[Reblog] Twelve ideas to help you stay healthy during flu season with home made sani-wipe recipe

From the December 2013 post at the Boone Medical Center

Twelve ideas to help you stay healthy during flu season

The 2013 flu season has begun, and while it is still early in the season, cases have already been reported in the U.S. Winter gatherings can bring together people who are vulnerable to the cold & flu virus.

People who get together for the winter holidays can be exposed to viruses from other parts of the region and can pick up and spread the illness from wherever they’ve been. Here are some small, individual changes you can make lending to a healthy winter season.

1. Drink black or green tea with lemon and honey. Drinking hot tea while breathing in the steam stimulates the cilia – the hair follicles in the nose – to move out germs more efficiently. Lemon thins mucus and honey is antibacterial.
2. Consume enough protein. Diets that are too low in protein can deplete the immune system. The current recommendation for protein intake is at least 60 grams per day for adult women and at least 75 grams per day for adult men, depending on age, activity level and if they need to gain/lose weight.
3. Slowly exhale. When walking past a person who is sneezing or coughing, slowly exhale until you’re past them. This avoids you inhaling contaminated air.
4. Try Zinc lozenges. If you get a scratchy throat, zinc lozenges can relieve cold symptoms faster.
5. Eat your fruits and vegetables. Eating 5 or more fruits and vegetables each day will provide many vitamins and minerals necessary for your immune system to function properly. Try to choose more vegetables than fruit.
6. Sanitize your space. You can sanitize commonly touched items (cell phones, grocery carts, keyboards, gym equipment) to help the spread of germs. Remember, rhinoviruses causing cold & flu symptoms can live on surfaces for up to 48 hours!
7. Pamper your nose. The job of your nose is to filter allergens, bacteria, and viruses floating in the air. By using saline nasal rinses, you can help flush germs and clear secretions in your upper airway.
8. Consume enough water. The urge to drink water can decrease in colder months, but the need for water is still important. Consuming enough fluids will eliminate toxins from your lymph system which keeps your immune system functioning properly.
9. Get a massage for your immune system! Massage increases circulation which boosts immunity by nourishing cells with more oxygen filled blood. Click here to learn about our massage services.
10. Sanitize your brushes. Think about the items you may reuse every day and consider cleaning or replacing them (cosmetics and make up brushes, toothbrushes, hair brushes, hand towels). A quick swipe of an alcohol wipe on a tube of lipstick or washing make up brushes in an antibacterial soap can support a healthy immune system.
11. Sleep. Research shows that adults need 7-8 hours of sleep to stimulate an immune response from our natural killer cells which are the cells that attack viruses.
12. Humidity. Dry air in the winter can cause your lips, mouth, & nose to become dry and cracked. Cracked skin can be an entry point for bacteria and viruses. Consider a humidifier to help keep moisture in the air.

Homemade Sani Wipes:

Fold or cut paper towels or napkins and put them into a wipe container. Use 1 1/2 cup of warm water, add 1 Tbsp. of coconut oil, and 1 tsp. of alcohol. Add 3 drops of lavender oil if you like. Then mix well and pour the mixture into the container of napkins to saturate them. Makes 2 containers.

Your health and wellness crew in WELLAWARE wish you a healthy winter season.

References

• Patz, A. (2013, December). Live healthy. Health 27(10).
• CDC. (2013, November 22). Seasonal Influenza. Retrieved fromhttp://www.cdc.gov/flu/
• CDC. (2012, October). Nutrition for everyone: protein. Retrieved fromhttp://www.cdc.gov/nutrition/everyone/basics/protein.html

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[Press release] First real-time flu forecast successful

“This season the forecasts will be more readily available to the public on a website hosted by Columbia’s Mailman School of Public Health expected to launch in the coming weeks.”

 

From the 3 December 2013 Columbia University’s Mailman School of Public Health press release via EurekAlert

Researchers take a page from weather forecasting to predict seasonal influenza outbreaks in 108 cities across the country

Scientists were able to reliably predict the timing of the 2012-2013 influenza season up to nine weeks in advance of its peak. The first large-scale demonstration of the flu forecasting system by scientists at Columbia University’s Mailman School of Public Health was carried out in 108 cities across the United States.

Results are published online in the journal Nature Communications.

The flu forecasting system adapts techniques used in modern weather prediction to turn real-time, Web-based estimates of influenza infection into local forecasts of the seasonal peak by locality. Influenza activity peaked in cities in the southeast as early as December 2012, but crested in most of the country in the first weeks of 2013.

Year to year, the flu season is highly variable. It can happen anywhere from December to April. But when it arrives, cities can go from practically no cases to thousands in a very short time. “Having greater advance warning of the timing and intensity of influenza outbreaks could prevent a portion of these influenza infections by providing actionable information to officials and the general public,” says first author Jeffrey Shaman, PhD, assistant professor of Environmental Health Sciences at Columbia University’s Mailman School of Public Health.

For the public, the flu forecast could promote greater vaccination, the exercise of care around people sneezing and coughing, and a better awareness of personal health. For health officials, it could inform decisions on how many vaccines and antiviral drugs to stockpile, and in the case of a virulent outbreak, whether other measures, like closing schools, are necessary.

Study Results

The new study builds on the researchers’ 2012 study that used the system to retrospectively predict the peak of the flu in New York City for the years 2003-2008. That research was limited to one city and performed as a test of the system. The current study is the first to make predictions in actual real-time and for the whole country.

Beginning in late November of 2012, the researchers used the flu forecasting system to perform weekly estimates for 108 cities. They shared the results with the CDC and posted them online in an academic archive. Near the end of 2012, four weeks into the flu season, the system had predicted 63% of cities accurately. As the season progressed, the accuracy increased. By week four, it successfully predicted the seasonal peak in 70% of the country. It was able to give accurate lead-times up to nine weeks in advance of the peak; most lead-times were two to four weeks.

The flu forecasts were also much more reliable than those made using alternate, approaches that rely on historical data. “Our method greatly outperformed these alternate schemes,” says Dr. Shaman.

The researchers saw regional differences in the accuracy of the system, but they were likely within normal variation. “As an example, retrospectively, we’ve been able to predict the flu in Chicago very well; this year we did a terrible job in that city. For other cities, the opposite held. It averages out. On the whole the system performed very well,” Dr. Shaman says. However, there were hints of geographical differences. “We were able make better predictions in smaller cities. Population density may also be important. It suggests that in a city like New York, we may need to predict at a finer granularity, perhaps at the borough level. In a big sprawling city like Los Angeles, we may need to predict influenza at the level of individual neighborhoods.”

Google Flu Trends Goes “Off the Rails”

The researchers designed the flu forecasting system to use combined data from 1) Google Flu Trends, which makes estimates of outbreaks based on the number of flu-related search queries, and 2) region-specific reports from the Centers for Disease Control on verified cases of flu. The system approach is analogous to weather forecasting, which employs real-time observational data to reduce model forecasts error. In the last year, the researchers slightly modified the system to be more representative of flu rather than flu and other respiratory problems. Nevertheless, there was unusual level of “noise” in the data related to problems with Google Flu Trends.

How did this happen? One explanation is the high number of media stories about the flu, including some about the flu forecasting system itself. The result was a spike in people using Google to research the flu, which could have overloaded the Flu Trends algorithm. It’s an irony not lost on Dr. Shaman. “There was a tremendous amount of media attention accorded to the flu last year. I was part of the problem myself,” he says. Another factor may have been the particular strain of flu in circulation. “The flu was very virulent and was making people very sick, more so than previous seasons,” says Dr. Shaman. Again this could have led to spike in flu-related Google search queries. (In October, Google announced that it has revised the Flu Trends, which Dr. Shaman hopes will make flu forecasting more accurate.)

The system will be put back in action as soon as the flu season begins again. “Right now there are few cases of the flu, but as soon as the needle starts to move, we will start making predictions,” says Dr. Shaman. This season the forecasts will be more readily available to the public on a website hosted by Columbia’s Mailman School of Public Health expected to launch in the coming weeks.

