Health beat

Recently by Jessica Snyder Sachs

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Haiti lies in ruins after Tuesday's devastating earthquake. American relief organizations are already on the ground and beginning to deliver desperately needed food, water, shelter, and medical aid.   Most are asking for cash donations, rather than food or clothing. Some also need volunteers with relief or medical expertise. 

(photo Juan Barreto/Getty Images)

Here's how you can help:

Text "Haiti" to 90999 to donate $10 to the Red Cross. The organization promises to use the first $1 million raised for Haitian Relief. (The donation will appear on your cell phone bill.) Or call 1-800-REDCROSS. 

Consider a relief organization with existing operations in Haiti. They include Save the Children,  Care USA, and Plan USA, all of which focus on helping children and families.

Donate to Doctors Without Borders, now mobilizing its volunteer medical teams. Call 1-888-392-0392 or send a donation to Doctors Without Borders USA, PO Box 5030, Hagerstown, MD 21741.

For a list of more organizations active in Haiti, go to msnbc's "Haiti Earthquake: How to Help."

For information on the unfolding situation, visit the White House home page or the U.S. Department of State's Haiti Advisory page. For help locating U.S. citizens in Haiti, call the Department of State at 888-407-4747.

--Jessica Snyder Sachs

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Vaccine maker Sanofi Pasteur ate crow yesterday with its recall of four batches of H1N1 baby shots--800,000 shots in all. It was not clear how many of the vaccines had been administered before the recall went out.

The good news is that the recall has nothing to do with safety, but concerns a small dip in vaccine potency that health officials say is no cause for worry.

All vaccine makers hold back samples of each lot they ship and over the ensuing weeks, test samples to ensure that their potency remains high. At the time of this follow-up testing, the lot samples in question had dropped below a predetermined limit. And, so, the recall.

How might this affect your child's protection against H1N1?

Not at all if your child is age 3 or older or was immunized with either the nasal-spray vaccine or the type of injectable vaccine packaged in multi-dose vials (the type used at most flu-shot clinics).

The recall involved only thimerosal-free baby shots in prefilled syringes.

But even babies and toddlers who received one of the sub-par shots will be fully protected so long as they complete the two-dose immunization regimen recommended for all children under age 10, says Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases. (These two doses are administered approximately one month apart.)

Still want more detail, even lot numbers? Visit the recall answer page set up by the Centers for Disease Control and Prevention.


Thumbnail image for Thumbnail image for jessica-sachs-68.jpgScience journalist Jessica Snyder Sachs is the author of Good Germs, Bad Germs: Health and Survival in a Bacterial World. Got a question or comment about swine flu? Post it here. Throughout the flu season, Jessica will be answering your questions on all things influenza.

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As H1N1 ebbs for a second week in the United States, critics of the national vaccination campaign have gotten louder. The overall death rate from this pandemic strain, they point out, has so far been lower than that seen with seasonal flu.

What unadorned mortality numbers don't show, health officials counter, is this pandemic's tremendous toll in "life-years" lost. This is because H1N1 continues to strike hardest among children, young adults, and pregnant women, while largely sparing the elderly.

This is not to say an older person's life is not precious. But a death of a young person results in many decades of life lost. This contrasts with the months to years lost from the life of the frail, elderly patient who is the typical fatality from seasonal flu.

"Already there has been three times the number of deaths among children than we would see in a usual flu season," CDC director Thomas Frieden noted during this week's H1N1 media briefing. And the usual winter flu season has just begun.

Pregnant women remain of particular concern, with a 10 times higher risk of life-threatening complications when compared to the general population. Understandably, these complications (pneumonia, septic shock, organ failure) also threaten a woman's pregnancy.

Nonetheless, two weeks of declining H1N1 infections is good news indeed. Even if there are more waves of H1N1 infection in store, this lull comes at a time when communities are finally getting enough vaccine to begin expanding immunization beyond high-risk groups.

More good news comes with the CDC's announcement that monitoring for vaccine side effects is showing no spike in the incidence of Guillain-Barre Syndrome. This rare autoimmune condition became more common during the 1976 swine flu vaccination campaign.

