Tuesday, August 20, 2019

Extreme heat is dangerous

By DR. MARTHA WHYTE | Region 7 Medical Director, Office of Public Health

With temperatures being in the 90s for most of this month, and with heat indexes in the triple digits, Louisiana is facing an extreme heat wave. Although most people understand that it is hot outside and even hear warnings about the risks of high heat, truly understanding and the dangers and taking the necessary precaution is important to prevent heat-related illness and death. Here are some key facts:

Friday, August 16, 2019

You’re always somebody’s type when it comes to blood donation

No matter your blood type, your blood donation can help save a life.

Blood transports oxygen and nutrients to the lungs and tissues, forms clots to prevent excess blood loss, carries cells and antibodies that fight infection, transports waste products to the kidneys and liver for filtering, and regulates body temperature. It is composed of four main building blocks.
  • PLASMA is the main component of the blood, made up of water, sugar, fat, protein and salts. Its primary job is transporting blood cells throughout the body along with other things like antibodies, hormones, nutrients and more.
  • RED BLOOD CELLS are the most plentiful cell in the blood and carry hemoglobin, which gives blood its red color. Hemoglobin helps carry oxygen from the lungs into the rest of the body, returning carbon dioxide to the lungs to be exhaled.
  • WHITE BLOOD CELLS fight off infection. There are two types: neutrophils, which respond immediately to infection, and lymphocytes, which regulate the function of other immune cells, attack infected cells and tumors and make antibodies.
  • PLATELETS are small fragments of cells that help with blood clotting.

Who needs blood donations?

When people think of who benefits from blood donations, typically they think of situations such as a car accident. Obviously, someone who has been severely injured in a car accident is likely to receive blood, but do you know who else needs donated blood?
  • CANCER PATIENTS: Certain cancers and cancer treatments prevent patients from producing their own platelets, a component of the blood.
  • TRAUMA AND SURGERY PATIENTS: Red blood cells carry oxygen throughout the body, so blood is frequently given to trauma and surgery patients, including women with pregnancy- and childbirth-associated bleeding.
  • SICKLE CELL PATIENTS: People with sickle cell disease require frequent blood transfusions that must be closely matched to the donor’s blood type, usually from the same racial and ethnic group. Most people in the United States who have sickle cell disease are of African ancestry, but it’s also common in people of Hispanic ancestry.
  • BURN PATIENTS: Plasma, another component of blood, is important to burn patients because it helps maintain blood pressure and other vital functions.
  • PATIENTS WITH CHRONIC DISEASES: Patients with certain conditions in which the body does not make blood properly, such as hemophilia or anemia, may require frequent transfusions.

Every few seconds somebody is in need of a blood transfusion, making it vital that we have a safe, quality, sufficient supply available at all times. That’s where you, the donor, comes in.

Just your type

Before getting into the donation process, let’s talk about blood types. Some are rarer than others, making them in high demand, but all types are needed for donation.

The four major blood groups are A, B, AB and O; each group breaks down further into subgroups of A+, A-, B+, B-, O+, O-, AB+ and AB-. The + or - refer to a protein called the Rh factor, which can be present (+) or absent (-). Your blood group and presence or lack of an Rh factor determines your blood type.

Because not all blood types are compatible, it’s important during a transfusion that a person receives the right type of blood. If you accidentally receive the wrong blood type, your body could have a dangerous immune response like blood clumping, which can be fatal.

Typically, if you are in need of blood you will be given the type that matches yours, but sometimes that’s not possible. In that case, the universal red cell donor is O-, which means O- blood can be given safely to anyone regardless of blood type. That puts O- in high demand since it’s used for emergency transfusions and infants with compromised immunity, though O+ is also in high demand because it’s the most common blood type.

The universal plasma donor is AB.

How to save a life

So, you’re ready to donate? A single blood donation can save up to three lives! Type “blood donation centers near me” into your preferred internet search engine to find locations where you can donate. The major blood banks in Louisiana are The Blood Center, LifeShare, Vitalant (formerly United Blood Services), Our Lady of the Lake Blood Donor Center and Ochsner Blood Bank. Then, schedule an appointment.

Here’s what you can expect if you’re a first-time donor of whole blood. First, remember to plan ahead: have at least 16 ounces of water and a healthy meal before your appointment, and wear a shirt with sleeves that you can roll up.

When you arrive for your appointment, you’ll get registered — so bring your ID — then go over some basic eligibility requirements and receive information about donating blood. You’ll undergo a short interview about your health history, travel history, prescriptions and medications, as well as checks of your temperature, pulse, blood pressure and hemoglobin level.

Now, it’s time for the draw. You’ll either be seated or lie down, and then an area will be cleaned on your arm and a new, sterile needle will be inserted. It takes about 8 to 10 minutes to complete the blood draw, during which you may be given a ball to squeeze regularly to keep the blood flowing. When a pint of blood has been collected, the needle will be removed and your arm will be bandaged.

With that done, it’s time for a snack and something to drink, which will help replenish the loss of your body’s fluid following the blood donation. After a brief rest of 10 to 15 minutes, you can continue on with your day. Staff at the blood donation center may provide after-donation tips as well, such as drinking plenty of water and eating foods rich in iron. You must wait at least eight weeks between donations of whole blood.

Blood donation is a short, simple process that saves lives — and hey, there’s free snacks! Are you ready to be a lifesaver?

