Pb Environmental Health Media Plan for Dissertation

HI -

This is a brief presentation on the media focus of my dissertation – “The effectiveness of the New York City Department of Health and Mental Hygiene’s Childhood Lead Poisoning Prevention Program in the Immigrant Communities of Central and Northwest Brooklyn, New York.” The link is listed below.

Regards,

Pat
Patricia Facquet, RN, M.Ed,N., MSPH, CCRC, PhD(c)
Reserach Assistant to Drs. Morrell & Thorn
Program: PhD in PUBH – Community Health Education & Promotion
Email: patricia.facquet@waldenu.edu

Facquet_PUBH Media Environmental Health Research Project

Pat’s Powerpoint test file.

PUBH Medial Environmental Health Project

This is a brief presentation on the media focus of my dissertation – “The effectiveness of the New York City Department of Health and Mental Hygiene’s Childhood Lead Poisoning Prevention Program in the Immigrant Communities of Central and Northwest Brooklyn, New York.”

Regards,

Pat
Patricia Facquet, RN, M.Ed,N., MSPH, CCRC, PhD(c)
Reserach Assistant to Drs. Morrell & Thron
Program: PhD in PUBH – Community Health Education & Promotion
Email: patricia.facquet@waldenu.edu

Schistosomiasis in Nigeria

 

 

 

 

PUBH- 6165

Environmental Health

Elizabeth Oguledo

Health Impact of Schistosomiasis and the Reduction of the Incidence of the Disease in Nigeria.

April 30, 2009

 

 

 

 

 

 

 

 

 

 

Abstract

Schistosomiasis is a public health problem in Nigeria because it causes chronic ill health among the poor and especially children. The disease is one of the major communicable diseases that infects more than 200million people in about 74 developing countries, 100 million reside in Africa, and 22 million of this number reside in Nigeria including children that need to be treated for Schistosomiasis.

This topic is extremely important and requires adequate attention because children are generally victims of this disease and this silent plaque prevents them from reaching their full potential.

There are two forms of parasites that cause Schistosomiasis common in Nigeria; they are Schistosomiasis haemobium (urinary schistosomiasis) and Schistosomiasis mansoni (intestinal schistosomiasis, but the urinary Schistosomiasis is more common. Both cause chronic bladder and intestinal health problems in humans.

Indeed, the Carter Center in partnership with the Nigerian Health authorities and the Bill and Melinda Gates Foundations, the village based health care delivery infrastructure was created for health education and drug distribution to prevent and control the disease.

 

 

 

 

 

 

 

                                                                                                                                                Schistosomiasis in Nigeria 1

Running head: HEALTH IMPACT OF SCHISTOSOMIASIS IN NIGERIA

Schistosomiasis is a parasitic disease that is commonly seen in developing countries among the socioeconomically disadvantaged communities.  The incidence is high in areas without clean water supply. In fact, some 600 million people are at risk of becoming infected.  Schiistosomiasis is caused by Fluke worm (Schistosomiasis haematobium and Schistosomiasis mansoni). They can severely impact the health of the infected because the both the male and the female fluke worms can live in human blood vessels for years releasing hundreds and thousands of  eggs (schistosomes) in to the blood vessels. (http://www.cartercenter.org/countries/Nigeria.html)

(WHO)World Health Organization in a review of the disease burden of Schistosomiasis is estimated more than 200,000 deaths per year the Sub- Saharan Africa. And 22 million Nigerians being infected with the disease including 16 million children. It is disheartening that children between ages 10 and 14 years are usually affected with this debilitating disease. (http://www.izumi.org/stories=carter center.html) Reports from a prospective and cross- sectional studies, 33.6% of 425 pupils from a community in a state in Nigeria according to Edungbola, indicated that the incidence rate is highest among children between 11 and 13 years. (http://www.3.interscience.wiley.com/journal/119986938/abstract?CRETRY=1&sRETRY=O) This condition calls for urgent attention by the government of Nigeria.

