Jîortlanh (¡Observer April 02. 2003 Page AS H ealth Health Workers Vaccinate Against Deadly Virus lic health. In Oregon, smallpox and other deadly diseases were major factors in the creation of the state Board of Health in 1903. One of the first state health officer’s priorities was to develop a smallpox preven­ tion and vaccination program. Thanks to public health pro­ by D r . G rant H igginson grams of vaccination and disease Oregon has begun vaccinating investigation, the disease was de­ up to 800 health workers across the clared eradicated from the entire state against smallpox in prepara­ earth in 1980. Routine smallpox tion for the unlikely, but possible, vaccination programs here and in release of the virus by a terrorist. other countries were discontinued. Smallpox is a devastating dis­ Smallpox is once again a public ease that, over thousands o f years, health concern because there is a has probably caused more deaths small chance that terrorists could worldwide than any other infec­ obtain the virus. Although the prob­ tion. About a third of those who ability that they would intention­ become ill with the virus die. ally use it as a weapon is low, we The disease is no stranger to pub- need to be prepared. State prepares for unlikely, but possible, smallpox threat and response. The second plan, underway now, is to vaccinate health workers. This month, health workers from all overOregon will travel to o n eo f three locations toreceive smallpox vaccination. Once vaccinated, they are able to serve on a smallpox response team. This means they can immediately and safely be de­ ployed to investigate a suspected case, provide care to the smallpox patient and vaccinate others. Oregon is among the last of the states to begin vaccination. We Dr. Grant Higginson have taken a conservative and cau­ In Decem ber, O regon’s two tious approach, weighing the need smallpox preparedness plans were to prepare for smallpox against the approved by the federal Centers for risk of side effects that the vaccine Disease Control and Prevention. carries. These side effects, though One plan calls for disease control not common, can be severe. OMW Smallpox vaccination involves extensive pre-screening, informed consent procedures and clinical follow-up. The vaccination itself is time consuming, involving more than a simple shot. We are not vaccinating profes­ sional groups other than health workers, nor is a smallpox vaccina­ tion a good idea for the general public right now. The last smallpox case was in 1978 and the vaccine is not completely safe. If Oregon ever had an outbreak, we would control it using "ring vaccination,” which worked before, finding cases and vaccinating their contacts. If given within four days o f exposure, the vaccination will prevent the dis­ ease or lessen the symptoms. The health workers now being vaccinated do so voluntarily. I re­ spect and thank them for their com ­ mitment to protecting public health. I sincerely hope the day never comes when we need to rely on them for a response to smallpox in Oregon. But the fact that they have taken this step means we are better prepared. For public health, it is ironic to find ourselves preparing for an old enemy that we already vanquished. As we prepare for this unthinkable threat, it’s important to remember, we conquered smallpox once. We can beat it again if need be. Dr. Grant Higginson is state publii ■ health officer in the Oregon Department o f Human Services and oversees the state's bioterrorism preparedness program. Spring Forward Without Sleep Loss Hospital Offers Birth Control Procedure Doctors offer tips to reduce sleep depravation It happens in the middle o f the night once a year, and can affect adults and children for several days. It's the return of daylight- saving time, which happens this year at 2 a.m. Sunday, April 6. The annual spring forward ritual can cause disruptions in normal sleep patterns. However, experts from the Providence Sleep Disor­ ders Center say there are steps that can be taken to minimize sleep loss. National Sleep Foundation polls reveal that most adults already get less than the recommended seven to nine hours of nightly sleep needed to he fully alert the next day. “Too many people will sacri­ fice yet another hour of sleep when the clocks change - an hour they cannot afford to lose, particularly For adults there are a few steps to help transition into daylight- saving time. Try to sleep more than usual a few nights prior to and immediately following the time change. Also, napping in the middle of the afternoon on Sun­ day can help. Be sure not to nap within a few hours of regular bed­ time because nighttime sleep may be distrupted. ™ Too many people will To help children with the time change adjustment, Dr. Libby of­ sacrifice yet another fers suggests maintaining regular hour o f sleep when the sleep, wake and nap times. Try not clocks change. w to compensate for the lost hour by -Louis Libby, M.D. delaying bedtime or allowing a child to sleep in. Gradual adjust­ ments should also be made. Some on the weekend, when people try to parents find it best to try to start catch up on the sleep they missed making adjustments on Saturday during the week,” said Louis Libby, night rather than wait until Sun­ M.D., medical director of the Provi­ day, a school night. To learn what can be done to dence Sleep Disorders Center. By making a few simple lifestyle improve sleep and to learn how changes, m ost people can find recognize signs of potentially seri­ the sleep needed to feel alert, ous sleep disorders, visit the Provi­ refreshed and ready to take on dence Sleep Disorders Center Web site at www.providence.org/sleep. the day. A new permanent birth control technique is being offered at Or­ egon Health and Science Univer­ sity. The Essure permanent birth con­ trol method, developed by Con- eeptus Inc., was approved by the U.S. Food and Drug Administra­ tion in November 2002. It has been used in A u stra lia , E u ro p e , Singapore and Canada for several years. It is the first alternative to invasive surgery for women seek­ ing permanent birth control in the United States. The procedure does not re­ quire any incisions and can be perform ed w ithout general anes­ thesia in an outpatient setting in about one hour. Tubal ligation, an o th er form o f ste riliz a tio n widely used by women, requires one or tw o incisions and usually is perform ed under general anes­ thesia. Dr. M ark N ichols, associate professor of obstetrics and gy­ necology in the OHSU School of Medicine and m ember of the Cen­ ter for W om en’s H ealth Nichols, said that Essure is irreversible, so women should be absolutely cer­ tain they w ant this permanent type o f contraception. “For some, that is a very attrac­ tive way to have perm anent birth control," he said. "There are no hormones involved and it doesn’t require using som ething at the time o f sexual activity. It has been attractive to w om en as perm a­ nent birth control because it gives w omen control." To perform the procedure, the physician places a scope through the vagina, the cervix and into the uterus. A flexible tube is inserted through the scope into both of the fallopian tubes. A ttached to the end of the tube is the micro device that is inserted into the fallo p ian tube. T he device is about the size o f a pencil lead in diam eter and about two inches in length. O nce in place, the tiny device uncoils and stays in the fallopian tube. It is designed to p ro m o te tis su e g ro w th , th u s blocking the fallopian tube so that sperm can not reach the egg. The tissue grow th is sim ilar to that in a vasectom y. T he insert is m ade o f m aterial sim ilar to that used in heart vessel surgery for years. The patient usually returns hom e about 45 m inutes aftei the p ro ce­ dure. Only minor cramping, which generally can be controlled by o v er-the-counter pain m ed ica­ tions, has been reported in som e cases during clinical trials. A fter 12 weeks the patient must return for an X-ray to ensure the insert has been effective. Until then, patients must use another form of contraception. 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