With concerns about this year’s flu season and H1N1 potential we need to arm ourselves with the knowledge necessary for a safe dojo setting, to protect ourselves, our staff, our students, and our business. During the past 26 flu seasons (October to May), months with the heaviest flu activity (peak months) occurred in November one season, December four seasons, January five seasons, February 12 seasons, and March four seasons. Many would think those working directly with patients in a healthcare setting would be most at risk for contact with the flu, but this is not necessarily true. It’s the meeter’s and greeter’s; the reception staff who see the majority of people, in fact all the people who come through the doors. With discussion in our media, everywhere from political commentators to Oprah the flu is selling news, but what’s the real scoop?
According to the Centers for Disease Control (CDC) the Epidemiology and Prevention Branch in the Influenza Division collects, compiles and analyzes information on influenza activity year round in the United States and produces a weekly report from October through mid-May. As of the week ending September 5th, 2009, NH was the only continental state showing NO FLU ACTIVITY. But this could and will change sooner than we think if we aren’t mindful.
We hear the terms flu, swine flu, canine flu, and avian flu. Don’t get too caught up in the names. What you really need to understand is the basics. Influenza (the flu) is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness, and at times can even lead to death. Each year in the United States on average, 5% to 20% of the population gets the flu; on average, more than 200,000 people are hospitalized from flu-related complications, and; about 36,000 people die from flu-related causes. Some people, such as seniors, young children, and people with compromised health conditions, are at high risk for serious flu complications. This flu season could be worse according to the CDC. There is a new and very different flu virus spreading worldwide among people called 2009 H1N1 flu. This virus may cause more illness or more severe illness than what we have been accustomed to.
What are the symptoms of the seasonal flu? The flu is different from a cold. The flu usually comes on suddenly and may include the following symptoms:
- Fever (usually high; greater than 101 degrees Fahrenheit)
- Extreme fatigue
- Dry cough
- Sore throat
- Runny or stuffy nose
- Muscle aches
- Stomach symptoms, such as nausea, vomiting, and diarrhea, may also occur but are more common in children than adults
These symptoms are usually referred to as “flu-like symptoms.”
Most people who get influenza will recover in a few days to less than 2 weeks, but some individuals may develop life-threatening complications (such as pneumonia) as a result of the flu. Anyone can get the flu (even healthy people), and serious problems from influenza can happen at any age. People at risk for the dangers presented by contacting the flu are those age 65 years and older, people of any age with chronic medical conditions (such as asthma, diabetes, or heart disease), pregnant women, and young children. Pneumonia, bronchitis, and sinus and ear infections are three examples of complications resulting from flu. The flu can make chronic health problems worse. For example, people with asthma may experience asthma attacks while they have the flu, and people with chronic congestive heart failure may have worsening of this condition that is triggered by the flu.
Your sudden respiratory illness this winter might just be the flu if you have sudden onset of body aches, high fever, and respiratory symptoms. However, during this time, other respiratory illnesses can cause similar symptoms to the flu. In addition, influenza can also occur outside of the typical flu season. It is impossible to tell for sure if you have the flu based on symptoms alone. Doctors can perform tests to see if you have the flu if you are in the first few days of your illness, so if there are any questions see your medical provider, and stay home from work; remember to cover your mouth and nose when coughing and sneezing and properly dispose of tissues, and wash your hands frequently.
The flu is contagious. Most healthy adults may be able to infect others beginning 1 day before symptoms develop and up to 5-7 days after becoming sick. Children may pass on the virus for longer than seven days. Symptoms start one to four days after the virus enters the body. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick
The main way that influenza viruses are thought to spread is from person to person via respiratory droplets of coughs and sneezes. (This is called “droplet spread.”) This can happen when droplets from a cough or sneeze of an infected person are propelled through the air and deposited on the mouth or nose of people nearby. Influenza viruses may also be spread when a person touches respiratory droplets on another person or an object that has been contacted with the infectious droplets and then touches their own mouth or nose (or someone else’s mouth or nose) before washing their hands. The most important and effect prevention measure we all can take in preventing flu exposure is frequent hand washing using alcohol based hand sanitizing products or using warm water and a soapy lather rubbing your hands vigorously for a minimum of 20 seconds, paying special attention to the backs of your hands, wrists, in between your fingers and underneath your fingernails (don’t have a timer, sing “Happy Birthday” to yourself for 1 full rendition).