Friday, August 9, 2019

What’s for lunch? Get your child ready for the school cafeteria

By EMILY PINEDA | School Health/Early Childhood Education Manager, Well-Ahead Louisiana and ANGELA VANVECKHOVEN | Health Education Manager, Well-Ahead Louisiana

Getting your children ready to go back to school includes getting supplies, buying new clothes, learning bus routes and many other details. You might not think about what is being served in the cafeteria, but many Louisiana students eat both breakfast and lunch at school, so it’s an important part of your child’s day. 

Here are some questions to ask and things to think about as your kids head back to the school cafeteria.

What is my child’s school cafeteria serving?

Review the cafeteria menu with your child. Menus often list alternate choices, such as entrĂ©e salads and sandwiches, available to students who don’t care for the daily special. Ask your children about the fruit and vegetable choices offered with each meal, and encourage them to try new things.

If you want more information, many school nutrition departments have a page on the school district’s website that lists ingredients, nutritional facts and allergen information.

Finally, make plans to have lunch with your child in their cafeteria, and see for yourself how the meal looks, smells and tastes.

Who should I contact with questions or concerns about the school cafeteria menu?

The school’s cafeteria manager can talk with you about anything from meal preparation to how long students wait in line for their food. If you have more detailed questions, the cafeteria manager may refer you to the nutrition director, who oversees cafeteria operations, food procurement and menu planning for the entire school district. Also, be sure to ask your child’s teacher about classroom policies regarding food rewards and items served during classroom parties.

How can I get involved in my child’s school meal program?

Ask the cafeteria manager and principal about volunteer opportunities in your school cafeteria or school garden, if there is one. Some schools request parent volunteers to help usher students through the lunch line and encourage them to try their fruits and vegetables.

Additionally, all school districts have an advisory council and wellness policy to help establish and update district nutrition and physical activity policies. These policies can affect such things as the choices available in vending machines and the amount of time allotted each week for physical education, among others.

My child has food allergies. Do school cafeterias accommodate special dietary requirements, such as being gluten-free or nut-free?

If your child has a life-threatening food allergy, it is important to build a team of key individuals at school who can help safely manage his or her needs. Start by contacting your school nurse to discuss implementing an allergy action plan. The school nurse can work with parents and healthcare providers to develop a healthcare plan to meet the unique needs of each student.

Is my child’s school a WellSpot?

In and out of the cafeteria, schools make a major impact in the health of children. Schools designated as WellSpots make the well-being of their students and staff a priority.  School WellSpots meet benchmarks that are centered on a campus-wide tobacco-free policy and a school wellness program that includes physical activity and nutrition components for both students and staff. 

To learn more about how School WellSpots make the healthy choice the easy choice, visit Well-Ahead Louisiana’s School WellSpot page and share it with your child’s school.

For more information

To learn more about school health, visit Well-Ahead Louisiana’s website or email wellahead@la.gov.

Wednesday, August 7, 2019

Louisiana’s hepatitis C subscription model: ‘We were going to fix this problem’

In case you missed it, Louisiana Department of Health Secretary Dr. Rebekah Gee sat down with the Brookings Institution on July 22 to discuss the Department’s plan to use a subscription model to obtain expensive hepatitis C drugs. The plan has generated considerable interest given the innovative use of a model that Dr. Gee has said could help Louisiana cure the disease for thousands of patients.

If you missed the video coverage of the panel discussion featuring Dr. Gee, you can find a transcript of it here

At left is Louisiana Department of Health Secretary Dr. Rebekah Gee.
Dr. Gee discussed how difficult it was to find a way around the expensive hepatitis C drugs, but told Brookings moderator Louise Sheiner that “as long as I had the ability to have this role and to fight for the people of my state, and my Governor, we were not going to take ‘No.’ We were going to fix this problem.”

“The goal,” Dr. Gee added, "is to treat everybody with this virus.”

About 90,000 people in Louisiana have viral positives for hepatitis C and in the Medicaid program, there’s about 37,000.

The event drew media attention for the focus on prescription drug prices, which is a topic the U.S. Congress is expected to take up in September.

The Washington Times reported that Neeraj Sood, a University of Southern California professor of public policy, told the panel that Louisiana’s idea is to “give these profits upfront to the pharmaceutical firm but also dramatically improve access because price is not a barrier.”

The Baton Rouge Advocate wrote that Dr. Gee said during the panel discussion that the focus was in helping Medicaid recipients and prisoners at risk of dying of the disease.

These are vulnerable populations,” The Advocate quoted Dr. Gee as saying. “We have to think outside the box."

And The Center Square noted that Dr. gee considered the subscription model a "win-win" that will "provide unlimited access of the drug to prisoners and Medicaid recipients at a cost of up to $58 million, which is about what the state spent last fiscal year to treat far fewer people with the same drug."

Monday, August 5, 2019

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

Friday, August 2, 2019

Add wellness exams to your back-to-school list

By DR. DAWN MARCELLE | LDH Region 2 Medical Director

The dawn of a new school year sees parents loading up on pencils, paper and all the trappings needed for their children’s academic success. But does that checklist make room for health? Along with up-to-date immunizations, the beginning of the school year is the perfect time for a variety of checkups.

Physical exams

Schedule an appointment with your family’s pediatrician for a wellness checkup. Your pediatrician will give your child a physical examination including height, weight, blood pressure, heart rate, reflexes, scoliosis (abnormal curvature of the spine) and a check of the eyes, ears, nose, mouth and skin for abnormalities.

This exam is also a great time to talk about any concerns you may have about your child’s health, including diet/nutrition, sleep and behavior.

