Infectious Disease Blog

Get your flu shots!

As if we haven’t heard that from the government every season.

On Wednesday, a federal panel recommended that all children older than 6 months old receive a yearly influenza vaccine, according to the Chicago Tribune.

While the current recommendation calls for 6-month-olds to 5-year-olds to get the vaccine, the new proposal would expand the age range to 18.

Thirty million more children would get the flu vaccine under the committee’s recommendation, according to the New York Times.

The proposal could be adopted by the CDC as early as 2009. Experts and doctors are confident that the vaccine industry would be able to provide enough doses to match future demands.

Expanding the age range of children who should get the vaccine came from a wish to keep children healthy and to defend parents and adults who come into contact with kids with the flu, according to the Tribune article.

“Kids are not just transmitters, they’re amplifiers,” said Dr. James King, a professor of pediatrics at the University of Maryland School of Medicine. “If you’re going to catch the flu, you’re much more likely to get it from a child.”

While preventing cases of influenza is a noble cause, it seems like the panel neglected to consider a simple truth: kids hate needles.

Evette from Babies & Kids blog brought up this practical point:

“That’s a lot of confrontations with needles. Not sure how many kids would like hearing this.”

I had the privilege of chatting with Dr. Michael Barza on Friday about what’s going on in the field of infectious diseases. Barza is the Chief of Medicine and Program Director for Internal Medicine at Caritas Carney Hospital and also Vice Chairman for Operations and Associate Chief of Medicine at New England Medical Center, both of which are in Boston, Mass. Barza also serves as the Deputy Editor of the journal Clinical Infectious Diseases.  

Click below to hear the interview.

Interview with Dr. Michael Barza

Here’s the transcript:

Christina Zdanowicz: How long have you been working in the field of infectious disease and what specifically is your specialty?

Dr. Michael Barza: For 40 years. At least I began my fellowship in 1968 at New England Medical Center. And my specialty is probably antibiotics, pneumonia, fevers of unknown origin. Those would be my main areas of interest.

CZ: What’s you affiliation with the Clinical Infectious Diseases journal?

MB: I’m the deputy editor of that journal. My main duty is to take the first look at virtually all of the unsolicited manuscripts, which is most of the manuscripts – about 2,500 a year. I take the first look at those and decide if I think we should be interested in sending them out for review or declining them without review.

CZ: What is the exact scope or what are some of the topics in that journal?

MB: It’s very broad reaching. It covers all aspects of infectious disease ranging from hospital epidemiology to immunization practices to infections by virtually any kind of pathogen: viruses, bacteria, fungi, parasites. As well as sometimes dealing with issues of ethics, of efficiency of consultations of sort of general topics like that. So, virtually all aspects of infectious disease but the emphasis is upon clinical infectious diseases, not so much in basic research, or if its basic research, it must be something applicable more or less now.

CZ: What are some of the hot topics relating to infectious diseases that the journal has been publishing about more recently? 

MB: In terms of viruses, influenza, both influenza A and B that we have in this country already as well as H5N1. Influenza has been a big topic. Other viral infections, of course HIV is always an important topic. Lately, we’ve actually had quite a few studies of treatment issues in HIV in developing countries – Africa, southeast Asia and so on.

In terms of bacterial infections, the biggest issue is probably been MRSA, which is an acronym for Methicillin-resistant Staphylococcus aureus. We’ve also had quite a bit on resistant bacteria, especially resistant Gram-negative bacteria, especially in intensive care units and elsewhere in hospitals, multi-resistant organisms, which have been an increasing problem in mot countries. Sticking with bacteria, tuberculosis continues to be a major killer and in particular now, there’s been a great deal of concern about multi-drug resistant tuberculosis. So called XDR, extended drug resistant TB. These organisms are actually resistant to virtually every antimicrobial that we can throw at them.

Then, a number of parasitic infections, malaria continues to be a major killer and cause of morbidity in a lot of countries, so we continue to have an interest in trials of new anti-malarial agents. 

CZ: And anything coming up in the new issue of the journal that is really groundbreaking or something that the community will really latch onto?

MB: Well, I haven’t looked yet at what’s on. I see these things usually several weeks in advance and I can’t remember what’s on for the next issue. I don’t remember anything that’s earth shattering. There is, in a few weeks, we’re going to have expedited publication, which we hardly ever do, of an article describing a kind of outbreak of a kind of E. coli in the United Kingdom. A kind of E. coli infection that can sometimes cause serious damage to the kidneys, it’s called the hemolytic uremic syndrome. In fact that manuscript is going to be the basis of an inquiry by some judicial commission in the United Kingdom. So we have been considering releasing that in expedited form.           

CZ: That sounds like something really explosive potentially if it’s going to a judicial committee. 

MB: It does have public health implications in part because mostly because there’s some evidence that these infections could be transmitted from child to child, I guess from adult to child too, or vice versa, but there have been some cases of transmission, so they want to alert the public that if one child has some of these symptoms, they should be kept separate from other children. So, I think that, in part, will be the subject of the inquiry. 

I was reading a book entitled “The Chicago ‘L’” when I stumbled upon a photo of a “fresh air car” from 1915. Chicago was doing its best to stave off an influenza outbreak, so the “L” would run one car with most of its windows opened to maximize air circulation. At the time, many people believed that fresh air from the lakefront would promote good health. The open-air car would only run on certain trains between Jackson Park and north suburban Evanston.

Advertisements inside the car read:

“Too much fresh air is just enough.”

“Get the fresh air habit; dress warm enough to enjoy it.”

