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What You Need to Know About Stomach Flu

The main difference between a “stomach flu” and “food poisoning” is duration. Both usually have vomiting and diarrhea, fever and chills to varying degrees, and abdominal cramps, but food poisoning should not last more than 24 hours, while a stomach flu may last up to 3-4 days. Also, food poisoning usually has a more abrupt onset with all of the above symptoms occurring almost simultaneously, within 1/2 hour to 24 hours after ingesting tainted food, while the symptoms of viral gastroenteritis may occur more gradually with vomiting or diarrhea occurring before the other begins.

The cause of food poisoning is usually an exotoxin (liquid) produced by staphylococcus bacteria very frequently, or an endotoxin (on the bacteria itself) such as from shigella, salmonella, campylobacter, or E. Coli. Ingesting food that has not been cooked thoroughly, or reheated, or improperly stored, or made from fresh vegetables/fruits that weren’t washed before preparation, is the main culprit. Use of antibiotics for treating some of these bacteria is controversial, since it is felt that they can cause the germs to become invasive into the walls of the intestines, and thus prolong illness.

Viral gastroenteritis, or “stomach flu”, occurs from the “fecal/oral” route, i.e. someone who has the virus does not properly wash their hands after using the toilet, and a healthy person touches a surface that the infected person touched, or their soiled clothing, or shakes hands with him/her, and then touches their own face or mouth. It has no cure.

Treatment of both is similar, except for the decision whether or not to use antibiotics. Only clear liquids in sips (no more than 1 oz every 3-5 minutes—that’s only 2 tablespoons!!) to start if vomiting/ nauseous. This lets liquids slide by the stomach. If one is thirsty and ingests a large quantity of liquid rapidly, the distention of an already irritated stomach causes reflex regurgitation. Thus, small amounts, frequently is indicated. However, if one also has diarrhea, then constantly ingesting liquids slides by the stomach, but keeps stimulating the bowels and thus propagates the diarrhea. So, if one has both vomiting and diarrhea: take clear liquids in small amounts frequently until thirst is slacked, but then wait 1-2 hours before repeating.

Also, it is important to not drink only water. One loses sodium, potassium, and other chemicals in the emesis and diarrhea that are important to maintain a normal heart rhythm. Drinking only water will further dilute them in the bloodstream, with potential life-threatening consequences. While Gatorade, Powerade, and other “sport” drinks have electrolytes, they are made to replace sweat, not emesis or diarrhea. Coconut Water, on the other hand, has almost the same concentration of electrolytes as human serum, although slightly more potassium (which is good when having both vomiting and diarrhea) and glucose. “Pedialyte” is good for children, but pretty much intolerable to take for anyone older. (Holding one’s nose while drinking/eating unpleasant substances greatly improves the process, since we really “taste” with our sense of smell – the tongue has limited sensations.)

The World Health Organization/UNICEF and others have looked at ORT (Oral Replacement Therapy) because of the unavailability of enough i.v. fluids in Third World countries when Cholera or Rotavirus epidemics occur to replace the massive fluid losses of these diseases. There are many different products of electrolyte powders that can be added to 1 qt of clean water. In general they contain: 1 tsp of salt, 1/2 tsp. of baking soda, and 2-4 tblsp of sugar or honey at a minimum. One can make the same if in a pinch. It is also now recommended to restart regular feedings in children after 6-8 hours if possible. Bananas, applesauce (apple juice can cause diarrhea), rice, and toast are binding. Keep away from caffeine drinks that will stimulate the bowels.

We use injectable, “ODT”s (oral dissolving tablets), or suppository medications to stop the vomiting, and “OTC” (over the counter) Kaopectate or Imodium AD to stop diarrhea in viral gastroenteritis, along with i.v. fluid replacement if needed. I prefer Acetaminophen to control fever and aches, since NSAIDs like Ibuprofen (Advil, etc.) or Naprosyn ( Aleve, etc.) are irritating on the stomach. Also, taking a non-milk-product-containing ProBiotic (at least 9 billion cfus/dose) 3x/day, will replace the normal good bacteria in your intestines that are lost from either of these diseases causing increased diarrhea. ProBiotics have no side effects, and are tasteless. If you cannot control symptoms by yourself, please call us before becoming dangerously dehydrated, or go to the nearest E.R.!!

Please share this email with the link below if you think that you can help someone you know to prevent or treat the stomach flu this season.

Updated 1/19/2020
STEVEN J. LIPSKY MD, FACEP



This article was updated on January 15th, 2020.

With flu season upon us, it is important that you learn everything there is to know about this illness. While the flu is fairly common, every year it claims numerous lives throughout the U.S.

The Centers for Disease Control (CDC) estimates that over 2.5 million people will be affected this year alone. They also predict that over 20,000 people will be hospitalized with upwards of 1,000 flu-related deaths.

So far flu season is off to an early start, a total of six children in Texas have died from the flu this year.  Maricopa County reported the first death of an infant as well. Children along with the elderly are two of the most vulnerable groups of people due to their relatively weak immune systems.

We have been seeing 3 viral syndromes lately:

1) Flu-Like: consisting of low-grade fever, malaise, weakness, headache, runny/stuffy nose with post-nasal drip causing coughing (especially during sleep), and nausea.

2) Influenza (it started as type B, but now is type A H1N3): like #1 but with higher fever, severe muscle aches, and some diarrhea and nausea as well

3) Norovirus: which causes fever (often high), and only extreme vomiting and diarrhea (no URI symptoms), lasting about 3 days, and often requiring i.v. hydration (it’s the “stomach flu” virus that causes huge outbreaks on cruise ships, etc.).

As always, public health officials have been urging people across the country to get inoculated against the flu. This seasonal illness can quickly worsen, causing health complications that can be fatal, even for healthy adults.

Current Flu Activity

This map provided by the CDC shows the overall influenza activity throughout the United States. Alaska, The Virgin Islands, and The District of Columbia are the only ones to report sporadic levels of flu activity.
An infographic showing where the flu is currently in the United States

States with the most widespread influenza activity include Alabama, Arizona, California, Connecticut, Georgia, Idaho, Indiana, Kentucky, Louisiana, Maryland, Massachusetts, Nebraska, Nevada, New Mexico, New York, North Carolina, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Washington.

Beginning of Flu Season

In the United States, cases of influenza-related illnesses typically start around October, continuing on through early spring. February has pretty much always been the worst month in terms of the sheer number of people getting sick.

Who Should Get a Flu Shot?

It is a good idea for just about anyone who is over the age of six months to get inoculated against the flu. Getting this shot early on in flu season significantly decreases one’s chances of becoming seriously ill. These shots are typically made available as early as September in most places throughout the U.S. However, many folks say: “I don’t get a Flu Shot because it gives me the flu!”. This is impossible! The injectable immunization consists of completely dead viruses that act only as a template for your body to make antibodies to them. However, it takes about 2 weeks to make these antibodies, and if one is exposed to the Influenza Virus during (or shortly before) the immunization, then one can come down with the flu before you have enough time to mount a resistance. Also, some people do not make enough antibodies to ward off a subsequent infection. Getting a Flu Shot in Sept. – Oct. should protect for the entire flu season, which hit earlier than normal this year and is still rampant in the West. However, it is still advisable to get one now if you have not already!
Flu myths vs flu facts infographic

Will The Current Vaccine be Effective?

There are many different factors that ultimately determine the efficacy of a flu vaccine, including the current strains that are going around. It is ultimately up to health officials as to which strains of the fly to cover in each year’s vaccine. The fact that these strains are capable of changing rapidly can make determining this quite difficult.

Scott Epperson, a spokesperson for the CDC, stated that he believes the current vaccine will be highly effective. It was formulated to prevent illness due to the H1N1 and H3N2 strains, which have been widespread in numerous states.

All indications suggest that this new vaccine is also going to be effective at combating the B strains that were identified earlier this year. The CDC has acknowledged that even effective vaccines can only work so well.

