Zika: Delaware Public Health Urges Caution for all Travelers

Dover – The Delaware Division of Public Health (DPH) endorsed Centers for Disease Control and Prevention (CDC) travel guidelines today, including urging pregnant women to postpone travel to areas where Zika transmission is ongoing. The countries listed include but are not limited to: Brazil, Colombia, Venezuela, Barbados, Dominican Republic, Haiti, Puerto Rico, U.S. Virgin Islands, Mexico, Guatemala, El Salvador, Honduras, and Panama. For the complete list of Caribbean, Central and South American, and African countries impacted, visit http://wwwnc.cdc.gov/travel/notices.

Because there is neither a vaccine nor antiviral medications available to prevent Zika virus infection, the CDC recommends that women who are pregnant in any trimester:

• Consider postponing travel to any area where Zika virus transmission is ongoing.
• If you must travel to one of these areas, talk to your doctor first and strictly follow steps to prevent mosquito bites during your trip.
• And women who are trying to become pregnant, before you travel, talk to your doctor about your plans to become pregnant and the risk of Zika virus infection.

There have been reports of a serious birth defect of the brain called microcephaly, a condition in which a baby’s head is smaller than expected when compared to babies of the same sex and age, and other poor pregnancy outcomes in babies of mothers who were infected with Zika virus while pregnant. Knowledge of the link between Zika and these outcomes is evolving, but until more is known, DPH joins the CDC in recommending special precautions.

“All cases of Zika transmission have occurred outside the continental United States,” said DPH Director Dr. Karyl Rattay. “All cases in the continental U.S. are linked to travel and we have no lab-confirmed cases in Delaware. But, given the reports of serious birth defects in babies of mothers infected with Zika, DPH wanted to reinforce the CDC travel guidelines.”

While preventing mosquito bites is especially important in reproductive-age women, people of all ages should take steps to prevent mosquito bites during travel given there are several illnesses spread by mosquito bites, including Zika, dengue fever, West Nile Virus, Eastern equine encephalitis (EEE),and chikungunya, among others.

Mosquito prevention strategies include:
Wear long-sleeved shirts and long pants.
Stay in places with air conditioning or that use window and door screens to keep mosquitoes outside.

Use Environmental Protection Agency (EPA)-registered insect repellents. All EPA-registered insect repellents are evaluated for effectiveness.
• Always follow the product label instructions.
• Reapply insect repellent as directed.
• Do not spray repellent on the skin under clothing.
• If you are also using sunscreen, apply sunscreen before applying insect repellent.

If you have a baby or child:
• Do not use insect repellent on babies younger than 2 months of age.
• Dress your child in clothing that covers arms and legs, or
• Cover crib, stroller, and baby carrier with mosquito netting.
• Do not apply insect repellent onto a child’s hands, eyes, mouth, and cut or irritated skin.
• Adults: Spray insect repellent onto your hands and then apply to a child’s face.

Treat clothing and gear with permethrin or purchase permethrin-treated items.
• Treated clothing remains protective after multiple washings. See product information to learn how long the protection will last.
• If treating items yourself, follow the product instructions carefully.
• Do NOT use permethrin products directly on skin. They are intended to treat clothing.

Sleep under a mosquito bed net if you are overseas or outside and not able to protect yourself from mosquitos.

Health care providers should ask all their patients about recent travel. Because of the similar geographic distribution and clinical presentation of Zika, dengue, and chikungunya virus infection, patients with symptoms consistent with Zika virus disease should also be evaluated for dengue and chikungunya virus infection, in accordance with existing guidelines.

All women who traveled to an area with ongoing Zika virus transmission during pregnancy should be evaluated for Zika virus infection and tested in accordance with CDC latest guidance. To report a potential illness or receive further guidance on testing, call the DPH Office of Infectious Disease Epidemiology at 302-744-4990.

Anyone who lives or travels in the impacted areas can be infected. Most people who are infected with Zika do not develop symptoms. About one in five people infected with the virus develop the disease and symptoms are generally mild. The most common symptoms of Zika virus disease are fever, rash, joint pain, or conjunctivitis (red eyes). Symptoms typically begin two to seven days after being bitten by an infected mosquito. Zika is primarily transmitted through the bite of infected Aedes mosquitoes. It can also be transmitted from a pregnant mother to her baby during pregnancy or around the time of birth. We do not know how often Zika is transmitted from mother to baby during pregnancy or around the time of birth.

