Thursday, March 15, 2018

The most effective way to kill mosquitoes

Author: Kyle Moppert, state entomologist

Are you guilty of saying, “those pesky mosquitos are making me sick!” If you are, then according to the World Health Organization, you’re 100 percent correct. Mosquito-borne diseases more than 300 million clinical cases each year are attributable to mosquito-borne illnesses, and despite great strides over the last 50 years, those illnesses continue to pose risks in the United States.

West Nile virus and St. Louis Encephalitis virus, both from the same family of viruses called flaviviruses which cause similar diseases, are found in Louisiana.

Humans contract West Nile when they are bitten by mosquitos infected with the virus. When people are infected with West Nile, the virus might affect them one of three ways. West Nile neuroinvasive disease is the most serious type, infecting the brain and spinal cord. Neuroinvasive disease can lead to death, paralysis and brain damage. The milder viral infection is West Nile fever, in which people experience flu-like symptoms. Most people who are infected will not experience symptoms, and not know they’ve contracted the disease.

Modern mosquito control programs are multifaceted and include surveillance, source reduction, and a variety of larval (just hatched mosquitos) and adult mosquito control strategies. 

Monitoring for Virus-Carrying Mosquitoes

Mosquito surveillance is an essential component of a mosquito-borne disease prevention and control program. The objective of surveillance is to determine which mosquito species are active, where they are located in a geographic area, seasonal occurrences and abundance of carriers of mosquito-borne pathogens.

Up-to-date information on mosquito species, their distribution and abundance of virus-carrying mosquitoes is essential to developing effective prevention and control programs. Samples of adult female mosquitoes can be collected and grouped by species and tested for the presence of mosquito-borne viruses. Surveillance data is then used to plan insecticide applications when and where mosquitoes are abundant.

Effective Mosquito Control

Control efforts can begin once established mosquito threshold populations are exceeded or virus-laden mosquitoes are found. 

Source reduction involves eliminating or modifying the habitat that mosquitoes need for reproduction. This includes proper management of water in the environment to reduce the production and survival of the mosquitoes. Biological control, such as the use of fish to reduce larva, are utilized to aid in control mosquito populations.

The Louisiana Department of Health’s mosquito surveillance program includes human surveillance and documents all reported human cases that occur in the state each year in its Arbovirus Surveillance Summary.

The Department also monitors mosquito-borne illnesses such as chikungunya, dengue and Zika, and includes any reported cases also reported in the Arbovirus Surveillance Summary. All of the state’s reported cases of those illness have been associated with travel to areas with active transmissions.

Protecting yourself against mosquito-borne illnesses is the first line of defense against these viruses and diseases.
  • If you will be outside, you should wear a mosquito repellent containing DEET. The American Academy of Pediatrics (AAP) recommends that repellents should contain no more than 30 percent DEET when used on children. Insect repellents also are not recommended for children younger than 2 months of age. CDC recommends that you always follow the recommendations appearing on the product label when using repellent.
  • Apply repellent on exposed skin and clothing. Do not apply under your clothes or on broken skin.
  • To apply repellent to your face, spray on your hands and then rub on your face, avoiding your eyes.
  • Adults should always apply repellent to children.
  • Wear long-sleeved shirts and pants when outdoors for long periods of time.
  • Avoid perfumes and colognes when outdoors for extended periods of time.
  • Make sure that your house has tight-fitting windows and doors, and that all screens are free of holes.

In addition, you can also take steps around your home to limit where mosquitoes can breed and the opportunity for them to enter your home.
  • Reduce the mosquito population by eliminating standing water around your home, which is where mosquitoes breed.
  • Dispose of tin cans, ceramic pots and other unnecessary containers that have accumulated on your property. Turn over wheelbarrows, plastic wading pools, buckets, trash cans, children's toys or anything that could collect water.
  • Drill holes in the bottom of outdoor recycling containers. Drainage holes that are located on the container sides collect enough water for mosquitoes to breed.
  • Check and clean roof gutters routinely. They are often overlooked, but can produce millions of mosquitoes each season.
  • Aerate ornamental pools or stock them with fish. Water gardens can become major mosquito producers if they are allowed to stagnate.
  • Clean and chlorinate swimming pools that are not being used. A swimming pool that is left untended by a family for a month can produce enough mosquitoes to result in neighborhood-wide complaints. Be aware that mosquitoes may even breed in the water that collects on swimming pool covers.  

For more information about LDH’s effort to prevent mosquito-borne illnesses, visit

Thursday, March 8, 2018

Problem gambling is a serious problem in Louisiana

Author: Quinetta Womack, Director of Problem Gambling Services

Problem gambling is a serious addiction that affects thousands of Louisianans. A state study on problem gambling revealed that as many as 275,000 people in Louisiana are involved in problem gambling activities, affecting the individual, their family, friends, co-workers and society as a whole.

