CLOSE
Tags Posts tagged with "Flu"

Flu

by -
0 637
Flu season is hitting New York and the country as a whole especially hard this year. Stock photo

By Daniel Dunaief

The flu season has hit with a vengeance in February, as a seasonal virus that can be deadly has  become the dominant cause of illness in the area.

Suffolk County hospitals reported 337 residents with influenza in the week ending Feb. 1, according to New York State Department of Health data.

Dr. Sharon Nachman

Just last year, for the 2023-2024 flu season, Suffolk County hospitalizations peaked on Dec. 30 at 52. Even in the year before, when people were starting to wear masks much less frequently than during the peak covid years, flu hospitalizations in the county peaked at 50 on Dec. 17.

“We are definitely seeing more people sick” with flu, said Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital. The emergency room is “wildly full, and even urgent care walk in is full.”

The number of positive cases of flu A at Stony Brook University Hospital in January was 800. That compares with 400 cases for the same strain last year, according to Nachman.

While the flu is cyclical and can cause different levels of infections from year to year, local doctors suggested that the overall flu vaccination rate was lower this year, which may have increased vulnerability to the virus and extended the time people exhibited symptoms.

The number of people vaccinated is “incredibly lower compared to past years,” said Nachman. On top of that, people may not have been exposed to the flu for several years amid measures to reduce the spread of Covid-19.

Residents’ immune systems may have “no good memory response” if the last exposure to the virus occurred some time before 2020, Dr. Nachman added.

The dominant strain of the flu this year is the A strain, which accounts for about 80 percent of the cases.

Nachman suggested that people who were vaccinated in early September may not have as much resistance to the flu this month, as their peak resistance, which typically lasts about three months, has wained.

Health care professionals added that people who haven’t been vaccinated could still receive the shot, as the flu season could continue to last for a month or more.

Dr. Adrian Popp

“It is not too late to get the flu shot,” Dr. Gregson Pigott, Commissioner of the Suffolk County Department of Health Services, explained in an email.

Dr. Adrian Popp, chair of Infection Control at Huntington Hospital, said the staff has been offering flu shots for residents who have were not already immunized.

“I don’t know how much longer this will last,” said Popp. “It’s still cold and it’ll be cold in March.”

Typically, it takes two weeks for the body to receive full protection from the shot. The shot does provide some incremental benefit immediately.

“You start building immunity from the moment you get” the shot, said Popp.

So far this year, there have been two deaths at Huntington Hospital, which is not unusual for the flu.

Mortality from the flu is “turning into what it used to be,” said Popp, with deaths at about pre pandemic levels.

High risk patients

High risk patients are typically older or have preexisting conditions.

People who have an inability to fight infections can get “much sicker from the flu,” said Dr. Alan Bulbin, St. Francis Hospital and Heart Center Director of Infectious Disease.

Dr. Gregson Pigott

Health care workers urged those who are in higher risk groups either to see their doctors if they start developing symptoms or to use some of the at home tests, including a recent one that can test for flu A and B, as well as Covid.

“If you are immunocompromised, you should have a low threshold,” said Bulbin. “You should speak with a doctor, go to urgent care, and do a swab. That may differentiate influenza” from other infections such as respiratory syncytial virus, or RSV, and Covid.

The antiviral treatment Tamiflu can be effective if people start taking it within 48 hours of developing symptoms. Paxlovid, meanwhile, can also help within a few days of developing covid.

“We urge residents, especially those at risk for severe illness, to contact their medical providers at the onset of symptoms,” Pigott explained in an email.

Lower Covid and RSV levels

While the flu has infected a larger number of people than in previous years, the incidence of RSV and Covid has declined.

In Suffolk County, 90 residents are hospitalized with Covid, while the number of deaths from the virus is 29 since the start of the year, according to the New York State Department of Health.

That compares with 190 residents hospitalized last year and 96 deaths from Covid from Jan. 1 through Feb. 14.

“The virus that causes Covid-19 is still circulating and causing disease, although not as aggressively as in previous years,” Pigott explained.

RSV, meanwhile, rose in the fall, peaked in late December and has been falling since then.

RSV accounted for 0.2 percent of emergency department visits on Feb. 1, Pigott added.

Future ID doctors

Specialists in infectious disease were unsure how the pandemic affected the interest among doctors in training and residents in their field.

For some, the appeal of reacting to fluid circumstances and to gathering insights about a developing disease that could and did affect billions of lives could be appealing. For others, however, the demands, the hours, and increasing politicization of medicine as well as the divided response to vaccines could have pushed them in other directions.

