One third of American adults have high blood pressure. Most of the time there are no warnings or symptoms, so most people do not even know they have it. High blood pressure is a health problem that, if not addressed, may lead to serious illnesses such as heart disease and stroke, the first and third leading causes of death in the United States. In fact, more than 616,000 people die each year in the United States from heart disease and 143,000 people die from stroke, according to the U.S. Centers for Disease Control and Prevention (CDC).

In New Jersey, in 2009, more than 17,700 people died from heart disease and 3,100 died from stroke, according to data from the New Jersey Center for Health Statistics. Considering these facts, everyone should visit their health care provider on a regular basis to ensure their blood pressure is at a normal and healthy level.

Blood pressure is the force of blood against your artery walls as it circulates through your body. During the course of the day, your blood pressure will rise and fall, but it can pose health problems if it remains elevated for too long.

Fortunately there are many actions individuals may take to help maintain healthy blood pressure levels. Eating a healthy diet that includes plenty of fresh fruits and vegetables will help keep your heart healthy, while maintaining a healthy weight and ensuring that you get plenty of exercise is proven to lower blood pressure. The Surgeon General recommends that adults should engage in moderate physical activities for at least 30 minutes on most days of the week.

Equally important to maintaining a healthy heart and proper blood pressure is to avoid smoking. Smoking is known to impact blood vessels and speed up the hardening of arteries. This leads to increased risks of heart disease and stroke. If you are a smoker and you have high blood pressure, you should quit immediately.

For more information on high blood pressure, please visit:

• CDC Website on High Blood Pressure
  
  
• National Heart, Lung and Blood Institute on High Blood Pressure Prevention

With diabetes rates on the rise in the United States, Americans are becoming more and more aware of the dangers of the condition. Approximately 25.8 million American children and adults—8.3 percent of the population—have some form of diabetes, according to the 2011 National Diabetes Fact Sheet. While in some cases diabetes is hereditary, living a healthy lifestyle has been shown to prevent the onset of diabetes and improve the health of those already diagnosed.

An estimated 580,000 New Jersey adults have diabetes and an additional 232,000 have the disease but have not been diagnosed. The New Jersey Department of Health offers a Diabetes Prevention and Control Program, along with other services, that are dedicated to helping those in New Jersey who are living with diabetes lead healthy and productive lives. The program focuses on increasing awareness of diabetes and its complications, improving the quality of diabetes care and access to care, developing partnerships and increasing community involvement to address diabetes issues and utilizing data to better apply resources and improve health outcomes.

Diabetes is a health condition in which blood glucose levels are above normal. Most of the food we eat is broken down into glucose, or sugar, for our bodies to use for energy. The pancreas makes a hormone called insulin to help that glucose get into the cells of our bodies. In the case of diabetes, your body either does not make enough insulin or cannot use its own insulin as well as it should. This causes sugar to build up in your blood. (CDC) Type 1 diabetes is usually diagnosed in children, and is caused by the body not producing enough insulin. Type 2 diabetes is the result of your body either not producing enough insulin, or the cells ignoring the insulin. This can lead to heart disease, kidney problems, and nerve damage among other effects.

The best way to prevent the onset of type 2 diabetes is by leading an active lifestyle and maintaining a healthy weight through proper diet. Choosing to be more physically active can be as simple as taking the stairs instead of the elevator, or walking a few blocks instead of driving. Even in the case of someone who is already living with diabetes, exercising and eating right may significantly limit the effects of both type 1 and type 2 diabetes in your body. Additionally, quitting smoking may also reduce the risk of heart disease, especially for people living with diabetes.

For more information please visit:

The American Diabetes Association Prevention Page
The Center for Disease Control Diabetes Briefing [pdf]
The New Jersey Diabetes Prevention and Control Program Website

A stroke can happen to anyone, at anytime regardless of race, sex or age; and it’s the third leading cause of death in the United States killing over 133,000 people each year.  The National Stroke Association estimates that in 2010, our nation spent $73.7 billion in direct and indirect costs due to strokes.

In New Jersey over 795,000 strokes occur each year, and in 2009, 23,575 people were hospitalized and 2,427 people died from strokes. 

A stroke is caused when a blood clot blocks the blood supply to part of the brain or when a blood vessel in or around the brain bursts. In either case, parts of the brain become damaged or die.  If the supply of blood or oxygen is not quickly restored permanent brain damage or death can occur.

The best way to prevent a stroke is to maintain a healthy weight, avoid smoking, keep the drinking of alcohol to a minimum and keep your blood pressure under control. By making good health decisions you help protect yourself against a possible stroke.

New Jersey is a national leader when it comes to treating stroke patients.  NJDOH designates licensed general hospitals that meet certain medical standards of care as either a Primary Stroke Center or a Comprehensive Stroke Center.  To date, New Jersey has 49 primary stroke center hospitals and 12 comprehensive hospitals that have met the state’s criteria for inclusion into these categories.  The criteria for being designated a primary and comprehensive hospital can be viewed here.

Many times family members are the first people to recognize that something is wrong with a relative or loved one and speed of diagnoses is critical to limiting the damage that a stroke may cause.  Should you notice a family member, or any person with the following symptoms, please dial 9-1-1 immediately:

• Sudden numbness or weakness of the face, arm or leg – especially on one side of the body,
• Sudden confusion, trouble speaking or understanding,
• Sudden trouble seeing in one or both eyes,
• Sudden trouble walking, dizziness, loss of balance or coordination,
• Sudden severe headache with no known cause.

People may also use the “FAST” test to recognize if a person may be suffering from a stroke.

For more information of Stroke please visit:

NJDOH stroke homepage
The National Stroke Association
Centers for Disease Control and Prevention stroke webpage

Amoebiasis or amebic dysentery is not a major problem in the United States and other developed nations.  However, if you are a world traveler, you could fall victim to the illness that is caused by the amoeba parasite that lives in the intestine and is passed through the body in stool.

Anyone can get dysentery if they have visited areas of the world with poor sanitary conditions.  Stool from infected people contaminates water or food supplies thereby exposing large numbers of people to the parasite. The parasite is also spread when food handlers do not take proper steps to ensure clean hands and to maintain a clean work environment.  Additionally, washing foods in contaminated water can lead to infection and cases of dysentery.

A person infected by the parasite may have mild, severe or no symptoms at all.  Approximately one in 10 people infected by the parasite become sick.  Symptoms include:  Abdominal discomfort, diarrhea that may include blood or mucus, constipation, nausea, weight loss, fever and chills.

Antibiotics are commonly used to treat dysentery.  The disease can also largely be prevented by taking the following steps:

• Wash your hands under warm soapy water for at least 15 seconds or use alcohol based sanitizers after going to the bathroom, before preparing meals, before eating and after changing diapers.
• Drink water only from known sources free of sewage contamination.
• Do not swallow water while swimming in pools, lakes, ponds or water parks.
• Drink only bottled water when traveling to a country with poor sanitary conditions.  Boil water for one minute if you are not using bottled water.  Only eat fresh fruit or vegetables you peeled yourself and eat only pasteurized dairy products.

More information on dysentery is available at:
NJ Department of Health
Centers for Disease Control & Prevention

Here in New Jersey, when you use the term “scarlet fever,” many people think you might be talking about a pep rally for the Rutgers Scarlet Knights football team. However, when it comes to medical diseases, scarlet fever is a serious bacterial infection that, if gone untreated, can cause serious health issues, especially for children.

Scarlet fever, or scarlatina, is a bacterial infection caused by group A streptococcus. It’s an illness that occurs in a small percentage of people who contract strep throat. Scarlet fever is treated with antibiotics and usually presents itself with mild symptoms that include a sore throat, rash, fever, bright red underarm, headache, swollen glands or body aches and whitish coating on the tongue and throat.

Scarlet fever most often affects children between the ages of 5 and 18, and is treatable with antibiotics. The bacteria (group A strep) lives in the throat and nose of an infected person, and is spread through coughing and sneezing. If an uninfected person touches their mouth, nose or eyes after being exposed to group A strep, they may become ill.

When the illness develops, scarlet fever presents itself with a fever and sore throat. Chills, vomiting and abdominal pain may also occur. Swallowing becomes painful. The tell-tale scarlet red rash that gives this illness its name usually appears first on the neck and chest before spreading over the rest of the body. This rash most often starts 1-2 days after sickness first begins, but may appear anytime from before the onset of the illness until one week later.

Usually, after a week’s time, the rash begins to fade and skin begins to peel around the finger tips, toes and groin areas. If left untreated scarlet fever may become much more serious and lead to kidney disease, rheumatic fever, ear infections, skin infections, arthritis, or pneumonia. Treatment with antibiotics usually results in full recovery.

The best way to prevent scarlet fever is to keep your hands clean. Wash your hands often and avoid sharing utensils, linens, towels or other personal items. If you are in contact with someone who has a sore throat, be extra careful to take steps that ensure proper hygiene. Currently, there is no vaccine that prevents scarlet fever or strep throat.

For more information on scarlet fever, please visit the CDC scarlet fever page.

Spring is approaching, which means that allergy season is not far behind. For the 35 million Americans who suffer from hay fever, it means several weeks of sniffling, sneezing, itchy eyes, runny nose and other common allergy symptoms.

Hay fever is caused when pollen is released into the air by trees, plants and grasses. If the pollen is inhaled by an allergy sufferer, that person’s immune system mistakenly kicks in to fight what it believes to be a foreign antibody. As a result, the immune system releases histamines into the blood that cause the common discomforts associated with hay fever and other allergic conditions.

As the pollen count rises, so to does the misery of allergy sufferers. Fortunately, there are many medications that can be used to help reduce symptoms. Antihistamines, decongestants, nasal spray and eye drops are all readily available over-the-counter drugs that are commonly used to help people overcome the effects of hay fever. Other practical ways to help relieve symptoms is to take a shower after you have spent time outdoors, keep indoor air clean, wash bedding frequently, and vacuum at least twice a week. If these actions do not help, those with allergy symptoms should consult a physician to see if they need to see a specialist or need prescription strength medicine.

Hay fever has also been known as a trigger for asthma attacks. Should allergy symptoms become increasingly severe, be sure to consult your physician to determine if you are at increased risk for asthma or an asthma attack.

Asthma is one of the most common diseases in the United States affecting about 24.6 million people, including 7.1 million children. According to the CDC, in 2007, asthma accounted for 3,447 deaths and more than $30 billion in direct treatment costs in the United States. In 2006, there were 444,000 hospital discharges relating to asthma, 1.1 million outpatient hospital visits and 1.6 million emergency department visits.

In New Jersey, there are approximately 511,000 adults and 188,000 children with asthma. In 2006, the most recent year for which data is available, 108 asthma deaths were reported in our State and in 2009, there were 16,608 asthma hospitalizations among residents.

A chronic illness, asthma is characterized by ongoing wheezing, breathlessness, chest tightness and coughing in individuals suffering from the illness. Asthma cannot be cured, but it can be controlled so that people are able to live active and healthy lives.

Asthma attacks are triggered by environmental factors such as dust, tobacco smoke, automobile emissions, cockroach droppings, pet dander and mold. Non environmental factors such as getting the cold or flu, strenuous exercise, and allergies can also play a role in triggering an attack. Once triggered the pathways that carry air to the lungs become restricted and mucus production is increased. As a result, breathing becomes more difficult leading to a severe onset of coughing and shortness of breath.

Fortunately, there are effective medications to treat asthma. These medications fall into two categories: Those that relieve short-term symptoms and those that help patients better manage their disease in the long-term. Quick-relief medicines are designed to manage the onset of asthma symptoms or exposure to a trigger, while the long-term medicines are used daily to prevent asthma attacks.

Proper asthma management is critical for asthma control. The disease requires constant monitoring even if no symptoms are present. Those with asthma should be sure to see their physician regularly, understand what triggers individual asthma attacks, monitor symptoms and obtain an Asthma Treatment Plan (ATP) from their health care provider. An ATP is a written plan that tells people with asthma, or their caregivers, how to manage asthma symptoms including what to do every day to prevent symptoms from happening and what to do if symptoms start or worsen. When used properly, the plan can help people control their asthma.

See the following resources for additional information on asthma.

• The New Jersey Asthma Awareness and Education Program (AAEP)
• The Pediatric Adult Asthma Coalition of New Jersey (PACNJ)
• The American Lung Association.
• CDC – Asthma Home

We all get colds, fevers and sore throats, but if you are experiencing prolonged bouts of coughing, you may be suffering from pertussis or as it is more commonly known - whooping cough.  Pertussis is a respiratory disease that is caused by the bacterium Bordetella pertussis.  The bacteria attach themselves to the upper respiratory system and release toxins that cause swelling.  The swelling results in violent coughing episodes, followed by a “whooping” noise caused by the sound people make trying to catch their breath.

Pertussis symptoms can begin  in as early as 7 -10 days after exposure, but sometimes may appear up to six weeks after initially contr the illness.  Common symptoms mimic a cold and can last up to two weeks before more violent, rapid and repetitive coughing appears.  Coughing episodes can be so violent that people with pertussis have been known to vomit after severe attacks.

Pertussis is spread from human to human by coughing and sneezing.  People are infected when they inhale the airborne bacteria.  Infants are particularly susceptible to pertussis, although if they are under the age of 6 months they may not develop classic pertussis symptoms.  Often, infants are infected by older siblings, parents and caregivers who may be unaware they have the illness.  For infants, pertussis can be life-threatening.  In fact, infants younger than one year of age are hospitalized more than 50 percent of the time; the younger the infant, the more likely the need for hospitalization.  Lung infections, convulsions, apnea and encephalopathy are complications for infants that are affected by the disease.

Pertussis is usually treated with antibiotics.  Early treatment is vital to making the affects of the illness less severe and in preventing the spread of the disease.  If you are infected and receive treatment three weeks after onset, the treatment is likely to be ineffective because the bacteria have already died off, but the damage to the body is done. 

The most effective way to prevent pertussis is through vaccinations with DTaP for infants and children and with Tdap for pre-teens, teen and adults.  Vaccine protection wears off over time.  It is important to follow the recommended vaccination schedule to make sure you and your loved ones are up to date with vaccination.  The schedule is available on the website for the Centers for Disease Control and Prevention (CDC) at http://www.cdc.gov/vaccines/recs/schedules/default.htm.

In 2009, almost 17,000 pertussis cases were reported in the United States.   World wide there are between 30-50 million cases annually, resulting in 300,000 deaths per year.  Since the 1980s, there has been an increase in the number of reported cases of pertussis in the U.S., especially among 10-19 year olds and infants younger than 6 months of age.

In New Jersey, 244 confirmed and probable pertussis cases were reported in 2009 and 246 in 2008.

If you have pertussis, you can help yourself and prevent the spread of the infection by taking the following actions:

• Take antibiotics exactly as prescribed by your doctor.
• Avoid exposure to smoke, dust and chemicals.
• Use a cool mist vaporizer to sooth the cough.
• Ensure you wash your hands thoroughly.
• Drink plenty of liquids.  Report any signs of dehydration to your doctor immediately.
• Eat small, frequent meals to help prevent vomiting.

Learn more about pertussis by visiting the CDC website.

A common saying among medical professionals is that it’s always better to prevent a disease than treat it. Which makes sense, because once a disease starts spreading, it can be very difficult to stop. From lost days at school and work, to the costs of medical care dedicated to treatment, the spread of vaccine- preventable diseases costs untold millions each year in the United States.

Vaccines work by safeguarding people-especially children-from illness and deaths caused by infectious diseases. When a vaccine gets injected in the body, the immune system develops antibodies that fight the disease. If the actual disease ever attacks, the antibodies prevent the disease from taking hold.

By vaccinating children against known vaccine-preventable diseases you protect entire communities for decades into the future. In fact diseases such as polio, mumps, tetanus, diphtheria and many others have been controlled and almost eradicated due to vaccinations.

Immunizing children also serves to protect the health of those children who have not been or cannot be immunized due to medical reasons or a weakened immune system. Additionally, if a child does get sick from a vaccine-preventable disease they are less likely to be exposed to germs that can be passed around by unvaccinated children. This slows down and sometimes stops disease outbreaks before they start.

Newborn babies receive natural antibodies from their mothers that help ward off diseases for a short period of time. Sometimes these natural defenses can last up to one year, however they are not effective against many vaccine-preventable diseases and the child’s body may not be strong enough to fight the disease.

The bottom line is that vaccines are safe, effective and they are the single best way to prevent the outbreak of many life-threatening illnesses.

For more information on the vaccines, please visit the CDC Website, or New Jersey Department of Health Vaccine Preventable Disease Program.

Lung cancer is the leading cause of cancer deaths in men and women in America today.  According to the CDC, in 2007, 203,536 were diagnosed with lung cancer, and 158,683 people died from the disease.  In New Jersey, 6,011 people were diagnosed in 2007 and 6,071 people died in 2006.

In its most basic form, lung cancer occurs when normal cells form a mass or tumor that differs from surrounding tissues, taking nutrition and space away from healthy cells.  Unfortunately, lung tumors are often malignant, meaning that they invade and destroy healthy tissues around them.

Lung tumors may also spread to lymph nodes or through the blood stream to other organs in a process called metastasis.  Once this occurs, treatment becomes more difficult and the risk of succumbing to the illness increases.

There are steps you can take to help prevent lung cancer. The first is to stop smoking, approximately 85 percent of lung cancers occur in a smoker or former smoker. Even living with a smoker increases your likelihood of lung cancer when compared to someone who is not exposed to second hand smoke.

It is also recommended that everyone test their homes for radon exposure.  Radon is a naturally-occurring radioactive gas.  Radon leads to more than 21,000 deaths each year, in America, and one in 15 American homes contains high levels of radon. The US Environmental Protection Agency recommends testing your home every two years for radon gas. 
Diets high in fruits and vegetables have also been shown to protect against lung cancer.  In fact, the more fruits and vegetables you eat, the less likely you are to contract a chronic illness, including cancer, stroke and heart disease.

There are several symptoms common to lung cancer.  If you have any of the following symptoms you should consult your health care provider:  A new cough or change in an existing cough, flecks of blood in the sputum when coughing, weight loss, fatigue, deep aches or pains.   Should you experience the following go immediately to the nearest hospital or emergency room:  Coughing up blood, shortness of breath, weakness and sudden vision problems, or chest pains.

he New Jersey Department of Health Office of Cancer Control and Prevention offers programs, resources and information to people with lung and other cancers.  The Department also offers counseling and smoking cessation resources to help people quit smoking. 

More than 2.3 million adult drivers and passengers were treated in emergency departments in 2009 as a result of being injured in motor vehicle crashes. Crash-related deaths and injuries cost more than $70 billion annually.

That is why the New Jersey Department of Health is highlighting a recent CDC study that found 1 in 7 adults do not use a safety belt every time they drive.  Those who don’t use seat belts are twice as likely as those who wear seat belts to be seriously injured or killed in a crash.

While seat belt use has become the norm in many states, the study indicated that self –reported seat belt use varies widely from state-to-state with a high of 94 percent in Oregon to a low of 59 percent in North Dakota.

The study also found that drivers in states with primary seat belt laws used their seat belts 88 percent of the time, as opposed to seat belt usage of only 79 percent in states with secondary enforcement laws.  1 in 3 U.S. adults lived in states with secondary enforcement laws in 2008 and accounted for 49 percent of unbelted drivers and passengers on U.S. Roadways.

In order to keep drivers and passengers safe, the Department urges everyone to take the following steps when riding in a car or other vehicle.

• Always use your seatbelt.
• Ensure everyone in the car is wearing a seatbelt.
• Check your seatbelt for signs of wear and that it is operating properly.
• Never double up or share a safety belt made to protect one person.
• Recognize that airbags are not a replacement for seatbelts.
• Make sure children are buckled up in a seat belt, booster seat or car seat depending on the age and size of the child.
• Be sure your seat belt is properly secured before starting the engine.

Visit the CDC website for more on seat belt safety and the latest CDC study on seat belt safety.

Nobody ever starts a trip with the thought of getting stranded. However, it happens to thousands of motorists across the country each year, especially in the winter. Cold weather, ice and snow makes traveling hazardous and unless you are prepared you might end up spending the night on the side of a highway instead of your home.

The New Jersey Department of Health is urging all motorists to take the following steps to make sure your vehicle is ready for winter weather:

• Service the radiator and ensure you have the proper level of antifreeze in your vehicle.
• Ensure you have enough windshield wiper fluid and that it is a brand designed specifically for colder temperatures.
• Make sure your tires are in good condition and that the air pressure is set to manufacturer recommendations.

Motorists should also plan ahead and have a “winter survival kit” in their car from December through March that includes the following items:

• Blankets
• Tow rope
• First aid kit
• Tire chains
• Matches and can to melt snow for water
• Shovel
• Windshield scraper
• Container of water
• Booster cables
• Can of compressed air with sealant
• Road maps
• Flashlight and extra batteries
• Mobile phone
• Compass
• Tool kit
• Brightly covered cloth
• Paper towels
• Cat litter (for traction on ice/snow)

Motorists should also take additional precautions when traveling including:

• Listening to weather reports to avoid hazardous traveling conditions.
• Not traveling in low visibility conditions.
• Avoid traveling on icy roads and surfaces.
• Alert someone to your destination and when you expect to arrive.
• Don’t rely on a car to provide heat as the car could break down.
• Always carry additional warm clothing for winter conditions.

For more information on preparing yourself for winter travel visit the Center for Disease Control.

As Commissioner of the Department of Health, my schedule is as busy as it can possibly be.  The position is incredibly rewarding and it keeps me on call 24 hours a day, 7 days a week.  Often I find myself working late into the evening making it difficult, at times, to get a good nights rest.   Not getting enough sleep makes it harder for me to perform at my best, so I do all that I can to ensure that sleepless nights are few and far between.

I suggest that anyone having trouble sleeping take the following steps.

• Go to bed and wake up at the same time each day. 
• Do not exercise close to bedtime.
• Avoid caffeine 8 hours prior to sleeping.
• Avoid large meals at night.
• Ensure your sleep environment is quiet and as dark as possible.

Lack of sleep affects the ability to learn, create memories, and solve problems.  It also affects mood and the ability to focus.  Studies suggest that chronic lack of sleep can increase the risk of obesity, diabetes, cardiovascular disease and other illnesses.

If you are chronically having trouble sleeping, you are not alone, over 70 million Americans have some type of sleep problem.  Including insomnia (trouble falling or staying asleep), or sleep apnea (pauses in breathing while sleeping). If you are having trouble sleeping you should see your doctor, as it could be a symptom of a serious medical condition.  

Visit the CDC’s website for more  sleep information.

For those with Arthritis, simple winter activities - like shoveling snow or opening holiday gifts—can make the season feel like the longest and most painful time of the year.
Arthritis occurs when cartilage lining and cushioning bones breaks down and the bones begin to make contact with each other. It affects joints of the fingers, knees and hips. In addition to pain and stiffness, arthritis can make it difficult to move.  Arthritis is New Jersey’s leading cause of disability, affecting over 1.5 million residents.  Of those affected, almost 80 percent have been diagnosed but are not receiving any treatment.  Half of those diagnosed are unaware of what type of arthritis they have.
The rate of arthritis increases with age:  9% of 18 to 44 year olds have arthritis, 32% of 45 to 64 year olds have arthritis, and 53% of those 65 years and older have arthritis. The estimated annual cost of arthritis in New Jersey exceeds 3 billion dollars in medical care and in lost productivity.
There are many ways to help prevent and manage Arthritis including:

• Maintain a healthy, balanced diet. Include plenty of vegetables, fruits and whole-grain products.
• If your actual weight is higher than your recommended weight, reduce calories and increase your level of physical activity
• Increase your physical activity - especially range-of-motion exercises, increasing muscle strength and aerobic or endurance exercises
• Avoid repetitive joint motion (bending knee or wrist)
• Wear protective gear to minimize your risk for sports-related injuries

Research shows that physical activity decreases pain, improves function and delays disability. In addition, research studies suggest that maintaining an ideal body weight and avoiding joint injuries reduce the risk of developing arthritis and may decrease disease progression. Obtaining an early diagnosis so that appropriate management, including self-management, can be initiated may improve the quality of life for persons with arthritis.

For more on preventing and living with arthritis visit the Department’s Arthritis Prevention, Diagnosis and Treatment resource center.

Everyone has heard the old saying, "An once of prevention is worth a pound of cure." It’s good advice especially when it comes to washing your hands to keep yourself and those around you healthy.  In observance of National Hand Washing Week, the Department of Health (DOH) is reminding everyone to wash their hands to ensure proper hygiene. 

“While hand washing is perhaps the simplest and one of the most effective ways to avoid common illnesses, many times people simply forget to wash their hands or are unaware of how clean of hands help stop the spread of disease,” said Dr. Poonam Alaigh, Commissioner of the New Jersey Department of Health.  “It is also critical that we as health care professionals incorporate this into our daily practice as we take care of patients.”

According to the CDC:

• It is estimated that washing hands with soap and water could reduce diarrheal disease-associated deaths by up to 50%.
• Hand washing can reduce the risk of respiratory infections by 16%.
• The use of an alcohol gel hand sanitizer in elementary school classrooms reduced infection related absenteeism by 19.8%.

DOH urges everyone to wash their hands regularly throughout the day and follow the guides listed below to ensure maximum effectiveness:

• Wet your hands with clean running water and apply soap. Use warm water if it is available.
• Continue rubbing hands for 20 seconds. Need a timer? Hum the "Happy Birthday" song from beginning to end twice.
• Rinse hands well under running water.
• Dry your hands using a paper towel or air dryer.

For more information visit the CDC website: Hand washing saves lives.