Helpful Articles And Information

Getting Your Flu Shots:

The Flu Vaccine (Influenza Immunization)

Flu season begins in October and can last as late as May in Los Angeles. The best time to get immunized for the flu is in October and November, but it’s still worthwhile to immunize for influenza later in Los Angeles

What is influenza?

Influenza, or the flu, is an incredibly common illness. The flu affects more than 15% of the population in the U.S. each year. More than 200,000 people are hospitalized from flu complications and about 36,000 people die from the flu.

The flu is a viral infection spread between people via secretions of the nose and lungs, such as sneezing. Flu (it is medically called influenza) is a respiratory infection, or primarily a lung infection. Respiratory infections caused by other viruses are often mistakenly called the flu. The differentiating symptoms are that Influenza often causes higher fever and severe body aches. While other viruses may cause these symptoms, it is less common.

Why vaccinate for the flu (influenza)?

The flu is a highly infectious and serious viral respiratory infection with prolonged and severe symptoms. It causes individuals who get the flu to be inactive for days on end. The flu also creates stresses for the body and can lead to greater bacterial infections. Bacterial respiratory infections are serious. They can cause death for both the elderly and the very young. While there are expensive medications to treat the flu once you have it, they are not as effective as the flu vaccination.

What is the vaccine for influenza?

Flu vaccine is an inactivated vaccine – it contains killed influenza virus. The flue vaccine is injected into muscles and stimulates the immune system to produce antibodies to the influenza virus. If the vaccinated person has the virus enter their body, the antibodies attack and kill the virus – preventing infection.

Each year there is a slight change in the influenza virus so the vaccine of the previous years is ineffective. Therefor, a new vaccine is prepared to immunize against the new influenza virus. Mostly scientists can accurately determine the types of influenza virus that will cause infections and prepare an appropriate vaccine.

Who should receive the flu vaccine?

There are certain groups that are particularly recommended by the

Centers for Disease Control and Prevention (CDC)

to be vaccinated each year because they are at greater risk for serious complications from the flu. However, the influenza vaccine can help everyone.

The priority groups for vaccinations are:

  • People ages 65 and older.

  • People in nursing homes and other long-term care facilities.

  • People with chronic heart or lung conditions, including asthma.

  • People who needed regular medical care.

  • People who were hospitalized in the previous year for a metabolic disease (such as diabetes), chronic kidney disease, or weakened immune system.

  • Children 6 months to 18 years of age on long-term aspirin therapy.

  • Women expecting to be pregnant during the influenza season.

  • All children 6 to 23 months of age.

  • People with any condition that makes it hard to breathe or swallow, such as brain injury or disease, spinal cord injuries, seizure disorders, or other nerve or muscle disorders.

Other groups who should be vaccinated:

  • People 50 to 64 years of age.

  • People who may transmit flu to those at high risk.

Who should avoid the flu shot?

Those who should avoid the flu vaccine include:

  • People with a history of allergic reactions to eggs.

  • People who have previously shown a hypersensitivity to the flu vaccine.

  • People with a recent fever illness.

  • People who have developed

    Guillain-Barré syndrome

    from a previous flu vaccination.

How is the flu vaccine administered?

The flu vaccine is given as a single dose of 0.5 mL of liquid injected through the skin into muscle, usually into the side of the arm. Rubbing alcohol is used to sterilize the area before the injection.

For more information see the treatment schedule for influenza

.

How effective is the flu vaccine?

The primary determination of if the flu vaccine is going to be effective is going to depend on how well the virus strains used to prepare the flu vaccine match the flu viruses in circulation. When the match is good, the flu vaccine prevents influenza in about 70-90% of healthy adults who are below the age of 65. It’s slightly higher in children 1 to 15 years old.

However, for older people residing in nursing homes, the influenza vaccine can prevent severe illness, secondary complications and deaths. The flu shot has been 50-60% effective in preventing pneumonia and 80% effective in preventing influenza-related death. Having said that, the effectiveness in preventing influenza respiratory illness can be as low as from 30%-40%.

What side effects can occur with flu vaccination?

Side effects from a flu shot are rare. It is unusual to have a serious allergic reaction, but mild side effects include soreness at the site of the injection, muscle aching, fever, and feeling ill.

In 1976 a vaccination with the swine flu vaccine was associated with development of GBS or Guillain-Barré syndrome. GBS is characterized by a fever, nerve damage, and muscle weakness. After careful studies it was determined that one person out of 1 million vaccinated persons may be at risk of getting GBS from the swine flu vaccine.

For more information on Guillain-Barre Syndrome visit the National Institute of Neurological Disorders and Stroke.

More information on flu vaccines visit:

http://www.medicinenet.com/flu_vaccination/index.htm

Immunizing Against Shingles:

Shingles Overview

  • Shingles is caused by the virus that causes chickenpox.

  • Shingles can be spread to people who have not had chickenpox.

  • Shingles is also known as Herpes zoster but it is not related to herpes genitalis.

  • Shingles may cause pain that can continue after the rash disappears.

  • A vaccine for shingles is available for people over 60 years of age that can reduce the incidence and severity of shingles.

What is shingles?

Shingles is common in Los Angeles as in other parts of America. Shingles is a skin rash that is caused by, Varicella zoster virus (VZV), the same virus that causes chickenpox. After someone has chickenpox, the Varicella zoster virus continues to live in the nervous system, never being fully removed from the body.

How is the shingles virus reactivated?

In many situations it is unclear why the Varicella zoster virus is reactivated. However, it is believed, that the Varicella zoster virus can be reactivated when there is emotional stress, an immune deficiency, or when the individual has cancer. If a person has ever had chickenpox they are at risk for the development of shingles.

Who gets shingles?

Shingles are most common in people over the age of 60. It is estimated that there are over 500,000 cases of shingles each year in America.

The Herpes Virus

Shingles and chickenpox are caused by a herpes virus but it is not the same herpes virus that causes the primarily sexually transmitted genital herpes or the herpes mouth sores. the medical term for shingles is Herpes zoster.

Shingles Symptoms

Shingles is a rash, but before the rash shows, the person with shingles may have days of burning and sensitive skin. The shingles display as small blisters on red skin, with new blisters showing along the individual nerves traveling in a path from the spinal cord, for three to five days. Ultimately, the shingle blisters pop, emitting pus and then the affected area crusts over and heals.

Duration of Shingles

From the beginning of the pain to the healing, shingles can take three to four weeks. Sometimes there will be pain but the shingles blisters don’t appear.

Are shingles contagious?

Yes. Shingles can be passed to people who haven’t had chickenpox. However, these people will develop chickenpox instead of shingles. If a person has had chickenpox, they cannot catch shingles from someone else but they may develop shingles later in life. Once the shingle blisters have crusted over, the virus can no longer be spread.

Is there a shingles vaccine?

While there are treatments for shingles (see below) getting vaccinated for shingles if you are over the age of 60 is by far the best modern choice. The

U.S. Food and Drug Administration (FDA)

approved a vaccine for adult shingles in May of 2006. This vaccine is Zostavax and is specifically approved for people over the age of 60 who have had chickenpox. The Zostavax vaccine is a booster dose of the chickenpox vaccine given to children. The tests that were conducted over a four-year period showed that the vaccine was 60% effective in reducing shingles symptoms and the occurrences of shingles in the 60+ community. Studies continue in an effort to determine the long term effectiveness of the shingles vaccine.

If a person has a weakened immune system, they shouldn’t receive the vaccine due to the fact that it contains live, weakened viral particles.

Vaccination against Varicella zoster is now recommended for children, so it is expected that the incidences of shingles in adults will decrease as these children age.

The treatment of Shingles

Shingles can be fought using antiviral drugs such as acyclovir or valacyclovir. These medicines can reduce the duration and intensity of the rash if treatment is commenced within 72 hours of the shingles rash appearance. While some doctors also prescribe steroids, the studies have not been conclusive about the benefit of this treatment. Pain medications may also be added for symptom control and patient comfort.

The affected area should be kept clean with soap and water, while anti-itching lotions may also ease discomfort.

Does shingles have complications?

Shingles tend to heal well and have few complications. Sometimes, though, the blisters may be infected. If this happens you may notice red streaks around the infection and you will need to call your doctor as antibiotics are used to treat this.

