Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
The flu is highly infectious and is a serious viral
respiratory infection.
Whereas with other viral respiratory infections the symptoms usually are mild
and most people can continue working or going to school while ill, with the flu,
the symptoms are severe and prolonged and cause individuals to miss days of work
or school. The infection stresses the body. In addition, superinfections may
occur. Superinfections are bacterial infections that occur on top of a
respiratory infection. Bacterial respiratory infections also are a serious type
of infection, and the simultaneous viral and bacterial infection can overwhelm
the function of the lungs and the body. Among the elderly and the very young, it can cause
death. Because of its infectiousness, morbidity (severity of symptoms and time
lost from work or school), and the potential for death, it is important to
prevent the flu by vaccination. Although there are medications to treat the flu,
they are expensive, not as effective as vaccination, and need to be started
within 24-48 hours of the start of symptoms.
What is the flu vaccine?
Flu vaccines are routinely available for seasonal influenza. Pandemic vaccines may also be developed for specific strains of the flu virus that are causing widespread disease, such as the H1N1 virus. Tested and approved, H1N1 vaccine first became available in October 2009 in the Americas.
There are two types of seasonal flu vaccines, the injection (with killed virus) and nasal spray vaccines (containing live but weakened virus). New for the 2011-2012 flu season is a vaccine that can be injected into the skin (intradermally) rather than into the muscle (intramuscularly).
Each year, the influenza virus can change slightly, making the vaccine used in previous years ineffective. Each year, a new vaccine must be prepared that will be effective against the expected type of influenza virus. These are known as seasonal flu vaccines. The reason for the differences in circulating strains of the flu virus is that the virus can mutate, or change its structure, rapidly, leading to new subtypes of the virus. The key is to be able to predict which influenza viruses are going to cause infection and to prepare a vaccine against those viruses. Usually, scientists can predict accurately which types of influenza virus will cause infections and prepare an appropriate vaccine. The viruses that are used to prepare flu vaccine are grown in eggs.
The vaccine is
generally effective against the influenza virus within two weeks of administration. The vaccine is only effective against the strains of the virus that
match the vaccine. These strains vary from flu season to flu season each year.
This is the reason that revaccination is required annually with the vaccine that
matches the strains of influenza that are currently prevalent.
Flu season can begin in October and last as late as May. October and November are considered the best times to receive the vaccination, but it is still effective when administered later.
Flu vaccination
does not protect against infection caused by microbes other than the influenza
virus.
The injection ("flu shot") vaccine
Flu vaccine is an inactivated vaccine, meaning that it contains killed
influenza virus. The killed influenza virus is injected into muscles and
stimulates the immune system to produce an immune response (antibodies) to the
influenza virus. When the virus enters a person who has been vaccinated, the
antibodies attack and kill the virus and prevent infection.
The inactivated flu vaccine is administered as a single dose of 0.5 ml of liquid injected through the skin into muscle (intramuscular or IM). Typically, the injection is into the deltoid muscle at the side of the arm, using alcohol rubbed over the skin for sterilization. A new preparation for the 2011-2012 flu season is an intradermal vaccine that is injected into the skin rather than into the muscle. The vaccine is given annually, each fall. Side effects of the inactivated flu vaccine are not common.
Additionally, a special high-dose vaccine has been developed for people aged 65 and older. The higher dose is designed to elicit a stronger immune response in this age group, since older people typically have weakened immune responses compared with younger people.
Side effects include soreness at the site of the injection, muscle aching, fever, and feeling unwell. People report less discomfort with the intradermal rather than the intramuscular vaccine. Very rarely, serious allergic reactions have been reported.
Guillain-Barré syndrome (GBS) is
an illness characterized by fever, nerve damage, and muscle weakness. In 1976,
vaccination with the swine flu vaccine was associated with development of GBS.
