Rhiza Labs FluTracker Forum

I'll preface this by stating that most governmental officials have referenced the fact that in severe situations, health care institutions could become overwhelmed, medications could run out, equipment such as ventilators etc be unavailable. So it is suggested that everyone get a quick crash course in Home Treatment.

I'll start this thread off with what many consider to be an excellent reference manual. It is "Good Home Treatment of Influenza" by Dr. Gratton Woodson MD. Dr. Woodson (often known by his Member Name as "The Doctor" on several discussion forums) is a Medical Practioner in Atlanta Georgia. I have had the pleasure of reading many of his comentaries over the years, and know him to be on the forefront of reputable information regarding influenza facts and treatment.

He has written many books on the subject of Influenza Pandemics - but he has TWO FREE BOOKS, one of which I referenced above. The other free book is titled "Consumer Medication Stockpiles for Pandemic Influenza".

These books are free, and I highly suggest everyone download them as a PDF to your hard drive and have them handy even if you don't feel the need to read them immediately.

Links to download the manuals are featured prominently at the following website - http://www.birdflumanual.com

2nd Item in Home Treatment actually relates to a preventive step (Pneumonia Vaccine) that is widely available, but much under-reported. This is also an excerpt from Dr. Woodson's website. I personally have researched and written rather extensively on this in the past, but the following article is rather comprehensive. Don't let the act that it was written in 2006 dissuade you - the facts are every bit as balid, if not more, for the current H1N1 outbreak...

http://www.birdflumanual.com/articles/P ... ildren.asp
Preventing Post-Influenza Pneumonia in Healthy Children and Adults During the Pandemic
By Grattan Woodson, MD, FACP
November 22, 2006

Recently I have heard from several people that they or their children were denied access to vaccination with Pneumovax® used to prevent infectious diseases due to Streptococcus pneumoniae including post-influenza Pneumococcal pneumonia. I was very surprised to hear about this for several reasons. It has been our internal medicine practice’s policy to encourage health adults well as the elderly and younger adults with chronic medical conditions to take advantage of this vaccine benefits for several years. I also recommended this vaccine be given to healthy children and adults in The Bird Flu Preparedness Planner1 and The Bird Flu Manual2 because this vaccine’s proven ability to prevent infections caused by Streptococcus pneumoniae, a very bad bug that can be particularly ruthless following influenza. This organism is a common cause of pneumonia, bronchitis, sinusitis, meningitis, pharyngitis, and otitis media occurring spontaneously and most particularly as a complication acute influenza.

The “old man’s friend”
Pneumococcal pneumonia has a long and infamous association with mankind. The disease is probably responsible for more human deaths through history than even influenza. The doctor’s of old dubbed this scourge “the old man’s friend” because of the quick and certain way in which it delivered the coupe de grace to the elderly and infirm.

The advent of the antibiotic era
Alexander Fleming’s discovery of the effect a mould had on the growth of staphylococcus in 1928 led eventually to the development of penicillin for clinical use in the early 1940s. The widespread availability of penicillin later that decade changed medical history. While S. pneumoniae was exquisitely sensitive to penicillin for almost 50 years, toward the end of the 20th century, this began to change.

Today this bacterium is becoming increasing resistant to penicillin and several alternative antibiotics including erythromycin. It is thought that the practice of adding penicillin to cattle feed and its inappropriate use in humans combined to cause this unfortunate development.

The US FDA Indications for Pneumovax
After being informed of the difficulty people were having obtaining this vaccination from other doctors, I reviewed the US FDA indications for Pneumovax.

The US FDA approved indications for Pneumovax taken from its Product Circular include:3

Immunocompetent persons:
* Routine vaccination for persons 50 years of age or older
*Persons aged ≥ 2 years with chronic cardiovascular disease (including congestive heart failure and cardiomyopathies), chronic pulmonary disease (including chronic obstructive pulmonary disease and emphysema), or diabetes mellitus
*Persons aged ≥ 2 years with alcoholism, chronic liver disease (including cirrhosis) or cerebrospinal fluid leaks
*Persons aged ≥ 2 years with functional or anatomic asplenia (including sickle cell disease and splenectomy)
*Persons aged ≥ 2 years living in special environments or social settings (including Alaskan Natives and certain American Indian populations)
NOTE: Current guidance has been changed to include"
*Any adult 19 through 64 years of age who:
- is a smoker
- has asthma

Immunocompromised persons:
*Persons aged ≥ 2 years, including those with HIV infection, leukemia, lymphoma, Hodgkin’s disease, multiple myeloma, generalized malignancy, chronic renal failure or nephrotic syndrome; those receiving immunosuppressive chemotherapy (including corticosteroids); and those who have received an organ or bone marrow transplant.

