“People don’t necessarily think of influenza when you include the symptoms of nausea or vomiting, but our study showed that they are common with influenza in pregnancy,” said Dr. Vanessa Rogers, assistant professor of obstetrics and gynecology and lead author of the study, which appears in the May edition of Obstetrics and Gynecology.

“Both physicians and patients should be aware of these findings so treatment is not delayed,” she said. “I think our findings should encourage people to be vigilant and to take symptoms seriously.”

Adults with flu tend not to have nausea or vomiting, according to the Centers for Disease Control and Prevention. These symptoms are more typical in children.

The researchers studied the cases of pregnant women during the 2003-2004 flu season, when the most common strain of influenza caused more severe symptoms than usual. There also were more cases of flu than expected, because the vaccine given that year didn’t match the strain that was predominant.

During that period, 107 pregnant women were diagnosed with flu at Parkland Memorial Hospital in Dallas. Ninety-three percent of the women had a cough, and 89 percent had fever common signs of flu the researchers found. Eighty-five percent had a “profound” elevated heart rate, and 60 percent had nausea and/or vomiting. Although “morning sickness” and nausea are common during pregnancies, the researchers said that reporting any unusual additional symptoms (fever, coughing, elevated heart rate) could help diagnose the disease earlier in these patients.

Nearly two-thirds of the expectant women treated at Parkland were sick enough to require hospitalization. The most common complication was pneumonia, which occurred in 12 percent of the cases.

Despite the illness, there was no significant difference in complications between women with flu and women without flu who gave birth at the hospital during flu season. After birth, the babies also showed no significant difference in complications.

“Early diagnosis and treatment might be the reason our patients did so well,” Dr. Rogers said.

Other UT Southwestern researchers involved in the study were Dr. Jeanne Sheffield, associate professor of obstetrics and gynecology; Dr. Scott Roberts, professor of obstetrics and gynecology; Dr. Donald McIntire, professor of obstetrics and gynecology; Dr. James Luby, professor of internal medicine; Sylvia Trevino, infection preventionist in internal medicine; and Dr. George Wendel, professor of obstetrics and gynecology.

Source: UT Southwestern Medical Center

“Most colds resolve without progressing to a sinus infection,” Wild said. “However, acute sinus infections those that last less than two weeks almost always begin as a cold.”

Telling the difference between the two illnesses can be difficult because they share many symptoms, such as headaches, congestion and discolored nasal drainage. However, if you experience a fever, persistent or worsening symptoms that last longer than seven days, thick nasal mucus or dental pain, you have most likely developed a sinus infection, Wild warns.

To keep a cold from turning into to a sinus infection, Wild recommends using saline nasal rinses such as a nettie pot or NeilMed Sinus Rinse™, as well as acetaminophen or ibuprofen. Decongestants, such as Sudafed, Mucinex and Vick’s Vapor Rub, cool mist vaporizers or even sitting in a steamy shower also may help. Of course there’s no substitution for resting and staying well hydrated.

Antibiotics are effective only when the sinus infection is caused by a bacterial infection something that only can be determined by a physician. Wild recommends starting with over-the-counter treatments before talking to your doctor about antibiotics.

People who experience frequent sinus infections, have an infection that lasts more than two weeks or have been diagnosed with abnormal nasal anatomy, such as a deviated septum or polyps, should see an otolaryngologist and have sinus imagining Xrays or CT scan.

“Imaging studies are a must to prove the diagnosis of sinus problems like an infection or polyps. If the diagnosis is made, I usually prescribe antibiotics for four to six weeks, combined with oral steroid medications and possibly a nasal steroid spray for the patient. Many times, I also do allergy testing in an attempt to identify a correctable cause for the infections,” Wild said.

“Following initial treatment and allergy testing, a repeat CT scan is often done. If the patient’s symptoms are not responsive to medication or he or she continues to have an abnormal sinus scan, then the next step is usually sinus surgery.”

Sinus Infection Prevention

The best sinus infection, though, is the one you never get in the first place. To keep a sinus infection at bay, Wild offers these five tips:

• Avoid contact with people who have colds.
• Wash your hands frequently.
• Do not smoke.
• Treat your cold symptoms with nasal rinses and nettie pots.
• Create a healthy environment by controlling the dust, mold and other allergens in your home and use a cool mist humidifier during the cold and dry winter months.

Source: Saint Louis University Medical Center

“Thanksgiving is a time to enjoy being with family, not to be in bed with the flu,” said Sharon Stanley, chief nurse of the American Red Cross. “You can follow easy tips to try and avoid becoming ill over the upcoming holiday.”

Thanksgiving is one of the busiest travel periods in the United States. If traveling for the holiday or hosting a family celebration, washing one’s hands as often as possible is important to help ward off illness. The Red Cross offers the following ideas to help halt the spread of the flu virus during the Thanksgiving holiday:

Tips for Travelers

Before traveling…

- If sick, stay home. It’s disappointing to not be able to join in the family celebration, but act responsibly and stay home to avoid spreading the flu.

- It’s possible to spread the flu virus one day before actually showing symptoms. Those who have been in close contact with a sick individual should be extra careful about using good hand hygiene and cough etiquette and very aware of what might be flu symptoms.

While traveling…

- Wash hands with soap and water as often as possible. If soap and water aren’t available, use hand sanitizer with at least 60 percent alcohol.

