"Imagine" a World of Vision Through Service

V O L U M E 3 2

DISTRICT 4 DISTRICT I S S U E 0 4

N O V E M B E R 2014

Inside

Governor's Message

1st VDG's Message "Imagine"

2nd VDG's Message A Student Speaker Contest

Membership Round-up World of Vision This and That

Around the District Through Service

LEF I am so very proud of all of our Lions and Clubs who were “on the ground” serving

the displaced while we were applying for the Lions Club International Foundation From International Grant which was speedily approved. Our Clubs and those in the surrounding Making Strides Districts were all on "alert status" to move up the hills to serve if needed. Thankfully, our District was spared any loss of life and fundraisers by From MD4 several of our Clubs in their respective communities have been initiated. Overall, our District survived the Sand, King and Applegate wildfires but we are still not out Lions 2015 Float of the woods as it may just be the “calm before the storm”. Now the imminent

Leadership Training danger to our foothill and mountainous areas may shift from fire hazard to flood and landslide risk. Many of our Lions Club has opted to donate their wildfire District Cabinet and expenses; thus, I will be returning most, if not all the Grant monies to Lions Club Committees International Foundation, but we had it "just in case" the need became greater. Please continue to hold good thoughts and prayers for those affected and Governor’s Visitation that clear sailing lies ahead for all of us.

Announcements Our Region and Zone Chairs continue to listen to your needs and suggestions to Health Topics keep our District strong. They are my eyes and ears, assisting us in continuing to" Strengthen the Pride" as our International President Joe Preston has requested. In Battle of the Bulge the last few days, I have had the honor of inducting four new members into our organization and within the next two weeks, I hope to induct another ten. This gives Invasion by Filovirus our Clubs additional hands to carry on their many projects so continue to “Just Ask"!

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Governor’s Message

Recently returned from the USA/CANADA Leadership Forum held in San Juan, Puerto Rico; what a wonderful three days of training, sharing, reflecting, fellowship and attending events to enhance the tradition of excellence of Lionism. Nearly 100 Forums, motivational/keynote speakers, entertainments and camaraderie shared with over 1600 guests from all over North America/Canada. Please plan to attend next year’s exciting USA/CANADA Leadership Forum to be held in Grand Rapids, Michigan U.S.A.

Our District offers excellent and continuous training in nearly any subject area you would like to enhance your leadership skills. Supplement that training by enrolling “Imagine” with "Lions University", a year round on-line webinar training program provided by the USA/CANADA Leadership Forum (not Lions Club International) to insure you have the skills and resources to meet the objectives of building strong communities through volunteer services. For instance, this month courses included Effective Club Meeting, Conflict Resolution, and Club Secretary and/or President training as an elective. Coming up in November are Member Motivation and Public Relations just to name a few. Checkout the excellent webinars by going to www.lionsuniversity.org. A The Holidays are quickly approaching and we have continued to serve in many diverse ways. We are in the final phase of our District Governor Official Club Visitations. What a voyage this has been delivering the message from International President Joe Preston World and my “Vision” for the District to our membership. It has reinforced my belief we are a strong District consisting of diverse and committed Lions from the smallest to the largest Lion Clubs in the execution of humanitarian services to those less fortunate in of our respective communities --- Thank You for the wonderful journey!

I would like to invite everyone to attend our second District Cabinet Meeting scheduled for Saturday November 22, 2014 at Pioneer High School in Woodland. Come and see Vision why my Cabinet does not follow the motto "If you always do what you always have done, you will always get what you have always gotten". Be prepared to “think outside of the box” and enjoy a day packed with something for everyone: entertainment, food, 18 action packed Forums, a fabulous lunch with our keynote Through speaker, "Helen Keller", canines, and humans who will keep our heads and minds whirling for days after the 7:30a start. Our host will be Dos Rios Region Chair Dave Evans who has chosen the Cabinet Meeting theme “Education through Entertainment” whereby he and his Zone Chairs have many innovations for all of us to enjoy. Confirm Service your lunch reservation by November 17 to Cabinet Treasurer Sarah Enloe [[email protected] or 916 686-2116] for an opportunity to take home a complementary gift basket. See you all in Woodland!

The Holidays are quickly approaching and we continue to serve in so many diverse ways. Trick or Treat... Continue your Feats ... of continuous kindnesses!

Lion Erv Gon District Governor 2014 - 2015 [email protected]

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1st VDG’s Message Step up to the Plate and “Serve”

The Spirit of Thanksgiving

You know, come to think about it, Thanksgiving and the Lions organization have a lot in common, we are thankful for what we have and give to those who need it more. I am not sure what “it” is but we sure give a lot of it to those less fortunate. We feed the hungry, we give sight to those who have never seen, have camps for the deaf or Mike Rezlaff hard of hearing, helping to eradicate illiteracy and much, much more. If we stretch it a little, we can liken it to what the Indians did to help out the starving Pilgrims so many years ago. The Spirit of Thanksgiving is still alive today. So how are you going to celebrate Thanksgiving – 2014? Many of us will spend it with our families. Some will work in an unfamiliar kitchen feeding those less fortunate. Some of us will be alone, some by choice, others not. If you can, reach out to those and adopt them for a day. In all my years in the military, I can’t remember a single year when I was home that Life is either a we didn’t feed a houseful of young airmen, eager to scarf down a home-cooked meal daring adventure and make a phone call back home to their family members doing the same thing or nothing. To keep many miles away. Yes, The Spirit of Thanksgiving was/is still alive. our faces toward change and behave This year, I have had the like free spirits in opportunity to visit many of the clubs you are a member the presence of of. I’ve been able to tell you fate is strength that International President undefeatable. Joe Preston wants each of us to “Just Ask One” to help Helen Keller bolster our membership numbers. But more important than getting new members, IP Joe has asked us to “Strengthen the Pride”. Get to know your club members better, find out how the club member that came in with you is doing because his attendance at club meeting has been dwindling. Does he or she need a ride because they can’t drive anymore? The reasons are numerous and all it takes is a phone call or a note to find out why.

In closing, thank you for being Lions and doing what you do to make the world a better place to live in. Happy Thanksgiving from my family to yours. Lion Michael Retzlaff 1st Vice District Governor [email protected]

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2nd VDG’s Message Sustainable Service Through Lionism

Dear Lions,

My whole life, I have been presented to a single element called change. Change occurs in many different forms and is carried out in many different ways.

Kumar Kalagara "There is nothing permanent in life except change," said philosopher Heraclitus. Others have called change or variety as 'the spice of life'. The great insight of the enlightened, Gautam the Buddha, was "the everything that is, will change and the changed will change further."

Change is in the very nature of being. Every new day is different from the previous day. Body metabolism is one such process as also growth of trees and revolving of planets. Tides come and go. Sometimes a whole river changes it's direction. What is happening with us LIONS is no different. We LIONS in different capacities and capabilities, been serving the communities across the globe for a century. Although our motto "We Serve" hasn't changed but our approach did. Adopting to the changing society is the only way we can continue our mission.

For obvious reasons, people reject change. They fight the change until they force the person to change. It is here that we need to ask ourselves some basic questions about change. Have I ever given a thought to changing things around me? Have I ever tried to act in a way that could bring about change for the better in society?

It's futile to stop change and argue against it.

We need to change.

I am the change agent and the change starts with me.

Yours in Lionsim.

Lion Kumar Kalagara 2nd Vice District Governor [email protected]

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Around the District

District’s 2015 Medical Mission to Northern Philippines will serve rural area poor Embarcadero Lions champion cause with hard-hitting project - LCIF matches local funds

Hats off to Sacramento Embarcadero Lions Club for their involvement in the development of a large medical mission to the Philippines scheduled for next year. No project is too large for these Lions as they team with neighboring D-4C5 clubs and with international counterparts to bring a combination of medical, dental and other humanitarian assistance to people in dire need. District Governor Erv Gon, himself a member of Embarcadero Lions, announced that the long list of mission preparedness tasks had been accomplished for the 16-20 February delivery of services. The host Lions Club, Quirino Mamparang LC, located in Quirino Province North of Manila, is a new and growing club and plans to twin with Embarcadero while the medical mission is underway.

Loomis Lion Jack Morris is coordinating the bonding of the two clubs. Among the larger responsibilities already encountered and completed by mission organizers were the arrangements for army security, identifying the medical treatment site, agreements with area doctors and dentists, acquisition of polio and measles vaccination medicines and the pre-screening of all potential patients.

All missions to overseas sites cost money. Planners for the 2015 Medical Mission determined the need for at least $11,000 and have, to date, raised more than $7,000. Their fund raisers set for the coming months are expected to reach their goal. Medical Mission Chair Embarcadero Lion MaryRose Barnhurst, requested and has received a matching grant from the Lions Clubs International Foundation (LCIF). In describing the health problems in Quirino Province to LCIF, Lion MaryRose pointed to poverty, distance to city treatment centers, and the fact the local people were farmers with daily on the ground responsibilities.

The need for assistance was first determined by a group of D-4C5 Maharlika Lions during their own medical mission in the general area. They witnessed first hand malnourished and barefoot children and some with serious dental, vision and health issues. Twenty Lions and their friends will make up the medical mission professional team from the United States. Arrangements for air travel and housing reservations were being made by team members at this writing. Courtesy : LOOMIS LIONS CLUB NEWSLETTER

My Sister’s House 5K Run for a Safe Haven: A few Sacramento Senator Lions were able to get together and form a team along with some Metropolitan Lions to participate in this year’s event. The morning was overcast and threatening rain but the temperature was still moderate as Senator Lions Gayle Kono, Karen Owyoung, Ann Brady, Vicky Brady and Dan Goodwin made their way to William Land Park for the 11th Annual “My Sister’s House 5K Run for a Safe Haven”. The event kicked off at 9:00 AM with the runners leading off followed shortly after by the walkers. Our group was definitely in the walkers category and enjoyed the brisk walk through William Land Park despite the fact that the weather decided to dump some dampness on the walk participants. Fortunately, it never really reached more than a moderate drizzle and ultimately only rained for about 1/3 of the event, trailing off for the last two-thirds of the walk. The team all successfully completed the walk and enjoyed the free refreshments and camaraderie after the event. Special thanks to Lion Gayle Kono who not only did all the “leg work” of getting the team together, she also found us a prime location to park. Despite the somewhat precarious weather, good fun and fitness was indeed had by all participants!! Courtesy : November 6th Bulletin - Sacramento Senator Lions Club

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Lions Education Foundation

Molding the Future with Action Today

A message from Lions Education Foundation

As we approach midway point of our Lion's year, and the traditional Season of Giving, the Lions Education Foundation (LEF) is encouraging clubs to recognize one of their club members, or a community leader, with a prestigious award from LEF.

Most clubs wait until June or July to honor those who go above and beyond as event Chairs and the "Always There" kind of Lion, so presenting a Paul Shimada, Gordon Daniels or Kay Fukushima Award at your Holiday gathering will be a unique and totally unexpected surprise to all!

LEF is a 501(c)3 Corporation. As such, clubs may use funds from their Community (or Project) accounts to purchase awards.

This program is one way LEF raises revenue needed for the Matching Grant Program - which has donated over $525,000 to clubs in our District since 1989 for youth and educational purposes.

Another way to support LEF is by attending our fundraising events. The Annual Soup and Salad Dinner is scheduled for January 30th at Roseville Host Clubhouse - so mark your calendars to attend!

It takes time to customize our prestigious awards, so don't wait! Contact Lion Donna Prince before November 10th to insure delivery by December 15th.

Find more information on LEF Awards at: lef4c5.com

Lions Pride District 4-C5 6 LIONS Worldwide Week of Service in January

The Lions Worldwide Week of Service is a special Centennial Service Challenge event that brings Lions around the world together for a week of celebration and service. It’s a great opportunity to showcase your club and celebrate the birthday of our founder, Melvin Jones.

Join the Lions Worldwide Week of Service in January 1) Plan your project – Host a service project that benefits youth, vision, hunger or the environment during the week of January 10–16 . 2) Share your project – Invite your community to serve with you to showcase your club and the power of service. 3) Report your project – Report your service on the MyLCI Service Activity Report to earn a Centennial Banner Patch for your club.

Start Planning Your Service Project Share this special event with your club and start planning your project today. Don’t miss this opportunity to join Lions around the globe in the Worldwide Week of Service in January!

Share event photos using the hashtag #Lions100 , and we’ll share them on the LCI Facebook page!

lions100.org

IAD 607 EN 10/14

4-C5 Member Round-up

Please welcome these baby Lions into District 4-C5 family. They joined in September 2014.

Zone Club Name Camillia Sacramento Embarcadero Darnell Lawrence Welcome Crocker Zone Sacramento Fort Sutter Tom Scheer Foothill Zone Auburn Host Danny Shuman bienvenido Mather Zone Folsom City Host Shalini De Mather Zone Folsom City Host Sharon Frost Foothill Zone Colfax Nicolette Dalpino Crocker Zone Sacramento Fort Sutter Beverly Ray

欢迎 환영 आपका वागत है 歓迎 chào đón maligayang pagdating

Do you know? Democratic Republic of São Tomé and Príncipe, a island nation in the Gulf of Guinea, off the western equatorial coast of Central Africa became 210th nation in LIONS Family

District 4-C5 2014 - 2015 Service Activity Summary as of October 31, 2014

Number of Activities 1062 Lion Hours Spent 30626 Number of People Served 98916 Number of Eyeglasses Collected 49685 Funds Raised $244,966.00 Funds Donated $141858.00

Way to go District 4-C5

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From International

Dear Lion,

Thank you for joining us on this journey to Lions Clubs International's Centennial in 2017. As we approach 100 years of service as an association, Lions around the world are celebrating by coming together to meet our Centennial goal of serving 100 million people. Every club can play a part in this historic event that will showcase the strength of Lions and the power of service to the world.

To honor the legacy of our founder, we're kicking off the Lions Worldwide Week of Service in January to celebrate the birthday of Melvin Jones. Lions all over the world will be participating, and we want you to be a part of it! It's a great way to get involved in the Centennial celebration and show your friends and family what it means to be a Lion.

Visit the Lions Worldwide Week of Service website and start planning your project today. Remember, when Lions join together in service, we can change the world!

Together in service, Joe Preston

Your International President

We are prone to judge success by the index of our salaries or the size of our automobiles, rather than by the quality of our service relationship to humanity. Dr. Martin Luther King, Jr.

Objectives

Service is our Bedrock Support is our Responsibility Partnerships are our Future Growth is our Destiny

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Leadership Training

Club Officer training : Dos Rios Region Cabinet meeting Saturday November 22, 2014

MD4 Leadership Institute North: Red Lion Woodlake, Sacramento, California ...... November 8-10, 2014 South: Ontario Airport Hotel, Ontario, California ...... January 17-19, 2015

LIC Webinars - (2014-2015 Schedule) Harmony in the Pride Intended Audience: All Lions Friday, 11/7/14, 9:00pm, PST Understanding generational differences can assist with both member recruitment and retention. This presentation explores diverse motivations among Lions and how each constituency can find and value varying perspectives to “strengthen the pride.”

Because a Cape Would Get in the Way Intended Audience: All Lions Wednesday, 1/7/15,2:00pm PST and Friday, 1/16/15,9:00pm, PST Become a Lions superhero! Presentation will guide Lions in discovering their superpowers, understanding their mission, considering the right tools, knowing their fatal weakness, and the importance of sidekicks.

Project Management Intended Audience: All Lions Wednesday, 2/4/15,2:00pm, PST and Friday, 2/13/15, 9:00pm, PST Effective project management is one of the foundations of a successful Lions club. Participants will learn the characteristics of effective project managers, review the five phases of service project management and enjoy a case study of a current successful Lions club project.

Minding Your Members—Leading Strong Teams Intended Audience: All Lions Wednesday, 3/4/15,2:00pm, PST and Friday, 3/13/15, 9:00pm, PST Develop confident and creative Lions teams through intuitive leadership that includes self-awareness, self- regulation, motivation, empathy and communication skills.

You’ve Been a Club President…What’s Next? Intended Audience: Current and past club presidents who want to explore district-level opportunities Wednesday, 4/1/15, 2:00pm, PST and Friday, 4/10/15, 9:00pm, PST Follow the journey of three Past Club Presidents as they continue their Lionism at the club, district, and zone levels.

Lionism as a Past District Governor Intended Audience: District Governors and Past District Governors Wednesday, 5/6/15, 2:00pm, PST and Friday, 5/8/15, 9:00pm, PST Lionism as a Past District Governor is an honor which offers both challenges and opportunities. In this webinar we will explore the characteristics and qualities of a Past District Governor, the unique challenges of Lionism as a Past District Governor, and possible roles a Past District Governor could pursue that are both personally satisfying and that further the mission and goals of LCI.

Webinar Site < Click Here http://www.lionsclubs.org/

Lions Pride District 4-C5 9 * For more qualifying service areas, please visit lions100.org.

Making Strides Against Breast Cancer Walk

On October 19, 2014, a beautiful Sunday morning, approximately 28 Lions, family members, and friends, walked in the American Cancer Society (The Society) Making Strides Against Breast Cancer Walk. The District Women's Development Chairperson, Kitty Kramer, worked towards a goal of $2,500 to donate to towards this effort.

Lion Kitty is pleased to announce that over $3,100 was donated, which surpassed her goal! In addition, District 4-C5 was the #12 team out of over 550 in collections and was designated a "Blue Ribbon" team for the second year in a row.

Kitty would like to thank the Woodland Host Lions, Country Club Lions, Higgins Diggins Lions, Esparto Lions, and Yolo Sunset Lions clubs for their contributions. There were many other donations made by individual Lions and others also did fundraising on their own and a special thanks to the ladies and gents who came out very early to walk!!

Donations will:

The Society helps people understand what screening tests they need and the steps to take to protect themselves from breast cancer by developing prevention and early detection guidelines that are the industry standard.

Help fund research to find, prevent, treat, and cure cancer than any other non-governmental organization.

Help cancer patients in many ways. One in every two women newly diagnosed with breast cancer reaches out to the American Cancer Society for help and support. The Society is in every community providing free information and services when and where people need it. If you need someone to talk with at 3 a.m. (or any other time of the day or night), we’re here. If your friend is losing her hair because of chemo, your mother needs a ride to treatment, or if a loved one needs a place to stay while in treatment away from home, we are the ones who can help. Submitted by : Lion Kitty Kramer

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Lions 2015 Float

Lions 2015 Float Under Construction

"Inspiring Challenges" Lions providing recreation for the blind and visually impaired

The 2015 Tournament of Roses Theme is "Inspiring Stories" and the theme of the Lions float is "Inspiring Challenges," a float that depicts five challenging recreational activities that Lions around the world provide for hundreds of thousands of blind and visually impaired individuals. These "Inspiring Challenges" are:  Blind Fishing Derby - District 31-J North Carolina  Blind Surfing - District 4-L6, Encinitas, California  Blind Buddies Golf Challenge - District 4-L4, Rancho Cucamonga, California  Blind Bicycling - District 4-C5, Antelope, California  Miracle League Blind Beep Baseball - District 34- B Moody, Alabama Many clubs around the world provide these activities, not only for the blind, but handicapped people as well.

Lions Float, Inc. (LFI) is a year round project and meets monthly on the second Saturday at Ontario Airport Hotel except in June and July. For more information about the float activities, call Norm MacKenzie @ 760-802-6018, Jon Casteel @ 951-235-4606 or visit http://www.lionsrosefloat.com/

2nd VDG Kumar Kalagara is your 4-C5 Coordinator @ [email protected] / 916 337 0914

From “The Leader” MD4 Bulletin

Patches and Pins will on sale at November (Dos Rios Region) Cabinet Meeting

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From MD4

Lions Eyes Across California Project by VDG Richard Davies (4-A3)

The following guidelines are a baseline of actions and considerations to be taken by Districts to participate in "Lions Eyes Across California" project. Districts may determine equally qualified ways to meet project objectives. Please advise "Lion's Eyes Across California" via e-mail [email protected] of any such alternate actions.

Goal: To advertise and bring awareness to Lionism - Melvin Jones, involve communities, service groups, business leaders, government leaders, to increase membership, collect eyeglasses, and begin an early celebration of Lion's Centennial.

MD4 has Guidelines: received a grant Participate on date as provide by MD4 Council of Governors - Date 3/28/2015 for LION EYES ACROSS 1. Use up to $1400.00 Grant money for advertising only. No matching funds needed. Must present receipts. CALIFORNIA, to 2. Provide a central contact person in your District to work with MD4 be able Lions Eyes Committee -Typically 1st VDG. 3. Need at least one club in a District to participate to qualify. implement the 4. Districts may also combine resources together to hold a joint event to project for a day qualify. 5. Locate an easy walk up or drive up venue or venues in your District statewide to for Public access. This can be held at your clubhouse, school, church, recycle glasses, community center, Chamber of Commerce, a parking lot at a chain retailer: Target, Walmart, Vons, Safeway, Home Depot, Lowes, outlet and much more. mall, etc. 6. Set up tables and/or booths to display Centennial information, Lion's Melvin Jones information, eyeglass collection and any local, national Read more in and international projects, and a membership information table. MD4 Newsletter Make it festive and attractive looking - balloons, banners, signage, “Leader” music, announcement bull horns.

Upcoming Events Event Date Hotel City Council of Governors (Mid-Winter) February 20-22, 2015 Marriot Visalia MD-4 Convention - 2015 February 20-22, 2015 Marriot Visalia International Convention - 2015 June 26 - 30 '15 Honolulu 4C5 Convention - 2015 May 08-10 ‘15 Marriot San Ramon MD-4 Leadership Institute (South) November 8 - 10 '14 Red Lion Woodlake Sacramento (North) January 17 - 19 '15 Ontario Airport Ontario

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Student Speaker Contest

District 4-C5 Student Speaker Contest Committee- 2014-15

Chairman, Ed Smith [email protected] (916) 300-4784 Bob Cushman (Dos Rios) [email protected] 916-343-0505 (C) Ina Elrod (Donner) [email protected] (530) 432-9321 (530) 265-3245 (C) Carleton Enloe (Sacramento) [email protected] 916-686-2116 (H) 916-801-8802 (C) Lorene Euerle (Dos Rios [email protected] 916-652-5838 (H) 916-539-0515 Kitty Kramer (Dos Rios) [email protected] (530) 662-3896 Diana Rowland (Dos Rios) [email protected] (530) 757-1965 (H) (530) 526-2898 (C) Jim Schulte (Dos Rios) [email protected] (530) 787-4441

2015 Student Speaker Contest Schedule for District 4-C5

July - Oct 1 Clubs need to order their packets from MD-4 on line. Oct-January Training in the local zones and regions. Nov 22, 2014 Student Speaker Contest Forum at District Cabinet Meeting January 01 - Feb 18 Club Contests Feb 19 - March 15 Zone Contests March 16 - April 5 Region Contests April 25 (Sat) @ 1:00 pm District 4-C5 Contest Pacific McGeorge School of Law Lecture Hall. 3200 Fifth Avenue, Sacra- mento, CA 95817 [tentative] May 9 @ 9:45 am Area 1 Contest Marriott Hotel @ District 4-C5 Convention [tentative] June 6 @ __?__ pm State Finals COG Meeting, San Jose, CA.

Should you have any questions please contact Student Speaker Contest Chairman Lion Ed Smith at [email protected] or (916) 300-4784

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2014-2015 District 4-C5 Executive Board

Title Name Home Club District Governor Ervin Gon Embarcadero 1st Vice District Governor Michael Retzlaff Pride of Laguna Creek 2nd Vice District Governor Kumar Kalagara Folsom City Host Cabinet Secretary Cat Gon Embarcadero Cabinet Treasurer Sarah Enloe Maharlika GLT Chair Andy Anderson Elk Grove GMT Chair Robert Olin Lincoln Hills

Donner Region Doug Wight Nevada City Foothill Zone Carol Mobley-Jordan Foresthill Golden Empire Zone Tim Luckinbill Colfax Sierra Zone Chuck Woerner Nevada City

Dos Rios Region David Evans Lincoln Hills Gordon Zone Carlos Carvajal Yolo-Sunset Eureka Zone Lorene Euerle Newcastle Wolfskill Zone Nerissa Fox Ambassador

Sacramento Region Cecille Baylon Golden State Camellia Zone Scott Rogalski Land Park Crocker Zone Klint Robins Mabuhay Poppy Zone Carle Enloe Maharlika Sutter Zone Jeri Retzlaff Pride of Laguna Creek

Washoe Region Becky Bell Mother Lode Diamond K Zone Cathy Messier Roseville Sunrise Marshall Zone Annie Schmidt Mother Lode Mather Zone Ben Hur Sierra

Student Speaker Trustee Donald Ring Orangevale Student Speaker Chair Edward Smith Roseville Host LCIF Chair Sue Olin Lincoln Hills Leo Chair Betty Sandland Higgins Diggins Sight Chair Derek Ledda Maharlika Peace Poster Chair Larry Vogelesang Woodland Host

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Standard 4-C5 E-Mail Addresses

District Governor Ervin Gon [email protected] 1st VDG Michael Retzlaff [email protected] 2nd VDG Kumar Kalagara [email protected] Cabinet Secretary Cat Gon [email protected] Cabinet Treasurer Sarah Enloe [email protected] GLT Chair Andy Anderson [email protected] GMT Chair Bob Olin [email protected] Donner Region Doug Wight [email protected] Foothill Zone Carol Mobley-Jordan [email protected] Golden Empire Zone Tim Luckinbill [email protected] Sierra Zone Chuck Woerner [email protected] Dos Rios Region David Evans [email protected] Gordon Zone Carlos Carvajal [email protected] Eureka Zone Lorene Euerle [email protected] Wolfskill Zone Nerissa Fox [email protected] Sacramento Region Cecille Baylon [email protected] Camellia Zone Scott Rogalski [email protected] Crocker Zone Klint Robins [email protected] Poppy Zone Carle Enloe [email protected] Sutter Zone Jeri Retzlaff [email protected] Washoe Region Becky Bell [email protected] Diamond K Zone Cathy Messier [email protected] Marshall Zone Annie Schmidt [email protected] Mather Zone Ben Hur [email protected]

Admin Assistant Dave Pevny [email protected] Chaplain Connie Donley [email protected] Directory Jan Windsor [email protected] Bulletin Editor Kumar Kalagara [email protected] FPVI Don Ring [email protected] IPDG Andy Anderson [email protected] LCIF Sue Olin [email protected] LEF Rich Wilmont [email protected] LEO Betty Sandland [email protected] LMEAF Mary Ellen Ware [email protected] Messages Tony Santos [email protected] Camp Ross Relles Nick Nicol [email protected] Technology Kumar Kalagara [email protected]

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Governor's Visitation

November 2014 Schedule is accurate as of Davis Aggies 5 Wed 7:00 PM October 31. Senator 6 Thu 6:30 PM Questions? Somerset Pioneer 12 Wed 7:00 PM Please check with individual Folsom Lake 13 Thu 6:30 PM club secretaries. Valley Hi 20 Thu 7:00 PM Or December 2014 Write to Lincoln Host 18 Thu 5:00 PM CS Cat @ [email protected]

This and That

Lions Clubs – Ready to Help, Worldwide

Whenever a Lions club gets together, problems get smaller. And communities get better. That's because we help where help is needed – in our own communities and around the world – with unmatched integrity and energy.

Lions 100th Anniversary Pins

Lions 100th Anniversary Pins are being offered by the Student Speaker Foundation to raise money for the Foundation. They are $7.00 each and can be obtained by contacting your 2VDG Kumar Kalagara @ 916 337 0914 or [email protected]. Will be on sale at Dos Rios Region Cabinet meeting on Saturday November 22, 2014

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The Bulletin (Pride)

Dear 4-C5 Lions,

Hope you are enjoying the new format of our district bulletin (Pride). It is our intention to dedicate sections for Clubs, Zones, Regions and projects. Every month pride will show case at least one from each category.

Pride will also cover news about Lions across the globe. Please take advantage of the new format and contribute. The size of the Pride is not going be restricted as it is primarily redesigned for electronic distribution. It will be available on our district website (www.district4c5.org) on 1st day of the month and through district email blast. Clubs are encouraged to help the Lions who do not have access to electronic media.

Looking forward to your continued readership. Regards Lion Kumar Kalagara, Editor, Lion’s Pride District 4-C5

Send your PDF documents do not always transfer well. announcements, articles The preferred format is and pictures to MS Word or Publisher. Please send pictures as Editor: Lion Kumar Kalagara attachment.

[email protected] or Deadline for submissions: [email protected] 20th of the month Ph: 916-337-0914 Send your club bulletin by mail 115 Austin Dr, or email to the editor to be Folsom, CA 95630 considered for the District Bulletin Contest

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2014-2015 DISTRICT 4-C5 CONVENTION

SAN RAMON, CA

May 08-10, 2015

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Toys for the Troops Kids

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Lions Pride District 4-C5 21 the Citrus Heights Lions present

Give the gift of Chocolate for the holidays, come see what Dove Chocolate Discoveries has to offer ! Join us for an evening of sampling a private line of Dove chocolate!

Presented to you by Independent Chocolatier Jessica Jones

Wednesday, November 19th

6:30 pm

Sylvan Community Center

7521 Community Dr, Citrus Heights Corner of Sylvan Rd

Space is limited. Call Cathy Stratton at 916-726-1530 or Claudia Ferguson 916-863-1774 to reserve a spot for you and a friend.

A percentage of the proceeds will be donated to the Citrus Heights Lions Club to help fund community projects.

PENN VALLEY LIONS CLUB

“ANNUAL CRAB FEED”

FRIDAY AND SATURDAY JANUARY 23 & 24, 2015

NO HOST COCKTAILS at 6:00 P.M. DINNER at 7:00 P.M. ALL YOU CAN EAT!!! SPAGETTI-SALAD-GARLIC BREAD-CRACKED CRAB

$40.00 PER PERSON(donation) ( Checks payable to: Penn Valley Lions )

AT PENN VALLEY FIRE DEPARTMENT FIREHOUSE SPENCEVILLE ROAD, PENN VALLEY

FOR TICKETS CALL: BRUCE PUPHAL 432-9828 Mail checks to: Penn Valley Lions, c/o 12651 Ridgecrest Pl., Penn Valley, CA 95946 Email: [email protected] Penn Valley Hi-Graders is a 501 (c) 4 organization Fed. Tax I.D. # 94-2716929

2nd Annual

DandeLion Arts and Crafts Show (formerly the APCC Dragon Arts and Crafts Fair)

Sponsored by the Sacramento Senator Lions Club

Sunday, November 16, 2014 9:00 am – 3:00 pm Sacramento Elks Lodge #6 6446 Riverside Blvd (at Florin Rd) Sacramento, CA 95831

Free Parking and Admission

We are proud to announce that 100% of our profits from this event will support various community projects. Please visit our website for information about how our organization serves the community.

www.SacramentoSenatorLions.org For event information: [email protected]

M d er u r p at the Ho Murder Mystery Dinner Theatre November 15, 2014 6:00pm At the Grange Hall 1315 G Street Performed by Rio Linda the Bohemian Players Only 64 tickets Gourmet Spaghetti, Ticket Price: $20 salad, locally baked Kids under 10: $10 bread & dessert Reserved Table for 8: No-host Bar $125 Produced by the Grange and the Rio Linda Lions Club 916-803-1530 or riolindalions.com LIONS Worldwide Week of Service in January

Share event photos using the hashtag #Lions100 , and we’ll share them on the LCI Facebook page!

lions100.org

IAD 607 EN 10/14

Health Topics

a. Battle of the Bulge

b. Invasion by Filovirus

Lions Pride District 4-C5 22 BATTLE OF THE BULGE by J. D. Villarica, M.D.

EYE AND MIND OPENER Simply speaking, the accumulation of body fat in excess of twenty percent (20%) or more of one’s ideal body weight for height, age and built is considered obese . Experts all agree that it is not just the amount of body fat but also its body distribution that is key to health risk. Obesity is the foot-plate of a towering multi-tiered health sky-scraper causing deleterious and life-threatening problems the like of which is local as well as universal. To name some of these: heart diseases, diabetes, ischemic strokes, kidney problems, cancer, high blood pressure, gall bladder disorders, liver problems, osteoporosis, joint and back problems, psychological dysfunctions, respiratory disturbances, sleep abnormalities, dementia, arthritis, GERD (gastro-esophageal reflux disease), hearing loss, premature deaths, accidents of all sorts and the list goes on and on. As one can see, obesity has a devastating effect on our wealth and health well-being to the tune of billions of dollars. These are all preventable if we nip that cause (obesity) in the bud, and we certainly can.

Globalization is rapidly bridging boundaries between nations’ cuisines, and most nations in the world are leaning towards Western taste and diet, energy dense meals , “fast food” patterns, rich in meat, dairy and processed sugar. Leading the parade of champions is Ray Kroc’s McDonald with a world-wide restaurant franchise establishment of over 31,000 in 120 countries and counting. Colonel Sander’s KFC, Burger King, Carl’s Jr., Pizza parlors, Dunkin’ Donuts, and many others are close behind. As this diet spreads, so does obesity. There is approximately 1.6 billion adults world-wide counted as overweight and 400 million are obese with the most rapid increase noted among low and middle-income urban populace. About one third of adult Americans are seriously overweight and are high risk for early death. Obesity is twice as common among women in the lower socio-economic scale compared to those in the higher status. It is also prevalent among black women versus white. In men, the prevalence is about the same in blacks and whites. Obesity and its complications account for as many as 300,000 premature death each year here, making it second to cigarette smoking as a contributor to the cause of death.

Underdeveloped countries are not as affluent as the western industrialized nations. They suffer malnutrition and food is food - no such thing as “junk food”. It is a real treat to them if our so-called “junk food” is on their tables. Don’t get me wrong though, they do have obese people too but not to the extent as we do have.

MEASURING FAT STORAGE While eye-ball estimates gives us a rough idea (apple, pear-shape or coca-cola bottle habitus) of who is overweight, obese or morbidly obese, we have various ways of calculating body mass - some very sophisticated measuring gadgets as calibrated calipers for skin-fold thickness fat in various body parts (triceps, sub scapular, lower thoracic, iliac and abdominal), Bio-electrical impedance analysis, underwater (hydrostatic) weighing, imaging procedures including CT scan (computerized tomography), MRI (magnetic resonance imaging), dual- energy x-ray absorptiometry (DEXA), which are usually used for academic and research presentation purposes mostly. We have simple down-to-earth ways of measuring BMI (body mass index) by using an insurance actuary BMI chart that is widely used in hospitals, health care clinics and other weight-loss facilities. Plot your height in inches and weight in pounds against the chart and you will come up with your BMI, ideal is 18.5 - 24 ( 21-23 in females, 22-24 in males). 25 and higher is overweight, 30 and higher is obese. Muscular guys will have higher BMI but without associated health risks. There is a mathematical calculation to arrive at

Page 1 of 5 BATTLE OF THE BULGE by J. D. Villarica, M.D. your BMI but the chart from the insurance company is very handy and easy to use. Even if you fall in the BMI healthy range , you still carry significant health risks if you carry too much weight around your stomach (the apple-shape habitus). Take your waist measurement in inches and divide it by hips in inches. Your Waist/Hip Ratio (WHR) should be no more than 0.80 (women)and 0.90 (men)`.

Use of your bathroom scales will tell you if you are gaining or losing the battle of the bulge, but you still need to know your BMI and/or WHR to give you a much better perspective on how to win this battle or even better, prevent it. Prevention trumps cure.

To some people keeping excess weight off seem almost impossible - but that is far from the truth. The most common mistake is taking shortcuts and relying on the short-term dieting weight reduction programs. Our extra pounds did not happen overnight, pounds begin to pile on us in our mid thirties when we start to become less active. Our bodies’ metabolic furnace cools and turn fewer calories even at rest. Every 10 years after age 50, we need about 100 fewer calories a day to maintain the same weight. But most of us continue eating just as we have always had, less exercise and activities. So week after week those calories that we don’t use are converted to fats. Now it is easy to see, that most of us gain about 10 # per decade after turning twenty. It also takes time to lose and keep it down.

There ought to be some kind of implantable, programmable device that could give our hypothalamus some feed-back that we already are calorie-filled. We do have hormones that reduce or increase food intake, but the message has to be integrated and communicated to the brain for the necessary action. There are Bariatric specialists and researchers who are actively looking into such device much like the AICD (automatic implantable cardiac defibrillator) does to the heart.

While we are patiently and hopefully waiting for this device to materialize there are things that we can do to treat and/or prevent this disease. If we have the genes, and 33% may inherit it, we have to be extra aggressive in warding obesity off. Remember, if we eat more than we need, the surplus calories is stored as fat. Invariably, eating too much food and exercising too little are key factors. If we want to lose weight, crash-dieting isn’t the answer. Instead, we gradually change the way we eat and exercise. Counting calories is not the answer but it’s a start.

CALORIE COUNT About 60-65% of our calories is spent fueling our beating hearts, maintaining optimal body temperature and keeping other essential body systems in working order. Thus, we need to calculate our basal metabolic rate (BMR) to determine how many calories we need. Step 1 - convert your weight from pounds to kilograms by dividing it by 2.2. Step 2 - multiply the result by 0.9 (men should skip this) Step 3 - multiply the result by 70. That gives us a rough idea how many calories we need a day, but allowing for physical activities and exercise, we need 30-50 more calories. You are probably putting more weight if you are taking more calories than your BMR. Boosting your muscle mass thru training can increase your BMR, you are burning calories faster even at rest - this is good, muscles matter. A pound of muscle burns about 45 calories a day. A pound of fat burns fewer than 2 calories a day. Boosting our metabolism can make us enjoy occasional snacks.

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DON’T TRY - DO Knowing how to take off pounds is one thing, doing it is another. Determination, positive attitude, perseverance and life-style changes are sine qua non in a weight loss effort. Though breaking habits is no easy task, we have relatives, loved ones, support groups of peers and professionals who can extend help in more ways than one. Exercise doesn’t have to be a chore, make it a fun part of your life-style and you’re much more likely to stick to the program. James Prochaska, psychologist, and head of the Health Promotion Partnership of the University of Rhode Island, has identified six stages of successful habit changing. 1 - Precontemplation - you are thinking about the change and weighing pros and cons. 2 - Contemplation - now your mind is made up about trimming your weight. 3 - Preparation - readiness for the habit change, set realistic goals for each day and week, then add six months and year. Write down in detail specifics (e.g. buy food scale, get 1% low fat milk, etc.) announce your intention to relatives, friends and co-workers. 4 - Action - plan weekly menus and detailed shopping list. Enlist a workout buddy, plan satisfying treats like a piece of your favorite pie so you would feel deprived. Be patient, new behaviors can take six months to “groove”. 5 - Maintenance - here is where you turn change to habits. Shift to a new mental gear. Research shows that identifying yourself as an exerciser of healthful eater is important to making your new habits a permanent life-style change. 6 - Termination - Here is where you put the past behind, continue with your present gained reassurance that a lapse is not a relapse. Look forward to a brighter future because now you are a truly new healthier person with a different look - and different outlook - than the one you started with.

See your doctor if you have an unexplained weight gain prior to embarking into your psychological venture. It could be linked to underlying disorder like thyroid or other conditions that cause weight gain including heart, kidney or other endocrine disorders. To figure out roughly how many calories you need to maintain your current weight, simply multiply your weight by 10 if you are sedentary, 15 if you are fairly active or 20 if you are exerting yourself all day long. To shed a pound a week - the rate at which experts recommend losing a week - subtract 3500 calories a week or 500 a day from your current total.

It’s not just about eating less, it is about eating differently. More fibers, less fat and yes, smaller portions should make up your new notion of nutrition. Trimming your meals doesn’t mean cutting calories from them. Calorie count works for some calorie-fixated dieters, it’s a tedious mathematically exact culinary science but there are other ways to streamline your diet without going stir-crazy. Here are a few applications to your meal plan that will cut down on calories without any superhuman sacrifices. *add more fibers, make fresh and cooked vegetables and fruits as well as whole grains and beans the star of your meals and relegate meat poultry and fat to supporting roles. * eat breakfast every day - not the “all-American” one that some fast-fooders offer, but the whole grain cereal with at least 3 grams of fiber each serving coupled with fresh fruits, skim milk or soy milk (for those with lactose intolerance). Some researchers now advocate that breakfast ought to be a big one to control appetite and craving for sweets and starches later in the day. * practice portion control, here’s a new mind set to adopt, think about quality over quantity and consider yourself done when you’re only 80% full. The point is to give your body the nutrition it needs, not to overstuff yourself as if food may never again be available. * use smaller plate, I know some people will grumble but studies find that if you use large plates, people will put more food on it and will dispatch the whole thing like a tornado. * slow down, most of us eat fast, this doesn’t give the brain time to receive the hormonal signals from the stomach that it is full. Along the same vein, wait at least 20 minutes before going for seconds or dessert, chances are you won't want either. * eat

Page 3 of 5 BATTLE OF THE BULGE by J. D. Villarica, M.D. in the dining room, serve in the kitchen. You’ll less likely get up for seconds if you have to get up to traipse to the kitchen to fill up.

A balanced diet providing about 1500 calories a day for women and 2000 for men is a reasonable approach. Combined with a moderate exercise program, it should allow a loss of one (1) to two (2) pounds a week. Since the aim is to find a diet you can live with in order to keep weight off permanently, it is better to shed weight off gradually by eating moderate amounts of lean meat and other high protein foods, pasta and other starchy foods and ample vegetables and fruits. Skim milk and other low-fat dairy products supply needed calcium and other nutrients.

No foods need to be totally forbidden, but the empty calories in alcohol, sugary desserts, and high-fat high-salt snack foods should be avoided. As pounds drop off, the urge to lose more will grow as desire for sugary, fatty foods fades away.

EASY FIBERS Fiber one - 13 grams Progresso Hearty Black Bean Soup - 10 grams Medium Orange - 7 grams Quaker Oat Bran - 6 grams Low Fat Bran Muffin - 4 grams One Slice whole wheat bread - 2 grams

COOKING HINTS Baking: keep fat to a minimum and boost flavor by pouring wine, fruit juice or even tea over fish, squash or potatoes before baking Broiling: use soy sauce, fruit juice, water or even melted fruit preserves to baste meat or fish instead of oil or butter Grilling: let the fat drip off your meat. Avoid oil-based marinades. Try wrapping seasoned food in foil packets so it steams in its own juice and stays moist Microwaving: this quick cooking method preserves the flavor and essential nutrients in vegetables and fruits Poaching: poach in broth, wine or fruit juice Pressure Cooking: Ideal for beans, grains soup, stews and dried vegetables. Chill soups after cooking then skim fat away Sautéing: prepare your food without adding fat by substituting a bit of water or broth for oil. Steaming: Use a steamer basket to prevent nutrients from leaching into water Boiling: you’ll trim calories by using this cooking method, but you’ll also lose water-soluble nutrients especially if the food is chopped. Try boiling potatoes with skin. Stir-fry: this quick-cooking method seals flavor of vegetables, tofu, meats or fowl. Minimize fat by using a little bit of water or stock instead of oil.

NO WAY .... Deep fry: avoid this high-fat disaster. If you must, drain food well on paper towel Pan frying: cut back on fat by using nonstick pans, spraying pans with nonstick cooking spray or wiping a small bit of oil onto the pan with a paper towel for an ultra light coating

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Over grilling: Avoid barbecuing food to a crisp. When fat from meat or marinade drips onto hot coals, the resulting smoky, charred bits contain dangerous carcinogens. Trim fat from meat and move food away from open flames.

REMEMBER * Consume plenty of fluid and juice to wash away metabolic waste Eat moderate amounts of *complex carbohydrates such as pasta, potatoes, rice legumes and whole grain products for energy, vitamins and fibers *fresh fruits and vegetables for vitamins and minerals *fish and skinless poultry for high quality protein and minerals *low-fat dairy products for vitamins and calcium *The Surgeon General recommends at least 30 minutes of moderate exercise daily. It helps preserve muscle, the more muscular we are, the more calories our body uses up even at rest. Exercise also seem to regulate appetite to more closely match caloric needs. Other benefits include increase Insulin sensitivity, improve lipid profile, reduce blood pressure, better aerobic fitness and improve psychological well-being. Exercise should not be a chore, make it a fun part of your life-style. It will help you maintain your ideal weight and wholesome health. Avoid high-fat items such as fatty meats, pastries, candy, potato chips and alcohol.

Diet pills and Bariatric surgical procedures are a part and parcel of obesity treatment but that is a whole separate topic in itself that will require another session and discussion.

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Page 5 of 5 INVASION BY FILOVIRUS by: Jose D. Villarica, M.D.

BACKGROUND Humans had been struggling against Ebola filovirus disease since first recorded and reported outbreak in 1976 in Southern Sudan and Yambuku in Zaire which lies on the Ebola River basin. According to data gathered from the World Health Organization (WHO), this first recorded outbreak claimed 431 lives. Three years later, the disease erupted suddenly in Sudan. It remained dormant for the next 15 years. Then a large-scale outbreak bared its fangs in Zaire in 2005 claiming 250 deaths. In 2001-2002, Uganda lost 224 people to Ebola and in 2002-2003 Congo suffered 128 deaths. Congo was visited again in 2007, this time taking 187 lives. The 25th, and so far the most severe and complicated outbreak, started in March 22, 2014 dealing devastating blows in West African countries - Sierra Leone, Ivory Coast (Cote D’Ivoire) and Guinea. The disease kept marching on uncontrolled for now and the mortality has passed 4,000 deaths. The projected figure if the epidemic continues unchecked in these countries is a staggering 28,000 next year with a potential unreported 2.5 under-reported correction factored into this calculation. Reported cases in Liberia are doubling every 15-20 days, those in Sierra Leone doubling every 30-40 days. Not a single day passes without radio, TV, news prints, media commentators, voices from around the world echoing the ravages of Ebola in West Africa, now Dallas, Texas is ground zero in the United States following the death of Ebola-infected Liberian man and the transmission of the virus to a couple of nurses who took care of the man in Dallas’ Texas Health Presbyterian Medical Center.

The WHO (World Health Organization) on August 8, 2014, declared the epidemic to be a “public health emergency of international concern”. This mandates countries to develop national preparedness capacities including the duty to report internationally significant events, surveillance and contact tracing as well as exercise public health powers, while balancing human rights and international trade. The United Nations has put its gears into the fight, the United States Center for Disease Control and Prevention has provided recommendations and management of persons exposed to the Ebola filovirus. The concerted efforts of world-wide clinicians, scientists, epidemiologists and other specialists are putting their heads together to fight this epidemic turning pandemic now.

The United Nations has created a special mission to help contain the outbreak. This is the first time that the UN has created a mission for a public health emergency. Adequate staff, as well as community support and engagement are required to implement control measures. Continued efforts should focus on case finding, identification and surveillance of contacts and safe burial practices.

FILOVIRUSES The filoviruses Ebola and Marburg are among the most deadly human pathogens causing severe multi-system disease leading to hemorrhagic consequences and death. Mortality rate ranges from 80-90%. Most infections have arisen out of unsuspected exposure to an animal harboring the filovirus or direct physical contact with body fluid of a sick patient - there are also concerns about accidental laboratory infections , exposure to a dead person in funeral preparations and bioterrorist activities.

Classification Ebola and Marburg viruses are nonsegmented single-stranded filamentous organisms. Together they make up the family Filoviridae, from the Latin “filum”, meaning thread-like. Ebola was discovered in the Ebola River area in

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Zaire and Marburg in the German city Marburg where the filovirus was isolated via an inadvertent transport of a non-human primate from Uganda for vaccine-production purposes in 1967. An outbreak in Europe ensued causing 21% mortality. This importation of infected monkeys into Germany and Yugoslavia resulted in severe illness among vaccine workers who came in contact with the animals killing them to harvest their kidneys, or preparing primary cell cultures for polio vaccine production. There has been no outbreaks in Europe since then, with the exception of a few accidental laboratory infections, all cases of filoviral disease have occurred in the sub-Saharan Africa.

Spread among wild non-human primates Ebola virus has also been spreading among wild non-human primates apparently as a result of their contact with unidentified reservoir hosts. The reduction of chimpanzee and gorilla population is in part due to this and has also triggered human epidemics primarily due to consumption of sick and dead animals as food source.

Perhaps the greatest mysteries regarding the filoviruses are the identity of their natural reservoir and the mode of transmission from the reservoir to wild apes and humans. There is a suspicion that the carrier host of Ebola and Marburg filoviruses are species of small animals that serve as a source of infection for both humans and wild primates. Bats have long been on top of the list of suspects because they have been present in large numbers at the site of several filovirus outbreaks. Finally, after numerous attempts, scientists at the CDC and their African colleagues reported in 2009 the isolation of Marburg virus from fruit bats captured at a cave in Uganda. Those viruses matched those that infected miners in 2007.

Diseases in humans due to Ebola and Marburg viruses are similar in their clinical manifestations differing only in severity and case-fatality rate``. Marburg less menacing than Ebola’s Zaire species.

Ebola virus is divided into five different species (Zaire, Sudan, Ivory Coast, Bundibugyo and Reston) which differ in their virulence in humans. The current outbreak is from the Zaire species, considered the most virulent. The magnitude of outbreak, especially in Liberia and Sierra Leone, has probably been underestimated due in part to individuals with Ebola virus disease being cared for outside hospital setting. On September 30, 2014, the first travel-associated case of Ebola was reported in the United States when an individual flew from Liberia to Dallas, Texas. He had no symptoms prior and en-route to the US but developed fever, and flu-like symptoms five days after arriving in Dallas. Subsequent studies revealed that the patient was Ebola-infected. He was hospitalized but the patient did not recover in spite of efforts to save him - the first Ebola victim of record in the US. To date, only experimental drugs and transfusions are being used for treatment regimen. Vaccines are being evaluated but nothing FDA-approved are available for general use.

HIGH INDEX OF SUSPICION Ebola Virus Disease (EVD) should be included in your list of possible offending diseases when confronted with a seemingly harmless common colds complaint. There are pertinent precautions to take and questions to ask a patient before deciding on further steps towards diagnosis and treatment.

The United States Centers for Disease Control and Prevention (CDC) and WHO have provided recommendations for the evaluation and management of persons who may have been exposed to Ebola virus. Their approach

Page 2 of 6 INVASION BY FILOVIRUS by: Jose D. Villarica, M.D. depends upon when the exposure occurred, if the exposure was high risk or low risk, and whether or not the individual is displaying signs and symptoms consistent with Ebola virus disease.

Signs and symptoms consistent with Ebola Virus disease include fever greater than 38.6 C (101.5 F). Additional signs and symptoms such as headache, muscle pain, vomiting, diarrhea, abdominal pains or unexplained hemorrhage are almost a giveaway for further diagnostic testing. Risk factors - the risk of exposure ranges from high to low to indirect only. Patients who are at risk for Ebola as defined by CDC are *those who have had contact with blood, body fluids, or human remains of a patient known or suspected to have EVD 21 days prior to onset of symptoms *residence in or travel to an area where Ebola virus transmission is active *direct handling of bats, rodents or primates from endemic areas

Decision for testing and quarantine are warranted as indicated by local and state health departments who should be immediately contacted.

High Risk Exposure - # percutaneous or mucous membrane exposure to blood or body fluids of a known EVD patient # direct skin contact with or exposure to blood or body fluids of a patient with EVD without appropriate personal protective equipment as prescribed by the CDC # processing of blood or body fluids of a confirmed EVD patient without appropriate personal protective equipment or standard biosafety precautions # direct contact with a dead body without protective equipment in a country where an Ebola virus disease is occurring

Low Risk Exposure - CDC recommends medical evaluation using infection control precautions for persons with low risk exposure who develop fever with or without other clinical findings which include # household contact with an EVD patient # other close contact with EVD patient in health care facilities or community settings

Close contact according to CDC , is defined as being within approximately three feet (one meter) of or within the room or care area of an EVD patient for an extended period of time (eg. Health care personnel, household members) while not in proper protective gear. Brief interactions, such as walking by a person, or moving through a hospital, do not constitute casual contact.

No Direct Exposure - evaluating asymptomatic individuals from an outbreak area who has no high or low risk exposure remains in limbo. The CDC states that individuals who have fevers but with no other signs and symptoms of EVD within 21 days of visiting an EVD-affected country should have medical evaluation and optional consultation with public health authorities to determine movement restrictions and infection control precautions as indicated. In general, the WHO and CDC are in one accord in their guidelines for evaluating individuals with a possible exposure to EVD. In addition, WHO considers a person to be at risk for infection if they have had sexual contact with a sick person or a person recovering from Ebola virus disease.

Other disease considerations should be entertained such as those common in the area like malaria, typhoid, yellow fever , meningitis, etc..

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Transmission of the disease in a hospital setting (nosocomial transmission) is an important factor in the spread of the disease as noted lately in Texas. An incident that happened in Kikwit, DRC in 1995, amplifies this hospital situation. A patient hospitalized with abdominal pains was taken to surgery and operated on. The patient had the filovirus, the entire surgical team became infected through unprotected exposure to aerosolized blood, they were then hospitalized and the disease spread like wild fire to staff, other patients, and family members through direct physical contact. The lesson - not just any hospital and their staff are trained and equipped to treat these cases.

Ebola virus disease is rarely, if ever, spread from person-to-person by respiratory route. Although aerosolized filoviruses are highly infectious for laboratory animals, in humans, airborne transmission has only been reported among healthcare workers who were exposed to aerosols generated during medical procedures. Be on the lookout for bioterrorists attackers who are presently working on the aerosol factor of spreading the disease. Intelligence agencies are well aware of this WMD (Weapon of Mass Destruction).

MODUS OPERANDI These Ebola and Marburg filoviruses spread devastating blows to our adaptive immune defense system as soon as they gain entry into our bodies by routes via skin breaks, mucous membrane, or any damaged tissues. They blitz our functional cells, break barriers and invade organ systems disrupt communication among our defending cells , replicate in rapid fashion and overwhelm body centers controlling blood flow, coagulation center, temperature , vital organs till our bodies succumbs - it takes about a week, if we can not contain the invasion. If our body defenses can mobilize antibodies against the invading filoviruses early on, chances are good for recovery. In non-fatal cases, patients typically improve 6 to 11 days after onset of symptoms. The formation of antigen-antibody complexes during recovery may cause some joint pains and other symptoms. Patients with Ebola virus disease typically have an abrupt onset of symptoms about 8-10 days after exposure (range 2 - 21 days). The incubation period for the individual patient depends in part to type of exposure (6 days for percutaneous exposure versus 10 days for contact exposure). There is no evidence that asymptomatic persons still in the incubation period are infectious to others. However all symptomatic individuals should be assumed to have high levels of virus in the blood and other body fluids and appropriate safety precautions must be taken.

Initially, EVD present with non-specific flu-like symptoms. It typically begins with abrupt onset of fever, chills and general malaise. They may complain of weakness, loss of appetite, severe headache and muscle pains involving the trunk and lower back. High fever may be accompanied by slow pulse as seen in typhoid fever. Rash - some people develop a diffuse non-itchy rash by day 5-7, which usually affect the face, neck, trunk and arms and could fade. Watery diarrhea, nausea, vomiting and abdominal pain may develop several days after initial presentation. Bleeding heralds terminal illness. Kidney failure occurs with progression of illness. Other findings can include hiccups, chest pains, shortness of breath, confusion and seizures. Pregnant women may end up with a spontaneous miscarriage, or pregnancy-related bleeding. Fatal cases are characterized by more severe clinical signs early during the infection and progress to multi-organ failure and septic shock with death occurring between day 6 and 16.

In non-fatal cases, patients typically improve approximately 6-11 days after the onset of symptoms. The

Page 4 of 6 INVASION BY FILOVIRUS by: Jose D. Villarica, M.D. formation of antigen-antibody complexes during recovery may cause joint pains. Patients who survive infection with Ebola will test negative for the virus in the blood after 2-3 weeks, but may persist positive for sometime (could be 2-3 months) in certain body fluids like semen and breast milk.

It is important that all health care providers know the a-b-cs of filovirus infection so they can take proper action when they are faced with it. Pregnant women who survive the disease and go on to deliver a full-term baby will need advise on what to do with breast or no breast feeding. Check the mother’s milk for the virus and go from there - seem to a simple answer!! Of course it is not that simple.

DIAGNOSTIC CONSIDERATION Although there is no approved specific therapy for Ebola or Marburg virus disease for now, it is important to arrive at a diagnosis as early as possible, in order to initiate supportive measures before the development of irreversible shock, alert public health authorities, and institute infection control procedures. Thus, it is important to take a comprehensive history including dates of travel to endemic areas, when exposure to known Ebola patients occurred, onset of symptoms if any, other people around or intimate with the subject, presence of skin cuts or bruises, level of exposure (high or low risk). It is also important to notify the local or state health agencies so proper safeguards and further consultations done. Rapid blood tests done in specialized laboratories confirms the diagnosis. This will initiate a cascade of infection control measures as provided by the CDC. For fortunate recovering patients from Ebola or Marburg virus disease, the test is also used to determine when a patient can be discharged, they have to have two negative tests results on separate whole blood samples at least 48 hours apart. Of course, other tests and procedures are done to rule out other diseases that might be endemic in the region (malaria, typhoid, Dengue, Lassa fever, other hemorrhagic diseases, parasitic infestations).

TREATMENT Supportive care is the mainstay of treatment for diagnosed and confirmed EVD and Marburg disease patients. Care is focused on maintaining circulatory function and blood pressure. Correction of severe bleeding factors and other measures to boost the patient's immune system is vigorously undertaken. There are no approved therapies for patients with EVD presently, there is a “cocktail” of three monoclonal antibodies directed against the Ebola viral glycoprotein (“Zmapp”) that saved two severely ill United States healthcare workers , however, two other workers given Zmapp were less fortunate, probably due to the late administration of therapy. This did not provide evidence for or against treatment efficacy. More controlled studies are being undertaken. Implementation of novel treatments are under way as WHO expert panel had recommended the use of whole blood or serum from convalescent Ebola virus survivors during outbreaks - the blood types of donor and recipient must match.

Transmission of the disease is of primary concern when a patient is diagnosed with Ebola or Marburg viral disease. Astringent guideline measures , as directed by the CDC and WHO must be followed to the letter to curtail spread of the disease. All healthcare providers, ambulance responders, undertakers, military personnel and laboratory animal handlers must be well oriented and drilled on how to prevent transmission of the disease. Security, airport screeners world -wide, need to be trained to spot possible suspects. Education of the public for proper conduct of reporting and safeguards trumps cure. Local and state health agencies should be proactive in this respect. This seem to be the Achilles heel, a weak link, in Ebola outbreaks as documented in previous crises.

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Rigid protocol must be followed.

EBOLA VACCINE - URGENT INTERNATIONAL PRIORITY The Ebola virus disease has reached pandemic proportions and seem to be marching unimpeded. The WHO convened an urgent meeting of world scientists, public health officials, representatives from industry and regulatory bodies, on September 20-30, 2014, in Geneva, Switzerland, to discuss two vaccine candidates at length from the United States and Canada. There were also other vaccine candidates from other countries that are considered. None so far has been approved for human use. There is optimism in the air, however.

SUMMARY Ebola and Marburg filoviruses are thread-like organism that are virulent, violent and rapid in its invasion of humans via intimate contacts through skin breaks, bruises and mucous membrane infiltrations with person symptomatic of the disease. This individual may have contracted the illness from another person or from contaminated food source, such as meat. The present outbreak of Ebola started in the West African nation of Guinea in March 2013 and subsequently spread to Liberia, Sierra Leone, Nigeria and Senegal. In August 2014, the disease was reported in the Democratic Republic of Congo (DRC) and in September 2014 the whole of West African was noosed by this filamentous culprit and casualties are staggering. Missionary workers were exposed and transported to Dallas Texas for treatment. They survived the illness, a person from Guinea arrived in Dallas without any initial signs and symptoms of the disease but 5 days after arrival was found to have Ebola. Efforts to save him was unsuccessful - this is the first reported Ebola mortality in the United States. The disease has reached pandemic proportions now. Clinical signs and symptoms are initially non-specific but later becomes apparent. Diagnostic rapid blood tests are done to confirm EVD .

The World Health Organization (WHO) declared the epidemic a public health emergency of international concern. This declaration sent a mandate to all countries to mobilize their healthcare resources in accordance with guidelines set forth by the WHO and United States Center for Disease Control and Prevention (CDC). There is no approved treatment for Ebola presently and measures to stem transmission and prevention of spread is being followed. Decontamination of body fluids, bodies, non-primate reservoirs are in place. Airports all over are alerted for possible cases. Vaccines are being evaluated, other modes of treatment are being done as necessary. The world is an Ebola-captive now, the search for a cure, prevention and treatment is on the march, optimism is in the air, things are beginning to crystallize for a better outcome.

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