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Archive for August, 2011

Late summer is the time we see more yellow jackets buzzing around us. These stinging insects are attracted to our delicious picnic food and are more aggressive than the common honeybee, but neither one usually attacks randomly. They sting defensively when they or their nests are threatened. They also sting when stepped on, sat upon or in some way provoked.

Yellow jackets can sting multiple times and do not leave behind their stingers. This is in contrast to the honeybee, which leaves its stinger in its victim. (It is now recommended to remove the stinger as quickly as possible, using one’s fingers to pull it out.)

Stings are very painful and are best treated by immediately placing ice over the sting. Taking the antihistamine Benadryl may also be helpful.

A reaction to the sting may occur within hours or days after the sting. It may be manifested by redness and swelling of just a small area around the sting or by a much larger reaction, often involving an entire arm or leg. This is just a toxic reaction to the venom and will resolve on its own in a matter of days. It is not an allergic reaction and, though it may feel uncomfortable, will cause no harm.

A sting on the face may cause worrisome swelling but is not dangerous. A sting inside the mouth or throat, however, can be quite serious and needs to be treated promptly. In this case, I would advise calling 911 to receive prompt evaluation and emergency treatment.

Serious, life-threatening reactions to a sting may occur within minutes or several hours. Usually, the worse the reaction, the sooner it occurs. Those who have a serious sting reaction should seek consultation with a physician who can prescribe an injectable adrenaline kit, such as an Epipen. This shot can be self-administered if one is having a potentially life-threatening reaction to a sting.

In summary, here’s what to do when stung:

– Pull the stinger out as quickly as possible, if it remains in the flesh.

– Get out of the vicinity of stinging insects, as fast and as far as possible.

– Apply ice compress to the sting.

– Take Benadryl by mouth.

– Call 911 if you experience a swollen tongue or throat with difficulty swallowing; tight breathing or shortness of breath; a feeling of faintness; or severe hives

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Swine Flu Reflections

I want to bring to your attention a TV program to be aired soon, which provides a look at California’s amazing response to the recent H1N1 swine flu epidemic. Station KRBC will be broadcasting this program Tuesday, Aug. 16, and again Aug. 25, a Thursday.

The H1N1 epidemic is, at least for now, over. This was a disease that killed more than 550 Californians and sent thousands to hospitals.

Interestingly, although this virus was similar to a virus carried by pigs and therefore commonly called swine flu, it actually was a human virus and did not originally come from contact with pigs. It was first detected in the United States on April 16, 2009, in a 10-year-old boy from Southern California.

Two days later, an 8-year-old living 130 miles from the first proven case was also reported positive for the new H1N1. Within a week, cases were reported from other states and then from Mexico, making it clear that cases were occurring outside of the U.S.

Within two weeks of the first case, others were rapidly reported, and the Federal government declared that a public health emergency existed nationwide. The Centers for Disease Control began distributing massive amounts of antivirus drugs and other equipment to help stem the tide of the escalating epidemic.

By June 18, 2009, the World Health Organization declared a worldwide pandemic. During this time, there was frantic work to develop a vaccine for the H1N1 influenza virus. This vaccine was first available to the general public in October 2009, the same month that the number of reported cases had reached its highest point. It soon began to taper off, and by May 2010, the U.S. government declared an end to the H1N1 flu season.

H1N1 was different from the more common influenza in that it targeted the 5- to 25-year-age group and had a minimal effect on people age 65 and older. This was likely due to older people having protection from previous influenza illness or from past immunizations.

There are those who claim that the response to the H1N1 epidemic was way overblown and driven by greedy drug companies and a big government seeking even more control over our lives. I would much rather see a response that, in hindsight, might be considered overly aggressive than to look back and see that a weak response caused the deaths of hundreds of thousands. One can never predict initially how severe an epidemic will become.

As I look back at the early days of the H1N1 epidemic, many of us on the front lines of health care, including myself, were quite concerned about our medical facilities being overrun by a multitude of very sick individuals. Fortunately, such a scenario did not occur. This experience made me realize how important it is for the public, health care professionals and the government to react swiftly to any potential growing epidemic. We will inevitably face a serious epidemic again sometime in the future, and we must be prepared.

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