infectious disease

Check your melons!

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CDC Case Count (click to enlarge)

Last week, CDC and FDA issued updated alerts about the multi-state Listeria outbreak associated with cantaloupe.  The alerts are based on 72 cases that have been identified since the beginning of August, resulting in 13 deaths. 

Listeria is a bacteria that causes fever and diarrhea, and usually resolves on its own.  However, for the elderly and people with suppressed immunity, this infection can be much more severe and and sometimes fatal.  It can also cause miscarriage or fetal damage, so it is especially dangerous for pregnant women. 

Most notable is that this organism can grow at refrigerator temperatures, and is killed by cooking.  For raw fruit like cantaloupe, thorough rinsing before eating is recommended.  The CDC has identified certain brands of cantaloupe, grown in southern Colorado, that should not be eaten.

CDC update, 9-21-11:  http://www.cdc.gov/nczved/divisions/dfbmd/diseases/listeriosis/outbreak.html

CDC Listeria page: http://www.cdc.gov/listeria/index.html

FDA press release, 9-14-11: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm271899.htm

Keep an eye out for updates on this situation.

Roger Miller, MD
Student Health Services
The Ohio State University

Pet Lovers Beware!!

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Pets/Salmonella (click to enlarge)

Keep it clean!

Lots of students have pets at home or on campus.  Did you known that dry pet foods and treats can be a health risk for humans?  The CDC recently published a report about outbreaks of intestinal infections with a bacteria called Salmonella, that was linked to humans handling certain dry foods for their pets.  These outbreaks were in multiple states, with Pennsylvania, New York, and Ohio leading the way.

How do you safely feed Fido or Frisky?  Here are some tips:

  • Purchase products (canned or bagged) with no visible signs of damage to the packaging, such as dents, tears, or discolorations.
  • Wash your hands for 20 seconds with water and soap right after handling pet food and treats, and especially before preparing, serving or eating food, drinks or preparing baby bottles
  • Preferably, people should feed their pet in areas other than the kitchen.
  • Wash pet food bowls, dishes and scooping utensils with soap and hot water regularly. Avoid washing these items in the kitchen sink or bathtubs to prevent cross-contamination. In households where there is no alternative, the sink area should be adequately sanitized after these items have been cleaned and removed.
  • Do not use the pet’s feeding bowl as a scooping utensil – use a clean, dedicated scoop, spoon, or cup.
  • Pet food should not be handled or stored in areas where food for humans is prepared.
  • If possible, store dry pet food in its original bag inside a clean, dedicated plastic container with a lid, keeping the top of the bag folded or closed.
  • Promptly refrigerate or discard unused, leftover wet pet food and containers (e.g., cans, pouches). Refrigerating foods quickly prevents the growth of most harmful bacteria.
  • Dry pet food and pet treats should be stored in a cool, dry place under 80 degrees F.
  • Children younger than 5 years of age should not be allowed to touch or eat pet food, treats, or supplements and should be kept away from pet feeding areas. Young children are especially at risk for illness because their immune systems are still developing and because they are more likely than others to put their fingers or other items into their mouths.

Remember, washing your hands is the most important step to prevent many types of illness.  Well, I just filled up Brutus’ food bowl, better go wash my hands! 

Come on, boy, lets go!!

Roger Miller, MD
Student Health Services
The Ohio State University

Source:  http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5719a4.htm

Are Sex Toys Necessarily Safe Toys?

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www.krazydad.com

I just ran across a great article about sex toys from our colleagues at Brown Univeristy.  Now I know this is an embarassing topic for a lot of people to talk about, but I wanted to share it with you for a couple of reasons:

1. The whole point of this blog is to talk about embarassing stuff that you want to know, and

2. It brings up an important point about not making assumptions about “safe” sex.

Just like sex that doesn’t include men isn’t automatically safe, the use of sex toys doesn’t guarantee a risk free experience either.

If you’re using a sex toy with a partner, you can catch a sexually-transmitted infection from it.  While bacteria and viruses prefer living at body temperature, they can survive in blood and bodily fluids for a time outside of the body and therefore can be on the surface of sex toys passed from one partner to another.

