Will measles become the next pandemic? a book review

Diseases that haven’t occurred much in the past 20 years are making a comeback all over the world. And they are largely preventable.

Influenza has arrived in the United States with some areas already experiencing epidemics. We pretty much expect this to happen in the winter despite wide availability of influenza vaccine.

But other diseases that haven’t been seen much in the past 20 years are making a comeback all over the world. The number of measles cases continues to climb, with 5 countries accounting for half of the world’s victims- Congo, Liberia, Madagascar, Somalia and Ukraine.

In 2019 the United States almost lost its measles elimination status because of a nearly year-long measles outbreak in New York, with the greatest number of measles cases since 1992. The New York State Department of Health declared the outbreak over in October, and the Centers for Disease Control and Prevention announced it would maintain the country’s elimination status.

And in a part of the world that conjures up images of a tropical island with sunny skies and pristine beaches, Samoan children are dying of measles due to increasingly low vaccination levels, currently only 31%. Over 5,100 measles cases have been reported since the outbreak, with 74 recorded in a recent 24-hour period alone, according to Samoa’s government. 

The low vaccination rate this year was caused in part by distrust of vaccinations that spread last year after two infants died after a vaccine error- nurses incorrectly mixed vaccines with another medicine. The accident compounded the worldwide spread of misinformation about vaccines. 

The anti-vaccination movement made the list of the World Health Organization’s top threats to global health in 2019

CBS NEWS

I don’t know if anyone has suggested it , but it seems we may be entering a pandemic of measles. Here is a review of a book explaining what that means.

Pandemic by Sonia Shah

Sonia Shah , a science journalist, 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.”

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

Epidemic– the rapid spread of infectious disease to a large number of people in a given population within a short period of time, usually two weeks or less.

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.

Why infectious disease still matters

With healthcare focus on chronic diseases like heart disease, diabetes, cancer, and dementia, even physicians 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 rare in the United States now, but in the past it has been deadly 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 recognized this, 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

how disease spreads

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 about how infections spread and how they can be stopped

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)

 At this link read how Dr. Gretchen LaSalle

blows the whistle on anti-vax false claims

an excerpt-

“Vaccines are recommended for personal health and required for the greater good. To protect those who can’t be vaccinated and to preserve the health of our communities, many vaccines are required for school entry. If you choose to participate in the community (ie, attend school), you have a duty not to harm those you come into contact with. And if you can’t make that decision for yourself, sometimes the states have to step in and make that decision for you. But still, you always have the choice to keep your kids out of school. The consequence for you is that you are now in charge of educating your own children. The consequence for your child is that their health is at risk and they are deprived of socialization and interaction with their peers. But, hey. You always have a choice! “

For a review of vaccine preventable diseases read my previous post

Vaccination prevents disease

exploring the HEART of preventing disease through vaccination

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

To start following Watercress Words , use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn. Thanks so much.

                              Dr. Aletha 

These are affiliate links you may find helpful and which help fund this blog with a commission when a purchase is made using them.

World Vision – Sponsor A Child Today. Help give children a better future. Sponsor a child through World Vision and change a child's life and community for good.

October Timely Topic- INFLUENZA

In this part of the world the influenza season is starting, even though influenza can occur year round. Once again, the majority of physicians and other health professionals recommend vaccination as the most effective way to lower one’s risk of getting influenza. No matter how many people would like to believe otherwise, for most people the risk of influenza is greater than the risk of the influenza vaccine.

This post is not very “timely” as October is halfway through. My husband and I have been dealing with some health challenges of our own as well as getting ready for a wedding. However, the topic is no less timely.

(This post has affiliate links; I hope they help you find information and inspiration and help me fund this blog by the commission they will generate. )

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

Influenza

In this part of the world the influenza season is starting, even though influenza can occur year round. Once again, the majority of physicians and other health professionals recommend vaccination as the most effective way to lower one’s risk of getting influenza. No matter how many people would like to believe otherwise, for most people the risk of influenza is greater than the risk of the influenza vaccine.

I recommend you read Dr. Gretchen LaSalle‘s thorough review

FLU VACCINE 101

Managing influenza and other winter illness

Most of the winter respiratory illnesses are not influenza, but can still make us feel miserable. Most of the time most of us recover uneventfully, but these diseases can cause more severe disease in certain people, like infants, elderly, and those with compromised immune systems. Here are some previous posts with info you need to know about keeping you and your family well and safe.

6 tips to cope during a flu epidemic

a man taking his temperature
Photo credit Lauren Bishop-CDC/ National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)

How you can cope with winter illness

6 smart facts about antibiotic use
graphic created by the Centers for Disease Control, http://www.cdc.gov

And here is how to know when to seek emergency medical help.

When should you call 911?

