Drug Monitoring Programs Do Curb Overdose Deaths: Study

THURSDAY, June 23, 2016 (HealthDay News) — Drug monitoring programs appear to help reduce deaths from prescription painkillers called opioids, a new study finds.

In an effort to curb overdose deaths from powerful painkillers such as OxyContin and Vicodin, all states except Missouri have implemented prescription-drug monitoring programs to track high-risk patients and prescription providers. But there have been conflicting findings about the effectiveness of these programs.

For instance, a study published June 23 in the New England Journal of Medicine found no change in opioid use or overdoses among disabled workers on Medicare between 2006 and 2012, despite tighter regulations.

But the current study — based on data from 1999 to 2013 — found that monitoring programs were associated with the prevention of about one opioid painkiller overdose death every two hours nationwide.

“Today, opioid overdose deaths are more common than deaths from car crashes. Our study provides support that prescription-drug monitoring programs are part of what needs to be a comprehensive approach to the prescription opioid epidemic,” said lead author Dr. Stephen Patrick, an assistant professor of pediatrics and health policy at Vanderbilt University, in Nashville, Tenn.

The largest reductions in opioid overdose deaths were in states with the most thorough monitoring programs, researchers found. These tracked a greater number of substances with abuse potential and updated their data at least weekly.

Although the study can’t prove causality, states with the most thorough programs had 1.6 fewer opioid overdose deaths per 100,000 people than states without such programs, according to the study. The findings were published June 22 in the journal Health Affairs.

Between 1999 and 2014, more than 165,000 people died nationwide from prescription opioid overdoses, according to the U.S. Centers for Disease Control and Prevention. The drugs are frequently misused because they produce euphoria as well as pain relief.

“Congress is currently considering legislation to bolster the U.S. public health response to the opioid epidemic. Our findings suggest that investments in upgraded prescription-drug monitoring programs will pay dividends in lives saved,” Patrick said in a Vanderbilt news release.

More information

The U.S. National Institute on Drug Abuse has more about opioids.

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Keep Safe When Temperatures Soar

THURSDAY, June 23, 2016 (HealthDay News) — With high temperatures moving across the United States this weekend, one emergency medicine specialist warns of the health dangers posed by the heat — and offers advice on how to keep cool as the mercury rises.

“Although preventable, many heat-related illnesses, including deaths, occur annually. Older adults, infants and children, and people with chronic medical conditions are particularly susceptible. However, even young and healthy individuals can succumb to the heat if one does not take appropriate precautions,” said Dr. Barry Rosenthal, chair of the department of emergency medicine at Winthrop-University Hospital, in Mineola, N.Y.

He outlined how to reduce the risk of heat-related illnesses during hot weather. One of the best ways is to be in an air-conditioned building. If your home doesn’t have air conditioning, go to a cooling center or an air-conditioned public place such as a library or shopping mall.

Wear loose, lightweight and light-colored clothing, wear a hat or use an umbrella, and apply sunscreen to any exposed skin. It’s also important to drink plenty of water in order to stay hydrated. Avoid alcoholic, caffeinated and sugary beverages, Rosenthal advised.

Ask your doctor or pharmacist if any medications you’re taking increase your risk of heat-related illness. For example, diuretics (water pills) can pose a risk during hot weather. If you’re taking a medication that ups the risk of heat-related problems, ask your doctor if there are additional steps you need to take to reduce the risk.

If possible, limit strenuous outdoor activity and exercise to early morning or evening, when temperatures are lower. Monitor local news and weather channels or contact your local public health department during extreme heat for health and safety updates.

Check on people who are at increased risk for heat-related illnesses, such as elderly loved ones and neighbors.

“At first signs of heat illness — dizziness, nausea, headaches, muscle cramps — move to a cooler place, rest a few minutes, then slowly drink a cool beverage. Seek medical attention immediately if conditions do not improve,” Rosenthal said.

More information

The U.S. Centers for Disease Control and Prevention has more about extreme heat and health.

