Two of the three members of a Maryland family who died of flu complications last month also had been infected with the drug-resistant bacteria commonly known as MRSA, according to a report released today (April 26).

All three family members who died were infected with the influenza a virus, and two were also infected with methicillin-resistant Staphylococcus aureus (MRSA), the report from researchers at the Centers for Disease Control and Prevention said. 

The cases serve “as a reminder that influenza can cause very severe illness and can result in death,” the CDC researchers wrote.

News reports have identified the family members as Lou Ruth Blake, 81, and her children Lowell Blake, 58, and Vanessa Blake, 56, of Calvert County, Md. Three additional family members were infected with the flu and two needed to be hospitalized, but neither was infected with MRSA and both recovered, the report said.

People infected with both the flu and MRSA have a higher mortality rate than people infected with only the flu, according to the report.

Signs that a person is infected with both include a rapid worsening of symptoms, and signs of pneumonia.

Two of the three family members who died had been vaccinated against flu, according to the report. although the influenza vaccine does not prevent all cases of flu, it remains the best method for preventing complications from influenza, the CDC said. the agency recommends that all people over 6 months of age be vaccinated against the flu. Hand washing and covering coughs and sneezes can also prevent the flu from spreading, according to the CDC.

People with severe respiratory illness should be treated with antiviral medications, the report said. in addition, when there’s a high suspicion that a bacterial infection exists, treatment with antibiotics should be considered.

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Tuberculosisof the lungs

Health care officials within Immigration and Customs Enforcement (ICE) have established more than 50 “airborne infection isolation rooms” at more than a dozen different detention centers across the country to deal with those illegal aliens they suspect may already have – or might soon develop – active tuberculosis.

Each year, ICE confronts approximately 150 to 200 cases of active or suspected tuberculosis nationwide, estimated Commander Diana Schneider, ICE’s branch chief for epidemiology, who spoke with Government Security News in an exclusive phone interview on April 18. That might seem like a small percentage of the 400,000 detainees who revolve through the agency’s detention facilities each year, but Schneider considers the threat posed by the disease to be a significant challenge.

“It’s an important public health issue because case management for tuberculosis patients is complex and treatment takes a long time,” she told GSN.

The airborne infection isolation rooms, which house one detainee at a time, are designed to maintain negative air pressure (to prevent any contagions from escaping the room and infecting other detainees or staff members in the center). the isolation rooms are outfitted with High-Efficiency Particulate Arresting, or HEPA, filters, which are intended to remove the vast majority of particles from the air that passes through them.

Tuberculosis, or TB, is a common, and in many cases lethal, infectious disease that most frequently attacks the lungs. it is typically spread through the air when an infected person coughs, sneezes or spreads his or her saliva. By some estimates, about 10 percent of all tuberculosis infections eventually become active, and, if left untreated, the disease is said to kill more than half of those it infects.

ICE detention facilities are particularly vulnerable to this dangerous disease because the foreign population it detains, processes and, often deports from the U.S. generally has received less preventative health care during their lifetimes than the average American. “They have not had routine, regular medical care in the past,” explained Gillian Christensen, deputy press secretary at ICE, who also participated in the phone interview. “Rates of TB in developing countries are higher than in the U.S.,” Schneider added.

Consequently, all detainees brought into an ICE detention facility are routinely checked for TB, as a mandatory component of their general intake medical screening, said Schneider. This examination may take the form on a chest X-ray, a skin test or a new type of blood test. If health personnel at a center detect active TB, or suspect that the symptoms may soon develop, the detainee is kept in the isolation room until the situation is clarified.

Depending on the outcome of such tests, the detainee might be deemed to be free of TB and moved in with the general population, might be kept in isolation, might be moved to an entirely different medical facility (such as a local hospital) or — if they are considered not contagious — might be deported to their home country. ICE considers these options to be part of its overall “continuity of care” program for “detainees with confirmed or suspected active tuberculosis.”

Nonetheless, a detainee’s status as a legal or illegal alien in the United States is not affected by these medical considerations. “They might be started on treatment for TB,” explained Schneider, “but they would still need to be processed in conformance with immigration laws.”

