Wednesday, September 5, 2012

What's new in 2012 Flu Vaccine

What’s New with Flu?

It seems that people have one of two general responses when the subject
of flu and flu vaccination is raised. Either they say, “We always get the flu
shot,” or else something along the lines of, “We don’t believe in the flu
shot.” Regardless of which group you fall into, it’s highly likely that we’re in
for a worse flu season than the incredibly mild one we had this past winter.

In the past year several new developments have occurred regarding flu
(medically known as “influenza”) and flu prevention. There is now a higherpotency
flu vaccine approved for seniors 65 years and older. Check with
your doctor to find out whether it’s available and right for you.

Two of the three components of this year’s flu vaccine have been
changed. Since flu viruses have the ability to adapt and change over time,
this year’s vaccine will provide protection against two newer strains,
influenza B and H3N2. Both of these flu viruses have been spreading over
the past 6-9 months in countries south of the equator, where their winter
flu season is now coming to a close. These viruses are expected to reach
the U.S. this fall. The third component of this year’s flu vaccine will
continue to provide protection against H1N1, the virus responsible for the
worldwide pandemic of 2009-2010.

Public health officials are closely following the emergence and possible
spread of a “variant” swine-related flu strain which has infected twenty or
more individuals in the midwest. Several public health advisories were
issued this summer for the public to avoid close contact with or handling
pigs at venues such as state fairs.

Another recent development has been the approval by the Food and Drug
Administration given to one of the larger pharmaceutical companies for its
vaccine providing protection against four flu strains. Don’t be surprised if
the use of a “quadrivalent” flu vaccine becomes more popular a year from

Lastly, clinics in New York reported that text messaging reminders to
patients to get a flu shot increased the numbers who did. In all likelihood,
savvy businesses and health care systems will figure out ways to employ
newer technologies to increase the number of friends and employees who
get vaccinated this year.

Brad Gascoigne, M.D.
Smart Readers

Wednesday, August 1, 2012

Beware of Ingesting Wire Bristles from Grill-Cleaning Brushes

Beware of Ingesting Wire Bristles from Grill-Cleaning Brushes There was an incident which occurred in mid-July involving needles found in sandwiches aboard several airline flights which had departed from Amsterdam to the United States. At least one passenger suffered a puncture wound to the roof of his mouth and required medical treatment. The story received fairly wide coverage in the television and print media. Hopefully the episode was a onetime action on the part of a disturbed or disgruntled individual. There’s another potential metal-ingestion hazard which has received less widespread attention than the Amsterdam airline incident but which may be an even more common threat. In early July a public health journal issued a report about the accidental swallowing of wire bristles contained in food cooked on home barbeque grills. The source of the bristles were grill-cleaning brushes. Between the months of March 2011 and June 2012 a total of six patients were treated in two Rhode Island emergency departments after unknowingly ingesting wire bristles. Three of the individuals complained of severe pain on swallowing. X-rays revealed the presence of the metal foreign objects, and removal of the wires with the aid of a laryngoscope was successful in all three patients. The other three individuals had severe abdominal pain as their main symptom. CT (computed tomography) scans were able to detect the source of the problem. In two patients the ingested wire had perforated the small intestine, and abdominal surgery was required to remove the object. In the third patient, the wire had traveled to the distal colon and was pressing upon the bladder. It was successfully removed via colonoscopy. All six patients had eaten meats cooked on home barbeque grills which they had cleaned before grilling with brushes containing wire bristles. Five of the six individuals were males. The patients’ ages ranged from 31-64 years. In at least one case the grilled meat was steak. Hamburger patties were suggested as another possible food source. While such accidental ingestions are uncommon, they may occur more often than is generally recognized. Since 2009 at least seven other patients have been described with similar accidents. One medical report in 2009 described a wire which had caused an abscess infection in an individual’s mouth below the tongue. The next time you or your friends grill food on a home barbeque and a grill-cleaning brush with wire bristles has been used to clean the grill, double check the surface of the grill to be sure wire bristles haven’t been accidentally left behind to become part of the meal you’ll be consuming. Brad Gascoigne, M.D. Smart Readers Health Column

Wednesday, March 21, 2012

Dengue fever reported in Pakistan earlier than previous years

Pakistan reporting dengue fever cases earlier than normal
Published on March 19, 2012 by Jeffrey Bigongiari

Dengue fever
Even without monsoon rains and high temperatures, public health experts have already started registering cases of dengue fever this year in Karachi, Pakistan.

Dr. Shakeel Aamir Mullick, the head of the Dengue Surveillance Cell at Civil Hospital, said that 29 cases of the fever have been reported and treated since the beginning of January. Four cases of dengue were identified last week, according to

“This disease is like influenza, which affects people throughout the year,” Mullick said, reports.

Dengue cases are expected to surge in between August and November. Typically, according to the provincial surveillance authorities, the first quarter of the year sees relatively few cases.

Mullick said that 15 cases were reported in the first six months of 2011, but that the number then skyrocketed in the second half of the year.

All of the cases reported so far in Sindh province have occurred in Karachi. Last year, out of 1,079 dengue cases in the region, 858 were located in city, reports.

Dengue fever is a mosquito-borne infection that is a leading cause of illness and death in the tropics and subtropics. The U.S. Centers for Disease Control and Prevention estimates that as many as 100 million people are infected with dengue every year.
This entry was published in Medical

Wednesday, March 14, 2012

Where are my (or my child's) immunization records?

There is no central repository of vaccination records. The only records that exist are the ones you or your parents were given when the vaccines were administered, and the ones in the medical record of the doctor or clinic where the vaccines were given. Sometimes schools hold the vaccination records of children who attended, but these records are usually not kept for more than a year or two.

If you cannot locate your personal record or the record from your doctor, it may be necessary to repeat some of the vaccines or arrange blood tests to determine your immunity.
Where can I look for existing immunization records?

Children's records

* Try calling your local or state health department's immunization program.
* Sometimes schools hold the vaccination records of children who attended, but these records are generally not kept for more than a year or two or, at the longest, until graduation. After a student graduates, records are sent to storage and may not be accessible.
* Look for family records such as a baby book.
* Check for records with your doctor or public health clinic. Please keep in mind, however, that immunization records are maintained for a limited number of years, and then usually only by the medical provider who actually administered the vaccines.

College student's records

* Many colleges provide vaccinations (often, certain vaccinations are required for enrollment). Contact your college's medical services department (student health) for further information.

Tuesday, February 28, 2012

Traveling Safely with Infants & Children - Passport Health Can Help

Traveling Safely with Infants & Children (partial article from CDC Yellow Book 2012)

Nicholas Weinberg, Michelle Weinberg, Susan A. Maloney

"The number of children who travel or live outside their home countries has increased dramatically. An estimated 1.9 million children travel internationally each year. Although data about the incidence of pediatric illnesses associated with international travel are limited, the risks that children face while traveling are likely similar to the risks that their parents face. The most commonly reported health problems among children are:

Diarrheal illnesses
Dermatologic conditions
Systemic febrile illnesses, especially malaria
Respiratory disorders

Motor vehicle and water-related accidents are also major health problems for child travelers. In assessing a child who is planning international travel, clinicians should:

Review routine childhood and travel-related vaccinations. The pre-travel visit is an opportunity to ensure that children are up to date on routine vaccinations.
Assess all travel-related activities.
Provide preventive counseling and interventions tailored to specific risks, including special travel preparations and treatment that may be required for children with underlying conditions, chronic diseases, or immunocompromising conditions.
Give special consideration to the risks of children who are visiting friends and relatives in developing countries. These conditions may include increased risk of malaria, intestinal parasites, and tuberculosis.
Consider counseling adults and older children to take a course in basic first aid before travel."

Tuesday, February 7, 2012

Good News on Breast Cancer

Some Good News Regarding Breast Cancer

Amongst all the tragic stories dealing with breast cancer, one published last month provided some clarity and perhaps some hope. The Susan G. Komen for the Cure, a foundation dedicated to research and education related to breast cancer, commissioned the study asking what environmental factors affect breast cancer. Here are some of the facts regarding what is known and what is yet to be determined.

Members of the study commission concluded that the following are not responsible for causing breast cancer: hair dyes, microwave ovens, and cell phones. That information may provide some measure of peace of mind for some women.

Then there is another group of environmental exposures, such as pesticides and industrial chemicals, about which too little is currently known to say whether or not they are a risk for breast cancer. Further research is clearly needed.

Then there are the causes about which there is general agreement that they do increase the risk for breast cancer. Postmenopausal hormones containing both estrogen and progestin are a risk. Once this association was recognized a decade ago, the use of these hormones decreased sharply in the U.S. and the incidence of breast cancer began to decline.

A second recognized risk factor for developing breast cancer is “gaining excess weight after menopause.” The report doesn’t specify exactly how much is too much.

A third risk about which there is general agreement is ionizing radiation resulting from overuse of CT (computed tomography) scans. One scientist quoted in the Jan. 4, 2012 issue of JAMA noted that “the amount of ionizing radiation from 3 abdominal CT scans is equivalent to levels that Japanese women were exposed to in the World War II atomic bomb explosions in Hiroshima and Nagasaki.”
The next time your physician or emergency department doctor tells you that you need a CT scan, be sure to question why and ask whether watchful waiting is an option.

Brad Gascoigne, M.D.
Smart Readers Health Column

Tuesday, January 17, 2012

Machu Pichu, Peru

Christine writes "Great trip - can't recommend it enough! We crossed Salkantay Pass at 15,000+ feet, an alt. record for our hiking. Thanks to Eileen (Passport Health Northern Ohio) for "hooking us up with the good stuff" before we left! One less thing to worry about!"