A study from Washington University School of Medicine in St. Louis showed that patients with sinusitis who were given Amoxicillin vs a placebo (sugar pill) were no better at day 3 or day 10.  In other words, antibiotics did not improve the situation. (JAMA)

Most sinus infections start as a viral infection.  Antibiotics do NOT kill viruses, they only kill bacteria.   About 10% of people may ultimately develop a bacterial sinus infection,  this occurs  7 to 10 days after the symptoms start. This  occurs as a secondary infection, that is  if the viral sinusitis does not clear up.

90% of people with a sinus infection will improve by day 7 to 10.  If they happened to be given an antibiotic, they will assume this is the reason they improved.  However, this is not the case. They would have become better anyway.

Treating the symptoms may be the best therapy during the first week.  Using a saline sinus rinse netipot, such as those made by SinuCleanse can help prevent and treat sinus infections by rinsing away mucous buildup. Consider  antihistamine medications (Claritin, Allegra, Zyrtec or the generic equivalent) or nasal steroids (Flonase, Nasonex, etc.) or even Sudafed to help control your symptoms.  Only if the pain persists or if a fever starts after 7-10 days should an antibiotic be taken.

To those patients who come into my office within 48 hours of an infection, I frequently will provide them with a prescription,  recommending they wait a week until taking it to their pharmacy.  This saves my patient a return trip back to my office.

First, eating a diet high  in fruits and vegetables will help optimize your immunity.  Consuming plant based foods which vary in color, such as red tomatoes, purple grapes or  orange carrots,  can  ensure a diverse intake of antioxidants.  A healthy diet  will give the body the tools necessary to fight off  bacteria and viruses.

Sleeping  at least 7 to 8 hours of each night is crucial  for a healthy immune system.   It is during the sleeping hours that the body repairs and heals itself from the damage done on a daily basis.  Poor sleep contributes  to poor health.

Keeping stress under control is also very important. When our body is mentally and physically stressed, cortisol, the primary stress hormone, is released in excess into the bloodstream.  Cortisol, a natural steroid,  suppresses the immune system  making one more susceptible to infection.

Studies show vitamin C  can reduce the duration of the common cold by up to 12% in adults and  21% in children.  Supplementing with 500 mg to 1000 mg of vitamin C  daily should be considered.

The Cochrane Collaboration, an independent research group,  has shown that  the mineral  zinc reduces risk of contracting a cold when taken within 24 hours of exposure.  Daily supplementation also appears to help prevent the need of  developing an  infection requiring antibiotic treatment.

Vitamin D supplementation also helps reduce the risk of developing influenza according to scientists.  The lack of sunshine, and ultimately blood levels of vitamin D,  likely accounts for the higher  incidence of upper respiratory infections during the winter months.  Ask your doctor to check your vitamin D levels before supplementing with doses higher than 2,000 IU per day.

Lastly, some people may also benefit from the influenza vaccine. Interestingly, the studies are not as overwhelmingly favorable as expected.   However, the best evidence reports that between 33 to 100 people need to be vaccinated  against the seasonal flu in order to prevent one extra infection with the virus. Even when vaccinated, one is never 100% protected from developing the flu.

As always, prevention is always the best medicine. Please talk with your healthcare provider before making and changes to your healthcare regimen.

In this randomized trial of 126 people, 62 received the vitamin D  + antibiotic while the remaining received the antibiotic + placebo.

Further analysis showed that individuals with the TT genotype of the Taq1 vitamin D receptor polymoprhism had the best response and their sputum cultures converted from positive to negative more rapidly when compared to the others in the study.  There were no reported side effects from the vitamin D.

While at this time, this type of genetic testing is not carried out due to cost, treatment of all tuberculosis (TB) patients with high dose vitamin D  would be prudent.   The overall safety profile and low cost of vitamin D would make this a reasonable approach.

Read more about the health benefits of Vitamin D.

Source:  Martineau AR et al. Lancet. 2011, January 15;377[9761]: 242-50

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Do you have a head cold, cough, body aches and it body aches all over- does this sound familiar?

Do you have a bad cough that is leading to vomiting?  if so, you may have whooping cough (read more about this here).

This is influenza season and virus season. Some become dehydrated and may need intravenous fluids.  Even though   you may have had your flu shot, you can still get flu-like illnesses. No one is 100% protected against infections.

I have seen many patients with stuffy noses, post nasal drip (you know you have this if your are clearing your throat all the time), sore throat, cough, body aches and a few with  vomiting and diarrhea.   A visit to your doctor may be of benefit.

