Tag Archives: influenza

Scarier than Ebola -the Flu

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Scarier than Ebola  — From NY Times (an excerpt)

“Do me a favor. Turn away from the ceaseless media coverage of Ebola in Texas — the interviews with the Dallas nurse’s neighbors, the hand-wringing over her pooch, the instructions on protective medical gear — and answer this: Have you had your flu shot? Are you planning on one?

During the 2013-2014 flu season, according to the Centers for Disease Control and Prevention, only 46 percent of Americans received vaccinations against influenza, even though it kills about 3,000 people in this country in a good year, nearly 50,000 in a bad one….

On CNN on Monday night, a Dallas pediatrician was asked about what she had advised the families she sees. She said that she urged them to have their children “vaccinated against diseases that we can prevent,” and that she also stressed frequent hand-washing. Ebola or no Ebola, it’s a responsible — and frequently disregarded — way to lessen health risks.

So are these: fewer potato chips. Less sugary soda. Safer sex. Tighter restrictions on firearms. More than 30,000 Americans die from gunshots every year. Anyone looking for an epidemic to freak out about can find one right there.”

“Because It Doesn’t Just Happen to Other People”

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While doctors and scientists extol the virtues of vaccination to prevent disease, the emotional arguments regarding vaccines are sometimes lost due to misleading anecdotal stories.  The stories of missed opportunities and suffering due to the lack of vaccination are underreported.

Here’s an excerpt from one that wasn’t:  Link from Eric Benchimol: fw.to/IiBDiOH 

He, our oldest, 5 1/2, who the day before had been jumping merrily on the trampoline at circus school. Monday morning he woke up, out of breath, complaining of a tummy ache…..He came downstairs to watch TV, sank into the sofa, wheezing as if he had just run a marathon…

Everything was not okay. At noon, our big boy was in the pediatric intensive-care unit of the Centre hospitalier de l’Université Laval; he was plugged in everywhere, an oxygen mask covering his whole face, making him look like an astronaut. The respirator was whirring beside him, the oxygen desperately seeking its path, but not finding it…

The doctor said it was time to intubate, “to give him a chance…”

I marvelled at the work of the nurses, the doctors, in a constant death-defying dance. They put in long days and nights, 12 hours at a stretch and more. They obsessed, they never forgot, always determined to make the right decision at the right time.

Thursday morning, they decided to wake up our big boy, to remove the breathing tube, the IVs, trading them for a simple oxygen mask. Friday morning, the mask gave way to two little prongs in his nostrils. His battered lungs still needed some help. But his heart was beating normally again….

Each time I sat down in that blue leather chair, I wondered: “Where did that pneumonia come from? How did he get hit so hard, so fast?”…

The definitive diagnosis came Wednesday night: H1N1.

“Your son wasn’t vaccinated?”

We lowered our heads. Guilty as charged…

So why am I telling you all this? Why would I annoy you with this little story which, after all, happens to countless others every day during flu season?

Because it doesn’t just happen to other people.

Also, a link from the New England Journal of Medicine: nej.md/1hLXqWt 

An excerpt: “Influenza activity has been surging in the United States, and there are reports of critical illness and death in young and middle-aged adults. The predominant virus so far this season is influenza A(H1N1)pdm09, the cause of the 2009 H1N1 pandemic. Despite many challenges, there is much that the public, patients, the public health community, and clinicians can do now to reduce influenza’s impact…”

“Annual influenza vaccination is recommended for everyone 6 months of age or older in the United States..” It is not too late!

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For the smoking skeptics

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How bad is secondhand tobacco smoke (SHS)?  This has been debated.  When I come out of an office room and the entire room smells of smoke, even though no one has smoked in the room, I know this is detrimental.  More proof of this comes from an article which shows that SHS is associated with an increase in the severity of children hospitalized with influenza (J Pediatr 2013; 162: 16-21).

In this study of 117 children, 40% were exposed to SHS.  They had increased need for intensive care (30% vs. 10%), increased intubation (13% vs. 1%), and longer length of stay (LOS) (4 days vs. 2.4 days). In children with chronic conditions, the LOS was 10 vs. 3.5.  After controlling for multiple variables, the authors found that SHS exposure was associated with a 4.7 fold increase in the likelihood of ICU admission and a 70% LOS.

This study had many limitations.  It was a retrospective chart review.  Patients between 2002-2009 were identified initially by the discharge diagnosis of influenza.  Among the 171 charts identified, 117 had a positive influenza culture and adequate data to retrieve.  As a retrospective review, it is possible that screening for smoke exposure was more common in the more severely affected cases.

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