Spring photo credit Francis X Driscoll

Outbreaks & Incidents

Outbreaks and Incidents

  • Zika Virus

    Diagnoses in the United States and in New York State are expected to increase due to travel related infections; however there have been no direct transmissions of the virus in the United States to date.


    What is it?
    Simply, Zika is a mosquito-borne virus that commonly causes mild illness but poses a serious threat to healthy fetal development in pregnant women. It is similar in transmission to West Nile, dengue and yellow fever, but lacks a vaccine or specific treatment. Outside of the United States, thousands of cases of babies born with developmental issues of the brain, namely microcephaly have been documented. In rare cases, paralysis can occur caused by Guillain-Barre syndrome, also associated with Zika virus.

    Where is it?
    Currently, there have been no documented direct transmissions in the United States – those patients that have been seen and diagnosed in the United States are believed to have been infected elsewhere in places like the Caribbean, Brazil and Central America. To keep up to date with the current locations of the virus, click here.

    How do people get infected?
    Zika virus is currently transmitted to humans when bitten by a specific species of mosquito that is not found in New York State and does not survive the Northeastern climate. During the warmer months, there is a possibility for another species of mosquito, located in the southern portion of New York below Orange County, to pass the virus but it is not known whether or not this will actually occur.
    There has also been documented evidence of mother-to-fetus transmission which may occur at any time during pregnancy. For this reason, the CDC has recommended that pregnant women, and women who may become pregnant, avoid traveling to areas where Zika is occurring. For more information on transmission during pregnancy, click here. Studies are currently being done to determine if there are any other ways to transfer the virus. For facts about transmission and risks click here.

    The Centers for Disease Control and Prevention have determined that the Zika virus can be transmitted through sexual contact.  Follow this link for Interim Guidelines for Prevention of Sexual Transmission of Zika Virus.

    Signs and Symptoms
    For most, the virus is generally mild with about 1 in 5 patients experiencing symptoms, meaning many who have been infected will not realize it. Those who do experience symptoms may have:

    • Muscle and/or joint pain
    • Headache
    • Rash
    • Fever
    • Conjunctivitis (red eyes)

    Symptoms may begin anywhere from two to seven days from transmission and last several days to one week. Hospitalization due to symptoms is uncommon and fatalities are rare; however pregnant women are advised to use special precautions and seek medical care immediately as the virus is particularly aggressive toward their unborn child and may lead to poor pregnancy outcomes. Microcephaly has been documented in thousands of births to Zika-infected mothers. Those wishing to become pregnant are being advised to consider delaying conception until 21 days after travel to an affected area.

    How is it prevented?
    There is no Zika-specific treatment at the moment and there is no vaccine. Currently, only the symptoms of Zika virus are being treated and guidance is being formulated on the treatment of pregnant women who have become infected. The most effective preventative measure is to avoid mosquitos in Zika-related areas. To avoid mosquito bites:

    • Wear light colored long sleeves and pants
    • Use mosquito repellent/bug spray
    • Be sure to keep screens in windows and doors in good working order
    • Avoid areas of standing water

    What we are doing
    We are currently monitoring the situation and educating ourselves about the virus to be prepared to address your health-related questions and concerns. We recommend that you use the same precaution that you would to avoid tick and other insect bites. Use an EPA-approved insect repellent when outdoors and keep skin covered as much as possible with clothing. Follow the CDC’s guidance when thinking about your travel plans. Be mindful of the signs and symptoms and always be sure to follow up with your healthcare provider if you have any concern that you may be infected. Tell your healthcare provider about your travel activities.

    At this time, Zika virus has not posed a direct threat to Greene County outside of those traveling to affected countries. The NYS DOH will be testing mosquitos in the lower portions of New York State once the weather becomes warmer to monitor whether or not the virus becomes actively transmitted here.

    To learn more about New York State and Zika Virus, follow along here.

    Find additional resources for care providers

  • Ebola

    Ebola was first identified in 1976 and has been associated with many smaller outbreak incidents throughout Africa and isolated incidents in countries worldwide since. In 2014 the world watched as an outbreak a new strain of Ebola was recognized in West Africa and quickly escalated to become the largest of its kind in recorded history. The countries of Liberia, Sierra Leone and Guinea were the most heavily affected but according to the CDC, patients were also documented in Nigeria, Senegal, Spain, Mali, Italy, the United Kingdom and the United States.

    Being very aggressive, Ebola can spread quickly throughout the body beginning with flu-like symptoms and is often difficult to diagnose. Because of this, and the havoc it wreaks on the body, Ebola has a high mortality rate for which no known cure or approved vaccine exists.

