What Do You Know About Adenovirus?

The news has been filled with reports of 7 deaths in New Jersey related to adenovirus. According to CNN, this is related to an outbreak among “medically fragile” children at the Wanaque Center for Nursing and Rehabilitation. This virus may not be a familiar name to many of the public. Things like the flu, whooping cough, or chicken pox are well known illnesses, but adenovirus does not frequently cause a national conversation.

So, what is adenovirus? It is a virus that can cause a wide range of illnesses, especially in children who are more susceptible to illness in general. According to Cedars-Sinai, in children, it can cause respiratory illness, colds, pink eye, croup, bronchitis, and pneumonia. It can even cause digestive tract infections, depending on the route of transmission from one person to another. While many people experience mild illness with symptoms of the common cold, some people- especially children, can experience complications such as chronic lung disease, severe infection or intussusception (telescoping of the intestine onto itself). Some strains of adenovirus are known to be very severe and can cause serious illness, especially in communal living situations where the virus can easily be passed from one person to another. The challenge with this pathogen is that it can be difficult to get rid of. It can live on plastic and metal surfaces for a month, making some medical equipment (often composed of these materials) susceptible to the virus. Additionally, some cleaners do not kill the virus easily, so precautions must be made to ensure that surfaces and equipment are cleaned properly.

Due to its resiliant nature, adenovirus has been linked to a number of outbreaks over the years. In fact, the military even vaccinates its personnel against the disease because they have increased risk of infection due to their close living quarters. The current outbreak is due to a failure of the healthcare facility to provide a clean and adequate physical environment and their deficiencies in sanitation allowed a severe strain of the virus to thrive- infecting children with compromised health.

Just like most viruses, adenovirus is present in our every day environment. What can you do to keep yourself healthy? The CDC recommends general hygiene practice as the best prevention method. This includes washing your hands with soap and water (especially after going to the bathroom), avoiding close contact with sick individuals, and avoiding touching your eyes, nose, or mouth with unwashed hands. These are simple steps that can help prevent both the common cold and serious illness.


Alternatives to Meat

A new Missouri law prohibits food companies from marketing meat-alternative products as meat. This law applies to all meat substitutes such as soy based or plant based meat. Senate bill numbers 627 and 925 specifically states, “Misrepresenting the cut, grade, brand or trade name, or weight or measure of any product, or misrepresenting a product as meat that is not derived from harvested production livestock or poultry” CNN reports that this move was made in response to concerns that meat-free products are misrepresented as meat products, which is in violation of the FDA’s prohibition of misrepresentation of food products. The decision in Missouri has garnered a large amount of backlash among organizations that feel this move works in the benefit of meat producers and against the free speech of meat alternative.

For those of us who are not well versed in the meat alternative market, these products often appeal to vegetarians or people who maintain meat free diets as part of dietary or religious restrictions. According to Mother Nature Network, the market for alternative meat products has increased over recent years as the health and wellness market has expanded. This market has also gained traction as concerns for the environment and animal/livestock welfare have grown. In fact, in 2012, it was an industry producing a whopping $553 million in sales.

How is fake meat created? Some products are just simple alternatives with masked flavoring. Things like beans, lentils, nuts, seeds, and grains can be used to develop meat free protein sources. However, many of these alternative products start with plant based proteins that are manufactured to produce textures that are comparable to actual meat. Changing the molecular structure is a very scientific process that requires hear, acids, or other solvents. If you are hungry for a hamburger, soy beans aren’t just going to fulfill the craving. As such, the goal is to make the substitution as close to the real thing as possible. Over the years the taste, texture, and quality of alternative meat products has improved. So much so, that it can even be difficult to determine the difference between the plant based product and the real thing.However, it is important to know that these sources (although they may taste, smell, or act like their counterparts) are often incomplete proteins that do not contain all of the essential amino acids that your body needs. Typically true meat counterparts are complete proteins and alternative meats are unable to meet this quality. The only alternatives that are complete proteins are soy, quinoa and hemp (Independent).