Now, if you’re flying solo you obviously don’t need to worry about getting a sexually-transmitted infection from a sex toy, but they can result in bacteria passing from the anus to the vagina or mouth, which can cause a vaginal or intestinal infection.  So if you plan to use them in multiple areas, cover them with a condom or wash them before moving from the anus to the vagina or mouth.  

The article by the folks at Brown covers a lot of this stuff in more detail and provides some really good tips for cleaning and maintaining sex toys.  If you are worried that you may have or have been exposed to a sexually transmitted infection, come in and see us – we’re always glad to help.

John A. Vaughn, MD
Student Health Services
The Ohio State University

A cool way of SEEING how safe the HPV vaccine is

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The Visual Miscellaneum

About a year and a half ago, we did a post linking to a very cool and informative article about the H1N1 vaccine that presented tons of information in an almost purely visual format.  The blog is called Information Is Beautiful, and it’s done by a London-based “independent visual & data journalist” named David McCandless whose passion lies in reporting information through images and with a minimum of text.  

Well he’s at it again, but this time he’s taking on the HPV vaccine.  The article is definitely worth a look – it should give you a whole new way of “looking” at the HPV vaccine.

If you have any questions or concerns regarding the HPV vaccine, our preventive services department will be happy to answer them.

John A. Vaughn, MD
Student Health Services
The Ohio State University

Let’s talk: STI (Sexually Transmitted Infection) testing

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photo: tbdhu.com

Love - Fear

GYT - Make your appointment!

So you’re no virgin – you fooled around in high school and had a “went all the way” partner before coming to Ohio State.  But now you’ve met a special person, and things are getting pretty serious.  When do you start talking about testing?

As a doctor at Student Health, I have talked to students that have made different decisions when it comes to sex and STI testing. Some get tested before they ever have any sex.  Some do it before they decide to have penetrative sex (you know, intercourse, either vaginal or anal).  Some decide to get tested when they are ready to stop using condoms with their partner. (which opens up a whole can of worms when it comes to preventing pregnancy, but that is a different post.)  

So, which decision is the right one? Let’s compare another situation:

  • Person 1 likes to put on her seat belt as soon as she gets in the car,
  • Person 2 waits until she is pulling out of the Lennox parking lot and onto the street, and
  • Person 3 only wears hers when driving on the freeway. 

Who is the safest? Who is right? It’s hard to say because everyone thinks about risk and how much risk they are willing to take on differently.  That is why you must talk to your partner about STI’s.  Don’t assume that they will decide for you, or that you can decide for your partner.  TALK. 

Need some suggestions for getting ready for the TALK?  Visit the GYT site for some talking tips. 

Ready to get tested?  Visit our web site or call for more information and to get it done.  All enrolled OSU students are eligible to be seen at Student Health Services, right here next door to the RPAC. 

See you soon.

Roger Miller, MD
Student Health Services
The Ohio State University

You Got What!?! Measles!?!

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Gorakhpur, India

1960, when measles killed many

Measles virus - up close

The CDC recently reported increased cases of measles across the country.  Here are some abridged questions and answers provided by the “Ask The Experts” panel from CDC:

Q: How many cases are we seeing across the United States, and where did they come from?

A: during the first 19 weeks of 2011, 23 states reported 118 cases (usually 56 cases for an entire year). Of those cases, 89% were associated with importation from other countries.

Q: How serious is measles?

A: Measles can lead to serious complications and death, even with modern medical care. Of the 118 cases reported in the U.S. in the first 19 weeks of 2011, 40% had to be hospitalized and nine had pneumonia.  Of the 118 cases, 47 (40%) resulted in hospitalization. All but one hospitalized patient were unvaccinated. The vaccinated patient reported having received 1 dose of measles-containing vaccine and was hospitalized for observation only.

Q: What are the signs and symptoms of measles?

A: Look for

  • a generalized rash lasting 3 or more days, and
  • a temperature of 101 degrees F or higher, and
  • cough, runny nose/congestion, and/or conjunctivitis.

especially if you have recently traveled abroad or have had contact with international travelers.

Q: How contagious is measles?

A: Measles is highly infectious. Droplets has been documented in closed areas for up to 2 hours after a person with measles occupied the area.  Following exposure, up to 90% of susceptible people develop measles. The virus can be transmitted from 4 days before the rash becomes visible to 4 days after the rash appears.

Q: How long does it take to show signs of measles after being exposed?

A: It takes an average of 10-12 days for the first symptom, which is usually fever. The measles rash doesn’t usually appear until 2-3 days after the fever begins.

Q: If a susceptible person is exposed to measles, can anything prevent them from developing the disease?

A: If the person has not been vaccinated, measles vaccine may prevent disease if given within 72 hours of exposure. Other treatment may also help.  See your doctor.

Q: I don’t remember if I ever received MMR vaccine or had measles disease and I am planning an international trip. How should I handle this situation?

A: You have the choice of testing for immunity or just getting 2 doses of MMR at least 4 weeks apart. There is no harm in giving MMR vaccine to a person who may already be immune to one or more of the vaccine viruses.

Q: I’m a healthcare worker or student. How can I ensure I am protected against measles?

A: If you do not have acceptable evidence of immunity for healthcare workers–documented receipt of 2 doses of live measles virus-containing vaccine at least 4 weeks apart or laboratory evidence of immunity–either get tested for immunity or get 2 doses of MMR at least 4 weeks apart. If you choose the testing route, and your result is negative, indeterminate, or equivocal, get 2 doses of MMR at least 4 weeks apart.

Q: Does the increase in measles cases indicate that vaccination with MMR isn’t effective?

A: No. Unvaccinated people accounted for 105 (89%) of the 118 cases. Among the 45 U.S. residents ages 12 months through 19 years who acquired measles, 39 (87%) were unvaccinated, including 24 whose parents claimed a religious or personal exemption and eight who missed opportunities for vaccination.

Among the 42 U.S. residents age 20 years and older who acquired measles, 35 (83%) were unvaccinated, including six who declined vaccination because of personal objections to vaccination. Of the 33 U.S. residents who were vaccine-eligible and had traveled abroad, 30 were unvaccinated and one had received only 1 of the 2 recommended doses.

Roger Miller, MD
Student Health Services
The Ohio State University

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Source: The Immunization Action Coalition (http://www.immunize.org/express/issue937.asp)

Images: Public Health Image Library

 

Do a shot before summer break

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Get your vaccination

Getting ready to leave campus for the summer?  Maybe you will be traveling, or visiting family, or starting that summer job at the retirement home or hospital.  Maybe you are doing all of the above?  If you are, then consider getting your vacinations updated before you leave campus.

One that is really worth talking about is the pneumonia vaccine, because the Centers for Disease Control just changed their recommendations for this vaccine and they could actually impact you.

The pneumonia vaccine used to only be recommended for people over 65, or for those who had certain chronic medical conditions.  But now, anyone 19 years of age or older who smokes or has asthma is being advised to get it.  People tend not to think of asthma as a chronic lung disease for some reason, but it is and if someone with asthma gets pneumonia, they’re at a much higher risk for having a bad outcome from it.  And we all know that smoking damages your lungs and weakens their ability to withstand infections.

If either of these conditions applies to you, you only need to get one shot and most of you will be good until you are 65 years old.  Depending on the rest of your health status, some people might need a booster shot 5 years after the first one.   If you have any questions about whether or not you need to get a pneumonia vaccine, or if you’d like to schedule an appointment to get one, contact our Preventive Medicine department and they’ll be glad to help you out.

John A. Vaughn, MD
Student Health Services
The Ohio State University

What the Hepatitis is going on around here??

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Where's my liver? (CDC)

CDC

May is Hepatitis Awareness Month – so, how much do you know? 

“Hepat-” (liver) and “-itis” (inflammation) is a general condition that can be caused by toxins, chemicals, or viruses. The most commonly recognized viral types of hepatitis are Hepatitis A, B, and C.  All three irritate the liver cells and cause abdominal pain, nausea and vomiting, and discolored urine.  But, each one is a different virus and impacts your body in different ways. 

Hepatitis A travels through the body in the stomach and intestines, and can be spread between people through sewage-contaminated water or food, through direct contact with feces (poop), or through sharing of saliva. 

Hepatitis B and C travel through the blood, and can be spread through blood exposures.  Blood-borne infections can also be spread through sex activities (contact with semen and vaginal fluid), but Hepatitis B is much more likely to spread through sex than Hepatitis C.

