Tuesday, December 20, 2011

Yellow Fever spreads in Brazil...get your vaccine before travel.

CDC / Yellow Fever in Brazil
Center for Disease Control and Prevention: update December 19, 2011

Current Situation

Yellow fever is a risk for travelers to most areas of Brazil, except coastal regions. During 2009, an outbreak of yellow fever, including a number of deaths, occurred in parts of southeastern Brazil that had not been affected by yellow fever for many years.

In response, the Brazil Ministry of Health has gradually expanded the list of municipalities for which yellow fever vaccination is recommended in the four southeastern states of São Paulo, Paraná, Santa Catarina, and Rio Grande do Sul
.
Globally, yellow fever occurs in sub-Saharan Africa and tropical South America and is spread to people through the bite of infected mosquitoes. Symptoms can include sudden onset of fever, chills, headache, backache, nausea, and vomiting.

Yellow Fever Risk Areas in Brazil
Currently, Brazil and CDC recommend yellow fever vaccination for travelers to the following states:

All areas of Acre, Amapá, Amazonas, Distrito Federal (including the capital city of Brasília), Goiás, Maranhão, Mato Grosso, Mato Grosso do Sul, Minas Gerais, Pará, Rondônia, Roraima, and Tocantins.
Other designated areas of the following states: Bahia, Paraná, Piauí, Rio Grande do Sul, Santa Catarina, and São Paulo. Vaccination is also recommended for travelers visiting Iguassu Falls.

Source: CDC / Yellow Fever in Brazil, update

Tuesday, December 6, 2011

A Doctor's Vaccine Christmas Wish List

Christmas Wish List

Wouldn’t it be wonderful if we had a vaccine to prevent tooth cavities? That possibility isn’t as far-fetched as you might think. For cavities to occur, they need sugar, plaque and bacteria, and the bacteria responsible for cavities in humans are lactobacillus and a type of streptococcus. I checked this week with three of my favorite dentists to confirm that there has been a lot of effort expended towards developing a vaccine that would protect us from ever getting cavities.

How about a vaccine against acne? The germ responsible for pimples and scars is propionibacterium acnes. It’s a bacteria against which we have antibiotics such as tetracycline and erythromycin. A vaccine which prevented acne would be welcome news for the complexions of millions of teenagers and young adults.

Here are a few others on my wish list. We currently have great vaccines against hepatitis A and hepatitis B. Whoever invents a vaccine against hepatitis C will be a rich man or woman.

Some day we’ll likely have a herpes vaccine. It’s a bit complicated, however, because there’s genital herpes and oral herpes and a few other cousins. A herpes vaccine might not help the more than 80 million Americans already infected with this virus, but it would be a boon for those in the future.

In many parts of the world, malaria is an everyday threat. An effective malaria vaccine could prevent an estimated 300-500 million infections per year.

It’s been more than twenty years since AIDS was first recognized as a new disease and HIV was identified as the virus responsible. Many thought that we would have a vaccine against HIV by the mid-1990s. Unfortunately, this virus has proven to be exceedingly resistant thus far to researchers’ efforts to come up with a safe and effective vaccine.

Lastly, MRSA (methicillin-resistant staphylococcus aureus) is a miserable bacteria that’s responsible for pneumonia and bloodstream infections, both in hospitals and in our communities. My Dad died as a result of an overwhelming staph infection, so I’ve always had a healthy respect for this particular bacteria. Selfishly, a vaccine against staph is at the top of my list.




Brad Gascoigne, M.D.
Smart Readers Health Column

Saturday, November 19, 2011

Better Hearing and Speech Month

May is “Better Hearing and Speech Month,” and in the fall we have “National Protect Your Hearing Month.” Both of these designations help remind us that good hearing is
not something we should take for granted.

The American Audiology Association (www.audiology.com) provides a helpful chart of levels of noise. Faint noises, like leaves rustling, are in the 20 decibel (dB) range. At the other end of the spectrum are “Painful & Dangerous” noises, e.g. fireworks and jackhammers, in the 130-140 dB range. Here’s a more complete listing:
20 dB leaves rustling
30 dB whispers
40 dB quiet library
50 dB moderate rainfall
60 dB normal conversation
70 dB traffic, vacuums
80 dB alarm clocks
90 dB lawnmowers, power tools, hair dryers
100 dB snowmobiles, MP3 players at full volume
110 dB concerts, car horns, sporting events
120 dB jet planes during take off
130 dB jackhammers, ambulances
140 dB fireworks, gun shots, custom car stereos at full volume

A large study released last summer reported that the prevalence of hearing loss in adolescents in the U.S. has increased in recent years. However, as the list above suggests, it’s not just teenagers who are being exposed to a myriad of loud noises.

Exposure to any noise over 85 decibels for a period of 30 minutes or longer is considered dangerous and can result in permanent hearing loss. Noise at 120 dB and above can damage one’s hearing in 30 seconds or less.

I recently asked Dr. Gail Murray, Director of Audiology Services at University Hospitals Case Medical Center in Cleveland, for her advice. She said that she had ear plugs form- fitted for her ears and that she carries them with her to use when she finds herself exposed to unavoidable loud noise.

What have you done lately to protect your hearing?



Brad Gascoigne, M.D.
Smart Readers Health Column

Tuesday, September 20, 2011

Try Adding Up Your Calcium Intake

Much has been written over the past couple of years about the important role vitamin D plays in our overall metabolism and the health of our bones. Overlooked to some degree, perhaps, has been the fact that it’s calcium which is the real key when it comes to maintaining bone strength.

The Institute of Medicine early this year updated its recommendations regarding calcium. For the first time ever the recommendations cover both the lower limits (RDA or Recommended Daily Allowances) as well as safe upper limits. In regards to calcium intake, how do you fare?

Think back over the past 24 hours and try to recall how much calcium you’ve consumed. Here are some common calcium sources:

______ 8 ounce glass of milk (300 mg)
______ 6 ounce serving of yogurt (about 200 mg)
______ 6 ounce glass of calcium-fortified juice (200 mg)
______ 1 ounce of hard cheese (200 mg)
______ salmon, tuna or sardines (varies) (about 200 mg)
______ 1/2 cup of turnip greens (100 mg)
______ 1/4 cup of almonds (100 mg)
______ 1 cup of beans or chickpeas (about 100 mg)
______ adult daily multiple vitamin (100-500 mg)
______ calcium supplement (e.g. TUMS) (200-600 mg)

Now add up your past-24-hour calcium intake. Teens are supposed to get 1300 mg/day. Men need 1000 mg till age 70 and then 1200 mg per day thereafter. Women are advised to take in 1000 mg/day till age 50 and then 1200 mg/day. How close are you to the new RDAs?

Intakes over 2000 mg per day might put you at risk for kidney stones or other problems, so check with your physician if you think you might be consuming too much calcium. Most of us, however, have the opposite problem: too little daily calcium. If you’re falling short of your body’s calcium requirements, drink an extra glass of milk this evening. When you get older, your bones will thank you.

Brad Gascoigne, M.D.
Smart Readers Health Column

Tuesday, September 6, 2011

Super-Flu Shots for Seniors

Two autumns ago Americans were anxiously awaiting the arrival of what had first been called “swine flu” and then officially became known as novel H1N1 influenza. In June 2009 the World Health Organization had issued its warning about an official “world pandemic.” By the end of the 2009-2010 winter flu season, millions of Americans had come down with the flu and between 10,000 and 20,000 had died from flu-related illnesses. A surprisingly large percentage of those who died were teenagers and young adults who had previously been in the prime of health.

Last winter’s flu season was comparatively mild. The peak of the flu season didn’t arrive until February, and numbers of flu cases were down in all regions of the country.

What can we expect this fall and winter? It’s reasonable to assume that our flu season won’t be as mild as last year’s was, as viruses have a way of mutating over time and becoming more infectious. On the other hand, it’s also not likely that we’ll see a flu season as bad as we had two years ago, since no dramatically new flu strains have appeared thus far in the Southern Hemisphere where it’s been winter south of the equator.

Flu vaccination will continue to be recommended for just about everyone 6 months of age and older. Those for whom flu vaccination is especially important are seniors, infants and young children, pregnant women, and health care workers. And for anyone else not wishing to miss a week or more of work or school.

This year there is now available a “senior strength” flu virus vaccine with the brand name “Fluzone High-Dose.” It was actually licensed by the Food and Drug Administration a year ago, and it will be more widely marketed by its producer Sanofi Pasteur this year. It has been known for many years that those 65 and older don’t produce as high an antibody response to the flu vaccine components (known as antigens) as do younger adults. The new higher-dose vaccine has 4 times the amount of antigen in it and produces approximately 40% higher antibody levels than does the standard flu vaccine. The new vaccine has been shown to be safe in clinical trials, but it has not yet been proven that higher antibody levels will necessarily result in less flu.

The cost of Fluzone High-Dose is covered for those with Medicare Part B. It will be interesting to learn over the coming one to two flu seasons whether this senior-strength vaccine is as great a value as is the usual flu vaccine.

Brad Gascoigne, M.D.

Wednesday, August 24, 2011

The Next Epidemic

All of us know about AIDS and the terrible toll this infection has taken around the world over the past two to three decades. Most of us are aware that tuberculosis remains a major threat. How many of us realize the extent of the worldwide spread of hepatitis?

The World Health Organization (WHO) recently established the first World Hepatitis Day which was observed on July 28, 2011. Among the nearly seven billion people living on this planet, nearly 500 million suffer from chronic hepatitis B or chronic hepatitis C. That figure translates to 7% of the world’s population.

There are several different types of hepatitis virus ranging from hepatitis A to G. All can cause inflammation of the liver and lead to yellow jaundice, nausea, lethargy and weight loss. Severe cases can be fatal. If a person’s body successfully fights off the infection, the individual recovers within a few weeks and the infection is viewed as “acute.” If the infection persists for six months or longer, it is termed “chronic” and will often last for years and even decades. According to the WHO, approximately one million people died from chronic hepatitis B or chronic hepatitis C last year.

If there’s good news to be found in this regard, it’s that a large majority of hepatitis cases are preventable. There are effective vaccines available against hepatitis A and hepatitis B. These vaccines are commonly given to infants and children in the United States (and hopefully, someday, to children throughout the world). Several types of hepatitis are totally preventable by practicing safe sex, by not injecting drugs of abuse, and by not sharing razors or blood-sugar-testing devices.

For further information about acute or chronic hepatitis, go to http://www.cdc.gov/hepatitis. By the time we reach the second World Hepatitis Day in July 2012, it will be interesting to see how we have fared both in the U.S. and in the rest of the world against this under-recognized epidemic.

Brad Gascoigne, M.D.
Smart Readers Health Column

Tuesday, March 22, 2011

The Daily Beast ranks Cleveland as the #7 sickest city

Online news site The Daily Beast compiled a list of the 20 sickest cities in America.

Cleveland came in at #7.

The index took into consideration a variety of factors, including a city's SDI Health ranking, statewide vaccination coverage, Influenza and pneumonia deaths per 100,000 people and estimated flu activity during the rest of flu season.

Cleveland's vaccination rate is under 65%. Vaccination is the cheapest and most effective forms of preventative medicine available and can not only keep you out of the hospital, but can save your life. Don't put it off!

Source: The Daily Beast

Tuesday, February 15, 2011

Flu on the rise in Northeast Ohio

After a relatively uneventful start of flu season in the United States, it looks like the seasonal flu is finally starting to strike Northeast Ohio. The CDC is now showing that flu is widespread in 30 states - including Ohio.

"Cuyahoga County saw a doubling in flu cases last week, said Richard Stacklin, a researcher with the county Board of Health." The CDC this year offers a universal recommendation for flu vaccination. It's cheap, quick, and the most effective way of ensuring you don't get the flu this winter.

Passport Health still carries the flu vaccine. Call our office at 216.295.9400 for an appointment. Mention this blog and receive $5 off.

Source: Cleveland.com

Tuesday, February 8, 2011

Vaccines and Autism: A Story of Medicine, Science and Fear

We can't emphasize enough the importance of routine vaccinations for children. Vaccines are the most effective and most economical way to prevent deadly diseases - they helped us exterminate the scourge of smallpox and nearly eliminate polio.

Diane Rehm's show from February 2 talks about the fear associated with vaccines and addresses much of the misinformation surrounding them. I encourage everyone to listen to this important program in order to understand the truth about vaccines and the risks we face as a society by choosing not to vaccinate our children against preventable illnesses.

Click the listen link on this page to hear the episode of the Diane Rehm show from NPR/WAMU.

If you or your child are not up-to-date on routine vaccines--particularly for critical illnesses such as whooping cough--please call Passport Health to schedule an appointment today.

Tuesday, January 25, 2011

The flu vaccine: separating the truth from myth

There's a lot of misinformation out there about flu vaccines. It's important to know what the truth it as we make decisions about the health and wellness of our families.

The article linked below was published in this morning's edition of the Cleveland Plain Dealer and addresses the following three myths about the flu vaccine:
1) Flu myth: The flu shot gives you the flu. "But the shot itself giving you the flu? Impossible, all three docs say."

2) Only unhealthy/old/sick/infirm people are really in danger from the flu. "...while it's true that the very young, the elderly, pregnant women and those with certain chronic health conditions are at greatest risk from influenza, healthy people get seriously ill and even die from the flu every year."

3) Flu myth: The flu vaccine is dangerous. "Study after study after study has shown no link between vaccines and autism,"

4) Flu myth: I got vaccinated last year, so I don't need a shot this year. "...last year's vaccine may offer you some protection this year, Congeni says, but it's unlikely you'll be fully protected." Some people are lucky enough to only have mild illness or have what is called a "subclinical" infection, one that is so mild it doesn't even cause noticeable symptoms

Source: http://www.cleveland.com/healthfit/index.ssf/2011/01/the_flu_vaccine_separating_the.html

Thursday, January 20, 2011

George Clooney Contracted Malaria In Sudan

Don't be like George Clooney and travel unprepared to the Sudan. The actor recently contracted malaria on a recent trip. Make sure that when you travel to malaria-stricken regions, you bring along proper anti-malaria medication!

Malaria caught on camera breaking and entering cell


From the New Scientist:
"The video above captures the moment when a malaria parasite invades a human red blood cell - the first time the event has been caught in moving pictures."

Tuesday, January 11, 2011

Two Doses of Chickenpox Vaccine Recommended

Recent outbreaks of the chickenpox among vaccinated children suggest a need for a second vaccine in order to preserve immunity.


As reported by NPR: "A study that measured antibodies and the disease history of more than 200 kids found that two doses of vaccine was 98 percent effective in preventing chicken pox compared with 86 percent for a single dose. The results appear in the latest issue of the Journal of Infectious Diseases."

If you have any questions, call Passport Health or your child's pediatrician. Passport Health Northern Ohio actively carries the chickenpox vaccine.

Source: NPR.org

Thursday, January 6, 2011

Medical journal: Study linking autism, vaccines is 'elaborate fraud'

As reported in just about every news source imaginable this morning (CNN, Washington Post, Wall Street Journal and The Telegraph to name a few), the infamously inimitable study by Andrew Wakefield linking MMR vaccination and autism in children has been declared an "elaborate fraud," according to the British Medical Journal BMJ:
BMJ, which published the results of its investigation, concluded Dr. Andrew Wakefield misrepresented or altered the medical histories of all 12 of the patients whose cases formed the basis of the 1998 study -- and that there was "no doubt" Wakefield was responsible. The journalist who wrote the BMJ articles said Thursday he believes Wakefield should face criminal charges.
Wakefield's fraudulent research helped to ignite an anti-vaccination movement in the UK and United States that has led to a resurgence of diseases such as whooping cough, killing and sickening scores of people.

The British government stripped Wakefield of his medical license in May, around the same time that the 

Britain stripped Wakefield of his medical license in May, following the February 2, 2010 full retraction of the original article by its publisher, The Lancet. In May, The American Journal of Gastroenterology retracted a study making further use of Wakefield's data.