Influenza experts continue to hold their breath over the possibility that H1N1 could yet grow more dangerous by either mutating or recombining with a more deadly cousin such as the H5N1avian flu circulating in Asia.

Even if H1N1 does change in ways that make it more deadly, those vaccinated should remain protected, Frieden says. The part of the virus used to make the H1N1 vaccine is distinct and independent of the portion that changes when influenza viruses become more lethal.

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Science journalist Jessica Snyder Sachs is the author of Good Germs, Bad Germs: Health and Survival in a Bacterial World. Got a question or comment about swine flu? Post it here. Throughout the flu season, Jessica will be answering your questions on all things influenza.

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Adjuvants are another class of vaccine ingredients that have proven controversial among people who remain uneasy about immunization.

In essence, adjuvants grab the immune system's attention to generate a stronger protective response. 

In gearing up for the H1N1 pandemic, World Health Officials asked developed nations to use adjuvants to stretch the vaccine supply to cover poorer countries. By generating a stronger immune response, adjuvants allows vaccine makers to use less "active" ingredient--in this case destroyed H1N1 flu virus--in each shot or squirt.

But while most European countries and Canada said "yes" to the WHO request, the United States said "sorry." Why?

U.S. flu vaccines have never included adjuvants. So using them would have warranted further safety testing, and that takes time. In other words, by making H1N1 flu shots in the exact same way as seasonal flu shots, U.S. suppliers were able to deliver a fully safety tested vaccine in under 9 months.

Alternately, the U.S. could have introduced adjuvant-containing flu vaccines on an "experimental" basis, based on their safety records in other countries. But U.S. polls showed that a majority of Americans wanted none of that.

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Science journalist Jessica Snyder Sachs is the author of Good Germs, Bad Germs: Health and Survival in a Bacterial World. Got a question or comment about swine flu? Post it here. Throughout the flu season, Jessica will be answering your questions on all things influenza.

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A new study comparing kids in the U.S. and the Phillipines has confirmed that growing up in a too-clean environment can boost inflammation levels, which in turn may increase the risk of heart disease and other chronic ills in adulthood. So is it still a good idea to get our kids to wash their hands all the time to prevent the spread of H1N1 and other cold and flu germs?

Coincidentally, this week two housemates familiar with my book Good Germs, Bad Germs emailed me with the hope of resolving just this debate over H1N1 and hand washing. Their household includes a 5-year-old as well as an adult with a donated kidney.

Housemate #1 had been urging the five-year-old to wash her hands frequently "to prevent the spread of too many germs," including H1N1. Housemate #2 countered that the germs that ended up on the child's hand were good for her--helping her build up resistance to disease.

The title of Good Germs, Bad Germs goes right to the heart of their question. So I'm glad to offer my two cents, based on the research of immunologists and infectious disease specialists.It's true that exposure to "germs" (i.e. viruses and bacteria) is necessary to strengthen and balance the developing immune system. This appears to be most important in early childhood.

Fortunately, this exposure doesn't have to involve the kind of germs that make you sick. In fact, the vast majority of germs in our environment are harmless. They're in our water, on our pets, in good, old fashioned dirt, everywhere. And that turns out to be a very good thing. Our world and our bodies could not functional normally without them.

By contrast, only a tiny minority of the viruses and bacteria we encounter each day make their "living" by causing disease. That said, this rogue's gallery includes some nasty characters, with the H1N1 influenza virus now among them. Such "bad germs" are definitely worth avoiding.

Bottom line: With H1N1 circulating widely in our communities, the experts agree that it's definitely a good idea for everyone to wash hands frequently or use an alcohol-gel sanitizer.

This is most important after being around other people who might be infected. Someone carrying H1N1 touches something (school desk, office keyboard, doorknob, etc.) and deposits the virus. You touch that something and then touch your eyes, nose, or mouth and, bingo, that virus has found a new home.  

Frequent hand washing is even more important if you live with anyone with an immune-compromising condition. This includes organ recipients, who must take powerful immune-suppressing drugs to prevent their bodies from rejecting the donated organ. 

