Diabetes is a chronic disease in which the body is unable to properly control the amount of sugar in the blood. The body cannot control the sugar in the blood due to the lack of the hormone insulin. Diabetes has long reaching and wide ranging health affects for those that suffer from it. Diabetes significantly raises the risk of heart disease and stroke, blindness and kidney failure. Uncontrolled diabetes can lead to death.
It is estimated that over 18 million Americans suffer from diabetes, and of these 18 million it is estimated that nearly one third are unaware they suffer from it.
Diabetes is easily diagnosed using a fasting blood glucose test. This if the most accurate test available. A fasting blood glucose result of 126 or higher indicates diabetes. Generally a fasting glucose test is part of an annual physical for adults.
Type 1 diabetes, or juvenile diabetes, is diagnosed in children and young adults.
Type 2 diabetes is the most common form of diabetes and is usually found in adults over the age of 40. Type 2 diabetes is most likely due to poor diet and overweight as 80% of those with Type 2 diabetes are overweight.
There is still debate about the genetics of diabetes. If both your parents have diabetes of course your risk is higher than if one parent has it. There are also environmental triggers to diabetes. Type 2 diabetes is more closely linked to genetic factors and factors such as poor diet and lack of exercise.
Some of the symptoms of diabetes are unexplained weight loss, lethargy, excessive thirst or excessive hunger, frequent urination, dry skin, slow healing sores, sudden vision changes.
If you find you have diabetes you will need to work very closely with your health care provider in order to keep your sugar levels within acceptable ranges. You'll start testing your blood sugar at least once a day and keeping the results in a diary. You will need to re-vamp your diet and pay close attention to portion size and meal frequency. A diabetic diet doesn't necessarily mean you cannot have foods that contain carbohydrates, it means you can't have them in an unlimited fashion. Exercise done on a regular basis has been found to help control blood sugar levels. It is suggested that those with diabetes should exercise 30 to 60 minutes a day.
Living with diabetes can seem overwhelming at first, and it will take commitment on your part. However, millions of Americans live full and active lives with diabetes.
Saturday, May 31, 2014
Friday, May 30, 2014
Bird Flu and Tamiflu—Making Your Supply of Tamiflu Go Farther in an Emergency Situation
I have discussed Tamiflu (oseltamivir) and Relenza (zanamivir) previously – see Bird Flu: Tamiflu and Relenza for Prevention and Treatment in the Articles section on our Web site, http://www.AvoidBirdFlu.com. This current article adds important information about making your supply of Tamiflu go farther in an emergency situation.
First, as I noted in my previous article, it is important to be aware of the fact that the effectiveness of Tamiflu and Relenza has been studied against circulating strains of human influenza (so called seasonal influenza), not against the bird flu virus. In a study reported in the August 2005 issue of the Journal of Infectious Diseases, Dr. Yen and others from St. Jude Children’s Research Hospital in Memphis, Tennessee found that in animal experiments eight-day regimens of Tamiflu were more effective than the suggested five-day regimen for treating infections with the H5N1 bird-flu virus.
The authors concluded that a prolonged and higher-dose oseltamivir regimen may be required for the most beneficial antiviral effect. This possibility was recently underscored when two Vietnamese (one a 13 year old girl) died of bird flu—as reported in a December 2005 issue of the New England Journal of Medicine—even after receiving treatment within the required 48 hours after the start of infection with standard doses of Tamiflu.
Let’s assume that you have one treatment course of Tamiflu (one 75 mg tablet taken twice a day for five days, for a total of 10 pills), that you either acquired on your own or that was given to you by your healthcare provider or by the government. Unfortunately you are still not home free yet, so to speak. You now may face one of two problems:
Problem # 1: If preliminary scientific studies indicating that a course of treatment of bird flu using higher doses than those currently recommended by the FDA, for more than the current recommended five days of treatment are correct—as indicated by Dr. Yen’s research—you will need more that one dose pack. In fact, the best treatment might mean taking two pills (150 mg) twice a day for eight or even ten days. That would mean that you should have FOUR dose packs (40 pills) for the treatment of one person, not just one!
Problem # 2: You have a dose pack—officially the amount need to treatment one person—but there are two people who just became infected with bird flu in your family. If you combine this problem with problem number one, you now actually need EIGHT dose packs, not just two!
What can you do? There are two possible solutions:
SOLUTION # 1: Take PROBENECID, a medicine approved for the treatment of gout, along with the Tamiflu. Probenecid interferes with the normal metabolism of Tamiflu, increasing the blood level of Tamiflu and keeping it in circulation longer—effectively doubling the amount of Tamiflu “exposure.” The precise dose is unclear. Until more scientific information becomes available, in an emergency situation, for otherwise healthy adults, I would recommend taking one 500 mg table twice daily. Probenecid is generally very safe. Nevertheless, I have included detailed information about it below.
According to information about probenecid from the National Library of Medicine’s and the National Institutes of Health’s Web site Medline Plus (available at http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202480.html):
Probenecid (proe-BEN-e-sid) is used in the treatment of chronic gout or gouty arthritis. These conditions are caused by too much uric acid in the blood. The medicine works by removing the extra uric acid from the body. Probenecid does not cure gout, but after you have been taking it for a few months it will help prevent gout attacks. This medicine will help prevent gout attacks only as long as you continue to take it.
Probenecid is also used to prevent or treat other medical problems that may occur if too much uric acid is present in the body.
Probenecid is sometimes used with certain kinds of antibiotics to make them more effective in the treatment of infections.
Probenecid is available only with your doctor's prescription, in the following dosage form (tablets):
a. Before Using This Medicine
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For probenecid, the following should be considered:
Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to probenecid. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.
Pregnancy—Probenecid has not been shown to cause birth defects or other problems in humans.
Breast-feeding—Probenecid has not been reported to cause problems in nursing babies.
Children—Probenecid has been tested in children 2 to 14 years of age for use together with antibiotics. It has not been shown to cause different side effects or problems than it does in adults. Studies on the effects of probenecid in patients with gout have been done only in adults. Gout is very rare in children.
Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. There is no specific information comparing use of probenecid in the elderly with use in other age groups.
Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking probenecid, it is especially important that your health care professional know if you are taking any of the following:
• Antineoplastics (cancer medicine)—The chance of serious side effects may be increased
• Aspirin or other salicylates—These medicines may keep probenecid from working properly for treating gout, depending on the amount of aspirin or other salicylate that you take and how often you take it
• Heparin—Probenecid may increase the effects of heparin, which increases the chance of side effects
• Indomethacin (e.g., Indocin)
• Ketoprofen (e.g., Orudis)
• Methotrexate (e.g., Mexate)—Probenecid may increase the blood levels of these medicines, which increases the chance of side effects
• Medicine for infection, including tuberculosis or virus infection—Probenecid may increase the blood levels of many of these medicines. In some cases, this is a desired effect and probenecid may be used to help the other medicine work better. However, the chance of side effects is sometimes also increased
• Nitrofurantoin (e.g., Furadantin)—Probenecid may keep nitrofurantoin from working properly
• Zidovudine (e.g., AZT, Retrovir)—Probenecid increases the blood level of zidovudine and may allow lower doses of zidovudine to be used. However, the chance of side effects is also increased
Other medical problems—The presence of other medical problems may affect the use of probenecid. Make sure you tell your doctor if you have any other medical problems, especially:
• Blood disease or
• Cancer being treated by antineoplastics (cancer medicine) or radiation (x-rays) or
• Kidney disease or stones (or history of) or
• Stomach ulcer (history of)—The chance of side effects may be increased
b. Proper Use of This Medicine If probenecid upsets your stomach, it may be taken with food. If this does not work, an antacid may be taken. If stomach upset (nausea, vomiting, or loss of appetite) continues, check with your doctor.
For patients taking probenecid for gout:
• After you begin to take probenecid, gout attacks may continue to occur for a while. However, if you take this medicine regularly as directed by your doctor, the attacks will gradually become less frequent and less painful than before. After you have been taking probenecid for several months, they may stop completely.
• This medicine will help prevent gout attacks but it will not relieve an attack that has already started. Even if you take another medicine for gout attacks, continue to take this medicine also. If you have any questions about this, check with your doctor.
For patients taking probenecid for gout or to help remove uric acid from the body:
• When you first begin taking probenecid, the amount of uric acid in the kidneys is greatly increased. This may cause kidney stones or other kidney problems in some people. To help prevent this, your doctor may want you to drink at least 10 to 12 full glasses (8 ounces each) of fluids each day, or to take another medicine to make your urine less acid. It is important that you follow your doctor's instructions very carefully.
Dosing—
The dose of probenecid will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of probenecid. If your dose is different, do not change it unless your doctor tells you to do so.
• For treating gout or removing uric acid from the body:
 Adults: 250 mg (one-half of a 500-mg tablet) two times a day for about one week, then 500 mg (one tablet) two times a day for a few weeks. After this, the dose will depend on the amount of uric acid in your blood or urine. Most people need 2, 3, or 4 tablets a day, but some people may need higher doses.
 Children: It is not likely that probenecid will be needed to treat gout or to remove uric acid from the body in children. If a child needs this medicine, however, the dose would have to be determined by the doctor.
• For helping antibiotics work better:
 Adults: The amount of probenecid will depend on the condition being treated. Sometimes, only one dose of 2 tablets is needed. Other times, the dose will be 1 tablet four times a day.
 Children: The dose will have to be determined by the doctor. It depends on the child's weight, as well as on the condition being treated. Older children and teenagers may need the same amount as adults.
Missed dose—
If you are taking probenecid regularly and you miss a dose, take the missed dose as soon as possible. However, if you do not remember until it is almost time for the next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Storage—
To store this medicine:
• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.
c. Precautions While Using This Medicine
• If you will be taking probenecid for more than a few weeks, your doctor should check your progress at regular visits.
Before you have any medical tests, tell the person in charge that you are taking this medicine. The results of some tests may be affected by probenecid.
For diabetic patients:
• Probenecid may cause false test results with copper sulfate urine sugar tests (Clinitest®), but not with glucose enzymatic urine sugar tests (Clinistix®). If you have any questions about this, check with your health care professional.
For patients taking probenecid for gout or to help remove uric acid from the body:
• Taking aspirin or other salicylates may lessen the effects of probenecid. This will depend on the dose of aspirin or other salicylate that you take, and on how often you take it. Also, drinking too much alcohol may increase the amount of uric acid in the blood and lessen the effects of this medicine. Therefore, do not take aspirin or other salicylates or drink alcoholic beverages while taking this medicine, unless you have first checked with your doctor.
d. Side Effects of This Medicine
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
The following side effects may mean that you are having an allergic reaction to this medicine. Check with your doctor immediately if any of the following side effects occur:
• Rare
Fast or irregular breathing; puffiness or swellings of the eyelids or around the eyes; shortness of breath, troubled breathing, tightness in chest, or wheezing; changes in the skin color of the face occurring together with any of the other side effects listed here; or skin rash, hives, or itching occurring together with any of the other side effects listed here
Also, check with your doctor as soon as possible if any of the following side effects occur:
• Less common
Bloody urine; difficult or painful urination ; lower back or side pain (especially if severe or sharp); skin rash, hives, or itching (occurring without other signs of an allergic reaction)
• Rare
Cloudy urine; cough or hoarseness; fast or irregular breathing; fever; pain in back and/or ribs; sores, ulcers, or white spots on lips or in mouth; sore throat and fever with or without chills; sudden decrease in the amount of urine; swelling of face, fingers, feet, and/or lower legs; swollen and/or painful glands ; unusual bleeding or bruising; unusual tiredness or weakness; yellow eyes or skin ; weight gain
Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:
• More common
Headache; joint pain, redness, or swelling ; loss of appetite; nausea or vomiting (mild)
• Less common
Dizziness; flushing or redness of face (occurring without any signs of an allergic reaction); frequent urge to urinate; sore gums
Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.
