Vaccines save lives. Period.

By DR. DAWN R. MARCELLE | Region 2 Medical Director, LDH Office of Public Health

Keeping our children safe and healthy rank among the highest of parents’ concerns — and where safety and health meet, the topic of vaccines will often arise. While parents have the right to make decisions about their children’s health, as a pediatrician and a mother of two, I can confidently say without hesitation that overall, vaccines are safe and effective.

Vaccines are the best way to protect your child against a number of illnesses, including measles, whooping cough (pertussis) and mumps, all of which have made a comeback in recent years due to a drop in vaccination rates. Other vaccine-preventable illnesses include tetanus, diphtheria, varicella (chickenpox), rubella, hepatitis B, polio, meningococcal meningitis and influenza, especially now with flu season in full swing across Louisiana.

How they work

A vaccine contains a version of the bacterium or virus responsible for a particular disease. Vaccines can be live (containing a weakened form of the bacterium or virus) or inactivated (containing a killed version of the bacterium or virus).

For example; if you receive a chickenpox vaccine, the presence of the chickenpox virus in the vaccine causes the body to think that it’s under attack. This activates the immune system, which treats the weakened/dead chickenpox virus (antigen) like a full-blown infection and makes antibodies to fight off the disease. These chickenpox antibodies remain in the person’s immune system, ready to provide active protection if you come into future contact with live chickenpox virus.

Immunization schedules

With so many vaccines out there, how is a parent to know which vaccine is needed and when? That’s where immunization schedules are helpful. Developed with your child’s safety in mind, immunization schedules show which vaccines are given at which stages of your child’s life. Following such schedules provides immunity early in life before most infants and children are exposed to life-threatening diseases.

Vaccination schedules are developed by the CDC’s Advisory Committee on Immunization Practices (ACIP). The committee includes physicians and public health practitioners who are dedicated to keeping children safe and healthy. All vaccines listed on immunization schedules have been exhaustively tested to be sure they are safe and effective. Sometimes multiple vaccines will be given at a single pediatric visit, and this is safe and normal. There’s not enough antigens in vaccines to overload a healthy baby’s immune system. In fact, during an average day a baby will encounter more antigens than they will receive in a vaccine.

Some parents, expressing concern about the number of vaccines their children receive from infancy to school age, may wish to follow an alternative schedule that spreads out vaccines or even skips some entirely. This practice is discouraged by the American Academy of Pediatrics, which recommends parents follow established immunization schedules. These schedules are for your child’s protection, and following them gives your child immunity early in life, before they can be exposed to potentially deadly diseases like measles.

Keep in mind that some children can’t be vaccinated, such as those with weakened immune systems due to an illness or medical treatment. The best protection for these children is for everyone around them to be vaccinated — that includes parents, grandparents, siblings, aunts, uncles and any caregivers.

Life savers

As a pediatrician, let me say once again that vaccines are overwhelmingly proven safe and effective. I encourage parents to follow the recommended immunization schedules to give their children the best possible protection against a number of serious diseases.

The American Academy of Pediatrics considers vaccines to be one of the the most significant medical innovations of our time. Considering the countless lives saved thanks to vaccines, I couldn’t agree more.

Helpful links

• View the Centers for Disease Control and Prevention (CDC) immunization schedule: https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html
• View the State of Louisiana’s 2019 immunization schedule: https://lalinks.org/linksweb/pdf/Immunization%20Schedule_January%202019.pdf
• Review and print your child’s official immunization records at any time, free of charge: https://la.myir.net/
• Free vaccines for qualified children younger than 19 years of age: http://www.ldh.la.gov/index.cfm/page/3015

Friends and family will be thankful for these healthy Thanksgiving dishes

Thanksgiving is famously known as a time for good eating. Your eyes are often bigger than your stomach, and you may be eating special foods that only come around once or twice a year. In anticipation of packing so many delicious dishes into your belly, you may even bring out your “fat pants” so you have extra room.

But, instead of letting temptations run free, why not make a healthy and delicious contribution to the Thanksgiving table? A little planning and preparation can go a long way toward giving you and your loved ones’ waistlines something to be thankful for, like one of these better-for-you side dishes from Well-Ahead Louisiana.

If you’re serving a larger group than what the recipe calls for, no worries — just double or even triple the recipe to meet your needs. Click on any recipe card to enlarge it.

