Tag Archives: vaccines

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. “

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Reconsidering vaccination- a book review

In 1961,  my mother and I went to my school on a Sunday afternoon to receive the newly released oral polio vaccine. She along with other parents eagerly sought a way to prevent a dreaded disease that had the potential to cripple or even kill their children.

In medical school I learned about diphtheria, a painful throat infection due to a bacteria, Corynebacterium diphtheriae. . Once a common cause of severe illness and death, a vaccine had rendered it rare. I saw no cases of diphtheria in medical school, nor have I since.

As a young physician I welcomed the introduction of the H.Flu vaccine (Haemophilus influenzae bacteria, not the virus) in 1985. At that time, any infant or toddler with a fever was a potential victim  of  meningitis due to H.Flu, which could be deadly or leave the child with neurological damage.

Similarly, the Hepatitis B vaccine made healthcare a less risky occupation; Hepatitis B is a blood borne infection contracted from contact with infected blood.

VACCINE-PREVENTABLE DISEASES

FROM THE CDC, UPDATED JANUARY 2016– follow link for detail

 

 

 

 

 

So, I was  first surprised, then puzzled, then alarmed , now resigned to the number of parents who reject vaccination for their children, and   adults who decline immunizations for themselves. Some people now fear the vaccines more than the diseases they prevent and we physicians must consider this to help people stay well instead of treating them when sick.

I was intrigued when I heard of a book, by a physician,that seems to promote a compromise-

The Vaccine-Friendly Plan

 

The Vaccine-Friendly Plan is published by Ballantine Books,  2016

 

 

The Vaccine-Friendly Plan by Paul Thomas, M.D., a pediatrician  and Jennifer Margulis, Ph.D.a science journalist.

It is based on his pediatric practice, Integrative Pediatrics,  as well as their extensively noted references. The book’s subtitle summarizes the contents accurately-

“Dr. Paul’s Safe and Effective Approach to Immunity and Health- from Pregnancy through your Child’s Teen Years.”

The book discusses pregnancy, infant and  child care in general, not just vaccination, although that is a major emphasis.There is a chapter about pregnancy and for each stage of child development through adolescence.

The first chapter discusses a popular health topic now- toxins. (As an aside, I don’t know when we started calling poisons  “toxins”) . This should grab your attention-

“Toxins, Toxins, Toxins: Raising Healthy Children in a Poisoned World”.

Anything can be “toxic” if misused, overused,or abused  but they concentrate on these toxins in particular- acetaminophen, aluminum, aspartame, fluoride, methanol, mercury, and what they call endocrine disruptors(this includes pesticides).  They state “environmental toxins are likely contributing to the autism epidemic” as well as other neurodevelopmental and mental disorders in children.  They base their conclusion on an extensive list of review articles from the medical and scientific that support their view (obviously) and also from Dr. Paul’s medical practice of 11,000 children who he calls “among the healthiest in the world.” While I suspect  families who are already health conscious tend to select a physician who is health oriented, this claim sounds impressive.

I agree with some of the advice the authors offer. For example this advice for pregnancy is hard to argue with-

  • Eat a whole foods, organic, non-GMO diet 
  • Skip the soda
  • Drink filtered water
  • Minimize stress
  • Get treatment for addiction
  • Join a support group

But in addition, they recommend declining all vaccinations during pregnancy, certainly not mainstream medicine advice.

 

A later chapter also offers sound advice:

“ The Best Ways to Support your Child’s Immune System” 

  • Breast feed
  • Enjoy cuddling
  • Laugh a lot
  • Relax often
  • Rock your body
  • Stay hydrated
  • Eat a variety of foods
  • Maintain social connection
  • Read
  • Get Dirty
  • Be cautious but not afraid
  • Choose vaccines based on real science, your family’s needs and common sense
  • Sleep enough
  • Trust your children
  • Trust yourself

 

He offers an interesting list  Ten Questions to Ask When Looking for a Pediatrician (which I assume would apply if you use a family physician for your child’s care).

As a physician, I have never liked the idea of being “interviewed” by a potential patient; I  want a relationship with patients, not a job. But I think pediatricians routinely offer “get acquainted” visits so you may find it helpful. Some of the questions seem more appropriate to explore  in a long term relationship with a physician, not quick answers in a short visit, like “What would you like me to know in order to keep my family healthy?”

An appendix compares the CDC immunization schedule of 1983 to the current 2016 version, illustrating  many more vaccines and doses are now recommended.

Of course the list is longer since several new vaccines have been developed in the past 30 years and the CDC recommends those considered necessary for the public health. Most areas of medical care have changed dramatically in the past 30 years, we have a lot more of everything-drugs, procedures, etc- so this should not be a surprise.

vaccines

CDC Immunization Schedule– follow link for detail

 

 

Also in the appendix is Dr. Paul’s Vaccine Plan at a Glance, which is a much abbreviated version of the CDC recommendations. The plan is offered free at his web site drpaulapproved.com by signing up to receive his newsletter. (There is also a “store” on the web site offering an assortment of vitamins, minerals, probiotics and melatonin.)