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Fiber: The Rx for Disease-Free Aging

By Alan Mozes
HealthDay Reporter

THURSDAY, June 23, 2016 (HealthDay News) — Foods rich in fiber not only keep you “regular,” they may help you live longer without disease, new research suggests.

Among more than 1,600 Australian adults, the top fiber consumers were 80 percent more likely to remain fully functional and disease-free as they aged, the study found.

Fiber-rich foods include fruits and whole grains.

“Our observations need to be confirmed by other large studies, and we can’t make recommendations at this stage such as pushing for a more plant-based diet,” said study lead author Bamini Gopinath, an associate professor in the University of Sydney’s Westmead Institute for Medical Research. Her Australian team only found an association rather than a cause-and-effect link.

Still, Gopinath and her colleagues weren’t surprised by the findings, “given that there are numerous studies showing fiber’s protective influence against a host of chronic diseases,” she said.

“Successful aging” was defined in the study as the continued absence of physical disability, depression, breathing problems, or chronic health issues such as cancer, high blood pressure, diabetes or heart disease.

“People can achieve the recommended intake of fiber consumption — around 30 grams per day — by eating a wide range of foods such as whole-grain breads and cereals, fruits, vegetables and legumes,” Gopinath noted.

The researchers tracked the study participants, who were 49 years and older, for a decade starting in 1994. At the start, all were free of cancer and heart disease.

Surveys assessed dietary routines, with a specific focus on fiber, carbohydrates and sugar intake.

By those measures, the study team concluded that 15.5 percent of the participants had aged “successfully” over the 10-year time frame.

By contrast, those whose fiber consumption was pegged at below-average levels were least likely to have aged well.

Blood sugar levels and the impact of carbohydrates on blood sugar levels did not seem to play a role in how successfully people aged, the team noted.

The researchers also found that only 25 percent of study participants were meeting daily fiber intake recommendations. Gopinath said this accurately reflects general population habits.

Certain fruits and vegetables contain more fiber than others, said Lona Sandon, an assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center at Dallas. Tops on her list are nuts, seeds, beans, avocados, strawberries, raspberries, blueberries, oranges, carrots, leafy greens, corn, peas, popcorn, bran cereals and oatmeal.

“A plant-based diet is the best way to go to get the fiber your body needs for optimal health,” Sandon said.

But what exactly is it about fiber that promotes longevity?

“Based on our study we can’t exactly pinpoint as to how fiber influences aging status,” said Gopinath. But she said that her team speculates that fiber may affect blood sugar levels, minimizing inflammation throughout the body.

“Inflammation is a key factor in aging and many chronic conditions. Also, fiber is known to increase satiety, which is likely to explain some of its health benefits,” she explained.

Sandon added: “What makes fiber so beneficial is up for a great deal of debate, and it is probably more than one thing.”

For one thing, not all fiber is the same, she said, noting soluble and insoluble dietary fiber have different functions in the body.

“Different fibers also provide food for the bacteria in the gut,” Sandon added. “These bacteria may produce substances that help promote health such as hormones that help regulate appetite and blood sugar.”

The study results were published recently in the Journals of Gerontology.

More information

The American Institute for Cancer Research has tips on nutrition after 50.

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Southern States Lagging in Tough Smoking Bans, CDC Says

THURSDAY, June 23, 2016 (HealthDay News) — Smokers in southern states can still find plenty of places to spread secondhand smoke to others, a new report finds.

In fact, no states in the U.S. Southeast have comprehensive smoke-free laws to protect nonsmokers from tobacco fumes, a federal government report says.

This type of law bans smoking in all indoor areas of workplaces, restaurants and bars.

Dr. Tom Frieden directs the U.S. Centers for Disease Control and Prevention. “We’ve made great progress in protecting many Americans from secondhand smoke exposure,” he said, “but millions of Americans, especially those living in southeastern states, are still unprotected from this completely preventable health hazard.”

The number of states with comprehensive smoke-free laws rose from zero in 2000 to 26 by 2010, including the District of Columbia. But progress has stalled: Only two more states were added to that list between 2010 and 2016, the CDC noted.