When Thanksgiving is over, what can you do with leftover turkey besides sandwiches? Try a hot, comforting and healthy cup of soup. To make this soup lower in saturated fat, prepare it ahead of time to cool and skim off the fat that rises to the top.

For more healthy lifestyle advice, visit Well-Ahead Louisiana.

Happy Thanksgiving!

Time to travel, but do it safely

By DR. DAVID J. HOLCOMBE | Medical Director, LDH Region 6

With summer well behind us and school in session, it is a great time to travel. Seniors, with time and disposable income, can devote more of their life to exploring the U.S. and abroad. In fact, world travel for all ages has exploded in the last few decades, with more people traveling to more and more exotic locations, often remote and underdeveloped.

Travelers need to consider many precautions, however, prior to any long-distance, prolonged voyage in order to have a safe experience.

Precautions start in the airplane. Reduced cabin pressure, prolonged inactivity and close quarters predispose travelers to reduced oxygen, deep venous thromboses and increases in airborne or contact transmitted infections.

Once on site, exotic foods, wild animals and insect-borne illnesses all pose threats to travelers. Avoiding unfiltered water and raw or undercooked foods, especially from street vendors, can go a long way toward preventing food- and water-borne diseases. Never touch or approach any dogs, cats, or other domestic or wild animals, since rabies is common around the world.

Safe driving, safe sex and mosquito avoidance can prevent a whole host of serious health issues.

High altitude carries its own danger of altitude-related sickness, a significant risk for older travelers and those with chronic heart or lung diseases. Careful acclimatization or the use of medications such as Diamox may be required.

Remember to use caution when climbing the steps of that wonderful, ancient pyramid or magnificent cathedral.

Vaccinations

Vaccinations largely depend on the location of travel. All travelers need to consult www.cde.gov/travel for site-specific vaccination recommendations.

• Yellow fever vaccination is required for multiple areas of Africa and South America. Unfortunately, stocks of the vaccine are severely limited worldwide and there is only a single site in Louisiana — in Metairie — with consistent availability.
• Hepatitis A and B vaccines should be up to date since both diseases remain widespread in developing countries. Because both vaccines are administered in a series that takes from four to six months to complete, do not wait until the last minute. That being said, it is better to be partially vaccinated than not vaccinated at all.
• Meningitis vaccine remains necessary for most of Sub-Saharan Africa, especially in the dry winter season from December through June.
• Typhoid vaccine, as either an injection or four capsules taken over seven days, offers protection, especially for travelers in Southeast Asia.
• Japanese encephalitis vaccine is also recommended in some parts of Asia, especially rural areas.
• Cholera, transmitted by contaminated food and water, remains a danger and travelers to countries where it occurs should be vaccinated with a single oral dose of the vaccine.
• Influenza (flu) varies depending on the season, which differs in the Northern (winter) and Southern (summer) hemispheres. Annual vaccination against the flu protects in either hemisphere although variations occur in the organism due to genetic shifts in the virus.
• Measles, mumps and rubella remain worldwide threats and that particular vaccine (MMR) should be administered to those born from 1957 to 1989. Measles is highly contagious and rates are much higher outside the U.S., even in Europe.
• Poliomyelitis and TdaP (tetanus, diphtheria and pertussis or whooping cough) vaccines should be up to date prior to any travel.

Pregnant women and those with complex medical conditions should always consult a physician prior to travel. Both MMR and varicella are live vaccines and should not be given to pregnant women.

Medications and insurance

Everyone should carry enough medication for the entire trip as well as a complete list of his or her medications (with commercial and generic nomenclature) and the doses.

For older travelers, remember that Medicare does not work overseas. Some private insurances do cover clients out of the U.S. but this coverage varies significantly. Supplemental health insurance for travelers is available for a price, often hefty in senior citizens.

Travel should be a mind-expanding experience and not one ending in costly medical problems or death. See the world, have fun, but be sure to take all the necessary precautions for safe travel. Prevention is always the best medicine at any age and anywhere in the world.

Vulnerable adults can be easy targets for financial abuse

By SHARON JACKSON | Adult Protective Services Program Director, LDH Office of Behavioral Health

News headlines in recent months have brought us stories of elderly Louisianans who have been tricked into withdrawing money from the bank or taking money from a family member’s account without permission, among other stories of financial abuse. While cases such as these are handled by the Governor’s Office of Elderly Affairs, which serves people ages 60 and older, there is a resource within the Louisiana Department of Health that serves a similar purpose for those under 60.

