Thursday, February 19

Health Care and Measles Update 2015

I have been writing this health care blog since 2007, and have published over 465 articles in the last eight years—sort of a Health Care 101 on all types of health care issues. For the most part, not too many of those have been updated with a follow up report—until this one. In 2012, I wrote an article about measles. With the recent outbreak in the US of this disease, just about wiped out fifteen years ago with only a few cases reported per year, has merited that this health care issue be re-examined.

Late last year, new cases of this very infectious disease started showing up. Since then, the number of measles cases in the United States has reached 141 patients in 17 states and the District of Columbia, federal health officials from the CDC have reported. The outbreak began at two Disney theme parks in southern California in December, the CDC says, and it's believed that the source of the infection was likely a foreign visitor or a U.S. resident returning from abroad.

Measles is still common in many parts of the world, including some countries in Europe, Asia, the Pacific and Africa, according to the U.S. Centers for Disease Control and Prevention (CDC). The majority of people who've gotten measles in the current outbreak were unvaccinated. This is not good. Despite the United States having declared measles eliminated in 2000, the virus has awoken anew, and with all the grace and predictability of a large bear coming out of sedation.

According to the UK Independent, Though best known for its telltale dappled rash, measles is a wildly infectious upper respiratory disease. Like the flu, it's airborne  –  and successful. It has a near-perfect infection rate: Put your baby in a room with a measles patient, and nine times out of 10, measles is coming home with you. In the space shared between you and a coughing, sneezing measles-ridden sap, the sweet oxygenated room air and unavoidable door handles are thought to remain infectious for up to two hours.

And measles delivers a double whammy because a person becomes infectious before they even know they have it. Four days prior to the rash is when most people become able to spread the love. Here's how the virus pulls it off.

Symptoms start out like standard-issue wintertime gunk: fever, cough, runny nose, red eyes. A few days of that misery and the decorative stage of the illness starts with a carpet of red lesions. Koplik's spots may appear before the rash  –  that's when the bright, beefy red of the inner cheeks become studded with lots of tiny, blue-white dots.

Complications from measles arise in almost one in three reported cases, and range from diarrhea (8 per cent) and pneumonia (6 per cent) to encephalitis (0.1 per cent) and death (0.2 per cent). It gets worse. For more details about how measles develops, visit this site: http://www.independent.co.uk/life-style/health-and-families/features/measles-makes-its-mark-all-over-again-one-of-humanitys-oldest-foes-is-back-on-the-increase-10054872.html#

According to the CDC it’s possible that measles could become endemic (constant presence of a disease in an area) in the United States again, especially if vaccine coverage levels drop. This can happen when people forget to get vaccinated on time, don’t know that they need a vaccine dose (this is most common among adults), or refuse vaccines for religious, philosophical or personal reasons. The measles vaccine is very effective. One dose of measles vaccine is about 93% effective at preventing measles if exposed to the virus, and two doses are about 97% effective.

Research shows that people who refuse vaccines tend to group together in communities. When measles gets into communities with pockets of unvaccinated people, outbreaks are more likely to occur. These communities make it difficult to control the spread of the disease and make us vulnerable to having the virus re-establish itself in the US. High sustained measles vaccine coverage and rapid public health response are critical for preventing and controlling measles cases and outbreaks.

People who received two doses of measles vaccine as children according to the U.S. vaccination schedule are considered protected for life and do not ever need a booster dose. Adults need at least one dose of measles vaccine, unless they have evidence of immunity.

Adults who are going to be in a setting that poses a high risk for measles transmission, including students at post-high school education institutions, healthcare personnel, and international travelers, should make sure they have had two doses separated by at least 28 days. If you’re not sure whether you were vaccinated, talk with your doctor. Significant amounts of material about measles is available at the this CDC site: http://www.cdc.gov/measles/.

Children are especially susceptible to measles. According to this website: http://kidshealth.org/parent/infections/lung/measles.html, infants are generally protected from measles for 6 months after birth due to immunity passed on by their mothers. Measles vaccine usually is not given to infants younger than 12 months old. But if there's a measles outbreak, or a child will be traveling outside the United States, the vaccine may be given when a child is 6-11 months old, followed by the usual MMR immunization at 12-15 months and 4-6 years of age.

The measles vaccine sometimes causes side effects in kids who don't have underlying health problems. The most common reactions are fever 6-12 days after vaccination (in about 15% of kids vaccinated) and a measles-like rash, which isn't contagious and fades on its own (in about 5% of vaccinated kids). As with all immunization schedules, there are important exceptions and special circumstances. Your doctor will have the most current information about vaccine recommendations. The measles vaccine should not be given to these at-risk groups:

--Pregnant women
--Kids with untreated tuberculosis, leukemia, or other cancers
--People whose immune systems are weakened for any reason
--Kids who have a history of severe allergic reaction to gelatin or to the antibiotic neomycin, as they could have serious reactions to the vaccine

According to Forbes Magazine, it doesn’t take much for this disease to spread through a population that isn’t immune from previous exposure or through vaccination. Or, to put it another way, in an unvaccinated population, each person infected with the measles will transmit the disease to 12 to 18 other people. However, no vaccine can protect 100% of those who receive it; vaccines can fail.

The antibodies your body creates can wane, or your body may not have sufficiently responded to the vaccine in the first place. But those who are unvaccinated are at a greater risk by far. An unvaccinated person is 35 times more likely to catch measles than a vaccinated person.

Protection against measles is delivered within the MMR (measles-mumps-rubella) vaccine. The second dose of the vaccine brings its effectiveness up to 99%. It’s a live vaccine, which ramps up the fear factor for some people, but it’s a vaccine we’ve been using since 1971. There is almost five decades of data with hundreds of millions of vaccinated individuals, and the medical community knows precisely the possible side effects of the vaccine.

The most common ones are a fever in one of six people, a mild rash in one of 20 people, and swollen glands in the cheeks or neck in one of 75 people. In one of every 3,000 doses, a child can experience a seizure caused by high fever, but febrile seizures do not cause any long-lasting damage, and they can be caused by illness (including measles) as well. A condition of low platelets, called ITP, can also occur in one out of 30,000 doses but usually goes away on its own. Any other severe occurrences that have been reported after the vaccine are, according to the CDC, “so rare that it is hard to tell whether they are caused by the vaccine.”

Measles is not a harmless childhood disease. It can kill and leave others with lifelong disabilities. Even if a person has an uncomplicated course of the disease, it’s still just a really miserable way to spend your time – a high fever, cough, sore throat and rash covering your entire body.

The problem is, there’s not much anyone can do for you when you’re sick except to help keep you hydrated. Doses of Vitamin A can reduce the severity of the symptoms, but is not a cure. More detailed information about the effects of measles on the population is available at this site: http://www.forbes.com/sites/tarahaelle/2015/01/20/five-things-to-know-about-the-disneyland-measles-outbreak/.

So, what is the answer? Initially, and very importantly, consult your doctor if you think you or your child have contracted the disease or may be symptomatic. Secondly, get vaccinated if you can at all possible. The benefits and effects of vaccination for measles far outweigh the risks. Third, stay away from anyone who has measles. Practice smart health. It’s simply best for you and your family.

Until next time.

 

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Friday, February 13

Health Care and Herbal Tea

For thousands of years, tea and the art of drinking it has had special significance in cultures around the globe. Japan, China, England, and the US are all huge markets for tea. Drinking tea can help your heart, boost your brainpower, keep your metabolism humming, and more according to Fitness Magazine. Entire industries have been built around tea, and America’s revolution against Great Britain was ignited over the Boston Tea Party in 1773.

Studies suggest that one cup of tea may contain up to five times more antioxidants than any fruit or vegetable. These disease-fighting compounds may help prevent certain cancers, keep your heart healthy, burn fat and ward off weight gain, sharpen your mind, and help your body beat the effects of aging and stress, according to experts reporting in Fitness Magazine. Much more detail on this topic can be found at this website: http://www.fitnessmagazine.com/recipes/drink/tea-health-benefits/ 

Although tea in general is a great beverage and has many healthy attributes, herbal tea has been found to be very good way to achieve even more ways to help your mind and body. According to Reader’s Digest Best Health Magazine, from soothing a troubled tummy to easing insomnia and calming a troubled mind, herbs have all sorts of healing powers. Drinking herbal tea can also be a great source of vitamins and minerals.

Herbal tea isn’t really made from tea—which is a specific kind of plant. The French use the word tisane, which is a little more accurate, since herbal tea is really just an infusion of leaves, seeds, roots or bark, extracted in hot water. In drinking a well-steeped herbal tea, you get all the plant’s benefits in an easily digestible form.

When it comes to choosing a herbal tea, it’s important to look for a well-sourced product made from high-quality ingredients. If you’re drinking tea for the medicinal benefits, then definitely steer clear of products that add things like essential oils or flavors. And to really get the full benefits from drinking herbal tea, make sure you steep your loose tea or tea bags long enough—in some cases, as long as 10 to 15 minutes—to really bring out all the healthful properties. More detailed information about herbal tea can be found at this website: http://www.besthealthmag.ca/best-eats/nutrition/7-herbal-teas-that-will-make-you-healthy#LV9ZqPRy1MCKcwhL.97.

According to the Dallas Morning News, there are teas that claim to boost the immune system, relieve constipation or sleeplessness, promote healthy liver function, healthy digestion or healthy lactation, or to support the cardiovascular system or prostate health. But do they really work? For most, the benefits are modest at best, according to Michael Rotblatt, professor at the David Geffen School of Medicine at UCLA. He says that “Most of the manufacturers are basing their information on folklore or on whatever studies they can find.”

The good news for tea lovers is that plenty of data suggests health benefits from green or black tea, but few medicinal teas contain either, according to the report. Instead, they’re made with herbals like chamomile, dandelion, sarsaparilla, licorice root, saw palmetto, fennel or stinging nettle. Evidence has shown the benefits of some, such as ginger, hibiscus and peppermint.

The evidence of healthy benefits is much more credible for green tea and black tea, according to Neva Cochran, a registered dietitian in Dallas who has written about tea’s healthy ingredients in Food & Nutrition Magazine, published by the Academy of Nutrition and Dietetics. However, the experts interviewed agreed on this: Tea is more healthful than soda. Unless you sweeten it with lots of sugar, tea will quench your thirst and help you hydrate without adding a lot of calories. All teas — black, green or herbal — contain phytochemicals, a key ingredient in the fruits and vegetables that we already know are part of a healthy diet.

The Dallas Morning News continues to report that more research is needed to back up the claims of most herbal teas, but nutritionists point to three exceptions that they say may offer modest benefits:

Ginger tea: Helps with nausea. Studies have shown that ginger may have a positive effect on digestion. Ginger helps with digestion by speeding up the movement of food from the stomach into the small intestine, according to one study.

Hibiscus tea: One study showed lowered blood pressure among people who drank this tea three times a day.

Peppermint tea:The oil in peppermint leaves may help with upset stomach by calming muscle spasms in the digestive tract.

Regardless of the science, the reason most people drink tea is because they like it. On any given day, 158 million Americans drink tea (including iced tea), and about three-quarters of them say they’re aware of the health benefits, according to the Tea Association of the U.S.A. More information can be found at this site: http://www.dallasnews.com/lifestyles/health-and-fitness/health/20140428-do-the-health-benefits-of-herbal-teas-live-up-to-the-hype.ece

Be careful, though, about any medical issues related to drinking various herbs, especially if you are pregnant, are on prescription medications, or have a reduced immune system. Herbal tea may taste good and help make you feel better or relax you. It may even provide a healthy stimulus to your day and provide the opportunity to enjoy the company of others who share the same desires and interests. However, if you are in one of the health watch categories mentioned here, talk with your family doctor or a health care provider to make sure you are approved to drink herbal tea.

Until next time.
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Monday, February 9

Health Care and Diabetes

One of the fastest growing health issues worldwide is diabetes. People with type 1 diabetes today lose more than a decade of life to the chronic disease, despite improved treatment of both diabetes and its complications, a new Scottish study reports. Men with type 1 diabetes lose about 11 years of life expectancy compared to men without the disease. And, women with type 1 diabetes have their lives cut short by about 13 years, according to a report published in the Journal of the American Medical Association.

 Glucose (blood sugar) is vital to your health because it's an important source of energy for the cells that make up your muscles and tissues, according to the Mayo Clinic. It's also your brain's main source of fuel. If you have diabetes, no matter what type, it means you have too much glucose in your blood, although the causes may differ. Too much glucose can lead to serious health problems.

Chronic diabetes conditions include type 1 diabetes and type 2 diabetes. Potentially reversible diabetes conditions include pre-diabetes — when your blood sugar levels are higher than normal, but not high enough to be classified as diabetes — and gestational diabetes, which occurs during pregnancy but may resolve after the baby is delivered. More info about this health topic is available at this website: http://www.mayoclinic.org/diseases-conditions/diabetes/basics/definition/con-20033091.

According to the American Diabetes Association, type 1 diabetes is usually diagnosed in children and young adults, and was previously known as juvenile diabetes. Only 5% of people with diabetes have this form of the disease. In type 1 diabetes, the body does not produce insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. With the help of insulin therapy and other treatments, even young children can learn to manage their condition and live long, healthy lives. Much more detailed information can be found at this website: http://www.diabetes.org/diabetes-basics/type-1/ .

However, type 1 diabetics younger than 50 are dying in large numbers from conditions caused by issues in management of the disease -- diabetic coma caused by critically low blood sugar, and ketoacidosis caused by a lack of insulin in the body. These conditions really reflect the day-to-day challenge that people with type 1 diabetes continue to face, how to get the right amount of insulin delivered at the right time to deal with your blood sugar levels, according to the study. 

A second study, also in JAMA, suggested that some of these early deaths might be avoided with intensive blood sugar management. Strict control of blood sugar appears to be key. Life expectancy lost for people under 50 is due to diabetes management-related complications like diabetic coma or ketoacidosis, a condition in which the body suffers from high levels of poisonous acids called ketones. These ketones are created when the body burns fat for energy, because low insulin levels are preventing the conversion of blood sugar into fuel. More details can be found at this site: http://media.jamanetwork.com/news-item/scottish-study-finds-substantially-shorter-life-expectancy-for-patients-with-type-1-diabetes/ .

Also,  people with diabetes are less likely to take their diabetes medications if they've been diagnosed with cancer, researchers report in Diabetologia. This study revealed that the medication adherence among users of [blood sugar-lowering drugs] was influenced by cancer diagnosis. Cancer patients with diabetes are also much more likely to die than those without diabetes, and part of that might be explained by the decline in medication adherence, according to the study. More information about this particular diabetes health issue is located at this website: http://www.diabetologia-journal.org/ .

Although it is a common practice to try pills before insulin if you are diabetic, you may start on insulin based on several factors. Insulin is a naturally occurring hormone secreted by the pancreas. Many people with diabetes are prescribed insulin, either because their bodies do not produce insulin (type 1 diabetes) or do not use insulin properly (type 2 diabetes), according to the American Diabetes Association.

There are more than 20 types of insulin sold in the United States. These insulins differ in how they are made, how they work in the body, and how much they cost. Your doctor will help you find the right type of insulin for your health needs and your lifestyle. For more details on this medicine and how it should be administered, visit this website: http://www.diabetes.org/living-with-diabetes/treatment-and-care/medication/insulin/.

Type 2 diabetes can have a slow onset, and early symptoms can be confused with signs of stress, being overweight, or a poor diet. But the arsenal of tools to combat diabetes grows every year. Diabetes affects 24 million people in the U.S., but only 18 million know they have it. About 90% of those people have type 2 diabetes, according to Health.com. In diabetes, rising blood sugar acts like a poison.

Diabetes is often called the silent killer because of its easy-to-miss symptoms. The best way to pick up on it is to have a blood sugar test. But if you have these symptoms, see your doctor.
If Also, if you need to urinate frequently—particularly if you often have to get up at night to use the bathroom—it could be a symptom of diabetes.

The kidneys kick into high gear to get rid of all that extra glucose in the blood, hence the urge to relieve yourself, sometimes several times during the night. The excessive thirst means your body is trying to replenish those lost fluids. These two symptoms go hand in hand and are some of your body's ways of trying to manage high blood sugar.

Overly high blood sugar levels can also cause rapid weight loss, say 10 to 20 pounds over two or three months—but this is not a healthy weight loss. Because the insulin hormone isn't getting glucose into the cells, where it can be used as energy, the body thinks it's starving and starts breaking down protein from the muscles as an alternate source of fuel. The kidneys are also working overtime to eliminate the excess sugar, and this leads to a loss of calories (and can harm the kidneys). For more detailed info on more symptoms, visit this site: http://www.health.com/health/gallery/0,,20442821,00.html.

There can be complications in your health caused by diabetes, according to Medical News Today. Here are a few complications linked to badly controlled diabetes:

Eye complications - glaucoma, cataracts, diabetic retinopathy, and a few others.

Foot complications - neuropathy, ulcers, and sometimes gangrene which may require amputation.

Skin complications - people with diabetes are more susceptible to skin infections and skin disorders.

Heart problems - such as ischemic heart disease, when the blood supply to the heart muscle is diminished.

Hypertension - common in people with diabetes, which can raise the risk of kidney disease, eye problems, heart attack and stroke.

Mental health - uncontrolled diabetes raises the risk of suffering from depression, anxiety and some other mental disorders.

Neuropathy - diabetic neuropathy is a type of nerve damage which can lead to several different problems.

Stroke - if blood pressure, cholesterol levels, and blood glucose levels are not controlled, the risk of stroke significantly increases.

Erectile dysfunction - male impotence.

Infections - people with badly controlled diabetes are much more susceptible to infections

Many presumed "facts" are thrown about in the paper press, magazines and on the internet regarding diabetes; some of them are, in fact, myths. It is important that people with diabetes, pre-diabetes, their loved ones, employers and schools have an accurate picture of the disease. For a more exhaustive overview of information about diabetes, visit this website: http://www.medicalnewstoday.com/info/diabetes/.

Over 25 million men, women, and children currently suffer from diabetes in the country. It is the fastest growing health problem in the US. And, almost 80 million people are considered pre-diabetic. This disease is complicated and often takes time to diagnose, unless the complications are severe. Your doctor or health care provider should run tests to see if your symptoms are conclusive. If you or a loved one has diabetes, don’t ignore your lifestyle regimen. Diabetes can lead to severe medical problems or death when left untreated. Keep your diabetes under control, and you can lead a better life.

Until next time.
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