Friday, August 17, 2018

There’s No Measles Outbreak in Louisiana

Despite what you may have read or heard recently from media outlets, there is no current danger of a measles outbreak in Louisiana – or in the U.S. 

Reports this week indicated 2018 is on track for the most cases of measles since 2014, when 667 cases were reported across the U.S. However, this was misinterpreted in the press.
The latest information from the Centers for Disease Control and Prevention (CDC) reports 107 people from 21 states have been diagnosed with measles from January 1 to July 14, 2018. Among those states, Louisiana has reported just two cases of measles this year. These numbers are in line with a typical year, and not at elevated levels as was reported. 
The measles cases that are being reported represent cases that come to the U.S. from other countries that have endemic cases. (Endemic means belonging exclusively or confined to a particular place.) 
Measles is not currently spreading from person to person in the U.S. or Louisiana.
Louisiana’s two cases are unrelated
Dr. Frank Welch, immunizations director for the Louisiana Department of Health, says the two Louisiana cases – which happened in early spring – stem from unvaccinated persons who traveled or lived outside the U.S.
The two cases are unrelated. The first report, in April, involved an unvaccinated man traveling from London to New Orleans for WrestleMania. The second report came in May and involved an unvaccinated school-age child who had traveled to a country where measles is endemic. 
Since the two cases occurred separately they do not meet the criteria for an outbreak, which is when a disease spreads rapidly from person to person.
Prevention is key
Even though there’s no measles outbreak, it’s important to be mindful of protection from the disease. The best prevention is two doses of the measles, mumps and rubella vaccine, also known as MMR. Two doses are about 97 percent effective against measles. Check with your primary care provider if you’re unsure whether you have been vaccinated.
Good hygiene is also important to prevent the spread of measles. Practice good hand hygiene habits, such as washing thoroughly with soap and warm water. Avoid sharing food, drinks and utensils.
Protecting our children
Children, particularly babies and the very young, are especially vulnerable to measles. The disease can lead to pneumonia, lifelong brain damage, deafness and occasionally death.
Children are required to receive two MMR vaccinations – at 1 year to 15 months of age and again at age 4, before starting school – according to Louisiana law. It applies to children in public, private or charter schools and home-schooled children. Exemptions are allowed for religious, philosophical or medical reasons, such as allergies to components of the vaccine.
Among the concerns cited for not vaccinating children with MMR is a belief that the vaccine causes autism. No such link has been found among scientists in the U.S. and other countries who have carefully studied the vaccine.
Louisiana’s exemption rate for the MMR vaccine is less than 1 percent, according to Dr. Welch.
Spotting measles
Signs of measles include high fever, cough, runny nose and red, watery eyes, followed by a rash that typically spreads from the head to the rest of the body. Sometimes, tiny white spots appear in the mouth two to three days after symptoms develop.
Complications commonly found with measles are ear infections and diarrhea, seen in about 10 percent of patients.
Measles is highly contagious and becomes so four days before the appearance of rash and four days after the onset of rash. It is spread by coughing, sneezing or sometimes being in the same room as someone who is infected.
There is no cure for measles, so treatment is merely to alleviate the symptoms. The recommended treatment for measles includes rest, pain and fever reducers, fluids, vitamin A supplements and the use of a humidifier.
A person who has developed measles is considered immune to the disease after it has been contracted. Regardless, vaccination is still recommended to protect against mumps and rubella.

Friday, August 3, 2018

DEET and Long Sleeves: Combating West Nile

With the first cases of West Nile Virus this year being reported, it is more important now to protect yourself, your family and your loved ones from mosquito-borne illnesses.

West Nile virus and St. Louis Encephalitis virus, both from the same family of viruses called flaviviruses which cause similar diseases, are two of several mosquito-borne viruses common to Louisiana.

Friday, July 20, 2018

LDH Introduces New Plan to Replace 25-year-old Waiting List

Through years of research and collaboration with individuals with developmental disabilities, families, providers and community organizations, the Louisiana Department of Health has ended the 25-year-old waiting list for specialized home and community-based services.

Friday, July 6, 2018

Staying Safe in the Summer Heat

As summer approaches in Louisiana, with record high temperatures already being topped and heat indices cracking triple digits, it is important to protect yourself and your loved ones from heat-related illness.

Wednesday, June 27, 2018

Improving the health of Louisiana's mothers and babies

Understanding women’s experiences surrounding pregnancy and childbirth is a cornerstone of the Louisiana Department of Health’s (LDH) efforts to improve the health of Louisiana mothers and babies.

LDH’s Bureau of Family Health uses the Louisiana Pregnancy Risk Assessment Monitoring System (PRAMS), an ongoing surveillance system administered in partnership with the Centers for Disease Control and Prevention (CDC), as a primary source of quantitative and qualitative data around those experiences and maternal behaviors before, during, and immediately following pregnancy.

Wednesday, June 13, 2018

Who gets Medicaid in Louisiana?

Although almost half of all Medicaid enrollees in Louisiana are children, they account for about a fourth (26.5 percent) of State's total Medicaid spending. Louisiana’s two most vulnerable populations, people with disabilities and those who are aging, make up less than 20 percent of the Medicaid population but account for more than half of the State's total Medicaid spending, 60.4 percent.

Friday, June 8, 2018

We all have a part to play in preventing suicide

Author: Danita LeBlanc, LCSW- BACS

Every 40 seconds, a life is lost to suicide. The 800,000 suicide deaths that occur worldwide are more than deaths caused by homicide and war combined.

Suicide is a major public health issue. In the United States, 44,995 lives were lost to suicide in 2016. Louisiana reported 677 suicide deaths that same year. In the state, it is the 11th leading cause of death, the second for children between ages 10 and 14 and third for those between 15 and 34. Addressing suicide on a public health level, including access to care, is made more difficult by the stigma that accompanies suicide.

Although it sounds conflicting, people who are thinking about suicide usually also want to live. They share signs about living that their friends, family and neighbors see, hear, feel and sense They also share signs about ending their life, those signs are not always recognized as being about suicide. When these signs about wanting to die are presented, it is important to be willing to talk about suicide and ask if someone is suicidal. Neither of these actions put the thought of suicide in someone’s head, and they help break down the stigma surrounding suicide.

It’s especially important to be willing to talk about suicide as impulsiveness plays a role in some suicide attempts. While a person may have been thinking about it for a while, the decision to act can be fast.

We all have a part to play in preventing suicide. Here are some things you can do to help.

Learn the warning signs of suicide so you can recognize them.
  • Threatening to hurt or kill oneself or talking about wanting to hurt or kill oneself.
  • Looking for ways to kill oneself by seeking access to firearms, available pills or other means.
  • Talking, writing about death or dying, or suicide when these actions are out of the ordinary for the person.
  • Feeling hopeless.
  • Feeling rage, uncontrolled anger or seeking revenge.
  • Acting reckless or engaging in risky activities, seemingly without thinking.
  • Feeling trapped as if there is no way out.
  • Increasing alcohol or drug use.
  • Withdrawing from friends, family and society.
  • Feeling anxious, agitated or unable to sleep or sleeping all the time.
  • Experiencing dramatic mood changes.
  •  Seeing no reason for living or having no sense of purpose in life.
Reach out.
  • Reaching out involves active listening and engaging with a person in a non-judgmental and supportive way – these skills can be taught to anyone.
  • Reaching out to those who may be struggling or may have become disconnected from others and offering support can be a life-saving act.
  • Reaching out involves linking people to relevant professional resources to ensure appropriate care and follow up for the person at risk. One resource is:
o   National Suicide Prevention Lifeline – 1-800-273-TALK (8255)
§  Veterans can dial “1” and be connected to a Veteran/Service personnel center; they also have the option to be called by the State VA Suicide Prevention Coordinators  within 24 hours
§  Spanish speaking callers can dial “2” and be connected to a call center with Spanish speakers
§  Chat option:
§  Text option:  741741

Help make the environment safer if someone is thinking about suicide.
  • Remove things that someone can easily use to hurt or kill themselves from the home (ex. unneeded or large amounts of  medications, firearms) or make them more difficult to access (lock up firearms, separate bullets from firearm; lock up medications or keep only small quantities on hand).
  • Stay with them or help them find someone in their circle of support who can be with them until help can be obtained.
Reaching out to people bereaved by someone else’s suicide death gives them the opportunity to talk about their loss, in their own time and on their own terms, which can also be a lifeline (postvention or prevention).

