Lindsey Downing

I was able to interview Jim Geddie from my hometown. He is the health care administrator that oversees Arbor Hills Rehabilitation Center and Generations Health Care in San Diego and was able to give me a lot of insight as to some of the current health problems and public health trends that he’s seeing in his facilities.

            The first one is that there has been a huge trend of a younger population coming in to the rehabilitation center. About ten years ago he said that the average age of residents was around 72-75 years old. Now their average is around 55. He thinks that it is probably due to unhealthier lifestyles and people are just getting sick at a younger age.

            The second trend that he has seen is a huge increase in mental instability. He said that recently he has seen more cases of Alzheimer’s, depression, dementia than he ever has in the past. He explained that the biggest problem with the trend is that they don’t have enough space for all of the people with this diagnosis. The facilities have a limited amount of space to be able to deal with and care for patients that have mental diseases so they don’t have anywhere to go. This has been a huge increasing problem.

            The third health trend he has noticed is a large increase in cardio pulmonary disease. He said that the main reason for this is a lifetime of smoking. The patients that he deals with everyday are the age of the baby boomers and back when they were younger smoking was the cool thing to do. At that time the health risks of smoking were not well known so people did it freely and became addicted. Because of this the people now getting older and coming to his rehab facility have had a lifetime of smoking and have developed many heart and lung problems from it.

Another thing that he said they have struggled with in their area is a shortage of nurses. With the amount of elderly people that they have they need a lot of staff to help care for them. Especially because at their age and with their limited abilities they need someone at almost all times to help them do even the simplest of things. Because of this they need a lot of nurses. He talked about how they don’t provide an easy access for people to become nurses and the limited amount of money available for health care there is a shortage of them.

            The last thing he said he has seen as a trend is an increase in diabetes. An increase in obesity is obviously hand in hand with this trend. As junk food has become more easily accessible, affordable and widely advertised, people have been turning to these foods in the last couple decades. As a result diabetes and obesity have become much more of a problem. Because it is the younger generations that are more affected by the new trend of junk food and because younger generations are now coming to the rehab center, he has seen it as an increasing problem.

Alexandra Johnson

I contacted Eric Edwards who is the director of Health Promotion in the Utah County Health Department. He emailed me a lot of information on the current issues and trends of problems that exist in the health of the community currently.

Currently there are many diseases out there that could be prevented. This also goes along with chronic disease. 100 years ago infectious disease was the main cause of death, but today the main cause of death comes from chronic diseases that are caused by unhealthy behaviors and lifestyle choices.

Globally, especially in the US obesity is a huge epidemic that is a big concern. They are increasing in all age groups; Type 2 diabetes is developing in children when it used to be known as “adult onset diabetes”. Now it isn’t even referred to as that by physicians. This type of diabetes is most commonly caused by poor eating habits and sedentary lifestyles; which could be easily prevented.

Injuries that come from accidents are another leading cause of death. Living in a college town where there are many young people driving and doing extreme things makes this a real concern in the environment in which I’m living. I went to high school in Maryland and there was a lot of high school aged kids who were always drinking and driving and so many people I knew, including me, were affected in some way by these fatal accidents. If people were aware of how dangerous driving recklessly was and better understood the importance to wear seatbelts a lot fewer I am sure a lot fewer accidents and deaths would occur.

The DIY health movement is showing increases in the amount of consumers taking advantage of programs that are coming with the advancement of technology. Smart phone apps that help count calories, provide health information, and provide other dietary motivation are increasing public awareness for personal health. Social media is also allowing people to broadcast their personal health goals and to get inspiration of workouts and diet plans. This can positively motivate and inspire people to change their lifestyles for the better. This is a positive change in the world of public health.

As the population of the world continues to increase, more and more concerns with the environment will exist. With a higher population, more food, houses, and transportation methods are needed and that increases the resources that are being used. The carbon emissions from factories and fossil fuels are detrimentally affected the atmosphere. This has caused a very high increase in organizations to help protect the planet and to find alternative methods of energy.

Hannah Tull

I contacted Jana Woodruff an Occupational Therapy site manager at Elks Rehab Hospital in Boise, Idaho. Jana is a Clinical Laboratory Technologist (CLT) and an Occupational Therapist, Registered, Licensed (OTR/L).  She informed me on the five treatment trends occurring right now for Occupational Therapists in Boise. She mentioned vision rehabilitation, modified constraint therapy, driving evaluations, alternative pain management in therapy and team approach for Parkinson’s disease.

Vision rehabilitation is a popular topic in occupational therapy currently and how to go about treating the patients. Woodruff mentioned that it is important for all of the doctors working on rehabilitating the patient’s vision to work together. Many factors come into account when treating a patient and all should work as a team to best fit the needs of the patient. The different parts of a patient’s “team” can include regular eye doctor, functional optometrists, neuro opthomalogist, and education primary physicians. What is happening with OT in this topic is they are trying to figure out what their role is and how they can best be part of this team.

Modified constraint therapy is a new method at the Elks Rehab Hospital and has proved to be very successful! The way the mCIAT works is if patients have had a neurological insult and they have trouble performing daily tasks with one of their arms they place the working arm in a mit and have the patients perform tasks with there non functioning arm while constraining the functioning arm. Patients are also given the mit to take home and a binder of tasks that they need to practice. This has been highly successful in helping patients return to function of their arms but it is also highly dependent on if the patients do there at work at home with the binder.  

Jana said driving evaluations is not just a Boise trend but is a current need in all communities. She said that many families and physicians are afraid of taking away patients driving privileges because they do not want to offend the patient. What an OT does is assesses the patients ability to perform certain functions while driving and then determines if they can continue to perform that task safely. Occupational Therapists start with a pre-driving assessment where they assess the patient’s visual, cognitive and motor response skills. Then they take the patient driving on a special route to determine how they do and may even suggest modifications to the vehicle to make it easier for the patient. After those two assessments a patient may move on to driver’s training where they will be taught how to drive safer and more successfully.

Occupational Therapists are always looking for new innovative ways to help their patients.  One thing they are looking for right now is alternative pain management in therapy. Jana said traditional pain management includes hot/cold packs, pain medication, and estim/TENS. Occupational Therapists are looking at integrative restoration and mirror box therapy to see if these treatments can be as effective or even more so than traditional treatments.  

The last trend Jana mentioned was a team approach to Parkinson’s disease.  Jana said that they recently sent a team of therapists including Occupational Therapists, Physical Therapists and speech therapists, to a conference in Denver on Parkinson's disease. She said that traditionally Physical Therapists treated Parkinson’s patients but a more team treatment approach is being considered. In a team approach to treating Parkinson’s disease the role of the OT would be to have a functional balance for the patient during activities of daily living.   

Danielle Scherbel

I am from Star Valley, Wyoming and I called our county health department and talked with Patrice. Patrice is the Lincoln County Public Health Nurse Manager.  She guided me to two websites. The first website is called http://www.wyominghealthmatters.org/, and is web-based source of population data and information about community health and healthy communities in general. The second site is called http://www.countyhealthrankings.org/, which lets you compare and contrast your county’s health status with other counties’ health status, and your state health status with other states’ health status. From these sites I learned that the top five health trends in my county, Lincoln County, are adult smoking, death due to strokes, colorectal cancer incidence, E. coli incidence, and Salmonella incidence.

Adults who smoke: In Lincoln County, Wyoming, 15.9% of adults smoke. These adults have smoked at least 100 cigarettes in their lifetime and are currently smoking everyday or some days. The Healthy People 2020 national health target is to reduce the proportion of adults aged 18 years and older who smoke cigarettes to 12.0%. This is a target obviously still not met in Lincoln County. Why is it important to reduce Tobacco usage? Tobacco is ranked the highest in the nation for being most responsible for avoidable illness and death in America today. Approximately one-third of all tobacco users in our country will die prematurely because of their dependence on tobacco.

Mothers who Smoked During Pregnancy: In Lincoln County, Wyoming, 8.9% of mothers smoked during pregnancy. The Healthy People 2020 national health target is to decrease the percentage of women who gave birth and who smoked cigarettes during pregnancy to 1.4%. Smoking during pregnancy poses risks for both mother and fetus. A baby born to a mother who has smoked during her pregnancy is more likely to have less developed lungs and a lower birth weight, and is more likely to be born prematurely. It is estimated that smoking during pregnancy causes up to ten percent of all infant deaths. Even after a baby is born, secondhand smoking can contribute to SIDS (Sudden Infant Death Syndrome), asthma onset, and stunted growth.

Age-Adjusted Death Rate Due to Cerebrovascular Disease (Stroke): In Lincoln County, Wyoming, there are 48 deaths per 100,000 population due to strokes. The Healthy People 2020 national health target is to reduce the stroke deaths to 33.8 deaths per 100,000 population. Lincoln County has some prevention work to do to lower the rate of deaths from strokes. Cerebrovascular diseases rank third among the leading causes of death in the United States. Cerebrovascular disease can cause a stroke. A stroke occurs when blood vessels carrying oxygen to the brain become blocked or burst, thereby cutting off the brain's supply of oxygen. Lack of oxygen causes brain cells to die, which then can lead to death or disability. Each year, approximately 795,000 people in the U.S. will suffer a new or recurrent stroke.

Colorectal Cancer Incidence Rate: In Lincoln County, Wyoming, there are 51.8 cases per 100,000 population due to colorectal cancer (colon or rectum cancer). The Healthy People 2020 national health target is to reduce the colorectal cancer incidence rate to 38.6 cases per 100,000 population. Colorectal cancer is the second leading cause of cancer-related deaths in the United States. If adults aged 50 or older had regular screening tests, as many as 60% of the deaths from colorectal cancer could be prevented. In the U.S. in 2009, it is estimated that there were 106,100 new cases and 49,920 deaths from colorectal cancer.

E. coli Incidence Rate: In Lincoln County, Wyoming, there are 6.0 cases per 100,000 population due to E. coli incidences.  The Healthy People 2020 national health target is to reduce the E. coli O157:H7 incidence rate to 0.6 cases per 100,000 population. E. coli bacteria cause disease by making a toxin, or poison. The symptoms of E. coli infections vary for each person but often include severe stomach cramps, diarrhea (often bloody), and vomiting. Most people get better within 5-7 days. Some infections are very mild, but others are severe or even life threatening. E. coli live in the guts of ruminant animals, including cattle, goats, sheep, deer, and elk. Major routes of transmission include consumption of contaminated food, consumption of unpasteurized (raw) milk, consumption of water that has not been disinfected, contact with cattle, or contact with the feces of infected people. Experts think that there may be about 70,000 infections with E. coli each year in the United States. 

Amy Sprouse: Milwaukee, WI

I spoke with Karen Urbanek, a Health Education Specialist in the region surrounding Milwaukee, Wisconsin. She presents on Nutrition and Chronic Illness at Health Clinics for Nurses and patients, and at Company-sponsored Seminars, Elementary Schools, and most often at a Health Center in West Bend, WI (my home town).

The first Public Health trend we discussed was and increase in prevalence of diabetes among children and adults alike. She said that the causes were consistent consumption of nutritionally-depleted and processed foods and overall lack of education. “When people are unaware of the effects of a poor diet, they don’t make the connection that they could be perpetuating their health issues with every bite they take,” she explained.   She presents frequently on the link between diet and diabetes, and definitely takes a more educational approach in combating it (i.e., rather than sending a pre-diabetic to a health clinic to learn about insulin injections, she would rather teach them how to reverse it through diet improvements).  It is rapidly spreading throughout particular regions in Milwaukee where the lowest divisions on the socioeconomic latter live. Not only is there a significant lack of education because of high school drop-out and insufficient health education programs in schools and the community, but previous lack of access to nutritionally dense foods created unhealthy cultural habits.

Secondly she discussed an increase in leukemia and childhood cancer. She said this is a very alarming health trend because previously cancer was an illness that would (by far and away) be associated with the later stages in life. Influences of this trend include a variety of sources, including poor diet (low in antioxidants, living plants, and cancer-fighting micro-nutrients), lack of exercise, and excessive exposure to EMF rays. This is a leading reason why education needs to be increased. A lot of the major health concerns we are dealing with are chronic, and can be largely prevented and aided in reversing through lifestyle changes.

Childhood allergies and intolerances are dramatically increasing as well.  Not the “seasonal” allergies but allergies and intolerances to foods (such as gluten).  Karen attributes this to a detrimental intake of mercury, of which the statistical correlation is undeniable, and also to the excessive modification of certain foods. She used wheat as an example:  although wheat used to be an amazing whole grain that was ideal for just about everyone, it has been genetically modified so excessively that it is practically a different plant. Not everyone can tolerate it now.  

On a brighter note, Karen also mentioned an increasing awareness on parents’ behalf of the correlation between lifestyle and health outcomes.  More and more parents are realizing that food may make a difference, she said. Her optional health classes (ones held at a health education center rather than at a school or workplace where people would be normally) are growing in size and diversity.  School Districts are welcoming health interventions, such as the one she is involved in, and parents are fully behind it. It is less “health-nutty” to be interested in how to incorporate more produce into one’s diet, although it will take a while for the culture shifts necessary to decrease bad foods to take place.

Lastly we discussed influenza.  Despite the increase in flu-shots that have become available, this is still a growing health concern. Karen believes it has more to do with people’s weak immune systems than anything.  People who get the flu-shot can still get sick, especially if their immune system was weak to begin with (namely, pregnant women and small children).  Karen actually gets irritated with how strongly flu-shots are promoted, because whether or not you get the flu has more to do with your personal state of health, she says. To combat this health issue, she teaches how to eat and live to maintain a strong immune system.

Ellen Stone

                My best friend is going to be serving her mission in Miami, Florida and so I decided to do some research on the public health trends in her area.  Because I am from the west coast I thought it would also be interesting to do research on an area that I am not familiar with.  I talked to Biological Scientist, Lakisha Thomas, of Dade County.   Their health promotion quest reads, “Our Mission is to protect, promote & improve the health of all people in Florida through integrated state, county, & community efforts” which is strikingly similar to the definition we defined in class and gave me comfort in their ability to do so.  Speaking with Lakisha I was able to understand the five major issues that is affecting the health of their community. 

                Out of all five, the first was the only one that I had not heard of.  In their area there have been almost 9000 cases of Chlamydia in the year 2011.  This rate surpasses number two by roughly 6500 cases, thus taking the lead by a long shot.  Chlamydia is the most common sexually transmitted infection in the United States and this is even without a large population of reportings because it is commonly a silent disease- meaning no symptoms.  Studies show that chlamydia can infect men and women; however women are more likely to experience consequences to their reproductive organs from it. 

                The second was gonorrhea.   This is spread by having sex with someone who has the disease or by birth if the mother is infected, passing it on to her baby.  Most people who have gonorrhea have no symptoms.  However, if one is experiencing symptoms of this sexually transmitted disease it is common to feel burning while urinating, itching, and soreness.  Men can experience a white, yellow, or green discharge from the penis up to two weeks after the infection.  They can also get swollen testicles and have pain in their bowels.  For women it is typically milder and is often mistaken as a vaginal infections as burning occurs and sometimes bleeding between menstruation cycles. 

                HIV was the third one and was one that I was not surprised to see on the list.  HIV is a virus that attacks a person’s immune system.  This can be life threatening as they are vulnerable to many infections that can be much more serious than if they did not have HIV.   HIV can be spread by blood, bodily fluids related with sex, or breast milk.  This is devastating as it is common and spreads to those innocent children that do not know better.  With this disease your helper T cells, macrophages, and dendritic cells become infected. 

                The next was yet another sexually transmitted disease, syphilis.  Syphilis is caused by the bacteria Treponema pallidum.  There are different phases of this disease with varying degrees of severity.  People with primary syphilis get sores that look like circular bug bites.  These are often painless and are found around the genitals or the mouth.  Secondary syphilis is when the rash is on the hands.  This can last up to three months after exposure.  The last stage is tertiary and is a problem because it leads to heart, brain, and nerve issues if not treated.  Before penicillin was developed, syphilis was a threat, causing arthritis, brain damage, and sometime even blindness.

                The fifth was salmonella and I was surprised to see it on the list because I have often been jokingly warned of it when eating cookie dough so it almost seemed a novel idea.  This infection is introduced to the body by consuming uncooked meat, eggs, or poultry.  Symptoms can last up to a week, while it can take many months for your intestines to heal completely.  Salmonella can result in typhoid fever which can be a big problem in developing countries.  However, the most common symptoms are less life threating and include vomiting, diarrhea, fever, chills, and blood in the stool.  Treatments include antibiotics and plenty of fluid to replace those lost during diarrhea. 

Lauren Cheney

Lauren Cheney

3/27/13

                        Clare Torres, who is the  Senior Health  Data Analyst at the Arizona Department of Health Services explained five different public health trends within the community of  Gilbert, Arizona.

                        One trend that is fairly common in the southern states, is excessive heat.  Excessive natural heat can cause death and dehydration. We know that from 1992-2009, 1,485 deaths were from exposure to heat due to weather conditions in Arizona. 43.5 percent of the total of these deaths were Arizona residents. Older adults  or older have been at the highest risk for heatstroke or sunstroke among Arizona residents.

Another trend is cancer. Cancer has been the number one cause of death between Arizona residents for ages 0-84. In people 85 and older that heart disease continues to be the number one killer among Arizona residents. In 2008, people 85 and older were 15.3 percent of all deaths from cancer, but the 3.6.9 percent were accounted from heart disease. In 1990-2008, the number of deaths that resulted from cancer has increased 2.3 times among Arizonians.

