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Minnesota Officials Expect Whooping Cough Outbreak

Booster shots advised for teens, adults
By Jeremy Olson jolson@pioneerpress.com
 
In between West Nile and peak influenza seasons, the Minnesota Department of Health is notifying doctors about another emerging but expected threat: whooping cough. So far this year, the state has reported 275 cases of the bacterial infection that doctors know as pertussis.
 
Of particular concern is the number of infections involving high school students and adults, whose childhood immunizations may be wearing off. "When you get to three to four years after your last dose, you start to see waning immunity," said Kris Ehresmann, who directs the vaccine programs for the Health Department. A rise in cases was expected: Pertussis comes in a three- to five-year cycle, and the last major outbreak was in 2005. That year, 1,571 cases were reported in Minnesota. The tally for 2008 is comparable to the totals for 2006 and 2007. But the number of outbreaks has jumped this fall, suggesting that pertussis, like clockwork, will become more common this year and in the next couple of years.
 
Outbreaks have been reported in Hastings and in an unnamed elementary school in Dakota County, officials said. An outbreak in central Minnesota's Douglas County involved 24 cases, mostly among high-schoolers, that took time to uncover. "There were cases in adolescents that had been occurring, but it wasn't until a case occurred in a young child that it really came to detection," Ehresmann said. Twenty years ago, most cases of whooping cough were diagnosed in infants, but that has changed with time and better vaccine coverage in that population.
 
An adult booster shot became available in 2005 and is recommended for 11- and 12-year-olds during their pre-adolescent checkups. Many young teens missed this dose and should receive it, Ehresmann said, along with adults who have children or might be at risk for exposure. Antibiotics can treat whooping cough, which gets its name from the classic symptom — a coughing fit followed by an attempt to breathe in air that often evokes a whooping noise. Other typical cold symptoms also are common.

By MIGUEL HELFT, New York Times
 
What if Google knew before anyone else that a fast-spreading flu outbreak was putting you at heightened risk of getting sick? And what if it could alert you, your doctor and your local public health officials before the muscle aches and chills kicked in?
 
That, in essence, is the idea of Google Flu Trends, a new Web tool that Google.org, the company's philanthropic unit, unveiled in late November — just as flu season is getting underway in the United States.
 
It's based on the simple idea that a lot of ailing Americans enter phrases such as "flu symptoms" into Google and other search engines before they call their doctor. It's a simple act, multiplied across millions of keyboards nationwide, that has given rise to a new early warning system.
 
Tests of the new Web tool suggest that it may be able to detect regional outbreaks of the flu a week to 10 days before they are reported by the Centers for Disease Control and Prevention. Some public health experts say the data could help accelerate the response of doctors, hospitals and public health officials to a nasty flu season, reducing the spread of the disease and, potentially, saving lives.
 
"This could prevent cases of influenza," said Lyn Finelli, lead for surveillance at the influenza division of the CDC. Five to 20 percent of the nation's population contracts the flu each year, she said, leading to an average of about 36,000 deaths. Still, some public health officials note that many health departments already use other approaches, such as gathering data from visits to emergency rooms, to keep daily tabs on disease trends.
 
For now the service covers only the United States, but Google is hoping to eventually use the same technique to help track influenza and other diseases worldwide.
 
"From a technological perspective, it is the beginning," said Eric Schmidt, Google's chief executive.
 
Researchers have long said that the material people publish on the Web amounts to a form of "collective intelligence" that can be used to spot trends and make predictions. But the data collected by search engines are particularly powerful, because the keywords and phrases that people type into search engines represent their most immediate intentions. Those queries express the world's collective desires and needs.
 
The tool appears to be the first public project that uses the powerful database of a search engine to track the emergence of a disease. "This seems like a really clever way of using data that is created unintentionally by the users of Google to see patterns in the world that would otherwise be invisible," said Thomas Malone, an MIT professor. "I think we are just scratching the surface of what's possible with collective intelligence."

(HealthDay News) — At least 170,000 Americans die each year from infectious diseases, and that number could increase dramatically during a major disease outbreak. That dire news was delivered in a report, Germs Go Global: Why Emerging Infectious Diseases Are a Threat to America, released recently by the Trust for America's Health (TFAH).
 
Globalization, increased drug resistance, and climate change are among the factors contributing to the growing threat from infectious diseases, according to the report, which listed some major disease threats currently facing the United States, including:

• Emerging diseases such as a potential bird flu outbreak or another new disease such as severe acute respiratory syndrome (SARS).
• Methicillin-resistant Staphylococcus aureus (MRSA), which is the sixth leading cause of death in the United States. More than 90,000 Americans have been infected by MRSA.
• Hepatitis C. About 3.2 million Americans have hepatitis C infections, which account for about $15 billion a year in health-care costs.
• HIV/AIDS, which affects about 1.2 million Americans. Last year, U.S. spending on HIV/AIDS-related medical care, research, prevention and other activities was $23.3 billion.
• Re-emerging diseases, such as measles, mumps and tuberculosis, which were thought to be nearly eliminated in the United States.

By LAURAN NEERGAARD, Associated Press
 
WASHINGTON — If there ever is another anthrax attack, the letter carrier may deliver your antibiotics.
 
Federal health officials are beginning a project in Minneapolis-St. Paul to let letter carriers stockpile a personal supply of emergency antibiotics so they are protected and ready to deliver aid to the rest of the city at a moment's notice. "These letter carriers are being asked to put their lives on the line to help their communities," Health and Human Services Secretary Michael Leavitt said Wednesday. By ensuring they are protected first, "the carriers can be ready on short notice to take to the streets."
 
The project aims to overcome a big hurdle of emergency planning. The government has drugs stockpiled in case of future bioterrorism, but few ways to get them quickly to panicked citizens. Leavitt noted that if someone possibly has inhaled anthrax, the chances of survival are best if antibiotic treatment begins within 48 hours. The U.S. Postal Service came forward, he said. "They have people who every day walk to every house." Those carriers could provide "a front-end quick strike," added William Raub, Leavitt's senior science counselor.
 
But could letter carriers successfully deliver medications to a great number of homes during an emergency, when the carriers might be mobbed? Would they be willing?
 
To address the first issue, test projects in Seattle, Philadelphia and Boston over the past two years paired letter carriers with police officers on holidays. Carriers volunteered to do double routes, delivering empty pill bottles along with a "This is a Test" flier explaining what was happening. In Philadelphia, 50 carriers reached about 53,000 households in eight hours, Raub said. As for getting volunteers, the post office and its unions told the government that carriers who stepped up during this kind of emergency would need assurances that they and their families were fully protected. That led to the idea of letting carriers store enough of the antibiotic doxycycline in their homes for them and their families. In an emergency, they could start taking the medication while the government raced in more supplies for the rest of the city that the carriers then would distribute to people's homes.
 
Some 700 letter carriers who deliver to 20 ZIP codes are eligible for the Minneapolis pilot project. Medical teams will screen volunteers to be sure they are appropriate candidates for a prescription of doxycycline. The carriers also would have to be physically fit enough to wear a special anthrax-protective mask while walking their mail routes. Volunteers receive extensive education, including a prohibition on dipping into their stored doxycycline for any other reason.
 
Leavitt has recently authorized the postal service's role in the event of another anthrax attack. Next, the Food and Drug Administration must approve prescribing the drug before the Minneapolis project begins. An FDA deputy commissioner, Randall Lutter, said the agency would act quickly. Minneapolis was chosen because of its extensive bioterrorism preparations, Raub said. If the $500,000 pilot project works well, it could be offered to other cities starting next year. In the fall of 2001, anthrax-laced letters killed five and sickened 17 others, and thousands were prescribed protective doses of the antibiotics Cipro and doxycycline.

By MIKE STOBBE, Associated Press
 
ATLANTA — The government recently approved a new genetic test for the flu virus that will allow labs across the country to identify flu strains within four hours instead of four days. The timesaving test could be crucial if a deadly new strain emerges, federal health officials said.
 