The news media also has a role.

Reporters and other media professionals should take special care when reporting on suicide.
More than 50 research studies worldwide have found that certain types of news coverage can increase the likelihood of suicide in vulnerable individuals. The magnitude of the increase is related to the amount, duration and prominence of the news coverage. When the suicide method is explicitly described, copycat suicides may occur.

However, covering suicide carefully can change public misconceptions and correct myths, which can encourage those who are vulnerable or at risk to seek help.

A list of recommendations when covering suicide as a media professional can be found here.

Suicide is complex, and there are almost always multiple causes including psychiatric illnesses that may not have been recognized or treated but these illnesses are treatable and help is available.

If you need to talk to someone, please call the National Suicide Prevention Lifeline at 1-800-273-8255. The Lifeline provides 24/7, free and confidential support for people in distress and prevention and crisis resources for you or your loved ones, and offers best practices for professionals.

Additional Resources:

Friday, May 18, 2018

EDITORIAL: Being Prepared

Author: Dr. Rebekah Gee, secretary of the Louisiana Department of Health

Recently, the attorney general and others have made statements and have published letters that suggest my agency was premature in alerting nursing home residents and others of the possible impact on their health care and lives should the legislature not properly fund health care services.

To that false allegation, I would ask, “when do you fill your car up with gas … when the tank starts to get low, or do you keep on driving it until it’s empty and it stalls?” Responsibility is not intentionally driving your car until it runs out of gas. Instead, we keep an eye on the indicator and take action before it is too late. Being prepared is being responsible, not only when driving a car, but in all situations.

It was this sole reason that we made the most difficult decision to send letters to nursing home residents and others alerting them there was a strong possibility that the funds necessary to pay for their care would be eliminated. It was important to us to give vulnerable Medicaid recipients enough early warning so they could be prepared.

Going back to the running on empty example … the tank became half-full when the Legislature refused to address the known budget shortfall in 2017 and during this year’s special session. Then, when the House approved a budget that cut health care by more than $1.8 billion a few weeks ago, the tank had run dry.

Although there were some promises that health care funds would be restored during a special session, history of inaction during past sessions left us with little confidence. Those letters were written to give full transparency to those who are at risk for a life and health upheaval, and we have been busy since they were mailed.

We have had numerous meetings with providers, advocates and families to keep them fully informed. We have researched every Medicaid rule and how it affects individual situations to see if there are alternative solutions, and my team has visited every nursing home in the state to meet with patients, families and nursing home staff.

I have also visited several nursing homes and have seen first-hand the heartbreak and anguish on the faces of those whose lives are at risk, and my staff and I have told them the hard truths. As another special session is set to begin, I hope and pray our elected leaders have the courage to take the actions to fully fund not only vital health care services but all of the services that the people of Louisiana rely upon to live their lives to the fullest. 

When a disease outbreak hits, who you gonna call? Disease Detectives

Author: Theresa Sokol, epidemiology manager

When a case of an infectious disease such as measles is confirmed in Louisiana, the epidemiologists in the Louisiana Department of Health’s Infectious Disease Epidemiology Program act as disease detectives to track the causes and consequences of these diseases.

The Program studies the spread of infectious diseases in the community and carries out or coordinates programs that prevent the spread of communicable diseases. With incidents such as the measles case in a traveler from the United Kingdom that was discovered in New Orleans in April 2018, an epidemiological investigation is done.

Monday, April 23, 2018

Don’t wait, vaccinate!

Author: Stacy Hall, Louisiana Department of Health Immunization Program Director

Despite many years of progress, Louisiana’s infant vaccination rates have declined slightly for each of the past three years, and now, over 30 percent of young children in Louisiana are not up-to-date on vaccines that prevent serious diseases.

