H1N1 Flu is Here

H1N1 Flu is in Houston

H1N1 Flu, aka swine flu, is a serious and potentially deadly illness. As of this date, late December 2013, it has caused 6 deaths and another 14 people are critically ill in Harris county. Deaths due to this flu have been confirmed in Longview and Austin. This area’s first cases were reported in the Conroe area, north of Houston.

Bad News

Get your flu shots today at Bellaire ER in Bellaire, TexasThis flu is particularly deadly when contracted by those with weak immune systems, which includes the young and the old, and those that have underlying health conditions. Some of the recent deaths were in people with cardiovascular disease and obesity.

In those who have died, the patients initially had flu symptoms and then developed pneumonia. In some of the patients organ failure occurred. Regardless, their immune systems were unable to defeat the flu virus.

There is still much that is unknown about this outbreak. Health officials don’t know exactly how or when it arrived. Some officials have stated that this is the same H1N1 flu strain that caused the worldwide pandemic in 2009. However, they have not excluded the possibility of a new strain that is more potent and a great deal of testing is being undertaken.

People should know that the commonly used flu test (RAPID) is not very reliable and it has given negative results (no flu present) for patients who were actually very ill with this flu. Another flu test is available but it is more costly and requires more time. Health officials are recommending that doctors give Tamiflu, an antiviral treatment, to patients that exhibit any flu-like symptoms.

A recent Houston Chronicle report said that Houston hospital emergency rooms are experiencing a five year high in the number of patients with flu-like symptoms. We are also seeing a surge in flu patients at Bellaire ER also.

Good News

The good news is that this year’s flu vaccine contains protection against the most common flu strains, including H1N1. People who receive their flu vaccinations should be protected against this year’s flu season. The most vulnerable are at very high risk. Although the sample is small, the mortality rate for those flu patients admitted to a hospital this year is around 50%.

Common Reasons people visit an Emergency Room

La gripe H1N1 se encuentra en Houston

Gripe H1N1 , también conocida como gripe porcina, es una enfermedad grave y potencialmente mortal. A partir de esta fecha, a finales de diciembre de 2013, que ha causado 6 muertos y otras 14 personas se encuentran en estado crítico en el condado de Harris. Las muertes han sido confirmadas en Longview y Austin. Primeros casos de esta zona fueron reportados en el área de Conroe , al norte de Houston.

Malas Noticias

Get your flu shots today at Bellaire ER in Bellaire, TexasEsta gripe es particularmente letal cuando se contrajo en las personas con sistemas inmunitarios débiles , lo que incluye a los jóvenes y los viejos , y los que tienen problemas de salud subyacentes. Algunas de las recientes muertes fueron en personas con enfermedades cardiovasculares y la obesidad.

En aquellos que han muerto , los pacientes que inicialmente tenían síntomas de la gripe y luego desarrollaron neumonía. En algunos de los pacientes se produjo fallo de órganos . En cualquier caso, sus sistemas inmunológicos no pudieron derrotar a los virus de la gripe .

Todavía hay mucho que se desconoce acerca de este brote. Los funcionarios de salud no saben exactamente cómo ni cuando llegó. Algunos funcionarios han declarado que esta es la misma cepa de la gripe H1N1 que causó la pandemia en todo el mundo en 2009. Sin embargo, no han excluido la posibilidad de una nueva cepa que es más potente y se está llevando a cabo una gran cantidad de pruebas.

La gente debe saber que la prueba de la gripe de uso común ( RAPID) no es muy fiable y ha dado resultados negativos ( hay gripe presentes) para los pacientes que estaban realmente muy mal con esta gripe . Otra prueba de la gripe está disponible pero es más costoso y requiere más tiempo. Los funcionarios de salud recomiendan que los médicos dan Tamiflu, un tratamiento antiviral, a los pacientes que presentan síntomas similares a la gripe .

Un reciente informe del Houston Chronicle dijo que Houston hospitalarias salas de emergencia están experimentando un máximo de cinco años en el número de pacientes con síntomas similares a la gripe . Estamos viendo un aumento en los pacientes con gripe en Bellaire ER también .

Buenas Noticias

La buena noticia es que la vacuna contra la gripe de este año contiene la protección contra las cepas de la gripe más comunes, incluyendo el H1N1. Las personas que reciben sus vacunas contra la gripe deben ser protegidos contra la temporada de gripe de este año . Los más vulnerables son un riesgo muy alto . Aunque la muestra es pequeña, la tasa de mortalidad para los pacientes con gripe ingresados ​​en un hospital de este año es de alrededor de 50%.

Razones más comunes de personas visitan la Sala de Emergencias

Whooping Cough

Whooping Cough in Texas

Whooping Cough (pertussis) is making a comeback and that is not good for you or your community. Whooping Cough is a highly contagious bacterial infection of the respiratory tract. Usually a person with whooping cough will have a severe hacking cough that is followed by a “whoop” sound when inhaling.

Whooping Cough can affect people of all ages but the most vulnerable are infants because they are too young to receive a complete series of vaccinations and their immune systems are immature. Infants are also at risk for other complications such as pneumonia and encephalopathy (disease of the brain). Many infants that become infected with this bacterial infection get it from those who are closest – parents, brothers and sisters, and other caregivers that may have Whooping Cough and not know it.

Why is Whooping Cough Making a Comeback?

The primary reason is the increasing number of non-vaccinated people. A majority of adults (61%) do not know if they have received a vaccination for whooping cough. Although most adults have received a Whooping Cough vaccination during their childhoods, they are in need of a booster shot to retain their immunity.

What are the Symptoms?

The symptoms of Whooping Cough can resemble the common cold and many people don’t develop the high-pitched “whoop” sound during inhalation. Sometimes the most prominent characteristic is a persistent hacking cough. The symptoms usually take one to three weeks to appear after one is infected. Generally the first symptoms are relatively mild and include:

  • Dry Cough
  • Sneezing
  • Runny Nose
  • Red and watery eyes
  • Mild Fever

About a week or two after the first symptoms appear they will worsen and other symptoms will appear. Persistent coughing attacks are caused by a thick mucus accumulation inside the lungs’ airways. These new symptoms may include:

  • Vomiting
  • Fatigue
  • A Red or Blue Face
  • A “Whoop” sound during inhalation

Why is Whooping Cough Important?

First, Whooping Cough can be and is deadly for some young children and infants. Second, Whooping Cough is highly contagious, that is, it can spread easily within human populations. Third, in 2012 the United States had the highest number of Whooping Cough cases in 50 years. This implies that the overall population is not receiving the suggested vaccinations and boosters.

Vaccines and Autism

At this point in time no one knows the exact cause or causes of autism. What we do know is that the number of children diagnosed with autism has continued to rise in recent years.  Most experts believe that is due to better diagnosis, better reporting, and wider, broader definitions of autism.

One of the most publicized theories on the subject dealt with childhood vaccinations – Do they cause autism? This began when a small study in England of 12 children was published in 1998 that claimed there was a link, or cause, between autism and a combination of childhood vaccines. The vaccine is known as MMR, or measles, mumps, and rubella.

Another factor, thimerosal, was also presented as a possible reason for childhood autism. Thimerosal is a mercury-based preservative that is / was used to prevent fungal contamination. Some people claimed that thimerosal was the source or cause of autism in children.  After many studies the scientific community is comfortable in claiming that there is no causation effect.  However, to be on the safe side this compound has been eliminated from almost all vaccines except some flu vaccines in the USADenmark phased out thimerosal years before the United States and they have not seen any affect on the incidence of autism.

Another argument that has been presented is that children receive “too many vaccines too soon.”  This theory has also been the subject of studies and has been found to lack validity.

There have been many scientific studies since 1998 and the vast bulk of them do NOT show any relationship between vaccinations and childhood autism. Although some parents feel it is best to NOT vaccinate their children, most doctors think that is a very bad idea. In those cases the children are much more susceptible to childhood diseases such as whooping cough, measles, rubella and other diseases which can be lethal. It is important to discuss your concerns with your pediatrician. Many pediatricians are now delaying and spreading out vaccinations as much as possible to mitigate the fear that some parents have.

Shingles Facts for Adults over 50

Adults over 50 years of age are at greater risk of getting Shingles because their immune systems have aged and are less effective against diseases like Shingles. The CAUSE of shingles is the Varicella-Zoster (Herpes varicellae) virus, which is the virus that causes the common childhood disease of chickenpox. What happens is that after a child has had shingles, the virus remains in the nerve tissues in a dormant state. As the individual becomes older, with a weaker immune system, the virus can reappear in the form of shingles.