SOLUTION # 2: Unless you are a divine follower of the late Mahatma Gandhi, who used to drink his urine daily, this solution is not nearly as appealing as taking probenecid. However, it apparently would be very effective. Dr. Grattan Woodson, a specialist in internal medicine at the Druid Oaks Health Center in Decatur, Georgia, offers the following advice for emergency treatment of bird flu:* This is an advanced, potentially life-saving emergency strategy, that should only be done under medical supervision—unless none is available.
Tamiflu Re-Administration Strategy: Tamiflu is excreted unchanged almost entirely in the urine. If Tamiflu supplies are limited, as they most certainly will be [during a bird-flu pandemic], consider giving the patient two Tamiflu tablets at the same time, collect the patient’s urine and re-administer it to the patient via naso-gastric (NG) tube or orally. If managed carefully, this approach means that you can completely treat a patient with only 2 Tamiflu tablets [by re-administering the patient’s urine daily for five to 10 days].
First, as I noted in my previous article, it is important to be aware of the fact that the effectiveness of Tamiflu and Relenza has been studied against circulating strains of human influenza (so called seasonal influenza), not against the bird flu virus. In a study reported in the August 2005 issue of the Journal of Infectious Diseases, Dr. Yen and others from St. Jude Children’s Research Hospital in Memphis, Tennessee found that in animal experiments eight-day regimens of Tamiflu were more effective than the suggested five-day regimen for treating infections with the H5N1 bird-flu virus.
The authors concluded that a prolonged and higher-dose oseltamivir regimen may be required for the most beneficial antiviral effect. This possibility was recently underscored when two Vietnamese (one a 13 year old girl) died of bird flu—as reported in a December 2005 issue of the New England Journal of Medicine—even after receiving treatment within the required 48 hours after the start of infection with standard doses of Tamiflu.
Let’s assume that you have one treatment course of Tamiflu (one 75 mg tablet taken twice a day for five days, for a total of 10 pills), that you either acquired on your own or that was given to you by your healthcare provider or by the government. Unfortunately you are still not home free yet, so to speak. You now may face one of two problems:
Problem # 1: If preliminary scientific studies indicating that a course of treatment of bird flu using higher doses than those currently recommended by the FDA, for more than the current recommended five days of treatment are correct—as indicated by Dr. Yen’s research—you will need more that one dose pack. In fact, the best treatment might mean taking two pills (150 mg) twice a day for eight or even ten days. That would mean that you should have FOUR dose packs (40 pills) for the treatment of one person, not just one!
Problem # 2: You have a dose pack—officially the amount need to treatment one person—but there are two people who just became infected with bird flu in your family. If you combine this problem with problem number one, you now actually need EIGHT dose packs, not just two!
What can you do? There are two possible solutions:
SOLUTION # 1: Take PROBENECID, a medicine approved for the treatment of gout, along with the Tamiflu. Probenecid interferes with the normal metabolism of Tamiflu, increasing the blood level of Tamiflu and keeping it in circulation longer—effectively doubling the amount of Tamiflu “exposure.” The precise dose is unclear. Until more scientific information becomes available, in an emergency situation, for otherwise healthy adults, I would recommend taking one 500 mg table twice daily. Probenecid is generally very safe. Nevertheless, I have included detailed information about it below.
According to information about probenecid from the National Library of Medicine’s and the National Institutes of Health’s Web site Medline Plus (available at http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202480.html):
Probenecid (proe-BEN-e-sid) is used in the treatment of chronic gout or gouty arthritis. These conditions are caused by too much uric acid in the blood. The medicine works by removing the extra uric acid from the body. Probenecid does not cure gout, but after you have been taking it for a few months it will help prevent gout attacks. This medicine will help prevent gout attacks only as long as you continue to take it.
Probenecid is also used to prevent or treat other medical problems that may occur if too much uric acid is present in the body.
Probenecid is sometimes used with certain kinds of antibiotics to make them more effective in the treatment of infections.
Probenecid is available only with your doctor's prescription, in the following dosage form (tablets):
a. Before Using This Medicine
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For probenecid, the following should be considered:
Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to probenecid. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.
Pregnancy—Probenecid has not been shown to cause birth defects or other problems in humans.
Breast-feeding—Probenecid has not been reported to cause problems in nursing babies.
Children—Probenecid has been tested in children 2 to 14 years of age for use together with antibiotics. It has not been shown to cause different side effects or problems than it does in adults. Studies on the effects of probenecid in patients with gout have been done only in adults. Gout is very rare in children.
Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. There is no specific information comparing use of probenecid in the elderly with use in other age groups.
Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking probenecid, it is especially important that your health care professional know if you are taking any of the following:
• Antineoplastics (cancer medicine)—The chance of serious side effects may be increased
• Aspirin or other salicylates—These medicines may keep probenecid from working properly for treating gout, depending on the amount of aspirin or other salicylate that you take and how often you take it
• Heparin—Probenecid may increase the effects of heparin, which increases the chance of side effects
• Indomethacin (e.g., Indocin)
• Ketoprofen (e.g., Orudis)
• Methotrexate (e.g., Mexate)—Probenecid may increase the blood levels of these medicines, which increases the chance of side effects
• Medicine for infection, including tuberculosis or virus infection—Probenecid may increase the blood levels of many of these medicines. In some cases, this is a desired effect and probenecid may be used to help the other medicine work better. However, the chance of side effects is sometimes also increased
• Nitrofurantoin (e.g., Furadantin)—Probenecid may keep nitrofurantoin from working properly
• Zidovudine (e.g., AZT, Retrovir)—Probenecid increases the blood level of zidovudine and may allow lower doses of zidovudine to be used. However, the chance of side effects is also increased
Other medical problems—The presence of other medical problems may affect the use of probenecid. Make sure you tell your doctor if you have any other medical problems, especially:
• Blood disease or
• Cancer being treated by antineoplastics (cancer medicine) or radiation (x-rays) or
• Kidney disease or stones (or history of) or
• Stomach ulcer (history of)—The chance of side effects may be increased
b. Proper Use of This Medicine If probenecid upsets your stomach, it may be taken with food. If this does not work, an antacid may be taken. If stomach upset (nausea, vomiting, or loss of appetite) continues, check with your doctor.
For patients taking probenecid for gout:
• After you begin to take probenecid, gout attacks may continue to occur for a while. However, if you take this medicine regularly as directed by your doctor, the attacks will gradually become less frequent and less painful than before. After you have been taking probenecid for several months, they may stop completely.
• This medicine will help prevent gout attacks but it will not relieve an attack that has already started. Even if you take another medicine for gout attacks, continue to take this medicine also. If you have any questions about this, check with your doctor.
For patients taking probenecid for gout or to help remove uric acid from the body:
• When you first begin taking probenecid, the amount of uric acid in the kidneys is greatly increased. This may cause kidney stones or other kidney problems in some people. To help prevent this, your doctor may want you to drink at least 10 to 12 full glasses (8 ounces each) of fluids each day, or to take another medicine to make your urine less acid. It is important that you follow your doctor's instructions very carefully.
Dosing—
The dose of probenecid will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of probenecid. If your dose is different, do not change it unless your doctor tells you to do so.
• For treating gout or removing uric acid from the body:
 Adults: 250 mg (one-half of a 500-mg tablet) two times a day for about one week, then 500 mg (one tablet) two times a day for a few weeks. After this, the dose will depend on the amount of uric acid in your blood or urine. Most people need 2, 3, or 4 tablets a day, but some people may need higher doses.
 Children: It is not likely that probenecid will be needed to treat gout or to remove uric acid from the body in children. If a child needs this medicine, however, the dose would have to be determined by the doctor.
• For helping antibiotics work better:
 Adults: The amount of probenecid will depend on the condition being treated. Sometimes, only one dose of 2 tablets is needed. Other times, the dose will be 1 tablet four times a day.
 Children: The dose will have to be determined by the doctor. It depends on the child's weight, as well as on the condition being treated. Older children and teenagers may need the same amount as adults.
Missed dose—
If you are taking probenecid regularly and you miss a dose, take the missed dose as soon as possible. However, if you do not remember until it is almost time for the next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Storage—
To store this medicine:
• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.
c. Precautions While Using This Medicine
• If you will be taking probenecid for more than a few weeks, your doctor should check your progress at regular visits.
Before you have any medical tests, tell the person in charge that you are taking this medicine. The results of some tests may be affected by probenecid.
For diabetic patients:
• Probenecid may cause false test results with copper sulfate urine sugar tests (Clinitest®), but not with glucose enzymatic urine sugar tests (Clinistix®). If you have any questions about this, check with your health care professional.
For patients taking probenecid for gout or to help remove uric acid from the body:
• Taking aspirin or other salicylates may lessen the effects of probenecid. This will depend on the dose of aspirin or other salicylate that you take, and on how often you take it. Also, drinking too much alcohol may increase the amount of uric acid in the blood and lessen the effects of this medicine. Therefore, do not take aspirin or other salicylates or drink alcoholic beverages while taking this medicine, unless you have first checked with your doctor.
d. Side Effects of This Medicine
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
The following side effects may mean that you are having an allergic reaction to this medicine. Check with your doctor immediately if any of the following side effects occur:
• Rare
Fast or irregular breathing; puffiness or swellings of the eyelids or around the eyes; shortness of breath, troubled breathing, tightness in chest, or wheezing; changes in the skin color of the face occurring together with any of the other side effects listed here; or skin rash, hives, or itching occurring together with any of the other side effects listed here
Also, check with your doctor as soon as possible if any of the following side effects occur:
• Less common
Bloody urine; difficult or painful urination ; lower back or side pain (especially if severe or sharp); skin rash, hives, or itching (occurring without other signs of an allergic reaction)
• Rare
Cloudy urine; cough or hoarseness; fast or irregular breathing; fever; pain in back and/or ribs; sores, ulcers, or white spots on lips or in mouth; sore throat and fever with or without chills; sudden decrease in the amount of urine; swelling of face, fingers, feet, and/or lower legs; swollen and/or painful glands ; unusual bleeding or bruising; unusual tiredness or weakness; yellow eyes or skin ; weight gain
Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:
• More common
Headache; joint pain, redness, or swelling ; loss of appetite; nausea or vomiting (mild)
• Less common
Dizziness; flushing or redness of face (occurring without any signs of an allergic reaction); frequent urge to urinate; sore gums
Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.
SOLUTION # 2: Unless you are a divine follower of the late Mahatma Gandhi, who used to drink his urine daily, this solution is not nearly as appealing as taking probenecid. However, it apparently would be very effective. Dr. Grattan Woodson, a specialist in internal medicine at the Druid Oaks Health Center in Decatur, Georgia, offers the following advice for emergency treatment of bird flu:* This is an advanced, potentially life-saving emergency strategy, that should only be done under medical supervision—unless none is available.
Tamiflu Re-Administration Strategy: Tamiflu is excreted unchanged almost entirely in the urine. If Tamiflu supplies are limited, as they most certainly will be [during a bird-flu pandemic], consider giving the patient two Tamiflu tablets at the same time, collect the patient’s urine and re-administer it to the patient via naso-gastric (NG) tube or orally. If managed carefully, this approach means that you can completely treat a patient with only 2 Tamiflu tablets [by re-administering the patient’s urine daily for five to 10 days].
Thursday, May 29, 2014
Allergies - Food Allergies
In this article we're going to focus on one of the most annoying types of allergies, especially to people who love to eat.
You go out to the local pizza parlor, order two slices with extra cheese, sit down at the booth with your pizza in one hand and coke in the other and chow down. A few hours later after you've arrived back home just in time to watch your favorite TV show, suddenly your stomach feels like it's about to erupt like a volcano. You run like a madman to the bathroom just in time to experience what seems to be the complete emptying of your insides.
Welcome to the world of food allergies and intolerances.
In the case of the runs after eating a couple of slices of pizza most likely you're lactose intolerant which is just one type of food allergy. Technically, you can be allergic to just about any kind of food but there are some that seem to be more common that others.
Before we go any further let's define exactly what a food allergy is. Food allergies can be broken down into 2 categories. The first one is hypersensitivity. This is an adverse reaction of the immune system itself and is unrelated to any actual physical effect of the food or food additive. These reactions are caused by immunoglobulin E (IgE) antibodies.
The second category is food intolerance. This is actually caused by the food itself and is not a function of the immune system itself overreacting to the food or food additive. The symptoms of an intolerance may be very similar to those of an actual immune symptom reaction but the causes are quite different.
Of the two, actual immune system reactions are the more common, though it does appear that a trend to intolerances, such as lactose intolerance, is on the rise. What actually happens with food allergies is that people with allergies produce IgE antibodies to specific epitopes in the food allergen. These antibodies bind to IgE receptors on the mast cells of tissue that are on the skin, digestive tract and respiratory system. The exposure of these antigens causes the release of histamines. This ultimately results in mucus secretion and muscle contraction which then leads to a wide range of symptoms which can range from unpleasant to serious or even severe. How severe?
Allergic reactions to food can be fatal almost immediately following the ingestion of food. Probably one of the most prevalent and dangerous of these food allergies are people who are allergic to peanuts. Just recently, as of this writing, a girl died simply from kissing someone who had recently eaten peanuts. That is how dangerous these allergies can be.
Less severe reactions to food allergies are oropharyngeal pruritus, angioedema, stridor, cough, dyspnea, wheezing, and dysphonia.
Aside from peanuts, the most common foods that people are allergic to are tree nuts, and shellfish.
Unfortunately the best way to avoid food allergies is to have a food allergy test done and then to avoid the foods that show positive on the test.
You go out to the local pizza parlor, order two slices with extra cheese, sit down at the booth with your pizza in one hand and coke in the other and chow down. A few hours later after you've arrived back home just in time to watch your favorite TV show, suddenly your stomach feels like it's about to erupt like a volcano. You run like a madman to the bathroom just in time to experience what seems to be the complete emptying of your insides.
Welcome to the world of food allergies and intolerances.
In the case of the runs after eating a couple of slices of pizza most likely you're lactose intolerant which is just one type of food allergy. Technically, you can be allergic to just about any kind of food but there are some that seem to be more common that others.
Before we go any further let's define exactly what a food allergy is. Food allergies can be broken down into 2 categories. The first one is hypersensitivity. This is an adverse reaction of the immune system itself and is unrelated to any actual physical effect of the food or food additive. These reactions are caused by immunoglobulin E (IgE) antibodies.
The second category is food intolerance. This is actually caused by the food itself and is not a function of the immune system itself overreacting to the food or food additive. The symptoms of an intolerance may be very similar to those of an actual immune symptom reaction but the causes are quite different.
Of the two, actual immune system reactions are the more common, though it does appear that a trend to intolerances, such as lactose intolerance, is on the rise. What actually happens with food allergies is that people with allergies produce IgE antibodies to specific epitopes in the food allergen. These antibodies bind to IgE receptors on the mast cells of tissue that are on the skin, digestive tract and respiratory system. The exposure of these antigens causes the release of histamines. This ultimately results in mucus secretion and muscle contraction which then leads to a wide range of symptoms which can range from unpleasant to serious or even severe. How severe?
Allergic reactions to food can be fatal almost immediately following the ingestion of food. Probably one of the most prevalent and dangerous of these food allergies are people who are allergic to peanuts. Just recently, as of this writing, a girl died simply from kissing someone who had recently eaten peanuts. That is how dangerous these allergies can be.
Less severe reactions to food allergies are oropharyngeal pruritus, angioedema, stridor, cough, dyspnea, wheezing, and dysphonia.
Aside from peanuts, the most common foods that people are allergic to are tree nuts, and shellfish.
Unfortunately the best way to avoid food allergies is to have a food allergy test done and then to avoid the foods that show positive on the test.
Wednesday, May 28, 2014
Bird Flu and You: How Will The Flu Affect You?
Flu is a common disease nowadays, with most people having developed the antibodies to fight against the disease. So the mention of "flu" doesn’t really create any alarm. However, say "bird flu" and there’s likely to be a pandemonium.
Bird flu, or avian influenza, is a highly pathogenic virus of 15 types. The virus spreads to poultry through direct or close contact with nasal secretions, saliva and feces of infected birds. What is alarming about this virus is that it has the ability to rapidly mutate into different forms that can affect human beings. Believed to be worse than the SARS outbreak, the bird flu outbreak brought millions of dead birds worldwide and at least 70 people dead in Asia.
From a not-so-harmful H5N2 virus strain, it can mutate into a killer virus with a low spread rate once the virus is transmitted to a bird. The virus has an incubation period of six to nine months before it becomes a full-blown, deadly pathogen. A bird that has been infected with the virus but has survived the disease continues to carry the virus in its body for more than week. When this happens, the bird passes on the disease to other birds that come in close contact with its secretions, saliva and feces.
Bird flu and ordinary human flu have the almost the same symptoms. These symptoms are fever, muscle pains and cough. This is the reason that a person who is actually infected with bird flu may be mistakenly diagnosed as simply having ordinary flu. However, bird flu symptoms can escalate into several life-threatening conditions. Some of these life-threatening conditions are lung inflammation, eye infections and pneumonia.
Because of the severity of symptoms of bird flu infection, the World Health Organization (WHO) is in the midst of a widespread effort to prevent the virus from infecting humans, particularly those whose who depend on poultry and livestock as their livelihood.
Bird flu virus and its subtypes can easily mutate into other forms. For example, the virus that was transferred from one animal to another is the H5N2 strain. However, the virus mutated into the H5N1 strain, which has been responsible for the death of at least 50 people. It is a very surprising discovery how these viruses can mutate itself from pathogens that can harm humans as it had started with birds.
In Asia, the countries plagued by the avian flu are Vietnam, Japan, Cambodia, South Korea, China, Indonesia, Laos, Thailand, Kazakhstan, Malaysia, Mongolia, Russia, Thailand. In Europe, Turkey, Romania and Croatia are the hardest hit by the disease.
WHO has issued a warning to travelers to these countries to avoid going to live poultry markets, getting close contact to any farms and having direct exposure to feathers, feces or droppings, eggs and poultry meat products. Travelers need to know that most contamination occurs during the slaughtering of poultry and being in direct contact with fecal matter.
No travel advisory has been issued restricting anyone from going to countries with the H5N2 strain. Travelers coming from afflicted countries are also not being screened. However, precautionary measures are in place, particularly in the media. Information is being disseminated in order to make people aware of the bird flu, its effects and what to do to avoid getting infected.
To date, no vaccines have been developed or available to fight the illness. However, anti-viral medicines are being used as alternatives in helping alleviate the severity of symptoms on those infected. While M2 inhibitors would be helpful, the body tends to develop resistance to those, diminishing the efficiency and effectivity of inhibitors.
The bird flu problem is both a government and global issue. Governments are in charge of making reliable declarations, initiating studies and putting objective measures in place. There is no reason to panic if the virus has not reached your area yet. The best thing you can do is to take practical steps in taking of your body and helping it build resistance to any kind of illnesses.
Bird flu, or avian influenza, is a highly pathogenic virus of 15 types. The virus spreads to poultry through direct or close contact with nasal secretions, saliva and feces of infected birds. What is alarming about this virus is that it has the ability to rapidly mutate into different forms that can affect human beings. Believed to be worse than the SARS outbreak, the bird flu outbreak brought millions of dead birds worldwide and at least 70 people dead in Asia.
From a not-so-harmful H5N2 virus strain, it can mutate into a killer virus with a low spread rate once the virus is transmitted to a bird. The virus has an incubation period of six to nine months before it becomes a full-blown, deadly pathogen. A bird that has been infected with the virus but has survived the disease continues to carry the virus in its body for more than week. When this happens, the bird passes on the disease to other birds that come in close contact with its secretions, saliva and feces.
Bird flu and ordinary human flu have the almost the same symptoms. These symptoms are fever, muscle pains and cough. This is the reason that a person who is actually infected with bird flu may be mistakenly diagnosed as simply having ordinary flu. However, bird flu symptoms can escalate into several life-threatening conditions. Some of these life-threatening conditions are lung inflammation, eye infections and pneumonia.
Because of the severity of symptoms of bird flu infection, the World Health Organization (WHO) is in the midst of a widespread effort to prevent the virus from infecting humans, particularly those whose who depend on poultry and livestock as their livelihood.
Bird flu virus and its subtypes can easily mutate into other forms. For example, the virus that was transferred from one animal to another is the H5N2 strain. However, the virus mutated into the H5N1 strain, which has been responsible for the death of at least 50 people. It is a very surprising discovery how these viruses can mutate itself from pathogens that can harm humans as it had started with birds.
In Asia, the countries plagued by the avian flu are Vietnam, Japan, Cambodia, South Korea, China, Indonesia, Laos, Thailand, Kazakhstan, Malaysia, Mongolia, Russia, Thailand. In Europe, Turkey, Romania and Croatia are the hardest hit by the disease.
WHO has issued a warning to travelers to these countries to avoid going to live poultry markets, getting close contact to any farms and having direct exposure to feathers, feces or droppings, eggs and poultry meat products. Travelers need to know that most contamination occurs during the slaughtering of poultry and being in direct contact with fecal matter.
No travel advisory has been issued restricting anyone from going to countries with the H5N2 strain. Travelers coming from afflicted countries are also not being screened. However, precautionary measures are in place, particularly in the media. Information is being disseminated in order to make people aware of the bird flu, its effects and what to do to avoid getting infected.
To date, no vaccines have been developed or available to fight the illness. However, anti-viral medicines are being used as alternatives in helping alleviate the severity of symptoms on those infected. While M2 inhibitors would be helpful, the body tends to develop resistance to those, diminishing the efficiency and effectivity of inhibitors.
The bird flu problem is both a government and global issue. Governments are in charge of making reliable declarations, initiating studies and putting objective measures in place. There is no reason to panic if the virus has not reached your area yet. The best thing you can do is to take practical steps in taking of your body and helping it build resistance to any kind of illnesses.
Tuesday, May 27, 2014
Bird Flu: A Historical Perspective
Recent outbreaks have put avian influenza, commonly known as bird flu disease, at the center stage of the global health community. From relative anonymity, the disease acquired notoriety for itself when it claimed more than fifty human lives. The deaths from bird flu disease are relatively small when compared to the number of deaths from other diseases. However, the possibility of a global pandemic is serious enough that deaths caused by bird flu warrant a closer examination and alarm.
Another pandemic waiting to happen
Officials at the World Health Organization (WHO) has said that the world is ripe for another influenza pandemic. An influenza pandemic occurs roughly every 30-40 years. The last influenza pandemic, which originated in Hong Kong in 1969, claimed 34,000 lives in the United States and even more in the Asian region. Although the viral subtype of the disease is still in circulation, the human body has already developed antibodies for it.
Historical precedence is not enough of a basis towards setting off global alarm bells. However, the patterns seen in the outbreaks point to the possibility of another influenza pandemic. There are an increasing number of cases wherein humans have been infected with the bird flu virus and the death toll from the disease is now more than 50.
One of the first signs of an impending pandemic is the crossing over of the disease from birds to humans. WHO is closely keeping its eye on the occurrence of a first case of human to human transmission of the bird flu virus. The human to human transmission of the disease will pose greater risks of infection to humans, which would effectively signal the start of a pandemic. To date, there are no recorded cases of bird flu being transmitted from an infected human to another.
To date, all human cases of bird flu were contracted by victims after having direct contact with infected animals and their secretions. However, the global health community is very much concerned because the bird flu virus mutates easily and is constantly evolving, and the first human to human transmission of the virus may just be around the corner.
Three global influenza pandemics: a brief history
Three major influenza pandemics have occurred: in 1918, 1957 and 1968. The first pandemic, the Spanish Flu of 1918-1919, had the highest mortality among the three pandemics. In less than a year, 20 to 40 million people died from the Spanish Flu, with over 50,000 lives claimed in the United States alone. Simultaneous outbreaks of the Spanish Flu were first detected in Europe and some parts of the United States. The infection spread to more areas through ships that traveled between the United States and Europe. Asia and Africa were eventually affected. The first wave of the pandemic was highly contagious although it was not deadly. The second wave, however, was deadly and occurred shortly in France, Sierra Leona and United States. It registered a ten-fold increase in mortality.
In 1957, a second pandemic occurred. Called the Asian Flu because it was first detected in Hong Kong and Singapore, it was much milder than the Spanish Flu, claiming between one and four million lives. When the second pandemic hit, the people were more prepared and knew what to expect. This was due largely to the world’s experience with the first pandemic. The Asian Flu virus was soon isolated in Japanese and Singaporean laboratories. The findings helped the World Health Organization alert the world about the onset of a pandemic and vaccines were immediately produced and distributed.
The most recent influenza pandemic happened in 1968 and lasted for a year. Dubbed as the Hong Kong Flu, it was first detected in China and later spread to Hong Kong where it escalated at an alarming rate. Like the Asian Flu, the Hong Kong Flu claimed between one and four million lives. It reached Canada, the United Kingdom and the United States, particularly California.
Another pandemic waiting to happen
Officials at the World Health Organization (WHO) has said that the world is ripe for another influenza pandemic. An influenza pandemic occurs roughly every 30-40 years. The last influenza pandemic, which originated in Hong Kong in 1969, claimed 34,000 lives in the United States and even more in the Asian region. Although the viral subtype of the disease is still in circulation, the human body has already developed antibodies for it.
Historical precedence is not enough of a basis towards setting off global alarm bells. However, the patterns seen in the outbreaks point to the possibility of another influenza pandemic. There are an increasing number of cases wherein humans have been infected with the bird flu virus and the death toll from the disease is now more than 50.
One of the first signs of an impending pandemic is the crossing over of the disease from birds to humans. WHO is closely keeping its eye on the occurrence of a first case of human to human transmission of the bird flu virus. The human to human transmission of the disease will pose greater risks of infection to humans, which would effectively signal the start of a pandemic. To date, there are no recorded cases of bird flu being transmitted from an infected human to another.
To date, all human cases of bird flu were contracted by victims after having direct contact with infected animals and their secretions. However, the global health community is very much concerned because the bird flu virus mutates easily and is constantly evolving, and the first human to human transmission of the virus may just be around the corner.
Three global influenza pandemics: a brief history
Three major influenza pandemics have occurred: in 1918, 1957 and 1968. The first pandemic, the Spanish Flu of 1918-1919, had the highest mortality among the three pandemics. In less than a year, 20 to 40 million people died from the Spanish Flu, with over 50,000 lives claimed in the United States alone. Simultaneous outbreaks of the Spanish Flu were first detected in Europe and some parts of the United States. The infection spread to more areas through ships that traveled between the United States and Europe. Asia and Africa were eventually affected. The first wave of the pandemic was highly contagious although it was not deadly. The second wave, however, was deadly and occurred shortly in France, Sierra Leona and United States. It registered a ten-fold increase in mortality.
In 1957, a second pandemic occurred. Called the Asian Flu because it was first detected in Hong Kong and Singapore, it was much milder than the Spanish Flu, claiming between one and four million lives. When the second pandemic hit, the people were more prepared and knew what to expect. This was due largely to the world’s experience with the first pandemic. The Asian Flu virus was soon isolated in Japanese and Singaporean laboratories. The findings helped the World Health Organization alert the world about the onset of a pandemic and vaccines were immediately produced and distributed.
The most recent influenza pandemic happened in 1968 and lasted for a year. Dubbed as the Hong Kong Flu, it was first detected in China and later spread to Hong Kong where it escalated at an alarming rate. Like the Asian Flu, the Hong Kong Flu claimed between one and four million lives. It reached Canada, the United Kingdom and the United States, particularly California.
Monday, May 26, 2014
Causes of Osteoporosis
It is a known fact that more bone is laid down more than it is removed in the early life of a person. An individual’s peak bone mass is reached at the age of thirty, wherein the remodeling process starts, that takes away more bone than is replaced. Remodeling is the process involving the laying down of new bone and the removing of old bone. So it can be said that the process of bone loss begins in the early to late thirties. It is from this age to the onset of menopause that women lose a certain amount of bone every year.
The average rate of bone loss in men, and in women who have not reached menopause, is actually quite small. However, after menopause, the bone loss in women accelerates to an average of one to two percent a year. It is after menopause that the level of the female hormone estrogen in a woman’s body decreases sharply. Estrogen is a hormone that is important in protecting the skeleton by helping the body’s bone forming cells to keep working. So after menopause, this protection can be considered lost as the level of estrogen decreases.
Other causes of osteoporosis are heredity and lifestyle. Whites and Asians, tall and thin women and those with a history of osteoporosis are those at the highest risk of getting osteoporosis. The behavioral causes of increasing the risk of osteoporosis are smoking, alcohol abuse, prolonged inactivity and a diet low in calcium. There are also some diseases that are associated with aging that cause osteoporosis, which include kidney failure, liver disease, cancers, Paget’s disease, endocrine or glandular diseases, gonadal failure and rheumatoid arthritis. There are some medications like steroids, seizure drugs, thyroid hormone and blood thinners that are also found to cause osteoporosis.
The average rate of bone loss in men, and in women who have not reached menopause, is actually quite small. However, after menopause, the bone loss in women accelerates to an average of one to two percent a year. It is after menopause that the level of the female hormone estrogen in a woman’s body decreases sharply. Estrogen is a hormone that is important in protecting the skeleton by helping the body’s bone forming cells to keep working. So after menopause, this protection can be considered lost as the level of estrogen decreases.
Other causes of osteoporosis are heredity and lifestyle. Whites and Asians, tall and thin women and those with a history of osteoporosis are those at the highest risk of getting osteoporosis. The behavioral causes of increasing the risk of osteoporosis are smoking, alcohol abuse, prolonged inactivity and a diet low in calcium. There are also some diseases that are associated with aging that cause osteoporosis, which include kidney failure, liver disease, cancers, Paget’s disease, endocrine or glandular diseases, gonadal failure and rheumatoid arthritis. There are some medications like steroids, seizure drugs, thyroid hormone and blood thinners that are also found to cause osteoporosis.
Sunday, May 25, 2014
Bird Flu Vaccines: What is Taking So Long?
With the current development of a vaccine for the H5N1 strain of the Bird Flu Virus still 2 to 3 years away. We don’t have much of a choice but to really be very cautious that the H5N1 strain does not mutate with a human flu virus.
If the outbreak we fear does happen without the vaccines ready yet, all we can possibly do is just quarantine the geographical area where the virus is rampant. Give them the vaccines that have been developed and prevent them from spreading it further. This will only work if the outbreak is limited geographically. When the outbreak does happen to 10,000 places, we’re in Big S*%T.
The development of a vaccine is so slow because we still use methods dating back 50 years ago. Ironically this is because they still use chicken eggs to develop the vaccines. New methods are on the horizon, instead of using chicken eggs, they may be able to use mammal cells.
Scientist would be storing the mammal cells in large numbers. So that when a flu strain or threat develops, they can just inject it to the cells. The injected cells will then burst and die. The scientist will then harvest the proteins of the influenza and distribute them as vaccines already.
Vaccines made from DNA are really appealing because they could be made and administered quickly. However this kind of vaccine is still being tested on humans. DNA vaccine works by attaching itself to a segment of our DNA. It contains the coded information of the flu virus’ protein.
Now you would want to ask why we would vaccinate everyone instead of just treating them. This is because giving vaccines is cheaper compared to treating everyone. With a vaccine the person only needs one or two doses in total. Compared to giving two doses a day for a period of time to treat the viral problem. It is also pretty stupid to wait for someone to suffer before treating the person. The person might not even live to see the day just to receive the medication.
The current stand of some people however is that why waste precious money on a threat that may never materialize. The best answer here is it’s better to be prepared than be sorry.
In the last 87 years we have had three pandemics. So it’s better to prepare for something that could be really catastrophic. The longer our world goes without a pandemic; there is more chance that it could occur in the upcoming years.
That’s why we should be very thankful for every company out there trying to create a vaccine for a pandemic that might hit us. Rather than be worried of money that might get wasted.
If the outbreak we fear does happen without the vaccines ready yet, all we can possibly do is just quarantine the geographical area where the virus is rampant. Give them the vaccines that have been developed and prevent them from spreading it further. This will only work if the outbreak is limited geographically. When the outbreak does happen to 10,000 places, we’re in Big S*%T.
The development of a vaccine is so slow because we still use methods dating back 50 years ago. Ironically this is because they still use chicken eggs to develop the vaccines. New methods are on the horizon, instead of using chicken eggs, they may be able to use mammal cells.
Scientist would be storing the mammal cells in large numbers. So that when a flu strain or threat develops, they can just inject it to the cells. The injected cells will then burst and die. The scientist will then harvest the proteins of the influenza and distribute them as vaccines already.
Vaccines made from DNA are really appealing because they could be made and administered quickly. However this kind of vaccine is still being tested on humans. DNA vaccine works by attaching itself to a segment of our DNA. It contains the coded information of the flu virus’ protein.
Now you would want to ask why we would vaccinate everyone instead of just treating them. This is because giving vaccines is cheaper compared to treating everyone. With a vaccine the person only needs one or two doses in total. Compared to giving two doses a day for a period of time to treat the viral problem. It is also pretty stupid to wait for someone to suffer before treating the person. The person might not even live to see the day just to receive the medication.
The current stand of some people however is that why waste precious money on a threat that may never materialize. The best answer here is it’s better to be prepared than be sorry.
In the last 87 years we have had three pandemics. So it’s better to prepare for something that could be really catastrophic. The longer our world goes without a pandemic; there is more chance that it could occur in the upcoming years.
That’s why we should be very thankful for every company out there trying to create a vaccine for a pandemic that might hit us. Rather than be worried of money that might get wasted.
Saturday, May 24, 2014
Bird Flu Is In The U.S.!
