Parent Forum to Address Questions about Vaccines

Are you a new or expectant parent looking for clear and accurate information about vaccines for your baby? The Onondaga County Health Department will be hosting a FREE Parent Forum on Vaccines for parents to learn more about vaccines and get their questions answered by experts. A brief presentation on the basics of immunizations will be shown, followed by time to ask the panel any questions you may have. The panel will include immunization experts from the Onondaga County medical community.

The Forum will be May 13 from 6:30 – 8:00 PM at the Dewitt Community Library, located in Shoppingtown Mall. This is a free event and refreshments will be provided.

For more information or to RSVP please call 435-2000.

National Infant Immunization Week April 18 – April 25

National Infant Immunization Week is a week set aside each year to highlight the importance of protecting infants from vaccine preventable disease. Children, especially infants, are at higher risk for disease. You can protect your infant by getting them vaccinated on time. Why should you immunize your baby? Here are five important reasons why:

Immunizations can save your child’s life. Children today can be protected from more diseases than ever before. Some diseases that once injured or killed thousands of children have been nearly wiped out in many parts of the world, mostly due to vaccines. For example, polio was once one of the most feared diseases in children, but today there are no reports of polio in the United States.
Vaccines are safe and effective. All vaccines that are given to children are thoroughly reviewed and approved by the Food and Drug Administration for safety. Of course shots may hurt for a minute, and may even cause short-term pain or redness at the site of the shot for a few days, however, that is a small price to pay compared to the pain and discomfort associated with the diseases they prevent.
Immunizations protect others you care about. Serious vaccine-preventable diseases still occur. Unfortunately, some babies are too young to be completely vaccinated and others may not be able to be vaccinated because of allergies or a weakened immune system. Getting your children vaccinated not only protects your family, but also helps prevent the spread of diseases to your friends and other loved ones.
Immunizations can save your family time and money. Children who have a vaccine-preventable disease may not be able to attend school or daycare for many days. Vaccines not only prevent disease but also can reduce the costs associated with missed time from work, doctor visits, and hospitalizations. Vaccines are usually covered by insurance. If you do not have health insurance, call the Onondaga County Health Department at 435-2000 to learn more about where you can get vaccines for your baby.
Immunization protects future generations. Vaccines have reduced, and in some cases eliminated, many diseases that killed or severely disabled people just a few generations ago. For example, the smallpox vaccination helped to eliminate the disease worldwide. Children today no longer need to be vaccinated against smallpox because the disease no longer exists. Continuing to vaccinate our children today protects future generations as well.

During National Infant Immunization Week, it is important to remember the benefits of having your children receive their shots on time. For more information on vaccines, call the Onondaga County Immunization Program at 435-2000.

Moms: Are You Ready for Your New Beginnings?

By Indu Gupta, MD, MPH, Onondaga County Commissioner of Health
Contributing Author: Lisa GreenMills, RN, MPH, Syracuse Healthy Start Project Director

Let us take our focus to the time where the life begins. We all know that to have a healthy baby, the most important thing is a mother’s complete health- physical, emotional, and social well-being.

At our Health Department, we provide amazing support to pregnant women during and after pregnancy, especially to those who need it most through our various programs: Syracuse Healthy Start; home visits to pregnant women, new moms and their babies; and Nurse Family Partnership for first time moms. The success of the these programs is evident by none other than our Syracuse Healthy Start Project Director Lisa GreenMills, a public health nurse by training, who knows this program up close and personal. Lisa told me her story the first time we met and in subsequent conversations. The following story is an abbreviated version of her story in her own words:

When I was younger my mom worked with Healthy Start. So for me growing up, “Healthy Start” was a household name. My mom and sister even starred in a commercial filmed in 1998 for Healthy Start. My inspiration for my work with Healthy Start today is my brother who I never got to meet. My brother died of SIDS (Sudden Infant Death Syndrome). He would have been my older brother. Even though I never met him, he’s had a profound impact on my life. You know, you hear the statistics- you hear that black babies are three times as likely to die as white babies, but it doesn’t really hit you. It’s not far away in some developing nation- it’s here. It’s not just in my neighborhood; it’s literally in my family. Infant mortality is not just a statistic, “oh, the infant mortality rate is going down, but a disparity still exists.” Yes, but what does that mean?

