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Dr. Stanley Martin, Geisinger’s director of infectious diseases, poses for a photo at Geisinger Medical Center.

LEWISTOWN — Excuses, excuses, excuses. It seems there’s no shortage of reasons people offer to avoid getting an annual flu shot.

Dr. Stanley Martin, Geisinger’s director of Infectious Diseases understands that there are myths out there about flu shots – and that many people naturally worry about vaccines.

Martin has heard most of the excuses a thousand times. He understands that there are myths out there about the shot and wants to separate fact from fiction.

Are there side effects from flu vaccinations?

Possibly, but there are potential side effects with any medication. Getting a flu shot in the arm commonly causes aches and soreness. Sometimes people get a low-grade fever or feel tired and run down. These are side effects that only last a day or so.

Can the flu spread from one person to another?

Yes, absolutely, Martin said. In fact, it’s how most people get the flu. It starts as a respiratory virus with coughing, sneezing and difficulty breathing. Typically, the person infected with the flu has spread it to the next person before they even show any signs of sickness. People can try to be diligent about not spreading the flu, but they can do it without even knowing it early on.

What’s the difference between a cold and the flu?

Martin said influenza, or flu, and the common cold are both contagious respiratory illnesses, but they are caused by different viruses. Flu is caused by influenza viruses only, whereas the common cold can be caused by a number of different viruses, including rhinoviruses and parainfluenza.

Because the flu and common cold have similar symptoms, it can be difficult to tell them apart based on symptoms alone. Generally, the flu is worse than the common cold, and symptoms typically are more intense and begin more abruptly. Colds are usually milder than the flu. People with colds are more likely to have a runny or stuffy nose than people who have the flu.

If you have been vaccinated against COVID, does that help fight against the flu?

Probably not. Martin said vaccines are pretty specific, such as the ones that battle COVID, so they don’t fend off other illnesses like the flu. There are vaccines in the works against co-infections. They would be more likely to fight off COVID and the flu. Martin cautioned if you really want to prevent yourself from getting the flu: Get a flu shot. The shots to measles, mumps and rubella have been combined in the “MMR” shot. He added it’s also “perfectly safe” to get the flu shot and COVID vaccine or booster at the same time.

If you have not gotten a flu shot yet this year, is it too late?

Absolutely not, Martin said. Despite being past its peak, flu cases will continue to pop up over the next few months. The flu is especially problematic for the elderly (age 65 and over), children ages 5 and under) and pregnant women. Those groups are much more likely to be affected by influenza if they have not been vaccinated.




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If you’ve been unfortunate enough to contract the COVID-19 virus, you may have noticed that your COVID cough is lingering longer than after your typical cold. And if it bothers you for long enough, you may even find yourself googling “how long does COVID cough last?”

First of all, you’re not alone. Many people who have had a COVID-19 infection report having a cough that they just can’t seem to shake, even up to a year after the virus has left their system—and, a lingering cough is something you should never ignore. But at what point does your extended cough indicate you have long COVID? After all, one in five adult COVID-19 survivors experiences long COVID symptoms and respiratory issues is one of the most common among them.

But before you worry about your lingering cough being a sign of bigger concern, we’ve spoken with infectious disease experts to help you find out when a COVID cough usually goes away, whether coughing is normal after you’ve recovered, at what point a chronic cough may indicate long COVID development, and how you may treat a cough too.

What is COVID cough and how is it different from other coughs?

Cough occurs in approximately 50% of patients with COVID-19 infection. It is usually dry and nonproductive, says Jill Howard, M.D., national director of infectious diseases at ChenMed. However, “17 to 34% of patients have persistent cough following acute COVID-19 infection.”

Many respiratory infections can also cause a post-infectious cough that lasts (typically) a few weeks after the initial infection ends, says David Cennimo, M.D., associate professor of medicine & pediatrics at Rutgers New Jersey Medical School. “This is thought to be due to hyper-responsiveness in the cough mechanism, possibly also due to some damage to the airways from the infection…This has been seen with influenza, COVID-19, and many other infections.”

When will a COVID cough usually go away?

For most people, it can take 3 to 18 months for their lungs to get back to their pre-COVID-19 baseline, says Richard Watkins, M.D., an infectious disease physician and professor of medicine at the Northeast Ohio Medical University. According to Hopkins Medicine, after a serious case of COVID-19, recovery from lung damage takes time. There’s the initial injury to the lungs, followed by scarring. Over time, the tissue heals, but it can take three months to a year or more for a person’s lung function to return to pre-COVID-19 levels.

In general, the more risk factors for severe infection, and the more severe the initial COVID-19 infection, the longer the patient experiences persistent symptoms, explains Dr. Howard.

When does chronic cough become a symptom of long COVID?

Some people have experienced a prolonged post-infectious cough after COVID-19 that has been characterized as part of the “Long-COVID” syndrome, Dr. Cennimo explains. “In some datasets, around 15% of people are coughing 3+ weeks after COVID infection. In most, this fades over time but it can take weeks to months.”

If a cough develops during acute COVID-19 infection, and lasts 3 months from the onset of illness, it is considered a manifestation of long COVID, says Dr. Howard.

How can you treat a COVID cough?

Treatment for lingering cough related to COVID is not well defined, says Dr. Cennimo. “Many people do find some comfort with cough drops, etc.”

It’s most important to make sure there is not an underlying issue causing the cough, Dr. Cennimo adds. “For instance, some COVID-19 infections do significantly damage the lungs and we can see a decrease in respiratory capacity. Some patients will also have a reactive airway disease triggered (like asthma) and their cough may be masking wheezing.” In these cases, inhalers can help.

When should you see a doctor about your COVID cough?

One red flag is the feeling of shortness of breath, says Dr. Cennimo. “If the cough lasts more than 2-3 weeks or is accompanied by shortness of breath, the person should be evaluated.” Dr. Howards adds that “if the cough is worsening rather than improving, or if it is associated with difficulty breathing, shortness of breath, fever or [phlegm] production, seek your doctor right away to further investigate.”

Dr. Watkins adds that your primary care physician “can assess your symptoms and develop a treatment plan that may include breathing exercises, antibiotics, or steroids. Referral to pulmonary rehabilitation is another option.”

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Madeleine, Prevention’s assistant editor, has a history with health writing from her experience as an editorial assistant at WebMD, and from her personal research at university. She graduated from the University of Michigan with a degree in biopsychology, cognition, and neuroscience—and she helps strategize for success across Prevention’s social media platforms. 

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If you’ve been unfortunate enough to contract the COVID-19 virus, you may have noticed that your COVID cough is lingering longer than after your typical cold. And if it bothers you for long enough, you may even find yourself googling “how long does COVID cough last?”

First of all, you’re not alone. Many people who have had a COVID-19 infection report having a cough that they just can’t seem to shake, even up to a year after the virus has left their system—and, a lingering cough is something you should never ignore. But at what point does your extended cough indicate you have long COVID? After all, one in five adult COVID-19 survivors experiences long COVID symptoms and respiratory issues is one of the most common among them.

But before you worry about your lingering cough being a sign of bigger concern, we’ve spoken with infectious disease experts to help you find out when a COVID cough usually goes away, whether coughing is normal after you’ve recovered, at what point a chronic cough may indicate long COVID development, and how you may treat a cough too.

What is COVID cough and how is it different from other coughs?

Cough occurs in approximately 50% of patients with COVID-19 infection. It is usually dry and nonproductive, says Jill Howard, M.D., national director of infectious diseases at ChenMed. However, “17 to 34% of patients have persistent cough following acute COVID-19 infection.”

Many respiratory infections can also cause a post-infectious cough that lasts (typically) a few weeks after the initial infection ends, says David Cennimo, M.D., associate professor of medicine & pediatrics at Rutgers New Jersey Medical School. “This is thought to be due to hyper-responsiveness in the cough mechanism, possibly also due to some damage to the airways from the infection…This has been seen with influenza, COVID-19, and many other infections.”

When will a COVID cough usually go away?

