West Nile Virus Update for Monongalia County WV

West Nile Virus Update

Morgantown, WV – August 27, 2012

As of August 21, 47 states have reported West Nile virus infections in people, birds, or mosquitoes. A total of 1118 cases of West Nile virus disease in people, including 41 deaths, have been reported to CDC. This is the highest number of West Nile Virus disease cases in people reported to CDC at this point in August since West Nile virus was first detected in the United States in 1999. Currently in West Virginia, there is one confirmed case of West Nile, seven cases under investigation and no cases being reported in Monongalia County.

It is not clear why there is more West Nile virus activity this year than in recent years, but many factors could be contributing. Some of these factors that can influence when and where outbreaks occur are: the weather, an abundance of mosquitoes that can spread the virus and human behavior.

The best way to prevent West Nile virus disease is to avoid mosquito bites:

• Use insect repellents when you go outdoors. 
• Wear long sleeves and pants during dawn and dusk.
• Install or repair screens on windows and doors. 
• Use your air conditioning, if you have it.
• Empty standing water from items outside your home such as gutters, flowerpots, buckets, kiddie pools, and birdbaths.
• Support your local community mosquito control programs.

For more information on West Nile virus visit our “All Hazards Data Board” website at: https://sites.google.com/site/allhazardsdb/

Protect Yourself Against H3N2v (Influenza A)

Fact Sheet: Protect Yourself Against H3N2v

 

Background

A number of human infections with a variant influenza A H3N2 virus ("H3N2v") have been detected in the United States since August 2011 (see Case Count: Detected U.S. Human Infections with H3N2v by State since August 2011). These are viruses that do not usually infect people but that occur in pigs and that are very different from human seasonal H3N2 viruses.

More than half of the recent infections with H3N2v have occurred after contact with pigs, but in some cases, the virus seems to have spread from person-to-person. So far spread has not continued beyond one or two people. The symptoms and severity of H3N2v illness have been similar to seasonal flu.

This virus is related to human flu viruses from the 1990s, so adults should have some immunity against these viruses, but young children probably do not. Early steps to make a vaccine against H3N2v have been taken, but no decision to mass produce such a vaccine has been made. (Seasonal vaccine is not designed to protect against H3N2v.) Public health authorities are watching this situation closely.

For more information, please visit Information on H3N2 Variant Influenza A Viruses.

 

Take Action to Prevent Influenza Virus Spread Between People

The risk of infection and spread of influenza viruses between people, including H3N2v, can be reduced by taking a combination of actions. CDC recommends you:

• Take everyday preventive actions, including:
• Cover your nose and mouth with a tissue when you cough or sneeze. (Throw the tissue in the trash after you use it.)
• Wash your hands often with soap and water, especially after you cough or sneeze. If soap and water are not available, an alcohol-based hand rub may be used.
• Avoid touching your eyes, nose or mouth. Germs spread that way.
• Try to avoid close contact with sick people.
• If you are sick, stay home from work or school until your illness is over.

 

Take Action to Prevent the Spread of Flu Viruses Between People and Pigs

• Wash your hands frequently with soap and running water before and after exposure to animals.
• Never eat, drink or put things in your mouth in animal areas.
• Children younger than 5 years, people 65 years and older, pregnant women, and people with certain chronic medical conditions (like asthma, diabetes, heart disease, weakened immune systems, and neurological or neurodevelopmental conditions) are at high risk from serious complications if they get influenza. These people should consider avoiding exposure to pigs and swine barns this summer, especially if sick pigs have been identified.
• If you have animals – including swine – watch them for signs of illness and call a veterinarian if you suspect they might be sick.
• Avoid close contact with animals that look or act ill, when possible, and
• Avoid contact with pigs if you are experiencing flu-like symptoms.

If you must come in contact with pigs while you are sick, or if you must come in contact with pigs known or suspected to be infected, or their environment, you should use appropriate protective measures (for example, wear protective clothing, gloves, masks that cover your mouth and nose, and other personal protective equipment) and practice good respiratory and hand hygiene.
Additional information and materials, including educational posters that can be displayed around animal exhibits, also are available in Compendium of Measures to Prevent Disease Associated with Animals in Public Settings, 2011.
It should be noted that swine influenza has not been shown to be transmissible to people through eating properly handled and prepared pork (pig meat) or other products derived from pigs. For more information about the proper handling and preparation of pork, visit the USDA website fact sheet Fresh Pork from Farm to Table.
 

If You Get Sick

At this time, CDC recommends the following:

• If you go to a doctor for flu symptoms (see below) following direct or close contact with swine, tell your doctor about this exposure.
• If you have flu symptoms, follow CDC’s regular recommendations for seeking treatment for influenza.
  1. If you have symptoms of flu and are very sick or worried about your illness contact your health care provider.
  2. Certain people are at greater risk of serious flu-related complications (including young children, elderly persons, pregnant women and people with certain long-term medical conditions) and this is true both for seasonal flu and novel flu virus infections. (A full list of people at higher risk of flu related complications is available at People at High Risk of Developing Flu-Related Complications.)
     • If these people develop ILI, it’s best for them to contact their doctor as soon as possible. (The majority of recent H3N2v cases have been in children.)
  3. Your doctor may prescribe antiviral drugs that can treat the flu, including H3N2v. These drugs work better for treatment the sooner they are started. If you are prescribed antiviral drugs by your doctor, you should finish all of the medication, according to your doctor’s instructions.

• Also, whenever you have flu symptoms and are seeing a health care provider, always remember to tell them if you have asthma, diabetes, heart disease, neurological and neurodevelopmental conditions, are pregnant, or are older than 65 or younger than 5 years. These conditions and age factors put you at high risk of serious complications if you have the flu.
• Flu signs and symptoms usually include fever and respiratory symptoms, such as cough and runny nose, and possibly other symptoms, such as body aches, nausea, vomiting, or diarrhea.
• Health care providers will determine whether influenza testing and possible treatment are needed.
• There are influenza antiviral drugs that can be used to treat infection with H3N2v viruses as well as seasonal influenza viruses. More information about influenza antiviral drugs is available at Treatment (Antiviral Drugs).

 

Content from CDC

Resources

Information and materials, including educational posters [389 KB, 1 page] that can be displayed around animal exhibits, are available in Compendium of Measures to Prevent Disease Associated with Animals in Public Settings, 2011.
Materials from North Carolina Department of Agriculture and Consumer Services
Reduce Your Risk (English)
Reduce Your Risk (Spanish)
Materials from Colorado Department of Public Health and Environment


Signs for Strollers at Fairs

CDC Reports Cases 18-29 of H3N2v Virus Infection; Continues to Recommend Interim Precautions When Interacting with Pigs

August 3, 2012 –This week CDC reports 12 additional human infections with influenza A (H3N2) variant* virus in 3 states: Hawaii (1 case), Ohio (10 cases) and Indiana (1 case). The H3N2v virus contains the M gene from the human influenza A(H1N1)pdm09 (2009 H1N1) virus, as have the previous 17 cases detected since July 2011. All of this week’s reported cases occurred in people who had direct or indirect contact with swine prior to their illness.The 10 cases in Ohio were associated with attendance at a fair where reportedly ill swine were present. The H3N2v case reported by Indiana also occurred in a person who attended a fair where swine were present. CDC continues to recommend preventive actions people can take to make their fair experience a safe and healthy one.
The number of cases of infection with H3N2v viruses with the M gene from the 2009 H1N1 virus detected in the United States since July 2011 now totals 29 [Hawaii (1), Indiana (7), Iowa (3), Ohio (10), Maine (2), Pennsylvania (3), Utah (1), and West Virginia (2)]. Twenty-three of these cases reported swine contact prior to illness onset. Among those 29 cases, 19 cases were associated with fairs where swine were present. Most human illness with H3N2v virus infection has resulted in signs and symptoms of influenza (fever, cough, runny nose, sore throat, muscle aches); 3 hospitalizations have occurred. All of the people hospitalized had high risk conditions. (See "people who are at greater risk of serious influenza-related complications" below.) All H3N2v virus cases have recovered fully.
According to USDA, swine influenza surveillance, this swine H3N2 virus with the pandemic M gene has been detected in swine in a number of U.S. states. This virus may be circulating widely in U.S. swine at this time. It should be noted, however, that influenza viruses have not been shown to be transmissible to people through eating properly handled and prepared pork (pig meat) or other products derived from pigs.
It is possible that acquisition of the M gene from the 2009 H1N1 virus may allow H3N2v viruses to be more transmissible from pigs to people and from person-to-person.
Late summer is typically fair season across the United States, and fairs are a setting that can provide many opportunities for exposures to occur between pigs and people. CDC continues to advise people to take recommended precautions when interacting with pigs or their environments, including frequent hand washing and avoiding contact with pigs that appear ill. The National Association of State Public Health Veterinarians has developed the "Compendium of Measures to Prevent Disease Associated with Animals in Public Settings, 2011" to provide some preventive actions that are applicable to people raising swine, showing swine at fairs, or attending fairs.
This includes:

• Wash your hands frequently with soap and running water before and after exposure to animals.
• Never eat, drink or put things in your mouth while in animal areas and don’t take food or drink into animal areas.
• Young children, pregnant women, people 65 and older and people with weakened immune systems should be extra careful around animals.
• If you have animals – including swine – watch them for signs of illness and call a veterinarian if you suspect they might be sick.
• Avoid close contact with animals that look or act ill, when possible.
• Avoid contact with pigs if you are experiencing flu-like symptoms.
• If you must come in contact with pigs while you are sick, or if you must come in contact with pigs known or suspected to be infected, or their environment, you should use appropriate protective measures (for example, wear protective clothing, gloves, masks that cover your mouth and nose, and other personal protective equipment) and practice good respiratory and hand hygiene.**

Additionally, in response to recent human cases of H3N2v virus infection, CDC would like to convey the following information:

1. Children younger than 5 years, people 65 years and older, pregnant women, and people with certain chronic medical conditions (like asthma, diabetes, heart disease, weakened immune systems, and neurological or neurodevelopmental conditions) are at high risk from serious complications if they get influenza. These people should consider avoiding exposure to pigs and swine barns this summer, especially if sick pigs have been identified.
2. Studies conducted by CDC have indicated that children younger than 10 years old would have little to no immunity against H3N2v virus, whereas adults may have some cross-protective immunity. Most cases of H3N2v have occurred in children at this time.
3. There are two FDA–approved drugs that are expected to be effective in treating illness associated with H3N2v virus infection. The antiviral drugs oseltamivir (Tamiflu) and zanamivir (Relenza) – which are used to treat infection with human seasonal influenza viruses –are also expected to be effective in treating H3N2v virus. Antiviral treatment is most effective when started as soon as possible after illness onset. (For more information about influenza antiviral medications, please see What You Should Know About Flu Antiviral Drugs.)
4. Signs and symptoms of H3N2v virus infection cannot be differentiated from those caused by other respiratory infections, including seasonal influenza virus infection.
5. Rapid influenza diagnostic tests may not detect H3N2v virus in human respiratory specimens (false negative results). If H3N2v virus infection is suspected because of recent exposure to pigs or to an ill person who had contact with pigs, testing of respiratory specimens should be done at a state health department.
6. Influenza viruses have not been shown to be transmissible to people through eating properly handled and prepared pork (pig meat) or other products derived from pigs. For more information about the proper handling and preparation of pork, visit the USDA website fact sheet "Fresh Pork from Farm to Table"

Other CDC recommendations related to H3N2v for the public are available in "Fact Sheet: Protect Yourself Against H3N2v".
Guidance for health care professionals is available at "Information for Health Care Professionals".

Background

Influenza is a contagious respiratory illness caused by infection with influenza viruses. Human influenza viruses infect people and swine influenza A viruses infect pigs. Occasionally, influenza viruses can spread between people and pigs. While this isn’t common, it can happen. When a swine influenza A virus infects a person, these viruses are called "variant viruses."
While swine influenza A viruses seldom infect humans, such infections can occur. Human infections with swine viruses are thought to occur in the same way that seasonal influenza viruses spread among people. Pigs that are infected shed influenza virus – possibly in coughs or sneezes – and people who are nearby can breathe the virus in. Infection also may occur by a person touching a surface or object that has virus on it and then touching their own mouth or nose."
Signs of swine flu in pigs can include fever, depression, coughing (barking), discharge from the nose or eyes, sneezing, breathing difficulties, eye redness or inflammation, and going off feed. Some pigs infected with influenza viruses, however, may have no symptoms at all.

More Information

• More information about the case in Hawaii is available in "An influenza A (H3N2) variant virus, known as H3N2v virus, has been confirmed in a Maui adult resident. An investigation into the source of this person’s illness is currently ongoing".
• More information about the situation in Ohio is available in a press release from the Ohio Department of Health: "Health Officials Confirm Flu Virus Strain from Butler County Fair".
• More information about the situation in Indiana is available in "Health Officials Continue to Investigate Flu Illness".
• More information about H3N2v is available on the CDC website at Information on H3N2 Variant Influenza A Viruses.
• More information on swine influenza can be found in What People Who Raise Pigs Need To Know About Influenza (Flu) .
• Additional information and materials, including educational posters [389 KB, 1 page] that can be displayed around animal exhibits, also are available in the "Compendium of Measures to Prevent Disease Associated with Animals in Public Settings, 2011".
• More information for people who are at greater risk for influenza complications is available at on the CDC website at People at High Risk of Developing Flu–Related Complications.

* A "variant" designation is applied when a virus that normally circulates in swine is found in humans.
** These recommendations are taken from Compendium of Measures to Prevent Disease Associated with Animals in Public Settings, 2011 and What People Who Raise Pigs Need To Know About Influenza (Flu).

Help Yourself, Help your Family, Help your Community



Help Yourself, Help your Family, Help your Community - Become a Community Emergency Response Team Member and learn how to prepare for an emergency.

The Community Emergency Response Team (CERT) Program educates people about disaster preparedness for hazards that may impact their area and trains them in basic disaster response skills, such as fire safety, light search and rescue, team organization, and disaster medical operations. Using the training learned in the classroom and during exercises, CERT members can assist others in their neighborhood or workplace following an event when professional responders are not immediately available to help. CERT members also are encouraged to support emergency response agencies by taking a more active role in emergency preparedness projects in their community.

The next Monongalia County CERT Basic Training will be held June 9th and 23rd at the Monongalia County Health Department. For more information or to register online go to:

https://sites.google.com/site/moncert/home

Prevent the Spread of Norovirus

 

Noroviruses spread easily, causing more than 20 million gastroenteritis cases each year in the U.S. There's no vaccine to prevent norovirus infection and no drug to treat it. Wash your hands often and follow simple tips to stay virus-free.

Noroviruses are a group of related viruses. Infection with these viruses affects the stomach and intestines and causes an illness called gastroenteritis (GAS-tro-en-ter-I-tis; inflammation of the stomach and intestines).

Anyone Can Get Norovirus

Anyone can be infected with noroviruses and get sick. Also, you can get norovirus illness more than once during your life. The illness often begins suddenly. You may feel very sick, with stomach cramping, throwing up, or diarrhea.
Noroviruses are the most common cause of gastroenteritis in the United States. CDC estimates that each year more than 20 million cases of acute gastroenteritis are caused by noroviruses. That means about 1 in every 15 Americans will get norovirus illness each year. Norovirus is also estimated to cause over 70,000 hospitalizations and 800 deaths each year in the United States.

Many Names, Same Symptoms

You may hear norovirus illness called "food poisoning" or "stomach flu." It is true that food poisoning can be caused by noroviruses. But, other germs and chemicals can also cause food poisoning. Norovirus illness is not related to the flu (influenza), which is a respiratory illness caused by influenza virus.
Symptoms of norovirus infection usually include diarrhea, throwing up, nausea, and stomach cramping.
Other, less common symptoms may include low-grade fever, chills, headache, muscle aches, and general sense of fatigue.
Norovirus illness is usually not serious. Most people get better in 1­ to 2 days. But, norovirus illness can be serious in young children, the elderly, and people with other health conditions; it can lead to severe dehydration, hospitalization and even death.
You may get dehydrated if you are not able to drink enough liquids to replace the fluids lost from throwing up or having diarrhea many times a day. Symptoms of dehydration include a decrease in urination, a dry mouth and throat, and feeling dizzy when standing up. Children who are dehydrated may also cry with few or no tears and be unusually sleepy or fussy.
The best way to prevent dehydration is to drink plenty of liquids. Oral rehydration fluids are the most helpful for severe dehydration. But other drinks without caffeine or alcohol can help with mild dehydration. However, these drinks may not replace important nutrients and minerals that are lost due to vomiting and diarrhea.
If you think you or someone you are caring for is severely dehydrated, contact your doctor. For more information on norovirus and dehydration, see How is viral gastroenteritis treated?

Norovirus Spreads Quickly

Norovirus can spread quickly from person to person in crowded, closed places like long-term care facilities, daycare centers, schools, hotels, and cruise ships. Noroviruses can also be a major cause of gastroenteritis in restaurants and catered-meal settings if contaminated food is served.

Norovirus and Food

Norovirus is a leading cause of disease from contaminated foods in the United States. Foods that are most commonly involved in foodborne norovirus outbreaks include leafy greens (such as lettuce), fresh fruits, and shellfish (such as oysters). However, any food item that is served raw or handled after being cooked can become contaminated with noroviruses.

The viruses are found in the vomit and stool of infected people. You can get it by

• Eating food or drinking liquids that are contaminated with norovirus (someone gets stool or vomit on their hands, then touches food or drink).
• Touching surfaces or objects contaminated with norovirus and then putting your hand or fingers in your mouth.
• Having direct contact with a person who is infected with norovirus (for example, when caring for someone with norovirus or sharing foods or eating utensils with them).

People with norovirus illness are contagious from the moment they begin feeling sick until at least 3 days after they recover. But, some people may be contagious for even longer. 

Norovirus: No Vaccine and No Treatment

There is no vaccine to prevent norovirus infection. Also, there is no drug to treat people who get sick from the virus. Antibiotics will not help if you have norovirus illness. This is because antibiotics fight against bacteria, not viruses. The best way to reduce your chance of getting norovirus is by following some simple tips.

Stop the Spread of Norovirus

Practice proper hand hygiene

Wash your hands carefully with soap and water, especially after using the toilet and changing diapers and always before eating or preparing food. If soap and water aren't available, use an alcohol-based hand sanitizer. These alcohol-based products can quickly reduce the number of germs on hands in some situations, but they are not a substitute for washing with soap and water.

Take care in the kitchen

Carefully wash fruits and vegetables, and cook oysters and other shellfish thoroughly before eating them.

Do not prepare food while infected

People with norovirus illness should not prepare food for others while they have symptoms and for 3 days after they recover from their illness. (see For Food Handlers: Norovirus and Working with Food)

Clean and disinfect contaminated surfaces

After throwing up or having diarrhea, immediately clean and disinfect contaminated surfaces by using a bleach-based household cleaner as directed on the product label. If no such cleaning product is available, you can use a solution made with 5 tablespoons to 1.5 cups of household bleach per 1 gallon of water.

Wash laundry thoroughly

Immediately remove and wash clothing or linens that may be contaminated with vomit or stool. Handle soiled items carefully—without agitating them—to avoid spreading virus. If available, wear rubber or disposable gloves while handling soiled clothing or linens and wash your hands after handling. The items should be washed with detergent at the maximum available cycle length and then machine dried.

Content from CDC

WV Poison Center: Saving Lives 24/7

What do you do if your toddler eats something in your yard at 11 a.m.? What if you brush your teeth with antibiotic ointment at 6 a.m.? What do you do if you take too much medicine at 1 a.m.? The West Virginia Poison Center (WVPC) provides free, confidential advice 24 hours a day, 7 days a week, 365 days a year. The Poison Center is always available; we never close!

1-800-222-1222

The WVPC receives calls regarding children, adults, seniors, and animals. Even healthcare professionals, such as doctors and nurses, utilize our service for treatment recommendations.

The WVPC can answer questions about:

• Accidental poisonings of children and adults
• Drug overdoses
• Bites and Stings
• Reactions to drugs and chemicals
• Drug interactions
• Poisoning of animals
• Chronic lead poisoning
• Toxic or non-toxic plan information
• Poisonings from drugs of abuse

All calls to the WVPC are free and confidential. The Poison Center take calls in many different languages and for the hearing impaired. If you have a question or concern, the WVPC can handle it!

Trained medical professionals (nurses, pharmacists, physicians) are ready to help you with any poison question you have at any time of day.

You never know when you may need the WVPC. Program our number into your cell phones and keep our number available at home. Remember, if you even suspect a poisoning, call the WVPC at 1-800-222-1222.

About the West Virginia Poison Center:

The West Virginia Poison Center provides comprehensive emergency poison information, prevention and educational resources to West Virginians 24 hours a day, seven days a week, 365 days a year. The WVPC is staffed by nurses, pharmacists and physicians with special training in treatment of poisonings. Located in Charleston, WV, the WVPC is a part of West Virginia University-Charleston Division. Toll-free: 1-800-222-122. Website: www.wvpoisoncenter.org.

National Poison Prevention Week - One Person's Story

Cathy’s Story – A Poison Tragedy

by the American Association of Poison Control Centers

Fifty years ago, in 1962, 3-year-old Philip was rushed to the nearest hospital, 30 minutes away.  Tragically, he had found and drunk a bottle of rat poison.  Though all attempts were made to save his life, he lived only a few more hours.  50 years later, his sister, Cathy Seifried of Kingwood, Texas, is still grieving.  According to Cathy, her brother’s death, a tragedy in itself, had long-lasting effects on her entire family as grief, sadness and remorse took its toll.  “I had good parents,” says Seifried. “They managed to function and go through the daily motions … but as a family, we were broken.” 

Today, Seifried focuses her efforts into supporting poison control centers.  She feels that had her family had access to the education, outreach, and support that today’s poison centers offer, her family might have eluded terrible heartbreak and devastation.

The nation celebrates the 50^th anniversary of National Poison Prevention Week March 18 through 24, 2012. National Poison Prevention Week was first proclaimed by President Kennedy in 1962 to raise awareness about the dangers of poisoning. Much progress has been made in poisoning prevention in the years since. In 1972, for example, more than 200 children in the U.S. died as a result of poisoning.  By 2007, that number dropped to 39. However, there is still much work to be done: poisoning is now the leading cause of death from unintentional injuries in the United States – ahead of motor vehicle crashes and guns.

Just one phone number—1-800-222-1222—will put you in touch with your local poison center.  According to the American Association of Poison Control Centers, 57 poison centers are in operation throughout the country, assuring coverage in all 50 states, Puerto Rico, Guam, American Samoa, U.S. Virgin Islands, and the Federated States of Micronesia.  These centers take calls 24 hours a day, seven days a week, 365 days a year.  Calls to the center are free and confidential and are answered by experts in poisoning treatment and prevention.  Callers have access to poison advice in more than 150 languages.

In 2011, federal budget cuts reduced funding for poison control centers by 36 percent.  Poison centers, which handle about 4 million calls a year, are now in jeopardy; further cuts will make it difficult for poison centers to continue providing life-saving services.

Poison centers are for everyone.  Parents and babysitters call poison centers when young children have become exposed to toxic substances.  Seniors use poison centers when they fear they may have made an error in taking their medicine.  And doctors, nurses, pharmacists and emergency room staff place 1,400 calls daily to the Poison Help number for treatment advice on drug- or poison-related cases.  Poison centers are also a highly cost-effective source of health care.  For every dollar spent on poison centers, 7 dollars are saved in unnecessary health-care costs.  On average, 70 percent of callers are able to be treated at home, thus avoiding the far more costly hospital or doctor’s office visits.  Poison centers also provide outreach to their communities, taking proactive steps to reduce both the number and severity of poison exposures.  It is estimated that poison center services, in addition to saving lives, are three times as cost-effective as child safety seats, bicycle helmets and smoke detectors and are as cost-effective as childhood immunizations.

What can you do to prevent poisonings?

·        Keep medicines and cleaning supplies locked up and away from children.  Children act fast.  Unfortunately, so do poisons. 

·        Always use your glasses to read your prescription bottle, and only take medicine with the lights on.  These simple actions can prevent accidents.

·        Ask visitors to keep purses and luggage containing medicine out of reach of children at all times.

·        Install carbon monoxide detectors and check batteries at least twice a year.

·        Keep the1- 800-222-1222 number accessible and programmed into your phone. Your local poison center can send you magnets and stickers with the number.  Call the Poison Help number even if it’s not an emergency.  When in doubt, check it out.

·        Support legislation that funds local poison centers.  

“Philip has been gone for 50 years,” says Seifried. “I know there are many other stories just like his. For their sakes, please get involved with your local poison center in promoting poisoning prevention and the Poison Help number. You can make a difference.” 

The American Association of Poison Control Centers supports the nation’s 57 poison centers in their efforts to prevent and treat poison exposures. Poison centers offer free, confidential, expert medical advice 24 hours a day, seven days a week. We take calls in more than 150 languages and from the hearing impaired.

For questions about poison or if you think someone has been exposed to a poison, call 1-800-222-1222 to reach your local poison center.