The authors describe themselves as “pro-vaccine”, have received vaccines themselves and vaccinated their children. But they also believe that physicians and parents should have a choice and make informed decisions about immunization and other procedures. 

Universal vaccination is recommended , but there are individual circumstances where the routine schedule might need to be altered due to a child’s particular medical circumstance, but not for some vague concern that vaccination might not b e “safe”. Neither is infectious disease.

If  you are a parent who has  rejected vaccination for your children,  please read this book soon.

Also, read another review of this book by  Vincent Iannelli, MD is a pediatrician and Fellow of the American Academy of Pediatrics.

 

 

 

 

Sonia Shah, a science journalist, also wrote about vaccination in her book

Pandemic – Tracking contagions from cholera, to Ebola, and beyond

Read my review at this link Pandemic- a book review

 

Pandemic by Sonia Shah

 

Previous posts about vaccination on this blog include

Vaccination prevents disease – Part 1 and Part 2

 

Explore the Category “books, literature, writing” for more book reviews.

And please follow this blog for more articles to

inform, instruct, and inspire you to explore the

HEART of HEALTH.      

a stethoscope, a red heart and a heart ekg tracing

exploring the HEART of HEALTH

Hand hygiene saves lives.

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

 

recommended vaccines for children

Vaccination prevents disease- part 2

In part 1  I discussed the vaccine preventable bacterial diseases . Here we’ll look at viral infections.

 

Virus vs Bacteria

One major difference between bacterial and viral infections is the treatment. We have many more effective antibiotics (drugs which fight bacteria) than we do antiviral drugs.

And antibiotics do not affect viruses. Despite that fact, patients often expect and even demand their physicians prescribe antibiotics for viral infections such as influenza, colds and bronchitis- and unfortunately too often we physicians do it anyway.

 

6 smart facts about antibiotic use

 

Influenza- the vaccine is given annually and targeted to the strains of virus predicted to be active in any given year.

symptoms of influenza

The nasal flu vaccine is not preferred as it is less effective than a shot. 

 

 

 

 

 

 

 

 

Measles (rubeola), Mumps, Rubella (German measles) -I am grouping these together since their vaccines are usually given together as the MMR. Recent outbreaks of measles have been attributed to the decline in vaccination rates.

Measles in the United States

Polio, a disease parents feared when I was a child, due to to risk of permanent paralysis, now essentially eradicated in the United States

Rotavirus,  in infants and small children, a common cause of gastroenteritis- vomiting and diarrhea, with or without fever and abdominal pain

HPV, the human papilloma virus, causes warts of all kinds, but the vaccine is targeted to the strains that cause genital warts and can lead to cervical cancer

The cousin viruses, Hepatitis A and Hepatitis B.

Hepatitis is an infection  of the liver, which can range from a mild disease to life threatening. Hepatitis A is spread through contaminated food or water. Hepatitis B is spread through contact with infected blood or other body fluids.

Another set of cousins, Varicella Zoster (VZ) virus causes two different infections and thus has two vaccines. The original infection is  varicella or chickenpox, formerly a common childhood illness but not seen often now due to the vaccine. When it reactivates, usually years later in adulthood, it is known as  zoster or shingles.

 

 

There are also several vaccines usually reserved for travel to specific areas of the world, occupational exposure, military service or other special circumstances. These include vaccines for anthrax, typhoid, cholera, (bacteria) and yellow fever, smallpox,and rabies (viruses). 

Diseases for which there is no vaccine

One of the most serious is malaria, caused by a parasite transmitted by infected mosquitos. Malaria is rarely a risk in northern or extreme southern areas of the world, but for the tropics, especially sub-Saharan Africa it is a major health problem.

Otherwise we all are at risk of other serious infections that we cannot yet prevent with immunization. These include

HIV-human immunodeficiency virus ,and most other sexually transmitted diseases including HSV- herpes simplex virus, gonorrhea, syphilis, and chlamydia.

HCV- Hepatitis C

Most respiratory viruses, including rhinovirus, cause of the common cold; RSV-respiratory syncytial virus and infectious mononucleosis

The Ebola virus

 

Borrelia, not really a bacteria, it’s a spirochete, which causes Lyme (not lime) disease

And the bacteria Staphylococcus, which causes “staph” (not staff) infections of the skin and Streptococcus, which causes “strep throat”

If you have any questions or concerns about which vaccines you might need to protect yourself against infections, please consult your own personal physician.

Detailed information about vaccines and infectious disease  is available from the Centers for Disease Control and Prevention 

 

Vaccination prevents disease- part 1