The start of the school year may be the most exciting time of the year (well maybe just for parents…) However going back to school can bring on a slew of health issues, so let’s look at how we can prevent them.

Good hand-washing

The most basic and easiest thing we can teach our children is to wash their hands whenever they touch something dirty, use the restroom or before they eat. True we need to be exposed to germs to increase our immunity, but some of these germs aren’t friendly and bring on colds, flu, rashes and intestinal bugs when we’re not expecting it.

 

Good nutrition

If a child skips breakfast or eats primarily sugar and carbohydrates, they not only face immune system weaknesses but also poor attention, concentration and ability to do well in school. Make sure your kids eat a good breakfast with protein and Vitamin C-packed fruits before heading for the school bus.

Good sleep

If the kids were accustomed to staying up late and now have to wake up at 5:30 in the morning, they might spend much of their school day nodding off.  Insufficient sleep has been linked to obesity as well as poor immunity so get them on a regular schedule of a bedtime that will allow 8-10 hours of sleep a night.

 

 

Proper clothing

Chances are your child grew an inch this summer, so shoes and clothing may be a little tight.  Use the finger tip rule for pants and shoes to make sure there is room to grow. And avoid accessories that your kids can chew on, swallow or can lose as they will concentrate more on the lost earring than what the teacher is saying.

Talk to them, often

Back to school can bring on anxiety in many children and make sure you have open conversations to allow them to share their fears.  Bullies make themselves apparent the first few days of school, and your child may be getting wet willies, wedgies or their lunch stolen right under the teacher’s nose.

Be aware of what’s going around the school

If joining the PTA doesn’t appeal to you, at least make buddies with parents of children in your kid’s class as they will be the first to notify you if lice, pink eye or sore throat is making the rounds before a school may.

Discuss stranger safety with your children

If you child walks to or from school or a bus stop, educate them on how to avoid strangers and what to do if approached by one.  Consider driving your child if you think they are at risk.

Teachers face health risks

In 2006, a study published in BMC Public Health, found teachers to suffer more from ENT (ear, nose and throat) ailments, dermatitis, bladder infections, bronchitis, conjunctivitis and varicose veins than those who work in other professions.  Teachers are on the front lines when it comes to cough and cold season as they come into contact with hundreds of children a day, many of whom are contagious prior to knowing they are symptomatic. Once the fever shows itself, parents may keep the child home but the student already exposed others earlier in the day.

Standing on one’s feet for extended hours does a number on the peripheral vascular system, manifesting in leg swelling and at times, varicose veins.  And when breaks are infrequent, bladder infections brew since one can’t visit the bathroom when they need.

Long work hours during the week prevent many educators from seeing a health care provider and many health plans don’t have providers who work on the weekends.  Teachers can very easily put their own health care needs on the back burner during a long school year.

Taking care of school business is paramount during the school year but parents, teachers and kids need to still put health and safety.

 

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

Published in Health

A 6th case of West Nile virus has been confirmed in Clark County, Nevada. The Southern Nevada Health District has declared an “outbreak of mosquito-borne diseases” following new cases of the virus being reported.

This summer has been a wetter season in the Southwest, most likely causing an uptick in mosquito activity.

States throughout the country have been reporting cases of West Nile virus as well, with the highest occurring in Arizona (42 cases as of 7/23/19 per CDC).

 

wnv-activity-07092019.jpg

 

West Nile Virus Disease Cases* and Presumptive Viremic Blood Donors by State – United States, 2019 (as of July 23, 2019)