“The lack of comprehensive statewide smoke-free laws in some U.S. states represents a key policy failure,” added Dr. Ernest Hawk, head of cancer prevention & population sciences at the University of Texas MD Anderson Cancer Center in Houston.

But progress has been made. Overall, the CDC report finds that nearly 60 percent of Americans are covered by comprehensive smoke-free laws at the state or local level, compared with less than 3 percent in 2000.

Local anti-smoking laws also protect some residents living in 14 of the 23 states without comprehensive smoke-free laws. However, nine states have no such laws at either the local or state level, and eight states even forbid local officials from passing smoke-free laws, the CDC researchers said.

Local anti-smoking regulations also vary widely in the 14 states without comprehensive smoke-free laws, the report found. For example, local laws protect 60 percent of people in West Virginia. In Kentucky, South Carolina and Texas smoking laws cover about 30 percent of people. However, only 2.4 percent of people in Georgia, and less than 1 percent of people in Arkansas and Wyoming are protected by smoking laws, the findings showed.

“Ten years ago, the Surgeon General concluded there is no risk-free level of secondhand smoke exposure,” Frieden noted in an agency news release.

Exposure to secondhand smoke causes heart disease and lung cancer. Together, the two diseases kill more than 41,000 nonsmokers every year in the United States. Even brief exposure to secondhand smoke is a health threat, and completely eliminating indoor smoking is the only way to fully protect nonsmokers, according to the CDC.

“Smoke-free laws provide a low-cost, high-impact benefit to the public’s health,” said Corinne Graffunder, director of the CDC’s Office on Smoking and Health.

“These laws substantially improve indoor air quality, help smokers quit, prevent youth and young adults from starting to smoke, change social norms about the acceptability of smoking, and reduce heart attack and asthma hospitalizations among non-smokers,” she explained.

The CDC also noted that smoke-free laws can be extended to other types of tobacco products, such as e-cigarettes. Currently, seven states — California, Delaware, Hawaii, New Jersey, North Dakota, Oregon and Utah — include e-cigarettes in their comprehensive smoke-free laws.

The report was published June 23 in the CDC’s Morbidity and Mortality Weekly Report.

More information

The U.S. National Cancer Institute has more on the dangers of secondhand smoke.

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Healthy Living Slashes Cancer Risk

By Dennis Thompson
HealthDay Reporter

THURSDAY, June 23, 2016 (HealthDay News) — A healthy lifestyle that includes regular exercise and eating nutritiously can lower your risk of developing cancer by as much as 45 percent, a new evidence review concludes.

The review also found that people who followed cancer prevention guidelines for diet and activity were up to 61 percent less likely to die from cancer, the researchers reported.

“Overall, we saw there is quite a reduction in getting cancer or dying from cancer if you follow [cancer-prevention] guidelines,” said lead researcher Lindsay Kohler, a doctoral student in epidemiology at the University of Arizona’s Mel and Enid Zuckerman College of Public Health.

Healthy living is particularly effective in preventing breast, endometrial and colon cancer, Kohler and her colleagues found.

Living right can reduce risk of breast cancer by 19 percent to 60 percent, endometrial cancer by 23 percent to 60 percent, and colon cancer in men and women by 27 percent to 52 percent, they reported.

“Those cancers have been shown in other studies to be related to obesity,” Kohler said. “Most of these guidelines are going to help prevent you from being obese.”

Nearly 1.7 million new cases of cancer are expected to occur in the United States in 2016, and about 596,000 people are expected to die from cancer, the researchers said in background information.

Eating poorly, drinking too much alcohol, carrying too much weight and being a couch potato could account for more than 20 percent of cancer cases, researchers said.

To see whether a healthy lifestyle would result in fewer cancer cases and deaths, the researchers reviewed 12 studies that examined the effectiveness of prevention guidelines published by the American Cancer Society and the World Cancer Research Fund/American Institute for Cancer Research.

