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					Public Health Notes
Volume 5 Issue 2                                                                                 May-June 2010

     NH DHHS Mission Statement: To join communities and families in providing opportunities for
                          citizens to achieve health and independence.

Flea and Tick Season
Along with the beautiful weather of New Hampshire in summer come the mosquitoes and ticks. Besides being
annoying, they can also carry diseases that can be transmitted to people when the bugs bite. With mosquitoes, the
greatest concerns in New Hampshire are West Nile virus and Eastern Equine Encephalitis (EEE) and with ticks
it is Lyme disease. EEE is a rare but serious disease that carries a high mortality rate for those who contract the
more severe encephalitis form. Symptoms may include high fever, severe headache, and sore throat. A stiff neck
can also be a symptom, and this more serious form can lead to seizures and coma. Symptoms usually occur 4 to
10 days after being bitten.
     For individuals who are bitten by a mosquito carrying West Nile virus, the risk of contracting the infection is
low, and in the majority of cases there are no symptoms or just mild, flu-like symptoms. At times, West Nile virus
can causes meningitis and can be a serious threat to seniors, young children, and those with compromised immune
systems. If illness does occur, it typically happens within 3 to 14 days after a bite by an infected mosquito.
     The symptoms of Lyme disease include chills, fever, headache, fatigue, stiff neck, swollen glands, muscle or
joint pain, and sometimes a large circular, or bullseye, rash. Symptoms usually begin within a month of exposure
but can range from 3 to 32 days. Lyme disease can be treated with antibiotics, but there is no treatment for WNV
or EEE. Residents of New Hampshire should take steps to prevent these illnesses. When in tick-infested areas
(such as woods and grassy areas):
     •	 Wear light-colored clothing to make ticks easy to see
     •	 Tuck pants into socks and shirts into pants
     •	 Consider using an insect repellent. Products containing >20% DEET have been shown to be effective in
        repelling ticks. Clothes may be treated with Permethrin. Always follow manufacturer’s instructions when
        applying repellents
     •	 Check after every two or three hours of outdoor activity for ticks on clothing and skin
     •	 A thorough check of body surfaces for attached ticks should be done at the end of the day
     •	 Reduce the number of ticks around your home by keeping grass short, removing leaf litter, and creating a
        wood chips or gravel barrier where your lawn meets the woods.
     •	 If a tick is attached to your skin for less than 24 hours, your chance of getting Lyme disease is extremely
        small. But just to be safe, monitor your health closely after a tick bite and be alert for any signs and
        symptoms of illness.
        To prevent EEE and WNV from mosquito bites:
     •	 If possible, stay inside between dusk and dark, when mosquitoes are most active.
     •	 When outside between dusk and dark, wear long pants and long-sleeved shirts.
     •	 Use an insect repellent with DEET according to manufacturer’s directions when
     •	 Make sure windows have screens on them without holes.
     •	 Eliminate standing water where mosquitoes can breed from your property, such as old tires, flower pots,
        and pool covers.

                              New Hampshire Department of Health and Human Services
                                        Division of Public Health Services
                    Public Health Notes
Volume 5 Issue 2                                                                               May-June 2010

   For more information about WNV, EEE, or Lyme disease, visit the DHHS website at or the
Centers for Disease Control and Prevention website at or call the New Hampshire Communicable
Disease Control and Surveillance Section at 603-271-4496.

World No Tobacco Day
    May 31, 2010 is World No Tobacco Day sponsored by the World Health Organization (WHO). The goal is
to highlight the dangers of tobacco and encourage people to quit smoking. This year’s theme is “Gender and to-
bacco with an emphasis on marketing to women.” Women comprise about 20% of the world’s smokers, but while
male rates of smoking have peaked, female rates are on the rise. Especially troubling is the rising prevalence of
tobacco use among girls. The new WHO report, Women and health: Today’s evidence, tomorrow’s agenda, points
to evidence that tobacco advertising increasingly targets girls. Data from 151 countries show that about 7% of
adolescent girls smoke cigarettes as opposed to 12% of adolescent boys. In some countries, almost as many girls
smoke as boys.
    For information on quitting smoking, call the NH Smokers’ Helpline and Tobacco Re-
source Center at 1-800-Try-to-Stop (1-800-879-8678) or visit, an online
guide to quitting smoking. For information on the DHHS Services Tobacco Prevention and
Control Program go to
Teen Pregnancy Prevention
May is National Teen Pregnancy Prevention Month. Did you know that despite a decline in the early 1990s, the
United States still has the highest rates of teen births among comparable countries? The majority of teens having
babies in New Hampshire are 18 and 19 years old. Having a baby when you’re a teenager of any age is linked
to many different social and health issues. Compared with those who delay childbearing, teen mothers are more
likely to delay seeking prenatal care, to drop out of school, remain unmarried, and live in poverty.
    Teen moms are also less likely to breastfeed, which is more beneficial to babies than bottle feeding. Children
of teen mothers are more likely than those born to older mothers
to be born at low birth weight, be born prematurely, experience      Important Dates
abuse and neglect and enter the child welfare system. Children         May is Clean Air Month
born from unplanned pregnancies, whic most teen pregnancies            May is Lupus Awareness Month
                                                                       May is Lyme Disease Awareness Month
are, have lower cognitive test scores when compared with chil-
                                                                       May 9-15 is Food Allergy Awareness Week
dren born as the result of an intended planned pregnancy.
                                                                       May 24-30 is Recreational Water Illness
    The Family Planning Program within DPHS funds services                     Prevention Week
throughout the State ensuring access to affordable care. It’s the      May 3 is Melanoma Monday
law that teens are provided family planning on a confidential          May 31 is National No Tobacco Day
basis. Teens are offered clinical services, counseled that consis-     June is Home Safety Month
tent abstinence is the safest way to avoid unintended pregnancy        June is National Scoliosis Awareness Month
and STDs, and they are encouraged to involve their parents in          June 6-12 is Sun Safety Week
their healthcare.                                                      June 20-26 is Lightning Safety Week
    For more information on visit the                                  June 27 - July 5 is Eye Safety Awareness
DHHS website at http://www.dhhs.state.                                         Week
                                                                       June 27 is National HIV Testing Day