Worldwide, influenza kills an estimated 250,000 to 500,000 people each year, according to the World Health Organization. In the U.S. 3,000-49,000 die from the flu every year, and about 45% of Americans were vaccinated for the flu, according to the CDC.

 

###

 

Co-authors include Wan Yang and James Tamerius, post-doctoral students of Dr. Shaman (Dr. Tamerius is currently at the University of Iowa); Alicia Karspeck at the National Center for Atmospheric Research; and Marc Lipsitch at the Harvard School of Public Health.

Funding was provided by the National Institutes of Health (GM100467, ES009089) and the Department of Homeland Security. Dr. Lipsitch discloses consulting or honorarium income from the Avian/Pandemic Flu Registry (Outcomes Sciences; funded in part by Roche), AIR Worldwide, Pfizer and Novartis. All other authors declare no competing financial interests.

 

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[Reblog] With CDC Seasonal Flu Data Unavailable, An Electronic Medical Record Offers a Glimpse of Early Activity Levels

Influenza (Photo credit: hesenrre)

From the 13 October 2013 post at The Health Care Blog By IYUE SUNG

As Washington remains deadlocked on the implementation of the Affordable Care Act, the US government’s shutdown has resulted in the furlough of nearly 70% of the Centers for Disease Control‘s (CDC’s) workforce. CDC Director Tom Frieden recently shared his thoughts in a tweet. We agree whole-heartedly.  Although it’s all too easy to take the CDC staff for granted, they are the frontline sentinels (and the gold standard) for monitoring disease outbreaks.  Their ramp-down could have serious public health consequences.

We are particularly concerned about the apparent temporary discontinuation of the CDC’s flu surveillance program, which normally provides weekly reports on flu activity. Although flu season typically begins in late fall, outbreaks have occurred earlier in previous years. In 2009, flu cases started accumulating in late summer/early fall.  And given the potential for unique variants, such as the swine or avian flu, every season is unpredictable, making the need for regular CDC flu reports essential. We therefore hope to see the CDC restored to full capacity as soon as possible.

In the meantime, we would like to help by sharing data we have on communicable diseases, starting with the flu.

Because the athenahealth database is built on a single-instance, cloud-based architecture, we have the ability to report data in real time. As we have described in earlier posts, the physicians we serve are dispersed around the country with good statistical representation across practice types and sizes.

To get a read on influenza vaccination rates so far this season, we looked at more than two million patients who visited a primary care provider between August 1 and September 28, 2013 (Figure 1).  We did not include data on vaccinations provided at retail clinics, schools or workplaces.

This year’s rates are trending in parallel to rates over the last four years, and slightly below those of the 2012-2013 season. However, immunizations accelerate when the CDC, and consequently the media, announce disease outbreaks and mount public awareness campaigns.

As for the government shutdown, nearly everyone hopes for a quick end.  Should the standoff drag on, detection of the flu (or other diseases) may be delayed, in theory endangering the public. Fortunately, we currently see no evidence of an early influenza outbreak.  But recent history shows that the flu can begin spreading at any time, and once it does begin, it spreads very quickly, as shown in Figure 2.

We believe that our data provides a reliable view of seasonal flu trends. Last year, wewrote about the 2012-2013 flu season and found that patterns in our patient population (consisting of a large proportion of patients receiving immunizations in primary care settings) closely mirrored CDC trends. With that in mind, we believe that sharing our 2013-2014 data would be valuable to the health care community.

Whether our nation’s politicians can come to an agreement tomorrow or next month, we will continue to deliver reports that monitor population health and look ahead to contributing any information we can. If you have any suggestions or comments – on the flu or other diseases where up-to-date data would be valuable – please leave a comment here or e-mail me directly at isung@athenahealth.com.

Iyue Sung is the Director of Core Analytics at athenahealth. The post originally appeared on the athenahealth blog.

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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.