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Science journalist Jessica Snyder Sachs is the author of Good Germs, Bad Germs: Health and Survival in a Bacterial World. Got a question or comment about swine flu? Post it here. Throughout the flu season, Jessica will be answering your questions on all things influenza.

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Headline writers are spinning away with the news of a dip in H1N1 influenza, or swine flu, outbreaks.

But any suggestion that H1N1 has peaked is premature, CDC officials say. In fact, the CDC has long predicted that H1N1, like most flu strains, will hit our communities in waves. And some of the states coming late to the H1N1 party remain on their first upsurge.

Even in places experiencing a lull, flu infection rates remain higher than usual for this time of year, cautions Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Diseases. In the best case scenario, vaccination efforts--now in full swing--will blunt any future waves.

What's more, as H1N1 ebbs, seasonal flu could come roaring in, Schuchat says. Now at minimal levels, season flu typically peaks in late December and January.

Of course, there's nothing typical about this year's flu season. With H1N1 infections continuing through the summer, the previous flu season simply merged into the present one.

Of one thing we can be sure: With millions of families getting together for Thanksgiving this week, there's sure to be some viruses exchanged along with the kisses and good food.

To help counter holiday flu spread, the CDC has launched a Traveler Health Campaign.  

It's four-step strategy is pretty basic:

Travel only if well

Wash hands often

Cover coughs and sneezes with tissue or sleeve

Get vaccinated 

Happy Thanksgiving, everyone!


Related links:

7 Common Myths about Swine Flu

A History of Flu Pandemics 

Swine Flu Survival Guide


jessica-sachs-68.jpgScience journalist 
Jessica Snyder Sachs is the author of Good Germs, Bad Germs: Health and Survival in a Bacterial World. Got a question or comment about swine flu? Post it here. Throughout the flu season, Jessica will be answering your questions on all things influenza.

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Yesterday I breathed a sigh of relief as I watched my teenage daughter get her H1N1 shot at a local public health clinic. Though she grumbled as I dragged her across town during her lunch period, she couldn't help smiling when she saw it was a girlfriend's mom, a volunteer nurse, administering the shots.

In fact, there was such an upbeat community spirit around the event--organized in the meeting room of a local arts center--that I half expected someone to break out doughnuts.

We'd arrived early after getting a heads-up from the town health officer that within 24 hours of his announcing the four-hour clinic, he had received hundreds of calls from as far as two states away. Yet it was so well organized that my daughter was in and out and back to high school with 15 minutes of her lunch period to spare.

Meanwhile, on Nov. 3, CDC officials announced the availability of another 31.8 million doses of H1N1 vaccine, bringing the total doses available for distribution to 10 million. This remains short of the national need, but should make headway in vaccinating high-priority groups such as pregnant women, children and young adults, and those with underlying health problems such as asthma or heart disease.

As the ranks of the vaccinated expand well into the millions this week, health officials also expect the inevitable. After being immunized, some people will suffer health problems for reasons that have nothing to do with the vaccine. For decades, the tendency to link such events to immunization has plagued childhood vaccination programs.

As a proactive measure, an international team of epidemiologists, immunologists, and infectious-disease specialists has published a report in the medical journal Lancet, cataloging the background rates of disorders that they suspect could be erroneously linked with vaccination. Their statistics include the following:

  • Miscarriage occurs in around 400 in a million pregnant women in any given day.
  • Guillain-Barré paralysis occurs in around 4 in 10 million persons in any given week.  
  • Sudden unexplained death occurs in 5 or 6 per 10 million persons in any six-week period.

Only if rates spike above these numbers, the researchers say, should any potential link to vaccination be proposed.

And now that I have my daughter's H1N1 shot checked off, I'm resuming my hunt for seasonal flu vaccine in our area. So far, no luck.

Thumbnail image for jessica-sachs-68.jpg

Science journalist Jessica Snyder Sachs is the author of Good Germs, Bad Germs: Health and Survival in a Bacterial World. Got a question or comment about swine flu? Post it here. Throughout the flu season, Jessica will be answering your questions on all things influenza.


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Like many science journalists this year, I find myself troubled by an underlying tone of advocacy in my reporting on H1N1 influenza. In particular, this uneasiness concerns my coverage of public concerns about the H1N1 vaccine.

The online conversation here on iVillage.com reflects what pollsters say they're seeing: A significant minority of Americans have misgivings about getting immunized. Within this group is a small but vocal core of individuals who see an underlying conspiracy between public health officials and the pharmaceutical industry--a conspiracy bent on delivering dangerous vaccines in the name of profit.

So here is my quandary:

As a journalist, I strive to give voice to both sides of controversial issues.

As a science writer, I must weigh and convey the scientific evidence.

The quandary? Study after study and decades of use show flu vaccines to be safe and effective. In the United States, the H1N1 vaccine is prepared no differently than other flu vaccines. Indeed, if the H1N1 strain had been detected earlier, it would have been included in this year's seasonal flu shot.

Admittedly, this is of little assurance to those who see vaccines as generally dangerous. But here, too, the science is overwhelming.

In extremely rare cases, vaccines may trigger problems. But when it comes to the vaccines currently approved for use, studies show that serious reactions are so rare that they do not rise above chance occurrence. Vaccinated children do not suffer neurological or other problems at higher rates than do unvaccinated children. But unvaccinated children do suffer higher rates of infection and related complications, including death.

In the last two months, over 22,000 Americans have been hospitalized for influenza-related pneumonia, and over 2,400 have died. All of this is presumed to be due to H1N1 influenza because seasonal flu has yet to begin its upswing. This rate of flu-related hospitalization and death has reached the level typically seen at the peak of a flu season, in late December. So health officials worry that far worse may be in store.

And so I circle back to my difficulty: How do I, as a journalist and a science writer address "both sides of a story" when the scientific evidence is on one side and the potential consequence of ignoring the science is so great? I pose this question with the sincere hope of a respectful dialogue. Please, continue to send your questions and comments.

Meanwhile, the writers and editors at iVillage.com remain committed to addressing your questions and concerns, both in this column and in Q&As such as Dr. Tanya Berenson's Questions about Swine Flu? iVillagers Asked and Dr. Tanya Benenson Answered and Swine Flu: Shots, Germy Kids and Other Questions.

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Science journalist Jessica Snyder Sachs is the author of Good Germs, Bad Germs: Health and Survival in a Bacterial World. Got a question or comment about swine flu? Post it here. Throughout the flu season, Jessica will be answering your questions on all things influenza.

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Swine flu parties are still in the news. And on the Internet, the topic has gone viral (sorry). A search on the phrase produces over 3.3 million hits.

Still, I have to wonder whether this buzz reflects media frenzy rather than any real indication that people are deliberately exposing their children and themselves. As a reality check, I'd love to hear from any reader who has actually participated in such a party or knows people who did--and why.

At the least, a number of surveys this month indicate that many people are feeling complacent. At this point, only a minority of respondents say they will definitely get the H1N1, or "swine flu," vaccine. Admittedly, the majority of those who get sick do recover with nothing worse than a miserable week in bed.

But a new Canadian study backs up those early, scary reports out of Mexico--the ones indicating that this flu was proving deadliest among otherwise healthy adolescents and young adults--especially young women.

The researchers focused on 168 critically ill H1N1 victims in Canadian intensive care units between April and August. Septic shock and organ failure were common. Over 80 percent ended up on mechanical ventilators, or breathing machines. And 29, or 1 in 6, died. Their average age? 32. Nearly a third were previously healthy children.

"Our data suggest that severe disease and mortality is concentrated in relatively healthy adolescents and adults between the ages of 10 and 60 years," the researchers conclude in a report released in advance of its November publication in the Journal of the American Medical Association.

The twist here is that these patients started out with what seemed like "ordinary" flu symptoms--the kind that public health officials tell us to treat at home. The difference was that their symptoms took a sudden and terrible turn for the worse.

This inability to tell who will or won't develop life-threatening complications seems to underscore the paramount importance of prevention. Vaccine party, anyone?


jessica-sachs-136.jpg

Science journalist Jessica Snyder Sachs is the author of Good Germs, Bad Germs: Health and Survival in a Bacterial World. Got a question or comment about swine flu? Post it here. Throughout the flu season, Jessica will be answering your questions on all things influenza.

h1n1_journal_icon_136.jpgLast week, I got my seasonal flu shot as part of my annual physical. But a lot of busy people are asking if they can just get a double jab when the H1N1 vaccine arrives in their neighborhood.

