OUTLOOK is a publication of the HUNTER COLLEGE EMPLOYEE ASSISTANCE PROGRAM. The EAP is a professional social service offering individual, group or family counseling to all employees of Hunter College and their dependents. An additional objective is to provide information about a wide range of family, health and mental health issues.
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Codependency in the Workplace......................................................2 Myths in Domestic Violence ........................................................3 Readers' Exchange..................................................................5 Twenty Suggestions for 2000........................................................6 The West Nile Virus...............................................................10 News from DC 37...................................................................13 Lunchtime Seminar Series..........................................................14 Benefits Information Day..........................................................15
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| Florence Vigilante DSW, Director; Patricia McDonald DSW, Program Administrator; Carol Barocas PHD, Supervisor; Constance Goldbeck BA, Administrative Assistant; Staff: Tara Slattery, Mark Smith, Peter Sultan. |
CODEPENDENCY IN THE WORKPLACE
Due to popular television shows like Oprah most people are familiar by now
with the term, codependency. It has been associated with other phrases common
to the "New Age" movement such as "dysfunctional family." It has attained
a certain pop-psychology status that has made the syndrome the object of
humor and scorn. But make no mistake about it, codependency is a very real
phenomenon that has consequences for those people who suffer from it.
Codependency is misunderstood. Misunderstood in that many believe the "codependent" is the spouse of an alcoholic when in fact anyone with a dysfunctional family can exhibit co-dependent behavior. The codependent family is usually organized around one individual's problem. Though tradi-tionally thought of as stemming from alcoholism, the codependent family can be formed by both emotional and physical problems. Things like mental and emotional illness, grave physical illness, compulsive gambling, work-aholism, just to mention a few.
Codependency is deceptive. Deceptive because many, if not most families, do not have an identifiably addicted or obviously dysfunctional family member. This is so because many families owe their dysfunction to a previous generation.
Experts in family therapy now agree that there is a generational transmission of dysfunctional beha-vior. So if Dad was an alcoholic but his sons and daughters did not abuse alcohol, they may still transmit codependent behavior to their offspring. Even when the addictive behavior is no longer present, codependent individuals will behave as if it is. In this way the children of codependents will pass along and continue codependent ways of func-tioning.
Codependency refers to the way those individuals in an addictive or dysfunctional family protect them-selves by super vigilance. The families may be chaotic or even emotionally or physically abusive. In order to feel safe a family member must remain constantly on guard to the possibility of violent or abusive episodes.
This extreme focus by young children on their parents breaches the natural order of things. It is the child that is in need of nurturing, focus, and guidance. An emotionally needy adult often requires attention and nurturing to maintain emotional balance. If he/she cannot get it from the spouse he/she may turn to a child for support. The vigilant child is only too willing to provide this attention, possibly in the role of confidant and companion, in the hope of "fixing" Dad or Mom, so that he/she might be able to give the longed for love in return. This child becomes expert at knowing what the parents are thinking and feeling. Over time they become less aware of their own thoughts and feelings until one day there is little distinction between what the parent is feeling and what the child feels.
In adulthood this creates a vulnerability to assuming the feelings of others as one's own. So, for example, if a wife has the blues it is very difficult for the codependen t husband to feel happy. If the boss is in a bad mood the codependent employee feels awful.
Moreover, dysfunctional fami-lies may require that children, in order to keep the chaos at bay, assume roles and tasks well beyond their maturation level. The responsibility for nurturing younger siblings may be thrust upon them or they may assume the parenting role in an attempt to bring balance and harmony to the family. It is not unusual for these children to be given the task of house cleaning or shopping and cooking for the family.
These role breakdowns serve to loosen the boundaries between members of a family so, for example, Dad may behave like an overgrown child who is taken care of emotionally, as well as physically by one of his children. When Dad behaves like a child and can no longer meet his wife's need for mature companionship, another child may fill the void for Mom by becoming her confidant.
The net effect of living in these families is that children fulfill the needs of others for their identity rather than looking for identity within themselves. Because their parents are needy individuals these children deny their own needs to please them. This is codependency.
These behaviors are functional in a chaotic or dysfunctional family. They work because they often provide an avenue for stability, even though imperfect, for the family unit. Codependency becomes dysfunctional when continued into adulthood.
The world of family influences the world of work in direct ways: behaviors and attitudes learned at home and in the community get recreated at work.
In a recent publication, Diana DiNitto (1989), describes some of the problems that can develop in an alcoholic or dysfunctional home that may have consequences for the work place. These include difficulty in handling stress, an inability to deal with conflict, an inability to discuss problems, or a lack of trust. Codependents may not use substances themselves but at home and work they behave in very similar ways to addicted individuals. They suffer with depression and fail to report to work. Codependents may utilize most or all of their sick leave and vacation time either nursing a sick partner or attending to their own symptoms.
Di Nitto notes that the rigid roles that codependents assume in dysfunctional families can later get played out in their work situations. In replicating their family roles, workers can suffer from workaholism and perfectionism; can overwork to the point of burning out; can get into office conflicts; or can inadvertently obstruct conflict resolution in an office by trying to defuse emotional situations. Individual employees may exhibit some or all of these traits.
The key point is that co-dependency has negative consequences for adults at home and in the workplace. Another point to keep in mind is that the syndrome may be difficult to identify. So if you find yourself having problems at home or at work, particularly around separating your feelings from others, it may be helpful to examine your family's behavior for clues. But not just your immediate family. Keep in mind that it may well be "the sins of the father visited on the sons" through the generations.
MYTHS IN DOMESTIC VIOLENCE
Perhaps now more than at any other time, domestic violence has become part of the national vocabulary. Who can forget Alan Dershowitz, one of the lawyers for O.J. Simpson, imploring women to "just leave...just leave!...? Such recom-mendations, no matter how well intentioned, illustrate the contra-diction in our growing awareness of domestic violence. The more we know, the more varied and confusing the information can be. Seeing through some of the myths about domestic violence can offer some clarity. Some of the myths include:
"It doesn't happen that often" .
How often does domestic violence occur? It depends on who you listen to, but most importantly, it happens with alarming frequency. A 1996 APA (American Psychological Association) study found that one of three American women suffered some kind of assault by their partner during adulthood. However, some critics, like Sally Satel, a psychiatrist and lecturer at the Yale School of Medicine, think statistics can be used to exaggerate the prevalence of domestic abuse to increase public awareness and government funding, but at the expense of a realistic picture. In a 1997 New York Times article, Satel critiqued the National Organization for Women for over-estimating domestic violence rates by misreading previous studies.
"It only happens to them...How could they stay anyway?" Domestic violence affects people of all classes, sexual orientation and ethnicity. As Siyon Rhee has noted in the Journal of Sociology and Social Welfare (1997), coping strategies and attitudes toward violence vary from one culture to another. Fear of loss of relationship, marriage or immigrant status, finances, or children, as well as cultural tolerance of male violence, drinking, and submissive female roles, are all factors that help perpetuate the cycle of forgive-ness and violence. Batterers can display great charm and emotional need, allowing victims to excuse the behavior.
"If it's in the home, it's none of your business" . According to writers Mihalic and Elliot in the Journal of Family Violence (1997), women (and men) still do not believe domestic violence is a crime, leading to underreporting. In fact, before 1977 it was not illegal for a man to assault his partner. Women's shelters and various feminist perspectives helped create a shift from patho-logizing the victim, to criminali-zation of the act, and hence the batterer.
"You can tell by the bruises". The helping professions, like society, used to emphasize the victim's personality or behaviors, thus creating a mystique of blame. Now symptoms of domestic violence, including the reluctance to leave, are considered reactions to real and dangerous stressors. The specific grouping of reactions include feelings of helplessness and hopelessness; insomnia or sleep disturbance; depression and anxiety; reluctance to speak of the abuse; exposure to violent trauma in the past, and re-enactment of the trauma.