If your child participates in sports, your pediatrician will perform a sports physical. The Louisiana High School Athletic Association, or LHSAA, mandates all student athletes to pass a sports physical as part of its participation requirements. Sports physical forms can be downloaded here.


During the wellness checkup, your pediatrician will make sure your child is up to date on immunizations. Common immunizations among school-age children include TdaP (tetanus, diphtheria and pertussis), varicella (chickenpox), MMR (measles, mumps, rubella), hepatitis B, polio and meningococcal.

Children who are Medicaid eligible, uninsured or of American Indian or Alaskan Native descent may be eligible to receive vaccines at no charge through the Vaccines for Children Program, a service offered through the Immunization Program within the Louisiana Department of Health’s Office of Public Health.

Beginning this school year, LDH is making it easier for parents to review and print their children’s vaccination records with LA MyIR. This website lets you access your family’s official immunization records at any time, from any device and at no cost.

Vision testing

A child who can’t see well is going to have problems in the classroom. Some schools conduct vision screenings, but that may not be enough to spot problems. You may be surprised to learn that the American Optometric Association says these screenings miss up to 75% of children with vision problems.

Signs that a child may be having problems with their sight include covering one eye, holding reading materials close to the face, squinting, a short attention span and complaints about headaches or other discomfort.

Schedule a comprehensive eye and vision examination with a doctor of optometry. The optometrist has access to specialized equipment and procedures to fully assess your child’s vision. Click here to find an optometrist near you.

Hearing tests

Babies have their hearing tested a few weeks after birth, but that doesn’t mean it should be the last time hearing is checked. Hearing loss is usually a gradual process, happening over time. If your child isn’t responding to a teacher’s instructions, it may be because their hearing is suffering. Poor hearing can affect speech development and even social development, since a child who can’t hear well may have problems interacting with other people.

The American Academy of Pediatrics recommends hearing screenings at school entry for all children; at least once during ages 6, 8 and 10; at least once during middle school; at least once during high school; and for any student entering a new school system without evidence of a previous hearing screening. Ask your pediatrician for a recommendation if your child needs a screening.

Dental exams

Many children drop their usual dental habits during the carefree days of summer. Get them back on track with a dental exam and cleaning. Your dentist will make sure your child’s teeth are strong and straight, their bite is in good shape and check for any problems such as cavities or gum disease.

Children who play year-round sports should bring their mouth guards along to the exam. Dental staff will check the guard for wear, tear and fit. Growing children may be fitted for a new guard if they are outgrowing the old one.

You can learn more about LDH’s efforts to provide healthy smiles here, and the American Dental Association offers an online Find-a-Dentist tool here.

Healthy eating

Of course, you can’t send the kids back to school without a nutritious lunch. Check the LDH Blog next week for tips on healthy eating in the school cafeteria.

Friday, July 26, 2019

Adult day health program is ‘a blessing’ to Gaye and Johnny Rosado

Eight years ago, Gaye Rosado’s life changed permanently when she suffered three brain aneurysms.

As Gaye received medical attention, her husband, Johnny, was the one to tell her the doctor’s diagnosis.

“I never even heard of a brain aneurysm until Johnny told me that I had one,” the former business owner said.

Gaye Rosado

A brain aneurysm occurs when a blood vessel in the brain bulges or balloons. If an aneurysm leaks or ruptures, it causes bleeding into the brain, which can destroy or damage brain cells. 

The experience took a heavy physical toll on her body.

“Gaye lost all mobility. She thought she was normal, but she wasn’t,” Johnny said. “She was so lost.”

Johnny, who works a full-time job, knew his wife needed a rehabilitation center and safe place to go during the day while he was at work. With assistance from the Louisiana Department of Health’s Office of Aging and Adult Services, Gaye began participating in the adult day health program at The Ballington Center in June 2015.

A safe, caring space

Located in Shreveport, The Ballington Center serves adults ages 18 and older who need supervision or interaction during the day. The Office of Aging and Adult Services contracts with Volunteers of America North Louisiana to run the center.

The center’s adult day health program helps clients and their families have a safe, caring and loving environment to come to during the day. It serves clients who are not yet ready for nursing home care, but may not be able to be left alone at home during the day.

Services available at the center include an on-site nurse, exercise and games, arts and crafts, daily devotionals, meals and snacks, referral to other social services, and transportation to and from the center.

New lease on life

When Gaye first arrived at the center she spent many days sitting and staring at the wall, but soon she began to settle in and enjoy her time there. She loves to read, work on crossword puzzles, exercise and socialize with the friends she has made.

Gaye is also “paying it forward,” as she said, by helping a fellow client of the center, a man who experienced a brain aneurysm. She said helping another person who has been through an experience similar to hers helped her stay mentally and physically active. Johnny agreed, saying he couldn’t be more proud of his wife.

Gaye spends three days a week at the center and the other days at home with her husband. Johnny said the center is a blessing to him and Gaye, providing them both with peace of mind.

“I don’t have to sit and worry about her safety every day,” Johnny said.

Learn more about The Ballington Center here.

Friday, July 19, 2019

Beat the heat

As you may have noticed, it's hot out there. Summer heat poses real dangers and isn't something to be taken lightly. Take the time to read up on heat-related illness with this information shared by the Louisiana Department of Health last summer. A quick guide from the Centers for Disease Control and Prevention is available below — just click or tap on the image for a larger, easy-to-read version, or click here. Stay safe and beat the heat!

