Calling Dr. Bones..........Again.

[Deans BMW]

Since you are our resident expert of all things medical............Dallara just might fool us though :028: .

What are your thoughts on the upcomming possible pandemic of Bird Flu????

[Dallara]

Bird Flu?

Or Bird Flew? :037:

Cheers!

Allan (Dallara - NACD)

[Deans BMW]

Giant brain fart, not uncommon in my case.

[BobFV1]

Dr. Bob says -

Avoid fucking chickens without a condom for the next five years, and also resist the pernicious temptation to add a raw egg to your foreplay routine if there is any chance that the raw yolk will come into contact with any of your mucous membranes.

Seriously -

I moderated a forum for the aviation industry at which the CDC participated as panelists. Bottom line - monitor it, but it really does not look like there is anything now that would call for action beyond reviewing emergency plans. There could be a big or small outbreak, with serious or not-so-serious effects for humans any time between the next five minutes and the next five years.

Be prudent, don't lose any sleep over it. Unless you sleep with a chicken....

:117:

[geechie]

Dean,

While we will get a more complete answer from Bones, I'll say this.

With the levee situation in New Orleans it was clearly a case of when, not if.

I don't think it's that clear cut with the HP (Highly Pathogenic) strain of the H5N1 virus.

In any case, I don't think there's a lot we can do right now. I plan to keep eating chicken and feeding wild birds. And paying attention.

George

[Dallara]

Ya' know...

All this flu talk got me to thinkin'... (which is often quite dangerous)

We've had the Swine Flu...

Now along comes the Bird Flu...

What's next, the Cow Flu? Tuna Flu? Shellfish Flu? Cabrito Flu? And heaven forbid... Maybe even the Snail Flu...

Seriously Folks... Has anyone here ever known or been related to someone who has died from any kind of Flu?

I dunno'... I've been hearing about these different "potentially deadly" flus all my life, and yet I've never actually known ANYBODY that has died from them, or actually even had one of them. I'm sure I will get royally flamed for saying this, but...

Personally I think all the friggin' hype the media pumps out about all these various "new" flus every year or so is strictly part of the media's penchant for manufacturing a "potential disaster" so they can keep people watching the tube, reading their pulp, and listening to their over-the-airwaves blather.

I think Bob is onto something here... If you don't actually sleep with a chicken, duck, goose, etc. then I don't think you should spend even more than one femto-second worrying about getting the *dreaded* Bird Flu.

But of course... YMMV... and Chicken Little might finally be right... the sky is falling, with bazillions and bazillions of Bird Flu laden air molecules!

Cheers!

Allan (Dallara - NACD)

[NoRRmad]

I never knew anybody who died of lung cancer either. So fuck it, got a cigarette?

[Dallara]

Hey... I'm a smoker! I got 'em... Need a light?

Cheers!

Allan (Dallara - NACD)

[arkline]

So far the only people who have died from "bird flu" were folks who were in close contact with birds, mostly chickens and geese. Farmers and farmer's families. While this flu does seem to jump from one species to another, it is not yet (and I stress, yet) communicated from humans to humans. So, until it mutates into something that is communicable between humans, we're okay, more or less.

If it turns out that it mutates so that it is passed from human to human, we'll see exactly how virulent it is and what the mortality figures will be. Frankly, the best advice you'll get is to wash your hands frequently. Isn't that what your mom was on you about all the time anyway? There is some question about how effective flu shots are for the general populace, so even if they do come up with a vaccination, it is likely that the really young and the elderly would be at most risk, as is usually the case. And health care providers...

Frankly, this is just another thing to raise the "I'm scared" level in people. Americans don't seem to be able to calculate risk very well on a day to day basis. That's why I have to stand 25 feet from any building while smoking, but others can stand up to the bar, get pretty liquidated, and go out and have their head on crash that kills both drivers, a small child in the back seat and sets fire to the median that was crossed...

[DJ Down Under]

The Australian government seem to be taking this very seriously and have stock piled hundreds of ventilators (life support) in preparation.

Boxerboy knows more about what's going on...we've had a few mysterious illnesses at work (ICU) and I sometimes think...ooooh..maybe it's the bird flu.

DJ

[Boxerboy]

No bird 'flu here just yet.:)
Yep, the Ozzie Gov. has purchased 200 ventilators and all the associated single use plumbing to use them for up to 2 years I believe. The resources have been spread around the country. We scored 2 vents.
At OZ$50K + each, you'd love to be the sales rep. for that one!
http://www.health.gov.au/internet/wcms/Publishing.nsf/Content/phd-pandemic-plan.htm

Cow 'flu! Interesting concept. Of course, mad cow's disease, "Bovine Spongiform Encephalopathy (BSE)", did put the frightener's on a few years back, but good surveillance and rapid government responses kept that under control.