One interesting trend was the trend of obesity and income in Arizona in the year 2007. Arizona residents with incomes $15,000- 24,999 were most likely to be obese. Those earning more than $50,000 were least likely to be obese. Obesity in Arizona decreased with incomes less than $15,000, but then it increased for the rest of the income groups. Obesity was also more common in non-white than whites.

From 1993-2007, adolescents and young adults were among the 2^nd group with the 2^nd highest death rate from motor vehicle accidents. The elderly older than age 85 had the highest mortality rate among all the age groups.  Among these years, there wasn’t a specific difference of mortality rate between ethnic groups, such as Blacks and Asians. Generally, as age increase, so does the mortality rate. The increase in mortality rate, was not as steep in females, than in males.

Injuries cause the highest rate of deaths among Arizonans ages 1 to 5 and 9 to 33. The highest among ethnic groups mortality rates for all injury deaths of children 1-14 years old in 2000 were those of American Indians. The injury death rates for adolescents 15-19 years old in 2000 were also higher among American Indians, than  Blacks, Hispanics and White nonHispanics. The highest mortality rates among ethnic groups for all injuries combined in both 1990 and 2000 were  American Indian residents of the State.In 2000, the injury mortality rate among American Indians was 2.4 times higher than the rate for Hispanics and 4.2 times as high as the injury death rate of Asians.

Natalie Williams-Top 5 Public Health Trends in Orange County, California

 Natalie Williams

Pauline Ries
Public Health Nurse
Hall of Administration
333 W. Santa Ana Blvd.
Santa Ana, CA 92701
714.834.5400
Top 5 Health Trends in Orange County, California

  
Orange County is my home town and I hope to live there again someday. In my study I was able to talk to a Public Health nurse, Pauline Ries from the Orange County department of public health. She explained to me some popular trends in the area that sparked my interest. First, issues involving Afghan refugees in Orange County. In addition, communicable disease trends found in Orange County. The trends I found are as follows.
    The first trend among Afghan refugees in Orange County, California are issues involving mental health. Refugees are at risk for mental health problems for a variety of reasons: loss of family members, traumatic experiences in and escapes from country of origin, culture shock, adjustment problems and culture conflict. They are also vulnerable to problems such as depression, somatic symptoms, and post-traumatic stress disorder.
    The next trend involving Afghan refugees in Orange County is the topic of challenges among Afghan refugee women. It states that refugee women face many challenges such as traumatic flight, loss of family members and property, and dramatic cultural differences in the country of resettlement. Interviews and observation was done and found that the elderly suffer from social Isolation and lack of respect; the middle generation struggle with the burden of being a house wife, employee and mediator between children and husband; young single women face culture conflict and lack of appropriate meals.
    Communicable disease trends in Orange County, California are as follows. First, Influenza activity remains elevated but is decreasing in Orange County. It is a respiratory illness caused by influenza viruses. Symptoms include fever, runny nose, cough, sore throat, headache, tiredness, and muscle aches. Prevent the spread of the flu by staying home and avoiding contact with others. Wash hands, cover mouth, avoid touching your eyes, mouth, or nose will prevent you from becoming ill.
    The next trend has to do with the importance of flu vaccinations. The best way to prevent yourself from getting the flu is getting vaccinated each year. The CDC recommends that everyone 6 months of age and older get a yearly vaccine. It states that you can get a vaccine from a local health care provider, clinics, or pharmacies. Those most recommended are pregnant women, children younger than 5 years of age, adults 50 years and older, those with chronic medical conditions, health care workers, and people who live with or care for those who are at a high risk of catching the flu.
    The last trend among communicable diseases is Tuberculosis control. Orange County provides screening services including two full service clinics for TB screening, diagnosis and treatment; one clinic in Santa Ana and another in Westminster. They also provide evaluation and treatment of individuals with the disease. Tuberculosis symptoms are as follows: cough, coughing up blood, fever, night sweats, unexplained weight loss, and abnormal chest X-rays. People who most have the disease are newly arriving refugees, immigrants, persons with HIV/AIDS, clients of residential detoxification centers, and clients of shelters.

Jon Conde

3/27/2013

I had the opportunity to interview Dr. McLane from the Utah Valley Sports Medicine office before she moved to Pennsylvania. She has seen me for a number of Rugby injuries and works closely with BYU athletics. She has been working as a sports medicine DO for many years here in Utah Valley and was very familar with some of the trends she see's on a daily basis.

1) Influenza: Dr. McLane said the number one reason she see's most patients is because of the flu or flu-like symptoms. This year was especially hard on the population and she saw multiple cases of the flu from the same patient over the season. She said that some of this can be attributed to people being hesitant to get the vaccine, or vaccine early enough for it to be effective, and that if someone gets the flu they need to stay home and rest instead of stressing out over school, work, or other activities.

2) Obesity: The number two health risk she saw in Utah county was obesity, even among some athlete groups. According to the Utah office of Public Health, over 60% of adults in UT are either over weight or obese. Dr. McLane said this could be the result of a long winter but that people need to start becoming more active even when it's cold outside and if someone is overweight, they need to take a smart and healthy approach into getting in shape instead of fad diets over overworking themselves.

3) Asthma: Asthma and other forms of respiratory illnesses have become quite serious in Utah County especially has the air quality has decreased at times. Pollution is the main culprit and she encouraged those who are susceptible to stay away from rigorous outdoor physical actives during low quality air periods. Dr. Mclane always recommends people use the medication they have been prescribed and know their limits.

4) Smoking: She said that although Utah County has a significantly lower rate of smoking among its residents as compared to other states and counties, she still see's the effects of smoking in patients that visit her. Smoking can lead to serious health effects such as respiratory illnesses and different types of cancer. Some people feel pressure and stress in Utah because of the culture and one of the ways peopletescape is through smoking. While it's not easy to quit the addiction, it is always possible and anytime to quit is the right time to quit, it's never too late.

5) Prescription Abuse: As a DO, Dr. McLane is generally opposed to prescribing drugs when possible and prefers to use more natural methods of healing and allow the body to self-correct. Still, she says that prescription drug abuse is a big problem in Utah County and is probably due to the culture and people feeling pressure from family and friends. This pressure leads to different kinds of activities that are unhealthy but most people don't feel too bad about overusing medications. People can even be abusing their drugs without even knowing by sharing painkillers or keeping and using medications after they expire.

Natalia Fisiinaua

I was able to talk to Isa Perry who is the community outreach planner at the Davis County Health Department. There were some general trends that Davis county is going through right now, bad air quality, suicide, and obesity but I was more interested in infectious disease because my emphasis is epidemiology. The top 5 trending infectious diseases in Davis county are chlamydia, hepatitis C, pertussis, latent tuberculosis, and streptococcal invasive.

Chlamydia- STDs in Utah are really high in general, but from what Isa told me Davis county is extremely high and it keeps climbing. People are having sex and it isn't protected. By people I mean the younger generation ages 14-19. It is transmitted by having anal, vaginal or oral sex. I think the reason why it is so high in Davis county is young people having multiple partners and not using protection properly. Take home message: If you're going to be active, be protected.

Hepatitis C- hep. C is a disease that affects the liver. It is transmitted when a person's blood, infected with hep. C, enters another person's body. It is commonly seen in avid drug users who use needles. There is no vaccine and the best way to avoid it is to stay away risky behavior that can spread the disease, like doing drugs. One reason why we think hep. C is so high is the process of screening is affordable. It is easier and affordable for a person to get tested so more people are able to get screened. Take home message: Stay away from needles and don't do drugs.

Pertussis- whooping cough. A respiratory tract infection. It is strange that a disease that has a vaccine to help prevent it is still infecting the community relentlessly. It is most common in infants. There are a lot of kids in Davis county. It is full of young families. The way that pertussis is spread is by contact so once one kid gets it, that chance of it spreading is high. Take home message: Take care of your kids.

Latent tuberculosis- At least if you have latent tb, you are not infectious, but you still have to be treated for it. Why would something like tb be such a problem in a county like Davis? I've got two theories; large elderly population, traveling. Davis county not only has a lot of young families, but there is also a large elderly population. Also people travel a lot out of the country and can contract the disease while on foreign lands and get tested here in the states and be positive for latent tb. Take home message: Be careful while traveling and get tested for tb if you haven't already.

Streptococcal invasive- I actually saw this a lot while growing up. Each school year at least 2 of my friends would be sick for a week or two with strep throat. It's an infectious disease that is spread by contact. The tricky thing about it though is a person can have it but won't show symptoms until a week or two later, and by then they have already made a lot of contact with a lot of things and people. Take home message: wash your hands.