Tis' the (Flu) Season! - Facts about the Flu and Dispelled Myths

Every September when we think about “back to school” season, we should also think about another season just around the corner - flu season.  Many people shrug off getting vaccinated against the flu with a variety of excuses like: “I never get the flu”, “the flu is just like a bad cold” or “I’d rather get the flu than get a flu shot which GIVES me the flu”.  So, let’s dispel some of these misconceptions.

How Dangerous is Influenza?

The flu is not just another cold.  In addition to making you feel absolutely miserable for days with fever, congestion, cough and body aches, it is far more dangerous than the common cold or other circulating upper respiratory infections.  Each year approximately 200,000 people in the U.S. are hospitalized due to influenza, and up to 49,000 die.  Compare that to the annual mortality from breast cancer (~40,000) or AIDS (~19,000) in the United States.  Although morbidity and mortality are generally highest among young children and adults over age 65, last year, 60% of hospitalizations occurred among adults between the ages of 18 and 64 – those who had vaccination rates of only 37%.    

When is Flu Season?

Flu seasons are unpredictable and vary from year to year in terms of timing, severity, and length.  Although influenza activity most commonly peaks in the U.S. between December and February, some years have seen cases begin as early as October and continue as late as May.

How is Flu Spread?

Influenza is spread by droplets up to 6 feet away through coughing, sneezing or talking. You can also get the flu by touching a surface or object that has flu virus on it and then touching your mouth or nose.  Most people know they can get the flu from patients and coworkers who are sick, but don’t realize they can spread it to others even if they don’t feel sick.  Most healthy adults can infect others beginning 1 day before symptoms develop and up to 5 to 7 days after becoming sick.  Approximately 20% to 30% of people carrying the influenza virus have no symptoms.

Who Should Get Vaccinated?

CDC recommends a yearly flu vaccine(http://www.cdc.gov/flu/protect/vaccine/index.htm) for everyone 6 months of age and older, preferably by October, since it takes about two weeks after vaccination for an immune response to develop. 

Individuals at particularly high risk for influenza include:

• Children younger than 5 (especially those younger than 2 years of age)

•Adults 65 and older

•Pregnant women

•People with chronic health issues like asthma, diabetes, heart disease, cancer and HIV/AIDS.

Dispelling the Myths

“The flu vaccine can give you the flu”

Injectable flu vaccines contain inactivated, non-infectious virus particles.  Although the nasal spray vaccine does contains live flu virus, it is attenuated (weakened) in such a way to be able to stimulate immunity without causing illness.  People not only mistake the side effects of the vaccine for the flu but also erroneously attribute illness with other unrelated cold viruses to the flu. 

“I can take antibiotics if I get the flu”

Antibiotics only treat bacterial infections – not the influenza virus.  Although there are antiviral medications against the flu, to be effective in reducing the duration and severity of illness, they must be taken within 48 hours of the beginning of symptoms. 

“I don't need to get a flu shot every year”

Influenza viruses are constantly changing (mutating), so each year flu vaccines are updated to protect against the most common circulating viruses.  Although protection from the vaccine decreases over time, protection typically lasts about a year.

“Pregnant women should not get a flu shot”

Pregnant women and their offspring are at very high risk for complications from the flu.  Pregnant women are 7 times more likely to be hospitalized than non-pregnant women and account for 5% of all flu-related deaths.  All pregnant women should to be vaccinated with inactivated flu vaccine.   

“Getting the flu vaccination is all I need to do to protect myself from the flu.”

Besides vaccination, avoid contact with people who have the flu and wash your hands frequently!

Bottom Line

By getting vaccinated and practicing good personal hygiene, you not only help to protect yourself, but your family, friends and patients.

Thoughts on Feminism

Feminism is getting a lot of buzz lately, with many examples of violence and unequal treatment towards women flooding the airways. However, there are mixed ideas about what feminism is, who is a feminist and the ultimate goals surrounding the idea.

The answer is very simple. Feminism is an ideology that focuses on creating equal rights for women and feminine qualities. Traditionally, women have not had equal opportunities to many things (employment, voting, education), which caused feminist movements to develop. There have been significant and positive changes in women's rights, but there still strides to be made. Women are still paid less than men (for the same work) and experience violence on a much higher scale.  Because of factors such as these exist, the focus of feminist ideals is mostly on women. However, men are not excluded. Feminism seeks to defend men who are perceived as feminine from back lash that should not exist in the first place. Feminism tells us that it is okay for a man to express his feelings and he should not be afraid of being "less than a man". Feminism glorifies a man in his role as a father, instead of making him think that is a woman's job. Feminism does not come at the expense of men and NEVER seeks to put a man down simply for his chromosomal make up.

At the same time, feminism does not seek to control women, want them to dominate men, or force them into certain careers. If a woman wants to be a stay at home mother, that is great. Feminism wants to make sure that she has the resources to look after her children and that society does not devalue the hard work that she does.

Some people may have made you think otherwise in the past, but feminism is not a bad word. It is not just about women; it impacts men as well and won't be recognized without the help of men. Thankfully, we are seeing more attention being paid to this issue. From Emma Watson's speech for the He for She Campaign to Joseph Gordon Levitt's Re: Feminism video. However, it would be great to see these messages promoted beyond celebrities and national meetings.

Feminism needs to be an everyday word and practice. Gender equality is an essential step in improving the lives of all people. Remember, just because you do not personally feel that you face inequities does not mean that millions of people do not experiences them everyday.

Mentioned Links: 
He for She Campaign Website:  He For She.org 

Preventative Health Lecture Follow-up: Talking with Patients and Vaccinations

After Dr. Nunez’s informative and entertaining lecture on Women’s Health and Prevention Issues this afternoon, a few additional thoughts came to mind.  As she pointed out, sometimes there’s a little bit of a disconnect (or at least order of priorities) between what the patient is seeking help for and what the physician considers most urgent.  In the case presented, the patient was concerned about joint pain (osteoarthritis), but the physician would also be concerned about cardiovascular risk (hypertension, obesity, hyperlipidemia in a post-menopausal woman).  One way of trying to tie the two together to unite common goals might be to explain to the patient that weight loss (which would benefit her lipids and blood pressure control) would also likely ease the stress on her joints (knees) and decrease some of the pain she is experiencing.

On a different note, physicians often forget about vaccinations as an effective preventive care measure.  This patient should have been receiving annual flu vaccinations (as we all should) and should also be asked about the last time she received a tetanus vaccine.  If she is due for a tetanus shot (which many adults neglect/forget since it is received ~ every 10 years), she should receive Tdap.  This tetanus toxoid combined with pertussis vaccine is now recommended for all adults who have not already received it and is especially important for those who may have small children (e.g. grandchildren) in their household, since pertussis is most serious, even potentially fatal, in infants.  When she turns 60, she will be eligible for the shingles vaccine (ZOSTAVAX) and at age 65 for two pneumococcal vaccines (PREVNAR 13 and PNEUMOVAX 23, which are recommended to be given sequentially).  If she were part of a high risk group such as individuals with diabetes, heart disease, chronic liver or lung disease, pneumococcal vaccination would be administered at a younger age.  Guidelines are currently in flux with the availability of two vaccines now for adults, so stay tuned for the CDC to issue new guidelines soon!

Resources:

http://www.cdc.gov/vaccines/schedules/hcp/adult.html

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Risk Factors For Heart Disease: Worse for Women & African Americans

A recent study reported in Health Day.com demonstrates the disparity felt by women and African Americans when it comes to risk factors for heart disease. In particular, diabetes and high blood pressure were found to be major contributors to this sex and race gap by increasing the chance for heart disease to develop significantly in these groups when compared to men in general.

When looking at combined risk from 5 factors (High cholesterol, smoking, high blood pressure, obesity and diabetes) blacks had an increased risk of 67% to develop heart disease as compared to 48% in whites. Women had a combined risk of 58% compared to 48% in men. These risks ultimately make these groups more likely to experience poor health outcomes, or even die from complications of heart disease and stroke.

 But why is this happening? From a clinical perspective, the article suggested that " this difference in risk could be due to the fact that heart disease has typically been considered a disease of white men, and doctors have not tackled contributing factors as much when they crop up in women and blacks." If this is the case, this image of the "typical" heart disease patient can be putting lives at risk. It is later suggested that doctors take risk factors more seriously in these populations since their chance for later development is higher.

Patients can also have an important role in bridging this gap. It is important to know your family history, be aware of the things you are at high risk for and  try your best to manage any risk factors you do have. If you don't feel like your doctor is taking your risk factors seriously, seek a second opinion. Remember, your family history does not have to be your biography. Ask your doctor what you can do to reduce your risk factors for heart disease. In some cases, small life changes can make a big difference.

Resources:

Original Article: Women, African Americans Hit Harder by Heart Disease Risk Factors, Heath Day.com

Article Referenced: Philly.com 

Article: How to Prevent and Control Coronary Heart Disease Risk Factors , NIH

Video: Heart Healthy Tips, 5 Superfoods 

Possible Health Benefits of Lower Bedroom Temperatures

You may want to think twice before turning down your air conditioner! An interesting study was released recently investigating the possible health benefits of sleeping in cooler temperatures at night. It is something we usually do not think about, but some are starting to think it can really make a difference. Specifically, researchers set out to see if it had an effect on stores of brown (good) fat which has the potential to improve metabolism.  Sponsored by the American Diabetes Association, researchers took 5 healthy young men and had them sleep in a controlled environment. During the course of the experiment, they had them all sleep in different room temperatures. It was found that when the temperature was cooler, significantly higher amounts of brown fat were found. This implies that there is possibility of metabolic benefit to sleeping in colder temperatures.

However, is the same true for women? We do not know. Since the study only included 5 men, it is impossible to know if the same results would have been found in a group of 5 women. With the possible metabolic benefits this study eludes to, it is hopeful that it will be repeated not only with women, but with a larger and more diverse group.

Resources:
Article abstract and link in PubMed

Article: Let's Cool it in the Bedroom  New York Times