Thursday, January 29, 2015
Doctor's Perspective
Disneyland deals with outbreak of measles

By Dr. Anthony Policastro
Disneyland is famous for being Walt Disney's first theme park. Disneyland is also now famous for the start of a measles outbreak. When I was a pediatric resident in 1972, measles was very common. I was able to walk into a room, look at a child and make the diagnosis without even doing the exam. Now most pediatricians have not even seen a real case of measles. The question is, why are we seeing this epidemic now? There are several reasons. The best way to explain is to look at history. Measles was a common childhood disease prior to the vaccine. However, it was more deadly than people remember. In wartime the troops lived close together which allows diseases like measles to spread. About 5,000 soldiers died from measles during the Civil War. An additional 2,000 died during World War I. Prior to the measles vaccine, measles was ranked within the top 10 causes of childhood death. There were 7,575 deaths in 1920 alone. The measles vaccine changed that. It has been very effective. However, the way it was developed caused us to have different groups with different levels of protection. Individuals born prior to the development of the vaccine likely had a natural case of the measles. They are protected for life. The exception would be if they had an unusual immune problem. This group includes individuals born before 1963, when the vaccine was first developed. Individuals born between 1963 and 1968 might or might not have received the vaccine. It was still new then so not everyone received it. People in this age group are at the greatest risk since they may have not received the vaccine or had natural measles. In 1968, an improved vaccine was developed. In 1971, the MMR (measles-mumps-rubella vaccine) started being used. Individuals born during this period will have greater protection. However, since they did not have a second dose of the vaccine, they may not have lasting immunity. Initially, we did not give the vaccine until age 15 months. Later, that was moved back to before one year of age. We later learned that the effectiveness of the immunization is higher if the vaccine is given later. Thus people who received it at 15 months have better immunity than those who received it at 9 months. In 1990, we added a booster dose to the schedule. From then on, children received two doses. These individuals should have sufficient protection, however, there is no guarantee. The good news is that if an immunized individual does get an infection, it is likely that the infection will be mild or that they will recover more quickly. The immune system will likely "remember" that it is supposed to fight the infection. Of course, some parents do not get their children immunized at all. These are the ones who are likely to get a severe case. They will be at risk of dying from measles. In summary, if you had a natural measles infection like me you are protected. If you had two doses of the vaccine, that would offer the next level of protection. If you had a single dose at 15 months of age or older, you will have the next level of protection. Those with a single dose prior to one year of age would likely benefit from a booster dose of vaccine if the epidemic gets worse and spreads eastward. Vaccines are historical and so is Disneyland. It looks like they are currently intersecting in history.

Smoking cessation program Nanticoke Physician Network will host Freedom from Smoking¨, a free, seven week program providing support and guidance to quit smoking. This program, from the American Lung Association, offers strategies to improve your lifestyle through modifying behaviors, changes in diet, reducing stress, and avoiding weight gain. You will also get the support you need to remain smoke free for life. Classes will be held at Nanticoke Memorial Hospital from noon to 1:30 p.m. on Mondays, Feb. 2 through March 16. A second session will be held at the hospital from 5:30 to 7 p.m. on Mondays, April 6 through May 18. This session includes one meeting on Wednesday, April 29. For more information or to register, call 752-8467 or 752-8469. You must be at least 18-years-old to register.

World Cancer Day is Feb. 4 Delaware Hospice wants to bring awareness for World Cancer Day which is Tuesday, Feb. 4. Every year, about 8.2 million people die worldwide from cancer. Union for International Cancer Control (UICC) sponsors World Cancer Day with the goal of promoting healthy life choices, early detection, treatment for all, and quality of life for every individual worldwide. Maximizing the quality of life is a significant part of Delaware Hospice's mission. Hospice's highly-trained teams of doctors, nurses, and social workers strive to provide quality palliative and hospice care to individuals regardless of age, gender, ethnicity, sexual orientation, mental and physical status, religion or ability to pay. Delaware Hospice President and CEO, Susan Lloyd, MSN, RN said "palliative and hospice care is about quality of life. With the help of Delaware Hospice, patients and families can focus on what's most important, living as fully as possible in spite of illness." To learn more about the Palliative Care Program of Delaware Hospice and the other services provided by Delaware Hospice, visit For more information, about the UICC and the World Cancer Day, visit

Hospice holds volunteer orientation Delaware Hospice will hold its next New Volunteer Orientation session on Tuesday, Feb. 10, from 8 a.m. to 4 p.m., at the Delaware Hospice Center, Milford. Register by Tuesday, Feb. 3, by contacting Susan Beckham, Sussex County volunteer coordinator, at 856-7717 or Delaware Hospice volunteers help in many ways, including telephone check-up calls, fundraising event organization, and patient and family visits. Special opportunities are available within the Volunteer RN Program for retired, unemployed, and underemployed nurses. Orientation provides individuals with a comprehensive education about hospice and end-of-life care. Orientation is open to anyone in the community who is interested in becoming a Delaware Hospice volunteer or learning more about hospice. Attendance at the orientation does not obligate anyone to volunteer.

Hospice board welcomes new members Delaware Hospice announces the appointment of two new Board of Trustee members, Carol Leashefski and Clarence A. Smith II. Each member will serve a two year term. Carol Leashefski of Millsboro, is a team member with Genesis HealthCare Seaford Center. She holds a master's degree in health administration and bachelor's degrees in nursing home administration and occupational therapy. Clarence A. Smith II is director of Operations at IPC The Hospitalist Company of Newark. Smith holds several degrees: a master's degree in physical therapy from the University of Maryland, a master's of business administration from the University of Phoenix, and a bachelor of arts in biopsychology from the University of Maryland Baltimore County. Thomas E. Brown has been elected to a two year term as chairperson of the Delaware Hospice Board of Trustees. Brown, who has been a member of the Board since January 2014, is the senior vice president for Nanticoke Health Services and president of the Nanticoke Physician Network.

Diabetes education program Nanticoke Memorial Hospital, Seaford, will hold a four-session diabetes educational program on Feb. 3, 10, 17, and 24, from 9:30 to 11:30 a.m. at the hospital. Registration is required. The cost of the program may be reimbursable by insurance. This four-session program includes weekly education sessions and individualized meal planning for diabetes self-management. The goal is to give you the self-management skills to control your diabetes. Family members/significant others are welcome to attend. To register and to obtain additional information regarding the course, contact Nanticoke Memorial Hospital's Diabetes Education department at 629-6611, ext. 2446.

Cancer Survivorship Series begins Living Beyond Cancer, a monthly series addressing important issues for cancer survivors and their loved ones, will begin Tuesday, Feb. 3 at 5:30 p.m. The program will be held in the Conference Room of the Nanticoke Cancer Care Center, 801 Middleford Rd., Seaford. The series will cover many topics such as fitness, nutrition, stress reduction, medical management and other survivorship topics. Session 1: Take Control of Your Personal Health - Tuesday, Feb. 3, 5:30 p.m. - Jo Allegro-Smith, BS, MS, Sussex County director, Cancer Support Community-DE Session 2: Be Strong: Customized Exercise - Tuesday, March 3, 5:30 p.m. - Jo Allegro-Smith Session 3: Medical Management Beyond Cancer - Tuesday, April 7, 5:30 p.m. - Isabel Benson, NP-C, AOCNP, nurse practitioner, Nanticoke Cancer Care Center Session 4: Nutrition: Start on the Road to Good Health - Tuesday, May 5, 5:30 p.m. - Wendy Polk, RD, Nutrition Services, Nanticoke Memorial Hospital Session 5: Stress Reduction - Tuesday, June 2, 5:30 p.m. - Mariann Wolskee, LCSW A light snack will be provided at each session. You must register in advance by calling 645-9150.

Child safety technician training class Safe Kids Delaware is sponsoring a Child Passenger Safety Technician Certification Course at the Delaware State Troopers Association in Dover on March 3-6. The course includes classroom lecture, hands-on practice with child safety seats and vehicle restraint systems, required written and practical exams, and an end of course public car seat check-up event. Participants who complete the course will be certified as National Child Passenger Safety Technicians (CPS Techs) for two years. CPS Techs are specially trained individuals who have the knowledge and skills to educate parents/grandparents/caregivers on the correct way to install child safety seats in vehicles and provide them with one on one, hands on assistance as needed. There are approximately 65 certified CPS Technicians in Delaware. The class is primarily geared toward safety (law enforcement, fire, injury prevention) and medical (nurses, EMS) professionals and community volunteers. Pre-registration is required and there is an $85 registration fee for the course. For more information and to register, contact the course's lead instructor Mary Ann Crosley at