%PM, %05 %844 %2017 %19:%Oct

October is Breast Cancer Awareness Month

Celebrities such as Julia Louise-Dreyfus, Olivia Newton-John, Christina Applegate and Rita Wilson have revealed their breast cancer diagnoses, helping raise awareness for the most common cancer to affect women.  It’s the second most common cause of cancer death in females.

How common is breast cancer?

 

1 in 8 women will develop invasive breast cancer of the course of their lifetime. According to BreastCancer.org, an estimated 252,710 cases of invasive breast cancer are expected to be diagnosed in women in the US with 63,410 cases of non-invasive breast cancer.

40,610 of these women are expected to die this year of breast cancer.

How is breast cancer staged?

 

Breast cancer is staged based on size of the tumor, if lymph nodes are affected and whether the cancer has spread to distant areas of the body.  Prognosis varies greatly on the stage.

Screen-Shot-2012-09-27-at-9.59.51-AM.png

IMAGE ABOVE FROM JOHNSTON HEALTH

 

Is family history a huge factor?

 

85% of breast cancer cases occur in women with NO family history.

Screening of breast cancer

 

Mammograms are the first line screening tool for breast cancer and are currently recommended biennial for women aged 50-74.  However for those at higher risk, mammogram screening should start earlier, with possible follow-up ultrasound, and be performed more regularly.

FullSizeRender (1)

3-D MAMMOGRAM IMAGE

What are the risk factors for breast cancer?

 

Risk factors for breast cancer include:

  • Age greater than 50

  • Family History

  • BRAC1 and BRAC2 genetic mutations

  • Alcohol use

  • Never been pregnant or becoming pregnant for the first time over 35 years old

  • Early menarche at age 11 or younger

  • Obesity, especially after menopause

  • Dense breasts

  • Lack of physical activity

  • Use of oral contraceptives

  • Previous “precancerous” tumors such as atypical hyperplasia

  • DES exposure

  • Previous radiation therapy

 

----

 Daliah Wachs is a guest contributor to GCN news. 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 News & Information
%PM, %03 %752 %2017 %17:%Oct

Las Vegas Shooting: How YOU Can Help

Sunday night’s shooting of concert goers at the Route 91 Harvest Music Festival has left 58 dead and wounded hundreds others in the deadliest mass shooting to affect the United States.  Here’s how you can help:

Las Vegas Victim’s Fund

Established by Steve Sisolak, Clark County Commission Chair, this fund is helping to raise funds for victims and their families.  Go Fund Me Page is here.

Blood Donation

Thousands of units of blood are needed and can come from local and out of state donors.

United Blood Services have locations throughout the country that can accept your blood Donation. Contact UBS here.

The American Red Cross is accepting donations. On their website, they ask to visit redcross.org.

Moreover Red Cross is taking donations. Call 1-800-RED CROSS or text the word REDCROSS to 90999 to make a $10 donation.

Petition

We are asking President Trump to help declare a National Blood Donation Week.  Please sign and SHARE the petition below:

Petition

Secret Garden Radio For Las Vegas Fund

R&B icon Al B. Sure, Host of Secret Garden @SlowJams Morning show via iHeart Radio & Host of Secret Garden Radio @ our historic KCEP Power 88.1 FM is raising money for victims and their families here.

National Compassion Fund

Funds will help the immediate and long term needs of victims and their families.  Donate here.

 

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Daliah Wachs is a guest contributor to GCN news. 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 News & Information

The Seinfeld and Veep iconic comedian is battling breast cancer.

 

On social media, Julia Louise-Dreyfus revealed that she was diagnosed with breast cancer the day after she won her 6th consecutive Emmy.

 

“1 in 8 women get breast cancer. Today, I’m the one,” Louis-Dreyfus, 56, wrote. “The good news is that I have the most glorious group of supportive and caring family and friends. The bad news is that not all women are so lucky, so let’s fight all cancers and make universal health care a reality.”

At this time no further details have been revealed of her cancer staging, which would come after further testing.

How is breast cancer staged?

Breast cancer is staged based on size of the tumor, if lymph nodes are affected and whether the cancer has spread to distant areas of the body.  Prognosis varies greatly on the stage.



Screen-Shot-2012-09-27-at-9.59.51-AM.png

Image above from Johnston Health

How common is breast cancer?

1 in 8 women will develop invasive breast cancer of the course of their lifetime. According to BreastCancer.org, an estimated 252,710 cases of invasive breast cancer are expected to be diagnosed in women in the US with 63,410 cases of non-invasive breast cancer.