Thursday, April 19, 2018

Freeing Louisiana of racial and ethnic disparities in health

Author: Rudy Macklin, director, Bureau of Minority Health Access

The Bureau of Minority Health Access’s vision is a Louisiana free of racial and ethnic disparities in health and healthcare. Minority Health Month is just one of several programs produced by the Bureau that shines light on that goal.

Since deciding to take part in the federal Department of Health and Human Service’s Office of Minority Health’s program in 1998, the Bureau has awarded mini-grants to deserving healthcare associations, churches, federally qualified health centers, historically black colleges and universities (HBCU), Hispanic groups, Native Americans and Asian Pacific Islanders to carry out minority health activities in their areas.

Many of our programs in Louisiana would never come to light without our community partners to assist with formulating policy, implementing new programs and promoting healthy living in the areas they serve.

Minority Health Month in 1998 was and still is designed to:
  •         promote healthy lifestyles;
  •         provide crucial information to allow individuals to practice disease prevention;
  •         showcase the resources for and providers of grassroots health care and information;
  •         highlight the resolution of the disparate health conditions between Louisiana's minority and non-minority populations; and
  •         gain additional support for the ongoing efforts to improve minority health year-round.

Health disparities are differences in the overall rate of disease incidence, prevalence, morbidity, mortality or survival rates between different groups. Disparities result not only in a lower overall quality of life among those impacted but of their families and communities as well.

Racial and ethnic differences in health perceptions and health behaviors are often unconventional when compared to modern medicine and can hinder the process of healing and promotion. This is especially the case when health care providers have not received training in cultural competence. The lack of knowledge about the cultural beliefs and health behaviors of a patient can be detrimental to the provision of care.

Although ethnic and cultural beliefs have a powerful influence on the health of minority populations, it is widely observed that socioeconomic status has a greater impact on health than does race and ethnicity.

Due to the overwhelming representation of minorities living below the poverty line in Louisiana, the socioeconomic factor becomes especially relevant to minority health. Level of income tends to dictate where groups live, and therefore what services are available to them. Geographic isolation from health care services is a great disadvantage to many minority populations.

The Impact of Poverty

Poor nutrition, inaccessibility to health care providers, and inability to pay for services are all factors which result from poverty and lead to poor health status. Poverty and poor health are also detrimental to education attainment, as accessibility and ability to afford are impacted by income levels, and poor health affects one's functioning in an academic environment.

For minorities in Louisiana, this means higher rates of diabetes, hypertension and being overweight or obese.

Since 2012, the push to eliminate health disparities has taken an entirely new narrative by minority health advocates. The big push today is about achieving health equity. It is said, “One must reduce health disparities in order to achieve health equity.” Health equity is the attainment of the highest level of health for all people. Health equity means efforts to ensure that all people have full and equal access to opportunities that enable them to lead healthy lives.

As for me personally, true equity lies in understanding not what is legal, but what is just. With new, bold leadership in Governor John Bel Edwards and a dynamic Secretary of Health in Dr. Rebekah Gee, I truly believe now we can get there.

For more information on Minority Health Access, click here.

Wednesday, April 11, 2018

Medicaid Expansion created new jobs, boosted economy by $3.5 billion

Author: Dr. Rebekah Gee, Secretary, Louisiana Department of Health

When this administration took office, Gov. John Bel Edwards took the immediate step to sign an executive order to make Medicaid coverage available to low-income, working adults. The goal was to ensure that more people had coverage for primary and preventive health care, hospitalizations, mental health care services and substance abuse treatment. The goal was to take the first and most important step to make our residents healthier. It was the right thing to do.

Monday, April 2, 2018

Setting record straight on Medicaid fraud

Results from a recent federal audit of Louisiana’s Medicaid program emphasized the state is both compliant with all federal fraud reporting requirements and has the proper procedures in place to detect and report fraud. The federal audit sets a high bar for its anti-fraud efforts, making it notable that Louisiana was one of only four states to pass this audit since 2014.

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.

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.

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

Thursday, February 15, 2018

7 tips for a healthy heart

Author: Dr. Martha Whyte, regional medical director for Region 7

According to the American Heart Association, in 2015, almost 13,000 Louisiana residents died of heart disease or stroke. Having high blood pressure puts you at high risk for cardiovascular disease, and managing high blood pressure is a lifelong commitment.

More than 29 Louisianans die from heart disease every day, making it the state’s number one killer. Louisiana also ranks fourth in the nation for stroke death rates.

Heart disease is usually caused when plaque builds up in the walls of the arteries. The build-up narrows the arteries, making it hard for blood to flow through. Sometimes, blood clots form, completely stopping blood flow. This can cause a stroke.

High blood pressure, or hypertension, increases your heart’s workload by quietly damaging your blood vessels and arteries over time. It is the leading cause of stroke.

One in every three adults has high blood pressure, and only about half of them have their blood pressure controlled which could lead to costly health complications, including heart attack and stroke. Many are unaware of their hypertension, as it frequently causes no symptoms, even when extremely elevated.

Get Screened

Blood pressure screening and treatment reduces the risk of heart disease, heart attacks, and stroke. This, in turn, has a positive impact on reducing the overall cost of healthcare.

On average, a heart attack costs $94,500 in the first year of treatment and $74,000 every year after. Strokes are even more expensive; $122,000 in the first year and $75,000 every year after.

In Louisiana, Medicaid expansion has made it possible for thousands to see doctors resulting in early diagnoses and treatment that has saved lives. And as shown above, there is a corresponding savings to the health care system when the focus changes from treatment to prevention.

Reduce Your Risk

There are a number of ways that you can stay healthy and lower your risk of having a heart attack or stroke or suffering from heart disease.

At the top of the list is eating a healthy diet, but eating healthy doesn’t mean sacrificing the foods and flavors you love. You can modify your diet in a way that will have your heart pumping for joy by:
  • Eating more poultry, fish, nuts and beets and less red meat. When purchasing meat, choose a lean cut and limit portion size.
  • Choosing low-fat or fat-free dairy products
  • Picking fresh or frozen fruits and vegetables instead of canned and processed fruits and vegetables, which contain added salt and sugar.
  • Selecting breads, pasta and other carbohydrate-rich foods that are made from whole grains.
  • Switching from butter to olive, canola, soybean, peanut, corn or safflower oils for cooking.
  • Choosing low-sodium foods whenever possible. Using herbs and spices to flavor foods instead of salt.
  • Cutting back on foods and beverages with added sugars. For example, eat fruits instead of drinking fruit juices.
  • Modifying your favorite recipes so that they contain less fat and calories.
A link that may help guide your choices is

Maintaining a healthy weight can also lower your risk for heart disease. Being overweight or obese can increase your risk for heart disease. To determine whether your weight is in a healthy range, doctors often calculate a number called the body mass index. Doctors sometimes also use waist and hip measurements to measure a person’s excess body fat.

If you know your weight and height, you can calculate your BMI with the Centers for Disease Control and Prevention’s Assessing Your Weight website.

Exercising regularly can help you maintain a healthy weight and lower cholesterol and blood pressure. The Surgeon General recommends that adults should engage in moderate-intensity exercise for at least 30 minutes on most days of the week.

For more information, see the CDC’s Nutrition and Physical Activity Program website.

Don’t smoke. Cigarette smoking greatly increases your risk for heart disease. So, if you don’t smoke, don’t start. If you do smoke, quitting will lower your risk for heart disease. Your doctor can suggest ways to help you quit.

Limit alcohol use. Drinking too much can cause high blood pressure. It can also add calories and cause weight gain. 

Reduce stress and get plenty of sleep: Both of these are important to reduce your risk for obesity and high blood pressure.  If you are stressed and not sleeping adequately, you tend to drink, eat and stress more! Exercise, take time to decompress before you go to bed by reading or listening to music, no television when trying to sleep, and let your doctor know if you are unable to accomplish your goals. 

Seeing your primary care physician regularly is also an important step in protecting yourself from heart disease. Many other diseases, such as Diabetes, can also contribute to heart disease development. High blood sugar can lead to damage to your blood vessels and nerves to your heart leading to a risk of stroke and heart attack.  Seeing your doctor for all regular screenings, such as cholesterol and blood sugar, will help lower your risk of damage to your heart and other vital organs.

For more information on the prevention and management of heart disease and stroke, visit Well-Ahead Louisiana’s resources page to increase awareness of hypertension among patients and implement quality improvement processes.

Thursday, February 8, 2018

Vaccines are Important for Adults

Author: Dr. Frank Welch, Medical Director, Immunization Program

You may remember trips to the doctors to get your immunizations throughout your childhood, but you may not realize that you need vaccines throughout your adult life as well. Vaccines are still important for your good health and are one of the safest ways to protect it.

One of the greatest technological developments in history, immunizations are so effective at preventing and eradicating disease that many Americans have never seen a single case of mass killers of the past, such as smallpox and polio. However, despite their effectiveness, more than 40,000 American adults die each year from diseases that can be inexpensively and effectively prevented by immunization. Infants, older adults, and people with weakened immune systems are especially vulnerable to vaccine preventable diseases.

Working with your body’s natural defenses, vaccines lower your chances of getting sick and spreading certain diseases. Side effects from immunizations are usually mild and go away on their own, and severe side effects are rare.

Some of the most common adult vaccines are for the flu and tetanus. A flu shot is recommended every year and your Td/Tdap shot should be boosted every 10 years. This shot protects against tetanus, diphtheria, and Whopping Cough. Click here for more information about different adult vaccines.

Despite concerted efforts to promote annual influenza vaccination in older adults, persistent knowledge gaps exist regarding the burden of disease and the risk of flu and related complications, especially for people age 65 and older.  

That said, awareness of the consequences of vaccine-preventable disease influences vaccination behavior. Rates of herpes zoster (Shingles) vaccination increased among people who witnessed friends or family members experience the disease, particularly if severe.

Vaccine protection wanes over time, and there are a number of other risk factors that could heighten your chances of getting sick. Your age, job, lifestyle, travel, and health conditions are all factors that could determine the vaccines you need as an adult. Check with your doctor about your current immunizations during your annual check-up.

In addition to the preventing the flu, immunizations prevent serious diseases, such as, pneumonia, tetanus, pertussis (Whopping Cough), Herpes Zoster (Shingles), Human Papilloma Virus, Hepatitis A and B.

Adults can get vaccines at doctors’ officers, pharmacies, Urgent Care facilities, federally qualified health centers, and parish health units.

Uninsured and underinsured adults are eligible for vaccination at parish health units. Most health insurance plans cover the cost of recommend vaccines. Check with your insurance provider for details and for a list of vaccine providers.

Don’t wait until you know someone who’s ill. Protect your health and the health of those around you by getting the recommended vaccines based on your age and health conditions.

To see a list of vaccines you may need, take the Louisiana Department of Health’s Adolescent and Adult Immunization quiz.

For more information on immunizations, click here.

Monday, February 5, 2018

Debunking the Flu Vaccine Misconceptions

Author: Dr. Frank Welch, Medical Director, Immunization Program

Being vaccinated against the flu, particularly in active seasons like this one, is the best way to protect yourself and those around you against getting sick. However, the talk of vaccines also brings all the misconceptions about vaccines back to the surface.

The flu vaccine remains the safest and most effective way to protect yourself and those around you from the flu. In the most severe seasons, the flu causes approximately 700 deaths and nearly 8,000 hospitalizations each year in Louisiana. The 2017/18 flu season is on pace to meet and possibly exceed those statistics.

The Louisiana Department of Health has actively been promoting the flu shot for the past several weeks. Although the response for this responsible public health/flu prevention tactic has been overwhelmingly positive, some people still talk nonsense and spread misinformation. Here are the answers to a few of the many myths and misconceptions about the flu  vaccines that have appeared on our social media pages.

If I take the flu shot, I will get the flu.

Many people fear that they will get the flu if they are given the flu vaccine, but it is absolutely impossible for the flu shot to give you the flu. Flu vaccines given with a needle are currently made in two ways: the vaccine is made either with a) flu vaccine viruses that have been ‘inactivated’ and are therefore not infectious, or b) with no flu vaccine viruses at all (which is the case for recombinant influenza vaccine). The most common side effects from the influenza shot are soreness, redness, tenderness or swelling where the shot was given. Low-grade fever, headache and muscle aches also may occur.

The shot isn’t effective in preventing the virus.

The flu shot is not perfect, but it does protect against, and minimize many complications of the flu.
There are many different flu viruses and they are constantly changing. Because of this, the composition of the U.S. flu vaccines is reviewed annually and updated as needed. According to the Centers for Disease Control and Prevention, flu vaccines protect against the three or four viruses that research suggests will be most common. For 2017-18, three-component vaccines are recommended to contain protections against:
  • ·        H1N1
  • ·        H3N2
  • ·        B/Victoria lineage virus

There are also four-component vaccines that protect against a second lineage of B viruses.

I got the flu shot and I still got the flu.

It’s possible to get sick with the flu even if you have been vaccinated. This is possible for a few reasons.

·        You may have been exposed to a flu virus shortly before getting vaccinated or during the period (two weeks after vaccination antibodies that provide protection develop in the body) that it takes to gain protection after getting vaccinated, resulting in you becoming ill with the flu before the vaccine begins to protect you.

·        You may have been exposed to a flu virus that is not included in the seasonal flu vaccine. There are many different flu viruses that circulate every year. The flu vaccine is made to protect against the three or four flu viruses that research suggests will be most common.

·        Protection provided by flu vaccination can vary widely, based in part on health and age factors of the person getting vaccinated. In general, the flu vaccine works best among healthy younger adults and older children. Some older people and people with certain chronic illnesses may develop less immunity after vaccination. Flu vaccination is not a perfect tool, but it is the best way to protect against flu infection.

·        You may be sick with a virus or bacteria that is not the flu. These other germs circulate more in the winter along with the flu virus and are sometimes confused with the flu.

The vaccine is only 10 percent effective.

The 10 percent vaccine effectiveness figure was an interim estimate of the vaccine’s benefit against one flu virus (H3N2) that circulated in Australia during its most recent flu season. In the United States last season, overall vaccine effectiveness against all circulating flu viruses was 39 percent. Estimates of the flu vaccine’s effectiveness against circulating flu viruses in the United States this season will be available later in the season but are expected to be significantly higher than 10 percent, and more likely in the 35-60% effectiveness range.

The flu shot is not safe for pregnant women or newborns.

With rare exception, an annual flu vaccine for everyone six months of age and older, including pregnant women and people with medical conditions. Vaccine providers should be aware of the approved age indications of the vaccine they are using and of any precautions. People getting vaccinated should also be screened for allergies as those with severe allergic reactions should not be vaccinated.

For a complete list of those who should speak with their doctor before getting vaccinated, refer to this list.

The mercury in vaccines causes autism.

There is no evidence that vaccines cause autism. Thimerosal, a mercury-based preservative, is used in trace amounts in vials that contain more than one dose of a vaccine to prevent germs, bacteria and/or fungi from contaminating the vaccine. Multi-dose flu vaccines contain thimerosal. However, scientific research does not show a connection between thimerosal and autism, and it has shown to be safe when used in vaccines.

Measles, mumps and rubella vaccines do not and have never contained thimerosal. Varicella, inactivated polio, and pneumococcal conjugate vaccines have also never contained thimerosal.
Flu vaccines are available in both thimerosal-containing and thimerosal-free versions.

For a complete list of vaccines and their thimerosal content, click here.

The Louisiana Department of Health recommends that everyone who has not received a flu vaccination to do so as it is the best way for you to protect yourself, your family, and the people around you. For more information on the flu, visit

Monday, January 29, 2018

Tips to Keep Your Super Bowl Party’s Meal Safe

Author: David J. Holcombe, M.D., M.S.A., Regional Medical Director, Region 6 (Alexandria Region)

It’s almost time for the Super Bowl, and like all big events, that means it’s time for a party. And where there’s a party, there’s plenty of food. And since most of us don’t serve large meals often, there’s a greater potential for food contamination. The Louisiana Department of Health warns it’s important to be wary of food borne illnesses and take precautions to keep yourself and all of your party-goers healthy this Super Bowl Sunday.