Adult Protective Services (APS) operates under the umbrella of the Department’s Office of Aging and Adult Services, serving ages 18 to 59 and emancipated minors (those who are legally considered an adult). APS investigates reports of abuse and arranges for services to protect vulnerable members of these populations who are at risk of abuse, neglect, exploitation or extortion.

Financial abuse, including exploitation and extortion, is one of the allegations APS investigates, and the number of cases APS investigates has been on the rise over the past several years. Reports of vulnerable adult Louisianans falling victim to financial abuse climbed from 760 in 2017 to 828 in 2019. It’s the third most common kind of abuse investigated by APS in Louisiana, after caregiver neglect and emotional abuse. While being highly common, financial abuse is also highly underreported.

What is considered financial abuse?

Adult Protective Services handles issues of theft and fraud by a family member, caregiver or other parties known to the adult.

Theft involves assets taken without the adult’s knowledge, consent or authorization. It may also include the taking of their cash, valuables, medications or other personal property. Fraud involves acts of dishonestly by those entrusted to manage the adult’s assets but instead use them for unintended purposes. Fraud may include falsification of records, forgeries, unauthorized check-writing and Ponzi-type financial schemes.

According to the National Adult Protective Services Association (NAPSA), vulnerable adults who fall victim to financial exploitation may be subject to:

• Loss of trust in others
• Loss of security
• Depression
• Feelings of fear, shame, guilt, anger, self-doubt, remorse and/or worthlessness
• Financial destitution
• Inability to replace lost assets through employment
• Inability to hire an attorney to pursue legal protections and remedies
• Becoming reliant on government safety net programs
• Inability to provide long-term care needs
• Loss of primary residence

Sometimes, people who have been the victims of financial abuse may also be victims of physical and/or emotional abuse or neglect.

Reporting abuse

Louisiana’s Adult Protective Services Reporting Law requires all Louisianans to report abuse, neglect, exploitation and extortion of adults with disabilities. Any citizen who reports in good faith and who cooperates or participates in judicial proceedings to assistant in an investigation by APS is granted immunity from civil or criminal liability.

Under this law, anyone who knows of such an incident and fails to report it or knowingly makes a false report is subject to criminal penalties.

To report a case of a vulnerable adult (between ages 18 and 59) who may be at risk of abuse, call APS at 1-800-898-4910. This toll-free hotline takes reports 24 hours a day, seven days a week. If the situation threatens the life of an adult with disabilities, call 911 immediately.

You don’t have to give your own name when making a report, but doing so along with providing your contact information helps APS with its investigation if additional information or details are needed at a later date. If you choose to share your name, it will be kept confidential unless the case requires the involvement of law enforcement.

When reporting a case to APS, you’ll need to provide the alleged victim’s name, location and details of the alleged abuse. Share as much information as possible. APS will screen your report to make sure it’s appropriate for APS services. If deemed appropriate, an APS specialist is assigned to the case. This specialist will conduct an investigation and arrange protective services for the victim.

Investigating abuse

Depending on the victim’s risk of harm, an investigation will begin within 24 hours or before 10 business days of the report being filed, with investigations being completed within 30 days. Because APS is not a law enforcement agency, these probes are not criminal investigations. However, APS may refer a case to law enforcement or the District Attorney’s Office when a crime is suspected.

If during the course of the investigation the victim is determined to be at continued risk of harm or mistreatment has occurred, APS will use social service or civil legal options to protect the victim. Interventions to protect the victim or reduce their risk of harm go into action within 90 to 120 days, though competent adults have the legal right to refuse intervention.

APS investigations are confidential, so results can’t be shared or released except for certain information and only to the victim and/or their legal representative and with law enforcement, medical or social service agencies, as needed, to coordinate services to the victim.

Remember: If you suspect or have evidence that someone is being financially abused, report it. Help keep some of our most vulnerable Louisianans safe.

For more resources on Adult Protective Services, click here.

Center for Evidence to Practice working to improve behavioral health

The Louisiana Department of Health’s Office of Behavioral Health and the LSU Health New Orleans School of Public Health are proud to say the Center for Evidence to Practice is up and running.

Now, you’re probably wondering — what is the Center for Evidence to Practice? This initiative serves Louisiana as a hub for training and implementation of best practices for behavioral health services for children, youth and families.

Behavioral health evidence-based practices are therapies that have undergone the multiple, rigorous, randomized controls vital to determine whether a practice has proven to be effective. While many behavioral health therapies exist, only a handful are considered best practices. Evidence-based practices in behavioral health are a nationally-recognized strategy to seeing improved outcomes, and it’s something that’s been gaining steam in Louisiana.

Resources at your fingertips

One of the biggest achievements of the Center’s launch is its website, laevidencetopractice.com. If you’re a parent seeking help for your child, a behavioral health service provider or any other kind of stakeholder in behavioral health, you will want to check out this website.

There’s a statewide map that shows where to find specialized, trained providers certified in evidence-based practices and providers currently working toward certification. This map is continually being updated, so if you find inaccurate information, just use the “Contact Us” function on the website to report it so that it can be corrected.

Another feature is a calendar listing events and trainings for behavioral health providers, sponsored by the Center and by other partners such as state agencies and managed care organizations. Many of these trainings are free of cost to providers who serve Medicaid-eligible youth.

You also will have the option to sign up for the Center’s newsletter, Behavioral Health Buzz, which includes monthly updates on evidence-based practice trainings and implementation.

Coming soon is E2P Learn, an online e-learning platform for behavioral health provider agencies, practitioners and other stakeholders. This platform will use videos and webinars to provide comprehensive support for the implementation and sustainability of evidence-based practices in Louisiana.

Find behavioral health providers certified in evidence-based practices using a map available
on the Center for Evidence to Practice website, laevidencetopractice.com

Best practices

So, what are these evidence-based practices? The Center currently recognizes these 10 evidence-based practices in Louisiana:

• Homebuilders: A home-based intensive family preservation services treatment program that enlists families as partners in assessment, goal setting and treatment planning, with the aim of avoiding unnecessary placement of children and youth into foster care or other out-of-home placements.
• Functional Family Therapy (FFT): Home-based intensive therapeutic model for families with multiple risk factors, serving youth ages 10 to 18 in the context of their families. The goals are to reduce behavioral and emotional problems in youth through family therapy that engages and motivates the family to improve family functioning, and change behaviors such as truancy, aggression and substance use.
• Multisystemic Therapy (MST): An intensive home-, family- and community-based treatment serving youth ages 12 to 17, in the context of their families, who are exhibiting significant negative behaviors such as chronic or violent juvenile offenses.
• Assertive Community Treatment (ACT): An intensive home- and community-based intervention delivered by an interdisciplinary team, for individuals 18 and older with a severe and persistent mental illness, with the goal of promoting symptom stability, increasing the individual’s ability to cope and relate to others, and enhancing the highest level of functioning in the community.
• Functional Family Therapy – Child Welfare (FFT-CW): Home-based intensive therapeutic model for families of youth ages birth to 18, where there are issues of child safety/neglect/family violence. The goals are to address safety and risk factors, change referral behaviors, reduce child maltreatment risk and preserve home placement.
• Parent-Child Interaction Therapy (PCIT): Therapy that focuses on improving parent-child relationships, by coaching the parents of young children in specific skills to help establish a nurturing relationship with their child, foster positive behavior and discourage negative behavior.
• Child-Parent Psychotherapy (CPP): A parent-child therapy for children up to age 6, which addresses trauma with the caregiver and child, with the goal of supporting and strengthening the parent-child relationship as a vehicle for restoring and protecting the child’s mental health.
• Youth- and Preschool-PTSD Treatment (YPT and PPT): For children who have experienced trauma, a therapy that works with parent and child to acknowledge the trauma experienced, learn skills to cope with trauma reminders and reduce the severity of trauma-related symptoms.
• Triple P Positive Parenting Program (Triple P-Standard Level 4): Parenting skills program for parents seeking intensive training in positive parenting skills.
• Trauma-Focused Cognitive Behavioral Therapy (TF-CBT): For youth ages 3 to 18 who have experienced trauma, this therapy provides skills for relaxation, emotion regulation and coping, and helps both the child and the caregiver to understand and process the trauma experience, to reduce trauma-related symptoms and enhance future safety.

By identifying these evidence-based practices, Louisiana behavioral health providers are able to apply the most appropriate therapy to youth and families, helping them to heal and live full, healthy lives.

To learn more about the Center for Evidence to Practice, visit laevidencetopractice.com.