Posted in flu, Health, news, seniors

Flu Deaths Reported in Multiple States: Do We Also Have a Severe Pneumonia Season?

 

This year’s flu season has claimed the lives of at least 6 children and many more adults.  It’s widespread in many states, and we are told to brace ourselves for yet another severe flu season as we enter the peak.

cdc week 48.png

CDC

 

However, the number one cause of death when it comes to the flu is pneumonia.  And the respiratory depression that appears to come on with these otherwise healthy individuals, appears to affect them within hours. Which brings the question…. Should we be entertaining the possibility that a severe pneumonia strain is affecting us this “flu season” and should we be encouraging pneumonia vaccines as well as the flu vaccine?

Most children are vaccinated against pneumonia

The vaccine schedule for children in the US includes the pneumococcal vaccine (PCV13) given at 2 months, 4 months, 6 months, 12 – 15 months of age.  Over 2 years of a child, one can get the PPSV23 if they did not receive the PCV13.

Not all young adults get the pneumonia vaccine, however if one if over 65, the CDC recommends the pneumococcal vaccines receiving a dose of PCV13 first, followed by a dose of PPSV23, at least 1 year later.

pneumonia.gif
CDC

 

Now a variety of pathogens can be responsible for pneumonia, including viruses’, fungi, and bacteria other than pneumococcus, but streptococcal pneumonia is the most common cause.  If those affected by pneumonia this year were vaccinated, we need to know the strain, meaning specifically what pathogen was responsible for their pneumonia.

Not all pneumonia presents with a cough

Although pneumonia presents with symptoms such as fever, body aches, cough, shortness of breath and sputum production, some individuals may not present with these symptoms when they have pneumonia. Some of the tragic “flu death” cases this year were in adults who initially had a “mild cough”. Since flu symptoms are similar, some may never know if they have pneumonia.

As a result we are telling patients who have the flu to return immediately to the doctor’s office/urgent care/emergency room if they have any of the below symptoms:

  • Recurring fever
  • Fever that won’t subside after 2 days
  • Shortness of breath
  • Difficulty breathing
  • Confusion
  • Weakness
  • Productive cough
  • Blood in sputum
  • Fast breathing
  • Fast heart rate
  • Chest pain

and speak with your medical provider regarding other symptoms they may want you to watch out for.

How to tell when your flu is turning deadly

 

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

 

 

 

Posted in disease, flu, Health, news

This Year’s Flu Season Has Begun

Although flu season officially starts in October, public health officials in Riverside, California have already reported the first “flu-related” death this year, a 4 year-old child.

And being that Australia’s flu season began a couple weeks early and was more “severe” than previous years, US health experts are bracing for a rough one of our own.

We still, however, cannot predict how “severe” this year’s flu season will be, but here are answers to the most commonly asked questions about the flu.

When does flu season begin and how long does it last?

Flu season has begun already. It typically starts in the Fall, and ends late Spring.  So the range is described as October to May with it peaking December to March.

How bad will this flu season be?

It is difficult to predict, but already this early in the season we’ve had a flu-related death.  As the season unfolds, more cases will be reported by the CDC’s Flu View.

What is the flu?  How can one die from it?

The flu is caused by a virus. Multiple strains of virus’ can cause the flu.  The virus itself can be lethal, however the greatest risk comes with what it does to your immune system, thereby putting one at risk of secondary infections.  Pneumonia is the number one cause of flu-related deaths.  Secondly, it can exacerbate existing conditions such as asthma, seizures, even promote preterm birth, hence those who are pregnant or have preexisting medical conditions are urged to get vaccinated against the flu.  Moreover those who qualify should get the pneumonia vaccine as well.

 

h1n1-swine-flu-virus
h1n1 virus

 

What does this year’s flu vaccine cover?

According to the CDC, the trivalent vaccine covers for these three strains of flu virus:

  •  A/Brisbane/02/2018 (H1N1)pdm09-like virus
  • A/Kansas/14/2017 (H3N2)-like virus
  • B/Colorado/06/2017-like (Victoria lineage) virus

Quadrivalent influenza vaccines will contain these three viruses and an additional influenza B vaccine virus, a B/Phuket/3073/2013–like virus (Yamagata lineage).

These vaccines are aimed at providing protection against the Swine flu, and some influenza A and B strains.

What about older individuals?

This year, those over 65 will have three options for their flu vaccine.

Fluzone High-Dose – a higher dose flu vaccine that will hopefully allow their immunity to protect against the flu longer

FLUAD – the trivalent flu vaccine with an adjuvant to stimulate more of an immune response.

Flublock Quadrivalent – provides protection against 4 strains.

What about the nasal spray vaccine?

This year, the CDC allows use of the nasal spray vaccine as it has shown to have improved efficacy from  prior years. However it is only recommended for  those who are between the ages of 2 and 49 and cannot be given to those who are pregnancy or who have compromising medical conditions as outlined by the CDC.

Who should get the flu shot?

All individuals 6 months old and older unless specified by their medical provider.

How long does it take the flu shot to “kick in”?

The average immune system takes a couple weeks of to prime, so we suggest getting the flu shot before the season starts…or peaks.  However, experts recommend to still get the flu vaccine to anyone who missed early vaccination.

What if I’m allergic to eggs?

Most individuals allergic to eggs can still get the flu vaccine, but if the allergy to eggs is severe (anaphylaxis, angioedema, difficulty breathing), the CDC recommends notifying your medical provider and being in a facility to monitor you if you do get the flu vaccine.

Will I get the flu from the flu shot?

No.  The flu vaccine has a “killed” version of the virus meaning it’s not an active virus (as opposed to a live attenuated vaccine, a weakened down version of it).   A “killed” or “inactivated” vaccine merely has the pathogen particles to induce an immune response.  Additionally, when one states they got the flu despite the flu shot it could be that the flu shot only protects against 3 – 4 strains and they were infected with a more rare strain not covered by the vaccine.

How effective is the flu vaccine?

The average effectiveness each year hovers around 60%.  Last year’s efficacy was much lower and this year’s has not been predicted as of yet. Australia is still reporting active cases on their Department of Health website.

I feel sick after the flu shot, why?

For some, the immune response that ensues can make one feel mildly ill, but should not resemble the flu. Those who state they got the flu “immediately” after receiving the shot, might have already been exposed and had not had a chance to produce immunity prior to their exposure.

sneezing

 

What are symptoms of the flu? How is it different from a cold?

A cold comes on slower and less severe.  Flu symptoms are more abrupt and can include:

  • Fever
  • Body Aches
  • Cough
  • Sneezing
  • Sore Throat
  • Shortness of Breath
  • Fatigue
  • Headache
  • Nausea
  • Vomiting

Are there medications to treat the flu? Will antibiotics work?

There are antiviral medications available, such as Tamiflu, to treat the flu.  Antibiotics, however, will not work since the flu is not caused by a bacteria but rather a virus. However if a secondary bacterial infection takes over, antibiotics may be used.

How can I prevent getting the flu?

Besides vaccination, avoid being around those who are sick, thorough hand washing, and take good care of yourself.  A balanced diet, exercise and sleep regimen can help boost your immune system.

Wishing you health this season!!

 

ultimate book cover final

Great Gift!!!

The Ultimate Medical Student HandBook

 

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

Posted in flu, Health, news

This Year’s Flu Shot Efficacy Improved Over Last Year

The CDC reports a mid-season efficacy rate of 47% for this year’s flu shot, up from 36% estimated efficacy last year.

In a good year flu shot efficacy may be 65%.  It’s difficult to reach higher numbers as viral flu strains mutate easily and immune systems of the general public are so varied.  Per the CDC the flu shot during the 2010-2011 flu season was one of the most effective.

 

vaccine-effectiveness_v3

This year the predominant flu strain is H1N1, in contrast to the more wily H3N2 which evaded being a sharp match for last year’s flu vaccine.

They report the following:

Interim estimates of vaccine effectiveness based on data collected during November 23, 2018–February 2, 2019, indicate that, overall, the influenza vaccine has been 47% (95% confidence interval = 34%–57%) effective in preventing medically attended acute respiratory virus infection across all age groups and specifically was 46% (30%–58%) effective in preventing medical visits associated with influenza A(H1N1)pdm09 (6).

It is not too late to get the flu shot and medical providers are still recommending vaccination.

According to the CDC “preliminary cumulative in-season prevalence estimates indicate that influenza has caused 155,000–186,000 hospitalizations and 9,600–15,900 deaths.”

To date, 28 children have died this year from flu related illness.

Flu season peak is still occuring as winter appears to more severe this year, hence numbers can rise.

 

The Flu – Your Questions Answered

__________________________________________________________

When does flu season begin and how long does it last?

Flu season has begun already. It typically starts in the Fall, and ends late Spring.  So the range is described as October to May with it peaking December to March.

How bad will this flu season be?

It is difficult to predict, but already this early in the season we’ve had multiple flu related deaths reported by the CDC’s Flu View.

What is the flu?  How can one die from it?

