CDC: Rhode Island Hit with Widespread Flu

Published in the Woonsocket Call on January 6, 2018

The U.S. Centers for Disease Control (CDC) says it’s a no brainer as to what issue I should cover this week. Being homebound for three or four days, with the flu, and my submittal deadline looming, I pen my commentary on widespread flu activity now being reported in Rhode Island.

CDC’s Influenza surveillance (ending Week 52) reported widespread influenza “flu” activity in 24 states including Rhode Island. This CDC warning recently triggered a requirement by the Rhode Island Department of Health (RIDOH} to require unvaccinated healthcare workers in a variety of health care settings to wear masks when entering a person’s room, serving food, or participating with patients in group activities.

The masking requirement helps protect healthcare workers from catching the flu, and helps protects patients who are often dealing with other serious health issues,” said Director of Health Nicole Alexander-Scott, MD, MPH., in a statement released on January 2. “For people who have not been vaccinated yet, it is not too late. Flu vaccine is the single best way to keep yourself and the people you love safe from the flu. Getting vaccinated today will provide you with months of protection,” she says.

According to the RIDOH, typical flu symptoms include having a fever, coughing, a sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people also may have vomiting and diarrhea. People may be infected with the flu, and have respiratory symptoms without a fever.

There are many types of illnesses or injuries even less severe cases of the flu do not require a visit to the emergency room, says RIDOH, noting that less severe cases of the flu will be treated more promptly by a primary care provider or in urgent care facilities. The department notes that going to an emergency room can oftentimes result in long waits because emergency room providers prioritize more serious injuries and medical conditions.

But, when do you seek out treatment for a nasty case of the flu? RIDOH says that difficulty in breathing or shortness in health, pain or pressure in the chest and having flu-like symptoms that improve and return with a fever and worse cough are clear warning signs to go immediately to an emergency room.

CDC expects that increased flu activity in the coming weeks, noting that the average duration of a flu season for the last five seasons has been 16 weeks, with a range of 11 weeks to 20 weeks. With significant flu still to come this season, CDC continues to recommend that anyone who has not yet gotten a flu vaccine this season should get vaccinated now. It takes approximately two weeks for the protection provided by vaccination to begin.

Although 480,000 Rhode Islanders were vaccinated last year, RIDOH, says that the flu sent 1,390 Rhode Islanders to the hospital and resulted in 60 deaths (compared to 1,216 hospitalizations and 33 deaths the previous year. The state saw more flu activity during the 2017-2018 flu season than during any flu season since the 2019-2010 season, when the state experienced the state experienced the H1N1 flu pandemic.

It’s Not too Late to Get Vaccination

In kicking off Rhode Island’s annual flu vaccination campaign last October, RIDOH Director Nicole Alexander-Scott, MD, MPH, said, “A flu shot is the single best way to protect yourself and the ones you love against the flu. When you get a flu shot you are not only protecting yourself, you are also protecting the people in your life by limiting the spread of the flu.”

So, if you have not been vaccinated, consider doing so. RIDOH recommends that children older than 6 months of age should be vaccinated against the flu. Others should, too., including health care workers, pregnant women, people over age 50, nursing facility residents and persons with chronic conditions (specifically heart, lung, or kidney disease, diabetes, asthma, anemia, blood disorders, or weakened immune systems).

It’s easily to quickly get a flu shot because of its availability at doctors’ offices and pharmacies throughout Rhode Island.

In addition to getting a flu shot, here are a few simple tips that can help prevent you from getting the flu.

Wash your hands thoroughly throughout the day, using warm water and soap. If you do not have soap and water, use an alcohol-based hand gel.

According to the CDC, the flu can spread to others up to about 6 feet away, by droplets made when a person cough, sneezes or talks. So, reduce spreading the flu, just by coughing or sneezing into your elbow or into a tissue.

Avoid touching your eyes, nose, or month because germs spread this way.

Get a good night’s sleep, be physically active and look for ways to manage your stress. Also, drink plenty of fluids, and eat nutritious food.

Keep surfaces wiped down, especially bedside tables, surfaces in the bathroom, and toys for children, by wiping them down with a household disinfectant.

Rotary Gears Up to Eradicate Polio

Published in the Woonsocket Call on October 16, 2016

Just days ago, Louis A. Marciano came to St. Paul’s Church on a mission to get his fellow Pawtucket Rotarians more involved in Rotary International’s efforts to create a polio-free world. Marciano, a former Mount Pleasant High School football player, a coach, a World War 11 veteran who fought in the Pacific Theater and a Rotarian for over 44 years, came to publicize the upcoming World Polio Day on October 24 and give an update on the international service organization’s efforts to eradicate Polimyelitis (polio).

Polio is a paralyzing and potentially fatal infectious disease that still threatens children in some parts of the world. The poliovirus invades the nervous system and can cause total paralysis in a matter of hours. It can strike at any age but mainly affects children under five. Polio is incurable, but completely vaccine-preventable. The infectious disease is found mostly in lower-income countries where poor sanitation and limited access to clean water facilitate the spread of the virus.

A Call for Action at
the Pawtucket Rotary Club

Marciano’s calls for assistance in raising funds to pay for polio inoculations for children and ratcheting up the awareness for Rotary’s efforts is not new. For over four decades, the former Rotary club president District 7950 Governor, has taken his fund raising campaign to end polio to 66 clubs in Rhode Island and southern Massachusetts. His efforts has received attention from his national headquarters, too. The North Providence Rotarian cherishes the Soccer Ball award “Kick Polio out of Africa” presented to him in 1998 for his efforts to eradicate Poliomyelitis

Some say that it may well “Takes a Village” to marshal the resources needed to make a world-wide impact. Over 1.2 million Rotary members belonging to 34,000 clubs world-wide work together to raise funds, advocate for government support, serve as volunteers to help immunize children, and raise awareness in their communities, said Marciano to his audience of Pawtucket Rotarians.

At the podium, the Cranston resident rattled off specifics as to why this global effort is important and is succeeding. Ending polio will save lives, is a very good investment, and most important is achievable, says Marciano.

Marciano notes, India is a prime example of one of the greatest Rotary International’s achievements in wiping out polio. “There were zero cases of polio in 2010 in India and they have been polio-free for nearly six years,” he says, noting that the World Health Organization has officially certified India polio-free in 2014. [According to Devin Thorpe in his March 15, 2014 article published in Forbes, in the 1980s there were approximately 150,000 cases of polio every year in India]

Marciano also announced the upcoming fourth annual world Polio Day event, co-hosted with the U.S. Centers for Disease Control and Prevention, to be held on Oct. 24. The event streaming live from CDC headquarters in Atlanta, Georgia, is expected to bring together more than 50,000 viewers around the world to learn from celebrities and experts about the progress to eradicate polio. For information about World Polio, go to http://www.endpolio.org.

While winding down his talk, Marciano acknowledges that there is still work to do but Rotary is moving closer to its goal of finally wiping polio from the face of the earth.

Carol Pandak, Director of Rotary’s PolioPlus program, agrees with Marciano’s assessment. “For more than 30 thirty years, Rotary has harnessed the dedication of community leaders around the world in support of polio eradication. When we started this effort, nearly 1,000 children a day were paralyzed by this disease. Today, there have been only 27 cases [Afghanistan (8); Nigeria (4); Pakistan (15)] in the whole world. Rotary remains fully committed to this important effort until every child is protected from this disease.”

From the Beginning

Rotary’s effort to eradicate polio began in 1979, with a multi-year project to immunize six million children in the Philippines. The international service organizations, “PolioPlus program, was established in 1985.

As indicated by the “plus” in PolioPlus, Rotarians also provide support for related health services, such as distributing Vitamin A and zinc tablets, providing bed nets to prevent malaria, assisting with preventative inoculations for other diseases, including measles, rubella, mumps, tuberculous, and other childhood diseases. The “plus” also means a system of advocacy and fundraising, and infrastructure and partnerships that will support the fight against infectious disease long after polio is gone.

Rotary also works closely with partners in the Global Polio Eradication Initiative (GPEI), including the World Health Organization (WHO), the US Centers for Disease Control (CDC), UNICEF, the Bill & Melinda Gates Foundation, and the governments of the world in this public health initiative.

Today, Rotary has given more than $1.6 billion to immunize more than two billion children against polio in 125 countries to wipe the infectious disease from the face of the earth. It is estimated that Rotary’s advocacy efforts have played a role in decisions by countries to contribute more than $7.2 billion to the effort.

Rotary’s polio initiative has also caught the attention of others. As far back as 2008, one of America’s biggest philanthropists came to the table to fight the war against polio. The Bill & Melinda Gates Foundation announced that every dollar Rotary committed to polio eradication would be matched two-to-one by the Foundation up to $35 million a year through 2018. Since this Foundation began its partnership with Rotary more than $2 billion has been contributed to Rotary’s polio eradication effort.

These funds help to provide much-needed operational support, medical personnel, laboratory equipment.

Public figures and celebrities have also joined Bill & Melinda Gates as ambassadors to help educate the public about polio through public service announcements, social media and public appearances. They include: Kristen Bell and Archie Panjabi; WWE superstar John Cena; supermodel Isabeli Fontana; Nobel Peace Prize laureate Archbishop Emeritus Desmond Tutu; action movie star Jackie Chan; boxing great Manny Pacquiao; pop star Psy; golf legend Jack Nicklaus; conservationist Jane Goodall; premier violinist Itzhak Perlman; Grammy Award winners A.R. Rahman; Angelique Kidjo and Ziggy Marley; and peace advocate Queen Noor of Jordan. These ambassadors help educate the public about polio through public service announcements, social media and public appearances.

Until polio is eradicated, all countries remain at risk of outbreaks, says Marciano.

Experts say that $1.5 billion is urgently needed to sustain the polio eradication initiative. Without full funding and political will power, polio could return to previously polio-free countries, putting children at risk contracting this paralyzing disease. From every corner of the globe Rotarians are gearing up on October 24 to garner support to wipe polio out, once and for all.

National Report Grapples with Impending Alzheimer’s Epidemic

Published in the Pawtucket Times, July 25, 2013
 
            This 56 page report must not sit on a bureaucrat’s dusty shelf.          
 
            With the graying of the nation’s population and a skyrocketing incident rate of persons afflicted with Alzheimer’s disease, the Chicago-based Alzheimer’s Association and the U.S. Centers for Disease Control (CDC) and Prevention release a report last week to address a major public health issue, an impending Alzheimer’s disease epidemic on the horizon.  
 
            Researchers say that in 2013, an estimated 5 million Americans age 65 and older have Alzheimer’s disease. Unless more effective ways are identified and implemented to prevent or treat this devastating cognitive disorder the prevalence may triple, skyrocketing to almost 14 million people.  Simply put, Alzheimer’s disease is now the 6th leading cause of death and 5th among those 65 to 85 years of age.
 

A Call to Arms

 
            On July 15, 2013, CDC, the federal agency charged with protecting public health and safety through the control and prevention of disease, injury, and disability, and the Alzheimer’s Association, the world’s leading voluntary health organization in Alzheimer’s care, support and research, unveiled The Healthy Brain Initiative: The Public Health Road Map for State and National Partnerships, 2013-2018 at the 2013 Alzheimer’s Association International Conference in Boston.
 
           The released report calls for public health officials to quickly act to stem the growing Alzheimer’s crisis and is a follow-up to the 2007 The Healthy Brain Initiative: a National Public Health Road Map to Maintaining Cognitive Health.
 
            “The public health community is now paying greater attention to the Alzheimer’s epidemic that millions of families have been facing for decades and that is poised to drastically increase,” said Robert Egged, Vice President of Public Policy at the Alzheimer’s Association. “On the heels of the 2012 release of the country’s first-ever National Alzheimer’s Plan, the Alzheimer’s Association and CDC have partnered again to create a tool for public health officials to improve the quality of life for those families and advance cognitive health as a integral component of public health,” says Egged.
 
            Released five years ago, the original Road Map addressed cognitive health and functioning from a public health perspective and provided a framework for the public health community to engage cognitive health, cognitive impairment, and Alzheimer’s disease and other dementias. More than 280 experts in the field contributed to this new Road Map report that outlines specific actions steps that state and local public health officials can take to promote cognitive functioning, address cognitive impairment for individuals living in the community and help meet the needs of caregivers.
 
            While federal agencies play a critical role in leading and funding efforts to address Alzheimer’s disease, state and local health departments organize and provide public health services at the community level.
 
            “The goal of the Healthy Brain Initiative is to enhance understanding of the public health burden of cognitive impairment, help build evidence-based communications and programs, and translate that foundation into effective public health practices in states and communities. This Road Map provides guidance to states, communities, and national partners to plan for and respond to this major public health issue,” said Lynda Anderson, PhD, Director of the Healthy Aging Program at CDC.
 
