More Influenza Fear Mongering

I'm starting to get tired of the various conspiracy theories that are floating around on the internet. People take half truths and use them to fuel their own beliefs. The newest theories I'm seeing are that the US bought a stockpile of antivirals that need to be used up, so the CDC is padding flu case numbers. Of course, anti-virals can be used to treat other viral illnesses besides H1N1 and seasonal influenza viruses. Do people not realize that the government buys a stockpile of anti-virals every year as a precaution?

People on both sides of the influenza debate are using scare tactics to try to make their points. Why can't people simply use honesty and logic?

Dr Mercola's newest fear-based H1N1 post (http://articles.mercola.com/sites/articles/archive/2009/10/27/Obama-Declares-Swine-Flu-Emergency.aspx) contains an out-right lie 2 minutes into the recording. It also claims "CBS has been trying to obtain state-by-state numbers for Swine Flu cases compiled, by the CDC, BEFORE the testing was stopped. The CDC has refused to come across with those numbers. It's been stonewalling CBS for the last three months." These numbers are easily found on the CDC website at http://www.cdc.gov/h1n1flu/updates/.

A few minutes into the audio, Barbara Loe Fisher, states that "[The CDC] stopped confirming the cases of hospitalization and deaths that were H1N1 related and this information is on the CDC website." Really? When I look on the CDC website I find provider guidance urging testing in cases involving hospitalization and deaths for H1N1 (http://www.cdc.gov/h1n1flu/guidance/diagnostic_tests.htm).

The change that has been made is in what the weekly flu report is tracking. You can read more about the CDC FluView and surveillance changes at http://www.cdc.gov/h1n1flu/reportingqa.htm and http://www.cdc.gov/h1n1flu/surveillanceqa.htm. Basically, it comes down to the number of cases that meet the criteria for H1N1 testing, is far less than the number of cases of influenza-like illness (ILI) that's in our communities. The cost, time, and availability of H1N1 diagnostic testing make it ridiculous to test every case. To help get a more accurate picture of the true breadth of illness in the nation, the report of flu activity includes all people that physicians have diagnosed with ILI. The World Health Organization had declared H1N1 a pandemic almost 2 months before the CDC changed the surveillance system.

The fatalities are off between the current chart, and what's being reported for the year because the numbers were reset on Aug 30, when the reporting system was changed. You have to add the old numbers to the current ones to get the total. The CDC is being honest with the facts. They were being completely honest and reset the case counts when the surveillance system became inclusive of ILI.

President Obama declared the emergency in order to allow hospitals to deal with possible mass flu outbreaks. If this was originally authorized in July, or October, does it matter? Why are we upset that President Obama is trying to allow hospitals to be able to handle mass influxes of patients? If the American people are being lied to about the severity of H1N1 outbreak, what harm does allowing hospitals to see more patients do?

Response to "Do NOT Let Your Child Get Flu Vaccine -- 9 Reasons Why"

I keep seeing "Do NOT Let Your Child Get Flu Vaccine -- 9 Reasons Why" as interpreted by Dr Mercola get posted. The problem with this list is most of the reasons are misleading or wrong. Please make sure that your facts are straight! The original post is from Bill Sardi and is a longer list that can be found at http://www.lewrockwell.com/sardi/sardi119.html. It at least has some research to support the assertions, but it was theoretically-based and is now outdated.