State

Neuroinvasive

Disease Cases†

Non–neuroinvasive

Disease Cases

Total

cases

Deaths

Presumptive viremic

blood donors‡

Arizona

42

15

57

1

16

Arkansas

1

0

1

1

0

California

2

0

2

1

1

Colorado

0

1

1

0

0

Iowa

0

2

2

0

0

Kentucky

1

0

1

0

0

Maryland

0

1

1

0

0

Missouri

1

0

1

0

0

Nebraska

1

0

1

1

0

Nevada

1

0

1

0

0

New Jersey

1

0

1

0

0

North Dakota

1

0

1

0

0

Oklahoma

1

2

3

0

0

South Dakota

0

1

1

0

0

Virginia

0

1

1

0

0

Wyoming

1

0

1

0

0

Totals

53

23

76

4

17

*INCLUDES CONFIRMED AND PROBABLE CASES.
†INCLUDES CASES REPORTED AS MENINGITIS, ENCEPHALITIS, OR ACUTE FLACCID PARALYSIS.
‡PRESUMPTIVE VIREMIC BLOOD DONORS (PVDS) ARE PEOPLE WHO HAD NO SYMPTOMS AT THE TIME OF DONATING BLOOD THROUGH A BLOOD COLLECTION AGENCY, BUT WHOSE BLOOD TESTED POSITIVE WHEN SCREENED FOR THE PRESENCE OF WEST NILE VIRUS. SOME PVDS DEVELOP SYMPTOMS AFTER DONATION.
PLEASE REFER TO STATE HEALTH DEPARTMENT WEB SITES FOR FURTHER DETAILS REGARDING STATE CASE TOTALS.

What is West Nile virus?

West Nile virus was originally discovered in the 1930’s in the West Nile district of Uganda.  It is believed to have reached the United States in the late 1990’s.

It’s in the family of Flaviviridae in which the disease is vector transmitted, such as by ticks, or mosquitoes, and can infect mammals as hosts. West Nile is in the same family as Zika, Yellow Fever, Dengue Fever, and Japanese Encephalitis.

Culex genus/species of mosquitoes are the usual culprit.  They feed from evening to morning, hence are more active during those times.

How is West Nile transmitted?

A mosquito contracts the disease while feeding on an infected bird and then can transmit it to humans.

 

WNV-transmission-cycle.jpg

 

What are the symptoms of West Nile virus infections?

80% of those infected do not exhibit symptoms.  Some however, may elicit the following if they have mild illness:

  • Fever
  • Body aches
  • Fatigue
  • Nausea
  • Vomiting
  • Joint  pains
  • Weakness
  • Rash

Rarely (1 in 150 people) may become seriously ill with neuroinvasive symptoms.  These include:

  • Headache
  • Neck pain/Stiff neck
  • High fever
  • Sensitivity to light (photophobia)
  • Tremors
  • Weakness
  • Paralysis
  • Confusion
  • Disorientation
  • Seizures
  • Coma
  • Death

Since mosquitoes are the primary vector, avoiding them is paramount to limiting infection.  We recommend the following:

Clean up areas of standing water around the house such as kiddie pools, puddles, buckets as they provide a breeding ground for mosquitoes.

Wear light long sleeve clothing, pants tucked into socks/shoes when outside.

Use DEET or insect repellant that can also be sprayed onto clothes when planning to be outdoors.

Be aware that many mosquitoes are active from dusk till dawn.

If bitten by a mosquito, contact your local medical provider if you have any of the aforementioned symptoms.

 

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

Published in Health
%PM, %25 %962 %2019 %22:%Jul

"Superfungus" cases continue to rise

The CDC is now reporting 685 confirmed clinical cases of the fungal infection, Candida auris (C. auris), that unfortunately is resistant to multiple types of antifungal drugs. Moreover another 30 cases are being monitored who were in contact with those infected.  This spike is very worrisome.

 

map

 

States reporting C. auris infections include:

  • New York
  • New Jersey
  • Indiana
  • Illinois
  • Massachusetts
  • Maryland
  • Oklahoma
  • California
  • Connecticut
  • Florida
  • Texas
  • Virginia

The majority of the cases are in New York, Illinois and New Jersey.  Many of those infected have died but they did have other comorbid conditions, which could have also contributed to their becoming infected with C. auris to begin with.

Please note that this fungus is different from  the species, Candida albicans, which causes common yeast infections.

When investigators first analyzed facilities reporting outbreaks, they found C. auris had colonized mattresses, beds, chairs, counter surfaces, infusion pumps, and window sills.  By this, the superbug demonstrates its resilience outside a human host.

The super fungus still has some vulnerability to antifungal medication but its resistance is increasing.

  1. auris can cause a variety of infections involving the skin and ear, but most concerning, is sepsis (infection of the bloodstream).  C.  auris was first identified in Japan back in 2009, but upon retrospective review, the CDC states the earliest known strain dates back to 1996. Since then it has been reported in multiple countries including the UK, Israel, South Africa, South Korea, Columbia, Pakistan, Kuwait and Venezuela.

Most hospital disinfectants are currently designed to be antifungal, antibacterial and antiviral.  The CDC has urged healthcare facilities to be diligent in their cleaning practices and to be aware of this “super fungus.”

 

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

 

Published in Health

Harvard researchers warn that 30 million Americans are taking aspirin for prevention of heart disease when they could be putting themselves at risk for other serious diseases.

They estimate that 1/5 of these individuals took aspirin on their own without a doctor’s order.

Although aspirin use is recommended for secondary prevention of future heart attacks and ischemic stroke in those at risk of having a future episode, primary prevention (in those who have never had an attack) is still debated.

One study last year found minimal benefit if at all for primary prevention in low risk individuals.  Many experts say the risk of gastrointestinal bleeding, heart disease, hemorrhagic stroke and kidney disease outweigh the benefits.

The latest guidelines from the American College of Cardiology states the following in terms of aspirin for prevention of heart disease:

FOR DECADES, LOW-DOSE ASPIRIN (75-100 MG WITH US 81 MG/DAY) HAS BEEN WIDELY ADMINISTERED FOR ASCVD PREVENTION. BY IRREVERSIBLY INHIBITING PLATELET FUNCTION, ASPIRIN REDUCES RISK OF ATHEROTHROMBOSIS BUT AT THE RISK OF BLEEDING, PARTICULARLY IN THE GASTROINTESTINAL (GI) TRACT. ASPIRIN IS WELL ESTABLISHED FOR SECONDARY PREVENTION OF ASCVD AND IS WIDELY RECOMMENDED FOR THIS INDICATION, BUT RECENT STUDIES HAVE SHOWN THAT IN THE MODERN ERA, ASPIRIN SHOULD NOT BE USED IN THE ROUTINE PRIMARY PREVENTION OF ASCVD DUE TO LACK OF NET BENEFIT. MOST IMPORTANT IS TO AVOID ASPIRIN IN PERSONS WITH INCREASED RISK OF BLEEDING INCLUDING A HISTORY OF GI BLEEDING OR PEPTIC ULCER DISEASE, BLEEDING FROM OTHER SITES, AGE >70 YEARS, THROMBOCYTOPENIA, COAGULOPATHY, CHRONIC KIDNEY DISEASE, AND CONCURRENT USE OF NONSTEROIDAL ANTI-INFLAMMATORY DRUGS, STEROIDS, AND ANTICOAGULANTS. THE FOLLOWING ARE RECOMMENDATIONS BASED ON META-ANALYSIS AND THREE RECENT TRIALS:
  • LOW-DOSE ASPIRIN MIGHT BE CONSIDERED FOR PRIMARY PREVENTION OF ASCVD IN SELECT HIGHER ASCVD ADULTS AGED 40-70 YEARS WHO ARE NOT AT INCREASED BLEEDING RISK.
  • LOW-DOSE ASPIRIN SHOULD NOT BE ADMINISTERED ON A ROUTINE BASIS FOR PRIMARY PREVENTION OF ASCVD AMONG ADULTS >70 YEARS.
  • LOW-DOSE ASPIRIN SHOULD NOT BE ADMINISTERED FOR PRIMARY PREVENTION AMONG ADULTS AT ANY AGE WHO ARE AT INCREASED BLEEDING RISK.

A report published in the American Heart Association’s Heart and Stroke Statistics annual report cited 48% of US adults have some type of cardiovascular disease.

The uptick could be due to rising obesity, and lowering thresholds for diagnosing guidelines such as high blood pressure (now considered high if over 130/80).

Although smoking rates have declined over the years, many still use tobacco and recent research has found E-cigs to increase risk of heart attack and stroke by 70%.

 What is a stroke?

A stroke occurs when an area of the brain does not get the proper oxygen and blood flow it needs. There are two major types of stroke:  ischemic and hemorrhagic.

Ischemic strokes are more common than the latter and occur when a clot prevents blood flow to part of the brain.  80% of all strokes fall under ischemic.  It is likened to a heart attack, except the brain tissue is being deprived of blood and nutrients.  Plaques commonly arise from arteriosclerosis that break off travel to the smaller vessels of the brain.

Hemorrhagic strokes are less common and occur when there is a bleed of one of the brain vessels.  The bleed prevents blood flow into the brain since it is seeping outside the brain tissue, causing damage to nearby cells.  The bleeds could occur from high blood pressure or aneurysms that rupture.

 What are the signs of a stroke?

Since a clot or bleed usually affect one area of the brain, we see symptoms on one side of the body, many times its contralateral (opposite) side.  We can also see central effects.  The symptoms of stroke include the following:

  • Weakness of one side of the body
  • Loss of balance
  • Numbness on one side of the body
  • Slurred speech
  • Vision issues
  • Headache
  • Facial droop

and more…..

 How are strokes treated?

If the stroke was caused by a clot (ischemic) immediate treatment includes dissolving/removing the clot.   Aspirin is used initially and if within the proper time frame, tissue plasminogen activator (TPA).  These clots can also be surgically removed and arteries widened to bring blood flow to the brain.

With a hemorrhagic  stroke, we need to stop the bleeding and improve flow to the brain.  Controlling the bleed, bypassing the vessel, “clogging” the aneurysm with techniques such as “coiling” (endovascular embolization) are sometimes utilized.

Time is of the essence, so it's crucial to identify the warning signs and call 911 immediately.  The American Stroke Association uses the acronym “FAST” (Facial drooping, Arm weakness, Speech difficulty, and Time to call 911).  The sooner a stroke victim receives medical attention the better the prognosis.

What are the risk factors for stroke?

The following put us at risk of having a stroke.

  • High blood pressure
  • Family history of stroke
  • Diabetes
  • Cardiovascular disease (artery clogging, such as the heart and carotid arteries)
  • Abnormal heart rhythms, such as atrial fibrillation
  • Smoking
  • Drugs
  • Obesity
  • Inactivity
  • Clotting disorder
  • Sleep apnea
  • Being older (greater than 55)
  • African-Americans appear to be more at risk than Caucasians and Hispanics
  • Men seem to be more affected than women

 How do we prevent strokes?

Avoid the following:

  • Excessive drinking
  • Drug use
  • Tobacco products
  • Control blood pressure, sugar and cholesterol
  • Get evaluated by a medical provider if at risk for heart disease or stroke. 

Preventing Heart Disease

Firstly, we must know our risk factors. These include:

  • Family history of heart disease
  • Personal history of heart disease
  • High Blood Pressure
  • High Cholesterol
  • Diabetes
  • Smoking
  • Obesity
  • Inactivity
  • Males over 40
  • Females who are post menopausal
  • High stress

and even short stature has been cited as a potential risk factor.

As you can see, many of us can be at risk for heart disease.  Therefore, secondly, we should be evaluated with an EKG, echocardiogram and any other exams our medical provider and/or cardiologist deem necessary.

 

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

Published in Health

In 2017, a 25-year-old mother of two died after over consuming protein supplements in preparation for a bodybuilding competition, and her mother is speaking out on the potential dangers that many athletes face.

Meegan Hefford was found unconscious in her West Australia apartment and was declared brain-dead, passing two days later.

Unbeknownst to her, she suffered from Urea Cycle Disorder (UCD), such that when she consumed protein shakes and supplements she overproduced a toxic byproduct.

What is Urea Cycle Disorder?

People with Urea Cycle Disorder (UCD) have a mutation that causes them to lack an enzyme that helps break down ammonia.  The urea cycle is responsible for removing ammonia from the bloodstream. Ammonia is made by cells, when they breakdown the nitrogen in proteins.  Ammonia needs to be eliminated, and through this cycle turns in to urea which can be excreted in the urine.  If a step is missing, ammonia and nitrogen products build up causing hyperammonemia.  This can cause liver and brain damage and eventually death.

What are the symptoms of Urea Cycle Disorder?