Here in Oz, I remember reading that at least 2000 people each year die from pneumonia/influenza. They present with a chest infection or "pneumonia", develop respiratory failure and go onto life support, then die! The offending pathogen is often 'flu. It's a reportable disease once confirmed in the lab.

Young people just feel sick for a week but the elderly, the chronically sick, smokers...all sitting ducks for a deadly dose of the 'flu!

Ever been to the Canary Islands?:104:

[arkline]

I'm pretty sceptical about much that is medical, simply because I'm married to a registered nurse whose practice has ranged from the psychiatric to the surgical to the coronary to same day care. If you really want to have a scare, find out how many patients die each year from infections that are contracted in hospitals. Why is that scary? Because there has been a rapid evolution (no Intelligent Design here) of noxious thingies in hospitals because the great attempt to wipe them out, but not succeeding. Drug resistant strains are just that - resistant to drugs that worked last year or last month or last week. And it doesn't look like our armamentarium is expanding at the same rate that those little buggers become resistant. And that doesn't even include viruses which are a whole different sort of beast or not beast. Bizarre stuff.

[Bones]

I go away for a few hours and look what happens!

First, let me ask: you guys ride motorcycles and you are worried about Bird Flu?


Currently there have been a little over 100 people that have died from it. But these have all been transmission from bird to person, not person to person. The current version of the virus does not transmit from human to human. So as Bob said, stay away from poultry farming and you are OK.

The concern is multifold:
1. The virus itself has a high mortality rate. This is to say that a relatively high % of those infected, die.
2. It is likely only a matter of time until mutations allow this to transmit from human to human. THEN it will be a real issue of major magnitude.
3. These types of viruses are pretty contagious.

A few things people forget about "The Regular" flu:
1. Most of the time when folks say they have the flu, they don't. They have some other virus.
2. The actual influenza virus can and usually does cause major illness. The effects can linger for weeks even if you only have a mild case.
3. Did you know that influenza is still one of the top few killers worldwide, each year? Yes, that is still true.

I used to poo poo the idea of flu shots. Then, about 12 years ago I got the real flu. I had not missed a day of work at that point in about 10 years. I was so sick I literally thought I was going to die. When it was clear that I wasn't, I wanted to. It took me almost 6 weeks to really get back to normal. So I started getting the flu shot. Fine. Until last year. I got the flu shot. I was fine all winter until I flew back home from 3 days at Freddie Spencer school. On the plane in front of me was a woman who was hacking up a lung the entire flight. 48 hours later, I was so sick I again wanted to vanish. Now days, there is actually a test that can diagnose the actual influenza. I had it despite having the flu shot a few months earlier. I started Tamiflu immediately and was onlyon the verge of death sick for 5 days.

The real flu is truly nasty. If you ever have it, you will understand why so many people die from it.

Meanwhile, at the moment, the statistical risk of contracting bird flu for folks in the US who do not raise poultry is very, very, very small. The concern for the future is real given mutation rates in these types of viruses.

Jeff

[BobFV1]

On the plane in front of me was a woman who was hacking up a lung the entire flight.

Organic breast reduction.

:117:

A GS guy who caught the flu? Seriously Sawbones, I could never understand how you Docs and Nurses and other people who work in a health care setting aren't sick all the time, especially with snotty little kids dribbling and spitting all over you all day. Yuk.

[Bones]

Bob,
The interesting thing is that I really don't think I was sick (beyond a head cold type of thing) for over a decade in Medicine, despite periods as a surgical resident working over 90 hours a week and eating hospital cafeteria food. THEN, I had kids. That is when getting everything viral known to man started happening at our house. Apparently, preschool is the most effective way to breed viruses, specifically to be taken home to parents, along with playdough figurines, finger painting and arts and crafts made from elements of nature.

We had our daughter when I was 41, so I am still enjoying her demonstration of how effectively microbes can move from one home to another. Next year she is in real school, so I am hoping that all settles down.

Dealing with patients seems to be less risky, but with them, at least I can don a mask if they sound like they have a cold. My kids don't like when I do that at home. Go figure.