Monday, July 15, 2019

Danger remains even after the storm has passed

By KENYATTA ESTERS | Emergency Preparedness Manager, LDH Office of Management and Finance

Did you know that after a storm such as a tropical system has passed, many people are injured or die from hazards that are not directly associated with the storm?

In a 2016 study, researchers Dr. Edward N. Rappaport, former acting director of the National Hurricane Center, and Dr. B. Wayne Blanchard, retired Higher Education Project Manager at FEMA, analyzed 50 years of tropical cyclones and found that there were over 1,400 indirect deaths associated with these storms. These deaths included heart attacks, electrocutions and car accidents.

Let’s look at some of these “indirect hazards” of tropical systems and ways that we can prepare for them.

Credit: Rappaport and Blanchard (2016)

Cardiovascular incidents
Rappaport and Blanchard found that heart-related problems resulted in about 34% of all indirect deaths associated with tropical cyclones. Both the physical and emotional stress of dealing with a storm’s aftermath may result in a worsening of symptoms for those with heart disease.

  • Take breaks during strenuous post-storm activities such as debris removal.
  • If possible, work in groups or utilize community resources to assist in post-storm cleanup.
  • Ensure that all heart medications are refilled before a storm arrives, and check with your health insurance company to see if extra refills can be authorized before the storm.
  • Stay aware of stress levels after the storm. If you are overwhelmed with feelings of anxiety or depression, seek medical care and try to stay connected with friends and family. You can also use resources such as the Disaster Distress Helpline, a crisis counseling and support line for those experiencing emotional distress related to disasters.

Vehicular incidents
After a storm has passed, our first instinct can be to get in our vehicles to tour damage in neighborhoods. This can be a very dangerous action, as many roadways remain hazardous well after a storm has passed due to floodwaters and debris. Traffic lights may not function, and street and road hazard signs may be displaced. These hazards can result in dangerous traffic accidents.

  • Always remained sheltered after a storm until authorities tell you it is OK to leave your home.
  • When you are allowed to leave your home, always yield the right of way to any emergency vehicles that may approach.
  • Stay aware of road conditions through local news and radio stations and through the 511 travel information line.
  • Never drive around barriers or through flooded roadways, and be aware of downed trees and power lines.
  • If a traffic signal is not operating at an intersection, treat the intersection as an “all-way” stop.

 Visit 511LA.org or call 511 for travel information in Louisiana.

Power problems

Power outages can be an inconvenience for some, but may result in serious medical consequences for others. Many storms have affected Louisiana in the months of August and September, a period when the state experiences high and humid temperatures. The lack of cool air can make heat-related illness in vulnerable populations worse.

Power outages can be especially dangerous for citizens who use electricity-dependent medical equipment such as oxygen concentrators, feeding pumps and nebulizers. Injuries from falls can occur due to the lack of light, and frozen and chilled foods can become contaminated due to lack of refrigeration. Unsafe generator usage during power outages can lead to deadly carbon monoxide poisoning.

  • If you or your loved ones are sensitive to heat or use electricity-dependent medical equipment, be sure to plan for evacuations well in advance of a storm.
  • Instead of open flames as light sources, use flashlights and battery-operated lanterns to prevent fires.
  • Purchase battery-operated fans to use in homes.
  • Stay away from downed power lines that could still be electrically charged.
  • Heed any boil water advisories.
  • Never use a generator inside your home. The CDC recommends using generators more than 20 feet away from your home, doors and windows.
  • To prevent foodborne illnesses, discard refrigerated foods when the power has been off for four or more hours.

With a little preparation and awareness, you will be capable of keeping yourself and your loved ones safe before, during and after a storm.


For more information on how to stay safe from both direct and indirect hazards of tropical systems, visit these links:

Wednesday, July 10, 2019

Emotional and psychological disaster preparedness

By DR. JAMES E. HUSSEY | Medical Director, LDH Office of Behavioral Health

Tropical weather in the Gulf this week has us on our toes, ready to spring into action if things get nasty. While here in Louisiana we’re always ready for the possibility of high winds and torrential rains, we usually look to the practical side of things: Did we stock up on food and water? Is the generator ready to go?

Those things are undeniably important, but it’s also a good idea to be prepared mentally and emotionally. Natural events such as a storm can unfold in minutes to hours, yet the feelings and emotions they evoke can linger for weeks, months and even years after.

Psychological preparedness can help you think logically and wisely during and after disasters, helping to keep you physically safe while also weathering the emotional storm.

Disaster-related stress can affect anyone, but some people may be more vulnerable than others. They may include those with disabilities, existing mental health issues, children, the elderly and those who have been previously impacted by floods, hurricanes and other disasters.

VIDEO: Dr. Hussey on emotional and psychological disaster preparedness

Recognizing disaster-related stress

FEMA has some online resources aimed at coping with disaster. First, it is important to be able to recognize signs and symptoms of disaster-related stress, and to seek counseling or assistance. According to FEMA, some symptoms may include:
  • Difficulty communicating thoughts
  • Difficulty sleeping
  • Difficulty maintaining balance in their lives
  • Low threshold of frustration
  • Increased use of drugs/alcohol
  • Limited attention span
  • Poor work performance
  • Headaches/stomach problems
  • Tunnel vision/muffled hearing
  • Colds or flu-like symptoms
  • Disorientation or confusion
  • Difficulty concentrating
  • Reluctance to leave home
  • Depression, sadness
  • Feelings of hopelessness
  • Mood swings and easy bouts of crying
  • Overwhelming guilt and self-doubt

It’s OK to seek help

If disaster-related stress starts wearing you down, it’s perfectly normal and OK to ask for help. Here are some helpful resources:
  • The Disaster Distress Helpline, 1-800-985-5990, is a 24/7, 365-day-a-year national hotline dedicated to providing immediate crisis counseling for people those in emotional distress related to any natural or human-caused disaster.
  • The National Suicide Prevention Lifeline: 1-800-273-TALK.
  • For non-emergencies, check the Office of Behavioral Health directory for local community behavioral health services in Louisiana.
  • The Substance Abuse and Mental Health Services Administration (SAMHSA) has a Disaster Kit for recovery workers, which includes wallet cards, guides for parents, caregivers, teachers and others. There is also a SAMHSA Disaster App.

