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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Breastfeeding Expert to Lead Conference in Fargo

Tackling the most common questions of breastfeeding is the goal of the “Solving Breastfeeding Mysteries” conference on Thursday, Oct. 23, at the Ramada Plaza Suites in Fargo.

Breastfeeding expert and co-author of The Breastfeeding Mother’s Guide to Making More Milk, Lisa Marasco, will lead the conference which will focus on the following topics:

  • Identifying tongue tie issues and latching,
  • The role of hormones in lactation,
  • Strategies for working with  “high need” mothers, and
  • Nutrients essential for milk production and lactogenic foods.

Kim Vance, director of the Women, Infants, and Children Nutrition Program at Fargo Cass Public Health says, “This conference will enable attendees to learn and share information and techniques on how to help moms have a successful breastfeeding experience.”

Nurses, dietitians, nutritionists, lactation experts, students and the public are welcome to attend this conference. The general registration fee is $75 and $35 for students. Pre-registration is required.

For more information and registration information for the conference, go to www.FargoCassPublicHealth.com, or call 701-277-1455.

Continuing education hours were approved by: North Dakota Board of Nursing 5.75 contact hours and IBCLE  6.0 CERPs,  Commission on Dietetic Registration hours are pending.

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September is Gynecologic Cancer Awareness Month

According to the American Cancer Society, 94,990 new cases of gynecologic cancers will be diagnosed in 2014, resulting in approximately 28,790 deaths.  That is why it is important for womento take care of their health, not just in September, but every day of the year.

Gynecologic cancers include cervical cancer, ovarian cancer, uterine/endometrial cancer, vaginal cancer and vulvar cancer. Uterine cancer is the most common (more than 52,500 new cases per year), while ovarian cancer is the deadliest due to late stage diagnosis.
Cervical cancer is almost totally preventable given the availability of a vaccine for both boys and girls, and a wide-spread primary screening program using both the Pap test and HPV test (HPV is the cause of almost all cervical cancer).

There are specific steps that women can take to reduce their risks and even prevent these cancers. More than half of all cancer deaths could be prevented by staying at a healthy weight, eating right, keeping active, and getting recommended screening tests.

The Fargo Cass Public Health Clinic offers physical examinations for women including: pelvic exams, pap smears, urinalysis, and blood work. Fees are based on a sliding fee scale. Women age 40-64 may qualify for Women’s Way which may help pay for cervical and pelvic exams.

For more information or to schedule an appointment, call Fargo Cass Public Health at 701-241-1383.

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Support for Moms Who Breastfeed on the Rise

Breastfeeding mothers in North Dakota can more easily identify where to find support in both local hospitals and workplaces thanks to two designations developed by the North Dakota Department of Health’s Division of Nutrition and Physical Activity.

The newest designation allows North Dakota hospitals to provide crucial support to new mothers by earning a breastfeeding-friendly designation. The “North Dakota Breastfeeding-Friendly Hospital Designation” is a five-step program that has been developed from research-based best practices in hospitals to help mothers who breastfeed get off to the right start. “We are thrilled that many hospitals across the state are interested in this designation and are willing to take the right steps in supporting breastfeeding mothers from the start,” said BriAnna Wanner, Division of Nutrition and Dietetics.

Two hospitals that are the first to apply for the designation are:

  • West River Health Services, Hettinger
  • Sanford Health, Bismarck

“Breastfeeding is natural, but is a skill that must be learned,” said Wanner. “The first few days of life are the most crucial in predicting duration and exclusivity for breastfeeding. That is why it is important to have the right practices in place in the hospital.”

For four years, the Department of Health has given the designation of “Infant Friendly” to North Dakota businesses if they adopt a policy that supports nursing mothers in the workplace.

The following 13 North Dakota employers have been designated as infant-friendly in the last year:

  • Bismarck – City of Bismarck
  • Dickinson – Southwestern District Health Unit
  • Emerado- Ascension Lutheran Church
  • Fargo- Discovery Benefits
  • Grand Forks – Altru Family YMCA, Amazing Grains, Kidney & Hypertension Center, Kidney Institute of North Dakota, Aurora Dialysis, Grand Forks Public Library, 1101 Dental, PLLC
  • Northwood- Valley Community Health Centers
  • Rolla- Presentation Medical Center

Businesses interested in becoming “Infant Friendly” can find resources for supporting their employees and the simple application at www.ndhealth.gov/breastfeeding.

The designation of these businesses coincides with Gov. Jack Dalrymple’s proclamation of Breastfeeding Week, Aug. 1-7, 2014, in North Dakota, which mirrors the annual global celebration event that draws attention to the health impacts of breastfeeding for both babies and mothers. The theme this year is “Breastfeeding: A Winning Goal For Life.”

For more information about the infant friendly designation or Breastfeeding Week in North Dakota, contact BriAnna Wanner, North Dakota Department of Health, at 701.328.4529.

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Community Forum on Alcohol Misuse Prevention

On Wednesday, August 6, Fargo Cass Public Health (FCPH) will host the Community Forum on Alcohol Misuse Prevention to reveal findings from a community assessment and discuss effective strategies to prevent adult binge drinking and underage drinking in Cass County. The forum will be held two times: 1-2 p.m., and 7-8 p.m. at the Fargo City Commission Room, 200 3rd St. N., Fargo.

Fargo Cass Public Health has been awarded the Strategic Prevention Framework State Incentive Grant (SPG SIG) for Cass County. The purpose of the grant is to build our prevention infrastructure. The SPF SIG focuses on the prevention of adult binge drinking and underage drinking and consists of three phases: assessment, planning and implementation.

Fargo Cass Public Health will begin the planning phase which will include learning about effective prevention strategies, aligning them with what will work in Cass County, and using the data from the needs assessment as a guide. The public is invited to become involved in our community prevention efforts through this grant.

The community forum will address:

  • the problem of alcohol misuse in our community
  • the SPF SIG project
  • how to provide input or suggestions
  • how to apply for funding to implement strategies

If you are unable to attend personally, please send an agency/organization representative and feel free to share this information with anyone else who may be interested in attending.

For more information on the event contact Robyn Litke Sall at 701-241-1341, or rlitkesall@cityoffargo.com.

 

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Practice Safety Tips during Extreme Heat

Summer events are in full swing and Fargo Cass Public Health would like to remind everyone to take the necessary precautions during this heat wave to avoid dangerous health conditions. Those most vulnerable to the effects of heat include infants and young children, the elderly and those with existing medical conditions. Dangers we face during periods of very high temperatures include:

Heat Cramps: These are muscular pains and spasms due to heavy exertion. They are an early signal that the body is having trouble with the heat.

Heat exhaustion: This typically occurs when people exercise heavily or work in a hot, humid place where body fluids are lost through heavy sweating. Blood flow to the skin increases, causing blood flow to decrease to the vital organs. This results in a form of mild shock. If not treated, the victim may suffer heat stroke.

Heat stroke (sunstroke): Heat stroke is life-threatening. The victim’s temperature control system, which produces sweating to cool the body, stops working. The body temperature can rise so high that brain damage and death may result if the body is not cooled quickly. 

During a heat wave practice these safety tips:

  • Slow down and avoid strenuous activity,
  • Stay indoors as much as possible,
  • Wear lightweight, light-colored clothing,
  • Drink plenty of water regularly and often. Do not drink liquids that      contain alcohol or large amounts of sugar–these actually cause you to lose more body fluid. Also, avoid very cold drinks, because they can cause stomach cramps.
  • Eat small meals and eat more often,
  • If you have to be outside, take frequent breaks in the shade,
  • Limit your outdoor activity to morning and evening hours,
  • Do not leave anyone or pets in a parked vehicle. Even with the windows cracked open, vehicles can still get 15-20 degrees hotter than outside temperatures,
  • Check on elderly neighbors, and
  • Keep infants and young children well hydrated.

Finally, never leave your pet in a hot car, not even for a minute, even with the air conditioning running. According to the Humane Society of the United States, temperatures inside a vehicle can rise rapidly to dangerous levels. For example, on an 85-degree day, the temperature inside a car, with the windows open slightly, can reach 102 degrees within 10 minutes, which may cause your pet to suffer irreversible organ damage or die.  Also, make sure all animals have plenty of cold water available.

For more information and videos on heat safety, go to www.JustInTimeDisasterTraining.org.

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