For further information on Zika, visit CDC Frequently Asked Questions.

Zika and other many mosquito-borne illnesses are considered “mandatory reports” and must be reported to the DPH Office of Infectious Disease Epidemiology at 302-744-4990.

For clinical guidance on screening http://dhss.delaware.gov/dph/php/alerts/dhan356.html.

Individuals seeking TTY services should call 7-1-1 or 800-232-5460. A person who is deaf, hard-of-hearing, deaf-blind, or speech-disabled can use a TTY to type his/her conversation to a relay operator, who then reads the typed conversation to a hearing person at the DPH call center.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, drink almost no sugary beverages


Delaware Health Equity Guide: Changing How we Think About Good Health

WILMINGTON – Good health is more than simply a visit to the doctor. Only about 10 percent of a person’s health status is impacted by traditional medical care. Health is also directly impacted by where people live, work, play, and pray. To empower communities to address these larger environmental issues, the Division of Public Health (DPH) and members of the University of Delaware’s School of Public Policy & Administration released today the Health Equity Guide for Public Health Practitioners and Partners.

Poverty, homelessness, crime, hunger, discrimination, unintended pregnancy, and education attainment can be linked to a risk of elevated rates of disease, disability, injury, and premature death. Since such factors extend far beyond traditional public health efforts, DPH hopes the Health Equity Guide will catalyze strong partnerships between public health, health care, businesses, schools, religious organizations, and lawmakers. The document shares evidence-based and promising strategies, and provides numerous references and web links for additional information.

DPH is working with many community leaders, non-profit organizations, other state agencies, and stakeholders to address health equity within our state and improve overall health for Delawareans. By improving environmental and social conditions, there is less risk of disease, disability, and injury. Many individuals working outside of the traditional health sector may not even realize the impact their work has on health and health equity. By raising awareness of the social determinants of health and sharing strategies and lessons learned for promoting healthier living and working conditions, we can mobilize our collective capacity to foster optimal health for all Delawareans.

“Health inequities are historically entrenched and pervasive, but they are not insurmountable,” Department of Health and Social Services (DHSS) Secretary Rita Landgraf said. “We can be most effective by transforming our health care system’s focus on disease and treatment of the individual to one that focuses on prevention, health, and wellness of the population. And by working with those outside of the health care system to address persistent inequities and encourage them to consider a ‘health in all policies’ approach where the impact on decisions is weighed against potential negatives for human health.”

Research shows that individuals who have low incomes or are of color are more likely to have diabetes, suffer certain kinds of cancers and other serious chronic diseases, life expectancy is often lower, and disability rates are often higher. And Delaware’s black infant mortality rate was as high as 2.8 times that of the white rate for the most recent data available. Hispanic children in Delaware are four times as likely and non-Hispanic black children are nearly twice as likely to be in less than optimal health compared to non-Hispanic white children. The number of Delaware children age birth to 5 years living in poverty (a factor directly linked to poorer health outcomes, climbed from 12,481 (17 percent) in 2008-2010 to 16,417 (24.7 percent) in 2012-2014, according to Kids Count.

“We have a duty to ensure equity in health because health is a public good necessary for a well-functioning society,” said DPH Director Dr. Karyl Rattay. “Everyone – regardless of race, religion, political belief, ability, sexual orientation and economic or social condition – has the right to a standard of living adequate for health and necessary social services. All sectors can work to dispel persistent health inequities.”

“I can vouch for the importance of teaching Delawareans about the connectivity between place and their health, and especially how to empower them to improve their communities,” added state Senator Margaret Rose Henry. “The guide can help community leaders, policymakers and community residents become familiar with the impact of underlying social and environmental conditions that are detrimental to the health of individuals and groups.”

The Health Equity Guide will be presented to a Wilmington City Council Committee later today. “It is vital that we reach the most vulnerable populations with this important information,” said Wilmington City Council Member Bob Williams, who is also a registered nurse. “The DHSS Health Equity Guide can help improve social and environmental conditions while serving as an excellent blueprint for better health. As Chair of City Council’s Health, Aging and Disabilities Committee, I am pleased to join my City and State colleagues in highlighting the underlying causes of health inequities. This is a great step forward in promoting equal opportunities for health for all Wilmington residents.”

