outbreak

As you may know, Zika virus is transmitted to people primarily through the bite of an infected mosquito. Travel-associated cases imply individuals infected abroad and then returned to the country. No immediately mosquito-transmitted Zika infection has been reported in the 50 US states so far, but the CDC has alerted the epidemic is likely to change with mosquito season’s arrival.

How should you be concerned?

Birth defects (e.g. microcephaly, fetal malformations) have been linked to Zika virus. Thus, pregnant women are particularly vulnerable to this emerging infectious disease.

If you are a healthy adult, you’re still not Zika-proof. In most cases, Zika virus causes a brief, mild flu-like illness. As documented, adults have also suffered from severe neurological disorders such as meningitis, meningoencephalitis and Guillain-Barre syndrome. A rare complication may be internal bleeding, which caused the first US Zika-related death.

Here are a few key points:

  • There is no vaccine or effective treatment for this disease.
  • Zika-specific tests could be expensive and not readily available.
  • There is a lot of UNKNOWN, though more research is underway.

How would you possibly be impacted?

With summer approaching, mosquitoes are coming. But don’t panic, not all mosquitoes spread this disease.

Two mosquito species may carry Zika virus: 1) Aedes aegypti; and 2) Aedes albopictus, the latter is also known as Asian Tiger mosquito. However, there is no way to tell if a mosquito is Zika-infected.

Next, where would Zika-carrier mosquitoes likely to be found?

Places like Florida, Texas and Louisiana are home of the Aedes aegypti mosquito, whereas the Midwest and much of the East Coast happen to be climate or environment for Aedes albopictus (Asian tiger) mosquito. So, a “New Bug” is expected to be around.

What can you do?

Current strategic measure is Self-Prevention and Self-Protection, as briefly summarized in the following areas:

Travel cautions: Pregnant women are advised against travel to the affected countries, and if a trip is required, test the positivity of Zika virus presence once returning.

Personal protection: Extra vigilance and care for pregnant women, wearing long-sleeved clothes, gearing up with mosquito repellent (EPA-certified), and remember – The mosquito-biting time could be daytime!

Note that other routes of Zika infection include sexual or maternal-fetal transmission or blood transfusion.

Environmental prevention: Eliminate potential mosquito’s egg-laying sites by emptying or drying water buckets, water storage units and other plant pots.

Medication alert: Although analgesics is a part of supportive management, avoid Aspirin and Non-steroidal anti-inflammatory drugs because of the risk for hemorrhage among patients with cancer or dengue or taking specific therapies at elevated danger of bleeding.

Last but not the least, because it’s unclear as how the course of Zika infection influences that of cancer, cancer patients should maintain close check-up or follow-up with your physicians and specialists, particularly for those with an immune-suppressed condition or with significant comorbidity.

Zika outbreak may come rapidly, so get prepared and get ready!

 

References: 1) Hepner and del Pilar Estevez Diz: Journal of Global Oncology. April 2016; and 2) Plourde and Bloch: EID journal. Vol.22, 2016

Image credit: physio-pedia.com and CPD