The Healthy Blogger

Oh no, chicken pox!

What an unbelievable day.  Someone at work had shingles, so a colleague and I had a discussion about chicken pox.  I was asked if my kids had chicken pox yet and I replied that they had received the varicella vaccine.  Of course, getting vaccines does not guarantee that you can’t get the disease, but it allows you to hope that the illness would be mild.  Since the varicella vaccine is relatively new, not enough data is available to show how effective it is.  You can only show that it is ineffective when an individual develops the illness that the vaccine was supposed to prevent.

I came home to find my husband dabbing calamine lotion onto my younger daughter’s torso.  It may have been that I had chicken pox on the mind, but my first reaction was, “Oh no, you’ve got chicken pox!”  Sure enough, it is chicken pox.  We hadn’t heard that there was an outbreak at school, so we’re not sure if she is the sentinel case or if she caught it from someone else.  I just hope that I was not a vector, as I was exposed to someone with shingles.  Or vice versa.

If she caught the virus from someone else, my daughter would have been exposed sometime in the last week or two.  Which also means that she could have been passing it on during that time.  Viral shedding occurs even before the rash breaks out.

It does appear that she is having a rather mild infection.  She has not had a fever and generally feels well. Though she complains of a mild sore throat and some fatigue, it does not prevent her from doing her usual activities.  She does complain about itch, but it has not been bad.  Of course, she hardly ever complains about itch with rashes of any kind.  Already, some of the lesions are starting to scab.  Once that happens, she will no longer be infectious and can interact with others, unless she is embarrassed about the sores on her face.  Fortunately, the end of term is nearly here.  I just hope the Easter holidays will not be ruined.

Treating head lice

I never expected to have to deal with this problem, but that’s life. I guess if hundreds of millions of people get it every year, I shouldn’t expect to escape unscathed through my kids’ childhood.

Head lice infestation, also known as pediculosis, commonly affects children between the ages of 3-10. This is the age of nursery through primary school. For whatever reason, it is less common in older children. However, exposure to the younger population will put you at risk. That is, unless you are bald, in which case, you are unlikely to ever get head lice.

Head lice only infects those with hair. That is because they attach themselves, as well their eggs, to the strands of hair, using their very sticky saliva. There is a common misconception that only those with poor hygiene will get head lice. However, lice prefer clean hair, as it is easier to attach. Having said that, they would readily climb onto any hair they find available. They do not like oils, as it makes it difficult for them to attach; so, those with greasy hair may have an advantage.

Lice do not fly or jump. They walk between hairs, so they can only be passed between close contacts. It is uncommonly passed simply by sharing combs or clothing. Lice quickly die in the absence of a host to provide warmth and food. Since they feed on the scalp, they do not survive long once removed from the head. Therefore, the treatment of head lice does not require washing of clothes or bedsheets exposed to them. This is different to body lice which does require boiling of the clothes and bedsheets, or burning, if boiling is not practical.

Suspicion is raised when a child scratches his/her head. This is because itching is the most common symptom. The itching is caused by irritation when a louse bites the scalp to suck the blood. As it does so, it releases its saliva and the body’s reaction to the saliva causes the itching. However, some people do not experience a reaction, therefore, they do not itch. By the time the itching occurs, the head may have been infected for several weeks.

Examination of the head for lice is very important. Most often, lice can be found behind the ears or at the nape of the neck. They may be difficult to find if the hair is thick. Sometimes, you may be able to see the red bite marks, or the black lice droppings. More often, you can find nits (empty shells of lice eggs) attached to the hair. Nits can be distinguished from dead hair cells by their strong attachment. Usually dead hair cells will fall off when you shake the hair.

Treatment for lice varies depending on your personal preference. No treatment is 100% effective. There are pesticidal and non-pesticidal chemical treatment, as well as “natural” therapy. The pesticidal treatments often require a doctor’s prescription, whereas, the non-pesticidal will be sold over-the-counter. You should ask your local pharmacist for help on this. The problem with pesticidal treatments is that the lice often form resistance to the agents. Natural therapies include the simple wet-combing method, tea tree oil and other natural products (some examples include olive oil, aniseed and coconut), and hot air.

The wet-combing method involves washing the hair with shampoo, followed by an application of conditioner. Then, comb the hair using a regular comb to get the tangles out. After this, use the nit comb to go over the hair to remove lice and nits. The comb should be rinsed to remove the lice and nits between combings. To be thorough, this process should take about 30 minutes. The wet-combing method should be used, regardless of whether a chemical treatment is used or not.

It is recommended that chemical treatments not be used unless a live lice is detected on head exam. When using the chemical treatments, you should ensure that the eyes are protected by using a towel to prevent dripping of the chemical onto the face. Rinse the eyes well if any of the chemical does go in. Because no treatment is 100% guaranteed to work, repeat treatment is often necessary. Chemical treatments may kill lice, but not the eggs, which incubate for 6-9 days. Therefore, after about 10 days, the process should be repeated to kill the lice that hatches. It is also recommended that the wet-combing method be used in between the two treatments. Experts suggest checking for lice every two days with the nit comb and if it is negative for 10 consecutive days, then the child can be declared lice-free.

Hot air is another non-chemical treatment. However, it requires a special machine to deliver the right amount of heat to destroy the lice and eggs. There are other treatments that people resort to that are considered dangerous and, therefore, strongly recommended not to use, such as gasoline or kerosene. And, there are newer products in development that show promise and do not rely on pesticides.

Unfortunately, there is no way to prevent head lice. You can reduce the risk of acquiring lice by tying long hair back so that it reduces the likelihood of coming into contact with other people’s hair. Though shaving the head is one way of reducing the risk, it is not recommended because of the psychological impact on the child. However, if the infestation is severe enough to cause matting of the hair, cutting or shaving the hair may be necessary.

Swine flu claims “healthy” victims

Now that there are documented reports of healthy individuals contracting and dying from swine flu, it becomes a more serious issue.  Yes, the authorities are still trying to calm people by reassuring them that most cases are mild, but it cannot eradicate the uncertainties that such a thing can strike close to home.

Every time someone coughs or sneezes, we joke about swine flu, and I hope that “normal” bystanders will recognise that we are only teasing and not think that we have swine flu and attempt to have us removed or quarantined.  But, I suppose that since it is becoming more serious, the jokes should end.

The school has sent out notices to encourage us to teach the kids to follow good sanitary hygiene, whether at home, school or anywhere else.  We do our best, but we cannot guarantee that the kids will follow everything we tell them.  It does not help that the state of public bathrooms leaves much to be desired in terms of sanitation and hygiene.  Perhaps, the councils should start by having more people inspect these public toilets more often and ensuring that there is adequate soap and water or even hand sanitizer.

Swine flu is not “uncontainable”, so everyone is at risk.  But, steps need to be undertaken to prevent the spread or at least, limit it.

Seven swine flu related deaths in UK

We have had seven deaths in the UK linked to swine flu.  Though the flu has not been confirmed as the cause of death in all the new cases, it may have hastened it.  The only thing reported about all seven cases is that they all suffered underlying health problems, despite the fact that they are all relatively young (under 40), except one.  What these “underlying health problems” are is not revealed except in the case of the youngest – a girl of 6 with an immune disorder.  The secrecy behind the health problems leaves one wondering if it is not a cover-up.

So far, most cases are mild, but the pandemic is spreading at an extremely rapid pace and it is expected to increase in the coming month, with predictions of around 100,000 new cases a day.  At that rate, it would not be surprising for resistance to occur.  In fact, it has already occurred outside of the UK.  Given these statistics, I find it extremely shocking that there are some ill-informed people giving swine flu parties.  With the holiday season coming on, the chances of catching swine flu seem almost inevitable.