The new test also could help doctors make better treatment decisions during a conventional flu season.The new test was developed by the Centers for Disease Control and Prevention and Applied Biosystems Inc. of Foster City, Calif. The Food and Drug Administration approved the test kit, and state health labs are expected to start using it this fall. CDC officials celebrated it as a potential lifesaver, especially if the nation is hit by a pandemic of bird flu or some other mutant influenza.
 
"We'll now be able to detect influenza in the community faster, which allows us to take steps more quickly to protect and save lives," CDC director Dr. Julie Gerberding said in a prepared statement. "The bottom line, for us, is that it will allow us to more rapidly detect introduction of a new strain," said Rosemary Humes, senior adviser for scientific affairs at the Association of Public Health Laboratories. But the test could be handy for conventional flu, too, said Dr. Doug Lowery-North, an Emory University emergency physician who does flu research.
 
Doctors usually don't have the luxury of waiting three or four days for lab tests before deciding how to treat a flu-stricken patient. But getting a faster, better reading on the type of flu might help in prescribing the best medication, Lowery-North said. Each year, the flu results in 200,000 hospitalizations and 36,000 deaths, according to official estimates. The elderly, young children and people with chronic illnesses are considered at greatest risk.

Launched in February 2003, Ready is a national public service advertising campaign designed to educate and empower Americans to prepare for and respond to emergencies including natural disasters and potential terrorist attacks. The goal of the campaign is to get the public involved and ultimately to increase the level of basic preparedness across the nation.
 
The public's complacency is the largest challenge facing organizations that seek to foster a national ethic of preparedness. A national survey conducted by The Ad Council in August 2008 asked Americans in an open-ended question why people are not doing more to prepare. Half of respondents (52%) said that it is because people believe that they are unlikely to be affected by an emergency. Another 21% said that people were too busy (11%) or apathetic (10%).
 
Although there is still a long way to go before all Americans are adequately prepared for emergencies, there have been indications of progress:

• From 2005 to 2008, the proportion of Americans who said they have taken any steps to prepare rose 13 points, from 45 percent to 58 percent. There were also several notable increases in key preparedness behaviors among American households nationwide:
• Put together an emergency kit: 44 percent in 2004 to 53 percent in 2008.
• Created a family emergency plan: 32 percent in 2004 to 40 percent in 2008.
• The study also found emergency preparedness progress in the workplace. Fifty-eight percent of employed respondents reported that their employers offered training or instruction about workplace emergency plans in 2008, a significant increase from 43 percent in 2006.

Your home should be a safe haven. But do you regularly check for home fire hazards? If not, there is the potential for danger. Fire departments responded to nearly 400,000 home fires in the US during 2006. In Carver County between 1999 and 2002, there was an average of just under 200 fires each year, most of which were building fires.
 
That's why the theme of Fire Prevention 2008 is "Prevent Home Fires!" During October, fire safety advocates will spread the word to their communities that, with a little extra caution, preventing the leading causes of home fires — cooking, heating, electrical and smoking-materials — is within their power.

When you hear a radio or TV station broadcast a severe weather watch, do you know what that means? How about a severe weather warning?
 
According to Homeland Security Secretary Michael Chertoff, it is important for residents to know the difference. A WATCH means storm conditions are possible in the specified area, usually within 36 hours. Residents should tune in to NOAA Weather Radio, commercial radio or television for more information.
 
A WARNING means storm conditions are expected in the specified area, usually within 24 hours. Again, local commercial news media are a good source for more information. If an evacuation is advised, residents should do so immediately.
 
For more emergency preparedness information, visit the ReadyCarver.org homepage.

Goal of CDC Vaccine Program Sets Record
 

 
The U.S. supply of flu vaccine sets a record this year, according to the CDC.
By David Brown, Washington Post Staff Writer
 
That was the message yesterday from officials at the Centers for Disease Control and Prevention and several private organizations, who convened in Washington to urge Americans to get flu shots.
 