Contact your primary care doctor and/or your insurance plan for referrals to behavioral health specialists.

Physical and emotional health

FEMA also recommends that you take steps to promote your own physical and emotional health and healing by healthy eating, rest, exercise, relaxation and perhaps even meditation. It is important to maintain a normal family routine as much as possible and to lean on your existing support groups of family, friends and religious institutions.

Be prepared

For many people, having a disaster supply kit stocked and a family disaster plan ready is a great comfort. When the storm comes, you’ll be ready to go. For more information, click here.

Wednesday, July 3, 2019

Beach Monitoring Program helps keep your summer safe

Before you hit the beach for your summer vacation, you may want to have a look at the Louisiana Department of Health’s Beach Monitoring Program website to see if any advisories have been posted for your vacation destination.

The program tests the water at 24 beaches along the Louisiana coast to determine if those beaches meet quality standards set forth by the U.S. Environmental Protection Agency. All 24 beaches are along the state’s coast and are tested weekly. Those beaches include:
  • Constance Beach
  • Cypremont Point State Park
  • Elmer’s Island
  • Fontainebleau State Park
  • Grand Isle State Park (four sites)
  • Grand Isle Beach (three sites)
  • Gulf Breeze Beach
  • Holly Beach (six sites)
  • Lake Charles’ north and south beaches
  • Little Florida Beach
  • Long Beach
  • Martin Beach
  • Rutherford Beach

The program tests these waterways for bacteria from human or animal waste that could potentially cause disease, infections and/or rashes. Whenever these bacteria are above an acceptable level, a swim advisory is issued. Advisories are posted at the beach with a diamond-shaped sign and on the program’s website.

Contaminants can enter water in a number of ways. Sometimes, it is a case of sewage discharge. In other cases, it could be from large amounts of rainfall increasing runoff that enters waterways.

Swim safety

Swim advisories do not mean that the beach is closed, however. LDH recommends that anyone with a compromised immune system or open wounds not swim in the water, but the public can swim at their own risk.

If there is a swim advisory, there are a number of ways to reduce your chance of illness, including:
  • Avoid putting your head under the water if you choose to swim.
  • Do not get into the water if you have open cuts, sore or wounds. If you do choose to get into the water, ensure that you have waterproof bandages to cover any open cuts.
  • After swimming, shower with soap and water.
  • Avoid eating seafood caught from waters where there are visible chemicals, algae is present, and there is an advisory.
  • Pets should not be allowed to swim in or drink from waterways that are under advisory.
  • Avoid areas with visible algae. Algae can be blue, bright green, brown or red, and can have a strong odor like rotting plants.

If you feel ill after entering the water or swimming, contact your doctor immediately.

If you’d like to learn more about swim advisories, you can visit LDH’s Beach Monitoring Program website here or the U.S. EPA’s BEACH program here.

Friday, June 14, 2019

LDH, CDC partner up on histoplasmosis outbreak investigation at Louisiana campsite

By JOSE SERRANO, MPH | LDH Public Health Epidemiologist Specialist; POOJA GANDHI, MPH, CHES | CDC Mycotic Diseases Branch Health Communication Specialist; and KAITLIN BENEDICT, MPH | CDC Mycotic Diseases Branch Epidemiologist

“Fungal diseases have taken a backseat to bacterial and viral infections, to the point where mycotics are left out of many doctors’ diagnoses. Awareness efforts, such as multiple statewide surveillance projects and outbreak findings, show the growing concern of invasive fungal diseases in the general population.” 
— Jose Serrano, MPH, epidemiologist specialist and lead investigator of this outbreak from the Louisiana Department of Health

In November 2018, what seemed like a normal camping trip led to a group of campers in Louisiana getting sick with what was later discovered to be histoplasmosis, an infection caused by Histoplasma capsulatum, a fungus that lives in soil.

The Louisiana Department of Health got a call about two patients — a teenage girl who was thought to have viral pneumonia, and a middle-aged man with an unknown respiratory illness — who were hospitalized with symptoms that weren’t improving after being treated with antibacterials. After their doctors consulted with an infectious disease specialist, the two patients were eventually tested, diagnosed with and treated for histoplasmosis. Both people have recovered from the illness.

Both of them had traveled to a campsite in a rural area in southern Louisiana in the three weeks prior to falling ill. LDH contacted campsite officials to get a list of fellow campers who might have also gotten sick and began an investigation, with support from the Centers for Disease Control and Prevention’s Mycotic Diseases Branch, to figure out if others were infected and how these campers became sick in the first place.

Investigating the outbreak

LDH’s interviews with the campers revealed that about half of the people on this camping trip were sick. They asked the CDC to test the campers’ urine samples, which confirmed histoplasmosis.

“The rapid and robust public health response to this outbreak highlights the importance of partnership and enhanced collaboration between CDC and state health departments,” said Nancy Chow, PhD, a molecular epidemiologist with the Mycotic Diseases Branch. 

