Leonardtown, MD — St. Mary’s County Health Officer Dr. Meenakshi Brewster’s semi-annual report to the county commissioners included some warnings about relatively rare health hazards but also about one health issue that is all too common in the area – smoking.

Dr. Brewster reported there have been studies that show that “nicotine reduces the threshold to addiction to other types of substance abuse.” In other words, just as marijuana has always been considered a gateway drug, so too could tobacco.

Healthy St. Mary’s Partnership has “Tobacco Free Living” as one of its four community health priorities. The other three are behavioral health, access to care, and healthy eating and active living.

A Youth Risk Behavior Survey conducted last year developed a “public health surveillance tool” aimed at curbing use of tobacco by youth. St. Mary’s County has higher averages than the state of high school students who have smoked prior to age 13, who have tried it for the first time in the last year and who have smoked 100 or more cigarettes in their life.

Dr. Brewster led her report to the commissioners, who were sitting as the Board of Health, with concerns about Vibrio, which is a group of bacteria causing different illnesses. The strain called ‘V.parahaemolyticus” is more prevalent, naturally occurring and often leads to gastrointestinal illness. It is caused by consumption of raw/undercooked shellfish and wound exposure to warm seawater.

The second strain, called “V.vulnificans” is also naturally occurring, can also be caused by eating raw shellfish or wound exposure, but also can lead to a blood infection (in 50 percent of the cases) and can be fatal. There were 35 fatalities last year nationwide from V.vulnificans.

Dr. Brewster said Vibriosis in Southern Maryland is complicated by underreporting and the cases are tracked by the county of residence of the person as opposed to the county in which the virus was contracted. She said there have been “less than a handful (of) reported and confirmed cases per Southern Maryland county per year.” In Maryland there is an average of confirmed or reported cases yearly.

The Bay Net was contacted by a reader recently alleging that an elderly St. Mary’s County man had died after contracting Vibrio while fishing. That incident was not confirmed and the Health Department said they would not release information about individual Vibrio cases due to health confidentiality regulations.

Dr. Brewster said the best defense against Vibrio is not to eat raw shellfish and if a wound comes in contact with brackish water, to quickly wash the wound with warm water. She said anyone regularly coming in contact with brackish water with a wound, particularly watermen, should wear protective gloves.

The health officer also reported on the spike in severe respiratory illness in children from the Enterovirus D58. It was first documented by hospitals in Missouri and Illinois and has since spread to 43 states, including Maryland, with 600 reported cases.
Infants, young children and teenagers are at greatest risk from EV-D58, with more severe symptoms for children with asthma. There is no specific treatment except for respiratory support in severe illness and there is no current vaccine. She urges seeking medical attention if having difficulty breathing or worsening respiratory problems.

Preventive measures for EV D58 include:

  • Avoid close contact with sick people
  • Wash your hands often with soap and water
  • Cover your coughs and sneezes
  • Avoid touching your face with unwashed hands
  • Stay home when you’re sick

Dr. Brewster also reported that the new Maryland health exchange website will be up and running by Nov. 9th, with signups starting on November 15th, Medicaid enrollments beginning Nov. 18th and self-service enrollment beginning Nov. 19th.

Consumers will need to re-enroll (even if they have existing coverage) between Nov. 15th and Dec. 18th, Coverage takes effect January 1, 2015. There are new private plans being offered this year.

For more information of the health exchanges go to the agency in Southern Maryland designated by the state: Calvert Healthcare Solutions at www.calverthealthcare,org/connect