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

There is hot, and then there is HOT! Extreme heat is a period of high heat and humidity with temperatures above 90 degrees for at least two to three days. In extreme heat your body works extra hard to maintain a normal temperature, which can lead to death.

Extreme heat is responsible for the highest number of annual deaths among all weather-related hazards.

• Older adults, children and sick or overweight individuals are at greater risk from extreme heat.
• Humidity increases the feeling of heat.
• Learn the signs of heatstroke:

Signs of Heatstroke

• Extremely high body temperature (above 103 degrees F) taken orally
• Red, hot and dry skin with no sweat
• Rapid, strong pulse
• Dizziness, confusion or unconsciousness

If you suspect heat stroke, call 9-1-1 or get the person to a hospital immediately. Cool down with whatever methods are available until medical help arrives. Do not give the person anything to drink.

• Never leave people or pets in a closed car on a warm day.
• If air conditioning is not available in your home go to a cooling center. Do not rely on a fan to keep you cool in extreme heat.
• Take cool showers or baths.
• Wear loose, lightweight, light-colored clothing.
• Use your oven less to help reduce the temperature in your home.
• If you’re outside, find shade. Wear a hat wide enough to protect your face.
• Drink plenty of fluids to stay hydrated.
• Avoid high-energy activities or work outdoors, during midday heat, if possible.
• Check on family members, older adults and neighbors.
• Watch for heat cramps, heat exhaustion and heat stroke.
• Consider pet safety. If they are outside, make sure they have plenty of cool water and access to comfortable shade.
• Asphalt and dark pavement can be very hot to your pet’s feet.

For more tips, see infographic at right or CLICK HERE

Hearing loss is a common condition that affects millions of people worldwide. In the United States, one in eight people over age 12, and more than 65 percent of individuals over 60 years old, experience hearing loss, according to the National Institutes of Health.

The impact of hearing loss is not limited to difficulty hearing; it is also linked to other health issues such as cognition, dementia, social isolation, and depression.

Here are five important facts you may not know about hearing loss:

• Individuals with hearing loss are at higher risk of dementia
• Hearing loss can lead to depression and social isolation
• Hearing loss is not a normal part of aging and should be treated
• Treating hearing loss can improve cognition
• There are many steps you can take to prevent hearing loss

Learn More

Already we are experiencing soaring summer temperatures. Extreme heat can pose a significant health risk– especially for the elderly, young children and those with chronic medical conditions. Notably, anyone participating in strenuous activities in high temperatures is at a significant risk for heat-related illnesses.

Follow these tips to stay safe in the summer heat:

• Stay hydrated. Drink plenty of water throughout the day – don’t wait until you feel thirsty. Avoid coffee, alcohol or sugary drinks before going in the sun.
• Protect against sunburn. Sunburn affects your body’s ability to cool itself, so protect yourself with broad-spectrum sunscreen, even if you’re only in the sun periodically.
• Pay attention to warnings on medications. Check the provided information on any medicines you may be taking for warnings about heat-related problems. Many common medications can affect the body’s ability to stay hydrated or dissipate heat.
• Take it easy during the hottest parts of the day. Only exercise or perform physical labor during cooler parts of the day, such as early morning or late evening. In the middle of the day, take regular breaks in air-conditioned spaces.
• Wear loose-fitting, lightweight clothing. Wearing excess clothing or clothing that fits tightly won’t allow your body to cool properly. Dark clothing also traps heat (When wearing less clothing, don’t forget the sunscreen!).

When spending time in the sun, always monitor for signs of heat exhaustion, including headache, dizziness, nausea, and heat rash. Anyone experiencing these symptoms should immediately try cooling measures such as drinking cold water, taking a cool shower or applying wet towels to exposed skin. If symptoms do not improve, seek medical attention.

Experts advise checking air quality alerts regularly. AirNow.gov enables people to track air quality by entering their ZIP codes.

AirNow generated the chart shown at left, showing exact air quality conditions in a location in Pennsylvania.

Many smartphones have apps that also track air quality.

Experts recommend that people stay indoors as much as they can, with doors and windows closed. That includes avoiding activities like outdoors exercise, which can cause stress on the lungs.

People with dry eyes or irritated eyes may find relief with use of artificial tears.

If one must go outside, wear a KN 95 or N 95 mask to block harmful particulates in the air.

“The small particulate matters of 10 micrometers or less are most dangerous since they can enter the lung and even translocate into circulation if smaller than 2.5 micrometers,” noted Philippe Chahinian, MD, a doctor of internal medicine and an oncologist. “Exposure to such particles affects the lung (causing irritation, asthma, cough, bronchitis) and heart (causing irregular heartbeat, even heart attacks).”

People with respiratory-related health conditions, including asthma, should monitor their symptoms closely, and make sure their medications, like inhalers, are available or not expired.

People with asthma should use their rescue inhaler 15 minutes before they go outside.

Anyone experiencing shortness of breath or respiratory difficulties should contact their healthcare provider or seek emergency care.

Learn more from the Centers for Disease Control and Prevention