- Use sanitizing wipes to disinfect hard surfaces such as airplane tray tables, luggage handles, cell phones, door handles and seat armrests.

- Remember to wash hands or use a hand sanitizer before eating any meals or snacks. It’s important to remember that you are touching a lot of surfaces that others are touching as well. Make sure your hands are clean before you put anything into your mouth.

- Bring personal blankets, pillows and earphones to avoid using something which may have been in contact with the flu virus.

- After washing hands in a public restroom, turn off the faucet with a paper towel. Then use another paper towel to dry hands and open the door when exiting the restroom.

Have a safe celebration

Thanksgiving is all about food, family and friends. Here are some steps that will help keep the celebration happy and healthy:

- Avoid the usual kisses and handshakes when greeting friends and family.

- If hosting the holiday dinner and someone in the household becomes ill, make sure that they can be isolated into a separate area for care, or ask another family member to host dinner to avoid spreading the flu.

- Wash hands frequently, before preparing food, while cooking, and especially before eating.

- Keep plenty of hand soap in the bathroom, preferably in a pump container. Skip the pretty hand towels this year and instead use disposable hand towels or a roll of paper towels.

- Consider putting the glasses away this year and using plastic cups, or provide a way for guests to identify their drinks. Don’t drink out of anyone else’s glass.

- Put serving utensils in every dish, including snacks like nuts, pretzels, etc. This allows people to spoon out their portion instead of reaching in with their hands.

Remember-always cover coughs and sneezes with a tissue and clean hands afterwards. If no tissue is available, cough or sneeze into the inside of the elbow or upper arm. Avoid touching the eyes, nose and mouth to prevent spreading germs. Visit Redcross.org for more information on how to keep safe and prepared for any emergency.

Source
American Red Cross

Parents of children with asthma should monitor their child’s health closely for signs of influenza. Symptoms of influenza include:

- Sudden onset of high fever
- Headache, muscle aches and joint pain
- Cough (usually dry)
- Chills
- Sore throat
- Nasal congestion and runny nose

If your child experiences these symptoms-or exhibits signs of worsening asthma-contact your health care provider immediately. If a child with asthma does become sick with the flu, they should continue taking their normal medications, unless recommended otherwise by their healthcare provider.

Remember these tips to protect your health and prevent spread of the flu:

- Get vaccinated for both the seasonal flu and H1N1 flu.
- Remember to cover your nose and mouth with your arm when you cough or sneeze.
- Frequently wash your hands with soap and water.
- Alcohol-based hand cleaners are effective when washing is not possible.
- Avoid large crowds if possible. Ask family and friends to be mindful of your higher risk and not expose you to their sickness if they are ill.
- The CDC recommends staying home if you have flu like symptoms for seven days or until you are clear of symptoms for 24 hours.
- Always watch for public health advisories, as these recommendations may change.

For those with asthma, please remember to refer to and maintain your Asthma Action Plan as necessary. The American Lung Association has a template you can download to create your Asthma Action Plan here.

For Related information about Influenza and H1N1 please visit:

http://www.lungusa.org

http://www.facesofinfluenza.org

http://www.flu.gov

Source
American Lung Association

ASHP’s new online resource, http://www.YouCanStopTheFlu.com, was developed by a panel of pharmacist immunization experts to engage pharmacists as advocates to improve seasonal influenza immunization rates of health care workers in their health systems. The initiative is supported by a grant from CSL Biotherapies.

The site features a robust resource center with links to recommendations and updates from the Centers for Disease Control and Prevention (CDC) and The Joint Commission, as well as list-serves to keep pharmacists informed about the latest immunization trends and vaccine shortages. An Immunization Campaign Toolkit provides sample forms, fact sheets, signs, planning checklists, and other practical tools pharmacists can use to lead an immunization campaign at their own health system. Pharmacists can also share success stories of effective strategies with their colleagues via an online submission form.

Influenza kills approximately 36,000 people and causes 226,000 hospitalizations each year in the United States.1,2 Influenza immunization rates in health care workers are low (36 percent to 42 percent) despite evidence of the effectiveness and safety of the vaccine in preventing illness in staff and patients and reducing employee absenteeism. Annual influenza immunization is recommended for health care workers by the CDC to minimize the risk of infection of workers and transmission of infection to vulnerable patients.3

As part of this initiative, the ASHP Research and Education Foundation will provide two $25,000 demonstration grants to support research that focuses on pharmacists’ roles in promoting immunization against seasonal influenza. Applications will be available on the ASHP Foundation Web site (http://www.ashpfoundation.org) on October 1, 2009 . The application deadline is April 16, 2010 .

As experts and educators in safe and effective medication use, pharmacists are uniquely qualified to lead efforts within health systems to encourage influenza immunization of health care workers. Public health campaigns such as these are the first line of defense against a potentially deadly illness.

References

1. National Foundation for Infectious Diseases. Influenza immunization among health care personnel: call to action. Bethesda, MD: http://www.nfid.org/pdf/publications/fluhealthcarecta08.pdf.

2. Fiore AE, Shay DK, Broder K et al. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2009. MMWR Recomm Rep. 2009(Jul 24); 58(early release):1-52. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr58e0724a1.htm

3. Pearson ML, Bridges CB, Harper SA et al. Influenza vaccination of health-care personnel: recommendations of the Healthcare Infection Control Practices Advisory Committee (HICPAC) and the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2006; 55(RR-2):1-16. Available here.

Source
American Society of Health-System Pharmacists