These guidelines recommend lifestyle changes such as maintaining a healthy weight, exercising regularly, choosing whole grains over refined grains, limiting consumption of processed or red meat, avoiding excess alcohol, and eating five or more servings of a variety of colorful fruits and vegetables every day.

Health officials believe sticking as tightly as possible to these cancer prevention guidelines will provide the most benefit, said Marjorie McCullough, strategic director of nutritional epidemiology for the American Cancer Society.

“The benefits really add up,” McCullough said. “The guidelines themselves are based on the current evidence of what we know to lower the risk of cancer. Each of these components are important. The more guidelines that are followed, the lower the cancer risk.”

The studies included in the new evidence review bear this out, Kohler said.

For example, one study found that a person’s risk of breast cancer decreased 11 percent for each additional recommendation they adopted, she said. Someone eating right would lower their risk by 11 percent, while eating right and exercising would lower risk by 22 percent.

“Even following some guidelines is going to make a difference,” Kohler said.

While these guidelines reduce overall cancer risk, some cancers did not respond as well as others. The review found they did not seem to reduce risk of ovarian or prostate cancer, and they only seemed to benefit men when it came to lung cancer, Kohler said.

Kohler noted that these sort of lifestyle changes also have been shown to reduce heart disease and improve a person’s overall health, making them worth pursuing for more than just cancer prevention.

“If you follow as many of these guidelines as you can, you’re going to improve your life overall,” she said.

Findings from the study were published online June 23 in Cancer Epidemiology, Biomarkers & Prevention.

More information

For more on cancer prevention, visit the American Cancer Society.

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Dengue Virus May Bolster Zika’s Attack

THURSDAY, June 23, 2016 (HealthDay News) — Prior exposure to the dengue fever virus may increase the severity of Zika virus, a new study says.

Early stage laboratory findings suggest this connection between the two viruses may help explain the current Zika outbreak in Latin American and Caribbean countries, according to the international team of researchers.

Dengue and Zika belong to the Flaviviridae family of viruses and are transmitted by the Aedes aegypti mosquito.

“Although this work is at a very early stage, it suggests previous exposure to dengue virus may enhance Zika infection,” said study senior author Gavin Screaton, dean of the Faculty of Medicine at Imperial College London, in England.

“This may be why the current outbreak has been so severe, and why it has been in areas where dengue is prevalent. We now need further studies to confirm these findings, and to progress towards a vaccine,” Screaton said in a college news release.

In recent decades, cases of dengue fever have increased sharply. The virus is believed to cause about 390 million infections a year, and about half of the world’s population is at risk of dengue, according to the World Health Organization. Like Zika, it is most prevalent in tropical and subtropical climates.

The researchers said that once someone has had dengue exposure, Zika may use the body’s own immune defenses as a “Trojan horse” in order to enter cells undetected. Once inside the cell, Zika replicates rapidly.

“We can’t say yet whether this interaction is playing a role in the current outbreak, but if confirmed it’s likely to have important implications for the control and global spread of Zika, and for the development of any vaccine for the virus,” said Dr. Jeremy Farrar, director of the Wellcome Trust, a medical research charity. The Trust funded the study, published June 23 in Nature Immunology.

Although most people infected by Zika suffer only mild symptoms, in pregnancy it can cause severe birth defects, including brain damage.

In another study, the same research team found that an antibody that’s effective against dengue may also counter Zika. The researchers believe this finding that could aid efforts to develop a vaccine against Zika.

These findings were published June 23 in the journal Nature.

Zika and dengue “share many similarities in their genetic makeup, transmission pattern and in the immune response they trigger,” said Farrar.

“These new studies suggest that prior infection with dengue doesn’t offer any protection against Zika, and may in fact predispose people to a more severe infection,” Farrar said.

For now, there are more questions than answers about Zika and this group of viruses, including dengue, he added.

“We know that Zika has been present in Southeast Asia and Africa for many years and yet has not taken off there as it has in South America. This is what the international research effort needs to work out, and quickly,” Farrar said.

More information

The U.S. Centers for Disease Control and Prevention has more on the Zika virus.

