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Taking Care of Your Feet

By Jane Jones, RN
Douglas County Health Department

footprintsDo your feet hurt?  If you answered “yes” then you are among the 75% of Americans who have foot problems at some point in their lives.

The human foot is designed to be strong, flexible, and functional.  Each foot has 26 bones, 33 joints, and more than 100 muscles, tendons, and ligaments, as well as many blood vessels and nerves.  These all work together to get us from place to place each day.

 An average day of walking puts a force equal to several tons on the feet.  No wonder then, that our feet are more likely to be injured than any other body part.  And ailments of the feet are among our most common health problems.  Some of these include:

These problems, as well as others of the feet, can decrease the quality of life for many.  Keep in mind too, that there is an important relationship between overall body health and healthy feet.  Sometimes other diseases that affect the whole body are first found in the feet.  These could include diabetes and arthritis. The American Podiatric Medical Association suggests the following tips to keep your feet healthy:

If you are diabetic it is important to have your feet thoroughly examined at least once a year by a health professional.

By paying attention to your feet and taking care of them, you can be rewarded by a lifetime of service.

More information about foot health can be found at www.apma.org.

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Cervical Cancer

By Jane Jones, RN
Douglas County Health Department

There has been much in the news lately regarding the new vaccine, Gardasil, for cervical cancer prevention. But what is cervical cancer?

Cervical cancer is a cancer that affects the cervix, or the neck of the uterus.  The cervix is about 1 inch long, has a rounded cone-shape, and part of it extends into the uterus. 

Different strains of the human papillomavirus (HPV), a sexually transmitted infection, are responsible for most cases of cervical cancer. Usually, when exposed to HPV, a woman’s immune system prevents the virus from causing harm.  However, in some women, the virus can lie dormant for several years. Over time it can change some of the cervical cells into cancer cells. Half of cervical cancer cases occur between the ages of 35 and 55.  Every year more than 10,000 women in the US are diagnosed with invasive cervical cancer and nearly 4000 die from it. However, Pap test screening has greatly decreased the death rate over the last 40 years.

Signs and symptoms of cervical cancer usually do not appear at an early stage, but as the cancer progresses.  These signs may include vaginal bleeding after intercourse, between periods, or after menopause; foul smelling watery, bloody vaginal discharge; and pelvic pain or pain during intercourse.

Certain factors can increase the risk of getting cervical cancer such as smoking, having many sexual partners, having sex before age 18, having other sexually transmitted diseases, and having a weak immune system because of other health conditions.

Pap tests are important because they allow for early detection of cervical cancer before symptoms appear.  Currently, it is recommended to have the first Pap test within 3 years of beginning sex, or age 21, whichever comes first.  Women ages 21-29 should have a yearly Pap test, and those aged 30-69 should be tested every 2 years if there have been 3 normal tests in a row.  After age 70 a woman can stop having Pap tests if there have been 3 or more normal tests in a row and no abnormal tests within 10 years.  However, if a woman is at high risk for cervical cancer she will need more frequent testing.  Women should discuss the frequency of testing with their doctor.  Even if a hysterectomy has been performed, pelvic exams will probably still need to be done.

To prevent contracting HPV which can cause cervical cancer, condoms should be used every time a woman has sex with a non-monogamous partner.  HPV spreads through skin-to-skin contact.  Other ways to help prevent cervical cancer are to not have sex until at least age 18, have fewer sexual partners, and do not smoke. Waiting to have sex until marriage is not a bad idea either.  The vaccine, Gardasil, is now available.  Girls as young as 9 can begin receiving the series of 3 injections. This vaccine could prevent up to 70% of cervical cancer cases, but it can’t prevent infection from every virus that causes cervical cancer. Routine Pap tests remain important to screen for early detection of cervical cancer.

If a woman is found to have cervical cancer, treatment options will depend upon the stage of the cancer. The pre-invasive stage means that the cancer only affects the outer lining of the cervix.  Invasive stage means that the cancer has spread to deeper tissue of the cervix or to other parts of the body. These treatment options can include hysterectomy, radiation, and chemotherapy, but other options may also be available.

As with most cancers, early detection leads to a better survival outcome.  The American Cancer Society says that with appropriate treatment all women with pre-invasive cervical cancer can be cured.  Also, according to the ACS, the 5 year survival rate for those with early invasive cervical cancer is over 90% with appropriate treatment.

For more information visit www.mayoclinic.org or www.cancer.org.

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Gardasil

By Susan Hays RN
Douglas County Health Department

We are bombarded with information. The nightly television news is complete with a crawl along the bottom of the screen that feeds snippets of information. Newspapers have front page blurbs that give samples of what is found in their daily publications. Computer home pages include news bites of the day. And radio stations provide information in one or two minute spots between musical programming or talk radio.

