Volume 5, Issue 5 January / February 2014 September/October 2018 Mushroom Poisoning

It’s been an interesting summer. Over the past few months, central New Jersey has been plagued by soaring temperatures, high humidity & soaking rains – the perfect recipe for a dangerous mushroom season in the Garden State.

Picking & eating mushrooms growing in gardens, on lawns, in fields or in the woods is a dangerous activity. So far, 45 mushroom exposure cases were managed by the medical experts at the NJ Poison Control Center since the beginning of July. Sadly, some of these cases have resulted in emergency room visits. Here’s what you need to know about mushroom safety:

It’s hard to tell if a mushroom is poisonous Mushroom varieties can look very similar, so it takes a trained eye to tell the difference between those that are safe & those that can be deadly. Unless you are a trained expert, don’t pick or eat wild mushrooms. Even so, experienced mushroom pickers can be fooled by toxic look-a-likes, which sometimes grow side-by- side. Some species are so similar that mycologists (mushroom scientists) can tell them apart only by using a microscope to determine cell structure or observing how spores react to certain chemicals. A good example of this is the Death Cap mushroom (Amanita phalloides) – one of the most deadly mushrooms in the world, which is responsible for around 90% of all mushroom poisoning deaths. The Death Cap mushroom looks similar to some harmless varieties, but is highly toxic. In fact just one mushroom can contain enough poison to kill an adult. Death Cap mushrooms usually grow near established deciduous hardwood trees – most commonly under oak trees. They are reported to grow, peel & taste just like a harmless field mushroom, & they are sometimes mistaken for edible Straw mushrooms used extensively in Asian cooking. Cooking a mushroom does not prevent toxic health effects, & eating even a few bites can cause serious health effects.

Symptoms of mushroom poisoning Gastrointestinal symptoms associated with eating poisonous mushrooms can appear to resolve after 2-4 days, but toxic damage to the liver continues & can cause death up to two weeks after ingestion. There is no complete antidote for mushroom poisoning & survival depends on early diagnosis & treatment. Symptoms include: violent stomach cramps, abdominal pain, nausea, vomiting, diarrhea.

Pets and Mushroom Poisoning Dogs can also be poisoned and die from acute liver failure after eating poisonous mushrooms in backyards & when Paul Masaba, MD, MPH & TM out on walks. While cats tend to be more discerning about Director of Health/Health Officer what they eat they are still at risk—particularly inquisitive kittens that might chew on a toxic species. If you suspect IN THIS ISSUE your pet has eaten a poisonous mushroom, contact your veterinarian immediately. Mushroom Poisoning……………….…………… 1

Anyone who has consumed a wild mushroom is at risk of Safe Infant Sleep………………….……………... 2 potential life-threatening illness. Don't eat a wild mushroom Hepatitis A………………...... …………………….. 3 unless you are 100 percent sure of its identification! Child Injury Prevention…..…………..………….. 4 For more information on poisons, call the New Jersey Poison Information and Education System (NJPIES)’s free Flood Safety Tips….....……….…………………... 5 24/7 helpline at 1-800-222-1222. Or visit: Events and Resources…………………………... 6 http://www.njpies.org/plants-mushrooms/ Public Health Focus September/October 2018 Volume 5, Issue 5 Safe Infant Sleep

Sudden unexpected infant death (SUID) is a term used to describe the sudden and unexpected death of a baby less than 1 year old in there is no immediately obvious cause. The three commonly reported types of SUID include the following:  Sudden Infant Death Syndrome (SIDS)  Unknown cause  Accidental suffocation and strangulation in bed

The exact causes of SIDS are unknown, however parents can help Source: Centers for Disease Control and Prevention to reduce the risk and other sleep-related infant deaths by doing the following:

Place your baby on his/her back for all sleep times, including naps and at night

Use a firm, flat sleep surface, such as a mattress in a safety-approved crib covered by a fitted sheet. For more information about a safety-approved crib, visit: https://www.cpsc.gov/Safety- Education/Safety-Education-Centers/cribs

Keep your baby’s sleep area, whether it be a crib or bassinet in the same room where you sleep until your baby is at least 6 months old, or ideally, until your baby is one year old

Keep soft bedding such as blankets, pillows, bumper pads, and soft toys OUT of your baby’s sleep area

Do not cover your baby’s head or allow your baby to get too hot. If your baby is too hot, they may sweat or his/her chest will feel hot

The American Academy of Pediatrics (AAP) Resources!

also recommends the following, to reduce The SIDS Center of New Jersey (SCNJ) the risk of SIDS: developed SIDS Info, a free safe infant  Do not smoke during pregnancy, and do sleep app. It’s SCNJ’s newest tool for not smoke or allow smoking around your educating providers and parents about the baby. If you need help quitting, visit: American Academy of Pediatrics' (AAP) https://www.cdc.gov/tobacco/campaign/ guidelines for reducing the risk of sleep-related tips/quit-smoking/index.html? infant deaths. s_cid=OSH_tips_D9385  Do not drink alcohol or use illegal drugs To obtain the app, go to the mobile during pregnancy. phone app "store" and type SIDS Info into  Breastfeed your baby. the search bar. Look for the icon to the  Visit your baby’s doctor for regular right when downloading the app. checkups. At these appointments, your baby will receive important shots to Safe sleep environment for your baby: prevent disease. https://www.nichd.nih.gov/sites/default/files/  Offer your baby a pacifier at nap time publications/pubs/documents/ and bedtime. If you are breastfeeding safe_sleep_environment_rev.pdf your baby, you may want to wait to use a pacifier until breastfeeding is For more information on SUIDs and SIDS, visit: well-established. https://www.cdc.gov/sids/index.htm

Page 2. Public Health Focus September/October 2018 Volume 5, Issue 5 Hepatitis A

What is Hepatitis A? Prevention

Hepatitis A is a highly contagious liver infection The best way to prevent hepatitis A is through caused by the hepatitis A virus. It can range vaccination with the hepatitis A vaccine. To from a mild illness lasting a few weeks to a get the full benefit of the hepatitis A vaccine, severe illness lasting several months. In rare more than one shot is needed. The number cases, it has caused death. and timing of these shots depends on the type of vaccine you are given. How is it spread?

Hepatitis A usually spreads when a person Another way to prevent the infection is through unknowingly ingests the virus from objects, food, practicing good hand hygiene. This includes or drinks contaminated by small, undetected thoroughly washing your hands after: amounts of stool from an infected person. ✔ Using the bathroom ✔ Changing diapers What are the symptoms of Hepatitis A? ✔ Before preparing or eating food.

Older children and adults typically have How should you wash your hands? Visit: symptoms. If symptoms develop, they can https://www.cdc.gov/handwashing/ appear quickly and can include: when-how-handwashing.html  Fever  Clay-  Fatigue colored  Loss of appetite stools How is it treated?

 Nausea  Joint pain Those who are unvaccinated and have been  Vomiting  Jaundice exposed to the Hepatitis A virus within 2 weeks,  Abdominal (yellowing of should get the hepatitis A vaccine or a shot of pain the skin & immune globulin to prevent severe illness.  Dark urine eyes) Doctors typically recommend rest, adequate nutrition, and fluids, to treat the symptoms of Most children younger than age 6 do not have hepatitis A. Some people will need medical symptoms when they have hepatitis A. When care in a hospital. It can take a few months young children present with symptoms, they before people with hepatitis A begin to feel typically do not have jaundice, however, most better. older children and adults have jaundice.

For more information on Hepatitis A, visit: https://www.cdc.gov/hepatitis/hav/index.htm

SCDOH in Action!

In partnership with the Centers for Disease Control, the American Chemistry Council, and other public health partners, SCDOH developed posters to illustrate steps in the prevention, clean-up and disinfection of hepatitis A. These posters are free for health departments, schools, businesses, healthcare providers and others to use in hepatitis A prevention.

To download these posters, visit www.co.somerset.nj.us/ health or http://www.disinfect-for-health.org/resources

Page 3. Public Health Focus September/October 2018 Volume 5, Issue 5 Child Injury Prevention Sports Safety

With school back in session, many students participate in sports and recreation activities. This is part of a healthy, physically active lifestyle for kids, however, injuries can, and do occur during the sports season. Many children from 0-19 years olds are treated in the emergency department each year for injuries related to sports and recreation.

Parents—you can take steps to help make sure your kids stay safe where they play/ Source: Centers for Disease Control and Prevention participate in sports activities. Here are some key preventions tips:

Make sure children use the right protective gear for their activity, such as helmets, wrist guards, knee or elbow pads.

Ensure that any protective gear they have is in good condition, fits appropriately and is worn correctly all the time—i.e., avoid missing or broken buckles or compressed or worn padding. Poorly fitting equipment may be Resources!

uncomfortable and may not offer the best protection. Middle School athletes fact sheet

Make sure the sports program or school has an action plan that https://www.cdc.gov/headsup/pdfs/ highschoolsports/ includes information on how to teach athletes ways to lower middleschool_athletes_fact_sheet-a.pdf their chances of getting a concussion and other injuries. High School athletes fact sheet To prevent heat-related illness or injuries, give child athletes time https://www.cdc.gov/headsup/pdfs/ to adjust to the hot or humid environments. Make sure that highschoolsports/athletes_fact_sheet- children are staying hydrated & appropriately dressed. a.pdf

Communicate positive safety messages & serve as a model of Concussion tips safe behavior, including wearing a helmet and following the https://www.cdc.gov/headsup/basics/ rules concussion_prevention.html

Bike Safety

Bicyclists face a higher risk of crash related injury and deaths than those riding in cars. One way to reduce injuries and fatalities in bicyclists is through bicycle helmets. Although there isn’t a concussion-proof helmet, a bicycle helmet can help to protect your child, teen, or an adult from a serious head injury. No matter what your age, wearing a properly fitted bicycle helmet can help protect you every time you ride. Source: Centers for Disease Control and Prevention Your child's helmet should fit properly and be:

Well maintained Resources!

