Campylobacteriosis

What is campylobacteriosis?

It is a diarrheal illness caused by infection with the bacterium Campylobacter jejuni. It is the most common cause of bacterial diarrhea in New York State. Most cases are seen in the summer months and occur as single cases. Outbreaks are uncommon.

Who gets campylobacteriosis?

Anyone can get Campylobacter infection.

How is the germ spread?

Campylobacter are generally spread by consumption of contaminated food or water and, occasionally, by contact with infected people or animals.

What are the symptoms of campylobacteriosis?

Infection with Campylobacter may cause mild or severe diarrhea (which may be bloody), cramping, abdominal pain and fever. Rarely, some people develop arthritis or the bacteria may spread to the bloodstream, which can cause a serious life-threatening infection.

How soon after exposure do symptoms appear?

The symptoms generally appear two to five days after the exposure.

Where are Campylobacter found?

Many animals including swine, cattle, dogs and birds (particularly poultry) carry the germ in their intestines. These sources in turn may contaminate meat products (particularly poultry), water supplies, milk and other items in the food chain.

For how long can a person carry Campylobacter?

Generally, infected people will continue to pass the germ in their feces for a few days to a week or more. Certain antibiotics may shorten the carrier phase.

Do infected people need to be isolated or excluded from school or work?

Since the organism is passed in the feces, only people with active diarrhea who are unable to control their bowel habits (infants and young children for example) should be isolated. Most infected people may return to work or school when their stools become formed provided that they carefully wash their hands after toilet visits. People with diarrhea should be excluded from childcare, food handling and direct patient care until their symptoms have resolved.

What is the treatment for campylobacteriosis?

Most people infected with Campylobacter will recover on their own. People with campylobacteriosis should drink extra fluids to prevent dehydration as long as the diarrhea lasts. Antibiotics are occasionally used to treat severe cases or to shorten the carrier phase, which may be important for food handlers, children in daycare and health care workers. Since relapses occasionally occur, some physicians might treat mild cases with antibiotics to prevent a recurrence of symptoms.

How can campylobacteriosis be prevented?

• Always handle raw poultry, beef and pork as if they are contaminated:
  • Wrap fresh meats in plastic bags at the market to prevent blood from dripping on other foods.
  • Refrigerate foods promptly; minimize holding at room temperature.
  • Cutting boards and counters used for preparation should be washed immediately after use to prevent cross contamination with other foods.
  • Avoid eating raw or undercooked meats.
  • Ensure that the correct internal cooking temperature is reached, particularly when using a microwave.
• Avoid eating raw eggs or undercooking foods containing raw eggs.
• Avoid consuming raw (unpasteurized) milk or milk products.
• Encourage careful handwashing before and after food preparation.
• Make sure children, particularly those who handle pets, wash their hands carefully.

Campylobacteriosis

What is campylobacteriosis?

It is a diarrheal illness caused by infection with the bacterium Campylobacter jejuni. It is the most common cause of bacterial diarrhea in New York State. Most cases are seen in the summer months and occur as single cases. Outbreaks are uncommon.

Who gets campylobacteriosis?

Anyone can get Campylobacter infection.

How is the germ spread?

Campylobacter are generally spread by consumption of contaminated food or water and, occasionally, by contact with infected people or animals.

What are the symptoms of campylobacteriosis?

Infection with Campylobacter may cause mild or severe diarrhea (which may be bloody), cramping, abdominal pain and fever. Rarely, some people develop arthritis or the bacteria may spread to the bloodstream, which can cause a serious life-threatening infection.

How soon after exposure do symptoms appear?

The symptoms generally appear two to five days after the exposure.

Where are Campylobacter found?

Many animals including swine, cattle, dogs and birds (particularly poultry) carry the germ in their intestines. These sources in turn may contaminate meat products (particularly poultry), water supplies, milk and other items in the food chain.

For how long can a person carry Campylobacter?

Generally, infected people will continue to pass the germ in their feces for a few days to a week or more. Certain antibiotics may shorten the carrier phase.

Do infected people need to be isolated or excluded from school or work?

Since the organism is passed in the feces, only people with active diarrhea who are unable to control their bowel habits (infants and young children for example) should be isolated. Most infected people may return to work or school when their stools become formed provided that they carefully wash their hands after toilet visits. People with diarrhea should be excluded from childcare, food handling and direct patient care until their symptoms have resolved.

What is the treatment for campylobacteriosis?

Most people infected with Campylobacter will recover on their own. People with campylobacteriosis should drink extra fluids to prevent dehydration as long as the diarrhea lasts. Antibiotics are occasionally used to treat severe cases or to shorten the carrier phase, which may be important for food handlers, children in daycare and health care workers. Since relapses occasionally occur, some physicians might treat mild cases with antibiotics to prevent a recurrence of symptoms.

How can campylobacteriosis be prevented?

• Always handle raw poultry, beef and pork as if they are contaminated:
  • Wrap fresh meats in plastic bags at the market to prevent blood from dripping on other foods.
  • Refrigerate foods promptly; minimize holding at room temperature.
  • Cutting boards and counters used for preparation should be washed immediately after use to prevent cross contamination with other foods.
  • Avoid eating raw or undercooked meats.
  • Ensure that the correct internal cooking temperature is reached, particularly when using a microwave.
• Avoid eating raw eggs or undercooking foods containing raw eggs.
• Avoid consuming raw (unpasteurized) milk or milk products.
• Encourage careful handwashing before and after food preparation.
• Make sure children, particularly those who handle pets, wash their hands carefully.

Campylobacteriosis

What is campylobacteriosis?

It is a diarrheal illness caused by infection with the bacterium Campylobacter jejuni. It is the most common cause of bacterial diarrhea in New York State. Most cases are seen in the summer months and occur as single cases. Outbreaks are uncommon.

Who gets campylobacteriosis?

Anyone can get Campylobacter infection.

How is the germ spread?

Campylobacter are generally spread by consumption of contaminated food or water and, occasionally, by contact with infected people or animals.

What are the symptoms of campylobacteriosis?

Infection with Campylobacter may cause mild or severe diarrhea (which may be bloody), cramping, abdominal pain and fever. Rarely, some people develop arthritis or the bacteria may spread to the bloodstream, which can cause a serious life-threatening infection.

How soon after exposure do symptoms appear?

The symptoms generally appear two to five days after the exposure.

