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Prevention and treatment improve outcome

By David Dunaief, M.D.

Cataracts are incredibly common; about 50 percent of Americans will have a cataract or have had cataract surgery by age 80 (1). Cataracts, the nuclear type, reduce visual acuity in an insidious process. Cataract surgery can resolve this, reducing the risk of falls and hip fracture. At the same time, it can reduce pressure in the eye.

Interestingly, research suggests that a diet rich in carotenoids may prevent the occurrence of cataracts. However, statins may have the reverse effect by increasing risk.

Let’s look at the evidence.

Cataract surgery and hip fracture

In one study, elderly cataract patients who underwent surgery were significantly less likely to experience a hip fracture during a year of follow-up than those who did not have surgery (2). This was a retrospective (backward-looking) observational study, and its size was considerable, with over one million patients ages 65 and older. The results showed a 16 percent reduction in the risk of hip fractures overall. Those who were older, between ages 80 and 84, had the most to gain, with a 28 percent reduction in hip fracture risk.

The increased fall risk and subsequent hip fracture risk among those with cataracts result from decreases in visual acuity and depth perception and a reduction in visual field that accompany cataracts (3). Hip fractures have a tremendous impact on the ability of elderly patients to remain independent. Many of these patients do not regain their prior mobility. Thus, avoiding hip fractures is the best strategy.

Cataract surgery and intraocular pressure

Yet another benefit of cataract surgery is the potential reduction in intraocular pressure (IOP). Why is intraocular pressure (pressure within the eye) important? High IOP has been associated with an increased risk of glaucoma.

A comparative case series (looking at those with and without cataract surgery) utilizing data from the Ocular Hypertension Treatment Study showed that those cataract patients with ocular hypertension (higher than normal pressure in the eye) who underwent cataract surgery saw an immediate reduction in IOP (4). This effect lasted at least three years. The removal of the cataract lowered the IOP by 16.5 percent from 23.9 mm Hg to 19.8 mm Hg. This is close to the low end of glaucoma treatments’ pressure reduction goals, which are 20 to 40 percent. Therefore, cataract surgery may be synergistic with traditional glaucoma treatment.

Cataract surgery and macular degeneration risk

There has been conflicting information in recent years about whether cataract surgery increases the risk of age-related macular degeneration (AMD) progression. A 2009 study suggested that, rather than increasing AMD risk, cataract surgery may uncover underlying AMD pathology that is hidden because the cataract obfuscates the view of the retina (back of the eye) (5). The study’s strengths were the use color retinal photographs and fluorescein angiography (dye in blood vessels of eye), both very thorough approaches.

Cataract prevention with dietary carotenoids

Diet may play a significant role in prevention of cataracts. In the Women’s Health Initiative Observational Study, carotenoids, specifically lutein and zeaxanthin, seem to decrease cataract risk by 23 percent in women with high blood levels of carotenoids, compared to those with low blood levels (6). In fact, those in the highest quintile (the top 20 percent) had an even more dramatic 32 percent risk reduction when compared to those in the bottom quintile (the lowest 20 percent).

As the authors commented, it may not have been just lutein and zeaxanthin. There are more than 600 carotenoids, but these were the ones measured in the study. Some of the foods that are high in carotenoids include carrots, spinach, kale, apricots and mango, according to the USDA. Interestingly, half a cup of one of the first three on a daily basis will far exceed the recommended daily allowance. Thus, it takes a modest consistency in dietary carotenoids to see a reduction in risk.

Vitamin C effect

The impact of vitamin C on cataract risk may depend on the duration of daily consumption. In other words, 10 years seems to be the critical duration needed to see an effect. According to one study, those participants who took 500 mg of vitamin C supplements for 10 or more years saw a 77 percent reduction in risk (7). However, only very few women achieved this goal in the study, demonstrating how difficult it is to maintain supplementation for a 10-year period.

Those who took vitamin C for fewer than 10 years saw no effect in prevention of cataracts. In the well-designed Age-Related Eye Disease Study, a randomized controlled trial, the gold standard of studies, those who received 500 mg of vitamin C supplements along with other supplements did not show any cataract risk reduction, compared to those who did not receive these supplements (1). There were 4,629 patients involved in the cataract study with a duration of 6.3 years of daily supplement consumption. Therefore, I would not rush to take vitamin C as a cataract preventative.

Statin use

Statins have both positive and negative effects, and the effect on the eyes according to one sizable study is negative. In the Waterloo Eye Study with over 6,000 participants, those patients taking statins were at a 57 percent increased risk of cataracts (8). Diabetes patients saw an increased risk of cataracts as well. And in diabetes patients, statins seem to increase the rate at which cataracts occurred.

The authors surmise that this is because higher levels of cholesterol may be needed for the development of epithelial (outer layer) cells and transparency of the lens. This process may be blocked with the use of statins. Before considering discontinuing statins, it is important to weigh the risks with the benefits.

Thus, if you have diminished vision, it may be due to cataracts. It is important to consult an ophthalmologist for diagnosis and, perhaps, cataract surgery, which can reduce your risks of falls, hip fractures and intraocular pressure. For those who do not have cataracts, a diet rich in carotenoids may significantly reduce their risk of occurrence.

References:

(1) nei.nih.gov. (2) JAMA. 2012;308:493-501. (3) J Am Geriatr Soc. 2009 Oct;57(10):1825-1832. (4) Ophthalmology. 2012;119:1826-1831. (5) Arch Ophthalmol. 2009;127:1412-1419. (6) Arch Ophthalmol. 2008;126(3):354-364. (7) Am J Clin Nutr. 1997 Oct;66(4):911-916. (8) Optom Vis Sci 2012;89:1165-1171.

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.

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Raccoons are naturally occurring hosts for the Leptospira bacteria. Stock photo

By Matthew Kearns, DVM

May and June always kick off the annual checkup season and with all our exams, we discuss vaccines. When I talk about vaccines like distemper, rabies, kennel cough and Lyme, I always see a nod of understanding. However, when I bring up the leptospirosis vaccine, the quizzical look on people’s faces always reveals a lack of knowledge on this disease.

I think the reason is that as little as 10 years ago, leptospirosis was limited to very rural areas primarily where dogs had more of a risk of coming in contact with wildlife. The more “suburban sprawl” we see brings us (and our pets) in closer contact with the natural reservoirs of this disease. 

Leptospirosis is a bacterial infection caused by various strains of the Leptospira bacteria.  This bacteria is carried by many wild animals. Naturally occurring hosts are raccoons, opossums, foxes, skunks and various rodents. Raccoons and skunks are scavengers as much as hunters, so they will commonly venture into our yards to knock over garbage pails etc., in search of food.

It has also been estimated that approximately 90 percent of rats in major cities carry leptospirosis, so it has become more of an urban threat than previously realized. These hosts shed, or pass, the bacteria in their urine, contaminating both the environment and water sources. Not only can these hosts carry the bacteria without showing symptoms of disease, they also can shed the bacteria for extended periods of time.

Once in the soil or water, the Leptospira bacteria is very hearty and can survive for weeks to months waiting for another host. The bacteria can gain access to a new host through the membranes of the mouth (drinking contaminated water) or through abrasions and cuts on the skin (from the soil). Once in the bloodstream the bacteria travels to the kidneys and starts to divide.  When the bacterial numbers are high enough, the new host will start shedding bacteria via the urine. 

No specific breed of dog appears to be more susceptible or resistant to the infection. However, middle-aged dogs (as compared to young or old) and male dogs (compared to female) appear to be at higher risk. It is theorized that middle-aged male dogs are more likely to wander and get into more trouble (so far as coming in contact with a natural host). 

The most common organ system affected is the kidneys, but the Leptospira bacteria can also affect the liver, lungs and central nervous system.  Once the bacteria reaches the kidneys replication, as well as inflammation, damages kidney cells.

The symptoms of leptospirosis can be quite general in the beginning. Anything from a drop in appetite and an increase in thirst to vomiting, severe lethargy and in some cases death.

The good news is that leptospirosis is a bacterial infection that can be treated with antibiotics and other supportive care (IV fluids, IV medications etc.). The bad news is many times the initial infection is cleared but there is permanent damage to the kidneys. 

An effective vaccine is now available to prevent this disease. So, check with your veterinarian if your dog is at risk (dogs that get out of the yard, are in contact with many other dogs, have wildlife nearby and standing water) and should be vaccinated.  Let’s keep our dogs safe this summer.

Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine.

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A new chemical rating system will inform people using dry cleaners in Suffolk. File photo

Customers will soon have more information about how their clothes are being cleaned.

The Suffolk County Legislature recently approved a new law that will require dry cleaners to share information with customers about the types of chemical solvents they are using and the environmental effects of those solvents.

County Legislator Kara Hahn (D-Setauket) had proposed the law, which passed on June 2. Under the new requirements, the county health department will categorize dry cleaning solvents, ranking “each chemical grouping based on both human and environmental impacts,” according to a press release from Hahn’s office.

From there, during the existing annual inspections for dry cleaners, county officials will provide the businesses with color-coded signs that “indicate the cleaning methods and solvents used by each individual shop.”

The dry cleaners would have to post the signs in their windows and behind their counters.

On the government side, the health department will also have a website — the address of which will be on the color-coded signs — with environmental and health information about different dry cleaning solvents and processes.

“This bill empowers consumers and allows them to make more informed decisions, which in the end is good for all of us,” Hahn said in a statement. “While it is common for consumers to read food ingredient lists and nutrition labels and to search out reviews for other products, most are hard-pressed to find the time to research details related to a myriad of dry cleaning solvents, figure out the exact solvent used by their cleaner and then investigate its potential impact on his or her self, family and environment.”

Suffolk County Executive Steve Bellone (D) still has to sign the approved bill into law.

Hahn’s bill was related to a previous one she put before the Legislature, which was also approved in mid-April, to stop garment-cleaning businesses from using the term “organic” to describe their services, because there are no set criteria for its usage in consumer goods and services and could be misleading. The legislator has given the example of dry cleaning chemicals that are harmful to the environment but might be referred to as organic because they contain naturally occurring elements such as carbon.

“Organic in this context is a technical term, and does not mean chemical-free,” Beth Fiteni, owner of Green Inside and Out Consulting, an advocacy organization committed to empowering the public to find healthier alternatives to common toxins, said in a statement at the time the bill passed the Legislature. “This legislation in Suffolk County helps address possible confusion.”

That law prohibited dry cleaners from using the term to advertise their services, with fines between $500 and $1,000 for violating the rule.

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Vapors is located on Main Street in Port Jefferson. Photo by Elana Glowatz

Local governments are cracking down on smoking in all its forms by confining related businesses to certain locations.

Brookhaven Town recently restricted smoke shops and lounges and one village is looking to strengthen rules already in place for the establishments.

The action started in the fall, when the Port Jefferson Village Board of Trustees passed a law that effectively banned hookah shops, as well as tattoo parlors and adult entertainment. Residents and village officials had been vocal about what they perceived to be too many shops on Main Street selling hookahs — water pipes used for smoking flavored tobacco — and their related products. Many had complained that the businesses attract an undesirable type of person to the area and sell unhealthy items. Some also said they feared the shops would sell paraphernalia and dangerous substances to underage patrons.

The dissent propelled a law that now restricts future hookah shops, tattoo parlors and adult establishments like topless bars to the Light Industrial I-2 District zone. While the preexisting shops are not affected, the law effectively bans future shops because only two properties in the entire village are zoned light industrial — and both of those Columbia Street plots are already occupied.

Hookah City is located on Main Street in Port Jefferson. Photo by Elana Glowatz
Hookah City is located on Main Street in Port Jefferson. Photo by Elana Glowatz

Passing an outright ban would have been an illegal action.

Port Jefferson Village is now seeking to tighten its restrictions by folding into the law marijuana dispensaries and stores selling products linked to e-cigarettes and vaporizers. The village code proposal, which will come up for a public hearing on June 6, states that such establishments bring “well-documented negative secondary effects … such as increased crime, decreased property values and reduced shopping and commercial activities.” It also cites the health risks of e-cigarettes and the dangers of exposing children to the behavior.