A gambling disorder, is gambling behavior which causes disruptions in any major area of life whether that be psychological, physical, social or vocational. It’s characterized by increasing preoccupation with gambling, a need to bet more money more frequently, restlessness or irritability when attempting to stop, “chasing losses, and loss of control manifested by continuation of the gambling behavior in spite of mounting, serious, negative consequences.

It is sometimes referred to as a “hidden disease” because it can’t be smelled on someone’s breath, and a urine test can’t be given to detect it. Also, the stigma, shame and guilt associated with the disease make those who have it want to deny it or keep others from finding out. Unfortunately, this also keeps people from seeking help early in the addiction, prior to major life consequences.

A 2010 study found that the problem crosses all ages, genders and races. Calls to the toll-free Problem Gamblers Helpline show that females represented 44 percent of the callers and males 56 percent. Most identified themselves as either Caucasian (49 percent) or African-American (45 percent).

There are a number of signs and symptoms of problem gambling. They include:
  • Feeling the need to be secretive about your gambling
  • Having trouble controlling your gambling
  • Spending more time gambling than intended
  • Increasing in size of bets (sudden and dramatic)
  • Working up special occasions for gambling (canceling other plans)
  • Gambling even when you don't have the money
  • Intensity of interest in gambling (constant tension & excitement)
  • Boasting about winning; evasive about losing
  • Family and friends are worried about you
  • Exaggerating displays of money and other possessions
  • Dropping off in other activities
  • Preoccupied
  • Frequent absences from home and work
  • Withdrawing from family
  • Personality changes (increased irritability/hostility)
  • Diversion of family funds
  • Borrowing Money
  • Criminal Activity

Additionally, if someone answers yes to any of the following questions, that person should seek the advice of an experienced gambling counselor.
  • During the past 12 months, have you become restless irritable or anxious when trying to stop/cut down on gambling?
  • During the past 12 months, have you tried to keep your family or friends from knowing how much you gambled?
  • During the past 12 months did you have such financial trouble as a result of your gambling that you had to get help with living expenses from family, friends or welfare?

Fortunately, problem gambling is a treatable addiction. There are multiple resources in Louisiana to provide support to gamblers and their families. The state offers counseling and treatment programs at no cost to Louisiana residents including the country’s premiere residential treatment facility, The Center of Recovery (CORE), located in Shreveport. Since it opened in 1999, CORE has treated more than 3,200 compulsive gamblers. The state’s toll-free helpline handles on average, 2,400 calls or direct requests for help each month.

The state also offers prevention services, which is aimed at preventing youth gambling. If you or a loved one is struggling with problem gambling, hope and help is available anytime. Please call the Louisiana Problem Gambler’s Helpline at 1-877-770-STOP (7867), chat live at

Friday, March 2, 2018

Food waste in America at staggering levels

March is National Nutrition Month and the theme this year is “Go Further with Food.”  There is a double meaning here since the message hopes to address better food choices for better nutrition and to call attention to our massive amount of food that is wasted.

Food waste in the U.S. has reached staggering proportions. It is estimated that 60 million tons of food (or 50 percent of all produce and worth about $160 billion) is discarded every year.

Most of this wasted food ends up in landfills where it represents the largest amount of discarded material. An American family of four throws away over $1,500 of produce annually. Worldwide, the waste is also about a third of all food, sometimes for different reasons such as harvesting and transport issues, but still at a cost of $3 trillion per year.

Why have we become such a wasteful society? There are various reasons, but one factor is the low-cost of food in the U.S. as compared with other countries, some of which is related to generous agricultural subsidies. There is also consumer demand, which favors perfect-looking produce and rejects anything that might be bruised, wilted or discolored, regardless of how the item will be prepared.  Supermarkets recognize this consumer demand for perfection and pre-emptively throwaway anything that looks deformed or blemished in any way.

Farmers also pre-emptively eliminate fruits and vegetables that lack consumer appeal in response to unrelenting consumer demands for the perfect looking product. Our Facebook photo culture aggravates the problem by compelling retailers and restaurants to make picture perfect dishes or risk the ire of hyper-sensitive consumers and foodies.

