Posted in Health, news, travel

How to Avoid Getting Sick When You Fly

Holiday season means it’s the travel season. And winter colds may be merrily jumping around an airplane you’re traveling in.  And not just viruses are lurking, deadly drug resistant bacteria, such as MRSA, have been found to colonize airplane surfaces.  So here’s a list of things you should consider to avoid getting sick when you fly this holiday break:

 Open the air vent and aim it IN FRONT of your face

The air will help blow pathogens away from your respiratory tree.

 

ac-on-a-plane-PLANEAC0817.jpg

 

Don’t sit next to someone who appears sick

This may seem like a no-brainer, but the average passenger does not want to appear rude and will suck it up, literally.  If your flight has you sitting next to a passenger who is coughing up phlegm in your direction and no other seats are available, considering changing flights or cover your nose and mouth with a mask or sweater.

 

plane sick.jpg

 

Wash your hands and avoid touching your face

A recent study from Auburn university found deadly pathogens like E. coli and MRSA to survive for up to 7 days on surfaces surrounding your airplane seat.  Tray tables, arm rests, bathroom doors, drinking fountain buttons and even the air vent button can house bacteria so wash your hands after touching any of these surfaces.

 

Lavatory-Sink.jpg

 

Wipe down your surrounding areas

Antimicrobial wipes can help protect you against nasty bugs on any of the aforementioned surfaces.

tray table.jpg

 

Avoid sitting in aisle seats, especially near the lavatory

People stand in line to use the bathroom and breathe and cough on you while you’re trying to enjoy your movie or nap.  The window seat may be safer.

aisle seat.jpg

Carry-on some of your prescriptions 

Make sure to have half of your medications in your suitcase and half with you in your carry-on in case the flight gets delayed or you lose one of your bags.

Use your own pillow when you sleep

Your body loves your own personal microbiome and airplane pillows may carry germs you don’t wish to keep.  Remember to bring an extra pillowcase so you can change it out before you use it again on the flight back.

Eat a balanced diet prior to travel, and every day for that matter  

Fruits, vegetables, protein, complex carbs and fiber help your immune system.  A strong immune system can help you fight some of the worst of pathogens.

Stay hydrated

We forget to drink water when we travel and moist mucous membranes in our noses and mouths are less likely to pick up bacteria and viruses than dry ones.

Be well rested prior to travel

Conversely, poor sleep will weaken your immune system.

Remember to reach out to your medical provider a few weeks before you travel in case he or she goes on vacation as well.  Any medications that need to be adjusted or refilled should be done prior to travel or you running out.

Safe travels!!!

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

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Posted in Health, news, travel

Bed Bugs: Your Questions Answered

Every night our parents would tell us, “Good night, sleep tight…. and don’t let the bed bugs bite.”  As a young child I wasn’t too sure how to combat a bed bug assault, and as an adult, I don’t feel we’re any more equipped.  Home, hotels and even places of work get infested.  So let’s break down this little critter.

What is a bed bug?

Bed bugs, most commonly Cimex lectularius, are insects that grow no larger than an apple seed.

 

Bed-Bug-pictures-eggs-and-adults-02.png

 

Their life span on average is 4-6 months, although some can be dormant over a year.

Females may lay anywhere from 250-500 eggs in her lifetime, sometimes as often as 1-5 a day.  The eggs hatch between 6-10 days and the baby nymphs are hungry and ready to feed when born.  They will become adult bed bugs in approximately 7 weeks.

Bed bugs prefer warm blood meals and take 5-10 minutes to feed.

As they feed they may change shape and turn from a brownish color to red.

 

bed_bug_feeding_sizes.png

Image from Do My Own Pest Control

Do bed bug bites hurt?

Usually you do not feel a bed bug bite as it’s feeding.  The bed bug injects a local anesthetic and anticoagulant so you don’t itch and bleed as it feeds.  Once it leaves your skin, your immune system starts to wall off the germs that were introduced and tries to heal the bite damage.  This may result in inflammation and itching.

Where do bed bugs hide?

Bed bugs can be found in virtually any setting where humans hang out. These include hotels, cruise ships, dormitories, apartments, homes, etc.  They specifically like to hide in any of the following:

  • mattresses
  • box springs
  • bed frames
  • torn wallpaper
  • carpet
  • furniture
  • rugs
  • flooring
  • corners
  • cracks
  • crevices
  • picture frames

 

How can I tell if there is a bed bug infestation?

Bed bugs will leave their exoskeletons when they molt and many times excrement.

bedbug_feces_03.jpg

Where do bed bugs most commonly infest?