“The expansion of the foregoing businesses has resulted in increased anti-social behavior involving minors,” it says.

Among the restrictions, the shops in the light industrial zone could not be within a certain distance of facilities such as community centers, churches or schools.

The Town of Brookhaven got on the same train recently when its town board passed a law on May 12 that restricts indoor smoking establishments — businesses in which tobacco in any form, including through e-cigarettes and vaporizers, or other substances are smoked indoors. New shops can now no longer open within certain distances of residential areas, schools, churches, parks or other family- or child-oriented places. They also cannot open within 1 mile of one another.

Councilwoman Jane Bonner (C-Rocky Point), who came up with the idea, touted it as a measure to prevent kids from using drugs.

“You cannot believe how creative addicts and users are when it comes to situations like this,” she said, “what they can do and how they can manipulate this apparatus.”

Some have used hookahs, vaporizers and other tobacco devices to smoke marijuana, among other substances.

“This legislation came to pass because of what we see, what’s happening in our communities all over the place,” Bonner said. “This is a very important first step and we may take further steps as we see how this works out.”

Both the town and village laws have had their critics. In Port Jefferson, Trustee Bruce D’Abramo and other residents did not want the village interfering with the free market, which would determine how many smoke shops one neighborhood could sustain, and did not want the village policing people’s heath. They compared the smoke shops to the numerous bars in downtown Port Jefferson.

And Alex Patel, who works at Rocky Point Smoke & Vape Shop, said the town law might have little payoff because parents buy devices for their kids or the kids shop online — those under 21 may still get what they are looking for.

“Online, I see people buying left and right,” Patel said about vaporizers and similar devices. “It’s much cheaper online because they’re buying in bulk.”

But the town law also had community support: “When I think of these [smoking] lounges I think of heroin dens, something I read about and saw movies about when I was a child and scared the heck out of me,” Jeff Kagan, of the Affiliated Brookhaven Civic Organization, said May 12. “I believe that we don’t really know what these dens are all about or what’s really going to go on in these facilities. We don’t know the long-term impact.”

Alex Petroski contributed reporting.

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By L. Reuven Pasternak, M.D.

At Stony Brook University Hospital, we’ve created a culture of excellence based on health care tailored to meet each individual’s needs and preferences. We want to ensure that our neighbors, friends and families on Long Island who come to us feel comforted, respected and confident about the care they receive from Stony Brook.

Our dedication to providing quality care has earned recognition from numerous organizations in the medical community. Many departments have been recognized by their specialty associations for meeting standards that directly benefit patients:

•Our Endoscopy Unit was recognized for endoscopic quality and safety by the American Society for Gastrointestinal Endoscopy.

•Our Stroke Program was awarded the highest recognition possible for quality care by the American Heart Association/American Stroke Association’s Get With the Guidelines program.

•Our Trauma Center has been ranked in the top decile in the nation for specific outcome measures.

•Stony Brook’s Cardiac Catheterization Laboratory was awarded a bronze-level Beacon Award for Excellence and our Cardiothoracic Intensive Care Unit earned a silver-level Beacon Award for Excellence, both from the American Association of Critical Care Nurses.

•Our Pediatric Nephrology Program has achieved a ranking within the Top 50 Best Children’s Hospitals from U.S. News and World Report.

Our dedication to providing quality care has earned recognition from numerous organizations in the medical community.

•The prestigious Press Ganey Guardian of Excellence Award was presented to our Ambulatory Surgery Center in recognition of its high level of patient satisfaction.

•We have been named a top performer in a New York State Department of Health project to improve nutrition for preterm babies in the Neonatal Intensive Care Unit (NICU).

•The New York State Perinatal Quality Collaborative has recognized our performance in reducing elective early-term deliveries by 75 percent, to lower the risk of serious health problems and death for newborns.

And the New York State Department of Health has given us leadership positions in important health care initiatives:

•We received a planning grant to serve as the leader in building a regionalized health care system throughout Suffolk County through the Delivery System Reform Incentive Payment (DSRIP) program.

•Stony Brook is spearheading a SBIRT (Screening, Brief Intervention and Referral to Treatment) program, which will screen and provide early intervention and treatment for people with substance use disorders.

Quality of care and patient safety are and always will be our top priorities. We’re proud of the recognition Stony Brook University Hospital has won, but the real winners, of course, are our patients and the community.

L. Reuven Pasternak, M.D. is the CEO of  Stony Brook University Hospital and the vice president for Health Systems at Stony Brook Medicine.

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Mather Hospital changed its visitation policies Nov. 23. File photo by Alex Petroski

In the National Football League, it is widely believed that team success can be traced back to a long, stable relationship between head coach and quarterback. The longer those two have been working together and in perfect harmony, the likelihood for success usually goes up.

The board of directors at John T. Mather Memorial Hospital have followed a similar blueprint, and they couldn’t be happier with the results. Mather’s board chairman is Kenneth Jacoppi,  and he has held that position for about 10 years, though he began serving on the board in May 1977. Konrad Kuhn joined the board a year later. One year after that, Harold Tranchon joined. All three remain on the board of directors to this day.

“Honestly, when you have board members who have been there for a long length of time they have institutional memory and a long understanding of [the] changing field of medical care,” hospital President Kenneth Roberts said in a phone interview.

He has a long tenure as well: This June marks the 30th anniversary of when Roberts took over that post. Prior to becoming president he served four years as the vice president.

Jacoppi, 78, who was the president of his senior class at Port Jefferson High School and later went on to become a lawyer, reflected on his near 40 years at Mather and his lifetime in the community in a phone interview.

“Never in my wildest dreams did I think I would serve this long,” he said.

Jacoppi referred to others on the board as his “Mather family,” and said that his fondness and pride for his community have contributed to keeping him in the position for so long.

During the decades under the current leadership team, Mather has earned a Magnet designation for nursing excellence, achieved the highest patient experience scores in Suffolk County, been recognized as the only hospital in New York State to earn nine consecutive A ratings for patient safety and quality from the Leapfrog Group and established a new graduate medical education program, among many other accomplishments.

“You have a stability you don’t have in most organizations,” Jacoppi said. “We obviously want to provide the best possible care to people in the area.”

‘Never in my wildest dreams did I think I would serve this long.’
—Kenneth Jacoppi

Jacoppi added one of the things he’s picked up in his experience over the years is to be “a bit more laid back and patient.” He referred to himself when he started as a “hard-charging young lawyer” who had to learn to listen to other viewpoints and think about the effect decisions would have on doctors and the community.

Clearly Jacoppi and the rest of the board have figured out a way to stay on top of their game in what he and Roberts both referred to as an extremely challenging time for health care.

“In the old days, the volunteers held grand card parties under the huge old tree on the Mather lawn that helped raise money to provide exceptional health care for the community,” Jacoppi said in a statement from the hospital.

Times may have changed, but the Mather board of directors has not.

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Participants from a previous Relay For Life at the high school take a lap. Photo from Alyssa Patrone

The fight to raise money and awareness for cancer research reaches far and wide, and on June 4, Northport High School’s track and football field will host nearly 900 people dedicated to doing their part to eradicate the disease.

Northport High School has held Relay for Life events since 2009, making the one this year its eighth annual. The popular American Cancer Society fundraiser starts with teams raising money from local businesses and individuals to be donated for the cause. During the event, which can last up to 24 hours, at least one participant from each team circles a track, usually at schools or parks, at all times as a reminder that cancer never sleeps. Campsites are set up for each team and laps during the relay are dedicated to various survivors and those who died of the illness.

Alyssa Patrone, the American Cancer Society representative overseeing Northport’s event, said Northport participants have raised more than $121,000 so far this year, bringing the total raised in eight years to about $1.3 million.

“There are so many incredible events that happen in our community, but Relay For Life really gives the Northport-East Northport community a place to gather and rally behind those who have been affected by cancer,” Patrone, a Northport resident herself, said in an email. “The volunteers that work to put the event together make sure that the Northport-East Northport community knows that if you’ve ever been touched by cancer in any way, we are here for you. At the event there really is a feeling of hope in the air that’s almost tangible. It’s hard to put into words, but it’s something truly special.”