What is Shingles?

It is a painful rash. Very painful. It affects about one million Americans every year and anyone with a history of chickenpox and a weakened immune system can contract shingles. People who are taking certain medications or immunosuppressive drugs, undergoing chemotherapy, or suffering from cancer or severe infections are at higher risk. Shingles cannot be passed from one person to another under normal circumstances.

How bad are the Symptoms?

Generally shingles will produce a blistering rash on one side of the body or face. There is usually pain and a burning sensation along the nerve paths on which the virus is attaching. Since nerve paths form half-circles around the body they have a distinct pattern. The burning rash is usually accompanied by both enlarged lymph nodes and fever.

In most people the rash and associated pain reach their peak in three to five days and then the blisters break and become sores which will scab over. After two or three weeks the scabs will heal and the patient is back to a normal life.

However, in some people, the area of the rash will remain painful for many years. This condition is called postherpetic neuralgia and affects about 10% of the people who contract shingles. This lingering pain is very difficult to treat and can significantly lower the quality of life for the patient.

Another serious complication of shingles is when it is located on the face near the eyes or nose. It can cause damage to the eyes, or other organs in the body. So it is very important to obtain prompt medical treatment for shingles.

Is there a Vaccine for Shingles?

Yes. The vaccine is not perfect but it has shown the ability to reduce the risk of shingles and postherpetic neuraligia by 50% and 66% respectively. The shingles vaccine is recommended for people who have never had chickenpox because it is possible for a person to have forgotten the chickenpox episode or to have had a mild case that was not diagnosed. The vaccine is also recommended for people who have had shingles before because it is possible to get shingles a second time.

Ear Infections in Children

Otitis, a general term for inflammation or infection of the ear, is a common childhood disease. Otitis media (middle ear infection) is the second most common infectious disease after nasopharyngitis, a condition in which the throat and nasal passages become infected and inflamed. The most common childhood ear infection affects the middle ear. An ear infection can occur in isolation or accompany another disease, such as postnasal drip. Otitis can affect one or both ears.

Symptoms

Any of the following symptoms may accompany an infectious episode caused by otitis. Usually the child will make it clear that he / she has an ear infection.

  • A runny nose a few days before the onset of otitis
  • Sudden pain, violent, heavy and throbbing of the affected ear
  • Ringing
  • Sensation of plugged ear
  • Appearance of a blood
  • The child may have difficulty hearing
  • Crying, fatigue, fever, headache, sore throat and difficulty sleeping may accompany infectious episode caused by otitis.

Treatment options for Ear Infections

The physical structure of the ear, nose and throat of a child can cause chronic (persistent / long term) ear infections. In this case, your doctor may recommend that the establishment of ventilation tubes in the ear or the removal of adenoids – the lining of the upper part of the throat behind the nose.

Most ear infections resolve spontaneously within a few days. This is why experts recommend the doctor to wait 2-3 days before prescribing antibiotics in some cases of acute ear infection.

Depending on the condition of your child, your doctor may recommend medication or surgery. Ear infections are the most common cause of hearing loss in children, which can affect learning and speech development. In some cases, hearing loss may be permanent.

Medication

If the infection is bacterial, your doctor may prescribe antibiotics. If the infection is viral, antibiotics will not help. Using antibiotics when they are not needed can be harmful and can lead to the emergence of bacteria resistant to antibiotics.

Your doctor may prescribe a pain reliever for you or your child be more comfortable while the virus is active.

Surgical Treatments

If the ear infection keeps coming back or lasts, your doctor may suggest surgery. Surgical treatments include the introduction of a ventilation tube in the eardrum to drain the fluid or removal of swollen or inflamed adenoids (adenoidectomy), where bacteria can multiply and prevent the natural drainage in the throat.

Do Cough Expectorants and Cough Suppressants Work?

Do cough expectorants and or cough suppressants work for cough and congestion?

Coughing is a response to various elements affecting the lungs including irritants, inflammation, mucous production and even particulate food or fluid in the airways.

Cough suppressants are supposed to suppress coughs. Expectorants, on the other hand, are supposed to help remove the mucous by making the cough more effective and by increasing mucous production in the lungs and airways in order to make it easier to expel.

Research done on these drugs reveals that many of the suppressants work by numbing the upper airway to the irritating elements mentioned above and do make patients more comfortable and they do cough less.  Expectorants on the other hand have not been shown to assist in the removal of mucous from the lungs.  The most effective method was found to be physical maneuvers called P, D and C or Percussion, Drainage and Cough.  Having the person take deep breaths and simply learn to hack or cough the mucous out.  Physical percussion or gentle pounding on the upper thorax area to loosen the mucous also helps.

Management of Fever in Children

Management of Fever in Children

Fever is a rise in core body temperature above the body’s normal set point. Normal body temperature is between 97.5° – 99.5° F. Fever is a temperature of 100.4° F or above.

What causes a fever?

There are various causes for a child to have a rise in temperature. Fever generally occurs in response to an infection, cancer, drug or toxin, autoimmune processes and even allergic reactions can cause a low grade fever. Hyperthermia, or overheating, can be caused by strenuous exercise or environmental exposure.

The hypothalamus regulates your body’s core temperature. During an infection your hypothalamus resets the body’s normal set point. This is why traditional cooling efforts are ineffective.

Treatment of fever

Fever is a very normal response to infection. How high your child’s fever is and how it responds to medication is not a good indicator of the severity of the illness.

Fever can be treated with acetaminophen or ibuprofen, (product names Tylenol and Motrin).  Fever should not be treated with cold baths or alcohol baths. Both can be dangerous and are ineffective in reducing fever. Bathing the child using the temperature normally used for their bath is effective.  Cooling efforts such as wearing light clothing and reducing air temperature may help provide comfort. These will however be more effective if used after medication is given.

When should I call my doctor?

Call your doctor immediately if:

  • Your child is younger than 3 months
  • Your child has a fever above 104°F
  • Your child looks or acts extremely ill
  • Your child has had a seizure
  • Your child has had a fever for more than 3 days
  • Your child has accompanying symptoms that may indicate a bacterial infection such as earache, stiff neck, headache, or sore throat

Flu Season is Here


Somewhere between 20 and 40 million people died in the influenza (flu) pandemic of 1918-1919. This is greater than the number of people killed in World War I. It has been cited in medical literature as the most devastating epidemic in recorded world history.

In the fall of 1918 something erupted that seemed as benign as the common cold. However it was far more than a common cold. In the next two years a fifth of the world’s population was infected with this flu virus. 28% of all Americans became ill and an estimated 675,000 Americans died from the flu during this period. This was ten times the number of Americans that died in World War I. What many people do not realize is that half of all the deaths U.S. soldiers in World War I were the result of the flu. The other half died from the enemy. An estimated 43,000 American soldiers in World War I died from the influenza virus.

Today the Flu activity continues to plague the United States. This year an early flu season with high levels of activity is concentrated in the south central and southeastern regions of the country. The Center for Disease Control (CDC) urges you to get a flu vaccine now if you have not done so already this season. The CDC has created a trivalent vaccine that covers you for the three most prevalent influenza A and B viruses. You could have the flu if you are running a fever, having body aches,  headache, cough, congestion and / or nausea. You could get the flu even if you had a flu shot. There are many mutations of the flu viruses every season. You may be one of the unlucky ones that acquired a viral mutation that was NOT one of the three in the CDC trivalent vaccine. We are seeing a lot of unlucky flu patients at Bellaire ER this season.

There is no cure for the flu. However, Tamiflu has been shown to decrease the number of days of illness if started in the first 48 hours. Along with Tamiflu, you should treat the fever by not covering up and taking Tylenol or ibuprofen. You lose a lot of fluid by evaporation when you run a fever. In addition, people often have nausea and fail to drink enough fluids. Therefore, you must keep well hydrated when you get the flu. The final treatment is pain management. The best treatment is rest, so minimize your activity. Finally remember you are highly contagious when you have the flu and are running a fever and congested. The virus is transferred most commonly with a cough or sneeze in aerosolized droplets. Protect your family by trying to keep your distance – don’t cough, sneeze or even breath near them. Wash your hands and all handles in your house.

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