Spring Has Sprung, & so Have the Microbes

4 04 2011

Photo Credit: James Gathany, CDC

“Sweet spring is your time is my time,” wrote poet e.e. cummings. It also happens to be the time for ticks that harbor the bacteria that cause Lyme disease, and sweet springs that harbor Giardia lamblia, an intestinal parasite guaranteed to get your intestines roiling.

Beautiful weather and warming temperatures draw people to the great outdoors, where they’ll put hiking boot to path in many places where these threats lie in wait. Borrelia burgdorferi, the bacterium responsible for Lyme disease, lurks in the blood of two of its hosts, mice and deer. Ticks take up the microbe along with their blood snack, and when they snack on you, the microbe transfers along with some tick saliva. Ewww.

While you are most at risk of encountering a Borrelia-toting tick in the northeastern United States, the ticks that carry it live throughout the country, anywhere their hosts and good weather await.

If you find a tick, gently tweeze it out by grasping it near the head (that old “match to the tick” solution will only singe your body hair). Watch for the telltale signs of a Lyme infection, which can include a bullseye rash that forms around the bite. Note also that you can pick up a tick bite not only from hiking or hunting where ticks occur, but also from walking in tall grasses, gardening, or from a pet that’s carrying them around.

If a tick bites you, keep an eye out for symptoms for 30 days. The good news about Lyme is that most people with tick bites don’t develop it, and an antibiotic treatment will usually take care of the disease if you do get it.

Ticks can be practically invisible and difficult to avoid in some places, but you can always be careful about the water you drink. And careful you should be, because in many of the most beautiful places in the U.S., swimming in that cool mountain stream is a nasty little pathogen, Giardia lamblia. While it has been associated with food-borne outbreaks and oro-genital contact, in the wild, this unwelcome microscopic protist emerges from the intestines of woodland creatures via poop to end up in water sources.

If you drink that water without filtering it first, using a water filter that keeps G. lamblia out of your mouth, you’ll swallow Giardia cysts along with that cool drink. Giardia will take advantage of the homey environment of your intestines, and in a week or two will start reproducing. Your end of the bargain is debilitating intestinal symptoms that can last for weeks. Treatments are available, but giardiasis can often resolve on its own, if unpleasantly.





Does Vaccination Prevent Cancer?

7 03 2011

The history of anxiety about possible negative effects of vaccines is long, tracing back at least as far as Benjamin Franklin. Countering these worries is the fact that vaccines are one of the greatest public health successes of our time, saving millions of lives worldwide.

Now we know that vaccine benefits may extend beyond prevention of the target childhood disease.

An already recognized extra benefit comes with the vaccines for varicella. A varicella vaccine not only can prevent chickenpox in young people, but may also stop the occurrence of shingles in older folks.

Shingles, a neurological attack by the chickenpox virus decades after an infection, can cause a rash that leaves behind chronic, unbearable pain. Vaccination in childhood may protect against shingles, and according to a new study from a Texas group, published in The Journal of Pediatrics, childhood vaccines may offer reduced odds of childhood cancer.

The researchers, going on hints from earlier studies, looked at vaccine rates in specific areas and compared those numbers to childhood cancer rates in the same region. While childhood cancers are rare, they are, of course, devastating. The most common cancers in children are leukemia and brain and spinal cord cancers. According to previous studies, some common childhood infections might increase a child’s risk of leukemia, while vaccinations might reduce that risk. It’s not a nutty idea that some infections—especially viral infections—might be associated with cancer. Indeed, a few viral infections have an established association, including human papillomavirus (HPV, associated with cervical and anal cancers), hepatitis B (associated with liver cancer), and Epstein-Barr (the “mono” virus, linked to a type of lymphoma).

The researchers looked at the 2800 cases of childhood cancer diagnosed in Texas from 1995 to 2006, focusing only on cases diagnosed in children two years or older. For every child diagnosed with cancer, the team identified four more children who had not had cancer, matched for age and sex. As a final step, they then mapped how many children from each group had been born in Texas counties with high vaccination rates.

Their results showed that where hepatitis B vaccination rates were high, odds of all childhood cancers fell by almost 20%. Where rates of inactivated polio virus, hepatitis B, or a specific mix of childhood vaccinations were high, odds of finding cases of a common childhood leukemia, acute lymphoblastic leukemia (ALL), dropped by as much as 38%. The biggest dip in odds came with higher rates of Hib (Haemophilus influenzae type b) vaccine and ALL, with a 42% decrease in ALL odds where Hib vaccination rates were high.