In that great Hitchcock thriller, the birds start attacking Tippi Hedron (Melanie Griffith's mom, for trivia fans) in Mendocino for no particular reason.Today, Ms. Hedron works actively in films, international relief efforts and for animal causes.She may get an ironic opportunity to combine her charity works with birds again, because scientists around the world are looking nervously at the increasing possibility of a return of avian influenza, also known as the bird flu.First identified in Italy in 1900, it is the H5N1 virus implicated in the great Spanish Flu pandemic of 1918-1919 that killed about 40 million people.I say "implicated in" instead of "caused," because it was government policies that made the death toll much higher than it needed to be.But there is no doubt H5N1 is a major killer.
There are three steps H5N1 has to go through in order to get to people.First, there needs to be a lot of infected birds.Almost 200 million chickens have been killed or died in Asia in the last year due to avian flu infection.Strike One. Next, unless someone eats diseased poultry, the flu has to cross species into an animal that can easily infect people.It has now crossed into pigs, which is where most human flu outbreaks begin.Pigs carry human influenza viruses.Viruses can combine (exchange DNA) in pigs, creating a variant of H5N1 that can spread as easily and rapidly as ordinary flu.Strike Two.
Finally, it has to hit an unprepared populace, with lowered immune systems and no effective drugs.Lowered immune systems are caused by, among other factors, cold weather, lack of sleep, excess weight, stress, high sugar intake and caffeine.Hmmm. Sound like anyone you know?
Serious scientists think H5N1 could kill as many people as the 1918 disaster, if only because there are now more than three times as many people in the world. The UN Coordinator for Avian and Human Influenza recently said a bird flu pandemic could kill as many as 150 million people.Other scientists have projected up to 354 million deaths.And you thought $3 gasoline was a major problem!
The H5N1 bird flu reappeared in Hong Kong in 1997.Eighteen people were infected, and six died.All the chickens in the area were slaughtered, and the outbreak was confined to Hong Kong.But it has now been found in Vietnam, Thailand, Japan, Mainland China, Malaysia and Indonesia.
It then showed up in Russia, almost certainly carried by migratory birds.So much for banning chicken.In August 2005, it appeared in Mongolia and Kazakhstan, and then in western Russia, poised to enter Europe.Roumania found infected and dead swans in October.An infected parrot died in quarantine in the United Kingdom.
The Senior United Nations System Coordinator for Avian and Human Influenza in charge of a response to H5N1 says a pandemic could begin at anytime, and kill five million to 150 million people.He confirmed the virus is in migratory birds, and said an outbreak could start in Africa, where immune systems are chronically depressed, or the Middle East as well as southeast Asia.What he didn't say is that the same migratory birds, mainly ducks, swans and geese, also travel thousands of miles to Canada and the U.S.The H5N1 virus is almost certainly in the U.S. already - it just hasn't been found yet.December, Janaury and February are the "flu season" in both the U.S. and Asia.
We have reviewed all the companies involved in bird flu vaccines, and found two stocks that should be bought immediately because they will make a fortune even if there is never a case of bird flu in the world again.Governments around the world are stocking up on vaccines just in case they are needed, and these stockpiles need to be replenished periodically.
There are three steps H5N1 has to go through in order to get to people.First, there needs to be a lot of infected birds.Almost 200 million chickens have been killed or died in Asia in the last year due to avian flu infection.Strike One. Next, unless someone eats diseased poultry, the flu has to cross species into an animal that can easily infect people.It has now crossed into pigs, which is where most human flu outbreaks begin.Pigs carry human influenza viruses.Viruses can combine (exchange DNA) in pigs, creating a variant of H5N1 that can spread as easily and rapidly as ordinary flu.Strike Two.
Finally, it has to hit an unprepared populace, with lowered immune systems and no effective drugs.Lowered immune systems are caused by, among other factors, cold weather, lack of sleep, excess weight, stress, high sugar intake and caffeine.Hmmm. Sound like anyone you know?
Serious scientists think H5N1 could kill as many people as the 1918 disaster, if only because there are now more than three times as many people in the world. The UN Coordinator for Avian and Human Influenza recently said a bird flu pandemic could kill as many as 150 million people.Other scientists have projected up to 354 million deaths.And you thought $3 gasoline was a major problem!
The H5N1 bird flu reappeared in Hong Kong in 1997.Eighteen people were infected, and six died.All the chickens in the area were slaughtered, and the outbreak was confined to Hong Kong.But it has now been found in Vietnam, Thailand, Japan, Mainland China, Malaysia and Indonesia.
It then showed up in Russia, almost certainly carried by migratory birds.So much for banning chicken.In August 2005, it appeared in Mongolia and Kazakhstan, and then in western Russia, poised to enter Europe.Roumania found infected and dead swans in October.An infected parrot died in quarantine in the United Kingdom.
The Senior United Nations System Coordinator for Avian and Human Influenza in charge of a response to H5N1 says a pandemic could begin at anytime, and kill five million to 150 million people.He confirmed the virus is in migratory birds, and said an outbreak could start in Africa, where immune systems are chronically depressed, or the Middle East as well as southeast Asia.What he didn't say is that the same migratory birds, mainly ducks, swans and geese, also travel thousands of miles to Canada and the U.S.The H5N1 virus is almost certainly in the U.S. already - it just hasn't been found yet.December, Janaury and February are the "flu season" in both the U.S. and Asia.
We have reviewed all the companies involved in bird flu vaccines, and found two stocks that should be bought immediately because they will make a fortune even if there is never a case of bird flu in the world again.Governments around the world are stocking up on vaccines just in case they are needed, and these stockpiles need to be replenished periodically.
Friday, May 23, 2014
Bird Flu Explained
Bird Flu or more correctly, avian flu, is much in the news and causing a lot of anxiety. Many people are worried that they may get it, and the papers are full of horror scenarios.
There are over 100 strains of avian flu, but most of them do not infect humans. The current strain H5N1 can infect humans, but not easily. The number of cases of avian flu in humans in the current outbreak is very small, and almost all have come about by direct contact with infected or dead birds – something that most of us are unlikely to experience. So far, the spread of H5N1 virus from person-to-person has been rare and has not continued beyond one person. In fact according to The Times (London, 23rd March 2006) only 184 confirmed cases have been reported worldwide so far from this strain, with 103 deaths. These have been in Cambodia, China, Indonesia, Thailand, Vietnam, and most recently, several cases in Turkey.
What the authorities are much more concerned about is the strain mutating into a variation that can be transmitted between human beings, rather than just from bird to human. This has been designated as influenza A/H5N1. Humans do not have any resistance to this strain, because these viruses do not commonly infect humans. If a strain developed that could infect the human population, a pandemic would be likely with many people being infected and dying. The 1918 ‘Spanish flu’ is estimated to have killed 50 million people worldwide. At least four of the eight genes of H5N1 avian flu now contain mutations seen in that deadly strain.
Jeffery K. Taubenberger, a molecular pathologist at the Armed Forces Institute of Pathology in Rockville, USA has said:
"These H5N1 viruses might be acquiring the ability to adapt to humans, increasing their pandemic risk ... there is a suggestion there may be some parallel evolution going on."
Scientists still do not understand completely how a bird virus becomes a human virus, but H5N1 is already showing some of the mutations necessary for it to become a human flu, but at the moment, in spite off all the panic, there is no pandemic flu strain.
Research in the Netherlands and the USA has shown that while human influenza viruses are able to bind with receptors in the windpipe, H5N1 binds only much deeper inside the lungs. This makes it more difficult for the virus to infect humans, because the virus is less likely to reach the inner lungs than the windpipe. The H5N1 virus is also less likely to spread from human to human. Coughing and sneezing easily transmits viruses that have multiplied in the windpipe, but not those located deep in the lungs. If H5N1 manages to mutate so that it can replicate in the upper respiratory tract, a pandemic becomes more likely. Scientists are constantly monitoring the virus for this mutation.
So should we be concerned? There have been many scares over the years that have not come to anything, and this could turn out to be one of those too, but it is worth taking some sensible precautions rather than just relying on the scientists to find a powerful enough solution. Having a strong immune system has to be the first line of defence. Eating a good diet, taking exercise, getting plenty of sleep, and reducing stress can all lead to a stronger immune system that can fight more effectively against the bugs of this world and any dangerous mutations.
References:
Daily News Central: Bird Flu on Similar Evolutionary Path as 1918 Killer Virus
Centers For Disease Control & Prevention: Key Facts About Avian Influenza (Bird Flu) and Avian Influenza A (H5N1) Virus
The Times (London) 21 January 2006 and 23 March 2006
The Guardian (London) 1 March 2006
There are over 100 strains of avian flu, but most of them do not infect humans. The current strain H5N1 can infect humans, but not easily. The number of cases of avian flu in humans in the current outbreak is very small, and almost all have come about by direct contact with infected or dead birds – something that most of us are unlikely to experience. So far, the spread of H5N1 virus from person-to-person has been rare and has not continued beyond one person. In fact according to The Times (London, 23rd March 2006) only 184 confirmed cases have been reported worldwide so far from this strain, with 103 deaths. These have been in Cambodia, China, Indonesia, Thailand, Vietnam, and most recently, several cases in Turkey.
What the authorities are much more concerned about is the strain mutating into a variation that can be transmitted between human beings, rather than just from bird to human. This has been designated as influenza A/H5N1. Humans do not have any resistance to this strain, because these viruses do not commonly infect humans. If a strain developed that could infect the human population, a pandemic would be likely with many people being infected and dying. The 1918 ‘Spanish flu’ is estimated to have killed 50 million people worldwide. At least four of the eight genes of H5N1 avian flu now contain mutations seen in that deadly strain.
Jeffery K. Taubenberger, a molecular pathologist at the Armed Forces Institute of Pathology in Rockville, USA has said:
"These H5N1 viruses might be acquiring the ability to adapt to humans, increasing their pandemic risk ... there is a suggestion there may be some parallel evolution going on."
Scientists still do not understand completely how a bird virus becomes a human virus, but H5N1 is already showing some of the mutations necessary for it to become a human flu, but at the moment, in spite off all the panic, there is no pandemic flu strain.
Research in the Netherlands and the USA has shown that while human influenza viruses are able to bind with receptors in the windpipe, H5N1 binds only much deeper inside the lungs. This makes it more difficult for the virus to infect humans, because the virus is less likely to reach the inner lungs than the windpipe. The H5N1 virus is also less likely to spread from human to human. Coughing and sneezing easily transmits viruses that have multiplied in the windpipe, but not those located deep in the lungs. If H5N1 manages to mutate so that it can replicate in the upper respiratory tract, a pandemic becomes more likely. Scientists are constantly monitoring the virus for this mutation.
So should we be concerned? There have been many scares over the years that have not come to anything, and this could turn out to be one of those too, but it is worth taking some sensible precautions rather than just relying on the scientists to find a powerful enough solution. Having a strong immune system has to be the first line of defence. Eating a good diet, taking exercise, getting plenty of sleep, and reducing stress can all lead to a stronger immune system that can fight more effectively against the bugs of this world and any dangerous mutations.
References:
Daily News Central: Bird Flu on Similar Evolutionary Path as 1918 Killer Virus
Centers For Disease Control & Prevention: Key Facts About Avian Influenza (Bird Flu) and Avian Influenza A (H5N1) Virus
The Times (London) 21 January 2006 and 23 March 2006
The Guardian (London) 1 March 2006
Thursday, May 22, 2014
Bird Flu: Fundamental Questions and Answers You Need To Know
Q - What is bird flu?
