Archive for the ‘Flu’ Category

A Mid-flu Season Update

Friday, February 14th, 2014

Flu Snapshot: As of February, 2014, the US Centers for Disease Control and Prevention (CDC) reports seasonal flu activity is elevated nationally, but rates vary from place to place, rising in some areas, declining in others. Flu activity, which usually peaks in January or February, is expected to continue for several more weeks.

Has Flu Spread to Your Area? The color-coded map below from the CDC website estimates the geographic distribution of flu activity in the United States. The map does not indicate the severity of flu.

How Severe is the Flu this Year? As one indicator of flu severity, for the week ending February 1, CDC reported the national proportion of people seeing their health care provider for flu-like illness decreased slightly, but remains above the national baseline. More detail is available on the CDC Seasonal Influenza website.

How Important is the Flu Vaccine? Getting a flu vaccine is the most important thing you can do to prevent getting the flu. It is not too late to get a flu vaccine, especially if you live in an area with increased flu activity. CDC estimates 70,000 flu hospitalizations were prevented by vaccinations in the 2012-2013 flu season. That’s enough people to fill an NFL stadium! Not sure where to get a flu shot? This HealthMap Vaccine Finder could help.

How Effective is this Year’s Flu Vaccine? Each year, the effectiveness of the vaccine depends on how well matched it is to circulating flu viruses. According to the CDC website, this year’s flu vaccine is made from three viruses that health experts predicted will be prevalent: Influenza A (H1N1) viruses, influenza A (H3N2) viruses, and influenza B viruses. So far this year, data reported to CDC show more than half of patients who tested positive for influenza for the period January 12 through February 1, 2014 tested positive for the same variety of the H1N1 virus added to the vaccine.

A Weekly Influenza Surveillance Report Prepared by the Influenza Division
From the US Centers for Disease Control and Prevention website

Want to Learn More about the Flu? Check out our “Handy Tips to Help Prevent the Flu” below and take the CDC interactive “Flu I.Q.” quiz to raise your “Flu I.Q.”

Handy Tips to Help Prevent the Flu:

Avoid crowds if flu is prevalent in your area.

Best to get vaccinated early!

Cover your mouth with a tissue or your elbow when coughing or sneezing.

Disinfect frequently touched surfaces to prevent the spread of germs.*

Encourage others to stay home if they have the flu, and you do the same.

Frequently wash hands for 15-20 seconds at a time to help prevent the spread of germs.

*Mix up an inexpensive germ-busting solution by adding ¼ cup chlorine bleach to 1 gallon of water. Apply the solution to frequently touched surfaces, leaving wet for 10 minutes. Rinse with plain water.

Ralph Morris, MD, MPH, is a Physician and Preventive Medicine and Public Health official living in Bemidji, MN.

How to Tell the Difference between the Flu and the Common Cold

Tuesday, December 31st, 2013

 Woman with the common coldThe winter holidays are for gathering with family and friends, but sometimes we exchange more than gifts and small talk during the festivities. Cold and flu viruses are usually present in impressive numbers at holiday functions, turning every guest into a potential host–of a viral infection. Sick is sick, and it’s never fun to be sick, but how can you tell the difference between the flu and the common cold when some of the symptoms are similar? We offer the interactive chart below to help you do just that.

Happy, Healthy Holidays!

 
 
 
 
 
 
 
 
 
 
 
 
 

Click here to download this chart

When Flu Comes a-Knockin’ at Your Door: Ten Steps to Prevent Flu Spreading through Your Household

Tuesday, December 10th, 2013

Ten Steps to Prevent Flu Spreading through Your HouseholdFlu season is here again, and although “influenza activity”–to use the language of the US Centers for Disease Control and Prevention (CDC)—is low right now, it is expected to increase in the coming weeks. So, what steps should you take when flu comes a-knockin’ at your door? How can you reduce the risk of infection to the rest of your family when one family member gets the flu?

