Information from the Bergen County Board of Health

Measles was declared eliminated from the United States in 2000 thanks to a highly effective vaccination program.  Unfortunately, due to individuals traveling abroad and some who refuse to be vaccinated for measles, the cases in the United States are growing rapidly.

With the celebration of the Passover and Easter holidays this weekend and other social events scheduled over the next several months, the New Jersey Department of Health has sent the following travel advisory for individuals in relation to the spread of measles and recommendations for health professionals  to be vigilant about measles:   

“As you may know, there have been multiple outbreaks of measles in the United States. As of April 11, a total of 555 cases have been reported in 20 states, including 13 cases in New Jersey, in 2019. This is the second-greatest number of cases reported in the U.S. since measles was eliminated in 2000. The majority of measles cases have been reported in New York City and New York state, and are primarily among unvaccinated people in Orthodox Jewish communities and associated with travelers who brought measles back from Israel. 

The upcoming Passover holiday begins the evening of Friday, April 19 and ends the evening of Saturday, April 27. This year, Passover coincides with Easter which is on Sunday, April 21. In addition, many other social events may be scheduled over the next several months (e.g., graduations, weddings). All of these celebrations provide opportunities for measles to spread as people travel and congregate away from home.

Families may travel to resorts, hotels, or take cruises for the holiday. And there will likely be an influx of international travelers before Passover, including many from Israel where measles is circulating. Popular destinations include New York, New Jersey, Florida, Las Vegas, Arizona, and Washington, D.C.

Measles is highly contagious and spreads through the air when an infected person coughs or sneezes. Healthcare professionals should be vigilant about measles-

• Ensure all patients are up to date on MMR vaccine.
• Consider measles in patients presenting with febrile rash illness and clinically compatible measles symptoms (cough, runny nose, and conjunctivitis). Patients exposed to measles while traveling for Passover could begin to develop symptoms between late April and mid-May.
• Ask patients about recent travel internationally or to domestic venues frequented by international travelers, as well as a history of measles exposures in their communities.
• Promptly isolate patients with suspected measles to avoid disease spread and immediately report the suspect measles case to the health department.
• Obtain specimens for testing from patients with suspected measles, including viral specimens for genotyping, which can help determine the source of the virus. Contact the local health department with questions about submitting specimens for testing.

Measles is so contagious that if one person has it, up to 9 of 10 people around them will also become infected if they are not protected. The virus can cause serious health complications, such as pneumonia or encephalitis, and even death.

The Centers for Disease Prevention and Control (CDC) continues to encourage parents to get their children vaccinated on schedule with the MMR vaccine. People 6 months and older should be protected with the vaccine before leaving on international trips. 

Attached is a new travel-related measles flyer, please feel free to distribute as you see fit. For additional information and resources on measles please visit the New Jersey Department of Health's measles website (https://www.state.nj.us/health/cd/topics/measles.shtml) or CDC's measles website (https://www.cdc.gov/measles/index.html).”

Special thanks to Thomas Rose, LINCS/PHENS Health Alert Network Coordinator,  Bergen County Department of Health Services, for providing the state health department’s public health advisory.

February is American Heart Month & Employing Life's Simple 7

The month of February is designated as American Heart Month to increase awareness of the impact of cardiovascular disease and the importance of cardiovascular fitness in all age groups.  Heart Disease (including Coronary Heart Disease, Hypertension, and Stroke) remains the No. 1 cause of death in the United States.  This awareness month is a great time for individuals to commit to a healthy lifestyle and make small changes that can lead to a lifetime of heart health.

According to the Association’s 2018 Heart Disease and Stroke Statistics Update, which is compiled annually by the American Heart Association, the Centers for Disease Control and Prevention, the National Institutes of Health and other government sources:

• Cardiovascular disease, listed as the underlying cause of death, accounts for nearly 836,546 deaths in the United States,  about 1 of every 3 deaths in the US.
• About 2,300 Americans die of cardiovascular disease each day, an average of 1 death every 38 seconds.
• Cardiovascular diseases claim more lives each year than all forms of cancer and Chronic Lower Respiratory Disease combined.
• About 92.1 million American adults are living with some form of cardiovascular disease or the after-effects of stroke. Direct and indirect costs of total cardiovascular diseases and stroke are estimated to total more than $329.7 billion; that includes both health expenditures and lost productivity.
• Coronary Heart Disease is the leading cause (43.8 percent) of deaths attributable to cardiovascular disease in the US, followed by Stroke (16.8 percent), Heart Failure (9.0 percent), High Blood Pressure (9.4 percent), diseases of the arteries (3.1 percent), and other cardiovascular diseases (17.9 percent).
• Coronary heart disease accounts for 1 in 7 deaths in the US, killing over 366,800 people a year.
• The estimated annual incidence of heart attack in the US is 720,000 new attacks and 335,000 recurrent attacks. Average age at the first heart attack is 65.6 years for males and 72.0 years for females.
• Approximately every 40 seconds, an American will have a heart attack.
• From 2005 to 2015, the annual death rate attributable to coronary heart disease declined 34.4 percent and the actual number of deaths declined 17.7% – but the burden and risk factors remain alarmingly high.
• Someone in the US has a stroke about once every 40 seconds.
• Stroke accounts for 1 of every 19 deaths in the US.
• Stroke kills someone in the US about every 3 minutes 45 seconds.

An individual’s lifestyle choices can increase their risk for heart disease and heart attack. An individual can help prevent or lower their risk heart disease by making healthy choices and managing any health conditions that they may have.  Making small changes every day can add up to big improvements in an individual’s overall health.

Through their Life’s Simple 7 Program, the American Heart Association has defined what it means to have ideal cardiovascular health, identifying seven health and behavior factors that impact health and quality of life.  Life's Simple 7 and the Center for Disease Control and Prevention (CDC) outline the following  steps an individual can take to live a healthy lifestyle:

1. Get Active—By exercising for as little as 30 minutes each day, an individual can reduce their risk of heart disease.  Without regular physical activity, the body slowly loses its strength and ability to function well.  Physical activity=living a longer, healthier life.  The American Heart Association recommends at least 150 minutes per week of moderate exercise or 75 minutes of vigorous exercise-or a combination of moderate and vigorous.  Physical activity is anything that makes an individual move their body and burns calories.  Physical activities that can benefit the heart include climbing stairs or playing sports.  Aerobic exercises such as walking, jogging, swimming or biking are beneficial as well.  In addition, strength and stretching exercises are best for overall stamina and flexibility.  The simplest, positive change and individual can make to effectively improve heart health is to start walking.

2. Control Cholesterol—Too much cholesterol is a major risk factor for coronary heart disease (which leads to heart attack) and for stroke.  Cholesterol is a waxy, fat-like substance made by the liver or found in certain foods. The liver makes enough for an individual’s body’s needs, but they often get more cholesterol from the foods they eat.  If they take in more cholesterol than the body can use, the extra cholesterol can build up in the walls of the arteries, including those of the heart. This leads to narrowing of the arteries and can decrease the blood flow to the heart, brain, kidneys, and other parts of the body.  Some cholesterol is “good,” and some is “bad.” High cholesterol is the term used for high levels of low-density lipoprotein, or LDL, which are considered “bad” because they can lead to heart disease. A higher level of high-density lipoprotein cholesterol, or HDL, is considered “good” because it provides some protection against heart disease.  A blood test can detect the amount of cholesterol and triglycerides (a related kind of fat) in your blood.  A cholesterol level of 200mg/dL or higher puts an individual in a high-risk category and is cause to take action.  Eating foods low in saturated fats, trans fat, and cholesterol and high in fiber can help prevent high cholesterol.

3. Eat Better—A healthy diet and lifestyle are an individual’s best weapons to fight cardiovascular disease.  Eat a colorful diet full of fruits, vegetables, whole grains, low-fat dairy products, poultry, fish and nuts. Try to limit sugary foods and drinks, fatty or processed meats, and salt.  With all the differing opinions regarding nutrition, it’s best to get informed from credible sources to make smart dietary choices for long-term cardiovascular benefits.

4. Manage Blood Pressure—high blood pressure is the most significant risk factor for heart disease.  Blood pressure is the force of blood pushing against blood vessel walls. Sometimes the pressure in an individual’s arteries is higher than it should be, a condition known as high blood pressure.  High blood pressure is sometimes called “the silent killer” because it has no symptoms and uncontrolled high blood pressure can damage blood vessels and can be fatal.  Blockages and blood clots prohibit the flow of blood to the body’s vital organs, and without blood, tissue dies.  This is why high blood pressure can lead to stroke, heart attack, kidney failure, and even heart failure.  While there is no cure, high blood pressure is manageable.  The following lifestyle changes may help reduce blood pressure without the use of prescription medication:  eating a heart-healthy diet, which may include reducing salt,; enjoying regular physical activity, maintaining a healthy weight, managing stress, limiting alcohol and avoiding tobacco use. 

5. Lose Weight—obesity is now recognized as a major, independent risk factor for heart disease, with individuals at higher risk for health problems such as high blood pressure, high blood cholesterol and diabetes.  Maintaining a healthy weight is important for an individual’s health.   For individuals who are overweight or obese, they can reduce their risk for heart disease by successfully losing weight and keeping it off. To lose weight, an individual needs to burn more calories than they eat.  It’s a matter of balancing healthy eating (caloric energy) with the (molecular) energy that leaves their body through a healthy level of exercise. 

6. Reduce Blood Sugar— A body needs glucose (sugar) for energy.  Insulin is a hormone made in the pancreas that helps move glucose from the foods eaten to body’s cells. If an individual has diabetes, their body doesn’t make enough insulin, can’t use its own insulin as well as it should, or both.  Diabetes causes sugars to build up in the blood. Diabetes is one of the six major controllable risk factors for cardiovascular disease.  The risk of death from heart disease for adults with diabetes is two to four times higher than adults who do not have diabetes.  Individuals can cut out added sugars by checking nutrition facts labels and ingredients, limiting sweets and sugary beverages, choosing simple foods over heavily processed ones and rinsing canned fruits if they are in syrup.   In addition,  moderate intensity aerobic physical activity can also help the body respond to insulin.  An individual should talk to their health-care provider doctor about ways to manage diabetes and control other risk factors.

7. Stop Smoking—smoking is the most important preventable cause of premature death in the United States.  Smokers have a higher risk of developing many chronic disorders, including atherosclerosis, which is the build-up of fatty tissue in the arteries, which can lead to coronary heart disease, heart attack (myocardial infarction), and stroke.  Controlling or reversing atherosclerosis is an important part of preventing future heart attack or stroke.  Also, nicotine raises blood pressure, and carbon monoxide reduces the amount of oxygen that the blood can carry. Exposure to other people’s secondhand smoke can increase the risk for heart disease even for nonsmokers.  For smoking cessation assistance, contact NJ Quitline, a free telephone counseling service, at 1-866-657-8677.

Other points to consider regarding cardiovascular disease risk:

ü Family members share genes, behaviors, lifestyles, and environments that can influence their health and their risk for disease. Heart disease can run in a family, and an individual’s risk for heart disease can increase based on their age, race, or ethnicity.

ü The risk for heart disease can increase even more when heredity combines with unhealthy lifestyle choices, such as smoking cigarettes and eating an unhealthy diet.

ü Drinking too much alcohol can raise an individual’s blood pressure levels and the risk for heart disease. It also increases levels of triglycerides, a form of cholesterol, which can harden their arteries.  Women should have no more than 1 drink a day and men should have no more than 2 drinks a day.

The American Heart Association has set a 2020 Impact Goal: to improve the cardiovascular health of all Americans by 20 percent and reduce deaths from cardiovascular diseases and stroke by 20 percent, by the year 2020. Individuals who employ the AHA’s Life’s Simple 7 program can take important steps in making a big difference in living a healthy life and helping the AHA realize their impact goal.

Employing healthy choices and behaviors can lower an individual’s risk for heart disease.  Individuals are encouraged to increase their awareness of the signs of heart disease, get regular check-ups and create an action plan for heart health.

Attached are information flyers on Life’s Simple 7 and employing it to prevent a stroke.  Please promote American Heart Month by networking this release and handouts to your personal and professional contacts. 

For more information on risk factors and prevention of heart disease, visit the American Heart Association at www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease  or the Center for Disease Control at https://www.cdc.gov/heartdisease/facts.htm.

Video from CDC on proper hand washing technique