Flu Is ‘Prevalent’ Unvaccinated Health Workers Must Mask Up

(TIMES UNION) State Health Commissioner Dr. Howard Zucker has declared the flu to be ”prevalent” which means that health care workers need to have been vaccinated or wear protective masks when coming in contact with patients. This has been the case for more than two years now.

There are confirmed cases in 44 counties as well as New York City.

Here are the details:

New York State Health Commissioner Dr. Howard Zucker today declared influenza prevalent in New York State. With this declaration, health care workers who are not vaccinated against influenza must now wear surgical or procedure masks in areas where patients are typically present.

Beware Influenza, The Silent Killer

It is likely that within the next few weeks, the number of infections with influenza virus will spike in much of the country. Flu cases typically peak in February and can last into May. As of December 26, the CDC reported“elevated” outpatient flu-like illnesses in most of the nation’s surveillance regions.

The “flu,” which is marked by high fever, muscle aches, malaise, cough and sore throat, is transmissible through airborne droplets and is so infectious that after an airplane sat for three hours with its engines off and no air circulating, within three days, 39 of the 54 people on boardcontracted the flu, infected by a single passenger.

And it’s a killer: The “Spanish flu” pandemic of 1918-19 caused the deaths of 583,135 Americans, according to public health authorities at the time. Although we no longer experience mortality on the scale of Spanish flu, during a non-pandemic season on average the virus still kills thousands each year in this country. From the 1976-77 season to the 2006-07 season, flu-associated deaths in this country ranged from a low of about 3,000 to a high of about 49,000, according to the Centers for Disease Control and Prevention.  (Worldwide, flu kills about 250,000-500,000 annually.)

Vaccination is the key to prevention, but the science surrounding flu vaccines is anything but straightforward. Last year’s vaccine, for example, was poorly effective against the predominant flu variant that was circulating; it reduced a vaccinated person’s risk of seeking medical attention by only 23 percent among people of all ages. (Within population subgroups, vaccines’ effectiveness varies widely because it is affected by various factors, including the general health and age of the recipient; for example, they are much less effective in the elderly.)

Two recent studies published in the Journal of Infectious Diseasesfurther complicate the picture: The use of statin drugs (a group that includes highly prescribed medications such as Lipitor, Crestor and Zocor), which is especially common in the elderly to control elevated blood lipids, seems to blunt the immune response to flu vaccination.

Flu Symptoms & Severity

Flu Symptoms

Influenza (also known as the flu) is a contagious respiratory illness caused by flu viruses. It can cause mild to severe illness, and at times can lead to death. The flu is different from a cold. The flu usually comes on suddenly. People who have the flu often feel some or all of these symptoms:

  • Fever* or feeling feverish/chills
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Muscle or body aches
  • Headaches
  • Fatigue (tiredness)
  • Some people may have vomiting and diarrhea, though this is more common in children than adults.

* It’s important to note that not everyone with flu will have a fever.

Flu Complications

Most people who get influenza will recover in a few days to less than two weeks, but some people will develop complications (such as pneumonia) as a result of the flu, some of which can be life-threatening and result in death.

Pneumonia, bronchitis, sinus and ear infections are examples of complications from flu. The flu can make chronic health problems worse. For example, people with asthma may experience asthma attacks while they have the flu, and people with chronic congestive heart failure may experience worsening of this condition that is triggered by the flu.

People at High Risk from Flu

Anyone can get the flu (even healthy people), and serious problems related to the flu can happen at any age, but some people are at high risk of developing serious flu-related complications if they get sick. This includes people 65 years and older, people of any age with certain chronic medical conditions (such as asthma, diabetes, or heart disease), pregnant women, and young children.

What are the emergency warning signs of flu sickness?

In children

  • Fast breathing or trouble breathing
  • Bluish skin color
  • Not drinking enough fluids
  • 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
  • Fever with a rash

In adults

  • Difficulty breathing or shortness of breath
  • Pain or pressure in the chest or abdomen
  • Sudden dizziness
  • Confusion
  • Severe or persistent vomiting
  • Flu-like symptoms that improve but then return with fever and worse cough

In addition to the signs above, get medical help right away for any infant who has any of these signs:

  • Being unable to eat
  • Has trouble breathing
  • Has no tears when crying
  • Significantly fewer wet diapers than normal

Deadly diseases like Sars, Mers hunt for special victims to facilitate their quantum leaps and ‘go viral,’ scientists say

Deadly viruses like Sars, Mers and Ebola are all quite different in nature, but they share a common tendency of cherry-picking their victims as they hunt for so-called “super spreaders,” or those capable of helping the disease make a quantum leap from just a few individuals to masses of people, according to a new study by Chinese scientists.

A person who is genetically predisposed to deliver many more viral strains than normal simply by coughing, for example, would be a strong contender to make the list.

The researchers carried out a comprehensive analysis of historical data related to the spreading of the three viruses, and they found that a number of major outbreaks were all driven by super-spreaders.

To rank as one of these, an individual must be capable of infecting a disproportionately large number of people. In such cases, a small fraction of a country’s population could be responsible for more than 50 per cent of the total number of infections.

The case of Mary Mallon (“Typhoid Mary”), a cook from Ireland who migrated to New York City and lived there in the early 1900s, sheds some light on the issue.

Medical workers disinfect a subway carriage in Seoul amid a recent Mers outbreak in the country. Photo: SCMP Pictures

She is believed to have transferred typhoid to 51 people, three of whom died, and is generally held as the first person in the US to be identified as an asymptomatic carrier of the pathogen associated with typhoid fever.

As one of the first and certainly most famous super-spreaders in modern history, she was put in forced quarantined for nearly three decades until her death.

For the latest study, the Chinese team, led by Professor Gao Fu with the Chinese Academy of Sciences’ Institute of Microbiology, warned that similar mass transmissions from a single source have been observed in recent viral outbreaks.

During the outbreak of Middle East respiratory syndrome (Mers) in South Korea early this year, “approximately 75 per cent of cases can be traced back to three super-spreaders, who have each infected a disproportionately high number of contacts,” the scientists reported in their paper, which was published in the journal Cell Host & Microbe earlier this month.

Irish emigre Mary Mallon, aka Typhoid Mary, shown in the foreground during one of her periods of quarantine, claimed to be perfectly healthy despite having infected scores of people with the disease. Photo: Wikipedia

Meanwhile, one patient at the Prince of Wales Hospital in Hong Kong infected 125 people during the outbreak of severe acute respiratory syndrome (Sars) in 2003, while the Ebola virus reportedly leapt from one doctor in Sierra Leone to eventually infect over 300 people this year.

“It’s not entirely the person’s fault,” said Dr Bi Yuhai, a corresponding author to the study at the institute’s Key Laboratory of Pathogenic Microbiology and Immunology.

The super spreaders often appeared after the virus underwent significant mutations, and so far no one has come up with an effective mechanism to monitor these mutations, he said.

The people capable of mass-transmitting the viruses also tend to appear in certain favourable environments. An enclosed space full of people, such as the cabin of an aeroplane, could provide an environmental trigger for a super-spreading event, scientists say.

Rugby fans ham it up with protective suits and masks on the opening day of the Hong Kong Sevens rugby tournament amid a Sars scare in 2003. Three teams withdrew because of an outbreak of pneumonia. Photo: SCMP Pictures

“Our study shows the urgent need for international cooperation to proactively identify super-spreaders,” Bi added.

Pilot projects led by Gao with the support of the Chinese government have explored the possibility of raising an alert before such events, which rapidly spread the virus, occur, he said.

Some teams have been developing mathematical models in the hope of predicting the time, location and severity of a super-spreading event. Some have been experimenting using animals to identify signs of viral mutation that could help the disease in its search for super-spreaders.

Bi said it is crucial for governments to take this issue to heart and deal with appropriately with such individuals once they are identified in future outbreaks.

“Taking a soft-handed approach to a super-spreader can prefigure a disaster,” he said.

“The recent outbreak of Mers in South Korea taught us a painful lesson [in that respect].”

“Once a suspect has been identified, decisive quarantine measures must be applied immediately. It might be considered cruel … [but] it could prove a saving grace for society as a whole.”

Why Do So Many People With the Flu Still Show up for Work?

Flu season generally starts in October and peaks in February, according to the Centers for Disease Control and Prevention, and somewhere between 5 and 20 percent of Americans get the flu every year, with hundreds of thousands hospitalized. During this time of year, many Americans with fevers, aches, and runny noses will face a question: Should they go into work?

Going to work sick isn’t preferable for workers or their colleagues. Human-resources experts say it’s a problem, as it limits individuals’ productivity and risks getting others sick, too. One study pegged the cost of “presenteeism” at about $150 billion, and researchers have found that staying home usually leads to less work time lost in the end.

Why does this persist, even for those who aren’t worried about getting their coworkers sick? According to a new report by the food-industry consultancy Alchemy (and survey conducted online by the Center for Research and Public Policy), 51 percent of food workers go to work “always” or “frequently” when they’re sick. That can’t be good for food safety, let alone for the basic health of the workers themselves.

The leading two reasons for going into work, both given by about 45 percent of respondents, were not wanting to let coworkers down and not wanting to miss out on pay. Thirty-four percent of those surveyed said they came in because they didn’t think they were contagious. (A study last year found that even those with paid sick leave feel non-financial pressures to show up. In that survey, 42 percent of workers said that they were afraid of not working while sick because too much work will pile up.)

The report also found a gap between management and workers: Of the 78 food-industry leaders surveyed, only 18 percent thought workers come to work sick—which could go some way toward explaining why so few workers in the food industry get paid sick leave (and perhaps even why about 43 millionprivate-sector workers don’t get it either).

There are things managers can do to discourage workers from showing up while sick. One CDC study found that food workers are less likely to work while sick if there is a policy requiring workers to tell their manager about their illness. Also, people working under more experienced managers were less likely to come in sick. Another variable is whether there’s someone to fill in for them on short notice. If employers have systems in place to make sure that a single worker’s absence won’t fall too hard on her colleagues, that could help alleviate some of this burden.

This post originally appeared on The Atlantic.

The New Flu Shot: Should You Get It?

Two new strains of the flu virus will soon be spreading via cough, sneeze, or sniffle near you. And while the Centers for Disease Control and Prevention (CDC) expect flu season to kick off in October and last as late as May, there’s good news: thanks to this year’s new and improved flu shot, you’re not necessarily doomed to catch the bug.

This year’s vaccine contains the two new strains of flu virus, which were not used in previous vaccines. Meaning? It’s locked and loaded to give you the extra line of defense you need, with about a 70-80% rate of effectiveness, says pediatrician Rasik Shah, M.D., pediatric pulmonary consultant for Continuum Health Partners hospitals including Beth Israel Medical Center in New York City, who is often among the first medical professionals to access new vaccinations. Which is a great thing, considering the flu can last up to two weeks, and inflicts fever, cough, sore throat, runny or stuffy nose, body aches, headaches, and fatigue upon its victims.
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The CDC recommends everyone over the age of 6 months receive an annual vaccination, but fewer than 36% of 18- to 49-year-old Americans were vaccinated last year. And while having a needle stuck in your arm or a mist puffed up your nose may be far from pleasurable, getting the flu vaccine isn’t only about protecting yourself. With new strains of the virus in the picture, Shah says it’s even more vital to suck it up and get the vaccine to avoid infecting those around you. Still not feeling it? Here, we debunk the most common excuses for refusing the flu vaccination. EXCUSE: Been there, done that. I got it last year. Verdict: Irrelevant—you need another one. The vaccine is only good for a year because it’s customized for that year’s flu season—and even when the same viruses are used in consecutive years, the antibodies that the vaccine created in your body last year won’t likely last to protect you for an extra season. This year’s vaccine debuts two newbies: the A/Victoria/361/2011(H3N2)-like virus and the B/Wisconsin/1/2010-like virus. So even if the antibodies from last year’s vaccine do remain in your body, you still won’t be completely protected. EXCUSE: Yeah…I don’t do needles. Verdict: There’s another way. No problemo. There are two kinds of vaccinations available: The flu shot (ouch, we know) and the nasal-spray flu vaccination. According to the CDC, either vaccine’s effectiveness depends your age, health, and the similarity between the viruses in the vaccination and those you’re exposed to. However, clinical studies found the nasal spray reduced the chance of influenza illness by a not-too-shabby 92%.

EXCUSE: The flu shot is going to give me the flu. Verdict: Patently false. The flu shot doesn’t give people the flu. It can’t because it uses a killed virus, not a live one. Shah says the misconception comes from people who finally decide to get the vaccine once they’re already slightly sick. Plus, it takes about two weeks to work, so it won’t help you if you already have the flu. It’s also possible to catch a strain of the flu virus that’s absent from the vaccination and get sick from that even after being immunized.

On the other hand, the nasal spray version of the flu vaccine is made with a live (but weakened) virus and, in very rare cases, can cause the flu. (For that reason, it’s not for everyone: it’s approved only for healthy, non-pregnant people between the ages of 2 and 49.) EXCUSE: Eh, it’s not worth the side effects. Verdict: They’re not as common as you think. Very few people experience severe reactions to the flu vaccines, but there are some side effects. After receiving the shot, you may experience soreness, redness, or swelling at the injection site, or a slight fever and body aches. Side effects of the nasal spray may include a runny nose, headache, sore throat, or cough in adults. Regardless of these symptoms, most people are better off getting the flu vaccine than avoiding it.

EXCUSE: Forget it, I’m already sick. Verdict: How sick? Unless you’re suffering from a fever, you can still get the shot. Otherwise, wait until you’re better.

EXCUSE: I don’t need it, I have the immune system of an ox. Verdict: Get it anyway. Everyone should get the flu vaccination unless you’ve had a bad reaction to past vaccines or are severely allergic to eggs. (The vaccine is grown using eggs and while most of the egg is excluded from the final product, it may contain trace amounts.) Even if you typically get a mild reaction to eggs, like a stomachache, you should still get the vaccine, says Shah, but talk to your doctor if you suffer from anything more severe.

EXCUSE: It’s too late. Verdict: Not the case! According to Dr. Shah, it’s only too late to get the vaccine once it’s summer (the flu doesn’t like warm weather) and we’re not there yet. Unless you’re already sick with a fever, the best time to get vaccinated is now.

The bottom line: The best way to prevent the flu is by getting the vaccine. If that isn’t possible, the second best defense is hand-washing with soap and water, using alcohol-based hand sanitizers, or avoiding sick people like, well, the plague.

Additional reporting by Elizabeth Narins

How to Avoid Getting Sick This Fall

Your science-based guide to beating cold and flu season as best you can.
John Tozzi jtozz
October 8, 2015 — 11:04 AM EDT
Employers are pushing flu shots. Kids are bringing germs back from school. Your sniffly co-workers are too scared of looking lazy to stay home when they ought to.
How can you protect yourself from the microbial swamp of the cooler months?
Everybody’s got a theory—orange juice, neti pots, raw ginger. Science hasn’t found a cure for the common cold, but it’s investigated a lot of possible candidates. Here’s your science-based guide to what works, and what doesn’t, when you’re trying to stay healthy during cold and flu season.
Flu shots help
Flu viruses kill thousands of people each year in the U.S., mostly the elderly or people with other health problems. Since 2010, the Centers for Disease Control has recommended flu shots for everyone except infants younger than six months or people who are severely allergic to the vaccine. In healthy adults, flu vaccines can reduce illness and sick days. The effect is “very modest,” according to reviewers from the Cochrane Library, which pools medical studies and evaluates the evidence. At least 40 people need to be vaccinated to prevent one illness, the research suggests. But getting healthy people vaccinated is important to protect the more vulnerable. “The more of us that get the vaccines, the less likely all of us are to get sick,” said Donald Ford, a family physician at the Cleveland Clinic.
Vitamin C and zinc don’t do much
Vitamin C doesn’t prevent colds1, according to evidence from dozens of trials involving more than 11,000 people. There’s some evidence that people who were already taking C supplements had slightly shorter colds when they got sick. But waiting until your cold starts to take vitamin C doesn’t seem to do anything, though researchers note that more studies are needed. Limited evidence suggests zinc may slightly reduce the length of colds, and zinc supplements are widely marketed as remedies. But doctors don’t recommend zinc for colds. It can have side effects, sometimes serious ones: The Food and Drug Administration warned about zinc nasal sprays in 2009 after 130 people reported they lost the sense of smell.
Antibiotics aren’t for viruses
Antibiotics can kill bacteria, not viruses. They’re useless against the common cold or flu. Doctors sometimes prescribe them anyway, particularly if patients badger them. Don’t. Unless you have another, bacterial infection, antibiotics won’t help. They will increase the risk of side effects such as diarrhea, though. And misuse of antibiotics contributes to the rise of drug-resistant superbugs in the population as a whole.
Garlic needs more research
While the value of garlic in the kitchen isn’t disputed, the evidence for keeping it in your medicine cabinet is thin. Reviewers found one trial with 146 people that reported that three months of garlic supplements seemed to reduce the frequency of colds compared with a placebo. More studies are needed to validate that finding. Most of garlic’s health claims “rely largely on poor-quality evidence,” Cochrane reviewers wrote. Possible side effects: rash, and smelling like garlic.
Echinacea: minor benefits possible
The case for using echinacea to treat a cold is shaky. “It is possible there is a weak benefit,” according to the Cochrane review. Trials for prevention indicated “small preventive effects,” though patients experienced more side effects than patients taking a placebo, including allergic reactions.
In short, there’s not much evidence to support a lot of the stuff people think helps. So beyond getting a flu shot, what should you do?
Take care of yourself
Eating well, exercising, and managing other medical conditions can help you stay healthy, said Pritish Tosh, an infectious-disease doctor at the Mayo Clinic in Rochester, Minn. Sleep and peace of mind help, too. “In general, we find that when people have a lot of stress or have sleep deprivation, there’s a lot of health problems that result,” Tosh said. “That can include becoming more susceptible to infections.”
Wash your hands and cough and sneeze into your arm
“The single most effective prevention for the spread of viruses is hand hygiene,” said the Cleveland Clinic’s Ford. Viruses expelled when people sneeze, cough, or talk can linger on desks, doorknobs, elevator buttons, and other surfaces. Practice the vampire sneeze into the crook of your arm.
Rest and fluids
If you do get sick, get lots of rest and drink plenty of fluids. It’s the best way you can help your body clear an infection that will go away on its own.
Stay home
When people try to power through an illness, “they actually make it worse for the people around them, and they make it worse for themselves,” Tosh said. (Doctors and nurses are bad at following this advice.) People are often most contagious during the early stages of a viral infection. Staying home when you first get sick can protect your co-workers and give your body more rest. It’s a tricky calculation for some. “Many people in this country don’t get paid if they don’t go to work,” Ford noted. If you can afford to, do everyone a favor and take a sick day.