Posted in Health, news

Fire at Texas Chemical Plant Prompts More Evacuations

Image above from NBC News

A series of chemical “pops”, not full explosions, and smoke at a chemical plant in Crosby, Texas prompted evacuations Thursday morning.

Flood waters disrupted power at Arkema Chemical Plant, such that they lost cooling in 8 of the 9 organic chemical containers containing organic peroxides.  As the chemicals warm up they become combustible and fires could release noxious hydrocarbons.

No chemical release is ongoing.  And no damage has been anticipated to any other property on site.

A 1 1/2 mile evacuation zone was initiated as all back up systems, including generators failed.

8 of the 9 organic chemical containers lost refrigeration and the contents are expected to degrade as they heat up and risk being combustible.  Organic peroxides explosively decompose.

According to Richard Rennard, spokesperson for Arkema confirmed, “This is not a chemical release.  It’s a fire.”  And he explained that the chemical hydrocarbons may be released from the fire.

Harris County Sheriff, Ed Gonzalez, said, “I want to be very clear: It was not an explosion.” and reassured citizens by saying “It is not anything toxic; it is not anything that we feel is a danger to the community at all.”

Rennard stated the flood water levels in the plant are starting to recede slightly.

Crosby Texas is located 25 miles northeast of Houston.

Fifteen police offers were hospitalized for observation when they complained of headaches and dizziness after the explosion.

The smoke may cause liver damage, irritate the cornea of the eyes, skin irritation and respiratory problems.

Organic peroxides, used ubiquitously in the plastic and rubber industry, must be kept cold.  When the organic peroxides heat up they begin to degrade and become toxic and corrosive.

It appears they plan to keep people out of the plant and let the chemicals degrade on their own.

Flood waters are preventing further inspection of the chemicals.

This is a developing story.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Advertisements
Posted in food, Health, news

Harvey Flooding Brings Major Health Risks

After the initial flooding and torrential downpour subside, Hurricane Harvey will put thousands of residents at risk for major health issues.

In addition to drowning, falls and other deadly injuries, victims of Harvey may endure the following:

Malnourishment

Many of those who did prepare for the storm may not have stored plenty of food, especially healthy fresh food.  Those trapped in their homes may find the food they did store contaminated by flood water.

food-bank-flooded-today-tease-161214_549ce953fa05d997cba48dc74ac69a99.today-inline-large.jpg

Greater Baton Rouge Food Bank 2016

 

Infectious disease

The World Health Organization states that floods bring water borne diseases such as cholera, typhoid fever, leptospirosis and Hepatitis A.  Vector borne diseases include Zika, malaria, dengue hemorrhagic fever, yellow fever, and West Nile.

Homepage-Mosquito-1024x689

Mosquitos initially get washed away during the storm, but the resulting puddles of water take weeks to dry and make ideal breeding grounds for insects.

The water gets dirty pretty quickly.  People touching the flood water need to wash their hands thoroughly before eating or preparing food.

Moreover due to the moisture that seeped into walls and floors of houses, mold can grow and cause a variety of respiratory issues among other physical ailments.  Massive disinfecting needs to take place before coming home to flood water contaminated residencies.

toxic-black-mold.jpg

Chemical exposure

Chemicals from garages and fuel seeping into flood water expose victims to many compounds such as benzene, toluene and xylene that can cause a multitude of health effects including those that affect breathing, skin, the gut, balance, thought, and memory.

Safety

A Cajun Navy rescuer told CNN that looters fired shots at him and his comrades, trying to take their rescue boat, which had actually broken down.  Panic fuels dangerous behavior and those without resources may try to take from those who prepared.

Sexual assault crimes can rise as predators find the chaos and lack of video surveillance ideal conditions to find victims who can’t yell for help.

Psychological

When one loses their home, neighborhood, income, treasured belongings and more, its devastating.  Post traumatic stress disorder may ensue.

To combat these risks, medical personnel and the CDC are preparing.  Among food, shelter and clothes, paper products, sanitizer, cleaning supplies, tetanus vaccinations and counselors will be needed is mass quantities.

How can we help?

Blood supplies will be needed as residents who routinely donate have evacuated the area. Donating blood at your local blood bank may be shipped to the area in need.

United Blood Services have locations throughout the country that can accept your blood Donation. Contact UBS here.