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Early Estimates of Seasonal Influenza Vaccine Effectiveness — United States, January 2013

Vaccination; 041028-N-9864S-021 Yokosuka, Japan (Oct. 28, 2004) – Hospital Corpsman 3rd Class Tiffany Long of San Diego, Calif., administers the influenza vaccination to a crew member aboard USS Kitty Hawk (CV 63). Currently in port, Kitty Hawk demonstrates power projection and sea control as the U.S. Navy’s only forward-deployed aircraft carrier, operating from Yokosuka, Japan. U.S. Navy photo by Photographer’s Mate Airman Joseph R Schmitt (RELEASED) (Photo credit: Wikipedi

On January 11, 2013, this report was posted as an MMWR Early Release on the MMWR website (http://www.cdc.gov/mmwr)

In the United States, annual vaccination against seasonal influenza is recommended for all persons aged ≥6 months (1). Each season since 2004–05, CDC has estimated the effectiveness of seasonal influenza vaccine to prevent influenza-associated, medically attended acute respiratory infection (ARI).

This season, early data from 1,155 children and adults with ARI enrolled during December 3, 2012–January 2, 2013 were used to estimate the overall effectiveness of seasonal influenza vaccine for preventing laboratory-confirmed influenza virus infection associated with medically attended ARI.

After adjustment for study site, but not for other factors, the estimated vaccine effectiveness (VE) was 62% (95% confidence intervals [CIs] = 51%–71%). This interim estimate indicates moderate effectiveness, and is similar to a summary VE estimate from a meta-analysis of randomized controlled clinical trial data (2); final estimates likely will differ slightly.

As of January 11, 2013, 24 states and New York City were reporting high levels of influenza-like illness, 16 states were reporting moderate levels, five states were reporting low levels, and one state was reporting minimal levels (3). CDC and the Advisory Committee on Immunization Practices routinely recommend that annual influenza vaccination efforts continue as long as influenza viruses are circulating (1). Persons aged ≥6 months who have not yet been vaccinated this season should be vaccinated.

However, these early VE estimates underscore that some vaccinated persons will become infected with influenza; therefore, antiviral medications should be used as recommended for treatment in patients, regardless of vaccination status. In addition, these results highlight the importance of continued efforts to develop more effective vaccines……

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The Compelling Need for Game-Changing Influenza Vaccines: An Analysis of the Influenza Vaccine Enterprise and Recommendations for the Future

English: This is CDC Clinic Chief Nurse Lee Ann Jean-Louis extracting Influenza Virus Vaccine, Fluzone® from a 5 ml. vial. (Photo credit: Wikipedia)

 

From the 11 December 2012 summary at Full Text Reports

 

….The ongoing public health burden caused by seasonal influenza and the potential global effect of a severe pandemic create an urgent need for a new generation of highly effective and cross-protective vaccines that can be manufactured rapidly. A universal vaccine should be the goal, with a novel-antigen game-changing vaccine the minimum requirement…

 

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CDC Releases First FluView Report for 2012-2013 Influenza Season (Week ending October 13)

From the announcement

The Centers for Disease Control and Prevention today issued the first “FluView” influenza activity report for the U.S. 2012-2013 flu season. The 2012-2013 reporting season began on September 30. The first FluView report shows that influenza activity is low nationwide.This season, FluView has new interactive visualization tools.

Where

To access the FluView report please go to (www.cdc.gov/flu/weekly).

Additional Information

CDC routinely tracks influenza activity in the United States with a system that determines when and where influenza activity is occurring, what influenza viruses are circulating, and detects changes in influenza viruses.
The system also measures the burden of influenza disease in the United States, including tracking flu-related illness, hospitalizations and deaths. Data for the week ending October 6 indicate that influenza activity is low nationally at this time.

This year, FluView includes enhanced web-based interactive applications which can provide dynamic visuals of the influenza data collected and analyzed by CDC. These FluView Interactive applications, allow people to create customized, visual interpretations of influenza data, as well as comparisons across flu seasons, regions, age groups, and a variety of other demographics.

CDC can’t predict how severe the upcoming flu season will be. However, the agency recommends that everyone 6 months of age and older get vaccinated against influenza each year.  More than 112 million doses of seasonal influenza vaccine already have been distributed by vaccine manufacturers in the United States this season and more is expected.

For more information about influenza,  please go to www.cdc.gov/flu/weekly/fluviewinteractive.htm

Here’s a few excerpts from the first weekly report (it is rather long and includes quite a few graphs and graphics)

U.S. Virologic Surveillance:

WHO and NREVSS collaborating laboratories located in all 50 states and Washington, D.C. report to CDC the number of respiratory specimens tested for influenza and the number positive by influenza type and subtype. Region specific data can be found at http://gis.cdc.gov/grasp/fluview/fluportaldashboard.html.

	Week 41
No. of specimens tested	3,285
No. of positive specimens (%)	129 (3.9%)
Positive specimens by type/subtype
Influenza A	61 (47%)
2009 H1N1	4 (6.6%)
Subtyping not performed	31 (50.8%)
H3	26 (42.6%)
Influenza B	68 (53%)

Centers for Disease Control and Prevention

Weekly Report: Image Download

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Busting Common Myths about the Flu Vaccine

From the 8 October 2012 article at Nationwide’s Children

With cold and flu season upon us, many companies have geared up for what is predicted to be a busy flu season producing 150 million doses of the influenza vaccine, up 17 million from last year.

“This is a pretty busy time around here,” said Dennis Cunningham, MD  a physician in Infectious Diseases at Nationwide Children’s Hospital. “Our emergency department, urgent care centers and our inpatient numbers always go up because of the flu, although many of those patients could avoid getting sick by practicing just a few simple precautions.”

Dr. Cunningham, also a faculty member at The Ohio State University College of Medicine, said that part of the problem is many people buy into the long-held myths about the flu vaccine and miss opportunities to avoid getting sick. He says following about some of the most common myths:

Myth: You can actually catch the flu from the flu vaccine.
“This is probably the most common myth out there, but it’s simply not true,” said Dr. Cunningham. “The vaccine can give you some mild symptoms, you may feel a bit achy and your arm may be a little tender where you first get the shot. But that’s actually a good thing and shows that the vaccine is working. It tells us your body is responding appropriately to the vaccine.”

Dr. Cunningham said that nobody should confuse a few slight symptoms with the actual flu. The vaccine may leave you feeling a bit warm or achy for a day or two, but with true influenza, someone is sick and in bed for a week with high fever.

It is especially important for children to get the flu shot, or flu mist, which works just as well. Because children are around so many people – from peers to teachers, siblings to adults and grandparents – children are the biggest carriers of the flu  and giving them the vaccine can protect a wide range of people.

Myth: You should wait until it is cold outside to get your flu vaccine.
“Some people are worried that if you get the vaccine too soon, it will wear off by the time winter gets here,” said Dr. Cunningham. “The truth is vaccinating people even in August will protect them throughout the entire flu season. This also includes the elderly who typically have been the group people are most worried about.”

Myth: The flu is only spread by sneezing.  
“Germs are pretty easy to pass around and flu is really contagious,” said Dr. Cunningham. “It’s very easy for one child to give it to another child and the next thing you know, they bring it home.”

Because of that, experts say it is important to wash and sanitize your hands often during flu season, and urge children to do the same. The easiest way is to use hand gels, but make sure they contain at least 65 to 95 percent alcohol. If soap and water are nearby, that is even better for protecting against germs. Wash often and lather up. Make sure to completely rinse your hands in order to get the soap and germs off.

Myth: Flu vaccines do not protect you from current strains.  
From the H1N1 scare in 2009 to swine flu and the bird flu, each year it seems there is a new strain making headlines. But researchers track the most recent, most dangerous strains, and work to stay one step ahead of it.

“The World Health Organization and Centers for Disease Control and Prevention pick the strains they think are most likely to circulate in the coming months so that people are protected against everything that may go around,” said Dr. Cunningham. “Every year there are two A strains and one B strain of influenza included in the vaccine.”

The vaccine may leave you feeling a bit warm or achy for a day or two, but with true influenza, someone is sick and in bed for a week with high fever.

Watch Dr. Dennis Cunningham, infectious disease specialist, explain the truth about some common myths about the flu vaccine.

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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.

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