For most people, it can take 3 to 18 months for their lungs to get back to their pre-COVID-19 baseline, says Richard Watkins, M.D., an infectious disease physician and professor of medicine at the Northeast Ohio Medical University. According to Hopkins Medicine, after a serious case of COVID-19, recovery from lung damage takes time. There’s the initial injury to the lungs, followed by scarring. Over time, the tissue heals, but it can take three months to a year or more for a person’s lung function to return to pre-COVID-19 levels.

In general, the more risk factors for severe infection, and the more severe the initial COVID-19 infection, the longer the patient experiences persistent symptoms, explains Dr. Howard.

When does chronic cough become a symptom of long COVID?

Some people have experienced a prolonged post-infectious cough after COVID-19 that has been characterized as part of the “Long-COVID” syndrome, Dr. Cennimo explains. “In some datasets, around 15% of people are coughing 3+ weeks after COVID infection. In most, this fades over time but it can take weeks to months.”

If a cough develops during acute COVID-19 infection, and lasts 3 months from the onset of illness, it is considered a manifestation of long COVID, says Dr. Howard.

How can you treat a COVID cough?

Treatment for lingering cough related to COVID is not well defined, says Dr. Cennimo. “Many people do find some comfort with cough drops, etc.”

It’s most important to make sure there is not an underlying issue causing the cough, Dr. Cennimo adds. “For instance, some COVID-19 infections do significantly damage the lungs and we can see a decrease in respiratory capacity. Some patients will also have a reactive airway disease triggered (like asthma) and their cough may be masking wheezing.” In these cases, inhalers can help.

When should you see a doctor about your COVID cough?

One red flag is the feeling of shortness of breath, says Dr. Cennimo. “If the cough lasts more than 2-3 weeks or is accompanied by shortness of breath, the person should be evaluated.” Dr. Howards adds that “if the cough is worsening rather than improving, or if it is associated with difficulty breathing, shortness of breath, fever or [phlegm] production, seek your doctor right away to further investigate.”

Dr. Watkins adds that your primary care physician “can assess your symptoms and develop a treatment plan that may include breathing exercises, antibiotics, or steroids. Referral to pulmonary rehabilitation is another option.”

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As temperatures fall in winter and people gather indoors more frequently, respiratory illnesses rise, including COVID, Respiratory Syncytial Virus (RSV), Influenza (flu), rhinovirus (common cold), and various other respiratory viruses. Many respiratory symptoms overlap, making it difficult to know whether to carry on as usual, stay home, or seek medical attention.

Malaika Stoll

Dr. Malaika Stoll

Dr. Malaika Stoll, senior medical director at Blue Shield of California advises, “Pay attention to symptoms. You might not know the cause, but serious symptoms such as difficulty breathing, or prolonged high fever – in adults 101.4 F - require an assessment from a medical professional.”

Dr. Stoll shares five tips to help you address respiratory symptoms this season.

  1. Prevention! Protect yourself and others

    • Get vaccinated for COVID, booster, and yearly flu.
    • Wear a mask, isolate when sick, and engage in frequent hand washing.

  2. Treat mild symptoms

    • Self-care, including over-the-counter medications, can be applied for mild symptoms, such as a stuffy nose or mild cough.

  3. Test at home

    • If you are experiencing respiratory systems, take a COVID-19 test at home. Even if you are unsure whether you have been exposed, positive or negative test results can help your doctor diagnose and treat you.

  4. Schedule a Virtual Care Visit

    • Virtual care visits are conducted via phone and or video call with healthcare providers. Consider a virtual care visit with your provider or if your plan allows, a Teladoc visit to explain your symptoms and to get medical guidance. There are tests and treatments available for many of the viruses discussed. They are a great way to get medical advice while staying safe at home.

  5. Seek immediate care

    • If you have difficulty breathing, dehydration, or persistently high fever, seek immediate care, possibly from an emergency or urgent care facility.

Get more tips from Dr. Stoll on staying healthy this season

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click to enlarge Scientists are looking at what factors may play a role in making winter a sickening season. - Photo: Pixabay

Photo: Pixabay

Scientists are looking at what factors may play a role in making winter a sickening season.


When bitter winds blew and temperatures dropped, my grandmother would urge me to come inside. “You’ll catch your death of cold out there,” she’d say.

Sure, freezing to death is possible in frigid temperatures. But doctors and other health experts have long stressed that being cold won’t give you a cold. Still, winter is undisputedly cold-and-flu season. It’s also a period when COVID-19 spreads more.

But if the chill doesn’t matter, why does the spread of so many respiratory viruses peak during the season?

“I’ve spent the past 13 years looking into this question,” says Linsey Marr, a civil and environmental engineer at Virginia Tech in Blacksburg who studies viruses in the air. “The deeper we go, the more I realize we don’t know [and] the more there is to figure out.”

She and I are not alone.

“That wintertime seasonality has puzzled people for a very long time; thousands of years, to be honest,” says Jeffrey Shaman, an infectious diseases researcher who directs the Climate and Health Program at the Columbia University Mailman School of Public Health.

There is some evidence that winter’s shorter days may make people more susceptible to infection, he says. Less sunlight means people make less vitamin D, which is required for some immune responses. But that’s just one piece of the puzzle.

Scientists are also looking at what other factors may play a role in making winter a sickening season.

Illness may spread more inside

My grandma’s well-intentioned urging to come in from the cold may have instead increased the risk that I’d get sick.

Colds, influenza and respiratory syncytial virus, or RSV, are all illnesses that are more prevalent at certain times of year when people spend more time inside. That includes winter in temperate climates, where there are distinct seasons, and rainy seasons in tropical zones. COVID-19 also spreads more indoors than outside.

Those diseases are caused by viruses that are transmitted primarily through breathing in small droplets known as aerosols. That’s a change in thinking. Many scientists thought until very recently that such viruses were spread mainly by touching contaminated surfaces.

“When you’re outdoors, you’re in the ultimate well-ventilated space,” says David Fisman, an epidemiologist at the University of Toronto Dalla Lana School of Public Health. Viruses exhaled outside are diluted quickly with clean air.

But inside, aerosols and the viruses they contain can build up. “When you’re in a poorly ventilated space, the air you breathe in is often air that other people have breathed out,” he says.

Since viruses come along with that exhaled breath, “it makes a lot of sense that proximity to individuals who might be contagious would facilitate transmission,” Shaman says.

But there is more to the story, says Benjamin Bleier, a specialist for sinus and nasal disorders at Harvard Medical School.

“In modern society, we’re indoors all year round,” he says. To drive the seasonal pattern we see year after year, something else must be going on too to make people more susceptible to infection and increase the amount of virus circulating, he says.

Drier air can give some viruses a boost

Some viruses thrive in winter. But the reason why may not be so much about temperature, but humidity.

“There are some viruses that like it warm and wet and some viruses like it dry and cold,” says Donald Milton, an aerobiologist at the University of Maryland School of Public Health in College Park. For instance, rhinoviruses — one of the many types of viruses that cause colds — survive better when it is humid. Cases of rhinovirus infection typically peak in early fall, he says.

Marr and other researchers have found that viruses that surge in the winter, including influenza viruses and SARS-CoV-2 — the coronavirus that causes COVID-19 — survive best when the relative humidity in the air falls below about 40 percent.

Viruses aren’t usually floating around naked, Marr says. They are encased in droplets of fluid, such as saliva. Those droplets also have bits of mucus, proteins, salt and other substances in them. Those other components may determine if the virus survives drying.

When the humidity is higher, droplets dry slowly. Such slow drying kills viruses such as influenza A and SARS-CoV-2, Marr and colleagues reported July 27 in a preprint at bioRxiv.org. During slow drying, salt and other things that may harm the virus become more concentrated, although researchers still don’t fully understand what’s happening at the molecular scale to inactivate the virus.

But flash drying in parched air preserves those viruses. “If the air is very dry, the water quickly evaporates. Everything is dried down, and it’s almost like things are frozen in place,” Marr says.

