Tuesday, February 27, 2018

Avoid folk remedies for the flu

Author: Brian Warren, food and drug/milk and dairy program administrator

Concerned about the lengthy and difficult 2017-2018 flu season? You should be—according to the latest information from the CDC1, there have been 97 children killed by influenza viruses during the 2017-18 season, and that number is expected to continue to rise.

In addition to getting the flu shot, over-the-counter cold medicines or seeking medical care are appropriate measures to take should you get sick.. Good nutrition and bed rest will often reduce the length and severity of your illness as well. However, there are two popular “alternative” medicines on store shelves in Louisiana that you should avoid because they are unproven and ineffective.

Elderberry is a flowering plant in the genus Sambucus. It is known as “fercido” in the River Parishes and the leaves are used in poultices as a folk remedy to treat conditions ranging from rashes to burns externally. A more widespread use of the plant is to distill the berries and create an extract or syrup, typically mixed with honey, maple syrup, and/or spices. Proponents claim that the product is effective as a prophylaxis and also to treat patients who are currently suffering from influenza. Note that there is insufficient evidence that any of these products are effective treatments for influenza or that they provide any relief from symptoms beyond what might be expected from a placebo. These items are considered dietary supplements by the Louisiana Department of Health, and the department does not regulate such items. At the federal level, FDA has labelling and good manufacturing practices regulations2 that manufacturers are supposed to adhere to, but, unlike actual pharmaceuticals, these products are not required to undergo testing for safety and efficacy as part of a pre-market approval process.

Please be aware that the leaves, berries and other parts of these plants typically contain secondary chemicals related to cyanide that can cause illness (though probably not death) if consumed raw, so avoid ingesting unprocessed elderberries or elderberry products.

Another popular remedy that is widely available at drug stores is Oscillococcinum®. This is a so-called homeopathic medicine. Homeopathy is a practice that dates back to the close of the 18th century and it has several key concepts but the most important one for the purposes of this discussion is that the “active” ingredients in homeopathic treatments are prepared using a large number of serial dilutions that serve to ensure that no molecule of that ingredient remains in the finished product. Homeopaths will readily concede this point but also state that the water of these dilutions “remembers” the ingredient. In the case of Oscillococcinum® in particular, the duck liver and brain that are supposed to contain the elusive bacteria that are the source of the product’s alleged curative properties are not to be found in the lactose-sucrose pill that is the end result of those many dilutions3. Thus, this homeopathic remedy is like all homeopathic remedies in that it is not going to provide the user with any relief beyond what might be expected from a placebo.

So what should you do about the flu?

·       Get your flu shot. Even if the shot you receive is not completely effective for the strains of the virus that are circulating in your area, it will nonetheless give your immune system a “leg up” on preparing for an infection and the partial immunity it provides will reduce the length and severity of your potential illness. Moreover, your immunization will contribute to “herd immunity.”4 Herd immunity refers to the immunity conferred upon individuals in a group once a certain threshold number of those group members have been immunized against a particular disease. In effect, it is a way for people who are able to be vaccinated (most healthy individuals) to protect those people who are unable to be vaccinated due to pre-existing medical conditions or severely-weakened immune systems. The benefits to those unimmunized individuals also have a secondary effect of reducing the overall severity of an outbreak by reducing the number of people who are susceptible to a disease at any given point in time.

The department is currently working through parish health units to provide no-cost vaccinations. Contact your local parish health unit for information on getting vaccinated.
 
·       Practice basic good hygiene. If you aren’t sick presently, wash your hands regularly with soap and water. Avoid close contact with those who are sick. If you are sick, do not go to work or school or church or any other gatherings where you may be exposing groups of people to your infection. Cover your mouth and nose when you sneeze or cough.

·       See your primary care doctor about any serious illness. If you experience severe symptoms such as a persistent high fever, shortness of breath, rapid heartbeat, and exhaustion or confusion, see your physician immediately. He or she may prescribe an antiviral agent such as Tamiflu. Any medicine that you are prescribed by a board-certified physician has undergone clinical trials to ensure its safety and efficacy, unlike the two treatments described in this article.