Hand hygiene saves lives. a sign reading "please wash your hands"
One of the most effective ways to prevent and stop the spread of infectious disease.

sharing the HEART of health

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

To start following Watercress Words , use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn. Thanks so much.

Dear friends, I hope all is well with you and that you are as healthy in body as you are strong in spirit. 

3 John 2 , NLT

Stay well this winter, or what ever season you are enjoying now.

                              Dr. Aletha 

These are affiliate links you may find helpful and which help fund this blog with a commission when a purchase is made using them.

myReader Rewards club- photo of woman on a bench reading a book

My Reader Rewards Club is a great way to earn free books and Bibles for yourself, friends, and family! Your journey to earning free faith-based products starts HERE.
(When you sign up through these links, I can earn free books too.)

As a member, you’ll have access to inspiring literature, Bibles, special promotional offers, and much more. Earning points is easy—you’ll receive 25 points just for signing up!

Get active

Becoming and staying fit may also help you fight off infection. I’ve been using this fitness app on my phone, Aaptiv. Consider trying it. I’d appreciate you using this affiliate link through which you can help fund this blog. Thanks and enjoy.

Spring/Summer Banners

6 tips to cope during a flu epidemic

The flu is bad, but don’t panic; basic tips to cope with the risk #influenza#CDC

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

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

Influenza- how to prevent, how to treat

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 4 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. “

7 underused medications

Here are 7 medications we should use more often

This week I discuss 7 groups of medications that are underused. ( A previous post discussed 7 that are overused. ) Both of these posts contain a lot of information and several links; you may want to bookmark to review later. (This post also has affiliate links, which when used to make a purchase, help fund this blog. )

I call these drugs underused.  However, I do not mean

  • That you should always take them
  • That you should start using them
  • That your doctor should prescribe them
  • That you should take them even  if your doctor recommends against them
  • That they are good or perfect drugs

We should think more about when, why and how to use these drugs.

By drugs and medications, I consider any substance we put into our bodies to treat or prevent a disease or symptom, whether prescribed or over-the-counter (OTC), synthetic or “natural”. I’m not considering foods nor any substance that is illegal or mostly recreational in this discussion.

I picked classes of drugs that I am familiar with as a family physician, excluding highly specialized medications like cancer chemotherapy, cardiovascular drugs, anti-rheumatics and neurological drugs.

I based my assessment on my experience as well as medical literature and the opinions of other physicians. As always, your best source of information about the right drugs for your conditions is your personal physician.

I easily came up with the list of 7 overused drugs but this list was harder. I tend to be a minimalist in using drugs, both in prescribing them for patients and in using medication myself. But once I started considering the issue, I realized there are helpful meds that can be better utilized.

No smoking sign
Smoking cessation meds are available and effective.

Smoking cessation medications

I suggest  reviewing 7 surprising reasons to be smoke free 

Many people use e-cigarettes as a way to stop smoking cigarettes. But other smoking cessation aids are available and effective. There are several types of nicotine replacement products as well as non-nicotine pills which help with the craving for cigarettes. Patients sometimes complain about the cost of these products but if you are already paying for cigarettes, what’s the difference? And you may qualify to get them free through the smoking hot line www.quit.com.

Allergy medication

Many people suffer from seasonal or year round allergy symptoms-sneezing, itching, runny nose, itchy/watery eyes. Once you get the diagnosis confirmed, effective medications available without a prescription  can manage the symptoms.  The key is using them soon enough and consistently enough. Sometimes finding the right ones is trial and error. I see people give up too quickly.

Asthma control medications

In the last post I talked about the overuse of rescue inhalers. Persistent wheezing and shortness of breath indicate uncontrolled asthma that will not be completely controlled by using a rescue inhaler over and over.  You should check with your doctor as to if and  when it is wise to  start or stop an asthma maintenance medication.

The human respiratory system
Respiratory allergies and asthma involve the breathing tract from the nose all the way down to the lungs. (photo complimentary from Pixabay)

Migraine medication

Most people with “sinus headaches” have migraine, a complex disorder that involves more than a headache. While many sufferers get relief with OTC pain relievers, many do not. Opioid pain medication does not work well for migraine but there are other prescription options, mainly the triptan drugs. I find that many patients with migraine have never tried these, or the various preventive drugs available. It’s worth talking to your doctor about these options.

Psychotropic medications

While milder forms of depression and anxiety can be managed without drugs, the more severe forms often require medication to achieve remission. In cases where one’s personal life and work suffer due to a mental illness such as severe depression, mania, panic disorder, PTSD, and alcoholism,  medication may restore control and function. Unfortunately, many of these people quit medication once they feel better, and ultimately relapse.

Anti-viral medications

In my last post I told you we use too many antibiotics, drugs used for bacterial infections. We mistakenly use them for viral infections like colds and bronchitis even though they don’t help. We don’t have anti-viral drugs for colds, but we do have some for other viruses. You may already be familiar with the use of oseltamivir, Tamiflu, used both for prevention and treatment of influenza (flu). 

