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Health

    About a quarter of Georgia’s hospitals received top marks for safety, according to a new report. The findings — published by The Leapfrog Group, a nonprofit that looks at safety in health care — gave 19 of Georgia’s 74 hospitals an “A” grade for safety.  » RELATED: These are the safest hospitals in Georgia, according to Leapfrog Group’s new report The grades in the bi-annual report are based on 28 measures that look at categories such as physician staffing, staff responsiveness and falls and trauma. The numerical score is calculated for more than 2,600 hospitals nationwide, then converted into a letter grade. The new findings mark two decades since the Institute of Medicine’s To Err Is Human report, which found that nearly 100,000 lives are lost every year due to preventable medical errors.  » RELATED: 7 Georgia hospitals earn ‘outstanding patient experience’ award 'In stark contrast to 20 years ago, we're now able to pinpoint where the problems are, and that allows us to grade hospitals,' Leah Binder, president and CEO of The Leapfrog Group, said in a statement. 'It also allows us to better track progress. Encouragingly, we are seeing fewer deaths from the preventable errors we monitor in our grading process.' Of the hospitals graded nationwide, 33% received an “A” grade in overall safety. » RELATED: Safety first: How nurses can minimize risks on the job The Georgia hospitals that received an “A” in the report are: AdventHealth Gordon, CalhounCartersville Medical Center, CartersvilleColiseum Medical Centers, MaconCrisp Regional Hospital, CordeleEmory St. Joseph's Hospital, AtlantaFairview Park Hospital, DublinNorthside Hospital Forsyth, CummingPhoebe Putney Memorial Hospital, AlbanyPiedmont Columbus Regional Northside, ColumbusPiedmont Fayette Hospital, FayettevillePiedmont Hospital, AtlantaPiedmont Mountainside Hospital, JasperPiedmont Newnan Hospital, NewnanPiedmont Newton Hospital, CovingtonRedmond Regional Medical Center, RomeWellstar Douglas Hospital, DouglasvilleWellstar Kennestone Hospital, MariettaWellstar Paulding Hospital, Hiram Other findings include:  - The five states with the highest percent of “A” grades were: Maine, Utah, Virginia, Oregon and North Carolina.- Wyoming, Alaska and North Dakota have no facilities with an “A” grade. - About 8% of hospitals nationwide received a “D” grade, while under 1% were graded “F.”
  • When you're part of the nursing staff, you never have to wait for Halloween for horror stories. They happen every day, right before your very eyes, no costumes or special effects required. Of course, most nurse horror stories are so awful or scary that they're no fun to talk about. But there are the incidents that you lived through, processed, and can now look back on and shake your head. » RELATED: 5 great Halloween costumes for nurses In celebration of the trick-or-treat holiday, here are a few true scary tales from nursing stations in the region. (Note that identifying information has been eliminated and certain sources are using their nicknames. Admittedly, any of these nurse horror stories could have happened to anyone.) Couldn't see the problem, at first 'I had a patient who went on a meth binge and sent her diabetes haywire. I noticed she had the lens from a pair of glasses on her bedside table that hadn't been there before. I asked where she got it and she said she must have put it 'inside' while she was high. I had to get a doctor to come do a pelvic exam for the other lens. Still couldn't find it.' - Fiona, a float nurse Why we have waiting rooms 'This truly was a nightmare, and very sad. I was working in a small community hospital emergency room, with just about five beds. We had EMS call in simultaneously with two from the same motor vehicle accident. The first was CPR in progress, and the other was walking around at the scene and just had a minor cut. They both came to the ER. Two nurses and one doctor were working, and all of our attention was on the CPR patient we will call Ms. Doe. Well, the family for both patients came to the hospital about 10 minutes after. It was a small town. So the family of the patient who was alive and well (we will call him Mr. Smith) kept trying to come in Ms. Doe's room while we are trying to perform CPR! They were threatening to sue because their child's car was wrecked! We didn't have security so we had to try to save Ms. Doe and keep Mr. Smith's family members out of the room at the same time.' - Former ER nurse Lany » RELATED: 7 things nurses want you to know I'll find time to yell, though 'Most of the attending and consulting doctors we work with are humble and willing to listen. But there was an attending once who traveled down several floors of the hospital to berate our secretary because she'd messaged him about a patient that wasn't his. She caught the mistake early and had only been requesting a diet change. When he responded that he didn't have the patient via our Instant Message system, she apologized, saying she'd just clicked on the wrong doctor. You would think that'd be the end of it? No, he came storming down to our floor and loudly berated her in front of patients and staff because 'Doctors have more important things to do than to respond to a page about an incorrect patient. There are lives on the line!' He came down there several hours after it happened, by the way.' - Ebony, nursing assistant What's for lunch, doctor? 'I worked in an ER with a doctor who was too lazy and out of shape to get around so he would move through the ED on a rolling chair and bark orders at us. He would literally get us out of other patients' rooms to do something he could do himself, like get a patient a blanket because that was 'a nurse's job.' And then he would wheel to his desk and snack. He also would go in the break room at night and eat food the nurses brought for themselves. At the desk. Right in front of us.' - Dee, a critical care nurse » RELATED: 7 tips to survive negative nursing co-workers A tragic and mysterious death 'A family member had come to pick up a patient. They said they were going to the bathroom before going down to pull the car around. They disappeared. We later learned they'd died feet from the patient in the room's bathroom, from a sudden cardiac event caused by a vasovagal attack.' - Ebony, nursing assistant Thor now stays in the supply cabinet 'Patients with feeding tubes or difficulty swallowing, things like that, would need us to crush their meds. We used to do this at the nurse's station with a big hammer we called Thor. One night a very large psychotic patient got out of bed and chased the nurses around with it. We don't leave the hammer out anymore.' - Fiona, a float nurse
  • Childhood obesity rates have more than tripled in the United States in the past 40 years, according to data from the Centers for Disease Control and Prevention in Atlanta. That means nearly 1-in-5 children, ages 6 to 19, is obese. Now, a study published this week suggests three factors most likely to contribute to adolescent obesity. » RELATED: 5 things moms can do to reduce child obesity risk, according to a new study According to the study, published in the International Journal of Obesity, a child’s and mother’s body mass index and a mother’s education level are key in determining whether or not a healthy child will be overweight or obese by the time they reach adolescence.  According to the study:  For every unit higher a child’s BMI is when he or she is 6-7 years old, the odds of that child being overweight or obese by ages 14-15 increased three-fold and cut the odds of resolution in half. For every unit a mother’s BMI increases when her child is 6-7, the odds of the child having a weight problem by the time they are 14-15 years old increased by 5%.  Finally, the study found if a child’s mother has a college degree, the child has lower odds of being overweight or obese when 2-5 years old and higher odds of having a weight problem resolved by the time they reach adolescence. » RELATED: How household dust might contribute to childhood obesityThe study notes that kids ages 2-5 have a low chance of resolving a weight problem by adolescence if all three factors are present. Researchers note these results could allow health care providers to compile a simple “risk score” and, therefore, focus on prevention.  'Because clinicians haven't been able to tell which children will grow up to become teens with excess weight, it's been hard to target interventions for those most at risk,' said Kate Lycett, one of the study’s authors. » RELATED: Georgia adult, teen obesity rates among worst in America The study looked at two cohorts of children, each group of about 3,500 participants. Their weight and 25 “potential obesity-relevant clinical indicators” were measured every two years.  The 25 potential indicators included breastfeeding and amount of time spent outside. The study concluded the “lifestyle factors were not predictive of weight outcomes.” Markus Juonala, the study’s lead author, said by removing focus on unlikely contributors, it should provide more opportunities for providers to focus on solutions. 'Combining data on these three easily obtainable risk factors may help clinicians make appropriate decisions targeting care to those most at risk of adolescent obesity,' Juonala said. 
  • Peach Bowl Inc., which owns and operates the Chick-fil-A Peach Bowl, planned to give up to $10 million to Children’s Healthcare of Atlanta to help find more treatments and possibly cures for pediatric cancer, but a spunky 6-year-old girl named Anna Charles Hollis motivated the organization to give more — a lot more. Always smiling and singing, even when confined to a pink wheelchair, Anna Charles, affectionately called “AC,” daughter of Benji Hollis, an executive at Peach Bowl, died exactly a year ago Monday, only five months after being diagnosed with acute myeloid leukemia (AML), a cancer of the white blood cells. Peach Bowl announced Monday a $20 million donation to Children’s Healthcare of Atlanta’s Aflac Cancer and Blood Disorders Center — with all of the money earmarked for funding clinical trials aimed at developing new treatments to fight childhood cancers. The donation, one of the largest-ever single donations to Children’s Healthcare of Atlanta, will establish the Peach Bowl LegACy Fund (capital AC in honor of AC). “It’s in our mission to give back and this was a member of our family,” said Gary Stokan, CEO of Peach Bowl Inc., a nonprofit organization that also owns and operates the Chick-fil-A Kickoff Game and is a founding sponsor of the College Football Hall of Fame in Atlanta. The five-year survival rate for children with AML is about 65%. In the past 40 years, only about 25 drugs have been approved for use in children with cancer, a number that pales in comparison to the hundreds developed for adult cancers. And while survival rates overall for pediatric cancer have been steadily rising, survival rates for some types of childhood cancer remain discouragingly low, including AML and bone cancers (especially when not caught early). Young cancer survivors also often face long-term complications, including heart disease, infertility or secondary cancers related to their treatment. “This is an unbelievable gift,” said Dr. Daniel Wechsler, director of pediatric oncology at Children’s. “What this means is we will be able to do cutting-edge clinical trials we would not be able to do otherwise.” Wechsler said the Peach Bowl LegACy Fund will help support clinical trials aimed at discovering potential treatments, and ones with less harmful side effects. He said they plan to get started early in 2020. One area of promise is immunotherapy. Cancer treatments like chemotherapy and radiation use medications or high-energy X-rays to kill cancer cells. Immunotherapy is different because it takes advantage of the body’s own immune system to fight off the cancer. In spring 2018, AC, an energetic child, struggled to recover from a routine tonsillectomy. She then complained about knee and back pain. Her parents, Benji and LeeAnna, headed to the emergency room at Children’s Healthcare of Atlanta, where AC was diagnosed with leukemia the same day, and then specifically AML the following day. Within a few days, a mass of AML cells was discovered on AC’s spine. She underwent emergency surgery to remove the mass, but it left her paralyzed from the waist down. For the next five months, the Buford family rarely left Children’s Scottish Rite hospital. “Her light was so bright, those last five months in the hospital were intentional. We had a choice: be bitter or angry, or be present, to live in the moment and love each other,” said Benji Hollis, who is vice president of sales for Peach Bowl. He has worked there for the past 16 years, starting as an intern. “We chose to love.” Inside the hospital room, awash in a rainbow of colors and unicorns, AC, her parents, and younger sister, Everlee, played board games, filled out Mad Libs, and built castles out of Legos. They played air hockey in the activity room. And AC, often wearing brightly colored clothing, zoomed up and down the hallway in her wheelchair, even doing complete, 360-degree turns. After four rounds of grueling chemotherapy, AC relapsed. AC was preparing for a bone marrow transplant when her body began to shut down. On a recent afternoon, Benji Hollis watched a video of AC smiling and singing (with sass) “Me Too” by Meghan Trainor. It was a moment captured only three weeks before AC died. “We didn’t think we were going to lose her until that morning,” said Hollis with tears in his eyes. “We had hope, and we still have hope. It’s a different kind of hope.” Nearly 16,000 children in the U.S. are diagnosed with pediatric cancer each year. Children’s Aflac Cancer Center, one of the largest pediatric cancer and blood disorders programs in the country, diagnosed 488 new cases of pediatric cancer in 2018. Only 4% of the National Institutes of Health’s cancer research funding goes to pediatric cancer research. MORE: Children’s Healthcare of Atlanta patient returns as nurse The differences between cancers in adults and children go well beyond age. The types of cancer that are seen in children are different from those in adults, and pediatric tumors have unique genetic makeup. Children can often tolerate higher doses of chemotherapy, and the side effects they experience may also be different. Outcomes for cancers in children are also generally better than for adults, with overall pediatric cancer cure rates of around 80%. “When we lose a patient, and it unfortunately happens more often than we would like, we want something good to come of it,” said Wechsler. “We were all pretty devastated when we realized we would not be able to cure AC. … The Peach Bowl gift is an incredible tribute to honor AC’s memory.”
  • Contrary to popular belief, the story of HIV in Atlanta has never been about white gay men with resources. The story is black gay men with few resources. If you’re wondering why that’s important, here’s your answer: The vast majority of people newly diagnosed and living with HIV are African American and living in metro Atlanta. That might not surprise a lot of people, but maybe this will. An end to the epidemic might be near. Give the county five years and the spread of HIV will be over, according to Derick Wilson, director of sexual health promotion for the Fulton County Board of Health. The temptation is to break out the bells and whistles, but that’s a tall order, especially in a county that leads the nation in the rate of new HIV infections. “If you look at new diagnoses around the country, no other large county has the same rate of new HIV infections,” said Wilson. “Sixty-nine of every 100,000 people in Fulton County were newly diagnosed in 2017. That compares to 29 per 100,000 in Kings County, New York, and 50 per 100,000 in Dade County, Miami, all with large, diverse populations similar to Fulton County.” End the epidemic in Fulton County, and we end it in the country. Until then, Wilson said, there’s little hope of ever ending it anywhere else. RELATED: An end to HIV in decade? First, Atlanta must catch up to other cities That explains in a nutshell why his office has drafted a “Blueprint for Ending HIV in Fulton County” and is working collaboratively with other county officials, including the Fulton County Board of Commissioners, to get people tested and in care. The blueprint, which spells out where the county is and where it needs to be, calls for decreasing by 25% new HIV infections by 2023; and getting 90% of people living with HIV to know their status, 90% retained in care, and 50% of those at risk of getting the disease on a daily dose of PrEP. “If we hit those goals, we basically end the HIV epidemic,” Wilson said. As part of its effort, the agency opened a PrEP Clinic in 2015 that provides free Pre-Exposure Prophylaxis medication and three years later hired a transgender coordinator, a first for any public health department in Georgia and maybe the Southeast. Trans outreach was one of Wilson’s first priorities when he joined the county health department in 2017. That’s significant because one of the highest risk groups for HIV infection is the transgender community. Continuing stigma associated with being transgender and the social alienation they face put them particularly at risk for infection. “To get them into treatment, we needed someone from the community to provide outreach and let them know there are safe spaces for them to come and talk about testing, PrEP, and treatment in a way that is respectful and authentic,” Wilson said. RELATED: Why Atlanta is still struggling with rising new HIV diagnoses Until the introduction of PrEP seven years ago, the most public health officials could do to prevent the spread of HIV was encourage condom use. That proved ineffective because people either didn’t want there to be a barrier during sex or in the heat of the moment, weren’t able to make the decision. “PrEP is an absolute game changer when it comes to HIV prevention,” Wilson said. “Taking one pill once a day can stop the virus from creating infection in the body.” Despite high rates when Wilson arrived here, few people were talking about HIV. It was as if high infection rates were an acceptable norm. It didn’t take long for him to realize that needed to change. And so along with a new PrEP outreach coordinator, Wilson launched the #STOPHIVATL campaign to remind people that HIV is out there and to let them know efforts were unfolding to end this crushing epidemic. Every day his office is putting out social media messages encouraging people to get tested and seek treatment. Those messages feature real people from metro Atlanta’s gay community so that they see themselves reflected in the campaign. “We can’t end the epidemic if people don’t think there is one or don’t think we can do anything about it,” Wilson said. While it’s still too early to tell if efforts are paying off, Wilson is confident they will. It’s why he left Philadelphia to come here in the first place. RELATED: Who, besides the CDC, didn’t know black gay men needed HIV outreach? Just as he arrived in 2017, Centers for Disease Control and Prevention funding to the county was cut 33% from $6 million to $4 million. However, by the end of his first year in 2018, the new system of HIV testing he implemented had more than doubled the number of new HIV diagnoses from 40 in 2017 to 95, which reflects significant growth in success in finding people who were unaware that they were HIV-positive. On top of that, he said, his staff and funded providers were able to double their rate of HIV testing, providing results for almost as many people in 2018 as they did in 2017 even with the reduction in funding. “By reprioritizing the way we do HIV testing, we’ve already done the impossible,” Wilson said. “We focused on communities most impacted by HIV infection and limited funding to partner agencies that had a history of working with those communities. Once we found people, we got them into treatment.” The county’s work hasn’t gone unnoticed. For the first time in the history of the epidemic, both the city of Atlanta and the county Board of Commissioners recently gave nearly a million in funding — $250,000 from the city and $700,000 from the county — for HIV prevention. In addition, Wilson said his office is working now with Ryan White Care Program officials to find people when they drop out of care and get them reconnected. Right now, the county is leading the nation in the rate of new diagnoses. Wilson wants to lead the way in ending the HIV epidemic. “We have the ability,” he said. “We have the resources and we’re getting more. This is something that we have to do. There is no other option.” Find Gracie on Facebook (www.facebook.com/graciestaplesajc/) and Twitter (@GStaples_AJC) or email her at gstaples@ajc.com.
  • A Centers for Disease Control and Prevention advisory committee will meet Wednesday to decide whether or not to keep in place a recommendation for older adults to get the pneumococcal vaccine that protects against certain types of pneumonia. The 15-member CDC Vaccine Advisory Committee on Immunization Practices could keep the recommendation, scrap it or leave it entirely up to a physician and patient without a specific recommendation to follow. The review addresses only those older adults with a healthy immune system, according to the CDC. The Georgia State Medical Association, one of the largest African American state medical associations in the U.S., has joined with the National Hispanic Council on Aging and others to call on the advisory committee to maintain the vaccine guidelines. “It’s a bad idea,” said Kimberly Williams, executive director of the GSMA. “We say keep it as a recommendation for seniors age 65 and older. If you remove it, people are not going to get vaccinated, and we risk what could be an epidemic. Not this year. Maybe next year or the year after that. You will see more and more seniors get sick.” Pneumonia is an infection in the lungs that can range from mild to severe. It can also be deadly. Common signs of pneumonia include cough, fever and difficulty breathing, according to the CDC. At one time, the vaccine recommendation was necessary because certain kinds of pneumonia among aging adults were considered a public health problem. However, so many children received the vaccine over the years that some health officials believe it’s resulted in an indirect benefit to older people and there is less need for the vaccine. Pneumonia is especially dangerous in older adults because they often don’t seek medical treatment until it’s too late and many already have underlying chronic health conditions such as COPD, heart disease or diabetes that may weaken the immune system, according to the National Council for Aging Care. As people age, there is also a greater inability to cough effectively. Smoking also raises the risk. There is also a general weakness in the body that may let a younger person rebound quickly. People can also be exposed in institutional settings such as hospitals and nursing facilities. The committee’s recommendation for PCV13 use among adults with compromised immune systems is not being reevaluated. It also wouldn’t cover the PPSV23 recommendation for older adults. “The assumption that it is going to be taken away is probably premature,” said CDC spokeswoman Kristen Nordlund. Dr. Linda Walden, a family physician in Cairo and the chairwoman of the National Medical Association’s Region III, said she will still recommend to her patients that they get vaccinated. “Pneumonia is one of the most common infectious diseases people get,” said Walden. ”So many people die from illnesses that could easily be prevented. I’m about primary prevention, not secondary prevention. I want to keep it from happening in the first place. Whether or not the CDC recommends this, I’m going to make sure my patients get it. If it’s not recommended, there are concerns whether insurance will pay for the vaccine, and if they don’t, this is going to add more burden for patients to make sure their health care needs are met.”
  • After nearly 15 years of helping protect children and supporting their families, Jamie Lackey had seen some things: moms using plastic grocery bags as diapers, washing disposable diapers and reusing them, returning them so they can pay for gas to get t0 work. That might be hard to imagine happening in a country as rich as ours, but it happens every day, in communities all over the USA. “This is not an isolated thing,” Lackey assured me recently. Lackey is the CEO and co-founder of Helping Mamas, a Norcross-based nonprofit that collects and distributes essential items for children up to age 12. When she began this work in 2014, she was a social worker and mother of two small children, a job she was passionate about and loved. She had a supportive husband, two incomes and friends and family who had her back. And yet, Lackey said, being a mom “was the hardest job” she ever had. Her own experiences made her realize how difficult it must have been for moms who didn’t have similar support. “If it was hard for me, how much harder would it be without that support?” she asked. Actually, it was pretty hard. RELATED | Open arms, full house For the vast majority of us, buying food, clothing and clean diapers is no big deal. For low-income parents, however, shelling out $70 to $80 a month for the eight to 12 diapers their infant or toddler needs each day can stretch the family budget to the breaking point. They don’t have rainy day funds, many don’t have health insurance, and they sure don’t have money for baby items. Lackey saw that for herself. Every day, she and her colleagues spent up to 30 minutes a day searching for resources, time that would’ve been better spent providing parenting education or job training for clients. “We always say kids can’t go to school and learn if they are hungry,” Lackey said. “Well, parents can’t learn and focus on the skills they need to move to self-sufficiency if they are worried about their child’s basic needs.” Lackey wanted to do something. There was plenty of baby gear at her home that wasn’t being used. If she gave it to someone who needed it, she could help a mom and free up time for social workers to do their jobs. A Google search proved there were no coordinated efforts to provide baby essentials to needy families. Lackey applied for nonprofit status, and a friend’s mother-in-law opened her home to host a launch party. There she did a PowerPoint that included pictures of friends and family with their children, hoping they’d see themselves in the lives of the poor families she served. She reminded them that they wanted their children to be happy, healthy, loved and successful. Regardless of their background, all moms wanted the same things. It worked. RELATED | Kids in Syria need diapers too; metro Atlanta woman wants to help Women signed up that day to host drives to donate and help collect supplies, and to introduce Helping Mamas to their friends and family who might help as well. Word of the nonprofit’s efforts began spreading like wildfire. “I was working and wanted it to be a passion project I did in my free time,” Lackey said. “My husband and I decided, either we stop or go all in.” They decided to take a “leap of faith” and, in 2016, Lackey quit her job to run Helping Mamas full time. Today, the nonprofit serves over 15,000 children a year and has donated over a million basic essentials to women and children in need. “A lot of people don’t know 1 in 3 moms have had to choose between buying food and diapers for their children,” Lackey said. “Without diapers, kids can’t go to child care; without child care, parents can’t work.” It seems unimaginable, doesn’t it? Listening to Lackey talk about moms struggling to pay for something as essential as a baby’s diaper, it’s hard not to just weep. I’ve struggled with a lot in my years, but buying diapers just so I could drop my daughters off at day care was never one of them. RELATED | If school is out, hungry children need our help I asked Lackey why moms didn’t just buy cloth diapers so they could reuse them. Her answer was simple and complex: health and sanitary issues. “You can’t dispose of them and they can’t wash them on-site at day care centers,” she said. “Plus a lot of the families we serve are in shelters and don’t have access to washers and dryers.” See the complexities? It’s why Lackey is using the success of her diaper bank to create a broader dialogue on poverty and not just here in Georgia. And so in addition to providing diapers, clothing and other essentials, Helping Mamas provides safe sleep education and car seat safety and is partnering with other agencies to reduce sudden infant death syndrome and infant mortality rates. “We literally do everything,” she said. No kidding. Recently Lackey was in Washington, D.C., hoping to persuade members of Congress to support HR 1846, the End Diaper Need Act, which would create a $100 million demonstration project to distribute free diapers and diapering products to help reduce the need for diapers in low-income families and underserved communities. If you think that’s for some Third World country, you’d be wrong. Find Gracie on Facebook (www.facebook.com/graciestaplesajc/) and Twitter (@GStaples_AJC) or email her at gstaples@ajc.com.
  • Memorial Day weekend is almost upon us and now comes a new pool season throughout metro Atlanta. But, before you take those deep dives that get you through sultry weather, the Centers for Disease Control and Prevention offers this warning: That sparkling blue water may not be as clean as it appears. Sometimes lurking in those inviting ripples are all manner of uninvited guests, like parasites and bacteria and a host of other foulness. And they’re not just hanging out backyard and community pools. They show up in hot tubs, water parks and splash pads, too. Just more than 20 years ago, 26 children were sickened by a strain of E. coli bacteria after playing in the kiddie pool at White Water Park in Marietta. Seven of the children were hospitalized; one died. A state investigation determined the chlorine level was too low in the pool, a finding that raised awareness about the importance of proper monitoring and ushered in a new era of vigilant oversight in Georgia. Nationally, from 2000 to 2014, close to 500 outbreaks of waterborne illnesses were reported in recreational venues in 46 states and Puerto Rico, causing 27,219 cases of sickness and eight deaths, according to the CDC. Georgia fared relatively well over the same period of time, with eight reported outbreaks and a total of 120 illnesses. Pool chemicals can take care of many problems, but not always. Getting optimal results for safety comes down to having the right balance. And, to be frank, it comes down to having the right users — those who adhere to, let’s just say, proper pool etiquette. “We want people to go to pools and have a happy, good time,” said Michele Hlavsa, chief of the CDC’s Healthy Swimming Program. “We just want to make sure people are doing it in a safe, healthy way.” To get down to the nitty gritty, most of the illnesses in pools, hot tubs and water playgrounds are caused by Cryptosporidium — that’s Crypto, for short. Crypto is a parasite that causes Cryptosporidiosis, which leads to diarrhea. Crypto — brace yourself — is spread by swallowing water that has been contaminated with fecal matter. Most germs are killed within minutes by common pool disinfectants like chlorine or bromine, but Crypto is a germ that can survive in properly chlorinated water for more than seven days. The diarrhea it causes can last for up to three weeks. And the number of Crypto cases have been steadily rising, with twice as many in 2016 as in 2014. Hlavsa said even a single mouthful of contaminated water can lead to a Crypto illness. She recommends parents encourage their children to not swallow water when swimming. And there are other steps you should take for healthy swimming. Hlavsa recommends that families check a pool’s inspections online or on site. In Georgia, public and semi-public pools (such as pools at apartment complexes), as well as hot tubs and water parks, are inspected by local health departments. Backyard pools are not. She also recommends that families check to make sure the drain at the bottom of the deep end of a pool is clearly visible – a sign that the water is crystal clear. Other safety measures should include making sure drain covers at the bottom of the pool appear to be secured and in good shape. Even if you’re not spreading Crypto, people need to consider everything on their bodies — sweat and dirt, dust, deodorant and hair spray — before jumping into communal waters, Hlavsa said. A recent survey found that more than half of Americans (51 percent) use a swimming pool as a bathtub — either swimming as a substitute for showering or using the pool to rinse off after exercise or yard work. It’s a habit that’s taken hold, even though nearly two-thirds of Americans report they know chemicals do not eliminate the need to shower before swimming. And that’s not all. The survey — commissioned by the Water Quality & Health Council, a group of advisers to the chlorine industry trade association — found 40 percent of Americans readily admitted they’ve peed in a pool as adult. While it may seem obvious that this is not a good idea, Hlavsa explained the science of why it’s not: Urine reacts with chlorine, reducing the amount of chlorine available to kill germs. That bodily fluid, along with dirt and sweat, mixed with chlorine creates chemicals called chloramines, which causes red and itchy eyes. Bottom line: It’s not the chlorine alone causing eyes to redden and sting. And speaking of chlorine, people can check water quality themselves by purchasing pool test strips at hardware stores that measure the level of the chemical and the pH level, Hlavsa said. She uses a test strip to check on water quality before swimming with her young children, who are 2 and 4. Chlorine levels should be at least 1 part per million for pools and at least 3 parts per million in hot tubs, according to the CDC. Getting the mix right isn’t always easy. An Atlanta Journal-Constitution analysis of inspections of public-serving pools, spas, hot tubs and splash pads found several in the metro Atlanta area were cited for having either too little or too much chlorine. Too little means germs can grow and spread. Too much chlorine can irritate the skin and eyes. Included in the analysis were pools located in subdivisions, apartment complexes, hotels and recreation centers. The Pointe at Colliers Hills on Collier Road had no chlorine detected in the water during an inspection on June 7 of last year, according to records from the Fulton County Health Department. Calls to the apartment complex were not immediately returned. One of the facilities with too much chlorine was The St. Regis Hotel and residences spa on West Paces Ferry. The spa registered 22 parts per million during a re-inspection on Sept. 5, according to health department records. The hotel decided to close the spa for the rest of the season, which was coming to a close in three days, the records said. Calls to the St. Regis were not immediately returned. Hlavsa said she is more concerned about too little chlorine in the water than too much, especially in pools where small children will be swimming. They’re more likely to swallow water while swimming. In Georgia, virtually all public and semi-public pools — which include those located in subdivisions or facilities that require membership — are inspected multiple times a year. Inspections include not just a check for water quality, but safety measures — such as making sure drain covers are secured and are in good shape, that pools have proper fencing and that there’s a land-line telephone that can be used to call 911. Nationwide, about two-thirds of local health departments inspect public pools, according to the CDC. Pools in Georgia weren’t always this well monitored. Dr. Chris Rustin, interim director of the Division of Health Protection at the Georgia Department of Public Health, said the White Water incident and other tragedies led to better oversight and regulations. Michelle’s Law — mandating that local and state public health officials regulate and inspect public swimming pools, hot tubs and water parks — was passed in 1999 after a young girl died after being trapped underwater by a faulty pool drain in an unregulated pool. Experts emphasized that online inspection reports performed last season may not reflect current conditions. So, it’s wise to check online and on site for the most up to date inspection reports. (http://ga.healthinspections.us/stateofgeorgia). AJC data specialist Jennifer Peebles contributed to this article.
  • Avengers: Endgame' fans and other moviegoers who attended late-night screenings at a California theater last week may have been exposed to measles, KNBC-TV and other news outlets are reporting. >> Can you get measles if you’ve been vaccinated? Should adults get a measles booster? According to the Orange County Health Care Agency, doctors recently diagnosed a Placentia woman, who is in her 20s, with the disease. The patient had taken an international trip to 'one of many countries currently experiencing widespread measles activity,' officials said in a Tuesday news release. >> Measles outbreak causes quarantine of students, staff at 2 California universities 'Orange County residents may have been exposed to measles since the ill person visited public locations while infectious,' the agency said. The woman, who is now 'under voluntary isolation at home,' reportedly visited the AMC Movie Theater at 1001 S. Lemon St. in Fullerton from 11 p.m. April 25 to 4 a.m. April 26. She also went to 5 Hutton Centre Drive in Santa Ana from 7:45 a.m. to 9 a.m. April 23 to 25 and the St. Jude Emergency Department in Fullerton from 7 a.m. to 9 a.m. April 27. >> Read more trending news  People who went to those locations at the same time as the patient should review their vaccination history and watch for symptoms such as fever or rashes for up to 21 days after they were exposed to the disease, officials said. >> CDC: Number of measles cases in U.S. second-highest since 2000 'People who have not had measles or the measles vaccine are at higher risk after an exposure, so they should talk with a health care provider about receiving Measles, Mumps and Rubella (MMR) vaccination,' the news release said. Read more here or here.
  • Defeat Antibiotic Resistance with the Same Old Antibiotics but Smarter Strategies  In the war on antibiotic resistant bacteria, it’s not just the antibiotics that are making the enemy stronger but also how they are prescribed. A new study suggests that to win against resistance, doctors should keep using the same drugs but as part of more targeted treatments and in combination with other health strategies.   The current broad use of antibiotics helps resistant bacteria strains propagate, but prescribed precisely, the same drugs can help reverse the spread of resistant strains, said researchers from the Georgia Institute of Technology, Duke University, and Harvard University who authored the study. But it can only work if combined with strategies that make sure people carrying resistant strains spread them to fewer people.   The new study delivers a mathematical model to help clinical and public health researchers devise new antibiotic prescription and supporting treatment strategies.   But basing a strategy on antibiotics needs to happen before bacteria resistant to most every known antibiotic become too widespread, rendering antibiotics ineffective. That has been widely predicted to occur by mid-century.   “Once you get to that pan-resistant state, it’s over,” said Sam Brown, who co-led the study and is an associate professor in Georgia Tech’s School of Biological Sciences. “Timing is unfortunately an issue in tackling antibiotic resistance.”   The strategic approach would also help clinicians treat infections effectively by flagging which antibiotics the bacteria are resistant to and which not.   “It’s great for fighting antibiotic resistance, but it’s also good for patients because we’ll always use the correct antibiotic,” Brown said.   The researchers published their study in the journal PLOS ONE on DATE XYZ. The research was funded by the Centers for Disease Control and Prevention, the National Institute of General Medical Sciences, the Simons Foundation, the Human Frontier Science Program, the Wenner-Gren Foundations, and the Royal Physiographic Society of Lund.