  1. BE PROACTIVE: GET THE ANNUAL FLU VACCINE: CDC says getting the flu vaccine is the single most important thing that everyone six months old and older can do to reduce their risk of flu. According to CDC, flu is more dangerous for children than the common cold; it can lead to severe complications, especially in children under the age of two, and in children with chronic health problems. Other people at high risk for flu-related complications are adults 65 years old and older and pregnant women. It takes about two weeks following vaccination for protective antibodies to develop in the body, so get your family vaccinated as soon as possible each year.
  2. AVOID OTHER SICK PEOPLE: As much as possible try to avoid other sick people during flu season.
  3. GIVE THE PATIENT SOME “SPACE.” The flu virus is a “cootie” that is never satisfied to infect just one family member. Through sneezing and coughing the flu virus is launched into the air with high hopes of reaching multiple hosts. One way to counteract that sneaky strategy is to keep your sick family member separated, as much as reasonably possible—ideally with a separate bedroom and bathroom—from everyone else.
  4. OFFER FLUIDS: Offer plenty of fluids to the sick household member. Fever with the flu can lead to dehydration, which makes the patient even sicker.
  5. PRACTICE “FLU HYGIENE.” Cover coughs and sneezes with a tissue that is disposed of after use. Everyone in the household should wash their hands frequently and properly (by singing the “Happy Birthday” song twice–no matter how unhappy you feel–while lathering up with warm, soapy water). Avoid touching your eyes, nose and mouth—that just makes it too easy for the flu virus to spread!
  6. HUMIDIFY YOUR HOUSEHOLD AIR. Flu viruses survive best in dry air. According to a 2009 study in the Proceedings of the National Academy of Sciences, humidifying your home to 40-60 percent relative humidity helps reduce flu virus in the air and on frequently touched surfaces such as sink faucets, door handles and countertops.
  7. USE YOUR WASHING MACHINES. The flu virus can survive on hard surfaces for several hours and on fabric surfaces for even longer, so use your washing machines to your best advantage: Wash and dry dishes, glasses and utensils in the dishwasher to help disinfect them. Wash linens and clothing with detergent and hot water (follow manufacturers’ directions; use bleach if fabric directions permit) and tumble dry on a hot setting.
  8. DISINFECT FREQUENTLY TOUCHED SURFACES: Professor Douglas Powell of Kansas State University was recently quoted in a CNN article titled Getting Dangerous Germs out of Your Home as saying, “Chlorine bleach is your friend.” Mix up a simple flu germ-busting solution of chlorine bleach by adding ¼ cup of regular household bleach to one gallon of water.1 Wash frequently touched surfaces such as doorknobs, handrails and faucets, and then disinfect them by applying the bleach solution. Leave surface wet for 10 minutes, then rinse with plain water.
  9. MEDICATED APPROPRIATELY: Avoid given aspirin to young children under the age of 5. Use acetaminophen or ibuprofen for the aches and pains of the flu.
  10. KNOW WHEN TO SEEK MEDICAL ATTENTION: Most cases resolve by themselves. Seek medical attention if you are concerned about the patient. If the patient starts have breathing difficulty, develops bluish skin, becomes dehydrated, or does not wake up, is irritable or does not interact with other household members, medical attention should be sought immediately.

For more information on preventing the spread of flu, please see www.cdc.gov/flu.

Ralph Morris, MD, MPH, is a Physician and Preventive Medicine and Public Health official living in Bemidji, MN.


1If using concentrated bleach, reduce the amount of bleach to 2 ½ tablespoons.

Flu Vaccination Blitz Needed for Long-term Healthcare Workers

Friday, October 5th, 2012

Patient being given a flu vaccination.The flu vaccine represents the single best strategy for preventing the flu, according to the US Centers for Disease Control and Prevention (CDC).  Many healthcare workers are vaccinated every year to help reduce their risk of contracting the flu and spreading it to their patients and families.  Long-term care patients in particular may be prone to serious complications from the flu, so it is important for them and their caregivers to be vaccinated.  There is unsettling news from CDC, however, that staff in long-term care facilities lag behind their colleagues in other healthcare environments in getting their flu vaccinations. This leaves the already high-risk population in long-term care facilities potentially more susceptible to seasonal flu.

The new CDC study finds flu vaccination rates among long-term care physicians and nurses and other healthcare personnel in the 2011-2012 flu season was only 50.2 percent compared to the overall rate among healthcare workers of 66.9 percent. Among healthcare workers, the highest vaccination rates were reported among hospital doctors (86.7 percent) and nurses (78.1 percent). But whereas flu vaccination rates rose among most monitored healthcare worker groups between the last two flu seasons, rates fell among long-term care facility workers. CDC reports that when healthcare workers were asked why they did not obtain a flu shot, the most common responses were:

About the Flu Vaccine, aka the “Flu Shot”

The flu vaccine, popularly called the “flu shot,” consists of a biological agent that stimulates the human body’s immune system to recognize and destroy influenza viruses. Vaccines may be administered through an injection or using a nasal spray.