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

Antiviral meds  are available for these infections- 

  • HIV-human immunodeficiency virus
  • HBV, HCV- hepatitis B and hepatitis C 
  • HSV, HZ – herpes simplex virus and herpes zoster (shingles).

For many of these, treatment needs to be started very soon after onset of symptoms, within a few days, for maximum effectiveness.

Supplements

This class made both lists. While there is little evidence that supplements in general are helpful, medical studies suggest some specific ones may be effective.  

Folic Acid, also known as folate a B vitamin (B9) . The USPSTF recommends folate intake for women who may become pregnant. Medical studies suggest that taking folic acid during pregnancy decreases the risk of neural tube defects such as anencephaly-impaired brain formation and spina bifida- spinal cord malformation. All women with childbearing potential should take 400 to 800 micrograms daily. Learn more at this link 

Fish oil lowers blood triglyceride (fats) levels. Triglycerides contribute to heart attack risk but we don’t know if lowering them with fish oil  decreases the risk. It is available as both OTC and prescription versions.

The herb ginkgo biloba improves mental and behavioral function in people with dementia, including Alzheimer’s patients. Results were similar to those for the prescription Alzheimer drugs.

Probiotics, such as Lactobacillus, Bifidobacterium and Saccharomyces can prevent or limit diarrhea from antibiotics. They should be started within three days of starting  the antibiotics and continued for one week after.

St. John’s  Wort (Hypericum perforatum) shows effectiveness for treating mild to moderate depression.

This information is presented for your information only and should not be considered a recommendation for treatment or prevention of any condition.

Discuss the use of these medications with your personal physician if you think they may be helpful for you. 

Please follow this blog for future discussion of non-drug treatments for several common conditions, including allergies, colds, migraine, insomnia, pain, depression, and anxiety.

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

This week autumn begins in the northern hemisphere. Where I live, fall brings brilliant orange,yellow and red to our trees and shrubs,  the start of the school term and football season. Unfortunately,  fall also brings the cold and 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 refers to influenza,  one of many viruses that cause illness. The other viral illnesses  are “colds”, upper respiratory infections, aka URIs, bronchitis, pharyngitis, sinusitis and 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 and 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 2 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

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.

I cringed last year when a friend wrote on her social media page, “My doctor said, ‘No one dies of the flu’.” And, technically, that is true. 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.

Here are some other posts about winter illness you may find helpful.

 

Get Smart About Antibiotics

6 smart facts about antibiotics

Sorting out sinusitis

 

How to navigate the antibiotic highway

Experts consider as many as 50% of the antibiotics prescribed in the United States unnecessary or inappropriate.

Now that we’ve covered some basics about antibiotics, let’s get specific. What you want to know is-

When do I need to take an antibiotic?

stoplight
Most medical experts believe we need to STOP using unnecessary antibiotics. (photo from Pixabay)

Experts consider as many as 50% of the antibiotics prescribed in the United States unnecessary or inappropriate. This causes

The best source of medical advice for you personally is your own doctor, or one who talks to and examines you.

Exceptions to rules exist, every medical situation is unique.  So although these recommendations are firm, they are not absolute. This is just a partial list which includes most but not all common infections.

2015-11-11 11.20.31

STOP- don’t treat these with antibiotics

Any form of upper respiratory infection including

  • colds,
  • laryngitis,
  • bronchitis,

“flu”-Influenza

infectious mononucleosis, aka “mono”

Acute viral gastroenteritis, aka stomach flu, with nausea, vomiting, and/or diarrhea

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SLOW DOWN- these may not need an antibiotic, at least not immediately

Ear infections -otitis media

Sinusitis– sinus infections

spider or tick bites- many of these are not bites at all, but are other skin diseases, including bacterial infections (see below)

sore throats– pharyngitis or tonsillitis

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GO- these infections usually need antibiotics to resolve successfully

Urinary tract infections– this includes the kidney, bladder, prostate

Skin infections including animal and human bites

Pneumonia (although can can be due to viruses, especially in children)

Whooping cough –pertussis

Lyme disease and Rocky Mountain Spotted Fever- these are both transmitted by tick bites; but not all tick bites result in infection

Sexually transmitted diseases caused by bacteria – gonorrhea, chlamydia, syphilis

Any infection severe enough to require admission to a hospital- including infections of any internal organ, bones, joints, brain; included here are infections which develop during a hospital stay

Check out the links for more info. You probably still have questions that I didn’t cover, so please ask and I’ll tell you more.

(By the way, I hope you enjoyed the photos. I took them at a Veterans Day parade.)

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exploring the HEART of responsible antibotic use

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

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                              Dr. Aletha