Our health department offers various links and documents based on current research of some of public health's biggest issue. Take some time review the research findings below to better understand how these issues impact our county.
MRSA and Staph Infections
Staphylococcus aureus, also called “staph”, is a common bacteria that can be found on the skin or in the nose of a healthy person. Staph bacteria can also cause the most common types of skin infections, including pimples and boils. MRSA (methicillin-resistant Staphylococcus aureus) is a type of staph infection that is resistant to certain antibiotics. MRSA can cause serious skin and soft tissue infections. The links below provide more detailed information about the prevention and control of MRSA and other staph infections. For additional information, please call 330-493-9928, ext. 287.
Influenza is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness, and at times can lead to death. Every year on average in the United States 5% to 20% of the population gets the flu, more than 200,000 people are hospitalized from flu complications and about 36,000 people die from the flu. Persons usually become infected by touching something an infected person has touched and then touch their mouth, nose, or eyes.
Presently, there are two confirmed cases of influenza documented in Stark County. So, it is time for everyone to exercise some personal hygiene practices so you don’t catch the flu. One of the most important things that a person can do to keep from getting sick is to wash your hands. It is most important to wash your hands:
Upper Respiratory Infections
Influenza is a contagious respiratory disease that can be prevented by immunization. It is caused by a virus that attacks the nose, throat, and lungs, but is different from a cold and the "stomach flu." Influenza symptoms come quickly in the form of fever, headache, tiredness, dry cough, sore throat, nasal congestion, and body aches. These symptoms can be severe and wipe a person out for a number of days. The best way to avoid influenza is to get a flu shot.
Influenza and the Common Cold
Information about how to protect yourself from the cold and flu.
Handwashing
Handwashing is the single most effective method of disease prevention. Please click on any of the links below to download a handwashing poster.
A pandemic is when a disease affects the entire world. A pandemic occurs when a disease spreads rapidly, affecting most countries and regions of the world Influenza pandemics have occurred periodically throughout human history – including a major pandemic in 1918, and smaller pandemics in 1957 and 1968. The symptoms of pandemic influenza are similar to those of ordinary flu but are usually more severe.
Pandemic Influenza & Other Resources
Below is a link to a study that took place in China published in The BMJ. The BMJ is a weekly peer-reviewed medical journal. In this study they got a bunch of patients who had already been sick with a respiratory illness, sent them home, and divided them into two groups: mask or no mask. The mask group had to wear a mask whenever someone else was in the room, while the no mask group didn’t need to do anything (although some did wear masks on their own). Then they counted the number of household members who got either a clinical respiratory illness (CRI), influenza-like illness (ILI), or lab-confirmed respiratory virus from each group and compared them. They found a statistically significant 78% reduction in risk of CRI associated with wearing a mask compared to not wearing a mask (RR=0.22, 95% CI 0.06 to 0.86).
Below is a link to a study solely comparing different surgical masks measuring inert particles and live aerosolized virus activity both in front of and behind the mask. Per the abstract they observed an average 6-fold decrease in aerosolized influenza activity associated with mask use.
Below is a link to a meta-analysis published in the journal, Influenza and Other Respiratory Viruses (IRV). In the United Kingdom, 17 studies looked at masks and respirators role in reducing influenza transmission. It seems pretty equivocal for the most part, but there is one randomized controlled trial they use that found a significant reduction in upper respiratory infection, influenza-like illness (ILI), and laboratory confirmed influenza when using a mask and hand sanitizer compared to solely education. Masks were also associated with a reduction in Severe Acute Respiratory Syndrome (SARS) transmission in the majority of the studies they pulled.
Annual pertussis incidence tends to spike during the holiday season and remain elevated throughout the winter months. Pertussis incidence as a whole has increased at a moderate pace since 1995, even accounting for the introduction of the Tdap vaccine. A crucial preventive action against pertussis that providers can recommend is uptake of the Tdap vaccine during every pregnancy. In October of 2012 the Advisory Committee on Immunization Practices (ACIP) recommended that a dose of Tdap be administered during each pregnancy (regardless of previous Tdap history), ideally during the early part of gestational weeks 27-36. This recommendation is supported by the American College of Obstetricians and Gynecologists (ACOG) and the American College of Nurses-Midwives (ACNM).
Some patients may have questions about the efficacy or timing of the vaccine. Patients should be informed that it is crucial they are vaccinated while pregnant so that antibodies can be formed and passed on to the child; postpartum vaccination does not confer immunity to the child, who is at further risk for transmission. The timing is also important due to the waning effectiveness of the Tdap vaccine over time; 27-36 gestational weeks is considered the sweet spot for vaccination. A case-control study performed by the CDC examining vaccine efficacy found that administration of the Tdap during the third trimester was 78% effective at preventing disease, and even more effective at preventing hospitalization and death. Emphasis should be placed on the vulnerability of infants under the age of 2 months, who have not received any pertussis-containing vaccinations and are at the highest risk for disease, serious side effects, and death due to pertussis.
Breastfeeding is not a contraindication for the Tdap vaccine and recent mothers who have received the vaccine should be encouraged to breastfeed, as additional protection can be conferred through breast milk. The pertussis vaccine can be given alongside the seasonal influenza vaccine, which can be administered during any stage of pregnancy. With pertussis cases rising in Stark County, it is vital that providers offer important preventive actions to protect the most vulnerable members of our community.
This article will be published in the Stark County Medical Society News Journal Spring 2019 edition. Check out the following list of publications if you are interested in research, immunization recommendations, and other references specific to preventing whooping cough in infants:
The Ohio Policy Evaluation Network (OPEN) is collaboration among the Ohio State University, the University of Cincinnati, Case Western Reserve University, and Cincinnati Children's Hospital. Dr. Ayaz Hyder who, together with Dr. Alison Norris, is leading a project at Ohio State's College of Public Health concerning the complex relationships between access to reproductive health services, the social determinants of health, and birth outcomes. OPEN conducts rigorous, impactful, and forward-thinking social science research on the reproductive health of Ohioans. Ohio continues to struggle with high levels and significant disparities in infant mortality, premature births, maternal morbidity, unintended pregnancies, and health care coverage and access. While it is widely acknowledged that poor outcomes result from a range of upstream factors (i.e. social determinants of health), the role of complex pathways among those factors is not well-understood. Sherry Smith MS, BSN, RN Director of Nursing Services in Stark County has been invited to participate in this statewide research activity regarding the role of reproductive health, planning, and care on maternal and infant health outcomes. The purpose of our project is to explore these complex relationships and bring attention to the experiences of Ohioans, particularly those who are often marginalized or forgotten in policy discourse. This participation includes three Group Model Building (GMB) sessions in Columbus, Ohio (beginning in February 2019) with 15-20 other stakeholders across Ohio. Our goal is to outline an estimable model that captures the core structure of the system, and to discuss policy options by taking an innovative and inclusive approach that focuses on the interconnections among social, economic, and other structural determinants of health.
So far, two full day workshops have been completed on 02/21/19 & 03/29/19. Below is a summary of the research methods we are using in this project. Also, there are links to three open-source peer-reviewed scientific articles for further reading (if you want to read more) on these methods and their application in public health and healthcare.
A primer on the research methodology
The Problem Statement We Developed
How do social determinants of health, biases, attitudes, cultural norms, laws, and policies in urban Ohio impact access to and use of reproductive and other health services (e.g. contraception, abortion, prenatal care, birth care), pregnancy, and maternal and child health?
What is the overall approach to solving this problem?
The above problem statement is a complex problem because it involves interactions and feedbacks between multiple determinants of health operating at multiple levels of organization. Using a complex systems approach, we can embrace the complexity of such problems, take a broad look, and use a learning process that slowly builds upon itself. Our overall approach to solving this problem involves a set of methods called Community Based System Dynamics (CBSD). If you are familiar with Community Based Participatory Research (CBPR), then you may think of CBSD as CBPR with a strong emphasis on computational modeling and policy simulation. The CBSD approach consists of three phases: 1) group model building workshops, 2) system dynamics (SD) modeling and 3) implementation and dissemination.
What is Group Model Building?
Group model building (GMB) relies on the experts in the research. It is all the expert participants that provide insights to come to consensus about key stakeholders, important factors, and policy options for the complex problem that will lead to the co-creation of a model of the reproductive health system in Ohio. Group model building is iterative, social, and oriented toward action, not just information gathering. The contributions through shared decision-making and co-ownership of the final model will enable us to envision and design a new future for reproductive health in Ohio.
What is a System Dynamics (SD) Model?
A System Dynamics Model is a type of computer simulation model that describes the complex interactions between many factors that are associated with explaining patterns in the outcome(s) of interest based on the problem. The SD Model is conceptually developed via Group Model Building and then iterated upon by GMB participants for the purposes of validation, usability and practical implementation in real-world settings. The development of such a complex model through a participatory modeling approach allows participants to reflect on their roles within these systems and their responsibilities to them. In our project, the SD model will allow us to carefully consider multiple perspectives in finding solutions to the set of complex problems in reproductive health in Ohio.
Further reading