Put another way, a detainee’s medical condition — even if they have an active case of tuberculosis — is not a factor when they are brought before an immigration judge. “That would not be a consideration by the immigration judge,” said Schneider.

TB might be the primary reason why a detainee would be housed in an airborne infection isolation room at an ICE detention facility, but it is not the only reason. such rooms are occasionally used to house individuals suspected of contracting chicken pox, influenza or measles, though Schneider told GSN, “I don’t recall any measles since I’ve been here.”

ICE recently awarded a $230,000 small business set-aside contract to Air Management Solutions, inc., of Powder Springs, GA, to maintain and certify the status of many of the isolation rooms at ICE detention facilities across the U.S.

If an individual detainee, in fact, has an active case of tuberculosis, but the disease has been brought under control by ICE specialists and is no longer deemed to be contagious, that person may be brought back to his or her home country. Ideally, government authorities, or non-profit charitable organizations in that country will arrange for “meet-and-greet” sessions at the port of entry, and help make arrangements for the individual’s continuing medical care.

This overall ICE initiative, which Schneider considers to be “a model for continuity of care and public health,” is part of a broader set of reforms which DHS Secretary Janet Napolitano and Assistant Secretary for ICE, John Morton, rolled out in October of 2009. the two DHS officials announced at that time that one of their goals was to “enhance detainee medical care” and pledged that ICE “will devise and implement a medical classification system that will improve awareness of an individual detainee’s medical and mental health conditions from the time the individual first enters detention.”

WASHINGTON, March 17 (UPI) — an unusually mild winter in much of the eastern United States has brought early misery to people with pollen allergies, doctors say.

Dr. Derek Johnson, medical director of the Fairfax Allergy, Asthma and Sinus Clinic in Virginia, said tree pollen counts on Feb. 23 in the Washington area were more than 100 times their level a year earlier, the Washington Post reported Monday. There were 365 grains of pollen per cubic meter in 2012, up from just 2.88 in 2011.

“It really is unusually early for patients to be this miserable,” Johnson told the Post. “The mild winter has resulted in very high pollen levels in February and early March, when they’re typically very low or negligible.”

Dr. Jackie Eghrari-Sabet, an allergist in Gaithersburg, Md., predicted “a slow, grand parade” of misery for the susceptible because some species of tree are pollinating early and others are on their usual schedule.

To complicate things further, doctors warn the flu season is not over, so people who develop respiratory symptoms or body aches and pains should not just assume it is early hay fever, WLS-TV in Chicago said.

Dr. Andrew Bonwit of Loyola University Medical Center suggested anyone with symptoms that could be influenza should consider visiting the doctor.

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Friday, March 9, 2012

The influenza virus has been steadily increasing in Kansas, spiking to its highest level this flu season.

The Center for Disease Control has identified flu activity in the state as widespread, reporting an outbreak in at least half of Kansas. Officials said while the number of influenza cases has remained lower than usual this year, the virus will continue to circulate through the spring.

“There is still time for people to get a flu vaccination to protect themselves, their families and the community,” said Robert Moser, Kansas Department of Health and Environment secretary.

The KDHE identified the first laboratory-confirmed influenza cases flu season on Dec. 21. Symptoms of influenza include fever, headache, extreme tiredness, dry cough, and muscle aches. Complications can include pneumonia, ear and sinus infections, and dehydration; influenza may also worsen other chronic conditions.

On average, five to 20 percent of the U.S. population contracts influenza yearly and more than 200,000 people are hospitalized with complications. Older people, pregnant women, young children, and people with certain health conditions are at high risk for serious complications. serious complications of the influenza can lead to pneumonia and even death.

a good way to avoidcontact from thepollen particles isto wear masks, useinhalers and getvaccinated.

ISLAMABAD: 

The recent rains in the capital have somewhat diluted the expected surge in the number of pollen allergy cases. On the flip side, the sudden increase in the number of patients suffering from influenza virus has taken the health experts by surprise.

“Due to similarity in symptoms pollen allergy and influenza virus attack are often confused. However, the main differentiating factor is that only patients of influenza virus suffer from fever, said an expert.

Taking about the affected patients, he said, “If they do not take timely precautionary measures, it (influenza) could make them vulnerable to severe pollen allergy this year.”

Institute of Medical Sciences Senior Chest Physician Dr Asadullah Nemati said that only few patients with pollen allergy are visiting him. But the percentage of those coming in with influenza virus is quite high.”In the last 10 days, 60 per cent of the patients have come to me with influenza, which is very rare,” he said. He added that due to the recent rains, pollen particles have settled down and are not affecting people much.

The World Health Organization on Global Alliance against Chronic Respiratory Diseases adviser Dr Muhammad Osman Yusuf said that this year, pollen allergy will start with a delay due to the recent rains. the season usually starts at the end of February. He added, “If it rains before March 22, there will be severity in pollen allergy and if after March 26, then the intensity will be low.”

He expressed concern over a large number of influenza patients being reported in the country since last November. He said that majority of the people who went for Umrah or Hajj last year returned with influenza as they were not properly vaccinated. Thousands of people were affected last year and many died but no record of such huge numbers is available with the government.

Moreover, due to lack of awareness, many people get vaccinated only once, when they should get a doze every month. He expressed dissatisfaction over the standard of vaccines being given to the people at public institutes. “Just before it is about to rain and humidity is high, one should avoid going around as it could cause a severe attack,” he added.

Meanwhile, pollen allergy still remains a potent threat. the doctors have warned people against going out when it is cloudy, as that is the peak time the pollen particles are suspended in the air. a good way to avoid contact from these particles is to wear masks, use inhalers and get vaccinated, said an expert.

Published in the Express Tribune, March 6th, 2012.

February 18, 2012    07:20 am Sabrina Ambler, MML News Reporter

Sonora, CA — the first case of influenza was positively identified yesterday in Tuolumne County marking an unusually late start to flu season.

According to Tuolumne County Health Officer, Dr. Todd Stolp, “flu season is any month, usually from October to March, in which officials expect people to contract influenza.” Dr. Stolp noted that last winter reports of positive tests for influenza started January 25th and peaked February 26th. he noted that hundreds of people likely had the flu last year but many do not report their symptoms and even fewer are tested for influenza. in the winter of 2009 the peak of the reports occurred much earlier at the end of October.

According to an associated Press report, this year is the slowest start to a flu season in nearly 25 years. Citing CDC officials, it was noted that the flu season hasn’t occurred this late since the winter of 1987-1988. the report noted nationally only California in the last two weeks, and Missouri, have documented cases so far.

According to Dr. Stolp numerous cases of RSV, (Respiratory Syncytial Virus) a fairly common respiratory virus, with similar symptoms to influenza have been reported in Tuolumne County this winter.

Influenza is highly contagious, health officials recommend frequent hand washing, coughing into your elbow, and staying at home when you are sick.