This Q&A will tell you what you need to know about Zika.

To see the CDC list of sites where Zika virus is active and may pose a threat to pregnant women, click here.

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Guidelines Stop Heat Stroke Deaths in High School Athletes

By Don Rauf
HealthDay Reporter

THURSDAY, June 23, 2016 (HealthDay News) — There have been no deaths among high school football players during preseason practice in states with guidelines to help students get used to the heat over time, a new study says.

In contrast, heat stroke deaths during preseason practices were 2.5 times higher in states before they adopted the guidelines, the study found.

“A lot of people don’t realize that heat stroke is preventable, and a bigger number of people may not realize that heat stroke is 100 percent survivable if it’s treated appropriately,” said study author Douglas Casa.

“The guidelines are an example of a policy change that can help prevent heat stroke,” Casa said. He is chief executive officer at the Korey Stringer Institute at the University of Connecticut in Storrs.

The National Athletic Trainers’ Association released protocols for helping athletes get used to the heat (heat acclimatization) in 2009. The guidelines were developed by an inter-association task force, which included representatives from the American Academy of Pediatrics, the American College of Sports Medicine, the U.S. Centers for Disease Control and Prevention (CDC), and other organizations.

The guidelines were developed in response to heat-related deaths in high school athletes. Between 1980 and 2015, there were 44 exertional heat stroke-related deaths during preseason high school football practices. A total of 22 of these deaths occurred in states that eventually went on to adopt the guidelines, the researchers said.

Exertional heat stroke is a life-threatening medical condition. It occurs when the body’s core temperature gets too high because of excessive physical activity. It often occurs in hot weather, but can occur any time, according to the Korey Stringer Institute.

When preseason training begins, athletes may not be prepared to cope with the hot weather and the physical demands required because they’re not used to exercising in the heat, the Institute notes.

Heat acclimatization methods help a body adapt to exercising in the heat and cope with heat stress. The guidelines include limiting practice to no more than one per day during the first one to five days of practice, and limiting practice sessions to no more than three hours in a day.

The study included 48 high school football preseasons. The high schools were in 14 states that had adopted heat stroke prevention guidelines since 2011. Casa noted only one exertional heat stroke death during these preseasons. And, that incident occurred at a school that “blatantly violated the state policy,” he said.

David Csillan is head athletic trainer at Ewing High School in New Jersey. He said that “the data clearly shows that catastrophic events, resulting from exertional heat stroke, continue to be present in those schools neglecting to adopt the heat acclimatization guidelines as a minimum best practice.”

According to Csillan, “Ensuring that proper guidelines are in place, that athletic trainers and others on the sports medicine team are closely monitoring activity, and that athletes recognize the signs and symptoms of exertional heat stroke are all important steps in reducing incidence.”

Even though the guidelines have led to a drop in student-athlete deaths, Casa said that changing policies on a high school level is daunting. “You have to change them state by state because there’s no national governing body that can set those guidelines,” he said. “It’s quite a process and probably one of the reasons that change is so slow for high school sports.”

Casa, who served as co-chair of the task force that put together the guidelines, added that some states have a hard time breaking with tradition.

“States all make changes after they’ve had a tragedy,” he said. “Very few states are proactive and say, ‘We haven’t had a tragedy, but this is working in all these other places, so to avert our potential tragedy we’re going to make the change.’ That doesn’t happen often, unfortunately. But they all make the push once there’s a death. We are constantly saying, do whatever you can before they die.”

The CDC says that muscle cramping can be a first sign of heat-related illness that can lead to heat stroke. Other symptoms may include heavy sweating, weakness, cold and clammy skin, fast pulse, nausea or vomiting, and fainting.

If experiencing heat-related illness, it’s important to get to a cooler location and lie down. If the condition is severe, call 911 and try to reduce body temperature with cool cloths or possibly a cool bath, the CDC advises. Do not give fluids in this situation.

Findings from the study were scheduled to be presented Thursday at the National Athletic Trainers’ Association meeting in Baltimore. Findings presented at meetings are generally viewed as preliminary until they’ve been published in a peer-reviewed journal.

More information

The University of Connecticut offers additional details on heat acclimatization policies.

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Sprained Ankle Could Pose Longer-Term Harms to Health

By E.J. Mundell
HealthDay Reporter

THURSDAY, June 23, 2016 (HealthDay News) — Many Americans have suffered through an ankle break or sprain, but new research suggests these injuries might have a larger effect on health.

The study, based on a survey of thousands of adults, found that people with injured ankles tend to have higher rates of disability and arthritis, heart or respiratory issues going forward.

The study can’t prove cause-and-effect, but it points to the importance of proper rehabilitation after such injuries, the researchers said.

“What is concerning is these differences are presenting across the life span — especially during the critical middle age years when our risk for these diseases begins to increase,” said study author Phillip Gribble. He’s an associate professor in the department of rehabilitation sciences at the University of Kentucky, in Lexington.

In the study, Gribble’s team conducted an online survey of over 3,500 adults. More than 1,800 of them said they had sustained some kind of ankle injury at some point in their lives.

Those who’d had such injuries were more likely to say they were “somewhat” to “completely” limited in their daily activities compared to people without such histories, at 46 percent vs. 36 percent, respectively. Rates of moderate to severe body pain were also higher (38 percent vs. about 27 percent).

The study also found higher rates of heart or respiratory ailments in people who’d injured their ankle versus those who hadn’t (about 31 percent vs. 24.5 percent, respectively).

Not surprisingly, arthritis of the ankle was also much more likely among those who previously injured the joint (9.4 percent) compared to those who hadn’t (1.8 percent), Gribble’s team found.

Overall, the findings suggest that ankle breaks and strains should be taken more seriously, the researchers said.

“In isolation, ankle injuries are seen as relatively benign and inconsequential injuries,” noted Gribble, who is also co-director of the International Ankle Consortium, a specialist research group.

“This is not just a problem for athletes, as a large percentage of the population reports chronic ankle issues,” he noted. “Better efforts are needed to prevent the initial injuries, and also to introduce improved interventions post-injury, to reduce the high rate of chronicity we see in ankle injury patients.”

Another expert in athletic injury agreed.

The study “supports other research reporting the negative long-term effects of an ankle sprain,” said Tricia Hubbard-Turner, an associate professor at the Center for Biomedical Engineering Systems at the University of North Carolina at Charlotte.

“The take-home message should be there is no such thing as ‘just an ankle sprain,'” she said.

Hubbard-Turner offered advice on proper recovery from an ankle injury:

• Give the ankle adequate time to rest and heal.
• Use crutches if possible during the healing process, and begin a rehab exercise regimen once healing occurs.
• Exercise could include: “motion exercises [pointing toes up and down, writing the alphabet with your feet], strengthening [tubing exercises, cuff weight around the foot], balance exercises [standing on one leg] and more functional activities [light jogging, zigzags, figure eights] before returning to activity,” she said.

“Enabling healing and rehabilitation is key to preventing the negative consequences reported in the Gribble study,” Hubbard-Turner said.

“This may mean missing sports activity or modifying exercise [for example, trying non-weight bearing exercise] for a few weeks, depending on the severity of injury,” she acknowledged. “But those few weeks are well worth it based on the long-term problems people are developing.”

The study was to be presented Thursday at the annual meeting of the National Athletic Trainers’ Association in Baltimore. Experts note that research presented at medical meetings is typically considered preliminary until published in a peer-reviewed journal.

More information

To find out more about ankle injury and recovery, head to the American Orthopaedic Foot & Ankle Society.

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Dallas Confirms 10 Zika Cases in Pregnant Women

By Dennis Thompson
HealthDay Reporter

THURSDAY, June 23, 2016 (HealthDay News) — At least 10 pregnant women in the Dallas area have been infected with Zika, Texas officials confirmed Wednesday.

All of the women contracted the mosquito-borne virus while traveling abroad, Dallas Health and Human Services officials told CBS News.

