RSV infection

RSV infection

Overview The respiratory syncytial virus, commonly known as RSV, can cause lung infections. These infections are usually mild in healthy adults but can be serious in infants, young children or in people with weak immune systems.
What is going on in the body?

RSV can cause infections in the nose, throat, windpipe, smaller airways called bronchioles, and the lungs. RSV infection typically causes mild, common cold-like symptoms in adults and older children. In infants younger than 1 year, RSV can cause pneumonia or a lower airway infection called bronchiolitis. RSV can also cause pneumonia in people with weak immune systems, such as those receiving chemotherapy for cancer.
What are the signs and symptoms of the infection? The most common symptoms of RSV are those of the common cold:
1- runny nose
2- mild fever
3- sore throat
4- cough These are often the only symptoms in healthy adults and children older than 1 year. In the very young, the very old, people with chronic disease, and individuals with weak immune systems, symptoms can include:
5- difficulty breathing. In infants, this can often be recognized by fast breathing or wheezing, an abnormal sound made while breathing out. Abnormal chest movements during breathing or labored breathing are other clues. In serious cases, an infant may stop breathing, a condition known as apnea.
1- severe coughing
2- irritability
3- poor feeding
4- vomiting
5- redness of the eyes due to inflammation known as conjunctivitis
6- ear pain. An infant may be fussy or tug or pull on his or her ear to show ear pain.
7- cyanosis, a bluish tint to the skin, which occurs only in very severe cases
What are the causes and risks of the infection?

RSV is highly contagious and is spread from person to person. RSV is spread through contact with infected secretions from the eyes, nose, and mouth. These secretions are usually spread to the hands and then to objects that the contaminated hands touch. When a person touches these objects, he or she may acquire the infection. Children younger than 1 year are not only more susceptible to the virus, but are also more likely to be exposed because they often place objects in their mouths. Premature infants are at especially high risk. Children in day care centers are at a higher risk of infection than other children. RSV tends to occur in large outbreaks between late fall and early spring, with most cases in the winter. If infected, those at high risk of complications include:
1- premature infants
2- children with serious heart disorders such as congenital heart disease
3- children with lung problems, such as cystic fibrosis, an inherited disorder causing the secretion of thick mucus in the airways
4- anyone with a weak immune system, or immunodeficiency disorder
5- elderly individuals
6- adults with chronic lung problems, such as a chronic lung disorder called emphysema
What can be done to prevent the infection?

Though it makes sense to keep infants away from those with respiratory symptoms, there is no practical way to prevent most cases of RSV. Frequent hand washing, especially by staff of newborn nurseries and day care centers, may help prevent some cases. Children who have chronic disease, immune disorders, or a history of prematurity may have a monthly shot of palivizumab (i.e., Synagis) during RSV season to help prevent serious infection. This medication is made up of proteins that can prevent infection for a limited period of time. It is used only in children who are at high risk of having severe problems if they do get infected with RSV..
How is the infection diagnosed?

Diagnosis starts with the history and physical exam. This may be all that is needed to make the diagnosis if the child has typical symptoms, is younger than 1 year, if it is winter, and if there is a current outbreak of RSV in the community. A chest X-ray may help with the diagnosis and rule out other causes for the symptoms. If needed, a special test called an immune assay can be done on nose or lung secretions to detect RSV. This is commonly done when children are admitted to a hospital so that outbreaks within the hospital can be limited.

What are the long-term effects of the infection?

RSV accounts for as many as 125,000 hospitalizations of children under the age of one every year. Up to 2% of these children may die from the infection or its complications. If a person requires a ventilator to help with breathing, the severe infection as well as the ventilator can cause permanent damage to the lungs. Most people, however, recover completely from RSV and have no long-term effects. Children who develop breathing problems because of RSV may have a slightly increased likelihood of developing asthma later in life.
What are the risks to others?

RSV is highly contagious. When an outbreak of RSV occurs, up to 50% of the infants in a community may be affected.
What are the treatments for the infection?

