The state Department of Health’s mission statement is to protect and improve the health and environment for all the people of Hawaii.
With the recent health issues we have been facing, the mission statement has been really put to a test, especially for health inspectors or sanitarians.
When I was a child living on Piopio Street, I remember the Health Department office was a stone’s throw from our house and its job then was to get your tuberculosis testing and vector control. Mosquito control encompassed a truck that sprayed a fog of chemicals.
Today, sanitarians not only check on food establishments, but also assist when there are issues concerning rat lungworm disease, dengue fever and, now, hepatitis A.
We, as responsible citizens, need to be knowledgeable and aware and not depend on the Health Department to handle all the health issues. There are steps we all can take now to control and prevent these diseases.
To control rat lungworm disease, we need to control the rodents, snails and slugs in our gardens. We should not handle the snails and slugs with bare hands, and when harvesting the vegetables from the garden, we need to rinse them several times. If we find greens slugs have eaten, we should discard them. If we can see slime on the raw foods, we should not eat them. Even freshwater prawns need to be cooked for at least five minutes.
Symptoms of rat lungworm, or angiostrongyliasis, a rare form of meningitis, can vary from mild symptoms to severe headaches, stiffness of the neck, tingling or painful feelings in the skin or extremities, low-grade fever, nausea and vomiting. There also could be temporary paralysis of the face, as well as sensitivity to light. These symptoms usually start one to three weeks after exposure to the parasite, but can range from one day to as long as six weeks after exposure. Symptoms usually last between two to eight weeks, but there have been reports of them lasting longer periods.
There is no specific treatment for rat lungworm disease. The parasites cannot mature or reproduce in humans and eventually will die. The only medications are supportive and pain medications to relieve the symptoms.
Dengue fever is a viral illness that can be contracted through the bite of an infected Aedes mosquito and is not spread from person to person.
Controlling mosquitoes in and around our homes and communities can prevent outbreaks. Removing standing water by cleaning clogged drains, emptying planter trays and flushing plants with fresh water are some ways to eliminate breeding sites. We also can prevent mosquito bites by avoiding areas with lots of mosquitoes, using repellent and wearing protective clothing. These are healthy habits everyone can be mindful of and do.
Symptoms of dengue fever include sudden onset of fever, severe headaches, eye, joint and muscle pain and rash. The rash typically appears on the hands, arms, legs and feet three to four days after the fever begins. Minor bleeding problems also can occur. The symptoms might go away completely or escalate to conditions that need immediate medical attention.
Symptoms usually start five to six days after being bitten by infected mosquitoes, but the onset can range from two to 15 days.
There is no specific treatment for dengue fever except bed rest and acetaminophen to treat the fever and pain. Aspirin and NSAIDS (ibuprofen, naproxen) are not recommended as they can make bleeding problems worse.
When Health Department sanitarians go to food establishments, one of the first items on the inspection report is whether the management has an employee health policy in place. Form B-1 is a Conditional Employee or Food Employee Reporting Agreement the manager has on file. If the employee has the following symptoms, they must not allow that employee to expose others to preclude the transmission of food borne illnesses:
• Diarrhea.
• Vomiting.
• Jaundice.
• Sore throat with fever.
• Infected cuts or wounds, or lesions containing pus on the hand, wrist or an exposed body part with the cuts, wounds or lesions not properly covered (such as boils and infected wounds, how ever small).
It is the responsibility of the owner or manager of the food establishment to be sure employees are not sick and spreading germs or viruses. It is also their responsibility to have signs in the bathrooms about washing hands thoroughly.
So, with the latest incidences of hepatitis A, a contagious liver infection, the signs are fever, fatigue, headache and/or body ache, loss of appetite, nausea, stomach pain, vomiting, diarrhea, dark-colored urine, pale-colored stools and yellow skin and eyes (jaundice can develop several days to a week after other symptoms begin).
Hepatitis A usually lasts from two weeks to as long as 50 days after exposure to the virus. If you are 20 years old or younger, you probably were vaccinated for hepatitis A.
Hepatitis A is spread by your hands touching infected feces as the virus can enter the body if the hand or something the hand touched is brought to the mouth or if the infected person did not wash their hands thoroughly after going to the bathroom and then contaminated food or utensils.
Washing hands is very important. To wash them properly you should:
• Use soap and warm, running water.
• Scrub for about 20 seconds.
• Clean under and around your fingernails.
• Wash all the way to the wrists.
• Rinse well with hands pointed downward.
• Dry with a clean towel.
In addition, make sure you wash dishes and utensils in hot, soapy water. The scrubbing action should help remove contaminated particles. Food service facilities should sanitize dishes and utensils in 171 degree water and with approved chemicals.
If you know a person is infected with hepatitis A, do not share utensils.
Small bites
• On another note, it is interesting the fees for food establishment permits jumped from $50 to $400 a year with the justification that more sanitarians are needed to enforce the new rules.
However, the Big Island has not gotten any new positions with the increased fees. To all the newly elected officials: Most positions have been filled on Oahu.
Are the other islands being treated like stepchildren again? Are our current Big Island sanitarians able to handle all upcoming issues with no additional help without compromising the health and safety of our community?
Email me at audreywilson808@gmail.com.