It’s important to remember that the authors didn’t establish a cause–effect link here. This study is based on the numbers, and the take-home message here is a simple one. The authors put it best in their abstract: “Some common childhood vaccines appear to be protective against ALL at the population level.”





Keep Your Illness to Yourself

17 02 2011

It starts with a sneeze and a sniff over the cubicle wall. “Ugh!” you think as you slather yourself in hand sanitizer, “Why is that person at work while they’re sick? I have a vacation next week, I cannot get sick!”

According to a recent study, nearly three out of four people go to work when they’re sick and about one in three Americans said they would show up to work no matter how sick they feel.

Image by Leonid Mamchenkov

Why do we do it?  Why do we insist on going to work sick and making ourselves and everyone else miserable?

Turns out there are reasons. We often have a lot of anxiety about taking a sick day. A study by the U.S. Bureau of Labor Statistics found that 19% of Americans feel pressure by their boss or supervisor to go to work when they are feeling sick. Some of us don’t have the luxury of sick days and taking a day off means less pay. While this might seem unfair, it’s a reality for many.

The truth is — everyone loses when we go to work sick.

We can prolong our illness or exacerbate it by not getting the rest our body needs to fight the infection.

Our coworkers lose by being exposed to a microbe that can sicken them and that they in turn will share with their family and friends. More than half of workers have pointed a finger at a coworker as the source of their illness.

There’s also a cost associated with coming to work sick. Presenteeism, when an employee shows up sick and isn’t productive, costs the U.S. economy $180 billion annually in lost productivity.

OK, maybe that’s not the best motivation for staying home when sick, but we need to give our coworkers a break.  Don’t be the coughing, hacking, germ-spreading guy who ruins everyone’s weekend or worse, vacation, by making them sick.  Stay home, watch TV, eat ice cream, sleep.  Your body deserves it.





HAIs and Patient Safety

27 01 2011

Did you know the landmark health reform law requires Medicare- and Medicaid-participating hospitals (i.e., most hospitals in the country) to make public their infection rates for certain healthcare-associated infections?

Consumers can use this information to determine whether a hospital is taking appropriate steps to minimize a patient’s chance of acquiring an infection such as staph or MRSA as a result of their hospitalization.

Beginning in January 2011, hospitals are required to report rates of central line-associated bloodstream infections (CLABSI) in the intensive care and neonatal intensive care units. Other reportable infections include surgical site and ventilator-associated pneumonia infections.

The CDC estimates that about 250,000 central line-associated bloodstream infections occur each year in hospitals, resulting in approximately 130,000 deaths.

The CDC defines healthcare-associated infections (HAIs) as “a localized or systemic condition that (1) results from an adverse reaction to the presence of an infectious agent(s) or its toxin(s), (2) that occurs during a hospital admission, (3) for which there is no evidence the infection was present or incubating at admission, and (4) meets body site-specific criteria.”

These infections include blood infections, staph infections, meningitis, pneumonia, and other infections that can be very serious and even fatal. Beginning in 2012, Medicare payments to hospitals will be tied to how well hospitals perform relative to the new safety standards.

Consumers should avail themselves of this information so they can protect themselves and loved ones from getting sicker during a hospital stay. It’s another tool to protect ourselves and our loved ones against the various risks associated with hospitalization.

Hospital-specific information is available at the Stop BSI website.

More patient safety information relative to the new health care reform law is available on the health reform website.





Back to School?!

9 08 2010

The kids are staggering around, moaning about school’s approach while we parents giggle in our sleep.  We have to put in some work to get our little sweetums of all ages launched into the new school year, but the payoff is worth it.  The kids – out of the house!

Vaccines.  Have to get pre-schoolers, collegians and everyone in-between up-to-date on those immunizations.  Ice cream afterward, no matter the age.

Flu.  Ok, this seems like it should be with the vaccines above, but most of us focus on the immunizations we need to get done before the kids go back to school, and this one usually isn’t available in clinics until September/October.  Put it on the calendar, because it’s easy to forget.  Check with your provider about each member of your family getting vaccinated against influenza.  It’s important.

Cover coughs.  With kids crammed into classrooms and adults back at the office after summer holiday, diseases have a chance to spread quickly.  Show the kids how to cough (or sneeze) into their elbows, or into tissues.  This helps stop the germs from floating around and being inhaled by others, or from landing on surfaces that others then touch, picking up the germs on their hands.

Wash hands.  Washing our hands throughout the day, and always after using the bathroom and before we eat, is an all-around good habit.  It’s one of the most effective ways to prevent infections.  Show the kids how to wash their hands.  We didn’t know there was a particular way that worked best until we had a nurse come in and show us prior to making this little video a few years ago.

Dating.  There will be a lot more interaction between teens after school starts.  Even though they know about STDs, it doesn’t hurt for them to hear us talk about the ways diseases spread.  It’s surprising how parents’ willingness to talk, and talk often, can impact a teen’s choices.  Also, thanks to the recent vampire craze, we have to explain that biting your date’s neck can spread all sorts of diseases.

Any parents out there want to chime in on what they do or say to keep their kids healthy?  We’d love to hear!





Twilight Love Bites… Ouch!

28 07 2010

The Twilight Series: It’s the rage among teens.  It’s a love story with hip, modern-day vampires.  Love the books, love the movies, but do NOT love the Twilight trend that is emerging among teen friends and couples: biting.

Teens caught up in the Twilight rage are “leaving their marks” on each other as a sign of closeness.  What does this mean?  It means that they are biting each other.  As parents, we thought we had left that nightmare long behind us in the toddler years!  It’s returned, and the implications are even more serious.

First there are the socio-psycho implications. Teen biting is a form of branding, and a form of ownership.  Some teens believe it shows commitment to a significant other, or group of friends. One teen noted biting was an “add-on to kissing,” comparing it to putting a case on his iPhone.

It seemed we had all but eliminated the idea of “blood brothers and blood sisters,” and now we have teens that cut each other’s skin to taste each other’s blood.    

This is extremely dangerous and can cause serious infections.  The human mouth is filled with bacteria, and a bite that draws blood can have serious implications.  If biting has occurred, we need to look for signs of more serious bites, including:   swelling, redness, pain, and pus at the site.   All bites need to be carefully cleaned, and may require treatment with oral or IV antibiotics. 

What often goes unmentioned is the danger of spreading bloodborne diseases,  such as HIV/AIDS, hepatitis C and B, and syphilis.  

There is a vaccine for hepatitis B, so please be sure your teen is vaccinated.  There are no vaccines for HIV/AIDS or hepatitis C.  These diseases do not discriminate, and if your biting, vampire-loving teen chooses to engage in such activities, she may end up with an infectious disease that at best remains with her for the rest of her life, and at worst, takes her life.

You can find evidence of this craze on teen-made YouTube videos and Facebook pages.  Some teens say they have been biting their partners for over a year. 

We all need to be talking to our teens about the health risks involved in this practice.  They need to hear our opinion on this; it will make a difference when it comes time for them to choose to participate in this risky behavior—or not.





Piercing? Stay Safe!

9 06 2010

Thousands of years ago, Egyptians loved to pierce their ears and wear jewelry as symbols of their status. However, only the Pharaoh was allowed to pierce his navel, and if others were caught doing so, they were put to death.

Mayans pierced their tongues for spiritual reasons, and the Roman centurions had their nipples pierced to hold their capes (ouch!), and to demonstrate loyalty to the emperor.

If you’re thinking of piercing, or even if you’ve done it but want more piercings, let’s talk safety.

The mall:

  • Piercing “staff” are often young and inexperienced.
  • The piercing gun is usually not a single-use device, and cannot be adequately cleanedInfections can come with piercings, if the staff don’t sterilize as they should, or if they reuse equipment. Some of those infections can be serious—hepatitis, tetanus or even TB.

The doctor’s office:

  • The healthcare provider that pierces your ears will do so with a sterile, single-use device, all while following standard precautions, which will significantly decrease the odds of infection.
  • Your provider might lack experience, so there’s no telling how the job will turn out, but it beats living with a disease for the rest of your life. Still, you may not be thrilled if you end up with lopsided earrings.

Your BFF’s house:

  • JUST SAY NO!
  • Tools and supplies may be purchased by anyone.  This does not mean your BFF, or her mom, is qualified to pierce your ears.  Due to lack of experience and the high probability that standard precautions will not be followed adequately, you’re going to want to rethink this option.

A professional shop:

  • Make sure that the piercer is a professional, follows standard precautions, and runs a clean shop. He should wear disposable gloves and change them between customers.
  • The piercer should be trained to avoid cross-contamination.
  • A sterile, single-use, long, smooth, hollow needle with a razor sharp tip, applied using a sterile mechanical device into a single-use sterile cork is likely the safest way to have your ears or other parts pierced.
  • Talk to your healthcare provider about any medical information that might be pertinent to your procedure.  Depending on the piercing, you might require prophylactic antibiotics, or the procedure might not be recommended at all.

A special note on tongue piercings and splitting: it’s important to read the warnings put out by the American Dental Association. It’s risky and the damage can be significant—and permanent.

Share