DPICtions

Cincinnati Drug and Poison

Information Center

Summer 2015

Website:

http://www.cincinnatichildrens.org/service/d/dpic/

default/

Blog:http://cincinnatichildrensblog.org/category/s

afety-and-prevention/

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Contents: Hamilton County

household hazardous

waste collection event.

Mosquitoes!

Mosquitoes!

Mosquitoes!

September is National

Prepardness Month.

Quadrivalent Flu

Vaccine

Naloxone can now be

acquired without a Rx

in Ohio.

National Toll Free

Poison Center hotline

Ohio House Bill 314

Giant Hogweed

invasion

Cuyahoga Corner

American

Association of Poison

Control Centers

www.aapcc.org

Hamilton County Household Hazardous Waste Collection Event

2015 Registration

Tisha Carson RPh, CSPI

1,570 cars came thru

on Sept 26, 2015.

The # of pounds

collected is currently

being tallied.

There is no funding

to conduct a waste

collection event in

2016

Campaigns are in

works to encourage

reduction of

hazardous waste

purchases.

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Once again the areas around Cincinnati are being invaded by mosquitoes that have been testing positive for West Nile Virus. Prevention is key for protecting your family! Homeowners are encouraged to use the “drain, dunk and protect” protocol to help reduce the mosquito population and prevent the virus. Mosquitoes like pools of standing water, DRAIN flower pots, buckets, wading pools, tires and even litter/trash that has collected water outside. Apply mosquito larvicide, sometimes called “DUNKS” to standing water that cannot be drained. These can be purchased at your local hardware store. PROTECT yourself by keeping grass and shrubbery cut, making sure screens and doors are tight-fitting, wear long sleeves and pants during peak hours which is dawn and dusk, and consider using an EPA-registered insect repellent such as DEET, picaridin or oil of lemon or eucalyptus. Take action and help to keep your family safe! Reference: "West Nile Virus Found in Hamilton County, Mt. Airy Forest Sample Tested Positive." N.p., 25 Aug. 2015. Web. 9 Sept. 2015.

Mosquitoes! Mosquitoes! Mosquitoes! Lisa Geis EMT

Did you know that September was National Preparedness Month?

We should all think about, and prepare for, all kinds of unforeseen things. During the month of September,

the CDC is outlining weekly emergencies to focus on and prepare for, even if you believe the event may be

unlikely in your area.

Anyone experience a power outage with the last set of storms that rolled through? Were you prepared for

that?

The focus this week is Floods.

Check it out: http://www.ready.gov/ready2015

Tabs across the top of the web page to scroll through, and find great information, include the following: Be

Informed, Make a Plan, Build a Kit, Get Involved, Business, and Kids.

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What is quadrivalent flu vaccine?

The quadrivalent flu vaccine is designed to protect against four different flu viruses; two influenza A viruses and two

influenza B viruses.

Why was the quadrivalent flu vaccine developed?

For years, flu vaccines were designed to protect against three different flu viruses (trivalent). This included an influenza A

H1N1 virus, an influenza A H3N2 virus and one B virus. Experts had to choose one B virus, even though there are two

very different lineages of B viruses that both circulate during most seasons. This meant the vaccine did not protect

against the group of B viruses not included in the vaccine. Adding another B virus to the vaccine aims to give broader

protection against circulating flu viruses.

*CDC Website

e CPT (Current Procedural Terminology) is a registered trademark of the American Medical Association.

*http://www.fluzone.com/health-care-professionals/fluzone-quadrivalent-vaccine.cfm

Quadrivalent Flu Vaccine Desiree Zink EMT

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Effective July 16th

2015 individuals, family members, friends, or other persons in a position to assist an individual

who is to be at risk for opioid related overdose may be able to purchase naloxone at participating pharmacies.

What is Naloxone:

Naloxone is a medication that can reverse an overdose that is caused by an opioid drug. When administered during

an overdose, naloxone blocks the effects of opioids on the brain and restores breathing. Naloxone has no effect

when administered to someone who is not experiencing an opioid overdose, and when administered to someone

who is experiencing an opioid overdose it will cause withdrawal symptoms.

How supplied:

Product: Nasal Spray Auto-injector

(Intramuscular

injection)

Vial for intramuscular

injection

How supplied: Naloxone 2 mg/2 ml

prefilled syringe, 2

syringes

Naloxone 0.4mg/0.4ml, 1

twin-pack

Naloxone 0.4 mg/ml

single dose vial, 2 vials

Directions for

administration:

Spray ½ of syringe into

each nostril upon signs

of opioid overdose. Call

911. May repeat x1

Use one auto-injector

upon sings of opioid

overdose, Call 911. May

repeat x1

Inject 1 ml

intramuscularly upon

sings of opioid overdose.