If one suffers from hyperammonemia, a result of UCD, the following symptoms may manifest:

  • Fatigue
  • Lethargy
  • Vomiting
  • Respiratory issues
  • Seizures
  • Behavior issues
  • Gait abnormalities
  • Cognitive issues
  • Headaches

UCD cases are rare with 1 UCD patient per 35,000 births. According to the National Urea Cycle Disorders Foundation, “Because many cases of urea cycle disorders remain undiagnosed and/or infants born with the disorders die without a definitive diagnosis, the exact incidence of these cases is unknown and underestimated. It is believed that up to 20% of Sudden Infant Death Syndrome (SIDS) cases may be attributed to an undiagnosed inborn error of metabolism such a urea cycle disorder. Some children with autism spectrum and behavioral disorders may have undiagnosed urea cycle disorders.” Treatment includes stopping the excess protein/nitrogen intake, fluids, medications, dialysis and at times, liver transplantation.

So do we need to fear protein supplements?

No.  But what we need to remember is if we are increasing our protein, and many times accurately, for bodybuilding, we need to realize that our bodies, including our kidneys, may not be on the same page.  When this happens, protein supplements can be dangerous so competitive athletes, or others using protein supplements, should be supervised by their health provider.

 

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

Published in Health

Multiple states are reporting an alarming increase in people overdosing on…..bug spray.

Bug spray, such as RAID contain pyrethroids, man-made versions of pyrethrin, a compound made by flowers to repel insects. The compound acts as a neurotoxin, overly exciting the nervous system leading to paralysis and death of the critter that gets exposed.

But humans are spraying the insecticide on their marijuana, tobacco, or spice before smoking it, in an attempt to increase the high. These bug spray-laced drugs, called KD, could cause serious illness.

In December, a Tennessee man went on a violent bender and was arrested after he smoked a mixture of  methamphetamine and bug spray to make “wasp“.

“Hot Shots” are even crazier.  The DenverChannel.com reports one takes a screen, sprays bug spray on it, hooks up a battery charger to  heat it, and once the solution crystallizes, melts it and injects the liquid into their veins.

Health officials are warning using any of the above drug mixtures can produce various symptoms including:

  • nausea
  • vomiting
  • headache
  • dizziness
  • fatigue
  • aggression
  • tremors
  • seizures
  • respiratory failure
  • cardiac arrest
  • coma
  • death

Because of the ubiquity of bug spray, anyone, including a child, can become exposed to toxic doses using it by itself or mixing it with other chemicals and drugs.

As a kid we used to collect bugs and play with them.  Now kids are getting high on bug spray.  What could possibly be next……

 

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

 

Published in Health

As August approaches, the CDC is asking health care professionals to be on the lookout and report any suspected cases of AFM (Acute Flaccid Myelitis), a paralyzing illness resembling polio, as cases may peak during this time.

Last year a total of 233 cases were confirmed in 41 states.  This year 11 have been reported and an additional 57 cases are being investigated.  Cases have been reported in California, Maryland, Nebraska, North Carolina, Pennsylvania, Texas, Utah and West Virginia this year.

 

afm-state-map.png

IMAGE ABOVE FROM CDC

Last year, California, Colorado and Texas appeared to be the worst hit with 15, 16 and 31  cases respectively.  Experts are urging states to report any cases of suspected AFM as the above map could be an under-representation of true numbers.

On their website, the CDC reports the following:

  • MOST OF THE PATIENTS WITH AFM (MORE THAN 90%) HAD A MILD RESPIRATORY ILLNESS OR FEVER CONSISTENT WITH A VIRAL INFECTION BEFORE THEY DEVELOPED AFM.
    • VIRAL INFECTIONS SUCH AS FROM ENTEROVIRUSES ARE COMMON, ESPECIALLY IN CHILDREN, AND MOST PEOPLE RECOVER. WE DON’T KNOW WHY A SMALL NUMBER OF PEOPLE DEVELOP AFM, WHILE MOST OTHERS RECOVER. WE ARE CONTINUING TO INVESTIGATE THIS.
  • THESE AFM CASES ARE NOT CAUSED BY POLIOVIRUS; ALL THE STOOL SPECIMENS FROM AFM PATIENTS THAT WE RECEIVED TESTED NEGATIVE FOR POLIOVIRUS.
  • WE DETECTED COXSACKIEVIRUS A16, EV-A71, AND EV-D68 IN THE SPINAL FLUID OF FOUR OF 570 CONFIRMED CASES OF AFM SINCE 2014, WHICH POINTS TO THE CAUSE OF THOSE PATIENTS’ AFM. FOR ALL OTHER PATIENTS, NO PATHOGEN (GERM) HAS BEEN DETECTED IN THEIR SPINAL FLUID TO CONFIRM A CAUSE.
  • MOST PATIENTS HAD ONSET OF AFM BETWEEN AUGUST AND OCTOBER, WITH INCREASES IN AFM CASES EVERY TWO YEARS SINCE 2014. AT THIS SAME TIME OF YEAR, MANY VIRUSES COMMONLY CIRCULATE, INCLUDING ENTEROVIRUSES, AND WILL BE TEMPORALLY ASSOCIATED WITH AFM.
  • MOST AFM CASES ARE CHILDREN (OVER 90%) AND HAVE OCCURRED IN 48 STATES AND DC.