            A former Assistant Secretary at the U.S. Administration on Aging, Bill Benson, now a managing partner of Silver Spring, Maryland-based, Health Benefits ABC, notes that the cost of providing care to people with Alzheimer’s disease will have a drastic impact on the nation’s economy due to the cost of lost productivity, and the care costs for those no longer able to care from themselves. “This does not include the profound personal impact and consequences to those who suffer from Alzheimer’s and to their loved ones,” he says.
 
            “The scope, cost and the extraordinary burden both to individuals and to society make it a true health crisis,” says Benson, stressing that public health officials need to know more about the disease and those who have it, better ways to diagnosis it.  There must also be a better understanding of the economic impact and programs and services that are proven to ease the burden of those who suffer from it and their caregivers, he adds. 
 

Action Steps for Local Communities to Follow

 
            The Road Map report includes more than 30 action steps that the public health community can take at the federal, state and local levels over the next five years to address cognitive health and cognitive impairment from a public health perspective. The actions are intended as a guide for what state and local public health officials could do – on their own or with other national, state and local partners. Agencies are encouraged to select those actions that best fit state and local needs and customize them to match priorities, capabilities and resources.
 
            As to specifics, the Road Map report calls for improved monitoring and evaluation of persons with dementia including Alzheimer’s disease and younger onset as they relate to employment and employers, and defining the needs of these individuals and their caregivers.  Also, increased support should be given to state and local needs assessments to identify racial/ethnic; lesbian, gay, bisexual, and transgender; socioeconomic; and geographic disparities related to cognitive health and impairment.
 
            Public health officials must educate and empower the nation in confronting the epidemic of Alzheimer’s disease by promoting advance care planning and financial planning to care partners, families, and individuals with dementia in the early stages before function declines.  They can also identify and promote culturally appropriate strategies designed to increase public awareness about dementia, including Alzheimer’s disease, to reduce conflicting messages, decrease stigma, and promote early diagnosis.
 
            The Road Map report urges that sound public health policies be developed and partnerships created to collaborate in the development, implementation, and maintenance of state Alzheimer’s disease plans. It also recommends that state and local government integrate cognitive health and impairment into state and local government plans (e.g. aging, coordinated chronic disease, preparedness, falls, and transportation plans).
 
            Finally, the Road Map report also recommends that strategies be developed to help ensure that state public health departments have expertise in cognitive health and impairment related to research and best practices.  Support must also be provided to continuing education efforts that improve healthcare providers’ ability to recognize early signs of dementia, including Alzheimer’s disease, and to offer counseling to individuals and their care partners.
 

A Local View

            Maureen Maigret, policy consultant for the Senior Agenda Coalition of RI coordinator of the Rhode Island Older Women’s Policy Group, agrees with the assessment of theRoad Map report, especially with the Ocean State having the “highest percent of persons age 85 and over in the 2010 Census and this is the population that is growing fast and most likely to have dementia.”
 
            Maigret notes the economic impact will have significant impact across our economy for the state budget and for individual families. “It is imperative for our public officials to promote programs to identify those with early cognitive problems and implement policies to strengthen community and caregiver supports that will help persons to safely remain in home and community settings as long as possible, she says.
 
            The Rhode Island General Assembly passed legislation this year that requires caregiver assessments in the state Medicaid long term care system.  “It’s a good first step in helping caregivers. But we must do so much more to inform the public about available resources, to adequately fund assistance programs such as RIde, Meals on Wheels and respite services and to promote cognitive screening as part of annual wellness visits funded by Medicare,” she says. 
 
            “Having a clear active mind at any age is important but as we get older it can mean the difference between dependence and independent living,” says Executive Director, Donna McGowan, of the Alzheimer’s Association-Rhode Island Chapter. “We are excited that the CDC has partnered again with the Alzheimer’s Association to create a tool for public health officials to improve the quality of life for those families afflicted by the disease,” she says.
 
            For more information on The Healthy Brain Initiative: The Public Health Road Map for State and National Partnerships, 2013-2018, visit alz.org/publichealth. For more information on Alzheimer’s disease and the Alzheimer’s Association, call 1-800-272-3900 or visit alz.org®.
 
            Herb Weiss, LRI ’12 is a Pawtucket-based writer who covers aging, health care and medical issues.  He can be reached at hweissri@aol.com.