Age appropriate Download the CDC HEADS UP Concussion

Worn consistently and correctly and Helmet Safety app, to help you learn how to spot a possible concussion and Appropriately certified for use what to do if you think your child or teen

has a concussion or other serious brain injury. For more information on helmet safety, including what to look for and what to avoid Also included in this app is a 3D helmet fit feature, to when picking out a helmet for your child, visit: teach you about proper helmet fit, safety and care. https://www.cdc.gov/headsup/pdfs/helmets/ For more information, visit: headsup_helmetfactsheet_bike_508.pdf. https://www.cdc.gov/headsup/resources/app.html

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Public Health Focus September/October 2018 Volume 5, Issue 5 National Preparedness Month

Flood Safety Tips

Floods, no matter the size, can have devastating effects on your home and your family. Take steps to protect yourself, your family, and your home.

During a Flood Watch or Warning After a Flood Watch or Warning

 Gather emergency supplies.  Avoid driving through flooded areas & standing water.  Listen to local radio or TV station for  Do not drink flood water, or use it to wash updates. dishes, brush teeth, or wash/prepare food.  Store immunization records in a waterproof Drink clean, safe water. container. It’s important to know the year of  If you evacuated: return to your home only your last tetanus shot. after local authorities have said it is safe to do  Have an emergency food and water supply. so. 1 gallon of water per day for each person  Listen to water advisory from local authorities and each pet. Store at least a 3-day supply of to find out if your water is safe for drinking & food. Food and Water Needs in an emergen- bathing. cy: https://www.cdc.gov/disasters/  During a water advisory, use only bottled, foodwater/prepare.html boiled, or treated water for drinking, cooking,

 Bring in outdoor possessions such as lawn etc. furniture, grills & trash cans or tie them down  Throw away any food & bottled water that securely. comes/may have come into contact with flood water.  If you need to evacuate your home, turn off  Prevent carbon monoxide (CO) poisoning. all utilities at the main power switch and close Use generators at least 20 feet from any the main gas valve. doors, windows, or vents. If you use a pressure  Leave areas that may flood such as low spots, washer, be sure to keep the engine outdoors canyons, washes, etc. Do NOT drive through and 20 feet from windows, doors, or vents as flooded areas & standing water. well.

After you return home, if your home was flooded, visit https://www.cdc.gov/disasters/floods/after.html, for more information about precautions to take during the cleanup process.

For more information on flood safety tips, visit: https://www.cdc.gov/features/flood-safety/index.html

Terms to Know! FLOOD WARNING= Flooding is happening or will happen soon. Move to high ground immediately

FLOOD WATCH= Flooding is possible. Stay tuned to radio/TV for info & be ready to move to higher ground.

September is National Preparedness Month

It serves as a reminder that we must prepare ourselves and our families for any type of emergency that could affect us. This NPM will focus on planning, with an overarching theme: Disasters Happen. Prepare Now. Learn How.

Follow the hashtags on social media throughout the month of September for preparedness tips:  #PrepareNow  #FloodSmart  #NatlPrep

Page 5. Public Health Focus September/October 2018 Volume 5, Issue 5 Events & Resources

Sept 4- Visit the Emergency Preparedness Health Education Table 28 County Administration Building 20 Grove Street—Somerville

Health Observances Sept 11 SCDOH will be at the ballpark—Somerset Patriots—TD Ballpark Going to the game? Come & visit us to learn about a number of September health topics!

National Sept 21 SCDOH will be at the ballpark—Somerset Patriots—TD Ballpark Preparedness Month Going to the game? Come & visit us to learn about a number of #PrepareNow health topics! #NatlPrep For a calendar of programs, please visit www.co.somerset.nj.us/health National Food Safety Education Month #foodsafety Get vaccinated! #familymealsmonth Protect yourself and those around you from the flu

Ovarian Cancer Every year, SCDOH holds adult flu Awareness Month clinics throughout the county. #knowovarian For a listing of the flu shot clinics, please September 17-21 visit our website at Septic Smart Week http://www.co.somerset.nj.us/health. #SepticSmartWeek

September 28 Preparing Safe Food World Rabies Day Free Basic Foodhandler trainings are regularly offered for #WorldRabiesDay staff working in food establishments serviced by Somerset October County Department of Health, including: Bedminster, Far Hills, Franklin, Manville, North Plainfield, Raritan, and Breast Cancer Somerville. Awareness Month #BCAM For information, or to register, check out: https://tinyurl.com/kndwsnk October 15-19 National Health Education Week Follow us! #NHEW #MyImpact Follow us on Twitter! Like us on Facebook! Look for more tips on https://twitter.com/ https://www.facebook.com/ these topics by schealthdept SomersetCountyNJ following SCDOH on social media For more information visit our website: www.co.somerset.nj.us/health

A publication of the Somerset County Department of Health P.O. Box 3000 27 Warren Street Somerville, NJ 08876 908-231-7155 www.co.somerset.nj.us/health

DISCLAIMER: Information provided in this publication should not be used as a substitute for medical care and advice of your physician. Readers should consult their physicians for answers to specific clinical questions.

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