How humidity affects airborne droplets

At low humidity levels, airborne droplets, or aerosols, dry quickly (left), preserving viruses under a feathery crystalline lattice, as this microscope image shows. At intermediate humidity levels, crystals form inside liquid droplets (middle), but those crystals may inactivate viruses, not preserve them. At high humidity levels (right), aerosols remain liquid, allowing viruses to survive better than at midlevel humidity.

click to enlarge At high humidity levels, aerosols remain liquid, allowing viruses to survive better than at midlevel humidity. - Photo: Janie French/Lakdawala Lab/Univ. of Pittsburg School of Medicine

Photo: Janie French/Lakdawala Lab/Univ. of Pittsburg School of Medicine

At high humidity levels, aerosols remain liquid, allowing viruses to survive better than at midlevel humidity.

Dryer, smaller aerosols are also more buoyant and may hang in the air longer, increasing the chance that someone will breathe them in, Fisman says.

What’s more, dry air can tear down some of people’s defenses against viruses. Studies in animals suggest that dry air can trigger death of some cells lining the airways. That could leave cracks where viruses can invade.

Mucus in the airways can trap viruses and help protect against infection. But breathing cold, dry air can also slow the system that usually moves mucus out of the body. That may give viruses time to break out of the mucus trap and invade cells, Fisman says.

Cold may harm our ability to fight off viruses

Being cold may not give you a cold, but it could make you more susceptible to catching one.

Normally, the immune system has a trick for warding off viruses, Bleier and colleagues recently discovered. Cells in the nose and elsewhere in the body are studded with surface proteins that can detect viruses. When one of these sensor proteins sees a virus coming, it signals the cell to release tiny bubbles called extracellular vesicles.

The bubbles work as a diversionary tactic, a bit like chaff being released from a military jet trying to avoid a heat-seeking missile, Bleier says. Viruses may go after the vesicles instead of infecting cells.

If a virus docks with one of the bubbles, it’s in for a surprise: Inside the vesicles are virus-killing bits of RNA called microRNAs. One of those microRNAs known as miR-17 could kill two types of rhinoviruses and a cold-causing coronavirus, the team reported Dec. 6 in the Journal of Allergy and Clinical Immunology.

How cold weather affects the immune system

The immune system has a diversionary tactic to keep viruses from infecting cells in the nose: When viruses (black and gray spheres) are detected, nasal cells release bubbles called extracellular vesicles (blue circles). These bubbles are studded with proteins (red, blue and black shapes on blue circles) that are normally found on the surface of nasal cells. Viruses may go after the bubbles instead of infecting cells. When temperatures in the nose drop below body temperature (right), cells release fewer bubbles, making it easier for viruses to find and infect nasal cells.

click to enlarge When temperatures in the nose drop below body temperature, it's easier for viruses to find and infect nasal cells. - Photo: D. Huang et al/Journal of Allergy and Clinical Immunology 2022; Adapted by E. Otwell

Photo: D. Huang et al/Journal of Allergy and Clinical Immunology 2022; Adapted by E. Otwell

When temperatures in the nose drop below body temperature, it's easier for viruses to find and infect nasal cells.

Researchers measured bubbles released from human nasal cells grown in lab dishes at 37° Celsius, our typical body temperature. Then the scientists lowered the thermostat to 32° C. Cells released about 42 percent fewer vesicles at the cooler temperature, the team found. What’s more, those vesicles carried fewer weapons. Vesicles can pack in about 24 percent more microRNA at body temperature than when it is cooler.

Three tips to bolster our immune system

I asked the experts what people can do to protect themselves from viruses in the winter. Some said using a humidifier might help raise moisture levels enough to slow the drying of virus-laden droplets, killing the viruses.

“Any increase in humidity should be beneficial,” says Shaman. “You get a lot of bang for your buck if you go from very dry to dry.”

But Milton doesn’t think it’s a good idea to pump a lot of moisture into a house when it is cold outside. “That humidity is going to find all of the cold spaces in your house and condense there,” creating a breeding ground for mold and rot, he says.

Instead, he advocates turning on kitchen and bathroom exhaust fans to increase ventilation and using HEPA filters or Corsi-Rosenthal boxes to filter unwanted viruses out of the air.

Bleier suggests wearing a mask. Not only can masks filter out viruses, but “our work suggests these masks have a second mechanism of action,” he says. “They keep a cushion of warm [moist] air in front of our noses, which could help bolster the immune system.”

This commentary was originally published in Science News and republished here with permission.

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"This has certainly been a distinctive season," said William Schaffner, MD, to Patient Care Online when asked about the current status of the 2022-2023 respiratory virus season.

This season is unique with the cocirculation of influenza, COVID-19, and respiratory syncytial virus (RSV). The "tripledemic," as it has been named, has brought challenges to clinicians caring for infected persons, such as diagnosing between the 3 respiratory diseases and persuading a vaccine weary population that they should get vaccinated, both with the influenza vaccine and the updated COVID-19 boosters. Below, Dr Schaffner gives a brief update on the current respiratory virus season and shares what his top challenges have been so far.

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Tina Tan, MD: Now that we’re talking about these diseases, Kevin, can you provide a brief overview of the clinical presentations of the different types of respiratory infections? Can you comment on the early onset of the respiratory viral season, especially flu and RSV [respiratory syncytial virus] that has occurred this year?

Kevin Michael Reiter, MD, PA: Yes, absolutely. The presentations, as we all know, have a lot of overlap, which makes it a little challenging, and I think that’s where testing comes into play. But a lot of times, dependent on the vaccine status of the individual for flu or COVID-19, we may see fever, body aches, fever up to 103, 104 °F, fatigue, headaches, sore throat, cough, and nasal congestion. In the past when somebody walked in with that, we had a saying in our urgent care, if it walked like a duck and talked like a duck, it was probably a duck in the peak of flu season. Now, unfortunately, that’s not true anymore because COVID-19 came to town, and with the varying strains of COVID-19 that we’ve seen over the years, the presentations are so different. I’m seeing a lot of flu-like symptoms now where I’m looking at somebody, I’m saying, “You have the flu,” and then I’m handed the positive COVID-19 test result, and I’m like, “Oh, I guess it’s COVID-19.” That’s where the testing strategy really comes into play.

I think we’re seeing an earlier season because for the last 2 years we saw a lot of masking, a lot of distancing, a lot of folks weren’t getting that normal low-level exposure and building up some degree of immunity. So I think now we’re seeing it hitting everybody all at once. It’s similar to the early days of COVID-19 is what I think of. In someone who’s naive to the virus in those first weeks to months of the infection, before there were antiviral medications, and before we knew a whole lot about it, it was this immune response, this over activity of immunity and the immune system, which I think is responsible for a lot of what we’re seeing now in folks who have been naive to RSV, adenoviruses, enteroviruses, rhinoviruses, influenza, and of course the varying strains of COVID-19.

Tina Tan, MD: Priya, do you have something to add?

Priya Nori, MD: Certainly. I would emphatically agree with everything that’s been said. What comes to mind for me is the fact that we have such good home diagnostics now for COVID-19. What I tell patients these days is, let’s say that you test positive for COVID-19 at home, but not you’re not improving in the way that you thought, or you received treatment and you’re not improving in the way that you thought. Well, go and get yourself tested for these other viruses like RSV and flu because it may be that you’re coinfected. Or that you had COVID-19 before and you have some residual virus, but truly what’s causing you to be symptomatic is one of these other viruses. Personally, I would love to see in the next, let’s say 18 months or so, that there is an approved or at least authorized home test that can pick up all of these 3 viruses. I think that would be a game changer in terms of access, speediness of treatment, and off-loading the health care system. We need to be moving toward that.

Tina Tan, MD: Wendy, do you have something to add?

