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V-v-v-vaccines! Part 2

Hello everyone! I thought this week would be a good opportunity to expand upon the importance of vaccines as a follow up to V-v-v-vaccines! Part 1:Flu from last week, which discussed the seasonal flu vaccine. Today, we are going to take a look at the development of vaccines and why they are such an important component of public health.

Infectious diseases have always had an impact on human life, particularly since the development of cities and townships, which provided close quarters and more human to human (or human to animal) contact, allowing diseases to spread easily. In fact, it is believed that almost 30% of children died before reaching 15 years old in the 1500s. These deaths can largely be contributed to the effects of infectious disease. Additionally, if you can recall back to your highschool history class, you probably learned that European settlers brought new diseases to the Americas that devistated the native population. Things like smallpox, whooping cough, chicken pox and the bubonic plague ravaged native peoples who had never been exposed to these illnesses before. In fact, it is believed that a whopping 80-95% of the native population perished to disease.

Deaths due to infectious disease lessened after the discovery and use of vaccines. Dr.Edward Jenner developed the first vaccine in 1796. He used material from cowpox lesions to innoculate people. The cowpox virus was similar enough to smallpox to confir immunity to the smallpox virus. Thus, people who were vaccinated against smallpox using Dr.Jenner’s cowpox vaccine did not become infected with smallpox. This was a huge medical development since smallpox had appeared around 10,000 BC and had been causing devastating disease outbreaks since that time. The development of the smallpox vaccine changed the course of human development and ultimately the path of public health and medicine. The use of the smallpox vaccine quickly took hold by the 1800s and completely replaced variolation in England in the 1840s. Smallpox was declared as completely eradicated from the world in 1980.

The development and use of vaccines has grown over time, and today it is considered one of the top 10 accomplishments of global public health efforts, as well as a top 10 achievement for US public health. Although Dr.Jenner discovered and used the first effective vaccine in the 1700s, it wasn’t until the 1900s that vaccine development really exploded due to further scientific advancements and interest in vaccinations. Since the turn of the 20th century, there has been the development of 21 vaccines. Now, let’s return to the basics and discuss why vaccines are relevant now. Let’s start with the basics. A vaccine is and “product that produces immunity from a disease and can be administered through needle injections, by mouth, or by aerosol.” On the other hand, vaccination is defined as “the injection of a killed or weakened organism that produces immunity in the body against that organism.” Therefore, vaccination is treatment with a vaccine, which causes an immune response. In the United States, it is standard care for children to receive vaccines against 14 diseases by the age of 2. This plan arose after the development of national efforts and use of federal funds to promote the use of the polio vaccine in 1955. Since that time, all levels of the government have been involved in a partnership with healthcare providers to develop and maintain a certain level of vaccine use among the population as a means of disease control. The CDC even has a table outlining all recommended vaccines and the most appropriate ages to give each vaccine under normal and altered circumstances.

I recognize that this introduction to vaccinations may have created more questions than it has answered for many of my readers. However, it is important to understand the history and development of vaccines before continuing onto current information (and controversies) surrounding the subject. Next week, we will continue to unpack some of the facts and myths surrounding childhood vaccines. See you then!

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V-v-v-vaccines! Part 1: Flu

Every year at the start of flu season there seems to be this ongoing debate about what the flu vaccine is and why it is necessary. I’m here to shed a little light on the practice and share why vaccines are such an important component to public health.

Influenza, commonly known as the flu, is a seasonal virus that can cause serious symptoms, leading to hospitalization or even death. The typical symptoms include fever, chills, upper respiratory symptoms (cough, congestion, runny nose, sore throat), body aches and headaches.However, if the flu is not treated appropriately, in some people, it can lead to pneumonia, ear/sinus infections, dehydration, or complications involving chronic health problems. The flu is very contagious and can spread easily from person to person through respiratory droplets. These droplets form during talking, coughing, sneezing, or kissing and can be further spread through physical contact or touching persons/objects with the virus. This virus infects millions of people each year, particularly during the months from October to May. Many cases can be avoided or have lesser severity, thanks to the flu vaccine, which targets specific types or strains of the virus.

The New York State Department of Health explains that the vaccine changes every year to account for forecasted dominant strains of the virus, so as to protect people from the most likely culprits. The typical vaccine is a trivalent variety and consists of protestion for 3 flu virus types from the influenza A and influenza B families. There is also a quadrivalent vaccine which protects against an additional virus type. There are many types of each of these vaccines that vary in their concentration or administration method. This is so that there are enough methods of protection to benefit the highest number of people. For example, a fit, young adult may have different needs than an elderly person with chronic medical problems. Their immune systems are different, so it makes sense that their vaccines may need to be different too.

So who should be vaccinated? That is a great question! The CDC recommends that anyone over 6 months of age receive an annual flu shot, including pregnant women. There is a small subset of people who are either advised not to recieve the shot or to talk to their doctor before being vaccinated, but most healthy people do not fall into this categoy. If you think you may have an egg allergy or a chronic health problem that puts your health at risk when receiving a vaccine, please refer to the CDC’s recommendations here. If you are concerned about what happens when you receive a flu shot or what the possible side effects may be, the Mecklenburg County website offers great, easy to read information.

We are coming up to the start of this year’s flu season, so now is an optimal time to get the shot and be protected. It takes 2 weeks for our immune systems to exert their fullest effects in response to the vaccine, so getting a shot before the season is in full swing is in your best interest. If you are unable to make an appointment at your PCP or regularly attended clinic, there are other options available. For my readers in my home state of Texas, the Texas Department of State Health Services allows you to search for locations near you based on your zip code, here. For readers outside of Texas, the CDC also has a great “vaccine finder” website. Another simple option is to frequent your local drugstore, such as CVS or Walgreens.

This series has 2 more parts. You can find Part 2 and Part 3 on the blog! (or click the hyperlinks 😀 )

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“I like to move it, move it”

Continuing with the lifestyle posts over the past 3 weeks, excluding the Hurricane Harvey intermission post, this week we will discuss exercise and physical fitness! Along with diet, physical exercise is one of the largest components of health. There is often information about exercise on television, social media, and even in the news, because, like dieting, fitness is not immune to fads or phases. Information about leg day in the weight room, yoga on the beach, or even about whether to exercise in the morning or night is available everywhere. Rather than tell you what the latest fads are in fitness today, I am going to outline the basics that you can use to direct your workout decisions. It is impossible to build a great routine if you don’t have a sturdy foundation.

The American Heart Association defines physical activity as “anything that makes you move your body and burn calories.” This includes walking, daily activities, and deliberate exercise such as scheduled trips to the gym, work out classes, or team sports. The rule of thumb is to achieve at least 150 minutes of moderate exercise or 75 minutes of vigorous exercise each week. Often times, the advice to have 30 minutes of physical activity 5 days a week is used, because it is easier to remember. Specific details of the types and combinations of exercise that are recommended for adults can be viewed on the CDC’s website, including examples of types of work outs appropriate for your age group.

The NFL Play 60 campaign pushes this goal even farther and encourages youth to have 60 minutes of physical activity to combat the obesity epidemic. In fact, while adults are encouraged to obtain at least 30 minutes a day, the US Department of Health and Human Services actually recommends 60 minutes of moderate to vigorously intense exercise every day.

So, what are the types of exercise that we can become involved in? Well, I am glad you asked! The NIH has a great outline of four major exercise categories with detailed descriptions on each. I will go over each one here.

Aerobic activity- This first category of exercise is what most children and many adults associate with exercise. Aerobic activity uses large muscle groups and is implicated in endurance training. This type of activity increases your heart rate, causes you to breath harder and faster, and helps build strong hearts and lungs. This is often referred to as “cardio” work outs. It includes walking, running, biking, swimming, many team sports such as basketball, tennis, and soccer. It can also include mowing the lawn, or vacuuming the floor if you work hard enough to elevate your heart rate.

Anaerobic activity- The other 3 categories of exercise are all encompassed under this umbrella. Anaerobic activity is anything that does not depend heavily on oxygen supplies, and often does not elevate heart rate or respiratory rate. Instead, the benefits of these movements are accumulated through repetitive actions. The first of this sub-group is muscle strengthening activities. These actions increase the strength, power, and endurance of your muscles. This includes things like lifting weights, push ups, sit ups, and using resistance bands. Around the house, gardening, moving heavy furniture, or climbing stairs can contribute to this. Bone strengthening exercises are the second sub-group. In this category, activities strengthen the integrity of your bones to prevent breakage or damage. The exercises that improve bone strength are encompassed in other activities, such as running, walking, and lifting weights. The last category is flexibility and includes stretching and balance. This type of exercise works on your body’s joints and can improve your muscles by reducing risk for injury. Warm up stretches such as touching your toes or the “sit and reach” exercise increase flexibility. Yoga and Pilates also have a large flexibility component to their routines.

What are the benefits of physical activity? Well, the CDC lists many positive benefits of becoming active and fit on it’s website.In addition to strengthening bones and muscles as we described above, there are many other health benefits of physical activity, including improved mental health, reduced stress, higher sleep quality, and a better overall mood. Many adults are motivated to exercise as a form of weight management, because regular exercise, when paired with a healthy lifestyle, can help prevent obesity or be a contributing factor to weight loss. Exercise can also reduce your risk for disease development, including hypertension, type 2 diabetes, obesity, heart disease, and even some forms of cancer!

These guidelines are not solely specific to America. In fact, the World Health Organization also promotes physical activity. In fact, the WHO specifically denotes on their website that exercise recommendations ” are applicable for all adults irrespective of gender, race, ethnicity or income level. They also apply to individuals in this age range with chronic noncommunicable conditions not related to mobility.” The WHO has established a “Global Strategy on Diet, Physical Activity, and Health” because it understands that by improving diet and exercise, they can significantly reduce deaths and the burden of disease.

Famous Names · Uncategorized

Dr.Virginia Apgar

This month’s “Notable Figure in Public Health” is Dr.Virginia Apgar. She played an important role in the development of a medical evaluation for newborns, called the “Apgar Score,” and she contributed to the development of an NGO organization that promotes awareness and funding for research.

The life and career of Dr.Apgar includes momentous accomplishments that have contributed to the direction of the medical field more than 50 years later. Her career began as a medical student at College of Physicians and Surgeons at Columbia University during the onset of the Great Depression. Despite the economic and social challenges of the time, she continued to thrive in her education and even graduated 4th in her class in medical school in 1933. She wanted to pursue surgery, a field completely dominated by men at the time. At the encouragement of Dr.Whipple, upon seeing her drive and skill, she was encouraged to pursue anesthesiology after the completion of her surgical residency. At that time, anesthesiology was not a recognized specialty and the field was still under continuous growth and development. She eventually trained with the first anesthesiology department in the country, located at the University of Wisconsin-Madison. She returned to Columbia University College of Physicians and Surgeons as an anesthesiologist in 1938, and when the field became a recognized specialty, she was appointed as the first full time female professor at the school.

During her time as a professor, her main focus was on obstetrical anesthesia. This is the study of the affects that anesthesia given to mothers during labor has on the newborn baby. During her study in this field, Dr.Apgar developed the Apgar Score. Changing the Face of Medicine states that the Apgar Score was “the first standardized method for evaluating a newborn’s transition to life outside the womb.” The Apgar Score scoring system evaluates newborns on their heart rate, respiration, movement, irritability, and color one minute after birth and again at five minutes after birth. The Apgar scor is represented by the APGAR acronym that represents Appearance (skin color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration. This scoring method is now an established standard of evaluation for newborns around the world. The scoring method reduced infant mortality and laid the foundations of neonatology. Furthermore, Dr.Apgar and her partners were able to establish a correlation between a newborn’s Apgar Score and the mother’s delivery conditions.

In 1958, obtained her Master of Public Health degree from Johns Hopkins. Following this, she became involved in the March of Dimes organization for 15 years. In fact, the website states, “she became a pivotal figure in redirecting the March of Dimes mission in the 1960s from polio to birth defects and other infant health problems such as premature birth.” She acted as the head of the Division of Congenital Malformations. During her time with the organization, she promoted rubella immunization through the organization after a German Measles outbreak in the mid 1960s. She also worked tirelessly to reduce the stigma surrounding birth defects. She even co-authored a book with Joan Beck titled Is My Baby All Right? addressing birth defects.

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Harvey, Harvey, Harvey

Hurricane Harvey struck the gulf coast of Texas this weekend and has caused record-breaking, devastating damage throughout southern Texas and Louisiana. Even as it has been downgraded from a Category 4 hurricane, the tropical storm is still raging over the coast causing flooding and destruction in its path. The financial cost of the damage that won’t be fully realized until the aftermath of the storm becomes more apparent, is nothing compared to the potential health costs that will arise in the future days, weeks, and months.

The immediate affects of flooding can be seen all over the news. From drowning, hypothermia, to tragic accidents, such as this boy who was electrocuted while wading through floodwaters.Rising water levels near coastlines can invite wild animals into residential areas. Muddy water can obscure visibility of what if lying below the water, from animals or glass. The most serious consequence to flooding is death. Many people often underestimate the risks of flood waters, even if the level of the water is low or it appears calm. Thus, in addition to the deaths that occur through tragedy, such as the family that was swept away while trying to drive through flood waters, there are also changes to risk behavior as people underestimate the dangers of flooding.

Officials presiding over the areas affected by Hurricane Harvey are concerns about the public health risks created by the flood water in the South. The concern is so great that Health and Human Services Secretary Tom Price declared a public health emergency for the state of Texas over the weekend. The CDC is concerned about the release of chemicals caused by the flooding. Additionally, this morning, there was a chemical plant explosion that led to air contamination that may have affected the staff at the plant and surrounding area, as well as had the potential to release peroxide into the water. Chemicals contaminate flood water when the water washes through houses, garages, stores, factories and other facilities that contain chemical-containing products. Additionally, the floods have overwhelmed sewage drains, trash disposal systems, and have swept garbage from businesses and residences. This further contaminates water with sewage and trash, adding to the chemical composition of the flood waters. The contaminated water then comes into contact with food, clothing and fabrics, and citizens that have not evacuated. The chemicals can cause gastrointestinal symptoms, leading to immediate illness, or even leech into items and cause a long term impact. It is important to note that this water can cause damage to medications and food that is even stored in plastic packaging.

The moisture from the water and the loss of sanitation is an ideal environment for bacteria growth, which may lead to an increase in infections in the coming months. Salmonella, E. coli, pink eye, rashes, and upper respiratory symptoms are all risks of contaminated flood waters. Areas affected by flooding are at particular risk for food borne illnesses. Additionally, the decrease in sanitation in the affected areas can lead to increased risk for tetanus and MRSA. Additionally, there is a risk for outbreaks of parasites. The risk of the spread of these infections is exacerbated by the makeshift housing facilities in the area, as many people are living in shelters after extensive damage to their homes have made them unlivable. The close quarters make fecal-oral transmission of disease much more likely, creating a potential environment for an outbreak. Luckily, cholera and dengue fever are not endemic to the United States so the risk of these diseases are minimized, because the illness would have to be brought in from another location in order to grow or spread in the current conditions.

As the water recedes, there will be mold growth on appliances, toys, hard surfaces, fabric/porous surfaces, and building structures. The increase in mold and mildew can contribute to respiratory infections and further contaminate food and objects.

The standing water can also contribute to the breeding of insects, particularly mosquitos. Mosquitos thrive in wet environments and lay eggs in standing water, creating more mosquitoes. These insects are vectors of diseases and can lead to outbreaks. Notably, they carry Zika, a disease which has been a large concern over the past year for causing microcephaly in babies born to infected mothers. Additionally, after Hurricane Katrina, there was an increase in the number of cases of West Nile Virus.

In addition to the physical damages of the storm, there are still mental health consequences as residents of the affected cities face the potential loss of friends, family members and possessions. Additionally, the need to accept help from others or be dependent on a situation that evacuees feel they cannot control can lead to feelings of helplessness. The stress of being dislocated from their homes or separated from loved-ones can contribute to mental health challenges, including anxiety, depression, or PTSD.

For those of you looking to help in the relief efforts, if you are unable to volunteer your time to organizations such as the Red Cross, there are numerous ways to make monetary donations or contribute physical items to the effort. Please note that following a suggested list is the most helpful way to extend your aid, rather than buying what you feel is the best gift of your own accord. To see donations options, please consider the Red Cross, Save the Children, or the Salvation Army.

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Balanced Diets and Fad Foods

Last week, we discussed the obesity epidemic (here). This week we are looking into dietary recommendations made by various organizations to maintain a healthy weight and lifestyle. Guidelines for a healthy diet have changed over the years as research and lifestyles have evolved. Most of us learned about nutrition guidelines in high school health class, so it doesn’t seem unreasonable that 5, 10, or even 15 years later we all might need a refresher or even an update on what recommendations have changed.

To review, it might be helpful to take a moment to reflect on your own eating habits and calculate your BMI (here) so that you have a baseline to reference to when you are looking at the suggestions below. It may surprise you to see how well you are (or are not!) meeting the guidelines in your daily life.

The USDA sponsors a website called “Choose My Plate” that outlines the government’s diet recommendations, including portion sizes, weight management, and education on making healthy food choices. The site outlines the 6 recognized food groups: fruit, vegetables, dairy, protein, grains and oils. A well rounded diet includes foods from all of the categories, but current recommendations no longer give a flat-out portion size. Instead, the recommended portion of each category is determined by your sex and age. For instance, women aged 31-50 years should eat 5 ounces of protein foods a day, whereas men of the same age are recommended to consume 6 ounces. For people who consume little or no meat, the website also has information on alternative ways to meet the protein recommendations, such as consuming beans, peas, nuts, or soy products. The website also has a component called the “Supertracker,” which is designed to help you track your diet and exercise, allowing for a comprehensive analysis of your healthy habits.

Due to the number of changes that have occurred to the dietary recommendations over the years, a number of fad diets have sprung up. Often times these diets are not based entirely on fact or they eliminate a food category entirely, which can lead to bodily harm or yo-yo weight gain and loss. A fad diet is defined as “a diet that promises quick weight loss through an unhealthy and unbalanced diet, often without exercise.” It is important to note that diets that taught quick results for little effort are often deficient in some way and can lead to harm, including anemia, organ damage, vitamin deficiency, or contribute to long term health problems.

While eating a food more frequently does not officially constitute a weight loss diet, or often even a significant change to your current nutritional status, super foods have recently become the latest trend in health and nutrition. These foods often are claimed to have amazing health benefits that were previously unknown or underappreciated, and the support of incorporating these foods into your diet is often founded on some miracle claim. UK’s NHS states that many people who cling to the “powers” of super foods mistakenly believe they can ‘undo’ the damage caused by unhealthy foods by eating a super food. Examples of super foods over the recent years have included blueberries, avocado, pomegranate, green tea, and even chocolate.

One of the recent foods that falls into this category is coconut oil. There have been many health claims linked to the food, probably because of it’s plant base, but it is important to know the nutritional facts about this food. In regards to fats and oils used in cooking, coconut oil is actually middle of the road, health wise. The latest concern with coconut oil is that studies indicate that it raises LDL cholesterol levels. As a reminder, this type is often referred to as the “bad” cholesterol that contributes to heart disease. Unsaturated fats from plant oils are the best type of cooking fat because the fat chains are “kinked” or “bent” because they contain less hydrogen atoms. These fats contain essential fats which are used in cells, tissues, and organ systems, and they also can contain other elements, such as Omega-3 or Omega-6 fatty acids that can prevent heart disease. Coconut oil has more saturated “straight chain” fatty acids than other plant based counterparts, making is a less healthy alternative to things such as olive oil, coconut oil or sunflower oil. (Although it is still a healthier alternative than using lard or butter, which are very high in saturated fats, like all other animal based fats). Thus, although coconut oil is better than some options, it is far from being the miracle alternative some people claim it to be. There are healthier alternatives and long term consequences to consider before converting 100% of your cooking oils or butter replacements with coconut oil products.

Evaluate your own diet and food choices to see how well you align with the current recommendations. The start of a new school year is often a great time of the year for families and students to make small changes to eating habits. Additionally, if you decide to lose weight or make a major overhaul of your food intake, please consult a physician or a dietitian for guidance. They will evaluate your current health and give you personalized recommendations about how to safely lose weight!