Written by Sabrina Ambler

By Jan SchultzThe Imperial Republican Several lab-diagnosed cases of influenza have Chase County Schools’ students at home this week or just returning to class. School Nurse Angie Paisley said the annual flu bug is showing up more among grade 7-12 students, several of which have the confirmed diagnosis after lab tests. two to three K-6 students have also been sent home, or stayed home, with symptoms, she said. the symptoms started showing up among students last week, Paisley said. They include the sudden onset of fever, chills, headache, dry cough or muscle aches. “They came in the morning fine and by afternoon they were sent home,” she said, one with a temperature as high as 102-plus degrees. Paisley said the best defense against influenza is keeping your immune system healthy. Besides getting a flu shot, those include getting enough sleep, adequate nutrition, regular hand washing and keeping your hands away from the eyes, nose and mouth. “Managing your stress level is another one,” Paisley said. the Southwest Nebraska Public Health Department (SWNPHD), which covers Chase County, sent out a release Tuesday announcing the first lab-confirmed influenza case in their area had been reported. Director Myra Stoney confirmed later that day by phone the case was in Chase County. Stoney said, even though cases are now confirmed in this area, it’s still wise to get a flu shot.     “It’s still beneficial,” she noted. “It takes two weeks to get full immunity” from the shot. the flu season typically peaks in February. She said sometimes the focus for flu shots is with adults, or senior citizens, whose immunity may be compromised. “We forget about the youths sometimes,” she said. That hasn’t been the case at the Chase County Immunization Clinic, reports coordinator Chris Tomky, R.N. She suspects their clinic has given 150 to 200 doses of the flu shot this season to youths age 18 and younger. her clinic operates the second Saturday of the month at the hospital. a check with Chase County Clinic in Imperial shows they still have the flu shot available. Appointments are not necessary, but a doctor must be at the clinic at the time the flu shot is given. Stoney noted the SWNPHD office in McCook, located one block north of Arby’s, has recently been named a Vaccines for Children site, and now provide the immunization and flu shots for youths 18 and younger, as well, and they have them available. People should call the office at 308-345-4223. the flu shot is recommended by health departments for everyone six months and older this season. Stoney noted it appears this year’s season hasn’t peaked yet, so a flu shot is still a good choice. Many insurance companies now provide 100 percent coverage for the flu shot, too, since it’s a preventative effort.      It’s also important to stay home when you are sick, Stoney added, especially with a fever. People should not return to school or work until they are fever-free for a minimum of 24 hours, without fever-reducing medicines.Stomach flu also a problem School Nurse Paisley said they’ve been dealing with gastro-intestinal (GI) illness at CCS much longer than with influenza. “This is the main thing we’ve been dealing with for two to three months,” she said. Symptoms of that illness include nausea, vomiting and diarrhea. Stoney said sometimes influenza and “stomach flu” are viewed as the same. “Don’t confuse them. Influenza is in your lungs. GI attacks your stomach and/or digestive tract,” she said.

I received my annual flu shot back in October, and I have to say, I felt pretty good about myself. though doctors constantly tell us to get vaccinated, most Americans don’t bother — a survey by the Centers for Disease Control and Prevention (CDC) in November indicated that just 36% of all Americans age 6 months and older will get the flu vaccine. That’s too bad — a simple flu shot can save the average person days of unhappy illness (and lost time at work or school) if they get exposed to the flu this winter. and for the very young, the very old and the immunocompromised, a flu vaccination might make the difference between life and becoming one of the 30,000 some Americans who die from influenza-related causes each year.

There’s just one problem: influenza is unpredictable. Flu viruses are notoriously promiscuous, which isn’t a judgment of their morals, but their genes. Flu viruses mutate constantly, sometimes on their own as they replicate inside an infected cell, and sometimes through recombination — directly swapping genes with other flu viruses. We need a new vaccination every year because the flu strains we might be exposed to over the winter differ from season to season. The flu shot itself is actually a trivalent vaccine, meaning that it protects against the three separate flu strains that experts believe are most likely to be circulating around the Northern Hemisphere this winter. if all goes well, you’re unlikely to be exposed to a flu strain that’s not covered by the vaccine.

Unless, of course, something unexpected occurs. and that may indeed be happening this winter.

Since the middle of August, the CDC has received 12 reports of human infections with a new flu virus — a swine influenza a strain called H3N2. so far the cases come from five states — Indiana, Iowa, Maine, Pennsylvania and West Virginia — and all but one of the affected individuals were below the age of 18. while the virus itself seems to have originated in pigs and initially jumped directly from swine to human beings, half of the cases had no documented contact with pigs, which means there’s at least minimal person-to-person transmission. Because there’s already a common seasonal flu called H3N2, health officials are calling the new strain H3N2v — meaning v for “variant.”

Twelve cases may not seem like much, especially since only three required hospitalization and no one so far has died. but in an article for Scientific American earlier this month, ace flu reporter Helen Branswell explained why the possible emergence of a new flu strain worries health officials — even as they fear overly alarming the public:

The cases leave public health authorities in the U.S. and elsewhere wondering if a new swine-origin flu virus is circulating at low levels among humans — and what needs to be done if that is indeed happening. (Read “Flu Factories” in the January 2011 Scientific American (preview) to learn why health authorities fear the next pandemic virus may emerge as a result of industrial farming  practices.)

Given the mercurial nature of flu viruses — which can easily mutate into lethal pathogens — ignoring the new virus is not an option, even though to date there have been no deaths and most of the infections have produced only mild symptoms. but the widespread perception that the 2009 swine flu pandemic was much ado about nothing means health authorities risk further damage to their already battered credibility if they sound an alarm and this virus turns out to be a dud. and they know it.

In fact, what unfolds with H3N2v could be similar to what happened in 1977, when H1N1 flu viruses suddenly re-emerged — possibly through a lab accident — after a 20-year absence. The new H1N1 infected mostly younger people who had never been exposed to a similar flu strain before, while older people proved more resistant.

Rick Jordahl, Associate Editor, Pork Network   |   Updated: December 30, 2011

Swine-origin influenza viruses identified in humans will now be referred to as “variant” viruses and denoted with a “v,” according to the U.S. Centers for Disease Control and Prevention. The decision was made after discussions among the World Health Organization (WHO), the World Organization for Animal Health, the Food and Agriculture Organization, CDC, and other U.S. federal agencies.

An official from the National Pork Board expressed optimism for the new naming system. “we welcome the scientific view on naming these viruses,” said Paul Sundberg, DVM, vice president, science and technology, NPB. “This new nomenclature will make communications more accurate and help prevent unintended consequences of naming a virus based on just one part of its genetic makeup.” Sundberg said the new naming system will help avoid implicating any of the genetic contributors of recombinant influenza viruses.

This change in nomenclature follows an announcement by WHO of a decision to standardize nomenclature for the pandemic influenza a (H1N1) 2009 virus (which has had diverse names) as influenza a (H1N1)pdm09. Influenza viruses identified in swine populations will continue to be referred to as “swine influenza” viruses.

Human infections with the influenza viruses currently circulating among swine are rare, according to CDC. since 2005, only 35 cases have been reported in the United States, but the frequency with which they have been detected increased in 2011.

Since August 2011, CDC has identified 12 human infections in five states with swine-origin influenza a (H3N2) viruses. per the new naming convention, these H3N2 viruses will now be referred to as “influenza a (H3N2) variant viruses with genes from avian, swine and human viruses,” and will be abbreviated as “A(H3N2)v” for scientific use and “H3N2v” for general public use. these 12 A(H3N2)v viruses also have the M gene from the A(H1N1)pdm09 virus. Of the 12 cases, two were from Indiana, three from Iowa, two from Maine, three from Pennsylvania, and two from West Virginia.

To minimize the risk for interspecies influenza transmission, CDC and the Occupational Safety and Health Administration (OSHA) encourage swine workers to be vaccinated against human seasonal influenza, wear appropriate personal protective equipment, and practice good hygiene, such as washing hands thoroughly with soap and water, when in contact with swine, especially swine that show signs of illness.

The National Pork Board also recommends producers work with their veterinarian to develop appropriate prevention and control measures for influenza in swine, which can include vaccinating swine against swine influenza. Similar to humans, swine infected with influenza viruses do not always exhibit signs of infection. Persons with swine exposure in the week before onset of an illness with symptoms of influenza requiring medical care should notify their health-care provider of their swine exposures.

Persons who develop symptoms of influenza after close contact with swine are recommended to stay home until well to minimize contact with persons and swine as much as possible.

In July 2009, USDA’s Animal and Plant Health Inspection Service and the swine industry implemented a SIV surveillance program to characterize the distribution of SIV in U.S. swine herds. to date, approximately 150 SIV isolates have undergone sequencing of three genes (hemagglutinin, matrix, and neuraminidase gene segments).

Read more.  

This is the time of the year when reported cases of cold, flu and pneumonia are high. Infants, children and the elderly are at higher risk of acquiring one or more of these diseases and often have severe forms of the diseases with additional complications. Uninfected individuals are likely to acquire infectious virus particles that are shed from patients in their nasal and oral secretions such as saliva and sneeze droplets, making direct and close contact the major transmission routes for the viruses.

COMMON COLD

Common cold is an illness that can be found all year round but is most prevalent during the winter months. a number of different viruses can cause the common cold but infection by a single type of virus is more commonly the case. The human immune system has an amazing memory capable of remembering the virus after recovery therefore preventing the same virus from causing the disease again because the immune system can recognise and eliminate the virus before it can cause any illness.

Transmission

Viruses are found in oral and nasal secretions and are spread via cough, sneeze or direct contact with surfaces or objects that are contaminated with the virus.

Symptoms

The symptoms usually present themselves one to three days after acquiring the virus with the most common being fever, fatigue, muscle pain, headache, coughing, sore throat and increased nasal secretions or sometimes leading to nasal congestion. The lymph nodes around the neck may become inflamed. Infants can rapidly develop severe fever and may also suffer from diarrhea.

Secondary bacterial infections

If the patients do not recover within four days, secondary bacterial infections may cause additional complications such as tissue damage or toxins. Tonsillitis, sinusitis, otitis media (middle ear infection), pharyngitis and pneumonia are examples of diseases that may result from co-infection with the bacteria. Infants are at risk of suffering from deadly shock from high fever and rapid fluid loss thus professional medical care is very important. Common cold usually resolves itself within a week and the best cure is to take lots of rest, drink plenty of clean water and consume a well-balanced diet.

INFLUENZA

Influenza is an acute respiratory disease caused by the influenza virus. The virus has the potential to cause a global pandemic as already seen in 1918 when Spanish flu killed more than 50 million people worldwide. it has been estimated that each year about 15% of the global population is infected with the virus during the winter months. Last year Thailand confirmed 115,183 reported cases of the flu or 180.82 per 100,000 individuals with a mortality rate of 0.2 per 100,000 individuals. The country had seen a constant decline in the number of cases between 2002 and 2006, but then experienced a significant increase in the number in 2009 with the number of confirmed flu cases being 189 per 100,000 individuals. The group with the highest infection rate is children under the age of four and the group with the highest mortality rate is the elderly group above the age of 55. Therefore, these two groups should take extra preventative measures against the influenza virus.

Transmission

Influenza virus is found in oral and nasal secretions of infected patients and spread via close or direct contact.

Infectious period

Patients may begin to shed infectious virus particles one or more days before the appearance of any signs and symptoms and can continue to shed the virus three to five days after the signs and symptoms have disappeared making the disease very difficult to control. Children and infants may continue to shed the virus for more than a week.

Symptoms

Symptoms caused by influenza are usually more severe when compared with viruses that cause common cold. The patient will start to display symptoms one to four days after becoming infected. most common symptoms are rapid onset of fever, shivering, severe headache, nausea, headache, fatigue, sore throat, coughing and pharyngitis. The recovery period usually ranges from one to two weeks. Secondary bacterial infections can lead to complications that may result in death in some patients, particularly those that are immunocompromised or immunosuppressed.

PREVENTION AND RECOMMENDATIONS

- Avoid coming in close contact with patients infected with the virus.

- Wash hands with soaps and clean water regularly and before every meal.

- Avoid touching or rubbing the mucosal areas _ eyes, nose and mouth.

- Maintain good health by exercising regularly, getting enough sleep and consume a well-balanced diet.

- get vaccinated every year (It is recommended that those older than six months, especially the high risk groups be vaccinated every year).

HOW TO ACT ONCE YOU BECOME INFECTED

- get enough rest and sleep.

- Keep your body warm with sufficient clothes and avoid rain, cold weather and cold water when showering.

- Stay in a well-ventilated room.

- Drink lots of clean, warm water to keep the body well hydrated and avoid cold water.

- Consume foods that are easy to digest and fruit juices that are rich in vitamins.

- never share utensils with other people.

- Use a mouth cover to help minimise spreading of respiratory droplets that contain infectious viruses.

- Wash hands with soap and clean water regularly.

- Rinse your mouth often with clean water.

- Keep a distance from young children, the elderly, immunocompromised and immunosuppressed individuals.

Next week, getting to know pneumonia and how to prevent it.

About the author Writer: Bangkok Hospital Research Centre Latest stories in this category: