Booster Shots

Oddities, musings and news from the health world

Category: swine flu

Lessons from the swine flu pandemic

February 7, 2010 |  8:09 pm

RomoX It's too soon to say if the swine flu pandemic is over, but health experts have begun to look back and survey the damage. One of the lessons from the pandemic is that pregnant women are at particularly high risk for severe complications, as is described in Monday's Los Angeles Times story, "A family left behind by the H1N1 virus." It's a story about the death of Virginia Romo, who was pregnant with her sixth child.

The U.S. Centers for Disease Control and Prevention hasn't conducted its own review of the pandemic. But an editorial published in the Jan. 14 issue of the journal Nature makes the first of what are sure to be several summaries of the lessons learned from the swine flu.

According to the Nature piece, the positive outcomes of the pandemic were that health researchers worldwide freely shared and published data on all aspects of the virus and its transmission. Also, most international health agencies reacted swiftly and communicated openly with the media and the public. Health officials in Mexico, in particular, "deserve credit" for alerting the world to the first outbreaks there. The news media and bloggers responded well by not sensationalizing the threat and by debunking misinformation (such as the idea that the H1N1 vaccine would be mysterious and dangerous).

On the downside, they noted, officials made predictions that the vaccine would be readily available for those who needed it the most last fall -- and that did not happen. The public health system is too reliant on a small number of vaccine suppliers, the editorial stated. Moreover, manufacturing vaccine from eggs is too slow and should be abandoned in favor of faster methods. Another problem: The swine flu virus had been circulating for at least a decade in pigs and probably jumped to humans well before it was spotted in Mexico. "That it was not spotted earlier is unacceptable," the editorial states. "Public- and animal-health communities need to help increase surveillance for emerging diseases with pandemic potential."

In short, we were lucky that the H1N1 strain was, for the most part, mild. Next time, we may not be so lucky. And, the writers note: "the danger now is that last year's relatively mild pandemic will create a false sense of security and complacency" when the next pandemic threat rolls around.

Not in everyone, however. For families victimized by H1N1, like the Romo family of Santa Ana, there is no complacency or security.

-- Shari Roan

Photo: Miguel Romo of Santa Ana and baby Virginia. Credit: Don Barletti / Los Angeles Times


A note for the next pandemic: Face masks might be the way to go after all

January 21, 2010 |  5:54 pm

PassengersWear the face mask? Don't wear the face mask? The question may seem moot now -- what with a decline in H1N1 cases and pharmacies now publicly trumpeting the availability of vaccine against the influenza strain -- but a few months back, it was anything but academic.

Researchers at the University of Michigan have been studying the 2006-07 flu season's effects on 1,437 students living in university residence halls. Some wore face masks (standard medical kind, nothing fancy); some wore masks and used a hand sanitizer; some just did whatever college kids normally would do in such situations. All watched an importance-of-hand-hygiene video.

The findings? That the two face mask groups had fewer influenza symptoms than those in the whatever-college-kids-normally-would-do group.

Previous research has been inconclusive on the effectiveness of face masks. The researchers point out that they asked participants to take such measures at the beginning of the influenza season, just after the campus' first flu case was reported. In other words, participants likely weren't already infected when the research started, as they might have been in other studies.

As for the lessons learned here, the researchers say: "The effect on influenza transmission could
be substantial, particularly early in a pandemic when vaccine supply will almost certainly be limited, as with the current nH1N1 pandemic."

Something to consider. Next time...  

Here's the study, published online today in the Journal of Infectious Diseases. A related editorial points out, however, that hand hygiene "cannot be overemphasized." 

-- Tami Dennis

Photo: These Hong Kong subway passengers weren't taking any chances last spring. 

Credit: Philippe Lopez / AFP / Getty Images  


Many have had H1N1 flu, many have had a shot -- and many remain vulnerable

January 15, 2010 |  3:17 pm

An estimated 18% of Americans have fallen ill with H1N1 flu, but about 20% have been vaccinated against the strain, according to new estimates released today by the U.S. Centers for Disease Control and Prevention.

The new numbers show that most of the U.S. population remains susceptible to falling ill with H1N1, also known as the swine flu.

“Now that there is ample supply of vaccine, efforts should continue to improve vaccination coverage among persons in initial target groups, as well as to offer vaccination to the rest of the U.S. population,” the CDC said in an early release publication of its Morbidity and Mortality Weekly Report.

The numbers, gathered from two national telephone surveys, show that health officials have more work to do get more of the population vaccinated. Areas of particular concern included pregnant women, of whom 38% received inoculations, and healthcare workers, of whom just 22% received a vaccination.

“Efforts should continue to urge obstetricians and other healthcare providers to provide influenza vaccine to pregnant women,” the report said. “The current high percentage of unvaccinated healthcare workers highlights the need to strengthen measures to improve their influenza vaccination coverage.”

Only 12% of chronically ill adults were vaccinated, the report said, as were 14% of adults who care for infants too young to receive inoculations.

-- Rong-Gong Lin II


In California, the H1N1 flu has taken a higher toll on Latinos

January 14, 2010 |  2:28 pm

We have new H1N1 numbers -- and these show the ethnic breakdown of H1N1-related deaths and hospitalizations in California.

Times staff writer Molly Hennessy-Fiske writes on the L.A. Now blog:

"California Latinos have been nearly twice as likely as whites to die of H1N1 flu since the pandemic began last spring, according to statewide figures released this morning by the California Department of Public Health."

Officials are still sorting, and in some cases, puzzling, through the numbers. For instance, Asians were more likely than whites to be hospitalized with H1N1, yet less likely to die of it.

Read the full post.

-- Tami Dennis


'Kill swine flu without use of chemicals'? Using what -- imagination?

January 14, 2010 |  9:41 am

Note to the easily alarmed: "Chemical-free" does not mean what you think it means. 

The term has quite irritatingly become shorthand for "scary compounds we know nothing about and thus must be bad," used to describe whatever a company wants you to think is gentle, benign or guaranteed safe. Enough, I say! As a description of tangible substances, it's wrong. And I want you not to be fooled by it.

Here's an about.com answer to the question What is a chemical?

"Short answer: Everything is a chemical. Longer answer: Chemistry is the study of matter and its interactions with other matter. Anything made of matter is therefore a chemical. Any liquid, solid, gas. Any pure substance; any mixture. Water is a chemical. Technically speaking, so is a chunk of your computer."

Oxygen? A chemical element. Water? A combination of the chemical elements hydrogen and oxygen. The human body? A whole passel of chemicals -- naturally occurring ones, no less.

There's more, but that's probably enough for today. If not, here's a fun site, chem4kids.com. Don't be chastened by the name. The very friendly home page does state that "it's for everyone."

As for the "kill swine flu without use of chemicals" reference, it's from a pitch for a product that uses tap water.

-- Tami Dennis


Pregnant? Don't trust those flu tests

December 23, 2009 |  6:08 pm

A new post over at the L.A. Now blog describes a report published online today in the New England Journal of Medicine.

Times staff writer Rong-Gong Lin II writes: "A new study by California health officials says pregnant women with flu-like symptoms should promptly undergo 'aggressive antiviral treatment,' even if a preliminary test shows that the patient tests negative for the flu."

The stakes are too high for a delay to be worth the risk.

Read more.

-- Tami Dennis


Tying up the week's loose ends -- broken noses, antigens and more

December 18, 2009 |  7:13 am

Context may be everything when it comes to news coverage, but sometimes, the health and medical specifics are fascinating on their own. Just this week for instance, you might have asked yourself the following questions... 

Berlusconi- What should I do if my nose and teeth are broken by a hurled statuette? (Relevant story: Italian Premier Silvio Berlusconi attacked at rally)

Here's what WebMD has to say about the former. Best tip: "Take an over-the-counter nasal decongestant to aid in breathing through the nostrils."

And here's an offering from eMedicineHealth on the latter, complete with explanation of the Ellis classification of tooth fractures. Best tip: "If a tooth is completely knocked out, it should be quickly rinsed off with water, but never scrubbed. The tooth should be held by the crown (top), not the root, so you do not damage the ligaments. In a cooperative adult, the tooth should be put back in the socket." The operative word is "cooperative."

Neither site mentions souvenirs of cathedrals as possible causes, but the advice should hold nonetheless.

- What can I do about this inability to see the bedside clock in the middle of the night? (Relevant story: Distance vision is all a blur to more of us)

Here are facts on myopia (nearsightedness) from the American Optometric Assn., complete with an explanation of refractive surgery and orthokeratology, in which rigid contact lenses are used to reshape the cornea.

Best tip: "People who do an excessive amount of near vision work may experience a false or “pseudo” myopia. Their blurred distance vision is caused by over use of the eyes’ focusing mechanism.... The symptoms are usually temporary and clear distance vision may return after resting the eyes. However, over time constant visual stress may lead to a permanent reduction in distance vision."

This is something you may have wanted to know before you spent a couple of decades at the computer.

