My boss, Dr. Lee B. Smith, executive director of Monongalia County Health Department and county health officer, often slips this line in when giving an overview of the different types of issues public health workers address. These actions sometimes occur without the public’s awareness of behind-the-scenes work that takes place to keep them safe. 

And to be sure, Americans are lucky to be able to drink tap water without having to worry much about coming down with illnesses such as cholera, typhoid and dysentery.

The Centers for Disease Control and Prevention maintains the Waterborne Disease and Outbreak Surveillance System, which investigates waterborne disease outbreaks in the United States and its territories. 

Unfortunately, keeping water pure has gotten more difficult in recent years.  

One newer threat has come to light in the past decade or so: per- and polyfluoroalkyl substances, also known as PFAS, a type of synthetic chemicals found in many consumer products like cookware, food packaging, stain repellents and firefighting foam. PFAS has seeped into water systems but also can be found adjacent to several packaged grocery items such as candy and fast food wrappers.

A captivating and absorbing new film, “Dark Waters,” has been in theaters for a couple of weeks now. It didn’t receive any Oscar nominations on Monday but it could be one of the most important movies you see. It should be of interest to just about everyone, because, according to information provided at the end, PFAS can be found in about 99% of all humans. 

It should especially intrigue West Virginians, however, because the key locale of the film is the Parkersburg, West Virginia area, home to the former DuPont chemical plant that is the antagonist in “Dark Waters.”

The type of chemical used at this plant was perfluorooctanoic acid, or PFOA, a type of PFAS.

But when the movie’s timeline begins, in the late 1990s, actor Mark Ruffalo, playing Cincinnati attorney Robert Bilott, can’t find any reference to PFOA on the rudimentary internet that existed at the time. He finally tracks down an industry chemist to explain it to him. As depicted in the film, this was the beginning of PFAS becoming known to the public. A settlement wasn’t reached until early 2017.

Bilott, an environmental attorney who usually represented major industries, got pulled into the case by an acquaintance of his grandmother’s in Parkersburg. The man’s cows were dying mysteriously. When Bilott examined the situation more thoroughly, he also found people in the area with black, rotting teeth and women who had worked on the line of one of the company’s more popular products, Teflon, bearing babies with birth defects.

Dr. Smith learned about PFAS when he attended the Executive Leaders Program at the Naval Postgraduate Academy in Monterey, California. Upon his return, he sent Jamie Moore, MCHD’s Threat Preparedness coordinator, and Richard McCord, an MCHD Environmental Health registered sanitarian, to a conference in Pittsburgh to get more information.

Here is what they found out:
 
• PFAS have been manufactured and used in a variety of industries around the globe since the 1940s. U.S. manufacturers voluntarily phased out PFOA and PFOS, two specific PFAS chemicals, but they still import them from other countries. PFAS also have been replaced by GenX chemicals, the safety of which have been questioned.

• The Environmental Protection Agency (EPA) has developed additional toxicity values and analytical methods for PFAS and non-drinking water media as well as treatment options for PFAS in drinking water.

• PFAS don’t break down over time, so they build up in the environment and our bodies.

• Health effects caused by PFAS can cause reproductive and developmental, liver, kidney and immunological effects in laboratory animals. In humans, the chemicals have been connected to higher cholesterol, infant birth weights, adverse effects on the immune system, cancer (PFOA) and thyroid hormone effects (PFOS).

So how can you keep safe from PFAS? The CDC has published a list at atsdr.cdc.gov/pfas/pfas-exposure.html. You can also get more information from the EPA.  

Also, Delegate Evan Hansen of Monongalia County, a water research scientist, announced in December that he will introduce a water safety bill during the upcoming state legislative session that would, among other things, identify where PFAS are being used and discharged so they can be regulated.

And finally, see “Dark Waters,” which will be available to purchase on DVD and Blu-ray in early March. 

It’s a great introduction into the topic of PFAS. It’s also an enthralling movie that hits very close to home, using the song “Take Me Home, Country Roads” ironically rather than in victory. 

Consider this from the World Health Organization:

“Vaccines prevented at least 10 million deaths between 2010 and 2015, and many millions more lives were protected from illness. The global push to end polio has reached its final stages, with just three remaining countries still working to eradicate this debilitating disease.”

And consider this from the past year: Measles was declared eliminated in the year 2000, following a goal that was set by the Centers for Disease Control and Prevention in 1978 to eliminate it by 1982. 

But in under two decades, 2019 became the year of a major measles resurgence, with 1,276 individual cases of measles in 31 states from Jan. 1 through Dec. 5. Those figures will be updated soon.

And guess which state was one of 19 that didn’t have a measles case? West Virginia, which has some of the strictest vaccination laws, only allowing exceptions for those who truly cannot safely have vaccinations for medical reasons, but not religious, philosophical or exemptions based on personal beliefs.

