Shingrix Vaccine

Good News!  As of May 1, 2018 Blue Cross Blue Shield of Massachusetts will reimburse  for the Shingrix vaccine for adults age 50+.  Harvard Pilgrim may be the next insurance to sign on.  Other private insurers will allow payment  beginning September 1, 2018.  Unfortunately, Medicare will not pay for the Shingrix vaccine.  A second injection is required  2-6 months after the first.  Please call the office for more information (508) 833-8020 or to schedule an appointment.

Flu Vaccine

It is not too late to have your flu vaccine!   Please call (508) 833-8020 to schedule an appointment.  People with some chronic illnesses, 65 or older, and younger than 2 years should be treated with Tamiflu within 48 hours of having flu symptoms.

ADULT FLU CLINICS 2017

The Sandwich Public Health Nursing Department will be offering flu shots to adults 19 years and older.

When:  Thursday, October 5, 2017

9A-12Noon     1P-4P

Tuesday, October 17, 2017

9A-12Noon     1P-4P

Where:  Human Services Building

270 Quaker Meetinghouse Road

East Sandwich

Charge:  Most insurances (EXCEPT Aetna) will pay.  Please bring all insurance cards including Medicare and Mass Health.  The cost for self pay:  Quadrivalent $20, High dose-65+  $45.  (Check or cash)

Appointments are necessary.  Please call (508) 833-8020 to schedule an appointment.

Those adults who will be having surgery, chemotherapy, or radiation prior to the clinics should call the office to schedule an earlier appointment.

 

 

TICKS!!!!!

It’s time to start preparing for the Cape Cod tick season. Lyme disease, babesiosis, anaplasmosis, miyamotoi, and now Powassan are names you should be familiar with

TickSmart “To-Do” List for May

Spray all outdoor shoes with Permethrin
Make sure pets are protected
Have yard treated with effective tick killers
Be especially vigilant about doing daily tick checks

Top Ten Things Everyone Should Know About Ticks These Days by Thomas Mather

Back in the day, we had ticks. Big, yucky American dog ticks. They usually crawled to the top of your head, you felt a lump, pulled the tick out, flushed them (or found some other form of revenge), and that was that. Usually no one got sick. Ticks were mostly just an annoyance, and that’s what people knew about ticks. American dog ticks are still around but these days, there’s another tick, a tiny blacklegged tick, smaller than a freckle.

It’s also known as the deer tick, and it crawls up under clothes, latches on without much fanfare, and these ticks are LOADED with disease-causing pathogens.

Once attached to people or pets, deer ticks are just hard to find! Their numbers are on the rise and they occur in more & more places – even your backyard! Read our “Top 10 Things Everyone Should Know About Ticks These Days” and stay disease-free.

Top Ten Things
10. Ticks crawl up

Ticks don’t jump, fly, or drop from trees onto your head and back. If you find one attached there, it most likely latched onto your foot or leg and crawled up over your entire body. Ticks are “programmed” to try and attach around your head or ears. On their normal hosts, ticks also usually crawl up; they want to blood feed around the head, neck, and ears of their host, where the skin is thinner and hosts have more trouble grooming.

9. All ticks (including deer ticks) come in small, medium and large sizes

Ticks hatch from eggs and develop through three active (and blood-feeding) stages: larvae (small-the size of sand grains); nymphs (medium-the size of poppy seeds); adults (large-the size of apple seeds). If you see them bigger, they’re probably partially-full or full of blood.

8. Ticks can be active even in the winter

That’s right! Adult stage deer ticks become active every year after the first frost. They’re not killed by freezing temperatures, and while other ticks enter a feeding diapause as day-lengths get shorter, deer ticks will be active any winter day that the ground is not snow-covered or frozen. This surprises people, especially during a January thaw or early spring day. Remember this fact and hopefully you’ll never be caught off-guard.