The American Red Cross is accepting donations. On their website, they ask to visit redcross.org, call 1-800-RED CROSS or text the word REDCROSS to 90999 to make a $10 donation.

The Salvation Army is also accepting donations online and by calling 1-800-SAL-ARMY (725-2769).

The Red Cross and Salvation Army may also need local volunteers to help set up shelters.  Contact the above numbers.

Local volunteers are asked to donate supplies to nearby recreation centers housing evacuees.

Supply drives in out-of-state locations may not be accepted directly but could help local charities who need to ship supplies to the affected area.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

 

Posted in food, Health, news

Hepatitis A Kills 14 in San Diego

A southern California city is reporting the “deadliest outbreak” of Hepatitis A that the US has seen in decades.

264 people have been hospitalized and 14 dead since the outbreak of the virus began in November of 2016.

70% of the cases were homeless individuals, lacking good sanitation and immunocompromised due to their lack of nutrition and possible drug/alcohol use.  9 people have died within the last 6 weeks.

What is Hepatitis A?

Hepatitis A is a disease that affects the liver.  Its caused by a virus (Hepatitis A virus) that is most commonly ingested. Poor hand washing and/or contaminated food are likely culprits.  Its transmitted by the fecal-oral route, where food or drink contaminated by fecal matter enters another person’s GI tract.  Sexual transmission of Hepatitis A has been reported during activities involving oral-anal sex.

Hepatitis A can live outside the body for months, so unclean dining areas can be contaminated and transfer to food.

Those who are immunosuppressed run the risk of dying from the infection.

 

What are the symptoms of Hepatitis A?

Symptoms of Hepatitis A include:

Jaundice – yellowing of the skin and eyes

Fever

Abdominal Pain

Fatigue

Dark Urine

Joint Pain

Clay – looking stools

Diarrhea

Nausea

Vomiting

Loss of appetite

Hepatitis-A.jpg

 

What is the treatment for Hepatitis A?

There is no specific treatment for hepatitis A.  Most hepatitis A infections resolve on their own.

We usually recommend rest, fluids, and offer medications to help with nausea and vomiting.

For liver injury we avoid medications and alcohol that can worsen liver damage. The liver will usually recover within months after hepatitis A infection.

 

There are vaccines for Hepatitis A included in the childhood vaccination schedule.  Those older who weren’t vaccinated as a child can get the vaccine from their local provider or health department.  Many states require all health care and food workers to be vaccinated.

The best form of prevention however is good hand washing, dining area hygiene, and cooking food thoroughly.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

 

 

Posted in Health, news

Undiagnosed Atrial Fibrillation More Common in Seniors Than Thought

A recent study found 1 in 3 patients to have atrial fibrillation during cardiac monitoring who were never previously diagnosed.

The study suggests that many people may unknowingly be at risk for this deadly heart rhythm.

Those with atrial fibrillation are at increased risk for blood clots, stroke, heart failure, and much more.

The study authors looked at data provided by long-term cardiac monitor implants and found close to a third had undetected atrial fibrillation.  According to lead researcher, James Reiffel, cardiologist and professor at Columbia University College of Physicians and Surgeons in New York City, “Based on these results, it’s likely there’s probably a lot more undetected atrial fibrillation among seniors.”

In 2014, the same study author published a paper in Am J Med, discussing how atrial fibrillation increases one’s risk of stroke 5-fold.

What’s so significant about a study such as this is the following:  If cardiac patients on long term monitors run the risk of this deadly heart rhythm being missed, what about those of us who aren’t continually monitored?

What is Atrial Fibrillation?

Atrial Fibrillation (Afib) is a type of abnormal heart rhythm in which the electrical impulses fail to travel through the heart muscle rhythmically and predictably.  Since the heart muscle is a pump, it relies on methodical impulses so it can fill and pump the blood throughout the body properly.

Electrical impulses, in a healthy individual, originate in the SA (sinoatrial node) in the right atrium of the heart.  The SA node gauges the rate of the impulses based on the person’s activity.  Hence if one is exercising and needs more cardiac output, the SA node will trigger a faster pulse so oxygenated blood is delivered throughout the body quicker.