The fungus lives in the environment, particularly in soil that contains large amounts of bird or bat poop.  But, none of the sick people remembered any bird or bat poop at the campsite. Or, at least that’s what LDH initially believed. The team searched the entire campsite looking for clues about where these campers could have become exposed to the fungus.

After more investigation, LDH learned that the campers participated in many different activities, including hiking, collecting firewood, digging soil and geocaching. Geocaching is a digital scavenger hunt-like game played through a smartphone app. The app directed the campers to different objects and locations throughout the campsite, which soon became key to the investigation, getting public health officials one step closer to the source of the outbreak.

This hollowed-out tree was found to be the source of Histoplasma at a Louisiana campsite.

The Mycotic Diseases Branch laboratory tested soil samples from areas surrounding a few of the geocaching sites and found that one of the samples tested positive for Histoplasma. The sample was from a hollowed-out tree that reportedly had bats living inside, based on photos. This site was one of the geocaching sites many of the campers had visited, making all the more sense that it was the source of infection.

After uncovering the site of this fungus, LDH worked to identify any potential high-risk areas to prevent others from becoming exposed, and told campers to avoid activities involving soil disturbance. Additionally, a summary risk reduction document was provided to camp officials for all future campsite visitors.

Preventing future outbreaks

The investigation team recommended that future campers consider the following to help prevent people from getting histoplasmosis:

  • Avoid soil disruption activities (including geocaching) and contact with hollow trees.
  • Teach campers about the risks for histoplasmosis and other fungal diseases, especially those who are weakened immune systems and at high risk.
  • Spread more awareness about histoplasmosis throughout Louisiana.
“Fungal disease outbreaks are relatively rare — this investigation confirmed that histoplasmosis is endemic to Louisiana, and that disruption of soil is still a significant health risk for both sick and healthy individuals,” said Jose Serrano, MPH, an LDH epidemiologist specialist and lead investigator of this outbreak.

“Once this outbreak was confirmed, every single epidemiologist dropped what he or she were doing to lend a helping hand in the investigation. Our strength comes from our teamwork, and no investigation is ever handled alone,” he said.

Learn more about histoplasmosis here.

Friday, June 7, 2019

Health equity: Informing LDH staff, practices and protocols to improve services, health and health outcomes

By DR. EARL BENJAMIN-ROBINSON, D.H.Sc. | LDH Deputy Director of Community Partnerships

In LDH’s Friday, April 26 blog, “Making 2019 the Year of Public Health for Louisiana,” Dr. Alexander Billioux noted that despite some improvements regarding Louisiana’s health outcomes and healthcare access, Louisiana continues to rank among the unhealthiest states in America. He then posed a rhetorical question: “Why does Louisiana continue to be ranked low with these improvements?” His answer: “Achieving and maintaining good health requires more than healthcare.”

Dr. Billioux’s answer is poignant and right!

Human beings cannot and do not live on bread alone, neither do they acquire or sustain wellness and well-being just by having access to healthcare. There are factors that affect people, populations and communities’ health and wellness. These factors are barriers to health, also referred to as social determinants of health: economic and social factors that contribute to and/or shape a person’s health and health outcomes. The World Health Organization defines barriers to health as “the conditions in which people are born, grow, live, work and age.”

Culture, social norms and policies affect the conditions in which people are born, grow, live, work and age. Conditions are further compounded by a society’s distribution of money, power and resources resulting in differences in health and healthcare between population groups — health disparities. Many of these health disparities occur across a number of demographics, including socioeconomic status, age, location, gender, disability status, race/ethnicity and sexual orientation. Additionally, many health disparities experienced and observed in Louisiana are seen as unnecessary, avoidable and unjust — health inequities.

Given these factors, concepts and Louisiana’s health inequities, LDH continues in its commitment to support all Louisianans in achieving their best, fullest health outcomes — health equity. According to the Robert Wood Johnson Foundation, “Health equity means that everyone has a fair and just opportunity to be as healthy as possible.” In an effort to achieve and sustain this, LDH will focus more intentionally on the words of Dr. Georges C. Benjamin, executive director of the American Public Health Association: "Eighty percent of what makes us healthy happens outside the doctor’s office.”

With this in mind, LDH is presently working to put practices and protocols in place that are informed by people, populations and communities’ behavior, social environment, physical environment and their experiences with health services.

We are excited about this work, and more equitably meeting the needs and supporting the wellness and well-being of the citizens of Louisiana. Stay tuned for more to come!

Friday, May 31, 2019

Protect the skin you're in

It’s summer in Louisiana and the heat is on.

Did you know daytime weather from June through August averages around 90 degrees Fahrenheit? On top of that, humidity hovers in the 90 percent range most days. Between the heat and the humidity, it’s no surprise that we feel hot and sweaty on a daily basis.

June, July and August are also among the sunniest months Louisiana sees all year, which makes it so important to protect yourself from harmful sun exposure. Skin cancer was the ninth most commonly diagnosed cancer in Louisiana between 2010 and 2014, according to the Louisiana Tumor Registry, which collects information about all cancers diagnosed and/or treated in Louisiana.

Ultraviolet (UV) radiation, which comes from the sun, reaches us whether the weather is sunny, cloudy or hazy. The most hazardous hours for UV exposure in the lower 48 states are from 10 a.m. to 4 p.m. CST.

What is skin cancer?

Cancer is a catch-all term for a disease in which abnormal cells in the body divide uncontrollably and invade other tissues, spreading throughout the body through the blood and lymph systems.