"Don't Women get violent too"? In 1998 Dr. John Archer, a psychologist from the University of Central Lancashire in Great Britain, conducted a large scale study of heterosexual relationships in the U.S., Canada, New Zealand, and Great Britain. He concluded that women acted violently more often than men, including slapping, kicking, biting, choking, and using a weapon. However, more instances of serious violence were caused by men, while women accounted for close to three quarters of all injuries requiring medical attention.
"Just leave" . Leaving or preparing to leave is the greatest trigger for domestic homicides, as Wiist and McFarlance have noted in the journal Violence-against-Women (1998). Don't "just leave". Leaving often requires a plan and professional help (Recommendations and resources are listed at the end of the article.) Batterer behavior which should indi-cate warning may include escalating violence, obsessive possessiveness, and morbid jealousy.
Getting professional help-individual and group therapy-is the first and hardest step. In emer-gencies, some local police precincts staff domestic violence officers, while dialing 911 is a valuable option.
Court orders of protection and the legal system do not always offer either protection or the best protection for victims of domestic violence. However, running away-going "underground"-can often endanger vic-tims even further, or risk losing custody of children to the batterer. Instead, consider the following alter-natives, some of which are suggested by Hagar Scher in Ms. Magazine (Feb.,2000). The Hunter EAP can refer clients to these and many other resources:
First and foremost: create a safety plan . The National Domestic Violence Network (800-799-SAFE or for the hearing impaired, 800-787-3224) links women to community programs. Local advocates help create a personalized safety plan, which can include motel vouchers and shelter, reference to legal experts, and other protective measures. The Domestic Violence Hotline (800-621-HOPE or 800-810-7444 for hearing impaired) offers counselors 24 hours.
Change social security number or name . In November 1998 the Social Security Administration (SSA) unveiled a policy allowing women who are victims of domestic violence to change their and their children's Social Security numbers. Any woman who can document abuse-with police or medical records, restraining orders, or letters from mental health profes-sionals, friends, or relatives-is eligible. Those changing their SS numbers may also consider changing their name, and children's names, with a local court. To find your nearest Social Security office, call (800) 772-1213.
Use a confidential address . Five states, including New Jersey, administer confidential address programs for victims of domestic violence, in which they are assigned a fictitious address but mail is forwarded to the 'real' address. In New York, a confidential address can often be set up with the help of advocates or acquaintances.
Use a supervised visitation center . State run agencies and non-profits allow the primary-custody parent to arrange for on-site, custodial visits. Such an arrangement lets victims' children be seen by the other parent in a safe, professional setting, without having to meet an abusive partner face to face.
Other Resources : The National Resource Center on Domestic Violence, Battered Women's Justice Project (800) 903-0111. Helps abused women who have been arrested to obtain legal help.
READERS' EXCHANGE
In each issue of Outlook, we like to share the names of GHI doctors and dentists on the SIDS plan offered by the PSC. These names are submitted by employees who have used the doctors or dentists and found them competent and caring. Now that HIP is using participating private practitioners, we would be most interested in adding HIP doctors that you would recommend to our list. If you have found a doctor or dentist that you would like to recommend, please submit his or her name to the EAP, Room 1305 West. Thank you!
GHI Orthopedic Surgeon
Dr. Robert D. Haar
62 East 88 th Street
New York, NY 110128
(212) 876-7000
TWENTY SUGGESTIONS FOR 2000
1 Think low-tech.
Medical advances like lasers, designer drugs, and laparo-scopic surgery are so impres-sive that we lose sight of the fact that they can't keep us healthy: their role is to treat disease , not to prevent it. Lifestyle factors play a role in most cases of heart disease, cancer, and adult-onset diabetes. So the prescription for good health is the same as it's always been: eat well, get adequate exercise and, to the best of your abilities, stay out of harm's way.
2 Practice preventive pet care.
The medical literature supports the role of animal companions in maintaining health. As a result, pet therapy is now a part of many hospital and nursing home routines. Yet our furry and feathered friends can also be vectors of diseases that infect humans. The American Veterinary Medical Assoc-ation cautions that pets can not only bring home the ticks that carry Lyme disease but also transmit microbes such as toxoplasmosis and psittacosis that cause disease in humans -- particularly in those with suppressed immune systems. Regular veterinary exams and immunizations are almost as important to your own health as to that of your pets.
3 Tote a toothbrush.
The word "halitosis" is an anachronism in this age of industrial strength breath mints. While these little lozenges may mask breath odors, they don't eradicate what is often the source of the problem -- oral bacteria. Moreover, if breath mints contain sugar or other natural sweeteners, they give bacteria a boost, promoting tooth decay, and gum disease. If you can't brush, try sugarless gum. It stimulates the flow of saliva to carry bacteria away.
4 Size yourself up.
We mean this in both the literal and figurative senses. Our physical parameters tell us a lot about our state of health. Pick a morning to weigh yourself and measure your height. Evenings aren't good because we tend to shrink during the day due to the force of gravity on the spine. To compute your body-mass index (BMI), multiply your weight by 700, square your height in inches, and divide the first figure by the second. A desirable BMI is 18.5-24.9. If your BMI is 25 or greater, measure your waist. A waist measurement of 35 inches or more is an indicator of excess visceral fat -- the padding between the abdominal organs -- and an independent risk factor for heart disease and diabetes. If you're shorter than you remembered you may want to talk to your doctor about having a DXA bone measurement. Lost height is often a sign of vertebral compression fractures -- an indicator of osteoporosis.
5 Take heed of your health plan.
Health plans across the nation are cutting costs, reducing benefits, and raising prices. Doctors and hospitals unhappy with the situation are dropping plans from the list of insurers they accept. Pay attention to any correspondence from your plan. It may contain notifi-cation of increased co-payments or reduced coverage for prescriptions or other services. If you are selecting new health coverage, be certain to review all the benefits -- particu-larly those covering prescription drugs -- before you sign. You may also want to consult the archives of your local paper for comparative evalua-tions of the plans available in your region. Also, check with your doctor to be certain he or she accepts the plan you are considering.
6 Teach your daughters well.
Although it is never too late to adopt better health habits, those begun early in life have additional benefits. For example, there is increasing evidence that calcium consumption and weight-bearing exercise during adolescence are major determinants of bone density in middle age. Unfortunately new data indicate that teenage girls are forsaking dairy products for soft drinks. Data also indicate that obesity and a sedentary lifestyle in childhood are predictors of heart disease and diabetes. If you don't think you can convince your teenage of the importance of robust health, try hanging up a few pictures of the U.S. Women's Soccer Team.
7 Take Tea.
Teatime may be more than a genteel alternative to the coffee break, especially if the leaves in the pot (or bag) are green. Observational evidence and laboratory studies indicate green tea contains powerful antioxidants that reduce the risk of cardiovascular disease and cancer. It may also protect the liver from toxins.
8 Log on to the E-vitamin.
Vitamin E has emerged as a powerful antioxidant with a multitude of applications. In clinical trials it has delayed the progression of Alzheimer's disease in some patients. It has been linked with reduced risk of heart disease. It also has been found to relieve hot flashes in perimenopausal and postmenopausal women. And some reports suggest that oil from vitamin E capsules is an effective vaginal lubricant.
In all these instances, the doses used were substantially higher than the recommended dietary allowance of 7 mg a day and far in excess of any amount that can be obtained in food. Although there has been some fear that excess vitamin E intake can cause bleeding, the evidence is limited to one study conducted in people with established clotting disorders. The high dosage probably isn't harmful to most people.
9 Beware the weather.
The Centers for Disease Control and Prevention occasionally reminds us that lives are lost due to unanticipated changes in tem-perature. People have died from the cold in Georgia and Mississippi and from the heat in Chicago. As befit-ting warm-blooded creatures, our organs and tissues perform efficiently only within a certain temperature range: approximately 95 to 105 degrees. When our temperature is outside that range for an extended period, we can become confused, lose consciousness, and eventually exper-ience organ failure. Both hypothermia and hyperthermia occur more frequently among older people, probably because it becomes more difficult to sense changes in temperature as we grow older. Confronting extreme weather means not only taking precautions when going outdoors but also keeping an eye on the thermostat at home.