The electrical activity, once discharged, travels to both upper chambers of the heart (the atria) and then down to the AV node and then to the septum between both lower chambers of the heart (the ventricles).

heart image.jpg

Image above from PinnacleHealth

 

The right ventricle pumps blood into the lungs to become oxygenated. This blood travels back to left atrium which pumps it into the left ventricle.  The left ventricle then pumps the blood into the aorta which transmits it to smaller vessels throughout the body.

As you can imagine, the pump and its electrical impulses need to work in concert.  In atrial fibrillation, however, the SA node isn’t in charge anymore and electrical impulses misfire throughout the atria.  This causes a “fibrillation” of the heart muscle where it loses its normal heart beat and beats erratically. The heart pump cannot fill adequately and blood starts to slosh around since its not being pumped out efficiently.

Blood that sits and sloshes around can form clots.  These clots can travel once they do finally exit the heart and block blood flow to the lungs (pulmonary embolus) or to the brain (stroke).

What are signs or symptoms of atrial fibrillation?

Patients can often go “in and out” of atrial fibrillation.  Many times they won’t notice it at all.  However symptomatic afib may cause the following:

Shortness of breath

Palpitations

Chest Pain

Dizziness

Fatigue

Cough

What are the risk factors for atrial fibrillation?

Although afib can occur at any age, it may become more common as we age.

Moreover those with high blood pressure, heart disease, sleep apnea, COPD, lung disease, diabetes and thyroid issues may be at higher risk as well.

Alcohol use in high quantities can increase one’s risk and energy drinks may trigger an abnormal heart rhythm as well.

How can I get screened for atrial fibrillation?

Firstly, you can discuss your risk factors with your medical provider.  Some insurance companies, however, may not always pay for screening.

Secondly, you can get screened and evaluated for stroke risk through Life Line Screening.  According to their website, they offer screening packages that not only test for atrial fibrillation but also evaluate for carotid artery disease (of which can also increase risk of stroke), abdominal aortic aneurysm, peripheral vascular disease, and osteoporosis.

 

life line

I just had my screening at Life Line and it was easy and painless. For me, I didn’t want to wait to have a heart condition before I wore a heart monitor.

The study above was presented in Barcelona, Spain, at the European Society of Cardiology’s annual meeting.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in Health, news, Politics

Hurricane Harvey Damage to Last Weeks to Months: How You Can Help

The Category 4 hurricane that hit southeast Texas Friday evening is expected to cause “widespread devastation” to the area.

Torrential downpours are expected to continue and power outages, floods, raging waters, and the potential for tornadoes threaten coastal and inland residents.

Hurricane Harvey, although weakening, is expected to hover over the next few days bringing more deadly conditions.

How can we help?

Blood supplies will be needed as residents who routinely donate have evacuated the area. Donating blood at your local blood bank may be shipped to the area in need.

United Blood Services have locations throughout the country that can accept your blood Donation. Contact UBS here.

The American Red Cross is accepting donations. On their website, they ask to visit redcross.org, call 1-800-RED CROSS or text the word REDCROSS to 90999 to make a $10 donation.

The Salvation Army is also accepting donations online and by calling 1-800-SAL-ARMY (725-2769).

The Red Cross and Salvation Army may also need local volunteers to help set up shelters.  Contact the above numbers.

Local volunteers are asked to donate supplies to nearby recreation centers housing evacuees.

Supply drives in out-of-state locations may not be accepted directly but could help local charities who need to ship supplies to the affected area.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

 

Posted in news, Sports

Bishop Gorman Remains Undefeated

The undefeated Bishop Gorman Gaels now boast a 55 game winning streak as a result of Friday night’s season opener.

Playing DeMatha Catholic High School of Maryland on Fertitta Field, the Gaels trumped the Stags, with a final score of 35-23.

Led by Coach Kenny Sanchez, the Gaels start this season 1st in the state, 4th nationally.

Their 55 game winning streak began back to 2013.

Dorian Thompson-Robinson Quarterback (UCLA),  Palaie Gaoteote Linebacker (USC),  Brevin Jordan Tight End (Miami), and Jimmy Telles wouldn’t let a 17-13 DeMatha lead in third quarter stop them.

Turning it around with three touchdowns and a 2 point conversion in the final quarter cemented their domination in high school football.

Bishop Gorman plays Mater Dei in Santa Ana, CA September 1.

This is a developing story.

 

 

 

Posted in Health, news

Swine Flu Outbreak Kills Close to 1100 in India

22,186 cases of swine flu have been reported in India, with the death toll reaching 1094.  This is a four-fold rise in deaths from last year.