Each January, Orkin releases their “Top 50 Bed Bug Cities” list.  In 2018, the top cities were:

1. Baltimore
2. Washington, D.C.
3. Chicago
4. Los Angeles (+2)
5. Columbus, Ohio
6. Cincinnati (+2)
7. Detroit
8. New York (-4)
9. San Francisco-Oakland-San Jose
10. Dallas-Fort Worth (+5)
11. Indianapolis
12. Philadelphia
13. Atlanta (+3)
14. Cleveland-Akron-Canton, Ohio (-1)
15. Raleigh-Durham, N.C. (-3)
16. Richmond-Petersburg, Va. (-5)
17. Houston
18. Norfolk-Portsmouth-Newport News, Va. (+2)
19. Charlotte, N.C. (-3)
20. Buffalo, N.Y. (-2)
21. Knoxville, Tenn.
22. Nashville, Tenn. (+1)
23. Grand Rapids-Kalamazoo-Battle Creek, Mich. (+4)
24. Pittsburgh
25. Greenville-Spartanburg, S.C.-Asheville, N.C.
26. Champaign-Springfield-Decatur, Ill. (+4)
27. Phoenix (-1)
28. Denver (-6)
29. Milwaukee
30. Hartford-New Haven, Conn. (+1)
31. Charleston-Huntington, W.Va. (+5)
32. Boston (-4)
33. Syracuse, N.Y. (+7)
34. Dayton, Ohio (-2)
35. St. Louis (+2)
36. Seattle (-2)
37. Miami-Ft. Lauderdale, Fla. (+9)
38. Flint-Saginaw-Bay City, M.I. (new to list)
39. Omaha, N.E. (-6)
40. Cedar Rapids-Waterloo-Dubuque, Iowa (-2)
41. San Diego (new to list)
42. Lexington, Ky. (+1)
43. Honolulu, Hawaii (+5)
44. Louisville, Ky. (-3)
45. Las Vegas (+4)
46. Greensboro-High Point-Winston Salem, N.C. (-4)
47. New Orleans (new to list)
48. Myrtle Beach-Florence, S.C. (-9)
49. Tampa-St. Petersburg, Fla. (-14)
50. Albany-Schenectady-Troy, N.Y. (new to list)

 

Are bed bug bites dangerous?

Usually the bites are benign. One may, however, have an allergic reaction or get a secondary bacterial infection so bites should be managed as below.

How do you treat a bed bug bite?

Firstly, make sure your tetanus vaccination is up to date.

Secondly, when you notice the bites, wash them with soap and water as bed bugs carry dirt and other disease.

 

bed bugs bite.jpg

Thirdly, consult your medical provider if you have multiple bites, severe itching, pain, or feel sick.

Your medical provider may recommend hydrocortisone creams, anti-histamines and antinflammatories.

How do you avoid getting bed bugs?

  • Inspect your home or hotel room for bedbugs by looking under mattresses, pillows, the sheets, behind the headboard and around where you will be sitting and sleeping.
  • Keep all clothes off the floor.  Suitcases should be placed on counter tops.
  • Avoid clutter and tuck sheets tightly under the mattress.  Yep that’s why hotels make the beds that way.
  • Vacuum thoroughly around beds, mattresses, legs of furniture, corners, crevices, rugs and upholstered furniture.
  • Wash bedding and clothes you think might be exposed in hot water.
  • Consider having a pest control professional come out and take care of business.

 

dw sketch.jpg

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

 

 

 

 

Posted in Health, Labor Day, news, travel

Labor Day Weekend Safety Tips

Image above from Getty Images

The holiday offers a day of respite for those who labor throughout the week.  But the federal holiday, established in 1894, may come with risks as its one of the most travelled weekends of the year.   Grill injuries can occur, and throughout the US we are seeing record high temperatures. Additionally, water injuries, including drownings may rise this weekend. We need to stay safe out in the sun, by the grill, in the water and on the roads.

 

240_F_186858370_dmKbP5YoH9cDUTYe6eDbvhe3YEDhLTho

 

Sun Safety

 

Record heat and extended time outdoors can increase the risk of heat illness.  Hydrate, stay in the shade and protect your skin from damaging UV rays.

Sunscreen with an SPF of 30 or greater should be applied 15-30 minutes prior to going outside and reapplied every two hours or more often if swimming.

Avoid excessive alcohol as it could accelerate dehydration and put one at greater risk of injuries and heat exhaustion.

For more on heat exhaustion and heat stroke read here.

LEAN-SunSafety-footer

 

Grill Safety

 

In 2012, a man caught on fire after spraying sunscreen prior to heading over to the grill. He sustained multiple second degree burns.