This is a good way to introduce or scratch the surface of a particular issue. The problem with this type of information is it can be easily taken out of context. It doesn’t always tell the whole story. And it can help us to be uninformed consumers.

Case in point. There is a new vaccine that has been getting a lot of press lately. It is called Gardasil and it helps protect against diseases caused by Human Papillomavirus. Specifically those diseases are cervical cancer, abnormal and precancerous cervical lesions, abnormal and precancerous vaginal lesions, abnormal and precancerous vulvar lesions and genital warts. This is the first vaccine I’m aware of that helps prevent cancer. Pretty amazing really.

Amazing until you read that this particular vaccine trial resulted in 17 deaths. Why in the world would the FDA release a vaccine that was responsible for 17 deaths? To answer that question let’s look at the clinical studies.

gardasil21,464 male and female subjects participated in clinical studies for the drug Gardasil. The participants were placed in two different groups. One group received the actual medication Gardasil and one group received a placebo. A placebo is an inactive harmless substance that is used in drug trials as a control group. These studies took place over 2-4 years.

Of the 17 deaths reported in the vaccine trial group, the most common cause of death was motor vehicle accident. The second most common cause of death was overdose or suicide. In fact, all deaths reported were consistent with events expected in healthy adolescent and adult populations. Almost half of the individuals that died received the placebo. In other words they didn’t even get the vaccine.

Don’t get me wrong. There are possible side effects with the Gardasil vaccine as with any medication. The most common side effects experienced during the clinical study was pain, swelling, redness or itching at the injection site or fever. But let me reiterate that 17 individuals did not die as a direct result of this vaccine.

The other pressing issue surrounding Gardasil is this. Some people feel that by utilizing this vaccine they are encouraging sexual activity in their children. When in reality what the vaccine is doing is giving our children another life preserver.

It’s estimated that approximately 50% of the population is infected with HPV. Not everyone has symptoms or knows they are infected. Most of our children will grow up and eventually have a sexual relationship. There are no guarantees that relationship will be with an individual that does not have HPV.

Giving the vaccine will provide some protection and decrease the chance that our daughters will end up with HPV, abnormal and precancerous cervical, vaginal and vulvar lesions, and/or cervical cancer. This is not an issue of encouraging sexual behavior. This is an issue of encouraging prevention. This is an issue of protecting the health of our daughters. And this is an issue of teaching our children respect and responsibility for their bodies.

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Heart –Healthy Eating

By Jane Jones, RN
Douglas County Health Department

We read about it and hear about it more and more, but what exactly does it mean to eat heart-healthy? And why is it important?

pepper in shape of heartFoods that are high in saturated fat, trans fat, and cholesterol raise the cholesterol level in your blood. High cholesterol is one of the major risk factors for heart disease and stroke. In the United States the number 1 killer is heart disease and stroke is number 3. Diabetes is number 5 and is closely related to heart disease and stroke.

Although there are many factors that can affect your risk of heart disease and stroke, eating a diet that is low in cholesterol, trans fat, and saturated fat can help lower your risk. The following are some tips that the American Heart Association suggests to help you eat heart-healthy.

Choose foods naturally low in saturated fat and cholesterol. Fruits and vegetables fall in this category. Try to have 5 or more servings a day.

Choose fat-free or low-fat products. For instance, instead of butter or margarine, try butter flavored granules. Instead of high fat cookies and crackers, try low calorie cookies and fat free or low fat crackers. Instead of devil's food cake, try angel food cake.

Use lean meats. For example, instead of tuna packed in oil, use tuna packed in water. Try baked chicken or fish instead of deep fat fried. Use fat-free or low-fat hot dogs and lunch meats instead of the regular processed meat kind. Instead of hamburger and fries, try a grilled chicken sandwich, a veggie burger, or lean roast beef.

Change to fat-free milk. If you currently drink whole milk, change to 2%. Then gradually switch down to 1% and fat-free.

Try fat-free and low-fat cheeses and other dairy products. This would include regular cheeses as well as sour cream and yogurt. There are fat-free or low-fat versions of all of these.

Fat-free and low-fat puddings and frozen desserts can be substituted for regular versions. Frozen fruit bars, frozen fat-free yogurt, fat-free ice cream are all good alternatives for ice cream and pudding.

heart healty comicLow-fat breads, cereals, and pastas can be enjoyed. Instead of doughnuts, pastries, muffins, or biscuits, try substituting a bagel, hot cereal, an English muffin, or a corn tortilla. High fiber foods such as wheat pasta or multi-grain breads are also good choices to help reduce cholesterol.

Watch your intake of foods that contain a lot of cholesterol. Foods from animals are high in cholesterol. Foods from plants do not have cholesterol. Try to limit your daily intake of cholesterol to less than 300 mg. For example, one large, whole egg has about 213 mg of cholesterol, but egg whites have no cholesterol. You can use 2 egg whites plus 2 teaspoons of unsaturated oil in place of 1 whole egg in cooking.

Use less fat in cooking. Choose fats that have 2 grams or less saturated fat per tablespoon. Examples include liquid or tub margarine, and canola, olive, corn, safflower, and soybean oil. Bake, broil, grill, poach, stem, or boil foods instead of frying. Try not to use gravies and sauces. Instead, use low-fat versions.

Read food labels. These can help you make better choices. Serving size, calories, daily value, saturated fat, total fat, cholesterol, sodium, total carbohydrate, dietary fiber, protein, and vitamins and minerals are all found on the nutrition label.

Remember that the way to heart-healthy eating success is balance. If you eat something with high-saturated fat for one course, balance it with a lower-fat food for another course. Eat smaller portions. Just because a food is low-fat doesn't mean that you can eat more of it. Learn to read nutrition labels and become informed on acceptable levels of cholesterol, fats, sodium, and so forth. Find out what your cholesterol and blood sugars levels are.

For more information log onto www.diabetes.org or www.americanheart.org.

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Don't be a squirrel

By Kim Hunter
Douglas County Health Department

The great thing about not having cable television is that you are constantly exposed to the great art of storytelling. Almost daily, someone asks if you saw such and such on t.v. and when they remember that you couldn't possibly have done so, they proceed to tell you the story. For at least five minutes, you are taken to this wonderful world of the storyteller. And since I don't want you left out of this especially good story, let me pass on in a similar tradition my favorite of last week.

Smoking SquirrelI was running errands over lunch hour in Tuscola and bumped into a gentleman whom I know from my smoking cessation class. After a pleasantry or two, he proceeded to tell me all about the squirrels. Yes, squirrels. It seems that a television program highlighted the plight of some squirrels who have been gorging themselves on leftover junk food in public parks and who eat cigarette butts. So the squirrels are fat, unable to fend for themselves and addicted to nicotine. Now, aside for the somewhat amusing picture of a chunky rodent sipping a cup of joe, chowing on a donut and blowing smoke rings, this seems to say something important. Yes, indeed. Even squirrels can't kick the habit.

Please allow me to bore you briefly with statistics in order to get to the point. According to the Illinois County Behavioral Risk Survey from 2001 to 2003, 25.6% of Douglas County residents smoke. And, according to one study validated by the Office of the Surgeon General, 7 out of 10 smokers want to quit. Maybe this is why every January, I am inundated with phone calls with questions about our smoking cessation program and resources for smokers to make their new year's resolution stick. Yet every year, at least half of the people who attempt to quit, do not.

Notice that I don't say fail. Or can not. Or will not. Why? Because it isn't true.

The fact is it usually takes several attempts to quit smoking before it sticks. Many people (most in fact) do not quit the first time they try. And then the cycle begins. He blames his willpower. She thinks its some sort of personal failing. He thinks it's because he is unable to cope with the stress of life. She believes that she was simply not meant to quit.

Really, what is happening is that person attempting to quit is doing the MOST important thing that can be done in the quitting process. He or she is practicing.

Think about it like this. Are great tennis players, race car drivers, lawyers, mechanics, golfers or even scrap-bookers made overnight? No, greatness comes from practice. Period. Sure, there are some people who are better at it than others. You all know THAT guy- the one who threw his cigarettes in the drawer and never smoked again? Aside from being the bane of most smokers' existence, he's also the rarity. Most smokers have to practice quitting, sometimes several times, before he or she becomes an ex-smoker. And that is not a failing. It is simply a fact.

So, for the person out there trying to quit, or thinking about quitting, or smoking happily with that twinge of an idea of quitting someday, what does this mean for you? Well, first, there are a lot of resources out there now to help a person during the quitting process. Your doctor is one. The internet even has some good stuff. Of course, your local health department can help you out. And the more resources you gather and try out, the better prepared you are to quit for good. Not everything works for everybody, but trying them out is the first step in finding what will work for you. But, more than anything, do not allow a slip or a slide-back determine your destiny. In the case of quitting, practice really does make perfect. Being able to recognize this idea can really make the difference in staying on track.

In the great tradition of storytelling, I feel that this should end with a lesson, an adage, or perhaps a moral. I could tell you that smoking stinks or some other ridiculous saying that usually annoys smokers into not wanting to think about quitting. I could be very positive and say something about how you can do it! Or I could even be forceful and tell you to quit now! Since most of these are equally annoying, I will leave you instead with this profound thought.

Don't be a squirrel.

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National Food Safety Month

By Erica J. Ochs
Douglas County Health Department

The Douglas County Health Department along with the National Restaurant Association Educational Foundation would like to show their commitment to food safety education by promoting National Food Safety Month in the month of September. This month is dedicated to educating the food industry on serving safe food, encourage food safety training, and make people aware of the importance of food safety. This year the theme for National Food Safety Month is "Don't Compromise-Clean and Sanitize". The focus is proper procedures for cleaning and sanitizing food contact areas, utensils, and equipment. Proper cleaning and sanitizing isn't just getting rid of visible soil, it is also reducing the number or microorganisms on a surface.

These procedures are not only necessary in a restaurant setting but are also necessary in your homes. Cleaning and sanitizing go hand and hand and should both be properly done to prevent the spread of infectious disease. All food contact areas should be cleaned and sanitized after each use. Food contact surfaces are anything that comes into contact with the food like a cutting board or countertop. Utensils need to be properly cleaned and sanitized after they are used as well. Tongs, knives, spoons, and other utensils should not be used for more than one food unless they are properly cleaned and sanitized. Utensils used on raw meat should also be cleaned before they are used on the cooked meat. All equipment used should be cleaned and sanitized properly after every use as well.

Proper hand washing is also a key component in preventing the spread of infectious diseases. Hand washing should be done every time before food preparation is done. To wash your hands properly you need to scrum your fingers, hands, and arms up to your elbows for 20 seconds. You should rinse off with warm water until all the soap is completely gone. Hands and arms should be dried with a one time use paper towel or an air dryer.

The goal of the Douglas County Health Department is to educate food servers on the importance of food safety at all times. Food Service Sanitation Manager classes are offered throughout the year for food service workers. These classes will help you better serve your community and reduce the risk of spreading diseases. For more information on National Food Safety Month or how to become Food Service Sanitation certified, contact the Douglas County Health Department at 217-253-4137 or online at douglascountyhealth.org. Additional information can also be found on the National Restaurant Association Educational Foundation website at www.nraef.org.

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The dangers of household hazardous products and wastes

By Lana Sanstrom
Douglas County Health Department

Almost every home contains hazardous products. They are used in cleaning, home improvement projects, automobile maintenance, lawn and garden care, and a variety of other tasks. In order to protect our health and environment, we must know how to properly use, store and dispose of these products.

Look in any storage cabinet in your home. Do you see products such as paint, paint thinner, pesticides, fertilizers, gasoline, windshield wiper fluid, antifreeze, motor oil, brake fluid, adhesives, batteries, furniture polish, drain opener, and oven cleaner? These products are all hazardous because they contain chemicals that are corrosive, explosive/reactive, flammable, or toxic.

Though usually safe when used according to label directions, these products can become dangerous when people are unaware, or forget, that they are handling hazardous products.

Each year, thousands of people are injured by products in their homes. Accidental poisoning can happen if a product is left within reach of a small child. It can also occur when food, drink, or cigarettes are used while handling hazardous products. Many products have fumes or vapors that can irritate lungs. Hazardous products have caused severe burns, illness, blindness, and even death.

When hazardous household products are no longer usable or wanted, they become household hazardous wastes. Household hazardous wastes make up only a small percentage of household waste, but they are a serious problem.

When disposed of improperly, they pose a threat to sanitation workers and the environment. Household hazardous wastes discarded in the trash may ignite or explode in the collection truck. Trash haulers have been injured from fumes and splashing chemicals. In the landfill, these wastes can leach into surface water and groundwater - the sources for our drinking water.

Disposal of household hazardous wastes down the drain can also pollute drinking water.

In septic systems, hazardous wastes can kill the organisms that make the system work. This may cause untreated wastes to drain into the soil and eventually seep into the groundwater.

Sewage treatment plants have been damaged by household hazardous wastes, resulting in the release of raw sewage and chemicals into streams. Storm drains, which are often used improperly for dumping, are a direct route to nearby waterways. Anything that is poured on the ground may spread or runoff the next time it rains.

Because of the dangers they pose, household hazardous products require special handling and disposal. Our health and environment are at stake, so it is important that each of us take responsibility for the products we use.

A household hazardous waste collection will be on April 29th, at the Solo Cup North parking lot at 1500 E. Main St., Urbana from 8am-3pm. All Illinois residents are encouraged to participate. Unacceptable wastes are:

If you have any questions please contact the Illinois EPA 217-782-9284 or the Douglas County Health Department at 217-253-4137.

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SO YOU WANT TO OPEN A RESTAURANT . . .

By Lana Sanstrom
Douglas County Health Department

With the New Year looming, many of us are making resolutions and plans for new beginnings and adventures. If one of yours happens to involve opening a restaurant, bar, coffee shop, snack shop, or some other type of establishment offering food for sale, this article will cover some information you need to know and consider before you begin.

If you are building of course you will need a building permit from the city or county depending on where your business will be located. If you are going to serve liquor, you will also need a special license for that. If you plan to renovate a present structure for your business, contact the health department for a plan review and fact-finding meeting before you commit to renting, buying, or doing any kind of work on this establishment.

The Douglas County Food Sanitation Ordinance requires that a plan review be completed by all potential food service operators whether they are selling commercially packaged items such as groceries or prepared foods. One cannot wait until the work is done and then submit a plan of what has been accomplished. A plan review’s purpose is to ensure that a proposed food establishment meets the Douglas County Food Sanitation Ordinance and the Illinois State Food Code ensuring that the operator will not have to spend time and money correcting unapproved work. A plan review application includes a step by step outline of what information will need to be submitted for review.

A floor plan is to be included in the plan review application of the establishment indicating where the kitchen, restrooms, dining rooms, food, food service articles, and toxic cleaning items storage areas, serving areas, break rooms, etc. will be located. Another drawing to be provided is one indicating where the lighting will be installed. It will be very important to include the location of all equipment on this floor plan, and brochures for the equipment must be submitted for each unit. The aisle space width should also be indicated with this submission (the minimum aisle space shall be 36 inches). All equipment must also meet the National Safety Foundation requirements.

All plumbing must meet the State of Illinois Plumbing Code and a licensed plumber must accomplish all the plumbing work. The type of menu to be served will determine the number of sinks necessary for installment. There will need to be a minimum of one hand sink in the kitchen area, a three compartment sink with an air gap, and a mop sink. Depending on the menu and the size of the establishment, one may want to install a food prep sink, a sink dedicated to raw chicken, and possibly more hand sinks. Each hand sink area must provide for paper towel and soap dispenser as well as trash containers.

Ventilation needs to be addressed for the cooking, dishwashing, storage, and toilet areas. The information submitted needs tol include the name of the manufacturer, the rated capacity of the exhaust fans and make-up air system, and the location of the ductwork.

Most importantly information regarding materials and the finished surface for all floors, walls, and ceilings must be provided along with samples. It is important to remember that all surfaces should be hard, smooth, non-absorbent, and easily cleaned.

Some other critical items to be included in the application are the menu, a plan for the garbage and its disposal, and the number of staff member including the number of those who will be Food Service Sanitation Manager Certified.

All food service establishments excluding retail food establishments must have certified food service sanitation managers from the first day of operation or within 90 days of opening. The number of certified staff members will vary depending on the category classification of 1 or 2 of the establishment. This topic is another article just by itself!

If you decide that 2006 is the year for you to become an entrepreneur, please contact Lana Sanstrom at 253-4137 for your plan review application. It will be so much more exciting to save time and keep money in your pocket as you start on “your adventure in food”.

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WATER QUALITY

By Lana Sanstrom
Douglas County Health Department

Spring time is a good time to think "water quality." Spring time can be dry or wet which can affect water quality. If it is a dry spring and you need to haul water from different sources, you need to make sure that the equipment and the sources of water are safe and disinfected. City water is safe, however water needs to be transported in a container that has been disinfected and has not hauled chemicals. If it is a wet spring, surface water runoff can contaminate your water source if your well is not properly constructed. This needs to be checked through a water sample by the local health department.

To obtain a water sample, you will need to contact the health department. The health department in your county will either sample the water for you or give you bottles to do the sampling yourself. You will need to sample the water on a Monday, Tuesday, or a Wednesday and send the water in so that it is received at the lab within 30 hours from sampling. The sample will only be tested for coliform bacteria, E. Coli, and nitrates. These are indicators of your water quality. Coliform bacteria is very common, therefore, it is very easy to test for this in your well to determine contamination and safeness. Once the test has indicated contamination, the health department will send you the information to correctly chlorinate your well. A follow-up sample will need to be taken after the chlorination to determine if the water is safe for drinking.

To ensure safe drinking water follow the helpful hints below:

Keep this spring a happy and safe one by ensuring that your drinking water is safe for you and your family.

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National Breastfeeding Week and World Breastfeeding Month

ByErica J. Ochs
Douglas County Health Department

The Douglas County Health Department would like to celebrate National Breastfeeding Week and World Breastfeeding Month in the month of August by informing mothers of the importance of breastfeeding and recognizing the mothers who do breastfeed. On August 2nd the Douglas County Health Department will be at various locations throughout the county distributing flowers with information about breastfeeding.

Mothers, expectant mothers, or any women interested in information on breastfeeding can stop by the following locations for information:

Breastfeeding gives the baby the best nutrients for growing and helps build a strong immune system. Breastfeeding provides the baby with more than 200 nutrients. Babies who are breastfed have fewer ear infections, allergies and asthma. They are also at less risk of sudden infant death syndrome (SIDS), diabetes, pneumonia, and childhood obesity. Breast milk is digested easier so breastfed babies have less gas, colic, and spitting up. Babies who are breastfed not only develop better physically but also cognitively.

Breastfeeding is not only the best for the baby, but is beneficial to the mother as well. Mothers who breastfeed are more likely to lose the baby weight faster. Producing milk requires 500 to 1000 calories a day; half of these calories come from weight gained during the pregnancy. Mothers who breastfeed are at less risk for breast, ovarian, and uterine cancer. Breastfeeding improves bone density and reduces the risk of hip fractures in older women. Breastfeeding is less of a hassle because it requires no mixing, measuring, or clean-up time. It is also financially beneficial for the family. Parents can save money by not buying formula and bottles.

The Douglas County Health Department encourages mothers to breastfeed their babies and provides information and support for breastfeeding mothers. For more information contact the Douglas County Health Department at 217-253-4137 or online at douglascountyhealth.org.

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Bats and Bat Exclusion

From Illinois Department of Public Health, http://www.idph.state.il.us/envhealth/pcbats.htm

Bats are among the most unique and fascinating of all animals. No other mammals can fly. Bats use echolocation to find flying insects at night much like sonar helps ships locate objects under water. Bats also have good night vision. They are not blind, as myth would have it.

batWhile Midwestern bats feed exclusively on insects, consuming many pest species, they prefer to expend the least amount of energy to obtain the most food. Thus bats typically capture larger insects, such as night-flying moths, and do not live up to their reputation for controlling mosquitoes.

Correctly considered beneficial animals, in certain situations bats, however, pose a threat to human health. Histoplasmosis is a disease associated with bat guano and bird droppings. When droppings accumulate for years, a fungus (Histoplasma capsulatum) can grow and produce spores that may cause histoplasmosis when inhaled. Where bat or bird droppings accumulate, in an attic for example, care should be taken to avoid contracting this disease. Clean up generally involves wetting the droppings before removal and wearing personal protective equipment, including a HEPA-equipped respirator or self-contained breathing apparatus (SCBA). Removal of large amounts of guano or droppings from structures should be left to experienced professionals familiar with proper removal procedures. For more information on histoplasmosis and clean-up procedures see the following Web sites:

Perhaps the greatest health risk from bats is rabies. In Illinois, rabies is found in bats more than any other wildlife species. Yet it should be noted that typically less than 5 percent of bats tested for rabies are found to be rabid. In the bat population as a whole, the percentage of rabid bats is much smaller – less than 1 percent. 

Rabies is a viral disease causing encephalitis (brain inflammation) in humans and animals. Humans can become infected when bitten by a rabid bat. Transmission also can occur when an infected bat’s saliva (but not blood, urine or feces unless these are mixed with spinal fluid – as can happen when a bat is beaten or crushed) comes in contact with a person’s eye, nose, mouth, a scratch or wound. Contact with aerosolized bat saliva, especially where large numbers of bats are roosting, also can transmit rabies to humans, although this type of transmission is quite rare. For further information on rabies, contact your local health department or visit:

Of less importance are parasites associated with bats. Fleas, lice, mites and bat bugs can infest bats, birds and other animals. Some may transmit diseases to humans. If the host animals are killed or leave their nests or roosts, the parasites look for alternate hosts and may wander into the living spaces of structures. They may bite people and domestic animals, but most parasites cannot live long away from their preferred hosts. Control can often be accomplished by simply vacuuming the parasites and carefully discarding the vacuumed material. Sometimes, bat parasites such as bat bugs may have to be eliminated by application of pesticides labeled for this purpose.

HANDLING BAT EMERGENCIES

Bats flying outside at night pose little risk. However, bats flying outside in daytime, flopping around on the ground, landing on or near someone, or roosting in accessible locations should be avoided, as should any bat found indoors. Bats typically enter structures in spring. Buildings, where bats may be roosting, should be inspected at this time. During daylight hours, inspect attics, rafters, walls, chimneys, porches and cellars for roosting bats, bat guano, crystallized urine or musty ammonia odor. Also inspect for exterior openings that will allow bats to enter the structure.

If a bat is found indoors, the structure should be thoroughly inspected for the presence of roosting bats. S tructure-infesting bats pose a health risk and must be prevented from entering occupied rooms. When bats are found roosting inside a structure, the building should be inspected for routes by which the bats might gain access to the living quarters. Such passageways might include ductwork, false ceilings, attic doors, chimney, holes in walls, and gaps around pipes and wiring. Every effort should be made to seal openings large enough for bats to squeeze through (see exclusion procedures below).

Rabid bats may exhibit no obvious abnormalities, so all contact with bats should be avoided. Where there is a likelihood of encountering bats, such as at children’s outdoor camps, people should be instructed not to touch bats. Similarly, people should NOT be allowed to occupy a room in which bats are found, until it is certain that no bats remain in the room and that the room has been sealed to prevent their re-entry.

Any bat suspected of having physical contact with a person should be captured and submitted for rabies testing. Bats can be captured using gloves, by netting, or by covering them with a box or can, then sliding a piece of cardboard or other stiff material under the container to trap the bat inside. It is advisable to wear heavy leather gloves to avoid bites and scratches. Your local health department, animal control office or veterinarian can assist you with submitting the bat to a laboratory for rabies testing. If the bat tests negative, rabies treatment can be avoided.

If a bat bites or has physical contact with a person, the wound or contact area should be washed immediately with soap and water. Unfortunately, b at bites and scratches are small and may go unnoticed. In certain situations it may be impossible to know if contact with a bat has occurred. These situations occur when a bat is found in the same room with a sleeping person, infant or young child, persons with diminished sensory or mental capacity, or persons under the influence of alcohol or drugs. Whenever a bat has physical contact with a person, or is suspected of coming in contact with a person, the bat should be captured, if possible, and the incident should be reported immediately to a physician and local health authorityto assess the need for rabies treatment.

The incubation period (time from exposure to appearance of symptoms) varies from days to years, but is usually one to three months. The initial symptoms of rabies in humans may be flu-like and progress to anxiety, confusion, agitation, insomnia, hallucinations, delirium and other abnormal behavior. To be effective, treatment should begin as soon as possible after exposure. Once symptoms appear, rabies is almost always fatal, although a recent experimental treatment appears promising.

BAT EXCLUSION

Like most birds and other wildlife, all 12 species of bats inhabiting Illinois are protected by law. Species most commonly found in structures include the little brown bat ( Myotis lucifugus ) and big brown bat ( Eptesicus fuscus ). These species have a wingspan of less than 12 inches and weigh ½ ounce or less. Four other species are classified as endangered species. It is unlawful to harm or kill a bat. Only under special circumstances are permits to kill bats granted by the Illinois Department of Natural Resources.

Popular “home remedies” for eliminating bats are temporary, ineffective, and/or illegal. No pesticides are registered for bat control. Moth crystals (naphthalene) can be temporarily effective, but the typical attic requires three to five pounds to be used and changed every few weeks. Other types of repellents may not be registered for use as bat repellents and therefore cannot legally be used to harm or repel bats. Bright lights, as well as fans and air-conditioners (used to cool down the roosting area), may be effective but temporary controls. In addition, ultrasonic and electromagnetic devices do not effectively repel bats, rodents or insect pests, despite advertising claims.

Exclusion remains the best way to prevent and control bats in a structure. Bats can be excluded by sealing exterior openings larger than ½-inch, using caulk, expandable foam, plywood, mortar, metal flashing, steel wool or ¼-inch mesh screen or netting. Make sure doors, windows and vents have screens and are securely framed; chimneys are capped; and gaps around utility lines are plugged.

In May and June, one or two “pups” are born to pregnant bats in Illinois. By the end of July, the young bats have taken wing, though they will continue to nurse until able to feed themselves exclusively on insects. Most bats, especially those in northern Illinois, leave their roosting places in September and early October to migrate south where they will overwinter in caves, rocky ledges and cliffs, and occasionally accessible walls and attics. Therefore, bat entry points in structures are best sealed during the months of September through April, when no bats are present. Proper exclusion at this time will prevent bats from entering the structure in spring. Only at certain times can exclusion be performed while bats are roosting within the structure. This involves sealing openings after the young bats are old enough to fly (August or later in Illinois).

Some skill is required to identify all entry points and to apply exclusion materials to openings. Openings through which bats are entering and exiting a structure may be identified from inside the structure by entering the roosting area, an attic for example, on a sunny day when light can be seen through the openings. Another method is to turn on a bright light in the attic at night and look for light escaping through the openings on the building’s exterior. Dark stains may be seen around and beneath openings used by bats. These result from bat guano and from “rub marks” where oils and dirt accumulate as bats pass through the openings. Yet another method of finding bat entry points is to watch for bats leaving the structure at dusk to make their evening feeding flights.

