Summertime, and the living is easy...
So says the song. Unfortunately, it's also easy to get sick or injured, so here are some more preventive-medicine reminders and references for you and your patients to help keep summertime easier and healthier.
In part 1 of this 2-part series, we briefly discussed skin cancer, insect bites, contact dermatitis, swimming safety, food, and fireworks. Some additional reminders include the following from the FDA Consumer publication:
|
Every year in the United States, an estimated 400 people die from natural heat-related exposure, a preventable cause of death. Most of these heat-related deaths occur among individuals 75 years of age and older, though a significant number also occur among children aged 4 years or younger. Heatstroke, which can occur in the absence of physical activity, has a fatality rate of approximately 15%, even when treated promptly.
Before the forecasters are predicting a miserable hot spell, try to advise those responsible for elderly or very young patients, patients that are socially isolated or homebound, or those with chronic physical or mental illness to have a contingency plan. The homebound elderly are especially vulnerable during a power failure, when available air conditioners don't work, and in neighborhoods where they keep doors and windows closed for security. Remember that any patient taking medications such as diuretics, tranquilizers, tricyclic antidepressants, and anticholinergics is also at increased risk.
Although only 78 cases of West Nile virus have been reported to date during 2004, we are also just coming into the worst time period for mosquito proliferation. Among these 78 cases, 21 were reported between June 30 and July 6 from 2 states, Arizona and California. The other cases have occurred in 6 states. It is important to avoid mosquito bites, whether by staying inside at dusk, wearing protective clothing, using repellant, preventing water from collecting in old tires or toys, or investing in a high-tech trap. Again, the young and the elderly are most at risk for serious infection or death as a result of West Nile virus, as are individuals who are immunosuppressed.
Remember to report those reportable diseases to your local health department. If you're not sure what needs to be reported or how to do so, give them a call. They'll be happy to hear from you and send you whatever forms you need for their reportable conditions, which will probably include a variety of bacterial and viral illnesses and assorted other conditions. If things are a little slow for you during the summer, this may be a good time to review your public health reporting obligations and the resources (eg, patient information sheets) available from your city, county, or state department of health. Your professional society may also be a good source of patient information material and public health resources.
Public health officials are begging people to get their pets vaccinated against rabies, and to use good judgment in avoiding contact with animal saliva, especially with nocturnal animals that approach people, whom they normally shun at any hour, during daylight. Bats in homes should be captured and submitted for testing if there is any chance whatsoever that they might have bitten anyone, including a victim who may not have realized that a bite occurred. Local health departments and animal-control officers have varying protocols, but here are a couple of anecdotes about what not to do.
A homeowner was advised to capture a bat and kill it without destroying its brain, then use a tool to put it into an empty coffee can for delivery to the county health department, which would then ship it to the state lab for testing. The homeowner complied, using a tennis racquet to kill the bat and flip it into the can, which he then covered and delivered to the county office, where staff filled out the paperwork and then shipped the canned specimen to the state. All well and good, until the state staff removed the lid and the bat flew out, having been stunned but not killed by the tennis racquet. It was the state workers' turn to be stunned, and they were neither amused nor appreciative of the gift.
My other favorite rabies anecdote involves a family driving down the road one day who spotted a cute little raccoon that appeared to be injured. They picked it up and showed it off to the relatives they were visiting at their destination. Their hosts' children tried to feed the raccoon marshmallows, but the raccoon wasn't interested and spat them out. However, the baby in the family felt very differently about those marshmallows, toddled over to the rejected specimens, and quickly scarfed them down. Nobody got too upset until the dad tried to splint the raccoon's injured limb, got nipped for his efforts, and only then considered the possibility of rabies. Fortunately, they got the ungrateful critter tested -- and had 11 family members treated for rabies exposure.
Knowing that common sense isn't nearly common enough, let's try to remind ourselves and our patients of the importance of basic precautions. Fasten those seatbelts, wear those bike helmets, take measures to avoid sun overexposure, heat-related illnesses, mosquitoes and ticks, and food poisoning, and have a safe and happy summer.