10 Survey your senses.
Although regular vision and hearing exams aren't specified in federal screening guidelines, they become increasingly important as we age. The primary reason for regular vision exams is to check for glaucoma, which is often asymptomatic until it causes irreversible vision defects. It's also important to identify and correct more subtle losses in vision and hearing. Not only do sharp senses make us better drivers but they also help prevent falls, pedestrian acci-dents, and other mishaps. Moreover, they help us to stay connected to others, which is important in main-taining health.
11 Ask for the odds.
If you're making a treatment decision, especially if there is a lot at stake, you should ask for -- and analyze -- the numbers. For example, an analysis of 47 major studies conducted in breast cancer patients indicates that for women over 50, chemotherapy might not have much of an influence on survival time. It determined that, on average, 69% of women with cancer confined to the breast who had chemotherapy lived for 10 years, as did 67% of those who didn't have chemotherapy. In younger women, the spread was significantly larger -- 78% compared to 71%. Some-times the survival statistics, when evaluated with other considerations such as quality of life during chemotherapy and one's expectations for the future, can become the deciding factor in determining which option to pursue.
12 Track your trans fats.
In a few months we should have a better means of tracking the trans fatty acids we consume. Trans fats -- essentially polyunsaturated fatty acids plus one or more additional hydrogen atoms -- are essentially bad fats posing as good ones. Although the atherogenic nature of trans fats was exposed several years ago, they slid between the labeling cracks until a few months ago. The only way to curtail trans fat intake was to eliminate all foods containing hydrogenized fats -- meaning most packaged snack and bakery products. According to a recently proposed FDA rule, the trans fat content of all prepared foods -- and the percentage of the recommended daily quota that a serving contains -- will be a required listing on nutrition facts labels. Within a few months the guesswork should be over.
13 Stay flexible.
We know that cardiovas-cular exercise --ideally, brisk walking totaling at least three hours a week -- helps prevent heart disease. We also know that weight-bearing exercise reduces the risk of osteoporosis. Yet the value of stretching is often over-looked. Keeping muscles supple not only helps prevent injury from aerobic and strength-training workouts but also improves balance and coordi-nation, thereby reducing the risk of falls. The best thing about flexi-bility training is that it costs nothing, requires no equipment, and can be done in the privacy of your home. Follow the exercises in the May 1995 HWHW or consider taking up yoga or tai chi.
14 Don't mix herbs and drugs.
Herbs have been billed as kinder, gentler alter-natives to pharmaceuticals, and in some cases, that reputation may be deserved. In investigations of ginkgo biloba for Alzheimer's disease, St. John's wort for depression, and black cohosh for hot flashes, the herbal remedies had few side effects. But keep in mind that when an herb is as effective as a drug, it's because that herb is acting like a drug. In fact, such herbs often contain compounds that have a strong chemical resemb-lance to prescription products. As a result, it may not be wise to take herbs while taking prescription drugs that have the same effect. There have been isolated instances of overdoses from taking kava with antianxiety medications and ginkgo with anti-coagulants. If you're taking an herbal preparation and prescription drugs, let your doctor know. Check out all the effects of the herb for yourself by referring to the Physicians' Desk Reference for alter-native medications.
15 Minimize middle age spread.
It's a sad fact of midlife: body composition changes as percentage of fat increases and lean body mass decreases. Numerous investigations have docu-mented an average 2-4 pound weight gain during the perimenopause period, even in women who maintain their previous exercise and eating habits. The cause seems to be a loss of lean body mass, which slows metabolism. Estrogen appears to halt the process somewhat -- the women on HRT in the Postmenopausal Estrogen/Progestin Interventions (PEPI) trial and in a recent Australian investigation tended to gain less weight. Exercise may be more effective than diet because it increases muscle mass, which in turn burns more calories than fat does. If you seem to be gaining weight for no apparent reason, try adding 10 minutes a day to your exercise program without adding any calories to your diet.
