Zika Virus Disease
                              Joanna Hayden, PhD, CHES

From time to time, Health News You Can Use addresses public health issues rather than the results of studies. This is one of those times.

 So, just what is Zika Virus Disease?

It is usually a mild viral infection usually contracted through  the bite from an infected mosquito, or sexually through the semen of a Zika infected partner.1  According to the Centers for Disease Control and Prevention (CDC), and the World Health Organization (WHO), Zika virus was first identified in 1947 in the Zika forest in Uganda, hence the name. It wasn’t until 1952 that the first case of a person infected with the virus was diagnosed. 

Until recently, Zika infections were confined to Asia, Africa, and the Pacific Islands. In May of last year, the first case of Zika was diagnosed in Brazil, and on February 1st of this year, the World Health Organization declared Zika Virus Disease an international public health concern.

In 75-80% of cases, Zika Virus Disease does not cause symptoms, which means most people don’t know they are sick. Even when symptoms do occur, they are often so mild or so similar to other common viral infections, that they go unreported. In the 20-25% of people who do develop symptoms, they last between 2-7 days and include:

          Mild fever
          Muscle or joint pain
          General malaise/illness  
       Skin rash

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       Conjunctivitis

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According to the WHO, it does not appear that Zika infections are fatal. However, in areas where Zika has been diagnosed, there has been an increase in the number of people diagnosed with Guillain-Barre Syndrome (GBS).  Guillain-Barre is an auto-immune disease, a disease in which something (maybe the virus) triggers the immune system to attack the person’s body. In GBS, the immune system attacks the nerves in the extremities, usually in the hands and feet first, progressing up the legs and arms leading to weakness and paralysis. Recovery from this can take as little as a few weeks to as much as three years or more. 2

The bigger concern is for pregnant women. A Zika infection during pregnancy can spread from the mother to her fetus causing microcephaly. Microcephaly, or a smaller than normal head, happens when the brain does not develop properly
Microcephaly is associated with:
·         Seizures
·         Developmental delays (speech, sitting, standing, 
          walking, etc.)
·         Difficulty learning
·         Difficulty eating or swallowing
·         Hearing impairment
·         Vision problems 3
         

The CDC recommends the following actions to decrease the risk of contracting Zika Viral Disease:

When traveling to countries where Zika Virus has been identified:

  • Protect yourself from mosquito bites
  • Wear long-sleeved shirts and long pants.
  • Stay in places with air conditioning or that use window and door screens to keep mosquitoes outside.
  • Sleep under a mosquito bed net if you are overseas or outside and are not able to protect yourself from mosquito bites.

                    Always follow the product label instructions.
                     Reapply insect repellent as directed.
                     Do not spray repellent on the skin under clothing.
                     If you are also using sunscreen, apply sunscreen                         before applying insect repellent.

  • To prevent sexual transmission from an infected male partner – practice safer sex or abstain from sex. Unfortunately, it is not known yet, how long Zika Virus remains in semen. All that is known is that it is present in semen for longer than it is in the blood, which is about a week.

The take away from all of this is

1. Avoid traveling to areas where Zika has been identified especially if you are pregnant or trying to become pregnant.

2.  If you cannot avoid travel, then follow the precautions above to minimize mosquito exposure.


For more information:

Microcephaly
http://www.cdc.gov/ncbddd/birthdefects/microcephaly.html

CDC - Zika Virus
http://www.cdc.gov/zika/index.html

WHO Zika Virus – FAQ’s
http://www.paho.org/hq/index.php?option=com_content&view=article&id=9183:2015-preguntas-frecuentes-virus-fiebre-zika&Itemid=41711&lang=en

National Institutes of Health – Guillain-Barre Syndrome
http://www.ninds.nih.gov/disorders/gbs/detail_gbs.htm


References:

1.        Centers for Disease Control and Prevention (2016). Questions and answers: Zika virus infection and pregnancy. Available from http://www.cdc.gov/zika/pregnancy/question-answers.html

2.        National Institute of Neurological Disorders and Stroke. (2015). Guillain-Barre Syndrome fact sheet.  Available from http://www.ninds.nih.gov/disorders/gbs/detail_gbs.htm

3.        Centers for Disease Control and Prevention (2016). Facts about mircocephaly.  Available at http://www.cdc.gov/ncbddd/birthdefects/microcephaly.html

 


 
 
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Taking Good Care of Your Teeth May Reduce Risk of Stroke

      Joanna Hayden, PhD, CHES


Researchers found yet another association between the health of our teeth and the risk of cardiovascular disease. This time, they uncovered a significant relationship between stroke and the presence of a specific strain of streptococcus bacteria in saliva. Tooth decay resulting from the acid produced by bacteria in the process of breaking down food, allows the bacteria to enter the blood stream. Changes in the small blood vessels in the brain from age and high blood pressure may attract the bacteria, increasing inflammation and setting off a cascade of events that results in increased stroke risk. The results were published online February 5, 2016 in the journal Scientific Reports.

The complete journal article is at:
http://www.nature.com/articles/srep20074

A summary of the article is at:
http://www.medicalnewstoday.com/releases/306664.php

Use this news

The results of this research adds to previous findings showing the relationship between oral health and the health of our blood vessels and heart. Good oral health practices reduce the risk of tooth decay, of  bacteria from entering the bloodstream and ultimately, of  damage to the blood vessels in the heart and brain.

The take away from this research is that stroke risk may be reduced by following good oral health practices, as most tooth decay can be prevented most of the time. According to the American Dental Association good oral health practices include:
  • Brushing at least twice a day for at least 2 minutes.
  • Using a soft toothbrush that fits in the mouth and allows access to all of the teeth.
  • Replacing toothbrushes every 3-4 months.
  • Using fluoride toothpaste.
  • Using proper brushing technique.
                   -  hold the toothbrush at a 45-degree angle to the gums. 
                    - move the brush gently back and forth in short
                      (tooth-wide) strokes. 
                    - brush all of the surfaces of the teeth, not just the 
                       chewing surface.
                    - tilt the brush vertically to clean the inside surfaces of the                         front teeth, and make several up-and-down strokes.
                    - and don’t forget to brush the tongue to remove bacteria
  • Flossing at least once a day, either before or after brushing.
Having regular dental check-ups is also important to attaining and maintaining good oral health. In June of 2013, the American Dental Association released a statement on regular dental visits  recommending that the frequency of visits for good oral health should be determined by the dentist based on individual oral health status and health history.

For more information:

American Dental Association –

        Brushing and flossing - http://www.mouthhealthy.org/en/az-    
        topics/b/brushing-your-teeth


         Flossing basics -  http://www.mouthhealthy.org/en/az-topics
         /f/flossing/


          Five steps to flossing  http://www.mouthhealthy.org/en/az-
          topics/f/flossing-steps


           Recommendation for frequency of dental visits
           http://www.ada.org/en/press-room/news-releases/2013-archive
            /june/american-dental-association-statement-on-regular-
            dental-visits


 


 
 
Use it or lose it” may be true of cognitive function as we age.
                       By Joanna Hayden, PhD, CHES

Following up on previous research that suggests maintaining cognitive function in older years is based on the “use it or lose it” premise, researchers compared the effects of learning challenging or difficult new skills with learning minimally challenging or no new skills on brain function.  They found that learning complex new activities improved the efficiency of brain cells in the areas that control attention and time management (executive function) and the area that controls the processing of words. The results of this research were published recently in the journal Restorative Neurology and Neuroscience.

The complete journal article is at:
http://content.iospress.com/articles/restorative-neurology-and-neuroscience/rnn150533?resultNumber=2&totalResults=734&&q=denise+park+mental++challenges&resultsPageSize=10&rows=10

A summary of the article is at:
https://www.nlm.nih.gov/medlineplus/news/fullstory_157205.html

Use this news
 
The take away from this research is that doing crossword puzzles isn’t enough to keep our brains working efficiently and us functioning competently. To keep or improve our cognitive abilities, we need to learn totally new skills, things that are demanding, difficult, complex, things we have to push ourselves to learn. Think of this as a work-out for the brain.  The more we challenge  ourselves to learn new things, the more efficiently our brains work, and the more likely it is that we will keep dementia at bay.  

If you want to challenge your brain:
  •           learn a new language – including sign language
  •           learn a new skill – painting, pottery, knitting or 
  •           crocheting,  quilting, clock repair, archery, etc.
  •          learn a new instrument – not just fine tuning one you 
                         already know
  •           learn a new computer program – build a website
  •          learn a new subject – take a college course in astronomy,
                         accounting, art history, etc.

Don’t want to do this alone? Get a group of friends together, form a club, join a club that focuses on the “new thing” you want to learn, take a course, take lessons.  Push yourself, for your brain’s sake –
use it before you lose it!