Fortunately, only a few will  develop bacterial sinus infections, bacterial bronchitis or even pneumonia.  For some, this virus may prove fatal.

Generally, less than 10% of those with a viral infection will need antibiotics, most just need time and fluids.

Also, its real important to note that the only  throat infection that needs antibiotics is strept throat.  No matter how bad your throat hurts, antibiotics won’t help unless you test positive for strept. See your doctor  if you are not sure.

If my patient does not have a bacterial infection, I simply recommend acetaminophen (Tylenol) or ibuprofen (Motrin, Advil).

How can you prevent these from occurring in the first place? First, make sure your vitamin D levels are adequate. Most people need to take 2,000-4,000 IU of Vitamin D3 daily. Ask your doctor to check your vitamin D blood levels before taking in excess of 2,000 IU daily. To learn more about vitamin D and how it can strengthen you immune system, read Vitamin D Prescription on Kindle.

Also, consider zinc supplementation which has been shown to be beneficial according to recent studies.

Also, consider influenza vaccination, which may also decrease risk.   However, the studies are not as clear cut as one thinks.

Cochrane reviewers, an independent research group concluded this when asked whether vaccines were helpful in preventing the flu for healthy people. “Influenza vaccines have a modest effect in reducing influenza symptoms and working days lost. There is no evidence that they affect complications, such as pneumonia, or transmission.”(cochrane). Ask  your doctor if the flu shot is right for you.

FYI: The above  symptoms are generally caused by a virus called, adenovirus. In addition to the above symptoms, adenovirus can cause gastroenteritis, conjunctivitis (pink eye), rash and whole body aches.  Another type of virus that can cause infection and common cold symptoms are known as the corona virus (no relation to the beer).

* Always consult your physician if you have a medical problem, the above it not my medical advice..

From the CDC website: Adenoviruses are medium-sized (90-100 nm), nonenveloped icosohedral viruses containing double-stranded DNA. There are 49 immunologically distinct types (6 subgenera: A through F) that can cause human infections. Adenoviruses are unusually stable to chemical or physical agents and adverse pH conditions, allowing for prolonged survival outside of the body.

By Rob Stein
Washington Post Staff Writer
Tuesday, August 25, 2009

Swine flu could infect half the U.S. population this fall and winter, hospitalizing up to 1.8 million people and causing as many as 90,000 deaths — more than double the number that occur in an average flu season, according to an estimate from a presidential panel released Monday.

The virus could cause symptoms in 60 million to 120 million people, more than half of whom might seek medical attention, the President’s Council of Advisors on Science and Technology estimated in an 86-page report to the White House assessing the government’s response to the first influenza pandemic in 41 years.

Although most of the cases probably would be mild, up to 300,000 people could require intensive care, which could tie up all those beds in some parts of the country at the peak of the outbreak, the council said.

“This is going to be fairly serious,” said Harold E. Varmus of Memorial Sloan-Kettering Cancer Center in New York, co-chair of the 21-member council. “It’s going to stress every aspect of our health system.”

The estimates mark the first time experts have released specific calculations about the possible U.S. impact of the pandemic. The “plausible scenario” is based on previous pandemics and how the swine flu behaved in the United States this spring and during the Southern Hemisphere’s winter over the past few months, said Marc Lipsitch of the Harvard School of Public Health, who helped prepare the estimate...read more here…

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Learn how vitamin D can help prevent swine flu

Margaret Chan, the WHO’s director-general, moved the alert to the top of the agency’s six-stage pandemic scale today on evidence the virus is spreading in communities outside the Americas. The new H1N1 flu strain has taken root in Australia, Chile, the U.K. and Spain since its discovery in Mexico and the U.S. in April.

The pandemic declaration confirms the fourth time in the last century a new influenza strain has swept across the globe. It’s the third time since April 27 that Geneva-based WHO has raised the alert level over swine flu, which has turned up in more than 70 nations as far removed as Iceland, New Zealand and the Bahamas. The move doesn’t mean there will be more deaths or severe cases, Chan said.

“We are seeing a moderate pandemic,” Chan told reporters on a conference call before making the announcement. “We are satisfied that this virus is spreading to a number of countries and it is not stoppable.”

Drugmakers will be finishing their production of seasonal influenza vaccine for the Northern Hemisphere winter in coming weeks, Chan said.

“We would advise them, as soon as they finish their seasonal vaccine production, quickly prepare to make commercial- scale pandemic vaccine,” she said.

Response Plans

WHO urged countries not to implement pandemic response plans designed for a more severe threat after government leaders said last month that moving to phase 6 may spur some countries to restrict travel, ban public events and adopt other measures that aren’t needed for mild flu, worsening the deepest economic slump since the Great Depression.

“Some political leaders worry about some unwarranted overreaction and some are also concerned that, because of the mildness of the disease, people will say ‘so what’s the big deal about pandemic?’” she said. “The balance between overreaction or complacency is another issue that’s of great concern.”

U.S. health officials said they won’t be changing their response to the virus based on the new pandemic designation and have already been responding to the outbreak like they would for a pandemic. There have been more than 13,000 confirmed cases in the U.S., which have caused about 1,000 hospitalizations and 27 deaths, according to the U.S. Centers for Disease Control and Prevention in Atlanta.

‘Strong Message’

“For all intensive purposes, the U.S. government has been in phase 6 of the pandemic level for some time,” Thomas Frieden, director of the CDC, said in a conference call today with reporters. “This does send a strong message that the virus is here and likely to stay.”

In the U.S., the virus has been most severe in children, young adults and those with asthma or who are pregnant, Frieden said. The virus has spread the most widely in Massachusetts, New York and New Jersey. About 7 percent of New Yorkers likely had swine flu in May, according to a survey released yesterday by the New York City health department.

The United Nations health agency doesn’t advise border closures or restrictions on travel and trade, Chan said.

WHO is watching for any sign the disease is worsening as the germ circulates during the Southern Hemisphere’s flu season, creating opportunities for its genes to mutate or combine with those of other viruses, including the H5N1 bird flu strain that’s lethal in three of every five reported cases. The new virus has genes from other strains that have sickened humans, pigs and birds.

Biggest Concern

“The tendency to move into complacency is our biggest concern because we need to continue to monitor this virus, follow its track and not allow it to come back in the second wave to give us more trouble,” Chan said…read more here…

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WHO: Swine flu pandemic has begun, 1st in 41 years By MARIA CHENG and FRANK JORDANS – 6 hours ago GENEVA (AP) — Swine flu is now formally a pandemic, a declaration by U.N. health officials that will speed vaccine production and spur government spending to combat the first global flu epidemic in 41 years. Thursday’s announcement by the World Health Organization doesn’t mean the virus is any more lethal — only that its spread is considered unstoppable. Since it was first detected in late April in Mexico and the United States, swine flu has reached 74 countries, infecting nearly 29,000 people. Most who catch the bug have only mild symptoms and don’t need medical treatment. WHO chief Dr. Margaret Chan made the long-awaited declaration after the U.N. agency held an emergency meeting with flu experts and said she was moving to phase 6 — the agency’s highest alert level — which means a pandemic is under way. “The world is moving into the early days of its first influenza pandemic in the 21st century,” Chan said in Geneva. Dr. Thomas Frieden, the new head of the U.S. Centers for Disease Control and Prevention, said in Atlanta that he does not expect widespread public anxiety in the United States as a result of the declaration, noting it came nearly two months after the virus was identified. For many weeks, U.S. health officials have been treating it as a pandemic, increasing the availability of anti-viral flu medicines and pouring money into a possible vaccination program. And scientists have grown to understand that the virus is generally not much more severe than the seasonal flu….read more here…

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May 19 (Bloomberg) — Dozens of swine flu cases in Japan may prompt the World Health Organization to declare a pandemic, a former WHO adviser said, spurring demand for vaccines to fight the contagion.

Japan reported its first locally-transmitted case on May 16, and the number of people infected with the virus, formally known as A/H1N1, has jumped to 135 from 4 in less than two weeks. Evidence of human-to-human transmission in a region outside North America may prompt the WHO to raise its pandemic alert to the highest level, said Hitoshi Oshitani, the former head of the agency’s Western Pacific region.

“Japan is definitely having human-to-human transmission,” Oshitani said yesterday in a telephone interview. “The WHO will have to take the Japanese cases into consideration when deciding whether to raise the pandemic alert.”

Margaret Chan, the WHO’s director-general, and United Nations Secretary-General Ban Ki-Moon are scheduled to broker an accord with executives from drugmakers such as Sanofi-Aventis SA and GlaxoSmithKline Plc in Geneva today to ensure developing countries can gain access to pandemic vaccines.

The outbreak worldwide extended to 8,829 infections in 40 nations as health officials from more than 190 countries began a meeting yesterday of the World Health Assembly in Geneva to debate whether swine flu is spreading widely enough to upgrade the threat to level 6, and declare it the first pandemic since 1968…read rest of story…