Travel Immunizations – Protect Yourself Against Yellow Fever and Typhoid:

Before you go anywhere, you should check out the local health risks and get immunizations. You should get a fairly complete

list of infectious diseases and recommended prevention, including immunization

especially if you are traveling to developing countries.

When you call to set up an appointment for your travel immunizations you should have a list of the countries you are traveling to, so the we can make specific recommendations to you. If you want to come in prepared, you can check out the

clickable destination health map from the Center for Disease Control (CDC)

, which – once you choose your travel destination, will show you which travel vaccinations are recommended.

Two of the most commonly required travel vaccinations are:

Yellow Fever


Typhoid


YELLOW FEVER

What is yellow fever?

Yellow Fever is a severe infectious disease. Symptoms can include jaundice, hemorrhages, and albumin in the urine. Yellow Fever is transmitted by Yellow Fever-infected mosquitos and primarily ails people in South America and Africa. Yellow fever can not be taken lightly. It’s symptoms can be fatal. 20 to 50 percent of people who get jaundice will die from it.

What is the Yellow Fever Vaccine?

The Yellow Fever vaccine is a live-virus vaccine that is injected. It is almost 100% effective in preventing an infection from a yellow fever-infected mosquito.

Who should get a Yellow Fever Vaccine?

The Yellow Fever vaccine is recommended for everyone 9 months or older who is living in or traveling to areas where there is a possibility that they can get yellow fever. For certain countries, it is actually required by International Health Regulations

What is the Yellow Fever Vaccine Schedule?

A single dose of the yellow fever vaccine provides protection for at least ten years and may possibly offer life-long immunity. Booster shots should be considered every ten years to protect the traveler and meet international entry requirements.

Possible side effects of the Yellow Fever vaccine

There are few if any side effects to receiving a yellow fever vaccine. However, some patients have experienced a fever or headache, and muscle aches in a period up to two weeks after the vaccination.


In rare cases, encephalitis has developed in very young infants.

Who should not take the Yellow Fever vaccine?

  • Infants younger than 4 months of age.
  • Someone who has had the cholera vaccine within the previous three weeks.

People who should exercise caution regarding the Yellow Fever vaccine

  • Immunocompromised persons, including people with HIV, AIDS, leukemia, lymphoma, generalized malignancy.
  • Pregnant women should not be vaccinated unless traveling to or residing in high-risk areas.

TYPHOID

The

World Health Organization

states that every year 16 million people get typhoid, with about 600,000 dying from typhoid.

Understanding Typhoid

Typhoid fever is a severe disease caused by the bacterium Salmonella enterica serotype Typhi (S. Typhi). People get typhoid by ingesting food or water that is contaminated by the feces of infected people.

What are Typhoid symptoms?

Typhoid symptoms include stomach pains, weakness, high fever, headache, loss of appetite, and occasionally a rash. Typhoid may spread to many other parts of the body such as the bones or intestines. Untreated, typhoid kills up to 30% of infected people.

Treatment of Typhoid

Typhoid fever is treated using antibiotics, which has reduced complications and the number of deaths caused by typhoid fever. But, recently the virus has acquired resistance to many of the antibiotics.

Typhoid Vaccination

There is an oral vaccination for typhoid but the more common treatment is vaccination via injection. The injection vaccination is a parenteral capsular polysaccharide vaccine, or a piece of the bacterium.

Who should receive the vaccine?

  • Travelers to places where typhoid fever is common such as the Indian subcontinent, Latin America, Asia, and Africa.
  • People in contact with a typhoid carrier.
  • Laboratory workers who work with S.Typhi

Typhoid Vaccination Schedule

Anyone over the age of 2 years can receive the injection typhoid vaccine. A single shot provides enough protection. It should be administered at least one week before travel. If you remain at risk to typhoid, a booster dose should be given every 2 years.

Effectiveness of the Typhoid vaccine

The efficacy of the vaccine ranges from 50% to 80%, thus it is important to still closely monitor food and drink when traveling in countries where you might be at risk of getting typhoid.

Known side effects of the Typhoid vaccine

There are few adverse reactions caused by the typhoid vaccines licensed in America. The mild reactions include fever, headache and/or soreness around the injection site.

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