Wednesday, September 29, 2004

Cayman Islands: Health Information Post-Ivan

Taken from Reliefweb Serving the information needs of the humanitarian relief community

Article source at Relief Web
http://www.reliefweb.int/w/rwb.nsf/6686f45896f15dbc852567ae00530132/02b24e879619b3bc49256f1f000e4878?OpenDocument

HEALTH ISSUES: DR. A. K. KUMAR Director of Public Health
General Update

Close monitoring during and post Hurricane Ivan confirms a death toll of two, one due to injuries and the other being under investigation.

Five people sustained fractures and 29 others received lacerations while handling debris and building damage.

Flooding and limited water supplies make cases of gastroenteritis (diarrhoea and vomiting) likely. To date, 14 children and one adult were admitted to the hospital for treatment of diarrhoea and vomiting since 13 September 2004. A further 10-12 persons were treated for diarrhoea and vomiting as outpatients and this number has now declined to 4-5 per day. These figures indicate that Cayman does not have a major outbreak of gastroenteritis.
Reports of 4-5 cases of rash have been received per day, due to heat as well as allergies resulting from foreign body contact.

Cayman is not endemic to Cholera, Hepatitis A or Typhoid. There were no such cases during this period. As our water supplies are from desalination, and bottled water, chances are remote for an outbreak even if a case were to be imported. Therefore, vaccines for these diseases are not recommended.

Cuts, bruises and puncture wounds will occur during this period of recovery and reconstruction, caused by nails and scrap metal. About 2-4 puncture wounds are reported daily.

How to Handle . . .

Cuts: Apply pressure with a clean cloth or bandage to stop the bleeding, then rinse with clean water and apply antibiotic ointment over the cut and dress it with a bandage. If the cut continues to bleed with pressure, elevate it if possible above heart level. For cuts that are difficult to clean or to stop bleeding, call 911 for immediate medical attention.
Minor sprains and bruises: apply a cloth-wrapped ice pack for about 20 minutes to the area to reduce swelling. Bandage the area to give support, and also elevate the sprained area to alleviate the swelling.

Fevers: (these may occur even with a mild infection, that is, a body temperature above 37ï C or 98.4 ï F). Paracetamol or aspirin can be taken as tablets by adults and as syrup by children. A doctor should be consulted if the temperature is over 40 degrees C or 104 degrees F.

Tips for Staying Healthy
- Use gloves when cleaning up around the yard and handling debris.
- Wear full shoes or sneakers if working in the yard or walking the streets.
- Wash hands thoroughly with soap and water or hand sanitizer after any clean-up.
- Wash hands thoroughly before preparing foods and before eating.
- Keep kitchen clean and dry.
- Ensure all food is cooked thoroughly and served piping hot rather than merely warm.
- Keep foods properly refrigerated, if possible; if not, use coolers for short-term storage and check for spoilage prior to use.
- Avoid eating raw eggs or products made from them.
- Discard products past their use-by date-do not eat them.
- Drink plenty of water (desalinated or bottled).


About Tetanus or Lock Jaw

Tetanus bacilli live in the intestines of horses and other animals and are harmless at that stage. The soil can become contaminated with their excreta and tetanus spores can be introduced into the body usually through a puncture wound or lacerations contaminated with soil or street dust. Tetanus is not directly transmitted from person to person.
Protection against tetanus: Due to possible injuries from nails and metal, boosters are given once in ten years.

A booster dose is recommended for adults who did not receive a booster during the past five years.

Most children (up to 95%) would have had their tetanus immunization up to date; hence they are protected. Children who left school within the past 5 years should also have had their booster; hence they are protected.

Some children aged 13-15 did not have their booster yet and will need one.

Some adults over 50 years old may not have had any tetanus vaccine during their childhood. They need two doses one month apart which will provide protection for a year and a third dose 6-12 months later to extend the protection.

Tetanus shots are available from 9:00 a.m. to 1:00 p.m. Monday to Saturday at the following locations:
West Bay Health Centre
North Side Health Centre
East End Health Centre
Prospect Primary School
Bodden Town

PrimaryMoulds in the Home
Moulds are one of the major forms of fungi. They are found y everywhere in the environment, both indoors and outdoors. The common term for mold growth is mildew.

Moulds require two things for growth:
(1) Food source: for example ceiling tile, dry wall, etc.
(2) Moisture: such as high humidity, condensation, water from leaking pipes or floods.
In such suitable conditions, mould growth will be abundant. Therefore the goal is a clean environment that is both free of visible mould growth and free of mould-related odors. The easiest way to detect mold growth is to see or smell it.

Cleaning up Mould:
(1) Wear gloves and a good quality nose mask.
(2) Discard truly porous materials such as sheetrock and ceiling tiles.
(3) Clean the surface with a standard detergent. DO NOT USE AN AMMONIA-CONTAINING CLEANER. MIXING AMMONIA WITH BLEACH CAN CAUSE RELEASE OF VERY TOXIC GASSES CALLED CHLORAMINES. THESE GASSES CAN CAUSE COUGHING, A FEELING OF SUFFUOCATION, OR EVEN DEATH.

Mould and . . .
Cloth-covered furniture can sometimes be cleaned by using a very high efficiency vacuum process (referred to as HEPA vacuuming), but this is expensive and simply discarding the furniture is the safest thing to do.

Floor carpets flooded with grossly contaminated sea water must be discarded. Floor carpets soaked just with rain water may be cleaned and dried using the usual methods or professional cleaning.

Semi-porous materials (concrete and wood) may have varying degrees of fungal penetration. These can often but not always be cleaned.

Non-porous surfaces (plastics) usually only have surface contamination and are readily cleaned.

Porous materials such as clothing and upholstery, can be cleaned using appropriate routine methods (for e.g., washing or dry cleaning), and need not be discarded unless cleaning fails to restore an acceptable appearance and to be odor free.

Moulds as Health Hazards:
(1) Can moulds infect human beings? Generally not. Many of these environmental fungi are unable to tolerate the temperature of the human body. And, even those that do sometimes cause infection in people (e.g., Aspergillus) usually do so only in individuals with significant reduction in their immune function (e.g., undergoing cancer chemotherapy).

(2) What are the symptoms of mould exposure? People vary in their sensitivity to moulds, but the most common symptoms are those due to mould allergies. Symptoms such as wheezing (difficulty with breathing), dry cough, and sore throat seem particularly common. Unfortunately, these symptoms can also be due to many other things. Thus, it can be difficult to know if a mould is causing your symptoms. The best way to find out is to prove to yourself that (a) getting away from the mould makes you better and (b) being exposed makes you worse. Other sorts of symptoms (headache, fever, joint aches) are much harder to relate to mould exposure.

(3) How does one get checked out for mould infection? There are two main ways that environmental fungi might make a person sick. The first is the well-known process of just being allergic to the fungus. For this kind of problem, one needs to see an allergist and be tested. Being allergic today doesn-t necessarily mean it is due to the fungus found last night. The person might have become allergic years ago, but have symptoms now due to a new exposure to the fungus.

The other way that fungi might cause disease in humans is through mycotoxins. Here, we-re not aware of any meaningful ways to make a diagnosis. We don-t know of any reliable blood test for fungal toxins, nor do we know of any tests that are specific for the effects of fungal toxins or fungal exposure. Usually the symptoms are very general in nature (e.g., a headache or fatigue).

(4) Is ringworm caused by a mould? The fungus that causes ringworm in humans and animals requires nutrients found in the skin and hair for its survival. It is quite different from the moulds that cause infestation of the walls and ceilings of homes.
N.B. Environmental Health Department may be contacted for advice on mould clean up at 949-6696.

Department of Substance Abuse Services
General Information:
Hurricane Ivan destroyed the DOSAS outpatient offices, but with the assistance of Lands and Survey-s Nigel Bates, as of Monday, 4 October, DOSAS will operate out of Trinity Square (ground floor) on Eastern Avenue, next to Sounds and Things.

Hours: 10:00am-8:00pm, Monday-Friday.

Counseling is provided on a walk-in basis-no appointment necessary. For further information phone 916-7545 (during above office hours)

While DOSAS counselors will be available for existing clients, counselors and family therapists will not be limited to addiction issues, but services will include assisting parents to help their children cope after Hurricane Ivan, providing adults with self-care tips for dealing with stress, and general counseling services. Services are open to families, children, individuals and employee groups.

Residential treatment services for addiction are still available at Caribbean Haven Residential Centre in Breakers and these services may be accessed through both locations.

Update:
Since Hurricane Ivan, DOSAS staff members have been visiting shelters to offer assistance, but demand for this service is dwindling as shelters empty.

Current emphasis is on providing community assistance through the counseling process and getting the new fixed outpatient location up and running so that people know where they can go to obtain necessary help.

Signs of Stress:
It-s important to know when stress is impacting your life and to understand that in the aftermath of Ivan, feeling stressed is a strong possibility.

Adults may be suffering from stress if you experience any combination of several of the following factors:
Difficulty sleeping
Nightmares
Easily frustrated, or irritability
Loss of appetite
Headaches, stomach problems, colds or flu-like symptoms
Mood swings
Crying easily
Persistent sadness and feelings of hopelessness
Chronic fatigue
Increased use of alcohol and/or other substances as a coping mechanism
Disorganized thought patterns or an inability to concentrate

In addition, children may exhibit the following behaviours:
Bed-wetting
Thumb-sucking
Clinging to parents
Difficulties expressing thoughts and feelings
Fears of darkness
Withdrawal from peers
Aggressive behaviour - including rebellion and refusal to do chores
Sleep and appetite disturbances


**************************************************************************
Cayman Update is a publication of Cayman Information Service, a virtually Texas company. Find what you need on the Cayman Islands at
Cayman Islands Internet or Grand Cayman Island
**************************************************************************

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