References

Oscillococcinum® is a registered trademark of Boiron USA, Inc.

Wednesday, February 21, 2018

How to talk to your children following a mass shooting

Author: Danita Leblanc, LCSW-BACS, State Suicide Prevention Coordinator

Restoring a sense of safety for your children in the aftermath of a mass shooting, especially one at a school, may be difficult as a parent. Too often our children are exposed to violence that is both senseless and harmful. Many children, those living in close proximity to a tragic event, and those who will learn about the event through television, social media, or newspaper coverage, will be affected and upset.

Children and teens may react differently to the shooting depending on their age and prior experiences, and parents should expect that youth may respond in different ways, and be supportive and understanding of different reactions, even when you are having your own reactions and difficulties.

Common Reactions

Many emotions will be evoked by this tragedy – sadness, grief, helplessness, anxiety, and anger. Children who are struggling with their thoughts and feelings with the stories and images of the shooting may turn to adults for help and guidance. Knowing some of the common reactions can help you be supportive both of yourself and your children. The National Child Traumatic Stress Network recommends looking for the following reactions: 

  • Feelings of anxiety, fear, and worry about the safety of self and others
  • Fears that another shooting may occur
  • Change in behavior:
    • Increase in activity level
    • Decrease in concentration and attention
    • Increase in irritability and anger
    • Sadness, grief, and/or withdrawal
    • Radical changes in attitudes and expectations for the future
    • Increases or decreases in sleep and appetite
    • Engaging in harmful habits like drinking, using drugs, or doing things that are harmful to self or others
    • Lack of interest in usual activities, including how they spend time with friends
  • Physical complaints (headaches, stomachaches, aches, and pains)
  • Changes in school and work-related habits and behavior with peers and family
  • Staying focused on the shooting (talking repeatedly about it)
  • Strong reactions to reminders of the shooting
  • Increased sensitivity to sounds

The Centers for Disease Control and Prevention lists such events as the type of occurrence which cause Post-traumatic Stress Disorder in children. Examples of symptoms of PTSD can be found on the CDC’s webpage, which also includes treatment options for PTSD.

Start the Conversation

It is important to talk about the shooting with your child. Not talking about it can make them seem even more threatening in your child’s mind, and silence suggests that what has occurred is too horrible even to speak about or that you do not know what has happened. With social media, it is highly unlikely that children and teenagers have not heard about it. Chances are your child has heard about it, too.

Start by asking what your child already knows about the event either from the media or from their friends. Listen carefully and try to figure out what he or she knows or believes. As he or she explains, listen for misinformation, misconceptions and underlying fears or concerns. Understand this information will change as more facts about the shooting are known.

With a high profile event of this magnitude, which can result in confusion or distress among communities across the country, it is important that parents communicate effectively with their children.

For more information on how to talk to your children about this shooting, or any other tragic event, NCTSN has compiled a list of tips to help you help your children with their thoughts and feelings, which can be found here.

Answers to some common questions

Children will undoubtedly have many questions when asking caregivers about a confusing or senseless act of mass violence.

Why do these things happen?

Often, children, like adults, want to know the motives of the people responsible for these horrible events. Past events have resulted from many causes including mental illness, rage, extreme political or religious beliefs, and hatred. Unfortunately, there usually isn’t a concrete answer to why a specific individual acted in such a way. It does not help children to have them fear groups of people who fall into any specific demographic category. Doing so only leads to discrimination, stigma, and victimization of people who are also struggling to cope with these events. More importantly, help your children understand that adults, including government authorities, work hard to identify and stop dangerous events before they ever happen.

Will this happen again and how do I keep my children safe?

Unfortunately, violent events are likely to happen again. It is important to remember that despite our awareness, random acts of violence occur rarely and does not occur in most neighborhoods. Remember that parents and professionals strive to keep our children safe yet allow them the space they need to grow and develop.

Use the guidelines that can be found here to keep your child safe.

There are a number of things you can do for your child and yourself to help restore a sense of safety in your home. A list of those things can be found here

Thursday, February 15, 2018

7 tips for a healthy heart

Author: Dr. Martha Whyte, regional medical director for Region 7

According to the American Heart Association, in 2015, almost 13,000 Louisiana residents died of heart disease or stroke. Having high blood pressure puts you at high risk for cardiovascular disease, and managing high blood pressure is a lifelong commitment.

More than 29 Louisianans die from heart disease every day, making it the state’s number one killer. Louisiana also ranks fourth in the nation for stroke death rates.

Heart disease is usually caused when plaque builds up in the walls of the arteries. The build-up narrows the arteries, making it hard for blood to flow through. Sometimes, blood clots form, completely stopping blood flow. This can cause a stroke.

High blood pressure, or hypertension, increases your heart’s workload by quietly damaging your blood vessels and arteries over time. It is the leading cause of stroke.

One in every three adults has high blood pressure, and only about half of them have their blood pressure controlled which could lead to costly health complications, including heart attack and stroke. Many are unaware of their hypertension, as it frequently causes no symptoms, even when extremely elevated.

Get Screened

Blood pressure screening and treatment reduces the risk of heart disease, heart attacks, and stroke. This, in turn, has a positive impact on reducing the overall cost of healthcare.

On average, a heart attack costs $94,500 in the first year of treatment and $74,000 every year after. Strokes are even more expensive; $122,000 in the first year and $75,000 every year after.

In Louisiana, Medicaid expansion has made it possible for thousands to see doctors resulting in early diagnoses and treatment that has saved lives. And as shown above, there is a corresponding savings to the health care system when the focus changes from treatment to prevention.

Reduce Your Risk

There are a number of ways that you can stay healthy and lower your risk of having a heart attack or stroke or suffering from heart disease.

At the top of the list is eating a healthy diet, but eating healthy doesn’t mean sacrificing the foods and flavors you love. You can modify your diet in a way that will have your heart pumping for joy by:
  • Eating more poultry, fish, nuts and beets and less red meat. When purchasing meat, choose a lean cut and limit portion size.
  • Choosing low-fat or fat-free dairy products
  • Picking fresh or frozen fruits and vegetables instead of canned and processed fruits and vegetables, which contain added salt and sugar.
  • Selecting breads, pasta and other carbohydrate-rich foods that are made from whole grains.
  • Switching from butter to olive, canola, soybean, peanut, corn or safflower oils for cooking.
  • Choosing low-sodium foods whenever possible. Using herbs and spices to flavor foods instead of salt.
  • Cutting back on foods and beverages with added sugars. For example, eat fruits instead of drinking fruit juices.
  • Modifying your favorite recipes so that they contain less fat and calories.
A link that may help guide your choices is https://www.nhlbi.nih.gov/health/health-topics/topics/dash

Maintaining a healthy weight can also lower your risk for heart disease. Being overweight or obese can increase your risk for heart disease. To determine whether your weight is in a healthy range, doctors often calculate a number called the body mass index. Doctors sometimes also use waist and hip measurements to measure a person’s excess body fat.

If you know your weight and height, you can calculate your BMI with the Centers for Disease Control and Prevention’s Assessing Your Weight website.

Exercising regularly can help you maintain a healthy weight and lower cholesterol and blood pressure. The Surgeon General recommends that adults should engage in moderate-intensity exercise for at least 30 minutes on most days of the week.

For more information, see the CDC’s Nutrition and Physical Activity Program website.

Don’t smoke. Cigarette smoking greatly increases your risk for heart disease. So, if you don’t smoke, don’t start. If you do smoke, quitting will lower your risk for heart disease. Your doctor can suggest ways to help you quit.

Limit alcohol use. Drinking too much can cause high blood pressure. It can also add calories and cause weight gain. 

Reduce stress and get plenty of sleep: Both of these are important to reduce your risk for obesity and high blood pressure.  If you are stressed and not sleeping adequately, you tend to drink, eat and stress more! Exercise, take time to decompress before you go to bed by reading or listening to music, no television when trying to sleep, and let your doctor know if you are unable to accomplish your goals. 

Seeing your primary care physician regularly is also an important step in protecting yourself from heart disease. Many other diseases, such as Diabetes, can also contribute to heart disease development. High blood sugar can lead to damage to your blood vessels and nerves to your heart leading to a risk of stroke and heart attack.  Seeing your doctor for all regular screenings, such as cholesterol and blood sugar, will help lower your risk of damage to your heart and other vital organs.

For more information on the prevention and management of heart disease and stroke, visit Well-Ahead Louisiana’s resources page to increase awareness of hypertension among patients and implement quality improvement processes.

Thursday, February 8, 2018

Vaccines are Important for Adults

Author: Dr. Frank Welch, Medical Director, Immunization Program

You may remember trips to the doctors to get your immunizations throughout your childhood, but you may not realize that you need vaccines throughout your adult life as well. Vaccines are still important for your good health and are one of the safest ways to protect it.

One of the greatest technological developments in history, immunizations are so effective at preventing and eradicating disease that many Americans have never seen a single case of mass killers of the past, such as smallpox and polio. However, despite their effectiveness, more than 40,000 American adults die each year from diseases that can be inexpensively and effectively prevented by immunization. Infants, older adults, and people with weakened immune systems are especially vulnerable to vaccine preventable diseases.

Working with your body’s natural defenses, vaccines lower your chances of getting sick and spreading certain diseases. Side effects from immunizations are usually mild and go away on their own, and severe side effects are rare.

Some of the most common adult vaccines are for the flu and tetanus. A flu shot is recommended every year and your Td/Tdap shot should be boosted every 10 years. This shot protects against tetanus, diphtheria, and Whopping Cough. Click here for more information about different adult vaccines.

Despite concerted efforts to promote annual influenza vaccination in older adults, persistent knowledge gaps exist regarding the burden of disease and the risk of flu and related complications, especially for people age 65 and older.  

That said, awareness of the consequences of vaccine-preventable disease influences vaccination behavior. Rates of herpes zoster (Shingles) vaccination increased among people who witnessed friends or family members experience the disease, particularly if severe.

Vaccine protection wanes over time, and there are a number of other risk factors that could heighten your chances of getting sick. Your age, job, lifestyle, travel, and health conditions are all factors that could determine the vaccines you need as an adult. Check with your doctor about your current immunizations during your annual check-up.

In addition to the preventing the flu, immunizations prevent serious diseases, such as, pneumonia, tetanus, pertussis (Whopping Cough), Herpes Zoster (Shingles), Human Papilloma Virus, Hepatitis A and B.

Adults can get vaccines at doctors’ officers, pharmacies, Urgent Care facilities, federally qualified health centers, and parish health units.

Uninsured and underinsured adults are eligible for vaccination at parish health units. Most health insurance plans cover the cost of recommend vaccines. Check with your insurance provider for details and for a list of vaccine providers.

Don’t wait until you know someone who’s ill. Protect your health and the health of those around you by getting the recommended vaccines based on your age and health conditions.

To see a list of vaccines you may need, take the Louisiana Department of Health’s Adolescent and Adult Immunization quiz.

For more information on immunizations, click here.


Monday, February 5, 2018

Debunking the Flu Vaccine Misconceptions

Author: Dr. Frank Welch, Medical Director, Immunization Program

Being vaccinated against the flu, particularly in active seasons like this one, is the best way to protect yourself and those around you against getting sick. However, the talk of vaccines also brings all the misconceptions about vaccines back to the surface.

The flu vaccine remains the safest and most effective way to protect yourself and those around you from the flu. In the most severe seasons, the flu causes approximately 700 deaths and nearly 8,000 hospitalizations each year in Louisiana. The 2017/18 flu season is on pace to meet and possibly exceed those statistics.

The Louisiana Department of Health has actively been promoting the flu shot for the past several weeks. Although the response for this responsible public health/flu prevention tactic has been overwhelmingly positive, some people still talk nonsense and spread misinformation. Here are the answers to a few of the many myths and misconceptions about the flu  vaccines that have appeared on our social media pages.

If I take the flu shot, I will get the flu.

Many people fear that they will get the flu if they are given the flu vaccine, but it is absolutely impossible for the flu shot to give you the flu. Flu vaccines given with a needle are currently made in two ways: the vaccine is made either with a) flu vaccine viruses that have been ‘inactivated’ and are therefore not infectious, or b) with no flu vaccine viruses at all (which is the case for recombinant influenza vaccine). The most common side effects from the influenza shot are soreness, redness, tenderness or swelling where the shot was given. Low-grade fever, headache and muscle aches also may occur.

The shot isn’t effective in preventing the virus.

The flu shot is not perfect, but it does protect against, and minimize many complications of the flu.
There are many different flu viruses and they are constantly changing. Because of this, the composition of the U.S. flu vaccines is reviewed annually and updated as needed. According to the Centers for Disease Control and Prevention, flu vaccines protect against the three or four viruses that research suggests will be most common. For 2017-18, three-component vaccines are recommended to contain protections against:
  • ·        H1N1
  • ·        H3N2
  • ·        B/Victoria lineage virus

There are also four-component vaccines that protect against a second lineage of B viruses.

I got the flu shot and I still got the flu.

It’s possible to get sick with the flu even if you have been vaccinated. This is possible for a few reasons.

·        You may have been exposed to a flu virus shortly before getting vaccinated or during the period (two weeks after vaccination antibodies that provide protection develop in the body) that it takes to gain protection after getting vaccinated, resulting in you becoming ill with the flu before the vaccine begins to protect you.

·        You may have been exposed to a flu virus that is not included in the seasonal flu vaccine. There are many different flu viruses that circulate every year. The flu vaccine is made to protect against the three or four flu viruses that research suggests will be most common.

·        Protection provided by flu vaccination can vary widely, based in part on health and age factors of the person getting vaccinated. In general, the flu vaccine works best among healthy younger adults and older children. Some older people and people with certain chronic illnesses may develop less immunity after vaccination. Flu vaccination is not a perfect tool, but it is the best way to protect against flu infection.

·        You may be sick with a virus or bacteria that is not the flu. These other germs circulate more in the winter along with the flu virus and are sometimes confused with the flu.

The vaccine is only 10 percent effective.

The 10 percent vaccine effectiveness figure was an interim estimate of the vaccine’s benefit against one flu virus (H3N2) that circulated in Australia during its most recent flu season. In the United States last season, overall vaccine effectiveness against all circulating flu viruses was 39 percent. Estimates of the flu vaccine’s effectiveness against circulating flu viruses in the United States this season will be available later in the season but are expected to be significantly higher than 10 percent, and more likely in the 35-60% effectiveness range.

The flu shot is not safe for pregnant women or newborns.

With rare exception, an annual flu vaccine for everyone six months of age and older, including pregnant women and people with medical conditions. Vaccine providers should be aware of the approved age indications of the vaccine they are using and of any precautions. People getting vaccinated should also be screened for allergies as those with severe allergic reactions should not be vaccinated.

For a complete list of those who should speak with their doctor before getting vaccinated, refer to this list.

The mercury in vaccines causes autism.

There is no evidence that vaccines cause autism. Thimerosal, a mercury-based preservative, is used in trace amounts in vials that contain more than one dose of a vaccine to prevent germs, bacteria and/or fungi from contaminating the vaccine. Multi-dose flu vaccines contain thimerosal. However, scientific research does not show a connection between thimerosal and autism, and it has shown to be safe when used in vaccines.

Measles, mumps and rubella vaccines do not and have never contained thimerosal. Varicella, inactivated polio, and pneumococcal conjugate vaccines have also never contained thimerosal.
Flu vaccines are available in both thimerosal-containing and thimerosal-free versions.

For a complete list of vaccines and their thimerosal content, click here.


The Louisiana Department of Health recommends that everyone who has not received a flu vaccination to do so as it is the best way for you to protect yourself, your family, and the people around you. For more information on the flu, visit www.ldh.la.gov/fighttheflu.