Flu & You: Protecting Your Family During the Flu Season

Originally posted on my US News & World Report parenting blog (Feb 16)

THIS YEAR’S flu season is officially reaching its peak, and this year’s strain of influenza virus is cause for considerable concern, striking with a vengeance not seen in decades. It’s causing more severe illness, more hospitalizations and even more children’s deaths, as parents do what they can to try to protect their kids.

In reality, the strategies being recommended to combat this year’s flu are essentially the same as those employed in years past. While you’re likely to have heard about many of these strategies before, it’s nevertheless useful to remind ourselves of the importance of washing our hands and covering our coughs; getting everyone in the family who is 6 months or older vaccinated; and being on alert for and recognizing early the signs of the flu – such as fatigue, body aches, cough, sore throat and fever – and it’s potential complications, from sinus infections and pneumonia to heart problems, particularly in more vulnerable individuals, like the very young and very old or those with compromised immune systems.

Now that’s easy to say, and it sounds like easy enough advice to follow. Yet each year I’m left wondering why it is that, as parents, we don’t always feel confident in our approach to fighting the flu. In large part, it’s the fault of the virus responsible for causing the flu. The influenza virus is cunning in its ability to change from year to year, which makes it all the more difficult to protect against.

But I would also suggest that there are some parenting practices and commonly held parenting beliefs that, despite our best intentions, stand to get in the way when it comes to protecting our children, and ourselves, from flu’s wrath.

It’s useful to start with a clear understanding of what “the flu” actually is, and what it isn’t….

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The truth about American Idol’s “Idol Bug”

I recently got around to watching a recorded episode of American Idol. Aside from all the melodrama associated with stress, sleep deprivation, and watching people who dream of living life in the spotlight compete against each other, I was struck by the fact that the episode was impressively reminiscent of the opening scenes from the movie Contagion. For anyone who hasn’t seen the movie, suffice it to say that the storyline is focused on the ensuing devastation invoked by the uncontrolled spread of a dangerous new virus.

Okay, so no one died on American Idol’s Hollywood Week episode. But I did experience the same sense of foreboding. Idol contestants shaking hands, exchanging frequent high-fives, offering each other lots of hugs, and just generally partaking in a whole lot of close contact also known as germ-sharing behavior. Worse yet, there was a clearly identified “Patient Zero” in the mix – runny nose, fever, fatigue and all. If germs were visible, I’m pretty sure any viewers who somehow missed the not-so-subtle foreshadowing by the shows producers would have been cringing along with me long before contestant after contestant proceeded to fall ill.

Hmmmm…If only germs were visible…Now there’s a thought. I majored in cellular, molecular biology, so I’ve admittedly had more opportunities to visualize germs than most. But the concept of helping people – even young children – be visually reminded of the presence of germs isn’t out of reach. In fact, there are even cool (and relatively inexpensive) soaps and science  kits that help children (and adults) visualize just how effective (or ineffective) they are at washing germs off their hands.

It is my sincere hope, however, that it won’t take actually visualizing germs for all of us to take stock in what simple measures we already know are effective in preventing the spread of germs. For a quick refresher, let me spell them out for you so you will have them at your (hopefully clean) fingertips! After all, the truth about the “Idol Bug” is that it was likely just another (admittedly nasty and poorly timed) virus making the most of making people sick.  More than just another virus, however, it was also a really good, attention grabbing reminder for the reported 19 million  that we’re still in the middle of cold and flu season, and that the sharing of germs that happened in Hollywood while the cameras were running could happen anywhere – especially to those who neglect to take the following actions!

Wash your hands with soap and water. Handwashing is particularly important not only before eating and after using the bathroom, but any time you or your children are sick or come in contact with people who are sick (or germy surfaces like grocery cart handles). And don’t just settle for a quick rinse. Lather up the soap and be sure to get all areas of the hands – both front, back and in-between fingers.

Cover your cough. I can tell you from lots of child-care-owning experience that it’s entirely possible to teach even very young children to not only cover coughs, but to do so with their arms rather than their hands. They may not get it right early on or every time, but over time they’ll pick up on this very important form of prevention. The fewer illness-causing germs that are coughed into one’s hands, the fewer that stand to contaminate surfaces or get shared directly with others.

