Thanksgiving Day

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As the year draws to a close I reflect on all that I am thankful for. I am grateful for the opportunity to serve as your Health Plan Director. I am grateful for the hard work of the Health Plan employees and for their continuing excellence in serving our members.

The APWU Health Plan offices are closed on Thursday, November 24 and Friday, November 25 to celebrate the Thanksgiving holiday. Our offices reopen on Monday, November 28, 2022.

The APWU Health Plan Board and Staff would like to wish our members a happy Thanksgiving Holiday. We are thankful for our health plan members; without you, there would be no APWU Health Plan. I hope to have you with us in 2023.

Happy and healthy holiday to you and your families!

1 in 5 Young Women Has No Plans to Get a Mammogram

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THURSDAY, Sept. 29, 2022 (HealthDay News) — Terlisa Sheppard knows the value of tracking changes in her body.

The Orlando Health patient was eight and a half months pregnant and just 31 years old when she felt a lump under her arm. She left work to get it checked out and “didn’t return back to work because that is the evening that I found out I had breast cancer,” Sheppard said.

Now, 23 years later — and long after delivering that healthy baby — Sheppard wants young women to understand the benefits of screening for breast cancer.

“I know for sure that that mammogram saved my life and my baby’s life,” Sheppard said.

Early detection of breast cancer is critical to help women avoid a late-stage diagnosis that is harder to treat. Yet a new survey finds many younger women have no plans to get a mammogram in the near future.

Researchers also found that many of these women are unaware of their individual risks for breast cancer. 

The national survey by a health provider in Florida found that more than one-fifth — 22% — of women 35 to 44 had no plans to get a mammogram that could detect cancer and potentially save their lives.

“That to me is really concerning because we recommend mammograms starting at age 40 and these women are saying, ‘Nope, I don’t plan to,'” said Dr. Nikita Shah, medical oncology team leader for the Breast Cancer Center at the Orlando Health Care Institute. The survey of more than 1,100 adult women was conducted online Sept. 8-12. 

Breast cancer specialists at Orlando Health aren’t sure why women might feel this way. But Shah believes it’s a combination of lack of awareness, concerns about the cost of a mammogram and worries that the screening procedure will hurt.

While cost can be a factor for some, most private insurers cover screening mammograms under the Affordable Care Act. Also, during October, which is Breast Cancer Awareness Month, many organizations offer them for free or at a low cost, such as $20 to $30, Shah said. 

“The other thing I hear is the compression hurts and, yes, it does hurt, it’s a little uncomfortable, but it literally lasts for a few minutes and then it goes away,” Shah said. “Don’t let that be a reason why you don’t do a mammogram, which can save your life.”

Women of average risk of breast cancer can get a mammogram annually beginning at age 40, according to guidelines. Those who have a family history of breast cancer should start earlier as should those with prior biopsies, atypical cells and dense breast tissue. While 22% of women ages 35 to 44 have never had a mammogram and have no plans to get one, only about 43% of women knew their family history, the survey found.

“We kind of just assume that people know, but sometimes patients don’t have good relationships with family members or they don’t know or they don’t ask or people may not talk about it,” Shah said. “Knowing family history is important.”

About 42,000 women in the United States die of breast cancer each year, according to the U.S. Centers for Disease Control and Prevention, but survival is over 90% if the tumor is caught early. Mammograms can spot tiny tumors, making it more likely to catch the disease at an earlier stage.

Orlando Health recommends women talk with their primary care physician or gynecologist beginning in their 20s to help assess their risks. The health organization also recommends monthly self-exams to feel for any changes.

The risks for women are not uniform, and Black women are 40% more likely to die from breast cancer compared to whites. This may be in part because Black women often are diagnosed with a more aggressive type of cancer. Social biases may also play a role, Shah said, including possibly delays in initial diagnosis and in treatment.

Susan Brown, senior director of health information and publications at cancer resource organization Susan G. Komen, said the reasons for disparities in outcomes by race aren’t fully known. 

“We think it may be related to the biology of breast cancer. Black women are more likely to have an aggressive form of breast cancer,” Brown said. “They’re also more likely to be diagnosed at a younger age. Then there are also questions about the quality of health care that Black women receive.”

Brown expressed disappointment at the survey results, but not surprise.

“That tells me that we have more work to do to provide some education so that women understand that finding breast cancer early and getting effective treatment if it is diagnosed has been shown to save lives,” she said. “We’ve had mortality decrease because of early detection and effective treatment from 1989 to 2019.”

Mammograms are a widely available tool, Brown said. “I think we have an opportunity to try to just reinforce that message that mammograms today are the best tool we have for finding breast cancer early,” she said.

When cancer is found early and confined to the breast, the five-year relative survival rate is about 99%, Brown said.  However, “if it’s found later, obviously the treatments are more difficult, the side effects are more difficult, the costs are greater and the outcomes are poorer,” Brown said. 

Shah pointed out that about 1% of breast cancers happen in men, and so they should also be familiar with what’s normal in their bodies. 

“If they feel a lump or nipple discharge, don’t ignore it. That’s not normal,” Shah said. “They need to also have it looked at if they feel something.”

More information     The U.S. Centers for Disease Control and Prevention has more on breast cancer.   SOURCES: Nikita Shah, MD, medical oncology team leader, Breast Cancer Center, Orlando Health Care Institute, Florida; Susan Brown, MS, RN, senior director, health information and publications, Susan G. Komen, Dallas, Texas; Terlisa Sheppard, Orlando Health patient; Orlando Health survey, Sept. 8-12, 2022  

What Is Monkeypox, and How Worried Should Americans be?

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Consumer news MONDAY, May 23, 2022 (HealthDay News) —

A worrisome international outbreak of monkeypox, a less harmful cousin of the smallpox virus, has now reached the United States and Canada. As of Saturday, 92 confirmed cases of the illness, and 28 more suspected cases, have been reported across 12 countries, according to the World Health Organization.