While it is true healthy adults under age 50 and healthy children are not included on the list, this in no way precludes their being given this vaccine for prevention of pneumococcal pneumonia and the other infections this organism causes.

The drug approval process
Pharmaceutical companies must prove their vaccine is safe and effective for specific indications before the US FDA will approve it for use. They do this by conducting a randomized controlled research studies in specific groups of persons who are likely to benefit most from the vaccine. The groups selected for inclusion in these studies must have a pretty high rate of infection with the disease the vaccine is designed to protect against in order to see a statistically significant reduction in those receiving the active vaccine compared with those given placebo vaccine. If the vaccine proves safe and effective in these trials, the FDA allows the vaccine to come on the market but limits the company from marketing it for use in anyone other than the subjects studied.

When Merck conducted its Pneumovax® studies, S. pneumoniae was still universally sensitive penicillin so healthy adults under age 50 were not included in the registration studies for Pneumovax. This is one of the reasons why this group did not get an indication for the vaccine.

Physician have wide prescribing discretion
Pharmaceutical regulations permit licensed medical practitioners to administer an approved drug of vaccine for any indication they chose as long as they judge the benefits of doing so outweigh the risks to the patient. In fact, this happens all the time. Studies of prescribing patterns by US physicians show that 44% of prescriptions written today are for indications not on the approved list.

What then are my reasons for thinking that the benefits of vaccinating healthy adults and children with Pneumovax® outweigh the risks? First is the growing antibiotic resistance of S. pneumoniae to out first antibiotics used to fight it. While the incidence of infections caused by this bacterium is not particularly high year over year in these groups, it is not inconsequential. Since the benefits of Pneumovax® are long lasting, this provides patients with near lifetime of protection against this disease.

Common side effects from vaccination are soreness, warmth, redness, and mild swelling at the injection site lasting for a few days. Very rarely more severe adverse reactions have been reported but the risk that an individual patient receiving this injection will develop one of this is exceeding low.

The coming influenza pandemic is predicted to be severe. The CDC predicts that post-influenza bacterial pneumonias will complicate the clinical course of 11% of those who contract pandemic flu. This amounts to about 10 million cases of pneumonia with many of these cases caused by S. pneumoniae. The US Department of Health and Human Services’ Pandemic Influenza Plan states that during the pandemic, access to commonly used antibiotics for treatment of post-influenza pneumonia could be in short supply or unavailable.4 For this reason, the recommend Pneumovax® be given to healthy adults and children as part of a key prevention strategy. Below is an excerpt from the US DHHS PIP regarding this practice:

“Efforts to maximize vaccination coverage against Streptococcus pneumoniae is an important component of post-influenza bacterial community-acquired pneumonia prevention during the Interpandemic, Pandemic Alert, and Pandemic Periods. Current guidelines on the use of the 23-valent pneumococcal polysaccharide vaccine among adults and the 7-valent pneumococcal conjugate vaccine among children are available.” 5,6

In summary, while Pneumovax® is not specifically indicated in its US FDA approved Product Circular for healthy adults and children; its use in these groups makes sense for several reasons. First is the ability to prevent S. pneumoniae associated respiratory infections including post-influenza pneumonia. Second is because this formidable foe of mankind is acquiring resistance to antibiotics commonly available to manage it. This practice is supported by the US DHHS’ PIP who recommends it be given to healthy adults and children interested in preventing post-pandemic influenza pneumonia, a complication that will be fatal in many during the next pandemic.