I did an internship here with Healthy Start back when I was in grad school. My project was to analyze the infant mortality statistics for a set of years and look for local trends. It was a pretty depressing internship, to say the least. But I learned a lot from that experience. I have been the Project Director for Syracuse Healthy Start for two years now. Our focus is on reducing health disparities, on reducing infant mortality, and improving birth outcomes in the City of Syracuse. Healthy Start is part of a national movement, and in Syracuse we are one part of a larger team under the Healthy Families umbrella. In addition to the work we do directly, we’re linked with so many agencies and individuals in the community who share a common goal.

I’m so proud and so excited to be in this role now, and I really feel like this is what I was meant to do with my life. I love that every day I get to work with people who are helping families overcome some really challenging situations, and I love that we also get to think about the “bigger picture” and bring together the community as a whole. It’s really a unique position that can combine the one-to-one support with community wide dialogue and collaboration.

I can see how proud Lisa is to be overseeing the Syracuse Healthy Start program. It is an important part of her own life and now she is teaching many women to benefit from this wonderful program.

Success of such programs is often assessed by various rates such as prenatal care, birth outcomes and maternal health. According to CDC, as many as 700 women died in 2010 in the US due to problems caused by pregnancy, and 65,000 had serious health complications. Many complications are due to genetic factors and chronic diseases such as diabetes, high blood pressure, depression, and obesity.

Other factors complicating the pregnancy are personal habits including smoking, lack of physical activity, poor eating habits, recreational use of alcohol and drugs, and sexually transmitted diseases including HIV and syphilis, which affect the health of both mother and the unborn baby. The consequences of using illegal drugs, prescription opiates, alcohol and smoking during pregnancy can have significant negative consequences for mother and the fetus (baby), resulting in withdrawal, birth defects, placental bleeding, premature birth, stroke, heart attack, fetal alcohol spectrum disorders (FASDs), neonatal abstinence syndrome (NAS) and sudden infant death syndrome (SIDS) in extreme cases.

So what is the solution? A prenatal care visit to a provider’s office including a detailed history and physical exam along with an assessment of social factors would start the conversation about all these risk factors and catch these problems at any stage of the pregnancy. Social determinants such access to care including transportation before, during, and after pregnancy also play a very significant role.

Where am I going with this discussion? With pregnancy, a woman’s life changes. Mine did as well- from taking care of oneself to two or three. This continues to unfold into something well-articulated as, “It takes a village to raise a child”. This is an old concept but still fresh and true to its value. Social support is very crucial for the changing landscape in a woman’s and baby’s life. What happens if someone does not have that village around to raise the child? Is this a public health concern? Yes, it is, because the social well-being of a mother and baby is the strong foundation for the next generation. Poverty, transportation, and family support all can affect getting proper health care. Removal of this barrier will result in proper care and reduction in maternal and infant mortality. In addition, a full evaluation of an infant will identify health issues in the baby and ensure effective treatment and reduce our still high infant mortality rates.

Cyber support is here! A new form of social support is now available in today’s virtual world. In this digital age, phone apps and text services have obliterated the distance and information can be provided to anyone at any time and is literally at your fingertips!

Text4baby is a text message service which provides significant support to the mothers by providing health tips including the importance of regular medical checkups by your obstetrician.
WebMD has an iPhone app for expectant mothers and there are numerous smart phone apps for the same purpose as well.

It is amazing to see how technology has changed the lives of everyone. Years ago when I was pregnant, besides regular visits to my obstetrician and reading the medical text books, I had relatively limited information. Today’s pregnant women have this power at their fingertips! Education is empowerment.

So here’s to all those expectant mothers…you have a lot of tools, providers, books, apps, nursing services, and your Health Department! Please USE them to EMPOWER YOU! Be yourself, be healthy, be happy. It may be hard at times, but not impossible. Reach out and find the help and resources you need…you are never alone. This is just the beginning of a new beautiful journey into your future! Welcome aboard!