Currently Deborah Kelly is listed as the top fundraiser on Northport’s page on the Relay for Life website, with more than $6,000 for her team “Steps for Christine.” Kelly’s page on the website says she is participating in the relay for “my sister and all the people who are battling this terrible disease.”

Ashleigh Basel of “Team Rainbow” has raised more than $4,000 for the cause. She also explained why she’s participating in the event on her Relay for Life page.

“I know there are a lot of worthy causes to support, but I think participating in an event that helps save lives from cancer is about as worthy as it gets,” she wrote.

The American Cancer Society has invested more than $4.3 billion in cancer research since 1964, according to its website. The organization estimates that in 2016 more than 1.6 million new cancer diagnosis will occur, and nearly 600,000 people will die.

For more information about Relay for Life or to make a donation, visit www.relayforlife.org.

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People at an anti-drug forum stay afterward to learn how to use the anti-overdose medication Narcan. Above, someone practices spraying into a dummy’s nostrils. Photo by Elana Glowatz

Residents from all Brookhaven communites are welcomed and encouraged to attend Brookhaven Town Youth Bureau’s free substance abuse awareness and opioid overdose prevention program training class, provided by Suffolk County EMS, on June 7 at Brookhaven Town Hall.

The training will discuss what an opioid overdose is, the signs and symptoms that will help identify an overdose, what to do until EMS arrives, and how to administer nasal Narcan to reverse an overdose.

Substance abose treatment information resources will be available from 5:30-6:30 p.m., and Narcan training will be held from 6:30-7:30 p.m.

Brookhaven Town Hall is located at 1 Independence Hill in Farmingville. Call 631-451-8011 for more information or to RSVP by May 27.

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When we hug our dog, we are removing their instinct to flee, which can lead to significant stress. Stock photo

By Matthew Kearns, DVM

I was somewhat taken aback when I saw plastered all over the internet that a hug is stressful to dogs. This hullabaloo came from an article published in Psychology Today. I didn’t have access to the entire article but the author, Stanley Coren, stated that in a review of over 250 images on the internet of dog owners hugging their dogs, he noted signs of stress in four out of five dogs. 

Coren is a psychologist and professor emeritus at the University of British Columbia, as well as an award-winning author. He has dedicated his career to researching dog behavior, so I truly believe he knows what he is talking about. 

Coren states that dogs are cursorial by nature. What does this mean? It means that dogs have limbs adapted for running and, as much as they will use their teeth to defend themselves if necessary, their first instinct is to flee. When we hug our dogs, what are we doing in their eyes? We are removing that first instinct to flee. This can lead to significant stress, even the potential for the dog’s perceived need to defend themselves. 

Now, I know that dogs are social beings and do like contact. However, I do agree that their idea of acceptable contact may not be the same as our own.  As much as we see dogs as part of the family, they see us as part of the pack. We may talk to a dog, but a dog will communicate with us as they would other dogs and this communication is mostly through body cues. If these cues are ignored by humans (particularly children who cannot understand the differences between human and canine behavior) or other dogs, the risk of aggression and bodily harm becomes very real. 

When we hug our dogs, we are removing their instinct to flee, which can lead to significant stress.

My own dog Jasmine loves to sleep in bed with my son Matthew. However, much to Matty’s chagrin, she will only sleep by his feet. Jasmine will tolerate Matty pulling her up to sleep next to him but always eventually moves back to his feet. If he tries too many times to change her position, she will jump off the bed and find another place to sleep. 

Jasmine’s reaction is nonconfrontational, but what if she were not of such a laid back temperament?  She would be face to face with my son where he is restraining her movement. Therefore, I think it is important to look for more subtle cues so we can intervene before disaster occurs. 

What are cues of stress in dogs?  In general terms a relaxed dog will have its ears forward, mouth open and a general look of happiness. A worried dog has its mouth closed, ears back or down, wrinkles around the eyes or forehead and is usually shrinking back.

Beyond these body cues are what are called “stress signals.”  Stress signals are signs that a dog is very worried and trying to communicate to others (another dog, a human) that, “I am not a threat.” However, if these stress signals are ignored (by other dogs or children), the dog may feel it has no option other than act aggressively to defend itself.

Stress signals include: a raised paw, yawning (when they are not tired), licking their nose, tail tucked, slouching or slinking, barking and retreating or hiding. If a dog is restrained (hugged) when showing these body signals or cues, things could get out of control quickly. 

I hope this article is helpful in not only explaining the differences between how dogs view certain behaviors compared to how we humans view them, as well as signs of stress to avoid conflict.  Now go give your dog a . . . scratch behind the ears!

Dr. Kearns practices veterinary medicine from his Port Jefferson office.

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Dr. Shetal Shah gives Assemblyman Steve Englebright a shot at the press conference announcing that the Neonatal Infant Pertussis Act was signed into law in 2012. Photo from Maria Hoffman

A young state law is already breathing new life into the number of newborns burdened with whooping cough.

It has been three years since state Assemblyman Steve Englebright (D-Setauket) saw his Neonatal Infant Pertussis Act signed into law, and last week, members of the Pediatric Academic Societies said it’s already paying off, by reducing infections 50 percent. Both Englebright and Dr. Shetal Shah, who worked alongside the lawmaker in 2012 as a member of the neonatal intensive care unit at Stony Brook University, heralded the legislation as an effective measure to keep newborns healthy across New York State.

Englebright wrote the NPPA with Shah’s help, requiring Tdap, a vaccine against whooping cough, be offered to parents and caregivers in contact with a newborn during birth hospitalization as a way to promote “cocoon” immunity for the infant, according to Shah. Five months later the legislation was signed into law by New York Gov. Andrew Cuomo (D), codifying Shah’s common sense idea into law.

“That year, the New York Department of Health had already reported a three-fold increase in whooping cough since the previous year,” Englebright said. “It is gratifying to learn that this law is working and that children are being protected from whooping cough.”

Whooping cough, also known as pertussis, starts with “cold-like” symptoms such as fever, sneezing or a runny nose.  It may then morph into a mild cough, which becomes more severe in the first or second week.

The NPPA fight started in 2012 when Shah reached out to Englebright’s office with an idea that he said could prevent whooping cough in newborns. In a statement, Shah said newborns are typically the most at risk of serious illness or death if infected. But with help from Englebright’s legislation, vaccinations have been effective in combatting the infection for newborns.

Using the New York Communicable Disease Electronic Surveillance System, Heather L. Brumberg from Maria Fareri Children’s Hospital and her colleagues obtained data from 2010 to 2015 on pertussis cases and hospitalizations for 57 New York counties outside of the city. In addition, they used state population rates in 2011 and 2013 to determine the incidence per 100,000.

During the study period, 6,086 cases of pertussis were detected, 68.8 percent of which occurred before the law passed and 31.2 percent of which occurred after. Overall, the pertussis incidence rate decreased from 37.3 per 100,000 children before the law to 16.9 per 100,000 after.

For children aged younger than 1 year old, pertussis incidence decreased from 304 per 100,000 children to 165 per 100,000 and pertussis hospitalization decreased from 104 per 100,000 children to 63 per 100,000 children. The NPPA was associated with these reductions, especially for those at high-risk, the researchers wrote.

“The data shows that passage of the Neonatal Infant Pertussis Act [NPPA] was associated with a reduced incidence of disease in children in each age group studied,” said Shah, who now works at Maria Fareri Children’s Hospital of the Westchester Medical Center Health Network. “This is associative, as we were unable to track actual parental and caregiver Tdap immunization rates.”

Whooping cough vaccine is a five-shot series that is recommended for children at 2 months, 4 months, 6 months, 15 to 18 months, and again at 4 to 6 years of age.

The pertussis vaccine is short-lived and can wear off within a decade, so some people who were immunized as children are no longer protected in adolescence or adulthood unless they get another booster shot.

“This should provide some degree of scientific impetus to other states and counties to consider this measure as part of a comprehensive strategy to reduce whooping cough,” Shah said.

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