Last updated: June 23. 2014 9:26AM - 1397 Views
Bill Smith

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In my last column, I wrote about the chikungunya virus in the Caribbean islands and the possibility it could arrive in North Carolina. Sure enough, in the past week a case showed up in Forsyth County.

It should also be noted that dengue fever utilizes the same vector (tiger mosquito) so it might not be long before it too shows up. Individual protection and removing standing water are the take-home points for prevention.

In other news, the baseball world just lost, by all accounts, an all around good guy when Tony Gwynn passed away at age 54. This Hall of Famer played his entire career in San Diego although opportunities existed to escape for more money and stardom.

Gwynn died from oral cancer likely caused by his use of smokeless tobacco. He was originally diagnosed in 2010 and has had facial reconstructive surgery. Smokeless tobacco (chewing tobacco and snuff) contains 28 carcinogens.

It is primarily a male habit with 11 percent of high school boys using smokeless tobacco as opposed to just 1.5 percent of girls. In adults it is 6 percent for men and 1 percent for women. Although usage is half of what it was in the mid-1990s, there has been no change in rates the past few years. Remember, tobacco use is banned from public school grounds in North Carolina as opposed to a smoking ban.

Baseball players have had higher rates than the norm. In the 1970s and 1980s about 30 percent of major leaguers were using smokeless tobacco. In 2011, Major League Baseball prohibited teams from providing tobacco products to players, barred players from interviews while using it and forbid tobacco tins being carried in the uniforms. However, a total ban on general use was not put in place.

Tobacco industry advertising encourages cigarette smokers to use smokeless tobacco as an alternative in locations where smoking is not permitted. Some cigarette smokers have switched for the purpose of harm reduction or smoking cessation. Smokeless tobacco is not a safe alternative to smoking tobacco and there has been no conclusive scientific evidence that shows that switching to smokeless tobacco promotes cigarette cessation. Nicotine dependence and addiction occurs just as in smoking — upon discontinuing use, withdrawal symptoms are as evident in smokeless as it is in smoking tobacco.

Since it is the season of sharing report cards, here is the final report for the 2013-2014 influenza season: the peak period in North Carolina was around Jan. 1. This barely differs from the previous two years when it was a week earlier, during Christmas week. While nationally the H1N1 virus (the so-called swine flu) made up a little over half of all flu cases, in North Carolina it was more like 90 percent.

Remarkably, the largest number of deaths in this state occurred in the 25 to 49 age group — which historically is also the worst age group for vaccination. This upcoming year will have vaccine that is identical to this year’s makeup and should be widely available at the end of the summer or early fall.

Bill Smith is the director of the Robeson County Health Department.

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