Resources:

CDC At-A Glance 2015, Safe Motherhood: http://www.cdc.gov/chronicdisease/resources/publications/aag/pdf/2015/safe-motherhood-aag-2015.pdf
Healthy Families Onondaga: www.onhealthyfamilies.com
Syracuse Healthy Start: www.onhealthyfamilies.com/healthystart/
Home Visiting: www.onhealthyfamilies.com/homevisit.html
Nurse Family Partnership: www.onhealthyfamilies.com/nursevisits.html
Pregnancy and Substance Abuse: www.nlm.nih.gov/medlineplus/pregnancyandsubstanceabuse.html
Illicit Drug Use During Pregnancy: www.marchofdimes.org/pregnancy/illicit-drug-use-during-pregnancy.aspx

What is Health?

By Indu Gupta, MD, MPH
Onondaga County Health Commissioner

Everyone uses the word “Health” every day irrespective of age, sex, gender, race, nationality, occupation, species, environment, and even in the context of non-living concept of money. So what is health? The answers vary. From healthy habits to the sense of relief that comes with being cured of a severe illness or the complete recovery from emotional instability. Technically, all of them are correct. We also use this word in the context of economic security, in order to describe the financial health of a household, an institution or a country.

So let’s return to the original question: what is health? According to the Oxford English dictionary, the word “health” originated from the Old English hǣlth, which is of Germanic origin (before the 12th century), meaning whole. Since I am a physician, I personally like the definition of health described by the World Health Organization’s 1948 declaration: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” The physical, emotional, and social well-being are interdependent to give us the concept of health.

This definition was further modified on November 21, 1986 during the International Conference in Ottawa to clearly define the expectations and emerging role of public health in the ever changing and increasingly complex world in the 21st century (see emblem at left). The concept of health promotion was introduced, along with the future vision, with an emblem reflecting the guiding principles for followers of public health.

This conference highlighted the empowering impact of health promotion. It was defined as, “Health is, therefore, seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities. Therefore, health promotion is not just the responsibility of the health sector, but goes beyond healthy life-styles to well-being.”

This means we have to consider the social determinants such as the place we are born, live, go to school, work, play, seek medical care, socialize, the safety of the neighborhood we live in, transportation, and opportunities we have for growth.

We also have to consider physical determinants such as city or rural living, housing and community design, lighting, presence of trees, sidewalks, bike lanes, roads and old construction hazards for possible toxic substances such as lead.

Now I would like to add the concept of “Healthy People 2020” to our discussion. This concept, coined by the Office of Disease Prevention and Health Promotion, proposes that if we can create a safe social and physical environment, it will result in good health for everyone. Stable economy, education, social and community context, appropriate and timely health care, and a safe neighborhood make up the five factors considered essential for the concept of “Healthy People 2020”. All of these 5 factors have to work together collaboratively, so the needs of a community are fulfilled and a healthy community would be sustainable after its inception.

Health starts where we live, eat, go to school, work, play, take care of ourselves by getting vaccinated, not smoking, following screening guidelines and participating in social activities in the community. For this we need safe neighborhoods to thrive, clean water to drink, safe food to eat, and good quality of air to breath. We also need to understand that our physical health is closely linked to our mental health. Mental health disorders can worsen the outcome of many chronic medical problems such as diabetes, high blood pressure, heart disease, and cancer to name a few. If Mr. Smith is depressed, he may forget to take his blood sugar medication, which can result in poor control of his diabetes, and he may suffer blindness, kidney failure, or heart disease affecting his quality of life as well as longevity.

On a very personal note, I learned this from my late father. He used to visit me from India, to spend time with his grandchildren during the summers. I was very busy in my solo practice of internal medicine in taking care of patients day and night. Everything had to move fast including food and conversations. I often had to rush out without finishing the food on the table and had no time for the kids. Life was chaotic, but I did not see it. One day he gently took me aside and said, “When you were little, I worked hard to provide safe shelter, food, clothing, and education for my family so that you would become something in life; now you have everything including a great job, house, and family but you have no time to sit, talk to your kids, and eat….” I was stunned. My father was very polite, I could see that he was not upset, not even frustrated but was genuinely concerned about his daughter, who seemed quite stressed as a young working mother. His observation was accurate. I was getting extremely stressed with competing demands in my life from work, children, family, and lastly, myself. He wanted to help but did not know how other than giving me advice and I am so thankful that he did! Even though it was painful to hear, he was right. I paused and started to think of ways to make changes. Change is always frightening and difficult; but it is real and is for the better. I restructured my day at home and work, to balance my life, and to take into account my wellness.

Wellness is not an event, symbol, or logo. It is a process of finding balance in life to get to our maximum potential in what we do- whether it is taking care of children or parents, aging and ailing family members, teaching, proving medical care, entertaining, being custodial, to managing small to large organizations to countries. It truly is a life-long process, which requires us to pay attention to our physical, emotional, social, environmental, intellectual, occupational and spiritual well-being.

If we continue to strive for balance, we will be better equipped to address unexpected events in our lifetime in a much better way, whether it is illness, loss of life, or setbacks in life. How? The balancing act of wellness makes us a driver, not a passive passenger, in our journey of life. This is what I would want, won’t you do the same?

References:
WHO: http://www.who.int/about/definition/en/print.html
The Ottowa Charter for Health Promotion http://www.who.int/healthpromotion/conferences/previous/ottawa/en/
Social Determinants of Health, Healthy People 2020: http://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health
Seven Dimensions of Wellness, UC Riverside: http://wellness.ucr.edu/seven_dimensions.html

Make the Right Choice and Get Screened for Colorectal Cancer

If you’re age 50 or older and haven’t been screened for colorectal cancer, now is your time! According to the Centers for Disease Control and Prevention (CDC), 1 in 3 adults ages 50-75 years are not getting tested for colorectal cancer as recommended. Screening can find polyps so they can be removed before turning into cancer. Celebrate Colorectal Cancer Awareness Month by scheduling your colorectal cancer screening test today!

Screening for colorectal cancer is recommended by the United States Preventive Services Task Force for men and women ages 50-75 years old using high-sensitivity fecal occult blood testing, sigmoidoscopy, or colonoscopy. Colorectal cancer is one of the only cancers that can be prevented through the removal of pre-cancerous polyps in the colon and/or rectum. There are often no symptoms during the early stages of colorectal cancer, making routine colorectal screening extremely important.

A person’s chances of developing colorectal cancer can be increased by certain factors such as having:

a family history of colorectal cancer or polyps,
a personal history of inflammatory bowel disease,
had polyps or colorectal cancer in the past.

If you are waiting to be screened because you are without health insurance, the Onondaga County Cancer Services Program (CSP) may be able to help. Free colorectal cancer screening is available for men and women aged 50-64 years who do not have health insurance. Call the CSP at 435-3653 to see if you qualify or visit our website at /health/cancerscreening.html to register online. Screening and early detection saves lives so call to see if you qualify for a free colorectal screening today!

My Salute to the Power of Vaccination

By Indu Gupta, MD, MPH
Onondaga County Health Commissioner

Growing up in India, I witnessed first-hand, the wrath of many infectious diseases. I clearly remember standing in a long line in my elementary school, waiting to get the small pox vaccination by the health care workers. The vaccination needles were long, with two prongs. I did not like being poked, especially more than once, but I was not given a choice. As a result, I never had small pox.

Years later, I realized that my small pox immunization was probably part of the World Health Organization’s (WHO) small pox eradication program. This global campaign, which was implemented effectively by WHO, with major US contribution, eliminated small pox from the world in 1979. If it weren’t for Edward Jenner in 1798, the inventor of the cow pox vaccine, I wonder what the world would be like today?

Continue reading →

It is Essential to Take Steps to Avoid Measles

The Onondaga County Health Department is reminding Onondaga County residents about the importance of being up-to-date on all vaccinations including measles. Since December 2014, there has been an ongoing multistate outbreak of measles in the United States. Dr. Indu Gupta, Commissioner of Health, explained “Onondaga County has not had a confirmed measles case since 2000. However it is very important to protect yourself, your children, and take precautions against measles.” The Health Department urges everyone to protect themselves and those around them by getting an MMR vaccine.

Facts about Measles
Measles is a highly contagious viral disease. The measles virus can live for up to two hours on a surface or in an airspace where the infected person has coughed or sneezed. If other people breathe the contaminated air or touch the infected surface and then touch their eyes, nose, or mouth, they can become infected. Measles is so contagious that if one person has it, 9 out of 10 people close to that person who are not immune will also become infected. The patient is contagious for four days before and four days after the rash appears.

Symptoms:
The following symptoms of measles usually appear 7-21 days after exposure to a sick patient:
• Fever of more than 101 degrees
• Cough and running nose (coryza)
• Conjunctivitis (pink eye)
• Rash generally spreading from the face at the hairline to the neck, trunk, and to the legs

Complications: Complications of the disease can range from ear infection, to pneumonia, encephalitis, and rarely, death.
We are urging everyone: Please take steps to prevent the spread of measles by:
1. Protecting yourself: by adequate vaccination of 2 doses of MMR vaccination.
2. Preventing the spread of disease: by staying home when sick until at least four days after the skin rash occurs; avoiding public places or use of public transportation; and avoiding contact with those who may have a weakened immune system and/or who have not been vaccinated, including infants less than 12 months of age.
3. Contacting your provider: If you have been exposed to someone with measles and have a fever and rash, please contact your medical provider first for further advice instead of going directly to urgent care or your doctor’s office due to the highly contagious nature of this disease.

For more information visit: http://www.cdc.gov/measles/about/transmission.html

Take Precautions During the Cold Weather

Take Precautions During the Cold Weather

Onondaga County Health Commissioner, Indu Gupta, MD, MPH, recommends that Onondaga County residents take precautions against the hazards of severe cold weather to prevent cold related injuries and carbon monoxide poisoning. Dr. Gupta stated, “With these low temperatures, people, especially the elderly and infants, are at risk for hypothermia and frostbite”. Dr. Gupta also explained that it is important to make sure your home is safely heated and reminds residents to check on other family members and neighbors during this extremely cold weather.

Hypothermia occurs when your body begins to lose heat faster than it can be produced. Hypothermia can occur even at cool temperatures (above 40 degrees) if a person becomes chilled from rain, sweat, or being in cold water. Warning signs of hypothermia in adults include: shivering, confusion, memory loss, drowsiness, exhaustion and slurred speech. Infants who are suffering from hypothermia may appear to have very low energy and bright red cold skin. If you see someone with symptoms of hypothermia, get medical help right away.

Frostbite is an injury to the body caused by freezing, most often to exposed body parts such as the nose, ears, cheeks, chin, fingers or toes. Frostbite causes a loss of feeling and color in affected areas. It can permanently damage body parts if not promptly treated. At the first signs of redness or pain in any skin area, get out of the cold or protect any exposed skin. If you have signs of frostbite, contact your health care provider right away.

During cold weather it is important to follow these safety tips:

stay indoors, if possible
eat well-balanced meals, this helps the body stay warmer
do not drink alcoholic beverages, it causes the body to lose heat more rapidly
do not ignore shivering – it is an important first sign that the body is losing heat and a signal to quickly return indoors

When going outdoors, adults and children should wear:

several layers of loose-fitting clothing
a wind and water-resistant coat
a scarf to cover face and mouth
a hat
gloves or mittens

It is also important to stay safe when heating your home, especially during a power outage. Take precautions to avoid exposure to dangerous levels of carbon monoxide. Carbon monoxide is an odorless colorless gas and is hard to detect. Common symptoms of carbon monoxide poisoning are: headache, dizziness, weakness, upset stomach, vomiting, chest pain and confusion.

Carbon monoxide poisoning can be prevented by taking the following precautions:

Install a carbon monoxide detector which is battery powered or has a battery back-up and is certified by Underwriters Laboratories (UL)
Have gas furnaces, gas water heaters, gas ranges and ovens, gas dryers, gas or kerosene space heaters, fireplaces and wood stoves inspected by a trained professional at the beginning of every heating season. Be sure that the flues and chimneys are in good condition
Choose appliances that vent their fumes to the outside whenever possible
Read and follow all the instructions that come with any fuel-burning device
Do not idle the car in a garage, even if the garage door to the outside is open
Do not use a gas oven to heat your home, even for a short time
Do not use a charcoal grill indoors, even in a fireplace
Do not sleep in any room with an unvented gas or kerosene space heater
Do not use any gas-powered engines (mowers, weed trimmers, snow blower, chain saws, small engines or generators) in enclosed spaces
Do not ignore symptoms, particularly if more than one person is feeling them. If you see someone with symptoms of carbon monoxide poisoning, get medical help right away

For more information on how to reduce your risks from carbon monoxide and other combustible gases contact the Consumer Product Safety Commission at www.cpsc.gov or (1-800-638-2772). Also, for more information on hypothermia, frostbite, and other cold weather conditions, contact the Onondaga County Health Department at 435-3280 or visit http://ready.ongov.net/.

Welcome!

Welcome to the new Onondaga County Health Department blog! This is my first blog article as Commissioner of Health for Onondaga County. I am looking forward to connecting with you and sharing the latest public health information and updates on local health issues that matter to you.

In this debut article, I would like to take this opportunity to introduce myself and tell you about my goals for the Health Department and priorities for the health of our community. I encourage you to interact with this blog and our Facebook page as we strive to build connections with the people we serve here in Onondaga County!

Why did I become interested in public health?
For years I have done individual care by taking care of sick patients, providing preventive care, and promoting self-empowerment and health promotion within the boundaries of my office and the hospital. My quest to take the same messages to the population level took me on the path to public health. I strongly believe that prevention is better than cure since it avoids the cycle of getting ill.

As a clinician, patients came to see me when they were concerned about specific things or were ill, which I addressed but I wanted to prevent disease. A lot of preventive steps have been taken to prevent chronic diseases of the heart and lungs such as smoking cessation, exercise, and controlling cholesterol. As a society we have come quite far with the advent of many vaccines (which have eliminated severe illnesses like small pox and decreased the severity of other infectious diseases such as flu and shingles). We also know that, at times, cancer can be cured or we can improve survival by early detection. The power of preventive medicine at the population level was one of the strongest motivators for me to move from direct care as a clinician to public health. Continue reading →

Get Treatment Immediately If You Have Flu Symptoms

Onondaga County, as well as New York State, is in the middle of a severe flu season. This year the predominant virus is flu A H3N2. This flu strain often affects the very young, those over 65 years old, and those with underlying medical conditions. Commissioner of Health, Indu Gupta, MD, MPH, explained today that there has been a total of 550 flu cases reported and seven confirmed flu-related deaths in Onondaga County. Each of those who succumbed to the flu had underlying medical conditions and was elderly; some previously having had a flu vaccine this season. Dr. Gupta recommends, “If you have symptoms of the flu, even if you have had a flu vaccine this season, seek medical attention immediately for early and prompt treatment of the flu”. The Health Department also reminds everyone to be immunized against the flu and to also practice hand and respiratory hygiene.

Flu symptoms include:

A fever of 100 degrees or higher or feeling feverish (not everyone with the flu has a fever)
A cough and/or sore throat
A runny or stuffy nose
Headaches and/or body aches
Chills
Fatigue
Nausea, vomiting, and/or diarrhea (most common in children)

Contact your health care provider as soon as your symptoms appear.
Contact your health care provider IMMEDIATELY for early and prompt treatment of the flu. Your health care provider may recommend that you take antiviral medicine within two days of getting sick. Starting them later can still be helpful. Antiviral medicine can make illness milder and can shorten the time you are sick. Antiviral medicine may also prevent serious flu complications.

For more information about controlling the spread of flu, visit: /health/ or http://www.cdc.gov/flu/protect/preventing.htm.
The Onondaga County Health Department will continue to post weekly flu case updates on their website.