Between 1 and 5 confirmed cases are currently under investigation in the United States, WHO said. 

Monkeypox was first seen in the United Kingdom, Portugal, Spain and other parts of Europe in early May. On Friday, the U.S. Centers for Disease Control and Prevention was monitoring six people in the United States for possible infection. They sat near to one infected traveler on a flight from Nigeria to the United Kingdom in early May. 

CDC officials are also investigating a confirmed case of monkeypox in a Massachusetts man who recently traveled to Canada, according to CNN. And the New York City Health Department is probing a possible infection in a patient at Bellevue Hospital there.

Despite all of these recent infections in areas where the virus is uncommon, and newfound concern that the disease may spread through sexual contact, health experts are warning against overreacting. Unlike newly emerging diseases like COVID-19, monkeypox is well understood and effective treatments are available.

“Nobody should be panicking,” said Anne Rimoin, chair of infectious diseases and public health at the University of California, Los Angeles. “Monkeypox is a known virus that is being introduced into a new population.”

The illness begins with fever, swollen lymph nodes and other flu-like symptoms, followed by a telltale rash on the face that spreads to other areas, including genitals, hands and feet.

Sexual transmission a possibility

The symptoms are similar to those of smallpox but milder, Rimoin said. 

“It can last for several weeks, and people can feel fairly ill,” she said. Effective treatments are available, however. Monkeypox is primarily spread from animals to humans — and less often from person to person because close contact with bodily fluids is needed, added Hannah Newman, director of epidemiology at Lenox Hill Hospital in New York City.

“Anyone experiencing an unusual rash or lesion and who has risk factors [or had sexual encounters with someone who has] should seek care immediately,” she said.

Many of the newer cases worldwide have occurred among gay and bisexual men.

On Monday Enrique Ruiz Escudero, senior health official in the Spanish capital of Madrid, said the city has recorded 30 confirmed cases of monkeypox so far. He said authorities are investigating potential links between a recent Gay Pride event in the Canary Islands, which drew some 80,000 people, and cases at a Madrid sauna.

According to Newman, “it appears that there may be a sexual transmission component to the current outbreak, which we haven’t seen in previous outbreaks.” Gay or bisexual men may be at special risk during the current outbreak, she noted.

However, “I feel like this is a virus we understand, we have vaccines against it, we have treatments against it, and it’s spread very differently than SARS-CoV-2 (the virus that causes Covid-19),” Dr. Ashish Jha, the White House Covid-19 response coordinator, told ABC News on Sunday. 

“It’s not as contagious as Covid. So I am confident we’re going to be able to keep our arms around it,” Jha said. “But we’ll track it very closely and use the tools we have to make sure we can continue to prevent further spread and take care of the people who get infected.”

New questions

Risk factors for past outbreaks included contact with live or dead animals and consumption of wild game or bush meat from wild animals, Newman said.

Once the virus jumps from an animal to a human, human-to-human transmission can occur through direct contact with respiratory droplets, bodily fluids or skin lesions.

In Africa, anywhere from 1% to 15% of people with monkeypox will die from the virus. “Severe disease and [death] is higher among children, young adults, and immunocompromised individuals,” Newman said.

The virus was first discovered in 1958 when two outbreaks of a pox-like disease occurred in monkeys. The first known human case occurred in 1970 in the Democratic Republic of the Congo, and it has since been reported in humans in other central and western African countries, according to the CDC.

While it does not occur naturally in the United States, this is not the first time monkeypox has been seen in the nation. A 2003 outbreak was linked to infected prairie dogs imported as pets.

Many questions about the new outbreak remain. 

“We need to monitor it and understand how it is behaving and how it has been introduced into the new population,” Rimoin said. This outbreak appears to be linked to the West African strain of monkeypox, which Rimoin said is less transmissible and tends to cause milder symptoms than the central African strain. 

“Once these details become available, we will know a lot more,” she said.

The outbreak isn’t totally surprising, she added. In recent years, cases of once-eradicated smallpox virus have also popped up. 

“It is not surprising that we see other poxviruses occurring through the world as a result,” Rimoin said.

Vaccines already here

Fortunately, the smallpox vaccine can protect people from monkeypox. 

In fact, the U.S. government has already placed a $119 million order for the vaccine with an option for more. British health authorities are offering smallpox shots to some health care workers and others who may have been exposed to monkeypox.

The good news is that outbreaks of monkeypox are rare and usually short-lived, Newman said.

The 2003 U.S. outbreak, for example, was quickly contained through extensive testing, deployment of smallpox vaccine and treatments, and guidance for patients, health care providers, veterinarians and other animal handlers. 

“All 47 people recovered, and none of the 47 cases spread the illness to another person,” she said.

Cases of monkeypox had previously been seen only among people with links to central and West Africa, according to the Associated Press. But in the past week, the United States was among seven countries reporting infections, mostly in young men who hadn’t previously traveled to Africa.

France, Germany, Belgium and Australia confirmed their first cases on Friday, the APreported.

“I’m stunned by this. Every day I wake up and there are more countries infected,” said virologist Oyewale Tomori, who sits on several World Health Organization advisory boards. 

“This is not the kind of spread we’ve seen in West Africa, so there may be something new happening in the West,” he told the AP.

More information   The U.S. Centers for Disease Control and Prevention has more on monkeypox.   SOURCES: Hannah Newman, MPH, director, infection prevention, Lenox Hill Hospital, New York City; Anne Rimoin, PhD, MPH, professor, epidemiology, and director, Center for Global and Immigrant Health, University of California, Los Angeles; Associated Press, May 20, 2022; CNN, May 20, 2022