ND Department of Health Reminds Residents to Test for Radon

During National Radon Action Month in January, the North Dakota Department of Health (NDDoH) reminds residents that January and other cooler weather months are a great time to test their home for radon, a leading cause of lung cancer among non-smokers.

“Radon is a cancer-causing, naturally-occurring radioactive gas that you can’t see, smell or taste, and it is found throughout the soil in North Dakota,” said Justin Otto, Indoor Air Quality and Radon Program Coordinator for NDDoH. “Its presence in the home can pose a danger to a family’s health.”

Radon is harmlessly dispersed in outdoor air at low levels, but when trapped in buildings, it can be harmful, especially at elevated levels. “The good news is that radon is a problem that can be managed,” said Otto. “By installing a radon mitigation system, homeowners can effectively lower the level of radon in their homes. These systems use many common building materials and require few specialized tools to install.”

Systems may be installed by a homeowner or a radon mitigation contractor.  A list of contractors is available on the North Dakota Department of Health, Division of Air Quality’s website at www.ndhealth.gov/AQ/IAQ/RADON/. Once in place, a properly installed mitigation system will reduce radon gas and safely vent it outside.

Radon-related illness claims more than 21,000 lives in the United States annually, according to Otto. “In North Dakota, 63 percent of homes have an elevated level of radon above the U.S. Environmental Protection Agency’s (EPA) ‘Action Level’ of 4.0 picocuries per liter (pCi/L),” said Otto. “In fact, the EPA lists North Dakota as Zone 1, meaning the entire state has the highest potential for elevated radon levels.”

The EPA has launched a new series of television, radio and print public service announcements encouraging people to test their homes for radon and fix any problems. During January, events nationwide will focus on testing and fixing problems in homes with a radon level of 4.0 pCi/L or higher.

Radon test kits are available by emailing Justin Otto at jotto@nd.gov and including a mailing address.  The radon test kits are available at no cost to the general public and they include all mailing and laboratory-analysis fees. The test kits are very easy to use and come with easy-to-follow directions, says Otto. Test kits also may be available for purchase at local hardware stores, building supply stores, local public health units or call the American Lung Association in North Dakota at 1.800.252.6325.

For more information about radon, visit www.ndhealth.gov/aq/iaq/Radon , or call contact Justin Otto, North Dakota Department of Health, at 701.328.5188.

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January is Cervical Health Awareness Month

The North Dakota Department of Health is reminding women to get screened for cervical cancer. According to the Centers for Disease Control and Prevention (CDC) each year approximately 12,000 women in the United States get cervical cancer and over 4,000 women die from the disease. As many as 93% of cervical cancers cases could be prevented through cervical cancer screening and HPV vaccination.

The main cause of cervical cancer is the human papillomavirus (HPV), the most common sexually transmitted infection in the United States. Most people with HPV do not even know they have it because they never have symptoms or problems. Usually the body’s immune system will fight off the infection, and it goes away on its own. But sometimes an HPV infection does not go away, and this can cause abnormal changes in the cells of the cervix. If that happens, treatment may be needed. If left untreated, these abnormal changes eventually can lead to cervical cancer.

You can prevent cervical cancer with regular screening tests, like the Pap test and the HPV test. The Pap test is a screening test that can detect the abnormal changes in the cervical cells before they become cancer.  If cancer does occur, the Pap test can find it early when it is easier to treat. An HPV test can find any of the types of HPV that can cause the abnormal cell changes on the cervix. The HPV test is done at the same time as the Pap test.

Current guidelines recommend that women should have a Pap test every three years beginning at age 21. These guidelines also recommend that women ages 30 to 65 should have a Pap test along with an HPV test every five years or a Pap test alone every three years. Women with certain risk factors may need to have more frequent screening or to continue screening beyond age 65.

Vaccines also have the potential to protect people from the HPV infections that can cause cancer. There are currently two vaccines available for people 11 to 26 years old. Both protect against HPV strains 16 and 18, the two main types of HPV that cause approximately 70 percent of all cervical cancers.   However, women who have been vaccinated still should get regular Pap tests.

“Unfortunately, many women do not get regular Pap tests because they are uninsured or underinsured,” said Barb Steiner with the North Dakota Department of Health. “The good news is that Women’s Way may be able to help women pay for their Pap and HPV test.

Women’s Way, North Dakota’s Breast and Cervical Cancer Early Detection Program, is available to eligible North Dakota women ages 40 through 64. Women’s Way may provide a way to pay for pelvic exams, Pap test, clinical breast exams and mammograms. Women’s Way is also available to women ages 21 to 39 who meet specific eligibility requirements. To learn more about Women’s Way or to see if you are eligible, call 1.800.44 WOMEN or visit  www.ndhealth.gov/womensway.

Another option is the North Dakota Family Planning Program, which provides reproductive health services to women, including Pap tests, pelvic exams and breast exams. Clients are charged for services according to their household income and family size. The Fargo Cass Public Health Clinic offers these services. For more information, or to schedule call appointment, call 701-241-1383 or go to www.FargoCassPublicHealth.com

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Health Department Reports Widespread Influenza Activity

The North Dakota Department of Health (NDDoH) is reporting widespread influenza activity for North Dakota. As of December 13, 332 cases of laboratory-confirmed influenza have been reported, with a large increase in the number of cases reported in the last two weeks. Several community outbreaks have also been reported in recent weeks.

For the third season in a row, influenza activity is starting earlier than is typical,” said Jill Baber, influenza surveillance coordinator for NDDoH. “Because the influenza season may very well continue for weeks, it’s important that everyone take precautions to avoid spreading the flu, including getting the flu vaccine.”  

It is common for different types of flu strains to circulate each season. Nationwide, the majority of flu cases have been caused by Influenza A H3N2 this season. However, this circulating A H3N2 strain has changed a little (or drifted) from the A H3N2 strain used to make the vaccine. “At this time, no cases of the drifted strain have been identified in North Dakota, but it is likely that it is present in the state,” said Baber. “We want to reiterate that vaccination is still advised.”  The vaccine is effective against other influenza strains circulating in the country and may still provide some protection against the drifted strain.

In years when the circulating influenza viruses differ from the vaccine components, treatment with influenza antivirals becomes especially important. Treatment with antivirals works best when begun within 48 hours of getting sick. For this reason, it is important people receive prompt medical attention if they think they may have the flu. Antivirals may also be given to people at risk of severe complications of flu if they know they have been exposed to someone diagnosed with flu.

Influenza can be a serious illness for some people. Complications of influenza and pneumonia contribute to the deaths of over 400 North Dakotans annually, most of whom are older than 64. However, a large number of influenza cases occur in children younger than 10, many of whom require hospitalization. “You should talk to your doctor promptly if you think you may have symptoms of influenza,” said Baber. “Common signs and symptoms of influenza include abrupt onset of fever, muscle aches, sore throat and cough.”

To help prevent the spread of influenza, the Department of Health urges everyone to:

  • Get a flu vaccine as soon as possible if you have not had one this season. Immunization is the best way to prevent influenza. As a reminder, it takes about two weeks for the vaccine to be effective.
  • Wash hands frequently with soap and water. Hand washing is one of the best ways to prevent all diseases, including influenza.
  • Use good respiratory manners. Cover your mouth and nose with a tissue when sneezing or coughing.
  • Stay home from work, school or recreational activities when you are ill. This will help prevent the spread of influenza to your friends, coworkers and family.

For more information about influenza activity in North Dakota, visit www.ndflu.com. Flu vaccine is available at Fargo Cass Public Health.  Call 241-1383 to schedule an appointment.


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National Influenza Vaccination Week Highlights the Importance of Flu Vaccination

The North Dakota Department of Health is reminding all North Dakotans of the importance of receiving flu vaccine as part of National Influenza Vaccination Week, observed Dec. 7 – 13, 2014.