16 Give trials a try.
Clinical trials -- studies designed to test the ef-fectiveness of methods to prevent, detect, or treat disease --
are a win-win situation. People in the studies get at minimum, state-of -the-art care and may receive a new treatment that works even better. The public benefits from increased knowledge of what works and what doesn't work in medicine. If you have a life-threatening illness, a chronic condition, or even if you are in the peak of health and are interested in disease prevention, you may find a study for which you qualify. If you're 60 or older or are younger and at increased risk for breast cancer, consider joining the Study of Tamoxifen and Raloxifene, or STAR, trial (1-800-4-CANCER). Check your paper for advertisements of studies or trials in your area.
17 Supplement sunscreen.
The melanoma rate con-tinues to rise along with the rate of sunscreen use. Some studies have even linked sunscreen use with melanoma. The good news is that sunscreen probably doesn't cause melanoma. More likely, people who use sunscreen stay out in the sun longer because they don't burn and, in the process, continue to absorb ultraviolet radiation in areas of the skin that may not be protected. While the lower-level UVB radiation may not deepen the color of the skin, it has a systemic effect of suppressing the immune system. In Australia, where melanoma is a national health problem, canopies have been installed to protect citizens from the sun. U.S. health officials are advising us to try a variant of that approach -- wear large hats and protective clothing.
18 Rehydrate.
In our zeal to find the perfect health foods, we often overlook one of the best -- water. That miraculous union of oxygen and hydrogen is not only vital to cellular processes, but it also keeps the whole organism afloat. It aids digestion, prevents consti-pation, maintains our electrolyte balance, and keeps our skin and other membranes moist. Although there is no minimum daily requirement, 64 ounces a day (about eight 8-ounce glasses) is usually recommended.
19 Pack in the protein.
Like many substances in food, protein has gone in and out of favor. It's back in as the centerpiece of a number of diets. It was once believed that a diet high in protein was hard on the kidneys and that the kidneys had an even harder time processing protein as we aged. However, recent evidence indicates hat there is little dif-ference in the way older and younger women assimilate protein. Although amounts of protein in excess of 85 grams have been associated with kidney problems and reduced calcium absorp-tion, there is no evidence that 45-60 grams (the amount in six ounces of lean fish, chicken, or meat) a day is harmful. One reason protein is assoc-iated with disease risk is that in Western countries, a high-protein diet tends to be a high-fat diet. When you seek protein, look for forms low in fat, particularly saturated fat. Nearly every dairy product comes in a low-fat or nonfat version. Soy and fish are naturally that way.
20 Keep the faith.
One practice that has emerged as healthful is attending religious ser-vices. Several observational studies indicate that people who belong to religious groups of any faith, sect, or denomination tend to be less vulnerable to a host of conditions -- from colds to depression to death. That doesn't mean immortality is the reward of going to services. But it does suggest that during periods in which people were surveyed, the death rate tended to be lower among people in religious congregations than in the population as a whole.
Excerpted from the January 2000 issue of the Harvard Women's Health Watch © 2000 President and Fellows of Harvard College.
Individual subscriptions ($32.00 per year) and bulk subscriptions (reduced rates on 10 or more copies per month) available. Contact the Harvard's Women's Health Watch . P.O. Box 420068, Palm Coast, FL 32142-0068
Emerging Disease
WEST NILE NEAR THE HUDSON The Statue of Liberty has welcomed the world's huddled masses for 113 years, but this August a tropical immigrant had even the most hardened New Yorkers worried: a virus called West Nile viral encephalitis killed seven people, sent dozens to the hospital, and panicked millions more.
The summer drought in the East generally lowered mosquito populations but, ironically, it created ideal conditions for this arriviste virus, which is spread by mosquitoes but is harbored in the blood of birds. Dry conditions concentrated birds and mosquitoes around the same scarce water sources, increasing the proba-bility that a mosquito could feed on infected birds. Disease experts and health officials still haven't figured out how the virus entered the New York City environment.
The big concern now is whether the warm-weather virus will survive this winter by holing up in hibernating mosquitoes or traveling south inside the bodies of migrating birds. This virus could become a permanent feature of North America's urban and suburban disease profile. Dead infected birds have been found in eastern Connecticut, northen New Jersey, and 200 miles north of New York City near Saratoga Springs, though none of the mosquitoes in those areas have tested
positive for the pathogen. New York City health officials have already said they are going to step up aerial spraying for mosquitoes next year, although some experts question how well spraying works against a type of mosquito the generally bites humans indoors.
Inflamed risk
The word encephalitis comes from enkephalos, the Greek word for brain, and means inflammation of the brain. West Nile infections can be relatively mild, causing only moderate fever, headaches, and joint stiffness accom-panied by a rash. These symptoms last about a week and are easily mistaken for the flu or a cold. But when the brain swells significantly, the result can be anything but mild: people become disoriented, have tremors and convulsions, and can even lapse into a coma. Brain damage and death, while uncommon, do occur. The elderly are the most vulnerable. In this outbreak, the youngest person to die was 60. There is no specific cure, though doctors can use steroids to limit brain swelling and prescribe pain relievers for the milder symptoms.
The West Nile virus brings the number of mosquito-borne viral encephalitides (the plural form of encephalitis) found in the United States to six. St. Louis encepha-litis, the most common and widespread, occurs throughout the continental United States, but outbreaks occur most frequently in the Mississippi River region. Approximately 130 cases are reported each year, and at first, health officials thought the West Nile virus was St. Louis encephalitis. Eastern equine encephalitis is the most ferocious. Generally found along the East and Gulf coasts, it is fatal in 50% of the clinical cases and causes moderate to severe brain damage in another 50% of the survivors. Only 53 cases have been reported in the United States since 1964 and outbreaks have been limited to a few cases per year. Health officials closely monitor the types of mosquitoes that carry eastern equine encephalitis.
West Nile virus was first identified in 1937 in the West Nile Province of Uganda, thus its name. Epidemics have occurred in Israel, South Africa, the Rhone delta of France, and Romania. Scientists have attributed recent outbreaks in Europe to migratory birds that picked up the virus while wintering in Africa. A fairly straightforward explanation
for the New York City outbreak is that an infected bird from Europe ended up in the city; its is not unusual for birds to lose their bearings and fly westward across the Atlantic. And the West Nile virus is well suited for that kind of long distance travel; it can live in a bird's internal organs for up to 100 days. It is also possible the virus arrived in infected mosquitoes or in illegally imported pet birds that were infected. An article in the Oct. 18-25, 1999, edition of The New Yorker caused a stir when it reported that the FBI and CIA are investigating the possibility that the virus was set loose as an act of bioterrorism.
Blaming the messenger
Scientists refer to mosquitoes as the Vector of West Nile encephalitis, in the same way the deer tick is the vector for Lyme disease. If the virus is the message, mosquitoes are the messengers. Birds are the pathogen's principal reservoir, which means they function as a kind of safe haven. They stay healthy while also maintaining high enough concentrations of the virus in their blood. Ticks in Africa and the Middle East are also known West Nile vectors, but no infected ticks have been found in the New York area.
Humans, like most mammals, are West Nile hosts, which means the virus can survive in our bodies. But we are a dead end as far as this virus is con-cerned. Even when people are serious-ly sick with the disease, they don't have enough of the virus in their blood to transmit it to a mosquito or tick, or to infect other people. Put another way, the evidence so far is that mosquitoes can spread the disease only by biting infected birds, not by biting infected people.
The northern house mosquito, Culex pipiens, was the species of mosquito primarily responsible for the spread of West Nile virus in the New York City outbreak, though the virus has been found in another species, Aedes vexans. Indistinguishable from other mosquitoes to anyone but experts, Cx. pipiens mosquitoes are found in urban and suburban areas worldwide and thrive in places like storm drains, cesspools, and subway tunnels. Experts disagree about how to classify Cx. pipiens mosquitoes, but one theory is that there are two subspecies, one of which prefers to feed on birds. The other feeds more indiscriminately -- on birds, people, and their pets. (Regardless of the species, female mosquitoes are the only ones that bite. Male mosquitoes live and die without ever feeding on blood.) A hybrid of these two types may supply the bridge that allows the West Nile virus to get from birds and into people.
New York health officials were first alerted to the virus's presence by an unusual number of dead birds, primarily crows. Experts doubt crows are innately more vulnerable to the virus than other birds. They were perhaps just more noticeable. Because these kinds of vector-borne viruses are usually benign stowaways in their reservoirs, it is odd that a West Nile infection would kill a bird. Re-searchers say a genetic difference between the virus in New York and the typical West Nile virus may explain the dead birds.
Fear and loathing
If this West Nile virus does make it through the winter, it is hard to say what the best defense next summer should be. Some experts have ques-tioned whether massive outdoor spraying for mosquitoes makes sense if the target is a mainly indoor bug. The decreased number of West Nile cases occurring after the initiation of aerial spraying in New York City and the distribution 300,000 cans of DEET-based mosquito repellent may have been caused by the coincidental hiber-nation of northern house mosquitoes, not the public health measures. Treating moist breeding habitats with larvae-killing chemicals reduces mos-quito populations, but some have ques-tioned the practicality of doing that in a city as vast as New York. Even recommendations to stay indoors during peak mosquito hours --dawn and dusk -- may be misguided: feeding indoors at night is exactly where you'll find the hybrid northern house mosquito.
Keeping the risk in perspective may be the smartest thing people can do. The New York City Department of Health told city residents this summer that the chances of being bitten by an infected mosquito in the city were 1 in 1,000. Even then, the likelihood that the bite would develop into full-blown disease is low, about 1 in 300. Still, these long odds may not really reflect the true, lasting effect of West Nile virus: an added fear buzzing in our ears.
Excerpted from the December 1999 issue of the Harvard Health Letter © 1999 President and Fellows of Harvard College.
Individual subscriptions ($32.00 per year) and bulk subscriptions (reduced rates on 10 or more copies per month) available. Contact the HARVARD HEALTH LETTER. 164 Longwood Avenue, Boston, MA 02115. 617-432-1485.
Co-Dependency Group
The Group will consist of four (4) weekly sessions beginning 6 p.m. on March 16 and ending on April 6, 2000. Each session will be 90 minutes.
The focus of the group will be to provide a supportive base for members who are experiencing either rela-tionship or interpersonal issues which are affecting their daily lives. If you are interested in attending this group, please contact Lucretia Pope at (212) 815-1250.
SPACE IS LIMITED. (All District Council 37 members are eligible to attend).
Outreach Program offers a Deferred compensation Plan Seminar
Are you aware that as a city employee you are entitled to join the Deferred Compensation Plan? Since pre-tax dollars are put into this plan, you are paying less taxes on your salary as well as planning for your retirement.
The Outreach Program of the Health & Security Plan's Personal Service Unit is organizing a seminar on the Deferred Compensation Plan. A repre-sentative from the Office of Labor Relations will provide an overview of the plan and will be available for questions and answers.
Only union members who are entitled to Health & Security benefits through District Council 37 are eligible to attend this seminar.
If you are interested, please call Linda Bobroff at (212) 815-1250.
All employees and retires of Hunter College, their families and domestic partners may consult with Employee Assistance Program staff. Since its inception, many members of the faculty, administration, and staff have used Employee Assistance Program counseling services and have bene-fited from them.
If a problem troubles you, arrange an appointment with the EAP to determine if we can help. Some common situations that create problems that the EAP may be able to help with include:
an impending change in your life, for example, getting married, becoming a parent, retiring from your job
relationship conflicts
excessive drinking--yours, or that of someone close to you
interpersonal problems on the job
feelings of anxiety or depression
a health-related problem of your own or a member of your family
separation or divorce
worry about children's development or behavior
concerns about aged parents
Call (212)772-4051 or come to RM 1305 in the West Building to make an appointment with a social worker. The hours are from 9:00 am to 5:00 pm. Monday through Friday.