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Lord Fairfax Health District warns residents of rabies risk



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On September 3, 2019, a skunk involved in an altercation with two dogs was killed by the dogs’ owner and made available to the Health Department. The event occurred in a rural area off of Oak Hill Drive, near Woodstock, in Shenandoah County. The skunk later tested positive for rabies, according to the Lord Fairfax Health District.

“This skunk no longer poses a threat,” stated Lord Fairfax Health District Director Dr. Colin Greene, “however, this case offers a reminder that any contact with a raccoon, fox, skunk, or bat that could result in exposure to the animal’s saliva should be considered a potential rabies exposure. This applies to humans and domestic animals, and anyone exposed should receive an immediate medical evaluation.”

The Health Department further advises:

• Never approach or touch wild animals, especially any raccoon, fox, skunk or bat, especially if it is behaving oddly or if it is seen in the daylight. These animals are the main carriers of rabies in the eastern United States.

• Avoid stray cats and dogs. Feral or unknown cats and dogs may also carry rabies. Report bites or scratches from these animals to your physician or the health department.
• Vaccinate all cats, dogs and ferrets against rabies (even if they don’t go outdoors) and keep their shots up to date. Vaccinate working barn cats as well, for their protection and yours.
• Do not feed wild animals or stray cats and dogs. Eliminate outdoor food sources around the home.
• Keep pets confined to your property or walk them on a leash.
• If one of your domestic animals is bitten or otherwise interacts with a wild animal, notify the local health department and animal control officer at once, and have the animal seen by a veterinarian.

If you are bitten, scratched, or licked by any of these animals, seek medical attention immediately. Rabies is fatal to both animals and humans once symptoms begin, but it can be prevented in humans if they receive vaccine and medication soon after exposure.

Finally, if in doubt, or if you have a question, call the Shenandoah County Health Department at 540-459-3733.

Additional information on rabies is available from the Virginia Department of Health at

The Lord Fairfax Health District serves residents in the city of Winchester and Clarke, Frederick, Page, Shenandoah and Warren counties. For more information, visit

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Trigger finger: causes and treatments



If your fingers are frequently stiff and un¬comfortable, especially in the morning, you may be developing stenosing tenosynovitis, better known as trigger finger. This common condition causes discomfort when flexing or extending the affected finger, which is often the thumb or ring finger. Bending or straitening it may result in a palpable snap. In severe cases, the finger may get stuck in a bent position.

Trigger finger is the result of inflammation in the flexor tendon sheath (the protective covering that surrounds the tendons in your fingers). This causes the affected finger to become partially or fully immobilized. Prolonged inflammation may result in nodules forming in the tendon, thereby restricting the finger’s movements even further.


Typically, trigger finger caused by unusual and forceful hand activity will respond well to rest, a splint, and anti-inflammatory medication. However, severe cases and those caused by a chronic health condition such as arthritis may require a corticosteroid injection to be resolved. Should this treatment fail to produce results, surgery will likely be necessary.

If you think you may be suffering from trigger finger, be sure to make an appointment with your doctor.

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Farm safety: how to protect outdoor workers from heat stress



Heat-related ailments are common among agricultural workers. Here’s how they can stay safe outdoors this summer.

1. Drink plenty of water. Heat exhaustion occurs when the body loses too much salt and water due to excess sweating. For this reason, it’s important for outdoor workers to remain hydrated.

2. Take breaks in the shade. Heatstroke, which is a serious condition, occurs after prolonged exposure to extreme heat. Therefore, outdoor workers need cool, shady places where they can rest and should take five- to 15-minute breaks every hour. This is especially important during periods of intense heat and for those who wear protective gear.

3. Don’t rush through tasks. Outdoor agricultural workers should build up their heat tolerance gradually. Initially, they’ll need to move slowly and take frequent breaks, but this is more efficient than dealing with a heat-related illness.

4. Know the signs. All outdoor farmworkers should know the signs and symptoms of heat-related ailments and feel comfortable reporting them. Supervisors should also be able to spot them.

Heat-related ailments can be dangerous and lead to serious complications, especially when treatment is delayed. Make sure you have a plan to handle heat-related health emergencies and that workers and supervisors know about it.

Know the signs
These symptoms of heat stress should never be ignored:

• Dizziness

• Fainting

• Nausea

• Vomiting

• Headache

• Muscle cramps

• Confusion

• Shallow breathing

• Rapid pulse or heartbeat

• Red, hot skin

• Lack of sweating

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Osteoporosis: who’s at risk?



Osteoporosis is a disease characterized by low bone mass and deterioration of bone tissues in the body. It occurs when the creation of new bone tissue can’t keep up with the natural breakdown of existing tissue, causing bones to become brittle. This disease commonly leads to fractures in the wrists, shoulders, vertebrae, and hips.

Risk factors
Though the cause of osteoporosis remains unknown, the risk factors are well understood. It’s more common in women, particularly following menopause. In men, the risk goes up after age 50. Other risk factors include low calcium intake, genetics, a sedentary lifestyle, smoking, and alcohol use.


Since it doesn’t cause pain or other noticeable symptoms as it progresses, osteoporosis is typically diagnosed quite late, often after a fracture occurs. A bone density scan following a suspect fracture will confirm the diagnosis.

There’s no cure for osteoporosis, but there are ways to prevent and delay its onset and progression. Depending on the case, certain medications may be prescribed. However, all patients benefit from taking calcium to help maintain bone mass. Additionally, vitamin D supplements allow the body to absorb calcium better. Regular physical activity will also reduce the risk of fractures and slow the rate of bone degradation.

At-risk individuals, especially women who underwent early menopause and those whose parents had hip fractures, should discuss osteoporosis with their doctor at their next appointment.