Also of note, from the Mayo Clinic. "If you're significantly nearsighted, it's possible that the retina of your eye is thin. The thinner your retina, the higher your risk of developing a retinal tear or retinal detachment. If you experience a sudden onset of flashes, floaters or a dark curtain or shadow across part of your eye, seek medical assistance immediately."

- Just what is a flu antigen anyway and how is it relevant? (Relevant story: 800,000 doses of swine flu vaccine recalled)

Check out this glossary of flu-related terms from the Neiman Foundation for Journalism at Harvard University. Don't stop with antigen. Learn about adjuvants. Hemagglutinin. Reassortment.

-- Tami Dennis

Photo: Italian Premier Silvio Berlusconi waves from his car Thursday after leaving a Milan hospital.

Credit: Associated Press
 


Flight attendants may offer too much slack; same can't be said for Blue Shield

December 16, 2009 |  9:48 am

Sometimes, stringent adherence to the rules can be good for one's health. Sometimes, the effects have more negative repercussions. Here are two examples from today's L.A. Times ...

Staff writer Rong-Gong Lin II writes: "Amid concern about H1N1 and seasonal flu, federal health officials issued guidelines late last month on how to handle obviously sick passengers: Flight attendants should ask the person with the cough to wear a mask and move them at least 6 feet from others. In the air, recent travelers report a different reality."

Read more.

On an unrelated topic, columnist David Lazarus begins:

"Amid a national debate on how to make the healthcare system friendlier and more accessible, and as millions of people grapple with the loss of jobs and homes, what does insurance heavyweight Blue Shield of California do? It decides to take a key benefit away."

Read more.

It seems much depends on who follows, and who makes, the rules.

-- Tami Dennis


800,000 swine flu doses for very young children recalled, but it's not a safety issue

December 15, 2009 |  9:09 am

Pig Vaccine manufacturer Sanofi-Aventis is recalling 800,000 doses of vaccine against the pandemic H1N1 virus meant for children younger than 3 because the vaccine has lost potency since it was shipped from the factory.

"This is non-safety related, but is part of a routine quality assurance program," Dr. Anne Schuchat, director of the Centers for Disease Control and Prevention's National Center for Immunization and Respiratory Diseases, said in a telephone interview. There are now 94.6 million doses of vaccine available, "so this is not as big a deal as it might have been earlier." She emphasized that "there are no safety concerns."

The doses in the recall are pre-filled syringes containing thimerosal-free vaccine made specifically for children ages 6 to 35 months old. At the time of manufacture, testing showed that the doses contained the recommended 7.5 micrograms of antigen, the virus component that is used to stimulate immunity. But later testing showed that some of the antigen had apparently degraded, leaving the vaccine less potent than desired. It is not yet known why that happened, Schuchat said, but it doesn't appear to be a storage issue.

Children who received the vaccine do not need to be re-immunized, she added, because they probably received a sufficient dose, "but we wanted to make sure that doses that weren't already given won't be," she said. She emphasized that children who have only received one dose of the swine flu vaccine should get their scheduled second dose. Two doses are required to provoke full immunity in children younger than 10, just as is the case with seasonal flu vaccine.

-- Thomas H. Maugh II


On Santa's Christmas list: Face mask, hand sanitizer, vaccine ...

December 11, 2009 | 11:00 am

Santa We've been remiss. The swine flu's potential effect on mall Santas has thus far been given little attention in this space -- despite their exposure to society's disease spreaders, otherwise known as children. We're glad others have stepped in.

From a story in CNNMoney.com:

Greg Winters, 54, a working Santa from Branson, Mo., got his H1N1 vaccination about a month ago.

Should all working Santas get the H1N1 shot?

"Absolutely," he said.

Winters said his doctor suggested that he get the shot, even calling him a "critical case."

"He asked me how many kids I'll see this year. I said thousands, and he immediately said I was a top priority for the shot," he said.

Read more.

The risk to, and from, mall Santas has been a concern in other parts of the country as well. From the Dallas Morning News: Santa uses anti-flu precautions at area malls this season

NPR gave a heads-up on the issue before Thanksgiving: Santa wants swine flu vaccine for Christmas 

But the guys in the red suits can start relaxing.

Posted earlier today on Booster Shots: Swine flu continues its decline, CDC says

Also today on latimes.com is some extra reassurance for California Santas: Shortage of H1N1 flu vaccine appears to be easing in California

We're happy for the mall Santas. It's stressful enough spending the day amid harried shoppers, overstimulated kids and parents looking for just the right photo. Factor in flu fears -- and incessant holiday music -- and it's really more than one person should have to bear. 

-- Tami Dennis

Photo: Santa greets patrons, and risks viral exposure, at a mall in Roswell, N.M., recently.

Credit: Associated Press



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