For more information:

HelpGuide – Dementia prevention
http://www.helpguide.org/articles/alzheimers-dementia/alzheimers-and-dementia-prevention.htm

Alzhemier’s Association – Speaking two languages
http://www.alzheimers.net/2013-11-11/speaking-two-languages-delays-dementia/

Mayo Clinic – Dementia Delay
      http://www.mayoclinic.org/diseases-conditions/dementia/basics/prevention/con-20034399

 
 
         Energy drinks may land you in the hospital                     
                               Joanna Hayden, PhD, CHES 
Researchers concerned by the increased use of energy drinks and reports of fatal heart irregularities, looked at the relationship between ER visits for heart palpitations and energy drink ingestion in young, healthy adults. They found that 36% of the patients had consumed at least one energy drink in the 24 hours previous to the visit, with some having more than 8 drinks. Palpitations, chest pain and increased heart rate occurred in people who were healthy and had no risk factors for heart disease. The results of this study were published in the February issue of the International Journal of Cardiology.

Reference: Ellis, M. (2016, February 4). "Energy drinks: adverse heart reactions linked to more than two per day." Medical News Today. Retrieved from http://www.medicalnewstoday.com/articles/306039.php.

A summary of the research is at:
http://www.medicalnewstoday.com/articles/306039.php

The journal article abstract is at:
http://www.medicalnewstoday.com/articles/306039.php


Use this news

Energy drinks are regularly used by more than 30% of 12 – 24 year olds1,2.  The caffeine content of these drinks varies widely from as little as 71 mg to more than 200 mg. To put this in perspective, a 1oz espresso has about 75 mg, and brewed coffee anywhere from 95 – 200 mg. The difference is that people don’t usually drink 8 espressos or 8 cups of brewed coffee in rapid succession, which does happen with energy drinks.

The amount of caffeine in about 4 cups of brewed coffee (approximately 400 mg) is considered the limit most adults can ingest without experiencing problems. Very large quantities, upwards of 5 grams (or what would be in 25 energy drinks with 200 mg of caffeine in each) can be fatal.

The National Institutes of Health 2 lists the following symptoms of caffeine overdose and its treatment:
  • Difficulty breathing
  • Changes in alertness
  • Confusion
  • Convulsions
  • Diarrhea
  • Dizziness
  • Fever
  • Hallucinations
  • Increased thirst
  • Increased urination
  • Irregular heartbeat
  • Muscle twitching
  • Rapid heartbeat
  • Sleeping trouble
  • Vomiting
Emergency room treatment for caffeine overdose includes:
  • Activated charcoal
  • Breathing support
  • EKG (heart tracing)
  • Fluids by IV
  • Laxative
  • Methods to correct abnormal heartbeat
  • Gastric lavage (tube through the nose into the stomach to empty the contents)

For more information:

Substance Abuse and Mental Health Services Administration -  2013 Update on ER visits involving energy drinks
http://archive.samhsa.gov/data/2k13/DAWN126/sr126-energy-drinks-use.htm

National Library of Medicine – Caffeine overdose
https://www.nlm.nih.gov/medlineplus/ency/article/002579.htm

Mayo Clinic – How much caffeine is too much?
http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/caffeine/art-20045678


References:
1.  Mintel International Group Ltd. (2007) Energy Drinks. Chicago, IL: Mintel International Group Ltd.
2.  Centers for Disease Control and Prevention (2015). Fact sheet: Alcohol and Caffeine. .Available from: http://www.cdc.gov/alcohol/fact-sheets/caffeine-and-alcohol.htm
3. A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M., Inc.; ©2005. Caffeine overdose; [updated 2014 Jan 18; cited 2016 Feb 8]; [about 2 p.]. Available from: https://www.nlm.nih.gov/medlineplus/ency/article/002579.htm

 

 
 
Lack of Sleep Associated with Type 2 Diabetes in Women
                            Joanna Hayden, PhD, CHES

When researchers at Harvard’s School of Public Health looked at the sleep habits of more than 130,000 U.S. women, they found that those with the most sleep problems (difficulty falling asleep or staying asleep, snoring, sleep apnea, getting less than 6 hours of sleep) had a four time greater risk of developing type 2 diabetes than those with none of the problems. The results of their study was published in the January 28th issue of the journal Diabetologia.

Reference: HealthDay[Internet]. HealthDay; 2016.
Sleepless Nights Might Raise Women's Type 2 Diabetes Risk;2016 January 29 [cited 2016 Feb 6]. Available from https://www.nlm.nih.gov/medlineplus/news/fullstory_156950.html

An abstract of the article is at:
http://link.springer.com/article/10.1007/s00125-015-3860-9

Use This News
Sleep is part of the 24 hour cycle or Circadian rhythm that regulates all of our bodily functions, including the release of hormones necessary for the regulation of blood sugar. As the researchers of the study point out, when sleep problems interrupt this rhythm the hormones (glucagon, epinephrine, growth hormone and cortisol) that work in tandem with insulin to regulate blood sugar, get out of sync. It is this loss of rhythm that may be a cause of not only the increased risk of diabetes they found in the study, but also of obesity.

Bottom line – we need to view sleep as a necessary part of a healthy lifestyle and perhaps a way to decrease the risk of type 2 diabetes. If you have difficulty sleeping and have tried all of the usual tips (below) and still don’t sleep, it may be time for an appointment with a sleep specialist.

Tips for a good night sleep:

  • Develop a soothing bedtime ritual to wind down from the day.
  • Keep your room cool, between 60 - 670
  • Keep your room dark or wear an eye mask
  • Turn off the computer and any other back lit device an hour before bed.
  • Read in bed, don’t watch TV or surf the net.
  • Set a bedtime and wake time that gives you between 6-8 hours of sleep.
  • If you wake during the night, try muscle relaxation or deep breathing to lull you back to sleep.
  • Keep paper and a pencil handy to jot down those thoughts that maybe causing you worry and keeping you awake, then let them go.
  • Eat dinner at least 2-3 hours before bedtime.

For more information:

National Sleep Foundation https://sleepfoundation.org/
American Sleep Association https://www.sleepassociation.org/
Centers for Disease Control and Prevention (CDC) http://www.cdc.gov/sleep/resources.html

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Acetaminophen (generic Tylenol) greatest cause of accidental infant poisonings

                           Joanna Hayden, PhD, CHES

Researchers looking at poison control centers data between 2004-2013, found that of the 270,000 calls made involving infants under 6 months, acetaminophen overdose was the problem in 27,000 of them. The concern with infants getting too much acetaminophen is liver failure. Among the causes for the accidental poisonings were: wrong dose, the correct dose being given too frequently, and the wrong medication being given. The results of this study were published on-line in the January issue of the journal Pediatrics.

A summary of the research is at:
https://www.nlm.nih.gov/medlineplus/news/fullstory_156676.html

Source: HealthDay [Internet]. HealthDay; ©2016.Acetominophen tops list of accident infant poisoning; 2016 Jan13 [cited 2016 Jan 28]. Available from https://www.nlm.nih.gov/medlineplus/news/fullstory_156676.html

 Use This News

According to the Food and Drug Administration (FDA), acetaminophen is generally safe and effective if the directions on the package are followed. But, if a child is given even a little more than directed or give more than one medicine that contains acetaminophen, it can cause nausea and vomiting and in some cases, in both children and adults, liver failure and death. In fact, acetaminophen poisoning is a leading cause of liver failure in the U.S. (FDA, 2011)

Incorrect dosing and over dosing often occurs because there are two different concentrations of liquid acetaminophen available, one for infants and one for children. Infant formulations are more concentrated, so less liquid has to be given. They contain 80 mg of acetaminophen per 1 ml. Children’s formulations are less concentrated and contain 160 mg of acetaminophen per 5 ml (or 32 mg of acetaminophen per 1 ml.) A 5 ml child’s dose of the more concentrated infant formula contains 400 mg of acetaminophen! (One adult tablet is 325 mg).

Although some manufactures voluntarily stopped producing the more concentrated infant formulation and only make the lesser concentrated one, some still continue to offer both.  So, both concentrations may still be on store shelves, and in your medicine cabinet.

Until all manufacturers of liquid acetaminophen change to the less concentrated formulations, parents and caregiver need to:

·         carefully read the packaging to find out the concentration of 
          medication and the dosing instructions

·         use the measuring device that comes with the medication (and
          make sure it stays with the container)

·         consult with the health care provider if the dosing amount on
          the package differs from his/her instructions.

A further issue with acetaminophen overdose has to do with the sheer number of medications, both over-the-counter and prescription, that contain the drug. In fact, there are over 600 medications that list acetaminophen as an active ingredient. To name just a few, Alka-seltzer plus®,  Forumula 44®, Mucinex,® Robitussin®, Panadol®. See the link below for a listing of all medications that contain acetaminophen.

When giving multiple medications to a child or infant, make sure to read the labels. If acetaminophen is an active ingredient in more than one of them – make sure the total amount of acetaminophen does not exceed the recommended amount. If in doubt, call the child’s health care provider before administering any medication.

Keep this number handy…

Poison Control Centers - 1- 800- 222-1222

For more information see:

American Association of Poison Control Centers –   
 http://www.aapcc.org/

Medications containing acetaminophen -
http://www.drugs.com/ingredient/acetaminophen.html

Food and Drug Administration –  Dosing
http://www.healthnews.com/en/news/FDA-Warns-of-Changes-in-Infant-Acetaminophen-Dosage/35z3cVFkH0jRUqonBO$9z2/

Food and Drug Administration – Q&A – acetaminophen and liver damage
http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm168830.htm

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