Adults and older children with RSV usually do not need treatment. Over-the-counter medications to relieve symptoms can be used as needed. Infants with RSV or those with weak immune systems may be admitted to the hospital for monitoring and treatment. Treatment for RSV often involves the use of humidified or moistened oxygen. Special medications, such as albuterol, can be mixed with the oxygen to help open the airways. Fluids can be given through an intravenous line (IV), a thin tube connected to a vein in the arm. In severe cases, an antiviral agent known as ribavarin (i.e., Copegus, Rebetol, Ribasphere) may be given. In rare cases, a person may need to be connected to a ventilator.
What are the side effects of the treatments? Most treatments for RSV have few side effects. Ribavarin is not given routinely for RSV infections, because it is often ineffective and sometimes makes breathing worse. Rarely, an infant can contract a new infection or suffer lung damage from a ventilator.
What happens after treatment for the infection?

Most people recover completely and return to normal activities as soon as they feel able. A person may still have the virus in his or her secretions for 1-2 weeks after symptoms go away. This is important to remember in terms of spreading the infection. Children in day care may be asked to stay home for a few days to prevent an outbreak.
How is the infection monitored?

Those with severe breathing difficulty need close monitoring in a hospital until the condition improves. For those at home with RSV, any new or worsening symptoms should be reported immediately to the healthcare provider.

jaundice

Jaundice

Jaundice is a yellowish discoloration of the eyes and skin.
What is going on in the body?

Jaundice is a condition caused by too much bilirubin in the blood. Bilirubin is a yellowish-orange breakdown product of red blood cells. It is removed from the blood by the liver. Bilirubin is then processed by the liver, passed into the bile, and excreted into the stool. If bilirubin is not excreted, it builds up in the blood. Eventually, the bilirubin can get deposited into the surface of the body. This can cause a yellowish tint to the skin, eyes and lining inside the mouth.
What are the signs and symptoms of the condition? Jaundice is considered a sign of disease that has affected the level of bilirubin in the body. Those with jaundice may have no other symptoms. Other symptoms may occur, depending on the cause, including:

1- nausea and decreased appetite

2- vomiting

3- fever

4- weight loss

5- itching

6- dark urine

7- clay-colored stool

8- abdominal pain
What are the causes and risks of the condition?

Jaundice can be caused by:

1- immaturity of the liver, which happens in a large number of newborn infants. This is usually normal, goes away on its own, and results in no problems. It is more common when babies are born early, or premature.

2- liver disease, such as liver infection, damage from alcohol or other toxins or drugs, or cancer.

3- obstruction of bile flow, which may be caused by certain drugs, gallstones, or cancer.

4- destruction of a large number of red blood cells, which may occur due to inherited defects in red blood cells, medications, or infections.

5- inherited disorders that affect metabolism.
What can be done to prevent the condition?

In adults, two of the most common causes of jaundice are viral liver infection known as hepatitis, and alcohol. Alcohol does not cause this condition unless it is abused. A hepatitis B vaccine is available and can prevent some cases of viral hepatitis. Many cases of jaundice cannot be prevented.
How is the condition diagnosed?

The affected person as well as the healthcare provider usually notice jaundice. Further tests are usually done to determine the cause of the jaundice. These commonly include urine, blood, and x-ray tests.
What are the long-term effects of the condition?

Jaundice itself doesn't have any long-term effects. It is a description of the yellowish tint that occurs. However, the underlying cause of the jaundice may have severe long-term effects, including liver failure and death. Babies with jaundice may rarely develop brain damage if the level of bilirubin gets too high.
What are the risks to others? Jaundice itself is not contagious and poses no risks to others. If viral hepatitis is the cause of the jaundice, it may or may not be contagious. The forms of hepatitis that are contagious are usually spread by sexual contact or sharing of needles, such as by intravenous drug users.
What are the treatments for the condition?

Most cases of jaundice in a newborn do not need treatment. If newborn babies develop severe jaundice, they may be put under special lights that cause a chemical change in bilirubin. This change allows the bilirubin to be excreted by the body. For extremely high levels of bilirubin, babies may need special blood transfusions that trade normal blood for their high-bilirubin blood. Treatment for other types of jaundice depends on the cause. Medications, such as antibiotics, or surgery may be needed in some cases.
What are the side effects of the treatments?

The lights used to treat babies with jaundice may cause diarrhea, rash, overheating, and dehydration. If a transfusion is needed, infection may occur. All medications have potential side effects. These may include allergic reactions, stomach upset, and others. Specific side effects depend on the drugs used. Surgery carries a risk of bleeding, infection, and reactions to the pain medicines used.
What happens after treatment for the condition?