“Despite some initial delays, there is more than enough flu vaccine available this year for anyone who wants to be vaccinated,” said Amy Schwartz, Immunization Surveillance Coordinator for the North Dakota Department of Health. “Everyone ages 6 months and older is recommended to be vaccinated, regardless of age or health status. It’s important to remember that getting vaccinated not only protects you, but everyone around you as well.”

Influenza vaccinations are available at physician offices, local public health units and pharmacies. Sixty-eight cases of influenza have been reported to the North Dakota Department of Health so far this season. The flu season typically does not peak in North Dakota until after the New Year, but the last two seasons have had early influenza activity. Now is a great time for people to get vaccinated if they have not done so already.

“The flu vaccine protects against flu viruses that research indicates will cause the most illness that year,” said Schwartz. “Protection from vaccination declines over time, so it’s important to get vaccinated again this season. Getting vaccinated each year is the best way to protect yourself and your family each flu season.”

The U.S. Centers for Disease Control and Prevention recommends that everyone be vaccinated against the flu, especially the following at-risk groups:

  • All children ages 6 months through 18 years
  • All adults ages 50 and older
  • Residents of long-term care facilities
  • Pregnant women
  • American Indians
  • People of any age who have long-term health problems, such as:
    • Heart disease
    • Lung disease
    • Kidney disease
    • Diabetes
    • Asthma
    • Anemia
    • Weakened immune systems due to HIV/AIDS and cancer treatments
    • Breathing problems due to neuromuscular disorders
    • Morbid obesity

People who could spread the disease to those at high risk – such as health-care workers, people who care for family members or other sick people in their home, and household contacts – also should be vaccinated.

Fargo Cass Public Health has vaccine. Call 241-1383 to schedule and appointment.  Walk-ins welcomed.  For information about influenza, visit www.ndflu.com.


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World AIDS Day: Free HIV Testing at FCPH

Dec. 1 is World AIDS Day and Fargo Cass Public Health (FCPH) encourages Cass County residents to take advantage of free HIV testing at Fargo Cass Public Health. The Centers for Disease Control and Prevention (CDC) recommends that people ages 13 – 64 get tested for HIV at least once during their lifetime. Those at higher risk should get tested at least once every year.

According to the CDC, the estimated incidence of HIV has remained stable overall in recent years at about 50,000 new HIV infections per year. In 2012, an estimated 47,989 people were diagnosed with HIV infection in the United States. In that same year, an estimated 27,928 people were diagnosed with AIDS. Overall, an estimated 1,170,989 people in the United States have been diagnosed with AIDS.

According to the North Dakota Department of Health, 24 North Dakota residents have been diagnosed with HIV/ AIDS so far this year; up from 16 cases in 2012.

North Dakota is one of the few states which began HIV/AIDS monitoring 30 years ago in 1984. Since then, more than 600 cases have been reported to the North Dakota Department of Health with approximately 373 individuals currently living with HIV/AIDS in North Dakota. Nearly 66 percent of those individuals have an HIV status, proving that early detection and treatment can help those who have HIV not only live longer but with a better quality of life, more than ever before.

In the United States, HIV is most commonly spread through body fluids during unprotected sex, sharing needles, or other drug equipment. In addition, a mother can pass HIV to her baby during pregnancy, during labor, through breastfeeding, or by pre-chewing her baby’s food.

Larry Anenson, health promotion and protection director at FCPH, says that getting tested is easy, “Fargo Cass Public Health is committed to the health of our community. HIV testing at FCPH is simple, free of charge, confidential, and the results are available within 25 minutes. Testing is the first step in protecting yourself and others from infection.”

The HIV antibody test detects the presence of antibodies to the HIV virus by using a simple blood test. This is not a test for AIDS. The test does not tell you if you have AIDS; it does show if you have been infected with the virus which can cause AIDS.

For more information on HIV testing call 701-241-1383, or go to www.FargoCassPublicHealth.com.


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ND Department of Health Provides Advice on African Travel

The North Dakota Department of Health (NDDoH) has advice to help keep those who plan to travel to Africa in the near future and their loved ones safe in light of the current Ebola outbreak.

“We want to make sure that everyone is as safe as possible without hindering their ability to travel as they wish,” according to Michelle Feist, Program Manager at the NDDoH’s Division of Disease Control.  “One of the challenges with travel is that we do not know from week to week what the situation will be in terms of where the outbreak may spread, what services might be available if someone became ill in another country, and what kind of restrictions might be in place when people come back to the U.S.   Travel to and from the vast majority of African countries is safe and unrestricted, though we advise following routine recommendations for foreign travel.  However, travelers should be aware of potential issues when traveling to West Africa or Democratic Republic of the Congo.”

The Centers for Disease Control and Prevention (CDC) warns against travel to Guinea, Sierra Leone, and Liberia except for those who provide essential medical and humanitarian services and has issued a travel alert for Mali. The NDDoH recognizes that medical workers are necessary to stop the outbreak in Africa and thereby protect the U.S. against Ebola.  However, NDDoH advises that church and other humanitarian groups avoid or postpone travel to the affected countries unless they are providing medical services under the auspices of a larger humanitarian or governmental group.  Anyone not directly involved in medical work should not travel to these countries until the outbreak is contained and travel restrictions are lifted.

The CDC has not issued travel warnings for other countries in West Africa.  However, if transmission were to occur in another country while a person was traveling, their return circumstances may change substantially and may provide a threat to their health.  In an abundance of caution, NDDoH advises that such travel be considered carefully and postponed, if possible, until the outbreak is over.  The remaining countries in West Africa are Benin, Burkina Faso, Ivory Coast, Cape Verde, Gambia, Ghana, Guinea-Bissau, Mauritania, Niger, Senegal, and Togo.

The CDC has issued an advisory to practice enhanced precautions when traveling in Democratic Republic of the Congo because of an outbreak of Ebola that is unrelated to the outbreak in West Africa.  NDDoH advises that such travel be considered carefully as to its necessity, and postponed, if possible, until the outbreak is over.

Travelers going to the other countries in Africa should follow the precautions routinely recommended for people traveling to those areas.  Travelers returning from countries not experiencing an Ebola outbreak have no need to self-monitor following their return.

NDDoH asks that a person traveling to Guinea, Sierra Leone, Mali or Liberia

  • Inform the NDDoH prior to traveling
  • Inform their employer of their travel plans
  • Coordinate travel with a well-established group (consult USAID at www.usaid.gov or an experienced umbrella group, such as Doctors Without Borders) that routinely operates in these countries
  • Follow all recommendations of the CDC for protecting their health
  • Inform the NDDoH of their expected return date
  • Review their health insurance policy to make sure that medical care and transport home would be covered in the event of illness or injury

Upon a traveler’s return to North Dakota, we ask that they

  • Comply with all CDC entry procedures
  • Follow all CDC protocols for monitoring their health
  • Contact the NDDoH as soon as  they return to the state to coordinate their 21 day monitoring period

The NDDoH contact phone number for those who are traveling is 1.800.211.4451.

General information about Ebola is available on the NDDoH website at http://www.ndhealth.gov/disease/ebola/default.aspx.  This page also contains access to the CDC website, which is updated regularly.  NDDoH also posts information on their Facebook page at https://www.facebook.com/home.php and on their Twitter page at https://twitter.com/NDDOH. Use #NDEbolaInfo.

For more information, contact Michelle Feist, North Dakota Department of Health, at 701.328.2378.

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Great American Smokeout emphasizes need for tobacco prevention

The 39th annual Great American Smokeout, which will take place on Nov. 20, encourages everyone to lead tobacco-free lives to prevent tobacco-related diseases and improve overall health and quality of life. The event is traditionally aimed at getting smokers to quit, but Fargo Cass Public Health and the North Dakota Center for Tobacco Prevention and Control Policy (the Center) are using the opportunity educate on the best ways to prevent tobacco use among our kids.

Tobacco prevention efforts are more important than ever because tobacco companies are finding new ways to market their products to youth, which increases youth rates of tobacco use.

According to the 2014 Surgeon General’s Report, “Advertising and promotional activities by the tobacco companies cause the onset and continuation of smoking among adolescents and young adults.” Tobacco companies frequently use brightly-colored packaging and fruit-flavored tobacco products that look and taste like candy to entice kids to try tobacco.

“In the 1998 tobacco settlement lawsuit, tobacco companies promised to stop marketing to our kids, but they have not kept their word,” said Melissa Markegard with Fargo Cass Public Health. “Today, it’s not just about cigarettes, but includes tobacco’s expanding products that include fruit- or candy-flavored cigars, smokeless tobacco and other nicotine-based products, such as electronic cigarettes.”

Another effective way to reduce youth smoking is to increase the price of tobacco products.  According to the 2014 Surgeon General’s Report, “increases in the prices of tobacco, including those resulting from excise tax increases . . . reduce the prevalence and intensity of tobacco use among youth and adults.”

In an attempt to keep prices low, tobacco companies use special discounts and promotions that make their products cheap to buy. Tobacco companies also make sure their addictive products are placed in highly visible areas that appeal to youth, such as near candy displays or at the checkout counter.

“Tobacco companies are using whatever tricks they can to get kids to try their products,” said Jeanne Prom, executive director for the Center. “Tobacco is big business and the industry works hard to replace the thousands of customers who die each year.”

Prom noted that tobacco prevention programs are essential in keeping the next generation tobacco free. “Nearly nine out of ten smokers had their first cigarette before age 18. That means if we can keep our kids tobacco free before age 18, most will never start to use tobacco,” Prom said.

To learn more about tobacco prevention contact Fargo Cass Public Health at 701-476-4083 or visit www.breathend.com.

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Flu Shot Friday-Nov. 21

Fargo Cass Public Health (FCPH) will be holding a Flu Shot Friday walk-in vaccination clinic for all ages on Nov. 21, from 7 a.m.-12:15 p.m., in the basement of FCPH located at
401 3rd Ave. N., Fargo. Cost of the vaccine is $45 for the flu shot and $46 for FluMist. Please bring your insurance cards.

The Centers for Disease Control and Prevention recommends that everyone 6 months of age and older should get vaccinated against the flu. For more information about the flu and vaccine, go to www.flu.gov.

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Sudden Infant Death Syndrome and Secondhand Smoke

October has been designated as Sudden Infant Death Syndrome (SIDS) Awareness Month and the North Dakota Department of Health (NDDoH) encourages residents to understand the relationship between SIDS and secondhand smoke. According to Katie Bentz, director of the SIDS program for the NDDoH, SIDS is the leading cause of death in the nation and in North Dakota for infants between 1 month and 1 year. Every year about 2,000 infants in the United States die from SIDS.

“While the direct cause of SIDS is unknown, we do know that breathing secondhand smoke or having a mother who smoked during pregnancy are risk factors for causing SIDS,” said Bentz. “Other ways to reduce the risk of SIDS are having your baby sleep on his or her back, never letting anyone smoke around your baby, and offering a pacifier at all sleep times once breastfeeding is well established.”

Secondhand smoke is a mixture of gases and particles that come from the burning end of a cigarette, cigar or pipe, along with the smoke breathed out by smokers. According to the 2014 Surgeon General’s Report, tobacco smoke contains more than 7,000 chemicals, including at least 69 that can cause cancer.