The event was hosted by St. Patrick’s Center in Wilmington at 107 East 14th St. St. Patrick’s Center Executive Director Joseph Hickey said, “The health equity challenges highlighted in the Guide are concentrated in the poorest areas of Delaware, and our center is located in the poorest area of the state. Fresh and healthy foods are not readily available in the neighborhood around St. Patrick’s Center. It is easier to buy liquor then lettuce.”

The Health Equity Guide is available at: http://www.dhss.delaware.gov/dhss/dph/mh/healthequityguide.html. For further information, call 302-744-4879.

Other contributors to the Health Equity Guide included, but are not limited to Christiana Care Health System, Delaware Greenways, Medical Society of Delaware, National Association of County and City Health Officials, Nemours Children’s Health System, and United Way of Delaware, among others.

Individuals seeking TTY services should call 7-1-1 or 800-232-5460. A person who is deaf, hard-of-hearing, deaf-blind, or speech-disabled can use a TTY to type his/her conversation to a relay operator, who then reads the typed conversation to a hearing person at the DPH call center.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, drink almost no sugary beverages


Test Your Home for Elevated Radon Levels: January is National Radon Action Month

Dover ─ January is National Radon Action Month and a perfect time to test your home for radon, the leading cause of lung cancer death for non-smokers.  If elevated radon levels are found, the Division of Public Health (DPH) encourages homeowners to install a mitigation system that removes the gas from around the home’s foundation.  Homeowners can call DPH for a list of trained and certified contractors at 302-744-4546 or visit: www.RadonSafeDelaware.org.

Radon is an invisible, odorless, tasteless and radioactive gas that occurs naturally in rocks and soils throughout the world.  This gas may be found in homes and buildings; even new construction can contain radon. Since newer homes are often more airtight than older ones they can allow higher concentrations of radon to accumulate and may be more likely to lead to health problems.
According to information published by the U.S. Geological Survey (USGS) and the U.S. Environmental Protection Agency (EPA), the two general areas in Delaware that exhibit the highest potential for elevated radon in homes are in New Castle County (Middletown and Odessa).  But radon can occur in homes anywhere in Delaware.  Radon is generally associated with granitic rocks and certain sediments. These geologic formations can be sources for radon gas.

Radon test data from inside homes, specifically in basements, and to lesser extent first floors, have been collected nationally since 1985. The data are organized by ZIP code and include approximately 35,700 tests performed from 1993 through 2011, of which over 32,000 results came from tests conducted in New Castle County. Using radon test data, DPH produced a map to aid in showing geographic areas of increased radon risk.

This year, in honor of National Radon Action Month, DPH will be re-launching ads, a press release, and social media to remind people of the importance of testing for radon.  The campaign will include television public service announcements and advertisements on mobile devices in New Castle and Kent counties.  The goal of the campaign is to increase awareness of radon risks and to urge home testing.

“January is a good time to remind people that they should test their residences for radon every few years,” said Dr. Karyl Rattay, DPH director. “The idea is that with the New Year, there are simple things you can do to protect your family and the air they breathe.”

EPA recommends that a home be fixed if its radon level is 4 pCi/L (picocuries per liter) or higher. And, because there is no known safe level of exposure to radon, you should consider fixing your home even if your tested radon levels are under 4 pCi/L but over 2 pCi/L.   By county, the ZIP code areas showing the greatest percentages of homes exceeding the EPA action level are:
New Castle County
·         Middletown (27 percent)
·         Odessa (22 percent)
·         Townsend (17 percent)
·         Arden (17 percent)
·         Hockessin (17 percent)
·         Talleyville (15 percent)

Kent County
·         Smyrna (13 percent)
·         Dover (12 percent)
·         Clayton, Frederica and Magnolia (7 – 8 percent)

Sussex County
·         Greenwood (5 percent)
·         Dagsboro (6 percent)
·         Lewes and Milton (4 percent)

“High Updated radon incidence data has been available for the public for many years but it is important to remind people that it is there,” said Kurt Olinger, DPH radon program manager. “Testing for radon is easy and the benefits are immense.”

To view the radon Delaware map or further information, visit:  www.RadonSafeDelaware.org.  DPH has radon test kits available free of charge while supplies last.  The test kits may also be purchased at most hardware stores. To request a free radon test kit, contact the DPH radon office at 302-744-4546 or call 800-464-HELP (4357).

