Surviving Winter’s Ills Without Abusing Antibiotics

Credit CDC, FDA, HHS

 

 

# 7987

 

As mentioned yesterday (see The Lancet: Antibiotic Resistance - The Need For Global Solutions), today marks European Antibiotic Awareness day and kicks off the CDC’s Get Smart About Antibiotics Week.  With each year that passes, more and more bacterial strains are finding ways to evade our dwindling arsenal of antibiotics – and so public health officials are working hard to improve the stewardship of the ones that still remain effective.

 

To that end, this week agencies like the World Health Organization, the CDC, and the ECDC are working to educate the public on when antibiotics are appropriate treatments, and when they are not.  Since most winter respiratory illnesses are viral in nature, antibiotics simply don’t work – and using them inappropriately can lead to increased resistance.

 

So today, a quick tour of (and some excerpts from) the messaging coming from these organizations.

 

From the World Health Organization we get European Antibiotic Awareness Day 2013: everyone is responsible.

18-11-2013

Antibiotic resistance affects the entire WHO European Region, driven by the overuse, underuse and misuse of antibiotics. Although some efforts have been made to combat indiscriminate use, many countries have no national regulation or enforcement on antibiotic usage; healthy animals are given antibiotics to promote growth or prevent disease, and commercial companies promote antibiotics irresponsibly. In too many countries, members of the general public can buy antibiotics over the counter (without a prescription) and use them at will. Doctors often prescribe antibiotics easily or inappropriately, and people take them to treat viral infections such as influenza and the common cold, against which they do not work.

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While today Public Health England is in myth busting mode, explaining that:

 

Green phlegm and snot ‘not always a sign of an infection needing antibiotics

Advice on European Antibiotics Awareness Day (18 November) to raise awareness of the risks of inappropriate use of antibiotics.

Having green phlegm or snot is not always a sign of a bacterial infection that will require antibiotics to get better, says Public Health England (PHE) and the Royal College of General Practitioners (RCGP).

 

This advice is issued on European Antibiotics Awareness Day (18 November) which aims to raise awareness of the risks associated with the inappropriate use of antibiotics and how to use them responsibly.

Research by PHE’s Primary Care Unit has found that 40% of the general public believed that antibiotics would help a cough with green phlegm get better more quickly rather than clear phlegm (6%).

 

White blood cells are produced by the body to attack any foreign materials the body does not recognise such as pollutants, dirt, pollen or microbes, and are carried in your phlegm and snot. Some white blood cells contain a green substance (a protein) so if more of these cells are present the greener your phlegm or snot will be.

 

Phlegm therefore comes in a range of colours from white to mustard-yellow to varying shades of green. Coloured phlegm or snot does not mean you need antibiotics.

 

In most healthy people, phlegm or snot production with or without a cough will stop as your cold or flu-like illness clears up, although it may take up to 3 to 4 weeks.

 

And from the CDC, some advice on how to deal with the miseries of a winter illness without resorting to antibiotics.

 

How to Feel Better

What can I do to feel better if antibiotics won’t treat my illness because it’s caused by a virus?
For upper respiratory infections, such as sore throats, ear infections, sinus infections, colds, and bronchitis, try the following:

• Get plenty of rest
• Drink plenty of fluids
• Use a clean humidifier or cool mist vaporizer
• Avoid smoking, second-hand smoke, and other pollutants (airborne chemicals or irritants)
• Take acetaminophen, ibuprofen or naproxen to relieve pain or fever (read about what is safe to give your child)

For children and adults, over-the-counter pain relievers, decongestants and saline nasal sprays may help relieve some symptoms. Remember, always use over-the-counter products as directed. Many over-the-counter products are not recommended for children younger than certain ages.

Over-the-counter medicines may help relieve symptoms such as runny nose, congestion, fever and aches, but they do not shorten the length of time you or your child is sick.

Learn more by reading below about over-the-counter medicines. Here are some helpful tips for how to feel better depending on how you or your child feels.

Sore Throat

• Soothe a sore throat with ice chips, sore throat spray, or lozenges (do not give lozenges to young children)
• Use a clean humidifier or cool mist vaporizer
• Take acetaminophen, ibuprofen or naproxen to relieve pain or fever (read about what is safe to give your child)

Ear Pain

• Put a warm moist cloth over the ear that hurts
• Take acetaminophen, ibuprofen or naproxen to relieve pain or fever (read about what is safe to give your child)

Runny Nose

• Use a decongestant or saline nasal spray to help relieve nasal symptoms (read about what is safe to give your child)

Sinus Pain/Pressure

• Put a warm compress over the nose and forehead to help relieve sinus pressure
• Use a decongestant or saline nasal spray
• Breathe in steam from a bowl of hot water or shower
• Take acetaminophen, ibuprofen or naproxen to relieve pain or fever (read about what is safe to give your child)

Cough

• Use a clean humidifier or cool mist vaporizer or breathe in steam from a bowl of hot water or shower (read about what is safe to give your child)

Over-the-Counter (OTC) Medicines

Questions and Answers for Parents about Over-the-Counter (OTC) Medicines

Related Materials

ECDC: Antibiotic Resistance In the EU – 2012

 

 

# 7980

 

 

Last September, in Referral: McKenna On CDC Antibiotic Resistance Report,  we looked at a new report from the CDC on the growing threat of antibiotic resistance – with  with Director Thomas Frieden warning, `“If we are not careful, we will soon be in a post-antibiotic era.”

 

This stark forecast echoed the sentiments that World Health Director-General Margaret Chan expressed a year ago (see Chan: World Faces A `Post-Antibiotic Era’).

 

On November 18th, the ECDC, Hong Kong’s CHP, and the United State’s CDC will kick off their antibiotic resistance awareness campaigns for 2013.  Here in the US, it signals the start of Get Smart About Antibiotics Week. 

 

Today, the ECDC has released a massive (218 pages) surveillance report report called Antimicrobial resistance surveillance in Europe 2012, along with a smaller (10 page) summary which will be easier to digest.

 

Highlights on antibiotic resistance

• Antibiotic resistance is a serious threat to public health in Europe, leading to increasing healthcare costs, prolonged hospital stays, treatment failures, and sometimes death.
•   
  Over the last four years (2009 to 2012), resistance to third-generation cephalosporins in K. pneumoniae and E. coli increased significantly at EU/EEA level. Combined resistance to third-generation cephalosporins and two other important antimicrobial groups (fluoroquinolones and aminoglycosides) also increased significantly at EU/EEA level for K. pneumoniae, but not for E. coli. 
• The increasing trend of combined resistance in K. pneumoniae means that only a few therapeutic options (e.g., carbapenems) remain available for treatment of infected patients. 
• Carbapenems form a major last-line class of antibiotics to treat infections with multidrug-resistant Gram-negative bacteria such as K. pneumoniae and E. coli, both common causes of pneumonia, urinary tract infections and bloodstream infections. However, the percentage of carbapenem-resistant K. pneumoniae is already high and increasing in some countries in the EU.
• Antimicrobial resistance data for Acinetobacter spp. are available in EARS-Net for the first time. Data for 2012 show large inter-country variations in Europe, and high levels of resistance (>25%) to carbapenems in nearly half of the reporting countries. 
• In contrast, in the past few years, the percentage of meticillin-resistant Staphylococcus aureus (MRSA) has shown a significant decreasing trend at EU/EEA level, and either a continuous decrease or a stabilising trend was observed in most EU/EEA countries during the last four years. Nevertheless, MRSA remains above 25% in almost one fourth of the reporting countries, mainly in southern and eastern Europe. 
• Prudent antibiotic use and comprehensive infection control strategies targeting all healthcare sectors (acute care hospitals, long-term care facilities and ambulatory care) are the cornerstones of effective interventions that aim to prevent selection and transmission of antibiotic-resistant bacteria.

 

Also released today is an ECDC Technical Report called Carbapenemase-producing bacteria in Europe which provides Interim results from the European survey on carbapenemase-producing Enterobacteriaceae (EuSCAPE) project 2013.

Bacteria resistant to the Carbapenem class of antibiotics (a class that includes imipenem, meropenem, doripenem, and ertapenem) – are called carbapenemases –  are of particular concern since Carbapenems are often the drug of last resort for treating difficult bacterial infections.

 

Short of seeing an extremely high mortality influenza pandemic, I can think of no looming medical crisis more dire than the growing threat of antimicrobial resistance. The World Health Organization, the ECDC, and the CDC all consider the spread of antibiotic resistant organisms to be an extremely urgent public health concern.

