Editor’s Note: Pediatric Infectious Disease Specialist and AAHPO Board Member Tsoline Kojaoghlanian, MD agrees with the article below, which asserts that Paxlovid is helpful and should be more widely prescribed and taken.

With COVID-19 cases again on the upswing, the antiviral Paxlovid has been slow to gain traction among patients and doctors even though the medication reduces hospitalizations and deaths.

A recent National Institutes of Health study of about 1 million people found that only 15% at risk for severe disease took a five-day course of the prescription medicine. Of the patients who took Paxlovid, the medication reduced the risk of death by 73% and hospitalizations dropped 26%, showing the medicine is highly effective for people at risk of severe complications.

COVID-19 deaths, hospitalizations and visits to the emergency room increased at double-digit rates in the last week of December, the Centers for Disease Control and Prevention reported. But deaths and hospital stays remain far below earlier peaks.

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Aspirin has long been considered a lifesaving option to lower the risk of heart attack or stroke. In fact, aspirin has been used for centuries for medical purposes, beginning more than 2,500 years ago when Egyptian physicians used willow bark as a pain reliever. Aspirin is also one of the most studied therapies in cardiovascular disease over the last half century.

However, taking a daily aspirin isn’t an option for everyone. Is it right for you? It depends on a variety of factors including age, general health, history of heart health, and more. which you should discuss with your health care provider.

Fortunately, we have AAHPO members and cardiologists Shant Manoushagian, MD and George Petrossian, MD to help us sort it out.

“Generally speaking, the widespread use of aspirin for primary prevention of cardiovascular disease has fallen out of favor due to bleeding risk, especially in those over age 60,” noted Dr. Manoushagian. “Guidelines now call for individualized, shared decision-making between health care provider and patient after weighing risk/benefit and cardiovascular (CV) risk vs. bleeding risk.”

“If able to be tolerated, aspirin should be used in patients who have had a prior heart attack, stroke, have documented CV disease, a prior stent of a heart artery or peripheral vascular disease,” said Dr. Petrossian. “In these patients, aspirin reduces the risk of heart attack and stroke.”

Both of these specialists emphasized that the decision to use aspirin should be made in discussion with your health care provider.

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Editor’s Note: AAHPO Board Member Tsoline Kojaoghlanian, MD, a pediatric infectious disease specialist, agrees with the article below, and also recommends the flu vaccine for those age 6 months and older, and recommends the RSV vaccine for the elderly (scroll down to see additional article).

Though many people remain on the fence about getting the latest COVID vaccine booster, new research suggests a strong argument for getting the shot this winter: It sharply reduces the risk for COVID.

Researchers found that getting vaccinated led to a 69% reduction in long-COVID risk among adults who received three vaccines before being infected. The risk reduction was 37% for those who received two doses. Experts say the research provides a strong argument for getting the vaccine, noting that about 10% of people infected with COVID go on to have long COVID, which can be debilitating for one quarter of those with long-lasting symptoms.

The data come from a systematic literature review and meta-analysis published in October in Antimicrobial Stewardship & Epidemiology. Researchers examined 32 studies published between December 2019 and June 2023, involving 775,931 adults. Twenty-four studies, encompassing 620,221 individuals, were included in the meta-analysis.

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There are many reasons to get an influenza (flu) vaccine each year.

Below is a summary of the benefits of flu vaccination and selected scientific studies that support these benefits.

Flu vaccination can keep you from getting sick with flu.

• Flu vaccine prevents millions of illnesses and flu-related doctor’s visits each year. For example, during 2019-2020, the last flu season prior to the COVID-19 pandemic, flu vaccination prevented an estimated 36 million influenza illnesses, 16 million influenza-associated medical visits, 390,000 influenza-associated hospitalizations, and 25,000 influenza-associated deaths.
• During seasons when flu vaccine viruses are similar to circulating flu viruses, flu vaccine has been shown to reduce the risk of having to go to the doctor with flu by 40% to 60%.

LEARN MORE FROM THE CDC

Respiratory syncytial virus (RSV) is a common respiratory virus that usually causes mild, cold-like symptoms. However, it can be dangerous for older adults.

RSV vaccines help protect adults 60 years and older from severe RSV illness. Older adults are at greater risk than young adults for serious complications from RSV because immune systems weaken with age. In addition, certain underlying medical conditions may increase the risk of getting very sick from RSV. Older adults with these conditions may especially benefit from getting RSV vaccine. If you are 60 years and older, talk to your healthcare provider to see if RSV vaccination is right for you.

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Travelers’ diarrhea (TD) is the most predictable travel-related illness. Attack rates range from 30%–70% of travelers during a 2-week period, depending on the destination and season of travel. Traditionally, TD was thought to be prevented by following simple dietary recommendations (e.g., “boil it, cook it, peel it, or forget it”), but studies have found that people who follow these rules can still become ill. Poor hygiene practices in local restaurants and underlying hygiene and sanitation infrastructure deficiencies are likely the largest contributors to the risk for TD.

TD is a clinical syndrome that can result from a variety of intestinal pathogens. Bacteria are the predominant enteropathogens and are thought to account for ≥80%–90% of cases. Intestinal viruses account for at least 5%–15% of illnesses, although the use of multiplex molecular diagnostic assays demonstrates that their contribution to the overall burden of TD disease is probably greater than previously estimated. Infections with protozoal pathogens are slower to manifest symptoms and collectively account for ≈10% of diagnoses in longer-term travelers (see Sec. 11, Ch. 7, Persistent Diarrhea in Returned Travelers).

What is commonly known as “food poisoning” involves the ingestion of infectious agents that release toxins (e.g., Clostridium perfringens) or consumption of preformed toxins (e.g., Staphylococcal food poisoning). In toxin-mediated illness, both vomiting and diarrhea can be present; symptoms usually resolve spontaneously within 12–24 hours.

LEARN MORE FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION

“RSV (Respiratory Syncytial Virus) is a severe viral illness that occurs in our communities each fall and winter. RSV is NOT a new virus, despite what some may think. RSV remains the number one cause of hospitalization in infants under 1 year of age and some of these infants suffer from the consequences of this virus for years. What is NEW is the development and FDA approval of a new ‘vaccine’ that can give our youngest clientele some passive immunity to get through their first RSV season. Beyfortus is a NEW one time “vaccine” for infants birth to 8 months of age that will give them the protection they need! This can be a total game-changer for our littlest of patients. It is heartbreaking to see our infants wheezing and struggling to breathe and then telling the parents they need to go to the hospital. To be able to prevent serious illness by giving a few months of immunity in one shot is incredible! Science and the progress we continue to make in disease prevention justifies all the hard work we do as medical professionals,” noted AAHPO Board Member and pediatrician Lynn Cetin, MD.

“Parents are already asking me about this important protection for infants,” noted AAHPO Vice President and pediatrician Garbis Baydar, MD.

The American Academy of Pediatrics (AAP) is recommending all infants under 8 months receive the new monoclonal antibody nirsevimab to protect them from respiratory syncytial virus (RSV), while also providing guidance for continued use of palivizumab (an injection used to prevent RSV) in the 2023-’24 season.

“Pediatricians are sadly familiar with the dangers of RSV and its devastating consequences for some families,” AAP President Sandy L. Chung, M.D., FAAP, said in a press release. “We are eager to offer all infants this protection and urge federal officials to see that it is made available and affordable in all communities.”

RSV causes about 58,000 to 80,000 hospitalizations and 100 to 300 deaths per year in children under 5 years, according to data from the Centers for Disease Control and Prevention (CDC).

Nirsevimab (Beyfortus) is a long-acting monoclonal antibody given as an intramuscular injection that is intended to protect children against lower respiratory tract disease caused by RSV. It was approved by the Food and Drug Administration in mid-July and the CDC in early August. It is expected to be available this fall, although some children may not have immediate access.

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Recently, the U.S. Food and Drug Administration (FDA) approved Zurzuvae (zuranolone), the first oral medication indicated to treat postpartum depression (PPD) in adults. Until now, treatment for PPD was only available as an IV injection given by a health care provider in certain health care facilities.
PPD

What is PPD?
PPD is a major depressive episode that typically occurs after childbirth but can also begin during the later stages of pregnancy.