1. The number of flu related deaths for this time of year is increased over normal years. http://www.cdc.gov/h1n1flu/update.htm
2. Neither seasonal nor H1N1 vaccine require 2 doses, except in children 9 and under, who need the repeated stimulation to mount a full immune response. http://www.cdc.gov/h1n1flu/vaccination/public/vaccination_qa_pub.htm
3. In the US no adjuvants are being used. http://www.flu.gov/myths/index.html
4. The vaccines that were tested this summer are the ones that are being given to the public. http://www.flu.gov/myths/index.html
5. Vets have issues with booster doses not initial dosing. http://www.naturalvetforpets.com/vaccines.html#a2
6. There are many things that could be causing an increase in autism rates. High fructose corn syrup has recently been implicated as another possible contributor as it contains mercury. Flu Mist does not contain thimerosal, but the injectable form does. http://www.huffingtonpost.com/paula-crossfield/one-more-link-in-the-merc_b_162202.html
7. Anti-virals are better at preventing flu than actually treating it, any pharmacist will tell you this. Not sure how this relates to vaccination, except not vaccinating may lead to more people becoming sick and being given antivirals which could lead to resistance. (See my previous post on this topic http://docmock.blogspot.com/2009/09/using-anti-viral-pharmaceuticals-to.html)
8. This is really the same as #7. Basically, not vaccinated has a higher possibility of breeding resistant strains than vaccinating.
9. More should be done to teach about prevention. However, most people in public health are nurses who are not allowed to give this type of advice without orders from a doctor. This is really a reason to fix our healthcare system, rather than not vaccinate. I totally agree that preventative measures besides vaccination should be taught to the public. Presently, it looks like this teaching needs to come from primary care physicians, rather than public health.

I ask that people do their research before buying into scare tactics. I don't care if the scare tactics are to get you not to vaccinate, or to vaccinate. You are responsible for your own health! Do the responsible thing and do research into things that frighten, or confuse you.

Climate Change

Today is Blog Action Day '09 with a focus on climate change. Today I urge you to visit www.blogactionday.org. Once there, you can ask President Obama to take actions to limit climate change. Climate change is a threat to our way of living. As any agriculturist will tell you, a small change in precipitation levels can be disastrous for crops. Low yields will cause increased food shortages and hunger.

Even if you don't believe that climate change is being impacted by human activity, you should still support efforts to try to limit our impact on the environment. After all, what harm will come from it? Most efforts to reduce climate changing impacts, also reduce the amount of illness causing pollutants in our environment and stimulate the economy.

You should also take actions to stem climate change in your daily life. Buy locally produced foods (this stimulates the local economy and gives your neighbors jobs too!), turn off power to things when not in use (saves you money on your power bill), and use www.freecycle.org (give away or find free items). These simple actions can curb climate change, and if you don't believe in human influenced climate change they will still have a positive impact on your wallet!

Flu: To vaccinate or not to vaccinate?

I am not an automatic nay-sayer on all vaccines. I think that there are people who are good candidates for vaccination, but others who are not. The decision to vaccinate is up to each person, with the guidance of their care provider.

This flu season I have an interesting dilemma. Should I be vaccinated? Should my daughter? These are separate, yet related questions.

Let's start with me. I'm a healthy woman in my 20s who has never had a flu shot. I'm not currently involved in patient care, but do work in a clinic, and in public venues where I can easily be exposed. So far, not very convincing that I need either shot, but there is a small concern.

The trick is entering my child into the equation. I'm a single mother. If either myself, or my child get sick, there will be missed work. If I get sick, who will watch my active preschooler? Now I'm starting to waiver, after all keeping my daughter healthy is very important to me. Hmmm...let's switch to thinking about my daughter now and see if there's more clarity.

My daughter is a highly active preschooler, who goes to daycare full time and is exposed to children of all age ranges. This puts her at an extremely high risk for contracting and spreading all sorts of illnesses. Some of the children there are under 6 months old and cannot be vaccinated. Their parents are relying on the other children to be immunized to protect their little ones. For the good of society it appears that my child should be vaccinated.

Here comes the problem, my child is immune compromised. She's at a high risk of catching respiratory and GI illnesses. You're thinking duh you should definitely do it. Problem being, immune compromised individuals should not receive flu mist because it contains live virus.

I prefer the live attenuated forms of vaccines. Flu mist provides exposure to the antigens, where the body would normally encounter them. It also provides a wider variety of antigens than the shot usually does, which makes it better able to protect people during antigenic drift. Since the virus is live, many of the questionable vaccine additives aren't used as they would inactivate the virus. Of course, live virus poses a very remote risk of reversion to the wild type, or infection with the weakened form (like has been seen with Polio.) I should avoid using the live form myself, to limit my chance of passing on the attenuated form of the virus to my daughter.

So my daughter could be vaccinated with both flu shots. She is 3 and has never had a flu shot, so she will require 2 shots for seasonal, and 2 shots for H1N1, flu coverage. See where this one is going? The shots contain a lot of the things that could possibly be dangerous. For instance, most of the flu shots are from multi-dose bottles. Since they are drawn from multiple times, they contain thimerosal as a preservative. So my child could be receiving 4 doses of thimerosal in less than 2 months time. After reading the research, I'm still not convinced whether thimerosal is safe, or harmful. To be prudent, I would rather avoid it.

There will be some single dose H1N1 shots available, which will be thimerosal free. When they will be available, and if they will be available in my county, is an unknown at this point. The other issue is that flu shots contain antibiotics. I avoid the use of antibiotics, and don't particularly want myself, or my daughter, to be exposed to them unless necessary.

I'm still facing my quandary. My daughter is the one who needs the most protection. She's the one who has the highest risk of exposure, and the greatest chance of infection. If I get vaccinated, she'll still have a major exposure at daycare, but I will hopefully stay healthy and able to care for her. Of course, its likely that I will remain healthy without vaccination.

I want to choose the option with the least harm. At this point, I'm favoring vaccinating my daughter, but waiting for thimerosal-free shots to be available. As for me, maybe I should just look into a back-up provider, like a family member, who can care for her if I get sick. After all, the flu isn't the only bug out there! I'll continue to keep us in the best of health by following basic wellness guidelines, no matter what my decision.

Using Anti-Viral Pharmaceuticals to Treat the Flu

Anti-viral pharmaceuticals will not miraculously cure the flu. They are decent at prophylaxis (prevention,) but not in treating. Most people who become sick with influenza will recover at home without the need for pharmaceuticals.

An analysis published in the Lancet (Jefferson T et al 2006: 367: 303-313) showed that Amantedine prevented 61% of influenza A cases and 25% of cases of influenza-like illness in non-vaccinted individuals. Treatment trials of Amantadine and Rimantadine showed fever duration decreased by 1 day. There were no effects on viral shedding, so people were contagious for the same amount of time.

A meta-analysis by NJ Cooper et al (BMJ. 2003 Jun 7; 326 (7401): 1235-42) focused on Zanamivir and Oseltamivir (Tamiflu) use in households where a case of flu was confirmed. Symptomatic influenza cases had a relative reduction of 80-91%. Thus Zanamivir and Oseltamivir appear to be better at preventing flu than Amantedine. Treatment with Zanamivir and Oseltamivir reduces time of symptoms by 0.4-1.5 days, once again not a very dramatic change. Their use did decrease the amount of antibiotics used to treat secondary bacterial infections.

What does this tell us? We need to work hard to prevent catching and transmitting the flu. We do not need to use pharmaceuticals to treat most cases of the flu. Everyone should continue basichabits that promote good health- drinking plenty of clean water, eating lots of fruits and vegetables, sleeping 8 hours a day, exercising, frequent hand washing, and using stress reduction techniques (yoga, meditation, exercise, prayer, etc).

Talk to your healthcare provider about other options to prevent the flu. There are many natural substances that may help, as well as the vaccine. You are unique and deserve to have expert advice on what is best for you!

Group B strep poses risk for newborns

Published Friday July 10, 2009
The Observer, La Grande, OR

Focus on Health
Tristin Mock, N.D.

Group B strep poses risk for newborns

Group B streptococcus (GBS) is a bacterium that can cause serious illness and death in newborns.

Approximately one quarter of women in the U.S. are carriers of the bacteria. These women often do not have symptoms, but can pass the infection on to their children during the birth process.

Group B strep is the most common life-threatening infection in newborns. It can be avoided, but there is no vaccine to prevent infection. GBS is more common than rubella, congenital syphilis, and spina bifida, yet many people have never heard of it. In 2001, around 1,700 newborns were infected.

Group B strep can infect and be carried by anyone. GBS is not the same infection as strep throat. It’s usually found in the gastrointestinal tract (guts) and can then spread to the vagina and rectum. GBS is not a sexually transmitted infection.