Each spring a group of scientists meet to take their best guess at which flu strains are likely to be circulating in the upcoming winter. They choose three and the vaccine is developed to destroy those viruses. Sometimes the scientists guess correctly and sometimes they do not. Because circulating flu strains vary over time, people need to be vaccinated each year to maximize their level of protection from flu.

  • A belief that they did not need it (28.1 percent)
  • Concern about vaccination effectiveness (26.4 percent)
  • Concern about side effects (25.1 percent)

Needed: An Intervention Strategy

To help improve flu vaccination coverage, CDC recommends medical care facilities develop a comprehensive intervention strategy. Educational outreach, an important part of that strategy, should emphasize the effectiveness and safety of flu vaccines as well as how the flu is transmitted and the benefits of the vaccine to staff, patients and family.

Last month the Duke University Health Systems held a 24-hour flu vaccination “blitz” (news report). Duke and ten other health centers in the Triangle area of North Carolina set up free flu vaccination stations for staff in well-traveled areas such as the front entrances of hospitals, entrances to cafeterias, and near elevators and conference rooms; staffers vaccinated each other on wards. The goal of the blitz was to vaccinate 10,000 healthcare workers to both reduce flu incidence and conduct a drill for a potential pandemic flu situation.

The Duke blitz can serve as a model for long-term care facilities. It could go a long way toward raising flu vaccination rates among caregivers in constant contact with our elderly and infirm.

Barbara M. Soule, R.N. MPA, CIC, FSHEA is an Infection Preventionist and a member of the Water Quality & Health Council.

Norovirus: The “Stomach Flu” That is Not a Flu

Friday, February 3rd, 2012

Norovirus is a highly contagious virus that causes flu-like symptoms of nausea, vomiting, diarrhea and abdominal cramping.Norovirus is a highly contagious virus that causes flu-like symptoms of nausea, vomiting, diarrhea and abdominal cramping.

(Image from CDC website)

The dreaded “stomach flu” that hits particularly hard in winter is not a flu at all. It is norovirus, a highly contagious virus that causes symptoms of diarrhea, vomiting and stomach cramping. According to the Centers for Disease Control and Prevention (CDC), the illness often begins suddenly and lasts for one to two days with no long-term adverse health effects. True “flu” is a respiratory disease caused by the influenza viruses; sometimes the “true flu” can also cause gastrointestinal symptoms similar to norovirus. Getting an annual flu vaccine can help prevent flu; unfortunately, there is no vaccine for the norovirus and antibiotics, useful only for bacterial infections, do not help.

Norovirus is extremely common and has gained notoriety as a vacation cruise spoiler and an unwelcome visitor in child and adult care facilities, schools, restaurants, hospitals and dormitories. Norovirus particles are extremely small and are discharged by the billions in the stool or vomit of infected people, according to CDC. Yet, fewer than 100 virus particles are highly likely to make a person sick. The virus spreads through direct contact with an infected person or when an individual touches a contaminated surface and then touches their mouth or even their nose.

A 2011 study found norovirus is the leading cause of foodborne illness in the US, responsible for 5.5 million cases each year. In many cases, sick food handlers are responsible for these outbreaks. Eating foods contaminated with norovirus is a leading cause of hospitalizations.

Recipe for an Outbreak

Close quarters and a breakdown in sanitation is the simple recipe for a norovirus outbreak. Attention to surface disinfection is critical to controlling the spread of norovirus. Proper hand washing is another “must” as the virus can be transmitted easily via contaminated hands. It is important to know that a norovirus carrier can infect others for at least three days after recovery.

These steps, from CDC, can help reduce your risk of contracting norovirus:

  • Wash your hands carefully with soap and water, especially after using the toilet and changing diapers and always before eating or preparing food.
  • Carefully wash fruits and vegetables, and cook oysters and other shellfish thoroughly before eating them.
  • If infected with norovirus, do not prepare food for others while experiencing symptoms and for three days after recovery (see Norovirus: Food Handlers).
  • After throwing up or having diarrhea, immediately clean and disinfect contaminated surfaces by using a solution made with chlorine bleach and water:

Disinfecting against Norovirus with Chlorine Bleach

Disinfection Scenario Regular Household Bleach Dilution Cleanup and Disinfection Directions
1Hard surfaces such as non-porous floors, counter-tops, sinks, toilets 5 tablespoons of bleach in 1 gallon of water
(1000 ppm)

CLEAN-UP: Wearing gloves and other protective clothing, wipe up any vomitus or stool with paper towels and dispose in a plastic trash bag. Rinse hard surfaces with water; use kitty litter or other absorbent substance on carpeted areas to absorb liquid.
DISINFECTION: Apply bleach solution to affected area and allow to remain wet for 10 minutes. Allow to air dry. Rinse with clean water if food preparation area. Remove gloves and discard in plastic bag. Wash hands with soap and water or use an alcohol hand gel immediately after removing gloves.

2Porous surfaces, including wooden floors 1 2/3 cup bleach in 1 gallon of water (5000 ppm)
2Routine disinfection of stainless steel food/mouth contact items; toys 1 tablespoon bleach in 1 gallon water (200 ppm) Clean object first and then apply disinfectant solution. Allow to air dry.
  • Immediately remove and wash clothing or linens that may be contaminated with vomit or stool. Handle soiled items carefully—without agitating them—to avoid spreading the virus. If available, wear rubber or disposable gloves while handling soiled clothing or linens and wash hands after handling. Soiled items should be washed with detergent at the maximum available cycle length and then machine dried.

Joan Rose, PhD, is the Homer Nowlin Chair in Water Research at Michigan State University and a member of the Water Quality and Health Council.


1http://emergency.cdc.gov/disasters/disease/pdf/diarrhea-evac.pdf
2http://health.utah.gov/epi/diseases/norovirus/Guidelines_for_Environmental_Cleaning_125846_7.pdf

Rapid Influenza Tests Often Fail to Detect H1N1

Wednesday, December 9th, 2009

Doctors’ offices and hospitals are using “rapid influenza diagnostic tests” to identify the presence of the H1N1 flu in patients; however, these tests actually do a poor job of sniffing out H1N1 because the rapid test does not detect H1N1, only influenza A. A confirmatory test must be done to identify H1N1 – a strain of influenza A.

Scientists confirmed this theory recently in a report published in The Journal of the American Medical Association, which found that one-third of California patients hospitalized with H1N1 flu were given a rapid test that came back negative. A different test that uses more sophisticated technology confirmed they had H1N1.

The discrepancy is caused by the high specificity (80-90 percent) and the low sensitivity (10-70 percent) of the rapid test for influenza A. The test often does not identify influenza A, especially in adults, who don’t shed as much virus as children. Therefore, correctly identifying those with influenza A, which could be either H1N1 or seasonal flu, is the real issue with the rapid tests. Since about 90 percent of circulating influenza A is H1N1, doctors can be fairly sure that anyone with flu-like symptoms who is also positive for influenza A – either on the rapid or more advanced tests – has H1N1 flu. But, there is still a 10 percent chance that it is seasonal flu.

Regardless, many are not taking the chance that their illness could be something other H1N1. Dartmouth pediatrician Hank Bernstein, who’s on the American Academy of Pediatrics’ infectious diseases committee, said in a recent USA Today article, if symptoms look like the flu, “it’s H1N1 until proven otherwise, almost.”

Stephen Baum, an infectious-disease physician at New York’s Albert Einstein College of Medicine, in the same USA Today story, says: “If you test positive, you got it. If it’s negative, you may still got it.”

Therefore, it is important to understand the symptoms of flu versus a common cold. Those symptoms, not the test results, should be the trigger to take relevant action – either treatment or protecting others from exposure. Further, a negative test shouldn’t make one complacent in taking steps to prevent spreading the flu. Learn what you can do to keep your family healthy this winter by visiting the “Prevention and Treatment” section on the Centers for Disease Control and Prevention H1N1 website.

(Jerod M. Loeb, PhD, is Executive Vice President, Division of Quality Measurement and Research, The Joint Commission, and a member of the Water Quality & Health Council).

Is it the flu or the common cold?

Saturday, November 7th, 2009

Viruses are unwelcomed visitors in many households right now. I am frequently asked how to tell whether a family member is suffering from the flu or just a common cold. Some of the symptoms are similar, but others generally indicate one or the other of these illnesses. To help you evaluate your symptoms, I’ve created this comparison chart.