Skin cancer, the fourth most common form of cancer in the U.S., is usually caused by overexposure to UV light. It is commonly classified into three types.

  • Basal cell carcinoma begins in the basal cell layer of the skin. The bad news is it can be disfiguring and expensive to treat, but the good news is that it’s highly curable.
  • Squamous cell carcinoma begins in the squamous layer of the skin. Like basal cell carcinoma, it’s highly curable though it can be expensive to treat and cause disfigurement.
  • Melanoma begins in the melanocytes, the cells that produce the pigment that gives skin its color. It is the third most common skin cancer, but it’s the most dangerous and the most deadly.

Skin cancer doesn’t discriminate against anybody, but it’s more likely to develop in people with these characteristics, according to the Centers for Disease Control and Prevention (CDC):

  • A lighter natural skin color
  • Skin that burns, freckles, reddens easily or becomes painful in the sun
  • Blue or green eyes
  • Blond or red hair
  • Certain types and a large number of moles
  • A family history of skin cancer
  • A personal history of skin cancer

If you have any of these characteristics — and even if you have none — it’s vital that you protect yourself when being exposed to the sun.

Safety in the sun

The CDC recommends these simple steps to protect yourself from UV radiation:

  • Stay in the shade, especially during midday hours. If you’re outdoors, sit beneath an umbrella, a shady tree or other shelter.
  • Wear clothing that covers your arms and legs. Choose tightly woven fabrics for the best protection. Keep in mind that a typical T-shirt has a sun protection factor (SPF) lower than 15, so use other types of protection as well.
  • Wear a hat with a wide brim to shade your face, head, ears and neck. Hats made of tightly woven fabric, such as canvas, are preferable. Avoid straw hats with holes that let sunlight through. If you wear a baseball cap, you should also protect your ears and the back of your neck by wearing clothing that covers those areas, using sunscreen with an SPF of 15 or higher or by staying in the shade.
  • Wear sunglasses that wrap around and block both UVA and UVB rays. Most sunglasses sold in the U.S. block both UVA and UVB rays.
  • Use sunscreen with an SPF of 15 or higher, and both UVA and UVB (broad spectrum) protection. Apply a thick layer on all parts of exposed skin. Get help for hard-to-reach places like your back. Reapply sunscreen if you stay out in the sun for more than two hours and after swimming, sweating or toweling off.

Sunscreen safety concerns

Sunscreen has been making headlines recently after a pilot study found it takes just one day of sunscreen use for several common ingredients to enter a person’s bloodstream at worrisome levels and for some to continue to build in the blood as daily use continued.

The Center for Drug Evaluation and Research, an arm of the United States Food and Drug Administration (FDA), conducted the study, published in the medical journal JAMA. The study concluded four common sunscreen chemicals — avobenzone, oxybenzone, ecamsule and octocrylene — are among 12 chemicals in need of further research by manufacturers before they can be considered “generally regarded as safe and effective.”

That doesn’t mean you should stop using sunscreen, because we don’t yet know whether these ingredients have any harmful effects after they are absorbed. We do know, though, that overexposure to the sun is harmful, so continue to protect your skin.

Let’s talk indoor tanning

If you think indoor tanning is a safe alternative, think again. The CDC says indoor tanning — whether it’s a tanning bed, booth, sunbed or sunlamp — should be avoided. All of these methods expose users to high levels of UV radiation, which may result in skin cancer. Just because it’s from a mechanical source doesn’t make it any safer than the UV radiation you’re exposed to when out in the sun.

Screening saves lives

The importance of getting screened for cancer cannot be overstated. Through screening, doctors can help find and treat a number of cancers at an early state, before symptoms show up. Cancer that is detected after symptoms appear may have begun to spread and therefore be harder to treat.

Talk to your doctor if you’re concerned about skin cancer — or any other type of cancer, for that matter.

Tackling cancer in Louisiana

The Louisiana Department of Health’s Taking Aim at Cancer in Louisiana (TACL) initiative launched last year and is working toward improving cancer outcomes in the state. TACL’s goals are increasing access to care, improving the quality of care and reducing the costs of care.

To learn more from the Department of Health about cancer in Louisiana, click here.

The bottom line

So, what’s the bottom line when it comes to sun exposure and tanning, according to the CDC? Every time you tan, you increase your risk of getting skin cancer. Take steps to avoid those harmful UV rays. And remember, skin safety isn’t just for the summer months. Protect the skin you’re in — every day.

Friday, May 24, 2019

Say cheese! Well-Ahead Louisiana aims for healthy smiles across the state

By MeCHAUNE BUTLER, MPA | Oral Health Promotion Manager, Well-Ahead Louisiana;  GEORGENA DESROSIER, MPH | Oral Health Promotion Coordinator, Well-Ahead Louisiana; and ANGELA VANVECKHOVEN | Health Education Manager, Well-Ahead Louisiana 

Oral disease is almost completely preventable, but it still affects children and adults throughout Louisiana every day. Oral health has a direct impact on many other diseases and conditions, including diabetes, heart disease and stroke. Additionally, gum disease in pregnant women is associated with premature births and low birth weight.

Along with those risks, 83% of the state’s parishes have a shortage of dental care providers. That is why Well-Ahead Louisiana, an initiative of the Louisiana Department of Health, focuses on promoting oral health through expanded access to preventive dental services, specifically through school dental sealant programs.

Dental sealants

Dental sealants prevent 80% of cavities on the back teeth, where 9 out of 10 cavities occur. These thin plastic coatings are applied to the chewing surfaces of the first and second molars, where food and bacteria are not easily removed, acting as a barrier to protect the teeth from plaque and acids that cause tooth decay. When correctly applied, dental sealants last several years before reapplication is needed.

School dental sealant programs

Tooth decay causes pain, and children suffering from dental pain cannot focus or be productive, particularly during school. School dental sealant programs are an evidence-based best practice for preventing tooth decay among children who are less likely to see dentists in a private practice. Schools are an ideal place to reach children, and they play a pivotal role in affecting children’s health. In Louisiana, a dentist must first perform an oral health screening; a dentist, dental hygienist or other qualified dental professional can then apply sealants.

These programs are either school-based or school-linked. School-based are conducted completely within the school setting using portable dental equipment. School-linked can include transporting the children to a linked federally qualified health center, having a mobile bus or van at the school, or holding the program in a school-based health center.

Louisiana Seals Smiles

Well-Ahead Louisiana is excited to continue its Louisiana Seals Smiles program, which is a replicable program that provides free oral health screenings and dental sealants to eligible students ages 6 to 14.  Recently, the Louisiana Seals Smiles Toolkit was added to Well-Ahead’s website to provide guidance and resources for any provider who wants to implement a school dental sealant program in his or her community. It includes step-by-step instructions for implementation and printable, ready-to-use downloads like parent flyers, a clinic charting form, a dental report card and more.

Children who have good oral health are better able to learn, grow and play. Be a leader in ensuring youth in your community have healthy smiles by using the toolkit to start a school sealant program. Together, we can move Louisiana’s health forward.

For more information

To learn more about oral health, visit Well-Ahead Louisiana or email wellahead@la.gov.

Friday, May 17, 2019

Mental health affects everyone, not just those with a mental illness

By DR. REBEKAH GEE | Louisiana Department of Health Secretary

Last fall, NOLA.com | The Times-Picayune's series “A Fragile State” placed a spotlight on one of our most vulnerable populations. Full of heartbreak and sometimes hope, these courageous stories reminded us of the tragic impact of mental illness on families and individuals in our state. Because May is National Mental Health Month, I turn to these stories once more as a call to awareness and action.

“A Fragile State” vividly portrayed the enduring impact of years of financial cuts and psychiatric hospital closures that occurred under the Jindal administration, actions that left thousands of people without some vital services. Now, however, the ball is in our court, and Louisiana can and must do better. 

These individual stories are heartbreaking and the solutions are complex. More inpatient beds are needed as well as adequate numbers of doctors who can treat patients who have mental health and substance use illnesses. True solutions start with addressing poverty, health disparities, early childhood trauma and violence – issues beyond the walls of a doctor’s office or hospital. The seeds of mental illness and addiction are sown in the pain of trauma and neglect. Louisiana must also invest new funds and renewed dedication to ensuring quality care options in the community – more crisis services and greater access to these services – are available for people when they need them most.

A lifetime of care

We need to demand care that occurs throughout the life course. This means a pregnant mom with mental illness is treated and there is help available as she parents her child. When and if a school-age child suffers from mental illness, she is diagnosed and treated instead of failing and dropping out.

It means that a family with a son in a sudden crisis is treated for mental illness instead of ending up in the criminal justice system, leaving a trail of pain in his wake. It means that individuals and families always know who to call and what to expect when help is needed.

Care throughout a person’s life, with a strong focus on immediately helping those who are facing a crisis, is the mental health system Louisiana must commit to building. This system will require more providers, more resources and greater investments from our communities.

An ideal system includes easily accessible mental health services in the community. Inpatient beds will be a component of this continuum, but not its foundation. We must address crises via mobile crisis response or specialized drop-in centers, for example, and the system should address homelessness and lack of transportation that can get in the way of recovery.

The Louisiana Department of Health is focusing on four critical areas: ensuring there is a full continuum of care, implementing effective crisis services, improving the access to and quality of care, and making the mental care system easier to navigate.

First and foremost, under Gov. John Bel Edwards’ leadership, we led the charge for coverage under Medicaid expansion. Prior to expansion, most low-income adults in Louisiana had no health insurance and no access to treatment for mental health. Rather than treating mental illness, it fell to the correctional system to remove mentally ill individuals from society, rather than treating people and preventing harm to others.

Since Medicaid expansion, more than 485,000 adults are now covered, of whom more than 65,000 have received specialized outpatient mental health services and more than 15,000 have received inpatient mental health care at a psychiatric facility. Tens of thousands of people have received treatment for addiction. We have sought and received millions of new federal dollars for addiction treatment and are rebuilding our system of mental health care in partnership with local human service districts that serve as the safety net for mental health care.

The way forward

The journey for families with a loved one with mental illness can be excruciating, even for our citizens with high incomes and the means to pay for care. The Louisiana Department of Health is charged with taking care of those in the shadows, individuals who are sometimes forgotten, neglected, the most vulnerable and complex. We are failing in that charge.

“A Fragile State” is a raw and honest account of a system that needs to change. That change will be led by the Department of Health, but it is bigger than a single state agency. Change will come only when we work in tandem with the community, with law enforcement, with the judicial system and any other stakeholders in mental health.

We commit that as a Department we will continue to fight this battle on all available fronts — to rebuild and strengthen a system of care that too often fails those who are desperately in need of help. This will not be easy, but we commit to fight for the systems of care and the resources needed to win the struggle against mental illness and addiction so that people can thrive. Only then will our communities reach their full potential.