News Important for Patients

2018 Flu Season New Symptoms and Experts Solutions

Now the flu season in the United States may be reaching a peak and so far it looks like a more severe season than others in recent memory.
John yang gets an update on why and what you need to know this flu season started earlier than in the past and
The Centers for Disease Control says it’s the most widespread outbreak it has ever seen.
Officials say doctor’s visits are climbing and pediatric deaths from the floor up as well at least 20 so far, the CDC says the flu leads to the deaths of thousands of Americans each year to bring us the latest on the current flu season.
A family medicine physician at Georgetown University and the health and medial fellow at the NewsHour asked:
dr. why is this season so bad?
This season is bad because this year we’re seeing more people with influenza A now, in the past we’ve seen a season
with influenza A means that we have more cases of the flu we have more hospitalizations and ultimately more deaths because of the flu,
and so that’s a concern this year as influenza A is a predominant flu strand and what makes it influenza A so problematic right it changes so quickly so even though we have the vaccine that’s made several months before the flu season.
actually begins here in the US the virus itself changes that it’s not an exact match to the actual vaccine so that is a point of
concern but it’s important to know that even though that may be the case if you get a flu vaccine you are less likely to have hospitalizations and then this the flu itself.
if you do get it after getting the vaccine your your symptoms are less severe and how effective is this vaccine this year all right it’s around 32 percent that’s what experts think for this year which is a little less than it has been in previous years
but again it’s better to get it than not get it better to be covered than not and could this season get even worse it.
could the question is though where are we in the flu season so like you were saying before we know that the flu season started a little bit earlier than it usually does but the question is are we at the peak of the season or is this a trend that is going upward so those questions we still don’t know the answers to until the flu season is over okay a little practical advice for people now when should someone go to the doctor a lot of people try to tough it out.
I see them in the aisles of the drugstores when should they decide to go to the doctor whenever you feel sick you should
either either think about going to the doctor or just call if you have any questions the symptoms of the flu are fevers chills night sweats cough feeling really horrible and those are also symptoms of a cold.

so it’s really hard to decipher which one is which and that’s our job to help you and be able to treat if we think that it is the flu is it too late for people to get a flu shot nope not not too late at all you can go to your clinic or you can go to the local pharmacy and still get a flu vaccine now.
and the people who should get it of course it’s people who are the age of six months and above but then also those who are pregnant those who may have some long term chronic diseases like heart disease we also know for influenza A those who are older and younger or the ones who are at more risk of having complications from it.
so those are the people that were saying you definitely need to get your flu vaccine two things I hear a lot of people say I never get the flu or if I get a shot I’m afraid I’m gonna get the flu what do you say to those folks well for the first one that
you people who say that they’ve never gotten the flu I hear so many patients say that they wish they would have gotten the vaccine once they get the flu so I would say you know even with your thoughts of not getting the flu it’s good to have some protection than no protection and with the flu being something that we’re giving you in the flu vaccine
that’s not necessarily true in the vaccine itself it’s using an inactivated flu virus meaning that it’s not a living virus and what that does is it helps your system be aware of the flu and what it looks like so that when you do come in contact with an active virus your body knows what to do and those fighter cells can go ahead and fight that flu.
we’ve heard a lot of talk about a shore of the antivirals like Tamiflu,
what is there what’s that about?
right so there are some places where it’s hard to get those antivirals and usually those
places are the places that have a lot of flu cases but overall in the United States there is not a shortage it’s just depending on where you’re trying to get the medication so if you’re in one of those places where you know that there are a lot of people who have the flu just calling your pharmacy and seeing if they have the medication would be helpful and again that medication is good to have when you’re in the first two days of the virus
because it helps shorten the duration of having the flu and also decreases the severity of the symptom.

10 Years Increase in Pulmonary Arterial Hypertension Life Expectancy

After the breaking news in the Pulmonary hypertension treatment options, scientists expect up to 10 Years more in Pulmonary Arterial Hypertension Life Expectancy and accurate prognosis.
More than two thousand patients was studied to gather the acknowledge of average patient’s life expectancy.
Studies found that:

  1. overall one year survival was 85%,
  2. three year survival was 68%,
  3. five year survival was 57%
  4. and seven year survival was 49%.

How Long Can I Expect to Live with Pulmonary Arterial Hypertension?