Vaccines are currently available for Hepatitis A and B.  Research is underway for a Hepatitis C vaccine, but progress has been slow. 

Interested in more details?  Check out this CDC summary, and go the CDC Hepatitis home page.  Learn about hepatitis, how to avoid it, treat it, and prevent it.  If you have more questions, come visit us at Student Health Services.  We have professionals who can get you answers, provide testing, and offer you the available vaccines. 

Live Healthy!

Roger Miller, MD

OSU Student Health Services

 

Get Yourself Tested. Know Your Status.

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Wilce Student Health Center

We have covered several topics related to STD’s this month: getting tested, safer sex, and some STD-related vaccines.  However, sex means lots of things to different people, and it is very important that you (and your clinician) know your exposures and risks in determining what tests need to be done. 

You need to share:

  • How many partners (male, female, or both) you have had.
  • All sexual activities you had with them.
  • Whether or not protection was used.
  • What previous screening you have done.
  • Whether or not you are having any symptoms.

If you are sexually active, have been with more than one person, and were negative at your last screening or have never been tested, you should consider:

  • Urine testing for Gonorrhea and Chlamydia, if you are a male who has had vaginal sex, insertive anal sex  or if you are a female who has had vaginal sex.
  • A rectal swab for Gonorrhea and Chlamydia, if you’ve had receptive anal sex.
  • Blood testing for HIV and Syphilis.
  • An examination to check out any bumps, sores, growths that have appeared since your last screening.

A word about oral sex – Risks and testing related to oral sex are somewhat sketchy. If you give oral sex, infections can occur in your mouth or throat, but may be hard to detect. In rare cases, you may also get infections when you receive oral sex. Testing is available for certain types of oral infections.  Talk to your clinician about these risks and tests.

Other tests such as for hepatitis B and C, may be needed for some people, as well.

Once you are tested negative, consider a regular screening schedule every six months, or more often if you are concerned about exposures or symptoms.  For more information, visit the GYT site and read the STD testing FAQ’s.

Please be aware that recommended tests done after you meet with your clinician OFTEN ARE NOT covered under health insurance benefits.   Check out your coverage before your visit, and consider paying for these tests yourself if you are not covered. 

At the end of the day, being well informed, using safer sex methods correctly, and getting screened appropriately will help keep you healthy, and that keeps your next partner healthy, and their next partner, and so on. 

Be Safe! 

Roger Miller, MD
Student Health Services
The Ohio State University

Meningitis – Shot or Not?

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Get your vaccination

With the tragic death of an OSU student just before break, it is timely to discuss meningitis vaccine.  We are talking about the worst form of meningitis in adults, which is Meningococcal meningitis.  Vaccines have been sought for many years to protect people from this disease. 

This is particularly true after the great success with vaccination against another form of meningitis in infants with the HIB vaccine.  Haemophilus Influnzae B used to be the most common cause of meningitis in children, and now happens in only 2 out of every 100,000 children.

Meningococcal meningitis is present in several forms (or serotypes) that are important to understanding the vaccine.  The current US vaccines protect against Type A, C, Y and W-135.  A fifth type, serotype B, is not included in the vaccine.  Vaccines that protect against B are still in development.  What does this mean for you?  We agree with the US Centers for Disease Control and Prevention (CDC) that all adolescents should be vaccinated before high school, and consider a booster dose of vaccine if they are going to college.  Additional doses are recommended for people with certain health conditions.

However, we must remember that even 100% vaccination is not going to prevent every case of meningitis.  In addition to getting the meningitis vaccine, we should all be practicing good hygiene by limiting contact with people when we have a fever, covering coughs and sneezes, avoid sharing things that can be contaminated with saliva (cups, cans, utensils, smokes of all kinds), and also seeking care for severe headache and fever.   These steps may not prevent all tragic outcomes, as this disease can be very aggressive, but should help. 

Another thought – consider getting your flu shot every fall.  A bout of respiratory infection, including influenza, may increase your risk of meningococcal infection.  For more meningitis information, you can visit our web site  and the CDC Meningitis web site.

Best of Health,

Roger Miller, MD
Student Health Services
The Ohio State University