A move toward acceptance of local crops, diversity of products, and a shift in aesthetics can all help reduce waste. On a personal level, as a consumer, we can take a few useful steps: 
  1. Take an inventory of food in your home before going to buy more, 
  2. Buy only limited quantities of food that correspond to what can be eating or frozen for a few days only, 
  3. Prepare and serve reasonable portions that contain all food groups, but not in excessive quantities, 
  4. Buy limited quantities (not the “economy” pack) rather than being obliged to discard what you cannot reasonably consume, 
  5. Exercise adequately to burn off calories rather than accumulate them as fat, 
  6. Recycle through composting, 
  7. Donate unwanted food to food pantries and 
  8. Learn about the meaning of food labeling (i.e. “Use by,” “best by” and “sell by”). 
In Europe, the refrigerators are tiny by American standards. European housewives will often shop daily, not weekly, at a market or grocery store within walking distance. Produce in a market is usually locally grown and may not be picture perfect. Prices at such markets, however, are usually lower than in a supermarket and thus a sound consumer choice, not a privilege of the wealthy. France and Germany both require supermarkets to compost or donate unsold or expiring food.

Louisiana prides itself on its rich and varied food culture.  It does not have to wasteful or unhealthy since an abundance of local products remains available. 

Eat a healthy breakfast and remain active throughout the day.  Celebrate National Nutrition Month by eating right, exercising and reducing waste following the instructions above.  If you have specific issues and concerns, do not hesitate to consult a nutritionist who will be happy to explain your food choices and their consequences.  Bon appetit!

David J. Holcombe, MD, MSA

Tuesday, February 27, 2018

Avoid folk remedies for the flu

Author: Brian Warren, food and drug/milk and dairy program administrator

Concerned about the lengthy and difficult 2017-2018 flu season? You should be—according to the latest information from the CDC1, there have been 97 children killed by influenza viruses during the 2017-18 season, and that number is expected to continue to rise.

In addition to getting the flu shot, over-the-counter cold medicines or seeking medical care are appropriate measures to take should you get sick.. Good nutrition and bed rest will often reduce the length and severity of your illness as well. However, there are two popular “alternative” medicines on store shelves in Louisiana that you should avoid because they are unproven and ineffective.

Elderberry is a flowering plant in the genus Sambucus. It is known as “fercido” in the River Parishes and the leaves are used in poultices as a folk remedy to treat conditions ranging from rashes to burns externally. A more widespread use of the plant is to distill the berries and create an extract or syrup, typically mixed with honey, maple syrup, and/or spices. Proponents claim that the product is effective as a prophylaxis and also to treat patients who are currently suffering from influenza. Note that there is insufficient evidence that any of these products are effective treatments for influenza or that they provide any relief from symptoms beyond what might be expected from a placebo. These items are considered dietary supplements by the Louisiana Department of Health, and the department does not regulate such items. At the federal level, FDA has labelling and good manufacturing practices regulations2 that manufacturers are supposed to adhere to, but, unlike actual pharmaceuticals, these products are not required to undergo testing for safety and efficacy as part of a pre-market approval process.

Please be aware that the leaves, berries and other parts of these plants typically contain secondary chemicals related to cyanide that can cause illness (though probably not death) if consumed raw, so avoid ingesting unprocessed elderberries or elderberry products.

Another popular remedy that is widely available at drug stores is Oscillococcinum®. This is a so-called homeopathic medicine. Homeopathy is a practice that dates back to the close of the 18th century and it has several key concepts but the most important one for the purposes of this discussion is that the “active” ingredients in homeopathic treatments are prepared using a large number of serial dilutions that serve to ensure that no molecule of that ingredient remains in the finished product. Homeopaths will readily concede this point but also state that the water of these dilutions “remembers” the ingredient. In the case of Oscillococcinum® in particular, the duck liver and brain that are supposed to contain the elusive bacteria that are the source of the product’s alleged curative properties are not to be found in the lactose-sucrose pill that is the end result of those many dilutions3. Thus, this homeopathic remedy is like all homeopathic remedies in that it is not going to provide the user with any relief beyond what might be expected from a placebo.

So what should you do about the flu?

·       Get your flu shot. Even if the shot you receive is not completely effective for the strains of the virus that are circulating in your area, it will nonetheless give your immune system a “leg up” on preparing for an infection and the partial immunity it provides will reduce the length and severity of your potential illness. Moreover, your immunization will contribute to “herd immunity.”4 Herd immunity refers to the immunity conferred upon individuals in a group once a certain threshold number of those group members have been immunized against a particular disease. In effect, it is a way for people who are able to be vaccinated (most healthy individuals) to protect those people who are unable to be vaccinated due to pre-existing medical conditions or severely-weakened immune systems. The benefits to those unimmunized individuals also have a secondary effect of reducing the overall severity of an outbreak by reducing the number of people who are susceptible to a disease at any given point in time.

The department is currently working through parish health units to provide no-cost vaccinations. Contact your local parish health unit for information on getting vaccinated.
·       Practice basic good hygiene. If you aren’t sick presently, wash your hands regularly with soap and water. Avoid close contact with those who are sick. If you are sick, do not go to work or school or church or any other gatherings where you may be exposing groups of people to your infection. Cover your mouth and nose when you sneeze or cough.

·       See your primary care doctor about any serious illness. If you experience severe symptoms such as a persistent high fever, shortness of breath, rapid heartbeat, and exhaustion or confusion, see your physician immediately. He or she may prescribe an antiviral agent such as Tamiflu. Any medicine that you are prescribed by a board-certified physician has undergone clinical trials to ensure its safety and efficacy, unlike the two treatments described in this article.


Oscillococcinum® is a registered trademark of Boiron USA, Inc.

Wednesday, February 21, 2018

How to talk to your children following a mass shooting

Author: Danita Leblanc, LCSW-BACS, State Suicide Prevention Coordinator

Restoring a sense of safety for your children in the aftermath of a mass shooting, especially one at a school, may be difficult as a parent. Too often our children are exposed to violence that is both senseless and harmful. Many children, those living in close proximity to a tragic event, and those who will learn about the event through television, social media, or newspaper coverage, will be affected and upset.

Children and teens may react differently to the shooting depending on their age and prior experiences, and parents should expect that youth may respond in different ways, and be supportive and understanding of different reactions, even when you are having your own reactions and difficulties.

Common Reactions

Many emotions will be evoked by this tragedy – sadness, grief, helplessness, anxiety, and anger. Children who are struggling with their thoughts and feelings with the stories and images of the shooting may turn to adults for help and guidance. Knowing some of the common reactions can help you be supportive both of yourself and your children. The National Child Traumatic Stress Network recommends looking for the following reactions: 

  • Feelings of anxiety, fear, and worry about the safety of self and others
  • Fears that another shooting may occur
  • Change in behavior:
    • Increase in activity level
    • Decrease in concentration and attention
    • Increase in irritability and anger
    • Sadness, grief, and/or withdrawal
    • Radical changes in attitudes and expectations for the future
    • Increases or decreases in sleep and appetite
    • Engaging in harmful habits like drinking, using drugs, or doing things that are harmful to self or others
    • Lack of interest in usual activities, including how they spend time with friends
  • Physical complaints (headaches, stomachaches, aches, and pains)
  • Changes in school and work-related habits and behavior with peers and family
  • Staying focused on the shooting (talking repeatedly about it)
  • Strong reactions to reminders of the shooting
  • Increased sensitivity to sounds

The Centers for Disease Control and Prevention lists such events as the type of occurrence which cause Post-traumatic Stress Disorder in children. Examples of symptoms of PTSD can be found on the CDC’s webpage, which also includes treatment options for PTSD.

Start the Conversation

It is important to talk about the shooting with your child. Not talking about it can make them seem even more threatening in your child’s mind, and silence suggests that what has occurred is too horrible even to speak about or that you do not know what has happened. With social media, it is highly unlikely that children and teenagers have not heard about it. Chances are your child has heard about it, too.

Start by asking what your child already knows about the event either from the media or from their friends. Listen carefully and try to figure out what he or she knows or believes. As he or she explains, listen for misinformation, misconceptions and underlying fears or concerns. Understand this information will change as more facts about the shooting are known.

With a high profile event of this magnitude, which can result in confusion or distress among communities across the country, it is important that parents communicate effectively with their children.

For more information on how to talk to your children about this shooting, or any other tragic event, NCTSN has compiled a list of tips to help you help your children with their thoughts and feelings, which can be found here.

Answers to some common questions

Children will undoubtedly have many questions when asking caregivers about a confusing or senseless act of mass violence.

Why do these things happen?

Often, children, like adults, want to know the motives of the people responsible for these horrible events. Past events have resulted from many causes including mental illness, rage, extreme political or religious beliefs, and hatred. Unfortunately, there usually isn’t a concrete answer to why a specific individual acted in such a way. It does not help children to have them fear groups of people who fall into any specific demographic category. Doing so only leads to discrimination, stigma, and victimization of people who are also struggling to cope with these events. More importantly, help your children understand that adults, including government authorities, work hard to identify and stop dangerous events before they ever happen.

Will this happen again and how do I keep my children safe?

Unfortunately, violent events are likely to happen again. It is important to remember that despite our awareness, random acts of violence occur rarely and does not occur in most neighborhoods. Remember that parents and professionals strive to keep our children safe yet allow them the space they need to grow and develop.

Use the guidelines that can be found here to keep your child safe.

There are a number of things you can do for your child and yourself to help restore a sense of safety in your home. A list of those things can be found here