Wendy Wright, DNP, ANP-BC, FNP-BC, FAANP, FAAN, FNAP: I’m a huge diagnostician, and we all have learned, this is the presentation for this and that. I’ll tell you, all bets are off at this point. I’d like to tell you that if they lose their smell and their taste, it’s definitely COVID-19, but with the Omicron strain, we’re not seeing that as much. I had someone today who has a low-grade fever and diarrhea, and she’s positive for COVID-19. I think there was a study that came out, Tina, that said over 60 symptoms have been reported with COVID-19.

Tina Tan, MD: Correct.

Wendy Wright, DNP, ANP-BC, FNP-BC, FAANP, FAAN, FNAP: We’re seeing this trifecta, and I think we have a lot of work to do as educators and clinicians because people aren’t thinking about RSV in adults.

Tina Tan, MD: I know, and that’s unfortunate.

Wendy Wright, DNP, ANP-BC, FNP-BC, FAANP, FAAN, FNAP: That’s a challenge, right?

Tina Tan, MD: That is unfortunate.

Wendy Wright, DNP, ANP-BC, FNP-BC, FAANP, FAAN, FNAP: Because those tests are not being run. Now granted, we’re going to treat them probably similarly whether we know or don’t know with RSV, particularly in our adults. But this early testing is crucial, and we began to see RSV in July and August, totally outside the RSV season. We have point-of-care testing for all of this, so we’re able to identify it. But we began to see flu type B. Historically, I don’t see flu B until March. I don’t know what the rest of you see, but we’re seeing flu B, we’re seeing flu A, and I had someone yesterday who had influenza and COVID-19. So, all bets are off, and I think it’s already a tough system. It’s a tough system when you know that in December the urgent care centers are saying, “We can’t see you for 2 days.” It’s really frightening out there because people can’t get early intervention, they can’t get tested early, and some of these folks are waiting in EDs [emergency departments] for hours and days for evaluation. It’s definitely a tough season right now.

Tina Tan, MD: JAM, do you have something to add?

Jacinda Abdul-Mutakabbir, PharmD: I will say that I completely and wholeheartedly agree with every single thing everyone said. I don’t know that I have anything of much value to add. One thing I will say is that my mother recently had COVID-19. While we don’t know what strain it was, she complained that she did not lose her appetite because she said she wanted to slim down for the holidays. Thankfully she was fine, but I think that what Wendy highlighted, it’s so important for us moving forward with how we manage these different diseases if they don’t look the way they did previously. They’re ever-evolving, and we have to be prepared for that, which is why testing is so important.

Tina Tan, MD: I agree. I think it’s even more important in the pediatric population because the way that children present with these different diseases is not the same as an adult. For example, with influenza, many of the younger children may only present with GI [gastrointestinal] symptoms. They may have a fever, and they may have nausea, vomiting, diarrhea, and not very much else until later. So the sudden onset of fever, chills, cough, sore throat, etc, does not always happen in very young children. Similarly with RSV, in very young babies, all you may see is a child who’s having increased work of breathing and then apnea, and that may be the presentation of RSV for these young babies. Which is not what you typically see in some of the older children, so definitely there is a bit of a difference with regard to the way some of these viral infections can present. But there’s a lot of overlap.

Transcript edited for clarity

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Dear Dr. Wong: Our daughter is 15 months old. In the last few months, she has been sick a lot after she started going to daycare. Every time, she started with a cold, and this invariably progressed into a bad cough that lasted for weeks. She would finally get better, and then pick up another cold and get sick again. 

The last time she coughed so much that she vomited up mucus and became lethargic. I was thinking about taking her to emergency room. Fortunately, I was able to reach a nurse practitioner who suggested that she might be somewhat dehydrated from vomiting and advised me to nurse her for longer periods of time. After a few hours of nursing, she perked up and gradually recovered. 

I grew up with pretty severe asthma, and her cough reminded me of my cough when I was young. I am much better now, although I still have exercise-induced asthma, and I use an inhaler from time to time. How can I tell whether my daughter has asthma or not?

Answer: I am very glad that your daughter improved after she got more breastmilk from you. When she was sick and coughing, she was breathing faster, coughing and vomiting up mucus. All of these can contribute to dehydration that made her lethargic. You did get good suggestion from the nurse practitioner.

Because of the COVID-19 pandemic, many children stayed home and had few contacts with other children. Once the pandemic rules were relaxed, children started going to school and daycare. Respiratory viruses naturally circulate among children who have little exposure and immunity to common respiratory viruses, including rhinoviruses that cause common cold, influenza viruses and respiratory syncytial virus (RSV), not to mention the COVID-19 virus and others.

When your daughter was exposed to any of these viruses, she would develop cold-like symptoms with stuffy and running nose, sore throat, fever and cough. Most children are sick for a few days with each cold, their cough is usually not too severe. Some may develop complications like ear infections, sinus infections or pneumonia.

It is not easy to tell if a young child has asthma. As you may already know, asthma is a genetic condition; usually one or both parents have a history of asthma. Adults can take a lung function test; those with asthma have narrowing of their bronchial tubes. These bronchial tubes can relax after taking a bronchodilator inhaler. However, it is very difficult to do this test in young children. A few centres can perform a modified lung function test in young children for research purposes only.

Some of the symptoms of asthma in young children include a prolonged and severe cough when they get colds. Very often, their cold symptoms can last for weeks, and they can cough and vomit up mucus. Sometimes parents can hear a wheezy noise when they breathe. If it is severe, these children can breathe very rapidly, and parents may see their chest sucking in between the ribs or under the ribcage. These are all signs of respiratory distress.

Not infrequently, doctors cannot tell whether a child has asthma or not when they are young. Listening to the chest with a stethoscope may not tell anything. Sometimes physicians have to rely on the patterns of cough when they are sick, as well as how frequent and how long each of these episodes lasted. They may prescribe a course of inhaled bronchodilator and steroid to see how the child responds.

Since you have a history of asthma, it is possible for your daughter to develop asthma. You may want to eliminate some common indoor triggers, like dust mites, moulds and certain household pets. You can also watch whether she starts to cough when she runs, even when healthy. Asthma symptoms are also more common in spring and fall.

In the meantime, if she has not received influenza or COVID-19 vaccines as yet, you should consider immunizing her against these viruses. Both of them can get her quite sick, whether she has asthma or not.


Dr. David Wong is a retired pediatrician in Summerside and recipient of 2012 Distinguished Community Paediatrician Award of Canadian Paediatric Society. His columns are in The Guardian on the last Tuesday of every month. You can see a collection of his previous columns at askdrwong.ca. If you have a question for Dr. Wong, please mail it to Prince County Hospital, 65 Roy Boates Ave., Summerside, P.E.I., C1N 2A9.



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The life expectancy for people with cystic fibrosis (CF) has greatly improved over time. Early diagnosis and treatment can improve both life expectancy and quality of life for people with the condition.

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CF is a genetic condition that affects breathing and digestion over time. However, the introduction of new treatments is changing the outlook for people with CF.

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Here’s what to know about cystic fibrosis life expectancy and the factors that can affect it.

Major strides have been made for people with CF since the disease was recognized. In the past, few people survived past early childhood. In contrast, people with CF today have a much-improved life expectancy.

According to the Cystic Fibrosis Foundation’s 2021 annual report, the median predicted survival rate for people born in 2017–2021 is around 53 years. This means that 50% of people born in those years are expected to reach more than 53 years of age.

Life expectancy for people with CF can vary depending on access to care. For example, researchers estimate that people with CF can live into their 40s before needing a lung transplant. This procedure can extend life expectancy by an average of 8.5 years.

Experts continue to look for further advances in treatments that address the root genetic cause of CF, which are mutations in the CF transmembrane conductance regulator (CFTR) gene. Newer treatments are also more effective in addressing recurrent lung infections and other symptoms of cystic fibrosis.

Even with improved treatments, there are factors that can affect the life expectancy of people with CF. However, each person will have their own, individual experience.

People with CF are prone to lung infections because of the mutations in the CFTR gene. These mutations make the mucus that lubricates parts of the body thicker and stickier. The mucus, called phlegm when it’s in the lungs, can trap bacteria such as Pseudomonas aeruginosa, which can cause repeated lung infections.

Fungi and viruses such as influenza can also take hold in the airways. Over time, these chronic infections can damage the lungs and may become life threatening.

People with CF may also develop serious liver disease if thickened mucus blocks small ducts in the liver. This can lead to cirrhosis, which is scarring of the liver that impairs its function.

People with CF can work with their care team to address complications. Preventing or treating these complications may extend life expectancy and improve quality of life.

CTFR modulators were a breakthrough in CF treatment beginning in 2012. However, the medications were not effective for everyone with CF. A recently introduced combination CTFR modulator called Trikafta, however, includes three different medications: elexacaftor, tezacaftor, and ivacaftor. The Food and Drug Administration has approved Trikafta for people over age 12 with certain CTFR mutations.

Additional treatment avenues that can improve life expectancy for people with CF are lung and liver transplants in the event of severe organ damage.

Learn more about living with CF.

The life expectancy for people with CF has greatly improved over the past decades. Current statistics show that people with CF can expect to live past 50.

Though infections and inflammation can damage organs such as the lungs and liver, newer medications are reducing those risks by addressing the genetic defect that causes CF. Researchers continue to look for even more effective ways to treat both the cause and symptoms of the condition.

Talk with your doctor about ways to manage CF.

Credit: www.healthgrades.com/right-care/lungs-breathing-and-respiration/cystic-fibrosis-life-expectancy

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The infusion of honey and garlic that has become the ‘salvation’ for many at peak times of respiratory diseases.

HUILA DAILY, HEALTH

Despite the fact that the traditional remedy to combat a flu or cold has been aguapanela with lemon or other ingredients that little by little have been added to the list of the ‘blessed’ as grandmothers call it, lately, what is coming talking is the infusion of honey and garlic.

These two ingredients have been attributed antibacterial and anti-inflammatory properties. For this reason, it is believed that, by mixing them in the same preparation, a suitable remedy can be obtained to treat and relieve congestion of the respiratory tract, cold, dry cough or throat infections.

Although it is not proven that these ingredients have curative purposes, their texture can help soothe the throat and relieve discomfort. Garlic for its part contains protein, iodine, phosphorus, potassium, vitamin B6 and sulfur compounds, such as allicin. It is best to consume it fresh and raw.

Although the combination of honey in most cases has been given with lemon and ginger, it can be done with garlic so that its properties, along with those of panela that are antioxidants, sugars, amino acids, tannins, glucose and alkaloids, have a much better effect on the body.

It is said that this combination, in addition, its expectorant effects help to remove excess phlegm. And, by the way, they calm breathing difficulties caused by congestion.

Preparation

The preparation of this antibiotic remedy is quite simple and its ingredients are easy to find. However, you should always try to use the best quality ones.

Its preparation is done in a matter of minutes and can be used both to soothe throat irritation and to reduce the symptoms of respiratory problems.

Ingredients

8 garlic cloves

1 teaspoon of cayenne pepper powder (5 g)

½ cup of honey (167 g)

Utensils

glass jar with lid

Wooden spoon

Preparation

To begin with, the garlic cloves should be placed in a mortar and crushed until a paste is obtained.

Then, the crushed mixture is poured into a glass jar, and then the cayenne pepper powder and organic honey are added.

Next, stir everything with a wooden spoon. It is essential to make sure that the ingredients are well integrated.

Finally, you must seal the bottle and let the remedy concentrate for 12 hours.

After the recommended time, start consuming it.

consumption mode

To begin with, it is advisable to serve a teaspoon of the remedy when you get up and take it before breakfast.

If you want, you can mix it in a little warm water to make it easier to consume.

Finally, in order to improve the sore throat in a short time, repeat the treatment every 3 or 4 hours.

In this recipe, pepper is included as an ingredient since it is a spicy seasoning widely used in alternative medicine. It stands out for its emollient, antibacterial and antioxidant properties, but if you don’t want to use it, simply don’t add it to the preparation.

Go to the doctor

Although this is a way to help with some symptoms of this pathology that can be treated naturally, if a few days pass and there is no improvement or new symptoms appear, the best thing to do is consult a doctor.

Most human cases of influenza are diagnosed clinically. However, other respiratory viruses, such as rhinoviruses, respiratory syncytial virus, influenza viruses, and adenoviruses, can also cause influenza-like syndromes that make differential diagnosis difficult during periods of low influenza activity and outside of epidemic situations.

The most effective way to prevent the disease is vaccination. In healthy adults, influenza vaccination is protective, even when circulating viruses do not exactly match vaccine viruses. However, in the elderly, vaccination may be less effective in preventing the disease, although it reduces the severity of the disease and the incidence of complications and deaths. Vaccination is especially important for people at high risk and for those who care for or live with them.

Outstanding: It is said that this combination, in addition, its expectorant effects help to remove excess phlegm. And, by the way, they calm breathing difficulties caused by congestion.



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Across the EU, common pharmaceuticals such as antibiotics and children's pain relievers are short in supply.

  • This photograph taken on October 19, 2022, shows medicine boxes on shelves at a pharmacy in Paris. (AFP)
    This photograph shows medicine boxes on shelves at a pharmacy in Paris, October 19, 2022. (AFP)

Since late 2022, EU countries have reported substantial difficulties obtaining key vital pharmaceuticals, with the majority now experiencing shortages.

In a new report, Politico eviscerated the severity of the issue and, more importantly, what is done about it. 

Is Europe running out of medicines?

A survey of groups representing pharmacies in 29 European countries, including EU members as well as Turkey, Kosovo, Norway, and North Macedonia, showed that over a quarter of countries reported a scarcity of more than 600 pharmaceuticals, while 20% reported a shortage of 200-300 drugs. 

Three-quarters of the countries indicated this winter's shortages were worse than a year earlier.  According to groups in four nations, shortages have been the cause of several deaths. 

It's a picture supported by regulatory data. According to Belgian officials, approximately 300 drugs are in limited supply. In Germany, that number is 408, while in Austria, more than 600 drugs are unavailable in pharmacies. 

Italy's list is much longer, containing nearly 3,000 medications, many of which are different versions of the same medicine.

Wide antibiotics shortage

Antibiotics are in short supply amoxicillin, used to treat respiratory infections. Other drug groups, such as cough syrup, children's paracetamol, and blood pressure medication, are similarly rare.

What's behind the shortage is a combination of rising demand and decreased supply.

Seasonal diseases, most notably influenza and respiratory syncytial virus (RSV), have begun early and are more severe than usual. There is also an uncommon incidence of Strep A in children. Experts believe the exceptionally high level of disease activity is due to immune systems that are no longer accustomed to the soup of germs that surrounds us on a daily basis as a result of lockdowns. 

After a couple of peaceful years (with the exception of COVID-19), this tough winter took drugmakers off guard.

Inflation and the rising energy crisis have also weighed on pharmaceutical firms, affecting supplies.

Read next: Spain: Patients must choose between eating or breathing

Will downplaying the drug shortage fix the crisis?

In principle, the EU should be more prepared than ever to deal with a pan-European crisis. It has reportedly improved its legislation to address health issues such as a scarcity of medications. The EMA's power is to monitor medicine shortages that have expanded. 

A new entity, the Health Emergency Preparedness and Response Authority (HERA), has been established, with the authority to go to the market and buy pharmaceuticals for the entire bloc. However, not everyone agrees that it is yet that bad.

The EMA opted last Thursday not to petition the Commission to designate the Amoxycillin shortage a "major event," which would have triggered some (limited) EU-wide action, claiming that current steps are helping the situation.

Read next: Europe faces massive shortage of doctors, zooming in on France

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His condition deteriorated rapidly and Levi, who works as a welder at JCB, went into septic shock and had multi-organ failure

Levi Dewey, now 21, suffered multiple organ failure after catching a form of the flu and subsequently suffered severe sepsis and at one point was described as the sickest person in the UK.

Levi’s family was told he only had a 30pc chance of survival leaving them devastated. The footballer from Willington, was sporty and lived an active lifestyle playing football for Willington FC and being a lifelong Derby County fan.

He had previously attended John Port Spencer Academy in Etwall, and completed an apprenticeship at age 16 for JCB, before taking up a job there full-time.

But on December 7 last Levi was taken to Royal Derby Hospital with flu-like symptoms and breathing difficulties. His condition deteriorated rapidly and Levi, who works as a welder at JCB, went into septic shock and had multi-organ failure.

Doctors discovered that he was suffering from influenza B and pneumococcal pneumonia.

Levi’s mother, Lara Dewey (47) said: “We were told fairly early on that Levi could potentially lose his legs and need an operation, we were prepared for this outcome if it was to save his life.

“Obviously, it’s going to be life-changing for everyone, but this is something we can work through as a family and we have such a strong and positive support network. Levi has always had a positive mindset and his glass is always half full.”

After his condition deteriorated further in Derby’s intensive therapy unit, Levi was transferred to Glenfield Hospital in Leicester to receive ECMO (extracorporeal membrane oxygenation) and full organ support.

He spent 20 days on ECMO - 14 of which were in an induced coma. He was gradually taken off organ support and, after 31 days, he was taken off a ventilator.

On January 9, Levi was moved back to Royal Derby for ongoing care, but two days later, he was informed that due to the severity of his sepsis he had contracted, he would need below-knee amputation on both of his legs.

“Despite this news, Levi remains optimistic about his future. He is so grateful to be alive after these life changing events,” his family wrote on a GoFundMe page raising money for him to walk again.

“We want Levi to have the best possible quality of life as a double amputee and therefore want to raise money to help with his recovery and the move from hospital to home.

“Later, once he has learnt to walk, we would like to provide him the best bespoke prosthetic legs so he is able to live as an independent life as possible, enjoying the many activities he did before this tragic event changed his life forever.”

The family have already raised almost £80,000 as of January 30.

Mother Lara, a child practitioner, said: “Initially we were looking to raise £10,000 but as you can see this has been exceeded and the response has been extremely overwhelming.

“It’s overwhelming and emotional and we are all speechless. It’s amazing how supportive friends, family, colleagues, communities and also strangers have been towards this cause and also their generosity.

“Initially the money will be used to buy Levi a wheelchair and for home improvements, including ramps and showering facilities. Once he’s able to walk again we will look at buying him the best prosthetic limbs possible privately and any further equipment he will need.”

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TOPEKA, Kan. (WIBW) - Shawnee County health officials will host drive-through operations to test for COVID-19 and the flu as respiratory viral infections continue to circulate.

The Shawnee County Health Department announced on Monday, Jan. 30, that it will provide a combination of COVID-19 and Influenza A and B rapid antigen tests to those who show symptoms of a respiratory viral infection through a drive-through testing operation.

“Symptoms to Covid and the flu are very similar,” said Craig Barnes with the Shawnee County Health Department. “So anybody who is exhibiting symptoms, this is just another great opportunity, you don’t need to go into urgent care, around other individuals and potentially expose other folks. You can do this all from the comfort of your own car. Drive up, get tested, drive away and then still get your results very quickly afterwards.”

SCHD noted that the operation will be held from 9 a.m. to 2 p.m. on Tuesdays and Fridays at 2701 SW E. Circle Dr. starting on Jan. 31.

Barnes said the decision to add Influenza testing was made due to high demand in urgent care and similar facilities.

“One of the things we had heard was how urgent cares and different centers had been very busy and people with long waits,” said Barnes. “So we looked at opportunities to provide a service free of charge that was easily accessible to community members and our drive through operation has been in operation now for almost a full year. We’ve kind of gotten the science behind how to get a quick test, you come through and then get your results the same day.”

Officials indicated that tests available will be rapid antigen and results will be provided on the same day - typically within one hour. Notification will be made via text or email. Registration is not necessary but is encouraged. To register, click HERE.

“Respiratory viruses continue to circulate throughout our community and as such we are expanding our testing options to Shawnee County residents and the surrounding region,” said Carrie Delfs, Clinical Services Division Manager. “We are excited to provide this resource to the community as part of our commitment to a healthier Shawnee County.”

Barnes said they will end the Flu testing at the end of Influenza season, typically late April. The county health department will then track the demand for influenza tests and determine whether to bring the test back for next season.

SCHD said test continue to be available and free throughout the community. To find a nearby testing location, click HERE.

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Each year, as flu season peaks, medical professionals who take care of pregnant women have to gear up to combat misinformation around the influenza vaccine.

"We've always seen fear or distrust of not wanting to get a flu vaccine in pregnancy," Melissa Simon, an obstetrician gynecologist at Northwestern Medicine, told Salon. "Every year we have to be very consistent and start that very clear, consistent messaging that the flu vaccine is indeed very well studied in pregnancy, it's very safe in pregnancy, and it actually improves outcomes."

As Simon alluded to, a 2018 study published in Clinical Infectious Diseases examined the influenza's vaccine effectiveness and flu-related hospitalizations in pregnant women between 2010 and 2016. The researchers concluded that getting vaccinated reduced a person's risk of being hospitalized by 40 percent. A separate study published in 2013 estimated that a pregnant woman's risk of getting a flu-related acute respiratory infection by one-half. Indeed, research has shown that pregnant women have a higher risk of getting hospitalized with pneumonia or being admitted to the intensive care unit when being unvaccinated and having the flu.

"When you have the flu, your lungs have a harder time to breathe [in pregnancy]," Simon said. "And you need those lungs to breathe well, in order to help give oxygen to your baby."

Denise Jamieson, professor and chair of the Department of Gynecology & Obstetrics ast Emory University School of Medicine, told Salon via email that there have often been long-standing myths and misconceptions about the flu vaccine that she's seen in her patients.

"Although the flu vaccine has been recommended in pregnancy for many decades, only about half of pregnant persons are vaccinated for flu each year," Jamieson said. "I have heard many pregnant persons say 'Whenever I get the flu vaccine I get sick, so I am not getting it while I am pregnant".'"

Jamieson said the influenza vaccine can cause mild side effects, but it's not true that it makes a person sick with the flu.

"In addition, there are many long and strongly held beliefs about the flu vaccine in families and communities," Jamieson said. "For example, my patients will say 'My mother never got vaccinated and she told me not to get vaccinated, particularly not in pregnancy.'"

Despite research and recommendations ensuring the safety of vaccines in pregnancy, if you search "flu shot" in many online pregnancy groups, you will find plenty of pregnant women expressing hesitancy at the thought of getting vaccinated. And it's not just the flu shot. When the COVID-19 vaccine finally came to exist, online pregnancy forums were immediately fraught with misinformation about these vaccines' safety. A Kaiser Family Foundation's COVID-19 Vaccine Monitor published over the summer found that nearly three-quarters of women who were pregnant or trying to conceive either believed or were unsure about at least one of the COVID-19 vaccine myths asked in the survey.

"More than two years into the pandemic, there's a surprising amount of confusion about the vaccine's safety for pregnant women," Mollyann Brodie, a Kaiser Family Foundation Executive Vice President, said in a statement at the time. "The fact that so many younger women incorrectly believe the vaccines can cause infertility or that they're not safe for pregnant women highlights the real challenges facing public health officials."

It's a question medical professionals have long been fixated on: why is health and vaccine misinformation so common in online pregnancy groups that are meant to provide support? Why does misinformation prevail when the research has advanced?

"Disinformation runs rampant on online forums because there's no one checking," Simon postulated. "There's no accountability, and no one's editing."

Andrea Vincent, an admin for a Facebook pregnancy support group, told Salon as admins they often find themselves having to monitor misinformation in the group.


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"We've always had a lot of rules and they've had to increase in the last few years with the world changing," Vincent said. "But I think that's helped us keep misinformation out and we really try to keep talking a lot behind the scenes about what we allow and what we don't."

Vincent said she believes that people seek out medical advice in online support groups, instead of asking their medical providers, for a couple of reasons. 

