Summer Safety

Don't Eat the Potato Salad!

Updated, June 2018

download.jpeg

Don’t eat the potato salad . . . unless you know it’s safe! Summer means cookouts, picnics, and beach parties with family and friends. Unfortunately, they are also occasions for getting a stomach bug from improperly handled or stored food.

To keep yourself and others from getting sick, take a few moments to review what causes “food poisoning” and some food safety tips.

Foodborne Illnesses

The following organisms commonly cause foodborne illness or “food poisoning”:

·      Norovirus. Many persons have never heard of this virus, but it affects over 5 million people per year. It leads to inflamed stomach and intestines and results in stomach pain, nausea, vomiting, and diarrhea. Proper hygiene after using the toilet or changing diapers and safe food handling will prevent most infections.

·      Salmonella. This bacterial infection causes abdominal cramps, diarrhea, and fever, usually within 12-72 hours. Most people recover without medical treatment, but sometimes severe diarrhea requires treatment or hospitalization. If the infection spreads, it can cause death. Very young, elderly, and immune-compromised persons are most at risk for severe infection.

·      Clostridium perfringrens. This bacterium causes about 1 million infections per year. Diarrhea occurs 6-24 hours after infection, but usually without vomiting or fever. Symptoms last about 24 hours, and most people recover without medical treatment. Very young or elderly persons can experience more severe symptoms that require treatment.

·      Campylobacter. This bacterium causes diarrhea (sometimes bloody), abdominal cramping, and fever 2-5 days after exposure. Symptoms last 1-2 weeks. If infection spreads to the bloodstream, usually in immune-compromised persons, it can become life-threatening.

·      Staphylococcal aureus. The staphylococcal bacterium produces toxins that cause vomiting, nausea, abdominal cramping, and diarrhea within 30 minutes to 6 hours of exposure. Since the toxins are resistant to heat and salt, they can survive cooking. Infections typically occur in foods that people handle but do not cook (sliced meat, puddings, pastries, and sandwiches). Contaminated food does not smell or look spoiled.

·      Escherichia coli (E. coli). Most E. coli bacteria are harmless or even beneficial, but some cause diarrhea (sometimes bloody), abdominal cramping, vomiting, urinary tract and other infections. While most infected persons get better in 5-7 days, some strains of E. coli cause a life-threatening condition that requires medical attention. If you have diarrhea that lasts for more than 3 days or is accompanied by high fever, blood in the stool, or so much vomiting that you cannot keep liquids down and you pass very little urine, go to an urgent care clinic or other health care provider. An outbreak of one strain of E. coli in the spring of 2018 was traced to contaminated romaine lettuce.

·      Listeria monocytogenes. This bacterium causes a serious infection, Listeriosis, that is especially dangerous for pregnant women and persons over 65. Although there are only about 1,600 cases per year, the mortality rate for those infected is about 16%. Foods most at risk for contamination include unpasteurized dairy products (especially soft cheeses), raw sprouts, and melons. Persons at high risk should probably avoid these foods.

Most of the time, foodborne illnesses will not require medical attention. But young children, elderly persons, and anyone whose immune system is compromised can develop more severe infections and symptoms that can become life-threatening.

Basic Food Safety

download.jpeg

Clean, Separate, Cook, Chill. This should be the mantra of every person who handles, prepares, and cooks food. Heed these four rules and you will eliminate nearly all foodborne illnesses from your life. It’s really that simple.

Still, a few specific tips will make safe food handling easier and more effective.

Potato Salad, Eggs, and Dairy

While potato salad serves as a primary example, other salads that include mayonnaise, eggs, and dairy products need special attention.

·      Keep prepared salads cold—that means 40ºF or cooler—in the refrigerator or ice chest until they are served.

·      No more than 2 hours (1 hour if surrounding temperature is 90º or higher) after serving, these foods should be chilled again. Remember, many bacteria thrive in warm, moist environments.

·      Even better, place serving dishes or pans for these foods on a bed of ice while they sit out.

·      If these dishes sit out more than 1 or 2 hours (see above), throw the food out! Better safe than sorry!

·      Rinse all produce under running tap water before using or packing it in a cooler.

Chicken, Beef, Pork, and Seafood

Favorites for outside grilling, raw meats require special handling.

·      Use separate cutting boards for animal products only, and wash these surfaces often with warm, soapy water.

·      When handling raw meats, wear disposable, vinyl gloves that you discard before touching other surfaces, utensils, or food.

·      If gloves are not available, wash your hands thoroughly (at least 20 seconds) before and after handling raw meat.

·      Marinate meats safely in the refrigerator. If you want to use some of the marinade as a sauce, reserve a portion ahead of time and separate from raw meat. Never reuse marinade that has been in contact with raw meat.

·      Cook food thoroughly (see chart), and use a meat thermometer to check (you can’t always tell by looking).

·      Keep cooked meats hot while serving. As with cold foods, do not let cooked meats sit out more than 1-2 hours.

·      Never use platters, dishes, or utensils that have touched raw meats to serve food after cooking unless such items have been thoroughly washed. Not heeding this rule is a major cause of cross-contamination and illness.

Raw Fruits and Vegetables

Bacterial contamination of raw fruits and vegetables account for roughly half of all foodborne illnesses according to the CDC. This is distressing because eating these foods results in many health benefits. Washing these food items is essential, but the absence of cooking means that bacteria cannot be killed.

Some experts have warned against pre-cut and washed vegetables, especially lettuce or spinach, that have become so popular because they reduce meal preparation time and trouble. Nevertheless, the jury’s still out on the safety of such items because many pre-washed products are rinsed several times in a chlorinated bath, thereby removing more bacteria than might be achieved when washing at home. Intact heads of lettuce—as with romaine or iceberg—are difficult to wash thoroughly because water cannot penetrate to the inside of the head or even the leaf’s surface.

Be sure to wash all fruits and vegetables before peeling or cutting them to prevent contamination. Keep them isolated from surfaces that have contacted meats, poultry, or seafood, and refrigerate them immediately, at least within 1-2 hours of washing. Above all, do not purchase bruised or damaged items, especially if they will be eaten raw.


Cleanliness and Storage

Untitled.png

Keeping yourself, dishes, utensils, and preparation surfaces clean, while storing food properly, will prevent most foodborne illness.

·      Wash your hands for at least 20 seconds in warm, soapy water and before, during, and after handling food. Handwashing after handling raw meat, but before touching other food, utensils, or surfaces, is especially important.

·      Similarly, clean food preparation surfaces—countertops, cutting boards, refrigerator shelves—often. Be especially careful to avoid cross-contamination from raw meats on such surfaces.

·      A consensus seems to be building to avoid antibacterial soaps. There is little evidence that they help prevent bacterial infection, and some evidence that they might contribute to antibacterial resistance.

·      Use separate cutting boards and other surfaces to prepare raw meats (glass or other impermeable surfaces preferred) and keep them separated from surfaces on which fruits and vegetables are prepared.

·      Consider using disposable paper towels for cleaning food preparation surfaces instead of sponges that can harbor nasty bacteria. If you use sponges, keep them as clean as possible and toss them in the trash often.

·      Also consider using disposable vinyl gloves for handling raw meat. Toss them in the trash before touching other utensils, surfaces, or food.

·      Store raw meats in leak-proof containers and separate from vegetables and fruits.

·      Store fruits, vegetables, meats, eggs, and dairy products properly, usually at 40ºF or lower. (Yes, eggs in the U.S. should be refrigerated.)

·      Do not thaw meat on the counter. Meat should be thawed in the refrigerator or, more quickly, in a microwave oven (follow instructions). If left on the counter to thaw, raw meat quickly becomes a site for bacterial growth.

Be safe when you cook out! Your family will thank you for being fussy about food safety. If, despite your best precautions, you or others become ill, monitor the symptoms. If diarrhea is severe and long-lasting or if vomiting prevents ingestion of fluids, seek medical attention.

And remember, we at Kathy’s Urgent Care are here to help. If you live or work near one of our convenient locations, just walk in. We’re open 7 days and evenings every week.

To add or view comments, click on the title of this article above.

The Sun is Hot! Skin Cancer’s Not!

Skin-Cancer-Prevention.jpg

As we all know, Memorial Day is the beginning of summer! Forget the calendar and head to the beaches! But don’t—please don’t—forget sun safety.

This year, over 10,000 Americans will die from melanoma. That’s about 1 person every hour. Some 160,000 people will be diagnosed with melanoma. And that’s not counting other types of skin cancer. No wonder May is Skin Cancer Awareness Month!

What Causes Skin Cancer?

Exposure to UV (ultraviolet) rays causes skin cancer most commonly. Either from long-term exposure or short-term intense exposure, UV rays damage the DNA (genetic material) in our cells, causing some to mutate into cancerous cells. Cumulative exposure results most often in basal cell or squamous cell cancers that are quite curable when treated early. Intense exposure, usually before age 18, can cause melanoma, the deadliest form of skin cancer but for which survival rates are good when treated early.

Most people encounter UV rays from the sun, usually during summer months (and even on cloudy days). But UV rays from tanning salons are just as dangerous and should be avoided. Less common causes include repeated exposure to X-rays or hazardous chemicals.

Anyone can get skin cancer, although fair-toned persons are at greater risk.

What Skin Cancer Symptoms Should I Look For?

There are basically 4 things to look for, since different types of skin cancer present slightly different symptoms.

1.     Actinic Keratosis (AK). These are pre-cancerous lesions that often appear as dry, scaly spots or patches of red rash or slightly raised skin. People might have several on the scalp, face, neck, arms, or other parts of the body. They can be easily removed by a dermatologist, but they are a sign of risk of skin cancer. Left untreated, they can develop into squamous cell cancer.

Untitled.png

2.     Basal Cell Carcinoma (BCC). This is the most common type of skin cancer, accounting for about 95% of cases. When detected early, survival rates are very high. These cancers are usually flesh-colored with pearl or white bumps. Early detection is important because they can grow into surrounding tissue and cause other problems.
 

Untitled.png

3.     Squamous Cell Carcinoma (SCC). The second most common type of skin cancer, SCC appears usually as a red bump with a scaly patch. It can also appear as an open sore that heals, but reopens. SCC sites can occur on nearly any part of the body. Early detection allows treatment that will prevent this form of skin cancer from spreading to other areas.
 

Untitled.png

4.     Melanoma. Compared to other types, melanoma is relatively rare, but much more deadly. It often appears as an enlarged, irregularly shaped mole. Close examination of moles that follows this acronym can often detect melanoma:

A = Asymmetry (one half differs from the other)
B = Border (irregular, poorly defined border)
C = Color (usually shades of tan, brown or black, but sometimes white or red)
D = Diameter (often about the size of a pencil eraser)
E = Evolving (growing larger or changing shape or color)

If you suspect that a mole or other abnormal spot might be melanoma, see a dermatologist at once. Left untreated, melanoma can spread to other body parts and become life-threatening.

Untitled.png

For more information about different types of skin cancer, symptoms, and treatment, visit the American Academy of Dermatology website.

How Can I Prevent Skin Cancer?

We can all prevent skin cancer by following these simple steps.

·      Avoid unprotected exposure to sunlight during the summer, especially between the hours of 10:00am and 4:00pm. (Cloudy days offer no significant protection.)
 

·      When outside, apply sunscreen rated at SPF 30 or higher to all exposed skin liberally and often.
 

·      Do not expose infants (younger than 6 months) to direct sunlight. Make sure that children are protected by sunscreen and/or clothing that UV rays cannot penetrate.
 

·      Avoid tanning salons.
 

·      Be careful around water, snow, and sand, since these surfaces can reflect UV rays.
 

·      Keep a close eye on moles, rashes, scaly patches of skin, or other areas that appear abnormal. If any of these areas change in appearance, have them checked by a health care professional.
 

·      Get a complete body scan by a dermatologist or other health care professional once per year, especially if you are at high risk. Remember that skin cancer can arise later in life because of sun damage caused during childhood or adolescent years.

As always, if you have questions or need treatment for overexposure to the sun, come to Kathy’s Urgent Care. We’re here to help.

To add or view comments, click on the title of this article above.

Traveling? Don’t Forget Your Vaccinations!

Screen Shot 2018-05-16 at 2.13.43 PM.png

Planning a trip abroad this summer? Whether for business or pleasure, traveling to other countries can be enriching, but not if you come down with a debilitating disease.

Well before you take off, make sure you have the necessary, up-to-date immunizations. Getting properly immunized can take 4-6 weeks. So don’t wait until the last minute.

Which Travel Vaccines Do I Need?

That depends on where you’re headed. At least make sure that routine immunizations—measles-mumps-rubella (MMR) vaccine, diphtheria-tetanus-pertussis vaccine, varicella (chickenpox) vaccine, polio vaccine, and your yearly flu shot—are up to date.

Beyond that, many countries or regions can present specific dangers. Risks vary also between urban and rural areas. The nature of your activity and where you will travel most of the time should determine which vaccines you need.

For example, if you’re traveling to South America or Africa, you should get vaccinated for Hepatitis A, since you can get this disease from contaminated food or water regardless of where you stay. If you venture into rural areas, you should also be immunized against Typhoid and other diseases.

Here is a list of a few popular destinations and the specific vaccines as recommended by the Centers for Disease Control and Prevention (CDC). Consult the CDC’s web page for a complete list of destinations and recommended vaccines worldwide.

[1] Yellow fever vaccine availability in the United States is currently limited. If you need to be vaccinated before your trip, you may need to travel some distance and schedule your appointment well in advance.  Find the clinic nearest you .

[1] Yellow fever vaccine availability in the United States is currently limited. If you need to be vaccinated before your trip, you may need to travel some distance and schedule your appointment well in advance. Find the clinic nearest you.

Screen Shot 2018-05-16 at 2.06.28 PM.png

The above list is not meant to be exhaustive. Before traveling, you should consult with your physician or other health care provider to determine which vaccines are right for you and especially your children.

An Important Note about Zika: Unfortunately, Zika has become a worldwide epidemic. It is especially risky for pregnant women and their fetuses. It can also lead to other problems in otherwise healthy persons. There is no vaccine to prevent Zika infection, and there is no medication to treat it.

It is especially important to prevent Zika infection. That means protecting against mosquito bites that carry the virus. Zika can also be transmitted by sexual relations with infected persons.

If you travel to most areas in central and southern Africa, South Asia, the Caribbean, Central America, Mexico, the Pacific Islands, or South America, you should take effective mosquito repellant and wear protective clothing. For more information, visit the CDC’s Zika web page.

Additional Tips for Healthy Travel

Even if your vaccinations are all up to date, there are many other things to consider to keep you and your family healthy on your trip.

  • Be sure to discuss with your health care provider any chronic conditions, immune system deficiencies, and medications that might affect your travel.
     
  • Check with your health insurance carrier about medical coverage while you are abroad. Many plans, including Medicare, do not cover medical expenses, and medical transport back to the U.S. can cost $50,000 or more.
     
  • Pack prescription medications in your carry-on luggage.
  • Bring copies of all prescriptions that include generic names for medications.
  • If you bring any controlled substances or injectable medications, include a note from your physician on his/her letterhead. If needed, remember your EpiPen.
  • Leave a copy of prescriptions with a trusted relative or friend.
  • Check with an American embassy or consulate in advance to make sure that the country you are visiting will allow you to bring your medications with you.
     
  • Bring medications for minor ailments.
    • If needed, medication to prevent malaria.
    • Antidiarrheal medication.
    • A decongestant, with or without an antihistamine.
    • Medicine for pain or fever (acetaminophen, aspirin, ibuprophen).
    • Mild laxative.
    • Antibacterial ointment.
       
  • Include basic first-aid items.
    • Insect repellent.
    • Sunscreen.
    • Bandages, gauze, antiseptic, tweezers, scissors, ace bandage, etc.
    • Moleskin for blisters.
    • Cream for sunburns.
    • Digital thermometer.
       
Screen Shot 2018-05-16 at 2.15.52 PM.png

 

Plan how to handle any special health conditions that affect you or your companions.
Watch your health for any symptoms after you return!

Final Thought

Before you embark on your international trip, consult a health care provider who is knowledgeable about travel medicine. This is as important as making sure that your passport and other travel documents are in order.

At Kathy’s Urgent Care, we think that a travel consultation is important enough to offer it for free. Of course, we will assess a fee for any vaccinations or medications that are required, depending on where you go and what you plan to do.

Above all, stay healthy and have a good time!

To add or view comments, click on the title of this article above.