The flu is caused by a virus. Multiple strains of virus’ can cause the flu.  The virus itself can be lethal, however the greatest risk comes with what it does to your immune system, thereby putting one at risk of secondary infections.  Pneumonia is the number one cause of flu-related deaths.  Secondly, it can exacerbate existing conditions such as asthma, seizures, even promote preterm birth, hence those who are pregnant or have preexisting medical conditions are urged to get vaccinated against the flu.  Moreover those who qualify should get the pneumonia vaccine as well.

 

h1n1-swine-flu-virus
h1n1 virus

 

What does this year’s flu vaccine cover?

According to the CDC, the trivalent vaccine covers for these three strains of flu virus:

  • A/Michigan/45/2015 (H1N1)pdm09–like virus
  • A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus
  • B/Colorado/06/2017–like virus (Victoria lineage)

Quadrivalent influenza vaccines will contain these three viruses and an additional influenza B vaccine virus, a B/Phuket/3073/2013–like virus (Yamagata lineage).

These vaccines are aimed at providing protection against the Swine flu, and some influenza A and B strains.

What about older individuals?

This year, those over 65 will have three options for their flu vaccine.

Fluzone High-Dose – a higher dose flu vaccine that will hopefully allow their immunity to protect against the flu longer

FLUAD – the trivalent flu vaccine with an adjuvant to stimulate more of an immune response.

Flublock Quadrivalent – provides protection against 4 strains.

What about the nasal spray vaccine?

This year, the CDC allows use of the nasal spray vaccine as it has shown to have improved efficacy from  prior years. However it is only recommended for  those who are between the ages of 2 and 49 and cannot be given to those who are pregnancy or who have compromising medical conditions as outlined by the CDC.

Who should get the flu shot?

All individuals 6 months old and older unless specified by their medical provider.

What if I’m allergic to eggs?

Most individuals allergic to eggs can still get the flu vaccine, but if the allergy to eggs is severe (anaphylaxis, angioedema, difficulty breathing), the CDC recommends notifying your medical provider and being in a facility to monitor you if you do get the flu vaccine.

Will I get the flu from the flu shot?

No.  The flu vaccine has a “killed” version of the virus meaning it’s not an active virus (as opposed to a live attenuated vaccine, a weakened down version of it).   A “killed” or “inactivated” vaccine merely has the pathogen particles to induce an immune response.  Additionally, when one states they got the flu despite the flu shot it could be that the flu shot only protects against 3 – 4 strains and they were infected with a more rare strain not covered by the vaccine.

How effective is the flu vaccine?

The average effectiveness each year hovers around 60%.  Last year’s efficacy was much lower and this year’s has not been predicted as of yet. Australia is still reporting active cases on their Department of Health website.

I feel sick after the flu shot, why?

For some, the immune response that ensues can make one feel mildly ill, but should not resemble the flu. Those who state they got the flu “immediately” after receiving the shot, might have already been exposed and had not had a chance to produce immunity prior to their exposure.

sneezing

 

What are symptoms of the flu? How is it different from a cold?

A cold comes on slower and less severe.  Flu symptoms are more abrupt and can include:

  • Fever
  • Body Aches
  • Cough
  • Sneezing
  • Sore Throat
  • Shortness of Breath
  • Fatigue
  • Headache
  • Nausea
  • Vomiting

Are there medications to treat the flu? Will antibiotics work?

There are antiviral medications available, such as Tamiflu, to treat the flu.  Antibiotics, however, will not work since the flu is not caused by a bacteria but rather a virus. However if a secondary bacterial infection takes over, antibiotics may be used.

How can I prevent getting the flu?

Besides vaccination, avoid being around those who are sick, thorough hand washing, and take good care of yourself.  A balanced diet, exercise and sleep regimen can help boost your immune system.

 

spanish book

Learning Medical Spanish is Easy!!!

 

 

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

 

 

Posted in flu, Health, news

80,000 Americans Died From Flu-Related Illness Last Year

We knew last year’s flu season was deadly, but we didn’t expect this.    The CDC has this week revealed the following: over 80,000 Americans died last year from flu-related illness. This is double and even triple previous flu seasons.  Thus the 2017-2018 season was one the deadliest in decades, nearly matching the 1976-1977 swine flu outbreak.

Last year’s pandemic was most notably caused by H3N2.  This notorious strain can sneakily avoid being replicated in a vaccine, hence our flu shot efficacy last year was only 16%.

Flu Deaths: Are We Missing a Severe Pneumonia Season?

The most common cause of death was pneumonia.  Which makes us wonder if we are dealing with more severe pneumonia causing strains as well.

 

When does flu season begin and how long does it last?

Flu season has begun already. It typically starts in the Fall, and ends late Spring.  So the range is described as October to May with it peaking December to March.

How bad will this flu season be?

It is difficult to predict, but already this early in the season we’ve had multiple flu related deaths reported by the CDC’s Flu View.

What is the flu?  How can one die from it?

The flu is caused by a virus. Multiple strains of virus’ can cause the flu.  The virus itself can be lethal, however the greatest risk comes with what it does to your immune system, thereby putting one at risk of secondary infections.  Pneumonia is the number one cause of flu-related deaths.  Secondly, it can exacerbate existing conditions such as asthma, seizures, even promote preterm birth, hence those who are pregnant or have preexisting medical conditions are urged to get vaccinated against the flu.  Moreover those who qualify should get the pneumonia vaccine as well.

 

h1n1-swine-flu-virus
h1n1 virus

 

What does this year’s flu vaccine cover?

According to the CDC, the trivalent vaccine covers for these three strains of flu virus:

  • A/Michigan/45/2015 (H1N1)pdm09–like virus
  • A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus
  • B/Colorado/06/2017–like virus (Victoria lineage)

Quadrivalent influenza vaccines will contain these three viruses and an additional influenza B vaccine virus, a B/Phuket/3073/2013–like virus (Yamagata lineage).

These vaccines are aimed at providing protection against the Swine flu, and some influenza A and B strains.

What about older individuals?

This year, those over 65 will have three options for their flu vaccine.

Fluzone High-Dose – a higher dose flu vaccine that will hopefully allow their immunity to protect against the flu longer

FLUAD – the trivalent flu vaccine with an adjuvant to stimulate more of an immune response.

Flublock Quadrivalent – provides protection against 4 strains.

What about the nasal spray vaccine?

This year, the CDC allows use of the nasal spray vaccine as it has shown to have improved efficacy from  prior years. However it is only recommended for  those who are between the ages of 2 and 49 and cannot be given to those who are pregnancy or who have compromising medical conditions as outlined by the CDC.

Who should get the flu shot?

All individuals 6 months old and older unless specified by their medical provider.

What if I’m allergic to eggs?

Most individuals allergic to eggs can still get the flu vaccine, but if the allergy to eggs is severe (anaphylaxis, angioedema, difficulty breathing), the CDC recommends notifying your medical provider and being in a facility to monitor you if you do get the flu vaccine.

Will I get the flu from the flu shot?

No.  The flu vaccine has a “killed” version of the virus meaning it’s not an active virus (as opposed to a live attenuated vaccine, a weakened down version of it).   A “killed” or “inactivated” vaccine merely has the pathogen particles to induce an immune response.  Additionally, when one states they got the flu despite the flu shot it could be that the flu shot only protects against 3 – 4 strains and they were infected with a more rare strain not covered by the vaccine.

How effective is the flu vaccine?

The average effectiveness each year hovers around 60%.  Last year’s efficacy was much lower and this year’s has not been predicted as of yet. Australia is still reporting active cases on their Department of Health website.

I feel sick after the flu shot, why?

For some, the immune response that ensues can make one feel mildly ill, but should not resemble the flu. Those who state they got the flu “immediately” after receiving the shot, might have already been exposed and had not had a chance to produce immunity prior to their exposure.

sneezing

 

What are symptoms of the flu? How is it different from a cold?

A cold comes on slower and less severe.  Flu symptoms are more abrupt and can include:

  • Fever
  • Body Aches
  • Cough
  • Sneezing
  • Sore Throat
  • Shortness of Breath
  • Fatigue
  • Headache
  • Nausea
  • Vomiting

Are there medications to treat the flu? Will antibiotics work?

There are antiviral medications available, such as Tamiflu, to treat the flu.  Antibiotics, however, will not work since the flu is not caused by a bacteria but rather a virus. However if a secondary bacterial infection takes over, antibiotics may be used.

How can I prevent getting the flu?

Besides vaccination, avoid being around those who are sick, thorough hand washing, and take good care of yourself.  A balanced diet, exercise and sleep regimen can help boost your immune system.

Wishing you health this season!!

 

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 flu, Health, news

This Year’s Flu Season Has Begun

Flu season has already begun, with three cases being reported in Western Massachusetts, and this year may be different from those past as the CDC has made multiple new recommendations and different options made available for the public.  Let’s answer your questions.

 

When does flu season begin and how long does it last?

Flu season has begun already. It typically starts in the Fall, and ends late Spring.  So the range is described as October to May with it peaking December to March.

How bad will this flu season be?

It is difficult to predict, but already this early in the season we’ve had multiple flu related deaths reported by the CDC’s Flu View.

What is the flu?  How can one die from it?

The flu is caused by a virus. Multiple strains of virus’ can cause the flu.  The virus itself can be lethal, however the greatest risk comes with what it does to your immune system, thereby putting one at risk of secondary infections.  Pneumonia is the number one cause of flu-related deaths.  Secondly, it can exacerbate existing conditions such as asthma, seizures, even promote preterm birth, hence those who are pregnant or have preexisting medical conditions are urged to get vaccinated against the flu.  Moreover those who qualify should get the pneumonia vaccine as well.

 

h1n1-swine-flu-virus
h1n1 virus

 

What does this year’s flu vaccine cover?

According to the CDC, the trivalent vaccine covers for these three strains of flu virus:

  • A/Michigan/45/2015 (H1N1)pdm09–like virus
  • A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus
  • B/Colorado/06/2017–like virus (Victoria lineage)

Quadrivalent influenza vaccines will contain these three viruses and an additional influenza B vaccine virus, a B/Phuket/3073/2013–like virus (Yamagata lineage).

These vaccines are aimed at providing protection against the Swine flu, and some influenza A and B strains.

What about older individuals?

This year, those over 65 will have three options for their flu vaccine.

Fluzone High-Dose – a higher dose flu vaccine that will hopefully allow their immunity to protect against the flu longer

FLUAD – the trivalent flu vaccine with an adjuvant to stimulate more of an immune response.

Flublock Quadrivalent – provides protection against 4 strains.

What about the nasal spray vaccine?

This year, the CDC allows use of the nasal spray vaccine as it has shown to have improved efficacy from  prior years. However it is only recommended for  those who are between the ages of 2 and 49 and cannot be given to those who are pregnancy or who have compromising medical conditions as outlined by the CDC.

Who should get the flu shot?

All individuals 6 months old and older unless specified by their medical provider.

What if I’m allergic to eggs?

Most individuals allergic to eggs can still get the flu vaccine, but if the allergy to eggs is severe (anaphylaxis, angioedema, difficulty breathing), the CDC recommends notifying your medical provider and being in a facility to monitor you if you do get the flu vaccine.

Will I get the flu from the flu shot?

No.  The flu vaccine has a “killed” version of the virus meaning it’s not an active virus (as opposed to a live attenuated vaccine, a weakened down version of it).   A “killed” or “inactivated” vaccine merely has the pathogen particles to induce an immune response.  Additionally, when one states they got the flu despite the flu shot it could be that the flu shot only protects against 3 – 4 strains and they were infected with a more rare strain not covered by the vaccine.

How effective is the flu vaccine?

The average effectiveness each year hovers around 60%.  Last year’s efficacy was much lower and this year’s has not been predicted as of yet. Australia is still reporting active cases on their Department of Health website.

I feel sick after the flu shot, why?

For some, the immune response that ensues can make one feel mildly ill, but should not resemble the flu. Those who state they got the flu “immediately” after receiving the shot, might have already been exposed and had not had a chance to produce immunity prior to their exposure.

sneezing

 

What are symptoms of the flu? How is it different from a cold?

A cold comes on slower and less severe.  Flu symptoms are more abrupt and can include:

  • Fever
  • Body Aches
  • Cough
  • Sneezing
  • Sore Throat
  • Shortness of Breath
  • Fatigue
  • Headache
  • Nausea
  • Vomiting

Are there medications to treat the flu? Will antibiotics work?

There are antiviral medications available, such as Tamiflu, to treat the flu.  Antibiotics, however, will not work since the flu is not caused by a bacteria but rather a virus. However if a secondary bacterial infection takes over, antibiotics may be used.

How can I prevent getting the flu?

Besides vaccination, avoid being around those who are sick, thorough hand washing, and take good care of yourself.  A balanced diet, exercise and sleep regimen can help boost your immune system.

Wishing you health this season!!

 

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 flu, Health, news

Flu Deaths: Are We Missing a Severe Pneumonia Season?

This year’s flu season has claimed the lives of at least 30 children and many more adults.  It’s widespread in all states except Hawaii, and we are told its one of most severe flu seasons yet.

However, the number one cause of death when it comes to the flu is pneumonia.  And the respiratory depression that appears to come on with these otherwise healthy individuals, appears to affect them within hours (as we learned with the tragic death of 36-year-old Tandy Harmon). Which brings the question?  Should we be entertaining the possibility that a severe pneumonia strain is affecting us this “flu season”?

Most children are vaccinated against pneumonia

The vaccine schedule for children in the US includes the pneumococcal vaccine (PCV13) given at 2 months, 4 months, 6 months, 12 – 15 months of age.  Over 2 years of a child, one can get the PPSV23 if they did not receive the PCV13.

Not all young adults get the pneumonia vaccine, however if one if over 65, the CDC recommends the pneumococcal vaccines receiving a dose of PCV13 first, followed by a dose of PPSV23, at least 1 year later.

Now a variety of pathogens can be responsible for pneumonia, including viruses’, fungi, and bacteria other than pneumococcus, but streptococcal pneumonia is the most common cause.  If those affected by pneumonia this year were vaccinated, we need to know the strain, meaning specifically what pathogen was responsible for their pneumonia.

Not all pneumonia presents with a cough

Although pneumonia presents with symptoms such as fever, body aches, cough, shortness of breath and sputum production, some individuals may not present with these symptoms when they have pneumonia. Some of the tragic “flu death” cases this year were in adults who initially had a “mild cough”. Since flu symptoms are similar, some may never know if they have pneumonia.

As a result we are telling patients who have the flu to return immediately to the doctor’s office/urgent care/emergency room if they have any of the below symptoms:

  • Recurring fever
  • Fever that won’t subside after 2 days
  • Shortness of breath
  • Difficulty breathing
  • Confusion
  • Weakness
  • Productive cough
  • Fast breathing
  • Fast heart rate
  • Chest pain

and speak with your medical provider regarding other symptoms he/she may want you to watch out for.

How to tell when your flu is turning deadly

 

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

 

 

 

Posted in flu, Health, news

How to Tell When Your “Flu” is Turning Deadly

IMAGE ABOVE FROM ABC NEWS

This week the CDC reports a 5th pediatric flu death as we face a season, many have predicted, to be “severe.”

And in previous years, once healthy children and young adults fell victim to severe circulating flu strains  prompting parents this year to fear the worse when it comes to theirs or their child’s flu symptoms.

Who can blame them. Flu symptoms can last up to 2 weeks, and most patients are told to go home and rest as antibiotics do not help fight the flu and symptoms will usually “resolve on their own.” This is true, but then why are some people..healthy people…dying?

What are the symptoms of the flu?

To understand why people are often misdiagnosed for flu-related illness when something even more serious is occurring, let’s first list the common symptoms of the flu.

  • Fever
  • Body Aches
  • Cough
  • Sneezing
  • Sore Throat
  • Shortness of Breath
  • Rapid Breathing
  • Rapid Heart Rate
  • Fatigue
  • Headache
  • Nausea
  • Vomiting

As opposed to a cold, in which symptoms are less severe and come on more slowly, the flu seems to hit you within hours.   The fatigue may be the first symptom, followed by body aches, scratchy throat, cough, runny nose and then fever. The fever could range anywhere from 100 – 106 F.  The fever usually lasts 2 days and the majority of those affected by the flu will average symptoms from 3-5 days.

How can you die from the flu?

There are multiple ways to die from the flu.  The most common cause is pneumonia.  A secondary viral or bacterial infection can affect the already weakened lungs.  Pneumonia can be deadly, especially if untreated.  Symptoms of pneumonia are very similar to the flu:  shortness of breath, cough, fever, fatigue, body aches, etc.

Respiratory failure from inflammation can be fatal as well. The flu virus affects the respiratory tree causing acute inflammation and distress of the tissues whose job is to bring oxygen to the blood.  Additionally, other organs including the heart may become inflamed, impeding their duties.

Flu can increase one’s risk of heart attack and stroke.  A study in 2007 found coming down with the flu doubled one’s risk of heart attack and stroke.

Moreover, having the flu could worsen any disease states already being battled. Hence a diabetic, if suffering from the flu, may struggle to control his blood sugar numbers.

Rarely, some may go into multi-organ failure as a result of septic shock initiated by the flu.  This is what killed 21-year-old body builder Kyler Baughman.

kyler-baughman-1.jpg

21-YEAR-OLD ATHLETIC TRAINER KYLER BAUGHMAN DIED DAYS AFTER FEELING FLU-LIKE SYMPTOMS

 

But one risk that doesn’t get discussed as much as it should is coming down with an illness during flu season and being mis-diagnosed, a “guilty by association” picture.

Four days before her death, 12-year-old Alyssa Alcaraz was sent home by an urgent care with a flu diagnosis when in fact she had a strep infection in her blood that put her into septic shock.

VTD023579-1_20171226.jpg

12-YEAR-OLD ALYSSA ALCARAZ WAS DIAGNOSED WITH THE FLU WHEN SHE IN FACT HAD A STREPTOCOCCAL INFECTION.

 

How will I know when the flu is turning deadly?

Since symptoms of the flu start to resolve in a couple of days, any symptoms beyond those few days should spark suspicions.   These can include:

  • A fever that does not subside
  • A fever that returns, recurring fever
  • New symptoms forming such as weakness
  • Confusion
  • Delirium
  • Dizziness
  • Unable to keep fluids down
  • Dehydration
  • Chest pain – could signify pneumonia or heart involvement
  • Bluish lips or skin
  • Difficulty breathing
  • Worsening cough

Understanding what the flu virus can affect and not underestimating its severity is paramount in preventing flu fatalities.  If symptoms start improving after 2 days it’s a great sign!!  However, any symptoms that either do not resolve, lag on for days, evolve into something worse, or recur are red flags that something more than the flu could be going on.

Most importantly, if one has not been vaccinated yet against the flu, they should still consider getting the flu vaccine.

 

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

Posted in Health, news

Did the Utah man who was refused a lung transplant die from an infection that came from weed?

The tragic case of a 20 year old Utah man who was denied a life saving lung transplant due to marijuana in his system might have become ill from the marijuana he was smoking.

Riley Hancey, 20, had smoked marijuana with his friends on Thanksgiving and the next day fell ill with pneumonia.  Three weeks later he was in the Intensive Care Unit on life support unsuccessfully battling a “rare lung infection”. A physician at the hospital, the University of Utah, allegedly refused to give Hancey the lung transplant due to his drug test showing positive for THC, tetrahydrocannabinol, the psychoactive ingredient in cannabis.

The family found “angels” at the University of Pennsylvania who offered to help their son and Hancey received a double lung transplant March 29th.  Unfortunately, he died earlier this week from complications from the transplant.

The family stated their son rarely smoked pot and had been drug free for up to year before then.

This tragic case reignited the controversy of hopeful transplant recipients being denied organs due to recreational marijuana use.  Marijuana has been found to many times contain contaminants including mold.  One reason for organ denial is the risk of fungal infection that could occur in an a immunosuppressed patient who is being treated to prevent organ rejection.

However, did Riley come down with the “rare lung infection” because of the marijuana he smoked the day before?

This month an investigation of marijuana dispensaries in California found 90 percent of marijuana samples to contain traces of bacteria and/or fungus that shouldn’t be harmful to those with healthy immune systems, but could be dangerous to those who are immunocompromised.  As a result the state’s Bureau of Medical Cannabis Regulation is working to finalize rules and regulations regarding the newly legalized marijuana industry.  Other states are following suit.

Marijuana-Fungi-and-Diseases.jpg

Image from Green CulturED

The investigation occurred after a man in northern California died from a rare fungal infection related to his medicinal marijuana.  Dr. Joseph Tuscano of the University of California, Davis Cancer Center observed with two of his young cancer patients, fungal superinfections that occurred after the men used medicinal marijuana for their chemotherapy-induced nausea.  After combining forces with Steep Hill Laboratories in Berkeley, he found “The cannabis was contaminated with many bacteria and fungi, some of which was compatible with the infections that I saw in my patients.”

His colleague, Dr. George Thompson, a fungal expert at UC Davis, said, “Klebsiella, E.coli, Pseudomonas, Acinetobacter, these are all very serious infections for anybody in the hospital. But particularly in that population, the cancer population. ”

Now, Hancey was in good health prior to his devastating lung infection, playing sports, travelling and working at a ski resort.  So it raises the question of whether his lungs were exposed to a contaminant his body couldn’t fight.   The type of infection that caused his “rare pneumonia” has not been disclosed but the above pathogens listed by Dr. Thompson can all cause “rare pneumonia” unlike streptococcal bacteria and those that commonly cause community acquired pneumonia.

Some researchers suggest users should ingest the marijuana rather than smoking it, as the heat from baking marijuana treats could potentially kill off the microorganisms, that otherwise could have direct contact with the lungs during inhalation.

This is a developing story.

                                                                                                       LearnHealthSpanish.com                                                                                                         Medical Spanish made easy

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

 

 

Posted in Health, news

Killer Mold from Dirty Hospital Sheets Blamed for Five Deaths

above image from MSU today

 

Five deaths have been blamed on fungal infections caused by linens used at two University of Pittsburgh Medical Center (UPMC) hospitals.  The linens had been supplied by Paris Healthcare Linen’s facility in DuBois, Pennsylvania, and the family of two of the victims filed wrongful death suits against the hospital system.

In 2015, the CDC looked into the first four deaths and could not find the source of the mold.  They reported, “Remediation was performed and there’s no evidence of any ongoing outbreak.”  However the CDC did not investigate the linens or the laundry facility.  It was thought the mold entered the hospital rooms through the ventilation system.

Currently the CDC and Pennsylvania Department of Health have no plans to reopen the investigation.

However, UPMC commissioned environmental specialists to investigate the cause themselves and their findings suggest the mold probably originated from the linen plant’s roof near dryer vents. Unfiltered air was used to dry the linens and could have contaminated them prior to being delivered to the hospitals.