Yet, our local legislators tell us that those who want to weaken our vaccination laws are coming on stronger and stronger. 
​
Monongalia County Health Department hosted legislators from around North Central West Virginia in mid-December review what public health officials wish to see addressed in the upcoming legislative session that begins today.

Sure, we’d love to see state health department budgets restored to previous funding levels that were cut by 25% a few years ago.

Public health is an important investment that helps keep everyone safe. Our services include not only immunizations but also free and anonymous STD testing and treatment; family planning; inspections of restaurants, day care centers, pools, hotels, motels and tattoo parlors; surveillance of diseases including those carried by vectors such as raccoons, ticks and mosquitoes as well as infectious illnesses such as influenza, hepatitis and tuberculosis; and unfunded public health issues of opioids, substance use disorder, unintentional overdose deaths, human trafficking, hepatitis and HIV outbreaks.

But as it stands now, we’ve already lost ground recently in West Virginia when it comes to children’s immunization and three vaccines: hepatitis A, Haemophilus influenza B (Hib) and pneumococcal disease. Those were part of the schedule for kids to be able to get into a West Virginia-approved preschool classroom.
​
Because of a loophole—it’s not specified in the state code—officials were convinced by those opposed to vaccines to remove this requirement. These vaccinations are recommended by the CDC’s Advisory Committee on Immunization Practices (ACIP).
 
At Monongalia County Health Department, this is especially frustrating. It hasn’t even been three months since a Morgantown restaurant employee was found to have been working while infectious with hepatitis A. That put everyone who had eaten at that restaurant within a certain time frame potentially at risk and on notice to get vaccinated. The health department fielded many phone calls and our public health nurses worked extra hours in order to get everyone who showed up immunized against hepatitis A.
 
Anyone who already had the vaccine could breathe easy knowing they were protected.
 
It’s like my boss, Dr. Lee B. Smith, MCHD executive director and county health officer, notes about rabies. People who are bitten by a rabid cat or who tussle with their bloody dog who just got into a fight with a rabid raccoon do not question the safety of a lifesaving rabies vaccine.
 
I am also reminded of an anti-vaxxer acquaintance who posted a video about measles vaccines meant to scare the public. There are times when parents, looking for an answer as to why their baby died from sudden infant death (SIDS), wonder if vaccines are the cause.
 
The CDC has addressed this issue, noting that babies receive many vaccines between the ages of 2 and 4 months old, which is also the peak timing of death attributed to SIDS. “However, studies have found that vaccines do not cause and are not linked to SIDS,” the CDC states.
 
Undeterred, however, my friend couldn’t understand why the vaccine was required when there are so few measles deaths.
 
I had to ask if she had ever considered that there were not many measles deaths because of the vaccine. She had not.
 
It’s also not fair for people to expect for their children to be protected by herd immunity provided by those kids whose parents understand that the science is clearly on the side of vaccines. If fewer children are vaccinated, herd immunity will dwindle. To be effective, herd immunity requires 95% participation. It is unfortunate that children with legitimate medical reasons to not be vaccinated must rely on others to become vaccinated, but that is the case.
 
Some consider measles and chickenpox to be common childhood illnesses that are almost a rite of passage. But they can cause serious complications. Of the 1,276 reported measles cases in 2019, 124 people were hospitalized and 61 reported complications that included pneumonia and encephalitis.
 
All from a vaccine-preventable illness.
 
A saying that has become popular lately is that people are entitled to their own opinions, but not their own facts. And the fact is, vaccines are the No. 1 advancement in public health in the 20th century.
 
We are now one-fifth of the way into the 21st century. Why are we moving backwards on this? 

​This New Year’s marks not only the start of a new year, but also the start of a new decade. What better time to set some new goals to make you the best you can be?

Many people commit to New Year’s resolutions meant to make them healthier, such as losing weight, dieting or exercising more. While these are all great things for your health, it can be daunting when it’s time to follow through.

No matter how far you have to go until you reach your goals, the most important thing is to get started. Join a gym, find some healthy recipes, find some local fitness classes. Many people find “accountability partners” with similar goals to keep each other on track. These days, many people buy fitness trackers to assess their daily steps or calories burned. Seeing what you did that day can motivate people to be more aware of their activity levels. 

One way to ensure that you are more likely to stick to your goals of being healthier is to think of it as a lifestyle change, not just a temporary change that will be over once you reach your goals. Learn to focus on how good you’ll feel with a healthier diet and frequent exercise, instead of dreading going to the gym or eating a salad instead of a fast food combo meal.

Another way to make creating healthier habits easier is to learn more about the unhealthy habits you currently have. Once you know more about what smoking, drinking, unhealthy diet or lack of exercise can do to your body, it will be easier to make better choices. 

One thing to remember about becoming healthier is that what works for someone else may not work for you. Some people may love waking up at 4 a.m. and going for a run, while some prefer late night workouts. Finding something you enjoy will help ensure that you stick to it. 

Personally, my resolution for 2019 was to quit drinking soda, juices, etc. and only drink water. It was difficult at first, because I always ordered Dr Pepper with my meals when I went to restaurants. After ordering water with my meals for about three weeks, I got used to it and didn’t want soda anymore. These days, Dr Pepper wouldn’t taste the same to me even if I wanted to drink it. Once you make it through the adjustment period, it will be easier to make healthy choices without even thinking about it. 

One thing that helped me while I was trying to live a healthier life was following people with similar goals on social media. There are many Instagram accounts dedicated to weight loss tips, healthy recipes, workout challenges and more. Many people even start their own weight loss accounts to track their progress. Pinterest is also a very helpful resource for finding healthy recipes for any type of diet, whether it's vegan, keto, paleo, etc.

Imagine where you could be in your health journey by the end of the year or decade if you start today! Just remember that getting healthier takes time and that one week can’t undo months or years of unhealthy habits. Also, remember that there is a reason you made these resolutions, and think of that reason every time you feel like quitting.

​There have been some great “Twelve Days of Christmas” parodies over the years, so why shouldn’t the Centers for Disease Control and Prevention add one into the mix?

After all, the holiday season coincides with the start of cold weather and winter, and when you gather together with friends and relatives, you want to exchange goodwill and gifts, not a cold or the flu. 

So sing along to the “Twelve Ways to Health Holiday Song” and remember to wash your hands, get your flu vaccine, indulge in food and drink safely and with moderation and stay warm and joyful during these celebratory times.

The first way to health, said the CDC to me
Wash hands to be safe and healthy.
The second way to health, said the CDC to me
Bundle up for warmth, and wash hands to be safe and healthy.
The third way to health, said the CDC to me
Manage stress, bundle up for warmth and wash hands to be safe and healthy.
The fourth way to health, said the CDC to me
Don’t drink and drive, manage stress, bundle up for warmth and wash hands to be safe and healthy.
The fifth way to health, said the CDC to me, be smoke-free, don’t drink and drive, manage stress, bundle up for warmth and wash hands to be safe and healthy.
The sixth way to health, said the CDC to me
Fasten belts while driving, be smoke-free, don’t drink and drive, manage stress, bundle up for warmth and wash hands to be safe and healthy.
The seventh way to health, said the CDC to me
Get exams and screenings, fasten belts while driving, be smoke-free, don’t drink and drive, manage stress, bundle up for warmth and wash hands to be safe and healthy.
The eighth way to health, said the CDC to me
Get your vaccinations, get exams and screenings, fasten belts while driving, be smoke-free, don’t drink and drive, manage stress, bundle up for warmth and wash hands to be safe and healthy.
The ninth way to health, said the CDC to me
Monitor the children, get your vaccinations, get exams and screenings, fasten belts while driving, be smoke-free, don’t drink and drive, manage stress, bundle up for warmth and wash hands to be safe and healthy.
The tenth way to health, said the CDC to me
Practice fire safety, monitor the children, get your vaccinations, get exams and screenings, fasten belts while driving, be smoke-free, don’t drink and drive, manage stress, bundle up for warmth and wash hands to be safe and healthy.
The eleventh way to health, said the CDC to me
Prepare dinner safely, practice fire safety, monitor the children, get your vaccinations, get exams and screenings, fasten belts while driving, be smoke-free, don’t drink and drive, manage stress, bundle up for warmth and wash hands to be safe and healthy.
The twelfth way to health, said the CDC to me
Eat well and get moving, prepare dinner safely, practice fire safety, monitor the children, get your vaccinations, get exams and screenings, fasten belts while driving, be smoke-free, don’t drink and drive, manage stress, bundle up for warmth and wash hands to be safe and healthy.

The CDC also offers some tips that didn’t make it into the song that can help us navigate temptations in a healthy manner. Such as, reach for veggies instead of salty and sugary snacks. When gathering together with family and friends, round some of them up for a walk or a hike. It’s also a good time to talk to them about family health history. Make sure you get plenty of sleep. Don’t smoke, and avoid other people’s second-hand smoke.

Most of all, relax and have a great time with family!

Before the dust has settled on the case of Jeffrey Epstein, who died in jail after being accused of sexually trafficking girls, an eerily similar story has emerged from Florida. This time, it’s center on a man who launched a non-profit to purportedly help children in the foster care system who was actually grooming them to be prostitutes.

Foster children, along with runaways, are two very vulnerable groups when it comes to falling victim to sexually trafficking, noted Andrew Cogar, an assistant U.S. Attorney in the Northern District of West Virginia who prosecutes federal cases of human trafficking.