Individuals seeking TTY services should call 7-1-1 or 800-232-5460. A person who is deaf, hard-of-hearing, deaf-blind, or speech-disabled can use a TTY to type his/her conversation to a relay operator, who then reads the typed conversation to a hearing person at the DPH call center. The relay operator relays the hearing person’s spoken words by typing them back to the TTY user. To learn more about translation services and TTY availability in Delaware, visit delawarerelay.com.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, drink almost no sugary beverages.


Protect Yourself and Your Animals During Cold Weather

DOVER – Looks like winter has finally decided to arrive and the Division of Public Health (DPH) reminds people to prepare both themselves and their animals for freezing temperatures.

Hypothermia can occur in cold weather or if a person becomes chilled by rain. Infants and the elderly are particularly at risk, but anyone can be affected. Cold weather can put extra strain on the heart, so individuals with heart disease or high blood pressure should follow their doctors’ advice about exerting themselves in the cold.

Frostbite is an injury to the body that is caused by freezing. Frostbite causes a loss of feeling and color in affected areas. It most often affects the nose, ears, cheeks, chin, fingers, or toes. Frostbite can permanently damage the body, and severe cases can lead to amputation. The risk of frostbite increases for people with reduced blood circulation and among those who are not dressed properly for extremely cold temperatures.
Recognize the symptoms of frostbite:

At the first signs of redness or pain in any skin area, get out of the cold or protect any exposed skin – frostbite may be beginning. Any of the following signs may indicate frostbite:
• a white or grayish-yellow skin area
• skin that feels unusually firm or waxy
• numbness

A victim is often unaware of frostbite until someone else points it out because the frozen tissues are numb. If you detect symptoms of frostbite, seek medical care.

Prevent problems before they occur:

When heading out in cold weather, remember the following:
• Water-resistant or waterproof outerwear is advisable to reduce the risk of hypothermia (abnormally low body temperature). Dress in layers of loose-fitting clothes, including extra socks, which can be removed as they become damp. Wear warm, comfortable shoes.
• When exerting yourself, it is important to remain hydrated by drinking water and other non-caffeinated beverages.
• Wear hats, water-resistant coats, scarves or knit masks to cover the face and mouth, and gloves or mittens. Mittens are warmer than gloves.
• Wool, silk or polypropylene inner layers of clothing will hold more body heat than cotton. Perspiration can increase heat loss, and wet clothing can chill the body rapidly.
• Avoid alcoholic or caffeinated beverages, which can cause the body to lose heat more rapidly.
For more information on cold weather preparation, visit: emergency.cdc.gov/disasters/winter/.

Protect your pet during cold weather:

• Bring pets indoors. This is the safest place for your pet during cold temperatures. Short-haired pets or very young or old pets should never be left outdoors in cold temperatures and all pet dogs and cats should be brought indoors when the temperature falls below freezing.
• Protect outdoor pets from the elements. If your pet must be outdoors, you must provide a dry, draft-free shelter from the elements that contains moisture-resistant bedding such as straw or cedar shavings, which will help pets retain body heat. Housing should be appropriately sized for the animal and designed for animal sheltering. Pet owners should also provide a water-proof flap over the doorway to protect from wind and rain.
• Ensure access to water at all times. Frequently check water bowls to ensure water is not frozen. If you typically use a metal watering bowl, replace it with plastic as a pet’s tongue can get stuck to metal in cold temperatures.
• Additional food may be needed. Animals burn more calories in cold temperatures in order to stay warm, so you may need to increase the amount of food you provide. Check with your veterinarian about your pet’s nutritional needs in cold weather.
• Outdoor cats need attention, too. Whether outdoor cats are owned, stray, or feral, they need the same protection from cold weather as your pets. If there are outdoor cats in your neighborhood, provide them with dry, warm shelter, as well as food and water to help them survive dangerously low temperatures. For your own safety, do not handle any unfamiliar animals, particularly if the rabies vaccination status is unknown. An animal may have rabies and not exhibit any external signs.

If you see a pet that has been left outdoors in cold temperatures without proper shelter or protection from the elements, food, or water, report it immediately to the Delaware Animal Services Hotline at 302-255-4646. In the City of Wilmington, call 302-654-5151.

Individuals seeking TTY services should call 7-1-1 or 800-232-5460. A person who is deaf, hard-of-hearing, deaf-blind, or speech-disabled can use a TTY to type his/her conversation to a relay operator, who then reads the typed conversation to a hearing person at the DPH call center. The relay operator relays the hearing person’s spoken words by typing them back to the TTY user. To learn more about translation services and TTY availability in Delaware, visit delawarerelay.com.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.


Start a Healthy Habit With “31 Days to a Healtheir You” Tips

Dover – Start your January 2016 right with the help of the Division of Public Health’s (DPH) “31 Days to a Healthier You” social media campaign.  Use the hashtag #31DaysDE to view how-to videos, tips, photos, and contact information for starting the New Year right.

“Healthy habits will lead to a healthier Delaware,” said Delaware Health and Social Services (DHSS) Secretary Rita Landgraf.  “I encourage all Delawareans to have at least one New Year’s resolution that is health-oriented:  walking more, eating wiser portions, or visiting your doctor or dentist.  Small steps can lead to big health improvements.”

“We all need refreshing and inspirational ideas for taking charge of our health,” said Dr. Karyl Rattay, DPH director.  “If Delawareans are more physically active, make healthier food choices, quit smoking, and get regular medical screenings and immunizations, they are at reduced risk of certain cancers, heart attacks and strokes, diabetes, and obesity.”

Secretary Landgraf and Director Rattay’s comments are reinforced by the newly issued 2015-2020 Dietary Guidelines for Americans.  New in this update of the Dietary Guidelines is the recommendation that less than 10 percent of calories should come from added sugars and saturated fats.  View the 2015-2020 Dietary Guidelines for Americans here.

Under the Affordable Care Act, Delawareans have access to free health screenings (like mammograms, blood pressure checks and autism screening for toddlers) and prevention opportunities (like free immunizations, nutrition counseling and more). To learn about Delaware’s health insurance marketplace, go to www.choosehealthde.com.

To learn about preventive benefits, visit healthcare.gov and search for “prevention.”

DPH offers these healthy lifestyle suggestions:

·      Re-thinking your drink to sugarless drinks can lead to a weight loss of up to 15 pounds in one year.  Visit http://www.deheal.org/projects/rethinkyourdrink/.

·      People at increased risk for type 2 diabetes can prevent or delay the disease’s onset by losing 5 to 7 percent of their body weight. Delawareans who lose weight might also lower their blood pressure and cholesterol, and lessen pressure on their joints.

·      DPH recommends following the 5-2-1 Almost None concept: eating at least five servings of fruit or vegetables a day, watching no more than two hours of recreational screen time daily, getting one hour of physical activity each day, and drinking almost no sugar-sweetened drinks.

·      Becoming more physically active reduces the chance of developing chronic diseases such as obesity, diabetes, cardiovascular disease and certain cancers. Most people feel better after taking a brisk walk or run, or participating in other activities such as ice skating, swimming, or working out.  Find out how much physical activity you need by clicking here.

·      Monitoring your blood pressure regularly and being aware of your recommended waist circumference can reduce the possibility of a heart attack or stroke. An ideal blood pressure is less than 120/80. The goal for waist size is less than 35 inches for women and less than 40 inches for men. (If you are South Asian, Chinese, or Japanese, the waist size goal is 32 inches for women and 35 inches for men.) Visit the Million Hearts® Delaware partnership.

·      Delaware residents 18 and older smoke can quit through a free program. Visit the Delaware Quitline’s website or call toll-free: 866-409-1858.

·      Visit the immunization schedules page on the DPH website to see immunization schedules recommended for adults and children, and then make an appointment with your provider.

·      Parent, teachers, and child care providers can find helpful physical activity ideas and resources at Making Health Easier.

Individuals seeking TTY services should call 7-1-1 or 800-232-5460. A person who is deaf, hard-of-hearing, deaf-blind, or speech-disabled can use a TTY to type his/her conversation to a relay operator, who then reads the typed conversation to a hearing person at the DPH call center. The relay operator relays the hearing person’s spoken words by typing them back to the TTY user. To learn more about translation services and TTY availability in Delaware, visit delawarerelay.com.
 
Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, drink almost no sugary beverages.