Linens, eating utensils, and dishes belonging to those who are sick do not need to be cleaned separately, but more importantly these items should not be shared without washing thoroughly first. Linens (such as bed sheets and towels) can be washed by using household laundry soap and tumbled dry on a hot setting. Individuals should avoid “hugging” laundry prior to washing it to prevent contaminating themselves. Individuals should wash their hands with soap and water or alcohol-based hand rub immediately after handling dirty laundry. Eating utensils should be washed either in a dishwasher or by hand with water and soap.
Remember it is very difficult to distinguish the flu from other infections on the basis of symptoms alone. A doctor’s exam may be required to tell whether you have developed the flu or a complication of the flu. There are tests that can determine if you have the flu as long you are tested within the first 2 or 3 days of illness.
If you develop flu-like symptoms and are concerned about your illness, especially if are at high risk for complications of the flu, you should consult your healthcare provider immediately.
|Fever is rare with a cold.||Fever is usually present with the flu in up to 80% of all flu cases. A temperature of 100°F or higher for 3 to 4 days is associated with the flu.|
|A hacking, productive (mucus- producing) cough is often present with a cold.||A non-productive (non-mucus producing) cough is usually present with the flu (sometimes referred to as dry cough).|
|Slight body aches and pains can be part of a cold.||Severe aches and pains are common with the flu.|
|Stuffy nose is commonly present with a cold and typically resolves spontaneously within a week.||Stuffy nose is not commonly present with the flu.|
|Chills are uncommon with a cold.||60% of people who have the flu experience chills.|
|Tiredness is fairly mild with a cold.||Tiredness is moderate to severe with the flu.|
|Sneezing is commonly present with a cold.||Sneezing is not common with the flu.|
|Cold symptoms tend to develop over a few days.||The flu has a rapid onset within 3-6 hours. The flu hits hard and includes sudden symptoms like high fever, aches and pains.|
|A headache is fairly uncommon with a cold.||A headache is very common with the flu, present in 80% of flu cases.|
|Sore throat is commonly present with a cold.||Sore throat is not commonly present with the flu.|
|Chest discomfort is mild to moderate with a cold.||Chest discomfort is often severe with the flu.|
Flu is a serious disease and it’s important to take action to protect yourself. Most healthy people recover from the flu without complications. But if you get the flu:
- Stay home from work or school, it’s nice to share, but in this case save your friends from the experience.
- Get lots of rest, drink plenty of liquids, and avoid using alcohol and tobacco.
- There are over-the-counter (OTC) medications to relieve the symptoms of the flu (but never give aspirin to children or teenagers who have flu-like symptoms, particularly fever! I.e. Reye’s syndrome).
- Consult your doctor early on for the best treatment, but also be aware of emergency warning signs that require urgent medical attention.
If you or someone you know is having any of following warning signs seek immediate medical attention.
In children, emergency warning signs that need urgent medical attention include:
- Fast breathing or trouble breathing
- Bluish skin color
- Not drinking enough fluids
- Not waking up or not interacting
- Being so irritable that the child does not want to be held
- Flu-like symptoms improve but then return with fever and worse cough
- Fever with a rash
In adults, emergency warning signs that need urgent medical attention include:
- Difficulty breathing or shortness of breath
- Pain or pressure in the chest or abdomen
- Sudden dizziness
- Severe or persistent vomiting
Prevention against the flu is not 100% guaranteed, but is possible. First and foremost remember you have options. The most common prevention measure in the USA is to get a flu vaccination each year. Two kinds of seasonal flu vaccine are available in the United States:
The “flu shot” — an inactivated vaccine (containing killed virus) that is given with a needle, typically in the arm. The flu shot is approved for use in people older than 6 months, including healthy people and people with chronic medical conditions (such as asthma, diabetes, or heart disease). It is recommended for those at high risk of contacting the flu. Since flu season is usually in late fall or early winter, a flu shot should be given in the autumn, so that full immunity can be built up. However, it is never too late to get a flu shot.
Most people have no adverse effects from a flu shot other than soreness at the injection site that lasts a few days. The greatest risk is an allergic reaction, which can be serious, but this is very rare. A low fever occasionally occurs.
Vaccines should not be given to patients taking antibiotic drugs. While both flu vaccines may be administered at the same time as other vaccines, if two vaccines are not given at exactly the same time, they should be spaced four weeks apart.
The flu vaccine should not be given to the following groups:
- Individuals with a severe allergic reaction to chickens or egg protein
- Individuals who have exhibited a moderate to severe reaction after a previous influenza shot
- Individuals who have ever been paralyzed due to Guillain-Barré syndrome
- Individuals who are sick with anything beyond a slight cold
The nasal-spray flu vaccine — a vaccine made with live, weakened flu viruses that do not cause the flu (sometimes called LAIV for “live attenuated influenza vaccine”; or FluMist®). LAIV (FluMist®) is approved for use in healthy* people 2-49 years of age who are not pregnant.
Use of nasal-spray flu vaccine’s together with antiviral drugs that are active against the influenza virus has not been evaluated; however, since there is a potential for these agents to reduce the effectiveness of the nasal-spray flu vaccine (by preventing infection with the viruses contained in the nasal-spray flu vaccine), such antiviral agents should not be administered until 2 weeks after the nasal-spray flu vaccine therapy, and nasal-spray flu vaccine’s should not be administered until 48 hours after antiviral therapy is discontinued.
PREGNANCY: A nasal-spray flu vaccine should not be given to pregnant women.
With the 2009 H1N1 reaching pandemic proportions (Pandemic flu refers to particularly virulent strains of flu that spread rapidly from person to person to create a world-wide epidemic) there is much talk about a vaccine for the H1N1. The H1N1 vaccine is expected to be available sometime in late October/early November. More specific dates cannot be provided at this time as vaccine availability depends on several factors including manufacturing time and time needed to complete clinical trials. No one vaccine is completely safe for everyone. Period. While I researched the Internet for reliable sources about the side effects, no one site proved reliable enough for me to pass along to. I encourage you to do your own research about the side effects and I will do the responsible thing and not spread or listen to rumors, but research the facts from reputable sites. What we do know is that according to the CDC pregnant women, persons who live with or provide care for infants aged over 6 months, health-care and emergency medical services personnel, children and young adults aged 6 months–24 years, and persons aged 25–64 years who have medical conditions that put them at higher risk for influenza-related complications and these people should consider the H1N1 when it is available based on the guidelines presented at that time. What we also know is that some people over 61 ½ years of age have been identified as having an immunity to H1N1. But, that means some, not all. In regards to the H1N1 virus the phrase “novel H1N1” virus which is being tossed around we need to understand the term. In this case it means new. Because H1N1 is a novel (new) virus, it spreads quickly because we have not developed antibodies to it yet. Though the human race has seen H1N1 before, we have not seen ‘this’ strain of the virus. Keep in mind that the seasonal flu vaccine is not expected to protect against the 2009 H1N1 flu, so this means an additional vaccine. It is anticipated that seasonal flu and 2009 H1N1 vaccines may be administered on the same day but given at different sites (e.g. one shot in the left arm and the other shot in the right arm). A number of clinical trials which test 2009 H1N1 influenza vaccine in healthy children and adults are underway. These studies are being conducted by the National Institutes of Allergies and Infectious Diseases (NIAID). Studies of 2009 H1N1 influenza vaccine in pregnant women are expected to begin in September. But as of Mid September 2009 the CDC has not released any results of these studies. What is being released is that some people, including pregnant women, may need two doses (It anticipated that 21-28 days will be needed between the first and second doses.). More will be known about the number of doses once data from the clinical trials are available. The side effects from 2009 H1N1 influenza vaccine are expected to be similar to those from seasonal flu vaccines. The most common side effects following vaccination are expected to be mild, such as soreness, redness, tenderness or swelling where the shot was given. Some people might experience headache, muscle aches, fever, nausea and fainting. If these problems occur, they usually begin soon after the shot and may last as long as 1-2 days. Like any medicines, vaccines can cause serious problems like severe allergic reactions. However life-threatening allergic reactions to vaccines are very rare.
The CDC will be distributing the 2009 H1N1 influenza vaccine to each state. If healthcare providers want to provide H1N1 vaccine directly to their patients, they can contact their local health department to obtain H1N1 vaccine. The vaccine will be distributed with a kit which will contain needles, syringes, sharps containers and alcohol swabs. The vaccine itself will be provided free; however, healthcare providers may bill for vaccine administration. Information is continually updated at 2009 H1N1 Flu Vaccine
And though masks may help in some settings and remind you of the late Michael Jackson remember that information on the effectiveness of facemasks and respirators for decreasing the risk of influenza infection in community settings is extremely limited. And in turn it is difficult to assess their potential effectiveness in decreasing the risk of the novel influenza 2009 H1N1 virus transmission in these settings. In the absence of clear scientific data, the interim recommendations have been developed on the basis of public health judgment, the historical use of facemasks and respirators in other settings for preventing transmission of influenza and other respiratory viruses, and on current information on the spread and severity of the 2009 H1N1 virus.
There are important differences between facemasks and respirators. Facemasks do not seal tightly to the face and are used to block large droplets from coming into contact with the wearer’s mouth or nose. Most respirators (e.g. N95) are designed to seal tightly to the wearer’s face and filter out very small particles that can be breathed in by the user. Use of N95 respirators or facemasks generally is not recommended for workers in non-healthcare occupational settings for general work activities.
Facemasks: Unless otherwise specified, the term ”facemasks” refers to disposable facemasks cleared by the U.S. Food and Drug Administration (FDA) for use as medical devices. This includes facemasks labeled as surgical, dental, medical procedure, isolation, or laser masks. Facemasks cleared by the FDA for use as medical devices have been determined to have specific levels of protection from penetration of blood and body fluids. Facemasks help stop droplets from being spread by the person wearing them. They also keep splashes or sprays from reaching the mouth and nose of the person wearing the facemask. They are not designed to protect against breathing in very small particle aerosols that may contain viruses. Facemasks should be used once and then thrown away in the trash.
Respirators: Unless otherwise specified, “respirator” refers to an N95 or higher filtering face piece respirator certified by the CDC/National Institute for Occupational Safety and Health (NIOSH). A respirator is designed to protect the person wearing the respirator against breathing in very small particle aerosols that may contain viruses. A respirator that fits snugly on the face can filter out virus-containing small particle aerosols that can be generated by an infected person, but compared with a facemask it is harder to breathe through a respirator for long periods of time. Respirators are not recommended for children or people who have facial hair.
Employers should continue to evaluate workplace hazards related to the novel H1N1 influenza A situation in accordance with CDC and OSHA guidance. Mandatory use of respiratory protection may be required when work activities in occupational settings confer risk that is task/function based, and risk analyses conducted by the employer could identify hazardous work activities. For example, performing activities which generate large amounts of aerosols require respiratory protection regardless of the setting in which it is performed (i.e. in a hospital, an outpatient setting, a prison).
In community and home settings, the use of facemasks and respirators generally are not recommended. However, for certain circumstances a facemask or respirator may be considered, specifically for persons at increased risk of severe illness from influenza. Use of N95 respirators (this is not a surgical mask) or facemasks generally is not recommended for workers in non-healthcare occupational settings for general work activities. When dealing with individuals who are potentially contracted with the flu:
- workers should try to maintain a distance of 6 feet or more from the;
- workers should keep their interactions with ill persons as brief as possible;
- the ill person should be asked to follow good cough etiquette and hand hygiene and to wear a facemask, if able, and one is available;
- workers at increased risk of severe illness from influenza infection should avoid people contact with infected individuals;
- where workers cannot avoid close contact with persons H1N1 flu infected individuals, some workers may choose to wear a facemask or N95 respirator on a voluntary basis.
Persons not at increased risk of severe illness from influenza
Persons at increased risk of severe illness from influenza (High-Risk Persons) 3
|No novel H1N1 in community||Facemask/respirator not recommended||Facemask/respirator not recommended|
|Novel H1N1 in community: not crowded setting||Facemask/respirator not recommended||Facemask/respirator not recommended|
|Novel H1N1 in community: crowded setting||Facemask/respirator not recommended||Avoid setting.
If unavoidable, consider facemask or respirator 4 5
|Caregiver to person with influenza-like illness||Facemask/respirator not recommended||Avoid being caregiver. If unavoidable, use facemask or respirator 4 5|
|Other household members in home||Facemask/respirator not recommended||Facemask/respirator not recommended|
|Occupational (non-health care)|
|No novel H1N1 in community||Facemask/respirator not recommended||Facemask/respirator not recommended|
|Novel H1N1 in community||Facemask/respirator not recommended but could be considered under certain circumstances 4 5||Facemask/respirator not recommended but could be considered under certain circumstances 4 5|
|Occupational (health care) 6|
|Caring 7 for persons with known, probable or suspected novel H1N1 or influenza-like illness||Respirator||Consider temporary reassignment. Respirator|
Additionally the use of some common herbs can help build resistance within the body. Cayenne or Capsicum which is known as a thermogenic (elevates metabolism), disinfectant (antibacterial and anti-parasitic), blood purifier (known in Traditional Chinese Medicine to equalize and dispense the stagnation and congestion of blood), and it has also been toted to kill flu and cold on contact. The Native First Americans and Native First Mexicans used Cayenne as a “cure all for fever”. Cayenne is relatively safe causing heat stimulation to the stomach and is best taken directly following a meal. And though it is contraindicated in “hot inflammatory conditions of the stomach” it is a useful remedy in treating bleeding stomach ulcers. Due to the intense heat of the herb it is best to take capsules of the preparation; one capsule 2-3 times a day as maintenance during flu season, though a small amount in ginger ale or cream soda is tolerable but not as therapeutic.
Garlic is another herb one can simultaneously add to their maintenance regime. Garlic is a known natural antibiotic and antiviral. Garlic’s active ingredient is allicin a sulfa containing compound. Heat kills allicin so cooked garlic forgoes its medicinal properties. The recommended dosing of garlic is ideally 1-2 raw cloves of garlic daily, but if the socially threatening thought of this turns you away consider cold prepared enteric coated garlic tablets containing 2,500 mcg daily of allicin for maintenance and prevention or 5,000 mcg of allicin daily for therapeutic acute dosing. Contraindications are that garlic is known to lower blood pressure, so be careful if you are already on anti-hypertensives as well as it being an anticoagulant or blood thinner (if already on an anticoagulant like Coumadin or Plavix, or pre-surgical one may first need to consult their medical provider.); garlic can also cause upset stomach, nausea and vomiting, facial flushing, insomnia, and rapid pulse and should be stopped and evaluated by a medical professional if persistent.
Decades ago, in Siberia, the government air dropped crates of raw garlic to successfully combat a flu epidemic raging in that country. The treatment was successful.
And lastly echinacea. In the 19th century, before the advent of sulfa drugs, it was echinacea that was prescribed for cold and flu. Typically taken at the first sign of a cold or flu it is a primary remedy for respiratory infections. Echinacea boosts the weakened immune system. It works by enhancing the immune systems already complex responses in fighting bacteria and viruses. Echinacea stimulates antibody production in turn stimulating the white blood cell count to fight infection. A contraindication in taking echinacea is cited for those with limited immune response and autoimmune disorders such as HIV, AIDs, Multiple Sclerosis, Lupus, and TB- these individuals should first consult their physician. Echinacea is safe during pregnancy. Echinacea is typically taken at the first sign of a cold or flu for 7-14 days. It can be taken as a maintenance dose for two months at a time with a 2-4 day break in between (this break is important so as to not allow the body to become accustomed to the herb and in turn decrease the immune efficiency response). Recommended dosing of powdered extract is 300 mg three times a day; alcohol tincture of 3-4 ml three times a day.
We’re used to the seasonal flu and its effects. It’s the term “swine flu” or H1N1 that scares many. The full clinical spectrum of the swine influenza/H1N1 infection appears in severity from mild illness to severe disease; ie mild disease in affluent countries, and more severe disease, with higher mortality, in developing countries. What we need to know that our government can only do so much to protect us. Each of us must be responsible to keeping up to date on the flu this season and assist in the educating of others. I suggest periodically that we each check the CDC website for updates and remember that influenza viruses are infamous for their fast mutation and unpredictable behavior, so be prepared. The influenza virus is one of the most changeable of viruses. These genetic changes may be small and continuous or large and abrupt. So being updated is the best preparedness yet.
About the Author
Professor Christopher Bashaw holds black belt/instructor ranking in multiple martial arts systems. He was awarded his Hachidan (8th degree black belt) from the World Martial Arts Hall of Fame in Cleveland, Ohio in 2006. In January 2007 Christopher was inducted into Action Magazine Martial Arts Hall of Honors. And in June of 2008 Bashaw was inducted into the World Karate Union Hall of Fame. Christopher has been a Registered Nurse for over 3 decades, including pediatrics, military, psychiatric, pain care, recovery room, occupational health, drug and alcohol recovery, psychiatry, case management, and rehabilitation. And over the last 30 years he has become certified in a number of healing arts; as a Reiki Master/Teacher he has developed his own system, Kokoro Ryu Reiki System of Natural Healing; Christopher is also the founder of Shugendo Yoga ©, a spiritual, gentle healing form of yoga. He has taken vows as a Buddhist Priest as well as being a professed Franciscan Friar. He holds a Doctorate in Divinity as well as a PhD/MA and the title of Professor presented to him by the World Martial Arts hall of Fame. He incorporates western herbalism, internal and external Chi Kung healing, and Shamanism into his practice and teachings. He developed Koshonic Body Stress Release © and is now teaching it privately to select students who are opening their own successful practices.