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The risk of dehydration among seniors



Did you know that seniors are more susceptible to dehydration? This is because aging causes the body’s thirst signals to weaken, thereby increasing the risk of not drinking enough.

In addition, the kidneys become less effective at conserving water when eliminating waste. Plus, mobility and memory problems can make it harder for older adults to drink fluids regularly.

Dehydration is also a side effect of medications used to treat high blood pressure and heart disease.


A dry mouth and thick saliva are common symptoms of mild dehydration. Other warning signs include reduced urination, having dark yellow urine, getting a headache, and experiencing muscle cramps.

More severe dehydration can result in an inability to urinate, low blood pressure, an elevated heart rate, and convulsions. Weakness, irritability, dizziness, and confusion are also symptoms.

The most effective way to prevent dehydration is to consume enough fluids, and seniors shouldn’t wait until they feel thirsty to drink. It’s a good idea for them to always have water within easy reach, drink gradually throughout the day, and include a beverage with every meal.

There are also a variety of foods that can help with hydration, including most fruits and vegetables. A bowl of low-sodium broth is a good source of electrolytes and a soothing alternative to water on a chilly afternoon. In the summer, consuming ice pops and smoothies may help counteract excessive perspiration.

It can also be beneficial for seniors to keep fruit juice or a sports drink on hand to quickly replenish fluid levels if they experience mild dehydration. Moderate to severe dehydration, however, is considered a medical emergency and requires immediate hospitalization.

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3 gluten-related issues



Gluten is a protein found in grains such as wheat, rye, and barley. Here are three health issues related to its consumption.

1. Wheat allergy
People who are allergic to wheat will have an autoimmune response if they consume it. This can result in trouble breathing, abdominal cramping, a drop in blood pressure, hives, redness, and other hallmark symptoms of an allergic reaction. While rare, anaphylaxis can occur.

2. Celiac disease

This chronic autoimmune condition primarily affects the small intestine, which becomes inflamed if gluten is consumed. This results in gastrointestinal symptoms such as abdominal pain, diarrhea, constipation, and bloating. The condition can also cause systemic problems like chronic fatigue, depression, anemia, and in some cases, osteoporosis.

3. Non-celiac gluten sensitivity (NCGS)
This controversial and still poorly understood condition is currently only diagnosed when a patient’s issues with gluten are clearly not due to a wheat allergy or celiac disease. Its symptoms, which include headaches, eczema, and joint pain, manifest after ingesting gluten and subside once it’s eliminated from the diet. Because of its close association with fad diets and dubious claims made by self-professed nutrition experts, there’s been resistance to recognizing NCGS as a legitimate diagnosis.

If eating foods that contain gluten causes you to experience unusual symptoms, be sure to consult your doctor.

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Reduce cancer risk and focus on wellness during COVID-19 with the new, updated American Cancer Society diet and physical activity guidelines



The American Cancer Society has updated its guideline for diet and physical activity for cancer prevention, with adjustments to reflect the most current evidence. The updated recommendations increase recommended levels of physical activity and have an increased emphasis on reducing the consumption of processed and red meat, sugar-sweetened beverages, processed foods, and alcohol. They also include evidenced-based strategies to reduce barriers to healthy eating and active living and to reduce alcohol consumption.

Published in CA: A Cancer Journal for Clinicians, the ACS’s flagship medical journal, “The guideline continues to reflect the current science that dietary patterns, not specific foods, are important to reduce the risk of cancer and improve overall health,” said Laura Makaroff, DO, American Cancer Society senior vice president, Prevention and Early Detection.  Here is a summary:

Physical Activity for Adults
Previous:  At least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity activity each week.

New:  150-300 minutes of moderate-intensity or 75-150 minutes of vigorous-intensity physical activity per week; achieving or exceeding upper limit of 300 minutes is optimal.

Previous:  Consume a healthy diet, with an emphasis on plant foods.

  • Choose foods and beverages in amounts that help achieve and maintain a healthy weight.
  • Limit consumption of processed meat and red meat.
  • Eat at least 2.5 cups of vegetables and fruits each day.
  • Choose whole grains instead of refined grain products.

New:  Follow a healthy eating pattern at all ages, including:

  • Foods high in nutrients in amounts that help achieve and maintain a healthy body weight
  • Variety of vegetables—dark green, red, and orange, fiber-rich legumes (beans, peas), and others
  • Fruits, especially whole fruits with a variety of colors
  • Whole grains.

Limit or do not include:

  • Red and processed meats
  • Sugar-sweetened beverages
  • Highly processed foods and refined grain products.

Previous: Limit consumption. Drink no more than 1 drink per day for women or 2 per day for men.

New:  It is best not to drink alcohol. People who choose to drink alcohol should limit their consumption to no more than 1 drink per day for women and 2 drinks per day for men.

Recommendation for Community Action
Previous:  Public, private, and community organizations should work collaboratively at national, state, and local levels to implement policy and environmental changes that:

  • Increase access to affordable, healthy foods in communities, worksites, and schools, and decrease access to and marketing of foods and beverages of low nutritional value, particularly to youth.
  • Provide safe, enjoyable, and accessible environments for physical activity in schools and worksites, and for transportation and recreation in communities.

New:  Public, private, and community organizations should work collaboratively at national, state, and local levels to develop, advocate for, and implement policy and environmental changes that increase access to affordable, nutritious foods; provide safe, enjoyable, and accessible opportunities for physical activity; and limit alcohol for all individuals.

“People eat whole foods –not nutrients—and  evidence continues to suggest that it is healthy dietary patterns that are associated with reduced risk for cancer, especially colorectal and breast cancer,” says Dr. Makaroff.

The full guideline:

Article: American Cancer Society Guideline for Diet and Physical Activity for Cancer Prevention; CA Cancer J Clin 2020 DOI 10.3322/caac.21591

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