In related news, the U.S. House on Thursday approved a $1.1 billion funding package to combat the Zika threat, the Associated Press reported.

The bill still needs to be approved by the U.S. Senate, and it remains to be seen if President Barack Obama will sign it. Obama originally asked Congress for $1.9 billion, and Democrats and the White House have voiced opposition to certain provisions of the package.

Even though there have been no local transmissions of Zika reported yet in the United States, the number of cases of infection among pregnant women keeps climbing.

As of June 9, the U.S. Centers for Disease Control and Prevention reported there are 234 cases of pregnant women on the U.S. mainland who have been infected with Zika, which typically involves relatively mild symptoms in most adults. However, it can cause devastating birth defects in babies that include microcephaly, where an infant is born with an abnormally small head and brain.

In Latin America, thousands of babies have already been born with microcephaly. And researchers reported Wednesday that fears over Zika-related birth defects may be driving up abortion rates in Latin American countries affected by the virus.

In Brazil and Ecuador — where governments have issued health warnings on the danger to the fetus from maternal Zika infection — requests for abortion in 2016 have doubled from 2010 rates, the researchers reported.

The other 17 Latin American countries covered by the new study had their rates rise by more than a third during that time, according to the report in the New England Journal of Medicine.

The researchers noted that because data on family planning in Latin America is often hard to come by, their numbers may underestimate the surge in abortions since Zika’s emergence.

“The World Health Organization predicts as many as 4 million Zika cases across the Americas over the next year, and the virus will inevitably spread to other countries,” noted study senior author Dr. Catherine Aiken, of the University of Cambridge in England.

But no nation has been more affected than Brazil. As a result of the Zika epidemic, almost 5,000 babies have been born with microcephaly there.

However, the CDC warned last Friday that infection rates are rising in Puerto Rico. Testing of blood donations in the U.S. territory — “our most accurate real-time leading indicator of Zika activity” — suggest that more and more people on the island have been infected, according to CDC Director Dr. Tom Frieden.

“The real importance of this information is that in coming months it’s possible that thousands of pregnant women in Puerto Rico could become infected with Zika,” Frieden stressed. “This could lead to dozens or hundreds of infants being born with microcephaly in the coming year,” he added.

“Controlling this mosquito is very difficult,” Frieden said. “It takes an entire community working together to protect a pregnant woman.”

Because the virus remains largely undetected, it will be months before affected babies begin to be born, Frieden said. Some will have microcephaly or other brain-related birth defects. But many will appear healthy and normal, and there’s no way to know how they might have been affected, he explained.

Zika is typically transmitted via the bite of the Aedes aegypti mosquito. But, transmission of the virus through sex is more common than previously thought, World Health Organization officials have said.

Women of child-bearing age who live in an active Zika region should protect themselves from mosquitoes by wearing long-sleeved shirts and long pants, using mosquito repellent when outside, and staying indoors as much as possible, according to the CDC.

More information

Visit the U.S. Centers for Disease Control and Prevention for more on the Zika virus.

This Q&A will tell you what you need to know about Zika.

To see the CDC list of sites where Zika virus is active and may pose a threat to pregnant women, click here.

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Jessica Sepel's top tips for nourishment

 

We got the inside scoop on how clinical nutritionist and author, Jessica Sepel balances food and wellness. Here she shares her three tips for nourishment.

 

 

Count macros, not calories: our bodies and metabolism are regulated by so many things other than calories, so how you burn a meal will depend on your hormones, stress levels, fitness and environment. Instead, ensure you have protein, good fat, carbohydrate and greens at every meal. Nutrients are what make you feel satisfied so you don’t over-eat.

Tune in to your body: portion control does have its place, so be present and mindful when you’re eating. I want to teach people to reconnect to their appetite – we are so busy reading different health advice that we have stopped listening to our own bodies. 

Keep it simple: as soon as I see a recipe with more than five ingredients, I can’t even look at it. Simplify health and make it a less daunting experience. Some of the best meals of mine are created using very few ingredients.

Discover more fat loss tips from celebrity trainer Alexa Towersey.

 

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