    Recently, through the successes of contact tracing, early identification and improved treatments, the World Health Organization (WHO) and Centers for Disease Control (CDC) have declared the affected countries Ebola-free. While it is no longer a direct threat to our health here, we are still actively monitoring the situation and preparing for the potential of another outbreak.

    What are we doing here in Greene County?
    Here in Greene County, we have been educating ourselves, practicing, preparing equipment, and following guidance provided by the New York State Department of Health (NYSDOH) and CDC to be able to address any possible Ebola-related issues in our area. In addition, we provide guidance and support for area first responders to address the concern for any occupational exposures.

    We regularly conduct drills and exercises, preparing ourselves to monitor a possible Ebola patient by using appropriate personal protective equipment.

    The good news is that even at the height of the Ebola crisis, transmission in the United States was and remains extremely unlikely. Ebola is transmitted person to person by direct contact with blood and other body fluids or through exposure to infected needles and other devices. It is not spread through food or water obtained legally in the United States and is not airborne.

    Simple hygiene practices can help fight nearly all contagious and infectious diseases and/or viruses. Always wash your hands with soap and warm water, scrubbing for at least 20 seconds. Don’t have soap and water available? An alcohol-based hand sanitizer can substitute until you can find a sink. Avoid touching body fluids or items that may have come into contact with the fluids of others without proper protection – this also helps keep you safe from many other communicable diseases such as HIV, AIDS and Hepatitis.

    Commonly Asked Questions:

    What if someone travels here from an Ebola-affected country? How will I be protected?

    Those arriving at airports here in the United States from active Ebola-affected areas go through a health screening process right at the airport. Their temperature and other pertinent data will be collected. Some travelers will have a more in-depth medical evaluation process at this time. Next, the travelers are provided with a CARE kit and have its use explained to them.

    This kit allows the traveler to monitor themselves for symptoms and to be in touch with health department staff when they arrive at their intended destination. The State and Local Health Departments will be notified of the person’s arrival to their region and local health department officials like us will begin actively monitoring and providing guidance to the individual for at least 21 days – the time Ebola typically takes to show signs and symptoms.

    Ebola is only contagious once signs and symptoms are present, so it is safe to interact with this person so long as they are not presenting with any of these issues:

    Fever, Severe Headache, Fatigue, Muscle Pain, Weakness, Diarrhea, Vomiting, Stomach Pain, Unexplained Bleeding or Bruising

    What happens if someone starts showing symptoms?
    In the absence of any acute, potentially life-threatening issues, a person showing signs and symptoms should remain in their home or similar location away from others to avoid exposing non-infected persons. Contact with the health department should be made for further guidance and assistance.

    Once it is determined these signs and symptoms are consistent with Ebola, appropriate transportation to a recognized Ebola treatment facility will be arranged by the local health department. If the person goes to an emergency room or other healthcare facility and are found to have symptoms while there, they will be appropriately isolated within that facility and transportation arranged.

    Once at the Ebola treatment facility, they will undergo a variety of tests to rule out other possible illnesses as well as to diagnose and begin treatment. Staff at the treatment facility have been trained to wear specially designed equipment which, when properly used, will keep them from being exposed to the contagion and thereby eliminate the exposure to others. At this time, we can only treat the symptoms of Ebola and provide supportive care to help improve the patient’s outcome. Even with treatment, mortality rates range from 25-90%.

    Is there a vaccine available?
    There is not yet a recognized vaccine available. Trials are ongoing to test potential Ebola specific treatments as well as vaccines, but none have yet been approved. This is a lengthy process, typically crossing a decade or more, which requires a great amount of testing and monitoring to ensure the safety and effectiveness of the product before being released for public use. To learn more about how vaccines are made, click here

    If there is no vaccine, how do we prevent Ebola?
    Currently in the United States, there is no longer a risk of Ebola present. Through proper isolation of recognized Ebola patients, quarantine and monitoring of suspected patients and contact tracing, we have eradicated those few cases present in the US. Globally, Ebola now presents a minimal threat and all previously affected countries have been declared Ebola free.

    In general, if you choose to travel to an Ebola affected region or one previously affected, practice good hygiene, do not handle body fluids or items that may have come into contact with body fluids, do not participate in funerary rituals that require body handling of someone who may have passed from Ebola, avoid contact with vector species (typically bats and primates) and do not consume their meat, avoid going to medical facilities that may be currently treating Ebola patients and continue to monitor your health for signs and symptoms upon your return for at least 21 days with health department guidance.

    Want to know more aIbout Ebola? Click here

  • Influenza

    Stay up-to-date on CDC flu surveillance.

    It can be difficult to separate fact from fiction when deciding on whether or not to be vaccinated against influenza, commonly known as the flu or bug. Sudden high fever, chills, body aches, joint pain, sore throat with a dry cough, headache and other symptoms can all come from the flu leading to extreme fatigue, dehydration and in some cases death. Flu symptoms can also be similar to those of other, possibly more serious illnesses and diseases so you should always see your doctor or seek immediate medical attention if symptoms worsen or do not subside.

    Did you know in 1918, more people died of influenza than in all of World War I?

    While there are recognized flu seasons, you can become sick with the virus at any time of the year and should take steps to protect your health every day. The flu is very contagious and certain populations of individuals are more at risk than others for serious complications. The CDC and NYSDOH recommend that everyone six months of age and older receive an annual flu vaccine.

    Throughout the year – you can protect yourself by:

    • Wash your hands often and keep an alcohol-based hand sanitizer with you to use when a sink isn’t available
    • Avoid touching your face, nose or mouth
    • Sneeze and cough into your elbow – not your hands
    • Stay home when you’re sick and avoid others who may be ill
    • Get the flu shot!

    Many people choose not to vaccinate themselves because they believe the flu shot will make them sick with the flu – this isn’t true! While it is possible to experience side effects of the flu shot such as achiness at the injection site and other minor symptoms, you are NOT sick with flu. To learn more about the seriousness of influenza, click here.

    Looking for flu shots? Contact us – we provide flu vaccines here in our offices throughout the year and also at our scheduled flu clinics around the county. The cost of the flu vaccine is $44.50 and the Pneumovax vaccine is $96.

    Greene County Public Health accepts the following forms of payment: cash, personal checks, credit cards, CDPHP, EmpirePlan (NYSHIP), Blue Shield of Northeastern NY, Senior Blue, regular (non-managed) Medicare and Medicaid HMO’s: CDPHP & Fidelis.Check back here for our 2016 clinic schedule.

    What You Should Know for the 2015-2016 Flu Season

  • Foodborne Illness

    Foodborne Illness, commonly referred to as Food Poisoning, is caused by consuming food contaminated with bacteria, viruses, parasites or toxins which can be present in undercooked or improperly prepared food. It is unfortunately common – but the good news is that it is also preventable.

    Did you know that bacteria, viruses, parasites and toxins can even be present in the things we drink?
    Water and other beverages can be contaminated with E. coli, giardia, legionella and more. For more information on water-related disease and contaminants visit this site.

    How can we prevent it?
    Safe food handling, proper cooking, and obtaining ingredients from reputable sources can all help combat foodborne illness and can even help prevent an outbreak.

    Always check expiration dates on purchased items and wash your hands prior to any food preparation. Separate your food and use separate cutting boards and utensils during preparation to avoid cross contamination. Always cook food to the recommended temperatures – just check the packaging. Promptly refrigerate any leftovers. Never leave food out for more than two hours.

    Be sure to see our Power Outage page on information for keeping your food safe when the lights go out.

    Signs and Symptoms
    Most foodborne illnesses are generally mild and consist of symptoms such as diarrhea, abdominal pain, vomiting and nausea. Moderate to severe cases can include chills, cramping, dehydration, dizziness, fever, lethargy, weakness and/or sweating.

    Think you may have a foodborne illness? Here’s what you do –
    First, ensure you are staying hydrated and always seek medical attention if symptoms become worse or do not subside. Drink plenty of fluids – avoid foods and drinks which may cause further stomach or bowel irritation until you are feeling better.

    If you believe you were made ill by food purchased at a grocery store, served at a restaurant or other public place, call the Oneonta District Environmental Health Office at 1-607-432-3911 or contact us using the information provided below. You may not be the only one affected, and your information can help! Someone is available to assist you 24/7.

  • Rabies

    While wildlife and other animals can be beautiful and enticing to touch, they are best left alone for many reasons.  One important reason is that the animal may be carrying rabies – a highly dangerous virus that could be deadly if left untreated.  The good news is that rabies is vaccine preventable for both you and your pets.

    How do humans and animals become infected?

    People and pets become infected through the bites of infected wildlife.  Pets may fight with or kill infected wildlife – becoming infected in the process.  Humans may receive the virus by interacting with their infected pet, or through the bite of infected wildlife.  Bats are the most common source of infection in humans.  The virus is transferred through the infected animal’s saliva.

    What are the signs of rabies?

    You can recognize signs of rabies by watching for a change in what would be a normal animal behavior.  With your own pets, they may become more excitable or more calm and sleepy than usual, have a glassy stare, change in eating and/or drinking habits, excessive drooling, showing new aggression, and eventually weakness and death.

    What animals get rabies?

    All mammals can become infected and spread rabies, but some are more likely than others.  Foxes, bats, skunks, and raccoons are the most common wildlife exhibiting rabies while cats are the most common domesticated animal diagnosed with rabies in New York State according to the NYS Department of Health.  Animals less likely to get rabies include rabbits, squirrels, chipmunks, rats, mice, and other small rodents.  Lizards, snakes, frogs, birds, fish and insects do not get or carry rabies.

    How do I protect myself and my pets?

    For people:  Stay away from wildlife and unfamiliar or stray dogs and cats.  Never attempt to feed, handle or capture them.  Remind children of the same and to tell an adult immediately if they see a strange animal while outside.  If you see wildlife on your property, let it wander away on its own.  Bring children and pets indoors until the animal is gone.

    For pets:  Get your pet vaccinated!  Check out our vaccination schedule here to see where the next clinic will be located.  If your pet is bitten by a potentially rabid animal or if your animal returns to your home injured from an unknown source, contact your veterinarian to get them medical care.  Even if your pet is vaccinated, they may require a booster dose.  Never let your pets roam unattended and keep pets indoors at night.

    What if I am bitten by an unfamiliar animal or wildlife?

    Wash the injury with soap and water thoroughly and seek medical attention – if severe or bleeding is uncontrolled, dial 911 immediately.   Report all bites to us by calling 518-719-3600 – even if the bite was only minor.  If afterhours or a weekend, contact Greene County Dispatch by calling 518-622-3344 and asking for the Public Health On Call Supervisor.  We will assist you and your physician in deciding appropriate treatment.  Try to keep track of the animal that bit you – but safely!  If possible, observe the animal from a distance and report this information to us.  We can assist in capturing the animal safely so that it can be tested.

    If bitten by a domestic animal that is otherwise healthy, the animal’s owner will be contacted and given instructions for confining and observing the animal for a determined amount of time.  If the animal remains healthy throughout confinement, it did not transfer rabies.

    For more information on rabies at the Center for Disease Control Website and the NY Health Department Website,

  • Chlamydia

    Chlamydia is the most common sexually transmitted bacterial infection. The Center for Disease Control and the New York State Health Department report it is the number one communicable disease reported.

    Where does Chlamydia infect you?

    • It is found in vaginal secretions in women and semen in men.
    • Both men and women can become infected with Chlamydia in their throats and rectum.


    What are the Symptoms?

    In half of all cases there are no symptoms

    • Symptoms in women include vaginal discharge, pain with sex, burning with urination or irregular spotting/bleeding
    • Symptoms in men include penile discharge and pain with urination, and uncommonly pain in the scrotum or testis
    • Chlamydia infections in the throat or rectum often have few if any symptoms


    What is the Risk?

    • Chlamydia does not discriminate by income or social status
    • A person acquires Chlamydia by having sex with someone who is infected.
    • There is a 7-14 day period after exposure before a person who has been exposed tests positive.
    • A person who has Chlamydia once can easily become infected again if re-exposed.
    • Infected Mothers can pass Chlamydia to their newborns during birth

    Untreated Chlamydia in women can cause a pelvic infection known as (PID), which can lead to permanent infertility and greater risk of a tubal pregnancy. In men it can lead to epididymitis.


    How do you protect yourself from infection?

    • The only 100% way to prevent getting Chlamydia is to be abstinent and not have sex
    • The second best way is to use a male or female condom with every act of sex
    • The third best way is to  get screened and tested with your partner and make sure both are negative before having sex


    How often should people be tested for Chlamydia?

    • Sexually active women aged 25 and under should get tested every year
    • Women and men at increased risk because of multiple partners, and men who have sex with men should also be tested routinely.


    What’s involved in the Screening Test?

    • Men and women can easily be screened by a urine sample. It is most accurate if you have waited at least one hour since your last void
    • A swab test of your throat or anus will detect Chlamydia infection if you are at risk (ask your provider to let you self collect your own rectal swab since research shows this is more accurate).
    • Women can also be screened with a vaginal swab.


    What’s the Treatment?

    • Chlamydia is easily treated with one dose of the antibiotic Zithromax. (If you are allergic you will be prescribed doxycycline twice a day for 7 days.)
    • Your partner(s ) will also need to be treated
    • The CDC recommends any and all partners in the past 60 days be treated whether or not they test positive for Chlamydia
    • You must wait to have sex for 7 days so you do not re-infect each other

    New York State permits your provider to give you a script or medicine to treat your partner (s) for Chlamydia if you know your partner won’t get treated. This program is called Expedited Partner Therapy.

    Three months after treatment it is recommended that you get retested to make sure your infection has resolved

    If you are positive for Chlamydia we recommend that you be tested for other STD’s and HIV



    Heymann, D. (2004) Control of Communicable Disease Manual 18th Edition, American Public Health Association.

    MMWR (2015) Sexually Transmitted Diseases Treatment Guidelines, 64 (3) US department of Health and Human Services, Centers for Disease Control and Prevention.

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