WHAT IS SEASONAL FLU Influenza is a virus that typically causes fever, cough, runny nose, sore throat, headache, muscle aches, and sometimes nausea, vomiting and diarrhea. It usually is present in the winter, though can infect people in the fall and spring as well. Some seasons are worse than others. It can affect any age patient, although infants, the elderly and those with compromised immune systems or underlying heart/lung conditions are at highest risk for complications from infection. WHAT IS “SWINE FLU”
The “swine flu” is actually a new type of influenza A – more properly termed “novel H1N1.” In fact, this flu has been “found to be made up of genetic elements from four different flu viruses – North American Mexican influenza, North American avian influenza, human influenza, and swine influenza virus typically found in Asia and Europe."(1) What makes it worrisome is that we’ve never seen this particular strain before and we do not know how it might change over time. The CDC site has an amazing amount of information about the novel H1N1 flu for those interested in digging deeper.(2) HOW BAD IS THE “SWINE FLU”
In a typical year, the CDC estimates 25-50 million influenza cases per year with 36,000 deaths per year. These numbers are hotly debated. For example, in 2005, influenza only appeared on the death certificates of 1,812 people in the United States.(3) How do we reconcile these data? Well, the mortality rates are estimates based on influenza and pneumonia-related death rates. In particular, tracking pediatric morbidity and mortality rates is very tricky. It is estimated that there are 80-100 child deaths per year in the US attributed to influenza. The novel H1N1 flu initially seemed more dangerous, but many healthcare practitioners have observed that, to date, it is causing relatively mild disease compared with the typical seasonal flu. According to the CDC, there have been roughly 400 deaths in the US reported to date attributable to novel H1N1 flu; many estimate a million cases of infection or more are probable, given that mild cases are not reported and routine testing is no longer being performed. IS THERE A VACCINE FOR THE “SWINE FLU”
Yes – Sanofi Pasteur and Novartis Pharmaceutical companies are currently in the process of manufacturing the Swine Flu vaccine. In fact, clinical trials to assure the vaccine is safe to give and to insure the vaccine is efficacious are already underway.
WHO WILL GET THE NEW VACCINE
The CDC has announced that the groups recommended to receive the novel H1N1 influenza vaccine include:
• Pregnant women because they are at higher risk of complications and can
potentially provide protection to infants who cannot be vaccinated;
• Household contacts and caregivers for children younger than 6 months of age because younger infants are at higher risk of influenza-related complications and cannot be vaccinated. Vaccination of those in close contact with infants less than 6 months old might help protect infants by “cocooning” them from the virus;
• Healthcare and emergency medical services personnel because infections
among healthcare workers have been reported and this can be a potential source of infection for vulnerable patients. Also, increased absenteeism in this population could reduce healthcare system capacity;
• All people from 6 months through 24 years of age Children from 6 months through 18 years of age because we have seen many cases of novel H1N1 influenza in children and they are in close contact with each other in school and day care settings, which increases the likelihood of disease spread, and Young adults 19 through 24 years of age because we have seen many cases of novel H1N1 influenza in these healthy young adults and they often live, work, and study in close proximity, and they are a frequently mobile population; and,
• Persons aged 25 through 64 years who have health conditions associated with higher risk of medical complications from influenza.
The CDC does not expect that there will be a shortage of novel H1N1 vaccine, but flu vaccine availability and demand can be unpredictable and there is some possibility that initially, the vaccine will be available in limited quantities. So, the ACIP also made recommendations regarding which people within the groups listed above should be prioritized if the vaccine is initially available in extremely limited quantities. For more information see the CDC press release CDC Advisors Make Recommendations for Use of Vaccine Against Novel H1N1.
Once the demand for vaccine for the prioritized groups has been met at the local level, programs and providers should also begin vaccinating everyone from the ages of 25 through 64 years. Current studies indicate that the risk for infection among persons age 65 or older is less than the risk for younger age groups. However, once vaccine demand among younger age groups has been met, programs and providers should offer vaccination to people 65 or older.
WHERE CAN I GET THE NEW SWINE FLU VACCINE? The Swine Flu vaccine will be given by Physicians and others who have registered with the state of Virginia. PAHP has registered with the Department of Health however the
manner and the number of vaccines we will have available has not been determined at this time. HOW CAN YOU PREVENT THE FLU?
Common-sense hygiene – hand washing with soap and water, keeping kids home with illness until fever-free for 24 hours, and focusing on proper rest, nutrition and exercise is still the best way. Some natural remedies are available and a recently published study in Pediatrics demonstrated that “daily dietary probiotic supplementation for 6 months was a safe and effective way to reduce fever, rhinorrhea, and cough, as well as the duration of the illness. It also showed the number of missed school days attributable to illness, for children ages 3 to 5 to be less.”(5) HOW IS THE FLU TREATED? Treatment is usually supportive – hydration and rest. Remember, the flu is a virus, so antibiotics are not used to treat the flu. Antiviral medications such as Tamiflu® and Relenza® are sometimes prescribed to treat flu symptoms, but many children find the adverse effects from the medications worse than the symptoms of the flu itself.(6) Many integrative practitioners recommend the homeopathic remedy oscillococcinum (7) to treat flu at the very first sign of any symptoms. Additionally, one study of elderberry syrup demonstrated efficacy for shortening the duration of flu symptoms.(8) HOW WILL THE OFFICE TREAT CHILDREN WITH THE FLU?
Despite being declared a pandemic, little has changed for our patients about Novel H1N1 Influenza (Swine Flu). At this time, the CDC continues to recommend treating "swine flu" the same as seasonal flu. If your child has developed flu symptoms (head ache, fever, sore throat, body aches) please call for an appointment. We are in contact with the local health department and will keep you updated as they modify their recommendations. At this time they are not recommending prophylactic treatment for classmates or children at the same school as confirmed "swine flu" cases. IF I COME TO THE OFFICE WILL I OR MY CHILD CONTRACT THE FLU? During the season, the CDC may recommend treating close contacts (family members, those caring for confirmed cases) with prophylactic medication. Examples of close contact include kissing or embracing, sharing eating or drinking utensils, or any other contact between persons likely to result in exposure to respiratory droplets. Close contact typically does not include activities such as walking by an infected person or sitting across from a symptomatic patient in a waiting room or office." WHERE CAN I GET MORE INFORMATION ON THE FLU? Here is a link for further information http://www.cdc.gov/h1n1flu/ For a succinct audio discussion for parents about swine flu: http://www.cdc.gov/h1n1flu/clinicians/ped_message.htm
The student will . . . •Identify international cultural differences as well as their impact on the business community. •Identify and differentiate between types of governments and political environments. •Identify the economic systems and how they answer the 3 economic questions. Globalization of Markets • One significant reason is technological—because of improved transportation a
Name: Dr.med. Dr.phil. Mag.rer.nat.Andrea Martinek Strasse: Ort: Telefon: Email: KRANKENGESCHICHTE 4 Art der Krankengeschichte: akut Initialen: H. D. Geboren:16.04.1918 Geschlecht: weiblich Alter beim Erstkontakt: 89a Familienstand: verwitwet Beruf: Pensionistin Diagnose: Insektenstich, chronisch cardiale Insuffizienz NYHA II, mittelgradige Demenz, Z. n. Schenkelhalsfraktur