Avian Influenza A (H7N9) - April 9, 2013

Dear folks,

Well, I was not expecting to write to you so soon. As mentioned in my last post, I thought we were at the apex of the flu season and, as it turned out, that was the case as the incidence of influenza in the North American season began to diminish soon afterwards. I had hoped to send a note out now, not on the flu, but on Lyme disease, but some news has changed my plans.

As you may know, just as our season winds down, our next year’s flu is beginning to gather steam in the East and in the Southern Hemisphere. Specifically, China is starting to have flu issues. And as has occurred before, there is a new strain of avian flu that has infected humans there, named Avian Influenza A (H7N9). The local bad news is that, to date, 24 or so people have been laboratory confirmed infected with this flu, and 7 or so have died. This makes catching the flu a highly lethal proposition. (Of course it is very possible that others had this same flu and have not been laboratory confirmed and recovered, shifting these numbers, which is a conversation for another time.) More than likely you will be hearing a great deal about this if it grows or if the news media picks up the story. What they may not make clear is what this all means. Allow me to mention a few points I have made over the past years, so that you have a scaffolding on which to place that information; I apologize for repeating myself, but it may be useful.

Current Influenza Epidemic-February 20, 2013

Greetings,

Well, after a long, odd, complex season, the influenza season is finally letting up. Yes, people will still become sick over the next couple of months, but overall, the intense epidemic nature of these illnesses is passing. This is great news to me, since February is typically still a very busy flu season, and in some ways the busiest month for influenza in North America.  We are finally getting less telephone calls and less worried patients.

What is still occurring, in the same frequency is the common cold. As I write this brief note, I can say that I am sneezing myself. After so many people shaking hands, or sneezing in my face, I got this as well. In terms of the most common symptoms associated with the cold, at this time, if the patient does not need their constitutional remedy, consider Sulphur, Pulsatilla, Gelsemium, Nux vomica, Allium cepa, and Euphrasia. Temperature differences and emotional states are the most useful ways to differentiate among the remedies on that short list.

And lastly, the vertigo epidemic seems to be leaving us now. Thank goodness.

Good luck. Hang in there. Just 1-2 more months before most of these epidemics are gone for good. Then we can think about seasonal allergies!

Sincerely,

Paul Herscu, ND MPH

Current Influenza Epidemic - January 2013

Dear folks,

Well…what a winter this has been so far. As you are aware, the number of people ill with some version of viral/bacterial infection is high, much higher than usual. After reading the different reports from around the country and abroad from colleagues, as well as from medical authorities, I thought I would share some details from my experiences over these past months, in the hopes of capturing that information. I hope you’ll find it useful.

Over the past few months, Amy and I have taken care of numerous patients who were acutely ill. The first thing that seemed striking is that, there have been several different viruses, and shifting sets of symptoms, in a way culminating with the current influenza epidemic. However, regarding this current epidemic, I have noted some observations. Many people who become ill are ill for a short period of time, days or a week, and then recover partially, only to ‘become’ ill once more, in a sort of ebb and flow manner for weeks or even months. This is extremely atypical for the flu virus, which has a typical duration of one week or so. Most of these people were not properly characterized with a lab test to confirm an influenza diagnosis. Many of the people who are ill at this time, while indeed suffering from some virus or bacterial infection, are not actually suffering from the flu.

Hurricane Sandy: the 1st week - Paul Herscu ND, MPH

Well…it is hard to know how to start. For those of you who have lived through this experience, our hearts and thoughts are with you. Given that, I wanted to send a quick note that most likely reiterates what you have been hearing from public health and government and public works officials. The topic of disaster response is a well thought-out one, with a great deal of research behind it. When I studied disaster response as part of my MPH program, my teacher was Linda Landesman. She is a thought leader on the subject and wrote a very important book entitled Public Health Management of Disasters, a useful resource for people wanting to understand how to prepare for this sort of situation. The book is published by the APHA.

The way I think of the topic is very similar to how I think of disease in general. Is it acute or chronic or an acute flare-up of a chronic situation? Which means that when the event first occurs, the needs are different than they are a few weeks or 6 months later.  So for where we are now, here it goes.

Updated Thoughts on The Vertigo Epidemic I Observed

This is a short update to my previous message on the increased incidence of vertigo I observed some months ago and which I properly labeled an epidemic. First, let me say that it is still occurring, as there are new people complaining of vertigo, though it does seem to be slowing down through the later month of October. And second, after looking in many possible online sites, and calling several public health authorities, there does not seem to be an awareness of this increased incidence, and it is that which I want to discuss.

Since we sent out the first notice, we have gotten over 200 emails with stories of people having experienced or experiencing new attacks of vertigo. And if I may, I would like to both thank and respond to many of those emails.

A Vertigo Epidemic - October 2012

I wanted to send a short update. Over the past 3 months I have had an unusual number of patients with the chief complaint of acute vertigo. What was most puzzling was that these episodes lasted not for seconds, but for days, weeks or months, not just the fleeting experiences many people have. At first, I thought it was only a fluke. However, over time, the number in my practice grew to be truly unusual. I searched in a variety of places to see if there were any reported causes to account for this increase in incidence but have not found one.

After these few months, I sent a query to a broad number of people, asking if anyone had experienced this vertigo. It was my intention to assess the incidence of vertigo from that sampling of readers. To do that, I asked you not to describe patients but yourselves. I found an incidence of 48 people who personally experienced vertigo out of every 1,000 people who viewed/opened the email. In other words, the reported incidence of vertigo reached nearly 5%, which is a much higher incidence than typically expected. This number could well have been higher if we consider that some individuals who had vertigo and who viewed the notice opted not to reply. This large population inquiry was proof for me that we are in sort of epidemic related to acute vertigo, though it is odd that no one is speaking of it. Any number over 1% is an unusually high number, and should be noted.