Medical Assistant

Travel-associated mosquito-borne risks


Mosquito-borne disease risks can vary considerably depending on geographic location, local mosquito ecology, time of year, and the traveler’s length of stay and previous exposure to mosquito-borne viruses.

Malaria: most commonly reported with vast majority occurring in foreign-born residents returning to their country of origin; Liberia and Nigeria. Minnesota has the largest Liberian population in the world outside of the country itself. Caused by several protozoan species, malaria is endemic in many tropical and subtropical regions of the world. Transmitted to humans through bites by one genus of infected mosquitoes; people develop symptoms within one month like serious febrile illness. Confirmed by blood tests.

Chikungunya: following a rapid spread in the Caribbean islands and Latin America, the virus was reported in 2014 in Florida; after this small outbreak no further cases have been reported in the US. Transmitted to humans from bites of two species of infected mosquitoes commonly referred to as the yellow fever and Asian tiger mosquitoes.  Symptoms develop 3-7 days of infection which include fever and joint pain primarily.  Diagnosed using serology.

Zika: Introduced to Latin America and Caribbean in spring of 2015. Transmitted primarily by tiger and yellow fever mosquitoes. Like Chikungunya, Zika is spread rapidly due to infected individuals traveling to areas with competent mosquito vectors. Minnesota due to lack of appropriate vector populations is a Zika free area.

Dengue: one of the most frequently occurring mosquito-borne diseases worldwide most of which are acquired in Latin America. Outbreaks have occurred in warmed states like Texas and Hawaii. Endemic regions include Africa, India, and Southeast Asia, Latin America and the Caribbean. Transmitted through bite of infected yellow fever or Asian tiger mosquitoes. There are four distinct but use of NSAIDs is not recommended due to increased risk of hemorrhage so needs to be ruled out.

MDH monitors other diseases not commonly seen in the US including Rift Valley Fever virus, Murray Valley encephalitis virus, yellow fever and Japaneses encephalitis.

Franny Dorr, MPH Minnesota Health Care News June 2016

Genetic Risks


Type 2 Diabetes

Who’s Got It: about 29 million Americans including 1 in 4 people 65 or older

Family Risk: If both parents have the disease, you have a 1 in 2 chance of developing it. I just one parent has it, your risk is 1 in 7.


Who’s Got It: nearly 14.8 million in the U.S.; some 43,000 commit suicide each year with men in midlife at highest risk.

Family Risk: Having one parent with major depression or another mood disorder makes people two to thee times more likely to develop depression. If both parents have a mood disorder, the risk rises to five times higher than average.

Colorectal Cancer

Who’s Got It: third most common cancer in the U.S and second most deadly, with approximately 137,000 people diagnosed each year.

Family Risk: People with a close relative who has had coon cancer are up to three times as likely to develop it themselves. African Americans have a 20 percent higher incidence rate and a 45 percent higher mortality rate.

How to Defy Your Genes by Sarah Mahoney; AARP The Magazine June/July 2016



Health fraud scams abound in nontraditional markets such as international stores, flea markets, and online warns the FDA.

Products may be marketed as dietary supplements that are ‘all natural‘ which is meant to target consumers who use herbal remedies,and shop at nontraditional places.

The FDA offers these tips to determine whether or not a non-prescription drug product is fraudulent;

One product can’t do it all. Be wary of products that claim to cure a wide range of disease.

Evaluate the evidence. Personal testimonials are not a sufficient substitution for scientific evidence.

True treatment takes time. Few diseases and conditions can be treated and cured quickly, even with legitimate products. Beware of quick-fix language.

Nature doesn’t equal nurture. Beware of ‘all-natural’ products; remember some plants can kill if ingested. Some products have hidden and dangerously high doses of prescription drug ingredients.

Check for FDA approval. Domestic or imported dietary supplements are not approved by the FDA.

CMA Today Mar-Apr 2016


Oil change


A little fat does a body good, and these oils are loaded with the healthy kind that keeps systems running smoothly.

Sesame- rich in flavor and packed with poly- and monosaturated fats. It has a low smoke point making it best for lower temperature cooking and dressings.

Olive- contains monosaturated fats and antioxidants. Has been shown to help reduce inflammation and to lower heart disease risk, Look for “col and “extra-virgin” which mean the oil has not been treated with chemicals or altered by temperature, so the nutrients are persevered. Loses antioxidants within six months of opening.

Walnut- one off the best nut sources of omega-3 fatty acids that are good for heart and brain. Has a low smoke point; try in vinaigrettes or drizzled on veggies.

Grapeseed- full of anti-inflammatory antioxidants along with heart-healthy polyunsaturated fats and vitamin E. Mixes well with herbs and spices.

Flaxseed- concentrated source of omega-3s and 6s that may help ease stomach issues. Only keeps for two to three months and should be refrigerated.

Avocado- nearly 70% heart healthy monosaturated fats. High some point and a smooth, nutty taste. Costs a bit more than most but has a long life- about a year.

Peanut- same health benefit as peanuts including monounsaturated fats and resveratrol, the antioxidant also found in red wine. High smoke point so good for stir-frying, sautéing and roasting.

February 2016 Better Homes and Gardens

Checking out chickenpox


Chickenpox cases in the US have dropped sharply since a vaccine against this disease became available in 1995. Before this, nationwide cases of chickenpox numbered about 4 million annually. Of these 4 million people, nearly 11,000 were hospitalized, and  up to 150 died according to the CDC. As of 2012 there have been 94% fewer hospitalizations and 84% fewer outpatient visits for chickenpox than before 1995.

The largest decrease in chickenpox occurred among the target group for vaccination: children and teenagers between the ages of 1 and 19. But there were also significant drops in outpatient visits and hospitalizations among children younger than 12 months- whom the vaccine is not recommended and among adults who tend to not get vaccination. These results illustrate the potential of herd immunity.

CMA Today Mar-Apr 2016

What’s your colon cancer risk?


Average risk: colonoscopy every 10 years starting at age 50 but age 45 for African Americans.

Increased risk:

1. Immediate family member with colon cancer or polyps at age 60 or younger- colonoscopy every 5 years starting at age 40 or 10 years younger than earliest family detection.

2. If two extended family members have been diagnosed with colon cancer- colonoscopy every 10 years staring at age 40.

3. Two immediate family members with colon cancer at any age- colonoscopy every 5 years starting at age 40 or 10 years younger than earliest family detection.

4. Positive test indicating blood in stool- schedule a colonoscopy immediately

High risk:

1. Familial adenomatous polyposis (a condition where numerous polyps form)- annual sigmoidoscopy starting at age 10-12; colonoscopy every 1-2 years starting in late teens.

2. Lynch syndrome (a condition that increases risk)- every 1-2 years starting before age 25 or 10 years younger than earliest family detection.


Adult addiction adding up


The largest portion of the US population addicted to narcotics is not teenagers or young professionals, but older adults ages 50-59. In 1996, 7.8% of older adults sought treatment programs for painkiller dependence and addiction; in 2012, that number increased to 35.9%. Additionally, the percentage of patients between the ages of 60 and 69 addicted to narcotics increased significantly.

In contrast, the percentage of such patients ages 40 and younger has dropped from 56% in 1996 to approximately 20% by 2012.

Although pain killer dependence isn’t new, and most states have rigorous prescribing protocols in place, these findings highlight the need for ample access to medical opiate treatment centers.

CMA Today Mar-Apr 2016

Top 5: Ways to lower your risk of diabetes


1. Get more physical activity: aerobic exercise and resistance training can help you lose weight, lower your blood sugar, boost your sensitivity to insulin which helps keep blood sugar within a normal range.

2. Get plenty of fiber: high fiber foods such as fruits, vegetables, beans, whole grains, nuts and seeds can improved your sugar control, lower risk of heart disease and promote weight loss by helping you feel full.

3. Go for whole grains to maintain blood sugar levels. Try to make at least half your grains whole such as breads, pasta products and cereals. Look for the word “whole” on the package and among the first few items on the ingredient list.

4. Lose extra weight: participants in one large study who lost a most amount of weight (7% of initial body weight) and exercised regularly reduced risk of developing diabetes by 60%.

5. Skip fad diets, make healthier choices: Low-carb diets, glycemic index diet and others help lose weight at first but their help at preventing diabetes isn’t known nor are their long term side effects. Think variety and portion control as part of an overall health eating plan.

The American Diabetes Association recommends a blood glucose screening if you’re age 45 and older and overweight or if you are younger that 45 and overweight with one or more additional risk factors such as family history or sedentary lifestyle.

Take Your Brain To The Gym


Try these techniques to help improve your memory:

Socialize regularly: helps ward off depression and stress both of which can contribute to memory loss.

Get organized: Jot down tasks, appointments  and other events in a specific place. Keep to do lists current and check off items completed.

Include physical activity in your daily routine: increases blood flow to your whole body including your brain and might help keep your memory sharp. Aim for at least 150 minutes per week of moderate aerobic activity or 75 minutes of vigorous aerobic activity.

Stay mentally active: try crossword puzzles, take alternate routes when driving or learn to play a musical instrument.

Eat a healthy diet: Eating fruits, vegetables and whole grains can work wonders for brainpower. Choose low-fat protein sources and drink plenty of water.



One ounce has 6 g protein, 24% of a daily dose of B6 and 6% of daily iron. Pistachios do have fat, but it’s polyunsaturated, heart healthy kind and this size contains 160 calories.

Ounce for ounce, pistachios are lower in calories than most nuts except for almonds and cashews.

Pistachios are ideal for in  between meal snacking. Shell them as eating to give stomach the fullness message.

These nuts last up to a year frozen, up to six months refrigerated and up to three months at room temperature.