Studies have been done to evaluate if other flu vaccines were associated with
GBS, with only one of the studies showing an association. That single study
suggested that one person out of 1 million vaccinated people may be at risk of
GBS associated with the vaccine.
The nasal-spray vaccine
The nasal-spray flu vaccine (sometimes called LAIV
for live attenuated influenza vaccine, brand name FluMist) was first licensed in
2003. It is directed against the same strains of virus as the flu shot but
differs in that it contains weakened live influenza viruses instead of killed
viruses and is administered by nasal spray instead of injection. The vaccine is
termed an attenuated vaccine because the viruses are weakened so that they do
not cause severe flu symptoms. The nasal spray flu vaccine (LAIV) has been
approved by the U.S. Food and Drug Administration (FDA) for use in nonpregnant
healthy people between 2-49 years of age.
People at risk for serious complications from the flu should not receive the
nasal spray flu vaccine. In particular, certain groups are advised to receive
the inactivated flu vaccine rather than the nasal spray vaccine, including
people less than 2 years of age;
people 50 years of age and over;
people with a medical condition that places them at high risk for complications from influenza, including those with chronic heart or lung disease, such as asthma or reactive airways disease; people with medical conditions such as diabetes or kidney failure; or people with illnesses that weaken the immune system, or who take medications that can weaken the immune system;
children <5 years old with a history of recurrent wheezing;
children or adolescents receiving aspirin;
pregnant women;
people who have a severe allergy to chicken eggs or who are allergic to any of the nasal-spray vaccine components;
people with a history of Guillain-Barré syndrome (a severe paralytic illness, also called GBS) that occurred after receiving influenza vaccine and who are not at risk for severe illness from influenza.
The live viruses in the
nasal-spray vaccine are weakened so that they do not cause severe symptoms.
However, mild symptoms can occur as a side effect of the vaccination. Side
effects of the nasal-spray flu vaccine can include runny nose, headache, sore
throat, and cough. Children who receive the vaccine may also develop mild fever
and muscle aches.
Several studies have shown excellent efficacy with respect to prevention of flu in children with the nasal vaccine, even better than the injectable vaccine. Among adults, efficacy of the injectable vaccine varies from year to year, but one study demonstrated that injectable vaccine was substantially more efficacious than nasal vaccine at preventing flu. If this difference in efficacy can be confirmed, it would support the use of injectable vaccine over nasal vaccine among adults who have no medical conditions that would prevent them from receiving the injectable vaccine.
There are many symptoms involved in the 1st, 2nd and 3rd trimesters of pregnancy. The first early pregnancy symptom is typically a missed period, but others include breast swelling and tenderness, nausea and sometimes vomiting, fatigue and bloating. Second trimester symptoms include backache, weight gain, itching, and possible stretch marks. Third trimester symptoms are additional weight gain, heartburn, hemorrhoids, swelling of the ankles, fingers, and face, breast tenderness, and trouble sleeping. Read more to learn about recommended procedures and tests for each stage of a healthy pregnancy.
An upper respiratory infection is a contagious infection of the structures of the upper respiratory tract, which includes the sinuses, nasal passages, pharynx, and larynx. Common causes of an upper respiratory infection include bacteria and viruses such as rhinoviruses, group A streptococci, influenza, respiratory syncytial, whooping cough, diphtheria, and Epstein-Barre. Examples of symptoms of upper respiratory infection include sneezing, sore throat, cough, fever, and nasal congestion. Treatment of upper respiratory infection are generally with OTC medication and home remedies.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
COPD (chronic obstructive pulmonary disease) is a disorder that persistently obstructs bronchial airflow. COPD mainly involves three related conditions, chronic bronchitis, chronic asthma, and emphysema. Symptoms of COPD include chronic cough, shortness of breath, frequent respiratory infections, wheezing, morning headaches, and pulmonary hypertension. Treatment of COPD is focused on the related condition(s).