Any number of reports of human trafficking in the United States is too high. A total of 10,949—the number of reported humans caught up in trafficking schemes in 2018—is especially alarming when you consider how these figures have tripled since 2012. Also, 7,126 were female; 1,137 were male. The remaining 2,686 were not identified by gender.

Back in 2012, according to the National Human Trafficking Resource Center, 3,409 cases were reported. The number has risen steadily in recent years, especially since 2016: 2013, 5,176; 2014, 5,382; 2015, 5,714; 2016, 7,748; 2017, 8,773; and 2018, 10,949.

Are those figures rising because the actual numbers of cases are going up or because more awareness has led to more instances of human trafficking being brought to light? 
It’s probably some of both, said Cogar, who also co-founded and co-chairs the West Virginia Human Trafficking Task Force.

Recently, Cogar presented a lecture on human trafficking at Monongalia County Health Department’s Quick Response Team (QRT). The QRT is a group of MCHD employees, law enforcement, first responders, peer recovery coaches and other community stakeholders who meet weekly to address the opioid crisis. Obviously, drug users can be targeted for human trafficking; in other instances, traffickers purposely get their victims hooked on drugs to help control them more.

In addition to QRT members, the lecture also was attended by MCHD employees in MCHD Clinical Services, MCHD Dentistry and Women, Infants & Children. The work of those public health workers in particular puts them in contact with groups of people who could be among the most vulnerable in our community, so it was good for them to learn signs to watch out for that someone might need help.

What are those signs? First, Cogar noted, in the United States, trafficking people for sex is more prominent than for labor, while internationally, it’s the reverse. 

A definition of different types of trafficking can be found on the website for the West Virginia Human Trafficking Task Force:

Human trafficking is a form of modern-day slavery in which traffickers use force, fraud or coercion to control victims for the purpose of engaging in commercial sex acts or labor services against his/her will.

Sex trafficking has been found in a wide variety of venues within the sex industry, including residential brothels, escort services, fake massage businesses, strip clubs and street prostitution.

Labor trafficking has been found in diverse labor settings including, domestic work, small businesses, large farms and factories.
​
In the United States, risk factors that might reveal that someone is being trafficked include restricted freedom of movement, a sexually explicit online profile, indebtedness to an employer, unusual tattoos that could be branding, large quantities of cash and several cell phones.

Also, Cogar noted, someone who has been trafficked in this way might not really know it.
“They don’t always realize they are victims,” he said. “And they might be conditioned not to cooperate if someone tries to help them.”

Just about everyone working in prostitution has been trafficked at some point, Cogar said, even those who end up working for themselves. “Nobody really wants to be a prostitute,” he added. And 50 percent of people who have been trafficked for sexual services were first trafficked as minors. “There are instances of children as young as 8 or 9 being trafficked with alarming frequency,” he added.

How close does that hit to home? Very close, noted Cogar. In 2018, of the nearly 11,000 cases of human trafficking reported in the United States, 40 of them took place in West Virginia. However, he said, that figure “undercounts significantly” what’s really happening in the Mountain State.

Cogar showed ads from now-defunct web services of purported Russian females offering massages in towns all over West Virginia. The ads create more questions than they answer, however. Are the females of legal age? Who placed the ad? Are they really from Russia? If so, who sponsored them in the United States? And why is one of them wearing a T-shirt that says “Sex” on it?

Sadly, Cogar said, ads like these have been replaced by websites with much more explicit offers these days. “This is child’s play compared to what’s being posted now,” he said. 

There are other human trafficking scenarios: restaurants that bring foreigners to work for them for long hours and low wages, promising to help getting a Green Card in six months. That never happens, and then there might be blackmail involved with threats of calling immigration services if the victims don’t continue to work under illegal circumstances.

Another way to ensnare someone into a trafficking situation is looking on the internet for vulnerable people, such as runaways and foster children. Many times, it’s an older man who preys on a girl. At first, they pretend to care; then they will say something like, “If you really love me, you will make money for me.” 

“That’s the way traffickers sink their teeth into their victims,” Cogar said. 

And then they might take video of the girl engaged in sex and threaten to show it to friends and family. Or they might give victims drugs so they are so strung out, they are easily to manipulate. Or both. 

Do you know of a situation in which there might be human trafficking involved? If so, Cogar urges you to report that. There are several ways you can do this, including by contacting the West Virginia Human Trafficking Task Force, the National Center for Missing and Exploited Children, or Cogar himself. His email address is andy.cogar@usdoj.gov.

Want to learn more? In addition to the above websites, you also can check out the Polaris Project and the National Human Trafficking Resource Center.
​
Remember, it takes a village to take care of our fellow citizens, especially those who are among the most vulnerable in a community.