The 2013 influenza season is well underway with most of the United States reporting a greater than average volume at most hospitals. Many of those seeking medical attention are doing so with Influenza like symptoms. I have compiled a list of FAQs that have recently come up:
As we head into another influenza season we are trying to improve our hospital staff vaccination rates. The goal of vaccinating hospital staff is two fold. First to keep the staff from getting influenza themselves and second by keeping the staff from getting ill they do not become involuntary spreaders of disease to hospitalized patients. Thereby protecting the chronically ill patients at the hospital. The second reason described is often forgotten and overlooked. I cannot begin to count the number of times I have been told that they do not need a flu shot because they don’t sick from the “flu”.
Remember it is more about protecting patients, the weak and infirm who may not have the ability to tolerate a respiratory tract infection
After that discussion the next heard is concerns over vaccinating patients and how the vaccine can or will make them ill. Often cited is a concern that a post vaccination fever is not discern able from a post op fever. Archives of Internal Medicine published this study in 1996 by Nichol et al. The study, a randomized placebo controlled prospective trial looked at the number of symptoms including minor ones such as injection site pain and fever post vaccination compared to placebo. Their findings include that fever post vaccination is no more common than placebo.
This is a recording of the recent lecture that I gave on West Nile virus in July of 2012.
This is a 48 minute recording of the Lyme disease presentation that was given on July 20th 2012.
This lecture focuses on the life cycle of the vector, the transmission and disease course. I also go in to the treatments and prevention of disease.
It may take minute or so to load, please be patient.
Update on the 2010-11 annual influenza vaccination season related adverse effects.
Some of the notable highlights include no increase in febrile seizures in children, no increase in post vaccine fever in adults when compared to placebo (the main hesitation to give it in hospitalized patients).
Anaphylaxis or immediate hypersensitivity is estimated to be rare (1.5 case per million doses) No cases of anaphylaxis was reported in the 2010-11 season.
Botton line: adverse events related to trivalent influenza vaccine (TIV) are very rare for all age groups. It is a safe and cost effective means to reduce influenza related morbidity and mortality.
Would you believe that parents (who do not believe in vaccination) are sending infected lollipops in the mail to one another to infect their children?
Collecting a pertussis specimen
We had a bit of confusion of pertussis collection this weekend, so I put together a brief overview on pertussis with focus on nasopharyngeal specimen collection for pertussis.
Excluding the possibility of tuberculosis is a common clinical situation. Older patients, chronic lung disease and increased use of immunosuppression increase the risk of tuberculosis reactivation and have created an increasingly common scenario where active contagious tuberculosis needs to be excluded quickly and with minimum inconvenience. Continue reading
This review was published in the Nov 18th, 2010 issue of the New England Journal of Medicine. It does a great job detailing the vaccine production and some of the pitfalls in developing newer universal vaccines; influenza vaccines that do not require annual shots. It is a must read.