The number of people targeted for flu vaccination has grown steadily in recent years and now constitutes 86 percent of the population. For the first time, the federal government is recommending this year that children 5 to 18 years old get vaccinated, along with the previously targeted group of 6 months to 5 years. That will add about 30 million children to the number advised to get the shots. CDC recommends that children ages 6 months to 8 years get two flu shots a month apart, because a single shot may not be enough to fully protect them.
 
Over the last decade, flu seasons have been marred sporadically by shortages or excesses of vaccine and, in the case of last year, relatively poor protection against the strains of influenza causing illness. None of those problems is anticipated this year, said Julie Louise Gerberding, CDC's director.
 
"I have a smile on my face this year because we are looking at a wonderful supply of flu vaccine," she said at news conference at the National Press Club. Manufacturers will make about 145 million doses. While the number of people targeted is substantially higher — 261 million — not everyone will choose to or be able to get vaccinated.
 
The targeted groups also include pregnant women, people 50 and older; younger adults with chronic illnesses such as diabetes and asthma; health-care workers; people in contact with children younger than 6 months; and people in contact with those who are at high risk of flu's complications, such as those with AIDS.
 
The vaccine consists of three killed flu viruses — two from the influenza A family and one from influenza B. The components are dropped and replaced by updated ones each year as influenza viruses circulating the world evolve. This season, all three of the components are new, an unusual event. Last year, the vaccine was poorly matched to the strains of flu virus in circulation. It was 58 percent effective in preventing infection with influenza A strains and did not protect against infection by influenza B at all. Its overall effectiveness was 44 percent — about half what it is when the vaccine is well matched to the season's viruses.

WASHINGTON — As hurricane season continues, Homeland Security's Ready Campaign and The Advertising Council are reaching out to small businesses and encouraging them to "define their day after" by putting emergency preparedness at the top of their to-do list.
 
A series of national public service advertisements (PSA) entitled "Procrastination" have been released nationwide for radio, print, internet and outdoor media. These PSAs focus on what can happen when a business owner chooses to place making an emergency plan at the bottom of their to-do list.
 
The theme taps into the natural tendency for individuals to put off making plans for another day. According to the U.S. Census Bureau, small businesses employ more than half of all Americans. However, Institute for Business and Home Safety research shows that, at the minimum, one in four businesses never reopen following a disaster.
 
"Research conducted by the Ad Council found that more than 85 percent of small businesses understand that emergency preparedness is important, yet only four in 10 businesses have a plan to protect their businesses," said Homeland Security Secretary Michael Chertoff. "The ability of these businesses to survive and recover quickly from both natural and man-made disasters directly benefits employees, customers, the community and the local, even national, economy."

WASHINGTON — Recent tropical storms Gustav, Hanna, Ike and Josephine served as stark reminders of the need for Americans to be prepared. Severe weather can happen anywhere the United States, including Carver County. The Department of Homeland Security's Ready Campaign encourages citizens to get an emergency supply kit, make an emergency plan, and be informed about what to do if severe weather approaches.
 
Severe storms can include tornadoes, flooding and power outages that affect citizens for hours or even days after the initial storm has passed. No matter where residents live, Ready wants to make sure citizens are on alert and listening to what local authorities are advising them to do. Ready recommends having a three-day supply of water for each individual in your family, including pets, along with non-perishable food, a battery-powered radio, extra batteries and a flashlight.
 
It is also important to consider your family's unique needs such as medication and any important documents like property insurance. Additionally, pet owners should check which shelters in the area will take animals in case of evacuation.
 
To find more emergency preparedness information, including an emergency supply checklist, a downloadable emergency plan and links to other sites, go to the ReadyCarver.org homepage or visit www.ready.gov.
 
Ready also has resources and tools available on its Web site to help business owners ensure their businesses stay up and running, how to talk to their employees and protect their assets. For information in Spanish, visit www.listo.gov

According to a recent article in the Minneapolis Star Tribune, Minnesotans deserve to know that when natural disaster strikes, state and local governments have a plan to swing into action.
 
