Tuesday, April 28, 2009

Racing to contain Swine Flu

Organ transplant recipients are particularly vulnerable to infections such as the swine flu because they are immunosupressed by the anti-rejection drugs they take daily. The following comment posted in the Baltimore Sun gives us some common sense guidelines we can follow to reduce the chances of getting the flu and what actions we should take if we do develop symptoms. I would also add that organ recipients should be very careful about traveling to Mexico at this time; The United States advised Americans against most travel to Mexico and ordered stepped-up border checks in neighboring states. The European Union health commissioner advised Europeans to avoid nonessential travel to Mexico and parts of the United States. On Monday, the Public Health Agency of Canada issued a travel warning advising Canadians to postpone any non-essential travel to Mexico until further notice.

Travel age diseases seem to be the norm--don't go to emergency rooms, doctors' offices and hospitals for trivial reasons if you are generally healthy--waiting rooms are great places to catch infections--those who are tempted to go for aches and pains, hair loss, skin blemishes and so on stay home until this reality passes.

The immunosupressed----smokers, cancer patients, those with AIDS, heart patients, those with COPD and asthma, diabetics, those with organ transplants, those waiting for transplants and those with TB, heavy drinkers, the drug addicted, the very old and the very young are particularly vulnerable.

Wear masks even if you look funny around sick people--carry alcohol rubs to wipe hands often if not wash hands often, stay hydrated, be careful in Gyms-they are great incubators of infection, so also physiotherapy equipments.

Cough and sneeze into tissues and don''t leave these tissues lying around. Keep up your nutrition and your sleep-these are best inoculations against any infection-even if you get it you will survive if you keep your immune system in good shape--not if you have run yourself ragged with junk food, soda, chips, alcohol, partying and 2 hours of sleep each night.

If you have a high fever, are short of breath, have neck rigidity, mental confusion, severe headaches or you cannot keep any food down go to the hospital--flu can cause pneumonia, acute and severe sinusitis, encephalitis, dehydration and even meningeal inflammation--supportive treatment, hydration, oxygenation and antibiotics for secondary bacterial infection are available in hospitals and can save lives.

More than the reporting systems being inadequate, private doctors seeing patients are so busy they may genuinely miss cases as being serious or part of an epidemic unless and until the numbers grow large or healthy people start dying---sporadic severe cases will not have the same urgency as will an ongoing steady flow of cases, an acute overwhelming number of cases or a group of cohorts, like in the case of New York, coming down with the illness together or healthy people not expected to die actually dying from the disease-- reporting is usally the result of a tipping point because the suspicion index is low until things get bad. Something should be out of the ordinary in Medicine to say--this is different-it smells like it could be dangerous. Unfortunately by the time a possible epidemic is nosed out, people are actually dying and the bug is having a spree.

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