My personal summary is as follows: Death by a complication of certain common pneumonias is completely avoidable by securing this vaccine. I've researched this vaccine and it contains no thimerasol, has been around along time, and there really are no reports of side effects that I can find. I am NOT normally a vaccine cheerleader, but my family has received this one. I believe it is one of the simplest prevention steps that can be taken. It won't stop the flu, but it will prevent the secondary pneumonia issue from developing - and if you are stuck in a home treatment situation, you do NOT want to be dealing with the additional onset of pneumonia.

Here's a link to the CDC data sheet on this vaccine. Please feel free to do your own research on this vaccine as well regarding any safety issues you may have.
http://www.cdc.gov/vaccines/pubs/vis/do ... is-ppv.pdf

3rd Item in Home Treatment relates to spread prevention based on facemask and respirator usage. If someone is sick, then placing a facemask on them will inhibit spread by "catching the virus" as it is exhaled / coughed. Higher protection level N95 Respirators are suggested to be worn by those treating the infected person.

A comprehensive discussion on facemasks and respirators can be found at the following website.....

http://flu.gov/individualfamily/prevent ... index.html

http://flu.gov/individualfamily/prevention/facemasks/index.html

Note: Facemasks & Respirators may become in short supply more rapidly than most items at some point during a pandemic. They can be purchased online, and in some local stores.

i think that another thing to think about is basic survival skills. i know that this topic can be a bit scary and depressing, but being a survivalist CAN help you. store basic needs (food, water, medical supplies, ways to defend yourself). above all else, you MUST have a plan. decide where you would go (stay home, go to a friends house, go to a shelter), how you would survive, and how you could continue normal life.

now unless this turns out as a species killer, the worst possible thing is that we would loose society for a few years. to survive that, you have to have a few things:

Food
canned food
home grown food
ways to cook
ways to get food

Shelter
Home (home repairs)
heat
AC
comfort (those who live in comfort do not last long without it)

Medical Supplies
prescription pills
common meds (pain, sleep, antibiotics)
cleaning supplies (bleach, hydrogen peroxide)
bandages

Protection
guns
knives
ways to make weapons IF NECESSARY!

Transportation
ration gas
animals (horses)
friends/family

this is just a basic idea of what you have to do to survive in the event of a social meltdown. i do see a healthcare overload soon (especially if this healthcare bill pases)

_________________
USAF recruit. Current ship date, 8/3/10. Assigned duty, imagery interpretation.

I am a semi-computer specialist and do IT for my church and friends. Also work with birds of prey at a rehab center for raptors.

Absolutely agree!

I'd respectively like to add that the key thing to remember is that the Second Wave in 1918 got significantly less lethal over the first 30 days after it first strikes your area. The trick is to isolate yourself from other humans etc. during those 30 days.

1918 REVISITED: LESSONS AND SUGGESTIONS FOR FURTHER INQUIRY
John M. Barry
Distinguished Visiting Scholar
Center for Bioenvironmental Research at Tulane and Xavier Universities

...Even if isolation only slowed the virus, it had some value. One of the more interesting epidemiologic findings in 1918 was that the later in the second wave someone got sick, the less likely he or she was to die, and the more mild the illness was likely to be.

This was true in terms of how late in the second wave the virus struck a given area, and, more curiously, it was also true within an area. That is, cities struck later tended to suffer less, and individuals in a given city struck later also tended to suffer less. Thus west coast American cities, hit later, had lower death rates than east coast cities, and Australia, which was not hit by the second wave until 1919, had the lowest death rate of any developed country.

Again, more curiously, someone who got sick 4 days into an outbreak in one place was more likely to develop a viral pneumonia that progressed to ARDS than someone who got sick 4 weeks into the outbreak in the same place. They were also more likely to develop a secondary bacterial pneumonia, and to die from it.

The best data on this comes from the U.S. Army. Of the Army’s 20 largest cantonments, in the first five affected, roughly 20 percent of all soldiers with influenza developed pneumonia. Of those, 37.3 percent died (Soper, 1918; undated draft report).

In the last five camps affected—on average 3 weeks later—only 7.1 percent of influenza victims developed pneumonia. Only 17.8 percent of the soldiers who developed pneumonia died (Soper, 1918).

Inside each camp the same trend held true. Soldiers struck down early died at much higher rates than soldiers in the same camp struck down late.

