Summer Diseases: There are Codes for Those

For those of you ready to pack up and head for the highways or airports and take off for your summer vacations, I have some advice…

Stay at home. 

I mean it: stay at home.

It’s not just travel-related peril I’m talking about here. There is a world of nasty stuff out there, and it’s waiting for you, at the beach, and in the mountains. 

It’s also in the north, south, east, and west – and in the country’s heartland.

Summer, it seems, is a time for some exotic and some very serious diseases.

In 2016, we learned a lot about the Zika virus. Marked by diagnosis code A92.8, it is primarily transmitted by mosquitos.

It spread from Uganda to South America and now to places that we all consider prime vacation destinations: Costa Rica, the Dominican Republic, Puerta Vallarta, Cancun, Barbados. 

The entire Caribbean and all of coastal Mexico currently have travel advisories regarding Zika infection. 

If you plan on staying in the U.S., remember that Florida has reported 72 cases of Zika.

Although Florida and Miami-Dade County health officials lifted a cautionary warning on June 2, 2017, they are wary of the months of July and August, when the Zika outbreak took off last year.

Since Zika mosquitos cannot survive at higher altitudes, maybe it’s safer to plan a getaway to the mountains.

Although mosquitos don’t do well at those altitudes, ticks love it. 

Lyme disease, diagnosis code A69.20, is found anywhere deer and their foul passengers: the deer tick.

That includes virtually every wooded area where you might want to hike, camp, fish, climb, or walk.

Centers for Disease Control and Prevention (CDC) figures show that the number of reported cases of Lyme disease in the U.S. recently tripled, as those ticks have expanded their geographic comfort zone to include the entire northeast and upper Midwestern United States.

There are reportedly 30,000 identified cases of Lyme disease treated annually. 

The CDC recommends that if you do go into the woods or fields of the Mid-Atlantic states, walk in the center of trails and just don’t touch anything. Spray yourself all over with DEET, pre-treat your clothes and gear with permethrin, and thoroughly wash everything you wear or carry as soon as you can.

Deer ticks infest the woodlands of the northeast and Midwest, but other ticks carrying other diseases infest other parts of the country.

Rocky Mountain spotted fever, A77.0, is a potentially deadly disease spread by ticks throughout the country. Although dogs do not suffer from the disease, the brown dog tick, which I presume prefers brown dogs, carries this infection across the entire continental United States.

There are other new tick-borne diseases that you are likely to hear about in 2017. These include the Heartland virus, which is predictably spreading across, well, the heartland: states like Texas, Oklahoma, Missouri, Tennessee, and Arkansas.

The not-as-much-fun-as-it-sounds Bourbon virus, B34.9, has been identified in Missouri, Oklahoma, and Kansas.

According to the CDC, although few cases have been identified, “several” of the patients have died.

Ticks are inarguably disgusting, but they are not the only carriers of this summer storm of diseases.

In Washington State, deer mice are said to be responsible for five cases of the deadly hantavirus, B33.4, so far in 2017.

So it might be a good plan to stay off of the beach, and stay out of the woods. Don’t go to the northeast, or the southeast, or the west coast, or the heartland.

Maybe the desert is safe: no mosquitos, less vegetation, no deer mice (or deer).

But you may have noticed temperatures exceeding 100 degrees in the southwest. These temperatures led to a spike in the number of potentially fatal heat stroke cases in affected areas. 

Although well-conditioned athletes are better able to survive a core body temperature of 104 degrees or higher, two young athletes training in 100+ degree temperatures recently died.

My advice for your vacation time in July and August is this: go home, pull your curtains shut, turn the air conditioning on high, and binge-watch “Friends from College” on Netflix.

That may not sound like much fun, but the alternative choices are too scary for me.

Like the song says: “sometimes I wonder what I’m a-gonna do, but there ain’t no cure for the summertime blues.”

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Stanley Nachimson, MS

Stanley Nachimson, MS is principal of Nachimson Advisors, a health IT consulting firm dedicated to finding innovative uses for health information technology and encouraging its adoption. The firm serves a number of clients, including WEDI, EHNAC, the Cooperative Exchange, the Association of American Medical Colleges, and No World Borders. Stanley is focusing on assisting health care providers and plans with their ICD-10 implementation and is the director of the NCHICA-WEDI Timeline Initiative. He serves on the Board of Advisors for QualEDIx Corporation. Stanley served for over 30 years in the US Department of Health and Human Services in a variety of statistical, management, and health technology positions. His last ten years prior to his 2007 retirement were spent in developing HIPAA policy, regulations, and implementation planning and monitoring, beginning CMS’s work on Personal Health Records and serving as the CMS liaison with several industry organizations, including WEDI and HITSP. He brings a wealth of experience and information regarding the use of standards and technology in the health care industry.

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