Irresponsible BBC reporting on the state of HIV therapy

I found the latest article on HIV and STDs on the BBC website extremely irresponsible and offensive.  I realise that the point of the article was to encourage those with HIV to see a doctor and be treated, but the message does not come across that way.

It did state that the main focus of prevention is on the use of condoms.  But this statement was made at the beginning.  For the rest of the article, it was never mentioned again.  In fact, the writer seemed to imply that condoms were completely unnecessary.  The story’s focus was on how good anti-HIV treatment has become – so good, that the person could be considered no longer infectious.  Because of this, the likelihood of the person passing on the virus was close to nil.

Never mind the fact that people have been shown to pass the virus on to their partners.  The article passes this off as few and far between.  Should this complacent attitude be what experts are advising?

There is no cure for HIV at this time, but antiviral therapy has helped to slow down the spread of the disease.  Because the epidemic has been stopped, is this reason to say that we can all relax our vigilance?

It is no wonder that the younger generation shows no fears about sexually transmitted diseases.

Avian flu does not like the cold

Despite all the warnings about swine flu, it still has not reached pandemic level.  One of the biggest concerns is that it may mutate and become more virulent.  Another concern is that it may mix with the avian flu and create a maor crisis.  However, a recent study suggests that the avian flu virus has not adapted to colder climates.  This makes it less likely to be carried in human noses, or at least, noses of humans living in colder climes.

The reason that many other human viruses can cause infections in our colder noses is that these viruses have adapted themselves to the cold.  There are still some that prefer warmer climes.  That is why sometimes cold air is recommended for cold sufferers.  The swine flu virus (H1N1) is able to survive in colder climates, therefore, it has been able to spread.  We would have a bigger catastrophe if the avian virus mutates.  Fortunately, this takes time and scientists are able to monitor any changes.

Experts still urge us not to be complacent about the swine flu, but some people are suggesting trying to get it now while it’s mild and you can develop an immunity to it.  This would only be advisable if you are healthy and can quarantine yourself so as not to inadvertently infect someone who is immunocompromised in any way.

Oestrogen protects against infections

Men might not like to hear it, but according to a new research, they are the “weaker” sex.  The research was performed at McGill University and was done on mice.  However, the research is applicable to humans because it involved a human gene that was transplanted into the mice.

The gene was for an enzyme called Caspase-12.  This enzyme, when present in the body, blocks anti-inflammatory responses, which is the first line of defense against infections.  Therefore, when this enzyme is present, the body is more susceptible to infections.  However, it has been shown that oestrogen blocks this enzyme, thereby, allowing the anti-inflammatory response.

In conclusion, scientists believe that women are better at fighting off infections than their male counterparts due to the beneficial effects of oestrogen.  Of course, it’s all relative because not all women have equal levels of oestrogen in their system.  Can we conclude that postmenopausal women will not fight off infections due to loss of oestrogen?  Should that be yet another argument for them to be on hormonal therapy?  What about obese men who make oestrogen?  Will they be more protected?  Some interesting questions to answer.

Swine flu epidemic moves closer to a pandemic

Swine flu cases continue to increase.  The WHO have upgraded the pandemic level warning to 5, one step short of calling it “imminent”.  In Mexico, schools and businesses have closed until at least 6 May.  In the US, about 100 schools have closed due to the rise in potential swine flu.  In the UK, one school has closed for a week.  Businesses in Mexico have suffered due to the shut-downs and travel restrictions.  This can only worsen the global recession crisis.

Though a flu pandemic is a potentially serious crisis, the world is more prepared than it has been in the past.  So far, the virus appears to be responding to anti-viral therapy.  Nevertheless, there is always concern that the virus may mutate, which would make it more virulent.

Are we overreacting to this new strain of the flu?  Or, could it be another SARS-like epidemic?  Whatever the case, vigilance is necessary, including measures to reduce the spread of the virus.  We should be grateful for the fact that the illness is still treatable at this stage.

Have advances in medicine caused people to become complacent?

We always greet advances in medicine with enthusiasm. We hope and pray for new treatments for serious health problems.  We are grateful for technology that saves lives.  Yet, there is a downside to all this technology.

We have extended lives and in doing so, we have created new problems, new illnesses. Take Alzheimer’s, for example.  When people started living longer, we began to see a rise in what was initially thought to be senility.  Now we have multiple diagnoses for dementia, one of which is Alzheimer’s.  We have machines to keep people alive.  Now we’ve run into ethical issues regarding end-of-life and right-to-die.  When is it permissible or ethical to turn off the ventilator or remove the feeding tube?  But another serious issue is that people start thinking that they can ignore serious health consequences because there are means of overcoming them.

I read an article about an HIV/AIDS survivor who expressed his concerns that young people are taking chances with their lives because they are no longer scared of contracting sexually transmitted diseases.  Had they witnessed first hand all the horrific side effects of HIV, they would not be so complacent.  As it is, HIV treatment has allowed many survivors to live normal lives.  Of course, this only applies to those who are being treated.  But it is rare for young people in developed countries to see the consequences of AIDS. Perhaps, they need to visit Africa and see the devastation there.

Now, I’m not saying that medical advances are bad.  They’re not.  It’s great that we can conquer illnesses, but the fight is never won.  The battle is never over.  There will always be obstacles.  Unfortunately, we shouldn’t have to keep fighting so many battles.  If people could take responsibility for their actions, we might prevent disease, rather than have to tackle them afterwards.  HIV/AIDS is still a major issue, but it does not attract attention as it did in the 1980s.  People have forgotten how scary it was when we first heard about it.  Young people today were  not around to experience it.  So, they ignore it.  If they were to receive the diagnosis now, they probably would shrug it off and ask for the treatment.  Their complacency means that they might not be compliant with the treatments.

Yet, I wonder if behaviour would change if young people knew first-hand about the seriousness of sexually-transmitted diseases.  Would there be the same rate of unprotected sex and teenage pregnancies?  Would there be any changes in attitude towards sexual activity?  Is it really the advances in medicine that have produced this complacency or is it a generational attitude?

Mumps outbreak in the news

A mumps outbreak made the news today. It appears that it is occurring at two universities in the north. Health experts are reassuring everyone that the outbreak is contained. They are putting the blame on the fact that when the single measles vaccine was switched to the MMR, not everyone was called back to receive the vaccine. Therefore, they are now seeing an outbreak amongst those in their early 20s. It is unfortunate, since those who suffer complications from mumps are those who are older. Parents who had refused the MMR in recent years due to concerns about autism need to be aware as their children may be at risk for developing mumps as well as the measles outbreak in the recent past.

The virus attacks the parotid salivary glands and sometimes, reproductive organs. The virus is very contagious and is spread through sneezing or coughing. It may take up to three weeks after infection before you show any signs of it, so you may be spreading it without knowing it. A person is contagious from about a week before any signs/symptoms to about a week after the signs/symptoms have shown up. The most common symptom is swelling of the parotid salivary glands giving a person the appearance of stuffing their cheeks. This may be associated with fevers, chills, fatigue, loss of appetite, pain with chewing or swallowing, sore throat, and headaches. Usually, the symptoms are mild and treated with analgesics/anti-inflammatory agents and plenty of fluids – mostly water. You should avoid anything that stimulates the salivary glands as this can cause pain.

Complications are rare but can arise in severe cases. These include deafness, decreased fertility due to inflammation of the testicles or ovaries, meningitis or encephalitis. Pregnant women who are infected may miscarry, but there is no evidence of any birth anomalies.

The best way to avoid getting mumps is through vaccination. It may not be 100% as is the case for contracting and surviving the disease, but it is very close. The MMR has been shown to be effective as well safe.

Doctors usually diagnose mumps through a physical examination. However, if there are complications and it is necessary to establish that mumps is the cause of the complications, there may be blood, urine or CSF (cerebrospinal fluid obtained through a spinal tap) tests that need to be run. It is always best to contact your doctor if you develop symptoms of mumps.