This depends on the underlying cause. The underlying cause may be treated or resolve on its own, causing the jaundice to go away. In this setting, no further treatment may be required and people can usually return to normal activities. In other cases, the underlying condition cannot be fixed. This is common with severe, permanent liver damage or cancer. In this case, treatment does not usually end.
How is the condition monitored?

This also depends on the underlying cause. Both the affected person and the healthcare provider can monitor the jaundice itself. Repeated blood tests can monitor the bilirubin level, liver function, and other factors. More specific monitoring depends on the underlying cause.

Kaposi's sarcoma

Kaposi's sarcoma

Overview Kaposi's sarcoma is a specific type of cancer that involves the vascular tissues of the skin or other organs and tissues.
What is going on in the body?
Kaposi's sarcoma, or KS, usually begins in certain vascular tissue. Blotches may be visible on the skin or in the skin cells of the mouth. These cells undergo cancerous changes and begin to grow uncontrollably. For people with intact immune systems, the cancer grows slowly, if at all, and rarely spreads. The disease becomes very aggressive if the person has an impaired immune system. Human immunodeficiency virus (HIV) infections and drugs given after organ transplant suppress the immune system. Until AIDS became widespread, KS was rarely seen. KS is common in people with AIDS.
What are the signs and symptoms of the disease?
A person usually will find an abnormal thickened purplish growth on the skin or on the mucous membranes inside the mouth. Any area of the skin can be affected. The growth may not cause any pain or discomfort. Inside the mouth or throat, it may be large enough to interfere with swallowing or breathing. Kaposi's sarcoma may also involve the gastrointestinal and respiratory systems.
What are the causes and risks of the disease? People with HIV infection are at very high risk for KS. After organ transplant, people are given powerful drugs to prevent rejection of the new organ. Those people are also at risk. KS is otherwise very rare, but may be seen in a lesser form in elderly men of Mediterranean origin.
What can be done to prevent the disease?
In an individual with HIV infection, it is possible to test for HHV-8, and if positive, to treat with antiviral medications specific for HHV-8. It is important to identify KS early in HIV-positive persons. This means skin areas and mouth should be regularly inspected by the person at risk and by a healthcare professional to find the lesions while they are still small. KS has been less prevalent since HAART (highly active antiretroviral therapy) has been used to treat people with AIDS.
How is the disease diagnosed?
If cancer is suspected, it must be confirmed by examining the abnormal tissue in the pathology laboratory. This can mean removing a piece of the tissue with a biopsy. Sometimes the whole tumor is removed, which is known as a resection. Additional studies such as specialized X-rays and blood tests may be performed to measure the extent of the disease, which is known as staging the disease.

What are the long-term effects of the disease?

If cancer is not successfully treated, it will spread in people with compromised immune systems. The spread of the cancer can destroy tissue around and press on other structures. If the cancer spreads to organs like the lungs, it will cause death.
What are the risks to others?

HHV-8 is a transmissible infection, though the means of transmission are still being studied. Sexual transmission is believed to occur. Therefore, as with other sexually transmitted infections, safer sex practices can reduce, but not eliminate, the risk of acquiring HHV-8.
What are the treatments for the disease?

Treatment for KS may involve chemotherapy (doxorubicin, daunorubicin, paclitaxel, vinorelbine), radiation, or immunotherapy. Aliretinoin topical gel may be used, or vinblastine injected into the KS lesions. Angiogenesis inhibitors may be used. Other local treatments involve laser therapy or cryotherapy. Occasionally, a combination of treatments is used. Effectively treating underlying AIDS, if present, is also important. As the AIDS is treated, the KS lesions usually regress with decreased risk of new KS lesions. The goal may be to control the cancer and reduce pressure from the tumor on other structures. New therapeutic regimens are being studied. However, KS is not likely to be cured.
What are the side effects of the treatments? The side effects of treatment depend on the specific therapy. Generally, treatment is designed to control the cancer and relieve symptoms. If the person with KS also has other medical conditions such as AIDS or has undergone organ transplant, those conditions may affect the person's well-being. Every effort is made to minimize side effects and maintain quality of life.
What happens after treatment for the disease?

The person will be monitored closely for recurrence and progression.
How is the disease monitored?