Several literatures reported that the source of Schistosomiasis infection is from water contaminated with snail, the intermediate host of the disease, so children are mostly at risk because they swim, bath and do laundry or even adults perform professional activities such as

 

                                                                                                            Schistosomiasis in Nigeria 2

Fishing, rice cultivation and irrigation in contaminated waters, more so, the disease is prevalent in areas where waters are contaminated with excreta and urine.

 

What is Schistosomiasis?

Schistosomiasis, also known as bilharzias is a parasitic disease that causes ill health in human beings. It was discovered by a young German pathologist named Theodor Bilhzar in 1851 hence the name bilharziasis. It is caused by schistosomes (eggs) which are deposited in bladder and intestine by adult fluke worms. Schistosomes (eggs) are often associated with the disease, when the eggs are discharged through excreta and urine; some are trapped in the body tissues causing damage to the bladder and abdominal tissues. (http://www.who.int/schistosomiasis/epidemiology/en/)

In addition, there are at least 19 species of schistosomes, of which 5 are pathogenic parasites to humans including two forms that are common in Nigeria; the Schistosoma haemobium and Schistosoma mansoni. (Nwoke et al, 2005).

Mode of Transmission

Schistosomiasis is transmitted by Fluke worms. When the eggs (schistosomes) are eliminated from human body in urine and excreta, the eggs hatch in water and liberate larvae (miracidia), which penetrate into the fresh water snail which is the intermediate host. The miracida mature after several into cercariae and emerge from the snail.  This is the infective stage as they can penetrate human skin they come in contact with. The cercaciae develop to maturity with the body and subsequently migrate to the lungs, liver and the veins of the abdominal cavity or the bladder plexus. (WHO)(http://www.who.int/schistosomiasis/epidemiology/en/)

 

                                                                                                                                                Schistosomiasis in Nigeria 3

Life Cycle

Schistosomiasis life cycle begin when the schistosomes leave human body in urine or excreta hatch in water and liberate the ciliated larvae (miracidia). These penetrate the fresh snail (intermediate host) digestive glands where they  form sporocytes that migrate into the snail’s digestive glands, and the sporocytes metaphose into cercariae which then migrate into the water. The cercaciae develop to maturity with the body and subsequently migrate to the lungs, liver and the veins of the abdominal cavity or the bladder plexus. The eggs escape through the excreta or urine and the cycle continues when the eggs are released in to the water. (http://www.cartercenter.org/resources/pdfs/health/schistosomiasis/schisto-disease-cycle.pdf)

Breeding Sites of the Snail

Studies show that patterns of infections have been prevalent in communities with stagnant or slow moving water, fresh water in the tropics, natural or artificial have been homes for snail. (Anosike et al, 2003) stated that species of snail infecting humans with schistosome cercariae were found in stagnant pools, waters from flooding, impoundment like dams. Also, (Nwoke, Nwoke and Anosike, 2005) said that “large waters associated with dams like the Kainji Dam in Nigeria are major transmission foci and  are endemic areas  for the fluke worms that cause Schistosomiasis” (http://www.cababstractsplus.org/abtract.aspx?AcNo=20053015573)

Also anther breeding site for Schistosomes are the water contaminated with urine and excreta. (SWAPHEP, Society for Water and Public Health Protection)

Clinical Manifestation

When the cercaria penetrates the skin, the initial entry in the skin looks like a common

 

                                                                                                            Schistosomiasis in Nigeria 4

 rash and is described as cercariae dermatitis or schistosome dermatis or (swimmer’s itch). After migration into the lungs, intestinal bladder and the liver 4-8 weeks, an acute illness that manifest  as fever, malaise, cough, rash, abdominal pain, hepatosplenomegaly, diarrhea, nausea, lymphadenopathy, eosinophilia (Katayama fever) can develop. More so, the severity of the symptoms   associated with the chronic disease is related to the burden of the worms. (http://www.pediatriccareonline.org/pco/ub/view/Red_Book/390533/0/Schistosomiasis). Also infected children have blood in their urine and the chronic bladder irritation has been linked with bladder cancer.

 Mortality/Morbidity

The World Health Organization (WHO) estimated the number of persons at risk of infection from S. haemobium and S.mansoni and reported it as 11,000 deaths per year and the morbidity due to Schistosomiasis is estimated as high as 200,000 per year.

