DPH and DNREC Share Updated Federal Fish Consumption Guidelines for Pregnant Women and Children

DOVER – Many of us have heard that eating fish is a key part of a healthy diet. But how much should we eat and are there risks to pregnant women and children? In January, the U.S. Food and Drug Administration (FDA) and the U.S. Environmental Protection Agency (EPA) issued updated advice regarding fish consumption that applies to fish and shellfish caught commercially and sold in U.S. retail outlets. This advice is geared toward helping women who are pregnant or may become pregnant – as well as breastfeeding mothers and parents of young children – make informed choices when it comes to fish that is healthy and safe to eat. The federal guidelines are based on mercury levels found in certain commercial fish species and do not consider fish caught in Delaware waterways by recreational anglers or anglers who rely on locally caught fish to supplement their diets.

Fish and other protein-rich foods have nutrients that can help your child’s growth and development. However, all fish contain at least traces of mercury, which can be harmful to the brain and nervous system if a person is exposed to too much of it over time. Children are especially sensitive to mercury poisoning because their organs and tissues are still developing. If pregnant women ingest methylmercury in fish, there is a danger to the developing nervous systems of their unborn children.

An FDA analysis of fish consumption data found that 50 percent of pregnant women surveyed ate fewer than 2 ounces of fish a week, far less than the amount recommended. Because the nutritional benefits of eating lower-mercury fish are important for growth and development during pregnancy and early childhood, the FDA and EPA are advising and promoting a minimum level of seafood consumption for these groups.

The advice recommends two to three servings of lower-mercury fish per week, or 8 to 12 ounces. The new advice is consistent with the 2015-2020 Dietary Guidelines for Americans.

To help consumers more easily understand the types of fish to select, the agencies have created an easy-to-use reference chart that sorts 62 types of fish into three categories:

• “Best Choices” (eat two to three servings a week)
• “Good Choices” (eat one serving a week)
• “Fish to Avoid”

Fish in the “Best Choices” category make up nearly 90 percent of fish eaten in the United States and often have the lowest levels of mercury.

For adults, a typical serving is 4 ounces of fish, measured before cooking. It is recommended that women of childbearing age (about ages 16 to 49), especially pregnant and breastfeeding women, eat two to three servings of fish a week from the “Best Choices” list or one serving from the “Good Choices” list.

Serving sizes for children should be smaller and adjusted for their age and total calorie needs. It is recommended that starting at age 2, children eat approximately 2 ounces of fish once or twice a week. Everyone should eat a variety of fish types.

In June 2016, DPH and DNREC issued updated fish consumption advisories for fish caught by recreational anglers in Delaware’s fresh, estuarine and marine waters. The state advisories and more information can be found on the Department of Natural Resources and Environmental Control’s website here.

For additional federal information on fish consumption:

For answers to frequently asked questions about mercury, exposure and poisoning, visit http://www.dhss.delaware.gov/dhss/dph/files/mercuryfaq.pdf. Effects of mercury on the brain may include irritability, shyness, tremors, changes in vision or hearing, and memory problems. Short-term exposures to high levels of mercury may cause lung damage, vomiting, diarrhea, increases in blood pressure or heart rate, skin rashes, eye irritation, and kidney damage. Exposure to mercury affects the kidneys in pregnant women.

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://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.

The mission of the Department of Natural Resources and Environmental Control is to ensure the wise management, conservation and enhancement of the State’s natural resources, protect public health and the environment, provide quality outdoor recreation, improve the quality of life and educate the public on historic, cultural and natural resource use, requirements and issues.


Delaware Announces Travel-Related Positive Zika Case;Preventing Mosquito Bites is the Best Protection

Dover – The Delaware Division of Public Health (DPH) announced today the state’s first Zika case in an adult female. The illness was travel-related and pregnancy is not an issue. Zika is primarily spread by mosquito bite and the individual is not considered infectious. The illness was mild, as expected, and was confirmed by a CDC blood test. To protect privacy, DPH will not be releasing additional details on this individual.

The most common symptoms of Zika virus are fever, rash, joint pain, or conjunctivitis (red eyes). Symptoms typically begin two to seven days after being bitten by an infected mosquito. It can also be transmitted from a pregnant mother to her baby during pregnancy or around the time of birth. It is not yet known how often Zika is transmitted from mother to baby during pregnancy or around the time of birth. In rare cases, it also may be transmitted sexually from male to female.

The most serious threat linked to Zika is serious birth defects. There have been reports of serious birth defects in infants whose mothers contracted the virus while pregnant. 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 infected with Zika are now being linked to the virus.

Because there is neither a vaccine nor antiviral medications available to prevent Zika virus infection, DPH joins the CDC in sharing precautions for pregnant women or women who may get pregnant:
• If you are pregnant, postpone travel to the countries where Zika virus transmission is ongoing.
• If your male sexual partner has traveled to, or lives in an area with, active Zika virus transmission, condoms should be used for the duration of the pregnancy. Discuss your male partner’s potential exposures and history of Zika-like illness with your doctor.
• If you are trying to become pregnant, talk to your doctor before you travel about your plans to become pregnant and the risk associated with Zika virus.
• If you are pregnant or may become pregnant and must travel to one of these areas, talk to your doctor first and strictly follow steps to prevent mosquito bites during your trip.
• If you are not pregnant, but your male partner lives in or has traveled to a country with Zika, consider using condoms.

“This local Zika case is not a threat to the public’s health,” said DPH Director Dr. Karyl Rattay. “The most serious issue linked to this disease is birth defects caused when the pregnant women is exposed to the disease. As a result, DPH is focusing its messaging and awareness on preventing exposure to pregnant women and their partners.”

Added DPH Medical Director Dr. Awele Maduka-Ezeh, “The best way for people to protect themselves from Zika or any mosquito-borne illness is to prevent mosquito bites during travel abroad and during Delaware’s mosquito season. There are too many mosquito-borne illnesses to take a chance.”

Those who recently traveled, or plan to travel, to areas where Zika transmission is ongoing, including, but not limited to, Brazil, Colombia, Venezuela, Barbados, the Dominican Republic, Haiti, Puerto Rico, Costa Rica, U.S. Virgin Islands, Jamaica, Mexico, Guatemala, El Salvador, Honduras, and Panama could be at risk for exposure. For the latest Centers for Disease Control and Prevention (CDC) list of countries, visit: http://wwwnc.cdc.gov/travel/notices.

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. Today, DPH shared educational materials and tools, including flyers in English and Spanish for posting in medical and social service offices that serve pregnant women. For copies of the flyers and more educational tools, see the below links.

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 should also be evaluated for dengue and chikungunya virus infection, in accordance with existing guidelines.

For further information:
• CDC information on Zika: http://www.cdc.gov/zika/
• Division of Public Health Zika page: http://dhss.delaware.gov/dhss/dph/zika.html
• Flyer for pregnant women in English: http://www.dhss.delaware.gov/dhss/dph/files/zikaflyerforpregnantwomen.pdf
• Flyer for pregnant women in Spanish: http://www.dhss.delaware.gov/dhss/dph/files/zikaflyerforpregnantwomensp.pdf
• DPH special bulletin on Zika: http://www.dhss.delaware.gov/dhss/dph/files/dphbulletin1602zika.pdf
• Zika information in Spanish: http://www.cdc.gov/spanish/mediosdecomunicacion/comunicados/d_recomendaciones_viajeros_virus_del_zika_011516.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.