Effectiveness of the flu shot from 2008 to 2016

Where are Flu Shots Available?

There are many different drugstores, schools, public health departments, and other places across the country that offers flu shots.

A vast majority of medical insurance policies cover these shots for children and adults. Those who have Medicare Part B will be able to get one of these shots without having to pay anything.

If you are looking for a flu shot near me check the map below


Is the Nasal Spray Vaccine Effective?

Those who are not a fan of needles will find that the nasal spray vaccine is a viable alternative to consider.

The young child Nose Spray Immunization is a weakened virus, and although the CDC says it is too weak to cause the flu in healthy patients, this is a possibility in immunocompromised ones (e.g. those with leukemias/other cancers, HIV, insulin-dependent diabetes, etc.).

Although, as our readers have previously been explained, antibiotics won’t kill a virus (it’s like trying to use weedkiller to kill a gopher!)

This vaccine offers protection for children and adults. There have been some changes made to this spray in the last year that have supposedly made it more effective than ever.

Many parents have started opting for the nasal spray option when it comes to protecting their children from the flu. It is not painful at all and only takes a matter of seconds to administer. This makes it an ideal choice for kids who don’t do well with needles.

This nasal spray did not protect against the H1N1 virus, but it offers protection from other viruses that were going around at the time.

How is the Flu Vaccine Created?

There are a few factors that are considered when creating a vaccine for each new flu season. Doctors and scientists thoroughly research cases of viral infections that are occurring within the U.S. They use this information to determine which strains should be included in the upcoming vaccine.

While this ultimately comes down to a guessing game, the estimates are based on actual data and years of experience among medical professionals. This data is compiled to come up with a final decision for the strains that the vaccine should protect against.

This year’s vaccine has been formulated to protect against H1N1 and H3N2 viruses, as well as two different B strains. Experts have been saying that this new flu shot is more comprehensive than before, which could mean more lives saved across the country.

There is never any guarantee that the flu vaccine will be completely effective for any person who gets it. It does, however, drastically reduce the chances of getting sick by up to sixty percent for most people.

Will We Have a Universal Flu Vaccine in the Near Future?

A recent endowment of $8 million by the National Institutes of Health was given to the University of Georgia. The sole purpose of this large grant was to create a vaccine that can protect against numerous strains of the flu virus in one dose.

The University of Georgia has collaborated with numerous other schools to come up with a universal flu vaccine. While officials are still saying that such a vaccine is still a little way off, it might be available to the public sooner than most of us think.

Human testing of the vaccine could begin as early as 2020, which is exciting news in the health and medical communities. There are other institutions that have been working towards a universal flu vaccine with varying degrees of success.

Who is Most at Risk?

There are certain groups of people who are more at risk of becoming seriously ill from the flu than others. Those who work around children on a regular basis are among these groups. It is also common among doctors and other people in the healthcare community who have direct contact with patients.

Many of the cases of flu-related death in the U.S. each year consist of children who are under the age of two. Elderly people who are over the age of 65 also make up a significant number of these cases each year. Any person with a weak immune system is particularly vulnerable.

Women who are either pregnant or recently gave birth to a child in the past couple of weeks can develop severe symptoms as well.

Any person who has asthma, diabetes or heart disease is also at a higher risk level for serious illness or death from the flu. People who are already in poor health are always the ones who are most likely to experience health complications when getting sick.

Infographic showing the most at risk ages for getting the flu

Is There a “Best” Flu Vaccine?

The fact is that there isn’t any single vaccine that is universally better than all of the others. The best thing that anyone can do is to ask their doctor which vaccine to get. Certain vaccines can be more effective than others for people of certain ages. A majority of the vaccines that are given out this year are going to be quadrivalent, which means they protect against four unique flu strains.

Types of Flu Shots

There are a number of different flu shots that you can get in 2019 through 2020, including:

  • High dose vaccine: These shots are best for older people who are at least 65 years of age.
  • Standard dose vaccine: These vaccines are administered using a needle.
  • Adjuvant vaccine: Vaccines with adjuvant in them are particularly effective for older people and children.
  • Cell culture vaccine: A small percentage of flu vaccines this year will be made using cell cultures as opposed to eggs. These shots are best for those who have allergies.
  • Nasal spray: There is also the nasal spray flu vaccine, which is not recommended for women who are pregnant or those who are in poor overall health.

Is There Anyone Who Shouldn’t Receive a Flu Shot?

Any person who has a known allergy to any of the ingredients that are used in a certain vaccine should not receive it. Those who contracted Guillain-Barre syndrome six weeks leading up to their last vaccination should not get the shot.

When Does the Flu Vaccination Take Effect?

These shots become effective at protecting against various strains of the flu within 10 to 14 days after they are administered.

Pregnant Women and the Flu Vaccine

Most types of flu vaccines are perfectly safe for pregnant women, with the exception of the nasal spray option. The Centers for Disease Control makes a point of telling pregnant women to get vaccinated. Taking this measure can serve to protect themselves and their unborn child at the same time.

The risk of health complications from getting the flu is far more worrisome than the potential reactions to the shot itself. One study conducted in 2018 showed that pregnant women who received a flu vaccine were far less likely to end up in the hospital from influenza. It made a difference of about 40%, which is impressive, to say the least.

Pregnant women are statistically more likely to develop health complications when getting the flu than women who aren’t pregnant. This is why anyone woman who is pregnant should get vaccinated early on in the year.

Which Symptoms are Associated with the Flu?

It is important that you are aware of the various symptoms that are associated with the flu. While it does not present the exact same way in everyone, there are common signs to watch out for.

Some of the symptoms of the flu include:

  • Sore throat
  • Headaches
  • Clogged sinuses
  • Fatigue/lethargy
  • Vomiting
  • Diarrhea
  • Fever
  • Chills

The symptoms of the flu tend to be more dramatic in children. It is a misconception that the flu is always accompanied by a fever, which may not be the case for some people. Most people who get the flu have a general “sick feeling” or malaise, as well as headache and stuffy nose.

infographic that shows the difference between the cold and the flu

What Should I do if I Exhibit Flu Symptoms?

The best thing that you can do if you think you have the flu is to relax at home for a minimum of one day. Once you are no longer running a fever, you won’t have to worry about giving the flu to anyone else.

There are more severe symptoms that you’ll want to be aware of as well, including:

  • Difficulty breathing
  • Irregular heartbeat
  • Changes in skin color
  • General disorientation
  • Vomiting that does not stop
  • Chest or stomach pain
  • Severe muscle aches and pains
  • Mental confusion

If you notice any of these symptoms, you should get yourself to an urgent care clinic right away. The sooner you seek treatment, the better your chances will be of coming through your illness without any major issues or complications. These are not the kinds of symptoms that you should simply ignore, as they are incredibly serious. Pregnant women in particular need to be aware of these symptoms due to their increased overall risk.

Other Ways to Keep from Getting Sick

There are other ways of avoiding the flu in addition to getting the shot that you should consider.

We have been having success treating the symptoms of  Flu Type#1 and  Flu Type#2 with:

Tylenol for fever, headache and muscle aches (Ibuprofen and Naprosyn–ie. Advil and Aleve–can further upset a tender stomach)

Pseudoephedrine (the “Sudafed” you have to show your driver’s license for) and prescription Fluticasone Nasal Spray for runny/stuffy nose/post-nasal drip

Prescription Hydrocodone Cough Syrup ( e.g. Hydromet or Tussionex – all Walgreen’s are currently out of Hydromet in the Valley!) and Pro-Air HFA (i.e. Albuterol Metered Dose Inhalers) for cough and chest congestion

Prescription Ondansetron for nausea/vomiting (along with Phenergan or Compazine Suppositories if uncontrollable)

OTC (i.e. “Over The Counter”) loperamide (e.g.Imodium AD) along with an OTC Probiotic powder or capsule of at least 9 billion cfus (i.e.”colony forming units”) 3x/day for diarrhea.

For those who truly appear to have Influenza (the nasal swab test is only about 50% accurate, and thus worthless in our opinion), and did not get a Flu Shot, we are adding prescription Oseltamivir (e.g. Tamiflu) that is very effective at ameliorating the symptoms of Influenza Type A & B if taken within 48hrs of onset (their literature says it’s effective up to 96hrs, but in our experience, it’s not!).

Remember to stay home and away from others until you are O.K. if you become ill – one is infectious to others from 1-2 days before you come down with symptoms until at least you’re completely normal (some studies say that you can transmit the virus up the 3-4 days after you’re completely normal!!). Cough into your elbow(not hands!) and wear a disposable surgical mask if you must go out, to prevent transmission. Wash hands with soap (it’s not necessary to use “antibacterial soap”) and warm water, front and back, vigorously for at least 30 seconds, frequently (and especially after being in public places). Bedrest and lots of clear liquids are very beneficial, and I personally like CoQ-10 at least 125mg 1-2x/day, a daily high potency B-Complex Vitamin, and at least 1000mg of Vitamin C daily, as well.

If you start to feel yourself getting sick, you should stay home for a day if possible. It is always better to be safe than sorry when it comes to your own health.

While this is not a definitive method of preventing illness, it is better than doing nothing.

Please share this guide with the link below if you think that you can help someone you know to prevent or treat the stomach flu this season.

Feel free to post questions you may have about the flu below and one of our board-certified emergency physicians will do their best to answer.

 



A New Weapon in the Fight Against Abscesses

A peptide developed by researchers at the University of British Columbia prevented drug-resistant bacteria from forming abscesses, or painful pus-filled lesions.

The peptide is a mini-protein, and works by disrupting the bacterial stress response.

There are 3.2 million emergency room visits each year in the United States due to abscesses. Standard treatment typically involves cutting to remove the infected tissue, or draining it. Antibiotics rarely work as a treatment.

This peptide offers a less invasive alternative.

“Abscesses can occur almost anywhere in the body, and antibiotics aren’t usually effective on them,” said Bob Hancock, a Professor in UBC’s department of microbiology said. “Our peptide offers a new strategy, because its mechanism is completely different from every known antibiotic.”

Hancock is also the senior author of the study published in EBioMedicine.

Hancock and UBC researchers used DJK-5, their synthetic peptide to interfere with the bacteria’s stress response and heal abscesses in mice.

Hancock said he is hoping for clinical trials to begin within a year.

His study “Bacterial Abscess Formation Is Controlled by the Stringent Stress Response and Can Be Targeted Therapeutically” appears online in EBioMedicine.

 



It has long been thought that environmental influences and lifestyle choices were risk factors for cancer incidence.  The Los Angeles Times (12/17, Healy) reports on a research study released this past month that confirms such a premise.  The study, published in Nature, indicates that a large majority of cancers are caused by extrinsic factors.  These are external factors such as cigarette smoking, obesity, ultraviolet radiation, and viruses.

This recent study seems to be at odds with controversial research released by a team at John’s Hopkins in January 2015.  That study seemed to indicate that most incidents of cancer were nothing more than bad luck.  As reported by STAT (12/17, Begley), researchers at Hopkins concentrated on intrinsic factors, concluding that two-thirds of cancers are due to cell division errors.

While the two studies seem to come to opposite conclusions, many believe that they both have merit.  In fact, it is possible that external elements can contribute to intrinsic risk factors, such as cell division.   According to a San Diego Union-Tribune (12/17, Fikes) report, the authors of the studies continue to debate their findings on the origins of certain cancers.   It is the opinion of most experts that both intrinsic and external factors play a role in cancer incidence.  Therefore, those patients who control their environmental factors will have a much more positive outcome overall.

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Steven J. Lipsky MD, FACEP has been a Board Certified Emergency Physician in Arizona for the last 37 years, and a resident of the Town of Paradise Valley for the last 37 years. Steve Lipsky on Google Plus[/author_info] [/author]



A recent article in US News & World Report (10/20, Sternberg) reported on emerging data indicating that it is both safe and beneficial for cancer patients to engage in exercise.  While long thought that cancer patients should take it easy or are much too weak to engage in strenuous activity, one specialist suspected otherwise and put his theories to the test.

Lee Jones, an exercise physiologist at Memorial Sloan Kettering Cancer Center, has been conducting studies in cooperation with Duke University physicians.  Some studies have shown that cancer patients who report exercising at higher levels have lower death rates and few recurrences.  Other studies indicate that exercise could increase the effectiveness of chemotherapy.  Research is still in its infancy, but Jones has 14 studies currently underway.

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Steven J. Lipsky MD, FACEP has been a Board Certified Emergency Physician in Arizona for the last 37 years, and a resident of the Town of Paradise Valley for the last 37 years. Steve Lipsky on Google Plus[/author_info] [/author]



Those who are suffering from cancer and who are in search of better drugs are understandably looking for one of two things – a medicine that will either extend survival rates or will improve quality of life.  While there have been scores of new drugs approved for the treatment of cancer in recent years, it turns out that many of them may not do either.

A recent Milwaukee Journal Sentinel (10/20, Fauber) report tells us that a study published in JAMA Internal Medicine found that two-thirds of the new cancer drugs approved in the past five years won approval based on so-called surrogate measures of effectiveness, such as scans showing tumor shrinkage.   Specifically, 36 of 54 drugs showed no evidence of extending life or improving quality of life of cancer patients, even after some of the drugs had been on the market for up to four years.

The same study looked at the price of many of these drugs and found that, on average, they cost $10,000 per month, with several costing more $20,000 per month and one priced at $40,000 per month.  While the FDA indicates that they are making sure that drugs are “safe and effective”, some of the drugs are not specific about the effectiveness for patients with regards to better survival rates or quality of life.

[author] [author_image timthumb=’off’]http://www.drhousecallsofpv.com/wp-content/uploads/2013/02/sjlphoto1sm.jpg[/author_image] [author_info]
Steven J. Lipsky MD, FACEP has been a Board Certified Emergency Physician in Arizona for the last 37 years, and a resident of the Town of Paradise Valley for the last 37 years. Steve Lipsky on Google Plus[/author_info] [/author]



CBS Evening News is reporting that this year’s flu strain is sending seniors to the hospital in record numbers.  While the flu spread appears to have peaked, the numbers of seniors being hospitalized is the highest in a decade.  NBC Nightly News reported that the alarming numbers are due to the severity of the strain in addition to a low effectiveness rate for this year’s flu vaccine.  The vaccine has been shown to be only about 23% effective.  Bloomberg News is reporting that some areas of the country are facing new surges in the spread of the flu.  This includes regions of the West Coast, New England, and the Northeast.   The CDC has issued a warning to healthcare providers to quickly treat patients with antivirals without waiting for tests to confirm a positive flu diagnosis.  The letter explained that the flu may spread for several more weeks, and anti-viral treatments can help keep high-risk patients from being hospitalized.

We are happy to provide patients with all necessary care and prescriptions to treat this epidemic outbreak.  Call us anytime at 480-948-0102!



Life Threatening Flu Strain

Doctors are warning families this year about a potentially life threatening flu strain.  Mayo Clinic infectious diseases physician Dr. Pritish Tosh explains that this year’s strain of flu can be fatal for even healthy children.  The virus works by entering the blood stream first and eventually the brain, resulting in symptoms such as shortness of breath and a very high fever.  The body may then overcompensate by sending white blood cells into the lungs, resulting in serious complications.  Three children in Minnesota have died due to complications from the virus, with another seven currently in the ICU according to the Minnesota Health Department.  Nationwide, the total deaths for children from this flu is reported to be 15.