 

So I expect I’ll be devoting a good deal of blog space to this topic over the next couple of weeks.

Washington State: Volcano Awareness Month

 

 

U.S. Volcanoes and Current Activity Alerts

 

# 6330

 

 

While Alaska and Hawaii are famed for their volcanic activity, it may come as a surprise to many Americans that the United States has 169 `active’ volcanoes within its borders, with about 40 of those in the `lower 48’ states.

Washington is one of the states with a large number of volcanoes, and so May has been proclaimed Volcano Awareness Month.

 

The Washington State EMD (Emergency Management Division) has advice and information for those living in close proximity of volcanoes.

 

News / Activities:
USGS / EMD Volcano Awareness Month Announcement

USGS Cascades Volcano Observatory

Preparedness for Volcano Hazards

In English PDF
In Spanish PDF
In Russian PDF
In Korean PDF
In Chinese PDF
In Vietnamese PDF

What To Do: During an eruption and ashfall (see page #2) (PDF)

How to Shelter-in-Place (PDF)     

Shelter-in-Place Video (Quicktime Required)

 

 

From the USGS we have a FAQ with that addresses many of the questions the public may have about volcanoes in the United States.  A brief snippet below, but follow the link to read it in its entirety.

 

 

Frequently Asked Questions About Volcano Monitoring

To anticipate the awakening or reawakening of a volcano, volcanologists watch for changes caused by moving or pressurizing magma and associated changes in the hydrothermal system surrounding the magma. Magma moving toward the surface can cause swarms of earthquakes; swelling, subsidence, or cracking of the volcano's flanks; and changes in the amount or types of gases that are emitted from a volcano. The USGS continuously monitors many volcanoes in the states of Washington, Oregon, California, Hawaii, Alaska, and Wyoming (Yellowstone) to detect unusual activity.

Q: Why is it important to monitor volcanoes?

A: The United States and its territories contain 169 geologically active volcanoes, of which 54 volcanoes are a very high or high threat to public safety [National Volcano Early Warning System (NVEWS)]. Many of these volcanoes have erupted in the recent past and will erupt again in the foreseeable future. As populations increase, areas near volcanoes are being developed and aviation routes are increasing. As a result, more people and property are at risk from volcanic activity. Future eruptions could affect hundreds of thousands of people. To help prevent loss of life and property, the U.S. Geological Survey and its partners monitor these volcanoes, and issue warnings of impending eruptions.

Real-time monitoring of volcanoes, with the use of volcano seismology, gas, thermal, and surface deformation measurements, permits scientists to anticipate with varying degrees of certainty, the style and timing of an eruption. While our present state of knowledge does not allow us to predict the exact time and place of eruptions, we can detect changes from usual behavior that precede impending eruptions. We communicate these changes in our volcano updates. The information in the volcano updates allows scientists, public officials, and people in communities at risk to make preparations that can reduce losses during an eruption. Because volcanoes can erupt with little warning, continuous monitoring is important even if a volcano is not showing signs of activity.

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While major volcanic eruptions on the U.S. mainland are rare events, they have the potential to be extremely disruptive when they do occur. 

 

For that reason, emergency planners urge:

 

Before a volcanic eruption:

• Plan ahead. Have emergency supplies, food and water stored. 
• Plan an evacuation route away from rivers or streams that may carry lahars.
• Keep a battery-operated radio available at all times.
• If there is an eruption predicted, monitor the radio or TV for information. Follow the advice given by authorities.

 

Note: Lahars are debris or mud flows from a volcano, and can be particularly dangerous. 

 

 

While it may sound a bit like a broken record, the advice for citizens to be prepared – whether it be for a volcanic eruption, tsunami, earthquake, or some other disaster – continues to ring forth from numerous federal, state and local agencies.

 

They know that during any serious disaster that emergency services will be severely strained, and that during the opening hours and even days, many people will have to fend for themselves.

 

 

The government takes these threats seriously, and so should you. To learn more on how to prepare for any type of disaster, visit Ready.gov and FEMA.

 

National Survey On Pandemic Awareness & Attitudes

 

 

 

# 6009

 

 

A survey out today, conducted by the Ecohealth Alliance, suggests that while many Americans worry about global disease outbreaks, few have good a good understanding about how, or from where, the next global health threat is likely to emerge.

 

 

First a link to the press release, followed by a link to the survey (very much worth reading).

 

EcoHealth Alliance Survey Analyzes Americans' Fear of Global Disease Outbreaks

Survey Respondents Lack Knowledge of How and Why Outbreaks Occur

NEW YORK, Dec. 14, 2011 /PRNewswire-USNewswire/ -- EcoHealth Alliance, a U.S. science-based nonprofit organization, announced the results of a just released survey that polled Americans' knowledge surrounding global disease outbreaks.  Results showed that more than two in three Americans (68%) worry about global disease outbreaks.  When polled about how and why the next big outbreak will happen and what causes them, Americans (88%) receive a failing grade when it comes to their knowledge on the subject.  Survey findings show that less than one in five Americans (17%) know that the next big disease outbreak is most likely to be transmitted from wildlife, according to EcoHealth Alliance.  "Around 75 percent of emerging infectious diseases originate in animals and then can spread to humans," said Dr. Peter Daszak, President of EcoHealth Alliance.  "The key to stopping global disease outbreaks is to protect wildlife and reduce our impact on their habitats.  Until citizens, scientists and governments focus on points of origin, we're at risk for a major outbreak."

 

While most Americans know that overpopulation and air travel contribute to global disease outbreaks, less than half know that contributing factors also include international wildlife trade (40%), climate change (33%), agricultural expansion (30%), deforestation (29%) and hunting (10%).  "Changes to the environment, including deforestation, intensive agricultural practices, bushmeat hunting, illegal wildlife trade, climate change and the encroachment of human populations on formerly untouched wild habitats are all factors contributing to disease spread," said Dr. Daszak.  "Disruptions to an environment from global travel and trade can bring viruses from the other side of the globe right to our very doorstep here in the U.S. within days of an outbreak."

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The 23-page PDF with the full survey results can be downloaded via this Link.

 

Cambodia: Promoting Bird Flu Awareness

 

# 4690

 

 

 

Just a few years ago, for many villagers in places like Indonesia, Vietnam, and Cambodia, it would have been unthinkable to believe that their chickens could make them sick.   

 

Families had raised these birds for generations without ill effect, and so convincing them that H5N1 is a threat isn’t easy.  

 

In 2007 the NGO CARE conducted a poll in Cambodia to gauge perceptions among villagers about the dangers of bird flu, and recently re-polled to see if these perceptions had changed in three years.

 

While progress has been made, more than 20% of respondents would still kill and eat a sick chicken.

 

A hat tip to RoRo on FluTrackers for this report from the Phnom Penh Post.

 

 

Project seeks H5N1 awareness

Thursday, 01 July 2010 15:00 Khoun Leakhana

POULTRY farmers in three border provinces exhibited improved awareness of avian influenza following the introduction of a village-based education project, though in some areas more than 20 percent still say they would eat an animal found to be infected with the disease, according to survey results released this week.

 

The survey was conducted in three provinces – Prey Veng, Svay Rieng and Koh Kong – as part of a programme led by the NGO CARE International. Overall, it found that the farmers benefited from education efforts implemented by Village Surveillance Teams, or VSTs.

 

In 2007, farmers were interviewed in order to assess their understanding of the A(H5N1) influenza virus, commonly known as bird flu. In particular, the initial interviews assessed the farmers’ knowledge of how the virus spreads to humans and how diseased poultry should be disposed of.

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THEY’RE NOT ONLY PROTECTING THE BIRDS. THEY’RE PROTECTING THEIR OWN FAMILIES.

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When they were interviewed again at the end of a three-year pilot programme in 2009, the farmers demonstrated that they were better equipped to deal with avian flu cases.

 

In villages in Prey Veng and Svay Rieng, for example, the number of respondents who said they would kill and eat a bird if they were to find it sick was nearly halved, from 43 to 23 percent, according to the survey.

 

“We saw that there was a behaviour change,” said Cecilia Dy, CARE’s avian influenza project coordinator.

 

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While they don’t get a lot of publicity, health education campaigns such as these by NGO’s like  CARE, SAVE THE CHILDREN, Humanitarian Pandemic Preparedness H2P  and others are taking place in remote regions all around the world.

 

These projects not only help to protect the people living in those countries, but they also help protect the world.

 

Every time a virus like H5N1 is denied a human host, it is also denied another opportunity to mutate and adapt to humans.

 

Something worth considering the next time you think about where your charitable contributions will go this year.