The Good Herd

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To Your Health…

Updated: 23 January

With my apologies to the great humanitarian, Pearl Buck, whose 1931 novel The Good Earth won her the Pulitzer Prize in 1932 and the Nobel Prize in Literature in 1938, it’s the  influenza season and time to get…yes…a flu shot.  I’ll explain the herd allusion below.

First of all if you have any reservations about vaccines and a purported connection to autism, (as well as the MMR vaccine [measles, mumps, rubella], and Crohn’s Disease [an extremely painful bowel disorder]) you may put your fears aside. Really.

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A Pernicious Lie Finally Crushed

This month, the British Medical Journal (BMJ) published a major investigative article in three parts by English journalist Brian Deer, titled Secrets of the MMR Scare: How the vaccine crisis was meant to make money.  The author details one of the most pernicious medical scams ever conceived and perpetrated virtually on the whole world, leading to millions suffering needlessly, not to mention the thousands of deaths from these diseases or complications related to them as a result of the patient and or family refusing to receive the vaccinations.  Add to that the fears of millions of others thinking they should mistrust vaccines in general (and now many will never give up that incorrect perception) compounding the suffering and deaths on annual basis that will continue because of one man’s incomprehensible lack of conscience and insatiable greed.  And as for those who decided to follow him…  It is my opinion that a new circle in Dante’s hell needs to be constructed for the likes of these.  As all health care providers will tell you, vaccines do carry risks, but in comparison to what this one English doctor did, they are minuscule.

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Please Get Your Flu Shot–There’s Plenty of Time

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The CDC has a new program this winter called “Take the Pledge”  It’s a quick and fun way to declare your solidarity with the millions of Americans who get their annual shots. Dr. John Bogen, MD, an Extreme Thinkover guest author, states,  “The shot is a cheap ‘insurance policy’ against missing a week of work or having to stay home from work due to a sick child.  It is covered by Medicare and most insurance plans. Why? Because the shot reduces overall health costs.  Also, even if you are in good health and could withstand the flu yourself, getting your shot reduces the number of children, chronically ill, pregnant, and elderly who get the flu: populations that are more susceptible to the complications and deaths from influenza.”  I took the pledge on the day I wrote this post.

I already got my shot, since I work at a hospital.  Not only am I protected from influenza so are my family, friends, coworkers and patients. The CDC stats show a low incidence of last year’s H1N1 Pandemic strain- this year’s vaccine protects against influenza A 2009 H1N1 & H3N2 and influenza B, the three main influenza strains shown by surveillance to infect humans this season. I urge you to get your shot, too, as soon as possible.

So, what’s with this “herd” reference in the title of the post?  Immunologists use the term “herd immunity” to describe when enough of a susceptible population has gotten vaccinated plus those who have contracted the disease and subsequently have natural immunity to create a “herd” large enough to mostly be immune to that pathogen the next time it comes around.  Dr. John helps us understand how the herd is created:

If each sick person transmits the illness to less than one other person, transmission stops.  Basically, if enough of a population is immune either through prior infection or vaccination, transmission is inefficient.  It isn’t as if the herd is completely immune, just that a critical mass is reached such that rampant infection doesn’t occur.  Sporadic cases still do occur from infectious contacts both outside and within the herd.

Of course, viruses that cause the flu and colds continuously mutate, so the challenge to keep up with the bugs will never end.  That makes getting a shot all that more important.  You never want to get behind the curve in the race against the germs!

So despite the fact we humans like to think of ourselves as pack animals, like wolves and lions, when it comes to your health, being part of the herd with immunity acquired by a vaccine is definitely the best option!  Need an image to help fix the idea in your mind?  Imagine you’re part of this stately elk herd in the mountains of Idah0!

 

Elk Herd in Idaho High Mountain Valley. Image: http://www.idahoriverjourneys.blogspot.com

My thanks to Dr. John for contributing his medical expertise to help make this post accurate and up-to-date.  DW

H1N1 Flu Vaccine: The CDC Gets it Right

You and I, right now, are living in the middle of a pandemic.   It’s in the news, but unless you are paying close attention above the noise coming out of Washington, D.C. on the East Coast, the media frenzy over Michael Jackson’s death on the West, or you folks in the middle of the country dodging humongous thunder storms, it may not be much on your personal radar.

But it should be.  Not at a Hollywood plague & panic mode, by any means, but H1N1 is a nasty virus.  As a chaplain, I have worked with several patients and their families who are being treated for H1N1.  Two were in our intensive care unit.  Both of these patients had developed pneumonia, and one was a pregnant woman (who had to be delivered early to save both her life and the baby’s).

In my 13 years as a chaplain, and having seen hundreds of cases of pneumonia, I was astonished–and I truly mean astonished–at how sick those two patients were (they both continue to recover. The infant did not have the virus.).   I can also say, that our patients generally match the age distribution and other physical conditions of those the Centers for Disease Control say are most at risk.

So, what’s a body to do?  First, go to http://www.flu.gov and check out the most current recommendations.  What prompted this post was this week’s announcemnt by the CDC of the priority list for who should get the vaccine when it becomes available.  Here is the list:

On July 29, 2009, the Advisory Committee on Immunization Practices (ACIP)—an advisory committee to CDC—recommended that novel H1N1 flu vaccine be made available first to the following five groups (News Release):

Pregnant women

Health care workers and emergency medical responders

People caring for infants under 6 months of age

Children and young adults from 6 months to 24 years

People aged 25 to 64 years with underlying medical conditions (e.g. asthma, diabetes)

Combined, these groups would equal approximately 159 million individuals.

You’ll see this is not the typical order for vaccination priorities, which is the elderly, people with certain other conditions that make them more susceptible, etc.  The reason for the change is very straightforward:  H1N1 infects a different set of demographics than the usual winter time influenzas.

This is where you need to pay attention.  H1N1 has idiosyncrises that we are not used to.   And the way it is spreading is one of those.  The CDC has provided a map so you can look at where the flu is having the most impact:

US Map H1N1 Flu Distribution 31Jul09.  Source: CDC

US Map H1N1 Flu Distribution 31Jul09. Source: CDC

Here is how to recognize possible H1N1 symptoms, from the CDC’s Website:

Emergency Warning Signs

If you become ill and experience any of the following warning signs, seek emergency medical care.

In children, emergency warning signs that need urgent medical attention include:

* Fast breathing or trouble breathing

* Bluish or gray skin color

* Not drinking enough fluids

* Severe or persistent vomiting

* Not waking up or not interacting

* Being so irritable that the child does not want to be held

* Flu-like symptoms improve but then return with fever and worse cough

In adults, emergency warning signs that need urgent medical attention include:

* Difficulty breathing or shortness of breath

* Pain or pressure in the chest or abdomen

* Sudden dizziness

* Confusion

* Severe or persistent vomiting

* Flu-like symptoms improve but then return with fever and worse cough

Protect Yourself, Your Family, and Community

* Stay informed. Health officials will provide additional information as it becomes available. Visit the CDC H1N1 Flu website.

* Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.

* Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.

* Avoid touching your eyes, nose and mouth. Germs spread this way.

* Try to avoid close contact with sick people.

* If you are sick with a flu-like illness, stay home for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer, except to seek medical care or for other necessities. Keep away from other household members as much as possible. This is to keep you from infecting others and spreading the virus further.

* If you are sick and sharing a common space with other household members in your home, wear a facemask, if available and tolerable, to help prevent spreading the virus to others. For more information, see the Interim Recommendations for Facemask and Respirator Use.

* Learn more about how to take care of someone who is ill in “Taking Care of a Sick Person in Your Home”

* Follow public health advice regarding school closures, avoiding crowds, and other social distancing measures.

* If you don’t have one yet, consider developing a family emergency plan as a precaution. This should include storing a supply of extra food, medicines, and other essential supplies. Further information can be found in the “Flu Planning ChecklistExternal Web Site Policy.

Related Media: YouTube: Symptoms of H1N1 (Swine Flu)

http://www.youtube.com/watch?v=0wK1127fHQ4&feature=channel_page

(Sorry, I couldn’t seem to get this video to embed.  Just click on the link to view it.)

The take home on this is simple: if you are in one of the groups designated as high risk for H1N1, get vaccinated as soon as possible when the shots become available.  If you aren’t in those first groups, don’t get your dander up.  The people who are in the high risk categories really are in danger of getting critically ill if they contract H1N1.  There will be vaccine available for you, too.

But keep in mind, even if you fall into the usual categories a for seasonal flu shot, the H1N2 vaccine will not replace your yearly dose.  For most of us, we’re going to be getting poked twice, just not all at the same time.

One last thing.  Go wash your hands.

Wash 'em Hand Washing Image: CDC

Wash 'em Hand Washing Image: CDC