PH is a terminal disease for which there is currently no accurate cure and shares many symptoms with other diseases, it is often misdiagnosed.
Since discovered in 1891, has no treatment until discovery of Flolan in 1994, optimistic research results show that Flolan increased the life expectancy from 3 to 5 years and more researches discover up to 10 medications to treat PAH and patients will continue to experience longer survival and better quality of their lives.
diff. between normal and PAH lungs and  arteries
According to the news site “kaplan herald“: Improved Pulmonary Arterial Hypertension Mortality Risk Scores Show Positive Impact of Ralinepag at the ISHLT 38th Annual Meeting & Scientific Sessions

indicated a ralinepag phase three program in patients with PAH is currently being planned to evaluate the impact on clinical outcomes and exercise capacity.

Another news website “brinkwire” wrote in Genetic study could lead to new treatments for sufferers of pulmonary arterial hypertension

A UK and Europe-wide consortium of researchers carried out whole-genome sequencing of 1,038 patients in the largest genetic study to date into this condition. They identified three novel genes and provided independent validation of another gene as a key risk factor in the disorder. Their study has been published in Nature Communications.
The identification of new genes relating to the condition highlights previously unexplored cell pathways in the disease’s progression and opens up new avenues for potential drug discovery and development.
Dr Laura Southgate, Lecturer in Genetics at St George’s University of London and a senior co-author of the research, said: “We knew that PAH has a strong genetic component but isolated cases were much harder to characterise genetically. This research takes us several steps closer to improved diagnosis and treatment as well as providing a comprehensive dataset for future researchers.”

A Blood test to Expect Low Risk of pulmonary Arterial Hypertension:
Brain natriuretic peptide (BNP) test is a type of blood tests that measures levels of BPN, BPN is a protein that is made by your heart and blood vessels. if the blood test results show higher BNP levels than normal you have heart failure.
Systolic blood pressure when comes high will increase the prognostic level of PAH
Echocardiogram: absence of pericardial effusion considered low risk of PAH.
However, Congenital heart disease is the lower risk type of PAH diseases, while other like familial, connective tissue, or liver related are on higher risk to be developed into PAH.
Hope you are alright and be optimistic.

Coronavirus case of Indiana Middle East respiratory disease explained

At the beginning of the month of April 2014 were the most newspapers in America talking about the arrival of the mysterious virus Middle East.
But, are you supposed to Americans fear the deadly syndrome the Middle East?
The Middle East respiratory syndrome coronavirus (MERS-CoV), also termed EMC/2012 (HCoV-EMC/2012), is positive-sense, single-stranded RNA novel species of the genus Betacoronavirus.

Respiratory disease definition
is simply a disease affecting the human respiratory system and this of course includes lung illness by viral diseases.
There is no vaccine or treatment yet and any medical care is supportive and to help relieve symptoms. But CDC is discussing with partners the possibility of developing a vaccine.
What does that means?
What is the size of the risks that can be caused by a virus Corona respiratory disease?
The official WHO MERS count is 238, with 92 deaths. As of 27 April 2014, there are 339 confirmed cases in Saudi Arabia, with 102 deaths. The first case of MERS-Cov in the United States was reported in Indiana on 2 May 2014.
There is very limited information on transmission, severity and clinical impact with only a small number of cases reported thus far.
Symptoms of Middle East respiratory disease: Most people who got infected with MERS-CoV developed severe acute respiratory illness with symptoms of fever, cough, and shortness of breath. 30% of them died. Some people were reported as having a mild respiratory illness.
Does respiratory diseases Coronavirus and SARS are the same?MERS-CoV is not the same coronavirus that caused severe acute respiratory syndrome (SARS) in 2003. However, like the SARS virus, MERS-CoV is most similar to coronaviruses found in bats. CDC is still learning about MERS.
The virus MERS-CoV is a new member of the beta group of coronavirus, Betacoronavirus, lineage C. MERS-CoV genomes are phylogenetically classified into twoclades, clade A and B. The earliest cases of MERS were of clade A clusters (EMC/2012 and Jordan-N3/2012), and new cases are genetically distinct (clade B).
MERS-CoV is distinct from SARS and distinct from the common-cold coronavirus and known endemic human betacoronaviruses HCoV-OC43 and HCoV-HKU1. Until 23 May 2013, MERS-CoV had frequently been referred to as a SARS-like virus, or simply the novel coronavirus, and early it was referred to colloquially on messageboards as the “Saudi SARS”.
It is not certain whether the infections are the result of a single zoonotic event with subsequent human-to-human transmission, or if the multiple geographic sites of infection represent multiple zoonotic events from a common unknown source.
In humans, the virus has a strong tropism for nonciliated bronchial epithelial cells, and it has been shown to effectively evade the innate immune responses and antagonize interferon (IFN) production in these cells. This tropism is unique in that most respiratory viruses target ciliated cells
How to diagnose Coronavirus respiratory disease?How can you know that you are MERS Coronavirus infected?
What are the Laboratory tests to differentiate Coronavirus from other respiratory diseases?
What test should I do to investigate MERS coronavirus?
There are a limited number of commercial tests available, but these are not FDA-approved.
MERS-CoV is clinically diagnosed by taking nasopharyngeal swab examination and PCR for Coronavirus “MERS CoV PCR”.
List of Specimens suitable for MERS-CoV testing based on current evidence by WHO:Specimens that do not need transport medium and should transport to laboratory in 4 degree C and shipped in cold ice if shipping was for more than 48 hours.
Serum for serological testing: paired samples are preferable with the initial sample collected in the first week of illness and the second collected two to three weeks later. A single serum sample should be collected at least 14 days after onset of symptoms.
Sputum, Bronchoalveolar lavage, tracheal aspirate, and nasopharyngeal aspirate.
Specimens require virus transport medium or sterile saline if specimen is also for bacterial culture. Combined nasopharyngeal/oropharyngeal swabs, tissue from biopsy or autopsy including lung