A - Bird flu is an infection of a flu virus known to affect birds, particularly migratory birds, ducks and chickens. Bird flu is also reportedly known to affect pigs and most recently, humans. Thought to affect all species, the virus does not adversely affect ducks. Ducks have developed antibodies against the virus and they only act as carriers of the disease without exhibiting any symptoms of bird flu infection.
Migratory birds are carriers of the bird flu virus and do not show symptoms of bird flu infection. This makes them a crucial factor in the spreading of the disease. Other known diseases are transmitted in one area or a few areas only with a small radius. However, in the case of bird flu, the virus can be transmitted over great distances – from one country to another – since migratory birds travel from continent to continent. Another factor that contributes to the spreading of the disease is the exportation and importation of infected birds in the international markets.
Q - How is bird flu transmitted?
A - Bird flu is transmitted through direct contact with infected poultry, particularly upon contact with infected skin, saliva, nasal secretions and feces. The virus also spreads through poultry feeds, water reservoirs and cages. When birds are packed closely together, such as in poultry farms, the avian influenza viruses spread very rapidly among them. Transmission of the virus from chickens to humans can occur through contact with equipment, vehicles and clothing that have secretions from infected poultry.
Bird flu virus is resilient. It can survive in contaminated manure at very low temperatures for at least three months. The virus can survive in water for up to four days in hot temperatures and up to 30 days in cold temperatures. However, heat and disinfectants such as formalin and other iodine compounds are able to kill the virus.
Q - Who are at risk?
A - Many people mistakenly believe that they can contract the bird flu virus if they eat cooked chicken and eggs. However, chickens cooked at 56 degrees Celsius for three hours or at 60 degrees Celsius for half an hour are safe. The only way that people can contract the virus is if they come in direct contact with secretions and feces of infected poultry. Poultry raisers and those who are in the poultry and livestock industry are highly susceptible to contracting the virus. Those who prepare chickens and eggs of infected poultry may also be infected if the virus is fresh enough to infect them.
Q - Is there a possibility of human to human transmission of the bird flu virus?
A - Fortunately, there is still no sign of the bird flu virus being transmitted from one human to another. There have been cases of humans being infected with the virus and dying from it, but these people acquired the infection directly from birds and not from another infected person. This needs to be emphasized because there are some who think that the disease could be contracted from an infected human similar to how ordinary flu is transmitted.
To date, there is no evidence of human to human transmission of the bird flu virus. However, many scientists believe that human to human transmission of the bird flu virus is highly possible because the virus is can easily mutate and is constantly evolving. Mutation of the virus may lead to human to human transmission and scientist say this can occur in two ways. One, the virus enters the human body and mutates within the body, and two, the virus combines with ordinary human flu in the body of humans or pigs, which are susceptible to both kinds of flu.
A - Bird flu is an infection of a flu virus known to affect birds, particularly migratory birds, ducks and chickens. Bird flu is also reportedly known to affect pigs and most recently, humans. Thought to affect all species, the virus does not adversely affect ducks. Ducks have developed antibodies against the virus and they only act as carriers of the disease without exhibiting any symptoms of bird flu infection.
Migratory birds are carriers of the bird flu virus and do not show symptoms of bird flu infection. This makes them a crucial factor in the spreading of the disease. Other known diseases are transmitted in one area or a few areas only with a small radius. However, in the case of bird flu, the virus can be transmitted over great distances – from one country to another – since migratory birds travel from continent to continent. Another factor that contributes to the spreading of the disease is the exportation and importation of infected birds in the international markets.
Q - How is bird flu transmitted?
A - Bird flu is transmitted through direct contact with infected poultry, particularly upon contact with infected skin, saliva, nasal secretions and feces. The virus also spreads through poultry feeds, water reservoirs and cages. When birds are packed closely together, such as in poultry farms, the avian influenza viruses spread very rapidly among them. Transmission of the virus from chickens to humans can occur through contact with equipment, vehicles and clothing that have secretions from infected poultry.
Bird flu virus is resilient. It can survive in contaminated manure at very low temperatures for at least three months. The virus can survive in water for up to four days in hot temperatures and up to 30 days in cold temperatures. However, heat and disinfectants such as formalin and other iodine compounds are able to kill the virus.
Q - Who are at risk?
A - Many people mistakenly believe that they can contract the bird flu virus if they eat cooked chicken and eggs. However, chickens cooked at 56 degrees Celsius for three hours or at 60 degrees Celsius for half an hour are safe. The only way that people can contract the virus is if they come in direct contact with secretions and feces of infected poultry. Poultry raisers and those who are in the poultry and livestock industry are highly susceptible to contracting the virus. Those who prepare chickens and eggs of infected poultry may also be infected if the virus is fresh enough to infect them.
Q - Is there a possibility of human to human transmission of the bird flu virus?
A - Fortunately, there is still no sign of the bird flu virus being transmitted from one human to another. There have been cases of humans being infected with the virus and dying from it, but these people acquired the infection directly from birds and not from another infected person. This needs to be emphasized because there are some who think that the disease could be contracted from an infected human similar to how ordinary flu is transmitted.
To date, there is no evidence of human to human transmission of the bird flu virus. However, many scientists believe that human to human transmission of the bird flu virus is highly possible because the virus is can easily mutate and is constantly evolving. Mutation of the virus may lead to human to human transmission and scientist say this can occur in two ways. One, the virus enters the human body and mutates within the body, and two, the virus combines with ordinary human flu in the body of humans or pigs, which are susceptible to both kinds of flu.
Wednesday, May 21, 2014
Bird Flu: The Threat of Animal to Human Transmission
When bird flu hit most Asian countries, it prompted the World Health Organization (WHO) to urge China to test its wild birds, particularly geese that migrate from its waters during the harsh winter. The disease spread so fast from one bird to another that about 5,000 birds were killed in one season. People who have close or direct contact to infected poultry can contract the disease after coming in contact with bird secretions or feces.
Although many are divided on the possibility of direct human to human transmission of the virus, this possibility has not been ruled out. Viruses, in general, are known to mutate. In the case of bird flu, family members infected with it may show different severity of symptoms, prompting a misdiagnosis. Also, if a person who has the common flu becomes infected with bird flu at the same time, it can lead to the mutation of the bird flu virus.
At the University of Leicester in Great Britain, it was discovered that a full-blown bird flu pandemic could cause an 80% mortality rate. A team led by Karl Nicholson is developing the bird flu vaccine with the goal of decreasing the fatality should a fourth major pandemic occur. In the last century, there have been three recorded major pandemics: the Spanish Flu in 1918, the Asian Flu in 1957 and the Hong Kong Flu in 1968. In total, the three pandemics claimed at least 20 million people.
The bird flu virus, which can be transmitted through direct contact with a bird’s infected saliva, nasal secretions and feces, can survive for up to a week at 22 degrees Celsius. At freezing temperatures, the virus can survive indefinitely. It is no surprise that the bird flu virus tends to last in colder climates and is pronounced to be almost as deadly as SARS (severe acute respiratory syndrome). In addition to the transmission of the disease from the migration of wild birds traveling great distances, the disease is also spread when contaminated birds are exported and imported in the international market.
In terms of safety in food handling and preparation, a cooking temperature of about 70 degrees Celsius is enough to kill the bird flu virus. It is important, however, to avoid raw birds and other raw markets meats from being contaminated. Cook eggs properly and check that the yolks are not runny. The simple act of washing your hands thoroughly with soap and water after handling raw meats could spell the difference. Keep in mind that transmission of the bird flu virus to humans usually happens during the slaughtering process and handling of infected bird fluids. After slaughtering infected poultry, the virus typically stays in the intestinal and respiratory tracts, not in the meat itself. Cooking at right temperatures can help avoid the virus from spreading.
The symptoms of bird flu are very similar to human flu. However, the severity of a disease can sometimes give way to announcements of a pandemic, which can cause political issues. In Asia where the incidence and actual cases of human transmission of bird flu occurred, WHO and the United States immediately took precautionary measures. The British Medical Journal, on the other hand, declared that a pandemic is still far from happening.
No travel advisory has been issued restricting anyone from going to countries affected by bird flu although WHO has issued a warning to travelers. Travelers are advised against going to live poultry markets, getting close contact to any farms and having direct exposure to feathers, feces or droppings, eggs and poultry meat products. Travelers coming from afflicted countries are also not being screened. However, precautionary measures are in place, particularly in the media. Information is being disseminated in order to make people aware of the bird flu, its effects and what to do to avoid getting infected.
Viruses are constantly mutating and evolving. Health watchers, practitioners and scientists are concerned about this because if a pandemic occurs, there won’t be enough time to prepare and develop a vaccine. They fear that we are once again on the brink of another major pandemic threat. However, with the strides being made by technology every day, hopefully the casualty won’t be nearly as high as the casualty of the past three major pandemics that claimed at least 20 million lives worldwide.
Although many are divided on the possibility of direct human to human transmission of the virus, this possibility has not been ruled out. Viruses, in general, are known to mutate. In the case of bird flu, family members infected with it may show different severity of symptoms, prompting a misdiagnosis. Also, if a person who has the common flu becomes infected with bird flu at the same time, it can lead to the mutation of the bird flu virus.
At the University of Leicester in Great Britain, it was discovered that a full-blown bird flu pandemic could cause an 80% mortality rate. A team led by Karl Nicholson is developing the bird flu vaccine with the goal of decreasing the fatality should a fourth major pandemic occur. In the last century, there have been three recorded major pandemics: the Spanish Flu in 1918, the Asian Flu in 1957 and the Hong Kong Flu in 1968. In total, the three pandemics claimed at least 20 million people.
The bird flu virus, which can be transmitted through direct contact with a bird’s infected saliva, nasal secretions and feces, can survive for up to a week at 22 degrees Celsius. At freezing temperatures, the virus can survive indefinitely. It is no surprise that the bird flu virus tends to last in colder climates and is pronounced to be almost as deadly as SARS (severe acute respiratory syndrome). In addition to the transmission of the disease from the migration of wild birds traveling great distances, the disease is also spread when contaminated birds are exported and imported in the international market.
In terms of safety in food handling and preparation, a cooking temperature of about 70 degrees Celsius is enough to kill the bird flu virus. It is important, however, to avoid raw birds and other raw markets meats from being contaminated. Cook eggs properly and check that the yolks are not runny. The simple act of washing your hands thoroughly with soap and water after handling raw meats could spell the difference. Keep in mind that transmission of the bird flu virus to humans usually happens during the slaughtering process and handling of infected bird fluids. After slaughtering infected poultry, the virus typically stays in the intestinal and respiratory tracts, not in the meat itself. Cooking at right temperatures can help avoid the virus from spreading.
The symptoms of bird flu are very similar to human flu. However, the severity of a disease can sometimes give way to announcements of a pandemic, which can cause political issues. In Asia where the incidence and actual cases of human transmission of bird flu occurred, WHO and the United States immediately took precautionary measures. The British Medical Journal, on the other hand, declared that a pandemic is still far from happening.
No travel advisory has been issued restricting anyone from going to countries affected by bird flu although WHO has issued a warning to travelers. Travelers are advised against going to live poultry markets, getting close contact to any farms and having direct exposure to feathers, feces or droppings, eggs and poultry meat products. Travelers coming from afflicted countries are also not being screened. However, precautionary measures are in place, particularly in the media. Information is being disseminated in order to make people aware of the bird flu, its effects and what to do to avoid getting infected.
Viruses are constantly mutating and evolving. Health watchers, practitioners and scientists are concerned about this because if a pandemic occurs, there won’t be enough time to prepare and develop a vaccine. They fear that we are once again on the brink of another major pandemic threat. However, with the strides being made by technology every day, hopefully the casualty won’t be nearly as high as the casualty of the past three major pandemics that claimed at least 20 million lives worldwide.