Sunscreen may be flammable, so make sure it is dry prior to grilling or use a lotioninstead of spray on.

Keep the grill outdoors but away from low roofing, branches, and trees. Watch the little kids and keep them and the pets away from the barbecue.

Assign someone to watch the grill if you need to step a way during grilling.

 

grill.jpg.838x0_q67_crop-smart.jpg

 

Do not add lighter fluid to already ignited coals.

If someone does catch on fire, remember to have them stop, drop and roll on the ground until the flames expire.  Call 9-1-1 and remove any jewelry or tight clothes around the area..

If a minor burn injury does occur, run it under cool (not cold) water for 10-20 minutes. Avoid applying ice to the burn as it can damage the skin.  Also remove nearby jewelry.

Bandage and see a medical provider if concerned with your injury.

 

Water Safety

 

Avoid drinking alcohol when swimming or engaging in water sports.

Make sure you are in arm’s reach of your kids in the water.

Use life vests while boating and make sure the kids are wearing appropriate sized vests.

Never swim alone. Always have a buddy.

 

Zz1hZmQ5ZjgyNDg5MmIwYTg5YWFiM2I0MWNlMDA0MzlmZQ==.jpeg

 

Road Safety

 

Know your route to avoid you checking your GPS app while you drive.

Allow extra travel time and don’t rush.  Expect travel delays coming home as well.

Consider leaving a day or two early or a day or two late to avoid congested traffic.

Drive the speed limit and avoid tailgating, leaving at least 2 seconds between you and the car ahead of you.

Make sure you have plenty of water, supplies and a first aid kit in the car in case you get stuck on the highway.

 

Thanksgiving-Traffic-Jam.jpg

 

Have a happy and safe Labor Day Weekend!

 

                                                                                                      

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in Health, news, travel

Hotel Related Illnesses – Your Guide to Not Getting Sick

Some of us travel to see family, some to hang out with friends…but some of us get some unexpected guests when we go on vacation that make us sick.  Hotel related illnesses result from any of a variety of exposures that can occur on vacation.  Here’s your breakdown:

The Bed

Most hotels do not wash the comforter.  Headboards may also be unclean.  Bedbugs may hide out, looking like dark spots on the sheet. Even though bedbugs should not cause disease from their initial bite, a secondary infection could take place and if one is not vaccinated could be at risk for tetanus.

hotel bed.jpg

The Air

Dust, smoke and allergens can pervade a room, if poor ventilation is in place. Those with asthma or lung disease could have an exacerbation due to allergies or poor air quality.  A rise in complaints of marijuana stench have been noted as well.

under-window-AC.jpg

Watch where you put your hands

Remote controls, light switches, glasses, ice containers, door handles, curtain wands do not get routinely cleaned and could harbor dangerous bacteria, viruses and fungi.

img_remote_living_room.jpg

Watch where you eat

Buffets are a travel favorite with all-you-can-eat access to food.  However buffet lines can be risky if patrons serve their own food.  You may be handling spoons and serving utensils others (who didn’t wash their hands after going to the bathroom) touched.  Moreover food may sit out for lengthy periods of time collecting bacteria.

buffet line.jpg

Norovirus – notorious for making multiple cruise ships, the S.S. Stinky, norovirus outbreaks can occur in hotels or ships where close quarters expose many to contaminated food, water or surfaces.  Symptoms occur within 12-48 hours of exposure, resulting in nausea, vomiting, diarrhea, abdominal cramps, low fever, and malaise.  Severe symptoms may cause dehydration.  Although symptoms last 1-3 days, those infected could shed the virus for weeks after exposure.

Hotel Shower/Tub

Most should be cleaned daily but use caution.  Some hotels have reported Legionnaires’ disease outbreaks, where the bacteria may spray from the shower head.  Legionella bacteria grow and flourish in water systems, therefore lurking in plumbing, air conditioning, and hot tubs.

shower head.jpg

Hotel Pools/Hot Tubs

These get cloudy and messy by the hour.  Hundreds of guests with sun screen, sun tan lotion, body lotion inadvertently lose it when they bathe in the pool exposing others to the chemicals.  Moreover when they drink they may not be inclined to jump out of the pool to go to the restroom.

tub.jpg

The Water Quality & Health Council found one in four adults ADMIT to urinating in the pool, which can affect chlorine strength.

Many choose not to wait in line at public bathrooms or use the wet toilets at public water parks and find it easier to relieve themselves in the pool.  For women worried about sitting on wet toilet seats I recommend using a  large soda cup and in the stall standing and urinating into it. Pour it out into the toilet and flush.  Clean, easy and environmentally sensitive.  Men, there’s no excuse. Towel off and head to the potty.

Hot tub folliculitis caused by Pseudomonas aeruginosa can cause an uncomfortable rash around the hair follicles.

The CDC reports outbreaks associated with “treated recreational water” due to multiple organisms including Cryptosporidium, Pseudomonas, and Legionella.

Looking at the time period between 2000-2014, the CDC reports the following:

Investigations of the 363 outbreaks identified 24,453 cases; 21,766 (89%) were caused by Cryptosporidium, 920 (4%) by Pseudomonas, and 624 (3%) by Legionella. At least six of the eight reported deaths occurred in persons affected by outbreaks caused by Legionella. Hotels were the leading setting, associated with 157 (32%) of the 493 outbreaks

Hotel pools and hot tubs appear to be the biggest culprits.

Pseudomonas has been known to cause skin infections such as “hot-tub folliculitis” and ear infections, otitis externa, known as “swimmer’s ear.”  Legionella is known for causing Legionnaires’ disease, a severe pneumonia as well as a milder illness known as Pontiac Fever.

The largest number of cases, however, were caused by Cryptosporidium.  Known as “Crypto”, this parasite can cause severe gastrointestinal illnesses. Here’s the breakdown:

What is Crypto?

Crytosporidium is a parasite protected by an outer shell.

This shell allows it to live outside the body on surfaces.  The shell also allows it to be chlorine resistant which explains why it can live in swimming pools.

Crypto-brochure-image.jpg

How common is Crypto?

According to the CDC, Cryptosporidium is a leading cause of waterborne disease among humans in the United States.   Its found in every region of the US and the world.

The CDC reports close to 750,000 cases of cryptosporidiosis occur every year in the US.

How is it spread?

Its spread in drinking water and recreational water, such as swimming pools.  Since it lives in the intestines of humans and animals it becomes spread after one passes stool, or poops.  People coming into contact with an infected individual’s poop could become infected with Crypto.

It is not passed through respiratory transmission or blood.  However if feces comes into contact with one’s mouth, or wound, it can transmit Crypto.

Coming into contact with feces contaminated soil, surfaces, water, food therefore put one at risk.

What are the symptoms?

The parasite can cause any of the following:

Diarrhea

Abdominal Pain and Cramping

Fatigue

Nausea

Vomiting

Dehydration

Lack of appetite

Weight Loss

and sometimes  no symptoms at all.

When do symptoms show and how long do they last?

After one becomes exposed to Cryptosporidium, symptoms could show within 48 hours to 10 days.  Symptoms can last 1-2 weeks.

 

What is the treatment for Crypto?

The infection many times is self-limiting.  Hydration is imperative and initial treatment is making sure one does not become dehyrated.  Young children, pregnant women, elderly, those with weakened immune systems, AIDS, cancer and immunosuppressed transplant patients are at higher risk  of serious infection.

Some medical providers may use Nitazoxanide. According to the National Foundation for Infections Diseases:

Nitazoxanide (Alinia ®) may be used to treat Crypto in both adults and children 12 months of age and over. Nitazoxanide is available as a tablet for adults and as a liquid suspension. A three-day treatment regimen is recommended.

How do we prevent Crypto?

Always wash your hands with soap and water

Avoid eating off of non clean surfaces

Avoid swimming pools that may have just been soiled

Avoid ingesting  water while swimming

Avoid feces of those individuals infected

Avoid sexual contact where oral – anal contact can occur

Change baby’s diapers away from the pool in case it blows into the water

Do not allow any family members with diarrhea to enter the pool

Inform your medical provider if you have any of the above symptoms so he/she can test the stool.

 

 

 

 

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in Health, news, travel

Memorial Day Weekend Safety Tips

 

Memorial Day is this weekend and the country honors those who have sacrificed for our freedom.  Many of us will travel and enjoy the outdoors.  However, according to a study by the National Coalition for Safer Roads, Memorial Day Weekend is the most dangerous holiday for road and highway accidents.  Additionally, water injuries, including drownings may rise this weekend.  Grill injuries can occur, and throughout the US we are seeing record high temperatures.  We need to stay safe out in the sun, by the grill, in the water and on the roads.

 

Sun Safety

 

Record heat and extended time outdoors can increase the risk of heat illness.  Hydrate, stay in the shade and protect your skin from damaging UV rays.

Sunscreen with an SPF of 30 or greater should be applied 15-30 minutes prior to going outside and reapplied every two hours or more often if swimming.

Avoid excessive alcohol as it could accelerate dehydration and put one at greater risk of injuries and heat exhaustion.

For more on heat exhaustion and heat stroke read here.

LEAN-SunSafety-footer

 

Grill Safety

 

In 2012, a man caught on fire after spraying sunscreen prior to heading over to the grill. He sustained multiple second degree burns.

Sunscreen may be flammable, so make sure it is dry prior to grilling or use a lotion instead of spray on.

Keep the grill outdoors but away from low roofing, branches, and trees. Watch the little kids and keep them and the pets away from the barbecue.

Assign someone to watch the grill if you need to step a way during grilling.

 

grill.jpg.838x0_q67_crop-smart.jpg

 

Do not add lighter fluid to already ignited coals.

If someone does catch on fire, remember to have them stop, drop and roll on the ground until the flames expire.  Call 9-1-1 and remove any jewelry or tight clothes around the area..

If a minor burn injury does occur, run it under cool (not cold) water for 10-20 minutes. Avoid applying ice to the burn as it can damage the skin.  Also remove nearby jewelry.

Bandage and see a medical provider if concerned with your injury.

 

Water Safety

 

Avoid drinking alcohol when swimming or engaging in water sports.

Make sure you are in arm’s reach of your kids in the water.

Use life vests while boating and make sure the kids are wearing appropriate sized vests.

Never swim alone. Always have a buddy.

 

Zz1hZmQ5ZjgyNDg5MmIwYTg5YWFiM2I0MWNlMDA0MzlmZQ==.jpeg

 

Road Safety

 

Know your route to avoid you checking your GPS app while you drive.

Allow extra travel time and don’t rush.  Expect travel delays coming home as well.

Consider leaving a day or two early or a day or two late to avoid congested traffic.

Drive the speed limit and avoid tailgating, leaving at least 2 seconds between you and the car ahead of you.

Make sure you have plenty of water, supplies and a first aid kit in the car in case you get stuck on the highway.

 

Thanksgiving-Traffic-Jam.jpg

 

Have a happy and safe Memorial Day Weekend!

 

                                                                                                      

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in Health, news, travel

How to Avoid Getting Sick When You Fly

Holiday season means it’s the travel season. And winter colds may be merrily jumping around an airplane you’re travelling in.  And not just viruses are lurking, deadly drug resistant bacteria, such as MRSA, have been found to colonize airplane surfaces.  So here’s a list of things you should consider to avoid getting sick when you fly this Christmas break:

 Open the air vent and aim it IN FRONT of your face

The air will help blow pathogens away from your respiratory tree.

 

ac-on-a-plane-PLANEAC0817.jpg

Don’t sit next to someone who appears sick

This may seem like a no-brainer, but the average passenger does not want to appear rude and will suck it up, literally.  If your flight has you sitting next to a passenger who is coughing up phlegm in your direction and no other seats are available, considering changing flights or cover your nose and mouth with a mask or sweater.

 

plane sick.jpg

Wash your hands and avoid touching your face

A recent study from Auburn university found deadly pathogens like E. coli and MRSA to survive for up to & DAYS on surfaces surrounding your airplane seat.  Tray tables, arm rests, bathroom doors, drinking fountain buttons and even the air vent button can house bacteria so wash your hands after touching any of these surfaces.

Lavatory-Sink.jpg

 

Wipe down your surrounding areas

Antimicrobial wipes can help protect you against nasty bugs on any of the aforementioned surfaces.

tray table.jpg

 

Avoid sitting in aisle seats, especially near the lavatory

People stand in line to use the bathroom and breathe and cough on you while you’re trying to enjoy your movie or nap.  The window seat may be safer.

aisle seat.jpg

Carry-on some of your prescriptions 

Make sure to have half of your medications in your suitcase and half with you in your carry-on in case the flight gets delayed or you lose one of your bags.

Use your own pillow when you sleep

Your body loves your own personal microbiome and airplane pillows may carry germs you don’t wish to keep.  Remember to bring an extra pillowcase so you can change it out before you use it again on the flight back.

Eat a balanced diet prior to travel, and every day for that matter  

Fruits, vegetables, protein, complex carbs and fiber help your immune system.  A strong immune system can help you fight some of the worst of pathogens.

Stay hydrated

We forget to drink water when we travel and moist mucous membranes in our noses and mouths are less likely to pick up bacteria and viruses than dry ones.

Be well rested prior to travel

Conversely, poor sleep will weaken your immune system.

 

Remember to reach out to your medical provider a few weeks before you travel in case he or she goes on vacation as well.  Any medications that need to be adjusted or refilled should be done prior to travel or you running out.

Safe travels!!!

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician