Whooping Cough Confirmed in Hillsborough

A second-grader at The Expedition School in Hillsborough has tested positive for pertussis, also known as whooping cough.

“We have one confirmed case of pertussis and one suspect case of pertussis in Orange County. They are two children that are both of the same family,” says Stacy Shelp, spokesperson for the Orange County Health Department.

The Expedition School is a year-round charter school serving children from kindergarten through 6th grade.

Patricia Brummit is the school’s business director. She says administrators received word of the diagnosis Monday afternoon. Parents have been notified, and some children who came in close contact with the student are taking preventive antibiotics to limit the spread of the disease.

“We have sent out all the information from the Orange County Health Department and then parents have made their own decisions about taking their children to the doctor,” says Brummit. “We have sent home some children who are showing symptoms and coughing for a while, just to be cautious.”

Shelp says pertussis is highly contagious.

“It is spread through coughing and sneezing. The good thing is it can be prevented through vaccination, so we do recommend that children receive the DTaP, it is actually one of the required vaccinations for school unless you have either a religious or medical exemption from that.”

Symptoms include runny nose, congestion, watery eyes, fever and a cough that can worsen until patients are left gasping for air. Shelp notes it can be especially serious for infants and young children.

“They are a lot more susceptible to this and often times they either end up hospitalized or it can be fatal, so we want to make sure people who are around newborns, infants or those who are immune-compromised have received their vaccination.”

While Orange County has high rate of school-aged children who are fully vaccinated, Shelp says our area also has one of the highest exemption rates in the state.

For more on whooping cough, click here.


OC Health Officials Challenge Durham Officials to Walk-Off

If you’re wearing a fancy pedometer like a Fitbit or a Jawbone, you may be swept up in a little competition for steps with your friends and co-workers.  Last week, the Orange County Health Department took step competitions to a whole new level.

“We have challenged our brothers and sisters at the Durham County Health Department to a walking challenge,” Orange County Health Department Director Colleen Bridger said.

The two departments will compete to walk the equivalent of the Appalachian Trail starting August 3. The first team to complete the trail’s 2,168 miles will win. And it’s not just bragging rights on the line.

“The health director and I have a friendly wager,” Bridger said. “So whichever health department wins, the other health department will owe a basket of that county’s themed items for a value of about $50.”

This is the Orange County Health Department’s second walking competition. The department held an internal competition among its staff this spring to walk to Orange County, California. Bridger says these competitions are meant show that exercising doesn’t have to be a chore.

“It’s really important to have people understand that moving can be fun—should be fun,” Bridger said.  “And any time that we get the opportunity as public health professionals to kind of walk that walk—complete pun intended—then we are really excited about it.”

Bridger says she hopes the competition will also raise awareness about the benefits of walking, which she says, are many.

“It’s good for your weight, it’s good for your blood pressure, it’s good for your muscles and balance,” Bridger explained. “But there have also been a lot of studies that show that walking is extremely good for your mental health. And the way that we’re doing it facilitates the fact that it’s a really good way to build camaraderie with people, which is also good for your mental health.”

The departments expect the challenge to last 6 to 8 weeks. We’ll have to wait until the fall to find out which county will come out on top.



OC Family Success Alliance Seeks Outreach Volunteers

This Saturday, volunteers with the Family Success Alliance will visit homes in Chapel Hill and Carrboro to help assess community needs.

“We’ll be asking folks questions about how well connected they are with their neighbors and also do they have trouble getting childcare or medical services?” says Orange County Health Department Program Manager Meredith Stewart. “Generally, what do they think are the strengths or challenges in their community to children and families being successful?”

The Family Success Alliance is a new initiative designed address issues of child poverty, health and education through community-specific programs.

“We are doing this as part of a gap analysis for the Family Success Alliance and that gap analysis is looking at the cradle-to-college or career pipeline for children and families in Orange County,” says Stewart.

Last week, volunteers visited Zone 4 in Hillsborough. This weekend, the focus will shift to Zone 6, which spans the boarder between Chapel Hill and Carrboro.

“We will be in Western Chapel Hill into Carrboro,” says Stewart. “We’re talking about the Highway 54-Jones Ferry intersection and around the Northside and Pine Knolls area, that downtown Chapel Hill and Carrboro residential area.”

But in order to make contact with all the homes in those neighborhoods, Stewart says more help is needed. If you’d like to help, call Meredith McMonigal at 919-245-2071.

Volunteers will meet at Carrboro Town Hall at 9 o’clock Saturday morning to go over the survey and receive red vests and name tags.“We will pair people up into teams of two and give them a designated area to go out to,” says Stewart.

The survey is also available online in English and in Spanish:  http://orangecountync.gov/health/fsa.asp

The data collected from the outreach effort will be presented back to the community for discussion at a meeting on April 9 at Carrboro Elementary.


OC Health Dept. Offers Limited Free Radon Test Kits This Month

The odorless, colorless gas radon is the second leading cause of deadly lung cancer in the U.S. – and too often, it’s found in our homes.

January is National Radon Action Month.

The North Carolina Radon program has distributed approximately 7,000 free radon testing kits across the state, and Orange County only received about 30 of them.

“They are available on a first-come-first-serve basis, said Stacy Shelp, public information officer for the Orange County Health Department. “Anyone’s eligible. There’s no income requirement, etc. People just have to stop by the Environmental Health Dept. in Hillsborough, starting on the 12th of January, or give us a call.”

They’re available through January 30th, or while supplies last.

Thirty test kits aren’t a lot, obviously. But Shelp said there’s no need to panic.

“The good news is that Orange County is not particularly prone to radon,” said Shelp. “You typically find radon in places that, geographically, have high presence of granite-type bedrock. So, the North Carolina mountains, particularly, would be more concerned.

Still, she added, radon is not found more often in any particular kind of structure, so we should all take precautions against it.

Shelp said that once the supply of free kits runs out, the NC Radon Program will return to providing kits for $5.35, at a savings of nearly $10.

You can also buy a kit for around $15 at a big-box home improvement store, or just about any small hardware store.

The Orange County Environmental Health Department is located at 131 West Margaret Lane, Suite 100.

You can call the EHD at 919-245-2360.

For more information on radon and how you can lower your family’s risk of lung cancer, you can visit www.ncradon.org.


OC Health Dept Targets Child Poverty With New “Family Success Alliance”

Despite an air of affluence, a growing number of families in Orange County are struggling to get by.

Now, the Orange County Health Department is spearheading a county-wide effort to reach out to families in need.

“The Family Success Alliance is a new endeavor in Orange County modeled after the Harlem’s Children Zone and the East Durham Children’s Initiative,” says Health Director Dr. Colleen Bridger.

A coalition of government agencies along with education and health care advocates is working to build a support network for children living in poverty. Dr Michael Steiner of UNC Hospitals says that’s important because early childhood poverty can have lasting repercussions.

“Challenges in early childhood can result in lifelong impact, including how our brains get built, how ready we are to start school, how we do in school and then what happens to us later on in life as adults,” says Steiner. “So the Family Success Alliance hopes to build a pipeline that will take kids from a successful early childhood through a successful young adult life.”

The Health Department has identified six zones in Orange County with the highest number of residents who are struggling to meet basic needs such as food, housing and access to health care.

By the end of the year, Health Department officials will select two of the six to participate in the Family Success Alliance pilot project. Bridger says a series of community listening sessions will be held now through next week to help detail the needs and strengths of each community.

“The community forums are designed to help the communities come together and learn more about the project and help the zone champion put together an application,” says Bridger.

The identified zones are:
Zone 1 Efland-Cheeks (70 Corridor)
Zone 2 Downtown Hillsborough
Zone 3 85/40 Junction
Zone 4 East of 40
Zone 5 15-501 & 40 (Martin Luther King Corridor)
Zone 6 Chapel Hill/Carrboro (54 and Jones Ferry Road)

Listening session schedules for each zone:

Zone 4: Thursday, November 6, from 6-7pm at New Hope Elementary School, 1900 New Hope Church Rd, Chapel Hill.
Zone 6: Tuesday, November 11, from 6-7pm at Hargraves Community Center, 216 N. Roberson St, Chapel Hill.
Zone 3: Thursday, November 13, from 6-7pm at Grady Brown Elementary School, 1100 New Grady Brown School Rd, Hillsborough.
Zone 5: Thursday, November 13, from 6-7pm at the Chapel Hill Library, 100 Library Drive, Chapel Hill.


Orange County Reports Lowest Teen Pregnancy Rate In NC

Health Department officials say Orange County’s teen pregnancy rate has dropped by 35 percent in the past year, making it the lowest in the state. The county reported 102 teen pregnancies in 2012, but only 68 in 2013.

Orange County Health Director Colleen Bridger credits comprehensive sex education, parent involvement and access to reproductive health care for the sharp decline.

However, she notes that racial and ethnic disparities still exist, with higher rates of unplanned pregnancy among local African-American and Hispanic teens.

The health department is exploring new ways to reach out, including an interactive health education avatar named “Anna,” who can answer questions from users to provide personalized advice.

You can find statewide information about teen pregnancy and sexual health here.


Carrboro Police To Carry Overdose Prevention Kits

Carrboro police will now carry kits to help prevent drug overdose deaths. The kits contain Naloxone,  which temporarily blocks the effects of opiates.

Officials say accidental poisoning deaths have risen 300 percent in North Carolina since 1999, and opiate overdoses account for 92 percent of that increase.

All Carrboro officers, including those who work in patrol, schools and community services will be issued the kits and trained to administer the drug nasally.

Since December of last year, the Orange County Health Department has offered the life-saving kits to friends and family members of opiate users, along with training on how to use them.

Under the 2013 Good Samaritan law, people who seek help for an overdose victim can no longer be prosecuted for possession of small amounts of drugs, paraphernalia, or for underage drinking. This is meant to encourage reporting of overdoses and get victims help right away.

Police say that if you suspect someone has overdosed, call 911 and stay with the person until help arrives.


OC Health Department Wants To Tackle Growing Poverty

As the number of Orange County families and children living in poverty continues to grow, officials with the Health Department are looking to other communities for strategies to help those in need.

The number of people living in poverty grew more in North Carolina than anywhere else in the nation, according to US Census Data. The state saw a 17.9 percent increase in its poverty rate between 2006 and 2010.

Despite the perception that Orange County is an affluent area, Meredith Stewart, planning manager for the Board of Health, says more and more local families are struggling too.

“About one in three of our kids in Orange County schools, so that’s both districts, are on free- or reduced-lunch,” Stewart says. “About one in four of our kids in Orange County are on Medicaid. We do have families struggling to get by, as evidence by those numbers.”

The area’s high cost of living is also a challenge for families. In Orange County, a household would need the income from 2.2 full-time minimum wage jobs to be able to afford the median rent on a two-bedroom apartment.

Stewart says officials are just beginning to plan how to tackle the multi-faceted problem of poverty.

“I think a conversation is beginning around the issues that are happening in Orange County and how we can address them from many different angles,” Stewart says. “So, this isn’t something that one person or one group can work on, we all have to come together to think about and talk about our families and issues like housing, food, education, and childcare. All of these issues go together.”

As part of that conversation, local leaders are looking to other communities that have launched successful intervention programs.

“We’ll have the privilege of having Dr. Betina Jean-Louis from the Harlem Children’s Zone, who will be joining us this Friday starting at 8:00 a.m. at the Friday Center in Chapel Hill, to talk about the Harlem Children’s Zone and the work that they have done to improve the pipeline, as they call it, from cradle to career or college for children and how that was really a community effort that started with a community conversation that we’re starting to have here in Orange County.”

Stewart and others hope that programs such as The Harlem Children’s Zone and the East Durham Children’s Initiative could provide a model for lowering child poverty rates in Orange County.

Friday’s meeting is open to the public.

For more information, click here.


OC Health Department Wins Award for Smoking Ban

Orange County’s smoking ban has received national recognition, as the National Association of Counties (NACo) has awarded the Health Department and Board of Health with a 2014 Achievement Award.

“We are thrilled with this award. It is wonderful that Orange County is being recognized as a national leader in the quest for healthier communities,” Orange County Manager Bonnie Hammersley said in a press release Monday.

NACo awards counties from across the United States for increasing the well-being of its residents while modernizing county government. Orange’s smoke-free public policy beat a host of other county policy applications to win its first Achievement Award.

The smoking ban, put in place on July 1, 2013, prohibits smoking in all outdoor locations owned by Orange County and its towns, including sidewalks, bus stops and parks, in addition to indoor areas that are open to the general public.

The goals of the ban are to educate residents about the dangers of cigarette smoking and eliminate secondhand smoke, one of the leading causes of preventable disease in the state.

To learn more about Orange County’s smoking ban, click here or visit the Health Department website.


Chikungunya Is Coming Part II

[Dear Readers:  It takes me the better part of each week to research, write, and edit my columns. Some weeks, like this one, events occur mid-week which have a bearing on the topic, but I don’t have time to fully rewrite the column to incorporate them. As I was putting the finishing touches on this one, the first ever case of local transmission of chikungunya in the United States occurred in Florida. Please keep that in mind as you read. – Jeff.]

Last week, in Part I of this series, I explained the background of chikungunya virus and why I believe an epidemic of this disease, which is transferred from person to person by mosquito bites, is likely to occur in the continental United States in the coming months. I received some feedback from several readers who thought I was being a bit alarmist. Let me respond to those comments before proceeding.

Mosquito-borne diseases are by no means unknown in the United States. In the early 1900s, malaria, a disease transmitted by mosquitoes, was common in every U.S. state other than Alaska. The Centers for Disease Control (CDC) was created specifically to combat malaria and organized the National Malarial Eradication Program from 1947 to 1952, which primarily involved spraying massive amounts of DDT. This effort was successful, and malaria was eliminated from the U.S. Unfortunately, this public health achievement came at the expense of significant environmental damage, as famously summarized in Rachel Carson’s classic book from 1962, Silent Spring.

In 1999, the first case of West Nile Virus, another disease transmitted by mosquitoes, was detected in New York City, the first recorded local transmission in the U.S. In just 15 years, this disease has spread throughout the country, with an estimated annual infection rate in excess of 100,000. So as you can see, we here in the U.S. have no special magic powers to protect us from diseases that we may have thought only affect other people in far away places.

Despite the fact that it has been clear for a long time that chikungunya would eventually reach the U.S., we have not been preparing in a meaningful way. In particular, we have not created a vaccine, nor have we been trying very hard to do so. A vaccine for chikungunya would come from either government labs or the pharmaceutical industry. Government health research has been hampered for the last several decades due to funding cuts, and developing new vaccines is not viewed as sufficiently profitable by the shareholder-value-driven pharmaceutical industry. As a result, we are about to be caught with our pants down.

While it seems clear to me that the southeastern United States is about to experience an epidemic of chikungunya (the first two locally-transmitted cases occurred this week in Florida), what is unclear is its likely extent. The current epidemic in the Dominican Republic may provide some insight.  Since chikungunya struck the Dominican Republic in early April, there have been almost 200,000 cases, an incidence rate of 20 per thousand for this nation of 10 million people. If the Southeast, with a population of approximately 80 million, had the same incidence rate as the Dominican Republic, we would expect 1.5 million cases in the first 100 days of an epidemic. However, due to widespread availability of insect repellent here and our stay-inside-the-air-conditioned-space lifestyles, our incidence rate is likely to be lower. For the sake of argument, let’s assume our incidence rate will be 1/3 that of the Dominican Republic. This would translate to half a million cases in the first hundred days, and we would then project approximately 10 million cases in the first year. With chikungunya’s fatality rate of 0.4%, an epidemic of this scale would kill 40,000, with fatalities being disproportionately among the very old and very young.

To put those 40,000 deaths in perspective, this is about the same number of annual deaths we see in the U.S. from each of the following causes: influenza, car accidents, suicides, and shootings. While we have become somewhat desensitized to deaths stemming from these familiar hazards, I anticipate that public reaction to an epidemic from a new and unfamiliar disease with a strange name will be something approaching widespread panic. Let me try to explain why.

First of all, nothing about the current level of function in either our state or federal government suggests that they could effectively coordinate either communications or logistics in a public health crisis. Now add to this the fact that a large portion of the public seems to have developed rather extreme anti-science views, for example the anti-vaccine and intelligent design communities. I think we can anticipate a fair number of non-productive conspiracy theories to arise from these factions and distract from addressing the problem. Furthermore, I think we can also safety assume the epidemic will be politicized almost immediately. Given that chikungunya has reached Florida already, we could only be hours away from claims that this epidemic is President Obama’s fault and that the public is being put at risk by “liberals” who valued salamanders over humans by banning DDT. I expect calls for the return of DDT as well. (1)

So what can or should we do here locally to prepare for chikungunya? Epidemics are all about math. In this case the key variables are the number of currently infected people, the number of mosquitoes that can transmit the virus, and the number of mosquito bites. As time passes, a fourth variable, the number of people who are immune from having had chikungunya already, will become a factor. We can collectively help to slow the spread of chikungunya by reducing the overall rate of mosquito bites in the county through common sense measures of which you are already aware: using bug repellent, wearing clothing the covers the body, minimizing pools of standing water near your home, and not going out at dusk and other times of day that mosquitoes are most active.

In addition, the Orange County Health Department should start making preparations. Cases of chikungunya will occur in geographic clusters. People who get the disease need anti-inflammatory and pain-reducing medications as well as fluids to fend off dehydration. Unfortunately, the United States is currently experiencing a shortage of sterile saline which is used to treat dehydration. In addition, if we had a cluster of cases in Orange County we could easily run out of hospital beds. We need to have a plan in place – and we may already have one – for a temporary clinic for hospital overflow, and we should work to build an inventory of saline solution. We also need a communications plan so that, at least here locally, people will have accurate information.

On the national level, an emergency allocation of money should be given to the National Institutes of Health to fast-track vaccine research and development. The economic return from avoiding waves of chikungunya epidemics will more than justify the expense. Plus, it’s just the right thing to do.

I will be continuing to monitor this situation as it develops. Follow my Twitter feed @commonscience for updates.

Have a comment or question? Use the interface below or send me an email to commonscience@chapelboro.com. Think that this column includes important points that others should consider? Send out a link on Facebook or Twitter.


(1)   In addition to its attendant environmental impact, DDT is not as well suited to fighting chikungunya as to malaria. Malaria is caused by a parasite rather than a virus. Having malaria does not make you immune to future infections, giving you the wonderful opportunity to have it over and over again. Therefore, the only effective way to get rid of malaria was to kill all of the mosquitoes and, therefore, the parasites. The CDC was able to do this in 5 years.

Chikungunya spreads much faster than malaria and you can only get it once. Long before we could even come close to killing off the mosquito population, the human population would have developed a fairly high level of herd immunity from the spread of the disease. So by the time we finished killing the mosquitoes it would not be necessary to do so any longer, and we would be despoiling the environment for no reason. Sadly, I expect the nuances of this to be too subtle for some.