Could it Be Dementia?

Do you ever wonder if your forgetfulness is normal or the sign of something wrong?

We all lead very busy lives, always on the go, often toggling many things at one time. This in turn can lead to forgetting things such as forgetting where you parked your car; having a child insist you said “yes” when you can’t ever imagine saying yes to that request; forgetting about an appointment; and on and on.

Most of the time these forgetful moments are benign. But when is it not?

How can you decipher the normal forgetfulness from the worrisome kind?

Normal changes                                                      

  • Forget parts of an experience; usually with eventual remembering
  • Forgetting a word, but realizing it and able to correct yourself
  • May use notes/lists to help with remembering
  • Able to follow spoken or written directions; may need clarification

Dementia changes

  • Forget an entire experience; will not eventually remember
  • Using made up words for everyday items
  • Not able to use notes to help with memory
  • Gradually unable to follow spoken or written directions

Dementia is a general term. There are many causes of dementia: Vascular, severe alcohol abuse, traumatic brain injury, Parkinson’s, Lewy body and Alzheimer’s.

Alzheimer’s is the most common cause of dementia. According to the Alzheimer’s Association, there are an estimated 5.5 million Americans living with Alzheimer's, the majority being 65 or older. But it can affect people younger as well.

Other facts sited by the Alzheimer’s Association include:

  • Alzheimer’s is the 6th leading cause of death in the U.S.
  • It kills more than breast and prostate cancer combined
  • Since 2000, heart disease deaths have decreased by 14%; Alzheimer deaths have increased by 89%

As always, if you are concerned, contact your doctor.

For great information and resources, visit the Alzheimer’s Association at www.alz.org

-Judith Ryan

 

 

 

June 1 - BoH Wrap-Up

6th Edition

June 6, 2017

The Board of Health met for their regularly scheduled meeting on June 1st here at Town Hall. 

After approving the previous month’s minutes, and amending their meeting schedule to exclude July and December meetings, they were asked to consider reducing the fee for a temporary food establishment.

Our fee schedule required a payment of $125 to the Town for the issuance of a Temporary Permit to Operate a Food Establishment.  For many applicants seeking only to sell some bottled drinks and packaged items, or charities, this was simply too much to ask.  We know from history that if you make compliance unreasonably difficult or downright impossible, then you can’t honestly expect to receive acceptable rates of compliance.  So, the Board voted to reduce the fee from $125 dollars to a mere $35 in the hopes that more temporary food vendors will reach out to us for permitting voluntarily. This new fee is effective immediately.

The Board received an update on their Environmental Health program. Since the last meeting, the following permits have been issued:

Next, Carleo updated the Board on the investigations conducted since the last meeting:

Of note, Carleo highlighted a cluster of Listeria Monocytogenes cases with the same PFGE (essentially the same DNA or fingerprint) which is being investigated by the MA Department of Public Health. Danvers was asked to consider the food history of one subject which had eaten in Danvers.  Information was gathered and sent back to DPH for review as part of their case.   Now, there was no reason to believe that the outbreak was caused by a Danvers establishment, but we investigated this as it may have been a part of a multi-jurisdictional product sold in the establishment which could result in a recall. 

Update: 55 Clinton Avenue

Continuing from the previous meeting, Carleo updated the Board on the activities at 55 Clinton Avenue. Since the May meeting, the owner has installed the “No Trespassing” signage as requested.  Next comes the removal of the material on the site.  Staff will continue attempting to work with Orchard Farm Trust to resolve this issue.

Food Program Standards

Carleo attended a multi-community Program Standards Sharing Session in Acton on the 17th.  The session was informative and well worth attending.  We now have sufficient data to begin working on Standard 3.  This Standard will ensure an inspection program which is based on HACCP Principles.  Much of the requirements we already have in place such as an inspection form which requires the selection of “in, out, NA or NO” when addressing Risk Factors and Interventions, risk categorization of establishments, a risk based inspection schedule, on-site correction of out of control risk factors and discussion of long-term control of risk factors.  However; we need to put these requirements and activities into actual policy that can be verified going forward.  This should be completed by the August meeting.

Public Health Nurse’s Report

Nurse Ryan provided a written report to Carleo to update the Board.  In sum, she attended the Danvers Cares Substance Abuse Awareness Walk which had a fantastic turnout and great speakers.  The annual MA Public Health Nurse’s Conference was largely on Substance Abuse as well. 

The Diaper Drive this past April was a bit of a let down.  Only 518 diapers were donated which is much less than last year. Other communities reported a decline in donations as well.

Nurse Ryan’s high school interns have completed their internship. One has been hired for a summer job with the Social Seniors Program. All were accepted into Nursing School. 

Disease Investigations

Since the last meeting, Nurse Ryan received reports of 1 Hep C case, 2 Influenza cases and 1 Salmonellosis case.

Ryan provided the Board some data about influenza infections compared to the statewide numbers.

Some additional data from MADPH:

  • It was a moderate season compared to last years’ mild season
  • Circulating strains were a good match with the vaccine
  • Overall vaccine effectiveness against A&B infection associated with medically attended acute respiratory illness was 48%
  • Saw many clusters in long term care facilities
  • 2 pediatric deaths occurred
    • Significant medical history for both cases
    • One was vaccinated, one was not
    • One was type A other was type B

Marijuana Update

Carleo informed the Board that Sanctuary Medicinals had met with key Town Hall staff regarding their proposed dispensary at 2 Electronics Avenue. They have some permitting hurdles to clear, but have experience which indicates this project will likely move forward as planned.  They will be meeting with the Board of Selectmen next.

Animal Care

Jean Marcotti provided Carleo with a monthly briefing on her activities.  In sum, there were a few dog on dog bites, but most notably was the increase of wildlife concern calls which increased to 21 for the month.

With no further business, the Board of Health adjourned their meeting.  The next regularly scheduled meeting is set for August 3rd at 7pm here at Town Hall.

-Mark L. Carleo, REHS

Human Remains - June 1, 2017

5th Edition

June 1, 2017

 

This is a grave topic (intentional pun) intentionally timed for Memorial Day, with all due respect, to relate burial grounds, veterans, and public health. I hope you find it interesting.

By now, most of the veteran gravesites have been flagged. It was a cold rainy season to fulfill this annual obligation. The charge to this office is done mostly by volunteers every year at this time, as it is done collectively across our nation of cities and towns. The tradition in Danvers glues our heritage to our youth. For example, prominent Revolutionary War Patriot Samuel Holten rests in peace with his extended family less than a mile from Town Hall; A small American Flag was placed at his gravesite earlier this week by one of the many Danvers Girl Scouts who do incredible volunteer work on this laborious project. Judge Holten can be viewed in the foyer of Town Hall as he leaves for the Continental Congress, of which he would preside.

Not two miles from the Holten Cemetery lies the Endicott-Russell burial grounds where decedents of prominent colonial Governor John Endicott are buried. Many corpses in that graveyard were Revolutionary War veterans and are identified with a small American flag as well.

These are but two of an estimated 2,392 veterans buried in 17 private and abandoned cemeteries across Town plus one cluster of Jewish Cemeteries located off Buxton Road. And this office tries to locate and show respect by placing an American flag upon their resting site before Memorial Day. The volunteers do it because of their deep devotion and curiosity. While I also hold these men and women in deep regard, it is the Law of the Commonwealth that requires me to fulfill my obligation. For example, when a veteran is buried, a certified copy of the veteran’s burial permit shall be maintained by the veterans' graves officer, appointed under section 9 of Chapter 115. This Massachusetts General Law also requires cities and towns to maintain veterans’ graves and to have a flag placed on all veterans’ graves for Memorial Day. This law was passed in 1861, around the beginning of the Civil War.

About this same time, the germ theory of disease was being developed by Louis Pasteur. The disease control ramifications of this development caused Massachusetts to also pass general laws in the 1800’s to protect the public health from improper disposal of human remains. Chapter 114 of those Massachusetts General Laws requires local boards of health to license funeral directors, approve the location of cemeteries and issue burial permits. (In 2015, with the development of the electronic burial permit system maintained by the Massachusetts Department of Public Health, Danvers determined that it was more efficient to simply allow the Town Clerk to issue burial permits.)

So, May concludes with my consciousness raised for the sake of honoring veterans and, what is typically overlooked in our journey through life, public health reasoning behind the proper disposal of human remains. How lucky am I to have a career with such a diverse scope of interest regardless of the season?

I Want You! - May 23, 2017

4th Edition

May 23, 2017

 

From a Letter to the Editor authored by Peter Mirandi published in the Salem News,  May 23, 2017.

The famous poster stating, “I Want You”, is perhaps the most successful marketing tool in American history. A war machine was recruited time and again with a request from Uncle Sam, in his stars and stripes top hat.

This is a patriotic appeal too. An appeal to answer the call of our civic duty. It targets children and adults of all ages; it matters not if you are male or female or if your abilities are limited. You need only the patriotic means to assist your Town, City or neighborhood in preparing to remember the people who died while serving in the country’s armed forces. Next week volunteers of every stripe will help decorate gravesites of veterans.

Then comes Memorial Day and it is now that I ask you to conjure the image of Uncle Sam. This appeal is for civilian veterans to rise to the occasion and march like we did in boot camp or on drill fields, decks, or in battle. We must again answer the call. Spectators are always moved by the site of the men and women who served to protect our way of life. Perhaps now, as much as ever, Uncle Sam calls, “I Want You” to keep the local spirit stirred.

I urge you, regardless of your military experience, to seriously consider that our duty carries on. Please answer the civic call to march on Memorial Day and for that, a grateful community thanks you.

Peter M. Mirandi

Veterans Service Officer

Danvers, MA

Of Lice and Men - May 12, 2017

3rd Edition

May 12, 2017

Last week and after many months of planning, new signs were installed at the four Squares in Danvers dedicated to prominent Danvers veterans. Local historians such as our Town Archivist, can certainly speak to the prominence the four men whose name adorns these Squares: Powers Square on the corner of Holten and Pine Streets; Lane Parkway on the corner of Lane Parkway and Conant Street; Woodman Square on the corner of Liberty, High and Water Streets; and my favorite, Carmichael Square on the corner of Forest and Maple Streets. These sites will be decorated with wreaths purchased by the Town from Curran’s Florist before Memorial Day. I’ll return to one of these sites after a few words on infectious diseases and I promise to connect the dots before signing off.

In 1812, after Napoleon captured Moscow, the Russians turned back the Grande Armée and the Russian composer Tchaikovsky wrote a tribute to that victory with his still popular Overture that wraps up with resounding cannon blasts. But much evidence supports the premise that lice infected with the bacterium Rickettsia prowazekii, which causes typhus, not cannons, were the real Russian heroes. By some estimates, Napoleon lost two-thirds of his troops during this campaign. Morbidity rates due to disease is uncertain but there are no doubts that 

unsanitary conditions, harsh weather and the subsequent disease was responsible, at least in part, for Napoleon’s defeat.

Diseases cause by the genus Rickettsia are common in Danvers and that’s a fact. We have on recent file cases of Babesiosis, Ehrlichiosis, Rocky Mountain Spotted Fever, and Human Granulocytic Anaplasmosis

From there we move quickly on to viruses. Influenza is a viral disease that has been reported to the Local Board of Health and has also played a role in war. Last week, the Danvers Board of Health met during their regularly scheduled meeting and heard the monthly report of the Public Health Nurse. For the 2016/2017 Flu Season:

  • 19 clinics prepared and managed by Board of Health Nurse
  • 490 injections done by CVS
  • 79 cases of confirmed influenza A & B Sept 1 through April 30, 2017
  • March had the most cases at 29
  • September through January total of 18

Now let’s double back to the veterans’ signage at the squares. Ludwig Carmichael, he’s the veteran at the 

corner of Forest and Maple Streets, was a well-known and well-like resident who went to Holten High School and was a pitcher on the baseball team. In 1918, just months before World War I ended, he was drafted and mustered off to Battery B of the 301st Field Artillery where he saw action in the European Theatre. A year later he was headed back to Danvers when he contracted influenza and perished. Unfortunately, this story is far from unique. The Great Flu Pandemic of 1918 claimed the lives of many service men and civilians alike.

The point of this Newsletter is to remind readers that war, a manmade public health atrocity, is shadowed by the naturally occurring threats to public health. When the two circumstances overlap, as they did with Napoleon’s Grande Armée, or closer to home as in the case of one of Danvers’ Finest, the impact is truly heartfelt.

-Peter M. Mirandi

A couple of footnotes:

1.) Special thanks to Richard Trask, Town Archivist for validating and providing further details for my story on Ludwig Carmichael. He also has details on Powers, Lane and Woodman if you’re interested.

2.) The US Centers for Disease Control & Prevention (CDC) has listed Rickettsia on their list of Bioterrorism Agents/Diseases. Maddening and how!   

Board of Health Wrap-Up - May 12, 2017

2nd Edition

May 12, 2017

On Thursday May 4th, the Board of Health met for their regularly scheduled meeting.  If you have never attended a meeting of the Board of Health you are of course encouraged to attend. All meetings are open to the public. The purpose of these meetings is to review the business of the previous month taken on behalf of the Board by their staff, as well as to discuss and amend policy and sometimes to adopt new regulations for the protection of public health.

We typically meet on the first Thursday of the month, however this occasionally needs to change. So please do check the calendar on the town’s site.

On to the business from May 4th

First up was the quick administrative requirement of approving the minutes of the April meeting. The Board unanimously voted to approve those minutes as written.

Next came the report on the activities of the Environmental Health programs such as permitting and investigations.

The Board received an update on the licensing and permitting activities conducted since the previous meeting in April.  Since April 6th the following permits were issued:

Carleo reminded the Board that no routine permitting is occurring this time of year. However, over the next two months, we will be inspecting and permitting numerous semi-public swimming pools and special purpose pools as well as the recreational camps for children which operate in Town.

Two Public Hearings were scheduled for this meeting date. The first hearing was for McKinnon’s Butcher Shop relative to the expansion of their food preparation operations and assurance that the equipment currently installed was suitable.  Just prior to the hearing the only remaining issue was resolved between the Inspector and McKinnon’s so the hearing was cancelled.

A second hearing for the owners of 55 Clinton Avenue relative to an order to cease the operation of an illegal dumpsite was postponed until the June meeting as the owner of the site was out of state.

Carleo updated the Board on their activites under a $20,000 grant from the US Food and Drug Administration and the Association of Food and Drug Officials. The purpose of the grant is to advance conformance with the FDA Voluntary Retail Food Program Standards; essentially, a program of excellence with measurable outcomes and continual improvement.  On May 17th Carleo will be attending a Program Standards Sharing Session in Acton. At this meeting, information, materials, resources and support is there to assist all communities working under this voluntary program.  Carleo will be there to share information on Standard 2 – Trained Regulatory Staff as well as to pick up some templates for uniform foodborne illness investigations and enforcement policy.

The Board was then provided an overview of the complaints received for the month by type and quantity:

A full report on all Public Health Services was provided. For details on these activities such as infectious disease cases investigated and a full report on influenza activity for the season be sure to look for that report in the Public Health Nurse’s newsletter to be published soon.

Teaser: Influenza activity this year has been very unusual…

Finally, Carleo provided a brief update from the Animal Care Program.  Jean Marcotti our Animal Care Specialist submitted a report stating that Strays in Need currently has no animals in its care.  Additionally, quarantines for possible rabies exposures are at typical levels for this time of year. Calls regarding wildlife are on the rise, which is again, typical of this time of year.

With that, the Board voted to adjourn their meeting.  The Board will meet again on June 1st.

-Mark L. Carleo, REHS

What do I know? May 5, 2017

This premier newsletter is an attempt to establish clear parameters, and ultimately many facts, around the scope of services provided by the Division of Health and Veterans Services. The Danvers Homepage, which held its kickoff in April 2017, dares visitors to “Ask Us Anything” and my gut is telling me that I need to prepare a response to residents intending to ask us anything by the means of a search engine.

So, let’s start with a few notes on what I know about teams. Scholars have studied teams and synergy (the whole is greater than the sum of its parts) and I know that outcomes improve with the employment of a well-functioning team of dedicated employees. I also know that Danvers is fortunate to have a well-functioning team of dedicated employees. Finally, I will share everything I know about our intentions, our skill sets, and our contact information.  It is our intention to build your trust through a worthy website for you to “Ask Us Anything”!

Mark Carleo is our environmental public health inspector. He is a Registered Sanitarian with a BS and is a full-time employee right here in Town Hall but spends much of his time in the field. His broad scope of work is defined under Massachusetts General Law. You may count on a report specific to some of those tasks in the future but for now, it is most important to know that he is a critical team member authorized to act on behalf of the Danvers Board of Health. Assisting Mark with his many inspections, complaint investigations, and permitting functions is our part-time sanitarian, Melanie Dineen.

Judith Ryan is our public health nurse. She is a Registered Nurse with an advanced nursing education, having earned her BSN, and is a full-time employee working directly out of the Danvers Senior & Social Center. Judith spends part of her day performing routine duties with the Supportive Day Care Program. She is also directly responsible for managing reportable diseases, representing the Danvers Board of Health in prevention and public health preparedness programs, and performing other associated duties required of her throughout the day. Examples of these programs and duties will be shared from this site soon with a recap of the 2016/2017 influenza season immediately forthcoming. I promise.

Jean Marcotti is our animal care specialist and inspector of animals. She has received specialized training and has an AS degree specific to animal care. Jean works on a part-time basis mostly from her home and in the field but she receives calls 24/7 from this office or directly from the Danvers Police Department. Jean also manages Strays-in-Need and plays a role in the management of our Canada Geese population, our doggie day care facilities and our barns too. But primarily, Jean is involved to some extent with any trouble caused by the 1,521 dogs licensed in Town as of today. As is the case with the other elements of our Public Health programs, you may count on more specific details in future newsletters.

Lisa Westrate is our social outreach worker with specialization in veterans’ services, especially those benefits described in Chapter 115 of the Massachusetts General Laws. Lisa is a full-time employee also working directly out of the Danvers Senior & Social Center. Lisa holds a BA degree and is a SHINE Counselor. She is extremely well-versed in outreach programs to veterans but routinely assists in the management of services offered to seniors as well. She has been instrumental in the development of our veterans’ affairs services to the point where Leanne Puleo had to be recruited and employed on a part-time basis to assist her.

I know that every team member described above has a sincere cause to help our community and a belief that they can make a positive difference in the lives of our residents, especially our resident veterans.

I know that this team is provided with training opportunities and other tools necessary to do the job.

I know that President Woodrow Wilson is credited with the quote, “We should not only use the brains we have, but all that we can borrow.” And, I know we will dedicate our collective brains to help you navigate the Danvers Website – a website that dares you to “Ask Us Anything”.

Now comes the most important question: Do you want to know more?

Visit us and Ask Us Anything.

-Peter M. Mirandi 

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