“The Chicago ‘L’” by Greg Borzo details the history of the “L” with photographs. Check out the book on Amazon.

The Chicago History Museum houses the first passenger car to operate on the “L” back in 1892. The museum also gives four different “L” tours of the city on Sundays: Brown Line, Green Line south, Green Line west and Blue Line.

Today and on March 30, Greg Borzo, the author of the aforementioned book, will lead a tour of the Loop “L.” Information and tickets are available at the Chicago History Museum by clicking here.

From over-the-counter medications like Nyquil and Theraflu to doctor-prescribed flu medications like Tamiflu to good old-fashioned rest, everyone has a different way of tackling the common flu.

Other people stand by their homemade concoctions. While reading the Infectious Disease Forum at TimeBomb 2000, a world events focus group and forum, I stumbled across a recipe for an elderberry extract syrup.

Most of the people who posted comments to the forum discussed either the process of making the syrup or how to best store it.

Here’s the recipe:

Fill a qt. canning jar 1/3 full of dried elderberries (1/2 full if using fresh berries)

Fill the jar with cheap 80/90 proof unflavored vodka or brandy,

Cap jar, shake, and store in a cool dark cabinet for 7-10 days.

Strain berries, and fill jar until full from another jar so each jar contains 1 quart of extract - you’ll need 3 quarts per person for treatment, and a spare quart for preventative dosages.

Elderberries come from the American Elder tree, or the Elderberry, which is native to North America. According to the Herbal Information Center, here are the common uses for the elderberry:

Topically for infections, inflammations and swelling. As a wash for skin healing and complexion purification. As a tea and cordial to sooth sore throats, speed recovery from cold and flu and relieve respiratory distress. Cooked and used in jams and conserves.

But, how effective are elderberries at treating influenza?

A 2003 study suggested elderberry remedies could short-circuit flu symptoms, if the medicine is taken as soon as a person starts experiencing symptoms, according to WebMD. Patients with the type A strain of influenza had the best response to elderberry treatment. The study reported that people taking the elderberry remedy showed “pronounced improvements” in flu symptoms after three days and they had no drowsiness.

According to WebMD, one expert said the results of the study were only preliminary. Dr. Andrew Weil from, the University of Arizona told WebMD:

“Sambucol is for treatment, not for prevention,” Weil tells WebMD. “It has an unknown mechanism of action. Research suggests it inactivates the flu virus, but we don’t know that for sure.”

The influenza pandemic of 1918 rocked the United States as it swept the country in three lethal waves. Hospitals were overwhelmed with patients and there was little doctors could do because of a lack of the proper drugs and vaccines.

Despite medical advances, there’s still a dose of uncertainty about the U.S.’s capacity to respond to an infectious disease emergency. This documentary suggests that we may be at more of a disadvantage now than the people who lived through the 1918 influenza pandemic.

The video was produced and underwritten by the Johns Hopkins Center for Civilian Biodefense Studies along with the U.S. Department of Health and Human Services.

The Centers for Disease Control and Prevention is warning doctors to be vigilant as we enter the peak of flu season. Especially since a large increase was reported in the number of U.S. children who died last year from the flu while fighting off staph infections, according to the Atlanta Journal-Constitution.

Last week, the CDC sent out the warning about children who may have fallen prey to the flu and staph. According to the AP, as posted on Demopolis Live:

“Last year, the CDC learned of 73 children who died from flu, and 44 percent of them had a bacterial co-infection — mostly staph. Compared to earlier years, that’s a five-fold increase in staph piggybacking on kids’ flu.”

Of the 22 children that died from the flu last year also had staph, according to the same Atlanta Journal-Constitution article. Fifteen of those children actually had MRSA, or methicillin-resistant Staphylococcus aureus. Click on my recent post about the latest MRSA developments to read more.

There have also been an increased number of staph pneumonia cases reported in children who have the flu. According to the Atlanta Journal-Constitution article:

“When I was trained as a doctor and an infectious disease specialist, we basically never saw staph pneumonia. … Now we see staph pneumonia all the time,” said Dr. Jonathan McCullers, a researcher who studies the interaction between influenza and bacteria like staph at St. Jude Children’s Research Hospital in Memphis.

The CDC has the following suggestions for parents wishing to keep their kids flu-free during flu season:

• Cover their nose and mouth with a tissue when they cough or sneeze—have them throw the tissue away after they use it.
• Wash their hands often with soap and water, especially after they cough or sneeze. If water is not near, use an alcohol-based hand cleaner.
• Remind them to not to touch their eyes, nose, or mouth. Germs often spread this way

This year’s flu vaccine may not protect against some common strains of the virus, according to the Detroit Free Press. While the vaccine was a 96 percent match to the first strain, the vaccine only matched 13 and 7 percent of the other two strains, respectively.

According to the CDC, the U.S. vaccine tries to protect against three strains of the flu. Three strains are recommended each year – one A (H3N2) virus, one A (H1N1) virus, and one B virus. The flu shot injected into your arm includes inactive versions of the viruses.

Widespread influenza outbreaks have already hit 11 states, according to the AP. Health officials say that even though the vaccine may not be a good match to the flu strains out there this year, it is still crucial to get vaccinated. The article also pointed out:

“Every year, the flu infects up to 20 percent of the population, causes the hospitalization of 200,000 people and kills 36,000.”

The American Public Health Association’s Get Ready for Flu Blog offers news and tips on how to prepare for the rest of the flu season. If you haven’t already, get your flu shots!