Vaccinate. I often get asked longingly in interviews about whether or not we’ll ever discover how to prevent the common cold. I agree that this would be nice, as the symptoms associated with the common cold can certainly be quite pesky. But the severity of the common cold is nothing compared to all of the vaccine-preventable diseases (think measles, mumps, rubella, diphtheria, tetanus, polio) we are now able to effectively prevent. Simply put, vaccination is deserving of its recognition as one of the biggest public health success stories of the past century.

Avoid contact with those who are ill. Within reason, that is. That means that when you’re sick, it’s best to limit contact with others whenever possible – especially in the first days of an illness, when you have a fever, the flu, or other significant symptoms likely to spread germs and infect others (such as a lot of coughing).

Disinfect contaminated surfaces. Think snotty tissues on the nightstand, door knobs, telephone receivers, or any other high-traffic surfaces that are likely to have come in contact with unwashed, germy hands.  Germs can live for hours (and in some instances, days), so don’t forget to disinfect contaminated surfaces.

Originally posted on Omaha World Herald’s Live Well Nebraska

Giving Thanks: Things the Whole Family Can be Thankful For

I bought my turkey this past weekend. Not only did I buy it, but I even took a moment to think about how thankful I am for it. Sure I’m thankful because I love turkey, but also simply because I am fortunate enough to be able to afford a turkey. As a parent, I know full well that taking a simple weekend task like grocery shopping and turning it into a shared reflection on what our family has to be thankful for is likely to lead to some eye-rolling from my tween- and teenage children.

But the fact of the matter is that there’s no better time than the present (i.e. Thanksgiving week) to take a few moments – whether waiting in line at the grocery store or gathered with family and friends around the Thanksgiving table – and reflect on those things in your life for which you’re truly thankful. While trips to Disneyland, ipods, and the latest greatest toddler toys will understandably spring to mind first, I suggest you challenge your children, and yourself, to dig deeper. As a pediatrician and parent, I figured I’d get you started by sharing some of my own, all-too often taken for granted things to be thankful for.

Breathing through your nose. Spoken like a true pediatrician, right? But years of tending to snotty nose colds (my own, my children’s, and others’) has taught me that it’s hard to take time to stop and smell the roses if you can’t breath through your nose. You may think I’m kidding, but I’m not. Just think how many times your child’s (or your own) stuffy nose cold has kept you up at night and caused you misery. Instead of being frustrated by the annual average 6-10 colds that kids catch each year and the fact that we still don’t have a cure for the common cold, I suggest that we all remember to be grateful for each day that we wake up healthy.

Shots. I figure while we’re on the subject of waking up healthy, I’d take this opportunity to give my thanks to modern medicine and all of the medical pioneers that have given us vaccines. No, I’m not a huge fan of needles, and neither are my children. But I have such a healthy respect for the dreadful diseases we are now able to prevent by simply making sure that our children’s (and our own) immunizations are up-to-date that I count each and every shot a blessing, needles and all.

Car Seats. As someone who had 3 kids in just over 3 years – the youngest of whom only just outgrew the need for a car seat at age 10 – I am certainly aware of the parental challenges inherent in the purchasing, installing, and juggling of car seats, especially during holiday travel season. Yet despite having spent every day of the past 10 years overseeing the use of numerous seats of my own, I’m exceedingly grateful for the fact that car seats even exist, much less that they are so incredibly effective in protecting kids from harm. With nothing more important than my children’s health and safety, car seats (and all those who contribute to making sure that children are secured safely) deserve my thanks.

Cell Phones. Yes, I do have tween- and teenage children of my own. And yes, I do face the daily parental challenge posed by a world now dominated by texting tots and teens and threatened by everything from cyberbullying to sexting. But having just returned from a mobile health summit in Washington DC, I am now very, very grateful for cell phones. World thought leaders the likes of Bill Gates, Director of the National Institutes of Health Francis Collins, and the president of the Rockefeller Foundation joined over 2500 attendees from around the world who all share the belief that cell phone technology is the tool by which we will be able to reach the world’s poorest and provide them with access to better health.

Here in the United States, innovative programs like text4baby are making use of the ubiquitous nature of cell phones to put valuable health information and access to local resources right at the fingertips of pregnant women and new moms.

While I will absolutely not be thankful for any cell phones that make their way to my family’s Thanksgiving table, I will nevertheless be grateful that they exist, not just to make my life easier, but improve the health and well-being of those less fortunate than me.

Originally posted on Omaha World Herald’s Live Well Nebraska

Coughs, Kids & Vaccines: Why parents are the key to silencing the sounds of pertussis!

You really don’t have to listen very hard to hear the sounds of the season – the rustling of fall leaves, the weekend cheers of husker fans, and lawnmowers out for one last run before being swapped out for snow blowers. But if you ask me, the most noticeable sounds this time of year are all of the coughs, sniffles and sneezes that predictably make their annual show of force during cold and flu season. For parents and pediatricians alike, these are familiar sounds that we learn to live with and treat as needed. This year, however, we are hearing a lot more than usual about another sound – a sound for which we should all be listening carefully: the sound of pertussis.

Perhaps you’ve heard of pertussis – also commonly referred to as whooping cough – from your pediatrician. Some of you may remember reading about it each time you received the standard set of vaccine information sheets describing each of your child’s scheduled immunizations, since the DTaP (the “P” part referring to pertussis) vaccine is routinely given.

Chances are that if you’ve been following the national news lately, however, you may have also heard that there’s a pertussis outbreak in California. In the world of infectious diseases, let me assure you that California isn’t very far away from Nebraska, and this outbreak is not just another news story about an isolated incident hundreds of miles away. The spread of pertussis in California is, in fact, proving to be the worst outbreak in 60 years, having already claimed the lives of 10 infants under the age of 3 months. If that’s not a reason to stop and take notice, I don’t know what is.

The fact of the matter is that pertussis is caused by one of the most contagious bacteria we know. The infection can start out seeming like a common cold, but over the course of a couple of weeks manifests itself as an escalating cough which then turns into coughing episodes sometimes severe enough to result in vomiting or the characteristic “whoop” sound that represents the dramatic effort to draw air back into the lungs.

While adults typically experience weeks (if not months) of a cough that just won’t go away, they don’t often “whoop” like kids do. Neither do babies under 6 months of age – a fact that increases their risk of life-threatening illness or death at a time when they can’t yet be vaccinated (under 2 months) or haven’t developed full immunity (under 6 months of age). Unable to draw air back into their lungs, babies may gasp, gag, or simply stop breathing altogether – making them the most vulnerable at a time when they are also the most at risk.

As someone committed to helping insure the health and well-being of all children, I’ve therefore pulled together some very important facts about whooping cough, who is at risk, and what each of us can do to prevent the spread of pertussis in hopes that we protect all of Nebraska’s children and adults against a sound you never want to hear at any time of the year….the sound of a young child with pertussis.

Make sure your child is up to date on his/her shots. DTap is recommended at 2, 4, 6 and 15-18 months, and again at 4-6 years. The best time to get your child protected against pertussis is the first day your child becomes eligible for each recommended immunization.

Get your adult tetanus booster. Immunity to whooping cough doesn’t last forever. Any adult (or teen) who doesn’t remember getting a pertussis booster shot, or hasn’t had one since they were immunized as a child needs to get vaccinated. The fact of the matter is that babies too young to be protected by the vaccine rely solely on all of us to not expose them. Sadly, an estimated 3 out of every 4 babies with life-threatening pertussis infection got it from a loved one. Prevent this from happening by rolling up your own sleeves, getting an adult booster shot, and doing your part to limit the spread of pertussis.

Be on the lookout for pertussis and contact your doctor or your child’s pediatrician with any concerns. It’s all too easy to mistake pertussis for the common cold at the outset of the infection, and while people are contagious for up to a month, antibiotics are of little benefit after the first week or so. Half of babies with whooping cough end up needing to be hospitalized.

Listen to the sound of pertussis. If my blog hasn’t already convinced you, or you simply want more information, watch my recent pertussis-focused CNN interview with Kiran Chetry on American Morning, go to www.soundsofpertussis.com and let Jeff Gordon of NASCAR fame convince you, or simply listen to what a baby with pertussis sounds like .

Now let’s all commit to doing everything we possibly can to silence the sounds of pertussis.

Originally posted on Omaha World Herald’s Live Well Nebraska