Where are Campylobacter found?

Many animals including swine, cattle, dogs and birds (particularly poultry) carry the germ in their intestines. These sources in turn may contaminate meat products (particularly poultry), water supplies, milk and other items in the food chain.

For how long can a person carry Campylobacter?

Generally, infected people will continue to pass the germ in their feces for a few days to a week or more. Certain antibiotics may shorten the carrier phase.

Do infected people need to be isolated or excluded from school or work?

Since the organism is passed in the feces, only people with active diarrhea who are unable to control their bowel habits (infants and young children for example) should be isolated. Most infected people may return to work or school when their stools become formed provided that they carefully wash their hands after toilet visits. People with diarrhea should be excluded from childcare, food handling and direct patient care until their symptoms have resolved.

What is the treatment for campylobacteriosis?

Most people infected with Campylobacter will recover on their own. People with campylobacteriosis should drink extra fluids to prevent dehydration as long as the diarrhea lasts. Antibiotics are occasionally used to treat severe cases or to shorten the carrier phase, which may be important for food handlers, children in daycare and health care workers. Since relapses occasionally occur, some physicians might treat mild cases with antibiotics to prevent a recurrence of symptoms.

How can campylobacteriosis be prevented?

• Always handle raw poultry, beef and pork as if they are contaminated:
  • Wrap fresh meats in plastic bags at the market to prevent blood from dripping on other foods.
  • Refrigerate foods promptly; minimize holding at room temperature.
  • Cutting boards and counters used for preparation should be washed immediately after use to prevent cross contamination with other foods.
  • Avoid eating raw or undercooked meats.
  • Ensure that the correct internal cooking temperature is reached, particularly when using a microwave.
• Avoid eating raw eggs or undercooking foods containing raw eggs.
• Avoid consuming raw (unpasteurized) milk or milk products.
• Encourage careful handwashing before and after food preparation.
• Make sure children, particularly those who handle pets, wash their hands carefully.

Campylobacteriosis

What is campylobacteriosis?

It is a diarrheal illness caused by infection with the bacterium Campylobacter jejuni. It is the most common cause of bacterial diarrhea in New York State. Most cases are seen in the summer months and occur as single cases. Outbreaks are uncommon.

Who gets campylobacteriosis?

Anyone can get Campylobacter infection.

How is the germ spread?

Campylobacter are generally spread by consumption of contaminated food or water and, occasionally, by contact with infected people or animals.

What are the symptoms of campylobacteriosis?

Infection with Campylobacter may cause mild or severe diarrhea (which may be bloody), cramping, abdominal pain and fever. Rarely, some people develop arthritis or the bacteria may spread to the bloodstream, which can cause a serious life-threatening infection.

How soon after exposure do symptoms appear?

The symptoms generally appear two to five days after the exposure.

Where are Campylobacter found?

Many animals including swine, cattle, dogs and birds (particularly poultry) carry the germ in their intestines. These sources in turn may contaminate meat products (particularly poultry), water supplies, milk and other items in the food chain.

For how long can a person carry Campylobacter?

Generally, infected people will continue to pass the germ in their feces for a few days to a week or more. Certain antibiotics may shorten the carrier phase.

Do infected people need to be isolated or excluded from school or work?

Since the organism is passed in the feces, only people with active diarrhea who are unable to control their bowel habits (infants and young children for example) should be isolated. Most infected people may return to work or school when their stools become formed provided that they carefully wash their hands after toilet visits. People with diarrhea should be excluded from childcare, food handling and direct patient care until their symptoms have resolved.

What is the treatment for campylobacteriosis?

Most people infected with Campylobacter will recover on their own. People with campylobacteriosis should drink extra fluids to prevent dehydration as long as the diarrhea lasts. Antibiotics are occasionally used to treat severe cases or to shorten the carrier phase, which may be important for food handlers, children in daycare and health care workers. Since relapses occasionally occur, some physicians might treat mild cases with antibiotics to prevent a recurrence of symptoms.

How can campylobacteriosis be prevented?

• Always handle raw poultry, beef and pork as if they are contaminated:
  • Wrap fresh meats in plastic bags at the market to prevent blood from dripping on other foods.
  • Refrigerate foods promptly; minimize holding at room temperature.
  • Cutting boards and counters used for preparation should be washed immediately after use to prevent cross contamination with other foods.
  • Avoid eating raw or undercooked meats.
  • Ensure that the correct internal cooking temperature is reached, particularly when using a microwave.
• Avoid eating raw eggs or undercooking foods containing raw eggs.
• Avoid consuming raw (unpasteurized) milk or milk products.
• Encourage careful handwashing before and after food preparation.
• Make sure children, particularly those who handle pets, wash their hands carefully.

Cancer Genetics: Focus on BRCA1 and BRCA2 Mutations

What is Cancer Genetics?

Cancer genetics is the study of how individuals' personal and family history may increase their risk for certain cancers. Cancer genetics is becoming an important part of understanding the complex disease of cancer and the role that inheritance may play.
Cancer may be caused by many things, such as exposures to chemicals in our environment, behaviors like smoking and the genes we inherit from our parents. In most cases cancer is likely the result of a complex interaction between all of these things.
The genes we inherit from our parents are part of what might increase our risk for certain cancers. If the genes we inherit carry unexpected changes known as mutations that might put a person at a higher risk for cancer. For example, mutations in the genes called BRCA1 and BRCA2 put a person at a higher risk for breast and ovarian cancer.
Genetic causes of cancer are not common. Recently genetic tests have been advertised as a way for people to find out if they are at risk. These tests are often done by taking a sample of a person's blood. Although these tests may be helpful to some people, they are not meant for everyone. It is important to talk directly to a doctor or a genetic counselor to help you decide whether genetic testing is right for you.
To help you understand cancer genetics, the following sections will focus on one example of a genetic cause of cancer: BRCA1 and BRCA2.

BRCA1 and BRCA2

One genetic test that is commonly promoted to the public is the test for BRCA1 and BRCA2 gene mutations. Mutations in either of these two genes are tied to cases of inherited breast and ovarian cancer.
BRCA1 and BRCA2 mutations can be inherited from either your mother or your father. These mutations are not common in the general population. Five to 10 percent of all breast cancer cases, and up to 14 percent of ovarian cancer cases, are thought to be caused by BRCA1 and BRCA2 mutations.
Genetic counseling can help women and men who may be at higher risk for a BRCA1 or BRCA2 mutation to understand their risk. Genetic counseling is an important part of deciding whether genetic testing is right for you.

breast cancer

About breast cancer

What should people know about breast cancer?

Breast cancer is one of the most common cancers among women in New York State. Each year in New York, over 14,000 women are diagnosed with breast cancer and over 2,700 women die from the disease. It is estimated that one in eight women will develop breast cancer during her life.
Men also get breast cancer, but it is very rare. About 125 men are diagnosed with breast cancer each year in New York State.

Who gets breast cancer?

All women can get breast cancer. However, breast cancer is more common among older women. The risk for getting breast cancer increases with age. More than three-quarters of women who get breast cancer are over the age of 50. White women are more likely to get breast cancer than Black women, but, once they have the disease, Black women are more likely to die from it. Asian and Hispanic women are less likely to get breast cancer than White women or Black women. Also, women of higher socioeconomic status (those whose family incomes are above average) are more likely to get breast cancer. Scientists believe this may be related to having their first child at an older age, fewer pregnancies, diet and possible other characteristics shared by women in higher income groups.

What factors increase risk for developing breast cancer?

At this time, the causes of breast cancer are not well understood. However, scientists agree that certain factors increase a person's risk of developing this disease. These risk factors include:

• Age. As women get older, their risk of developing breast cancer increases.
• Family history. Women whose close relatives (parents, brothers/sisters, children) have had breast cancer (especially at an early age) are more likely to get breast cancer.
• Genetics. Women with certain changes in breast cancer related genes (BRCA1 and BRCA2) are at higher risk for getting breast cancer. About 5% to 10% of breast cancers are believed to be due to genetic factors.
• Personal history. Women who have had cancer in one breast are more likely to develop it in the other breast or in remaining breast tissue. Women who have a history of certain types of benign (non-cancerous) tumors and cysts in their breast are more likely to develop breast cancer. Also women with dense breast tissue are at increased risk for the disease.
• Hormonal factors. Women who start their menstrual periods at a young age, start menopause at a late age, have their first child later in life, or have not had full-term pregnancies may have an increased risk of developing breast cancer.
• Not breastfeeding. Not breastfeeding increases a woman's chance of developing breast cancer.
• Hormone use. Long-term use of hormone replacement therapy (estrogen and progesterone combined) increases the risk of developing breast cancer. However, women who have not used hormone replacement therapy in the past 10 years may not be at increased risk.
• Personal behaviors. Some personal behaviors have been shown to increase risk for getting breast cancer. These include excessive alcohol use and not getting enough exercise. Also, being overweight or obese increases the risk of breast cancer after menopause.
• Ionizing Radiation. Exposure to high levels of ionizing radiation to the chest area early in life, such as radiation therapy for Hodgkin lymphoma, increases the risk of developing breast cancer.

What other risk factors for breast cancer are scientists studying?

Scientists are studying other possible personal risk factors for breast cancer including diet, smoking, exposure to second hand smoke, current or recent use of oral contraceptives (birth control pills), use of the synthetic estrogen diethylstilbestrol (DES) prior to the early 1970s to prevent miscarriage, exposure to estrogens and progestins in some personal care products and night-shift employment.
A number of chemicals are being studied as possible risk factors for breast cancer. These include various by-products of industrial processing, production and combustion, pesticides, metals, and solvents.
Additional research is needed to determine the role, if any, these factors may have in the development of breast cancer.

What can I do to reduce my chances of getting breast cancer?

To help reduce the risk of getting breast cancer:

• Be aware of your family history and discuss any concerns with your health care provider.
• Discuss the use of hormone replacement therapy with your health care provider.
• If possible, breastfeed your baby. Studies have shown that breastfeeding for longer periods of time lowers the risk of getting breast cancer.
• Stay at a healthy weight.
• Exercise regularly.
• Discuss the risks and benefits of medical imaging, such as CT scans, with your health care provider to avoid unnecessary exposure to ionizing radiation.

Regular check-ups and screening tests can find breast cancer at an earlier stage, when treatment works best. The most important action women can take is to have routine breast cancer screenings. For more information on breast cancer screening, call the Cancer Services Program at 1-866-442-CANCER (2262) or visit the website at www.health.ny.gov/diseases/cancer/services/.

How else can I reduce my risk for cancer?

The following may help reduce the risk of developing cancer:

• Choose a healthy diet to achieve and maintain a healthy weight. Eat more vegetables, fruits and whole grains and eat less red and processed (e.g., bacon, sausage, luncheon meats, hot dogs) meats. These actions may reduce the risk of developing many types of cancer and other diseases.
• Do not smoke. If you currently smoke, quit. Avoid exposure to second hand smoke. For more information on quitting smoking, visit the NYS Smoker's Quitline at www.nysmokefree.com or call 1-866-NY-QUITS.
• Talk with your health care provider about recommended screenings for other types of cancer.

For more information:

• National Cancer Institute
• American Cancer Society
• Centers for Disease Control and Prevention
• American Society of Clinical Oncology

Babesiosis

What is babesiosis?

Babesiosis is a rare, severe and sometimes fatal tick-borne disease caused by various types of Babesia, a microscopic parasite that infects red blood cells. In New York state, the causative parasite is Babesia microti.

Who gets babesiosis?

While anyone can get babesiosis, it can be more severe in the elderly, people who have had their spleen removed or in immunocompromised individuals. Cases of this disease in the U.S. have been primarily reported during spring, summer and fall in coastal areas in the Northeast, including on Long Island in New York State, Nantucket Island off the coast of Massachusetts and in New Jersey. Cases also have been reported in the some upper Midwest states, including Wisconsin and Minnesota, and in California, Georgia, Missouri and some European countries.

How is babesiosis transmitted?

Babesiosis is transmitted by the bite of an infected deer tick, Ixodes scapularis. Transmission can also occur via transfusion of contaminated blood and possibly from an infected mother to her baby during pregnancy or delivery.

What are the symptoms of babesiosis?

The disease can cause fever, fatigue and hemolytic anemia lasting from several days to several months. Infections can occur without producing symptoms.

When do symptoms appear?

It may take from one to eight weeks, sometimes longer, for symptoms to appear.

Does past infection with babesiosis make a person immune?