Similarly, the first cities struck—Boston, Baltimore, Pittsburgh, Philadelphia, Louisville, New York, New Orleans, and smaller cities hit at the same time—all suffered grievously. But in those same places, the people struck by influenza later in the epidemic were not becoming as ill, and were not dying at the same rate, as those struck in the first 2 to 3 weeks.

Cities struck later in the epidemic also usually had lower mortality rates. One of the most careful epidemiologic studies of the epidemic was conducted in Connecticut. The investigator noted that “one factor that appeared to affect the mortality rate was proximity in time to the original outbreak at New London, the point at which the disease was first introduced into Connecticut…. The virus was most virulent or most readily communicable when it first reached the state, and thereafter became generally attenuated” (Thompson and Thompson, 1934a: 215).

The same pattern held true throughout the country and the world. It was not a rigid predictor. The virus was never completely consistent. But places hit later tended to suffer less.

One obvious hypothesis that might explain this phenomenon is that medical care improved as health care workers learned how to cope with the disease. But this hypothesis collapses upon examination. In a given city, as the epidemic proceeded, medical care disintegrated. Doctors and nurses were overworked and sick themselves, and victims—possibly even a majority of victims—received no care at all late in an epidemic.

Even in Army camps, where one could expect communication between physicians from one camp to the next, there seemed to be no improvements in medical care that could account for the different mortality rates. A distinguished investigator specifically looked for evidence of improved care or better preventive measures in Army camps and found none.

A second obvious explanatory hypothesis, that the most vulnerable people were struck first, also fails. For that hypothesis to be true, Americans on the east coast had to have been more vulnerable than those on the west coast, and Americans and western Europeans had to have been more vulnerable than Australians.

But another hypothesis, although entirely speculative, may be worth exploring. If one steps back and looks at the entire United States, it seems that people across the country infected with the virus in September and early to mid-October suffered the most severe attacks. Those infected later, in whatever part of the country they were, suffered less.

At the peak of the pandemic, then, the virus seemed to still be mutating rapidly, virtually with each passage through humans, and it was mutating toward a less lethal form.

We do know that after a mild spring wave, after a certain number of passages through humans, a lethal virus evolved. Possibly after additional passages it became less virulent. This makes sense particularly if the virus was immature when it erupted in September, if it entered the human population only a few months before the lethal wave....

http://www.nap.edu/openbook.php?record_id=11150&page=63

_________________
If your leaders tell you the Kingdom is in the heavens, the birds will get there before you.
If they say it's beneath the ground, the fish will get there before you.
It is within you and outside you..P.Oxy 654

I think that this is a very appropriate "Timeframe Commentary". Sometimes, we can appear to seem overly panicky about the consequences by implying that if you don't prepare for the absolute and utter chaos of societal destruction - then you are doomed to die. Knowledge of "Survivalist Skills" is perhaps a doomsday scenario that frieks many people out, and has the opposite oeffect of not taking things seriously.

"Disaster Planning" on the other hand is normally for brief periods of time. When talking about a Pandemic ONLY scenario - Rick is absolutely correct that the probabilities favor the need to "Shelter In Place" for shorter periods of time. Sheltering in Place (or SIP) is designed primarily just to stay away from other potentially infected persons until the virus passes from the local area. And it is important that people understand that outbreaks come in Local / Regional waves. They do pass. So at a minimum one should consider 1 - 2 months of food & medicines for that period. Getting back to the exact topic of this thread - "Home Treatment Issues", medicines that you NORMALLY take + medicines and disinfectants and safety gear (masks etc) to take care of anyone that gets sick anyway should be considered strongly. In a medium to severe pandemic, it is very likely that hospitals will be over run, run out of critical care supplies, doctors and nurses may even be the 1st to die due to the fact that Influenza doesn't respect the fact that they are "Doing a Noble Job". Also, if one family member gets sick - caretakers might be exposed simply by taking the patient TO a highly infected area such as a hospital.

Best to know how to "Do It Yourself". My own local Pandemic Preparedness Committee is fond of saying "You might be on your own". Government officials have made the statements as well. Simple inexpensive, non panicky preparation could save your life, your spouses, childs, or relatives.