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New Alabama Mothers Encouraged to Complete PRAMS Survey

New Alabama Mothers Encouraged to Complete PRAMS Survey

Why are some babies born healthy while others are not? The Pregnancy Risk Assessment Monitoring System (PRAMS) surveys new mothers about their pregnancy, delivery and their infant to find answers.

PRAMS is a joint research project between the Centers for Disease Control and Prevention and the Alabama Department of Public Health. Mothers who receive surveys are randomly selected from reported Alabama births. Alabama is one of 47 states currently participating in PRAMS.

“If you receive a survey booklet, please complete it,” Alabama PRAMS Data Manager Victoria Brady said. “The information collected is used in developing health care programs and policies, and the results help doctors and nurses improve health care while making better use of health resources.”

The types of questions asked include:

  • Attitudes and feelings about the most recent pregnancy
  • Content and source of prenatal care
  • Mother’s alcohol and tobacco use
  • Any physical abuse before and during pregnancy
  • Infant health care
  • Contraceptive use
  • Health care coverage
  • Mother’s socioeconomic situation
  • Postpartum depression
  • Knowledge of pregnancy-related health issues such as nutrition, the benefits of folic acid, infant safe sleep practices, oral health during pregnancy, and the risks of STDs and HIV

Answers will be used for research purposes only and grouped with those of other women.  Surveys take about 20 minutes to complete, are available in English and Spanish, and can be mailed back postage-free or completed over the telephone. Mothers may not want to answer a particular question, and that is okay. There is no penalty for not answering all questions.

Mothers who complete a survey may choose from among three complimentary items—disposable diapers, an insulated cooler, or a manicure set—mailed to them in appreciation for their participation.

“Every pregnancy is different, as is every birth,” Ms. Brady said. “Your experience may have a profound effect in bringing about a successful pregnancy and delivery for another mom or even for yourself with a subsequent pregnancy. You can play an active role in improving the health and well-being of Alabama women and babies.”

Download Help Alabama SHINE Poster

Download PRAMS Fact Sheet

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ADPH Issues Synthetic Cannabinoids Alert

ADPH Issues Synthetic Cannabinoids Alert

ADPH Issues Synthetic Cannabinoids Alert; Severe Bleeding a Dangerous Side Effect

The Alabama Department of Public Health (ADPH) cautions the public about the hazards of synthetic cannabinoids after the Illinois Department of Public Health (IDPH) linked serious complications including death to their use. As of April 24, 2018, IDPH has received reports of 153 cases, including four deaths, linked to the outbreak, since March 7, 2018. Ill persons report using synthetic cannabinoid products before experiencing severe bleeding.

Similar findings have been identified in other states including Florida, Indiana, Kentucky, Maryland, Missouri, Pennsylvania, Virginia and Wisconsin. ADPH has conducted a review of possible cases, but has not confirmed any cases in Alabama to date.

Synthetic cannabinoids are toxic psychoactive chemical compounds that mimic marijuana and have a high potential for abuse. These chemicals are called cannabinoids because they reportedly stimulate the same brain areas affected by marijuana. The manufactured products have brand names such as K2, Spice, AK-47, Black Mamba, Bombay, Blue Genie, Kronic, Kush, Mr. Happy, Scooby Snax, Zohai and others.

Synthetic cannabinoids are not safe, and individuals consuming them may experience severe bleeding, Medical Officer for Disease Control and Prevention Dr. Burnestine Taylor said. These products may contain brodifacoum which is found in rat poisoning. Individuals who have been sickened by the synthetic cannabinoids have reported coughing up blood, blood in the urine, severe bloody nose, bleeding gums, heavy menstrual bleeding and internal bleeding.

“Their effects can be unpredictable, harmful and deadly,” Dr. Taylor advised. “Anyone experiencing severe, unexplained bleeding or bruising after using these products needs to seek medical attention immediately.”

Other signs and symptoms include:

  • Agitation and irritability
  • Confusion and concentration problems
  • Hallucinations, delusions, psychosis, suicidal thoughts and violent behavior
  • Seizures
  • Sleepiness and dizziness

Synthetic cannabinoids are unsafe, and it is hard to know what the products contain or what reactions to them will be. There are no standards for making, packaging or sales. Synthetic cannabinoid products may also be contaminated with other drugs or toxic chemicals. These products are illegal in Alabama. There are other symptoms experienced by users of synthetic cannabinoids that include rapid heart rate, nausea and vomiting, headache, kidney and respiratory problems, sweating and trouble sleeping. Health problems the user experiences depend on many factors, including the specific synthetic cannabinoid, how much is used, and for what length of time.

ADPH urges the public not to use synthetic cannabinoids and to warn others about their dangers. For more information, contact Burnestine Taylor, M.D., at (334) 206-5325.

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NIH’s All of Us Research Program Kicks Off in Birmingham on May 6

NIH’s All of Us Research Program Kicks Off in Birmingham on May 6

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Study: Flu May be Spread Just by Breathing

Study: Flu May be Spread Just by Breathing

It is easier to spread the influenza virus than previously thought, according to a new University of Maryland-led study. People commonly believe that they can catch the flu by exposure to droplets from an infected person’s coughs or sneezes or by touching contaminated surfaces. But, new information about flu transmission reveals that we may pass the flu to others just by breathing.

The study “Infectious virus in exhaled breath of symptomatic seasonal influenza cases from a college community,” published in the Proceedings of the National Academy of Sciences, provides new evidence for the potential importance of airborne transmission because of the large quantities of infectious virus researchers found in the exhaled breath from people suffering from flu.

“We found that flu cases contaminated the air around them with infectious virus just by breathing, without coughing or sneezing,” explained Dr. Milton, M.D., MPH, professor of environmental health in the University of Maryland School of Public Health and lead researcher of this study. “People with flu generate infectious aerosols (tiny droplets that stay suspended in the air for a long time) even when they are not coughing, and especially during the first days of illness. So when someone is coming down with influenza, they should go home and not remain in the workplace and infect others.”

Researchers from the University of Maryland, San Jose State University, Missouri Western State University and University of California, Berkeley contributed to this study funded by the Centers for Disease Control and Prevention and the National Institutes of Health.

Dr. Milton and his research team captured and characterized influenza virus in exhaled breath from 142 confirmed cases of people with influenza during natural breathing, prompted speech, spontaneous coughing, and sneezing, and assessed the infectivity of naturally occurring influenza aerosols. The participants provided 218 nasopharyngeal swabs and 218 30-minute samples of exhaled breath, spontaneous coughing, and sneezing on the first, second, and third days after the onset of symptoms.

The analysis of the infectious virus recovered from these samples showed that a significant number of flu patients routinely shed infectious virus, not merely detectable RNA, into aerosol particles small enough to present a risk for airborne transmission.

Surprisingly, 11 (48 percent) of the 23 fine aerosol samples acquired in the absence of coughing had detectable viral RNA and 8 of these 11 contained infectious virus, suggesting that coughing was not necessary for infectious aerosol generation in the fine aerosol droplets. In addition, the few sneezes observed were not associated with greater viral RNA copy numbers in either coarse or fine aerosols, suggesting that sneezing does not make an important contribution to influenza virus shedding in aerosols.

“The study findings suggest that keeping surfaces clean, washing our hands all the time, and avoiding people who are coughing does not provide complete protection from getting the flu,” said Sheryl Ehrman, Don Beall Dean of the Charles W. Davidson College of Engineering at San José State University. “Staying home and out of public spaces could make a difference in the spread of the influenza virus.”

According to the authors, the findings could be used to improve mathematical models of the risk of airborne influenza transmission from people with symptomatic illness and to develop more effective public health interventions and to control and reduce the impact of influenza epidemics and pandemics. Improvements could be made to ventilation systems to reduce transmission risk in offices, school classrooms and subway cars, for example. Meanwhile, we can all heed the advice to stay home, if possible, when we are beginning to get sick to prevent even greater numbers of flu cases. And, get vaccinated — it is not perfect but does prevent a significant amount of severe illness.

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Learn more about Dr. Milton’s Public Health Aerobiology, Virology, and Exhaled Biomarker (PHAB) Laboratory in the University of Maryland School of Public Health: https://sph.umd.edu/phablab

About the University of Maryland School of Public Health: The UMD School of Public Health is a dynamic and growing school located at one of the nation’s top-ranked public research universities. Established in 2007 and accredited by the Council on Education in Public Health, our school offers 25-degree programs for undergraduate and graduate study. We are committed to promoting and protecting the health and well-being of the diverse communities throughout Maryland and beyond. Grounded in the philosophy that health starts where we live, learn, work and play, we partner with communities and apply research to promote health, advance health equity and create policies that will enhance health across the lifespan. Visit: sph.umd.edu

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ADPH to Hold Special Flu Shot Clinics

ADPH to Hold Special Flu Shot Clinics

MONTGOMERY — With influenza activity levels continuing to increase across the state, including several deaths attributed to the deaths, the Alabama Department of Public Health is conducting free flu shot clinics for Alabama residents. The vaccine is available for both children and adults and there will be no charge for the vaccination during these Influenza Vaccination Clinics.

Some schedules may be adjusted, so please call the numbers located within the Influenza Clinic Schedule found at alabamapublichealth.gov/immunization. Click here to view and download the Influenza Clinic Schedule.

“I have never seen a flu season this serious. Pediatricians are alarmed about the severity of recent cases and I urge families to be vaccinated against influenza as well as follow the advice of their physicians regarding any treatment measures, including antivirals,” said Dr. Wes Stubblefield, president of the Alabama Chapter of the American Academy of Pediatrics.

Some of the symptoms of influenza include fever, cough, sore throat, runny/stuffy nose, headache, muscle aches, and extreme fatigue.

Preventive measures include:

  • Get flu vaccine, it is not too late
  • Stay at home when ill
  • Cover your cough and sneeze
  • Wash hands
  • Clean and disinfect

Antiviral medication should be considered to reduce the severity of influenza.

“While much of the information for antiviral use has been for high-risk patients, antiviral medication can be prescribed early in the course of the illness in otherwise healthy persons as determined by the clinical judgment of the healthcare provider.  The medication works best when given within the first 24-48 hours of symptom onset,” said Dr. Karen Landers, a pediatrician with ADPH.

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Flu Outbreak Causes State of Public Health Emergency

Flu Outbreak Causes State of Public Health Emergency

An outbreak of the influenza virus has prompted Gov. Kay Ivey to issue a “State Public Health Emergency” for the state of Alabama.

The virus poses a high threat of widespread exposure to an infectious agent that poses a risk of substantial harm to a large number of people, according to the proclamation issued by the office of Gov. Kay Ivey.

The proclamation gives health care facilities permission to provide care through emergency operation plans that adhere to “alternative standards of care” in response to the influenza outbreak.

Alabama hospitals have reached maximum capacity with patients with flu-like symptoms and other respiratory illnesses, and wait times have increased for non-emergency care, according to the flu alert advisory issued by the Baptist Health System.

Baptist Health in Montgomery is asking those with flu-like symptoms with no signs of serious illness to first see their medical doctor or an urgent care before coming to the emergency room. Alabama hospitals are also advising against anyone with flu-like symptoms visiting hospital patients.

The Alabama Department of Public Health’s weekly influenza Surveillance Map reports the fourth week of a flu outbreak that is increasing. While this is not a flu epidemic, according to the Alabama Department of Public Health, it is a major seasonal flu situation.

The 2018 flu season is expected to be one of the worst in years with cases reported in 46 states.

To combat the flu, the ADPH is urging the public to follow the 10 “Fight the Flu” actions. These include:

  1. Get Vaccinated
  2. Wash Your Hands
  3. Cover Your Coughs and Sneezes
  4. Stay Home With Fever
  5. Stockpile Supplies
  6. Clean and Disinfect
  7. Know Your Office Emergency Plan
  8. Learn Home Care
  9. Call Your Doctor if Symptoms Get Worse
  10. Stay Informed

Read Gov. Ivey’s declaration

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Alabama Experiences Significant Influenza Activity this Season

Alabama Experiences Significant Influenza Activity this Season

Influenza activity levels are increasing across the State of Alabama. Several positive influenza specimens in northern Alabama have been identified in the previous three weeks. While the flu season is just getting started in much of the country, activity is already high in Alabama. Flu is a very contagious respiratory illness. Some of the symptoms of influenza include fever, cough, sore throat, runny/stuffy nose, headache, muscle aches and extreme fatigue.

“Increased numbers of providers who report influenza-like illness and send influenza samples for testing to public health suggest an indication of a geographic spread of influenza in Alabama,” said Dr. Karen Landers, District Medical Officer for the Alabama Department of Public Health. “This is concerning because influenza can be a serious disease for anyone, even children, pregnant women and previously healthy young adults.”

An annual influenza vaccination is recommended for everyone age 6 months and older and is the best prevention against getting the flu. Physicians, pharmacists and county health departments can provide flu vaccinations for Alabamians.

In addition to taking the flu vaccine, other measures can reduce or prevent the spread of influenza. These include staying at home when sick, covering the mouth and nose with a tissue/cloth when coughing or sneezing, and washing hands or using hand sanitizer frequently.

“Even healthy people can get very sick from the flu and spread it to others. It’s not too late to get a flu shot to protect against this serious disease. People become protected about two weeks after receiving the vaccine,” said Dr. Landers.

Contact your physician, pharmacy or local county health department to receive an influenza vaccination. For more information about the flu visit http://www.alabamapublichealth.gov/immunization/index.html, and to save money on your flu medicine visit AlabamaRxCard.com.

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Alabama’s Infant Mortality Rate Increased in 2016

Alabama’s Infant Mortality Rate Increased in 2016

According to the Alabama Department of Public Health the state’s infant mortality rate of 9.1 infant deaths per 1,000 live births in 2016 is the highest since 2008. This represents the deaths of 537 infants who did not reach 1 year of age. There were 59,090 live births in 2016.

“Our infant mortality rate is troubling and disheartening and trending in the wrong direction. Challenges include ensuring mothers have access to healthcare before, during, and after pregnancy, reducing premature births, the opioid epidemic, and addressing persistent racial disparities,” said Acting State Health Officer Dr. Scott Harris.

For reasons not fully understood, disparities in infant mortality by race continue to persist. One major predictor of a woman’s likelihood of delivering a baby preterm is her race. The infant mortality rate for black infants was more than twice that of white infants. The 2016 black infant mortality rate was 15.1 per 1,000, a slight decrease from the 2015 infant mortality rate of 15.3.

According to Dr. Paul Jarris, chief medical officer of the March of Dimes, race or ethnicity does not cause preterm birth, but some racial and ethnic groups face challenges related to racism that have a profoundly negative impact on birth outcomes:  inequities in health care, housing, jobs, neighborhood safety, food security and income. For white mothers, infant mortality increased from a record low rate of 5.2 in 2015 to 6.5 in 2016. Of note, the top three leading causes of infant death remain the same:  congenital malformation, premature births, and Sudden Infant Death Syndrome.

The percent of preterm births increased in 2016 from 11.7 percent to 12.0 percent. Infants born preterm, before 37 weeks gestation, are more likely to die before their first birthday or face life-long disabilities or chronic health conditions. Low birth weight infants, defined as those weighing less than 5 pounds, 8 ounces, are more than 20 times more likely to die than infants of normal weight. The percent of low weight births in 2016 declined slightly from 10.4 in 2015 to 10.3 in 2016.

Approximately 75 percent of births in 2016 were to women who had adequate prenatal care; 2.1 percent of births were to mothers with no prenatal care. In many states, including Alabama, women whose incomes are not low enough for Medicaid but cannot afford health insurance can qualify for Medicaid once they become pregnant and coverage lasts throughout pregnancy and a few weeks after.

On a positive note, as seen nationally, the percent of birth to teenagers in Alabama continues to trend downward to its lowest ever recorded of 7.7 percent in 2016.

Maternal smoking decreased to 10.1 percent of all live births, the lowest ever recorded. Of the mothers who smoked during pregnancy, 8.1 percent of births were to teen mothers and 10.3 percent of births were to adults.

Strategies to reduce infant mortality in Alabama:

  • Increase the use of progesterone to women with a history of prior preterm birth.
  • Reduce tobacco use among women of childbearing age.
  • Encourage women to wait at least 18 months between giving birth and becoming pregnant again.
  • Expand the Well Woman Preventive visit to provide pre-conception and inter-conception care.
  • Continue safe sleep education efforts.
  • Continue collaborative efforts to address the opioid epidemic.
  • Expand the Fetal and Infant Mortality Review activities at the community level.

Initiatives:

  • Identifying, studying, and learning the factors that play a role in infant survival; implementing initiatives at the community level to improve infant health and vitality statewide.
  • Establishing a Maternal Mortality Review Committee to analyze the maternal deaths that occur within the state so as to improve maternal health outcomes.

Graphs and detailed charts are available at alabamapublichealth.gov.

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November is American Diabetes Month

November is American Diabetes Month

 

November marks the annual observance of American Diabetes Month. Sponsored by the American Diabetes Association, this observance aims to focus our nation’s attention on the disease and the tens of millions of Americans affected by it.

Judging by the numbers, it is imperative that individuals are informed about diabetes and the consequences associated with the disease. Data from the Behavioral Risk Factor Surveillance System survey suggests that approximately more than 552,000 adults in Alabama (14.6 percent of the adult population) have been diagnosed with diabetes. However, there are many who are unaware they have the disease. According to the Centers for Disease Control and Prevention, an estimated 30 million Americans have diabetes and 84 million have prediabetes.

Diabetes is not just physically costly – complications include heart disease, stroke, amputation, end-stage kidney disease, blindness and even death – it is also economically costly. Individuals with diabetes have medical expenses 2.3 times higher than those who do not have diabetes. Combined, diabetes and prediabetes cost an estimated $5.4 billion each year in Alabama.

While these statistics are alarming, there are programs available to help individuals keep from developing the disease and assist those diagnosed with diabetes to better manage their health. Diabetes Prevention Programs (DPPs) and Diabetes Self-Management Education (DSME) Programs are available throughout the state and can help reduce the burden caused by the disease. These programs are proven effective for those who regularly attend.

For more information, visit these resources from the Alabama Department of Public Health:  alabamapublichealth.gov/diabetes. To access information about DPP, including a map featuring sites throughout the state, click the “Prevention” link in the left-hand column. For information on DSME sites, select the “Self-Management Education” link. More information from ADPH regarding diabetes can be found online at facebook.com/DiabetesInAlabama or twitter.com/DiabetesInAL.

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Rural Americans More Likely to Die in Motor Vehicle Crashes

Rural Americans More Likely to Die in Motor Vehicle Crashes

Motor vehicle crashes are among the leading causes of death in the U.S. A recent study found the rate of death for adult drivers and passengers from motor vehicle crashes is 3 to 10 times higher among rural Americans. The simple act of buckling seat belts can prevent needless loss of life.

Researchers at the Centers for Disease Control and Prevention examined passenger vehicle occupant deaths among adults ages 18 or older. The study found lower seat belt use, higher death rates, and a higher proportion of drivers and passengers in rural areas were not buckled up at the time of the fatal crash. About 40 percent of Alabamians live in rural areas.

Seat belt use prevented an estimated 64,000 deaths in the United States during 2011-2015. The study found that “increasing rurality is consistently shown to be associated with increased crash-related death rates and lower seat belt use.” Wearing seat belts has been shown to reduce the risk of serious injury or death by about 50 percent.

Buckle up!

  • Lap and shoulder belts should be secured across the pelvis and rib cage. These areas are better able to withstand crash forces than other parts of the body.
  • Place the shoulder belt across the middle of the chest and away from the neck.
  • The lap belt needs to rest across the hips, not the stomach.
  • NEVER put the shoulder belt behind the back or under an arm.

Airbags are designed to work with seat belts, not replace them. Motor vehicle occupants who do not buckle up could be thrown into a rapidly opening frontal airbag. Such force could injure or even kill.

More information is available at http://www.alabamapublichealth.gov/injuryprevention/motor-vehicle.html.

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