The “48 states” refers to cases since 2014.   90% of the cases occurred in children under the age of 4.

The age range of children affected appear to be 3-14.  A 6-year-old boy in Washington State died in 2016 and was the first death to be linked to this mysterious illness.  His parents reported he had felt ill, became dizzy and within hours suffered swelling in the brain and paralysis.  Despite medical efforts, he passed.

In 2018 parents of two children who died from AFM accused the CDC of hiding their deaths.

Although the exact cause of AFM is unknown, health experts are considering a variety of possibilities. They have actually been investigating this since 2014 when reports of AFM began to surface across the United States.

What is AFM?

AFM stands for Acute Flaccid Myelitis.  It’s a condition that occurs suddenly, causing inflammation of the brain and spinal cord, causing loss of muscle tone and reflexes.  Although limb weakness is the primary symptom, patients could also exhibit slurred speech, facial drooping, and in serious cases inability to breath due to paralysis of the respiratory muscles.  Mild cases appear to resolve but serious cases can cause residual paralysis or death. Children appear to be more affected than adults.

What causes AFM?

Although health officials do not know for certain, due to its rapid onset, a pathogen such as a virus seems highly likely.  With the 2013-2014 outbreak, some of the cases tested positive for enterovirus (EV-D68), but it is not conclusive whether this was the exact cause or just coincidentally found in the patients tested.

Some postulate a combination of viruses may be a factor or an autoimmune disease.  Although Guillain-Barre syndrome causes acute limb weakness and paralysis when the immune system begins attacking the nervous system, the report that many individuals feel feverish or ill prior, seem to point to a pathogen as the primary cause although the latter is not being ruled out.  Virus families such as enterovirus (including polio and nonpolio enterovirus), adenovirus (causing respiratory and GI illness) cocksackieviruses and flaviviruses (including West Nile) have been suspected.

How common is AFM?

Per the CDC, acute flaccid myelitis is rare (less than 1 in a million cases) however currently they report 570 cases have been confirmed since the outbreak began in August 2014.

How is it diagnosed?

Medical professionals look at a variety of factors.

Medical professionals look at a variety of factors.

History: how the paralysis/loss of muscle tone began and which limbs did it affect first

Laboratory tests and CSF (cerebrospinal fluid) testing: to look for signs of infection

MRI of the brain: which may show gray matter involvement in a case of AFM.

Is there a treatment?

There is no standard treatment that has been proven effective, however depending on the severity of the symptoms, health professionals can consider a variety of options including steroids, IVIG, interferon, antivirals and supportive measures.  Some physicians are using “nerve transfers”, similar to a transplant, to help children regain control of their limbs.

Is there a vaccine?

No.  Until they can identify the exact cause, or causes, health officials cannot create a vaccine.

How does one avoid getting AFM?

If we assume it’s a pathogen causing the illness, avoiding contact with sick individuals, being up-to-date on one’s vaccines and good hand-washing are imperative.  Although we do not know if AFM is caused by a mosquito-born illness, avoiding mosquitoes would be wise as well.   More therefore needs to be researched to determine why and how those individuals with AFM were infected.

 

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

 

 

 

 

 

 

 

 

 

Published in Health
%PM, %06 %809 %2019 %18:%Jul

Earthquake preparedness

As multiple earthquakes and aftershocks rattle the Southwestern US, seismologists predict more to come and people fear the “big one” could follow.

Here’s how to prepare:

Have An Emergency/Earthquake/Fire Readiness Plan

Assuming cell phones will not work in the event of a natural disaster, map out with family and friends where possible meeting sites will be.

Know your emergency exits and plan what to do in case of an earthquake/fire (explained below).

Have food, water and supplies stored in plastic garbage bags that can be easily grabbed and taken with you in case of an emergency.

Have an “emergency kit” with phone numbers, medications, money and other important documents in water-proof/fire-proof casing.

Include tools, whistles, flash lights and batteries in your emergency kit as well.

Ensure Your House is Safe

Loose foundations, awnings, book shelves, chandeliers and knickknacks to name a few could cause serious injury in the event of an earthquake.  Anchor down any loose fixtures.  Family members should know how to shut off gas/electric/water supplies and appliances should have flexible, break away connections. Avoid hanging anything heavy such as pictures or chandeliers above the bed.

Consult professionals if unsure if your house is able to withstand shifts in its foundation.

During a Quake

If indoors, take cover under a table, desk, or doorway.  Be careful of swinging doors, and keep hands and arms close to your body, covering your head if possible.

 

Earthquake-Safety-Tips.jpg

 

Avoid running outside during an earthquake. Find a room in the house with few  wall/ceiling hangings and stay in the center to avoid windows, bookshelves or other furniture shifting and falling onto you.

If you’re in bed, and no time to run to a safe room, you can cover your head with a pillow.

If you are outside when the shaking starts, find an open area and drop to the ground, staying low.  Avoid power lines, trees, overpasses and buildings.

If in a vehicle when the shaking starts, pull over to a safe open area. Again avoid power lines, trees, buildings and overpasses.

After a Quake

Exit any damaged buildings, move away from them and go to an open area, and refrain from going into another building that may appear damaged.

If you live in an area near water, go to higher land in case a tsunami follows. 

If trapped inside, use a whistle or nearby object to alert first responders of where you may be.

For more information on earthquake preparedness, visit here.

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

 

 

 

Published in Health
%PM, %25 %735 %2019 %16:%Jun

Prevent childhood drowning

The leading cause of death in children are “unintentional injuries” including drownings.  According to the CDC, 20% of drowning victims are under the age of 14.  And non-fatal drowning victims could sustain brain damage and long term disability.

Pools, bathtubs and any body of water pose risks, however this time of year is especially dangerous, because activities surrounding pools, such as BBQs and alcohol use, become distractions to the adults supervising.

When it comes to drowning prevention, the following is necessary:

All pools should be enclosed

Fence height should be at least 4-5 feet high and the entry gate should self-close and self-latch.

Even if your pool has a fence, be aware that the house who’s hosting the BBQ, play date, or sleep-over may not.

And any kiddy pools or ice buckets used for drinks should be dumped out after use and flipped over so they do not become a future threat.

All young children should be within arm’s reach of an adult when swimming

The farther you are away from the child you’re supervising, the longer it takes to rescue. With distance between you and the victim, other children may swim in your path and you may lose sight of where the victim submerged.  And seconds count.  A panicked child under water may also aspirate water into the lungs becoming hypoxic quicker.  Moreover they could be at risk of “secondary drowning” in which water in the larynx triggers a spasm closing up the airway, or water falling into the lungs causes pulmonary edema and respiratory failure days after the water incident.

Do not get distracted

Put the phones away.  Adults supervising kids in a pool should not be answering a phone call or on social media.  Moreover, adults should not be drinking alcohol while supervising a child. Reaction time is key, and a drunk adult could become a drowning victim as well.

Remember that drowning is silent

Many drownings occur while others are feet away from the victim. Why? Because a submerged victim makes little sound and nearby splashing visually and auditorily obscures the victim’s splashes.

 

Parents have long learned that when children get quiet during playtime, something could be going wrong.  Use that same Spidey-sense when they are in the pool.

swimming-pools

Learn CPR and water rescue skills

Most CPR classes teach adult, child, and infant CPR.  Having this knowledge and becoming certified could save a life one day.

If swimming in open waters, know the weather and sea conditions prior to jumping in.  Life jackets/vests, appropriate for the child’s size, should be worn, even if the child is out of the water, such as in a boat.

What is “Dry Drowning” and “Secondary Drowning”?

Dry Drowning occurs when water touches the first pass of the respiratory tree, one’s vocal cords, larynx.  When water touches this area a reflex is triggered, causing a spasm (laryngospasm) such that the vocal cords constrict and close up the airway.  It’s a defense mechanism designed to prevent water from falling into the lungs. However, laryngospasm causes immediate hypoxia, lack of oxygen, and if not reversed, the victim will die.  In dry drowning, water never officially reaches the lungs!

 

 

bronchi_lungs.jpg

IMAGE FROM SEER TRAINING

 

In Secondary Drowning, water gets inhaled and sits in the respiratory tree and if uncleared through coughing, will sit and prevent proper oxygenation.  Moreover the water will irritate the lung linings causing more fluid and inflammation, resulting in pulmonary edema.  This could occur hours to days after the water activity.

According to Florida Hospital Tampa pediatrician, Dr. James Orlowski, these events are very rare, comprising only 1-2% of drowning incidents.

What are the symptoms?

The symptoms for both “Dry” and “Secondary Drowning” are similar in which the victim could have any of the following:

  • Cough
  • Chest Pain
  • Difficulty Breathing
  • Shoulder Pain
  • Neck Pain
  • Confusion
  • Irritability
  • Behavior Changes
  • Fatigue
  • Difficulty speaking
  • to name a few…

Prevention

Horse play in water should be avoided. This includes bathtubs, plastic pools, hot tubs, pools, lakes, ocean, etc.

Never swim alone. 

Swim in areas staffed with lifeguards and/or appropriate supervision. 

If water does get inhaled, watch the child or adult to look for any of the above symptoms. If concerned, seek medical help immediately. 

Have a safe and healthy summer!

 

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, if expressed, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

 

 

Published in Health

A Hepatitis A outbreak has now been declared in Clark County Nevada.

According to the Southern Nevada Health District, 37 cases have been reported since the start of this year.

Drugs and homelessness have contributed to the outbreak but it can be spread by eating contaminated food.

Per the CDC, 20,133 cases, with 11,595 hospitalizations have been reported in multiple states including Ohio, Tennessee, West Virginia, Kentucky, Indiana, Florida and Arizona to name a few. According to the CDC, California and Utah have declared their outbreaks’ over.  191 deaths have been reported since the outbreak began in 216.

What is Hepatitis A?

Hepatitis A is a disease that affects the liver.  Its caused by a virus (Hepatitis A virus) that is most commonly ingested. Poor hand washing and/or contaminated food are likely culprits.  It’s transmitted by the fecal-oral route, where food or drink contaminated by fecal matter enters another person’s GI tract.  Sexual transmission of Hepatitis A has been reported during activities involving oral-anal sex.

Hepatitis A can live outside the body for months, so unclean dining areas can be contaminated and transfer to food.

Those who are immunosuppressed run the risk of dying from the infection.

What are the symptoms of Hepatitis A?

Symptoms of Hepatitis A include:

  • Jaundice – yellowing of the skin and eyes
  • Fever
  • Abdominal Pain
  • Fatigue
  • Dark Urine
  • Joint Pain
  • Clay – looking stools
  • Diarrhea
  • Nausea
  • Vomiting
  • Loss of appetite

Hepatitis-A.jpg

 

What is the treatment for Hepatitis A?

There is no specific treatment for hepatitis A.  Most hepatitis A infections resolve on their own.

We usually recommend rest, fluids, and offer medications to help with nausea and vomiting.

For liver injury we avoid medications and alcohol that can worsen liver damage. The liver will usually recover within months after hepatitis A infection.

There are vaccines for Hepatitis A included in the childhood vaccination schedule.  Those older who weren’t vaccinated as a child can get the vaccine from their local provider or health department.  Many states require all health care and food workers to be vaccinated.

The best form of prevention however is good hand washing, dining area hygiene, and cooking food thoroughly.

 

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, if expressed, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

Published in Health
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