“Am I concerned that not enough people are going into the specialty?” Nachman asked. “Yes.”

by -
0 790
METRO photo

By Dylan Friedman

Recent Centers for Disease Control and Prevention data indicates a significant increase in illness across the United States, with roughly 40 states reporting high illness activity levels in the past week.

So, what illnesses are hitting the hardest at the moment?

According to Carrie Reed, epidemiologist with the CDC Influenza Division, as reported in a recent NBC News Chicago article, “There is a lot of flu out there.”

Reed further emphasized that the current flu surge is being driven by multiple strains, a fact supported by the latest CDC hospitalization data.

According to the CDC, “flu symptoms usually come on suddenly.”

Some of the most common symptoms include fever or feeling feverish/chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches and fatigue (tiredness). Some people may have vomiting and diarrhea, though this is more common in children than in adults.

According to the CDC, antiviral medications may be a treatment option if you contract the flu. These medications can potentially lessen the severity of illness and shorten the duration of sickness. They may also help prevent certain flu complications, such as pneumonia.

For optimal effectiveness, antiviral medications should be initiated promptly, ideally within the first two days of the onset of flu symptoms.

While the flu is prevalent at the start of 2025, it is essential to note that several pathogens, including COVID-19 and respiratory syncytial virus, can present with similar symptoms, such as fever, cough and sore throat. While RSV typically causes cold-like symptoms, it can pose significant health risks for infants and the elderly.

According to the CDC, people infected with RSV usually exhibit symptoms within four to six days after getting infected. The most common symptoms are runny nose, congestion, decrease in appetite, coughing, sneezing and fever.

It is also important to note that symptoms often appear in stages rather than simultaneously. While adults may experience more pronounced symptoms, they can be less noticeable in young infants. Although RSV typically causes mild cold-like illness, it can lead to severe conditions such as bronchiolitis and pneumonia.

Preventive and protective measures against RSV infection vary depending on the age group. For adults, RSV vaccination is recommended for individuals aged 75 and older as well as those aged 60-74, who are considered at increased risk for severe RSV. In infants, two primary approaches are utilized to mitigate the risk of severe RSV infection. First, a maternal RSV vaccine can be administered to pregnant women, providing some level of protection to the developing fetus. Alternatively, an RSV antibody can be administered to infants after birth to enhance their immunity against the virus.

Additionally, the common cold can present with symptoms similar to both RSV and the flu, including a runny nose, sore throat and cough. While the common cold is generally considered a mild illness, it can cause significant discomfort and may lead to more serious complications in individuals with weakened immune systems, such as the elderly or those with chronic health conditions.

According to the CDC, the manifestation of cold symptoms usually reaches a peak within two to three days of infection and may include runny nose or nasal congestion, cough, sneezing, sore throat, headache, mild body aches and fever (usually low grade in older children and adults).

The common cold is a self-limiting viral infection that typically resolves without the need for specific medical intervention. It is crucial to understand that antibiotics are ineffective against viruses and, therefore, will not alleviate cold symptoms. 

Additionally, individuals experiencing cold-like symptoms who suspect a possible COVID-19 or flu infection, particularly those at elevated risk for severe illness, are strongly encouraged to undergo testing. 

Antiviral treatments are available for both COVID-19 and flu, and their efficacy is significantly enhanced when administered promptly following the onset of symptoms.

More information can be found on the CDC website: www.cdc.gov.

by -
0 599
Photo courtesy Metro Creative Graphics

By Daniel Dunaief

While the fall provides a break from the summer heat and a respite for exhausted parents who coordinate and carpool for recreational activities, it also can trigger a return to more concentrated time indoors.

Dr. Sharon Nachman, Chief of the Division of Pediiatric Infectious Diseases at Stony Brook Children’s Hospital.
File photo

That can trigger the beginning of the flu season, as students and their families share much more than the lessons of the day and stories about teachers and classmates.

Timing shots can be a delicate balance, as the antibody coverage from these shots is typically about three months.

With the peak flu season often occurring during December and January and even into February, Dr. Sharon Nachman, Chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital, suggested that residents receive their vaccines in a few weeks.

“Getting a vaccine in October is probably the right time,” Nachman said.

Dr. Gregson Pigott, Commissioner of the Suffolk County Department of Health Services, added that the timing for Covid vaccinations is somewhat trickier.

“Because the evolution of new variants remains unpredictable, SARS-CoV2 [the virus that causes the disease] is not a typical ‘winter’ respiratory virus,” Pigott explained in an email.

The county health department recommends that residents stay up to date with their vaccinations.

“Individuals should speak with their healthcare providers for advice that is specific to them,” Pigott added.

Simultaneous shots

Doctors generally recommend receiving both shots at the same time, if people are eligible and the timing for each vaccine is right. Residents who are unsure about their eligibility should speak with their healthcare providers, Pigott explained.

Dr. Gregson Pigott, Suffolk County Health Services commissioner. File photo

The flu and Covid are viruses that change over time, creating a battle between the pharmaceutical companies that manufacture vaccinations and the viruses that attempt to evade them.

Each year, the vaccines attempt to provide the best match against the dominant or most likely strains.

The Centers for Disease Control and Prevention “determines if the vaccine will protect against a circulating virus by conducting laboratory studies on circulating flu viruses,” Pigott explained in an email. “Updated 2024-2025 flu vaccines will be trivalent” and will protect against H1N1, H3N2 and a B/ Victoria lineage virus.

Vaccine manufacturers create immunizations based on the flu strain circulating in the southern hemisphere during the recent season.

“We expect that those are what’s going to hit us in our winter,” Nachman said. “The science is there. We know generally what types will be rolling around. We could hit or miss it by a subtype.”

Nachman added that the flu vaccines represent educated guesses about the type of microbe that might cause illnesses.

“The educated guesses are still better than no vaccine, which will, for sure, not cover you at all,” Nachman said

As for the Covid immunization, doctors added that it is also likely to change as the virus that caused the pandemic mutates.

Nachman said people should plan to get the Covid shot around once a year.

“I don’t think we’re going to go to more often” than that, Nachman said.

During the summer, when an infectious strain of Covid surged across the county, state and country, Nachman said the data is not available to determine how much protection a vaccine provided.

“Only on TV do computer models work instantly,” Nachman said.

She suspects that the Covid shot offered some protection for residents, who may not have been as sick for as long as some of those who dealt with a range of symptoms.

Concussion awareness

With the start of a new school year and the beginning of contact sports like football, school districts are continuing to ensure that coaches and athletes follow concussion protocols.

“Schools have done a nice job thinking and talking about it,” said Nachman. “Coaches know you can’t throw [student athletes] out and say, ‘You’ll do fine,’” after a head injury.

Nachman suggested that area athletes may engage in activities that are not connected to the schools and that may involve head injuries that people ignore.

“We know what’s happening with school-regulated” sport, but not with those that are outside the academic umbrella, she added.

As for the emotional or psychological impacts of a divided and bitter electorate during an election year, Nachman said people are under considerable emotional stress.

“The social media echo chamber is making it worse,” she said. The abundance of misinformation on both sides is causing mental anguish.

“Election times are very stressful and I think, in particular, this election may be even more stressful,” Nachman said.

Nachman urges people to minimize their time on social media and to create down time from electronics during meals.

As students move up a grade and into new places, they also can endure stressors, peer pressure and bullying. She suggests that parents understand what their children are seeing online.

Newborn RSV protection

Children born in March or later are eligible to receive an approved shot called Beyfortus, which, in 80 percent of cases during clinical trials, prevents the development of respiratory syncytial virus, or RSV.

The Beyfortus monoclonal antibody will make a “huge difference” for newborns and their parents, Nachman said. Last year, Stony Brook had numerous hospitalizations in children under one year of age.

“We’re not going to have those children coming into the hospital,” Nachman said. “That’s amazing and is a huge step forward.”

When newborns get RSV, doctors don’t have an effective treatment for the virus and typically treat the symptoms.

The mortality rate from RSV is low, but the morbidity is high. Newborns who contract RSV can end up developing chronic asthma.

As with any shot, Beyfortus can have side effects, with the most common including rash and pain, swelling, or hardness at the site of the injection, according to AstraZeneca and Sanofi, which manufacture the antibody.

Beyfortus is covered by insurance and is under the vaccine for children program and numerous private health insurance plans. Parents can opt out of the shot. Nachman suggested they should understand what they are opting out of when they make that decision.

by -
0 1712
Stony Brook doctor, tending to a newborn baby. Courtesy Stonybrookchildrens.org

By Daniel Dunaief

Water inside a house isn’t just bad for the structure, it can also be damaging to your health.

Local health care professionals suggested that Stony Brook residents whose basements flooded from this weekend’s heavy rainfall should be careful about the growth of mold or mildew, which can be especially problematic for anyone with chronic breathing issues.

“People can inhale spores over a period of time and can develop respiratory symptoms,” said Dr. Sunil Dhuper, Chief Medical Officer at Port Jefferson’s St. Charles Hospital.

People with asthma, chronic obstructive pulmonary disease, bronchitis and emphysema “need to be particularly concerned about some of these issues,” he continued.

Dr. Sharon Nachman, Chief of Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital, suggested that residents of Stony Brook, who experienced a localized 10 inches of rain this weekend, should “aggressively clean” their basements, from any standing water, as mold and mildew can start growing within a few days.

“You won’t see it because it’s small,” but people should dry the walls and under the floorboards and carpet, she said. “You want to get the water out.”

Local doctors, also, recommended dumping standing water off any surface that might become a breeding ground for mosquitoes, who can carry the West Nile virus.

At this point, the County Department of Health believed the West Nile threat wasn’t likely particularly high.

“The heavy rains and wind might have washed away adult larvae and adult mosquitoes,” Dr. Scott R. Campbell, Laboratory Chief in the Arthropod-Borne Disease Laboratory at the Suffolk County Department of Health Services, explained in an email.

“Wet springs and hot, dry summers — in which mosquitoes and birds may congregate at limited sources of water — may be conducive to higher West Nile virus transmission.”

The heavy rain, which was triple the usual average for the entire month of August, according to Weather Spark, likely reduced area mosquitoes.

Local medical care professionals suggested that residents should still remove standing water as a way to protect themselves against any remaining mosquitoes.

Congenital viral infection

Apart from the impact of local flooding, doctors discussed a host of other medical issues.

New York State has been testing newborns, since last fall, for congenital cytomegalovirus, or CMV, which infected mothers can give to their unborn children.

The testing so far has shown that CMV is less prevalent than previous estimates.

The state started the one-year study of the virus to track children who might develop symptoms, such as hearing loss or learning challenges, later on.

“The earlier you identify babies with hearing deficits, the sooner you can act, and there will be fewer ramifications on their intellectual development, as a result of it,” said Dr. Andrew Handel, pediatric infectious diseases expert at Stony Brook Children’s Hospital, and a co-leader, along with Dr. Nachman, of one of the 11 units across the state.

Dr. Sharon Nachman. Courtesy Stony Brook Medicine Facebook page

Earlier medical sources estimated that the infection rate for newborns was about one in 200 babies. But, with about 300 newborns testing positive, the rate is closer to one in 325.

The percentage of symptomatic babies is tracking with previous expectations, at around 10 percent. Symptoms of congenital CMV at birth include hearing loss, jaundice, low birth weight, seizures and retinitis.

“Our numbers are matching up with the 90 percent” of those who have the virus, but are asymptomatic, Handel added.

“That’s why we feel screening is so important.”

For the asymptomatic newborns, about 10 percent will develop permanent hearing loss, which is why doctors are tracking them so closely.

The virus, which is a relative of the Epstein Barr virus, which causes mononucleosis, is spread through direct contact with body fluids, such as tears, saliva or urine. Over half of all adults have had a CMV infection, with some studies estimating the rate as high as 80 percent.

Adults can shed the virus for a few weeks after contracting it, while children can shed it for a few months.

While all newborns will receive CMV screening after birth, parents have five days to opt out of any link to a report of the presence of the virus in their children.

At this point, fewer than one percent of parents are opting out of the testing. Some of the parents aren’t interested in the test, others don’t believe it’s useful, while some believe their babies look fine, and don’t want the additional test.

Most parents appreciate the opportunity to gather information about their children’s health. Patients are “grateful the state has this program,” said Dr. Sunil Sood, Systems CMV specialist at Northwell Health.

At Stony Brook and other hospitals, doctors are monitoring those babies who test positive.

The County Department of Health supports the testing, as well.

“Routine screening of newborns for [congenital CMV] will help identify affected infants early on so they can receive appropriate follow-up and treatment,” Cynthia Friedman, Director of Public Health Suffolk County Department of Health Services, explained in an email.

“Infants who screen positive … should be followed closely by their pediatricians and referred to specialists as needed to ensure early detection of problems with hearing, vision or development so that appropriate care and support can be implemented.”

Once the funding for the testing runs out, which will be around October, hospitals around the state will no longer perform the test.

Parents can ask for a urine test, which doctors estimate could cost between $50 and $100, but which insurance, likely, won’t pay for — especially if the child is asymptomatic.

Legislators, including Assemblymember Linda Rosenthal (D-NYC) plan to introduce a bill in January that would fund tests, in future years.

“We would advocate that that become a permanent part of infant testing,” said Sood. “There are diseases that are far less common than CMV that have made it into the newborn testing programs.”

Immunization

Amid pushes by some pharmacies to encourage people to get flu shots, health care experts suggest waiting until closer to late September, or early October, for the inoculation.

“Vaccine efficacy is about three to four months,” said Nachman. “If you get it in August, when the flu season hits in January, you may not have much protection.”

The Centers for Disease Control and Prevention recommends similar timing, around September or October.

At the same time, Nachman expects a new batch of Covid vaccines will be available around September.

She recommends getting both shots at the same time, which increases both vaccines’ effectiveness.

Pharmaceutical giant, Pfizer, and BioNTech, recently reported that a single combined shot for Covid and flu was not effective against influenza B, which means that people interested in receiving vaccines this fall should plan to get two shots.

Covid numbers

As for Covid, the current strain has made the rounds this summer.

“Everybody and their neighbor had Covid,” said Nachman, who added that the virus has spread across all ages. Covid was “clearly more infectious than what we had in the spring” and people were sicker for longer.

While the number of infected people has decreased, the start of the fall semester could trigger an increase.

by -
0 648
Stock photo

After a November and December in which realities like a “tridemic” of viral threats sickened residents throughout Suffolk County, the new year has started off with fewer illnesses and cautious optimism among health care professionals.

“The numbers are coming down now,” said Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital. The overall threat is “less” and “we’re in the take-a-deep-breath phase.”

Indeed, the frequency of cases of several viruses is lower.

“Flu and RSV (respiratory syncytial virus) are down,” Dr. Adrian Popp, chair of Infection Control at Huntington Hospital/Northwell Health and associate professor of medicine at Hofstra School of Medicine, explained in an email.

At the Catholic Health hospitals, including Port Jefferson-based St. Charles and Smithtown-based St. Catherine of Siena Hospital, the emergency room visits are down around 10% from a few weeks ago, said Dr. Jeffrey Wheeler, medical director of the Emergency Department at St. Charles.

In between too busy and too quiet, the hospital is in the “sweet spot” where health care providers have enough to do without frantically racing from one emergency to another, Wheeler said.

Among those visiting St. Charles, Wheeler added that health care providers are seeing a smattering of illnesses.

At the same time, the vaccine for the flu has proven to be a “good match” for the current strain, Nachman said. “Amongst those who did the flu shot, they have tended to not get sick enough to go to the doctor.”

According to New York State Department of Health figures, the overall numbers across the state have been declining for the flu. For the week ending Jan. 14, the number of infections was cut in half.

Suffolk County saw a slightly larger drop, falling 59% for the same week, to 571.

This year, people who were going to get the flu vaccine may have helped themselves and their families by getting the shot earlier, rather than dragging out the process of boosting their immune systems over the course of months. Nachman said.

Cases of monkeypox continue to be on the lower side, in part because of the number of vaccines people in the area have received.

To be sure, health care workers are still helping people overcome a range of infections circulating in the county.

“We are still seeing a smorgasbord of flu, COVID and RSV,” said Nachman. Of the people admitted to Stony Brook Hospital, most of them have a comorbidity.

At Huntington Hospital, admissions are “high,” and the hospital census remains high, Popp added.

Health care workers are diagnosing viruses like the flu and COVID-19 and have used available treatments to reduce the symptoms and the spread of these viruses.

New COVID vaccine approach

Earlier this week, the Food and Drug Administration posted documents online that reflected a possible future change in its approach to COVID-19 vaccinations.

Instead of recommending bivalent boosters or a range of ongoing vaccinations to provide protection against circulating strains, the FDA plans to approach COVID-19 vaccinations in the same way as the flu.

Each year, people who are otherwise healthy and may not have high risks may get a single dose of a vaccine based on the strains the administration anticipates may circulate, particularly during the colder winter months.

Health care professionals welcomed this approach.

Nachman and Popp thought a single shot would be “great” and appreciated how the annual vaccine would simplify the process while reducing inoculation fatigue.

“The simplest messages with the simplest strategy often wins,” Nachman said.

Bivalent booster concern

Addressing concerns raised by the Centers for Disease Control and Prevention about a potential link between the bivalent booster and stroke, Nachman suggested that was one data point among many.

Israel has used the Pfizer bivalent booster exclusively and hasn’t seen any such evidence linking the booster to stroke.

The CDC data is “one of multiple data points that we use to look at safety events,” she said. “Not a single other one has shown any relationship with stroke among the elderly in the first 21 days.”

by -
0 241
People are waiting once again for COVID-19 and other tests at local urgent care centers. File photo by Lina Weingarten

Around this time of year, parking lots are often full.

That’s true of the mall parking lot, as people go out to shop for holiday gifts for their friends and family, but it’s also true, especially this year, for hospitals and urgent care centers.

With the so-called “tridemic,” which is a combination of viruses that typically affect the lungs, including COVID-19, the flu and respiratory syncytial virus (or RSV), infecting people of all ages, the need for health care and medical attention has been high in the weeks leading up to the holidays.

When Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital, arrives at work at 7 a.m., she drives past urgent center parking lots that are “full for a reason. It’s because people are sick” and need medical attention at the start of the day.

Indeed, the combination of the three viruses, as well as other viruses and bacteria in the community such as adenovirus and enterovirus, has made it difficult for some children to attend schools and for adults to go to work.

For the week ending Dec. 10, which is the most recent period for which data is available, Suffolk County reported 3,936 cases of the flu, which is up 35% just from the prior week. The week ending Dec. 10 alone represents more than half of all flu cases for the entire 2019-2020 season, according to data from the New York State Department of Health.

At the same time, COVID and RSV numbers have climbed.

“We almost doubled our COVID census over the last three to four weeks,” Dr. Michael Khlat, chief medical officer at St. Catherine of Siena Hospital in Smithtown, explained in an email. St. Catherine currently has almost 60 COVID-positive patients. Nearly a third of those patients are admitted for COVID and are receiving intravenous remdesivir, while the others are incidental findings in the context of other medical needs.

“What is special about this surge is that it is inclusive of COVID, influenza, rhinovirus as well as RSV,” Khlat wrote. “The symptoms are very similar, and treatments are all supportive at this time.”

Family gatherings at Thanksgiving contributed to the increase, adding “extra turbocharging to the current respiratory viruses,” Nachman said.

The most vulnerable patients are the immunocompromised, patients with diabetes, chronic lung and cardiac disease, obese residents and patients with chronic liver and kidney disease, Khlat added.

Demand for beds

The influx of patients has meant that St. Catherine has had to increase its capacity of staffing using nursing agencies to meet the needs of the community for “seamless, high-quality care,” Khlat explained.

St. Catherine has also added more providers on the medical wards to care for patients and has load balanced patients with their Catholic services partner St. Charles Hospital and other Catholic Health facilities.

Nachman urged residents to see their primary care doctor if they have routine viral symptoms. Coming directly to the emergency room slows the process of delivering urgent care.

To be sure, Nachman urged anyone with chest pains or stroke-like symptoms should head directly to the emergency room.

Nachman said Stony Brook Children’s Hospital is transitioning to a model in which they triage patients who walk into the ER to assess the need for services.

As people prepare for family gatherings, Nachman suggested that they evaluate the risks of interacting with others.

People with an immune deficiency might want to wear masks or speak outside with others, particularly if someone in the group had one of the respiratory viruses.

Viruses like RSV are generally contagious for about three to eight days, according to the Centers for Disease Control and Prevention.

RSV spreads through close contact, which means that passing someone in a supermarket won’t likely spread the virus, while sitting and doing homework or eating a meal next to someone could.

As for COVID, Nachman continued to urge people to get the bivalent booster shot.

Every study, she said, shows that the booster drastically reduces the risk of being hospitalized with COVID.

by -
0 388
Doctors suggest getting immunized before the holiday gathering season begin. Stock photo from Metro

This fall and winter, several infections have their sights set on your lungs.

Amid threats from diseases that affect other organ systems, three of them — COVID-19, the flu and respiratory syncytial virus — can and often do attack the lungs.

While the current strain of COVID isn’t as lethal as the original, the virus continues to mutate, leading to new strains and, potentially, to different strains later this fall.

At the same time, the flu and RSV have been waiting for an opening after COVID protections like masks also kept them at bay during 2020 and 2021.

“How bad is the winter going to be?” asked Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital. “It will be based on more [COVID] variants coming through, with a strong flu season, which is never something you want to see.”

The number of cases of respiratory illnesses like RSV and the flu has been lower in the last few years. The lack of exposure to those viruses, however, may give them an opening for a stronger return in the population.

These viruses “didn’t paddle along for a while,” Nachman said. “Now, they are paddling furiously. Everyone is seeing them.”

People’s immune systems may not be prepared for the threat from these recurring viruses.

When people arrive at the hospital, health care officials often see the same symptoms, with coughing and sneezing.

“It could be one, two or three” causes at the same time, Nachman said.

The combination of contracting more than one virus at the same time could lead to prolonged and painful illnesses.

COVID reality

Much as people would like to return to a pre-pandemic reality, the SARS-CoV2 virus not only continues to infect people, but it also remains something of an evasive target, with mutations leading to new variants.

While area hospitals don’t test for the specific COVID strain when patients are sick, doctors expect that some of the people who have contracted the disease have the modern variants.

“Undoubtedly, many cases that are coming to our Emergency Department are due to the new Omicron sub-variants,” said Dr. Sunil Dhuper, chief medical officer at Port Jefferson’s St. Charles Hospital. “Information from the Centers for Disease Control and Prevention has shown that Omicron BA.5 cases are trending downwards and the cases due to the sub-variants are on the rise.”

“The purpose of the vaccine is to attenuate the symptoms from the virus and reduce the severity of illness, hospitalizations and/or death.”

— Dr. Sunil Dhuper

Symptoms of the newer variants are similar to others, with fever, chills, cough, runny nose, fatigue, muscle or body aches, shortness of breath, loss of smell or taste, sore throat, nausea or vomiting and diarrhea, Dhuper explained.

Doctors said it was difficult to gauge how effective the new bivalent COVID vaccines are against the latest strains.

The latest booster may “not be active against all the coming variants,” explained Dr. Phillip Nizza, attending infectious disease physician at St. Charles Hospital.

The new booster was designed to enhance the reaction to the BA.4 and BA.5 variants.

“We don’t have enough data” to determine the effectiveness of the booster against current and future threats, Nachman said. “How effective it will be depends” on differences between the booster and the strain someone contracts.

Still, the vaccine is likely to provide some benefits, doctors said.

“The purpose of the vaccine is to attenuate the symptoms from the virus and reduce the severity of illness, hospitalizations and/or death,” Dhuper wrote. “And I think the vaccines would be very successful in accomplishing that objective.”

Even for people who have been infected recently with COVID, Nachman urged people to get a booster.

The combination of an infection and a booster “Is always better than not getting a vaccine,” Nachman said. “You should get a vaccine. The timing is tricky” and could involve getting a dose two weeks after contracting the virus or waiting.

The viral threat during the December holidays, in particular, is higher, so Nachman urges being as immunized as possible before then.

With people not wearing masks and not even testing for the virus even when they get sick, Nachman suggested that it’s “highly likely” the country will see new variants by the spring.

Nachman urged people to take steps to protect themselves, which includes eating well, exercising, receiving the latest vaccination and limiting exposure, particularly for those who might be vulnerable.

“Take care of yourself,” Nachman urged.

At Stony Brook University Hospital, the wards are busy, with a steady stream of patients coming in, receiving treatment and getting discharged, Nachman said.

“We’re seeing a lot of other viral illnesses,” she added.

She sees a ramp-up in RSV, which she doesn’t expect to peak until Thanksgiving.

Dhuper remains concerned about viral threats this fall and winter.

“We do anticipate a worse flu season this year as the herd immunity is at a lower level,” he wrote. “People should get their flu shots sooner rather than later as that is the only primary protection we have to offer. People with comorbidities should particularly be concerned as the likelihood of severe illness, hospitalization and even death could be higher without the protection from the vaccine.”

While Nizza hasn’t seen any major spike in the flu yet, he suggested in an email that “now would be a good time to get vaccinated.”

Got all that? Good, now, when you’re outside, far from other people and you want to give your lungs a break, take a deep, cleansing breath. Other times? Protect your health and the health of your family and community.

by -
0 290
Stock photo

Get a flu shot now. 

While timing a flu shot can seem like timing the stock market — buying or selling a stock now might mean missing out on gains later — it’s not. A flu shot generally provides immunological coverage against the flu from about four weeks after the shot until six months later.

With a flu season that doesn’t follow a yearly calendar, residents sometimes try to balance between minimizing the possible effect of exposure to the flu in the next few weeks with exposure to the flu in the middle of the spring.

“It makes most health professionals very uncomfortable when people [suggest holding off on protection through the spring] as a reason to delay immunization, as it takes four weeks for protective antibodies to mature,” said Michael Grosso, Chief Medical Officer at Huntington Hospital. Influenza season can begin as early as November and sometimes earlier, so “any time now would be the right time.”

Medical professionals urged people to be even more proactive about getting a flu shot this year, as the pandemic continues to lurk in the shadows, on door knobs, and within six feet of an infected individual.

When people contract the flu along with other respiratory illnesses, the combination, as people might expect, can cause significant sickness.

“The novel coronavirus is just that, it’s novel,” Grosso said. “We don’t know exactly how it will interact with influenza. We do have significant prior experience with concurrent infections with other respiratory viruses. Individuals coinfected with one or more serious respiratory viruses frequently get sicker.”

That’s the case for both children and adults, Grosso added.

Getting an influenza vaccine could also reduce the confusion that will occur if people experience flu-like symptoms, which are also a hallmark of COVID-19 cases.

“Getting as much of the population immunized as possible is even more important than at other times,” Grosso said.

Each year, somewhere between 150,000 to 180,000 people are hospitalized from the flu and the death toll can range between 12,000 to 61,000 people per year in the U.S.

Doctors recommended that people who are 65 and older get a quadrivalent flu shot, which includes an additional influenza B strain.

In a trial of 30,000 people over 65, people who received the quadrivalent shot had 24% fewer illnesses compared to those who got the standard shot, according to the Centers for Disease Control and Prevention.

Susan Donelan, Medical Director of Healthcare Epidemiology at Stony Brook Medicine, said the side effects of the flu shot include an uncomfortable arm for a few days, a low grade fever and fatigue.

“The vast majority of people can easily manage the minor side effects for a day or two with Tylenol or Ibuprofen or a cold pack on their arm,” Dr. Donelan said.

Doctors said practices such as wearing a mask, social distancing and frequent hand washing, which are designed to reduce the spread of COVID-19, are also helpful in cutting down on the transmission of the flu.

Those measures will only help if residents exercise them correctly. Masks that fall below the nose of the wearer, which may make it easier to breathe, are not as effective at reducing the spread of these viruses, Dr. Donelan said.

 

by -
0 1726
Puppies and older dogs are especially susceptible to contracting the Canine Influenza virus. Stock photo

By Matthew Kearns, DVM

There has been a lot of media attention recently about outbreaks of the canine influenza virus (CIV), the H3N8 strain, which was first reported in racing greyhounds in Florida in 2004.  Rather than the typical respiratory infections (both viral and bacterial) that were limited to mild upper respiratory signs (coughing, sneezing, etc.), many of these dogs developed a sudden onset of severe pneumonia and death.

Later that year similar cases were documented in shelters and veterinary clinics in the New York City area. Dogs that recovered were tested at the Cornell Animal Health Diagnostic Center at Cornell University and tested positive for the  CIV H3N8 strain. In 2011, there was another outbreak in the NYC Metro area (three cases in NYC, three in Nassau County but none in Suffolk County) of the CIV H3N8 strain.

Fast forward to 2015 — an outbreak of the CIV occurred in the Chicago area that affected more than 1,000 dogs and led to eight deaths. Another outbreak shortly after the Chicago incident occurred in the Atlanta area affecting approximately 80 dogs (no deaths). In December 2015, another outbreak occurred in the Seattle area affecting approximately 80 dogs (again, no deaths).

Interestingly, none of the cases in 2015 were caused by the CIV H3N8 strain, but rather an H3N2 strain. The H3N2 strain was previously only seen in Asia (first diagnosed in 2006-2007). It is believed that this Asian strain gained entrance to the United States through Chicago’s O’Hare Airport inside a dog from Korea.

CIV is passed from dog to dog via aerosolized respiratory secretions from coughing, barking, sneezing, contaminated objects (food and water bowls, kennel surfaces) and people moving between infected and uninfected dogs. Dogs that stay at kennels, groomers, doggy day care, parks etc. are more at risk.

Approximately 80 percent of dogs exposed to CIV will show symptoms of the disease and the other 20 percent will not. This is unfortunate because this 20 percent may not show symptoms, but they can still shed virus and spread disease.  Symptoms will start three to five days after exposure and can be very mild to severe. 

Mild symptoms include a low-grade fever, runny nose and cough. Severe symptoms include pneumonia and in some cases death. Risk factors include age (the very young and very old are most severely affected), pre-existing disease or genetic susceptibility. There is no evidence at this time that CIV poses any health risk for humans.

Treatment for CIV is supportive in nature. Less severe cases where the patient is able to eat and drink are self-limiting in nature and symptoms resolve within three to seven days. More severe cases require hospitalization, IV fluids/medications, nebulization treatments and, in some cases, supplemental oxygen.

Two vaccines against the CIV H3N8 strain (the first was approved by the FDA in 2009) are available for dogs at this time. The goal of the vaccine is to expose the host (in this case dogs) to a weakened or inactivated form of the virus and stimulate the immune system to produce antibodies against it. Then, if the host is exposed to the virus naturally, the immune system will respond rapidly and fight the infection before signs of disease will occur.

At this time there is good news and bad news. The good news is there have been no reported cases of either strain of CIV in Suffolk County. The bad news is there is no evidence at this time that the vaccine currently available will protect against the new Asian strain (it may, but the veterinary community just doesn’t know at this time).

Please consult with your veterinarian as to whether your dog is at risk for the CIV virus (H3N8 or H3N2 strain) and whether vaccine is warranted for your own dog.  I will keep everyone posted through Times Beacon Record Newspapers as new information becomes available.

Dr. Kearns has been in practice for 16 years.

TBR News Media is your local news and entertainment website.
We provide you with the latest breaking news and information for your community.
Contact us: [email protected]

Most Viewed

©