Food borne illnesses are frequent, affecting well over 48 million people in the U.S. each year. Such illnesses are also a significant cause of sickness and result in over 128,000 hospitalizations and 3,000 deaths annually as reported by the CDC. The older and sicker (or younger) the patient, the more likely they are to have a tragic outcome.

In addition to Salmonella, other illnesses related to food include E.coli, Shigella, Hepatitis A, Listeria and Norovirus. These are all common causes of food poisoning, sickening millions of people annually in the U.S.

Food borne illnesses are caused by a great number of agents including viruses, bacteria, vibrios and others. Sometimes it is a situation where the food itself contains the toxins, while at other times the illness is caused the growth of the bacteria (such as Salmonella) within an infected person. In any case, the symptoms usually include fever, nausea, vomiting, abdominal pain and diarrhea, sometimes explosive and even bloody.

Protect Yourself
As you prepare your Super Bowl meal, the goal is to keep germs from finding their way into your food. To keep your foods safe during preparation and as you serve items, put these tips in your playbook. This will ensure that a case of food poisoning doesn’t put a damper on your party.
  • Don’t leave food in a hot car.
  • Keep your kitchen clean, especially cutting boards, sponges and knives.
  • Make sure your refrigerator is 40 degrees and your freezer is zero.
  • Cook red meat to 160 and poultry to 180 degrees F.
  • Never leave perishable foods out of the refrigerator for more than TWO HOURS.
  • Keep cold party foods on ice.
  • Heat leftovers to 165 degrees and keep them above 140 F.
  • Put hot foods into small units for rapid cooling.
  • If it looks strange or smells strange, throw it out.
  • Wash your hands before, during and after food preparation.

The Top 10 Causes of Food Poisoning
Viruses, especially noroviruses, cause about 63 percent of all cases.  Noroviruses are the culprits in the infamous cruise ship outbreaks of diarrhea and are also responsible for the periodic closures of some Louisiana oyster beds. It requires very few viruses to cause an infection and the transmission potential is staggering, often affected an entire cruise ship in a matter of days. Noroviruses can also spread through an entire nursing home or other institution in a very short time.

Next is Salmonella, causing about 20,500 infections occurring every year in Louisiana with nearly all caused by food-borne transmission. Salmonella, like Escherichia coli, Shigella, Listeria and Campylobacter (all also among the top 10 culprits), invades the intestinal wall and causes significant fever, abdominal pain and diarrhea. Symptoms are preceded by an incubation period lasting anywhere between six hours to three days, with symptoms lasting up to week. Poultry products (including the annual holiday turkey) are particular culprits since up to 90 percent of chicken carcasses are contaminated with Campylobacter and around 20 percent with Salmonella and Listeria. Turkeys and chickens share similar germs (as do some reptiles).

Other agents include Clostridium perfringens (as was identified in the recent Louisiana incident), Staphylococcus aureus and Bacillus cereus. All three of these produce toxins, the former after being ingested and the latter two prior to being ingested. In other words, with Staph and Bacillus, the poison is already in the food before you take a bite, while Clostridium perfringens produces it in your gut. In any case, victims get sick in a few hours after eating the food, often prepared and stored under improper conditions for that Super Bowl shindig, but usually get better within a few days.

Rounding out the top 10 are Vibrio parahaemolyticus and its close cousin, Vibrio vulnificus, both saltwater organisms. Vibrio Parahaemolyticus (causing about 45,000 cases a year) is often associated with partially cooked shrimp, and can cause an unpleasant episode of diarrhea.

Vibrio vulnificus is found in raw oysters, another holiday favorite and causes about 100 cases a year. While most people can eat oysters with relative impunity, those with severe liver disease run a life threatening risk with Vibrio vulnificus.