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A PDF version of our 2013 Winter Newsletter is now available.
-- Current Flu Seasons Consist of Resurgence in H1N1 --
A recent Morbidity and Mortality Weekly Report (MMWR) from the Centers for Disease Control and Prevention reported elevated influenza activity in certain parts of the United States. This activity is projected to last several more weeks. A unique aspect of the CDC report is the predominant role of H1N1, commonly known as the swine flu, in this year’s influenza season. Although the flu season is close to over, the CDC urges anyone who has not received the flu shot and is approved by their doctor to get one to visit their local pharmacy to receive the shot. If you received a flu shot at the start of the flu season, you do not need a repeat vaccination.
Persons aged 18-64 are particularly susceptible to this year’s flu, which is a population group with a low vaccination rate. The severity of this year’s flu season is evident when comparing statistics from last year.
Despite the current prevalence of the illness, H1N1 is not at the same epidemic levels it was back in 2009 which included 527 deaths. Locally, the District of Columbia has seen a recent flu surge with 90 percent of the cases identified as H1N1. Virginia and Maryland also are experiencing wide-spread flu in the region.
H1N1 symptoms are similar to the regular seasonal flu. Consult with a medical professional if you have flu symptoms. Visit flu.gov for continued updates on this year’s flu season.
February 13, 2014
-- Hurricane Sandy & Disaster Mental Health Risk Surveillance --
A recent NCDMPH webinar featured Learning in Disaster Health: A Continuing Education Workshop poster winners which included the poster "Integration and Performance of Mental Health Triage Core Competencies in Los Angeles County Disaster Exercise" by Dr. Merrit D. Schrieber and Sandra Shields. Dr. Schrieber et al recently were published in the Annals of Emergency Medicine for their paper, "Snapshot from Superstorm Sandy: American Red Cross Mental Health Risk Surveillance in Lower New York State."
The study assessed mental health impact of Hurricane Sandy in New York State. American Red Cross volunteers used PsySTART, a mental health triage tool, to record survivors' mental health risk factors immediately after Hurricane Sandy. Out of a sample of 18, 823, the study reported 17,979 risk factors. A unique aspect of this study is that it emphasized the psychosocial effects of disasters beyond the adisaster impact site. Survivors surveyed displayed mental health risk factors even if they were located outside the flood or damage zones.
NCDMPH shares the researchers' interest in improving disaster mental health outcomes through the production of psychosocial-focused resources:
The recent report also highlighted the utility of acquiring mental health data from areas beyond the disaster impact site. With this data, responders can justify extending disaster mental health triage in areas surrounding the severest-hit regions.
The National Center applauds the efforts of the American Red Cross and the report authors. By supporting the mental health of disaster-impacted communities, responders contribute to a nation of resiliency.
February 7, 2014
-- CDC Releases 2013-2014 National Snapshot of Public Health Preparedness --
The Centers for Disease Control and Prevention recently released the 2013-2014 National Snapshot of Public Health Preparedness which highlights CDC's preparedness priorities as well as features national and regional preparedness fact sheets. In 2012 alone, 11 storms, including Superstorm Sandy, surpassed $1 billion in damages. Despite these challenges, "state public health staff with incident management lead roles reported for immediate duty an average of nine minutes faster."
To achieve greatest health impact in the current fiscal climate, the CDC focuses on three key priorities that are used as guideposts for future preparedness efforts. The following priorities are guided by the National Strategic Plan for Public Health Preparedness and Response:
The second priority is partially accomplished via "improving the workforce's ability to respond to emergencies by conducting training exercises so staff can practice response skills." NCDMPH supports this priority via providing accredited online training materials on pediatric disaster health as well as resources for educators and trainers.
The report also emphasized the accomplishments of the Preparedness and Emergency Response Learning Centers (PERLCS) which deliver competency-based preparedness training. By 2012, PERLCs reached 210,000 learners and helped communities prepare, respond, and recover from disasters including Superstorm Sandy, the Boston marathon bombing, and tornadoes in Oklahoma and Alabama.
The National Center applauds CDC’s accomplishments and goals featured in the report. NCDMPH will continue to contribute to national public health preparedness by providing training and preparedness resources and conducting research.
January 28th, 2014
-- Paper reports on disaster preparedness among older adults in the US --
The American Journal of Public Health recently published a paper from the University of Iowa, School of Public Health, regarding the natural disaster preparedness levels among older US adults. "Preparedness for Natural Disasters among US Adults: A Nationwide Survey" measured these preparedness levels by interviewing subjects on a set of factors that may adversely affect their safety in a disaster.
An overall preparedness score was calculated by analyzing data on demographic characteristics, disability or functional limitations, personal preparedness, and/or familiarity with preparedness concepts. Led by MPH student Dr. Tala M. Al-Rousan, the study found that preparedness in the older population is negatively affected by factors including age, physical disability, income, and lower educational attainment. The research revealed an lack of preparedness in the senior population with only 1/3 of the population engaged in any preparedness materials.
Dr. Al-Rousan recommends the following preparedness materials for both older adults and response workers:
More resources for disaster preparedness can be found in the National Center's Resources for Core Competencies in Disaster Health page.
January 16th, 2014
-- West Virginia Chemical Spill: A Public Health Crisis --
The Centers for Disease Control and Prevention recently created a webpage compiling information on MCHM, the chemical that recently spilled in the Elk River in West Virginia. In addition, MCHM has now been assigned a Chemical Abstracts Service Registry Number (CASRN) of 34885-03-5.
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On the evening of January 9th, over 30,000 residents of West Virginia were devastated by a catastrophic chemical leak of of 4-Methylcyclohexanemethanol (CASRN: 34885-03-5; "MCHM"; "crude MCHM" or "4-Methylcyclohexane methanonal") into the Elk River. MCHM, a chemical known to cause skin and eye irritations as well as breathing problems and vomiting, is used to clean coal.
The event posed a challenge to disaster responders who had to learn about the properties of MCHM during their response. Due to a lack of information on MCHM, the Centers for Disease Control and Prevention deferred to their guideline of one part MCHM per million parts water. For over five days, residents and facilities in nine counties could not use tap water beyond flushing the toilet. While the immediate crisis is close to over, there are still significant health effects of water loss and chemical exposure. Secretary of the West Virginia Department of Health and Human Resources reported that 14 people have been admitted to area hospitals due to exposure and 231 people were treated and released.
Extended water loss can cause a variety of severe health effects. A Morbidity and Mortality Report from 2011 reported on the effects of water loss in Alabama after pipes burst in January 2010. Much like how West Virginia was not prepared for the chemical leak, Alabama did not have a significant plan in place to cope with burst pipes. Follow-up research in Alabama revealed health issues that included acute gastrointestinal illness, acute respiratory illness, and reports of skin and eye irritation.
The National Center for Disaster Medicine and Public Health extends its gratitude to the disaster health workforce working tirelessly to serve the communities affected by the spill. For more information about chemical exposure, visit the National Library of Medicine’s Toxicology Data Network.
January 8th, 2014
-- Two Centers of USUHS Collaborate to Produce Curriculum Recommendations --
The National Center for Disaster Medicine and Public Health and the Center for the Study of Traumatic Stress, two research institutes with the Uniformed Services University of the Health Sciences, recently collaborated on a set of curriculum recommendations for disaster health professionals. "Curriculum Recommendations for Disaster Health Professionals: Disaster Behavioral Health" is the second in a series of disaster health curriculum recommendations from NCDMPH. The first set of curriculum recommendations from NCDMPH were based on the pediatric population.
These recommendations provide resources on planning education and training activities on behavioral health factors in disasters to those working with health professionals. As with many NCDMPH products, these recommendations align with the disaster health core competencies outlined in the Disaster Medicine and Public Health Preparedness article "Core Competencies for Disaster Medicine and Public Health."
This resource can help address the Nation's need of a health workforce that is sensitive to disaster behavioral health. These recommendations feature the following topics:
The curriculum recommendations are not prescriptive but rather adaptable to the needs and circumstances of the educator. Additionally, the recommendations can be tailored to each educator's needs when they create trainings.
The National Center looks forward to future partnerships and collaborations with CSTS. Congratulations to authors Dr. Brian Flynn and Dr. Joshua Morganstein for creating this comprehensive and useful resource.
January 2nd, 2014
-- Centers for Medicare & Medicaid Services Proposes Emergency Preparedness Requirement --
The Centers for Medicare & Medicaid Services recently released a proposed rule suggesting national emergency preparedness requirements for Medicare and Medicaid participating providers. CMS research suggests that providers' current disaster preparedness efforts are not comprehensive and lack coordination.
The proposed rules address current gaps in providers' plans and also ensure that these providers coordinate with federal, state, tribal, and local emergency preparedness systems. CMS compiled the requirements by reviewing guidance from CDC, FDA, HRSA, ASPR, and other federal, state, and private agencies.
In order to create a comprehensive preparedness program, CMS created a list of four benchmark standards for Medicare and Medicaid providers:
The National Center will continue to track the status of these proposed rules and looks forward to their possible contribution to the resiliency of the nation. The Centers for Medicare & Medicaid Services' proposal is open for commentary until February 25th, 2014.