2                            New Hampshire Department of Health and Human Services
                                      Nicholas Toumpas, Commissioner
                    Public Health Notes
Volume 5 Issue 2                                                                                 May-June 2010

    The NH Department of Health and Human Services has joined with 13 other State Health Departments as an
outreach partner for the text4baby project. Text4baby is a new free mobile information service of the National
Healthy Mothers, Healthy Babies Coalition (HMHB) made possible through a partnership with the White House
Office of Science and Technology Policy, the U.S. Department of Health and Human Services, Voxiva, CTIA-The
Wireless Foundation, the Grey Healthcare Group, and founding corporate sponsor Johnson & Johnson. Text4baby
provides pregnant women and new moms with the information they need to take care of their health and give their
babies the best possible start in life.
    Women who sign up for the service receive three free text messages each week timed to their due date or
baby’s date of birth. Messages focus on a variety of topics critical to maternal and child health, including breast-
feeding, immunization, nutrition, mental health, smoking, oral health, and safe sleep. Text4baby messages also
connect women to prenatal and infant care services. Messages are specifically targeted to pregnant women and
new moms ages 18-25, but older women and dads are welcome to subscribe. You can sign up by texting BABY
(or BEBE to receive messages in Spanish) to 511411.
    The organizers hope this effort can help curb premature births, which can be caused by poor nutrition, exces-
sive stress, smoking, and drinking alcohol. About 500,000 babies are born prematurely in the U.S. each year, and
28,000 infants die before their first birthday. In New Hampshire, about 1,500 babies are born prematurely each
year. The Maternal and Child Health (MCH) Section and the WIC Nutrition Program are leading the text4baby
campaign in New Hampshire, along with local community agencies. WIC nutrition programs, comunity health
centers, and MCH home visiting programs across the State will be promoting text4baby at
their clinics.
    To join the campaign in New Hampshire, send an email to
For more information about the program, visit

May 3rd is Melanoma Monday and June 6-12 is Sun Safety Week in the U.S. In recognition of these two impor-
tant events, the Division of Public Health Services wants to make you aware of the dangers of melanoma and skin
    Excessive exposure to ultraviolet light (UV), from the sun and indoor tanning devices, is the most important
preventable cause of all skin cancers, including melanoma. The United States Department of Health and Human
Services has declared UV radiation from these sources to be a known carcinogen (cancer-causing agent). In June
2009, the International Agency for Research on Cancer (IARC), the leading cancer research agency (an inter-
governmental agency forming part of the World Health Organization [WHO] and the United Nations), raised the
clarification of the use of UV-emitting tanning devices to “carcinogenic to humans.” Additionally, the IARC wrote
that, “The risk of (cutaneous) melanoma is increased by 75% when use of tanning devices starts before 30 years
of age.”
    Skin cancer is the most common form of cancer in the United States according to the Centers for Disease
Control and Prevention (CDC). The 2005 U.S. adjusted rate (AR) is 19.9 cases per 100,000 population and New
Hampshire 2005 AR was 32.9. The incidence of malignant melanoma, one of the deadliest forms of skin cancer,
more than doubled between 2000 and 2008: U.S. 2005 AR was 18.4 and the NH 2005 AR was 30.9. In 2005, NH
ranked 2nd highest in the nation for incidence and 17th highest for deaths due to melanoma.
    Most skin cancer is preventable by using sunscreen of at least SPF 30 when outside in the sun and by not using
an indoor tanning device. For more information, visit or cancer/.

                         New Hampshire Department of Health and Human Services
                                  Nicholas Toumpas, Commissioner