7. Ticks carry disease-causing microbes

Tick-transmitted infections are more common these days than in past decades. With explosive increases in deer populations, extending even into semi-urban areas in the eastern and western U.S., the trend is for increasing abundance and geographic spread of deer ticks and Lone Star ticks; and scientists are finding an ever-increasing list of disease-causing microbes transmitted by these ticks: Lyme disease bacteria, Babesia protozoa, Anaplasma, Ehrlichia, and other rickettsia, even encephalitis-causing viruses, and possibly Bartonella bacteria. Back in the day, tick bites were more of an annoyance but now a bite is much more likely to make you sick.

6. Only deer ticks transmit Lyme disease bacteria

The only way to get Lyme disease is by being bitten by a deer tick or one of its “cousins” found around the world. Deer ticks also are known as blacklegged ticks in the U.S., sheep ticks in Europe, or Taiga ticks in Asia. Dog ticks, Lone star ticks and other types of ticks just don’t seem to be able to transmit Lyme disease. While that’s good news, it makes saving any tick that you find biting more important so you can identify it. Doing so may save a lot of unnecessary doctor visits and treatments.

5. For most tick-borne diseases, you have at least 24 hours to find and remove a feeding tick before it transmits an infection.  Powassan virus is an exception.

Even a quick daily tick check at bath or shower time can be helpful in finding and removing attached ticks before they can transmit an infection. You’ll probably want to check even more carefully if you know you’ve likely been exposed. Many of the disease-causing microbes transmitted by ticks need a “re-activation” period in the tick once it begins to feed. The germs eventually make their way into the tick’s salivary glands and the tick spits them into you while feeding. Some infections, especially viruses, move into the tick salivary glands faster than others. Lyme disease bacteria take at least 24 hours to invade the tick’s saliva.

4. Deer tick nymphs look like a poppy seed on your skin

And with about 1 out of 4 nymphal deer ticks carrying the Lyme disease spirochete and other nasty germs in the northeastern, mid-Atlantic, and upper mid-western U.S., it’s important to know what you’re really looking for. They’re easy to miss, their bites are generally painless, and they have a habit of climbing up (under clothing) and biting in hard-to-see places.

3. The easiest and safest way to remove a tick is with a pointy tweezer

Think of a tick as a little germ-filled balloon. Squeeze it too hard on its back end, and all the germs get pushed to the front end, which by the way, is attached to you by the tick’s straw-like mouthpart. Using really pointy tweezers, it’s possible to grab even the poppy-seed sized nymphs right down next to the skin. The next step is to simply pull the tick out like a splinter. Don’t worry if the mouthpart stays in your skin as long as you’ve got the rest of the tick by its head. Other tick removal methods, like a hot match, Vaseline, dish soap and cotton, or various little key-like devices don’t work as consistently as pointy tweezers on all types of ticks. Remember to save the tick and try to identify it (see # 6).

2. Clothing with built-in tick repellent is best for preventing tick bites

An easy way to avoid tick bites and disease is to wear clothing (shoes, socks, shorts or pants, and shirt) with permethrin tick repellent built-in. This strategy can be especially effective for protecting children. Dressing kids in tick repellent clothes everyday is a safe and easy way to keep ticks from biting and transmitting disease. Commercially-treated tick repellent clothes last through at least 70 washes, while using kits or sprays to treat your current outdoor wardrobe can last through 6 washes. Tick repellent on clothing, not skin is something everyone needs to know about to stay safe outdoors.
Top Ten Things Thumb
1. Tick bites and tick-borne diseases are completely preventable

There’s really only one way you get a tick-transmitted disease and that’s from a tick bite. Reducing tick abundance in your yard where you spend a lot of time, wearing tick repellent clothing everyday, treating pets every month with tick repellent spot-on products, getting into a habit of doing a quick body scan for attached poppy-seed sized or larger ticks, and pulling ticks off quickly and safely are all great actions for preventing tick bites. These days, ticks are more than just an annoyance. One bite can make you sick, even change your life! Remember these 10 things and you’ll stay safer.

The author is professor of public health entomology at the University of Rhode Island, and is director of the non-profit TickEncounter© Resource Center. His Think T.I.C.K Take ACTION! strategy and toolbox for tick-safe living is available on www.tickencounter.org.

HPV Vaccine

Imagine if you could protect your child against cancer. Turns out, you can – with the HPV vaccine.  To highlight this, the American Cancer Society recently released a video series of HPV-related cancer survivors sharing their stories. These individuals serve as a powerful reminder of the importance of the HPV vaccine and underscore the need for all parents to talk to their children’s doctors to learn more.

Human Papillomavirus (HPV) is a virus spread by close skin-to-skin contact. It is so common that nearly all sexually active adults have had at least one type of HPV at some point in their lifetime.  Around 80 million people in the US currently have HPV and 14 million people are newly infected each year. While most cases of HPV clear on their own, some can cause cancer.

A recent report showed that the current number of cancers caused by HPV is rising with an estimated 30,700 each year. Cervical cancer is the most common cancer caused by HPV in women, while in men; it most commonly leads to a type of head and neck cancer. Overall, HPV is thought to cause more than 90% of anal and cervical cancers, about 70% of vaginal and vulvar cancers, and more than 60% of penile cancers.

The HPV vaccine offers the best protection against these cancers when given at the recommended age – which is 2 doses if the patient starts the vaccine series before their 15th birthday and 3 doses if they start on or after their 15th birthday. Younger adolescents have a higher immune response so it’s best to vaccinate early. Young women can get the HPV vaccine through age 26 and young men can receive it through age 21 (age 26 in some cases).

Pediatric Flu Clinic

         Pediatric Flu Clinic

            Ages 5-18 Years

When:  Tuesday November 8, 2016

9AM-3PM

Where: Sandwich Public Health Nursing

270 Quaker Meetinghouse Road

East Sandwich, Ma. 02537

Cost:   There is no charge.  Please bring

insurance card, Mass Health,

Medicaid.

A parent or guardian must accompany the

child.

Flumist is NOT available this year.   Please call (508) 833-8020 with questions.

 

 

         

 

                                                                      


                                                                                 

 

 

Barnstable County Emergency Shelter System

 

Regional Shelter System

If you can’t leave the area and staying at home is not an option, then you can turn to the regional shelter system. Visit this map for an overview of the shelter system and the location of a shelter near you.

Important things to know about regional shelters

  1. You should look at going to a shelter the same way you would look at going on a trip. If you were planning to go away for a few days you would pack for the trip. The same goes for the shelter. You should arrive with at least three days worth of essentials. You wouldn’t leave your medications at home if you went on a trip, nor should you leave them behind when you go to a shelter.
  2. The stay at a shelter is not a vacation, and a shelter is not a hotel or a pharmacy. It is not a cruise ship but rather a lifeboat. The shelter provides a secure facility, a cot to sleep on, food and water, basic first aid, and functional assistance. Beyond that, it is up to you to pack and bring the essentials of your life including extra clothing, medications, and any medical equipment such as walkers, wheelchairs, and oxygen concentrators.
  3. If you live at home with the assistance of a caretaker, the caretaker must come to the shelter with you. If you have a visiting nurse, make sure you bring your medical supplies and let your nurse know which shelter you will be staying at.
  4. If you are bringing infants, babies, or toddlers to a shelter make sure you bring formula, food, diapers, wipes, changes of clothing, toys, and a “pack ‘n play” or portable crib and bedding.
  5. If you have a pet—a dog or cat, a bird perhaps—the Cape Cod Disaster Animal Response Team (CCDART) component of the shelter system supports the care of your pet(s) while you are in the shelter. Remember, you must check your pet(s) in first with CCDART before checking yourself into the human shelter. Please bring all your pet supplies to the shelter except for crates, which are provided by CCDART. You cannot sleep with your pet(s). Once your pet(s) are in the CCDART shelter, you will be able to see them during visiting hours, typically between 7:30 a.m. and 12:30 p.m. and 2 p.m. to 7 p.m.
  6. The reason every town on the Cape doesn’t have its own shelter is because of the expense and lack of volunteer resources to staff 15 separate shelters across the Cape. Volunteers deliver the vast majority of services provided at the six regional shelters. These volunteers work with groups including the American Red Cross (ARC), the Cape Cod Medical Reserve Corps (CCMRC), the Cape Cod Disaster Animal Response Team (CCDART), Community Emergency Response Teams (CERT), and AmeriCorps.

ADULT FLU CLINIC

The Sandwich Public Health Nursing Department will be offering flu shots to adults 19 years and older:

WHEN:  Wednesday, September 28, 2016            9A-12 noon       1P-4P

              Wednesday, October 12, 2016                 9A-12 noon       1P-4P           

 

Where:  Human Services Building

270 Quaker Meetinghouse Road

East Sandwich, Ma.

Charge: Most insurances will pay (exceptions are Humana and United).  Please bring ALL insurance cards including Medicare and Mass Health.  The cost for self pay is $15….exact amount appreciated.

Appointments are necessary.  Please call (508) 833-8020 to schedule.

Those adults who will be having surgery, chemotherapy, or radiation prior to the clinics should call the office to discuss an earlier appointment.

 

 

 

 

Powassan Virus

Ticks abound on Cape Cod and can cause a variety of diseases.  The black legged tick (Ixodes scapularis) can carry pathogens that cause the following diseases:   Anaplasmosis, Babesiosis, Borrelia mayonii, Borrelia miyamotoi, Lyme disease, and TickIdentificationPowassan virus.

Ehrlichiosis and Stari are transmitted to humans via the Lone star tick.

Powassan disease is relatively rare but is causing concern because of the severity of the disease  and the rapidity of transmission from tick to human…..minutes rather than hours.  Many people who are infected do not become ill, but those who do can develop encephalitis (inflammation of the brain) and meningitis (inflammation of the covering of the brain and spinal cord).  Other symptoms may include headache, fever, vomiting, confusion, weakness, speech difficulties, loss of coordination, and seizures.  The time from infected tick bite to symptoms can be anytime from one week to one month.  Diagnosis is based on symptoms and lab tests on blood and spinal fluid. This is a viral disease and the antibiotics normally used in tick borne illnesses are not as helpful.  Treatment is supportive and may include hospitalization, respiratory support, and intravenous fluids.

Protect yourself from tickbites.  Stay away from brush and high grass.  Use DEET products on skin and permethrin products on shoes and clothes.  Wear long pants tucked into socks.  Do a tick check as soon as you go indoors and put clothing in a hot dryer first, then wash.  Take a shower within two hours of being outdoors.

Remove ticks as soon as possible.giphy

How to remove a tick

  1. Use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible.
  2. Pull upward with steady, even pressure. Don’t twist or jerk the tick; this can cause the mouth-parts to break off and remain in the skin. If this happens, remove the mouth-parts with tweezers. If you are unable to remove the mouth easily with clean tweezers, leave it alone and let the skin heal.
  3. After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water.
  4. Dispose of a live tick by submersing it in alcohol, placing it in a sealed bag/container, wrapping it tightly in tape, or flushing it down the toilet. Never crush a tick with your fingers.
	clipart image of a tickAvoid folklore remedies such as “painting” the tick with nail polish or petroleum jelly, or using heat to make the tick detach from the skin. Your goal is to remove the tick as quickly as possible–not waiting for it to detach.

 

 

Follow-up

If you develop a rash or fever or above mentioned symptoms within one to 6 weeks after removing a tick, see your doctor. Be sure to tell the doctor about your recent tick bite, when the bite occurred, and where you most likely acquired the tick.