It is not known whether past infection with babesiosis can make a person immune.

What is the treatment for babesiosis?

While many people do not become sick enough with babesiosis to require treatment, there are effective therapies, usually either a combination of quinine and clindamycin or a combination of atovaquone and azithromycin. It is possible to become infected with babesiosis and Lyme disease at the same time, so be sure to seek medical attention if you become ill after a tick bite.

What can be done to prevent babesiosis?

When in tick-infested habitat - wooded and grassy areas - take special precautions to prevent tick bites, such as wearing light-colored clothing (for easy tick discovery) and tucking pants into socks and shirt into pants. Check after every two to three hours of outdoor activity for ticks on clothing or skin. Brush off any ticks on clothing before skin attachment occurs. A thorough check of body surfaces for attached ticks should be done at the end of the day. If removal of attached ticks occurs within 36 hours, the risk of tick-borne infection is minimal.
Repellents can be effective at reducing bites from ticks that can transmit disease. But their use is not without risk of health effects, especially if repellents are applied in large amounts or improperly. Repellents commonly available to consumers contain the active ingredients DEET (N, N-diethyl-m-toluamide), picaridin (also known as KBR 3023), oil of lemon eucalyptus, permethrin, or botanical oils. DEET products have been widely used for many years, but have occasionally been associated with health effects. Skin reactions (particularly at DEET concentrations of 50 percent and above) and eye irritation are the most frequently reported health problems. Picaridin and oil of lemon eucalyptus have been shown to offer long-lasting protection against mosquitoes but there are limited data regarding their ability to repel ticks. Products containing permethrin are for use on clothing only, not on skin. Rather than acting as a repellent, permethrin kills ticks and insects that come in contact with treated clothes. Permethrin can cause eye irritation. Insect repellents containing botanical oils, such as oil of geranium, cedar, lemongrass, soy or citronella are also available, but there is limited information on their effectiveness and toxicity. If you decide to use a repellent, use only what and how much you need for your situation. In addition:

• Be sure to follow label directions.
• Use repellents only in small amounts, avoiding unnecessary repeat application. Try to reduce the use of repellents by dressing in long sleeves and pants tucked into socks or boots.
• Children may be at greater risk for reactions to repellents, in part, because their exposure may be greater. Do not apply repellents directly to children. Apply to your own hands and then put it on the child.
• Do not apply near eyes, nose or mouth and use sparingly around ears. Do not apply to the hands of small children.
• After returning indoors, wash treated skin with soap and water.

How should a tick be removed?

Grasp the mouthparts with tweezers as close as possible to the attachment (skin) site. Be careful not to squeeze, crush or puncture the body of the tick, which may contain infectious fluids. After removing the tick, thoroughly disinfect the bite site and wash hands. See or call a doctor if there are concerns about incomplete tick removal. Do not attempt to remove ticks by using petroleum jelly, lit cigarettes or other home remedies because these may actually increase the chance of contracting a tick-borne disease.

Skin Infections in Athletes

Skin infections can take athletes out of the action and put them on the sidelines. Wrestlers, rugby players, and others who participate in sports where there is direct skin-to-skin contact have an increased risk of getting contagious skin infections. While most cases of skin infections are mild and treatable, without the right treatment, some can be very serious and even life threatening. Learn how to prevent the spread of skin infections and safely participate in sports.

reventing Skin Infections

What is the most important way to prevent the spread of skin infections?

Hand washing (hand hygiene) is the most important way to prevent the spread of skin infections in any setting.
To wash your hands properly:

• Wet your hands with clean water and apply soap. Use warm water if it is available.
• Rub hands together to make a lather and scrub all surfaces.
• Continue rubbing hands for 20 seconds (the time it takes to sing "Happy Birthday" twice).
• Rinse hands well with clean water.
• Dry your hands using a paper towel or air dryer.
• If possible, use your paper towel to turn off the faucet.

If soap and water are not available and your hands are not visibly dirty, use an alcohol-based hand sanitizer (60% alcohol or greater) if permitted by your school or athletic club. If alcohol-based hand sanitizers are not allowed or are unavailable, hand sanitizers that do not contain alcohol may also be useful.
To use an alcohol-based hand sanitizer:

• Apply product to the palm of one hand.
• Rub hands together.
• Rub the product over all surfaces of hands and fingers until hands are dry.

As an athlete, what can I do to prevent getting or spreading skin infections?

• Report any skin lesions or sores to your coaching staff immediately (and parent or guardian if you are under 18 years of age).
• Have rashes and sores evaluated by a medical provider before resuming practice or competition.
• Wash your hands frequently or use an alcohol-based hand sanitizer (if approved by your school or club) in the absence of soap and clean water.
• Wash your hands after using shared equipment (such as barbells and free weights).
• Use a clean towel as a barrier between your bare skin and shared surfaces (for example, exercise equipment, sauna benches, or physical therapy tables and equipment).
• Avoid contact with others' lesions and possibly contaminated items (for example, bandages, towels, or gear).
• Wash your hands after contact with others' potentially infectious wounds, skin, or soiled bandages.
• Use your own container of liquid soap (do not share!) and shower before and as soon as possible after EVERY practice, game, or tournament.
• Avoid touching your eyes, nose, or mouth with your hands to help prevent the spread of infections.
• Do not pick or squeeze skin sores, which can worsen an infection and possibly spread it to others.
• Completely and securely cover skin infections that are not contagious (such as eczema) before practice, meets, or games.
• Do not share towels, washcloths, soap, razors, toothbrushes, or topical preparations (including deodorants, lotions, ointments, gels, or creams).
• Wash towels after each use, using hot water with detergent (and bleach if possible) and dry completely on high heat setting.
• Wash and disinfect, as indicated, personal and shared athletic gear and equipment (including wrestling mats).
• Launder uniforms and other clothing after every use.
• Shower with soap (preferably liquid, not bar, soap) before using whirlpools, cold tubs, steam rooms, or saunas.
• Do not use whirlpools, cold tubs, steam rooms, or saunas if sores, scratches, scrapes, or wounds are present anywhere on your body.
• Do not share cell phones, beverage containers (such as water bottles or sports drinks), cigarettes, or anything else that touches the lips, enters the mouth, or has contact with an affected skin area.

What should coaches, trainers, or other authorized persons do to reduce the spread of skin infections in athletes?

• Examine athletes for skin infections before each practice or competition:
  • Exclude athletes who have contagious skin infections from practice or competition until a medical provider determines that the infection is no longer infectious.
  • Comply with your district's or club's standard clearance process before allowing athletes to return to sports or physical education class.
• Know and use hand hygiene and teach athletes how to properly wash their hands with soap and clean water or use an alcohol-based hand sanitizer (if approved by the school or club administration). In addition:
  • Know the school or club policy on the use of alcohol-based hand sanitizer. If they are approved for use, provide appropriate student supervision. In situations where access to sinks is limited (e.g., in a gymnasium), provide individual containers of alcohol-based hand sanitizer to each team member.
  • Use hand hygiene after contact with players, especially after changing bandages or providing wound care. Authorized persons who assist with the application of clean dressings should wear disposable gloves and wash their hands and forearms immediately after removing gloves.
  • Remind athletes to use a clean towel as a barrier between bare skin and shared surfaces such as exercise equipment to reduce the need for frequent sanitizer application.
• For athletes with skin wounds:
  • Ensure that non-contagious skin wounds or conditions are covered completely and securely (bandaged and covered with a protective sleeve) during practices and meets.
  • Make sure all wounds (e.g., cuts, scrapes, abrasions) are covered with a bandage until healed -- especially when contact with shared items (such as physical therapy or weight equipment) may occur.
  • Exclude athletes with draining lesions or open wounds (regardless if they are covered) from swimming pools, whirlpools, ice tubs, saunas, and hot tubs.
• Provide enough clean towels to your team so that no one has to share, and remind athletes not to share towels, even in the gym during practice or competition.

What should schools and clubs do to prevent the spread of skin infections?

• Environmental surfaces in the athletic setting should be cleaned and disinfected. Establish a regular cleaning schedule for shared environmental surfaces such as wrestling mats or strength-training equipment:
  • Sanitize mats and other high-use equipment before each practice and several times a day throughout a tournament.
  • Sanitize all skin-contact points of weight equipment at least once a day.
  • Use a sanitizer or US Environmental Protection Agency (EPA) registered disinfectant for use against MRSA on surfaces or use a freshly mixed solution of one part bleach to 100 parts water (1 tablespoon bleach to 1 quart of water).
  • Follow the directions listed on the labels of all cleaning and disinfecting products. Pay particular attention to the contact times for these products.
• Repair or discard equipment with damaged surfaces that cannot be adequately cleaned (e.g., equipment with exposed foam).
• Cover treatment tables. Discard or launder coverings after each use.
• If soiled linens and clothing are washed on school premises, wash with regular laundry detergent in hot water (minimum 160°F). If the water temperature is not 160°F or higher, add one cup of bleach to the wash. Dry in a hot dryer. Consider wearing gloves when handling dirty laundry.

Asthma

Asthma Information

Asthma is a chronic disease of the lungs. In New York State (NYS), more than 1.1 million adults have asthma ¹. Asthma occurs at any age but is more common in children than adults. Nationally, nearly one in 13 school-age children have asthma, and that rate is rising more rapidly in preschool-aged children and those living in urban inner cities than in any other group. Although there is no cure for asthma, asthma attacks can be prevented and controlled with proper care. New York is actively working with health care providers, community coalitions, schools, families and many others to fight asthma so people with asthma can live a full and active life.
This web site is designed to provide accurate, current and useful information for people with asthma and for the people who care for them. New resources will be added often. Please check back frequently.

Asthma Overview

• Asthma is a serious public health problem in New York and the nation.
• Asthma currently affects about 8.4% (370,000) children ¹ and 9.3% (more than 1.1 million) of adults in New York ².
• Asthma caused an average of 301 deaths per year in New York during 2003-2005, including 45 deaths in children 0-14 years of age (2003-2005)³.
• New York residents had an average of 41,797 asthma hospitalizations per year during 2003-2005. This is equivalent to a rate of 21.7 asthma hospitalizations per 10,000 population. Asthma hospitalizations for children between the ages of 0-17 averaged 14,411 per year for a rate of 33.8 per 10,000. In children 0-4 years of age, hospitalization rates dropped from 79.0/10,000 (1997-1999) to 66.6/10,000 (2003-2005). In children 5-14 years of age, hospitalization rates dropped from 29.6/10,000 (1997-1999) to 24.8/10,000 (2003-2005).⁴
• Total Medicaid health care expenditures for recipients with asthma in New York State exceeded $1 billion in fiscal year 2000 ⁵, inclusive of asthma related and unrelated medical services.
• Asthma takes its toll in many ways. Asthma is the leading cause of school absenteeism. Asthma results in many lost nights of sleep and disruption of activities for the individual, as well as his or her family. Parents frequently miss days from work as a result of their child's asthma.

Sources

1. National Asthma Survey NYS data for children under 18 - 2003
2. New York State Behavioral Risk Factor Surveillance System (BRFSS), 2005
3. New York State Department of Health, Bureau of Biometrics, Vital Statistics
4. New York State Department of Health, Statewide Planning and Research Cooperative System (SPARCS)
5. Claim Detail/Special Reporting System, New York State Department of Health, Office of Medicaid Management.

Arboviral Infections

Arboviral Infections (arthropod-borne encephalitis, eastern equine encephalitis, St. Louis encephalitis, California encephalitis, Powassan encephalitis, West Nile encephalitis)

Last Reviewed: November 2006

• "Arboviral Infections" is also available in Portable Document Format (PDF, 25KB, 2pg.)
• Versión en español
• Further information on arboviral infections from Wadsworth Center for Laboratories and Research

What are arboviral infections?

Arboviral (short for arthropod-borne) infections are caused by any number of viruses transmitted by arthropods such as mosquitoes and ticks. These infections generally occur during warm weather months, when mosquitoes and ticks are active.

Who gets arboviral infections?

Anyone can get an arboviral infection but the elderly appear to be most susceptible. Young children may experience more severe illness with eastern equine encephalitis and certain types of California encephalitis.

How are arboviral infections transmitted?

Most arboviral infections are spread by infected mosquitoes. Fortunately, only a few types of mosquitoes are capable of transmitting disease and only a small number of the mosquitoes will actually be carrying a virus at any one time. Occasionally, migrating birds have the ability to carry viruses from one area of the country to another; humans, however, cannot become infected by birds, only mosquitoes. Some arboviral infections, such as Powassan encephalitis, may be transmitted by infected ticks.