Tuesday, May 20, 2014
Bird Flu: Human Infection
Bird flu is a disease caused by a specific type of avian (bird) influenza virus, the so-called H5N1 virus. This virus was first discovered in birds in China in 1997, and since then has infected 125 people in Vietnam, Cambodia, Thailand, and Indonesia, killing 64 of them. It is spread by infected migratory birds (including wild ducks and geese) to domestic poultry (primarily chickens, ducks, and turkeys), and then to humans.
Some infected people have developed abnormal clotting profiles resulting in excessive bleeding—which was a frequent clinical symptom in the deadly so-called Spanish influenza of 1918-19, which killed more than 100 million people worldwide. Indeed, bird flu shares a number of disturbing characteristics with the 1918-19 influenza virus. These two viruses have, in fact, recently been shown to be similar genetically. And in a recent laboratory experiment with mice, the 1918-19 virus was found to produce 39,000 times more viruses four days after infection than the regular seasonal human flu strain. The 1918-19 virus killed 100 percent of the mice that were infected with it, compared to none of the mice infected with the regular flu strain. With a current “case fatality rate,” or death rate of approximately 50 percent in humans, bird flu is obviously also a very deadly disease.
There are only a few reports in the medical literature describing the clinical features of bird flu in humans. The clinical spectrum of H5N1 infection ranges from asymptomatic infection—where the person doesn’t even know he or she is infected—to fatal pneumonia and multiple organ failure. Some infected individuals develop liver or kidney dysfunction, and there were two children who died from the virus that came to medical attention because of diarrhea and seizures related to encephalitis (infection of the brain). However, the most common presentation is one of fever, cough, and trouble breathing. Approximately 70 percent of patients also have diarrhea, and a few patients have had only gastrointestinal symptoms (such as stomach ache, vomiting, and diarrhea) and no breathing problems.
Deaths have generally been in normally healthy people. The first report in the medical literature of deaths from bird flu was on 12 patients living in Hong Kong. Their median age was nine years, with a range of one to 60 years. All presented with fever, and eight had symptoms or signs of upper-respiratory infections (five had clinical and X-ray evidence of pneumonia when first diagnosed). Gastrointestinal (GI) symptoms, including stomach pain, vomiting, and diarrhea, were present in eight patients. There were a total of five deaths (one died with Reye’s syndrome, which is associated with taking aspirin in children).
In a study of 10 patients in Vietnam with laboratory-confirmed avian influenza (H5N1), the mean age of the patients was 13.7 years. For eight of the patients, there was a clear history of either direct handling of poultry (chickens or ducks) or exposure to sick poultry in the week before the onset of illness. All presented in January 2004 with cough, shortness of breath, and fever, and seven had diarrhea; none had myalgia (muscle aches)—which is often found in the regular seasonal flu. Notably, oseltamivir (Tamiflu) was administered to five patients, four of whom died (treatment was probably started too late for the medication to be effective—it must be given within 48 hours after onset of symptoms to be effective). In total, eight of the patients died, for an 80 percent case fatality rate or death rate.
As is apparent from the descriptions above, the presenting symptoms of individuals with bird flu are very similar to the symptoms of the normal seasonal flu. Infections caused by either the bird-flu virus (H5N1) or the seasonal influenza virus can be completely asymptomatic—that is, cause no symptoms at all. Fever, cough, malaise (feeling ill), and gastrointestinal symptoms are common to both infections. Excessive bleeding occurs only with bird flu, but currently this symptom doesn’t appear to be common. Difficulty breathing is more common with severe cases of bird flu, not seasonal flu. Runny nose and sneezing are found only with colds (or allergies).
The cough in either type of infection is what is referred to in medicine as “nonproductive”—meaning there is no sputum brought up when coughing, or if any sputum is brought up, it is white in color. This type of cough is characteristic of upper respiratory viral infections. As either type of infection progresses or worsens, tissues may be damaged, disrupting the normal structure and function of the infected cells. This in turn may allow bacteria to grow and also cause damage. When this happens following a viral infection, it is referred to as a “secondary” bacterial infection. When this occurs, the color of the sputum characteristically turns yellow or green. If this happens, antibiotics are indicated to treat the bacterial infection. (Antibiotics are not indicated in the treatment of viral infections, because they don’t work.)
It is safe to assume that during a bird-flu pandemic, most individuals who become infected with the bird-flu virus will either be asymptomatic—having no symptoms—or their illness will not be severe enough to require hospitalization. The small percentage who do become seriously ill will have to be hospitalized, and treated with either of the two antiviral agents available, oseltamivir (Tamiflu) or zanamivir (Relenza). A smaller subset of that group will develop life-threatening complications such as acute respiratory distress syndrome (ARDS), which requires treatment with a mechanical ventilator, a respirator.
Some individuals may develop other serious complications such as liver failure, kidney failure, neurological problems—such as seizures, paralysis, psychiatric problems such as delirium or psychosis, or bleeding problems. However, it is reasonable to predict that most people infected with the virus will not die and will not have significant residual symptoms, although a small percentage will.
Some infected people have developed abnormal clotting profiles resulting in excessive bleeding—which was a frequent clinical symptom in the deadly so-called Spanish influenza of 1918-19, which killed more than 100 million people worldwide. Indeed, bird flu shares a number of disturbing characteristics with the 1918-19 influenza virus. These two viruses have, in fact, recently been shown to be similar genetically. And in a recent laboratory experiment with mice, the 1918-19 virus was found to produce 39,000 times more viruses four days after infection than the regular seasonal human flu strain. The 1918-19 virus killed 100 percent of the mice that were infected with it, compared to none of the mice infected with the regular flu strain. With a current “case fatality rate,” or death rate of approximately 50 percent in humans, bird flu is obviously also a very deadly disease.
There are only a few reports in the medical literature describing the clinical features of bird flu in humans. The clinical spectrum of H5N1 infection ranges from asymptomatic infection—where the person doesn’t even know he or she is infected—to fatal pneumonia and multiple organ failure. Some infected individuals develop liver or kidney dysfunction, and there were two children who died from the virus that came to medical attention because of diarrhea and seizures related to encephalitis (infection of the brain). However, the most common presentation is one of fever, cough, and trouble breathing. Approximately 70 percent of patients also have diarrhea, and a few patients have had only gastrointestinal symptoms (such as stomach ache, vomiting, and diarrhea) and no breathing problems.
Deaths have generally been in normally healthy people. The first report in the medical literature of deaths from bird flu was on 12 patients living in Hong Kong. Their median age was nine years, with a range of one to 60 years. All presented with fever, and eight had symptoms or signs of upper-respiratory infections (five had clinical and X-ray evidence of pneumonia when first diagnosed). Gastrointestinal (GI) symptoms, including stomach pain, vomiting, and diarrhea, were present in eight patients. There were a total of five deaths (one died with Reye’s syndrome, which is associated with taking aspirin in children).
In a study of 10 patients in Vietnam with laboratory-confirmed avian influenza (H5N1), the mean age of the patients was 13.7 years. For eight of the patients, there was a clear history of either direct handling of poultry (chickens or ducks) or exposure to sick poultry in the week before the onset of illness. All presented in January 2004 with cough, shortness of breath, and fever, and seven had diarrhea; none had myalgia (muscle aches)—which is often found in the regular seasonal flu. Notably, oseltamivir (Tamiflu) was administered to five patients, four of whom died (treatment was probably started too late for the medication to be effective—it must be given within 48 hours after onset of symptoms to be effective). In total, eight of the patients died, for an 80 percent case fatality rate or death rate.
As is apparent from the descriptions above, the presenting symptoms of individuals with bird flu are very similar to the symptoms of the normal seasonal flu. Infections caused by either the bird-flu virus (H5N1) or the seasonal influenza virus can be completely asymptomatic—that is, cause no symptoms at all. Fever, cough, malaise (feeling ill), and gastrointestinal symptoms are common to both infections. Excessive bleeding occurs only with bird flu, but currently this symptom doesn’t appear to be common. Difficulty breathing is more common with severe cases of bird flu, not seasonal flu. Runny nose and sneezing are found only with colds (or allergies).
The cough in either type of infection is what is referred to in medicine as “nonproductive”—meaning there is no sputum brought up when coughing, or if any sputum is brought up, it is white in color. This type of cough is characteristic of upper respiratory viral infections. As either type of infection progresses or worsens, tissues may be damaged, disrupting the normal structure and function of the infected cells. This in turn may allow bacteria to grow and also cause damage. When this happens following a viral infection, it is referred to as a “secondary” bacterial infection. When this occurs, the color of the sputum characteristically turns yellow or green. If this happens, antibiotics are indicated to treat the bacterial infection. (Antibiotics are not indicated in the treatment of viral infections, because they don’t work.)
It is safe to assume that during a bird-flu pandemic, most individuals who become infected with the bird-flu virus will either be asymptomatic—having no symptoms—or their illness will not be severe enough to require hospitalization. The small percentage who do become seriously ill will have to be hospitalized, and treated with either of the two antiviral agents available, oseltamivir (Tamiflu) or zanamivir (Relenza). A smaller subset of that group will develop life-threatening complications such as acute respiratory distress syndrome (ARDS), which requires treatment with a mechanical ventilator, a respirator.
Some individuals may develop other serious complications such as liver failure, kidney failure, neurological problems—such as seizures, paralysis, psychiatric problems such as delirium or psychosis, or bleeding problems. However, it is reasonable to predict that most people infected with the virus will not die and will not have significant residual symptoms, although a small percentage will.
Monday, May 19, 2014
Bird Flu: An Introduction To The Latest Global Health Threat
The World Health Organization (WHO) recently sounded a global health alarm in response to a new threat that has been emerging in several regions, particularly Asia. This threat is the avian influenza, more commonly known as bird flu, which is an infectious diseases that affects only birds...until recently.
What exactly is bird flu?
Bird flu is an infectious disease caused by several subtypes of the Influenza A virus, which is known to affect birds, particularly migratory birds, ducks and chickens. Bird flu is also reportedly known to affect pigs and ducks although these animals only serve as carriers and are not known to exhibit symptoms of the disease. Migratory birds, in general, are equipped to handle the virus. They do not get sick but they have the ability to contaminate other birds in areas they migrate to. This is crucial factor in the spread of disease because migratory birds travel great distances, often from one country to another.
When did bird flu start?
Bird flu is not a new disease. First discovered in Italy in 1878, it was initially called “fowl plague” because it largely affected chicken livestock. However, it was only in 1955 that the Influenza A virus is the cause of bird flu. Since then, several subtypes of the Influenza A virus has been discovered in about a hundred bird species.
According to research, wild waterfowls, particularly ducks, are the most common carriers of the disease. The ducks, however, do not get sick from it. It was discovered that gulls, waterfowls and shorebirds are natural “reservoirs” of the bird flu virus. These animals appear to have developed antibodies to fight against the virus. Other bird species, however, have not developed this immunity to the virus.
Symptoms of bird flu
Birds with mild forms of avian influenza can exhibit ruffled feathers and poor egg production. Birds with advanced or extreme forms of the disease may show signs of excessive shedding, respiratory infections and a swollen head. When the disease worsens, death usually comes within 48 hours. This is because bird flu not only affects the respiratory systems of birds but also other tissues and organs, causing major hemorrhaging.
History of bird flu outbreaks
In the 1980s, bird flu outbreaks in chickens and birds occurred in Scotland, England, Canada, Germany, United States, Australia and Ireland. Again in the 1990s the same countries, with the exception of Germany and Scotland, had outbreaks. This time, Italy, Pakistan, Hong Kong, the Netherlands and Chile joined them. However, these outbreaks were small-scale; and highly pathogenic outbreaks are rare.
Then in 1997, a major outbreak of bird flu occurred in Hong Kong, which left 18 people infected and six people killed. In response to the outbreak, the Hong Kong government killed Hong Kong’s entire poultry population, which was estimated at 1.5 million. Many believe that this rapid response to the bird flu outbreak was the best solution and helped avert it from becoming a pandemic.
To determine if a bird flu virus is highly pathogenic, eight chickens between four and eight weeks old are inoculated with the infectious virus. If 75 percent of the samples (six chickens) die within eight days, the virus is considered to be very pathogenic. In addition, a highly pathogenic virus will show a distinctive sequence of amino acids located at the cleavage site, the HA part of the chain.
What exactly is bird flu?
Bird flu is an infectious disease caused by several subtypes of the Influenza A virus, which is known to affect birds, particularly migratory birds, ducks and chickens. Bird flu is also reportedly known to affect pigs and ducks although these animals only serve as carriers and are not known to exhibit symptoms of the disease. Migratory birds, in general, are equipped to handle the virus. They do not get sick but they have the ability to contaminate other birds in areas they migrate to. This is crucial factor in the spread of disease because migratory birds travel great distances, often from one country to another.
When did bird flu start?
Bird flu is not a new disease. First discovered in Italy in 1878, it was initially called “fowl plague” because it largely affected chicken livestock. However, it was only in 1955 that the Influenza A virus is the cause of bird flu. Since then, several subtypes of the Influenza A virus has been discovered in about a hundred bird species.
According to research, wild waterfowls, particularly ducks, are the most common carriers of the disease. The ducks, however, do not get sick from it. It was discovered that gulls, waterfowls and shorebirds are natural “reservoirs” of the bird flu virus. These animals appear to have developed antibodies to fight against the virus. Other bird species, however, have not developed this immunity to the virus.
Symptoms of bird flu
Birds with mild forms of avian influenza can exhibit ruffled feathers and poor egg production. Birds with advanced or extreme forms of the disease may show signs of excessive shedding, respiratory infections and a swollen head. When the disease worsens, death usually comes within 48 hours. This is because bird flu not only affects the respiratory systems of birds but also other tissues and organs, causing major hemorrhaging.
History of bird flu outbreaks
In the 1980s, bird flu outbreaks in chickens and birds occurred in Scotland, England, Canada, Germany, United States, Australia and Ireland. Again in the 1990s the same countries, with the exception of Germany and Scotland, had outbreaks. This time, Italy, Pakistan, Hong Kong, the Netherlands and Chile joined them. However, these outbreaks were small-scale; and highly pathogenic outbreaks are rare.
Then in 1997, a major outbreak of bird flu occurred in Hong Kong, which left 18 people infected and six people killed. In response to the outbreak, the Hong Kong government killed Hong Kong’s entire poultry population, which was estimated at 1.5 million. Many believe that this rapid response to the bird flu outbreak was the best solution and helped avert it from becoming a pandemic.
To determine if a bird flu virus is highly pathogenic, eight chickens between four and eight weeks old are inoculated with the infectious virus. If 75 percent of the samples (six chickens) die within eight days, the virus is considered to be very pathogenic. In addition, a highly pathogenic virus will show a distinctive sequence of amino acids located at the cleavage site, the HA part of the chain.
Sunday, May 18, 2014
Bird Flu: Diagnosis
Central to the problem of dealing with bird flu is diagnosis. A number of upper respiratory infections have similar symptoms—at least at the onset of the illness, including the common cold, seasonal influenza, and bird flu. Seasonal flu and bird flu have almost identical symptoms—including fever, cough, malaise (feeling unwell), nausea, vomiting, and diarrhea. This is, needless to say, a gigantic problem in accurately diagnosing bird flu—which is critical to beginning appropriate treatment as well as initiating infection control procedures and public health measures.
Currently, accurate testing for bird flu and other vial infections that can cause similar symptoms is difficult and requires specialized testing. This testing is time consuming and only available in specialized reference laboratories, which are few and far between. Fortunately, this may change in the near future.
According to Richard Janeczko, Ph.D., executive vice-president and chief scientific officer, Tm Bioscience, located In Toronto, Canada, is feverishly working to complete the final stage of development of an amazing test—not only for bird flu, but for more than 15 other viral infections (including severe acute respiratory syndrome or SARS), many of which can mimic the symptoms of bird flu (personal communication). (Tm Bioscience is a DNA-based diagnostics company developing a suite of genetic tests. Tm Bioscience’s product pipeline includes tests for genetic disorders, drug metabolism, and infectious diseases. Additional information about Tm Bioscience can be found at http://www.tmbioscience.com.)
The test, called the Multiplexed Respiratory Test, discriminates influenza A from influenza B and identifies the H5-subtype of influenza A (bird flu is “H5N1”) from all other H subtypes. In addition, it can identify almost all the other common—and some uncommon—viruses that cause influenza-like illnesses. This is extremely important in managing patients, communities and economic issues. Other tests have lower clinical sensitivities and specificities which can lead to both false positives and false negatives.
By incorrectly identifying an outbreak as due to H5N1, patients could be treated with anti-virals unnecessarily (thus raising the chances of selecting for drug-resistant strains), unneeded vaccination programs in asymptomatic individuals could be initiated, and damage to local and national economies—through such measures as culling of commercial poultry operations—could occur. Conversely a false-negative test result could lead to catastrophic outcomes, including a pandemic.
The assay utilizes swab specimens taken from the nose and takes less than 5 hours to perform. It was developed for use as a diagnostic tool and for infection control in hospitals. The assay has been slated for expedited review by the Food and Drug Administration (FDA), and TM Bioscience is hoping to have an FDA-cleared test available by the end of January 2006. If this assay delivers what it claims, it will have huge applicability on a global basis and save many lives.
Currently, accurate testing for bird flu and other vial infections that can cause similar symptoms is difficult and requires specialized testing. This testing is time consuming and only available in specialized reference laboratories, which are few and far between. Fortunately, this may change in the near future.
According to Richard Janeczko, Ph.D., executive vice-president and chief scientific officer, Tm Bioscience, located In Toronto, Canada, is feverishly working to complete the final stage of development of an amazing test—not only for bird flu, but for more than 15 other viral infections (including severe acute respiratory syndrome or SARS), many of which can mimic the symptoms of bird flu (personal communication). (Tm Bioscience is a DNA-based diagnostics company developing a suite of genetic tests. Tm Bioscience’s product pipeline includes tests for genetic disorders, drug metabolism, and infectious diseases. Additional information about Tm Bioscience can be found at http://www.tmbioscience.com.)
The test, called the Multiplexed Respiratory Test, discriminates influenza A from influenza B and identifies the H5-subtype of influenza A (bird flu is “H5N1”) from all other H subtypes. In addition, it can identify almost all the other common—and some uncommon—viruses that cause influenza-like illnesses. This is extremely important in managing patients, communities and economic issues. Other tests have lower clinical sensitivities and specificities which can lead to both false positives and false negatives.
By incorrectly identifying an outbreak as due to H5N1, patients could be treated with anti-virals unnecessarily (thus raising the chances of selecting for drug-resistant strains), unneeded vaccination programs in asymptomatic individuals could be initiated, and damage to local and national economies—through such measures as culling of commercial poultry operations—could occur. Conversely a false-negative test result could lead to catastrophic outcomes, including a pandemic.
The assay utilizes swab specimens taken from the nose and takes less than 5 hours to perform. It was developed for use as a diagnostic tool and for infection control in hospitals. The assay has been slated for expedited review by the Food and Drug Administration (FDA), and TM Bioscience is hoping to have an FDA-cleared test available by the end of January 2006. If this assay delivers what it claims, it will have huge applicability on a global basis and save many lives.
Saturday, May 17, 2014
"Bird Flu": What You Need To Know
Before you become overly concerned about "bird flu," there are a few important facts you need to know about this disease.
"Bird flu" is not the same thing as human pandemic flu. "Bird flu"-H5N1 highly pathogenic Asian avian influenza-is a severe disease of birds. All the people known to have gotten it had close contact with infected birds, mostly in rural villages in Asia. Where there is no close contact with infected birds, there's no human disease.
More good news: The food supply is protected. The poultry industry and the U.S. government take Asian avian influenza very seriously because it can threaten commercial poultry. It's spread by migratory birds, so the federal government monitors wild birds in areas where there could be contact with Asian birds.
In addition, security on poultry farms is very tight. Poultry are kept away from wild birds. Strict procedures keep the virus from being tracked into the birds' living space. Poultry farmers' number one priority is to protect their flocks.
The industry and state governments sponsor extensive testing programs to watch for any signs of Asian avian influenza. Under the National Chicken Council's program, which nearly all chicken companies follow, each flock is tested. Any poultry flock found to be infected with Asian avian influenza would be destroyed on the farm and would not enter the food supply.
You can also feel confident about your chicken or turkey dinners. According to the U.S. Centers for Disease Control and Prevention (CDC), you can't get "bird flu" from properly handled and cooked food. Just be sure to follow the instructions already printed on each package of fresh meat and poultry sold in the United States. The instructions are the same as they have always been-nothing special is needed. On the remote chance that an infected bird got into the food supply, it wouldn't affect consumers. The U.S. Department of Agriculture recommends cooking poultry to a minimum internal temperature of 165 degrees Fahrenheit. This is more than enough to destroy any flu viruses that may be present.
"American consumers don't have to worry about getting the avian flu virus from eating poultry," says Dr. Michael Doyle, director of the Center for Food Safety at the University of Georgia. "We know that if you properly cook poultry, it's safe."
"Bird flu" is not the same thing as human pandemic flu. "Bird flu"-H5N1 highly pathogenic Asian avian influenza-is a severe disease of birds. All the people known to have gotten it had close contact with infected birds, mostly in rural villages in Asia. Where there is no close contact with infected birds, there's no human disease.
More good news: The food supply is protected. The poultry industry and the U.S. government take Asian avian influenza very seriously because it can threaten commercial poultry. It's spread by migratory birds, so the federal government monitors wild birds in areas where there could be contact with Asian birds.
In addition, security on poultry farms is very tight. Poultry are kept away from wild birds. Strict procedures keep the virus from being tracked into the birds' living space. Poultry farmers' number one priority is to protect their flocks.
The industry and state governments sponsor extensive testing programs to watch for any signs of Asian avian influenza. Under the National Chicken Council's program, which nearly all chicken companies follow, each flock is tested. Any poultry flock found to be infected with Asian avian influenza would be destroyed on the farm and would not enter the food supply.
You can also feel confident about your chicken or turkey dinners. According to the U.S. Centers for Disease Control and Prevention (CDC), you can't get "bird flu" from properly handled and cooked food. Just be sure to follow the instructions already printed on each package of fresh meat and poultry sold in the United States. The instructions are the same as they have always been-nothing special is needed. On the remote chance that an infected bird got into the food supply, it wouldn't affect consumers. The U.S. Department of Agriculture recommends cooking poultry to a minimum internal temperature of 165 degrees Fahrenheit. This is more than enough to destroy any flu viruses that may be present.
"American consumers don't have to worry about getting the avian flu virus from eating poultry," says Dr. Michael Doyle, director of the Center for Food Safety at the University of Georgia. "We know that if you properly cook poultry, it's safe."
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