 

40,610 of these women are expected to die this year of breast cancer.

Is family history a huge factor?

 

85% of breast cancer cases occur in women with NO family history.

Screening of breast cancer

Mammograms are the first line screening tool for breast cancer and are currently recommended biennial for women aged 50-74.  However for those at higher risk, mammogram screening should start earlier, with possible follow-up ultrasound, and be performed more regularly.

 

FullSizeRender (1)

3-D Mammogram image

What are the risk factors for breast cancer?

 

Risk factors for breast cancer include:

  • Age greater than 50

  • Family History

  • BRAC1 and BRAC2 genetic mutations

  • Alcohol use

  • Never been pregnant or becoming pregnant for the first time over 35 years old

  • Early menarche at age 11 or younger

  • Obesity, especially after menopause

  • Dense breasts

  • Lack of physical activity

  • Use of oral contraceptives

  • Previous “precancerous” tumors such as atypical hyperplasia

  • DES exposure

  • Previous radiation therapy

 

This is a developing story.

 

----

 Daliah Wachs is a guest contributor to GCN news. 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 News & Information

As Baby Boomers age out of blood donation, younger generations need to help fill the void.

 

Although the process of blood donation and transfusion was discovered in the 1600’s, widespread civilian blood donation became popular during World War II. According to the American Red Cross, 13 million pints were collected for the war effort. And children of this era learned of how significant blood product was for our troops and war effort. Baby Boomers incorporated routine blood donation as part of their culture.



 

blood donation.jpg

 

 

Yet as Baby Boomers age are the younger generations picking up the slack?

 

According to James AuBuchon, president and chief executive of Bloodworks Northwest, “The older generations seemed to have internalized the message that we always have to have an adequate supply of blood on the shelves.”  He continues, “The younger generations just seem less wired toward that message.”

 

Blood banks have, however, made some progress recruiting younger individuals as many are beginning to donate blood on high school and college campuses.

 

According to USA Today:

 

  • 20% of blood donations come from the youngest of age groups 16-18 and 19-22.

  • Less than 10% of blood donations come from 23-29 year olds.

  • Less than 12% of blood donations come from those in their 30’s.

  • This year, the active hurricane season has hampered blood collection efforts.

The White House Can Help

A petition has been started asking the White House to proclaim a National Blood Donation Week to help raise blood supply and awareness. People can easily add their name to the petition here:

 

Petition for National Blood Donation Week

How can I Donate Blood?

 

As long as you are over 17 years old (16 with the consent of parent) and weigh above 110 lbs, you may qualify for blood donation. The blood bank will screen you prior to donation.

 

Local drives can be found going to  American Red Cross Blood Drive Locator.  or United Blood Services/BloodHero.com.

 

One pint of blood can help save up to three lives.  Thank you so much for your support!!

 

LearnHealthSpanish.com / Medical Spanish made easy.

 

 

Daliah Wachs is a guest contributor to GCN news. 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 News & Information

Ex-Patriot’s tight end, and convicted murder, Aaron Hernandez, was found post mortem to have had severe CTE.

 

Athletes who sustain multiple concussions are at high risk of developing CTE, Chronic Traumatic Encephalopathy. This progressive, degenerative disease of the brain is also found in veterans and those who sustained repeated head trauma. Symptoms include mood disorders, paranoia, impulse control issues, aggression, and memory loss to name a few.

 

A lawsuit (reportedly $20 million) has been filed by the family against the NFL and New England Patriots. Hernandez was only 27 years old when he hung himself in his prison cell April 19th of this year.

Researchers from Boston University concluded the 27 year-old football star had stage 3 of 4 CTE. This severity is rarely seen in someone this young.

 

The lawsuit claims that by the time Hernandez joined the NFL, the league knew of the dangers of concussions and led players to believe they were safe. Attorney Jose Baez stated the Patriots and NFL were “fully aware of the damage that could be inflicted from repetitive impact injuries and failed to disclose, treat or protect him from the dangers of such damage.”

 

Neuropathologists found loss of brain volume (atrophy), and tau protein deposits throughout his frontal lobes. The frontal lobe of the brain regulates impulse control, memory, judgement, social behavior and problem solving.

 

What are the stages of CTE?

 

The CTE Stages are as follows:

 

Stage 1: Loss of concentration, attention, dizziness and headaches

 

Stage 2: Additionally short term memory loss,  mood disorder such as depression, and at times explosive outbursts

 

Stage 3: Worsening loss of memory, judgement, ability to do daily tasks, movement disorders, tremors and suicidality

 

Stage 4: Amnesia, severe cognitive impairment, evidence of dementia.



CTE.jpg

Image from Sites at Penn State

 

--

 

LearnHealthSpanish.com / Medical Spanish made easy.

 

 

Daliah Wachs is a guest contributor to GCN news. 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 News & Information
%PM, %19 %756 %2017 %17:%Sep

Study: Bald Men ARE Sexy

A recent study reports bald men are found to be more attractive, confident and dominant.

 

For years I’ve been urging listeners and patients to embrace their receding their hairline and shave their heads rather than struggling to maintain their precious locks.  So many men who’ve donned the clean-shaven look have overshadowed their hairy competitors. Just look at Bruce Willis (image above).

 

Now a study out of the University of Pennsylvania confirms that people find bald men more attractive.

 

Researchers asked male and female college students to rate attractiveness, confidence and dominance after viewing pictures of men with hair and then their hair digitally removed.  Although shaving one’s head made the subject appear 4 years older, they were found to be at an advantage in all categories.

 

Maybe it’s because we grew up seeing Mr. Clean with his bald head and ripping muscles make our mom’s giggle when she cleaned the house.  Maybe its because of the myth that balding could signify high testosterone.

What causes baldness?

 

Hair is made in follicles within the skin and grows for about three years until it sheds and new hair grows.  Hair loss (alopecia) occurs when hair follicles shrink and smaller, thinner hairs grow, lasting shorter and shorter times.

 

Genetics play a huge factor, with the most influential genes coming from mother’s X chromosome, which came from her father.  So maternal and paternal genes can both be responsible for baldness.

 

Sex hormones, androgens, can cause male pattern baldness.  Medications (such as anabolic steroids), illness such as low thyroid and diabetes, and cancer can cause hair loss as well.   A recent study found Prostaglandin D2 protein may block hair growth in those who suffer male pattern baldness. It’s believed 80% of men under 70 will have some receding hairline.

 

Although hair offers many protective elements, especially from the sun, male pattern hair loss is not considered dangerous.  And study authors suggest rather than spending time, money and energy on hair loss treatment, embrace the scalp.  It's sexy….

 

Yul-Brynner

 

Yul Brynner, The King and I



 

--

LearnHealthSpanish.com / Medical Spanish made easy.

 

 

Daliah Wachs is a guest contributor to GCN news.  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 News & Information

Media giant, Larry King, reveals he underwent surgery this summer to treat lung cancer.

The 83-year-old veteran broadcaster and TV host said, in an interview with US Weekly, that a routine check up revealed an abnormal chest x-ray that was followed up with a CT scan and later PET scan.  The result was early stage lung cancer.

 

In July, King had a stage I cancerous mass removed at Cedars-Sinai Medical Center in Los Angeles and was back to work within a week.

 

King suffered a heart attack in 1987 and hadn’t smoked since.  Prior to quitting he had been smoking three packs a day.  Since then, he’s been diligent with his annual check-ups stating, “I’ve gone through a lot in life – I’ve had a heart attack and heart surgery. Part of my checkup is the chest X-ray, and that is the protocol.”  King referred to his bypass surgery after his heart attack, managing diabetes, and undergoing radiation treatment for prostate cancer over the years.

 

King suggests the cancer was not a metastasis to the lung but rather a primary lung cancer.  In the US interview, he stated, “the doctor said that tobacco from 30 years ago is still related to this lung cancer.”

 

It’s true. Although lung cancer risk drops dramatically the longer one avoids tobacco products, the resulting tissue damage, injury to one’s immune response, and genetic mutations may persist.  Moreover, lung cancer can occur even in non-smokers.

 

Early lung cancer can be silent.  As it progresses, however, symptoms such as chronic cough, wheeze, blood in sputum, lethargy and weight loss can ensue.

 

But Larry King won’t let this hold him back. He’s currently working on the sixth season of Larry King Now.

 

larry king and I.jpg

Larry King and Dr. Daliah Talkers Los Angeles 2011


 

--

LearnHealthSpanish.com / Medical Spanish made easy.

 

 

Daliah Wachs is a guest contributor to GCN news.  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 News & Information

A study from Germany and Synchrotron Radiation Facility, published in Scientific Reports, states that nanoparticles from toxic tattoo elements leak into the body.

 

Although previous studies suggested tattoo ink compounds to migrate to lymph nodes, as researchers would find pigmented lymph nodes, this was the first study that identified ink particles in nano form that leaked and deposited in distant tissues.

 

“The lymph nodes become tinted with the color of the tattoo. It is the response of the body to clean the site of entrance of the tattoo. What we didn’t know is that they do it in a nano form, which implies that they may not have the same behavior as the particles at a micro level. And that is the problem: we don’t know how nanoparticles react,” Bernhard Hesse, study author stated.

 

Tattoo ink contains multiple compounds, such as the inorganic compound titanium dioxide, heavy metals such as lead, beryllium, chromium, cobalt, nickel and arsenic, as well as preservatives. Their safety in human tissue has been controversial.

 

 

tattoo-in-skin-cross-section2

 

The lymphatic system is an intricate drainage system that helps clear the body of debris, toxins and unwanted materials.  Lymph nodes hold the white blood cells that fight infections and act as a filter as the debris gets cleared through.  Liver and kidney’s eventually handle the detoxification needed.

 

The consequences of tattoo ink depositing elsewhere has yet to be determined. Can it lead to cancer?  Can it cause inflammation increasing heart risk?

Study author, Hiram Castillo, states, “When someone wants to get a tattoo, they are often very careful in choosing a parlor where they use sterile needles that haven’t been used previously. No one checks the chemical composition of the colors, but our study shows that maybe they should.”

 

Dr. Daliah says, "I'm not overly worried as people have had tattoos for decades, but some full back or body tattoos could be risky."

 

 

--

LearnHealthSpanish.com / Medical Spanish made easy.

 

 

Daliah Wachs is a guest contributor to GCN news.  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 News & Information
%PM, %29 %807 %2017 %18:%Aug

Hurricane Harvey: How You Can Help

The Category 4 hurricane that hit southeast Texas Friday evening is expected to cause “widespread devastation” to the area.

 

Torrential downpours are expected to continue as power outages, floods, raging waters, and the potential for tornadoes threaten coastal and inland residents.

 

Hurricane Harvey, although weakening, is expected to hover over the next few days bringing more deadly conditions.

 

After the initial flooding and torrential downpour subside, Hurricane Harvey will put thousands of residents at risk for major health issues.

 

In addition to drowning, falls and other deadly injuries, victims of Harvey may endure the following:

Malnourishment

 

Many of those who did prepare for the storm may not have stored plenty of food, especially healthy fresh food. Those trapped in their homes may find the food they did store contaminated by flood water.

 

Infectious disease

 

The World Health Organization states that floods bring water borne diseases such as cholera, typhoid fever, leptospirosis and Hepatitis A. Vector borne diseases include Zika, malaria, dengue hemorrhagic fever, yellow fever, and West Nile.

 

Mosquitos initially get washed away during the storm, but the resulting puddles of water take weeks to dry and make ideal breeding grounds for insects.

 

The water gets dirty pretty quickly. People touching the flood water need to wash their hands thoroughly before eating or preparing food.

 

Moreover due to the moisture that seeped into walls and floors of houses, mold can grow and cause a variety of respiratory issues among other physical ailments. Massive disinfecting needs to take place before coming home to flood water contaminated residencies.

 

Chemical exposure

 

Chemicals from garages and fuel seeping into flood water expose victims to many compounds such as benzene, toluene and xylene that can cause a multitude of health effects including those that affect breathing, skin, the gut, balance, thought, and memory.

Psychological

 

When one loses their home, neighborhood, income, treasured belongings and more, it’s devastating. Post traumatic stress disorder may ensue.

 

To combat these risks, medical personnel and the CDC are preparing. Among food, shelter and clothes, paper products, sanitizer, cleaning supplies, tetanus vaccinations and counselors will be needed in mass quantities.

How can we help?

 

Blood supplies will be needed as residents who routinely donate have evacuated the area. Donating blood at your local blood bank may be shipped to the area in need.

 

United Blood Services have locations throughout the country that can accept your blood Donation. Contact UBS here.

 

The American Red Cross is accepting donations. On their website, they ask to visit redcross.org, call 1-800-RED CROSS or text the word REDCROSS to 90999 to make a $10 donation.

 

The Salvation Army is also accepting donations online and by calling 1-800-SAL-ARMY (725-2769).

 

The Red Cross and Salvation Army may also need local volunteers to help set up shelters.  Contact the above numbers.

 

Local volunteers are asked to donate supplies to nearby recreation centers housing evacuees.

 

Supply drives in out-of-state locations may not be accepted directly but could help local charities who need to ship supplies to the affected area.



 

LearnHealthSpanish.com / Medical Spanish made easy.

 

 

Daliah Wachs, MD, FAAFP is 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 News & Information

22,186 cases of swine flu have been reported in India, with the death toll reaching 1094.  This is a four-fold rise in deaths from last year.

 

The hardest hit areas appear to be Maharashtra with 437 deaths followed by Gujarat with 297 casualties.

What is the Swine Flu?

 

Swine Flu is the H1N1 Influenza A virus.  It originated in pigs before infecting humans. Current swine flu is not contracted from swine but passed between humans.

How deadly is Swine Flu?

 

The 2009 Swine Flu pandemic killed over 12,000 people in the US, and 200,000 people worldwide.  Many who die, do so from viral or bacterial pneumonia, although dehydration can also play a role.

Is the current outbreak in India the same virus that caused the 2009 pandemic?

 

No.  In 2009 the predominant strain of H1N1 was the California strain. This was replaced last year with the Michigan strain.

Do we have a vaccine against the Swine Flu?

 

Yes.  In the US, the trivalent and quadrivalent flu vaccines have included H1N1 since 2010.  These vaccines would include the following strains (according to the CDC):

 

  • an A/California/7/2009 (H1N1)–like virus,

  • an A/Hong Kong/ 4801/2014 (H3N2)–like virus, and

  • a B/Brisbane/60/2008–like virus (Victoria lineage)

with an additional B virus called B/Phuket/3073/2013-like virus (B/Yamagata lineage) for the quadrivalent vaccine.

 

Currently the World Health Organization (WHO) recommends changing the Northern Hemisphere flu vaccine to:

 

  • For H1N1, an A/Michigan/45/2015-like virus

  • For H3N2, an A/Hong Hong/4801/2014-like virus

  • For B, Brisbane/60/2008-like virus (belonging to the Victoria lineage)

with an additional B virus called B/Phuket/3073/2013-like virus (B/Yamagata lineage) for the quadrivalent vaccine.

What are symptoms of the Swine Flu?

Symptoms can include:

 

  • Fever

  • Cough

  • Chills

  • Sore Throat

  • Headache

  • Body Aches

  • Diarrhea

  • Vomiting

 

Who is at risk for Swine Flu?

 

Any child or adult could be at risk for H1N1 infection. However, the 2009 outbreak appeared to predominantly affect younger adults. One theory proposed for why this occurred was older individuals might have been immune having been exposed to the H1N1 during the 1950’s and when it reemerged in the 1970s.  Moreover 40 million Americans were vaccinated against swine flu in the 1970’s.

 

Those, however, at high risk for a severe Swine Flu infection include those who are pregnant, children under 2, asthmatic or other lung conditions, diabetic, immunocompromised (HIV, transplant recipient), sickle-cell, elderly, those in a nursing home, and patients with heart, liver or kidney disease.

How is Swine Flu treated?

 

Many times the H1N1 flu symptoms will last a week and then subside on their own. Some patients will need antivirals such as Tamiflu or Relenza. Any worsening symptoms (persistent fever, vomiting, diarrhea, chest pain, dizziness, confusion, lethargy), should prompt immediate evaluation by one’s medical provider.

How can we avoid Swine Flu?  Do face masks work?

 

swine-story_650_022415095428.jpg

 

 

Prevention of swine flu is best accomplished through vaccination, avoidance of affected individuals and good hand washing. Face masks generally are not recommended, but the CDC provides some guidance with these tables:




            Setting

Persons not at increased risk of severe illness from influenza

(Non-high risk persons)

Persons at increased risk of severe illness from influenza (High-Risk Persons) 3

Community

No 2009 H1N1 in community

Facemask/respirator not recommended

Facemask/respirator not recommended

2009 H1N1 in community: not crowded setting

Facemask/respirator not recommended

Facemask/respirator not recommended

2009 H1N1 in community: crowded setting

Facemask/respirator not recommended

Avoid setting.

If unavoidable, consider facemask or respirator 45

Home

Caregiver to person with influenza-like illness

Facemask/respirator not recommended

Avoid being caregiver. If unavoidable, use facemask or respirator

Other household members in home

Facemask/respirator not recommended

Facemask/respirator not recommended

Occupational (non-health care)

No 2009 H1N1 in community

Facemask/respirator not recommended

Facemask/respirator not recommended

2009 H1N1 in community

Facemask/respirator not recommended but could be considered under certain circumstances

Facemask/respirator not recommended but could be considered under certain circumstances

Occupational (health care)6

Caring 7 for persons with known, probable or suspected 2009 H1N1 or influenza-like illness

Respirator

Consider temporary reassignment. Respirator





  1. The effectiveness of respirators and facemasks in preventing transmission of 2009 H1N1 (or seasonal influenza) in various settings is not known. Use of a facemask or respirator is likely to be of most benefit if used correctly and consistently when exposed to an ill person.  (Ref. a) MacIntyre CR, et al.  EID 2009;15:233-41. b) Cowling BJ, et al. Non-pharmaceutical interventions to prevent household transmission of influenza. The 8th Asia Pacific Congress of Medical Virology, Hong Kong, 26-28 February 2009.)

  2. For the purpose of this document, respirator refers to N95 or any other NIOSH-certified filtering facepiece respirator.

  3. Persons at increased risk of severe illness from influenza (i.e. high-risk persons) include those groups at higher risk for severe illness from seasonal influenza, including:  children younger than 5 years old;  persons aged 65 years or older;  children and adolescents (younger than 18 years) who are receiving long-term aspirin therapy and who might be at risk for experiencing Reye syndrome after influenza virus infection;  pregnant women;  adults and children who have pulmonary, including asthma, cardiovascular, hepatic, hematological, neurologic, neuromuscular, or metabolic disorders, such as diabetes; adults and children who have immunosuppression (including immunosuppression caused by medications or by HIV); and, residents of nursing homes and other chronic-care facilities.

  4. The optimal use of respirators requires fit testing, training and medical clearance. Proper use is recommended to maximize effectiveness. The use of facemasks may be considered as an alternative to respirators, although they are not as effective as respirators in preventing inhalation of small particles, which is one potential route of influenza transmission.  There is limited evidence available to suggest that use of a respirator without fit-testing may still provide better protection than a facemask against inhalation of small particles. Respirators are not recommended for children or persons who have facial hair (see FDA websiteExternal Web Site Icon).

  5. Use of N95 respirators or facemasks generally is not recommended for workers in non-healthcare occupational settings for general work activities.  For specific work activities that involve contact with people who have influenza-like illness (ILI) (fever plus at least either cough or sore throat and possibly other symptoms like runny nose, body aches, headaches, chills, fatigue, vomiting and diarrhea), such as escorting a person with ILI, interviewing a person with ILI, providing assistance to an individual with ILI, the following are recommended: a) workers should try to maintain a distance of 6 feet or more from the person with ILI; b) workers should keep their interactions with the ill person as brief as possible; c) the ill person should be asked to follow good cough etiquette and hand hygiene and to wear a facemask, if able, and one is available; d) workers at increased risk of severe illness from influenza infection (see footnote 3) should avoid people with ILI (possibly by temporary reassignment); and, e) where workers cannot avoid close contact with persons with ILI, some workers may choose to wear a facemask or N95 respirator on a voluntary basis  (See footnote 1). When respirators are used on a voluntary basis in an occupational work setting, requirements for voluntary use of respirators in work sites can be found on the OSHA websiteExternal Web Site Icon.

  6. See case definitions of confirmed, probable, and suspected 2009 influenza A (H1N1). Also see infection control in the health care setting. When respiratory protection is required in an occupational setting, respirators must be used in the context of a comprehensive respiratory protection program as required under OSHA’s Respiratory Protection standard (29 CFR 1910.134). This includes fit testing, medical evaluation and training of the worker.

  7. “Caring” includes all activities that bring a worker into proximity to a patient with known, probable, or suspected 2009 H1N1 or ILI, including both providing direct medical care and support activities like delivering a meal tray or cleaning a patient’s room.

 

Setting

Recommendation

Home (when sharing common spaces with other household members)

Facemask preferred, if available and tolerable, or tissue to cover cough/sneeze

Health care settings (when outside of patient room)

Facemask, if tolerable

Non-health care setting

Facemask preferred, if available and tolerable, or tissue to cover cough/sneeze

Breastfeeding

Facemask preferred, if available and tolerable, or tissue to cover cough/sneeze



LearnHealthSpanish.com / Medical Spanish made easy.

 

 

Daliah Wachs, MD, FAAFP is 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 News & Information
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