Call 911. May repeat x1

Reference:

http://pharmacy.ohio.gov/Pubs/NaloxoneResources.aspx

http://www.recordpub.com/news%20local/2015/03/04/ohio-attorney-general-dewine-announces-agreement-with-

naloxone-manufacturer

Naloxone can now be acquired without a prescription in Ohio Logan Blakely BS, UC PharmD candidate

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The DPIC Education and Outreach team has been working on strategies to encourage access to the poison control hotline.

The American Association of Poison Control Centers (AAPCC) Public Education Committee developed a QR scan code.

This code enables anyone to easily scan the hotline number into their cell phone or mobile device.

The DPIC Education and Outreach team has launched a campaign to promote use of this tech savvy feature. The national

number automatically connects callers to the closest local poison center. No matter where a person calls from, he or she will be

connected to the closest poison center based on the phone’s area code. Specially trained nurses, pharmacists, doctors and other

health care professionals answer calls 24 hours a day, 7 days a week.

Scan the QR code below and the number will be programmed automatically into your cell phone or mobile device.

---------------------------------------------------------------------------------------------------------------------------------------------

National toll free poison center hotline

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Originally native to the Caucasus region and Southeast Asia, Giant Hogweed was first documented in the United States in 1917. It was brought here as an ornamental plant. The species has since jumped the garden border and can now be found in 16 states in flowerbeds and along roadsides, the forest edges, and stream banks. Per the National Poison Data System, poison control centers have handled about seventy cases in the northeastern part of the country related to Giant Hogweed over the past 6 years.

Giant Hogweed (Heracleum mantegazzianum), often mistaken for Cow Parsnip or Angelica, belongs to the Apiaceae (Umbelliferae) family of plants. Carrots and Parsley also belong to this plant family. Giant hogweed is on the federal and Ohio noxious weed lists making it unlawful to propagate, sell, or transport. It has been included on these lists because of its ability to crowd out native plants and because of its potential human health hazard.2

Plant Can grow up to 15 feet tall

Sap contains

furanocoumarins

Stems 2 – 4 inches in diameter

Hollow and rigid

have purple blotches

have coarse, white hairs

Leaves are up to five feet in width

have deep, irregular lobes

Flowers a cluster of white flowers

that form a compound umbel

up to 2.5 feet wide

Effects

The sap contains photosensitizing furanocoumarins which causes the skin to become overly sensitized to the sun leading to severe sunburn. Severe swelling, blisters, itching and redness can occur. Symptoms can last for days, weeks or months. Scarring may occur. Hyper-pigmentation may occur leading to purplish or brownish marks that can persist for several years.

Avoiding Reactions Don’t touch or handle plants using your

bare hands.

Don’t transplant or give away giant hogweed plants

or seeds. These actions are illegal.

Do wash immediately with soap and water if

giant hogweed sap gets on your skin. Do apply a liberal amount of sunscreen to the area

and keep it covered from the sun for 48 hours.

It is possible to walk through the plant and work around it, as long as the sap does not get on the skin. The sap isn’t exposed until the plant is punctured. It is best to leave removal up to professionals.

Giant Hogweed Invasion

Tisha Carson RPh, CSPI

Distinguishing Characteristics

http://beacon-bollin.org.uk/wp-content/uploads/2014/07/Giant-Hogweed-ID-Sheet.jpg

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Giant Hogweed Invasion (contd.)

What are the symptoms of exposure to giant hogweed sap?

Painful blisters that form within 48 hours if area is exposed to the sun Dark pigmentation or scars that last up to six years, though typically only last a few months Long-term sensitivity to sunlight is common Blindness may occur if the sap gets into the eye

Photo of giant hogweed burn - 5 days to 5 months after initial exposure Photo credit: Bob Kleinber

References: http://ohioline.osu.edu/anr-fact/hogweed.html http://www.dec.ny.gov/animals/72556.html http://www.farmanddairy.com/news/hogweed-creeps-into-northeast-ohio/1335.html http://www.michigan.gov/documents/mdard/E2935_2012_Revision_391739_7.pdf http://www.michigan.gov/mdard/0,4610,7-125-1566_2403_34669---,00.html Works Cited: "Giant Hogweed." Giant Hogweed Bulletin E-2935 - MSU Extension (n.d.): n. pag. June 2012. Web. 2 Sept. 2015. "Giant Hogweed." National Invasive Species Information Center. United States Department of Agriculture, n.d. Web. 29 Aug. 2015."Health Hazards & Safety Instructions for Giant Hogweed." Health Hazards & Safety Instructions for Giant Hogweed (with Graphic Photos). New York State Department of Environmental Conservation, n.d. Web. 27 Aug. 2015. "Hogweed Creeps into Northeast Ohio - Farm and Dairy." Farm and Dairy RSS. N.p., 17 Aug. 2005. Web. 02 Sept. 2015. Marrison, David L., and David J. Goerig. "Ohio State University Extension Fact Sheet." Giant Hogweed (Heracleum Mantegazzianum). Ohio State University Extension, n.d. Web. 27 Aug. 2015.

