The Cedars-Sinai Health Forecast keeps you current on illnesses and other health challenges affecting our community. Medical experts share what’s on their radar—and what should be on ours—as summer winds down and we get ready to welcome fall.

During the dog days of summer, sweltering heat escalates mosquito hatching. More mosquitos mean there is a higher risk that one of the insects might be carrying West Nile virus.

Most people who contract West Nile virus are either asymptomatic or only have mild, flu-like symptoms and will recover on their own. But a small percentage of infected people will be hospitalized, and the disease can be life-threatening. Enjoy evening outdoor barbecues with caution and take steps to avoid bites.

Protect yourself: "West Nile is present year-round in Los Angeles, and we typically see a spike in cases as summer draws to a close," said Michael Ben-Aderet, MD, an infectious diseases specialist and associate medical director of Hospital Epidemiology at Cedars-Sinai. "There’s no treatment for this virus, so the emphasis in the healthcare community is on prevention. Cover up as much as possible, and use DEET on exposed areas of the body."

End-of-summer heat can put some people at greater risk for kidney stones. The reason, noted Laura Simpler, MD, a general internal medicine provider with the 24/7 Cedars-Sinai Connect service, is the dehydrating effects of the later summer months.

An estimated 10% of people in the U.S. will have a kidney stone at some point, and the risk is higher for men than for women. Symptoms include sharp pain in the side or lower back and severe discomfort during urination. Concerns about kidney stones can be addressed by your doctor or at urgent care.

Helpful hydration: “One of the best ways to avoid kidney stones is to maintain good hydration,” Simpler said. “Maximize water intake and avoid coffee, tea and sugary beverages.”

Measles cases in the U.S. have recently hit a record high, despite the disease having been declared eliminated in 2000 by the U.S. Centers for Disease Control and Prevention. Stopping new infections will rely on encouraging as many people as possible to get the measles vaccine.

Vaccinate to prevent: "Measles is a completely preventable disease, but the outbreak we’re seeing is still not under control," said Jonathan Grein, MD, director of Hospital Epidemiology and infection-control officer for Cedars-Sinai. "Measles is many times more infectious than [the virus that causes] COVID-19, and we need to see about 95% vaccine uptake for herd immunity to prevent community spread. That’s the way to stop transmission, and I would urge everyone who is eligible to get vaccinated as soon as possible."
 

After months of summer recess, school-aged kids and teens will be reassembling for the academic year ahead. In addition to recommending that every youth be up to date with appropriate vaccines, Simpler emphasized the importance of common-sense self-care.

Teach hand hygiene: "When young people gather in enclosed, poorly ventilated spaces, there’s a risk they will be spreading viruses back and forth," she said. "Hand hygiene is key: Remind kids and teens to wash up frequently and to try to avoid touching their faces. These basic things can make a huge difference in terms of staying well."

Back to school can also be prime time for bicycle injuries, as kids throw their book bags in their front baskets and set out for campuses near and far. Cyclists should pay close attention to road signs and traffic—and they should also take extra precautions when it comes to putting on appropriate gear.

"Helmets, helmets, helmets—I can’t push on that enough," said Sam Torbati, MD, co-chair of the Department of Emergency Medicine at Cedars-Sinai and the Levin/Gordon Chair in Emergency Medicine in honor of Joel M. Geiderman, MD. “If kids are riding their bikes to schools, I urge parents to talk to them about helmet safety. There’s nothing easy about treating head injuries, so prevention is the name of the game.”

Flu season arrives like clockwork every year in September and runs through March. Vaccines designed to address the current strain of the virus are usually available by late August.

Seek the shot: "Getting the shot earlier is better," said Sarah Allen, MD, a general internal medicine doctor at Cedars-Sinai. "The goal is to be protected when the virus starts spreading. If we get ahead of the curve, we can hopefully start to make a dent in transmission."

Hepatitis A

Recently, for the first time, the L.A. County Department of Public Health recommended that all residents get the hepatitis A vaccine.

Over the past year or so, Los Angeles County has seen a rise in the incidence of non-travel-associated hepatitis A, notching close to 200 cases and several related deaths. Unlike hepatitis B and hepatitis C, which are bloodborne, hepatitis A is shed in infected people’s stool. “It spreads easily in unsanitary conditions, which is why in places like restaurants, food handlers are required to be diligent about washing their hands,” Grein said.

Scheduling Routine Care

With the new year just months away and insurance deductibles nearly met, people commonly schedule routine checkups in the fall. “Now is a great time to have your annual physical and make sure you’re not behind on checkups like mammograms, colonoscopies and pap smears,” Allen said. “Doctors are always happy to check in with patients to make sure they’re feeling well.”