The report went further that “chronic morbidity is the major impact of schistosomiasis on ill health and this is because of repeated infection and the development of non-fatal but delibilitating disease. They are two types of schistosomiasis infections; the urinary schistosomiasis which classical sign is blood in the urine (hemturia) and then the intestine schistosomiasis which does not have any specific but can present with diarrhea, abdominal pain, blood in stool enlargement of the liver. (WHO, Geneva, 2002)

Incidence/prevalence of Schistosomiasis

Nigeria is the most endemic country in the world. Surveys indicate that prevalence of urinary schistosomiasis in some towns and communities in Benue state varies from 32.0% to

                                                                                   

Schistosomiasis in Nigeria 5

98%  and it confirmed that the disease is mostly found among school children, also, the infection rate in the study cut across gender and all age brackets and slightly high among 11-20 years age bracket. (Mbata, Orji & Oguma. http://www.ispub.com/yj.htm)

Diagnostic Methods.

There are basically three methods used; Reagent strip method, Filtration method and the visual examination of urine in a clear container. The latter is the only way local healthcare workers can determine schistosomiasis infection among the children the rural communities. (http://www.academiajournal.org/AJB/PDF/pdf2005/Nov/Ibidapo%20et%20al.pdf)

Indigenous beliefs, Attitude, and Water Contact Activities about Schistosomiasis

Two different studies were done in two separate communities to know the conception of the villagers about Schistosomiasis. Amazigo et al, 1997 reported that 230 adults were studied about urinary Schistosomiasis, one – third of 230 interviewed believed that hematuria (blood urine) to be veneral disease, 20% thought it was a sign of maturity and only 2% knew that snail transmitted the disease, though the authors said that the perception of seriousness of the hematuria differed by level of education and by sex. (http://journals.cambridge.org/action/displayabstract;sessional=DB540DEOF6342…tomcat1?frompage=online&aid=69803)

 Another study reported that 300 respondents studied 67(22.3%) said that they had infection, 233 (77.7%) thought otherwise. And all other respondents associated the disease with the passing of blood in urine, although, they did not associated the disease with swimming in

 

                                                                                          Schistosomiasis in Nigeria 6

infected water, others linked it with eating water snail while a few linked it to God’s wish and some linked to the Nigerian –Biafran civil war 1967-1970. (Ekwunife & Ukaga, 2005.)http://www.ajo/info/viewarticle.php?id=26831)

Involvement of Stakeholders

The aforementioned report about the general ignorance of the causation and mode of transmission of Schistosomiasis in most parts of Nigeria especially in the poor rural communities, and other hindrances in advancement of prevention and control of Schistosomiasis such as the poor habits of people not visiting hospitals, indiscriminate self-medication; the condition is worsened by the presence of inadequate health facilities…. (Nmorsi et al, 2005,)

However, efforts are being strategized by the Global Health Organizations to prevent and control the Schisosomiasis, these include stakeholders   that have initiated urinary Schistosomiasis in the three endemic states; Plateau, Nasarawa and Delta in Nigeria. Literature reported that Bill and Melinda Gates Foundations and Carter Center with support from GlaxoSmithKline, infected people treated with a dose of praziquantel as cheap as 18 cents; up to 90% of the damage due to Schistosomiasis infection can be reversed. (http://www.jimmycarter.com/health/Schistosomiasis/index.html)

The Carter Center celebrated one millionth treatment on June 28, 2007  and President Carter hopes that the nationwide initiative to bring a more enjoyable and healthy life to those who are living in Nigerian communities endemic with the parasite will continue and “hope the work and success of its partners will kick-start a nationwide initiative with increased government funding….” (http://cartercenter.org/news/documents/features/schistotx.html)

 

                                                                                                            Schistosomiasis in Nigeria 7

Although, treatment with praziquantel is effective but the most cost effective is to encourage Community –based intervention Program that will emphasize prevention. According to (Aladesanmi, 2007) the research on the use of mulluscicides in the control of Schistosomiasis,

the laboratory screening of Nigerian medicinal plants which contain chemicals thought to be potent for control of snail as this will be more cost effective.) Aladesanmi also stated that community members are taught to avoid bathing, washing or drinking contaminated water and efforts to control snail population. (http://www.bioline.org/br/request?tc07003)