When all openings are identified, a “one-way valve” can be applied to each opening. One-way devices are those that allow bats to leave the structure, and prevent them from reentering. These can be as simple as a sheet of plastic or plastic bag attached above the opening and allowed to hang flush against the building’s exterior. The plastic should be wider than the opening and long enough to hang at least one foot below it. The sides (but not the bottom) of the plastic can be attached to the building by staples or duct tape, to prevent wind from lifting the flap. At dusk, the bats will find their way out beneath the plastic flap, but will not be able to lift the flap to reenter the structure.

Similar devices can be constructed from screening or polypropylene netting of ¼-inch mesh, or a short length of PVC pipe can be positioned in the opening. A tube sock should be fitted around the outside end of the pipe and allowed to hang down with the toe cut out. Bats will exit the pipe and crawl through the sock to get out but will not be able to reenter through the collapsed opening in the toe of the sock. Once all resident bats have exited the structure, the one-way devices can be removed and the openings immediately sealed as described above. Again, this type of exclusion should NOT be performed when young bats, incapable of flying, are present (typically May-July).

Although exclusion is the best way to rid structures of bats, knowledge and timing are critical for effective “bat proofing.” Especially in older construction, there may be several bat entry points that can be difficult to discover. If all openings are not found and sealed, bat problems will continue. Installing sealing materials and one-way devices can also be difficult because bat entry points are often several feet off the ground, requiring the use of ladders (note that falling is a much more common accident than being bitten by a rabid bat). For these reasons, bat exclusion may be best left to professionals. A list of wildlife control specialists, who may be familiar with bat exclusion procedures, can be obtained from the Illinois Department of Natural Resources (217-782-6384).

Illustrations courtesy of Penn State University and the University of Missouri.


For more information, contact the Illinois Department of Public Health, Division of Environmental Health, 525 W. Jefferson St., Springfield, IL 62761, 217-782-5830, TTY (hearing-impaired use only) 800-547-0466.

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November is American Diabetes Month

By Jane Jones, RN
Douglas County Health Department

Diabetes is a serious disease in which the body does not produce enough insulin or can not properly use the insulin produced. Insulin is a hormone that our bodies need to convert sugars, starches, and other foods into energy needed for everyday life. Almost 21 million Americans have the disease, but about 1/3 of them do not know it. There is no cure and is the fifth deadliest disease in U.S.

American Diabetes MonthComplications of diabetes can include nerve damage, heart disease, blindness, and kidney damage among others. Early detection and treatment of diabetes can help prevent or reduce the effect of some of these complications and help the diabetic to cope with the problems of having a chronic disease.

There are different types of diabetes. Type 1diabetes (formerly called juvenile diabetes) is the result of the body's inability to produce insulin. Perhaps 5-10% of Americans with diabetes have this type. It is usually diagnosed in children and young adults.

Type 2 diabetes results from the body inability to properly use insulin (a condition called insulin resistance), along with a lack of enough insulin. Most Americans with diabetes have this type.

Gestational diabetes affects pregnant women who have not had diabetes before pregnancy, but have high glucose (sugar) levels during the pregnancy. It usually goes away after the pregnancy. About 4% of pregnant American women have this every year.

Pre-diabetes (formerly called borderline diabetes) is a condition that happens when a person has blood sugar levels that are higher than normal, but not high enough to be diagnosed as having type 2 diabetes. There are about 54 million people in the U.S. who have this condition. This is addition to the almost 21 million who have diabetes. Studies have shown that those with pre-diabetes can delay or prevent developing Type 2 diabetes by making diet changes and increasing physical activity.

Are you at risk for diabetes? Some risk factors are: age 45 or older, race, obesity, family history of diabetes, depression, having had gestational diabetes and/or giving birth to a baby that weighed over 9 pounds, and inactivity. Of course we do not have control over some of these risk factors such as age or family history, but we can usually make diet changes and increase our activity levels.

Sometimes diabetes is not diagnosed as early as it could be because the symptoms are not taken as seriously as they should be. As with many other diseases, the earlier the detection, the better. Early finding can help decrease the chances of developing diabetic complications. Symptoms of diabetes include frequent urination, excessive thirst, extreme hunger, unusual weight loss, increased fatigue, irritability, and blurry vision. If you have one or more of these symptoms, see your doctor as soon as you can.

For more diabetes information log onto the American Diabetes Association at www.diabetes.org

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