Most women are screened for group B strep during the 35th to 37th week of pregnancy. Infected women generally have no symptoms, although some may have a bladder infection. If the mother tests positive for GBS she will need IV antibiotics during labor to prevent passing the infection on to her child. The bacteria regrow rapidly, so antibiotics before labor are ineffective. According to the CDC, “a C-section should not be used to prevent early-onset group B strep infection in infants.”

Group B strep can be contracted at times other than birth, although the birth process is the most common time for transmission. Pre-natal transmission often leads to stillbirth. Late-onset cases can occur in children more than one week old. GBS can cause babies to catch pneumonia, get meningitis (inflammation of the brain), suffer sepsis (blood infection), have lifelong handicaps or die.

If you’re pregnant, please talk to your healthcare provider about testing for group B strep. Not all babies born to infected mother’s contract group B strep, but it is devastating for those who do.

For more information about group B strep please visit http://www.groupbstrep.org/ or http://www.groupbstrepinternational.org/.

Tristin Mock, N.D., is an Americorps VISTA volunteer with the Center for Human Development in La Grande.

Increasing Health Literacy: Two VISTAs in Rural Oregon

Viewfinder July 2009: Volume II, No. 4

Increasing Health Literacy: Two VISTAs in Rural Oregon

In newspapers and magazines across the country, articles covering the future of health care in America are prevalent. You can find articles like these in the Observer, the major newspaper for rural Union County in Oregon. But you will also discover another type of health care story. These stories focus on increasing health literacy for at-risk communities. Two VISTAs, Billie Jo Craigsmile and Dr. Tristin Mock, are behind this effort (read one of Billie Jo’s articles in the Observer), as well as many other activities to help the local population increase health awareness.

The task of informing the community about these issues is not an easy one. Billie Jo is in her second year of VISTA service, and much of her first year was researching the specific health needs within the community and the readiness of the community members for learning, developing, and implementing prevention programming. From this research, Billie Jo and Tristin are working on six social marketing projects: substance abuse, teens at risk for mental illness, household smoking, general communicable diseases, family planning, and immunization.

The research also shows that the readiness level of Union County is very low for many of these issues, to the point that many community members are in denial that problems even exist. The county has the lowest immunization rate in the state, and while teen pregnancy rates have been going down statewide, Union County’s rate has been increasing.

To take on these issues, Billie Jo and Tristin are using a six phase approach (problem description, market research, market strategy, interventions, evaluation, and implementation) for their social marketing projects. As part of this, they are reaching out to the community through multiple avenues. They are meeting with community groups, such as the Rotary and Kiwanis Club. They are holding presentations for teens, parents, coaches, and teachers. They are even reaching out to school bus drivers, as they recognize the positive connections many have to the students.

In addition, these VISTAs are also using opportunities and resources available to them. As word of the H1N1 (commonly referred to as the swine flu) made its way through the major media outlets, Tristin used this opportunity to talk with local leaders about general communicable diseases, as many were more willing to listen as concerns increased. Instead of creating a new social marketing campaign regarding family planning, she is adapting the efforts of a state-wide campaign for her needs in Union County.

In her second month, Tristin recognizes that her biggest hurdle is “Trying to figure out where you are going and how to get there is the hardest…looking, listening, and finding out what’s going on is very helpful.” Having already served in an AmeriCorps State/National program that included direct service of health care to an underserved community, she has a good understanding of how to approach these issues and build relationships with the population she is serving.

Billie Jo, having a VISTA year under her belt, is setting a goal of having her efforts complete by the end of year two so that in year three, continued implementation of the program will be in effect. To a point, she recognizes she is “territorial” about her project, and is really nervous about handing them over to her replacement next April (a mother of four, her protectionist nature has found its way into her VISTA project!).

Knowing their VISTA service will end before all of the goals for the social marketing projects are achieved, Tristin and Billie Jo are laying the foundation for their projects to be sustainable for years to come. They are creating user-friendly manuals and developing databases that contain the social marketing materials. Additionally, they have been engaged in agency education about their programs and are thinking about who they can train and hand the program over to in order to continue their success.

The Observer may soon be in need of something else to write about.