The Medical Director's Desk

Topics of Interest:

  Preventing Colds and Flu

  Flu Vaccine Season is Here

  In 2009 I will resolve to… (Part 1 of 3).

Preventing Colds and Flu

“What can I do to avoid getting sick?”

This question is on everyone’s mind as we approach the winter cold and flu season.

Very few popular preventive strategies like Echinacea, zinc lozenges or nasal gel have shown consistent, significant benefits; though, there has been some evidence to support the benefit of taking higher doses of Vitamin C (200mg – 500mg per day) for reducing the frequency of viral upper respiratory infections.

Unfortunately, none of the above has proven effective in shortening the duration or severity of a cold once it begins. So the best strategy to prevent illness is to reduce your direct exposure to the viruses that cause infection.

Unlike common colds, influenza can be treated if caught early, ideally within 48 hours of symptom onset. Specific anti-viral medicines can be prescribed by your doctor. These same medicines can also be used to reduce your risk of catching influenza from a close contact or family member. And remember: getting vaccinated every year against influenza remains one the most effective ways of avoiding this serious and potentially deadly viral illness.

Perhaps the simplest and least expensive way to reduce the risk of contracting colds and flu is to develop an understanding and commitment to hand washing and hygiene.

People with colds and flu carry the virus on their hands. The virus remains alive on the skin and is capable of infecting another person for at least two hours. It can then be transmitted if the person touches their eye, nose or mouth. Some cold viruses can live on surfaces (such as a counter top, door handle, or phone) for several hours. Droplets containing viral particles can be exhaled (blown out) into the air by a person with a cold as the person breathes, coughs, or sneezes.

Hand washing is an essential and highly effective way to prevent the spread of infection. Hands should be wet with water and plain soap, and rubbed together for 15 to 30 seconds, then dried with a single use, clean towel. Alcohol-based hand rubs are an excellent alternative for disinfecting hands if a sink is not available. They also cause less drying and irritation of the skin than soap and water with frequent hand cleansing. Carrying an alcohol-based hand gel allows you to disinfect your hands frequently, especially after touching shared objects like phones, pens or door handles.

In addition, always carry tissues and cover your mouth when you cough or sneeze. Then discard the tissue and wash or sanitize your hands right away. If no tissue is available, sneeze or cough into the crease of your elbow so that you won’t spread the virus to your hands. If you are caring for a loved one who is sick, be extra careful to wash or sanitize your hands whenever handling their clothing, bedding or any objects they touch.

While there is no guaranteed way to avoid colds and flu, the best defense truly can be in your own hands – or on them!

For additional information on the topics of “Common cold “and “hand hygiene” from which some of the above information was drawn, follow or paste the following web link:

Flu Vaccine Season is Here

As the seasons change and the colder weather approaches, it’s time to prepare for the annual return of one of the most preventable illnesses we face: influenza. Unlike the many respiratory viruses for which there is no effective vaccine or drug treatment, those which cause the common cold, bronchitis and sinus infections, influenza is both preventable and treatable.

Unfortunately, just as we are seeing with many bacterial infections, some influenza virus strains are becoming resistant to the few anti-viral medications available to treat the illness. Fortunately, during the years when the vaccine is well-matched to the active strains, its effectiveness in preventing infection can be as high as 70-90 percent.

Flu season typically does not reach its peak until January or February; but it can begin as early as October and run as late as May. It usually takes about two weeks for the vaccine to begin to protect you; so waiting until close contacts are sick may be waiting too long.

Flu vaccine for the 2008-2009 season is now available and no shortage is predicted. Important changes and updates have been made to the 2008 recommendations including

o     Annual vaccination of all children ages 5-18 is now recommended.

o     Children age 6-months – 59-months with health conditions which place them at increased risk from influenza complications should be vaccinated.

o     Children age 6-months – 8 years should receive 2 doses of vaccine (separated by 4 or more weeks) if they have not had a 2-dose vaccination series in any prior year.

o     Either influenza vaccine injection or live attenuated (nasal spray) vaccine can be used when vaccinating healthy persons aged 2-49.

o     Children age 6-23 months, children with possible reactive airway disease (asthma, recurrent wheezing or recent wheezing episodes), and adults older than 49 or persons at higher risk for complications from influenza should receive the influenza vaccine injection not the nasal spray vaccine.

 Many misconceptions still exist about flu vaccine.

• The most common misconception is that the vaccine will cause influenza.

- While the effect of stimulating your immune system to make antibodies which will protect you may cause low grade fever, soreness or redness at the vaccine site or mild achiness, these are not symptoms of the flu but are signs that your immune system is responding to the vaccine.

•  The vaccine doesn’t work.

- The effectiveness of the vaccine does vary with the match of the strains chosen; however, in 16 of the last 20 U.S. flu seasons, the viruses in the vaccine have been well matched to the predominant circulating strains. Further, even in years when the circulating strains do not match the vaccine, cross-reacting protection may still provide  enough protection to lessen the severity of the illness and prevent flu-related complications.

•  I don’t need to be vaccinated as long as other people around me do.

 - While it’s true that populations can develop a certain degree of “herd” immunity when a enough people become immune that the virus cannot spread easily across the community, that protection only works if the majority of vulnerable individuals are vaccinated before the illness emerges in the area. Further, there is a real moral hazard in counting on others to be responsible for protecting you and your family. Obviously, if everyone opted for the free ride, no one would be protected.

Influenza remains a major cause of severe illness, hospitalization and death, especially in the most vulnerable among us: the very young, the very old and those with serious medical conditions.

Much of that could be avoided if everyone were to take responsibility for their own health and for the health of their family and community by getting their flu shot every year.

For more information, see the Center for Disease Control and Prevention (CDC) website at:

In 2009 I will resolve to… (Part 1 of 3).

So it’s no wonder that the tradition of New Year’s resolutions also stirs an equal mixture of hope and disappointment. Setting your sights on improving yourself and your life is a worthwhile goal; but setting unrealistic expectations is a recipe for failure.

During the course of this first month of 2009 I’d like to highlight three of the most common New Year’s resolutions: exercising more; losing weight; and quitting smoking.

I.                    “In 2009, I Resolve to Exercise More”

Many Americans have little or no physical activity in their daily lives. Only about half get the recommended minimum amount of physical activity. Numerous medical studies have shown the risk of the sedentary lifestyle and the benefit of regular moderate exercise. These benefits include:

• weight reduction;
• decreased triglyceride and increased HDL (good cholesterol) levels 
• blood pressure reduction; 
• prevention or delay of Type II diabetes
• stress and anxiety reduction;
• preventing osteoporosis;
• helping to quit smoking.

The American Heart Association (AHA) recommends that all adults get at least 30 minutes of physical activity on most days. That should be 60 minutes if you’re trying to lose weight. The activity does not have to be all at once but can be broken up into 15 minute intervals that better fit your schedule or your exercise tolerance.

People who don’t normally get much exercise should begin by moderate exercising (like walking) for a few minutes at a time. As fitness improves, the duration, intensity and frequency should be slowly increased. Develop a routine, like choosing the same time of day each day, so it becomes a regular part of your lifestyle. Exercise with a friend or family member; you’ll both be more likely to stick with it. Most of all don’t be discouraged if you stop. Life’s demands have a way of derailing the best intentions. Gradually start again and work back up to your old pace.

You don’t need expensive gym memberships or home fitness equipment to get the exercise you need. Once you make exercise a regular part of your lifestyle, you may want to challenge or motivate yourself even further by adding machines or fitness programs. Best of all, once you’ve gotten into the routine and begin to feel the benefits, the chances will be even better that you will stick with the gym or continue to use the equipment.

By setting realistic goals you’re more likely to succeed. Studies show that the greatest health benefit is seen among people who change from a sedentary life to a lifestyle including modest amounts of regular exercise. Start small and work your way up. The benefits will last a lifetime so they’re worth the effort.

Remember: individuals with a history of heart disease or heart disease risk equivalents like diabetes, peripheral or central vascular disease, should discuss any planned exercise program with their doctors before beginning.

For further information on starting a Physical Activity Program, check the following link: