Nearly 30,000 cases of Lyme disease are reported to the CDC each year, yet about 20 percent of people in areas where Lyme disease is common are unaware that it’s a risk. And, even in those areas where the disease is common, 42 percent of individuals report taking no preventive measures against ticks.

If you’re wondering about your risk, this is where 95 percent of Lyme disease cases occur in the US:

• Connecticut
• Delaware
• Maine
• Maryland
• Massachusetts
• Minnesota
• New Hampshire
• New Jersey
• New York
• Pennsylvania
• Virginia
• Wisconsin

Other tickborne diseases include Rocky Mountain spotted fever, anaplasmosis, ehrlichiosis, and babesiosis. These diseases tend to be concentrated in specific parts of the country. Check with your county health department to see what the risks are in your area.

Diseases reported to CDC by state health departments. Each dot represents one case. The county where the disease was diagnosed is not necessarily the county where the disease was acquired.

Tickborne diseases can cause mild symptoms to severe infections requiring hospitalization. The most common symptoms of tick-related illnesses can include fever/chills, aches and pains, and rash. Early recognition and treatment of the infection decreases the risk of serious complications, so see your doctor immediately if you have been bitten by a tick and experience any of these symptoms.

Stay on top of prevention by following these CDC recommendations:

• Avoid areas with high grass and leaf litter and walk in the center of trails when hiking.
• Use repellent that contains 20 percent or more DEET on exposed skin for protection that lasts several hours. Parents should apply repellent to children; the American Academy of Pediatrics recommends products with up to 30 percent DEET for kids. Always follow product instructions.
• Use products that contain permethrin to treat clothing and gear, such as boots, pants, socks and tents or look for clothing pre-treated with permethrin.
• Treat dogs for ticks. Dogs are very susceptible to tick bites and to some tickborne diseases, and may also bring ticks into your home. Tick collars, sprays, shampoos, or monthly “top spot” medications help protect against ticks.
• Bathe or shower as soon as possible after coming indoors to wash off and more easily find crawling ticks before they bite you.
• Conduct a full-body tick check using a hand-held or full-length mirror to view all parts of your body upon returning from tick-infested areas. Parents should help children check thoroughly for ticks. Remove any ticks right away.

Thanks to the CDC for the info!

Approximately one-third of teens may be missing annual checkups, according to data from the US Department of Health and Human Services and the US Census.

Teens often encounter social, emotional, and physical issues that may include eating disorders and obesity, substance abuse, and sexually transmitted infections. While experts agree that teens should get annual medical checkups to be screened for health risks and discuss important health-related matters, perceptions exist that may contribute to millions of teens missing out on yearly visits.

To better understand perceptions about teen health, the National Foundation for Infectious Diseases (NFID), in collaboration with, and with support from, Pfizer Inc, conducted a national survey, fielded by Harris Interactive, of more than 2,000 parents of teens, teens, and healthcare professionals.

A key finding was that about one in four parents surveyed said that teens’ lifestyle choices today won’t affect their health in the future, and one in five teens surveyed agreed.

The disconnect among parents and teens between today’s choices and future impacts on health contrasts with medical thinking that health behaviors in the teen years can have a long-term impact on health in adulthood.

The survey revealed a number of misperceptions and potential missed opportunities, including:

• About 60 percent of teens surveyed identified at least one reason for not getting an annual checkup; of those, about one-third believes that they only need to see a doctor when sick.
• When teens are joined by a parent in the exam room, it can restrict the conversation, according to 84 percent of physicians surveyed.
• About half of physicians surveyed assumed teens’ friends were a most trusted source for health information, teens surveyed (43 percent) actually listed healthcare providers as their most trusted source for health information.

Checkups are not just for babies

Parents of infants and young children are accustomed to regularly visiting a pediatrician for their child’s checkups. But when children reach the teen years, these annual checkups may fall off the radar. While 85 percent of parents polled say an annual checkup is very important for those zero to five years, there was a 24 percent drop in the percentage who believe the same is true for teens (61 percent).

Professional societies, including the Society for Adolescent Health and Medicine (SAHM) and the American Medical Association (AMA), recommend annual checkups for teens. The Affordable Care Act allows teens and young adults to remain under their families’ health coverage up to age 26, which can help ensure that they have access to preventive health care, including checkups.

Annual checkups can be an important opportunity for positive health discussions. Physicians polled report that teens and their parents are more likely to ask about a number of health topics, including weight, sexual health, vaccines, and stress-related conditions during an annual checkup than at a sick visit.

“Teens are smart, but they’re just like the rest of us: overscheduled and overwhelmed. It’s normal to have an ‘it won’t happen to me’ attitude,” said Aria Finger, chief operating officer of DoSomething.org, a large social change nonprofit in the United States. “It’s about changing the consciousness of teens and those who care for them. Everyone wants what’s best. Making the annual checkup part of the norm during teen years sets young people up to take charge and get ahead of the curve about their own health.”

Teens worry about health

Nearly all parents, teens, and physicians surveyed (94, 96, and 97 percent, respectively) agree that teens should have a say in decisions about their own health. And the survey shows being healthy can be top of mind for many; two out of three teens surveyed say they worry a lot or a great deal about staying healthy. However, only 28 percent of parents reported that they believe their teens worry a lot or a great deal about their health.

While teens may trust doctors, they don’t necessarily like talking with them. Almost 40 percent of teens surveyed say they don’t like talking with doctors or other health care providers. Fifty percent of teens surveyed turn to the Internet for health information. Parents surveyed report that when they are in the room, only half of the conversation is directed solely toward the teen.

Furthermore, as noted, having a parent in the teen’s exam room during an annual checkup can restrict the conversation, according to 84 percent of physicians.

“The information and communication dynamic among teens, parents, and doctors is an important one,” said Leslie Walker, MD, immediate past-president of SAHM and division chief of adolescent medicine and professor of pediatrics at University of Washington School of Medicine and Seattle Children’s Hospital. “It’s appropriate for teens to be able to talk to their doctor alone. Establishing this one-on-one relationship between patient and physician encourages independence and responsibility for one’s own health.”

It takes a village

Teens may also turn to other adults in their lives. One in four teens surveyed said they may turn to school-based professionals (teachers, guidance counselors and school nurses) for health information.

“Teens are social beings,” said Finger. “The adults and peers in their lives model behaviors and influence attitudes about health and well-being. Engaging these audiences or equipping them to positively influence teens can go a long way.”

About the survey

Harris conducted an online survey of 504 teens aged 13-17, 500 parents of teens aged 13-17, and 1,325 healthcare professionals including pediatricians and primary care physicians (n=510) and nurse practitioners, physician assistants, registered nurses, and licensed practical nurses (n=815) in the United States.

All respondents were sampled from the online panels maintained by Harris Interactive Inc. and its partners, invited by e-mail to be screened, and if qualified, participate in an online self-administered survey. Data was collected between Dec. 27, 2012 and Jan. 23, 2013. Data for all three surveys (teens survey, parents survey, and healthcare professional survey) were weighted.

US Department of Health and Human Services. Healthy People 2020: Adolescent Health Objectives. http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=2. Updated March 28, 2013. Accessed April 5, 2013.

U.S Census Bureau. Population Estimates. http://www.census.gov/popest/data/historical/2000s/vintage_2009/. Updated November 2012. Accessed on March 1, 2013.

American Medical Association. Guidelines for Adolescent Preventive Services.1997. http://www.ama-assn.org/resources/doc/ad-hlth/gapsmono.pdf. Accessed April 5, 2013.

SAHM. Clinical Preventive Services for Adolescents. J Adolesc Health.1997;21:203-214.

Harris Interactive. “Adolescent Wellness Survey.” Parent Data Tables. February 7, 2013.

Harris Interactive. “Adolescent Wellness Survey.” Teen Data Tables. February 7, 2013.

Coker T, Sareen H, Chung P, et al. Improving Access to and Utilization of Adolescent Preventive Health Care: The Perspective of Adolescents and Parents. J Adolesc Health. 2010;47:133-142.

Harris Interactive. “Adolescent Wellness Survey.” HCP Data Tables February 7, 2013.

US Department of Health and Human Services. Young Adults and the Affordable Care Act. http://www.healthcare.gov/law/information-for-you/young-adults.html. Updated April 2013. Accessed April 5, 2013 

We put out the call for infant vaccination resources that groups were prepared to share, and this is what we received. If you have any tools or resources you can share with others, either hard copies or downloadables, just add them to the comments section.

Vaccinate Your Baby has a nice section on their website of video FAQs, featuring Dr. Paul Offit, Dr. Mark Sawyer, Alison Singer, and Dr. Mary Beth Koslap-Petraco. The videos are very short, and they each ask and answer a question about vaccines. Plus, they have the full transcripts available for download. Nice way to hear how other healthcare professionals answer questions, and something you can show patients.

AAP has a multitude of resources, as you would imagine.

Here’s the Childhood Immunization Support Program Best Practices Summary. Clinicians answer several questions, and their answers are compared to best practices for each question. Sample question: “How does your practice ensure that, whenever possible, immunization appointments are scheduled along with other appointments, to prevent missed opportunities?” Good opportunity to find out how others are overcoming issues related to best practices.

AAP also has a nice page with several provider resources listed for those wanting to communicate with parents of infants, or children of any age.

The Alliance for Immunization in Michigan has a toolkit available for download that addresses infant immunization, as well as immunization in other age groups.

The Illinois Maternal & Child Health Coalition has a Community Immunization Education Guide Toolkit available in English and Spanish. It provides background information that the trainee can use as they train fellow community workers and/or educate the public about immunizations. Key topics include: What is a vaccine preventable disease, what are the five key immunization messages, what do vaccine preventable diseases look like, how to give an excellent presentation.

The Hepatitis B Foundation has a downloadable flyer promoting hep B vaccination.

CDC has an entire infant/toddler immunization section on its website.

Stanford’s Asian Liver Center has a flyer available in multiple languages that addresses HBV and Moms-to-be

CHOP’s Vaccine Education Center has several resources available:

Print materials: - Vaccines and Your Baby booklet; Q and A sheets about related vaccines: rotavirus, hep A, chickenpox, influenza, pertussis; Vaccine safety q and a sheets – facts about childhood vaccines, aluminum, recommended immunization schedule, thimerosal, too many vaccines, vaccine ingredients, vaccines and autism; Clings of the immunization schedule.

Videos: - Vaccines and your baby (for new or expectant parents), Vaccines: Separating Fact from Fear (for parents concerned about vaccine safety)

Parents PACK program – website and monthly e-newsletter (sample)

IAC has several resources for those working with infants:

FOR PARENTS:

Immunizations for Babies  (also available in 8 translations)

Vaccinations for Infants and Children, Age 0–10 Years

Clear Answers & Smart Advice About Your Baby’s Shots by Dr. Ari Brown, MD, FAAP

Cocooning Protects Babies

Personal belief exemptions for vaccination put people at risk. Examine the evidence for yourself.

Questions Parents Ask about Baby Shots   (also available in 8 translations)

Reliable Sources of Immunization Information: Where to go to find answers!

What if you don’t immunize your child?

FOR PROVIDERS:

Vaccine Administration Record for Children and Teens

Summary of Recommendations for Child/Teen Immunization

Recommendations for Pneumococcal Vaccine Use in Children and Teens

Meningococcal Vaccination Recommendations by Age and/or Risk Factor

Screening Checklist for Contraindications to Vaccines for Children and Teens   (also available in 9 translations)

Decision to Not Vaccinate My Child (declination form)

Standing orders for all routine childhood vaccines

PKIDs has several infant-specific resources that anyone may use. There’s a nice section on pertussis with video and audio PSAs, , and other materials for use by providers and parents. For the Make On-Time Vaccination Easy program, there are radio PSAs available for download . There are also videos covering a variety of vaccine-preventable diseases that may be used by anyone as PSAs, or there are longer versions for showing in waiting rooms .

Every 20 seconds, a child dies from a disease that could be prevented with a safe and effective vaccine. Millions more children survive, but are left severely disabled. Vaccines have the power not only to save, but also transform lives by protecting against disease – giving children a chance to grow up healthy, go to school, and improve their lives.  Vaccination campaigns sometimes provide the only contact with health care services that children receive in their early years of life.

Immunization is one of the most successful and cost-effective health interventions—it currently averts an estimated 2 to 3 million deaths every year in all age groups from diphtheria, tetanus, pertussis (whooping cough), and measles.

Immunization is a global health priority at CDC focusing on polio eradication, reducing measles deaths, and strengthening immunization systems. CDC works closely with a wide variety of partners in more than 60 countries to vaccinate children and provide technical assistance to ministries of health to strengthen and expand countries’ abilities to create, carry out, and evaluate their national immunization programs.

Too few people realize that the health of Americans and the health of people around the world are inextricably linked. Viruses don’t respect borders, so they travel easily within countries and across continents. By helping to stop vaccine-preventable diseases (VPDs) globally, CDC is also helping to protect people in the United States against importations of VPDs from other countries.

For example, in 2011, there were 220 reported cases of measles in the United States—200 of the 220 cases were brought into the U.S. from other countries with measles outbreaks.

The most effective and least expensive way to protect Americans from diseases and other health threats that begin overseas is to stop them before they spread to our shores. CDC works 24/7 to protect the American people from disease both in the United States and overseas. CDC has dedicated and caring experts in over 60 countries. They detect and control outbreaks at their source, saving lives and reducing healthcare costs. In 2012, CDC responded to over 200 outbreaks around the world, preventing disease spread to the U.S.

CDC’s global health activities protect Americans at home and save lives abroad. They reduce the need for U.S. assistance and create goodwill and good relationships with global neighbors.

Thanks to the CDC for sharing this information.

The NCAA and NATA and other sports organizations carefully spell out the standards athletic organizers, including coaches, teachers and others, should follow before, during and after an athletic event.

Before the Event Begins

As part of the “pre-game” education program, NATA encourages trainers to:

• Educate athletes about bloodborne pathogens.
• Discuss the ethical and social issues related to bloodborne pathogens.
• Review the importance of prevention programs, including standard precautions and immunizations.
• Educate athletes about the signs and symptoms of hepatitis B [and hepatitis C] and HIV.

Make sure the athletes know the rules concerning standard precautions, including reporting all wounds immediately if and when they occur.  This is part of the coach or trainer’s critical pre-game education.

Before the opening whistle, cover all wounds, abrasions, cuts or weeping wounds that may serve as a source of bleeding or as a port of entry for bloodborne pathogens.  Remember, protection is a two-way street.  No one wants germs entering or exiting these wounds or abrasions. The “cover” or bandages should be able to withstand the demands of competition.

Wear protective equipment over high-risk areas where bruising commonly occurs, such as elbows or hands.

Make sure the necessary equipment and supplies needed to comply with standard precautions are available, including latex [or other non-permeable] gloves, biohazard containers, disinfectants, bleach solutions, antiseptics, containers for soiled equipment and uniforms and sharps containers.

During the Event

Underscore the importance of early recognition and control of any cuts or bruises that bleed.  Coaches and athletes alike should be prepared for appropriate cleaning and covering procedures and changing of blood-saturated clothes.

Require all athletes to report all wounds immediately.  Players with active bleeding should be removed from the event as soon as practical.  Return to play should be determined by appropriate staff.

All personnel involved with sports should be trained in basic first aid and infection control, including standard precautions:

• They should use sterile latex [or other non-permeable] gloves for direct contact with blood or body fluids containing blood.
• Gloves should be changed after treating each individual participant.  After glove removal, hands should be washed.
• Any surface or equipment contaminated with spilled blood should be cleaned with gloves on.  The spill should be contained in as small an area as possible.  After the blood is removed, the surface should be cleaned with a disinfectant or decontaminant.
• Proper disposal procedures should be practiced to prevent injuries caused by needles, scalpels and other sharp devices.
• Any equipment or uniforms soiled with blood should be laundered in accordance with hygienic methods.

Any life-saving equipment should be maintained in accordance with infection control guidelines.

After the Event

When the game is over, any wounds, cuts, and abrasions should be tended to.

Coaches and athletic personnel should constantly review the level of knowledge and implementation of standard precautions policies and recommend revisions and retraining where necessary.

Appropriate policy development with legal and administrative assistance of existing OSHA (Occupational Safety and Health Administration) and other legal guidelines and conference or school rules and regulations should be considered on an as needed basis.

Medical Records and Confidentiality

While many experts feel an athlete should not have to “disclose” an infection to a coach, trainer or teacher, some athletes may decide personally to share information about a bloodborne viral infection.

The security, record-keeping and confidentiality requirements and concerns that relate to athletes’ medical records generally apply equally to those portions of athletes’ medical records.

Because social stigma is sometimes attached to individuals infected with HIV or viral hepatitis, athletic officials should pay particular care to the security, record-keeping and confidentiality requirements that govern the medical records for which they have a professional obligation to see, use, keep, interpret, record, update or otherwise handle.

An Infected Trainer, Teacher or Coach

A coach, teacher or trainer infected with a bloodborne pathogen should practice his or her profession while taking into account all professionally, medically and legally relevant issues raised by the infection.

Depending on individual circumstances, the infected coach, trainer or official must take reasonable steps to avoid potential and identifiable risks to his or her own health and the health of his or her team.

More information may be found at PKIDs’ Infectious Disease Workshop

Image courtesy of PShanks

As of 12:00 p.m. today, there have been 38 cases identified in humans, and 11 deaths. When healthcare staff identify the infection, they hospitalize and quarantine the patient, no matter how mild the symptoms.

There are most likely people infected who do not have symptoms, and who have not yet been identified. It’s therefore hard to know the total number of infected.

The virus is showing up in four provinces in China, and positive test results have been found in market birds, including ducks, chickens, pigeons, and quails. The poultry markets have been closed in an attempt to arrest the spread of this disease.

So far, the virus has not been found in wild birds. What this means is that we don’t need to worry about wild birds migrating and bringing the disease with them to other geographic areas around the world.

There’s been no confirmed person-to-person transmission of the virus, although it may be going on in a limited fashion and no one is aware of it.

The Avian influenza A (H7N9) virus seems to impact those over 60 years of age more than the younger groups. About one-third of those infected are adults ages 18 to 59, and there has been at least one pediatric infection.

Diagnostic kits are being sent overseas first, and once the CDC has received FDA approval, those kits will be distributed in the US.

Here’s the website for up-to-date information: http://www.cdc.gov/flu/avianflu/h7n9-virus.htm

Thanks to the CDC for its teleconference this afternoon, during which this information was presented.

By Trish Parnell

Image courtesy of Phil @ Delfryn Design

The American Academy of Pediatrics tackled this difficult issue in December, 1999, with a policy statement on HIV and Other Bloodborne Viral Pathogens in the Athletic Setting.  In it, the Academy made clear, “Because of the low probability of transmission of their infection to other athletes, athletes infected with HIV, hepatitis B or hepatitis C should be allowed to participate in all sports.”

That participation, however, assumes all athletes and coaches will follow standard precautions to prevent and minimize exposure to bloodborne viruses.  The Academy tackled each infectious disease individually:

HIV: The risk of HIV infection via skin or mucous membrane exposure to blood or other infectious bodily fluids during sports participation is very low . . . such transmission appears to require, in addition to a portal of entry, prolonged exposure to large quantities of blood.  Transmission through intact skin has not been documented: no HIV infections occurred after 2,712 such exposures in 1 large prospective study.  Transmission of HIV in sports has not been documented.  One unsubstantiated report describes possible transmission during a collision between professional soccer players.

Hepatitis B: HBV [hepatitis B virus] is more easily transmitted via exposure to infected blood than is HIV . . . the risk of infection [is] greater if the blood [is] positive for HBV e antigen . . . transmission of infection by contamination of mucous membranes or broken skin with infected blood has been documented, but the magnitude of risk has not been quantified.

Although transmission of HBV is apparently rare in sports, 2 reports document such transmission.  An asymptomatic high school sumo wrestler who had a chronic infection transmitted HBV to other members of his team.  An epidemic of HBV infection occurred through unknown means among Swedish athletes participating in track finding (orienteering).  The epidemiologists concluded that the most likely route of infection was the use of water contaminated with infected blood to clean wounds caused by branches and thorns.

An effective way of preventing HBV transmission in the athletic setting is through immunization of athletes.  The American Academy of Pediatrics (AAP) recommends that all children and adolescents be immunized.  Clinicians and the staff of athletic programs should aggressively promote immunization.

Hepatitis C: Although the transmission risks of HCV infection are not completely understood, the risk of infection from percutaneous [through the skin] exposure to infected blood is estimated to be 10 times greater than that of HIV but lower than that of HBV.  Transmission via contamination of mucous membranes or broken skin also probably has a risk intermediate between that for blood infected with HIV and HBV.

“There is clearly no basis for excluding any student from sports if they are infected,” said Dr. Steven J. Anderson, who was chair of the Academy’s Committee on Sports Medicine and Fitness when it drafted the Academy’s policy, “and we should also try to protect the confidentiality of each athlete.”

Dr. Anderson, a pediatrics professor at the University of Washington and a team doctor for many high school athletic teams, ballet companies and the U.S. Olympic Diving Team, suggests students should have access to any sport, except boxing, which the Academy opposes for all youths because of its physical risks.

“I personally feel parents have no obligation to disclose the infectious status of their children to anyone,” said Dr. Anderson.  Strict compliance with standard precautions is critical for this open-embrace of all athletes, regardless of their infectious status.  Coaches and teachers must have a plan in place to handle blood spills, said Dr. Anderson, including latex [or non-permeable] gloves, occlusive dressings, appropriate sterilizing solutions, disposal bags and even a printed protocol for coaches, athletes and officials.

The following is an excerpt of a sample school policy, used by numerous public school districts and in compliance with ADA that addresses HIV infection:

“The privilege of participating in physical education classes, programs, competitive sports and recess is not conditional on a person’s HIV status.  School authorities will make reasonable accommodations to allow students living with HIV infection to participate in school-sponsored physical activities.

“All employees must consistently adhere to infection control guidelines in locker rooms and all play and athletic settings.  Rulebooks will reflect these guidelines.  First aid kits and standard precautions equipment must be on hand at every athletic event.

“All physical education teachers and athletic program staff will complete an approved first aid and injury prevention course that includes implementation of infection control guidelines.  Student orientation about safety on the playing field will include guidelines for avoiding HIV infection.”

In addition to the Academy, several sports and other health organizations have also weighed in on this issue.  According to the NCAA, National Football League (NFL) and World Health Organization, athletes with HIV should be permitted to participate in all competitive sports at all levels.

These organizations all endorse immunization against hepatitis B for all athletes.

The National Athletic Trainers’ Association (NATA) echoes Dr. Anderson’s suggestion that coaches, trainers, athletic directors, school officials and others take the lead in educating themselves, their teams, parents and their communities about the importance of effective disease prevention.

Trainers and coaches, they suggest, should provide the following information in age-appropriate terms to all participants before or during any competition :

• The risk of transmission or infection during competition.
• The risk of transmission or infection generally.
• The availability of HIV testing (for teens and adults).
• The availability of hepatitis B vaccination and testing (for parents, teens and adults).

“Athletic trainers who have educational program responsibility should extend educational efforts to include those, such as the athletes’ families and communities, who are directly or indirectly affected by the presence of bloodborne pathogens in athletic competitions,” the NATA stated in a position paper.

See PKIDs’ Infectious Disease Workshop for more information.

Photo courtesy of Lolie Smith

Close physical contact and a heightened chance of bleeding present a chance for disease transmission unless appropriate precautions are taken.

Athletes, trainers, coaches, parents, and teachers alike must know how to prevent the transmission of bloodborne viruses such as HIV and hepatitis B or C, or even skin-to-skin infections.

These infectious diseases, and others, pose complex problems for athletes of all ages and everyone involved in sports activities.  But following standard precautions to prevent bloodborne, skin-to-skin, and respiratory infections simplifies and safeguards sports events and ensures that everyone can participate safely.

Sports and Standard Precautions

Universal use of standard precautions is critical because many children, adolescents, and adults who are infected with viruses, such as HIV and hepatitis B or C, may not even know they have these viruses.  Estimates vary, but some predict that more than half of those infected with these viruses do not know they’re infected.

Standard precautions protect everyone, from those whose diseases have been identified, to those that have not yet been diagnosed, to those not infected.  When everyone follows standard precautions, no one who has an infection needs to be treated differently.  Essentially, standard precautions are the great equalizer; when followed, they allow everyone to fully and safely participate in sporting events.

The more serious bloodborne viruses that athletes need to be aware of are: HIV (the virus that causes AIDS), hepatitis B, and hepatitis C.  There is no recommendation that people infected with these viruses not be allowed to participate in most sports.

Although HIV and hepatitis C are not vaccine-preventable, there is a safe and effective vaccine that prevents hepatitis B infection.

Skin-to-Skin Infections

According to the NCAA Injury Surveillance System, “skin infections accounted for almost one-third of the practice time loss events” in wrestling during the 2001-2002 season.  As a result, the NCAA recommends that coaches, teachers and other sports officials be able to identify symptoms of skin infections.  Symptoms may include:

• Crusting
• Scaliness
• Oozing lesions

Skin infections may include:

• Bacterial skin infections including impetigo, erysipelas, carbuncle, staphylococcal disease, folliculitis and hidradenitis suppurativa.
• Parasitic skin infections including pediculosis and scabies.
• Viral skin infections including herpes simplex, chickenpox and molluscum contagiosum.
• Fungal skin infections including ringworm.

In some cases, such as fungal infections, the skin conditions can be covered with a securely attached bandage or non-permeable patch to allow participation in the sporting event.

In addition to identification and treatment of individuals with skin infections, prevention can occur through proper routine cleaning of all equipment, including mats and shared common areas, such as locker rooms.

Respiratory Illnesses

Anyone with an infectious respiratory illness, such as flu, or whooping cough, or perhaps tuberculosis, should be prohibited from playing to prevent the spread of infections that are transmitted through respiratory routes.

Check back over the next couple of weeks for Parts 2 and 3 in this sports series. Part 2 gets into specifics on bloodborne pathogens, and Part 3 provides guidelines for sports teams to follow before, during, and after each event.

See PKIDs’ Infectious Disease Workshop for more information.

Photo courtesy of University of Exeter

Mine calls to me, along with the garage, all of the windows, the closets, and every surface that is bespeckled with dust.

If you can’t fight the urge to clean, beware of the risks (you knew this was coming). If, however, you can resist the urge, feel free to use this list in your defense, should your SO wave a rake or sponge your way.

I can’t clean or do yard work . . .

—until I get my tetanus shot. Rusty nails, hoes, and rakes that are pokey and dirty, debris blown onto the yard from winter storms—they’re just waiting for me. (Swap out this Td shot for a one-time Tdap shot, get protected against tetanus, diphtheria, and pertussis.)

—because I saw mouse poop in the garage and I don’t want to get hantavirus by sweeping up those virus-laden bits. I have delicate airways. (There are safe ways to clean up mouse droppings, but the SO doesn’t need to know that.)

—as long as there are mosquitoes in this world. West Nile virus is everywhere! And I can’t wear mosquito repellent while doing yard work because it smells funny, although that’s not the case when I’m kayaking. Strange.

—while ticks live in this world. Lyme disease, Rocky Mountain spotted fever, Colorado tick fever—these are all insidious infections brought on by ticks. I believe I saw a tick on the bathroom wall last week. Possibly it hitched a ride on the dog, which shook it off while in the bathroom. I really have no other explanation.

These excuses are reasonable and clear. If your SO is having trouble swallowing understanding them, feel free to share our contact info.

By Trish Parnell

Following are some ‘in the home stretch’ flu tips and resources from the CDC.

This patient’s brochure is spot-on for this year’s (or next) flu season. And if you’re worried about getting the flu, take a look. It includes tips on prevention and what you can do to make it better, should you become infected.

If you’re a health educator and your message is getting a little tired, here are some free resources, including audio/video, badges, and widgets.

We hope you got a flu shot this season. If not, take this year as a lesson and do so next year and all the years after. The vaccine works for the majority of those who take it. Don’t miss out on this crucial first step in flu prevention.

The US flu season continues; flu-like illness has fallen in the East and risen sharply in the West, so take care for the next month or so.

The timing of flu is very unpredictable and can vary from season to season. Flu activity usually peaks in the US in January or February. However, seasonal flu activity can begin as early as October and continue to occur as late as May.

Symptoms of the flu may include fever, cough, sore throat, runny nose, body aches, headaches, and fatigue.

To find out what’s going on in the world of flu, get timely information at: http://www.cdc.gov/flu/weekly/fluactivitysurv.htm

If you’re infected, get to your provider and start on antivirals.

And next year, as soon as you hear about flu vaccine being available, hightail it to your pharmacy or provider and get vaccinated!