The hardest hit areas appear to be Maharashtra with 437 deaths followed by Gujarat with 297 casualties.

What is the Swine Flu?

Swine Flu is the H1N1 Influenza A virus.  It originated in pigs before infecting humans. Current swine flu is not contracted from swine but passed between humans.

How deadly is Swine Flu?

The 2009 Swine Flu pandemic killed over 12,000 people in the US, and 200,000 people world-wide.  Many who die, do so from viral or bacterial pneumonia, although dehydration can also play a role.

Is the current outbreak in India the same virus that caused the 2009 pandemic?

No.  In 2009 the predominant strain of H1N1 was the California strain. This was replaced last year with the Michigan strain.

Do we have a vaccine against the Swine Flu?

Yes.  In the US, the trivalent and quadrivalent flu vaccines have included H1N1 since 2010.  These vaccines would include the following strains (according to the CDC):

  • an A/California/7/2009 (H1N1)–like virus,
  • an A/Hong Kong/ 4801/2014 (H3N2)–like virus, and
  • a B/Brisbane/60/2008–like virus (Victoria lineage)

with an additional B virus called B/Phuket/3073/2013-like virus (B/Yamagata lineage) for the quadrivalent vaccine.

Currently the World Health Organization (WHO) recommends changing the Northern Hemisphere flu vaccine to:

  • For H1N1, an A/Michigan/45/2015-like virus
  • For H3N2, an A/Hong Hong/4801/2014-like virus
  • For B, Brisbane/60/2008-like virus (belonging to the Victoria lineage)

with an additional B virus called B/Phuket/3073/2013-like virus (B/Yamagata lineage) for the quadrivalent vaccine.

What are symptoms of the Swine Flu?

Symptoms can include:

Fever

Cough

Chills

Sore throat

Headache

Body Aches

Diarrhea

Vomiting

to name a few.

Who is at risk for Swine Flu?

Any child or adult could be at risk for H1N1 infection.  However, the 2009 outbreak appeared to predominately affect younger adults.  One theory proposed for why this occurred was older individuals might have been immune having been exposed to the H1N1 during the 1950’s and when it reemerged in the 1970s.  Moreover 40 million Americans were vaccinated against swine flu in the 1970’s.

Those, however, at high risk for a severe Swine Flu infection include those who are pregnant, children under 2, asthmatic or other lung conditions, diabetic, immunocompromised (HIV, transplant recipient), sickle-cell, elderly, those in a nursing home, and patients with heart, liver or kidney disease.

How is Swine Flu treated?

Many times the H1N1 flu symptoms will last a week and then subside on their own.  Some patients will need antivirals such as Tamiflu or Relenza.  Any worsening symptoms (persistent fever, vomiting, diarrhea, chest pain, dizziness, confusion, lethargy), should prompt immediate evaluation by one’s medical provider.

How can we avoid Swine Flu?  Do face masks work?

 

swine-story_650_022415095428.jpg

 

Prevention of swine flu is best accomplished through vaccination, avoidance of affected individuals and good hand washing.  Face masks generally are not recommended, but the CDC provides some guidance with these tables:

Table 1. CDC Interim Recommendations for Facemask and Respirator Use for Home, Community, and Occupational Settings for Non-Ill Persons to Prevent Infection with 2009 H1N1 1 2
Setting Persons not at increased risk of severe illness from influenza
(Non-high risk persons)
Persons at increased risk of severe illness from influenza (High-Risk Persons) 3
Community
No 2009 H1N1 in community Facemask/respirator not recommended Facemask/respirator not recommended
2009 H1N1 in community: not crowded setting Facemask/respirator not recommended Facemask/respirator not recommended
2009 H1N1 in community: crowded setting Facemask/respirator not recommended Avoid setting.
If unavoidable, consider facemask or respirator 45
Home
Caregiver to person with influenza-like illness Facemask/respirator not recommended Avoid being caregiver. If unavoidable, use facemask or respirator 45
Other household members in home Facemask/respirator not recommended Facemask/respirator not recommended
Occupational (non-health care)
No 2009 H1N1 in community Facemask/respirator not recommended Facemask/respirator not recommended
2009 H1N1 in community Facemask/respirator not recommended but could be considered under certain circumstances 45 Facemask/respirator not recommended but could be considered under certain circumstances 45
Occupational (health care)6
Caring 7 for persons with known, probable or suspected 2009 H1N1 or influenza-like illness Respirator Consider temporary reassignment. Respirator
  1. The effectiveness of respirators and facemasks in preventing transmission of 2009 H1N1 (or seasonal influenza) in various settings is not known. Use of a facemask or respirator is likely to be of most benefit if used correctly and consistently when exposed to an ill person.  (Ref. a) MacIntyre CR, et al.  EID 2009;15:233-41. b) Cowling BJ, et al. Non-pharmaceutical interventions to prevent household transmission of influenza. The 8th Asia Pacific Congress of Medical Virology, Hong Kong, 26-28 February 2009.)
  2. For the purpose of this document, respirator refers to N95 or any other NIOSH-certified filtering face piece respirator.
  3. Persons at increased risk of severe illness from influenza (i.e. high-risk persons) include those groups at higher risk for severe illness from seasonal influenza, including:  children younger than 5 years old;  persons aged 65 years or older;  children and adolescents (younger than 18 years) who are receiving long-term aspirin therapy and who might be at risk for experiencing Reye syndrome after influenza virus infection;  pregnant women;  adults and children who have pulmonary, including asthma, cardiovascular, hepatic, hematological, neurologic, neuromuscular, or metabolic disorders, such as diabetes; adults and children who have immunosuppression (including immunosuppression caused by medications or by HIV); and, residents of nursing homes and other chronic-care facilities.
  4. The optimal use of respirators requires fit testing, training and medical clearance. Proper use is recommended to maximize effectiveness. The use of facemasks may be considered as an alternative to respirators, although they are not as effective as respirators in preventing inhalation of small particles, which is one potential route of influenza transmission.  There is limited evidence available to suggest that use of a respirator without fit-testing may still provide better protection than a facemask against inhalation of small particles. Respirators are not recommended for children or persons who have facial hair (see FDA websiteExternal Web Site Icon).
  5. Use of N95 respirators or facemasks generally is not recommended for workers in non-healthcare occupational settings for general work activities.  For specific work activities that involve contact with people who have influenza-like illness (ILI) (fever plus at least either cough or sore throat and possibly other symptoms like runny nose, body aches, headaches, chills, fatigue, vomiting and diarrhea), such as escorting a person with ILI, interviewing a person with ILI, providing assistance to an individual with ILI, the following are recommended: a) workers should try to maintain a distance of 6 feet or more from the person with ILI; b) workers should keep their interactions with the ill person as brief as possible; c) the ill person should be asked to follow good cough etiquette and hand hygiene and to wear a facemask, if able, and one is available; d) workers at increased risk of severe illness from influenza infection (see footnote 3) should avoid people with ILI (possibly by temporary reassignment); and, e) where workers cannot avoid close contact with persons with ILI, some workers may choose to wear a facemask or N95 respirator on a voluntary basis  (See footnote 1). When respirators are used on a voluntary basis in an occupational work setting, requirements for voluntary use of respirators in work sites can be found on the OSHA websiteExternal Web Site Icon.
  6. See case definitions of confirmed, probable, and suspected 2009 influenza A (H1N1). Also see infection control in the health care setting. When respiratory protection is required in an occupational setting, respirators must be used in the context of a comprehensive respiratory protection program as required under OSHA’s Respiratory Protection standard (29 CFR 1910.134). This includes fit testing, medical evaluation and training of the worker.
  7. “Caring” includes all activities that bring a worker into proximity to a patient with known, probable, or suspected 2009 H1N1 or ILI, including both providing direct medical care and support activities like delivering a meal tray or cleaning a patient’s room.
Table 2.  CDC Interim Recommendations For Facemask Use For Persons Ill With Confirmed, Probable, Or Suspected 2009 Influenza A (H1N1)1 To Prevent Transmission Of 2009 H1N1 2
Setting Recommendation
Home (when sharing common spaces with other household members) Facemask preferred, if available and tolerable, or tissue to cover cough/sneeze
Health care settings (when outside of patient room) Facemask, if tolerable
Non-health care setting Facemask preferred, if available and tolerable, or tissue to cover cough/sneeze
Breastfeeding Facemask preferred, if available and tolerable, or tissue to cover cough/sneeze

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician