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Cedar County Public Health Dealing with Infectious Diseases
These days, it's enough
to make you want to walk around with a surgical mask and rubber gloves on. Cedar County Public Health is into infectious diseases
in a way that it hasn't in it's history. Director Rick Fleshin stated "We" currently dealing with MRSA, Cryptosporidium, Salmonella,
and the usual viruses and other bacteria."
Cryptosporidium
The state health department has issued repeated
alerts about Cryptosporidium a protozoan infection that is passed along in recreational water like swimming pools and then
by people handling food without proper hand washing. There have been 863 cases this year so far as opposed to 230 cases in
2006.
Here are the symptoms to look for: Diarrhea, abdominal cramps, loss of appetite, vomiting, and weight loss.
Those symptoms can keep going almost constantly for 1 to 2 weeks. Fleshin says sometimes they'll start to go away and but
recurrence is actually fairly common. There's actually no way to prevent it... just follow good hand washing hygiene and don't
drink contaminated water. What is interesting is that alcohol or bleach based cleaning (hands or surfaces) is not effective
and doesn't work. Hydrogen Peroxide (3%) is the only known readily available cleaning solution and should be used undiluted
to effectively clean up after someone with cryptosporidium.
In March and April 1993, the largest US waterborne disease
outbreak occurred in Milwaukee, Wisconsin, causing illness in more than 400,000 people. The etiological agent responsible
was Cryptosporidium. Milwaukee was served by two water treatment plants which were contaminated by upstream meat processing
facilities that used raw water from Lake Michigan.
MRSA
MRSA stands for Methicillin Resistant Staphlococcus
Aureus which is to say it is a bacteria (called "staph") that is resistant to a extremely strong kind of Penicillin.
MRSA has received a huge amount of media/press attention in the last weeks but the truth is it has been present in hospitals
for decades. Mary Dorris, the Public Health Nurse who heads up infectious disease investigations, says that parents are calling
school nurses, clinics, and the public health department wanting information on how to protect their children or themselves.
She says it was one of the first germs to outwit all but the most powerful drugs. She is advising Cedar County schools regarding
policies when a student who is an athlete gets diagnosed with MRSA. MRSA infection can be fatal. MRSA is spread by contact.
So you could get MRSA by touching another person who has it on the skin. Or you could get it by touching objects that have
the bacteria on them. Hospital and clinic infection rates are rising rapidly.
The Centers for Disease Control and
Prevention recently calculated that MRSA is responsible for 94,000 serious infections and nearly 19,000 deaths per year in
the United States. These numbers would make MRSA responsible for more deaths each year than AIDS.
How to prevent MRSA
infection ? Four things: (1) keep your hands clean by washing thoroughly with soap and water or using an alcohol-based hand
sanitizer, (2) keep cuts and scrapes clean and covered with a bandage until healed (3), Avoid contact with other people's
wounds or bandages and (4) avoid sharing personal items such as towels and razors.
Salmonella
Salmonella
is the bacteria that causes both typhoid and food poisoning. The disease is characterized by diarrhea, abdominal cramps, vomiting
and nausea, and generally lasts up to 7 days.
There is a current recall of Banquet pot pies that are contaminated
with Salmonella. At this time, CDC recommends that people do not eat any Banquet pot pies or pot pies made by ConAgra Foods
that have a printed code ending in "P9". Other brands of pot pies made in the ConAgra Foods factory that makes Banquet brand
pot pies and sold under other brand names may also be contaminated with Salmonella. These other pot pie boxes also have a
printed code ending in "P9". If you have any of these products at home, the safest thing to do is to discard them.
Most
persons infected with Salmonella develop diarrhea, fever, vomiting, and abdominal cramps 6 to 72 hours after infection. In
most cases, the illness lasts 3 to 7 days—most affected persons recover without treatment. However, in some persons
the diarrhea may be so severe that the patient becomes dangerously dehydrated and must be taken to a hospital. Cedar County
has had people hospitalized in the last 2 weeks for this.
The best way of avoiding Salmonella infections is make sure
that everything is thoroughly cooked. Other precautions include washing hands and surfaces often, washing hands, cutting boards,
dishes etc with hot soapy water before handling food, separating raw meat, poultry, and seafood from other foods, cook to
proper temperatures and refrigerating promptly.
Food Borne Illness
Cedar County Public Health recently investigated
a food borne illness outbreak in which 18 out of 22 people attending a birthday party got violently ill with vomiting and
diarrhea. After an extensive 2 week investigation into the sources of the food for the party, Dorris says that the only people
who got ill were those at that party and that was a young 23 month old who was ill with diarrhea who somehow contaminated
everyone at the party. Those hospitalized, unfortunately did not have culture and sensitivity tested so it is unknown what
got everyone so sick. Everyone eventually recovered.
"Mystery Illness"
Several weeks ago, one of the school
nurses in the county noticed an unusual number of students in elementary, middle and high school were out with fever, nausea,
headache, and dizziness. Public Health began monitoring all 5 school systems for this unusual constellation of symptoms. In
all five school systems, the school nurses began dutifully sending in daily reports of what the students were out with. Immediately,
the picture at each school and countywide indicated no pattern or any indication of anything amiss. This has continued. Fleshin
said "There is no indication of anything out of the ordinary we more than likely have a small fall surge (school has started)
in upper respiratory infections as well as viral gastroenteritis bugs out there but nothing out of the ordinary or supremely
dangerous line to all of these is basic hygienic practices: lots of good hand washing, proper food preparation, covering sneezes,
proper rest, exercise, hydration and nutrition.
Mumps
We have one current case of known mumps in the county. Mumps is an infection of the salivary
glands spread through respiratory secretions (saliva). Mumps spreads by sharing drinks, kissing, sneezing or coughing. Symptoms
include swelling of the glands close to the jaw, fever, headache, and muscle ache. Although mumps is a mild disease, one in
three young men may get painful, swollen testicles. Some of these men may end up with permanently shrunken testicles and in
rare cases infertility. Women who develop mumps during their first trimester of pregnancy have a much higher risk of miscarriage.
Mumps can also cause meningitis/encephalitis. Meningitis may lead to permanent damage of the brain and spinal cord and can
rarely cause death. Please see our "Mumps" page for more info and if you think someone in your family has mumps, please get tested.
Cryptosporidiosis Outbreak in Cedar County
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Sep 4, 2007--Cedar County Public Health Director Rick Fleshin confirmed there have been two confirmed cases of
Cryptosporidiosis (crypto) in Cedar County and at least 4 other cases that were presumed to be without laboratory verification.
Cryptosporidiosis is a protozoan infection that is most commonly spread by contaminated swimming pools, interpersonal contact
(fecal-oral), drinking contaminated water, and by eating food that was contaminated during preparation.
Crypto
can cause watery diarrhea, dehydration, loss of appetite, stomach cramps, fever, nausea, and vomiting. Symptoms typically
occur 2 to 12 days after exposure, but the illness may go in cycles of getting better then worse before the illness ends.
Fleshin said as of last week Iowa had 206 crypto cases for this year which is a 61% increase over the 3 year average.
"Cases
counts are still increasing statewide, which is why we are requesting follow-up on all cases for the next 30 days, as we are
seeing pockets of increased activity in counties. We need to stop these pockets from spreading before it gets out of control
" stated Sarah Brend, Epidemiologist for the state health department.
"We continue to follow up all confirmed cases
and any promising leads, and we are convinced that appropriate steps have been and are being taken to prevent the spread of
this disease," Fleshin said. Cedar County Public Health has contacted all restaurants, childcare centers, and schools
in the county, given guidelines and suggestions on how to prevent transmission. Children with diarrheal illness should not
attend childcare or school. Employees who handle or prepare food should not be working. All persons should practice significant
hand washing before food preparation and after using the bathroom.
Cedar County Environmental and Zoning has gotten
involved in one case already and Department Head Phil Larue is testing a Cedar County well of a family that has the disease.
The results are still pending.
In March and April 1993, the largest US waterborne disease outbreak occurred in Milwaukee,
Wisconsin, causing illness in more than 400,000 people. The etiological agent responsible was Cryptosporidium. Milwaukee
was served by two water treatment plants which were contaminated by upstream meat processing facilities that used raw water
from Lake Michigan.
If you have been sick with diarrhea or an upset stomach, however, the Iowa Department of Public
Healths recommendation is to stay out of the water. ;Two weeks. That's how long you need to wait before going back into the
water if you've had diarrhea due to cryptosporidiosis (crypto), said Dr. Patricia Quinlisk, state epidemiologist at IDPH.
Crypto is one of the most common waterborne diseases and it can spread very easily in recreational water. She went on later
to say "While it is important to remember that there are multiple potential sources of exposure to Cryptosporidium
in our environment. These sources include contaminated food or drinking water, ill people or infected animals." It is estimated
that greater than 90% of all dairy farms are infected with cryptosporidium.
The large outbreaks of crypto in several
Iowa counties that have been linked to swimming pools. Especially high numbers of cases have been reported in Dubuque and
Cerro Gordo Counties. Fleshin said "We are investigating any possible links here to swimming pools but my impression is
that this may not be the case." He said that one person has been hospitalized from Cedar County already and that this disease
should not be taken lightly. The problem is that once someone is ill from a swimming pool they can infect hundreds others
without going near a swimming pool.
Persons who think that they might have crypto, should see their doctor. To avoid
getting crypto yourself, do not swallow recreational water. Remember to wash your hands thoroughly after going to the bathroom
and before eating. ========================================================
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