Most new moms experience postpartum “baby blues” after childbirth, which commonly include mood swings, crying spells, anxiety and difficulty sleeping. Baby blues usually begin within the first 2 to 3 days after delivery and may last for up to two weeks.

But some new moms experience a more severe, long-lasting form of depression known as postpartum depression. Sometimes it’s called peripartum depression because it can start during pregnancy and continue after childbirth. Rarely, an extreme mood disorder called postpartum psychosis also may develop after childbirth.

PPD is not a character flaw or a weakness. Sometimes it’s simply a complication of giving birth. If you have postpartum depression, prompt treatment can help you manage your symptoms and help you bond with your baby.

Learn more from the Mayo Clinic

An Indiana family had been touring Lake Freeman, located about 80 miles north of Indianapolis, over the Fourth of July weekend. On the final day of their trip, the mother, Ashley Summers (photo at left), started complaining of a headache and other signs of dehydration, like feeling lightheaded. She reportedly drank four 500ml bottles of water in 20 minutes because she couldn’t seem to get enough to quench her thirst.

After that, Ashley went back home with her husband and two young daughters before passing out in the garage. She had severe brain swelling when she was taken to the hospital, but she tragically never recovered consciousness.

Doctors determined that Ashley had water toxicity, also known as hyponatremia, which is brought on by low blood salt levels. It can happen when a large amount of water is consumed quickly, diluting the sodium levels in the body. This exceeds the capacity of the body’s intricate organ systems, particularly the kidneys, to control the fluid balance.

Muscle cramps, soreness, nausea, vomiting, headaches, and general malaise are among the symptoms. In severe cases, the brain may swell, which may cause coma, death, seizures, confusion, and a loss of consciousness. People who frequently work outside or exercise have a higher risk of developing the fatal illness.

Learn more from the Mayo Clinic

Our news feeds are filled with stories of social media trends gone wrong, as impressionable children engage in risky behaviors in search of attention but all too often find broken bones or serious illness instead.

Parents are left wondering what makes dangerous social media challenges so attractive to teens and preteens, and maybe incorrectly assuming their child wouldn’t be foolish enough to make the same mistake.

“Personal connection is so important, especially to teens. Social media challenges can be a powerful way for some to feel connected and receive attention,” said Dr. Gautam Bhasin, a psychologist at Holy Name Medical Center, Teaneck, NJ. “When kids engage in these behaviors, they just do what others are doing, seemingly becoming part of something bigger than themselves and gaining a feeling of acceptance.”

Among the current challenges most popular with kids and young adults are stunts involving overeating, jumping or falling from heights, and abusing over the counter medications. Each can cause injury or even put your child’s life at risk.

Read How 3 Challenges Endanger Kids

When minutes matters, knowing where to go can make all the difference.

Emergency care plays a vital role within the healthcare system, often serving as the primary gateway to essential or even lifesaving treatment. Despite this, hospital emergency rooms are often overlooked until after an urgent situation arises.

While primary care physicians or urgent care facilities may be better suited to treating minor conditions, a trip to the ER is a better choice for a range of all-too-common emergencies, including bone breaks, significant burns or cuts, serious infections or allergic reactions, prolonged fevers or gastrointestinal issues, and symptoms of a potentially life-threatening illness such as signs of respiratory, cardiovascular, or neurological distress.

In emergency care, minutes can make the difference between life and death. Quickly choosing an emergency department during a crisis can be difficult, and a decision is better made beforehand based upon factors including a hospital’s designation as a specialized emergent care facility.

When to go to the Emergency Room or call 911:

1. Chest pain or pressure
2. Difficulty breathing or shortness of breath
3. Uncontrolled bleeding
4. Severe injuries or pain
5. Loss of consciousness or fainting
6. Confusion or sudden severe headache
7. Seizures or convulsions
8. Compound fractures or broken bones
9. Deep cuts or open wounds
10. High fever with vomiting and/or diarrhea
11. Severe allergic reactions
12. Signs of stroke or heart attack
13. Poisoning or an overdose from drugs or alcohol
14. Prolonged dizziness or weakness
15. Sudden inability to speak, see, hear, walk, or move

Learn about Emergencies and Children