What are the symptoms of arboviral infections?

Symptoms of the various types of viral infections transmitted by mosquitoes and ticks are usually similar, except for their severity. Most infections do not result in any symptoms. Mild cases may occur with only a slight fever and/or headache and bodyaches and resolve with no complications. Severe infections are marked by a rapid onset, headache, high fever, disorientation, tremors, convulsions, paralysis, coma or death.

When do symptoms appear?

Symptoms usually occur three to 15 days after a bite from an infected mosquito or tick.

Does past infection with an arbovirus make a person immune?

Infection with an arbovirus may provide immunity to that specific virus and perhaps to related viruses.

What is the treatment for an infection due to an arbovirus?

Health care providers will usually attempt to relieve the symptoms of the illness, but there is no specific treatment available for arboviral infections.

How can arboviral infections be prevented?

To minimize exposed skin, insect repellents containing DEET can be used by persons spending time outdoors in mosquito- or tick-infested areas. Be sure to follow label directions carefully. Consider wearing long sleeves and tucking pants into socks and shirt into pants when in tick habitat or outdoors at dusk or dawn, the time of day when mosquitoes are most active. Wear light-colored clothes to spot ticks easily.
To reduce the mosquito population around your home and property, reduce or eliminate all standing water:

• Dispose of tin cans, plastic containers, ceramic pots or similar water-holding containers.
• Remove and recycle all discarded tires on your property. Used tires are a significant mosquito-breeding site.
• Drill holes in the bottoms of recycling containers that are kept outdoors.
• Make sure roof gutters drain properly and clean clogged gutters in the spring and fall.
• Remove leaf debris from yards and gardens.
• Turn over wading pools and wheelbarrows when not in use.
• Change the water in birdbaths twice weekly.
• Clean vegetation and debris from edges of ponds.
• Clean and chlorinate swimming pools, outdoor saunas and hot tubs.
• Drain water from pool covers.
• Use landscaping to eliminate standing water that collects on your property.
• Make sure window and door screens fit properly and are in good condition.

Anthrax (malignant edema, woolsorters' disease)

What is anthrax?

Anthrax is a rare infectious disease caused by the bacterium Bacillus anthracis. Anthrax occurs naturally around the world in wild and domestic hoofed animals, especially cattle, sheep, goats, camels and antelopes. It can also occur in humans when they are exposed to the bacterium, usually through handling animals or animal hides. There are three forms of anthrax infection: cutaneous (skin), inhalation (lungs) and gastrointestinal (stomach and intestine). If people have been intentionally exposed, as in a bioterrorist release, contact with skin would be the most likely route of exposure. Breathing in the spores that have been spread through the air could cause inhalation anthrax.

How common is anthrax and who can get it?

Anthrax can be found around the world. It is most common in agricultural regions where it occurs in animals. It is more common in developing countries or countries without veterinary public health programs. Anthrax is reported more often in some regions of the world (South and Central America, Southern and Eastern Europe, Asia, Africa, the Caribbean and the Middle East) than in others. It has been extremely rare in the United States in recent decades, and until cases in Florida and New York City in 2001, has been limited to the cutaneous (skin) form. When anthrax affects humans, it is usually due to an occupational exposure to infected animals or their products. However, anthrax is considered to be one of a number of potential agents for use in biological terrorism.

How is anthrax spread?

Anthrax is usually spread in the form of a spore. (A spore is a dormant form that certain bacteria take when they have no food supply. Spores can grow and cause disease when better conditions are present, as in the human body.) Anthrax is generally spread in one of three ways. Most persons who are exposed to anthrax become ill within one week but can take as long as 42 days for inhalation anthrax:

• Skin (cutaneous) - Most anthrax infections occur when people touch contaminated animal products like wool, bone, hair and hide. The infection occurs when the bacteria enters a cut or scratch in the skin.
• Inhalation (lung) - Some anthrax infections occur when people breathe in the spores of the bacteria.
• Gastrointestinal - Some people may get anthrax by eating infected meat that has not been properly cooked.

What are the symptoms of anthrax?

• Skin (cutaneous) - This is the most common form of anthrax. Infection requires a break in the skin. The first symptoms include itching where the skin has been exposed. Then, a large boil or sore appears. The sore becomes covered by a black scab. If not treated, the infection can spread to the lymph nodes and bloodstream.
• Inhalation - Inhalation anthrax has been very rare in the U.S. First symptoms include fever, fatigue, malaise and a cough or chest pain. High fever, rapid pulse and severe difficulty breathing follow in two to five days. Inhalation anthrax is often fatal.
• Gastrointestinal - This form occurs only after eating infected, undercooked meat. First symptoms include fever, severe abdominal pain, loose, watery bowel movements, bloody diarrhea and vomiting with blood.

How soon after exposure do symptoms develop?

Symptoms usually develop between one and seven days after exposure but prolonged periods up to 42 days for cutaneous (skin) anthrax and 60 days for inhalation anthrax are possible, though rare.

Can anthrax be spread person to person?

Inhalation (lung) anthrax is not spread from person to person. Even if you develop symptoms of inhalation anthrax, you are not contagious to other persons. If you develop cutaneous (skin) anthrax, the drainage from an open sore presents a low risk of infection to others. The only way cutaneous (skin) anthrax can be transmitted is by direct contact with the drainage from an open sore. Anthrax is not spread from person to person by casual contact, sharing office space or by coughing and sneezing.

How is it diagnosed?

Anthrax is diagnosed when the Bacillus anthracis bacterium is found in the blood, skin lesions or respiratory secretions by a laboratory culture. It can also be diagnosed by measuring specific antibodies in the blood of infected persons. Nasal swabs are not a good way to diagnose anthrax because a swab cannot definitively determine if someone has not been exposed to anthrax.

What is the treatment for illness caused by anthrax?

There are several antibiotics that are used successfully to treat anthrax. Treatment is highly effective in cases of cutaneous (skin) anthrax and is effective in inhalation and gastrointestinal anthrax if begun early in the course of infection. The United States has a large supply of these antibiotics and can quickly manufacture more if needed.

Is there a way to prevent infection?

Persons known to be exposed to confirmed anthrax spores will be given antibiotics, usually ciprofloxacin (cipro) or doxycycline, for several weeks to prevent infection.