The current moves made by the Missouri government and associated organizations (both those for and against) may change our consumption and understanding of the meat and meat alternative products available on the market. If this discussion gains national traction, it could lead to changes in our diet and perception of alternative diets. On top of this is the emerging lab produced meat scene that is continuing to grow here and overseas. Lab grown meat contains the same cells, taste, and structure as actual meat products but is is not actually produced by animals. If this type of alternative meat becomes available to the general public, how will it fit into this law? We might soon find out, as some people anticipate that meat produced by this alternative might be available by the end of 2018 (CNN!


Car Safety

In this day and age, most people have a driver’s license or regularly use a motor vehicle in the United States. Becoming 16 and getting your license is a right of passage among modern Americans. In order to become a driver, everyone must pass a driver’s safety test- and with good reason. The CDC states that there were “22,441 passenger vehicle occupants died in motor vehicle traffic crashes in 2015.” Additionally, more than 2.5 million passengers and drivers were treated in the Emergency Room for injuries related to motor vehicle collisions in that same year. So, for this week’s post, I am going to explore motor vehicle safety. Hopefully we can reduce the number of collisions and injuries on the road, one smart choice at a time!

First up is car seat safety! The National Highway Safety Administration has information about the types of car seats and recommendations regarding their use. A rear facing car seat should be used, at minimum, for all children under 12 months. If your child is still below your car seat’s maximum height and weight requirements when they are 12 months of age, continue to keep your child in the rear facing car seat until they reach that limit, or until they reach 3 years of age. Follow whichever happens first. Why? This is because rear facing car seats are the safest for your infant or toddler. The only notable exception to this rule is if your child was born premature. Since it may be more difficult for a premature child to breath in the inclined position of a car seat, he or she may need to use a car bed or have an adult attend to them in the back seat during car rides. Parents of premature infants should consult their pediatrician for the best and safest practice for their child. Most children are ready to move up to the next seat around 2 years of age. After using a rear facing car seat, a child should move to a forward facing car seat until they reach your car seat’s maximum height and weight limits or until they reach 7 years of age. After a child has outgrown his or her forward facing car seat, he/she should move to a booster seat that is forward facing and uses a seat belt. Your child may use a booster seat until 8-12 years of age, or until the seat belt fits properly without it.

Remember that a car seat or booster seat should always be placed in the rear seat of the car and never in the front seat. The safest place for a car seat is away from airbags, ideally in the center seat of a row of seats. This is safer than positioning the car seat near a door. Additionally, always fully buckle the car seat as instructed by the manufacturer and as instructed in your vehicle’s manual. A car seat or booster seat should be installed securely and properly, and a safety seat should only be used in the vehicle, not outside of it (ie: not as a place for a baby’s nap in the house). Ensure that the safety belts fit snug across the body. Shoulder belts should go across the chest and shoulder, not the neck, and the lap belt should go across the thighs, not the stomach. The back seat is the safest place for your child until they are 13 years old.

Adults and older children should also follow safety belt rules and regulations to protect themselves. According to the CDC, “every day, about 6,400 adults are injured in a crash.” Young adults (18-24) are less likely to wear seatbelts than any other age group and men are less likely to wear a seat belt than women. This is despite the fact that there are primary or secondary seatbelt laws throughout the country. This is despite the fact that seat belts “reduce serious crash-related injuries and deaths by about half.” For those who don’t know, a primary seat belt law is one that allows a police officer to pull over a car for a driver or passenger not wearing a seatbelt, whereas a secondary seat belt law means that if a driver is pulled over for a different offense, the officer can issue a ticket for not wearing a seat belt.

If you are interested in your particular state’s facts and figures regarding seat belt use and motor vehicle collisions, the CDC has a list available here.(There are more visual aids and state comparisons here.)

Beyond safety belt use are concerns over the driver’s condition. These include things such as drunk driving or distracted driving. In 2010, the CDC reported that 112 million adults drove while intoxicated. 4 out of 5 of these drunk drivers were men and those who binge drink were more likely to get behind the wheel than those who don’t. While many teens and young adults may argue in favor of a younger drinking age, by keeping the legal limit to 21 years old, we are able to keep inexperienced and drunk drivers off the road. Choosing a designated driver, drinking wisely (not binge drinking) and preventing others from drinking and driving can reduce the problem nationally. The National Safety Council also notes that driving the speed limit, using extra precaution in locations where children might be present (especially while driving in reverse), as well as refraining from driving after consuming illicit drugs or prescription medications, especially those that may make you drowsy.

You are the best advocate for safe driving. Wearing a seat belt, being a proactive driver, and making smart decisions about your role as a driver or passenger can help prevent accidents, injuries, and even potential death.

Famous Names · Uncategorized

Bernardino Ramazzini

Hello everyone!

I hope you all had a great summer. You may have noticed that I took quite a hiatus from the blog. I started my MPH classes in May (which took up a LOT of my time), visited some family, and moved across the state! Now that some of this craziness has passed, I am glad to be back on the blog as I start medical school. However, instead of posting on a weekly basis, I will likely post every other week. Ideally, there will be a few personal or medical school related blog posts in the mix as well, but I can’t make any promises this early in the game.

Let’s start this month with a popular section, “Famous Names in Public Health!” This month’s figure is known as the father of occupational health. His name is Bernardino Ramazzini.


Ramazzini was born in Italy in 1633. He studied medicine at Parma University where he developed a particular interest in worker’s health and the prevalence of disease among specific professions. During his career he published De Morbis Artificum Diatriba (Disease of Workers) which was a collection of works regarding detailed and specific information regarding worker’s diseases, notes of his observations, and advice. Much of this information was collected through observation, interviews, and interaction with the workers.

Since 1700, Ramazzini’s work has remained popular around the world and has been translated into many languages (although it is important to note that it wasn’t until it’s re-printing in 1940 that his writings on occupational diseases truly gained traction in the public health field). He has been cited numerous times throughout history by prominent members of society including Karl Marx, Cotton Mather (the Puritan minister), and Alice Hamilton (considered the founder of toxicology). (1). In these works, Ramazzini made some interesting insights. He condemned smoking tobacco by noting that it contributed to illnesses among tobacco workers and he made many important observations about the effects of posture and movements on physical health (an important component of ergonomics). An overview of many of the observations that Ramazzini makes in his collection can be viewed here.

Rammazzini’s continued interest in worker-related illness contributed to a lifelong commitment to the field of worker’s health and served as the foundation of the field of occupational medicine. (2). His recognition of the impact that occupations can have on a person’s health has revolutionized our understanding of illness and disease. Without his notable works, organizations like OSHA would not exist to protect workers today.



Ever wonder why people hesitate to share hair brushes or hair ties? Why is hair hygiene is such a big deal? Why do people just others by how clean their hair appears? While the basis of these questions is about hygiene and self care rituals that we value in our society, part of the concern is related to one, tiny issue. That tiny issue is lice.

What are lice? Firstly, the singular form of lice is louse. These tiny insects often infect hairy places (like the scalp) and feed on our blood. They are mostly spread by head to head contact, but they can also be spread through personal items such as headwear, hats, combs, or brushes. I was relieved to find out that lice cannot fly, so near but non-touching contact to an infected person does not put you at significant risk. Additionally, these little guys can only live for 1-2 days without feeding, so getting lice from furniture or the floor is limited. The reason there is so much fuss about lice is that these little bugs can cause itching, scalp irritation, or sores. You may have an allergy to them or by scratching the itch, you could introduce a secondary infection that will worsen your symptoms! It is surprising to note that head lice are not a sign of poor hygiene because people of every cleanliness level can be affected by lice. Additionally, although lice can cause symptoms like itchiness and discomfort, they don’t carry diseases. You can read (and see) more about lice here (beware, there are pictures!)

Head lice prevention: School aged children are at the highest risk of lice because close contact and play with others means that they are more likely to come into personal contact with another person. (As an adult, I can’t think of the last time I shared a hat with a coworker! It just doesn’t happen as frequently as it does with children.) There is no current FDA approved lice prevention product available. Most suggestions are not well regulated and should be undertaken with the understanding that there can be significant risks involved. Do not try homeopathic solutions without checking with your doctor first. Mayo Clinic notes that many formularies include “plant oils such as rosemary, citronella, eucalyptus, tea tree and lemon grass.” You can also disinfect brushes by cleaning them and soaking them in hot water. However, the best tool for prevention is behavior. Limit head to head contact with others. Don’t share personal belongings, especially items that come into contact with your head or hair. Also, avoid coming into contact with clothing, sheets, and materials that a known infected person has used. This will lessen the possibility of the lice being transferred to you. It is important to note that the CDC warns against using fumigation sprays or fogs because they are not effective against lice.

Head lice treatment: It is currently recommended by the CDC that any person with an active lice infection be treated. Additionally, any person who has knowingly come into contact with the infected person should also be treated so that they limit the outbreak and reduce the spread of lice. First and foremost, if you think you may have a lice infection, consult your physician. They will be able to guide your treatment plan and may be able to tell you if the lice in your area is resistant to standard treatments. Lice treatments can be bought over the counter or prescribed. These medications usually come in a combination of 2 categories, pediculicides and ovicides. Pediculicides kill only the lice. Ovicides kill the eggs. For the best treatment, it is ideal to choose a formulation that does both. Follow the instructions on the packaging and be aware that some methods require more than a one time treatment (often a repeat treatment a few days after the first one). Using a fine tooth comb in conjunction with this is also ideal to ensure that all of the nits have been removed from the hair. Additionally, anything that has had contact with the infected person in the past 2 days should be washed in hot water to kill the lice. (Anything used more than 2 days ago is considered safe because lice cannot live longer than that without a host for food). Any item that cannot be washed should be quarantined in a plastic bag for 2 weeks. As always, there are natural and homeopathic alternatives for lice treatment readily available by a simple search on the internet. This list Health.com list contains both over the counter lotions such as Spinosad and alternatives such as olive oil. The American Academy of Dermatology reminds us that some treatments fail because of population resistance and unregulated treatments, although effective, can have unforeseen risks. This could include unsafe ingredients, reactions with other products you have used, or even toxic effects. As always, do not undergo treatment without the guidance of your physician. If necessary, he or she can provide a referral to a dermatologist.


Lead paint, lead pencil, lead bullet

Do you remember the ordeal in Flint, Michigan? The city decided to change its water supply from Lake Huron to the Flint River to save money. Furthermore, the city was not treating the water properly with an anti-corrosive agent so not only was the iron from the main water pipes leaching into the water supply, it was also pulling water from the residents’ pipes as it flowed into their houses. As a result, the community members were being exposed to levels of lead. The children here started suffering from lead exposure and lead poisoning. Their blood lead levels were sometimes double or triple what their records showed their previous toddler blood lead levels to be. This event reignited the national conversation about lead poisoning and environmental health.

Flint is not isolated in their lead level problems. In April, 2018, news broke about elevated lead levels in the Chicago water supply. Even though many of us think of lead exposure as an “old fashioned” problem affecting our parents or even our grandparents, recent studies have shown that this is not the case. Lead and metal exposure should still be part of our discussion when it comes to health and safety today.

Lead is a metal that is a natural part of our earth. It is used in many manufactured items such as paint, pipes, toys, glassware, and even gasoline around the world. The problem with this element is that it can accumulate in the body and cause dangerous changes in our health. This is why some lead containing products, such as paint and gasoline, are banned in the United States. However, there is still possibility of lead exposure to products made before regulation was put into place or from objects that are imported into our country.

There is no safe blood level of lead. According to the CDC “at least 4 million households have children living in them that are being exposed to high levels of lead.” Lead exposure can have negative effects on almost all body systems. The WHO states that lead can be “distributed to the brain, liver, kidney and bones.” Lead also decreased vitamin D levels in our body. The biggest risk is to the brain and nervous system. It can accumulate in stores found in the teeth and bones. This means that small exposures over time can have a compounding effect. These affects are particularly dangerous for children because they are still developing and their digestive tract can absorb over 50% of the lead they are exposed to (as opposed to 15% in adults).

In children, lead poisoning can cause brain damage, slowed development, learning and behavior problems as well as hearing and speech problems. These symptoms can contribute to decreased attention span and lower IQ scores. As a result, these children may struggle in school and may be prevented from reaching their full potential as adults.

There are some treatments available for patients who have elevated lead levels. If someone is acutely affected by the ingestion of a large amount of lead over a short time, a gastric lavage (stomach pump) can be used to remove lead containing material. For chronic treatment, chelation therapy can be used. These molecules bind to lead in the body to prevent its absorption. However, there is little information about the treatment available to manage the developmental and behavioral affects of lead poisoning. There is also very little information available about how beneficial those types of treatments may be.

In fact, lead exposure is so important that it is an objective of the Healthy People 2020 campaign. There is education on their website as well as detailed plans to mobilize and implement changes. There is also a National Lead Poisoning Prevention Week every year. (This past year it was October 22-28). The goal of this event is to raise awareness as lead exposure as a preventable issue and to encourage the implementation of programs and outreach in the community.



If you live in Texas, like I do, you are probably more than aware that this Spring has been a terrible allergy season. Hopefully the rest of the country has been able to avoid the abundant amount of pollens, grasses, and molds that cause allergy symptoms that have been plaguing Texas over the past few weeks. But, if you are like many of us Texans and suffering from allergy symptoms, let’s learn a little more about what causes these seasonal reactions.

In the United States, spring allergy season usually runs from February to early summer as trees and plants transition from winter conditions to the warm summer weather. Additionally, a wet and rainy spring can encourage plant growth, increasing pollen counts and leading to a worse allergy season. However, there is also an allergy season in the later summer and fall as the weather transitions from warm to cool. Some regions have worse allergy symptoms than others. Apparently, Knoxville, Tennessee is the worse place in the US for spring allergies. Pollen is the biggest aggravator of seasonal allergies and every year, the pollen count continues to rise.

Some traditional medications for seasonal allergies include antihistamines, nasal steroid sprays and decongestants. According to the FDA, “Antihistamines reduce or block symptom-causing histamines and are available in many forms, including tablets and liquids.” Nasal steroids are usually sprayed into the nose to treat nasal inflammation. Decongestants are used to treat congestion symptoms. There are natural practices that can also be used to treat allergies, with some possible (although inconsistent) effectiveness. For instance, some probiotics may affect the immune system, including the body’s allergy response. Probiotics can be found in foods like kefir, kimchee, sauerkraut, yogurt and kombucha. Another possible treatment is honey. The concept reasons that since honey contains small amounts of pollen, honey ingestion can help someone increase their tolerance of pollen. Thus, making them less sensitive to pollen and lessening their allergy symptoms. An alternative school of thought is that honey may have antihistamine or anti-inflammatory effects that can counteract your body’s histamine response. Congestion and runny nose can be managed with the use of a neti pot which rinses the nasal sinuses. However, it is important to use only filtered or sterile water in these devices. Improper use can lead to serious illness or possibly death. This was the case of a Louisiana man and woman who died from a brain eating amoeba infection in 2011 after using tap water in their neti pot.

For people who suffer from seasonal allergies, tracking pollen counts and knowing what types of grasses, trees, and pollens aggravate your symptoms can be a great help and indicator of your symptoms. On high pollen count days, it may be better to keep windows closed and stay inside. Additionally, if your allergies continue to progress for a long time, knowing what the allergy season is like in your area may help advise your decision to meet with your doctor to discuss additional symptom management. A great website to track pollen and allergy demographics in your area is pollen.com.