This particular strain of flu, H3N2, has accounted for approximately 90% of flu cases this year, according to the CDC.  And while this year’s flu vaccine does not appear to match this particular strain, doctors are advising that patients, especially those in high-risk groups, continue to get the flu shot as some cross-protection may occur



REPRINTED FROM the Arizona College of Emergency Physicians

Periodically, as the AzCEP Executive Team sees fit, we will forward alerts that we deem pertinent to you.

 

At the request of the Arizona Health Alert Network:

In late August, the Centers for Disease Control and Prevention (CDC) was notified by two states of an increase in children hospitalized with severe respiratory illness. Enterovirus D68 (EV-D68) was identified in many of these patients. There are now several other states reporting increases in admissions for severe respiratory illness. It is possible that these are also associated with EV-D68.

EV-D68 appears to spread via close contact (e.g., saliva, sputum, feces) with infected individuals. Currently, there is no vaccine to prevent EV-D68 and no specific antiviral treatment recommended.

However, patients can help protect themselves and others from respiratory illnesses by:
o avoiding close contact with people who are sick;
o avoiding touching eyes, nose, and mouth with unwashed hands;
o washing hands often with soap and water, especially after changing diapers;
o cleaning/disinfecting frequently touched surfaces, such as toys and doorknobs, especially if someone is sick;
o ensuring vaccinations, including the influenza vaccine, are up to date.

Clinicians should be aware of EV-D68 as one of many causes of viral respiratory disease and should report clusters of unexplained respiratory illness to their local public health agency: http://www.azdhs.gov/phs/oids/contacts.htm.

Please refer to this MMWR for more detailed information: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm63e0908a1.htm

Thank you,
Arizona Health Alert Network



The Global Polio Eradication Initiative began in 1988 in order to put an end to one of the world’s most crippling diseases. The initiative is a joint effort by the World Health Organization (WHO), UNICEF, Rotary International, the U.S. Centers for Disease Control and Prevention, the Bill and Melinda Gates Foundation, and governments around the world, with the support of many others globally. So how is it going? Only three endemic countries remain and 2.5 billion children have been immunized against polio. But the fight is far from over.

In May, the WHO declared an international public emergency after outbreaks were cited in 10 countries. Travel has begun to complicate the eradication effort, causing the threat of polio to re-emerge in countries once considered polio free.

We need to step up our efforts against the fight. MSN News (AP, 8/22, Neergaard) reported on a new study released by the World Health Organization in Science Magazine stating that children who received a single vaccine shot after already receiving an oral vaccine greatly boosted their immunity. WHO has begun using the combo oral vaccine and vaccine shot strategy in mass vaccination campaigns targeting hard-hit areas. It is also being introduced in developing countries.

“It could play a major role in completing the job of polio eradication once and for all,” said Dr. Hamid Jafari of the WHO and lead study author.

The key to eradicating polio in the tough-to-reach areas is taking maximum advantage of each vaccination encounter. Inevitably that means fewer doses but the same potency. As reported by the Los Angeles Times (8/22, Healy) “Science Now” blog, “vaccination campaigns are so easily disrupted by conflict, mass migrations and rumors of medical malfeasance, getting the highest level of polio immunity with the fewest vaccine doses delivered is key.”

The WHO’s global polio eradication effort has relied heavily on the oral vaccine due to cost and ease of administering the vaccination. But as revealed in TIME (8/22, Park), places where polio is rampant, such as Northern India, the oral vaccines weren’t doing much to reduce the disease’s burden. Multiple vaccinations were being given above the recommended three doses to control the spread of the disease and limit transmission. Something better had to be done. Researchers conducted a test adding the inactive shot vaccination to the schedule. Among 954 infants and children aged five years to 10 years who had already received several doses of oral vaccine, adding a shot of the inactivated vaccine helped them shed less virus compared to those who received another dose of the oral vaccine, adding strength and longevity to their immunity.

HealthDay (8/22, Preidt), MedPage Today (8/22, Smith), and Medscape (8/22, Hand) also covered the story.


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