Do I need to disinfect myself or my belongings if I believe I was exposed to anthrax?

Most threats regarding anthrax have proven to be hoaxes. However, in the event of a possible exposure to a powder or other unknown substance with a threat that may indicate anthrax, call 911 and leave the material alone. To prevent infection if you have a skin exposure to the powder or other substance, wash your hands vigorously with soap and water, and shower with soap and water if necessary. Similarly, washing possibly contaminated clothes in the regular laundry will safely remove any possible anthrax. To be inhaled, anthrax spores must first be aerosolized (dispersed in the air) which does not usually occur. In the unlikely event that you do inhale spores, medical evaluation and treatment is needed.

Amebiasis (amebic dysentery)

Last Reviewed: October 2011

What is amebiasis?

Amebiasis is an intestinal illness caused by a microscopic parasite called Entamoeba histolytica. Approximately 600 cases are reported each year in New York State.

Who gets amebiasis?

Anyone can get amebiasis, but it is recognized more often in people arriving from tropical or subtropical areas that have poor sanitary conditions, individuals living in institutions and people exposed to human feces through sexual contact.

How is amebiasis spread?

Amebiasis is contracted by consuming contaminated food or water containing the cyst stage of the parasite. It can also be spread by person-to-person contact.

What are the symptoms of amebiasis?

People exposed to this parasite may experience mild or severe symptoms or no symptoms at all. Fortunately, most exposed people do not become seriously ill. The mild form of amebiasis includes nausea, loose stools, weight loss, abdominal tenderness and occasional fever. Rarely, the parasite will invade the body beyond the intestines and cause a more serious infection, such as a liver abscess.

How soon after exposure do symptoms appear?

The symptoms may appear from a few days to a few months after exposure but usually within two to four weeks.

For how long can an infected person carry this parasite?

Some people with amebiasis may carry the parasite for weeks to years, often without symptoms.

Where are the parasites that cause amebiasis found?

The parasite lives only in humans. Fecal material from infected people may contaminate water or food, which may spread the parasites to anyone who consumes them. Fecal material from infected people may also contaminate surfaces.

How is it diagnosed?

Examination of stools under a microscope is the most common way for a doctor to diagnose amebiasis. Sometimes, several stool samples must be obtained because the number of amoeba being passed in the stool, which varies from day to day, may be too low to detect from any single sample.

What is the treatment for amebiasis?

Specific antibiotics such as metronidazole can be prescribed by a doctor to treat amebiasis.

Should an infected person be excluded from work or school?

Although people with diarrhea due to amebiasis should not attend school or go to work, it is not necessary to exclude infected persons when they feel better and stools are normal. Casual contact at work or school is unlikely to transmit the disease. Special precautions may be needed by foodhandlers or children enrolled in daycare settings. Consult your local health department for advice in such instances.

What precautions should the infected person follow?

The most important precautions are careful handwashing after each toilet visit and proper disposal of sewage. People with amebiasis should refrain from sexual contact until the infection is treated and has cleared.

Alzheimer's Disease and Other Dementias Alzheimer's Disease

Alzheimer's Disease and Other Dementias

Alzheimer's Disease

What is Alzheimer's Disease?
Alzheimer's disease is a progressive, degenerative disorder that attacks the brain and results in disorientation, with impaired memory, thinking, and judgment. People with Alzheimer's also undergo changes in their behavior. Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks. This combination of these symptoms is also called dementia.
As mentioned above, Alzheimer's is a progressive disease, where dementia symptoms gradually worsen over a number of years. In its early stages, memory loss is mild, but with late-stage Alzheimer's, individuals lose the ability to carry on a conversation and respond to their environment. Alzheimer's is the sixth leading cause of death in the United States. Those with Alzheimer's live an average of eight years after their symptoms become noticeable to others, but survival can range from four to 20 years, depending on age and other health conditions.

Dementia

What is Dementia?
Dementia is a gradual and progressive loss of memory, thinking and reasoning skills, as well as physical function. Alzheimer's disease is the most common cause of dementia.
Dementia is a non-specific syndrome in which affected areas of brain function may be affected, such as memory, language, problem solving and attention. Dementia, unlike Alzheimer's, is not a disease in itself. When dementia appears the higher mental functions of the patient are involved initially. Eventually, in the later stages, the person may not know what day of the week, month or year it is; they may not know their surroundings, and might not be able to identify the people around them.
Dementia is significantly more common among older people. However, it can affect adults of any age.

Other Causes of Dementia

• Mild Cognitive Impairment (MCI)
• Vascular Dementia
• Mixed Dementia
• Dementia with Lewy Bodies
• Parkinson's Disease
• Frontotemporal Dementia
• Creutzfeldt-Jakob Disease (CJD)
• Normal Pressure Hydrocephalus
• Huntington's Disease
• Wernicke-Korsakoff Syndrome

For further information about other causes of Dementia, please visit these sites:

• Alzheimer's Association
• National Institute of Neurological Disorders and Stroke

ALS (Lou Gehrig's Disease)

Amyotrophic lateral sclerosis (ALS) is commonly known as "Lou Gehrig's disease," named after the famous New York Yankees baseball player who was forced to retire after developing the disease in 1939.
ALS is a progressive disease that destroys nerve cells in the brain and spinal cord which control the muscles throughout the body. When these nerve cells (also called motor neurons) die, the brain can no longer send impulses (messages) to the muscle fibers that normally result in muscle movement. The disease most commonly afflicts people between the ages of 40 and 70. As many as 30,000 Americans have the disease at any given time.
The earliest symptoms of the disease depend upon which nerves and muscles are first affected. Any muscle group may be the first to show signs of the disease. For example, the person may experience twitching and weakness of the muscles of the hands or lower legs. If the muscles of the face or throat are affected, the problem at onset would be difficulty with speaking, chewing, swallowing or movements of the tongue and face. If the muscles of the chest are affected the person may have difficulty breathing. In some instances the first symptoms may be involuntary weeping or laughing. In the beginning, muscle groups on only one side of the body may be affected, but as time passes, more and more muscles on both sides are involved and the patient becomes totally paralyzed. Yet, through it all, for the vast majority of people, their minds remain unaffected.
A-myo-trophic comes from the Greek language. "A" means no or negative. "Myo" refers to muscle, and "Trophic" means nourishment---"No muscle nourishment." When a muscle has no nourishment, it "atrophies" or wastes away. "Lateral" identifies the areas in a person's spinal cord where portions of the nerve cells that signal and control the muscles are located. As this area degenerates it leads to scarring or hardening ("sclerosis") in this region of the cord.

Resources for Caregivers and Service Providers

Services for patients are offered through the two New York Chapters of The ALS Association. The Chapters also provide information, training, and services for caregivers, health care providers, and researchers.
The Greater New York Chapter serves all of New York City, Long Island, Westchester County, and the Hudson Valley.
The Upstate Chapter serves Central and Western New York State.

ALS Centers of Excellence

The ALS Association Certified Center program defines, establishes and supports a national standard of care in the management of ALS. The ALS Centers encourage and provide state-of-the-art care and clinical management of ALS through:

• Multi-disciplinary care of the person with ALS and his/her family
• Specially-trained clinical staff knowledgeable about the needs of those living with ALS
• Collaborative work among Centers to enhance ALS patient care and conduct research studies

New York State has three ALS Association Certified Centers of Excellence

• Beth Israel Medical Center
  New York, NY
• SUNY Upstate Medical University
  Syracuse, NY
• Stony Brook University Hospital
  East Setauket (Suffolk County), NY

National ALS Registry

The goal of the National ALS Registry is to collect information on people living with ALS to help scientists learn more about the disease.

Facts You Should Know

ALS Association of New York State

Latest on ALS Research

ALS Association

AID/HIV

AID/HIV

Human Immunodeficiency Virus (HIV) is a virus. You may hear that someone is "HIV infected", "has HIV infection", or "has HIV disease." These are all terms that mean the person has HIV in his or her body and can pass the virus to other people.
HIV attacks the body's immune system. The immune system protects the body from infections and disease, but has no clear way to protect it from HIV. Over time, most people infected with HIV become less able to fight off the germs that we are all exposed to every day. Many of these germs do not usually make a healthy person sick, but they can cause life-threatening infections and cancers in a person whose immune system has been weakened by HIV.
People infected with HIV may have no symptoms for 10 or more years. They may not know they are infected. An HIV test is the only way to find out if you have HIV. See HIV Counseling and Testing for information and resources on HIV testing in New York State.
HIV spreads when infected blood, semen, vaginal fluids, or breast milk gets into the bloodstream of another person through:

• direct entry into a blood vessel;
• mucous linings, such as the vagina, rectum, penis, mouth, eyes, or nose, or
• a break in the skin.

HIV is not spread through saliva (spit).
HIV is spread through:

• Vaginal, anal, or oral sex without using a condom.
• Sharing needles, syringes, or works to inject drugs, vitamins, hormones, steroids, or medicines.
• Women with HIV infection can pass HIV to their babies during pregnancy, delivery, and breastfeeding.
• People who are exposed to blood and/or body fluids at work, like health care workers, may be exposed to HIV through needle-sticks or other on-the-job exposures.

It may also be possible to pass HIV through sharing needles for piercing or tattooing.
A person infected with HIV can pass the virus to others during these activities. This is true even if the person:

• has no symptoms of HIV
• has not been diagnosed with AIDS
• is taking HIV medications
• has an "undetectable" viral load

HIV is not spread by casual contact like sneezing, coughing, eating or drinking from common utensils, shaking hands, hugging, or use of restrooms and drinking fountains.

AIDS

Acquired Immune Deficiency Syndrome (AIDS) is a late stage of HIV disease. Medications can help people living with HIV or AIDS live longer, healthier lives. Some people have lived for more than 20 years and have taken medicines for more than 10 years. Not everyone's disease progresses or responds to medications in the same way. AIDS has serious health consequences, it can interfere with quality of life and there is no cure.

Note: This site contains HIV prevention messages that may not be appropriate for all audiences. Since HIV infection is spread primarily through sexual practices or by sharing needles, prevention messages on this site may address these topics.

AIDS/HIV

HIV/AIDS

HIV

Human Immunodeficiency Virus (HIV) is a virus. You may hear that someone is "HIV infected", "has HIV infection", or "has HIV disease." These are all terms that mean the person has HIV in his or her body and can pass the virus to other people.
HIV attacks the body's immune system. The immune system protects the body from infections and disease, but has no clear way to protect it from HIV. Over time, most people infected with HIV become less able to fight off the germs that we are all exposed to every day. Many of these germs do not usually make a healthy person sick, but they can cause life-threatening infections and cancers in a person whose immune system has been weakened by HIV.
People infected with HIV may have no symptoms for 10 or more years. They may not know they are infected. An HIV test is the only way to find out if you have HIV. See HIV Counseling and Testing for information and resources on HIV testing in New York State.
HIV spreads when infected blood, semen, vaginal fluids, or breast milk gets into the bloodstream of another person through:

• direct entry into a blood vessel;
• mucous linings, such as the vagina, rectum, penis, mouth, eyes, or nose, or
• a break in the skin.

HIV is not spread through saliva (spit).
HIV is spread through:

• Vaginal, anal, or oral sex without using a condom.
• Sharing needles, syringes, or works to inject drugs, vitamins, hormones, steroids, or medicines.
• Women with HIV infection can pass HIV to their babies during pregnancy, delivery, and breastfeeding.
• People who are exposed to blood and/or body fluids at work, like health care workers, may be exposed to HIV through needle-sticks or other on-the-job exposures.

It may also be possible to pass HIV through sharing needles for piercing or tattooing.
A person infected with HIV can pass the virus to others during these activities. This is true even if the person:

• has no symptoms of HIV
• has not been diagnosed with AIDS
• is taking HIV medications
• has an "undetectable" viral load

HIV is not spread by casual contact like sneezing, coughing, eating or drinking from common utensils, shaking hands, hugging, or use of restrooms and drinking fountains.

AIDS

Acquired Immune Deficiency Syndrome (AIDS) is a late stage of HIV disease. Medications can help people living with HIV or AIDS live longer, healthier lives. Some people have lived for more than 20 years and have taken medicines for more than 10 years. Not everyone's disease progresses or responds to medications in the same way. AIDS has serious health consequences, it can interfere with quality of life and there is no cure.

Note: This site contains HIV prevention messages that may not be appropriate for all audiences. Since HIV infection is spread primarily through sexual practices or by sharing needles, prevention messages on this site may address these topics.