Group B strep poses risk for newborns

Published Friday July 10, 2009
The Observer, La Grande, OR

Focus on Health
Tristin Mock, N.D.

Group B strep poses risk for newborns

Group B streptococcus (GBS) is a bacterium that can cause serious illness and death in newborns.

Approximately one quarter of women in the U.S. are carriers of the bacteria. These women often do not have symptoms, but can pass the infection on to their children during the birth process.

Group B strep is the most common life-threatening infection in newborns. It can be avoided, but there is no vaccine to prevent infection. GBS is more common than rubella, congenital syphilis, and spina bifida, yet many people have never heard of it. In 2001, around 1,700 newborns were infected.

Group B strep can infect and be carried by anyone. GBS is not the same infection as strep throat. It’s usually found in the gastrointestinal tract (guts) and can then spread to the vagina and rectum. GBS is not a sexually transmitted infection.

Most women are screened for group B strep during the 35th to 37th week of pregnancy. Infected women generally have no symptoms, although some may have a bladder infection. If the mother tests positive for GBS she will need IV antibiotics during labor to prevent passing the infection on to her child. The bacteria regrow rapidly, so antibiotics before labor are ineffective. According to the CDC, “a C-section should not be used to prevent early-onset group B strep infection in infants.”

Group B strep can be contracted at times other than birth, although the birth process is the most common time for transmission. Pre-natal transmission often leads to stillbirth. Late-onset cases can occur in children more than one week old. GBS can cause babies to catch pneumonia, get meningitis (inflammation of the brain), suffer sepsis (blood infection), have lifelong handicaps or die.

If you’re pregnant, please talk to your healthcare provider about testing for group B strep. Not all babies born to infected mother’s contract group B strep, but it is devastating for those who do.

For more information about group B strep please visit http://www.groupbstrep.org/ or http://www.groupbstrepinternational.org/.

Tristin Mock, N.D., is an Americorps VISTA volunteer with the Center for Human Development in La Grande.

Increasing Health Literacy: Two VISTAs in Rural Oregon

Viewfinder July 2009: Volume II, No. 4

Increasing Health Literacy: Two VISTAs in Rural Oregon

In newspapers and magazines across the country, articles covering the future of health care in America are prevalent. You can find articles like these in the Observer, the major newspaper for rural Union County in Oregon. But you will also discover another type of health care story. These stories focus on increasing health literacy for at-risk communities. Two VISTAs, Billie Jo Craigsmile and Dr. Tristin Mock, are behind this effort (read one of Billie Jo’s articles in the Observer), as well as many other activities to help the local population increase health awareness.

The task of informing the community about these issues is not an easy one. Billie Jo is in her second year of VISTA service, and much of her first year was researching the specific health needs within the community and the readiness of the community members for learning, developing, and implementing prevention programming. From this research, Billie Jo and Tristin are working on six social marketing projects: substance abuse, teens at risk for mental illness, household smoking, general communicable diseases, family planning, and immunization.

The research also shows that the readiness level of Union County is very low for many of these issues, to the point that many community members are in denial that problems even exist. The county has the lowest immunization rate in the state, and while teen pregnancy rates have been going down statewide, Union County’s rate has been increasing.

To take on these issues, Billie Jo and Tristin are using a six phase approach (problem description, market research, market strategy, interventions, evaluation, and implementation) for their social marketing projects. As part of this, they are reaching out to the community through multiple avenues. They are meeting with community groups, such as the Rotary and Kiwanis Club. They are holding presentations for teens, parents, coaches, and teachers. They are even reaching out to school bus drivers, as they recognize the positive connections many have to the students.

In addition, these VISTAs are also using opportunities and resources available to them. As word of the H1N1 (commonly referred to as the swine flu) made its way through the major media outlets, Tristin used this opportunity to talk with local leaders about general communicable diseases, as many were more willing to listen as concerns increased. Instead of creating a new social marketing campaign regarding family planning, she is adapting the efforts of a state-wide campaign for her needs in Union County.

In her second month, Tristin recognizes that her biggest hurdle is “Trying to figure out where you are going and how to get there is the hardest…looking, listening, and finding out what’s going on is very helpful.” Having already served in an AmeriCorps State/National program that included direct service of health care to an underserved community, she has a good understanding of how to approach these issues and build relationships with the population she is serving.

Billie Jo, having a VISTA year under her belt, is setting a goal of having her efforts complete by the end of year two so that in year three, continued implementation of the program will be in effect. To a point, she recognizes she is “territorial” about her project, and is really nervous about handing them over to her replacement next April (a mother of four, her protectionist nature has found its way into her VISTA project!).

Knowing their VISTA service will end before all of the goals for the social marketing projects are achieved, Tristin and Billie Jo are laying the foundation for their projects to be sustainable for years to come. They are creating user-friendly manuals and developing databases that contain the social marketing materials. Additionally, they have been engaged in agency education about their programs and are thinking about who they can train and hand the program over to in order to continue their success.

The Observer may soon be in need of something else to write about.

National HIV Testing Day

June 27th is National HIV Testing Day. Since its on a Saturday, many places are doing tests a day early. Today in La Grande, CHD is offering HIV tests for a $5 donation! The tests are available during their normal walk-in hours, 9-11:30 am and 1-3 pm. Annual testing is recommended for everyone who is sexually active that is not in a long-term monogamous relationship.

Of the estimated 1 million people infected with HIV in the US, 25% don't know they are infected! Take control. Take the test.

National Men's Health Week

June 15-21 is National Men's Health Week. This is a good time for men to remember to schedule their annual physicals. Annual screening can catch illness early while its still easily treated. Not a male? Give the gift of health! Include a gift certificate for a check-up in your Father's Day cards.

There is a silent health crisis facing men in the US. On average, men die almost 6 years earlier than women. Men are more likely to be uninsured, and less likely to see a physician, than women.

Men can take other preventative measures, besides going to a doctor. Younger men need to do monthly testicular self exams. Men should check their mouths from any funny looking spots that could indicate cancer. Breast exams are not just for women, men can get breast cancer as well!

Take precautions against mosquitoes

Published 11 June 2009 The Observer, La Grande, OR

Focus on Health
Tristin Mock, ND

Take precautions against mosquitoes
Tristin Mock, ND
AmeriCorps VISTA

As we enter the warm days of late spring, mosquito season is starting. Now is the time to start taking precautions to protect yourself from bites. Not only are mosquitoes annoying, they also can transmit West Nile Virus.

West Nile Virus can be transmitted by mosquitoes to humans, horses, and birds. In humans symptoms can vary widely. Some people may have a mild fever, or flu-like illness. In others the disease can progress to encephalitis (brain inflammation) and possibly death.

Killing mosquitoes should not be your goal. They provide food for animals including fish, frogs, birds, and bats. Mosquitoes can even pollinate flowers! Instead, focus on preventing mosquito bites and eliminating mosquito breeding sites around your home.

There are several simple steps you can take to protect yourself and your family from West Nile Virus. You should avoid mosquito bites by using repellant, covering up, and staying indoors at dusk and dawn. Classic synthesized repellants include DEET and picaridin. Repellants need not contain harsh chemicals. Some naturally derived mosquito repellants recommended by the CDC are oil of lemon eucalyptus, PMD (para-Menthane-3,8-diol), and IR3535 (3-[N-Butyl-N-acetyl]-aminopropionic acid, ethyl ester). No matter what type of repellant you use, be sure to read and follow the label directions before applying it!

You should also mosquito-proof your home. This includes installing or repairing screens, avoiding standing water, and cleaning up possible sources of standing water. Remember to clean your gutters so water doesn’t collect in them. Water sources, like bird baths and water troughs, should be cleaned at least once a week.

The last step in limiting the spread of West Nile Virus is to report dead birds. The virus can infect birds. If you find dead crows, ravens, jays, magpies, hawks, eagles, or red-breasted robins please report them to Union County Vector Control at 963-2974. These reports aid in tracking the spread of West Nile Virus in Union County.

Together we can prevent the spread of West Nile Virus. For more information on the virus, please visit the Center for Human Development, Inc website www.chdinc.org, or call 962-8801.

Formulary Modernization Act Passed!

Thank you everyone who contacted your legislators about this bill! The Oregon ND formulary modernization act, SB 327, unanimously passed the house on June 2. The bill is now waiting for the governor's signature to become law. It will go into effect on January 1, 2010.

All drugs used in the primary care setting will now be on the naturopathic formulary! This will allow us to provide the highest quality of care to our patients. This bill allows us not only to prescribe more drugs, but most importantly to be able to remove patients from them. We're only allowed to remove people from drugs that we can prescribe.

Once again, thank you everyone for your help in passing this landmark legislation!

Teen pregnancy prevention needs to be a priority

Below is a copy of an article I wrote that was published in the La Grande Observer on Friday May 29. They have not posted the article online yet.

Health Matters
Tristin Mock, ND

In the US, 3 out of every 10 girls will be pregnant as least once before the age of 20. According to the Oregon Department of Human Services, in 2004, at least 5,832 teenage girls became pregnant in Oregon. In comparison, in 2003, there were only 3,117 new cases of breast cancer, in all ages and sexes, in Oregon. Many people are ignoring this disturbing trend that allowed over 2% of teenage girls, including 106 girls under the age of 15, in our state to become pregnant.

DHS reports that around 30% of teen pregnancies end in legal abortion. Of those girls who underwent abortion procedures, 68.5% were not using contraception! Most teens wait 6-12 months after becoming sexually active to seek contraception. During this time they are at increased risk for pregnancy and contracting sexually transmitted infections.

There is hope in slowing this trend. Research has shown five things that result in teens using birth control regularly, or postponing sexual activity. These five simple things are easily provided by supportive parents, schools, and communities.

Teens that have adequately discussed sexuality, pregnancy and birth control with their parents have lower pregnancy rates. Some parents may want to avoid discussing sexual health with their teens, but it is important. As the state pregnancy rate shows, it’s never too early to start these discussions. Be open and honest with your child. Age appropriate information can be found from a variety of sources including at http://www.chdinc.org/.

Another protective factor is having had a comprehensive sexuality education course. These courses are available in schools and the general community, including at churches. These classes are important to reinforce the message parents are giving children, and to provide a venue where children can ask questions they may be embarrassed to ask their parents.

Having realistic life options are important. Recently, increasing amounts of teens have decided that it’s cool to have a child. Many of these children do not realize the true impact of their choice. Of the families started by unmarried teen moms, 2/3 are poor. Children of teen mothers are more likely to be born prematurely, suffer abuse and neglect, and end up in foster care compared to children of older parents.

Living in a supportive environment that contributes to an individual’s self-esteem can protect teens from pregnancy. High self-esteem can give teens the strength they need to resist sexual activity, or to assert their choices regarding safer sex practices. Being a community that offers varied activities for youth can help improve the self-esteem of teens.

Finally, sexually active teens are more likely to use contraception if there is guaranteed confidentiality and easy access to birth control. In Oregon, there are no laws limiting access to contraceptive services; family planning services are free for those who qualify through FPEP. Please call public health to see if you qualify and to schedule an appointment, 541-962-8801. Free condoms are available at public health for those who need them.

For more information about how to become involved in teen pregnancy prevention, or if you would like to participate as a member on the Union County Teen Pregnancy Prevention Coalition, contact Sandra Leavitt at the Mt. Emily Safe Center, 963-0602.

Tristin Mock, N.D., is an AmeriCorps VISTA volunteer with the Public Health Team at Center for Human Development