What You Can Do To Prepare for Covid-19

There are some basic interventions we can all do to mitigate our chances of contracting the Corona virus.

  1. Wash your hands frequently, do not touch your face until you wash your hands (Most people touch their faces 23 times a minute!)
  2. Sneeze or cough into your elbow or tissue.  Discard the tissue into a receptacle.
  3. Stay Home If You Are Sick

You can prepare your home as well.  Stock up on food supplies important to you such as frozen fruit, frozen vegetables, canned items, juices, tea, coffee, treats, pasta, rice, cereal, soup etc.  Remember, you may not be able to go to the supermarket for several weeks!  Also, do you have enough personal items, toothpaste, and shampoo?

Be sure you have adequate medications in your house/apartment so you do not have to go out if we find ourselves dealing with this virus.  (4 weeks supply would be ideal).  Also, if you use Tylenol, Ibuprofen, saline drops, etc, check your supply.

Check your basic items such as toilet paper, tissues, cleaning supplies (such as Lysol or Clorox wipes or spray).


West Nile Virus and Eastern Equine Encephalitis

You have probably heard that positive mosquito samples for West Nile Virus and Eastern Equine Encephalitis have been found in South Shore communities and on the Cape. In fact, a man from Plymouth County is currently hospitalized with Eastern Equine Encephalitis. Both diseases can present with symptoms of fever, headache, stiff neck, and flu like symptoms and, in severe cases, can quickly progress to encephalitis (inflammation of the brain). You should take precautions to protect yourself from mosquito bites:
1) Plan to decrease unnecessary outdoor activities from dusk to dawn especially in critical areas.
2) Apply insect repellent when outdoors. Use an EPA registered ingredient (Deet, picaridin, oil of lemon eucalyptus, or IR3535 on your skin, permethrin on your clothes). Read the labels carefully for age limits and how to apply.
3) Wear long sleeved shirts, pants and socks while outdoors.
4) Repair screens to keep mosquitoes out of house.
5) Drain standing water around your house.


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.

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.




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.

Heart Health

Every 34 seconds someone in the United States has a heart attack.  When blood, with its oxygen supply, is either reduced or completely cutoff from the heart muscle, cells die and a heart attack occurs.  There are ways to modify your chance of having a heart attack. /What-Are-My-Risks-For-Getting-Heart-Disease-Infographic_UCM_443749_SubHomePage.jsp

Heart disease is the #1 killer of American women. Women’s symptoms may be different from men’s.

  • Neck, jaw, shoulder, upper back or abdominal discomfort
  • Shortness of breath
  • Right arm pain
  • Nausea or vomiting
  • Sweating
  • Light headedness or dizziness
  • Unusual fatigue

These symptoms can be more subtle than the obvious crushing chest pain often associated with heart attacks.  Women often tend to overlook symptoms.  This American Heart Association video is humorous but has some great take home points.

Diet, exercise, and stress reduction are important factors in heart health. Recommendations include  eating more fish, whole grains, and fruits and vegetables and avoiding trans fats, as well as limiting saturated fats, salt and sugar.  The Mediterranean Diet and The Harvard School of Public Health Healthy Eating Pyramid are two of the diets that promote heart health.                                 http://www.hsph.harvard.edu/nutritionsource/pyramid-questions/

Additional information can be found at:






PBS Documentary-September 10th

Diseases that were recently considered eradicated (measles, chickenpox, polio, whooping cough, mumps) are now reemerging as more families are choosing not to immunize their children.  PBS’s NOVA is airing a documentary  “Vaccines-Calling the Shots” on September 10th at 9 P.M.  Information from researchers, parents, and the tracking of worldwide epidemics will be presented.  

Ebola Virus

Update 9/3/2014

Dr. Tom Frieden, the director of the Centers for Disease Control, stated that there was a small window of opportunity to stop the Ebola epidemic.  Nearly 40% of the cases have occurred during the past 3 weeks with healthcare facilities filled beyond capacity, a devastating shortage of healthcare workers and medical supplies, and now a shortage of food.  Currently, the World Health Organization believes that the count of 3,069 cases and 1,552 deaths is an under count.

Research continues on the experimental monoclonal antibody, ZMapp, which has been used on a handful of patients.  In a Nature study, 18 monkeys infected with the virus and then given ZMapp survived.

Update 8/20/2014

The number of Ebola cases continues to increase.  The World Health Organization http://www.who.int/csr/don/2014_08_20_ebola/en/  states that between August 17th and August 18th there were 221 new cases and 106 deaths.  That brings the total number of cases to 2473 and the deaths to 1350.  Most of the new cases were attributed to lack of appropriate infection prevention when in contact with the bodily fluids of an infected patient. 

Update 8/7/2014

While the 2 American patients at Emory University seem to be improving, the overall situation in Africa is worsening, prompting the Centers for Disease Control to move its Emergency Operations Center to its highest activation level.  This may be due, in part, to the emergence of several Ebola cases in Lagos, Nigeria, a city of 20 million people.  The World Health Organization updated the Ebola numbers to 1,711 cases with 932 deaths.  

The experimental drug, ZMapp, a mixture of 3 antibodies which was given to the American medical workers in Liberia, is now part of a worldwide discussion about the ethics of giving experimental drugs, not approved by any government agencies, to critically ill patients.  To complicate the issue further, if the decision were made to give the limited number of experimental drugs available, which patients in which countries would receive them?  The World Health Organization is convening a group of ethicists to discuss these very issues.

                                                                                                                                                   Update 8/1/2014

The CDC issued a Level 3 travel warning yesterday for non essential travel to Liberia, Guinea, and Sierra Leone.  The number of cases of Ebola Virus continues to increase and the hospitals are understaffed and overwhelmed with critically ill patients.

Yesterday, the United States Centers for Disease Control and Prevention issued an advisory for US health care workers to consider Ebola virus, and possible isolation, for those patients presenting with viral symptoms and returning from affected countries within the past 21 days.Ebola_Virus

Ebola virus is an acute illness spread through blood and body fluids with an incubation period from 2-21 days.  Symptoms include headache, muscle pain, intense weakness, nausea, vomiting, impaired kidney and liver function, and in some cases, internal and external bleeding.  The disease so far has infected over 1000 people in West Africa and killed more than 660.  The fruit bat is considered a likely reservoir and infected animals, which are handled or eaten by locals, the way the virus moves from animals to humans.  Humans then contract the disease by coming in contact with bodily fluids such as blood, sweat, urine, breast milk, vomit, and diarrhea of persons who have already contracted the disease.


The disease is spreading quickly in Sierra Leone, Liberia, and Guinea because of multiple issues:  lack of personal protective equipment such as masks, gloves, and gowns;  small numbers of staff and isolation-wardisolation units; and the beliefs of some locals that the medical professionals themselves are spreading the disease.

While several vaccines are being tested, none are on the market at this time and intravenous fluids and fever medications are the only treatment options.


WARNING: Pure Powdered Caffeine

The FDA is warning people not to use pure powdered caffeine after the death of a teenager.  The drug is easily bought on the internet and just one teaspoon of the powder is equal to 25 cups of coffee.  This stimulant can cause irregular heartbeat, nausea, vomiting, seizures, and death.

  • The FDA wants to know about adverse events associated with powdered pure caffeine and other highly caffeinated products. You or your health care provider can help by reporting these adverse events to FDA in the following ways:
  • By phone at 240-402-2405
  • By email at CAERS@cfsan.fda.gov