Furthermore, the use of iodine and chlorine to treat water to remove parasites and let it stand for 48-72 hours before use. (http://www.globalhealthorg/infective_diseases/mortality/neglected_diseases/#Schistosomiasis)

The good news is that the disease is completely preventable and can be controlled through the annual inexpensive drug treatment, and with community-based intervention with Nigeria health department initiating health education with emphasis on avoiding washing, bathing or drinking contaminated water coupled practicing basic hygiene. (Former President Carter) Also, cultural beliefs about schistosomiasis in most parts of Nigeria should be addressed through education.

Nevertheless, prevention as always is the most cost effective method of the disease control but WHO recommends that community –based control of schistosomiasis based on prevalence level; that is communities with high prevalence, moderate and low prevalence, treatment should be made available accordingly.

                                                                                   

Schistosomiasis in Nigeria 8

 

 

 

REFERENCES:

Carter Center Waging Peace, Fighting Disease, Building Hope. Retrieved on April 24, 2009 from:  http://www.cartercenter.org/countries/Nigeria.html

Izumu Foundations. Retrieved on April 29, 2009 from: http://www.izumi.org/stories=cartercenter.html

The Prevalence of Urinary Schistosomiasis in Ogbadibo Local Government Area of Benue State, Nigeria. Retrieved on May 8, 2009 from: http://www.ispub.com/journal/the_internet_journal_of_infectious_diseases/volume_7_number_1_20/article/the_prevalence_of_urinary_schistosomiasis_in_ogbadibo_local_government_area_of_benue_state_nigeria_1.html

World Health Organization; Schistosomiasis: Epidemiological Situation. Retrieved on April 8, 2009 from:   http://www.who.int/schistosomiasis/epidemiology/en/

Epidemiological Assessment of Vesicle Schistosomiasis in Bende Local Government Area of Abia State, Nigeria. Journal of Applied Sciences & Environmental Management, Vol. 10, No. 2, 2005, pp. 55-60. Retrieved on April 10, 2009 from: http://www.bioline.org.br/request?ja06025

 The Life Cycle of Schistosomiasis. Retrieved on April 15, 2009 from: http://www.cartercenter.org/resources/pdfs/health/schistosomiasis/schisto-disease-cycle.pdf

Aladesanmi, 2007 Tetrapluerra tetraptera- Molluscicidal Activity and Chemical Constituent. Retrieved on April 19, 2009 form (http:ajol.info/index.php.ajtcam/article/view/31189/23290)

T. Mbata, M. Orji & V. Oguoma. The Prevalence Of Urinary Schistosomiasis In Ogbadibo Local Government Area Of Benue State, Nigeria http://www.ispub.com/journal/the_internet_journal_of_infectious_diseases/current.html

Ibidapo, C.A. (2005) Comparison of three diagnostic methods for the determination of prevalence of urinary schistosomiasis among residents and pupils of Badagry Area of Lagos State, Nigeria. Retrieved on May 1, 2009 from: (http://www.academiajournal.org/AJB/PDF/pdf2005/Nov/Ibidapo%20et%20al.pdf

Nmorsi et al. (2005) Urinary schistosomiasis in a rural community in Edo state, Nigeria: Eosinophiluria as a diagnostic marker. Retrieved on April 19, 2009 from: http://www.bioline.org.br/request?jb05034

Ekwunife et al (2005). Urinary schistosomiasis in Anambra State, Nigeria. Retrieved on April 27, 2009 from: http://ajol.info/index.php/njpar/article/view/37719

World Health Organization: Report of a WHO Expert Committee, Geneva, 2002 Ref: ISBN 9241209127.

Pandemic Flu: The Facts Not Told

Pandemic Flu: The Facts Not Told

This article presents some facts not yet told in public.

How serious a pandemic can be?

Are we now in a real pandemic?

Are there something to get panicked?