An allergy refers to a misguided reaction by our immune system in response to bodily contact with certain foreign substances. When these allergens come in contact with the body, it causes the immune system to develop an allergic reaction in people who are allergic to it. It is estimated that 50 million North Americans are affected by allergic conditions. The parts of the body that are prone to react to allergies include the eyes, nose, lungs, skin, and stomach. Common allergic disorders include hay fever, asthma, allergic eyes, allergic eczema, hives, and allergic shock.
Influenza (flu) is a respiratory illness caused by a virus. Flu symptoms include fever, cough, sore throat, runny nose, headache, fatigue, and muscle aches. The flu may be prevented with an annual influenza vaccination.
Before treating a cold, the flu, or allergies with over-the-counter (OTC) medications, it's important to know what's causing the symptoms, which symptoms one wishes to relieve, and the active ingredients in the OTC product. Taking products that only contain the medications needed for relieving your symptoms prevents ingestion of unnecessary medications and reduces the chances of side effects.
Chronic bronchitis is a cough that occurs daily with production of sputum that lasts for at least three months, two years in a row. Causes of chronic bronchitis include cigarette smoking, inhaled irritants, and underlying disease processes (such as asthma, or congestive heart failure). Symptoms include cough, shortness of breath, and wheezing. Treatments include bronchodilators and steroids. Complications of chronic bronchitis include COPD and emphysema.
Novel H1N1 influenza A virus infection (swine flu) is an infection that generally is transferred from an infected pig to a human, however there have been reported cases where infection has occured with no contact with infected pigs. Symptoms of swine flu are "flu-like" and include fever, cough, and sore throat. Treatment is generally with the antibiotics oseltamivir (Tamiflu) or zanamivir (Relenza).
Guillain-Barre Syndrome is an autoimmune disease of the nervous system due to damage to the myelin sheath around nerves. It is the most acquired nerve disease (neuropathy) and usually follows a virus infection but can also be associated with immunizations, surgery, and childbirth. The cause is unknown but appears to be related to autoimmune reaction. Symptoms include weakness beginning in the legs and progressing upward, lost reflexes, and in severe cases breathing can be affected. Patients can expect a slow but progressive recovery over several months maintaining vital functions and passively exercising the muscles. Plasmapheresis (removing toxic substances from the blood) has been shown to improve outcome and shorten the disease as well as intravenous immunoglobulin.
Pregnancy planning is important to help prevent exposure of the mother and fetus to potentially harmful medications and substances during the early days, and throughout the pregnancy. Nutritional planning, prevention of birth defects, conditions such as high blood pressure, heart disease, diabetes, and kidney disease need careful monitoring. Gestational diabetes, preeclampsia, and pregnancy induced hypertension are conditions that may arise during pregnancy. Immunizations, inherited disorders, exercise, air travel, intercourse, and birth control are important factors to consider when planning a pregnancy.
Travelers should prepare for their trip by visiting their physician to get the proper vaccinations and obtain the necessary medication if they have a medical condition or chronic disease. Diseases that travelers may pick up from contaminated water or food, insect or animal bites, or from other people include malaria, meningococcal meningitis, yellow fever, hepatitis A, typhoid fever, polio, and cholera.
Children's health is focused on the well-being of children from conception through adolescence. There are many aspects of children's health, including growth and development, illnesses, injuries, behavior, mental illness, family health and community health.
Teenagers recognize that they are developmentally between child and adult. Teen health prevention includes maintaining a healthy diet, exercising regularly, preventing injuries and screening annually for potential health conditions that could adversely affect teenage health.
Pregnant and women who are breastfeeding are encouraged to receive the seasonal flu shot as well as the 2009 H1N1 influenza (swine flu) vaccine. H1N1 flu is treated with the medications Tamiflu® (oseltamivir) or Relenza® (zanamivir). Pregnant women should not receive the H1N1 attenuated nasal spray vaccine. Possible side effects of the H1N1 flu vaccine include muscle aches, fever, nausea, tiredness, or headache.
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