Patients Can Emit Small, Influenza-Containing Particles Into the Air During Routine Care

From the 31 January 2013 article at KevinMD.com

[The]majority of influenza virus in the air samples analyzed was found in small particles during non-aerosol-generating activities up to a 6-foot distance from the patient’s head..

Vaccination of health providers remains a fundamental and key part of protecting them from influenza

 

A new study suggests that patients with influenza can emit small virus-containing particles into the surrounding air during routine patient care, potentially exposing health care providers to influenza. Published in The Journal of Infectious Diseases, the findings raise the possibility that current influenza infection control recommendations may not always be adequate to protect providers from influenza during routine patient care in hospitals…

…

The current belief is that influenza virus is spread primarily by large particles traveling up to a maximum of 3 to 6 feet from an infected person. Recommended precautions for health providers focus on preventing transmission by large droplets and following special instructions during aerosol-generating procedures. In this study, Dr. Bischoff and his team discovered that the majority of influenza virus in the air samples analyzed was found in small particles during non-aerosol-generating activities up to a 6-foot distance from the patient’s head, and that concentrations of virus decreased with distance. The study addressed only the presence of influenza-containing particles near patients during routine care, not the actual transmission of influenza infection to others.

Fitted respirators are currently required for health care providers during aerosol-generating procedures with patients. During routine, non-aerosol-generating patient care, the current precautions recommend that providers wear a non-fitted face mask. Based on their findings, Dr. Bischoff and investigators are concerned that providers may still be exposed to infectious dosages of influenza virus up to 6 feet from patients with small wide-spreading particles potentially exceeding the current suggested exposure zones.

These findings suggest that current infection control recommendations may need to be reevaluated, the study authors concluded. The detection of “super-emitters” raises concerns about how individuals with high viral load may impact the spread of influenza, they noted. “Our study offers new evidence of the natural emission of influenza and may provide a better understanding of how to best protect health care providers during routine care activities,” the study authors wrote. However, studies of influenza virus transmission will be necessary before the role of super-emitters can be firmly established, they noted…

Whatever protective equipment or infection control practices are used for preventing influenza transmission, vaccination of health providers remains a fundamental and key part of protecting them from influenza, noted Dr. William Schaffner, professor medicine and chair of the department of preventive medicine at Vanderbilt University School of Medicine in Nashville, Tenn., who was not involved with the study. “Influenza vaccination, although not perfect, is the best tool we have to protect health care workers — and their patients — from influenza illness.

 

Related articles

• Health care providers may be at greater risk of flu exposure (eurekalert.org)
• Stand Back: Flu Virus Travels 6 Feet (livescience.com)
• People with flu can release small, flu-filled particles into air: Study (sunnewsnetwork.ca)
• 2012-13 Influenza vaccine effectiveness: a preliminary estimate (bio230fall2010.wordpress.com)

 

Speaking fluently

Reblogged from Engineer & Entertain:

I could not have said it better myself.

Great presentation! complete with graphs (you might need to pause to read them, as I did!) Language is a bit earthy, but not vulgar Only negative comment I have... Speaker said to stay home if you have flu, it is not the end of the world if you do stay home. Perhaps not, but for those in low paying jobs without paid sick days, it is a very difficult choice to make...the money is needed just for basics as food...

Related articles

• The Time for Earned Sick Leave is Now (blueoregon.com)
• Paid sick leave a wise investment (waworkandfamily.org)
• How No Sick Days Make Us Sick (andrewsullivan.thedailybeast.com)

 

Rumor Control – Flu Epidemic: Fact or Fiction

A 19th January post at MedPage Today addresses rumors and “conspiracy theories” about flu epidemic reports.

Responses in a recent survey ranged from blaming Hurricane Sandy (with a government coverup) to profit motivations by BigPharma to vaccine inffectiveness.

The entire article may be read here.

Related articles

• Flu myths: Know your bug (sacbee.com)
• CDC: Flu activity continues to be high across the United States (medicalxpress.com)
• How To Avoid The Flu Epidemic While Traveling (gadling.com)
• US flu epidemic worsens, 29 children dead (terradaily.com)

 

Researchers Find “Google Flu Trends” a Powerful Early Warning System for Emergency Departments

Researchers Find “Google Flu Trends” a Powerful Early Warning System for Emergency Departments

From the 1 January 2012 article at newswise

newswise — Monitoring Internet search traffic about influenza may prove to be a better way for hospital emergency rooms to prepare for a surge in sick patients compared to waiting for outdated government flu case reports. A report on the value of the Internet search tool for emergency departments, studied by a team of researchers at Johns Hopkins Medicine over a 21-month period, is published in the January 9 issue of Clinical Infectious Diseases.

The researchers reported a strong correlation between a rise in Internet searches for flu information, compiled by Google’s Flu Trends tool, and a subsequent rise in people coming into a busy urban hospital emergency room complaining of flu-like symptoms….

Pitt researchers propose new model to design better flu shots

From the 22 December Eureka news alert

PITTSBURGH—The flu shot, typically the first line of defense against seasonal influenza, could better treat the U.S. population, thanks to University of Pittsburgh researchers.

New research that focuses on the composition and timing of the shot design was published in the September-October issue of Operations Research by Pitt Swanson School of Engineering faculty members Oleg Prokopyev, an assistant professor, and Professor Andrew Schaefer, both in the Department of Industrial Engineering, and coauthors Osman Ozaltin and Mark Roberts, professor and chair in Pitt’s Department of Health Policy and Management. Ozaltin, who is now an assistant professor of engineering at the University of Waterloo in Ontario, did his research for the study as a Pitt graduate student in the Swanson School; he earned his Pitt PhD degree in industrial engineering earlier this year.

The exact composition of the flu shot is decided every year by the Food and Drug Administration (FDA), and the decision is complicated.

“The flu’s high rate of transmission requires frequent changes to the shot,” said Prokopyev. “Different strains can also cocirculate in one season, which gives us another challenge for figuring out the composition.”

The Pitt researchers used powerful optimization methods from engineering to examine whether they could improve the yearly decisions made regarding what strains of influenza should be included in the current year’s vaccine. The strains of flu that will be most likely to appear in the regular flu season are not known with certainty, but waiting longer to finalize the composition of the vaccine and observing what strains are occurring in other parts of the world improves the accuracy of the selection. However, the longer the FDA waits to make the decision, the more likely it is that there will be insufficient vaccine produced by the start of flu season. The model developed by the Pitt researchers balances these two important characteristics of the flu selection decision and integrates the composition and timing decisions of the flu shot design….

Read the entire news article

Related Resources

• Flu (MedlinePlus) with links to overviews, basic information, health check tools, research articles, and more

  

• Flu.gov (US CDC and other federal agencies) with links to news articles, prevention tips, ask-an-expert answers, vaccine location finder, and much more
• Seasonal Influenza (Flu)(Centers for Disease Control and Prevention) with links to activity/surveillance map, flu basics, treatment/prevention, info for specific groups, and more

 

Related articles

• Grocery Store or Doctor’s Office: Does It Matter Where You Get Your Flu Shot? (livescience.com)
• Get the Flu Vaccine, America, CDC Urges (inquisitr.com)
• Flu finally makes an appearance (mysanantonio.com)

How Influenza Evolves – And How To Stop It From Doing So

How Influenza Evolves – And How To Stop It From Doing So.

If you become infected with the flu after getting vaccinated, your body activates an immune response that stops you from becoming ill. Although, this can trigger the virus to change into a slightly different form – one that may be more infectious.

A novel investigation from MIT reveals the mechanism responsible for this phenomenon, known as antigenic drift. The study was funded by the National Institutes of Health and the Singapore-MIT Alliance for Research and Technology and appears in the December 19 online edition of Scientific Reports, an open-access journal published by Nature.

Related articles

• How Influenza Evolves – And How To Stop It From Doing So (medicalnewstoday.com)
• Lab-Made Bird Flu Details Kept Secret (myfoxny.com)
• Influenza A (H1N1) [swine flu] (codesandstuff.wordpress.com)
• Georgetown researchers lead discovery expected to significantly change biomedical research (eurekalert.org)
• The Flu – How To Stop It! (jflahiff.wordpress.com)

The Flu – How To Stop It!

 

Image via Wikipedia

From the 8 December 2011 Medical News Today article

During the 1918 to 1920 global influenzaepidemic, between 50 to 100 million people lost their lives, with over a quarter of the world’s population having being infected. Although vaccines might help in the event of a similar outbreak today, the possibility still remains that vaccine production would not be able to cope with such an influx in demand to make an important impact. In addition, hospitals would probably be overstretched, leaving many patients to be cared for by family members at home.

According to Richard Larson and Stan Finkelstein, members of MIT’s Engineering Systems Division (ESD), non-pharmaceutical interventions (NPIs) would be critical in these situations to minimize the spread of infection. Larson and Finkelstein want to inform people on how to avoid flu from spreading amongst family members and those living or working in close quarters. Larson, Mitsui Professor of Engineering Systems explains:

“We thought, let’s look at the dynamics of the home and see if there are any reasonably inexpensive steps that people could take to care for their loved ones and simultaneously minimize the chance of getting infected.”


 They discovered that following simple steps, such as washing hands properly, wearing masks and strategically controlling temperature, humidity and air circulation, could all assist in decreasing the risk of flu from spreading. Even though their recommendations are based on fighting pandemic flu, these measures could also prevent the spread of the common seasonal flu, which typically kills about 30,000 people each year in the U.S. 
….

 

Related articles

• The Flu: A Guide For Parents (education.com)
• Do flu shots cause the flu? 12 influenza vaccine myths busted (cbsnews.com)
• Swine Flu: Caring for a Sick Person at Home (everydayhealth.com)
• Skip the flu vaccine? “There’s no excuse,” says CDC (cbsnews.com)
• Dec. 4-10 Is National Influenza Vaccination Week! (cdc.gov)
• More People Getting Flu Shots This Year (webmd.com)
• How to Choose the Right Flu Vaccine (everydayhealth.com)
• Cold and Flu Prevention (everydayhealth.com)
• 8 *BUSTED* Myths About Flu Vaccines (mayorshealthline.wordpress.com)
• Flu Myths: Fact and Fiction (abcnews.go.com)

8 *BUSTED* Myths About Flu Vaccines — From The [Boston] Mayor’s Health Line Blog

8 *BUSTED* Myths About Flu Vaccines « The Mayor’s Health Line Blog

From the Boston Mayor’s Health Line Blog

There is a lot of information about flu vaccines and the effects it has on the human body.  Most of the information regarding flu vaccines is true and factual, and is often disseminated through publications and fact sheets authored by members of such organizations as the Center for Disease Control and Prevention, the Massachusetts Department of Public Health, and the national office of Health and Human Services.

However, there are still misconceptions about the flu vaccine.  This post will offer another avenue for correct information that keeps Boston healthy and happy.

 

Myth 1: Flu shots can cause the flu

All vaccines contain an inactive sample of the virus it’s meant to fight. The same is true for the flu vaccine.  The body recognizes these inactive flu viruses and makes antibodies to destroy them.  When an active flu virus is present in the body, the body already has stored antibodies that can and will attack the flu virus.

 Myth 2: Flu shots can cause autism
This myth has gained considerable notoriety as GOP presidential candidate Michele Bachmann recited this misconception.  The flu vaccine contains thimerosal, a preservative that has mercury.  Thimerosal has been linked to many health problems, including autism.  However, health and medical professionals agree that a small exposure to thimerosal will cause no more harm than some minor red irritation at the injection area.

 Myth 3: Flu shots received late in the flu season are ineffective at preventing the flu

Some people believe that getting a flu shot after November is pointless.  However, it is never too late to start protecting yourself.  Although it is recommended that one gets a flu shot early in the season, for ample protection time.  The flu season typically lasts as long as the winter season.  Especially in Boston, residents can expect exposure to the flu until late February or even early March.

 Myth 4: Flu shots protect for many years

Unlike most vaccines, the flu shot should be given annually.  Every year the flu virus changes and new vaccines are needed so the body can continue to protect against the flu.

Myth 5: Babies should get flu shots

Although babies under the age of 6 months are at risk of catching the flu, it is not recommended that infants under 6 months get a flu shot.  Instead, parents and other members of the family should get vaccinated and lessen the risk of passing the flu to their infant children.

 Myth 6: Any and everyone should get a flu shot

Those who have a severe allergy to chicken eggs should not get the flu vaccine.  Also, those people who have allergies to any of the other substances in the vaccine should talk to a health professional about whether or not the vaccine is a healthy choice for them.   Those people who have had bad reactions to the vaccine in the past should forgo the vaccine now, too.

 Myth 7: One flu shot in the season is not enough

One flu shot per flu season is enough to protect an adult against the flu.  Only kids 6 months to eight years old who have no previous history of getting the flu shot, should get a second at least four weeks after the first dose.

Myth 8: The flu shot is the only option

There is also the nasal spray that protects against the flu virus.  The spray is for healthy people age 2-49 who are not pregnant.

  A lot of this information was pulled from CBS News and their article 12 Vaccination Myths Busted.

Related Blog item

         From Urban Update

Is city living good for your immune system?

This week is National Influenza Vaccination Week (is there a Hallmark card for that?), which got me wondering whether urban dwellers have better immune systems because they’re exposed to so many people–and germs. After all, a subway car is not too dissimilar to a daycare center: uncovered coughs, shoving, and issues with sharing abound. And we know that in the long term, kids in daycare have stronger immune systems.