As of this year, they do. A disaster coordination plan, set in statute, is one of the legacies of the record rainfall and flooding one year ago this week in southeastern Minnesota.
 
Thirteen state agencies play a role in responding to a disaster like that flood — not to mention the affected municipal and county governments and school districts. While last year's response by those agencies ultimately served the area well, earlier and clearer understanding of each jurisdiction's responsibility would have helped, said the sponsor of the new law, Winona DFL Rep. Gene Pelowski.
 
The law spells out those responsibilities in a way that ought to prevent duplication and minimize confusion. It also sets in law a template for the design of relief programs, so that future legislators need not take the time to reinvent them before acting. Its guidelines should also help those legislators quickly determine how much money to appropriate to respond to a stricken region's need.

What Is a Traumatic Event?
Almost everyone has been through a stressful event in his or her life. When the event, or series of events, causes a lot of stress, it is called a traumatic event. Traumatic events are marked by a sense of horror, helplessness, serious injury, or the threat of serious injury or death. Traumatic events affect survivors, rescue workers, and the friends and relatives of victims who have been involved. They may also have an impact on people who have seen the event either firsthand or on television.

What Are Some Common Responses?
A person's response to a traumatic event may vary. Responses include feelings of fear, grief and depression. Physical and behavioral responses include nausea, dizziness, and changes in appetite and sleep patterns as well as withdrawal from daily activities. Responses to trauma can last for weeks or months before people start to feel normal again.
Most people report feeling better within three months after a traumatic event. If the problems become worse or last longer than one month after the event, the person may be suffering from post-traumatic stress disorder (PTSD).

What Is PTSD?
Post-traumatic stress disorder (PTSD) is an intense physical and emotional response to thoughts and reminders of the event; it can last for many weeks or months after the traumatic event. The symptoms of PTSD fall into three broad types: re-living, avoidance and increased arousal.

• Symptoms of re-living include flashbacks, nightmares, and extreme emotional and physical reactions to reminders of the event. Emotional reactions can include feeling guilty, extreme fear of harm, and numbing of emotions. Physical reactions can include uncontrollable shaking, chills or heart palpitations, and tension headaches.
• Symptoms of avoidance include staying away from activities, places, thoughts, or feelings related to the trauma or feeling detached or estranged from others.
• Symptoms of increased arousal include being overly alert or easily startled, difficulty sleeping, irritability or outbursts of anger, and lack of concentration. Other symptoms linked with PTSD include panic attacks, depression, suicidal thoughts and feelings, drug abuse, feelings of being estranged and isolated, and not being able to complete daily tasks.

What Can You Do for Yourself?
There are many things you can do to cope with traumatic events.

• Understand that your symptoms may be normal, especially right after the trauma.
• Keep to your usual routine.
• Take the time to resolve day-to-day conflicts so they do not add to your stress.
• Do not shy away from situations, people and places that remind you of the trauma.
• Find ways to relax and be kind to yourself.
• Turn to family, friends, and clergy for support, and talk about your experiences and feelings with them.
• Participate in leisure and recreational activities.
• Recognize that you cannot control everything.
• Recognize the need for trained help, and call a local mental health center.

What Can You Do for Your Child?

• Let your child know that it is okay to feel upset when something bad or scary happens.
• Encourage your child to express feelings and thoughts, without making judgments.
• Return to daily routines.

When Should You Contact Your Doctor or Mental Health Professional?
About half of those with PTSD recover within three months without treatment. Sometimes symptoms do not go away on their own or they last for more than three months. This may happen because of the severity of the event, direct exposure to the traumatic event, seriousness of the threat to life, the number of times an event happened, a history of past trauma, and psychological problems before the event.
You may need to consider seeking professional help if your symptoms affect your relationship with your family and friends, or affect your job. If you suspect that you or someone you know has PTSD, talk with a health care provider or call your local mental health clinic.