Health
With the new school year fast approaching, Dr. Ron Chapman, director of the California Department of Public Health and the state public health officer, is encouraging parents not to wait until the fall to make sure their children are fully immunized before classes start.
"Immunizations are a safe and effective way to help our kids stay healthy in school and protect them from vaccine-preventable illnesses that can be very serious and have lifelong consequences," said Dr. Chapman.
"As families make plans for heading back to school, those plans should include making sure their children are up-to-date on required immunizations for school, including an adolescent whooping cough booster shot (Tdap) for incoming seventh graders,” he said.
Schools are required to verify each child's immunization record to ensure all shots and boosters are completed before entry to kindergarten and seventh grade.
Kindergartners need a total of five DTaP (diphtheria, tetanus, pertussis), four polio, three hepatitis B, two MMR (measles, mumps, rubella) and one varicella (chickenpox) shot. Kindergarten boosters for DTaP, polio and MMR are given at 4 or 5 years of age.
Since 1962, California has required certain vaccinations for incoming kindergarteners. In 2012-2013, nearly 90 percent (almost 500,000 California kindergarten entrants) were fully immunized, with the remainder typically behind on only one or a few required vaccines.
In addition, since a new California law was signed in 2010, students entering seventh grade will need to show proof of the whooping cough (pertussis) booster before starting school.
Dr. Chapman urges parents to make an appointment with their provider now to protect themselves and their families and to ensure kids start school on time.
If a child does not have health insurance, or is only partially insured, a doctor or local health department can provide information about the Vaccines for Children Program, which provides free or low-cost immunizations.
Some local health departments are offering expanded immunization clinics during the month of August, National Immunization Awareness Month.
To learn more about immunizations required for school entry, visit www.shotsforschool.org .
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An analysis of West Nile virus epidemics in Dallas County in 2012 and previous years finds that the epidemics begin early, after unusually warm winters; are often in similar geographical locations; and are predicted by the mosquito vector index (an estimate of the average number of West Nile virus-infected mosquitoes collected per trap-night), information that may help prevent future outbreaks of West Nile virus-associated illness, according to a study in the July 17 issue of JAMA.
“After declining over the prior five years, mosquito-borne West Nile virus infection resurged in 2012 throughout the United States, most substantially in Dallas County, Texas. Dallas has been a known focus of mosquito-borne encephalitis since 1966, when a large epidemic of St. Louis encephalitis (SLE) occurred there, necessitating aerial spraying of insecticide for control,” according to background information in the article.
“With the introduction of West Nile virus into New York City in 1999 and its subsequent spread across the country, West Nile virus appears to have displaced SLE virus,” the background explained. “Dallas recognized its initial cases of West Nile virus encephalitis in 2002 and its first sizeable outbreak in 2006, followed by five years of low West Nile virus activity. In the 2012 nationwide West Nile virus resurgence, Dallas County experienced the most West Nile virus infections of any U.S. Urban area, requiring intensified ground and aerial spraying of insecticides.”
Wendy M. Chung, M.D., S.M., of Dallas County Health and Human Services, Dallas, and colleagues conducted a study to examine the features associated with the West Nile virus epidemics and to identify surveillance and control measures for minimizing future outbreaks.
The researchers analyzed surveillance data from Dallas County (population, 2.4 million), which included the numbers of residents diagnosed with West Nile virus infection between May 30, 2012 and December 3, 2012; mosquito trap results; weather data; and syndromic (pertaining to symptoms and syndromes) surveillance from area emergency departments.
From May 30 through December 3, 2012, patients with any West Nile virus-positive test result were reported to the health department; 615 met laboratory case criteria, and 398 cases of West Nile virus illness with 19 deaths were confirmed by clinical review in residents of Dallas County.
The outbreak included 173 patients with West Nile neuroinvasive disease (WNND) and 225 with West Nile fever, and 17 West Nile virus-positive blood donors. Regarding patients with WNND, 96 percent were hospitalized; 35 percent required intensive care; 18 percent required assisted ventilation; and the case-fatality rate was 10 percent.
The overall WNND incidence rate in Dallas County was 7.30 per 100,000 residents in 20l2, compared with 2.91 in 2006.
The first West Nile virus-positive mosquito pool of 2012 was detected in late May, earlier than in typical seasons. Symptoms of the first 19 cases of WNND in 2012 began in June, a month earlier than in most prior seasons; thereafter, the number of new cases escalated rapidly.
Sequential increases in the weekly vector index early in the 2012 season significantly predicted the number of patients with onset of symptoms of WNND in the subsequent l to 2 weeks.
The 2012 epidemic year was distinguished from the preceding 10 years by the mildest winter, as indicated by absence of hard winter freezes, the most degree-days above daily normal temperature during the winter and spring and other features.
During the 11 years since West Nile virus was first identified in Dallas, the researchers found that the annual prevalence of WNND was inversely associated with the number of days with low temperatures below 28°F in December through February.
“Although initially widely distributed, WNND cases soon clustered in neighborhoods with high housing density in the north central area of the county, reflecting higher vector indices and following geospatial patterns of West Nile virus in prior years,” the authors write.
Aerial insecticide spraying was not associated with increases in emergency department visits for respiratory symptoms or skin rash.
“This report identifies several distinguishing features of a large urban West Nile virus outbreak that may assist future prevention and control efforts for vector-borne infections,” the authors write. “Consideration of weather patterns and historical geographical hot spots and acting on the vector index may help prevent West Nile virus-associated illness.”
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UKIAH, Calif. – The Pain Management Center at Ukiah Valley Rural Health Center is pleased to welcome Rachel Chavez, physician assistant.
Joining the Pain Management Center team was an easy decision for Chavez.
“Dr. Young is progressive in treating pain and believes in a holistic approach which includes a mind, body, spirit philosophy,” said Chavez.
Helping residents in Mendocino and surrounding counties who deal with pain is one reason why Chavez chose to practice at the Pain Management Center.
“For me it’s really like coming home,” said Chavez. “I was born in Ukiah and grew up in Mendocino County so I really have a passion to help the people of this community.”
Chavez chose to work in the field of pain management because she saw a gap between primary care and helping those suffering from chronic pain.
“I started my career working in a primary care setting and realized that I was limited in what I could do for those suffering from pain,” she said. “I really felt there was a need for a holistic approach to treatment – incorporating nutrition principles, education, behavioral health, massage, medication and procedures.”
Rachel Chavez, P.A., is now accepting new patients at the Ukiah Valley Rural Health Center Pain Management Center, located at 260 Hospital Drive, Suite 108 in Ukiah. To schedule an appointment please call 707-463-8003.
The comprehensive pain management specialists include Michael Young, D.O., Rigpa Shunya, Psychiatric Nurse Practitioner, and Rachel Chavez, P.A.
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Because of a diet low in fish and seafood, children and adults in North America and other parts of the world, have a “nutrition gap” of omega-3 fatty acids, particularly docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA),according to a presentation at the 2013 Institute of Food Technologists (IFT) Annual Meeting & Expo in Chicago.
Numerous studies have found that DHA and EPA can prevent or minimize the effects of inflammatory disorders, such as rheumatoid arthritis, promote cardiovascular health and limit the effects of heart disease, said Bruce J. Holub, Ph.D., professor emeritus at the University of Guelph in Guelph, Ontario.
For children, adequate levels of DHA are critical for normal brain and nervous system development, said Alex Richardson, Ph.D., senior research fellow at the Centre for Evidence-Based Intervention at the University of Oxford in Oxford, England, founder and director of the United Kingdom charity Food and Behavior (FAB) Research; and author of the book “They are What You Feed Them.”
Richardson said the “physical risks to children from a nutritionally poor diet are now acknowledged, but the damage being done to their behavior, their learning abilities and mood is not.”
Richardson cited numerous studies linking low levels of DHA in children and expectant mothers to a wide-range of cognitive and behavioral disorders.
The problem is exacerbated by the fact that half of the fish consumed in the world today is cultivated on farms without diets that foster omega-3 nutrients,said Holub.
The average American consumes 1.6 grams of omega-3 fatty acids, of which only .2 grams (200 milligrams) are DHA or EPA. The American Heart Association recommends 500 milligrams of DHA and EPA each day for healthy adults and 900 mg/day (one fatty fish meal per day, or one omega-3 supplement) for patients with coronary disease.
Richardson recommends 500 mgs of omega-3 fatty acids a day for children and 1 gram a day for pregnant women.
“I applaud any attempts (to recommend and encourage supplements) in the diets of mothers and women of childbearing age,” said Richardson, who believes that consistent, pervasive diets lacking in omega-3 fatty acids could results in genetic modifications affecting future generations.
“It's never too late” to address this issue, said Richardson.
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