"I think people want reassurance that it's normal, so they don't have to go to their doctor or they think it's easier to go to a group, or sometimes people have gone to a doctor and want to then ask the group, 'this is what my doctor says, has anyone done this?'" Vincent said. "There's a lot of misinformation out there, and it's scary to have a baby."

Previously, Simon told Salon the fact that a lot of the misinformation clouds pregnancy stems from "structural issues," such as "excluding pregnant and birthing and lactating persons" from research. "And that's really unfortunate because when certain groups are left behind from being included in clinical trials, there is relatively less data." But now, more data is here. 

Jamieson told Salon she believes there is often a reluctance to do anything in pregnancy, like take medications or vaccines, in a misguided attempt to ensure that they've done everything to ensure their babies are born healthy. But this can often have the reverse effect.

"What is not appreciated is that by doing nothing, and not getting vaccinated, the risks to the mother and baby can be substantial," Jamieson said. "Pregnant people who are vaccinated for influenza can also pass protective antibodies to the fetus; these protective antibodies are critically important because they help protect newborn babies, who are too young to be vaccinated, from getting sick with influenza."

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COLUMBIA, Mo. — In a new study, a team of University of Missouri researchers made an unexpected discovery: people experiencing long-lasting effects from COVID-19 — known as “long COVID” or post-COVID conditions — are susceptible to developing only seven health symptoms for up to a year following the infection. They are: fast-beating heart, hair loss, fatigue, chest pain, shortness of breath, joint pain and obesity.

To develop their findings, the team reviewed Orcale Cerner real-world data from electronic medical records containing de-identified information for medical research purposes. After examining data from a total of 52,461 patients at 122 healthcare facilities across the United States, the researchers selected the top 47 most commonly reported health symptoms from long COVID to examine for this study. Then, the researchers looked for any comparisons in the reported health symptoms — many also shared by other viral respiratory infections — among people in three different subgroups:

  • People diagnosed with COVID-19 but do not have any common viral respiratory infections like influenza or pneumonia 
  • People with common viral respiratory infections but do not have COVID-19 
  • People who do not have COVID-19 or any other common viral respiratory infections. 

“Despite an overwhelming number of long COVID symptoms previously reported by other studies, we only found a few symptoms specifically related to an infection from SARS-CoV-2, the virus that causes COVID-19,” said Chi-Ren Shyu, director of the MU Institute for Data Science and Informatics and the corresponding author of the study. “Before we examined the data, I thought we would find an ample amount of the symptoms to be specifically associated with long COVID, but that wasn’t the case.”

Shyu, who is also the Paul K. and Dianne Shumaker Professor in the Department of Electrical Engineering and Computer Science at the MU College of Engineering, said the results could benefit ongoing efforts by fellow researchers to study various impacts of COVID-19.

“Now, researchers will be able to better understand how SARS-CoV-2 may mutate or evolve by creating new connections that we may not have known about before,” Shyu said. “Going forward we can use electronic medical records to quickly detect subgroups of patients who may have these long-term health conditions.”

Adnan Qureshi, a professor of neurology in the MU School of Medicine, doctor of neurology with MU Health Care and co-author of the study, said the findings will provide health care providers with much-needed information about what to ask and look for when visiting with a patient who has symptoms of long COVID.

Qureshi said the study’s results could also benefit researchers examining other aspects of COVID-19, such as the impact of the virus on the brain or the immune system. He said the concept of long COVID was developed after clinicians started noticing a group of people who were dubbed “survivors” of COVID-19 were “not necessarily normal anymore.”

“The survivors still have symptoms that are at times disabling and preventing them from going back to work or the activities of their daily life,” Qureshi said. “This is not because the COVID-19 infection is still active, but instead the infection has caused long-term consequences, or sequelae, in the form of a post-COVID syndrome that could persist for months or even years. Our research was able to identify long-term sequelae that are distinctive to COVID-19 and separate the post-COVID syndrome from other post-viral syndromes.”

COVID-specific long-term sequelae in comparison to common viral respiratory infections: an analysis of 17,487 infected adult patients,” was published in the journal Open Forum Infectious Diseases. Other co-authors were Jane Armer and William Baskett at MU, and Daniel Shyu at University of Minnesota. The study was supported by a grant from the National Institutes of Health (5T32LM012410). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.


Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

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The potential “tripledemic” of influenza, SARS-CoV-2 and RSV (respiratory syncytial virus) infection continues to be a concern. Vaccines remain the best defense against COVID-19 and influenza, with the flu vaccine mainly targeting two proteins on the virus’s surface. Now, researchers in ACS Central Science report that simulations show the proteins can tilt and wave in “breath-like” motions, which could be exploited to better defend against the flu. Watch a video of the proteins here.

The flu virus sickens people by sneaking past their immune defenses, entering cells and then replicating. Hundreds of hemagglutinin (HA) and neuraminidase (NA) proteins cover the viral particles, helping the particles get into cells and helping new virions leave. But researchers have a limited understanding of how these proteins move in vivo — information that could assist scientists in developing a universal flu vaccine and more effective antiviral drugs. So, Rommie Amaro and colleagues at the University of California San Diego wanted to simulate the whole influenza A virion and look at the proteins’ movements and interactions for potential weaknesses.

The researchers conducted detailed simulations of the 161 million atoms of the influenza A H1N1 virion, commonly referred to as swine flu, and found that both HA and NA are quite flexible. Here are the details:

NA proteins have globular heads on top of a thin stalk, and the head can tilt down more than 90 degrees, acting like a weedwhacker on a rotating axis. From these data, the researchers realized that as the head tilts, the underside of the protein becomes accessible to a human monoclonal antibody, NDS.1.

HA proteins protrudes up from the viral membrane, connected by a flexible hinge, and can also tilt but not quite as much. Interestingly, some of the HA proteins seemed to “breathe” — the top of the protein shifted from a closed position to a partially open structure and back again. In the open state, the protein was accessible to a broadly protective human antibody, FluA-20, suggesting that keeping it in that position could be a way to develop more effective drugs against the flu virus.

Finally, the simulations showed that the HA and NA proteins could clump together with up to five nearby HA and/or NA proteins and then form even larger aggregates involving tens of proteins. By clustering, the two proteins could contend for the same receptors on host cells, potentially affecting the virus’s entry into or exit from cells, the researchers say. They conclude that these first-of-their-kind visualizations show many new vulnerable states of flu viruses, which could improve future vaccines and antiviral drugs.

Reference: Casalino L, Seitz C, Lederhofer J, et al. Breathing and Tilting: Mesoscale Simulations Illuminate Influenza Glycoprotein Vulnerabilities. ACS Cent Sci. 2022;8(12):1646-1663. doi:10.1021/acscentsci.2c00981

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SEOUL, South Korea (AP) — Russia’s embassy in North Korea says the country has eased stringent epidemic controls in capital Pyongyang that were placed during the past five days to slow the spread of respiratory illnesses.

North Korea has not officially acknowledged a lockdown in Pyongyang or a re-emergence of COVID-19 after leader Kim Jong Un declared a widely disputed victory over the coronavirus in August, but the Russian embassy’s Facebook posts have provided...

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SEOUL, South Korea (AP) — Russia’s embassy in North Korea says the country has eased stringent epidemic controls in capital Pyongyang that were placed during the past five days to slow the spread of respiratory illnesses.

North Korea has not officially acknowledged a lockdown in Pyongyang or a re-emergence of COVID-19 after leader Kim Jong Un declared a widely disputed victory over the coronavirus in August, but the Russian embassy’s Facebook posts have provided rare glimpses into the secretive country’s infectious disease controls.

The embassy posted a notice Monday issued by North Korea’s Foreign Ministry informing foreign diplomats that the “intensified anti-epidemic period” imposed in Pyongyang since Wednesday was lifted as of Monday.

Last week, the embassy said that North Korean health authorities required diplomatic missions to keep their employees indoors and also measure their temperatures four times a day and report the results to a hospital in Pyongyang. It said the North Korean measures were in response to an increase in “flu and other respiratory diseases,” but it didn’t mention the spread of COVID-19 or restrictions imposed on regular citizens.

Shortly before that post, NK News, a North Korea-focused news website, cited a North Korean government notice to report that health officials had imposed a five-day lockdown in Pyongyang in an effort to stem the spread of respiratory illnesses.

North Korea’s state media didn’t mention any preventive measures specifically tied to COVID-19 as it tightened restrictions in Pyongyang last week. But on Wednesday, the state-run Korean Central News Agency said North Korean health workers have “redoubled” their efforts to prevent the spread of infectious diseases and firmly maintain an “anti-epidemic atmosphere” throughout society to cope with the “daily-worsening world health crisis.”

“(Health workers) are directing primary efforts to consolidating the anti-epidemic barrier and intensifying the medical examination and disinfection to prevent the outbreak and spread of viral respiratory diseases including influenza,” the agency said. “They also make it a daily routine to measure temperatures and sterilize hands of the people in crowded places and ensure the accuracy of medical examination.”

Getting a read of North Korea’s virus situation is difficult as the country has been tightly shut since early 2020, with officials imposing strict border controls, banning tourists and aid workers and jetting out diplomats while scrambling to shield their poor health care system.

North Korea’s admission of a COVID-19 outbreak in May last year came after it spent 2 ½ years rejecting outside offers of vaccines and other help while steadfastly claiming that its socialist system was protecting its population from an “evil” virus that had killed millions elsewhere.

South Korea’s Unification Ministry, which handles inter-Korean affairs, said the number of foreign missions that are currently active in North Korea would be 10 or less, a list that includes the missions of China, Vietnam and Cuba along with the Russian embassy.

North Korean state media in recent weeks have stressed vigilance against a possible re-emergence of COVID-19. The official Rodong Sinmun newspaper, which previously described the anti-virus campaign as the “No. 1 priority” in national affairs, called for North Koreans to maintain a “sense of high crisis” Monday as COVID-19 continues to spread in neighboring countries.

Some analysts say North Korea could be taking preventive measures as it prepares to stage huge public events in Pyongyang — possibly as early as next week — to glorify Kim’s authoritarian leadership and the expansion of his nuclear weapons and missiles program.

Recent commercial satellite images indicated preparations for a massive military parade in Pyongyang, likely for the 75th founding anniversary of the Korean People’s Army that falls on Feb. 8 — an occasion Kim could potentially use to showcase his growing collection of nuclear-capable missiles.

Satellite images taken Friday indicated continuing parade practices at a training site in southeast Pyongyang despite the reported lockdown, according to 38 North, a website specializing in North Korea studies. But no activities were seen at Kim Il Sung Square in the central part of the city where the country usually hosts military parades, the report said.

Some outside experts linked North Korea’s 2022 COVID-19 outbreak to a massive military parade in April, where Kim vowed to accelerate the development of nuclear weapons and threatened to use them if provoked.

North Korea maintains it has had no confirmed COVID-19 cases since Aug. 10, when Kim used a major political conference to declare the country has eradicated the coronavirus, just three months after the country acknowledged an omicron outbreak.

While Kim claimed that the country’s purported success against the virus would be recognized as a global health miracle, experts believe North Korea has manipulated disclosures on its outbreak to help him maintain absolute control.

From May to August, North Korea reported about 4.8 million “fever cases” across its population of 26 million but only identified a fraction of them as COVID-19. Experts say the country’s official death toll of 74 is abnormally small, considering the country’s lack of public health tools.

North Korea has dubiously insisted that rival South Korea was responsible for its COVID-19 outbreak, saying that the virus was transported by anti-Pyongyang propaganda leaflets and other materials flown across the border by balloons launched by South Korean civilian activists. South Korea has dismissed such claims as unscientific and “ridiculous.”

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In recent weeks, a surge of three viruses has swept over the United States: COVID-19, respiratory syncytial virus (RSV) and influenza.

Unfortunately, as virus numbers mounted, it got harder to find medications to relieve symptoms. Many people rushed to the drugstore looking for acetaminophen, better known as Tylenol, which is known for its fever and pain-reducing powers. Children's Tylenol is in particularly short supply, causing anxiety and stress for parents everywhere—and it doesn't help that Tylenol alternatives, like children's Motrin (ibuprofen), and in short supply too. 

Why Is There a Tylenol Shortage?

The current Tylenol shortage (and this is far from the only medicine shortage), isn’t actually a manufacturing issue, says Dr. Wendy Hasson, MD, a pediatrician and spokesperson for the American Academy of Pediatrics (AAP). “But it’s an enormous increase in demand,” she says. “There was probably an element of people trying to stock up, not unlike the infamous toilet paper incidents of early 2020.”



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Ujjain (Madhya Pradesh): Intense cold conditions in the year 2023 have triggered new viral fever in many areas of Malwa region. There has been a marked increase in patients exhibiting flu-like symptoms and many of these patients are testing positive for influenza H3N2. Giving this information Dr Naresh Purohit, advisor, National Communicable Disease Control Programme, said that city hospitals are witnessing a spike in H3N2 cases, which is a respiratory disease. He said that H3N2 influenza presents as a fever with chills, cough, runny nose, sore throat, body aches and diarrhoea.

Even after fever subsides, patients complain of cold and cough for a longer period. It is more severe in older adults and sees more hospitalisations than other strains. Quadrivalent vaccines can prevent it. Purohit cautioned that if H3N2 viral fever is not treated on time it leads to pneumonia. “The gullible populations who are at risk of severe infection and death are patients with other diseases such as kidney failure, diabetes mellitus, elderly with comorbidities like heart and kidney problems.

The surge is further increased with social events, travel and other activities. The patient is infectious in the first 3-4 days of infection. Once the infection travels to the lungs the patients develop breathing difficulty and chest pain,” said he. The current treatment of pneumonia varies as per the severity of symptoms. “Mild symptoms in young people with no other co-morbidities and normal blood parameters can be treated at home with medicines.

In case of either elderly or deranged blood parameters or co-morbidities the patients have to be admitted to the hospital. If oxygen measured by pulse oximeter or ABG (arterial blood gases) is low, oxygen inhalation is started in the form of nasal prongs or mask,” averred he.   Purohit pointed out that some patients may require ventilator support. In case of either elderly or deranged blood parameters or co-morbidities the patients have to be admitted to the hospital.

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Kevin Proctor, pictured with the Titans in 2021, played through the pain barrier of a heavy flu in England because he didn’t want to let his coach down.

Albert Perez/Getty Images

Kevin Proctor, pictured with the Titans in 2021, played through the pain barrier of a heavy flu in England because he didn’t want to let his coach down.

Kevin Proctor – the former Kiwis forward sacked by NRL club Gold Coast Titans – says he was struggling to breathe after playing with influenza for his new English Super League club.

Proctor signed a one-year contract with Wakefield Trinity after being sacked last season by the Titans for vaping in a toilet at halftime of a NRL match.

The 33-year-old told League Express he told his coach he was “a bit ill’’ on the eve of a pre-season derby with Featherstone Rovers.

He warned coach Mark Applegarth that “if I wake up tomorrow like this I don’t know how I will play,'” Proctor told League Express.

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“Then I rang him this morning and showed him my face and I looked like s.. and he said I didn’t have to play if I didn’t want to.

“I said ‘give me an hour and I’ll come down, but I felt like s... out there.

“I’m feeling better right now. Just at the start I couldn’t breathe, we had no ball either which didn’t make it any easier, but once we started getting into the groove it was good.”

Proctor started in Wakefield’s front row against a Featherstone side fielding his former Kiwis teammate Elijah Taylor at loose forward.

Taylor scored as second-tier Featherstone raced out to a 12-0 lead, but Wakefield, who included former Warriors and Samoa halfback Mason Lino, showed their class in the second half to win 24-12.

Proctor had 282 NRL games for the Storms and the Titans and earned 22 Kiwis caps between 2012 and 2019.

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