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Cynthia Friedman

Stony Brook doctor, tending to a newborn baby. Courtesy Stonybrookchildrens.org

By Daniel Dunaief

Water inside a house isn’t just bad for the structure, it can also be damaging to your health.

Local health care professionals suggested that Stony Brook residents whose basements flooded from this weekend’s heavy rainfall should be careful about the growth of mold or mildew, which can be especially problematic for anyone with chronic breathing issues.

“People can inhale spores over a period of time and can develop respiratory symptoms,” said Dr. Sunil Dhuper, Chief Medical Officer at Port Jefferson’s St. Charles Hospital.

People with asthma, chronic obstructive pulmonary disease, bronchitis and emphysema “need to be particularly concerned about some of these issues,” he continued.

Dr. Sharon Nachman, Chief of Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital, suggested that residents of Stony Brook, who experienced a localized 10 inches of rain this weekend, should “aggressively clean” their basements, from any standing water, as mold and mildew can start growing within a few days.

“You won’t see it because it’s small,” but people should dry the walls and under the floorboards and carpet, she said. “You want to get the water out.”

Local doctors, also, recommended dumping standing water off any surface that might become a breeding ground for mosquitoes, who can carry the West Nile virus.

At this point, the County Department of Health believed the West Nile threat wasn’t likely particularly high.

“The heavy rains and wind might have washed away adult larvae and adult mosquitoes,” Dr. Scott R. Campbell, Laboratory Chief in the Arthropod-Borne Disease Laboratory at the Suffolk County Department of Health Services, explained in an email.

“Wet springs and hot, dry summers — in which mosquitoes and birds may congregate at limited sources of water — may be conducive to higher West Nile virus transmission.”

The heavy rain, which was triple the usual average for the entire month of August, according to Weather Spark, likely reduced area mosquitoes.

Local medical care professionals suggested that residents should still remove standing water as a way to protect themselves against any remaining mosquitoes.

Congenital viral infection

Apart from the impact of local flooding, doctors discussed a host of other medical issues.

New York State has been testing newborns, since last fall, for congenital cytomegalovirus, or CMV, which infected mothers can give to their unborn children.

The testing so far has shown that CMV is less prevalent than previous estimates.

The state started the one-year study of the virus to track children who might develop symptoms, such as hearing loss or learning challenges, later on.

“The earlier you identify babies with hearing deficits, the sooner you can act, and there will be fewer ramifications on their intellectual development, as a result of it,” said Dr. Andrew Handel, pediatric infectious diseases expert at Stony Brook Children’s Hospital, and a co-leader, along with Dr. Nachman, of one of the 11 units across the state.

Dr. Sharon Nachman. Courtesy Stony Brook Medicine Facebook page

Earlier medical sources estimated that the infection rate for newborns was about one in 200 babies. But, with about 300 newborns testing positive, the rate is closer to one in 325.

The percentage of symptomatic babies is tracking with previous expectations, at around 10 percent. Symptoms of congenital CMV at birth include hearing loss, jaundice, low birth weight, seizures and retinitis.

“Our numbers are matching up with the 90 percent” of those who have the virus, but are asymptomatic, Handel added.

“That’s why we feel screening is so important.”

For the asymptomatic newborns, about 10 percent will develop permanent hearing loss, which is why doctors are tracking them so closely.

The virus, which is a relative of the Epstein Barr virus, which causes mononucleosis, is spread through direct contact with body fluids, such as tears, saliva or urine. Over half of all adults have had a CMV infection, with some studies estimating the rate as high as 80 percent.

Adults can shed the virus for a few weeks after contracting it, while children can shed it for a few months.

While all newborns will receive CMV screening after birth, parents have five days to opt out of any link to a report of the presence of the virus in their children.

At this point, fewer than one percent of parents are opting out of the testing. Some of the parents aren’t interested in the test, others don’t believe it’s useful, while some believe their babies look fine, and don’t want the additional test.

Most parents appreciate the opportunity to gather information about their children’s health. Patients are “grateful the state has this program,” said Dr. Sunil Sood, Systems CMV specialist at Northwell Health.

At Stony Brook and other hospitals, doctors are monitoring those babies who test positive.

The County Department of Health supports the testing, as well.

“Routine screening of newborns for [congenital CMV] will help identify affected infants early on so they can receive appropriate follow-up and treatment,” Cynthia Friedman, Director of Public Health Suffolk County Department of Health Services, explained in an email.

“Infants who screen positive … should be followed closely by their pediatricians and referred to specialists as needed to ensure early detection of problems with hearing, vision or development so that appropriate care and support can be implemented.”

Once the funding for the testing runs out, which will be around October, hospitals around the state will no longer perform the test.

Parents can ask for a urine test, which doctors estimate could cost between $50 and $100, but which insurance, likely, won’t pay for — especially if the child is asymptomatic.

Legislators, including Assemblymember Linda Rosenthal (D-NYC) plan to introduce a bill in January that would fund tests, in future years.

“We would advocate that that become a permanent part of infant testing,” said Sood. “There are diseases that are far less common than CMV that have made it into the newborn testing programs.”

Immunization

Amid pushes by some pharmacies to encourage people to get flu shots, health care experts suggest waiting until closer to late September, or early October, for the inoculation.

“Vaccine efficacy is about three to four months,” said Nachman. “If you get it in August, when the flu season hits in January, you may not have much protection.”

The Centers for Disease Control and Prevention recommends similar timing, around September or October.

At the same time, Nachman expects a new batch of Covid vaccines will be available around September.

She recommends getting both shots at the same time, which increases both vaccines’ effectiveness.

Pharmaceutical giant, Pfizer, and BioNTech, recently reported that a single combined shot for Covid and flu was not effective against influenza B, which means that people interested in receiving vaccines this fall should plan to get two shots.

Covid numbers

As for Covid, the current strain has made the rounds this summer.

“Everybody and their neighbor had Covid,” said Nachman, who added that the virus has spread across all ages. Covid was “clearly more infectious than what we had in the spring” and people were sicker for longer.

While the number of infected people has decreased, the start of the fall semester could trigger an increase.

Pregnant woman standing beside crib. METRO Creative Connection photo

By Daniel Dunaief

Cases of syphilis, a sexually-transmitted infection, have climbed dramatically on Long Island over the last decade and have continued to increase, creating a health care risk for those infected including pregnant women and their unborn children.

The number of infectious syphilis cases on Long Island quadrupled between 2011 and 2021, reflecting a national trend, Dr. Cynthia Friedman, Director of Public Health Suffolk County Department of Health Services, explained in an email, citing Centers for Disease Control and Prevention data.

“Unfortunately, case numbers continued to increase through 2022,” while 2023 numbers were not yet finalized, Friedman added.

Photo of Cynthia Friedman.

The incubation period for syphilis is between two and three weeks, with primary symptoms including painless open sores or ulcers and enlarged lymph nodes near the sore.

Left untreated, syphilis can progress through four stages, from primary, to secondary, latent and tertiary, with the last of those occurring in about 30 of cases and threatening the heart and brain and potentially causing death.

“The CDC and New York State Department of Health have issued advisories urging providers to screen their patients for syphilis when appropriate,” Friedman wrote. “Prevention of congenital syphilis is a priority.”

Indeed, pregnant women can pass along syphilis to their unborn children.

Children born with syphilis look healthy, but develop problems as they age.

“It’s a life-long debilitating disease” for infants, said Dr. Sharon Nachman, Chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital. “It affects the brain, bones, growth, teeth and every part of the body.”

Nationally, the number of children born with syphilis has also increased, with CDC data indicating that 3,700 were born with the disease in 2022, 10 times the level from 2012.

Area hospitals have been actively screening pregnant women for syphilis and, in cases where tests come back positive, have been prescribing Bicillin L-A, a form of penicillin that treats the disease and protects unborn children.

“We at Stony Brook have been very aggressive about knowing each mother’s status,” said Nachman.

At Huntington Hospital, pregnant women are also screened at least three times, on initial intake, in the middle of a pregnancy and on admission to the hospital, explained Dr. Mitchell Kramer, Chairman of the Department of Obstetrics and Gynecology.

Suffolk County runs a Congenital Syphilis Prevention Program, which follows women who test positive for the infection during their pregnancy to ensure they are adequately treated and that their infants receive appropriate monitoring and follow up, Friedman wrote in an email.

Still, infections occur among newborns in the county.

“There are generally a few babies born with congenital syphilis in Suffolk County each year,” explained Friedman. “This usually occurs when mothers have had no or limited prenatal care.”

Supply of medicine

Hospitals have been extremely careful with their supply of Bicillin L-A, which is the most effective and safest treatment for pregnant women who aren’t allergic to penicillin.

“Across our institution, nobody could touch those [treatments] unless they were treating a pregnant woman,” said Nachman.

Pfizer, which manufactures the drug, indicated in June that they have enough Bicillin to treat diagnosed cases of the disease.

Kramer said the earlier supply limitations of Bicillin L-A hadn’t been an issue in his practice, although he “wouldn’t be surprised if smaller health care facilities had a shortage.”

Causes of the increase

Health care professionals suggested several possible causes of the rise in syphilis.

An improvement in the prevention and treatment of HIV, the virus that causes AIDS, has likely led to a reduction in the use of condoms, which help prevent the spread of sexually transmitted infections.

An increase in the use of apps to find potential partners may also have increased the spread of these infections, said Nachman.

Additionally, some people may feel there is a “stigma associated with STIs” and may be reluctant to go to a doctor and ask for a test, said Kramer.

Numerous states have lost funding for STI prevention, which also likely reduced the awareness of the need for people to protect themselves, Kramer added.

Populations where there’s disparities in health services and that don’t have access to screening and treatment are “health care deserts” as patients “are not getting proper care and screening,” Kramer said.

Syphilis isn’t just a problem for any one age group.

The infection has been making the rounds at senior centers and assisted living facilities, with cases rising among people over 65 years old. Seniors who aren’t concerned about pregnancy can be at risk for contracting a sexually transmitted disease.

Area hospitals have been urging residents to understand the prevalence and health consequences of STIs and have urged people to protect themselves from the disease.

“There is a concerted effort to get the message out,” Kramer said.