World TB Day

Can you name a disease that plagued Egyptian royals, was once associated with vampires, and that was the leading cause of death due to infectious disease until the COVID-19 pandemic?

If you guessed tuberculosis, you are correct!

Tuberculosis, often abbreviated “TB”, is a contagious illness that is caused by bacteria known as Mycobacterium tuberculosis. The disease mainly impacts the lungs, but it can infect any part of the body. TB spreads from person to person through tiny droplets in the air called “aerosols” that contain TB bacteria. When someone breathes in these droplets, they can settle in the lung where the TB bacteria multiply.

In most people infected with TB, the body can “wall off” the bacteria so they aren’t able to cause active disease. This is called latent tuberculosis infection, or LTBI. But in about 5-10% of people, the body is not able to contain the infection and they develop active TB, also known as TB disease. People with active TB often have symptoms such as a cough lasting three or more weeks (sometimes with blood), fevers, night sweats, and weight loss. Thankfully, it is possible to treat TB with a combination of antibiotic medications, although treatment often lasts for many months.

The best way to prevent TB disease is to know if you have risk factors for TB such as living in a high incidence country, close contact with an active TB case, or medical conditions that can increase your risk of active TB such as HIV infection, diabetes, or the use of medications that suppress the immune system. Screening people for risk factors and testing those at high risk for TB disease is one of the important ways to find people with latent TB and treat them before it becomes a more serious, active illness.

Each year on March 24, we observe World TB Day. This day marks the anniversary of when Dr. Robert Koch discovered the bacteria that causes TB. Before Dr. Koch’s discovery, people were not sure how TB was spread. Many people thought it had to do with germs that floated through the air, but some people thought it was caused by visits from relatives who died from TB and came back as vampires to infect their families. (See? We didn’t forget to elaborate on that interesting fact!)

World TB Day doesn’t just mark the anniversary of an important scientific discovery, but also sheds light on the all the work that has been done to eliminate TB over many centuries. In many countries like the United States, TB is far less common than it was even 50 years ago. But worldwide, TB is still very common and is the second leading cause of death due to infectious disease—second only to COVID-19.

It takes the dedicated medical professionals, public health workers, and community partners to detect, diagnose, and treat cases of TB and LTBI. This World TB Day, the Virginia Department of Health acknowledges and celebrates the hard work of all those working toward TB elimination. And we acknowledge and offer our support to those with TB/LTBI and TB survivors who have overcome one of the most impactful infectious diseases in history!

 

Virginia Health Officials Investigating Potential Measles Exposures in Northern Virginia

January 13, 2024

VIRGINIA HEALTH OFFICIALS INVESTIGATING POTENTIAL MEASLES EXPOSURES IN NORTHERN VIRGINIA
Virginia Department of Health is Working to Identify People Who Are at Risk

(Richmond, Va.) – The Virginia Department of Health (VDH) was notified of a confirmed case of measles in a person who traveled through Northern Virginia when returning from international travel. Out of an abundance of caution, VDH is informing people who were at various locations, including Dulles International Airport on January 3, 2024, and Ronald Reagan Washington National Airport on January 4, 2024, that they may have been exposed. Health officials are coordinating an effort to identify people who might have been exposed, including contacting potentially exposed passengers on specific flights. more>>

National Handwashing Awareness Week

Washing your hands is one of the most effective ways to stop the spread of germs. Did you know that you can prevent 1 in 3 diarrhea-related and 1 in 5 respiratory-related illnesses, just by washing your hands? It’s true! Good hand hygiene starts with washing your hands properly.  

Follow these five steps to clean hands.  

  1. Wet your hands with clean, running water. Warm or cold is fine.  
  2. Apply soap and lather by rubbing your hands together. Remember to get the backs of your hands, between your fingers, and under your nails. 
  3. Scrub for at least 20 seconds. You can hum the Happy Birthday song from beginning to end twice if you need a timer.  
  4. Rinse your hands under clean, running water.  
  5. Dry your hands using a clean towel or air dry them. 

Yes, it’s that easy!  

But, wait! What if soap and water aren’t available? You can use an alcohol-based hand sanitizer as well, but make sure it’s at least 60% alcohol. Need more information? Visit www.cdc.gov/handwashing. 

Aah! Fresh clean hands!  

September is National Preparedness Month and it’s the Perfect Time to Build a Kit, Make a Plan and Sign Up to Be Informed 

You may have heard that it’s important to “Build a kit, Make a plan and Be Informed” before severe weather or another type of emergency happens. 

September is National Preparedness Month, and it’s the perfect time to get prepared for emergencies that could force you to evacuate your home and require you to survive on your own for several days. 

Most of us know how to Stay Informed about the weather and other emergencies by reading or watching news outlets or signing up for alerts. You also can download the FEMA app, and listen to NOAA weather radio.

Building a kit means putting together important documents and items that you may need to survive if your power goes out or you need to evacuate.

But what about making a plan?

An emergency plan for your family means discussing ahead of time how you will communicate during an emergency. It also includes figuring out how to reconnect after the danger has passed. It involves having all the information you will need in one place, such as phone numbers, insurance information and more if you need to evacuate in a hurry or search for loved ones after an emergency. Before filling out the form, ask yourself a few questions: 

  • How will my family/household get emergency alerts and warnings?  
  • How will my family/household get to safe locations before and after emergencies?  
  • How will my family/household get in touch if cell phones, internet, or landlines don’t work?  
  • How will I let loved ones know I am safe?  
  • How will family/household get to a meeting place after the emergency? 

Topics on your form can include:    

  • Household information, including your address and phone number  
  • List of family members, including email addresses and medical information  
  • Information on schools, childcare, caregivers, and workplaces  
  • Emergency contacts  
  • Emergency meeting places where everyone can reconnect  
  • Doctors’ names and numbers  
  • Veterinarian information  
  • Insurance information  
  • List of medications and dosage  
  • Gathering important documents

Having a plan means that everyone will know exactly what to do in an emergency. To learn more about how to be ready for an emergency or disaster, visit the Ready.gov website.    

 

Stay Well and Enjoy Holiday Cookouts With a Few Food Safety Tips

Outdoor fun, especially when the weather is nice, includes picnics, barbecues, camping, outdoor parties and other activities. Don’t miss out on the fun by getting sick.

Typical symptoms of food-related illness are vomiting, diarrhea, and flu-like symptoms, which can start anywhere from hours to days after contaminated food or drinks are consumed.

When the air temperature and humidity climbs into the 70s and above, harmful bacteria growth increases rapidly, making handling food safely even more important.

Here are a few warm-weather food safety tips to help keep your festivities and food safe:

Preparation

When preparing meals remember to follow these safety tips: 

  • Clean: Wash hands, cutting boards, utensils, and countertops. 
  • Separate: Keep raw meat, poultry, and seafood separate from ready-to-eat foods. 
  • Transport food: It’s important to remember that harmful bacteria can start to grow when prepared food falls between temperatures of 40 -140 degrees. Perishable food transported without an ice or heat source won’t stay safe long. 
  • Thaw: Always thaw food in a refrigerator or place the frozen food in a cooler filled with ice or frozen gel packs. Never thaw food at room temperature.    
  • Marinate: Safely marinate foods inside a refrigerator. Never marinate foods at room or air temperature, and do not re-use marinade. If it is to be used as a dipping or other sauce, save a portion of the mixture, keep it away from raw meat and store it in a refrigerator or cooler filled with ice or frozen gel packs before serving.  
  • Coolers: Have several coolers. Have one that can be opened frequently and used for beverages, one for snacks and ready-to-eat foods, and one for meats.  
  • Trash: Have trash bags stored away from the serving and cooking area. Close or cover the trash bag when it’s not in use.   

Cooking Safety

The onset of warm weather often prompts many people to begin using their outdoor grills to prepare foods. The following tips can help reduce the risk of getting sick:  

  • Always supervise a barbecue grill when in use.
  • Wash your hands with soap and water for a minimum of 20 seconds prior to cooking food.
  • Always cook foods to the proper temperature. Do not rely on the food’s color or firmness to determine if it’s thoroughly cooked. Always use a food thermometer and clean the probe end with soap and water before and after use.
  • When checking food with a thermometer, remove the food from the grill surface, place it on a clean plate, and then take the temperature in the thickest part of the food (not touching any bones).
  • Since grills and cooking surfaces may have cold spots or cook unevenly, check the temperature of each piece of meat on the grill.
  • Always use a clean plate and utensil for cooked foods; don’t use the same tongs or platter that you used to bring raw foods to the grill.
  • Check to make sure your grill tools are clean, in good condition, and not shedding any brush bristles.
  • Cooked foods on the grill surface can be moved off to the side in a hot holding area away from the hot coals or heating elements.
  • Store hot foods in a chaffing dish, table-top warmer, or in an insulated container.
  • Have mesh covers/tents to cover dishes to prevent flies and bugs from landing on the food. 

Leftovers  

Keep these tips in mind when storing and eating leftovers:

  • Don’t leave food sitting out at room or air temperature for more than 2 hours. If the air temperature is 90 degrees or higher, then the time limit drops to one hour. The food should be thrown away if it sits out longer than that.
  • Refrigerate cooked leftovers within 2 hours and ensure the temperature in the refrigerator is at 40 degrees or below.
  • Divide leftovers into smaller portions and store in shallow containers in the refrigerator.
  • Leftovers should be eaten, frozen or discarded within 3 to 4 days.
  • Reheat cooked leftovers to 165 degrees as measured with a food thermometer. Sauces, soups and gravies should be reheated by bringing them to a boil.
  • When microwaving leftovers, make sure there are no cold spots in food where bacteria can survive.
  • When they are not in the fridge, keep cold foods at the proper temperature by storing them on ice (e.g., use an empty bowl, place some ice in the bottom, set the dish with the food product inside the bowl, fill ice around the food dish so that the ice level outside of the food dish is level with the food in the dish). Monitor the bowl and empty the water as the ice melts and refill with new ice. Use an inflatable cold tray and fill will ice, then set your cold food dishes into the ice tray.
  • Store coolers closed, in the shade or cover them. Store them in an air-conditioned area, if possible.

For more tips, visit the VDH Food Safety page and read more about Food Safety Fridays (#FoodSafetyFridays).

It’s Time to Recognize the Professionals Who Make Sure We Have Clean Water

On Friday, June 30, Virginia will recognize the professionals across the state who make sure we have clean and safe drinking water and who treat wastewater. A proclamation by Gov. Glenn Youngkin recognizes Friday as Drinking Water and Wastewater Professionals Day. The General Assembly passed Joint House Resolution 88 establishing the day in 2016. 

Without reliable drinking water and wastewater treatment, thousands of people would die each year from waterborne diseases. Thanks to these professionals who operate public and private drinking water and wastewater treatment plants, Virginia’s 8.6 million residents have water that is clean. 

 At the Virginia Department of Health, the Office of Environmental Health Services and local health departments monitor and oversee private projects and data related to safe drinking water and wastewater treatment. Programs include private wells, onsite sewage systems food and shellfish safety, marinas, waterborne hazards, healthy swimming and more. The Office of Drinking Water ensures public water systems provide a safe and adequate supply of drinking water by enforcing drinking water regulations, monitoring drinking water quality, applying engineering judgement, providing technical assistance and training, and financing improvements to drinking water systems.   

To learn more about drinking and wastewater treatment in Virginia, visit the VDH Office of Environmental Health Services and Office of Drinking Water websites.   

State Health Commissioner Karen Shelton, MD, Discusses Her Priorities for the Health of All Virginians

State Health Commissioner Karen Shelton, MD, is newly appointed to her role leading the Virginia Department of Health, (VDH), but she isn’t new to public health or to Virginia. She’s a native Virginian who formerly was Director of the Mount Rogers Health District and Acting Director for Lenowisco and Cumberland Plateau Health Districts. She also served in the role of vice president and chief medical officer at Bristol Regional Medical Center before her appointment as state health commissioner.  

Dr. Shelton holds a Bachelor of Science degree from Wake Forest University and a Doctor of Medicine degree from the University of Virginia. She completed her residency in obstetrics and gynecology at Eastern Virginia Medical School.

Having lived in several areas of the state and serving in several roles has helped shaped her perspective on the role public health plays for all Virginians, especially given modern challenges facing the Commonwealth such as the opioid crisis. Dr. Shelton is a mother of two grown daughters.  

The VDH Office of Communications sat down with Dr. Shelton to talk about her priorities for goals for protecting and promoting the health of all Virginians.   

What are your top priorities as you begin your new role as state health commissioner?  

It was thrilling when I started as Health Commissioner to be able to sign the declaration of the end of public health emergency for COVID19 for our state. We have been working the last three years on COVID-19 and now that it is decreasing, it is good to be able to turn our attention to other things. We do need to focus on our public health workforce – we need to retain and recruit to enhance our workforce. We have been through a lot with COVID, and we need to make sure we address our own wellness.   

The Opioid Crisis and Fentanyl 

We want to refocus, certainly, on our opioid crisis efforts. We started seeing a large increase in overdose deaths in 2016 across the Commonwealth. We had started some efforts and began to make some headway to decrease those deaths from 2017 to 2018. By 2019, we were beginning to see a decrease in those deaths. Unfortunately, they have skyrocketed again over the three years of COVID-19.  

Substance use disorder increased, unfortunately, during COVID-19 and we’ve seen an increase in our overdose deaths. So, as we refocus our efforts on the opioid crisis, the governor has enacted his Executive Order 26, to crush the fentanyl crisis. We at VDH look forward to partnering with other agencies across the state as we tackle this problem. We want to focus on education, prevention, harm reduction, treatment and anything that we can do to combat overdoses as well as substance use disorder. 

In doing so, we are always asking how we can reach those with substance use disorder, how we can help them and how can we guide them toward recovery when they’re ready. And then what are the recovery options that we have for them and how do we reduce the harm during their time of need until they are ready to get to recovery?  

Also, we look at the people who have been experimenting with drugs and who may overdose on a first-time use or infrequent use of drugs. How do we combat that as well? We have a lot of initiatives ramped up and we also rely on education and prevention. 

Naloxone distribution is a huge effort across the state, so we’ll be working on that along with the many different efforts to combat the opioid overdose and addiction crisis that we have. 

 Maternal and Infant Health 

As an OB/GYN, another main goal of mine is looking at maternal and child health issues. We want to have healthy families, moms and babies. As we focus on those efforts, we want to address issues of maternal and infant mortality. Specifically in maternal health, we want to address mental health, substance use disorder, chronic disease, intimate partner violence, and healthcare access. We are using data to inform our initiatives, and we have some great programs in our agency and partnerships with other agencies and community resources that are already addressing these issues, but we want to double down on our efforts and see if there are additional programs or initiatives that we can use to fill some gaps. I’m looking forward to championing these initiatives with our partners, along with the great work that is already going on within our agency. 

The Public Health Workforce 

Before COVID-19, a lot of people didn’t really know much about what we did as a public health workforce and all the wonderful programs that we have throughout the Commonwealth. 

During COVID-19, we’ve had a trial of our public health workforce. We have people who are still with VDH who have worked tirelessly over the last three years to address COVID-19 for our state. We have a lot of people who came to work for our agency over that time and then a lot of people who have now left public health. We want to champion the public health workforce that we have and see what we can do to bring healing and resilience and to boost the energy again of those who are still working in public health. I look forward to getting out to visit the local health districts and connecting with them on what their needs are. We also are thinking about how we can recruit new people into public health., and looking at how we can get people excited about public health, how we get them into our workforce and champion with us for the best, the healthiest state in the nation. 

How can citizens learn more about fentanyl and what can they do to help or to get involved? 

Our local health departments have free naloxone and provide training on how to recognize an overdose, administer naloxone, and save a life. There are also REVIVE trainings that are offered in communities that are also a good way for people to learn about opioids, about addiction, and about how to recognize an opioid overdose., and how to save a life with naloxone.  

Naloxone is a medicine that can temporarily reverse the effects of opioids. Opioids are very dangerous because when people take too much of an opioid, they stop breathing. And so that’s how they die. The naloxone blocks those receptors and allows people to start breathing again. 

The REVIVE! trainings have been going on across the state for some time and I know the efforts will continue. As we get further into our campaign against overdose and addiction, that will be spreading more in communities.  

How have all your roles – from doctor to health director to chief medical officer – shaped your perspective for this new role?  

I feel like my new role is really to evaluate the health of the Commonwealth. Part of what I enjoy, being chief health strategist, is asking how do I make sure that the important services are covered not only for healthcare, but for the well-being of the community? 

What is the access? How do we connect people to care? How do we get people to value their health? 

I think that my time at the hospital really helped me understand a lot about what hospitals do to provide for our communities and how VDH partners with them. Not the least of those is our Community Health Assessments which are integral in our community when it comes to the overall health strategy of a community. 

Also, while I was there (on the hospital side), I learned a lot working on the hospital side about quality initiatives. I learned a lot about patient safety initiatives, best practices, peer review, peer guidance. Part of that was asking how we make sure that our healthcare providers are performing at their best and learning how to guide them in their efforts.  

In 2021, as I was leaving the Virginia Department of Health, we had rolled out the vaccines. We were working on outreach in areas that had not had the opportunity to receive the COVID-19 vaccines and we were making good progress. When I arrived at the hospital, Delta began to surge. We saw the highest numbers of cases that they had to that date at the hospital, followed by Omicron in the winter.  

It’s important that we are refocusing now. I think as a Commonwealth it’s important to make sure people are getting back to taking care of themselves with routine primary care visits and preventive visits such as screenings for cancer and other diseases to make sure we’re taking good care of our health.  

Continuing on that theme, how can Virginians continue to stay healthy now that we’re going to be living with COVID-19?  

Well, COVID-19 is now a part of our community.  It is worse than the flu. When we look at the outcomes, as far as the percentage of hospitalizations and deaths that have occurred from COVID-19 in comparison to the flu, it is an illness of significance for our communities. At the same time, so much of our population has been vaccinated. We do have a lot of immunity that, for most people, it’s not an extreme health concern. Certainly, for people who have certain medical conditions and those who are immunocompromised, that it is a significant factor. 

We all need to be aware, but most of us are now getting back to normal. I don’t know that it’s the same normal. But it’s important for people to get back to getting those mammograms, colonoscopies, and other screenings that healthcare providers recommend for their general health. One thing Virginians can focus on regarding their health is getting out and about. By that, I mean physical exercise, getting out and walking or doing the things you love. Get those breaths of fresh air and taking care of yourself that way.  

Mental Health Focus 

There has also been a lot more attention on mental health in our communities because of COVID-19. People experienced isolation and seclusion. They were not able to get out and about and to socialize. Now we have mental health repercussions. Fortunately, the stigma has been reduced in discussing mental health. I think people are a little bit more open now to talking about it. They want to know about the resources where they can seek help.   

The state of Virginia and the Governor’s plan has looked at increasing our capacity for mental health services. And we do have the 988 line that people can call. This is a national number, but the state of Virginia is up and going with that faster than even the national plan. 

So, we’re thrilled to have that resource in Virginia, and we know that health care providers do have resources for referral. I know that in the behavioral health world, they’re working a lot with “Right Help, Right Now.” They are focusing on educating people on where they can go in a crisis and how they can get the care they need at the time they need it.  

We want people to focus on their own wellness, not only mental health, but also social wellbeing. As we look at our communities, part of public health is looking at social determinants of health. We look at whether people have a place to live, whether they have access to nutritious food, how they are educated and if they can make a livable income. We look at these things to see how, as public health workers, we can work with our resources and link people in our communities with those resources.  

  

To learn more about the REVIVE! Opioid Overdose and Naloxone Education (OONE) program, visit the Department of Behavioral Health and Developmental Services website.  

To contact your local health district or department and learn more about naloxone and REVIVE! Training, visit the VDH website.