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If it looks like a mole, moves like a mole, and eats like a mole, it has to be a mole, right? Well, maybe not. The Northern Short-tailed shrew (Blarina brevicauda) is a small mammal that primarily inhabits the northeastern United States and looks very similar to a mole!

Shrew Mole

Note that the shrew is much smaller but very anatomically similar to the mole. The interesting salivary glands secrete toxic saliva that is delivered into wounds made by their bite. The venom contains a kallikrein-like protease that causes paralysis. Although the shrew mostly feeds on worms and insects, it may also feed on small vertebrates like other shrews, making the paralyzing venom a necessity to subdue its prey. The venom is typically only strong enough to subdue small vertebrates and poses little threat to humans but may cause significant pain and swelling of the site.

Although the shrew doesn’t appear to be particularly harmful or worrisome to humans, there is some growing concern that it may serve as a reservoir for Human Babesiosis. The causal agent of human babesiosis is Babesia microti (B. microti). It is typically transmitted by the nymph stage of Ixodes scapularis, also known as the deer or black doglegged tick. The Northern Short-tailed shrew can act as a reservoir host for B. Microti, which means that if a tick bites the shrew and then the tick bites a human, the human could contract Human babesiosis. Symptoms include mostly nonspecific flu-like symptoms, such as fever, chills, sweats, headache, body aches, loss of appetite, nausea, or fatigue. The Babesia parasite infects red blood cells. Therefore immunocompromised patients, individuals without a spleen, and the elderly are of higher risk for severe even life-threatening symptoms like severe hemolytic anemia (hemolysis), a very low platelet count (thrombocytopenia), disseminated intravascular coagulation (DIC), vital organ dysfunction, and even death. Effective treatments are available, so make sure to seek medical care from your physician if you suspect you may have a tickborne illness. As with any tickborne illness prevention, it is important to follow the Center for Disease Control and Prevention’s (CDC) guidelines. You can find them on the CDC’s website. (http://www.cdc.gov/parasites/babesiosis/prevent.html)

References: http://www.cdc.gov/parasites/babesiosis/disease.html, http://mlbs.org/organism/northernshorttailedshrew, http://www.science.smith.edu/departments/Biology/VHAYSSEN/msi/pdf/i0076-3519-261-01-0001.pdf,www.epa.gov/region1/ge/.../EcoRiskProfile_short-tailed_shrew.pdf

Meet your DPIC management team

Cuyahoga corner

The Cuyahoga County Medical Examiner’s office released 2014 statistics on heroin-related deaths.

There were 350 overdose deaths in 2014, and 198 of these were heroin-related deaths. This number is slightly increased over the previous years where there were 194 deaths attributed to heroin in

Cuyahoga County.

Gender: 41 female deaths (20.7%) and 154 male (77.7%).

Ethnicity: 86.36% of the heroin-related deaths were white.

Age: 24.25% of the deaths were in persons 18-29 years of age

50% of the deaths were residents of Cuyahoga County, and 50% resided in suburban communities or were from another county (but found in Cuyahoga County)

http://medicalexaminer.cuyahogacounty.us

Top row L to R: Jim Barter, Jeff Schmees, Lisa Galbraith, Mike Davis, Earl Siegel, Jerry Wiesenhahn, Jon Colvin, Dave Merhley, Todd Carson. Bottom row L to R: Jennifer Dauer, Marsha Polk, Vicki McIver, Patty Klein.

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North American Congress of Clinical Toxicology

© 2015 By the Cincinnati Drug & Poison Information Center (DPIC) Topics, print and layout editor: Sheila Goertemoeller PharmD, D.ABAT, ICPS Content editors: Alysha Behrman RN, MSN, CSPI, ICPS; Sheila Goertemoeller PharmD, D.ABAT, ICPS; Jan Scaglione MT, PharmD, D.ABAT and Earl G. Siegel PharmD, OCPS. The opinions expressed herein are those of the contributing authors and do not necessarily reflect the views of the editor, publisher or supporting institutions. DPIC is a service of the Cincinnati Children’s Hospital Medical Center and Children’s Hospital Research Foundation. Services are also supported by: the US Department of Health and Human Services (HRSA), the Ohio Department of Health, Hamilton County Mental Health and Recovery Services Board, and the Ohio Department of Alcohol and Drug Addiction Services (ODADAS). Additional support for DPIC services is provided by Akron Children’s Hospital Medical Center and additional member hospitals.

This newsletter is brought to you by the Cincinnati Drug and Poison Information

Center and was produced with assistance from the American Association of Poison Control Centers and local poison centers across the country.

When you dial 1-800-222-1222, your call is answered by a medical professional with special training in poison management. Help is fast, free, confidential and

available 24 hours a day, every day.

Poison centers offer free, private, confidential medical advice 24 hours a day, 7 days a week. You can reach your local poison center by calling 1-800-222-1222.