Without spending too much time researching this question, I came across an interestingNational Geographic piece that illustrated the impact ancient cities have had on bolstering present-day immunity. At the same time, however, a quick glance at this Google Map tracking the spread of H1N1 reminds us that urban areas were particularly hard-hit.

Moral of the story? Get a flu shot! Find a vaccination location nearby athttp://www.flu.gov/whereyoulive/index.html.

Bird flu science too scary to publish, some say

Some biosecurity experts are concerned new research could be used as a blueprint by nefarious forces and are arguing against publication of the work. (CBC)

 

From the 19th November 2011 CBC (Canadian Broadcast Corp) news item

(via a Linked In item by Sandeep Pulim M.D.,Sr. Medical Editor at M3-USA, who is also on Twitter)

 

New bird flu research that shows that the dangerous virus can mutate to become easily transmissible among ferrets — and perhaps humans — has embroiled the scientific community in a difficult debate.

Some biosecurity experts are concerned the research could be used as a blueprint by nefarious forces and are arguing against publication of the work.

But others, especially influenza scientists, are countering that the flu world needs to know the possible paths the H5N1 virus could take to become one that can spread easily among people so laboratories can be on the lookout for those changes in nature….

…

2 papers already published

The body does not have the power to bar publication, but it is unclear whether a scientific journal would feel comfortable publishing an article if the group says it should not be placed in the public domain.

It’s also not clear whether the funders of the research — in this case, the U.S. National Institutes of Health — would permit publication if the government’s biosecurity advisers objected to publication of an article.

The controversy relates to several papers, two of which have recently been published and another which is in the publication pipeline.

That latter paper is the one garnering the most concern.

The senior author, virologist Ron Fouchier of Erasmus Medical Centre in Rotterdam, the Netherlands, won’t talk about the work other than to confirm it is under review by the National Security Advisory Board on Biosecurity.

But Fouchier electrified the flu world in September when he gave an outline of the work at a major influenza conference in Malta.

He told the gathering that in trying to find out whether H5N1 could acquire the ability to spread easily among people, he came up with a virus that spread among ferrets as easily as seasonal flu viruses, according to a report on the meeting in Scientific American.

Scientists caught in Catch-22

Ferrets are considered the best animal model for human infection with influenza. It is feared that a virus that could spread easily among the animals would spread easily among people as well.

H5N1 currently does not transmit easily to people or among people. To date there have been 570 confirmed cases of H5N1 infection in 15 countries and 335 of those people have died.

The other two recently published studies, one by scientists from the U.S. Centers for Disease Control and another by scientists at St. Jude’s Children’s Hospital in Memphis, Tenn., both involved engineering viruses with some genes from H5N1 viruses. Both papers were published without being referred to the biosecurity advisory board.

Flu scientists may feel like they are caught in a Catch-22 situation. For years they’ve faced demands from governments anxious to know whether H5N1 could become a human flu virus and what it would take for that to happen.

 

 

 

Related articles

• Bird flu science too scary to publish, some say (talesfromthelou.wordpress.com)
• Debate rages over new bird flu research; some argue it’s not safe to publish (thestar.com)
• Bird Flu Experiment Rattles Bioterrorism Experts (npr.org)
• Bird Flu Experiment Rattles Bioterrorism Experts (npr.org)
• NIH grantees rebut theory that seasonal flu strains originate in tropical regions (jflahiff.wordpress.com)
• Five easy mutations to make bird flu a lethal pandemic (newscientist.com)
• Flu cases up 50% (premierlinedirect.co.uk)
• Where did the bird flu come from (wiki.answers.com)

CDC Issues Initial 2011-2012 Seasonal FluView Report

CDC Issues Initial 2011-2012 Seasonal FluView Report
http://www.cdc.gov/media/releases/2011/p1014_fluview_report.html
The Centers for Disease Control and Prevention has released the initial FluView report for the U.S. 2011-2012 flu season with the message that flu activity is currently low, making this the perfect time to get vaccinated.

Related articles

• CDC issues initial 2011-2012 seasonal “FluView” report-cnbnews.net (gloucestercitynews.net)
• NIH grantees rebut theory that seasonal flu strains originate in tropical regions (jflahiff.wordpress.com)
• Flu Season (emilymariec.wordpress.com)
• Annual Childhood Flu Vaccines May Interfere With Development of Crossresistance (jflahiff.wordpress.com)
• More Than 690,000 Americans Have Already Been Vaccinated Against The Flu This Season, SDI Reports – Cdc Supports Expanded Access To Flu Vaccination (prweb.com)
• Flu season is coming. Are you ready? (today.msnbc.msn.com)
• Flu Season is Here – Get Vaccinated Today. (franklinmatters.org)