Category Archives: infections, vaccination, and hygiene

an open Bible next to a world globe

Why we should love our neighbor

Mark 12:32-34 New International Version (NIV)

 “Well said, teacher,” the man replied. “You are right in saying that God is one and there is no other but him.

To love him with all your heart, with all your understanding and with all your strength, and to love your neighbor as yourself is more important than all burnt offerings and sacrifices.”

 When Jesus saw that he had answered wisely, he said to him, 

“You are not far from the kingdom of God.” 

And from then on no one dared ask him any more questions.

New International Version (NIV)Holy Bible, New International Version®, NIV® Copyright ©1973, 1978, 1984, 2011 by Biblica, Inc.® Used by permission. All rights reserved worldwide.

FAITH, HOPE, LOVE in wooden block letters

Faith Hope and Love, graphic from the Lightstock.com collection

 Dr. Kent Brantly, missionary physician to Liberia

Dr. Kent Brantly awoke feeling ill- muscle aches, fever, sore throat, headache and nausea. As his condition progressively worsened to include difficulty breathing, he learned the cause of his illness- the Ebola virus.

Having spent the past few weeks caring for patients caught up in the Ebola epidemic that swept Liberia in the spring of 2014, Dr. Brantly had contracted the disease himself, and would likely die, as almost all victims do.

Dr. Brantly, a graduate of Indiana University’s School of Medicine, had volunteered to work at ELWA Hospital in Liberia which was receiving aid from Samaritan’s Purse, an international relief organization. This hospital served as Monrovia’s Ebola treatment center and Dr. Brantly headed the unit.

As his condition deteriorated, his physicians decided his only hope for recovery was use of an experimental drug, ZMapp, previously untested on humans. Since otherwise he was likely to die, he received the drug by infusion into a vein.

By the next morning he felt well enough to arise from bed and shower. Unknown to him, thousands of people around the world had been praying for him.

During this time his colleague, nurse Nancy Writebol, was battling her own Ebola infection. She also was treated with ZMapp.

Samaritan’s Purse arranged for both of them to be evacuated to the United States. There, they could continue receiving supportive medical care, as well as allow infectious disease specialists to learn from their conditions. It also would relieve the workload on the doctors who continued to care for Ebola patients at ELWA.

Dr. Brantly and his wife Amber, who had just left Liberia to return home for a visit, wrote a book about their experience,

Called for Life: How Loving Our Neighbor Led Us into the Heart of the Ebola Epidemic.

I hope you enjoyed these words of faith, hope, and love; please share and follow watercress words as we explore the HEART of health.

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Dr. Aletha 

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a woman taking her temperature

6 tips to cope during a flu epidemic

In the United States we are in the midst of a brutal influenza epidemic that is sickening thousands of people , hospitalizing hundreds, and may  kill a hundred children. As scary as that sounds, there is no need to panic. 6 tips to cope during an influenza epidemic

 

Even those who get the flu will likely fully recover. Children are still more likely to die from a motor vehicle accident than influenza. But parents should still be vigilant about protecting their families.

Here is a repeat of information I’ve shared before. Due to the enormous number of flu cases I’ve been treating in my clinic, I get home late and am exhausted. I will have some new content developed when this is over, which should be soon.

 

 

 

  1. If you think you have “the flu”, you probably don’t. (This season may be an exception.) 

Another doctor posted on Twitter , “If you feel like you’ve been run over by a truck, but you haven’t , then you have the flu.”

To many people “the flu” is any respiratory illness characterized by some combination of fever, cough, congestion, headache, fatigue,  and body aches. That term has become so nonspecific even we doctors use it that way. But it more correctly refers to influenza, which is  one of many viruses that cause illness. The illnesses caused by the other viruses are usually called “colds”, upper respiratory infections, aka URIs, bronchitis, pharyngitis, sinusitis and pneumonia.

I recommend this resource  from the Centers for Disease Control and Prevention to understand

influenza symptoms 

emergency warning symptoms that warrant an emergency room visit 

influenza complications 

 

 

 

The human respiratory system

The respiratory tract including the nose, sinuses, mouth, throat, trachea, bronchi in blue and the lungs (pink). Infections can involve the breathing organs from the nose all the way down to the lungs. (photo complimentary from Pixabay)

  1. If your doctor thinks you have “the flu”, you probably do.

Prior to the availability of the “rapid flu” test, we doctors diagnosed influenza by the characteristic symptoms, confirmatory findings on exam, and knowing there was an outbreak in the community. The test is not absolutely necessary but is helpful for confirmation in the event the illness doesn’t progress as expected.

3. The best way to prevent influenza is by vaccination.

The World Health Organization (WHO), Centers for Disease Control and Prevention(CDC) , the National Foundation for Infectious Disease and every other reputable medical organization recommends vaccination against influenza.

My family and I always get vaccinations which have successfully protected us without side effects or adverse reactions. There are risks, just like there are with any medical procedure, or lots of other things we do in life. In this case we have decided the benefit outweighs the risk.

 

  1. If you want to avoid getting influenza, avoid being around people who may be infected.

This means everyone, since one may be contagious 2 to 3 days before symptoms. It’s not a coincidence that influenza outbreaks coincide with the American holiday season (approximately November through January). So to protect us all,

  • Stay home if you are sick, and ask your family, co-workers and employees to do the same.
  • If you absolutely must go out among other people, put a mask over your nose and mouth.
  • Cover your nose and mouth when coughing or sneezing
  • Wash your hands frequently.
  • Wash frequently touched surfaces frequently.
Hand hygiene saves lives.

a common sight now in public restrooms

  1. If you do get sick, don’t ask your doctor for an antibiotic.It will not help. 

    Antibiotics attack bacteria. Influenza and 99% of all respiratory illnesses are due to viruses.

The antiviral drug Tamiflu, generic oseltamivir,  will “shorten the duration and severity of symptoms” by 1-2 days, if started early (within 24-48 hours). There is some evidence that it will also lessen the risk of serious complications , especially in higher risk people (see below ).

I warn people that even with Tamiflu they will still feel miserable for a few days. But if it gets you back to school or work a day earlier, it may be worth the cost.

Oseltamivir can also be prescribed for prevention, if you know you have had close contact with someone with confirmed influenza, such as a household member. It’s only effective though for that episode, a 10 day course taken as soon as possible after exposure.

Otherwise, the treatment is“symptomatic” or “supportive” care:

  • Rest; eat and drink as normally as possible; extra fluids if running a fever 
  • Non-prescription cough/congestion /pain/fever meds

 

Don’t confuse Tamiflu (generic oseltamivir) a prescription anti-viral drug with Theraflu, an over the counter drug that treats symptoms.

Theraflu does not affect the course of the illness.

 

Here are  general guidelines  on what to do if you get a respiratory illness.

  1. You can die from influenza, but you probably won’t.

Influenza causes uncomfortable disabling symptoms but most people recover fairly quickly and fully. In some cases influenza can progress rapidly and overwhelm the respiratory and/or nervous systems,  leading to death.

People also die from complications of influenza, and infants, young children and the elderly have greatest risk.The most common fatal complication is bacterial pneumonia, infection in the lung. Influenza can also attack the nervous system causing brain inflammation (encephalitis and/or meningitis) and paralysis in the form of Guillain Barre syndrome .

an xray of healthy lungs with no signs of pneumonia.

Healthy lungs with no signs of pneumonia.

 

 

High risk persons- use caution when dealing with influenza

Persons with chronic illnesses like diabetes, lung disorders, chronic liver or kidney disease, depressed immune systems and cancer , as well as infants and persons of advanced age are at greater risk of complications and should always consult a physician if feeling ill. If you are not sure if you fall into that category, ask your doctor.

 

Please share this important information , you may save someone’s life.

Thanks and stay well.

                                                                    Dr. Aletha 26952564_10213093560871954_4239554644472378905_o

a man taking his temperature

How you can cope with winter illness

Where I live we recently had our first freeze of the winter. It gets dark earlier now since we “fell back” to standard time. And we’ve already had our first reported cases of influenza, which I reviewed in a previous post.

Chances are you or someone close to you will have a respiratory illness this winter , illnesses we frequently just lump into the category of “colds and flu”.  This usually means illnesses with some combination of these symptoms-

  • Sneezing, stuffy  or runny nose,
  • coughing
  • sore throat, hoarseness
  • ear pain, fullness
  • fever,
  • body aches, fatigue, 
  • nausea, vomiting, diarrhea 
  • headache.

We call these by various names but they have much in common, including symptoms and treatment. Let’s talk about what you can do to cope when they hit your family.

diagram of the nose and sinuses

Winter illnesses commonly affect the nose, throat, sinuses, ears and lungs.

Don’t panic.

Most otherwise healthy people recover from common respiratory illnesses. You may be miserable for several days, and need several weeks to feel back to normal, but you won’t suffer any permanent harm.

Fever ,especially in children, alarms parents. Don’t ignore it but don’t panic either. Reading this post should help you keep calm about fever .

a woman taking her temperature

This photograph depicted a woman who was using a modern, battery-powered oral thermometer, in order to measure her body temperature. In order to return an accurate reading, this particular type of thermometer needed to be placed beneath the user’s tongue, for a set amount of time, beeping when the ambient, sublingual temperature was reached. Photo credit-James Gathany, CDC, public domain

Some  people are at risk of developing  severe symptoms and serious complications from respiratory illnesses, so seek medical help sooner, rather than later. These include

  • Infants, especially under one month old
  • Elderly,  now a relative term, advanced age, especially combined with chronic disease
  • Those with chronic lung disease, like asthma, COPD, emphysema, cystic fibrosis
  • People on drugs that suppress the immune system
  • Other chronic diseases – diabetes, liver disease, kidney disease, heart disease, cancer 

If you are not sure if you fit into one of these categories, ask your doctor.

Check here for tips on

the difference between a cold (acute rhino-sinusitis) and flu (influenza)

rhinoceros

“Rhino” obviously means NOSE.

What you need to know about influenza. 

Stay home.

This is when you shouldn’t share- germs that is. These illnesses spread person to person, so minimize contact.

Keep your kids home from school and stay home from work, at least the first few days, when you are  the most contagious. When  there is widespread illness in your community, avoid crowds and public gatherings.

Resting, getting extra sleep, drinking fluids and staying warm and dry  make staying at home therapeutic.

Wash hands.

Speaking of person to person contact, the best way to avoid getting or giving germs is to wash your hands often, but especially after being with others ,using a restroom,  and before cooking or eating. Cleaning household surfaces helps too, as well as clothing and linens. Don’t forget to clean your cell phone, tablets, and keyboards too. 

Hand hygiene saves lives.

a common sight now in public restrooms

Use medication wisely.

Some of these illnesses have a specific medication that clear it faster- strep throat, influenza, pneumonia. The others will “run their course” and meds are used to help relieve symptoms.

Many people assume that any illness with fever, sore throat and cough will improve with an antibiotic. The fact is, most will not. Antibiotics only treat infections caused by bacteria, and most of these are caused by viruses. To learn more read about

How to navigate the antibiotic highway 

These illnesses cause the greatest overuse of antibiotics, contribute to the cost of health care, and the development of antibiotic resistance. Please do not insist on an antibiotic if the doctor says you don’t need it; if offered an antibiotic, ask why.

6 smart facts about antibiotic use

Does nasal drainage and congestion need treatment with an antibiotic?

Maybe not. Learn how to sort out sinusitis.

WebMD offers this advice on choosing non-prescription cold remedies

 Be patient

The “24 hour virus” is for the most part a myth. Expect to be ill anywhere from 3 to 10 days; some symptoms, especially cough, can linger for weeks. If you are a smoker, this is a great time to quit. 

But if after 7-10 days you are getting progressively worse, instead of better, something more may be going on, so it’s wise to seek professional medical help.

 

 

I would love for you to share this  information (but not our germs) on your social media pages.

And follow Watercress Words for more information, instruction, and inspiration to help you explore the HEART of HEALTH .

 

My favorite home remedy for a cold is a warm cup of tea,

it always makes me feel better.

White House China teacup

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Hand hygiene saves lives.

6 things you need to know to get through the flu season

As I write this, the World Series of baseball has just concluded, football games dominate the weekends, and basketball is getting started. Another season is also looming- the influenza-flu season.

This is usually the busiest time of the year in physician offices, urgent care clinics, emergency rooms and hospitals. This information may make this season easier for you and for your doctor.

1. If you think you have the “flu”, you probably don’t.

To many people “the flu” is any respiratory illness characterized by  fever, cough, congestion, fatigue and aches. That term has become so nonspecific even we doctors use it that way. But flu should refer  to influenza,  one of many viruses that cause respiratory illness.

The other viral respiratory illnesses  are

  • rhinosinusitis, aka “colds”, upper respiratory infections-URIs,
  • bronchitis,
  • pharyngitis,
  • pneumonia.
The human respiratory system

The respiratory tract including the nose, sinuses, mouth, throat, trachea, bronchi in blue and the lungs (pink). Infections can involve the breathing organs from the nose all the way down to the lungs. (photo complimentary from Pixabay

  1. If your doctor thinks you have “the flu”, you probably do.

Prior to the  “rapid flu” test, we doctors diagnosed influenza by the characteristic symptoms,  exam, and knowing there was an outbreak in the community. The test is helpful for confirmation but not absolutely necessary, but  patients have come to expect it now.

3. The best way to prevent influenza is by vaccination.

The World Health Organization (WHO), Centers for Disease Control and Prevention(CDC) ,the National Foundation for Infectious Disease and  other reputable medical organizations recommend vaccination against influenza.

People refuse vaccination because they believe it is ineffective, unnecessary, dangerous, toxic, unnatural, subversive, and who knows what else.  I don’t think I or anyone else are going to change their minds.

My family and I always get vaccinations which have successfully protected us without side effects or adverse reactions. There are risks, just like there are with any medical procedure, or lots of other things we do in life. In this case we have decided the benefit outweighs the risk.

If you don’t want a “flu shot”, just say no. Your doctor doesn’t need or want to hear a speech; we’ve already heard them all.

  1. If you want to avoid getting influenza, avoid being around people who may be infected.

This means everyone, since one may be contagious 2 to 3 days before symptoms. It’s not a coincidence that influenza outbreaks coincide with the American holiday season (approximately November through January). So to protect us all,

  • Stay home if you are sick, and ask your family, co-workers and employees to do the same.
  • Cover your nose and mouth when coughing or sneezing
  • Wash your hands frequently.
  • Wash frequently touched surfaces frequently.
Hand hygiene saves lives.

a common sight now in public restrooms

  1. If you do get sick, don’t ask your doctor for an antibiotic.It will not help. 

    Antibiotics attack bacteria. Influenza and 99% of all respiratory illnesses are due to viruses.

There are 3 antiviral drugs that will “shorten the duration and severity of symptoms” by 1-2 days, if started early. The effectiveness is uncertain for an illness that will resolve within 10-14 days regardless. But if it gets you back to school or work a day earlier, it may be worth the cost-they are not cheap drugs.

Otherwise, the treatment is“symptomatic” or “supportive” care:

  • Rest; eat and drink as normally as possible; extra fluids if running a fever 
  • Non-prescription cough/congestion /pain/fever meds

Acetaminophen for aches and fever

Lozenges for sore throat, cough, and congestion

Breathing moist air with the use of a humidifier  helps with cough and congestion

(the previous are affiliate links. )

  1. You can die from influenza, but you probably won’t.

People die from complications of influenza, and infants, young children and the elderly have greatest risk.The most common fatal complication is bacterial pneumonia, infection in the lung. Influenza can also attack the nervous system causing brain inflammation (encephalitis and/or meningitis) and paralysis in the form of Guillain Barre syndrome .

an xray of healthy lungs with no signs of pneumonia.

Healthy lungs with no signs of pneumonia.

Persons with chronic illnesses like diabetes, lung disorders, depressed immune systems and cancer are at greater risk of complications and should always consult a physician if feeling ill. If you are not sure if you fall into that category, ask your doctor.

Influenza is a disease to take seriously; consider my suggestions, talk to your doctor, and stay healthy this season.

 

Please share this post and follow  Watercress Words  for more information, instruction, and inspiration about common medical problems.

Here are some previous posts about infections .

Get Smart About Antibiotics

“Most common infections, such as colds, flu, most sore throats, bronchitis, and many sinus and ear infections, are caused by viruses and do not respond to antibiotic treatment. “

6 smart facts about antibiotics

“You may think of antibiotics as safe, harmless drugs with no potential for serious effects.  Usually antibiotics are well tolerated and safe. But serious side effects are possible, though infrequent.”

Sorting out sinusitis

“If you have a bacterial sinus infection with more than mild symptoms, an antibiotic may relieve symptoms and help you recover sooner. “

young women walking on a beach

Don’t drink the water- how to avoid water related disease

 

You’ve probably heard the advice “Don’t drink the water” when you travel to less developed areas of the world. But water can make you sick even without drinking it.

Bacteria and other disease causing organisms can be transmitted by swimming and other water related sports

  • in private and public pools
  • recreational freshwater and oceans
  • hot tubs, splash pads, water parks
  • decorative fountains

Drinking, inhaling, and direct contact with water contaminated with a variety of bugs can cause a wide range of illness, most of which is preventable. Here is an overview of common conditions to watch out for.

Drowning-

The most serious risk of water is drowning or near drowning, with 3,300 deaths and another 5,000 hospitalizations annually in the United States.

Children are especially at risk of drowning. Teaching children to swim as early as practical and supervising them around pools and other bodies of water are critical to prevention.

Drowning Prevention

caution signs at a swimming pool.

Drowning can be prevented by following rules.

Gastrointestinal (stomach and intestines) illness-

Symptoms

Nausea, vomiting, diarrhea, cramps, fever

Causes

stream with a kayak

Water in creeks, streams, and rivers is not safe to swallow.

Respiratory (nose, throat, lungs) illness

Symptoms-cough, nasal/sinus congestion,ear pain/fullness,fever

Swimmer’s Ear

Causes-

  • pool chemicals
  • Legionella and other bacteria

rapids in a stream

Skin conditions

Symptoms– rash, redness, itching, burning

Causes –

Most of these conditions resolve without treatment, or are treatable with appropriate antibiotics.

two people dangling their legs into a pool.

Don’t let water related illness spoil your summer fun. photo from stock photo site- Lightstock.com- affiliate link

Serious but rare

Primary amebic meningoencephalitis is a rare but deadly sinus-related infection caused by Naegleria fowleri in freshwater and soil 

Leptospirosis is another brain infection caused by a group of spirochetes known collectively as leptospires. It also is infrequent.

How to prevent infection

  1. Water used for recreation should not be drunk ,even if treated with chlorine.
  2. Children younger than five years should not use hot tubs.
  3. Persons with diarrhea or recent diarrhea infection should not swim for one week after symptoms have cleared.
  4. Swimmers should shower before using a hot tub or pool.
  5. Don’t swim with open wounds, or use waterproof bandage if you do. .
  6. Learn more and get more tips on staying well at these links from

drawing of a child standing on a diving board at a pool

from the American Academy of Family Physicians

from American Family Physician

Waterborne Illnesses

Safe Surfing

Sea Creature Injuries and Fish Poisoning

And from the Smithsonian , get more detail about

8 diseases to watch out for at the beach 

 

 

 

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Please share this post and follow Watercress Words for more information and inspiration for your healthcare journey.

Thanks for exploring the HEART of health with me.

                      Dr. Aletha       WATERCRESSWORDS.COM-exploring the HEART of health

5 insect repellents to keep you safe this summer

The cold and flu season is done, but that means the bugs and bites season is starting. Depending on where you live and what you do, you may be at risk of getting bitten or stung by a variety of insects, especially during the summer months. Continue reading

The word "Read" written in black paint on a colorful watercolor washed background.

Pandemic- a book review

Pandemic by Sonia Shah

a review

 

Genre-non-fiction, science, medical, history, politics, geography, sociology, international relations

 

Sonia Shah is a science journalist, not a scientist or physician, who has built a career  writing about medical science. She explains the “what”  of her book in the subtitle-

 

Tracking contagions from cholera, to Ebola, and beyond

 

And she answers the “why” in the introduction-

 

“By telling the stories of new pathogens through the lens of a historical pandemic, I could show both how new pathogens emerge and spread, and how a pathogen that had used the same pathways had already caused a pandemic.”

 

Pandemic by Sonia Shah

 

 

 

Let me back up and define some terms.

 

Pathogen– any disease producing agent, but especially referring to a living  microscopic organism, such as a virus, bacteria, or  parasite; this includes the organisms that cause Lyme disease, Ebola, West Nile, HIV, bird flu, even the common cold

 

Pandemic– a disease outbreak that spreads throughout a country, continent, or the world, as opposed to an epidemic, which is localized.

 

map of the world

In a pandemic, an infectious disease may spread all around the world.

 

 

 

With current focus on chronic diseases like heart disease, diabetes, cancer, and dementia, even I as a physician can get lulled into thinking that infectious disease has been conquered and no long a serious medical threat. This book reminded me that is not the case.

 

Ms. Shah recounts the history of cholera, which has caused epidemics on every continent except Antarctica, focussing on the epidemics which devastated London, New York City, and more recently Haiti.

 

Cholera is little known in the United States now, but in the past it has been deadly both here and throughout the world. Cholera, an infection due to a bacteria Vibrio cholerae causes severe uncontrollable diarrhea which quickly renders its victims helpless, dehydrated and critically ill. The bacteria lives in and is spread by contaminated water, but for many years physicians did not know this; and even when some doctors proposed this as the method of spread, others refused to believe it. Thus the opportunity to control it and prevent thousands of deaths was delayed .

bacteria under the microscope

photo of the Vibrio cholera bacteria under a microscope; used courtesy of CDC/ Dr. William A. Clark

The author explains how cholera and other infectious diseases cause so much human suffering by detailing “How disease spreads” in these  chapter titles

 

Locomotion– Humans and pathogens travelling from place to place spreads disease.

Filth-Waste management and in some cases mis-management, leads to contamination of drinking water by human waste.

Crowds-People living in crowded slums creates perfect conditions to spread disease person to person.

Corruption– Public officials and business people who place profit and power above public health.

Blame No one willing to take responsibility for making hard choices, and too willing to blame someone else.

 

Ms. Shah uses examples from her personal life, like her annual family trips to India to visit relatives who lived in less than clean and sanitary neighborhoods. She also shares her and her sons’ battle with skin infections due to  MRSA, a form of staph (staphylococcal) that is resistant to many antibiotics and can be difficult to eradicate.

 

Pandemic includes extensive footnotes and a glossary of terms used in the book.

 

If you like history, current events, medical science, or just want to be more knowledgeable about why we should be concerned about infections , antibiotic resistance and vaccine phobia, you should read this book.

 

Here are other resources that address  the risk of global spread of infections.

 

 

 

For a visual lesson on how pandemics occur, watch this video.Warning: it is rather graphic. 

“How Pandemics Spread”

created by Mark Honigsbaum and animated by Patrick Blower 

 

When Germs Travel: Six major epidemics that have invaded America since 1900 and the fears they have unleashed

by Howard Markel

“Medical historian and pediatrician Howard Markel, author of Quarantine! tells the story of six epidemics that broke out during the two great waves of immigration to the United States—from 1880 through 1924, and from 1965 to the present—and shows how federal legislation closed the gates to newcomers for almost forty-one years out of fear that these new people would alter the social, political, economic, and even genetic face of the nation.”  (quote from Goodreads)

 

In this article from the New York Times, Gina Kolata reports  how scientists use genetics to discover and track bacteria and viruses . The New Generation of Microbe Hunters

 

In May 2017, TIME magazine reported  on The Pandemic Panic

 

In this  TED talk Dr. Larry Brilliant explains how new pandemics may be prevented.