The 2006 Surgeon General’s Report, The Health Consequences of Involuntary Exposure to Tobacco Smoke, reports the following facts:

  • Babies who breathe secondhand smoke after they are born are more likely to die of SIDS
  • Mothers who smoke during pregnancy are more likely to have their babies die of SIDS
  • Smoking and exposure to secondhand smoke during pregnancy can lead to a low birth-weight baby and can reduce a baby’s lung function
  • During pregnancy, many of the compounds in secondhand smoke change the way a baby’s brain develops
  • Babies who breathe secondhand smoke have weaker lungs; their breathing problems can continue as they grow older and even when they become adults

According to Kara Hickel, health promotion coordinator for the North Dakota Tobacco Prevention and Control Program, there is help available for those who would like to quit smoking.

“NDQuits is a free service for North Dakotans to help them quit smoking and tobacco use,” said Hickel. “NDQuits offers advice and encouragement from quit coaches and free nicotine replacement medications, like nicotine patches, gum and lozenges for those who qualify. Quitting smoking and protecting your baby from secondhand smoke are two of the most important things you can do to give your baby the healthiest start possible.”

If you would like help quitting smoking or tobacco use, contact NDQuits by calling 1.800.QUIT.NOW (1.800.784.8669) or logging on to www.ndhealth.gov/ndquits.

For more information about SIDS, log on to www.ndhealth.gov/SIDS or call Katie Bentz at 701.328.4538.

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Inflammatory Breast Cancer Awareness

Inflammatory breast cancer (IBC) represents 1 to 5 percent of all diagnosed breast cancers, and is far more aggressive and more difficult to diagnose than other breast cancers.

IBC is a relatively rare and very aggressive disease in which cancer cells block lymph vessels in the skin of the breast.  This type of cancer is called “inflammatory” because the breast often looks swollen and red or “inflamed.” Because the symptoms of IBC are so different from other forms of breast cancer, accurate diagnosis is often difficult, and may result in delaying timely treatment, which is essential to survival. IBC does not present with a lump but with a red rash that often is mistaken for mastitis or other skin conditions. IBC usually grows in ‘nests’ or ‘sheets,’ rather than a tumor that causes a lump. Some women also experience thickening of the skin, pain and itching. As the cancer grows, it can result in dimpling of the skin, a condition called ‘peau d’orange.’

With the introduction of systemic chemotherapy, the five-year overall survival rate with a diagnosis of IBC has improved from 0 to 5 percent in the 1990s to a current five-year survival rate of 40 percent.  With the advancements in targeted therapy, many women with IBC are now living longer with a better quality of life.

Because IBC tends to be more aggressive (it grows and spreads much more quickly) than other types of breast cancer, it is at least stage IIIB when diagnosed (locally advanced with cancer cells in the skin). Unfortunately, it is often diagnosed at stage IV (metastatic) because it has already spread to distant parts of the body.

The advanced stage of IBC, along with the tendency to grow and spread quickly, makes it more difficult to treat successfully than other types of breast cancer. This is why it is very important for women to recognize the signs and symptoms of the disease.

Symptoms of inflammatory breast cancer include:

  • A breast that appears discolored (red, purple, pink or bruised)
  • A tender, firm and enlarged breast (sometimes overnight)
  • A warm feeling in the breast (or may feel hot/warm to the touch)
  • Persistent itching of the breast (not relieved with cream or salve)
  • Shooting or stabbing pain
  • Ridged or dimpled skin texture, similar to an orange peel
  • Thickened areas of breast tissue
  • Enlarged lymph nodes under the arm, and/or above or below the collarbone
  • Flattening or retraction of the nipple
  • Swollen or crusted skin on the nipple
  • Change in color of the skin around the nipple

If one or more of these symptoms continue for more than a week, talk to a health-care provider.  Because tenderness, redness, warmth and itching are more common than IBC, a health-care provider may first suspect infection to be the cause and treat with antibiotics.  However, if the systems do not get better in seven to 10 days, further evaluation is needed.  It is important that women become their own best advocate when it comes to ruling out inflammatory breast cancer.

More information about inflammatory breast cancer can be found by visiting www.eraseibc.com. For more information about Inflammatory Breast Cancer Awareness Month, contact Barbara Steiner, North Dakota Department of Health, at 701.328.2389.

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