Interpretation of MERS-CoV test results and sensitivity:What does Positive MERS Cov Pcr test means?

How to confirm MERS coronavirus infection?
Routine confirmation of cases of MERS respiratory disease infection is based on detection of unique sequences of viral RNA by real-time reverse-transcription polymerase chain reaction (rRT-PCR) with confirmation by nucleic acid sequencing when necessary. See below for a discussion of serological testing for MERS-CoV.
Suspected MERS virus must follow these steps by PCR test:
1- upE specific “rRT-PCR” .
2- If Positive, do “ORF 1a rRT-PCR” assay.
3- If Positive then the case is confirmed.
*rRT-PCR” means “real-time reverse-transcription polymerase chain reaction”.
From WHO advices for May, 2014, for the potential infected people even if an initial test on a nasopharyngeal swab is negative. Repeat testing should be done when the initial testing is negative, preferably on specimens from the lower respiratory tract.
Investigation into the source of exposure should promptly be initiated to identify the mode of exposure, so that further transmission of the virus can be prevented.

Three rRT-PCR assays for routine detection of MERS-CoV have been developed and their details published. Currently described tests are an assay targeting upstream of the E protein gene (upE), and assays targeting the open reading frame 1b (ORF 1b) and the open reading frame 1a (ORF 1a). The assay for the upE target is considered highly sensitive and is recommended for screening, with the ORF 1a assay considered of equal sensitivity. The ORF 1b assay is considered less sensitive than the ORF 1a assay. References 4 and 5 contain detailed descriptions for performing these assays.
In addition, the US Centers for Disease Control and Prevention (US CDC) has developed rRT-PCR assays targeting the MERS-CoV nucleocapsid (N) protein gene, which can complement upE and ORF 1a assays for screening and confirmation.
What should healthcare providers and health departments do?What should I do if I feel I am infected with Middle East respiratory disease?
The Last Update from WHO advice for respiratory disease infected people upon May, 2014:
1- Health-care facilities that provide for patients suspected or confirmed to be infected with MERS-CoV infection should take appropriate measures to decrease the risk of transmission of the virus from an infected patient to other patients.
2- It is not always possible to identify patients with MERS-CoV early because some have mild or unusual symptoms. For this reason, it is important that health-care workers apply standard precautions consistently with all patients – regardless of their diagnosis – in all work practices all the time.
3- All patients with symptoms of acute respiratory infection must have contact precautions and eye protection should be added when caring for probable or confirmed cases of MERS-CoV infection. Airborne precautions should be applied when performing aerosol generating procedures.
4- Recent travelers returning from the Middle East who develop SARI should be tested for MERS-CoV as advised in the current surveillance recommendations.
5- All Member States are reminded to promptly assess and notify WHO of any new cases.
6- People at high risk of severe disease due to MERS-CoV should avoid close contact with animals when visiting farms or barn areas where the virus is known to be potentially circulating. For the general public, when visiting a farm or a barn, general hygiene measures, such as regular hand washing before and after touching animals, avoiding contact with sick animals, and following food hygiene practices, should be adhered to.
7- Periodic Checkup is must.
Conclusion: Respiratory diseases such as chronic bronchitis, pneumonia, and lung illnesses caused by viral infection and many of them have the same symptoms