Yes, says the CDC. Getting the two vaccines on the same day is safe and effective, not that public health experts want you to delay one for the other.

But many of us know "flu shot arm" too well. Admittedly, it's just a little achiness. Some people also report a mild fever. Would getting two jabs at once deliver a double whammy of discomfort or worse?

I asked Johns Hopkins University virologist and vaccine researcher Andrew Pekosz.

"Probably not," Pekosz says. "We know from a European study where they did exactly that." Though subjects got a flu shot in each arm, they were no more apt to report side effects than others who received one shot. And those who did experience mild achiness or fever rated the discomfort no more severe than those in the one-shot group.

flu-shot-136.jpgIt bears mentioning that the arm ache and slight fever that occasionally follow a flu shot do not mean that it has given you the flu. Flu shots contain only destroyed virus. Nothing infectious. The symptoms reflect your body's immunity-building response.

And if needles make you crazy, you have the option of the nasal spray flu vaccine. Flu Mist is available for both H1N1 and seasonal flu this year. But at this point, you can't get a double squirt of H1N1 in one nostril and seasonal flu in the other. They've not yet been tested in tandem. 

In addition, Flu Mist is not for everyone. It contains weakened live virus. So caution demands that it not be given to the immune-compromised, pregnant women, or those under 2 or over 50. Also, it occasionally triggers mild wheezing. So it's not for anyone with a respiratory condition such as asthma or chronic obstructive pulmonary disease (COPD). Otherwise, squirt away.

--Jessica Snyder Sachs

jessica-sachs-68.jpgScience journalist Jessica Snyder Sachs is the author of Good Germs, Bad Germs: Health and Survival in a Bacterial World. Got a question or comment about swine flu? Post it here. Throughout the flu season, Jessica will be answering your questions on all things influenza.


image: a. cappetta/getty images
h1n1_journal_icon_136.jpgWith flu vaccine production at full tilt, public health concerns have shifted from having enough vaccine to getting enough people to roll up their sleeves and get immunized.

All vaccination programs depend on wide participation to produce so-called "herd immunity." In essence, a disease-causing germ can't spread if enough people are immune to it. 

High vaccination rates also protect those who can't be vaccinated or won't respond to a vaccine. Of particular concern are babies under six months. A newborn's immune system isn't yet developed enough to respond to a flu vaccine. But that baby is at high risk of fatal complications should she catch the flu.

That said, many people have a kind of free-floating anxiety around vaccines. We got a clear snapshot of their reluctance last week with the release of a Consumer Reports poll of 1,502 adults. Only 35 percent definitely planned to get themselves and their children vaccinated against the H1N1 flu. Half remained undecided.

The No. 1 reason for opting out? "I want to build up natural immunities." (63 percent)

That drew a sharp retort from the director of Consumer Reports Health Ratings Center, Dr. John Santa:

"Your body produces exactly the same antibodies, whether it's from a natural infection or from the vaccine, Santa said. "If your child is the one that dies, you've paid a very high price for natural immunity."

Santa's impatience is typical of many physicians who point to the reams of studies that show vaccines to be safe and effective. But in all honesty, citing studies that most people have never read doesn't fully dispel public hesitation.

The good news is that, in rolling out the H1N1 vaccination campaign, public health experts are directly addressing some of the top concerns people have about vaccines--even providing alternatives for people worried about specific vaccine components such as the preservative thimerosal.

In my next few posts, I'll be describing how government health experts are taking public concerns seriously. Meanwhile, if you have a concern to be addressed, please leave a comment.

--Jessica Snyder Sachs

jessica-sachs-68.jpgScience journalist Jessica Snyder Sachs is the author of Good Germs, Bad Germs: Health and Survival in a Bacterial World. Got a question or comment about swine flu? Post it here. Throughout the flu season, Jessica will be answering your questions on all things influenza.