Jeff

[DarthRider]

Jeff -

Do you think the alcohol gels for hand rubs are worth it while in an office environment where there are usually people working sick? We have lots of doors and other things being touched all the time, plus many of our workers, especially warehouse workers don't wash their hands ever as far as I know, and certainly not after using the can. One day one of them even managed to shit on the wall! Maybe it was a dose of that explosive, projectile diarrhea I had a while back...

We have to share the same restroom and it's pretty nasty. I've gotten pretty good at opening & closing doors with my elbows or paper towels when I have to, but I also use the gel.

Just wondering if this is just snake oil?
Thanks,

Dave

[BobFV1]

Darth said "hand rubs". He he, he he.

[Bones]

Darth,
If you mean the alcohol foam that is now popular in doctors offices and surgical scrub areas, yes. I am not as sure about the stuff that is more liquid that you buy at Kmart and carry around in your pocket. They are different.

As it turns out, I actually end up washing my hands about 50-60 times per day when I am seeing patients on a non surgical day. It has gone from the sublime to the ridiculous, because I end up washing before touching them, then after touching them. And if I use gloves, I have to wash after that, too. The chapping is rough in the winter. I switched over to the alcohol foam last year because it ends up being less irritating in some ways and has an emollient.

I had my doubts about the stuff, but our Medical Center went to having surgeons use the stuff as surgical scrub before operating on people. No more standing at the scrub sink slathered to the elbows in Betadine for 5 minutes then rinsing. Now, after doing one thorough wash the morning of surgery, when the surgeon is ready to "scrub" (now called "foaming" rather than scrubbing), we go to the foam area, activate a foot pedal and a giant ball of foam is dispensed. It is gently rubbed from finger tips to elbows and left to dry over about a minute of two. On go the gown and gloves and up to the operating table.

Plenty of studies have been done on the stuff. It decreases bacteria count well enough to be able to do the above.

But I read the package insert and it specifically says:
"This product is to be used by trained medical professionals. While effective in treating skin prior to human contact, it is useless if someone has shit on the walls." So it might not work in your environment.

In case it makes you feel any better, I recently walked into the bathroom at McDonalds to take a leak (that is a medical term) and in front of the commode there was the largest crap laying on the floor I have ever seen in my life. It was literally the size of someone's forearm. I have no idea what it was doing there, but I didn't stick around long enough to find out. I also left my lunch on the table and jettisoned my son to the car immediately. Just had to share that with you, because I am sure it was like that "what the hell?" moment you must have had seeing feces on the wall.

Jeff

[arkline]

Ah, the wonders one encounters, 'eh? I don't know if it is still part of the public health historical canon, but the real change in general health began when clean water and closed sewers began to show up in the 17th and 18th century European cities. Mortality began to drop and people started being healthier when they basically quit living in a common sty. And Lister with that hand-washing thing? Too cool!

Now, if we could convince folks that hocking that luggie like they do in the majors isn't cool we'd be making some progress again.

But I digress. Frequent hand washing with warm water and just about any soap will do more to prevent contracting nasty colds and such than most other things, including those liquid things that are being touted now. Just like mom said.

[socalrob]

So,

If there is a deadly flu outbreak, seems like the best chance is to avoid infection. Along those lines, would it be prudent to stockpile surgical gloves & face masks to wear at the grocery store or when out in public, so as not to infect your house? If so, any recomendations on kind of masks?

[DJ Down Under]

What mask...here ya go...you might as well have some fun at the same time..:icon_mrgreen:

DJ

http://i10.ebayimg.com/02/i/04/ag/8b/fe_1_b.JPG

[Bones]

The gloves and masks worn going to the grocery store are not exactly practical, though I have seen folks where them around, actually.

The flu is contracted by inhaling microscopic bits of moisture droplets that carry the virus. Being in the same room with someone with the flu, especially if they cough will do it, because the exhaled vapor of their breath can carry enough for you to inhale. But it is magnified many many times by touching, having it get on your hands and then you touch yourself anywhere near mucous membranes. That is why handwashing works so well. It drops the viral count down to much lower.

As Arkline said, plain old soap and water is about as good as anything, unless you wash your hands upwards of 50 times a day....then your skin gets so raw it is ridiculous.

Jeff

[arkline]

I've often wondered how effective a mask might be. I think that some Japanese folks are accustomed to wearing masks in public. But I don't think I've ever seen any data to suggest that it makes any difference. I like DJ's mask. People would full out laughing, reducing your chance of contact!

[NoRRmad]

http://images.auctionworks.com/hi/46/45919/0842.jpg
Medieval Plague Mask