The two molds found on tested linens were mucor and rhizopus. These are common molds that rarely affect healthy individuals. The victims, however, were transplant patients who were in an immunosuppressed state to prevent rejection.  In the lawsuit, Daniel Krieg, 56 suffered from a rhizopus pneumonia, one month after his kindey transplant.  Che DuVall, 70, also suffered from the same mold-induced pneumonia, after undergoing a lung transplant. Both mold infections required the patients to undergo lobectomies (lung lobes removed), but neither patient survived.

 

rhizopus_sporangia_X_40_small[1].jpg                  Rhizopus: BioMedHome

 

 

Two other mold-related deaths were settled out of court by UPMC for $1.3 million each.  One additional case was a transplant patient as well, who was treated at their Montefiore campus.

Hospitals routinely contract out laundry services, but whether the CDC reopens this investigation or not, these deaths highlight the need for all external sources to be diligent in their cleaning practices in case they introduce a pathogen into a delicate hospital environment.

 

 

                                                                                                         LearnHealthSpanish.com

                                                                                                         Medical Spanish made easy

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

 

Posted in Health, news

Can’t stop coughing? Tips to quell your cough

Now that the holidays are over, the sounds of jingle bells are being replaced with coughs and throat clearing.  Some of us can’t get rid of our nagging  cough.  Let’s figure this out.

Why do we cough?

Coughs are actually a brilliant defense mechanism designed to spew out unwanted irritants that make it to our respiratory tree. Its lining has sensory neurons, that when triggered, tell the brain to induce a mechanism that will help clear the airway.  This can, simplistically stated, include a cough but also immune cells mobilized to fight possible infection or heal inflammation.  If the act of mechanically coughing irritates the respiratory tree, you may cough more. Likewise, if inflammatory cells produce excess mucous, this could cause a cycle of continued coughing.

What causes a cough?

We’re well aware that infections caused by viruses, bacteria and fungi can cause coughs. But the following need to also be considered.

GERD – reflux disease – the acid can be an irritant to the lungs

Medications – such as ACE inhibitors – causing accumulation of bradykinin which can induce coughing

Pollution – including dust, pollen, and smoke

Chemicals – such as household products who’s aerosol irritates the lung lining

Mold spores

Cold weather

Exercise

Allergies 

Post nasal drip

Lung conditions – such as asthma, sarcoidosis, emphysema

Heart conditions – such a heart failure

Tumors

Psychological coughing – such as a tic

and more……

What can cure a cough?

We don’t actually “cure” the cough, because remember, it’s a well received defense mechanism.  But to control the cough requires us knowing why you’re coughing in the first place.

If one has pneumonia, antibiotics will be needed to kill the bacteria causing the lung infection.

If one has GERD, medications that decrease acid production and secretion may be required.

If its due to allergies, avoidance of the allergen and medications such as antihistamines, or corticosteroids might be utilized.

If its a tumor, then surgery, radiation and/or chemotherapy may be necessary.

But for the common viral nagging cough that many of us are dealing with this season, here is what we recommend:

Steam – whether its holding your head over a pot on the stove, humidifier, vaporizer or steam shower, the cough reflex subsides and the moisture helps decrease inflammation.

Stay hydrated – mucous thickens when water content is low, so loosening it up with hydration will make it less irritating.  A dry throat doesn’t do us any good either so keep your fluids up.

Honey – studies have found this to be an effective cough suppressant. Add it to some warm water, lemon juice or tea and your throat will be soothed as well. Avoid in children under one year of age.

Cough drops – menthol cough drops work by causing a local anesthetic effect on the back of the throat, temporarily decreasing irritation

Cough suppressants and expectorants – decrease the cough reflex and thin the mucous respectively.  One, however, should not self treat using these chronically without having their cough evaluated first.

Other natural remedies (without much scientific evidence) such as Peppermint, Thyme, Eucalyptus, Licorice, Ginger may also provide some relief.

Chocolate – yes chocolate.  This yummy treat has theobromine, which can suppress cough, and a study in late 2015 found it to work better than codeine.

 

What about alcohol and narcotics for cough?

These are not medically recommended, however, many people choose to self-medicate with alcohol and pain pills to control their cough.  Here’s why. Older cough syrups used to contain alcohol, as alcohol may dry up mucous, and induce sleep which may lessen the cough.  Narcotics decrease respiratory drive and provide analgesia which also decreases the cough reflex.  But alcohol is a no no as it can increase acid reflux, worsening cough, and narcotics are a bad idea as they decrease respiratory drive.  However, many prescription cough medications do include codeine and are used when the cough is severe.

 

                                                                                                         LearnHealthSpanish.com

                                                                                                         Medical Spanish made easy

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