A health warning to avoid romaine lettuce was issued on Tuesday, Nov. 20, by the Centers for Disease Control and Prevention.
People should not buy or eat romaine lettuce; restaurants should stop serving it; and anyone who has it on hand should throw it out and clean the refrigerator immediately.
This advisory was issued as a precaution after 32 people in 11 states have become ill in the last month with an aggressive form of E. coli, a bacteria blamed for a number of food-borne outbreaks in recent years.
This E. coli outbreak was first identified on Oct. 8 and has led to the hospitalization of 13 people, including one person who developed kidney failure. So far no deaths have been reported.
Roughly a third of the cases were reported in California; the others are concentrated in the northeast and in the Great Lakes region.
Another 18 people have gotten sick in Canada. The source has not yet been identified, but the lettuce was most likely grown in the US or Canada.
While the bacteria in these cases are genetically different from an E. coli outbreak associated with Romaine lettuce earlier this year, the strain in this current outbreak (identified as Shiga toxin-producing Escherichia coli O157:H7) has been involved in other outbreaks.
The most serious one was in 1993 that killed four children and left nearly 200 other people very ill from eating contaminated hamburger meat.
Symptoms of E. coli Infection
– People usually get sick from Shiga toxin-producing E. coli (STEC) 2–8 days (average of 3–4 days) after swallowing the germ. – Some people with a STEC infection may get a type of kidney failure called hemolytic uremic syndrome (HUS). Up to half of the people with known infections in this outbreak have needed to be hospitalized. – E. coli infection is usually diagnosed by testing a stool sample. – Antibiotics are not recommended for patients with suspected E. coli infections. Some studies have shown that administering antibiotics to patients with E. coli infections might increase their risk of developing kidney problems, and a benefit of treatment has not been clearly demonstrated.
What to do
– Consumers who have any type of romaine lettuce in their home should not eat it and should throw it away, even if some of it was eaten and no one has gotten sick. – This advice includes all types or uses of romaine lettuce, such as whole heads of romaine, hearts of romaine, and bags and boxes of precut lettuce and salad mixes that contain romaine, including baby romaine, spring mix, and Caesar salad. – If you do not know if the lettuce is romaine or whether a salad mix contains romaine, do not eat it and throw it away. – Wash and sanitize drawers or shelves in refrigerators where romaine was stored. – Restaurants and retailers should not serve or sell any romaine lettuce, including salads and salad mixes containing romaine.
Take action if you have symptoms of an E. coli infection
– Talk to your health care provider. – Write down what you ate in the week before you started to get sick. – Report your illness to the health department. – Assist public health investigators by answering questions about your illness.
LAKEPORT, Calif. – Sutter Lakeside Hospital is hosting a free public rehabilitation seminar with licensed physical therapist Joe Prisco, director of rehabilitation at Sutter Lakeside Hospital.
The seminar will be on Thursday, Nov. 29, from 5 to 6 p.m. in the hospital conference room at 5176 Hill Road East in Lakeport.
Interested participants can register by calling 707-262-5121.
The seminar will include light refreshments, a brief presentation on common musculoskeletal and speech-language conditions, and an open forum for attendees to ask questions.
Half of Americans report muscular or skeletal injuries – painful and debilitating injuries or conditions that affect daily productivity.
In fact, musculoskeletal conditions are far more common than other chronic conditions such as cancer, diabetes, or respiratory disease.
From a child with a broken arm to a senior with a hip replacement, physical therapy can benefit people of all ages.
Physical therapy can reduce or eliminate musculoskeletal pain, help patients recover from an injury without surgery, improve mobility, recover from a stroke, and more.
Additionally, rehabilitation services include speech-language therapy. Speech-language therapy aids patients of all ages in a number of ways, including recovery from a stroke or overcoming a stutter.
Sutter Lakeside recently expanded its speech-language therapy program to include pediatric speech-language therapy, which can help children with speech disorders such as difficulty producing sounds or pronouncing words correctly, and language disorders such as difficulty understanding or processing language.
WASHINGTON, DC – White House Office of National Drug Control Policy, or ONDCP, Deputy Director Jim Carroll and U.S. Department of Agriculture Assistant to the Secretary for Rural Development Anne Hazlett have unveiled a listing of federal programs that can be used to build resilient communities and address opioid misuse in rural communities.
“Many rural communities in America have been especially hard hit by the opioid crisis,” said Deputy Director Carroll. “ONDCP and USDA partnered to create this guide to help them find the Federal resources that can help them respond.”
“Strong and healthy communities are a cornerstone for prosperity in rural America,” Hazlett said. “Under the leadership of President Trump, USDA is committed to empowering rural leaders with tools to better leverage state, local and private resources with federal investment.”
More than 300,000 Americans have died from overdoses involving opioids since 2000. President Donald J. Trump has mobilized his entire Administration to address opioid abuse by directing the declaration of a nationwide Public Health Emergency. For a rural community or county already struggling to attract new – or maintain existing – businesses, the impact of opioid misuse on the quality of life and economic prosperity can be enormous. The Centers for Disease Control and Prevention reported in October 2017 that death rates from drug overdoses in rural areas have now surpassed drug overdose death rates in urban areas.
The Rural Resource Guide to Help Communities Address Substance Use Disorder and Opioid Misuse was developed by the Rural Opioid Federal Interagency Working Group. In May 2018, the ONDCP stood up the Rural Opioid Federal Interagency Working Group to help address the opioid crisis by improving coordination and reducing potential overlap among federal agencies responding to the crisis in the Nation’s rural communities.
The working group is co-chaired by ONDCP and USDA. The departments and agencies represented on the Rural Opioid Federal Interagency Working Group include the Departments of Commerce, Education, Health and Human Services, Housing, Justice, Labor, Transportation, and Veterans Affairs; the Corporation for National and Community Service; and the Appalachian Regional Commission.
The Rural Resource Guide to Help Address Substance Use Disorder and Opioid Misuse is the second tool announced this month in USDA’s Community Opioid Misuse Toolbox – a suite of essential tools supporting grassroots strategies to address the opioid epidemic.
In October, USDA launched the Community Assessment Tool, an interactive database to help community leaders assess how and why the opioid epidemic is impacting their regions. USDA’s Community Opioid Misuse Toolbox is free and available to the public. It can be accessed on USDA’s Rural Opioid Misuse Webpage. https://www.usda.gov/topics/opioids USDA Rural Development provides loans and grants to help expand economic opportunities and create jobs in rural areas. This assistance supports infrastructure improvements; business development; housing; community facilities such as schools, public safety and health care; and high-speed internet access in rural areas. For more information, visit www.rd.usda.gov.
Sixty-two percent of people diagnosed with chronic pulmonary disorders have never heard of pulmonary rehabilitation – an effective non-pharmacological treatment option covered by Medicare and private insurance – according to a survey released by the American Thoracic Society, or ATS.
Pulmonary rehabilitation is a comprehensive 6- to 12-week program of exercise and education that is proven to reduce symptoms, improve exercise capacity and enhance quality of life for patients living with chronic respiratory diseases. However, it is significantly underutilized, particularly as compared to pharmacological treatments such as inhalers or steroids.
A recent study published in the Annals of the American Thoracic Society showed only 1.9 percent of patients hospitalized for COPD received pulmonary rehabilitation within six months of being discharged.
The survey sample comprised 500 patients diagnosed with COPD, pulmonary hypertension, interstitial lung disease or other chronic pulmonary disorders. It was conducted by Wakefield Research, an independent market research agency, and commissioned by ATS, a nonprofit organization dedicated to improving global health by advancing research, patient care and public health in pulmonary disease, critical illness and sleep disorders.
Chronic respiratory diseases, the most common being chronic obstructive pulmonary disease, or COPD, are the third leading cause of death in the U.S. after heart disease and cancer; of these, they are the only cause of death that is on the rise.
The survey revealed that 40 percent of patients diagnosed with these diseases are unaware of how deadly their condition is. Respondents ranked stroke, diabetes and Alzheimer’s over chronic respiratory diseases as leading causes of death. In fact, 28 percent of respondents did not rank chronic respiratory diseases in the top three at all.
The new survey data builds upon the 2015 American Thoracic Society/European Respiratory Society policy statement on implementation of pulmonary rehabilitation, which highlighted key gaps in its utilization worldwide. Lack of health care provider and patient awareness were identified as key concerns. This follow-up survey confirms the concerns identified in the original statement and highlights the urgent need for increasing awareness of pulmonary rehabilitation.
People with chronic respiratory diseases are often limited in many daily activities and may not be able to even walk from one side of their home to the other, prepare a meal or wash their hair, according to Carolyn L. Rochester, MD, professor of medicine, pulmonary critical care and sleep medicine, Yale University of Medicine, past chair, ATS Assembly on Pulmonary Rehabilitation.
“With these diseases being a leading cause of death and the only one that’s on the rise, we had to ask, ‘Why aren’t patients getting treatment that’s proven to reduce their symptoms and improve their quality of life?’” said Rochester. “Although the ATS/ERS statement addressed this issue, this is the first U.S. study to quantitatively answer the question. Raising awareness of pulmonary rehabilitation, which is similar to cardiac rehabilitation for people with chronic heart conditions, is critical so that individuals can advocate for themselves.”
According to the new survey, in contrast with the lack of knowledge of pulmonary rehabilitation, the majority of patients with a chronic pulmonary disorder have heard of oxygen therapy (70 percent) as well as medicinal interventions, including long-acting or maintenance inhalers (61 percent), short-acting or rescue inhalers (52 percent) and inhaled or oral steroids (52 percent) as treatments for their disease.
The Wakefield survey also found that many patients who have heard of pulmonary rehabilitation do not pursue treatment or fail to complete treatment. Of the 38 percent of respondents who had heard of pulmonary rehabilitation, only 29 percent completed the program.
For those who did not participate in pulmonary rehabilitation or started and did not complete the program, the following were the most common reasons given:
– 36 percent said it is too difficult to travel there. – 28 percent said the program is too expensive. – 27 percent said their breathing is so bad, it is difficult to leave home. – 27 percent said it is emotionally too difficult, such as due to feelings of embarrassment or anxiety.
“Understanding the reasons why people don’t utilize pulmonary rehab and minimizing the barriers to participation enables us to help more people with COPD and other chronic respiratory diseases get the treatment they need,” said Chris Garvey, FNP, MSN, MPA, MAACVPR, UCSF Sleep Disorders and Pulmonary Rehabilitation. “Pulmonary rehab works by strengthening the muscles to ease the burden on the lungs. It’s a safe, friendly environment to learn how to manage breathing, allowing patients to not only feel better, but to do more in their lives – activities they currently avoid because of their symptoms.”
The survey revealed that more than half (57 percent) of respondents avoid climbing stairs due to their breathing problems. Half (50 percent) don’t carry items when they walk.
Other avoided tasks include:
– Household chores, such as cleaning the house or doing laundry (48 percent); – Going outside their home to do errands, such as grocery shopping (43 percent); – Going outside their home to attend social events or gatherings (42 percent); – Caring for their pet(s), such as taking them for walks (37 percent); – Playing with or entertaining their children or grandchildren (37 percent); – Cooking or preparing meals (28 percent); – Daily personal hygiene tasks, such as washing their hair or brushing their teeth (28 percent).
People who complete a pulmonary rehabilitation program report having a positive experience.
“When I first started pulmonary rehabilitation, I couldn’t even get mail from my mailbox, so it was hard to imagine exercising. Every two weeks, I added in a new activity and within nine months, I was able to do most of what I wanted to do,” said Lynn Markwell, a patient who completed pulmonary rehabilitation one year after being diagnosed with interstitial lung disease in 2004. “I was told I didn’t have long to live, but if you do the exercises, learn to manage your breathing and know your medications, you can feel better and start living your life again.”
For more information about pulmonary rehabilitation and to find a local program, visit www.livebetter.org.