The lesion will be observed for changes. All other skin areas will also be observed because new KS lesions can develop. If organs such as the lungs are involved then X-rays will be used to follow the person's progress. The frequency will depend on the person's condition and the extent of the cancer.

arthritis

Arthritis

Arthritis refers to inflammation of a joint. The inflammation may cause pain, swelling, stiffness, and damage.

Symptoms vary according to the type of arthritis and how severe it is. However, common symptoms include the following:
1- difficulty with weight-bearing activities, such as walking, bending, and moving
2- joint deformity
3- joint pain and swelling
4- joint stiffness, especially in the early morning
5- limping or making other adjustments to protect the affected joint
6- warmth or redness in a joint
7- weakness of the joint

There are many types of arthritis, with a host of different causes, such as:
1- ankylosing spondylitis, which affects the spine and other joints
2- arthritis caused by mechanical problems, such as a bone fracture or dislocation
3- gout, caused by an accumulation of uric acid crystals in the joint
4- infectious arthritis, caused by infections such as Staphylococcus, Streptococcus,Lyme disease or gonorrhea
5- osteoarthritis, a degenerative process also known as wear-and-tear or degenerative arthritis
6- pseudogout, caused by an accumulation of calcium pyrophosphate crystals in the joint
7- psoriatic arthritis, an autoimmune disorder that is related to and often accompanies a skin condition of the same cause called psoriasis
8- reactive arthritis, which may develop after an infection of the urinary tract, bowel, or other organs
9- rheumatoid arthritis (RA), an autoimmune disorder in which the body makes antibodies to its own tissues
10- lupus, an autoimmune disorder which often includes arthritis and rash and may include heart, lung, kidney, and brain involvement
Some of the risk factors for arthritis are as follows:
11- aging changes in the bones and joints
12- bodywide infections that affect the joints
13- diabetes
14- genetic or hereditary tendency to arthritis
15- immunodeficiency disorders, such as HIV
16- injury to the joints
17- menopause, which increases a woman's risk for osteoarthritis
18- overweight or obesity• smoking, which doubles a woman's risk for RA


Reducing repetitive strain on muscles and joints may help prevent arthritis. Be on the lookout for any chronic aches and strains caused by work, hobby, or recreation-related activities. For example, if you think your work is causing joint symptoms, you may want to see about changing tasks or modifying your workstation. Regular exercise that does not abuse your joints may prevent arthritis as it creates healthier and more flexible joints.The exercise doesn't have to be strenuous. Just, just regular. And, being evaluated for sprained joints is recommended. For example, a severe ankle sprain that is not properly splinted may lead to osteoarthritis. Being overweight or obese increases your risk for osteoarthritis, particularly in the weight-bearing joints. Maintaining a normal weight may be one of the most important arthritis preventatives. Overweight and obese individuals are at far greater risk for osteoarthritis, particularly in the weight-bearing joints. Losing weight, or maintaining a normal weight, cuts your risk for arthritis. Some infections, left untreated, may lead to infectious arthritis. Early treatment of RA may prevent worsening of the disease.

Diagnosis of arthritis starts with a medical history and physical examination. Joint X-rays may be normal at first, perhaps showing some swelling. Later the X-rays may show narrowing of the joint space, roughness of the joint surface, or poor alignment of the joint. Bone spurs, which are calcium deposits at the edge of the joint, may also be seen. Blood tests, including a complete blood count, or CBC, rheumatoid factor, and antinuclear antibody can help detect some types of arthritis. Joint aspiration, which means removing joint fluid with a needle under local anesthesia, can sometimes provide useful information. Rarely, a magnetic resonance imaging, or MRI, is needed to determine the cause or extent of the arthritis.

If the arthritis progresses, joint function may keep declining. The person will have more joint pain, stiffness, and swelling. The amount and rate of decline depend on the type of arthritis and how well the available treatments work.


What are the treatments for the condition?
Treatment varies depending on the type of arthritis, the severity of symptoms, and the degree to which the condition has progressed. The age, general health, and activity level of the person also are factors to consider. Education about the disease can help bring about improved daily self-management and coping skills. Nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen (i.e., Advil, Motrin) naproxen (i.e., Aleve, Anaprox, Naprosyn) and aspirin, are often used to treat early symptoms of arthritis. NSAIDs come in over-the-counter and prescription varieties. In addition, some patients find acetaminophen (i.e., Tylenol) to be helpful. Two prescription COX-2 specific inhibitors, rofecoxib (Vioxx) and valdecoxib ( Bextra), were withdrawn from the U.S market because they may increase the risk of serious and potentially fatal cardiovascular events in some patients. One COX-2 specific inhibitor, Celecoxib (i.e., Celebrex), remains on the market. At the present time, all NSAIDs carry a black box warning about the possibility of increased cardiovascular risks. For some forms of arthritis, corticosteroids such as prednisone can work very well. Corticosteroids can be taken by mouth or injected into the joint. Depression and sleep disorders may be treated with low doses of antidepressant medicines, such as amitriptyline (i.e., Elavil). A wide variety of medicines are used to treat RA:
1- antibiotics, such as doxycycline (i.e., Adoxa, Doryx, Oracea, Periostat, Vibramycin) and minocycline (i.e., Minocin, Solodyn)
2- non-steroidal anti-inflammatories (NSAIDs) or acetaminophen (i.e., Tylenol)
3- corticosteroids, such as prednisone
4- the COX-2 specific inhibitor Celecoxib (i.e., Celebrex)
5- disease-modifying medicines may slow down the progression of the disease. The fastest acting, best tolerated and most commonly prescribed DMARD is methotrexate (MTX). Although often used alone, many studies have shown that the outcome of two or three of these medications used in combination, is more effective at managing the disease.
6- Other DMARDs used on their own or in combination with MTX, include hydroxychloroquine (i.e., Plaquenil), sulfasalazine (i.e., Azulfidine), azathioprine (i.e., Imuran), and leflunomide (i.e., Arava).
7- Older DMARDs, such as gold therapy (Myochrisine) and D-penicillamine are virtually never used anymore.
8- another option for treating RA is a class of drugs called biological response modifiers (BRMs), or biologics. In people with RA, proteins called Tumor Necrosis Factor (TNF) and Interleukin-1 (IL-1) are present in the blood and joints in excessive amounts where they increase inflammation (pain, swelling, and stiffness).
9- Biologics are specially engineered medications which block the effects of TNF or IL-1 and are used to treat moderate to severe RA. These medications work quickly to ease inflammation and are often used in combination with other DMARDs such as methotrexate.
10- BMRs in the U.S. include infliximab (i.e., Remicade), etanercept (i.e., Enbrel), and adalimumab (i.e. Humira), which block the effects of TNF.
11- Anakinra (i.e. Kineret) is an Il-1 receptor antagonist.
12- newer treatments include abatacept (i.e., Orencia) and rituximab (i.e., Rituxan)
If there is a bacterial infection of the joint, antibiotics are critical. The joint may be drained by repeated aspiration or by open surgical drainage. A change in diet may help some forms of arthritis. People who have arthritis might experience loss of appetite or anemia, which is a low red blood cell count. Frequent small feedings or protein supplements may be prescribed. Some medicines, such as oral corticosteroids, can stimulate the appetite and lead to weight gain. Losing excess weight can help, especially when the leg joints and other weight-bearing joints are affected. Foods high in protein, iron, and vitamins contribute to tissue building and repair. Physical activity is important in the treatment of arthritis. Thirty minutes of moderate exercise a day can help to prevent complications of arthritis, as well as heart disease, stroke, and diabetes. Low impact aerobics and water aerobics are two exercises that minimize joint stress. A recent study focused on adults with osteoarthritis who used tai chi, a form of Chinese exercise that uses slow, fluid movements. Study participants reported better management of their symptoms, along with improved physical and mental health. Surgery may be indicated when pain cannot be controlled or function is lost. Several types of surgery may be done:
13- arthroplasty, which is the partial or total replacement of a joint, such as knee joint replacement or a hip joint replacement
14- arthroscopy, a procedure that uses a small scope and instruments to get inside the joint without opening it
15- arthrotomy, which involves opening the joint through a larger incision
16- osteotomy, or realignment of the bone next to the joint
17- synovectomy, or removal of the lining of the joint
There has been a great deal of interest lately in the use of supplements in treating arthritis, especially for osteoarthritis. According to the Natural Medicines Comprehensive Database, several supplements are "likely effective" in treating osteoarthritis:
18- Glucosamine sulfate significantly improves symptoms of pain and functionality in patients with osteoarthritis of the knee in studies lasting up to three years. It seems to reduce pain scores by 28 to 41 percent and improve function by 21 to 46%. Glucosamine hydrochloride may not be as effective as glucosamine sulfate.
19- Chondroitin sulfate may also relieve the symptoms of osteoarthritis, but 2-4 months is required before significant improvement is experienced. Adding chondroitin sulfate to NSAIDs has been shown to be more effective than NSAIDs alone in osteoarthritis of the hip and knee and may allow lower doses or discontinuation of NSAIDs after 6-8 weeks of use.
20- Same has been shown in several clinical trials to be superior to placebo and comparable to NSAIDs, including the COX-2 inhibitor celecoxib (i.e., Celebrex) for decreasing symptoms associated with osteoarthritis and is associated with fewer side effects than NSAIDs. Symptom relief with SAMe may require up to 30 days of treatment compared to 15 days with NSAIDs.


What are the side effects of the treatments?
Medicines used to treat arthritis may cause stomach upset, allergic reaction, and decreased resistance to infection. Surgery may cause bleeding, infection, or allergic reaction to anesthesia.


What happens after treatment for the condition?
Most types of arthritis require lifelong treatment. Exercises to maintain range of motion and muscle strength are very important.


How is the condition monitored?
A healthcare provider will monitor the person's level of comfort and function of the joint. Any new or worsening symptoms should be reported to the healthcare provider.

Tips for Treating the Flu

Unlike some other infections, when the flu is uncomplicated, it doesn't usually require medical treatment. Your child's doctor may prescribe an antiviral medicine (if symptoms are reported within 48 hours of the onset of illness), but these medicines usually only shorten the course of the infection by just 1 or 2 days, and most times are only used when a child is at risk of serious complications.So how can you help your child feel better in the meantime?Offer your child plenty of fluids (fever, which can be associated with the flu, can lead to dehydration). If your child is tired of drinking plain water, try ice pops, icy drinks mixed in a blender, and soft fruits (like melons or grapes) to keep him or her hydrated.Encourage your child to rest in bed or on the couch, with a supply of magazines, books, quiet music, and perhaps a favorite movie.Give acetaminophen or ibuprofen for your child's aches and pains (do not give aspirin unless your child's doctor directs you to do so).Dress your child in layers. When your child feels warm, you can peel a layer or two, and when he or she feels chilly, layers can be easily added.Have your child call a close relative or far-away friend to help lift your child's spirits.Help your child by taking care of yourself and the other people in your family! If you haven't done so, ask your doctor whether you (and other family members) should get a flu shot. Also, wash your hands thoroughly and often, especially after picking up used tissues.If your child's doctor recommends a prescription medicine to ease your child's symptoms, be sure to call before you go to your local pharmacy. Because the flu can strongly affect many areas of the United States, many pharmacies may have difficulty keeping certain medicines in stock.

Influenza (Flu)

Influenza, commonly known as "the flu," is a highly contagious viral infection of the respiratory tract. Although the flu affects both sexes and all age groups, kids tend to get it more often than adults. The illness even has its own season — from November to April, with most cases occurring between late December and early March.
Signs and SymptomsThe flu is often confused with the common cold, but flu symptoms are usually more severe than the typical sneezing and stuffiness of a cold.
Symptoms of the flu may include:
fever chills headache muscle aches dizziness loss of appetite tiredness cough sore throat runny nose nausea or vomiting weakness ear pain diarrhea Infants with the flu may simply seem sick all of a sudden or "just don't look right." The flu discussed here is not the same strain of virus as the avian flu.
DurationAfter 5 days, fever and other symptoms have usually disappeared, but a cough and weakness may continue. All symptoms are usually gone within a week or two. However, it's important to treat the flu seriously because it can lead to pneumonia and other life-threatening complications, particularly in infants, senior citizens, and people with long-term health problems.
ContagiousnessSpread by virus-infected droplets that are coughed or sneezed into the air, the flu is contagious. People infected with the flu are contagious from a day before they feel sick until their symptoms have resolved (usually about 1 week for adults, but can be up to 2 weeks for young kids).
The flu usually occurs in small outbreaks, but epidemics tend to occur every several years. Epidemics (when the illness spreads rapidly and affects many people in an area at the same time) peak within 2 or 3 weeks after the first cases occur
About the Flu VaccineThe flu vaccine usually is offered between September and mid-November, although it may be given at other times of the year. It reduces the average person's chances of catching the flu by up to 80% during flu season. Because the vaccine prevents infection with only a few of the viruses that can cause flu-like symptoms, it isn't a guarantee against getting sick. But even if someone who's gotten the shot gets the flu, symptoms usually will be fewer and milder.
Flu vaccines are available as a shot or nasal mist. Given as an injection, the flu shot contains killed flu viruses that will not cause the flu, but will prepare the body to fight off infection by the live flu virus. Getting a shot of the killed virus means a person is protected against that particular type of live flu virus if he or she comes into contact with it.
Because the nasal mist contains weakened live flu viruses, it is not for people with weakened immune systems or certain health conditions. It is only for healthy, non-pregnant people between the ages of 2 and 49 years.
People who got the vaccine last year aren't protected from getting the flu this year because the protection wears off and flu viruses constantly change. That's why the vaccine is updated each year to include the most current strains of the virus.
Kids under 9 who get a flu shot for the first time will receive two separate shots a month apart. It can take about 2 weeks after the shot for the body to build up protection to the flu.
Getting the shot before the flu season is in full force gives the body a chance to build up immunity to, or protection from, the virus. Although you can get a flu shot well into flu season, it's best to try to get it earlier rather than later. However, even as late as January there are still 2 or 3 months left in the flu season, so it's still a good idea to get protection.
Who Is Considered High Risk?In times when the vaccine is in short supply, certain people need it more than others. The Centers for Disease Control and Prevention (CDC) often will recommend that certain high-risk groups be given priority when flu shot supplies are limited. The CDC does not anticipate a shortage this year, but it's difficult to predict how many doses will be used. Call your doctor or local public health department about vaccine availability in your area.
The American Academy of Family Physicians (AAFP), the American Academy of Pediatrics (AAP), and the CDC currently recommend that these high-risk groups be given the flu shot:
kids 6–59 months old anyone 50 years and older women who will be pregnant during the flu season anyone who lives or works with infants under 6 months old residents of long-term care facilities, such as nursing homes any adult or child with chronic medical conditions, such as asthma health-care personnel who have direct contact with patients kids ages 6 months to 18 years on long-term aspirin therapy out-of-home caregivers and household contacts of anyone in any of the high-risk groups People who should not get the flu shot include:
infants under 6 months old anyone who's severely allergic to eggs and egg products (ingredients for flu shots are grown inside eggs, so tell your doctor if your child is allergic to eggs or egg products before he or she gets a flu shot) anyone who's ever had a severe reaction to a flu vaccination anyone with Guillain-Barré syndrome (GBS), a rare condition that affects the immune system and nerves anyone with a fever Preventing the Flu From SpreadingThere's no guaranteed way — including being vaccinated — to prevent anyone from getting the flu. Avoiding large crowds can help, but it's often impossible to keep kids cooped up.
Here are some practical ways to help prevent the spread of the flu:
Wash your hands thoroughly and frequently. Never pick up used tissues. Never share cups and eating utensils Stay home from work or school when you're sick with the flu. Cover your mouth and nose with a tissue when you cough or sneeze. TreatmentCases of the flu rarely require specific medical treatment. But some kids with chronic medical conditions may become sicker with the flu and need to be hospitalized, and flu in an infant can also be dangerous. For a severely ill child or one with other special circumstances, a doctor may prescribe an antiviral medicine that can ease flu symptoms, but only if it's given within 48 hours of the onset of the flu.
These at-home tips can help most otherwise healthy kids cope with the flu. Have them:
drink lots of fluids to prevent dehydration get plenty of sleep and take it easy take acetaminophen or ibuprofen to relieve fever and aches (but do not give aspirin unless your doctor instructs you to do so) wear layers, since the flu often makes them cold one minute and hot the next (wearing layers — like a T-shirt, sweatshirt, and robe — makes it easy to add or subtract clothes as needed) When to Call the DoctorCall the doctor if your child:
has flu symptoms has a high temperature seems to get better, but then feels worse than before has any trouble breathing, seems confused, or seems to be getting worse For the most part, though, the flu is usually gone in a week or two with a little rest and tender loving care.

Cough and Cold Medicine Abuse

Chugging cough medicine for an instant high certainly isn't a new practice for teens, who have raided the medicine cabinet for a quick, cheap, and legal high for decades. But unfortunately, this dangerous, potentially deadly practice is on the rise.
So it's important for parents to understand the risks and know how to prevent their kids from intentionally overdosing on cough and cold medicine.
Why Do Kids Abuse Cough and Cold Remedies?Before the U.S. Food and Drug Administration (FDA) replaced the narcotic codeine with dextromethorphan as an over-the-counter (OTC) cough suppressant in the 1970s, teens were simply guzzling down cough syrup for a quick buzz.
Over the years, teens discovered that they still could get high by taking large doses of any OTC medicine containing dextromethorphan (also called DXM).
Dextromethorphan-containing products — tablets, capsules, gel caps, lozenges, and syrups — are labeled DM, cough suppressant, or Tuss (or contain "tuss" in the title).
Medicines containing dextromethorphan are easy to find, affordable for cash-strapped teens, and perfectly legal. Getting access to the dangerous drug is often as easy as walking into the local drugstore with a few dollars or raiding the family medicine cabinet. And because it's found in over-the-counter medicines, many teens naively assume that DXM can't be dangerous.
Then and NowDXM abuse is on the rise, according to recent studies, and easy access to OTC medications in stores and over the Internet could be contributing to the increase.
The major difference between current abuse of cough and cold medicines and that in years past is that teens now use the Internet to not only buy DXM in pure powder form, but to learn how to abuse it. Because drinking large volumes of cough syrup causes vomiting, the drug is being extracted from cough syrups and sold on the Internet in a tablet that can be swallowed or a powder that can be snorted. Online dosing calculators even teach abusers how much they'll need to take for their weight to get high.
One way teens get their DXM fixes is by taking "Triple-C" — Coricidin HBP Cough and Cold — which contains 30 mg of DXM in little red tablets. Users taking large volumes of Triple-C run additional health risks because it contains an antihistamine as well.
The list of other ingredients — decongestants, expectorants, and pain relievers — contained in other Coricidin products and OTC cough and cold preparations compound the risks associated with DXM and could lead to a serious drug overdose.
Besides Triple-C, other street names for DXM include: Candy, C-C-C, Dex, DM, Drex, Red Devils, Robo, Rojo, Skittles, Tussin, Velvet, and Vitamin D. Users are sometimes called "syrup heads" and the act of abusing DXM is often called "dexing," "robotripping," or "robodosing" (because users chug Robitussin or another cough syrup to achieve their desired high).
What Happens When Teens Abuse DXM?Although DXM can be safely taken in 15- to 30-milligram doses to suppress a cough, abusers tend to consume as much as 360 milligrams or more. Taking mass quantities of products containing DXM can cause hallucinations, loss of motor control, and "out-of-body" (disassociative) sensations.
Other possible side effects of DXM abuse include: confusion, impaired judgment, blurred vision, dizziness, paranoia, excessive sweating, slurred speech, nausea, vomiting, abdominal pain, irregular heartbeat, high blood pressure, headache, lethargy, numbness of fingers and toes, facial redness, dry and itchy skin, loss of consciousness, seizures, brain damage, and even death.
When consumed in large quantities, DXM can also cause hyperthermia, or high fever. This is a real concern for teens who take DXM while in a hot environment or while exerting themselves at a rave or dance club, where DXM is often sold and passed off as similar-looking drugs like PCP. And the situation becomes even more dangerous if these substances are used with alcohol or another drug.
Being on the LookoutYou can help prevent your teen from abusing over-the-counter medicines. Here's how:
Lock your medicine cabinet or keep those OTC medicines that could potentially be abused in a less accessible place. Avoid stockpiling OTC medicines. Having too many at your teen's disposal could make abusing them more tempting. Keep track of how much is in each bottle or container in your medicine cabinet. Keep an eye out not only for traditional-looking cough and cold remedies in your teen's room, but also strange-looking tablets (DXM is often sold on the Internet and on the street in its pure form in various shapes and colors). Watch out for the possible warning signs of DXM abuse listed above. Monitor your child's Internet usage. Be on the lookout for suspicious websites and emails that seem to be promoting the abuse of DXM or other drugs, both legal and illegal. Above all, talk to your kids about drug abuse and explain that even though taking lots of a cough or cold medicine seems harmless, it's not. Even when it comes from inside the family medicine cabinet or the corner drugstore, when taken in large amounts DXM is a drug that can be just as deadly as any sold on a seedy street corner. And even if you don't think your teens are doing it, chances are they know kids who are.