This article answers these questions.

If you have any query, please contact:

Dr Selim Khan

selim.khan@waldenu.edu

or khan147@un.org

Pandemic Flu: The Facts Not Told

Dr Selim Khan

MBBS, MPH (Student)

Walden University

May 27, 2009

PUBH-6165-4/Environmental Health

Instructor: Prof. Dr. Raymond Thron

Spring, 2009

At the very beginning of this century the virologists predicted pandemic flu to be a virtual reality within the next few decades (Jocelyn, 2004). The experts of World Health Organization (WHO) believed that the world was very closer to another influenza pandemic which could be greater in intensity than any of the previous ones. Osterholm in his Nieman report (2008) on preparing for pandemic flu, made a call “Wake up: It’s already tomorrow. There will be pandemics in the future.”

Has that time already come? On April 27, 2009, the Emergency Committee of the WHO based on the data collected from the United States of America, Mexico, and Canada confirmed the pandemic outbreaks of swine influenza A/H1N1(from April 30, 2009, WHO was not using the term swine flu to protect the interest of proc meat, Reuters) and upon recommendation of the committee the Director-General of WHO decided to raise the level of influenza pandemic alert from the current phase 3 to phase 4 (WHO, 2009a) and lately on April 29, 2009 to phase 5, the second highest alarm forecasting for a pandemic (AP, Wed April 29, 7:59pm).

What are the pandemic alerts?

There has been much research on this topic of epidemic flu. Upon the scientific evidences gathered so far, WHO has revised its phase description on 2009. Allowing flexibilities in its strategy in incorporating innovative recommendations and initiatives, the WHO has kept in place the system of its six-phased approach to make them more comprehensible, precise, and based upon incidental phenomena. While phases 1–3 concern preparedness in respect to capacity building and designing plan for response, Phases 4–6 more evidently signal the emergencies for action aimed at mitigating the problem directly. Moreover, it extends the times immediately after a first pandemic course in order to easy the recovery endeavors (EPR, 2009).

Phase 1: It is for preparedness, capacity building, and response planning activities. In nature, influenza viruses circulate constantly among animals, especially in birds. Although such viruses might theoretically develop into pandemics among animals, no human being is affected.

Phase 2: An animal influenza virus circulating among domesticated or wild animals is known to have caused infection in humans, and is therefore considered a potential pandemic threat.

Phase 3: An animal or human-animal influenza resorting virus is to cause sporadic cases or small clusters of disease in people, but it is not resulted in human-to-human transmission sufficient to sustain community-level outbreaks and to cause a pandemic.

Phase 4: It is characterized by verified human-to-human transmission of an animal or human-animal influenza resorting virus able to cause “community-level outbreaks.” Then a rapid pandemic containment operation is warranted. Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is cannot be avoided.

Phase 5: This phase is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.

Phase 6: The pandemic phase, is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5. Designation of this phase will indicate that a global pandemic is under way.

The post-peak period signifies that pandemic activity appears to be decreasing; however, it is uncertain if additional waves will occur and countries will need to be prepared for a second wave.

In the post-pandemic period, influenza disease activity will have returned to levels normally seen for seasonal influenza. At this stage, it is important to maintain surveillance and update pandemic preparedness and response plans accordingly. An intensive phase of recovery and evaluation may be required (WHO, 2009b).

Although the move for preparation before the outbreak is definitely a positive aspect, there is no justification of creating panic by imposing restriction on travel, closing borders, and hampering day-to-day businesses. We know from the past 10 pandemics that within short periods of time millions of lives were swept away (the death toll since 1900: Spanish influenza during 1918-1919: U.S. 675,000+, Worldwide 50,000,000+, Asian influenza during 1957-1958: U.S. 69800+, Worldwide 1-2, 000,000, and Hong Kong influenza during 1968-1969: U.S 33,800+, Worldwide 700,000+ Influenza Outbreak, 2007). But now a day, both the members of the public and the authorities are more alert and relatively better equipped than anytime in the past. There remained controversies whether it can happen actually however we may be assured that once it comes to happen, the consequences would not be that much devastating. Though we know that the pandemic is quite different than any other calamities, when it spreads worldwide severity and death toll may rise so dramatically that countries would not always be able to come to the aide of other countries. So, we have to reevaluate our preparedness from time to time. The researchers at Harvard University estimated that about 62 million people worldwide would die if a flu pandemic similar to the one that occurred in 1918 hit today (APHA, 2008).

The Center for Disease Control and prevention (CDC) is working in collaboration with the health officials in the U.S. affected states as well as with the WHO. It is also deploying staffs both in home and abroad to extend scientific directions and technical assistances. Through its Emergency Operations Center CDC is continuously coordinating the agency’s response to this emerging health threat. The Secretary of the Department of Homeland Security declared public health emergency that would facilitates quick release of essential funds for the public health response programs. CDC has set the targets to cut down transmission and magnitude of public suffering, and thus addressing the challenge in collaboration with health care providers, public health officials, the members of the governments and the public, and the mass media (CDC, 2009a).

The raise of pandemic alert on the basis of epidemiological data that delineated human-to-human transmission and ability of community level outbreak of the virus to a higher phase signifies the increase likelihood of spread of ongoing pandemic, but it does not necessarily indicates that a pandemic is inevitable. As per the Director-General of WHO as the virus is ubiquitous and containment is not feasible, the present emphases are focused towards mitigation measures. Borders are not yet closed and no restriction is being imposed on international traveling. Apparently ill people are advised to delay international traveling and people getting sick after any international travel to seek medical help (WHO, 2009a).

However, public health experts from around the world are watching the H1N1 situation very closely. The U.S. Department of Health and Human Services (HHS), through its National Institute of Allergy and Infectious Diseases (NIAID), has been addressing the problem in multiple ways. Over the past year, the U.S. Government supported the training of more than 129,000 animal health workers and 17,000 human health workers in flu surveillance and outbreak response and deployed more than 300,000 personal protective equipment kits to more than 70 countries for use by surveillance workers and outbreak response teams and invested more than $1 billion in the development of new vaccine. Federal and State stockpiles are reported to contain enough antiviral medications to treat nearly 50 million people. In addition, the U.S. Government is developing new antiviral medications to extend their capabilities (The White House, 2009).

Vaccination is a leading health indicator of Healthy People 2010, that’s objective is to vaccinate annually against influenza but there are still significant obstacles, prejudice and disparities in terms of its coverage. Apart from vaccination public awareness through effective communicating is a crucial aspect of pandemic prevention measure. Mass media is playing a major role in public awareness and health education as we saw in SARS outbreak in 2003 that excessive media coverage though created some panic but it caused people to be more informed and staying safe with particular measures. Than a deficient communication strategy among national and international health agencies created confusion and uncertainty within both the media and general public (Influenza Outbreak, 2007) that we think, this time the visible integrated efforts could overcome.

The United Nations experts are working towards find out the validation of the report that pig farms were the source of the outbreak. As per the WHO vaccine production is underway and it may take more 5 to 6 months to come to the open market. Their experts believe that the virus has come from the same strain that causes seasonal outbreaks in humans but is mutated by genetic material from strain that affect pigs and birds (BBC, April 28, 2009).

In an article in Journal of Law, Medicine, & Ethics, Robert Boyle, Childress James, Gravely Steven, Kaplowitz Lisa, Melnick Alan, Rothstein Mark, et al. (2007) highlighted the overwhelming legal and ethical issues that hospitals, health care providers, health departments may encounter in distributing scarce medical resources (medications, hospital beds, ventilators), adjusting standard of medical services, creating “agents of the state” for legal coverage during widespread public health crises. They elucidated the legal and ethical pros and cons of a model in managing medical emergencies in hospital, in maintaining the relationship between hospital administration and health department, in using ethics as a guideline for easing the analysis and mitigation of the demands, prospective, and interests of various stakeholders. In focusing the medical triage during an influenza pandemic they emphasized on the priority setting, medical rationing with a view to implement established ethical obligation and material criterion of justice to treat the similar cases similarly and dissimilar cases dissimilarly. They argued that a medical triage should be sort out as per real need, expected outcomes, and available resources. The target should be to ensure the greatest good for the greatest number of people under crisis.

The latest about pandemic flu

WHO reports only laboratory-confirmed cases. As of May 22, 2009 there are 34 cumulative cases and 12 death in the year 2009 in comparison to 44 cases and 33 deaths in 2008; 88, 59 in 2007; and 115, 79 in 2006 respectively (WHO, 2009c).

So, from the epidemiological point of view as the current case rate is not more than the expected case rate in comparison to the previous years, we can say that there exists no epidemic at all presently anywhere in the world- this is just the usual seasonal manifestations of naturally circulating influenza virus. Albeit, it’s wise to remain alert to face any inadvertent situation but nothing is foreseeable yet to get panicked.

References

Associated Press (AP). (2009, April 29). WHO warns swine flu threatening to become pandemic. Retrieved April 29, 2009, from http://news.yahoo.com/s/ap/20090429/ap_on_he_me/med_swine_flu

A.P. (2009, April 30).Mexican health chief: Swine flu leveling off. Retrieved April 30, 2009, from http://news.yahoo.com/s/ap/20090430/ap_on-he_me/med_swine_flu

American Public Health Association. (2008). Get ready campaign. Retrieved April 26, 2009, from / http://www.getreadyforflu.org/newsite.htm

B.B.C. (April 28, 2009). More countries confirm swine flu. Retrieved April 28, 2009, from http://news.bbc.co.uk/2/hi/americas/8022437.stm

Boyle, R., James, C., Steven, G. D., Lisa, K., Alan, M., Mark, R., et al. (2007). Health department, hospitals, and pandemic flu: Overlapping ethical and legal questions, /i/Journal of Law, Medicine, & Ethics/i/. 4(35): 53-54, Suppl. 4. Doi: 10.1111/j.1748-720X.2007.00210.x.

Center for Disease Control and Prevention (CDC). (2009a). Swine influenza. Retrieved April 28, 2009, from (Flu).http://www.cdc.gov/swineflu/

CDC. (2009c). Swine flu. Retrieved April 29, 2009, from http://www.cdc.gov/swineflu/

Epidemic and Pandemic Alert and Response. (2009). Current WHO phase of pandemic alert. Retrieved April 28, 2009, from http://www.who.int/csr/disease/avian_influenza/phase/en/index.html

Influenza Outbreak: Middleton, U.S.A. (2007). /i/Laureate Education, Inc. /i/ [DVD]. Baltimore: Walden University.

Jocelyn, K. (2004). Facing Down Pandemic Flu: the World’s Defenses Are Weak. /i/Science/i/, 306(5695): 354-361

Osterholm, M. (2008). Preparing for pandemic flu. /i/ Nieman Report/Spring 2007/i/. Retrieved April 28, 2009, from http://web.ebscohost.com.ezp.waldenulibrary.org/ehost/pdf?vid=4&hid=16&sid=543b841d-406b-4061-97c1-dbdcecde53cc%40sessionmgr9

Reuters. (2009, April 30). Mexico begins shutting down as flu fears spread. Retrieved April 30, 2009, from http://www.reuters.com/article/newsOne/idUSTRE53N22820090430

The White House. (2008)./i/Pandemic flu./i/Retrieved November 17, 2008, from http://www.whitehouse.gov/infocus/pandemicflu/

World Health Organization. (2009a). Swine influenza. Retrieved April 28, 2009, from http://www.who.int/mediacentre/news/statements/2009/h1n1_20090427/en/index.html

World Health Organization. (2009b). Current WHO phase of pandemic alert. Retrieved Amy 27, 2009 from

http://www.who.int/csr/disease/avian_influenza/phase/en/index.html

World Health Organization. (2009c). Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO. Retrieved May 27, 2009, from http://www.who.int/csr/don/2009_05_22a/en/index.html

Article URL: http://environmentalhealthtoday.files.wordpress.com/2009/05/pandemic-flu-the-facts-not-told.doc

Heifer International: An interesting non profit organization

It is no surprise to those working in the field of environmental health that improving the environment is one of the most significant ways in which we can improve the health of the public. There are many non-profit organizations which have environmental health components. Heifer International is a lesser known non-profit entity, whose mission is devoted to ending hunger and caring for the Earth. Projects involve an array of initiatives, including education on sound agricultural practices, animal management, urban agriculture, and supporting small businesses through loans and provision of livestock. They even cover HIV/AIDS education, on the assumption that the devastating toll of this disease impacts sustainable development. According to the website, in 2008 they had 869 active projects in 53 countries/provinces and 27 U.S. states. In Minnesota, a local school was in the newspaper recently for their fundraising efforts to donate livestock for Heifer International projects.  Anyone looking for a place to donate that focuses on environmental health and sustainability may want to check this organization out.

New “green” concrete prevents runoff

Shoreview, MN is taking a gamble on a new form of pervious concrete that is designed to let rainwater go through it rather than it running off into storm sewers and lakes. The pervious concrete is made of gravel and cement, but does not include sand, the component which provides the impervious nature of typical concrete. Under the pervious concrete layer is a layer of aggregate, which will store the water so that it can filter gradually into the ground.

According to the Minneapolis Star Tribune, for about five years, several cities in MN have experimented with this concrete in some limited areas such as parking lots. Shoreview is the first MN city to fully commit to using it on residential streets in place of traditional storm drainage systems, which include catch basins, pipes, and settling ponds. Settling ponds need maintenance and generally result in buildup of potentially toxic materials that have to be removed and disposed of. It is hoped that the reduced runoff will help to protect a nearby lake, which has been becoming increasingly polluted from runoff.

There are some concerns and caveats. One question is whether it will hold up in frigid Minnesota winters. It is crucial that snow and ice does not build up and result in freeze-thaw cycles that will break apart the concrete. However, the history of the product where it has been used so far, and the very nature of the product allowing drainage of the water, has been promising. It does require some special maintenance to keep the pores open. Shoreview has included in the budget a special street sweeper machine to do the job. It also requires those who install it to be familiar with the product, and as one may expect, it is more expensive than traditional concrete. The Ramsey Conservation District will be monitoring the groundwater to determine any impact on either the level or the quality of the groundwater in the area.  

This exciting project holds great promise, and should be carefully watched by other cities as a model for the future.

Blake, L (2009, May 26). Paved With Good Intentions. Minneapolis Star Tribune. Retrieved May 26, 2009 from http://www.startribune.com/local/west/46020057.html?elr=KArksUUUU

Onchocerciasis

Improvement of School Nutrition in Primary and Secondary Schools

This commentary focuses on efforts to improve school nutrition in primary and secondary schools specifically in Aurora, IL. Improvement of School Nutrition in Primary and Secondary Schools offers some information on obesity in children and cultural influences on nutrition and mechanism to have encourage community participation. This commentary is directed to parents, teachers and families in the Hispanic community.

I hope the information is helpful. If you have any questions, or care to leave a comment, please do so, below.

Thank you.

Deanna Sommers PhD student, MSN, RN, CPNP
PUBH 8165, Environmental Health
College of Health Sciences
Walden University
deanna.sommers@waldenu.edu

Onchocerciasis – River Blindness: Does Pharma Hold the Answer?

The effects of River Blindness are extensive from medical implications to the socioeconomic implications. This presentation beckons the pharmaceutical industry to act without premise of profitability but to act on behalf of basic human healthcare in aiding the impoverished countries in Africa and South America.

By

Nataskia Lampe

PUBH 8165-01

Please click here for presentation

Motivating Primary and Secondary Schools In The Community To Improve The School Nutrition

This presentation is designed to inform and educate the school administrators on the importance of a nutritional meal program within their school. Statistics and data on children with diseases and disorders resulting from poor nutritional habits are provided. It is also designed to motivate school administrators to develop a more nutritional program within their school by providing  ideas and strategies that will aid in the development of such a program. This presentation offers some tools for the school administrators and student population to use in redesigning the school lunch program with a good nutritional program that is aesthetically attractive and well balanced, to combat childhood obesity.

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Paula Wright

PUBH 8165-01